427 INLAND WAY WIND �S.y Jl'rlri
Sts CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-WIND-578
Job Type: WINDOW AND/OR DOOR
Description: exterior door FL 13541.4
Estimated Value: $963.00
Issue Date: 12/15/2014
Expiration Date: 6/13/2015
PROPERTY ADDRESS:
Address: 427 INLAND WAY
RE Number: 169463-1526
PROPERTY OWNER:
Name: TILLMAN, STANLEY W
Address: 427 INLAND WAY
GENERAL CONTRACTOR INFORMATION:
Name: BUTTERFIELD REMODELING LLC
Address: 4220 PLANTATION OAKS BLVD APT 1516 SIDING ONLY
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $55.00
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $27.50
STATE DBPR SURCHARGE $2.00
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845p-
Job Address: 427 INLAND WAY ATLANTIC BEACH, FL. 32233 permit Number:/7"�s/*�� 2
Legal Description 42-018 37-2S-29E OCEANWALK UNIT 4 LOT 13 Parcel# 169463-1526
Floor Area of Sq.Ft. 7q.-F3096
Valuation of Work S 963.00 Proposed Work heated/cooled 2500 non-heated/cooled
Class of Work(circle one): New Addition Alteration e ai Move Demolition pool/spa window/door
Use of existing/proposed structu ire e e): Commercial e�es
If an existing straetare,is sprin er syste installed? (Circle one): No N JA
Florida Product Approval FL 13541.4
For multiple products a pro uct appio orm
Describe in detail the type of work to be performed: REPLACE EXTERIOR DOOR
Property Owner Information:
Name: DONNA TILLMAN f S-;N -rIVLMA-rJ Address: 427 INLAND WAY _
City ATLANTIC BEACH State FL Zip 32233 Phone 904-247-1469
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: BUTTERFIELD REMODELING, LLC. Qualifying Agent: CLINT BUTTERFIELD
Address:deft PLANTATION (MAKS BLVD #1516 City QRAN(,F PARK State FI Zip 32065
Office Phone an4-ss3_840a Job Site/Contact Number 90433-8409 Fax#
State Certification/Registration# NSS 14
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'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 sus ended or abandoned fora 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, ells,Pools,Furnaces,Boilers,Healers,
Tanks and Air Conditioners,etc-
WARNING
tcWARNING 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 hereb cert that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o7Mrk will be complied with whether speci�d 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, law regulating construction or the performance of construction. _
Signature of Ow. Signature of Contractor
Print Narne D s'TIkJ '(l L. M -Print Name .CLIN.TBUTTERFIEL .........................
Sworn and subscribed before me Swo and subs ed before e
this L Day of bee ,20/� this Day of / 20
Notary Public Notary Public
s..�"'�'• W CARL BROWNtif,;ly •, CAROL JEAN HUGHES d 01.26.10
Notary Public-'State'of Florida =gY Commission#FF 171959
• •i My Comm.Expires Jul 23,2017 '
z : :»;. :d,-.Expires December 3,201
:' Commission i FF 25413 . eamw Thru Troy Fin Inum. 5»t9
''� T ft*IMbnM Nohry Assn.
r
City of Atlantic Beach APPLICATION NUMBER
�uildiirag Dd'partmeL'il� -o be assigned by the Building De art n(.) �
800 Seminole Road
Atlantic Beach, Florida 322:33-5445
Phone(904)247-5826 - Fax(904)247-5845 A /
City web-site: http://wviw-,,oab.us )ate routed: 2, (f
APPUCATW !+ REVIEW. AND TRACK�HG FORM
Property Address: �2�f � 9e arirPrac'nt review required Yes No
Buildinc
Applicant: r i 1Planning .':Zoning —
I ree Administrator
Projec 0 Public Wor-ks
Public Utilities
Public Safety
Fire Servlices . .
Review fee $ Dept Signature
.ONTRACTOR EMAIL AIDDRESS
XINTRACTOR CONTAC° -
APPLICA`I1 H STATUS
Reviewing Departrinervt f=irst Review: proved. ❑Denie-1
(Circle one.) Comments:
CBUILDING
PLANNING 8:ZONING
Reviewed by: _ Date:-12-'9
TREE ADMIN.
Second Review: ❑Approved as revised. ❑D led.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES
Third Review. ❑Approved as revised. []Denier!.
Comments:
Reviewed by: Date:
VISED 092520-14'