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Permit 421 Oceanwalk Dr S CITY OF ATLANTIC BEACH IS .1 el) 800 SEMINOLE ROAD S ATLANTIC BEACH,FL 32233 -5826 INSPECTION PHONE LINE 247 j Application Number . . . . . 09-00002052 Date 1/29/10 Property Address . . . . . . 421 S OCEANWALK DR Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 40000 ---------------------------------------------------------------------------- Application desc addition ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLARK PHILLIPS BUILDERS LLC 421 OCEANWALK DR.S. 1250 SELVA MARINA ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 349-2999 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL HVAC PERMIT Additional desc MOVE AND ADD DUCT, NEW SYSTE Sub Contractor REGISTER' S HEATING & AIR Permit Fee . . . . 111 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/28/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO RRMATN ON THR WTNDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and cannot be placed on City right-of-way. ---------------------------------------------------------------------------- Fee summary I Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 111 . 00 111 . 00 . 00 . 00 Plan check Total . 00 . 00 . 00 . 00 011111911 W11 I jj � ME) ECEWE I ra CITY OF ATLANTIC BEACH 10- L FA 800 SEMINOLE ROAD.ATLANTIC BEACH,FL 32233 JAN 29 20 V OFFICE:(904)247-5826*FAX NO.:(904)247-5846 i t�; VMW.COAB.US MECHANICAL PERMIT APPLICATION DUVAL C-OUN TY RMI Al�i PEI 7- HI , , '1.JOB'ADDRESSVM�,�-` hili EIIES PERMIT#:09 -2 P T-2- -T-77- .......... a 0A i PROPERTY., CIA 6.PHONE: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: ...................... ...... ....... MECHANICAL C �: ; —�A B.AARESS' 2236 7. 1— ..y Kin- 9. TATE OF FLORIDA L.1 ENSE NO: 10.C ,,F.L�PHO ee,% --7 C'�e- F fin: -7 eir?.EMAIL DRESS', .t//44- t3 R`641111' Application is hereby made to obtain a permit to do the work and installations as Indicated. I certify 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)mon s at any time after work is commenced. ARI CONTRACTORS SIGNATURE: on s allt any time a IT SERVICE., ii! IT'S crzl�ow��.,,.,,��,.",,�ll,��i�i�.�,�,I&,CURRENT CODE�E, M MINEW INSTALLATION 0 NEW 1211�ESIDENTIAL 0'07 FLORIDA BUILDING CODE- 0 REPLACEMENT OF EXISTING SYSTEM 61KXISTING 0 COMMERCIAL MECHANICAL 0 A ,�TERAT ITI)N TO EXIST SYSTEM 0 OTHER Q#REPAIR OcAlf Dut+ i� 0 11, ,"' —, 2 . IN NTTOISEPISTALLED: ��N,!V 4 �q, �twv,� lia�I�� a NICAL EQqI ME 19.HEAT: 0 SPACE EIRECESSED IDIF-ENTRAL 13 FLOOR BURNERS: -EF NTRAL 20.AIR CONDITIONING: 0 ROOM 21.DUCT SYSTEM: MATERIAL:[",&Ad I f-le THICKNESS: MAX CAPACITY:S.��cfm___ 22.REFRIGERATION: MAX CAPACITY:-cfm 23.COOLING TOWER: CAPACITY:-9PITI 24.FIRE SPRINKLER: NUMBER OF HEADS: 25.LIFT SYSTEM: ELEVATOR: MANLIFT: ESCALATOR: AUTOLIFT: 26.COMMERCIAL HOOD NUMBER: 27.FIREPLACE: PREFABRICATED: MASONRY: 28.IRRIGATION: 0 PUMP 0 WELL 0 PIPING 29.GAS PIPING: OF OUTLETS. 0 GAS AHU: 0 GAS WATER HEATER: 30.OTHER-SPECIFY: SOLAR HEATING, BOILERS,UNFIRED PRESSURE VESSEL,HEAT EXCHANGER VALUE FOR OTHER ITEM Llx6w OR COIL IN DUCTS ETC. S: COOLING, .......... v5 i�', ITIONINq.REFR160AAt ON EdUIi*MENt:CON "R R 0 ID APPROVING NUMBER OF UNITS DESCRI PTION MODEL# MANUFACTURIER TONS AGENCY Q IP 2 INT" _.,HE 1 AT RE-' CE I�A 5 IR 1,HANDL FURNIACES�BOILER911�OL ERS ETC. NUM,B ER 11 — i APPROVIN(3 OF UNITS DESCRIPTION MODEL# MANUFACTURER BTU AGENCY 33.TANKS: I YPE LIUi APPROVING NUMBER GALLONS CONTAINED MANUFACTURER SERIAL# AGENCY Mech Permit Appicaton 2010 ff SS CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 09-00002052 Date 1/07/10 Property Address . . . . . . 421 S OCEANWALK DR Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 40000 ---------------------------------------------------------------------------- Application desc addition ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLARK PHILLIPS BUILDERS LLC 421 OCEANWALK DR.S . 1250 SELVA MARINA ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 349-2999 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 250 . 00 Plan Check Fee 125 . 00 Issue Date . . . . Valuation . . . . 40000 Expiration Date . . 7/06/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and cannot be placed on City right-of-way. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . CITY RADON SURCHARGE . 00 ST CONSTRUCTION SURCHARGE . 00 AB CONSTRUCTION SURCHARGE . 00 DEV REVIEW-SINGLE & 2-FAM 50 . 00 STATE RADON SURCHARGE . 00 ------------------------------ ax-------- PERMIT I&APPROVED ONLY IN ACCORDANC ---7�ffy__CFF_,�Tl, PhTIC FRIEAZR Oft0fN7,5C'E*S AN5,Tniz Frou IT .,E WITH ALL X BUILDINd*EME§ummary Charged Paid Credited Due CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 -5826 INSPECTION PHONE LINE 247 Page 2 Application Number . . . . . 09-00002052 Date 1/07/10 ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 250 - 00 250 . 