1842 Forsyth Ct 2015 Doors CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-276
Job Type: WINDOW AND/OR DOOR
Description: 3 exterior doors
Estimated Value: $750.00
Issue Date: 2/6/2015
Expiration Date: 8/5/2015
PROPERTY ADDRESS:
Address: 1842 FORSYTH CT
RE Number: 172097-9807
PROPERTY OWNER:
Name: RANGDIT, BITH G
Address: 1842 FORSYTH CT
GENERAL CONTRACTOR INFORMATION:
Name: BEACHES HABITAT OR HUMANITY
Address:
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $55.00
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $27.50
STATE DBPR SURCHARGE $2.00
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
FILECOP CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
-5826 Fax (904) 247-5845
Office (904) 247
Job Address: 1842 ForsAh Ct. AB, 32233 Permit Number:
Legal Description 56-26 17-2S-29E .08, Francis Cove Tbree W 34.44 FT Lot I Parcel#
Floor Area ot Sq.Ft. Sq.Ft
Valuation of Work$ 750.00 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair X Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)(circle one): Commercial Residential
11P
If an existing struc9re,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#Masonite Steel Exterior door: #FL4904
For multiple products use product approval form
Describe in detail the type of work to be performed: Remove and replace 3 exterior doors
Property Owner Information:
Name: Beaches Habitat Address: 797 Mayport Rd..
City Atlantic Beach State FL—Zip 32233 —Phone : 904-241-1222
E-Mail or Fax #(Optional)__
Contractor Information:
Company Name: Beaches Habitat Qualifying Agent: Robert Peterson
Address: 797 MMort Rd. City Atlantic Beach State FL Zip 32233
Office Phone Job Site/Contact Number 904-334-1202 Fax# 904-241-43 10
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication is hereby made to obtain a permit to do the work and installations as indicated. I cert�&that no work or installation has commenced prior to the
issuance ofa permit and that all work will beperformedto meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void If work is not commenced within six(6)months, or i(construction or work is suspended or abandonedfor a Period qfsixj�)months at any time after
work is commenced. I understand that separate permits must be securedfor Electrical-Work, Plumbing,Signs, Wells, Pools, urnaces, Boileis,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 Y61jR NOTICE OF
COMMENCEMENT.
Ihereb,cerofy that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
work will be coMplied with whether specifled herein or not. The granting of a permit does not presume to give authority to violate or cance the
provisions of any other ral,state,or local law regulating construction or the peTformance of construction.
Signature of Owner Signature of Contract(L
Print Name Ljt.k4 Print Name V� rl—
. ........ f ..............................................................
Sworn to and subscribed efore me Sworn toind sub ribed before me
this <t')-Day of A20 /5— this -"Vt ay of sca�- � 201S
76LE MURRAT
�JSSI ON#�EE IS
M
EXPIRES Apr#02.2016 9P
Notary Public N�otary Publi
M
MV OMM MYC
EX 90 .
c
ComMiSSON#EE185723
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
F
Permit No. Tax Folio No.
State of Ez- County of
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 56 26 17-2S-29E .08 Francis Cove Three
W 34.44FT Lot 1
Address of property being improved: 1842 Forsyth Ct. Jacksonville FL. 32233
General description of improvements- REmove and Replace 3 Exterior doors
Owner Beaches Habitat for Humanity
Address 797 Mayport Rd., Atlantic Beach, FL. 32233
0
Owner's interest in site of the improvement 100/0
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Beaches Habitat for Humanity
Address 797 Mayport Rd.Atlantic Beach FL 32233
Phone No. 904-334-1202 Fax No. 904-241-4310
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 Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone No. Fax No.
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 Signedl)�k- DATIEz-6-15
X 11 'i, -
Before me this_day of L—1 in the
County of Duval.State of Florida.has personally appeared
e
_37n_Vj"4 ,e-i-�o '' �- herein by
Doc#20150279612,OR BK 17057 Page 13119, Nniself,herself and affirms 1hat all statements and declarations herein
Number Pages: 1 are true and accurate
Recorded 02,,05/2015 at 1137 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00 Notary Public at Large.Stat
My commission expires:
Personail Kn wn--
roduced Identification 723
EXPIRES APrN 0 16
City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
Building Department
800 Seminole Road --02
.5 Atlantic Beach, Florida 32233-5445 L
Phone(904)247-5826 - Fax(904)247-5845
E-mail� building-dept@coab.us L Date routed- J?
Cityweb-site. http://\wwwcoab.us
APPLICATION REVIEW AND TRACKING FORM
Department review required Yep,- No
Property Address:
Applicant: L5i'- tot,0- Planning &Zoning
Tree Administrator
Project: _3 en -2)ddie's Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or eceipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St.Johns RiverWater Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: R-A--pproved. E]Denied.
(Circle one.) Comments:
(ig�
PLANNING &ZONING Reviewed by: Date:-21
TREE ADMIN. Second Review: nApproved as revised. E]De . d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 07127/10