415 Seminole Rd 2013 windows CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003515 Date 10/16/13
Property Address . . . . . . 415 SEMINOLE RD
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 11958
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Application desc
REPLACE 17 WINDOWS
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Owner Contractor
------------------------ ------------------------
EUGENE & LISA KEMP WINDOW WORLD OF JACKSONVILLE
415 SEMINOLE RD 8110 CYPRESS PLAZA DR #405
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32256
(904) 443-7001
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Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 110 . 00 Plan Check Fee 55 . 00
Issue Date . . . . Valuation . . . . 11958
Expiration Date . . 4/14/14
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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 110 . 00 110 . 00 . 00 . 00
Plan Check Total 5S . 00 5S . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 169 . 00 169 . 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: 4( retoe Permit Number:
Legal Description lq�: 15 (jb-7S-jqC :SeC t 5A,�T-A,*Z Parcel# jj(hq(0 —q50qs0
Floor Area of Sq.Ft. �,q
Valuation of Work S Proposed Work heated/cooled n�n`-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa <EE�M>
Use of existing/proposed structure(s) (circle one): Commercial <]E=:71-�
If an existing structure,is a fire sprinklMstern iZyalleil (Circle one): Yes No
Florida Product Approval # 46-e-e CIA
For multiple products use-�roduct approval form
Describe in detail the type of work to be performed: WtA�
Property Owner Information:
Name:C
.� L.1 S,+ Vj:�le Address: AJ06C
City 7-,&- &2WIll State?T--Zip37-zM—Phone 'FOY qq4( ;-71-7
E-Mail or Fax#(Optional)
Contractor Information: L
Company Narne: Window World of Jacksonville Qualifying Agent:
Address: 8110 Cypress Plaza Dr., Ste 405 City Jacksonville f S Zip 32256
Office Phone 904-443-7001 R F"Ill- Fax 904-443-7778
State Certification/Registration# CBC 12! A.,
Architect Name& Phone t3l 11C 'I'll III I
,1 1 1 ' BELl
Engineer's Name& Phone#—
Mai PERMM FOR ADDMONAL
Fee Simple Title Holder Name and Addres MON&
Bonding Company Name and Address_ 7.
"&wQsl -aWo 7
Mortgage Lender Name and Address DAM
commenced prior to the
mit becomes null
at any time after
aces, Boilers, Heaters,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO)(OUR PROPLUX. F YOU INTEND TO OBTAIN FINANCING9 CONSULT WITH
U 1% %fftff#AW0l r% ATTORNEY BEFORE RECORDING YOUR NOTICE OF
Notary PubliC-Stateof!Fiorida COMMENCEMENT.
15 0
My Comm.Expires Apr 15,2017
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ilitic6phavownco(hf(�p,pu..�f,§?PWpnellhis application and know the same to be true and correct. All provisions of laws and ordinances governing this
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PNot ecifTed herein or not. The granting of a permit does not presume to give authority to violate or cance
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-W regulating construction or the pe�ormance q
Signature of Owner Signature of Contractor
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................ ........... ............................................................................................
Print Name
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NOTICE OF COMMENCEW":1 ,
Permit No._/
State of Florida
County of
The undersigned hereby gives notice that improvements will be made to certain real Property, and in
accordance with section 713.13 of the Florida Statutes, the following information is provided in this
NOTICE OF COMMENCEMENT,
Legal description of property(Include Street Address, if available 4 li5-Sw?wt, ()ojto
J4---f;s t
------------
General description of Improvements L'_q
Owner
Address
-N
Owner's Interest in site of the provement
Fee Simple Title holder(if other than owne.r)
Name
Address
ContraclOr Lo� v
Address t U CL
W --:YSure R 2
Address Amount of bond
Any person making a loan for the construction of the Improvements:
Name
Address
Person within the State of Florida designated by owner upon whom notices or other documents may be
served as provided by Section 713.13(l)(a) 7, Florida Statutes,
Name
Address
In addition to himself, owner designates
Of
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1)(b), Florida Statutes.
