Beach Ave 1660 Equal Opportunity/Affirmative Actioi) Employer
REGULATORY&ENVIRONMENTAL
SERVICES DEPARTMENT
Air &Water Quality Division
WELL
GRAR= TO: Ernest J. Alford N\/
3020 99= QW&
J_QCkggMdlle, Elgridd 32246 PERKrT 96-0309
WKL ID=CK: 1002 begmia Street. Atlantic Beach WELL #: J-9440
CIONMRACUR: Larry Will aim LIC91SE/B0KD 1417
Permission has been granted to ccinstruct, repair, alter or plug well(s) at the above
location in --- � � ixtu-ce with information supplied on the Application for Permit form and
with the authority of Chapter 366, City of Jackscnville Mziicipal Code (OC). Water shall
not be used for purpose(s) other than that indicated without prior approval from this
office. This well shall be subject to the following additional provisions:
APPLICABLE IF CHOMM
1. This well shall not be constructed or located within 75 feet of pollution
sourcest including, but not limited to sewage disposal systems, dry or wet
retention ponds, treated lakes or ponds and rivers and their tributaries.
X 2. A legible and coWleted copy of the St. Johns River Water Management District
(SJR*V) well coupletion report shall be filed with the Groundwater Section (GS)
within 30 days after completion of this well.
_2L 3. Water from this well _ may X may not be used for once-through cooling
poses (ie.,, water-cooled heat pump).
4. The well contractor and owner shall be responsible for notifying the GS at
least 24 hours prior to starting work and receive an authorization number.
X 5. A copy of this permit is given to any future property owner when the pr�operty
is sold.
X 6. Water taken frcm this well shall not be used to create or maintain surface
water level or quality (ie., ponds, pools, streams, etc.) or go to waste.
X 7. See attached proviso(s) 8 tb=j3h 11, Please review these proviso(s)
carefully. There may be a difference between the itevs requested in the
application and the requirements of this permit. Appeals mist follow the
requirements of the Environmental Protection Board (EPB) Rule 8 and Rule 1 and
Chapter 366, OC.
WELL APPROYED FCR:
Irrigation and recreation use only Recovery
Construction of a potable water supply - Abandauwnt/Plugging
Nion-potable water supply - Industrial Use Only
Monitoring Injection
Public Supply X Other Irriggtion
ISSUED BY: 44A 6;�MAA DAM: A)"
Groundwater Section/Head
em.dn.putts.patt_d Air Quality 630-3484
Water Quality 630-3461
421 West Church Street-Suite 422 Ground Water 630-4900
Jacksonville, Florida 32202-4111 Hazardous Materials 630-3404
toc"'I' wl G�
e ?j20 1--;,0"c'
-At )
BEGONIA 5dRIW UNIMPROVED STREE
A0 1" 16' Od'E. 100.00
-20-00'
SET 1/2 IRCIOPIFE-� SET#/Z"IRON PIPE
3 a T 2 3672
POINT OF BEGINNING
-0
LOT 2 LOT 3 LOT 5
C\J- 8 NOTES
z 0
0 0 0:
C\j - THIS IS A BOUNDARY SURVEY.
z
-qrt BEARINGS BASED ON THE CENTERLINE OF
(3) 0
EG
\-SEY VZ"511RO"
3 72
P0 N'
BEGONIA STREET AS PER PLAT.
NO BUILDING RESTRICTION LINE PER PLAT.
ilo
B 0 c K c?c 168
Cl *L 0�' al
n 169
B
Ito L 1EUM-,
MAP SHOWING SUf
'to co sc? 4 r. 13c)
CLOTS 3 AND 4, BLOCK 168
PART OF BLOCK 169, SECTIC
FIRACII AS RECORDED IN PLAI
34 OF THE CURRENT PUBLIC F
COUNTY, FLORIDA AND
PARTICULARLY DESCRIBED AS
POINT OF BEG I NN 1110, CC
�LJ 1)8 SOIJI'llEAS,r CORtIER OF SAID
SOUTH 09002 ' 00" WEST ALONC
OF SAW LOT 4 AND A WES1
'iII!;I6!,UF, A UlSlANCE OF 29
Ld 1.P-3 1.1 TO THE EDGE OF 7
IIARS11; THENCE NORTHEASTE
0 E D(;E. OF SAID MARSH, A E
FRET, MORE OR LESS, TO I
q, vrn A WESTERLY PROLOI&ICAT'
LINE OF SAID LOT 3;
-*,"" ar.nnG LAS
STATE OF FLORIDA PERMIT # 96-1283-N
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID 11/25/96
ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $ 220.00
CONSTRUCTION PERMIT RECEIPT # 207647-
Authority: Chapter 381, FS & Chapter 1OD-6, FAC
"ONSTRUCTION PERMIT FOR:
X) New System I Existing System Holding Tank Temporary/Experimental System
I Repair I Abandonment Other(Specify)
,PPLICANT. ERNEST JEFF ALFORD AGENT: NA
)POPERTY STREET ADDRESS: 1002 BEGONIA STREET JACKSONVILL
0'.7 : 3 & 4 BLOCK: 168 SUBDIVISION: SECTION H
ID #: NA (SECTION/TOWNSHIP/RANGE/PARCEL NO.]
(OR TAX ID NUMBER]
�YSTEM MUST BE CONSTRUCTED IN ACCORDANCE W4.TH SPECIFICATIONS AND STANDARDS OF CHAPTER 1OD-6, FAC
'EPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM �HE DATE OF ISSUE. ALL OTHER PERMITS
XPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SA�ISFACTORY
ERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A
ASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH
:��DIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
YSTEM DESIGN AND SPECIFICATIONS REMOVE "0" HORIZON BENEATH THE DRAINFIELD, SHOULDER AND SLOPE
OF THE ENTIRE FILL SITE PRIOR TO CONSTRUCTION OF A FILLED OR MOUND SYSTEM.'
