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Permit Windows 701 Beach #103 2010 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00001258 Date 10/20/10 Property Address . . . . . . 701 BEACH AVE UNIT 103 Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 8235 ---------------------------------------------------------------------------- Application desc replace 2 sliders ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PELLA WINDOW AND DOOR 8174 BAYMEADOWS WAY W. JACKSONVILLE FL 32256 (904) 731-8330 ---------------------------------------------------------------------------- Permit . . . . . . WINDOW AND/OR DOOR PERMIT Additional desc . . Permit Fee . . . . 95 . 00 Plan Check Fee 47 . 50 Issue Date . . . . Valuation . . . . 8235 Expiration Date . . 4/18/11 ---------------------------------------------------------------------------- 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 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 95 . 00 95 . 00 . 00 . 00 Plan Check Total 47 . 50 47 . 50 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 146 . 50 146 . 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: 3:!L>I Ze-a Ct\ CLU-0- �3 Permit Number: Legal Description 16-2-S-146 Lb Chcx+e_ckD .k qu+1&A-k'C. 6e4dXarcel# Floor Area ot q.Ft. SqTt Valuation of Work S i�Z I S -_Proposed Work Seated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteratiom Repair Move Demolition pool/spa win(02W/4r Use of existing/proposed structure(�)(�ircle one): Commercial RevQ-esal If an existing structure,is a fire spnnkler system instaHed?(Circle one): No N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: �4 JD I C4.0-2 (S� 1 '4 ell Property Owner Information: Name: 3fAjj Ct-*;v%r% ip Address: jig I 'Rfgd, Ay-e- city tk� StateF�_Z .3_�Phoneqpq- 2LW - 6�40 E-Mail or Fax#(Optional Contractor Information: Company Name::NA(o, �)Our (0 Qualifying Agent: tm�+ Wes+ �0,m*_S F� [-�_L� ' We Address:- ,,�e W CityAac&r_-s C+A(j, -State F<-- zip s u's(6, Office Phone q OL4- 5go S 3 Job Site/Co Fax# State Certification/Registration# P-c-c),5 -?--z I Architect Name&Phone# FOR ic DE COMPTJANC p, 11 Engineer's Name&Phone CITY OFATTANT-IC-BEACM 11 2 Fee Simple Title Holder Name and Address Ai SEE PERMrrS pol Alb If 1 :1 Bonding Company Name and Address �j it* "=Kfu%ffiNT-S AND CONDITInUS- Mortgage Lender Name and Address /V REVTEM%jD PA.- A LA6J F,05 F—M-Ra co edpriqWr t 'the w is itaVio4e 41 mon I.Opwmne er WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE 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 fication and know the same to be true and correct. All roykXn-s-q7T&m anc es gov this '"s work will be complied with whether sreci7e§herein or not. The granting o 't pe. av&ao give auffiozr4 to vio ate or the type p/11 f a permit does nc ��to'=011 rip provisions of any otherfederal,state, or local aw regulating construction or the pe�fo�mance of construn is Signature of Owner f Signature of Co r Print Name Print Name _u............................................. .............................................. ................ Sworn.jo and subscribed�efpre me Swom to and subscribed before me this 7"In- Day of Ocropel- 20/K) this *1*6 Day of S .20 IC -QPY%- Not — j1hik'Stah.n ZAQ&� Notary Public WRav ftb eljab-013 MY commission Dogi8800 DIANA 6.WITHEMPOON VX/ EXP'reS 0812012013 Revised 0 1.26.10 NOWY Pubk-Steg of Roft MY Comm.Expim May 11.2013 COMMiS6100 0 00 IN10143 Permit No. /0 RECORDING$10,00 TaxFolioNo- THE 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 COMMENCEMENT. I.Description of property(legal description): tl -7-'� -Z-4k 6 U a)Street(job)Address: 'N)I Rx-c--P� . 2.General description of improvements: c-.L- N--5 3.Owner Information a)Name and address: kt-4 b)Name and address of fee sim�le titleholder(if other than owner) c)Interest in property 4.Contractor Information a)Name and address: b)TelephoneNo.: '1cjL(—+31—teE,3?, Fax T�o.(Opt.) 5.Surety Information a)Name and address: b)Amount of Bond: c)Telephone No.: Fax No.