2235 Beachcomber Tr RES20-0021 2 Doors RESIDENTIAL PERMIT PERMIT NUMBER
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'` CITY OF ATLANTIC BEACH RES20-0021
�� ISSUED:SEMINOLE ROAD 2/12/2020
ATLANTIC BEACH. FL 32233 EXPIRES: 8/10/2020
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: I VALUE OF WORK:
2235 BEACHCOMBER TR RESIDENTIAL 2 DOORS $1249.00
WINDOWS/DOORS
TYPE OF REAL ESTATE ZONING: BUILDING USE
CONSTRUCTION: ! NUMBER: 1 GROUP: SUBDIVISION:
169463 0168 OCEAN WALK UNIT 01
COMPANY: ADDRESS: CITY: I STATE: ZIP:
BUTTERFIELD 4220 PLANTATION OAKS BLVD APT
REMODELING LLC 1516 ORANGE PARK FL 32065
OWNER: ADDRESS: CITY: STATE: ZIP:
COX MELVIN L 2235 BEACHCOMBER TRL ATLANTIC BEACH FL 32233-4567
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.
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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 455-0000-208-0600 0 $2.00
TOTAL:$94.00
Issued Date:2/12/2020 1 of 2
'',,:, RESIDENTIAL PERMIT PERMIT NUMBER
`,-, CITY OF ATLANTIC BEACH RES20-0021
/ 800 SEMINOLE ROAD ISSUED: 2/12/2020
*frto;i»%' EXPIRES: 8/10/2020
ATLANTIC BEACH. FL 32233
Issued Date:2/12/2020 2 of 2
City of Atlantic Beach APPLICATION NUMBER
k - .. Building Department (To be assigned by the Building Department.)
800 Seminole Roadrt____ REszy- O / a
j Atlantic Beach, Florida 32233-5445
Phone(904)247 5826 Fax(904)247 5845 I z 1
�JSI�'' E-mail: building-dept@coab.us Date routed: `
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z Z3S 6EAC-1-100111,e)6‘ , ent review required Ye No
4Buildin
Applicant: 6 0 rr e2.R1 C-__(_ C-
'iv103E-LI/Lx-Planning &Zoning
ree Administrator
Project: 12_ ,S
❑, V Q0 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: pproved. I (Denied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: ril / Date: /-A1-66
TREE ADMIN. Second Review: ['Approved as revised. ['Denied. ['Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I 'Approved as revised. ['Denied. Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
OFFICE COPY
o*. Building Permit Application Updated 12/8/1/
City of Atlantic Beach
'~ h„;./ 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 fax:(904)247-5845
Job Address:2235 BEACHCOMB.EB_TI LATLANTIC_BEAC.H,..EL.3223 Permit Number:.1.""NJ Z� OO Z
Legal Description 42-1 OCEANWALK UNIT 1 LOT 82 .__.__. REtt 169463-0168_..:........______..._..........
Valuation of Work(Replacement Cost)S 1249.00 Heated/Cooled SF 2720 Non-Heated/Cooled 646
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool tWindow/Door
• Use of existing/proposed structure(s)(Circle one): Commercial! Residential )
• If an existing structure,is a fire sprinkler system instailed?(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: INSTALL EXTERIOR DOORS (2ea)
Florida Product Approval 4 FL1 16468.4 & F(_#13541.2 for multiple products use product approval form
Property Owner Information
s
Name: MELVIN COX Address:2235 BEACHCOMBER TRL ILI c'I
City ATLANTIC BEACH State FL Zip_32233 Phone W14-2117-1410 (.)
E-Mail MELGQX...X@Y_AHQQ,.CQt4 _ _ .___--- -•-2 N
CJi
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) = J ` C
aUdO `
Contractor Information c� p
Name of Compa+ty:.FLUSI_EBEIF{ ll RFMC)1)FI INJG (LC Qualifying Agent: CLINT BUTTEREIELD ..-__._-__. O ca E z F
Address 4220 PI ANTATION OAKS RI Vl?_.-#1ti16....._ __-.._. _City_.Q ANGE..P.ARK__ State-._._.-EL. Zip.._...32065..._......_.0 -g O
Office Phone 904-333-8409 .W Job Site/Contact Number c) 4-=13143409 ill h .44
State Certification/Registration# NSS-14 E-Mail ,3M.HtJ(HFS 15:11 RMAll MO _ a Z CC
Architect Name&Phone ft _ —_ -0 < O
Engineer's Name&Phone#_.__...._.........._. __ _ _ _ _ F—
CC < I- z
Workers Compensation _.................._ O ILI
Exempt/Insurer J Lease Employees/Expiration Date (yi L!- `5Application is hereby made to obtain a permit to do the work and Installations as indicated.I certify that no work or installation his] 0 w LI g
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulation-1 u 5 G
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, WV til Q U
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.NOTICE:In addition to the requirements of tht CC L:
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,andW r.
there may be additional permits required from other governmental entities such as water management districts,state agencies,.1.ZCC
federal agencies.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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 YO ' NOTICE OF COMMENCEMENT.
MELVIN COX CSS- CLINT BUTTERFIEL ._:_. _ !J/
(Signatur:of• nerorAgent) / (Signature o Contractor) A:14.'i:"�:•
(Inc ding contractor) i 1 to:I. bS
(or ! '�o,�`'•
Si;ned and sworn to ffirm .)before me his day of Si5i ed and sworn to(or affirmed)before me this l b....clay�;` ,,,,off�'
el
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UMW
1' . _._.....__ _ �� _... ....` :_ VI i i i
y nu AUBREY M.LI ( •gnature o Notary) ":nature of Notary)
a
% Notary Public,Stale of Florida
„;,; " tr ris r n.#p�3 v 259573,
ttt•+it P Q'i lavisn t�7 r'ersonally Known OR i S
.,fl n t ar�* 5$Int 17,2112 -c.w
,, ' .:.1 n icabp ( ]Produced Identification rn •
Type of Identification:_. 1 Type of Identification: g c*
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OFFICE COPY
RE#169463-0168
2235 BEACHCOMBER TRL
ATLANTIC BEACH
INSTALL AREA INSTALL AREA
16
a *"
BA S
9 -
L
rd
13 41
�--1 _LLE p4,_,
OWNER PLEASE DRAW A CIRCLE ON THE SKETCH*
TO SHOW WHERE YOUR NEW DOORS ARE TO BE
INSTALLED. INSURE YOU RETURN THIS ALONG
WITH YOUR PERMIT APPLICATION . THANK YOU