172 POINSETTIA ST - REMODEL -S rL`Ir
s\ CITY OF ATLANTIC BEACH
o 800 SEMINOLE ROAD
J 40, • ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-2740
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR REMODEL- BATH TUB AND SURROUND
Estimated Value: $7,307.00
Issue Date: 11/24/2015
Expiration Date: 5/22/2016
PROPERTY ADDRESS:
Address: 172 POINSETTIA ST
RE Number: 170638-0080
PROPERTY OWNER:
Name: HUBBARD, LETITIA
Address: 172 POINSETTIA ST
GENERAL CONTRACTOR INFORMATION:
Name: SEARS HOME IMPROVEMENT
Address: 1024 FLORIDA CENTRAL PKWY QA ALFRED WILLIAM
NYMAN, JR
Phone: - -
PERMIT INFORMATION:
FEES:
STATE DBPR SURCHARGE $2.00
BUILDING PERMIT FEE $86.54
STATE DCA SURCHARGE $2.00
Total Payments: $90.54
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
O f f i c e (904)247-5826 Fax(904)247-5845 1 5-f(A i R-Z74 0
Job Address: 1 -2 901 n 5'..p f*-C, Si • P-1--- aik Permit Number:
Legal Description yb.//o •!ee • S 024E- Parcel # p kz7 2_
- D093
loor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 3� Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire installed?sprinkler system nstalled?(Circle one): _ 10 N/A
Florida Product Approval#
For multiple products use product approval form �, r
Describe in detail the type of work to be performed: -f\.zsdz L./UL-u 72dj7 //t) LL irtoa t C
Property
�� )Owner Information:
Name:1-41-114 f�f U (j Le4.4�t) , Address: 1-4-Z Po I , . l 4 , FL 322
City A- ( G1,L f State Zip 3 2233 Phone -- • iusQ•
E-Mail or Fax# (Optional)
Contractor Information: n
Company Name: 4/-4/4 // n
, ._.;�? Qualifying Agent: 4-(ked W�/me2-/7 ,
Address:/D�V rZO vi d� �l s-�Li0IG City Z € ( Stag fit_ Zip32
Office Phone3?,131-9v9f Job rte/Contact Number 95 31/3- Fax#31:24225101S_
State Certification/Registration# C C7 C O i2.13J
Architect Name&Phone# \
Engineer's Name&Phone# /
Fee Simple Title Holder Name and Address Z 4 — &S66
Bonding Company Name and Address am.
Mortgage Lender Name and Address M - VIA— • A■
...--1^c>nne_f-
Application is hereby made to obtain a permit to do the work and installations as indicated. /certify th• : • •• • ation 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 aperiod of six r6)months at any time after
is commenced. I understand that separate permits must be secured for ElectricalpWork, 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 i
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 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.
/ /
Signature of Owner „% i4aAgir v, Signature of Contractor
Print Name LP,- ► i(� �. - 14j L � (: Print Name i9L.`,.? It) Jy1.7/9
Sw, o_,�1d su • i•,..• before e Swort to and subscribed before me
thi• - Day • 11_ a...' ==-1 this j1 -Bay of JS o dri»,C��2 ,20$
CMMISSIOtt t FF•92'951 1� f�-0 t :4LC-G
Ilk a 111AM:OeNi G1NDLESPERG •n 1�..a E. Notary it<; , ;, yi`rttA s DE8QRM P.Rh�1,UF�S. a 0 .26.10
.5
:., :., MY COMMI8SlON 1 '
••./� a/ EXPIRES;August 13,2019
'
wiry W.l. Bonded Thry Not•ry public Underwriters
;Lc!...Alik. City of Atlantic Beach
i' f t\ Building Department APPLICATION NUMBER
800 Seminole Road (To be assigned by the Building Department.)
'' �� ,•r' Atlantic Beach, Florida 32233-5445
- .1_s�R1A-R-Z74b
Phone(904)247-5826 • Fax(904)247-5845
•.,;; 0- E-mail: building-dept @coab.us Date routed: Z 4 1
City web-site: http://www_coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1-1Z. PC)i rvSE.TT( 4 ST Department review required Yes No
koly\ 1 Building
Applicant: s, t •t,v ti, ping &Zoning
Tree Administrator
Project: EAT (4 I E YYIO p G. C Public Works
Public Utilities
Public Safety
0—)0 R- �L ���p U�O� Fire Services
Review fee $ Dept Signature
Iti•-D . ritD P1-C. 00% P60___TcD �
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:
APPLICATION STATUS
Reviewing Department First Review: []Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
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: DApproved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
1111111111 III III Office Location:ORLANDO
Proposal Date 09/22/2015 pcb Number 19237765 Sears Home Improvement Products,Inc.
