1119 Jasmine St 2013 doors windowsCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003076 Date 7/18/13
Property Address . . . . . . 119 JASMINE ST
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2700
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Application desc
WINDOW/DOORS
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Owner Contractor
PENDERGRASS, THOMAS W KOEHLER HOMES INC
87 W 3RD ST 5538 COASTAL LN S
ATLANTIC BEACH FL 32233 JACKSONVILLE
FL 32258
(904) 545-6195
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Permit . . . . . . W/W/O BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 130.00 Plan Check Fee
65.00
Issue Date . . . . Valuation . . .
. 2700
Expiration Date . . 1/14/14
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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 130.00 130.00 .00
.00
Plan Check Total 65.00 65.00 .00
.00
Other Fee Total 4.00 4.00 .00
.00
Grand Total 199.00 199.00 .00
.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION 0 0
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: I I &,AS Q, n e_ Permit Number: 15-3076
Le al De cription / T -3 4 39-A.5 ,R w s&_ if 4 Nji44?ea reel
864 Qx Floor Area of SgYt. Sq.Ft
Valuation of Work 'c; 700, 00 _ Proposed Work heated/cooled non-heated/cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of egisting/proposed, structure(s) (circle one): Conunercial esiden i
If an existing structure, is a fire sprinkler system installed? (Circle one): es N /A
Florida Product Approval # 6-o ra e 3 U -le 2 -
For multiple products use -p-r-odiR approval form
Describe in detail the type of work to be performed:
e_
Property Owner Informatiiion: 7,%� D o f o Ai S' V MOI\ C"r S
Name: (_o'`�, lo"! a �b > Address: I Ad
City eXco1\V0kC State Zip S22 Phone
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: r Quali Nin Agent: J
Address: City � kCoVel e State j Zi
Office Phone5�1 �--(q( q— Job Site/ Contact Number a Fax #
T
State Certification/Registration #_�
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and
Address
Bonding Company Name and
Address
Mortgage Lender Name and Addre
CITY OF ATLANTIC
REQUIREMENTS AND CONDITIONS.
REVIEWED BY: DATE: 7 -
IK
Copy
Application is hereby, made to obtain a permit to do the work and installations as indicated. 1 certify. that no work or installation leas commenced prior
to the issuance of a permit aril that all work will be performed to meet the standards of all laths regulating eonshuc[iorn in this jurisdictirnr. 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 periodsix (6)
months at any time atter work is commenced. I understand that separate perp its must be secured for Bearical Work, Phunbing, Sigiss, We_oJ, Pools,
Furnaces, Boils, 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 NSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y * R� *gmor88E882228
COMMENCEMENT. EXPIRES: March 11, 2017
Jt0F F� Bonded Thru Budget Notary Services
I hereby certify that I have read and examined this application aril !know the same to be true and correct. All provisrons of laws and ordinances
govenung this type of wank will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate
or Cance// the provisions of any other fed al, state, or local law regulating construction or the performance of construction.
~Par ape KELLY PLEWNIAK
�o ,
* MY COMMISSION t EE 882228
Signature of Owner RF�h 11, 2017Signature of Contract00
&'sr .°! Bonded Thru Budget Notary services
PRODUCT APPROVAL INFORMATION SHEET PAIS FOR THE CITY OF JACKSONVILL
(Revised: July 8, 2008)
_ WAU4
Project Name: Jasmine Permit #: / =C'
i -n
Project Address: 119 Jasmine Street Atlantic Beach Florida, 32223 x
As required by Florida Statute 553.842 and Florida Administrative Code 913-72, please provide the information and produ l """VI
approval number(s) for the building components listed below as applicable to the building construction project for the per it �C
number listed above. You should contact your product supplier if you do not know the product approval number for any b he
applicable listed products. Information regarding statewide product approval may be obtained at: http://www.floridabuildi grg,# „
See Bulletins G-25-04 and G-03-05 for more information.
Product escrip ion or
Category/Subcategory Manufacturer Model No.