Expiration ateof 1,.tice of Commencement(the expiration date is one(1) year from the date of
recordin less erent date is specified) 10— .- '
Sign ure of Oxvne Keh-40-
N 7 Printed Name of Owner '
—Ngitazy JLubbeOtarna Seal I have reliedup-on the following identification ofthe Affiant
"01--off" � T:)
GREGORY RAY FITE
W�-5f
Notary Public-Stato of FlOrMs
qorn to nd subscribed before 7meffiii'u�^day-3�
MY COMM.Expires Apr 15,200
L*
Commission#FIF 008500
Bonded Through National Notary Alin.
tary
Doc#2013262355,OR BK 16559 Page 1273, PA_nted Name
Number Pages:I
Recorded 10/11/2013 at 11:56 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00
4te
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city of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building DeparhmnL)
800 Seminole Road
Atlantic Beach, Florida 32233-6445
Phone(9(9)247-W26 - Fax(904)247-5845 1 C)
Date routed:
E-mail: building-dePt@coab.us
City web-she: http:/ANww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Dwartinent review quired , Yes �R-o-
_q L5 e-!rum Q0
Applicant: AOUN) Planning &Zoning
Tree Adminisb-ator
Project: Ef Public Works
(—C'
Public Utilifies
Public Safety
Fire Services
Review fee Dept Signature
Review or Receipt
other Agency Review or Perrnit Required of Permit Verifled By Date
Florida Dept of Environmental Protection
Flo a 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: CIA/p`proved. [-]Denied.
(Circle one.) Comments:
PLANNING &ZONING Reviewed by:
TREE ADMIN. Second Review: nApproved as revised. ffDenled.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by- Date:
FIRE SERVICES Third Review: []Approved as revised. []Denied.
comments:
Reviewed by: Date:
Revised 05/14109
ilk
CITY OF ATLANTIC BEACH
N
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r
Application Number . . . . . 13-00003499 Date 10/23/13
Property Address . . . . . . 415 SEMINOLE RD
Application type description WINDOW AND/OR DOOR
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 15000
----------------------------------------------------------------------------
Application desc
ENTRY DOOR AND WINDOWS
----------------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
EUGENE & LISA KEMP OWNER
415 SEMINOLE RD
ATLANTIC BEACH FL 32233
---------- -----------------------------------------------------------------
Permit . . . . . . WINDOW AND/OR DOOR PERMIT
Additional desc . .
Permit Fee . . . . 125 . 00 Plan Check Fee 62 . 50
Issue Date . . . . Valuation . . . . 15000
Expiration Date . . 4/21/14
----------------------------------------------------------------------------
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 125 . 00 125 . 00 . 00 . 00
Plan Check Total 62 . 50 62 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 191 . 50 191 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION fi- : A-
CITY OF ATLANTIC BEACH
;f
800 Seminole Road, Atlantic Beach, FL 322
F
n.
ILE COPY
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 46 1 "5- e- yp) 1 0 Permit Number: e3—3 5"'19
Legal Description 4,c5,7' 1.--u 2 Parcel#_
&V 'loor Area of Sq.Ft. Sq.k't
Valuation of Work$ /57- Proposed Work heated/cooled 200 non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa ��n�dow/doo
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval # 10 r1-1 C---4r,4 F4# F-2 2 9,7 Y/dONPI-1. /S. ; ?I-31k /0??/,6
For multiple products use product approval form G13.e
0 /, 31 /,;Lc;l 1 .5 'Fkl
Describe in detail the type of work to be performed: 7--,0!5;7�4 /V )4--
,4// tp, ,U,4&U'S�
Property Owner Information:
Name: /1 1 .5 A e k" /3 Address: ej
city T-,ks., State-V'4 Zip��L 3 r
, Phone -
E-Mail or Fax#(Optional) el E P1 P*<�:p d ce.-W
Contractor Information: CONTRACTOR EMAIL ADDR-ESS:
Company Name: Qualifying Agent:
Address: city -State Zip
Office Phone Job .L"VL11U1L1U-1 —
State Certification/Registration ED FOR CODE CO-Ad-PU�40LIWE
Architect Name&Phone# GIWOF H, BEACH
Engineer's Name&Phone 4 SEE P-.,,dfT-S FOR F9
Fee Simple Title Holder Name and Address REQ111REMEWS AN GE)NDITfEw—
Bonding Company Name and Address
R
Mortgage Lender Name and Address 3 EVIEWED BY. jrT1 I I 1Q;;T_1 7
4pplication is hereby made to obtain a permit to do the work and installations as indi ed. certijy that-no orkor I d- ation has commencedprior to the
issuance of�aopermit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void f rk is not commenced within six(6)months, or if construction or work is Yu ended or abandonedfor aWeriod of six(6)months at any time after
work is commenced. I understand that separate permits must be securedfor Ff wtrioarwork, Plumbing,Signs, ells, Pools,Fitrnaces,Boilers,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 herelb certify that I have read and examined this application and know the same to be true and correct. Allprovisions of laws and ordinances governing this
be complied wi
4 work will th whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any otherfederal,spte, or loi;bl law regulating construction or the pe�fbrmance of construction.
