312 19TH ST RES ALT PERM RESIDENTIAL PERMIT PERMIT NUMBER
RES19-0015
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 1/29/2019
EXPIRES: 7/28/2019
ATLANTIC BEACH. FL 32233
-5814 BY 4 PM FOR NEXT DAY INSPECTION.
MUST CALL INSPECTION PHONE LINE (904) 247
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
312 19TH ST RESIDENTIAL ALTERATION 7 WINDOWS & 2 DOORS $10547.00
RESIDENTIAL
TYPE OF REALESTATE I I BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1720200530 SELVA MARINA UNIT 09
COMPANY: ADDRESS: CITY: STATE: ZIP:
THE HOME DEPOT 9208 Florida Palm Drive TAMPA FL 33619
OWNER: ADDRESS: CITY: STATE:
DEVERILL DIRK P 6046 S LAKESHORE DR SHREVEPORT LA 71119-3704
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY 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, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
I
DESCRIPTION ACCOUNT QUANTITY PAID AMOU T
BUILDING PERMIT 455-0000-322-1000 0 $105.00
BUILDING PLAN CHECK 4SS-0000-322-1001 0 $52.50
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.36
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.001
TOTAL:$161.86�
Issued Date: 1/29/2019 1 of 2
T City of Atlantic Beach APPLICATION NUMBER
Building Department (To be ned by the Building Department.)
9
800 Seminole Road
tlantic Beach, Florida 32233-5445 C) —0 0
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http-://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Y No
��ilding ' X
Appl ica nt: C_ PC) 'Fq;E!ag__&Zoning
Tree Administrator
Project: �7A) QC PublicWorks
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: PA-pproved. FIDenied. ONot applicable
(Circle one.) Comments:
(:B�U I L D�IN
PLANNING &ZONING Reviewed by: nA Date: I—r,? 9
TREE ADMIN. Second Review: DApproved as revised. nDenied. F]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by.- Date:
FIRE SERVICES Third Review: FlApproved as revised. E]Denied. [:]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Cali Tim for Pick Up 727-.637-8400 ul-�iL;t wr T I V W 0 � f to j4osc vv--r V�')
Building Permit Application Updated 10/1�/18
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road,Atlantic Beach, FIL 32233 HIGHLIGHTED IN GRAY
'19, Phone: (904) 247-5826 Fax: (904)247-5845 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 3, ct S-7- Permit Number: Rc-sig - ool
Legal Description S -,,2 q 0�' �e(vo,- rtA,r, yra ? 10"IS' N/4E# 1'75,1 Od 0
Valuation of Work(Replacement Cost)$ to ff? _Heated/Cooled SF Non-Heated/Cooled
ClassofWork: i6"w OAddition ElAlteration EIR�epair LJMov Derno E]Pool(�
Use of existing/proposed structure(s): �`i 13kesidential
If an existing structure, is a fire sprinkler system installed?. eVSN o
Will tree(s) be removed in association with proposed proeect?Wes(must submit separate Tree Removal Permit)rao)
Describe in detail the type of work to be performed:
f f-P�v,,cz --2 W,^��,& -f-") �w a 5
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name- k)e_veck0 Address �(,2 Iqll f7
city tc-�i,C-1 L�e&cj_ State ZiP 3aa 3 3 Phone VZO -23 3 -9�W 3 '�
E-Mail
Owner or Agent(if Agent, Power of Attorney or Agency Letter Required) n/a
Contractor Information
NameofCompany A40(-"t Qualifying Agent /4FIL Era�^C,
Address 47,40e City—ko�r-Qlo, State F1 Zip 3�4151
OfficePhone Job Site Contact Number
State Certification/Registration# (,IGL-Q�/(7147 E-Mail _T7M - Ai.,oq 7; ��,Pe_
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer 0 lk ORExempto ExpirationDate S/1 //9
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 regulating
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
RECORDI G YOUR NOTIC-E-%F OMM CEMENT.
