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DATE DESCRIPTION
EXISTING HOUSE
26 GA. GALY-ALUM. 26 GA. GALV-ALUM. EXISTING ROOF
STRUCTURE
IX4 PT PURLIN (2)2X8 PT W/ 1X4 PT PURLIN-
(TYP') FLITCHED P.)
PLYWOOD
-8'-0" A.F,F. -- - - - - f u 2X6 PT EX. 2X4 FASCIA
FASTNER #
SIMPSON LUS-26Z 2x2 PT CLEAT
(2) )j- DIA. GALV.. MID) (2) Y2" DIA. GALV.,
THRU-BOLT W/ THRU-BOLT W/ EXISTING HOUSE
WASHER & NUT OXG PT POST WASHER & NUT
(TYP, OF ALL POST) (TYP. OF ALL POST)
EXISTING WOOD DECK (NOT TIED INTO PORCH)
-0'-0" GRADE ANN
-9r- - - - - - - -
-2*-0" B.F.F. _I$`- Li SX6 PT POST IN CONC, W/
(1) j- DIA. X 12- THRU-BOLT
W/ NUT ON BOTH SIDES, EACH WAY
(TYP. OF ALL POST)
('1-N� NORTH ELEVATION.
A1.0 .0 1/4ff = 1 001
(2) X- 01A, GALV..
THRU-BOLT W1 EXISTING HOUSE
WASHER & NUT
(TYP. OF ALL POST)
EXISTING ROOF 26 GA. GALV-ALUM. 26 GA. GALV-ALUM.
2X6 PT STRUCTURE
CONSULTANTS:
1X4 PT PURLIN (2)2X8 PT W/ IX4 PT PURLIN
--A. GA V-AL 6X6 PT POST PLYWOOD
LEE J. ENGINEERING, INC.
(TYP.) Ir-j" FUTCHED (TYP,) Vo-
2XI5 [T (3( OC)
(2)2X8 PT W/ 2XG PT u u -8--e A,F,F, JAE Y. LEE P.E. .31276
J" FLITCHEO PLYWOOD 2X8 FASCIA t 10381 Cypress Lakes Drive,
SIMP N I-St - 26Z
K (TYI OF 8) Jacksonville, FIL 32256
SIMPSON LUS-26Z Ph 904-519-1934
(TYP) (2) DIA. GALV..
(2) Y2- DIA. GALV.. Cell 904-234-3518
THRU-BOLT W/ THRU-SOLT W1
EX�STING HOUSE
CN SNPSON LJS--21;; WASHER & NUT 6X6PTPOST WASHER & NUT
EXISTING ONE STORY P OF 4) 14'-5" (TYP. OF ALL POST) (TYP. OF ALL POST)
MASONRY RESIDENCE <
2
(2)2X8 PT W/
A1.0
SIMPSON FLITCHEO PLYWOOD
MTS
>1) PT RLIN- TYP OF 2) 6X6 PT POST
EXISTING WOOD DECK (NOT TIED INTO PORCH 0'-0" GRADE
2 AM 1-1 P-1 IN CONC. W/ 2*-0" B.F.F.
(1) '" OIA. X 12" THRU-BOLT
S APSDN LUS-2f FASTEN W/ '1) #8 SCREW W/ NUT ON BOTH SIDES, EACH WAY
YP. OF 5) (TYP.) (TYP. OF ALL POST)
A
1X4 PT PUR 2 EAST ELEVATION
(TYP.), 0- PROJECT:
'D
x 411 11-0))
X
C(N A PORCH ADDITION
SIMPSC LSU-26Z IX4 PT PUFIIN TO THE HANCOCK
(TYP F 9) (TYP,)
RESIDENCE
it
0 2X5 FACIA 3 26 GA. GALV-ALUM. 255 NAUTICAL BLVD.
ATLANTIC BEACH , FL
(2)2X8 PT W/
1X4 PT PURLIN FLITCHEO PLYWOOD
(TYP.)
8.
(2) DIA. GALV..
EXISTING ONE STORY SEE PLAN AT RIGHT THRU-BOLT W/ ------- -------- FINAL REVISION
MASONRY RESIDENCE (2)2XB PT W/ WASHER & NUT
(TYP. OF ALL POST)
FLITCHED PLYWOOD -8'-0" A.F.F. u u
4'-6 t2
V
SIMPSON LUS-26Z (2) )j" IDIA. GALVj..
