498 selva Lakes Cir 2015 Window CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j 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-698
Job Type: WINDOW AND/OR DOOR
Description: GARAGR DOOR
Estimated Value: $1,720.00
Issue Date: 4/14/2015
Expiration Date: 10/11/2015
PROPERTY ADDRESS:
Address: 498 SELVA LAKES CIR
RE Number: 172027-5052
PROPERTY OWNER:
Name: CARRAHER, REBECCA L
Address: 498 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: PRECISION DOOR SERVICE OF N FL JASON SHEPPARD
Address: 11323 Business Park BLVD
Phone: 904-638-2220
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $29.30
BUILDING PERMIT FEE $58.60
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $91.90
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
FILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 U L5
Office (904) 247-5826 Fax (904) 247-5845 MAR 2 5
Job Address: "\O�� C_D \"IQ\ Permit Numb B --
Legal Description A\_55 \-I - �-CJ Parcel# '-I Z�Z
Floor Area o ��2 q. t. q t
Valuation of Work$—\—A\�•��Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed struc circ75 -7��Commercial ResidentialIf an existing structure,is re sprin der ed? (Circle one): o N/AFlorida Product Approval � 5`�
For multiple products use net a rova
Describe in detail the type of work to be performed:
\Y�\ !(�4�,V�j w
Property Owner Information: \
Name: CC\V`f 0\\,rke� Address: Lo.�e S &P-,
City 4t1 NN_�7\ State A-Zip 3227jS Phone 0 0!� - X 5 5 - O
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: pf2C\S\bti1 '900`0- Qualifying Aent:
�GSON p�
Address: 0\4 y- b\ a` City 56N-J V\�\e State \A_ _Zip 32 S
Office Phone 4\04- \93$5 ' 2.21uJob Site/Contact Number t Fax# aLA- 2\l
State Certification/Registration#
Architect Name& Phone# Pr�\GY _YeAri C_
Engineer's Name&Phone# t `�
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. 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 rconstruction or work is egulatingconstruction in this jurisdiction. This perat mit becomes null
and hin six
work er
is cid o nmenced.work is not commenced I understand that separate permits mior st be secured for Electrical Work,i Plumbing,Signs,oi or aWells, Poeriod ols, urnaces monthsBoile s,t�Heatme ers,
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 this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work ivdl 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.
Signature of Owner ` ature of Contractor
Print Name Print Name �5...................S
........A. .........................................................
c�lJl0................... ....... ........... .. ...................
Sworn to and subscribed before me Sworn to and subscribed before me S�
this�'5 Day of WXVC� 20 t5 this � _Day of \A.GVc�-\ 20
Nota Notary
.. MICHELLE ABRAHA : .....�...''" MICHELLE ABRAHAM
•i
MY COMMISSION#FF146360 MY COMMISSio4?,,3iFitvl(01 26.10
v1a
EXPIRES July 29, 2018+? � EXPIRES July 29. 2018
(4071�-0163
FloridallotaryseN1Ce com 3 Fk3tidallotaryService.rom
PP
City of Atlantic Peach �g
Building Department APPLICATION NUMBER
(To be assigned��y the Building Deparimen,
800 Seminole Road
Atlantic Beach, Florida 32233-5445 FLF Q . 4
Phone(904) 247-5826 - Fax(90/4) 24 7-15R,15
E-mail: building-dept@coab.us t
City web-site littp//,Afwwcoab.LIS Date APPLICATION
APPUCAMN REVIEW AND TRACKNG FORM
CC l ,, f� 64
Property Add - sc.,: D a ment review required Yes 0
Building
D a Men
rrt Ir t ------
Public
eiew requi ed
review
Applicant: annfng &Zoning
Tree
ree Administrator
Public
k
Works
6
Public Utilities
I
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept. of Environmental Protection____ of Permit Verified By
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
APP L'I TION STATUS
Reviewing Department First Comm Review: Approved. F]Denied.
(Circle one.) Comments:
UILDING
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN-
Second Review: []Approved as revised. oDeniedd
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date
FIRE SERVICES Third Review: []Approved as revised. []Denied.
Comments:
Reviewed by: Date:
swiscd 07/27/90