1949 SEMINOLE RD - WINDOW / DOOR PERMIT r.J - � , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD•J - ` ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
0.21>f'
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-2069
Job Type: WINDOW AND/OR DOOR
Description: WINDOWS
Estimated Value: $24.531.00
Issue Date: 9/2/2015
Expiration Date: 2/29/2016
PROPERTY ADDRESS:
Address: 1949 SEMINOLE RD
RE Number: 169542-0516
PROPERTY OWNER:
Name: MAZUR. KAUNATH TERESA
Address: 1949 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: ALESCH CONTRACTING INC
Address: 1946 BEACHSIDE CT THEODORE ALESCH
Phone: --
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $86.33
BUILDING PERMIT FEE $172.66
STATE DCA SURCHARGE $2.59
STATE DBPR SURCHARGE $2.59
Total Payments: $264.17
InimPERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ii )�� City of Atlantic Beach APPLICATION NUMBER
�s Building Department (To be assigned by the Building Department.)
r ' 800 Seminole Road / (`�� aQ ,v
�;; �� Atlantic Beach, Florida 32233-5445 APPLICATION
J I /
Phone(904)247-5826 • Fax(904) 247-5845 Date routed: / /1 AS-
City�? E-mail: building-dept @coab.us //
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
•Property Address: /9 fig iiiittAii/6 /CI Department review required Yes o
CBuildmg
Applicant: A6S6A 6Planning &Zoning
Tree Administrator
Project: �'U'7 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: Approved. ['Denied.
(Circle one.) Comments:
BUILDI
PLANNING &ZONING Reviewed by: J'21 , Date: 9`,71'/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 ejl &(ti O pl
CITY OF ATLANTIC BEACH Na '' e S
800 Seminole Road,Atlantic Beach,FL 32233 �p
Office(904)247-5826 Fax(904)247-5845 e 1�
Job Address: 1949 SEMINOLE RD Permit Number: PL f �
Legal Description 42-14 9-2S-29E BEACHSIDE LOT 48 BLK I Parcel# 169542-0516 I L •
Floor Area of Sq.Ft. Sq.Ft 'A` p1 t
Valuation of Work$ •31or58ttof9 Proposed Work heated/cooled 2139 non-heated/cooled I /�
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door 0 w'
Use of existing/proposed structure(s)(circle one): Commercial :`Residential s;
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No
Florida Product Approval# FL5414-R12 SIMONTON ^ -" •---.-
For multiple products use product approval form 1111-1M,-.
1■, ,M1■\�
Describe in detail the type of work to be performed:
1IP� 1111 °
REMOVE AND REPLACE EXISTING SIDING 4AIp W!NOOWA ' I III
IuPro,ert Owner Information:
n
Name: KAUNATH TERESA MAZUR Address: .• a °' 4.0 City ATLANTIC BEACH State FL Zip 32233 Phone 503-707-1766 0
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: ALESCH CONTR4CTING,INC Qualifying Agent: THEODORE W ALESCH
Address: 1946 BEACHSIDE CT City ATLANTIC BEACH State FL Zip 32233
Office Phone 904-613-6517 Job Site/Contact Number 904-613-6517 Fax#
,
State Certification/Registration#CGC1516238
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address ii=iimilE Bonding Company Name and Address I
Mortgage Lender Name and Address `
Application is hereby made to obtain a permit to do the work(and installations w ind/c• f�e tV thA Grork�r i�sta,Giltloln)rus[[ombb�enc'ed trior to
Inc issuance of a permit and that all work will be performed to nice:the standanis o laws gulaing co struction in this jurisdict us. Thi permit
becomes null and void if work is not commenced within sLs(6)months,or ijconstruetio waam*�is suspended or abandoned/or a wix(6 months
at any tine after work is c•ornntenced I understand that separate permits must be secs for+Elctrical Work,Plumbing,Signs,Wells, maces,
Boilers,Heaters,Tanks and Air Conditioners,etc
WARNING TO OWNER:YOUR FAILUR 1 TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT iN YOUR PA • '• . - • • . • • 'TS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
/hereby centifi'that/have read and examined this ap lication and know•the sane to be true and correct. Al/provisions of laws and ordinances governing
this rype of work will be complied with whether specified herein or nor. The gruntin oju permit does not resume to give authority to violate or cancel the
/4(4 provisions of any other federal e,or local law slating construction or the performance of construe ion.
I
Signature of Owne /11111611001 • ignature of Contractor /I 1I. •Aii
1 , r
Print Name KA . •TH TERESA AZ Print N••• THEODORE`A SCH
Sworn ti . , subsc ryked bef,re a worn to. . subscribed be e.
this ' lay of u. it . 1 t this Day up 20
Nota�rP is �,�� Nota.�a .l•� f
Rev1 01.26.10
PAUL FORBES „un ' PAULfORBE
�� �`B '• Notary Public State of F1lxida ..'r•
.4'.-: .?"----.• .m Expires Sep 22.2018 4. •-s Notary Public-State of Florida
„„ r rc 161974 E My Comm.Expires Sep 22,2018
'\ ,,,ta y Assn V,;;,,,,-..........q .Commission#FF 161974
'",I'il Bonded through National Notary Assn.
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