1959 Selva Marina Dr door permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
;3 INSPECTION PHONE LINE 247-5814
RESIDENTIAL-ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0091
Description: REPLACE ONE DOOR
Estimated Value: 0
Issue Date: 7/13/2017
Expiration Date: 1/9/2018
PROPERTY ADDRESS:
Address: 1959 SELVA MARINA DR
RE Number: 169506 1002
PROPERTY OWNER:
Name: GATLING TRUST
Address: 1959 SELVA MARINA DR
JACKSONVILLE, FL 32233-4519
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: PELLA WINDOW AND DOOR
Address: 7818 PHILIPS HWY QA JAMES SAMUEL ROWLAND
JACKSONVILLE, FL 32256
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE 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 RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
ri-:vr City of Atlantic Beach APPLICATION NUMBER
n� Building Department (To be assigned by the Building Department.)
800 Seminole Road _
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@wab.us Date routed: 3�
-- _ City web-site: hftp:i/�.wab.us
APPLICATION REVIEW AND TRACKING FORM
q
Property Address: 1 tp S9 ',C=.LVA 1 f/�t (AU "A D ent review requi Yes No
(� Building
Applicant: I— LLP, �/L. ( 000 (Q &Zoning
Tree Administrator
Project: V rO C 002. RGPLACC_ Public Works
Public Utilities
Public Safety
Fire Services
WewJ10.. Dept,Sigpature . .
Other Agency Review or Permit Required Review or Race It
Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: t6ftproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: ��6>� Date: Z r1
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. [-]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05119/2017
BUILDING PERMIT APPLICATION Cal 111n for pick Op w-aa?-Bopp
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 p
Job Address: lq.� S z\Y4 \'`a'c'`Yw. .a_ Permit Number: RES 1 7 - 0 0 I I
Legal Description 39- N0fr-"S-291FSeX1J` N k dna l"Llparcel# /69 6-/aka
Floor ao —SgTt.—54F
Valuation of Work$ `�6 6 Proposed Work heated/cooled bu n-heated/cooled
Class of Work(circle one): Now Addition Alteration Repair Move Demolition pools window/door
Use of
existing/p=wdstructp� rcle one): Commercial
Ifanexistingstrucure,,mafres1ersystem instaled?
(Circle one): es No N/A
Florida ProductApproval# IyxF -1�
For multiple products use p net approvform
Describe in detail the type of work to be performed:��u.
Property Owner Information:
Name:V� x�\ �'-`�- Address: 1459 Se\y0.
City State LZip 33 Phone 4oV-a7d-713a-
E-Mail or Fax#(Optional)
Contractor Information:
PaWindows&Dods �axsaa �a�s.,,xi3-
Company Name: uo yt etr,t,rx,od dad Qualifying Agent:
Address: City State Zip
Office Phone7�7 4D7-bYU Job Site/Contact Number Fax#
State Certification/Registration#
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 1 tang that no work or installation has commenced prior to the
issuance ofo permit and that all work will beperformed to meet the standards ofall laws regulating construction in rhisjurisdlction. This permit becomes null
and void fwork is,tat commumed within six(6)months, or ifcoustmetion or work is suspemied or abandonedfar ape�Pqrs. (6fmm�� thee,nil ,
work is commenced. 1 understand that separate permits must be secured far Ekc&i Work,Plumbing,Signs, WW tL eelers
ranks oMAir Conmaonas,de
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 Oil NOTICE OF
COMMENCEMENT.
IhemV certify that I have read adexamined this plicatianaMknowthesametobetmeadcomect. Allprmnsions oflaws and ordinmcesgoveming this
W of work will be complied with whether specie d herein or mt. The growing of a permit does not p mume to gi+'e authority to violate or cartel the
provisions of any other federal,state,or local law regulating construction or the performance ofcorutmetton.
Signatureof Owner Co mc-I Wc,-Q Signature of Contractor r�
`(-yv.t�awZ
Prior Name Car_...._. Pant Name ....._._..._..... .
