1034 BIG PINE KEY - WINDOW -
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
r 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-2380
Job Type: WINDOW AND/OR DOOR
Description: door replacement
Estimated Value: $3,644.00
Issue Date: 10/13/2015
Expiration Date: 4/10/2016
PROPERTY ADDRESS:
Address: 1034 BIG PINE KEY
RE Number: 172027-5058
PROPERTY OWNER:
Name: HEFFNER, PHILLIP L AND BARBARA. *
Address: 1034 BIG PINE KEY
GENERAL CONTRACTOR INFORMATION:
Name: PELLA WINDOW AND DOOR
Address: 7818 PHILIPS HWY QA JAMES SAMUEL ROWLAND
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $34.11
BUILDING PERMIT FEE $68.22
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $106.33
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
51..iv;,�, City of Atlantic Beach APPLICATION NUMBER
JS r 6 t+ Building Department (To be as i n by th Bui ng Departm )
800 Seminole Road � � �■"-, Atlantic Beach, Florida 32233-5445 JJJ
,v �~ Phone (904)247-5826 • Fax(904) 247-5845
-orris%- E-mail: building-dept @coab.us Date routed: / 1I,c--
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:/431-/ it,1 9 E kil Department review required Yes`No
/ Inc �, V
Applicant: 71f/ et, — Planning &Zoning
Tree Administrator
Project: Deo( 7 4/ i/ 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 L
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. I 'Denied.
(Circle one.) Comments:
:UILDING
PLANNING &ZONING Reviewed by: / , ( Date:/0la'/.
TREE ADMIN.
Second Review: I 'Approved as revised. F IDenie .
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 1 teo`-w- C" 1-11" -4(
!� CITY OF ATLANTIC BEACH
Berm it PP 7017.637-£�yoo
��r-•1•+ Copy 800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: /().3"1 `(6.Q;ro-. ke1 _Permit Number: 15"w/ run --.??..to
Legal Description (1/•3s /7•,),S Q96 &luck Loges 1-4c-018 Parcel#17)oa-7- J-1,3--S)
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 3G,49•66 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 n '
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes o 0
Florida Product Approval# /`18 L,t
For multiple products use product approval orm
Describe in detail the type of work to be performed: 0(N.est. \ mot c vie S J —%cl,-Q
Property Owner Information:
Name:-c1o0.«. �e.cSsne- Address: )c1-1`4 Q%2, S„r■Q YyL
City i\-s`c.vlr.e �gov. State ff-Zip 3a13J Phone `Yo`t- a47-it 3 7 y
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: L\\4 W. 1/4,44 a. vtt...s Qualifying Agent: "Sc.y Q-6.,.)....NI_
Address: 650 w &..,yR_(L._434 City l-ot.t.)-Ic30 State Fe- Zip 3.3 7.rd
Office Phone -( 7.g37•aPa 9 Job Site/Contact Number Fax#
State Certification/Registration#Ct%&(:).4 C.7t a
Architect Name& Phone#
Engineer's Name&Phone#
Fcc 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 certifi'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 juisdiction. This permit becomes null
and void hf work is not commenced within six(6)nmonths,or if construction or work is suspended or abandoned for a_penal 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 this a plication and know the same to he true and correct. All provisions of laws and ordinances governing this
type of work will he complied with whether spec/red 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.
Signature of Owne4� ,./taJ '-(/ Signature of Contractor
Print Name �c,�•c o u.c.0% We. Y\s k_ Print Name jO,,rnes gok,,./..
