2139 SEMINOLE RD - WINDOW / DOOR f-------��r- '`,IM, CITY OF ATLANTIC BEACH
_ 800 SEMINOLE ROAD
\� s' ATLANTIC BEACH,FL 32233
\ �` INSPECTION PHONE LINE 247-5814
r
4J,,1
WINDOW AND/OR DOOR PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-WIND-1776
Job Type: WINDOW AND/OR DOOR
Description: window replacement
Estimated Value: $5.930.00
Issue Date: 8/3/2015
Expiration Date: 1/30/2016
PROPERTY ADDRESS:
Address: 2139 SEMINOLE RD
RE Number: 169515-0500
PROPERTY OWNER:
Name: SCHAFFNER. MARY ANN
Address: 2139 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: THD THE HOME DEPOT AT-HOME
Address: 2690 CUMBERLAND PKWY STE 300 QA BOYSIE GANGA
REMDIAL
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $39.83
BUILDING PERMIT FEE $79.65
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $123.48
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
y BUILDING PERMIT APPLICATION '\eo Se (,,,,...\' -`'�M �v( f7,
;1 PY CITY OF ATLANTIC BEACH
-7a-7- 637- ftY0O
_ 800 Seminole Road,Atlantic Beach,FL 32233
Office(904)247-5826 Fax(904)247-5845 /
Job Address: .2139 £er+i rn alt a J Permit Number: /$ Gtr I IV O - 17 7 L�
Legal Description 9,.25'0291 • Jy.1 er 60,(7 /01I Parcel# 10-ris--O SO()
w Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ .S930 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move molition pool/spa winclo�cicloor -In
Use of existing/proposed structure(s)(circle one): Commercial widen
If an existing structure,is a fire sprinkler sys m installed?(Circle one): Yes No 4 �a
Florida Product Approval# S179•S �5/6 7.1 Y/1 V 7k7•/ r i"1
For multiple products use product approval orni /
Describe in detail the type of work to be performed: Ce r io,. ti
44 W r^A?m,S I ti.e -4( 5/74
CD
Property Owner Information:
Name:M f, gnA 544I( Address: 02139 S&'s rat a It R �'\
City IPr7,L Ileac,. StateGi Zip 3.2233 Phone goy- `.2 6.6700
E-Mail or Fax II(Optional)
Contractor Information:
Company Name:The Home Depot r Home Services Qualifying Agent: o�Ste /co,r" oh.•I
Address: 9208 Florida Palm Dr City Tampa State FL Zip 33619
Office Phone 813-626-7548 Job Site/Contact Number Fax#
State Certification/Registration# C R C DY6 kre
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
,app/ianirnr is hereby etude to obtain a pennil to do the work and installations as indicated l certiJj•that no work or installation has commenced prior to the
issuance of permit and that all work mill he pefonued to meet the standards of all laws regulating construction in this jnrisdicvion. This permit becomes null
and raid if node is no commenced within sir(61 mocks,or if canstniaioi or work is suspended or abanehoeil fin•a period of six(6)momhs at any time after
nark is commenced. l unekis and that separate permits mint he secured far Electrical IVork,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters.
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby cep Ji•that/have read and ermined this c plication raid th
d know the same to be true and cared. All provisions of laws and ordinances governing this
tine of work mill be complied with whether specified herein o/at. Ti, g ranting of a permit does not presume to give authority to violate or cancel the
provisions isious of any oterJederal,ski e it local law i Mating a true '• or ie pe�inuance r f coitruaion.
