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603 Camelia St 2015 Window/door 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: 15-WIND-394 Job Type: WINDOW AND/OR DOOR Description: 2DOORS Estimated Value: $737.00 Issue Date: 2/27/2015 Expiration Date: 8/26/2015 PROPERTY ADDRESS: Address: 603 CAMELIA ST RE Number: 170917-0900 PROPERTY OWNER: Name: WALINSKY, LILLIAN Address: 603 CAMELIA ST GENERAL CONTRACTOR INFORMATION: Name: BUTTERFIELD REMODELING LLC Address: 4220 PLANTATION OAKS BLVD APT 1516 SIDING ONLY Phone: - - PER lIT INFORMATION: FEES: PLAN CHECK FEES $27.50 BUILDING PERMIT FEE $55.00 STATE DCA SURCHARGE $2.00 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 APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904) 247-5826 Fax(904)247-5845 E-maili building-dept@coab.us L__�ate routed: C;' Cityweb-site: http://www.coab.us L APPLICATION REVIEW AND TRACKING FORM DV rt Property Address: CfT-- gp4rtment review required Yes --No Building �) �7 Applicant: 'Pra-nnina & Zoning Tree Administrator Project: _Nhip %/,MYN iA Public Works 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 Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other APPLICATION STATUS Reviewing Department First Review: pproved. []Denied. (Circle one.) Comments: (�B�UILDI PLANNING &ZONING Reviewed by: Date: TREE ADM IN. Second Review: E]Approved as revised. LIDaied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [:]Approved as revised. F]Denied. Comments: Reviewed by: Date: Revised 07127/10 UITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904)247-5826 Fax(904)247-5845 Job Address: 603 Permit Number: /-5--all kx)—39y'— Legal Description_18-34 - Parcel# 170917-0900 oor Area.of Sq.Vt. sq.1't — Valuation of Work$ 737.00 ProposedWork heated/cooled 1150 non-heated/cooled 61 Class of Work(circle one): New ' Addition Alteration, EEO Move Demolition pooyspa window/door Use of existing/proposed structure(s)(circle one): Commercial esidentia If an existing structure,is a fire sprinkler system installed?(Circle one):14e;PQo Florida Product Approval# 13541.4015213.1 For multiple pro ducts use Pro u_ctap�p'_r'o�uvzalt��m� Describe in detail the type of work to be performed: REPLACE EXTERIOR DOORS (3) rip, r Property Owner Information: Name: STAN WALINSKY Address: 603 CAMELIA ST. CitY_AILANTIG' BEACH __—State — — FLZip 32233 M...—e = E-Mail or Fax#(Optional) Contractor Information: Company Name: BUTTERFIELD REMODELING, LLC. Qualifying Agent: CLINT BUTTERFIELD Address:A22Q PLAN '4 OAKS BLVD,#1516 City DERANGE PA State EL Office Phone_q04__i3a-8409 - Job Site/Contact Number Zip 32065 ication/Registration# NSS-14 State Certif _904-33.2-8409 Fax;4 Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Addres Ty CO Fin BOX 1635 N411 VVAI-IKF=F VVI 53201 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 i.ssuance�fapennit and that all work will bepe?lbrmed to meet the standards ofall laws regulating construction in thisjurisdiction, This permit becro'01.110.111111 and void rfwork is not commenced within six(6)months, or ifconstruction or work is suspended or abandonedfor a period ofsix(6)months at any time after work is commenced. I understand that separate permits must be secured Tanks andAir Conditioners,etc. for Electrical Work,Plumbing,Slins, Wells,Pools,Furnaces,Boilers,Heatem, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR E14PROVEMENTS TO YOUR PROPERTY. r-F YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. [here certify that 1have read and examined thisg Vication and know the same to be true and correct. Allprovisions oflaws and ordinagn, governLn'g this ces type ol�work will be co�nplied with whether speci ed herein or not The granting of a permit doesnot presume to give authority to at, the provisions ofany otherfederal,state, or local law regulating construction or the perfomance ofconstruction. Signature of Owne Signature of Contracto Print Name tj 5TAANL.EEY._.... Print Name CLINT BUTTERFIELD Sworn to and subscribed before me Sworn W and subscrjbed.before,me this Z_3_Day of 20 /-S— this Day of Ll �20 Pubill N6tar�Publ or . ......... ised 0 1.26.10 ;�OTA ----- - 'V CAROL JEAN HUGHES MY Comm.Expires* 'A Commission#FF 171b59 January 6,2019 Expires December 3,2018 No FF 187613 Bonded Thru D"Fain Insurance 8DO.1385-7019 ee, N OF FVO\�O' I Trar \j BCIS Home Lo,M User Regis1ralion H01 T-lics submit Su,,Ia,,e Slals 1,Fac,s Pullicalio"s FBC Slaff BCIS S e Ma, n1s Se,cl i, Li BusineSS IflProduct Approval Professional USER: Public User R-r-0-d"t-Al212LQV?1-1-M9-nU>PrOA"t Or AD"hc I&D-Seff-C-11>A1212k-iftlon-Li5t>Application Detail FL# FL15213-RI Application Type Revision Code Version 2010 Application Status Approved Comments Archived Product Manufacturer Plastpro Inc. Nanya Plastics Corp. Address/Phone/Emai 1 5200 W CENTURY BLVD. LOS ANGELES, CA 90045 (440) 969-9773 Ext 16 rickw@rwbldgconsultants.com Authorized Signature Vivian Wright rickw@rwbidgconsultants.com — Z Technical Representative Scott Johnson Address/Phone/Email 5200 W Century Blvd. W Los Angeles, CA 90045 (440) 969-9773 Ext 18 scottjohnson@plastproinc.com Quality Assurance Representative Ron O'Connell Address/Phone/Email 5200 W Century Blvd. Los Angeles, CA 90045 (440) 969-9773 Ext 16 ronoconnell@pfastpro.com Category Exterior Doors Subcategory Swinging Exterior Door Assemblies Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report - Hardcopy Received Florida Engineer or Architect Name who developed Lyndon F. Schmidt, RE. the Evaluation Report Florida License PE-43409 Quality Assurance Entity National Accreditation and Management Institute Quality Assurance Contract Expiration Date 12/31/2018 Validated By Ryan J. King, RE. Validation Checklist - Hardcopy Received Certificate of Independence FL152,13—Rl—C(-)-I—lze-rtifica,te-Of-I—ndependence.pcif Referenced Standard and Year(of Standard) Standard Year 101/I.S.2 1997 101/I.S.2/NAFS 2002 AAMA/WDMA/CSA10 I/I.S.2/A440 2005 ASTM E1886 2002 ASTM E1996 2002 ASTM E330 2002 TAS 201, 202, 203 1994 Equivalence of Product Standards Certified By Sections from the Code Product Approval Method Method 1 Option D Date Submitted 05/03/2012 Date Validated 05/03/2012 Date Pending FBC Approval 05/08/2012 Date Approved 06/11/2012 Summary of Products Go to Page 43 Pagel/24 0 FL# Model, Number or Name Description 15213.1 a. Smooth/Wood Grain/White Wood 6'8"Impact" Opaque Fiberglass Single Door- Grain/Rustic/Mahogany Series Inswing/Outswing (X - Configuration) Fiberglass Door Limits of Use Installation Instructions Approved for use in HVHZ: No FL15213 RI II INST 15213.1.pdf Approved for use outside HVHZ: Yes Verified By: Lyndon F. Schmidt, RE. 43409 Impact Resistant: Yes Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 15213.1 for Design Pressure Ratings, any FL!5213--Rl AE—EVAL15213.1.p-Of additional use limitations, installation instructions and Created by Independent Third Party: Yes product particulars. 