305 Garden Ln RES19-0335 Door - � ''r%� RESIDENTIAL PERMIT PERMIT NUMBER
C11 ITY OF ATLANTIC BEACH RES19-0335
-5V: �" ISSUED: 11/14/2019
\ c T 800 SEMINOLE ROAD EXPIRES: 5/12/2020
ATLANTIC BEACH, FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA 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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
305 GARDEN LN RESIDENTIAL ALTERATION DOOR $3961.00
RESIDENTIAL
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 5062 SELVA MARINA GARDEN
COMPANY: ADDRESS: CITY: STATE: ZIP:
PELLA WINDOW AND 350 State Road 434 W LONGWOOD FL 32750
DOOR
OWNER: ADDRESS: CITY: STATE: ZIP:
AYCOCK CHERYE D 305 GARDEN LN 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 S;.
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 $70.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $35.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$109.00
Issued Date: 11/14/2019 1 of 2
11.An le, RESIDENTIAL PERMIT PERMIT NUMBER
iii ' CITY OF ATLANTIC BEACH RES19-0335
7- ii Z
800 SEMINOLE ROAD ISSUED: 11/14/2019
<:-.!--91119%. EXPIRES: 5/12/2020
ATLANTIC BEACH. FL 32233
Issued Date: 11/14/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
'. Building Department (To be assigned by the Building Department.)
� 'i 800 Seminole Road "� C'
i� X519 - 3 5
'•!,f Atlantic Beach, Florida 32233-5445 1
Phone(904)247-5826 • Fax(904)247-5845
_on E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 5 (PR EAJ Department review required Ye 'No
<Building 1
Applicant: PeLtpt W 1 ND3c) _C+anning &Zoning
Tree Administrator
Project: ( O O 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: P pproved. ❑Denied. I 'Not applicable
(Circle one.) Comments:
r BUILDING
PLANNING &ZONING Reviewed by: Date: /J^d 17
TREE ADMIN. Second Review: ['Approved as revised. ❑Deni . ['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
For Pick Up Call Tim 727-637-8400
r,: :l=:?;; Building Permit Application UpdntediU/9/18
7 `. .= >i: City of Atlantic Beach Building Department **ALL INFORMATION
-, HIGHLIGHTED IN GRAY
f; 800 Seminole Road, Atlantic Beach, FL 32233
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
7:1)
Job Address:
305 C1os.rd er LrlPermit Number: �� ES1 C�. �
Legal Description'31 -8Li OQ -2S-z.61E Sew)... 1"laci a C-larden t- 10 Pt 27 RE# 1`12.O2o`50-CI
Valuation of Work(Replacement Cost)$ 3 Q to I Heated/Cooled SF Non-Heated/Cooled
o Class of Work: ONew OAddition DAlteration ❑Repair ❑Move ODemo OPool 'Window/Door `
o Use of existing/proposed structure(s): OCommercial residential an
O If an existing structure,is a fire sprinkler system installed?: OYes ONo
s Will tree(s)be removed in association with proposed proiect? DYes(must submit separate Tree Removal Permit) ONo
Describe in detail the type of work to be performed: Lu
eR1oCe 1doat' Size -car 5i2,7- C .)
Florida Product Approval if .2.0 1 14(0. \ for multiple products use product approval form LL,„
Property Owner Information ` ..1). ()
..L.
