Permit 1917 Seminole Rd Window 2010 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001479 Date 12/22/10
Property Address . . . . . . 1917 SEMINOLE RD
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5300
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Application desc
replace 7 windows impact
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Owner Contractor
------------------------ ------------------------
WHITEHEAD, TERRY AMERICAN WINDOW PRODUCTS
1917 SEMINOLE ROAD 2633 POWERS AVENUE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207
(904) 731-2247
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 80 . 00 Plan Check Fee 40 . 00
Issue Date . . . . Valuation . . . . 5300
Expiration Date . . 6/20/11
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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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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 80 . 00 80 . 00 . 00 . 00
Plan Check Total 40 . 00 40 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 124 . 00 124 . 00 . 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: 5107U�wl �e, Kd Permit Number: . 9
Legal Description M -:2t> - 2ciC ibeCk�t4de�- Parcel# t09S4 2 - 0 5
Eloor Area of S q_.T Z.- Sq.Ft
Valuation of Work Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/sp(:Edow�/door
Use of existing/pro osed structure(s)(circle one): Commercial esidentiaL---'
If an existing structure,is a fire sprinkler system installed?(Circle one):---T'es No N/A
Florida Product Approval 4
For multiple products use product approval rorm
Describe in detail the type of work to be performed: LOU Ljcws
Property Owner Information:
N r7
CZ Iql
E-Mail or Fax#(Optional)
Contractor Information:
AMERICAN WINDOW
Company Name: PRODUCTS, INC. QualiPjing Agent:
Address: 2633 P0VVEHS AVE. city State zip
Vn-r
ei(SE)N 0 �:F
OfficePhone -7??L- 22-r-I lte�rNZYga Number -Fax 9 9" S Z L4
State Certification/Registration
Architect Name&Phone#
Engineer's Name&Phone It
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
b de bana do he work and fnsta" 'i�ns a'ind or installation has commencedprior to the
he stan a,, thisjurisdiction. This permit becomes null
f k i a e iod of s�16)months at any time after
0
nst"ci n r wor
f -s,Heaters,
or I cin
us ,sec.ff E e P661s, Urnaces,Boilei
to ermit t
p be pe ormed to m7t t
Is i a �'s e i ma t 0 t 'r h i n1l, (6 mont , or
P' 0 r ty nd hatal w- k w
'p
-ance a rm wL
p d t
'Sd",'d 0'ok'not commence 'a, Ob
I 'k is c 'e"ed understand t t ep a e per is, t
Tanks andAjr Con;htzoners,eta
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE 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 YOVIi NOTICE OF
COMMENCEMENT.
a., !�,Jrue and correct. All provisions of laws and ordinances governing this
work will be coTp ecifed herein or not. �ofk permit does not presume to give authority to violate or cancel the
w regulating construc* �fo�rkance ofconstruction.
Ihere cergfy that I have read and examined this ?plicationandkno!
1V _lied with whether
provisions of any otherfederal,state, or localsfal Tor"560�
Signature of Owner 11 e-1 i *ature of Contractor
7j 10. 0
Print Name P Name
.... ......... I....................................................................... + .............................. ................... .............. .....................................................
CMD
scri e toeTore'
FOR CODE CoMpla C=
CITY OF ATLANTIC BEACH
Q f
PERMffSF0RAD1J1j10NAL ublic --1
4otary P 02
IREMENTS AND CONDInONS. OWDD271 756
EXPIRES:December 7,2011 Revised 01.26.10
REVMWEDBY. DATE:Z��O_ F Bonded Thfu Budget Notary Services
CITY OF ATLANTIC BEACH -FT-E]
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 08-FT
OFFICE:(904)247-5826*FAX NO.:(904)247-5845
BUILDING-DEPTCCOAB.US
BUILDING PERMIT APPLICATION DUVAL COUNTY
W
Atlantic Beach, FL 32233
13 NEW BUILDING 13 DEMOLITION 0 RESIDENTIAL
LO T_BLOCK SUB DIVISION 11 ADDITION 13 CONVERTING USE [3 COMMERCIAL
[3 ALTERATION 13 ACCESSORY BLDG.
0 REPAIR 13 POOL/SPA 13 YES 13 N/A
Q MOVE 0 OTHER 13 NO
15.COMPANY NAME: 23.COMPANY NAME:
16.NAME: 24.LICENSEE NAME:
10.ADDRESS/ 17.STATE OF FLORI15*1_ EN 25.STATE OF FLORIDA LICENSE NO.:
C, 18.ADDRESS: 26.ADDRESS:
n ni,
11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 2t*Aj(V(j.: 27. IC 0 :
Vs.�g No.:
13.CELL PHONE: 21.CELL PHONE: 24. LL PHONE:
14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRES
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 indica'ted. I certify that no work or installation has
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 this
jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work Is suspended or
abandoned for a period of six(6) months at any time after work is commenced. I understand that separate permits must be secured for
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 applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof,until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
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.
