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Permit 598 Viking Lane « a4 CITY OF ATLANTIC BEACH SS 800 SEMINOLE ROAD J ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000227 Date 3/04/10 Property Address . . . . . . 598 VIKINGS LN Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 6703 ---------------------------------------------------------------------------- Application desc WINDOW REPLACEMENT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PERRY, RICHARD E. OWNER P.O.BOX 330472 ATLANTIC BEACH FL 32233-047 ---------------------------------------------------------------------------- Permit . . . . . . WINDOW AND/OR DOOR PERMIT Additional desc . . Permit Fee . . . . 85 . 00 Plan Check Fee 42 . 50 Issue Date . . . . Valuation 6703 Expiration Date . . 8/31/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 85 . 00 85 . 00 . 00 . 00 Plan Check Total 42 . 50 42 . 50 . 00 . 00 Grand Total 127 . 50 127 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. "fµ CITY OF ATLANTIC BEACHP7 I I f4 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 09- 1 OFFICE:(904)247-5826•FAX NO.:(904)247-5845 a BUILDING-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY a s 2�VALUATION M. S'Cts V1 K-.&J -703, ori q:'( GAI CIESCRI TION..- a 6,CLASS OF Y4>ORW =6.1! E OF"S7#�t�fiJi3� n. nn S J� — e ❑NEW BUILDING IJ DEMOLITION SIDENTIAL LOT JO BLOCK aSUB DIVISION 6I'`14 ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7,DESCRIPTION OF WORKS _. a'; 'ALTERATION: Windt t1W9❑ACCESSORY BLDG S,•IFRE$PRIMKLER"r �,�-� ❑REPAIR (CQl6f.14'-it11 POOL/SPA ❑YES N/A 11 MOVE ❑OTHER ❑NO A-.PROPERTY OWNERtI :r "' 'I ,. . ':;,, .CONTRACTOR, �_ ��' ARCHITECT I ENGINEER.," ry..15.COMPANY NAME: 23.COMPANY NAME: t1�(L, /n,, 16.N E: 24.LICENSEE NAME: 10.ADDRESS. 17.STATE ORUOROWCENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: �' ;w S C- S 1 �3a L B L 1 .ADDRESS' 26.ADDRESS: l/r l,s 32-,33 \lgC�y�(Psslazc�t. t�rs4��fUS 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE 20 0.: 27.OFFICE PHONE: 28.FAX NO.: I - yt}3 an 3-777b' 13.CELL PHONE: -7 21.CELL PHONE: 29.CELL PHONE: 216 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: _n Vg -� W ri( L ax h ` ,(0 4 IX FE SItdIPI,E TITLE HOt.DER - SO DIN OMPANY M(RTC3AGE t lSNDI 1. M. {IF atHEli TtHA14E MWER .; x ::.,,r 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: 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 laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. 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, I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. *** 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. oWN t o NT„z ) CONTRACT,OR Ag0n ower” omoybr noy Letter,Req n, ` tt uallferonl Signed: // Date: 1 f�0 (� Signed: Date: i 4f l� Before me this 7 day of „2A69'in the county of Before me this day of ,2009 in the ounty of DuvA te of Florida, as persoyrally appea a 2491 / Duval,State Florida,has personally app red rf ellr herin by himself I herself and affirms that all statements and declarations are herin by hi elf 1 iArseff and affirms that all statements and beclarkions are true and accurate. true and accurate. Notary Public at Large,State of �Ld��4sw County of �[!f Notary Public at Large,State of ,County of P Lk L14 45'Personally Known M-FeRsonally Known ❑Produced Identificatio - Notary Signature: Notary Signature: FOR CODE CO JEAN PROBST RI ( SSION N DD 956269 ( F ATLANTIC B MY sato: Janua 25,2014 BLDG01 Permit Applicati E Copy ED. '�t RMITS FOR ADDITTt�0°"10T~`YMENTS AND CONDITIONREVI EWED BY: DATE: 3 ,,,, '. NOTICE OF COMMENCEMENT Permit No. /0 a J-J-7 Tax Folio No.' (J 1 / State of Florida,County of Duval THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement. 