2033 SELVA MADERA CT WINDOW PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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WINDOW ANDIOR DOOR PERMIT
MUST CALL BY 4PMI FOR NE)Cr DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-WIND-1254
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLACEMENT
Estimated Value: $9,928.00
Issue Date: 6/13/2016
Expiration Date: 12/10/2016
PROPERTY ADDRESS:
Address: 2033 SELVA MADERA CT
RE Number: 169506-1646
PROPERTYOWNER:
Name: WOLFROM, LEWIS J
Address: 6482 GRISTMILL SQUARE LN
GENERAL CONTRACTOR INFORMATION:
Name: LOWES HOME CENTERS INC
Address: 4948TELSONPL CIA PETER ANTHONY CAFARO III
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $99.64
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $49.82
STATE DBPR SURCHARGE $2.00
Total Payments: $153.46
PERNUT IS APPROVED ONLY IN ACCORDANCE WELL ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
7
Phone(904)247-5826 - Fax(904)247-5845
Building Department (To be assigned by the Building Department.)
1
i,� 800 Seminole Road
Atlantic Beach, Florida 32233-5445
E-mail: building-dept@wab.us Date muted:
J, City web-site: http://�.coab.us �2
APPLICATION REVIEW AND TRACKING FORM
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Property Address: ZO_�`S SF�LVA M!PA D nt review required Yes No
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Applicant: Loy\)F,� Ho F=t-)Tc-�?-K Planning &Zoning
g Tree Administrator
Project: Vhf\)PmiL� _PLACP ry\r_�,D Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Rev'rew or.Rece'pty
of Pe .1,, rifled B Date
Florida Dept.of Environmental Protection
Flonda Dept of Transportation
St.Johns River Water Management Distnct
Army Corps of Engineers
Division of Hotels and Restaunan�s_
[A-vi-sion of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: EPA/pproved. ElDenied.
(Circle one.) Comments:
EEF�
PLANNING&ZONING Reviewed by: Date i� k/6
TREEADMIN. Second Review: F]Appmved as revised. F]DeniX.
PUBLIC WORKS Comments: -5s-z -2 B z --;s 4
PUBLIC UTILITIES F RX - - 300 —
PUBLIC SAFETY Reviewed by: Date
FIRE SERVICES Third Review: E]Approved as revised. DDenied.
Comments:
Reviewed by: Date
Revised 05/14109
05/31/2016 13:29 3523048237 KDOORS PAGE 02/11
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OFFICE COPY
FAX COVER SHEET
TO: DATE:
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FAXNO:
FROM: Dan Smith for Lowes Home Centers
7635 CACHE COURT
KEYSTONE HEIGHTS,FL.3265L,_
FAX NO: 30Y.JW7 CF�<-.�904-535-3793
COMMENTS;
05/31/2016 13:29 3523048237 KDOORS PAGE 03/11
DoQ # 2016121538, OR BK 17578 Page 217R, Number Pagem; 1, Recorded
05/31/2016 at 10:30 AK, Ronnie Fusgall CLZRK CIRCUIT COURT DUVAL COUNTY
RECOMINO $10.00
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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, Fl- 32233
PHONE (904) 247-5855
Cashier Id: atlbcld\atlbbja
Receipt Date: fi/13/2016 9:02:19 AM
Receipt Number: OS-7OOqq
JOb ID:_I"IND-1254 - WINDOW REPLACEMENT 0
LDGFEE BUILDING PERMIT FEE $99.64
JDb ID: 16-VIND-1254 - WINDOW REPLACEMENT D
C - STATE DCA SURCHARGE $2,00
1 JOb ID: 16-WIM-1254 - WINDOW REPLACEMENT P
PLAN CHEEV FEES $49.92
Job ID; 16-WIND-1254 - WINDOW REPLACEMENT S
S - STATE DBPR SURCHARGE $2.00
J& TO: 16-WIND-1 M - ENTRY DOOR REPLACEAE
NT DC - STATE OCA SURCHARGE $2�00
job LD: I"IND-1255 - ENTRY DOOR REPLRIEME
NT SS - STATE VBPR SURCHARGE $2.00
Job ID: I"IND-1255 - ENTRY DOOR REPLACEME
NT BLGGFEE - BUILDING PERMIT FEE $55.00
Jab ID: '"IND-1255 - ENTRY DOOR REPLACEME
NT PC - PLAN CHECK FEES $27.50
Aw.rt Due: $23196
Tender Inform,ti,r: C��h $239.96
Tender Type: CC
Tender Around: $239.96
Change Due: $0.00