1Xf,PT PUR (TYP. OF 3) THRU-BOLT W/ SIMPSON LUS-26Z
WASHER & NUT (TYP)
(TYP. OF ALL POST)
ej
0 < 4 2X6 PT DECK 6XIS PT POST
>1 SHEET CONTENT:
0 ICE
I- (2)2X6 PT Ty
a.
x ROOF . FRAMING PLAN ,
N " P"'
0 1XI
2X6 P
SIMPSON LSU-26Z -0'-0* GRADE _I$1,-- - - - - ELEVA I
(TYP OF 3) NOTES
-2'-0" B.F,F.
5X6 PT POST IN CONC. W/
SIMPSON LUS-26Z (1) 4" DIA. X 12" THRU-BOLT
(TYP) W/ NUT ON BOTH SIDES, EACH WAY
(TYP. OF ALL POST)
ROOF FRAMING PLAN (TN� NORTH ELEVATION
ROOF FRAMING PLAN 1 /4" lf-0" �-01/4") = V-0))
1 /4" V-Otj
26 GA. GALV-ALUM. NOT VAUD FOR
1.0 PERMIT"nNG
(2)2X8 PT W1
J" FLITCHED PLYWOOD IX4 PT PURLIN---� WTHOUT COLOR
WIND LOAD NOTES (TYP.) SIGNATURE, RAISED
D -ATE
GENERAL STRUCTURAL NOTES CODES: FLORIDA BUILDING CODE 2007 (W/ 2009 SUPPLEMENTS) AND ASCE-7-05 (2) Y2" DIA. GALV.. SEAL, AN U IL
THRU-SOLT W1
120 MPH (WIND BORNE DEBRIS ZONE) WASHER & NUT 2X6 PT
BASIC WIND SPEED: (2)2X6 PT (TYP. OF ALL POST)
1. CODES: FLORIDA BUILDING CODE 2007 (W/ 2009 SUPPLEMENTS), AMERICAN CONCRETE INSTITUTE AND WIND IMPORTANCE FACTOR: 1=1.0
AMERICAN INSTITUTE OF TIMBER CONSTRUCTION. BUILDING CATEGORY: 11
WIND EXPOSURE: C
2. LIVE LOADS: ENCLOSURE: ENCLOSED BUILDING SIMPSON LUS-26Z SCALE: AS NOTED
ROOF 20 PSF INTERNAL PRESSURE COEFFICIENT: GCpi +.18 OR -�18 2x6 PT DECK� (TYP. OF 3) (2) )�" DIA. GALV..
WIND PRESSURE TO WINDOWS / DOORS (TYP.) It it THRU-BOLT W/
3. WIND LOADS: SEE WIND LOAD NOTES END ZONE = 6'-0" It 6X6 PT POST WASHER & NUT DRAWN: SDH
11 TYP. OF ALL POS
4.ALLOWABLE SOIL BEARING: 2500 PSF it 4 X6 TDECK
0 0- (TYP.) DESIGN: WET
5. SOIL COMPACTION: ZONE EFFECTIVE WIND AREA (SF) WIND LOADS (PSF) I to
SOIL UNDER SLAB ON GRADE AND FOUNDATION SHALL BE COMPACTED TO 95% -0
RY DENSITY (ASTM D-1557)
MODIFIED PROCTOR MAX. D POSITIVE SUCTION DATE:
03/03/10
6. MATERIALS: INTERIOR 10 +31.3 -34.0
2X6 PT
CONCRETE (NORMAL WEIGHT-28 DAYS) 3000 PSI 20 +29.9 -32.5 SIMPSON LUS-26Z JOB NO: 010- HAN
REINFORCING BAR ASTM A615, GR 60 +28.1 -SO.7 (TYP. OF 3)
WELDED WIRE FABRIC ASTM A185 50 11 11 117, 1 u-
HOLLOW LOAD BEARING CMU ASTM C90, GR N-1 100 +26.6 -29.3 6X6 PT POST IN CONC. W/ DRWG. FILE:
ANCHOR BOLTS ASTM A307 OR A36 (1) J" DIA. X 12" THRU-BOLT
WOOD MEMBER FOR BEAMS & POSTS #2 S.Y.P. '11111\(2)2X6 PT W/ NUT ON BOTH SIDES. EACH WAY 'YUL 4
FOR STUDS #2 SPF OR BETTER +31.3 -42.0 .0..........�^E E T:
END ZONE 10 (TYP, OF ALL POST)
1.911 .*'* -ENSeq-% %
MICROLLAM Va
20 +29.9 1 -39.2 .0
50 +28.1 35.5 (7� EAST ELEVATION
I I - FLOOR FRAMING PLAN 110
+26.6 32.5 x
WIND LOAD NOTES 1100
1 /4" 11-0)f 1 /4" 2 OF 2 SHEETS
�-o
NAL
V
j j
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$CIA
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FASTNER #
-Nj
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r 72X
"6 T
(2 DIPAT GALV..
