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1965-1969 Seminole Rd (vault) PSR-3844 13571 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH -- -- PERMIT INFORMATION --- - ------ - LOCATION INFORMATI013 _ _ ___ Permit Number : 13571 Address : 1969 seminole rd . Permit Type:WELL ATLANTIC BEACH , FLORIDA 3221-- " :lass of Work :NEW -------- LEGAL DES+�RIPTION ------- Constr . Type:WOOD FRAME Block : Lot : Twp : Proposed Use: SINGLE FAMILY Section : 0 Subd: Rnq : Dwellings : 0 Subdivision: Est . Value: 0 . 00 Improv . Cost : 0 .00 Total Fees : 10 .00 Amount Paid: 10 . 00 APPLICATION FEES Name: 'ioe mccan PERMIT 10 . 00 Addr : 1y69 semir;ole rd . ATLANTIC EEA''H . FLORI1 A ? FhonB Q-1-j4 ; . ;`1' 67 - - - - - CON'T'F.ACTOR INFORMATION Name; L.N. WILLIAMS Ad d t L i cExp , Type. NOTES: NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS." ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT M." $10.00 A TLICAMN FOR WELL PERMIT CITY OF A27_1NTIC BFAQi PROPERTY 944 R tame: To � 171 < e-qA.'.y Day Phare ZYy 7 96 7 Address c� 6 Cl 5 > i.v /rte /?c Zip 3z z 33 APPLICANT, IF MER THAN OWNER Name: Day Phone? Y/- Y�9 Address: ! . Q Zip ,?3 a JOB Address or Location: Z el Legal Description: Is well to be used for drinking purposes? J,/n Any Person, individual, corporation or other entity receiving a permdt as provided in Section 22-40 of the Atlantic Beach Code, and who plans to use water from the permitted well for drinking purposes, must first obtain a bacteriological test report from.the State of Florida Health Department, furnishing a certified copy thereof to the building department of the City of Atlantic Beach. A certificate of occupancy will not be issued until said report is on file with the building department, Department Notes: p PDQ Oki I'agree to comply with regulations stated herein: 2- aLghat=e to PSR-3844 12180 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ----- PERMIT INFORMATION ---- ------ LOCATION INFORMATION - Permit Number : 12180 Address : 1969 SEMINOLE ROAD Permit Type:MECHANICAL ATLANTIC BEACH, FLORIDA 32233 Class of Work:ALTERATION ---------- LEGAL DESCRIPTION --------- Constr . Type:WOOD FRAME Block: Lot : Twp: Proposed Use : SINGLE FAMILY Section: 0 Subd: Rna* Dwellings : 0 Subdivision: Est . Value: 0 .00 Improv . Cost,: 0 .00 Total F- d, 41 . 00 41 . 00 e c 1,c4kLK t; , N :'LASER AN r A?F F A N D L A-TION ------ APPLICATION FEES --- - Name PERMIT 41 .00 Addr ,.- N�LE �OAD a& BtA H " FLORIDA : `' PhoriQ ( Ori CO#j TRA, I FORMAT 10N ------ N Addr : 10947 B BLVD. 6 L MH � NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT ANfij$WB�jF2 /T36TQjREV%6TIJb R VIOLATION OF APPLICABLE PROVISIONS OF LAW. CHECKS 18892 ATLANTIC BEACH BUILDING DEPARTMENT By: BUILDING,:''AND ZONING' INSPECTION DIVISION CITY OF ATLANTIC BEACH :.ATLANTIC UZACH, FLORIDA 32233 4� APPLICATION ,FOR MECHANICAL PERMIT CALL-IN NUMBER F�_c IMPORTANT Applicant to complete all items in sections I, II, III, and IV, s#r et AddrollOIn#�rsecf(ng $treets$ sot.-son And BUILDING., Subdivision ' Il.``'IDENTIFICATION To be completed by all applicants. t: In cont(duetion :of permit given for.doling the work as described in the above titetoment we hereby agree to perform said work In accordance with the.'ettechOd'plans and specifications which ere a port hereof and in accordance with the City of Jacksonville ordinances and stondords of good.prectia listed thereto, Neme'of Meohenical {(ttp [[ Contrecfors Master Confreclor (Print) •'_ '(k1L�+:1�� s 1 Nan;I of 1 hoperty Owner N. r Signature of Owner , Signature of or:Aulhorisadr)�gent /� 'r Architect or Engineer III.. "-GENHtAL'INFORMATION,;:;•-` A; .Type o be fuel: ,f . IS OTHER CONSTRUCTION 0 ING DONE ON 6+ctnc I .jj THIS BUILDING OR SITET P Gaa=o lP Q Netunl 7..Q Central Utility Q Oil4. IF YES, GIVE NUt.10ER of CONSTRUCTION N PERMIT Q. Other seedy :;: IV, MICHAN"-EQUIiMENT TO`IE INSTALLE0 ali list of cam •� w,, NATURE OF-WORK irovlde cam t r.( P poneph.on brick of this form) -moi Residential or C7 Commercial lteat. ❑ Space. �Q Racessdd •C_6enfr4l O Floor Cl Now Building .-Jr Conditioning ❑ Room C3�Centnl �Isling Building f� O DuctySyshm: Mahrial' Thicknau j2-1topiacomont of oxisting systom i ". YMaYimum eepectFy e.f.m. CI Now Installation(No systom provious)y Inslallod) � ._._ ❑ . -xlonslon or add-on to oxlsting syslorn Q Refrigeration, 7. � 0 Othor- Spoclly Q Cooling lower$ Capacity Q Fin'spnnklsn$'Number. of hgod� i O Hevelor Q. Meplift Q Escalator (number) THIS StACE FOR OFFICE USE ONLY Q Gasoline Pum; (number) ( I D rTankr Remarks Q `lJ'G containoH (number) 0 ',Unflnd pr•ssun veael;'�:., Q' iollen' Petmii Approved by Date Q ,Other SPadty Permit Fee 7 EST-ALL EQUIPMENT _ C.ONDITIOMNG AND;REFRIGERATION EQQiPbiENT rcc11. .' `NumbarVniti DeiarlDtlon Mod#1Xwnber Manufacturer c(Tons)Y App y �. ,;,:.,b•r:,. ,., . :4 ori j�ft, �, .,t,t.';r,, F�r1,tE11TIPiGy�1^FURNACFSII30ILER.S;BIREPIrACE$ . 0- CITY OF Bim_ ' Office Of Building Official REQUEST FOR 1 NSPECTION Date 56 Time ------ Received —Received A.M. 4\ Permit No. ---------- Job — Job A Owner's � Name BUILDING --Contractor CONCRETE ELECTRICAL Framing PLUMBING I Re Roofing Footing CHAN![`A Slab Rough Wiring G Rough Insulation — Temp Pole L!n;el Final C Top Out C Heating r Sewer C Fire Place READY FOR INSPECTION Pre Fab on. � Tues. Wed. Thurs. Friday_ Inspection Made JIMr r� A.M. Inspector ___ _ __PM. Final Inspection 1 Certificate of Occupancy r Date �G } CITY OF oqL 2 / #J 3 3 'Office of Building Official � REQUEST FOR INSPECTION Date Time Permit No. -1L�1� Received J�' o A.M. -----_P.M. J b Address G�t � ' Owner's Locality Name BUILDING --Contractor CONCRETE ^ Framing ELECTRICAL PLUMBING Re Roofing Footing - MECHANICq� Insulation Slab Rough Wiring Tem pole Rough _ Lintel Final C. Top Out r Air Cond. d >i, Sewer _ Heating Fire Place 0 Mon. READ fl INSPECTION Pre Fab Tues Wed' Thurs. Friday A.M. nspectior, 41ade — --- --- ., /__PM. -------PM. ------ ----_ — Final Inspection Certificate of Occupancy C' Date 000850 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT ifil°'ORMATTON LOCATION INFORMATION - - Permit Number : 850 A.ii,fl-ess; 1965 SEMINOLE ROAD Permit Type: WELL ATLANTIC BEACH, FLORIDA Class of Work; ADDITION LEGAL DESCRIPTION -58 Constr. Type: N/A Lot : �& Blocks Section: Proposed Use: OTHER plat Book: Page- 0 Subdivision: BEACHSIDE Dwellings= 0 Code: 0 $0. 00 OWNER INFORMATION Estimated Value: Nm ae: JAMES MATEJA p Imrov. coats $0. 00 Total Feeftz $10. 00 Address: 1965 SEMINOLE ROAD Amount Paid; $10. 00 ATLANTIC BEACH, FLORT11A 1 2 2- Paid- 5/'24/89 Phone: (904)247-3421 on p& *ES ONLY WEL[ FOR ! RRIGAT1 i',)NTP,' ..r ' ­­_ APPLICATION FEES F,P(jPFRTY OWNF�,, PERMIT $10. 00 WATER IMPACT FEE $0. 00 SEWER 1"PACT FIFE 00. 00 WATER METER $0. 00 RAD014 GAS- II. R. $0. 01 RADON GAS - 5% sc�fjq WATER TAP $0. 00 SEWER TAP soopq HYDRAULIC SHARE $0. 00 RE-INSPECT FEE $0. 00 ENGINEERING $0. 