619 SELVA LAKES CIR WINDOW / DOORS 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-1055
Job Type: WINDOW AND/OR DOOR
Description: exterior door
Estimated Value: $476.00
Issue Date: 5/11/2015
Expiration Date: 1 JM2015
PROPERTY ADDRESS:
Address: 619 SELVA LAKES CIR
RE Number: 172027-5552
PROPERTY OWNER:
Name: MEYERS, LISA
Address: 619 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: BUTTERFIELD REMODELING LLC
Address: 4220 PLANTATION OAKS BLVD APT 1516 SIDING ONLY
Phone: - -
PERMIT 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.
BEACII
800USeminole Road,Atlantic Beach,FL 32233 FILE COPY
Office(904)247-5826 Fax(904)247-5845
Job Address: 619 SELVA LAKES CIR ATLANTIC BEACH, FL. -Permit Number: /F //L19—lXSS"
Legal Description 43-11 17 2S-2;)F VA LAKES UNIT 2 LOT 76'aroei# 172027 5552
F nor a oa of Sq Ft S2
Valuation
et Work S 476.00 Proposed Work heated/cooled 1411 nou-haakadkwte t 510
Clangor Work(circle one): New Addition Alteration &7MP move
Demoltion pool/spa wmdowldoor
Use of existipglproped structure(s) rM �eCommercial inMalT(Cirle one):GOoIf an existing strucs,is a firspriner system
( /A
Florida Product A pmval 4 12769.3
For multiple products use product approval form
Describe In detail the type of veork to be performed: REPLACE EXTERIOR DOOR
Property Owner Information:
Name: LISA MYERS Address: Rao eel VA LAKES GIR
City ATI AN3:irRF CH state ELZip 32233 Phone Qfld-�d7-�RAfI
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: BUTTERFIELD REMODELING,LLC. Qualifying Agent: CLINT BUTIERFIELD
Address:499n Pi ANTATKIN OAKC RI Vrl x1516 City QPANGE PARK State Fl zip 32065
Office Phone 04-Q33-nano Job SiWCoutact Number 9ne-31uunn Fax#
State Certification/Registraturl#
Architect Name&Phone#
Engincer's Name&Phone# -
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made m obtain aperma to da the work and installation an indicated f certify that w work ar installation Fns commenced prior to the
once o(apermitandtMt all week will De dtomeetthe standards ofaU laws mgnlatingcorutrucdan in thajiaeniction Thispertakbecomesmdl
avoid tJ worksnotcommencedwithinsit(6 months,or+fconnruetian ar work' saspended or abasrdosredfar oFr� dofsiu/s)months at atry nae atter
wank u commenced I arsderstand that separme permas mast be secwedfor Pderbttat Work Pleasant,Sums, Wella,Pools Fkrwaav,donna,l7ea/ma
Tanis act Air Cendhtoners,de.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR DVROVEMENTS
TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY EYBBEFFOOMERECORDING YOUR NOTICE OF
!hereby unify thatlAave nadandexamitd rho tcation and Maw dm same to be nue < cA!! o(�shordlna�l,'owsvrmel
type o work will be romplied wi t whether c' d hemvs or wt. The granting ofa pe ➢+U+'s^e t� b'
proautoa ojany otherfederd,s re.orlad w guladng caratraedon or rFe perfmmanee ofcomhuctims 7`
Signature of Oamer SigoaNre pf Contmcto� '�
Prim Name LISA MVFRR Print Name CUNT BIJrrERFIEI�D��,_,,,_,_ ._,�
Swo2•o and subscribed store subs me, swon�t d ad 6eh me
SwS.�
of 0 .0 of
Notary u c Notary —
01.26.10
o4axr suer Colley B. Court , 2w' i'*d CCOL JEAN HUES
omaussion#FF 171959
State of Florida 6omlres December l3,90186as
y MY COMMISSION # FF 8073
Expires: April 14, 2017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road /,5-- /, l — /Ogs'r
Atlantic Beach, Florida 322335445 W_
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
Cityweb-site: http'.//w coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I ✓ll C. e e a t review required Y No
Building
Applicant: 1 no"t Zoning
Tree Administrator
Project: p Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verged BY
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: RALI/pproved. ❑Denied.
(Circle one Comments:
BUILDIN
PLANNING&ZONING Reviewed by: Date:
TREEADMIN. Second Review:
❑Approved as revised. ❑De ' d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised min110