Beach Ave 578 CITY OF
4&4*dW Be4CA-99&%d* 4
Office of Building Official
REQUEST FOR INSPECTION
�,) Vk0
Date 0 Permit N
Time A.M,
Received RM.
OIL--
Locality
Job Add)ess
Owner's
Name Contractor —
BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL
Framing Footing F-I Rough Wiring [7, Rough Air Cond. &
Re Roofing Stab F-11 Temp Pole r-, Top Out C Heating
Insulation Lintel Final E Sewer D Fire Place r-
Pre Fab
READY FOR INSPECTION
A.M.
Mon. Wed. Th rs Friday
uY
A.M.
Inspection Made --PM.
Insp or- Final
Certificate of Occupancy F�,
Date
CITY OF
4&4046 13"-494114 d- 4
Office of Building Official
REQUEST FOR INSPECTIO
Date Permit N
Time A.M.
Received P M
---------------
Job Add es Locality
Owner's
e Contractor
BUI CONCRETE ELECTRICAL PWMEIING MECHANICAL
Framing 11 Footing 1-1 Rough Wiring D Rough E Air Cond. & F�
Re Rooting 0 Stab 11 Temp Pole Fj Top Out 0 Heating
Insulation Ell Lintel Final E Sewer 0 Fire Place [3
Pre Fab
READY FOR INSPECTION
A.K
Mon. T.0e.. Wed. Thurs. Friday PW
A.M.
—P.M.
Inspection Made Final lnspect�<
Inspector—
Certificate of cc.p cy E,
Date
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLAMTJC S"CK MORIDA 32133
APPLICATION FOA MECHANICAL PERMIT ---U—LwNNumsER
IM ORTANT—Applicant to Complete ali items in sections 1, 11, 111, and IV.
LOCATION street Add;.'..:_19 I e-A T—
OF lmfltsfcfihg
l!��' L And
BUILDIN
IDENTIFICATION—To be completed by.all applicants.
LIn co"sidoration Of permit given for doing the-ark as doscri6od in the sbo�e statement.0 hereby agree to Perform aid ark in acco-rd.,
with the attschpd plans and 'Pecificatiaris�hich 6,0 part hersof and in -cco,danc. witi, the c;t I j
Of 900d,praofica listed therein. V ackso-lille Ordinances and standards
CN..fflo Of meehanlesil CO I'mcf.rs
alreator I Print) ft
Master
A" CA t" t'�qCj
Name of
Property Owner ke T 14 F
slinatwre of d5mos,
or Authorized Agent signafvr*:'F
Architect
INFO
A. Type of hoolinq fee
IS OTHER CONSTRUCTION BEING DOME ON
TH13 BUILDING OR SITEI A.)C,
C Gas Nehiral 13 Central Utility
oil If YES, GIVE NUMBER OF CONSTRUCTION
PERMIT
[3 Olhor Specify
IV. 11101111CHANICAL IQUIPMIKT TO AN INSTALUED NATURE OF WORK
(Provide,commilloto list of compoftepth an bad of this laml Residential or 0 Commercial
Heat Space 0 Recessed Central a Pow Now Building
Air Co"111fiftimo: 13 Room C Control Existing Building
Dwe I syrissm: Material nkkx*K— Replacement of existing system
malifflVni capacity Now Installation(No system previously Installed)
Reithroretion C3 Extension or add-on to existing system
Other—Specify Qe�(,t
Coollog lo of capacity 94LM
C) Fire sprinklers: Number of heads
Elow, k4amillt C3 Esscalaslor
THIS SPACE POR OFFICE USE ONLY
C3 Sassoum*PgRIPIL.—inkir"b")
0.Ta*il._(nvmb*r) Remarks
0 LPG Contai"WL--ing-baw)
[3 Unfired prossift"Not
win" Pormii Appe!vod Do
Othes,—-specify Fatnitit NC-1
LIST ALL EQUIPMENT
AIR CONDITION)ING AND REFRICERATION EQUIPML14T
C& t
(=)Y
NUMber'Unitm Deacept.1on Modlel Number Manufacturer A41MW
HEATMG-FURNACES, BOILERS, 111IREFILACES
Number Unit& Capacity Ana-hW
1310"ription XO"Number Manufacturer (BTty) ASMAy
A(Q- HNIIJ�Xr-T T V,P_i�'3; _'UAN e_
Z' 0
'�Z
TANKS
POW Many Nowbal capacity TM L4qW4 Name of Serial AA.—vin--
and DiOUVAlOUS 0ontainad xamdactww No. P=
CITY OF ATLANTIC BEACH
MECHANICAL PERMIT
800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877
LOCATION INFORMATION
Permit Number: 23213 Address: 1972 BEACHSIDE COURT
Permit Type: MECHANICAL ATLANTIC BEACH, FLORIDA 32233
Class of Work: ALTERATION Township: 0 Range: 0 Book:
Proposed Use: SINGLE FAMILY Lot(s):22 Block: 1 Section: 0
Subdivision: BEACHSIDE
Square Feet:
Est. Value: Parcel Number:
Improv. Cost:
MATI N__��.
