201 S NAUTICAL BLVD - WINDOW / DOOR (1) S \ 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-1713
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLMNT
Estimated Value: $4.475.00
Issue Date: 7/29/2015
Expiration Date: 1/25/2016
PROPERTY ADDRESS:
Address: 201 S NAUTICAL BLVD
RE Number: 170703-0386
PROPERTY OWNER:
Name: WARDREP, CHRISLEY P
Address: 201 NAUTICAL BLVD
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN WINDOW PRODUCTS
Address: 2633 S POWERS AVE QA KEITH ALAN GURR
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $36.19
BUILDING PERMIT FEE $72.38
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $112.57
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
, CITY OF ATLANTIC BEACH
FILE ® Y
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 201 5• AGA `coil bl Y d . Permit Number: 15— 11/4 Iv/—j1 3
Legal Description 7� I 6 # I (4 10 (NIL 4 Parcel# I 3- 0 3 o
l oor • ea o q. t. q. t
Valuation of Work$ '"T1 5 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/sp. window/door
Use of existing/proposed structures)(circle one): Commercial Residential
i
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval# /4160g j / 58-
For multiple products use product approval form
Describe in detail the type of work to be performed:1 eetiorttneni 1,thyd-oups i f l(kCe(/1QJ'l7 b
Ne W? u t,P.E)
Property Owner Information:
Name: Cf tA2 5i eij Walcizze Address: 201 5 . t ea Q blvd. 6
City State Zip 3`723' Phone Z4Co- 111+3
E-Mail or Fax#(Optional)
Contractor Information: AMERICAN WINDOW 1)1.641 6.çu2z
Company Name: PRODUCTS,INC. Qualifying Agent:
26
Address:
2633 POWERS AVE. City State ' Zip
Office Phone? 1-22'f 7 JACKSONVIU b it P9Titact Number Fax#
State Certification/Registration# C/7C/2 5/2 b7
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. 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 null
and void if work is not commenced within six(6 months, or if construction or work is suspended or abandoned for aperiod of six(6)months at any time after
work is commenced. I 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 YO1JR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this a placation 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 violate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner �� Signature of Contractor
Print Name c/HttrjEy ,ARbRV Print Name I'1
o and sub ibed„t7ef• - Sworn to and subscribed before me
s o1 Day of A_. 20 3 this R Day of oTu.It-a— ,20/s
' e , ROGER AUSTIN , .ua—)
j Publi ialli T'` EXPIRES:September 6,2015 otary Public MY COMMISSION a EE 127993
w Flit -� l�5 z x-12 r.°°'°e eaaeo fire Budget Nobry Seivkes *� �I' " EX21 eptember 6,20.15
7EOF FV°. Notary Services
15- LW2)
FfL.7 CC77
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NOTICE OF COMMENCEMENT
J
o; > Permit No.
(D D
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a) it- H
State of Flo i a _
Cl- -° County of )LUIG 4' 1
m• o fY The undersigned hereby gives notice that improvements will be made to certain real property, and in
ce '117 Y accordance with section 713.13 of the Florida Statutes, the following information is provided in this
oi o w S NOTICE OF COMMENCEMENT.
rN V o (�
co a)N v' 0 r1 e' i
1 (8 N Z Legal description of property(Include Street Address, if available) .1 ��� r
?-5.- -,,,,f>. 8 )'s /td C t O
0O o g L O •'01 J '
E
OZ��U,
General description of Improvements 1� 1t 1AT s
Owner ?Q-I I 2c4 J-- ..
Address qol Oc VOI i 5'o /-�/6, ccc.- 3'Z 2 3�
Owner's Interest in site of the Improvement
Fee Simple Title holder(if other than owner) , -
Name
Address AMERICAN W1P OW '64.13 — 224-
t'Contractor PRODUCTS,%`' RA. Address
Surety •
Address . Amount of bond$ ,
Any person making a loan for the construction of the Improvements:
Name l'
Address o!---
Person 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.
Name
Address • .
In addition to himself, owner designates
Of ..
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1)(b), Florida Statutes.
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of
recording unless a different date is specified)
�. - J A).i C _b C. _1>
S • ,.. of Owner Printed Name of Owner
r Notary Rubber Stamp Seal 1 I have relied upon the following
�iidennttific/ation of the Affiant
of"�Y.KGB/ . - )'`1 CARa-r `3,- 1) .L)•)
• *. , LARRY J.GALLAGHER
* !:(� * MY COMMISSION#EE 127992 Sworn to . ` -.- •-•before me this`�day of 20/._
�' F R EXPIRES:September 6,2015 ir 94,(A1-04,7
1rfof c'" Bolded Thru Budget Notary Services "
N Sigaafge
Z-442, 7 3-.-C -AC 14C I' iL.
Printed Name
l •
-r .
OL l:i;�� City of Atlantic Beach APPLICATION NUMBER
>\ Building Department`r 800 Seminole Road (To be assi ned by the Building Department.)•
kt
Atlantic Beach, Florida 32233-5445
�d_ //1�� /7�3
Phone(904)247-5826 - Fax(904)247-5845
._%.,�ii;�y- E-mail: building-dept @coab.us Date routed: /�
City web-site: http://www.coab.us ,
APPLICATION REVIEW AND TRACKING FORM
Property Addres : d / s A4 Cal 4YdDPartment review required Yle7rfio
Buildin�
Applicant: /64-11- //)- el ing&Zoning
Tree Administrator
Project: / , /' A _ `. /.1 I 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: oved. ❑Denied.
(Circle one.) Comments: /.1) r
ILDING
/LjD
(�
PLANNING&ZONING Reviewed by• : PI Date: 7'/ 7`/5
TREE ADMIN. Second Review: roved as revised.
❑App ❑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