1957 Seminole Rd RES19-0218 Garage Door RESIDENTIAL PERMIT PERMIT NUMBER
r CITY OF ATLANTIC BEACH
RES19-0218
800 SEMINOLE ROAD
ISSUED: 8/2/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 1/29/2020
MUST CALL INSPECTION • • • 1 : ♦ BY 4 PM FORDAY INSPECTION.
ALL •RK MUST CONFORM T• THE CURRENT 6TH EDITION1 OF • ' BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
1957 SEMINOLE RD RESIDENTIAL ALTERATION GARAGE DOOR $1887.00
RESIDENTIAL
TYPE OF
ZONING: : . •
• • GROUP:
1695420512 BEACHSIDE
COMPANY: ADDRESS:
PRECISION DOOR SERVICE 6676 COLUMBIA PARK DR S JACKSONVILLE FL 32258
OF N FL JASO
• ADDRESS:
NICHOL WILLIAM 1957 SEMINOLE RD ATLANTIC BEACH FL 321233
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $60.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 8/2/2019' 1 of 2
rS :LT', City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
n 800 Seminole Road
Atlantic Beach, Florida 32233-5445 1 Y li
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: /--7
t cT
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:
Em t !yQL& Department review required Yes No
I--) uildin
Applicant: I" ��C tS (d(�N ��Cj arming &Zoning
Tree Administrator
Project:
JCS 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 B
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: proved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
=BUlN
PLANNING &ZONING Reviewed by: Date: —71k6
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
' Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department ''MALL INFORMATION
R;
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone. (904) 247-5826 Fax: (904)247-5845 Email: Building-DeptigtDcoab.us IS REQUIRED.
Job Address: Permit Nu er:REQ (9 0 Z (8::^
Legal Description _
Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addltion ❑Alteration ❑Repair ❑Move []Demo ❑Pool OWindow/Door
• Use of existing/proposed structure(s): Ocommercial Besidentlal
• If an existing structure,Is afire sprinkler system Installed?: EYes ®No
• Will trpp(q posed oro'ect?0yes(must su —It,tanapsts Tr moval Permitl 111A
Describe in detail the type of work to be performed:
c�plact c�a�ac�� � oaf- wffi) "t Lki.
Florida Product Approval# for multiple products use product approval form
Name —z / ` L- Address
City State_ -�Zip Phone o
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agen ettrar
Contractor Information
Name of Company Precision Door Service of N.FL Qualifying Agent Jason Sheppard
Address6676 Columbia Park Dr S. City Jacksonville State FL zip
,32258
Office Phone Job Site Contact Number 3-47T§—
State Certification/Registration#CRC1330804 E-Mail isheppard.0e69mall.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation insurer see certificate OR Exempt® 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 regulating
construction in this Jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGN Q
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county3nd N \C
there may be additional permits required from other governmental entities such as water management districts,state agenc ,5 G O \
federal agencies. LL BZ H
OWNER'S AFFIDAVIT:I certify that all the foregoing information Is accurate and that all work will be done in compliance wlthl m j= Z LI
applicable laws regulating construction and zoning, 0 C U C
W Q 0
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAZ cc a�
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PRO TY. IF YOU INTU u-
y
TO OBTA FINANCING, CONSULT YOUR LENDER OR AN O Y BEFORE Q w
COR YO R FCO ENCEMENT, LL U. w U
(L CC m
(Signature of Owner or Agent) V Sig ature of Contractor) w :3W VC
t) W W
Signed and sworn o or affir ed)before me t Is day of SI ned and sworn to,�or affirmed)before this of W
aid b U� by cc
Si nature of Notary)
rr` MICHELLE VAD570
�,� o� ir�Y'ii�•.• MICHELLE VAN VUREN
Notary Public St •,
�' ` Commission# Notary Public•State of FloridaPersonally Known OR ''dor M1My Comm.ExpirePersonally Known OR ;% Commission GG 203567C )Produced Identificati . Bonded through NationC 1 Produced Identification o►n..•' My Comm.Expires Jul 29,2021
Type of Identification; _._ __ Type of Identification: Bonded through National Nota Assn,