1865 Selva Grande Dr - Replace 9 Windows �� '', `s CITY OF ATLANTIC BEACH
- ' ""` ') 800 SEMINOLE ROAD
• r =" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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WINDOW AND /OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- WIND -335
Job Type: WINDOW AND /OR DOOR
Description: Replace 9 Windows
Estimated Value: $5,900.00
Issue Date: 2/18/2016
Expiration Date: 8/16/2016
PROPERTY ADDRESS:
Address: 1865 SELVA GRANDE DR
RE Number: 169542 -5024
PROPERTY OWNER:
Name: PYELL, RICHARD K
Address: P 0 BOX 330198
GENERAL CONTRACTOR INFORMATION:
Name: GREEN MACHINE
Address: 267 SOPHIA TER SUITE 112
Phone: 904 - 436 -5151
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $39.75
BUILDING PERMIT FEE $79.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $123.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
It-up, ' City of Atlantic Beach
J � ' APPLICATION NUMBER
tt Building Department
(To be assigned by the Building Department.)
- � To Seminole Road
9� - Atlantic Beach, Florida 32233 -5445 1 to ■ y1 Q _335
Phone (904) 247 -5826 • Fax (904) 247 -5845
"` ": E -mail: building- dept @coab.us Date routed: (:)�,\ O (
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: \gks) \ uQ Ca cc,,rn4 ent review required Ye o
(�
Iding
Applicant: G-Ce-- `e..t\ Q-9.-��� •..Q, Planning & Zoning
Tree Administrator
Project: p,,C___V__ 9 k/3\ (N6 tx 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: proved. I IDenied.
(Circle one.) Comments: 0 6.._
BUILDING' N
PLANNING & ZONING
Reviewed by: rn A Date: d//y/ L
TREE ADMIN.
Second Review: I 'Approved as revised. I IDeni d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: 1 lApproved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION
nq mth•Vn h., I.
OFFICE COPY CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
gob Address: 1$(Z SEL-U A & Ktin 0E k Permit Number:
Legal Description 3' -Z' D' 25 Z16 SELU - 1 - 1 ER' ; LG P Parcel # / 9542- 501
Valuation of Work $ '7 00 Proposed Work heated/cooled 1•$D non - heated/cooled Z-S
:lass of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa indow door
Use of existing/proposed structure(s) (circle one): Commercial Residentia
if an existing structure, is a fire spnnkler system installed? (Circle one): Yes o
lorida Product Approval # S ! Z
• � .• • ( 3
F or multiple .products use product appro4ral form
Describe in detail the type of work to be performed: R E I f1(E W t n 'Do W S
Property Owner Information:
name: E l C 5 ? 0-C`T S Address: ISLE se L PP 6 e vih D E 1)(
Cit c REW-GN Statefl.Zip 32233 Phone 9o4- Si ct- 17,21
E -Mail or Fax # (Optional)
Contractor Information:
ompany Name: & EEn kilt F4 Lou raEfl 6t1 Qualifying Agent: S ft ME S TS 1 S N o?
Address: Z/ ? SO PR - r � P- .AGE City 5t AO&LISTI111 State ft Zip 32215
Dffice Phone %LI- i3ro` SI,SI Job Site/ Contact Number '{p y - 36- s Fax #
State Certification/Registration # L / I ()C'()1 'icy G 3 1 )-
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address -
Mortgage Lender Name and Address
: Ipplication is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
ssuance 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
end void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of sic 16) 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.
l hereb certify that 1 have read and examined this placation and know the same to be true and correct. All provisions of laws and ordinances governing th
!ype 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 e
provisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Own . Signature of Contractor f, ,L _ I/ - ti--Ag��
m
Print Nae 5p G f > Print Name d at )Yt .‘" S --110 / S 11 c'
Sworn to and subscrib� before me Sworn and subscribed f re me
this. 5 Day of (IJ . 20 / 6 this Day of 20 - '
No Public BRETT C MAUR otary b is (
�Y G ', MY COMMISSION MFF13S933 BRET� (C HAURY
o• EXPIRES Julie 29 20i ' SION #FF136933
taor► 8-0153 Florid3NOtillyfrVie4PASOM EXPIRES June 29, 2018
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Doc # 2016036541, OR BK 17464 Page 976, Number Pages: 1, Recorded 02/18/2016
at 12:37 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RE CO RD ING $10
■ I
NOTICE OF COMMENCEMENT
Tax Folio No. 1121,5___ �4Z r �
State of -064 p l4
County of pUU k4
To Whom It May Concern:
The undersigned hereby informs you that improv•r nts will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes, the following information is in this NOTICE OF COMMENCEMENT. r ELM �t TI tcl�l�R
Legal Description of property being improved: 3$' ZR t — ZS — Z J
9 E /-or l Z
Address of property being improved: ) g ct,' S F LV IA D E 1 A T7!11 TIG a E WA
L 3223 3
General description of improvements:
-FErIIV-E . , Do S €
owner: P 1 C- 51'61-6 Address: ! S LS $ E LU A G 0 nR
Owner's interest in site of the improvement: Wit- Aral L B EWLit CL. 3 Zz3 3 t
Fee Simple Titleholder (if other than owner):
Name:
contractor: 6 EEkJ ICI eCt+I E kEnELTIUe TAU bIO&te LLC.-
Address: 7-6:7 SD NI L • TER-RAGE sr 4,j S Uc it t_ fL 3 2.-p ct s
TelephoneNo.: 4 436, 1 Fax No:
j Surety (if any)
Address: �J`
M �/) T Amount of Bond S
J Telephone No F ax No:
Name and address of any person making a loan , • the construction of the improvements
Name:
Address: .4 I a
Phone No: Fax No
designated by owner upon whom notices or other documents may be
Name of person within the State of Florida, o � � than himself, grated Y
served: Name: fill
A
Telephone No: Fax No:
In addition to himself, owner designates the , ollowing person
to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(6), Florida Statues. (Fill in at a .. s option)
Name: MI
a
Address:
Telephone No: Fax No:
Expiation d a t e of Notice of Commencement i . e expiration date is one (1) year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE 0 Y OWNER /� / Date:
— der of 1. r in the County of Duval, State
Bef. � Y
Of F has P appe& d , of larval.
or
�"" BRETT C HAURY Not Public at Large, of Florida. County
, 7 1 MY COMMISSION AFF13a93 M y commission lorida expires:
'�►;i;;� EXPIRES Junta 2>i, 201: Personally Know
, jy4e (407) 3000153 Fldd N04a15 Produced I den dScation:
4724,,