300 5th St RES19-0135 Door RESIDENTIAL PERMIT PERMIT NUMBER
J CITY OF ATLANTIC BEACH RES19-0135
800 SEMINOLE ROAD
ISSUED:5/21/2019
-�""9� ATLANTIC BEACH.FL 32233MUST CALL INSPECTION PHONE LINE (904) EXPIRES: 11/17/2019
• • BY
AU—WIAK THE CYRRENT • f • • • . • .
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
300 5TH ST RESIDENTIAL ALTERATION DOOR $2195.00
RESIDENTIAL
TYPE OF REALESTATE ZONING: BUILDING
GROUP:CONSTRUCTION: NUMBER:
169827 0500 ATLANTIC BEACH
COMPANY: ADDRESS:
BUTTERFIELD 4220 PLANTATION OAKS BLVD APT ORANGE PARK FL 32065
REMODELING LLC 1516
• ADDRESS: CITY: STATE: ZIP:
WINGATE OWEN W 3005TH ST ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
1 I BUILDING BUILDING OFFICIALNOTES ACTIVE
Notes:
WindW/door installation Instructions shall be on the lob site,provided by the qualifier of this permit,in order to receive an Inspection from the
Inspector.Failure to supply this information will result In a re-Inspection fee.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING VERMIT 455-0DW 322-1000 0 $65.00
Issued Date:5/21/2019 1 of 2
RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0135
800 SEMINOLE ROAD ISSUED:S/21/2019
ATLANTIC BEACH.FL 32233 EXPIRES: 11/17/2019
BUILDING PLAN CHECK 455-0000322-IDOL D $3250
STATE DBPR SURCHARGE 455-0000.208-0700 1 0 $2.00
STATE DCA SURCHARGE 455-0000208-0600 1 0 $2A0
TOTAL:$101.50
Issued Date:5/21/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assignetl by the Building Department.)
( 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@wab.us Date routed: Z
City web-site: http://ww✓r.coab.us
APPLICATION REVIEW AND TRACKING FORM
l.���J
Property Address: S �7 De eM review required Ye No
uildin
Applicant: E Uorr e-pz(-l E-c—, ning
1� Tree Administrator
Project: L J(n0z, Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Sigrh
Other Agency Review or Permit Required Review or Receipt Dale
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
Sl.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: L�Approved. []Denied. ❑Not applicable
(Circle one.) Comments:Pe l m 1 I haS. CovJ-1 -r ld n.S
BUILDIN T
PLANNING&ZONING SY
Reviewed by: Date:
TREE ADMIN. Second Review: []Approved as revised. ❑Denie . ❑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:
Revleed OVIV2017
800SIemTiYn°RD�LAtlaanHos m,AF 32233 OFFICE COPY
Office(904)247-5826 Fax(904)247-5845
Sob Address: 300 5TH ST ATLANTIC BEACH, FL. permit Number• RES�g ' b( 35
Legal Description 5.69 16.2829E ATLANTIC BEACH LOT61,3 BLK 6 parcel N 169827-0500
Fluor Area.o
Valuation of Work$ 2195.00 Proposed Work keated/cooled N/A nonkeateV/mokd 156
Class of Work(circle one): New Addition Alteration (lao Move Demolition pool/spa window/door
Use of eaisting/proppwed structure(a)(circle one): Commercial idea '
If an existing structure,is a fun spr' r system installed?(Circle one): es No N/A
Florida Product Aroval# 13074.9 (3EA) 13074.1 (1 EA)
For multiple products use product ap�}'orm - -
Describe in detail the type of work to be performed: REPLACE EXTERIOR DOOR
APR 30Dg019 I
prober"Owner brformafion: Q J uZzr
Name: OWEN WINGATE Address: 300 5TH STr�r.;eEi„ ;+tSL (h
City ATLANTIC BEACH StahF�Zip32233 Phone 904-553-2002
E-Mail or Fax#(Optional) (-
ContractorInformsfioa: W 200 a
Company Name: BUTTERFIELD REMODELING, LLC. Qualifying Agent; CLINT BUTTERFIELD 13 Z
Address:4220 PLANTATION OAKS BLVD #1516 City ORANGE PARK $late FI Zi
Office Phone 9th-vav- 4na Job Site'Contact Number Rn4-a93.Bdn9 Fax# m 2
Slate Cer ification/Registmtion# NSS-14 5 ul
Ambitect Name&Phone#
Engineer's Name&Phone# ¢ in
Fee Simple Title Holder Name and Address w G
Bonding Company Name and Address w U N w 3
Mortgage lender Name and Address cz G w
W w
ApplicaAon is hereby made to obtain apermtt to da the work mid tnsta/lafioru as indicated I certify that no work or iutdlan'on has com ermu bprmr to the
once ojaperminot eeneut wank thin!be performed,o r lfc the stondardr work laws regdatingconmucnan in Ihisjurudbtion. Thv perms becomes nu!!
