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860 Begonia St r CITY OF ATLANTIC BEACH F' ELECTRICAL PERMIT APPLICATION Date: -� Property Address: Ix cd n('A 57J�L&-7- Owner: Mpovl- [)eV. Telephone #: Contractor: KV'Awr aLic- 1Z LLC_ Telephone#: 277-00 Contractor Address: 02 (Av4-( 0 U j. Fax#: 2? -671-7 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 attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Building: Building Type: ❑ Trailer Service: If other construction is ❑ New ❑ Residence 31--Temp. ❑ New being done on this building ❑ Old L3 Commercial 13Si ns ❑ Increase Or site,list the building Signs P it n ber: Ll Re-wire ❑ Addition Sq.Ft. ❑ Repair - UC047,20 Conductor Size: AMPS: COPPER ALUMINUM Switch or 2`% RACE l /� Breaker AMPS PH W VOLT j10 WAY Existing Service RACE Size AMPS PH W VOLT WAY Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Receptacles CONCEALED OPEN 0 10 AMPS 31 100 AMPS Switches Incandescent Fluorescent & M.V. Fixed 0.100 AMPS OVER BELL Appliances TRANSFER. Air H.P.RATING H.P.RATING CEILING KW-HEAT Conditioning COMP. MOTOR OTHER MOTORS AMPS HEAT Motors 0-1 H.P. VOLTAGE PH NO. OVER 1 H.P. PHS LNDER600V OVER600V Transformers NO. KVA NO. KVA No.Neon_Transf. Ea._Sign Miscellaneous C�?1 Wle, 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800. Fax: (904)247-5845 • http://www.ci.atiantic-beach.fl.us X It CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . 04-00027965 Date 3/24/04 Property Address . . . . . . 860 BEGONIA ST Tenant nbr, name . . . . . . TEMP POLE Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------ --- -- - --------- --------- - ----- KNIGHT ELECTRIC LLC 172 CANAL BOULEVARD PONTE VEDRA FL 32082 (904) 273-6969 ---------------------- ------------ ------------- ----------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- - - -------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 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 COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS WHICH PART OF THIS PERMIT S JECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. BUILDING OFFICIAL CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION r) J Date: AD r`r �� �'`• Property Address: C' nid Owner: A l;r'©0'V _ Telephone#: 2-;t Contractor: (/��i'SZ�' '��'c'� ' Telephone#: Contractor Address: 'Fax#: 45-3 6 -1 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 attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type• /New If other construction is being done on this building or site, list the building ermit number: ❑ Re-Pipe Number of Fixtures: _2 Bath Tubs Showers Closets Shower Pans Dishwashers �_ Sinks Disposals Urinals Floor Drains �^ Washing Machine Lavatory �� Water Sewer _� Water Heaters Other Fees Permit Issuing Fee: $35.00 Total Fixtures: d,, X $7.00 + $35.00 = 800 Seminole Road. Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800. Fax: (904)247-5845. http://www.ci.atiantic-beach.fl.us CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 4t!'?j31r� Application Number . . . . . 03-00026720 Date 4/19/04 Property Address . . . . . . 860 BEGONIA ST Tenant nbr, name . . . . . . NEW SFR 1191 RAD/1427SCHG Application description . . . SINGLE FAMILY RESIDENCE Property Zoning . . . . . . TO BE UPDATED Application valuation . . . . 