2135 Seminole Rd RES20-0134 door permitOWNER:ADDRESS:CITY:STATE:ZIP:
Walker Giorgina 2135 Seminole Rd Atlantic Beach FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
AMERICAN WINDOW
PRODUCTS 2633 S POWERS AVE JACKSONVILLE FL 32207
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169515 0520 SECTION LAND
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2135 SEMINOLE RD RESIDENTIAL
WINDOWS/DOORS replace door $979.00
FEES
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
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 6/12/2020
PERMIT NUMBER
RES20-0134
ISSUED: 6/12/2020
EXPIRES: 12/9/2020
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 6/12/2020
PERMIT NUMBER
RES20-0134
ISSUED: 6/12/2020
EXPIRES: 12/9/2020
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
3'3~-'20
Building Permit Application
Ot y of Atlantic Beach
800 S3m ino le Rlad, Atlantic Beach, R.32233
Alone: (904) 247-5826 Fax: (904) 247-5845
.bbAddress:d\?Js 'S?rr\\N)\~ ']d ~\. \2-cb ~L~~~c--~ __ -::-::-~
Legal l:es:riPtiorffi ';;l'S --;f\E . \\.Q I {J+ Go,,\ l.o\ \ reed 0\\21 f€# \L.09~\t? 000 (3
Valuation of Work (Replacement COst) $ CfJC1. 00 Heated! COo led s= Non-Heated! COoled, ____ _
CJ aassofWork (Ordeone): New Addition Alteration ~pair Move Demo FOOl Windo~
GJ Use of eXisting! proposed structure(s) (Orde one): COmmeraai @ji:>
GJ If an existing structure, is a fire sprin kl er system installed? (Orde one): Yes No ~
Cil 8Jbmit a Tree ~moval ~rmit Applicat ion if any trees are to be r emoved or Affidavit of No Tree ~oval
l:es:ribe in detail the type of w ork to be performed:
\ COOl rep\o.~_ '::;) -z.e Rx--'S \-u?
for multiple products use p roduct approval form Aorida A'oduct Approval # ::,[2,(;1.( . .0. -ffi+ ~ ()G
FfO;€ONner Informati on
Nam
OtY
e ~ID(Q~M\'<Q C "ate C\ ZiAdpd7~~~?,?~5L-~~~::lli:'O.l.;\~rL\~e",=.,:.'Rd~",,=-=--_ ~C=,~ ""!.1 Z2O'><X~.2 Alone q:f( g,)lo '~ __ )'g\
E-Mail 1'\ \ e.
ONner or Agent (If Agent, F\)wer of Attorney or AgenC)' Letter Required) ________________ _
Cbnt r ador Information AMERICAN WINDOW
PRODUCTS, INC. \) 'j \ _ r r-r
Name of COm pany: 2633 pOWERS AVE Qualifying Agent: r.e l..TrI Ql) \ \
Address Oty Sate Zip ____ _
afioe Alone .bb Ste/COntact Number~~~~~~--~-~~=_
9:ateCertifi cat ionlR:lgi st ration# . ~'1 Ei-MaiI O{)"jX'(b@\-Jf[El,crnl.")lf(b uprri("j3\S.can
Archrtect Name & Alone# _____________________________ _
81gineer's Name & Alone #=::--=-0:;::-;"""::--,;,..,-=:0;-,....,""''''''''::::----;-...,....,.,,''''''''''-=----------
Workers COmpensa ion m'-lcbf>x::.-O\Ol(Qq~\3") .-(Q\I\'OO-:;;lG
r-" i ExEmpt / inrurer / ..",." Employees/ Expiration Date
Application is hereby made t o obtain a permit to do the work and installations as indicated. I oertifythat no work or installation has
commenced prior to the iSSJance of a permit and that all work will be performed to meet the standards of all the laws regulat iong
construction in thisjurigjiction. I understand that a separate permit must be seaJred for aEClRO\L Wrn\ A.lJMBlNG, SGNS
~ f'ClQS RJ~c::ES BOII..ER:\ HEl\~ TANKS and AlRru.JDlllONERi etc.
OWNERSAFFIDAVlT: I certify that all the foregoing information is aocurate and that all work will be d one in compliance with all
applicab le laws regulating const ruction and zoning.