00 OTHER a9t(7a 00 NOTES: NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AN MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.99 ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT FM $10.00 APPLICATION FOR 41ELL PERMIT CITY OF ATLANTIC LEACH 'PROP= OWNER Name: ADay Phone Addressc •a `4, Zip APPLICANT, IF O'= THAN OWNER Name: Day Phone Address,, Zip JOB Address or Location; Legal Description:bl-6-)O-c-114,OG;? Is well to be used for drinking purposes? Any person, individual, corporation or other entity receiving a permit as provided in Section 22-40 of the Atlantic Beach Code, and who plans to use water from the permitted well for drinking purposes, must first obtain a bacteriological test report from the State of Florida Health Department, furnishing a certified copy thereof to the building department of the City of Atlantic Beach. A certificate of occupancy will not be issued until said report is on file with the building department. Department Notes: I agree to comply with regulations stated herein: Signature Date J,r CITY OF ATLANTIC BEACH •:- _ 800 SEMINOLE ROAD r ATLANTIC BEACH,FL 32233 J INSPECTION PHONE LINE 247-5826 Application Number . . . . . 07-00000150 Date 2/21/07 Property Address . . . . . . 1969 SEMINOLE RD . Application type description RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2394 ---------------------------------------------------------------------------- Application desc WINDOW REPLACEMENT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MCHAN WINDOW WORLD OF JACKSONVILLE 1969 SEMINOLE ROAD 8535 BAYMEADOWS ROAD UNIT 12 ATLANTIC BEACH FL 32233 DBA NATIONAL HOMECRAFT JACKSONVILLE FL 32256 (904) 443-7001 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 45 . 00 Plan Check Fee 22 . 50 Issue Date . . . . Valuation . . . . 2394 Expiration Date . . 8/20/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 45 . 00 45 . 00 . 00 . 00 Plan Check Total 22 . 50 22 . 50 . 00 . 00 Grand Total 67 . 50 67 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH PLAN REVIEW SHEET r :DHufstetler Building Department Public Works&Public Utilities Departments oerr 800 Seminole Road 1200 Sandpiper Lane R.Carper Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 D. Kaluzniak (904)247-5800 (904)247-5834 Public Safety (904)247-5845 Fax (904)247-5843 Fax PLAN REVIEW COMMENTS Permit Application# Property Address Applicant: / 0 A J l a x/C( Project: -D0 IJ 491 jq Y J&t£ kl- c This permit application has been: Approved as noted by the Department. Final application approval must come from the Building Department. ❑ Reviewed and the following items need attention: F? 2 Please re-submit 2-copies of all revisions. Please re-submit your revisions to the Department re uestin them. Building Dept, Public Works and Utility information at top of page, failure to notify the correct department may delay your permit from being issued. Reviewed By: Date: Date Contractor Notified: ''�� CITY OF ATLANTIC BEACH WINDOWS, SKYLIGHTS, GARAGE DOORS, HURRICANE SHUTTERS Date:- Please submit(2)complete sets of plans with application. L Job Address: j1AUq �Y1�npI2 J")Qndr1 ?,A Nl kankic, Berkc-h FL Owner: c—&an 11 MAC' 1 Address: q Sernsnol e_ 9 ea ItY1LY511C �/1 Phone: y ' —7q (0--] Legal Description: Block Number: Lot Number: Zoning District: Contractor: kQ State License Number: uAC.I `)©cJ o� Address: t, Phone:of e City: State: 'PL Zip:3,9,�S (o Fax: 445--7-7-7S Describe proposed use and work to be done: ;n �_«�(�jC Q MQnl OW nQ f- 'b Q) �ro�ec�ion Present use of land or building(s): t Valuation of proposed construction: z-6`7 Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application. Required Building Data: Mean Roof Height Building Width (ft) Building Length L3 (ft) Roof Slope Z Window Height ( Window Width l Window Elevation from Grade (ft) Measurement from corner of building to window (ft) Number of windows being installed _ Mean Roof Height 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 Fag: (904)247-5845 • http://www.ci.atlantic-beach.fl.us Page 1 Revised 1/27/03 Procedure: In order to expedite issuance of permits provide all information as appropriate. Incomplete applications may 'result in delay in issuance of permit. In addition to the building data,the following information is required: 1. Product approval for all (FBC 2004) 2. Installation Procedures 3. Window Description/Type 4. Garage Door Description/Type 5. Skylights Description/Type 6. Hurricane Shutter Description/Type 7. Elevation View of Window Locations I hereby certify that all information provided with this application is correct. Signature of Owner: Date: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the 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 federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being Ztrueco ect and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: b9- 1Y - 0 Address and contact information o pens to receive all correspondence regarding this application(please print). Name: �s `,, I Mailing Address: l� CP s s P 1t�2 Q S}e_- "[C-IJES ax z_ Telephone: L4LJ OC l Fax: L{y 3-_]7"7 E-Mail: i-,_)tr.ACI p3-jc 1A VXk tkh_Q�l • AS TO OWNER: Sworn to and subscribed before me this day of .20 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Page 2 Phone: (904)247-5800 Fax: (904)247-5845 - http://www.ci.atlantic-beach.fl.us Revised 1/27/03 Fl- 3 33 iruPacu (904)443-7001 (800)549-5132 6110=plaza Drive,Ile 415 Fax(904)443.7778 Jacksonville,FL 32256 —d LP a i Floor 15-�� �i 3/44 � ��•i aD'� at.��e Slid e(' � � 1 r- f� alo9, 'ol ,fie S1,CteY- Florida Building Code Online Page 1 of 3 ommunity i Affairs: BCIS Home Log In ' Hot Topics i Submit Surcharge Stats&Facts Publications FBC Staff ' BCIS Site Map Unks Search Product Approval V USER: Public User Community. 'I Affairs Product ADoroval Menu>Product or Application Search>Application List>Application Detail FL# FL1089-R1 SII !II ILII II IIID Application Type Revision Code Version 2004 Application Status Approved Comments =' Archived Product Manufacturer Alside, Inc., Division of AMI Address/Phone/Email 3773 State Road Cuyahoga Falls, OH 44223 (330) 922-2108 mfernbaugh@alside.com Authorized Signature Marsh Fernbaugh mfernbaugh@alside.com Technical Representative Marsh Fernbaugh Address/Phone/Email 3773 State Road Cuyahoga Falls, OH 44281 mfernbaugh@alside.com Quality Assurance Representative Address/Phone/Email Category Windows Subcategory Double Hung Compliance Method Certification Mark or Listing Certification Agency American Architectural Manufacturers Association Referenced Standard and Year(of Standard Year Standard) ANSI/AAMA/NWDA 101 IS-2 1997 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 06/14/2005 Date Validated 08/05/2005 Date Pending FBC Approval 08/09/2005 http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEV XQwtDgtwudLxnkwGm... 2/14/2007 Aw Florida Building Code Online Page 2 of 3 Date Approved 08/24/2005 . ... ...._.____..._.....—.