2239 Barefoot Trace-replace 3 doors (--- 1, CITY OF ATLANTIC BEACH
;-' "
; ' 800 SEMINOLE ROAD
) .'"N ATLANTIC BEACH, FL 32233
' !�,�i INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0067
Description: replace 3 doors size for size
Estimated Value: 10900
Issue Date: 2/27/2018
Expiration Date: 8/26/2018
PROPERTY ADDRESS:
Address: 2239 BAREFOOT TRACE
RE Number: 169463 0636
PROPERTY OWNER:
Name: HANSON JAMES R
Address: 2239 BAREFOOT TRCE
ATLANTIC BEACH, FL 32233-4565
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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.
?S ,�irj, City of Atlantic Beach APPLICATION NUMBER
rS,I i4 Building Department (To be assigned by the Building Department.)
J 800 Seminole Road �! j J ��
w . " -�� Atlantic Beach, Florida 32233-5445 r J ( 1 )
\ Phone(904)247-5826 • Fax(904) 247-5845 //
o,tl., E-mail: building-dept@coab.us Date routed: ,�—7,� — !53
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: --9 1 (-. ` .(C t Department review required YterNo
Building
Applicant: )t�ACt.,\\A nC.oc,vs Planning Zoning .
Tree Administrator
Project: 7.7, , a - c Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
I Review or Receipt
Other Agency Review or Permit Required of Permit Verified By Date
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. ❑Denied. ['Not applicable
(Circle-oke:), Comments:
.BU1LD1N_ '.-�
PLANNING &ZONING Reviewed by: Date: 2'/S a01 a
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. . El 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
v/ = ( BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH Cats Tim for Pick Up 727437.8400
F EB 1 5 2018 800 Seminole Road, Atlantic Beach, FL 32233 OFFICE C O P
Office (904) 247-5826 Fax (904)247-5845 i
Job Address: a a 39' 1 `Ttdce- Permit Number: R65 !D `00(t9 I
Legal Description t d (3 n6-`ds--"°79(1 Parcel# it 9'f 3-a6 3-6
8. Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ /0 9 4'0 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move lition pool's.: window/door
Use of existing/proposed structure(s)(circle one):• Commercial
If an existing structure,is a fire rinkler syste �pstalled? (Circle one): Yes No
`1
Florida Product Approval# l I6•I y / /o'666,3
For multiple products use product approval form
Describe in detail the type of work to be performed: (2ePlace 3 S $ tlt,4,0, S l�
Property Owner Information:
Name: o.n.4f SSD^ Address: ' gosre-4 d1 Tro.ce-
City cr -v Q6-c'. Stategl Zip 32 33 Phone qo'r Y7-2-76.1
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: et Uo, Qualifying Agent:-3-0".es )2014L"' .
Address: 3 5b )R 43 K we,r City State P1 Zip ,V7-1Zb
Office Phone 761,4 37-k'C4' Job Site/Contact Number Fax#
State Certification/Registration# C-g C b Y6 71.Z
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 abandoned for aperiod 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,Healers,
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 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, or local law regulating construction or the performance of construction.
Signatme-of-Awner Signature of Contractor
Print Name ff 1 Print Name .50.4,4. 1•," 2
Sworntj and subs ribed before me Swornj9 and subscribed before me
this r-71.Day of C- ,20 (7 this Day of FCS ,20
Notary Public Notary Public
Revised 01.26.10
ot,; y •, TIMOTHY R.O'MALLEY
•• ,.. • S. MY COMMISSION#GG 117135 s;RYo�
.. EXPIRES:August 7,2021 ,°i• °; TIMOTHY R.O'MALLEY
!� MY COMMISSION#GG 117135
• ;''•• Bonded Thru Notary Public Underwriters ia:
na
7�`: % EXPIRES:August 7,2021
3,;,`.°'• Bonded Thru Notary Public Underwriters
— —., . K
Doc # 2018029984 , OR BK 18276 Page 910, Number Pages: 1 ,
Recorded 02/07/2018 10: 58 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
Permit Number i2 s/r7 -006 9 OFFICE COPY
Parcel ID Number /6 g t.(Q3-O(Q34)
NOTICE OF COMMENCEMENT •
State of Florida
County ofT\1 V c1/4•N
The undersigned hereby gives notice that the improvement(s)will be made to certain reel property,and'n accordance with
Chapter 713,Forida Statutes,the following information is provided in this Notice of Commencement.
