334 6TH ST - WINDOW/ GARAGE DOOR �' '" \1' CITY OF ATLANTIC BEACH
"'°`` 800 SEMINOLE ROAD
\v - ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
' 0.219
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-2297
Job Type: WINDOW AND/OR DOOR
Description: REPLACE GARAGE DOOR
Estimated Value: $1.601.00
Issue Date: 10/26/2015
Expiration Date: 4/23/2016
- --- ------
PROPERTY ADDRESS:
Address: 334 6TH ST
RE Number: 169861-0010
PROPERTY OWNER:
Name: PURNELL, RUSSELL E & JILL M, *
Address: 334 6TH ST
GENERAL CONTRACTOR INFORMATION:
Name: PRECISION DOOR SERVICE OF N FL JASON SHEPPARD
Address: 11323 Business Park BLVD
Phone: 904-638-2220
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $58.01
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $29.00
STATE DBPR SURCHARGE $2.00
Total Payments: $91.01
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH AI.1. CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION r' � ��� CITY OF ATLANTIC BEACH
6.�....1 `,. •s 800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 l eJ - \id Q I `Z7 1-7
Job Address: 3D2k UI t" SYet.-\ Permit Number: /S''it"dip' 2 2 97
Legal Description 5 O\ W-2S-2c) C . -I\-L- gC),(A Parcel # `\j O\ t ` - 00\h
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ W.10\ "Z\ Proposed Work heated/cooled non-heated/cooled $4
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/d
Use of existing/proposed structure(s) (circle one): Commercial esidential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes 'o N /A
Florida Product Approval # bs62. ■ \
For multiple products use product approval form
Describe in detail the type of work to be performed: V--e*\Ce' C •1•\Sk\\ O Q\�G c
c\UNR--- \, \N\I\ -t\iN\ ....„
g
Property Owner Information: 1
Name-cV\SS� \ cwAt.\\ Address: 33A .V S* •
City 1 .1, • i " •. State FA-Zip 3')-23'3 Phone 404- 311- Z'iO- 1-1 c1
E-Mail or Fax#(Optional)
Contractor Information: `,�
Company Name:ck,Q,\S\Ok %PO-- SQ(\\\C;t- Qualifying Agent: -�5CA J't ve,'QpC c
Address:\\3'' %AS\�e S Qv V- g\v� City �o,1. State FL Zip 32251{,
Office Phone A- \D¢,- 3'512. Job Site/Contact Number " %. Fax#
State Certification/Registration# \°j�jC)lD O4,
Architect Name& Phone# "QrM���
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 I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other ." al,state, or local l w regulating construction or the performance of construction.
!Signature of OAF Alp. ' Signature of Contractor AR
nt Nam I/LL i' l)ras/ c/isf/- Print Name ,,,�AS c PP
Sworn to and subsc 'bed before me Sworn to and subscribed before me
this Day of 'D' 1d1\OQ,Y ,20 \`s this 30 Da of 5 - h mb<n- ,20 I S
�'I _ *H LEA- .AHAM Notary 'u i l•,,; MY COMMISSION#FF746360
Otary t.. •40 MY COMMISSION#FF146360 vl •1
tl'?o M1a! ' EXPIRES July 29, 2018 "`'?orr� EXPIRES Jul aglail /(•10
(407)398.0153 F oridallotaryService.com (407)398.0153 FloridallotaryService.com
f5_a,t.,7 City of Atlantic Beach APPLICATION NUMBER
' ;-IV "`.S� Building Department (To be assigned by the Building Department.)
�W J 800 Seminole Road 7
91,' , Atlantic Beach, Florida 32233-5445 1 S -'W I N Q - 2 Z�
Phone (904)247-5826 • Fax(904) 247-5845
o,t1 j: y E-mail: building-dept@coab.us Date routed: 9/Z o/(5
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 53'4. C`rn' S I . Departuent review required Yes o
/Building
Applicant: h R Ee.t S t LAND 0 ooR SEP-VtC 4 Planning Wining
Tree Administrator
Project: R P L A C[r Cl2AcRE I Public Works
Public Utilities
Public Safety
I Fire Services
Review fee $ Dept Signature
1
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:
111 oved. ❑Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING 1(�' /73"
Reviewed by: / Date:
TREE ADMIN. Second Review: ❑Approved as revised. [1Denied.IF
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