Loading...
2359 Seminole Rd - SGD r S, CITY OF ATLANTIC BEACH r� ... j 800 SEMINOLE ROAD �r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 JJlIc)r WINDOW AND/OR DOOR PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-WIND-2820 Job Type: WINDOW AND/OR DOOR Description: SGD Estimated Value: $13.901.00 Issue Date: 12/30/2015 Expiration Date: 6/27/2016 PROPERTY ADDRESS: Address: 2359 SEMINOLE RD I RE Number: 168349-0000 PROPERTY OWNER: Name: JACOBSON, SAMUEL S Address: 2359 SEMINOLE RD GENERAL CONTRACTOR INFORMATION: Name: INTACT CONSTRUCTION Address: 12920 N ROCKY RIVER RD JOSHUA D MEYERS Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $59.75 BUILDING PERMIT FEE $119.51 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $183.26 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH OFFICE COPY 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 2359 Seminole Rd. Permit Number: /S'GUj)1/0— Og40 Legal Description Parcel# Floor Area of Sq.Ft. Sq.Ft Valuation of Work$ 13901.96 Proposed Work heated/cooled non-heated/cooled, Class of Work(circle one): New Addition Alteration X Repair Move Demolition pool/spa window/door Use of existing/proposed structure circle one):. Commercial X Residential If an existing structure,is-arfire sprig r system installed? (Circle one): Yes No X N/A Florida Product Apppro'�al # 13241.1 For multiple produc use prod gta proval form Describe in detail the type of work to be performed: Replace existing sliding glass door with a new sliding glass door., Property Owner Information: Name: Judy Jacobson Address: _2359_Seminole Rd. City Atlantic Beach State FL Zip 32233 Phone 904-400-2245 E-Mail or Fax#(Optional) Contractor Information: Company Name: ' aC.T' einNS i. i (rtzet,c Qualifying Agent: Josh Myers Address: )24 2 `�Z-cck 1 1214.c.� !2.- t.... . City Jacksonville State FL Zip 3222 4( Office Phone 904-753-9003 Job Site/Contact Number Fax if State Certification/Registration# L'.i'i ( f 26 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. 1 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. 1 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. 1 hereby certify that 1 have read and examined this.application 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 , • 1' (- Signature of Contr. Print Name :.) it k o lose--)v\ Print Name .12,4.,r-4,,. , Ml/ I e 5 rn to ;nd ubscr{{bed before me SwoLnto and subs bed bd. e me �i T 0. of N dvF.-iv%&,z , 20 IS this Da •f�o�I , au _ 20P A A .. _ _v"Li4J/LT- I'z,Ais/�a ,,,.r,....,,*.s1...e.. �r:�.�IIAI► •I jW` ; rry'•u•lic elf ��..•�� ALBERT MORENO ::°.--. : Nutary Public-State of Florida II `�—i r° Notuy Public-State of Florida •: �a : • My Comm.Expires Oct 2.2018.vised 01.26.10 +a 'iii•1 Commission#F FF 239295 .+ "'' 1 - "�roc Commission# FF 26104 £' My Comm.Expires Jun 9,2019 FO` Bonded Through National Notary Assn. .,°;�Ao's Bonded through National Notary Assn. ( -' 0.47.1,,), City of Atlantic Beach APPLICATION NUMBER o• b • Building Department to (To be assigned by the Building Department.) ;r;p 800 Seminole Road � 2820 ) Atlantic Beach, Florida 32233-5445 _ • Phone(904)247-5826 • Fax(904)247-5845 / • pit gs• E-mail: building-dept @coab.us Date routed: 2©/l- City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 0236 ley Department review required Yes No Building Applicant: /i?mu' AS-7Z Gt���SY) Planning &Zoning A Tree Administrator Project: $ 6 D 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: I l‘proved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Date:la//y Reviewed by: TREE ADMIN. Second Review: ❑Approved as revised. ODenietal 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