5514 RIGEL CT WINDOW / DOOR CITY OF ATLANTIC BEACH
y 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-1034
Job Type: WINDOW AND/OR DOOR
Description: garage door
Estimated Value: $450.00
Issue Date: 5/14/2015
Expiration Date: 11/10/2015
PROPERTY ADDRESS:
Address: 5514 RIGEL CT
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: NCCRF
Address: JASON PAUL HOLDER JASON PAUL HOLDER
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $55.00
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $27.50
STATE DBPR SURCHARGE $2.00
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH FILE COPY
800 Seminole Road,Atlantic Beach, FL 32233
Office(904) 247-5826 Fax (904) 247-5845
Job Address: 5514 Rigel Court Atlantic Beach,FL 32233 Permit Number: S - k/I N'0-103V
Legal DescriptionP loor Area of Parcel#
Valuation of Work$ 450.00 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 structures)(circle one):. Commercial Residential
If an existing structure,is a fire sprinkler system rmtalled?(Circle one): Yes No N/A
Florida Product Approval#FL 14170.1
For multiple products use pro net form
Describe in detail the type of work to be performed: GARAGE DOOR PANELS REPLACEMENT
Property Owner Information:
Name:NCCRF dba Fleet Landing Address: 1 Fleet Landing Blvd
City Atlantic Beach State FL_Zip 32233 Phone 904-246-9900 xt 431
E-Mail or Fax#(Optional)jholder@fleetlmding.com
Contractor Information:
Company Name:NCCRF dba Fleet Landing Qualifying Agent: Jason Holder
Addressa Fleet Landing Blvd City Atlantic Beach State FL Zip 32233
Office Phone 904-246-9900 xt 431 Job Site/Contact Number 904-219-4002 Fax#
State Certification/Registration#CBC 1254586
Architect Name&Phone#
Engineer's Name&Phone#
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 f certify that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet the standards afall laws regulating construction in thisjurisdiclion. This permit becomes null
and void If work is not commenced within six(b)months, or if construction or work is suspended or abandonedfor a period afsir/6)months at any time after
work is commenced. I understand that separate permits most be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces, Bailers, Heaters,
Tanks and Air Comadmiers,enc
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 1 have read and examined this a plication 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 spped red herein or mt. The groaning of a permit does not presume to gate authority to violate or cancel the
provuronsofanyotherfederol,state,arlacallawre Rlaling construction or thepeZure
e ofconstrucdon.
Signature of Owner of Contractor
Print Name Jason Holder Print Name Jason Holder
Swom�and subscribed before me Sworn to�n d subscribed fore me !
this�Day of '7 20/S' this L•-Day of s—
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Notary 11 mblu, <�—
ELIZABETH TESKE �� w, ELIZABETH TESKE
eyised 01.26.10
'i MY COMMISSION:MFF001 a59 � � of MY COMMISSION#FF001858
•.� Q°' EXPIRES A,ol 5.W17 3e,F�/f EXPIRES Amt 5.W1
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/ City of Atlantic Beach APPLICATION NUMBER
/ Building Department (To be assigned by the Building Department.)
800 Semmde Road v/
Atlantic Beach Florida 32233-5445 t/ 0 3 `/
Phone(904)247-5626 - Fax(904)247-5845
E-mail: building-dept@mab.us Date routed: /
-- Citywebsite: http7/vow.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 45 rl Department review required Yes No
wilding
Applicant: ing&Zoning
///��� o Do
p Tree Administrator
Project: fJQQ^ Public Works
Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: LKproved. ❑Denied.
(Circle one.) Comments:
BUILD
PLANNING&ZONING --1 -/.5'
Reviewed by: Date:
TREEADMIN. Second Review: [_]Approved as revised. [—]De .
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
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