2340 W OCEANFOREST DR - WINDOW / DOOR \ 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-1406
Job Type: WINDOW AND/OR DOOR
Description: REPLACE WINDOWS
Estimated Value: $16,068.00
Issue Date: 6/23/2015
Expiration Date: 12/20/2015
PROPERTY ADDRESS:
Address: 2340 W OCEANFOREST DR
RE Number: 169463-1566
PROPERTY OWNER:
Name: SANDARG ET AL, MICHELLE
Address: 2340 W OCEANFOREST DR 2340 W OCEANFOREST DR
GENERAL CONTRACTOR INFORMATION:
Name: PELLA WINDOW AND DOOR
Address: 7818 PHILIPS HWY QA JAMES SAMUEL ROWLAND
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $65.17
BUILDING PERMIT FEE $130.34
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $199.51
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION `�lr'0 St" Ca I T�w� -CD
� MM CITY OF ATLANTIC BEACH /�``f �f'� -2a 9- 6 3?'����
300 Seminole Road, Atlantic Beach, FL 32233
JUN 1 Office (904) 247-5826 Fax (904) 247-5845 Ff COPY
1
Job AddressOa&' 4/M c,,, Permit Number: /5-"t///l// YL2
Legal Description 4,)-I3 37• '0 °! 6 uwvIs c1 1-01-33 Parcel# /(p 41/(43 - /SCo
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$/(o, 0G 8-' Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Gsai iial-
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No { 5-3 I ; 14/65-3'3
Florida Product Approval # II/S'U,3 d I ll 6O4 //d 06,7i )i Jo 6, Cl 1 • . 'I )
For multiple products use product approvai form
Describe in detail the type of work to be performed: (4s60es- s C z C-
Property Owner Information:
Name Address: ab`{U �Cec1/41r" ice - fir:
City ■00A-Nr'e- c-c‘" State Ft Zip 3. .a33 Phone9'39• c(?`i •C73.).>'
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:�tz\\o. Qualifying Agent: 5 c-,
Address: t•• sue,. y� 1 City ovta- State FC- Zip 3 7_T
Office Phone 4'67- 331-OG Job Site/Contact Number 1 7-(e37—& f 0 Fax#
State Certification/Registration#C.,,0--O` (41 I
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 hereby 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 permit and that all work will be performed 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 period of six(6)months at any time after
work is commenced. /understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, Furnaces, Boilers, 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 YOUR NOTICE OF
COMMENCEMENT.
1 hereby certify 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 of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to ate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner �h.� klctea44 Signature of Contractor
•
Print Name f 1.1-CO LL� ROLLA 0.J Print Name (Low1s.r
Sworn Nand subsc ibed before me Sworn to and subscribed before me
this q��''' Day of Aa.. ,20 / r this LflcDay of 'Tart ,20 if
Notary Public No'
ry tary Public
,Zgti;�Y:y CHRISTINEUmAlici '- TIMOTHY R.O'MALLEY Revised 01.26.10
MY COMMISSION#FF 087307
EXPIRES:January 29,2018 =. r�. :. MY COMMISSION w FF 042794
o?° Bonded'Nu Notary Puhlc Ucdenvrders i r :g EXPIRES:August 7,2017
Rr1` ' .4•Rf,,t,■ ' Bonded Thru Notary Public underwriters
•
Doc # 2015136450, OR BK 17200 Page 1121 , Number Pages: 1 , Recorded
06/15/2015 at 02:57 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 .00
AFTER RECORUIN(t-_RETI IRN TO' FILE C py
PERMIT NUMBER:/C.-. I// 4/10 /4ED C
NOTICE OF COMMENCEMENT
The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713, •
Horida Statutes,the following information is provided in this Notice of Commencement.
I. DESCRIPTION OF PROPERTY(Legal de<crilr ion of the property&street address.If available)TAX FOLIO NO.: AD Q 1 y 43"A-4'L
SUBDIVISION 0 k4/a.• o.\\\' BLOCK 1RAcr TO 3.BLDG LNFT +
-la-t8 3-7- 5-a9g a3YU Dces>,.N.Co • - '.
2.GENERAL DESCRIPTION OF IMPROVEMENT:
9-Q ye\ovCQ. \,J,,,,,As-•-1
S. OWNER INFORMATION OR LESSEE INFORMATION IFTRE LESSEE CONtttACTED FOR THE IMPROVEMENT:
a N.mcandadetsf' \ k�€-\\q., M A A,n. .- a6,40 ..t.,Acke•+ac-O r \'s 4>r\c....-se. Li¢-tire FL.3' ?1
b Interact in properly O -'&E 11"--
_ .
