60 Ocean Blvd 2015 Canopy (Awning) CITY OF ATLANTIC BEAM
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
COMMERICAL ALTERATION/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-COTH-221
Job Type: COMMERCIAL OTHER
Description: patio canopy
Estimated Value: $3,820.00
Issue Date: 2/25/2015
Expiration Date: 8/24/2015
PROPERTY ADDRESS:
Address: 60 OCEAN BLVD
RE Number: 170227-0000
PROPERTY OWNER:
Name: JUBRAN AND JUBRAN A ET AL
Address: 9912 VINEYARD
GENERAL CONTRACTOR INFORMATION:
Name: ADVANCED AWNING & DESIGN
Address: 2155 CORPORATE SQUARE BLVD BLDG 100
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $34.55
BUILDING PERMIT FEE $69.10
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $107.65
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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�X5 A? Certificate of Flame Resistance
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Issued Byf
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FREIP� HERCULITE PRODUCTS INC
Registered Fabric ABERDEEN ROAD COMPANY
or Concern Number PO BOX 435
Date treated or manufactured:
F-06901 EMIGSVILLE, PA 19175-8310 01/09/2015
This is to certify that the materials described below have been treated with a flame-retardant chemical or are inherently
nonflammable.
FOR: Trivantage, LLC ADDRESS: 1831 North Park Ave.
my: Glen Raven STATE: NC 27217
Certification is hereby made that: (Check"a" or"b")
(a) The articles described at the bottom of this Certificate have been treated with a flame-retardant chemical
approved and registered by the State Fire Marshal and the application of said chemical was done in conformance
with the laws of the State of California and the Rules and Regulations of the State Fire Marshal.
Name of chemical used: Chemical Registration#:
Method of application:
x (b) The articles described at the bottom of this Certificate are made from a flame-resistant fabric or material
registered and approved by the State Fire Marshal for such use.
Trade Name of flame-resistant
fabric or material used: REINFORCED VINYL Registration#: F-06901
The Flame-Retardant Process Used Will Not Be Removed By Washing
DONALD E. KAUFFMANN STEPHANIE MUMMERT, Q C MANAGER
Name of Applicator or Production Superintendent Title
RCN # 00000000001023695501 000000000
CUSTOMER ORDER NO. 3488
CUSTOMER INVOICE NO. 735732
YARDS OR QUANTITY 80.00
DESCRIPTION Weblon Coastline Plus #CP-2712 62" Deepsea Blue (Standard
Pack 50 Yards)
ITEM NUMBER 857212
We hereby certify the above to accurately reflect the information contained within a"CERTIFICATE OF FLAME RESISTANCE" issued to
Trivantage, LLC from the registrant set forth above. A copy of the original Certificate of Flame Resistance is available upon
request to Trivantage, LLC and the registration information set forth above is on record with the California State Fire Marshal.
ADVANCED AWNING AND DESIGN LLC
MAILING ADDRESS 2155 CORPORATE SQ BLVD STE-100
JACKSONVILLE, FL 32216-0323
City of Atlantic Beach APPLICATION NUMBER
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
:•� �;t f sj;,
E-mail: building-dept@coab.us Date routed:
City web-site. http://www coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: l�Q il.Cft,� �lV ent review required Yes No
&MMing &
Applicant: Ar
Project: uces
Public Sa
ire Services'
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt 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: Approved. ❑Denied.
(Circle one.) Comments:
L v,iy.�. M� a T �Z�•-�o.�t� ♦,f��.a t.l.. c 5 Pitirt�ci�
BUILDING 14 *PR4_vte_,T—* p to P-&?Or
(
PLANNING &ZONING Reviewed by: Date: O Z t t t ,
TREE ADMIN. Second Review:
❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
Q
PUBLIC UTILITIES i
6
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. l
Comments:
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Reviewed by: Date:
Revised 07/27/10
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City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road RECEIVED
.'� Atlantic Beach, Florida 32233-5445
Phone(904) 247-5826 Fax(904)P47-58KB 0 6 2015
i;�,• E-mail: building-dept@coab.us iDate routed:
City web-site http-//wwwcoab.us
IBy.
