106 SARATOGA CIR - WINDOWS ri ' ��v; � CITY OF ATLANTIC BEACH
i1 800 SEMINOLE ROAD
ay)
V~ ATLANTIC BEACH, FL 32233
\<"---'stkp,V INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0172
Description: replace 15 windows
Estimated Value: 5350
Issue Date: 9/21/2017
Expiration Date: 3/20/2018
PROPERTY ADDRESS:
Address: 106 S SARATOGA CIR
RE Number: 171800 0000
PROPERTY OWNER:
Name: Anne Marie Tucker
Address: 106 SARATOGA CIR S
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: AMERICAN WINDOW PRODUCTS
Address: 2633 S POWERS AVE QA KEITH ALAN GURR
JACKSONVILLE, FL 32207
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.
I
CJ )
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole RoadNUMB Atlantic Beach, Florida 32233 5445
11-1
Phone(904) 247-5826 • Fax(904)247-5845
319' E-mail: building-dept@coab.us Date routed: 05 he II -4
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: IOP S . SAfp—p G ( . De artment review required Yes No
p uilding
A
Applicant: mQi(d_Q.o Wiftko v3 'P tt bititAS Planning—8:,Zoning
Tree Administrator
Project: 1014(,L IS 0 (r it(WS 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: roved. EDenied. Not applicable
(Circle one.) Comments: ili 0BUILDING
PLANNING &ZONING ?I Ill 9
Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ['Denied. ['Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Ill Approved as revised. ['Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
BUILDING PERMIT APPLICATION
OFFICE COPY CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904) 247-5845 6-) --((7o
Job Address: i 0(0 S .,r -I-OCID
c...,;.(- S - Permit Number: e6s1-1--0(1 a.
uni+Z
Legal Description.3?-13 f1-as-ORE. qQ t1Ia iO4-(4 Parcel # ( 1 ( &3O�' coo°
Floor Area o q. t. ! Sq.Ft
Valuation of Work$ ) •°-� Proposed Work heated/cooled ( I4 non-heated/cooled U f
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spawindow/door
Use of existing/proposed structure(s) (circle one): Commercial esidenti
If an existing structure,is a fire s',pr^inkler system installed? (Circle one): es No N A
Florida Product Approval# 110l3�••A L 10 �)H
For multiple products use product approval form �(
Describe in detail the type of work to be performed: i3 12,��IV1� Lu i n Oct
, i2..Q. col" Si 2,(
Property Owner Information: r- _]_
Name. C {`i @ --X'ke,r Address: I C(Ci ` c 1 o Q i r •
City e (1-4 i IdOia On State FLZip 5g933hone - 00o- `10
E-Mail or Fax#(Optional) if*
Contractor Information
AMERICAN WINDOWPR ,l")€ 1-14.1
�1�
Company Name: 633 POWER,INC. Qualifying Agent: T1 (4 1 ( Ur
2633 POWERS AVE. %�
Address: �E FL 3322City State Zip
Office Phone 1 I-aa� '� �W17oT'Site/Lon tract Number - �,�
State Certification/Registration# C e Ias-,a02. .i 04 I„�
�v . 1 -- A a s, ' i�S../... rri�..� kat aNr. .LI
Engineer's Name&Phone 4
Fee Simple Title Holder Name and Address
Bonding Company Name and Address SEP 1 2
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I yy� g :, •.. e+ : has commenced prior to the
issuance pia permit and that all work will be performed to meet the standards of all laws regula��tr4�ti• t•' . . , • ti This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspe r,i, ••..•i : ••• •r si months at any time after
work is commenced. I understand that separate permits must be secured for Electrical N � Y'„ n�'1-,'igns, 'ells, Pools, urnaces, 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 certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and• ,inanees governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give autho ' to violate or cancel the
provisions of any other federal, +•te,or local law regulating construction or the performance of construction.
t 1
Signature of Owner , # • Signature of Contractor Air G ---
Print Name (}nom, )1/4)1t ► ...........s.�etCu' Print Name ''' e--�(.(�'r
Sworn o . • bscribey.-,/•re 1. Sworn to and subscri ed befor9�nr�p
this !/ r, ' .f r •a) 20 thi Day of k •(,(. "
/
" 2_0 '7
i j;, .��rF 1.11.r.44.
