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627 Selva Lakes RES20-0067 Window App (% ,\17--,--, City of Atlantic Beach APPLICATION NUMBER t.s'r �,,. Building Department (To be assigned by the Building Department.) r ' 800 Seminole Road ,� -, , !� Atlantic Beach, Florida 32233 5445 1\ CS (--) —0010 7 Phone(904)247-5826 - Fax(904)247-5845 /-7 7; E-mail:-mabuilding-dept@coab.us Date routed: 3 Z U City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Lcs ent review e No Property Address: z 7 CLVA Department required Y p uildin>� V Applicant: L1 REr'\GOEL_I pU( "'Fanning &Zoning fl Tree Administrator Project: L' -- I k)(30 L �' KE Pl A C_E-- rt /,3 r Public Works Public Utilities Public Safety Fire Services Re (.:,14,i =, Dept Signature Other Agency Review or Permit Required Review or Receipt Date 1 of Permit Verified By L./ Florida Dept.of Environmental Protection ') Florida Dept. of Transportation fJ St.Johns River Water Management District ,> * ' Army Corps of Engineers � 'V Division of Hotels and Restaurants �v \./ • Division of Alcoholic Beverages and Tobacco (^' Other: APPLI TION STATUS Reviewing Department First Review: I Approved. ❑Denied. ['Not applicable (Circle one.) Comments: BUIL PLANNING &ZONING 310-C) Reviewed by: m ' Date: TREE ADMIN. Second Review: Approved as revised. Denied. Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I lApproved as revised. ❑Denied. Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 ` :, Building Permit Application OFFICE COPD Updated 10/9/18 l City of Atlantic Beach Building Department '*ALL INFORMATION „� 800 Seminole Road, Atlantic Beach, FL 32233 H GHLIGHTED IN GRAY Phone: (904) 247-5826 Email: Building-Dept(«@coab.us IS REQUIRED.. Job Address: J�7 s�� ,a/�„� 47,914.I Permit Number: 1 ES zv c��7 Legal Description 1J'/l /2i7 , ?9 S atZeiisor fi2,24 o(, Al ye �RE#/924,42-5, „S��J z ` Valuation of Work(Replacement Cost)$ '"h Z `J 7 v ated/Cooled SF /We Non-Heated/Coc led a C.) 7 O (Vr. nwEa • Class of Work: ❑New ❑Addition DAlteration ❑Repair ❑Move ❑Demo ❑Pool leWindow/Door F- Z H 0 Ca � O • Use of existing/proposed structure(s): ❑Commercial Lesidential U 0 a U O • If an existing structure,is a fire sprinkler system installed?: ❑Yes ric10 Wp • Will tree(s)be removed in association with proposed project?liYes(must submit separate Tree Remov. I Permit" - < Describe in detail the type of work to be performed: �/Na/k./ - ea 4 CC/S/ 7 I-- h 1— i 0CC a v1 Li- to Florida Product Approval# for multiple products use product app�ira 'for�cc 5 0 Pro•ert Owner Information / /� W Q W Name — ' 2 - (Jdt SC/ ♦/X�� ' cA W i ••./ Address OC u City / _. ?ZIA"' State, Zip 1 Phone d'OY•a/7. „?�a P\Li > E-Mail � SF�/AG e2E����,,�.LDr'I C� cc Owner or Agent(If Agent, Powe f Attorney or Agency Letter Required) et dez-n Contractor Information /40MN Rr/fr/y. SNC• Name of CoEliany /Tel /'PPOd L/frs,// ing Qualif Agent _ Address r] j3/mi r 4-/i` City it/t71, `/-State 1...