00 . 00 . 00 Plan Check Total 125 . 00 125 . 00 . 00 . 00 Other Fee Total 50 . 00 50 . 00 . 00 . 00 Grand Total 425 . 00 425 . 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 APPLIC 'TION M R m ent.) (To be assignE he �d ��l , byj Building Department 'Seminole Road 800 8 Atlantic Beach, Florida 32233-5 110,09 �41 1 Phone(904)247-5826 - Fax(904) 47—_kP45 Date rout d: I it, E-mail: building-dept@coab.us Cityweb-site: hffp://www.coab.us APPLICATION REVIEW AND TRACKING FORM #,t)IL))q L Q ent review required Ye Property Address: 12- Build' Applicant: Planning &Zor� a ee dministrator Project: 141-6Y-) ublic Wor s u ic ilities Public Safety Fire Services Ar�,i Ou Other Agency Revijewor Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection F r I pt. of Tr po tic lorida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoiolic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: [�Approved. [-]Denied. (Circle one.) Comments- BUILDING (P�LANNING &ZONIN Reviewed by: Date: TREE ADMIN. Second Revieww:�P�PrMved4aw&ftd. RDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: S 'O�L� Date: FIRE SERVICES Third Review: RApproved as revised. E]Denied. Comments: Reviewed by: Date: Revised 05114/09 CITY OF ATLANTIC BEACH 09- IN 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 OFFICE:(904)247-5826 0 FAX NO.:(904)247-5B45 R. -1''..1 BUILDING-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY —1�'IT,,, VALUATION PFY.V NPEIR 4-01 CLASS�OF.' RK CE STRUCTURLR;",�- 13 NPWBUILDING 0 DEMOLITION 04-ESIDENTLAL LOT—BLOCK—SUB DIVISION 9KDDITION 11 CONVERTING USE El COMMERCIAL E TIO ALTERATION 0 ACCESSORY BLDG. R W`%."O SCRIP K F Km, 11 REPAIR 0 POOL/SPA �YE � 13 wA 0 0 MOVE 0 OTHER 0 C AR HITECT I ENGINEE To P1;11�1511�1��-`-111 P R 0 P E R TY,OWN E R 9.NAME' 15.COMPANY NAME: 23.COMPANY NAME' -? I 16.NAME: 24.LICENSEE NAME: P H I LA.'I Pi f4a.6(),� 039 Z_ 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 4'Z I Q-3c- ) 2,�--73j* 18.ADDRESS:j 7 j-0 .26.ADDRESS: -721-LA, 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 4 120.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 1 341-7-,1--1 1 13.CELL PHONE 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22 EMAIL ADDRESS' ,EMAILADDRESS: ('�61 0450�� 15-*�:A1('r'C) FEEZIMPLE71TILE HOILDER.'��',,�--.Ri -"..-Mil- ,T-H-Ah— UF P-ER 0&4E 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 perforyned 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. OWNEITS 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. CONTRACTOR-��-,.-,',`* ER',' 'V.'AGENT',*�i�:!-�, :OWN elit,P6*Cr' orAgencytefter Required). (QU91ifier On yy Signed/)44(da t�� Date: lgi S ne Date: Before nile'this—day of �Ij 2009 in the county of B this day of 2009 in the county of Duval,State of Florida,has personally appeared D-ufv-j7s"t,-ate of Florida,has personally appeared herin by himself/herself an ffirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are s true and accurate. true and accurate. of L rg Notary Public t e, te of Notary Pul;ilic at La ta Of Coun 1:1 Pers ly'nown r16, -u_ t",_,. Zced identffi b d Identili I ,�a 11 Pe lly s. ally Kno ig kt."; a nip Notary Si4n Nota 9� 6 111 R Notary PLFV- N ate of Plonda :!late ot F 'tary Publi, .,,,MY COmmissKn ExT State of p, )ires Fet��MO 10 lssiOn Ex - 017da Commission#DD 518533 Plres Feb 14 2 Bonoed By Nat;jonal Notary Assn. Corn - �'p -s 18 '2010 Tr S misslon#70)D5 0,9ded By�jat. 518,533 g.P 'onal IV t BLDG01 Perm' Applicattlan BI . MIS I WW �"-Alolla''votary Assn. City of Atlantic Beach APPLICATION NUMBER (To be assigned by the Building Depart]ment.) Buildind Department vl� 800 Seminole Road 00, Atlantic Beach, Florida 32233-54 4 �0 1100.9 _77 Phone(904)247-5826 - Fax(904) Date routed: E-mail: building-dept@coab.us Cityweb-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1-12_1 Depa�ment review required Yes No Applicant: Build. 2ul -Tre—e-Kd-ministrator Project: f:u:b�licWor S -Pu=ictilities Public Safety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management Distdct Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: E$Approved. E]Denied. (Circle one.) Comments- BUILDING PLANNING &ZONING Reviewed by: Date:_)_)—).7_/c/2v5 TREE ADMIN. Second Review: []Approved as revised. ElDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. E]Denied. Comments: Reviewed by: Date: Revised 05/14/09 city of Atlantic Beach APPLICATION NUMBER % Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 ,r E-mail: building-dept@coab.us Date routed: g a It City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: etkl)A),9 I DWpadMent review required Ye No Buil ' Applicant: lanning &4oDWg -Tre—e Administrator Project: 41-u-blic WorRDs -P-M—FITtilities Public Safety Fire Services p�m wy, ........... $101113 - Q Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: pproved. [-]Denied. (Circle one.) Comments: PLANNING &ZONING Reviewed by: Date: 1-6 -162 TREE ADMIN. Second Review: FlApproved as revised. Rienied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 CITY OF ATLANTIC BEACH 09- OFFICE:(904)247-5826*FAX NO.:(904)247-5845 BUILDING-DEPTGCOAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: 2.VALUATION OF WORK�. I ISO;Fr.UNDERROOF, -12- 1 064-_-h�0 tvn0c, De.