533 SEASPRAY 2014 WINDOW 11 SS\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
X ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-S814
JOB INFORMATI:)N:
Job ID: 15-WIND-33
Job Type: WINDOW AND/OR DOOR
Description: window/doors
Estimated Value: $2,535.00
Issue Date: 1/27/2015
Expiration Date: 7/26/2015
PROPERTY ADDRESS:
Address: 533 SEASPRAY AVE
RE Number: 170703-0312
PROPERTY OWNER:
Name: OETJEN ET AL, ROBERT J
Address: 533 SEASPRAY AVE
GENERAL CONTRACTOR INFORMATION:
Name: DAHLGREN ENTERPRISES INC
Address: 9827 BUNCOME RD ERIC WILLIAM DAHLGREN
Phone: - -
PER lIT INFORMATION:
FEES:
PLAN CHECK FEES $31.34
BUILDING PERMIT FEE $62.68
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $98.02
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
POW BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
FILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 JA
qw��s!va"AE� , , a_ Office (904) 247-5826 Fax (904) 247-5845
Job Address: S33 Permit Nu
Legal Description Floor Area of S Ft. Parcel# 'q
Valuation of Work$ Proposed Work �eaited/cooled / Z 7- (,e 'n'0�n!heated/cooled Ll
Class of Work(circle one): New Addition Alteration Repair Move Demolition poollspa(!�7in�dow/doo
Use of existing/proposed structure(�)(�ircle one): Commercial (k:esid:e:�—w-_;
es N
If an existing structure,is a fire sprmider system installed? (Circle one): es No (N:
Florida Product Approval#
For multiple products use product approval ro—rm
Describe in detail the type of work to be performed: -bo&I- 1
Property Owner Information:
C4_
Name:�M Address: 'S
- I ?)'_�Phone ej 0 If U L�*
city State fLZip
E-Mail or Fax f_(Optional)_
Contractor Information:
-Al
CompanyName: Da_kl�~ QuafifyiN Agent:
Address: ;3/Z-L Leo"Vi P-c Citv Da_x State FL. Zip
Office Phone qov- qaY-059-4 Job Site/Contact Number 47q-0S-f2_ Fax# Str 8-ys-i
State Certification/Registration# Z!Z,�j
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Ap I a reby ade oba ape 1�d work and insta ork or installation has commenced prior to the
is i n m t ,0 t t to mZt It a thisjurisdiction. This permit becomes null
or- st f six(6)months at any time after
i�Ct' to / t r ii or, a period o
t al - rk w be e
)m t
(6 n
P
� a a t a t 0 ill p
0 p i th
_" id�ork s not'a eri"d' in 0 Ob, e, Wells,Pdols, Furnaces,Boilers,Heaters,
w k is, ,n,,d. I understand t Ct separate per it, . t
Tanks and Air Conifitioners,dc.
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 here certify that I have read and examined this.arplication and know the same to be true and correct. All provisions of laws and ordinqnces governing this
work will be comp d h n or not. The granting of a permit does not presume to give authority to violate or cancel the
1�1 lied with whether specyie erei
provist.ons of any otherfederal,state, or local law regulating construction or the performance of construction.
Signature of OwMr_______,_, Signature of Contractor
Print Name Print Name '_'!!��lc
...................................................... .... ..........................................................
S5 Mt and subscri�e�before me Sworn to and subscribed before me
tworn Day of V
t 201 — this
s Day of 20 t-�
Notary Public Notary P_ublic
ANDREW MOCKO M
AND
'f'� commission#EE 217492 Z, EW M CKO Revis0d 0 1.26.10
J �. c ission#EE 217492
omm
Expires July 17,2016 Z*:
July 17,2016
Expires
800-385-7019 V F,,,Med Thru Troy Fain Inwrl -3854019
B��dd Th.T,.y Fan In. nce 800
-0 o
E
0
> =
C�j
th
I L
o3 r-\
42,
a ;t4
CL
CA a3
bh
r-
U
C
—CR
ca.
EL
ca
a3
41.1
z rn- -4-
0 ca
-2
Ito
cz
kr)
Ln
9z
a3
E
0 0
Qn �:: U
4w,'
.2 E Ln
vs
"73 IW *� v
ca V) u
2
0
kn, �6 r--:
5. r-I 4
Ln
C)
I
v C
Ln
Ln
Ln Ca
v v 'n
4V
CZ
bb zj v ca. th w th
to
b
r- -r- ;To C). -0 0 r-
00
00, 0� rn tr;
cd
(Ld
fj
41
.2
0. ca 0
75 C's A�p
ua —Cd 0
cz cd 0
u w C4 u uo Ln
,6 t- 00 c� R 1— :2 Qr
U
el
u
rn
0
rA V)
0
TA
i;i 14
bi)
CL.
Ln
En
ca
ul
=ul cd
C>d
.cm co
> Cd
2
0 Z
o no.
to 0 .14
0
A4
Cd 0 0
X 0
Ed .14
J-.
0 0 co
u
U u
APPLICA I TION NUMBE]]R
City of Atlantic Beach
(To be assigned by the Building Department.)
Building Department
800 Seminole Road 3,3
5 P Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date routed'�//_I_
E-mail: building-dept@coab.us
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
SJ Department review required Ye 'No
Property Address: fm�3 3 1.4
IS'
--< Buiiding
ri 'mo
Applicant: Plannl_n�gZoning
I ree Administrator
Publi,-Works
Project: Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt 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 Hotelc and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: EPA/pproved. E]Denied.
(Circle one.) Comments:
4B U�IL D I N�G!
PLANNING&ZONING Reviewed by: Date:
TREEADMIN. Second Review: E]Approved as revised. OlDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 07127110