__. Summary of Products FL# Model, Number or Name IDescription 1089.1 0201 placement: 48x78 DP30, 44x77 DP35, 44x60 445, 36x72 DP55; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0201:48x78 (1/8" annealed) DP30, ��44x77 (1/8" annealed) DP35, 44x60 (1/8" annealecl)DP45, 36x72 (1/8" annealed) DP55 1089.2 0301 New Construction: 48x77 DP25, 44x77 D1330, 44x60 DP35, 36x72 D1350; 3/32" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0301:48x77 (3/32" annealed) DP25, 44x77 (3/32" annealed) DP30, 44x60 (3/32" annealed)DP35, 36x72 (3/32" annealed) DP50 1089.3 0401 Replacement: 48x78 DP25, 44x77 DP30, 44x60 DP40, 36x72 DP35; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0401:48x78 DP25 (1/8" annealed), 44x77 (1/8" annealed) DP30, 44x60 (1/8" annealed)DP40, 3602 (1/8" annealed) DP35 1089.4 0501 Replacement: 52x84 DP25, 44x77 DP40, 44x60 DP45, 36x72 DP45, 36x60 DP60; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0501:52x84 (1/8" annealed) DP25, 4407 (1/8" annealed) DP40, 44x60 (1/8" annealed)DP45, 3602 (1/8" annealed) DP45, 36x60 (1/8" annealed) DP60 1089.5 711 0501 Replacement: 52x61 DP35; 1/8" glass,3 cam locks/keepers,"DP" tilt latch w/"H Key" Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0501:52x61 "C" package (1/8" annealed) DP35 1089.6 8001 Replacement: 44x77 DP30, 44x60 DP40, 36x72 DP40; 3/32" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 8001:44x77 DP30,44x60 DP40,36x72 DP40 http://www.floridabuilding.org/pr/pr_app_dti.aspx?param=wGEVXQwtDgtwudLxnkwGm... 2/14/2007 ,Florida Building Code Online Page 3 of 3 1089.7 �I9001 Replacement: 44x77 DP35, 44x60 DP50, 36x72 DP50, 36x60 DP65; 3/32" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: Other: 9001:44x77 DP35,44x60 DP50,36x72 DP50,36x60 DP65 Back Next DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee,Florida 32399-2100 (850)487-1824,Suncom 277-1824,Fax(850)414-8436 ©2000-2005 The State of Florida.All rights reserved.Copyright and Disclaimer Product Approval Accepts: Vv�r�sivo� BOlSjT cu ea vE kiFV� http://www.floridabuilding.org/pr/pr appdtl.aspx?param=wGEVXQwtDgtwudLxnkwGm... 2/14/2007 Florida Building Code Online Page 1 of 3 t �t Affairs BCIS Home Log In I Hot Topics Submit Surcharge Stats&Facts Publications FBC Staff BCIS Site Map ':. Links Search I Willi `I Product Approval s♦ �. " USER: Public User Affairs Product Approval Menu>Product or Application Search>Application List>Application Detail 11� FL# FL1100-R1 Application Type Revision Code Version 2004 Application Status Approved Comments Archived Product Manufacturer Alside, Inc., Division of AMI Address/Phone/Email 3773 State Road Cuyahoga Falls, OH 44223 (330) 922-2108 mfernbaugh@alside.com Authorized Signature Marsh Fernbaugh mfernbaugh@alside.com Technical Representative Marsh Fernbaugh Address/Phone/Email 3773 State Road Cuyahoga Falls, OH 44281 mfernbaugh@alside.com Quality Assurance Representative Address/Phone/Email Category Windows Subcategory Horizontal Slider Compliance Method Certification Mark or Listing Certification Agency American Architectural Manufacturers Association Referenced Standard and Year(of Standard Year Standard) ANSI/AAMA/NWDA 101 IS-2 1997 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A Date Submitted 06/15/2005 Date Validated 08/05/2005 Date Pending FBC Approval 08/09/2005 http://www.floridabuilding.org/pr/pr_appdtl.aspx?param=wGEVXQwtDqu3k5JzSanEoA... 2/14/2007 Florida Building Code Online Page 2 of 3 Date Approved 08/24/2005 .Summary of Products FL# Model, Number or Name IDescription 1100.1 =10102 New Construction X-0: 72x60 DP35; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0102:72x60 (1/8" annealed) DP35 1100.2 0103 New Construction X-O-X: 108x48 DP25; 3/32" glass (Xs) and 1/8" (0) Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0103:108x48 (3/32" annealed in active and 1/8" annealed in fixed) DP25 1100.3 110202 lReplacement X-X: 72x48 DP35; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0202:72x48 (1/8" annealed) DP35 1100.4 0203 Replacement X-O-X: 108x48 DP25; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0203:108x48 (1/8" annealed) DP25 1100.5 02A2 Replacement X-0: 72x48 D1335; 3/32" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 02A2: 72x48 (3/32" annealed) DP35 1100.6 02A2 Replacement X-0: 72x56 DP30; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 02A2:72x56 (1/8" annealed) DP30 1100.7 0402 Replacement X-X: 84x64 DP25, 72x56 DP35; 0402 �FOO.7 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0402:84x64 (1/8" annealed) DP25, 72x56 (1/8" annealed) DP35 1100.8 FZT����EDP735, ment X-O-X: 120x64 DP25, 108x56 108x48 DP40; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions http://www.floridabuilding.org/pr/pr app_dtl.aspx?param=wGEVXQwtDqu3k5JzSanEoA... 2/14/2007 Florida Building Code Online Page 3 of 3 Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0403:120x64 (1/8" annealed) DP25, 108x56 (1/8" annealed) DP35, 108x48 (1/8" Illannealed) DP40 1100.9 0602 placement X-X: 84x68 DP30, 72x56 DP40; Replacement glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/ Other: 0602:84x68 (1/8" annealed) DP30, 72x56 (1/8" annealed) DP40 1100.10 0603 placement X-O-X: 108x56 DP25, 108x48 F35; 1/8" glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: Other: 0603:108x56 (1/8" annealed) D1325, 108x48 (1/8" annealed) DP35 1100.11 0702 Replacement X-0: 72x60 DP35; 1/8"glass Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0702:72x60 (1/8" annealed) DP35 1100.12 0703 Replacement X-O-X: 108x48 DP25; 3/32" glass (Xs) and 1/8" (0) Limits of Use (See Other) Certification Agency Certificate Approved for use in HVHZ: Installation Instructions Approved for use outside HVHZ: Verified By: Impact Resistant: Design Pressure: +/- Other: 0703:108x48 (3/32" annealed in active jj�and 1/8" annealed in fixed) DP25 Back Next DCA Administration Department of Community Affairs Florida Building Code Online Codes and Standards 2555 Shumard Oak Boulevard Tallahassee,Florida 32399-2100 (850)487-1824,Suncom 277-1824,Fax(850)414-8436 ©2000-2005 The State of Florida.All rights reserved.Copyright and Disclaimer Product Approval Accepts: v..is'!� BOtI s.�W a � nrrKcsr r, ve A.f T I http://www.floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDqu3k5JzSanEoA... 