Permit Doors 1605 Beach Ave 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001508 Date 10/19/12
Property Address . . . . . . 1605 BEACH AVE
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 28000
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Application desc
door replacement
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Owner Contractor
------------------------ ------------------------
KELLY PATRICK ACE DOOR & WINDOW SERVICE
P.O. BOX 55095 9123 HARE AVENUE
JACKSONVILLE FL 322160095 QA VICTOR AVERILL HALE
JACKSONVILLE FL 32211
(904) 727-6811
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 190 . 00 Plan Check Fee 95 . 00
Issue Date . . . . Valuation . . . . 28000
Expiration Date . . 4/17/13
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Special Notes and Comments
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 85
STATE DBPR SURCHARGE 2 . 85
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 190 . 00 190 . 00 . 00 . 00
Plan Check Total 95 . 00 95 . 00 . 00 . 00
Other Fee Total 5 . 70 5 . 70 . 00 . 00
Grand Total 290 . 70 290 . 70 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WIT" ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department)
800 Seminole Road __67
Atlantic Beach, Florida 32233-5445
A;2
Phone(904)247-5&6 - Fax(W4)247-6845
E-mail: building-dept(Mcoab-us Date routed:
City web-site: http:/twww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: A-1 _Department review required Yesoo, No
Building
Applicant: Al /D 0 10 , ing&Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept.of Environmental Protection of Permit Verified By
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: EfA"'pproved. nDenied.
(Circle one.) Comments:
PLANNING&ZONING Reviewed by: /W cle— Date:16 26F_/z
0q
TREE ADMIN. Second Review: FlApproved as revised. E]D e n4e/d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised 07/27110
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5945
Permit Number
Job Address:
Legal Description nAQ kQtParcel#
Floor Area of Sq.PI. Sq*Ft
Valuation of Work$-J�J�� Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa �Er �wldoqr__-
sting/proposed structureQ) (circle one�l: Co esi
Use of exi� er
s m nstalle /A
If an existing structure,is a installe ircle one): e
Florida Product Approval 4 k
prov 0
For multiple products use product approva orm
nf.rfnrm
Describe in detail the type of work to be performed: X _1
.........
LProperty Owner Information: CO P Y
'Nam Address:��10�7)
city Stat��Zipt�Phone. -�C-,k-��- -6qk-�-
E-Mail or Fax# (Optional)
Contractor Information: 61c�: Qualif i g A
Name: yin gent: Jw_kT_-� ":.�\�P_
c ie ame 0
r-AFLANTIC
Engineer's Name&Phone#
—ERMIINFORADD
Fee Simple Title Holder Name and Address REQUjpEM&M,1
Bonding Company Name and Address EVIEWEDBY , 'ITIONS
Mortgage LenderName and Addr;,%s' jjju'h:�t-7-6- 2-
nenced prior to the
ction in thisjuris 1
is �rmit becomes null
hs fter
oM.ene on, �on w is nedforaperiodo sixg Mont ata
time a
its Z, ugns, Mells,Ponly urnaces, no Heaters,
c.,e,or�,c�c
Tanks andAir Con(fitioners,eta
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 FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby cerofy that I have read and axamined this application and know the same to be true and correct. All provisions�f 1,ls�,nd, ordinances governing this
type of work will be coTplied with whether speciffed herein or not. The granting of a permit does not.presume to giv authority to violate or cancel tht.,
provisions of any otherfederal,state, or local law regulating construction or the pe�formance of construction.
Signature of Owner Signature of Co;ntrac r
12 Print Name lc�
Print Name ...................
...................................... ...........t4l()........................ .................. ..................................................
Sworn to and subsc-�11 1—c—�-W and subs be re me
this Q f v-z,
< this of 20
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j Notary ublic
Notary Public
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n0Md40Wd!== 1 .1 , rli.u il#DD849274
BONI) B MING CO..INQ
NOTICE OF COMMENCEMENT FILE COPY
Permit No. Tax Fell I
I � I —
State of Florida, County of Duval
]"l IE UNDFRSICTNIED herchy give notice that(lie improvement%vill be made to certain real property in accordance with
Cl)jptei 713,Florida Statutes,the followina information is provided in this Notice of'CommencCinent.
I. De�cription ofproperty(legal description orproperty and address ifavailable):
cy-1 t��
General Description ofirnprovements:
3. Owncr Information:
a)Name and Addi
b) Interest in property: -j
d Name arid address ofsirnple titleholder(if other than owner):
4. Contractor J11formatio
a)Name and Addres I ctvu-5
b)Phone Number:
5. Surety Information:
a)Name and Address-
§ b)Plione Number:
C)A -f-5.�d:
6. Lender Information:
m W
CL 0 a)Name and Address:
"T :�0 h)Phone Number:
0 CL 0
7) 7. Peison within the State of Florida designated by owner upon xhom notices or other documents may be served as
2 provided by 713.13 (1)(a)7,Florida Statutes:
Co —
W %0 a)Narne arid Address:
0 C'4 b) Phone Numbers of Designated Person:,
6— S. In a ddition to himself/herself,Owner desi-nates of— to receive
- a. copy n C the Licnor's Notice as provided'in Section 7 1113(1)(b),Florida Statutes.
N mi3 W (D
N m Uj Z a)Name and Address:
�� --ji r R b) Phone Number of person or entity designated by owner:
.8'2 Z)z 0 0
E 0 u-=,C-) 9 Expiration date of Notice of Commencement(The expiration date is one(1)yea-r fi-om the date of Recordin�unless a
0 = 0�0 Uj
0 z W=3 0 W diffierent 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
1, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IN411ROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFOPE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FFNANCING,
CONISULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COINVLMENCING WORK OR RECORDING
YOUR NOTICE 0 CEMENT.
Signature of'O�xncr or 0101r's Authorized Officer/O�rector/Partiier�Maiiager Signatory's Printed NarnATitle/office
The [`orcgoin� instrument was ack-nowled-ed before nic this—day o f SR 20 lol—by
4�"")-Af6
as for
(Mmic of Pul s011) (.,%uthority Type,i e Officei/Attoi ney) (Name of"Paity Instiumcm was Executed for)
CHERYL BOYKINII NOTARY NJ21-0C, STATF-VOF FLOf ID
-4 MY, *
-.116 COMMINION060100
P] t,
&WOOM, SJ*26,20iG
117crsonally Known
F Identification/Type:
V�:ril�catimi pm-sunnt m Section 92.-�2-5. Ronda Statutes. Undet pc�naltics ofpcijury. I declare that I ha�,c 1-cad the
and that flic lacts statcd in it are truc to thc bcst ot'my'Know1cdLe and belief
S 111i"';atur ol'Mtuia �rson
Rmiscd 10/1,2009