Product
Limits of Use Approval # Local #
A. EXTERIOR DOORS
1. Swinging /y - L
- ) ` i
2. Sliding
3. Sectional 14 f\,-\ C.- V—
4. Roll up
5. Automatic
6. Other:
R winlnnWc
1. Single hung L „ 162
2. Horizontal slider
3. Casement
4. Double hung
5. Fixed
6. Awning
7. Pass-through
8. Projected
9. Mullion
10. Wind breaker
11. Dual action
12. Other:
I- onnin IAIAI I
1. Siding
2. Soffits
3. EIFS
4. Storefronts
5. Curtain walls
6. Wall louvers
7. Glass block
8. Membrane
9. Greenhouse
10. Synthetic stucco
11. Other:
Printed Date: 7/10/2008 Page 1 of 3
Cate or /Subcate or Manufacturer Product Description I Limitation of Use State # Local #
D. ROOFING
PRODUCTS
1. Asphalt shingles
2. Underlayments
3. Roofing fasteners
4. Nonstructural metal roof
5. Built-up roofing
6. Modified bitumen
7. Single ply roofing
8. Roofing tiles
9. Roofing insulation
10. Waterproofing
11. Wood shingles/shakes
12. Roofing slate
13. Liquid applied roofing
14. Cement -adhesive coats
15. Roof tile adhesive
16. Spray applied
polyurethane roof
17. Other:
E.SHUTTERS
1. Accordion
2. Bahama
3. Storm panels
4. Colonial
5. Roll -up
6. Equipment
7. Other:
F. STRUCTURAL
COMPONENTS
1. Wood connector/anchor
2. Truss plates
3. Engineered lumber
4. Railing
5. Coolers -freezers
6. Concrete admixtures
7. Material
8. Insulation forms
9. Plastics
10. Deck -roof
11. Wall
12. Sheds
13. Other:
Printed Date: 7/10/2008 Page 2 of 3
Cateaory/Subcateaory 1 Manufacturer I Product Description I Limitation of Use I State # I Local #
1. Skylig
2. Other:
In addition to completing the above list of manufacturers, product descriptions and State approval numbers for the products used
on this project, it is the Contractor's or Authorized Agent's responsibility to have a legible copy of each manufacturer's printed
instructions, along with the list above, on the job site available to the inspector.
The products listed below did not demonstrate product approval at time of plan review. I understand that before these products
can be inspected, they must be submitted for review for code compliance and approved by a Plans Examiner. This form will be
revised to include each new product in the categories listed above and will be highlighted to indicate the new products and
required information.
Contractor/Authorized Agent: Leslie C Koehler
(Print)
Company Name: Koehler Homes
Mailing Address
5538 Coastal Lane South
City: Jacksobville
Telephone Number:
Cell Phone Number:( 904
State: Florida
(Signature)
Zip Code: 32258
Fax Number: ( )
545-6195 E-mail Address: Jagl848@gmail.com
Printed Date: 7/10/2008 Page 3 of 3
i�Ali ; City of Atlantic Beach
Building Department
800 Seminole Road
-� Atlantic Beach, Florida 32233-5445
Phone (904) 247-5826 • Fax (904) 247-5845
�!0, 19 E-mail: building-dept@coab.us
City web -site: http://www.coab.us
Property Address:
Applicant: ✓` 6 EA 1,4e-
Project: Z4 -Vol,) ,) &) -
Review fee $
APPLICATION NUMBER
(To be assigned by the Building Department.)
1-3-30-70
Date routed:
-Departaent review required Yes No
uiWing
Fanning & Zoning
Tree Administrator
Public Works
Public Utilities
Public Safety
Fire Services
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:
DApproved.
❑Denied.
(Circle one.)
Comments:
BUILDIN
PLANNING & ZONING
Reviewed by:
Date: 7-A,
TREE ADMIN.
Second Review:
❑Approved as revised.
❑Denied.
PUBLIC WORKS
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by:
Date:
Third Review:
❑Approved as revised.
❑Denied.
FIRE SERVICES
Comments:
Reviewed by:
Date:
Revised 05/14/09