2215 Alicia Ln window & siding permit t� CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
- 1 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: 17-WIND-3095
Job Type: WINDOW AND/OR DOOR
Description: REPLACE 31 WINDOWS AND REPAIR STUCCO
Estimated Value: $43,464.00
Issue Date: 1/26/2017
Expiration Date: 7/25/2017
PROPERTY ADDRESS:
Address: 2215 ALICIA LN
RE Number: 169519-0755
PROPERTY OWNER:
Name: LEWIS LIVING TRUS,DENISE KLETT
Address: 335 W 107TH ST
GENERAL CONTRACTOR INFORMATION:
Name: BOSCO BUILDING CONTRACTORS
,CBC1250212
Address: 2158 MAYPORT RD QA TODD ALBERT BOSCO
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $133.66
BUILDING PERMIT FEE $267.32
STATE DCA SURCHARGE $4.01
STATE DBPR SURCHARGE $4.01
Total Payments: $409.00
PERMIT LS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORB)A
BUILDING CODES.
yq,arr City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department(.)
i 800 Seminole Road
Atlantic Beach, Florida 322335445
u ' Phone(904)247-5826 Fax(904)247-5845
r�tii�rvN E-mail: building-dept@coab.us Date routed:
City web-site: http://w .mab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Zz �S - (C)� l.,N De entreviewre aired Yes Ao
Applicant: � ds Co tJ b(1..pc—e—S Planning&Zoning
Tree Administrator
3 1 lnl l IJ n 0l J S �7 n Public Works
Project: Public Utilities
ST(9GCC7 �GPfl r.� Public Safety
Fire Services
Review fee $ :alb,, Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Lt3Approved. [-]Denied.
(Circle one.) Comments: yi .I�
ILDING `(/}�y/
PLANNING &ZONING Reviewed by: irn Date: /-,26-t2_
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)24�7--5845 17-W 5
WE) - 309.
Job Address: /��J�� �C �.!`( C. ermit Number:
Legal Description Y(�-9 37-a5- lE
p 'P/ Parcel# 16g519- 0TSS
oor Area o q. t. q. t
Valuation of Work$ 3. 6 0 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Mo lition pool/s window/door
Useofexisting/proposed structure(s)(circle one): Commercial esiden '
If an existing structure,is a fi sprinklers Jem��/t V?(Circle on s No N/A
Florida Product Approval # L 101?7 f
For multiple products use product approval erm �/�
Describe in detail the type of work to be performed: Di,� .U// E���
6XVo4di clef �!T � J� r� SrdlCo
PropertyOwnFr Information: � `
Name: U//Ir �` Address: ;Z;4/ _f/ �• '
City State ip 3 Phone 3/ - 6,000
E-Mail or Fax#(Optional)
Contractor Information: /�JI µ�/t�-
Company Name: (� L />�TD ,Qualif1j�g A�enC %(J/y �-5<O
Address: / o oA City J✓ State Zip X33
Office PhoneO -O'.? Job Site/Contact Number O a - f ,6 0 Fax#�O% A /- 05.7
State Ce-tification/[tegistration# 66L /asOd/a
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 in a1 cerd that no w r . a a 'on has commenced prior to the
issuance ofa permit and that all work will be performed to meet the standards ofall aws�radedarabandomedfora
nuc mn m t is jwis tion. This permit becmes nul(
and void ffark is not commenced within six(6J months,or ifcaretruction or work surind osix/6Jmonthsatanytimeager
workiscommenced. l understand that separate permits must be securedfar£l h, P Is,Aamacm;Boilers,Heaters,
Tanks and Air Condidoners,enc.
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.
/herebp certify that/have readand examined thi plication and know the same to be true and correct. Allprovisiew oflaws and ordimvwc s governing this
type of work will be complied with tether sp i d herein or no[ The graving of a permit does nwt presume to give t t v' ate ar cane he
provmoru of any o&erjedera,. to r(o,al! gula(ing construction or the performance ofconstruction.
Signature of Owner Signature of Contract ,t p
Print Name ...�S'...V... ..�CAM...... ............_...._.._......._ Print Name ......A. ET�SC10
Sworn to and subscribed before me 1 D A.Emil Sworn to and subscribed efor�@I tea'-
this ?3 Day of I PUBLIC this � Day of TV�r AO RY PuNt 11
STATE OF FLORIDA IDA
Camdl FF988C2a Cons11 FF96ak26
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NOTICE OF COMMENCEMENT
State of 11y4wTax Folio No.
County of
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 smW in this NOTICE
-a O Comm
LgDof property being improved: �� 7 j E('/N/1}CSETM..SENT.
AD
- 0 6, 7S W ,B oT 9
Address ofproperty being improved:
General description of improvements: (�
Owner: a �f� Address:
Owner's interest in site ofthe improvement:
Fee Simple Titleholder(if other than owner):
Name: �"r�
Contractor: O l�,v/,Y
Address: /J ,:77 L 3733
Telephone No.: 90 -(J Fax No: -
Surety(if any)
Address: Amount of Bond S
Telephone No: Fax No:
Name and address ofany person making a loan for the construction ofthe 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:
Telephone No: Fiat 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 m Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(l)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER /
Signed: 4aptpe.fd—
Dal : 0 Before me this '2 in the Cow ofDu al,State
OfFlorida has personally
Notary Public at Large,State of Florida Countyof Duval.
My commission expires:
ell, Personally Known: _ Wr TE OF FL or
Produced Identifica[io� � p�
*1.ra STATE OF FiORIDA._
+r�� Cam*FFON428
Expires 311IM20