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1921 SEMINOLE RD - WINDOW REPLACEMENT I i e:- ' ,.,, sA CITY OF ATLANTIC BEACH III ''� . -j 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 � INSPECTION PHONE LINE 247-5814 �JJil9f WINDOW AND/OR DOOR PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-WIND-889 Job Type: WINDOW AND/OR DOOR Description: WINDOWS - REPLACEMENT Estimated Value: $5,000.00 Issue Date: 4/22/2016 Expiration Date: 10/19/2016 PROPERTY ADDRESS: Address: 1921 SEMINOLE RD RE Number: 169542-0530 PROPERTY OWNER: Name: JONES, RAYMOND E Address: 1921 SEMINOLE RD GENERAL CONTRACTOR INFORMATION: Name: DUVAL CONSTRUCTION INC Address: 13221 Mendenhall PL Phone: - - PERMIT INFORMATION: FEES: --- - -- -PLAN CHECK FEES $37.50 BUILDING PERMIT FEE $75.00 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $116.50 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA BUILDING CODES. r51,i-vyrc, City of Atlantic Beach APPLICATION NUMBER J ;..St, Building Department (To be assigned by the Building Department.) Atlantic tic Beach,Road � / _kilt I C\ _ � 9 �� Atlantic Beach, Florida 32233-5445 l.0 J: Phone (904)247-5826 • Fax (904)247-5845 101319r E-mail: building-dept @coab.us Date routed: 4 t City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 19 Z k S enil 1.1000.._C Ru Def. + 1 ent review required Yes No :uildi • Applicant: iUV'(,,L e,OY ,T,t)�r t,--,,_ 'tanning &Zoning - 1 Tree Administrator Project: W I !J c>OI,R�P -o L Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature I Review or Receipt Other Agency Review or Permit Required 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: P pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: Date:y s /. TREE ADMIN. Second Review: Approved as revised. fDe d. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 FILE CQ '? /•f't r�l,l lei. E C E 0 V E BUILDING PERMIT APPLICATION D J St� r� CITY OF ATLANTIC BEACH APR 1 5 2016 800 Seminole Road,Atlantic Beach FL 32233 _)'iii Office: (904)247-5826 • Fax:(904)247-5845 Job Address: /V/5.E. x/ozE €1 Permit Number: Legal Description 42-AI 07-.25-21E eF7,945/ RE# /1 9,542 -0,53 t Valuation of Work(Replacement Cost) O�teated/Cooled SF /Q50 Non-Heated/Cooled 25,3/ It'`D rim fJ©i.OS SVC) C) • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Doo • Use of existing/proposed structure(s)(Circle one): ommercia Residentia • If an existing structure, is a fire sprinkler system installed?(Circle one): Yes N N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: Florida Product Approval# TL f 3/J F i 5/ for multiple products use product approval form • Property Owner Information C y Name: / 1ON� d�,,J FS Address: /9.2/ ,5'rw vi(2. P,) City T/C� .8 State aZi p 2 2223 Phone .94 - r) E-Mail Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) N/4- 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. Contractor Information: Name of Compan :tr�//�gZ CO.v rj/ (oL /(AJ Qualifying Agent: E��0 D I/ Address: /?J ,/ J77a/1).FR/, 9Z2 4 City %NG' State Zip ;3-�� Office Phone ix)- 9R7_29_39 Job Site/Contact Numb 907— 7t '7 9 State Certification/Registration# CGC /37.2e1/20 E-Mail lol'i9Z69167 /drier - e G/Mil_ C©i Architect Name &Phone# Engineer's Name &Phone# Worker's Compensation /`'/-F''T Exempt / Insurer / Lease Employees / Expiration Date 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 r us ended or abandone,for a period of six(6)months at any time after work is commenced. I understand that separate permits must be secur' f, Electrica Work,P1 don_, Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Conditioners,etc. i(Signature of Property Owner: r Signature of Contracto �. ._ A Befor;,tyte, ,� t� %r � ' • this / ay of '' r✓/ Before me this II.y •of ion i. C �C3 I/ - $4 f Notary Public: I, % , I '�:7.ilta a,, y _ . .. !,r 'ubliQp,..• ' .�, a• 4.:a EXPIR :January 5,2020 ,. MY COMMISSION a FF•' ' 1 =?R;h ' Bondad Thw Notary Pubic Undaiwibn = EXPIRES:October 6,2019 I hereby cert(that I have re -----'---- -- --- ' kno f&a„ a�bd-riv Netofet��?o9 P.f5 , provisions of laws and ordinances governing this type of work will be complied with whether --•--- —__Ar.t., 1e giu g of a permit does not presume to give authority to violate or cancel the provisions of any other le era?, state, or local law regulating construction or the performance of construction. Rev.3/14/16