1 900 fGALLQN� GPD1 SEPTIC TANK/AEROBIC UNIT CAPACITY MULTI-CHAMBERED/IN SER
it's I�yj
0 [GALLONS GPD1 - CAPACITY MULTI-CHAMBERED/IN SERIES: [N]
0 GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
300 ��ON�PER DOSE DOS U_ZANK CAPACITY DOSE RATE (61 PER 24 HRS NO. OF PUMPS: [1)-
462 1 SQUARE FRET PRIMARY DRAINFIELD SYSTEM_
0 1 SQUARE FEET
SYSTEM
TYPE SYSTEM: STANDARD f I FILLED [X I MOUND
CONFIGURATION: TRENCH (X I BED
LOCATION OF BENCHMARK: LG PINE TREE APPROX MID LOT (FRONT) SQ NAIL PINK RIBB014
ELEVATION OF PROPOSEP SYSTEM SITE IS [36.0 1 jUCBZS g9jMAgNfj21ARK/REFERENCE POINT
BOTTOM OF DRAINFIELD TO BE [31.0 1 INCHES BELOW BENf11MARK/REFERENCE POINT
FILL REQUIRED: (26.0 1 INCHES EXCAVATION REQUIRED: [ 0.0 1 INCHES
MAINTAIN 751 FROM SURFACE WATER & PRVT WELLS 101 FROM WATER SUPPLY LINES 51 FROM
BLDG. FOUNDATION & PROP. LINES. STABILIZE 3:1 SLOPE WITH SOD 5:1 SLOPE WITH SEED &
HAY. STABILIZATION MUST BE COMPLETED WITHIN 7 DAYS OF 1ST INSP. CALL BEFORE COVER.
INSTALLER TO FURNISH PUMP SPECS. PRIOR TO APPVL. DOSING HIGH WATER ALARM REQD. IF
GRAVITY FLOW CAN'T BE MAINTAINED. REMOVE 11011 HORIZON OF TOP SOIL & VEGETATION.
M I TITLE: ENV. SPEC. I
.--'PROVED BY:, TOM RIDDLE TITLE: ENV. SPEC. I DUVAL —CPHU
lt77- ISSUED: 11/27/96 EXPIRATION DATE: 05/27/98
;S-H --orm 4016 March 1992 (Obsoletes Previous Editions Which May Not Be Used) Page 1 of 2
STATE OF FLORIDA PERMIT # 96-1283-N
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DATE PAID 11/25/96
ONSITE SEWAGE DISPOSAL SYSTEM FEE PAID $ 220 .00
CONSTRUCTION PERMIT RECEIPT 4 207647-
Authority: Chapter 381, FS & Chapter 1OD-6, FAC
'ONSTRUCTION PERMIT FOR:
X1 New System Existing System Holding Tank Temporary/Experimental System
I Repair Abandonment Other(Specify)
PPLICANT- ERNEST JEFF ALFORD AGENT: NA
ROPERTY STREET ADDRESS: 1002 BEGONIA STREET JACKSONVILL
,�jT: 3 & 4 BLOCK: 168 SUBDIVISION: SECTION H
;ROPERTY ID #: NA [SECTION/TOWNSHIP/RANGE/PARCEL NO.]
(OR TAX ID NUMBER]
YSTEM MUST BE CONSTRUCTED IN ACCORDANCE WITH SPECIFICATIONS%AND STANDARDS OF CHAPTER 10D-6, FAC
EPAIR PERMITS AND HOLDING TANK PERMITS EXPIRE 90 DAYS FROM THE DATE OF ISSUE. ALL OTHER PERMITS
XPIRE ONE YEAR FROM THE DATE OF ISSUE. HRS APPROVAL OF SYSTEM DOES NOT GUARANTEE SATISFACTORY
ERFORMANCE FOR ANY SPECIFIC PERIOD OF TIME. ANY CHANGE IN MATERIAL FACTS WHICH SERVED AS A
ASIS FOR ISSUANCE OF THIS PERMIT, REQUIRE THE APPLICANT TO MODIFY THE PERMIT APPLICATION. SUCH
ODIFICATIONS MAY RESULT IN THIS PERMIT BEING MADE NULL AND VOID.
YSTEM DESIGN AND SPECIFICATIONS REMOVE "0" HORIZON BENEATH THE DRAINFIELD, SHOULDER AND SLOPE
OF THE ENTIRE FILL SITE PRIOR TO CONSTRUCTION OF A FILLED OR MOUND SYSTEM.
