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399 BEACH AVE - WINDOW / DOOR \ v CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD - ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 J,31�'r- WINDOW AND/OR DOOR PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: lob ID: 15-WIND-1533 Job Type: WINDOW AND/OR DOOR Description: garage door Estimated Value: $6.579.00 Issue Date: 7/6/2015 Expiration Date: 1/2/2016 PROPERTY ADDRESS: Address: 399 BEACH AVE RE Number: 170187-0000 PROPERTY OWNER: Name: GOELZ. THOMAS AND DONNALEA. * Address: 399 BEACH AVE GENERAL CONTRACTOR INFORMATION: Name: D & D GARAGE DOORS INC Address: 1177 CATTLEMEN RD DALLAS MILLER Phone: - - PERMIT INFORMATION: FEES: PLAN CHECK FEES $41.45 BUILDING PERMIT FEE $82.90 STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 Total Payments: $128.35 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. rs� u1k_ City of Atlantic Beach APPLICATION NUMBER '� Building Department (To be assigned by the Building Department.) ' ) 800 Seminole Road / � / 1 ' / _ 3 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 n11or: r E-mail: building-dept @coab.us Date routed: 2.6//,c c City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: c 9 ief. t 6i1 AYE ..-3P ent review required Yes No T � Building Applicant: 9i,-raf, `l /r� Planning &Zoning Tree Administrator Project: t.tv� 04 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: APPLICATION STATUS Reviewing Department First Review: proved. ❑Denied. (Circle one.) Comments: yt ,D BUILDIN /v PLANNING&ZONING Reviewed by: / ,'M Date: '30 0 Ol TREE ADMIN. Approved as revised. ❑Devi . 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 Llowo BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH P. r �;? T%,, ,.tt D �Y� C©PY 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 JUN 22 6 4C /- mow/ D-1533.10I) Address: 3 qQ adater, Ave_ Permit Nt Bp er: 1.e gal Description • 1aL [(D-2' -31 F 4 T (,,, Parcel # 1701 1V— eta _a Floor Area of q.1-t. q. -t Valuation of Work $ ?4i. 35. Proposed Work heated/cooled non-hutted/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 Residential If an existing structure, is a lire sprinkler system installed? (Circle one): Yes No N /A Florida Product Approval # ( 2 • te9C, For multiple products use pro( ct approval form 11 Describe in detail the type of work to be performed: 2 �`Oc (s (2/ �- � (-LEO Cle ears 20- cc t �� Property Owner Information: Name: _�� _c L7rwmr1Z Address: 341q tear,. 4a. City _MAIM State Wip 30.9.53 Plt,, 61.64-g 74,3{ E-Mail or Fax # (Optional) -- Contractor Information: Company Name: D41) Game P00r5 Qualifying Agent: Pa)laas Miller Address: I i1'q Cg4f1er'rten Dad City Sara bf(A- State FL Zip '')14 23",./.. Office Phone (NI. 3.11.7a14 Job Site/Contact Number jcre' Bia(k gty.535,. ..K4ax # 9111. 3'1'7, tSOq State Certification/Registration # Q be.Ia5gao5 - 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 10 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.will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes nail and void if work is not commenced wit/,in 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. I understand that separate permits must be secured for Electrical Work, I'hunbing, Signs, Wells, Pools, Furnaces, //oilers, Heaters. Tanks and Air Coalitioners,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 ATTORN,, EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. i hereby certify that i/rave read and examiner(th.