Ocean Grove Dr 2015 window ° , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
N } I
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-220
Job Type: WINDOW AND/OR DOOR
Description: window replacement
Estimated Value: $8,784.00
Issue Date: 2/10/2015
Expiration Date: 8/9/2015
PROPERTY ADDRESS:
Address: 1834 OCEAN GROVE DR
RE Number: 169625-0000
PROPERTY OWNER:
Name: WATERS ET AL, ANGELA M
Address: 1834 OCEAN GROVE DR 1834 OCEAN GROVE DR
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA HOME IMPROVEMENT
Address: 4070 SW 30 AVE WAYNE T BURNETT
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $93.92
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $46.96
STATE DBPR SURCHARGE $2.00
Total Payments: $144.88
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PERMIT APPLICATION
' ZITY OF ATLANTIC BEACH
FI C 0 F;L�eminole Road, Atlantic Beach, FL 32233 L E
ce (904) 247-5826 Fax (904) 247-5845
Job Address: b J`t 0C(!CA/1 �7 ►� Permit Nu r: 2-0
Legal Description a �ro UlltjZ 3 Parcel# to 1
Floor Area o q. t. q• t
Valuation of Work$ 8-1�� Proposed Work 6 rated/cooled non-heated/cooled
Class of Work(circle one): New Addition AlterationRepair 1 Move Demolition pool/spa w' dow/door
Use of existing/proposed structure(s)(circle one): Commercial
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval# _-T'i 14 Q cl b ' I -YL`1ST-O
For multiple products use pro uct approval form
Describe in detail the type of work to be performed:�2 K��C a t n Ok- -0— �;?j R
Property Owner Information:
Name: A10 fe
VG Wu V-(5 Address: 0 3� Oc fenn C rc�v2 fir'
City fx L Stated Zip:', 1, Phone qO-i a`t f?14,79
E-Mail or Fax;=(Optional)
Contractor Information":
Company Name:T t�+-R �rn 0 Roo rf V�on� SOC Qualify' Agent: CA �
Address: v City 1. State Zip 3312
Office Phone O `1 Job Site/Contact Number G -l0 x Fax#
State Certification/Registration#_L(� � o i 9��
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 her
made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
issuance of a perm:t and that all work wiU be perfornied to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for a penod of stx(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
`DARNING 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.
1 herecertify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type certify
will be complied with whether spec'ted/lerein or not. The granting of a permit does not pres�,me give authority to violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor ,, II
Print Name ` '.t .............f"....'...................... . Print Name .�� .�-...........-../.../..J��
Sworn to and scrib d b ore me Sworn and subsc ' befor me
this__)--,[D of this t o 0
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City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
�. Building Department
800 Seminole RoaIVA d
Atlantic Beach5445 ZZ�/
, Florida 32233 /
Phone(904)247-5826 Fax(904)247-5845 Date routed:
E-mail: building-dept@coab.us
City web-site. http://www coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /1V
e& N eee VG 4�1- Department review required Yes o
Building
rQ m�n ning Zoning
Applicant: 1446r&044Administrator
/��/��� /��►'� ��� Public Works
Project: Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Dateof 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: / y
BUILDI;�
�(
PLANNING&ZONING Reviewed by: /, Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio NQ.
State of County of i cr
i
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 0 O 9 116
COc ec"n h
Address of property ei improved: ell�
General description of improvements:
Owner c� (�S
Address y
Owners interest in site of the improvement zi . "1
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor
Ufa Name-Improvemen s
4070-SW 3M Ave
Address
Phone No_ Fax No.
Surety(if any)
Address Amount of bond$
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 Lienors Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option)_
Name
Address
Phone No. Fax No.
s
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY IER
SCiogun�e(dy:,pf � (/ of DATE QtiQR
Before para of Fioridal has persq�a9Y a herei
himself!herself and affirens Dim
all
tementsrand declarations herei 15
are true and accurate
Doc#2015019681,OR SK 17046 Page 1679,
Number Pages: 1 c
Notary Pubua at Large,State of
Recorded 01:27/2015 at 03:41 PM, My commission expires: — >e.
Ronnie Fussell CLERK CIRCUIT COURT DUVAL PersonaliyKnown
OUNTY Produced Identification
RECORDING$10.00
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