<,�,Vr 4 4-0, 0 00, 0. 4.LEGAL DESCRIPTION: 5.CLASS OF WORK 6.USffF STRUCTURE: 0 NF,"UILDING 11 DEMOLITION 01,4 FNT LOT BLOCK-SUB DIVISION WKIDEDITION 0 CONVERTING USE 13 COMMERCIAL DESCRIPTION OF WORK 11 ALTERATION 11 ACCESSORY BLDG. B.FIRE SPRINKLER: 0 REPAIR OPOOL/SPA [I PYE§,- 0 N/A 0 ADDIFT)do Q MOVE Q OTHER 0 PROPERTY OWNER: CONTRACTOR: ARCHITECT/ENGINEER. 1.NAME: 15.COMPANY NAME: 23.COMPANY NAME' C lAe,11( -P/4 I Lie i PS Qlaorc-<' _TN-,(i�� Do A244-6 i I t C)(;,11, f"C 611110JIJJ� 16,NAME: 24.LICENSEE NAME: K(AAC-i- PHILulpi FIZ601 039 Z- 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 0 % C%3 C 11 2A'7-3)l 4 4S , 18.ADDRESS:i zj-b SeJoIA AA ft rZ,,,VA 26.ADDRESS: a Vs S r- S I-r- zo L� 1�71. _74&bc, 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 120.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 24 1--2,1-7 4 1 13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22 EMAIL ADDRESS' 30.EMAIL ADDRESS: FEE S TITI R- MORTGAGE LENDER: O=THA�EHOLDE BONDING COMPANY* N 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNEWS AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof,until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU'Ri NOTICE OF COMMENCEMENT. 0 NE I or AGENT CONTRACTOR (If.Ag4t,P r otA"y or Agency Letter Required) u lifier Only) Signed (16,,( (t-� -Date: i2ALC Signe Date: 59-L)C) 1, - d� Before Fthi. day of �Ij 2009 in the county of Bel �re a this day of 2009 in the county of v Duval,State of Florida,has personally appeared Du ,State of Florida,has personally appeared herin by himself/herself an ffirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations arel,�, true and accurate. true and accurate. d, )C--. lic:t Larqg,--A Notary Publi t rge, te of 6n ?.�J 4 fPu , te of Coun .1 na ly 7n Pe ly Known n.1 Identiri to :;P�rdumd Idan Note 2 Note S4na't'*_"� Notary P Ph ��'(F FORCODE , 'State of F, n ond'a COMrniSSio #DD 5185C OF !"rniss -�Plres Feb 14 20 10 Bonded By Na nal Notary As Co #DD 322 PERMITS FOR nded By N 51853� BLDG01 Permit Application Bldg:REVISED: 1W2003- IREMENTS AND COND ONS. nal Notary 4ss,. LAIN. REVIEWED BY: DATE: CITY OF ATLANtIC BEACH PRODUCT APPROVAL SPECIFICATION SHEET (short form) As required by Florida Statute 553.842 and Florida Administrative Code 913-72,please provide the information and approval numbers on the building components listed to be utilized on the construction project for which you are applying. We recommend you contact your local product supplier should you not know the product approval number for any of the applicable listed products. Statewide approved products are listed online @ www.floridabuilding.org Category/Subcategory Manufacturer Product Description FL Approval#(s) EXTERIOR DOORS a. Swinging b. Sliding c. Sectional/Roll Up d. Other WINDOWS --------- a. SinC�/Double Hun j Ft- 2-- b. Horizon—t—arSM—er c. Casement d. Fixed e. Mullion f. Skylights g. Other PANEL WALL a. Siding b. Soffits c. Storefronts d. Glass Block e. Other ROOFING PRODUCTS a. Asphalt Shingles 40 vp" b. Non-Structural Metal V c. RoofingTiles d. Single Ply Roof e. Other STRUCTURAL COMPONENTS a. Wood Connectors b. Wood Anchors c. Truss Plates d. Insulation Forms e. Lintels f. Others NEW EXTERIOR ENVELOPE I understand that,at the time of inspection,the following information must be available to the inspector on the jobsite: 1. A copy of the product approval. 2. The list of performance characteristics which the product was tested and certified to comply with. 3. A copy of the"aicable manAacturers'installation requirements. Further,I derst d ct m ve to be removed if approval cannot be demonstrated during inspection. Z 0 -7 A cant Signature Date H:/Product approval spec sheet short form.xlsx APPENDIX 13-P FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUC71ON FORM 60(kA-"R Residential Whole Building Performance Method A NORTH 12 3 PROJECT NAMM qd Oc earala I k sun-om 13&?Ialers AM ADDRIZESS: PERMITTING CLIMATE F OFFICF-, ZONE: 1 F]2 F OWNER., PERMIT NO.: 191 0 1:;� 1.57-5�- JURISDICTION NO.:1 I I I I L] Please Type CK 1. Now construction or addition I �I��"I 2. Single-family detached or Multiplo-familly attached 2. 0 3. It Multiple-family-No.of units covered by this submission 3. 4. Is this a worst case?(yestino) 4. A)b S. Conditioned floor area(sq.fL) 5. sq.It. 6. Predominant save overhang(M) 6. ft. T. Glass typs'and area:(Label required by 13-104.4.6 If not defauft) Description Area a.IJ-faclor(or Single-or Double-Pane DEFAULT) 7a. sq.ft b.SHGC:(or Clear or Tint DEFAULT) 7b. sq,ft. & Floor"a and Insulation: a.Slab-on-grads(R-value+perimeter) Be. R=_,_I.ft. b.Wood,raised(R-value+sq.ft.) 8b. R= .