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1619 BEACH AVE RES ALT PERM RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH RES19-0029 800 SEMINOLE ROAD ISSUED: 2/12/2019 fty` ATLANTIC BEACH, FL 32233 EXPIRES: 8/11/2019 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' i BUILDING CODE, OF iCH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. LNOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property be found in the public records of this county, and there may be additional permits required from other ental entities such as water management districts, state agencies, or federal agencies. JOB ADDRESS: PERMIT TYPE: --DESCRIPTION: VALUE OF WORK: RESIDENTIAL ALTERATION 1619 BEACH AVE RESIDENTIAL replace sliding-glass door $2943.00 TYPE OF • • GROUP: 169648 0000 NORTH ATLANTIC BCH UNIT 1 COMPANY: ADDRESS: AMERICAN WINDOW 2633 S POWERS AVE JACKSONVILLE FL 32207 PRODUCTS OWNER: ADDRESS: MOODY DOUGLAS W 1619 BEACH AVE ATLANTIC BEACH FL 32233 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 . • Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $65.00 BUILDING PLAN CHECK 4SS-0000-322-1001 0 $32.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 Issued Date:2/12/2019 1 of 2 RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH RE519-0029 ISSUED: 2/12/2019 800 SEMINOLE ROAD EXPIRES: 8/11/2019 ATLANTIC BEACH, FL 32233 TOTAL:$101.50 Issued Date:2/12/2019 2 of 2 City of Atlantic Beach APPLICATION NUMBER Jt �n Building Department (To be assigned by the Building Department.) 800 Seminole Road S _0 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 I �y E-mail: building-dept@coab.us Date routed: City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: t to r `tet /wx D nt review required Ye No Llfu-ildin Applicant: Win� Planning &Zoning Q(t,���S / Tree Administrator Project: (Q ��f��rQ SVL6L%7, � Y Public Works Public Utilities Public Safety Fire Services Review fee $_ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: UPeApproved. []Denied. [-]Not applicable (Circle one.) Comments: BUILDIN PLANNING &ZONING - 9 �p j Reviewed by: Dater / TREE ADMIN. Second Review: ❑Approved as revised. ❑Den i d. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 rs'�ulr Building Permit Application y OFFICE CO" Cit of At Beach 13� 800 Seminole Fbad,Atlantic Beach, 832233 `'T;"~ ` Phone: (904)247-5826 Fax (904)247-5845 ,bb Address I L rmit Number: S l`"l _ C-)`3- Legal Description -10 ."107 Ili 9 ja7l� Valuation of Work(tomplacement Cost)$Q_T431 CD Heated/Cooled g—KALL Non-Heat 0 Class of Work(Clydeone): New Addition Alteration Felpair Move Demo Fool Windo Door 0 Use of etasting/proposed structures)(ardeone): Commercial Fbsidential-` 0 If an eAsting structure, is afire sprinkler system installed?(Orde one): Yes N N A D 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: ►- P�a �-F- SCO -S�7S� rSiZ2 JAN 31 2019 Florida Product Approval# � for multiple products use product approval form Property Owner Information Name. \ Address: l City 2 Rate FL zip Phone - '3144 - 9- E-Mail E-Mail IQ owner or Agent (If Agent, Power of Attorney or Agency Letter FL-quired) Contractor InformatioAmerican Window Products Name of Company: 2633 Powers Avenue Qualifying AgentU„-c Address FL 22207 Qty Rate Zip Office Phone ��1--131-2 bb 9te/Cont umber Rate Cert if icat ion/Regi st rat ion I J 7 EMailE\4�C'C/H(Y1C�',C�l��i(1 Architect Name&Phone# Engineer's Name&Phone# Workers Compensation `njj.I _,jc'= 1- I ci 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 regulat iong construction in thisjurisdiction. I understand that a separate permit must be secured for BFCfRCALWOW PLUMBING,SIGN$ WCL$ POOLS$F JF;IACE$ BOILER$ HEATB:;$TANK$and AIROONDITONEI:�S etc. OWNERSAFRDAVIT: I certify that all the foregoing information isaccurate and that all work will be done in compliance with all applicable laws regulating construction and Zoning. WARNI NG TO OWNER YOUR FAI LURE TO RECORD A NOTI CE OF COM M ENCEM ENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEM13 TSTOYOURPROPEMY IFYOU INTEND TO OBTAI N FI NANa NG, CONSULT WITH YOUR LENDER ORAN ATTORNEY BE ORE FECCIRDI NG YOUR NOTI CE OF CUM M ENCEM ENT. (9 ure of Owner or nduding Contract r) (Signature of Contractor) Signed and sworn to(or affirmed)before me tH4 day of Signed and 9,yorn to(or affirmed, )befgrp m�his day of �,by c� � 1 1 � b �`1�..