650 Sailfish Dr RES19-0224 5 Windows RESIDENTIAL PERMIT PERMIT NUMBER
J ' RES19-0224
1 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ISSUED: 7/25/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 1/21/2020
MUST CALL INSPECTION PHONE • 1 PM FORINSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF i '
CODE, • OF BEACH CODEOF ORDINANCES .
A LL 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
650 SAILFISH DR RESIDENTIAL ALTERATION 5 WINDOWS $4117.00
RESIDENTIAL
TYPE OF
ZONING: :D •
• • GROUP:
171214 0000 ROYAL PALMS UNIT 01
COMPANY: ADDRESS: STATE: ZIP: .
Preservation Home 128 Seabury Cir Ponte Vedra Beach FL 32082
Specialists
®. • ADDRESS:
CURRELLEY FREDDIE 650 SAILFISH DR E ATLANTIC BEACH FL 32233-4233
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 • . •
,Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
I
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $75.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $37.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $116.50
Issued Date: 7/25/2019 1 of 2
City of Atlantic Beach APPLICATION NUMBER
rj •�� Building Department (To be assigned by the Building Department.)
-. 800 Seminole RoadZZ4
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 ``
E-mail: building-dept@coab.us Date routed: 1
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 6� SO SPOLRSH
ent review required Yes No
uildi
Applicant:
PR Planning CS�2U AT(C)/�_ MLL E �� Planning &Zoning
Tree Administrator
Project: �C; W (n�Cxi�C LS Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ 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: IK—Proved. []Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:�'2?i�C�
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
OFFICE COPY
Building Permit Application Updated 10/9/18
f` City of Atlantic Beach Building Department "ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: Salll C Permit Number: RCS I q - V
Legal Description — 177�—�SZ R0 IPq A/
''f M RE# 1f7 a�/ �Q (J Bl1
Valuation of Work4eplacemennt/CosA � Heat /Cooled SF��Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool XWindow/Door
• Use of existing/proposed structure(s): ❑Commercial Residential
• If an existing structure, is a fire sprinkler system installed?: ❑Yes XNo
• Will trees be removed in association with proposed roiect? ❑Yes must submit separate Tree Removal Permit [--]No
Describe in detail the type of work to be performed: VJ I V1 CLQ l�S —
ou b l�e
0 S o U 1;,
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Ileq Address (.e5o S19/G
City ate ( Zip Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company V,(V_ y-aJ1 m f-f��no[ Qualifying Agent N C19 i)kea`4
Address Ili V, City State PI Zip
Office Phone Job Site Contact Number
State Certification/Registration# E-Mail Ma ✓i ?VIA61r t J • Ld
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer T7,(I�ll)l( �'Y(�/n OR Exempt❑ Expiration Date 17 ( - 2MJ0
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 regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAREWVE D
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addn f
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. JUL 16
2019
OWNER'S 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 CO Iment
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPE l�D'• FL
Tn BTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
ItEC RDI YOURTI11C OF C [M^j ENCEMENT'. ^I//11 ^/�
CO w (Signature of caner r Agent) (Signature of Contractor)
ua m cD o
0m� �N
ZN a i
S� d and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed) before me this day of
o E ((11 `T, ��i by �✓
�a Eu, Plw
-'E ? (Signature of Notary) (Signature ofNotary)
(no L) SHAWN L INGERSOLL
= �'• - ersonall Known OR ' '_Notary Public-State of Florida
rsonally Known OR y - a Commission # GG 349293
oduced Identification [ ]Produced Identification •F ate, My Commission Expires
'�. �1, G Co�0 2�j °„°„ June 24, 2023
•t' y of Identification: Type of Identification:
OFFICE COPYA jLU(h
-FLOOR PLAN-
All contracts must be accompanied by floor plan sheet showing each product identified.