X)Q
(Son tuF�of 6%kner or Agent) (Signa t�,of C"nt ctor)
Signed and sworn to(or affirmed)before me this -3 day of Signed and sworn to(or affirmed)before me this /d'ay of
, AQ\� by 'T_ rCct-A -04\j c.nl ( —_T� , by
1ARY SUZANNE il--,(
ture
NOTARY PUBLIQVrna" of-Notary) (Signature of Notary)
-------- - - - -- - -
STATE OF FLORIDA �2 TIMOTHY R.O'MAILLEY
e** F-'
Comrn#GG 143975 J�6 PAY COMMISSION#GG 117135
P irsoM rKno��s 9/18/2021 Wersonally Known OR EXPIRES:August 7,2021
dentification
Produced Identification Produced I Bonded Thru Notary Public underwriters
Trinp nf lripntifiratinn- Tvpe of Identification:
Doc # 2019012726, OR BK 18661 Page 457 , Number Pages: 1 ,
Recorded 01/16/2019 04 :00 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
THIS INSTRUMENT PREPARED BY:
Name: The Home Depot
Address: 9208 Flori Palm Dr
Tampa.F ,11619
NOTICE OF COMMENCEMENT
Permit Number;
Parcel ID Number:
The undersignk hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,the
following information is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY:(Legal description of the property and street address if available)
'7' n C-44 FL_ >
C&-Az GT --0 -c)-It 39,ksc"�-N"-V-,Q% �j L
2. GENERAL DESCRIPTION OF IMPROVEMENT:
12&7�g_A ,Z (CJ&j_Q4A,)C_ I—0�s,
3. OWNER INFORMATION OR LESSEE INFORMATION IF YHE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: 1444, P. �> -L+yt, —C 4 S I Pk. ISA_
Interest in property: 0k191)_*C>1 t"o.-
Fee Simple Title Holder(if other than owner listed above)Name: j5 a.
Address:
4. CONTRACTOR:Name:The Home Depot Phone Number: 813-626-7548
Address: 9208 Florida Palm Dr Tampa FL 33619
5. SURETY(it applicable,a copy of the payment bond Is attached):Name:
Address: Amount of Bond:
6. LENDER:Name: Phone Number:
Address:
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(l)(a)7.,Florida Statutes.
Name: I \.,, — Phone Numbe..
Address: to
8. In addition,Owner designates --of
to receive a copy of the Lienor's Notice as provided in Section 713.13(l)(b),Florida Statutes.Phone number:
9. Expiration Date of Notice of Commencement(The expiration is 1 year from date of recording unless a different date is specified)
WARNING TO OWNER ANY PAYMENTS MADE BY THE OWNER AFTER THE 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, CONSULT NTH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
Kouriney L.Rollilis
USAF Paralegal,2 SWIJA
Barksdale AFB,LA
Notary Public,10 USC 1044a
or Lessme.or 0�nees or Les�'s (PnrTt Narne and Provide Signatory's'ntWOffice)
Augvcri=,oerlDirectorlPanneriwnaw)
State of —County of So�_s i e r
The foregoing instrument was acknowledged before me this day of 1�1j._)" 10
by r(2 Uk,-,V e C Who is personally known to me 0 OR
�Yama of person making state"nt
Who has produced identification 9iype of Identification produced: MILITARY ID CARP
Ti
X
ly, "41JJ4
ary
e,
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED
*Project Address: 312 19th St —Permit#: etc_ U 00/
*Owner/Project Name: Dirk Deverill
As required by Florida Statute 553.842 and Florida Administrative Code Rule 913-72, 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 yourLL.
