2179 S Fairway Villas Ln 2013 Door CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003274 Date 9/09/13
Property Address . . . . . . 2179 S FAIRWAY VILLAS LN
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . PLANNED UNIT DEVELOPMENT
Application valuation . . . . 451
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Application desc
door install
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Owner Contractor
------------
_ ------------------------
REVELS, ALMA BELO BUTTERFIELD REMODELING LLC
2179 FAIRWAY VILLAS LN P O BOX 1954
ATLANTIC BEACH FL 32233 CLINT BUTTERFIELD
ORANGE PARK FL 32067
(904) 333-8409
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc .
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 451
Expiration Date . . 3/08/14
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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
Fee summary Charged Paid Credited Due
----------------- ----------
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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: 2179 FAIRWAY VILLAS LN. S. Permit Number: 3d 7
Legal Description 39-22 08-2S-29E Parcel# 169398-1060
Floor Area o q. t. Sq.Ft
Valuation of Work$ 451.51 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed str s circle one): Commercial e ' is
If an existing structur • a fire sir stem installed? (Circle one): es o /A
Florida Product Appp oval# 15213.1
For multiple pro s use product approval form
Describe in detail the type o pe ormed:INSTALL PRE-HUNG EXTERIOR DOOR
Property Owner Information:
Name:ALMA REVELS Address:2179 FAIRWAY VILLAS Llr•S.-
City ATLANTIC BEACH State FL Zip 32233 Phone 904-994-1787
E-Mail or Fax#(Optional) A
Contractor Information:
Company Name:BUTTERFIELD REMODELING LLC
Address:4220#1516 PLANTATION OAKS BLVD. City ORANGE PARK State FL Zip 32065
Office Phone 904-333-8409 Jo Fax# 904-771-0981
State Certification/Registration#NSS-14
Architect Name&Phone#
Engineer's Name&Phone emy OF ATLANTICSUC—H
Fee Simple Title Holder Name and Addres R ADDITIONAL
Bonding Company Name and AddressREOUMMMEN NS.
Mortgage Lender Name and Address
Al2 .W ,WJ%z=_,
Application is hereby made to obtain a permit to do the wor an tns a a toI M In allation 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:f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period ofsix months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,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.
1 hereb 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 oP work will be complied with whether speci eed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor=r `'�! '
Print Name ALMA REVELSPrint Name CLINT BUTTERFIELD
Swo o and subscribed before e Sworn to andsubsc 'bed before me
this Day of �� N ,20 [ /7 Da of tc 4 it S 7� 20/ 3
.,60Z EVELYN EVA1
Notary Public Commission#EE 187024 3, t4
-a Expires April 5,2016 "` q' &Wd Ta,,F hftww„ t9
'"�%,R,1: ' BMW TMTmyFan kawanc M385-7019 Revised 01.26.10
City of Atlantic Beach APPLICATION NUMBER
�S r Building Department (To be assigned by the Building Department.)
r3+ .- r 800 Seminole Road /3 . Z
u _ Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
j�tj> E-mail: building-dept@coab.us Date routed:
City web-site: http://mm.coab.us
APPLICATION REVIEW AND TRACKING FORM
LWj .
Property Address 1 Ila Department review required Yes No
/ Building
Applicant: r d C11� //� anning &Zoning
Tree Administrator
Project: d 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:
TREE ADMIN. Second Review: ❑Approved as revised. ❑D ied.
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