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1965 W Sevilla Blvd RES21-0160 8 Windows, 3 DoorsOWNER:ADDRESS:CITY:STATE:ZIP: KELLEY JAMES E 1965 W SEVILLA BLVD ATLANTIC BEACH FL 32233 COMPANY:ADDRESS:CITY:STATE:ZIP: MIRACLE WINDOW AND SUNROOMS 8933 WESTERN WAY # 11 JACKSONVILLE FL 32256 TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 169462 0365 SEVILLA GARDENS UNIT 02 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 1965 W SEVILLA BLVD RESIDENTIAL WINDOWS/DOORS 8 WINDOWS AND 3 DOORS $14000.00 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00 BUILDING PERMIT 455-0000-322-1000 0 $125.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $62.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.56 LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 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. 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. 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. 1 of 2Issued Date: 6/16/2021 PERMIT NUMBER RES21-0160 ISSUED: 6/16/2021 EXPIRES: 12/13/2021 RESIDENTIAL PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.38 TOTAL: $243.44 2 of 2Issued Date: 6/16/2021 PERMIT NUMBER RES21-0160 ISSUED: 6/16/2021 EXPIRES: 12/13/2021 RESIDENTIAL PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $243.44 RES21-0160 Address: 1965 W SEVILLA BLVD APN: 169462 0365 $243.44 BLDG SUBSEQUENT PLAN REVIEW FEES $50.00 BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00 BUILDING $125.00 BUILDING PERMIT 455-0000-322-1000 0 $125.00 BUILDING PLAN REVIEW $62.50 BUILDING PLAN CHECK 455-0000-322-1001 0 $62.50 STATE SURCHARGES $5.94 STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.56 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.38 TOTAL FEES PAID BY RECEIPT: R16103 $243.44 Printed: Wednesday, June 16, 2021 11:37 AM Date Paid: Wednesday, June 16, 2021 Paid By: MIRACLE WINDOW AND SUNROOMS Pay Method: CREDIT CARD 468875117 1 of 1 Cashier: CG Cash Register Receipt City of Atlantic Beach Receipt Number R16103 ~+; CENTRALSQUARE Final Plumbing Final Electrical Final HVAC CC Final Final Building* Swimming Pool Steel Swimming Pool Safety Electrical Grounding & Bonding Swimming Pool Final (Bldg) Swimming Pool Final (PW) Formed Columns/ Beams* Masonry Cell Fill Structural Steel* OTHER: OTHER: OTHER: OTHER: OTHER: Power Pole Silt Fence Piers/ Stem Walls Underground Plumbing Underground Electric Foundation/ Footing Slab** Retaining Wall Footing Driveway Sewer (Building Dept) Sewer Tap (Utilities Dept) Rough Electric* Rough Plumbing/ Top Out* Rough Mechanical* House Wrap Wall Sheathing Roof Sheathing Tie-down Framing Connections Rough Framing Roofing In Progress Window/Door In-Progress Insulation Ceiling Insulation Wall Exterior Lath Stucco Scratch Coat Exterior Siding In-Progress Brick Flashing & Ties Early Power Gas Rough Gas Final* * When all rough electric, plumbing, mechanical are complete but before any work is covered up. * When all gas piping is complete and wallboard is installed but before gas is attached to any appliance. All outlets must be capped and pipe pressurized at a minimum of 15 lbs. * For new living space: When all construction work including electrical, plumbing, mechanical, exterior finish, grading, required paving and landscaping is complete and the building is ready for occupancy, but before being occupied Additional inspections may apply to your project if your project contains these elements: INSPECTIONS REQUIRED FOR BUILDING PERMITS To verify compliance with building codes, inspections of the work authorized are required at various points of the construction. The following inspections are typically required for residential projects: Date: Initial: Date: Initial: _____________________________________________________ Permit Type ____________________________________________________ Permit No. __________________________________________________________ Job Address ____________________________________________________ Contractor POST THIS CARD WITH PERMITS AND PERMIT DOCUMENTATION IN FRONT OF