387 10TH ST WINDOW NQ 11 IS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
-rj ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
19
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-1046
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLMNT
Estimated Value: $4,887.00
Issue Date: 5/12/2015
Expiration Date: 11/8/2015
PROPERTY ADDRESS:
Address: 387 10TH ST
RE Number: 170093-0000
PROPERTY OWNER:
Name: MUELLER, CONRAD
Address: 387 10TH ST
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA HOME IMPROVEMENT
Address: 4070 SW 30 AVE WAYNE T BURNETT
Phone:
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $37.22
BUILDING PERMIT FEE $74.44
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $115.66
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
FHA - DIAGRAM SHEET FLE COPY
MEASURE DATE
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Florida Building Code Online Page 1 of 3
FILE COPY
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51
Publications F13C Stafr 5CIS Site Map Links SWr&
FkL,r"Op3traItc Bcis Home Log In User Registration Hot Topics Submit Surcharge Stats&Fact5
Busines
Product Approval
USER:Public Usu
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PE�Jdgt Approwll Menu> >Apolrcatipn Li >Application Detail
FL# L4091-R6
Application Type Revision
Code Version 2010
pproved
Application Status
Comments
Archived
Product Manufacturer Custom Window Systems Inc.
Address/Phone/Emall 1900 SW 44th Avenue
Ocala,FL 34474
(352)368-6922 Ext 207
mlafevre@cws.cc
Authorized Signature Michael LaFevre
mlafevre@cws.cc
Technical Representative Brian Tenace
Address/Phone/Emall 1900 SW 44th Ave.
Ocala,FL 34474
(352)366-6922 Ext 291
btenace@cws.cc
Quality Assurance Representative CalLedy
Address/Phone/Email 1900 SW 44th Ave.
Ocala,Fl-34474
(352)368-6922
cledy@cws.cc
Category
Subcategory D
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
RV Evaluation Report-Flardcopy Received
Florida Engineer or Architect Name who developed Lucas A.Turner
the Evaluation Report
Florida License PE-58201
Quality Assurance Entity Keystone Certifications,Inc.
Quality Assurance Contract Expiration Date 04/10/2016
Validated By Steven M. Urich,PE
2, Validation Checklist-Hardcopy Received
Certificate of Independence FL4091 R6 COI EvalRer)CWS-1 54C(SH-8100.NI).r)df
Referenced Standard and Year(of Standard) Standard Year
AAMA/WDMA/CSA/101/I.S.2/A440-05 200S
AAMA/WDMA/CSA/101/l.S.2/A440-08 2OD8
ASTM E 11300-04 20134
PA TAS 202 1994
Equivalence of Product Standards
Certified By
Sections from the Code
http://www.floridabuilding.org/pr/pr�_app_dtl.aspx?param=wGEVXQwtDquz931�/�2b4g5fa.. 2/25/2014
Florida Building Code Online Page I of 2
.a�
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FILE COPY
BCIS Home Log In User Registration Hot Topics 'I Submit Surcharge StaitS Facts Publications FBC Staff SCIS Site Map Links i Search
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usr:R:Public user
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10MMIT-YETTIMS > >Application U >Appilicaition Detail
FL# 4092-RS
Application Type Revision
Code Version 2010
Approved
Application Status
Comments
Archived
Product Manufacturer Custom Window Systems Inc.
Address/Phone/Email 1900 SW 44th Avenue
Ocala,FL 34474
(352)368-6922 Ext 207
mlafevre@cws,cc
Authorized Signature Michael LaFevre
mlafevre@cws.cc
Technical Representative Brian Terrace
Address/Phone/Email 1900 SW 44th Ave.
Ocala,FL 34474
(352)368-6922 Ext 291
btenace@cws.cc
Quality Assurance Representative IeffThompson
Address/Phone/Emall 1900 SW 44th Ave.
Ocala,FL 34474
(352)368-6922 Ext 221
jthompson@cws.cc
Category
Subcategory (!fD
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
Evaluation Report-Hardcopy Received
Florida Engineer or Architect Name who developed Lucas A.Turner
the Evaluation Report
Florida License PE-58201
Quality Assurance Entity Keystone Certifications,Inc.
Quality Assurance Contract Expiration Date 07/21/2020
Validated By Steven M.Unch,PE
2 Validation Checklist-Harcicopy Received
Certificate of Independence FL4092 R5 COI EvalRep CWS-340B(HS-8200,XOX YO.NI).od
Referenced Standard and Year(of Standard) Standard Y=
AAMAIWDMA/101/I.S.2IA440-05 2005
ASTM E 1300-04 2004
PA TAS 202 1994
Equivalence of Product Standards
Certified By
Sections from the Code
http://vwww.floridabuilding.org/pr/pr�_app_dtl.aspx?param--wGEVXQwtDquz931`/�2b4g5fa... 2/26/2014
city of Atlantic Beach APPLICATION NUMBER
the Building D
S Building Department (To be assi ned byL
_111 .'j 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904) 247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us [D]aterouted:
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
a m review required Yes 0
Property Addre!�� A97 uilding
ng &Zoning
Applicant: Pro I
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire services
Review fee $ Dept Signature_
other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Proiection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic 3everages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: T'A_`pproved. []Denied.
(Circle one.) Comments: 0
CEH5)
PLANNING &ZONING Reviewed by: rL__ Date:
TREE ADMIN.