Date Issued: 12/27/2001 Name: KENT HAINES
Total Fees: 25.00 Address: 1972 BEACHSIDE COURT
Amount Paid: 25.00 ATLANTIC BEACH, FLORIDA 32233
Pn0% 39
lion G ,� -8654
I L Date Paid: 12/27/2001
349
g,
Work Desc: REPLACE AIR
ON FEES
C N
25.00
OCEAN STATE HEAT&Al . �F ,
4
_MR
P
_k
�Vl
f
S"
i ZV'l-1_11�-'�_'_,-,
.......... ......
FINAL
f
T-24 H0, UR$
NOTICE- I REQUESTED AT-LEAS .0RIOR TO 10,APECTION
WORKMUSWT
HAND p�, CEQAN PUBLIC SPACE,AND
BUILDING MATERIAL, RijtBIS 11S,
CONTRAC
ED N E T_H
Q NER
MUST BE CLEARED UP ANbf�L I ' ER gidw
AESULT IN THE
"FAILURE TO COMPLY W&k.'THE N 1 vo
T"� TS11
PROPERTY OWNER PAYING
ISSUED ACCORDINGTO APPROVED PLANS WHIC THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
ATLANTIC BEACH BUILDING DEPT. Date; 12/jefial $a.@@ 14
at: MR67
111118111111113221IN 16903
BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT
CITY OF ATLANTIC BEACH, FLORIDA
CERTIFICATE OF OCCUPANCY
WORK SHEET
Date Requested:
Building Contractor:
Building Permit Number:
Address: ot
Legal Description: OL
Improvements to the above described property have been comple
in accordance with the ter:,, o he permit and is certified to
ready for occupancy as
------- ------ ------
Lowest Floor Elevation: ---------- ---
required as built n/a
Sales Tax Certificate: L---�-
------- --------
date submitted
BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE
DEPARTMENT DATE NOTIFIED: DATE APPROVED: BY:
Fire Chief
Public Works
Planning Director ---------------- ---------------
Building Inspector ---------------
ADDRESS -----------
BUILDING PERMIT #--- -3---------
INSPECTIONS FOOTING--- _2 INSULATION------------
SLAB------/-o� STEEL-----------------
FRAMING--- FIRE------------------
FINAL BUILD----------
C/o------------------
ELECTRICAL PERMIT
INSPECTIONS ROUGH---
FINAL----------------
PRELIMINARY SENT TO
FINAL SENT TO JEA--------------------
CALL TO JEA--------------------------
MECHANICAL PERMIT f--- - ---------
INSPECTION ROUGH-- Z-Z/
PLUMBING PERMIT #...... --------
INSPECTIONS UNDER SLAB__-.L_-
ROUGH_ �"- / "'� Cl
- 4 -V4&-4
SEWER---------------
PUBLIC WORKS--------
JOB ADDRESS
PROPERTY OWNER
PEJMTNUMBER DATE
INSPECTIONS. FOOTING
SLAB
TIE BEAM
LIATEL
NAILIIVGISHEATII17VG Va4-t-VZZtFi-�
FRAMiNGICOVER UP
VVSULATION
FVVAL BUlLDLVG
CERTIFICATE OF OCCUPANCY
ELECTRIC,4L PERMIT0
EVSPECTIONS ROUGH
FINAL
MECHANICAL PERMIT0
XSPECTIONS ROUGH
FINAL
PL UMB17VG PERMIT#
17VSPEC77ONS ROUGHIVNVER SLAB
TOPOUT
WATE"EWER
F17VAL
NOTES:
CITY OF ATLANTIC BEACH 09-