15213.2 b. Smooth/Wood Grain/White Wood 6'8 "Impact" Opaque Fiberglass Single Door with Sidelite Grain/Rustic/Mahogany Series utilizing "Snap Frame" Glazing -Inswing/Outswing (OX or XO Fiberglass Door -Configurations) Limits of Use Installation Instructions Approved for use in HVHZ: No Fl-15213 Rl II INST 15213.2.Ddf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, RE. 43409 Impact Resistant: Yes Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 15213.2 for Design Pressure Ratings, any fl-15213 Rl AE_EVAL 15213.2,pff additional use limitations, installation instructions and Created by Independent Third Party: Yes product particulars. 15213.3 c. Smooth/Wood Grain/White Wood 6'8 "Impact" Opaque Fiberglass Single Door with Sidelites Grain/Rustic/Mahogany Series utilizing "Snap Frame" Glazing -Inswing/Outswing (OXO- Fiberglass Door Configuration) Limits of Use Installation Instructions Approved for use in HVHZ: No FL15213 RI II INST 15213.3.Ddf Approved for use outside HVHZ:Yes Verified By: Lyndon F. Schmidt, RE. 43409 Impact Resistant: Yes Created by Independent Third Party: Yes Design Pressure: N/A Evaluation Reports Other: See INST 15213.3 for Design Pressure Ratings, any FL15213 Rl AE EVAL1521".3. Of additional use limitations, installation instructions and Created by Independent Third Party: Yes product particulars. 15213.4 d. Smooth/Wood Grain/White Wood 6'8"Impact" Opaque Fiberglass Single Door with Sidelite Grain/Rustic/Mahogany Series utilizing "Lip Lite" Glazing -Inswing/Outswing(OX or XO- Fiberglass Door Configurations) TIN 71 J P-, .......... .................... ----------- Li TO rr P-s- tq..: r1'Iffct,, Of -�WL LIE $',hmidt,P.E. tso, 4�.4109 Air _.TtF _ 11—A J�p 4Ln o -------------- �ZV ,lt. N-1 46! =47 4m :13 X. TI-V ,L I T, IIL L 7- 7 al Ft ><' p� -q z_ 'a I ---------- "T, ul) ----------- Pr t --T7RORO-T. V_'ILDWC-QCq4SV.:7AWT5.INC. FLA'S n--.o Z., or -..."'..; C�rtif;oot, Of A�tfs,,L N- DL31,Z; 1-OPIZONTIAL UATE ORQ�s SECTO<; Ill-. 4340� oil 17': ..................... rr F7 (fig) CA JJ5 oil T777, . ............. 2- Fj 1,:4 MR, Ba aw.; 'T' wc. OR"A' 11— 313-450 V107 L-L.— ai. I IR -N6 �p P 4.p- R, ON CCWT-R o ----------- i,j 4L lit, .10, ON%TNTR YF -TA tFOX crlff—f.01 K3 BUCK UISONNY crq*vsmR1,�Mf).14 4r).71' .T It alga yoga Pei! A I . c Q _14 lilt A 1 I--Iva ...... .....777"" ------ KEW fir �W'. R_ NAME AMC.......... 1A Y.JCK W�ZANFY K TWA& RE M, mWe. FZ1 > C;j x -IX u 12 iW11 I- > f rn, 'Alf. (N ff v v 1c, " ��im .. . - .1 11.1�� ::.;: —j� ::E FF v > rA I �m Mi r) m �711 C,L, C) 1S o 1� -5!. > r7l: — C- I In rn rry rn tv on, je: rin SO 5:, > C)C� >i—I m m In k, < in Ux �1 R-r'w IT ml A-> PRI M —1c t� 1 8 > �E C) J� 0 i o L Li ilk C-4 1-21 V t Y �W)PRQ INC. if r zs"� CLASS D r!�M� 0—rd W-t.C4 R Mrs I yf Ts F.F. 77 n,�� ;;�, 7—