1. Description of property(legal description of property and address if available : 31 - (04 1 -, --I-s 9e S EAS 2. General Description of improvements: 3. Owner Information: a)Name and Address: Gam. it, b)Interest in property: lf 2 tn3 j7 c)Nae and address of simple title older(if other than owner): WINDOW WORLD OF ACKSONVILLE, INC. 4. Contractor Information: 8110 Cypress Plaza Drive, Suite 405 1 a)Name and Address: b)Phone Number: n 4 i-a-cksonville, FL 32256 5. Surety Information: a)Name and Address: L)oc#20'I0045366,OR BK'i 51 n i Page 735, b)Phone Number: Number Pages: 'I c)Amount of Bond:$ Recorded 02/26/2010 at 02:54 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL 6. Lender Information: COUNTY a)Name and Address: RECORDING'$10-00 b)Phone Number: 7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by 713.13(1)(a)7,Florida Statutes: a)Nannie and Address: b)Phone Numbers of Designated Person: 8. In addition to himself/herself,Owner designates of to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. a)Name and Address: b)Phone Number of person or entity designated by owner: 9 Expiration date of Notice of Commencement(The expiration date is one(1)year from the date of Recording unless a different date is specified: WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NO E OF COMM CEMENT. Signature of Owner or O er's Authorized O(icer/Director/Partner/Manager �S•ignatory's Printed Name&Title/Office The foregoing instrument was acknowledged before me this-Z5-day of t'e-6%-S� 20 10,by as for (Name of Person) (Authority Type,i.e.Officer/Attorney) (Name of Party Instrumpent was Executed for) }9 Y•'Y CARIA JEAN PROBST MY COMMISSION#DD 955269 NOTARY PUBLIC, STATE OF FLORIDA ehti O 14 Eord Tru Notary Public Undenvrters name: )0— 0 J " Prtto 3+ Pers, nally Known ❑ Identification/Type: Verification pursuant to Section 92.525,Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true to the best of my knowI dge and belief. Signature of Natural Person Signing Above Revised 10/1/2009 TM 8110 Cypress Plaza Drive,Ste.405 FL STATE Jacksonville,FL 32256 License (904)443-7001 � CBC 1250321 Fax(904)443-7778 (800)549-5132 ��'tZCIrZQaiC�r /i4C. Windborne Debris Statement for Home Owner I/WE, +I C-�': d'" _;�, Nx,14 residing at - VI j , mMh C,� &4&s, , Florida, Do swear/affirm that we have or are responsible for providing WBD protection at the above address. We do realize that the WBD protection IS required by the State of Florida building codes, as this has been explained to us by the salesperson of Window World of Jacksonville, Inc. OR Do Swear/affirm that we have existing WBD protection that meets the State of Florida building codes, as this has been explained to us by the salesperson of Window World of Jacksonville, Inc. H EOWNER DATE HOMEOWNER DATE ------------------------------------------------------------------------------------------------ POST A COPY OF RECORDED NOTICE AT JOB SITE. STATE OF FLORIDA COUNTY OF l.t V THIS INSTRUMENT WAS ACKNOWLEDGE BEFORE ME THIS p1- day of FZb. '20 lb Known Personally Or Identification L'"-- Type of Identification Notary Public — +ww,k CARLA JEAN mi COMMISSION#DD 955269 a ) r+ rXiDIRMJax traty .2014 I Barr11#d fiMIN atadypuplie'Underrrtiters s« (Name of Notary,typed or printed) (Commission Number and Expiration Date) House Map For: �Y'iC� '- KpItq N e u,16- Window World of Jacksonville 39 v i a s 8110 Cypress Plaza Dr St 405 A 16,-,K c ocVi � , 3 33 Jacksonville, FL 32256 Phone: (904) 443-7001 Gregory Fite CBC12 0321 8 Ot NOT TO SCALE 1a Window Size Window Type ':� © ;� 0e35 j 3/Lj � b 1 DP y 5 '< 5 t� `7 5/ 16 X 35 1`1 �t 3/Lj 35 �. 