Signed: Z)eZt"Zr ate- Z� C) Signed: Date:
Before me this_��_-;day of 007 2e in the county Of Before me this day of �h�theoounty of
-70 16 —
Duval,State of Florida,has personally.a Pee ad Duval,State of Florida,has personally a9p,
Te 1A. r1k&,iCk
� W1 -
herin by himself/heradand affirms that all statements and declarations are herin by himself/herself-and affirms that all statements and declarations are
true and accurate. true and accurate.
N ta Public at Large,State of County of Notary Public p(Large,State of untyof
_.Co
7..nally Known
Personp*Known
13 Prood6ed Identification-
13
0 Produced Identification- L bee . A,
Notary Signature: Nota-r/y Signature:
C, VM GURR
MY COMMISSION#DD 774313
COAB FORM BLDGOi:REVISED:11/6/2007 EXPIRES:May 13,2012
O�F Bonded Thru Budget Notary Serylow
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
#
Project Name: Permit ZC . 3�
Project Address:
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!pproval ma be obtained at:www.floridabuilding. rg.
Category/Subcategory Ma ufacturer Product Description Limitation of Use State# Local#
0-1 owl 11",0 1 0"
A.EXTERIOR DOORS
1.Swinging
2. Sliding
3. Sectional
4.Roll up
5.Automatic
6.Other
B.WINDOWS
1.Single hung
2.Horizontal slider
uz
3.Casement
4.DouRe hung
5.Fixed
6.Awning
------------------
7.Pass-through
8.Projected
9.Mullion
10.Wind breaker
11.Dual action
2.Other
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
H.NEW EXTERIOR
ENVELOPEPRODUCTS
1. 4
2. , _ I I
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 theories
listed in this document must be approved by the Building Official.
(Contractor Aame (Print Name) (Signature)
Company Name:
AMERICAN WINDOW
Mailing Address: PRODUCTS, INC-
2633 POWERS AVF--
City: JACKSONVILLE. FL:32207 State: Zip Code:
—1-2
Telephone Number: Fax Number:
Cell Phone Number: E-mail Address:
...............
V7
rionaa tsuilaing 1—oae uruine rage 1 01
Community Affe"Irs'
L
scis Home I Log In I User Registration Hot Topics Submit Surcharge
1 Stats&Facts I Publications FBC Staff SCIS Site Map Unks Search
�ProdUiizt Approval
46 11INNYUSER:Public User
Product Approval Menu>Product or Application Search>Application List>Application Detail
FL# FL13322
Application Type New
Co e Version 2007
Application Status Approved
Comments
Archived IN
Product Manufacturer Gorell Enterprises Inc.
Address/Phone/Email 1380 Wayne Ave.
Indiana,PA 15701
(724)465-1839
rgibson0gorell.com
Authorized Signature Richard Gibson
rgibson@gorell.com
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Email
Category Windows
Subcategory Double Hung
Compliance Method Certification Mark or Listing
Certification Agency American Architectural Manufacturers Association
Validated By American Architectural Manufacturers Association
Referenced Standard and Year(of Standard) Standard Year
AAMA/WDMA/CSA 101/I.S.2/A440 2005
ASTM E1886/E1996 2005
Equivalence of Product Standards
Certified By
Product Approval Method Method I Option A
Date Submitted 11/10/2009
Date Validated 01/04/2010
Date Pending FBC Approval 01/05/2010
http://www.floridabuilding.org/pr/�r� app dtLaspx? aram--wGEVXQwtDquFsbThi%2b3j... 4/27/2010
1 _ P 1--
Florida Building Code Online Page I of 2
BCIS Home Log In User Registration Hot Topics Submit Surcharge Stars&Facts Publications FBC Staff BCIS Site Map Links Search
Product Approval
USER:Public User
A
Product Aoproval Menu Product or Application Search>Appli�ation Lis >Application Detail
FL# FL14264
I BE, Application Type New
Code Version 2007
Application Status Applied For
Comments
K ,7 Archived
,
Product Manufacturer Gorell Enterprises Inc.
Address/Phone/Email 1380 Wayne Ave.
Indiana, PA 15701
(724)465-1839
rgibson@gorell.com
Authorized Signature Richard Gibson
rgibson@gorell.com
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Emall
Category Windows
Subcategory Fixed
Compliance Method Certification Mark or Listing
Certification Agency American Architectural Manufacturers Association
Validated By American Architectural Manufacturers Association
Referenced Standard and Year(of Standard) Standar Year
AAMA/WDMA/CSA 101/I.S.2/A440 2005
ASTM E1886 and ASTM E1996 2005
Equivalence of Product Standards
Certified By
Product Approval Method Method I Option A
Date Submitted 11/23/2010
Date Validated
http://www.floridabuilding.org/pr/p�_app_dtl.aspx?param=wGEVXQwtDquDEJErtOSCet... 12/15/2010
Florida Building Code Online Page I of 2
.. ..... ...