2/14/2007 14 f . Ak Architectural Testing AAMA/WDMA/CSA TEST REPORT Rendered to: ASSOCIATED MATERIALS, INC. 3773 State Road Cuyahoga Falls, Ohio 44223 Report No.: 63479.01-501-47 Test Dates: 03/02/06 Through: 03/03/06 Report Date: 03/24/06 Expiration Date: 03/03/10 Project Summary: Architectural Testing, Inc. (ATI) was contracted by Associated Materials, Inc. to perform tests on two Series/Model 0202, PVC horizontal sliding windows at their facility located in Cuyahoga Falls, Ohio. The samples tested successfully met the performance requirements for the following ratings: Test Specimen#1: HS-R15 2134 x 1676 (84 x 66); Test Specimen #2: HS-R35 1829 x 1219 (72 x 48). Test specimen description and results are reported herein. Test Specifications: The test specimens were evaluated in accordance with the following: ANSI/AAMA/NWWDA 101/l.S.2-97, Voluntary Specifications for Aluminum, Vinyl (PVC) and Wood Windows and Glass Doors. AAMA/WDMA/CSA 101/I.S.2/A440-05, Standard/Specification for Windows, Doors, and Unit Skylights. Test Specimen Description: Series/Model: 0202 Product Type: Poly Vinyl Chloride(PVC) Horizontal Sliding Window(Type XX) Test Specimen#1: HS-R15 2134 x 1676(84 x 66) Overall Size: 2134 mm (84")wide by 1676 mm (66")high Sash Size(2): 1051 mm(41-3/8")wide by 1594 mm (62-3/4") high Screen Size: 1080 mm (42-1/2")wide by 1581 mm(62-1/4") high Overall Area: 3.6 m2 (38.5 ft2) 130 Derry Court York, PA 17402-9405 phone: 717-764-7700 fax: 717-764-4129 www.archtest.com 63479.01-501-47 Architectural Testing Page 2of9 Test Specimen Description: (Continued) Test Specimen #2: HS-R35 1829 x 1219 (72 x 48) Overall Size: 1829 mm(72") wide by 1219 mm (48") high Sash Size(2): 899 mm (35-3/8")wide by 1138 mm(44-13/16") high Overall Area: 2.2 m2 (24.0 ft2) The following descriptions apply to all specimens. Finish: All PVC was white. Glazing Details: The sash were exterior glazed with nominal 21 mm (13/16") thick, sealed insulating glass fabricated from two sheets of 3.0 mm (1/8") clear annealed glass, a "U" shaped steel spacer system embedded in sealant, single sealed. The insulating glass was set against a double-sided adhesive tape and secured with rigid vinyl glazing beads. Frame Construction: The PVC frame was constructed using mitered and welded corner construction. Rigid PVC drop-in roller tracks were applied at the sill. Sash Construction: The PVC sash were assembled utilizing mitered and welded corner construction. Screen Construction: The screen was constructed with extruded aluminum. The corners were miter cut and secured using plastic corner keys. The fiberglass mesh screen cloth was held-in-place with a flexible vinyl spline. t Ak 63479.01-501-47 Architectural Testing Page 3of9 Test Specimen Description: (Continued) Weatherstripping: Description Quantity Location 4.7 mm (0.187') backed by 2 Rows Head, sill,and jambs, all rails 6.6 mm (0.250")high pile with center fin 4.7 mm (0.187") backed by 1 Row Jamb stiles, interior meeting stile 6.6 mm(0.250") high pile with center fin 4.7 mm(0.187') backed by 1 Row Exterior meeting stile (exterior) 8.9 mm (0.350") high pile with center fin 4.7 mm (0.187") backed by 1 Row Exterior meeting stile (interior) 14.0 mm (0.550") high vinyl jacket/foam filled bulb 25.4 mm(1.0") by 12.7 mm (1/2") 4 Meeting stiles, one at each end by 6.4 mm(0.250") high adhesive backed pile pad Hardware: Description Quantity Location Locking metal cam lock 2 Lock stile, 216 mm(8-1/2") in from and keeper each end, mating keepers at exterior meeting rail Dual metal roller with 4 Bottom corner of sash Plastic housing PVC anti-lift blocks 2 Head,one at each sash Ak 63479.01-501-47 Architectural Testing Page 4of9 Test Specimen Description: (Continued) Drainage: Description Quantity Location 25.4 mm(1") wide by 2 Exterior face of sill,one at 4.7 mm(3/16") high weepslot each end (with flap) 25 mm (I") wide by 4 Interior sill track and intermediate 4.7 mm(3/16") high weepslot sill wall, one at each end 19.1 mm (3/4")wide by 2 Sill screen track, one at 3.0 mm(1/8")high weepslot each end 6.4 mm(1/4") wide by 2 Exterior sill rack,one at each end 6.4 mm (1/4")deep weepslot 25.4 mm(1") wide by 4 Sill roller tracks,one at each end 6.4 mm (1/4") high weep notch 9.5 mm(3/8")wide by 4 Bottom sash rails, 4.8 mm (3/16")deep weepslot one at each end Reinforcement: The lock stile contained a custom shaped, formed steel reinforcement measuring 22.2 mm by 11.7 mm by 1.2 mm (0.875" by 0.461" by 0.047"), reference Drawing No. UY0095. The keeper stile contained a custom shaped, formed steel reinforcement measuring 11.7 mm by 12.0 mm by 1.5 mm (0.875" by 0.473" by 0.059"), reference Drawing No. UY0094. Installation: The unit was installed in a wood buck constructed of Spruce-Pine-Fir construction lumber and secured through the frame to the buck using five #8 x 64 mm (2-1/2") long screws, one at the top and bottom of each jamb, and one at mid-span of the head. The exterior and interior perimeter was sealed with a silicone sealant, with the exception of an approximate 102 mm (4") long void at each interior sill corner. A nominal 5 mm (3/16")gap was maintained at the perimeter between the buck and window frame. Ak 1 63479.01-501-47 Architectural Testing Page 5 of Test Results: The results are tabulated as follows: Paragraph Title of Test-Test Method Results Allowed Test Specimen #1: HS-R15 2134 x 1676 (84 x 66) 2.2.2.5.1 Operating Force per ASTM 2068 5.3.1.1 Interior Sash Open Breakaway 125 N(28 lbs) N/A Maintain motion 80 N(l 8 lbs) 90 N (20 lbs) Close Breakaway 80 N (18 lbs) N/A Maintain motion 53 N(12 lbs) 90 N (20 lbs) Exterior Sash Open Breakaway 116 N (26 lbs) N/A Maintain motion 53 N (12 lbs) 90 N (20 lbs) Close Breakaway 58 N (13 lbs) N/A Maintain motion 49 N (I I lbs) 90 N(20 lbs) Locks Open 22 N(5 lbs) 100 N (22.5 lbs) Close 36 N(8 lbs) 100 N (22.5 lbs) 2.1.2 Air Infiltration per ASTM E 283 (See Note#1) 5.3.2 75 Pa(1.57 psf, 25 mph) 0.6 L/s/m2 1.5 L/s/m2 (0.12 cfm/ft) (0.30 cfm/ft2) max. Note #1: The tested specimen meets (or exceeds) the performance levels specified in ANSI/AAMA/NWWDA 101/I.S.2-97, 101/1.S. INA FS-02, AAMA/WDMA/CSA 101/1.S. 21A440-05 for air infiltration. 2.1.3 Water Resistance per ASTM E 547 5.3.3 (with and without screen) 140 Pa(2.90 psf) No leakage No leakage Ak 63479.01-501-47 Architectural Testing Page 6of9 Test Results: (Continued) Paragraph Title of Test- Test Method Results Allowed Test Specimen #1: HS-R15 2134 x 1676(84 x 66)(Continued) 2.1.4.1 Uniform Load Deflection per ASTM E 330 5.3.4.2 (Deflections reported were taken on the exterior meeting stile) (Loads were held for 10 seconds) 720 Pa(15.0 psf) (positive) 26.2 mm(1.03") See Note#2 720 Pa(15.0 psf)(negative) 33.0 mm (1.30") See Note#2 Note#2: The deflections reported are not limited by AAMA/WDMA/CSA 101/I.S.2/A440-05 for this product designation. The deflection data is recorded in this report for special code compliance and information only. 2.1.4.2 Uniform Load Structural per ASTM E 330 5.3.4.3 (Permanent sets reported were taken on the exterior meeting stile) (Loads were held for 10 seconds) 1080 Pa(22.5 psf)(positive) 1.5 mm (0.06") 6.4 mm (0.25")max. 1080 Pa(22.5 psf)(negative) 4.8 mm (0.19") 6.4 mm (0.25") max. 2.1.8 Forced Entry Resistance per ASTM F 588 5.3.5 Type: A Grade: 10 Hand Tool Manipulation No entry No entry Tests A 1 through A7 No entry No entry Hand Tool Manipulation No entry No entry 5.3.6.2 Thermoplastic Corner Weld Test Meets as stated Meets as stated / 63479.01-501-47 Architectural Testing Page 7of9 Test Results: (Continued) Paragraph Title of Test-Test Method Results Allowed Test Specimen #1: HS-R15 2134 x 1676(84 x 66)(Continued) 2.2.2.5.2 Deglazing Test per ASTM E 987 5.3.6.3 Interior Sash In operating direction -320 N (70 lbs) Lock stile 1.5 mm (0.06") 11.43 mm (0.45") Handle