115000 Owner Contractor ---------------------- -- -------------------- ---- MAYPORT DEVELOPMENT H,H, & A CONSTRUCTION 645 MAYPORT ROAD #3A NEPTUNE BEACH FL 32266 ATLANTIC BEACH FL 32233 (904) 241-0474 (904) 241-4619 --------- ----------------------------------------------------- -------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Sub Contractor . . CHRIS FRAZE & SONS Permit Fee . . . . 119 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 -------------------------------------------------------------- -------------- Special Notes and Comments 12 FIXTURES NEW SERVICE Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 119 . 00 119 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 119 . 00 119 . 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 COMPLY 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. W' DING OFFICIAL CITY OF ATLANTIC BEACH r' MECHANICAL PERMIT APPLICATION Date: Property Address: 8 6 b Owner: CI&2 S ?—, Telephone #: Contractor: Telephone #: 2 -w Contra A51dr ss: Fax#: 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 attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of good practice listed therein. Type of Heating Fuel: If other construction is being done on this building or site,list the building permit number: lectric ❑ Gas: _LP Natural _Central Utility ❑ Oil U 2� Zn ❑ Other—'Specify MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK Heat _Space _Recessed l<Central _Floor Residential Conditioning: _Ro _ Central � 11 Duct System: Material ickness�Z El Commercial Maximum capacity 2 ,6 A...._Cfin ❑ RefrigerationNew Building ❑ Cooling Tower: Capacity gpm ❑ Existing Building ❑ Fire Sprinklers:Number of Heads ❑ Elevator: __ Manlift Escalator (Number) ❑ Replacement of Existing System ❑ Gasoline Pumps (Number) ❑ Tanks (Number) ❑ New Installation ❑ LPG Containers (Number) (No system previously installed) ❑ Unfired Pressure Vessel ❑ Extension or Add-on to Existing System ❑ Boilers ❑ Gas Piping ❑ Other-Specify, ❑ Other—Specify LIST ALL EQUIPMENT AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving umber Units Description Model# Manufacturer Ton's Agency CAA -C) C v HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving Number Units Description Model# Manufacturer BTU's Agency ivtn /t - 5 6 - 6 TANKS Nominal Capacity Type Liquid Serial Approving How Many &Dimensions Contained Manufacturer No. Agency 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845 • http://www.ci.atiantic-beach.fl.us CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD �] ATLANTIC BEACH, FLORIDA 32233 a ^ °°' ` INSPECTION PHONE LINE 247-5826 -irAll Application Number . . . . . 03-00026720 Date 5/28/04 Property Address . . . . . . 860 BEGONIA ST Tenant nbr, name . . . . . . NEW SFR 1191 RAD/1427SCHG Application description . . . SINGLE FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 115000 Owner Contractor ------------------------ ------------------ ------ MAYPORT DEVELOPMENT H,H, & A CONSTRUCTION 645 MAYPORT ROAD #3A NEPTUNE BEACH FL 32266 ATLANTIC BEACH FL 32233 (904) 241-0474 (904) 241-4619 --------------------------------------------------- ---------- --------------- Permit . . . . . . MECHANICAL PERMIT Additional desc INSTALL NEW HVAC Sub Contractor H & H HEATING & A/C INC Permit Fee . . . . 