464 IREX RD - WINDOW : � CITY OF ATLANTIC BEACH
.J - ,A S 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
30B INFORMATION:
Job ID: 15-WIND-2003
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLACEMENT
Estimated Value: $850.00
Issue Date: 8/26/2015
Expiration Date: 2/22/2016
PROPERTY ADDRESS:
Address: 464 IREX RD
RE Number: 171426-0000
PROPERTY OWNER:
Name: PITTMAN. BLAKE CAROLYN
Address: 464 IREX RD
GENERAL CONTRACTOR INFORMATION:
Name: EMCO RAIN GUTTERS INC
Address: 404 BEVERLY LN STEVEN MIDYETTE
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 ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
0Liv.;. City of Atlantic Beach APPLICATION NUMBER
, ' 16 Building Department (To be assigned by the Building Department.)
--ye l•s 800 Seminole Road Al— /,1�'.,/a Z O�
5 Atlantic Beach, Florida 32233-5445 A £4 iY
Phone(904)247-5826 • Fax(904)247-5845 0
3.--,r It 9• E-mail: building-dept @coab.us Date routed: Q
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: � I r led De artment review required Y`es/ No
Buildin V
Applicant: [fit i ('d Td 171 fr/, z ng &Zoning
/� � 1 �/� ! Tree Administrator
Project: kt / /i F> 0 ieg /acv 1 L4 r Public Works
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: I Approved. ❑Denied.
(Circle one.) Comments:
BUILD
PLANNING &ZONING Reviewed by: (11 ly Date: '07 S / S
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
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax (904)247-5845
Job Address: 'I (me Pei Mlu 2 it8esicln,1L ?i 223 3 Permit Number: /5--GUII?/ID—2ba3
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ it SO Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa windo door
Use of existing/proposed structure(s)(circle one): Commercial 'esidenti:
If an existing structure,is a fire sprinkler system installed?(Circle one): •es No N/A
Florida Product Approval# FL.* (SZ 17.
For multiple products use product approval form
Describe in detail the type of work to be performed: JYls++,1 t n '1. 01,..._\ { 2,(ks ,.-IC,- - c (,)t - \Ow S
Property Owner Information: ffII
Name:W lh Soy. or 1.y o� �i tJ hi� UXAddress: t{2' Lite h lot
City State Zip 1Iiii4 Phone 1A) 39?— 5 )I O Es+ a.
E-Mail or Fax#(Opti nal)
Contractor Information: EMAIL: ePAGp roo.649 (c LiG hoo.ao•✓-%
Company Name: emCv th (7�t v5 -Eat . Quali m Agent: 9140e-rt tv11dt4 '�
Address: eeLk d \Cb' - Ci ,Ai-e_ State -F1 Zip 322S`{•
Office Phone\p•1) (vq3•N 1 Job Site/Contact Number(oA') SO 3. 2,7s Fax#00-0 7fsee• 153 j.
State Certification/Registration# LR.G l 32'fj ri c5
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 ofapermit and that all work will be performed to meet the standards of-all laws regulating construction in this urisdiction. This permit becomes null and
void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned fora riodf fsix(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 this application and knm ., , ie and correct. All provisions of laws and ordinances governing this type
ofwork will be complied with whether specified herein or not. The grai, ng of a er'1,i•oes not presume to give authority to violate or cancel the provisions of any
other federal,state.or local law regulating construction or •• .•rfor anoe. o - coon.
N
Signature of Owner 1 • 7 a'"'e a ature of Contractor C
W . -
$ le
Print Name i/�,� y . .' int Name
Z •-
Before me , o o : •fly=
this Day of `�°, ,20/( _ �" . �f ��L� '_ 20/c
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.t Pu. i• .4: •'/'. S Graham
Notary Public :;;,..41-,-;� ary
A c . , c My . fission FF 086990
' °jdor n, Expires 02/1 Wised 10.24. 2
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