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627 Selva Lakes Cir RES20-0049 Door , o' '-# RESIDENTIAL PERMIT PERMIT NUMBER alk k CITY OF ATLANTIC BEACH RES20-0049 woz 800 SEMINOLE ROAD ISSUED: 3/5/2020 F ATLANTIC BEACH. FL 32233 EXPIRES: 9/1/2020 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: VALUE OF WORK: 627 SELVA LAKES CIR RESIDENTIAL DOOR $959.00 WINDOWS/DOORS TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 172027 5556 SELVA LAKES UNIT 02 COMPANY: ADDRESS: CITY: STATE: ZIP: BUTTERFIELD 4220 PLANTATION OAKS BLVD APT REMODELING LLC 1516 ORANGE PARK FL 32065 OWNER: ADDRESS: CITY: STATE: ZIP: ** CONFIDENTIAL ** ** CONFIDENTIAL ** ** CONF ** XX ##### 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 of7f 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 $55.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $27.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$86.50 Issued Date:3/5/2020 1 of 2 RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH RES20-0049 800 SEMINOLE ROAD ISSUED: 3/52020 �r; tc, EXPIRES: 9/1/2020 ATLANTIC BEACH, FL 32233 Issued Date: 3/5/2020 2 of 2 i.A,y;yy City of Atlantic Beach APPLICATION NUMBER 'J , Building Department (To be assigned by the Building Department.) PAW 800 Seminole Road _. ••• _ r' Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 ��++,, • E-mail: buildin de t coab.us Date routed: lJ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: L; 7 -s swa Lik(e-- Department review required Yes No ui ding Applicant: l� i�"F��( C r 1► Planning 8,zoning 1,4 Tree Administrator • Project: CC FZ 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. L]Denied. Not applicable (Circle one.) Comments: UILDIN PLANNING &ZONING Reviewed by: Date: J? /L/2-0 TREE ADMIN. Second Review: Approved as revised. ❑Denied. nNot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. Denied. I INot applicable Comments: Reviewed by: Date: Revised 05/19/2017 OFFICE COPY a;" F`,Is* Building Permit Application Updated 12/8/17 °°- ii� , City of Atlantic Beach tidn- 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 Job Address: 677 SFI VA LAKFS CIR ATLANTIC BEACH, FL.322n Permit Number: R CSZ© Coo Legal Description 43-11 17-25-29 cELVA LAKES UNIT 2 LOT 80 RE# 172027-5556 . Valuation of Work(Replacement Cost)$ 959.00 Heated/Cooled SF 1410 Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial Residential • If an existing structure,is a fire sprinkler system installed?(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 DOOR Florida Product Apt# FL#18582.1 for multiple products use product approval form Property Owner In mation Name: BARRY STEVENSON Address: 627 SELVA LAKES CIR. City ATLANTIC BEACH State FL Zip 32233 Phone gf14-21 A-7127 E-Mail DCSPINE2@GMAIL.COM Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Contractor Information Name of Company: BUTTERFIELD REMODELING, LLC Qualifying Agent: CLINT BUTTERFIELD -% Address 4220 PLANTATION-OAKS BLVD.#1516 City ORANGE PARK State FL Zip 3206r6. t Office Phone 004-333-8409 Job Site/Contact Number 804 333 8400 t.) tli State Certification/Registration# NCS-14 E-Mail JM.HUGHES1513@GMAIL.COM > cnRi Architect Name&Phone# _ < i —I Z "►1 Engineer's Name&Phone# & z O ', " I Workers Compensation LiJ C) Exempt/Insurer/Lease Employees/Expiration Date 0 in N zH Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instal lat[Bn tipsE U O commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regul*tlopg < 0 construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIG $,2 o Q WELLS,POOLS, FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.NOTICE:In addition to the requirement``sgf, 6su- permit,there may be additional restrictions applicable to this property that may be found in the public records of this countyaH I— z there may be additional permits required from other governmental entities such as water management districts,state agenes,L S w federal agencies. n ui Illj: OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance wittOill H u 10 applicable laws regulating construction and zoning. 5 LL' U lJ UU (nLAI y CC 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 a TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. S_ BP jRY STEVENSON — ..°,,,NT jT FREIE l (Signature of Owner or Agent) (Signat •f Contractor) (including contractor) �` Signed and sworn to(or affirmed)before me tthjs I9 day of Si ed nd sworn to(or,. •rmed)before me this_�oay of darAINIKV - 5°• • n of o . (Si- ureofNotary) , Personally Known O• ;?`'a. °;" LESLIE HALE Personally Known OR ........ CAROL JEAN HUGHES [ ]Produced Identificat .n•; ,., ,: Notary Public State of Florida [ ]Produced Identification ,+�'; .: Commission#GO 274780 Commission rr FF 996433 I.: Type of Identification: , Type of Identification: •.• • : .. ____ a«•,, 'y CO xpires ug ''. ***e.,*, ,. '' ,.�F ,•• .• .:.Nu Troy Fan Insurance SOO-38.5-7019