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1175 Seminole Rd 2014 window-doorsCITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . 14-00000817 Date 5/23/14 Property Address . . . . . . 1175 SEMINOLE RD Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 6000 ------------------------------------------------------------------- Application desc WINDOWS, DOORS AND GARAGE DOOR ----------------------------------------------------------------- Owner NAUMANN LIFE ESTATE, ANNELIESE % KEITH NAUMANN 908 PRINCE PHILLIP DR VIRGINIA BEACH VA 23452 Contractor MACK BROTHERS GENERAL CTRS. 5521 BARKER STREET JACKSONVILLE FL 32207 (904) 237-0868 ------------------------------------------------------------ Permit . . . . . . WINDOW AND/OR DOOR PERMIT Additional desc . Permit Fee 80.00 Plan Check Fee 40.00 Issue Date . . . Valuation 6000 Expiration Date . . 11/19/14 ---------------------------------------------------------- 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 ------------------------------------------------------ Other Fees . . . . . . . . . STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 ---------------------------------------------------- Fee summary Charged Paid Credited ------- Due ----------------- ---------- ---------- Permit Fee Total 80.00 80.00 .00 .00 Plan Check Total 40.00 40.00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 124.00 124.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. R BUILDING PERMIT APPLICATION ' CITY OF ATLANTIC BEACH > F11 E Pnpy,; .lob Address: t 800 Serninole Road, Atlantic Beach, FL 32?33 I Office (904) 247-5826 Fax(904)2147-`, 5 Y— 1175 Seminole Rd. Per rt Number: I - l— 23-4 16 -2S -29E Selva Marina Unit 1 Lot3 Elk 4_ # Legal Description f -floor Area o q. t. q. Valuation of Work _ r Proposed Work heated/cooled non-heated/cooled i Class of Work (circle one): New Addition Alteration Repair Move emolitton pool/spa window/door Use of existing/proosed structure(s) (circle one): Commercial Residen al if an existing struc ure, is a fire sprinkler system, installed? (Circle one es N fA Florida Product Approval # For multiple products use —pr -o --duct approval Form Describe in detail the type )f work to he n—f^r'_�A w/4;os -- Propertv Owner Information: Name: Phyllis Arnold _ Address:_ P.O. Box 11508 City Jacksonville StateFLZip 32239 Phone 904-502 114 E -Mail or Fax # (Optional) _ Contractor Information: Mack Brothers Building Contractors,Inc. Company Name:____-_ __ _.- Qualifying Agent: rederick W Mack Address: 1546 _Girvin Rd Unit 1 City Jaeksonvitl.,:.e State FL Zip 32225 Office Phone 9 n 4- 2 2 o- 2 5 o 0 Job Site/ Contact Number 904 - 2 3 7- 0 8 6 8 Fax # 9 0 4_ 2 3 7- 0 8 6 8 State CertificationfRegistration #_CBC1258062 Architect Name & Phone # Engineer's Name & Phone # Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address __-- ipplicutiun is Jrere%y mule to obluirr n perrmit to do t/re work and insta/lutiars as /rultcated. i certify the no work or installation has commenced prior u) the i.ctivance of a permit and that all work mill be performed to meet the standards of a/t lam regulating cora action in this jurisdiction. This pennit become Y null and mid i/•awk is not commenced within six (6f months. or if constriction or work is suspended or ahan need for a period of six L6) months at nnv time after uvn•k is commenced. / rrnder:titand that separate permits must be secured for Electrical- Work, Plum bi g, Signs, cUs, Pools, Furnaces, Boilers, Heaierc. 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 FINE NCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORL .. NG YOUR NOTICE OF COMMENCEMENT. I hercbv certi/v that / have read and examined tltit a plicwtion and know tiie sarme to be true turd correct. .411 provisions a s anti ordinances gover•niag t/ri.r rtgx• of work 44// be complied with whether sppeeci ted herein or not. The granting of a permit does not prmenume to gt author** }• tr viola ar cane./ dre jrrnrisiorrs afanP other,%p�cral, state. or loco! !a►i regulating cops telion or the per onnarrce of comstntcti rt. Signature of Ownc Signature of Contractor ` �e Print Name �' ���j 1"I r �.."