2129 Seminole Rd RESO21-0076 Siding, DeckOWNER:ADDRESS:CITY:STATE:ZIP:
COCKREL SAM WESLEY 2129 SEMINOLE RD ATLANTIC BEACH FL 32233-5921
COMPANY:ADDRESS:CITY:STATE:ZIP:
HOME SERVICES BY
MCCUE OF NORTH
FLORIDA
981 11TH AVE S Jacksonville S JACKSONVILLE
BEACH FL 32250
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169722 0200 NORTH ATLANTIC BCH
UNIT 3
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2129 SEMINOLE RD
RESIDENTIAL OTHER SINGLE OR
TWO FAMILY RESIDENTIAL
OTHER
REPAIR 2nd FLOOR DECK
AND T1-11 TRIM BOARDS $34280.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $225.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $112.50
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 9/16/2021
PERMIT NUMBER
RESO21-0076
ISSUED: 9/16/2021
EXPIRES: 3/15/2022
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
STATE DBPR SURCHARGE 455-0000-208-0700 0 $5.06
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.38
TOTAL: $345.94
2 of 2Issued Date: 9/16/2021
PERMIT NUMBER
RESO21-0076
ISSUED: 9/16/2021
EXPIRES: 3/15/2022
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $345.94
RESO21-0076 Address: 2129 SEMINOLE RD APN: 169722 0200 $345.94
BUILDING $225.00
BUILDING PERMIT 455-0000-322-1000 0 $225.00
BUILDING PLAN REVIEW $112.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $112.50
STATE SURCHARGES $8.44
STATE DBPR SURCHARGE 455-0000-208-0700 0 $5.06
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.38
TOTAL FEES PAID BY RECEIPT: R17167 $345.94
Printed: Thursday, September 16, 2021 11:30 AM
Date Paid: Thursday, September 16, 2021
Paid By: HOME SERVICES BY MCCUE OF NORTH FLORIDA
Pay Method: CREDIT CARD 512971844
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R17167
Final Plumbing
Final Electrical
Final HVAC
CC Final
Final Building*
Swimming Pool Steel
Swimming Pool Safety
Electrical Grounding & Bonding
Swimming Pool Final (Bldg)
Swimming Pool Final (PW)
Formed Columns/ Beams*
Masonry Cell Fill
Structural Steel*
OTHER:
OTHER:
OTHER:
OTHER:
OTHER:
Power Pole
Silt Fence
Piers/ Stem Walls
Underground Plumbing
Underground Electric
Foundation/ Footing
Slab**
Retaining Wall Footing
Driveway
Sewer (Building Dept)
Sewer Tap (Utilities Dept)
Rough Electric*
Rough Plumbing/ Top Out*
Rough Mechanical*
House Wrap
Wall Sheathing
Roof Sheathing
Tie-down Framing Connections
Rough Framing
Roofing In Progress
Window/Door In-Progress
Insulation Ceiling
Insulation Wall
Exterior Lath
Stucco Scratch Coat
Exterior Siding In-Progress
Brick Flashing & Ties
Early Power
Gas Rough
Gas Final*
* When all rough electric, plumbing, mechanical are complete but before any work is
covered up.
* When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance. All outlets must be capped and pipe pressurized at a
minimum of 15 lbs.
* For new living space: When all construction work including electrical, plumbing,
mechanical, exterior finish, grading, required paving and landscaping is complete
and the building is ready for occupancy, but before being occupied
Additional inspections may apply to your project if your project
contains these elements:
INSPECTIONS REQUIRED FOR BUILDING PERMITS
To verify compliance with building codes, inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
_____________________________________________________
Permit Type
____________________________________________________
Permit No.
__________________________________________________________
Job Address
____________________________________________________
Contractor
POST THIS CARD WITH PERMITS AND PERMIT
DOCUMENTATION IN FRONT OF BUILDING
Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends
Building Department Public Works/Utilities Fire Department
Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789
Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203
* When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all
electrical, plumbing and mechanical work is in place, but before concrete is poured.
* When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
L i;a9'' IS REQUIRED.
