Permit 1871 Selva marina Dr 2011 wdo repairs st CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00003040 Date 12/29/11
Property Address . . . . . . 1871 SELVA MARINA DR
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2500
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Application desc
wdo repairs
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Owner Contractor
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POWELL, GREGORY DUSTIN MATHIEU BROWN INC
1871 SELVA MARINA DR. 15899 SHELLCRACKER RD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32226
(904) 813-3661
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Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . . Valuation . . . . 2500
Expiration Date . . 6/26/12
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONAL 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
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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 65 . 00 65 . 00 . 00 . 00
Plan Check Total 32 . 50 32 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 101 . 50 101 . 50 . 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
Building Department (To be assigned by the Building Department.)
r 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
j,I E-mail: building-dept@coab.us Date routed: 71-11
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: l(�7 �j/� �r��a Department review required Yes No
`� 9 &Zoning
Applicant: j
Plannin
Tree Administrator
Project: U&4 , 26 7h Public Works
/ Public Utilities
�J
h^� CJ1m A Public Safety
f� 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:
APPLICATION STATUS
Reviewing Department First Review: proved. ❑Denied.
(Circle one.) Comments:
UILDING
PLANNING &ZONING
Reviewed by: Date: c1-c92—
TREE
rTREE ADMIN. Second Review: ❑Approved as revised. ❑ enied.
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
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 1871 Selva Marina Drive Atlantic Beach Permit Number: //— 304f8
Legal Description 37-40 08-25-29E Parcel# 172020-0846
Floor Area of Sq.Ft. Nq.Ft
Valuation of Work$_2500 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 Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use product approval orm
Describe in detail the type of work to be performed: Increase opening of living room slider from 6' to 8'
a,,?d /'e lac e V- S/W /! lq tl moi Cl/Wel
Property Owner Information:
Name: Carol Brady Powell Address:1871 Selva Marina Drive
City Atlantic Beach State FL_Zip 32233 Phone 904-608-8046
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:Dustin Mathieu Brown Inc Qualifying Agent: Dustin Brown
Address:15899 Shellcracker Drive City Jacksonville State FL Zip 32233
Office Phone 904-813-3661 Job Site/Contact Number Fax#
State Certification/Registration# CBC1257586 _,..�.,,:.,:.,, . .__r. . �;, ,,•
Architect Name & Phone# Harelson Parkes 904-962-6368
Engineer's Name& Phone# u
Fee Simple Title Holder Name and Address lAir
Bonding Company Name and Address
Mortgage Lender Name and Address I
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance 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
and void if 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
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Conditioners,etc.
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
COMMENCEMENT.
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type 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
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contracto,�
Print Name k_X4 Print Name
Sworn nd sub ibed before me swom to and subs gibed before me
this' ay of Q 20 ) ) thDay of D 20
Nota ublic Qj airy Public E��
RN
vised 01.26.10
lic State of Floridaohnson "'.PSHANNA 1.THOMPSON
sion DDS90114 =:°: Notary Public•State of Florida
2312013 + :•= My Comm.Expires Jul 1,2012
Commission#DD 802490
__ 8ondtd Throueh National Netary ae:n