...__..vl A._..X05_4�..._..---..._-'--._._............_
Sworn to and subscribed before we Swom tpgnd subsc�before me
this, ay of �Cno- 20 t7 gSi93't" llay o_�J .20 t7
No `\tmy aM\ pith N 4 PublicoDAy
. r."+ri �- aa�snxeorawFv cxnsnxEanu.tE�' evised01.26.10
aYCQNAIISS10xpFFOBTJW "�5k, MY rA;tR7dS510NSFF�i
a, E%PIPES:January?0,2018 EXPIPEa:January PB.2018
$„pit mmmrn�veuanv�BlK uwenam � y got mmu wanv�usum.mn.+
A6Aa
Doc R 2017149954, OR BK 18032 Page 1061, Number Pages: 1, Recorded
06/27/2017 at 09:36 AM, Ronnie I1aea11 CLERK CIRCUIT COURT DWA COUNTY
RECORDING $10.00
Permit Number
Parol ID Numbe(/
NOTICE OF COMMENCEMENT
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WARNMG]OOWNER: ANY PAYMEMs MRD, By THE OWNED AFTER THE ,,EAW I OF WE NOTOE OF
COMMENCEMEM ARE CONSIDWO I ,,,i pAYMENR UNDER CHAPTER 713, PMT 1, YCTION 713.13, FU)RIDA
STAMU, AND (AN RENLT IN HOUR PAYING TWIG FOR IMPROVFMENIS TO YOUR PROPERTY, A NOTICE OF
C IAVJRMEM MUST BE RECOMIED AND POSTED ON WE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO
OBTAIN FMN M,CONSULT YWRIENDER OR AN ATTORNEY BEFORE MANANDNG WORN ON RECORDING YOUR NOME
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BCI$Home Lop In U reegiHtatlon Ho[ToP6 Su[mR sulcNrye so.a rias nud etas rac Staff BCIS Ste Map Lmks Scarth
dbpr Product Approval
Pro User
p,poo,, M1> >6p,fixtion PNall
R p 819896-113
gpplica0on Type Revision
Code Version 2014
Application Status Approved
'Approved by DBPR. Approvals by DBPR shall be reviewed and ratified
by the POC and/or the Commission if necessary.
Comments
Archived
Product Manufacturer Pella Corporation
Address/Phone/Email 102 Main St.
Pella, lA 50219
(641)621-6096
pellaproductapproval@pella.com
Authorized Signature Andrew Morse
morseaj@pella.com
Technical Representative Joseph Hayden
Address/Phone/Email 102 Main Street
Pella, U 50219
(641) 621-6096
jahayden@pella.com
Quality Assurance Representative Pat Bortscheller
Address/Phone/Email 102 Main Street
Pella, G 50219
(641) 621-1000
PJBortscheller@pella.com
Category Exterior Doors
Subcategory Swinging Exterior Door Assemblies
Compliance Method Certification Mark or IJsting
Certification Agency Window and Door Manufacturers Association
Validated By Terrence E. Lunn, PE
Validation Checklist- Hardcopy Received
Referenced Standard and Year(of Standard) Standard YS r
ASTM E330 2082
Equivalence of Product Standards
Certified By
Product Approval Method Method 1 Option A
14896.16 Pella&Architect Series Steel & 37 1/2"X 97 3/4'single gOeed operable tloor with 3-point
'..Fiberglass Panel In-swing Doors lack
with Aluminum Clad or Wood Frame
Limits of Use Certification Agency Certiffli
Approved for use in If VHi: No Fl 14896CAC Fl 16 odf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant; No 06/27/2019
Design Pressure: +55/-55 Installation Instructions
Other.Lock system with door shall be 3-Point Lock. FL14896 R3 11 Drawing 1774.odf
Configurations of glass shall conform m the Current ASTM Verified By: Warren W. Schaefer, P.E. 44135
E1300 standard&have safety rated glass. Door panel may be'.. Created by Independent Third Party: Yes
full or partial light panel. ..Evaluation Reports
Fl 96 R3 AE Drawing 1774 df
Created by Independent Third Party: Yes
14896.17 Pella &Architect Series Steel & 43 1/2" X 97 3/4"single solid operable door with 3-point lock
Fiberglass Panel In-swing Doors
with Aluminum Clad or Wood Frame
Limits of Use Certification Agency CertMCate
Approved for use in HVHZ:No Fl 14896 R3 C CAC FL14896 17 otlf
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Data
Impact Resistant: No 06/08/2019
Design Pressure: +55/-55 Installation Instructions
Other: Lock system with door shall be 3-point lock. FL14896 R3 II Draw oo 1774 odf
Verified By: Warren W. Schaefer, P.E. 44135
Created by Independent Third Party: Yes
Evaluation Reports
Fl 14896 3 AE DOntori 1774 otlf
Created by Independent Th d Party: Yes
19896 8 Pella &Architect Series Steel & 37 1/2 X 97 3/4"single glazed operable door with standard
Fiberglass Panel In-swing Doors latch and de dbolt, cordinforced mullions and dual sidelights
with Aluminum Clad or Wood Frame (68 1/2 X 97 3/4'overall unit size).
