1285 STOCKS ST - GARAGE DOOR �lj ! ACITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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ATLANTIC BEACH, FL 32233
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C INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0241
Description: GARAGE DOOR
Estimated Value: 0
Issue Date: 11/2/2017
Expiration Date: 5/1/2018
PROPERTY ADDRESS:
Address: 1285 STOCKS ST
RE Number: 171055 0100
PROPERTY OWNER:
Name: MILLNER RANDY L
Address: 1285 STOCKS ST
ATLANTIC BEACH, FL 32233-2631
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.
-11,M:r City of Atlantic Beach APPLICATION NUMBER
cs . Building Department (To be assigned by the Building Department.)
r - 800 Seminole Road BS
/,
J -r Atlantic Beach, Florida 32233-5445 R W 1 7 Z`—t
Phone(904)247-5826 • Fax(904)247-5845 /
k art 9r E-mail: building-dept@coab.us Date routed: 10/7 7 /i 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:
Z�j5 S i cc_ { l De nt review required Yes No
uilding
Applicant: 0kree_4&>4O CD 0 Wining &Zoning
Tree Administrator
Project: l " i4P ' 6 Doo Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
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: proved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDI
PLANNING &ZONING Reviewed by: 41 SDate:/0-i) 7 1 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
OFFICE COPY
,p Building Permit Application Updated 5/5/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904)247-5826 Fax: (904) 247-5845
Job Address: STt7L Permit Number: ' ` E '7
Legal Description RE#
Valuation of Work(Replacement Cost)$ G l 0vv Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo PoolWindow76 )
• Use of existing/proposed structure(s)(Circle one): Commercial Qesidential)
• 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:
GuetSZ(Pt mac; b 00 R A4.4 D Rt:LMOVe,
Florida Product Approval# ( ^1 7 D for multiple products use product approval form
Property Owner Information
Name: H0 j 1`I C..L.J'4.t (2- Address: U 1$5
City (a''fLPi-t fl C (>ji_,AC,1-1- State 17-Lit Zip 3 . 33 Phone 1 S- 3.426-7
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company:( Qualifying Agent: 111tiLL. NiLL1 g41-"5
Address (.o P41 L LpS PKwy Oyu• ►.-( City , , State "E1.,pr Zip 3 a.�15'Lp
Office Phone d1p L - at/1—)L .•7 tt Job Site/Contact Number Li O'4" CSOa. • (dye
State Certification/Registration# aD/E E-Mail in/Le k.6 . O HD /i .Co,vv •
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation 10C1003
i
Exempt/Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
R • • 4ING UR NOTICE OF COMMENCEMENT.
•
(0 r (i Y
(SignatuYe owner or Agent) 2)(7-to_r�ft� • p(� (Signatur of"Contractor)
(including contractor) Zj�/&.._
and swffirm- .efore me this(7�+�:..y of Signed an. •.j med e me thi dna/�
t, / r
�, ($mature of, ry)LAWSON /1'(Sign.ture of Notary)
'�'•LO '::= MY COMMISSION#FF 142405
1 7: EXPIRES:September 18,2018 l ,-` JOYCE A.LAWSON
F e`
Bonded Thru Notary Public Underwriters t r• MY COMMISSION#FF 142405
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Type of Identification: Type of Identification: