Permit Bldg Enclose Porch 1973 W Sevilla Blvd 44 ` : `x CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
� X4119:&
Application Number 10- 00001288 Date 10/26/10
Property Address 1973 W SEVILLA BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 6100
Application desc
enclose lanai
Owner Contractor
PATTERSON HOME IMPROVEMENTS
6967 PHILIPS HIGHWAY
JACKSONVILLE FL 32216
(904) 296 -0045
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . 85.00 Plan Check Fee 42.50
Issue Date . . . Valuation . . . . 6100
Expiration Date . 4/24/11
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 85.00 85.00 .00 .00
Plan Check Total 42.50 42.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 131.50 131.50 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
A: --
t�';t...'�� r �' CITY OF ATLANTIC BEACH " . air I " 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 (� �J j
ti . . ti OFFICE: (904)247 -5826 • FAX NO.:(904)247 -5845 4 . `• BUILDING- DEPT@COAB.US
* It 6711. BUILDING PERMIT APPLICATION DUVAL COUNTY
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<,It 1 .. ". s+�i� y °4 4 'iq �' , ::A,. ¢. e¢ ., *�d a*'8 ',r• x41 .. €`, . . :'.
�Juu' -7� ❑ NEW BUILDING ❑ DEMOLITION ' - ESIDENTIAL
LOT /BLOCK SUB DIVISION Q'�y 2 /Z-409%-.410c„„„ -. ADDITION ❑ CONVERTING USE ❑ COMMERCIAL
, 31 3 ° "' n s ZF % , ,,„%t % " .. ,,,r , G ` -40 ❑ ALTERATION ❑ ACCESSORY BLDG. EXIMTVIAMfaliii
,t ��` ` _1 /7 ,,� � /�� �,�_ ry i- ❑ REPAIR ❑POOL / SPA ❑YES ❑ N/A
u [�✓ G��G� ❑ MOVE ❑ OTHER
❑ NO
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9. NAME: 15. COMPANY NAME: 23. COMPANY NAME:
,7aE,eyt 9 A/e4 r .r KGs
16. NAME: 24. LICENSEE NAME:
d
3 L T .�'eX 7
10. ADDRESS: 17. STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA LICENSE NO.:
/973' Set/ /«,R9,eze/d2 At", e6C o�7 J
18. ADDRESS: .74E 26. ADDRESS:
�ridA/r/e BC's -/, Ft ,3ae?33 i�4/4/`3.�.sr/r/Je-st '0 Sv/
gAfe <sewd/ /e; CL--5.27.-
` 3 � ELL H "//7-e17 „2
112. FAX NO.: 19.
EL � C 0 4 2 J 6 NO .2, 27. OFFICE PHONE: 128. FAX NO.:
! PHONE: 29. CELL PHONE:
14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS:
j c � ' <x "' " r-'4,4;1'.,' ¢ ,� - , € .., '' ,, + .,. 3k�.z r,9 „�s ro'f ,., 9� ;9 � � ., z" k j'� �' „ r° F, y a.� �' s a ? � � , ,� l .
31. NAME: 33. NAME: 35. NAME:
32. ADDRESS: 34. ADDRESS: 36. ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation -.._.. ._ v,
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in ;III
jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspende '
abandoned for a period of six (6) months at any time after work is commenced. 1 understand that separate permits must be secured i CL.,
Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc.
OWNER'S AFFIDAVIT - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applic*
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled ;1
prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. f
*** WARNING TO OWNER: *** , L1 `, r
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR ...,� .
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF i i.a.. fr,
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE y, . ;, `a
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR _. ,�.. --;� • ,,J
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCE I
, a s�: 1 Tv t , *4 r 1 r',. ` 4
's ., .a<.._ .x�, („- ,, ub,:.,�faa, ��k-- ,..,�« •�, r,��. � said.,. a'�. . s ... , . s i0 �,".�a ar �d. x' " o-. -
Signed: .L.. 0 Wj. Date: 9-/ ; 2 Q . O Signed: J ' 4 -Ia. Date: 1 d �
f
Before meth _ __ J I_ day of e - e • et - , th cO my of Before me this 1 D day of oa - robe d Mehl t 1 a ,...1 --.1' :. Z '
Duval, / S � tat= •f Florid h )pper;;d' ally appeared Duvet, State of Fl°�ida, has persona appeared X01 / -p L„Feltay -7 3ek
hen., .y himself herself and affirms that all statements and declarations are herin by himself / herself and affirms that all statements and decla 1 tio�a A �� Q
true and accurate. ! true and accurate. I I W ..
