Permit Window 156 Belvedere 2012 , 'I CITY OF ATLANTIC BEACH
A s) 800 SEMINOLE ROAD
J = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
- 1 ' 74 J 1 �%
Application Number 12- 00000249 Date 3/06/12
Property Address 156 BELVEDERE ST
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 3357
Application desc
REPLACE 3 WINDOWS
Owner Contractor
DOWNING GERALD M MIRACLE WINDOW AND SUNROOMS
156 BELVEDERE INC
ATLANTIC BEACH FL 322334107 8933 WESTERN WAY # 11
JACKSONVILLE FL 32256
(904) 363 -8319
- -- Structure Information 000 000 REPLACING 3 WINDOWS
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 70.00 Plan Check Fee . . 35.00
Issue Date . . . Valuation . . . . 3357
Expiration Date . 9/02/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 1 to I C I f e e , , � Q . ' hC t; Permit Number: / 2 — o 9
Legal Description 19 - i ° YIE..,°ai , ' - ' ! N (-I ` - rj Parcel #
F loor Area of Sq .F k i t. Sq.F't
Valuation of Work $ ?)5 ° 90 Proposed Work heated /cooled 11 10 non - heated /cooled 32-0
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window / door
Use of existing/proposed structure(s) (circle one): Commercial Ciesidential
If an existing structure, is a fire sprinkler system installed? (Circle one . • - 1 o N /A
Florida Product Approval # 1114 13 . g
For multiple products use product approval form �/►
Describe in detail the type of work to be performed: f'l k1 C. ` hree L 3 ) v ► MOWS '
b i2TC Cb( 61 2_e
Property Owner Information:
Name: C:Fer �o10t - N ‘ Address: 1510 C Y U
e -e-f�f- .61--- City N `Cl 1 G eye .(Th State'L Zip 30,931 33 Phone qo L( —,.3S — ,'573 a�
E -Mail or Fax # (Optional)
Contractor Information: Thomas Lloyd Lic # CGC1514481
Miracle Windows And Sunrooms Inc
Company Name: 8933 Western Way, #11 Jacksonville FL 32256 ying Agent:
Address: Phone: 904- 363 -8319 — Fax 904 - 363 -8320 Zip
Office Phone tracyyost6 @gmail.co F. 4 0 r�
State Certification/Registratic
l / / .
Architect Name & Phone # ! • a "ul°°"M`"""E °'`'4"'Y",.""" "^^ 4
wasiggrwism
Engineer's Name & Phone # 2" ' 0 IN
Fee Simple Title Holder Name and Address 11.111111 - t • V/
Bonding Company Name and Address i= � .
. W o r n i gimmui ll Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. / crtirrat 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. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, urnaces, Bo 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 certify that 1 have read and examined thisplication 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 authority to violate or cancel the
provisio of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner �,,` _,e--t /��' �3'I a z�ru - "� Signature of Contractor at ..--.'21--4,---
Print Name 6294- 0 7, t w N / Ai 6- Print Name -- wo . mas uoy a
Swo to and subs ed before me Swo t and subs ri • ed before me
this,., , Day of �G bftic , 201g, thi Day of ►.. of CL\ , 20 \D—
i /
Notary ' ublic r" i�� ; i; .,, T RACY S. YOST No ry Pu. is q„
� k t �,�Y
'4 ;,- Commission # DD 8437
TRACY S. YOST
mission # DD 843798
p iles M arch 22, 2013 •, ;
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F PM lneunnc. �^1e 7018 ' ; ;° 22, 2013
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Doc # 2012038816, OR BK 15858 Page 2224, Number Pages: 1,, Recorded
02/23/2012 at 03:12 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING
$10.00
Permit l' - 0 9 LER
Folio No.
• NOTICE OF COMMENCEMENT'
State. of - yr ii,ri. .._.
County of_ +
The undersigned hereby give; notice that improvement will he rnade" to r,ertain real property, rand In accordance
with f'haptei 713, Florida Statutes, the following information is provided in this Notice of Cominencr'.rnent.
