90 OCEAN BREEZE DR - DOOR d .
�� - ►' CITY OF ATLANTIC BEACH
-f 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
J INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-WIND-3690
Job Type: WINDOW AND/OR DOOR
Description: replace exterior door
Estimated Value: $745.00
Issue Date: 4/10/2017
Expiration Date: 10/7/2017
PROPERTY ADDRESS:
Address: 90 OCEAN BREEZE DR
RE Number: 168908-8255
PROPERTY OWNER:
Name: WALSHAW, LARRY E * MICHELLE, *
Address: 90 OCEAN BREEZE DR
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 DBPR SURCHARGE $2.00
STATE DCA SURCHARGE $2.00
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CTTY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
owvi-rjr, City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
"Wir�s ,� � Building Department
! 800 Seminole Road l�� N�,^!,Q"
- 7 ,s)r Atlantic Beach, Florida 32233-5445
�
Phone(904)247-5826 • Fax(904)247-5845 /��
�oy E-mail: building-dept@coab.us Date routed: ��
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 9 0 0 Ce-ttititt37L ,Df Department review required Yiey No
i
Q (`
ui
Applicant: &ttia fil,(��d V-k-m1061anning &Zoning
1 ,� Tree Administrator
l�p�.
Project: ( aL�Lt' l Ltii3( &O ( Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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: [pproved. ❑Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING Reviewed by: /' I ` Date: 41"7'/7
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 05/14/09
l;ITY OF ATLANTIC BEACH 9
800 Seminole Road, Atlantic Beach,FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: 90 OCEAN BREEZE DR. ATLANTIC BEACH, FL Permit Number: II JJ-A/D_ 3k ?O
Legal Description 46-51 37-2S-29E OCEAN BREEZE PLAT LOT 11 parcel# 168908-8255
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 745.00 Proposed Work heated/cooled 43 non-heated/cooled N/A
Class of Work(circle one): New Addition Alteration cepaiir 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 67.70
Florida Product Approval# 12769.1
For multiple products use product approval form
Describe in detail the type of work to be performed: REPLACE EXTERIOR DOOR
Property Owner Information:
Name: MICHELLE WALSHAW Address: 90 OCEAN BREEZE DR.
City ATLANTIC BEACH State f„Zip 32233 Phone 941-299-5273
E-Mail or Fax#(Optional)__Contractor Information:
Company Name: BUTTERFIELD REMODELING, LLC. Qualifying Agent: CLINT BUTTERFIELD
Address:4220 PLANTATION OAKS BLVD.#1516 City ORANGF PARK State Ft Zip 32065
Office Phone 904-333-8409 Job Site/Contact Number 904-333-8409 Fax#
State Certification/Registration# NSS-14
Architect Name&Phone# —
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
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��rsod of six 6)months
on sat any time
mea after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,
ers,
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 this a plication 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 speci ted 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 loc. law regulating construction or the performance of construction.
Signature of Owner • . _ Signature of ontr �r -G �GC
%
Print Name MI_-1-1.E.LLF WALSHAW Print Name CLINT BUTTERFIELD
Swo•• • and subscri.kee befor p e r7 Sworn to and subscri.-• befor me ' 20/
this iv Dr~ Tf I 1 C�XC-4/ _ ,201 l this :� Da�; ./ ��w ,
. dot'amok ...dr— A
Notary Public N.tary Pu.is
ENID V.JOHNSON Revised 01.26.10
"'•,.�t't,:Commission#GG 0085046 JEAN HUGHES
V. " ' 'Expires July 5,2020 •• •^v. CAROL
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Rondec Thru Troy Fain Inwrance SW385 7019 Commission#FF,J71959 Expires December 3,2018
•. - :,��,Pf•��`. Banged No Troy Fin Imv.nu -7019 '
RE#168908-8255 90 OCEAN BREEZE DR. ATLANTIC BEACH, FL. 32233
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OWNER, PLEASE CIRCLE THE AREA ON THE SKETCH
26 FGR 26 WHERE YOUR DOOR OR DOORS ARE BEING INSTALLED.
PLEASE RETURN THIS SKETCH WITH THE PERMIT APP.
TO MY PERMIT PROCESSOR. THANK YOU.
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