THRU_BOL W/
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000274 Date 3/24/10
Property Address . . . . . . 225 S NAUTICAL BLVD
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1500
----------------------------------------------------------------------------
Application desc
OPEN COVERED PORCH
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
HANCOCK CHRISTINE THOMAS OWNER
225 NAUTICAL BLVD. SO.
ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee 30 . 00
Issue Date . . . . Valuation . . . . isoo
Expiration Date . . 9/20/10
----------------------------------------------------------------------------
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2007 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
Roll off container company must be on City approved list
and container cannot be placed on City right-of-way.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60 . 00 60 . 00 . 00 . 00
Plan Check Total 30 . 00 30 . 00 . 00 . 00
Grand Total 90 . 00 90 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach
AP�LIQATION NUMBER
Building Departinent (To be assigned by the Building Department)
800 Seminole Road
Atlantic Beach,Florida 32933-5445 7 74/--
Phone(904)247-5826 - Fax(904)247-5845
D.pj E-maff: buffding-deptQcoab.us Date routed:
LXY Web-site- hffp:/1Www.mab.us
APPLICATION REVIEW AND TRACKING FORM
-14 V / -
Property Address: c>�6-, DeQsAmprit review required Yes No
-Suildin
Applicant: -Sn541�- nin%j�n[
e;� M—
Tree Admmsftator
Proiect.- Q
Public Safety
Fire Servbas
Other Agency Review or Permit ReWired Review or Receipt Date
of Permit Verffled By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
SL Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Dhftfon of Alcoholic Beverages and Tobacco
Offier
APPLICATM14 STATUS
Reviewing Department First Review: ELJAP�Proved. MDenied.
(Circle one.) Comments:
BUILDING
MING&ZONING Reviewed X1404o�� Date: e
TREE ADMIN. Second Review: DApproved as revised. F-113enled.
PUBLICWORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. FIDenied.
Comments:
Reviewed by: Date-
evEsed GS114fG9
City of Atlantic Beach APPLICATIOWNUMBER
(To be assigned by the Bu'ddi g Department)
Building Department
n
1,l A R 1 2, 2 10
800 Seminole Road
Atlantic Beach,Flodda 32233-5445 7 74-/-
Phone(904)247-5826 - Fax(904)
'�rjli E-mail-- buffd1ng-deptQcoab.us Date route.d:
City web-site- http:1A&ww.coab.us
APPLICATION REVIEW AND TRACKING FORM
.14 V /
Property Address: c�e>-, Degarinwrit review required Yes No
Applicant: Sn541�- 4�,J"-A- -r9ffn-ing Morfl�
Tree Adminish'ator
Pruiect:
Public Safety
Fire Services
Other Agency Review or Pennit Required Review or Receipt Date
Of Permit Veriffed By
Florida DeprL of Environmental Protection
Florida Dept of Transportation
St Johns Rkrer Water Management District
Affry Corps of Engineers
Division of Hotels and Restaurants
Division,of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
Reviewing Department First Review' proved. F]Denied.
(Circle one.) Comments: ' Ap
BUILDING
PLANNING&ZONING Reviewed by.-. Date:
TREE ADMIN. Second Review: ElApproved as revised. FlDenled.
PUBLICWORKS Comments:
PUB 11-1-PES
TY
Reviewed by: Date:
FIrs/ErRVICES Third Review: DApproved as revised. FlDenied.
