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Permit 1604 Coquina Place CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 INSPECTION PHONE LINE 247-5826 Application Number Property Address 10-00000574 Application t 1604 COQUINA PL Date 5/07/10 ropert ype description ROOF PERMIT Py Zoning TO BE UPDATED -----Application valuation Application desc ------------------ 5850 -------------------------------- reroof --------------------- Owner ---- --------------------------------- Contractor MEARS 1604 COQUINA PLACE SHORE ROOFING COMPANY ATLANTIC BEACH914 7TH AVENUE SOUTH FL 32233 JAX BEACH ----------------------------------- (904) 241-8842 FL 32250 Permit ROOF PERMIT -------------------------------------- Additional desc . Permit Fee Issue Date _ 80 . 00 Plan Check Fee Expiration DateValuation . 00 - --------------------- 11/03/10 5850 Fee summary --char ed --------------------------------- --------__ ----g_ Paid Credited ----------- Permit Fee Total ---------- ---_-_ Due Plan Check Total 80 . 00 80 . 00 ------ . 00 . 00 . 00 Grand Total . 00 . 00 80 . 00 80 . 00 . 00 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. NOTICE OF COMMENCEMENT BARE IN DUPLICAM Permit No. Tax Folio No. State of Oxy of To Whom it way Concern: The undereignad hereby irrfonns YOU OW inproVIemerrte will be made to frerlydrr aCCord reel property.and in CORWR Ce with Section 7t3 al the t'lortda Stsrdea,the fb0ow ft tnibmreflon b stated to this NOTICE OF EI17: - Law descOption of pity beft I m prwmt Address of property beg i L — L ZZ General ofkWovemsr ta: xG (umQ r . owner SAACAg" 0- Address_1_1QJG1Q 4 OQI A l_4 el ,r1 T�g.dr ?C, ownerls Merest In oils of the hnprrnrement Fee Simple Titleholder Ofother than owner) Name Address Aftess W31 /4 V.- Phone No. o y-•��//— ��- .� Fsx No. 5d�/—a q1- pj)S/? Surly Of arsy) Address Amount of bond s Phone No. Fax No. Name and address of any person mating a loan forthe construction-oflw iopmements. Name Address Ptmne No. Fax No. Name of person within the Stabs of Florida,other than himself.designated by owner upon whom naboss or other documents may be served: Name Address Phone No. Fax No. In addWon to h6sreeif,owner des%vabes the tjowing persons to receive a copy of the Lienees Notice as provided In Section 713.08(2)(b),Fiodde Sfahrtes.(FIR In at Owner's option). Name Address Phone No. Fax No. dExpiration i»date a of Notice ofCommenoement(the aq*adon date Is one(1)year from the die of recording unless a TMS SPACE FOR lNBC 0OS USE ONLY CENAER e a acrd ., , a►[E how 0 b �rw�+.st.t:orFrodr�,rt� „ted hemla by _--�+ -- Mn6��N�dirAtnstliat�saMdae�lanio�IMs .. Doc 8 2U'U*IU45%1,OR 8K 15236' Page 141 Number Pages:1 Recorded 05;107;2010 at 09:47 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY z- _ RECORDING$10.00 PabAc ts�gs Smiad Ca+nr�ror IAyaonrtlsoTmKamm eo�6s� Pmdamd 1 - M tit}yRf Ally PUBLIC ]U STATE OF FLOPJDA • Ccmm#r D00933778 Expires 10/30/2013 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904)247-5845 Job Address: Z�6 (j, - / i � 71°" `�' • Legal Description Permit Number: oor ea o t Parcel# Valuation of Work S ��f e) proposed Work heated/cooled t non-heated/cooled Class of Work(circle one): Ne Addition Alteration Repair Move Demolition pools a wind Use of existing/pro osed structure(s)(circle one): p ow/door If an existing structure,is a fire sprinkler system installed?(Circle one):Residential N/A Florida Product Approval# For multiple products use pro uct approval orm Describe in detail the type of work to be performed: X_ ), A 41 36 /6 T, /f121.1'/,L 30 r.4 S-I ;n f - Property Owner Information• Name: 'k rs rc. ✓j'!c o.`"s 11116-16'1 City Q /G„,C Address:_ Q 4 G t 4 State N L Zip 3a_ 13 Phone �1y Y a y7- V?O 7 E-Mail or Fax#(Optional) Contractor Information: Company Name: X-00 Address:9/y Qualifmg Agent: Office Phone 9 Y- o� /- o? Job Site/Contact Numbcity �X State /-L Zip 3 State Certification/Registration# Fax# 9vsly- Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and 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 ofa 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(work is not commenced within six(6)months, or if construction or work is suspended or abandoned for apejuri d icti (. months at b time work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. y after 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE COMMENCEMENT. OF I hereb cert that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether sppeci:ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions ofany other federal,state, or local l w regulating construction or the performance ofconstruction. Signature of Owner_&Lz� Signature of Contractor Print Name E)912 3 A" b. M E-,4 Q S ........................................................................................................ ........ Print Name /0^ Day Sworn}to and subs ed before me ........................................................................................................... . . .. Sworn to andsub ed before me ........... ............... this Da of 20 s �Day of ( I—' 20 �\ r otary P bli A NOTARY PUBLIC Jub STATE OF FLORIDA NOTARY PUBLIC • pmt DD0933778 STATE OF FLORIDA Revised 01.26.10 Expires 10130/2013 COMM#DD0933778 Expires 10/30/2013 CITY OF ATLANTIC BEACH. 800 SEMINOLE ROAD ' ATLANTIC BEACH,FI, 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00033574 Date 7/26/06 Property Address . . . . . . 