237 MAGNOLIA ST - GARAGE DOOR 1 CITY OF ATLANTIC BEACH
"'` ,.., _��. ' 800 SEMINOLE ROAD
Kvf ATLANTIC BEACH, FL 32233
o;319%� INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0117
Description: REPLACE GARAGE DOOR
Estimated Value: 1133
Issue Date: 4/5/2018
Expiration Date: 10/2/2018
PROPERTY ADDRESS:
Address: 237 MAGNOLIA ST
RE Number: 170545 0050
PROPERTY OWNER:
Name: SUMMERS COLLIER S
Address: 237 MAGNOLIA ST
ATLANTIC BEACH, FL 32233-4007
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: GEORGE'S GARAGE DOOR SERVICE, INC
Address: 870 MAIN ST
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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.
riiM City of Atlantic Beach APPLICATION NUMBER
rs'I (\ Building Department (To be assigned by the Building Department.)
800 Seminole Road cs
a 011
I/ 7
rAtlantic Beach, Florida 32233-5445 �J !
,�� � Phone(904)247-5826 • Fax(904)247-5845 a`�
` �;t>>/ E-mail: building-dept@coab.us Date routed: (/� ( -
/X(
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address."_ di_, Al a ,1 i t review required Ye No
Building >�
Applicant: �i'♦ / 'S ' , * _, PI nna Ing Zoning
/ /' Tree Administrator
Project: h."', A i .. ..4 , __♦ad ( 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: ❑Approved. I Denied. / ❑Not applicable
(Circl Comments: i \
C BUILD_ `D
fl-
PLANNING &ZONING
Reviewed by: i / Date: 3h2/20/a
TREE ADMIN.
Second Review: ['Approved as revised. �Denied. nNot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. []Denied. nNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
e"af OFFICE COC ,
dding Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Z
Job Address: (�3� Permit Number: J - O 117
Legal Description RE#
Valuation of Work(Replacement Cost)$ � /3 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New 'Addition Alteration Repair Move emo Pool ndow/Door
• Use of existing/proposed structure(s)(Circle one): Commercial I
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes 6 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:
iC:r-t
Florida Product Approval# t 'D )'4 1�S for multiple products use product approval form
Property Owner Information �i
Name: /✓ / 4 )(/f ijAddress: o�u 7 /It-iv.)/
City / J- ti )( �C,-c ''. State I Zip jr?-J-J J Phon .S SZ - '�/�; - 0-) fc
E-Mail L)jt� ./ q i� �7416,i/.C Fat's
Owner or Agent(If Agent, Power of Att6rney or Agency Letter Required)
Contractor Information
r �nn
Name of Com,p/an�y: L cel, ' ? l'"�i'rl �l'i i`J!i`'(Qualifxip$Agent: 6G
Address O (.) 1l�v. , City f'� ! n �;( '�.y,State )4= Zip :, 22*
Office Phone CIO/ LTJ 1`/()TY Job Site/Contact Number :1' 0-1IJ 9,j -f
State Certification/Registration# (�,1) ,j - E-Mail Ti.j cj 1'){ /C'L r,S c i L`f , .eh-%
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation 4 /tel / 9
Exem t/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. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
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 NOTICE OF COMMENCEMENT.
`► ` ��' ,rte �--
(Signature of Owner or Agent) / (Signatur Contractor)
Sith(including contractor) J
Mned and sworn to(or affirmed) before me this 1� day of S,i d and sworn to(or affirmed)before me this j day of
ctrc.h b( ,by \N./kart i it 'C(Lt f cr4 i�ia'�'G , # )/k,by \-\ATz.O.t [2-1c4 tT
(Signature of Notary) (Signature of Notary)
],Personally Known OR MAYORHARRIET PRUETTE [ ]Personally Known OR MAYOR HARRIET PRUET1E
[ ]Produced Identification Notary Pubic,stele of norms kr Produced Identification Mary NANG,Stab*florid.
Type of Identification: My Corr.Ems Feb.141= ype of Identification: let Comm.Expires Fob.14,201E
Commission No.FF 1!0141 F` 1:)12,tOn P4 - J
7L LSo -34 3 - 411 "°
•
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