1810 Selva Grande Dr - Shutters I 4 CITY OF ATLANTIC BEACH
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: 16- WIND -203
Job Type: WINDOW AND /OR DOOR
Description: SHUTTERS
Estimated Value: $2,427.00
Issue Date: 2/9/2016
Expiration Date: 8/7/2016
PROPERTY ADDRESS:
Address: 1810 SELVA GRANDE DR
RE Number: 169542 -5004
PROPERTY OWNER:
Name: CARPER, RICKY L
Address: 1810 SELVA GRANDE DR
GENERAL CONTRACTOR INFORMATION:
Name: M.J. WETZEL CONSTRUCTION CORP.
Address: 441 Mississippi Ave ST
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $31.07
BUILDING PERMIT FEE $62.14
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $97.21
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 F E COPY
800 Seminole Road, Atlantic Beach, FL 32233
............ . .
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: dYO S ' VC,1/4
Permit Number: -l(/1 r�A ?03
Legal Description S E /U'S. T ` � ., , —, 4 ,
Valuation of Work $ 8'' oor A rea o q. t a cel # • `� 5 - — �'
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 structures) (circle one
If an existing structure, is a fire sprinkler system installed? (Circle one) :
Florida Product Approval # 7 3 j �fe,
For multiple products use product approva orm
Describe in detail the type of work to be performed: in S c \ �
i • Tani , t'
r
Pro er Owner Information:
Name: 1C � �/'�'& ) P
City =NM! � Address: � Z�v � ��,�„,� � �
St
E -Mail or Fax # (Optional) 1 0 ' a \ te�'t gip �1� Phone
Contractor Information: CONTRACTOR EMAIL ADDRESS: 'OA.Ov- N4ANVe e kl- •
Company Name: i t Ze in .} • ��`a- ►CA
Address: /� ��., , Qualifying Agent; l� C fy; __ l; Z.}
Office Phone 1 7 701 .- ��--t City - 7t �lou State CI— Zip `37
State Certification/Registration # i Job Site/ Contact Number 7a?- ��7 �y Fax #
Architect Name & Phone # t
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 cert fy that no work or installation has commenced prior to the
issuance of 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.
I hereby ertify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances -.'�
type of work will be complied with whether speck zed herein or not. The granting of a permit does not presume to gm- author to viola ,, t ..
'rovisions of any other federal, state, or local law regulating construction or the performance of construction.
�� lc
Signature of Owner J . , ;i 3 D z o
Signature of Contractor
'Tint Name 1! ,/� „ ;
/�.a Print Name �1 i(`11�..2, O coo
his day'. 1 _ '-
AAR ilk this Before,.me g can
'.�riL t
t" y,.. T OPE r ' a o., ER 1Ay n
4111 -41 •IMIK I l i k I i. CO/MISSION IFF9244951 �-
iota' %'ublic i- — yv ti.
eadesibi scan u+aaw •St' `ub
Revised 01.26.10
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ol-t r, City of Atlantic Beach APPLICATION NUMBER
t � Building Department (To be assi ned by the Building Department.)
800 Seminole Road
s Atlantic Beach, Florida 32233 -5445 ' �� 2 3
Phone (904) 247 -5826 • Fax (904) 247 -5845 / >/�
E -mail: building- dept @coab.us Date routed: / 1 7
City web -site: http: / /www.coab.us !!!
APPLICATION REVIEW AND TRACKING FORM
Property Address: /L' SE /r4., 0Thclf Department review required Yes No
uildin
Applicant: l g & Zoning
Tree Administrator
Project: — W Z.1 S 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: F( Approved. I IDenied.
(Circle one.) Comments:
UILDING
PLANNING & ZONING Reviewed by: Date:/ `
TREE ADMIN. Second Review:
Approved as revised. ❑Deni
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: 1 JApproved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10