stile 1.5 mm(0.06") 11.43 mm(0.45") In remaining direction -230 N (50 lbs) Top rail 0.8 mm(0.03") 11.43 mm (0.45") Bottom rail 0.8 mm(0.03") 11.43 mm(0.45") Exterior Sash In operating direction -320 N (70 lbs) Keeper stile 1.5 mm (0.06") 11.43 mm (0.45") Handle stile 1.5 mm(0.06") 11.43 mm(0.45") In remaining direction -230 N (50 lbs) Top rail 0.8 mm (0.03") 11.43 mm (0.45") Bottom rail 0.8 mm (0.03") 11.43 mm (0.45") Optional Performance 4.3 Water Resistance per ASTM E 547 4.4.3.4 (with and without screen) 290 Pa(6.0 psf) No leakage No leakage Ak 63479.01-501-47 Architectural Testing Page 8of9 Test Results: (Continued) Paragraph Title of Test-Test Method Results Allowed Test Specimen#2: HS-R35 1829 x 1219 (72 x 48) Optional Performance 4.4.1 Uniform Load Deflection per ASTM E 330 4.4.3.2 (Deflections reported were taken on the exterior meeting stile) (Loads were held for 10 seconds) 1680 Pa(35.0 psf) (positive) 15.0 mm (0.59") See Note#2 1680 Pa(35.0 psf) (negative) 19.3 mm(0.76") See Note#2 4.4.2 Uniform Load Structural per ASTM E 330 4.4.3.2 (Permanent sets reported were taken on the exterior meeting stile) (Loads were held for 10 seconds) 2520 Pa(52.5 psf)(positive) 0.8 mm (0.03") 4.6 mm(0.18") max. 2520 Pa(52.5 psf) (negative) 2.5 mm (0.10") 4.6 mm(0.18") max. Drawing Reference: The test specimen drawings have been reviewed by ATI and match the test specimen reported herein. Detailed drawings, representative samples of the test specimen, and a copy of this report will be retained by ATI for a period of four years from the original test date. The above results were secured by using the designated test methods and they indicate compliance with the performance requirements of the above referenced specification. This report does not constitute certification of this product, which may only be granted by the certification program administrator. This report may not be reproduced, except in full,without the approval of Architectural Testing, Inc. For ARCHITECTURAL TESTING, INC. Digitally Signed for.Lynn George by Jwwdbr L Debs Digitally Signed by.Michael L M@bwreth Lynn George Michael L. Mackereth Project Manager Director-Operations LGJld Attachments(pages): Appendix-A: Alteration Addendum(1) Appendix-B: Drawings(12) Architectural Testing AAMA/WDMA/CSA TEST REPORT Rendered to: ALSIDE WINDOW COMPANY SERIES/MODEL: 0201 PRODUCT TYPE: PVC Double Hung Window Summary of Results Title Test Sp ecimen#1 Test Specimen#2 Test Specimen#3 Primary Product Designator H-LC25 1118 x 1956 H-LC45 1 1 18* 1524* H-LC55 914*1524* 44 x 77 44 x 60 36 x 60 Design Pressure* 1200 Pa 25.0 s 2160 Pa 45.0 sf) 2640 Pa 55.0 sf) Negative Design Pressure* 1200 Pa 25.0 pst) 2160 Pa 45.0 pst) 2640 Pa. 55.0 st Operating Force in motion 89 N 20 lb N/A N/A Air Infiltration 1.1 L/s/m z N/A N/A 0.21 cfm/ft Water Penetration Resistance Test Pressure 440 Pa 9.0 s N/A N/A Uniform Load Structural Test Pressure ±1800 Pa(±37.5 sf) ±3240 Pa ±67.5 s ±3960 Pa(±82.5 s Forced Entry Resistance Grade 10 N/A N/A *-Optional Secondary Designators Test Completion Date: 01/27/06 Reference must be made to Report No. 62609.02-501-47, dated 02/14/06 for complete test specimen description and data. 130 Derry Court York, PA 17402-9405 phone: 717-764-7700 fax: 717.764.4129 www.archtest.com CITY OF Pe�y) S4&4"'c Beni- _ Office of Building Offal I '1 (� REQUEST FOR INSPECTION Date 'L�v U 17 Permit No. Time A.M. Received P.M. District No. /9 5- V d Ed— Job Addre n Local it Owner's Nam "Contractor C BUILDING CONCRETE ELECTRICAL BING / MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough L'1' Air.Cond.& ❑ Re Roofing ❑ Slab Temp Pole ❑ Top Out E Heating Lintel Final ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION ` yet Mon. Tues - 2(9- W 7 Thurs. Frida P M. Inspection Mao.— 'S / Inspector Final Inspection❑ Certificate of Occupancy Date AA4t 4 1-r 0 F- oOLS S00 V+ CITY OF IJN 17- IS 06-r h'04-01N6 0DATE2 yw-z. 0.,. 'JG- & 3 1 'V-?9 Office of Building Official REQUEST FOR INSPECTION Date ✓� Permit No. Time A.M. Received P.M. District No. Job Address Locality Owner's Name Contractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough Air.Cond.& ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Lintel ❑ Final ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION A.M. Mon. Tues. Wed. urs �J Friday— Inspection riday Inspection Made P.M. Inspector Final Inspection❑ Certiticate of Occupancy Date CITY OF 4&aa tic BeacA-Qaorida JOffice of Building Official REQUEST FOR INSPECTION )ate — Permit No. 'ime A.M. Received P.M. District No. Job Address I�y Owner's Name Contractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing Footing Rough Wiring Rough ❑ Air.Cond.& ❑ Re Roofing ❑ Slab Temp Pole ❑ Top Out ❑ Heating Lintel I FinalFire Place ❑ n Pre Fab READY FOR INSPECTION A M Mon. Tues. Wed Thurs. CFrday— A.M. Inspection Made Inspector Final Inspection C Certificate of Occupancy Date { �/Mn CITY OF 06 J� v^ / 1 Office of Building Official REQUEST FOR INSPECTION ;ate / Permit No. i i me A.M. Received - P.M. District No. Job Address Locality Owner's /j y/ Name Contractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ i Air.Cond.& ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out Q/ Heating Lintel ❑ Final ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION C-trot' Mon. Tues. Wed. Thurs. Friday _ A.M. Inspection Made Inspector Final Inspection❑ Certificate of Occupancy Date CITY OF fQ&whit /S sa4CA-49/4 ik Office of Building Official REQUEST FOR INSPECTION - g� -qqa Date Permit No. Time A.M. Received P.M. District No. Job Address Locality Owner's ►-- ec Name C NS BUILDING CONCRETE LECTR AL PLUMBING MECHANICAL Framing ❑ Footing Roug i ming Rough ❑ Air.Cond.& ❑ Re Roofing ❑ Slab Temp Pole - / Top Out ❑ Heating Lintel - Final iY/ Fire Place ❑ Pre Fab READY FOR INSP [d A.M. Mon. Tues. Wed. hurs � Friday P M. Inspection Made / w • P.M. Inspector --6 Final Inspection❑ Certificate of Occupancy Date CITY OF ATLANTIC - BEACH ,APPLICATION. FOR. PLUMBING .PERMIT •I I �� I iw JOB LOCATION j � 6 � J �/YJ LSI/�" �f"- � .;�_-_;�C•� ' , ;,��,, ) rr;. . { ,'s�PLUMBING CONTRACTOR LICENSE NUMBERS '/ l+ OWNER i BUILDING CONTRACTOR ;;rl ,TYPE OF BUILDING j/1D1yNT/lI+L ,, ) j ,�,.+ _SINKS / SHOWERS LAVATORY I i �I•. . WATER HEATERS ? BATH TUBS . . DISHWASHERS Ir• ;• ' i , t+V. URINALS ,{ DISPOSALS * J CLOSETS WASHING MACHINE .,f j it FLOOR DRAINS OTHER ; NOTAL FIXTURE COUNT a `.n!INSTALLATION OF PLUMBING AND FIXTURES.' MUST' BE IN ACCORDANCE WITH ►+r;1' 4 t { ,,-t.THE MOST RECENT 'EDITION OF THE SOUTHERN STANDARD PLUMBING CODE • , d ilr�l •; , rpt I •,; t •, .' a ''`' !•"' it - %','•l,, .: , 11.1 y.�' '' ' , ri�i{ •.A' t CITY OF ATLANTIC- BEACH Jri 'i'r APPLICATION. FOR PLUMBING PERMIT • �ti �}� .. Y..,. r 1. LOCATION PLUMBING CONTRACTOR I :, LICENSE NUMBERS C '•�. �•�' �,r ' ,OWNER C(it/ /.'� � � R'. �,►I,�' , ii BUILDING CONTRACTOR TYPE OF BUILDING T//iG it f'�I',I�{�. .