(Opt.) 61ender a)Name and address: N) 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: &J 1.0k b)Telephone No.: Fax No.(Opt.) 8.In 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.Expimtion 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 EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 1,SECTION 713.13, FLORIDA STATUTES,AND CAN RESULT IN YOUR PAVING 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF PINELLAS 10. Signature 9EDAer or Owner's Authorized Officer/Director/Partner/Manager Yel- --��'y I clwo1ju Print Name ore 7,�A- The foregoing instrument was acknowledged bef me this davof &447brr 20_��by 8&Ny �q Ch ;S as (type of authority,e.g.officer,trustee, attorney in fact)for (name of party on behalf of whom instrument was executed). Personally Known k-OR Produced Identification Notary Signature Type of Identification Produced Name(print) d/;r"/7,q Ig OR 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 are true to the best of my knowledge and belief. A A A DIANA 8.WMEMP00111 "Poo FORMS/N0C,ra&010 Notary Public-S Sign - —D- Commission#PD0 8891943 _00 4 iQ Florida Building Code Online Page I of 3 1,141i=- Z I SCIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publications FSC Staff SCIS Site Map Unks Search (a. Product Approval USER:Public User Community V Affairs Proauct Aooro�al Menu>Product or ADDlication Search>Application us >Application Detail FL# FL12606-Rl Application Type Revision Code Version 2007 Application Status Approved Migg--m—ulj� Comments Archived Product Manufacturer Pella Corporation Address/Phone/Email 102 Main St. Pella,IA 50219 (641) 621-6096 pellaproductapproval@pelia.com Authorized Signature Joseph Hayden jahayden@pella.com Technical Representative Joseph Hayden Address/Phone/Email 102 Main Street Pella,IA 50219 (641)621-6096 jahayden@pelia.com Quality Assurance Representative All Zarghami Address/Phone/Ema 11 102 Main St Pella,IA 50219 (641)621-1000 zarghamia@pella.com Category Exterior Doors Subcategory Sliding Exterior Door Assemblies Compliance Method Certification Mark or Listing Certification Agency Window and Door Manufacturers Association Validated By Terrence E. Lunn, PE 1 Validation Checklist-Hardcopy Received Referenced Standard and Year(of Standard) Standar Year AAMA 1011I.S.2-97 1997 AAMA/WDMA/CSA 101/I.S.2/A440-05 2005 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A hM:HfloridabuildinR.org/vr/t)r avD dtl.asDx?Daram=WGEVXOwtDatkfS%2fv%2fDAtOF,..- 10/12/2010 Florida Building Code Online Pagel of3 -T-7 7 8CIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publications FDC Staff SCIS Site Map Unks Search JaProduct Approval USER:Public User Community Affairs Pro0uU_A s >Application Detail ,Qoroval Menu>Product or ADDliCatiOn Search>Application Li FL9520-R2 Application Type Revision Code Version 2007 Application Status Approved Comments Archived Product Manufacturer Custom Window Systems Inc. Address/Phone/Email 1900 SW 44th Avenue Ocala, FL 34474 (352)368-6922 Ext 207 mlafevre@cws,cc Authorized Signature Michael LaFevre mlafevre@cws.cc Technical Representative Michael LaFevre## Address/Phone/Email 1900 SW 44th Avenue Ocala, FL 34474 (352)368-6922 Ext 207 MLaFevre@cws.cc Quality Assurance Representative Ralph Emminger## Address/Phone/Emall 1900 SW 44th Avenue Custom Window Systems, Inc. Ocala, FL 34474 (352)368-6922 Ext 208 Ralph@cws.cc Category Windows Subcategory Mullions Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer - Evaluation Report-Hardcopy Received Florida Engineer or Architect Name who Roberto Lomas developed the Evaluation Report Florida License PE-62514 Quality Assurance Entity Keystone Certifications, Inc. Quality Assurance Contract Expiration Date 07/21/2020 Validated By Steven M. Urich, PE Validation Checklist-Hardcopy Received Certificate of Independence FL9520 R2 COI 510190B(Impact 3 in Mull Eval).odf Referenced Standard and Year(of Standard) Standard Year AAMA 450-06 2006 ASTM E1300-02 2002 ASTM E1886-02 2002 httn:Hfloridabuilding.org/nr/nr