- Zi - �. n B / Office Phone •-,f;�' G/ t. '— job Site Contact Nu be '''.0 / ,./' State Certification/Registration# C-i C /75-2/41(E-Mail .; L4 ^ • • 1 0 , C C/y Architect Name&Phone# v Engineer's Name&Phone# Workers Compensation Insurer OR Exempt q�xpiration Date ////d )-- Application Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work c r installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standa s flfalfth rmg-re kti construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL .tJ. BFr(E,1G ?...1f WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the rec uirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of Ihis county,and there may be additional permits required from other governmental entities such as water management districlARte aganr federal agencies. OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compl ance with all applicable laws regulating construction and zoning. Building N.,n1rtrnent WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENC MENT MAY lcil, FL. RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIJYOU,R N TICE OF COMMENCEMENT. _ - --j _ vLvx �� , (Signature of Owner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed)before me thiscL( day of Signed and sworn to(or affirmed)before me this , C.�day of `�Rt'1. 2-02-U ,by —Y- �`X \- j$ �62ur�,-Lt Rc ci3,bi i ty ?v .,- Sc„\-, A (Signature of Notary) ,r• . r - . •tp- • P6"4 el ' •RIE REMOLJE 1 `t ': Notary Public-State of Flcrita 1Wciy [ ]Personally Known OR I t My Comm.sE Expires Oct 20,2023 sion#GG 924059 [ ]Personal) Known OR Produced Identification [j.P oduced Identification 1 Bonded through National Notary Assn. - Type of Identification: t Ur LcLQ w.ve J S L. ec:t-' Type of Identification: F _ • 111. • • • i 1 1 iIi es G• L RAIL 1 s I .n.,.r r..:-•.w'.k..kr.-J•6 .4.0.t'r..:a,.aWrr7.•.t 0. OFFICE COPY FLORIDA INDIVIDUAL ACKNOWLEDGMENT F.S. 117.05(13) — Effective January 1, 2020 State of Florida County of �L;vo\\L The foregoing instrument was acknowledged before me by means of VI.Physical Presence, --) —OR— ❑Online Notarizati•n, b"1-Q this OLI day r,f :1 1" t • , 2O ZC) Date Month Year viambdbabook-- —— �(L\ , CoClt' JASMINE R.HOVE Nl of•- _ • owledging Notary Public-State a'•crida Commission=GG 362066 'For.. My Comm.Expires Oct 26.2023 I •igna re ry Public—State of Florida C \nrine__.-Q- • Ot•ccp Name of Notary Typed, Printed or Stampe ❑Personally known YI Produced Identification Type of Identification Produced: C t CV t CI CI Place Notary Seal Stamp Abovef,D)J C;� LY \\i r i C Yl,Se OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document \ Title or Type of Document: ��C\w"lCIRt'v VYN' } O S739\ 'C CA i w l C ,C L\C� A \C\;r1C ��� , A t -ee Document Date: 2'C`;(.I ) 7(".? C) Number of-pCV ages: art Signer(s)Other Than Named Above: ©2019 National Notary Association M1304-11 (01/20) 14`.. AO A 4 "•„; 'N F _ rE. OFFICE COPY Y JIMMY PATRONIS CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION ** CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW** CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 2/12/2020 EXPIRATION DATE: 2/11/2022 PERSON: MARLON D THOMPSON EMAIL: REMODELINGATOZ@GMAIL.COM FEIN: 200598771 BUSINESS NAME AND ADDRESS: A TO Z REMODELING & HOME REPAIR, INC. 131 S. WILDERNESS TRL. PONTE