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1126 Main St RES19-0195 10 Windows/1 DoorRESIDENTIAL PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 PERMIT NUMBER RES19-0195 ISSUED: 7/2/2019 EXPIRES: 12/29/2019 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: 1126 MAIN ST RESIDENTIAL ALTERATION 10 WINDOWS AND ONE $6936.00 RESIDENTIAL S.G.DOOR 171017 0040 ATLANTIC BEACH SEC H ADDRESS: CITY: STATE: ZIP: AMERICAN WINDOW 2633 S POWERS AVE JACKSONVILLE FL 32207 PRODUCTS FIBELKORN STEPHEN M 1799 SEA OATS DR 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. Roll off container company must be on City approved list . Container cannot be placed on City right-of-way Issued Date: 7/2/2019 1 of 2 DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $85.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $42.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $131.50 Issued Date: 7/2/2019 1 of 2 City of Atlantic Beach Building Department 800 Seminole Road CI-11 �' Atlantic Beach, Florida 32233-5445 �j, V Phone (904) 247-5826 - Fax (904) 247-5845 E-mail: building-dept@coab.us City web -site: http://www.coab.us APPLICATION NUMBER (To be assigned neCby the Building Department.) w// -- r 0 n - Date routed: o Z APPLICATION REVIEW AND TRACKING FORM Property Address: Applicant: &P'"y) ( to 0C) 5 Project: Q VVI NjOciVoS Review fee $ 139pajiWnt review required Yes o Buildin Zoning Tree Administrator Public Works Public Utilities Public Safety Fire Services Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: Approved. ❑Denied. ❑Not applicable (Circle one.) � Comments: PLANNING & ZONING Reviewed by: Date: G " 2%' 20/q 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 i ax Fol r — a2P?iFii ISD. County Serie of FLORIDA To whom. Et may Wfic9rn: The uatdersigned hereby inform you Haat irnPrvveme.nts w39 be :rade to certain neat propartY, and in a=ordance with Section 7i3 of tie Florida Statdea the foRowirg inii0m- ati©n is stated in this N07CE OF COMMENCE-kIT_ �-in-pr Legal descriptor, of prope," � g ved: iC, Address of op,.t$r being irti�roved: r GEneifs�25GFiiaiiD^fYOM©` 'T5- —�� i�(�^% %Tc owner . v% ��1yr I I N A ddreSS 1 c/� t R, 1 A V G'�;mer's pie: of in rife of, i;?e inprove�rtf N/ Fee Strnpte a ftiet:ofder kff afler -ar, OW nee) NYS` Name N/A . A ddcess rCon ti -ac or AMERICAN' WINDOW PRODUCTS, !NIC. Address 2633 POW --RS "SNNUE - JACKSONVILLE, FL 3220' Phone No. 90-731-2247 r2V N0. 9;"=131-832= surety (-- n arty) NIA of Address Phone No. Fax No. rNarne and address m. a^.y pe;-sor! '181 �Ftg c Noar� fcr 4-)e asrtsL�IcS0' � the ir�roves,^er s_ Nam N/A Address Phone No. Fax No_ Nee, o; per-ionViiViin tile State of Florida, a' her hirnseNf, !''e51, -.cried by D' cr UPO, whom nOrC Dr other docurnentts r?ay -+e set Vet:: Name N/A Address Phone No. N 3_ In addition to Tt mse:i, owrec desigrta`_,s the following person tc receive a copy of itle Lienor's NJoiice as P, ovmed in Section 743.06 (2) (b). 904,5 S`e`ine•- (i lli ii1 a: rtet1s option) - Marr e NIA Address Phone : ;^. Fax P:o_ —t• Di."`LOTt date �OijCr Df CJ i : i a iC$1??efii {7S? axp&,a§ r1 fl8Ye i5 'r?e (;) elf i`rC!?3 ule date of recording unless 8 drterent date is Y;Rls —SPACE FOR RECC MRIs USE ONLY j° DAicS�� - _ eft the Doc # 2019153797, OR 8K 18848 Page 1862, Number Pages: 1 Recorded 07/01/2019 03:58 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 camty of Durdat. c ac _ r� -- FiSS�FF by r s resit/ tee �e>f zr�a-7elnEVANGEI IE CLARKE am and _---am 2° ° Commission # GG 10283'. s Expires May 9, 2021. v r 0F09¢ Bonded TWBu�petNotary Sark My ". I .sal. 4sl-n r Building 1 City of Atlantic Beach COPY IC 800 SBminole Fbad, Atlantic Beach, R-32233 Phone: (904) 247-5826 Fax (904) 247-5845 Q ,bb Address I d Permit Number: Legs! Description -3�1 - �' 11 H� �iC h Syo�+. I�+S Fes Valuation of Work (fesplacement Cost) $ (e --,`i -3�1)c� t-ieated/cooled T oled 0 Class ofWork (Ordeone): New Addition Alteration Pepair Move Demo Pool Window/Doo_r-7 0 Use of existing/ proposed structure(s) (Cirde one): CommercialSdential 0 If an existing structure, is afire sprinkler system installed? (arde one): Yes Ncz ' Submit a Tree Femoval Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of w k to be perfo . ed `. 