ann dtl.asnx?naram=wCYFVXOwtT)i3vll4vmii.TRWcZl2oT... 10/12/2010 One and Two Family Dwelling Window Replacement Worksheet'- C)k---- )�- C V". ,I L- --S Job Addrr-sr,- 1-1--�o gt 0-� kc:L'A". KrpDgure: B 0 C D Product approval fDr MDdDW#— PrDduct approval for shuttcrs# Lo,catiDn 0 Fast of 1-9,5 (opening proti�cfion rNtdreA) D WeSt of 1-95(OPERing PrOtEC60D Dot required) Method of open-ing protection: o impact-Glags D Plywood 0 Shuffers (mquirrs ttPZMte ptnuit) Component and Cladding Charts B FXPDS:Ure 3D, Mrb C Erprure 3W mrb- Dpniing Siv,in En d Z.DD r, JB tMi DT Z;DD r C)PCDjDg Si7-M iD End ZDDt*" Intmim 7-Drit PSF SqFt PSF PSF Pqpt PSE D-10 25.9--34.7 25.9--29.1 (Mo 25-9- -49.6 25-91- -39.4 11-20 24.7--32-4 247--26-9 11-20 24.7- -45.4 24.7- -37-9 21-50 23-2--293 2-3 --25.4 �1-50 2-3-2- -41.0 23-2- -35.6 51-100 1 22-- .9 22--24-2 534-OD Z1:6--37-9 ZID- --�4.0 Sketcli fcotprint of bufldin,—,, indicate size and IDCatiDn of windows to he replacad and IDcation of bedrooms. oe T-41 1 i J I I I I I i L i -J I I I I I I I I I I I I I I I I I H11- 1 111111 --t--fli '-Optning protectiDn is rmfuirf--d ia thD wind-bomt dt-,bris region When the rr-plac-emtat glazing exmeds 25 perceat of the aggregate area of glaz,!�d openings in tbD dwe'lling. -"'End 7-one 10% oftha length of'waU and nDt Itszs tbe--n 3 fmt- Plans ExamiDer City of Atlantic Beach Building Department 800 Seminole Road Atlan ic Beach, Florida 32233 -5800 Telephone (904) 247 Fax(904)247-5845 www.coab.us WIND-BORNE DEBRIS PROTECTION AFFIDAVIT Date: l0b\ 110 Permit#: Property Address: , Ave- AM I understand the Florida Building Code requires replacement windows in a Wind-borne Debris Zone be impact glass or have openings provided with wind-borne debris protection. I recognize the structure involved is located in a Wind-borne Debris Zone. I am in the process of having windows replaced which require this protection but have elected not to have the required protection installed by my window contractor. I understand that before a final inspection may be approved, the required window protection must be provided. If the required window protection is not provided it will be a violation of State law and the City of Atlantic Beach may take appropriate code enforcement action which may result in fines beings made against this property. I also understand that my insurance company may not reimburse me for damages suffered due to the lack of required window protection. I agree to have the required window protection installed on or before: RlAiivici 5kV&—� (Date) I will be using the following material to provide the window protection: (check ol A._Plywood per the Florida Building Code B._K_Other approved method (Provide Florida Product Number) Name of Homeowner's Insurance Company (Signatun?of Property Owner) (Dtte) R y C f4//J/J Lf (Print Name) STATE OF FLORIDA COUNTY OF DUVAL The foregoing instrument was acknowledged before me this 14 dayof n4obr_v- 1201o'by (name of person acknowledging). J a n i c e S av e A :Commission#DD602177 Signatur o Not A Signatu f tary Public-State of Florida M...... Expires January 13,20il , i B0rtjedTmyFam-1Asur3ft,,,tne soo-385-7010 Personally known OR Produced lidentific ion_-_- Type of Identification C' �-.Z o- 0 If' 3 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road tiantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date rout d: Cityweb-site: hftp://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 7d e,,,v AIL -pepartment review required Yep( No Building Planning &Zoning Applicant: Tree Administrator Project: Ar;.d A7 if Public Works Public Utilities Public Safety Fire Services 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 Reviewing Department First Review: MApproved. OlDenied. (Circle one.) Comments: (LBU�ILD ' PLANNING &ZONING Reviewed by: Date: /0 9-10 Oct TREE ADMIN. Second Review: FlApproved as revised. FIDVNied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. E]Denied. Comments: Reviewed by: Date: Revised 05/14/09