2017 Duna Vista RES19-0360 Window "1\--Anne,, RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES19-0360
�r ISSUED: 12/13/2019
800 SEMINOLE ROAD
0'»" ATLANTIC BEACH. FL 32233 EXPIRES: 6/10/2020
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 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:
2017 DUNA VISTA CT RESIDENTIAL ALTERATION WINDOW $3617.00
RESIDENTIAL
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169506 1624 SELVA NORTE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
HOMERITE WINDOWS AND 4801 Executive Park CT N JACKSONVILLE FL 32216
DOORS
OWNER: ADDRESS: CITY: STATE: ZIP:
WOLFEL JOHN JR 2017 DUNA VISTA CT 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.
LIST OF CONDITIONS
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 $70.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $35.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $109.00
Issued Date: 12/13/2019 1 of 2
Svrr, RESIDENTIAL PERMIT PERMIT NUMBER
r � }s, RES19-0360
CITY OF ATLANTIC BEACH
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ISSUED: 12/13/2019
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800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 6/10/2020 j
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Issued Date: 12/13/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
`�' 800 Seminole Road. C C // •
(LIStilli�� Atlantic Beach, Florda 32233-5445
E t G`1 - V 3 C.
Phone(904)247-5826 • Fax(904)247-5845
•;;W.?'" E-mail: building-dept@coab.us Date routed: 1 z /G., I (9.
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z 01 / 1.___)0/\)(4 V (S(.A Department review required Yey, No
Building
�� OMEl7"C�
Applicant: RL,•( _)i 1':)001Z - rnng &Zoning
Tree Administrator
Project: Lk_—' ( &_::bO(i .) Public Works
Public Utilities
Public Safety
Fire Services
Review fee $_ _ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation _
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [Approved. ['Denied. ❑Not applicable
(Circle one.) Comments:
BUILDIN �/}�
PLANNING &ZONING Reviewed by: / Date: 2 7019*
TREE ADMIN.
Second Review: ['Approved as revised. ['Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. [Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
'4 - . 1 ,s ' Building Permit Application Updated 10/9/18
01 ,' ' City of Atlantic Beach Building Department "ALL INFORMATION
._ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
/ ' u• IS REQUIRED.
Phone: (904) 247-5826 Email:
Email: Building--De�pt@coab.us
Job Address: cza`, b LMA V if ' G� tq-/-4,/L i 3ZPe3
rmit Number: I q_CO(O 6 ?
Legal Description WY) Of -2S-2-K Setvgt Nca94 C I.)--/.-O L 04-‘'7 RE#
Valuation of Work(Replacement Cost)$ 3 l'7 0,+ Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ONew ❑Addition DAlteration DRepair ❑Move ODemo ❑Pool Nindow/Door
• Use of existing/proposed structure(s): ❑Commercial Residential .
• If an existing structure,is a fire sprinkler system installed?: - ❑Yes po
• Will tree(s)be removed in association with proposed project?DYes(must submit separate Tree Removal Permit) iallo
Describe in detail the type of work to be performed:
�n S}a `r` vs I N110 VJ f l 22 4,-- S(Le i" 41,10• li'`s.�, 111.Y L 444W i A Mew oid11 n j >.,
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Florida Product Approval# for multiple products use product approval form Q
Property Owner Information V
Name N e II, �0« Address Zvi/ N 4- P`.11 (� w
City A4-14,t-ti_ b".e State FL Zip 3 Z'1-31 Phone Boc 7 ('Ce 0 y20 U
E-Mail Br't,1�jt,�" u01Z. /y 4)6Mu-11ICoon
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Ll_
LL_,t
Contractor Information ( 0
Name of Company 14-0 PAL k. . vvI"1CJOtl f Dow; Qualifying Agent C h Gnr1 (-el.
Address Li of E><{r 4.4-tve.- pac(c-co.,,,, .1- City 1 ax State ?L Zip 3 Z2 l t,
Office Phone ciaq 29 b 2 S./3" Job Site Contact Numrbpr yt / grs 3 306
State Certification/Registration# C&C (S/27Z7 E-Mail /ee. Of-Omer 441 O1 of.ce'"1
Architect Name&Phone# .S'/1 610.t1/t C..Le 9 0-1P S-3306
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt o Expiration Date Q
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installatiq has
ibt
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulartag N
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGC)I Q Z (
,rl �
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the requirements t Z
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county2 p !..
there may be additional permits required from other governmental entities such as water management districts,state agencies,SO 0 ZZ Q
federal agencies. W V Q V 0
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with O Z cc Q
applicable laws regulating construction and zoning. u-
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAbV a
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTLoE5 CC m
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE w F�„ W o
Wa UI
RECORDIN UR illF COMMENCEMENTLacydzr),... w V N >
(Signature of Owner or Agent) (Signature of Contractor) ce
W
cc
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this day of
'b�zaidi / ./ �� HI NI/I
/ / " \�� •-ISC((��/
(Signature of Not-,� pRISC/ /// (Signature of Notary) •. ... •• (,+�
\ .......,,,4„// * ' IAMY -y,,-
�` 4�C (�y' A.i 2 Liv•: '.
