606 DAVID ST - WINDOW / DOORi
i, rs r\i'r
CITY OF ATLANTIC BEACH
.. ..-.V �-9 800 SEMINOLE ROAD
,� ATLANTIC BEACH,FL 32233
+� r 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-2114
Job Type: WINDOW AND/OR DOOR
Description: window/doors
Estimated Value: $1,275.00
Issue Date: 9/22/2015
Expiration Date: 3/20/2016
PROPERTY ADDRESS:
Address: 606 DAVID ST
RE Number: 170622-0100
PROPERTY OWNER:
Name: CALIFANO. JUDITH VICKI
Address: 4120 BUCK CREEK RD
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $28.19
BUILDING PERMIT FEE $56.38
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $88.57
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH '7
800 Seminole Road, Atlantic Beach, FL 32233 W
Office (904) 247-5826 Fax (904) 247-5845
Job Address: COD 6 >AVI D Permit Number: /Si.O,i1, 'c)//4/
Legal Description Parcel#
Floor Area of Sq.Ft. q. ,t
Valuation of Work$ /1 215 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/sp window/door
Use of existing/proposed structures) (circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval # 76/2,/ $ I 5-‘, 13.15- It /5)./3,/y
For multiple products use product approval orm
Describe in detail the type of work to be performed: !Jew 5(0 D - /J EA; F•evA,z ■ool_ -
N Ew S'be book-
Property Owner Information:
Name: /"' �- eA�'R LL Address: (0040 MA 0/1) S C.
City 4'Ha,14.41 t &L StaterVip 3LZ33Phone 90Y - SVS --11/2g
E-Mail or Fax#(Optional) M 44.or “-& C 4tJTREU,coo sozoc` ro3 . co so-
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: C41412&C.t. ComsTiCoa.':aa Qualifying Agent: II4R&PC. c Ai*PrkeC L
Address: ID IS 4 rtiA.wft t 3Nd A-44)9 City At ktc4i a $& State F/ Zip 32712
Office Phone 9a V S I"S -1VZSob Site/Contact Number Fax#
State Certification/Registration# C GC 0415
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 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 1 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 s ecz zed herein or not. The granting of a permit does not presume to give authority to viol - or cancel the
7rovisions of any other federal, ,fate, or loc my re! • 'i f construction or the performance of construction.
L signature of Owner :� I/S/ / Signature of Contractor i: ���`11--
'
'Tint Name itilffe i4 44/0e 4C. Print Name I/f/f4 k " /-4e ie
3efor 4 e B r.
`tis i D. • _ •A , 201 - th'r r la f
h !�1 Notary Public Stata of Florida
Mk4 ._. -.. - .• . _ • A ��_ Shirley L Graham
�.t b =q !Dada ��/
f0 . ; Shirley L Graham s otaty Pu 1 , ,de
ysc My Commission FF 088990 Expires 02!74/2018
apo� Expiro902/14/2018 evisec I . .11
City of Atlantic Beach( rN\ APPLICATION NUMBER
Building Department (To be assigned by the Building Department)
800 Seminole Road �/ 7 / Li
uv . •v.1 Atlantic Beach, Florida 32233-5445 /$ l V /NQ - 2-
Phone(904)247-5826 • Fax(904)247-5845
0111�'�' E-mail: building-dept @coab.us Date routed:
City web-site: http://www.coab.us /
APPLICATION REVIEW AND TRACKING FORM
Property Addr s: 6 4, l'l d Jr D ent review required Yi7Ado
Bum
Applicant: /147-gill Q 4 S-j jm Planning &Zoning
Tree Administrator
Project: 1th/J )0 la Ped es 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:
APPLIC TION STATUS
Reviewing Department First Review: pproved. ❑Denied.
(Circle one.) Comments:
UILDING
PLANNING &ZONING ci-
Reviewed by:_rn • Date:
TREE ADMIN. Second Review: ['Approved as revised. ['De ed.
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
7