386 10th St window 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002805 Date 6/10/13
Property Address . . . . . . 386 10TH ST
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 5000
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Application desc
WINDOW REPLACEMENT
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Owner Contractor
------------------------ ------------------------
SCHAEFER, JOHN D HERBENICKS CONTRACTING INC
386 10TH ST 35 OAKWOOD ROAD
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32250
(904) 716-6398
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee 37 . 50
Issue Date . . . . Valuation . . . . 5000
Expiration Date . . 12/07/13
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAl 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
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total 37 . 50 37 . 50 . 00 . 00
other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 116 . 50 116 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
13UILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 F� JUN 2OT13
Jo b Addres s: 3 Y69 10 dhwh� 1,57M, AZ 1Z Z 3-3 —P erinit Nu 0
0 to
C)to
Legal Description ZQT 39g-1A e- 6:A5T- 06z,01 ,i,11 A01Z Parcel# 10 0 56, to
Floor Area ot Sq.lt.
Valuation of Work 000- Proposed Work heated/cooled AJ#Or non-heated/cooled NA
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa(��
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure,is a flire sprinkler system installed? (Circle.one): T ei--� N/A
Florida Product Approval# /0 q5-3, 3
For multiple products use approVaiffofni
Describe in detail the type of work to be performed: //1,0v ('j
Propert FILL UUPY
y Owner Information:
Address: /0 157
Name: _k)�A e��C,6ara,-x, 3A6 FE
city State Zip_�FZZ53 Phone ZZ-1— 01z
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: ent:
Qualifying Ag
Address: 119Zl 34, Aoee IN CIN;� Pik -State -XL' Zip 7,Z6j
T. U
Office Phone 9o4l-61.L— Z116 6 Job Site/Contact
State Certification/Registration# :::2!6 — e 0 58,67 1 ED FOR CODE COMPLIANCE
Architect Name&Phone# !mJA
Engineer's Name&Phone /V A CITY OF, ATLANTIC-BEACH
Fee Simple Title Holder Name and Address /V.4 SEE PERMM FOR ADDMONAL
Bonding Company Name and Address N A,— RE0U1KhMhN'1SA DCONDMONS.
Mortgage Lender Name and Address &!A
]jRmVRaVM�VTTFE_D
Application is hereby made to obtain a permit to do the work and inytal,11furM 710 you/t U, need prior to the
issuance a ed to meet the st becomes null
,fa permit and that all work will be perform andards of all laws e il�i,�ingqnst;�uction in thisjurisdict time after
and void ff work is not commenced within six(16)months, or if construction or work is su e ied abandonedfoi qwe�iod ofsixpo)mo�thsBat
work is commenced I understand that separate permits must be securedfor Electrica Work,Plumbing, Signs, ells,Pools, urnaces, 0 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 FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here certify that I have read and examined th* plication and know the same to be true and correct. All provisions of laws and ordinances governing this
Is
type VIwork will be co�nplied with whether elci 7zed herein or not. The granting of a permit does,not presume to give authority to violate or cancel the
provisi.ons ofany otherfederal,itate, or locilsf1w egulating construction or the pe�fbrmance ofconstruction.
Signature of Owner Signature of Contract
5&Vt%,e6 P r i n t N a in e ... . ......
Print Name K
Be jq& or
thi -$TDay of . 20 t ayof �_)LArUj_'_ 20 2>
-13 6
A AIRERT MORENO
PAM HENDROW41ENeM
Notary Public 0 otary Public Notary Public-State of Florida
Notary Public,State of Florida
q n es ay
Commission#DD929656 eMli C k E i M 26 2015
My comm.expres Oct 13,201 dMqist#EE 97846
Bonded Through National Notary Assn.
MMEN
NOTICE OF CO WZNT
(PREPARE IN DUPLICATE)
Permit No.
Tax Folio No.
State of County of
To whorWit may concern:
The undersigned hereby informs you that Improvements will be tai I I a to certain real propeft and In
accordance with Section 713 of the Florida Statutes,the following in Dn ii ition Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: OA 7-
ik 1111
I lak"k-7 1"2)C t, gz�Z-33;
Address of property being improved:
General.description of improvements:
Owner
Address
Owner's Interest In site of the improvement A61ne"
Fee Simple Titleholder(if other than owner) A1141
Name
Address
Contractor 14ef-bpicL
Alt
da 2,1 -s-At- -Jo!;e- 15ZL)b -Z Z-5-1
Phone No. Y Fax No.
Surety(Ifarry)
Address
pou�ofbond$,
Phone No. Fax No. 11
Name and address of any person making a loan for the construction of the 1 ap �ernents.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated b q:�,Nu�n whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.—1 H
In addition to himself,owner designates the following person to receive a co he Lienor's Notice as provided in'
Section 713.06(2)(b),Florida Statutes�ffll in at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1) r the date of recording unless a
different date Is specified): -
THIS SPACE FOR RECORDER'S USE ONLY G�JNER
Signed:_ DATE 5
Before me Is dW'f in the
Coun D off df tia ters
Doc#2013146057,OR BK 16403 Page 356, t a .*,;2eGared hemn ty
Number Pages:1 hirnsenersel nd affirms that I sl itiments and eclarationsAan
Recorded 06/10/2013 at 09:23 AM, are b7n and accurate
Ronnie Fusse' PAM KMORLi-PRENCH
11 CLERK CIRCUIT COURT DUVAL Notary Public,State of FlorWa
COUNT�
RECORDING$10.0o commissior;4 DD7
929656
ct 1 0
m.evires Oct.13,2013
Notary Public at Large,State
Personally Known or
Produced IdenIM-107-9 I I in I--
My cornassion expires: If
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road fe s
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date routed: /3
E-mail: building-dept@coab.us
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
S: a?y 6 7?/ ment review required Ye No
Property Addres ju 7il di In :�:::_
Applicant: --Planning &Zoning
Tree Administrator
Project: Public Work
Public Utilities
Public Safety 77
Fire Services
Review fee $ Dept Signature
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: DRApproved. ElDenied.
(Circle g Comments:
'rc
(!B U 1:1 L D fIN G
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. V
Second Review: FlApproved as revised. F�Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. E]Denied.
Comments:
Reviewed by:- Date:
Revised 05/14109