product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide product LL_
approval may be obtained at:www.floridabuilding.org. 0.11
Category/Subcategory Manufacturer Product Description Limitation of—Use State# Local#
A. EXTERIOR DOORS
1. Swinging
2. Sliding
3.Sectional cn
x 7�
4.Garage Roll-Up
5.Automatic Zw
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6. Other
B.WINDOWS
Z qcz
1.Single hung < %.., q
0 _J GO
2. Horizontal slider cc
(I <
3. Casement LL
U W
4. Double hung >Z LL LZ M
5. Fixed t— L;J S_ 0
ul U LU LJJ
U)
6.Awning >
7. Pass-through
LC
8. Projected
9. Mullion
10.Wind breaker
11. Dual action
12. Other
Page 1 of 4 Updated 10/1,7/iS
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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):Arthur Frances *Contractor Signature:
*Company Name: The Home Depot
*Mailing Address: 9208 Florida Palm Drive
*City: Tampa *State: FL *Zip Code: 33619
*Telephone Number: (727) 637-8400 *E-mail Address: tim.omalley@expeditepermit.com
Cell Phone Number: Fax Number:
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Me(ju>Euld%t or Applirarfi)lj SPwCh>AM lCatwr List Application Detail
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-1117
FL7612
Application Type Revision
Code Version 2017
Application Status
Approved
*Approved by DBPR.Approvals by DBPR shall be reviewed and ratified by
the POC and/or the Commission If necessary.
Comments
Archived
Product Manufacturer Simonton Windows
Address/Phone/Emall 3948 Townsfair Way
Columbus,OH 43219
(614)532-3596
luanne-harris@simonton.com
Authorized Signature Luanne Harris
luanne.harris@simonton.com
Technical Representative Luanne Harris
Address/Phone/Email 3948 Townsfair Way
Suite 200
Columbus,OH 43219
(614)532-3596
luanne.harris@simonton.com
Quality Assurance Representative AAMA
Address/Phone/Emall 1827 Walden Office Square
Suite 550
Schaumburg,IL 60173
(847)303-5664
webmaster@aamanet.org
Category Exterior Doors
Subcategory Sliding Exterior Door Assemblies
Compliance Method Certification Mark or Listing
Certification Agency American Architectural Manufacturers Association
Validated By American Architectural Manufacturers Association
Referenced Standard and Year(of Standard) Standard Year
AAMA 450 2010
AAMA/WDMA/CSA 101/I.S.2/A440 2008
Equivalence of Product Standards
Certified By Florida Licensed Professional Engineer or Architect
f_�7612 R17 Eauiy EvalReport-IN0444-R7.odf
.. ........
OFFICE COPY
8CIS Home Lcig Fri use,Registration 'lot Topics Submit Surchar,ge
Stats&Facts Nblicaticiri. FBC Staff 9CIS S'te Map L,,,ks Search
Product Approval
USER:Public User
Pr,,dtjCt Approval'Jenu>Produt:t or Apirlication Search>Aoolicatioi)List>Application Detail
FIL# FL5167-R26
AM
kt P. Application Type Revision
Code Version 2017
Application Status Approved
.Approved by IDBPR.Approvals by DSPR shall be reviewed and ra-lified by
the POC and/or the Commission If necessary.
Comments
Archived
Product Manufacturer Simonton Windows
Address/Phone/Emall 3948 Townsfair Way
Columbus,OH 43219
(614)532-3596
luanne.harris0simonton.com
Authorized Signature Luanne Harris
luanne.harris@slmonton.com
Technical Representative Luanne Harris
Address/Phone/Eirrail 3948 Townsfair Way
Suite 200
Columbus,OH 43219
(614)532-3596
1 uanne,ha rrisosim onto n.corn
Quality Assurance Representative AAMA
Address/Phone/Email 1827 Walden Office Square
Suite 550
Schaumburg,IL 60173
(847)303-S664
webrnasterr-&aamanet.org
Category W�nclows
Subcategory Double Hung
Compliance Method Certification Mark or Listing
Certification Agency American Architectural Manufacturers Association
Validated By American Architectural Manufacturers Association
Referenced Standard and Year(of Standard) Standard Y=
AAMA 450 2010
AAMA/WDMA/CSA 101/I.S.2 A440 2005
AAMA/WDMA/CSA 101/1.S.2 A440 2008
Equivalence of Product Standards
Certified By Florida Licensed Professional Engineer or Architect
FLS167 R26 Emily EvalRei)ort.pdf
....................................................