BUILDING Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends Building Department Public Works/Utilities Fire Department Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789 Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203 * When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all electrical, plumbing and mechanical work is in place, but before concrete is poured. * When all structural steel members are in place and all connections are complete, but before such work is covered or concealed. ** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION IN fE'1r l@N l lN E~ ~I@ ~1-iM Musr CAIi. BY 4PM PREVIOUS DAY FOR NIEXI' DAY INSPECIION 1 9 6 5 W S E V I L L A B L V D A t l a n t i c B e a c h F L 3 2 2 3 3 4 5 - 7 0 8 - 2 S - 2 9 E S E V I L L A G A R D E N S U N I T 0 2 L O T 2 2 1 6 9 4 6 2 - 0 3 6 5 1 4 , 0 0 0 x x x R e p l a c i n g 8 w i n d o w s & 3 D o o r s S i z e f o r S i z e J a m e s E . K e l l e y L i f e E s t a t e C a r o l L . K e l l e y L i f e E s t a t e J a m e s E . & C a r o l L . K e l l e y , K e l l l e y F a m i l y T r u s t , 1 9 6 5 W S E V I L L A B L V D A t l a n t i c B e a c h F L 3 2 2 3 3 2 0 7 - 4 6 8 - 2 0 6 7 j e k e l l e y d d s @ g m a i l . c o m M i r a c e l W i n d o w s & S u n r o o m s I n c K a t h l e e n C l i n e 8 9 3 3 W e s t e r n W a y S u i t e 1 1 J a c k s o n v i l l e , F L 3 2 2 5 6 c h r i s t i a n g @ a l l i a n c e p e r m i t i n g . c o m 9 0 4 - 8 6 3 - 3 2 7 5 8 5 5 - 2 3 2 - 4 5 4 4 C R C 1 3 3 0 4 7 8 R E S 2 1 - 0 1 6 0 B u i l d i n g P e r m i t A p p l i c a t i o n C i t y o f A t l a n t i c B e a c h B u i l d i n g D e p a r t m e n t 8 0 0 S e m i n o l e R o a d , A t l a n t i c B e a c h , F L 3 2 2 3 3 P h o n e : ( 9 0 4 ) 2 4 7 - 5 8 2 6 E m a i l : B u i l d i n g - D e p t @ c o a b . u s U p d a t e d 1 0 / 9 / 1 8 0 A L L I N F O R M A T I O N H I G H L I G H T E D I N G R A V I S R E Q U I R E D . J o b A d d r e s s : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ P e r m i t N u m b e r : _ _ _ _ _ _ _ _ _ _ _ L e g a l D e s c r i p t i o n _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ R E # _ _ _ _ _ _ _ _ _ _ V a l u a t i o n o f W o r k ( R e p l a c e m e n t C o s t ) $ _ _ _ _ _ _ _ H e a t e d / C o o l e d S F _ _ _ _ N o n - H e a t e d / C o o l e d _ _ _ _ _ • C l a s s o f W o r k : □ N e w □ A d d i t i o n □ A l t e r a t i o n □ R e p a i r □ M o v e □ D e m o □ P o o l □ W i n d o w / D o o r • U s e o f e x i s t i n g / p r o p o s e d s t r u c t u r e ( s ) : □ C o m m e r c i a l □ R e s i d e n t i a l • I f a n e x i s t i n g s t r u c t u r e , i s a f i r e s p r i n k l e r s y s t e m i n s t a l l e d ? : □ Y e s □ N o • W i l l t r e e l s l b e r e m o v e d i n a s s o c i a t i o n w i t h o r o o o s e d o r o i e c t ? □ Y e s I m u s t s u b m i t s e o a r a t e T r e e R e m o v a l P e r m i t \ □ N o D e s c r i b e I n d e t a i l t h e t y p e o f w o r k t o b e p e r f o r m e d : F l o r i d a P r o d u c t A p p r o v a l / # _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f o r m u l t i p l e p r o d u c t s u s e p r o d u c t a p p r o v a l f o r m P r o p e r t y O w n e r I n f o r m a t i o n N a m e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ A d d r e s s _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ C i t y _ _ _ _ _ _ _ _ _ _ _ _ _ _ S t a t e _ _ _ Z i p _ _ _ _ _ _ P h o n e _ _ _ _ _ _ _ _ _ _ _ _ E - M a i l _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ O w n e r o r A g e n t ( I f A g e n t , P o w e r o f A t t o r n e y o r A g e n c y L e t t e r R e q u i r e d ) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ C o n t r a c t o r I n f o r m a t i o n N a m e o f C o m p a n y _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Q u a l i f y i n g A g e n t _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ A d d r e s s C i t y _ _ _ _ _ _ _ S t a t e _ _ _ Z i p _ _ _ _ _ _ O f f i c e P h o n e J o b S i t e C o n t a c t N u m b e r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ S t a t e C e r t i f i c a t i o n / R e g i s t r a t i o n # E - M a i l _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ A r c h i t e c t N a m e & P h o n e I I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ E n g i n e e r ' s N a m e & P h o n e I I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ W o r k e r s C o m p e n s a t i o n I n s u r e r _ _ _ _ _ _ _ _ _ _ _ _ _ _ O R E x e m p t o E x p i r a t i o n D a t e _ _ _ _ _ _ _ A p p l i c a t i o n i s h e r e b y m a d e t o o b t a i n a p e r m i t t o d o t h e w o r k a n d i n s t a l l a t i o n s a s i n d i c a t e d . I c e r t i f y t h a t n o w o r k o r i n s t a l l a t i o n h a s c o m m e n c e d p r i o r t o t h e i s s u a n c e o f a p e r m i t a n d t h a t a l l w o r k w i l l b e p e r f o r m e d t o m e e t t h e s t a n d a r d s o f a l l t h e l a w s r e g u l a t i n g c o n s t r u c t i o n i n t h i s j u r i s d i c t i o n . I u n d e r s t a n d t h a t a s e p a r a t e p e r m i t m u s t b e s e c u r e d f o r E L E C T R I C A L W O R K , P L U M B I N G , S I G N S , W E L L S , P O O L S , F U R N A C E S , B O I L E R S , H E A T E R S , T A N K S , a n d A I R C O N D I T I O N E R S , e t c . N O T I C E : I n a d d i t i o n t o t h e r e q u i r e m e n t s o f t h i s p e r m i t , t h e r e m a y b e a d d i t i o n a l r e s t r i c t i o n s a p p l i c a b l e t o t h i s p r o p e r t y t h a t m a y b e f o u n d i n t h e p u b l i c r e c o r d s o f t h i s c o u n t y , a n d t h e r e m a y b e a d d i t i o n a l p e r m i t s r e q u i r e d f r o m o t h e r g o v e r n m e n t a l e n t i t i e s s u c h a s w a t e r m a n a g e m e n t d i s t r i c t s , s t a t e a g e n c i e s , o r f e d e r a l a g e n c i e s . O W N E R ' S A F F I D A V I T : I c e r t i f y t h a t a l l t h e f o r e g o i n g i n f o r m a t i o n i s a c c u r a t e a n d t h a t a l l w o r k w i l l b e d o n e i n c o m p l i a n c e w i t h a l l a p p l i c a b l e l a w s r e g u l a t i n g c o n s t r u c t i o n a n d z o n i n g . W A R N I N G T O O W N E R : Y O U R F A I L U R E T O R E C O R D A N O T I C E O F C O M M E N C E M E N T M A Y R E S U L T I N Y O U R P A Y I N G T W I C E F O R I M P R O V E M E N T S T O Y O U R P R O P E R T Y . I F Y O U I N T E N D T O O B T A I N F I N A N C I N G , C O N S U L T W I T H Y O U R L E N D E R O R A N A T T O R N E Y B E F O R E F C O M M E N C E M E N T . RES21-0160 Cust o m e r N a m e : S t y l e C o d e DI A G R A M \ ~ , - . ~ : : : : \ . I In addition to completing t h e a b o v e l i s t o f m a n u f a c t u r e r s , p r o d u c t d e s c r i p t i o n a n d S t a t e a p p r o v a l n u m b e r f o r t h e p r o d u c t s u s e d o n t h i s p r o j e c t , t h e Contractor shall maintain o n t h e j o b s i t e a n d a v a i l a b l e t o t h e I n s p e c t o r , a l e g i b l e c o p y o f e a c h m a n u f a c t u r e r ' s p r i n t e d s p e c i f i c a t i o n s a n d i n s t a l l a t i o n instructions along with this P r o d u c t A p p r o v a l S h e e t . I certify that this product a p p r o v a l l i s t i s t r u e a n d c o r r e c t t o t h e b e s t o f m y k n o w l e d g e . I f u r t h e r c e r t i f y t h a t u s e o f d i f f e r e n t c o m p o n e n t s o t h e r t h a n t h e ones listed in this documen t m u s t b e a p p r o v e d b y t h e B u i l d i n g O f f i c i a l . *Contractor Name (Print N a m e ) : K a t h I e e n C I i n e * C o n t r a c t o r S i g n a t u r e : _ _ _ _ c ) _ h \ _ . _ _ ~ _ _ { _ t _ ' t _ J l t _ _ _ _ _ _ c t ? t = - - . , z : c . c . ' - - " . ! , , - / , , v ' c . e . . . . c . _ _ _ _ _ _ *Company Name: Mira c l e W i n d o w s & S u n r o o m s *Mailing Address: _ _:8...:9....:3:. . . : : 3 : . . . . . W . . : . . . . : _ e : : . . : s : : . . : t : . . = e . : . . . r n ; _ c _ _ : W - - - = - - - - = . a : L y - - - - ' S = - u = - · : . . : . 