Second Review: FlApproved as revised. F Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. [--IDenied.
Comments:
Reviewed by: Date:
Revised 07127/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
00 Seminole Road,Atlantic Beach, FL 32233
FILE COPY Office (904) 247-5826 Fax (904) 247-5945
Permit Number:
Job Address: 38710THSTATLANTI.(�BEACH L32U3
1 5-69 16-2S-29E ATLANTIC BEACH Parcel# 170093-0000
Legal Description Floor Area of S q.f�t_. Sq.Ft
Valuation of Work S 4 Proposed Work heated/cooled non-heated/cooled_
8_87
Class of Work(circle one): New Addition Alteration (�Re�air) .Move Demolition pool/spp window/door
Commercial , Kkesidential
Use of existing/proposed structure(s) rele one): N/A
N ys
If an existing structure,is afire spnn ers tem installed? (Circle one
Florida Pioduct Approval# -CA-qO'i E- 4&9 2,
For multiple products use product approval form
Describe in detail the type of work to be perform d: REPLACE7 W�IND�OWS, SIZE FOR SIZE
Prope Owner ln_formation:
Name:- CONRAD AND ELVA MULLER Address: 387 10TH.ST —2-
City ' ATLANTIC BEACH .—State_FLZip 322-3
E-Mail or Fax# (optional
Contractor Information:
Company Name:FLORIDA HOME IMPROVEMENT Qualifying'Agent:WAYNE T.BURNETT—
city HOLLYWOOD State Ft ._Zip 33312
Address:4070 SW 30 AVE actNumber 407-4728380
Office Phone 954-7924415 Y Job Site/Cont
State Certification/Registration# CGC061890
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Addres
Mortgage Lender Name and Address
jermit to do the work and installations as indicated. I certify that no work or installation".has commenced prior to it.
Application is hereby made to obtain a I ri
!e of a permit and that all work will beper o meet the standards of all laws regulating construction in this ju sdiction.' This.permit becomes nu
issuanc formed i ?r if construction or work is s ended or abandonedfor a period of Ar�'(6)mofiths at any time afti
(6)months, c Wells, Pools,Furnaces,Boilers, Heater
and void if work is not commenced within six
work is commenced. I understand that separate permits must be securedfor Electrica Work,Plumbing, Signs,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY IKYWULT IN YOUR PAYING-TWICE FOR,IMPROVEMENTS
TO YOUR PROPERTY. IF YOti INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
ication andknow the same to bet eandcorrect. A 11provisions of laws and ordinances governing ti,
Iherel certify that I have read and examined thisap ru ume o give tho.rity violate or cancel t.
�"�I'
omplied with whether speci ied herein or not. The granting of permit does not presume gopve,iin�ny to tca,.."
type 0 work will be c,
provisions of any otherfederal,state,or local taw lating construction or the performance of constniction.
7� 'or
Signature of Owner/(�D Signature of Contractor
Print Name
...............
Name
print
Sworn to and subsc before me Swo t and subsc ed bqfore m
this bQ Da of this Y!6 Day of 2
S�0�4 A 6
Notary Fu zFil.` f s
V
161Dde
Notary Pu
sed 01.26.10
Doe # 2015108649, OR BK 17163 page 1845, Number Pages: 1, Recorded
05/12/2015 at 02:25 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10-00
NOTIC]E OF COMMFNCEMF-NT
Tax Folio No. 170093-0000—
State of—FLORJDA�
County of—DUVAL
ToW bDm It May Concern,
The un&rsigned hereby informs You that improvements will be made to certain realproperty,and in accordance with Section 713 of
following information is stated in this NOTICE OF COMMENCEMENT. '– 1�5
the Florida Statutes,the oATLANTIC BEACH�� 14 2
Legal Description-Of property being improved:_5-69 16-2S-29110
Addrenof beingimproved: 38710THSTOGAT ANTICBEACH
L
pro"
Gen"description of improvements:_WINDOW
O,ncr 'ANDELVA MIJLLER—Address:387 IoTH ST ATLANTIC BEACH, FL- -3?t"
_jCONRAD
Ownees interest in site of the imPrOverneirl"
Fee SiMpIe Titleholder(if other than Owner)'
Name.
FLORIDA HOhE naRoVEMENT ASS
Address: 4070 SW 30 AVE.HOLLYWOOD,FL.333
Fax No:--------
Teleplione No.:__y54-7924415—
Surety(if any) Amount of pond S
Address.
Telephone NO: No:
Nam and address of any person making a loan forthe construction of the improvements
Name:
Address: Tax No:
Phone No: other than himself,designated by owner upon whom notices or other documents may be
Name of person within the State of Florida,
served: Name:
Address:
Telephone No:— y Fax No:
to receive a copy of the Lienor's Notice as provided in Section
In aMition to himself,owner designates the following person
713.06(2XIi�Florida Stalum (Fill in at Orwrces 000a)
Nam:
Address:
No:
Telephone No: is one(1)year from the date of recording unless a different dak is
Expiration daft of Notice of Commencement(the expiration date
specified):
THIS SPACE FOR RECORDE'VS USE ONLY OWN ate:
Signed: is day of the(5..,y�M.-L�SW
Before me
Of Florida,has lyoppearcd d Co tY Of
NDtwy public at Large,State r
My cominission jxpires: or
pg�8117n: .
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DUVALCOUNTY CWk oft"ChVk&C4WW COMMD"
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