1236 MAIN ST - WINDOW f.. \` CITY OF ATLANTIC BEACH
c-)1 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'\�11
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-1675
Job Type: WINDOW AND/OR DOOR
Description: NEW WINDOWS
Estimated Value: $10,000.00
Issue Date: 7/24/2015
Expiration Date: 1/20/2016
PROPERTY ADDRESS:
Address: 1236 MAIN ST
RE Number: 171052-0060
PROPERTY OWNER:
Name: HERNANDEZ, JOHN ALAN
Address: 1236 MAIN ST
GENERAL CONTRACTOR INFORMATION:
Name: ECO ONE INC
Address: 2711 Seminole Village DR STE 4
Phone: --
PERMIT INFORMATION:
FEES: _ ------PLAN CHECK FEES $50.00
BUILDING PERMIT FEE $100.00
STATE DCA SURCHARGE S2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $154.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
jCity of Atlantic Beach Buildin De artment APPLICATION NUMBER
g p (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 k S — S10 C- 1 [x'74
Phone(904)247-5826 • Fax(904)247-5845 t
-Stl9i. E-mail: building-dept @coab.us Date routed: 7/ 14/ Z Q
City web-site: http:/lwww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z3 G M, I0(1 S T Department review required Ye No
Buildin•
Applicant: ECo O N B E N C ' - o• —• ing
Project: NEW ` 1 eE,� a R MF,&__ -j- Public Works
St ( � Public Utilities eN 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: proved. ❑Denied.
(Circle one.) Comments:
CETUILDING
PLANNING&ZONING Reviewed by: Date:7' /6 /S
TREE ADMIN. Second Review:
['Approved as revised. ❑D vied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. Iii Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
•
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
F ILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 i
Office(904) 247-5826 Fax(904)247-5845 1 JAIL 1 4 -�
By —Job Address: 1236 Main St Permit Number: - "_---
Legal Description 18-34 38-2S-29E SEC H ATLANTIC BEACH N1/2 LOT 6 BLK 226 Parcel# 171052-0060
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$_tOp00 Proposed Work heated/cooled 896 non-heated/cooled 56
Class of Work(circle one): New Addition Alteration MEDP Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial
i
If an existing structure,is a fire sprinkler system installed?(Circle one): es N/A
Florida Product Approval# a A'f(nc.htJ
For multiple products use product approval form
Describe in detail the type of work to be performed: NEW FIBER CEMENT SIDING.
NEW CARPET, PAINTING AND FLOORING
Property Owner Information:
Name: ONE MISSION PROPERTIES LLC Address: 8941 EASTON RIVER DR
City JACKSONVILLE State FL Zip 32257 Phone 904-208-0315
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: ECO ONE INC Qualifying Agent: DONALD HEMINGER
Address:271 I SEMINOLE VILLAGE RD City MIDDLEBURG State FL Zip 32068
Office Phone 904-545-2233 Job Site/Contact Number DONALD 904-545-2233_Fax#
State Certification/Registration# CGC 1517525
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_penod of six 16)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,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 of 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 regulating construction or the performance of construction.
Signature of Owner Signature of Contra o .—�/` _ ----
Print Name ,/f-LA-A/ LT. I,0,4t.44,F.A Print Name bJ4- IC (-4rM, N __
Sworn to and subscribed before me Sworn to and subscribed before me
this Day of ai,t ly ,20/5 this/ D., of wlh ,20
tart'Pubs, ` •tary ' • is
Revised 01.26.10
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