1604 COQUINA PL Tenant nbr, name . . . . REWIRE SERVICE 200AMP Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ MEARS COTHREN ELECTRIC 1604 COQUINA PLACE 1139 N. 13TH STREET ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 241-4945 ----------------- ----------------------------------------------------------- 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 PERMIT.IS,APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. �SY Lyrl� = J CITY OF ATLANTIC BEACH ELECTRICAL PERMIT APPLICATION Date: ✓��/_ � 1 Property Address: Owner: e''�� n Telephone#;,�-7' Contractor: �n7��� r�G'C%�/' C, C Telephone#- Contractor Address: Fax#• � ��� Contractor Signature: In consideration of permit given f oing e work as described in the above statement, we hereby agree to perform said work in accordance with the attachedWns and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of od practice listed therein. Building: Building Type: ❑ Trailer Service: 1f other construction is ;3-1/ New Residence ❑ Temp. 4 New being done on this building Or site,list the building Old ❑ Commercial ❑ Signs �/� ❑ Increase Perm't number: ❑ Re-wire 11 Addition Sq.Ft.'//'n ❑ Repair ir, Conductor Size: AMPS: CSO COPPER ALUMINUM Switch or RACE Breaker AMPS PH W VOLT WAY Existing Service /� RACE Size AMPS 20,17 PH W VOLT 7 4? WAY Meter Number ,J Feeders: NO. SIZE `7/ NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Receptacles CONCEALED OPEN Switches n 3n AMPs I I 100 AMPS t 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.F. VOLTAGE PH NO. OVER 1 H.P. PHS UNDER600V OVER600V Transformers NO. KVA NO. KVA No.Neon_Transf. Ea. Sign Miscellaneous 800 Seminole Road.Atlantic Beach,Florida 32233-5445 Phone:(904)247-5800• Fax: (904)247-5845 htt //www.ci.atlantic-beach.fl.us Revised 1/04 rS ' y CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 r' INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00034043 Date 10/10/06 Property Address . . . . . 1604 COQUINA PL Application type description SIDING Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 57000 ---------------------------------------------------------------------------- Application desc REPLACED PERMIT ## 06 32932 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MEARS TRADEWIND SIDING CO. 1604 COQUINA PLACE 9661 MACARTHUR CT ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216 (904) 742-5684 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 191 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 57000 Expiration Date . . 4/08/07 ------------------------ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 191 . 00 191. 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 191 . 00 191 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE 'WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. fr fP= CITY OF ATLANTIC BEACH 800 SEWIINOLE ROAD ATLANTIC-BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00034135 Date 10/23/06 Property Address . . . . . . 1604 COQUINA PL Application type description MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc LP GAS FOR RANGE AND FIREPLACE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MEARS AEI INTERNATIONAL CORP. 1604 COQUINA PLACE 9378 ARLINGTON EXPWY #310 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225 (904) 724-9771 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 105 . 00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date . . 4/21/07 ---------------------------------------------------------------------------- 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 CODES. CITY OF ATLANTIC BEACH MECHANICAL PERMIT APPLICATION Date: Property Address: �� ., ,A (_A-CE Owner: A-2S Telephone#: Contractor:_ Telephone Contractor Address:c'i Fax#: �_?2L( 3 3I D Contractor Signator In consideration of permit given for doing the 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: ❑ Electric Gas: ?CI P Natural _Central Utility ❑ Oil ❑ Other—Specify MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK ❑ Heat _Space Recessed _Central _Floor U Residential ❑ Air Conditioning: ,Room _Central ❑ Duct System: Material Thickness ❑ Commercial Maximum capacity cfm ❑ Refrigeration ❑ New Building ❑ Cooling Tower: Capacity gpm L3 Fire Sprinklers:Number of Heads �►✓ existing Building ❑ Elevator: _— Manlift Escalator (Number) ❑ Replacement of Existing System ❑ Gasoline Pumps (Number) ❑ Tanks (Number) V New Installation LPG Containers (Number) (No system previously installed) ❑ Unfired Pressure Vessel ❑ Extension or Add-on to Existing System V ❑ Boilers Gas Piping ❑ Other-Specify ❑ Other—Specify LIST ALL EQUIPMENT AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving Number Units Description Model# Manufacturer Ton's Agency HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving jp"�(V log,/ Number Units Description Model# Manufacturer BTU's Agency g TANKS Nominal Capacity Type Liquid Serial Approving How Many &Dimensions Contained Manufacturer No. Agency Z '2_4 PmoQc 1 lcsi 800 Seminole Road •Atlantic Beach,Florida 32233.5445 Phone: (904)247-5800• Fax: (904)247-5845• http://wwNv.ci.atlantic-beach.fl.us Revised 1/04 J '"L ra4 w °' CITY OF ATLANTIC BEACH 5 I s) 800 SEMINOLE ROAD j y ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . 05-00030734 Date 7/12/05 Property Address . . . . . . 1604 COQUINA PL Tenant nbr, name . . . . . . KITCHEN FIXTURE/OUTLET Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ MEARS,BARBARA MOORE ELECTRICAL CONT. , INC. 1604 COQUINA PLACE 10526 CRAIG INDUSTRIAL DR ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225 (904) 645-6807 ---------------------------------------------------------------------------- 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 P� PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CO Ick BUILDING OFFICIAL t CITY OF ATLANTIC BEACH ELECTRICAL PERMIT APPLICATION JUL 1 2 2005 Date: Property Address: i (_0U + - �q�_j i I'�c, �� G SL. Owner: �G•f bG V C- � �_Q t('S Telephone #: -3C-7- E Contractor:"ON-S)Cf.