Loading...
81 5TH ST - WINDOW / DOOR -S rVir, r._/ ' \s, CITY OF ATLANTIC BEACH r., ,�. : j 800 SEMINOLE ROAD "r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ''''1-- WINDOW AND/OR DOOR PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-WIND-2762 Job Type: WINDOW AND/OR DOOR Description: WINDOW DOOR Estimated Value: $20,000.00 Issue Date: 12/4/2015 Expiration Date: 6/1/2016 PROPERTY ADDRESS: Address: 81 5TH ST RE Number: 170151-0000 PROPERTY OWNER: Name: HOLMES, HARRIET E Address: 81 5TH ST GENERAL CONTRACTOR INFORMATION: Name: Inc, Surfside Homes LOUIS Address: 108 Osprey Cove LN Phone: 904-534-3904 PERMIT INFORMATION: FEES: PLAN CHECK FEES $75.00 BUILDING PERMIT FEE $150.00 STATE DCA SURCHARGE $2.25 STATE DBPR SURCHARGE $2.25 Total Payments: $229.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r..:,y,„.„ City of Atlantic Beach APPLICATION NUMBER ^ !^ r `` Building Department (To be assigned by the Building Department.) . 800 Seminole Road ""�� g p ) �� 1 Atlantic Beach, Florida 32233-5445 /0_ t '/ry� » 2 76 Phone(904)247-5826 - Fax(904)247-5845 /v .J;{ E-mail: building-dept @coab.us Date routed: ///Z57/,5' City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Ki ,5--771- sr Department review required q YeVNo _ Ouilding, Applicant: .1 1 -_,..4 6 -- Ar a) s Planning &Zoning / i' Tree Administrator Project: t),7 b 6 t) ) fd RS Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature • Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date 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: 1 proved. ❑Denied. (Circle one.) Comments: BUI DIN T PLANNING & ZONING Reviewed by: Date:1 1•a •15- TREE ADMIN. Second Review: ❑Approved as revised. ❑De led. 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 CITY OF ATLANTIC BEACH OFFICE COPY 800 Seminole Road,Atlantic Beach, FL 32233 Office (904)247-5826 Fax(904) 247-5845 Job Address: q 1 6 A S'r't_ut Permit Number: f$"-!4///t'O'Z76 3. Legal Description Parcel # &A 000 Floor Area of Sq.Ft. q, t Valuation of Work$ Proposed Work heated/cooled a,50 0 non-heated/cooled C- Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): - tip N/A Florida Product Approval# 1 For multiple products use product app- pprova or `m . a0 O PI Describe in detail the type of work to be performed: t44161 KZ*(Q kin IAA Out S ,4balsteeli,15,0744.- Property Owner Information: Name: ( I.•1 14 ' -1 eck - Address: 1 '; DS, 0 1 - La , City + ' ;_ ■i !A. Stat- /I ip ,' ,f,,i Phone 0 • E-Mail or Fax#(Optional) 1'10 e i ,Sa a ■e is • tt' o v '' , h.2 t Contractor Information: CONTRACTOR EMAIL ADDRESS: 1-00 1 O 1&S(A - Ol'1 Lk . CpwC&n{, het ' Company . e: `A ! $`1 )k is t_ 14 Qua ' in A,gien : L.0 Ills• 4 at. '1 1 Address: • ! ill1:Ti17,IRj fN ',�,LT City 19 IRA ri*. 'tat 1 tate r(, Zip ap Office Phone Job Site/Conta tj•ignber tj�jj,f_ �('1 04, Fax# State Certification/Registration# 6 ' I i 'Co e4- Architect Name&Phone# : l 1 , ' :.