-sq.ft c.Concrete,raised(R-value) 8c. R sq.fL 9. Not wall type,area and Insulation: a. Exterior: 1. Concrete block(insulation R-value) ga-I R=_, sq.fL 2. Wood frame(insulation R-value) 9a-2 R= sq.fL 3. Steel frame(insulation R-value) 98-3 R= sq.fL 4. Log(insulation R-valus) ga-4 R= sq.fL 5. Other: b. Adjacent: 1. Concrete block(insulation R-value) 9b-1 R= sq.fL 2. Wood frame(Insulation hi-value) 9b-2 R- sq.fIL 3. Steel frame(insulation R-value) 9b-3 R= sq.fL 4. Log(insulation R-value) 9b-4 R= sq.fL 10. Coiling type,area and Insulation: 10s.- sq.fL a.Under attic(insulation R-value) b.Single assembly(Insulation 19-value) 10b. sq.ft c.Radiant barrier,IRCC or white roof installed? loc. 11. Air distribution system* Ila.R= a.Ducts(insulation+Location) Ilb.R= b.Air Handier(Location) 7, 0-1 l7a. Type: 12. Cooling system: 12b. SEERIEERICOP: (Types:oentral-split central-single pkg.,room unit,PTAC,gas,none) l2c. Capacity: Ls 13. Meeting system: 13S. Type: V, -zp (Types:heat pump,elec.strip,not.gas,LP gas,gas h.p.,room or PTAC,none) 13b. MSPFICOPIAFUE: 13c. Capacity: 14. Hot water system. l4a. Type. �'I-.-4 (Typos:elec.,natural gas,solar,LP gas,none) l4b. EF: 9 15. Hot water credits a.Heat Recovery(HR) 15a. b.Dedicated Heat Pump(DHP) l5b. c.Solar 150. 16. HVAC Credits 16. (Use:CF-ceffing fen,CV-cross vent,PT-programmable thermostat,HF-whole house fan, MZ-Multizone) 17. COMPLIANCE STATUS:(PASS if As-Built Pts.are less than Base Pts.) 117. a- Total As-Buift points -j�� b. Total Base points l7a. 7b. 7 L/-3 I hereby certify that s and specificall rod b ft calculation are in Review of plans and specifications covered by Oft calculation Indicates compliance with compliance with tile Orgy the Rorida Energy Code.Before construction Is completed.this building will be Inspectad PREPARED BY: DAM. for compliance in accordance with 553".F.S. I hereby cer*thl this building is in cm- with the Florida Energy Code. BUILDING OFRCIAL: /r Ton OWNER AGENT; DATE.- DATE:-I . CZ Z -- EAU- Predominant glass type.For actual glass type and areas,see summer and winter glass output on Pages 2 and 4. Page I APPENDIX 13-D SUMMER CALCULATIONS CUMATE ZONES 12 3 OVERHAW GLAW S94GLE-PANE SUMMER I DOUBLE-PANE SUMMER SUMMER I As-exALT ORIENTATION LENGTH AREA POINT MULTIPLIER R POINT MULTIPLIER ON( (SO.FT.) CLEAR I TWr CLEAR ON FACTOR N _Mr ffrom IIA-1) ��pn 21.73 1725 19.20 14,84 NE 33-% 27.37 29.56 23.48 E 47.92 39.62 42.06 _3&89 BE 48.65 40.24 42.75 34.47 - S 40.81 33.55 35.87 2&73 - Sw 45.75 37,77 40.18 32.30 W 43.84 36.13 38M 30-93 NW .29.42 nm 2&97 20.48 H, 84-46 68.97 74.r7 59.51 OVERHANG PATIO-OH LENGTH OH HEIGHT WEIGA11TEID CLASS 13ASE CLASS lax' ki ':T FLOOR AREA MULTIPLIER SUBTOTAL 1LA:M OTAL .18 ;,nno I L 151f q v v COMPONENT BASE SUMMER BASESUMMER1 COMPONENT SUMMER POINT MULT. AS-13U§LT DE$CRPTM AREA PONT.MULT POINTS DESCF#PTIDN AREA X PA-2 THRU 6") SUMMER POINTS EXTERIOR 1.7 7)0" ADJACENT .7 v EXTERIOR 6.1 ADJACENT 2-4 w yj 1 A,� L c UNDER Am v All= BASE CEILING AREA EQUALS FLOOR AREA DIRECTLY UNDER CELING,AS-BUILT CEILING AREA EQUALS ACTUAL CEILING SQUARE FOOTAGE SLAB qp� I i -37.0 v RAISED w..) 1 1 _&99 FOR SLAB-ON-GRADE USE PERIMIETER LENGTH AROUND CONDITIONED.FLOOR.FOR RAISED FLOOR$USE AREA OVER UNCONDIT10NE. v K19LTHATION& 1021 IZC2 1 1 1 1021 L INTERNAL GAINS USE TOTAL FLOOR AREA OF CONDmONED SPACE TOTAL COMPONENT BASE SUMMER POINTS j TOTAL COMPONENT AS-SUILT SUMMER POINTS Base Cooling Total Base BASE ATOTALT As-Built As-Built AS-BUILT x COOLING S_SUL DSM AsIBuilt As Buill 1 As" 1 COOLING System Mu1%*er Summorpok" CSM X COM COOLING SYSTEM POINTS SUM.PTS. (SA-S) (6A-20) (SA-7) (6A-9) (6A-19) POINTS -325 Dqd 1.15 or 1.0 Base UILT HOT I As Bull Sys- Number of X1 As-Sulft HINM 4 -_- TEM DESC. bedrooms (6A-22) (410 H 14ORIZONTAL GLASS(SKYLIGHTS) FOR GLASS WITH KNOWN SHGC,SEE SECTION 2.1.1 APPENDIX C. 'MUST MEErCRITEF:HA OF MULTIPLIERS MAY BE USED FOR GLASS WrrH SOLAR SCREENS,R S.607AA- Page 2 APPENDIX 13-D WINTER CALCULATIONS CUMATE ZONES 12 3 OVERHANG GLASS SINME-PANE vNITER i DouBLE-P X,wRfrm AS-SU,[LT ORIENTATION LENGTH AREA POINT MULTIPLIER C R " U CA R - GLA.4 OH(F EET) MG.FT-) cum THW CLEAR --TR-f—r --1 0� 0) WINTER PTS N 331i 34.06 24M 25.37 NE 32.04 33.06 23.57 Z4M E 2&41 2&18 113.79 20.51 BE 21.82 2424 14.71 17.06 S 2024 22.87 1&30 15.87 SW 24.09 26-20 16-74 1&79 Ll W 28AM 30.32 20.73 22.15 H NW 32a3 33.82— 24M 25.14_ 29.19 31.47 19.86 2Z11 I H CONIL v I WEXL4M GLASS BA A"UHL.T .18 1 SEGLASS X FLOOR AREA X MULMPLIER SUBTOTAL GLASS SUBTOTAL 4ql- I -la 1 (o o3 1 20.17 -7 1'7 X 1- /6 il�) I V v COMPONENT AREA I SASEWINTER -BASEWINTER COMPONENT VWMR POINT MULT. AS-BUILT DESCRIPTION POINT.MULT. POINTS DESCRIPTION AREAL. (11A-114M�15) WINTERPOINTS EXTER &7 d ADJACENT 3.6 v v cc I EXTERIOR 1-3 12-3 1 Mon 11.5 v v UNDER ATnc OR ?