1651 Becah Ave 2012 door 4 CITV OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-d0001101 Date 8/27/12
Property Address . . . . . . 165�, BEACH AVE
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1500
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Application desc
exterior door replacement
--------------------------------------- ------------------------------------
Owner I Contractor
------------------------ ------------------------
BRYAN JOSEPH S JR & MARY ANN CORNELIUS CONSTRUCTION CO.
i
1651 BEACH AVE 71 19TH STREET
ATLANTIC BEACH FL 32233584 ATLANTIC BEACH FL 32233
(904) 249-9706
--------------------------------------- ------------------------------------
Permit . . . . . . WINDOW AND/ORI:DOOR PERMIT
Additional desc
Permit Fee . . . . 60 . 00
Plan Check Fee 30 . 00
Issue Date . . . . Valuation . . . . 1500
Expiration Date . . 2/23/13
------------------------------
------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 14ATIONAl ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRE6
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO ! INSPECT FASTENERS
--------------------------------------- ------------------------------------
Other Fees . . . . . . . . . STA E DCA SURCHARGE 2 . 00
STA�E DBPR SURCHARGE 2 . 00
---------------------------------------- ------------------------------------
I
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
Office (904) 247-5826 FaN (904) 247-5845
ber:
JobAddress: itnn—1 'Bi_=Anr( Permit Num A2.
Legal Description k�oCtw 4n.AblZic- '-Bni- . okill- ) Parcel#
Eloor Area ot Sq.Ft.
Valuation of Work$ i5ton Proposed Work heated400led non-heatei/—cooled
Class of Work(circle one): New Addition Alteration (R-jea�r Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one):. Commercial
If an existing structure,is a fire sprinkler system installed? (Circle o�,ne)-_'L_�Yes N/A
Florida Product Approval#H I!F-V-z q
For multiple products use producf approval form
Describe in detail the type of work to be performed: R E P LAC k-7 R
Property Owner Information:
Name: S,4F_G4R p _RRYA Address:- 1(oSl E3EeC_W L/;—:7
City State tlZip E203 Phone 24#1- 3-2
E-Mail or Fax# (Optional)
Contractor Information:
Company Name- F_L10:S Quali�ing Agent: n)hQA C7-r ("QP,1J4F_) -10--
city JMA f� —State F1 Zip -5322_1`3
Address: e r) 7
Office Phone kig q�� Job Site/Coni
State Certificatio�/R6gistratio� it,
/XXIVIL Win Tittv FOR CODEtOMPH&NICL,
Architect Name&Phone#
Engineer's Name&Phone
Fee Simple Title Holder Name and Address SEE "ERMITS FOR ADDITIONAL
Bonding Company Name and Address REQU REMENTS AND CONDFITONS.
Mortgage Lender Name and Address
mvmwtl
licatio is ere ma e to obtain a ermit to o the work and qT. .... ........... mmencedprior to the
i suance o a er it an that all work will be er orme to meet the stan ar s o 11 s regulating nstruction in this jurisdiction. This permit becomes null
P
co I f six
an voi i or is not commence within six months, or i construction or w r is uspended or abandoned a (6)months at any time after
,f eriod o
Work, Plumbing V ells Pools, P�rnaces, Boilers, Heaters,
or Plum
MriaF7w
or is co mence . I un erstan that se arate ermits must be secure or 't I k b
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR P YING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO 0 3TAIN FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCED IENT.
]here certify that I have read and examined this application and know the same to b�true and correct. All provisions of laws and ordinances governing this
work will be complied with whether speciji-ed herein or not. The granting a permit does not presume to give authority to violate or cancel 1he
7� 111,
provisions of any otherfederal,state, or local law regulating construction or th, i mance of construction.
Signature of Owner oi(l,_ Signature of Contractor
> 6 int Name W.... ................................
Print Name 15. P (I WET
Vk ..................................... ...... ....... ..............
Sworg,4_,p scr* before mf,- 0 S 0 u
1,5
s, v 20
th . ;ay)V* 6e�� 2
# 577eC,
Notal'y--P� SHIRLEY L,GRAHAM
MMISSION#DD 957760
ly 0(�-,
Revised 01.26.10
1a1*-A,1'1"1
W EXPIRES:February 14,2014
Bonded Th(u Notary Pubtic Underwriters
City of Atlantic Beach
APPLICATION NUMBER
Building Department (To be assknW by ft Buftv Deparbrot)
SW Sen*x)le Road 12
Adandc Beach,Fkxida 32233-5445
.. ........ Phone(904)247-SM - Fax(904)247-5845
E-mail: bundkqdept@coab.us Daft routed: 112-
CifywWabs! M1p-Jkuw.&wb.u*
APPLICATION REVIEW AND TRACKING FORM
Property Add Department review required Yee -No
7t7
Buildini--:2-
<Wnning&Zoning
Applicant
Tree Adminishalm
Project: --;kq11 (1 -La'66e Public Works
Public Utilifies
Public SafbW
Fire Servi-
Other Agency Review or Permit Required k6vii—w or Receipt Daft
of OMM Vedfled Sy
Florida DePL Of Protecfion
Florida DepL of Transportation
SL Johns River Water Managernent Distrid
Affny Co"of Enginw"
Division of Hotels and Restaurants
Division of Akx*wlc Beverages and Tobacco
odw.
APPLICATION SWTUS
RevivAnq Departmertt First Review: MAMMved. ElDenied.
(Cirde one.) Commerift:
(_BUIL
�Dl N7G
PLANNING&ZONING Reviewed Oy:—Jn Date: P-.,)7-t
49
TREEADMIN. Second Review: [:]Approved as revised. DeWed.
PUBLIC WORKS Comments:
PUBUC UTIUTIES
PUBLIC SAFETY Reviewed Y: Date:
FIRE SERVICES Third Review: [34provedasreviso[d. [:]Denied.
Comments:
Reviewed Date:
Rawimf(=118