1763 E Park Ter 2015 window CITY OF ATLANTIC BEACH
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}' 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-244
Job Type: WINDOW AND/OR DOOR
Description: window/ door
Estimated Value: $2,283.00
Issue Date: 2/6/2015
Expiration Date: 8/5/2015
PROPERTY ADDRESS:
Address: 1763 E PARK TER
RE Number: 172020-0412
PROPERTY OWNER:
Name: HAGIST TRUST, JULIETTE B
Address: 1763 PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: WINDOW WORLD OF NE FL
Address: 8110 CYPRESS PLAZA DR APT 405 BRIAN WALL
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
BUILDING PERMIT FEE $61.42
PLAN CHECK FEES $30.71
STATE DBPR SURCHARGE $2.00
Total Payments: $96.13
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Building Permit Application
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904)247-5845
Job Address: Permit Number: l s -IVI IUn r 0 y
Legal Description: Parcel # 1 7j'ZD -0412-
ki je>ItS1 Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ ,Li��c� Proposed Work heated/cooled non he ed
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa indow/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
o
If an existing structure,is a fire sprinkler system installed. (Circle one): es N/A
Florida Product Approval #F1 5213• I I CA F L8134-1-3
For multiple products use product approval form
Describe in detail the type of work to be performed: Replace windows size or size 2
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ProperPrope!U Owner Information: _ •^^ ,[
Name: nth Wt 1 +"tm-4- Address: /743 Park T e Y�c•e•. Z�s/
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City:/n't�K ri2- ac State: FL zip: 32-2--3 3 Phone:
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Window World of NE Fla Qualifying Agent: Brian Wall
Address: 8110 Cypress Plaza Dr., Suite 405 City:Jacksonville State: FL Zip: 32256
Office Phone: 3MJ6?_Pt ontact Number: Fax#: 904-443-7778
State Certification/Registration#: CBC 1259710
Architect Name&Phone#:N/A
Engineer's Name& Phone#:N/A
Fee Simple Title Holder Name an Address:N/A
Bonding Company Name and Address:N/A
Mortgage Lender Name and Address:N/A
Application is hereby made to obtain a permit to do the work and installations as indicated. l 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,Phumbing,Signs, Wells,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.
/hereby certf,that 1 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 will
be complied with whether specified 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.
J
Signature of Owner Signature of Contractor y
Print Name 2 j✓a� i a/j► Print Name
Sworn to an subscribed before me Sworn to subscribed be ore e _
't'•this Q_"-Day of J4 �r , 20'S this p „,� u�w ^ucttc^ry M ,20—
ON#FF049667
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, MICHAEL REs sepiemlmer
Nota Public +� '' s NolaryService.com
•i •r MY COMMISSIONMFF133316 evised01.26.10
EXPIRES June 16,2018 ritiES. .
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City of Atlantic Beach APPLICATION NUMBER
t �� , (To be assigned by the Building Department.)
J. �1 Building Department
800 Seminole Road // Z
') Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845 Z
E-mail: building-dept@coab.us Date routed: Z.
City web-site. httpJ/www coab.us
APPLICATION REVIEW AND TRACKING FORM
/762 ment review required Yes o
Property Address: Buildin
Planning &Zoning
Applicant: IA/� �1�� U�d Tree Administrator
Public Works
Project: ,V Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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:
APPLI TION STATUS
Reviewing Department First Review: Approved. []Denied.
(Circle one.) Comments:
UILDI
PLANNING &ZONING Reviewed by: Date: ' el-
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:
II
i
Reviewed by: Date:
Revised 07/27/10