Sworn t and subscribed before me Sworn t, and subscribed before me
this o� ay of .t r- . 20 I T this , C' Day of ocr4ee- 20 tS
.1,01.1 dgt;•; CHRISTINE O'MALLEY Y^4., TIMOTHY R.O'MALLEY
Notary Public y,•. �`,j EXPIRES:January 29,2018 otary Pub;.#. ;'' 't.1 1 MY COMMISSION wFF042794
% ?,thy Bonded Thu Notary PubSc Undenxltea ,,, a; EXPIRES:August 7,2017
''• a:h:• Goaded nm Notay RNMe11L ,6.10
Doc # 2015230759, OR ER 17328 Page 926, Number Pages: 1, Recorded 10/07/2015
at 02:18 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
4-
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.2r, r.st..\s\- CC' FILE cok:r-
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Pc'R.tiT?I„.„.1 3E.,,/5'-ww)Q•- 2 38 -
NOTICE OF COMMENCEMENT
The le:dersigned heeSy gives notice that improvement will be made to cet:i.•t real property,and in accordance with Chapter 713,
Florida Stetutrs the following infcrration is provided in this Notice of Ccnmcncuncet, 1
t. D°.Sceo-TIONOF PROPERTY(Leeldemaipdonofthepropery&street address,ifasefleble)TAX TODUONO.: �:(ao1-1";CSY
SUBDIVISION BLOCK TRACT LOT d a BLDG UNIT
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1. OV.IrtR VFOPM�ATION OR LE65N:EINTOR�MATION hY TEE LESSEE CO\:RACTEI)FOR 721 L�CPROV£XENT:
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7. Persons within the Ste of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13(I)(e)7.,Florida Solutes:
a.Yunc aed addrme
b.Pbere art bersef Ecivatcd ponces
S.e.In addition to himself or hem.]l Owner dessignatt: of
to receive a copy of the Liencr's Notice as provided in Section 713.13(1)(b),Florida Shetues
b.Pb.-nc call, ofpcsaoarcoey deiveted by Owen
9. Expiration date of notice of commencement(the=91.-dtion date will be 1 year from the date of recording unless a different dee is
speci•ed): ,20`
W. ' ••• ...tat• :a :Mao,u:• : I.-• .rx.seat It• a•-'RATION OF u E Nona OF CO\,24ENCEMENT
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RE�Oti_Zn _ANvO O STEl 3ONTHE.ORSITE.EEFOFF17 37irRSTThI.4PF.CISON.1F•YOTUINI11'I)7n0117A7NFINANCC:G_CON.t7LT
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State of C_
County of )1,1.L�1Cs1
Tee foregoing instrument was aclmovdadged before me this (.l day of 5-Q r ,20 c?by �;`1,Af6a1ra. �1 ✓f -- ,as
(name (type of au for ty...e.g.ofc:,,trustee,attorney in fad)
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(name of party on behalf of whom instalment was executed)
Personally Known_or Produced Identification _ Type of identification... 1*,_
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BUILDING PERMIT APPLICATION 1 teo`-W- CO`' 1'
CITY OF ATLANTIC BEACH permir P/✓ 7;7.637'eyeo
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: /ovy `1S■b•\ ∎Y`Q.. Ke Y Permit Number:
Legal Description (1/-3‘3. l7•01<5 Q96 Se-Wo- L&Ke s 14X-c b' Parcel # 0 7-Pc) �sc>
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ c3Ca4y•6d 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 n i
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval# /`I i"96.1
For multiple products use product approval form
Describe in detail the type of work to be performed: (ZikkAckest.. \ ' c s.z e. %c t.•e.
Property Owner Information:
Name: ,-cam-« We,.4-4ane.r" Address: 1c`{ %■s. \ra V!ay
City '(moo-i.r'e Qa n State ri-Zip()13J Phone `Yo 4 - a Y 1.11 s 7
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: Q�.\\q W.v vsa 4rOc&I►ti-1 Qualifying Agent (4-6 Q,NA.
Address: 3,70 w Q. 934 City)---o►..yob State FL Zip 3a T,rd
Office Phone":117•CI 37°a P8 9 Job Site/Contact Number Fax#
State Certification/Registration 7i 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 if 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,Healers,
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 hereb y certify that I have read and examined this a plicatioi and know the.same to be true and correct. All provisions of laws and ordinances governing this
type of wok will be complied with whether spec:ued herein or not. The granting of a pernut does no!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.
Signature of OwneEeaJ (/ Signature of Contractor
Print Name �e �u.cu� 2 Ave._ Print Name -7:1";pie.4
Sworn ttq,_and subscribed before me Sworn tp and subscribed before me
this a91- Day of S-t t- , 20 1 T this Cr' Day of oc-r.kp- , 20 lS
0"° CHRISTINE O'MALLEY ;�'*:rY'•; TIMOTHY R.0 MALLEY
•?. !!b ..� MY COMMISSION rFF 08td0t MY COMMISSION M FF 042794
Notary Public otary Pub ii �z
_ 4 EXPIRES:January 29,2018 _., EXPIRES:August 7,2017
q;;t.. Bonded Thru Notary Public Underwriters "'•.F of Bonded Thru Notary QuIN attrr l 6.10