707 SELVA LAKES CIR - WINDOW / DOOR (r ' `S, 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-1956
Job Type: WINDOW AND/OR DOOR
Description: window replacement
Estimated Value: $2,600.00
Issue Date: 8/25/2015
Expiration Date: 2/21/2016
PROPERTY ADDRESS:
Address: 707 SELVA LAKES CIR
RE Number: 172027-5870
PROPERTY OWNER:
Name: LEVIN, LEON YALE
Address: 707 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: RADON PROFESSIONAL SERVICES
Address: 336 14TH AVE QA WILLIAM TONY DAVENPORT
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $63.00
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $31.50
STATE DBPR SURCHARGE $2.00
Total Payments: $98.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
C ity of Atlantic Beach APPLICATION NUMBER
(cLj
r e> Building Department (To be assigned by the Building Department.)
• rl`i 800 Seminole Road /� 101A46 -196- ,
- Atlantic Beach, Florida 32233-5445
\ / Phone(904)247-5826 • Fax(904) 247-5845 p
\x1;319'' E-mail: building-dept @coab.us Date routed: i(J /5-
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 70 7J'i/Va._ i4h/rS ________-nt review required Yes No
4 Buildi •
Applicant: 1P/Y!J ?rd/ 767?t $5rdern ° - nifig &Zoning
Tree Administrator
Project: It) / 7/7)Qk) Piuhli 1A/nrLc
odcl nod Si r\ a�
Review fee $
Other Agency Review or Pe _/ c,j late
Florida Dept. of Environmental P 0
Florida Dept. of Transportation
St.Johns River Water Managem
Army Corps of Engineers
Division of Hotels and Restauran
Division of Alcoholic Beverages
Other:
APPLICATION STATUS
Reviewing Department First Review: pproved. ['Denied.
(Circle one.) Comments:
UILDIN
PLANNING &ZONING Reviewed by: ni Date: c /E 1 S
TREE ADMIN. Second Review: ❑Approved as revised. ❑De dd.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I 'Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION 2 .,1
?Pk CITY OF ATLANTIC BEACH gill, i�
® Y 800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 f 7
Job Address: �o $e �s� -' �4 ( � Permit limber:
Legal Description X4400 `17- 25-2A E tekft 5 Parcel # - -•-> = o
0, Floor Area of Sq.Ft. Sq.Ft '
Valuation of Work$ 21(OO Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Iteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Resid- .
If an existing structure,is a fire sprinkler system installed?(Circle one): 'es N/A
l
Florida Product Approval # G l`/9 it • 17
For multiple products use product approva form
Describe in detail the type of work to be performed:jilitrffdreedie
• .
Lw�autn�r x:w�,... _ --•— ., e L t ( o Gk wt'1.1, 041 id
Property Owner Information: S ��� ^ieol '''l` N�owa
Name: L e O/lL�(A ...1/1 Address: 707 Se I Va. ke s Cl fZG'
City i�}+ (t'rSti c. State Zip32233 Phone
E-Mail or Fax # (Optional)
Contractor Information: n
Company Name:, aJ. . ) 1A &cSt(1ro.O SQvtACv2-. Qualifying Agent: tJ. 7 1 kO'�`! Oa
Address: 33(., ,, // �� City J Stated-C; Zip32-? S
Office Phone q e t'. s:- / •/1/o Job Site/Contact Number 4 o c( . (2. 10 Fax#
State Certification/Registration# G G 05') 7€I3
Architect Name& Phone# ~55L 'b arc— fl es .- -.1-6 (o$Co • 1, (..cL fi iL 4 'r7 SP1
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 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 Contractor W 1—Pao
Print Name peJ L .%) 1 & Print Name j f bil U.e.AI PO/2 7
Sworn to and subscribed before e Sworn to and subscri.-. b- o - r.-
this l f{ Day of ` � — — — — .—7 ►—�. this _ " •• • e,, :7Rt' IM•. HAFT 20 t
O ;;;'I&" STEPHEN HAFT B Notary Pudic-State of Florida
` = Notary Pblic-State olorida omm.Expires May 5.2018
My Camm.Expues May 5,2016 A Commission EE 1'
ubliC ; Commission EE 195483°:� Bonded Through National Notary Assn.
Bonded Through National Notary Assn. • , . •.