165- 167 Pine St (vault) PREPARED 4/10/03, 8:18:06 INSPECTION TICKET PAGE 8
CITY OF ATLANTIC BEACH INSPECTOR: LARRY J HIGGINS DATE 4/10/03
------------------------------------------------------------------------------------------------
ADDRESS . : 165 PINE ST SUBDIV:
TENANT, NBR: REPLACE HVAC
CONTRACTOR GURLEY HEATING AND AIR PHONE (904) 221-6221
OWNER SAPIA, PAULNA PHONE
PARCEL 170635-0130- -
APPL NUMBER: 03-00025784 MECHANICAL ONLY
------------------------------------------------------------------------------------------------
P M IT: NICK 00 NBC W ICAL PRINIT
REQUESTED INSP DESCRIPTION
'�YR
I PTI"
TYP/SQ COMPLETED RESULT RESULTS/COMMRNT
--------------------------------------------- --------------------------------------------------
34 01 4/10/03 LJH ME FINAL T MR: 08:00
L CALL FIRST OHN WHITE 626-9452
-------------------------------------- MMENTS AND NOTES --------------------------------------
y,4 tZ 0.4.
CITY OF ATLANTIC BEACH as-- 1(00
SPECIAL INVESTIGATION
TO BE FILLED OUT BY COMPLAINTANT
DATE
ADDRESS
LOCATION A 7
COMPLAINT &2:4z
d2 Y C-A oQ :Lo (n pwu (J,,,4e---4, -4n
OWNER Of PROPERTY J54 A-An,tnelt?�C/-4,j1d. lk-7 PI
SIGNATURE OF COMPIAINTANT PHONE
L9
-----------------------
FOR OFFICE USE ONLY
DATE OF"INVESTIGATZ INVESTIGATOR
CONDITIONS FOUND L
T— L/ -'ll 71
ACTION TAKEN'
COMPLIANCE-
NOTES:
---------------
Nt) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 05-00030403 Date 5/26/05
Property Address . . . . . . 166 PINE ST
Tenant nbr, name . . . . . . REROOF
Application description . . . ROOF
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2188
Owner Contractor
------------------------ ------------------------
GRAESTER, MARK HOME DEPOT AT-HOME SERVICES
166 PINE STREET 2455 PACES FERRY RD NW BL C-8
ATLANTIC BEACH FL 32233 ATLANTA GA 30339
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 68 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 2188
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 68 . 00 68 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 68 . 00 68 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET
Address
Date
Heated Square Footage @$ -persqft= $
Garage Shed r) 1P $ per sq ft $
�,.Xv (.Aft-'
Carport Porch $ per sq R $
Deck @$ per sqft= $
Patio
@ $ per sqft= $
TOTAL VALUATION: $
I-
3.5 $
Total Valuation $ oevvo
- I L9 F2 $ (C
Remaining Value $f. per thousand
or portion thereof
CONSTRUCTION TYPE: TOTAL BUILDING FEE $ -2
ZONING: + 1/2 Filing Fee
$
FLOOD ZONE: )Fireplaces@ $35.00 $
IMPERVIOUS SURFACE:
BUILDING PERMIT FEE $
WATER IMPACT FEE $
SEWERIMPACTFEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT$
SEWER TAP $
C ( ) RADON .0050 $
SECTION H PAVING( ) $
HYDRAULIC SHARES $
CROSS CONNECTION $
ST( ) SURCHARGE $
OTHER $
GRAND TOTAL DLE: $ C)
CITY OF ATLANTIC BEACH Cc:
BUILDING ZONING DEPARTMENT
iggins
800 Seminole Road
Msoerr
Atlantic Beach,Florida 32233
(904)247-5800
(904)247-5845 Fax
www.coaKus
PLAN REVIEW COMMENTS
Permit Application # 5- �-5()+ 0 5,
---Crk I
Property Address: n 1p,
Applicant: W fme a H 6 ro
Project:
This permit application has been:
Cn/Approved
Reviewed and the following items need attention:
Please re-submit your application when these items have been completed.
Reviewed By: Date:
Date Contractor Notified:
-7 D 0
16tTY OF ATLANTIC BEACH
U -
�YOOFING PERMIT APPLICATION
Date:
Job Address:
Owner of Property: Ot 1q F-5 Ifft-
Address: K"T-LKrJTi(- 322-33 Telephone: .
