1019 BIG PINE KEY - PERMIT RES18-0175 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
K ua 0• INSPECTION PHONE LINE 247-5814
RESIDENTIAL-ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0175
Description: replace windows&sliding-glass door
Estimated Value: 10597
Issue Date: 5/31/2018
Expiration Date: 11/27/2018
PROPERTY ADDRESS:
Address: 1019 BIG PINE KEY
RE Number: 172027 5072
PROPERTY OW NER:
Name: GEIB LOUISE
Address: 1019 BIG PINE KEY
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: BENTON INTEGRITY ROOFING &WINDOWS
address: 5570 FLORIDA MINING BLVD S Ste S STE 310
JACKSONVILLE, FL 32257
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$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road � p'� �-
.� Atlantic Beach, Florida 32233-544g
5 -cs14
Phone(904)247-5826 Fax(904)247-5845
"4 0P E-mail: building-dept@wab.us Date routed:
City web-site: http:/Avww.coab.us
APPLICATION REVIEW pAND TRACKING FORM
61 q P
Property Address: "I I a FRy It review required Ye No
p, Buildin
Applicant: 41x,1 Ttm 7wti:ty Planning &Zoning
(� Tree Administrator
Project: ( \ AU 4Jt1\JPublic Works
Public Utilities
�J 1 Public Safety
Fire Services
F?eyjew fee$_ Dept Sjgnature
Other Agency Review or Permit Required Review or Receipt
of Pernik Ver'died B Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaumnis
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. [-]Denied. []Not applicable
(Circle one Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: S -lGC
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 0fifISM017
Building Permit Applicationt2/8/t7
MAY i 4
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233 _.
Phone:(SN)247-5826 Fax:(904)247-5845
JobAddress: P •-vada A>:MwwLtitR•nr9.. FL3'.1713$ Permit Number:
Legal Description 4t.159
u 1q, a,S-Xffi S&WX Lok S "136 RE# 1.4r:k02} -50?;t
Valuation of Work(Replacement Cost)$ 10. 594.00 Heated/Cooled SF 14$5 Non-Heated/Cooled L9S6
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool in ow
• Use of existing/proposed structure(s)(Cirdeorre): Commercial esidenti
• If an existing structure,is a fire sprinkler system installed?(Circle oris): Yes No
• 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: Mous- " Y e p1 Cf L iSA Win ul i W T4k
C-ayatm�W51 wirtdataS;Q�unoWL aa+e(extYtQax bvUt e'xcv".oa door' W14tn dDW'i>_Sit C"ot dO&C.
Florida Product Approval If 34.4.a `P VOEW6 for multiple products use product approval form
Property Owner Information
Name: LOv'4.F-. e;b Address: I OL
city AHAA,% L'LccAA State I L _zip 32'#33 Phone o _
E-Mail —
Owner or Agent(if Agent,Power of Attorney or Agency Letter Required) I -S..L G100
Contractor Information n—f
Name of Company: #ova GaD in *LLA-'.(o ualifying Agent: -Toh AE(IFy'i40l
Address 6520 Sl ici& W - yyd. S ,gy;.A BID City TAz.ILsanvilu StateFL_ Zip 3,A/d5a-
OfficePhone6— lob Site/CaadactNumber
State Certlfication/Registration# CRGi33101."). E-Mail AAmiyK 3�WL(Ze Ar s cove,%
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation A FO014
xempt/Insurer/Lease Employee,/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 ATT RNEY BEFORE
RECO Ell
c�A`U jNR�OFC_/rOE CEM1MENT.
V (Signature of Owner or Agent) G�Cigr'aure c Con rector)
(including contractor)
Signed and sworn to(or affirmed)before me this_J[!�day of Signed sworn to(or affirmed)before me this_ILA day of
_Apti . 2012 .by I.OLtiU 09;bMaTI&lr by
t- alesruxsuv
�
cury9ubk-ase,'am (Signature of Notary)x Cc.n IFF91&Ol
!. t wrnaKSKY
.9*i,d
IN'Perscnally Known OR snrnruur-slaeasaNr
( roduced Identification I (Produced ldenfdkeden rtl�"I°"rnA�s
Typeof identification: FL C)L 0111DO-922-L44294) Type of lden[ifira[ion: •\ /. wc"" Emlmseplx Nl9
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Doc 4 2018113210, OR BK 18385 Page 6, Number Pages: 1,
Recorded 05/11/2018 02:34 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
OFFICE COPY
NOTICE OF COMMENCEMENT
State of__, F In t ICI-a-- Tna Folio No. I321014
Counyor ThIvall
To Whom It May Concern:
The undersigned hereby inflame you Nat impmvemenle will be nude so certain red properly,AM is accordance with Swwr 713 of
Inc,Florida Statutes,the following information is slated in this NOTICE OF COMMENCEMENT.
Legal Description of propery,Ming Improved: 141-195 lit-'d5-21F S•twa Iokge: I .F'45
Addre®ofpropmybeingimgoved: 1019 M94flas LGn_.i. A1.la,.mt 'R.e.d.� R 3=331
Genetical description ofimprovemenb: Q�wvw.:.uane Qrp- /./. dYit_ n._v�4w1 a A I door ;3
owner. l-er,csL Qt& Address: 1pw'R:yE Fie, .., .Aun..ue. iwic. n :_ 3-3
Owoa'sInterest in siteof Ne improvement:
Fee Simple Titkholda(if other that owner)c
Name:
Codada:
Address: $.SIO FlnrtM Mirih RWd.S,e${'E.SIDt,�RCkSnrkxhllP, FL 32257
Tdephoae Nru(110�262-71e1n3 Pas No! (904 2b0-1355
Smety(Ikay)
Address: Amount of Bond S
Telephone No:__.,, _ FUNo:
Name and address army parent making a Ion forth cmuwnlon of the improveneate
Name:
Address:
Phone No: Faa No:
Name of person within the Saw of Florida,other than himself deaigmted by owner upon whom ratites or other doannnxs may be
served: Name:
Address:
Telephone No: Fax Nm_________ _..
In addition to himself, owner denigrates, the following person ta recoi ne a copy of the Lima's Nmine a provWel Y Section
713.06(2)(bN Florida Sletues. (Fill in M Owners opal.)
N.:
Adding:
Telephone No: In Nce
Expiation date of Notice of Cammeneemem(tin outptratloa data Is one(1)year Mom to data of recording whin a dilfarat data b
specified): _._�..-"------ ------ '"—"'-'--
THIS SPACE FOR RECORDER'S USE ONLY OWNER r
Signed; these II I I U
Refarenrthh III dere( n1M CemerofDuvASms,
NeNoddybpLarge, yaPpaaxd
My or Public as cVl CamyafWvd.
My comm kion apircr: 15 4014
Pmonally Known:_ a
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'g REVIEWED BY: DATE:� /�'
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