314 12th Street IRR23-0022 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
HENDERSON ROBERT
WAYNE 2102 BEACH AVE ATLANTIC BEACH FL 32233-5514
COMPANY:ADDRESS:CITY:STATE:ZIP:
SIMS HICKORY CREEK
NURSERY 12615 IVYLENA ROAD JACKSONVILLE FL 32225
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171924 0000 SELVA MARINA UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
314 12TH ST IRRIGATION Irrigation $2500.00
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 UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is
needed, call 247-5878. State Law requires calling Sunshine 811 to have ALL public utilities located BEFORE beginning the work.
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: 10/4/2023
PERMIT NUMBER
IRR23-0022
ISSUED: 10/4/2023
EXPIRES: 4/1/2024
IRRIGATION PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $65.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $101.50
2 PUBLIC UTILITIES RPZ BACKFLOW INFORMATIONAL
Notes:
A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow
preventer must be tested by a certified tester and a copy of the results sent to Public Utilities.
3 PUBLIC UTILITIES SEE ATTACHMENT INFORMATIONAL
Notes:
Tester Form Required
2 of 2Issued Date: 10/4/2023
PERMIT NUMBER
IRR23-0022
ISSUED: 10/4/2023
EXPIRES: 4/1/2024
IRRIGATION PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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
Irrigation
314 12TH ST
SIMS HICKORY CREEK NURSERY
IRR23-0022
01--''' . IRRIGATION PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
9f City of Atlantic Beach PERMIT# .,-P--C-2 -CC22-
F,) Building Department
800 Seminole Road Atlantic Beach, FL 32233
on P)904-247-5800
SITE INFORMATION
C
ADDRESS 3\1' l Z- JT PROJECT VALUE 4 2 5oc
Contractor/Owner Irrigation Self Certification Checklist
Irrigation Standards: Please review all of the following standards prior to signing the certification section.
E High Volume irrigation, if used does not exceed 60%of landscape/pervious area
Example:Total lot area=5,500 sq.ft.; Impervious area=2,200 sq.ft.;Total landscape/pervious area=5,500-2,200=
3,300 sq.ft.; Maximum High Volume Irrigation=3,300 x 60%= 1,980 sq.ft.
For lawns and turf areas that exceed 50%of the total landscape area of the lot, low volume irrigation may be used as
needed.
At least one(1)moisture sensor shall be located in each irrigation zone.
Emitters shall be sized and spaced to avoid excessive overspray on to impervious surfaces.
A hydrozone plan must be submitted that indicate areas to be irrigated and shows low, moderate and high water use areas.
Plans may be prepared by property owners or contractors on a copy of the survey or a site plan.
RPZ backflow preventer must be installed for all irrigation systems. Backflow preventers must be tested by a certified tester
and results sent to Public Utilities.
Irrigation system shall be installed according to Section 24-178.
Permit becomes void if work does not commence within a six(6) month period or work is suspended or abandoned for six(6)
Imonths. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and
ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate
the provisions of any other state or local law regulation construction or the performance of construction.
OWNER INFORMATION
OWNER NAME V-0\ 51 \"n
l PHONE# (go) 231 • c (Z3
COMPANY \LY.-D Y C Z._\L i,\,\3Q..5.N2.y OFFICE# ( b4 771 ' Plc OS
COMPANY ADDRESS i 2J. 1 t= \\) L. ..----‘•.1 f\ ' ) . FAX# 1N1 ( P1
CITY JV\CE--S043vk1, Lt STATE\ L ZIP CODE 37-22.5 EMAIL W(.1Cpric ceekr1u`CSe('\
LICENSE HOLDER -1—\24.0V \1' \ STATE CERT/REGISTRATION#
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SIGNATURE OF LI NSE HOLDER PRINT R TYPE] NAME DATE
Signed and sworn before me on this )61 ft
day of ills "Y1be9'- r Q2 by State of Flo r )(LCt
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Oath Sworn: L`J Yes No LORI A.MCELHANEY e Z
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otary Signature
r,:= Expires December 14,2024
F t,f 0' Bonded TMu Troy Fain Insurance 800-305101!
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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