417 OCEAN BLVD - WINDOW / '#' 1 f CITY OF ATLANTIC BEACH
;_,,. ,- ,-, 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-2646
Job Type: WINDOW AND/OR DOOR
Description: WINDOWS
Estimated Value: $6,250.00
Issue Date: 12/1/2015
Expiration Date: 5/29/2016
PROPERTY ADDRESS:
Address: 417 OCEAN BLVD
RE Number: 170162-0000
PROPERTY OWNER:
Name: MILO, STEPHAN E & SARA E. *
Address: 417 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: HARRINGTON REMODELING, INC
Address: 12442 APPLE LEAF DR QA CHARLES HARRINGTON
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $40.63
BUILDING PERMIT FEE $81.25
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $125.88
PERMIT IS AI'I'ROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rifa,9 , City of Atlantic Beach APPLICATION NUMBER
\ Building Department (To be assigne by the Building Department.)
'p 800 Seminole Road '4)///i • 2 /
r) Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 1/ 1
��; �� E-mail: building-dept @coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Add4h7T,rI ss: / 7 e It—PP) Department review required Yes o
�uildin�
Applicant: Ana / jØ 1 ning &Zoning
Tree Administrator
Project: IA -4)60 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: roved. ['Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING
Reviewed by: Date: /J/ �/Y
TREE ADMIN. -
Second Review: ❑Approved as revised. ❑De ed.
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 COPY
00 Seminole Road, Atlantic Beach, FL 32233 OFFICE ``
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 417 Ocean Blvd Atlantic Beach, FL 32233 Per/n(14 # Is- w i 11/o-.26n
Legal Description S-69 16-2S-29E.11 ATLANTIC BEACH Parcel# 170162-0000
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 6250 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 Residential
i
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval# 5179.12 5179.13
For multiple products use product approval form
Describe in detail the type of work to be performed Vinyl window installation
Property Owner Information:
Name:Sara Milo Address: 417 OCEAN BLVD
City ATLANTIC BEACH State FL Zip 32233 Phone 904.469.6046
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:HARRINGTON HOME RENOVATIONS INC Qualifying Agent:
Address: 403 UPPER 36111 AVE SOUTH City JACKSONVILLE BEACH State FL Zip 32250
Office 904.372.0313 Job Site/Contact Number 904.571.4722 Fax#
State Certification/Registration# DUVAL COUNTY LIC#NSS-17
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. 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 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, •ate, or • •l law regulating construction or the performance of construction.
' " , of Contract. -r
Signature of Owner �, Signature o /
^ ,1 ' JJ
Print Name ��� �'��� /"'6 Print Name V�f�l-1/L y �4 - /��✓
Swop,apd subscribe f f i Sworn to and s •. ribed before me
this 'T Day of Y -(-11 ,20 I'3 this,Std R.
.ti'n•f" CARA FORD
//Zip MURAT
Notary Public " ``" EXPIRES U 201812' 9 �t
ro` :J ly 20 N.tary:fi`: :, � •►f 2�4N1
Bonded Thu Notary Dude Undenmtant %. ''R N.eb i•VM1 lr 122.2019
• •
NOTICE OF COMMENCEMENT OFFICE COPY
(PREPARE IN DUPLICATE)
Permit No. /15- 41/11/0—r-26 7 6, Tax Folio No.
State of FLORIDA County of DUVAL
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: 5-69 16-2S-29E.11 ATLANTIC BEACH
Address of property being improved:417 OCEAN BLVD ATLANTIC BEACH, FL
General description of improvements: VINYL REPLACEMENT WINDOWS
I
Owner SARA MILD •
Address 417 OCEAN BLVD ATLANTIC BEACH, FL
Owner's interest in site of the improvement 100
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor HARRINGTON HOME RENOVATIONS INC.
're1�'
Address 403 UPPER 36TH AVE.SOUTH JACKSONVILLE BEACH,FL 32250
Phone No. 904.372.0313 Fax No.
Surety Of any)
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name NA
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 NA
Address
Phone 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 Statutes.(Fill in at Owner's option).
Name
Address
Phone 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 1�
Signed: , 4 �\ XJ�"' DATE r� t-� l�
Before this day of in the
Cop_ Dytial,State bride,h s persarrplty�p red
Doc#2015255444,OR BK 17360 Page 883, 7 N ��— ( �(�+ ` •• , . _...
himself!herself a rms that all statements and decla.'•irivt
Number Pages: 1 are true and acc rate CARA FORD
Recorded 11/05/2015 at 01:11 PM, MY COMMISSION FF 104912 •
Ronnie Fussell CLERK CIRCUIT COURT DUVAL EXPIRES:July 20,2018
of fl;o Bonded T ru Notary Public Underwriters
COUNTY
RECORDING$10.00 "L� dip
Notary Public at Large.State of County of •
My commission expires:
Personally Known C' or
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