1735 BEACH AVE - WINDOW & DOOR r `I, CITY OF ATLANTIC BEACH
A, 800 SEMINOLE ROAD
yys ATLANTIC BEACH, FL 32233
_N 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-1579
Job Type: WINDOW AND/OR DOOR
Description: NEW WINDOWS AND DOORS
Estimated Value: $131,500.00
Issue Date: 7/19/2016
Expiration Date: 1/15/2017
PROPERTY ADDRESS:
Address: 1735 BEACH AVE
RE Number: 169668-0000 _
PROPERTY OWNER:
Name: LANE III, EDWARD W
Address: 1735 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: MCANENY BUILDERS LLC
Address: 1010 EAST ADAMS ST LEONARD W MCANENY
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $287.25
BUILDING PERMIT FEE $574.50
STATE DCA SURCHARGE $8.62
STATE DBPR SURCHARGE $8.62
Total Payments: $878.99
I'ERsIIF IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
BUILDING CODES.
x.0-4 yy�� City of Atlantic Beach
`Jai BuildingDepartment APPLICATION NUMBER
ir
(To be assigned by the Building Department.)
III - Iv
800 Seminole Road I _\, /I 0 ��
+�� Atlantic Beach, Florida 32233-5445 �/V
Phone(904)247-5826 • Fax(904)247-5845
'=�J;;is%- E-mail: building-dept@coab.us Date routed: 7 j 1 3 I Coe,
City web-site: http://www.coab.us 1111
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 '7 EA-CN rAVC Department review required Ye No
BUILOER_ _
‘_Buildings) VApplicant: c P N C—N S ming &Zoning
Tree Administrator
Project: WIl000UL) kh CO 1,S 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:
APPyCATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle n Comments:
SING\ fVo
PLANNING &ZONING Reviewed by: Date: ! 'F 6
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
0•
s,
BUILDING PERMIT APPLICATION
7.5 �' CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233 r:ILI Ell vi‘OPY
���;sl>r Office: (904)247-5826 • Fax: (904)247-5845 l c ,—,VJ(t)c ._ ( C -79
Job Address: /77-jamAkle.77"el- r, ?MI Permit Number:
Zs-ZfF ofrumoric 4104.,Awl.6, ofL.Qri
Legal Description Larriaig-t3•reoZ4vs6/511f 6N3 //1 RE# /6 9668-O7Ja8
Valuation of Work(Replacement Cost) $13 1 5.00.-1-. Heated/Cooled SF Non-Heated/Cooled
I
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool 0-iindow/157or
• Use of existing/proposed structure(s) (Circle one): Commercial Residential
• 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 beyperformed:
, lA'ifP&-1efleE- !N/ 1000- sq/E1(4--�v»tS
Florida Product Approval#_ for multiple products use product approval form
Property Owner Information
Name: 144tx. hove Address: /11W X� 4 �v�•+4NF
City i4p e— Xf.441/ StatcrG Zip 32233 Phone
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 of Company: %/44y .i,‘.~-5, LAG Qualifying Agent: Ge,I/ d/�.y'f fft
Address://o f/lion � e — c€O II' city iei-S►✓ ,,.cam- State Zip 9/ ,L2oL
Office Phone?Iv- 3 -/956 Job Site/Contact Number
State Certification/Registration#44e/5'08,Z,-7- E-Mail LAW e/$141✓e(/.fi/i"}E5t$,e-ool
Architect Name & Phone#
Engineer's Name &Phone#
Worker's Compensation
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 o jsix(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,Boile Heaters, Tanks and Air Conditioners,etc.
Signature of Property Owner: A—A...e._ /1- Signature of Contracto • /`�
Before me
this Day of 71N1.t_ hQ r rr, efore me this
i o'."•.•; JENN i'ER vitt i 3( Day of VV1.0— 0
I * * MY COMMISSION f FF 158293
Notary Publi��t 9 A, d EXPIRES:September9, 1$_ `�`Y"'�� ,JENNIFERyVIWA1
�� ry Public: * * MY COMMISSION i FF 158293
a� EXPIRES:September 9,2018
! v udpet No0ryBenzes
I hereby cert that I have read and examined this application and know the same to be true and correct. All prow s?eht3°oof laws anc
ordinances governing this type of 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.
Rev. 3/14/16 '
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REVIEWED BY: //y' DATE: 7'Y y/6
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