86 Nicole Ln window permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NE)(T DAY INSPECTION: 247-5814
JOB INFORMATION:
lob ID: 16-WIND-1871
Job Type: WINDOW AND/OR DOOR
Description: 4 replacement windows - size for size
Estimated Value: $2,350.00
Issue Date: 8/24/2016
Expiration Date: 2/20/2017
PROPERTY ADDRESS:
Address: 86 NICOLE LN
RE Number: 169519-0720
PROPERTY OWNER:
Name: HETH, DONALD G &VIRGINIA S,
Address: 768 RIVENOAK I
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN WINDOW PRODUCTS
Address: 2633SPOWERSAVE QAKEITHALANGURR
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $30.88
BUILDING PERMIT FEE $61.75
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $96.63
PERMIT IS APPR(YVED ONLA 1� ACCORDAN� WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODE&
City of Atlantic Beach APPLICATION NUMBER
AMk Building Department Cro be assigned by the Building Department.)
800 Seminole Road k)
Atlantic Beach, Florida 32233-5445 L W-1-
Phone(904)247-5826 Fax(904)247-5a45 C)
E-mail: building-dept@coalous Date routed:
City web-site: http://�.mab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: '%(a 1) 0 A De a ent review required Yes 'No
;;g_ -7-
g
Applicant: Arn t4 :(_c4LA Virjpw ficoilaiLks -N�ing
Tree Administrator
Project: L1L0 _pkkLCVrJA4r S�-Cf_6 Public Works
Public Utilities
-Public Safety
Fire Services
Dept Signatur���
Rev Z9 0I.ReC t
Other Agency Review or Permit Required ofP9 ,V rifltidpft Date
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: EYAploroved. [-]Denied.
(Circle one.) Comments:
(��D
PLANNING &ZONING Reviewed by: Date: 2 Z 6
TREEADMIN. Second Review: DApproved as revised. [:]Den!eV.
PUBLICWORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: —Date
FIRE SERVICES Third Review: E]Approved as revised. DDenied.
Comments:
Reviewed by: —Date:—
Reviiiiixi 05/14109
BUILDING PERMIT APPLICATION sab-lro
ic BEACH
c Beach, Fl, 32233 FILE COPY
Lx(904)247-5945
Job Address: PervaitNumber: 1%0-W1AJ6- IT+1
Legal Description. ?arcel#
Valuation of Work 'cooled heated1cooled-
16-6bD
Clam of Work(circh AMERICAN WINDOW iir Move Demolition pool/sp<�Ioor
Use of eldirtin PRODUCTS.INC. Residemi �
P-M-C 2633 POWERS AVE No N/A
If an existingf 07 [WaP�l
Florida Product pr jACKSONALL.E,FL 322
For multiple prtsuc
Describe in detail the Lork(ew-s ze', -Gz
Proverty Owner Ilif d
20MUT W.-
Nang Y"W- R" Addrow S(O Nicole Larw-
city 449 0 Statef:ff Zip_�L�P�Phggne
E-Mail or Fax�#(Optic )
Contractor Information: AMERICAN WINDO W
Company Name:— 2GUM ElOR'SINACME. Quali6ingAgent:
Address: jACKSONVILLE,FL 32207 city State Zip
Office Phone -1�>
- �Z -7 �Job Site/Contact Number Fm# -701- SSZ4
State Certificifion/Registration# 2"51 SO"I
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bending Company Name and Address
Mortgage Under Name and Address
Application is hereby made to obtain a permit to do the work and intallations a,indicated Icertiyuhat no work or inuallation hot commencedprior to the
matuawe ofapermit and that all work will bepe onnedc,meet the standagrals o(all laws regulating construction in thajurabetrom Thispermitbeconunnull
andvoid ffwmk is not commented within six(40-onthe,or OrcongOgtozon or work u, ndedorabandanedfora rzodofgbrA
wor*ucomaw.d. itmdouanddulmparalepe�ia,onat be secaredforElectr4nork,Plumbing,Signs, wed1hPooft, ) omhs ar any it. iler
Tank,andAhr Conditioner;et, urnacee,BoUm,Heaters,
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 ArrORNEY BEFORE RECORDING YOM NOTICE OF
COMMENCEMENT.
linee ceraythatfluvereadandexaminedtha ficagio�analkow the so.to be true and correct Allprwlsione ollawspa!ordinances gacernmg,tha
X �, spill be complied with whether -x9heremornot. The granting of apermit does notpremgme to give authority go violate or cancel the
&W-nkf wry otherfede at ale,orlocalTm.eci= construction or the p&f&mance of construction.
SignatureofOnuner Zr_oVVU-(2 Signature of Cont7
-k�......... Print Name e
Print Name y1i ................... ...
Svtong to and a bacribed befbrepe,2 Sworn to and subscribedbefore me
o"lore
diF --204/- .20/1e,
A3 Day ODa of 1�1[on.
U
t RMAUSTN Notary Pottle
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COMMISSION#FF NW MYCONAMIFFIM06
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