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640 PALM WINDOWS i" / • CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD r ATLANTIC BEACH, FL 32233 WINDOW AND /OR DOOR PERMIT MUST CALL BY 4PM FOR NEXT .DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 16- WIND -999 Job Type: WINDOW AND /OR DOOR Description: window door Estimated Value: $2,450.00 Issue Date: 5/10/2016 Expiration Date: 11/6/2016 PROPERTY ADDRESS: Address: 640 PALM AVE RE Number: 170439 -0010 PROPERTY OWNER: Name: WHALEN III ET AL, ALBERT G Address: 640 PALM AVE 640 PALM AVE GENERAL CONTRACTOR INFORMATION: Name: PLUMBING BY JOSH Address: 5677 FLORAL AVE THOMAS R PORTER Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $31.13 BUILDING PERMIT FEE $62.25 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $97.38 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. FILE COPY ir ,4 BUILDING PERMIT APPLICATION A CITY OF ATLANTIC BEACH ��'� + ' VW' 800 Seminole Road, Atlantic Beach FL 32233 Office: (904)247 -5826 • Fax: (904) 247 -5845 Job Address: 64/-0 f41i A de AT / � � L Permit Number: /'////i/40 _V Legal Description RE# ) 70 4 -} 3 7 — 00i0 Valuation of Work (Replacement Cost) $2 SO, / Heated /Cooled SF Non Heated /Cooled • Class of Work (Circle one): New Addition Alteration Repair Move emo Pool Window/Door • Use of existing /proposed structure(s) (Circle one): Commercial Residentia • If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No 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: *( 7 T c 0),004 S - 1 662-s. FL I I (o L f 6. t 47 b fr -.0) 00CA 1) 04e S Florida Product Approval # J S 22—s a 3 g p ©e R • for multiple products use product approval form Property Owner Information /�n�� LT /9 Oh veL )<& 0 )/DstieS �'� Name: O Address: 4 TAY/ i, WClO a�??g ( bbV;l)e )L City .3A Y. f3eM State F1-Zip 322.SO Phone /Oil - 3 01 37,2,0S E -Mail Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) 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 C o m p a n y : 4 JAL .�JC Qualifying Agent: 7D, S le.. ! 0 /e7� Address: 56.... 7 ? F J O ) 4 e City ., • l i d i-z ... , " - , , --- Office Phone (it) 7? — 7000 Job Site /Contact Number 1111 L C- L 1 MrAl State Certification/Registration # C6CP,." M7 E -Mail i ; i -- ` f,tl Architect Name & Phone # Engineer's Name & Phone # 1111 • ; 1 M IIIII Worker's Compensation `,• 1 • gm �� — �U Exempt Insurer Lease Emp oyees ' xplration • . e Application is hereby made to obtain a permit to do the work and installations as indicated. I cert t • • - • • • ion has commence prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construc ion • . . . This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or ab. done, , or a period of six (6) months at any time after work is commenced. 1 understand that separate permits must be secured f Elect cal s r , P1 bing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks and Air Conditioners, etc. Signature of Property 1wner: Signature of Contractor: Beforl r this G D ay of Al Ill • a ,, i - Before me this 2" Day of A l • r ZO 1 r laire 4 fr L • Notary Pu. • • j — Notary Publi • _____ IF e ill • I her ct'i . , t , - 1 , , e', , ed this application a , , Ot7 ajte maievertat ,w rr' t. Al provisions of laws and ordi - n . •%; et0l31! MAO'S t rnr c • I be complied with ail* fec it Th ishemnot. e . anting of a permit d oes not pres e lb °_ i e c '•If ®Y• rtPiO ate or ca el the provis of A ' / ei natate,naF dee blaw 'gulattng construction or the perf, C ry 2� n FF 08 or $ i"xpires 02/14/2018 orr xpures 02/14/201® + Uiv 3/14/16 4 ri it , City of Atlantic Beach APPLICATION NUMBER • . Building Department (To be assigned by the Building Department.) 800 Seminole Road / /AJ ,,/ Atlantic Beach, Florida 32233 -5445 ! - vv� / Y ed -999 9 Phone (904) 247 -5826 • Fax (904) 247 -5845 , p E -mail: building- dept @coab.us Date routed: 1" 2 // 0 City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 61 4 /n1 ent review required Ye o Building Applicant: / 14 /7)6'/ /? � y JdSh arming & Zoning Tree Administrator Project: W / /l/b Q �,(� QQ `� Public Works Public Utilities Public Safety Fire Services ,Review Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By 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: (ILDING PLANNING & ZONING Reviewed by: Date: S 3 "� TREE ADMIN. Second Review: ❑Approved as revised. ❑Deni . 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