160 MAGNOLIA ST - WINDOW Iy\J\
S f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
\13 • 7
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-2558
Job Type: WINDOW AND/OR DOOR
Description: window
Estimated Value: $500.00
Issue Date: 11/19/2015
Expiration Date: 5/17/2016
PROPERTY ADDRESS:
Address: 160 MAGNOLIA ST
RE Number: 170616-5000
PROPERTY OWNER:
Name: PASKO TRUST, PAULA & FRANK, *
Address: 13692 VICTORIA LAKES DR
GENERAL CONTRACTOR INFORMATION:
Name: PRO-BUILDERS OF FLORIDA LLC
Address: 1115 S OAKS RIDGE DR LUIS EDUARDO ROSERO
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.
-i.t.a;%, City of Atlantic Beach APPLICATION NUMBER
JS rt. Building Department
o (To be assigned by the Building Department.
c� 800 Seminole Road . /
yr Atlantic Beach, Florida 32233-5445 - (N� - Zs. s"
Phone(904)247-5826 Fax(904)247-5845
q%• E-mail: building-dept @coab.us Date routed: /V2
City web-site: http://www.coab.us JJJ
APPLICATION REVIEW AND TRACKING FORM
Property Address: (4o !Ud Jr I : : . e review required Yes o
l
Buildin•
Applicant: & • - - 'ng &Zoning
Tree Administrator
Project: kfr NI o Yf c 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: roved. ❑Denied.
(Circle one.) Comments:
UILDING
PLANNING & ZONING 1 �
Reviewed by: ill Date:
TREE ADMIN. Second Review: ['Approved as revised. ❑ nied.
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
1PP
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233 OFFICE COPY
Office (904)247-5826 Fax (904)247-5845
Job Address: 114t• 1M(A5Y10\,G, g t r 1c ,r bt„ L t il 72Z ermit Number: -40/yd r g
r
Legal Description
Floor Area of Sq.Ft. Parcel#
Valuation of Work$ ° Proposed Work heated/cooled t
non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed st • 1 re s circ e ' ,
If an existing structure, •: a fire sprin er syste i stalled?(Ci cle one):Reddsnti No N/A
Florida Product Appro :I# .7 C' '6
For multiple products . e pro uct approva Pr'm
Describe in detail the type of work to be performed: le , )iirPQ r\/-
Proper Owner Information:
Name: AlOn(\ c�autinn►s
Address: ((�0 ry'tov,yw`w 51-
City Riltt,,,}t� dad... State Et Zip 3ZZ33 Phone 1484_ud83-45--4
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: �t LPEPs� p
Address: u i 5 5` oX�. ��bG� �r�L„�S�v 1{ �- Qualifying Agent: ��S Q_�s�
Office Phone ' 0 - 3 .6 00 e City (Kra- �, V t = State Zip 3Zz
,' `f Job Site/C ntact Number Fax#
State Certification/Registration# eG C. 1G1 41( I .
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 certi6 that no work or installation has commenced prior to the
issuance ofa 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 YO�]R NOTICE OF
COMMENCEMENT.
l hereby certify that I have re.•and examined this a plication and know the same to be true and correct. Al!provisions o aws and ordinances governing this
.ype of work will be come ed ith whether specified herein or not. The granting of a permit does not presume to !iv authority to violate .r cancel the
7rovisions of any other f 1 era A. : -, or local law regulating construction or the performance of construction.
ii na �� -
g tore of Ow -r Signature of Contractor_ '`���
'rint Name iLrle) StAmi S Print Name -I-U tS P2)1 PIPM •
elor,' �'
,20 /5 try!
MO ilr‘, this- I Da ..�.�a:u�4 irsi- 0 o a State of Florida APP„;•ary Public State of Florida■
rotary Public i • Shirley L Graham _, •F • :�%.Y L Graham
My Commission FF 086990 RQ�' • IC .
'1l4y Emma,•02/14/1018 Piroa 02/14/2018
evised 0 .2..10