Contractor'll' 4-"L)g):1-JA�j��S9jyj(
0,,C, State License Number:
Contractor's Address:c<M Q<-Z��A-r On
Telephone: Fax:
Scope of Work: Q,!�Ynnp —1 d 5 15- 5 L�A;z P)7' -(,6
Deck Slope: -Greater than 2:12 Less than 2:12
Valuation of work:
Product Name(Example:Timberline): 6' "
/-1/X . Y �j
Manufacturer(Example: GAF): L--Imy
ASTM Designation(s): J%�Z LIZ of-L
Required Inspections:: Shea d F' al
Signature of Ownen Date:
Signature of Contxacto §-jnjo6-
AS TO'OWNER:
Sworn to and subscribed before me this C) day of
State of Florida,County of Duval
Notary's Signature:
VC 11 C.76UTHSERTSON Personally known
Corn"000311161110
Expees 10r&VrA= Produced identification L
Bonded thru(OW)432.4M Type of identification produced
[021mll �, onda Notsfy Assm.Me
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of 20
State of Florida,County of Duval
Notary's Signature: �-c
SUSAN C.S:h!AkwPiR0
StIte of Florida Personally known
_Notary Public a
1Z -)n ExrAies,kil 25,2M7
WyCornrniv*
Produced identification
-nmib,�ior� # L)02 0 720
"al t Type of identification produced
...... bonded By Nutional Notaiyj�ssn.
800 Seminole Road Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 Fax: (904)247-5845 -bttp://www.ei.atiantic-beach.fl.us
Page I Revised 2/21/03
U x vj-'
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00025784 Date 3/31/03
Property Address . . . . . . 165 PINE ST
Tenant nbr, name . . . . . . REPLACE HVAC
Application description . . . MECHANICAL ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
------------------------
------------------------
SAPIA, PAULNA GURLEY HEATING AND AIR
165 PINE STREET 2028 INDIAN SPRINGS RD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32246
(904) 221-622 1
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . .
Permit Fee . . . . 79 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 79 . 00 79 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 79. 00 79 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER- "FAILURE TO OOMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS-ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW,
BUILDING OFFICIAL
8887
WNTOPSUILOM
`0�
CITY OF ATL40C-00
ioc �ION INPORKATION
INFORMATION ,,-
it "umbe r AddressIt' .161 ,"PINE STREET
'ATLANTIC BEACH , F'WRIDA 32233
t Type* XECHAN1 CAL,
LEGAL DESCRIPTION
t W rk, REPAIR
t
'FRAME : Lot. ,
y�p WQOD
t1qns r
R
hip No*. D
0 io p e STOIX FAKtLY
ATLANT I C BEACH,
suw
1 1 code--
Ue
OiA0
Vi a
�,Taprov
0s,t 00
$27 .00
' Total
$27 �00
Da
APPLICATION FEES
TTON I-
wt $27 .G0
I.t4PACT FEE,i
0
ev
T AT
PLO
ON GAS-H.R. S. $01(0
'FORMAT
CAB
c E
CAPITAL IMPROVE,
4 tp
'aft,
AN'
'TION
moss co
L -FLOIR I DA 31 20 MNEC
H, L
S
ACT PEE
Ice Tyoe
10
14-1URCHAR03
mw
cell
4SPECT
0'T, —ALL 19 fp#�W�ANO FOOTINGS MUST 61E It BEFORE MjURING
JET
ft
E�OF ISSUE,
'PERM VOID SIX MONTHS AFTtA OAT
ft. WMATEfItAL,RUBBIS AN, SAIS F T,S)EPLACED N PUBLIC SPACE,AND MUST BE
>RK MUST,rNO
H D,'DE 'ROM THJS WC1
JI EDUPAND y HER,CONTRACTOR OR OWNE�,
HAULED AWAY IT
IFAILUAS T C 1,11EN, LAWCANIRESIJ IN
;OOA,PLYl�"-WIT"HTHE. MF.,CHAN ICS
E -0,00
Y 0WNJM'-PAYING wuli�_,;', AM"OVEMEN SO ,
F.AT % 'Twice �0101
' OC
PROVED P" W T
60 A0 Ot ING TO AP
V -CC LAWS, -HICH ARE PART.oF.TKIS PEAMIT,AND SUBJEC TO REV,�n A:I
Of �w
f E PROVISION 0F'LA1
IMICARL
00*m $27.00
00000m
ACH� UILDIOG RTMeNT. 00717A
9EPA
V 1161
77 777 77 77 7
BUILDING AND ZONING INSPECTION DIVISION
CITY Of ATLANTIC BEACH
ATLANTIC BEACH. FLORIDA SX233
APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER
IMPORTANT — Applicant to complete all items in sections 1, 11, 111, and IV.
