Permit Windows 372 10th St 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000496 Date 7/12/12
Property Address . . . . . . 372 10TH ST
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
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Application desc
WINDOW REPLACEMENT FOR HOME
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Owner Contractor
------------------------ ------------------------
FLETCHER JULIA TRUST EASTERN SHORES CONSTRUCTION
800 GRAYDON AVE B3 1015 ATLANTIC BOULEVARD
NORFOLK VA 23507 ATLANTIC BEACH FL 32233
(904) 545-7878
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 80 . 00 Plan Check Fee 40 . 00
Issue Date . . . . Valuation . . . . 6000
Expiration Date . . 1/08/13
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 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 80 . 00 80 . 00 . 00 . 00
Plan Check Total 40 . 00 40 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 124 . 00 124 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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rs!- rrr'i City of Atlantic Beach APPLICATION NUMBER
8 Building Department
s 800 Seminole Road (To be assigned by the Building Department.)
;,r Atlantic Beach, Florida 32233-5445 "T 9�p
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: � 2? �Z_
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �2 �� rW ST D artment review required Yes No
Sh�eis
Applicant: i9�$7�`,e.'� Planning &Zoning
Tree Administrator
Project: //✓�O ltd �F�j�A CC M F h 7'" Public Works
Public Utilities
Public Safety
Fire Services
Gi
A
1r�,alaoih������Ji�
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [EI'Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: -30
`'yI't Date:_
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
"U""JV11"' 1t"11CV1I-I' 1•' FFLIC;A1•ION
CITY OF ATLANTIC BEACH
800 Seminole Road;Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: `3 ~? 2- wl-
p Permit Number: 1�
Legal Description (� evo, UO
oor ea o q t Parcel#
Valuation of Work$� Proposed Work heated/cooled q t
,,-�-'� _ non-heated/cooled
Class of Work(circle one): New (, Additio ` Alteration Repair Move Demolitionool/s a win
Use of existing/proposed structures) circle one): P P dow/door
Commercial Residential =.
If an existing structure,is a fire sprinkler system installed?(Circle one): o N/A�1�
Florida Product Approval #
For multiple products use product approve form
Describe in detail the type of work to beperformed:
Pro a Owner Information
Name: JLC t I f� t i, TZ
City A 11A ,-Dir Address:
Wit" t{ Statef_rr Zip ' 'a Phone �? 7 r
E-Mail or Fax#(optional)=
Contractor Information:
Company Name: c �" (,� C�-,,�G�O� `
Address: l o l S h. Qualifying Agent: i� �r 62— �w
--� 131 J d., � u i E c. l. h
Office Phone �b Ctn S- •l$15 CityI�r^^►'`C ;3� State "t. Zip ZZ;
State Certification/Registration# C. Job Site/Contact Number C/kv _ Fax# a+
Architect Name&Phone# t� 4 333L' Zg ---
Engineer's Name &Phone# 0`1 ' 0S C s— (o6t
Fee Simple Title Holder Name and Address v
Bonding Company Name and Address py
Mortgage Lender Name and Address
4pplication is hermade to obtain a permit to do the work and installations as indicated. I cert that no work or installation has commencedprior to the
issuance of a permit and that all work wrll be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes rru!!
and void if work is not commerTced within srx(6)months, or if construction or work is suspended or abandoned for a�pperrod of six/6)nrorrtl�s at arty time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, We/Is, 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 IMPROVEMENT
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereby cer7ifv that I Dave read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances gover rlinr>this
type of work will be complied with whether speci red herein or not. The granting of a permit does not presume to gree authority to violate a cwacel lire
provisr.'ons of my other federal•state, or local law regulating construction or the per
of construction.
Signature of Owner ° �- ..�
Signature of Contract r
Print Name '
_ ....... . ..................................... Print Name a 'e
Sworn to and subsc-ied before free .......................... . .. . .
,this2.'>Dayof �. h savr and sub�cr' ed before me
z 1 y of ,1 20/1
No ubiic b
✓' N Pu is
! SHIRLEY L.GRAHAM
_.
rhe personis)appearing before me was(were)identifiers . „ =w ���l �saO�c-WEb0
By Uniformed Services Identification Cardial ; �'�� EX P,t S:February 14,2014
n LiOrd,e Nru Netan•Public Unierwrilers