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1860 N SHERRY DR GARAGE DOOR PERMIT c„ , �� , ''= �s, CITY OF ATLANTIC BEACH :a► 800 SEMINOLE ROAD .) 1Ole_, ' ;r 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-1134 Job Type: WINDOW AND/OR DOOR Description: REPLACE GARAGE DOOR Estimated Value: $1,300.00 Issue Date: 5/24/2016 Expiration Date: 11/20/2016 PROPERTY ADDRESS: Address: 1860 N SHERRY DR RE Number: 172020-0838 PROPERTY OWNER: Name: BANKS, RICHARD A Address: 1860 NORTH SHERRY DR GENERAL CONTRACTOR INFORMATION: Name: AMERICA'S GARAGE DOORS Address: 1110 SHETTER AVE STE 104 QA RONALD C STEPHENS Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $28.25 BUILDING PERMIT FEE $56.50 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $88.75 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. iJ:‘ui City of Atlantic Beach APPLICATION NUMBERs r Building Department (To be a si ned by the Building Department.) r 800 Seminole Road — IN/A)�) _1 I Wit''' y�'� c• Atlantic Beach, Florida 32233-5445 ,� r Phone(904)247-5826 • Fax(904)247-5845 • .^.ost �. y E-mail: building-dept@coab.us Date routed l 7 16 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 860 S t E ERL fI . N Department review required Yes No uilding� Applicant: 1'Me1'(.c_c �S Qatote5 ��(' anning &Zoning pp , Tree Administrator Project: �e(;JC 4(--; c o i` Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature 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: proved. ❑Denied. (Circle one.) Comments: BUILDING �/►� �t VPLANNING &ZONING Reviewed by: / / 1 Date: ,5 / t b 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 /rS�1,`l ri;; BUILDING PERMIT APPLICATION FILE'• -, -..--.) ,.. CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 ��;ttvr Office: (904)247-5826 • Fax: (904)247-5845 ' 0 - �I�l ( tom ( 1 34— Job Address: 18(P 0 N t( 1 S k e rr P (. Permit Number: Legal Description �� RE# 1 9 2 0 20 - D8 38, c;, Valuation of Work(Replacement Cost) $ I)3' Heated/Cooled SF Non-Heated/Cooled ■ Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool ndow/Doo) • Use of existing/proposed structure(s)(Circle one): Commercial Ienti,al • 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: rep(&Ce - •0, Florida Product Approval# 1 4 b 0 i for multiple products use product approval form Property Owner Information ----.---- Name: irkS 7 f u3 r Address: 18 1p L) Sher PC N City k 1&v 'C tea WI State k Zip3 2133 Phone 904- 2-41 '7 0 . 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: Lt,C 1- Name of Company: A YYv� _ S CLQ r& ' 1�,� Qualifying Agent: 1:..0 a.�� S }" F`S� Address: t h )0 � e--H-ex ' .0 IU14 , City Jetti-5 mv.JIc geetC1Statee ZipS FL 3 Z2 Office Phone 10 • 9q$•Q200 Job Site/Contact Number St•CP'` State Certification/Registration# E-Mail ill CO LQVl4e.r C_I S ?AM rs. Low Architect Name & Phone# L} or ron s f p t e r<SJ R e1 A-l1 a D. Cir-‘ Engineer's Name & Phone# Worker's Compensation ( ;`!kak -c47_73 •-• 4, t r‘Srae2� c� r\ 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 is suspended or abandoned for a period 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,He er s and Air onditioners,etc. h Signature of Propert •wrier: Signature of Contra tor: Al I`, gi l Befo e i this Day of A a( ' Air 0 Before me this : Day 1• `4. s /, r=rr,acv.:<ecFiG�a .A •4 Notary Public: _0 4 � Ak.., ,1o• • - ` ''S1 etary Public: ___ • tar i`s _;;p mbar 6.2019 __ iik,--7'� tV�,l S'C 1 l4 Nw EPi--1 ;� .. hmNosYPubicU�derwnten •� �� I here ', that ttniteiNti RG @�e. tri t'% - ..:_._..,-.�---, e same to be true and correct. All provisions of law.. �d ordin s,rt ,• rnit`tgaMIM1sssNAM kfig'44�1 `"" a e coy"!ied with whether specified herein or not. The granting of a permit does not preset .r te?' , au&XelflS:Actol l&f019r al.cel the provisions of any other federal, state, or local law regulating construction or the petfom cfli calque-Thro9ptyPubkUnden iters Rev. 3/14/16