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972 Ocean Blvd 2014 Window CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 Application Number . . . . . 14-00001242 Date 8/13/14 Property Address . . . . . . 972 OCEAN BLVD Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2432.............................. ---------------------------------------------- Application desc window replacmnt ------------------------------- --------------------------------------------- Owner Contractor-------------- ---------- WINDOW WORLD OF NE FL ZIEBELMAN ET AL, PENNY J 8110 CYPRESS PLAZA DR # 405 ARONECK CHARLES M SR JACKSONVILLE FL 32256 972 OCEAN BLVD ATLANTIC BEACH FL 32233 (352) 572-3154 ---------------------------------------------------------------------------- Permit WINDOW AND/OR DOOR PERMIT Additional desc 65 . 00 Plan Check Fee 32 . 50 Permit Fee . . . . Valuation . . . . 2432 Issue Date . . . . Expiration Date . - 2/09/15 ----------------------- -- ----------------------------------------- -------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE To THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ---------- --------------------------------------- -------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ------------------ --------------------------------------------------------- Fee summary Charged Paid Credited Due ----- ----------- ---------- ---------- ------- - 00 00 Permit Fee Total 65 . 00 65 . 00 . 00 Plan Check Total 32 . 50 32 . 50 . 00 . 00 other Fee Total 4 . 00 4 . 00 . 00 Grand Total 101 . 50 101 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION AUG 0 5 2 4 CITY OF ATLANTIC BEACH FILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 -4" , - By—Q Office (904) 247-5826 Fax (904) 247-5845 - 6' Job Address: kh\6 Permit Number: /�,—/ Legal Description Ito '93 'd-qf, Parcel# I _703(45-C_QC1'(3 I,loor Area ot Sq.Ft. Sq*l"t Valuation of Work$ LA Is Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed.structure(s) (circle one): Commercial Residential If an existing structure,is a fire s -inkler system installed? (Circle one): Yes No N/A Florida Product Approval 4_ For multiple products use prod Des in detail the type of work to be performed: N27C Property Owner Information: Address: Name: �,p Is 4su k city eL j!C Pk\ Sat a ktdkZ i p one !�A_oq E-Mail or Fax#(Optional I— t - �f_A60%)NJ oy )6 0 e,f wm�% Contractor Information: Qualifying A ent: e Company Name: Nt�)OANAI city State Address: 2 Id � a Office Phon`e J�o�b Site/ContactNumber CiO4- _)t Fax# State Certification/Registration# ?2L I 25q 1_0 Architect Name&Phone# , 0 Engineer's Name&Phone# N IN Fee Simple Title Holder Name and A�dress Bonding Company Name and Address Mortgage Lender Name and Address 4pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commencedprior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating c onstruction in this jurisdiction. This permit becomes null f work is not commenced within six(6)months, or if construction or work is suspended or aba�donedjbr a period of six months at any time after and void i in'rnaces, Boilers,Heaters, work is commenced I understand that separate permits must be securedfor Electricar Work, Pluntbing,Signs, Wells,Pools, Tanks andAir 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 FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 'e.