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Permit Windows/doors 2041 Beach Ave 2012 r ` u CITY OF ATLANTIC BEACH s) 800 SEMINOLE ROAD 4 " -% 14 ,„ u� � ""' ATLANTIC BEACH, FL 32233 ss 's ! INSPECTION PHONE LINE 247 -5814 . ( sj >' , Application Number 12- 00000171 Date 2/13/12 Property Address 2041 BEACH AVE Application type description WINDOW AND /OR DOOR Property Zoning TO BE UPDATED Application valuation . . . 25500 Application desc window and door replacement Owner Contractor BROTMAN, LESLIE W. K.E. SCOTT SYSTEMS INC 2041 BEACH AVENUE 225 BRAUSCOMB RD ATLANTIC BEACH FL 32233 GREEN COVE SPRINGS FL 32043 (904) 282 -4445 - -- Structure Information 000 000 WINDOW AND DOOR REPLACEMENT Permit WINDOW AND /OR DOOR PERMIT Additional desc . Permit Fee . . . 180.00 Plan Check Fee . . 90.00 Issue Date . . . Valuation . . . . 25500 Expiration Date . 8/11/12 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 2.70 STATE DBPR SURCHARGE 2.70 Fee summary Charged Paid Credited Due Permit Fee Total 180.00 180.00 .00 .00 Plan Check Total 90.00 90.00 .00 .00 Other Fee Total 5.40 5.40 .00 .00 Grand Total 275.40 275.40 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Feb.10.2012 09:52 AM K. E. Scott Systems Inc. 904 291 8062 PAGE. 2/ 2 Doc # 2012030578. OR 8K 15849 Page 764, N umb P 1 R ecorded 02,13' 12, NOTICE OF COMMENCEMENT J$ M FULLER ages: CLERK 2012 CIRCUIT at 24 C DUVAL COUNTY RECORDING $10.00 State of l \( Y ' . c:__ t'. Tax Folio County of \ ) C i\J c To Whom It May Concern: The tmdersigned 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: 9.2,,'. ' A/ At 4A.7; c �QM+.d UJ✓• 3 r i RE ' /b 9 7 // 4040 _ .. Address of property being improved: AO yit t SeA t A. 1q u P General description of improvements: /00i/Ate / «p d ttp Q a ed j,. C # A•''4' d. st, s Owner: , DA. S / 4i20��lAwJ Address: 0 t +'J &4C.} AVE _ .. Owner's interest in site of the improvement: ., O 1/,APR - Fee Simple Titleholder (if other than owner): Name: Contractor. 4,06- _Sce7f ' $y r »,y Address: _ _ ,L • i 4/ e - . L - F 320 fy Telephone No.: co ii) A0a - vie VJr- Fax No: (9 49) e2.91 — 80 62. Surety (if any) Address: Amount of Bond $ •�__ . ,._ Telephone No: • Fax No: Name and address of any person maidng 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 whore notices or other documents may be served: Name: Address: Telephone 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 Statues. (Fill in at Owner's option) Name: Address: Telephone 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): THIS SPACE FOR RECORDER'S USE ONLY OWNER ,-, �� signed: Date: c�7 /. c A - L. Before me this t 4� day of 1.�7 „ KATHY AVADIKIAN Of Florida, has personally y the County of Duval, State ,,,, Pe Y aPPe c J �- v R� e4('''' Notary Public at Large, State of Florida, County of Duval. 0 -,, t, Notary P ublic •State of Florida -- My Commiss Exp Feb 11, 2012 My cyrntnisston facpires '_) t t >. 1 }, N -�., o,_ Commission # 00 757347 sonall �►. " Or . ''' ", ,°;,;" Bonded Through National Notary Assn. Produced ldentiflcation: f y r , • s `r 141),",. City of Atlantic Beach APPLICATION NUMBER Building Department „ .n� (To be assigned by the Building Department.) 