1064 LITTLE CYPRESS KEY - DOOR Ii1
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Ji Jl�S�f
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-WIND-3518
Job Type: WINDOW AND/OR DOOR
Description: REPLACE DOOR
Estimated Value: $684.00
Issue Date: 4/4/2017
Expiration Date: 10/1/2017
PROPERTY ADDRESS:
Address: 1064 LITTLE CYPRESS KEY
RE Number: 172027-5820
PROPERTY OWNER:
Name: Schory, Grace K
Address: 1064 LITTLE CYPRESS KEY
GENERAL CONTRACTOR INFORMATION:
Name: BUTTERFIELD REMODELING LLC
, NSS14
Address: 4220 PLANTATION OAKS BLVD APT 1516 SIDING
ONLY
Phone: 904-631-8511
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $27.50
BUILDING PERMIT FEE $55.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORID:1.
BUILDING CODES.
�t..L r City of Atlantic Beach APPLICATION NUMBER
Js s,\ Building Department (To be assigned by the Building Department.)
K, - 800 Seminole Road 17 -\/'\)
\ J
,, Atlantic Beach, Florida 32233-5445 V 1 IUD ' �>
\ Phone(904)247-5826 • Fax(904)247-5845
,„cm !„ E-mail: building-dept@coab.us 11
Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
K -
Property Address: 106,4 Lt T i LeC' PRE,\s D ment review required `fir No
Building
Applicant: El''1"t . ° L1 f writ ! niny&Zoning
ree Administrator
Project: I ,(pc)( IR e_PL1C C13Tublic 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: [ved. ❑Denied.
(Circle one.) Comments:
BUILD NG Q
PLANNING &ZONING Reviewed by: i / ` Date: 7/2"%//7
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
a f'' y A CITY OF ATLANTIC BEACH
'211 ropi 800 Seminole Road,Atlantic Beach,FL 32233
Office (904)247-5826 Fax (904)247-5845 1 -7 -w 1 {U fl - 351
Job Address: 1064 LITTLE CYPRESS KEY Permit Number:
I Legal Description 44-60 17-2S-29E SELVA LAKES UNIT 3 LOT 114 Parcel# 1720275820
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work 684.00 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration MO Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial (esidentia
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No 6/A)
Florida Product Approval# FL#13541.4
For multiple products use product approval form
Describe in detail the type of work to be performed: REPLACE EXTERIOR DOOR
Property Owner Information: S" ,,
Name: bra CC, ih0 Address: 1064 LITTLE CYPRESS KEY
City ATI ANTIC BFACH State fLZip 32233 Phone 508-314-4'170 _
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: BUTTERFIELD REMODELING, LLC. Qualifying Agent: CLINT BUTTERFIELD
Address:4220 PLANTATION OAKS BLVD.#1516 City ORANGE PARK State Fl Zip 32065
Office Phone 904-333-8409 Job Site/Contact Number 904-333-8409 Fax#
State Certification/Registration# NSS-14
Architect Name& Phone# Co 3 .•- tS 5 j l - 0416 0
Engineer's Name&Phone# i i 2Q j
Fee Simple Title Holder Name and Address
7
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby 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
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a_period of six 6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, Furnaces,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.
I hereby cert that I have read and examined thisapplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state,or local law regul• ing construction or the performance of construction. , r•
Signature of Owner I/ Signature of Contracto,7 � ����—fa�
Print Name t Print Name CLINT BUTTERFIELD __....._. __-_.
...__ ..fl(�TRIGK�# -.��i.�Q.L�i.. .��[Jl.:� _... .._......_..---
Sworno and subs ri.ed bef e me Sworn to and subscri.-. bef. " me
this D. of 0 `( \ .20\r. thi 1`t Day of I ' . I 20/ 7
`: :� � a �F
y. Giro ,_,„0' i .
Notary rubs Notary Pu."i.
'evi •d01.26.10
ARL JEAN HUGHES
1.2. Commmmfssion#F,F 171959
•--- 'eta Expires December 3,2018
.: ALSIRE KLING +�:e ' Boded TMu Troy Feinlnwmwe 80oJE6.7019
MY COMMISSION#FF197947
'1,; EXPIRES February 10,2019
(407)398-0'53 FlondalloraryServKecom •
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1064 LITTLE CYPRESS KEY
ATLANTIC BEACH, FL. 32233
PARCEL: 1720275820
FEE COPY
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