Notary Public at Large, St- e of FL , County of D 1q j ' Notary Public at Large, Stat., C
of I L- , County of ; v� C:
El Personally Known u Personally Known r l
❑ Produced (Identification/ 41 0 Produced Identification - 1 I O n ,
n r
, f "
Notary Signature: Notary Signature: /�-�` �" C 1 _ - - -.., .§
osi
...'ROB -C a
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so" " - ° - MAN S. WARREN ' ,s CpRV o,e,� W O' pa
0 - r , , n Notary Public • State of Florida _ • 1 IAN S. WARREN rn
COAB FORM BLDGOI • I , / 2i3 My Comm. Expires Nov 25, 2012 ` , Notary Puc�ic - Stale of FI, .' V m
1 , , +` My Expires '�
, ,, ,, Commission # 00 841452 11 F F`w Comm. m P es Nov 25, r ; • F.3 Commission • 00 8414 �� a 5
I _ i
! - ` CITY OF ATLANTIC BEACH
J f s� BUILDING PERMIT APPLICATION
r
, tz z..,
(Alterations & Additions)
Date: /o-
Job Address: / �Ef/ /LLB eze.,.. ,17Z '77' ? j ? i ex ' `L
Owner of Property: / " 36Z7Z
Address: /f75G7// ? /,0 2 ,17Z , eSW. FL ` 07.25 . a .24/ _
Legal Description: Block Number: Lot Number: o �
Zoning District:
Contractor: ..0'77 �� ,‘'jyl�c- ,v,,eo�*"A ,3 State License Number: eioG ,e7e7r
Contractor Address: ,/2/3 ,>� iTE - .03/1/ ... 0 7—e-...."0/' �� / FL /Q
/
Telephone: 0.& gyp - Ul / S Fax: l�p� 79a, - �, �e,
Describe proposed use and work to be done: 62 /else ` � , / , - / ' jN
Present use of land or building(s): ,,ee,$jL06 7/T / p,G
Valuation of proposed construction: 1 /pO, ---
What are the dimensions of the added space: /'U feet x /Go feet
Will the added area be heated and cooled? `C/',;7 New electrical or increase in service? .A..,"
Add plumbing fixtures? ite ' Add fireplace? ,moo Add heating/air conditioning? ice-z,
Is approval of Homeowner's Association or other private entity required? If yes, please submit with this
application.
Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to
the original impervious area or the removal of any trees?
L!'I NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this
project.
❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building
Permit.
O. Applicant certifies that no trees will be removed for this project.
N .
❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree
Removal Permits to be reviewed by the Tree Conservation Board, which meets two times each month.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.
Incomplete applications may result in delay in issuance of permit.
STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please
contact the Planning and Zoning Department at 904 - 247 -5826. In order to correctly verify zoning designation, please have
Property Appraiser's Real Estate Number available.
STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre - construction or post - construction
topographical survey or grading plan is required. (If not required, written verification must be provided with this application.)
The Department of Public Works is located at: 1200 Sandpiper Lane, Atlantic Beach, FL 32233 Telephone: (904) 247 -5834
STEP 3. Submit Tree Removal Application if trees are to be removed or relocated.
STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner /Contractor Affidavit if
owner is contractor, and four (4) complete sets of construction plans to the Building Department, which is located at the Atlantic
Beach City Hall, 800 Seminole Road, Atlantic Beach, FL 32233 Telephone: (904) 247 -5826
800 Seminole Road • Atlantic Beach, Florida 32233 -5445
Telephone: (904) 247 - 5800 • Fax: (904) 247 - 5845 • http : / /www.ci.atlantic beach.fl.us
Page 2
Revised 8/04
e \
In addition to construction and engineering detail, plans must contain the following information as appropriate for the type of work being
performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner.
1. Current survey showing the property boundary with bearings and distances and the legal description.
2. Location of all structures, temporary and permanent, including setbacks, building height, number of stories and square footage. Identify
any existing structures and uses.
3. If required by the Department of Public Works, a pre - construction topographical survey.
4. Any significant environmental features, including any jurisdictional wetlands, CCCL, natural water bodies.
5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools
may be excluded from total Impervious Surface.
6. Other information as may be appropriate for individual applications.
I hereby certify that all information provided with this application is correct.
X Signature of owner: — --- 2/1 --
Date: _ L i ct
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and
ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any federal, state or local rules, regulations, ordinances, or laws in any manner, including the
governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the
above information being true and correct an. at the plans and supporting data have been or shall be provided as required.
Signature of Contractor:
Date: l 0 / 2 U 11 Q
Address and contact information of person to receive all correspondence regarding this application (please print).
