Permit Front Door 270 5th St 2012 .‘
CITY OF ATLANTIC BEACH
\ \ ss. (---,„\\
) 00 SEMINOLE ROAD
0,4 r..,„",, =% ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
�
Application Number 12- 00000080 Date 2/07/12
Property Address 270 5TH ST
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 1200
Application desc
replace entry door
7
Owner Contractor
FLYNN GEORGE BURTON CONSTRUCTION INC
1 SUNNY ROAD
ATLANTIC BEACH FL 32233 ORMOND BEACH FL 32174
( 90) 730 -2053 (386) 676 -2837
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 60.00 Plan Check Fee . . 30.00
Issue Date . . . Valuation . . . . 1200
Expiration Date . 8/05/12
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 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
800 Seminole Road, Atlantic Beach, FL 32233
L Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: _ SH Permit Number: /
Legal Description � � /-1--- 2-8.7
` ZS- Z Parcel # 1 1 D` 7 -DCOO
iivi_ (c tvikh c: 5- ef.AC.G- :rev/ v ct ck 06
Valuation of Work $ I �,-' .
Class of Work (circle one): New Addition Alteration Re air i • - !! -molition pool/spa window • oor
Use of existing /proposed structure(s) (circle one): Commercial " -siden , '
If an •xistin r structure is a fire sprin • r system stalled? (Circle one): • es No N /A
or multiple pro • ucts use pro • uct approva orm
Describe in detail the type of work to be performed: O_ Ce_. 4- - C_r 0(c r
S
S (Ze —FAY i -- c _12.
Property Owner Information: -
Name:6'. -? �-- _ � 0 -�e�'
1' • Address:
City P'<i tCt +) C✓ f _ Statek- Zip 3 2 Z.3 hone Q L/- - .. - 7 - I: O 04,11111111M1111 '
E -Mail or Fax # (Optional)
Contractor Information:
Company e at_IP - fSne -OLS Qualifying Agent: 'e-C.)Y •
Address: - U 0 4/4 0 City, a aC-ij Zip -
Office Pho a►, . ! 3 Job Site/ Contact Nr �;�:_: -- -, ,__ - _ _ -a. -
State Certification/Registration # C C_ Sl 59 .n tiInity . . 0 , 0 _
Architect Name & Phone # g /' 1 " '
Engineer's Name & Phone # W Y 1 ° 1s! H
Fee Simple Title Holder Name and Address V-
' ' 1 ' ADDITIONAL
Bonding Company Name and Address ' ' rS 1,UNll11IONS.
Mortgage Lender Name and Address ._ • 41a:n. a ;i • .1L ram
ii
Application is hereby made to,obtain a permit to do the work and installations as indicated. 1 certify a1176,75PIMPTIrSTMIFIt . ced 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 PROPERTV_•TF VOTT INTENT) TO OBTAIN FINANCINt_t NSUL T WITH
_ - - �YS s� �." . �. ., ��. ., � CO �.�. ..����.
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that 1 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.
f ill - r — ( 1-4(-).
Signature of Owner g nature of Contractor _ _
Print Name CV'N -- l v Print Name 6p "ajy . et -7
Sworn to and subscribe before me 6l Sworn to and subscr• d be ore me
this I{ Day of SAIL el , 20 1 this f Day of , 20 / 1
. i . �,
O •N #Dp698414
N otar Public apt- of "i. .p 1` � - -•@ pNRY • . p �d-44/ I� • +• • � :c y . , RODNEY N WOOD iN
DavinHWilii3r'.t5 0 4 ; r i u NC
a na Comrn, Burn t'f 11967•. r•. �; MY COMMIS ; EE092485 1 or�o�e XPIRFS: July ., • J
�; 4i t ?r •; (1SIt' r�015 -�; •''� EXPIRE July 2a, 2015 t ! Notary evised 01,26.10
• •. 407 •8 -0153 Florida Servic-.00m
(417) -0153 FloridaN0taryServico.com
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City of Atlantic Beach APPLICATION NUMBER
a 4 Building Department (To be assigned by the Building Department.)
't71..„, 800 Seminole Road
Atlantic Beach, Florida 32233 -5445 2 r Q
Phone (904) 247 -5826 • Fax (904) 247 -5845 / a /
t • E -mail: building- dept @coab.us Date routed: A
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: c 70 cc De pth 1Q 4nt review required Yes
q o
Buildi ct,..)
Applicant: 4 ,// if Intl Ar ; � ' 0 Planning & Zoning
Tree Administrator
' � �„7e
Project: /»e ---000 Public Works
Public Utilities
Public Safety
Fire Services
Re :*: e.
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: [Approved. ❑Denied.
(Circle one.) Comments:
(BulL[
PLANNING & ZONING
Reviewed by: 771 i, Date: ' ,.). 371—
TREE ADMIN. Second Review: Approved as revised. ODeni d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10