1 900 _WALLQH,-� / GPD1 SEPTIC TANK/AEROBIC UNIT CAPACITY MULTI-CHAMBERED/IN SERTfs'�Iyj
1 0 [GALLONS / GPD1 CAPACITY MULTI-CHAMBERED/IN SERIES: [N]
0 GALLONS GREASE INTERCEPTOR CAPACITY [MAXIMUM CAPACITY SINGLE TANK: 1250 GALLONS]
300 2�I,�QN PER DOSE DOSI U_ZANK CAPACITY DOSE RATE (61 PER 24 HRS NO. OF PUMPS: [1]
462 501JARE FEET PRIMARY QRAINFIELD SYSTEM
0 SQUARE FEET SYSTEM
TYPE SYSTEM: STANDARD FILLED (X I MOUND
CONFIGURATION: TRENCH [X I BED
LOCATION OF BENCHMARK: LG PINE TREE APPROX MID LOT (FRONT) SQ NAIL PINK RIBBON
ELEVATION OF PROPOSEP SYSTEM SITE IS (36.0 1 IN S P-ELQA AgNfjMdA2K/REFERENCE POINT
BOTTOM OF DRAINFIELD TO BE [31.0 1 INCHES BELOW BENfI14ARK/REFERENCE POINT
FILL REQUIRED: [26.0 1 INCHES EXCAVATION REQUIRED: [ 0.0 1 INCHES
MAINTAIN 751 FROM SURFACE WATER & PRVT WELLS 10' FROM WATER SUPPLY LINES 5' FROM
BLDG. FOUNDATION & PROP. LINES. STABILIZE 3:1 SLOPE WITH SOD 5:1 SLOPE WITH SEED &
HAY. STABILIZATION MUST BE COMPLETED WITHIN 7 DAYS OF 1ST INSP. CALL BEFORE COVER.
INSTALLER TO FURNISH PUMP SPECS. PRIOR TO APPVL. DOSING HIGH WATER ALARM REQD. IF
GRAVITY FLOW CAN'T BE MAINTAINED. REMOVE "011 HORIZON OF TOP SOIL & VEGETATION.
DECIFICATIONS M I TITLE: ENV. SPEC. I
'PROVED BY: TOM RIDDLE —TITLE: ENV. SPEC. I DUVAL CPHU
,TE ISSUED: 11/27/96 EXPIRATION DATE: 05/27/98
,S-H Form 4016 March 1992 (Obsoletes Previous Editions Which May Not Be Used) Page 1 of _2
J o h ri 17 . E 11 j_-, , f'D
10101 Lakevie�w Rd( w )
JackSOTIVille , I--L 32225
REPORT OF : Hand-Auger Soil InVe�',ti'j,�,tiOn
PROJECT : Ernest Jeff Alford Residence
Begonia & 9th Streets
Sect .H , Blks 168 & 169 , Lots 3 4
Atlantic Beach , Florida
DA.TE : October 25 , 1996
7�EPORTED TO: Mr . Ernest Jeff Alford
3020 Sugar Creek Lane
Jacksonville , FL 32246
On October 23 , 1996 this writer visited the abovo projecl.
ur the purpose of determining - It
1 . If any debris , such as garb-age or other undesi-eahl.c-, mate) i-il
was buried under the proposed structure ,
2 . If the buried debris , found by the owner , had been suces_,:,�fully
removed from under the proposed structure .
3 . If the site is suitable for construction for a sto) y
residence .
This writer visited the above listed site- on the inorning of
2-� . 1996 along with the owner Mr . Jeff Alford . Mr Alford had laid out
the 'location of the structure on the lot and fUrni�,;hed a surve-y , wit-h
the house location , and a plan of the house layout , Mr . Alford indicatcl�d
the area where he had removed debris from under the 10CatiOn Of the,
proposed house . This area was at the garage and extended to the noi,t],
:Droperty line . Mr . Alford indicated the unsuitable material was about
9 -9 feet deep and was removed and replaced -with clean fill and thi-,3
is indicated on the attached sheet .
This writer utilizing a hand-auger performed tori( I.0 ) auiger boring-r-1
at the locations on the attached plan . The bor- ings were taken to a
/i .0 to 4 .5 feet and no debris was found at any location . The
table varied from 16 to 20 inches below the exi,,:�;ting
_�3ch location the soil was so firm that, the augei could no,, be adva�ic _,d
,N:'1,Ually without extreme effort . -rhe soil. removed from the auger bori-n�is
medium to light brown to grey fine sand with some very slight
-i at the llocation
)f clay at the botton of the borings . The borings takei
�- he debris removal indicated light brown to light grey fii,ie sands,
trace of clay and also very firm at, the bottr.,m of the
it is the opinion of this writer that. there is no other debris
_�Dcated under this proposed structure and that the site is suitable or
,-�onstruction of a single story residence . Prior to construction tho cl i t,,
,hould be cleared of the silt which has wiashed into the low areas ,,I)id
'Layer of clean fill be placed and compacted being careful riot tc,) sa-,urai,
tl-,e fill by over compacting and bringing UP tl-)C� a- T-OUnd WEfter , P1,_jG('
eeding layer as above U�Itil reaching the, olevatin-n .
Re,,�,pect_�.,jely Submi-,�,te�d
J i E . Ellis ,. PE-7
CITY OF
AWWa&z &ad - 574u�d4
800 SEMINOLE ROAD
ATLANTIC REACH,FLORIDA 32233-5445
TELEPHONE(904)247-5800
FAX(904)247-5805
.hapter 489, Florida Statutes.Put I 'CONUMUCMON COMTLACTIN(P requires Owner/Builder to acknowledge the law:
-DISCLOSURE STATEMENT for Section 4$9.103(1�Florida Statutes:
State law.equit es construction to be done by licensed contractors. You have applied for a paTnit under the exemption to
�-,Alsw. The OW71*ion Alloirs you a the owner of your property,to act as your Own contractor even though you do not have a
.Icense. You -.6 - I -Xmzzelf You may build or improve a one-fornily or two-faily residence or a form
-utbuildwg You
may also build or kr4pc a commercial building at a cost of$25,000 or)esx. The bWldingjwaLhtfQtyDjxMM
and occupance. it msy not be built for ode or lone. If you sell or lease rnore then one building you have built yourself within I
yew after the construction is conqdet*,the law will presume that you built it for sale or lease,which is a giolatioin of this
�-Xffnptlon. You N=cguk%=. Your construction must be done according to building codes
and zoning regWations. I is yaw :e sure that people=gland by=have lirenzes reqliired by state law and y
- or muntapal kasnoft or&nanm.