Name: l77 ' oit/ />?F" , >f7
Mailing Address: ./ S ir/tTB 0 ' 44 1', .T-ar—,S -e f J , G - G ,3.• 3
Telephone: C9O� -. "* Fax: � i qer /��G .- 427 E -Mail:
AS TO OWNER: //
Sworn to and subscribed before me this J._ day of 0 e p I "" _ 6 e , 20 1
State of Florida, County of Duval
.•'s; IAN S. WARREN I Notary's Si �//,7 '4441/44-1---7
■
s: \ . '. ` .. Notary Public - State of Florida I gnature. C /
iin :;..- My Comm. Expires Nov 25, 2012 ( 2 known
I ,,Ire Commission 0 DD 841452 I l ] Produced identification
Type of identification produced
AS TO CONTRACTOR:
Sworn to and subscribed before me this 2 U day of ( 6 , 20 1 0.
State of Florida, County of Duval
-' t7
' . 41 ,,,,,, ` ,, ,,, Notary's Signature:''''
o n ° B , IAN S. WAR t
I • c �'c Notary Public - State of F lorida I ,�(
s My Comm. Expires Nov 25, 2012 I U Personally known
?''"f �`'� Commission DD 841452 ❑ Produced identification
,
' " " ,,, I Type of identification produced
800 Seminole Road • Atlantic Beach, Florida 32233 -5445
Telephone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ci.atlantic- beach.fl.us
Page 3
Revised 8/04
Florida Building Code Online Page 1 of 3
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# BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats & Facts Publications FBC Staff BCIS Site Map Links Search
Alt
Z.„ 0,4 s ie PrH,R Tr) Product Approval
i USER: Public User
Community
Affairs : Product Approval Menu > Product or Application Search > Application List > Application Detail
a , n ANUMA
fit,. FL # FL239 -R13
;r Application Type Revision
Code Version 2007
> x §
Application Status Approved
Comments
nrrar Archived
Product Manufacturer PGT Industries
Address /Phone /Email 1070 Technology Drive
Nokomis, FL 34275
(941) 486 -0100 Ext 22318
druark @pgtindustries.com
Authorized Signature Robert Clark
bclark @pgtindustries.com
Technical Representative Robert Clark
Address /Phone /Email 1070 Technology Dr.
Venice, FL 34275
(941) 480-1600 Ext 21106
bclark @pgtindustries.com
Quality Assurance Representative
Address /Phone /Email
Category Windows
Subcategory Single Hung
Compliance Method Certification Mark or Listing
Certification Agency Miami -Dade BCCO - CER
Validated By Miami -Dade BCCO - VAL
Referenced Standard and Year (of Standard) Standard Year
TAS 201, 202, 203 1994
TAS 202 1994
Equivalence of Product Standards
Certified By
Product Approval Method Method 1 Option A
Date Submitted 05/06/2009
http:// www. floridabuilding .org /pr /pr_app_dtl.aspx ?param= wGEVXQwtDquS 1 Bu8CAE... 10/12/2010
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Longitudinal Elevation of N
. 1J-V1;. City of Atlantic Beach APPLICATION NUMBER
JS 1V, Building Department (To be assigned by the Building Department.)
r
800 Seminole Road la - /2 v I
5 * ' - ,.. Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 - Fax (904) 247 -5845
"�011 tjr E -mail: building- dept @coab.us Date routed: /Q 22//0
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
U�
Property Address: / 7 �/ (/ ilia -3/V01 ent review required Ye No
Building
Applicant: T,-7T r Srn /he t Arrelcal k a Planning & Zoning
/ ' /A / Tree Administrator
Project: £ C./0S i L 4- LJl Public Works
Public Utilities
W / A/bOG() S Public Safety
Fire Services
Review fee $ Dept 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
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. nDenied.
(Circle one.) Comments:
4 G o /7,co!
BUILDIN
PLANNING & ZONING Reviewed by: t in Date: /012
TREE ADMIN. Second Review: nApproved as revised. nDe ' d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of r/,,,,cu,.q County of 4014vA)
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 stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 4 �B'�� 5
.5e7s /L4.v Li/v /3 Dr
Address of property being improved: /7 5 /LL' ZeP
/7TG,vit/rC
General description of improvements: cs'�t/GO 5u dee 4
Owner /J7F.Q C .C3FL
Address / �3 ,567//4L gIi P Le). ,47Z, /W7e. 5.e, ,4" G�3 , ��
Owner's interest in site of the improvement
FEE SIMPLE
Fee Simple Titleholder (if other than owner)
Name
Address
Contractor PATTERSON HOME IMPROVEMENTS
Address 12443 San Jose Boulevard, Suite 501, Jacksonville, FL 32223
Phone No. (904)296 -0045 Fax No. (904)551 -6910
Surety (if any)
Address Amount of bond $
Phone 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
Phone 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 Statutes. (Fill in at Owner's option).
Name
Address
Phone 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):