Comments:
Revievved by: Date:
evised 05[14M
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: �.15_ IWU_177*Cq � OL-1),01 Permit Number: /0 - Z_7
Legal Description Parcel#
Valuation of Work$ lo5—d-6, e;o-
Class of Work(circle one): New Additio Alteration Re Movv—Demolition. pool/spa window/door
cl
Use of existing/proposed.structureQ)(qce�i�ne): Cornmerr fair ('�esidentiaTt-s
If an existing structure,is a fire sprinkler system installed? (Circle oney---*e9---Tqo N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Od-f eX 0 Vef dee�L
()Jd/-hMa (
Property Owner Infou
7mation:
r d
m6da_ 1�
Name: Njs-�/*/7 r I - - Address: Naa:17 ' al -6 L
city 17TT-7 U? UWte ttZip ��hone Z
1±1 Xn - I - -S
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: ��g Agent:
Address: Citv State zip
Office Phone Job Site/Contact Number Fax
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
is h b d ob ain a d h work and ns a a n e t no work or installation has commencedprior to the
- I t1l'
s I-I I c, t r
al aw gula ng struction in this jurisdiction. This permit becomes null
tl rm to e t h-Ss fsix 6)months at any time after
li-ca on ere m e to I t pe b it 0 0 t d to, tt stan' 0
f i d th rk e e e
AP rm r of
grwo k is d or and6nedfor a period o
P c 0 ap r, an f t'�
s ' e I t a w r
6 nt or co c
us scu, 0 1 ctri W -s,Heaiers,
0 Ing,
s at 0 p mo 17 b ed E e bing,Sikns, Wells,Pools, Furnaces,Boilei
and vo d i work is not commenced w thin s
work is comemd understand t at separate per its m t
ranks�dAzr ConJitionen,eta
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMIENT MAY RESULT IN YOUR PAYING TWICE FOR EMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby cergfy that I have read and exami.ned thisia plication and know the same to be true and correct. Allprovisions of laws and ordinances governing this
cy esume to give authority to violate or cancel the
)J work will be co�nplied with whether e ,Jed herein! or not. The granting of a permit d e; 0 P'�e
T, on s ZtVn.
provisions ofany otherfederal,state, or local aw regulatin f c1l's"luction or the pe�fbrmance ofc
Signature of Owner
Signature of Contractor
................................................................................................. .. .....................
Print Name Print Name
Swo subscri e before me Sworn to and subscribed before me
this Da f ,.20/0 this —Day of
jKEVWV!XWVV.J)�FWW8 CODE COMPLLME
Notarf Public
CrrY OF ATLANTIC BEAC4vised 0 1 26.1 LA6J
SEEPERMnSFORADDITIONAL
DEBORM A.==WHrrE
SION 0 DD 634126 REQUfREMENTS AND CONDITIONS.
S May oil
my COMMISSION#DD 634126
EXPIRES:May 21,2011
P s
Bonded Thru Notary Pubft UndarwrIters
REVIEWED BY. DATE:3 0
41
W
CITY OF ATLANTIC BEACH
OWNER / BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW.
DISCLOSURE STATEMENT FOR SECTION 489.103(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 TEE 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 13UELDING 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 TmS 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.
if. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND/C)R FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO$5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(l). 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.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
(�ZZ,-
ADDRESS PHONE N
/
PRINT NAME
SIGNATURE FATE
6 ore me this day n -county of
as
Deufval,State of�Iond.,h poe'rsorLally appeared heIrM&I Ithh.rself and affirms that
all statements and declarations ar t d curate,
C. of
Notary Public at Large,State of e unty
0 Personally Known
tifi mirrE
duced Iden cation- WNR
N MYCOM�,':, _ -:I#DD634126
1 011
EXF-1r'll' vlay:21,2011
Banded Tllr,,V�!�vy PLft UndorWIfterl
Notary Signature:
F/BLDG/0—r-Builder Affadavit;REVISED:4/16/2009
MAP SHOWING BOUNDARY SURVEY OF
LOT 8, BLOCK 4, SEASPRAY, AS RECORDED IN PLAT BOOK 35, PAGES 64 AND 64A,
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
CHRISTINE A. HANCOCK AND WILLIAM E. THOMES
FLAGSTAR BANK
FIRST COAST TITLE SERVICES, INC.