2Z ; IAAY� 1; ' Wally Known OR _a; i
[ )Per ally Known OR •`
[ —O. muted Identification S7-34.•111
7o.=m `fit .
roduced Identification —0••
Type of Identification: S:.I IS j[pe c�ldentification: .1;.'t:`IN/ ls/On 0lc
/// iS);�F.. FL ��t���� 1101191111110
NOTICE OF COMMENCEMENT /9/- \
(PREPARE IN DUPUCATE)
Tax Folio No. I C SD(o — 1( Z VPermit No. roc County of / L
}l� /S
State of Florida
To wham 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. go _ 2 Fe
Legal description of property being improved: - ` Two
SP /✓G i±c\
Lo+ �,^?
Address of property being improved:
General description of improvements: Replacing windows doors. Size for size.
owner p h►1 W o I -C-e l
Address 20(7 b 1,4_40., vw\ c IQ'f"/art i(6 >'c cJ► 3 `7 7 3 3
Owner's interest in site of the improvement Primary residence
Fee Simple Titleholder(if other than owner)
Name ] 0\h L-70� t €
Address 20 17 -0vc, �I/S < C +16-1 L P ec.iA 3 2 2-73
Contractor Homente Windows and Doors
Address 4801 Executive Park Court Bldg.200 Suite 200 Jacksonville,FL 32216
Phone No.904-296-2515 Fax No.904-296-2528
Surety(if any)
Address Amount of bond
Phone 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
Phone No. Fax No.
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice es provided in
Section 713.06(2)(b).Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone 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):
THIS SPACE FOR RECORDER'S USE ONLY II /w yj/NER
�o W fl� DATE 111'4/0
Before
., e dsN d \s va,:«mm"F�,.a..d �� G1 C(qy
harrsett/herseland&Ionsthat asstatements anddadaral tnere'�W' � a;_�yo�•;�
are true and accurate 400 e,
Doc#2019269184, OR BK 19012 Page 2225,
Number Pages: 1 / L 2i87'
Recorded 11/21/2019 09:56 AM, AC, / r
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL tArkat Large, / / • . • 'dad the ob; ���
COUNTY My commission wpm: NAILS/a• •iGYri • fyts��•pQ'
RECORDING $1000 Pporsonooy rod ldex r aar,d•.• �A6 •••rC STATES ��`\
1
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH FLORIDA
Project Name: IA)c( FLf
2017 Permit # ES ICt .°
Project Address: DLLA- vi k c
322 33 :. /%/10,k, heUGti
As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72,please
for the building components listed below as applicable to the building construction project for the permit number
Your product supplier if you do not know product approval number for anyof provide the information and product approval pproval number(s)
product approval may if obdo at:k ow the r oductldin..or•. listed above. You shouldw dentact
the applicable listed products. Information regarding statewide
Category/Subcategory
Manufacturer Product Description Limitation of Use State# Local#
A.EXTERIOR DOORS
11111111
1. Swinging � '
2. Sliding111111111111116...1.1111.111111111111
3. Sectional1111111111111111111.11111111111111111.1111111
4.Roll up11111111111111111111.......11111111111111.
5.Automatic 111111111111111 .■11111111.1111111111111111
6. Other ■ ,■�
B. WINDOWS
1. Single hung
M ( 3V-1,o *So - so ,.
2.Horizontal slider
3. CasementIllii
4.Double hung
5.Fixed �—���-
6.Awning i'h ( 5N0 :o t SS- I:6 y
7.Pass-through
8.Projected ����
9.MullionIIIIIIIIMIMIILmm...__111M111.1.1.11
10.Wind breaker
IMMOIIIIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIMI
11.Dual action
2. Other OFFICE COPY
Category/Subcategory
Manufacturer Product Description d imitation of Use
IL NEW EXTERIOR A
ENVELOPE PRODUCTS111111111111111111.1111111111111.111.11111
Local#
1.
In addition to completing g the above list of manufacturers, product description and State approval
Contractor shall maintain on the job site and available to the Inspector,
instructions alongwith this Product A p number for the products used on this project, the
Approval Sheet. p r, a legible copy of each manufacturer's printed specifications and installation
I certify that this product approval list is true and correct to the best of my
listed in this document must be approved by the Building Official, knowledge. I further certify that use of different components other than the ones
511444A tee
e
(Contractor Name) (Print Name)
(j Company Name: ,,,, ,(Signature) r r /
Mailing Address: g0 PCutom ��'k ��,,,,r.�
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City:
State: ICS— Zip Code: 3 7 2
Telephone Number: ((o .j Z� 6 Z S-1 S
�'D�{ Fax Number: (Qny
Cell Phone Number: (
330
E-mail Address: Siee e/o/tte`, ci-2af