10 10th ST #40 - DOOR , 0�LyrJL,ii:r „ CITY OFATLA TI BEA H
a .s-) 800 SEMINOLE ROAD
0
ATLANTIC BEACH, FL 32233
'2-013 r) INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0258
Description: replace 4 sliding-glass doors
Estimated Value: 32000
Issue Date: 8/13/2018
Expiration Date: 2/9/2019
PROPERTY ADDRESS:
Address: 10 10TH ST Unit 40
RE Number: 170237 0092
PROPERTY OWNER:
Name: WILLIAM A BLOCK FAMILY GST TRUST
Address: 2648 BEAUCLERC RD
JACKSONVILLE, FL 32257
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: HOMERITE WINDOWS AND DOORS
Address: 4801 Executive Park CT N BLDG 200 STE 207
JACKSONVILLE, FL 32216
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
.11.:1uj-f. City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
- 800 Seminole Road
uv " �� Atlantic Beach, Florida 32233-5445 �' `� U r �
Phone (904)247-5826 • Fax(904) 247-5845
4,01t19,- E-mail: building-dept@coab.us Date routed: 114
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
tn-SProperty Address: (0, V D artmatit review required Yes o
��,``
Applicant: t,VtYl Q.1) tL dtt4)3 ei'Opal S Planning &Zoning
1 Tree Administrator
Project: ( LQ lxLL A 4 S l t t12j—5Litts C 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 (v'
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: Fq4proved. ['Denied. ❑Not applicable
(Circle one.) Comments:
BUILDI G
PLANNING & ZONING
Reviewed by: Date:
TREE ADMIN.
Second Review: UApproved as revised. I IDenie . INot 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
RECEIVED
rS���iflf BUILDING PERMIT APPLICATION
s
J
t��
CITY OF ATLANTIC BEACH
S)
t:; , ,
JUL 2 7 201
\\ 800 Seminole Road,Atlantic Beach FL 32233 p I S
`''319 Office:(904)247-5826 • Fax: 904 247-5845 F—G
Building fleperboant
3'',2" City of Atlantic Beach,,, FL
Job Address: 10 10 i /- Tey.,ice_ P .,44.. 1%1 14' 41-40 permit Number:
O
Legal Description t tp-2..5—mg.'.�. -i'it g, Clo aved,( # t--lot 3 7 - cr.)Q7__
Valuation of Work(Replacement Cost)$ 3c1,(.b Heated/Cooled SF 1(0$(4 Non-Heated/Cooled l
la
• Class of Work(Circle one): New Addition Alteration Repair Move I emo Pool �indo II oo
• Use of existing/proposed structures) (Circle one): Commercial ;e I-retia 1 Q = ..t Z i
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes N IA a U z O
H
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree RgatgaP ZFui.
Describe in detail the type of work to be performed: W U a V 0
2€pL# c el Glns-s s"A..,.r. Doo--s 0 z cc °z
7 0 � ° a
Florida Product Approval# 7�7 31.. 21 % Zo834- > for multiple products use prodvr Ia
QQ Z
Property Owner Information O U w
0O �„iw
u
Name: 44);t l t'a - (31.w- - Address: ID j 64.1-, 54— wi W >- a Lt CO
City Mai1A��^ 4-;‘...
- ` {3 � Stater Zip 301a 33 Phone 1 - clog - 361 - .1-1 Co( w C) v ¢ w
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) W w
IX ¢
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.
Contractor Information:
Name of Company: (.).1 ,,149,a„n ce,bow, Qualifying Agent: yl,(oX,aet_ O. itream.,
Address: 4e0 t -iga i'ot Prat -r City a' -k5ar r•‘1 1 State Zip Ft 3 1
Office Phone I •goy -aei(o o?515 Job Site/Contact Number 1-9dY- 374 -53,Aa.
State Certification/Registration# C&c= I t d 1 a l E-Mail P cle.(ottly 4D ewttl l'1:c.12 ua e9 • Coot,
• Architect Name &Phone# '—
Engineer's Name&Phone#
Worker's Compensation C 6 ?
p Exempt`/ Insurer / Lease Employees / Expiratu n Dale
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 laws regulating construction in this jurisdiction.
