64 13th Street West GARAGE DOOR r r�J`J J,
JS, CITY OF ATLANTIC BEACH
'fi "°'"' f 800 SEMINOLE ROAD
K -nn, :)
ATLANTIC BEACH, FL 32233
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-2458
Job Type: WINDOW AND/OR DOOR
Description: NEW GARAGE DOOR
Estimated Value: $795.00
Issue Date: 10/30/2015
Expiration Date: 4/27/2016
PROPERTY ADDRESS:
Address: 64 W 13TH ST
RE Number: 170805-0010
PROPERTY OWNER:
Name: LANG, MARY E
Address: 64 W 13TH ST
GENERAL CONTRACTOR INFORMATION:
Name: ADVANTAGE DOORS INC
Address: 10752 S DEERWOOD PK BLVD ARTIMUS WALKER
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DBPR SURCHARGE $2.00
PLAN CHECK FEES $27.50
BUILDING PERMIT FEE $55.00
STATE DCA 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.
rifeP,-,, City of Atlantic Beach
APPLICATION NUMBER
JS :. Building Department (To be assigned by the Building Department.)
, ;: 800 Seminole Road
• Atlantic Beach, Florida 32233-5445 I 5 '-VV I N Q -2 45 8
Phone(904)247-5826 • Fax(904) 247-5845
< ,r);; E-mail: building-dept @coab.us Date routed: 0A( (p 1( 5
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 6 4- ( 3 s4- , ent review required Yes o
DOO Building
t Applicant: b V Acv rc G c 12-S • Zoning
Tree Administrator
Project: Gfli P% OC' 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: proved. ❑Denied.
(Circle one.) Comments:
:UILDING
PLANNING & ZONING Reviewed by: nisy Date: /0 1?/3--
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑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
OFFICE COPY CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 15--\IQ I N0-Z4 5S
Job Address: VJJ 13 44 ('- p r Permit Number:
1g-34 3t-3.5-99 .093
Legal Description See.N-;rok> La All 4.e_ c 1-. Parcel # X75 — )()
00 Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 75 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa indow/doo>
Use of existing/proposed structure(s)(circle one): Commercial (esidential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval # f ) . i
For multiple products use product approval orm
Describe in detail the type of work to be performed: 7-05k-PIN\ IDPL, 0)(`POS c
Property Owner Information:
Name: -Se+e Qt x>,Ile (A \\\ 6A-,145-____s Address: `-256fl3 Pp„.,1-,(3 5 WW 1 su,i le ) Q9
City .7 he SOhwi 1 %e State Fes--Zip 3aD,SCc, Phone goy -(p??-6, 7") 7
E-Mail or Fax#(Optional) 9014-33,3 3333
Contractor Information:
Company Name:Augp\p, e ('5 10c_. Qualifying Agent:
Address: -15a iSi Au ak;�'C Pe, �e City -$AC�tgt,l.xv,11e State Fe._ Zip 3aaY7
Office Phone 9044- 6,25 9os Job Site/Contact Number Fax#
State Certification/Registration# C113 -36
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 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.
!hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinan es governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authori : , • ate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor ��
`��
Print Name 01141 S1 kr‘ Print Name ,,1 il/1044 6..• v'e
Sworn to and subscribed •efore me Sws� .r.nd r . . . me '�
this /e( r. of t� a' y 20 t r./. 0 Da of if ,201S
1 •
- . mail .0 �•i�. !. r i§.,„d.E. ..f Florida
I ,:o JAMIE
NN ELL # Y ^ ' . . , sc'o-'Revised 0 ♦6.10 ii' a Commission H FF 111385 , 0 ■
Y�r2, s,:'∎1‘.
,:ref II sei My Commission Expires «+.v"�1✓�„�.•.vti,
',:ref II April 09, 2018