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1834 George St 2014 Door � t CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 WINDOW AND/OR DOOR PERMIT JOB INFORMATION: Job ID: 14-WIND-12 Job Type: WINDOW AND/OR DOOR Description: DOOR REPLACEMENT FL8832.1 Estimated Value: $3,361.00 Issue Date: 9/25/2014 Expiration Date: 3/24/2015 PROPERTY ADDRESS: Address: 1834 GEORGE ST RE Number: 172252-0010 PROPERTY OWNER: Name: TRIUMPH APOSTOLIC FAITH CHURCH Address: GENERAL CONTRACTOR INFORMATION: Name: ACE DOOR & WINDOW SERVICE Address: Phone: - - PERMIT INFORMATION: FEES: BUILDING PERMIT FEE $66.81 STATE DCA SURCHARGE $1.00 PLAN CHECK FEES $33.40 STATE DBPR SURCHARGE $1.00 Total Payments: $102.21 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION `Y`t N 2 CITY OF ATLANTIC BEACH 9 L U "D � FILEC800 Seminole Road, Atlantic Beach, FL 32233 SEP 5 2 Office (904) 247-5826 Fax (904) 247-5845 C 1 MV� Job Address: 3 S-free--� Permit Nf qfe y -- Legal Description 07 b 1 - 3 Parcel#. 1 -7 J�' �© ---Floor Area o q. t. Sq.Pt Valuation of Work$ 15 3 3 �' Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa windo oor Use of existing/proposed structure(s) (circle one): Commercial 'dential If an existing structure,is a fire sprinkler system instal a irc a one : Yes No Florida Product Approval# Y?.3 2-. y For multiple products use product approval orm Describe in detail the type of work to be performed: c or P 10eM P t1+ Property Owner Information: Ghu�,h ?(� otrn h osM ;G FbA Address: �g 3 GP_t�f e e'� Name: 11 City an fi'C State_Zip 3 a.�Phone (00"7 E-Mail or Fax#(Optional) Contractor Information: Company Name: Ce A10 Qualif ing Agent: 6 A Address: / City State Zip LZ� Office Phone7(a 7' 6¢��/ Job Site/Co tact Number V 1 C C Fax# 7 d27— S'/3 State Certification/Registration G(7 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. 1 certify that no work or installation has commenced prior to the issuance of ape 'it permit and that a!!work will be performed to meet tlae standards of all laws rpegulating construction in thisjurisdiction. This permit becomes mdl aodk osl o menced of/omderstan 1 that separ to permits must be seta e i for Electrical Workl Plumbing, Sigirs,aWellsoP olsxFUY taceS,sBOile s,t 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 BBEFORERRECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work wdill be complied with whether speTed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other.federal,state.or local law regulating construction or the performance of construction. h Signature of Owner Signature of Conti c �( p �( Print Name _k7� ...�./.W................. Print Namet. .................TI.1I.... .r................................................ ................................ Sworn o and subscribed b fore e Sworn to and subs ibed before me 20 this Day of 20/ this �'I''bay of t N�Xubl Notary Publi P Jennifer Patton commwAoNtF'14e753 Revised 01.26.10 EXPIRES: JUL 31,2418 f JO ATM SWITUH p fld!;••' BONDED THRU �1!!_ .u�cc�nN M EEl49t7ti 1st FLORIDA NOTARY.LLC City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) a 800 Seminole Road Atlantic Beach, Florida 32233-5445 14-WI ND-I2 Phone (904)247-5826 • Fax(904) 247-5845 �I �I (I_T_ LOU�t�r E-mail: building-dept@coab.us L Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ne-17> `4 sk rtngent review required lies o / � Buildin �� p W 47 Applicant: y v 000r Planning &Zoning ,� �o �� Tree Administrator Project: Doo r_e_P1 QC Lp./ I 1 Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Rece'pt 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: Approved. ❑Denie,,-!. (Circle one. Comments: (EDING / V V PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: []Approved 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