2011 BEACH AVE - WINDOW r" tr-
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: 16-WIND-1385
Job Type: WINDOW AND/OR DOOR
Description: WINDOW - 17 REPLACEMENT
Estimated Value: $12,838.00
Issue Date: 6/20/2016
Expiration Date: 12/17/2016
PROPERTY ADDRESS:
Address: 2011 BEACH AVE
RE Number: 169707-0000
PROPERTY OWNER:
Name: BARNWELL, STANLEY L
Address: 21453 ROSEPARK CT
GENERAL CONTRACTOR INFORMATION:
Name: THD THE HOME DEPOT AT-HOME
Address: 2690 CUMBERLAND PKWY STE 300 QA BOYSIE GANGA
REMDIAL
Phone: - -
PERMIT INFORMATION:
FEES: -- --- --
PLAN CHECK FEES $57.10
BUILDING PERMIT FEE $114.19
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $175.29
PER\Irr IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC I3EACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
rf-:.vrjCity of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
ti ,, /
Atlantic Beach, Florida 32233-5445 I I�7'1A 3
Phone(904)247-5826 Fax(904) //-247-5845 //���� 1
c' - E-mail: building-dept@coab.us Date routed: 1.+� t Gd I C7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Za( ( L'H Imo-ye, Department review required Yes No
J v
i mg
Applicant: �H€ ti OM E IcPO l Planning &Zoning
n ) RPLAC Tree Administrator
V
Project: v ( (� 0O(A) t ((7)
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: �1 A<pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: O 'a A
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 YERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
Can Tim for plckUP727-6374400 800 Seminole Road,Atlantic Beach,FL 32233 1
Office(904)247-5826 Fax(904)247-5845 ' (N 0-
3.F35
Job Address: p3 \ l�+zQL) 42— Permit Number:
Ni eact Uvtor 32.
Legal Description 5.--°13 �`e S9s,alreel# 4-70-)-0
Floor Area of q.Ft. Sq.Ft
Valuation of Work$la 1s3e- 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
It'an existing structure,is a fire sprinkler system installed?(Circle one): es No N/A
Florida Product Approval
For multiple products use product approval form
Describe in detail the type ofwo•k to be performed: Rrp�0_17 w trAAd�J GluC...- -1C s �-
Property Owner Information: 1
Name:c5 ' - ''' ' Address: eZO\I. �a}�
City( \t��nV‘c. ACV' StateIt-lip 3 a33 Phone .5 3- F3- 7-•t-a-
Co
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:The Home Depot(it?Home Services Qualifying Agent: 11:..'4.- `,( c).-Y"'`- kaA
Address: 9208 Florida Palm Dr City Tampa State FL Zip 33619
Office Phone 813-626-7548 Job Site//Contact Number-7.).-,-(„1--,_,Fy6ki Fax#
State Certification/Registration# `l�C�y 6 X 3-d''
Architect Name&Phone# 1 M •O 1'n 0.1 (eye etc C!p l�i`pe_I-� -�
Engineer's Name&Phone# 1 1
Fee Simple Title Holder Name and Address C.cm
Bonding Company Name and Address
Mortgage Lender Name and Address
.Application is hereby made to obtain a(monis to do the work and installations as Indicated. l cenifn that no uark or in.rtallatio n has commenced prior to the
issuance ofu permit and!hen all hark will he perftumed to meet the standards of all Imcc regulating constnrcimr in this juricdiction. This permit becomes null
and roil if woe*is inn commenced within six(6/months.or Vanua-nano;or work is suspended or ahtamlaned fora period of six(6f tont/hr at one f%Nle after
work i.cm+menced. /understand that separate permits must he secured for Electrical Work,Plumbing,Signs,(Yells,Pools,Furnaces,Boilers,Hearers,
Tanks and.-lir 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.
1 herehr certify that/have read and examined thisa rplication ul know the same to be one and correct. provisions a flaws and t nihumces gowning this
for ref n ork hill be complied with whether specified and herein or not. The grmnng td a permit does not prestu»e to glee authority to violate or micathe
on
prmsls(irony otherfederal,.slate.or loral law regulating construction or the perlonnance ufeonstructimh.
Signature of Owner X Signature of Contractor4 ....411
Print Name k-��ct ` �C Z y-ko..Q-.1 Print Name SC� i w. ��t
Sworn t.and subscri. • before me / Sew Ig red subs Ihed before me
this _ Day of /�� .20 Ib thi. `'iT Day:of \'`a•1 _- .20/(e
.0 / (l
No any Pubi otary u. rc
Revised 01.26.10
'if BENJI NiCKS
l�I NOTARY pUBL1C
STATE OF FLORIDA
• " : :• Camrtt#FF177687 CHRISTINE O'MAl1EY
moires 11/18/2018 MY COMSSION a FF 087307
t` EXPIRES:January 29Unde,
Bonded Thru Notary Public rwrite n
Doc # 2016121480, OR BK 17578 Page 2026, Number Pages: 1, Recorded
05/31/2016 at 10:04 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
THIS INSTRUMENT PREPARED BY: OFFICE COPY
Name: The Home Depot at Home Services
Address: 9208 Florida Palm ler
Tampa,Ft.33619
NOTICE
LLOFCOMMENCEMENT/,
Permit Number: /V vV /ivQ r i385
Parcel ID Number: I(A I-7Q • QQC D
The undersigned hereby gives notice that Improvement will be made to certain real property,and in accordance with Chapter 713,Flor'da Statutes.the
following information is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY:(Legal description of the property and street address if available)
• - -. ,a 9 G r a a ; a.Nk r -• -c.\,‘ -• 3 . 4-Ca
2. G NERAL.DESCRIPTION OF IMPROVEMENT: \ �
�� W. Cly---►
3. OWN INFORMATION OR LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address. ht.fL ibck.c n W 1\ 2 o c. '( \a�.4.‘e F
Interest inpropey p�r.S` C -
Fee
Simple Title Holder(if otter than owner listed above)Name n \
Ns 1/I
Address: I v 1
4. CONTRACTOR:Name• The Home Depot at Home Services _ Phone Number 813-626-7548
Address 9208 Florida Palm Dr Tampa, FL 33619
6. SURETY(If applicable,a copy of the payment bond Is attached):Name: `I
Address:
Amount of Bond.
S. LENDER:Name' \ n Phone Number
Address' \j-^
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7.,Florida Statutes,
Name: Phone Number.
Address:
8. In addition,Owner designates of
to receive a copy of the Lrernore Notice as provided in Section 713 13(1)(b),Florida Statutes.Phone number.
9. Expiration Date of Notice of Commencement(The expiration i3 1 year from date of recording unless a different date is specified)
WARNING TQ OWNER. ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I,SECTION 713.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR
PAYING 'MICE FOR IMPROVEMENTS TO YOUR PROPERTY A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE
JOB SITE BEFORE THE FIRST INSPECTION IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
01.=Na'n neRA. CRntr./i nseiXkrel
A.Cote,M OaxerillroucePtornstAa chin
stale et �'U'tai CI r3 County of 1J u V 4 /
The foregotnp Instrument was acknowledged before me this aZ q day of MCI./
by S -CA• '0.r -kk
„p,apew,, w arm Who Is rsorrally known to met OR
• 9 nI
who has produced(dentinoatron type of kfentAleetion produced: ft/4- _ C
1 mats:.� .. ARY PUBLIC
STATE OF FLORIDA
Canna FF177687
Expires 11/18/2018
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