300 GARDEN LN - DOOR ( -
,
° trCITY OF ATLANTIC BEACH
, , 'I '-. 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
"o;ii> INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0118
Description: REPLACING A SLIDING GLASS DOOR
Estimated Value: 2427
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 300 GARDEN LN
RE Number: 172020 5008
PROPERTY OWNER:
Name: FANNIN MEGAN
Address: 300 GARDEN LN
ATLANTIC BEACH, FL 32233-4522
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: PILLAR LLC
Address: 3167 ST JOHNS BLUFF ROAD
JACKSONVILLE, FL 32246
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$7,500.
0...M;
DocuSign Envelope ID:D839B278-CB52-41 EB-8D0C-03061836A8A8
r,a,
i<Y ` OFFICE CO ilding Permit Application 0---
C
Updated 12/8/17
City of Atlantic Beach
' a 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: J4 2 t 2-c„,1eic 1 .61,-,,,e I i it
Permit Number:ez
Legal Description 77-�nS'/-6-19-25---,2.96- ./ 7- 7ido G
RE# f �,s?O 'sG
Valuation of Work(Replacement Cost)$ '/a?7 Heated/Cooled SF c71 /5' Non-Heated/Cooled �,R38''
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/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:
Florida Product Approval# /5"-: -. 37.4.0
for multiple products use product approval form
Property Owner Information
Name: fX' • �--7-7,-/,'_ die.-/"Peff, Address: ?"2 �zsfh.-,1,.,e-p'1 '
City A c Ze /',A Mate �!. Zip -r� ? Phone
E-Mail //&*.6 g-g' V/�t/1.4,..‘--7e7-
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: ,./`fir-/(.4 G `f
Address �/�) Sr, �1,, Qualifying Agent: 41,/� � ,L /
5 A/a1 Jed/5- . e� City for*Serwdi ik State./'/ Zip,?!?.?/G
Office Phone 9ev s yS-y9,-3 Job Site/Contact Number
State Certification/Registration# (6C , -4/V/s-- E-MailS/ura-� ,
Architect Name&Phone# A.1/.f �`� ��'Gey"'
Engineer's Name&Phone# X s 1.4,7014' S/ 1.") 55 /y �/T�/" -
Workers Compensation ....-9:1/e/7.- -7 '�
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.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.
�DocuSpned by:
4B7C13B52A694DA..(Signature of Owner or Agent)
(Signature of Contractor)
(including contractor) 21*
Si nedd and sworn to or affir .bb efore -this 21 '-day of Signed and sworn to(or affirmed)before me this 21 day of
Si
.by V L91,pg, d .1 i 1 . i 1�Ur , by i okl
( ignature•Notary) A&`"""
(Signa 4 e of Notary)
�[ ]P rsonally Known OR personalty Known OR _
duced Identification )Produced Identification Alk,,,,f�yy I� �,,,,�,. HALEY ELISE BAKER
pe of Identification:F�� 0 10-51-6 -.93-4;42--0 ,,�• �•,�,,,
Type of Identification: :dri .n Commission*FF 989863
.,Sa c- ELISECommission
HALEY BAKER I ;'.iwr,Sr My May 08, 2020ires
eirivi Commission#FF 9898
?',i'le.•` 'y ommission Expires -- —.___