225 5th St 2014 door CITY OF ATLANTIC BEACH
sy 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
a, INSPECTION PHONE LINE 247-5814
Ji31�?
Application Number . . . . . 14-00001091 Date 7/14/14
Property Address . . . . . . 225 5TH ST
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 650
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Application desc
door replacement
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Owner Contractor
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----------------
____
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FISCELLA, MOLLY G LOWES HOME CENTERS INC
4948 TELSON PLACE
225 STH ST
ATLANTIC BEACH FL 32233 ORLANDO FL 32812
(904) 486-4701
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . . Plan Check Fee 27 . 50
Permit Fee . . . . 55 . 00 650
Issue Date Valuation
Expiration Date . . 1/10/15
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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
-----------------------------------
2 . 00
Other Fees . . . . . . . . . STATE DCA SURCHARGE
STATE DBPR SURCHARGE 2 . 00
_ ________ -----
Fee summary Charged
Paid Credited Due
_ _ ------- . 00
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- - . 00
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
Grand Total 86 . 50 86 . 50 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
LU'14-U(-U( 15:SU Lso 9044864710 >> 3524733167 P 2/2
BUILDING PERMIT APPLjc,A.TIoN
CITY OF ATLANTIC$E.A,C]EIrf
� FILE
�
800 Seminole Road,Atlantic Beach,FL 32233
PY
Office (904)247-5826 Fax(904)247-5845
Job Address: t ?df ::5� c_ -57 -7r Permit Number:
Legal Description..�.��9 f �—Z�� parcel## -7 0/3
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el-
P
Valuatioik of WortS 4"- o v a
Proposed Work heated/cooled luou->I�eated/cooled
Class of Work(circle one): New. Addition Alteration Repair Move Demolition pool/spa windo. door
Use of existing/proppoos3ed s refs)rctrcle one): tnercial
If an existing sttruciure,is tie splriWer system x stalled (Circle one): Yes No N/A
Florida Product A pxoval L�9
For multiple products us ro uct approve orm
Describe in detail the type of to be ed:
Property Owner Information:
Name: QL L j$CL'l�L t! Address:
City sJ—I G ZIWAL14 State/ Zip
E-Mait or Fax#(Optional)
Coutractor Information-
Company Name: L010-VA64 A4056,- 4'T /NU Qualifying Agent:
Address:a ene_7v99_3 -. _City State_Aex Zip_ $�'
Office Phone 407- ?--91L,/ Job Site/Contact Number GK/S3S 3793 Fax#
State Certification/Registration# 4n&/
Architect Narrtc&Phone# ��
Engineer's Name&Phone#
Fee Simple Title Holder Name and,A,ddress �
Bonding Company Name and Address
Mortgage Lender Name and Address
dpplication is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
Issuance of a permit and that all work will be performed to meet the standards of alt laws regulatixg constrrstion in thisjurisdiction, This p¢rmlr b¢cvntts Hirtl
and void f work is not commenced within six(6)months.or if construction or work is susppended or abandoned for a pperiod of siz(o)months at any time after
work is commenced. I understand that separate permits must be secured for ElertricaCWork,Plumbing,Signs, WY ls,Pools,Furnaces,Sollers,Hearers,
Tanks and Air Canditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD,A.NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPER'T'Y. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN.ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
l ltereb certify that I have read and examined ti- a plication and know the same to be trite and correct. All provisions of laws and o antes g ernixg this
type o1 Ywork will be complied with whether sp�.ci ted herein or not The granting of a permit does not ptesum¢to give author o violate concel the
provisions of arty other federal,state, or local la-,,regulating construction or the performance of constructr'on.
4
Signature of Ownerl � Signature of Contracto
Print Name Print Name
Sworn to and subscribed before me Swo and su i ed before me
this -/ Day of v L 24 /Y this Day o 20/+/
BERT C CURTIS JR
Notary Pub its.; MY COMMI ®86209
`' ..oi .nm....
9 O ap,. EXPIRES Saptember 27.2619 sem.Pu � DEBRA L CARTER _ Revised 01.26.10
(4 T) Q163 FlortdaNOWNSO'_ - ®m 3 ' ° Notary Public-state of Florida
*:9 My Comm.Expires Mar 18,2017
Commission #EE 874638
City of Atlantic Beach APPLICATION NUMBER
rjs Building Department (To be assigned by the Building Department.)
t� 800 Seminole Road /� A l4 /
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 y
?L
r ftp' E-mail: building-dept@coab.us -Date routed: /
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z� C ✓ nt review required Yes No
Buildin
Applicant: /S 14m.5 Planning &Zoning
Tree Administrator
Project: DD �'� 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 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. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
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. ❑Deniea
Comments:
Reviewed by: Date:
Revised 05/14/09