149 BELVEDERE ST - WINDOW S y�J'r
,� '' \S, CITY OF ATLANTIC BEACH
;
� ..,� .. j 800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
N INSPECTION PHONE LINE 247-5814
_____)
\Jlil� '
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-WIND-2892
Job Type: WINDOW AND/OR DOOR
Description: REPLACE THREE WINDOWS
Estimated Value: $1 ,236.00
Issue Date: 1/10/2017
Expiration Date: 7/9/2017
PROPERTY ADDRESS:
Address: 149 BELVEDERE ST
RE Number: 170586-0000
PROPERTY OWNER:
Name: KELLY, CANDANCE
Address: 149 BELVEDERE ST
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 $28.09
BUILDING PERMIT FEE $56.18
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $88.27
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
�s rjir. 5\ Building Department (To be assigned by the Building Department.)
• -_ 800 Seminole Road j i N.)O - Z�>�Z
'! Atlantic Beach, Florida 32233-5445
Phone(904) 247-5826 • Fax (904)247-5845 /
:/. 9� E-mail: buildin de t coab.us Date routed: Z 1 2-9 /1 (47
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: `T Q► C—�L-V EOEE t De. . . is -nt review required )(ley No
ilding
Applicant: Lc7wE S �O ME -,
:ening &Zoning
Tree Administrator
Project: A) 10 S `� Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ _ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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: r�Approved. I (Denied.
(Circle one.) Comments:
UILDING
PLANNING &ZONING /' /
Reviewed by: Date: -/
TREE ADMIN. Second Review: Approved as revised. !Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845 I ( '--\A) (100-Z 89 Z._.
Job Address: j 1:-1 Oe..,( V cJe re -S•f--• Permit Number:
Legal best riorel /7- Z.C. L`,L- 4-7-4 .SEZ-/ Ld a8 l# /7e5-6G --
Floor Area of Sq, t. :inn-then
qt � c
Valuation of Work $ 12,3� Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa ndow/doo
Use of existing/proposed struct •s (circle otftkle : Commercial ( _
If an existing structure, is a e sprisyst: ins -lied?(Circle one): Cs��No N/A
Florida Product Approval • //1:5.3 •
For multiple products us pr. ,uct approv: it l''
Describe in detail the type o wor to be performed. e"a4�C-e-- al/NC 4 ->v
57i TO/L- 5-41- -- ._ AV 6-7,4767g/ te___ (itJO. .<
Property Ow9er Information: j
Name: &ie , L e-.1 Address: (�CI .0e I V k re- SI'
City .. 4 ..-• y. I —Stated zip3,;?, Phone - I'4 -4-2/ i'J _? :
E-Mail or Fax ii(Optional)
Contractor Information:
Companamc: r i S 0/1? ' ./1'4•5 1L(. � e-:•11-e-- ��➢Gt. P-.6.)
Qualifying Agent:.
-
'�
Address:A10 " ,X rjg/• I . City/3 r tex.hzie, state 2- Zip..3.A.67
Office Phone_ '7-:_3'1.3 -- /4 /Job Site/Contact Number Fax#
State Certification/Registration# C >C- /.0 0 /c
Architect Name& Phone# iiii4 --- ------
Engineer's Name& Phone fI -
Fee Simple Title Holder Name and Address —
Bonding Company Name and AddressMortgage Lender Name and Address • -' -
.Ipplication is hereby made to obtain a permit to do the work and installations as indicated 1 certify that no work or installation las commenced pnor to t
issuance ofa permit and that all wont wall beoaed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes to
and void i work is not commenced within six 6J� mmonths,or if construction or►.vrk is suspended or abandoned j r aperiod of six/6)months at any time o i
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools. Furnaces. Bailers,Neale.
Tanta and.fir Con&tiorsers,do
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 NOTICIi OF
COMMENCEMENT.
I herebycertify that I have read and examined this o lication and brow the sane to be true and correct. .411 provisions of lass:s d ord ces governing th
type of work will be complied with wiiemther specified herein or not. The grunting of a permit does not presume to Rive tiny t iolare or cancel n
provisions of any other federal,state,or local law regulating construction or the peaformance of construction.
Signature of Owner
Signature of Conti r
Print Name .... .c/- ...�'.. .. .... . ...._ Print Name - C- (...A-- flit=-U
Swop to and subsc ' before me Swor o and •• ► c r . • .,
•this/L-• Day of ---i,.. 1,2.4.. . 20 f �,"-,W_ .
!his ��nay . _ G
<.__ -,...:ter 010trx-.
.ate ".• Notary Public -Slate ,s stood
Notate Publi `otary •u. tc . .\' '. s:.• . • . . , ,
' ,•1 1, COmmIi ,on i EE 5:4638
(f "4i;. ROBERT C CURTIS JR �" -•Res ised+i t.26 10
•I MY COMMISSION#FF056258
ayo,A-c EXPIRES Septombor 22.2017
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