1912 N Sherry Dr RESA19-0001 Win Rev Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMITM
O-Revision to Issued Permit OR ❑ Corrections to Comments Date:
Project Address: yCl I
Contractor/Contact Name: rAzLAO
Contact Phone: s7-"' 5' S 5 / Email: U
Description of Proposed Revision/Corrections:
loo s aIt-litI./r- (= 6all ce-J,
An er c
I affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
CKMQ o ❑ Yes (additional s.f.to be added: )
• Will proposed revision/corrections add additional in ase n building value to original submittal?
El*Yes (additional increase in building ue:$ ) (contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
LV Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Du $ �•��
Revision/Plan Review Comments n /17'0'-'7 TO /2,CX --/n Sop 9:'—'OP y AQ
Department Review Required:
Building
Planning&Zoning eviewed By
Tree Administrator
Public Works
Public Utilities �
Public Safety Date
Fire Services Updated 10/17/18
OFFICE COPY
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
*Project Address: 101/ L Permit#:
_ f A � n
*Owner/Project Name: /yA- l6i, ►
As required by Florida Statute 553.842 and Florida Administrative Code Rule 913-72, please provide the information and product approval number(s)for
the building components listed below as applicable to the building construction project for the permit number listed above. You should contact your
product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide product
approval may be obtained at:www.floridabuilding.org.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A. EXTERIOR DOORS
1. Swinging L k ( Sv i� Iz t 1�vZ�3 . ILt
3.Sectional
4. Garage Roll-Up
5.Automatic
6. Other ....
B.WINDOWS
1.Single hung w
2. Horizontal sliderIP�. I �, 113 6 _ Q
3. Casement J����.� Li .
4. Double hung
5. Fixed ka L� s O
6.Awning
7. Pass-through
8. Projected
9. Mullion
10. Wind breaker
11. Dual action
12. Other
Page 1 of 4 Updated 10/17/18
OFFICE COPY
In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project, the
Contractor shall maintain on the job site and available to the Inspector, a legible copy of each manufacturer's printed specifications and installation
instructions along with this Product Approval Sheet.
I certify that this product approval list is true and correct to the best of my knowledge. I further certify that use of different components other than the
ones listed in this document must be approved by the Building Official.
*Contractor Name (Print Name): OA-741 -�v L)GWW *Contractor Signature: /4�2
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*Company Name: :� v i (5,�,�,-
*Mailing Address: 1 11 Z S4&%. �J Z,V_ .
*City: A'� F �v1 Lhi *State: *Zip Code: 10-3)
*Telephone Number: �� �" r�L 3 7 3 j` *E-mail Address: Al "(v y,ftc l
Cell Phone Number: Fax Number:
Page 4 of 4 Updated 10/17/18