Permit Door 781 Jasmine St 2012 441
CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001532 Date 10/29/12
Property Address . . . . . . 781 JASMINE ST
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 800
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Application desc
INSTALL PATIO DOOR
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Owner Contractor
------------------------ ------------------------
CAUSEY STEPHANIE BUTTERFIELD REMODELING LLC
781 JASMINE STREET P 0 BOX 1954
ATLANTIC BEACH FL 322331717 CLINT BUTTERFIELD
ORANGE PARK FL 32067
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 800
Expiration Date . . 4/27/13
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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 55 . 00 55 . 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
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 781 Jasmine St. Atlantic Beach Fl. 32233 Permit Number: / 191 '
Legal Description 18-34 38-2S-29E 0.117 ATLANTIC BEACH SEC H LOT 4 BLK 147 Parcel 170929 0000
Floor Area of Sq.Ft. SqTt
Valuation of Work $800.00 Proposed Work heated/cooled 1209 non-heated/cooled 1502
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spawindow/door
Use of existing/proposed_structure(s) circle one): Commercial Resi n is
If an existing structure, ►s a fire sprin> r system installed? (Circle one): es o N/A
Florida Product Approval 9 FL 13074.9
For multiple products use product approv } orm
Describe in detail the type of work to be performed: INSTALL HINGED PATIO DOOR
Property Owner Information: '
Name:STEPHANIE CAUSEY Address:781 JASMINE ST. FILE C 0 Y
City ATLANTIC BEACH State FL Zip 32233 Phone 904-246-0449 t
E-Mail or Fax#(Optional) k -
Contractor Information:
Company Namc:BUTTERFIELD REMODELING LLC Qualifying Agent: CLINT BUTTERFIELD
Address:PO BOX 1954 City ORANGE PARK State FL Zip 32067
Office Phone 333-8409 t Job Site/C Number 333-8409 Fax 4 771-0981
State Certification/Registration#
Architect Name& Phone# REVIEWED FOR CODE COMPIJANC
Engineer's Name &Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address REQUIREMENTS
Mortgage Lender Name and Address JAAA
BY: DATE:
Application is hereby made to obtain a permit to do the work a 2s,
commenced prior to the
issuance ofa permit and that all work will beperformed to meet the stop ar s o a aws re ahng cons ruc to his permit becomes null
and void tf work is not commenced within six(6)months, or if construction or work is suspended Ora
fora_period ojsix/6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wefts,Pools, Furnaces,Bodlers,Healers,
Tanks and Air Cond&tdoners,etc
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 NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined th' lication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether spec;ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of arry other federal,state,or local Iaw regulating construction or the performance of construction.
Signature of Own Signature of Contractor
Print Nameo� _. Print Name CUNT BUTTERFIEL
;Woonu, cribe before me Sworn to and subsc>' ed befo re me
2012- this J—DayofS.- O 20JEANNETTE I.HAWKINBi RRY ocomossm
Commission#DD 989601 -*i =. ExpitekS Deowtw 3,2014
H
Expires July 15,2014 ��,,,T,oyF,hnw.«� ed 01.26.10
'�,�„ Bonded TMu Tray F&Wavar ce WO385.7619
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road /� . 1�5_3,
jJ Atlantic Beach, Florida 32233-5445 l
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
-7Q 1
Property Address: D ent review required Yes No
/ p �. ,lam_ LreD, `�
A Building
Applicant: Planning &Zoning
Tree Administrator
Project: 5�zjPA'0 T) Public Works
Public Utilities
Public Safety
Fire Services
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: Approved. ❑Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING Reviewed by: Date: '2Z^/Z
TREE ADMIN. Second Review: ❑Approved as revised. ❑De ed.
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