857 Amberjack ln 2014 door CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001295 Date 8/26/14
Property Address . . . . . . 8S7 AMBERJACK LN
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 450 --------------
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Application desc
NEW BACK DOOR. FL4904 . 6
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Owner Contractor
------------------------
DARLGREN ENTERPRISES INC
KSN INVESTMENT CORP 9827 BUNCOME RD
9191 SKINNER PKWY # 501 FL 32246
JACKSONVILLE FL 32256 JACKSONVILLE
(904) 434-0582
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc - - 30 . 00
Permit Fee . . . . 60 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 450
Expiration Date . . 2/22/15 -----------------------
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONA1 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
Due
Fee summary Charged Paid Credited
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total 30 - 00 30 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PEIMITAPPLICATION
CITY OF ATLANTIC BEACH
FILE COPY 800 Seminole Road, Atlantic Beach, FL 32233
AUG 12 4
-5826 Fax(904)247-5845
Office(904)247 /-->.—
By
9:21 Permit Numb
Job Address: 65 7 5---ck e--t Parcel#
Legal Description of 1q. jq�
Valuation of Work L150. �Por.orp.sa Work Uaited/cooled n!heated/cooled_
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa
Use of exi�tingtproyosed structure(j)Wrcle one): Commercial <9��
Yes No N/A
u
If an existing struc, ure,is a fire nn er system installed?(Circle one):
Florida Product Approval# 70Y. 6
For multiple products use pro uct approval form
Describe in detail the type of work to be performed: J�Usk(( ,�Aw f3,xk L)CW,
Property owner Information:
Name: K 5.A) --T-.,rVVCS4-Me-ff 001-P Address: '?/f/ 5k.'-imec PtY4V A'S01
City State -jilff—& Phone
E-Mail or Fax#(optional_
Contractor Information:
Company Name: gg-^Lr�,vs-e.) Qualifyi!2$Agent: 6-514(c t>- ' /a
City qt W F6 ZijD
Address: 31.12, Lten r4dt
Office Phone Job Site/Contact Number 7,oll 4'Jy 0$5 a. -Fax#--.r2 7 SM-1
State Certification/Registratiori#- Z�—ieo- ljZjq'7S
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
A ca i eb a b ain a do he �k d a?,a as indicated. I certify that no work or installation has commenced prior to the
m t wo t ti 0 ' i, ng construction in thisjurisdiction. This permit becomes null
it t �ta r a 1.a- fsj months at any time after
'�0 0 1 is s �xpu`rnaces,Boilers,Heaten,
n r k or abandonedfor aWeriod o
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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 Y61TIi NOTICE OF
COMMENCEMENT.
d this U t' nd kn the same to be true and correct. All provisions of laws and ordinances governi.nj),,this
I hereby ce that I read and examine ica 0 a ow to violate or ca el t
type oj war will be am ied with whether cl he * or not. The granting of a permit does not presume to give authority nc he
provisions 0 rfe 1,state,or local la construction or the peiformance ofconstruction.
Signature of Signature of Contractor L��
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469� Print Name I�......................b!!!�hb .........................................
Print Nam ............ .. ............... ....... ....
Sworn to and subs ritied befors Pie I L11
Swo an ubscrjbed before me Day of AjAja
this Of this U116+— 20"
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Notary c .... 'ESSICA SMT o ission#FF 029375
E v 01.26.10
tommission#EE 128051 xpires June 20,201ke
2015
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C 12 15 08 ADDED SPAC WOOD-M SIM D"
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8 1 2 08 HINGE SCREW LENGTH TWS F—PART OR ASSEWLY:
:E (n A 7120 07 ADDED VENTLITE swsl WEST CHICACO, IL 60185
o A TYPEA aEVABONS
NO. DATE &GOAM AIM
REVISIONS Ig
City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
Building Department
800 Seminole Road
i 1215
z Atlantic Beach, Florida 32233-5445
-5826 - Fax(904)247-5845
Phone(904)247 routed:
E-mail: building-dept@coab.us Date =__j
City web-site: http://wvv\&,.c;(),-ib.us
APPLICATION REVIEW AND TRACKING FORM
L Q�elpartment review required Yes ' No
Property Address: (261 aq, (
Applicant: T��hl a - Planning &Zoning
to--\ �Y�� --free Adrninistrator
Project: NlCkh) y adL Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature _
Other Agency Review . 73ermit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Ma,--,,; ,ment District
Army Corps of Engineers
Division of Hotels and Rest- rants
Division of Alcoholic Bever� :)s and Tobacco
Other: -
APPLICATION STATUS
Reviewing Department First Review: ��Pproved. DDenied.
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Rev, FlApproved as revised. ElDenied.
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