1. Description of property(legalescri tion of the property,and street address:f available)
Address 3 I fac t\e40�--Cre-Q-
Legal Description \L}- - ,50•k:;1S-•a19e U I S•.)cl Ds\1KO-a Lc - 7
2. General description of improvement(s)
3. Owner Information
Name`5s YY\ h J0 Phone&Fax Number
Address a C:1 jip C O C CSL. \tnv1}A C Gh 1= 3a
!merest is Property ltal V�s�
4. Fee Simple Title Holder(if other than owner shown above)
Name ,t� Phone&Fax Number
Address
5. Contractor • Pella Windows&Doors •
Name Phone&Fax Number
Address 350W State Road 434
6. Surety(if any) Longwood.FL 32750 .
Name" Longwood.
&Fax Number
AddressWA
•
7. Lender(if any)
Name" Phone&Fax Number
Address"
8. Persons with the State of Florida designated by Owner upon who notices or other documents may be served as
provided by 713.13(1)',a)7,Florida Statutes.
Name i Phone&Fax Number
Address
9. In addition to himself or herself,Owner designates the following to receive a copy of the Licnor's Notice as provided in
713.13(1)(b),Florida Statutes.
Name Phone&Fax Number •
Address
10.Expiration date of Notice of Commencement(the expiration date is ore year from the date of recording unless a
different date is specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER 7HE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713.13, FLORIDA
STATUTES, AND CAN RESULT IN YOUR 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,CONSU YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE
OF COMMEN .. NT.
Signature of en or Owners Authorized OH•ur/J'rectcr/Pdr:ierMa
1- �gcr Pt Na^Y
, `
Sworn.to(or affirmed)and subscn'bed before me:his /J day of 20 17 .."-S-‘Yr t4 GL".ag "\
k-x-SAAA— (type of authority,e.g.officer,trustee,attorney in fact)for ..SO a-- (name of party on
behalf of whom instrument was executed. persn. 1. own to me or K producedas identification.
( /V e CHRISTINE R.°WALLEY
MY COMMISSION i#GG 163512
s:anatoryo(Noary (Seal) •w `:�.:
EXPIRES:Jan
Name lariat) •
•POE M•• 9onded ihN nary 29,2022
Notary nw
Public Undeilers
-AND-
Verifimtior pursuant to Section 92.525,Florida Statutes. Under penalties of pe jury,I declare that I have read the foregoing and
that the facts stated are true to the best of my knowledge and belief.
Sgnatory of Nat al SSnin¢;in line NW Ahmre
OFFICE COPY .,
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
Project Name: i5p'�‘'.12- '-\`5-`4\SQ-'-`\ Permit # Q&si oo 6
Project Address: a-.)-3c1\ �o�ce-rc� '' �rC-�
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. Information regarding statewide
product approval may be obtained at:www.floridabuilding.or..
Category/Subcategory Manufacturer Product Description , Limitation of Use State# Local#
A.EXTERIOR DOORS
1. Swinging ()O\c3v �rc�n�ec� /v/e9- 6 -/�
2. Sliding �\`� �r" /�(s Od.
3. Sectional
4. Roll up
5.Automatic _
6.Other
•
B.WINDOWS
1. Single hung
2.Horizontal slider
3. Casement
4. Double hung
5.Fixed
6. Awning
7. Pass-through
8.Projected
9.Mullion
10.Wind breaker
11. Dual action
OFFICE COI Y
2. Other
Category/Subcategory Manufacturer Product Description 'Limitation of Use State # Local# j
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) (Signature)
Company Name: �.`�� �`�� "`� 7k cV��
Mailing Address: 3S w `S'r^t. 't 3 `{
City: State: F Zip Code: 317 J
Telephone Number: ti d ) S 7' Y� Fax Number: ( )
Cell Phone Number: ( ) E-mail Address:
OFFICE COPY
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