VEDRA BEACH, FL 32082 SCOPE OF BUSINESS OR TRADE: Roofing-All Kinds and Contractor-Project Manager, Drivers Construction Executive, Construction Manager or Construction Superintendent IMPORTANT:Pursuant to subsection 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to subsection 440.05(12),F.S.,Certificates of election to be exempt issued under subsection(3)shall apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to subsection 440.05(13),F.S.,notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 E01114501 QUESTIONS?(850)413-1609 1 Perm, 1 ie6S2d — 066 '7 '"' NOTICE OF COMMENCEMENT State of,/T�`idQ County of;2 � OFFICE CO "° �r�3 ~ OODD To Whom It May Concern: The under-sill-led hereby informs you that improvements will be made to certain Peal properly, and in accordan_e'with Section 713 of the Floric a Statutes,the following informatio is stated in this NOTICE OF COMMENCEMENT. Legal Descri tion of property being improved: •/ /�f-, wAL F e Address of p-operty being improved: CP.77 �./ � ` ' A(/ / / l^� 2 / • Sufi /'L General des(ription of improvements-mo i>d Owner._i__ — / _ // — — O Address: (��' 2 /� �,, T� 142 Owner's inte est in site of the improvement:_ _174/ ,'!rf- Fee Simple Ti leholder(if other than owner): - Nam?: — Contractor:_ 6_70_1_ P vim,,y41 Addr'ss: Air 0/1-1 7 1 ��, 4 /2C 3 ,_a ii k- i-- Telec hone No.:q y , 1% ._,9) Fax No: 410.:/./,• r Surety(if any) n ss: — Amount of Bond$ Telep lone No: _ Fax No: Name and add•ess of any person)making a loan for the construction of the improvements Name /4 Addre.s: Phone No: Fax No: Name of person within the Slate of Flurida,other than himself,designated by owner upon whom notices or other iocuments may be served:Nam=:�/����+-„ ,7� ����`��_ Addre s:_rvpp0,,7�� � 4 4,, ,, /7// 14(f-z_ 122 3/ Teleph me NoN 'pZ�f•pZ,�2 --- Fax No: In addition to I imself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Fl.rrida atues. (Fill' at Owner's option) Name: .4. /[2014.•*fir 4,r Address 429 • . / / � '2'$t',2/.2.2.- 3 � Telephc ne No: Fax No: Expiration date c f Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR 1ECORDER'S USE ONLY OWNER , :/_ _ ..±, ci.....tx_39 I.N\ Doc#2020049473,OR BK 19124 Page 454, fined: Date: Number Pages:2 ZG 7 U Recorded 03/02!2020 11:35 4M, efore me this 0 • da of RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL personalty appeared 7�7 �.n the County of uvai, tate f Florida,has COUNTY otary Public at Large,State of Florida,County of Duval. RECORDING $18.50 ly commission expires: ?rsonally Known: -- _ 'oduced Identification: or N. OFFICE COPY FLORII IA INDIVIDUAL ACKNOWLEDGMENT F.S. 117 05(13) — Effective January 1, 2020 so_'Tt i�ih" vf,T. :i` F S"r° k i t-i' e ci fi *s;�::f y '�,. ,s,: :;F w.,,tett 3t_ " "? State o Florida County of Ul. ...I _ The foregoing instrument w < dged before me by means of/ ill Physical Presence, —OR— ❑Online Notarization, -1-0 \ I this L L/ day of ,•V, PCZ by Date Month Year iffiallirdbANdhdbalbahAllhAlbillb°1 Na of Person Acknowledgin .r+",yy JASMINE R.HOPE .,;'`�F.` .,.