6 516 x 3 g/tet ' 0 S of, S5 35 :11L4 © y 7 3/q X 3 5 619 13 t-r -7 %r x 3 6 ,/c;Z 15 3 x 3 5 '/ak CP 01 Page 1 of 3 "Florida Building Code Online BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publications FBC Staff BCIS Site Map Links Search Product Approval t tp; ti USER:Public User �•r'/ Product Approval Menu>Product or Application Search>Application List>Application Detail FL# FL8134-R4 Application Type Revision Code Version 2007 ' �<•>s, Application Status Approved Comments i � Archived �, Product Manufacturer Alside Window Company Address/Phone/Email 3773 State Road Cuyahoga Falls, OH 44223 (330)922-2108 rickw@rwbidgconsultants.com Authorized Signature Marsh Fernbaugh rickw@rwbldgconsultants.com Technical Representative Marsh Fernbaugh Address/Phone/Email 3773 State Road Cuyahoga Falls,OH 44281 mfernbaugh@alside.com Quality Assurance Representative Address/Phone/Emall Category Windows Subcategory Double Hung Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report- Hardcopy Received Florida Engineer or Architect Name who Lyndon F. Schmidt, P.E. developed the Evaluation Report Florida License PE-43409 Quality Assurance Entity Architectural Testing, Inc. Quality Assurance Contract Expiration Date 12/31/2011 Validated By Ryan J. King, P.E. Validation Checklist- Hardcopy Received Certificate of Independence FL8134 R4 COI Certificate of Independence odf Referenced Standard and Year(of Standard) Standard Year 101/I.S.2 1997 AAMA/W DMA/CSA 101/I.S.2/A440 2005 Equivalence of Product Standards Certified By Sections from the Code http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqul jdteSXaTw%2... 2/9/2010 Florida Building Code Online Page 2 of 3 Product Approval Method Method 1 Option D Date Submitted 12/29/2009 Date Validated 01/04/2010 Date Pending FBC Approval 01/07/2010 Date Approved 02/02/2010 ........ ....... . .... ._..........., ..... .. . ........ ........... .. _......_.... .. .. ............. ............ 'Summary of Products FL# Model,Number or Name Description 8134.1 Ila. Model 0201 Extruded Vinyl Double Hung Window"Non-Impact" Limits of Use Installation Instructions Approved for use in HVHZ: No fL�134 R4 II INST 8134.1.gdf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E.43409 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 8134.1 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.1.odf any additional use limitations, Installation Instructions Created by Independent Third Party:Yes and product particulars. 8134.2 b. Model 0301 Extruded Vinyl Double Hung Window with Nail Fin- "Non-Impact" Limits of Use Installation Instructions Approved for use in HVHZ: No FL8134 R4 II INST 8134.2.Ddf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E. 43409 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 8134.2 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.2.pdf any additional use limitations, installation Instructions Created by Independent Third Party: Yes and product particulars, 8134.3 c. Model 0401 Extruded Vinyl Double Hung Window-"Non-Impact" Limits of Use Installation Instructions Approved for use in HVHZ: No FL8134 R4 II INST 8134.3.pdf j Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E.43409 Impact Resistant: No Created by Independent Third Party:Yes Design Pressure: N/A Evaluation Reports 1 Other: See INST 8134.3 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.3.Ddf any additional use limitations, Installation instructions Created by Independent Third Party: Yes and product particulars. 8134.4 d. Model 0501 Extruded Vinyl Double Hung Window-"Non-Impact" Limits of Use Installation Instructions Approved for use in HVHZ: No FL8134 R4 II INST 8134.4.pdf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E. 43409 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 8134.4 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.4.pdf any additional use limitations, installation Instructions Created by Independent Third Party: Yes and product particulars. 