Permit Folder 87 Forrestal Cir S IS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000235 Date 3/03/10
Property Address . . . . . . 87 FORRESTAL CIR
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 500
----------------------------------------------------------------------------
Application desc
WASHER AND KITCHEN SINK
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
RODRIGUEZ BENTON F.W. FAIR PLUMBING CO.
87 FORRESTAL CIRCLE P.O. DRAWER 51558
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 241-7191
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 69 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/30/10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 69 . 00 69 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 69 . 00 69 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: T-M L L) tZ
X7 Iq 6 O-L* P.RMIT#10-235
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FmTuRE QTY TYPE OF FvcTupx QTY
Bathtub Septic Tank&Pit
Clothes Washer —7— Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain - Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FmTuRE QTY TYPE OF FVCTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
Ei Sewer Replacement o Back Flow Preventer Ej Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Ei Lawn Sprinkler System-Number of Heads El Well
**&IR WD Well Completion Form. Completed form to be submitted to tWe-—Building Department for final inspection.
Ei Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I=veread
this application and know the same to be true and correct. All provisions of laws apd 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 st*e or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
Plumbing Company Office PhonP-;��' Fax
Co.Address:
city C State ZiD
�Rate oql:� OV 7V_57
License Holder(Print): fA Certification/Registration
Notarized Signature of Lic VA Af
A.WHITE "/--i
q ION#DD&10ko and subscribed'��!'me
M1 MMIS da f 2VO
EXPIRES'M&Y 21.2011
8MM ThrU WAN pftu*U Me ure of Notary Public
KK CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000297 Date 3/17/10
Property Address . . . . . . 87 FORRESTAL CIR
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1500
----------------------------------------------------------------------------
Application desc
Insulate and drywall water damage
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
RODRIGUEZ BENTON JAMES & SON BUILDERS, INC
87 FORRESTAL CIRCLE 129 15TH AVENUE SOUTH
ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH, FLORIDA
JAX BEACH FL 32250
(904) 509-0812
----------------------------------------------------------------------------
Permit BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee 30 . 00
Issue Date . . . . Valuation . . . . 1500
Expiration Date . . 9/13/10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total 30 . 00 30 . 00 . 00 . 00
Grand Total 90 . 00 90 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904)247-5845
Job Address: /4 Permit Number:
Legal Description
Valuation of Work
Class of Work(circle one): New Addition Alteration e Move Demolition pool/spa window/door
Use of existing/pro osed structure(�) circle one): Comma�Residential
If an existing strucriure,is a flre sprm=system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type lof w�ork Ito performed:
Property Owner Information:
Name: Address: 0-T-e5-
city ip-2
?24L(4Phone /01
E-Mai or ax#(Optional
Contracto-EInformation;
Company N if
Address: ame: 5 ev-n Quali,�mg Agent: J --i�Z_51
City- 14_�14_ Orlin —State zip 17 P?5_6
Office Phone f2 Job Site/Contact Number Fax#
State Certification/Registration# C tzc_0 qq 0<115
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address—
Bonding Company Name and Address
Mortgage Lender Name and Address
A tz e eb ade b a na e do 1h work a�d nstallat''�ns as'pdic or installation has commencedprior to the
8 nc i h m to e
Ic r it i
f
P' a 0 r r i y to 0 r P be e or ed to m an a a �w thisjurisdiction. This permit becomes null
i Ps a e a e a ha a k m r
k i s a period of s�xJ6,)months at any time after
t, ch n r 0
0 1 r
c, f
" I etrIc W 11s,
m t ,or Z ttsseu red Ee e Pools, urnaces,Boileis�Heaiers,
n ix 6 n Z ' co
k nc 'wo ,w p Oer i s m, t be
m
a v -d w k s no c m en ed thi s
nd i I c w
I Z see ed 0 nd, tand t at separate P
0 f
Work is'0
T, Ir C
n s anflAl on.�htjonen,da
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined th' plication and know the same to be true and correct. Allprovisionis offlaws and ord' e overnin
,I s7zed here- r not. The granting of a permit does not presume to g7ve authority or cance
work will be co�nplied with whether eci this
'��te,""Io"c'�y '�'Ir'e�Ua stru�tiol n' 0 Fth,
st
the
Provisions of any o�t�herfederal,state, locils, regula c struction or the perfo�mance ofconstruction.