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
001 -5826*FAX NO.:(904)247-5945
OFFICE:(904)247
BUILDING-DEPTQCOAB-US TY
F11 DUVAL COUN
BUILDING PERMIT APPLICATION
2..VALUATIOW Sa.FT.UNDER RQOF'-'��'!-',
B-AD
LcL- TRUCTURE,
6;USE.OF S
77774��
LA
LEGALDESCRIPTI &C
ON
Ll NEW BUILDING 13 DEMOLITION EFRIESIDENTIAL
LOT BLOCK SUB DIVISION 13 ADDITION 13 CONVERTING USE 0 COMMERCIAL
8
: � ,!.' �FIRE SPRINKLER��'.
P 11 ALTERATION 13 ACCESSORY BLDG.
'TION 49 f gOtf-1 4_ E01REPAIR 0 POOL/SPA [3 YES 13 WA
Q MOVE E)OTHER
ARCHITECT I ENGlNEER'i'r-',,'
CONTR
PROPERTY OWNEK:r" AcToRiv?,""'
9.NAME:,/,.,_ 16.COMPA MAIIE: 23.COMPANY NAME:
eS
q
evz
'0 e"'A S I&NAME 24.LICENSEE NAMt:
4re,-,,ol-e 4 114, r/, e-e-t--s
10,ADDRESS: 17.STA-fE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.;
is e-,k c if�- / 2s,.z-- 3 V, 2
I C- 'eT IB.ADDRESS:A7&._l 26.ADDRESS:
27.OFFICE PHONE: 28.FAX NO.:
11.OFFICE PHONE: 12.FAX NO.- 19.OFFICE PHONE: 120.FAX NO.: 9 S'2(o
19191y _r
Y-5-Y149 Z111101
13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE,
S Zr- 4""& -'7'r
22. 30.EMAIL ADDRESS:
14.EMAIL ADDRESS: E AIL DRESS:
ENDER-.'
FEE SlIAPILE31TI.E."OLPIE
P P.
�IB
31.NAME: 33.NAME: 35.NAME:
32.ADDRESS: 34.ADDRESS: 36.ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or
abandoned for a period of six(6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNEWS AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof,until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
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.
or"AGENT' C.ONTRACTOR'
R
(Qualifier Only),
nt, Agency Lefler Require
if kie d
Signed r\—. Data: Signed�-40ZO e6� Date:(q 0--
V—
Before h-mis day of 2009 in the county of Before nife:�`this 'd�� day of KU C-L.%-&T- ,2009 in the county of
Duval,State of Florida,has personally appeared Duval,State,of Florida,has personally appeared
A S-S
henn by himselfl herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate.
Notary Public at Large,State ofFLoe-t PA,County of -b\.k\/A L Notary Public at Large,State of C'�-O iLkQ4 ,County of_.-Z%-&V A L-
0 Personally Known 0 Personally Known
IT00roduced Identificatio EWP.duced Identificabon- 4E�)2S So*�I- Leo 'I("-I-
Notary Signature: 11 'A012c,64 ):�)�&—INotary Signature: I&tAq6.— &AIVINVo!_0
F- - —
SU ANSPEAKSGORMAN
'*41 My COMMISSION#DD643668 SUSAN SPEAKS GORMAN
Or WIRES:Febmry25,2011 wi Lb'&A'l;'111101i f�Dwyw&
%OFfl'� Fl,Nomry Discount Assoc.Co
EXPIRES:February 25,2011
BLDG01 Permit Applica y Fl�N4*)y Disowtit Amoc.Co.