330 GARDEN LN - DOOR / REPLACEMENT 1.--- -\s, CITY OF ATLANTIC BEACH
':_ _
� 800 SEMINOLE ROAD
11' 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-513
Job Type: WINDOW AND/OR DOOR
Description: DOOR REPLACEMNT
Estimated Value: $1,870.00
Issue Date: 3/8/2016
Expiration Date: 9/4/2016
PROPERTY ADDRESS:
Address: 330 GARDEN LN
RE Number: 172020-5015
PROPERTY OWNER:
Name: WALSH, BETTE L
Address: 330 GARDEN LN
GENERAL CONTRACTOR INFORMATION:
Name: GREEN MACHINE
Address: 267 SOPHIA TER SUITE 112
Phone: 904-436-5151
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $29.68
BUILDING PERMIT FEE $59.35
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $93.03
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
r :'1)44:,:„.„ . City of Atlantic Beach
0 J , Building Department APPLICATION NUMBER
- fi: v 800 Seminole Road
(To be assigned-by the Building Department.)
��' �� fjr
�� Atlantic Beach, Florida 32233-5445
/(0 aA _S3
`,` �_ l Phone(904)247-5826 • Fax(904)247-5845
L0;;Ic- E-mail: building-dept@coab.us
Date routed: i
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Addre s: ZZ D , r: L--71 De s artment review required Ye A No
Applicant: bra-7) /79/10)/.71 Building n--
- . g &Zoning
Q Tree Administrator
Project: '3004 rtiok e t a 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 VI'Approved. ❑Denied.
(Circle one.) Comments:
:UILDINe
PLANNING &ZONING
Reviewed by: Date:0//6
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
II PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
2evised 07/27/10
i
I
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
OFFICE COPY
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
ob Address: 33c i- t✓p.E:Af G N Permit Number: A-Ai/Iva- 5/3
regal Description Z-OT S Scatel 1414P40 4 1 f Sq.Ft.i Parcel#
Floor Area of Sq.Ft
'aluation of Work$ I+�� Proposed Work heated/cooled non-heated/cooled
lass of Work(circle one): New Addition Alteration epair Move Demolition pool/spa window/door
'se of existing/proposed structures)(circle one): Commercial Residenti.
Pan existing structure,is a fire sprinkler system installed?(Circle one . - No N/A
lorida Product Approval# 51'79 a
or multiple products use product approval form
I
lescribe in detail the type of work to be performed: Pra(j L1 ' 7_ 51 (D/116- bob es
5/meoTov) 9stw
ronerty Owner Information: �
ame: P• A L.Sf Addcess: 33P 0E N &,/tJ
ity tit :u /C- lal., State.L,Zip.57Z5' Phone CO y1- 43b-5151
-Mail or Fax#(Optional) i
'ontractor Information:
ompany Name: G-EY) 11f 1(ve. > IELtwE Tait. U-C Qualifying. Agent: - - 6 S l3 is Ho k�
ddress: 7(p1 �f-hI lekiew City y (- LrhvSTV el State -$L Zip 32A 4155
Thee Phone '4o -4 - ci cI Job Site/Contact Number 4,4-Li -S i i Fax#
tate Certification/Registration#
rchitect Name&Phone#
ngineer's Name&Phone#
x Simple Title Holder Name and Address
onding Company Name and Address
[ortgage Lender Name and Address
2plication 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
;uance 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
id void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for aeriod of six(6)months at any time after
,rk is commenced I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Healers,
inks 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.
ereby certify that 1 have read and examined thisgoplication and know the same to be true and correct. All provisions of laws and ordinances governing this
,e 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
ovisions of any other federal,state,or local law regulating construction or the performance of construction.
gnature of Owner_________________________ Signature of Contractor .Q✓ e desiAry
int Name - / ,L_.,/612.1.S.-1e., Print Name Van es- 2 BiS A d
p
,,om to and subscribed before me Sworn to and subscribed bef9re me
is ()S.D a y of f1.b ,20/<o this 5 D a y of e b ,20 /(-
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o; ;;'4' aRttT C HAUI :v &•t otary Public ����� Ems: Notary 116W/tt"
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MY COMMISSION//MOW ' MY COMMISSION iMFttl 3�t)
i o f' EXPIRES Juno 2s, �Oit ! ..'? 'is�OlF 1AJne 2o,2§i13 I
vio(407)398-0153 FbridallotaiyII Ce 66t i (407)398-0153 Floridallotary$INiC0 0olH