1073 Beach Ave RES19-0192 Renewed PermitOWNER:ADDRESS:CITY:STATE:ZIP:
OKEN DEBORAH MARIE 1073 BEACH AVE ATLANTIC BEACH FL 32233-5753
COMPANY:ADDRESS:CITY:STATE:ZIP:
STYLES CONSTRUCTION 1537 PENMAN RD SUITE A JACKSONVILLE
BEACH FL 32250
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170268 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1073 BEACH AVE RESIDENTIAL ALTERATION
RESIDENTIAL WINDOWS $6000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $85.00
BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $18.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $42.50
BUILDING WINDOW DOOR INSTALL 10/01/2019 RBE 455-0000-322-1002 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
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: 4/5/2024
PERMIT NUMBER
RES19-0192
ISSUED: 4/5/2024
EXPIRES: 10/2/2024
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $205.00
2 of 2Issued Date: 4/5/2024
PERMIT NUMBER
RES19-0192
ISSUED: 4/5/2024
EXPIRES: 10/2/2024
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
RESIDENTIAL PERMIT PERMIT NUMBER
r CITY OF ATLANTIC BEACH RES19-0192
800 SEMINOLE ROAD
ISSUED: 7/29/2019
ATLANTIC BEACH. FL 32233
EXPIRES: 1/25/2020
MUST CALL INSPECTION • • 1 i PM FORr
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF
CODE, OF j BEACH CODEOF ORDINANCES .
ALL • 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:
1073 BEACH AVE
RESIDENTIAL ALTERATION
WINDOWS 6000.00
RESIDENTIAL
TYPE OF
CONSTRUCTION:GROUP:
170268 0000 ATLANTIC BEACH
C'd ADDRESS:
STYLES CONSTRUCTION 1537 PENMAN RD SUITE A
JACKSONVILLE
FL 32250
BEACH
ADDRESS: CITY: STATE: ZIP:
OKEN DEBORAH MARIE 1073 BEACH AVE ATLANTIC BEACH FL 32233-5753
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
Roll off 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 85.00
BUILDING PLAN CHECK 455-0000-322-1001 0 42.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 2.00
TOTAL: $131.50
Issued Date: 7/29/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER
s Building Department To be assigned by the Building Department.)
E i9r
800 Seminole Road
Atlantic Beach, Florida 32233-5445 te
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us L Date routed: CP
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Ye No
uildin /
c-- Planning &ZoninApplicant: L-1.ES fV (
Tree Administrator
Project: V V IBJ S 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 B
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: Approved. Denied. Not applicable
Circle one.) Comments:
B
PLANNING &ZONING
Reviewed by: pry Date:
TREE ADMIN. Second Review: Approved as revised. Denied. Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:Date:
FIRE SERVICES Third Review: Approved as revised. Denied. Not applicable
Comments:
Reviewed by:Date:
Revised 05/19/2017
Building Permit Application Updated 10/9/18
J
City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
i;19~ IS REQUIRED.
