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450 Mako Dr ACC20-0020 Door ,.'-j-V1r RESIDENTIAL PERMIT PERMIT NUMBER ',\ ACC20-0020 �t ': CITY OF ATLANTIC BEACH JM yr 800 SEMINOLE ROAD ISSUED: 3/5/2020 '42,o1119', 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: 450 MAKO DR RESIDENTIAL DOOR $1049.00 WINDOWS/DOORS TYPE OF I REAL ESTATE BUILDING USE { CONSTRUCTION: I NUMBER: ZONING: GROUP: 1 SUBDIVISION: 171476 0000 ROYAL PALMS UNIT 02A3.00 COMPANY: ADDRESS: CITY: STATE: ZIP: BUTTERFIELD 4220 PLANTATION OAKS BLVD APT FL 32065 REMODELING LLC 1516 ORANGE PARK OWNER: ADDRESS: CITY: STATE: ZIP: MILLER RICHARD 1 450 MAKO DR 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 Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 BUILDING IN-PROGRESS INSPECTION REQUIRED INFORMATIONAL Notes: IN-PROGRESS INSPECTIONS ARE REQUIRED FOR EXTERIOR SIDING,WINDOW,AND DOOR INSPECTIONS,AND SHOULD BE SCHEDULED FOR THE FIRST DAY OF WORK. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT Issued Date: 3/5/2020 1 of 2 S.Ay e, RESIDENTIAL PERMIT PERMIT/ NUMBER rs 1111". `o ACC20-0020 iii CITY OF ATLANTIC BEACH ,� v� 800 SEMINOLE ROAD ISSUED: 3/5/2020 -``13 >.e ATLANTIC BEACH. FL 32233 EXPIRES: 9/1/2020 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: 3/5/2020 2 of 2 rig A,c,,. City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) �� 800 Seminole Road4 "� s Atlantic Beach, Florida 32233-5445 ��w �w` p Phone(904)247-5826 • Fax(904)247-5845 / /� f \-P uni. - E-mail: building-dept@coab.us Date routed: O City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 4 so M (a (.) (? D• . • • 'lent review required Ye No Buildin• t� Applicant: (no( cap ( ELL) (---Monrii L annm• : Zoning -e Administrator .. Project: l b (cL— 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: APPL TION STATUS Reviewing Department First Review: Approved. Denied. I Not applicable (Circle one.) Comments: BUILD! PLANNING &ZONING Reviewed by: / Date: )--C TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie . ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. I !Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 1 ZC PY ask OFFIC Building Permit Application p ate 12 8/17 ,+r, . City of Atlantic Beach ! ---,4- 800 Seminole Road,Atlantic Beach,FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 [� Job Address: 450 MAKO DR. ATLANTIC BEACH, FL. 32233 PermitNumber: I \�� 00Z� 31-16-17-2S-29E R/P OF PT OF ROYAL PALMS UNIT Legal Description 2 A t OT 7 RI K 13 RE# 1714476-0000 Valuation of Work(Replacement Cost)$ 1049.00 Heated/Cooled SF 1224 Non-Heated/Cooled 204 • 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 W (v Describe in detail the type of work to be performed: INSTALL EXTERIOR DOOR 2 co . � ZO � E. Florida Product Approval# FL#16468.2 for multiple products use product approval for= LIp 0 u j Property Owner Informatio C) m 0 0 Q Name: RICHARD MILLER • Address 450 MAKO DR. 00: 0 0 0 City ATLANTIC BEACH State FL Zip 32233 Phone 904-247-2668 a F-• Q 0 E-Mail RICRJMILLFR{�AOl COM 0 d O a Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) V J <L N Contractor Information CC i-- Cl) Z W Name of Company: BIJTTFRFIFI 0 RFMODFI INC; I I f: Qualifying Agent: CLINTBL)TTFRFIELD LL LL Address 4220 PLANTATION OAKS RI VD #1516 City ORAN(F PARK State El Zip 32055 O 0 tcr il w $-: Office Phone 904-333-.8409 Job Site/Contact Number A(14-33.9-14(14 Ltl ›- a 5 m I.