5822 FLEET LANDING BLVD - WINDOW / DOOR r ''- .., ` , CITY OF ATLANTIC BEACH
--, .,k .._
800 SEMINOLE ROAD
-- �f 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-1496
Job Type: WINDOW AND/OR DOOR
Description: window/doors
Estimated Value: $2.000.00
Issue Date: 6/29/2015
Expiration Date: 12/26/2015
PROPERTY ADDRESS:
Address: 5822 FLEET LANDING BLVD
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: .�
PLAN CHECK FEES $30.00
BUILDING PERMIT FEE $60.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $94.00
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: 5822 Fleet Landing Blvd Atlantic Beach, FL 32233 Permit Number: /S-k// fl',O - / `/9'/'
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 2,000.00 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 structure(s)(circle one): Commercial Residential
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approve orm
Describe in detail the type of work to be performed: NEW SINGLE EXTERIOR DOOR AND (2) CRANK OUT
WINDOWS
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 @fleetlanding.com
Contractor Information:
Company Name:NCCRF dba Fleet Landing Qualifying Agent: Jason Holder
Address:1 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 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 this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after
work is commenced I understand that separate permits must be secured for Electrical FVork, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaters,
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 thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o, work will 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 r gulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name Jason Holder Print Name Jason Holder
Sworn to and subscribed bpforc me Sworn to_apd subscribe5l before me
this Z.etay of - , 20/S this 2..r1Day of ,
• vv. /
Notary Public No . a '
{fti rv4 SHARI R QUEST
34. 4,, SHARI R QUEST
�, !*f MY COMMISSION#FF068247 ' "
'�� * MY COMMISSION#�Fls4ttac 01.26.1 O
�, EXPIRES November 4.2017 i �� yam. ,,,
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(4o7)398-0153 FloridallotaryService.com (4o;; 153 FloridallotaryService.com
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,:5=.:0/1./ City of Atlantic Beach
l\ Building Department T APPLICATION NUMBER
800 Seminole Road ( o be assigrie�y the Building pepanment.)
�� s Atlantic Beach, Florida 32233-5445 /,L Q Ai/di Phone(904)247-5826 Fax(904)247-5845 7 {
�1;»� E-mail: building-dept @coab.us
City web-site: http://www.coab.us Date routed: 4 1
APPLICATION REVIEW AND TRACKING FORM
Property Address: c
f z Z fiar ;77 pega., il ent review required Y / No
Se Applicant: N
Planning&Zoning
Tree Administrator
Project: iXr__,C �,� deaf( - 2 Public Works
/, '`�4) O ,/ Public Safety
(i(/ �(JJ Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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: proved.
❑Denied.
(Circle one.) Comments:
:UILDI
PLANNING&ZONING
Reviewed by: Date: 6 c?'f JS
TREE ADMIN.
Second Review: ❑Approved as revised. ❑D ed.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10