699 Seaspray Ave RES21-0279 App " _.._ ': City of Attantic Beach Building Department "'ALL INFORMATKON
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (9(:4) 247-5826 Email: .iui cl ng Deptticoa3.Js 'sREQWRED.
lob Acdress: 699 SEASPRAI AVE ATLANTIC BEACH,FL 32233-4152 Permit Number:
Legal Descr pticn 30-94 17-2S-i i±E ROYAL PALMS wirr 2 LOT 10BLX 7 REI 17127$40000
Valuation of Work(Rel.laceree it Cost)S 1259.Od Heated/Cooled SF X424 Non-H
COPY
• Class ofWork: "_New ❑Addition ^Alteration fiepair , IMove l_iuerno L;Pool Win
nn Approved By Permit Desk
• Use of existing/proposed gfproposedstructure(s): CI-Commercial XResidentia'
Building Department
• If an existing structure is a fire sprinkler system installed': Eves '31 No City of Atlantic Beach,FL
• WO trgtjV be remo'rr i it association with proposed Droirc. 1:,es'must submit separate Pee Removal Permit) YNo
Describe in detail the type of r ork to be performed.
REPLACE EXTERIOR DOOR F_ORIDA PRODUCT APPROVAL NUMBER FOR THE NEW DOOR IS FL#22513.6
lo,i1,1 ?rind.;CI Approval IF r #22513 6 for multiple products use product approva term
Property Owner InforrnatiQ .
Name LEFT DEBORAH,H Address 699 SEASPRAYAVE
City ATLWTICBEACtf State FL Zip 32233 Phone 904-59f-5816_
E-Mail MO Etoetrc.4L@A01 .COM
Owner or Agent)If Agei it.Powe'of Attorney or Agency Letter Required) __
Contractor Informat:i)n
Name of Company BUTTERF EL(}REMODELING. LLC Qualifying Agent CLINT BUTTERFIELD
Address4280 GREAT EGRE i WAY City MIDDLEBURG Stare FL Zip 32068
Office Prone 904-631-8511 .ub Site Contact Number
State Certification/Regrstratior k NSB-14 E-Mail JMHUGHES 15130)GMAfL.CON
Architect Name&®hone C
•Engineer's Name&Phone M_
Workers Compensation Insurer zd OR Exempt XX Expiration Date 611/2022
Application is hereby made to c stain a permit to an the work and installations as indicated.I certify that no work or installation has
commenced prior to the issuan a of a permit and that all work will he performed to meet the standards of all the°aws regulating
construction in this Jurrsd'ctron I understand that a separate permit must be secured for E ECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,ROI ERS,HEATERS.TANKS,and AIR CONDITIONERS,etc. NOTICE.in addition to the requirements of this
permit,there may be additiona restrictions applicable to this property that may be found in the public records of this county,and
there may be addition/1i permit required from other governmental entities such as water management districts,state ageneses,or
federal agencies.
OWNER'S AFFIDAVIT:I certify t at alt the foregoing information is accurate an that at wort will be done:n romp lance with all
applicable laws regulating cons ruction and toning,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR FAY! 16 TWICE FOR'IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCIN s,CONSULT WITH YOUR LENDER OR A ORN , B FORE
RECORDINGYOUR NOTjE OF COMMENCEMENT �"iS� 44.0
(Signature oft r or Agee 1 :Srgnaprre of Ccntre:
• 41.. 22
Signed and sworn to(or affirn ed)before me this ' day of Signed and sworn to for affirmed)before me this/.7 day of
/ A
` a It l3
,
'yr L i._ t%\ �s�j ( res of Notary
7!S?la: NEr wwmaiwii
? � Jrrt "iSSQa a:1902;9 to*!ary) -
'x-+ *Fees.' CAROL JEAN HUGHES
1'� erscsally Known OR ;;se ��:
~ 's'•''; 1 Commission 1 GG 274780
( )Produced idlMiftetio1
Type et(dent*ation f L'PL K.C.- `s',l-c-,3-`Mr-C Type of identification:_ '+'�' Expires December 3.2021
C k n_ r< 'd r= 7C 3 "'t"'"°"-tan�O/RI Troy Fan,Issuance 800-385~7019
699 SEASPRAYAVE
ATLANTIC BEACH, FL
32233-4152
RE# 171273-0000
JOB COPY
Approved By Permit Desk
Building Department
City of Atlantic Beach, FL
U$1 `.