-05 Au- SINGLE ASSEMBLY RBSARCCAvMs mce X- BASEC ING AREA EQUALS FLOOR AREA DIRECTLY UNDER CEILING.ASSUILT CEILING AREA EQUALS ACTUAL CFJUNG SQUARE FOOTA-:.:t:::: SL-:-:—� 1 8.9 RAISED MEA) I I .% FOR SLAB-ON-GRADE USE PERIMETER LENGTH AROUND CONDITIONED FLOOR.FOR RAISED FLOORS USE AREA OVER UNCONDITIONED SPACE. INFILTRATION& -om 1 3 1:71/177- -Q58 INTERNALGAINS USE TOTAL FLOOR AREA OF CONDITIONED SPACE. v v TOTAL COMPONENT BASE VANTER POINTS ;2 j TOTAL COMPM-ENT AS-BUILT WINTER POINTS I �77�L6 Base ToW Base BASE TOTAL I As-suat I As-Bt& As Built A8431JILT Syste- x winter HEATING AS-BUILT X DM X OSM AHU Ars,-,k L HEATING HEATING Multiplier Points POINTS WIN.PTS. (6A-17) I (SA-20) (6A-16) I (sA. POINTS SYSTEM "" 1 (6"1) .04 1.170 1.0 1 BASE COOLING BASE BASE HOT TOTAL BASE AS-BUILT AS-BUILT AS-BUILTHOT TOTAL POINTS + HEATING +WATER POINTS POINTS COOLINGPOWTS+HEATINGPOINTS +WATERPOINTS AS-BUILT (Fmm P-2) POINTS (gom P.2) (Enter on P.1) (I=P.2) (F..P.2) POINTS (Erder on P.1) t r 7.=H;;�ONTAL GLASS(SKYLIGHTS) FOR GLASS WITH KNOWN SHGC,SEE SECTION 2-1.1,APPENDIX C.-nNT MUST MEET CRITERIA OF S.607AAL MULTIPLIERS MAY BE USED FOR GLASS WITH SOLAR SCREENS,FILM,OR TINT. Page 4 SS CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 09-00002052 Date 2/03/10 Property Address . . . . . . 421 S OCEANWALK DR Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 40000 ---------------------------------------------------------------------------- Application desc addition ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLARK PHILLIPS BUILDERS LLC 421 OCEANWALK DR.S . 1250 SELVA MARINA ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 349-2999 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc ADDING BATH 3 FIXTURES Sub Contractor TDG PLUMBING Sub Contractor REGISTER' S HEATING & AIR Permit Fee . . . . 76 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/02/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and cannot be placed on City right-of-way. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 76 . 00 76 . 00 . 00 . 00 PERMIT IS RaF-MV01&QX IWQtC&DANCE WITH ALL)Q'ITY OF ATLANTI(Q DEACH ORDINANGEQ OkND THE FLORIDA0 0 BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Page 2 Application Number . . . . . 09-00002052 Date 2/03/10 Grand Total 76 . 00 76 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF A71ANTIC BEACH 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 BUILDING-DEPTCCOAB.US PLUMBING PERMIT APPLICATION DUVAL COUNTY 11.J013 ADDRES& 2.IS THIS A SUB PERgL,,Zj;�� 3.DATE: 0 , �0 NO Z.—PER IT#: PROPERTY r4.NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.. HONE: C I I F NTRACTOR. 7.NAME OF COMPANY: 8.ADDRESS,: 14 z Lc-4 iNc qcsovw�k F% 32 9.STATE OF FLORIDA LICENSE NO, j 10-CELL PHONE. 11.Fr4 C FC i A?- lo Z_ 54s- \ 12.EMAIL ADDRESS: 13.OFFICE PHONE, 14, Application is hereby made to obtain a permit to do the work and installations as indicated. I certify 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. CONTRACTORS SIGNATURE: 15.MATURE OF WORK: 15. 17. 11S.CURRENT CODE: 13 NEW 0'07 FLORIDA BUILDING CODE- 0 RE-PIPE PLUMBING 0 OTHER: 113.NULWER FIXTURES: BATH TUB SEWER CONNECTION BIDET SHOWERS DISH WASHER SHOWERS PANS DISPOSAL SINK DRINKING FOUNTAIN WATER CLOSET TANK FLOOR DRAIN WATER CLOSET VALVE HOSE BIB WASHING MACHINES ICE MAKER WATER CONNECTION INTERCEPTOR WATER HEATER LAVATORY URINALS LAUNDRY TRAY OTHER(SPECIFY): ROOF DRAIN 20.PLUMOM PERMIT FEES: PERMIT ISSUING FEE: $35.00 TOTAL FIXTURES: x $7.00 (PER FIXTURE) + $35.00 BLDG03 Pe"Applicsfion Pkmi,.b:05 D5 09 SS CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000128 Date 2/16/10 Property Address . . . . . . 421 S OCEANWALK DR Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 15325 ---------------------------------------------------------------------------- Application desc REROOF ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLARK RANDLE ET AL PERFORMANCE ROOFING LLC 421 OCEANWALK DR. S . 2235 MERCATOR DR ATLANTIC BEACH FL 32233 ST. AUGUSTINE FL 32087 (904) 853-6336 (407) 210-1503 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 130 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 15325 Expiration Date . . 8/15/10 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 130 . 00 130 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 130 . 00 130 . 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 APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 .7 0-Rif Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date ro,:uted�-.