2109 Becah Ave 2014 window CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
cqni 19' WINDOW AND/OR DOOR PERMIT
-M"C= r-A' ' RY-*PM FeR Naff BAY iNSPEeTleN-44-7 581:4
JOB INFORMATION:
Job ID: 14-WIND-14
Job Type: WINDOW AND/OR DOOR
Description: REPLACE 2 WINDOWS FL12603-R4
Estimated Value: $4,088.00
Issue Date: 9/29/2014
Expiration Date: 3/28/2015
PROPERTY ADDRESS:
Address: 2109 BEACH AVE
RE Number: 169722-0050
PROPERTY OWNER:
Name: BLOCKER TRUST ET AL, GEORGE C
Address: 2109 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: PELLA WINDOW AND DOOR
Address:
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $35.22
BUILDING PERMIT FEE $70.44
STATE DCA SURCHARGE $1.06
STATE DBPR SURCHARGE $1.06
Total Payments: $107.78
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
17
Co, r- ILDING PERMIT APPLICATION
�7-6 37- tO 00 CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 1,J52 4 ---
Office (904) 247-5826 Fax (904) 247-5845
luv_ - h
4- 4
4,194;0-116o, '�t-2—A)313 PermitNumber:
Job Address: Nt� b[>-C'-A\ V�
67
-311b klr\ckvcl"c�$,L-6 Parcel#
Legal Description Q 'q
............ ..................71 .�
.199 rea�o�
11311,111, rea o
0904-7 eated/cooled. n�n`-heatedifcooled
Valuation of Work Proposed Work h
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa
44arcle one): Commercial CR e s Zid e n:t:i a�1
Use of existing/propos( t Iled? (Circle one): 0 N/A
If an existing structure *ls�a=ire sPlinkle 'Ll�ms a
Florida Product Approva
For multiple products i�s o u�ctap3p�rov"a �m
- r -�L
Describe in detail the type of work to be performed: NQa Amt-FRI C
Property Owner Information: aw,
Name: Address:
at -t zip 5
City Phone c101
E-M
Contractor In rormation:
11,11, 1 kgent:
01 4 —Qualif�ing 1 -7
Company Narne. city State r�4- Zip
Address: J��Cl Fax#
Office Phone�-O-W31-6 �s Job Site/Contact Number
State Certification/Registration#�� U-) 6 -71
Architect Name& Phone#
Engineer's Name&Phone
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commencedprior to the
)f a permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
issuance c -k is su ended or abandonedfor qW f sixP6)months at any time after
ells,Pools, urnaces,Boilers,Heaters,
and void if work is not commenced within six(6)months, or if construction or woi ip, eriod o
work is commenced I understand that separate permits mu9t be securedfor Electrica Work, Plumbing,Signs,
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.
on and know the same to be true and correct. All provisions of laws and ordinances governing this
I hereby certify that I have,read and examined this applicati thority to violate or cancel the
ope of work will be complied with whether specifled herein or not. The granting of a permit does not presume to give au
provisions of any otherfederal,state, or local lawregulating construction or the performance of construction.
Signature of Own Signature of Contractor
Print Name ...............2-
................
Print Name 6.......... . ....
Sworn and b'cribedu before me Sworn t and subscribed before me 20
ay su c this Day of
ko I of 2014
this Day
ry Public �otary Mile
— vised0l.26.10
TIMOTHY R.OUALLEY
My COMMISSION#FF 042794
�MALLEY
EXPIRES:August 7,2017
CHRISTINE O'M LL Y
My COMMISSION#FF 08 07 Bonded Thru Notary Pubfic Underwriters
F
Doc # 2014203909, OR BK 16906 Page 1827, Number Pages: 1 , Recorded
09/10/2014 at 08:14 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 .00
350 State Road 434 Mst FILE COPY
Longwood,FL 32750
407-831-0600 off 407-339-7742 fax
W A ILI LR* 141
NOTICE OF COMMENCEMENT
The undemigned hereby gives noticethat improvement will be made to certain real properly,and inaccordance with Chapter?13,
Florida Statutes,the lbilowing information is provided in this Notice of Commencement.
I)II,S('RlVrION OF PROPERTY(Legal doscription ofthe properly&street addre&%ifavailable)TAX FOLIO NO.:
SCHDIVISION R1J)G_IINTT 3
i-0
r,,C\V\PO4P
2 GEN CRA L I)ESCRI MON Op,IAII-IiOVF.Ki ENT-
OjVN ERIN FORMATION OR LESSE LIN FORM ATION 11;7 RIF.LES-SEX CONTRACTED FOR T)IF IMPROVEMENT:
11 Ime�t in Property:C�\ --------
c.ND.ne and Wfess of foe munple liticimider�ifdifrwv"t i1rain O%slun luted above):
a.CONTRACTOR'S NAM E;�QV lo"k"N'\'t -,-N j-Drc).4 S
14 11A ]5X�-r 13 b Phona number:C4 6
S. SURE,
a N&nvudaddcw
b Phano number: c.Amount oC bond:
n.a.LFND+",R'SNAME:
b.Phone number._-
I.eader's address:
7' Persons within the Slate ol'Fiorida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7.,Florioa Statutes:
Namead addrm.� �r L.. -
8.a.In addition to himself or herself,Owner dosignates ol'---
to receive a copy oflhe Uctior's Notice Its provided in Section 713.13(1)(b).Florida Statutes.
b pbone puInW of pxsun ur exany designated bv Owner
9. Expiration date oftiotice ofcommencernOnt(the C"piration date will be I year from the date ofreOOrding unless a di(Terent date is
specified): FTER 1. F-Pll-'ljON OF , 0 1 -M M EN CE hflN�
13 &AND CAhL
'A J ANY l`AYN4I-.N1SAlADEBYTjjr�ONXNER
d Provide Signatory's THICK)MCC)
sultroo wriercur Assee,orOwner'sorLessee's i(Print Naje—AndProvid,Sigat'
10
ri ed officerl[)irector/Partner/Maiiager)
imn-,qle ���! I r:.Or V11 r"s vrl Is",
Statcor
County of A--)1.�,
The 1j)rpLwing instrument was acknowledged before me this DRA*\ day of 20-IA-- --
%/ as 2
by
\�A -r.trustee,atl(xlxeY in ffict)
(name ot person) (type ofouthority,...e.g.officL
(narne ofparty an behalrorwhom instrument was executed)
Personally KnovAl or Produced Identification Type of1dentification Produced
(Signxtu�;of Notary PAW)
(Print,Type,or Stamp Commissioned Nimic ofNotarY Public)
CHROnNEOWILEY
My rokM&�IDN 0 FF 087307
Re�.to-15-12 19 2018
EXPIRES Jarm-ly L
APPLICATION NUMBER
City of Atlantic Beach
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 - Fax(904) 247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us L
APPLICATION REVIEW AND TRACKING FORM
Property Address:-Z I 0QJ Devartment review required Yes/- No
BuildinD
Applicant: PSUL49 Planning &Zoning
Tree Administrator
Project: �AJ ID Public Works
Public Utilities
Public Safety
Fire Seivices
Review foe $ Dept Signature ......
Other Agency Review or Permit Required Review or Rece,,pt 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: VApproved. L1 D e n i e-,J.
(Circle one.) Comments:
(2D
PLANNING &ZONING Reviewed by.- Date: C/
TREE ADMIN.
Second Review: FlApproved as revised. []Denieo
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [JApproved as revised. [:]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09