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
NAUTICAL BOULEVARD SOUTH
(60.0- RIGHT OF WAY)
N 22*32'00" E 80.00' (PLAT)
PC4NT OF CURVA-WRE FOUND 1/2'IRON PIPE FO�D 1/2-IRON PIPE
NO;ENT!F!C.AT!ON N 22*45'02" E 80.12' (MEASURED) DENTIFFICATION
N 2232*00'E
50,00' (PLAT)
ICTION LINE
20'BUILDING RESTR
6.2' 8.2'
13.0' 5.0, .3.9, 13.1' —
0
LILI Lti
—0., ONE STORY
< b <
_j LL1 6 MASONRY LLI
IL 2
POSTED # 225 a-
AIR
0 to CONDITIONER U-) -0
0 — I PAD 00 0
6 c; 13.1, 0; C3
5.3.9'
61 1/4' X� -0.8' cy) LOT 7
WELL BLOCK 4
_PIPE
LLJ uj
0 (0 0
0
p to 0
DO
pn 10 Do
C14 �q
On
z LOT 8 _0 On
z BLOCK 4 — V)
LOT 9
BLOCK 4 2.7-
10 DRAINAGE AND UTILITIES EASEMENT—, 1.3,
0.2-4 -x—X X—X-- X_
--7,
FOUND 1/2 A I.,
"'N�FIIRON PIPE FOUND 1/2'REBAR
CATION 5' s 22'V'04- W 80.23' (MEASURED) x STAMPED"LB 6481'
S 22*32'00" W 80.00' (PLAT)
SECTION NUMBER 1, SALTAIR
PLAT BOOK 10, PAGE 8
NOTES: I ACCEP 0 BY:
LEGEND:
R = RADIUS _X_ FENCE
L = LtNGrH
NOTES: REVISIONS
1. BEARINGS ARE BASED ON THE PLAT BEARING OF S 67*28'00" E ALONG THE
NORTHEASTERLY BOUNDARY LINE OF SUBJECT PARCEL. DATE DESCRIPTION
2. BY GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS LIE WITHIN FLOOD ZONE AS SHOWN ON THE
NATIONAL FLOOD INSURANCE MAP DATED APRIL 17, 1989, COMMUNITY NUMBER 120075. PANEL 0001 D
3. THIS SURVEY REFLECTS ALL EASEMENTS&RIGHTS OF WAY AS PER RECORDED PLAT&/OR TITLE COMMITMENT
IF SUPPLIED. UNLESS OTHERWISE STATED, NO OTHER flTLE VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED
4. THIS SURVEY NOT VALID WITHOUT THE ORIGINAL SIGNATURE AND EMBOSSED SEAL OF THE CERTIFYING SURVEYOR.
-JOB # 22342 DATE OF FIELD SURVEY: 10-13-03 DATE OF ISSUE: 10-15-03 SCALE: 1 20'
CERTIFICATE
2522 Oak Street I HEREBY CERTIFY THAT THIS SURVEY WAS MADE UNDER MY RESPONSIBLE CHARGE
Jac sonville, Florida 32204 AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA
(Phone) 904-389-5989 8 ARD PR ��TAL SURVE PPERS IN CHAPTER 6IG17-6.FLORIDA
I
G OF FUR 'T�MM7TEI*
m(F..) 904-389-6175 A MINISTR PURI N T
AIELLO
MICHAE V
UCENSED BUSINESS 111 6702 REGISTERED SURVEYOR AND MAPPER #4879 STATE OF FLORIDA
LAND SURVEYS 0 CONSTRUCTION SURVEYS 0' SUBDIVISIONS
A z iN PLAT BOCK 35, PAGES 35, PAGES 6- A,,� 5-
='-PLC :RECCRCS OF DUVAL COUNTY, FLORIDA
E30ULEVARD SOUTH
RIGHT OF WAY)
N 22'45'02" E 80.12'
20' BLDG. RESTRICTION LINE
- ------ ---
EXISTING, ONE STORY
MASONRY
POSTED #225
Lo
A.C. PAD
LLJ
0
P
cc)
rl
to
PATIO
LOT 8
BLOCK 4
:-Pj'Sa-D ADDITION FRAME
SHED
- -----------------------------------
10' DRA�NAGE AND UTILITY EASEMENT
S 22'33'C4" E 80.23'
