2218 Barefoot Tr 12-00001264 Door It, CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001364 Date 9/19/12
Property Address . . . . . . 2218 BAREFOOT TRAC
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2026
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Application desc
DOOR REPLACEMENT
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Owner Contractor
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ROHRBAUGH MICHAEL & GINGER LOWES HOME CENTERS INC
2218 BAREFOOT TRAC 4948 TELSON PLACE
ATLANTIC BEACH FL 32233 ORLANDO FL 32812
(904) 486-4701
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . . Valuation . . . . 2026
Expiration Date . . 3/18/13
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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 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.
09/18/2012 16:04 3524733167 KEYSTONE DOORS & ETC PAGE 01/13
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Serninole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904)247-5845
Job Address:
Permit Number:
Legal Description ]: Parcel # /6 —
oor xea o t, 6.
Valuation of Work$ ""'^ 9' q.
Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/sp window/door
Useofexlstiag/pro used structures)((circle one): Commercial Residential
If an existing structure,is a ire sprinkler stem,installs ?(Circle one): Yes No N/A
Florida Product Approval 4 46�. .� .
For multiple products use pro uct ap ova orris
Describe''in detail the type of work to be performed:
t
Prone,00wner•Information. C2
Name: 46.1
Address: , W
City tat _Zip Phone
E-Mail or Fax#(Optional)
Contract 'r Inform ion:
Company Naxno:
Address [XQualifying Agent'
: � /r� City State
Office Phone ,3,�'37 Zip,
State Certification/Registration# �
Architect Name&Phone#
Engineer'sName& Phone#
Fee Simple Title Holder Name and Address SEE PERMITS FO
Bonding Company Name and Address REQUIREMENTS AND CON 0 S.
Mortgage bender Name and,Address
IKEV
Application is hereby made to obtain a permit to do the 1vork and ins! j DATE.
issuance of a permit and that all work will be performed to meet the standards of a! aws re8tr uaeng ons ruction in rs u r aced prior to rhe
and void tf wcark is not commenced within six(6)months, or if construction or work is stnspended or abandoned for a�perird of six(6)months att a,becomes!ince a ter
work is coinnienced. I understand that separate permits must be secured for Electrical Work,Plum , Signs, Wells, Pools, rnaces, Boilers, flea/cis,
Tanks and Air Conditioners,elG
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 NO'T'ICE OF
COMMENCEMENT.
1 herecertify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing airs
type "work will be complied with whether speci ted herein or not. The,granting of a permit does not prestune to give a thori violate or cancel the
Provisions of any other federal,state,or local law re slating colAlrunrion or the performance of construction.
Signature of Owner i t�_
Signature of
g Cont c r
----------------
Print Name
t
71. .t.�' /� Print Name ' L
....................................
Sworn to ubscr' a ore cite Swoi ri to ubscrefore Ric
this Ory of 'this / Da f ZtY -
L.CARTER"...■,..■:
Notary u Itc Edea 3118=13 of u ac
r'►aride Nota �xWra9 3/1p8M13 s
1!■,nuu•.r■•a■■••■■..■Y.nu■■■+■■■ro■ani is�6�""�,7r�,tnd
3■■.agr■lrf�
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building D artment.)
r 800 Seminole Road /2 ..�
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Gi e Z
r,y�> E-mail: building-dept@coab.us Date routed: ! v
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 222-1 imT74 Department review required Yes o
Bui Tin
Applicant: Planning &Zoning
Tree Administrator
Project: Public Works ff
Public Utilities
Public Safety 4
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:
!BUILDING
PLANNING &ZONING Reviewed by: fV Date:
TREE ADMIN. FlApp
Second Review: roved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
i
Comments:
Reviewed by: Date:
Revised 07/27/10