/ , r
Signature of Owner I4 _�_h_el = .., / Signature of Contractor-t41 - et �d�
Print Name 1 ;1T mTi�.1 4 I
/!t.i . __._.. .. L3 . Lt . .. Print Name 4,ti e../4M dii.l.__.... ._._._._._..._........- ._...._..._
Swo Ti tsi and subscribed before me Sworn toand subscribed before me
this..074 Day of- 2( this,s�Day of Tub .20/S
Notary Publ —. otaT y P G llc
•iM':r'•. TIMOTHY R.O'MAUEY
''R '__ MY COMMISSION Y FF 042794
• BENJI NICKS I':• i-r :`_
. .,,•. EXPIRES:August 7,2017
NOTARY PUBLIC ••?,g ,,•' Bonded Thnr Notary Pudic Underwriters
�. _STATE OF FLORIDA l
^`t 7 Cornm#FF177687
�' Expires 11/18/2018
Doc # 2015148014, OR BK 17215 Page 1756, Number Pages: 1, Recorded
06/29/2015 at 08:37 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
THIS INSTRUMENT PREPARED BY: FILE COPY
Name: The Home Depot at Home Services
Address: 9208 Florida Palm Dr
Tampa, FL 33619
NOTICE OF COMMENCEMENT
Permit Number:
Parcel ID Number: )(9C15(.5
The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713, Florida Statutes,the
following information is provided in this Notice of Commencement.
1. DESCRIPTION OF PROPERTY:(Legal description of the property and street address if available)
9-JS- a i s-Gdc a�oy
Y\ S4-0,..o\sz 2�
2. GENERAL DE�SCRIPTI N OF IMPROVEMENT:
P-e �aCR- w,Y`aos-
3. OWNER INFORM TIdN OR r LESSEE INFORMATION IF THE LESSEE CONTRACTED FOR THE IMPROVEMENT:
Name and address: tr..c s Yee\ S G\eN et S-S,\N-e∎C' a\3 �� A■••• U
o\� \\a o�v.�a� Le aC� �L �ac1
interest in property:
Fee Simple Title Holder(if other than owner listed above)Name: L1 \In
Address:
4. CONTRACTOR:Name: The Home Depot at Home Services Phone Number 813-626-7548
Address: 9208 Florida Palm Dr Tampa, FL 33619
6. SURETY(If applicable,a copy of the payment bond Is attached):Name,
Address: 1v Amount of Bond:
6. LENDER:Name (t Phone Number:
Address: \ —
7. Persons within the State of Florida Designated by Owner upon whom notice or other documents may be served as provided by Section
713.13(1)(a)7.,Florida Statutes.
Name: , \ Phone Number.
Address: �J 777fff���
8. In addition,Owner designates of
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Fonda Statutes. Phone number:
9. Expiration Date of Notice of Commencement(The expiration is 1 year from date of recording unless a different date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE
CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I SECTION 713.13, FLORIDA STATUTES,AND CAN RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON'HE
JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
I
r�; / `' /
(S.grrahlre of Owner or Les %roes or Le (Print Name and P'ovde S:gnattrys Titl 1Ofhoe`
Y;' uthonzed Officer/Di od ner/Managee
r/ I
State of L ,!)•'j ' county of �! ✓n'
i 1
The foregoing Instrument was acknowledged before me this �-- day of �,�;'■ � ,zp/-.5-
by 47I(1 i'�J ��l'+:t /y►..r< �C ��. /y/C
by F Who Is personally known to me C OR
Nam of person,a4c person, mg statement
who has produced identification getype of Identification produced: 1-71. J•J4•-,.
,k/.r:'.i�' Sty
S Lib' „• BENJI NICKS
NOTARY PUBLIC / `,�/
v�: STATE OF FLORIDA ,i /t ��
0�
4"11•-+°* Ccmnsit FF177687 Notary S gnature
.„/Expires 11/18/2013 '
City of Atlantic Beach APPLICATION NUMBER
, Building Department (To be assigned by the Building Department.)
800 Seminole Road / 7
��;' Atlantic Beach, Florida 32233-5445 £)' /770
Phone(904)247-5826 • Fax(904)247-5845
> y E-mail: buildin de t coab.us 7 Z /�
9- P @ Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:p?/3 A /ec/ ......Department review required Ye
qo
uilding
Applicant: Ain 0,/ ® Q�f'l `>�iartryng•&Zoning
Tree Administrator
Project: jU/i4 81/9l a C f m/A 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: I roved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING I 7°.)u'/s-
Reviewed by: Date:
TREE ADMIN.
Second Review: ❑Approved as revised. ❑De#d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10