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Permit Windows 1743 Ocean Grove 2012
w S L- '-`Jr Ak ry r AP CITY OF ATLANTIC BEACH '- s) 800 SEMINOLE ROAD �: w ATLANTIC BEACH, FL 32233 �., INSPECTION PHONE LINE 247 -5814 r 13 Application Number 12- 00000064 Date 1/23/12 Property Address 1743 OCEAN GROVE DR Application type description WINDOW AND /OR DOOR Property Zoning TO BE UPDATED Application valuation . . . 14397 Application desc window replacement Owner Contractor POWERS, DEBRA SIDING INDUSTRIES OF N FL 1743 OCEAN GROVE DRIVE P 0 BOX 840292 ATLANTIC BEACH FL 32233 201 BASQUE ROAD ST.AUGUSTINE FL 32080 (904) 460 -9367 Permit WINDOW AND /OR DOOR PERMIT Additional desc . Permit Fee . . . 125.00 Plan Check Fee . . 62.50 Issue Date . . . Valuation . . . . 14397 Expiration Date . 7/21/12 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 125.00 125.00 .00 .00 Plan Check Total 62.50 62.50 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 191.50 191.50 .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 o O 800 Seminole Road, Atlantic Beach, FL 32233 ' Office (904) 247 -5826 Fax (904) 247 -5845 SAN 2012 7 Job Address: ( 7 143 CCf A ' ( V CJ �� By � P ermit Number: -:,........-7.4,0 6 t h / Legal Description - D-0 - G' 9 - , S 2-9 L ` e " '" 6 C'w e L.w . r /Vo z Parcel # P (v `� (eC7 — CC S .rte ;�`'�' Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ Proposed Work heated/cooled non-heated/cooled /C/ 39 1 Class of Work (circle one): New Addition Alteration Re air 2 i Move Demolition p pool/spa window door Use of existing/proposed structures) (circle one): Commercial : - 'de i • . If an existing structure, is a fire sprinkler system installed? (Circle one): ' es No N A j Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: ( / Property Owner Information: Name: S rev &. F Deb b t=_ c e ( r...�. J Address: 1 '13 G>G' phi �- r~G l, . F , City f� T ic �3e 7iCCr State r-� Zip 31 z 3 Phone _ &iC" - 9� li� see i y E -Mail or Fax # (Optional) y G I e T y t�l � � f1 f1 C � C L -t FILE �� 1 1' Contractor Information: Company Name: ,,' i d i AJ 9 .Lit, cI i, r-t E Qualifying Agent: 3-c 4 L �' (E 1 I F . �,_.: -- '''' Address: Pc 13o ,x e. ,'o Ls Z Cit S a-.-- ,..-f ._ ` . . Office Phone A / 9 l/' 7 & - 7 Job Site/ Contact N State Certification/Registration # C 12 C ( 3 2 7 C + l � 1 - I i ' '' it Architect Name & Phone # CITY OF ATLANTIC BEACH Engineer's Name & Phone # SEE PERMITS FOR ADDITIONAL Fee Simple Title Holder Name and Address REQUIREMENT'S AND eUNv1TIONS. Bonding Company Name and Address l _ Mortgage Lender Name and Address REVIEWED ' `� ► Application is hereby made to obtain a permit to do the work and installations as indicated I certf 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 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 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 cert� that I have read and examined this a placation 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 specif ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or local I regulating construction or the pe>Jormance of construction. Signature of Owner ,i . b '( . l ;. ,) Print Name e ` �te PO i ,` f � �r � � .. lnl"� JOHN KEILE „Il e 01 l� U ` Notary Public - State of Florida Sworn t and subscribed -before me , _ • My Comm. Expires Mar 14, 2015 this ,/ Day of /E t/ • 20 /Z.— :v.! Commission N EE 69452 ° % %l.l, , Bonded Through National Notary Alen. Notary Pub . Signature of Contractor 4.-40. Al PiP Print Name 1< t k l e k e Sworn/te • s • - r ed before me this . of 400.1 , 20/2 - v. .ggrfi�.r�'L! . -e--(* - Notary ' 1 ` * Revised 01.1 r SHIRLEY L. GRAHAM * ' *= MY COMMISSION # DO 957760 , p y o , : EXPIRES: February 14, 2014 A Bonded Thru Notary Public Underwriters VI 2 45 1 I U "7 =0 V 0 E N i p a o la = = ;� a U * s,, .o OA la Q , d � , ,a p J © - 0 v a S aW °.0 es 5 ..... s ca. a al a J O p U o o 4.1 cr, o V - Q fT <j , :- . 7 i B .. � o O O mow f Iri? 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City of Atlantic Beach APPLICATION NUMBER . Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233 -5445 / a 6 �(I� Phone (904) 247 -5826 • Fax (904) 247 -5845 / 5 E -mail: building- dept @coab.us Date routed: / ®a City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /7y e ?Q-7] 9hh I7f i D rtment review required Yes o Buildin Applicant: c T 3 /m / j Planning & Zoning /�� Tree Administrator Project: (ti' /`71 / ¢ ¢ Public Works Public Utilities /a (/2i n r Public Safety Fire Services '' .,44' , : 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: L Approved. ❑Denied. (Circle one.) Comments: BUILDINe PLANNING & ZONING Reviewed by: hi a Date: / ^ ,Z_ TREE ADMIN. Second Review: DApproved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10 NOTICE OF COMMENCEMENT Permit No. Tax Folio No. 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): c) 7 " J C% "e..45: 9i CC erg C (,V( C ` ,c i7 — /z'o 2. a) Street (job) Address: 17 4 3 GC- ft-Li ,477H - wT G f:3 r'tt_ s f f = 1 < 3 2 Z .. 3 2.General description of improvements: L ` I 4 / Sr c/, ,-c r t t , , t�, C(c -c-.; 3.Owner Information a) Name and address: ab rt' b b. ee+''s i ti c-F 3 cc - t' A • 1 C ; i c -c. cJ 2 , , .r Til4 ,1 (-// b) Name and address of fee simple titleholder (if other than owner) fiL 3 ,4 c) Interest in property Pe LI I2e ict- WC e 4.Contractor Information `� z a) Name and address: ,`:�; c l ; w 47 1 rL' c4 5 ; `r ! � y. ' - G 2 y Z c- Try e- b) Telephone No.: Fax No. (Opt.) FT— '3 `2-G c';c; 5.Surety Information a) Name and address: b) Amount of Bond: c) Telephone No.: Fax No. (Opt.) 6.Lender 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.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 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. +L ( 1 )1i/ l Signattu�re of Owner or Owner's Authorized Officer/Director/Partner/Manager 1J- Print Name The foregoing instrument was acknowledged before me this 17 day of " / r , 20 (Z by" L h22G p c, (1 as (type of authority, e.g. officer, trustee, attorney in fact) for (name of party on ' If of w i rument was ex uted). Personally Known " OR Produced Identification ✓ Notary Signature ( . r� _✓ Type of Identification Produced 1 V Name (print) o 14" d « .t .. p� OR Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare tI have read the foregoing and that the facts stated in it are true to the best of my knowledge and belief. FORMSMOC vsd2OIo ' 1 i' �� p JOHN KELLEHER 1 . t i . i f - Si Notary Public -State of Florida Doc # 2012009606, OR BK 15823 Page 2101 My Comm. Expires Mar t4, 2015 A� Commission N EE 69452 1 ''4 I.ta;,, Bonded Through National Notary Assn. JIM FULLER 1 17'2012 CIRCUIT C U I COURT FLE CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00