8134.5 lie. Model 0601 Extruded Vinyl Double Hung Window-"Non-Impact" Limits of Use Installation Instructions Approved for use in HVHZ: No FL8134 R4 II INST 8134.5.Ddf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E.43409 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 8134.5 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.5.odf any additional use limitations,installation Instructions Created by Independent Third Party: Yes and product particulars. 8134.6 f. Model 8001 Extruded Vinyl Double Hung Window-"Non-Impact" Limits of Use Installation Instructions Approved for use In HVHZ: No FL8134 R4 II INST 8134.6.Ddf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E.43409 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 8134.6 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.6.pdf any additional use limitations, Installation instructions Created by Independent Third Party: Yes and product particulars. 8134.7 . Model 9001 Extruded Vinyl Double Hung Window-"Non-Impact" http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqul jdteSXaTw%2... 2/9/2010 `Florida Building Code Online Page 3 of 3 Limits of Use Installation Instructions Approved for use in HVHZ: No FL8134 R4 II INST 8134.7.Ddf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E. 43409 Impact Resistant: No Created by Independent Third Party: Yes fDesign Pressure: N/A Evaluation Reports Other: See INST 8134.7 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.7.Ddf any additional use limitations, Installation Instructions Created by Independent Third Party: Yes and product particulars. 8134.8 h. Model "i"-201 Extruded Vinyl "Tilt" Double Hung Window- "Non- Impact" Limits of Use Installation Instructions Approved for use in HVHZ: No FL8134 R4 II INST 8134.8.Ddf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E.43409 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 8134.8 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.8.Ddf any additional use limitations, Installation instructions Created by Independent Third Party: Yes and product particulars. 8134.9 i. Model V101 Extruded Vinyl Double Hung Window with Nail Fin- "Non-Impact" Limits of Use Installation Instructions Approved for use in HVHZ: No FL8134 R4 II INST 8134.9.Ddf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E.43409 Impact Resistant: No Created by Independent Third Party:Yes Design Pressure: N/A Evaluation Reports Other: See INST 8134.9 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.9.Ddf any additional use limitations, Installation Instructions Created by Independent Third Party: Yes and product particulars, 8134.10 J. Model V121 Extruded Vinyl Twin Double Hung Window with Integral Mullion and Nail Fin-"Non-Impact" Limits of Use Installation Instructions Approved for use in HVHZ: No FL8134 R4 II INST 8134.10.odf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, P.E.43409 Impact Resistant: No Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 8134.10 for Design Pressure Ratings, FL8134 R4 AE Eval 8134.10.Ddf any additional use limitations, installation instructions Created by Independent Third Party: Yes and product particulars. Back Next DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee,Florida 32399-2100 (850)487-1824,Fax(850)414-8436 ©2000-2010 The State of Florida.All rights reserved. Privacy Statement I Copyright Statement I Accessibility Statement I Plug-In Software I Customer Service survey I Contact Us Product Approval Accepts: 91 WN E yrris7gM1 srrurrd Vi r,PYY http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqul jdteSXaTwD/o2... 