APPLICATION REVIEW AND TRACKING FORM
Property Address: ent review required Yes No
Applicant: Aing &Zoning
a or
Project: ublic W
F1.1011C Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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:
BUILDING
PLANNING &ZONING
Reviewed by: Ci Date: �F /
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
i
City of Atlantic Beach APPLICATION NUMBE=R
Building Department (To be assigned by the Building Department E
r 900 Seminole Road � x2/
.. Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 /
` 7r E-mail: building-dept@Coab.us Date routed: /
Cityweb-sire. http-//wvvwcoab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Wd 6n—n ek� #Fn!WbTor
t review re aired Yes No
Applicant: orn
Project: s
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
Of Permit Verified ��
Florida Dept_of Environmetat Protection
Florida Dept. of Transportation
SL Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of AloOhaic Beverages and Tobacco
Other
APP TION STATUS
Reviewing Department First Review: Approved. CDD-enied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed by: Dom:
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
E PUBLIC UTILITIES
PUI3 Reviewed by: tate:
FIRE SERVI Third Review: DApproved as revised. [Denied.
Comments:
Reviewed by: Date:
Revised 07rn110
9 /L # st?sLtZb06' 6�S85S?6:o1 - �oa�' ZZ Zl :Sl-lI-ZO
-- City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
} 800 Seminole Road
i,..'1 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-//wwwcoab.us _
APPLICATION REVIEW AND TRACKING FORD
Property Address: 61Q UQ,m ent review required Yes No
Buil '
Applicant: ing &Zoning
a or
Project:
Public Works
Public Utilities
Public Safety
Fire Services i
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receiptof Permit Verified By Date
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: ktApproved ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING /
Reviewed by:
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:
i
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
y,is CITY OF ATLANTIC BEACH D /�
l± r s 800 Seminole Road, Atlantic Beach, FL 32233 M /�
Office(904) 247-5826 Fax (904) 247-5845 J
Job Address: Permitber. -CG4� "' Z/
Legal Description (cc1 - - Parcel# C3E3O
Floor Sq.Ft. sq.111
Valuation of Work$ '3 g oZU Proposed Work heated/cooled non-heated/cooled` c-A'AI , S
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) ((circle one):. erci Residential
If an existing structure,is a fire sprinkler system installed? irc1e one): Yes No N/A
Florida Product Approval# >1 I r-V
For multiple products use product approval form
Describe in detail the type of work to be performed: 1 c�l-t[� �J(4,n�f �t�uMt(1urY1 �fi�l�e
L)4� pe eQ�A-rckn� ri't at W x k 1'L'` Q x a'(a-Af-till! (1co�c� - ►e�k��c 1
Prooerty Owner Information: ,^ II
Name: -i,6rf r l lzb i 4 �t C4� Address:Ga r _
City C_c. - StagZip LPhone - Lr-
E-Mai or Fax#(Optional)
Contractor Information: ,,^^
Company Name: l Qaallfying Ageiri \ � r-� ~yM
Address k55ZZA Mae 047-29-&-�hv i Ll�e State PL- Zip 3OQ 15-
Office Phone - 1515 07 Job Site/Opntact Number eV 4- 50�- 14494 Fax# Gld� `t_ 13x3
State Certification/Registration# i
Architect Name&Phone#
Engineer's Name&Phone# ),+L- r. g!� �x,C. cjoL►— FITS— l�
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 commenced prior to the
issuance of a permit and that all work w111 be per/ormed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void tf work is not commenced within sr'x(6 months, or ifconstruction or work is susp�en�d�ed or abandoned for apenod ofsix16)months at any time ajler
work is commenced. I understand that separate permits must be secured for ElecbicaCWork; P6unbing, Signs, Wells, Pools, urnaces,Boilers,Heaters,
Tanks and Air Conc&tioners,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.
I hereb certify that I have read and examined this a lication and know the same to be true and correct. All provisions of laws and o�rlinances governing this
type of work will be complied with whether speci herein or not. The granting of a permit does not presume to give authority to violate or cancel the
protnsrons of arty other federal,state,or local law regulating construction or the performance of construction.
v�
Signature of Owner Signature of Contractor
Print Name �. ^. ..... ....
Print Name o -D
----- -> 5-M....
..... ................
.... ...................... ..
Sworn to and sub ed before me Sworn to and su scribed before me _
this Day of . 20 this 07 Day of J At-'v AiZ 20
r 4 10ELSA B.MURPHY No
:=_ Commission#FF 09 261 awFxpWes
ublic State of Florida
* Expires February 11,2018 Dicker Kev d 01.26.10
%? 4' awded Nu Tmy Fein Urmu 9043857019 m"io�EE14236810/30/2015
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