157 BELVEDERE ST - WINDOW / DOOR jrLyS ;
� CITY OF ATLANTIC BEACH
;) 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-1982
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLACEMNT NO CHG PERMIT TOTAL VALUE
ON KITCHEN REMODEL
Estimated Value:
Issue Date: 8/24/2015
Expiration Date: _ 2/20/2016 -
PROPERTY ADDRESS:
Address: 157 BELVEDERE ST
RE Number: 170584-0000
PROPERTY OWNER:
Name: BURCH, ROBERT & LESLEE ANN, *
Address: 157 BELVEDERE ST
GENERAL CONTRACTOR INFORMATION:
Name: JEP CONTRACTORS INC
Address: 1416 FOREST AVE QA JOHN EWEL PEARSON, III
Phone: - -
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TilE FLORIDA
BUILDING CODES.
,
BUILDING PERMIT APPLICATION
OFFICE COPY CITY OF ATLANTIC BEACH s --/A// /1r/� % 9 1
800 Seminole Road, Atlantic Beach, FL 3 r-: .
Office (904) 247-5826 Fax(904)247-': f - ,
/ -7 , Ii
Job Address: / 5-
/ r el v e d re., 5±r-�[ ` Pe I i
Legal Description par, I , .W I �L/I
Floor Area of Sq.Ft.
Valuation of Work s/3" riP Proposed Work heated/cooled non-heate I cooled
Class of Work(circle one): New Addition teration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial :esidentia
If an existing structure,is a fires rinlcler system installed? (Circle on• . -es �., N/A
Forlmu multiple products Product use 'oducOttcoval form ieid ��4� .„�1 Sc,icy,v- �1Na'O4.
P approval
in detail the type of work to be performed: reJ ;,, „�
' - t 0 r f1- c / , . .
Property Owner Information: (�
Name: obIIt;� L LeSleo )t AAA �ikccln Address: )S l 1�-'Z�Va �� . .,
City A t�an�,� d�0cri,- Stater-Zip 322-33 Phone X04 -X5-5'-b(cZ
E-Mail or Fax#(Optional) \eS\ee.%v.ccv. a,-,..N.cosc ,v1e-
Contractor Information: CONTRACTOR EMAIL ADDRESS: TEP c-arEtretctor� cast'.-ii.0- •
Company Name:J'EP CO1Atr o.G*vrs N frie-r Qualifying Agent: hr &rrsc .
Address:f y-16. F r e t,4 v ., City TVe futte. Bes State F� Zip-3 E> ,
Office Phone9�r-247-45"zS Job Site/Contact Number 2 Z?- 683 Z Fax#
State Certification/Registration# CCL. c5)S23zj4,
Architect Name&Phone# Nit-
Engineer's Name&Phone# /Vii
•Fee Simple Title Holder Name and Address -. .c a vo NER .A vc
Bonding Company Name and Address
Is Mortgage Lender Name and Address ',4.
Application is hereby made to obtain a permit to do the work and installations as indicated. I certi.6,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 f 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 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 is a placation 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 t, ;we authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction. /
1•
Signature of Owner (� Signature of Contractor ....a-.Print Name �Q� \�v-t'� Print Name TO/wry f . Pt°at f S o, Xi
Before Be . e �-
this `lay of 20 1 S 1s .f Ab.�, _ _ L20( ��4
. 1/72- .......;:e4, SUE C. HECKLER �'f Tk, '- ..& -
Notary Public '�qv: ry Public tole of Florida. fig 'truer„ blICstateo o •a
tary ' , r t raham
,.My Comm. Expires Jun 18,2016 My Co .. ,'on FF 086990
+.�����P;-' Commission # EE 176887 ores. Expires 02/14/201 ,e i es I ►26.10
e . ."� Bonded Through National Notary Assn.
rSrL`lr�� City of Atlantic Beach APPLICATION NUMBER
10.7A Department (To be assigned by the Department.)
1• 800 Seminole Road 5 �, ], _/4 . / 9 p
Atlantic Beach, Florida 32233-5445 2.
+ / (N 'r Q
Phone(904)247-5826 Fax(904)247-5845 Z
j; a' E-mail: building-dept @coab.us Date routed: Q
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /�7 g ' hi cry/ De rtment review required Yes No
Q Building
Applicant: / �D���/"" �Qy� Planning &Zoning
Tree Administrator
Project: f)J//tjjjJ
i Public Works
f1 ` Public Utilities
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: ❑Approved. ['Denied.
(Circle one.) Comments: A
BUILD! e
PLANNING &ZONING Date:�,d Reviewed b y: �
TREE ADMIN. Second Review: ❑Approved as revised. ❑D 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