and mid rJ wmkunot commenced within six(6)months.or ijcanstrucnanmwork is susendedorabandonedjara ad ofsix/6J mmvhr at airy Hme aper
work is commeraed I understand Mat separate permits must be secured for Eledrion, Work,PhensU g,Signs, �,Pdolr, umeeea,Boilers,H ess,
Tanks asWAir Condnionen,ac
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.
]herebbyyrcrdfy Matlhawreadmdes.m dth �pheetionaM/moxthesametobetrueandearract. Allprovisiwuoflawsardordtrmncer Som,midis
type afwork will be complied with whether sppeecvcIX herein or not 77ie granfing of o permit does not presume m give auMoriry to violme or caxe the
provmomofanyotherfederal.state rlocal law regu7 'rgcomvr on ar the erformance ofconstruction
Signature of Ovmer Signature of Con
Prim Nme OWEN IMNGATE _ Prim Name
Swom to and subsmbed me Swom h�gnd subs. ed befo a me
this_22�Dayof Pion1.. . 2 (Dal 0
�i Q�,r1 0D
N� Not"Pu
Revised 01.26.10
D'Arcy Hubbard r
NOTARY PUBLIC "- CAROLJEMl HUGHES -
4 VvExpires10121/2019
STATEOFFLORIDA .COmmissionRGG274780CarnnW FF929009ExpiresDecember82022
-°d^.°` BmMad Vvu Tan Fan lnSurenpd00.1aSaHt
OFFICE COPY
RE : 169827-0500
300 5TH ST
ATLANTIC BEACH , FL.
r.1.2t �
24 B'^S F
2" 4 '^ 23
` FUA " U I
,,:4 ,�
R
L �
2r.
20 22
OWNER PLEASE DRAW CIRCLES ON THE
SKETCH TO SHOW WHERE EACH OF YOUR
DOORS ARE BEING INSTALLED. INSURE YOU
RETURN THIS WITH YOUR APPLICATION,
FAILURE TO DO SO WILL DELAY THE PROCESS
THANK YOU .
11 OFFICE COPY
Business : Professional Regulation
r�
SCIS Hame Log In USS "Inon Nat Too. sudnit Sur&A '. Stan a FaR PubhnInons ConWR lis MIS SO.an links Se n
Ur
product Approval
USER wblcUmr REVIEWED FOR CODE COMPLIANCE
CITY OF ATLANTIC BEACH
Pmt,,m >Proeua or APpn=emnsearcn>Ay_P mennn w,>wrpnrwm o.r.R SEE PERMfrS FOR ADDITIONAL
R# FL13074-R8 REQUIREMENTS AND CONDITIONS
Application Type Revision REVIEWED BY:_12L'� DATE: $ �O')Ol j
Code Version 2017
Application Status Approved
*Approved by DBPR.Approvals by DBPR shall be reviewed and ratified by
the POC and/or the Commission If necessary.
