544 Ocean Blvd RES19-0282 6 Windows RESIDENTIAL PERMIT PERMIT NUMBER
RES19-0282
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ISSUED: 9/25/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/23/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL •RK MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ BUILDING
CODE, NEC, IPMC, AND OF ATLANTIC + CH 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, or federal agencies.
JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
544 OCEAN BLVD RESIDENTIAL ALTERATION 6 WINDOWS $4128.00
RESIDENTIAL
TYPE OF
ZONING: : . •
• • GROUP:
170140 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
AMERICAN WINDOW 2633 S POWERS AVE JACI<SONVILLE FL 32207
PRODUCTS
• ADDRESS: '
BISHOP JOHN BUTT 544 OCEAN BLVD ATLANTIC BEACH FL 32233-5340
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.
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:9/25/2019 1 of 2
Timmy;�, City of Atlantic Beach APPLICATION NUMBER
�s Building Department (To be assigned by the Building Department.)
r 800 Seminole Road
j s Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 n
E-mail: building-dept@coab.us Date routed: `7
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ` "T l� �Lty V0 Department review required Yes No
Applicant: M�fZI �l`-5 Vy L(��dco Hing
Tree Administrator
Project: C')V�J 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: MApproved. []Denied. ❑Not applicable
(Circle one.) Comments: N O G
BUILDIN
PLAN G &ZONING Reviewed by: Date: 5 'l
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie . ❑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
Building Permit Application
City of Atlantic Beach OFFICE COPY
800 Saminole Fbad,Atlantic Beach, R-32233
Phone: (904) -5826 Fax (904)247-5845
,bb Address: (DC I�24 Permit Number:
Legal Descriptions(Oq �-C.;t��r�Z IG` 1 6ilr) �R FU# 110 1140 OQnC-
-= J ,�:
Valuation of Work(F;bplacement Cost)$ t �� Heated/Cooled g —Non-Heated/Cooled I !A v
►-
❑ Cass ofWork(C7rdeone): New Addition Alteration Fbpair Move Demo Pool Window Door LU - a W
►-
Use of e)asting/proposed structures)(Orde one): Commercial dentia) U U n U o
0 If an eAsting structure, is afire sprinkler system installed?(Orde one): Yes No GD LU H 44 G]
0 SJbmit a Tree F emoval Permit Application if any trees are to be removed or Affidavit of No Tree Fbmoval 0
Describe in detail the type of work to be performed: U J N H
ni 3 LL 1,3
Rorida Product Approval# for multiple products use product apgjfile m
Property C caner Information, l ,l ,^� 1 � — w o w
Nam i S Address: S'�-1"l Zl , I W U cn w W
Qty aate Zip Phone
E-Mail
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required)
Contractor InformatiaAmerican Window Products
Name of Company: 2633 Powers Avenue Qualifying Agent: ��� &,_�—r
Address invillp PI 1 207 City gate Zip
Office Phone - —1 - bb 9te/Cbntact Number
Sate Certification/Pegistration#C.9-iC, 0;, I DO-) E Mai11iNF_C:6(pi;_4r, U:. � fi_UYl
Architect Name& Phone#
Engineer's Name& Phone# /111
Workers Compensation - nI3 IASI - ("11c)
lExempt/Insurer/Lease Employees/Expiration Date
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 regulat iong
construction in thisjurisdiction. I understand that a separate permit must be secured for ELECTRCALWOF;( PWMBING,3GNq
WELLS POOLS RJIRNACfri BOILHFE� HEATEfR5 TANKS and AIROONDITIONEFZ5 etc.
OWNERSAFTIDAVIT I certify that all theforegoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARM NG TO OWNER YOUR FAI LURE TO RECORD A NO7n CE OF COM M ENCBVI ENT MAY
RESJLT I N YOUR PAYI NG TWICE FOR I M PROVEM ENTSTO YOUR PROPERTY I F YOU I NTEND
TO OBTAI N R NANa NG, CIONaJLT WITH YOUR LENDER ORAN ATTORNEY BEFORE
PEODMI NG YOUR O-TI{E OF COM M ENCE3\A ENT. '
(Signet of Owner or Agent including Contractor) (Signature of(lontractor)
Sig ed and sworn to(or affirm-')before me th day of 9 ed and ornnttlo`(or affirmed)befo_r e thisJ��a day of
by h(� c b r 1
ur Notary) (9 a of Notary)
RYAN ALWARDT EVANGELIECLARKE
r MY COMMISSION#GG 000431 ? o Commission#GG 102835
V� rsonaaly Known OR 9 Q EXPIRES:June a,2020 [ Personally Known OR �r °� Expires May 9,2021
[ ] Produced Identification .FoFF`oP Bonded 1hiuBudgetNGtaySOWGS [ ] Produced Identification "eeFF�oP Bond edThruBudpetNote 9ervlcee
Type of Identification: Type of Identification:
OFFICE COPY PERMIT
COPY
19
Q-3 c� x W ,
� XQcl
G
PERMIT
COPY
OFFICE COPY (c)iq- Iq
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA �+
Project Name: , I � Permit #
L!
