510 ROYAL PALMS DR - WINDOW / DOOR i r�J`I r
, r J��
CITY OF ATLANTIC BEACH
"` `;-� 800 SEMINOLE ROAD
J r ' ATLANTIC BEACH, FL 32233
2 . INSPECTION PHONE LINE 247-5844
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-2127
Job Type: WINDOW AND/OR DOOR
Description: WINDOW REPLACEMENT
Estimated Value: $4,755.00
Issue Date: 9/14/2015 •
Expiration Date: 3/12/2016
PROPERTY ADDRESS:
Address: 510 ROYAL PALMS DR
RE Number: 171514-0000
PROPERTY OWNER:
Name: KRECH. BRENT A
Address: 510 ROYAL PALMS DR
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA GEORGIA CONTRACTORS
Address: 11433 SAINTS RD QA KENNETH MICHAEL BRANHOLM
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $36.89
BUILDING PERMIT FEE $73.78
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $114.67
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FL
BUILDING CODES.
•
:51.4. r City of Atlantic Beach
�s �`,, APPLICATION NUMBER
P Building Department%- ,' 800 Seminole Road (To be assigned by the Building Department.)
. ••_r Atlantic Beach, Florida 32233-5445 /e5 W/�1/ - 2/27
Phone(904)247-5826 • Fax(904)247-5845 n r
dr4finJ>� E-mail: building-dept @coab.us Date routed: y
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: .5/61 .4A-4 -A2 kJ 5 Department review required Yes o
� uilding
Applicant: ! V Ar i4/iQ g/46.--- Planning &Zonin g
/
Tree Administrator
Project: / jegO/4L' ' i,�l" 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
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
r
APPLIC TION STATUS•
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
PLANNING &ZONING (` (�
Reviewed by: /77 l Date:!r 4 / 4/ —
TREE ADMIN.
Second Review: Approved as revised. DD ied.
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
BUILDING PERMIT APPLICATION FILE COrY
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904) 247-5826 Fax (904) 247-58
�, �I r i t 1. t '\ ! t rzl
Job Address: 510 �YAL /PAL-Kf (1 - 'G &904; n 3ZZ33 Pent Plumber: Ill
31 -1(, t*-Z5-Za6
Legal Description ► P PT 1 It, ii MS (Jut i- 2 A- Parcel ill-4'KR 4-b
Valuation of Work$ 55a� Proposed• lea o Batt. Sq.Ft
; Proposed Work heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa *ndow/d
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkle l installed?nstalled?(Circle one): Yes No N/A
Florida Product Approval # '51 .
For multiple products use product approval form ALL
Describe in detail the type of work to be performed: Q QL C(<Ravi W i id d c (ci)
Property Owner Information: n, n
Name: ' C 06 l 1%4 � Address: (p(0( KAIN 171�� K-el
City A to Le_ State -Zip .?2291-- Phone CtO4-q-LG,'-5051
E-Mail or Fax#(Optional)
Contractor Inforrmation:
Company Name:t'ba4M 6LS�RC�I.t- J(,',sh',shads i bUD�1 Quali ing Agent: �2u �`� L'l
Address:1 1130 ST Tj6W5 LID. P14141 44 5 City DtCKSO ith 4 le State ( L- Zip 3224(,
Office Phone 10Y-(,1I-9-r)10 Job Site/Contact Number Fax#eivi-(,QZ-1 132
State Certification/Registration# CO-C-U41 04o
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 f work 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. 1 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.
1 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
d
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.
kgnature of Owner / '�� Signature of Conti c .�i/�
Print Name `' i/ ..■.... .(,._\ / Print Name ehtttellaght.,( L.,h
Swop to and su.. i;ed before me Sworn to and subs.ribed be ore me
this Da s w.... .1 ,20 l S this Day • Al .4.. 20 13
49
Ai Op, ,7 " A)J .rI'r.jfi.1
ifa
Notary ' I is No . ;�•f■ ic-"ra!i -Ill
r Notary Public State of Florida
s vised 01.26.10
f-4 Sarah S Biggerstafi el Notary Public state.v Florida
My Commission FF 213614 , Sarah S Biggerslaff
Expires 0312512019 1t My Commission FF 213814
.>aw Expires 03125/2019
Pefin •L iS—lv,rv4- 2/2
NOTICE OF COMMENCEMENT
State of FLO P-4 Tax Folio No. I-+1514 -00oD
County of t(iV4L— Pu COPY
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 COMMENCEMENT.
Legal Description of property being improved: 31 -((e ('-). -25-29
C�
P ) OF .PT or Q.)L./Ac( '24-L.hS LO L 1 t- Z
Address of property being improved:( J t o 12.09d1 'Paths- ha. ( Af'jt j(C j y PL, 3 2237
General description of improvements: 0(S p /U,DDld5
Owner: J4 Q6 Ii4 Address: t1()( 1 s s R.-60 i - A-ciativoilte, PL. 3 22 fl-.
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name: Lb ,
Contractor: Ro M G con_A 1 A)1 iI DWS Db6R-S LIC -
Address: 1126/o Sr J b thJ S T &Ant p L
xwi psi 1-ACKSansUl lc2 i PL 72-4c
Telephone No.: 04.404
I-%I D Fax No: q 64_cacti_q z,
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: E C E D V E
Telephone No: Fax No: 114e In addition to himself, owner designates the following person to receive a copy of th cnor's Notice,�s provided rn section
713.06(2)(b),Florida Statues. (Fill in at Owner's option) S E P y provided
Name: .J
Address: ...J
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 OWNER P
)6igned: � �
/� /� Date:
Before me ti• Nr. da .' in the Coun of uval,State
Doc#2015206361,OR BK 17295 Page 645, Of Flo ':. has . onally appe. :, ,_ !�t
Number Pages:1 Notary Public at Large,State of Floridp,County of Duval.
Recorded 09/09/2015 at 08:17 AM, My commission expires: 2 S ( l
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Personally Known: ;• fr
COUNTY Produced Identification: •&, Nota Public State of Florida
RECORDING$10.00 ry
� �t: Sarah 5 Biggerstatt �
; My Commission FF 213814
'>o4 fo Expires 03/25/2019