\:.,•s Notary Public-5tate o`Florida i A Commission'GG 362066 1 . - • oF°` My Comm.Expires Oct 26.2023 1 A. Si ature •f otary Public— tate of Florida _51(Y) I n _ V.,. cc_. Name of Notary Typed, Printed or St ped ❑Personally known Produced Identification Type of Identification Produced: 1C;V VC:tg Place Notary Seal Stamp Above �v'w-eYr`-'-) 1 tC e'_Y74k_ OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Descr ption of Attached Document Title o Type of Document: \N-k-A\C C;cCC a CY\Y 1e\"'C.1rY rlA Docun entDate: C-2 ) CL-1 / '7.C. 2 C Number of Pages: (t Signers)Other Than Named Above: IL ( ),e, ` tea„r 2 31...14_ Att)MtlsW > ` s taai_' :c-2019 Ni tional Notary Association M1304-11 (01/20) OFFICE COPY }R✓��y� re"' PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED) *Project Address: g df7 , L b,6 2-1 1-r6-=5 G JY , Permit#: R6S2O —0069 *Owner/Project Name: f / V i > 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 ,� 3 /0 %( r, q 1.Single hung A 6C"11A-Mrp' �V^ v � COTS/dA' , If 2. Horizontal slider � 0 3 A2— pci?`side / ,,4 Z„ ,/J 6J%. 9 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 10/17/18 . } �( \ � (( (! ( � { { •\ «( {; �) � »( ƒ \ } t ' §} . ^t . . 10. � \ �} � | )\ � I. � | OFFICE COPY 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): 46-4i-J ) ----D. I "°Contractor Signature: *Company Name: ii-1-...-2-- O2c 0trLA--t."-- /'-7. ice`— R. eiO4.4 ,./ C ? / *Mailing Address: 755 - Ri4167,9742!- AV`z • *City: 7�rvZ� V --4- *State: f`2- *Zip Code: <3 2-`v 87 *Telephone Number: 9D (. all-6 /. *E-mail Address: '72- --/21`-'°1Z:=4--c-iNdc..r 4.7-t3.2-e (::444.7 L, ( )-4-N. Cell Phone Number: /d ci — Y/3 6 (g Z— Fax Number: e7 "Y 2 y r— g44 fS ..,„,.„.......,...,......,ita....iumillIlIllnwijmai..ioimmirmua Page 4 of 4 Updated 10/17/18 OFFICE COPY SEE CHART FOR \```````UllinTlr��� ,' ASSC3�IATED MATERIALS F-OVERALL FRAME WIDTH `\ •-•.. t>, 22 ,i�l�l� O Z�+ N` / 2: w o:.JCa 'i:)) 3773 STATE ROAD =�'• * i4'!„.9:.-.0 /'"/rl*Iv `` o n°'n qnCUYAHOGA FALLS, OH 44223 , g� a � ., .... 4s: O . U N .. m Od MODEL 03A0/03S0 "ST" 2._ " $ Z m `EdbfW E ug 9 d oa SINGLE HUNG "Replacement" WINDOW .LLjoz 8 + w ia "NON-IMPACT" o Y �` UO ZOZ W ��' ,74 ., OW F 2Q CO Ww Wy -I Iv GENERAL NOTES t Er, g � MAX. MAX. DESIGN PRESSURE(PSI) o Erin FRAME D.LO. GLASS o s=w� 1. This product has been evaluated and is in compliance with the 6th Edition(2017)Florida DIMENSION DIMENSION TYPE POSITIVE NEGATIVE & a a. o Building Code(FEC)structural requirements excluding the'High Velocity Hurricane Zone" (HVHZ). 52.0"X 96.0" 46.25"X 44.25" or +20.0 •20.0 E>; 2. Product anchors shall be as listed and spaced as shown on details.Anchor embedment 48.0"X 96.0" 42.25 X 44.25" Cl +25.0 -25.0 m to base material shall be beyond wall dressing or stucco.LA 44.0"X 96.0" 38.25 W X 44.25' GI +30.0 -30.0 = 0 3. When used in areas requiring wind borne debris protection this product is required to be o as o g protected with an impact resistant covering that complies with FBC Sections 1609.1.2& 40.0"X 96.0" 34.25"X 44.25' Cr +35.0 -35.0 -.o N A R301.2.1.2. a Z ' vNn 55 g 48.0"X 84.0" 42.25"X 38.25" GI +25.0 -25.0 w 4. For 2x stud framing construction,anchoring of these units shall be the same as that m ce d g rr shown for 2x buck masonry construction. 