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1600 Selva Marina Dr MECH23-0010 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP: ATLANTIC BEACH COUNTRY CLUB INC 1600 SELVA MARINA DR ATLANTIC BEACH FL 32233 COMPANY:ADDRESS:CITY:STATE:ZIP: COASTAL UTILITY CONSTRUCTORS 821 Mamie Rd JACKSONVILLE FL 32205 TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 172000 0010 SELVA MARINA UNIT 05 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 1600 SELVA MARINA DR MECHANICAL COMMERCIAL SEPARATE PLANS OTHER Underground Fire Main - Phase 1 Main Clubhouse & Fitness $22000.00 LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC UTILITIES FIRE SPRINKLER BACKFLOW REQUIREMENT INFORMATIONAL Notes: If fire sprinkler system is provided, call 247-5878 for backflow requirements. At a minimum, will require a double check backflow preventer. Backflow preventer must be tested by a City of Atlantic Beach Approved certified tester and a copy of the results sent to Public Utilities. Tester form is attached to the permit 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 3Issued Date: 9/27/2023 PERMIT NUMBER MECH23-0010 ISSUED: 9/27/2023 EXPIRES: 3/25/2024 MECHANICAL COMMERCIAL SEPARATE PLANS PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $200.00 2 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL Notes: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (904-247- 5814) to request an Erosion and Sediment Control Inspection prior to start of construction. 3 PUBLIC WORKS DUMPSTERS/ROLL-OFF CONTAINERS INFORMATIONAL Notes: Dumpsters and roll-off containers must be used in compliance with Section 16-8 and must comply with all standards, per City code. 4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration, including sod, is required. 5 PUBLIC WORKS UTILITY ROAD CUT INFORMATIONAL Notes: Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10 feet in each direction from the center of the cut. Repair must be shown on the plans.\r\r\r\r\r\r\r\r 6 PUBLIC WORKS CONSTRUCTION SITE MANAGEMENT INFORMATIONAL Notes: Provide construction site management plan, including location of silt fence, dumpster, portable toilet. Right-of-Way Permit is required if using right-of- way for construction parking. 7 PUBLIC WORKS GRASS INFORMATIONAL Notes: Full site to be grassed. 8 PUBLIC WORKS REVISION INFORMATIONAL Notes: Any plan change must be submitted as a Revision to the Building Department. 9 PUBLIC WORKS DEBRIS REMOVED INFORMATIONAL Notes: All construction debris must be removed from job site by Contractor. 10 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL Notes: Any damage done to infrastructure must be repaired by Contractor. 11 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL Notes: Provide GIS information at completion of project. Email to: dmartin@coab.us 2 of 3Issued Date: 9/27/2023 PERMIT NUMBER MECH23-0010 ISSUED: 9/27/2023 EXPIRES: 3/25/2024 MECHANICAL COMMERCIAL SEPARATE PLANS PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD FIRE DEPARTMENT FEE 45500002080800 0 $160.00 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.83 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.55 TOTAL: $421.38 3 of 3Issued Date: 9/27/2023 PERMIT NUMBER MECH23-0010 ISSUED: 9/27/2023 EXPIRES: 3/25/2024 MECHANICAL COMMERCIAL SEPARATE PLANS PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD MECH23-0010 Pipe DR 18 pvc CL150Min Burial 36in pavement, 30in non pavementRiser 1'-0"AFFFDC to have Signage 1600 Selva Marina DR 322336inch 4inch 4inch City of Atlantic Beach—BACKFLOW PREVENTION ASSEMBLY TEST REPORT 902 Assisi Lane Jacksonville, Florida 32233 Phone: 904-247-5886 Name of Premises: _____________________________________________ Account No: ____________________________ Service Address: _______________________________________________________________________________________ Mailing Address (If Different): ____________________________________________________________________________ Contact Person: ________________________________________ Phone Number: __________________________________ Type of Service: Process Fire Domestic Irrigation Other: ________________ Type of Assembly: ___________________________________ Manufacturer: _____________________________________ Model: ____________________________________________ Serial No: _________________________________________ Size: ______________________________________________ Location: _________________________________________ Gauge Manuf: _________________________Serial No: ________________________ Date Calibrated/Verified: _____________ Remarks: ______________________________________________________________________________________ I certify that the data in this report is accurate. Tester Name (print) : _______________________________________ Date: ________________________________ Tester Signature: __________________________________________ Phone: _______________________________ Affiliation: ________________________________________________Cert No.: ______________________________ Tester Company: __________________________________________ Address:______________________________ THIS ASSEMBLY PASSED FAILED Email completed form to Ebrown@coab.us/jdsmith@coab.us Initial Repairs Final Check Valve #1 Check Valve #2 Relief Valve PVB or SVB Closed tight at __________ PSI Leaked Closed tight at ___________PSI Leaked Opened at __________PSI Did Not open Air inlet opened at _________ PSI Did not open Check Valve Held at _________PSI Leaked Cleaned only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Cleaned Only Replaced: Rubber Kit CV Assembly Disc O-Rings Seat Spring Stem/Guide Retainer Lock Nuts Other, Describe Closed tight at ___________PSI Closed tight at ___________PSI Opened at _____PSI Air Inlet ______________PSI Check Valve _____________PSI