- Ele-�C- S ( C-4 Q� S"' `Telephone#: Contractor Address: p. r3�� 3 Fax #: Co`�S 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 Servicer if other construction is ❑ NewResidence ❑ Temp. C) New being done on this building Or site,list the building Old ❑ Commercial C) Signs ❑ Increase Permit number: ❑ Re-wire ❑ Addition Sq.Ft. ❑ Repair Conductor Size: AMPS: COPPER ALLNUNUM Switch or RACE Breaker AMPS PH W VOLT 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 I I 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 UNDER600V OVFR600V Transformers NO. KVA NO. KVA No.Neon_Transf. Ea._Sign Miscellaneous h Gr .`h , K- 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845• http://www.ci.atlantic-beach.fl.us CITY OF ATLANTIC BEACH ELECTRICAL PERMIT APPLICATION JUL 1 1 2005. ' Date: propsrtY Address: (_y CH t..a 1 r-' p, 01 C U.__- Owner• G.f �JG'✓C~ - -0'.1r_"� Telephone#: �,-_�•5 r `elepltone A o,v. ism S`79 � y3 Fax#: .(o�S k�$I? Conta~aetor Address: � � . bconaidetatie�n of permit given for dohs the work as bed in the above stetem AN01, we h=bY OFm P is accordance with the attached plass and specifi tdons mAlid►we a pact hergof and in aecorft= with the ChY'of Atlantio Seam ardinaaoe and standards of EW Practice Hated therein. Redding: Wding lyrpa: ❑ Tnilef Sorvica,' if oe ff, aoeanwtim is a New Roaidence O ',t'em p, ❑ New W4 dome an![b buuuding Old ❑ Cogttaerow. O Signs t7 Iucrpme ����t+ullding 0 Re-win O, Addition Sq.Ft O: Repair Conductor Size: AMPS: C4PPPR AL Switch or RAKE Breaker AMPS PH W VOLT WAY Existing Sarvice RACE S'ise AMPS PH W VOLT WAY Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Radeptacles CONCEALED OPEN (410A Knq Switches Incandescent Fluoresoemt & . M.V. Fixed- BELL A fiancee TRAI`ISFER. , Air EP.RATING H.P.RATING CEILING XW-I AT Conditioning COMP.MOTOR OTHER MOTORS AMPS HAT Motors 0-1 a?, VOLTAGE PH IVO. OVER 1 H.P. PH9 Traaafortum NO. KVA NO. KVA Na.Neon Trans Ea. Si Miscellaneous h do v� 1�,:kc.�.Q,r. —,:1c��1n�: -,� ►�v�o�K.irS '� C.KiS�M s00 9emiaose xo,►d•Atlantle Hench,Florida 32233-5445 Phone:(904).247-5W Fas: (944)247-51145-- http:!/wwW.el.etlanttc-beacL,%ua 2 'd L989949406 01420aj3 a�J00W Wdbb :2 9002 11 the + 4 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 jilt Application Number . . . . . 08-00000992 Date 7/22/08 Property Address . . . . . . 1604 COQUINA PL Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1900 ---------------------------------------------------------------------------- Application desc REROOF REPAIR ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MEARS AWARD SERVICES UNLIMITED, INC. 1604 COQUINA PLACE 1912 BELLE ANGELINE COURT ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32223 (904) 699-8739 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 40 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 1900 Expiration Date . . 1/18/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 40 . 00 40 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 40 . 00 40 . 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 08 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 rt OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 FA J I LD I N G-DEPT@ C OAB.U S ` >> BUILDING PERMIT APPLICATION DUVAL COUNTY I1;JOB�AjDDRESS �_•,..a 0. 2.VALUATION'OF�/JIORK4 a" _ 3;SQ,FT,UNDER/ROOF a I' � vl(,6to Atlantic Beach, FL 32233 D✓ + " (G� 5i CLASS OF=:WORK.."..': t,. B:1JSEiAF,STRUCTURE.',. F ❑NEW BUILDING ❑DEMOLITION 01ESIDENTIAL LOT_BLOCK_SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7, TIO .WORK.,::> ,`. ...,.. ❑ALTERATION ❑ACCESSORY BLDG. 8:F,IRESPRINKLER ❑REPAIR ❑POOL/SPA ❑YES ❑N/A ❑MOVE ❑OTHER ❑NO ✓d„ _ • PROPERTY OWN ER' CONTRACTOR ),.,.r ., ,.:';ARCHITECTi ENGINEER 9..NAME: 15. PANY NAME: 23.COMPANY NAME: 309&444 7 ��1�I� .7 16.NAME; 24.LICENSEE NAME: 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 16�+�y �c�o■civ AJA f� A/ �.��/i i C AS F Iq Ci� 18.ADDRESS: y� / ,/) / L6.A�DpRESS: 3 ZZ 3 3 r)`/i�'Gy /'L+ (Y 11.OFFICE PHONE: 112.FAX NO.: 19.OFFICE PHO • 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 339-oat 3 13.CELL PHONE: 21.CELL P40 E: 29.CELL PHONE: o?.. 2S 7 14.EMA(-ADDRESS:ksQ DD •C O 22.EMAIL ADDRESS:13 1 �� f 30.EMAIL ADDRESS: i4�iw�k'/N.FEE SIMPLE.TiTLE OLDER }3 W! BGO�`NUAtlC'ING CDMPANYFa" i"zki "� F MORTGAGE LENDER } a{r OTHERTHAN bb N M ... 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. OWNER'S 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. x OWNER:'or AGENT , �„ j k > ,t CONTRACTORS` F :(IfAgent;PowerofAttorney0.genvy"LetterlRequlred):, Signed: Date: 17-Al Signed: Date: Before me this-24-day of L 007 in the of Before me this day of 2007 in the county of Duval,State of Florida,has Pers a�1 re JANICE M.MADSEN Duval,State of Florida,has personally appeared I. MY COMMISSION#DD 724227 herin by himself/herself and a �ta herin by himself/herself and affirms that all statements and declarations are true and accurate. true and accurate. Not Public at Large,State of County of H L Notary Public at Large,State of ,County of Personally ❑Personally Known ❑Not I entifica io ❑Produced Identification- Notary Signatu Notary Signature: COAB FORM BLDG01:REVISED:11/6/2007 P.01 Jun-30-97 03:29P PRICE QUOTE APPLICATION FOR WATER AND/OR SEWER TAP APPLICANT NAMEc- MAILING ADDRESS PHONE NUMBER DATE 1a - 36i___`� 7 SERVICE REQUESTED SERVICE LOCATION , DATE SET TO PUBLIC WORKS DATE RETURNED TO BUILDING DEPARTMENT PUBLIC WORKS DEPARTMENT PRICE QUOTE RESPONSE WATER: SEWER: e-.. OTHER: PRICE QUOTE PREPARED BY: Signature - Title DATE NOTIFIED OWNER „ ... j, ; DEPARTMIENTOF BUILDING CITY OF ATLANTIC BEACH f PEt I T I NFORMATIOfi ------ -"----- LOCATION INFORMATION � Permit N trer 15911. Address: 1604 COQUINA PLACE T `Pe ELE TRI AL ATLATTIC BEACH, FLORIDA 32233 i ash o WPrk':ALTtRATIO�I . �_�.