�k"' City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z12,1 S 0Ce_Ax_Aj 4,�q � De t review required Yes No % Zu i Id 7in g 7 Applicant: ninag 8&,Zoning —Tree Administrator Project: A-cv/-- Public Works Public Utilities Public Safety Fire Services e re Other Agency Review or Permit Required Review or Receipt Date - - of Permit Verified By Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS f D N Reviewing Department First Review: [-]Approved. [-]Denied. t/ (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: FlApproved as revised. FjDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. FIDenied. Comments: Reviewed by: Date: Revised 05/14109 CITYLLr i L Lj L.�: FEB 0 2010 �-1 y 09- Date: ROOFING PERMIT APPLICATION Job Address: A+(,--�%r_ 9"rt,% CL 12213, OwnerofPrope Address: �5A_PK-e— Telephone: 3 S 3 — (PSI(0 Roof Contractor: -State License Number: CC.C, OS-716SLA Contractor's Address: ZZ5S rAtte"r D& brI0040 FL S260-1 Telephone: G(91-110- MOS -Fax: 52( -?-39 - 073 Email: Scope of Work: ize Roofing Material Fl.Product Approval# 5 LA411LA Valuation of Work: S I S,3 L-S- Required Inspections: Sheathing/In Prog In /Final If re-roof: Assessed Value of Structure:7 WOW/__>$300,000,Roof-to-wall Improvements required? (Applies to single family structures only) "WARNING TO OWNER.' YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMEN73 TO YOUR PROPERTY.A N077CE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPEC770N. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDERORANATTOR BEFORE RECORDING YOUR NOTICE OF commwamwr SIGNATURE OF OWNER: Date: AS TO OWNER: Sworn to and subscribed before me this day of 20 St lorlda,CoAaft"vab(m NOTARY PUBLIC Notary's Signature: STATE OF FLORIDA 0,Personally known Comm#DID09259" Produced Identification Expires 9/16=13 "'Type of identification produced SIGNATURE OF CONTRACTOR;.E�� Date: 24�1 0 AS TO CONTRACTOR: Sworn to and subscribed before me this day of .20 /0 State of Florida,County of Duval Notary's Signature* KATH LELN AN��CAS,EY ...... Personally known C mm#DD0676201 0 Produced identification 0 Type of identification produced Expires 9/13/2011 Florida Notary Assn.,Inc -Atlantic Beach,Florida 32233-5"5 800 Seminole Road Telephone: (904)247-5800.Fax:(904)247-5945 F:\roof permit applicaton.docx 7/28/09 NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State Of .4 4t"00*1 County of �V�41 To whom it may concern: The undersigned hereby informs you that Improvements will be made to certain real property,and In accordance with Section 713 of the Florida Statutes,the following information is stated In this NOTICE OF COMMENCEMENT. Legal description of property being improved: re- fbbf Address of property being improved: Liz I btub'y'U&-1 K 60 VIA, A 7- General description of improvements: Owner tAt, vkka-la�, Address AfT1, fkkf'23 ?—Z- 33 Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address $,,qontraictor V-LA A V) VZZ) Address 61)z e. t a 24 Fax No. Phone No. !2L Surety(if any) Address unt of bond$ Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name Address V oi� C:ic=Q0 Phone No. Fax No. Name of person within the State of Florida,other than himself,designated by owner upon whom no or 0 documents may be served: Name Address Phone No. Fax No. In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option). Name Address Phone No. Fax No. Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): :3 THIS SPACE FOR RECORDER'S USE ONLY OWNER R a! Signei DATE Before etft X—Idayof- 16 in te of Fl 'd h Doc 20-1 002t020,OR t3K 15144 Page'1349, &.1mUril h mr! by Number Pages:I himself/herself and that all statements and aeclarations herein accurah Recorded OZ03i201 0 at 12:43 PM, are true and 17s JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00 Notary Au"T"j?'s, stat t,:i -Isu'!9 1-, —-------- My comZ�io= Personally Known Produced Identification CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 Telephone: (904)247-5800 Fax: (904)247-5845 www.coab.us FAX T o: ?e,t 4W/-� V Fax#: 23�- 14?73 From: af kzt Date: Pages: Re: �"rgent F-� For Review X-Please Reply Notes: '44—AAA-k -12f t An :5 a-dn�� 1(511 ®r THE CITY OF ATLANTIC BEACH BUILDING INSPECTION DEPARTMENT ROOFING INSPECTION AFFIDAVIT Re: Permit# 1, 0 licensed as a &cwAm Contractor*/Engineer/Architect,or Building Inspector* (print name) (print type) Licensem CC-C,0S9 (.5'i A. C-C-C-Q57L5V� On or about -V Sr,, lzsnlo did personally inspect the roof-to-,wafl connections as required by Rule 913-3.0475 at e (Job Site Address) ,O:ZBased u n that examination I have determined: (circle one) Th�e roof-to wall connections were installed according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S. ) I made the necessary corrections to comply with the Hurricane Mitigation Retrofit Ma Signature STATE OF FLORIDA COUNTYOF Sworn to and subscribed before me this dayof ' 20 By_ I) KATHLEEN ANN CASEY Notpiry Public,Stat of rida -0m,"#DD0676201 /2 —oiresg/113 011 t yp Irin ,t Notary Assn.,Inc (Print,type or stamp name) Commission No.: Personally Known or Produced identification