1065 Hibiscus St 2014 windows j►.,rl,yr
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
MITIS CA" 91V A^M CSP NEXT DAV TNc-RPCIIOFJ* 7a7 RATA
JOB INFORMATION:
Job ID: 14-00001500
Job Type: WINDOW AND/OR DOOR
Description: WINDOW DOORS
Estimated Value: $2,000.00
Issue Date: 10/8/2014
Expiration Date: 4/6/2015
PROPERTY ADDRESS:
Address: 1065 HIBISCUS ST
RE Number: 171088-0108
PROPERTY OWNER:
Name: HOMES, SALT AIR
Address:
GENERAL CONTRACTOR INFORMATION:
Name: PLUMBING BY JOSH
Address:
Phone: - -
PERMIT INFORMATION: BUILDING DEPARTMENT:
2010 FLORIDA BUILDING CODE, 2008 NATIONAI 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
FEES:
PERMIT FEES $60.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
PLAN CHECK FEES $30.00 "
Total Payments: $94.00
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 G d
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 SEP 10 014
Job Address: 10&5&S l 1 $C-V S S+- +, �e
' Permit Num
Legal.Description Parcel#
ao
Floor Area o t. t
Valuation of Work$ Z 6 Q o r Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approva orm
Describe in detail the type of work to be performed: !N
Property Owner Information:
Name: 5A,--F A j 1z- No VKES l N k?. Address: p 6- Boy, 5o$5n
City Jjy, M,�, 1FL- Statepi-Zip22- J Phone S7 6 o-7
"�—
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Q L Qualifying Agent:
Address: s o VC, City ,jrt,•tC State F=L Zip,3 AA/
Office Phone X37-57 Job Site/Contact Number Fax#
State Certification/Registration# G.fZC.. 39a�
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
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 now ork or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended 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 Work,Plumbing,Signs, Wells, Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,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 examined this a lication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether sped ied herein or not. The granting of a permit does not presume to give authority to violat or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner(Q ,� Signature of Contractor
Print Name CSL �.Ucm.........�.iZrk�l......'..................................... Print NameV�`►A.J....../ .: ��IeTK
........................................
Befor Befor e
this Day of 20 thi F rias 20
N t h
hir Y
miF p86990
s
Nota i i4 Shirley L Graham Not c Ex s
M. My commission�f o86990
�.r Fxpre502'14�2WA Revised 01.26.10
'yM
"U'%J', City of Atlantic Beach F -
APPLICATION NUMBER
Building Department
u1 (To be assigned by the uilding_Department.)
-.>` --•.� 800 Seminole Road /�' /� O
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: IO
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �(0� CA 5 Department review required Ye Ido
ui d'
Applicant: h Planning &Zoning
Tree Administrator
Project: 'b 0 aJ Public Works
Public Utilities
Public Safety
Fire Seivices
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Rece pt
of Permit i/erified By Date
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: [qApproved. ❑Denied
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date:Q—ll
TREE ADMIN. Second Review: A
❑ pproved as revised. ❑Denied.
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