1991 MIPAULA CT - DOOR i, 'r lei`.
' ' `� \s, CITY OF ATLANTIC BEACH
�, � 800 SEMINOLE ROAD
j� ,. ` _v ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
N
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-WIND-1962
Job Type: WINDOW AND/OR DOOR
Description: FRONT DOOR REPLACEMENT
Estimated Value: $2,002.00
Issue Date: 9/1/2016
Expiration Date: 2/28/2017
PROPERTY ADDRESS:
Address: 1991 MIPAULA CT
RE Number: 169506-1032
PROPERTY OWNER:
Name: GRIFFITHS, HARRY JOHN
Address: 1991 MIPAULA CT
GENERAL CONTRACTOR INFORMATION:
Name: LOWES HOME CENTERS INC
, CGC1508417
Address: 4948 TELSON PL QA PETER ANTHONY CAFARO III
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $30.01
BUILDING PERMIT FEE $60.01
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $94.02
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
01..Jvp/y, City of Atlantic Beach
rf tit, Building Department APPLICATION NUMBER
" :� 800 Seminole Road (To be assigned by the Building Department.)
Atlantic Beach, Florida 32233-5445 J —f� _ Q / 7
Phone(904)247-5826 • Fax(904)247-5845 //(p C_
'"..o E-mail: building-dept@coab.us /2 /j
City web site: http://www.coab.usDate routed: 8 (�
APPLICATION REVIEW AND TRACKING FORM
Property Address: I (:)c) ( I V \ 1 PF o cA 0, I_Dep. iadzent review required Y7-No
I cBuilding
Applicant: LOQ S )---10/11 E alOr - anning &Zoning
Tree Administrator
Project: RC Pu c rgQ O7 00 2_ Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
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: F roved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONINGni y W
�� �6
Reviewed by: Date:
TREE ADMIN.
Second Review: DApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY _ Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUIJLOING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845 1 -Y ) (NO -1 962
Job Address: 4 l. Mi
MA 1� �"� ��-�6tri-�'1 C�kCtCC1 Permit Number: _
Legal Description-3!; .- F a i n A ' '-y 2-Z-2. -
7 o� S- i Parcel# A9 - �3y
Valuation of W 1(12---0--Z-- :Proposed• r` theateof Sq.Ft.d/cooled
q t
Work b�atealcooh➢d upn fieatedlcooled
Class of Work a New Addition Alteration Repair Move Demolition pool/spa window/door
Use of eristietg/pro recta _�
1e° • Commercial Rcsidenrial
If an existing structure, st
i$a pciro r ayateraa i taped?(Chichi,one): Yes No N/A
Florida Product Approval /S27-.7
For multiple products u r uc A prove m '•-.. ..71-,,,
Describe in detail the type of work to be performed: N'' .\)�r tv Ufa ..-S.:›1-1\'CC Y\AQ N'r
Property Owner Information;
Name: TP"\A E.Com, D/'( .Address: 1e:1 , L
• 1 } M I pL L A er
City —Crit c.. I e IA. • 1 .StateS_zip 22'33 Phoane 4' , --
E-Mail or Fax#(Optional)
•
Coetreett;laformetions
company Va0e: -D W S �ctY1�_ Lie`L-tcr s P-Qualifying e t ✓
Address; .P)0}4 -1.1&1'71c-71 City OrAvGf1 State -
_Lip_... )-- -til '.t
Office Phone40-1 '' C'tEe.,X Job Site/Co tan Number
Fax/*
Sento Certifcation/Regimration 0f co /'7
Architect Name&Phone* Al - - -- — -- _ ___
Engineer's Name&Phone# .,-----
Fee Simple.Title Holder Name and Address ' _ '
Bonding Company Name•and Address
Mortgage Lender Name and.Address
4pp(rcemen is hereby made to obwm a permif•tu o the work and installations as indicated I c.rgfy that no work or Jn*lallalion has earn,.eneed prio,to Me
issuance a permit gad that all work.Will be per armed to meet the standards of oil laws.egvlaring t nfMuctean vt this tterisdictton, Thas psi mit tiscotncs lull
and void tea
is not otos al within sir(6 atontht.or fconstrttaion or wgrk l4 stipp�nended ar abandonei for a purled of At 6)tnotuhs at ani:heft after
work is commenced F smderstand that separate permits must be secared for Ekctttical Work,Amenn%,Ste:, We/h,Pools,Furnaces,Boilers, Heaters,
hank*and Air Conditioners,etc_
WARNING T4 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, IT
YOUR LENDER OR Ai ATTORNEY BEFORE RECORDING YOUR NOTICE OF
r N. COMMENCEMENT.
I hereby certify.that I haw renal and examined this kaftan and know the same to be tree and correct All provisions if lows oredi , e,+scenting this
type d work will be comatewit whether spec ed herein or not. The granting of a permit sloes not presx�e to 8ysoe as. • style ,.late or c'o,, ul the
prowrwnss of wry other federal,`,•• or local how .. •Ong conseructton or the performance ofcontrrumion. / /
Signature of Owner
Signature of C:ontr
Print Name
.. -_.. ...A...t ._...J __.........:....__-.,..____. Print Nameia
_�
Sworn to and subsor'bed before me Swum to and subsc before me
this.o ,Day of ask- ,20 112 this ._Da„ - • 2 /-6
Notary u is1 otary 'u, tc
. * STACEY OWES.,
MYCOAb smOircrgeoi3 Revised 01.26;10
. t WfS:APR 10,2020
.4.J.'.."' s same nowt 1st Stale insulate
9
i
;
...OWE
Lowes Home Centers LLC
Permit and License Administration
PO Box 781993
Orlando,FL 32878-1993
Bus.407-393-9161
Fax 407-393-9151
Date
To: 17— �i -,17 i,tJ — 'V
Re:Authorization to obtain permits
To Whom It May Concern:
The following persons,J9hn D.Smith Jr., Nathan Ryder and Vanessa Woods are authorized
to act on my behalf to-obtain permits in your jurisdiction.
Sincerely,
Peter Anthony Cafaro Ill
State License Qualifier
Lowes Home Centers LLC
CGC1508417
State of Florida County of Orange
The foregoing instrument was acknowledged before me as Peter Anthony Cafaro Ill who its personaly known
to me and who did not take an oath. //��
Sworn to and subscribed before me-this '7/ day of }CJIs4,6V'7 ,2016
(.
No.Pubic
My Commission expires ,,,,,,,,,�
:°ta` 4° ,, DEBRA L CARTER
'`tr,t,& Notary Public-State of Florida
q=y My Comm.Expires Mar 18,201711
n ,,o 14 Commission#EE 874638
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