1670 SELVA MARINA DR - GARAGE DOOR CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
JSil�f-
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-WIND-876
Job Type: WINDOW AND/OR DOOR
Description: garage door
Estimated Value: $2,100.00
Issue Date: 4/28/2016
Expiration Date: 10/25/2016
PROPERTY ADDRESS:
Address: 1670 SELVA MARINA DR
RE Number: 172001-0000
PROPERTY OWNER:
Name: WHITAKER, I B
Address: 1670 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: PRECISION DOOR SERVICE OF NF
Address: 11389 TRADE CT STE 101 JASON EDWARD SHEPPARD
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $30.25
BUILDING PERMIT FEE $60.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $94.75
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BI'II.DING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH FILE COPY
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: \fl `R\WK %0\\Q--\\1(1\ Permit Number: /6 M Vi/t/6" F76
Legal Description C)t\Z NAM� \\ C) 156 �� Parcel# 2O-2° O2 " -)s - -)01F,
Floor Area o Sq.Ft. Sq.Ft
Valuation of Work$ 2V3 -IC) Proposed Work heated/cooled non-heated/cooled \\2.
Class of Work(circle one): New Addition Alteration Repair M molition pool/s a window/door?
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one . o N/A
Florida Product Approval # � 2 \\
For multiple products use product approval form
Describe in detail the type of work to be performed: gep\o\Ce, e`'\ \ J nOO dmv
Property Owner Information:
Name: \ g VAh\ atR Address: \1u16 St\ 0\ Ma's`N°`. VP-
City its \C ?eA,C1- State G\-Zip 32 2V6 Phone cte4-24° - 1 c0 3 I
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: WtC\S■0\-.1 9- GC'(2-V1CC. Qualifying Agent: -30■ N SV1tWAV
Address: \Vb2.'3 123,a'f1C7S City 7AM State Cl— Zip 32251
Office Phone qb,k- log- ti Job Site/Contact Number t` Fax#
State Certification/Registration# C 1360C4
Architect Name&Phone#
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. 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 f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod of six(6)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 I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o/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 ' ' • Lf/J�aPG2kAC— Signature of Contractor
Print Name /?.e..,6, CGS /j. r- Name SAijilltAb
Sworn to and subscribed before me Sworn to and subscribed before me
this 12 D y of Pch\ ,20 1l4 this \2 Day o al ■ 20 \
7M67"Lelif aid*/ AFATIfff.
Notlry.Jtti)ic Notary Put .4,,,,„ MICHELLE A.• :H �"
;r' °:�:. MICHELLE ABRAHAM 44, t�
MY COMMISSION#FF146360 • MY COMMISSICReviS d O I. 6.10
•. EXPIRES J► v ':9.
EXPIRES July 29, 2018
(407)398.0153 FloridallotaryService.com (;071 8.0163 Floridallotary.•:r%w,c.:.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
• SJ` 800 Seminole Road - ,,/
1-3 � Atlantic Beach, Florida 32233-5445 1✓Q ��
�. Phone(904)247-5826 • Fax(904)247-5845
c) E-mail: building-dept @coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
2)-/-
Property Address: /4 10 -S! V� D 'I714. Department review required Yes o
Building)
Applicant: 7 3 C/ ) 'Tr) 2ôe Planning &Zoning
/' Tree Administrator
Project: a e *vQ1e Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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: roved. ❑Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING Reviewed by: Date: y' /5.1&
TREE ADMIN. Second Review: ❑Approved as revised. ❑D ied.
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