This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a
period o fsix(6 months at any time after wo k is corn nced. I understand that separate permits must be secured for Electrical Work,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers,Hs-;ters,Tr � and Air Conditioners,etc.
, I
Signature of Property Owner: ignature of Contractor: ii' a
Before me
this 17 Day of 414 Flo i 'e re me this /1 Da of �edyq�a/c'
AL GATES L�EAREN Y
Alf :A ,0% Commission#FF 190928
"�•.%:a Expires May 20,2019 ' .•:i:4'�x'''''• '• t GATES DEAREN III
Notary Public b.-dm= .7A :onded Thu Tro F In Inc . ,tt ry Public / �� ,:: Commission#FF 190928
_.;•.4x',7 Expires May 20,2019
"ckg','ry°:'� Banded Thu Troy Filn Insurance 800385-7019
I hereby certifj,that I have read and examined this application and know the same to be true and correct. fill pt t.rJA„r., ,f L.
ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the
performance of construction.
Rev.3/14/16
Per T
NOTICE OF C I MMENC EMIENT
State of talvr'd County of .fit:.✓A
Tax Folio No. —/,rp3 7— y
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:
1(42 —• � _-��-____Z�l,e � f�t�l,•a// nrt,��t 4 rl,�u�,,�
tb,),Q t h ,t3 tiA i- 4
•
Address of property being improved: 1 O 1(134-4` S tit L�. c C3 ca �l ��_
33 4'a
General description of improvements: 4 61,q s S boa,-
Owner: 1411 I k Address: 10 I 014h
Owner's interest in site of the improvement: : 3
Fee Simple Titleholder(if other than owner):•
Name:
Contractor: 140 en Q e i-i (fir 1 ,4.,,s a— OoJ-s
Address: 460 t EA GC:(.. 1-1✓£ Pn-i�, L1- t ct=t
cT 304,a t c.. scA:l-i c)u,
Telephone No.: j -co`i• cACG at5 Fax No: t ' 9439 •a'<v.
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 improvement
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): c2z> I
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signed: Date: 9//1 /
Before Mt this /el day of .0-go o2 e I in the County of Duval,State
Of Florida,has personally appeared ki-L rAAN , �bcx
• Personally Known: of
Produced Ideati '! , ROYAL GATES DEARhN 111
Notary Public; / CommiSsiun#FF 190928
Doc#2018177086,OR BK 18471 Page 2106, Emission expires; ; �� Expires May 20,2019
Number Pages:1
Recorded 07/27/2018 09:11 AM,
RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00
nn
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
.. .._..
Project Name: ( t1 c,. Ib Ic.c-1c Permit # e'S1ci 'v.P5-&
Project Address: 10 IO 1A 51-- (4} (... 6-E,cr,\.. C::----1
3<Pd--3 3
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
•roduct approval may be obtained at:www.floridabuilding.or•.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A.EXTERIOR DOORS
1. Swinging
2. Slidmg
III
po .
4.Roll up
5.Automatic Millill
6.Other
C.WINDOWS 1
1. Single hung
2.Horizontal slider
3. Casement 111.1111111.1111 1111111111111111111111
4.Double hung
5.Fixed
6.Awning
7.Pass-through _ ...
8.Projected
9.Mullion 111111
10.Wind breaker
11.Dual action
''rriut VVIa
2. Other
Category/Subcategory
Manufacturer Product Description Limitation of Use State# Local#
H.NEW EXTERIOR
ENVELOPEPRODUCTS
1.
2
In addition to completing the above list of manufacturers, product description and State approval number for the products used
Contractor shall maintain on the job site and available to the Inspector, a legible copy of each manufacturer'sprinted on this project, the
instructions along with this Product Approval Sheet. specifications and installation
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) rr 1l i d 640,,N_, r
'(Signature) o
Company Name: /4r L 4'/- &i"- c�o, , J- pod, s
Mailing Address: e/80( z of 2 L��.✓�/� � —/� L� r- c9- 1
City: ac-7,4 •
State: Zip Code: .Yoga t Cn
Telephone Number: ( joy ) a 5 6. a $- / S" Fax Number: ( g6(f )
Cell Phone Number: ( 54,7t) a 3 y - ov E-mail Address: