Permit Windows Impact Glass 2010 SS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . jo-0000liol Date 9/07/10
Property Address . . . . . . 123 25 MAGNOLIA ST
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 15000
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Application desc
window replacement
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Owner Contractor
------------------------ ------------------------
LOMBARDI INTERCOASTAL CONSTRUCTION
123-25 MAGNOLIA ST 9 FOXHUNTER FLAT
ATLANTIC BEACH FL 32233 ORMOND BEACH FL 32174
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 125 . 00 Plan Check Fee 62 . 50
Issue Date . . . . valuation . . . . 15000
Expiration Date . . 3/06/11
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC 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
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 125 . 00 125 . 00 . 00 . 00
Plan Check Total 62 . 50 62 . 50 . 00 . 00
Grand Total 187 . 50 187 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: 17-S VA"Vw 5EP 0 3
6+-,AtL&di&Ae4--F1- Permit Nu er.
I I �S�,3 i
Legal Description L_ct-(O&S 10 P4.14 Parcel# I 2_1-0(a o
Valuation of Work$ +_ Floor-Area ot- Sq.Fil
Proposed Work heated/cooled 44t,40 non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a flre spriler system installed? (Circle one): Yes No N/A
Florida Product Approval# f L - tLI*3 5
For multiple products use product approval form
Describe in detail the type of work to be performed:
Fe&4c &,E�&qC,1--A0WS L01 VV-W P677
Property Owner Information:
Narne: Address: 1?-9 014C
!!�kt,*WA !a
city AC4,+4 C, ..134—AX& State PL Zip 7,?,7-33 Phone. AftyW- 9,0( -&v4-qj(eq
E-Mail or Fax#(Optional
Contractor Information:
Company Name::y
kt
�&*&�.K( Qawrr�ty% 0A. Qualifying Agent:?;,vLAJ4&% +4Awrt.
jjtt�
Address:-q Fp)� 64uA+w FcAi- -City 0r-r-%cs�,%A -State r-t-- Zip ft 14-1
Office Phone S 181p-5 q7-e>4 og I -55(d-(075
State Certification/Registration# OR CoDg
C
Architect Name&Phone Ul TV 0- A rVT A a T—
Engineer's Name&Phone# Ic 81' 40
Fee Simple Title Holder Name and Addres REQUIR M
Bonding Company Name and Address
Mortgage Lender Name and Address
DATE, f 4t
on, In rior to the
this 'c �.�)
ction in 4len becomes nu
nedfor a e sic mo t any time after
Sijgns, s, oilers, Heaiers,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTI OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here certify that I have read and examined th's lication and know the same to be true and correct. All provisions of laws and ordinane v viing this
T herein or not. The granting of a permit does not presume to gi authority to vi ate or ncel the
)Vwork will be complied with whether spelcirfale
provisions of any otherfederal,st or local law regulating construction or the pe�formance of construction.
I
Signature of Owner Signature of Contract(
QA
PrintName Print Name
...... .......j.......... .......................*.................. . ...........................
S,�orll t0rand subscribed bpeffore ine Sw and subscribed before me
Sw
this 3EoAv DP of .::-7 20 to is IL Day of 6e- 101?�
ROBERT L MONTGOMERY ROBERT L MONTGOMERY
MY COMMISSION#EEOO Pu lia.�_ My .V......
11�cotary Public 00 ry Public V1 __-0 41881ON 0 EEGN
0 EXPIRES July 12,2014
EXPIRES July 12,2014 (-Joqw.
sed 0
Floftaftts rvice.com *116M
0 DOC#20102069 74,0 R 8 K 16.35 1 page 19 Z,
NOTICE OF COMMENCEMENT Number Pages: i
Recorded 09/03/20-10 at 11:10 AM,
jIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
Pennit No. RECORDING$10.00
Tax Folio No.
TBE UNDERSIGNED hereby gives notice that improvements will be made to certain real property,and in accordance with Section
713.13 of the Florida Statutes,the following information is provided in this NOTICE OF COMMENCEMEENT.
I.Description of property(legal delcr* do 6.3 , 5P,4�4,r �e
- � 3 M� 4,10
a)Street(job)Address:
2.General djscription of
- 0"&) &d 4d
3.Owner Information
a)Name and address: 19 f r, A
b)Name and address of fee simple titleholder(if other than o!t'r)
c)Interest in property
4.Contractor Information
a)Name and address: 13'6"dt" A444±!n1c4C MAAL56�� 06
b)Telephone No.:
Fax No.(Opt.)
5.Surety Information
a)Name and address:
b)Amount of Bond:
6.Lender c)Telephone No.: Fax No.(Opt.)
a)Name and address:
Phone No.
7.Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a)Name and address:
b)Telephone No.: Fax No.(Opt.)
8.1n addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(l)(b),Florida Statutes:
a)Name and address:
b)Telephone No.: Fax No.(Opt.)
9.Expiration date of Notice of Commencement(the expiration date is one year from the date of recording unless a different date
is specified):
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EY.PIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13,
FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE T1111E FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE, OF CO NCEMENT.
STATE OF FLORIDA
COUNTY OF PINELLAS to.
'i natut ...e
".,".e
Signatut 0 C 'i frikMfficer/Dir ;or/Partnj/Manager
CA V�
Print Narne
The foregoing instrument was acknowledged before me thisq" day of�2ep4f4oj:�6tr- 20(C) 'by
as_ 4-�t- (Q(A)1-� - (type of authority,e.g.officer,trustee,
a ttorn ey in fact)fo r-04 6 L,.P.,r-e-k (,,19—bay,4 (name of par!y�alf of w in inst ment was executed).
Personally Known k--�OR Produced Identification Notary Signature
Type of Identification Produced OR Name(print) F" '+ VA/I (j
Verification pursu an -5_qRjj:qr02 525 Florida Statutes. pena ies f ec a
der It' o p eyj ry,I d I re that I have read the foregoing and that
the facts stated in I belief.
t le�l / ,W�u
F0RMS/N0C,,sd201 0 MY COMMISSION#EE008296
EXPIRES July 12,2014
FlorldallotaryService.com Signature ofNatural.Person Signing(in 10.)Above
Beach
City of Atlantic APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 /zo
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
Cityweb-site: http://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: "Ma!pis 11'A, P,!��nt review required Y No
�Lu�ilcrl
Applicant: enb'Ay-) Planning &Zoning
I ree Administrator
Project: t 22 Za Zg.2 4 y- Public Works
Public Utilities
Public Safety
Fire Services
ka
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:
APPLICATION STATUS
E]Denied.
Reviewing Department First Review: EjApproved.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: ?- 3-lb
TREE ADMIN.
Second Review: E]Approved as revised. ElDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05114/09