1890 LIVE OAK LN - WINDOW / DOOR f CITY OF ATLANTIC BEACH
Ak f,-) 800 SEMINOLE ROAD
j ;: 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-1887
Job Type: WINDOW AND/OR DOOR
Description: WINDOWS
Estimated Value: $600.00
Issue Date: 9/10/2015
Expiration Date: 3/8/2016
PROPERTY ADDRESS:
Address: 1890 LIVE OAK LN
RE Number: 172020-1418
PROPERTY OWNER:
Name: Hickey, Genevieve
Address: 1890 Live Oak LN
GENERAL CONTRACTOR INFORMATION:
Name: COASTAL CONSTRUCTION COMPANY LLC
Address: 404 N Harbor Lights DR
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: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 FILE COPY
Office (904)247-5826 Fax (904)247-5845
Job Address: 00 ,L/1JE CeZ/C Permit Number: /C.-W/4/JD / F-7
Legal Description Parcel #
o'" Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 6 _ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/doo5
Use of existing/proposed structure(s)(circle one): Commercial e.
If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval# I S 2 S 5- - T h P r v1n a Tr via. to O ces
For multiple products use product approval form
•
Describe in detail the type of work to be performed: ?Wilts aL D . �m-i226v.-}5 G,.i/77-)-
&)677,3 -Z 62D e i3 Er Opp g_
Property Owner Information: ''n� /5--
Name: . • t)/ 72:)/ Address:
y/ /70 ,/./i/6.-7 Oe2-
City 1- ;4-3-7-1c 'j . H State,Zip3ZZ 'hone a s/ 71(0— 112-0 1
E-Mail or Fax# (Optional)
Contractor Informmation: CONTRACTOR EMAIL DDRESS:
Company Name: ✓ c ,5TH L- C �.S7 7 Zk C7 A' Qualifying Agent:ent: 21? -57-H'-J
Address: q3 / )- l+442 302 )—l o t+73 D42. City 7 //-
State — Zip320 /
Office Phone 10 y-303—35.2. }} Job ite/Contact Number.s/ t Fax# 41e v-8/(3 _'3 2O 7
State Certification/Registration# ( ,�� 0 )2- 5'0 3
Architect Name&Phone# / V/c}
Engineer's Name&Phone# /...)/4-
Fee Simple Title Holder Name an ddress /2o 3 6., ,/t IS6TM-1 t /`S 5 0 1-/✓c cio &�> 4-�_ec,y,-�
Bonding Company Name and Address /J/4
Mortgage Lender Name and Address /4.4-
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 ElectricalWork,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 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 to gi • lhority to violate • canc•1 t •
provisions of any other federal,state, or local law regulating construction or the performance of construction.
At,
Signature of O er �— ��
Signature of Contracts,/ i��
Print Name ep, co (} /f., 6 7-731-1 Print Name Fer e ., ea /
Before me Befo i. ,J
this 3 D - c.4) Gt 4 T / , 20 / S t1i" Day o. !!� . 04 . . 20 .
Not Public `t= '0 <<--dy e
%. PtIEHW.SCHW S �Q y .r0264i•∎. �a08Q0 .
€: MY COMMISSION r FF 246243 P :ed 01.26.10
rfZ7 x EXPIRES:July 10.2019
't;;P Bonded TTru Notary Public Uncerwtiters
rjD,,�� City of Atlantic Beach
.} ;�, Building Department APPLICATION NUMBER
. , (To be assi d by the Building De n
800 Seminole Road
/41—'4(1/� } fie Atlantic BeachFlorida 32233 5445 a / UY
Phone(904)247-5826 Fax(904)247-5845
\\e!:, ;fii.;"i E-mail: building dept @coab.us Date routed: /
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
A
,,L
Property Address: 1 livs � ��;,,,,�„�ent review required Yes o
0.6fisir& _Building
Applicant: &G/� Z. Q • ann ng&Zoning
Tree Administrator
Project: Id 1/Alt O /t) s 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: pproved.
❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed by: ` Date: 9 Vi 3—
TREE ADMIN.
Second Review: ['Approved as revised. ['Del
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
I
. 0r1Itycl CITY OF ATLANTIC BEACH
j, s�1
J 800 Seminole Road
41.)
Atlantic Beach, Florida 32233
J , r� Telephone
FAX(904)(904)247-5845 247 5800
Q REVISION REQUEST SHEET
Date: % I /f Received by: cr L Resubmitted: 9/05--Permit N be : /� ,^/,4. 1K7
Original Plans Examiner: /7) ,�N��� Project Name:
Project Add - : " ' , C 1.y e. Da .»
Contractor: ,e: Zia Contact Name: :lerr) 6
Contact Phone : 0 fffo 3 • 3 (Z 4, Contact e-mail:
Revision/Plan Check/Permit Fee(s) Due: $
Description of Proposed Revision to Existing Permit:
Mb ftii4- g l o o Ie
Additional Increase in Building Value: $ boa • 0 D Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below. I (print name)/hL(c {( grate��t/t affirm that the above revision
is inclusive of the proposed changes. r
,L io e f r14 Ji eAw 9-B via- fay
riA5---
Signature of Contractor/Agent(contractor must sign if increase in valuation) Date
Office Use Only
(/�- 5-
Date: / � Approved: 2( Rejected: Notified by:
Plan Review Comments:
Department review required Yes No
Building
Planning &Zoning
Tree Administrator Plans Examiner
Public Works
Public Utilities '. 9V 5-
Public Safety
Fire Services Date Created8/20/IS Rev.2