93 KIMBERLY CT - GARAGE DOOR rr\r,1`.
f____,-4 n\,� t;, CITY OF ATLANTIC BEACH
`. 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
J1.'1c`l
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-2012
Job Type: WINDOW AND/OR DOOR
Description: garage door
Estimated Value: $3.109.00
Issue Date: 9/1/2015
Expiration Date: 2/28/2016
PROPERTY ADDRESS:
Address: 93 KIMBERLY CT
RE Number: 169519-0785
PROPERTY OWNER:
Name: DOMIMICK II, ESMOND LESTER
Address: 1431 RIVERPLACE BLVD APT 2310
GENERAL CONTRACTOR INFORMATION:
Name: D & D GARAGE DOORS INC
Address: 1177 CATTLEMEN RD DALLAS MILLER
Phone: 941-371-7242
PERMIT INFORMATION:
IFEES:
PLAN CHECK FEES $32.77
BUILDING PERMIT FEE $65.55
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $102.32
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
Flit COPY 800 Seminole Road, Atlantic Beach, FL 32233 W - 2a /2_
Office (904) 247-5826 Fax (904) 247-5545
,lob Address: "1S 4( e'F' __ • Permit Number:
Legal Description v�q{ �- 11,2h�-�4 1 7 c �y�I're 4_ Parcel # f�trp b7
Floor Area of 1 q.Ft. Sq.t-t
Valuation ()I' Work $ 3(09.'60 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 algElft
If an existing structure, is a tire sprinkler system installed", (Circle one): 'e. a N /A
Florida Product Approval # I45a,C1
•
For multiple products use product approval form
Des 'be in detail the type of work to be performed: (a_c)CC t e,Q 4-
Or. , C1 l-kbf�D6 i-37 f-4 l/!!
Property Owner In bl rmatiun:
•Name: (,eS-�Cc Qotn(d t is _Address:_
City _ State _Zip Phone
E-Mail or Fax # (Optional)
Glutractur Inl'urmation:
Lonlpwiy Name: D-t p r7Qrai e. POOrs Qualifying Agent: Pa.Ilac, Mi I l er
Address: I (1'1 Co-H e rnen WeDad City .Sarasvf-a- State FL Zip 3LI 23
Office Phone 6y41. 3'1 7a4a. Job Site/ Contact Number jcej $iack Rey. 535,-;/46,►x # 141, 31'7, t$0`I
State Certification/Registration # e. CI25$x05
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 no obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
i\suanee o'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 cool if icork is not commenced within sir(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. / understand that separate permits trust be sectored for Electrical Work, Plumbing, Signs, Wells, fools, Furnaces, Boilers, Heaters,
Tanks and Air(onditionert. 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.
/hereby certify that/have read and examined this application and know the sante 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,sate,or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor /�d� .�'e?ik
Print Name 10 l�,)� L-L Print Name
�.�.OQ'1.1..i111 � 1`'� __ . Tall a � ► Iles._.
Swor and subsc )ed before • Sworn to and subscribed before me
this Day of 4 . 2O I this�, ,� Day of._.. , 20
r . #EEt85f, — — �r•(µ� ,,,.` _TWEE HOUSE•
Notary Pohl Co Imes lutach 11 2��7�/ Notary Public :.r,r'" p°"�s. Notary Public-State of Florida
gBo, TryNTm/FanYsxarce8043B670t9 =•• '.1;• my.comm`y Exo�jr s Sep 23,2016
:s 111: •of
-vilik IF L 203072
Bonded Through National Notary Assn.
•
5l,:vp;.e., City of Atlantic Beach APPLICATION NUMBER
rs `" t1 Building Department (To be assi ned by the Building Department.)
800 Seminole Road /5� // / /^ J,
j�: �' Atlantic Beach, Florida 32233-5445 (/�/ �V,�J (Q
iir)
\ / Phone(904)247-5826 Fax(904)247-5845
S /�x o;t1�/ E-mail: building-dept @coab.us Date routed: Z� / ��
City web-site: http://www.coab.us ///
APPLICATION REVIEW AND TRACKING FORM
Property Address: 93 1 /hg,r/ 0,-,-- t ent review required Yes No
i Buildin
Applicant: S/ Goa 6d �"S ing &Zoning
Tree Administrator
Project: (i-r _ 00 2 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:
li APPLICATION STATUS
Reviewing Department First Review: pproved. ❑Denied.
(Circle one.) Comments:
BUILDI
PLANNING &ZONING
Reviewed by: Date: Y, 31-/-/ S
TREE ADMIN. Second Review: ['Approved as revised. ❑ nied.
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
�l'll('E OF COMMENCEMENT
State of 'FLp__ County of GeV Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements 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 CO/sail C
Legal Description of property being improved: 44—.4:14 — r ICras,7 ,
�`f -'
Address of property being improved: 4 3 k'.A.NN ,e( e L 32253
General description of improvements: Geica5 Q C km- '^
er: L.e•sAec DoM'lnoC Address: q3 r'i(), -,Cly�,�
er's interest in site of the improvement: `
p t. (�o�e Ot.,�nee
-
Fee Simple Titleholder(if other than owner):•
Name:
Contractor: //// ".//
Address:
Telephone No.: 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 Florida: other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
. Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWN: ' "
Sign- c •
'Al% $AL ! ` `Ull .A
�
t . � Date:
Before m t is a d y of tAr F in the County of Duval,State
Of Florida,has personally peared f" '
Doc#2015200980,OR BK 17287 Page 2058, Personally Known:
`�^ '`r"
Number Pages:1 or
Recorded 09/01/2015 at 10:12 AM, Produced Identifi�''on:
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Notary Public: ,,,
COUNTY My commission exp w s;. ^', TM
RECORDING$10.00 j : =
•: =, Commission#EE 851266
Expires March 11208011385.7019
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