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28 Forrestal Cir 2014 replace door CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000402 Date 4/01/14 Property Address . . . . . . 28 FORRESTAL CIR Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 411 ---------------------------------------------------------------------------- Application desc REPLACE DOOR ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SHUDA, MARY E. BUTTERFIELD REMODELING LLC 28 FORRESTAL CIRCLE P 0 BOX 1954 ATLANTIC BEACH FL 32233 CLINT BUTTERFIELD ORANGE PARK FL 32067 (904) 333-8409 ---------------------------------------------------------------------------- Permit . . . . . . WINDOW AND/OR DOOR PERMIT Additional desc . . Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50 Issue Date . . . . Valuation . . . . 411 Expiration Date . . 9/28/14 ---------------------------------------------------------------------------- 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 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- 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. Business & ProfessJonall Re I tion A�li W — j :3= Su rch a rge Stats&Facts FBC Staff ECIS Site Map Busin s Product Approval Profels2t`nal OJI-11 USER: Public User Regulation >Product or Application Search >Application List>Application Detail FILE COPY -R2 FIL# FL12769 Avq*f Application Type Revision Code Version 2010 Application Status Approved *Approved by DBPR. Approvals by DBPR shall be reviewed and ratified by the POC and/or the Commission if necessary. Corrinents Archived Product Manufacturer JELD-WEN Address/Phone/Enna il 3737 Lakeport Blvd Klamath Falls, OR 97601 (541) 205-1171 garyr@jeld-wen.com Authorized Signature Gary RDllinson fbc@jed-wen.com Technical Representative JELD-WEN Corporate Custon-er Service Add ress/Phone/Erna il 3737 Lakeport Blvd. Klamath Falls, OR 97601 (800) 535-3936 custornerserviceagents@jeld-wen.com Quality Assurance Representative Address/Phone/Email Category Exterior Doors Subcategory Swinging Exterior Door Assemblies Compliance Method Certification Mark or Listing Certification Agency Validated By Referenced Standard and Year(of Standard) Standar Year ASTM E330 2002 ASTM E331 2000 TAS202 1994 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 03/07/2013 Date Validated 03/07/2013 Date Pending FBC Approval Date Approved 03/14/2013 Summary of Products City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by t�e Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: 7J� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property AWdmss: fin�L ._Pap�ent review required Yes "No f�, Building Applicant: Planning &Zoning Tree Administrator Public Works Project: 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: PApproved. E]Denied. (Circle one.) Comments: (2EF) PLANNING &ZONING Reviewed by: Date: 3-do-d' TREE ADMIN. Second Review: FlApproved as revised. [—]De PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. E]Denied. Comments: Reviewed by: Date: Revised 05/14/09 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH FILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 28 FORRESTAL CIR. N. ATLANTIC BEACH, FL. 32233-3325 Legal Description 30-56 38-2S-29E ATLANTIC BEACH VILLA UNIT I LOT 9 BLK 2 Parcel# 171759 0000 Floor77e_a_oT_ Sq.Ft. Sq.Ft Valuation of Work$ 411.00 Proposed Work heated/cooled 1185 non-heated/cooled 1453 Class of Work(circle one): New Addition Alteration (�R:epaDiir Move Demolition pool/spa window/door Use of existing/proposeol�str circle one): Commercial 6esi ential e -=* e, s If an existing structur a fire spri e stem installed?(Circle one): es 0 (N=/A Florida Product pr al# 14111.2 v For multiple prosuc use product a val form Describe in detail the type of work to be performed:Install entl:y steel door. Property Owner Information: Name:MARY SHUDA Address: 28 FORRESTAL CIR.N. City ATLANTIC BEACH State FL —Zip 32233-3324—Phone 904-241-7647 E-Mai I or Fax#(Optional) Contractor Information: Company Name:BUTTERFIELD REMODELING LLC Qualifying Agent: CLINT BUTTERFIELD Address:4220 PLANTATION OAKS BLVD#1516 City ORANGE PARK State FL Zip 32065 Office P�one 904-333-8409 Job Site/Contact Number 904-333-8409 Fax# 904-771-0981 State Certification/Registration# NSS-14 Architect Name&Phone 4 Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address OLD REPUBLIC SURETY CONW.PO BOX 1635 MILWAUKEE,WI.53201 Mortgage Lender Name and Address A ca re ade b an a er �,do work a din a rtify that no work or installation has commencedprior to the Or' to m7 t s ' * h' ' 'diction. This permit becomes null s y ha 0 'k bme it et Z sta ng ction in t isjurls fsi (6)months at any time after i_ Ot �s, or, c t c or=nedfor a period o X or P P(6 Plumbing, nce wi n L c d thin s m i It ru Signs, Wells,Pools, Fjirnaces,Boilers,Heaters, to 'io ' �rm ap _ It i pp" 7 k s 0 com e s ua 0 " idi -0, ' 7 'k is c� _ 'd. 'stand t t separate Per ts must be sec enc T nks�A,Condift", ,d, 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. lhere certify that I have read and examined this plication and know the same to be true and correct. All provisions oflaws and ordinances governing this 1�work will be complied with whether speciXied herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any otherje�d*eral,state, or local la"w r�e aung construction or the peifomance of construction. Signature of Owner Signature of Contracto 'y Print Name CLINT BUTTERFIELD Print Name MARY S .......................................................... ...................................F-a._ wu U- Sworn to and subscribed before e ......... wo7mito and subscrib 9 nMROL jEAN HUGHES this 205T ww" is -tL Day of mm on#FE 040" Day of A Sm 81 ftidiai6 Exores pecernber 3,2014 my Cam.flom Avg Is,2016 Tft Try Fain Inssam 8*38&70ig -No 0 12 027393 otjry P Ic otary 1��Wic Revised 01.26.10