- ti' � Ir;tt i;� '• ., SINKS i °;! ►;,,!! .. i ;•�,.;, SHOWERS LAVATORY , WATER IIEATERS 1' , :, BATH TUBS TUBS DISHWASHERS URINALS , r ,i•,:±,.�'. 4 DISPOSALS ' CLOSL I'S ' ' 'WASHING MACHINE •{L ��;I .,r. FLOOR DRAINS ' �5��' ►' OTHER 'Li 'TOTAL FIXTURE COUNT +it1:�r{ , . . r,i 11 '•iy i�''.•�` � r '.i , i7��3t..! �� 1 • I a ;r �.ih;INSTALLATION OF PLUMBING AND F ?:�•; ;.:,t ;; ;. , FIXTURES MUST' BE IN `ACCORDANCE WITIL I►' ' r ' i :: t r. ;. r, � ,• '� +t 11tih.S'.I,1.,.'•i;,. I:►,TIiE MOST RECENT EDITION OF TliE SOUTILERN ,STANDARD PLUMBING C ODI; . I DEPARTMENT OF BUILDING 8492 l CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB 8700 T. Date 3/18/99 19 87,00CKT 3601 1 'A 3/18/8 Valuation$ Fee$ $7'OtJ 0492 .09CACT 3601 i ,a. 3/18/8 This permit not valid until above fee has been paid to City Treasurer,and is I An subject to revocation for violation of applicable provisions of law. This is to certify that C.W. WOOD PLUMBING i has permission toMild INSTALL PLUMBING i I Classification RESIDENTIAL DUPLEX Zone Owned by CDM PROPERTIES Lot_ Block S/D 1965-1969 SEMINOLE ROAD House No. According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS „ AFTER DATE OF ISSUE 4 10 . i O Building material, rubbish and debris _ from this work must not be placed in public space, and must be cleared = up and led away by either con- tracto o owner. i Building Official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER i PLUMBING ELECTRICAL SEWER WATER City of Atlantic Beach Fixture Unit Worksheet for Water Impact Fee FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TEN DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. ____BATHROOM GROUP CONSISTING OF _____SERVICE SINK TRAP STAND WATER CLOSET, LAVATORY & BATH (8) TUB OR SHOWER STALL (6) WATER CLOSET VALVE _____WATER CLOSET, TANK OPERATED (4) VALVE OPERATED (8) BATHTUB/SHOWER (2) URINAL WALL LIP (4) SHOWER GROUP PER HEAD (3) FLOOR DRAIN ( 1 ) SHOWER STALL DOMESTIC (2) LAUNDRY TRAY (2) LAVATORY ( 1 ) COMBINATION SINK AND TRAY (3) _____WASHING MACHINE (3) -----POT, SCULLERY SINK (4) DISHWASHER (2) WASH SINK EACH SET OF FAUCETS (2) KITCHEN SINK (2) DENTAL LAVATORY ( 1 ) _ KITCHEN SINK WITH WASTE GRINDER (3) DENTAL UNIT OR CUSPIDOR ( 1 ) _____BIDGET (3) -----URINAL STALL, WASHOUT (4) FLUSHING RIM SINK (8) _COMBINATION SINK AND TRAY WITH FOOD DISPOS. (4) _____URINAL, PEDESTAL, SYPHON JET BLOWOUT (8) DRINKING FOUNTAIN ( 1/2) ___-_LAVATORY, BARBER/BEAUTY SHOP (2) ___/__LAVATORY, SURGEONS (2) SURGEONS SINK (3) / ICE MAKER ( 1/2) TOTAL FIXTURE UNITS @ $10. 00 EACH 9_ , JOB I NFORMATION' I ------------------------------------------------- 26?C3 REORDER FROM,QUALITYDUSINESS rORMSINC (904)3963652 CITY OF ' ATLANTIC BEACH No. 4627 FLORIDA 19 ` NAME CDM Properties ADDRESS 810 Third Street Ste. A CITY Neptune Beach 32233 X11 Water Impact Fee #40-343-3700 $510.00 PAID_- 1 ;27 S 1ot.9t; $2.070.00 it Sewer Impact Fee #4 343-5200 _ JUN 41987 $2,580.00 Lots 2A 2B Beachside 1965 Seminole Road 1969 Seminole Road When Signed, Dated and Numbered, This Becomes an Official Receipt MAKE CHECKS PAYABLE TO Received Payment CITY OF ATLANTIC BEACH, FLORIDA TREASURER `J, NL F: T'. t p-c •' '.�, k"-7J� .. '`' �i IG' '.,, 1 t� J QW z CITY OF ATLANTIC BEACHP A I. D � o o �`' Z ATLANTIC BEACH, FLORIDA 32233 TELEPHONE: 249-2395 JUN `�A 1987 Coas 3 UD w � odg UTILITY BILL 'Q U o to _ - car_ O Z > DATE WATER WATER SEWER GARBAGE OTHER TOTAL �i O _ yy Ir t a METERS �1 DUE ¢ N W �J �II r J S+ r' r^ P.S k"'Of , W a < cn O Il 1111S �t�CL i T JCI\! LJ 1( g� I M - . ¢ 4 ~ W a~7 `1 Y ORDER. TP �E RECE FT TO UELIC N �� WORKS DET. TO `CffEDUL WORK. z ° N m W 3 C) a 200 SA'N PEER Lf,Ii. g U Z w `n w ~- Q N I ¢ � _M IL '' o o� z RETAIN THIS STUB Liv � U Q SERVICE DISCONTINUED I O F, W L.+J PAYABLE IN ADVANCE IF NOT PAID WITHIN z F I= C� C/a 902 NO REFUNDS 30 DAYS OF DATE SHOWN r J i LaJ ,��„ CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL PERMIT 1 TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL FAM: MASTER ELECTRICIAN SI ATURE JOURNEYMAN NAME 41 � ADDRESS: / 5 �=�_=�-`� RFD-BOX- BLDG. FDBOXBLDG.SIZE BETWEEN: RES. �,l APT. ( 1 COMM. ( 1 PUBLIC ( ) INDUS. 1 1 NEW ( ) OLD ( 1 REW. ( ) ADDITION ( ) TRAILER ( 1 TEMP. ( 1 SIGNS ( 1 SQ. FT. SERVICE: NEW ( 1 INCREASE ( 1 REPAIR ( 1 FEE CONDUCTOR SIZE AMPS COPPER I 1 ALUM. ( ) SWITCH OR BREAKER Zv[/ AMPS PH W ' YVOLT RACEWAY EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY FEEDERS NO. SIZE IND. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.30 AMPS. 31.100 AMPS. SWITCHES INCANDESCENT _ FLUORESCENT&M.V. FIXED 0.100 AMPS, OVER APPLIANCES BELLTRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT 0.1 OVER MOTORS H.P. I VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS �_ wrco cnn v rnVFR ROO V. CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL. PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL RM: MASTER I LECTRICIIAN SIGNAT66E JOURNEYMAN NAME ADDRESS: 12'Z 2 RFD BOX BLDG.SIZE BETWEEN: RES.( 0 APT. ( 1 COMM.( 1 PUBLIC ( 1 INDUS. ( 1 NEW ( 1 OLD ( 1 REW. ( 1 ADDITION ( ) TRAILER ( 1 TEMP. ( ) SIGNS ( ) SQ. FT. SERVICE: NEW (X) INCREASE ( ) REPAIR ( 1 FEE CONDUCTOR SIZE AMPS COPPER'( 1 ALUM. ( \�1 SWITCH OR BREAKER AMPS PH W ' ZL, LVO© RACEWAY EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0-80 AMPS, 31-100 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER BELL TRANSF. APPLIANCES AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT 0.1 OVER MOTORS H.P. I VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS nvFR ROO V_ BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I, II, III, and IV. a 1• h\ LOCATION Street Address: 4 OF Intersecting Streets: Between And BUILDING Sub-division II. IDENTIFICATION — To be completed by all applicants . Inconsideration of permit given for doing the work as described in the abcve statement we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards of good practice listed therein. Name of Mechanical Master Contractors �) Contractor (Print) \ Name of Property Owner Signature of Owner Signature of or Authorized Agent Architect or Engineer Ill. NERAL INFORMATION A' Type of heating fuel: B' IS OTHER CONSTRUCTION REIN NE ON Electric THIS BUILDING OR SITE? .J ❑ Gas—❑ LP ❑ Natural ❑ Central Utility IF YES, GIVE NUMBER OF CONSTRUCTION ❑ Oil PERMIT ❑ Other — Specify IV. MECHANICAL EQUIPMENT TO RE INSTALLED NATURE OF WORK (Provide complete list of components on back of this form) Residential or ❑ Commercial Heat ❑ Space ❑ Recessed O Central O Root X New Building Air Conditioning: ❑ Room ❑ Central ❑ Existing Building Duct System: Materiel Thickness o- Replacement of existing system Maximum capacity c.f.m. \y�� L/yjQ( New installation(No system previously installed) ❑ Extension or add-on to existing system ❑ Refrigeration ❑ Other — Specify ❑ Cooling tower: Capacity 9-P-sn- ❑ Fin sprinklers: Number of heads.