P^h oo}ne:
7((
9 041)
n24
7-582'
l6(
Email: Building-Dept@coab.us
Job Address: LI 2-ti .1€{! I 1 Y IO l t., pail
MOM( t
Permit Number:
I /
Legal Description 15-3 l -25•-1 F 0 Ni Ml(fM( B(T 1I,UI L,1ilt rte ../RE# j oc'i12 2 ` 0200
l ry 1 S3jj A p_tcp o/!Z ;03`'5 -.1`1 SC(/
Valuation of work(Replacement Cost)$ `T, 7, ;S 0•Z- Heated/Cooled SF 14 Non-Heated
tibihr1)C
Class of Work: New Addition Alteration Repair Move ElDemo Pool DWindow r
AUG•
Use of existing/proposed structure(s): Commercial `Residential UG 2 6 202
If an existing structure,is a fire sprinkler system installed?: Yes No
BY:
Will tree(s) be removed in association with proposed proiect? Yes(must submit separate Tree Removal Peermi
Describe in detail the type of work to be performed: 1 jkn.ea S -'f/ '
rtN LtLlncl ren wood on xatolg eie,cL >.da4:Ir,
ci,.(,,i.i , fr,A Tlo Q,cks
Florida Product Approval# for multiple products use product approval form
Property Owner Information (
d
Name )y{( . ..\( ). ) \t It\I Address i1 emlot ?-c( GG
City • )()l" 1 i Dam State FL. Zip ?, /Z 3 3 Phone lS 1 110,
E-Mail v j CO( , e t@ ma f (b4'Yl
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
t ' 1
Name of Company U . A A Qualifying Agent t l i clAitt p,I.,e,-.
4.
1-th.e, _
Address 1,1(I I ( 1 A V O kl 0 1 City State Zi .Z - OOfficePhoneC' D-- 1 7 1 Job Site Contactsi Nuber (i)I 2- 5 (. .-
State Certification/Registration# 12(;1 I 1 Q2)(4 2-4 E-Mail YY\1 i( 1 C 00110 V al
2.-
Ly (4(,4 ( OM
Architect Name&Phone#
Engineer's Name&Phone#
p nNr
Workers Compensation
Insurerrr_`t(,lit, MI011 1I1S C.0 ' OR Exempt u Expiration Date 01 / 0 i / Z.0 2-2-
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS,FURNACES,BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies, or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD : + •TICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEME : n Y• I R 'ROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LE c : ' c R A A 0 EY BEFORE
RECORDIN)G YOUR NOTICE O COMMENCEMENT. 4
1
e.yz. -,..._",,
Signature of Owner or Agent)Mir •nature of Contractor)
Signed d worn to(or affirmed)before me this day of Sided and
sworrn(
r
affirm
efor• m-this `.a o
Vt' JSignatureofNotary)N ata )l- lir MIIIPP"
Personally Known ORIrsonally Known OR
Produced Identification Produced Identification
Type of Identification:Type of Identification ..
CIN J.MCI REOPY.Gv4;..
z, ,a‘ • Commission#GG 279801
r 4.:os Expires February 14,2023
4'!,`,' BondedT6ro Troyain Insurance t00-135-70T9
RESO21-0076
CALIFORNIA JURAT
A notary public or other officer completing this certificate verifies only the identity of the individual who signed
the document, to which this certificate is attached, and not the truthfulness, accuracy,or validity of that
document.
STATE OF CALIFORNIA
COUNTY OF //l.g..Y/(/t-
Subscribed and sworn to (or affirmed) before me on this / ? day of .rief' s"7 2o2/
Date Month Year
by VIA.yre CDC ie/
Name of Signers
proved to me on the basis of satisfactory evidence to be the person(s)who appeared before me.
J C URIOSTEGUI LOPEZ
Signature: Notary Public-California
Signature o Notary Public Marin County
Commission k 2318135
My Comm.Expires2024
Seal
Place Notary Seal Above
OPTIONAL
Though this section is optional, completing this information can deter alteration of the document or fraudulent
attachment of this form to an unintended document.
Description of Attached Document
Title or Type of Document: So/aboy ?efl'W,1 At,/P/,y /o- -
Document Date:
Number of Pages:
Signer(s) Other Than Named Above: