254 S OCEANWALK DR - WINDOW r� �S f 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
30B INFORMATION:
Job ID: 15-WIND-1835
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLACEMENT
Estimated Value: $6.279.00
Issue Date: 8/6/2015
Expiration Date: 2/2/2016
PROPERTY ADDRESS:
Address: 254 S OCEANWALK DR
RE Number: 169463-0508
PROPERTY OWNER:
Name: BRANDSTAETTER, RAYMOND & DIANE, *
Address: 254 S OCEANWALK DR
GENERAL CONTRACTOR INFORMATION:
Name: PELLA WINDOW AND DOOR
Address: 7818 PHILIPS HWY QA JAMES SAMUEL ROWLAND
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $81.40
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $40.70
STATE DBPR SURCHARGE $2.00
Total Payments: $126.10
PEI2\IIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
II
-.: :,: City of Atlantic Beach
,' ,, Building Department APPLICATION NUMBER
�' 800 Seminole Road (To be assigned by the Buildin Department.)
:� Atlantic Beach, Florida 32233-5445 /�- //1 l - /b 3�/ Phone(904)247-5826 • Fax(904)247-5845
,, „� E-mail: building-dept @coab.us �!
City web-site: http://www.coab.us Date routed:
APPLICATION REVIEW AND TRACKING FORM
SD‘
Property Address: �� 0eby�/��,f,/ A, epartment review required�s" q
RE o
//a, /rl2 ��_Planning =�
Applicant: If �� Planning&Zoning
/ Tree Tree Administrator _-
Project: � C i.. t(),,,aoluj Public Works
Public Utilities _-
Public Safety ==
_-
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
Florida Dept.of Environmental Protection IIIIIIIIIIII
Florida Dept. of Transportation
IIIIIIIIIIII
St.Johns River Water Management District
MI
Army Corps of Engineers
Division of Hotels and Restaurants
D
MEM
ivision of Alcoholic Beverages and Tobacco IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
Other: —_
IIIIIIIIIIII
APPLI a TION STATUS
Reviewing Department First Review: 10 Approved.
(Circle one.) Comments:
❑Denied.
BUILDING
•
PLANNING &ZONING
Reviewed by: , 3 I 1 -_______—
TREE ADMIN. Date:
Second Review: ❑Approved as revised. Denied I
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
PI@ ee G.It-rip. (a(f r P/v a7-637- ti/0°
n r°-s •-■ ,,--, r^ v
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH it.......r `/ e 1
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 c /', n`
Job Address: O'1.3•`(Qt.oyv.wA - DvS gqPermitNumber: /5 W/ /l/ iO iff s,
Legal Description `la-)1.0fr•7,$-a9E Oq- S-496 3'7-DSaParcel# /A9963-OStlr
Ocqumv...v4 vv.o,Q Lpc3 Floor Area o Sq.Ft. Sq.F't
Valuation of Work S GJ7q.(� Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Mo Demolition pool/spa window/door
Use of existing/proposed structures)(circle one): Commercial sidenital
If an existing structure,is a fire sprinkler ystem installs ?(Circle one): o
Florida Product Approval 10 /1/706.�JiVb•s.N•as J/'1 G1J.(a /16if0e6
For multiple products use product approval form
Describe in detail the type of work to be performed: (*.v\au. 3 w.Au.u. s,z.e c.v. S a-e-
Property Owner Information: i ) /�
Name: Y' .'e.. ;r, iiae-I! Address: 2311 l�ie••‘�-.:'/G (// S
City irra�3aliirMAW-... Slater-4-2,,_ ip 3 3 3 Phone `T(?(-).'17-- .2.4tO7
E-Mail or Fax#(Optional) kits;.-..sc r (w riV ntasfo itr...t
Contractor Information: r1 Q.��
Company Name: ps\\0.l,s.wao s ,J e.ee s Qualifying Agent:BSc,v ea u�ow\ci,,. (j v
Address:5t vs,v.-.).1(d`Fay City hx v.awo's, State F•- Zip Sa.•�.ra /) '1J
Office Phone 107. 937•a ketrct Job Site/Contact Number-k17-(,37-yyd 0 Fax# 'V
State Certification/Registration# C'`O,C 64(•71'k
Architect Name&Phone# /I
Engineer's Name&Phone#
j.. 4`
Foe Simple Title Holder Name and Address J
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 cert16,that no work or instal/orlon has commenced prior to the
issuance of a permit am!that all work will be pediamed to meet the standards of all laws regulating construction in this Jurisrlictimc Thu permit becomeszedrt
turd void work Is not commenced within sir(6l months.or if construction or work is suspended or abandoned for a period of sir//6)mon s at any time a itr
work is commenced. /understand that separate permits mast he secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Beaters,
Tanks and Alt Cottdldoaers,etc
LA
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 YOu R NOTICE OF
COMMENCEMENT.
I hereby certify that!have read and examined this a, lication and/mow the sane to be true and correct All provisions of laws and ordinances governing this
nix of work will be complied with whether specified herein or not. The granting of a permit does not presunne to give authority to violate or cancel the
provisions of any other federal,states,on!...1law regulating construction or the performance of construction.