C.Name and address of fee simple.liaehotder(if different from Owner tided rabone)
a. a.CONTRACTOR'S NAME:e..C`.\`\-ov \.)...„„ 6Ja..s� .„ C��p`�-s ,�_ G
Comracten a odd dyer sr„-o l td r,r�+',_g_ . T-+,4 L OVIb-woor� �C. 34-1 3 i,one mobs,.UOa7.O.5 1-C o
s. SURETY(if applicable,a copy of��`hh^the payment`payment bond is attached).
a Neine and address U
b Phone flambe:.- / l c.Amount of bond S
6.a.LENDER'S NAME.: p`,f1
Folder's address �`}` b Phone raamhcr
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(1)(a)7.,Florida Statutes:
A.Name and address
b Phone numtvs of deamated persons.
8.a.In addition to himself or herself Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(I)(b),Florida Statutes.
b Nairn:number of person or entity designated by Own.:'
9. Expiration date of notice of commencement(the expiration date will be 1 year from the date of recording tmless a different date is
specified):_ ,20
WARNING TO OWNER: ANY PAYMENTS MADE•BY THE OWNER Al-TERTHE E)(PIR.ATION OF 111E11OTTCE OF COMN1ENCFMbNT
ARE CONSIDERED BvfPROPFR PAYMENTS UNDER CHAPTER 713.PART I.SECTION 713.13_Fltf-It ID)A STATUTES.AND CAN
RFNI1LT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF CONOsftNCEMFNT MUST DC
1 E.COROF.I)AND POSTED ON THE JOB SITE BEFORE THE EW.ST INSPECTION, IF YOU INT NDTOOBTAIN FINANCING.CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE CO CING WORK OR RECORDING YOUR NOTICE OF COMMFNCF.ME,NT.
. nature o Owner or Lessee,or Owner's or Lessee's (Print Name and Provide Signatory's Tide/Office)
Authorized Officer/Director/Partner/Manager)
State of .k4c. -..-,.
County of)v s)aA
The foregoing instrument was acknowledged before me this t�V day of AN\0-'1 .20 15"
by \f\AC\AeArz_ \N-4.\\'4-v•-k— _ .as N-3,.. ■4-.ti
(name of person) (type ofauthority,...e.g.officer,trustee,attorney in fact)
fon -\Sr-- •
(name of party on behalf of whom instrument was exec ted)
Personally Known or Produced Identificatiol Type of Identification Produced 7:I`-•
ra,_.............. clitio it).____
�" (Signature of Notary Public)
.✓.'...r GW.fi:�RYi7IF1 sY
1P•A i hIvCO �S:X*1aFErZK)r (Print Type,or Stamp Commissioned NameofNotaryAibliy
9'..-,L,;�F Ex?!r,F.S:,laa:nn 24.2o3
ea.. --
/. n Pawl rva taaa'wivt-n.ur 1, I N:.v'ss,,, csmsntffi o swjr!
'..k.'as ,v
6f�� ?Ay caa+:ssov r;F 06730
Rev 10.15.12 :12;— :veil EXPIRES.Jaluary'29.2C1S
.1/2,:;,::.,/,,,t,' 6ante re.\daa•weretar firm'.
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1-I Ik rent of Health•Vital l Statistics
(STATE FILE NUMBER)
v STATE OF FLORIDA
MARRIAGE RECORD
C.L TYPE IN UPPER CASE
USE BLACK INK
This m0an•a not vallo amine•ul of Clock. Z�1� j^^ y DocA 200161 179
N Circuit or County Court,app.re thereon. P f J,
Book: 991
111 I-� i L._ ,i Page: 1053
01 { Filed 8 Recorded
03/19/2001 09:16:48 AM
JIM FULLER
O 2001-00980 CLERK CIRCUIT COURT
O DUVAL COUNTY
al APPLICATION NUMBER
APPLICATION TO MARRY LtWo
I.b ItVtNELF LAND 2.ilcE. e�c�T7t/ .DnY Yeeri-.
3a.RESIDENCE-CITY.TOWN,OR LOCATION 130.COUNTY 30.STATE 4.BIRTHPLACE(Soto or Fa
ATLANTIC BEACH , DUVAL FLORIDA ' NORTH CAROLINA
5a BRIDES NAME/Fiat.?Ad dl..I nt) l- ��— 50. I .SIIA 4ME(N 8.DATE OF BIRTH(Mon"INA Vow) —
MITCHELLE ELIZABETH SANDARG 10/26/1967
7..RESIDENCE•CITY.TOWN.OR LOCATION M.COUNTY —_.. C - —T8—.BIRTFpLACE(Stab or Foreign Country)
ATLANT IC BEACH DUVAL FLORIDA � NEW YORK
WE THE APPLICANTS NAMED IN THIS CERTIFICATE.EACH FOR HIMSELF OR HERSELF,STATE THAT THE INFORMATION PROVIDED
ON THIS RECORD IS CORRECT TO THE BEST OF OUR KNOWLEDGE AND BEUEF.THAT NO LEGAL OBJECTION TO THE MARRIAGE
NOR THE ISSUANCE OF AUCEN•.TO AUTHORIZE THE SAME IS KNOWN TO US AND HEREBY APPLY FOR LICENSE TD MARRY.
9.SD S'R"• GROOM(Sign r. AND'1 '10.SUBSCRIBED A SWORN TO BEFORE ME ON(DATE)
46,4;r 14 F d.;:e.°.:!. ,A I j1,'/ 02/27/2001
P:'0 19•p,! AL 12.e�` luaaoucketa) .. ..—___..
�7r k 11; 11. •-• Gtr "`
." °�� � DEPUTY CLERK • 't`'r�-'.�,/'�-'n,�--�'
•4x t 13.SIGNATURE DF BRlr rsr7n rue name wig book srki 14. SC D SWORN TO BEFORE ME ON(DATE)
° `d 02/27 001
13.
13. EOFOFFIGAL _ _ 16.- RE OF OF„..7 (Uaa NOM 41k)
DEPUTY CLERK ►.-r ii AA-4.41M.--/
•
LICENSE Ti • • -YA
AUTHORIZATION AND LICENSE IS HEREBY GIVEN TO ANY PERSON DULY AUTHORIZED p E LAWS OF THE STATE OF FLORIDA TO PERFORM
A MARRIAGE CEREMONY WITHIN1HE STATE OF FLORIDA AND TO SOLEMNIZE THE IAMBI OF THE ABOVE NAMED PERSONS.THIS LICENSE MUST
�••1>�T BE USED ON OR AFTER THE EFFECTIVE DATE AND ON OR BEFORE THE EXPIRATION DATE IN THE STATE OF FLORIDA IN ORDER TO GE RECORDED AND VALID.
.•!.w•`uyck I7.COUNTY ISSUING LICENSE 18.DATE LICENSE ISSUED IN.DATE LICENSE EFFECTIVE 19.EXPIRATION DATE
al1, K•I DUVAL BEACHES 02/27/2001 03/03/2001 05/03/2001
•' .. w 20a SIGNATURE OF COLIRiT CLERK OR.IUOCE _-r2CD.1'TLE II Zoe.By D.C.
110 .:�., lrk of the Circus Court 1__--
CERTIFICATE OF MARRIAGE
•
I HEREBY CERTIFY THAT THE ABOVE NAMED GROOM AND BRIDE WERE JOINED BY ME IN MARRIAGE IN ACCORDANCE WITH THE LAWS OF THE STATE OF DA.
21.DATE OF MARRIAGE(MOmb.Day,Yew) 122.CITY, O
Y,TOWN,OR LOCATN OF MARRIAGE _....—_—.... ._—....
M t l a t L 'i 10,0-0 v7 =ATLAN'T'IC 8EIC.$, F&.• _.... _
23e. TURE OF PER PERFORMING CCITT c�luM.T No*MX) 230.ADDRESS(Ofpagonpanomrg ceremony)
. SEAL (�l.o!nc pAcv y 5233 .r NOrLDE►, -ria;SA1c,Cc. 3220
230. AND TITLE OF PE PERFORMING CEREMONY 24.SION TORE OF WITNESS T• REMONY(Ise black IMO
(Of nobly stomp)
IZ¢ue►,el.af Svt1 k l�:e t cis 25. �E''y� •/- - WO — - ...~
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NMORWOION BELOW FOR USE ST VITAL STATISTICS• Y- • TO SE RECORDED
125.SOCIAL SECURITY NUMBER 127.RACE 28.WERE YOU EVER,,,._1,,;, --_ . • e • • • • • EnTTEMS'EaIES—"nn'O" ..__...�
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httpil/apps.coj.net/PAO PropertySearch/Traverse/Traverse.dll?width=300&height 300&tr... 4/29/2015
City of Atlantic Beach
,S r %•,-. APPLICATION NUMBER
�S, Building Department (To be assigned by the B ildin Depart ent.
Ar-Ni . �i
r� 800 Seminole Road
Atlantic Beach, Florida 32233-5445 �,d /
Phone(904)247-5826 • Fax(904)247-5845
4",`,ty,- E-mail: building-dept @coab.us Date routed: l�//6// S
`
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z 340 c..e.,flN(=v Q j Department review required Yes/No
(uildin
Applicant: PE.u-4nt p(AaS 19rarrarrrg&Zoning
Tree Administrator
Project: 2 s;- p L fl O \A) [ po Q [ 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 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:
APPLI TION STATUS
Reviewing Department First Review: Approved. ['Denied.
(Circle one.) Comments:
BUILDI NG
PLANNING&ZONING
Reviewed by: fri Date: 1615—
TREE ADMIN.
Second Review: ❑Approved as revised. ❑De d.
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