Permit Windows 2041 Beach 2012 '� if µ'
e , fit z CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
, - -:z r ,. ` " ATLANTIC BEACH, FL 32233
' } ' (� INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000908
Property Address Date 7/19/12
2041 BEACH AVE
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 2700
Application desc
GARAGE DOOR REPLACEMENT
Owner Contractor
BROTMAN SOLOMON G & LESLIE G OVERHEAD DOOR CO. OF JAX
2041 BEACH AVE 6884 PHILIPS PARKWAY DR. N.
ATLANTIC BEACH FL 322335934 JACKSONVILLE FL 32256
(904) 268 -1627
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 65.00 Plan Check Fee 32.50
Issue Date Valuation . . 2700
Expiration Date . . 1/15/13
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 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 65.00 65.00 .00 .00
Plan Check Total 32.50 32.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 101.50 101.50 .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 1' I riLE cop
800 Seminole Road, Atlantic Beach, FL 3223
Office (904) 247 -5826 Fax (904) 247 - 58451 , ., _ , _ q ,
..
Job CJ `t' x ..;�. �«.�.wMf
Address: I
Permit Number: / dam 90e-
Legal Description
co Floor Area of Sq.Ft. Parcel # Sq.Ft
Valuation of Work $ 27610 Proposed Work heated/cooled
non-heated/cooled
Class of Work (circle one): New Addition Alteration Repai Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure, is a fire s e rinkler system installed? (Circle one): Yes No N /A
Florida Product Approval # „, ,_ i, -'
For multiple products use pro ' uct approva orm
Describe in detail the type of work to be performed:714 `
Property Owner / Informatio n: p
Name: Q 2 is 7` Address: &) /
City /` A . /7 , 4., - 7Z___
e - Stat Zip r Z & 37 Phone Br �j L� / & Be_
E -Mail or Fax # (Optiona) e T 9 9� `Z 9
Contractor Information: /
Company /L fc�An/ ,�
am �US Qtl ,�
Address . r . n D ' dike/4 /t ing AgenalM/ '/�'� /4 ,L1u , .,.
, // � 4 ' r Cit }�. �Ick f - or✓t/. /1 1.
State f ip S
Office Phone
Job Site/ Contact .: — - - - -__
DOW. State Certification/Registration # D "I t ! , ! t r I
Architect Name & Phone # , •
Engineer's Name & Phone # 1 j • ,il: , , i _ , ir - :
Fee Simple Title Holder Name and Address - -- .• . ,� s.,
Bonding Company Name and Address " - _ ` "`• " �e 4- ; ,
Mortgage Lender Name and Address
�. r: w
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify t at no wor or insta a ion as 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 aperiod 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, 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.
I hereby ertify that 1 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 authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
xf_ j___________ A__ ,
Vignature of Owner (.. "'
Signature of cgiatt<fr 11 4P
All
Print Name n tt 11ii11! 0# — •
2 , a ; ,'„ Print Name
Swo • O • • . ' � S SION oc ¢ ''•.„ . , \ . A tl/.gt rr r
r r} su. • eed • . • 7 _ ,:r p r9 ; � A, Lgw r rr r
this / • o - _ 1. I LO i SwornC{ nd sub,*-,;: �' ?
;.1�� `' r this !ay o_ , t ' %. _ 20 ...
Notary Publ' �� , • '' '
'i".? aonde4 ' . ;• �O`r l 99306 ' a/
f • •• , '$ �\ .,• ed 01.26.10
.+. m rf � // ` I i iHt 4 1ti • V+q� 1
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Doc # 201 21 5061 4, OR BK 16004 Page 2023,
Number Pages: 1
NOTICE OF COMMENCEMENT Recorded 0771 i'at �f2 4cy M
1 ^ ..,.a.....,, ,, , m
JiM FULLER C
COUNTY I 4 °
Permit No. Q�' RECORDING 1 .Ot J L E C ,ii
Tax Folio No.
t
THE UNDERSIGNED hereby i.,
. max,..