`......... •��f a i............x...(�..t1........._......................... _.._.... Print Name .....1...:' . tJ[tt " ...C. _...'......... Sworn to and subscribed before me Swo to and subs,,--iibed Afore me thiti _.1( Day c►f t __...--._.............__...... 20 this 14 -Day of Notary Public Notary Public �o1ApY •Pq4 PAMELA HRYNCEYJICZ __________- • Revised 01.26.10 MY COMMISSION # FF 098164 V"11�PAMELA HRYNCEWICZ } EXPIRES: March 4, 2018 re�tir MY fiA9iIS8ION # Ff 0981&4 �= ee: tr !� =l�i$t tto Bonded Thru Notary Public Underwriters Ex�I� �; Maith 4.20`18 4�� F .? ��� ��• Lorded lhiu NolaryRt+* Undarwriten W LA. a Q � Z '0 0 a a� b O gg r a a r d �4 U U) rr^^ vl O Ln 0�. a H z �O L 0, 0.4 M N Ln H Q1 Ir I N Lr co M M rl H O Ln Lr M Ln M N N Ln Ln N N 144 4 1 144 w W ri r.+ CC W C O 0. U A U 0 b i a i 3 3 w ° a rcl .H C m � 3 3 P4 H � z bA O O � L u C� cn c s a -o •° O = U Ca � W '—' N M � V1 \O r3 N M � V•) �D [� 00 � O ^" U d 0A 0 u o ..7 I a I L u v w c 0 a 0 •L u u C U 7 v C L a L U L 7 U W C C CC U �w 0opiz U3� 0�0o¢'��zoa iz cr33c:��c�° C'4 ^ vi �G U U A wop, 4t ea u 0 e� y V] GJ tr.. O C O C O w+ CS, �L u 'v A u 0 .ti 0 s, 0. L L a 'u w 0 c� 0 U y N � 421 cz � Q CA O cl u to r. 3 C o 0 0 ¢ mv a w o a 3 w v v 5 a D Ln N N N M O U C C\ Lr C I C c� CC V � V 0 O a U � � y H u � �4 G4 O c� 0 k +� C 0 w �4 41r F� C O U 'L u Q u 0 b L a L L D w+ u w a a Vi H U o C) W 0. � Ha O � Z U x Ln N N N M O U C C\ Lr C I C c� CC L b bA C V � O Ol U � � y H � �4 G4 O k +� w �4 41r U L b bA C City of Atlantic Beach �s r� Building Department r s 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 • Fax (904) 247-5845 -1 E-mail: building-dept@coab.us City web -site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) 11.A.'01rl Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: I r -7J Srmly� Applicant:r (x::: OK)s - Project: V`�� W Q,r ei dr Review fee $ Department review required Ye No Buildin Planning & Zoning Tree Administrator Public Works Public Utilities Public Safety Fire Services Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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:Approved. ❑Denied. (Circle one.) Comments: UILDING PLANNING & ZONING Reviewed by: Date: 57 b " Second Review: ❑Approved as revised. ❑Den d. TREE ADMIN. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: Third Review: [—]Approved as revised. [—]Denied. FIRE SERVICES Comments: Reviewed by: Date: Revised 05/14/09 Detail by Entity Name Detail by Entity Name Florida Limited Liability Company 221 OLEANDER LLC Filing Information Document Number L14000003363 FEI/EIN Number NONE Date Filed 01/07/2014 State FL Status ACTIVE Effective Date 01/04/2014 Principal Address 101 CENTURY 21 DRIVE SUITE #104-A JACKSONVILLE, FL 32216 Mailing Address P. O. BOX 11508 JACKSONVILLE, FL 32239 Registered Agent Name & Address BRANCH, GWENDOLYN L 101 CENTURY 21 DRIVE SUITE 104-A JACKSONVILLE, FL 32216 Authorized Person(s) Detail Name & Address Title MGR BRANCH, GWENDOLYN L 101 CENTURY 21 DRIVE #104-A JACKSONVILLE, FL 32216 GR ARNOLD, PHYLLIS L 101 CENTURY 21 DRIVE #104-A JACKSONVILE, FL 32216 itle MGR Page 1 of 2 http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail/EntityName/flal-11... 5/20/2014 Detail by Entity Name MOREAU, GARY 2353 ST. JOHNS BLUFF ROAD S JACKSONVILLE, FL 32246 Title MGR MOREAU, LISA 2353 ST. JOHNS BLUFF ROAD S JACKSONVILLE, FL 32246 Annual Reports No Annual Reports Filed Document Images Page 2 of 2 01/07/2014 -- Florida Limited Liability I View image in PDF format Copyright G' and Privacy Policies State of Florida, Department of State http://search. sunbiz.org/Inquiry/CorporationSearchISearchResultDetail/EntityName/flal-11... 5/20/2014