240 Belvedere St 2014 window ' 'I SS\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT t4
—MUST-LAtt EsV 47PM FOR NEXT DAT INSFE-ILALu"'; 24 -!981:4
JOB INFORMATION:
Job ID: 14-WIND-330
Job Type: WINDOW AND/OR DOOR
Description: REPLACE WINDOWSFL 7058.5
Estimated Value: $9,202.00
Issue Date: 11/4/2014
Expiration Date: 5/3/2015
PROPERTY ADDRESS:
Address: 240 BELVEDERE ST
RE Number: 170498-0000
PROPERTY OWNER:
Name: MATTSON LIFE ESTATE, EMILY M,
Address: 240 BELVEDERE ST
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $48.01
BUILDING PERMIT FEE $96.01
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $148.02
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDINGPERMIT
APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
FILE ` '
Office (904) 247-5826 Fax (904) 247-5845
kF 237
- t NN� j-33 0
lq--WWI_
Job Address: 2,10 BLELLV6DEF2E Permit Number:
_bT I'l-lb
Legal Description /0-1 4 9 N 1/2 'Parcel# q. t
Floor Area ot Sq.r L.
Valuation of Work Proposed Work heated/cooled. non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition poot/spa ��oor
Use of existing/proposed structure(s) (circle one): Commercial Residentia
If an existing structure,is a fire sprinkl s tem installed? (Circle one): Yes (�D N/A
Florida Product Approval# rL- 20
For multiple products use product ap
Describe in detail the type of work to be performed: PEMCeg' NA� AJDbVJS
Property Owner Information:
Name: WLY N ft-TIV 5 D�j Address:
6
TLAP*�\( , _t�EAC�" State7f��Zip ��233��hone 904- ZAT
City _rT_
E-Mail or Fax#(Optional-
Contractor Information: TEL01W110 L I AM U�s alstt_D:�
Company Name: &Mo N"kolc- Rz-F(,GakQe7 Qualifying Agent: �j " .
Address:206&3!2we!�1, ?"MI ce= City llgx�isvw a State zip_32j�
OfficePhone q3t.-Si,51 Job Site/Contact Number E I S-1 Jax
State Certification/Registration#_ \1\j b
Architect Name&Phone#
Engineer's Name&Phone
Fee Simple Title Holder Name and Address
Bonding Company Name and Addres
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 commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
or if construction or work is su ended or abandonedfor aWeriod of sixP6)months at any time after
months, ms, Pools, urnaces, Boilers, Heaters,
and void if work is not commenced within six(6 r,
work is commenced I understand that separate permits must be securedfor Electrica Work,Plumbing,Signs,
Tanks andAir Conditioners,eta
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.
' h' lication and know the same to be true and correct. All provisions of laws and ordinances governing this
I hereb certify that I have read and examined t is app rity to violate or cancel the
typ e 17, c will be complied with whether not. The granting of a permit does not presume to give autho
o wor) sfecifLed herein or
provisions of any otherfederal,state, or local aw regulating construction or the pe�fbrmance of construction.
Signature of Owner Signature of Contract/—IMM
.......... ...
Print Name . .....+ r............
Print Name .V /l/ L�S o AZ ...........
. ...............7,1-1 1. . ........ ...............
Sworn to and subscribed before me S�vyoj
to and subscl* dge e
�s ,
20 t
"AT P
el,vbe, r 20 /l/ I —
this Day of . ............. P,n BRETT C HAURY
P,
RETT C HAURY
B
89 3 '&PIRES June 29, 2018
otary Public .............
EXPIRES June 29, 9018 (40'7-).398--0153 FloridallotaryService. OnRevised 0 1.26.10
(407)398-0153 F1orki#N01&rV§#fV10e,cqm_
f Atlantic Beach APPLICATION NUMBER
City 0 (To be assi ed by th Buil in Depa e t.)
Building Department
800 Seminole Road
Atlantic Beach, Florida 322:33-5445 Iq
- Fax(904)247-5845
Phone(904)247-5826 Id I
9�- City web-site: http://www.r-i:)ab.us L=�96
APPLICATION REVIEW AND TRACKING FORM
090 adi '--int review required Yes No
Property Address: Buildino--;P
P
annin-. Zoning
Applicant: A&I Tr" n 'I-
Tree Ao.ninistrator
Project: w0ndows P-u b-1i c r,-)-r k s
Public Wil ities
Public"'a'r'ty
--Fire Sei - :!s
Review fee $ Dept Signature
CONTRACTOR EMAIL ADDRESS ,
CONTRACTOR CONTACT #
APPLICATION STATUS
Reviewing Department First Review: [94prproved. []Denip.(!
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING Reviewed by: Date: 10-31-1V
TREE ADMIN. Second Review: 0APProved as revised. nDenit
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES
Third Review. DApproved as revised. F]Deniec:
Comments:
Reviewed by:_. Date:
REVISED 09252014
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
To whom it may concern:
The undersigned hereby Informs you that improvements will be made to certain real property,and In
accordance wtth Section 713 of the Florida Statutes,the following Information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: CIL
-Q:-
-f sb
Addre ;of property being impq0ved'. 0
L 3 -L-�-3 --5
General description of improvements: LIJ RIC NVU-k-
Owner. HEIJ
Address
) �A,�, 16E L 0 E DER
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor SUSJA; S'C-A U6-L) Li z,C f q 7_
7 L
Address 'C� 6!�5
Phone No. Cl Q,-1-Li 3 Fax No.
Surety(if any) Amount of bond$
Address
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
Fax No.
Doc#201142502298.00 R B K 6966 Page 1293,
N'umber Paces: 1, e expiration date is one(1)year from dalke of recording unless a
Recorded 1 1,104,2014 at 10:i 2 AM,
COURT DUVAL OWNER
DATE 0
C"I R 0)1 INI G S 10.or-, lgned:6t th
efore me thisL�- ,"�Fl-
_&_-A,j aY n
Counv of Duval,St*.of ppr! h s o ally appeared
1= N I IN . W'k!11!,r herein by
himseff/herself and affirms that ag siatemprits and cieciarations herein
t�are true and accurate
V'
BRE17 C HAURY
MY COMMISSION#FF136933
F-XPiRES June 29, 2018
of
(407)398-0153 FloridallotaryService,com Notary Public at Large. ounty
My commission expires., or
Personally Known
Produced Identification