Street Address: Ito-11)-irie- -ST
U)CATION I -
OF Intersecting $tree It: Between And
WILDING
Sub-d;vision
Ill. IDENTIFICATION — To be completed by all applicants.
In consideration of permit given for doing the work as described in the above statement we hereby agree to perform said work in accordance
with the attac4d plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards
of good practice listed therein.
Home, of Mechanical Contractors
QH*4001 (Print) KW A&0 FAC-f VA Se—#Z—
Home of Owner 6- ': L
Property
-nor Signature of
S
,�A=6-9(1)Agont Architect or Engineer
Ill. CPS41M INFORMATM
A. Type of 6sting fW: IS OTHER CONSTRUCTION OIEING
C3 E14,doic THIS SUILOING OR SITE?
C) E3 LF 0 Natural 0 Central Utility IF Yes, GIVE NUMBER OF CONSTRUCTION
(3 09
0 00sor — Specify
IV. MWHANICAL I*UMANT TO N IN 14ATURE OF WORK
(F 90we complete list of compowInts 00 bed of this fetal "Ir Residential or 0 Commercial
13' ""t 13 Space 0 R000000,11 0 C40W 0 fIW 0 Now Building
*IuCoadd;omiag: E3 Room X,Existing Building
C) Dect Systems: Me% $!� Riplacement of existing system
maxismum capacity 0 Now installation(No System p#eVjoU$Iy InSt~
C3 0 Other— Specify
C) Cooling 100m: Capacity
(3 Fro WrinUors; Nuokbor of
13 Ellevotor 0 Monlift 0 Escelet" THO SPACI PC* Of I 1= US OWY
0 6 me,PUMPL— -
D (flumberl ROMA$
LP6W C0ft#6i%M- (mumber)
Uvfimd pressure, vesm
C) loan Permm* Appov*d Data_
d 0*W — SW* Permit on
Uffr ALL EQUIPMENT
AIR CONDMONI[NG AND REFRIGERATION EQUWh1ENT
Ptusnber Uuft me."Numbell! 111111111111111d'actow R�T
4
DEPARTMENT OF BUILDING
4443
CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO.
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
13 80
D t,__._._..AU9USt
Valuation S 71 ,270m64 Fee S 179-04
This permit not valid until above fee has been paid to City Treasurer, and is
subject to revocation for violation of applicable provisions of law. I
This is to certify that RJ113Z Ar7ip Const- Co.-
has permission tobuild__a_di*Lleir arecirding to plans Rijbinittad.
Residetial
Classification
Owned by— 678 BAL11Y Arzie Cmat, CO3 Salt Air Sect.#3
Lot BI Ir S/D
HouseNo- 165 & 167 Pine Strap-t
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
110. 0 Building material, rubbish and debris
Zfrom this work atust not be placed in
public space, and must be cleared up
and haxiled. away by either contractor
or owner. 179IU4 TL
179,04CKT11
Bill..�*71)avii!;A d/19/iiiJ
i i 4 Building oih��CAV")
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
SEWER
WAT
ER
FOR OFFICE USE ONLY
Date__.f:�X.3................19 EO
CITY OF ATLANTIC BEACH Permit *!��....Fee
Valuation $ .............
FLORIDA House #/
..............
.... ...........
.. . . ......
APPLICATION FOR BUILDING PERMIT
.....................
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlaniic Beach,Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that-a list of sub-contractors be submitted to this office so that licenses can
be verihed.
Date.... 19
7_1'�.....*----------------------------------------------------
Owner........ --------------------------- -----------............ Address-77064- fe - le
............ ��IAP �2 f.9--K-5 Z61
.................................I-------------------Telephone No.............................
Architect............................574fn-e...............................................Addres&...........................................................Telephone No...........................
..................
Contractor Builder----- S0910r7 a -- ---_----------------_Address............................................................Telephone No.......................
Lot No...-------4�.7.�K----_-------------------BI- ----------- --------5-----------_-------------....__Zone.................
-----------------------------
e,
-------------I----------------------------- S'17 0 e-
...........Street__.��_r......Side Between.. ....*------------- ......and.....................................................sts.
