817 Bonita Rd RES19-0157 Replace Windows RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0157
800 SEMINOLE ROAD ISSUED: 5/29/2019
ATLANTIC BEACH. Fl.32233 EXPIRES: 11/25/2019
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 applicableto 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: VALUE OF WORK:
817 BONITA RD RESIDENTIAL ALTERATION replace windows $8800.00
RESIDENTIAL
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1711530000 ROYAL PALMS UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
PELLA WINDOW AND 350 State Road 434 W LONGWOOD FL 32750
DOOR
OWNER: ADDRESS: CITY: STATE: ZIP:
JACKSONVILLE FL 32250
CHRISTOPHER J ROOD 509 9TH ST BEACH
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_ PAI
BUILDING PERMIT 4S5 000C322-1000 a $9500
BUILDING PI-AN CHECK 455�0000 322-1001 0 $47,50
STATE OBER SURCHARGE 455-0000 208-0700 0 $2.14
STATE OCA SURCHARGE 455 MO-208 0600 0 52�00
Issued Date:5/29/2019 1of2
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RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0157
800 SEMINOLE ROAD ISSUED: 5/29/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 11/2S/2019
issued Date:5/29/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be as Building Department)
800 Seminole Road MA —0 is 3-
Atlamic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Date routed
Citywelh-site: httpfl�coabus
APPLICATION REVIEW AND TRACKING FORM
Property Address: D nt review required Y No
Building, -7—
Applicant: ftlkek \A�I\kz -Pra—nning &Zoning
Tree Administrator
Project: li.,�446,sg Public Works
Public Utilities
Public Safety
Fire Services
Review fee $
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Fbirida Dept—of Emnronmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
ivision of Alcoholic Beverages and Tobacco
Other:
APPLI us
Reviewing Department First Review: Approved. E]Denied. [-]Not applicable
(Circle one.) Comments:
ig�au
PLANNING&ZONING Reviewed by:— Date:
TREE ADMIN. Second Review: E]Approved as revised. ODenie'd. ONot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRE SERVICES Third Review: DApproved as revised. [:]Denied. E]Not applicable
Comments:
Reviewed by: Date:—
Revised OW1912017
"Tim for Ali UP?V43744W
Building Permit Application Upda,0 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone:(904)247-5826 1":(904)247-5845 Email:Building-Dept@ccab.us IS REQUIRED.
Job Address: Liy Sipoviax, at Pe rilt Number: 0 L-S - 0 LS�4
Legal Description-3.0 1-7 '21 j�_ j I RE# -00
Valuation of Work(Replacement Costj$ k-IY00- Heated/Cooled SF Now Heeed/Cooled_
• ClassofWork: 4r]Nevv OAddmon OAlteration OR ODenno OPoal 01061indaWRECEIVED
• Use of existingtiarroposed structure(s): 9% a[45teside
• Ifan existing structure,is afire sprinkler system installed?: Eyes EINO
• Will tree(s)be removed in association with ropq5ed Pro ect4lk-5farustsubrinit separate Tree Removal PerMT[U 2019
Describe in detail the type of work to be performed:
t- eviLil 9 3-7Wr^P—Cb AR Sullcling Z4,14
�i aM
Florida Product Approval# I A 6 C).1- t Itov . if for multiple products use p)r
rox(�npllcppgq,14�w EL
Property Owner Information
Name r, ia Address 81-7 6'P^n`x`
City A-Tl_,;71� J'k,,A. Zip '>1ZX3
State
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) n/a
Contractor Information
Name of Company- ( W�A .1� 0 r5 Qu.1"Y Ing Agent �30"s
Address ';10 A LfJ'f W Oty_6!v2n��"Z
OfficePhone 10-1:1371-l"k Job Site ContacON�umbe,
State Ceftification/Registration# C_9C_0Yj71#Z E-Mail '1iM- 0,14.418114a)
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer seemQl! Ca _. (0 OR Exempt 0 Expiration Date
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify the no worker installation has
com menced prior to the issuance of a permit a no that al I work wi 11 be performed to meet the sta ndards of all the laws regu lating
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.