�!N� EMCBMALL I hereb read and examined this application and know the same to be true and correct. A1,19� #1'a"SwRow governing this certify that I have hether specified herein or not. The granting of a permit does not '0jr",gafste or cancel the ,V giveEXPAIRP ied wit't w/ cti 0 type work will be comp of constru provisions of any otherfederal,st4 tei or local law regulating construction or the Peifi�rmance BwdedThrvWNftYS9v Signature of Owner Signature of Contracto�� 4. — Print Name ............4............._.AA................................... Print Name C.. I ....... ............................. ................. All..... ......... ... - q Before me Before me \\"�I I � I a this I'S Day of ?0 14 this ay of 20 Z14JY� N-C$ttl U S. MANO Notary Public %Jy C0�11.1111��'SiON 4 EE 02q992 Revised 01.26.10 t EXP!r� Oct,-,Ier 21.2014 I F ILE ,simply the Best for Less" Of NE Florida 8110 Cypress Plaza Dr#405 Jacksonville,Florida 32256 (352)443-7001 - Fax: (352)861-7587 Limited Pow r of ttorney I Is- ) Date: 7M To: Building Dept. From: Brian Wall I hereby name and appoint Christy Galas, Gregory Galas, Ryan Gibson, Donna Malvar, Megan Constable, Joshua Galas, Sabrina Sierens a permit service for Window World NE Florida, to be I wful attorney in fact t act for me to register my license and apply to: E 162bt��permit for work to be performed at: &��a Lot: Blk: _Sec: Twp: —Rge: Subdivision: Parcel or Altkey: Address of Job: nap,21 n �qv Owner of Property: ZhQk')r)q and to sign and do all things necessary to this appointment. Thank you for your assistance. Brian Wall State Qualifier CBC1259710 State of Florida County of Duval The foregoing instrument was acknowledged before me by Brian Wall,who is personally known to me and who did not take an oath. this S—day of 2014. Swom to and su ribed before e Notary Public mzr; [SEAL] my Commission Expires: 10/21/2014 Property Appraiser - Prope I rty Details Page I of 2 41 Primary Site Address official Record Book/Pacie MCA ZIEBELMAN PENNY 3 ET AL - 972 OCEAN BLVD 14434-02256 9416 972 OCEAN BLVD Atlantic Beach FL 322313, ATLANTIC BEACH, FL 32233-5432 ARONECK CHARLES M SR TRUST R/S ARONECK CHARLES M SR ZIESELMAN PENNY 3 FILE COPY ARONECK CHARLES M SR 972 OCEAN BLVD Value-Sumn a- Property Detail 1-0 1-4111 as_ ............ RE# 170343-0000 -------------- ------- Value method CAMA Tax Distri ..........--------------- ........... $113,285.00 Total Building Value $118,840.00 0100 SINGLE FAMILY ........ PrQoertv Um Extra Feature Value $1,398.00 $1,455.00 - --------- #of Buildings ............. 0.00 $350,000.00 Land Value(Market) $260,00 .... ....... 15-6116-2S-29E ........------ ;$0.00 Land V@lue(Agric-1 $0.00 Legal Desc. ATLANTIC BEACH PARKWAY $464,740.00 ... .................. Just(Market)value $380,238-00 �u—ivi i�n 03112 ATLANTIC BEACH PARKWAY ......... .. ......... ...... .... —-------- $246,351.00 $250,046.00 Total Area :5735 Assessed Value ---------------- 4.06/$6.00 'Cap Diff/Portability Amt $133,887.00 $0-0&$214,69- The sale of this property may result in higher property taxes.For more information go to Save Our Homes and our Property Tax Estimator.Property values,exemptions and ExeiviRtions $50,000.00 See below ubject to change.These numbers are ............. See below other information listed as'In Progress'are s Taxable Value 1 $196,351.00 part of the 2014 working tax roll and will not be certified until October.Learn how the Property Appraiser's office values property. Taxable Values and Exemptions-In Progress Value is the same as the Assessed Value listed above in the Value If there are no exemptions applicable to a taxing authority,the Taxable Summary box. School Taxable Value County/Municipal Taxable Value SIRWMD/FIND Taxable Value ...............