Permit Door 716 Selva Lakes Cir 2010 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001262 Date 10/22/10
Property Address . . . . . . 716 SELVA LAKES CIR
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 850
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Application desc
garage door
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Owner Contractor
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EVERIDGE OVERHEAD DOOR CO. OF JAX
8081 PHILLIPS HIGHWAY 6884 PHILIPS PARKWAY DR. N.
SUITE 14 JACKSONVILLE FL 32256
JACKSONVILLE FL 32256 (904) 268-1627
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 850
Expiration Date . . 4/20/11
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC 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
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 55 . 00 55 . 00 . 00 . 00
Plan Check Total 27 . 50 27 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 86 . 50 86 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDINGPERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: � � �/� C;�,�,GNU Permit Number: Ip 1a�6 oZ
Legal Description Parcel#
CvFloor Area of Sq.Ft. Sq.Ft
Valuation of Work$ J U Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window door
Use of existing/proposed structure(s) (circle one):. Commercial Retial
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval# 11,�S`ZZ,
For multiple products use product approval form a,,
Describe in detail the type of work to be performed:
Property Owner Information: /
Name: �`���' Address:
City i i < Statq,Zip�Phone
E-Mail or Fax# (Optional)
Contractor Information: A
Company Name � 4J55A r00X- Qualifying A , .
Address Cit?t A,&,)rlle, State 6�C Zips?
Office Phone Z G F to o Fax
State Certification/Registration# T
Architect Name &Phone# ra
Engineer's Name&Phone# P-EA
Fee Simple Title Holder Name and Add r s ITIONAL 1040"Pan
�
Bonding Company Name and Address ONS.Mortgage Lender Name and Address WED BY:2077 0Application is hereby made to obtain a permit to do the work and installation as an ice nstallatioommen d` for to the
issuance of a permit and that all work wall be performed to meet the standards of all laws regulating construction in t as jurisdictis b times null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a_peraod of si ,.time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, i7rr�ac le Reaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICi-of
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
l hereby certify that I have read and examined thids plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether sppetied herein or not. The granting of a permit does not presume to give authority to violate or cancel the
7rovisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner ignature of Coin
Print Name ! f/ � /`� o%41111111"',
�1. 't............ .. , 1 1 111................... Print Name ....... C �... E.A. �%i,..............
e,�\ ,0�(CEA:Iq �ioi, . ycoM bay. •.��,
Swtnd subscrib d before e �� ly Sworn nd subscrib bef re e� MIS * \ember;hisay of 4dAM ';oo m13e�� this y of �mQ '
v A
Vota ujfis =y; '1`UD3
yy6t :*Z No c a°• mru
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+fN;,ettlli!iN 1\�0' ttttllii1111\1\
A X11 vr� City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road �f�1 _ /
j Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ��� � ��Q, �S C ./ ment review required YeIK No
Building
Applicant: (/ V 1 d Planning &Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire Services
a
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: 110,71 Date: 10—d0-10
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09