�_� . LEGAL DESCRIPTION class. � .� _ ” Constr. ype.,WOOD FRAME �Block: Lot," Proposed Use: Seotion* � S�bd-0 Rngt Dwellings: s4division:OCEAN OROVZ Est . Value: 0 1mpr v'.. Cort: 0 .00 Total Feer : 25.00 Amount <P 25.0 'Date AW 198 rk D� ' r 1 RV- 111L E �14 US 'BION ,'�» APPLICATION FEES -"- ,-.. -- 25 .00 Name .lS LACE , it FLORIDA 32 ------ C R11 FORMAT 16 -- EL. SR RIC SER" Name SAR CE Addy2 ! 1 3tt AV ENUE NORM w, JACKSO EA P'L. 2 ► Lir ER OO48 Exp: ' fie a 1,01 a e "0 �.. • a I NOTES: i 1 I I I {' i " NOTICE-INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOUR$"PRIOR TO INSPECTION E SWLDINC MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED}N4,PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER ` FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW.CAN ,RESULT IN T14E PROPS RTY OWNER PAYING 'TWICE FOR'BUILDING IMPROVEMENTS, " WHICH ARE PART OF THIS PERMIT AND"SUBJECT TO �AEViDCATf OR k ISSUED ACCORDING TO APPROVED PLANS � VIOLATION OF APPLICABLE PROVISIONS,OF LAW. *�fbtl W3 _1 ATLANTI EACH BUILDING DEPARTMENT By: CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL. PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE:i4 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. ELECTRICAL FIRM: 6WASiE4 EtECTRICIAN SIGNATURE JOURNEYMAN � - i NAME_`�,,ma�yy� ��w"` — ADDRESS: ;`�Q � RFD BOX BLDG.SIZE BETWEEN: RES. ( 1 APT. ( 1 COMM. ( 1 PUBLIC ( ► INDUS. ( 1 NEW( 1 OLD ( 1 REW. AO (TION ( I TRAILER ( 1 TEMP. ( ) SIGNS ( ) SO. FT. SERVICE: NEW( 1 INCREASE ( I REPAIR ( 1 FEE CONDUCTOR SIZE AMPS COPPER ALUM. SWITCH OR BREAKER AMPS PH W VOLT RACEWAY EXIST.SERV.SIZE Co AMPS PH W Z-v-//VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS �'L CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0-30 A 31-100 AMPS, SWITCHES INCANDESCENT Y FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER APPLIANCES BELL TRANSF. AIR N.P. RATING N.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT O-1 OVER MOTORS H.P. VOLTAGE PHS NO. 111.P. VOLTAGE PHS MISCELLANEOUS I fill —j— AM DEPARTMENT OF BUItt�lNti CITY OF ATLANTIC BEACH I . _ .PERMIT I NF'ORMAT I ON - LOCAT I OAi INFORMATION Permit umber; 15280 Addre�ssc 1604 COQUINA P1.ACE. ( Permit Type:RZKOIaELING ATLANTIC BEACR, FLORIDA 32233 �{ Cl its f Work:ALTERAT ION _. LEGAL.1,-DESCIR1 PT TON, i Cons t r. Type:WOOD F`RAI+lE B 1 o ck: Lott, Tia e 0 ; ` Proposed UsetStation.: 0 Subd.O Dwellings: ISubdivision OCEAN GROVE' I, Est . Value- 0.00 Improv.. Cost ; �51,390 .00� � TotalFee CCl tt? r Amount 60-00 Oates /1'997 i I) CLOSET k OR APPLICATIOtF"EEr -- Names6o .06 t Addy 4„ LPCE. 'y. p., FLORIDA. 322 �� , C P, OR AT l OP Name': PRS T ' N Addy �i� r # Exp s' 's w DOTES; NOTICE INSPECTIONS MUST BE REQUESTED At LEAST 24 HOURS PRIOR TD IN BPECTtON f BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST'NOT BE.PLACEJ7IN PUBLIC SPACE,AND MUST BE ; CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAtLURE TO COMP WITH 7HE MECHANICS' LIEN LAW CAN .RESULT IN THE PROPERTY OWNS PAYING TWICE FOR SU1L ?1IMIG Et TS " ISSUED ACCORDING TO APPROVE.© PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. 1 ATLANTIC B AGH BUILDING"DEPAR MENT .rr j By: . „ ' CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address 1 Co b C o Q c� rN v't I" C_ • 0 Or C- D a t e -Date Heated Sauare Footage _@ $ _per sq ft = Garage/Shed @ $ per sq it = S Carport/Porch. @ 8-per sa ft = $ Deck (a $ per sa ft = $ Patio @ $ per sq ft = S TOTAL VALUATION : 3 o S_ t Total Valuation 1st $ /4©0 Remaining Value $ per thousand or portion thereof TOTAL BUILDING FEE $ + 1/2 Filing Fee $ 2 6 ( ) Fireplaces @ $15 . 00 $ 0 BUILDING PERMIT FEE S Cao WATER IMPACT FEE $_ SEWER IMPACT FEE S WATER METER/TAP $ CAPITAL IMPROVEMENT S SEWER TAP S f ) RADON (HRS) . 0050 S SECTION H PAVING HYDRAULIC SHARES S CROSS CONNECTION $ ( ) SURCHARGE . 0050 S 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 : RECEIVED 1 , 1997 CITY OF ATLANTIC BEACH tlantic 'Beach PERMIT APPLICATION REMODEL, ADDITIONS, OR Ty( 1ning MOVING,DEMOLITIONS u� Owners) %r� 166P7 $ �,1q/_//c - / 4YAJl E./- Address: / 6 ()� Q O O u J k jq P(- Phone: J q 1 1� 3 q 7 Lot # -7_ Block or Unit # Subdivision: 0�_Ig 0- (_0 T (_0T q i4 y Contractor: Ott) N C—r� State License # Address: Phone No: City Startle II Zip Code Describe work to be done: A Q Q cS H O W to it C LD S E. Ib EXI S 'T► Ny 3GO000 H LOD �BATNU2OOL( Present use of building: E! E A) C.E Valuation of Proposed Construction: ,J O U Proposed use: C-P-EA ► E _�pr'TH lW)- 4 S14ou-ek ffco H //Z Is this an addition? C) If Yes, what are the dimensions of the added space: ft. X ft. Will the added area be heated and cooled? New electrical (or increase) ? New plumbing fixtures? New fireplace? N New Heat/AC? _ SUBMIT T7a= (COIF RCIAL) TWO (RESTDENTIA LJ CaMpLETE SETS OE PLANS, INCLUDING S=fiE PLAN, SURVEY, 27WjGY CODE FORMS, NOTICE OF CCb2MgCEbMq!r, ANr OWNER/CONTRACTOR AFFIDA IE' OWNER S C NT�2ACTOR Signature OWNER: Date: )1I 1997 Signature CONTRACTOR: Date: Sworn to and sub, ed before me is /7 —day of .f 191,7 4rti. c c�1 N Y PUELIC STATE OF FLORIDA AT LARGE ?°•` y Petdda Amro efts =* += MY COMMISSION#CC-W881 EXPIRES August 27,2000 q7 h' 80NOE0 TWU TROY FAIN INSURANCE,INC. CITY OF 500 SETIINOLE ROAD - - - --- -- ATLANTIC BEACH. FLORIDA:32233-5445 TELEPHONE(904)347-5800 F.A_Y(904)247-5805 SUNCOM 852-5800 CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489. 1 03(7), FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT 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 SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER $2,000) BE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. 