Valuation ---------For what purpose will building be ...........Type of construction..._!�rngo_
Dimensions of Building_��K_AS---_----------Dimensions of Lot--- ---------- a 7-0-------
............. -------_-------..Size of Footings.-/4 X
----------------*---------
Size of Piers.----___%------------------Size of Sills------......—-----------Greatest Sill Span in ft.---.---- ------------Type Roof............)514.4c_r
.........................
How will Building be Heated?--------41!5_11-lec- %f-,f-A-.--'
------------------- ---------------------_-----------Will Building be on Solid or Filled Ground?--------------------------........
Size ,of Ceiling Joists___.---------------------------------- Distance on Centers............-1------------I................. Greatest Span................I.........................
Size of Floor Joists--- -------------------- Distance on Centers. _Z IL ................ Greatest Span......./_7..............................
--------- ...------------- ......
Size of Rafters........ Distance on Centers.....,.. ...... ...........------ Greatest Span...........................................
---------------------------------
This rectangle is to represent the lot
Locate the building Or buildings in the
right position. Give distance in feet from
all lot-lines and existing buildings.
REAR LOT LINE
Two copies of plans and specifications shall
be submitted with application.
Inspections required.
1. When steel is in place and ready to pour footing. AU604 NO
2. When steel is in place and ready to pour columns and/or lintel. Z 7
1-4 .S Z
3. When steel is in place and ready to pour beam. ITY Of ATIART,IC BECH �1
4. When framing is completed. ,I,, D E-4
5. When rough plumbing is completed,-and ready to cover up. R r 3
6. When septic tank drain field or sewer is laid but before r
7. Electrical inspection by City of Jacksor.ville.
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called for 01 40
corrections are made. .A
C- 7
F qT OF LOT
75
y for
In consideration of pe for doing the w
�9* as described in th above statement, we hereby agree to perform said
work in accordance wi$thatta hed Aans an spdeifications, which are a part hereof, and in accordance wit the building
A
regulations of the City of nr e r
Signature of Builder------ ... . .............771, Address----*---71.0'._-.............. Xt
Signature of Owner........ .... ----- .. ..... Address..................................... An..a.................................
------ .... ------
CITY OF ATLANTIC BEACH
716 OCEAN BOULEVARD
AnANTIC BEACH, FLORIDA
ADDENDUM '10 BUITeDING PLAN
1. Building location:
2. The attached plan for the above building is, approved subject to meeting the following
applicable construciton requirenents:
a. Footings shall be continuous monolithic concrete under exterior walls, rein-forced
with two 5/8" deformed reinforcing rods for one-story buildings and three 5/8"
deformed reinforcing rods for two-story buildings. Reinforcing rods shall be
placed in. the lower one-third of the footings, properly placed and fastened on
metal cables with wire. Footings shall be six inches wider on each side than the
wall above, shall be at least &ight inches thick and shall rest on firm soil at
least twelve inches below undisturbed soil.
b. In hollow masonr
y unit constructicn, each unit cell shall be reinforced with at
lea t on No. 4 bar at aff—corners, poured and tanpea with concrete; such rein-
forcing shall be Properly tied into the footing and spandral beam.
c. All wood truss rafters (roof construciton) , shall be securely fastened to the
exterior walls with approved huxmicaneanchors or clips.
d. Construction of nearby onefamily dwellings, which are duplicates or intensely
similar, shall be avoided. Such similarity considers the external configuration
and appearance (i.e., roof, outer wall Traterials, window size and design, and
other like characteristics)_ of structures. in- accord with the foregoing, similar
or duplicate hcmes shall not be constructed within close proximity of each other,
and shall be at least 500 feet apart if any one similar dwelling is visible frcm
arrj other similar dwelling.
e. The final connection between the house plumbing and th&s service
connection (at the property line) m-ist be by fore being
covered.
?9
The undersigned hereby certifies that he has read the above and understands that this
addendun takes precedence over any contrary details to, the 4pand specifications
and agrees to ccnply with the intent of this addendum.
r
t
ractoor/Owner
70ate
DEPARTMENT OF BUILDING 4453
CITY OF ATLANTIC BEACH, FLORIDA PERM_
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date A119118t 19 19-8-0-
Valuation S P I—,,h ing-_ Fee$ 20.00
This permit not valid until above fee has been paid to City Treasurer, and is
subject to revocation for violation Of Applicable Provisions Of law.
