1741 Seminole Rd. RES19-0077 Replace sliding glass doors RESIDENTIAL PERMIT PERMIT NUMBER
l CITY OF ATLANTIC BEACH RES19-0077
800 SEMINOLE ROAD ISSUED: 3/19/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 9/15/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
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:
RESIDENTIAL ALTERATION
1741 SEMINOLE RD RESIDENTIAL replace sliding glass doors $12185.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169640 0500 OCEAN GROVE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN WINDOW 2633 S POWERS AVE JACKSONVILLE FL 32207
PRODUCTS
OWNER: ADDRESS: CITY: STATE: ZIP:
Dlugasch Philip 1741 Seminole Rd ATLANTIC BEACH FL 32233-5615
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $115.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $57.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.59
STATE DCA SURCHARGE 455 0000-208-0600 0 $2.00
TOTAL: $177.09
Issued Date: 3/19/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER
rlfi Building Department (To be assigned by the Building Department.)
A,. 800 Seminole Road (1 l_ `J 1 g •- Do-Atlantic Beach, Florida 32233-5445
j.a l- I
Phone(904)247-5826 • Fax(904)247-5845 ( )
I�wr E-mail: 31uilding-dept@coab.us Date routed: I JJ
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I L1 . S Q (Y1 t R(� - nt review required YierNo
1 ` Building
Applicant: 1 CD- rl W �^(�,Ow f(4/6,1-5 Planning &Zoning
Tree Administrator
Project: tioV _Q a Salt NG'1 - L(�S Public Works
J Public Utilities
ON 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: I Approved. ❑Denied. ['Not applicable
(Circle one.) Comments:
BUILD NI.
PLANNING &ZONING Reviewed by: Date: 3/0 X20//
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 05/19/2017
22 -
NOTICE OF COMMENCEMENT
Permit No. Tax Folio No. 10 (9 40' b S oo
State of FLORIDA County of OU,N \
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 stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 20ZD 01- 2S - VIE . Qq Ocean &tttJe.
oxylt- 2 S '12 LO-t- Lib Recd 18(04D -2Z-
Address of property being improved: 1 141 Sew 1,(\
A--Harr\-Eie teotc-t t Vi 322-55
General description of improvements: 2 f 2 C,et'(Y ea-" door 5
Si C�.r Si
Owner Qh i ll i P O w)a)c.►„SV'
Address I'44-4 1 Semi f't e. Czci. fl-1-t9.n+C. geoC)(,Fi.- 32233
Owner's interest in site of the improvement N/A
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.904-731-2247 Fax No. 904731-8824
Surety(if any)N/A
Address N/A Amount of bond$N/A
Phone No. N/A Fax No. N/A
Name and address of any person making a loan for the construction of the improvements.
Name N/A
Address N/A
Phone No. N/A Fax No. N/A
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name N/A
Address N/A
Phone No. N/A Fax No.N/A
In addition to himself.owner designates the following person to receive a copy of the Lienors Notice as provided in
Section 713.06(2)(b).Florida Statutes.(Fill in at Owner's option).
Name N/A
Address N/A
Phone No. N/A Fax No. N/A
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY . •
Signed: `:/ ATE —2al
Before me this - daii of in the
County of Duval iaty,f tlpryda,t p-rs ap• a pear d
i ms that all s(atem- and declarations hesOcir Pri$ EVANGELIE CLARKE
Number Pages:1 are true and accurateo
Recorded 03/14/2019 03:14 PM, y Commission#GG 102835
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL -ti it; Expires May 9,2021
COUNTY
et, 'QF OQ- Bonded ThruBudgotNo(arySenlces
RECORDING $10.00 4 ���iG e-C�
v•t, ubliee :r•c. ton• . County of i`g]rf�l
try cemmissl xpires:
Personally Kncv.n ✓ or
---- _--""— Produced Identification
��� D422-665-56-181-0
WZW--j q
-:‘,,,,,, Building Permit Application OFFICE COpy
1 -- o City of Atlantic Beach
800 FL32233 tit
N
li'r Phone: (904)247-5826 Fax: (904)247-5845 00
cn
,bb Address: 12-4-1-1\ Sem1,no\e_ Rd• M-lari3CBeo►u,, 31233 Permit Number: K- L 'St el — II -JP'—
-10-Zept
LI p M
Legal Description 20•-20 01-25•-29E .09 oceo+nc-1rove.kAn;t2sV2.1.0l-4i6 Recdoes igeREit 169 2 –
�-lo-cost) Enrz II.