Type of identification produced *General,Building,or Residential Contractor or any individual certified under 468 F.S.to make such an inspection. This form must be on file at the Building Department prior to calling for a Hurricane Clip Inspection, F:\roof permit applicaton.dou 7/28/09 02/12/2010 11:01 3212391973 PAGE 02 CERTIFICATE OF LIABILITY INSURANCE OP ID DATE tMMMDwYYY1 RLHAI�l Qi4j&110 PR90IM9111 TM13 CERTIFICATE 1-9 I-flUEO AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTWICATE aXHL& INSML%NCZ MtOUP, INC. HOLDER.THIS CERTIFICATE DOES NOT AMEND.EXTEND OR P. 0. WX 160399 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ALTAMONTE SPRINGS M 32716 Phono:407-869-0962 Fax:407-774-0936 INSURERS AFFORDING COVERAGE NAIC INSURED INSURER k. t—A Vt.ftak SPOAL011ty INSURER wrldwerLeld zmloyeory Ifte, 10701 ggOVO&A00 Roofing, LLC (14SURIZA Phoenix Insurance Co. Meltsfe8q. I INSURER D 1. I rlando INSURER E! COVERAGES THE POLICIES OF INVVRAWA LIGTGO ULOW HAVE MEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE F40LICY PERIOD INDICATED,NOMrTMOTAMNG ANY REQUIREMENT,tIRM OR CONNMN OF ANY CONTRACT OR OTHER DOCUMENT wrrm RESPECT TO WHICH THIS GERTiriwe MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POUCIIE9 DESCRIBED HEREIN 13 SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS of SUCH POLIC0.AOMIGATE UMITS$MOWN MAY HAVE BEEN REDUCEDBY PAIOCLAjMS. L wslqa TYPII OF IMMMINI D LIMITS ylk POLICYNUMBER 7AIX NI,;A�=M I GON11RAL LJA44LITY I EACH OCCURRENCE ill'0001000 A commaitoAL GENERAL LIABILITY CLO141064 01/27/10 01/27/11 Cal S50,000 CLAIMS MAOff ;x]OCCUR MEDEXP(Anyomp"rom) s5,000 PERSONAL&ADV INJURY 31,000,01 00 GENERAL AGGREGATE GEN*L AGGREGATE LIMIT APPLIES PER' PRooucTs-compiopAw s2,000,000 7 POUCY FE TECT 7 LOC AUTOMOBLE UAMUTY COMBINED SINGLE LIMIT ANY AUTO (Es udft"Q ALL CWN10 AUTO& ROOPLY INJURY SCHEDULED AUT03 (Per perem) HIRED AkITCS 3M4Y IN4VRY NON-OWNGDAUTOS wdGAI) PROPERTY DAMAGE (Por n=Wanl) rARA"WASILITY !�U!OON -EAACCIMNT 3 ANY AUTO OrHIIR THAN 19A ACC S AUTO ONLY: AGG S EXCESS I UMBRELLA UANKLITY EACH OOCURRENCE s2,00(1,000 A 7X OCCUR 7 CLAIMS MADE XSOII1016 01/27110 01/27/11 AGGREGATE s2,000,000 DEDUCTIBLE 9 X_RETENTION S10,000 —AMIR5 COMPM14TON ANDEMPLOYERI'614BUTY YIN X I TrRYSUTAMTrK I I Is' a MY PROPRIETOIWARTNERPEXECUTIV" OFFICE R)meMBER EXCLUDEE" 83030396 10/22/09 10/22/10 &L.rAc 1000 " �ry In NH) E L DISEASE-tAEMPLDYEE�$1,000,000 11yos,dozcAm undur I SPECIAL PROVISIONS bow* �t DISEASE-POLICY LIMIT;3 1 b50""'000 OTHER C Equipment Floater 6601169K259 01/27/10 01/27/11i Leased & 100,000 Rented Eq DESIMPTION OF OPERATION5 I ILWATKIN%/VVHICLX$I EXCLUSIONS ADDED my am"21 mtw IMPOMWM0148 CERTIFICATE HOLDER CANCELLATION SHOULD ANY CW-THE AWA DESCRIBED FOWC%S BE CANCELLED WFORIS TK%X"RATION CITOATL 10 DAYS WRITTEN NOTICE TO THE CORTIPICATE HOLDER NAMED TO THE LEFT.BUT WALURE TO 00 50 S"A" City of Atlantic ftach IMPOK NO 4001.10ATION OR UABUTV(W ANY KV40 UPON TM INSURM ITS ACANTS OR Fax; 247-5845 INIPINISSWTATIVES. 800 Seminole Read Atlantic Beachn 32233 ACORD 25(2009MI) 009 ACORD CORMAMION. AN rights morved. The ACORD awft S"d logo are 1"Istared=ACORD 02/12/2010 11:01 3212391973 PAGE 01 .......... ............ ROOFING PERFORMANCE DRIVE Ph(407)210-1503 Fax(321)239-1973 FAX To, '�SC-J% Flu# Fax �0'4' Uj phone! DOw 834 z-&i C, Re- CC- 0 ureem 0 For ReWww 0 Pleaw Comment 0 Nease Reply COMMENTS: ts LA^ Ll THIS COMMUNICATION IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED AND MAY CONTAIN INFORMATION THAT Is PRIVILEGED, CONFIDENTIAL.AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW.If the reader of this message is not the Intended recipient, you are hereby notified ftt any distribution, use,or copying of this communication is prohibited, If you have received this communication in error,please notify us immediately by te*Mone at 407-210-1503 and return the original message to us at the address above via the U.S. Postal Service.Thank you. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000213 Date 2/25/10 Property Address . . . . . . 421 S OCEANWALK DR Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 200 amps 240 volt ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLARK RANDLE ET AL GATEWAY ELECTRIC COMPANY 421 OCEANWALK DR. S . 11246-19 DISTRIBUTION AVE E ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32256 (904) 853-6336 (904) 268-0275 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/24/10 ---------------------------------------------------------------------------- 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 10— FF-F-f-F-1 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 VWVW.COAB.US ELECTRICAL PERMIT APPLICATION DUVAL COUNTY Z.� ffl$,�XSUE -M,JOBA DPRESS'*�00�40 H4r-r�'-!""'l-4;P ONO 2C C�r _K( ()?