This is to certify that Rnb Mitchell Plturbing Co.
has permission to)M80__JUst-,n1 1 7 sinks-4 laVatnrip-sq.2 batb tubs.4 c-lasetti
2 water heaters,2 dishwashers,2 dtsposals,2 washing machines.
Classificati ptgnidprltial ------zo
Owned b Billy Arzie Gonst. Co.
Lot 678 Block----------S/D Sla Air
House No 165 & 167 Rine StZeAt
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
0 Building material, rubbish and debris
7- from this work must not be placed in
public space, and must be cleared up
and hatiled away by either contractor
or owner.
T
Bill M, DAVis
Rilh,4 Ofib* 71
FOR OFFICE PERMIT I!197M
DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
SEWER
WATER
CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
Location
Firm
plumbing .1 ,
-master PluTber
City/County occupational License No.
State Certificate No.
Builder or Contractor
Type of Building_-�t'
ZL:!��
_,�9,SINKS SHOWERS
_��VATORY M= HEATEw
RATH UJBS DISHWASHERS
URINALS DISPOSALS
CLOMTS WASHING MACHINE
FLOOR DRAINS
OTHER
,;;:�o TUIAL FEMM COUNT
L
INSMLT-ATION OF PLUMBING AND FDMI;ES MUST BE IN ACCORDANCE WITH THE M1:)ST
RECENT EDITION OF THE SOLMEM SMMM PLUMBING CODE.
CM OF ATLANTIC BEACH
L DAY" WATER CONNECTION CHARGE
LOCAT)
OWNER
UMBING
WiSTER PLUMBERk_
BUILDER OR CONTRArircr'
TYPE 10 fiU_-;"l_BlNG_
BATHP40M -ROUP 0-UN-37STINC Of, Z')HDWEF� STALL, 104ESTIC' i'2 vni ts,
"WATER CLO"Z LAVATORY & BATNIIJ8 00
,/,;?o� �11014ERS GROUP PER HEA5 (3 t�Nvlt�k)
BATil"ma (WITH fill 411-YHOUT OVER
—WEAV, SHOWER) Quilfts) SURGEONS SINK 015 onftO
FLBHtNG RIM SINK (8wn`4�tsl
_._Cf*l3lNATl0N SIRr AND T�AY (3 uniti) SINX TkQ STANa (B units)
COPliBli"LATION SINP JAND TRAY WFOOD fll:Sn P T, SCALLER'i' SINK (4 uwlits�'
D�NTA,L UN11T OR V smits)
DENTAF'L LAVATORY (I u0t) URINAL, WALL UP '4 1,�-nftf"
DRINKING FOUNTAIN (h; unft) INAL STALL. WASNOUl (4 umitr-��
% -JR
'SHW ER (2 urifts) URINAL TROUGiR EACH ?-FT� SECTION
D! ASHE 4 _--2 vollts
FL60R CIIAINS (I twit)
Fn�"c'Ha4i sm (P. Units) .YASHING WCHINE RES, (3 unlW
WAS4 SINK EACH SET OF FAOCYT
'l,"K W/FaID WASTE GRINDER --2 us)its
,2jJ`G -.N
.1
0 Wilt.11)
2�JAVA7,60 (I unit) ZYATER CLOSETS, TANK OP (4 units)
WATER CLOSETS, 7ALVE* OP (8 arit-ts"
LAVATORY 1.) BARBEiR, BEAUTY PARLOR
LAUNDRY TRAf (2 witt,!s)
LAVAIFORY, SURGEONDS
0 � (2 units)
CITY OF ATLANTIC BEACH
APPLICATION FOR ToaTER. CUT-IN
APPLICATION IS HEREBY M%DE FOR�&' lVaTER CUT-IN AT
THE FOLLaJING ADDRESS FOR UNIT (S)
CUT-IN CHARGE OF_Z.IE:�.�
STREET NO.
SUBDIVISION e,
ACCOUNT NO.
NASTER PLUMBER
MAILING ADDRESS
DATE_Z-26)'-��
NETERNO LP-s DATE INSTALLED
CITY OF ATLANTIC BEACH
APPLICATION FOR TVaTER CUT-IN
APPLICATIM IS HEIMY MADE FOR WATER CUT-IN AT
THE 11OLLOWING, ADDRESS FOR 'UNIT (S)
CUT-T-N CHARGE OF gyOZ) 'Y—
STREET NO.