Signature of owne Signature of Contractor
Print Name
............ Print Name
Swo SI-41 nd subscrib before Swo d su b efor e ..........
this Day of 20/0 this D of me
)ZZL��I_k . 20/6
'Won
this
Notary Public
A.WHITE Notaryrublic
.1V I
d�,
Da
er MISSION#DD 63026
My...RES May 21,201 A R evise .2
EXPI 6.10
9onded Thru No"pw*undo DEBORAH A.INHITE
6
My COMMISSION#DD 634126
EXPIRES:May 21,2011
Bm&d Thru Notary PLubk UrRierwr#ers
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
PHONE (904) 247-5800
March 3, 20 10
CERTIFIED MAIL RETURN RECEIPT REQUESTED
Benton Rodriguez
1224 Forest Oaks Drive
Neptune Beach, Florida 32266
RE: Unpermitted Work-Stop Work Order
87 Forrestal Circle, Atlantic Beach, Florida
Dear Mr. Rodriguez:
On February 25h, 2010, a stop work order was issued on work in progress on your property
referenced. The work included roofmg, general construction, electrical, plumbing, etc, without the
required permits in violation of the City of Atlantic Beach, Code of Ordinances Section 6-16, Florida
Building Code adopted.
Please be advised that all permits are required to be obtained by a State of Florida licensed contractors
prior to the continuation of any work on this project.
Should you have any questions relative to this matter,please feel free to contact me(904)242-3464.
Sincerely,
CITY OF ATLANTIC BEACH
-pli-U 96-f�
Mike Jones
BUILDING INSPECTOR
0 - Z
STOP WORK
Atlantic Beach
JURISDICTION
OFFICE OF BUILDING OFFICIAL
NOTICE W1 V-
This buildi has been inspected and CLI
VGeneral Construction
Concrete, Masonry and Finish Cement Wo k
F1 Lathing
Plastering NQtd5 Mrv�o-ded ref"-r-
Elevators
El Plumbing
%�,-7 F,,y V-,,3ja-1 CwrtFl Mechanical Work
F1 Electric Wiring
7oq-0je? F1 Gas Piping
IS NOT ACCEPTED
lease correct as noted below before any further work is done.
NOTE -
020C91ci-t14 Re % ul ;/-.t % Per M-1
Date 9--A 5-1 C) Do Not Remove This Notice inspector-
------------------------------------------------------------------------------------------------
DETACH and Bring this Portion of Card With You
Location: 5?,-7 Fby'y'v--5-)-Q1 o:four -t– 44/qP1//z fjrqcA,--�
Date -- ,;L-aLs--to
��l=10N
INSPKCTOR
—2�� –J� M
0 V4ej . Uj
Compliance Investigation Form
Investigation# Date of Request: A) Time of Request:
Name of Person Making Request: 4V/ 477-)
Address: -7 62 f Phone#
Investigation Type:
Location (Address) of Violation:
Phone Number: Property Owner/Manager:
Request Taken by: Investigator:
-
Action Taken: /,4
Aky A", .�/
10 ep*710(Ile r-144�_P /
Ov A
ox
Compliance: Z c,-* e0l cl-0 4 7'�a
Legal Description: —RE#:
FACode Enforcement\Compliance Investigation Form.doc Oct 9 2009
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000291 Date 3/16/10
Property Address . . . . . . 87 FORRESTAL CIR
Application type description MECHANICAL HVAC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
1 cu 1 ahu
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
RODRIGUEZ BENTON MCCORMICK HEATING & AIR
87 FORRESTAL CIRCLE 1620 S . EVANS DR.
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 247-9S36
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL HVAC PERMIT
Additional desc . .
Permit Fee . . . . 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/12/10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 95 . 00 95 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANric BEAcig
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS:
PROJECT VALUE$
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTUs Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING Sk HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit ARI# . 11 1 1�
Heat: Unit Quantity BTIJ's Per Unit Seer Ratin
Duct Systems: Total CFM Jqj!�6 REQ
t�:QU#R—ED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty_ Automobile Lifts
Goo Piping Outlets Boilers BTU'—.g
Elevators—IE-scalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigemor Condenser B—TU-;s
Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER:
Permit becomes void if work does not commence witbin a six monffi period or work is suspended or abandoned for six month&I hereby certify t-b—at-1have�read
this application and know the same to be true and correct. All provisions of law and ordinances governing this work will be cmWfled with whether specified
or not The permit does not give authoribr to violate t
,�e provisions of any othcr state or local law regulation construction or the performance of consiruction.