Phone: (904) 247-58/26 Email: Building-Dept@coab.us
f
Job Address: `0 7 9 g 4t 5 l ys Permit Number: Kcs qI - o l C
t
Legal Description Wf)v_tt L Ij L:3c h t;0 ff J4//kY/ RE# D
Valuation of Work(Replacement Cost)$ jCD'Oo,CN Heated/Cooled SF Non-Heated/Cooled
Class of Work: New Addition Alteration Repair Move Demo Pool Window/D
pOtqJ6N19
Use of existing/proposed structure(s): Commercial Residential
If an existing structure,is a fire sprinkler system installed?: Yes No
Will trees be removed in association with ro osed roject? Yes must submit se arat T e e i,dory T r 1 4 b811t
Describe indetail the type of work to be performed: CiI@aC
P_'j- /,I CC,
Florida Product Approval# for multiple products use product approval form
Property Owner Information'
I
Nameli G kz"' tt (i I ( Address io7s l•TTrL AV F
City &IL -r 1 `U? FAC J4 State_P'L-- Zip 3 Z 2 Phone Gj' 1/1!n 5 l C/2)0
E-Mail I
Owner or Agent(If Agent, Power of Attorney or Ag,--n&Letter Required)
Contractor Information
Name of Com any J y C k"< l« salifying Agent Z rr l ryAddress3 h City Stati Zip_ Z
Office Phone
V
4 S- Q 1 U7 Job Site Contact Number
State Certification/Registration# r_ 2SD(n(o E-Mail Do,rrr ` Z
Architect Name& Phone# Q(y O
Engineer's Name&Phone# O F=Ct
Workers Compensation Insurer OR Exempt Expiration Date O LYY> 1= Z
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or instal lagnUs V G
C
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws reguit < p
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SKOSp a
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requiremencs)o> o y S
permit,there may be additional restrictions applicable to this property that may be found in the public records of this coun%z4d t= Z y
there may be additional permits required from other governmental entities such as water management districts,state agert e}yor, W
federal agencies. C tau W ?}i
a ¢ m
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance wilja W j p
applicable laws regulating construction and zoning. V N WW
Q W
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY w
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND C
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDE O AN ATTORNEY BEFORE
REFOP DlNq YOUR NOTICE OF COMMENCEMENT.
Signature of Owner or Agent)Signature of Contractor)
Signed and sworn to(or affirmed) before me this to day of Signed and sw(2rn to or affir ed)before me this day of
k)O1 by c%h CX1(Lo— I by Y r')
Signat SfttA11 Signature of Notary)
I MYCOMM, #O(3 317919
r...
r".: BETHANY SALCAN
PP•` EXPIRES:May 11,2023 J MY COMMISSION#t3G 311919
Personally Known !p:i 4• BoridedTIvuNotaryPuDAelhb•rwr—1 Personally Known OR
z EXPIRES;May 11,2023roducedIdentificaProducedIdentification ? M1o?,. BonOedT?nuNotaryPuDralhMenNitarsXTYPofIdentification: V LA, D L_ _ Type of Identification:
Res l9- 619z OFFICE COPY
NOTICE OF COMMENCEMENT
State of County ofTax Folio No. ( ` bO C6
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is statt d in this NOTICE OF COMMENCEMENT_
Legal Description ofproperty being improved: Co ^ 4 y
Address of property being improved: I bZ 2 J e A 4 A U
General description of improvements:
Owner: Ptq,( Y,oh CD Address: 1
Owner's interest in site of the improvement: q,kIN,,
Fee Simple Titleholder(if other than owner):
Name:
CContractor: p
Address: 0 car^ — ' )3
Telephone No.:SHS D Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY O
Signe : Date:q
Before me•this
19
day of • ,t { W/1 in the County of Duval,State0
Doc#2019143007, OR BK 18833 Page 1173, Florida,has personally appeared
Number Pages: 1 rsonally Knownli or
Recorded 06/19/2019 11:22 AM, educed Iden ation:
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Mary Public
COUNTY commission xpires: 1
RECORDING $10.00 tir'%.;•• BET}{ANY SALCAN
Wy COMMISSION#GG 311919
EXPIRES:May 11,2023
r'' Bord Thru Notary Pubric UWenrtt"
OFFICE COPY
fy
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
Project Address: t D-1 Q _ Permit#:
Owner/Project Name: r ia, O
As required by Florida Statute 553.842 and Florida Administrative Code Rule 913-72, 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
2. Sliding
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 10/17/18
OFFICE COPY
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.
Contractor Name (Print Name): 1Jfa Cf t.` Contractor Signature:4
Company Name: Ink _
Mailing Address:
City: 4 \ .3 State: = `Zip Code: 3ZZ j
Telephone Number:S S _ C E-mail Address:a c J_f ft e:L
Cell Phone Number: Fax Number:
Page 4 of 4 Updated 10/17/18