270 6TH ST - WINDOW 1f -
,
- ,. CITY OF ATLANTIC BEACH
3�l' ""; 800 SEMINOLE ROAD
\ �� / ATLANTIC BEACH, FL 32233
\�;3i�/ INSPECTION PHONE LINE 247-5814
RESIDENTIAL OTHER - SINGLE OR TWO FAMILY RESIDENTIAL OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RESO17-0006
Description: WINDOW CHANGE OUT
Estimated Value: 1100
Issue Date: 6/5/2017
Expiration Date: 12/2/2017
PROPERTY ADDRESS:
Address: 270 6TH ST
RE Number: 172562 0000
PROPERTY OWNER:
Name: YEATS ALEXANDER
Address: 270 6TH ST
ATLANTIC BEACH, FL 32233-5318
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: PHILLIPS BUILDERS LLC
Address: 1250 SELVA MARINA CIR QA BARBARA CAROLINE PHILLIPS
ATLANTIC BEACH, FL 32233
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
11 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
exceeds and estimated value of$7,500.
ai �� r�,,�� City of Atlantic Beach APPLICATION NUMBER
* Building Department (To be assigned by the Building Department.)
J • 800 Seminole Road R rr -� /�
ti Atlantic Beach, Florida 32233-5445 GS� / - V(�
Phone(904)247-5826 • Fax(904) 247-5845 f
\<:4----0.219',- E-mail: building-dept@coab.us Date routed: -5/1 t7A 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2. 7 0 Cp s Department review required Yes o
-- i
din_laiD
Applicant: p t-{ ( LL t.(3 601 Lie 6Z S Planning &Zoning
I '' Tree Administrator
Project: iV O8 vW C N R E our 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: Approved. ❑Denied.
(Circle one.) Comments:
BUILDIN
PLANNING & ZONING
Reviewed by: Date: s."-.d S'l 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 07/27/10
OFFICE COPY
,t
,:c1-4-kr,,,f BUILDING PERMIT APPLICATION
• ►% III
CITY OF ATLANTIC BEACH DATE
800 Seminole Road,Atlantic Beach FL 32233
''�osl>r Office:(904)247-5826 • Fax: (904)247-5845 � < ( 1 7
Job Address: -2.7)0 (aC if >t A. Q , 12 k, 3 Z 233 Permit Number: (RCs(3 (7-0006,
Legal Description RE#
Valuation of Work(Replacement Cost) $ ! ) 6 O Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New. Addition Alteration Repair Move Demo Pool indow oor
• 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
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
I—
Florida Product Approval I-L_ {4 (4( OS,. -"'-'2 for multiple products use product approval form
Property Owner Infor tion
Name: SQA AA- V EVN Address: 216 GT"' ST .
City A &. Stater& Zip 2223 3 Phone
E-Mail
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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.
Contractor Information:
Name of Company:PLM.is g u; ka ccs (...k.L Qualifying Agent:
Address: i 7.X-0 St:L4 rsAiNeza.p.-f,a. City PN..2 _ FN, State Zip 3 Z.2 33
Office Phone (464 2'tq- um Job Site/Contact Number •
State Certification/Registration# C6'C.,i zS 7.31+ E-Mail 'Pb►L.L.A.PI t ers ,rt.44:r-., f•-•-c_ '•
Architect Name &Phone #
Engineer's Name &Phone#
Worker's Compensation
Exempt / Insurer / Lease Employees / Expiration Date
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 forElectrical Work,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. v
Signature of Property Owner: Signature of Contractor
Before ane l 1 -t�.
this `1%-Day of I\1\-CN 1t11" Before me this Day of May I r)-0\
Notary Public: \._, A al►11' ---.0.1, Notary Public:A /1.V lG C .ejI/A l'W1'�1
^-i''irii'r�^
-r.'----6. ''r—"T rrnd rr•td.oxamined this application and know the same to be true an c. All ...44,0,,. s and
/rtes god db14Ftiti'�lf o }t.irk will be complied with whether specified herein or not. l� rtin:,rrr s not
e e to � � t to or cancel the provisions ofany otherfederal, state, or lot ~ '
3 � ,tic ;tar.�•if'►�"�:'' or the
ige 1 rtpzzce :202o
%.,Ffr:f ;••' Bonded Ttw Notary Public Underwriters Rev.5/2/16