- 0 – ❑ Elhvtor ❑ Manlift ❑ Escalator (number) THIS SPACE FOR OFFICE USE ONLY ❑ Gasoline pumps —(number) O ❑ Tank: (number) Remarks ❑ LPG contains (number) ❑ Unfired pressure vessel Permit Approved by Da+e ❑ oilers � • ��, E3 Other — Specify Permit fy LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT Number Units Description 11[odelNumber Manufacturer (Tons) A � BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I, II, III, and IV. — a I. Street Address: \ LOCATION �� pnd �� OF Intersecting Streets: Between \ � - BUILDING V Sub-division II. IDENTIFICATION — To be completed by all applicants . In consideration of permit given for doing the work as described in the abcve statement we hereby agree to perform said work in accordance with the attaclLed plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards of good practice listed therein. Name of Mechanical Contractors Contractor (Print) �� Master Name of Property Owner Signature of Owner Signature of or Authorized Agent Architect or Engineer III. GENERAL INFORMATION A, T of heating fuel: B. Type g IS OTHER CONSTRUCTION BEING ONE ON 1— ElectricTHIS BUILDING OR SITE? -�4_77!��' ❑ Gas—❑ LP ❑ Natural ❑ Central Utility IF YES, GIVE NUMBER OF CONSTRUCTION ❑ Oil PERMIT 7SA_1 LA ❑ Other — Specify IV. hALCMANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK \ (,Provide complete list of components on back of this form) Residential or ❑ Commercial Heat ❑ Space ❑ Recessed ❑ Central ❑ Floor New Building [3Central El Existing Building Air Conditioning: ❑ Room Duct System: Material Thickness ❑ Replacement of existing system � New installation(No system previously installed) Maximum capacity c.f.m. ❑ Extension or add-on to existing system ❑ Refrigeration ❑ Other — Specify ❑ Cooling tower: Capacity g•p m. ❑ Fire sprinklers: Number of heads - ❑ Elevator ❑ Manlift ❑ Escalator (number) THIS SPACE FOR OFFICE USE ONLY ❑ Gasoline pumps (number) (Received) ❑ Tanks_ (number) Remarks ❑ LPG conteinan (number) ❑ Unfired pressure vessel PermitZE by Deta E3 Boilers � �C: ❑ Other — Specify Permit ` LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT Capacity Appravinr Number Units Description Model Number Manufacturer (Tons) =CY DEPARTMENT OF BUILDING O FCITY OF ATLANTIC BEACH.FLORIDA PERMIT NO. Q 75 PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB 96.00 T Date May 13 19 87 96.OnCKT :3345 1A 5/13/9 Valuation$ Fee$ 86.00 9575 of)(TAC_ This permit not valid until above fee has been paid to City Treasurer,and is :. 345 1 n 5/11/91��� subject to revocation for violation of applicable provisions of law. This is to certify that Air Flow Designs,Inc. has permission to ll{i3'i11flX i n st a 1 1 heat/air Classification New Residential Zone Owned by CDM Properti ec Lot_ Block S/D House No. 1965-1 �S'Prtinnlc RnAll According to approved plans which are part of this permit = NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS 'n AFTER DATE OF ISSUE —� O Building material, rubbish and debris I from this work must not be placed in public space, and must be cleared up and hauled away by either con- tractor or owner. Building Official. FOR OFFICE PERMIT DATE USE ONLY NUMBER CONTRACTOR PLUMBING ELECTRICAL SEWER WATER i 1 CITY OF 716 OCEAN BOULEVARD P.O.BOX 26 ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-2396 July 23, 1987 Third Floor Pre-Service Section Jacksonville Electric Authority Building 233 West Duval Street Jacksonville, Florida 32202 The following final inspections have been made and are satisfactory: Permit #5299----544 Pelican Key Permit issued to Adkins Electric Company. Permit #5491----1965 Seminole Road Permit issued to Bill Thompson Electric Company. Permit #5267----1878 Beachside Court Permit issed to Bill Thompson Electric Company, Permit # 5520--,1062 Snug Harbor Court Permit # 5521 -..4064 Snug Harbor Court Permits issued to Early Electric Company. Sincerely, Rene' Angers . Community Development Director cc; fide RA/te k CITY OF Awtu�a 716 OCEAN BOULEVARD P.0.BOX 25 ATLANTIC BEACH,FLORIDA 32233 TELEPHONE 1904)249-2395 July 16, 1987 Third Floor Pre-Service Section Jackosnville Electric Authority Building 233 West Duval Street Jackosnville, Florida 32202 The following final inspections have been made and are satisfactory: Permit # 5490----1969 Seminole Road Permit issued to Bivins Electric Company. Permit # 5520-,--1042 Snug Harbor Court Permit # 5521' T=,1044 Snug Harbor Court Permits issued to Early Electric Company. Sincerely, 1� )(5 \> Rene' Angers Community Development Director cc; building file RA/te CITY OF jqja� LV Office of Building Official I REQUEST FOR INSPECTION 7 Permit No. Date __9 A . District No. / m �ed P.M. � 1 G � Locality Job Address � __ Owner's Contractor /// Name Y MECHANICAL BUILDING CONCRETE ELECTRICAL PLUMBING ❑ Air.Cond.& C1❑ Rough wiring EJ Rough Framing 12 Footing Heating Re Roofing El Slab ❑ Temp Pole L7 Top Out ❑ Fire Place ❑ Lintel ❑ Final ❑ Pre Fab R y FOR INSPECTION A.M. Thurs. Friday�-- Mon. Tues. �7 W ' 4 P.M. Inspection Made _ Final inspection Inspector t,A Certificate of Occupancy Date r BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT GI TY OF ATLANTIC BEACH, FLORIDA CERTIFICATE OF OCCUPANCY WORK SHEET Date Requested : 7/24/87 Building Contractor: CDM Properties,lnc, Building Permit Number: Jacksonville Address: 1965 Seminole Road Legal Description: Improvements to the above described property have been completed in accordance with the terms of the permit and is certified to be ready for occupancy as --_Duplex- -------------- Lowest Floor Elevation: N/A required as built n/a Sales Tax Certificate: ----------------------- date submitted BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE DEPARTMENT DATE NOTIFIED: DATE APPROVED: BY: Fire Chief 7/24/87 � � �' --------------- ----- -- --- -- ------ Public Works __-- 7L2J87 ----�- -_ -- Planning Director Building Inspector ____ 7/22/87 ukt rtifiratr of Mrrupattrg CITY OF Drpartmmt of Bniiding Jnopprtinn MECH, ELEC, and nLMARING This Certificate issued pursuant to the requirements of Section 109 of the Southern Standard Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances regulating building construction or use. For the following. New Residential Jacksonville Use Classification Bldg.Permit No. Atlantic Beach Group Type Consttuclion Fire District.. Owner of Building CD1,4 Pronerties,IncAddreu__810 Third Street N.B. Building Address 19 6 5 Seminole Road focality_—__ — By.— -- — - — '.enet Angers July 24 1987 Builditt6 Official Date' - �— POW IN A CONSPICUOUS MACE BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT CITY OF ATLANTIC BEACH, FLORIDA CERTIFICATE OF OCCUPANCY WORK SHEET Date Requested: 7/16/87 Building Contractor: CDM Properties Building Permit Number: Jacksonville Address: 1969 Seminole Road Legal Description: Improvements to the above described property have been completed in accordance with the terms of the permit and is certified to be ready for occupancy as Dutil ex Lowest Floor Elevation: N/A ---------- ---------- ---------- required as built n/a Sales Tax Certificate: ----------------------- date submitted BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE DEPARTMENT DATE NOTIFIED: DATE APPROVED: BY: Fire Chief 7/16/87 / Public Works 7L16/87 --------_-- -_-_7 Planning Director 7/16/87 2122� 7 Building Inspector _______________ (:krrtif iratr of Mrrupaurg CITY OF oakoat - Rw& MECH,PLIMBING, DrIpar#mpnf of Building happrfion ELECTRIC ONLY This Certificate issued pursuant to the requirements of Section 109 of the Southern Standard Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances regulating building construction or use. For the followi%W chr Plumbing, Use Classification New Residential Bldg.Permit No. TacCsonylllely GroupType Construction Fire District..