800 Seminole Road / .5 Atlantic Beach, Florida 32233 -5445 /c2 '` ° Phone (904) 247 -5826 • Fax (904) 247 -5845 1.;;:'; p. E -mail: building- dept @coab.us Date routed: 01 9 fc City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 7 Lt Department review required Ye o Building) V Applicant: k k• Jeer ,:::, ,`71 "77r Planning & Zoning l/ Tree Administrator Project: 1 ed £ `4 a) 1 Q 6L)s Public Works q f �C �L � � � Public Utilities Public Safety Fire Services a ,n '< a r, s� ,h, �' �-` ,�"d � � 4� �� E � i a r �� ' Ir �1i6 �-�Ilhi �� ? � � 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: roved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: - -` '71 Date: e1 - /C2^/2- TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10 Feb.06.2012 08:18 PM K. E. Scott Systems Inc. 904 291 8062 PAGE. 1/ 1 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 10 @ u LI i? 800 Seminole Road, Atlantic Beach, FL 32233 t_ Office (904) 247 -5826 Fax (904) 247 -5845 111 FEB 0 9 2112 Job Address: 2t '/ , P,l C A R ve Permit Num e Legal Description 9 -.lc -40 ,/►(,¢T i� �C{ (�ln,,t *.1 PT P arcel # /697 // - O Dp p Valuation of Work $ .25; ,rdD Floor Area work h eate Sq.kt Proposed heated/cooled non-heated/cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa indow /doo Use of existing/proposed structure(s) (circle one): Commercial esid , j]� If an existing structure, is a fires , rinider system installed? (Circle one): es o N /A `� �/ Florida Product Approval #. ° 1 • For multiple products use pr .uc�app , va orm ©� Describe in detail the type of work to be performed: / [ e' /Are 2 day `/r d Q gjt 'ro rty Owner Information: Name: PR. Co / 0/7A AO 4e/ ..8eAcI„ /41,ie City ___� . o4Y J .,, Tee: Berme 4 Statea_Zip T1? 43 Phone .. E -Mail or Fax # (Optional) , _ Contractor Information: i �-- Company Name: /"l 7/ ,,C 77 c Qualifying Agent: A i dram Address: a . _ CI .Sty+ Office Phone X0 y 9ti'1' Job Sit . . tj - , • = - . State _ Zip _720 Y3 State Certification/Registration # ' /U.:tKI t��j (SjI ) ��i(S ) J ' au Architect Name 8t Phone # , ' �"' , 1 `` ) xKlh� 1 +� k t ►�i . .. , �VUUtI %a af�t3vT.Taii�; —vow M,?#71 Engineer's Name 8c Phone # 1 . Fee Simple Title Holder Name and Address M " = • - , Bonding Company Name and Address - YY �. ,,,� , l' Fly Mortgage Lender Name and Address I + ' L eta __ _ Application is herey made to obtain a permit to do the w• „ +7 --"."7. �' has . commenced . t o the .,.,,,. • issuance ofa permit and that all work will be pe ormed to meet the standards o all laws regulating s i th has' commenced prio s o the and void {work is not commenced within six (6) months or if construction or work is sn abet' abandoned f a his jurisdiction. o 6) This at any time after work Ls caramelised. l understand that se permit become null Tanks and 4fr Conditioners, etc parnts permits must be secured fir Lfeemen/ Work, Plumbing. Sigma Wells, Pooh Pkrnaces, Boilers, F/ta/ers. 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. I hereby certify that l have read and examined this plication and know the same to be true and correct, All provisions of laws and ordinances governing this type of work will he complied with whether specified construction granting of a permit does not pre:wne to give authority to violate or cancel the provision: *forty other federal. state, or focal law re performance ofconstructlon. Signature of Owner ��`'� ... _ r Signature of Contractor / 1 Print Name t�C Oltt0/� 4 i'EO/ZG'(_ -' ;8 ©t HA/ /C ` • .............. �. ..:...::••.•.::.. _.:_ .._......_.. Print Name �. o and subscri. . b - fore me Sworn to and subscribed before me this Day o r...--' s ,201& V64 _._ �' this , Day of �,� .�� 20 t ‘44 Notary Publi •e (2? a►�" "G4 Notary Public State d Florida ; sI ''.. JESSICA ENNIS Jana L Romer 1 s Notary Public - State of Aoi�lg 01.26.10 or I My xp Com hes 0 312 0/2 mission 01 5 y , EE0758e8 A *Comm. Expires Nov 17, 2014 n E �. I #,: Commission 0 EE 42890 0