Property Owners Name A w'� (7
Phone Number 7 Y-1
Mechanical Company- Office Phone'2q7 q��
Co.Address:1/,/, -2 6 -1,--tj Fax
City 22hi 0't'- State r-7 'pa��'50
License Holder(Print); aL State Certification/Registration
L�94—PJA—hi- L
Notarized Signature ofLicense Molder
Sworn and subscribed before me this day of 20
Signature of Notary Public
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000269 Date 3/11/10
Property Address . . . . . . 87 FORRESTAL CIR
Application type description ROOF PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4000
----------------------------------------------------------------------------
Application desc
reroof
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
RODRIGUEZ BENTON ROMANO ROOFING SERVICES
87 FORRESTAL CIRCLE P.O. BOX 33037
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 246-5649
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 4000
Expiration Date . . 9/07/10
----------------------------------------------------------------------------
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
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Permit No. NOTICE OF COMMENCEMENT
Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Descri tion property(legal descMron of property --d address if available):
/r,7
-71
2. General Description of improvements:
C_ 5� I
3. Owner Information.'
a)Name and Addre s: 'I ell A A
s —a--
b)Interest in property: . L,9,4jjj,#_A
c)Name and address of simple titleholder other than owner
;y Al �
4. Contractor Information: v�/n e-S, e1v
a)Name and Address: _!�_6 a T7_ T-1Y
b)Phone Number:_ 0 rl
5. Surety Information: T- 4
a)Name and Address:
b) Phone Number:
c)Amount of Bond: $
6. Lender Information:
a)Name and Address:
b)Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a)Name and Address:
b)Phone Numbers of Designated Person:
8. in addition to himself/herself, Owner designates of to receive
a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
a)Name and Address:
b) Phone Number of person or entity designated by owner:
9 Expiration date of Notice of Commencement(The expiration date is one (1)year from the date of Recording unless a
different date is specified:
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART
1, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 YOU ', OVTR_�)R AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
OMR� LE�
YOUR NWICE OF C CE T.
s4l�ure of Owner or Ok4er(s A-u-tho���fcer/Pit�c—tor/Partner/Manager Signatory's Printed Naine Title/Office
Ir-qj—
The foregoing instrument was acknowledged before me this 0 ' day of_kA4,0_ 20 by
as for Fa,, 4, t7
(Name of Person) (Authority Type,le. Offi*er/Attorney) (Name of Party instrument was EUcuted for)
CITY OF ATLANTIC BEACH
"",OAL A 1;AN Tt'
,�',f 09
0 rAK*3 f90`1j1_'4�,T"IL45
I JOH ANDRE-SS BUILDING PERMIT APPLICATION DUVAL COUNTY
2 VAL7ATION -AX)RK S Fi UNDER pfy,)F
VDOC)
4 I.F GAL,DESCR jr,;10f,4
_577-1,17)"tz_1111R,
13 NEW BUDiNG
"-)N 11 AUIDITIII"t 0 DEMDLITI�1�4
' 4 11 r�_)NVET,T!NG,
C1 At,It R A 1,Y4
0"C'Ci ssop 8 FIRE SPRINKI.ER
119 r- El Rf FAIR Lli'�Jlo' 'Sf'�� 70 1�
z 31-25-OF f-I C9.—o T t' I,,, E)rin
PROPERTY OWNER: (;UNTRACTX04'R"'(:F AKCHITECT I ENGINEER:
L In Rod rntAt Z_
24 --J
t,'CRES'�
/1?3-), 3 ot Pei /Ze P41 6-1 Or
6 Y A I f :'L, H,L"'K)r'"Ici
nre
ACDR!��,S N, A1-11�i*_S��,
q10
2 FA�W-'� 1 -----T------------ j:A7,W73'77:33--
'E pt,)r,
PW 2 8 ',A K
_k U N4,'1114F
I tELL PI�Lork 21� CELL PLV_)NE
7,4q- 1PY 6,119-OV76 I
t E MAL-A E 22 ENWL 6,10RES' 7,0 E M A I L_ R E ——————
rgim kb
h 1:111 i:: ITTLE HOLDER: Yt;.* icok*
OF OTi-TR TIIAN()Mrm BONDING COARrAINY:' MORTGAGE LENDER:
NAME
75NAAA F
'I'Mit to (10 Ole Wofi� arid installations as indicated I certify that no worj� or installation has
Applicatk)n is hereby made to obtain Ei Pf
�,onlmenced prior to the issuance of a perrnit and that all work will be per!ormed to meet the standards Of all IaWS regulating construct'Or)it,t1jis
jurisdiction, This perniij becomes null and void if work is not commenced within six (6)months, or if construction orwork is suspendefJ w
abandoned for a period of six (6) months at any time after wo(i( is commenced I understand that separate permits mu,,;l be securiw""'I fo,
Electrical Work.Plumbing,Signs,Wells.Pools.Furnaces,Boilers,Heaters,Tanks, Air Conditionem etc,
OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with aft applicaNe
iaw';FegUlating construction and zoning. I willnOt Occupy or use the referenced building or any part therof, until all inspections are finaled wv,
pnor 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, CONSULTWITH YOUR
-LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
9
,MR or AGENT CONTRACTOR
(If Agem PO y Of Agren't,Letter Reir.ned)
)are
'jay c.