ordbrimscer dso allow an Owwr to Improve tAwir own property*4wn it isforpersonal orfamly use,and like-mse
,equ;re all work(cwqpt xagnk"onm mWer 82,=)be wider a bWA*nSpermt andpass all normal inspections. The
,)r&nanoe states ownerx wayphyakuUy do work diemselves;or a=&re unhaensed workers provided suc*wor*ers be under
I-L red z"rytzan cVdw owwr,,4*o mawt be an dwAh WE at ail Amies w4ule work 13 inprogress by unlicensed trades
wcp1e.0 7hs does not allow use ofwxUamsed contractors.
�.,rxr ogmrz a= ft 940ida to workers they hire,the Building Department suggests Worker's Compensation insurance
.,e purd-med unless the hwiieo�xmxuwe policy clearly protects the Owner. Owners hiring workers become employers and
ahould also observe MS witliholding tm wWor Forrn 1099 requirernerts an the workers they employ on their improvement work.
JnlicCWed ---.a unAw xW--iron-Atances. Owners being s&ject to$5,000 penalty under Florida Statute
lo.455.228(l). An*Ocalp 'TiccoW am agLadequitz The owner should physically see the county"Certificate of
cn4etencyl or the Fl"lContractors Certificate'to ascertain if a person is a licensed contractor. Telephone the Building
D,partment(247-5826)if in doubt.
I hereby acknowledge I have read 9%d understand
all the above on this_ day of— 1996,
-�5
'grtr�ncl"ld ployee 07�
an
:-e emphasized by the Budding Phone
CITY OF
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORU)A 32233-5445
TELEPHONE(904)247-5800
FAX(904)247-5805
,n�489, Florida Stab-fts.Put I TONIMUMON CONTRACTIN(P requires Owner/Builder to acknowledge the low:
DEKLOSURE STATEMM for 3ection 489.103(7),Florida Statutes:
State low requiree constructionto be done by licensed contractors. You have applied for a permit under the exemption to
'-!%A law. The exernption allow you a the owner of your property,to act as yaw own contractor even though you do not have�
:1cm2c. You uo& .. yanelf. You may build or improve a one-firnily or two-faily residence or a form
�.utbtulding Yournsy also beAld or kMg a conwwrcial building at a cost of$25,000 or less. The buildingjmudjw_fw y2UCjnm
Ac mid occupence. R may not be bWk for sale or lease. If you sell or lease more than one building you have built yourself within I
year after the corubvction is conVidke,the law will proaxne dug you built it for sale or lease,which is a vioWoin of this
P7
TnIptiOn YOU mmucantrectar Your construction rmwt be done according to building codes
and zonw*regulations. It W your responsibility to nuke are thal people gnland by 3=have lirenses regairad by"e law and by
- or metdpal limigrg or&xanm.
On*nanwr also allowan Owwr to Improve fhdr ownproperty u4sen if isforpersonai orfamily use,and likewise
-eqwre all work(exWtxx*dWxrxRW1*rS2,0W)beUndera buil4ngpermitandpass all normal inspections. 7he
,ntnanoe sows owiers may physicaUy do work daensielves:or ma Au m uaUazwgd worke provided such workers be under
":Ii red n"rWzion ofdar mmr,who matst be an dw-id We at aU hmas w4ule work is inprogress by unlicensed trades
.7e*1e.0 77nz does nof a0ow war ofwdieffsoed contractors.
Sznce owurs a= &tj4AuWtov,oikes they hire,the Building Department suggests Worker's Compensation insuronce
7�e purchased unless the hounowners iourance policy clearly protects ffie Owner. Owners hiring workers become employers and
shoLdd also observe Mwithholdingtax andforForrn 1099 requirements on the workers they employ on their improvement work.
—nlicen2ed IL- —9
j =undor KW ek-awastances. Owners being subject to$5,000 penalty under Florida Statute
jcame inn,*adcqu&. The owner should physically seethe county'Certificate of
.To.455.228(l). An*QCa—,*=T.
'ornpetencyl or the Florida 4C;oritractors Certificate$to ascertain if a person is a licensed contractor. Telephone the Building
Deparunent(247-5826)if in doubt.
I hereby acknowledge that I have read and understand
all the above on this— of ' 199—,
-witness,Building Dept Ernployee Owner/Builder
-30a� (-'J
Address
;,DTF-: Ph-am undertkied above
-I!
m#mtzed by dw Building Phone
epartment
CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET
Address 14
D a t e
0 OF2 3`i. 00
Heated Square Footage _per sq ft = $ 21
Garage/Shed @ $ - per sq ft = $ /2.
