982 Ocean Blvd RES19-0094 Window, Door RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0094
800 SEMINOLE ROAD ISSUED:4/3/2019
ATLANTIC BEACH. Fl.32233 EXPIRES: 9/30/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT STE! 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,orfederal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUEOFWORK:
982 OCEAN BLVD RESIDENTIAL ALTERATION 14 WINDOWS &2 DOORS $16028.00
RESIDENTIAL
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
1703420000 PARKWAY
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN WINDOW 2633 S POWERS AVE JACKSONVILLE FIL 32207
PRODUCTS
OWNER: ADDRESS: CITY: STATE: ZIP:
WOESSNER, BRIAN 982 OCEAN BLVD ATLANTIC BEACH FIL 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 CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455 SEES 322 1000 0 $135,00
BUILDING PLAN CHECK 455 DOUG 322-1001 0 $67,50
STATE DBPR SURCHARGE 455"IT208 07W 0 53'�
STATE DCA SURCHARGE 455-0001 06M 0 $2 03
Issued Date:4/3/2019 1 of 2
RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0094
800 SEMINOLE ROAD ISSUED:4/3/2019
ATLANTIC BEACH. FL 32233 EXPIRES:9/30/2019
Issued Date:4/3/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be a Building Department.)
800 Seminole Road
Atlantic Beach, Flonda 32233-1445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coeb.us Dale routed:
Qty web-site: hiftip:/twww coab.us =L�
APPLICATION REVIEW AND TRACKING FORM
Property Address: 9�!)7_ Ccjcap � LQ40 iDepaftent review required Y No
Applicant: Planning &Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fre Services
R
,q.yjp,w fee Dept Signature
Other Agency Review or Permit Required Review t
of Permit=PBY Date
Florida Dept of Environmental Protection
Florida Dept of Transportation
St Johns RiverWater Managerrient District
Any Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beveniges,and Tobacco
Other
APPLICATION STATUS
Reviewing Department First Revili [B61proved. []Denied. E]Not applicable
(Circle one.) Comments:
PLANNING&ZONING Reviewed by: Date: z"'561
TREE ADMIN. Second Review: ElApproved as revised. []Deniedk/ [JNot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. [—]Not applicable
Comments:
Reviewed by: Date
Revised 0&1912017
Building Permit Application
My of Atlantic Beach OFFICE COPY
800 SwninoleFbad,Atlantic Beach,R-32233
FhonE(904)247-5826 FEDc(9D4)247-5845
,lobfiddreseziPiso Oce�oc) O�� —Permit Number: R q - C) 0 9 e4
Leo TA?M�-QVAi4 %ay.k vi n-aliQ-g�Q00
Valuation of Work(Pbplac*aTwft0od)$K0,00N.f'c` .Fleded1GooledT__h1=N,.-i:�ewcxdA-
IM (lassorVilork(Urdeone): Nlew Addition Afteratim fbpar Move Derno Pool Wnd=/Mor
MI Useof e)dstinWpropcsBd structure(s)(arcle one): commercial (�� E��
0 if an e)dsting structure,isafire sprinlder"m installed?(arde one): Yea No(�F)
MI Sibrrut a7ree Femovad Permit Application if anytreeasareto beremoved orAfficavit of KbTreeplarnov.4
Describein detail lhetypeofmrktobeperFor ad
TE
4r','
Florida Product Approval# 3F4L� R-�--tOOVJL�d —for multiple products use product appro\d fomn
ProDertv QNner Information
. r; Addr_"� &A
at Rate-p-- zip !6� Phone !S�t-
E,Meil
Owner or Agent(if Agent,power of Attorney or Agency Letter Fisquired)
ODntractor information LU
AMOdcan Mndow Producto z
Nernst of company. QualifyingAgent:
Address 1, 2633 Powem onus aty� z
()ffm phoa�;M_z2g-" Jadigionville. FL 32:M - _�a le— ZD x _j
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aateOxtification/P,4stration#kjt!�C-ld,':a EM6124 "CCr*x)T A3
Architect Name&Phone# 0 M -
Engneer'shlarne&Phom# W L) 93
WorkersCompensation va-v niol[OH813-1- (Allig i,- 5_0�
Qaan�plfl�_ f Lease Rnployeesl Eapiration Date C) �-� Zj
Application ishereby madeto obtain a permit to do thework and installationswindicated.loartifythat noworkorinsWaiic�N! t'-
commenoodpriortotheissuanceof apermit andthat allworkvAll be performed to meet the standardsof all the laws reaulak. wgz
constructioninthisjurisdiction.I understandthat aseparatepermit must loesecunedforRECIPICALWOW RIJIMBING
VYELL5 POC65 FLMACEF,BGIUR�FENTE15 TANK5 and AIROONDITONUr,etc. I
LA Li
OMERSAFFIDAVIT I cadifythat all theforegoinginforrnation isaccarateandthat allworkwill be done in compliaryCEWt4
applicablelaMnsregulatingwnstruction anclaoning. U) w
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WAFNINGTOOMER YOURFAII11FETO FEMITIA NCFnCEOFODMM IENCEM ENT >
FESIXT IN YWRIPAYINGTWICE FOR IMPIROVEM 134MR)YOURIPFUTIRW IFYCIUD
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EVANGELIECURKE
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Exores May 9,2021
(4froduceci Idelificat"'n [ IRodumd1dentification
Typeof Identificatiorr Typeof Wenfiflication:
NOTICE OF COMMENCEMENT
or XL
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To whom It may concern: I COPY
The undersigned hWdbY informs You that will be made W caftak,real property,and In
accordance Win Sftfion 113 of Him Florida Stat the following Information is stated in this NOTICE OF
COMMENCBAENT.
