Permit Wind/Door 2208 Fairway Villa 2011 CITY OF ATLANTIC BEACH
Js) 800 SEMINOLE ROAD
' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001733 Date 3/03/11
Property Address 2208 N FAIRWAY VILLAS LN
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 1500
Application desc
12 NEW WINDOW AND DOORS
Owner Contractor
BAYS, ROBERT & CATHERINE MATHIEU BUILDERS
2208 FAIRWAY VILLAS LN 15899 SHELLCRACKER RD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32226
(904) 813 -3661
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 60.00 Plan Check Fee . . 30.00
Issue Date . . . Valuation . . . . 1500
Expiration Date . 8/30/11
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
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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH D 1E @ rn 1
800 Seminole Road, Atlantic Beach, FL 32233 l'
Office (904) 247 -5826 Fax (904) 247 -5845 1111 MAR 1 2011 Li
Job Address: e470i ofii.va b /4C r / /t/ I/ Pl
Permit Num 1
Legal Description 4,4-e., , t eiy 4 / /.r Parcel # /I — /7.2
Floor Area of Sq.Ft. Sq.Ft
Valuation of Worl 't a ) Proposed Work heated /cooled non- heated/cooled
Class of Work (circle one): New Addition Alteration Repair Mo - 1 -molition pool/sp window /door
Use of existing /proposed structures) (circle one): Commercial : - . - . •
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval # FL o7,S " 0 , 3( (16,
For multiple products use product ap ova orm
r .
Describe in detail the type of work to be performed: .� 740. - = o - Gt,Lir"1: CVs la ., oC do._ -
-f. 4 /e' /RCe1.
/2 0//4105
Property Owner Information: ��"
Name: i ... i Se's Gaol Address: $?9 g Si.- r eS
City Witot ri%` .Qr re 4_ State `c -Zip 3z- z. 33 Phone 7 V gl3 3 G G /
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: "AteX = a w da - ( /c fes Quali�f ing Agent: 4 Si- sk. 460 ..-.
Address:. /rr9r She //e onofe ,Qa( City J A )c. State `c- Zip 3 L r.3_3'
Office Phone . . -^ ....._.. —= ' _ __ Fax # 9oY 2 / Z
- - - —'- -- -
/So /
State Certification/Registration # G ..1 ry
4rchitect Name & Phone # - -• -- "� •� °:� :•'RRi�►� I r w l_�►�[ �[ JAI _.:1::.::: •.• >'
Engineer's Name & Phone # 1 1 • liffl 1 ; ' CH I1
Fee Simple Title Holder Name and Ad. I- ss is Po t ' • DITIONAL 11111111111.1.11111W
Bonding Company Name and Address
V
i 1 I )
lortgage Lender Name and Address 1 1 ;■ • a • • . M1 — �;... 4 - -.-, i , '
Application is hereby made to obtain a permit to do the work and insta atio ' as le, •"---------- ------- J, 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 permit becomes null
znd void (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
vork is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
tanks and Air Conditioners, eta
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE 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
COMIIIENCEMENT.
hereby certify that I have read and examined this placation and know the same to be true and correct. All provisions of laws and ordinances governing this
vpe of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
Irovisions of any other federal, state, or local law regulating construction or the performance of construction.
>ignature of Owner dm. 1 tt;' ALA . _ ki,_,....i. Signature of Contractor -- --
'riot Name f \ e .c am Print Name /)L�J n 6 , 0,-.
;worn to and subscribed before me Sworn to and subscribed before me
his i Day of M out c) ^' , 20 1I this 1 Day of fflc rck) , 20 1
•
' +'c ,,.ayp�, _
lotaryPub
iN s Notary B ONADIO N otary P '.lic P a y �Ge� ,,, ANGELIOUE BONADIO
y Public - State of Florida : ÷°,.* A
. A i y4.7 My � Essp es D 014 1
My Comm. Expires Oct 5, 2014 � ,', -c► : Commi NEE 32353 •,. ..."..0- P.• ■
%,FOr•�,.• • ' ,; F O, Commission # EE 32353
CITY OF ATLANTIC BEACH PRODUCT APPROVAL SPECIFICATION SHEET (short form)
As required by Florida Statute 553.842 and Florida Administrative Code 9B -72, please provide the information and approval
numbers on the building components listed to be utilized on the construction project for which you are applying. We
recommend you contact your local product supplier should you not know the product approval number for any of
the applicable listed products. Statewide approved products are listed online @ www.floridabuilding.org
Category/Subcategory Manufacturer Product Description FL Approval # (s)
EXTERIOR DOORS nn
a. Swinging a 4( a/c/, £c, Rio /Ile z/ 404. /o 7 '5
b. Slidin a e/L `G - 3
g r.ic�..r „ 1.wi.[c.