79 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 ----------------- --------------------------------------------- -------------- Special Notes and Comments 12 FIXTURES NEW SERVICE 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 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Im DING OFFICIAL p CITY OF ATLANTIC BEACH ELECTRICAL .PERMIT APPLICATION., ; _d4 _- Propirm. Address: la . Owner: ✓G�0 J'�d'1 - Telephone ri: Contractor: Telephone*•104'r1 71y Contractor Address: �y/Q � ax • �Q�(• 7-�j� ncun'sidauidn of ptnnit tpven kW;ming rhe wa^t a described rn the abve Sw�CZt wn ne"e ;mer w gnaw», .end »:vk,,;+ arwtdsnw with tht attached plwrs eras spwitiQtiotis which are n purt hermit and in tw.tmt;tnt;e ..'+th he t:it% -v Atimlil. Ac3c,•, ordinangx and%ugulards 0(goml DWim listed therein a Trailer �ervlc ' ,.rhw ,..neunIre te,na.h.+. �n.h,i tu.rd„y Q( New ! Residence :] Temp iii New I ,,y yNe•I,w t!e tWllJtnt :J Old j CammerLut! 7 sisr:s lncrwse r i u Rewire Lt Addittoln it. _ _ i u Repair cmWwor Sint AMP_S»�~ _ *`OPPFR RACF `i3rwkor AMPS PH a - K alt Existing Serv:ce� _.».__.- Sipe i AMPS PH U, VOLT WAN' Feeders SIZE i NU SIZEyU SIZE. Lighting Uuttett CONCEALED _ OPE' �.._.. .... Rc,r tacles CONCEALED r UA�� ,,.,_.�,._T... 'tJ-ton s►If� _ .`.--._..�»..._.......__r_�.,.,...._._ --- ' switches _ rincandescertt� ----•. . _.._.......�..__.�-....� _.� ��_.�,.___�_�� -.._.,,,.,.._�.�Y.�,._•_,;, ._-. .... .. ,. ... �-,,. _......_.._ ,._r—.....►,....._._ -_. _. _...r,- ..,�._ Fluorescent a ; Fixed 9A MrsHF_I,t. Appliances t M 1 .____� TRANSFER: pl! - �ir K.P.itAYt`G ll.P. RATI�`G ' t'F11 144( ��'.W,H. ` K�A'.N�.4Y Cu� rrditwninx CC)1tP. !VIA'IOIt OTHER MOTORS ASIPS HFAT i tutors ,—15-11— % ! VOL �^PH NO yE.R 1 N P ! PH'S Transformers- _ i NO. KVA ti0. KtA� _H ;a.D%WCk 7ran sf. Ea. _..,.__...__.__- - -•- Soil Seminok Reed•Atisntic Bosch, Plorids 32233-.5445 ►Rosa:(9taN)2d7•Si0@• Fart: (!61)2.17-Sif4S• Irttp:!'.rwr.clatiaratic•t,.oarb.il.rs ylf��f J, CITY OF ATLANTIC BEACH ssz -� ► 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 ten% INSPECTION PHONE LINE 247-5826 l:r lilt Application Number . . . . . 03-00026720 Date 6/10/04 Property Address . . . . . . 860 BEGONIA ST Tenant nbr, name . . . NEW SFR 1191 RAD/1427SCHG Application description . . . SINGLE FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 115000 Owner Contractor ------------------------ ------------------- ----- MAYPORT DEVELOPMENT H,H, & A CONSTRUCTION 645 MAYPORT ROAD #3A NEPTUNE BEACH FL 32266 ATLANTIC BEACH FL 32233 (904) 241-0474 (904) 241-4619 ---------------------------------------------- ---------------- -------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc 200AMP, 1PH, 3W, 220V, 2 "RACE Sub Contractor KNIGHT ELECTRIC LLC Permit Fee . . . . 105 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 ----------------------------------------- -------------------- --------------- Special Notes and Comments 12 FIXTURES NEW SERVICE Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- - --------- Permit Fee Total 105 . 00 105 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 105 . 00 105 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING COD (, BUILDING OFFICIAL Knight Electric, LLC 908 11t' Ave South Jacksonville Beach, Fl 32250 � ER#13012523 904-247-9884 Fx: 904-247-9843 August 23,2004 City of Atlantic Beach 800 Seminole Road Atlantic Beach,FL 32233 Knight Electric,LLC will hold the City of Atlantic Beach harmless for early power to 860 Begonia, Lot 2, Atlantic Beach. Please call our office if you have any questions regarding this matter. Steve Knight Its: President Appearing before me on this _day ot'-A—L,. , 2004, the above signed is personally known to me. p 1 pv� otary Publ>c "Y. Janet,In,.,Young • Vic.. .: ... _, 33603 '07,2008 Tbru APPROVED CITY OF ATLANTIC BEACH BUILDING OFFICE AUG 2VO4 012 r, H H & A CONSTRUCTION, INC. 645 Mayport Road,Suite 3A Atlantic Beach,FL 32233 904.241.4619•fax 241.8111 hhaconstruction@bellsouth.net September 9, 2004 Building Department City of Atlantic Beach 800 Seminole Road Atlantic Beach FL 32233 Attention: Don Ford Due to Charlie & Frances it's been impossible to obtain sod for our completed house at 860 Begonia Street. HH&A Construction hereby confirms that the appropriate amount of sod will be delivered and installed on or before the 24th day of September 2004. We understand the city will issue a CO based on this commitment. S' e ly, Bob Alligood President PERMIT WORKSHEET Certificate of Occupancy d Job Address: S(40 Type Work: 77S F-R- Property Owner: Dca Phone # Contractor: Phone # LVe (9 Permit#: 03 2!a-1 Date Issued: Building Inspections: Footing M,a•c t% Slab Tie Beam Lintel Nailing / Sheathing Framing / Cover Up L1. -7.0L_ Insulation G-z -p Final Building Tree Permit# ( ES NO Electrical Permit# Date/ Copy to 03- Z i.7 Zo JEA Co Io-'C)4 Temp, Pole Permit# Date/ Copy to 0,'-1 - a 7`l&S JEA Temp. Power Letter Received: YES NO Inspections: Rough Electric -1 0-11 Released to JEA Temp. Power Released to JEA Temp. Pole Released to JEA Final - Released to JEA Mechanical Permit# ? Inspections: Rough Final r q - }p bL4 Plumbing Permit# F63 - aki l d Inspections: Rough / Underslab Topout b 1J0 Water/Sewer Finale ID�p Drainage Inspection: Pool Permit# Inspections: Steel Final Grounding Final Roofing Permit# Inspections: Nailing /Sheathing Final Fire Inspection: Faile lnspections: Date Paid: Date Paid: WORTANT: In hese spaces,copy I*carraslioncllnq Itfonrnallon from Semon A L 14 DNG STREET ADDRESS g Apt.,Lbt Su,err t ft.No.)OR P.O.ROUTE APD BDX ND. kfih� 860 BEGONIA STREET "' t CITY STATE ZPCC)DE . ATI.ANTI(,BE" FL 32233 SECTION D-SURVEYOR,EN13NMg OR ARCHITECT CERTWATION(CONTINUED) Copy batt sides of fie Bweliion CerfrT mb for(1)=mu *otUctiai,(2)nuance agedlcornpany,and(3)hA tg owner, COMMENTS ❑Check how I afteohrrnertts SECTION E-BALDING ELEVATION HRM%TION(SURVEY NOT RE( URED)FOR ZONE AO AND ZONE A(14MTHOUT ME) Fa Zane AO and Zone A(mlWBFE),cattpteb Nems E1 ttrotrgh E4. Nto Swaim Cadcal s is ibrKled for use as sLgv tg kiw afon for a LOMA or LOMRf, Sec1m C mugtbeoanpleted Et.Buidrtg Oiagem Nurlber�Seled 1te bticfg diagram most simTar b tie bttilrirng for whidt Itis certificate's being carrpleted-see pages 6 and 7. i t no cfagam aaotgatety represents MebAft pv^t a dwich aowbgraph-) F2 The bP dite bolbm toot Odud rg basernierit or andosrr+e)d the baiting is _ft(rnn)_n.fio)p above or p below(c w*are)the hqnest adjacent gale.