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL 4896 R3 C CAC R 14896 18.pd
Approved far use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 05/15/2019
Design Pressure: +30/-30 Installation Instructions
Other: Lock system with door shall be standard latch and FL14896 R3 11 Dr,i,urd 1774 otlf
deadbolt. Configurations of glass shall conform W the current Verified By: Warren W. Schaefer, P.E. 44135
ASTM E1300 standard&have safety rated glass. Door panel Created by Independent Third Party: Yes
may be full or partial light panel. Unreinforced vertical Evaluation Repots
mullions. Standard or ADA sills apply Fl 14896 111 AF Drowing IZZ4.Ddt
Created by Independent Third Party: Yes
14896 19 Pella&Architect Series Steel & 43 1/2 X 97 3/4" single solid operable door with standard
Fiberglas Panel In-swing Doors latch and deadbolt unremforced mullion and dual sidelights
With Aluminum Clad or Wood Frame (74 1/2" X 97 3/4" overall unit size).
Dmits of Use Certification Agency Certificate
Approved for use in HVHZ: No Fl R3 C CAC FL1489619odf
Approved for use outside HVHZ:Yes !quality Assurance Contra;Expiration Date
Impact Resistant: No 05/16/2019
Design Pressure: +40/-40 Installation InslreRions
Other: Lack system with door shall be standard latch and FL14896 R3 II Dravida 1774.odf
deadbolt Configurations of glass shall conform to the current Verified By: Warren W. Schaefer, P.E. 44135
ASTM E1300 standard&have safety rated glass. Sidelight Created by Independent Third Party: Yes
panel may be full or partial light panel. Unreinforced vertical Evaluation Reports
mullions. Standard or ADA sills apply R14896 R3 AE Draw na 1774.pd
Created by Independent Third Party: Yes
14896 20 Pella &Architect Series Steel & 37 1/2"X 97 3/4"single glazed operable door with 3-point
Fiberglass Panel In-swing Doors lock, unremforced mullions and dual sidelights(68 1/2" X 97
with Aluminum Clad or Wood Frame 3/4" overall outsize).
Limits of Use codification Agency Certificate
Approved for use in HVHZ: No FL 48 6 R3 C 4C Rl
Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date
Impact Resistant: No 05/15/2019
Design Pressure: +50/-50 Installation Instructions
Other:Lock system with door shall be 3-Point Lock. FL14896 R3 I1 Drawn, 1774 df
Configurations of glass shall conform to the current ASTM Verified By: Warren W. Schaefer, P.E. 44135
E1300 standard&have safety rated glass. Door panel may be Created by Independent Third Party: Yes
full or partial light panel. Unreinforced vertical mullions. Evaluation Reports
Fl 96 R3 6E Drawing 1774.pulf
Created by Independent Third Party: Yes
Go to Page _ ® Page 1/2 O is
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