Customer Home S e Box 522290
LETITIA H. HUBBARD a' 1024 Florida Central Parkway
Customer's Home Plane Customer's Work Phone Home Improvement Products Longwood,FL 32750-7579
(904) 994-0337 Phone(800)469-4663
Street Address ESTIMATE AND PROPOSAL Contractor LicenselRegistration Number
172 POINSETTIA ST FL(CGC012538)
City State Zip Code Bathroom Remodeling
ATLANTIC BEACH FL 32233 Is installation within city limits?
Installation Address County DUVAL (Yes/No): YES
Billing Address(if different from above) City State Zip Code Project Consultant Name&License No (if applicable)
SAM,E MARIA DYGERT 262
Description of the Project and Description of the Significant Materials to be Used and Equipment to be installed
Shower/Tub STRAIGHT FRONT TUB / FRANCISCAN SLATE TILE
(induding strrounds)
Shower Doors NONE
CabinetsNanities NONE
Countertops NONE
Flooring NONE
Mirrors/Lighting NONE
The Bathroom Remodel Addendum is made a part of and incorporated into this contract by
Customer(s)initials c/....,",46Z
reference.
Additional work to be done:NEW TUB, TILE WALL SUROUND, FIXTURES.
Work NOT to be done: Removal or moving of any walls;painting,wallpaper work;repairs of water or termite damage to sub-floors or walls;electrical or
plumbing work outside of this bathroom project.
NOTHING ELSE
SPECIAL INSTRUCTIONS:NONE
All of the above check boxes, "Work NOT to be done," "Additional work to be done," and
Customer(s)initials , ,(�
"Special Instructions"sections have been reviewed and explained to me. `' "
SBR1-H.. (Dig.) Rev 08/13/12 Page 1 of 3
1111111 11 111 1111 Job Number: 19237765
APPROXIMATE START DATE and APPROXIMATE COMPLETION DATE:
The work will start approximately 4 WEEKS (Approximate Start Date)
It will be substantially completed by approximately 5 WEEKS (Approximate Completion Date)
These dates are subject to change at the time the contract is accepted by Sears Home Improvement Products, Inc. ("Sears")or at any other time by mutual
written agreement. Customer understands that the Approximate Start Date is only an estimated date and the Customer will be contacted prior to this date to
schedule the actual start date.
MOLD REMEDIATION: This Estimate and Proposal assumes that no mold remediation will be needed during installation work. If, upon inspection by the
contractor or others,it is learned that mold remediation is necessary then Customer must arrange and pay for such remediation by a qualified person prior to
the start or continuation of work.If Customer fails to arrange for necessary mold remediation within thirty(30)days,Sears may cancel this contract upon written
notice to Customer.
Customer(s)initials o `
PLEASE NOTE that Sears is not responsible for correcting any existing code violations or pre-existing conditions of any subflooring not being replaced at this time.
If additional work is required, it will be the Customer's responsibility.Any additional charges will be quoted and approved prior to the start of any additional work.
Customer(s)initials ..4!,/g
ASBESTOS ABATEMENT: This Estimate and Proposal assumes that there are no asbestos containing materials ("ACMs") that would be disturbed in the
performance of the installation work. If upon further inspection by the contractor or others it is learned that ACMs have to be disturbed to perform work,then
Customer must arrange and pay for abatement of asbestos by a qualified person prior to the start or continuation of work. If Customer fails to arrange for
necessary asbestos abatement within thirty (30)days, Sears may cancel this contract upon
Customer(s)initials
written notice to Customer.
