670 PLAZA - WINDOWS yr,
r3 .r'"' CITY OF ATLANTIC BEACH
J
", 0 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
la
n � INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0031
Description: remove& install 11 new windows
Estimated Value: 4800
Issue Date: 5/24/2017
Expiration Date: 11/20/2017
PROPERTY ADDRESS:
Address: 670 PLAZA
RE Number: 171294 0000
PROPERTY OWNER:
Name: JACKSON TREASA ANNE
Address: 670 PLAZA
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name: Gregory Silas Anderson
Address: 3504 Lawrence Road
Orange Park, FL32073
Phone:
Name: Anderson Installations, LLC
Address: 466 Oldfield Drive
Fleming Island, FL 32203
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
IIexceeds and estimated value of$7,500.
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�i,ay City of Atlantic Beach APPLICATION NUMBER
el
6 P �� Building Department (To be assigned by the Building Department.)
1-. :>_. • 800 Seminole Road 1 _S 1 _O,�7
j.4Y yr Atlantic Beach, Florida 32233-5445 G IJIJ�
Phone (904)247-5826 • Fax(904)247-5845 �1
l'--a 3 9• E-mail: building-dept@coab.us Date routed: OS I III( 'r'
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Lon 'Y \.ct-ti1 l . De.artment review required Yes No
:uilding (/
Applicant: AA` &-(S a l) to Sk-C (IQ v ' anni . : oning
Tree Administrator
Project: (k P Vt L ` kd)-0>, 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: I pproved. ❑Denied.
(Circle one.) Comments:
C.31---JILDIN9
PLANNING &ZONING
Reviewed by: Date: "c�`1'1
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 07/27/10
FILE COPY
, t„,,,'i BUILDING PERMIT APPLICATION
JS '40'4*.,
r. `� CITY OF ATLANTIC BEACH DATE
r)
u ff ri,,-=. -:- .: • V 800 Seminole Road,Atlantic Beach FL 32233 .5-''c7 y./7
_uti PC' Office:(904)247-5826 • Fax:(904)247-5845
Job Address: ( 70 P c..Zo. f2.0 Permit Number: e__E SI3-b c
Legal Description RE#
Valuation of Work(Replacement Cost)1,7 ti E3C0 caoHeated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): CommercialResidentia
• [fan existing structure, is a fire sprinkler system installed?(Circle one): Yes No 44l,2
• Submit a Tree Removal Permit Application if any trees arc to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be,pe �rformed: .[v10 _ t&r,6, \S Q l ` 2'2,. f
ktAj_ ' %__ OI o 4.0 S CJI 2.-e— -Co.r- S I z_e-
Florida Product Approval - FL- S7 7q11CZ- 5/(o'7 FL a� for multiple products use product approval form
Property Owner Information nn
Name:�r� .S�.. ac
cJ o ort Address: (07 d 1`"(4 2....e>—. �-.oe
City 4t othil.C. / c4i State Zip3 ?-33_Phone go — tele; — 0 44 3
E-Mail _
Owner or Agent (if Agent,Power of Attorney or Agency Letter Required)__ cY r N.-.0--C
WARNING TO OWNER: YOUR FAILURE TO REG.:ORtD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPR()V1 M NTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WI.1.H YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMLNT.
Contractor Information:
Name of Company: 1tderSort 'l&1 J(et.��ok S Qualifying Agent: C')re.A. mrd A'ex-S o vi
Address: 't & O/cH1 /c/ 'Dr- City fI-eni/i: q .mac. State Zip 3 'a-c c• 3
Office Phone Y07-76:-c> -C 0 3 Job Site/Contact Number c-to 7 --7 to 0 —I o 3''
State Certification/Registration# Ca G/3 3/ 5-'3 ") E-Mail aqi f}nder eA7i4s•i,,//c 4?'o 1.sO3a9
Architect Name& Phone# y\ /D` e5'^'��'
Engineer's Name&Phone# tn0?)._
-
Worker's Compensation y ,A„
Exempt )—insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I cert fy that no work or i tallation has commenced
prior•to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating const•ircllon in this jurisdiction.
Thus permit becomes null and void if ork is not commenced►,ithin six(6)months, or if construction or work is su ;ended or abandoned for a •
period of six(6)months at any time r work is commenced. I raider standd that separate permits m lust be secured for lectricnl Work,Phwibing,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tan and Air Conditioners,etc.
Signature of Property Owner: Q(/ Signature of Contractor: �1• ,�..;� 1114 ��%
111
Before Inc / qik
this 1 I Day of /V\\City 90 , Before me this / I Day of 4'impr �? "
It ' [c �l
Notary Public: /1..--/-7 • Notary Public: .., ,1 �,L `., ti r.
1' ,_&
a.P„�.,, C.TAYLOR
��,' " �. �--- , ,,,••• JENNIFER JOHNSTON
I hereby certify ;416-7W. F�dfiiE@iitfativrrlfittYkrdlti lerlita/ (Ilion and know the sante to i ..' cotptidjyyQ�{ + ge, •
ordinances gov i T', '*pi?0 rrinv tdxpit6V nimpi: with whether specified her ! r'';,fM The '1/c s and
��rr .1 , r. $riaagEtR t 1 •s not •
presume to grver. •,:.�.,:�i vi��gn{gtlg�t�cllgq��ovt 'ons of any ether federal, sta : •fir'•:_ J
er vrnrance o orfslli1 rt. �, , �biid�N��r1 n the P / Bonded Through National Notary Assn. -._. _. •
'` Rev.5/2/16
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