2359 Seminole Rd RESO18-0035 door permit f v�1f;/jr
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: RES018-0035
Description: Replace Door
Estimated Value: 3234
Issue Date: 6/21/2018
Expiration Date: 12/18/2018
PROPERTY ADDRESS:
Address: 2359 SEMINOLE RD
RE Number: 168349 0000
PROPERTY OWNER:
Name: JACOBSON SAMUEL S
Address: 2359 SEMINOLE RD
ATLANTIC BEACH, FL 32233-5971
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: GREEN MACHINE REFLECTIVE TECHNOLOGIES
Address: 267 SOPHIA TER SUITE 112
ST.AUGUSTINE, FL 32095
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$7,500.
Sywri , City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road D cCplaw- 6031
Atlantic Beach,Florida 32233-5445 /�6J
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@wab.us O
Date routed: O
City web-site: http:/hvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2 (� e, Department review required Yes No
InU
ZoningApplicant: eh B Tree Administrator
Project: 1Ze „lK[�e
Public Works
T _ Public Utilities
Public Safety
Fire Services
jteview fee.$ Dept.SigDatyre,
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection / L
Florida Dept.of Transportation
St.Johns River Water Management Dishict
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: 0Approved. []Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING �r�
PLANNING&ZONING Reviewed by: �-� � Date: t t o
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 e51912017
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
Office (904)247-5826 Fax(904)247-5845
Job Address: a.�sv a u (� / r ''� PermitNumberi�S6a-&-LT
Legal Descri tion S Cp/A/l �, yA # /q rl
8 P -o1/a1 9'v' -a7yE 98S< ./i+ Pars-M
Valuation of WorkS 3aipropoAM
sld Work heated/cooled �n-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pontis window/door
Use of e>usting/propased structure(q)(circle one): Commercial esrden
If an existing structure,is a fire prmWer system installed?(Circle one): o /A
Florida Product Approval#
For multiple products use p net appro o
Describe in detail the type of work to be pixfor�ed:� 1@Q ]�f �cp,�_-Fp- ppb„
Pro a Owner�I�n�formation:
m e:_ TeThEi<. Address: Q35? cSe/77tncYe �Oad
City
£-Mml or Fax#(Optional)
Contractor Informaatiro—n:
mPC`6 a y r� Li . TCOYId�vS iAn �(t. ✓,f/p2S RASis`Of2
Address: rh:_ T�n� P
Office Phone 91,I/-S' '�/r/ Fax#
JOb SiW ontactNumb Qu ��� S� s
State Cernfication/Registretion#_ y8L `S�
Architect Name&Phone# A k�
Engineer's Name&Phone# n
Fee Simple Title Holder Name and Address 2
3onding Company Name and Address
Yiortgage Lender Name and Address .L
1pplication is hereby made to obtain a perms to do the work andinsta/lations as aid sed I rer*
ssuance ofd permit and that all workwi[!be that no work w installation has commenoedprior to the
l performed to meet the standards ofd!laws regalming coneb toa in thujwiedicHon rh!,permit becomes m ,
and votd r work is not commenced within six _
()months,w ifconstruction r work is suryended or abandoned for aperiod ofsix 6j months at any time after
cork u commenced I understand that separate permits mart be secured jar Eterblrn/WorAS plambasg,Slgws, ryy(y ppp/y l�arvsacea,gpLers;Heaters,
ranks and Ab ConsBtloners,etc
WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESUL11 IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. II YOU TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN
Ory BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
hem,b, rtify that l ha madand examimd ddsap plication and know the same to be true ardcammo All prmfslons of(aws and mdinmuva�govern ng dds
rye 01 work will be complied with whether spec!/ted herein w not. The gmming of a permit dies not presume to give authority to violate or canes!the
.ovtsima ofany oeherfe((d��erak state,or lam//lnlawregdating oowu don or theperformarme ofcaratmctton.
ignature of Ownert "( LCg �
P
rint Name
11 1I l� .. Signature of Contractor .�-C=��-e o.7 .(s.L��'`p
Jtw;'rvt �(y Lo I� SOY} i
- - _.._._---...._..._. rot Name
wom�to and subsrnged before me Swom and suborn before me /P
as/i 0.y of u 20 � this I)ey oY E. .20
off, 11C ��t. ? LINDA BISHOP
• CommieaioneG as13e a 4e
�� My Commieaion xpina 9TH� MV Commiaslpn Expires
� »� Dacambas 17, 2a2G mbar 11. 2020
I l NOTICE OF COMMENCEMENT
✓ nM
State of Llll f� Tax Folio No.
Countyof DUV4J
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�m this NOTICE OF COMMENCEMENT.
Legal Description ofproperty being improved: hltT- " t37�d rg"a9E 984 yi/ as baid, sW
Pt Jnr I W6 &db o/a 5965-1194 I
Address ofgnperty being improved: 25�.5eq��,I�^�,�ZYY)L(lote M .b11{7 &h F Ju.�-5qV
&AW
General description of improvements: r7CO✓ C'�,,
Owner:i Ml)t'1 x/11'17 Q.C�l'�17�'.�/D ' /) Addrest,{A1
s: a )3R 11.Wlt
Owner's interest in site of the improvement:
Fee Simple Titleholder(ifother than owner): n h
Name:
Contieemr.Dr9nOrlmy ftlle�7a)e, �Py1r1�1[ oy 11
Address: 91A /n . '162M
Telephone No.: qbi '- .431P- MSI Fax No:
Surety(if MY) Alk
Address: Amotmt of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the consW a of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other then himself;designated by owner upon whom notices or other documents may be
served: Name: Ii
Address:
Telephone 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)(6),Florida Statues. (Fill in at Owner's ppnon)
Name: l�
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)yeryr from the date of recording unless a different date is
specified): M
r
THLS SPACE FOR RECORDER'S USE ONLY OWNS �j
Dac M 201 81 4808 6,OR BK 18428 Page 2217, lil.• V Date:
Number Pages:1 is �,n�d of in aCoun ofDuvaL State
Recorded 0621201810:29 AM, da,has personally appeared Vc CU�SO/'l
BONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY ryublic et Large.Stam ofFloridb County of Duval.RECORDING E10.00 mission expires
ly Known:
d Identifi m 'w ANDA BISHOP
Commit salon t 66 84124
_' MY Lommlasion Expires
k;;,> ;,a•`• December 11, 2020
Quote
Quote Number: 25D7 Date: 602018
Sales Person: STEVE
Customer Information
Name: LANSING/JAX
Address:
yy
t it I
E y
Phone 1: 28
i t
Phone 2:
Fax:
Contact: KEVIN
Job Name: GM JACOBSON
SpeeiRcations nvrrvat� _� _�
atinn
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Image is viewed from Exterior/
DescriptioD Smooth-Star Fiberglass Door wNVellealeyBIS ickel Glass- 1
Rig t and Inswing (No StileStileLinesLines))
2 3/8"Backset-Double Bore(2 1/8"Die.Bore)w/Mortised Edge Latch Preps w/Full Lip 1
(Standard)Strike Prep w/Deadbolt V x 2-1/4"Strike Prep
Set of Bell Bearing-Stainless Steel Hinges 1
Primed Composite Frame-4 9/18"Jamb w/No Exterior Trim w/(1)Brushed Nickel 1
Adjustable Security Strike Plate(for Lockset only)
White Compression Weatherablp 1 -
Adjustable Composite-MITI Finish Sill 1
Custom Cut 3/4"from Height `Q� 1
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