- to0 0 State Certification/Registration# NSS-14 E-Mail .IM H130HFS1fi13C ,'MALI COM — W 0 W Architect Name&Phone# u1 U N ¢ w Engineer's Name&Phone# > Workers Compensation LLIILI 1 7--, 7,_ CC OC Exempt/Insurer/Lease Employe �{rat�oDd:iate ,.._, • p ,� Application is hereby made to obtain a permit to do the work and installations as ihdhate '�e.itify at tfo iittork 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 regulationg construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.NOT mi addi io i oI e requirements of this permit,there may be additional restrictions applicable to this property that may be fours in The public' - . ds of this county,and there maybe additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. Pt J,iCllr,T E.) .1 -,r•�� t4,.�Fs .-a..l.. } ;•' ••. OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate ar��.i at alf work Witt be done in Cdiirpl#ante with all ;,;;• .••: applicable laws regulating construction and zoning. , I d y J r; " zi til, 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 t I.c"), TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE V'4• RECORDING YOUR NOTICE OF COMMENCEMENT. _ .R . 40= RIC ARD MI / <I•'-Ii_ // c' 2 1 o 4=--4T, (Signat e of Owner or Agent) (Signature of • rector) g N'e (including contractor) ��J�„ __99/ Si ned and sworn to(or affirmed)before me this (�.t�'day of S' ned and sworn to(or affirmed)before me tlf+ � `E day of b l.UL.I) ,by `'lt theWY\ttkl ti)(-) • r•Ifi. Ggli . . l'Ulil.'' 4 /. :natuII of • b4 `" (Si: • of Notary) d y�"'i�'i(`/ ' State of Florida I )Personally Known OR �tj, W t:ortmission Expires 11/30/2021 I sonally Known OR I�PFaduced Identrficatio r GO 135172 I I Produced Identification Type of Identification: �i)I(iJ ( l.- Type of Identification: RE#171476-0000 450 MAKO DR. OFFICE COPY ATLANTIC BEACH UST BAS ADT FOP Frip OWNER PLEASE DRAW A CIRCLE ON THE SKETCH TO SHOW WHERE YOUR NEW DOOR IS BEING INSTALLED. INSURE YOU RETURN THIS SKETCH ALONG WITH YOUR PERMIT APPLICATION. THANK YOU. _If ,.`, :':. +k' I't'N Mf✓ � a .,-wa � ::: :,:;.® T-.- OFFICE COPY i4as s k z. ., 9 %iatiatims & Pro i na ,R ,,,,,k„.--- ,,,,,,,,,,,,,,,,,,,,-,-.-i<,of---s-s;- ?, s ,, '7::- ,- 7, , €"' kms" "- „-, ';f ` +".<,''�^,a: "2 5'( "i``7'r ,1?4, BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publications Contact Us BCIS Site Map Links Search bpr Fd ,, mi,, USER: Public User Product Approval Menu>Product or Application Search>Application List >Application Detail x A5, FL# FL16468-R15 Application Type Revision Code Version 2017 Application Status Approved Comments Archived Product Manufacturer JELD-WEN Address/Phone/Email 3737 Lakeport Blvd Klamath Falls, OR 97601 (800) 535-3936 fbcl@jeld-wen.com Authorized Signature Rylee Sumner Fricks fbcl@jeld-wen.com Technical Representative JELD-WEN Corporate Customer Service Address/Phone/Email 3737 Lakeport Blvd. Klamath Falls, OR 97601 (800) 535-3936 customerserviceagents@jeld-wen.corn Quality Assurance Representative Address/Phone/Email Category Exterior Doors Subcategory Swinging Exterior Door Assemblies • Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Evaluation Report- Hardcopy Received Florida Engineer or Architect Name who developed the Hermes F. Norero, P.E. Evaluation Report Florida License PE-73778 Quality Assurance Entity National Accreditation and Management Institute Quality Assurance Contract Expiration Date 12/31/2022 Validated By Locke Bowden P.E. Validation Checklist- Hardcopy Received Certificate of Independence FL16468 R1S COI COI JW SS 2015-04-27.pdf Referenced Standard and Year(of Standard) Standard Year TAS 202 1994 Equivalence of Product Standards Certified By Florida Licensed Professional Engineer or Architect FL16468 R15 Equiv ASTM E84 Equivalency Letter SS 2017-08-31.pdf Sections from the Code