Valuation of Work(I placement Cost)$ ('Z 1(BS • Heated/Cooled: Non-Heated/Cooled 0 C) ca U il
® CJassof Work(C3rdeone): New Addition Alteration Fbpair Move Demo Pool Window/Door Z 2
ED Use of existing proposed structure(s)(arde one): Commercial Cbsidenti 0 aC O q
® If aneAstingarudure,isafire sprinkler system installed?(Circle one): Yes No WA 0 W y H
® SLbmit a Tree femoval F rmit Application if any trees are to be removed or Affidavit of No Tree Removalcc Z
cc t-
Describe in detail the type of work to be performed: u- cu
yp p 2 Reo cemeav s1idr,N c 0,• 5 do 0 a] }
-- `j 'Ze.. %, Si2-� 0: m
.�a, k' � w
Rorida Product Appr. . # a S` , 0 for multiple products use product approiii fb rfn FC w
R-operty Owner Info •• .• :�
Name: Philip Dlugasch Address: 1741 Seminole re4 (i"" r -, .( ,,1t `.��i w
i cc
City Atlantic Beach aate H Zip 32233 phone '3b ,2898=5892 l Il
E-Mail dlugascp@bellsouth.net 1 y,
Ow 'ner or Agent(If Agent,Rower of Attorney or Agency Letter Fequired) MAR - 8 ?119 11 i
Contractor Information '
Name of Company: F't'Ct1eCiairW',r\do,.,yPYJ LftS,th.C • Qualifying Agent: Keile-lu.nF------------
-
Address 2(43 Powcrs Avaviut_ City -Tbs,k5-oivtuL Sate Fi Zip -31..Larf
Office Phone Ci()(-1-r431-2 y'4- .bb Ste/Contact Number qk)(4- 1-1 1- 224 11-
Sate Certification/I stration#C$C\2S12ta' E-Mail Nem 6) aotbri,can p—uc-t. co/14-
Architect Name&Phone#
Engineer's Name&Ffione#
WorkersCompensation FrxycyMex_ 01266 t-(g13e--10101 1q
Exempt/Insurer/ 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 thisjurisdidion.I understand that a separate permit must be secured for ELECTRCALWOFa<,PWMBING,SC'1S
WELLS POOLS RIRVACES BOILERS HEATERS TANKS and AIRCONC4110NNB etc.
C7iNN SAFFIDAVIT: 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.
WARM NG TO OWNER YOUR FAI WRETO RBCORD A NONCE OF COM M BNCBIA BNT MAY
RESULT 1 N YOUR PAYI NG 1WI CE FOR I M PROVEM ENTS TO YOUR PROPERY. IF YOU INTEND
TO OBTAI N F-1 NANa NG, CONSULT WITH YOUR LENDER ORAN ATTORNEY BEFORE
RECORD G YOU: OTICE• Si M ENCEM ENT.
(9 ureofOw - or including Contr o (9gnatureofCbntrador) ,^,1�+
Sgned and sworn to(or affirmed before me is 1'-day of Sgned and sworn to(or affirmed)before e thisi dayof
Feb , 1q� •h.. 1 • •1 .. ,h web , Zolcl b ;-+ c-
r
(S. ,e re of Notary) (•.-.*Tire of Notary)
4°.. nua�c EVANGELIE CLARKE oltav Fuer EVANGELIE CLARKE
* ,r+; * Commission#GG 102835 �2., ,,i°# Commission#GG 102835
�. •" '''' - 8 Expires May 9,2021 ! N car" Expires May 9,
[ ]Ifiraonal ly Known OR 9lFo"
F FLoQ B21
onded Thru Budgol Notary Services [1]R-oduc l ly Known OR ��r F f,dizs Bonded hru Budgeto Notary Services
[I.?4oduced Identification yy,_� [ ]R-oduced Identification
Type of Identification: Vi- cVi--, - Type of Identification:
L. ay.... D422-665-56-181-0
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