► 1 !MMOIMl!r;�i. Engineer's Name&Phone# _ W,.� ' t �t;�rs�[to . N(, .9 _ + Fee Simple Title Holder Name and Address • I.I, airVI, ► ;'1 a• 0 ,111-0M • i •' Bonding Company Name and Address 11 Mortgage Lender Name and Address 13 R Application is hereby made to obtain a permit to do the work and installations as indicated. I certifii that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a_period of six(6)months at any time after work is commenced I understand that separate permits must be secured for Electrical'Work,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,eta , WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state, or local law regulating construction or the performance of construction. I ,,I � 1 Signature of Owner ' • �IL�X4IL/ Signature of Contractor Print Name tiaahle, S ` P6l. Print Name LOU 1$ C 44'1 1 E R Before me Before me this SC Day of - REf � — — � this 'Z� Da of ,. .rte�.,,, GRAN7 GAR ,�`,jk°P.,, GRANT GARRETSON +° os I 1 _ s Notary Public-State o}Florida `�� lir° Notary Publle-State 01 Florida `/ •,� � /,'`�I�t�" Commission#�FF 237122 �1' Come►isiion iFF237122 Not e 1 c I N. ary Pu is '•, -4„� ' uy�omm.Expires Jun 3,2019 1 +.FOB 0,,, My Comm.Expires Jun 3,2019 Bonded Assn. Bonded through National Notary Assn. \C 1 • - • - •-• o .-n y b b °o., o 0 0 '-. p �O oo �1 O� to : w N -. O\ tm .A w N --. •'' ,� O �.. v. d n x ►..1 X ofA ,nom " CD .- A A Z g• Z °. 8 ° uio t7 5 g ° t i q ¢. E. c o i O Cr va 0 .°n o- cra ° • C4 P d 6. cn a. o v� cra O cm, 171 o o IQ O °o-Osa O E- C • ° c' �, n c 6 0. ° w y 1,5 P -.4 r� bo • zi g' a. C l_i_j E UU1 o C a' C n II)0 1. I (.7 O t 0 f 44;• ~ ^A* C D 0 (A -t (r4 d o CD ti7 � e' ,a. H c f 0 �. CO o 5o z 71 � � m�, CD. ,-. oK3 y 0 O - -1 O o< CDD Q-. - o co a O © C C.1 -CS CD y 00. • o `0 ° S� Ho 0 n G.-- S, - , . • t• a cD n ) C'-" o A ¢, O cn CD P P 0 II PO CD co >l O\ CA A w N . , p 0 oo J O\ CA w N .- e ° o o O ' ? c.) C� o O o ' o o o o ° ° ° �• °p � , 0 co CfQ CD 0 p N d ° r t o aQQ n °' U) F �c7 A F "L3 .ter A A'+ n L. j • �i-) O O oo .1 ON (11 W N O i� �l cn n w N <p J I •x I go O O‘ • N i p' I -erU4 F.) 2. R. r A .9 n N itIIMJiIj, _ P", Z , 0 En 1 6. go ,..,_ v, OM '-c; 0 '-4 ,..., a. ,,..,1 ■-1 pi 0 til CD '—' ga o n crci { co co Po 1 O , j 4 0 n a b K O I C. I C k CA I Z. 4- O • CI. F >v s' 0 O r_, CP CD 4t r O A AD 1 I I 0 CD C) o ' 2, ' o ` — n _ c. w 0' ¢' N Z N p ,_ O p 6 ti cn CD n v'• UQ .-� p0 Id y 0' CD O ;; �, vo d �' cco 'd O CD n cA ■ CD 'CS to il■1 �' fa. vi O Fr; g' o 04 O .� CD K. ¢ Z li V' Gd ta. CD C �� e� -c- ,, 0. 0 a c u ,;1 o o rn •`D _1 C �°., a. c o �' z P ca. d e� Cl) < (7 n sri i1 ~ 0 CD O O p S. f14. 0 0 0 S- a co ti • ... c� O k A� ? fa. k (.1) "p � a o- -1=1 r. -. 5 .-. ,s,,,, g CD o 0 5. c,) CD 4t ff aCD o 2. ° i n CA CD Po CD AD cil 0 ¢ C Ili OE. o. 5.o o CD 0 PD cn