LOT j�z/ BLOCK. SUBDIVISION�
ACCOUNT NO.
YASTER PLLZMER.
MAILING ADDRESS
METER NO. DATE INSMLLED
J?e
CITY OF ATLANTIC BEACH
APPLICATION FOR SEM�R COW=IONS
ACODUNT NO.
DAM f-1,3-SO
IOCATION. /--4� 7
UYT NO. BLOCK NO.
OWNER
Z-; 2
TYPE OF BUILDU�_A
MASTER PIUMBER,
DATE
INSPECTED BY
CITY OF ATTANTIC BEACH
APPLICATION FOR SEWER COt0=IONS
ACCOUNT NO.
DATE
IOCATION_
LOT NO. BLOCK NO. SUBDIVISION
OWNER
TYPE OF BUILDING. eel�
MASTER PLUMBER
DATE
INSPECTED BY
SS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 09-00001109 Date 8/03/09
Property Address . . . . . . 165 PINE ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3500
----------------------------------------------------------------------------
Application desc
REMOVE AND REPLACE EXISTING ROOF FL10124 . 16
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
SAPIA, PETER WHITES ROOFING
1655 SELVA MARINA DR 14262 PLEASANT POINT LN
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . . REMOVE AND REROOF FL10124 . 16
Permit Fee . . . . 50 . 00 Plan Check Fee .00
Issue Date . . . . Valuation . . . . 3500
Expiration Date . . 1/30/10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50 . 00 50 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 50 . 00 50 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 * Fax: (904)247-5845
Job Address: 165 Pine St. Atlantic Bch, Fl. Permit Number:
Legal Description 165 Pine St. Atlantic Bch, Fl.
Valuation of Work(Replacement Cost)
• Class of Work(Circle one): New Addition Alteration �RppAk,_,. Move-,,
• Use of existing/proposed structure U�s) Circle one): Commercial , Residential',
• If an existing structure, is a fire sp i er system installed?(Circle one N/A
• Is approval of homeowner's association or other private entity required?(Circle one): Yes KNo)
Describe in detail the type of work to be performed:
Remove existing roof, install new roof. F L
Property Owner Information
Name: Peter Sapia Address: 1655 Selva Marina Dr.
City Atlantic Bch StateFl Zip 32233 Phone 612-4296
Contractor Information:
Name of Company: White' s Roofing Co. Inc. Qualifying Agent:Tim White
Address: 14262 Pleasant Pt Ln city Jax _Stak� zip
Office phone 2 2 0-5 5 4 6 Job Site/Contact T4umber
State Certification/Registration# CC C U 5 6 U 17 Office Fax# —=-5 5 4 6
Architect Name&Phone#
Engineer's Name&Phone#
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or
ififtallation has commencedprior to the issuance qfapermit and that all workwill be per/ormedto meet Me standards ofall
laws regulatigg construction*inthisjurisdiction. This permit becomes null and void ifrork is not commencedwithin six(6)
months, or if construction or work is suspended or abandonedjor a period 9f six (6), months at any time after work is
commenced I understand that sqparate permits must be securedfor Electri6al Work,Plumbing,Signs, Wells,Pools,
Furnaces,Boilers,Heaters, Tank andAir 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 certify that I have read and examined this application and know the same to be true and correct. 411provisions9f
laws and ordinances governing this type ofwork wX be complied with whether specified herein or not. The granting qfa
permit does not presume to give authority to violate or cancel the provision I s bf any other federal, state, or local law
regulating construction or Te
th_performance of construction.
Signature of Property Owner: 5- Signature of ConiTacto,,. \- A-r,
Sworn to and subscEibed before me Swom to and subscribed befo me
this Da 2_eo -3 , -.1
y of /A this -L Day of
NotaryPublic: �Lda',- n Notary Public:
DEBWE J.RITTER
;DR77-TIFE J.RiTrER
M ON cl� llr�i_��iON*DD498844
REVISED 03.05.07 'A W.�,CV,%C,SION*DD499944 I_S: Dec.12,2009
i'�__'. Dec.12,2009 (407)39""W, 71,-.,nda Nwn:y SwAce.00m
(407)39"153 aomn No"Aty swWoo.mm
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of V1 nT-i da County of r),]x761
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:
165 Pine St. Atlantic Bch, Fl.
Address of properly being improved:
165 Pineo St. Atlantic Beach,, ,Fl.
General description 6f improvements:
Remove existing roof, install new roof.
