1878 BEACH AVE - WINDOW PERMIT C
u °�I CITY OF ATLANTIC BEACH
111
- .. 800 SEMINOLE ROAD
1"`"" `;r•
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
'.01119x'
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 15-WIND-1840
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLACEMENT
Estimated Value: $49,253.00
Issue Date: 8/6/2015
Expiration Date: 2/2/2016
PROPERTY ADDRESS:
Address: 1878 BEACH AVE
RE Number: 169542-0606
PROPERTY OWNER:
Name: WALLS, THOMAS D
Address: 1878 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: WCI GROUP. INC.
Address: 1100 SHETTER AVE STE 203 QA JOSEPH D WILSON
Phone: --
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $296.27
STATE DCA SURCHARGE $4.44
PLAN CHECK FEES $148.13
STATE DBPR SURCHARGE $4.44
Total Payments: $453.28
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
a
City of Ai antic Beach APPLICATION NUMBER
,..;;:i:_;.,',./...."/ Building Department (To be assigned by the Building D p rti ent.)
800 Seminole Road /� g� �
fl*"
Atlantic Beach, Florida 32233-5445 ���/� /
u
Phone(904) 247 5826 Fax(904)247-
( ) 5845 _
E-mail: building-dept @coab.us Date routed: 7 3 o /5
City web-site: http://www.coab.us
•
APPLICATION REVIEW AND TRACKING FORM
Property Address: JE 7f Q,eh ,/vi D ent review required Ye No
ildin
Applicant: //.) 6� 9/Q aId Planning &Zoning
(/ / 1 \ Tree Administrator
//
Project: _ O/4Be 1p 6 Public Works
Public Utilities
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: P‘proved.
❑Denied.
(Circle one.) Comments: g 0 c.......
BUILDING
PLANNING &ZONING ((��
Reviewed by: I Date: , '3'
TREE ADMIN.
Second Review: []Approved as revised. ❑De ied.
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
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: / 575 5 g G) p V e- .. Permit Number: /5"-to 0D-1?la
' p (jeck.c-hgl
Legal Description � 2 r 1 i 0 Q 2 s - -^q Lof 3i ilk) Parcel#
�c Floor Area of S.Ft. Sq.1't
Valuation of Work j 25 3, Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa wind wo o/d or
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure ,is a fire sprinkler system installed? (Circle one): Yes o N /A
Florida Product Approval # 516 9. 5 j
For multiple products use product approval form
Describe in detail the type of work to be performed: nSlLan 1g S/MOnIOII DAI 4 uhie tc1indocw S -..
In_OAP 4 --1J ert,►,, a f rU Fii1/ 1/,e*,j (3 0 st//n" -i-ehth f-s-
Property Owner Information: ,/�
Name: CA-)) Address: J 7 2 c /11/e
'�' State Zip 32243 Phone 2 29- �j,�"�7
City Y,t��v c �.- _E-Mail or Fax#(Optional)
Contractor Information:
Company Name: 14)C OV Qualifying Agent: -Oe. 1"W//5O!
Address: CO 41� n : City '1t.)c j�r2c■C'j-, State J/ Zip 3 22 st
ice Phone ligeffir:al 1 Job Site/Contact Number ,Aj7 G 33,F Fax# Z,(-1,2-707-.7
gate Certification/Registration# -2 /5-0 9/rl 2.
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 ii;,
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 become.,I1 u;months at and
work isdco n commenced.not I commenced understand within separate months, or permits mot be secured fin.Electrical-Work,suspended Plumbing,Signs.a Wells,Pools.six Furnaces, Boilers.time
fleaterN.
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 this a plication and know the same to be true and correct. :ill provisions of laws and ordinances governing ttu'
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 tit,
provisions of any other federal.state. al law regulating construction or the performance of construction.
Signature of Owner Signature of Contracto iL'i ___
Print Name 71,1AM h 1 U.)&i S Print Name jp e_
`"worn tR and subscribed before r Sworn to nd subscribed before me �0 l 3,
s T, ef
Day of V l . 20 /- this /Day of
C42.-- - Z?2 -
Notary P lic ,P. ' BENJAMIN C REBMANI
.iik BENJAMIN C REBM se 2
='i ': MY COMMISSION A FF241271 ?.: .•. MY COMMISSION A FF24 d 0 I. 6.10
,, EXPIRES June 17,2019 *-�
-t.o EXPIRES June 17,2019
'e61� 165 FaoaGaNO:r•yServite.eaP . — ��'•,,,.
14C713S8-0153 . ••/IOAAWot ySavice.car
FILE COPY
PRODUCT APPROVAL INFORMATION SHEET (PAIS) FOR THE CITY OF JACKSONVILLE
(Revised:July 8,2008)
Project Name: C
L I Permit#: /5--111/4'd �8 Yo
Project Address
75/ I e te-1. A V /9`TLan c Rc..A , 7% 32233
As required by Florida Statute 553.842 and Florida Administrative Code 9B-72, please provide the information and product
approval number(s)for the building components listed below as applicable to the building construction project for the permit
number listed above. You should contact your product supplier if you do not know the product approval number for any of the
applicable listed products. Information regarding statewide product approval may be obtained at: http://www.floridabuilding.org.
See Bulletins G-25-04 and G-03-05 for more information.
- Product Description or Product
Category/Subcategory Manufacturer Model No. Limits of Use Approval# Local #
A. EXTERIOR DOORS r 1 5-Y/
1. Swinging Th erm a fr[, Der_
2. Sliding
3. Sectional
4. Roll up
5. Automatic
6. Other:
B. WINDOWS
1. Single hung
2. Horizontal slider
3. Casement
4. Double hung cjnrtc'11*►A UgL -5%h'15
5. Fixed
6. Awning
7. Pass-through
8. Projected
9. Mullion
10. Wind breaker
11. Dual action
12. Other:
C. PANEL WALL
1. Siding
2. Soffits
3. EIFS
4. Storefronts
5. Curtain walls
6. Wall louvers
7. Glass block
8. Membrane
9. Greenhouse
10. Synthetic stucco
11. Other:
Printed Date: 7/10/2008 Page 1 of 3
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Category/Subcategory I Manufacturer I Product Description I Limitation of Use I State# I Local#
G. SKYLIGHTS
1. Skylight
2. Other: _
H. NEW EXTERIOR
ENVELOPE
PRODUCTS _
I Harp i 41: Y.2 ' apt eS l-IAC1ae 5' tf kf dge- fare rl (3[gL1i
2
In addition to completing the above list of manufacturers, product descriptions and State approval numbers for the products used
on this project, it is the Contractor's or Authorized Agent's responsibility to have a legible copy of each manufacturer's printed
instructions, along with the list above, on the job site available to the inspector.
The products listed below did not demonstrate product approval at time of plan review. I understand that before these products
can be inspected, they must be submitted for review for code compliance and approved by a Plans Examiner. This form will be
revised to include each new product in the categories listed above and will be highlighted to indicate the new products and
required information.
Contractor/Authorized Agent: OCII if eLhA,cr
(Print) (Signature)
W J
Company Name: CT C rO OF
Mailing Address: / [ 0 D 5A 4 e`' Vim" 20
City: Jc22( 1 4'—C 1\ State: F/ Zip Code: _5'22S C),
Telephone Number: (.90q) 2,1 2 / q Fax Number: ( < d'f) Z 7 Z–?G 77
Cell Phone Number: ( ) rJ 0 -` ` 6 ' 3' E-mail Address: C/CUic>/eijGL 6c I cob,
Printed Date: 7/10/2008 Page 3 of 3