Carport/Porch @ $-�
-�2-66 per sq ft = $ ,..,�?� 0
Deck $ per sq ft = $
Patio @ $- -per sq ft = $—
TOTAL VALUATION : $ 0,3"
$
1st $
Total Val ation
A 1)/ - $
Remalihing value $
per thousand
or portion thereof
TOTAL BUILDING FEE $
+ 1/2 Filing Fee
(0) Fireplaces @ $15 - 00 $
BUILDING PERMIT FEE
0
WATER IMPACT FEE $—
SEWER IMPACT FEE $
WATER METER/TAP
CAPITAL IMPROVEMENT
SEWER TAP $
�iOTJ) RADON (HRS) .0050 $
SECTION H PAVING
HYDRAULIC SHARES
CROSS CONNECTION 5 C)
(;b?2) SURCHARGE .0050
OTHER
GRAND TOTAL DUE
ADDITIONAL PERMITS OR FEES: Mechanical Plumbing
Electric/New Electric/Temp_; SwimmingPool
Septic Tank Well Sign--Finish Floor Elevation
Survey ; ,other-
CALCULATIONS and/or NOTES:
p8R11"4
WARTMENT OF 6UILDING
ITY Or
ATLANTIC61EACH
4F, N 4&W$ 7 T.v
PERMIT ,INFORMATION
LOCATION INFORMATION
Permit Numb ek 4* Address: ' 1002 BEGONIA T
STRIE
Permit, T
ype:BUILDINGi ATLANTIC BEACH FLORII-DA 32233 : 1
'Class, of Work:NEW LEGAL DESCRIPT11ON
Constr. Iryp'*:WOOD FRANS B16ck* 168 Lot:S- 3
ProP0sed . Use:SIN0LZ.. FAXILY Secti�n:' 0 : Subd-' 4
0
Dwelliags: 0 Subdivision.*SECTION H
rat -L Val��Ie:' 0.00
Imprbv Cost : 103,016.00
To
4
!k"
t a, `6
' Amo nt 8 .8
u
vati
1kh
wail w VIM I LAX zlvrl
p
roN APPLICAT
ION FEES
D PERMIT
Addr: LANE
WATX oo' Ex q.00�
�4
JDA 32
Pho OT
p
0 ., 0
RAD014 GAS-H.R.S. 9. 90
CO RA - -------
RADON CAt 5% 0 .52 —
A Name -PROPER CAP I TAL-1,MPROV9-.� -00 -
325.
P
SEWER TA 1.00
CROSS CONNECTION 0 .00
SEC H 114PACT FEE 0 60 ,
T
CHARGE/A'TL.SCH.L
NOTE&
NOTWE ALL COINC WE,0ORMS'AND FOOTINOS MUST BE INSPECTED BOORE POU
-PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
B,UIL-01,NG MATfJA R 01SHIANDQEORIS
PA AWA�e".iy e FROM THIS WORK MUST NOT BE PLACED 14 PUBLIC SPACE,AND MUST Be�
CLEARED U: HAU ITHER 06NTRACTOR'OR OWNER
FAIL, MPLY WIT". TH E MECHAN tCS9 tlgN LAW C O'ESULT IN
OR AN
�T PR - �p ING T CE 'OOR 6WL0INQ4',M0R0Vt ENTS.
OLE FIR ER wl
WED PLANS WKICH ARE PART OF THIS PERMIT AND SUBJECT TO"REVOCATION FOR
IM D ACCOA' 0-TO,* PPRC_
V "ATION OF A PAOVI816NS OF LAW. $9.36 72
IOL 73.0 14,
Ann- 1/j
T F
ceipts Now
ATLANTICB
EACH BUILDING Or-V VVA=WR6WMF.—
By;
W—p
CITY OF ATLANTIC BEACH
APPLICATION, OR PLUMBING PERMIT
JOB LOCATION: 0 0
OWNER OF PROPERTY:
PLUMBING CONTRACT?� . /IS06 PLUAa,4�/ C 6.
CONTRACTOR'S ADDRESS: 1394 7 15 El-l<_0 IS 4
STATE LICENSE NUMBER: C.2 a s-)3
—TELEPHONE: 2
HOW MANY OF THE FOLLOWING FIXTURES INSTALLED
SI'NKS SHOWERS
—LAVATORY WATER HEATERS
BATH TUBS DISHWASHERS
—URINALS DISPOSALS
3 CLOSETS WASHING MACHINE
FLOOR DRAINS SHOWER PANS
OTHER
TOTAL FIXTURES1 , IV x $3 . 50 + $15 .00 o o
MINIMUM PERMIT FEE - $25 .00
SIGNATURE OF OWNER:
SIGNATURE OF CONTRACTOR:_(0-N!77-l&_j,�
-----------------------------------------------------------------
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE.
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826
SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION
PRIOR TO COVERING UP - ( 904) 247-5834
P61?
8 V44 13249
DEPA1117MENT OF BUILDING
CITY OF ATLANTIC BEACH
PERMIT INFORMATION ------- LOCATION INFOR14ATION- --------
Te it NuAer 0. 13249 Address: 1002 BEGONIA STREET
FLORIDA
�''�.Permit Type:PLUMBING ATLANTIC BEACHP 12233,
------ LXGALDESCRIPTtON -------
"Class of Work*.,Ijxw
Constr. Ty I pe.00OD� FRAMZ Slock:168 , 'Lot*.S. 3 & 4 Tuip: 0
Proposed Use*.SINGLE- FAMILY Section: 0 Subd: Rng 0 �
Dwellin4s : 0 Subdivision*SECTION H
Est-. Value: 0.00
IMprov, Cost:
Total Pe
F, 64.00
Am unt
'25
----------
C
ION -' A PLI ATION FEES
Nam' 4 RD PERMIT
APRON"
' Addr : 3, K LANE '10
4a
RIDA 32 4 r
it
Pho�
did
'C 'A , ORMATION ------
Name, 9 .'G P I a
ftrr''A' 997 B
FL 32224
JACXSON
12� - Up
C T. 2 59
W
NOTE& -
NOTICE—ALL CONCRETE F R SAND FOOTINGS MUST,BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
'$UILDINGMATERIAL,RUOBIS�H AND DEBRIS FROM TH is WORK MUST NOT BE PLACED IN PUBLIC SPAQE,AND MUST BE
CLEAREDU WA,
CONTRACTOR OR OWNER
'FAILURE.,,TO. COMPLY' WITH THE MECHANICS' LIEN L 9 LT IN
AW CAN'_R' ' SU
A PAYING TWICE FOR BUILDING IMPRO
THE PR6pkiqTY1O*4`e' VtMENTS.1
Ak�ED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT,AND SUBJECT TO REVOCATIONFOO
14
TON OFAP' PLICAI!ILE�PFICIVISIONS OF LAW.