OWN E RS 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
RECORDING YOUR NO COMMENCEMENT.
X 6_�4
(Signature of Owner or Agent)
Signed and sworn to(or affirmecil before me this Signed and s.f ;Sagratun,of C.mxct.r) '�ay of
day of om to(or affirmed)before me this
ilia'j. _aft�y&z_,a�e
(Signature of NohmFF ' J (Sivatureallifounry)
I Personally luxr.OR P onallyl(m n
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OFFICE COPY
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA ('REQUIRED)
*Project Address: 817 Bonita Road Permit#: R6�S,19-015-7
*Owner/Project Name: Chris Rood
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 your
product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide product
approval may be obtained at:www.floridalbuilding.org.
Category/SubcategDry Manufacturer Product Description Unnitarfion of Use state# Local#
A.EXTERIOR DOORS
LS
winging
2.Sliding
3.Sectional
4.Garage Roll-Up
5.Automatic
6.other
Bp VANDOWS
1.Single hung Pella Impervia 12602.1
2. Horizontal slider
3.Casement
4. Double hung REVIEW
5 Fixed n, IEACH
6.Awning sp PFRMITqFORADDTIONAL
7.Pass-through FJEQIL IFLEMENTS AND CONDITIUNb
8.Prdjected nATE,
9. Mullion
10.Wind breaker
—11 Dual action
12.Other
Pa,1 f4 Upd.wd10117118
U� HUL UUIJY
Category/Subcategory Manufacturer Product Description Unnitation of Use State# Local#
E.SHUTTERS
1. Tordion
2.Bahama
3.Storm panels Storm Smart Industries Storm Catcher 11291.1
4.Colonial
5.Ro Flup
6.Equipment_
7.other
F.STRUCTURAL
COMPONENTS
1.Wood
connector/anchor
2.Tr-uss plates
3. Eneineered lumber
4.Railing
S.Coolers-freezers
6.Concrete admixtures
7.Material
8.Insulation forms
9.Plastics
10.Deck-roof
11.Wall
12.Sheds
13.Other
G.SKYUGHTS
1.Skylight
2.Other
H.NEW IDMRIDIR
ENVELOPE PRODUCTS
1.
2.
Page 3 of 4 UpdaW J0117118
OFFICE COPY
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 bythe Building Official.
*Contractor Name(Print Name):James Rowland *Contractor Signature:/d:::�_
*Company Name: Pella Windows and Doors
*Mailing Address.. 350 W State Road 434
*City: Longwood *State: FL *Zio Code: 32750
*Telephone Number: (727) 637-8400 *E-mail Address: tim.omalley@expeditepermit.com
Cell Phone Number: Fax Number:
Page 4 of 4 Updated 10117118
professionals,having experlence and knowledge In(he field of pmctice,nor to substitute for the standard of care required of
such professionals in interpreting and applying the results of the report provided by this website,Users of the information from
this wobsito assume all liability arising from such use.Use of the output of this walbsile does not Imply approval by the
governing building code bodies responsible for building code approval and interpretation for the building site described by
latitude/longitude location In the report
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Doc 4 2019086039, OR EK 18756 Page 1839, Number Pages: 1,
Recorded 04/15/2019 02:57 pm, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
2
JOB COPY
NOTICE OFCOMMENCEIRIENT
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,TATEref, AND (AN FRUIT IN FOUR RATED Toldhot FORR INFROWARNIS TO MR MOPHOW. A NOTICE OF
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Cash Register Receipt Receipt Number
City of Atlantic Beach R9590
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $55.00
RES19-0157 Address: 817 BONITA RD APN: 171153 0000 $55.00
BUILDING WINDOW DOOR INSTALL 06/17/2019 RBE $55.00
BUILDING WINDOW DOOR INSTA�= 455-0000-322-1002 $55.00
06/17/2019 RBE 0
TOTAL FEES PAID BY RECEIPT: R9590 $55.00
Date Paid: Wednesday, July 17, 2019
Paid By: PELLA WINDOW AND DOOR
Cashier: CT
Pay Method: CREDIT CARD 05145
Printed:Wednesday,July 17,2019 8:23 AM I of 1