• ,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 sp herein or not. The granting.of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or local(a' „construction or the performance of construction. Signature of Owner Signature of Contractor •,(//l./ Print Name `y o Notek\ C31Z)C `Z Print Name Da(..kls. Ml fter Swor scribe I before me Sworn to and subscribed before me this - I r 2( this _ Day of- , 20 ' .,. �Qh-.t" - . a-`-- 4......................................,"'Y n•• TARtiEE HOUSE Notar"'�"` (� •off°as ota Public State or Florida otary Public ( ;=0--.e'; Notary Public-State of Florida hi L Grah :•: i•• :• My Comm.Expires Sep 23,2016 to y` mmi3Sion 086990 9 r•i'V 112 lirlil;sild.i(F3E 203072 40;o° spires 02/14!2 19 I %`...:,,'• Bonded Through National Notary Assr. Is • -fir-, ®®® .�s= W.. »wrwvon....w®;ill ' ..vtti.aa i h J uIN wr.1 0 '�wWVQN�wr T (/pOuOlwON IIOS...i ;Cci 5.d314fV9 W r T L l' 1 $ a 1 )i ! f1lr! i i r!i! y11 d$i�t eld et i � } °' H � 6fi l Id !ja P 2 1 o f i;. 1,11 a ! itI1JiIj 'hjJi g $ d 1 �"lit yj II� Ill'JMiIll1 11111 11 rs� ;S Q '` (,, i .j.k.). . , ^ ,it t hhh:Ii- « O Ob 1l" 1 1 7 O N M W = a o z U Z r u. d W '....t• � ati �a m — Z `moo I x }'- f- — - -_ '1 i' ,I Q Q W U1j .. =ice 1 �'n. 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N gi a • ild I 11 : ii 11 ,15 g • 8 O O ` bb x �[GJ{1 R,..; ° y' li 7 % gi �S i55 Wo[°�y! °y^ i CCCC 4 11101 i 01 >Zw �Y �V 3 FJJ -- = x 0 ° O 11001 11000■DWI 000d0 = '. 0¢1m ro h°,, .h.0m- 8 Ii:G_.igilliti _iii— i— I Cl. - bb. bbbo tk' F -.n �31V �2 V+ u `Dmo?. .E• S Q rt3p � M 7 ail ~� :y of o� :,,Its Ro O w s ro i2x a 4A liL > >Ri7t lip.;213g..e- .>„,g 0 riii s ! glils2i,i1 .., 1° 3Y i • 8 "4t. 1v>uiV3 6 :„/4 l' 41 ArimitL "WU W E F.iyi a -got 4s-A Lt`d ;l0 •81 ! : 1 i§ 1 y0Y iii-gT Y .: P I g k'"1 (NMONS•)e-SN01035 eo'ON%VS •=]3< - - - d; K a °Y,'.'_ 3 S ,0-.91 -10013N!1000's. .ti ty< 33m o I CD + m I a N /TICE OF COMMENCEMENT State of / County of VIL / Tax Folio l.. o �o No. To Whom It May Concern: The undersigned hereby informs you that►:'!provements 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 COMM9K MENT. Legal Description of property being improved: +—(p/, /b ,L5 d 7 Q.7.4,N `() Address of property being improved: _ q 9' 6 LA IL,. V. General description of improvements: 9 atilt. 2 ace 721,0/A d t £4/7- Owne . 1�''L.. l S e- Address:V i' Vi q deke#Aye, Owner's interest in site of the improvement it/LAN L (,11-� Fee Simple Titleholder(if other than owner Name: Contractor: • • i i LILT Od Address: • ! At 11.-N 4c Telephone No.: 9 o 1 S. 32 GU Fax No: Surety(if any) Address: Amount of Bond$ Telephone 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 Floric. •ther than himself, designated by owner upon whom notices or other documents may be served: Name: Address: ii; Telephone No: Fax No: s o r.a E In �� . addition to himself, owner designates following person to receive a copy of the Lienor's Notice as provided in :ett:3m` 713.06(2)(b),Florida Statues. (Fill in at O''• er's option) a 0 0 Eo Name: m �c>- Address: s•( , a zrn2w Telephone No: Fax No: °"64 Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a differen d ` t specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: ' _ Date: SiP is Before me this .(t day of —1 in the Coun of Duval State Doc#2015153069 OR BK 17222 Page 1706, Of Florida,has personally appeared Number Pages: 1 Personally Known: i Recorded 07/06/2015 at 09:42 AM, Y /, 1 i - L_ or Ronnie Fussell CLERK CIRCUIT COURT DUVAL Notary Publ�tificat '):_ COUNTY f RECORDING$1000 My commission • IM'