�?50,046.00 Assessed Value $250,046.00 Assessed Value $250,046.00 Asse.s.s.ed V.alye............................... ... ............. ......................................................................................................... .................................... S 2 5 0 0 0 0 0 Homestead.(HX) -s25,000.00 ............................................................................... Homestead(HX) .�000,00 Homestead(HX)....................................................................... ....................................... ....... ... ............... ..... ...-....... ...... .H.o.m.e.st.e.a.d Ba.n.di.n.g I.9.6..0.3.1 1. .b. H.B.). .............. H.o.m.e.s.t.e.a.d..B.a.n.ding 196.031(l)(b)(HB) Taxable Value —�225,046.00 -!��5 000.00 -$25,000�00 .............. I................I..................................&4aEWr%MWWVMWWM.................................... ..............................qqMr1WqWMMMWMVVV Taxable Value $200,046.00 Taxable Value $200,046.00 Sales mlsto!y", "i Vacant/Improved Ouallfied/Unnualifie 3Book/Page Deed In§trum§fljj-y2§-C.WS Improved Unqualified 3/25/2008 1 $100.()0 WD-Warranty Deed 14434-W256 Improved 14418-01208 12/7/2005 WD-Warranty Deed Unqualified $100.00 Qualified Improved 08761-01763 10/22/1997 $199,000-00 WD-Warranty Deed Qualified Improved $11o,000.00 WD- 06834-00801 1/26/1990 Warranty Deed Improve d Unqualified 05437-00425 10/23/1981 $95,000-00 WD-Warranty Deed i Improved 05334-00308 15/12/1981 $100.00 1 WD-Warranty Deed Unqualified Improved W 04924-00576 17/12/1979 1 $89,000.00 D-Warranty Deed Unqualified Unqualified Improved 04546-01013 1 12/7/1977 $100.00 QC-Quit Claim Length Extra Features --------------------------7�- Width Total Units Value �LN Feature, Feature Description Bldg. 0 .0 1.00 $425.0 i 1 z 0 FPPR7 Fireplace Prefab $1,030.00 screen Enclosure 0 41.00 i2 SCNP3 Land&Legal Legal Land I Land rLN",'L�egal Description LN Code.Use Description Zoning: Front. Depth Category Units Im 15-61 16-2S-29E Value 0,000.001 2 ATLANTIC BEACH PARKWAY .00 RES LD 3-7 UNITS PER I Lot $35 0100 AC ARS-2 60.00 95-00 Common I 2(EX S 1.5FT) S 3FT LOT 1,LOT 13 BLK I Buildings Building 1 Detail Building 1 Site Address Element Code http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1703430000 8/4/2014 LIC.#CB04259710, 1 Riferi-ed BY: TFIL"""" Copy Installer ��Fbd&322M silo Cy am Plaz**.4*4 .7 r-o I Name. C-ko,-f kv� -,Pr r*'NC�k-- Phone(W): Install Address: '5134 Phofi6jodw� city;state,Zip.., heti 2 1.7-00USLIE HUNG- -1 -SMEumffXrAMVAM9dAMLMALjC0W d0REVEM,:!-, `3 Uti�SgdtqM WeK Series- D114' & nsulifdd 2b6" _�mqi?VA ng 'L - -, - —6—S.ries 6000 DH All-weld&Insulated '249 Ing L e Cap 14 -U!kd '40 ul.)