('�'h r (Signature of Notary) (8 ure of Notary) rotPR'P�ey�o RYANALWARD7 r°SPR PGB<c EVANGELIECLARKE * My COMMISSION#GG 000431 ,�5 , Commission#GG 102835 F _Sonal ly Known OR EXPIRES:June 8,2020 [a-15e sonal l y Known OR Expires May 9,2021 [ ] Produced Identification 9l`-,,L�\o Bonded thruBudget Notary Services [ ] Produced Identification oFpBonded ThruBudp(NotaryServlcee Type of Identification: Typeof Identification: NOTICE OF COMMENCEMENT Permit No_ Tax Folio N (o`1 1 n©c>0 State of FLorUDA County of To whom it may concern: c 1c,\ 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 stated in this NOTICE OF COMMENCEMENT. //�� n Legal description of property,being im roved: ��1� V —(9 �C o 2- A dre sof prepe be g i roved: '�o�l -L 5 . General description of improvements: 1TFT Owner Address EL 5 003 Owner's interest in site of the improvement NIA Fee Simple Titleholder(if other than owner) N/A Name N/A Address N/A Contractor AMERICAN WINDOW PRODUCTS,INC. Address 2633 POWERS AVENUE-JACKSONVILLE,FL 32207 Phone No. 904731-2247 Fax No.904-731-8824 Surety(if any) NIA Address N/A Amount of bond$NIA Phone No. N/A Fax No. N/A Name and address of any person making a loan for the construction of the improvements. Name NIA Address NIA Phone No. NIA Fax No. NIA Name of person within the State of Florida,other than himself.designated by owner upon whom notices or other documents may be served: Name N/A Address N/A Phone No. NIA Fax No.N/A 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)(b).Florida Statutes.(Fill in at Owner's option). Name NIA Address N/A Phone No. N/A Fax No. N/A Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY NER Signed: DATE �—z. Before me this day of in the Cou of Duval.State of Mon a,has pe onally appeared rh/C �1'C7 -V herein by himself/he r and affirms at all statsmertis�rn> � Doc#2019034585,OR BK 18689 Page 725, are true and accurate arationsherftNALWARDT ro�...,��ic Number Pages:1 * MY COMMISSION#GG 000431 Recorded 02/12/201911:27 AM, u� EXPIRES:June 8,2020 RONNIE FUSSELL CLERK CIRCUIT COURT DUVALpo adnruBudptNotaryservices COUNTY 6VK-1 Z, ) I . RECORDING $10.00 6146rY Putxic state of . County of l N-ly commission expires, Personally Kno:-:n or Produced Identification SIG- (3-7 REVIEWED FOR CODE COMPLIANCE CITY OF ATLANTIC BEACH PERMIT SEE PERMITS FOR ADDITIONAL COPY REQUIREMENTS AND CONDITIONS REVIEWED BY: DATE: _�dI OFFICE COPY PERMIT CpPY Florida Building Code Online https:Hfloridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwt... IIWMOA MAW~09 Business & ProfessionalRegulation PERMIT - ry COPY rm� a BCIS Home Log In User Registration Hot Topics Submit Surcharge Stats&Facts Publications Contact Us BCIS Site Map Links Search db Pu a -®j Product Approval OFFICE ///��� v USER:Public User COP Y 1T Product Approval Menu>Product or Application Search>Aookation List>Application Detail • y FL# FL251-R30 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 PGT Industries Address/Phone/Email 1070 Technology Drive North Venice, FL 34275 (941) 486-0100 Ext 22318 druark@pgtindustries.com Authorized Signature Jens Rosowski jrosowski@pgtindustries.com Technical Representative )ens Rosowski Address/Phone/Email 1070 Technology Drive Nokomis, FL 34275 (941) 486-0100 Ext 21140 jrosowski@pgtindustries.com Quality Assurance Representative Address/Phone/Email Category Exterior Doors Subcategory Sliding Exterior Door Assemblies Compliance Method Certification Mark or Listing Certification Agency Miami-Dade BCCO - CER Validated By Miami-Dade BCCO - VAL Referenced Standard and Year(of Standard) Standard Year TAS 201, 202, 203 1994 Equivalence of Product Standards Certified By Product Approval Method Method 1 Option A 1 of 4 1/29/2019, 2:16 PM Florida Building Code Online https://floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwt... Impact Resistant:Yes 03/24/2020 Design Pressure: N/A Installation Instructions Other: Please see Miami-Dade County Notice of Acceptance FL251 R30 II 17042014.pdf (NOA)for product performance information, anchorage Verified By: Miami-Dade BCCO- CER details, and anchor type, size, and spacing information. Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 1 251.7 SGD- 780 (Impact) WinGuard Aluminum Sliding Glass Door Limits of Use j Certification Agency Certificate Approved for use in HVHZ: Yes FL251 R30 C CAC 17042004.pdf Approved for use outside HVHZ:Yes j Quality Assurance Contract Expiration Date Impact Resistant:Yes I 08/02/2022 Design Pressure: N/A I Installation Instructions Other: Please see Miami-Dade County Notice of Acceptance FL251 R30 II 17042004,pdf ■� (NOA)for product performance information, anchorage Verified By: Miami-Dade BCCO - CER C") I details, and anchor type, size, and spacing information. Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 251.8 SGD-2500 (Non Impact) Aluminum Sliding Glass Door Limits of Use ! Certification Agency Certificate Approved for use in HVHZ: Yes FL251 R30 C CAC_18-02.07.05_Doonpdf Approved for use outside HVHZ:Yes I Quality Assurance Contract Expiration Date Impact Resistant: No I 05/22/2019 j Design Pressure: N/A I Installation Instructions Other: Please see Miami-Dade County Notice of Acceptance j FL251 R30 II 18-0207.05 Door.pdf (NOA)for product performance information, anchorage Verified By: Miami-Dade BCCO- CER details, and anchor type, size, and spacing information. Created by Independent Third Party: 1 Evaluation Reports Created by Independent Third Party: 251.9 1 SGD-5470 (Non-Impact) Vinyl Sliding Glass Door imits of Use Certification Agency Certificate Approved for use in HVHZ:Yes FL251 R30 C_CAC 17042007.pdf Approved for use outside HVHZ:Yes Quality Assurance Contract Expiration Date Impact Resistant: No 04/21/2021 Design Pressure: N/A j Installation Instructions Other: Please see Miami-Dade County Notice of Acceptance FL251 R30 II 17042007.pdf (NOA)for product performance information, anchorage Verified By: Miami-Dade BCCO - CER details, and anchor type, size, and spacing information. Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: 251.10 SGD-5570 (Large Missile Impact) Vinyl Sliding Glass Door Limits of Use I Certification Agency Certificate Approved for use in HVHZ:Yes 1 FL251 R30 C CAC 17042006.pdf Approved for use outside HVHZ: Yes I Quality Assurance Contract Expiration Date Impact Resistant:Yes 04/14/2021 Design Pressure: N/A I Installation Instructions i Other: Please see Miami-Dade County Notice of Acceptance I FL251 R30 II_1704200.6.pdf i (NOA)for product performance information, anchorage Verified By: Miami-Dade BCCO - CER details, and anchor type, size, and spacing information. Created by Independent Third Party: Evaluation Reports Created by Independent Third Party: Back Next; Contact Us::2601 Blair Stone Road.Tallahassee FL 32399 Phone:850-487-1824 The State of Florida is an AA/EEO employer.Copvnaht 2007-2013 State of Florida ::Privacy Statement::Accessibility Statement::Refund Statement Under Florida law,email addresses are public records.If you do not want your e-mail address released in response to a public-records request,do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mai.If you have any questions,please contact 850.487.1395.'Pursuant to Section 455.275(1),Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee.However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public.To determine if you are a licensee under Chapter 455,F.S., please click tiff€. . Product Approval Accepts: ® 3 of 4 1/29/2019, 2:16 PM