Wel IW97
CHECKS
777�7771
DATE: 7
PRE-SERVICE DIVISION
JACKSONVILLE ELECTRIC AUTHORITY
233 WEST DUVAL STREET
JACKSONVILLE, FLORIDA 32202
THE FOLLOWING FINAL INSPECTION( S) HAVE BEEN MADE AND ARE
SATISFACTORY :
/-7 -
_7
L
/-----------------------
-------------------------------------------------
-------------------------------------------------
-------------------------------------------------
-------------------------------------------------
Enclosed are the blue copies of the permits.
NCERELY
BUILDING INSPECTION DIVISION
cc:FILE
CITY OF
4&aatQc Be4c4-d9&u*da
Office of Building Official
REQUEST FOR INSPECTION
Permit No.
Date
Time A.M.
Received RM.
Job Address Locality
Owner'
Name
BUILDING CONCRETE ELECTRICAL 'PLUMBING MECHANICAL
Framing E ooting E I-Qaugh-Wking�---E-,-;' Rough El Air Cond. &
Re Roofing flab El Temp Pole Top Out [:1 Heating
.17 Intel
Insulation El Final sewer 0 Fire Place
Pre Fab
READY FOR INSPECTION
ay,
Mon. Wed. Thurs. Frid
L A.M.
Inspection Made L PM.Final Inspection E
Inspector L Certificate of Occupancy 1--J
Date
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FLORIDA 32233
APPLICATIO-N FOR MECHANICAL PERMIT CALL-IN NUMBER
IMPORTANT Applicant to complete all items in sections 1, 11, 111, and IV.
LOCATION Street Address: '.7)j LX)i-J k A 5 (
OF Intersecting Streets: Between, '71CCIIL'ej And
BUILDING
Sub-division R
11. 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 attacked plan,� and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards
of good practice listed therein.
Name of Moch.anica Contractors
Contractor (Print) C Master
Name of
Property Owner 11,Aj;E�S- Lj�Co
Signature of Owner Signature of
Architect or Engineer
or Authorized Agent 4L
Ill. CrWERAL INiOR/MATION
A, Type of heating fuel:
IS OTHER CONSTRUCTION BEING DONE ON
pr Electric THIS BUILDING OR SITE 7,
0 Gas-0 LP [3 Natural 0 Control Utility
IF YES, GIVE NUMBER OF CONSTRUCTION
13 Oil PERMIT
13 Other — Specify
IV. MWH�NIC.AL EQUIPMENT TO If INSTALLED NATURE OF WORK
(Provide complete list of components on beck of this form) Residential or [I Commercial
Heat 0 Space 13 Recessed )5111� Central 13 Flow New Building
Air Conditioning: [3 Room Control El Existing Building
-/ &Thichniiiss.—L.—I( El Replacement of existing system
Duct, System: Material *Iztmi 41S
Maximum capacity c.f.m. New installation(No system previously Installed)
0 Refrigeration Extension or add-on to existing system
0 Cooling tower: Capacity Other — Specify
C) Fire sprinklers: Number of head-
C) Ellevator C) Monlift C] Esicalafo (number) THIS SPACIE FOR OFFICE USE ONLY
C3 Gasoline pumF4 (number)
E3 Tanks (number) Remarks
C3 LPG contains (number)
E3 Usifired pressure vessel
0 1111011411IM111 Permit Approved Do
00W — Specify Permit Fee
LI19T ALL EQUIPMENT
AIR CONDITIONING AND REFRIGERATION EQUIPMENT
r-am"-fty Approving
Number Units DescripUon Model Number Manufacturer Agency
C to
PSA-3844
`13 8' '
019,PARTMENT OF BUIL011NO
CITY bp ATLANTIC BEACH
PERMIT INFORMATION ------ LOCATION INFORMATION,, ------.--
Permit Number: ;�,13428 Address.: :
1002 BEGONIA STREET
'Permit, Typt,*MRdHANICAL ATLANTIC BEACH , FLORIDA 32233
Class of' work:NEW ------I--- LEGAL DESCRIPTION ----------
' Con'st:r.' Typ0#.WOOD FRAME Block: 168 Lot :S. 3 & 4,' Twp* 0
Proposed Use:SINGLE FAMILY Section: 0 Subd: 0
Rng*
e Ags. 0 Subdivision:�SECTroii H
Est .� Value: 0.00'
Improv- to$t : 0 .00
Total Feo' 55 -00
44 W,/o
5,5.00
-,A5w
1A
mount,
ION APPLICATION FEES
Name RD PERMIT
Addr: K LANE
L ORIDA 322-,,
Pho
C,
ORMAT dx�`
Nam4e N AND AIR "I"
IVE
JACKSON 4- 'FLORIDA 32236
Exp:
T
'41C
NOTES-
NOTICE ALL CONCRIETE FORMS AND FOOTINGS MUST BE INSPE:CTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE.OF.ISSUE
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT,BE PLACED IN PUBLIC SPACE,AND MUST BE
CLEARED UPANQ HAULED AWAYL$Y EITHERCONTRACTOR OR OWNER
"FAILURVL�To COMPLY WITH THE MECHANICS! LIEN LAW CANAIESULT IN
T P0,00 d*.NtW,0AYINGTWIC F ROVEMItNt I!