KE
ROGER� es/� Commission#��102835
691096
,,,,`f '_ f`�.-.4e ;Notary `'ubl7 * � * ' ,
i s EXPIRES:September s,201 o" � P c•
.�F pBonded TMu Budget Notary Woes
k/Mt/C' �` d'' ocBonded Thru Budget*Amy Benito
Revised 01.26.10
Florida Building Code Online https://floridabuilding.org/pr/pr_app_dd.aspx?param=wGEVXQwtD...
PERMIT ;,
FLORIDA CEPAPTMONY OF
Business & Professional Regulation COPY ��
r®®r
BCIS Home Log In User Registration ; Hot Topics Submit Surcharge Stats&Facts I Publications FBC Staff BCIS Site Map Wks Search
dasnr
fProduct Approval
IJ
USER:Public User
ur�yNctQ Wr c
Product Approval Mend>Prockazt_orAppicatian_Sea[sh>ARplsation_List>Appicatbn Detail
*OFFICE OF THE FL# FL17234-R3 OFFICE COPY
SECRETARY
Application 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 Custom Window Systems Inc.
Address/Phone/Email 1900 SW 44th Avenue
Ocala, FL 34474
(352) 368-6922 Ext 245
kpine@cws.cc
Authorized Signature Kevin Pine
kpine@cws.cc
Technical Representative Erin Koss
Address/Phone/Email 1900 SW 44th Ave.
Ocala, FL 34474
(352) 368-6922 Ext 291
ekoss@cws.cc
Quality Assurance Representative Jay Lathrop
Address/Phone/Email 1900 SW 44th Ave.
Ocala, FL 34474
(352) 368-6922 Ext 291
jlathrop@cws.cc
Category Windows
Subcategory Single Hung
Compliance Method Certification Mark or Listing
Certification Agency Keystone Certifications, Inc.
Validated By Steven M. Urich, PE
Validation Checklist- Hardcopy Received
Referenced Standard and Year(of Standard) Standard Year
AAMA/WDMA/CSA/101/I.S.2/A440 2008
ASTM E1300 2004
Equivalence of Product Standards
Certified By
1 of 2 9/7/2017,2:33 PM
Florida Building Code Online littps://floridabuilding.org/pr/pr app_dtl.aspx?paiam—wGEVXQwtD...
Product Approval Method Method 1 Option A
Date Submitted 02/29/2016
Date Validated 02/29/2016 OFFICE COPY
Date Pending FBC Approval
Date Approved 03/03/2016
Date Revised 09/06/2017
Summary of Products
FL* Model,Number or Name Description
17234.1 SH-610 Vinyl Single Hung SH-610 Vinyl Single Hung, Non-Impact, 53 1/8"x 76"
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL17234 R3 C CAC CAR 138-1305.pdf
Approved for use outside HVHZ: Yes FL17234 R3 C CAC CAR 138-1306.pdf
Impact Resistant: No FL17234 R3 C CAC CAR 138-1379.pdf
Design Pressure: +50/-50 Quality Assurance Contract Expiration Date
Other: SH-610 Equal Split or Oriel, Max. size 53 1/8" x 76", 08/15/2018
Fin, Flange, DP +50/-50 PSF. Glass complies with ASTM Installation Instructions
E1300-04. FL17234 R3 II CWS-935C(SH-610, NI).pdf
Verified By: Lucas A.Turner PE-58201
Created by Independent Third Party:Yes
Evaluation Reports
FL17234 R3 AE EvalRep CWS-935C(SH-610, NI).pdf
Created by Independent Third Party:Yes
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Contact Us::2601 Blair Stone Road,Tallahassee FL 32399 Phone:850-487-1824
The State of Florida is an AA/EEO employer.Coo/right 2007-2013 State of Florida.::Privacy Statement::Accessbitty Statement::Refund Statement
Under Florida law,email addresses are public records.If you do not want your e-mail address released in response to a pubic-records request,do not send electronic
mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395.*Pursuant to Section
455.275(1),Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address f they have
one.The emails provided may be used for official communication with the licensee.However email addresses are public record.If you do not wish to supply a
personal address,please provide the Department with an email address which can be made avalable to the pubic.To determine if you are a licensee under Chapter
455,F.S.,please click here_.
Product Approval Accepts:
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Safe
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2 of 2 9/7/2017,2:33 PM
11 - (0-10
PERMIT
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