1.. Description of property: (legal dest:ription of t he :vcoerty. anct.treet. addrt>tz if availat:le
1 — 1 :At5 . :. &U ( &C.. 1 1\1 45 FT T 5q, 5 l -1- Lot 563
2, Gener'ai description of improvement :' /1. 1 _ y t r't�.f' L i r
3. Owner information: r Yl 1�t l C* yt :! .:�_ Jt c� � 1 t "�l
a_ Name and address: t r� , , t
b'. Interest in property: lt , 11CV 'A'! ._.. 6e0L — . r i 1 f(..._. JA:0.?..Z - - 1 1 0 �
c, Name and address of fee simple titUi hotter (it otter t.tun ow +,rrt
Thomas Lloyd Lic # CGC1514481
4. Contractor: a, Contractor name and address: Miracle Windows And Sunrooms Inc
8933 Western Way, #11 Jacksonville FL 32256
b. Contractor's Phone number: Phone: 904 - 363.8319 — Fax 904- 363 -8320
5. Surety a. Surety rtarne and address: tracyyost6 @gmail.com
h. Phone number:
c. Amount of bond:
fi, Lender: a. Lender name and address:
b. Lender's phone number:
7. a. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as
provided by Section 113_i.(1)(a)7., Florida Statutes; (mire and attires} .
b_ Phone numbers of designated persons:
8, a- In addition to himse(f or herself, Owner designates ___.__...__.w..__._._. of __________ to receive a cony of the
Lfenor's notice as provided in Section 7Z__13(1)(b), Florida Statutes.
b. Phone number of person or entity designated by owner:
$, Expiration date of notice of commencement (the expiration date is 1 year from the date* of recording unless a different
date is specified): ____________
WARNING TO OWNER: ANY PAYMENTS MADE BY TiiE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713,13, FLORIDA STATUTE'S, AND CAN
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUSE" BE
RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION, IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LE vF)FR OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCEMENT.
Y
S �� "- I i wmn or f writ'+ A artrtort e:S OO erIOirec.tin/Partraerirdana
+ (tQr'a± +x'8 _ _ g£rl Ofgnatnry's Tttteictftice) .. _
C
. The foregoing instrument was acknowte�dged before me thi _ day O _ _ ? . r by d--k . >< , _,_ - �E r
(Year) !Warn u 1 rwr son!
as .._.. __. _ ___._ .....__._._�. _.. for
of authority. ,V, o'fv;er, truttcr, , attorney in tact) !name of party on behalf of when) lrtstnurerd was executes()
( ty Ct t tl of Notary 'b - 5ta eof Fiurida). __._.. ,, -„ �.w�wa, - -� - .
. � : , 4;'. TRACY S. Y05
Pt rsonatly known ___ ()R Proclu ed Identifirlltion _ =' I ; :ry t r omml5sion # DD $4379$
Fvpe of identification Produced _ ..._... -. N
FX trPs March 22, 2013
-. _.........._,__.._.... ? ". atrt ymmr r.ri Fdn IMAM. AP00485-701B
` ✓trifh;atttin pursuant to Section 9Z525. Florida Statutes.
Under penal es of perjury, I declare thet l Kaye read the forr_+v g d that the facts stated ill it are true to the best of my
�411tJY ✓lr. Sfgt': and belief. ` i J t -j / /// '
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;:tft Product Approval
USER: Public User
Corrsrnunit y s .
Affairs �. P[4dStfLFR7C2'r�!Merv� a P:O�V . 2!14?Rlirel! 47J. S �drG h . ? MRi1zeLloq IJ it > Application Detail
Code F ) ; `s{l th ;` FL # F111413 -R0
8 1.0.4 � r.`awitA4 w Application Type New
F i tZt R'" '
� . 5, r' f Coe Version
s > ,.c :kzl" 2007
I: ?r + a:. Application Status Approved
f< . t =r Comments
O ,i'f t4 "cif P p FA Archived
Product Manufacturer Regency Plus Incorporated
Address /Phone /Email 2000 Locust Gap Highway
Mount Carmel, PA 17851
(570) 339 -3374
joek@window- pros.info
Authorized Signature Joe Korzeniecki
joek@window-pros.info
Technical Representative
Address /Phone /Email
Quality Assurance Representative
Address /Phone /Email
Category Windows
Subcategory Double Hung
Compliance Method Certification Mark or Listing
Certification Agency National Accreditation & Management Institute,
Validated By Rene J.Quiroga, PE
Validation Checklist - Hardcopy Received
Referenced Standard and Year (of Standard) st ndar4 Mar.
AAMA/NW WDA7.01 /I.S.2 -97 1997
TAS 201 1994
TAS 202 1994
TAS 203 1994
Equivalence of Product Standards
Certified By
, 41 , 4 4\ ^'.St 43M N'YfT ^ t�gM�K.S\P RW:iHPW+Y!7"".^
Product Approval Method Method 1 Option A .. FILE CO p
Date Submitted 09/15/2008
n. 1,>a a er :k a w., .. , „„� - •
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