52.0"X 78.0" 46.25"X 35 25' or +25.0 -25.0 2 m o 5. Site conditions that deviate from the details of this drawing require further engineeringa a w fi 44.0 X 78.0" 38.25"X 35.25" GI +35.0 35.0 a a z$ analysis by a licensed engineer or registered architect. > 0 36.0"X 78.0" 3025"X 35.25" GI +45.0 -45.0 ^fO__a N TABLE OF CONTENTS ^ 5 9 N Q 44.0"X 75.0" 38.25X33.75 ct +40,0 40.0 S r ',, SNEET# DESCRIPTION w Q 1 Typical elevations,design pressures&general notes < n N-o 36.0"X 72.0" 30.25"X 32.25 Cr +50.0 -50.0 Z z 2 Horizontal cross sectionsDA r:12/20/t 3 LZ' 3 Vertical cross sectionsa ___.._. .. 52.0"X 62.0" 46.25"X 27.25" GI +35.0 -35.0 SCNX: N.T.S. _ 4 Buck&frame anchoring _ s kt 5 Bill of materials,glazing detail and components 44.0"X 60.0" 38.25'X 26.25" GI +45.0 -45.0 DWG.BY: JK m CHK.B1: LFS ; It DRONING NO.: Q 36.0"X 60.0" 30.25"X 26.25" Cl +55.0 -55.0 FL-10465.9 m I% o n SHEET 1 OF 5 0 '....--• OFFICE COPY ,„„,r,rrlr, ASM�IATFD MATFRIAI .� a ...• = I N C 0 R P 0 .R A T E D :O:w #�&&•J=O”' =r * id:z<-KLn 3773 STATE ROAD —ci3 Z k'0. CUYAHOGA FALLS, OH 44223 :•. �,`, ° m ' ''/,,rrrrr iPs ,`` zomo SEE CHART FOR MAX.FRAME WIDTHS --- oro z ( o N 'e Em i m 2 c ni MODEL 03A2 / 03S2 "ST" / ` eN< 9doa N c 4a m daT Extruded Vinyl Horizontal m N ,// /// 9 W fh Sliding "Replacement” Window "NON-IMPACT" < LL5 nz F. X o W12 " O ,c2 06 2 m t 4 4 N WO U / / F 0 U� O w o o z GENERAL NOTES I �// /// o ~ cc / 4 °a. l Ts I. This product has been evaluated and is in compliance with the 6th Edition(2017)Florida Building / > m S Code(FBC)structural requirements excluding the"High Velocity Hurricane Zone(HVHZ). ----- 2. Product anchors shall be as listed and spaced as shown on details.Anchor embedment to base a material shall be beyond wall dressing or stucco. os Zn8 a 10 } 3. When used In areas requiring wind borne debris protection this product is required to be protected W..N. 11'- Nn with an impact resistant covering that complies with FBC Sections 1609.1.2&R301.2.1.2. 8•ON 8 N 2 z,,, 4. For 2x stud framing construction,anchoring of these units shall be the same as that shown for 2x OVERALL OVERALL a a buck masonry construction. DESIGN PRESSURE o 2 Di rr o FTcc FRAME DAY LIGHT GLASS TYPE (PSF) ma <ok'o S. Site conditions that deviate from the details of this drawing require further engineering analysis by DIMENSION DIMENSION 3 0 w$o a' a licensed engineer or registered architect. POS. NEG. o o 0 84.0"x 72.0" 38.25"x 66.25" +20.0 -20.0 .--'. '2 W TABLE OF CONTENTS " -\w m o m^ 30 r- a " SHEET# DESCRIPTION 96.0"x 60.0" 44.25"x 54.25" +20.0 -20.0 ry a,c,•,n o g 1 Typical elevations,design pressures&general notesLo tr,_ v N o 0 ID i 2 Horizontal cross sections 72.0"x 56.0" 32.25"x 50.25" G1 +35.0 -35.0 ` 3 Vertical cross sections - -- - _ 12/17/133 = SCAM N.T.S. T. 4 Buck&frame anchoring 72.0"x 48.0" 322r x 42.25` +40.0 -50.0 DWG.er: JK m 2 5 Bill of materials,glazing details and components CHIC BY: LES ° 63.0"x 44.0" 27.75"x 38.25" +40,0 -60,0 DRAWING NO.: i FL-11141.29 0 9 sum l or 5 N