1759 Ocean Grove Dr RES20-0051 8 Windows 6.$ 10:445, RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH RES20-0051
15-MF"'
800 SEMINOLE ROAD ISSUED: 3/3/2020
`j ATLANTIC BEACH. FL 32233 EXPIRES: 8/30/2020
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:
1759 OCEAN GROVE DR RESIDENTIAL 8 WINDOWS $8622.00
WINDOWS/DOORS
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169604 1500 OCEAN GROVE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
Anderson Installations, LLC 3278 BYRON RD GREEN COVE FL 32043
SPRINGS
OWNER: ADDRESS: CITY: STATE: ZIP:
HALL BARBARA 1759 OCEAN GROVE DR JACKSONVILLE FL 32233-5844
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $95.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $47.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.14
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$146.64
Issued Date:3/3/2020 1 of 2
c0.1.,'„1, RESIDENTIAL PERMIT PERMIT NUMBER
1
CITY OF ATLANTIC BEACH RES20-0051
/ 800 SEMINOLE ROAD ISSUED: 3/3/2020
"C)'; 9� ATLANTIC BEACH. FL 32233 EXPIRES: 8/30/2020
Issued Date:3/3/2020 2 of 2
r,y � City of Atlantic Beach APPLICATION NUMBER
E10. Building Department (To be assigned by the Building Department.)
800 Seminole Road K /"`S Zo -00S(
Atlantic Beach,Florida 32233 5445 l-'
Phone(904)247-5826 • Fax(904)247-5845 •
i rA31>` E-mail: building-dept@coab.us Date routed: 2 20
CD
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: I 7SC) ('eq,c (`ov, De rtment review required Yes/ No
Applicant: f\C1 �rSp
l'--) (‘ I 11&1C11, ( c1--E On Ss—Planning &Zoning
C CAO
Tree Administrator
Project: C.-) vV 1 10 dV t.l.) S 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: liKproved. [ 'Denied. Not applicable
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING
�/�,� Date: 3/ /2d
Reviewed by: / / '
TREE ADMIN. 1
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
',"fri, Building Permit Application OFFICE COPY Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
,, i 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
��'''�� IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us / ,
Job Address: 1759 Ocean Grove Drive Atlantic Beach,Florida 32233 Permit Number: (RE ) -C) (Do I
Legal Description 20-20 09-2S-29E.103 OCEAN GROVE UNIT NO 02 W 75 FT LOT 9 RE# 169604-1500
Valuation of Work(Replacement Cost)$8622.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition [Alteration ❑Repair ❑Move ❑Demo [Wool VIWindow/Door
• Use of existing/proposed structure(s): ❑Commercial gResidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s)be removed in association with proposed project?DYes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:8 replacement windows size for size
Florida Product Approval#5419.1 ,228.1 for multiple products use product approval form
Property Owner Information
Name Barbara Hall Address 1759 Ocean Grove Drive
City Atlantic Beach - State Florida Zip 32233 Phone 904-422-7578
E-Mail
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Anderson Installations,LLC Qualifying Agent Greg Anderson
Address 3278 Byron Road City Green Cove Springs State Florida Zip 32043 u
Office Phone 904-955-5830 Job Site Contact Number 407-760-1033 C)
State Certification/Registration# CRC 1331537 E-Mail Q J N�
Architect Name&Phone# 1-1
U Z O
Engineer's Name&Phone# C Q 0 ��
Workers Compensation Insurer OR Exempt i Expiration Date 02/25/2021 0 m I- 0(�/� F
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or instal laGan t03E 0
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws reguL4irg < Q
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIC8S7- a Z
WELLS, POOLS, FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. O'tlf1 In idditior3 to`the'regUirernent�oi i
I..