771E ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES; OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION OF THE OWNER, WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS. SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKERS COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY CLEARLY PROTECTS THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1 099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228( 1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE 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 THE ABOVE DISCLOSURE /"""���STATEMENT AND THAT I C THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. n ZWITH ALL 1pw,�ed Cl 4" PROPERTY OWNER/BUILDER A C) . C - ADDRESS TELEPHONE SWORN TO AND SUBSCRIBED BEFORE ME THIS 77 f I J /. NOTARY PUBLICNOTE: PHRASES dapmonetba ARE EMPHASIZED BY THE IBUILDING ABOVENED MY COMMISSION EXPIRES: LcommasslumIf C44RES '°S•. ° gUS EPARTMENT. FAIN INSUMKE,INC. 80 NDED iHRUTROY •�� fid;: 77, 21 Lu APPROVED MY OF ATLANTIC BEACH BUILDING OFFICE EP 2 3 97 t j 1 i i ! t 4 !f t w / S fff 4 1 1N LA-) E t CE/VE 11� SEP 17 1997 City of ,atlantic Buildin Beach g and Zoning t{tl f i 1 I !f { {Jr i 4 j/4 RECEIVED SEP 17 1997 City of Atlantic Beach Building and Zoning Universal-Rundle F RAMING DIMENSIONS Bath Products A B C D E F G H 6848 32" 32" 32'/s" 73'/." 16" 16'/m" 2934" 3%" 15'/;" i i ATL AS!! 6808•36" 36" 35" 73'/." 18" 16'/4" 33%" A HOW TO INSTALL FINISHED WALL G E LATTICE B FIBERGLASS SHOWER °�`� SC RE W \ �'/.' DETAIL OF 1 STUD ` MOUNTING LINE Y FLANGE I FIXTURES H-y V/171 F� FITTINGS /Iy�/'_.1 I FLANGE These units are too big to fit through `-'[�„OWER ARM ■ average door openings, so move units SUPPLY FITTINGS MAXIMUM within installation location before you complete i+ HEIGHT framing. Optional procedure is to omit studs in 9GGI I one wall or to install studs without nailing to I allow moving unit into place. Keep unit cartoned •�” w, all the way to bathroom site for added protec- tion. When moving, avoid flexing of sidewalls to prevent radius cracking. Unit should be cen- 4" tered on handtruck and handled with care. SUB FLOOR NOTE: DO NOT STORE FIBERGLASS UNITS OUT OF DOORS- KEEP OUT OF SUN- LIGHT. FRAMING DIMENSIONS 6865 If plumbing is adjacent to a masonry wall, 1/411 NISHED 7'e"" 2■ you must arrange for access to connec- LATTICE W"" tions. This may be handled by building a separ- SCREW DETAIL OF 361/." STUD I1 MOUNTINGOUTLET ate plumbing wall six inches from masonry wall. LINE v FLANGE 341. �,y 3%"61A. Install firring strips when back of unit is against L -1 OUTLET; I q' HOLE masonry wall. EDGE OF 1� -� _MOUNTING FLANGE 4534"(MAX.DOOR WIDTH) L""' FITTINGS w Before installation, arrange to provide 30 access to drain and overflow connec- 83,,,.. r017 tions. Where units are installed on the floor LF SHOWER UNIT E WITH 'Z OPTIONAL above a basement or in places where drain 70.1 ARM TOP G GRAB BAR SUPPLY FITTINGS ! ,73'.^ connections are accessible from below,connec- 1, 73:1/4" tions can be made at either end.When units are a1: MX. 73;' installed on a slab at the corner of outside walls, - DOOR UNIT 48" 41.. connect at the accessible end or provide access OP to connections. If units are installed on a slab SUB T- ,FLOOR - ---_... ----- --, back to back against outside walls, plan to r pr, *,ie access to connections or connection at ac.,,vssible end of at least one unit In wood parti- SHOWER DOOR WIDTH:453/4" SHOWER DOOR HEIGHT:731/4" tion construction and both units with masonry or fire-rated partitions. NOTE: DIMENSIONS MAY VARY±1/4". CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: Z&()q_ r OWNER OF PROPERTY:- PLUMBING CONTRACTOR: /^�SY�1`�yCiS /�/u..5�c%�o►-�N�, CONTRACTOR'S ADDRESS: f'o, 6��c sp 4(V6 AC4, STATE LICENSE NUMBER: C�CC�j(�4:p 7 TELEPHONE: 01/^vL 4/7-4,V/7 HOW MAVY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORIES WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINES FLOOR DRAINSL tt SHOWER PANS OTHER Set. - SetAc. 1b TOTAL FIXTURES: X 3.50 + $15.00 MINIMUM PERMIT FEE _ $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR.��_�. CD ±j ----------------------------------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834. 1 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ._ �4RMTT INFORMATION, -------- LOCATION INFORMATION ATION Permit Number: 13899 Address ! 1604 COQUINA IPLACE Perdu. Type".PLUMSIN04 ATLANTIC SEA N ' FLORIDA 32233 c ` of. Work.A.LTUATIO t L SAL : 2lESCF xPTSt?N �. +ion trk `t` P -WOOD FRAME �BIock: Lot Twp-. Pt`� � ed LAB�e D r l ire I Section: Subd*,O Rnv a Subdivision: Est . Value-, 0.00 Improv. Cost : .oo 'Total Fees,. 25 .CQ Ate' §E 23 .00 r. ' Da T'MR ION APPLICATION FEES N ►rte s FIT 25-00, Add . GLACE B FLOR I DA 32 - .Ti 'nW.IA ' 4 t; AMR° ORMAT I Name MO lel IN a` ' ATLAI Acii} FLORIDA 32233 a } k 0 ro � III NOTES: i 3 NOTICE-INSPECTIONS MUST BE`REOUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION a 9 i 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 t "FAILURE TCS COMPLY WITH THE MECHANICS' LIEN LAIN CAN RESULT IN THE PROPERTY QW'NIER PAYI14tG TWICE FOR BUILDING IMPROVEMENTS." IS UE0 ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND, JBJECT TO RE1�0�4TION`F4f1 .. VI ITIQN OF�APPOCABLE PROVISIONS,OF LAIN. + 8 I4 AU of ATLANTIC ACH BU LDIN 17 P, RTMENT 79 By: i CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: D , OWNER OF PROPERTY: ( s� {� PLUMBING CONTRACTOR: CONTRACTOR'S ADDRESS: Z/03 / UJ STATE LICENSE NUMBER: O! / � TELEPHONE: HOW MAVY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORIES WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINES FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES: X 3.50 + $15.00 MINIMUM PERMIT FEE _ $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: L4— ------------------- ----------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS — (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP — (904) 247-5834. PSR•3844 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT INFORMATION ------ - -_ LOCATION -I NFORMAT I ON --------- P ttlid t - Pttlidt Number: 9290 ddress: 1604 'COQUINA PLACE I? * mit Type: RE-ROOF ATLANTIC EEAI"HsFLO ILA 32233 '1s f Work: N»W _ _- LEGAL DESCRIPTION Con tr . 'Type: WOOD FRAME o+ : � Slack : Section* _ j P oposed Use: SINGLE FAMILY Township: RNG: 0 D r I lin s : 1 Code: 0 ,ubdivisian: -+OCEAN' GROVE 1 Eatimtted' Value: $2400�00 Improv. C t: m 0 Tot����m � � $22 . 50 ' Amount 2 . 5 /94 TION APPLICATION FEES .. .. N ' PERMIT22. 50 Adrs • G O PLACE N �P C EE �0 00 C FLORIDA ' Ph.'` 5� WAT R 1 T R TAF $0 .00 RADON OAS-H.:R. S $0.00 CTI RADON CAB 5% $0 .00 CAPITAL ::.Z 1FFtCItI'E. $0 .00216 N STREET-SV I TE ASEi R TAP $0.00 LE EACH, FL 32250 CROSS CONNECTION Lq e: Type SEC' H IMPACT FEE0 M. . SC1RCEATI,.HCM NOTES:' NOTICE--ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOTBE PLACED IN PUBLIC SPACE,.AND MUST BE CLEARED UP'AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER I AILURE TU COMPLY 11 ITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS." 16UED ACCORDING TO APPROVED PLANS WHICH-ARE PART OF.THIS PERMIT'ANQ�SUBJECT TO #�E�iQCATIOC+t-;FOR t�#APPLICABLE PROVISIONS OF LAW. � ATLANTIC BEACH BUILDING DEPARTMENT � �'� CITY OF ALANTIC BEACH ROOFING _ PERMIT APPLICATION Owner(s) : 'Bo 77�921e12 Address: AR, Phone: Lot # Block or Unit # Subdivision: Contractor: Address: QJ10 City, State and Zip `SA-k .3 2- 2 SCS, Phone -23 -5- State State License # Describe work to be performed: a Valuation of Proposed Construction: , ADD Materials to be used: S/ &;E A- s Signature of Owner; Signature of Contractor: r �� Liability Insurance Supplied Workers Compensation Insurance Supplied License Information 9183 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH , ,;.. ` PERMIT INFORM ON, ---- _- LOCATION INFORMATION Pet ;I '>!umbe 91,83 Iddress: 1664 COQUINA, PLACE P it Type{ UTILITIES ATLANTIC BEACH, FLORIDA 322 C mark: NEW ...._,.�,� �_. LEOAL DESCRIPTION --�-- --- ., C nstr . Type WOOD FRAMEest . Block.. , Se n n: Proposed Use: SINGLE FAMILY Township: RNC : 0 " l allings : 1 Code, ubdiviEion: OCEAN GROVE � I E tiiha ed Value: $0. 00 i 1uprov. Cost, $0 . 0'0 Total ' F1 725,00 A ountpW V 2 5 Oo �+ Date 7:'94 WATER: SERVICE .« . ,. TION, � ;' m" - APFL I CAT I OK FEES . x • �PERMIT a 0 ,00 Addy: ' .,, A� PLACE WATER IMPACT FEE 00 C' FLORIDAWEE' " fl. r ro RAVON OAS -H.R.S. $0 .00 R. ORMAIT I O - RADON CAH .'5% p� ^� �r y+��1 y�! tom.......u.:.+�.. CAPITAL �} * �y ;r'�¢ y I .EiF m LI I' DEPART 1 'wr F J, .k AG" V i'�x i x < b Ad"O' :E,� ��,�.,.�_ �.w .., SEER TAP { x Q as CROSS CONNECTION $35.00 Li ns eo, ` Type: D SEC, N IMPACT FEE � O CONST x SURCHARGE °�'w� W f f� Y t i s NOTICE-ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTEC BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BU.ILPING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE y CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER �TAILURE'TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THEPRC?PERtY OWN ER PAYING TWICE'FOR BUILDINGIMPROVEMENTS.$$ I t�t1l*I) ACC0RDING TO APPROVE.D PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REYOC,ATIOtd FOR ' ON,OF APPLICABLE-PROVISIONS OF LAW. 71 ATLANTIC BEACH BUILDING DEPARTMENT Det •. 1 � pl St. � +!� ;; CITY OF 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE(904)247-5800 FAX(904)247-5805 Dear Property Owner: 8a�� �fir� 'PltK'� l�c�V 6 0 Ru IA"� The costs to connect your building to the City sewer and/or water system are as follows : Sewer Tap - Labor and Materials to tap into sewer main $ Water Tap - Labor and Materials to tap into water main $ �A7 Water Meter - Cost of Meter $ ;Fj', 6 (-) Cross Connection Inspection - Inspection by Public Works to ensure backflow prevention $ S-1 0 Sewer Impact Fees - Funds future expansion of the sewer plant $ �� Water Impact Fee - Funds future expansion ,� of the water plant $ �� © D Captial Improvement - Funds for improvements, expansion or replacement to ��' � water system $ TOTAL COSTS $ If you have any questoins concerning these charges please call the building department at 247-5826. Sincerely, 6(,)- a� C' ?0—�� Don C. Ford Building Official DCF/pah y r CITY OF ATLANTIC BEACH Fixture Unit Worksheet for Water Impact Fee FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TWENTY DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. BATHROOM GROUP CONSISTING OF SERVICE SINK TRAP STAND WATER CLOSET, LAVATORY & BATH (8) TUB OR SHOWER STALL (6) (—'Zi-)iWATER CLOSET WATER CLOSET, TANK OPERATED (4) VALVE OPERATED (8) BATHTUB/SHOWER (2) URINAL WALL LIP (4) SHOWER GROUP PER HEAD (3) FLOOR DRAIN (1) SHOWER STALL DOMESTIC (2) LAUNDRY TRAY (2) LAVATORY (1) CO COMBINATION SINK AND TRAY (3) WASHING MACHINE (3) POT, SCULLERY SINK (4) DISHWASHER (2) WASH SINK EACH SET OF � FAUCETS (2) KITCHEN SINK (2) -; DENTAL LAVATORY (1) KITCHEN SINK WITH WASTE DENTAL UNIT OR CUSPIDOR (1) GRINDER (3) BIDET (3) URINAL STALL, WASHOUT (4) FLUSHING RIM SINK (8) COMBINATION SINK AND TRAY WITH FOOD DISPOS. (4) URINAL, PEDESTAL, SYPHON JET DRINKING FOUNTAIN (1/2) BLOWOUT (2) LAVATORY, BARBER/BEAUTY ICE MAKER (1/2) SHOP (2) SURGEONS SINK (3) LAVATORY, SURGEONS (2) JACUZZI (2) URINAL STALL, WASHOUT (4) TOTAL FIXTURE UNITS c� @ $20.00 EACH $ JOB INFORMATION O c r— PSR•3&t4 9239 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH --------- PERMIT 1,100 ATION . ,....._.. �._-w _ LGCAT10 INFORMATION --- �,m*~t Nu r e qz39 Address: 104 !COQUINA PLACE I' mast + PLt1M INO ATLANTIC. SEACN, FLOR DA 32233 �"1 t of Work, NEW ------------ LEOAL DESCRIPTION ---------- 'Type _x.e-_-- ' `y _ WOOD P`RAME of : Bltaska section: Pro 6zed Use# SIIVIoLE I'At TL Tvwrn hiP: RN(3s Q Dwell Ingm 1 Code. Q ubdivision: .0ii-inated Value: 13 .0 IIaP ov Cost . E0 .00 Total F Fi r 525 .0 Amount . Dat e' N. y I OIC ..