property bems;.
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Owner IPW -
Add. (
Owners interest in sb d the Improvement WA
Fee Simple Titleholder(If otiver man owner)N/A
Name N/A
Address
AMERICAN WNDOW PRODUCTS.INC.
Address 2833 POWERS AVENUE - JACKSONVILLE,Fl, 32207
Phone No.si Fast No.904731 S824
Sondy(Very)NZA
Address Amm�dborvd$
Phone No —Fiki
Narow and addrese;of any Person making.loan ibir Dw wrisbudicin of the improvements.
Name N/A
Address
Phone No. Fix No-
None of person within Me Slow,of Florida,other thert himsei clemignmeavc!by ovmu upon wirom notices or other
doc�mnenls may be served:
Name WA
Addraws;
Pleem,No. —F.XN..
In acmillon b,hurnseff.owner designames me following persort to receive a copy of Me Uences Nonce as pmvided in
Section 711306 C2)ft Florida Stii(Fill in at Owners option).
Nam N/A
Addowas
Phone No- Fas No-
Expiration dater of Notice of Commencement ft expiration dide,Is we(1)year town an,dele,Of recording unless 0
mament date is spealledc
THIS SPACE FOR RECORDER
Is USE ONLY
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DoC#20190579811ORSK18719 Page3Q.
Number Pagm 1 e=AR Y�JGALLAGHER
R000rded 01`1 412DIO 03:14 PM. WYCOMMIMONIFF)W
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL EXPIRES:September 6,20 19
COUNTY BeeNU.801IN"Sens.
RECORDING $10.00 a4FO � L;,A_, I A�
d*id'�bopy
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORI
Project Name: V4 S50Gr Fermi, OR&-SJT 009'el
QU -rC&3j
PritjectAddress: q1?a cQean a
As required by Florida Stanst:553.842 and Florida AArninistrative Code Rule 9B-72,pleace provide the information and product approval munbert)
for the building component listed below as applicable to the building cons(ruction project for fire permit number listed above. You should cormul
you product supplier ifyou,do not know the product approval number for my of the applicable listed product. In6orcumonmgandingshatewide
�Jlomdabuildirosmg.
Category/Subutegory Manufacturer Product Description LimicationollUse State 9 Vocal 4
A.EXTERIOR DOORS
1.Swinging P�a�� �11 01 13
2.Sliding
3.Sectional
4.Roll up
5.Autornatic
6.Other
R.WINDOWS
1.Single hung
2.Horisomal slider
3.Casement
4.Double hung V14 (oC;-
5.Fixed
6.Awning
7.Pass-through
8.Projected
9.Mullion
Wood turealeer
OFFICE COPY Iq
2.Other
Category/Sub�teleDry Manufacture, I Limitation of Use State 9 "Cal N
IL NEW EXTERIOR
ENVELOPE PRODUCTS
I. k 1
2. 1
In addition to completing ft above list of ason.fanclumers, product description and State approval mmbCr for the products used on this project, the
Contractor shall maintain on the job site and available M the Inspector, a legible Copy of each trainufacurnes printud specifications, and intafflation
instructions along with this Product Approval Sheet.
I mody that this product approval list is true,and Correct to die best of my knowledge.I firther cortify that use of different carnpostents other than the ones
listed in this docuument must be approved by the Building Official.
(Contractor Name) (PrintNarnc)—be� C—Axr (Signsione)
Cou'lianyNnon": A-m-mWsnVfin,'*wProd,ycft
Mailing Address 2633 Powers Avenue
City: Jed(sonville, FL 3220 State:— Zip Code:
Telephone -I.Nurnbeclqd4)-i5l-SGR�
Cell Pharm,Nundicr: E-amil Addrc�-N
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