- 0 VJ 1j) 0 YES PERMIT M Y f OW ERi 9.1 OWN E, 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE: C'I 1 1 N '-r ELECT RIC��LCONTRACT 8.ADDRESS.: 7(n �No+ C" C L 11.FAX NO.: 9.STATE OF FLORIDA LICENSE NO: 10.CELL PHO�NE: �C PHO I .EMAIL DDRE;S: #13.OFF! 14. CL-V1 12 CCr'C-o'6 i-<- 15.Application is hereby made to obtain a permit to do the work and installations as indicated. I certify 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 ny time aft (�ork is commenced. CONTRACTORS SIGNATURE: �ka W 'A"- ao 111:METER, .7�SERVIC %20'e 0 MULTI FAMILY-#OF UNITS: ZRESIDENTIAL [3 SINGLE FAMILY 0 TEMP SERVICE 0 COMMERCIAL Ala WKSDITION 0 TRAILOR 0 ALTERATION 0 SIGN 0 OLD 0.14M EL!e"ATIONAL ELECTRICAL CODE 0 REPAIR 0 POOL SPA 0 REWIRE 0 OTHER. l Mill- R 4X:"!"A,96 pR h 'AIR Air S1,101 h 20.TYPE OF SERVICE: 0 OVERHEAD 2-TNDERGROUND 0 UNDERGROUND UP POLE 21.NEW SERVICE: CONDUCTORS PER PHASE: q.POWER IS ON 0 POWER IS OFF I OPACITY: 22.SIZE OF CONDUCTOR: _Z:.n() OCOPPER n-ALUMINUM 23.SWITCH OR BREAKER SIZE: AMPS: 00 PH:___L_ w:_3— voa:-7,�E> RACEWAYSIZE: 24.EXISTING SERVICE SIZE: IAMPS:_ PH:_ W: VOLT:_ RACEWAYSIZE: 26.FEEDERS"- OF— AMPS:— #OF— AMPS: #OF— AMPS: 26.LIGHTING FIXTURES: INCANDESCENT:�� FLUORESCENT&M.V.: 27. FIXED APPLIANCES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: 28.FIRE ALARM: 410 YES 0 NO 29-31 DO NOT APPLY TO NEW SINGLE FAMILY,MULTI-FAMILY AND ROOM ADDITIONS 29.SMOKE DETECTORS: NUMBER: 30.RECEPTACLES: 0-30AMPS:_",O_ 31-100AMPS: OVER 100 AMPS: 31.SWITCHES: 0-30 A PS: 31-100AMPS:- OVER1.00AMPS:- 9 AIRCQK #OF UNITS: COMP. MOTOR HP RATING: AMPS: H EAT KW: #OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW: A3. NUMBER: VOLTAGE: HP: KVA: NUMBER: VOLTAGE: HP: KVA: TRANSFORIl UNDER 60OV: NUMBER: K\/A: OVER 60OV: NUMBER: KVA: 35.MI§C—ELANEOUS REPAIRS: DESCRIBE IN DETAIL: I I Elect Permit Application 2010 Property Appraiser-Property Details Page I of I CLARK RANDLE ET AL Primary Site Address officiallilt rd..WookLPa — --eco age Tile 421 OCEANWALK DR S 421 S OCEANWALK DR 14973-00217 9405 JACKSONVILLE,FL 32233-4574 Atlantic Beach Fl-32233 MCCULLOUGH DONALD R/S 421 S OCEANWALK DR Value Summary --------- 266i 26 rogress RE* 169463-0548 Value Method CAMA CAMA Tax District USD3 Building Value $343,578.00 $325,772.00 Property Use 0100 SINGLE FAMILY Extra Feature Value $13,286.00 $10,641.00 #of Buildings I Land Value(Market) $200,000.00 $200,000,00 Legal Desc. 42-13 08-2S-29E 09-2S-29E Land Value(Agric.) $0.00 $0.00 Subdivision 04161 OCEANWALK UNIT 02 Just(market)Value $556,864.00 $536,413.00 The sale of this property may result in higher property taxes.For more information go Assessed Value(A10) $476,188.00 $536,413.00 to Save_Our Flom -rty Exemptions $50,000.00 See below __ es and our PfopL -Tax Esti—mator.Property values,exemptions and other information listed as'In Progress'are subject to change.These numbers are Taxable Value $426,188.00 See below part of the 2010 working tax roll and will not be certified until October.Learn how the Pro er -_p-ty Appralw's Office values property, Taxable Values and Exemptions—In Progress If there are no exemptions applicable to a taxing authority,the Taxable Value is the same as the Assessed Value listed above in the Value Summary box. County/Municipal Taxable Value SJRWMD/FIND Taxable Value School Taxable Value No applicable exemptions No applicable exemptions No applicable exemptions 2009-Not kqeo—f PTRV Pro Taxes(Trutl9l !—fiiing-iiist—rict-- Assessed Value Exemptions Taxable Value Last Year Proposed Gen Govt USD2,2A,2B,3,4 $476,188.00 $50,000-00 $426,188.00 $2,210.90 $2,321.87 $2,321.87 Public Schools:By State Law $476,188.00 $25,000.00 $451,188.00 $2,304.G4 $2,293.84 $2,483.29 By Local Board $476,188.00 $25,000.00 $451,188.00 $1,103.80 $1,127.07 $1,189.69 1 FL Inland Navigation Dist $476,188.00 $50,000.00 $426,188.00 $14.69 $14.70 $15.98 Atlantic Bch $476,188.00 $50,000.00 $426,188.00 $1,276.03 $1,344.75 $1,344.75 Water Mgmt Dist.SJPWMD $476,188.00 $50,000.00 $426,188.00 $177.01 $177.21 $200.22 School Board Voted $476,188.00 $25,000.00 $451,188.00 $0.00 $0.00 $0.00 Urban Service Dist3 $476,188.00 $50,000.00 $426,188.00 $0.00 $0.00 $0.00 General Gov Voted $476,188.00 $50,000.00 $426,188.00 $0.00 $0.00 $0.00 Totals $7,086.47 $7,279.44 $7,555.80 Just Value Assessed Value Exemptions Taxable Value Last Year $619,341.00 $475,713.00 $50,000.00 $425,713.00 Current Year $556,864.00 $476,188.00 $50,000.00 $426,188.00 Property Record Card(PRC) The Property Appraiser Office provides available historical record cards(PRQ.The Property Appraiser's Office no longer uses PRCs;therefore,there will be no PRCS available from 2006 forward.You must set your browser's Page Set Up for printing to Landscape to print these cards. 200 5 -QO I 20N 12003 12002 1200112 0 1 IM 11998 1 19�W 1 1996 1 1995 More Information parcel Tax_RKQrd I GIS Ma map_thi o ertyonGooale Maps ___p FEB 082010 By E2 nQnv9RP=1 AQA610';AR 1)/R/1)()1 A