1505 JORDAN ST - WINDOW / DOOR sLJAI,P.rie,
my)
CITY OF ATLANTIC BEACH
A
Is- - -,
. sl 800 SEMINOLE ROAD
0 ti: Zs' 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-1775
Job Type: WINDOW AND/OR DOOR
Description: window replacement
Estimated Value: $8,610.00
Issue Date: 8/3/2015
Expiration Date: 1/30/2016
PROPERTY ADDRESS:
Address: 1505 JORDAN ST
RE Number: 172296-0010
PROPERTY OWNER:
Name: BRANCH, SHEILA, *
Address: 1505 JORDAN ST
GENERAL CONTRACTOR INFORMATION:
Name: THD THE HOME DEPOT AT-HOME
Address: 2690 CUMBERLAND PKWY STE 300 QA BOYSIE GANGA
REMDIAL
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $46.53
BUILDING PERMIT FEE $93.05
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $143.58
PERMIT IS APPROVED ONLY IN ACCORDANCE NNTI II ALL CHI OF ATLANTIC REACII ORDINANCES AND TIIE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION P twe. 0„i► -r,;,�. .4t,, pp
r9 r r®p 1 CITY OF ATLANTIC BEACH /47— b3.7 app
..._,;,,.. 800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: I C a 5 37 e c ,^ S' Permit Number: /S w'/l�rf - /7 7 S
Legal Description o26--So I7-,?S •a9 G • O47 E` S,.t7 S7VParcel# 1 7;e296 -Ov/D
(,,t Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 610 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair iMove Demolition pool/sp window/door
Use of existing/proposed structure(s)(circle one): Commercial f fflia, 45
If an existing structure,is a fire sprinkler system installed?(Circle one): o
Florida Product Approval# 71/02•if 7 3167•/S
For multiple products use product approval form
Describe in detail the type of work to be performed: COIe.a. wM�ow> 4- I /161-`° Aso( J1:74-(-1)1 1Ze
Pronerty Owner Information:
Name: .511 o-ron ;Per Address: I CO S 3-ado, s
City 4^>'bn-tio be .t,t, State.( Zip 5.2.2 33 Phone Dii-9.23 -394Y
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:The Home Depot n Home Services Qualifying Agent: 13O .JIe rite'
Address: 9208 Florida Palm Dr City Tampa State FL Zip 33619
Office Phone 813-626-7548 Job Site/Contact Number Fax#
State Certification/Registration# CRC 6'16 frs-K
Architect Name&Phone#
Engineer's Name R.Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
.applicoaiun is hereby made to obtain it permit to do the um*and installanuns as indicated. /certify that 00 u•o3*or insralladon has commenced prior to the
issuance 01a permit and that all 1.01*will he pelfnnted 10 meet the standards of all laws regulating carrsnuciimr in this jurtsdicrion. This permit becomes null
and 1301/i1 WM*IS 1303 commenced within.sir(4,nnurrhs,or if construction or work is suspended or ahanduned fin-a period of six(G/month.;at pay time alter
work is cvunmenced. I understami that separate permits must he secured fin.Electrical-;Fork,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters.
Tanks and.alr 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.
I hereby cerdir that/have rend and examined this implication and know the sate to be true and correct. All pr risrons of laws and ordinancesgocenring this
type of um*:will he complied with;,/tether specified herein or nor. The granting of a permit does not presume to give authority to palate or cannel the
provisions o f any odier.lidernl,mare,or local lawn regulating Cur me r r the perlamance of coma-m.1nm.
Signature of Own —old i ' /}/ �j Signature of Contractor go../41-- 2°`— , '•°i
Print Name .� 4)/. ......MJV. ✓ ... ...........___ Print Name V ilal
Sworn IQ and subscri d before me / Swot"(to and subscribed before me
this Day of .20/-� thiss:11"Day of fit?- .20 1S
Notary Pu otP6Tic
I oL 3'. 134 Revised 01.26.10
BENJI NICKS : TIMOTHY R.O'MALIEY
7. NOTARY PUBLIC ,""y*%-_
l ' .-.,:.2.,. ,.; ,., MY COMMISSION N FF 042794
STATE OF FLORIDA ��;,ro EXPIRES:August 7,2017
`1-.1? Comm#FF177687 R,ht^' Bonded Thin Notary PubGt Under ,rders
• Expires 11/18/2018
11
Doc # 2015167850, OR BK 17242 Page 605, Number Pages: 1 , Recorded 07/22/2015
at 11 :30 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
THIS INSTRUMENT PREPARED BY: FILE COPY
Name: The Home Depot at Home Services
Address: 9208 Florida Palm Dr
Tampa, FL 33619
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number: 17?a?6 -QUID
The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,the
following information is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY: (Legal description of the property and street address if available)
26 -56 I-7-4 S.a9 C • s/D /Q; l Rec-g / 993-r-76/
2. GENERAL DESCRIPTION OF IMPROVEMENT:
roil^z‘ew -t ' n0( rep(.l.�rt,T
3. OWNER INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: �11ua,. A1,tler ISbS Ter do, 1i AYToni'USGT+ , L/ .3.2r2 33
Interest in property Ow Cr n
Fee Simple Title Holder(if other than owner listed above)Name._
Address:
4. CONTRACTOR:Name: The Home Depot at Home Services Phone Number. 813-626-7548
Address: 9208 Florida Palm Dr Tampa, FL 33619
6. SURETY(If applicable,a copy of the payment bond is attached):Name.
Address: 1 "T Amount of Bond:
6. LENDER:Name: Phone Number:
Address: ---
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7.,Florida Statutes.
Name: Phone Number:
Address:
8. In addition,Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes.Phone number:
9. Expiration Date of Notice of Commencement(The exp-ration is 1 year from date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE
JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YCUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
7 /M./ ,Sko,r I r tiler
;Signature I Owne,or ,or Owner's or Lessee's (Prrt ve^r and Provide Signatory's-to/Office)
Authorized OMioer/Drrcc;or/Partnor/Manager)
State of ; G✓)a4 County of /3 UV/11 -- //
The foregoing instrument was knowledged before me this day of W)) ,/ /
,20 --r
by St IAY�r /11, 1 e7)14.>„6,- . Who is personally known tome E OR
Name of ocirson,aktng statement
who has produced Identification - type of identification produced: FZ-
( 32$IIa BENJI NICKS
NOTARY PUBLIC
7.£ TATEOFFLORA
1`;`-s:.Cow FF177687
1'
Expires 11/18/2018 Nola!,slylature
r; r ; City of Atlantic Beach APPLICATION NUMBER
j, 4\- Building Department
N<<l■ (To be assig -d by the Building Department.)
A s 800 Seminole Road
Z. -i4.yl Atlantic Beach, Florida 32233-5445 ,1l {—
Phone(904)247 5826 Fax(904)247-5845 er+
f 7- f�
- [„y oa .us D E-mail: building-dept @cb AN
'-� Date routed: SS��
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1(ic edr„ Jr Department review required Yes o
C Building
Applicant: //fl A 01 t og 07-0(:1 1- ning &Zoning
P Tree Administrator
Project: Ada) /,.0 N Public Works
'�`�'j ✓ Public 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:
APPLI TION STATUS
Reviewing Department First Review: Approved. ['Denied.
(Circle one.) Comments:
LDING
PLANNING &ZONING /`
Reviewed by: Date:7'p?4c1
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denie
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