178 Beach Ave windows & door permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
3 ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
lob ID: 16-WIND-2533
Job Type: WINDOW AND/OR DOOR
Desciption: FINALIZE WINDOWS, DORRS AND HARDY SIDING -
REPLACE 13-3026 French Doors FL14752.6, 15-WIND-690, and 15-SIDE-669 Siding
Insulation Facia
Estimated value: $3,000.00
Issue Date: 11/30/2016
Expiration Date: 5/29/2017
PROPERTY ADDRESS:
Address: 178 BEACH AVE
RE Number: 170210-0000
PROPERTY OWNER:
Name: 178 BEACH AVE LLC
Address: 6 E BAY ST SUITE 500
GENERALCONTRACTOR INFORMATION:
Name: CANTRELL CONSTRUCTION, INC
,CGC062514
Address: 1015 ATLANTIC BLVD CIA MARK FRANCIS CANTRELL
Phone: -PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $32.50
BUILDING PERMIT FEE $65.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $101.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDWANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road I / _1n ,t (^v,Q —C_7SS3
g - Atlantic Beach, Florida 322335445 lO V V ,
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@mab.us Date routed: I
City web-site: http://wvnv.mab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 17L Eago t)re De artment review re uired Yes o
�l uildin
Applicant: AK)TRPLL l N'i `( Planning&Zoning
1 I Tree Administrator
Project: W 1 k Public Works
Public Utilities
Public Safety
Fire Services
p� ermt s
Other Agency Review or Permit Required Review of Pernit VeNRed or ReceipB t Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Anny Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUIL NG
PLAN G &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie .
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05114/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach,FL 32233
Office (904)247-5826 Fax (904) 247-5845 1 (o-W I N D-7
Job Address: 178 Beach Avenue-Atlantic Beach,FL 32233 Permit Number:
Legal Description Lot 5 Block 31 Atlantic Beach PB 5 page 69 Parcel# 170210.0000
so Floor Area of Sq.rt. Sq.rt
Valuation of Work $ 30 0 Proposed Work h"ted/cooled non-heated/cooled
rteanti•�4rt t.,ke.-ypr«iZ Cy�l.
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of exisNng/proposed.structure(s)(circle one): Commercial Residents OFFICE COPY
Man existing structure,is a fire sprinkler system installed?(Circle one . o N/A
Florida Product Approval#
For multiple products use pr uct approve orm /J
Describe in detail the type of work to be performed: aa•.�
f� / #4-Ac 'y 51Dloj6e
Property Owner Information: ' \e�1,�1a� 13- 3oz eV- r-ti.CL'.h O0or8 - r-(_ ) a7s z,(o
IS-w l No_ Co90 -W 101�+Doo es , IS-Si 0 E. - (o 89 --34I 3sa4,
Name: 178 Beach Avenue LLC Address: c/o David Edwards,200 W.Forsyth St.,Ste 1300 � anirl
City Jacksonville State FL Zip 32202 Phone 904-699-5333
E-Mail or Fax#(Optional) dedwards(Lbedcolaw.com
Contractor Information: �1 1
Company Name: CAeJYReik 10 Rod mV--r4iO4Qualifyigg Agent: �1•I.nRI� t`MJ*2E/'L
Address: X45 AA l a�.4 City 9llwwYt t &lc. State _Zip 12-4 ?3
Office Phone I e/28 Job Site/Contact Number - Fax#
State Certification/Registration# r. 6 r &e.26'/f/
Architect Name&Phone#
Engineer's Name&Phone# —
Fee Simple Title Holder Name and Address -
Bonding Company Name and Address
Mortgage bender Name and Address -
Application is M1ereby 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
E-
ofa permit pad
all work will be performed m race(the standards ofa/,laws regulating construction in this jurisdiction. This permit becomes null
and void,,work is not commewed within six(6)months,or if construction or work is suspended or abandoned far areried ofsis/6)months at any time after
work is commeneed. I understand that separate permits mast be secured far Electrical Work,Plumbing,Signs, Wells, Pools, Pwnness,Boilers,Heaters,
Tanks and Air Conditioners,etc.
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.
1 hereb certify that I have read and examined this a,ppplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type oJywork will be complied with whether speciped herein or not. The granting ofa permit does rot presume to give authority to violate or cancel the
Pro.
.ant of any otherfederal,state,or local law regulating construction or the performaroe of construction. yy� /f
Signature of Owner ,1�,( �j\�\1C- '/f ,/ _ Signatureof Contractor I'4avf,--F / we
Print NameV-If�...�-1:......�tL'r'V f/�i�5 ._....._........ Print Name
—..---...---.....—
Sworn to and subsc 'bed before me Swo and subs rib d before me
this Q Day of 20 I this y of 20
do
Notary Public Notary Public
Revised 01.26.10
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