HIE 9:RTY E OR BUILDING MR S.
F
ACCORDING TO APPROVED,PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR.
OF-APPLICABLE PROVISIONS OF LAW.
-PARTMENT
ATLANTIC,BEACH'SLIILDI�NG
By
A
CITY OF
Ve4d — 9&ud4
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE(904)247-5800
FAX(904)247-5805
Chapter489, Florida Statutes,Pot I CONSTRUCTION CONTRACTINCya requires owner/.Builder to acknowledge the law:
DISCLOSURE STATENENT for Section 489.103(7).Florida Statutes:
State law requires construction to be done by licensed contractors. You have applied for a permit under the exemption to
ttiat law. The exemption allows you as the owner of your property,to act as your own contractor even though you do not have a
license. You must mWervise the construction y2melf You may build or improve a one-family or two-faily residence or a farm
outbuilding. You may also build or improve a commercial building at a cost of$25,000 or less. The buildingMLULhC_fQr_yQUCMM
=and occupance. It may not be built for sale or lease. If you sell or lease more than one building you have built yourself within I
year after the construction is complete,the law will presume did you built it for sale or lease,which in a violatioin of this
exerription. You may not hire an unlicensed Rerson as=contracto Your construction must be done according to building codes
and zoning regulations. It is your responsibility to make sure did people=pland by you have licenses regaind by state law and by
muoty or munidpal licensing or&nances.
Ordinances also allow an Owner to improve their ownproperty when it isforpersonal orfamily use,and likewise
require all work(c=pt maintenance under$2,000)be under a buildingpermit andpass all normal inspections. 7he
Or&nanCe SAVes owners may physically do work themselves;or a=In re unlurnsed workers provided such workers be under
wdirect n"rvision ofthe owner.who must be on the-Job site at all lines while work is inprogress by unlicensed trades
people.ff Vus does not allow use ofunlicensed contractors.
Since owners am be hable-far L4tu=to workers they hire,the Building Department suggests Workees Compensation insurarice
be purchased unless the homeowners insurance policy clearly protects the Owner. Owners hiring workers become employers and
should also observe IRS withholding tax and/or Forin 1099 requiremerits on the workers they employ on their improvement work.
Unlicerised contractors camot be=pl=d under=circurnstawxt Owners being subject to$5,000 penalty under Florida Statute
No.455.228(l). An-0coQational License*is not adegjAc The owner should physically seethe county'Certificate of
Competency'or the Florida'Contractors Certificate*to ascertain if a person is a licensed contractor. Telephone the Building
Department(247-5826)if in doubt
I hereby acknowledge that I have read and understand
all the above on this i o of 199*7
E -7
7' L';:�G g-D
Witness.Building Dept Employee Owner/Builder
C)-o
Address
ULLD C_ ;hCi-A _22-2,23
NOTE: Phrases underlined above -14,y 0 -7 3 C -I V 0
are emphasized by the Building Phone
Department
CITY OF ATLANTIC BEACH, FLORIDA /33/
Approwd by I APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 19
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, 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 ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
ELECTRICALFIRM: QVJA) ;:jZ, MASTER ELECTRICIAN SIGNATURE ALf%vt4Q JOURNEYMAN
N AM E. A ADDRESS: RFD—BOX—
BLDG.SIZE BETWEEN:
RES.1-� APT. ( comm.( PUBLIC ( INDUS. ( NEW I OLD ( REW.
ADDITION ) TRAILER I TEMP.6j'-/ SIGNS ( I SO. FT.
SERVICE: NEW( INCREASE ( REPAIR FEE
i
CONDUCTOR SIZE AMPS COPPER ALUM. 1
SWITCH OR BREAKER AMPS -�— PH 3 W 2-qQVOLT RACEWAY
EXIST.SERV.SIZE AMPS PH w VOLT RACEWAY
FEEDERS NO. SIZE IND. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
.30 AMPS. 31-100 AMPS.
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100 AMPS. OVER
APPLIANCES I I I BELL TRANSF.
AIR H.P. RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS ICEIL HEAT: KW-HEAT
0.1 OVER
HP
MOTORS VOLTAGE PHS No. 1 H.P. VOLTAGE PHS
MISCELLANEOUS
14 PA D I-EIVA,
'rft A
City of Atlantic Beach UT500L
** S E R V I C E 0 R D E R CYCLE/ROUTEt 04 99
8 A R B A 6 E C 0 M P L A I N T
CREW CODE: SVC ORDER NO* : 25528
SECTION: AB ATLANTIC BEACH ISSUE DATE! 1/06/97
LOCATION IDI 15074 CLASS: RESIDENTIAL I UNIT ISSUE TIME: 16139102
ADDRESS: 1002 BEGONIA ST REQUEST DATE! 1/06/97
CITY: ATLANTIC BEACH USER I D: CSTARR,
-----------------------------------------------------------------------------------
SERVICE/SEQ: OB 000 GARBAGE
DWAYNE 100-JAX WAST
.................................................. ..........
