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892 OCEAN BLVD - WINDOW ' rS!r��� p, " '`� `�'� CITY OF ATLANTIC BEACH s: 1S1 800 SEMINOLE ROAD ,; 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-2858 Job Type: WINDOW AND/OR DOOR Description: WINDOWS - REPLACE Estimated Value: $8,000.00 Issue Date: 12/17/2015 Expiration Date: 6/14/2016 PROPERTY ADDRESS: Address: 892 OCEAN BLVD RE Number: 170344-0000 PROPERTY OWNER: Name: HARRIS, ROBERT L Address: PO BOX 40126 GENERAL CONTRACTOR INFORMATION: Name: WINDOW WORLD OF JACKSONVILLE Address: 8110 CYPRESS PLAZA DR APT 405 QA GREGORY R FITE Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $45.00 BUILDING PERMIT FEE $90.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $139.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. II -0...A ., City of Atlantic Beach APPLICATION NUMBER :;• ,t Building Department '+ (To be assigned by the Building Department.) J ; ^ ■.' 800 Seminole Road .a Atlantic Beach, Florida 32233-5445 S 'N 85 Q Phone(904)247-5826 • Fax(904)247-5845 V it V •01; >% E-mail: building-dept @coab.us Date routed: 21°1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z D CEAN &_V D- • - •4ent review required Ye No " Building Applicant: I tV(JO V�J O R L _- . . oning Tree Administrator Project: R GPZ--ACC \x-L 1 t' P o uo 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: Approved. ❑Denied. (Circle one.) Comments: BUILDING 0 PLANNING &ZONING Reviewed by: Date: �9 .14' TREE ADMIN. Second Review: (Approved as revised. ❑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 5—\I N Q -28S A 2 7 .lob Address: F 0 � ��4"'"- N'`°`"` �I, �co. Permit Number: Legal Description Parcel # �d Floor Area of Sq.Ft. Sq.li t Valuation of Work S g‘94"" Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa endow /door Use of existing/proposed s i cture(s)(circle one): Commercia 'esi•- . If an existing structure, a fire sprinkler system ig,,talled?(Circle one): es No N/A Florida Product Approv. # -'L ^ /l?2 0, I3 t t --44,o",. /3 For multiple products u • . .Qs uct a 1 prova •rm Describe in detail the type of wor to be performed: el, vt. 12 Q// Gci'0-1 do.4- 5 a h JLc 4-J j/po Property Owner Information: 3 322 33 Name: 44°/5 C1/- c Address: 842 ©ce4,,1 �a4. 4/1...... c. c 13,.z , ) City Ai lA hd-:c. /3.«c StatelZip 32233 Phone g04 S4S /2 3 E-Mail or Fax#(Optional) Contractor Information: Company N me: �//h a 0 uc. UiOV-[vL` F1 el'i oit:., l ify• g Agent: G G-t G IX/o, lC Address: 'I 10 Cy re.S5 .s.s-, L . # (O S City J a t•12-so'., it-4. State "FC Zip 3 22 Shy Office Phone 404 4 3 0 1 Job Site/Contact Number 0t0'( 4-6S/ 23.1GFax# State Certification/Registration# C13 (2S'Z (0 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 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 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/have read and examined thisplication 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. Signature of Owner -,� Signature of Contractor /344,01.-- i ./_ Print Name 410k C V J Print Name 1.5rIckl, t,,q II Sworn to and subscribed before me Sworn to and subscribed before me this 3 Day of Ae•C., t, r ,20 (S_- this Day of De t . ,,,her . _ 20 IS w � G /t� ��y•kok6 ERIC B.WALL 4(.'l1,4---- o,,a�Y.."�e�, ER(CB:WACL Notary Public *�* MYCOMMISSIONSFF130688 Notary Public : MY COMMISSIONiFF130688 EXPIRES:June 9,2018 * .A: * S ne 9,2018 uj�r�oFr��'��' BondedThruBudgetNObryArvkes Cd ��. Q)J q,Fa,,de Booted Thru Budget Notary Ilbrrkes