360 3rd St window 2014 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
M U S I CAL t BY 4 r M r 0 K N EX I DAY-A.1-14-a-P E%—�l-L%Uj N 24 7-3 81:4
JOB INFORMATION:
Job ID: 14-WIND-269
Job Type: WINDOW AND/OR DOOR
Description: windows
Estimated Value: $5,232.00
Issue Date: 10/27/2014
Expiration Date: 4/25/2015
PROPERTY ADDRESS:
Address: 360 3RD ST
RE Number: 169787-0000
PROPERTY OWNER:
Name: CAMPBELL, PATRICK H
Address: 360 3RD ST
GENERAL CONTRACTOR INFORMATION:
Name: LOWES HOME CENTERS INC
Address:
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $76.16
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $38.08
STATE DBPR SURCHARGE $2.00
Total Payments: $118.24
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLA�NTICREACH
COPY 800 Seminole Road,Atlantic 13each,FL 32233
Office(904)247-5826 Fax (904)247-5845
Job Address- Perm'Pulu
-e
44
Legal Description
j,v Floor Area 6f---9cq-KFt. t U/�
Valuation of Work Proposed Work heated/cooled ated/cooled
Class of Work(circle one): New Addition Alteration Repair Move L)-amolition pool/Is win or
Use of existing/proposei�structtkre(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler syAtew installed?(Circle one): Yes No N/A
Florida Product Approval 4- 16, e 1Z 3 3 -71
For multiple products use product approval form
Describe in detail the type of work to be performed: A&PA4�
----------
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ProDertv Owner Information;
Natne: 4--e- Address-
city staft?T4 -6=7
E-Mai I or Fax#(Optional A4—
Contractor Information-
Company Name: 'uaJifying Agent- 10611-136-
Address: oe/,) AP*1 7,9',`c/`/- City (f��JAAW,0 zi
P
de
Office Phone A/07-A�� Aob Site/Contact Number
State Certification/Registration
Architect Name&F�Qne#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Addres5
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication is hereby made to obtain ORermit to do Me work and installations as indicated. I Certify that no work or installation h04 commencedprior tQ the
issuance ofa permit and that all work will be per
formed to meet the standards of all lawT regulatirfg construction in f1lisjwIsdiction. TilispermilUcomesnidt
and vaid ffwork is not commenced within six(6)months. or ifconstruction or work is suspended or aban(- nedfor aWeriod ofsixfi months at an or
y time aftL
work a commented. f understand that separate permits must be semredjor Electrical'Work,Plumbin, �-Jjs,pooLs, urnjees,Evilers,H,,tem,
Tanks and Air CandidonerS�de-
WARNING TO OWNER: YOUR FAILURE TO RECP ,,�1,�D 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.
? 1,
I heraby certffy that I have read and examined thisqoplicadon and know the same to be trife and correct. All provisions oflaws and rtanc overning this
e5
"a.
V
�vpe of work-will be coTplied with whether specified herein or not. Thezwantingo `�h . I
a permildoes not presisme to give 0 Vi or concel the
0 4
provi,vions of any otherifederall or local.law re latinaf onstruction or the Pe�formancr of romtruclion.
n
Sipature of Own Signature of Contractor)
Print Name Print Name
_g�
..........
Sworn 1p and 5ubscribe_4 before me Swo and 3ubs,7rib before me
this_ZDayof- 0 L", this Day of 20,*/
R013ERjQrljRTIQ I
Notary ub&
otary Pubb . .�! My COMMISSION#FF056258
EXPIRES September 22.2ID17
107)398-01
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�A NotarY
M Com�i.Expires MariB.2017 1
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()Mmission EE 874638 0
OF
Doc # 2014237181 , OR BK 16949 Page 285, Number Pages: 1 , Recorded 10/20/2014
at 09: 12 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
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NOTICIS OF COMMENCEIMNT
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APPLICATION NUMBER
City of Atlantic Beach
o be assigned by the Building Department.)
Building Department .0
800 Seminole Road AV AA ;6 2,&
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 -)ate routed: 40
City web-site: http://www.ci:)ab.us
APPLICATION REVIEW AND TRACtJNG FORM
2 ired
Yes 0
parhvwunt review required,
Property Addres, B ildin,
Planning &Zoning
Applicant: LA
Tree Ar� nistrator
-Public �-ks
Project:
--Public L'Aities
Public Safety
Fire Ser\/';-,es
Review fee $ Dept Signature
CONTRACTOR EMAIL ADDRESS
CONTRACTOR CONTACT #
APPLICATION STATUS
Reviewing Department First Review: EyApproved. DDeni�.::
(Circle one.) Comments:
E� Date. �27-
PLANNING &ZONING Reviewed by:
TREE ADMIN. Second Review: DApproved as revised. [Eo]]Den
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES
Third Review: nApproved as revised. FIDenied.
Comments:
Reviewed by:_ Date:
REVISED 09252014