5 10TH ST - WINDOWS S r•j,� r/ra.
:? '- � CITY OF ATLANTIC BEACH
iii0 800 SEMINOLE ROAD
xATLANTIC BEACH, FL 32233
''.-1,0.219t
"!0i3i>' INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0202
Description: REPLACE 3 WINDOWS
Estimated Value: 3200
Issue Date: 10/18/2017
Expiration Date: 4/16/2018
PROPERTY ADDRESS:
Address: 5 10TH ST
RE Number: 170263 0100
PROPERTY OWNER:
Name: CAIRNS SCOTT S
Address: 2358 RIVERSIDE AVE APT 804
JACKSONVILLE, FL 32204
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: MARTIN HOME EXTERIORS
Address: 5749 HAVEN RD QA KENNETH BRIAN MARTIN
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.
olan;..4, City of Atlantic Beach APPLICATION NUMBER
3lir iiiiAA Building Department (To be assigned by the Building Department.)
800 Seminole Road ESI 7-
OZ-OZ-
-5.,
o Z-
5; �,' Atlantic Beach, Florida 32233-5445 l/
Phone(904)247-5826 • Fax(904)247-5845 l
A„ 9�J;t E-mail: building-dept@coab.us Date routed: I O [ 1 I ( l7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Li 1 O ( Department review required Ye No
cBuilding�
Applicant: M t\R.T I fl) 1-4 0 r?'1 K l Cei 0 Q- tanning &Zoning
Tree Administrator
Project: 6 V I N c,O w S Iti F(�LA CkPublic 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: ['Approved. nDenied. ['Not applicable
(Circle one-: Comments: nit0BUILDING �
PLANNING &ZONING Reviewed by: Date: /0-42/
TREE ADMIN. Second Review: ❑Approved as revised. ❑De ed. ['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
OFFICE COPY
? Building Permit Application
kjikr
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
- Phone: (904) 247-5826 Fax: (904)247-5845
Job Address: c )bid S TR ct, AT LA(V1-1 C k•A( H ' F L Permit Number:
Legal Description 0.1.1915 Arn.4-011(.8cAiliPf1,7TiRt:cool ILK Mi- RE# 110-to3 woo
Valuation of Work(Replacement Cost)$ 3 2_00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move -mo Pool indow'Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residenti.
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes NoN/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed:
g'e[/Y\CUe f `1'151l-ckt( C-6 ..i i•'•
Florida Product Appro :I# tzL, 3e5, 1 for multiple products use product approval form
Property Owner Information _
Name: S LOQ � A 1 -Imo- Address: tWi kt Sr121✓ .
City d 11,A N n C (gVA- V1 State Zip ;y2.33 Phone (clo-f)S: 1 —5103
E-Mail SC0Tr,CA12NS(@( MA1► GUM
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: IA M t2T1 c J -1'M'Y U XTCRI UR S Qualifying Agent: N N
Address T 1 S t tArV r=N NAP City JAC kc(JN) LE LState fl—'" ZipOffice Phone Cc10`�)12)- -- cOJob Site/Contact Number
State Certification/Registration#(.Q.C D,*O 3e E-Mail KEN tv1 `' Mian.PrA• e__O M
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
Exempt/Insurer/Lease Employees/Expiration Date
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 the laws regulationg
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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 OBT! ► FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RE ORDIN YOUR NOTICE OF COMMENCEMENT. .%431
dir ignature of Owner or Agent including Contractor) (Signature of Contractor) q di
Si: . .nd sworn to(or affirmed)before me this CJ day of Sinecd and sworn to(or affirmed)before me this 1 day of
DeAti-r , ao r-( ,by SOYA S_Cc,. ,.0J>1S c boo', 2'/ 'r,by / i
r.
.,. miterry t P1. _'__
rR "? CATIBERT sn6nNIA7 32u4 X3 ;1.c
: MY COMMISSION 1 FF 918321 tlOZ'£► jWW00
W.-11*. ;,= EXPIRES:January 12,2020 91£tit 00#NOlSSIaHO
''•1 g;ti; Bonded"BIN Notary Public Underwters b3HdOIS
[4Sersonally Known 0 [ ]Personally Known OR L3)1Z1N31 dllllHd •
[ ]Produced Identification 6a Produced Identification
Type of Identification: type of Identification: FL pt_
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. ?GC 1'}-oaoaTax Folio No. 170263-0100
State of FL 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: 6-1 16-2S-29E.096 ATLANTIC BEACH PT LOT 1 RECD 0/R 15502-2278 BLK 41
Address of property being improved: 5 10TH Street,Atlantic Beach, FL 32233
General description of improvements: siding, windows or screen room
Owner Scott Cairns
Address 5 10TH Street,Atlantic Beach,FL 32233
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor Martin Home Exteriors,inc.
w ,�� Address 5749 Haven Road,Jacksonville,FL 32216
,v",IPhone No. 9°4'737-5°09Fax No. 904-594-3064
J1 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 expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY WNERc9
/4/7
Signed: DATE
Before me thls 5'M'day of De+ober In th
coSlychas personally appeared
reava —
Doc#2017239443,OR BK 18156 Page 1158, ChimseI erself and affirms that all statements and declarations heRLir :tftCATHIE M.MIST
Number Pages: 1 ere true and accurate •:;;,.;-{' s1 MY COMMISSION FF 916321
Recorded 10/18/2017 04:36 PM, l' Ai EXPIRES:January 12,2020
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL ^
/( G�!)�� %�' �' r 't BondedThmrbluyPubic tfidenrih
COUNTY $ �•
-136Q V2I,(22
RECORDING $10.00 Notary Public at Large.State of FIOvIti . County of Duvwl
My commission expires: 01-t2-
Personally Kno::n ✓ or
ProducedIdentrication