Comments
Archived
Product Manufacturer Andersen Corporation
Address/Phone/Email 100 Fourth Avenue North
Bayport,MN 55003
(651) 264-5308
alan.bamtad@AndersenCoM.com
Authorized Signature Alan Barstad
alan.barstad@AndersenCorp.com
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Emall
Category Exterior Doors
Subcategory Swinging Exterior Door Assemblies
Compliance Method Certification Mark or Listing
Certification Agency Window and Door Manufacturer Association
Validated By Window and Door Manufacturers Association
Referenced Standard and Year(of Standard) Standard Year
101/IS2/A440 2011
Equivalence of Product Standards
Certified By Approved Testing Lab
FL13074 RR Ea I A A 101-I -6440 LEiva�bdf
Product Approval Method Method 1 Option A
Date Submitted 12/06/2017
Date Validated 12/08/2017
OFFICE COPY
Bumma of Products
FL* Model,Number or Name Description
13074.1 -SeAriesIFrenchwood Hinged Patio A-Series Frenchwood Hinged Patio Door-Inswing
Door- nswing/FWHID33100A IG
Limits of Use Certification Agency Certificate
Approved for use In HVHZ: No FL13074 RB L CAC HID 31 IG df
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 07/17/2026
Design Pressure: +45/-55 Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting F113074 RB II FL13074 R6 II A-Series Inswing Doorpd
of two 3 mm tempered lites separated by a desiccant filled Verified By: Window and Door Manufacturer Association
metal spacer.Other configurations comply with ASTM E1300. Created by Independent Third Party:
Hardware tested was a 4 point lock with a bolt. Evaluation Reports
Created by Independent Third Parry:
13074.2 A-Serfes Frenchwood Hinged Patio A-Series Frenchwood Hinged Non- Operable Patio Door-
Door-InsWing/FWHID33100S IG Inswing
Limits of Use Certification Agency Certificate
Approved for use In HVHZ: No FL13074 RB C CAC FWHID33100S 15,1112f
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 08/19/2026
Design Pressure: +45/-55 Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting FL13074 R8 II FL13074 R6 II A-Series InIwirig Doocp&f
of two 3 mm tempered lites separated by a desiccant filled Verified By: Window and Door Manufacturer Association
metal spacer. Other configuratons comply with ASTM E1300. Created by Independent Third Party:
No Hardware was utilized. Evaluation Reports
Created by Independent Third Party:
13074.3 A-Series Frenchwood Hinged Patio A Series Hinged Patio Door-Inswing-Single
Door-Inswing/FWHID3380A IG
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL11074 R8 C GAC FWHID1380A IG,ad
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Data
Impact Resistant: No
Design Pressure: +45/-55 Installation Instructions
other: Glass tested was 19.5 mm Insulated Glass consisting FL13074 WE 11 A-Series InswingDoorpdf
of two 3 mm tempered lites separated by a desiccant filled Verified By: Window and Door Manufacturer Association
metal spacer.Other configurations comply with ASTM E1300. Created by Independent Third Party:
Hardware tested was a 3 point lock with a bolt. Evaluation Reports
Created by Independent Third Party:
13074.4 A-Series Frenchwood Hinged Patio A-Series Fremchwood Hinged Non-Operable Patio Door-
Door-Inswing/FWH1D3380S IG Inswing/FWHID3380S IG(Screw-in-panel)
Limits of Use Certification Agency Certificate
Approved for use In HVHZ: No FL13074 R8 C CAC FWHIU3380S IG pd
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 03/17/2026
Design Pressure: +45/-55 Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting FL13074 18 11 A-Series Inswino Doorgdf
of two 3 mm tempered liter separated by a desiccant filled Verified By: Window and Door Manufacturer Association
metal spacer. Other configurations comply with ASTM E1300. Created by Independent Third Party:
No Hardware was utilized. Evaluation Reports
Created by Independent Third Party:
13074.5 A-Series Frenchwood Hinged Patio A Series Hinged Patio Door-Inswing
Door-Ieswing/FWHID6080AS IG
Limits of Use Certification Agency Certificate
Approved for use In HVHZ: No FLIA074 R8 C CAC FWHID6080AS 1G-Ddf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Data
Impact Resistant: No 07/17/2026
Design Pressure: +45/-55Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting FL13074 R8 11 A-ser es Inswing Doorad
of two 3 mm tempered lites separated by a desiccant Filled Verified By: Window and Door Manufacturer Association
metal spacer. Other configurations comply with ASTM E1300. Created by Independent Third Parry:
Hardware tested was a 3 point lock with a bolt. Evaluation Reports
Created by Independent Third Party:
13074.6 A-SeriesFrenchwootl Hinged Patio A-Series Frenchwogd Hinged Patio Door-Inswing
