615 Selva Lakes Cir RES19-0086 Replace Win RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0086
800 SEMINOLE ROAD ISSUED:4/3/2019
ATLANTIC BEACH. FIL 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 EITH EDITION (2017) OF THE FLORIDA BUILDIN
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 befound 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,orfecleral agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
615 SELVA LAKES CIR RESIDENTIAL ALTERATION replace windows
RESIDENTIAL $11798.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1720275550 SELVA LAKES UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN WINDOW 2633 S POWERS AVE JACKSONVILLE FIL 32207
PRODUCTS
OWNER: ADDRESS: CITY: STATE: ZIP:
TINNEYJAN A LIFE ESTATE 615 SELVA LAKES CIR ATLANTIC BEACH FIL 32233-4378
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 ORAN
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
BUILDINGPERMIT 455 WOO 322 TOM 0 $Ila Go
BUILDING PLAN CHECK 455 WOO 322 1001 0 $55 SO
STATE DBPR SURCHARGE 45S WOO 20a 07M 0 $248
7 STATE DCA SURCHARGE 455 WOO 208 06M 0 $200
TOTAL:$169.48
Issued Date:4/3/2019 1 of 2
RESIDENTIAL PERMIT PERMIT NUMBER.
CITY OF ATLANTIC BEACH RES19-0086
800 SEMINOLE ROAD ISSUED:4/3/2019
ATLANTIC BEACH. FIL 32233 EXPIRES:9/30/2019
issued Date 4/3/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 32233-5445 0 C, ho
Phone(904)247�5826 Fax(9D4)247-5845
E-mail: building-dept@wab,us Date routed: [Lab
City web-site hmp 1/www.walb.us 4
APPLICATION REVIEW AND TRACKING FORM
Property Address: y C, L4�� - nt review required Yes flo
( Buildina ) L70
Applicant: _A-M-u �can -Fla�oning
Tree Administrator
Project: Public Works
Public Utiltres
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.ofTransportation
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: R�pproved, [—]Denied. E]Not applicable
(Circle one.) Comments: rill 0
1311 PLANNING &ZONING Reviewed by: A-P 5�_ Dratei
TREEADMIN. Second Review: ElApproved as revised. []Denied. — E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date
R.1risd 0511912017
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OFFICE COPY
Selva Lakes Homeowners Association,Inc.
c/o Selva Lakes Homeowners Association, Inc.
P.O. Box 331365
Atlantic Beach,FL 32233
Customer Care: Fax:
Website: selvalakes.com
Date: March 01,2019
Project Ref. [64029492] 615 Selva Lakes Cir
Jan Tinney
615 Selva Lakes Circle
Atlantic Beach FL 32233
Dear Jan Thmey,
I am pleased to inform you that the Selva Lakes Homeowners Association,Inc.
Architectural Committee has approved your application for the listed project item(s):
Windows
The approval is contingent upon compliance with the specifications set forth in the approved
application.If your change or addition requires a county,city or state permit,it is the
responsibility of the homeowner to obtain this before starting construction.
Please do not reply to this message. If you have my questions or need to provide additional
information,please e-mail us at arcsla(Z�gmail.co
Sincerely,
The ARC Committee
Selva Lakes Homeowners Association,Inc.
c/o Selva Lakes Homeowners Association,Inc.
P.O. Box 331365
Atlantic Beach, FL 32233
Main Phone: Fax:
Website: selvalakes.com
2
Building Permit Application
8W-Seminole Fbad,Atlantic Beach,R-32233
Oty of Atlantic Beach OFF1 9 COPY
Phone:(904)247-W6 Fac(904)247-BM
,bb Addrese Co I S (_d(Z4_ Permit Numben.
k*4-1-1 FED 10
Valuation of Work(Papecement Q)st) Fleated/Ccoled STF n-Heeted/Cao z
U (Imof Work(arde one): Nw Addition Alteration Repair Move Derno Pbol nd r U3 P 0
171 1.1secif exhitingliproposed structure(s)(03rde one): Cbminerdal U Ei OZ
Fasidential Q 0
ILL. ay
MI Ifanexistingstructure ISO fire sprinkler system installed?(Orde one): Yes NA cc
