724 Selva Lakes Cir garage door permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
;1 v INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0107
Description: replace garage door
Estimated Value: 1493.14
Issue Date: 8/18/2017
Expiration Date: 2/14/2018
PROPERTY ADDRESS:
Address: 724 SELVA LAKES CIR
RE Number. 172027 5844
PROPERTY OWNER:
Name: MCCULLOUGH MAUREEN A
Address: 724 SELVA LAKES CIR
ATLANTIC BEACH, FL 32233-4368
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.
0F"W,;_,
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be as((s��igned by the Building Department.)
809 Seminole Road � 'Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845 �]E-mail: building-dept@coab.us Date routed: 0 I (Ct (I r-
City web-site: http:/Avww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: �a'y Sp�V q �.(�,�(Q-S �..��• Dnteview required Ye No
(�
Building
Applicant: 4 (LIDS\B n DDar Planning&Zoning
/ Tree Administrator
Project: [Q 1QLk_ Public Works
T 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
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: LyApproved. [-]Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:• 6-/-3
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 05/19/2017
".. OFFICE COPY
Building Permit Application
City of Atlantic Beach JUL 1 8 2011
800 Seminole Road,Atlantic Beach,FL 32233
nQ \` 1
Phone:
�(9Q04)224�7r-5826 Fax:(904)247-5845 p _.
Job Address:� G 1 11\`t y�y��."-"` A�" v �JZ1� 1 /P�er1mit Number: (L&sl�_ __.i
Legal Description�V� `QkI 01A n`lAaYUA"r ; ) Ln \/W RE# 54-60)
Valuation of Work(Replacement Cost)$1-T"1 -J.\'l Heated/Cooled SF Non-Heated/Cooled 112
• Class of Work(Circle one): New Addition Alteration Repair Move Pgjpo Poolendow/
• Use of existing/proposed structure(s)(Circle one): Commercialelidetial
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes NoNA
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit .Tree Removal
Describe In datall the type of work to be performed:
re00rtt gaYa9e (lW)12 \AOI neW
Florida Product Approval ff '5?V1, IS for multiple products use product approval form
Property Owner Information 7�A SQUck LgQS C
(v -
:aC ( C\1\QQh Address:
city flL1�1C RPoC " J state Fl zip ').'12?, Phone . "1' O
E-Mail
Owner or Agent(If Agent,Power of Attomey or Agency Letter Required)
Contractor Information C�V� 1r�aL� /1u
Name of Com an : PC 1 k QlJ� S quali ing Agent: 7Ub1r 1 S\1\,tvDatA
Address X1 City State zip 4S�
Office Phone 01 ontact Numrr�ber
State Certification/Registration# E-Mail Al a-br=1an •ThokSA14MAt l.Lf1Yl
Architect Name&Phone#
Engineer's Name&Phone 4 AMO,
Workers Compensation SEICO,.
Exempt/Inwmr/Lease Employees/Expiation me
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 regulat long
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 PROPER IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNO BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
�tgtgnature of Ow ngY rAgent ncl ding Contractor)) (S nature of Contractor)
Signed and sworn to(or#Firmed)before me this 11 day of Signed and mom to t6r affirmed)before methis-nday
1 T ,2Q by 2 1 2011 by 7015 3
(Signature of Notary) (Signature of Notary)
MICHELLE ABRAHAM
� � MY COMMISSION#FFI HBaE. t�� y;._MICHELLE ABRAHAM
I )Personally Known OR +*ep� r ) ersonally Known OR fp� MY COMMISSION#FFt48380
ti„a rr,/ EXPIRES July 29, 201[@,'
F'Q Produced Identification �P r.duced Identlfirabon '.�a`a ' E%PIRES Jul 29, 201 B
Type of Identifications IHW)aaa419 FbrldM aIC¢.com eo(Itlen[ification: - y
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