Permit Windows 97 Dudley A 2011 '� : CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
'.1 ATLANTIC BEACH, FL 32233
A INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002705 Date 9
Property Address 97 DUDLEY ST A /30/11
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 3166
Application desc
WINDOW REPLACEMENT
Owner Contractor
JACKSONVILLE HOUSING AUTHORITY E B MORRIS GENERAL CONSTRUCTIN
1300 BROAD STREE 7011 BUSINESS PK BLVD 101
JACKSONVILLE FL 32201 JACKSONVILLE FL 32256
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 70.00 Plan Check Fee 35.00
Issue Date Valuation 3166
Expiration Date . . 3/28/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC 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 70.00 70.00 .00 .00
Plan Check Total 35.00 35.00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 109.00 109.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
4'K 'tre, City of Atlantic Beach
^ ill Building Department APPLICATION NUMBER
y 800 Seminole Road (To be assigned by the Building Department.)
J d - « Atlantic Beach, Florida 32233 -5445 / / 7e , _,
"' Phone (904) 247 -5826 • Fax (904) 247 -5845 ..�
»uti - E -mail: building- dept @coab.us Date routed:
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 91 21i� S7 De ment review required Y7 No
Applicant: ES /a rr /S uilding j
ing & Zoning
Tree Administrator
Project: o0/A/2)0/xj ' /4,/7 & 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: [Approved. ['Denied.
(Circle one.) Comments:
BUILDIN
PLANNING & ZONING ��/
Aw
Reviewed by: Date:
TREE ADMIN. Second Review: ['Approved as revised. ['De ' d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. [' Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845 //'
_
Job Address: 97 Dudley Street, Atlantic Beach, FL 32233
Legal Description 19 -16 17- 2S -29E Parcel #
Floor Area of S.Ft. S.I't
Valuation of Work $ 3166 Proposed Work h ted /cooled n heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa indo • oor
Use of existing/pro osed structure(s) (circle one): Commercial - sid .. '
i
If an existing structure, is a fire sprinkler system installed? (Circle one): es No
Florida Product Approval # 13575.01
For multiple products use product approval f orm
Describe in detail the type of work to be performed: Remove and Replace Windows
Property Owner Information:
Name: Jacksonville Housing Authority Address: 1300 Broad Street
City Jacksonville State FL Zip 32202 Phone 904 - 630 -3810
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: EB Morris General Contractors Qualifying Agent:
Address: 7011 Business Park Blvd., N., Suite 101 City Jacksonville State FL2 •
Office Phone 904 - 998 -9584 Job Site/ Contact Number: Jon Berthiaume (904)838 -2929 Fax # 904 - 998 - `
State Certification/Registration # CGC 057425 I i
Architect Name & Phone # ' " 1 I , 1 1 t 111111111=M
Engineer's Name & Phone # , Y S I"
Fee Simple Title Holder Name and Address 1 SEE P ; „ 0 . _ 1 • fa : ;Et` 4
Bonding Company Name and Address 1 REQUIREME t :. a a ,1. „ : • j 1 I'I 1
Mortgage Lender Name and Address 1MUM ,1
l i e . :; �:� I J • —,,,ezir' DATE ' • 9—/"
I I Application is hereby made to obtain a permit to do the wor ryrCe pp io t the
issuance of f a permit and that all work will be performed to meet the standards o al aws ' e ain . �s . • 7 - r o � 1, •• has c r �,. u t gu - n. Th -. ' -r to ull
and void if work is not commenced within six (6) months, or if construction or work is suspended or ended abandoned for a period of six (6) m E er
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furn' ` 7� .' i 7 s uura • ers,
Tanks and Air Conditioners, etc
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 YOUR NOTICE OF
COMMENCEMENT.
1 hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of 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 authori o violate or cancel the
provisions of any other federal, state, or local taw regulating construction or the performance of construction.
,r
Signature of Owner /--= 4'k z — I' Signature of Contractor
Print Name ' (IIrvn M \,(--\-- Print Name t K, C. M o!Z It if
Swo.e o and subscr ed be ore m Sworn o and subsc :bed ,efor me
this .... Day of •P + � Per , 20 \ \ this ,_. Day of • ,4!' Ll . er 20
• •• "' I J• NATHAN B BERTHIAUME
;� 4Ns
4 Public THAN B BERTHIAUME &A t, • ,,,
.f+' •
- MY COMMISSION # EE107642 0 u � 1C - ,, �� :d,�� ;
•'�� � ' E XPIRES June 28, 2015
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NOTICE OF COMMENCEMENT NNumter Pages 11 4' OR BK 15724 Page 93,
Recorded 09/28/2011 at 09:36 AM,
/_� 7 JIM F.'LLER CLERK CIRCUIT CO 'RT DUVAL
Permit No. COW ' TY
Tax Folio No. RECORDING $10.00
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.
1.Description of property (legal description): 19-16 17
a) Street (job) Address: 97 Dudley Street, Atlantic Beach, FL 32233
2.General description of improvements: Remove and Replace windows
3.Owner Information
a) Name and address: Jacksonville Housing Authority, 1300 Broad Street, Jacksonville, FL 32202
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4.Contractor Information
a) Name and address: EB Morris General Contractors, Inc, 7011 Business Park Blvd, N., Jax, FL 32256
b) Telephone No.: 9 04 - 998 - 9584
5.Surety Information Fax No. (Opt.) 9 04 - 998 - 9584
a) Name and address:
b) Amount of Bond:
c) Telephone No.:
6.Lender Fax No. (Opt.)
a) Name and address:
of Phone No.
7.Identi
Identity 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.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.13(1)(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 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 COMMENCEMENT MUST BE RECORDED AND POSTED ON '1'1iE 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 of or Owner's Authorized Officer/Director/Partner/Manager
Print Name
The foregoing instrument was acknowledged before me this day of wL-f : 20 \ , by
(type of authority, e.g, officer, trustee,
attorney in fact) fo ► ��� �} �
• - ` 1 ►; a party on be of whom • i strument was executed).
pally K OR Produced Identification k
Notary Signature
Type of Identification Produced Name (print) T
OR
Verification pursuant to Section 92.525, Florida Statutes. Under penalties : : - - • w
the facts stated in it are true to the best of my knowledge and belief. ' ' 'the foregoing and that
JONATHAN B BERTHIAUME
FORMS/NOC,rvsd2010 y •; MY COMMISSION # EE107642
Signature I . , .: "son Signgt(iQ 1 11 �' ve
o a ry arv�•,�.com
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