1 t e = - - - - - ' 1 ' - - ' 1 : . . . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ *City:_J_a_c_k_s_o_n_v _ i _ l l e _ _ _ _ _ _ _ _ _ * S t a t e : _ F _ L _ _ _ _ _ * Z i p C o d e : _ 3 - ' - - - 2 _ 2 _ 5 _ 6 _ _ _ _ _ _ *Telephone Number: _9_0_ 4 _ - _ 8 _ 6 _ 3 _ - 3 _ 2 _ 7 _ 5 _ _ _ _ _ _ * E - m a i l A d d r e s s : _ - = . c . : . . . : h . : . . . : r i c : : s . . : : t i - = a : . : . . . n : . s . g , _ , , @ = - = a . : . . : . 1 1 : . : . . . i a : : : c n : . . : . c = - - e = p - = - e . : . . . : r m : . : . . . : . : . . . i t : : : . : i n c . c g ; ; , _ : _ _ _ : . c : . . : o : . . : . m . : . . : . . . . . _ _ _ _ Cell Phone Number: __ _ _ _ _ _ _ _ _ _ _ _ _ _ F a x N u m b e r : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ P a g e 4 o f 4 U p d a t e d 1 0 / 1 7 / 1 8 Revision Request/Correction to Comments **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED. City of Atlantic Beach Building Department 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: _____________________ Revision to Issued Permit OR Corrections to Comments Date: ________________ Project Address: ____________________________________________________________________________________ Contractor/Contact Name: ____________________________________________________________________________ Contact Phone: ______________________________ Email: _________________________________________________ Description of Proposed Revision / Corrections: __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ I_______________________________ affirm the revision/correction to comments is inclusive of the proposed changes. (printed name)  Will proposed revision/corrections add additional square footage to original submittal? No Yes (additional s.f. to be added: _____________________________)  Will proposed revision/corrections add additional increase in building value to original submittal? No *Yes (additional increase in building value: $____________________) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: _______________________________________________________ __________________________________________________________________________________________________ (Office Use Only) Approved Denied Not Applicable to Department Permit Fee Due $_______________ Revision/Plan Review Comments_______________________________________________________________________ __________________________________________________________________________________________________ Department Review Required: Building _____________________________________________ Planning & Zoning Reviewed By Tree Administrator Public Works Public Utilities _____________________________________________ Public Safety Date Fire Services Updated 10/17/18 □ □ □ □ □ □ □ □ □ RES21-0160 PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA ('REQUIRED) *Project Address: 1965 Sevilla Blvd W Permit ff: ___________ _ *Owner/ProjectName:_J_a_m_e_s_E_._K_e_ll_e~y _____________________________________ _ As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72 1 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 Energ! Fenestration Solutions Serles Opera NG Pat!o Door +50/-50 17058.4 3, Sectional 4. Garage Roll-Up 5. Automatic 6. Other B.WINDOWS 1. Single hung Regency Plus Inc Serles 2000 Vi~)\ Till Sing'<> Hung V{,nd<m +40/-40 11412.1 2. Horizontal slider 3. Casement 4. Double hung 5. Fixed 6.Awning 7. Pass-through 8. Projected 9. Mullion 10. Wind breaker 11. Dual action 12. Other Page 1 of 4 Updated J0/17/18 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 Name):._K_a_th_l_e_e_n_C_lin_e _______ *Contractor Signature: __ ¢4+-"~~~=~---(/hu_,===~~---- *Company Name: Miracle Windows and Sunrooms *MailingAddress: 8933 Western Way, Suite 11 *City: Jacksonville *State: _F_L ________ *Zip Code: _3_2_2_5_6 _________ _ *Telephone Number: _,(_9_0_4'-) _8_6_3-_3_2_7_3 _______ *E-mail Address: christiang@alliancepermitting.com Cell Phone Number: ________________ Fax Number: ________________________ _ P;ige <l of <l Updr,ted 10/17/18