Owner Peter Sapia
Address 1655 Selva Marina Dr. Atlantic Bch, Fl.
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor White' s Roof ing Co. Inc. (Tim White)
Address 14262 Pleasant Point Ln Jax. Fl. 32225
PhoneNo. 904-220-5546 Fax No.
Surety (if any)
Address Amount of bond $
Phone 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
Phone 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 Statutes. (Fill in at Owner's option).
Name -
X Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a
rfiftrPint ristp iq Rnprifip(l).
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 09-0o0ollio Date 8/03/09
Property Address . . . . . . 167 PINE ST
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3500
----------------------------------------------------------------------------
Application desc
REMOVE AND REROOF FL 10124 . 16
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
SAPIA WHITES ROOFING
167 PINE STREET 14262 PLEASANT POINT LN
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . . REMOVE AND REROOF FL 10124 . 16
Permit Fee . . . . 50 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3500
Expiration Date . . 1/30/10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50 . 00 50 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 50 . 00 50 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BuILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 * Fax: (904)247-5845
Job Address: 167 Pine St. Atlantic Bch, Fl. Permit Number:
Legal Description 167 Pine St. Atlantic Bch, Fl.
Valuation of Work(Replacement Cost) $ C6.0
• Class of Work(Circle one): New Addition Alteration Re
. pair) Move--
• Use of existing/proposed structure(s Circle one): Commercia ��esidentia
• If an existing structure,is a fire spriMer system installed?(Circle one): Ve�- 0 N/A
• Is approval of homeowner's association or other private entity required?(Circle one): Yes �� O)
Describe in detail the type of work to be performed:
Remove existing roof, install new roof
Property Owner Information
Name: Peter Sapia Address:1655 Selva marina Dr.
City Atlantic Bch 19ate—ZiD 32233 Phone 612-4296
Contractor Information:
Name of Co pan�.White' s Roofing Co. Inc. ualifying Agent: Tim White
m -Q
Address:142 2 leasant Pt Ln Citv Jax State F 1 zip
220-5546
Office Phone Job Site/Contact P�umber 2 2 0-5 5 4 6
State Certification/Registration# CCC058017 Office Fax#
Architect Name&Phone#
Engineer's Name&Phone#
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or
installation has commencedprior to the issuance qfapermit and that all workwill be performed to meet Me standards ofqll
laws regulating construction in thisjurisdiction. This permit becomes null and void if"rk is not commencedwithin six(6)
months, or i
_f construction or work is suspended or abandonedjor a period 9f six (6), months at any time qfter work is
commenced- I understand that sqparate permits must be secuAedfor ElectrMal Work, Plumbing, Signs, Wells,Pools,
Furnaces,Boilers,Heaters, Tanh�andAir 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
INT`END TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
i hereby certif I
y that I have read and examined this appl'cation and know the same to be true and correct. Allprovisions9f
laws and ordinances governing this type of work wX be complied with whether specified herein or not. Thegrantin qfa
permit does not presume to give authority to violate or cancel the provisions bf any other federal, state, or loc'al law
regulating construction or the performance of construction.
Signature of Property Owneir� Signature of Co cto .
Sworn to and subscribed before me Swom to and b*r,*b3ed before me
this
__LDayof A
Notary Public:QXIA�
------ Notary Public:
4
RI L-R
RITTER r'R
0 DD49OW -C)D498844
REVISED 03.05.07 or 19
�DCC.12.2(a "(7
(407)39"163 12,2009
(407)3WIS2 A01da,4ovy sorvimom JY Sorv.ce.com
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. T,3x Folio No.
State of F1 nri tia County of I
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 be.ing improved:
167 Pine St. Atlantic Bch,, Fl.
Address of property being improved:
167 Pine St. Atlantic Beach, Fl.
General description 6f improvements:
Remove existing roof, install new roof
Owner Peter Sapia
Address 1655 Selva Marina Dr. Atlantic Bch, Fl.
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
lz(N�Contractor White' s Roofing Co. Inc. (Tim White)
Address 14262 Pleasant Point Ln *Jax. Fl. 32225
PhoneNo. 904-220-5546 Fax No.
Surety(if any)
Address Amount of bond $
Phone 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
Phone 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 Statutes. (Fill in at Owner's option).
Name . -
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a