10 ? 'C' P Florida Product Approval # . ( ( "� � for multiple products use product approval form Propggy Owner Infor -tion` Name: 1 Address: c?(,<D Cit \ _ateF�_ _Zp 3, P'1oI E -Mail Owner or Agent (If Agent, Power of Attorney or Agency Letter wired) Contractor InformationAmerit-8n Window ProdlUdS 1L /� Name of Company: Qualifying Agent: r l�t � `� r� Address2 655 Powe" Qty -a Z Office Phonel I 1 FL StelContaNumber -� gate Certification/Registration #'. 1- 5 1 �_ Mai1VFC - �i Architect Name & Phone # Bigineer's Name & Phone # Workers Cbmpensation 1 Exempt / Insurer / Lease Employees/ Expiration Dke N Application is hereby madeto obtain a permit to do thework and installations asindicated. I certify that nowork or install*�n has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regu4 iong construction in this jurisdiction. I understand that a separate permit must be secured for P�1FdCX�L.WOFK PLUMBING, SgyV c _j z 71,' F WB14 PCS FUF?JAC� BOILH� F�TB� TANKS and AIRCCiNDillCNS etc. -CL j U , O CkIVNffZSAFFIDAVIT: I certify that all the foregoing information isaccurate and that all workwill be done in compliancewidi'aliri O a wl applicable laws regulating construction and zoning. U U �� 0 � O a n U m WARNI NG TO OWNER YOUR FAI LURE TO ARD A NOTT CE OF ODM M ENCEM ENT M�( RESULT INYOUR PANGTWICEFORIMPRRO OVB\A9 TSTOYOURPPERTY IFYOU I� Y.a TO OBTAI N R NANa NG, CONSULT WITH YOUR LENDER ORAN ATTORNEY BEORE ' Z Y R NOTICE OF COM M ENCEN HNT. o� w 0 W Ld a -amu p t.0 (gc�ature of Owner or Agent including Corrtr (Sgn�ure of Contractor) U u7 w[G w S ed and swom to �9,r firmed before meths day of S . and swornn t�o, affirmed) before ethis of A tL iol—I uj Uar\j azure of Notary) ( ature of Notaaryy ��P ll LVAN RIECLARKE r°1Pa. U9`o EVANGELIE CLARKE Commission # GG 102835 Commission # GG 102835 F ' ` ,a, � u ` o� Expires May 9, 2021 � Expires May 9, 2021 yrF oP Bonded Thru Bud et Voter services [ �Personally Known OR �rFOFFfZ� o Bonded Thru budget Notary SWAM [ �r�nailyKnownOR Notary OF F� [P' oduced Identification [ } Produced Identificztion Type of identification: Type of identification: FTI)i_-� F -5`90 -(off 0 OFFICE COPY I a _ .H -7 PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH FLORIDA Project Name: \ 9 Permit # Res/ -q d/'7 n 5— ^ Project Address: `3 1 1 C3 � 1 , ` �. As required by Florida Statute 553.842 and Florida Administrative Code Rule 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 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 produciapprovai may ne ootamea at: wNv%N Jionaanui 0Jn .ora. Category/Subcategory Manufacturer Product Description Limitation of Use State # Local # A. EXTERIOR DOORS 1. Swinging 2. Sliding S 3. Sectional 1. RuII up �- 5. Automatic 6. Other i B. WINDOWS 1. Single hung , _ IC► _............ r��3 J 2. Horizontal slider 3. Casement 4. Double hung 5. Fixed IS i'� 6. Awning 7. Pass-through 8. Projected 9. Mullion 1 10. Wind breaker 11. Dual action 19-14$--7 2. Other Category/Subcategory Manufac rer P0 du escription imitation of t se State # Local # H. NEW EXTERIOR ENVELOPE PRODUCTS I. 2. 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 by the Building Official. (Contractor Name) (Print Name) V1�4'4 \'-)o rr Company Name: American Window Products Mailing Address: 2633 Powers Avenue jacksonville, FL 32207 City: - -- -- State: - Zip Code: (Signature) 90_�r� Telephone Number: O - - ��t Fax Number: ( ) Cell Phone Number: ( 1 _ _E-mail Address: 1Ccn (,¢D� OFFICE- COPY 3 35 23 n 35 x C� 47 x 51