415 Seminole Rd garage door 2013 CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�Jf3 �
Application Number . . . . . 13-00002827 Date 6/10/13
Property Address . . . . . . 415 SEMINOLE RD
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1000
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Application desc
NEW GARAGE DOOR
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Owner Contractor
EUGENE & LISA KEMP PRECISION DOOR SERVICE OF NF
415 SEMINOLE RD 11389 TRADE COURT STE 101
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32256
(321) 302-2883
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 1000
Expiration Date . . 12/07/13
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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: 4A'J Permit Number: 2,f2--7
Legal Description \0-05 ►b-ZS-Z°1 C SEC- 'Z SAut'A►R __Parcel# 00 tD-c�OO
Floor Area o� q. t. q.F�t
Valuation of Work$ \oto Proposed Work heated/cooled non-heated/cooled
Class of Work(cjrcle one): New Addition Alteration Repair Move Demolition poo indow/door
Use of existing/proposed structure(s)(circle one): Commercial Residential D LS
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/ �O
Florida Product Approval # 'S-SO-Z-Q
For multiple products use product approva form— �7
Describe in detail the type of work to be performed: tOS'c aux- G A'QA(-5E ZOO By >3
Property Owner Information:
Name: (,\S A V_EtAP Address: 445 SEM�aro�A': ��►D
City ATL.g+•fir- tom. eACA State_Zip 7SZZ33 Phone IZ t•UR- S-?3o
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Qualifying Agent:
Address: Itkba► -Tk&DC CA-15K '-SN V- 00 City ,4cx�Vk"Z. State Ft. Zip 32 6
Office Phone `tu -6 3-ZZ'w J °l�4- Zt2- 1 00S
State Certification/Registration#
Architect Name&Phone#
CM OF A TJL11,t!%.r11ffJLJ1L%- EUVCM rit r nninu
Engineer's Name& Phone# Q--1p-nA 64 a
Fee Simple Title Holder Name and Addres
Bonding Company Name and Address
Mortgage Lender Name and Address RPMEM RK I 4L nATIP.
Application is hereby made to obtain a permit to do the work and installations as i4dicated I certe th t no wor or uutallation 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 rf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electricaf 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 hereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with hether sppeci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,stat or local,aw regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
i4sa-
......Print Name ..k 'Y
--- Print Name A`,:a ..._� ........�r. ._..__..........................................
.........
Sworn to and subscribed bere me Sworn u scribe be e
this Day of 20 )3 thi ay of 20
Notary Public , " SANDRA K INGERSOLL EXPIRES: ebruary 14
j MY COMMISSION#DD920346 „'SRF 9ondedThruNOtaryPUbliC d ised 01.26.10
EXPIRES:September 19,2013 'J/
as FI.Nat Discount Assoc.
1-500-3-NOTARY �' 9
?S�:Lvr�JCity of Atlantic Beach APPLICATION NUMBER
JS i j� Building Department (To be assigned by the Building Department.)
I 800 Seminole Road �(�z -
�r Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 Date routed: 7
may." 31�• E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 4� •�f 1-4016 ✓�`' D rtment review required Yes No
Building
r ��j d/) Planning &Zoning
Applicant:
Dp Tree Administrator
Project: /2tra fE-- 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 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: [Approved. -]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: "7^17
TREE ADMIN. Second Review: ❑Approved as revised. ❑Den' d.
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