1853 SELVA GRANDE DR - PERMIT RES18-0155 CITY OF ATLANTIC BEACH
Lr 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: RES18-0155
Description: replace garage doors
Estimated Value: 2425
Issue Date: 5/10/2018
Expiration Date: 11/6/2018
PROPERTY ADDRESS:
Address: 1853 SELVA GRANDE DR
RE Number: 169542 5028
PROPERTY OWNER:
Name: BRINKLEY ROBERT J
Address: 1853 SELVA GRANDE DR
ATLANTIC BEACH, FL 322334526
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.
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.
.�St � l"tr City of Atlantic Beach APPLICATION NUMBER
c :<" •� Building Department (To be assigned by the Building Department.)
800 Seminole Road C (
Atlantic Beach, Florida 32233-5445 �C.J I n w�
Phone(904)247-5826 • Fax(904)247-5845 t ! r
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: D aftment review required Yes No
C_Building
Applicant: Off.Q-f �y k& D ou Planning &Zoning
Tree Administrator
Project: .t Ci�44 E bob 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. ❑Denied. ❑Not applicable
(Circle one.) Comments:
U I�D11VG��,
PLANNING &ZONING Reviewed by: Date: S' 7'20/
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 RECEIVED
Building Permit Application Updated 12/8/17
..a City of Atlantic Beach ��� 3 ����
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 C-,S I 0 -O
Job Address: ( �Ll-�Y� G f10 iA oe '10(Z Permit Number: ^e
i !
Legal Description 6-a ZAG Dooy.. oo � » Atlan�cBeaGh. FL
Valuation of Work(Replacement Cost)$ a Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool EEEHDD
• 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:
-r U T a ��aAiw oD095b
Florida Product Approval# IL i L66 0,!JJ FL 1(d.p j0. 3 i for multiple products use product approval form
Propertv Owner Information
Name:-S1,-^ i I esule. ! tQwvLe-y Address: t$ 3 SI&LL'VA 6446"V,
City_01awbc—113(,14 kate %A zip 3X13 Phone gL)LA_Ff (t 1- 4LoLi
E-Mail L'",li(3R1 hi1J.LL q 4) fn U rK(,AS I- .
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: +Oy(&(WV_ 0 ''060% Qualifying Agent:M11C9 M11 -L 11-Aid
Address L% Q��\UI.��1b 4'l�e•`'Y 4C?.t�. City dl-Ctr.�orayte�.� State'V-k4- 1 Zip 'S!�-S�✓
Office Phone IQ 0 1 Job Site/Contact Numbery -4- 5CIA-(Qat JL 9 Q h
State Certification/Registration# GD 19 E-Mail D HD 6 ®H Dd4g . Olim • �
Architect Name&Phone# g Q n
Engineer's Name&Phon # /� ®. 14 7 p=.
Workers Compensation •�r��fi Al 1 l ! 13
- UJ
Exempt/Insurer/Lease Employees/Expiration Date C) Q
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or in lfaiQ Ives O
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the lawsa bpr2
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBINZ , Q
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,et NOTICE:In additi111 on to the require e - t s
ermit,there maybe additional restrictions applicable to this property that may be found in the puc reco
blirds of this ' uay ,{n
here may -e additional ,ermits re•uired from other ouernmen-al entities such as water many ement districts,stat
ederal a •envie ® Lu L
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in complian�v M 0 W
applicable laws regulating construction and zoning. LU N w
� � w
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMM ENCEMENIUMAY w
cc X
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
J - ' Of
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor) �(
Sig ed and s or �rJ firmed) before me this�ay—of Signed and swoLn to(or affirme �
before me th
n Io " may of
-�i Y A ,by - -
'_ - JOYCE k LAA''SON
ASHLEY GILL 'f0%'- ON;#FF142405
t� State of Florida-Notary Public ° =�^4
i atu a of otar 4_.� t_ EXF ft6a�ef d)'.
_ Commission#GG 153109 =•�,'.-v' ars
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[.-]-Pro [ ]Produced Identification
Type of Identification: Type of Identification: