65 19TH ST - REPLACE DOOR 'r��\J`1 r
�� ' '' ,� CITY OF ATLANTIC BEACH
111
�. ' .. .9 800 SEMINOLE ROAD
�O'a`:'ells_., ''... r)
j" ' — „r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
0.21>`"
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-WIND-397
Job Type: WINDOW AND/OR DOOR
Description: REPLACE DOOR
Estimated Value: $7,100.00
Issue Date: 2/23/2016
Expiration Date: 8/21/2016
PROPERTY ADDRESS:
Address: 65 19TH ST
RE Number: 169723-1040
PROPERTY OWNER:
Name: SWEENEY,DAVID & PATRICIA, *
Address: 65 19TH ST
GENERAL CONTRACTOR INFORMATION:
Name: RADON PROFESSIONAL SERVICES
Address: 336 14TH AVE QA WILLIAM TONY DAVENPORT
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $42.75
BUILDING PERMIT FEE $85.50
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $132.25
PERMIT IS APPROVE]) ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
? ' City of Atlantic Beach Building Department APPLICATION NUMBER
(To be assigned by the Building Department)
j ti. lti4'�� 800 Seminole Road ' y
Atlantic Beach, Florida 32233 5445 I N ;� — �c �
.- Phone(904)247-5826 • Fax(904)247-5845
`<v;t»/ E-mail: building-dept @coab.us �7
City web-site: http://www.coab.us Date routed: Cr
APPLICATION REVIEW AND TRACKING FORM
Property Address: i
CO(p ' 1 S4_
De artment review required Yes No
Applicant: RPboM i: RoFst ONA L Planning &Zoning
Tree Administrator
Project: Opt RPCAcYEIT Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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: I Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: in Date:o?)/ 9116 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
1
1
I
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH FILE COPY
800 Seminole Road,Atlantic Beach,FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: (ps 1? ?� 5 � A( 7 f
C g6.A c Permit Number. NO 97
Legal Descri tion p - v1% ;we E/OFT Number:/6-W/,L� e Ls
P q7-9/ g ZS-2S-2fE .t q 40- (k6 Parcel# `�� `` y
Valuation of Work$ ', /00���Proposed Work he ted/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move De r'lima-
Use of existing/proposed ucture s c • . _ k i- 11 V f
If an existing structure,i. a fire sprinkler syste■'�i led? (Circle one): si dent'. Ali \I ` 1
Florida Product Approva -L
For multiple products us• 1 roduct approva orm FEB 2016 1
Describe in detail the type of wor . .- . s - e
.� // : Reto�,rco a rPs7,'d9 4 5/a .. ...-
5t'4it VAce .�pDa( t Ch4Alq a (') 13BJ li" hote 70 (Zi p. • ' / /
Property Owner Information:
Name: /14/A%(i4477' SWe,,4eY Address: lvS /' It S re
City 4 744/41;Y. 3 6,Aft‘ State PLZip 332 31 Phone $3 S - *SZ t
E-Mail or Fax#(Optional)
Contractor Informatiion: CONTRACTOR EMAIL ADDRESS:
Company Name:R,.els,s PAD P 5.°411i ce s Qualifying Agent:
Address:334 / li n At e_ ill • City Z4)4 13e4 el, Stat r t Zip 3 22 so
Office Phone 2 Li G— 'q 7 G rob Site/Contact Number C-7/ i Z f o Fax#
State Certification/Registration# (' 6 C p s 7 7 g 3 Z Y G -3 s Y 6
Architect Name&Phone# 8/472-heg.4- D e 5 tf •d 2-1q- 744 q
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. 1 certi&that no work or installation has commenced prior to the
and void work istnot commenced within six(6)fmonthst or if construction or of is s spen regulating abandoned for in a plc jurisdiction.fsix(6)Tmonths 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 certiiji 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 fed--.1,state, or local law regulating construction or the performance of construction.
Signature of Ow er 1� 4 Al .4, _ Signature of Contractor/'(7
'rint Name Tr/ 4-..-, SW C Crl Print Name
3efore me . — —r. — — ———— — Before me
his Day o:�,�;;K ir.4f N STEPHEN HAFT 2 1 this
4 .4. -1,;(1,,s Nota y Public-State of Florida g7� t1AFT •20 �D
•. " .•E My Comm.Expires May 5,2016 ���P�
�� ._ :° e`.s Notary Public-State of Florida
.c,., Public '' -'�—P4,�—Commission r -EE14548-3— -------- .._--------
�'••:k'oa fo,• O ��.'S 1�'„� o` -My Comm Comm.-Expires May-5,201.6.-
",,,, 4`` Bonded Through National Notary Assn. Commission EE 195483
• 1 �,,0 �` Bonded Through Natiol Notary A s
• 0"siii,f 126.10
OFFICE COPY
NOTICE OF COMMENCEMENT
State of .... ` i County of Dv va I Tax Folio No.
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: •? -91-47q-2 -5---ZS -2 96 . /1 C(
A L L , Ai 1C 6 e3 r- • .7 ' 1- 7 0 4
Address of property being improved: rj ici 77, 5 f A-77_A,d T L Rc d-C 4
General description of improvements: JNS�?-LL (23 5,74,460 4 its ,.1,l�
Lit I) e, s .f., P <'a'e 7
e,d,e- - i iti 7e,Z4 o, . Ll (Z 1\
Owner: 04 ur,'d .t. 14-777 61,1re/de./ Address: / q7/ -7
Owner's interest in site of the improvement: /46' r#)
Fee Simple Titleholder(if other than owner): -
JName: _____
Co tractor: ',*•I, Pie.e S e-'Al{j L.e
Address: 33 C 0'7A /I u Ai. i4 7L tic li. S2 Z. ;u
.j Telephone No.: 2 y4:.-- 0 76 Fax No: 2 Y A, — 3 4( 6
Surety(if any)
Address: Amount of Bond$
Telephone No: r" Fax No:
Name and address of any person making a loan for the construction of the improvements LS 0 LS u V
Name: i
Address: I , III f.
Phone No: _—_ Fax No: • '
mu
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents lay be
served: Name:
.____.._
Address:
Telephone 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 Statues. (Fill in at Owner's option)
Name: -----,
Address: .......'�
Telephone 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 OWNS
Signed: Qi/LC(.L Date: 416 i
_______
Before me this (,6 day of _J,2g4 in the County of Duval,State
Doc#2016034491,OR BK 17461 Page 2118, Of Florida,has personally appeared PA r l'e /.(A... `-4.1/,-T--6 n C
Number Pages: 1 Personally Known: ■
Recorded 02/1612016 at 02:21 PM, Produced Identificltion:_ X1,0"""'� STEPHEN HAtT-
pro ,,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL Notary Public: ?°,���^ 'o ary •u. is- tale of Ftortd `
COUNTY My commission expires:
1114#4( '' E 'Y om
RECORDING$10.00 `��.�';,= ssiuu#EE 195489-
' O °ss Bonded Through National Notary Assn. I
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