� =^—E�uble Locks(on windows>25") M., ^1 Doulbft Stmngth Sigh-4%6ilormarim Glass] $52L— PP`G1Sd~70t0*U1EhW#4gw,Gas; $57 -$45 wn bT on. arnl;is and Head ijAltage Warrdi* Coll S,;�� 95 opo i Specialt1tGridS SkwMW oWkW Lite, Half Screenst Almond/Beige $44_ $95 fft(ergo tr.jBrqjz* .T 1EM sifttu d Cbl6r Odei/C a Vvft G�y gr BiDrize J Window Color(Inside Outside "�XT -sidw4Pa#oDaar:5ft�vrMt,,f M cusk"W"CapAk $2fi rekM ? Vilindow 7 -$715 $W �77 pitiobtio �-;" r T, $35 Tempered Sash(BSP)�(T�O� b-77777-777��'� $3 SAW— 'Aflen"loval gindir" ITS Cuebm,E)(*rw4 Thin" P4vwvsA1Q, $7� 31-glin -7 I cio-� bde4ioroa�`Cdbr§ ,SO I I'M -bfDW PRE 19 :60,M", 'op s h4l 44— YOU Instaftflon of any exWOOMW drapes,4#adMr=- aaaMoW.-No*m of You did-tii*,im� ay canag .'VMW ER ad carlddIll"66 111161st be in!= r sorlarsrimlirChwren s fKaso jJnrvWddnaw;i1-uv for P&MWADIM Wo&titk�'grM poide elx�dow you h!Ekr,purcha ............. CAIis toW A -? I ,q;*kl a0yopfu -F' IN J"Ift.00 CM A "ZOO &F $ Total Ainount 7, Ck# ditom, 50% �Z, WS Pfww 06?"WM we 7 0wrw Sat"MaM- ;o-wn-ed:anj1dWope-r-WWd wantowaRwiroms,and Doom LLC drola M cj Norueast Fiorida,undwlimise woM,Inc. Tims Wwdow WwW Franch"'s kXIePMIenfJy Whitle Copy-OrWW Yebaw copy-cu-slomwer PRODUCT APPRdVAL SPECIFICATION SHEET As required by Florida Statute 553.842 and Florida Administrative Code 9B-72,please provide the information and approval numbers on the building components listed below if they will be utilized on the construction project for which you are applying for a building permit. We recommend you contact your local product supplier should you not know the product approval number for any of the applicable listed products. Statewide approved products are listed online @ www.floridabuilding.org. Catego --- Manufacture Product Descripbon Approval Number(s) 1.EXTERIOR-DOORS A.SWINGING B.SLOING C.SECTIONALMOLL UP b. OTHER 2.WNDOWS A.siNGLEiDouBLE HUNG cnlv B.HORIZO14TAL SUDER C. CASEMENT D. FIXED E. muLLION �M4 F.SKYLIGHTS G. OTHER 3. PANEL WALL, k SIDING 4- B.SOFFITS C. STOREFROWTS D. GLASSIMLOCK E.'OTHER ------- 4. RoOPINd PkODU"T A.ASPHALT SKI—NGLES B.40N�sTRUcT NuEtTAL- C. ROOFING TILES D. SINGLE PLY ROOF E. OTHER 5.STRUCT COMPONENTS IRS A.W066 CONNECTO b.Woob ANCROWS d.- TRUSS PLATES - - --- - D.INSULATIONFORIMS E. LINTELS FATHERS 6.NEW EXTERIOR ENVELOPE PRODUCT S -A. The products listed below did not demonstrate product approval at plan review.I under-stand that at the time of inspection of these products,the following information must be available to the inspector on the jobsite; 1)copy of the product approval,2)performance characteristics which the product was tested and certified to comply with,3)copy of the applicable manufacturers installation requirements. Further,I understand these products may have to be removed if approval cannot be demonstrated during inspection. APPLICANT SIGNATURE SABRINA SIERENS DATE 7/22/14 R-1 305 01-04 --J------- ............. 4-- 4 ------ -- -------- .......... ........... .......... 7 ------- . . ................. T 4-- . ..... ........ 4-- -j, ..........r .......4:7 ........... ---------- ..........: r- ? .......r .......... - .......r--. CustOMer Name C4,,-�3 Alarm SyqtqM: Date: Yft Comrnerft: Modes: LOW-E LE Burglar 8aps: yes No TYpe Of Construcgm: Block k FrosW Color Grkb TYpe Of Windows. Wood Iron 'Wnyl wl& NO Window 2. 473/9 13. 3. �e,, 4 Low 14. tf 15. 600v 48 16. 4-8 x 17. Low e Pee 18. 19. 20. 21. 22. 23. 