1791 SEA OATS DR - DOOR ��' ' CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
jti „r ATLANTIC BEACH, FL 32233
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-3613
Job Type: WINDOW AND/OR DOOR
Description: ONE EXTERIOR DOOR
Estimated Value: $695.00
Issue Date: 4/10/2017
Expiration Date: 10/7/2017
PROPERTY ADDRESS:
Address: 1791 SEA OATS DR
RE Number: 172020-0452
PROPERTY OWNER:
Name: VENN, JEFFREY E
Address:
GENERAL CONTRACTOR INFORMATION:
Name: BUTTERFIELD REMODELING LLC
, NSS 14
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 FLORIDA
BUILDING CODES.
1
i,,\,��� City of Atlantic Beach APPLICATION NUMBER
; Building Department (To be assigned by the Building Department.)
f ti, � 800 Seminole Road
ui �r Atlantic Beach, Florida 32233-5445 17-.(t ivQ — G (�
Phone (904)247-5826 • Fax(904)247-5845
" 01119 E-mail: building-dept@coab.us Date routed: l z 9 1 1 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I 01 4 S c ORIS L t2., Department review required Ye No
t�uildin�
Applicant: rU-v�'< Z,p't,i;•,� REA,00E_ Pr.-Frig&Zoning
Tree Administrator
Project: 0 0 R• R ,Q(•..p-Ce- 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: Rticproved. ❑Denied.
(Circle one.) Comments:
LUILDING
PLANNING &ZONING !�
Reviewed by: Date: �• j'/7
— - I
TREE ADMIN. r
Second Review: I 'Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. I ]Denied.
Comments:
1
Reviewed by: Date:
Revised 05/14/09
CITY OF ATLANTIC BEACH OFFICE COPY
800 Seminole Road,Atlantic Beach,FL 32233
Office (904)247-5826 Fax(904)247-5845
Job Address: 1791 SEA OATS DR. ATLANTIC BEACH, FL. 32233 Permit Number: 1 '7 W I I)U-3 6a (3
Legal Description 34-85 09-2S-29E .316 SELVA MARINA UNIT 8 LOT 10Parcel# 172020-0452
PT-TRACT C Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 695.00 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): ,- New Additi•\ Alteration MOO Move Demolition pool/spa window/door
Use of existing/proposed ructure(s)(circle one , Commercial 'esidentia
If an existing structure,• a fire sprinkler system : tailed?(Circle one): 'es No �N/A)
Florida Product Approv41#
For multiple products nse pro.uct approva o II
Describe in detail the of work to be pe .rmed: REPLACE EXTERIOR DOOR
Property Owner Information:
Name: MARGARET VENN Address: 1791 SEA OATS DR.
City ATLANTIC BEACH State FL,Zip 32233 Phone_904-705-7379
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 FL Zip 32065
Office Phone 904-333-8409 Job Site/Contact Number 904-333-840g 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 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 YOI R NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined thisplication 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 spec' d 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 regulating construction or the performance of construction.
,,,r_.,
Signature of Owner Z " c 14 AA..---n.----Signature of Contract.r �, /�.,�
Print Name "ARGARE.T...VE.N N Print Name . CLINT BUTTERFIELD __...__�_..,._____._.____
Sworn to and subscribed before me Sworn to and subscri.e. befo yme 7
this drflp of ,_ 20 this Day L,//, , +WA
20
Notary : bl ,`— / N tary Pub ' r/
"-----
Revised 01.26.10
Zanwamirorr
4iti:."''';;: LAURIE ROLL ;i' 'y''' CAROL JEAN HUGHES
*` �;� = mission#FF 171959
MY COMMISSION#FF950443 �.o? Expifes December 3,2018
'37 cr Bo*/7lw troy Fin rrtWuro.000.905.707
..ti1. • EXPIRES January 13.2020
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/77. OFFICE COPY
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