The TOTAL PRICE including all labor,material,taxes and any applicable discount is$ 7,307.95 Contract Price $7,307.95
Initial Payment(not to exceed 30%of Total Price unless Special Order)$ 2,192.38 State Sales Tax( 0.00 %) $ 0.00
Final Payment(balance payable upon completion of job)$ 5,115.57 Local Sales Tax( 0.00 %) $ 0.00
The Initial Payment is due prior to Sears ordering products. Total Amount Duel$7,307.95
The form and method by which the Customer(s)will pay is described in a separate Cash/Credit
Customer(s)initials
Card Payment Addendum made a part of and incorporated into this contract by reference.
NOTICE TO BUYER: YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY
(FIFTH BUSINESS DAY IN ALASKA, FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER)AFTER THE DATE OF THIS
TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.
ADDITIONAL PROVISIONS
Proposal and Approval. Sears offers to furnish the materials and arrange for their delivery and installation as specified on the first page and/or the attached
sketches and specification sheets for the TOTAL PRICE shown.This offer must be approved by the Installation Department. If this is a credit sale or a payment
on completion sale,it must be approved by the Credit Sales Department. If this proposal is not approved or the installation cannot be made in accordance with
the law,this offer will be withdrawn and any payments you have made will be refunded to you.Any materials left over after the installation has been completed
are Sears property and will be removed by Sears.
Installation. I understand that Sears will not install the materials but will arrange for the installation.Sears is not responsible for materials or installation NOT
furnished or arranged by Sears. Sears'installation contractor(s)will obtain all building permits required by local law. For homes located in historic or landmark
zoning districts,Customer will be responsible for obtaining required approvals and related permits prior to the commencement of work on this contract.
Authorization. I authorize Sears to: (1)arrange for a contractor(licensed where required by law)to make the installation of materials; (2)issue a work order
for this installation to a contractor;(3)inspect the installation;and(4)pay the contractor when the installation is complete if I have signed a certificate that the
installation has been completed to my satisfaction.
Delays in Installation. I agree that Sears is not responsible for delays in delivery or installation due to weather,fire,strikes,war,government regulations or any
causes beyond Sears'control.
Oral Agreements and Changes in Contract.I understand that there are no oral agreements between Sears and me.Everything I expect Sears to do has been
included in writing in this contract.Nothing can be changed in this contract unless it is in writing on a separate form accepted by me and Sears.
Responsibility of Buyer. I agree that any information or measurements that I give to Sears are correct and complete. I am responsible for any special work
described in this contract.
Electrical&Plumbing Service. I will provide adequate electrical and/or plumbing service(s)to run any newly installed appliances or other furnishings. If the
electrical and/or plumbing service(s)do not meet the standards of the utility company or electrical and/or plumbing codes, I will make the necessary changes at
my expense unless Sears has agreed in this contract to make the changes.
Payment. I will pay Sears the cash price that covers the price of material and installation as shown on the first page.
Warranty Information.Appropriate product warranty documents will be given to me by Sears.Sears'Warranty on Installation is:
SEARS'LIMITED WARRANTY ON INSTALLATION
In addition to any manufacturer warranty extended to you on the product(s)used(which warranty becomes effective the date the merchandise is installed), if
the workmanship(or application)of any Sears'arranged installation proves faulty within one year after the completion of installation,then upon notice from you
Sears will cause such faults to be corrected by repair at no additional cost to you. If Sears determines that repair is not commercially practicable or cannot be
timely made,then,at Sears'sole discretion,Sears may elect to provide replacement or refund. Service under this Limited Warranty is available by calling
Sears Home Improvement Products at 1-800-222-5030,Option 4. This warranty gives you specific legal rights,and you may also have other rights that vary
from State to State.
SBR1-1=L (Dig.) Rev 08/13/12 Page 2 of 3
H111111111111 Job Number: 19237765
NOTICE TO BUYER
1. DO NOT SIGN THE AGREEMENT IF ANY OF THE SPACES INTENDED FOR THE AGREED TERMS TO THE EXTENT OF THE AVAILABLE INFORMATION
ARE LEFT BLANK.
2. YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AT THE TIME YOU SIGN IT. KEEP IT TO PROTECT YOUR LEGAL RIGHTS.
3. THIS HOME IMPROVEMENT CONTRACT MAY CONTAIN A MORTGAGE OR OTHERWISE CREATE A LIEN ON YOUR PROPERTY THAT COULD BE
FORECLOSED ON IF YOU DO NOT PAY.BE SURE YOU UNDERSTAND ALL PROVISIONS OF THIS CONTRACT BEFORE YOU SIGN.
4. YOU MAY PAY OFF THE FULL UNPAID BALANCE DUE UNDER THE AGREEMENT AT ANY TIME,AND IN SO DOING YOU SHALL BE ENTITLED TO
A FULL REBATE OF THE UNEARNED FINANCE AND INSURANCE CHARGES.
5. YOU MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY[FIFTH BUSINESS DAY IN ALASKA,
FIFTEENTH BUSINESS DAY IN NORTH DAKOTA IF YOU ARE AGE 65 OR OLDER]AFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED
NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. FAILURE TO EXERCISE THIS OPTION, HOWEVER, WILL NOT
INTERFERE WITH ANY OTHER REMEDIES AGAINST THE RETAIL SELLER YOU MAY POSSESS. IF YOU WISH, YOU MAY USE THIS PAGE AS
NOTIFICATION BY WRITING "I HEREBY RESCIND"AND ADDING YOUR NAME AND ADDRESS.A DUPLICATE OF THIS RECEIPT IS PROVIDED BY
THE SELLER FOR YOUR RECORDS.
6. IT SHALL NOT BE LEGAL FOR THE SELLER TO ENTER YOUR PREMISES UNLAWFULLY OR COMMIT ANY BREACH OF THE PEACE TO
REPOSSESS GOODS PURCHASED UNDER THIS AGREEMENT.
FLORIDA HOMEOWNERS'CONSTRUCTION RECOVERY FUND
PAYMENT MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YOU LOSE MONEY ON A PROJECT
PERFORMED UNDER CONTRACT,WHERE THE LOSS RESULTS FROM SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR.
FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM,CONTACT THE FLORIDA CONSTRUCTION INDUSTRY LICENSING BOARD
AT THE FOLLOWING TELEPHONE NUMBER AND ADDRESS: CONSTRUCTION INDUSTRIES RECOVERY FUND, 1940 NORTH MONROE STREET,
TALLAHASSEE,FL 32399;TELEPHONE: (850)921-6593.
ACCORDING TO FLORIDA'S CONSTRUCTION LIEN LAW (SECTIONS 713.001-713.37, FLORIDA STATUTES), THOSE WHO
WORK ON YOUR PROPERTY OR PROVIDE MATERIALS AND SERVICES AND ARE NOT PAID IN FULL HAVE A RIGHT
TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINST YOUR PROPERTY. THIS CLAIM IS KNOWN AS A CONSTRUCTION
LIEN. IF YOUR CONTRACTOR OR A SUBCONTRACTOR FAILS TO PAY SUBCONTRACTORS, SUB-SUBCONTRACTORS,
OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO ARE OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT,
EVEN IF YOU HAVE ALREADY PAID YOUR CONTRACTOR IN FULL. IF YOU FAIL TO PAY YOUR CONTRACTOR, YOUR
CONTRACTOR MAY ALSO HAVE A LIEN ON YOUR PROPERTY.THIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD
BE SOLD AGAINST YOUR WILL TO PAY FOR LABOR, MATERIALS, OR OTHER SERVICES THAT YOUR CONTRACTOR OR
A SUBCONTRACTOR MAY HAVE FAILED TO PAY.TO PROTECT YOURSELF,YOU SHOULD STIPULATE IN THIS CONTRACT
THAT BEFORE ANY PAYMENT IS MADE, YOUR CONTRACTOR IS REQUIRED TO PROVIDE YOU WITH A WRITTEN
RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A"NOTICE TO OWNER." FLORIDA'S
CONSTRUCTION LIEN LAW IS COMPLEX,AND IT IS RECOMMENDED THAT YOU CONSULT AN ATTORNEY.
09/22/2015 09/22/2015
Customer's signature Date Customer's signature Date
09/22/2015 41.4, A"
Accepted by Sears Home Improvement Products, Inc.("Sears")on by:
Date Management Representative
SBR1-FL (Dig.) Rev 08/13/12 Page 3 of 3
Bathroom Remodel Addendum
Consultation Info
Lead Number: 19237765 Date: 9/22/2015 Sales Rep: Maria Dygert
Customer Name: LETITIA H.HUBBARD Phone: (904)994-0337
Address: 172 POINSETTIA ST
City: ATLANTIC BEACH (State: IFL IZipcode: 32233
Worksheet Summary
Quote 2
Proposal Items
Code Description
Drains Drains. Drains
Adders: 'Drain Finish:Brushed Nickel
Franciscan Slate Tile Surrounds. Franciscan Slate Tile
Tile
Adders: (Tile Surround Color.Desert Creme
Grab Bars Grab Bars. Grab Bar
Adders: Grab Bar Width:24"SOLID
Grab Bar Finish:Kingsley/Brushed Nickel
Over Flow Over Flow. Over Flow
Adders: !Oyer Flow Finish:Brushed Nickel
Shower Rods Shower Rods. Shower Rods
Adders: Shower Rod Width:5
Shower Rod Finish:Brushed Nickel
Soap Niche Tile Redi. Tile Redie Soap Niche
Adders: 'Size: 16 x 14 Single
Straight Front Am Acrylic Bath Sys. Straight Front Tub
Adders: Tub Length:60
Tub Depth: 13
Tub Width:29
Tub Drain:Left
Tub Finish:White
T14492 Tub/Shower. Delta-T14492-Addison-Tub&Shower Faucet(requires R10000UNWS)
Adders: 'Faucet Finish:Bri llance Stainless
ZONE-BR-B Zone Charge. Zone Charge B
•
/.?L.!!..-, 09/22/2015 09/22/2015
Bathroom Remodel
Consultation Info
Lead Number: 19237765 Date: 9/22/2015 Sales Rep: Maria Dygert
Customer Name: LETITIA HUBBARD Phone: (904)994-0337
Address: 172 POINSETTIA ST
City: ATLANTIC BEACH (State: FL Zipcode: 132233
1 Worksheet Summary
Description Comments
Quote 2
Proposal Items
Description Units Price Total
Drains" Drains. Drains 1.00 $23.10 $23.10
Adders: 'Drain Finish:Brushed Nickel
Franciscan Slate Tile Surrounds. Franciscan Slate Tile 77.00 $59.40 $4,573.80
Tile"
Adders: (Tile Surround Color.Desert Crema
Grab Bars" Grab Bars. Grab Bar 1.001 $166.731 $166.73
Adders: Grab Bar Width:24"SOLID
Grab Bar Finish:Kingsley/Brushed Nickel
NPS1B Non Pricebook Service. extra 10.00 $51.25 $512.50
Over Flow` Over Flow. Over Flow 1.00 $108.17 $108.17
Adders: 'Over Flow Finish:Brushed Nickel
1 Shower Rods' Shower Rods. Shower Rods 1.00 $120.171 $120.17
Adders: Shower Rod Width:5
Shower Rod Finish:Brushed Nickel
Soap Niche` Tile Redi. Tile Redie Soap Niche 1.00 $166.001 $166.00
Adders: 'Size: 16 x 14 Single
Straight Front' Am Acrylic Bath Sys. Straight Front Tub 1 1.001 $2,019.001 $2,019.00
Adders: Tub Length:60
Tub Depth:13
Tub Width:29
Tub Drain:Left
Tub Finish:White
T14492" Tub/Shower. Delta-T14492-Addison-Tub&Shower Faucet(requires 1.00 $765.31 $765.31
R10000UNWS)
Adders: 'Faucet Finish:Brillance Stainless
ZONE-BR-B Zone Charge. Zone Charge B 1 1.001 $45.001 $45.00
"Quantity calculated by RapidSketch "Quantity calculated by RapidSketch&manually changed by consuant
Discounts
Bathroom Remodel
RETAIL ITEMS
Retail= $8,499.78
Volume Savings= $591.83
Employee Discount= $0.00
Offer Savings= $0.00
Marketing Offer= $0.00
Additional Discount= $0.00
Instant Rebate= $600.00
Tax= $0.00
TOTAL= $7,307.95