2/9/2010 R: 4 N H — to 0 D X 0 W 0 QO ZO m Z nFp =0 z C") 9 W C 0 ^t0 p00oD 3 v ° �? Cl 0n o o n = oc a-• o o L, a f. OL H 2 o n mz n � A.. ~C Z CD o m p c a p Z I C m Q_ a A m o a m 0Nnc a c Y 4! moaD D ZO 33' o o p K z 1' W CD m C) O n 0 3 fi C, moa x 3 CD C mm' m(,D.9 n120 2L c� ft•• � ao p S j n ° be doom A xZ o'Q � Am F3 a'CZ, n-m no 0 ID o > > Z Z \ ° 4• X A t� m �T za z i ]i A PRODUCT: Doeummt. Pr•parad By: [(�/`�/:UILDINC CONSULTANTS. INC. �1 P.O. Box 230 Veldoe FL 33; DOUBLE HUNG WINDOW Phen. No.: 813,659.9197 2 N Florldo Board of Prof...1 el Enginee PART OR ASSEMBLY: QI W r- "1 L71 CertHiooU Authorizetton No.9613 t. \ 9 A I A I N RW NO DATE gY BUCK & FRAME ANCHORING REVISIONS Lyndon F. Sohmldt P.E Ne. 434 K')2009 R.W.BUILDINo C. ULTPNT.I- R:\A-Projects\Project Folders\Proj 1201-1300\pf 1273\D.RWBC Drawings\FL-8134\FL-8134.5.dwg,6F b' o Q j Q Z zrn � x n n 0 a o rn m ::r Q:�n 6�• C A O W D k> > O CC `s > rn ro OZ-m ®z0 `^ n J-6' IliA. m C rn C5 n 0D0 mZnY� U) — (Sp 33aa z 333 —I I- s" m2 cN- O 3" 3otpa y 3" O a (D .Y Q�c ism a30 >A n A Q.Z. ti p �•0 D C j p 0 x N to 3 rD < z Z n • N '.��' �cai� rn ccx5 O b G)2 CD (.4 rn rn m a 3 a v m a� a� Nim x z N Z C7 Ln V O D N �n r Z rnoma o vZo A � a w Db a32 oZ - -3 2 D o a j ON CENTER 0,:01 J L D A 6 a 0 C In m W O 3 Z > --- (-)o H X Zz C) ^ z a_ U X'3 N T1 0 D rnCom D ®Z C7 (T N= 0D0 Gl r z — v0" O Z f I 3.I 3 z D A\ " J L 6" 3" 00 O >A os I� 4 q PRODUCT: Dente Pr•Par•a By: BUILDING CONSULTANTS, INC. DOUBLE HUNG WINDOW I/I/P.O. Bo. 23o Val'lFL 335 Ipl " YY Phone No.: 81oo 3.859.9797 ? N Flortdo Beard f Profee•Ional Engin•• —I Cn PART OR ASSEMBLY: CertificatetAufhorlxotion No, 9813 I� a FRAME mNO DATE BY ANCHORING 9�6<�� REVISIONS Lyndon F. Schmidt, P.E. Na. 434t ® 2009 R.W.SUI—Na rnl—TAN—INC. 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MUM-0-3 5t—utN :sa0naasg0 lgla jj303o Is17 Sut sautaaa11 paltodaa uatut3-1ds 1s31 a1113o anrluluasatdaa a i Z lgtnloalt11-1j'Xq paMatnaa uaaq 0AVq sRurnngap uatg pug uttaads 1sa1 a11Z :aauaaa3ag guu�gaQ 0111 `uorutdo ano uI •gu1lsaltjn10 'lsal at{lio sllnsaa atll aouanjlui lou PIP wlg put;adel I tuts Suunp oggpol 11lsuIBRB leas 01 pasn atan4,uzl3 Pett: adgZ 60/80/bo :I uolslna- ZI3o II abed Sullsa1 1e.,n oa Lb-I09-90'I L998 1 1l yon b ILW- r - �1 City of Atlantic Beach t Building Department APPLICATION NUMBER 800 Seminole Road (To be assigned by the Building Department) o3 Atlantic Beach,Florida 32233-5445 Phone(904)247-5828 - Fax(904)247-5845 �i;,jv E-mail: buffding-dept@coab.us City web-site: httpJ/www.c aab.us Date routed: / APPLICATION REVIEW AND TRACKING FORM Property Address �' • �. /�/✓� en#review required Yes o Applicant Building &Zoning Project: Tree Administrator Public Worcs Public Utilities Public Safety Fire Services Rvtew►fed$ Other Agency Review or Permit Required Review or Receipt of Permit Verified B Date Florida Dept of Environmental Protection Florida Dept.of Transportation St`johns River Wafer Management District Army Corps of Engineers Division of Hotels and Reafau yts Division of Alcoholic Beverages and Tobacco Other. APPI-1 TION STATUS Reviewing Department First Reviews 93Aepproved. (Circle one.) Comments: ❑Denied. BUILDING PLANNING&ZONING TREE ADMIN. Reviewed bw Date: 3 a-1c) Second Review: [)Approved as revised. ODenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: i Reviewed by: Date-- Revised ate_Revised 05114109 7: --_7 77 -777'-T. V-.-- 7 % N. 7+ v P W 0 ev 6� �j 6 IN lie �4/ bar A-m" D -gA t5 t Ar ko. A. w-j �17' A'. RL KA I 1rJ;A 41 -elk,- .......... r;? v7zrw eO7L' 71 CA &4 v-I Am �7! F7 -4 CA _jlp�/'v /Z-v H 7 MA 0� q [I CoqM& ..........I (ID QD 7 // lla,'-1 WA Al,e��- �7 R k14 4- OD T'qlz�A 4 4 ,r77 Ao 7L4 a:f 7-4t -7—o ----------- /V 0 C4, We I �-7 -4 4 4 4,.4 T Ij L E. 3-5q 1-7 V1. 4;2 9 AV 9 BLUEPRINT SERVICE . . . I .. ------ _ . _ - - ..- , - - - . . .i, r: . . . . . X00 "c7"nr,r.s. CAL t5c� ,4 . - . - ._ ---- . ---__-..._,�.__ .�..�..� .�__ _ _- _ 5 . , 1. ; . � 1. 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