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355 10th St door 2013 CITY OF ATLANTIC BEACH it 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Wilt Application Number . . . . . 13-00002736 Date 6/05/13 Property Address . . . . . . 355 10TH ST Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 401 ---------------------------------------------------- Application desc INSTALL ENTRY DOOR -------------------------------------------- Owner Contractor - ------------------------ ----------------------- DAVIDSON RYAYMOND E BUTTERFIELD REMODELING LLC 355 10TH ST P O BOX 1954 ATLANTIC BEACH FL 322335529 CLINT BUTTERFIELD ORANGE PARK FL 32067 (904) 333-8409 ------------------------------------------------- Permit WINDOW AND/OR DOOR PERMIT Additional desc . Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50 Issue Date . . . . Valuation . . . . 401 Expiration Date . . 12/02/13 ----------------------------------------------- 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 --------------------- ------ Other Fees STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- 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 @ 0 CITY OF ATLANTIC BEACH M ' 2 3 013 800 Seminole Road, Atlantic Beach, FL 32233 , Office(904) 247-5826 Fax (904) 247-5845 13v- M3_4�3—� 34 Job Address:355 10TH ST. ATLANTIC BEACH, FL. 32233 Permit Number: Legal Description 16-2S-29E ATLANTIC BEACH Parcel # 170082-0000 Floor Area of Sq.Ft. Sq.Ft Valuation of Work$ 401.50 Proposed Work heated/cooled 1568 non-heated/cooled 108 Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa Cindo Use of existing/proposed struct ne). Commercial If an existing structure, >ts a f e sprinkler y em installed? (Circle one): es No /A Florida Product Approval # 15129.17 For multiple products use roduct appr a form Describe in detail the type of w o be performed-.INSTALL ENTRY DOOR Property Owner Information: Name: RAY DAVIDSON Address:355 10TH ST. City ATLANTIC BEACH State FL Zip 32233 Phone 904-607-5578 E-Mail or Fax#(Optional) Contractor Information: Company Name:BUTTERFIELD REMODELING,LLC Qualifying Agent: CLINT BUTTERFIELD Address:PO BOX 1954 City ORANGE PARK State FL Zip 32233 Office Phone 904-333-8409 Job Site/Contact Number 904-333-8409 Fax# 904-771-0981 State Certification/Registration# NSS-14 ^v Architect Name&Phone# a 01%rift CITY OF ATLANTIC BEACH jr 1.1 Engineer's Name &Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address _. Mortgage Lender Name and Address_�b� DATE Application is hereby,made to obtain a permit to do the work-72 installations as incutatedIcern that no wor or insta talion has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a enod of six(6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers,Heaters, Tanks and Air Conditioners,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 hereb certify that I have read and examined this a lication and know the same to be true and correct. ,411 provisions of laces and ordinances governing this type of work will be complied with whether spped ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of arty other federal,state, or local law regulating construction or the performance of construction. R Signature of Owner A Signature of Contract Print Name RAY DAVIDSONPrint Name CLINT B,UT FERFIELD SN subs b f re e Sworn to and subscribed before me y of 20-Lthis Day of 20 / 3 Notary u i Notary Publia x res December 3,2014 State of Florida .;.o��eP', Bonded Tin Troy Fair Insurance 900.385.7019 Revised 01.26.10 My Commission Expim 0?l2a/Mf Commission No.1332370 City of Atlantic Beach APPLICATION NUMBER Js Building Department (To be assigned by the Building Department.) 3. 800 Seminole Road 3j Atlantic Beach, Florida 32233-5445 J Phone (904)247-5826 • Fax(904)247-5845 MJ.31y'' E-mail: building-dept@coab.us Date routed: '51 2 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM I r\Property Address: 355 u) S"�• D rtment review required Yes No Building Applicant: F .�fi�CGI ��l Pil nfn Planning &Zoning •,� ^ ,� J Tree Administrator Project: =nStN\I1 �1 1 tr v1 D�Y Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature 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: APPLI ATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circ) one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑Deni 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