275 Sailfish Dr 15-WIND-1628 replace windows permit 'L`1
. S r
tS `' ,,, ';, CITY OF ATLANTIC BEACH„..,
;--. - s)
800 SEMINOLE ROAD
J V;. 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-1628
Job Type: WINDOW AND/OR DOOR
Description: REPLACE TWO WINDOWS
Estimated Value: $960.00
Issue Date: 7/15/2015
Expiration Date: 1/11/2016
PROPERTY ADDRESS:
Address: 275 SAILFISH DR
RE Number: 170579-0000
PROPERTY OWNER:
Name: PETERSON TRUST, TERRY LEE
Address: 1500 SELVA MARINA BLVD
GENERAL CONTRACTOR INFORMATION:
Name: HOWARD CONSTRUCTION (GC)
Address: 580 WELLS RD STE 3 QA DONALD TOWERY
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: $86.50
PERMIT IS APPROVED ONI.I IN ACCORDANCE NITII ALL C11Y OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION COPY CITY OF ATLANTIC BEACH FI L E 800 Seminole Road,Atlantic Beach,FL 32233
n Office(904)1247-5 826 Fax(904)247-5845 p,
Job Address: 915 5 ,1-C k Dr E to ri j7 )-5-5- Permit Number: /1-11.//�0— l 6J 0
Legal Description l()- / t7- .S,.-. o q�qc l-fe: 'Sec.�Parcel# jq 51 -()QOO
Valuation of Work$ .9f0(�j Proposed Work heated/cooled ,574- non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/do
Use of existing/proposed stracture(s)(circle one): Commercial esiden
is �
If an existing structure, s a fire sprinkler syste gr installed?(Circle one): Yes No N/A
Florida Product Approval# ' �Q
For multiple products use pro uct ap$rruvor:orm
p llyn J� �
Describe in detail the type of work tote performed: a?"t,A. dera (,{,1 hOt4 /.ee}M
X
ft , v. ( .L10 . /k, t cE & Q.. J
Property Owner Information:
Name:P .i.Q.8-1.4m—CC vi,41f) To-fy L-Z.P Address: (.>0 el ic_A\c gtr Q 1 t VA-
City Rt)e-A- Pc l'-‘ State ip 3:.233 Phone �t04-246 -C i 5/4.
, E-Mail or Fax#(Optional)
Contractor Information:
Company Name: . i ' ft. Quali ing Agen• ,ova 'I'•
Address: 5- U,e. S ' . City C., _ - t. State Zip 9.X7
Office Phone le,4- "4k-Li 1 Z Job Site/Contact Number 1) Fax# •- "L'A -
State Certification/Registration# C(-G 151.4M
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Bolder 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 cert fy 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(6J 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 Elecnica!Work,Plumbing,Signs,Wells.Pools,Furnaces,!toilers,Meiners.
Tanks and Alr Conditioners.era
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 mndication and know the same to be true and correct. All provisions of laws a •ordinances governing this
type of work will be complied with whether specified in or not. The granting of a permit does not presume to give autho f o,to violate or cancel the
provisions of any other Feder .state,or local law re• construction or the rformance of construction. I
Si azure of Chv p,, " ,0 Signature of Con.r• .r — .4
L
Print Name et- /V�"1-z�2SD� Print Name , AI
Sworn t and subscn. . ore me Swo and sub .-. be .. me
this .
Day of t 20 this Day)-)f _ 2r
ti; I , WO t -----)‘kk " ttkl
votary ublic Not`�u
V80 L
Revised 01.26.10
Notary Public State of Florida
Mark L Alexander
1 y 1, My Commission FF 221219 JENNIFER K
4.00, Expires 05/19/2019
LJ
otary Public•StFlorida
y Comm.Expies 7,2017 Commission # 5309tary Assn.
City of Atlantic Beach APPLICATION NUMBER
(- .
...A 1 Building Building Department (To be assigned by the Building Department.)
a 800 ea Road
; Atlantic Beac h, Florida 32233-5445 6 S` V I N Q" `(jL 8
Phone(904)247-5826 • Fax(904)247-5845 / Q
E-mail: building-dept @coab.us Date routed: 7/ a /
City web-site: http://www.coab.us (((
APPLICATION REVIEW AND TRACKING FORM
•
Property Address: Z Sci R �
75 S D ment review required Yes o
(—Building
Applicant: I`{ pv.A R(Q ento&T Ru CTi 613 Hianriing&Zoning
Tree Administrator
Project: I N p O LAD E.P CE Public Works
Public Utilities
Pt Re D Public Safety
Fire Services
Review fee $ Dept Signature
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: [oved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: 7-io-i
TREE ADMIN. Second Review:
❑Approved as revised. ❑Denied.
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