Permit Bldg Repairs 595 Selva lakes Cir 2010 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5826
INSPECTION PHONE LINE 247
Application Number . . . . . 10-00001264 Date 10/18/10
Property Address . . . . . . 595 SELVA LAKES CIR
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1100
----------------------------------------------------------------------------
Application desc
residential repair garage door window trim
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
Magee, Joan GIL MACIAS ENTERPRISES
595 SELVA LAKES CIRCLE P 0 BOX 50728
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee 30 . 00
Issue Date . . . . Valuation . . . . 1100
Expiration Date . . 4/16/11
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total 30 . 00 30 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUMDING PERMIT APPLICATI[ON
CiTy oF ATLANnC BEACH
800 Seminole Road,-Atlaritic Beacb,FL 32233
Office(904)247-5826 Fax(904)247-5845
JobAddress: S7C-Lj,,4L4kES c((L, Permit Number:
Legal Description Parcel N
Floor Area of Sq.Ft. SqXt
Valuation of Work S Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Altcmtion Move Demolition pool/spa window/door
Use of existing/proposed stmeture U$) c1rcle one): Commercial ResidentW
If an existing ifiructure,is a fire sp, or system installed?(Circlr one): Yes No N/A
Florida Product Approval
For multiple products use product appr-o-Vaorm--
Describe in detail the type of work to be perfbrme?—R--,eACL-c-e b c,4+:,� s
02 rk�' Pa^le 6
Pro erty Own2r laftMation:
Kamm 1)47CQ 515 5 L--Z-VA
----Address:
'-ity Oct., State 07�p �21=jj-Yhone
B-Mail or Fmc#
Contractor johnnation:
. t - - - .1 k,
ompany Name: INA C-I AA t7 t-1 Qualifying A ent: 6
kddress:-q to I' I I 'A-up li� City -s- %&L, zip -�"r-ft
3fficePhone lob Site/Contact Number Sig-n17-7— Fax
3tate Certification/Registration
krehitect Name&Phone#
tngineee s Name&Phone#
�ee Simple Title Holder Name and Address
3onding Company Name and Address
Viortgage,Lender Name and Address
Ipplication is hereby made to obtain a Rgermit to do the work and installations as indicated. I certify that no work or installation has comnsencedprior to Me
:duiance o�a=and that all work will be ormed to meet the standards of all laws re wjcons&ucdoninrhisjWi�d1ction. Thupfrmitbeicamesn
.9o,d w gulat. ulf
otcommencedwh (I months,or f construction k *d or abandonedfor aweHod of US moAths at any time ailer
e
I r.
vorkisconunenced I understand that separate permits must be secured?,r,6'1,'c&'Ic'j"do'rk,Plmbing,Signs. dbPook aces,Batten,Heays,
ranks and Air Condidonem,eic.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
CONINIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR EMPROVEM1ENTS,
TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU NOTICE OF
COMMIENCEMENT.
here certVy that I d and know the same to be true and correct Allprovisions oflaws and ordinances governin
re'd. eithis
r�r .nting o
.,Pd work will be rrlie w er in or not 71m gra f a pvWt does not presume to give authority to violate or cance the
e
rovisions ofany oth4 eg state, locall construction or the paFjb�ce ofconstructibm
lignatare of 0 Sigmature of Contractor
,riat Name Doug K.Ow"SVPfro Print Name
-7on and su s e 0 Swo and subscribed b9fore me
.vq� 'I
21S 1 X-Day 20 /0 of
of this a
—,T-,,t
rotary lie V
pt
ALICE E.'TAFT ExpiM
Notary Public. Nototy Seal Revised 01.26.10
State of Missouri
Jasper County
Commission # 09450235
My Commission Expires August 30,2013