Signature of Owner -t�_
jr-— Signature of Contractor
Print Name 1j4iC?LkkM.(; Print Name
...............................................................r.................................................................... ........................................................................................................................................
B Before me
th ay of 20 ) S this Day of 20
Njota ublic V Notary Public
JMFER WNMR Revised 01.26.10
IS�IOWN FF 011480
S.�, 24 6 201�
N My cOMMISSION#FF 011480
EXPIRES:ApdI 24,2017
P I d w,
Bo�ded Thru Notary Public Underwriters
TWO FAMILY RESIDENCE OF, A FARM OUTBUILDING YOU MAY ALSO BUILD OR
R&ROVE A COMMERCIAL BUILDING AT A COST OF S25�000-00 OR LESS- TBE BUMIN-K
AMILU
MUST BE FOR �OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF you SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER TBE CONSTRUMON IS COMPLETE,TBE LAW WML PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE,WhICH IS IN VIOLATION OF THIS EXEMPTION. Y Y NOT
HI kN UNUCFNSED PERSQN AS YOUR C ACTOE, YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO TTIE BUILDING CODES AND ZONING REGULAnoNS. IT IS
YOUR RESPONSIBILITY 10 MAKE SURE THAT PEOPLE E,_M_P_L9Y_M By YOU HAVE
LICENSES REOU �ED B� S ATE_ W D Y C0I_ZffY OR MUNICIPAL LICEN51NG
ORDINANCES.
11. INJURY LIABILITY; SINCE WVNER L FOR I TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S ompENSA11ON INSURANCE BE
PURCHASED.
III. IRS WITHHOLDING;'OWNERS HIRING V40RKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED - E EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO$5,000 PENALTY UNDER FLORIDA STATU I E NO.
455-2281(l). AN:O-CCUPATIONAL LICENSE-IS NOT AQEQIJAT(L THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY 'CERTIRCATE OF COMPETENCY' OR THE FLORIDA 'CONTRACTORS
CERTIFICATE' TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
V.ACKNOWLEDGEMENT;I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
PHONE NUMBER
qL -�1 � -
ADDRESS Re r- L_ �!)2?_-6 5
L v;a .4K0-
�PRINT NAME
............
DATE
S G TU
RE
2OL-3in the county of
Before rrie
W f x by�
Duval.State of FlmW has I ppeared herin by hirriself herself and affimis that
afl sta.ternents and declarations are true and accurate,
-Vt—,county of
Notary public at Large,State
Wp..Uy Kn.—
o pmd,,wd identfication-
SANDRA L�y P"GERSOLL
NY CCIVWSSION v1)D920346
IF y OCIDIRES:'t;4*1=4w 39,zo 13
Notary Signature: i
MY Fi--tArT D4,10UM Ar�C11,
L FILE COPY
, 1 U r y
e_Q City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Build g Deparhnerfl
800 Seminole Road
'9
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5846
E-mail: building-dept@coab.us Date routed:
City web-site: http:/Amw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: partment review required Yes,AOL
guildind
Applicant: :Plihfibin-J &Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public SafLety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Envirorunental 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:
APPLII;ATION STATUS
Reviewing Department First Review: EIX/pproved. [:]Denied.
(Circle one.) Comments:
(��BUILDI I
PLANNING &ZONING Reviewed by: YP Date:/0 1-3
TREE ADMIN. Second Review: nApproved as revised. nl:�A/ied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by- Date:
FIRE SERVICES Third Review: nApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05114/09