171 Submit a7reeFernovad Permit Application if anytreesareto beremoved orAffidaMit of NoTree
Describe,in detail the type of work to be pwforrrmd
0 U.
51. 0
RondaProductApprovai# —for multiple productsuse,product
Property ON
Nam% Addr
g
a
K)ENS2h Etate H Zp Phcne'iQ-i-1Ml-N!'1W,
MR.-�(\+; on >
E,Mail
Owner or Agent(if Agent,Pbwer of Attorney or Agency b*er Flaquiredytt
(brttractorinfornmetiaArnerican Window Products
Name of Oxnpany: 2631 P-oaars Nyen,-a QualifyingAgsnt:_Ve�A Cmorr-
Address aty. a a Op
I EMaj
Architect Name&Phore#
Englineer'sName&Phone#
Workers(brnpensation— 01fici
I Bw*I Insurver/LaaaeEmployeael EpreflorlDste
Application is hereby madeto obtan a permit to do thework and insballationsasindicaled.I oertifythat nowork or in4lation has
commenced prim to the issuance of a permit and thatafi workwill be performed to meet the slanclandsof all the laws ulationg m
ocrystructioninthisjurisdiction.I understandthat aseparateperrynit must thessouradfor ELECROALIACIR rs(34 , 0 M
WELL&POW9 RJFNA=EXALEP$FFATESS4 TANITA and AR00tM0NEFr4 etc. In 0 m - *
0 cm � fn
OWNERSAFFIDAMT I certify that all theforegorng information is accurate and that all work will be done in I 1pithilm a
ox"Plim.. MM 0
applicable lawsregulatingoanstruction and zoning. n
0
WAFNINGTOOVVNER YDIJRFAdWFETC)FEMFUANO-nCEOFOOMM
FESULT IN YC(JRPA)1NGTVv10E FOR IM PFOVEM BITISTO YOURPROPER11Y. IF 0
zy z
T009TAINFINANaNQ CONSULTWITH YCXJR LENDER ORAN ATrOMEY
0000
FUUUN13YOURNOMEOFOOMMENICEMEN'r 0
HMO
0
(8gnatureofContrert
a d swo n to(m affirmed) this0_dayof Sffuyj and sworn to(m affirry%=re me t his Of z
1?10/1 , - C� 0
ROGERAUSTIN In
MY COMMISSION I FF SM 0 Ntg
EXPIRES Septemba,6,2019 4 (8 0 t ae of Wary)
�ME Tr
EVANGELIECLARKE
C_�Iayl.r#GG102835
I Personally Khown GR t4.aflyK�OR E�pjras May 9,ZD21
Coducedtidendification I I Produced Identification
of Iden ification: �)R;velv lit Type of Identification:
T- —0
OFFICE COPY
!�=F!KL INFORMATION SHEET FOR TIJE CITY OF AnANTIC REACK FLORIDA
Project Name;. :M�a–,:lV Permit # Rt-SIV-000c"6
ProjectAddreane UIS AMA 1—nYM OA -N fC 3� 3
As required by Florida Stands:553.842 and Florida Administrative Code Ride 9B-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 perraft number listed above. You should conduct
your product supplier ifyou do non know the product approval number for my ofthe applicable listed produces buffmaration regarding statewide
randuct approval may be obtartaxi W::: Aloridabuildincom.
Categmy/Subscategory M..uliarturer ProductDascription Limitationoruse State 4 1 Locd#
A.EXTERIORDOORS
I.Swinging
2, Slid,,g
4.11.11,�p
5.Automatic
6.Other
B.WINDOWS
1.Single hung SJA 00 1
2.Hornontal slider j5li4 to
3.Casement
4.Double hung
5.Fixed
6.Awning
7.Pass-through
B.projected
9.Mullion
W�hxl loco,r
achar
OFFICE COPY
2.Other
Category/Sub-Inge" M..olacturer Product Dri imitation of Use State Ural 4
KNEWEXTERIOR
IENVELOPE PRODUCTS
1.
2.
in addition 0 completing the above lon of reamlischurers, product description and Slow approval number for the produm used on this project, the
Contractor shall maintain on the job site and "table to the Inspector, a legible copy of each manufansurtes printed specifications and installation
instniations,along vith this ProatuctApproval Sheet.
I certify that this product approval list is true and cormelt W the best of my knowledge.I rather catify that use of different components other than the ones
listbd in this document must be approved by the Building Official.
(ContracturName) (PrintNarna) izv—� .ayr (Signa1.)_47-----
Company Nama:Amftan Window Products
Mailing Address
city: Jacksonville, FL 3220 -Smc:— Zip Code:
-1 -7aL
Telephone Number:�JA__3 I�-D IP'A�F-Numb e r: 9 Qq)— —
-DPkfVa
Cell Phone Number: FmailAddress:J�NIEC2
OFFICE COPY
PERMIT
COPY
PERMIT
COPY
NOTICE OF COMMENCEMENT
Permit No. Tax Foll. .. I lao - 55:5c)
State of F� County Of
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.
Legs IM E
of party.Ming prov
a an
r1w115---1715 1 1 -
4 A dres of pro arty Man 15 01 rz-
10Z V(- sozna
General description of Improvements: fAL4,E d"
i�� Wil'N
r
-NM +hr zs-zo,
Owner ZaO -Al.
Appinuni '!zel
Owner's Interest!in site of the improvement NIA
Fee Simple TMelholder fif other Man owmn.) N/A
Nam. NIA
Add..NIA
PBConnector AMERICAN WNDOW PRODUCTS,INC.
Address 2633 P94VERS AVENUE- C ONVILLE,FL3=7
Phone No.Ill Fax No.9D4-731-8824
Surety(if any) NfA
Address WA _Ammnlofbond$N1A
phone No. N/A Fax No. N/A
Name and address of any person making a loan for Me oonstructrin of the Improvements.
Name NIA
Address NIA
Phone No. WA Fax No NIA
Name of person within Me State a Florida.other than himself designated by owner upon whicat nothas or other
documents may be servec:
Name W4
Address N/A
Phom.No. WA Fax No.N/A
In addition to himself.owner designates Me following Person to receive a copy of the Lieri Notes as provided in
Section 713.06(2)(b).Florida Statutes.Fill In at Ownses option).
Name NIA
Address NIA
Phone No. NIA Fax No. N/A
Expiration date of Notice of Commemosament(the expration date 13 one(1)year frorn the date of recording unable a
different date is specified):
THIS SPACE FOR RECORDRR'S USE ONLY
aw" 0
ERAUSTIN
R BK 18719 Page 3Q.
"k My C0sw6$gNjFF8M
Number Few.I EXPIRES September 6.2019
Recorded owl 4=9 03:14 PM. DUVAL
RONNIE FUSSELL CLERK CIRCUIT COURT
COUNTY
RECORDING $10.00
b,
amms'atGE
1 :500 Si --7 V -D