Project Address: S� \,�� (?l U
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:wwxy.tloridabuildin .orp.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A.EXTERIOR DOORS
1.Swinging
2. Sliding
3.Sectional
4.Roll up
5.Automatic
6.Other
B.WINDOWS
L Single hung
2.Horizontal slider
3.Casement
4.Double hunc
5.Fixed
6.Awning
7.Pass-through
8.Projected
9.Mullion
10.Wind breaker
11.Dual action
Co I q
2.Other
Category/Subcategory Manufacturer Product Description Lim' ion oft ,e State# Local#
H.NEW EXTERIOR
ENVELOPE PRODUCTS
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 Namel I)O�M (Signature
Company Name: Amarhn Window Drno1uds
Mailing Address: 2633 Powers Avenue
Jacksonville,
City: l ' State: Zip Code:
Telephone Number." I2 CJ "1 Fax Number:(9A
Cell Phone Number:( ) E-mail Address:t)JT,C, W'nCL:)
OFFICE COPY
erFnlF No. Tax Folio No 1•�tn�� 1��W
$tet8 of`=CRiDA - count"r of
To whom.it may concern:
he undersigned hereby informs you that improvements will be made to certain real property,and in
accrdance with Section 713 of the Florida Statutes,the following information:is stated in:ti3is NOTiCc CF
COMMENCEMENT.
_ c-i d s r'.pi o, o`grope= oeing lmpr^ved:
c- Z
-235
;edr'SS of preps I. being is -roved_ `
Genera'description oflmprovemen*s:
Address
Ovner s interest in s'e of the mprovenlent NIA
=ee Simple rtiet cider "oI ^:2r. .r,er) NIS.
Name NIA
'ddi e55
A
Coma=, AMERICAN WINDOW PRODUCTS,INC.
iddress 263.3 POWERS AVENUE-JACKSONVILL—E FL 32207
-P r. 904?3i e'2=? =3Y tG.9 -73: 832-
ro.:_ o.
n
Address WA .A;^.1G15.^.t Gi�On�SNIA
PClv:iC No. NIA 'Gra No.
NIA.
Name and address of any person making a:oan for the cons'sucaon or trie improver:ens.
Name N/A
,uG-e55 NIA
P•.^.Ci?e No. NIA,
Fa x NC. WA
Name of Gerson w hi?the 61,1 e of Florida.other thar,himself.designated.b,%,or.."ner Upon` riom nGiics Or Cider
documents may be served:
Nadine NIA
NIA
Address A
NIA
in addition to himsetf.o•.•mer designates_ie foliorring person to receive a copy of the Lienor S Notice as provided in
Section 713.06(2)(b).=Kids S`ta-Mes.(F!ii in at Darner's option)-
Name NIA
Address NIA.
Phcne-No. NIA Fax No. NIA
ExpiZion date of Not:Ce of Co!Ttmen--rnen`%the eXGira%�n Caic i5 ore . San'.Cr- e d'cie Gf raArdlP� :nI�55 G
afferent date is Spec;-,e ;..-
THIS SPACE FOR RECORDER'S USE OMLY
__----- PYAN R9F
1-.frnst£'hersaC z;�z�.rr,s 7 �t s� MS'
-Ceclzraxzs nv rn
--8;92 t.a and a�zte * MY COMMISSION#GG 000431
OR BK 15935 Pa9 N i+ �° -EXPIRES:June 8,2020
019215097' ! Co F�p�\ Bonded7hm udgelNotarySerVoes
Doc#2 es:1
Number Pa9 COURT DUVAL : �i
Recorded 0911712019 12:25 PM,
RONNIE FUSSELL CLERK CIRCUIT C L p�_, a,xea,sala of cCU.".-y I
N-ly commmsion ezo:r
COUNTY Perso--m y Kna'+.'n or
RECORDING $10.00 I -.�'c'a•a'un` a,•