NAME OF EMPLOYEE
-------------------------------------------------- -----------
---------------- C G M P L. E ir I o N y hi g- ri r% LZ X N -------------------
DATE: .... .... MISC CHARGE: 0 ,144-v AMT.*
C
ACTION: --------------- COMPLETION ME1 4TENANCE
"ti�.f
MTR READER COMMENTS
---------------- ----------
CARLENE MATTHEWS NEED TO KNOW WHEN CO HAS BEEN ISSUED SO WE CAN
START BILLING OB AND ST ONLY*
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FLORIDA 32233
APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER
IMPORTANT — Applicant to complete ali items in sections 1, 11, 111, and IV.
Street Address: /0 6 -:R 1.4
LOCATION
OF Intersecting Streets: Between A'q—, P0-"-r And
BUILDING Sub-divition
11. IDENTIFICATION — To be completed by all applicants
In consideration of permit (given for doing the work as described in the abcve statement we hereby agree to perform said work in accordance
with the attacked plans and specifications which are a part hereof and in accordance �ifh the City of Jacksonville ordinances and standards
of good practice listed therein.
Name of Mechanical Contractors
Contractor (Print) ad�Lg :Edo ot, A-r 16d M aster 6
Name of
Property Owner �AAA��a
ignafure of Owner Is Signature of
r Authorized Agent T--5 Co') 6-T- I Architect or Engineer
Ill. GENERAL INFORMATION
A, Typo of heating fuel: IS OTHER CONSTRUCTION BEING D 0
C] Bodric THIS BUILDING OR SITE7
C3 LP Natural [3 Central Utility
IF YES, GIVE NUMBER 0 ONSTjRU.QTION
C3 Oil PERMIT Z�5Z sl��-
0 Other — Specify
IV. MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK
(Provide complete list of components on back of this form) I?"' Residential or 0 Commercial
0- Heat 0 Space 13 Rocessod 0 Central 0 FIW 0 New Building
C3 Air Conditioning, E3 Room [3 Control 0 Existing Building
Duct, System: Material Thickneu— 0 Replacement of existing system
Maximum capacity C.f.m. D/New installation(No system previously installed)
C3 Refrigeration 13 Extension or add-on to existing system
0 Cooling tower: Capacity g.p.m. El Other — Specify
E3 Fir* sprinklers: Number of heads-
0 Elevator 0 Monlift 0 EscAlato, (number) THIS SPACE FOR OFFICE USE ONLY
E3 Gasoline Pump$ .(number)
[3 Tanks (number) Remarks
[3 LPG contains, (number)
[3 Unfired pressure Y*uoi
0 Boilers Permit Approved b Date
It-,Other — Specify aAs_ t&'[ Permit Fee
LIST ALL EQUIPMENT
AIR CONDITIONING AND REFRIGERATION EQUIPMENT
Canjw_lty Approving
Number UnItA Z)eacription Model Number Manufacturer Agmey
or
DEIRAMU _N r OF BUILDI-IN
CITY�O#ATLANTIC BEACH.
PZfW IT INFORMATION LOCATION INFOR14ATION
REST
Permit -Number: Addr st� 1002 BEGONIA ST
Permit Type:MECHANICAL ATLANTIC BEACH, FLORIDA �2233
----------
Class, ot Work*.NEW ----- --- LEGAL DESCRIPTION
Qonztk. Ty,pe:WOOD FRAME Block: 168 Lot:S. 3 & Twp* 0
Proposed Use:SINGLE FAMILY Section; 0 Subd: Rnq*, 0
Dwellings: 0 Subdivision:SECTION H
Est. Value.-
Improv. Cost:
Totat Fees- 25,600
Amount ,, 25 .00
A 497
Da
Work PLACE, �j GAD PIPE
— , APPLICATION FEES ----------
I ON
7
14 ame D PERMIT 25.00
Addi. � LANZ
IDA 322
Thon
C R 014MAT19, ------
Name. GA T,
4
D�s
JACKSO OR I DA 32207
TV
no�'w'A_' c
.NOTE$'.
NOTICE—ALL CONCRSTR FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT'VOID SIX MONTHS AFTER DATE OF ISSUE
ND MUST BE
BUILDING MATERIAL,RUBBISHAND DEBRIS'FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,A
CLEAREOUPAND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
TO COM PLY,WIT NIC46I;V LIEU LAW CAN �RESU
LT IN
q
H THE MECHA
ERTY QW� KPAYING, TWICE FORSUILDING PROVEMENTS.
F,
ISSUED ACCORDING TO APPROVED PLAN;S WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCAT
V LATION 0 1 PLICABLE.PROVISIONS OF LAW.
10 F�AP
ACH -.PA-4TMENT
BUILDING DE,
ATLANTI
q�
klkf' n6
CITY OF
4&4A44-C Beac-4-
Offici
Office of Building !&,
REQUEST FOR INSPECTION
Z30
Date. 9 Permit No.
Tme A.M.
Received
Job Address L cality
Owner's
Nam. Contractor
CBUIiED1:N:G :*� CONC LECTRICAL PLUMBING MECHANICAL
t ugt
Framing 11 Footin E Rough Wiring Rough 7 Air Cond. &
I
Re Roofing El jSlab C: Temp Pate Top Out F] Heating
Insulation Lin 1 0 Final E Sewer Fire Place
READY FOR INSPECTIO Pre Fab
(� M.
Mon. Tues. Wed. Friday P�
A
4 P.M.
Inspection, Made
Inspector Final Inspection E
Certificate of Occupancy E,
Date
TRANSMITTAL DOCUMENT FOR JEA
DATE: 7
The following permits�e passed "rough" inspection:
Permit No. Address
3 2:5
S7 Q
/33 kl-,"Y/J W
3' 5 7
Please update
your records accordingly.
Thank you,
BUILDING CLERK
CITY OF ATLANTIC BEACH
/vcb