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26 BAS
19
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ADT
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Owner, please draw a circle on the sketch to show where your new
door is to be installed. Please return this and the permit application
as soon as you can. Thank you.
c, / PRODUCT APPROVAL INFORMATION SHEET FOR THE CITYTL
OF ATLANTIC BEACH, FLORIDAp (*REQUIRED)
JOB COPY
*Project Address: 699 Seaspray Ave. Atlantic Beach, Fl. 32233-4152 Permit#:
Approved By Permit Desk
*Owne Project Name Marilyn Berry Building Department
Glry of Atkliti►.Beach, rt
As required by Florida Statute 553.842 and Florida Administrative Code Rule 61G20-3, please provide 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 listed products. Information regarding statewide
product approval may be obtained at:www.floridabuilding.org.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A. EXTERIOR DOORS
1. Swinging Masonite Stl. Side Res FL#22513.6
2.Sliding Hinged
3. Sectional
4. Garage Roll-Up
5.Automatic
6. Other
B.WINDOWS
1. Single hung
2. Horizontal slider
3. Casement
4. Double hung
5. Fixed
6.Awning
7. Pass-through
8. Projected
9. Mullion
10.Wind breaker
11. Dual action
12. Other
Page 1 of 4 Updated 06/21/21
JOB COPY
Category/Subcategory Manufacturer Product Description Limitation of Use State# Approved Eiplaitirihit Desk
C. PANEL WALL Building Department
C'ty of Atlanta:Beach�TL
1.Siding
2.Soffits
3. EIFS
4.Storefronts
5. Curtain walls
6.Wall louvers
7.Glass block
8. Membrane
9.Greenhouse
10.Synthetic stucco
11. Other
D. ROOFING PRODUCTS
1.Asphalt shingles
2. Underlayments
3. Roofing fasteners
4. Nonstructural metal
roof
5. Built-up roofing
6. Modified bitumen
7.Single ply roofing
8. Roofing tiles
9. Roofing insulation
10. Waterproofing
11. Wood shingles/shakes
12. Roofing slate
13. Liquid applied roofing
14. Cement-adhesive
coats
15. Roof tile adhesive
16.Spray applied
polyurethane roof
17. Other
Page 2 of 4 Updated 06/21/21
filp�roved
Category/Subcategory Manufacturer Product Description Limitation of Use State# $uild{np�No� l IAit Desk
E.SHUTTERS City o ti:lr;te r+rre^'
1.Accordion
2. Bahama
3.Storm panels
4. Colonial
5. Roll-up
6. Equipment
7. Other
F.STRUCTURAL
COMPONENTS
1. Wood
connector/anchor
2.Truss plates
3. Engineered lumber
4. Railing
5. Coolers-freezers
6. Concrete admixtures
7. Material
8. Insulation forms
9. Plastics
10. Deck-roof
11.Wall
12.Sheds
13. Other
G.SKYLIGHTS
1.Skylight
2. Other
H. NEW EXTERIOR
ENVELOPE PRODUCTS
1.
2.
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In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project, the
Contractor shall maintain on the job site and available to the Inspector, a legible copy of each manufacturer's printed specifications and installation
instructions along with this Product Approval Sheet.
I certify that this product approval list is true and correct to the best of my knowledge. I further certify that use of different components other than the
ones listed in this document must be approved by the Building Official.
I
/ �%
*Contractor Name (Print Name): CLINT BUTTERFIELD *Contractor Signature:
*Company Name: BUTTERFIELD REMODELING
*Mailing Address: 7530 SUITE 1 103RD ST
*City: JACKSONVILLE *State: FLORIDA *Zip Code: 32210
*Telephone Number: 904-631-6827 *E-mail Address: Im.hughes1513@gmail.com
Cell Phone Number: 904-631-8511 Fax Number:
JOB COPY
Approved By Permit Desk
Building Department
City of Atlantic Beach, FL
Page 4 of 4 Updated 06/21/21