(Use natural glade,i amiable). E3.For BtAft Di gwns 6$wifr aperwgs(see page 71 the rad how Hoa ar eteraled Hoar(etevaton b)dire buitdnng is _tt(m)_in.(cm)above the ltigheetacJjaaernt Bade. Cmrpleie dents C3.h and C3i cnit d d tam. E4.The nP dtte plalhm dmadmeny ar dbr eq*ff*vtt seruidrg fn bttikl V is _itM,n.(cm)p above or p below(dteck one)the highest arijacentgada. (Use ns"al gale,i airadebte)_ E5.Far Zorn AO ori: N no food depM mntw is a mifft is fie tap d fie bollom tour elevated in aoeordmce wilt 1te cmv undy s loocipiairt rrrwmgenr ent ordnance? [:]Yes p No p Untimonurn. The iocalollaalmustpm*#tis idlfmrmim m Sec im O SECTION F-PROPERTY OWNER(OR OWNER'S SENTATINE)CEIMFICATiON The property owner or owner's auftoreed repreertia m Ww cmVh*s Seclons A,B.C Pm C3h and C3i orly),and E for Zane A(wifiout a FEMA and or xrdy- issued BFE)a Zan AO must dp hem lltestataments in Sections A,A C,avdE are toured to flhe best ofmy hpdedget PROPERTY OWNERS OR OWNERS AurHOWZED REPRESENTATNES NAME - ADDRESS CiTY STATE zu3 CODE SI WTURE DATE TELEPHONE _ COMMENTS El Check here Naffadtrrnertis SECTION G-COMAIK)NITY UWORMATiON(OPTIOW The local diicial who is auftoraed by Maw or adnance to adnirlisier fie eamnurWs too*ia n managment andnartee can ca»pide Secio ns A,B,C(a F),and G dots Bowdon Ce� Complete tie appirtb rkm(s)and sign below G1.p The Wmnd rn in Sedan C was taken km after docurwiafan fiat has been signed and embossed by a licersedsuw1w.engrneer,or a d iced who is au mized by stab or local lawb cer*i dwaliion intfonn inion.(kndicate fn sauce and date d the ebfi*rt data in the Carrrrnernts area below.) G2.p A andel camp*d Secion E for a builft baled in Zone A(wittotd a F EMA49sued or oarrrn m4 issued BFE)or Zane A0. G3.p The Mm"trrk Telion(Netts G44A isprwidedfioroarrrKr*looefpisnrt>artagerrrentpupases G4.PERW NUMBER G6. DATE PERMIT ISSUED G6.DATE CERTFICATE CF COWPLIANCE4DOCL)r°ANCY ISSLED G7.This pemtd has been issued for.p NewCorsbtclion p Stbsnnlal hpwernertt _ G8.Efwafrn o(m bA lowest icor(mkrdrtg bwmnnerA)d the bt"V is ;—ft(M) Dakin: G9.BFE or(h Zane AO)deplt of foodrg at Im bcitirng sde is: __ft(m) Fakm LOCAL OFFICIALS NAME TITLE _ COMMAUNIIY NAME TELEPHONE _ SIGNATURE DATE COMMENTS _ El check Mere I a tad nests FFIUA Fnrm R1-31 .lantiary?n n.'A RanianrFs all rxnvinim edittnna thUMALtl ftM3t1 t:TMANAbt:f ftnI AW_-IWr O.M.B. Nc, 3067-0077 rY�D NATIONAL FLOOD TRANCE PROGRAM Expires December 31,2005 ELEVATION CERTIFICATE Read the k*n dions on pages 1-7. SECTION A-PROPERTY OWNER WORMA71ON BUILDING OWNER'S NAIVE -: H.H.