330 19TH ST - WINDOW f-sf ' `' `T CITY OF ATLANTIC BEACH
- � ; A .,. (-) 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
JOB INFORMATION:
Job ID: 15-WIND-2298
Job Type: WINDOW AND/OR DOOR
Description: window doors
Estimated Value: $8,650.00
Issue Date: 10/16/2015
Expiration Date: 4/13/2016
PROPERTY ADDRESS:
Address: 330 19TH ST
RE Number: 172020-1208
PROPERTY OWNER:
Name: MARKEE JOHN A & CHRISTINE L, *
Address: 330 19TH ST
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN WINDOW PRODUCTS
Address: 2633 S POWERS AVE QA KEITH ALAN GURR
Phone: - -
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $93.25
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $46.63
STATE DBPR SURCHARGE $2.00
Total Payments: $143.88
PERMIT IS APPROVED ONLY IN ACCORDANCE Wr1'H ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rsyArt;l' City of Atlantic Beach APPLICATION NUMBER
*: . �tii Building Department (To be assi ned b the Building Department.)
2 800 Seminole Road /� � d -- 2-2- f
�r�'.'W r� Atlantic Beach, Florida 32233-5445 ',�Y /Q
�� r Phone(904)247-5826 • Fax(904)247-5845 /� ?
0;31 :- v E-mail: building-dept @coab.us Date routed: 7 ...+" 1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Addres : S.36 / 9 771 S T- De artment review required Ye No
uildin
Applicant: iC/'O// bolo Planning &Zoning
/� /� - _Tree Administrator
Project: .)Q !•'_w/ Public Works
Public Utilities
Public Safety
Fire Services
Review fee $_ Dept Signature _
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review:
1E(..-roved. ❑Denied.
(Circle one.) Comments: /�
BUILDIN V C
PLANNING & ZONING 1C y /0'9-/�
Reviewed by: / Date:
TREE ADMIN. Second Review: Approved as revised. (Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH red E' r"
800 Seminole Road, Atlantic Beach, FL 32233 -1 1
■
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 3 gq Permit Number: /5 W//1Q -22y8-
Legal Description S€1VQ. MaP-t(-1a, l I (2- Lot Parcel# 112-0W' 12-0S
00 oor • ea o q. t. q. t
Valuation of Work$ 0 Abe Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/s window/door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure,is a firs�nnkler system (Circle one). ^ Yes No N/A
Florida Product Approval # e- U 4/6 g'/; /y(,U'/-23 /9605--rz 3
For multiple products use product approval form
Describe in detail the type of work to be performed: r2- P131,0-c,42-61 eat W 114 CLOWS
1 OL1010z.e.61 eat 56-b I L -a) k)L P jui &L
Property Owner Information:
Name: an .15t} 1r11L ,(, (,E'& Address: 33G iC
City J) State F ti Z i p ?32 2& Phone 21— "Pi $
E-Mail or Fax#(Optional)
AMERICAN WINDOW
Contractor Information: PRODUCTS, INC.
2633 POWERS AVE.
Company Name: JACK8ONVILLE, FL 32207 Qualifying Agent: 1
Address: City State ' Zip
Office Phone '131- 22 4 1 Job Site/Contact Number Fax# "7 3(- g3 2y
State Certification/Registration # (%�C=1 Z5 1 209
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 thi
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 nul
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. 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 opplication 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, or local law regulating construction or the performance of construction.
( ; ) P ^
Signature of Owner Signature of Contrac r
Print Name Cam,,,-.:. a C )6.__Q- Print Name tilt) etal
Sworn to and subscribed befor me Sworn to and subscribed before me
thi Day of before 20 I ' is Day of t ,20 (S
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NOTICE OF COMM NCEIIENT
Permit No.
•
State of Flow
County of aJl
0 1S.511g
The undersigned hereby gives notice that improvements will .e made to certain real property, and in
accordance with section 713.13 of the Florida Statutes, the fdlowiing information is provided in this
I NOTICE OF COMMENCEMENT.
ii Legal description of property(Include Street Address, if avail:ble) 19 20 20 - 12.0s
tei Vo_ t k°2ana, 1 i- 1-2_ o f 3
General desg:;•i. - pro ements ' '.,1 (T _laI►! pI •' • `S 5
Own- h R-i st7 rt Y 7 Ce_e_
Ad. ess SSC lcltb bt . A 2?
Ow - r• - -
•, ' - • •- ' •rovement
Fee Simple Title holder(ifother than owner) -
• Name
•
40,034-
r - Addre
ss A ERICANw1pw • -IS — z2� ' -
Rid ..t'Contractor
�;�� Address 243rowl x5`1tVL -
;l � Surety - - -
Address -o° Amount of ••nd $
Any person making a loan for the construction of the Improv-.ments:
Name �-'
Address i
• Person within the State of Florida designated by owner upon whom notices or other documents may be
served as provided'by Section 713.13(1)(a)7, Florida Statutes.
Name
Address , ._
In addition to himself, owner designates /'
Of /
to receive a copy of the Lienor's Notice as provided in Sectiof 713.13 (1)(b), Florida Statutes.
Expiration date of Notice of Commencement(the expiration date isone(1) year from the date of
recording unless a different date is specified) -
I ��
—," i 1 �- /\: \-�-!\c...k_. L 7ç Lk_t_
Signazure of Owner Printed Nan*of Owner •---
F Notary Rubber Stamp Seal 1 1 have relied upon the following i tiScation of the Affiam
Doc#X15236044,OR BK 17335 L}11I e &A_CL42-i( C�.
Number Pa 35 Page 8g.
Pages: t Sworn to and subscribed before me this I C day of 41-t 20 i
Recorded 10;14;2015 at 10:59 AM.
Ronnie F ussell CLERK CIRCUIT COURT DUVAL
COUNT`!
RECORDING 510.00 No- �ignahrrc
WA
Printed Name -
r,,+ A,�, VICKI GURR
* * MY MIS t 8
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