200 5th St door permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
- ATLANTIC BEACH,FL 32233
-rc o V INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0094
Description: REPLACE ONE DOOR
Estimated value: 430
Issue Date: 7/11/2017
Expiration Date: 1/7/2018
PROPERTY ADDRESS:
Address: 200 5TH ST
RE Number. 170174 0000
PROPERTY OWNER:
Name: RIPLEY MARGARET J TRUST
Address: 200 5TH ST
ATLANTIC BEACH, FL 32233-5312
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: LOWES HOME CENTERS INC
Address: 4948 TELSON PL QA PETER ANTHONY CAFARO III
ORLANDO, FL 32812
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.
, cu�a> City of Atlantic Beach APPLICATION NLDepartment.)
.� Building Department (To be assigned by the Buildir800 Seminole Roadt=� Atlantic Beach, Florida 32233-5445 1\ S '" U
Phone(904)247-5826 Fax(904)247-5845
I'),-�;;i�a E-mail: building-dept@coab.us Date routed:
.-- City web-site: hftp://ww .mab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �� %
D ant review required Y No
I '' Building
t
Applicant: Lowe& om& CE,,3yezS &Zoning
Tree Administrator
Project: N C lam- Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Data
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: l�Approved. ❑Denied. [-]Not applicable
(Circle one.) Comments:
BUILDI
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: []Approved as revised. ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05119/2017
06/22/2014 15:35 3524733167 KEYSTONE DOORS & ETC PACE 02/02
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH .. OFFICE COPY
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Addresa: -2,6 in .S� S'f Permit Number: R E51:2 (
'Qd 9--
Legal Description 5-69 16-2S-29E ATLANTIC BEACH LOT 6 BLK 23 Parcel N 170174-0000
Valuation of Work S 430.00 Proposed Work beatedfcooled aoa heated/cooled
Clens of Work(circle one): New Addition Alteration Repair Move Demolition poollspa wind door
Use of e:istiag/proptx9ed,strucmre(s)(circle one):. Commercial
If as existing structtaare,is a firespria er system installed?(Circle one): y'et rvo
Florida Product Approval 4 4904.1
For multiple products use pr net approve orm Awl—
Name:
�,, f 1
'.. Describe in detail the type of work to be performed: I�- <-� S I �P e / iL w l—
,.'., ProveM tv 1 a
Nem : RI I PIPS Address: _ •S _ _
City G e-RF Stam_Zi Z.:7 one D Z-:2W
E-Mail or Fax B(Optional)
Contractor laformatiou:
y Nam: Lowes Home Centers LLC uali$in Agent: Pete Cafaro
Address: RQ BOX 781993 cityrlano State on a Zip 32R70
Office Phone lob Site`Comaet Number Den SmMtea13as5.3r93 Fax
Stale CertificatiodRegistration B CW19D8R17
Architect Name&Phone M NA
Engui er's Name&Phone d WA
Fee Simple Title Holder Name and Address WA
Bonding Company Name and Address arA
Mortgage Lender Name and Address NIA
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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.
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rope o Nwk vill be aomplicd wvh whether spoofed harem rwr, The M,.f.pared alae+not pnsnme io g as archon ro vial w mace!res
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Signature of Con actor
Print Name x /'Yi/4/j(/t . _.. /Zf AdF7 Print Name NathanByttp___-
Swore to and wbwr'bed before me Ssvom to and subscribed before me
this, Day n( __- 1. I this I_ .yof ,IE3(y 20 17
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