455 Selva Lakes Cir siding permit CITY OF ATLANTIC BEACH
r - 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
SIDING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-SIDE-2961
Job Type: SIDING PERMIT
Description: REPAIR SIDING FROM WATER DAMAGE
Estimated Value: $1,275.00
Issue Date: 1/25/2017
Expiration Date: 7/24/2017
PROPERTY ADDRESS:
Address: 455 SELVA LAKES CIR
RE Number: 172027-5016
PROPERTY OWNER:
Name: Walsh, Robert
Address: 455 Selva Lakes CIR
GENERAL CONTRACTOR INFORMATION:
Name: LANG'S GENERAL CONTRACTING LLC
John Raymond Lang,CGC062543
Address: 2201 SAWGRASS VILLAGE DR QA JOHN R. LANG
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $28.19
BUILDING PERMIT FEE $56.38
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $88.57
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
OFFICE COPY CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233 p7 Z9
Office(904)247-5826 Fax(904)247-5845 ( -S lDE
Job Address: 455 Selva Lakes Circle Permit Number:
Legal Description 41-55 17-2S-29E Selva Lakes Lot 7 Parcel#172027-5016
Por Area o Sq.F' Sq.Ft
Valuation of Work$1.275•W Proposed Work heated/cooled_ non-hested/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval #
For multiple products usepro ucTF t approval form
Describe in detail the type of work to be performed: Remove and replace a roximate total of 97' of water
dame ed 8" RS Channel Rustic sidin at various Peri ons
nme a sr es
au an Paint approximately 97' of new material
Property Owner Information:
Name: Robert Walsh Address: 455 Seiva Lakes Circle
City Atlantic Beaeh State FL Zip 32233 Phone(757)404-6898
E-Mail or Fax#(Optional)
Contractor Information:
Company Name, Lane's General Contracting&Renovation,LLC Qualifying Agent : John R.Lane
Address: 13653 Macava Road City Jacksonville State FL, Zip 32246
Office Phone 904-422-6690 Job Site/Contact Number 904-422-6690 Fax#aa
State Certification/Regisuation# CGC 062543
Architect Name&Phone#na
Engineer's Name&Phone#na
Fee Simple Title Holder Name and Address na
Bonding Company Name and Address as
Mortgage Lender Name and Address na
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has cammencedprior to the
issuance oojjapermit andthat all work wi//be per(ormedto meet the standards ofall laws regulatingconstruction in thisjurisdiction Thupsrmitbecomesnul/
and void ifwork is not cammerceed within six(6J months, or ifconstrucdon or work is suspended or abandonedjor a nod ofsix/6)monde of airy rime after
work is commenced. !understand that separate permits mast be secured for Elecrrtco!Work,P/umbllg,Signs, Deas,Pools,FLrvaaces,Boilers,Hera,
Tanks andAlr Condhlon us,eta
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 FINANCINGCONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO'[JR NOTICE OF
COMMENCEMENT.
!hereby certifythat/have read and examined thie tca(ion and krww the same tobePrue and correct All provisions oflawa rind ordiwnces governing this
type of work wall be complied with whether speci red herein ar rmt. The graining of a permit does not presume to give authority fo vialale ar cancel the
pravrsianr ojarry other federal,slate,or local lass regulating comfruction ar the perfarmartce ofcomnuction.
Signature of Owner Signature of Contracto
t Name
S to bscribed before me Sw d subs fore m
f J-a4n+ rtr2-/ .20 this Day o 20
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o Public Notary Public
_ Revise .Z .10
kE9EflT MOflENO .+Y'"..'"ry' TOMGINgESPERGER
r.=o"pY�w`ti. Notary Public-9lale M Flonba M1'OIXES:Oc er 6,W 51
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Comm.Expires Jun 9, Assn.
'":€,°;.5.••"••• Borde4tNW9a tialonNNuary
as �`r City of Atlantic Beach APPLICATION NUMBER
o`t r Building Department (To be assigned by the Building Department.)
n 800 Seminole Road 17 —S I I
_ s Atlantic Beach, Florida 322335445
Phone(904)247-5826 - Fax(904)247-5845 Q
;;�to% E-mail: building-dept@wab.us Date routed: 1/9/ 17
City web-site: http://www.wab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 4SS S ELVA Lpir IrFire
ent review re uired Yes o
Applicant: LGna(s ��p .A{ A) .Zoning _
1r,'�� inistrator
Project: tR� S( (A3q orks
t ilities
fety _
ices
Review fee,$ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: EApproved. ❑Denied.
(Circle one.) Comments:
UILDIN
PLANNING&ZONING Reviewed by: Date: /'I7^17
TREEADMIN. Second Review:
❑Approved as revised. E]DenietY
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: - Date:
I
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 0e114/o9