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872 AMBERJACK LN - WINDOW iS�'' CITY OF ATLANTIC BEACH 1J 800 SEMINOLE ROAD r 'T.��, ATLANTIC BEACH, FL 32233 ,,,,.______.) .,,,„_________j\ 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-2324 Job Type: WINDOW AND/OR DOOR Description: DOORS Estimated Value: $3,400.00 Issue Date: 10/13/2015 Expiration Date: 4/10/2016 il PROPERTY ADDRESS: Address: 872 AMBERJACK LN RE Number: 171146-0000 PROPERTY OWNER: Name: MCKENZIE, JEROME & CHARLENE, * Address: 509 CAMELIA ST GENERAL CONTRACTOR INFORMATION: Name: PLUMBING BY JOSH Address: 5677 FLORAL AVE THOMAS R PORTER Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $33.50 BUILDING PERMIT FEE $67.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $104.50 1 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r11:vy f., City of Atlantic Beach APPLICATION NUMBER i�,, ' i P Building Department (To be assigned by the Building Departmentt.) ' 800 Semin ole Road /+1 /Vi�U 2 3 2 t 0`r'' 'r' Atlantic Beach, Florida 32233-5445 \ Phone(904) 247-5826 • Fax(904)247-5845 /4 9 E-mail: building-dept @coab.us Date routed: / l� City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM • artment review required Yes o Property Address: S7Z 6g L7 1.6 Building OP • Applicant: d . .. Planning &Zoning 4. I .r� %� Tree Administrator Project: ) 'Oi /�-L C /l ,rµ-c r Public Works Public Utilities Public Safety . Fire Services Review fee $ _ Dept Signature Review or Receipt Date Other Agency Review or Permit Required 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: Approved. ❑Denied. (Circle one.) Comments: UILDIN PLANNING & ZONING Reviewed by: / Date: /0—/0 ./� TREE ADMIN. Second Review: [ [Approved as revised. ['Den d. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. I [Denied. Comments: Reviewed by: Date: Revised 07/27/10 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH r y COPY •800 Seminole Road,Atlantic Beach, FL 32233 Office (904)247-5826 Fax(904)247-5845 / - _ `�� '4)-3 Job Address: 21 2- Am 4 A&k LAI �. Per 1111.77, : • f� J;1 Legal Description Parc!! 111 yd Floor Area of Sq.Ft. rt i Valuation of Work$ ,1 t bo. Proposed Work heated/cooled 1/ no heat�edl le, ; jI; . " `1J Class of Work(circle one): New Addition Alteration Repair Move +-molition pool/spa window/do.) Use of existing/proposed structure(s)(circle one): Commercial •esidenti. If an existing structure,is a fire sprinkler system installed? (Circle o e): •esr o N /A Florida Product Approval# 0001 ES " FP�t�I' Fl- l S22-5.3 REAR T L- to 04. 3 0 2 L(q c q. , For multiple products use product approva oiF rm Describe in detail the type of work to be performed: NEv■) E$C1"- - OtZ t.002S , 'FfZoN',. W I Ji4ot,JS SLLb IA)6 • Sf 6t,4ss ,bao2 Property Owner Information: I ' 6 117.41) F� # //6116) P Name: SAirhli. HOMES I NC. • Address: 224, TMA_WdoA 124 City J4X Sck VV StaterkZip 323-.50 Phone Qpu- ?333_ 6607 E-Mail or Fax#(Optional) ©. tk(t1—e�► Co NA L'AS"—, lr r Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: PA/ 4 I y ?,1 Qualifying Agent: 177o,.,r-S RveTc/e. Address: S6S7 J% AI r .4 tk City 4.6.4," State FL _Zip 3 A // Office Phone 704 ,137- S7/.6 Job Site/Contact Number 437-•S706 Fax# State Certification/Registration# [ G,/as /3/t-2 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 f 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 certj that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and or.'nances verning this ype o1 work will be complied with whether specified herein or not. The granting of a permit does not presume to g,v• .uthority viola or cancel the 7rovisions of any other federal,state, or local law regulating construction or the performance of construction. QQ4AA.S4 . 'ignature of Owner Signature of Contracto 'rint Name O Lt i= Print Name Ipri43 I 144e7-c<a 3efor;/ e I idly Bef.. -/.;- its • ay of 20 •:r'4 ,y of_ 20�� Mary Public . a •, i:• rotary-I': No ary - .lie • Shirley L eArah m My Cem OBMMO miwen rR O r' • e� �4`.•d`4 Y .. 0