Permit 145 Pine Street CITY OF ATLANTIC BEACH
�? 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
111 9'"
Application Number 10-00000701 Date 6
Property Address . . . . . . 145 PINE ST /04/10
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . 3353
-
Application desc-------------------------------------------------------
replace 4 windows
----------------------------
Owner Contractor
------------------------ _ _ _
WELLS LOWES HOME CENTERS INC
145 PINE STREET 4948 TELSON PLACE
ATLANTIC BEACH FL 32233 ORLANDO
FL 32812
------------------------------------ (904) -486_ ----------------------
4701
Permit . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee .
Issue Date 35 . 00
Expiration Date . . 12/01/10 Valuation . . . . 3353
-----------------------------------------------------
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2007 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
------ -
------*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
-------------------
--------------
--------------------
-ee-summary Charged Paid Credited Due
---------- ---------
Permit Fee Total 70 . 00 70 . 00 . 00
Plan Check Total 35 . 00 35 . 00 . 00 . 00
Grand Total 105 . 00 105 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
-"uj-ULuvu rERMT APPLICATION
CITY OF ATLANTIC $EACH
= 800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: .5 1144V ,�Tjp�7
Legal DescriptionPermit Number:
m Parcel#
Valuation of Work S "
Class of Work(circle one):
Use of existing/proposed struct New circle one : Alteration Repair
If an existing structure is a fire s rm ) Commercial olition pooUspa window/door
P er system installed?(Circle one): �denti o N/A
Florida Product Approval#
For multiple products use pro uct approva orm
Describe in detail the type of work to be performed:
� l
Property Owner Informatinr
-?-
Name: it/ �J �yc
City �L Address: i�,f r //l/or
E-Mail or Fax#(Optional) State— Phone
Zip 32L-J D 7 7
Contractor Information:
Company Name: � 7i�af
Address: Qualifying A
Office Phone City "d State -
State Certification/Re gist Job Site/Contact Number "- 7 Fax# ..
slration# Zip
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain aperto do the work and installations as indicated I certify that no work or installation has commenced prior to the
an�viissuance o f a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction This
d rf work is not commenced within six(6)months,or if construction or work is s ended or abandoned fora eriod ofsiz 6)months at any time er
wos commenced I understandtse orate usp ( perntit becomes mdlTand Air CondieYoners,etc I' permits must be secured for Elegb�'ca[Work,Plumbing,S*t'�,ns, p�e11s,Pools,Furnocet oilers H ers
B eam ,
COWARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
MMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR EM PROVEMENTS
TO YOUR PROPERTY, IF YOU IIyTE� TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO�IJR NOTICE OF
COMMENCEMENT,
gover!hereb certify that I have read and examined this plication and know the same to be true and correct. All provisions o laws and ordinanc
ype ofYwork will be complied with whether specid herein or not. The granting of a permit does not resume-t
provisions of arty other federal state, or local tsw regulating construction or the performance of construction �V a to vi or this
signature of Owner
Signature of Con or
'riot Name
...J C H f✓ (^/� L G S
....... Print Name
;worn to and ....._..... ........ . ...�. .................._
scribed fore me -
his
y of20/d Sworn an subscri a re me '
this 8 of
T Publ'
--
REVIEWED FO R
CITY OF ATL A NT
(&Bonded
?AMI Z.MACKINNON LANTI• r Vi P1.26.10
MY COMMISSION#DD9578 SEE PERMITS FOR ADM E�IrK 18/2013 s
EXPIRES:FEB 02,2014 REQUIREMENTS AND C( Fkmkm Assn.,Inc j
through 1st State Insura •611188096•• •ff�fffNHt� �IY�
VJEVVED BY: 1171 DATE: I l4 �`�
2010-05-27 10:46 (904) 486-4710 1699-INSTALLED SALES p 4/8
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City of Atlantic Beach
Building Department Irouted:
ICATION N2Department.)
800 Seminole Road [Date
d by the Buil
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904)247-5845
�ust �� E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address- �7 `� �j�� �T,e�� a nt review required Yes No
Buildi
Applicant: 11, 11161, i� �e Planning &Zoning
Tree Administrator
Project: S Public Works
Public Utilities
Public Safety
Fire Services
Review fee sbe 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 N
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: ` Date: 6-/_/0
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
THE UNDERSIGNED hereby give notice that the improvement will be made to cermn rest pmpmy m aumnuuwo way,
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
1. Description of Property 00821 description of property and address if available):
2. General Description of improvements:
3. a&) ner Information: V
Name and Address:Joy 14)e41.5 f�S P NFcSr /C �c6j 3z?�3
b)Interest in property: o c -- �.
C)Name and address of simple titleholder(if other than owner):
1�4. Contractor Information:
a)Name and Address: Pr—. —2
b)Phone Number �/rs
Surety Information:
a)Name and Address:
b)Phone Number._
c)Amount of Bond:S
6. Lender Information:
a)Name and Address:
b)Phone Number.
7. Person within the State of Florida designated by upon wham colicas or other documents may be served sa
provided by 713.13(lxa)7,Florida Statutes
a)Name and Address:
b)Phone Numbers of Designated person:
8. In addition to himsolnerself,Owner designates of
to a copy of the Liam's Notice as provided in Section 713.13 receive
1
a)Name and Address: ( ),Florida S
b)Phone Number of person or entity designated by o
9 Expiration date of Notice of Commencement(The exp
different date is specified: iration data is one(1)Year ffmn the date of Recording unless a
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART
i. SECTION 713.13• FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF CONIMCEM8I+IT 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 COIWIbIENCING WORK OR RE
YOUR NOTICE OF COMMF.NCF. CORDING
Sir or Owner's Authorized Of Wr/DvwtodParww&4a14gw Signatory's Printed Name k TidlFice
e/O
The foregoing instrument was acknowledged before me this; Zday of
es �
sweo ( �Tsrns astrwnent' r'-,
TµazKAMM
WCMUSONOMMM NOT
ARE
DS:Fid 02,204 Print Name:
Sondsd are*10 S*patsm
0 Personally Known
�datiscaa°nrl�+Pe:
Verification pursuant to Section 92.525,Florida Statutes.Under penalties of perjury,I declare that I have read the
foregoing and that the facts stated in it am true to the best of my knowledge and belief.
11*4 =dNst"Person 81sninS Above