1849 Seminole Rd 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 NEXT DAY INSPECTION: 247-5814
106 INFORMATION:
Job ID: 16-WIND-2563
Job Type: WINDOW AND/OR DOOR
Description: replace door size for size
Estimated Value: $2,599.00
Issue Date: 12/1/2016
Expiration Date: 5/30/2017
PROPERTY ADDRESS:
Address: 1849 SEMINOLE RD
RE Number: 169629-0000
PROPERTY OWNER:
Name: MORIN, EDWARD H
Address: 1849 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: PELLA WINDOW AND DOOR
,CBC046712
Address: 7818PHILIPSHWY QA JAMES SAMUEL ROWLAND
Phonw� -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $31.50
BUILDING PERMIT FEE $63.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $98.50
PERNIFT IS APPROWD ONLY IN ACCORDANCE WITH ALL CM OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 PO -aw-3
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coalous Daterouted: Idly
City web-site: http://�.wab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I %'iCl SW',f)Okk Dan�qge�t review required Yes -No
u
Applicant: Planning &Zoning
Tree Administrator
Project: C wk ILL 2- dw( �-k I-e- Public Works
Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review=P,,'y Date
of Permit
Florida Dept.of Environmental Protection
6-orida Dept.ofTransportation
St.Johns River Water Management District
Mmy Corps of Engineers
DiNdsion of Hotels and Restaurants
I Trvision of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First ReAWK. �A`pproved. [-]Denied.
(Circle one.) (te�)
(!H�R
PLANNING &ZONING Reviewed by: Date
TREEADMIN. Second Review: ElApproved as revised. ODenieV
PUBLICWORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. [-]Denied.
Comments:
Reviewed by: Date:
Revised 06114ffig
od,nmforpickupw4w4m BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
Can To for Pick Up 727-637-6400 800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: f`5� oi r Permit Number: 110-W-711UP -�(YW
Legal Description Pamel# /Ctci rZxq-0046
kloor Area ot Sq.rt. Ziq.kt
Valuation of Work S .0-el ProposedWork heated/cooled— non-hented/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pwl/spa(�w�i-d,,/door
Useofexisting1pro osedstructure(s) circleone) Commercial
If an existing structure,is a fire spriler system installed?(Circle one)(�'ii, !N�,
Florida Product Approval 9
For multiple products use pr'�W, iap�'p�n form
Describe in detail the type of work to be perforraed: (�AvNat.\ sut� s�o st-n—
Property Owner Information:
Nant-&'�Z_ Q 'A Address: &I
city —StateE4Zip3AXP Phone YOY-;N(P -QuO
E-Mail or Fax:#(Option
Contractor Inforin't'
-L'�wmVm&Dow
Company Nanre: mnw&a%Rood434 Qualifying Agent:
Address: LGog,1 FIL 32750 city state zip
Office Phone-707-(na7-.P(4 b ta Job Site/Contact Number
State Certification/Registration#Q_' W_04& i �. i� 1 r)x
Architect Name&Phone# ----------—III
Engineer's None&Phone#
Fee Simple Title Holder Name,and Address rIV I A 9A14
Bonding Company Name and Address
Mortgage Leader Name and Address
Applionion is hembv onole to obtain a p.�it to do the .,k and installations as naacptd ,i
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Tanks andAr Condiao.,d. 72 Fdd f
WARNING TO OWNER: YOUR FAILURE TO RFCORD 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 Y6M NOTICE OF
COMMENCEMENT.
Ilds
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Signatme of Ownera��_.;r_'A� Signature of Contractor 41��
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EXPIRES JUIY.9.201 a I
-IY29 2018
Doc # 2016254300f OR RK 17766 Pago 1666, Nuniber Pages: 1. Rewrded
11/04/2016 at 11:22 AM, Roft.is Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
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