Permit Window 930 Sailfish 2011 )� � CITY OF ATLANTIC BEACH
(1
` 800 SEMINOLE ROAD
� ATLANTIC BEACH, FL 32233
J ,
. „ ) INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002987 Date 12/13/11
Property Address 930 SAILFISH DR
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 500
Application desc
2 replacement windows
Owner Contractor
BROWN, WILLIE HURST CONTRACTING INC
930 SAILFISH DRIVE 841 SHADY REACH DR
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32221
(904) 626 -8813
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 55.00 Plan Check Fee . . 27.50
Issue Date . . . Valuation . . . . 500
Expiration Date . 6/10/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC 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 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.
APPLICATION NUMBER
City of Atlantic Beach Ro be assigned by the B ing Department.)
/ ,. °� � r� ,, y Op
-t ry Building Department C�
r 800 Seminole Road
-. . V,, Atlantic Beach, Florida 32233 -5445 f �� j �
Phone (904) 247 -5826 • Fax (904) 247 -5845 Date routed:
� _
- e � „��,- E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
/ J v / ent review required Yep No
Property Address: Buildi �/
Applicant: / �.51 (6 Sr i-a e T7 0 /) Planning & Zoning
� Tree Administrator
/ Al tai / VAAe `14 47 Public Works
Project: Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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: Approved. ❑
Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by: PP Date: /2131/
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. j
Comments:
Reviewed by: Date:
i
Revised 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH D
800 Seminole Road, Atlantic Beach, FL 2
Office (904) 247 -5826 Fax (904) DE
Job Address: 930 sailfish dr w atalntic beach fl 32233
Permit Numt,r: 11 1g2
Parcel #
Legal Description oor • ea o q. t no n- heated/cooled
Valuation of Work S 500.00 Proposed Work heated/cooled
: New Addition Alteration Repair Move Demolition pool/spaow /d
Class of Work (c ircle one )
Use of existing/proposed
structure(s) (circle one): Commercial +• ! - I 110
a
If an exi sti ng structure, is a fire sprinkler system installed? nstalled? (Circle one): es o
Florida Product Approval # 11626.6 atr
For multiple products use pr uc approva orm
Describe in detail the type of work to be performed: replace 2 windows
P r ty Owner Information:
Name: dollie brown Address: 930 Sailfish D Ph ne 982ic Beach, F1 32233
City State Zip —
E -Mail or Fax # (Optional)
Contractor Information:
N ame: hurst contracting ualifying Agent: ryals hurst
Co City '
ty acksonville , - �
Address: 841 shady reach dr Job Site/ Contact Number K IANCE
Office Phone 626 -8813
State Certification/Registration # cge 15,E : , , - I t . ■� � � a��) �:y Y 1l \` Y [ � � �:��: �
_; .. , • 7 S FOR A DDITIONAL
Architect Name & Phone # 11' O. A D ADDITIONAL
Engineer's Name & Phone # ', ■ 11 • 1 f '1' /tk ' "
Fee Simple Title Holder Name and Ad < ; - s ,,,' a . . 0,1 _ ■ i b .. , � _ am r I
Bonding Company Name and Address L
Mortgage Lender Name and
Address ermit to do the work and installations as indicated. 1 certi that no work or installation has commenced prior to the
- _
Application is hereby made to all work p
or i construction or work is suspended or abandoned for a_period e f six u) moths at a Boilers, t me after
'ssuance o a permit and that all work will be pe orme� o meet the standards of all laws regulating constructil ns thWWislurisdiction. This permit becomes null
r
and void i ork is not commenced within six (6 mon .f
Plumbing, S g ,
T a r ns and Air Conditioners, reta� that separate permits must be secured for Electric Work,
WARNING TO OWNER: YOUR FAILURE TO E O E FOR M ROVEMENTS
COMMENCEMENT MAY RESULT IN YOU RECORDING YUR NOTICE
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT ULT WI TH OF
YOUR LENDER OR AN BEFORE
eci ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
1 hereby certify that 1 have read and examin this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of ofedrl with p
provisions ns o of any any other federal, state, , or or local law regulating construction or the performance of construction.
Signature of Owner " " 1—
Signature of Contracto 1g"—
Print Name - 1 . v 01 c f rQ N
Print Name lztxk t st'
Sworn to and subscribed bd., - e Sworn to and subscribed before me ZU
20 this 1,'t\ Day of (c
this " t...- Day of �►_ - L '� 2) .ArJ
Notary Pu '
1aa� ue RODNEY
COMMISSION ON 00
, p j * MY COMMISSION # DD 763650 LOPRh e , � C MS R : ised 01.26.1
* =, a L Lary Put�yic. ta of Florida
EXPIRES: March 2, 2012 r �
t Services . fir s, ' ;• aura X6;911
s, 4 ° Bonded Thru Budget Notery ,e .y >� G;Q Rr 20
o
',E�,F� �` i �X ." MY Coi rlllt. Bx ;)ts'2S Nov . 25,