Door-Ins wing/FWHID64100AP IG
Limits of Use Certification Agency Certificate
Approved for use In HVHZ_ No_ _ 4 R8 C GAC FW HID64100AP IG.gdf
` Design Pressure: +45/-55 Installation InstruNons
Other: Glass tested was 19.5 mm Insulated Glass consisting FI 11074 R8 II FL13074 R6 lI A-Sens Inswing DoorodP
of two 3 mm tempered Rtes separated by a desiccant filled Verified By: Window and Door Manufacturer Association
metal spacer. Other configurations comply with ASTM E1300. Created by Independent Third Party:
Hardware tested was a 4 point lock with a bolt on the active Evaluation Reports
panel and two shoot bolls on the passive panel. Created by Independent Third Mnpr- mw
13074.7 A-Series Frenchwood Hinged Patio A Series Hinged Patio Doors-Inswing
Door-Inswing/FWHID6480AP IG
Limits of Use Certification Agency Certificate
Approved for use In HVHZ: No FL13074 R8 C CAC FWH[126480AP IG.Pd
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 07/09/2026
Design Pressure: +45/-55 Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting F113074 Ra II A-Series Inswing Doora f
of two 3 mm tempered lites separated by a desiccant filled Verified By: Window and Door Manufacturer Association
metal spacer. Other configurations comply with ASTM E3300. Created by Independent Third Party:
Hardware tested was a 3 point lock with a bolt. Evaluation Reports
Created by Independent Third Party:
13074.8 A-Series Frenchwood Hinged Patio A Series frenchwood Hinged Patio Door-Inswing
Door-Inswing/FWHID81180ASA IG
Limits of Use CertMcation Agency Certificate
Approved for use In HVHZ: No FL13074 R8 C CAG FL13074 8 CCL.pd
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Data
Impact Resistant: No 10/18/2023
Design Pressure: +45/-55 Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting FL13074 R8 II A-Series Inswing oor df
of two 3 mm tempered ties separated by a desiccant wiled Verified By: Window and Door Manufacturer Association
metal spacer. Other configurations comply with ASTM E1300. Created by Independent Third Party:
Hardware tested was a 3 point lock with a bolt on each Evaluation Reports
operable panel. Created by Independent Third Party:
13074.9 A-Series Frenchwood Hinged Path A-Series Frenchwood Hinged Patio Door-Outswing
Door-Outswing/FW01033100A IG
Limits of Use CortHlcatlon Agency Certificate
Approved for use in HVHZ: No FL13074 Re C CAC FWDD33100A IG,pd
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 11/06/2026
Design Pressure: +45/-55 Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting FL13074 R8 11 FL13074 R6 II A-Series Outswing-Door.0
of two 3 that tempered lites separated by a desiccant filled Verified By: Window and Door Manufacturer Association
metal spacer. Other configurations comply with ASTM E1300. Created by Independent Third Party:
Hardware tested was a 4 point lock with a bolt. Evaluation Reports
Created by Independent Third Party:
13074.10 A-Series Frenchwood Hinged Patio A-Series Frenchwood Hinged Non- Operable Patio Door-
Door-OutsWng/FWOD33100S IG Outswing
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL13074 RB C LAC FWOD331005 IG odf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Data
Impact Resistant: No 03/01/2026
Design Pressure: +45/-55 Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting FL13074 R8 II FL13074 R6 It A-Series OULswingggnypdf
of two 3 mm tempered lites separated by a deslCC3m filled Verified By: Window and Door Manufacturer Association
metal spacer.Other configurations comply with ASTM E1300. Created by Independent Third Party:
No hardware was utilized. Evaluation Reports
Created by Independent Third Party:
13074.11 A-Series Frenchmix! Hinged Patio A Series Hinged Patio Door-Outswing
Door-Outswing/FWDD3380A IG
Limits of Use Car tficatlon Agency Certificate
Approved for use in HVHZ: No FL13074 R8 C CAC FWOD3380A IG Rd
Approved for use outside HVHZ: Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 03/19/2026
Design Pressure: +45/-55 Installation Instructions
Other: Glass tested was 19.5 mm Insulated Glass consisting FL13074 R8 II A-Series Outswing Door.odf
of two 3 mm tempered lites separated by a desiccant filled Verified By: Window and Door Manufacturer Association
metal spacer.Other configurations comply with ASTM E1300. Created by Independent Third Party:
Hardware tested was a 3 point lock with a bolt. Evaluation Reports
Created by Independent Third Party:
13074.12 A-Series Frenchwood Hinged Patio A Series frenchwood Hinged Nan-Operable Patio Door-
Door-Outswing/FWOD3380S IG Outswing
Unfit,of Use I Certiflca ion Aeencv Certificate