A
BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publications FBC Staff BCIS Site Map Links Search
4
Product Approval
USER:Public User
Product Approval Menu>Product or Application Search>Application Lis >Application Detail
FL# FL8546-Rl
Affirmation
Application Type
Code Version 2007
kg2m Approved
g ji/
Application Status
Comments
v1—M.-"W'
Archived
Product Manufacturer Goreli Enterprises Inc.
Address/Phone/Email 1380 Wayne Ave.
Indiana, PA 15701
(724)465-1839
rgibson@gorell.com
Authorized Signature Richard Gibson
rgibson@gorell.com
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Emall
Category Windows
Subcategory Horizontal Slider
Compliance Method Certification Mark or Listing
Certification Agency Keystone Certifications, Inc.
Validated By
Referenced Standard and Year(of Standard) Standard Year
AAMA/WDMA/CSA 101/IS2/A440-05 2005
ASTM E 1886/1996 2005
Equivalence of Product Standards
Certified By
t affirm that Ll�ete are no changes in the new Flo,ida
t3(jilding co(-je villri-I afF,e,-t rry product('s) and rny
PrOCJLFA(�') ate w (,on�piiancp vitri tho, new Florida
13ml(fing cocir-�'
Documentation from approved Evaluation or Validation Entity y("-, No N/A
http://www.floridabuilding.org/pr/p�_app_dtl.aspx?param=wGEVXQwtDquLegv�/�2flN... 12/15/2010
APPLICATION NUMBER
City of Atlantic Beach (To be assigned by the Building Dep�artment.)
Building Department
800 Seminole Road
Atlantic Beach, Florida 32233-5445
- Fax(904)247-5845
Phone(904)247-5826
E-mail: building-dept@coab.us
City web-site: hftp:/twww.coab.us
APPLICATION REVIEW AND TRACKING FORM
J�tpll7dl�-, D ntreviewre uired Ye No
Property Address: uildin
tZ
ganning &Zoning
Applicant:
Tree Administrator
Public Works
t
Project: Public Utilities
—public Safety
Fire Services
w
ii'm K O_Qp"N
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept. of Environmental Protection of Permit Verified B
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Divisi:)n of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
dApproved. [:]Denied.
Reviewing Department First Review
(Circle one.) Comments:
(��p
PLANNING &ZONING Reviewed by: Dateld -17-10
TREE ADMIN. Second Review: r_�Approved as revised. enied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: RApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Doc # 2010293539, OR BK 15464 Page 2089, Number Pages: 1, Recorded
12/22/2010 at 12:32 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING
$10.00
NOTICE OF COMMENCEMENT
Permit No.
State of Florida
County0f Dw-mL I-�'?
The undersigned hereby gives notice that improvements will be made to certain real prope% and in
accordance With section 713,13 of the Florida Statutes, the following information is provided in this
NOTICE OF COMMENCEMENT.
Legal description of pro erty (Include Street Address,if av�11a4lejV 1542 -1�5-52-
�E2-14 C)(�- T- -ZC�C /6eaajZ4 0 C-
/) I 10 � - t
General description of I �-Uzo' �
I m p ro v,je ritts,. 41-
Owner 12-44" -e_ U";�
Address -I-) I :Ser?U/'-W-k'
Owners Interest in site of the Improvement
Fee Simple Title holder(if other th,,
Name I--,'
Address AMMMAN WR400W q 64
ee-VContractor rRUIRUCTIS,INC.
2633 POWM'XvL
Address I-A
1-0" Surety -
Address Amount of bond$
Any person making a loan for the construction of th I mentsi
Name
Address
Person within the State of Florida designated by owner upon whom notices or other documents may be
served as provided by Section 713.13(l)(a)7, Florida Statutes,
Name
Address
In addition to himself,owner designates
Of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statute�.
Expiration date of Notice of Commencement(the expiration date is one(1) year from the date of
recording unless a different date is specified)
kym et44)L'
Sign,dure of,6wner Printed Nwn�/,Owner
FNotaq Rubber Stamp Seal I have relied upon the following identification of the Affiant:
Sworn to and subs�ribed before me thi.4Wday of�20�i
Nttary�ignatu
�-1—� 1:2 W
My COMMISSION#Do T7431
EXpIFIES.May 13,2012
BoWdThrubu*N01ery Ber*0