1918 Oak Circle - WINDOWS (----
f* t`
, A CITY OF ATLANTIC BEACH
"1-3 _ ' �� #�,4 800 SEMINOLE ROAD
= ' ATLANTIC BEACH,FL 32233
%J ii9 INSPECTION PHONE LINE 247-5814
RESIDENTIAL - NEW SINGLE FAMILY RESIDENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0252
Description: 5 WINDOWS
Estimated Value: 5176
Issue Date: 11/9/2017
Expiration Date: 5/8/2018
PROPERTY ADDRESS:
Address: 1918 OAK CIR
RE Number: 172020 1252
PROPERTY OWNER:
Name: KLEIN LIVING TRUST
Address: 1918 OAK CIR
ATLANTIC BEACH, FL 32233-4506
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: HOMERITE WINDOWS AND DOORS
Address: 4801 Executive Park CT N BLDG 200 STE 207
JACKSONVILLE, FL 32216
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.
t F4r,�r , a City of Atlantic Beach 'APPLICATION NUMBER
r7.4r r, Building Department (To be assigned by the Building Department.)
800 Seminole Road RE.Sl`7-0ZS Z
P Atlantic Beach, Florida 32233-5445. l/
Phone(904)247-5826 • Fax(904)247-5845 /�,
J:)-471,11;:,) E-mail: building-dept@coab.us _- Date;routed: `` t
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (:) ,Kat2._ Department review required Yes No
tBuilding
\ I O MG-� E �A l Jot0t, Planning._
Applicant: � � ( &Zoning
Tree Administrator
Project: w 1 N Q0t,0-S Public Works
Public Utilities
Public Safety
Fire Services
;Review fee $o Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. nDenied. [Not applicable
(Circle one.) Comments:
•
BUIIlD 1
PLANNING &ZONING //-6 to/7
Reviewed by: �n Date:
TREE ADMIN. Second Review: ❑Approved as revised. nDenied. nNot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. ❑Denied. fNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
,
BUILDING PERMIT APPLICATION OFFICE COPY
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
:_-s---..; Office (904)247-5826 Fax (904) 247-5845 R Est 7- o z5 a
Job Address: I at 1 g 1` GTVi y +C.. _Le) 1 Permit Number:
Legal Description �-�� l Sem n.-4 c:r,�4 �r,�,�" �fi�°e.-6 Pe
� � Parcel
Floor Area of S .Ft.Valuation of Work$ $17(•7 I Proposed Work he ted/cooled t
non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/sp window/door
Use of existing/proposed structure(s) (circle one): Commercial 'esidenti.
If an existing structure,is a fire s rinkler system installed? (Circle one): -es o N/A
Florida Product Approval # 1 S ,s1• LI ILL,) I 39.(4. 1.--)4Q g• 1 Q4-
For multiple products use product approval form Pw
Describe in detail the type of work to be performed: " c-12. ''I^,J< u ,e,- , S kA,‘ i
:,ti -c9,-.JC w 1: , t v r\.
J
Property Owner Information:
Name: k ARL 1<L2i6 . Address: ii1i SPK C jack
City4`
• 'I.�CState Zip 3L-z-33 Phone q'b y - 2 6-.23/S-
E-Mail or Fax#(Optional)
•
Contractor Information: CONTRACTOR EMAIL ADDRESS: `PSCfAyM.t- l eR, i, a , co,
Company Name: 14..2Ri —z 14(AN.•.35 4 0,0-"S Qualifying Agent: •etiuk.q. &row
Address: No( 1X2cs it-zv-e_ O-. 11Zd 2-0' ,ir-;42-67 e State FL Zip 322/ b
Office Phone Goy-,PL. -2.s71---- Job Site/Contact Number CO 4-L f 2'.-W ' Fax#
State Certification/Registration# GC,151 a 1 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 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 abandonedfor a period of six(6)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 hereby cert fy 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 work will be complied with whether specified herein or not. The granting of a permit does not.presume to give authority to violate or cancel the
Provisions of any other federal,state, 6.1, law regulating construction or the performance of construction.
Signature of Owner X •
Signature of Contractor 1 AV! 4 c 0
'Tint Name 6Levi ' ...�P/.�(A) Print Name 1,A LI nd-a, I- gakj'" 1
3efore me
Beforp me
his Day of Dd 1p-er ,20 ) —1 this Day of or obey ,2017
cia �/_
.. _ .---
,,,44:47,, PRISCILLA CLAYMAN
r _ Commission li FF 190924A:2"Y°ve4F PR CILLA CLAYMAN
CI "' Expires May 20,2019 a .. Commission#FF 190324
=r•� .7. : . P. = Exp•ires May 20,2010 n evised 01.26.10
o�°: Bonded Ttnu Troy Fain Insurance 900-385-7019 •1 �C�e
•• IP'oQ.•• Bonded Thai Troy Fern Insurance 800-385-7019
kt
NO? - OF COMMENCEMENT OFFICE COPY
(PREPARE IN DUPLICATE)
Permit No. gEJ 7 Ogg Seal- Tax Folio No.
State of Florida County of Duval
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 stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 404- 10 SQL,P1-OL1t`A-i:1} J Vry 4- f.111--
-
Address of property being improved: j /I' 0Jv- cock .-6.:- ,, 6-IL g2-2-5y
General description of improvements: Replacing windows size for size. - •
Owner (,<A(L L to LL ` -fd\) r
Address 9 jOP4-— c lba)-e— 1-(e-,• l
Owner's interest in site of the improvement fpcv,-I
- Fee Simple Titleholder(if other than owner) 1
Name
Address
Co ractor Homente Windows and Doors
Address 4801 Executive Park Court Bldg.200 Sujq. ite 207 Jacksonville 32216
Phone No.904-29B-2515 Fax No.904-29-2528
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 expire ionsdate is one(1)year from the date of recording unless a
different date is specified): 1,Z--'(7 1-
THIS SPACE FOR RECORDER'S USE ONLY 17,,411/ / -,OWNER
Signed:T— •l . `.TE y 9
/-7Before me this rtay of %
in -
Coun •u -.—t of Florida,has'.ersonally ear ;•
sy ' r iii ,�V•v,.% rf ii ISO)I.LA CLAYMAN
Dec 2017249393,OR BK 1 81 69 Page 552 himself/herself and affirms that all statements a •,,:T_f;-r rUFIN OommiSslon#FF 100024 :
Number Pages:1 are tru d accurate s •: = Expires May 20,2019
Recorded 11/01/2017 12:48 PM, c;f,° , „•` ik °d tin Troy FainInsumnca80046§dig
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY i _/ ' - -11-;
�
RECORDING $10.00 •tdry Public atLarge,Statgpf /" .. Countf W1VkW
My commission expires (if/ it it:) Ldp,1
Personally Known or
Produced Identification 0Lo