Signature of Owner i'` N, Signature of Contractor
i
Print Namc _ .- C ,_ s s - Print Name ;To.,.. S Row/t."41
Swore,and subscribed before me Sworn to and subscribed before me
s 9 Day of �a.- Y.20 t this 7e Day of--Mir- .20 a
Notary Public 'Notrycublic
r
_ mow' 870vALLE eevt 0126.10
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CHIME MY t)ONJissict13FF0127B,
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EXPIRES:Janmry 29.2318 .\
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Doc # 2015174901, OR BK 17251 Page 2240, Number Pages: 1, Recorded
07/30/2015 at 10:05 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
Permit w FILE COPY
emit Numher / / it
Parcel IDNumberLlpq )(i:3•C3c1r
NOTICE OF COMMENCEMENT
State of Florida
County arC>,0 c■\
The undersigned hereby gives notice that the improvement(s)will be made to certain real property,and in accordance with
Chapter 711,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)
Address ts`4 6Ceo.hwv,\K'D(.& . law\-se 1;3�ac4. FL Q1,.3
Legal Description kid.I3(3&•- .S-a9& In-DS•a9i •a,6 CY c.v....,\t •(,).,,Jr a 2.4}-b
2. neral description of Improvement(S) •
\Nkvs.a.A,..
3. Owner Information
Name`'&VwA.1 ec\kv le.s Phone&Fax Number 104• -11-1•aEf•-G
Address &,5-4 CR to4n.w' -°t ( S {�'r\a.ate t e�tt, Ft- 'NA. 13
Interest In Property pwyw•K.
4. Fee Simple Tito Holder(If other than owner shown above)
Name ,` Phone&Fax Number
Address I
5. Con tr-4kftor
Name''e\\o Ua._...t,,..)arDaaF-S Phone&Fax Number C/b7-u. S, .S11-1-J
6. Surety(If any)
Name IA Phone&Fax Number
Addressl'A
7. Lender(if any)
NarreNA Phone&Fax Number
AddressN'A
8. Persons with the State of Florida designated by Owner upon who notices or other documents may be served as
provided by 713.11)(a)7,Florida Statutes.
Name t t (p Phone&Fax Number
Address
9. In addition to himself or herself,Owner designates the following to receive a copy of the Uenofs Notice as provided In
713.13(1)(b),Florid?Statutes.
Name Phone&Fax Number
.Address
10.Expiration date of Notice of Commencement(the expiration date Is one year from the 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 1, 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE
OF COMI ENCEMENT.
11. 0•-j(t_4-.1 LA-447.- N-. �1;tn, LAVA-3�hu1s 9 1s.L
Signature of Owners or Owners Authorized Officer/O!rector!Partner/t,1anager Print Mme
Sworn to(or affirmed)and subscribed before me this ` day of '-'6s`y ,20 1' by7F M,(1-vi{a-Bcwd t eN-
LWV.r (type of authority,e.g.officer,trustee,attorney in fact)for $.t 1 d— (name of party on
behalf of whom Instrument was executed. _personally known to me or - produced
(��L as Identification.
` R.i/k
f CIHSt@Eh l fIEA 7
X7
ryo{Not, (Seal) EXPIRMJimary .271a
Vaienlon
Naga(prim)
--AND-
Verification pursuant to Section 92.525,Florida Statutes. Under penalties of perjury,i declare that I have read the foregoing and
That the facts stated are true to the best of my knowledge and belief.
Signatory of Natural Person Sign Ing(In me 011)Above
f leaxe Ca i i -rip. .fir Pem.'r O/v 1,27-- 63 -frY ov
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: a' CQ-&,...v+wt.`Y.- p.r S Permit Number:
Legal Description �1a- 13• oir•aS-aqC Og•as- -96 3-7-DS-Parcel # / 99 3'OS6�
Ocacnv.wavk r..1, a Loll Floor Area of Sq.Ft. q.Ft
Valuation of Work$ CRc 7 Y. 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 esidential
If an existing structure,is a fire sprinkler pystem installe ?(Circle one): o 0
Florida Product Approval # l y7O 6 l Y(e s 3 d /Y 4 IS. (p
For multiple products use product approval form
Describe in detail the type of work to be performed: (��,kAc,t.st.. 3 w•,/-a�w-.% s I 1...e. c-vc s t1.
Property Owner Inforrmation:
Name: A ' ne- ;(- JAR- Address: 9)y Q "tI 4 l lL 0, c
City ira it : S ateC�Zip 7tt3 3 Phone 'IU`(- 7'-(7-- A86-
E-Mail or Fax#(Optional) 10 c�c-1' 7 6.1101.CA.st o het
Contractor Information:
Company Name: Q.eA\e W "-a , r *-s Qualifying Agent: ----Sa v►.e,) O2-n
ow\G�.lb-
Address:,'a5O VS 6\. (- `t a•1 City J-tiv�woga. State F'- Zip Ja.-7-7-6
Office Phone 1/4101• et 37-a i- l Job Site/Contact Number- Y7-637-P1 d o Fax#
State Certification/Registration# C`bC- 6 4 (7t a
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 iwork 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. 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 YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined thisplication 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,oar I al law regulating construction or the performance of construction.
Signature of Owner �` Signature of Contractor
Print Name �„�,..t - 16l Sttel Print Name j..e,. .$ 1Q0.4444
Sworn o and subscribed before me Sworn to and subscribed before me
's ei Day of �• ,20 I this 70,Day of-Tub ,20 t
CAM !�
Notary Public Notary Public
404, TIMOTHY R.o'MALLEYKevI d 01.26.10
MY COMMISSION#FF 042794
tp?:y CHRISTINE O'MALLEY
W.--',,igi EXPIRES:August 7,2017
7.jo, 4 MY COMMISSION$FF 087307 -iff 1;;?°.` Bonded Thor Notary Public undenvreers
a, EXPIRES:January 29,2018
'"''� d`:•• Bonded Thru Notary Public Unden+rilers
F„oT h••