1763 PART TER E - WINDOW ., r
�� t,', CITY OF ATLANTIC BEACH
- -,- ;.:,IJ INOLE ROAD
I 800 SEMINOLE
ATLANTIC BEACH, FL 32233
_ INSPECTION PHONE LINE 247-5814
`Jill=r
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 15-WIND-1878
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLACEMNT
Estimated Value: $2.710.00
Issue Date: 8/13/2015
Expiration Date: 2/9/2016
PROPERTY ADDRESS:
Address: 1763 E PARK TER
RE Number: 172020-0412
PROPERTY OWNER:
Name: HAGIST TRUST. JULIETTE B
Address: 1763 PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: WINDOW WORLD OF NE FL
Address: 8110 CYPRESS PLAZA DR APT 405 BRIAN WALL
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $31.78
BUILDING PERMIT FEE $63.55
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2 00
Total Payments: $99.33
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
•
BUILDING PERMIT APPLICATION 1pgROIT
_T
ar. COPY CITY OF ATLANTIC BEACH _ AUG 05
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 By
Job Address: fl( ' 7 E PaC k, \e( _ Permit Number: /SW/40—/F-7
Legal Description • gS (P1•o2S.agE S€ ja .ci U�t4 a Parcel #\" '2,023-0q� l2,Valuation of Work $ Z I Q Floor Area of Sq,Ft. Sq.}-t
Proposed Work heated/cooled non-heated/cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa indow/door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed:itec i ci2, U`Jl c■cA Sl 2...e - i
S iZ.€
Property Owner Information:
Name: N6 \\l\ 3.1 Address: i
�-6 V_Te<( C kCA City PC YDe Can
l State`f Zip "b2233Phone istys 19-26?ceq
E-Mail or Fax # (Optional)_
Contractor Information:
Company Name: t. . L 11 • A wok.I
Address: tD Qualih�i�lg Agent: _1��q�
�I �Q,(P.S� Pks12a Otf — ADS Cit\ .)q,c
office Phone .2 Spppp 33(a� Job Site! Contact Number 3 �N t� State Zip32zSZo
State Certification/Registration # C c- 12LSR—i 1 p 9o�ty�131 oo i Fax SZ1?Co I-7S?-1
Architect Name & Phone #
Engineer's Name & Phone #
=ee Simple Title Holder Name and Address
3onding Company Name and Address
vlortgage Lender Name and Address
• p/ication is hereby made to obtain a permit to do the work and installations as indiccttea. /certifi•that no work or Installation has commenced prior to the
:Nuance of«permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
nd void if work is not commenced within six 16/ months. or if construction or,cork is sus ended or abandoned for a.period of six(6)months at any time after
•ork is commenced l understand that separate permits must be secured for ElectricalpH-ork, Plumbing, Signs, filells, Pools, Furnaces, Boilers, Heaters,
antis and.-t it 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.
terebv cern6 that l have read and examined this application and know the same to be true and correct. .411 provisions of laws and ordinances governing this
2e of work will be complied with whether specified herein or nor. The granting o,; a permit does not presume to give authority to violate or cancel the
ovisions of any other federal.slate. or local law regulating construction or the permai•„urnc..of construction.
! ti���
gnature of Owner ��
Signature of Contractor-- p '", r'
da'A el �`//• �� M
tat Named t .a&•5
W rn
8�0 ,� 652 Print Name nap i �
torn to and subscribed before me .a�G�'S,,pea�a �,� ,rn =. ..
s�_ Day of ``ii �g worn ro and subscribed before me 2 "' al al
1.
� f.a � ', 4•`� this Day of ,it 5 '$
V • j T
•** IF.. - T
,tart' Public '...1-
, °nary Public
Reviced 01 ')A in
FIE COPY
"Simply the Best for Less"
Of NE Florida
8110 Cypress Plaza Dr#405
Jacksonville,Florida 32256
(352)443-7001 • Fax:(352)861-7587
Limited Power of Attorney
Date: C'1'K
To: Building Dept.
From: Brian Wall
•
I hereby name and appoint Christy Galas, Gregory Galas, Naomi Mason, Donna Malvar, Megan
Constable,Joshua Galas, Sabrina Sierens a permit service for Window World NE Florida, to be
my lawful attorney in fact to act for me to register my license and apply to:
P\anic 9,61 for a permit for work to be performed at:
Lot: Blkk: Sec: 1-1 Twp:3 Rge: O 1
Subdivision: JU VQ MQh na y:Parcel or Altkey: 11 P-62.4?_)y0
Address of Job: 11.1k C 1�� k _(
Owner of Property: V )t it I a.YVIS
and to sign and do all things necessary to this appointment.
Thank you for your assistance.
Sincerely
Brian Wall
State Qualifier
CBC1259710
State of Florida
County of Duval
The foregoing instrument was acknowledged before me by Brian Wall,who is personally known to me and
who did not take an oath. , ,,�
Sworn to and su 'bed before (ee this —I[f Q day of J3 ooS1 2015.
Notary Publi �l
My Commission Expires: 10/21/2018 [SEAL]
,aR,PQ ANNE S.ROMANO
MY CAMMISSION t F,•!668G0
EXPIRES:October 21$z0ic$
s °� Bonded TMu Budget Notary
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Customer Name
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Dale: — Stories:
Alarm System Yes___--_ No
Burglar Bars: Yes No
Comments: Low-E LEE
Frosted Color Grids
Type of Construction: Block Brick Wood r��
\ Stucco Hardy Board Vinyl
Type of Windows: Alarm u t Wood Iron No Window
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Outside Measurements:
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rvey City of Atlantic Beach
Building Department APPLICATION NUMBER
v "" "'.r (To be assigned by the Building De a
Atlantic tic Seminole Road
/cr." /./14 y
`� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
�?;�iiii)l City E-mail:web-building-dept@site: http:/lwww.cocoab.ab.us us Date routed: 45--
APPLICATION REVIEW AND TRACKING FORM
Property Address: /76 3 j j' ,r 4' Tit- ■- • - . ent review required Yes
Building
Applicant: Vj t a Q ht.) A aieG 01 - - . • : Zoning
lit-) Tree Administrator
Project: r niAd k) S Public Works
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 �__�
2 . r ,;�.
St.Johns River Water Management District r
Army Corps of Engineers i .....,'
Division of Hotels and Restaurants ; j
Division of Alcoholic Beverages and Tobacco i
Other: ji
APPLI TION STATUS
Reviewing Department First Review: Ricproved. ['Denied.
(Circle one.) Comments:
BUILDIN
PLANNING&ZONING /' /Reviewed by: Date:k-71.5.---
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
i
NOTICE OI'' COMMENCEMENT
Permit No. ll
Tax Folio No. 1■__ ()-- U- U-1IZ.-
State of Florida,County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real properly in accordance with
Chapter 713, Florida Statutes,the following intimation is provided in this Notice of Commencement.
I. D�escri riot of roperty I gal description of property and address if available
- �i.- -3223 - y A S vI-a -a5u- it/a tvtouni>t.,
2. •6reral Description of impr vements:
3. Owner nformation:
a)Name and Address: \Vo,
b)Interest in property: t•a — �� �U! �� ( [;�•�
c)Name and address of simple titleholder(i�other than �j
4. Contractor Information: `
a)Name and Address: l), to -
b)Phone Number: al= ■��� 1 ► f �� vV ( �
5. Surety Information:
a)Name and Address: JAG c..0()nth'(l ef�lZ-S-•�
b)Phone Number:
c)Amount of Bond: S
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon wham notices or other documents may be served as
provided by 7•.3.13(I)(a) 7, Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. In addition to himself/herself,Owner designates
copy of the Licnor's Notice as provided in Section 713.13(I)(b),Florida Statutes. of to receive a
a)Name and Address:
b)Phone Number of person or entity designated by owner:_
9. Expiration date of Notice of Commencement(the expiration date may not be before the completion of construction
and final payment to the contractor,but will be one(1)year from :he date of recording unless a different date is
specified:
J
j WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
M p NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,
cu SECTION 713.13, FLORIDA STATUTES. AND CAN RESULT IN YOUR PAYING TWICE FOR
c O IMPROVEMENTS TO YOUR PROPERTY. NOTICE OF COM
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION IF YOU INTEND TO OBTAIN OFINANCING,
N a? CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
cv U
YOUR NOTICE OF COMMENCEMENT.
Y o-
Under penalty of perjury. I declare that I have read the foregoing notice of commencement and that the facts stated
0 o} w O therein are true to the best of my knowledge and belief
b fio tg z Signature of Owner or Owner's Authorized Officer+Director/PSrtncrRvlanager Signatory's Printed ,me&Title/Of�e
v
k.n_° �Z00 Ei
ct
)' �i o O w The foregoing instrument was acknowledged before me this �_
)zxtrc�ce day of (,GU✓F
by A, ,e /.i as U• ���5
(Name of Person �Jn ��� for
(Type of Aufhnrity,i.e.OfficenAUOrney) (Name or Party Instnrmenr,gas Executed far)
MICHAEL BENNEI'T �N'oTAI .IC,STATE OF FLOIt[D.4
?;•; 'c MY COMMISSION#FF236682 Print Name:
�.,,.. ,• EXPIRES June,03.2019
r+c7,i9's-0 sa Fto,+e.ram yswvc•.conr ❑Personally Kr.own
(Affix Nuiary Sr.I Abuvc7Idenlification'Type: '
irC Revised 3/15/12