2040n the county of B fore me this
_A 2CAI�On the counly
"�rate of FIrinda,has personalty appeared
Dijval Statecif"londa haspersonallyA)Reafed
nt'IM�Yhtrrlsuff"heisd!arid affirms Ihat all staterrients and declarations are henn by himself 1 herself and affirms that ail statement and declarations are
ifue arId aC.'_UN)fP rrue and accurate
Nota,y Public at raigp stwe of
('ourify of Nrfary Public at L arge,State of courity0f
C3 PeMII�30-j
ary-
.t
Ir4 _�Z)/2 7,?�
AS
'Norar,,
r' If L-visEu, DANKL4.ROMANO my COMMISS #DD 126
EXPIARCE:sq: 21 t
*my Pok-$0111 at AN
ffkc Un
00 Iffm
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000258 Date 3/09/10
Property Address . . . . . . 87 FORRESTAL CIR
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
ADD DRYER CIRCUIT AND REWIRE AS NEEDED
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
RODRIGUEZ BENTON MCCLURE ELECTRICAL CONTRACTORS
87 FORRESTAL CIRCLE PO BOX 51368
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 237-4701
----------------------------------------------------------------------------
Permit * ' ' * * * ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/05/10
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 90 . 00 90 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH.FL 32233 10
OFFICE:(904)247-5826*FAX NO.:(904)247-5845
WWW.COAB.US
ELECTRICAL PERMIT APPLICATION DUVAL COUNTY
Rtit,l'.�-JMADDRESS44 0!lii��
g.
GKO
OYES PERMITM
�,ffv� PER
4.NAME: OWNEWW"
MO
5.ADDRESS IF IFFERENT FROM JOB
ADDRESS: 6.PHO
K
7.NAME OF COMP Y:
8.ADDRESS.:
tA
9.STATE OF FLORIDA LICENSE NO: V-\-v C-
10.CELL PHONE:
12.EMAIL AYDRESS:
4\-,-(J"i 14.
15.Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that all work will be perfi 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 an t time after work'is co
CONTRACTORS SIGNATOqRE:
RE:
,7i i5i Viii ..... .....
in,
13 1 FAMILY-*OF
ESIDENTIAL P 4,0"Mmi
SINGLE FAMILY 11 TEMP�ERVIcE 0 COMMERCIAL
0 ADDITION 0 TRAILOR
191:EI
..........
0 ALTERATION 11 SIGN LID 0 NEW El-0 ION L 5UD—E
0 REPAIR 0 POOL SPA 0 REWIRE THEIR:
LIIST�
20.TYPE OF SERVI E: VEERHEAD 0 UNDERGROUND 0 UNDERGROUND UP POLE
21.NEW SERVICE: COND ',TOR PER PHASE: 0 POWER IS ON 11 POW R IS—OFF
22.SIZE OF CONDUCTOR: — AMPACITY: EICOPPER 0 ALUMIN M
23.SWITCH OR BREAKER SIZE: AMPS: PH- VOLT:
RACEWAY SIZE:
24.EXISTING SERVICE SIZE: AMPS: PH: W::: VOLT: Z'S 0 CEWAY SIZE:
25.FEEDERS: #OF— AMPS:_ #OF_ AMPS: #OF AMPS:
26.LIGHTING FIXTURES: INCAND :SCENT:— FLUORESCENT&M.V.:
27. FIXED APPLIANCES: 0-30 AMPS: — 31-100AMPS: OVER 100 AMPS:
28. FIRE ALARM: 11 YES 11 NO
29-31 DO NOT APPLY UNEW—nimru P vlui�
1. 11 1 1 1, 61 !C 011111 Ill Ll )I I IONS
29.SMOKE DETECTORS: NUMBER:
30.RECEPTACLES: 0-30AMPS:_ 31-100AMPS: OVER100AMPS:
31.SWITCHES: 0-30 AMPS:
.. .. ... ........ 31-100 AM PS:
7177— OVER 100 AMPS.
IN
#OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW:
#OF UNITS: COMP. MOTOR HP RATING: AMPS:
..............................!,,
HEAT KW:
...........................
NUMBER: VOLTAGE: HP: KVA:
NUMBER: VOLTAGE: HP: KVA:
34.T
UNDER 60OV: NUMBER: KVA:
OVER 60OV: NUMBER: KVA:
11 5 l��:1::1 1 �1 119 1 I=1:11.1k!its.
DESCRIBE IN DETAIL:
Elect Permit Application 2010