Form Center

2. INSPECTION REPORT TYPE*

   1. Phase One Inspection Report
   2. Phase Two Inspection Report
   3. Structural Threshold Inspection Report
3. UPLOAD INSPECTION REPORT*
4. MASTER PERMIT NO.
6. STREET NO.*
7. STREET NAME*
   -- Select One --Abaco LaneAmerica AvenueAlmonaster StreetAnhinga CourtArden WayAshford Oaks WayAshley Oaks DriveAvalon CircleAzalea DriveBarbara LaneBay Island CircleBeach BoulevardBentin DriveBermuda PlaceBirchwood RoadBlue Heron LaneBoardwalkBonaire CIrcleBurling WayCardinal CourtCayman CourtCilewood CourtCoastal AvenueCoconut KeyColonies DriveConstitution PlaceCoral WayCosta Verde BoulevardDeclaration DriveDemocracy CourtDogwood CourtDuval DriveEastern DriveEastwind DriveEvans DriveFairway LaneFairway RoadFoss LaneFreedom WayGail AvenueGonzales AvenueGorden AvenueGrande BoulevardGrassey KeyGreat Abaco CourtGreen Heron CourtGreen Heron PointGrove StreetGulfstream DriveHeron DriveHolly DriveHopson RoadHorn CourtHorn StreetIndependence DriveIsabella BoulevardJacksonville DriveJardin de Mer PlaceKings CourtKings RoadLaguna Villas BoulevardLakeside DriveLiberty LaneLincoln CourtLions Club RoadLois LaneLower 4th Avenue NorthLower 8th Avenue SouthLower 36th Avenue SouthMadrid StreetMarathon KeyMarsh DriveMarsh AreaMarsh Inlet CourtMarsh Landing BoulevardMarsh Landing ParkwayMarshside CourtMarshside DriveMarshview DriveMcClure LaneMerrill BoulevardMilie DriveMills LaneMourning Dove LaneNorberta WayOak Forest DriveOak Grove CircleOakbreeze CourtOakbreeze LaneOaks DriveOakwood CourtOakwood RoadOcean DriveOcean Cay CircleOcean Course DriveOcean Pond CourtOcean Pond DriveOcean Terrace DriveOceanfrontOsceola AvenueOwen AvenuePablo AvenuePalm CirclePalm WayPalm Tree RoadPalmwood CourtParadise WayPatricia LanePenman RoadPinewood LanePinewood RoadPintail DrivePlantation Oaks DrivePoincianna BlvdPonce de Leon BoulevardPonce de Leon StreetPonte Vedra BoulevardPonte Vedra CourtPullian CourtPullian StreetQuail LaneRannie StreetRepublic DriveRiley StreetRio LaneRip Tide BoulevardRita Rae LaneRoberts DriveRosewood DriveRoyal Fern LaneRoyal Palm KeyRoyal Tern CourtRoyal Tern RoadRuth AvenueSable Palm LaneSan Pablo CircleSanctuary BoulevardSanctuary WaySandpiper CourtSandra DriveSea Grove LaneSeabreeze AvenueSeagate AvenueSeagrape DriveSeaside DriveShetter AvenueSnowy Egret WaySouth Beach ParkwaySt Augustine BoulevardSt George CourtSt Johns BlvdSt Maarten CourtSummer CourtSunset DriveSunshine CourtTallwood RoadTanglewood RoadThe Greens WayTheodore AvenueTrident CourtTropical TerraceTrudee Dee LaneUpper 4th Avenue NorthUpper 8th Avenue SouthUpper 36th Avenue SouthVictory CourtWaterway Island LaneWestwind DriveWhippoorwill CourtWilliams StreetWillow Oaks DriveWoodstork CourtZephyr Way1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th15th16th17th18th19th20th21st22nd23rd 24th25th26th27th28th29th30th31st32nd33rd34th35th36th37th38th39th40th41st43rdOther Not Listed Above
8. STREET TYPE
   -- Select One --AvenueStreet
9. DIRECTION
   -- Select One --NorthSouthEastWest
11. CONTACT PERSON*
12. PHONE NUMBER*
13. ELECTRONIC SUBMISSION STATEMENT*

    By checking the box below, I agree to conduct transactions with the City of Jacksonville Beach by electronic means. I understand that if there are errors with uploaded files during processing, I may be required to submit documents in hardcopy format.

    All reports submitted electronically shall be digitally signed and sealed in accordance with F.S. 471.025 and F.S. 481.221 for architects. The report should be submitted in pdf format.

    1. I agree and understand.
15. E-MAIL ADDRESS OF THE PERSON SUBMITTING THIS REPORT*
Leave This Blank:


17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

* indicates a required field