411 Skate Rd - Windows in Kitchen and Bath CITY OF ATLANTIC BEACH
~ ri 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: RES17-0142
Description: REPLACE WINDOWS IN KITCHEN AND BATH
Estimated Value: 9850
Issue Date: 8/29/2017
Expiration Date: 2/25/2018
PROPERTY ADDRESS:
Address: 411 SKATE RD
RE Number: 171529 0000
PROPERTY OWNER:
Name: MIKE PHILLIPS
Address: 992 OCEAN BLVD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: PHILLIPS BUILDERS LLC
Address: 1250 SELVA MARINA CIR CA 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
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$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
t 800 Seminole Road G5t 7 1\v
s Atlantic Beach,Florida 32233-54450 Z
Phone(904)247-5826 Fax(904)247-5845 Q l `
E-mail: building-dept@wab.us Date routed: O
City web-site: http:/Aviw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: `"t < < S KR-Te P,-D_ De nt review ulred Yes o
wilding
Applicant: PH(C-LiPad 0tC-Oer" Panning &Zoning
/l ,, , (� Tree Administrator
Project: W t r 0ou3J „ G� C.FIf-� Public Works
^1 Public Utilities
pet`) IV -C C-fu CO re— W O Q L-" Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. [—]Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 0er19rl077
r Building Permit Application 117
City of Atlantic Beach OFFICE COPY
800 Seminole Road,Atlantic Beach, FL 32233
4 e �C�
Phone:(904)247-5826 Fax:(904)247-5845 R 7
Job Address: i `' K'4 Z A �- taP�ermit Number: ' `G`S- l_7✓0(4`,
Legal Description G - P � R7'oG J�fl Rel"'S UIJiT ZA bK )Ql"'T6 RE# 171529 -0006
Valuation of Work(Replacement Cost)$ 91 SSo. Heated/Cooled SF/w#6• Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repai Move Demo Pool Indo /Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes Q N/A
• Submit a Tree Removal Permit Application If any trees are to be removed or Affidavit of No Tree Removal
De�{kllle In detall the type of work to be pert med: CLW AN,p �T�.M ,
Keg/rrt.� 6LD W, .D. M w
Florida Product Appro I# 1=C. 4 1 O for multipple products use product approval form
Property Owner InformPRpoP62YV fi PP¢.Mse�
Name: �f}1WL S MIGH+ Address: iqZ �� a�✓If '
city State F 1 . Zip 37-233 Phone CIO
E-Mail PH1(gti0b 3i4Tt C.pM�G.q,#f'nkT'
Owner or Agent(If Agent,Power of htrorney or Agency Letter Required)
Contractor Information 1 n
Name of Company: 1'fl $ {3µhPds qualifying Agent:
Addressgg2OR" U7, city RE . State Yl, Zip XZ '3_T
Office Phone q09' I— lob Site/Contact Number
State Certification/Registration tio2 )4 E-Mail ��l{ P.�,81J{LO�S'(Q(.QIsL+QSrNM7�
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation C
WUW IS
Exempt/ urer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to 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. I 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 ATTORNEY BEFORE
RECORDING YOUR NOTJCE OF COMMENCEMENT.
/ / i� All—
(Signatureof ner or Agent) (Sign tui o ractor)
(inclu ngc otractor) /
k�. d sway to affbi e )bef this( ay of ned and swc to(or Ir ed) efor t � K Say of
(Signa of tary)
1DMGI PGE
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Personally Known [ IPersonallyx OR
I I Produced Identifica I Produced Identification y
Type of Identification: Type of Identification: