500 Orchid St door 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:
Job ID: 16-WIND-2269
Job Type: WINDOW AND/OR DOOR
oescriptfon: REPLACE DOOR
Estimated Value: $2,773.00
Issue Date: 10/12/2016
Expiration Date: 4/10/2017
PROPERTY ADDRESS:
Addrew: 500 ORCHID ST
RE Number: 170906-0000
PROPERTY OWNER:
Name: HADDEN, BEVERLY E
Address: 500 ORCHID ST
GENERAL CONTRACTOR INFORMATION:
Name: PELLA WINDOW AND DOOR
,CBC046712
Address: 7818PHILIPSHWY QA JAMES SAMUEL ROWLAND
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $31.93
BUILDING PERMIT FEE $63.87
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $99.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES A" THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
y 800 Seminole Road I tic) – z
Atlantic Beach,Florida 32233-5445
-5826 - Fax(904)247-5845
01: Phone(904)247
E-mail: building-dept@coalo.us Daterouted:
Citywelb-site: http:/A�ww.coaIb.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -5c� nfz0_o4(3 T Qpp ant review required Y ?NO–
uldn_m
Applicant: rjC)o F',,On t? Planning&Zoning
PCPL r::�Ca Tree Administrator
Public Works
Project:
Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt
of Pennit Verified By 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:
APPLICXION STATUS
Reviewing Department First Review: EgA'p"proved. ElDenied.
(Circle one.) Comments:
0 C_
PLANNING &ZONING Reviewed by: Date:/0_
TREE ADMIN. Second Review: [JApproved as revised. E:]DenieV
PUBLICWORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: —Date:
FIRE SERVICES Third Review: ElApproved as revised. E]Denied.
Comments:
Reviewed by: —Date:
Revised 05114109
I
Can 11m for Pick Up M4W414W BUILDING PiERmT APPLICATION OFFICE COPY
CITY OF A TLANTIC BEACH
$00 Seminole Rua d,Atlantic Beach,FL 32233
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WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU IINTE TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR ANATTORNE4YEFO RECORDING V6U NOTICE OF
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Doc # 2016229588, OR EK 17732 Page 93, Number Pages: 1, Recorded 10/04/2016
at 11 :51 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
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