277 BEACH AVE A - WINDOWS r,- 1,i-vi-r,,,
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' CITY OF ATLANTIC BEACH
J i
r � 0 800 SEMINOLE ROAD
74_ ATLANTIC BEACH, FL 32233
�;3 INSPECTION PHONE LINE 247-5814
RESIDENTIAL - NEW SINGLE FAMILY RESIDENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0199
Description: REPLACE 13 WINDOWS
Estimated Value: 5594
Issue Date: 10/11/2017
Expiration Date: 4/9/2018
PROPERTY ADDRESS:
Address: 277 BEACH AVE A
RE Number: 170192 0000
PROPERTY OWNER:
Name: HOLMES MARK H LIVING TRUST
Address: 275 BEACH AVE
ATLANTIC BEACH, FL 32233-5214
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.
0}...A4-,7„,. City of Atlantic Beach APPLICATION NUMBER
Js41141440iBuilding Department (To be assigned by the Building Department.)
`i 800 Seminole Road
Atlantic Beach, Florida 32233-5445 ESL (�
Mr
Phone (904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: 1 &/(p /I 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (___7 7 1�C—,INCH V Department review required Ye No
uil mg �
Applicant: 1Y\E=Z1 C •U0 Planning &Zoning
1J II Tree Administrator
L
Project: t i I N) 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:
APPL ATION STATUS
Reviewing Department First Review: Approved. ❑Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: /0— /'l-7
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 05/19/2017
D U 1Lll11N li rL+K1v111 AYYLICA1 IUIN
OFFICE COPY CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845 =0y--
Job
y-
Job Address: 01 c 7 CI\ �, Re FL. 3,9,933 Permit Number: R ES 1 7- 0 l 99
ft-Han+ic
Legal Description S-(09 I(Q-a5-- E eieach 10+5 6 1 I'i al Parcel# ( p t q -Od Q 0
w Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$5l5 9*1. Proposed Work heated/cooled non-heated/cooled 1(fA
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spawindow door
Use of existing/proposedstructure(s) (circle one): Commercial esidentiaL
If an existing structure,is a fire sprinkler sy tem i stalled? (Circle one): es No N/A
Florida Product Approval # SEE A k
For multiple products use product approval orm
Describe in detail the type of work to be performed: Iet c@r �-4- LC';fcb.L* .
SI, za - :)C . 's 1
Property Owner Information:
Name: kAac--C_V No4mc5 Address: 011 13( 2d1 41A-Vt.
City A# C 4 i C 8E Ch State FC.Zip 3)3 3Phone 9044-b14)So- O 3413
E-Mail or Fax#(Optional) M 1-As WINDOW
Contractor Information: PRODUCTS,INC.
2633 POWERS AVE. I L
Company Name: JACKSONVILLE,FL 32207 Qualifying Agent: 1 C err
Address: City State ' Zip
Office Phone -131-07 Job Site/Contact Number Roll-13)-031A 7 Fax#13 I- 8�3,),.14
State Certification/Registration# C' C: l Os 1 ao-1
Architect Name&Phone# QC]. _ 5 A47
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 abandoned fora eriod of six(6)months at any time after
work is commenced I understand that separate permits must be secured for ElectricalpWork,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 hereb certify 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 speci ted 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, or local law regulating construction or the performance of construction.
*ignature of Owner NN \)\\/----' Signature of Contractor
Print Name (.A 4\GA Print Name -het-inG-I.0 r
Sworn to and subscribed before eSworn to and subscribed b fore ride
;'
this Day of ^ • i I r 20 this I Day of r ,20 r7
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ota Publi �_ _ �'ub
rY ;oil?ve� EVANGELIE CLARKE
L4 ih A 62. —S 4 ..i .'1.-,5,4-'
, r 0CommIsslon#GG 102835 �,�Y P EVAission CLARKE
O — -" Commission#GG 10283 evised 01.26.10
- ,i I c5 Expires May 9,2021 * "1 A , *
iit`.o,,t00 BondedThm Bort*buysemws % In' p�o7 Expires May 9,2021
�'0*o O Bonded Thru Budget Notary services
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PRODUCT ,APPPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
�
Project Name: l oC` 1q�O�O�k nile Permit #R&577 "'G/9o
/
Project Address: 01 1 c) di,1 4 j Ag Fe- 300 3 3
As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72,please provide the information and product approval number(s)
for the building components listed below as applicable to the building construction project for the permit number listed above. You should contact
your product supplier if you do not know the product approval number for any of the applicable listed products. Infomuation regarding statewide
product approval may be obtained at:www,floridabuilding.org.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A.EXTERIOR DOORS
1.Swinging
2.Sliding )11
3.Sectional Ob.
4.Roll up PPP'F'
5.Automatic
6.Other
B.WINDOWS
1.Single hung GA LI 3 1.k-1(.c.O 1
2.Horizontal slider
3.Casement
4.Double hung / �.
5.Fixed 5 f I�-1 z J( N(cc
6.Awning
7.Pass-through
8.Projected
9.Mullion
10.Wind breaker
I11.Dual action
OFFICE COPY
2.Other
Category/Subcategory Manufacturer Product Descripti Limitation of Use State# Local#
H.NEW EXTERIOR
ENVELOPE PRODUCTS
1.
2.
In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project,the
Contractor shall maintain on the job site and available to the Inspector,a legible copy of each manufacturer's printed specifications and installation
instructions along with this Product Approval Sheet
I certify that this product approval list is true and correct to the best of my knowledge.I further certify that use of different components other than the ones
listed in this document must be approved by the Building Official.
(Contractor Name) (Print Name) he 1-4( 1 AMERICAN WINDOW (Signature)
Company Name: Cil(—r PRODUCTS, INC.
2633 POWERS AVE. - --
Mailing Address: JACKSONVILLE, FL 32207
City: State: Zip Code: 1
Telephone Number.(4O 4 )`7 , (..),D1-4-7 (q0
Cell Phone Number.( ) i`(�- E-mail Address: ,NIEG'51 1 -Vicx-0
- Corn
OFFICE COPY
NOTICE OF COMMENCEMEm.
Pmt No. Tax Folio No. 1 7019 r
state of FLORIDA County of C C 1 V�1
To whom It may concern: ( - -7c2D S-
The undersigned hereby informs you that improvements will be made to certain real property,and in
adcordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT. Q 'p
Legal description of property being improved: 1 1 V
un • ICSS x-15 0-7
-•• -_of property being t ved: •
1 1 -
11 1arc .ac, , FL. . 4 cD
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General description of prove ts: 13 p` .0 r�,e 1T f ndOL.L. '
Si 2-G
Owner LA a r- ) 140\TS n
Address 0-1 +��c�C l��' 40,FL' r9r)as
Owner's interest in site of the improvement N/A
Fee Simple Titleholder(if other than owner) N/A
Name N/A
QQ Address
y� Contractor AMERICAN WINDOW PRODUCTS,INC.
��✓✓l Address 2633 POWERS AVENUE - JACKSONVILLE,FL 32207
Phone No.904-731-2247 Fax No, 904-731-8824
Surety(if any) N/A
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name N/A
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 NIA
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 N/A
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLYOWNER4 .,‘At DArEq-)5- / r
,4 Signect
appeared
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Doc#2017233658,
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Pages'.1 VAL °• �� ExIre/May 9,T021
Number Pag 02'.5K CIRCUIT COURT DU
Recorded 101111201 CLER BondedT ruaudpetNolery$ervh
RONNIE FUSSELL / //
COUNTS $10.00 Notary Public at •- . •, Courtly of EJr�t
RECORD" Known,., 5
Personallyor
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