Permit Windows 1039 Beach Ave 2010 . ` A CITY OF ATLANTIC BEACH
1 ^�� s 800 SEMINOLE ROAD
�`3 .. ATLANTIC BEACH, FL 32233
t INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001314 Date 11 /01 /10
Property Address 1039 BEACH AVE
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 1536
Application desc
REPLACE 2 WINDOWS WITH IMPACT WINDOWS
Owner Contractor
HARWARD, JERRY E. LOWES HOME CENTERS INC
1039 BEACH AVE. 4948 TELSON PLACE
ATLANTIC BEACH FL 32233 ORLANDO FL 32812
(904) 486 -4701
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 60.00 Plan Check Fee . . 30.00
Issue Date . . . Valuation . . . . 1536
Expiration Date . 4/30/11
Special Notes and Comments
NEED ORIGINAL APPLICATION
*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
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.
City of Atlantic Beach
APPLICATION NUMBER
Department S s� Building p artment
(To be assigned by the Building Department.)
a ,r � 800 Seminole Road
Atlantic Beach, Florida 32233-5445 w — / 3/ 3
Phone (904) 247 -5826 Fax (904) 247 -5845
Azoll E -mail: building- dept @coab.us Date routed: /C3 — 28_
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /64.2-7?"-tA 610 cc t De review required Yes No
// Iding
Applicant: `O -t■,, f c ( Planning & Zoning
Tree Administrator
Project: Ve J L74- gar- Public Works
Public b c Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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:
APPL ATION STATUS
Reviewing Department First Review: Approved. nDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: '17 Date:j' 2 0 7 ,'! 0
TREE ADMIN. Second Review: A roved as revised.
n pp ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
L a., A..1.4.10.1_01 vlir r r,tc1v111 bU'k LlCATION
/ CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
D ! , / -/3/3
Job Address: i �'� T � � � � - ���� Permit Number:
Legal Description Parcel # _
Valuation of Work $ 63 c
Class of Work (circle one): New Addition Alteration Repair M. - -molition pool/spa windo door
Use of existing /proposed structure(s) (circle one): _ Commercial- esi 1! den i , 0
If an existing structure, is a fire sprinkler system installed? (Circle one): • es No N /A
Florida Product Approval # /) 9/9
For multiple products use product approval form
Describe in detail the e of work to be performed: �� 0 /a & ��� /�" j
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City ii ; /f
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COntl"dCt Qpmation' , Agent: � State zip __ZW- --
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` CITY OF ATLANTIC BEACH
r. :, , ,' , 800 SEMINOLE ROAD
V ,,, = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
444 V131 `'
Application Number 10- 00001314 Date 11/12/10
Property Address 1039 BEACH AVE
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 1536
Application desc
REPLACE 2 WINDOWS WITH IMPACT WINDOWS
Owner Contractor
HARWARD, JERRY E. LOWES HOME CENTERS INC
1039 BEACH AVE. 4948 TELSON PLACE
ATLANTIC BEACH FL 32233 ORLANDO FL 32812
(904) 486 -4701
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 60.00 Plan Check Fee 30.00
Issue Date . . . 11 /01 /10 Valuation . . 1536
Expiration Date . 4/30/11
Special Notes and Comments
NEED ORIGINAL APPLICATION
NO INSPECTIONS UNTI ORIGINAL APP IS
RECIEVED
*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
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.
n u 11..U11N G YER.MIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: / 49 - 361 81
Permit Number:
Legal Description Parcel #
Valuation of Work $ /53 b • 5
Class of Work (circle one): New Addition Alteration Repair Mo - 1- II olition pool/spa '' do , door
Use of existing/proposed structures) (circle one): Commercial ; - siden i,..
If an existing structure, is a fire sprinkler system installed? (Circle one): -- - -- No N /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: 4 ak thz10o -- nyet a
Property Owner Info ation:
Name, • . 1�leRY i?vv Ar2D °2 t
City (r�Ir�t
Address: A E
State R- Zip3 ZZ33 Phone ') ct a t ( - Cl (v -a-
E -Mail or Fax # (Optional)
Contractor Information;
Company Name: ,'r, d ,A, 1 -/4 1-- �r /`lam
Address: Qg Ap,;ent: ,7
�U - �� �� Cit State P� Zip - 31.e�/
Office Phone r2 , ( S79-3 Fax # p
State Certification/Registration # l� Site/ C 7
Architect Name & Phone # Al/-
Engineer's Name & Phone # / R
Fee Simple Title Holder Name and Address / VI--
Bonding Company Name and Address
Wortgage Lender Name and Address
1pplication is hereby made to obtain a permit to do the work and installations as indicated 1 certt r that no work or installation has commenced prior to the
ssuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This
rnd void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned fora riod of six 6) months at becomes null
vork is commenced I understand that separate permits must be secured for Electrical" e Work Plwnbin pe (( any time a }�r}
ranks and Air Conditioners, eta g, Signs, Wells, Pools, l� Y�rnaces, Boilers, Heaters,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COM1VIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
T() YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCE 1 NT.
hereb certify that I have read and examined this application and know the same to be tru: and correct. All provisions of laws and ordinances governing this
pa of work will be complied with whether ssssssppppppecid herein or not. The grant of a p it does not presume to . • e aut to violate or cancel the
rovisiorrs of any other federal state, or local egu • tin. construc or the performanc of construct
ignature o Owne Signa - of Contractor Alla
rust Name ,, �,. r r. ,: Print Name f >� ', c
worn to and sub; , be @ i1 CURi18'R Sworn to and su, scribed before me
us o/ t Day of ye OD916858 20 % O ,,..,,.. ' ; � this day / i= ..z.... 20 ! C
r_
"= Bonded througllst&OMI'S l
o lr.. I c Notary 'r . CARTER
irAZ Comm* DD0871944
I. = Revised 01.26.10
I V
`= Expires 3/18/2013
4,4, Florida Notary Assn., Inc