2233 Seminole Rd # 32 Window 2014 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
�. ATLANTIC BEACH,FL 32233
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WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 14-WIND-657
Job Type: WINDOW AND/OR DOOR
Description: WINDOW/ PORCH
Estimated Value: $2,100.00
Issue Date: 12/31/2014
Expiration Date: 6/29/2015
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 032
RE Number: 169519-0162
PROPERTY OWNER:
Name: COPLEY, ELIZABETH A
Address: 2233 SEMINOLE RD APT 32
GENERAL CONTRACTOR INFORMATION:
Name: DKB ENTERPRISES INC.
Address: P O BOX 331458 QA DONALD KEN BERGERON
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $60.50
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $30.25
STATE DBPR SURCHARGE $2.00
Total Payments: $94.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City®x Atlantic Beach
APPLICATION NUMBER
Building Deparrtme`
800 Seminole Road -o be assigned by the Building Department.)
6
E
Atlantic Beach, Florida 322:33-54451 � //�� ��7
Phone(904)247-5826 • Fax(904)247-5845
I i
City web-site: htt //www.,�oab.us f date
routed:
APPLICATWNREVIEW AND TRACK8NG FORS
Property Address � �- � NQ `L d scant review require yes b�®
/ Building
Applicant: ,L l5 S
L
Planninc '..Zoning
Tree Acinninistrator
Pmject: V ,7�X�5 Public Works
Public Lhiiides
Public Safety
Fire Servs c.es. . .
Review fee $ Dept Signature
CONTRACTOR EMAIL. ADDRESS
CONTRACTOR CONTACT
APP I ATIOi STATUS
Reviewing DepartmentFFirstRAproved ❑Denie%;(Circle one.)
BUILDING
PLANNING &ZONING
Reviewed by: Date: /Z 2
TREE ADMIN. - i—� --- --- - --
Second Review: []Approved Approved as revised. nied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES
Third Revievtir Approved as revised. ❑Denie
Comments:
Reviewed by: , _ Date:
VISED 09252094'
BUILDING PERMIT APPLICATION
F cn CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
ILE
Office (904) 247-5826 Fax (904) 247-5845
Job Address: Z33 51 m,Yto% d ltu;k- 1pl,,6t aeA PL Permit Number: /`f'G'1-pK)- GIF7
Legal Description ( 4dD `1? 'UrP1 3z.->33Parcel#
Floor ea o q. t. �t
Valuation of Work$2/0 0 . 0 V Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteratio Repair Move Demolition pool/spa window/door
Use of existing/proposed stru re(s) (circ o e): Commercia 1
If an existing structure,is a re sprinkler sy a installed? (Circle on No N/A
Florida Product Approval#
For multiple products use roduct approv orm
Describe in (detail the type of w performed: "L((r$A)C 0 i,.cT U-) I,y 0000S Cwt) 9kA/-
D 12 C- I4
Property Owner Information:
Name: -7 u�6zi-h �011,c/ Address: 0'03 SQrn n W cp Ye?,t 3 z
City l Q,yt 6-C, 6,tal-? State EZip ,� 33 Phone 1?b 7d – 4 3 3
E-Mail or Fax#(Optional)
Contractor Information:
Company Nam ��t'(j ��� KISi�S .�'NC Qualifying Agent: �a/V►'i L (� I3�G IrAo'J
Address: iy. AO X 33 1 L4TRr City 471-4uric ac It State Z_ Zip3 223
Office Phone OLJob Site/Cont ct Number Fax# 9 4 7S'8= SCc/j-y
State Certification/Registration# CIL C 9- 11) y 3
Architect Name&Phone# A)m
Engineer's Name&Phone# 1-0
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 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 suspended or abandoned for a period of six(6)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, ells,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 thisplication 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 speci ted 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.
Signature of Owner Signature of Contracto ,('
Print Name1...... .. . ... .... .. .....�e................................................ Print Name Q t...... �.... ..
Before;e . / Before me
this I Day of� 4� 20/ �-f' this g!�kDa),;,of ec t Q 20
EISIE MEIpgTT
Nbtary Public"Nowwon1if11A my t blic SANDRA 8EMR0
tow4we M!a 14816".
i -': •~ MY COMMISSION 0 EE" 01.26.10
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