1878 BEACH GARAGE DOOR 2017 CITY OF ATLANTIC BEACH
u.
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0054
Description: replace garage door
Estimated Value: 2434
Issue Date: 6/14/2017
Expiration Date: 12/11/2017
PROPERTY ADDRESS:
Address: 1878 BEACH AVE
RE Number: 169542 0606
PROPERTY OWNER:
Name: Makaika Underwood
Address: 1878 BEACH AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: PRECISION DOOR SERVICE OF N FL JASO
Address: 11323 Business Park BLVD
JACKSONVILLE, FL 32256
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
exceeds and estimated value of$7,500.
City of Atlantic Beach APPLICATION NUMBER
�s Building Department (To be assigned by the Building Department.)
Boo Seminole Road '��S(-J —O W q
Atlantic Beach, Florida 322335445 .
Phone(904)247-5826 Fax(904)247-5645 0IW to-+ l r+
E-mail: buildingdept@coab.us Date routed:
-- City vreb-site'. http liw ,Coab.us
APPLICATION REVIEW
AND TRACKING FORM
Property Address: � u� a�uL�-h /`V� ' MServices
ant review uired TYeso
p
Applicant: Y (&^St V/1 'Q aq SW ✓rUZ Zoning
inistrator
Project: �Q »;<) �(.(,-P- q It-((fL -�- Uwe`+ rks
ities
ces
Review or Receipt Dale
Other Agency Review or Permit Required of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept of Transportation
St.Johns River Water Management District
Any Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: E4proved. ❑Denied. . []Not applicable
(Circle one.) Comments:
UILDI
PLANNING&ZONING Reviewed by: Dale:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. . [-]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Dale:
FIRE SERVICES Third Review: []Approved as revised. ❑Denied. . [-]Not applicable
Comments:
Reviewed by: Date:
Revised OSII W2017
OFFICE COPY
Building Permit Application 1uN - 6 2017
City of Atlantic Beach D
800 Seminole Road,Atlantic Beach,FL 32233
Q p/� (Phh\onn�e:(904)247-558826 Fax:(904)247-5845
Job Address: vnq� \ 1\ ll\\��.1,�)1 �NA\'�. Permit Number:
Legal Description (6tI SAt WI �y Cl1 RE# a2-w-og -2g2gE
Valuation of Work(Replacement Cost)$12_+ Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo PoolWindow/Door
• Use of existing/proposed structure(s)(Circle one): Commercialesidentlal
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe In det ill the type of work to be perfo ed:
�e loce ora t�N new ,
Florida Product Approval# for multiple products use product approval form
Pro a Owner Informatlon p
Name: Address: ,t)
City _State—Zip J Phone - 7X25-OCOto
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: (31F0-t' Qualifying Agent: UD('A
Address 1223 City - -N State�Z p% (�—
Office Phone - - lob Site/Contact Number It L t
State Certification/Registration# E-Mail C XNDY� o
Architect Name&Phone#
Engineers Name&Phone#
Workers Compensation \ -
Exempt/Insurer/Lease Employees/Expiration pate
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 the laws regulationg
construction in this jurisdiction.l understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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 ATTORN EFORE
RECORDING YO NOT .E 0 OMMENCEMENT.
(Signature of er Agent including E'^^t="� rt, qswornto
a[ure of ntaaorI
Si ned and sworn to-(otr ed)before me this day of Signed anfirmed)before me this day of
�UYIf. .�by r\ SSY1e .lz\1 by _J SY1e'
(Signature of Notary)
R
=EAB:�1,1'fHAMMICHELLE ABRAHAM ta63goMY COMMISSION#FF148360 Wl8
Personally Known OR ayx pJ(pIRES July 29, 2018 Personally Known OR Produced Identification )Produced Identificationrwn
•pr BY IM Pbtld 5 Itt.wm
Type of Identification: pe of Identification:
6/12/2017
To Whom This May Concern,
I give Jason Sheppard from Precision Door Service permission to sign as my agent for my garage door
permit application on my behalf.
Sincerely,
r14�u��a. stn QerWood � ov.�,
_..,
MICHELLE ABRAHAM
MV COMMISSION#FF146360
`S',R„ •"• FxpmrS July 29, 2018
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