2341 FIDDLERS LN - GARAGE DOOR ': � CITY OF ATLANTIC BEACH
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: RES17-0193
Description: REPLACE GARAGE DOOR
Estimated Value: 1900
Issue Date: 10/10/2017
Expiration Date: 4/8/2018
PROPERTY ADDRESS:
Address: 2341 FIDDLERS LN
RE Number: 169463 0114
PROPERTY OWNER:
Name: DEEM WILLIAM W
Address: 2341 FIDDLERS LN
ATLANTIC BEACH, FL 32233-4681
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: OVERHEAD DOOR CO. OF JAX
Address: 6884 N PHILIPS PARKWAY DR
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.
r,fyarJ;y�� City of Atlantic Beach APPLICATION NUMBER
Js' IP46.f> Building Department (To be assigned by the Building Department.)
800 Seminole Road p
-5.... „).:: Atlantic Beach, Florida 32233-5445 I \ S —
„
Phone(904)247-5826 • Fax(904)247-5845
J, !_.>? E-mail: building-dept@coab.us Date routed: I 0/5 3 I 17
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z34 t k OC .E.i LIQ De artment review required Ye>/No
uildin �/
Applicant: ()V (��{2A---cPi-cam 1,1-
J 00 anning &Zoning
Tree Administrator
Project: G AJ - E-- cx:2). 2 Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature KR. .
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection (3
Florida Dept. of Transportation -c p.
St.Johns River Water Management District r`
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: roved. ['Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING -G�-1
Reviewed by: Date: ` 7
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
I
'r BuildingPermit Application
, OFFICE COPY7
City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233
o: Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: as.1 cl1 Permit Number: R ES i 7- 0193
Legal Description Rat,L,Aca & f1. 4' OOaR RE#
Valuation of Work(Replacement Cost)$ 'goo - 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): 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:
MUVC tZIrG14z c toys, 1 (p0c)(2,
Florida Product Approval# (' I i p q ' for multiple products use product approval form
Property Owner Information
Name: 6�y lam\N O 13,Q,Ok P► Address: a 34 t �=\00 IkC2, L-44
CityAwri State F.LA Zip 3 3 3. Phone LD0'S "(4(„2$- 11 )
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company:O\AjZ'4'YnfkD OUB. Qualifying Agent: \1,\(,l 1`1�l.Jl4i iA
Address 1.9%%$-1 Pla1LLI('i PKt'`'Y O . IJ City 311LLCSoi4W/lu.k State F14 Zip 52 (p
Office Phone iDU , 2445^ k,44"1 Job Site/ContactrNumber t��Q{t t4 5(?°l- LACIag
State Certification/Registration# �� I8 E-Mail O �Q-06'�u..J,4 (•C0or)
Architect Name& Phone#
Engineer's Name& Phone#
Workers Compensation A wc.io9o/07 C AFJ�
Exempt/Insurer/Lease Empl es/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 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
RECO:DING YR NOTICE OF COMMENCEMENT.
r
AF., !Ai ./ //r ..
Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
0)7
Sig d an swornA/�ja�(orA,ffirmed) before me thisa�day of Signed d s n t�c91-,a ed) before me this day of
�
��.by
94 4 � / 40(
f t naturyRD N r ;Y (SlgnavillE41fAV FN)
MY COMMISSION;t FF 142405 :f: ,+•':+": MY COMMISSION#FF 1=. • '�+
°'.r EXPIRES:September 18,2018 a: EXPIRES:September t8, 9 '
'-If u' Bonded Thru Notal Public Underwriters r Bonded Thru Nota Public Under,.,:;,
y L�'Y'.�'r�, ry
[ ]Personally Known OR [ ] Personally Known OR
[ ]Produced Identification [ ] Produced Identification
Type of Identification: Type of Identification: