1536 OCEAN BLVD - VINYL SOFFIT & FASCIA f. -j \.T./�
(----
`s f CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
7ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
'�J131>r
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-RAAR-1249
Job Type: RESIDENTIAL ALTERATION
Description: INSTALL VINYL SOFFIT AND FASCIA
Estimated Value: $2,870.00
Issue Date: 6/9/2016
Expiration Date: 12/6/2016
PROPERTY ADDRESS:
Address: 1536 OCEAN BLVD
RE Number: 171883-0000
PROPERTY OWNER:
Name: CAMPBELL, DONALD
Address: 1536 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: PERMALAR INC. OF FL., INC.
Address: 8841 ATLANTIC BLVD QA WILLIAM T KOVER
Phone: - -
PERMIT INFORMATION:
FEES: -- - -- - --
PLAN CHECK FEES $32.18
BUILDING PERMIT FEE $64.35
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $100.53
PERNuT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rS J n-pif, City of Atlantic Beach APPLICATION NUMBER
j1 Building Department (To be assigned by the Building Department.)
r • .y800 Seminole Road // D
s Atlantic Beach, Florida 32233-5445 1 (0 `f2�-�in^
�-f k"I z'-'
v, (904)247-5826 • Fax(904)247-5845 /— /
�Ji3 9%= E-mail: building-dept@coab.us Date routed: 62/ i /i((j
City web-site: http://www.coab.us (((
APPLICATION REVIEW AND TRACKING FORM
Property Address: I55& Cifk-FV ElAtcp review required Yes No
Building >
Applicant: PGRY1'►aLAK 11000S-C2J S • Hing
` / Tree Administrator
V
Project: I NVL SO p p Y £ Ppsso_i_A 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: Approved. ❑Denied.
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING !
Reviewed by: MDate:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie .
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION
OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845 1 (0--RAA -- 14
Job Address: /.rev Oct ,(BLW? 4-7GA*/7 Sal/Cyt. J933 Permit Number:
Legal Description //'19NDi1-/Ay L0( eLto Y Parcel# /7/0.3 ^0000
Floor Area ofSq.Ft. q. t
Valuation of Work$ a 870, 'Y 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)
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No
Florida Product Approval # ( 'e f1119/1 -/7'5 / ,
For multiple products use pro uct approver orm
Describe in detail the type of work to be performed: /H,SriLL I!/!h'YL SOFFIT���fSoiA
Property Owner Information:
Name:Ot IAL.Q r-TRc€tDbip E C-447P6C-Gt. Address: /3 ' Oc69/y(3L l/,D.
City 141 hrirG 4b4-c , State/Zip 3,,,1233 Phone clo 8'ol 1 - 416,
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Permalar Industries of Florida, Inc. Qualifying Agent: William T.Kover
Address: 8841 Atlantic Boulevard City Jacksonville State Florida Zip 32211
Office Phone 904-721-2227 Job Site/Contact Number 904-2227 Fax#904-721-7682
State Certification/Registration# SCC 056760
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 f6)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 herebycertify 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 ork will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to vio ate or cancel the
provisions of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owne 44Signature of Contractor
Print Name A oetta c prif84 4.L Print Name k/4-4-/A/ti' TI/E0 /2-
Sworn to and subscribed before me Sworn to and subscribed before me
thisgtofh Day of 20 this It Day of .�.. (0 20
(defidele_ Alut
e.
Notary Publicrot :°u&c RONALD Notag ;.::•6licRONALD C.LYNCH
* , * MY COMMISSION#EE 857628 * * MY COMMISSIONS EE 857628 Revised 01.26.10
T EXPIRES:February 15,2017 EXPIRES:February 15,2017
-Sof 101 Bonded Thar Outer Notary Services "f'a nd+� Bonded Thru Budget miry Services
NOTICE OF COMMENCEMENT (� r
(PREPARE IN DUPLICATE) OFFICE COPY
Permit No. /( %'c'/�f�-�7~
State of Florida Tax Folio No. i 7/ 3 -oaoO
County of
To whom it may concern:
The undersigned hereby informs you that improvements will be made to certain real ro e
accordance with Section 713 of the Florida Statutes, the following information is stated in th s O�TICE'OF
COMMENCEMENT.
Legal description of property being improved: //174 (0114,4}1 Lo'T a QLK
Address of property being improved: /536 OCe/9i‘1,,(JLU,J, ,-TG,q Tic 60.4"/ F‘,
233
General description of improvements: f N5 ri.9L L r///Y7 5o1-F'7 y%f=,4s-c/ ,
Owner Do/Y t-,g ry Tii9-641- PL3C-GL.
Address (& o�%g/� L I (/L7• 47-LA/`CTrG 6 /. /c( 3 2 33
Owner's interest in site of the improvement (Z//7-Al
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Permalar Industries of Florida, Inc.
Address 8841 Atlantic Boulevard Jacksonville, Florida 32211
Phone No. 904-721-2227 Fax No. 904-721-7682
Surety (if 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
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
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
rliffarPnt rlatP is snecifiedl: __