680 PALM AVE - DECK REPAIR \st, CITY OF ATLANTIC BEACH
r _ 800 SEMINOLE ROAD
J ", ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
J JF,IV
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RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RAAR-523
Job Type: RESIDENTIAL ALTERATION
Description: deck repairs
Estimated Value: $9,200.00
Issue Date: 3/2/2016
Expiration Date: 8/29/2016
PROPERTY ADDRESS:
Address: 680 PALM AVE
RE Number: 170432-0000
PROPERTY OWNER:
Name: GILPIN JR, SAMUEL A & JANICE M, *
Address: 680 PALM AVE
GENERAL CONTRACTOR INFORMATION:
Name: ANDREWS REMODELING, INC
Address: 6816 CAMELOT RD QA RUSSELL FRANKLIN MATTHEWS
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $96.00
Total Payments: $100.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
r
1 Job Address: (p Bo 0A1A-A l f./ Aft,,t3C44 ,VL32/M Permit Number:
1
Legal Description Parcel#
0,) Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ I12a� Proposed Work heated/cooled non-heated/cooled 220
Class of Work(circle one): New Addition Alteration Repair ' ove Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercia 'esidenti.∎► .
If an existing structure,is a fire sprinkler system installed?(Circle one): 'es `o N/A
Florida Product Approval# 1-kk FI:kl tNI, ,
For multiple products use product approval form /
Describe in detail the type of work to be performed: out woo() ou 6,6.a- �.., (PCALA-
C;ewrri( ('DYti ibri t A A4■9 c -1 u/ x x 1 4aA- in c.(Ny4 t (0
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Property Owner Information: Z-{� e -
Name: 41kin 6 t t,p l N\ Address: (-G/o tri, A4 (.1 Prtt. ("Ca� , 2� 12
City ATt,AturiC, -j 1 StatetZip ' y�hone 41 - 2
E-Mail or Fax#(Optional) i �a� � ��
Contractor Information: 419-iii-l't Company Name: b - A�. ', ` i1.! !I� Qualifyin AgentZ 'p7 * kg°. l 2.
Address: t ,..� a, • City JP)C State 14, Zip '2,-'2A(00,
Office Phone i bE M 1 J b Site/Contact Number (.,e42.lr Fax# 774,r qj 7 a9
State Certifica io 'e:istration • - i (P8i
Architect Name&Phone# ---------
Engineer's Name&Phone# .-
Fee Simple Title Holder Name and Address --
Bonding Company Name and Address o/r
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 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(4)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 "ILA../k'
Print Name S4-1-1,..ly t 1 44. 61./...2..P I ili Print Name - A 4j. { /
Sworn to and subscribed be •re me Sworn to and subscribed be re me
this . A .► Day of ,.;C, 20 id' thisaND Day of 4 (;tt ,20 i i,
//l,a,,a;n V 4W1. • *MARY,1 VERgtt FF 141645E Nuctah"-
c L ' Q AC•IVA. MY WANIISSION t FFDUPREE
VIP e•No Public v ,- EXPIRES:August 4,2018 EXPIRES:August 4,2018
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