REVIEWED FOR CODE COMPLIANCE
CITY OF ATLANTIC EEACH
SEE PERMITS FOR ADDITIONAL
REQUIREMENTS AND CONDITIONS
REVIEWED BY: DATE: 2
y
� 1
3
q � �
NOTICE OF COMMENCEMENT
State of F OFFICE COPYTax Folio No.
County of 1)0,4h L
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: 3 • 6 6 0 j-t- S — aq 6 R,b AI
Lof �q ?)Ica :5 . a/K. 3D31 -13-7
Address of property being improved: &5D S K}-1[ r'—/S Dr. acA Q_ a9 33
General description of improvements: Qf LP n/hCl. S W►N�3Gls
Owner: Ito 64 IK dress: �
11
Owner's interest in site of the improveme .
Fee Simple Titleholder(if other than owner):
Name: L
Contractor: Y /Y?e S �/ LS
Address: lus q &ac,� F71
Telephone
Telephone No.: -7� Fax No:
Surety(if any)
Address: Amount of Bond$ _
Telephone No: / Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served: Name:
Address:
Telephone No: Fax No:_
Doc#2019165924,OR BK 18866 Page 100,
In addition to himself, owner designates the following person to rece Number Pages:1
713.06(2)(b), Florida Statues. (Fill in at Owner's option) Recorded 07/16/201903:49 PM,
Name: RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY
Address: RECORDING $10.00
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified): _58 I L�
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Sign Date:
Before me this day of_y� in th ounty of Duval,State
SHAWN L INGERSOLL Of Florida,has personally appeared
NOt8ty Public-State of Florida
's Cammission M GG 349293 Notary Public at Large,State of Florida,Co u f Dial.
R1u 1Ar My Commission Expires My commission expires: �n'-0— ai��
Juhe 24, 2023 Personally Known: or -Q,.
Produced Identification: � r-i UAD LSC( —fig 1 6�r— -
g aI- 2/,a
OFFICE COPY
44 cl' ' PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH FLORIDA (*REQUIRED)
*Project Address: U�(� _%if gzsh 1)R Permit#: 12&_s19 — D_2 2 y
*Owner/Project Name: JVJ i G C14 r7 ,
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.floridabuilding.org.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A. EXTERIOR DOORS
1.Swinging
2.Sliding
3.Sectional
4.Garage Roll-Up
5.Automatic
6.Other
B.WINDOWS
1.Single hung
2. Horizontal slider V �'Z � L
3.Casement
11 H 3L_7
4. Doublehung M VI"Z F L 0 7 2,D —�
5. Fixed
6.Awning '
7. Pass-through
8. Projected
9. Mullion
10. Wind breaker
11. Dual action
12. Other
Page 1 of 4 Updated 10/17118
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 by the Building Official.
*Contractor Name(Print Name): &&n L &ONO *Contractor Signature:N4,A—
(� TI r--'
*Company Name: T -1'I 4 (IS
,Q
*Mailing Address: rd
*City: CSI *State: r ( *Zip Code: ZZ 5Z
*Telephone Number: `1�f{ R5���j/ 79 *E-mail Address:
Cell Phone Number: 3 � 'g U� Fax Number:
Page 4 of 4 Updated 10/17/18
JIM • Inspections
Permit Number: RES19-0224 Description: 5 WINDOWS
Applied: 7/17/2019 Approved: 7/22/2019 Site Address:650 SAILFISH DR
Issued: 7/25/2019 Finaled:8/8/2019 City,State Zip Code:Atlantic Beach, FI 32233
Status: FINALED Applicant: <NONE>
Parent Permit: Owner: CURRELLEY FREDDIE
Parent Project: Contractor: <NONE>
Details:
LIST OF •
SEQ SCHEDULED DATE COMPLETED DATE TYPE INSPECTOR RESULT REMARKS
ID
8/8/2019 8/8/2019 BUILDING FINAL" Rick Bell PASSED
Notes:
Marion:315-527-8585
00.
.
Printed:Tuesday, 13 August, 2019 1 of 1 1..