&A.Construction BUILDING STREET ADDRESS(ktdtidirg APL,Unt,Sute,andlor Bldg.No.)OR P.O.ROUTE AND BOX NO. }per 860 BEGONIA STREET: CITY STATE ZIP CODE ATLANTIC BEACH FL 32233 PROPERTY DESCRIPTION(Lot and Black Numbers,Tax Pard Number,Legal Deem"on,etc.) LOT 2 BLOCK 144 SECTION"if',ATLANTIC BEACH,AS RECORDED W PLAT BOOK 18 PAGE 34 OF THE CURRENT PUBLIC RECORDS OF DUVAL BUILDING USE(e4,Residential,Non4eeiderttial,Addl w,Accessory,etc. Use a Conrmernts area,I m any.) RESIDENTIAL. LATITUDEA.ONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: El GPS° (rype):—_ ( -W-WAW-WA' or NAWNNP) W NAD 1927 ❑NAD 1983 ❑USGS 01WMap 0011W. SECTION B-FLOOD INSURANCE RATE MAP INFORMATION Bt.NFIP COM MLHTY i•WYE&CCMMl.1r1TY NLU ER 82 COLIM NAME B3.STATE �� CiTY OF JACKSOWILLE DUVAL FL B4.MAPAhD PANEL 87.FIRM PANEL B9.BASE FLOOD ELEVATION(S) Nl1MBE11 B5.SUFFIX B6.FIRM INDEX DATE EFFECTNEAZEVISED DATE BB.FLOOD ZONE(S) (Zak-AO,use dept►oft m&W 120075001 0 417-1989 4-17-1989 X(Sii) 9.5 B10.Irldmtertesa.ceoflheBase FbodEleve1on @FE)dararban looddq*errlenedin139. _ ❑FIS Prolle ®IRA ❑Cornrnunily Deed o Ober(Describe). B11.Irl mie,the deuatiort dahm used for to BFE in W.®NGVD 1929 ❑NAVD lees ❑Otter(Deacribe): B12 Is tie building located in a Caasiat Border Resources 8/slan(CBRS)arae or Otieruise ProisciedArea(OPA)? ❑Yes ®No DesigrayA Dasa SECTION C-BUILDWG ELEVATION INFORMATION(SURVEY REWIRED) , C1.BukkV elevators are based ore❑Consirudion Drawigs* ®Buildtg Under Conslruretiort' ❑Frwshed Consruchon •A mNEievatiat Cailicale will be reglied when co shichon dtie buidng is carO*-& C2 Butdng Diagram Number I(Select to building diagarn most mft b ria btrkkV far which firs ate is berg eornpleied-seepages 6 and i If no diagam acctird*representstiebtllldng,pruardeasitelc torodogreph.) C3.BwaWm-ZmesAI A30,AE AH,A O&8ftg11E,VlAM V MM BFE),AR,AWA ARAE,AWAl-",AWAH,AR/AO G>tTbb Newts C3.-m bedow a000rcirty b tie btlidrg dbgam WecW n Nem C2.State tie datum used.If the datum is different from the dabnx used br the BFE in Sedon B,cannot to detm b i W utsed for tie BFE.Shaw field ineaslrerneris and dAm cawersion calmAtion. Use the space prodded or th(,Cmnie its acre of Secion D orSec§Dn G,as appropriate,b doanw t the dahrn cmvasion. Datum 1929 ConvertiorMorrintenis Elerafion sakence(mark used BM Does tie elaraim reference rnark used appear an to FiRM? ❑Yes ®No o a)Top ofbolb, lfocr ftludngbasermentorenclosure) 8. 54n) o b)Tap of nod higher floor WA. o c)Bcdbn ofb iesthori ntalsttrWff ariw(V or,� WA. t .j� o d)Atacliedgaaga(bp ofdab) Z. 04m) E CLU o e)Lowest elerrab n drnachiiay andtr"Wrnerrt t° seivicirg tie building(Describe,in a Corrnents area) 6.6 t fin) E= o f1 Lowest (nistiodl gab(LAG) 6.01L(m) fs zN 0 9) t(ndwo)grade(HAG) 6. B iL(m) o h)No-dpermanent openings(toodvents)IA*M 1 IL above ad#a W grada wa I FL q'707 o 0 ToFal area of at pemiartert glaiigs(food verils)in C3.h WA sq.in.(sq an) SECTION D-SURVEYOR,ENGINEER,OR ARCHTECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,wow",or architect aWated by law to certify elevation information. i certify that the hrtomation in Sections A,8,and C on this cmtlfncate represents my best elfods to interpret the data available. I understand that airy false statement may be punkhable by free or impasorynentt under 18 U.S.Code,Section 1001. CERTEER'S NAME H.Bruce Dtndan,Jr. LICENSE NUMBER 4707 _ TITLEPresident COMPANY NAME Dtnien Suv%"&Mappitg,Inc. ADDRESS CITY STA7E - NOW 8150 Lone Star Road,Ste. Jadmowille FL 32211 SIGfdATURE DATE 8127104 (904)724-5588 FEMA Fnrm R1-31 .lanuAry 9(1(13 SPA rPvwraA airier fnr nnntinnafinn RPniarAc ant nmvinim Aditinna