24, i-iviiva�Diuuiumg %-uuu urnine Page I of I Business Professional Regulation �.jor...da DeparnV BCIS Home 1 Log In User Registration Hot Topics Submit Surcharge Sim&Facts Publications FBC Staff BCIS Site Map Unks Search Busines Product Approval Professig&�' I OUWR:Public User Regulation Product Approval Menu>Product or Application Search>Application Ust Search Criteria Refine Search Code Version 2010 FL# 8134.4 Application Type ALL Product Manufacturer ALL Category ALL Subcategory ALL Application Status ALL Compliance Method ALL Quality Assurance Entity ALL Quality Assurance Entity Contract Expired ALL Product Model,Number or Name ALL Product Description ALL Approved for use in HVHZ ALL Approved for use outside HVHZ ALL Impact Resistant ALL Design Pressure ALL Other ALL Search Results-App ications FL# iym Manufacturer YAlida-tedAy Status FL8134-RI3 Revision Alside Window Company Ryan 1.King,P.E. Approved History FL*:FL8134.4 (813)787-8283 Model:d. Model 0501 Description*Extruded Vinyl Double Hung Window-"Non-Impact" Category:Windows Subcategory:Double Hung -Approved by DBPR.Approvals by DBPR shall be reviewed and ratified by the POC and/or the Commission if necessary. Contact U :;1940 North Monroe Streft.Tallahassee FL 3aW Phone,,850-487-1824 The State of Florida is an AAJEEO employer.Coavright 2007-2013 State of Florida,::Privacy Staterne ::Accessibility Statement::Refund Statement Under Florida law,email addresses are public records.If you do not want your e-mail address released in response to a public-records request do not send electronic mail to this entity.instead,contact the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395.-Pursuant to Section 455.275(l),Florida Statutes,effective October 1,2012,lkwisees licensed under Chapter 4SS,F.S.must provide the Department with an email address if they have one.The emalls provided may be used for official communication with the licensee.However email addresses are public record.If you do not wish to supply a personal address,please provide the Deparbrmit with an email address which can be made available to the public.To determine if you are a licensee under Chapter 455,F.S.,please click hKL. Product Approval Accepts: 0 a Me=E les=m lucs, mom http://floridabuilding.org/pr/p�_appjst-aspx 81512014 I lullua r3ullullig %-vut; uruine Page I of 4 R-0QZA CLRAM"�N'CW Business & Professional Regulation -lord BCIS Home : Log In ; User Registration Hot Topics Submit Surcharge ts&Fa Publications FBC Staff BCIS Site Map Links Search Sta cts Bushe AON&Product Approval ProfeS '21 NWUSER:Public Us., lRegulat n ELQ=,AQDroval Menu>Product or Application Search>Application Li >Appileaflon Detail FL# FL8134-R13 Application Type Revision S rt, 0 Code Version 2010 Application Status Approved Comments Archived Product Manufacturer Alside Window Company Address/Phone/Email 3773 State Road Cuyahoga Falls,OH 44223 (330)922-2108 rickw@rwbidgconsultants.com Authorized Signature Marsh Fembaugh rickw@rwbidgconsultants.com Technical Representative Marsh Fembaugh Address;/Phone/Email 3773 State Road Cuyahoga Falls,OH 44281 mfernbaugh@alside.com Quality Assurance Representative Address/Phone/Email Category Windows Subcategory Double Hung Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report-Hardcopy Received Florida Engineer or Architect Name who developed Lyndon F.Schmidt,P.E. the Evaluation Report Florida License PE-43409 Quality Assurance Entity Architectural Testing,Inc. Quality Assurance Contract Expiration Date 12/31/2014 Validated By Ryan 3.King,P.E. Validation