- . .. � APPL I CAT'I ON FEES "� PEFII"I' alt? Ad s A PLACE VATV � MPA ' FEE � O,00 irtw 0 RADON C# S~H:It.S 'S0.00 ...._ r_ kI " OR"ti -_-�--�-_ ' RADON CAB 5% WOO Name,' . . A Ca USI A CAPITAL.,._I14P ED.tU.. w... ..v . � t A�_- < SEWER TAP � $0.00 ATLAN . E A N 'LA,. 3 2 2 3 3 CRSS C.CNNECT ION $0 -00 L a �. 7 7�TP�"" 4 � SEC";R 'IMPAC FEE CONST.SURCHAROZ, Tr M.' � NOTES- k NOTICE-ALL CONCRETE,FORMS AND FOOTINGS MUSt-BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE SUIL-DING MATERIAL,RUBBISH ANDE DBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER F iILURE TO.COMPLYVITH THE MECHANICS!,LIEN LAW CAN RESULT IN THE PROPERTY �31NNER PAYING TWICE F0� BUILDING 111 Rt3VEMENTS." ` IS 1 D ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVf3CATIONt l^O�I ; I �!43IQN OF APPLICABLE PROVISIONS OF LAW. ATLANTIC EACH BUILt51NCx DEf'AtT1lENT � .$Y CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION:/ OWNER OF PROPERTY: BUILDING CONTRACTOR: PLUMBING CONTRACTOR AND ADDRESS: i TELEPHONE NUMBER: . STATE LICENSE NO: TYPE OF BUILDING: TYPE OF WORD: HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS OTHER _ ,- TOTAL FIXTURE COUNT: x $3.50 + $15.00 = $ ---------------------------------------------------------------- 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 CONVECTIONS MUST BE CALLED INTO PUBLIC WORDS FOR INSPECTION BEFORE COVERING UP - (904) 247-5834 i 1-6076 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH i r PERMIT INrOP-MAT16N ------ LOCATION INFORMATION, � _ Permit Nuiiber: I: sJ Addree : 1604 COQUINA, PLACE Permit `Type:UTI'LITIES ATLANTIC $EACH, FLORIDA 32233 "lays :work-,'NEW --------- LEGAL DESCRIP3`Tt?N _-_.�----- Constr. Type:WOOD FRAME B 1,06k.- ' Lot : Twp', 0 Proposed, Use: Si don'» 0 Subd i o t Dwellings . RnI: 4 Est. Value. fl,0C Subdivisiot :OCEAN GROVE ` ImProv.. Cost: 6"00, Tota1 'Fe 12S0 .00 Mount nx if, , .A vr 44 I TION, � . .� APPLICATION PE E ����* y� N an) T 01001 Ad r: LACE n MATER I T,. FEE B C ;FLORIDAPho 3 > a R . i CO: A Re ORNAT I O1 Name ;a %fir i 3111 414 #xes!#,ta,,ya..'..M_?'t s'tt. zaY t,.,. . ".w,=.,.,. uana:.,+ ..«h" ",a,•rew,re+ . Of NOTES: i s t NOTICE—INSPECTIONS MUST RE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECtON i i BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN.PUBLIC SPACE,AND MUST BE I CLEARED UP AND HAULED AWAY BY,evrHER CONTRACTOR OR OWNER y , "FAILURE TQ COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT-ISN { THE PROPERTY OWNER PAYING TWICE FOR EUILDING I U1PROV 1 ENts.': 14NED ACCORDING TO APPROVED PLANS WHICH ARE FART OF THIS. PERMIT AND SUWECT TO REV A1'ION ftp � VJ LATION OF�APPLICABLE PROVISIONS OP LAW. . lift ATLANTIC BEACH BUILDING D PARTMENT ' 41 3 i By: psi. 4 DEPARTMENT OF BUILDINQ CITY OF ATLANTIC BEACH PERMIT INFOP14ATION, ------- L4CT#TIOM INI?'oRmATIQN Permit. FJurnbe r. ITB 6 Address: COQOINA PLACL ' " Fermi t T TPS:PLTERA { " ATLANTIC B ACA, FL - IIA 32233 cit Work€AL"I�TI©N _� -_-_ -• LEGAL DESCRIPTION k Cox s t ' Type;WoOD FRAME _Block:1 cock: � Lot: Twp. Q . I�'x°aPo e?sl tJ> Section: 0 Subd:0 Rng,. 0 i I3 ze l in r l Subdivision:OCF.N ,C;ROVE Est. Value: 0;.00 k Improv. Cost- a.4Q Total Fe b a .44 Amount ION ,Nam 45 P ' .. Addr: 3, A L,A+CL 25.W ' Bo PLORIVA 3P oil 2 Name `HR STT, ST,'COAST P�f Add : ,P . I N ,C. R CICS' i JA,CdKSO '$EACH, ,PL 32240 Lxc, CP ` y , ,.a. ww,rarr;a x axd,u.m,�.wa„ f NOTES. { 1 I 'NOTICE—INSPECTIONS MUST BE REQUESTED AT LEAST 24 NOt�iRS PRIOR TO INSPECTION { BUILDING MATERIAL,:RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, j CLEARED UPAND HAULED AWAY BY EITHER CONTRACTOR OR OWNER AND OUSTBE `4FAILURE TO COMPLY WITH THE MECHANICS' LhEN LAW CAN. RESULT IN THE PROPERTYWNER PAYING TWICE FORBUILDit4G IMPRQV MENTS." ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMaT AND SUBJECT TO REYtyIA. VIOLAION OF TAPPLICABLE PROVISIONS OF LAVW, Dues bf1l71.. ATLANTIC EACH BUILDING EPA TMEhlT � 1 By: x ; DATE:/__ PRE-SERVICE DIVISION JACKSONVILLE ELECTRIC AUTHORITY 233 WEST DUVAL STREET JACKSONVILLE, FLORIDA 32202 THE FOLLOWING FINAL INSPECTION<S> HAVE BEEN MADE AND ARE SATISFACTORY: -�o`' ------- ----------------- _.� 1_. _ ------ _ ________________ ----------------------------------------------- ------------------------------------------------ ------------------------------------------------4 Enclosed are the blue copies of the permits. 7SINLY, BUILDING INSPECTION DIVISION cc:FILE CITY OF ATLANTIC BEACH, FLORIDA q t,3-� Aoo►ov.d by APPLICATION FOR ELECTRICAL PERMIT / ZYTO THE CHIEF ELECTRICAL INSPECTOR: DATE:_.1�1 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. �In t4 6&47Z —ELECTRICAL FIRM: MWER ELEMI-CIAN /// NAME- L `� AOORESS:�D CoN `' A)O FD BOX BLDG.SIZE BETWEEN:_ C.f� -IV %of s�'i�001f,, RES.(1, APT.( 1 COMM.( ) PUBLIC( ) INDUS.( ) NEW( I OLD( 1 REW.