1546 Ocean Blvd - Permit RES18-0141 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0141
Description: replace 14 windows
Estimated Value: 11832
Issue Date: 4/26/2018
Expiration Date: 10/23/2018
PROPERTY ADDRESS:
Address: 1546 OCEAN BLVD
RE Number: 1718840000
PROPERTY OWNER:
Name: CAMPBELL DONALD ROGERS
Address: 1546 OCEAN BLVD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: THE HOME DEPOT
Address: 9208 Florida Palm Drive Raquel Swanner, Boysie Ramdial
TAMPA, FL 33619
Phone:
PERMIT INFORMATION:
Please see aftached 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.
I A A
N 'Vi APPLICATION NUMBER
City of Atlantic Beach
IS Building Department (To be assigned by the Building Department.)
800 Seminole Road
tlantic Beach, Florida 32233-5445 L—S t
Phone(904)247-5826 - Fax(904)247-5845
oil E-mail: building-dept@coab.us Date routed: q1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: u Du o id P�-�nt review required Yes.,,,No
BuildAi
q_--)
Applicant: t 0'�'MA-t-Vla-jp Planning &Zoning
I Tree Administrator
Project: ( LiAA1 W', rkCtoJ-1) 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: R�Approved. F�Denied. E]Not applicable
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:J1_.'213_-.?q�
TREE ADMIN. Second Review: ElApproved as revised. [—]Denied.V F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Cafl 71m for Pick Up M-637-84M
OFFICECOguilding Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
A rJ
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: Permit Number: C)
Legal Description
Valuation of Work(Replacement Cost)$ Heated/Cooled SIF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Derno PoolC�in:d:q�Door
• Use of existi ng/p ro posed structure(s)(Circle one): Commercial Qesid�enti
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/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:
I Ll W"VL!4 W--s S I--w—
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: bo/,)P,+L� Cy+m P&I-L- Address: 1VL0 (X12" ]?�LL)0
city A-TL4�,oiic'i-3e�,N State /-Z- Zip 3 ZZ53 _Phone 69(3 -
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Inforrna!Aon
Name of Company: Qualifying Agent:
Add ress city�r-e!— State Zip
OfficePhone -ta-�-(Q37— _job Site/Contact Number
State Certification/Registration# C- eJl�'E-Mail QPA,kk&J
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. 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.
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 OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RE ORDING YOUR NOTICE OF COMMENCEMENT.
(Signature of Owner or/gent) (Signature of Contractor)
(including contractor)
7igned and sworn to(or affirme me this ay o d d orn to(or affirmeA before me is --I' day of
gn kgne an�sw
by V vi �-C,-Jqv
N
(S of (Signature of Notary)
NOTARY
Personally Known OR -STATE OF FLORIDA ersonally Known OR
HIRISTINE R.OUALLEY
G 163512J
My COMMISSION#GG 163512
9Produced Identification GG 132355 Produced Ident-ifi-c-aTion.:
6 Comm# 9.n
Type of Identification: Fixpires 81712021 Type of Identification: EXPIRES:January 29,2022
LWOW I hru wary Rbk
Doc # 2018074878, OR ElK 18333 Page 1780, Number Pages: 1,
Recorded 04/02/2018 08:21 AM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
perml) � 4#-
NOTICE OF COMMENCEMENT
State o-- '4� 1
i— El(1-s, tax Fojiff No.JqL,�,gyV-GQWj
Count) of-0,4 v ck�
To)&`hoin It may.concern:
The undersialw!hcrcby jafortris yok:that finproveniewswill be niade to certain real property,and in accordance with Section 713 of >--
the Florida Stattiles,the followin.a information is stated in this NOTICE OF COMMENCEMENT
Legal Description of property being ini--woved: (0-I I-I
E f—V1
.4L�1(iressofpro,)cnybehiginipi-oved.- lTq&, Z�usv.-
General description of improvements:
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Owner: Addr--ss: fX.Vr,, CLY1 LL,
Ovyi ter's interebt in site of the if nproveinera:
an owner):
Fcc Simple Tit leholder(if other tli,
Nam-
ConlrilclOr. A\1 7W
Address:
TelepboncNo., Fax No:
Suret) ffany)
Add-ess:..— 4 -- -- Anfount of Bond S W
Telephone No:. Fax No.- U
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Naine and address of any person making a loan 1br the construction of the improvements < = -i Z
Nanx: 73 L) < 0
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Addres:s: W a
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rax No: 0
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Kairfe Of Pef-s--)"Nvithin the State of Fiorida,other than himself,dc.,,hpiated by owner uponwboin notices or other doctuneos 171ay be W
served: NaTno: C3 ZXZ
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Address: Cj —j I
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'I clephone No- I.-
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e ac. provided in seetlo;j LL 0 X 2
Tn addition to himbelf, oj\-ner (,csiL) -mics the lbllowjr-�, person io receive a copy of the Lienor's Nutic LL
Flori(-,a st-.1tites. (Fill it'at Om-ner's option) C3 LLJ W
LLJ >. CL CC
t= LU 5
Addres-i:, LU 0 W
Teleplione No: W W
Fax No: W
Fxpiration date of Notice ot'Comineacerneni(11:0 expiration daw is One 0 year fi-orn thc dWe ofmcording indess a different date is JIM" W
specified):
'r"IS SPACE FOR RECORDER'S USE ONLY OWNTt
Ri- -d. 2
WC
e 5: dav of
this — n the C-01 I).ol, umilt statc
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\'Mary PLWic of Large-Stirteof Florida.(AmmyofDoval.
MY conin-issien"pirc.i:
--1=rENRY-ECKfA,1e14—
Ncducotd IdentificathAn'.
NOTARY
��STATE OF FLORIDA
C oGG132355
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Er freS81712021
/o-7 36S -7 OFFICE COPY
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH
Project Name:(��VAo�\� Permit-_ # ,FLORIDA
Project Address: (::�(:!Q_o_y\ QwL
As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72,please provide die information and product approval number(s)
for the building components listed below as applicable to the building construction project for the pennit 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.
Category/Subcategory Manufacturer roduct Description Lim.itation of Use State Local#
A.EXTERIOR DOORS
1. Swinging
2. Sliding
3. Sectional
4.Roll up
5.Automatic
6.Other
' B.WINDOWS
1.Single hung
2.Horizontal slider
3.Casement
4.Double hung Ca 1 60 (Ap
5.Fixed
6.Awning
7. Pass-through
Projected
9.Mullion /L1787
10. Wind breaker
11.Dual action
OFFICE COPY
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
H.NEW EXTERIOR
ENVELOPEPRODUCTS
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 docuinent must be approved by the Building Official.
(Contractor Narne) (Print Name) (Signature)
Company Name: :�� \)"m�
Mailing Address: R C�<�-' W-" —t>
City: State: Zip Code: 3 3 Ct t
Telephone Number: Fax Number:
Cell Phone Number: E-mail Address:__R%,-, Pe J.i4,0 Pe r1K 10 fv�
OFFICE COPY
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