Checklist-Hardcopy Received Certificate of Independence FL8134 R13 COI Certificate of Independence.i)d Referenced Standard and Year(of Standard) Standard YM 101/I.S.2 1997 AAMA/WDMA/CSA101/I.S.2/A440 2005 AAMA/WDMA/CSA101/I.S.2/A440 2008 Equivalence of Product Standards Certified By Sections from the Code http://floridabuilding.org/pr/p�_app_dtl.aspx?parani---wGEVXQwtDquljdteSXaTw�/�2fYnf.. 8/5/2014 Gon't 'ON "AM vop"i SNOISVaN IMNSANMNAIRMW -A mu o1w bw g"Yqtn A- vi PR-U go �*N W64d Oct momm opm 3-onw '13M)Obd + it x 3c x x ty__ :1 X w 0. 0 iw-)Bm 3v4v&Ivo"".W" FT. x x x x qu 00 cl 1.2 z z 0 u E E 12 'a 0 uj z cl IQ = C) 'a E. I � .0-- < .9 .:s — 1 4= -ft LAA .12 e 2 6--m- 8 4) c*;:.2 E — u x .81 's t 3? Z - ca LU C 0 - P� 0 5?;i u z u m-2 1 'o '0 < C9 LU z LU I I �i Aw, C4 11i -4 Id 600ft '-N *3*4 IP11.40S '.q CPU.(I W�wwlmwmom sma,me-AmV &DOE 0 :s--r:2� SNO1103S SSOW 7VLNOZtdOH SNGSVUN 'ON co CL96'-WUU9=P-qTrpliO.4-W.P.0 Dad oroz-wiauvadn lXVd A3NJ UNMAYM a3SKU 46 6'699'M :'-N —16 3,]-U-P-iWci 1.pi" pij.0 :,kISV43SSV bo --4d "I'l-A OCZ --a -O-djAy .1 's.LNv.LInsNoo amcnina MOONMA 9Nf)H 31000 :/Q P--d-ld :ion(30?Jd C4 :c 2 gu u 0 u P" t z 19 40 u zc U 0 - -a 1 (3 u 0 0 40 0. u ON u U au x ID m Eo .2 :E x J2"o 2:E I I D 2 z x z 0 co C4 C-i 0 > 8- OW Z n'&WKWlAdu—ja 3ay.V aWco=rEj=ldftn wn bAd%�park.An-lmd M sm—no Acti G=Z 'ON *3 OPUAI SNOISLA3M RVO 'ON SWLL03S SSON.) 7#0LLY3A OPPOU --*4d I I": i c6m -U OMWIDA OCZ XOS Wd amcrune Ay moomm DNnH 3ionoo c I! :,(8 pw"Wd.1--000 Un-aou 'SW3 C4 101 Ewa AU 04 us u to 0 lu 'T—IN MtajHONV 3wu T )(One MYO WN Jo 04—LKWOD olu OLOZ I ao—1 Puol� po PI-6 W..Ld JZVd LSIS'699'CLO :'-N--4d -1116A .Q .0. hLy MOOMM !)Nnk --nanoo C;Q; ocz d I 'SiNviinsNoo omicnins L48 PWDd�d nuowm�a X .9 L) r,777f.j x z 0 .9 r.9 u Iv go uj E6 V ur 2 r �Eo e F3 u*a"Ad t Sit a E h lie US EIL E 0 .0 1Y ru c 0 0" a .2 u g UR z z 0 u C4 cli DM VOMOMMMAOM-MET WASOPPA PBFCMdWNPWd-YIN W*C* '-N '!:.�4 uopukl 6�,'-w-cm ammme Will 600C 0 I SNOISIA3ki IIVJ20 ONIZV70 CNV nv x SLPONOMOO 'MMM-40 7718 RVU 'ONloo Cleo i r#Ao opompso Me 010 Iwo — --- --- &L I bou miyogn vi All"Awd A PACKS DPIIOU lWd CONUSaL SAIMAWWO a3SKU "*N:'!'dg g M - �d MOCNIM WH 3Vn00 to 3NI '&Lw.L"nsNoo ommons :48 P—d-d SZU-W--O �wo 6 ti zo a cs 7 0 6 cl I lil ; Z. — Z gll- c; L wo C11 C4 Wo— 19,0 W L cs Wo ziro .90'0— .69.1 0.07 0 uj 0 zd w Ed u U-1� z 12 ,.NQ Q 1 8 9 9 Q9 ne u -L:t— OR CD cn u m LU of pe 0 U M ILI Z in 9 1 U z 0 (-)0 u Uz— w Mz m Wu :.Wo cc 0' 8 u 6ull ad z �i nE 0 U, u u d 0 'iT 41 MM8 w6nmm -W!-I & -i El W�IL �o cd 0 It Hi 2&I'.g 5;!S�5;!5�- V V it I!I. Cj CL&L 2 1 ZZ�Mw AAM —00. zzzz ZZ > 5:> >mu f O!EZ m '2 2103 VS�UWMB-IAOUIAMUO MM-d'C\VCO D=Wat AWn-=PMWppd pgwt\%�.M City of Atlantic Beach APPLICATION NUMBER 4DBuilding Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 outed: E-mail: building-dept@coab.us Emal City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: q-7 2- ent review required rYesNo Building Planning &Zoning Applicant: Tree Administrator Project: XCAT Public Works Public Utilities Public Safety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: rApproved. nDenied. (Circle one.) Comments: PLANNING &ZONING Reviewed by: TREE ADMIN. =0 ed. SecondReview: nApproved as revised. [JDe ed. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. nDenied. Comments: Reviewed by: Date: Revised 05/14/09