(--r- ADDITION( I TRAILER ( ) TEMP.t ) SIGNS ( j SQ FT. SERVICE: NEW( j NCREASE kap -REPAIR( ) FEE CONDUCTOR SIZE0 AMPS 090 COPPER ALUMJ TCH OR BREAKE 00 AMPS p _,Zvc)VOLT EXIST.SERV.SIZE O AMPS PH 3 W Z Yo VOLT . C.44rf`rRACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL , 0•$0 AMPC $1.100 AMrs. SWITCHES INCANDESCENT . FLUORESCENT&M.V. ' FIXED 0•100 AMPs. oval APPLIANCES BELL TRAN$F: AIR H.P.RATING H.P.RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS ICEIL HEAT: KW-HEAT °-� ovIR MOTORS H.P. VOLTAGE PHS NO. i N.P. VOLTAGE PHS MISCELLANEOUS TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA NO. IKVA Heated Square Footage $ per sq ft = $ Garage/Shed @ $ per sq ft = $ Carport/Porch @ $ per sq ft $ _ Deck l @ $ per sq ft $ Patio @ $ per sq ft = $ TOTAL VALUATION: $ I'� -Ulb $ / . f; Total Valuation 1st $ /�C;0 0 Ranainder Valuation per thousand or , portion thereof ---------------------------------------------� Total Building Fee $ -'0 ADDITIONAL PERMITS and/or FEES REQUIRED + 2 Filing Fee $ & 'Mechanical Fireplaces @ 15.00 $ b � BUILDING'PERMIT FEE $ Plumbing Electric/New '------------------------------------------------- Electric/Temp ---- - ----------------------------------Electric/Tamp Septic Tank BUILDING PERMIT $ Well WATER METER CHARGE $ -- % Swim ring Pool SEWER IMPACT FEE $ % Sign WATER IMPACT FEE $ c� Water Connection MISCELLANEOUS $ — c� Sewer Connection ' o $ Water Meter $ Elevation Certificate ' GRAND TOTAL DUE $ =� ---------------------------------------------------------------------------------------------- CALCULATIONS and/or NOTES . i i r. Y p _11 CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS Owner (s) :-g6,9/_/V --------------------------------------------------- �Zo4� Co�ui Nit Address:- �b �6� GGP�.-/�v Phone: ��76 ----- -------- ---------------_:- . :----------------- Lot #------ Block or Uni # Subdivision Contractor: Describe work to be done: `- ---------------------------------- Present use of building :------ �'- Valuation: '(' � 60. C t' ----------f----------�____-�_-- - -- --------------- Proposed use: Is this an addition?---�dIf yes, what are the dimensions of the added space: A'6 ft. X _ ft. Will the added area be heated and cooled?__ A/e _ New electrical for increase) ?_A/6 New plumbing fixtures?_N0 New fireplace?_/0 New Neat/AC?__ /Vj -_ SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER:- ------------- Date: 72, Signature CONTRACTOR: ------------------------------ Date: JUL 2 997 ; ..,. 2 2 1992 ,. "4'i ZJ i6 i J '1 _. . APPROVED CITY OF ATLANTIC BEACH f BUILDING OFFICE S 'E JUL 2 31992 a i 4 4-1 CIO a j S ` { 's D { i t i f 1 ]] a y t } y 4 y 5 � E i i . t r L� pppnovF _ IVTIC LBEACH i. C1TB D,NG OFFICE JUS 2 19 2 ( t 4 Y } r ; i t i ' t s 1 4 f i { 1 , ' r �. ,t S X CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00032932 Date 5/08/06 Property Address . . . . . . 1604 COQUINA PL Tenant nbr, name . . . . . . INSTALL SIDING Application description . . . SIDING Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 6500 Owner Contractor --- --------------------- ------------------------ MEARS, BARBARA TRADEWIND SIDING CO. 1604 COQUINA PLACE 9661 MACARTHUR CT ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216 (904) 742-5684 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50 Issue Date . . . . Valuation . . . . 6500 ---------------------------------------------------------------------------- Special Notes and Comments **HAVE INSTALLATION INSTRUCTIONS ON JOBSITE** CALL FOR INSPECTION DURING INSTALLATION 247 5826** Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 65 . 00 65 . 00 . 00 . 00 Plan Check Total 32 . 50 32 . 50 . 00 . 00 Grand Total 97 . 50 97 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILD,,*- CODES. t !ate BUILDING OFFICIAL rt L`J X53 CITY OF ATLANTIC BEACH cc: r ;�1 D. Ford S BUILDING /ZONING DEPARTMENT T" 800 Seminole Road oer�s Atlantic Beacb,Florida 32233 r�'1lil�� (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application Property Address: I LoD4 hoUj .h 0 , place) 4kL CC Applicant: 1 l Project: � ' I This permit application has been: EV Approved Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: Date: ` Date Contractor Notified: CITY OF ATLANTIC BEACH SIDING PERMIT APPLICATION Date: Please complete(2)complete set plans with application. Job Address: 16,0,4 e!� O&W/OA ,�L ATLA k;7(L IS E_A C-P Owner of Property: #;A A &/3 PA igA A-S Address: Telephone: Legal Description: Block Number: Lot Number: 9 —Zoning District: �'' V/ 0'ro 4E V N I t- Siding Contractor: A149 Qfsld 6/j/i le C D Contractor's Address: q b Telephone: 741— b iLl - Fax: 17 le Tod 2, 2— Describe 2--Describe proposed use and work to be done: bu c9 L _ C(A Present use of land or building(s): 96-61 VA-A.)-r7 A L Valuation of proposed construction: Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. 1. Provide detailed information of product being used and how it is to be attached,i.e.,fasteners,etc. 2. Provide completed Owner's Authorization Form if applicant is other than property owner. �a, i�. — fb Address and contact information of person to receive all correspondence regarding this application(please print). Name: 2 11'11 1c1 J1/a 1 1��Ct f" W 1V� 6/dlAw C0 Mailing Address: , / Telephone: ►��{— � 2',5-6�� Fax: 9DL/" (o'y2 Z �� E-Mail: t Ll..�� / ax ' a4 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Page 1 Revised 3/04/04 I hereby certify that all information provided with this lication is correct. Signature of Owner: Date: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information bein e and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: AS TO OWNER: Sworn to and subscribed before me this day of 120 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced Identification Type of Identification Produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of /_( /T"I 20 d State of Florida,County of Duval ,IANICE M. MADSEN tNo/tary's Signature: tary public, State of Flodda Personally own My comm. exp. Nov. 9, 2007 Comm.No.DD 265690 ❑ Produced Identification Type of Identification Produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atiantic-beach.fl.us Page 2 Revised 3/04/04