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CITY OF ATLANTIC_BEA
800 SEMINOLE R6 D
J
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000053 Date 1/21/14
Property Address . . . . . . 1230 OCEAN BLVD
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2324
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Application desc
WINDOW REPLACEMENT
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Owner Contractor
-
------------------------
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ETTLINGER, ELLIOTT FARRELL & PELLA WINDOW AND DOOR
CAROLYN 8174 BAYMEADOWS WAY W
1230 OCEAN BLVD JACKSONVILLE FL 32256
ATLANTIC BEACH FL 32233 (904) 731-8330
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc .
Permit Fee 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . Valuation 2324
Expiration Date . . 7/20/14
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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 65 . 00 65 . 00 . 00 . 00
Plan Check Total 32 . 50 32 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 101 . 50 101 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 12 1'd.,,/-t/a 0. a Permit Number: � J
Legal Description (��� G ' -1S-0119' Parcel# 1 -719Q I
�1 Floor Area o q. t. Sq.Ft
Valuation of Work$-d 3or Y Proposed Work heated/co d non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa indow/door
Use of existing/proposed structure(s)(circle one Commercial esid
If an existing structure,is a fire sprinkler syste stalled?(Circle one es No N/A
Florida Product Approval# l .X
For multiple products use product approve rm � - A ,, 1,, 4r :;Describe in detail the type of work to be performed: geD/a w 5 z!r 1/�/G�s Sr7� r��
Property Owner Information: /� J
Name: l Go G f 44i'A e.!' A 3Q / Ca/� a/,,a
City16 State ip 4931,3 JPhone
E-Mail or Fax#(Optional)
Contractor Information:
-4�4 D9tQ/CompanyName: Aa (A40J
Address:
CityState Zip
Office Phone 1-7'fr3l—O P W Job Site/Contact Number Fax#
State Certification/Registration# G g L O 4 G 7 1'.1.
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address y'
Bonding Company Name and Address
Mortgage Lender Name and Address
Application 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 -
tssuance qJ'a perm:[and that all work rv�ll be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null �s�asaaa�� f
and void t work is not commenced within six(6)months,or if construction or work is sus ed 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 Electrical�rk,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Condidoners etc
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS L&Je
TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING
CONSULT H
LENDER OR AN ATTORNEY BEFORE RECORDING YO'URNO ICE OF
Od.aj f
COMMENCEMENT. fa.�
1 hereby certify that I have read a ined this plication and know the same to be true and correct. Al!provisions ojlaws and ordiwnces governing thisLA6 -
type of work will be complied ith a er s ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the
proviatam ofany other jeder ,st o aw regulating construction or the performance ojconstruction. t
>r•�!'+Y
Signature of Owner Signature of Contractor
Print Name (�t CJT'4' �(tif C?.l Print Name
Sworn tQ and subscti �dbeforme e � Swornto�,�.nnd subscribed before me w ^�
this y of 20 this f�7 flay of 1' 20 t/
T
N 'Plubhe otaryZ 1
Rev'
AMBER FLENKER %PTI MOTHY R.O'M&LEY ® p
NOTARY PUBLIC ?�� ' *
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STATE OF FLORIDA ' MY COMMISSION It FF 042794 A. EXPIRES:August 7,2017Comm/#EE21502 �or h� Bonded Thio Notary Public Utdonaiters Expires 7/11/2016 Z O j
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http://apps.coj.net/PAO—PropertySearch/Traverse/Traverse.dll?width=300&heighr300&... 11/20/2013
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road 141—
'J
—' r� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
< <r E-mail: buildin de t coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �2 ��� ✓ WDeartment review required Yes No
Applicant: 71 // a-, ning
trator
Project: Public Works
'�— Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Dateof 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:
APPLICATION STATUS
Reviewing Department First Review: Approved. ElDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: / / ' Date:-L-/6
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