WAR'IIING TO OWNER YOUR FAI WF£TO REOOFn A NOTlCEOFOOMM ENCBv1 ENT MAY
RESJLT IN YOURR Y1NG lWICE FOR 1M PffiV8v1 ENTSTO YOUR PR)PERIY IFYOU INTEND
TO OBTAIN NG, CDNSJLTWITH YOUR lB\IOER OR AN A TrQR\lEY BER)F£
F£X)R)I OTlCE OF OOM M ENCE'v1 ENT.
of Q.vner or P;)ent induding Cbntr,r..h
s,wed and orn to (or affirmed) beforemethis 'd of
~1~fl~L( __ ~,20~ ,b,f-------~~--~~~~~~--'~~~~~~~~~~~==~ (
""
[ 1 Rlrs:mally ~own OR
[51ffoduced Identification 12k' 8.1 ·~ . 0 y, J 0 1-_ '"
Type of Identification: \IV .2 b /t1W v
~nal lY ~own OR
[ 1 ffoduced Identification
... $,~,;;"'r;;., ROGER AUSTIN
iJJ:,,\., MY COMMISSION # GG 914188
'~J~~~~i EXPIRES: September 17, 2023 ···.f.kf.r.:~y Bonded Thru Notary PubilcUodelwrttefS
Type of Identification: ___________ _
e PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (-REQUIRED)
·Project Address: @ \?fS 9?m\CXJIe '\?d I ffi\. \ti::Jb, EL. 3':P33 Permit #: _______ _
·Owner/Project Name:6\OC~C'(). \~ )o..\¥.er
As required by Florida Statute 553.842 and Florida Administrative Code Rule 98-72, please provid e the information and product approval number(s) for
the building components listed below as applicable to the building construction project for the permit number listed above. You should contact your
product supplier if you do not know the product approval number for any of the applicable li sted products. Information regarding statewide product
approval may be obtained at: www.florid abuilding.org.
category/Subcategory Manufacturer Product Description Limitation of Use State # local #
A. EXTERIOR DOORS
1. Swinging
2. Sliding
3. Sectional
4. Garage Roll-U p
5. Automatic
6. Other
B.WINDOWS
1. Single hung on....l. c::JJ.lY'; ~'H-\.t ~
2. Horizontal slider
3. Casement
4. Double hung
5. Fixed
6. Awning -
7. Pass -through
8. Projected
9. Mullion
10. Wind brea ke r
11. Dual action
12. Other
Pa ge 1 of4 Updated 10/17/18
In addition to completing the above list of manufacturers, product description and State approval number for the products used 011 this project, the
Contractor shall maintain on the job site and availabl e to the Inspector, a legible copy of each manufacturer's printed specifications and in sta ll ation
instructions along with this Product Approva l Sheet.
I certify that this product approval list is true and correct to the best of my knowledge. I f urther certify that use of different components other than the
ones listed in this document must be approved by the Building Official.
,
'Contractor Name (Print Name): KEITH GURR 'Contractor Signature: __ ~~~:=:=:::-....~ _______ _
'Company Name : AMERICAN WINDOW PRODUCTS
*MailingAddress: 2633 POWERS AVENUE
"City: JACKSONVILLE 'State: FLORIDA *ZiPCode:_3_2_20_7 __ . _____ _
'Telephone Number: (904) 731 -2247 *E-maiIAddress: Omorda@ Qff'e(\cp(\W\cda.u9fCdd .ctfY)
Cell Phone Number: Fax Number: (904) 731-8824
Page 4 of 4 Updated 10/17/18
-
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DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $90.50
RES20-0134 Address: 2135 SEMINOLE RD APN: 169515 0520 $90.50
BUILDING $55.00
BUILDING PERMIT 455-0000-322-1000 0 $55.00
BUILDING PLAN REVIEW $27.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $27.50
STATE SURCHARGES $8.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R13570 $90.50
Printed: Wednesday, September 30, 2020 4:36 PM
Date Paid: Wednesday, September 30, 2020
Paid By: AMERICAN WINDOW PRODUCTS
Pay Method: CREDIT CARD 382498536
1 of 1
Cashier: JJ
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R13570