Name I he'llA tr�('rsc•V -1`'1. Address ? ()t Liat•(Gr In. c'
City_ I ccf1vi C eo•-Ch .• State H.- Zip2:2.x2; Phone
E-Mail r
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)—
Contractor Information
Name of Company t •\\:1 V tlai'` ..:tti Y 1-5 Qualifying Agent ..ae.rrve. ?-okfr4t1
Address "'DSO '- 3 213`- City r OnCl toLICOd State 3'L Zip 31-16:::'
Office Phone 1401 -61?../1-2... t--i 43 Job Site Contact Number q
State Certification/Registration# C O`i01 t? E-Mail '`1 ,in. Cma..`12-1 tiz)f;/(�P..e- t P-(e.(rt-iV (Lrl W •1
Architect Name&Phone# 0 ON
Engineer's Name&Phone# Z
Workers Compensation Insurer Holmes Murphy&Assoc- WDMoR Exempt❑ Expiration Date 9/01/20 Q
I -� co \
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has a Z
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating W O a
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, 0 m H ZF
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements of this C.) 0 U 8
;
permit,there may be additional restrictions applicable to this property that may be found In the public records of this county,and W H a a
there may be additional permits required from other governmental entities such as water management districts,state agencies,or CI Z
federal agencies. U -J N CC a
H
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all F- Z
applicable laws regulating construction and zoning. 0 IL LaL W
WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY w O in w
>. a5 c
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND 1' c3 E
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR A ATTORNEY BEFORE w 0 uw) w
co u
RECORDING YO NOTICE OF COMMENCEMENT. W
o
Y7
n urcc e of Owner or Agent) (Signature of Contractor) . \IV
NI
SidSignedcorn
l q ,by ro rtia5 -{fit C.0(_ . NOV. , 10\ ,by
's-.6 &5 vs t.6.1-Ct
(Signator ot, ota Yr:
5� ,.I�y �in-_ • �NOTAI�� 11BLIC
(1)
,� � 'NOTARY PUBLIC 4- STATE OF FLORIDA
rNATE OF FLORIDA )y(lpersonall Known OR ' Comm#GG2?5648
[ )Personally Known OR Comm#00235648 y rf :�1`O Expires 71512022
Produced Identificat' SiM`'-i9�g r I ]Produced Identification
Type of Identification: v r Expires 7/5/2022 Type of Identification: -
9/11/2019 Florida Building Code Online OFFICE CSP
Date Submitted 07/25/2019 Y
Date Validated 07/29/2019
Date Pending FBC Approval
Date Approved 08/07/2019
Summary of Products
Model,Number or Name Description
20146.1 250 Series Vinyl Sliding Patio Door 96"x 96"OX or XO Sliding Patio Door with joined&screwed
together frame corners
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL20146 RO C CAC 411-H-1503.9 10.pdf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant:No 05/22/2029
Design Pressure: +30/-30 Installation Instructions
Other:Glass shall conform to the current ASTM E1300 FL20146 RO II Drawing 1961.pdf
standard and shall be safety glazed. Verified By: Warren W.Schaefer, P.E.44135
Created by Independent Third Party:Yes
Evaluation Reports
FL20146 RO AE Drawing 1961.pdf
Created by Independent Third Party:Yes
20146.2 250 Series Vinyl Sliding Patio Door 96"x 96"OX or XO Sliding Patio Door with mitered&welded
frame corners
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL20146 RO C CAC 411-H-1503.1 2.pdf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant:No 05/17/2029
Design Pressure: +35/-35 Installation Instructions
Other:Glass shall conform to the current ASTM E1300 FL20146 RO II Drawing 1961.01
standard and shall be safety glazed. Verified By: Warren W. Schaefer, P.E.44135
Created by Independent Third Party: Yes
Evaluation Reports
FL20146 RO AE Drawing 1961.201
Created by Independent Third Party: Yes
20146.3 250 Series Vinyl Sliding Patio Door 96"x 82"OX or XO Sliding Patio Door with mitered&welded
frame corners
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL20146 RO C CAC 411-H-1503.17 18.pdf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant:No 05/17/2029
Design Pressure: +40/-40 Installation Instructions
Other:Glass shall conform to the current ASTM E1300 FL20146 RO II Drawing 1961401
standard and shall be safety glazed. Verified By: Warren W. Schaefer, P.E.44135
Created by Independent Third Party: Yes
Evaluation Reports
FL20146 RO AE Drawing 1961.pdf
Created by Independent Third Party:Yes
20146.4 250 Series Vinyl Sliding Patio Door 96"x 82"OX or XO Sliding Patio Door with joined&screwed
frame corners
Limits of Use Certification Agency Certificate
Approved for use in HVHZ:No FL20146 RO C CAC 411-H-1503.25 26.01
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant:No 05/22/2029
Design Pressure: +45/-45 Installation Instructions
Other:Glass shall conform to the current ASTM E1300 FL20146 RO II Drawing 1961.pdf
standard and shall be safety glazed. Verified By: Warren W.Schaefer,P.E.44135
Created by Independent Third Party: Yes
Evaluation Reports
FL20146 RO AE Drawing 1961.pdf
Created by Independent Third Party: Yes
20146.5 250 Series Vinyl Sliding Patio Door 48"x 96"Fixed Panel Door
Limits of Use Certification Agency Certificate
Approved for use in HVHZ:No FL20146 RO C CAC 411-H-1504.01 08.pdf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 05/31/2029
Design Pressure: +50/-50 Installation Instructions
Other:Glass shall conform to the current ASTM E1300 FL20146 RO II Drawing 1961.pdf
standard and shall be safety glazed. Verified By:Warren W.Schaefer, P.E.44135
Created by Independent Third Party:Yes
Evaluation Reports
FL20146 RO AE Drawing 1961.0f
Created by Independent Third Party:Yes
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