permit,there may be additional restrictions applicable to this property that may be foprfii ih,tjie publjclecords of this c_qun�ate h Z
there may be additional permits required from other governmental entities such as water management districts,state agenO styor� u1
LL ix 2
federal agencies. C] O a Q a
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will b dc?rein go liance wit ll- w 5 c
applicable laws regulating construction and zoning. LU V N w
Zi
CC u
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE O• F,pOMMENCEMENT1M� u
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YO,UR(PROPERTY. IF YOU IN1iND a
TO OBTAIN FINANCING, CONSULT WITH YOUR LEND V• OR L i • • • 1 - BEFORE
REC��RRDII)t'G YOU T O OMMENCEMENT. j` - /,
A tqa' 1 - _ -at . 6..4rna.411% —
(Signature of Owner or Agent) Ilk ignature of Contractor)
Signed and sworn to(or affirmed)before me this V$ day of Signed and sworn t• (or affirmed)before me this -2-"day of
fc‘clY o zvy- , Zth 20 ,by &C bay(1._ \- o, bYvt.�ir-y, 242-V ,by / " F fit. Alleitr it n-
1
�u•--...__- -
•
NR� nature of Nor n. ur Ndary�u���te of Florida
n 11. ENRICfUE A.FLORES I ' � Jacqueline F Tacandong
ry Public,State of Florida �,ty Commission GG 193555
mmissions GG 3280874. Expires 03107/2022
R [ ]Persynally Known OR , o,t,
r �'{bi s Apr.25,2023rNL�denliftio roduced Identification
Type of Identification: �- ' L— Type of Identification: . -V'r r2 r &ce
fern-17 pts. 06,_ dei.' I
TICE OF COMMENCEMENT
OFFICE COPY
State of Florida Tax Folio No.
County of Duval
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: 20-20 09-2S-29E.103 OCEAN GROVE UNIT NO 02 W 75FT LOT 9
Address of property being improved: 1759 Ocean Grove Drive Atlantic Beach,Florida 32233
General description of improvements: Replacement windows
Owner: Barbara Hall Address: 1759 Ocean Grove Drive Atlantic Beach,Florida 32233
Owner's interest in site of the improvement: 100% Doc#2020037870,OR BK 19107 Page 1336,
Number Pages: 1
Fee Simple Titleholder(if other than owner): Recorded 02/18/2020 02:00 PM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
Name: COUNTY
00 Contractor:
Anderson Installations,LLC RECORDING $10.00
Address: 3278 Byron Road Green Cove Springs,Florida 32043
Telephone No.: (407)760-1033 Fax No:
Surety(if any) _
Address: Amount of Bond$ _
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:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
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):
THIS SPACE FOR RECORDER'S USE ONLY NER
Signed: G `( /• Date: �Q
Before me this IS day of Fe Lr f/*-v7 in the Coun of D val,State
Of Florida,has personally appeared /Serr lor.,--e.. tea-I(
Notary Public at Large,State of Flo ida,County of Duval.
o — A.FLOES
p°m� Notary pl bUElic,State oRFlorida My commission expires: r. ZS t z07:5
_ " Commission#GG 328087 Personally Known: or
Produced Identification: FL. 1Q L,_
My comm.expires Apr.25,2023 '
OFFICE COP\
PRODUCT APPROVAL INFORMATION/) SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED)
i
*Project Address: €151 `-'e' NI � ' �1 Permit#: RES -005"
*Owner/Project Name: B '" ��\
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 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
3. Casement
4. Double hung Simonton StormBreaker Plus 5419.1
5. Fixed Simonton StormBreaker Plus 228.1
6.Awning
7. Pass-through
8. Projected
9. Mullion
10.Wind breaker
11. Dual action
12.Other
Page 1 of 4 Updated 10/17/18
OFFICE COP''.
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.
1141
*Contractor Name (Print Name):Greg Anderson *Contractor Signatur::
*Company Name:
Anderson Installations, LLC
*Mailing Address: 3278 Byron Road
*city: Green Cove Springs *State: Florida *Zip Code: 32043
*Telephone Number: (407) 760-1033 *E-mail Address: 9anderson0329@gmail.com
Cell Phone Number: Fax Number:
Page 4 of 4 Updated 10/17/18