c. Sectional /Roll Up C 4/ ..
d. Other
WINDOWS
a. Single /Double Hung vi/1a/tJS 5 ;,,1 / ,4<<., Id/i 4,./s ?-G
b. Horizontal Slider
c. Casement
d. Fixed
e. Mullion
f. Skylights
g. Other
PANEL WALL
a. Siding
b. Soffits
c. Storefronts
d. Glass Block
e. Other
ROOFING PRODUCTS
a. Asphalt Shingles
b. Non - Structural Metal
c. Roofing Tiles
d. Single PIy Roof
e. Other
STRUCTURAL COMPONENTS
a. Wood Connectors
b. Wood Anchors
c. Truss Plates
d. Insulation Forms
e. Lintels
f. Others
NEW EXTERIOR ENVELOPE
I understand that, at the time of inspection, the following information must be available to the inspector on the jobsite:
1. A copy of the product approval.
2. The list of performance characteristics which the product was tested and certified to comply with.
3. A copy of the applicable manufacturers' installation requirements.
Further, I understand a product may have to be removed if approval cannot be demonstrated during inspection.
3//7a i/
Applicant Signature Date
H: /Product approval spec sheet short form.xlsx
1-1 1 j thils)- ‘ City of Atlantic Beach Building Department
ro � .. . � 800 Seminole Road
Pii x ~ Atlantic Beach, Florida 32233
, Telephone (904) 247 -5800
Fax (904) 247 -5845
www.coab.us
WIND -BORNE DEBRIS PROTECTION AFFIDAVIT
Date: 3/ /01. et
Permit #:
Property Address: o 0 f of ova y „ // s Gae2.e-. /./
I understand the Florida Building Code requires replacement windows in a Wind -borne Debris
Zone be impact glass or have openings provided with wind -borne debris protection. I recognize
the structure involved is located in a Wind -borne Debris Zone. I am in the process of having
windows replaced which require this protection but have elected not to have the required
protection installed by my window contractor. I understand that before a final inspection may be
approved, the required window protection must be provided. If the required window protection is
not provided it will be a violation of State law and the City of Atlantic Beach may take appropriate
code enforcement action which may result in fines beings made against this property. I also
understand that my insurance company may not reimburse me for damages suffered due to the lack
of required window protection.
I agree to have the required window protection installed on or before: y/ e /Z- o of
(Date)
I will be using the following material to provide the window protection: (check one)
A. 7 Plywood per the Florida Building Code
B. Other approved method
(Provide Florida Product Number)
Name of Homeowner's Insurance Company AVA
. 1► ..k e, . I 7.-- _, 4 16 . _ Th bCA 1
( ignature of • operty Owner) ate)
\
(Print Name)
STATE OF FLORIDA
COUNTY OF DUVAL
The foregoing instrument was acknowledged before me this 1 day of M0--v CH , 201 1 , by
H(
O*Q- k(O u )fn (name ofperson acknowled • g) o; Pw ; ANGELIOUE BONADIO
OKA (� r , ,,,� : � : Notary Public - State of Florida
B \ i f ,p I � My Comm. Expires Oct 5. 2014
Signature of No Public — State of Florida '. ;;e o! g',. Commission # EE 32353
•, ,, I,I I
Personally known OR Produced Identification / Type of Identification V iCr1 \ (Z i E--q S t. Ce \ -
Y 11-,r,t3 City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road / / 3
° v�� Atlantic Beach, Florida 32233-5445 / 1 7 g
=.?
Date /
Phone (904) 247 -5826 • Fax (904) 247 -5845
N E -mail: building- dept @coab.us Date routed: oJ- / /1
City http://www.coab.us
htt : / /www.coab.us
APPLICATION REVIEW AN TRACKING FORM
Property Address: 220 /iLbm V //)4Depament review required Ye No
"'may, �" , : uilding
Applicant: i at / -4L. % //d6es Planning & Zoning
� -n� � a � Tree Administrator
Project: / 6 004) Public Works
Public Utilities
V AA 4 rttt� - Public Safety
Fire Services
Ftevi = _ _
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:
APPLICATION STATUS
Reviewing Department First Review: LKIProved. ['Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by: Date: 4)
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