275 Beach Ave window 2013 Pr
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
............ ATLANTIC BEACH, FL 32233
........ INSPECTION PHONE LINE 247-5814
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Application Number . . . . . 13-00003815 Date 12/12/13
Property Address . . . . . . 275 BEACH AVE
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 16600
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Application desc
window/door
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Owner Contractor
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HOLMES MARK H LIVING TRUST J S BUILDING CORP
275 BEACH AVE 13058 TALL TREE DRIVE SOUTH
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32246
(904) 509-7048
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 135 . 00 Plan Check Fee 67 . 50
Issue Date . . . . Valuation . . . . 16600
Expiration Date . . 6/10/14
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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 . 03
STATE DBPR SURCHARGE 2 . 03
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 135 . 00 135 . 00 . 00 . 00
Plan Check Total 67 . 50 67 . 50 . 00 . 00
Other Fee Total 4 . 06 4 . 06 . 00 . 00
Grand Total 206 . S6 206 . 56 . 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
DEC 800 Seminole Roadj Atlantic Beach, FL 32233
Office(904) 247-5826 Fax(904)247-5845
Job Ad Avc-m i is Permit Number:
Legal Description i�o-T- C, eir)4k 10 Parcel#
ep P'loor Arta ot �;q.Pt. Sq.1,t
Valuation of Work$ 1G ) GOD Proposed Work hPated/cooled non-heated/cooled-
Class of Work(circle one): New Additiorl Alteration Repair Move Demolition pool/spa indow/
Use of existing/proposed structure(s) circle on --e �rcial aesidentia �1
er syNetm—stall 0�? ( '. 40 N /A
If an existing structure,is a fire spriW installed ircle one):
Florida Product Approval# \,j 0\06 6-to-S. - --
I
For multiple products use product appro I form
Describe in detail the type of work to be performed: 1)00/t "I Vow W/
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Property Owner Information:
Name: AAJL. )Ao A a 0- Address: :aa-S LCD L) r, r)
city MAcl-I State MZip Fhone (-Ct 02A3. L-ri lr,* i� Q
E-Ma'i I-o-r -Fax 9(Optional �'? I I
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Contractor Information: if'
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Company Name:::M jjtj%LZi m&- t!:aPj09,&-ryDM Qualifying Agent: ':�O 0
Addres ft A
ALL nMAL "No NL :5"-MI4 �City=p6e 1-14—AP4 V 3 1)4JL State
Job Site/Contact Number Fax 9
Office Phone
610
State Certification/Registration# e--Ib. 4�10S�1)1114
Architect Name&Phone# gamp- 0 r&S t��Zi") **)I(, - -A(.5
Engineer's Name&Phone 9 =uj%wjjp_y r,&L;rLjLj6, 043 cl 10
Fee Simple Title Holder Name and Addres-S
Bonding Company Name and Address
Mortgage Lender Name and Address
�pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance ofa permit and that all work will be pe?jbrmed to meet the standards ofall laws regulating construction in thisjurisdiction. This permit becomes null
and void ifwork is not commenced within six(6)months, or ifconstruction�rrworkk' ended or abandonedfor a period ofsLx months at any time after
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work is commenced I understand that separate permits must be secured ork,Plmbng,Skns, Wells,Pools,Pul`rn,ces, Hoileis, Heaters,
Tanks and Air Con"oners,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 exa ined th*s plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be coTplied with wh�Ne,s elci?ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any otherfederal.state,or local faw regulating construction or the peifiormance ofconstruction.
S�l A&N
Signature of Owner 04 Signature of Contiactor Jz&; —
Print Name M Print Name 14
4,(0-f- ............... ..... ...........st-.l
................................................ ..... ........k
Sworn to and subs e efore yne Sworn me_
thisZ10 Vayof. I avv-0J211- . 20/ 3 this C� 20
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Xor 1 4V�K-1, sion #DO 986504
My Comm.Expires Oct 14,2014
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Bonded Through National Notary Assn.
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City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 e le Road
t ant c each, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: 2-
Cityweb-site: http:/Ivvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: c7? L5 4f& 6# 4 Vo� Department review required Ye-o"No
A3T�in g � 7
Applicant: -Ma—nr,,n-g &Zoning
Tree Administrator
Project: /'777 -0 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: PA/pproved. [—]Denied.
(Circle one.) Comments:
(:B U I L:D I��G
PLANNING &ZONING Reviewed by: Date:—/C;t
TREE ADMIN. Second Review: FlApproved as revised. E]6/enied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09