— Atlantic Beach C 810 :Third Street: .B. Ste. A Owner of Building Dr-� Properties Address___ 1969 Seminole Road ,,ty__, Building Address E,, •.,, ers July_16,.._1:; Building OW11 Date: 'WT IN A CONSPICUOUG r C[ CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000498 Date 4/23/10 Property Address . . . . . . 1969 SEMINOLE RD Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 5700 ---------------------------------------------- Application desc reroof ---------------------------------------------- Owner Contractor ------------------------ ------------------------ REDDICK, GERALD E. DAVID MERRITT CONSTRUCTION 1969 SEMINOLE ROAD 1930 RIVER OAKS ROAD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207 (904) 858-9400 ---------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 80 . 00 Plan Check Fee 00 Issue Date Valuation . . 5700 Expiration Date . . 10/20/10 -------------------------- ------------------ Fee summary Charged Paid Credited Due - ---------- ---------- -------- Permit Fee Total 80 . 00 80 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 80 . 00 80 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Apr 20 10,09:31a Information SystemsClTY O 904-247-5845 p.1 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904) 247-5826 Fax(904) 247-5945 b Address: jq&q 001( 0 Permit Number: gal Description Parcel# Gro oor ea o q. t t tluation of Work$.-S2c0 J Proposed Work heated/cooled non-heatedfcooled ass of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door e of existinglprogosed structure(s)((circle one): Commercial Residential an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A >rida Product Approval# r= r multiple products use proact pprowaform ;scribe in detail the type of work to be performed: , operty Owner Information_ me;'r /'n�- ,a,'A Jgx ,L..-n&Ik3.ddress: rt 6ci.' SeN e%at 2 R oIL ..y (ak'i;g�- so-a-c G,- State Zip 33x33 Phone a Mail or Fax#(Optional) intractor Information: /� , , L 60(k�oj-(?( 1mpany N e: l IV l l�l�T Qual�g A ant: "V L�f(�SSGt NI P-V"t I-/ (dress_ 5-1 SZ(P city J State La- zip 3"27 five Phone D V _Job Site/Contact Number 3- '7 Fax# l Certification/Registration# CG ( ?�2� /11 1 c] chitect Name&Phone# gineer's Name&Phone# e Simple Title Holder Name and Address ending Company Name and Address xtgage Lender Name and Address 2lication is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to th tante of a permit and that all work will be p owned to meet the standards of all laws regulating construction in this jurisdiction. Ais permit becomes nu. I void i work is not commenced within six(months, or if construction or work is suspended or abandoned for a.Qertod of six(6)months at arrf time of le ,k is commenced. I understand that separate permits mast be secured for Efectricar Work, PliumUng,Signs, Wells,Pools,Furnaeea,Boilers,HemEr alts and Air Condition,dr- WARNING taWARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR EWFROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. .reb certify that I have mad and examined this plication and know the same to be true and correct. All provisions of laws and ordinances govern*,tri e of work will be complied with whether speed herein or not. The granting of a permit does not presume to give authority to violate or cancel th n4stons of any other federal,state,or local law regulating cons tion or pert mance of const iicliori mature of Owner ignature of Contractor int Name T�, P r Print NameI Sl rota and subscribe bel a me 20��} SU'o d sub r t3 of e s.7 ay of th' gay of 1 20 1 >tary 16Ablic ��,•`j'�J D, ?ITT Nota M COMMISSION# ns0 '•' += W COMM,{:, i; a1:+9288T7 E PIRES:Febru ry 2014. EXPIRESSe, :,lIp�r 20,2013 . Bo ed 7hru Notary P 01.26.10 (407j30-0153 Florwamot ;Service.com SEP-4-2001 03:47 FROM:CLERK OF COURTS 904 270 1512 TO:92475845 P:1/2 NOTICE OFC �MI;:NT Number plouy1�11 UR dpage z&-;. — Reoarc*d 0423/2010 at 11:215 AM. Permit No. qqKCOUNTY LI.ER CLERK CIRCUfT COURT DUVAL TY Tax.Polio No.^ RECORDING 510.00 THE UNDERSIGNED hereby gives notice that improvcmeM will be made to certain real propaty,and in aocordanoe with Section 713.13 of the Plorida Statutes,flee following infornwtion,s provided in dds NOTICE OF COMMENCEMENT. I.De wnpdon of property(legal 5' O a)Sheet(job)Address: a 2 2.0encral description of ins Memeiats: 10 r In1winabon e)Name and address: h R(I RA ✓zz33 b)Name anal address of Cee simple titleholder(if other than ownaI c)interest in property �, 1 4Contractorinformation '1^ f n _ 1„"'1N '�-I a)Name and addcces: L!(�l t� V I fid �( t;Q f�6� W C ?Q� 5 g,:& �`( 7 b)Telephone No.: c-'j`[ / 4 ISurta<y lnfotmWon Pax No.(Opt.) LO—�?, a)Name and address: b)Amount ofBonck ti.Lcedcx c)Telephone No.: Fax No.(Opt.) a)Name and address: 7.ldcudty of person within the State of Flar;da d Phone No. a)Name and address d o`""ar uA�"' notices or other doaunents may be served: b)Telephone No.: _ Fax No.(Opt) "-- B.In addition to bimseK owner design the following person to repgVe a ,o1'tlee Liertor's Notice as 713.13(lxb),Florida Statuoes; provided in Section a)Name and address. b)Telephone Na: — Fax No.(Opt.) ft mpe rstionWed)dame of Notice of Cammeno t(tUa CWPiration daft is one year from the datre of reoordiw6 a�nlests ad lnI date 1e apecill�: WARNING TO OWNER: ANY FAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OIF TBE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,PART 4 SECTION 713.13, 1+WRMA STATUTES,AND CAN RESULT IN YOUR PAYING TRICE FOR iWROVEMZNTS TO YOUR PROPERTY. A 1M107IC8 OF COMMENCEMENT MUST BE RECORDED AND POSTED ON TIME JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT YOUR LENDER OA AN A'ITCMEY BEFORE COMMENCING WORK OR RECORDING 1COUR NOTICE OF COMMENCEMENT. RrA"OR tAAarDA Cannan oN VINKULA6 10 OMae Oen+e►'s Antliorresd � t 'nt Name The foregoing instrument was acknowledged before me this I day of ! _ 2010 ,by M as (type of a1Nbexty,aB Off,trustee, attorney 4 bet)for {same of patty behalf lash We ct was atrecMtcd). PersonR,ly Known OR Produced Identification Notary Signature lJ Type of ldemitication Produced Name(print) ` Ot owr a OR Verification ptasuant to Section 92.525,Florida Ste.Under penalties of perjury,I declare tha I have need the foregoing and that the btu stated in it are hue to the best of my knowledpe and belicE rorwanr�c,n,ianio DAVID Le UNtRf Si-aM ortlatunl POWs' (in tine . MY COMM, EXPIRES Set;(a am 20,2013 � .sem