Permit Windows 717 Triton 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000638 Date 5/23/12
Property Address . . . . . . 717 TRITON RD
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1000
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Application desc
window replmnt
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Owner Contractor
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FORE, STUART ASHBY HOMEOWNER BLDG SVCS, INC (RC)
717 TRITON ROAD 739 BROOKMONT AVE E
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
(904) 322-1054
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 1000
Expiration Date . . 11/19/12
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 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
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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 5S . 00 S5 . 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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH @
800 Seminole Road, Atlantic Beach, FL 32233 1� ILI
A4AY_" 9n,,)
Office (904) 247-5826 Fax (904) 247-5845
JobAddress: ;717 M21762y-k Permit 3'r
S,
Legal Description (P 209) 9- '-L-I — E E Parcel#
Floor Area of Tq-.Ft—. Sq Ft
Valuation of Work .0,3, 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 f-orm
Describe in detail the type of work to be performed: T540,Q UF— 21
W t f�Ab a\�At S , I
Property Owner Information:
Name: 5-ru,&(L Address: !�7
City PC�L_-� CC- V�rF4,_A/r State ELZi�_,3ZJj�_Phohe`
E-Mail or Fax#(Optional
Contractor Information:
Company Name:
-7 )z,1,'yctc4S Qualifying Agent:
Address: =9ff 15A 0C#44yk>,)—7 &L,6C Ci —JA k --State_4--4 Zip.3 22-11
Office Phone '70 Y -3 2 71- it):57V Job Site/C( +on+XT�j
State Certification/Registration _q_
Architect Name&Phone# I%Z MOTAT TAUDAR FOR CODE COMMUANCE
Engineer's Name &Phone# FR__Y Or�q ATLAN W "Ek0l
Fee Simple Title Holder Name and Address SEE PERMF1 S FUK AuDfTfONAL
UIREMENTS AN5 e0NDMONS.
Bonding Company Name and Address REU
Mortgage Lender Name and Address DATF-
A a ere ade an a ermit to do the work an,�WORRR59�_maicarea. I cerryy inar Z-work or installation has co ced pri r t
11
to O't 'r p! be performed to meet the standards of all laws regulating construction in thisjurisdiction. This i e u
all wo k w
d w t
it months, or if construction or work is susp�nded or abandonedfor a period ofsix�6)mon t any ti e .#r
i pp' c io s'rm by md hat
ssuan e o a e is it an
oi , P-k ot om""e I' in six(6
,d v d fwo
is'o" I u rs t t s
k e d nde tand ha eparate permits must be securedfor Electrical Work,Plunthing,Sikns, Wells,Porols, Purna 0*
Tanks and Air Conditioners,etc. �1
110mm" "i 1
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPRO
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Ihere 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
71work will be coTplied with whether s The granting of a permit does not presume to give authority to violate or cancel the
,fz0ed herein or not.
provisions of any otherfederal,state, or loca regulating construction or the peifi��mance of construction.
Signature of Owner Signature of Contractd;��-_,��/
Print Name 1.44� Print Name e�4-r-164V
.... ............. ......I.......................................................................................................................A,
..... ........I...... ............. ......... I&Q-4........................................ ..........
SIN and subscribed be ore me Sworn to and subscribe�,4)efore me
av o 2 0 204 -
this f Im A±1 this Day of
Notary Pu CINDIE HERNANDEZ liC JASON D&MWr'
My COMMISSION#EE149600 S. Notary Public-State of Florida
EXPIRES:Novanber 27,2015 My Comm. Expires Aug 9,201 vised 01.26.10
or Fl.No9my Diftwat An..C�. Commission#EE 14543
1-800-3-NOTARY
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City of Atlantic Beach APPLICATION NUMBER
Building Department (ro be ass;igned by the Building Department)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail; building-dept@wab.us Date routed: IZ31
Z-7.
City vmb-sifa- http-/A~e*ab.u9 I - ......
APPLICATION REVIEW AN D TRACKING FORM
Property Address: 7p;i-/ 7-on Department review required Yery No
(.�uilding_�) — V/
Applicant: NME Pra—nning &Zoning
Tree Administrator
Project: Public Works
-Public Utilities
Public Safety
Fire Services
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: 09cpproved. [-]Denied.
(Circle one.) Comments:
(��p
PLANNING&ZONING Reviewed by: Date:_S� 3—)_:�-
41
TREE ADMIN. Second Review: E]Approved as revised. E]Denie.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. [-]Denied.
Comments:
Reviewed by: Date:
Revised 07127110