712 Kestner 2015 window N r CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
DIM,-
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-333
Job Type: WINDOW AND/OR DOOR
Description: WINDOW
Estimated Value: $1,100.00
Issue Date: 2/18/2015
Expiration Date: 8/17/2015
PROPERTY ADDRESS:
Address: 712 KESTNER RD
RE Number: 172379-0000
PROPERTY OWNER:
Name: LERIAN, MICHAEL J & JENNIFER,
Address: 712 KESTNER RD
GENERAL CONTRACTOR INFORMATION:
Name: ACE DOOR & WINDOW SERVICE
Address: 9123 E HARE AVE QA GARY S.HALE CBC035180
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $27.75
BUILDING PERMIT FEE $55.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $87.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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City of Atlantic Beach
APPLICATION NUMBER
6.
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 33.3
Phone(904) 247-5826 - Fax(904)247-5845
Date routed:
E-mail: building-dept@coab.us 'Al
City web-sit& http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Addres-: 77/7- A_.57_,YU*4 Zd DepAftent review required Yes,,*"No
iC-Building __--) —_V_ —
Applicant: A!E -'�Ooe X aboij Planning &Zoning
Tree Administrator
Project: 7),0 a)
g InCM Public Works
IF Public Utilities
Public Safety
Fire Services
Review fee $ Dept Siqnature
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: LK/Proved. F]Denied.
(Circle one.) Comments:
(�U I L nD1 N G
PLANNING&ZONING Reviewed by: Date:
41
TREE ADMIN. Second Review: [-]Approved as revised. F�Deniev
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. FIDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
F% Ikr CITY OFATLANTic BEACH
800 Seminole Road, Atlantic Beach, FL 32233
C r
FES
Office (904) 247-5826 Fax (904) 247-5845 3
Job Address: AILURC 'ZO-2-EeLit Num
Legal Description IQ Ke 54 rWe- RJ. Parcel 9
Floor Trea of Sq.Ft. Sq Ft
Valuation of Work$ WO,o?7 —ProposedWork heated/cooled non-heated/cooled
_�o
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/sp<win:do�w::/do
e"-,— _ /
Use of existing/proposed structure(s) (circle one): Commercial Resicie�ntial �
If an existing structure,is a fire sprinkler system installed?�Circle one): es N/A
Florida Product Approval# /Y 55, ")-/ O'd fie i.9
For multiple products use product approval form
Describe in detail the type of work to be performed: W 146LO Q-0 i 06Q,IWP-
5io4le 11411 a a, I A, i '(Vdysw _:o_ri �es '2.),tho
Proper _ Owner Inforgation:
Name:-W - t cror) Address: -_7 1 ol e_g er
city (an-b e-, 6C41 Stateg Zip'32,0-3�? Phone 161 S-3
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRIESS:
Company Name: boorieWmAnv) Qualifying Agent:
Address: 9 1 a 3 HAre Citv State t-L- zip 3
OfficePhone �on 6WI Job Site/Contact NumberV i C-fir lk-CQ e Fax# -?A-7-6 F1_3
State Certification/Registration 0-c o 3.5 1 ob C-ACAS - 1.147
Architect Name&Phone#
Engineer's Name &Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication isherebymade 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 thisjurisdiction. This permit becomes null
and void if work is not commenced within six(6) months, or if construction or work is suspended or abandonedfor a period of sixi,6)months at any time after
work is commenced I understand that separate permits must be securedfor Electrical Work, Plumbing,Sikns, Wells,Pools, urnaces, Boilers,Heaters,
Tanks andAir 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 herelb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
work will be complied with whether s ci ied herein or not. The granting of a permit does not presume to give authority to v' ate or cancel the
s
provisions of any otherfederal,state, or local regulating construction or the performance of construction.
e f,
Signature of Own Ll Signature of Contractor
r
PrintName .............. ........................................................................................................................ PrintName G<,etA 4,q I
.... ..........i
........... . ....... ..............................................................................
e
Before me 4)�( Before me
this-5-Pay of f UCAf 20 kS this -5-Dayof 'F-Obt'VQY�U 20 I!S�
,fk��L :��j 4�� t_� b- -
Notary Public Notai C Ico a
Nicole Hale
-.CmydWon I FF 156954 n-,,Ca-r-.T,!ssion 9 FF1559M
�b .` E SEP 04,201itevised 0 1.26.10
*lExores: SEP 04,2016 - A-1- �.
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