713.13 of the Florida Statutes, the following information is prov d d in this NOT IC n OF 1 COMMENCEMENT.
property, and in accordance with Section
1 .Description of property (legal description): /
a) Street (fob) Address: l r /(
2.General description of improvements:
3.0wner Information
a) Name and address: 00 < ; it n, .- - n
b) Name and address of fee simple titleholder (if other than owner) C ,
c) Interest in property
4.Contractor Information
a) Name
and address. L , G) <t �,, /.,', . � 7: , ; 4 a, l t • ' , F t r� / /7 7 �E L-4 )-t} Jr' li '
b) Telephone No.: _ �j i (: 4 r ;. r ;32 z_, r 4,
S.Surety information ( ' ' ° Fax No. (Opt.) " r r'
a) Name and address:
b) Amount of Bond:
c) Telephone No.:
6.Lender Fax No. (Opt.)
a) Name and address:
m 7. Identity of person within the State of Florida designated by owner upon whomnotices or other document may b e served:
a) Name and address:
b) Telephone No.:
8.In addition to himself, owner designates the followin Fax No. (Opt.)
713.13(1)(b), Florida Statutes: g person to receive a copy of the Lienor's Notice as provided in Section •
a) Name and address:
b) Telephone No.:
9.Expiration date of Notice of Commencement (the expiration date is one year from th 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 COMMENC . MEN
STATE OF FLORIDA - (!
COUNTY OFPINEL.LAS
10. ( —
Signature o Owner or Owner's Authorized Officer/Director/Partner/Manager
, .7.) r.� 4,,. ,./ ( � ' ,),O ? -1
Print Name
The for- ing instrument was acknowledged before me thisk day of 204‘2,.by
r ° (type of authority, e.g. officer, trustee,
attorney in fact) for _
(name of party o half of whom instr me as executed).
Personally Known R Produced I ����'\16 �N /�rArs; ,,,, y
�' i ; n " r f Notary Signature �/ _C� ��C. -,/� ---�'
c, • \ON I' • '' ''....0 LG/< /
Type of Identification Produced O g� me 18, 20 � t
. m — 4�arne (print) f/`
• ,_ .m
Verification pursuant to Section 92.51_, Flbnda St
1Lrtalties of perjury,l declare that I have read the foregoing and that
the facts stated in it are true to the besrtf-tngc.kno l dlp�^ ??
A ��
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FOR7.1S/NrJC.t}:sd2b10 /r /r /!l'/ /PI B ! i C 4 � \` Si�,a!;a ot'Naturaf Person Si min
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1 City of Atlantic Beach - - -- - - -_. --
f -
Building Department
o APPLICATION NUMBER
, �N g partment
/t 800 Seminole Road (t be assigned by the Builoaing Department)
?' Atlantic Beach, Florida 32233 -5445 /Z 9�
�" ' Phone (904) 247 -5826 • Fax (904) 247 -5845 /
� E -mail: bUU ng•deptOcoab.us Date muted:
i web -site: uteri: Mr
City httpalwWrw.coab.us ammo'
APPLICATION REVIEW AND TRACKING FORM
Property Address: c2 7O & A N AL ent review uired
6 Y G rA. E, — DQ a 1° . re9 Y No
Applicant: _ uiidin
- in g &Zoning
Tree Administrator
Project: — /, �_N_ �, i • ,/ i., 1 Public Works
Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required of Permit Verified By Date Review or Receipt
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
� y Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
Reviewing Department First Review: Approved.
(Circle one.) Comments: ❑Denied.
BU LDING
PLANNING & ZONING
Reviewed by: fr 7 Date: 7
TREE ADMIN. 1
Second Review:
[]Approved as revised. []Den': • .
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied.
Comments:
I Reviewed by: Date:
Revised 07127110