FLORIDA SECT10N NUMBER 1, SALTAIR
PLAT BOCK 10, FACE 8
STP
LAN FOR ADDITIONAI i
RCSE9T 2c CHRISTINE HAIIC=�
City of Atlantic Beach
Building Deparfinent APPLICATION'NUMBER
(To be aZsigned by the Bu
800 Seminole Road (T ilding Department.)
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
rJ113 9' E-maff. buffdlng-dept@?coab.Us te rot[te(
City web-sita.* httP:/Avww.coab.us [.FDate routed.-
APPLICATION REVIEW AND TRACKING FORM
-1 A y /
Property Address: c,(c�-1 77e.4-e-1-%VIDe nt review required Yes No
Applicant Uildin
Sn�41�- h�IJ44 cle- nin & oni
Tree Adminishator
Proiect.- 4541�' 0
-77 Public Safety
Fire Senfices
Other Agency Review or Permit Required lew o r Receipt Date
Florida Dept Of EnVk0 ental Protection of Permit Verffled B
Florida Dept of Transportation
St Johns Rhmr Water Manaaeme
- nt District
ArrnY Corps of Engineers
Division of Hotels and irants
DivISIOnOf AIC0110fic Beveracies,and Tobacco
Other
APP ATION STATUS
Reviewing Department Fimt Review.- Approved. DDenied.
Im
(Circle one.) C
Corn
F ments-:-
PLANNING&ZONING Reviewed�b�vr.- '-/�)17 Date: -/C)
TREE ADMIN.
Second Review: []Approved as revised. E]Denied.
PUBLIC WORKS Conunents:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F—]Approved as revised. ElDenied.
Gornments:
Reviewed by: Date:
Revised 05114109
dry
Vy d
f (f/
j-hjLt-a
COOL
JTFEB 5 ZOI�O
LBy--
White, Debbie mm�
Subject: DEADLINE FOR PERMIT 225 NAUTICAL BLVD S CHECK FOR PERMIT
Start: Wed 3/10/2010 8:30 AM
End: Wed 3/10/2010 9:00 AM
Recurrence: (none)
Organizer: White, Debbie
o
1�e 's 4/a � //'n5
Public Utilities Plan Review Comments
Initials:
Date: 3 .LVD. Application Permit (0
PrDject Name/Address: CO'L
:Che'ek Box
Appliration T racking Commeents to Add
-10.omment
Avoid damage to underground water/sewer utilities. Verify vertical and horizontal
location of utilities. Hand dig if necessary. If field coordination is needed, call
247-5834. sewer cl.I eanouts and valve covers are set to grade-and
Ensure all meter boxes,
visible.
A sewer cleanout must be-installed at the property line. Cleanout must be covered El
with an RTI concrete box with metal lid. Cleanout to be set to gTade and visible.
A reduced pressure zone backdow preventer must be installed-if irrigation will be
provided or if there is a private well on the property. Backflow preventer must be
tested by a certified tester and a copy of the results sent to Public Utilities.
Plans note the building will be unsprinkled. If plans change, any fire-line installed
must be metered-with a Sensus touch-read meter in a properly sized vault and an
appropriate backnow preventer installed. Bacl:fow preventer must be tested by a
certified tester and a copy of the results sent to Public Utilities.
If fire sprinkler system is provided, contact Malcolm Clemons at 247-5839 for
back1low requirements. At a minimum,will require double check backf low
meventer.
Fire lines must bemetered with a Sensus touch-Tead meter. Meters larger than 2"
must be installed in a vault as noted in JEA specifications.
El
0
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904)247-5845
Job Address: �.g 5- lVa Cq� BL10S_ —Permit Number: /0 - Z,7
Legal Description Parcel#
Valuation of Work$ /�56r6, eP—
Class of Work(circle one): New Additio Alteration Re Movv—D–emolition pool/spa window/door
17cl
Use of existing/proposed structureQ) q6�65e): Comme fair rResidentia
If an existing structure,is a fire spriWer system installed? (Circle one 0 N/A
Florida Product Approval#
For multiple products use product app—r—oviaMorm,
Describe in detail the type of work to be performed:
dJd1'-hMa ( (ilVel'-ed
Property Owner Information:
Add MU47 1�a
Name: ,�qdr
ss.
city ffafflate hone
E-Mail or Fax#(Optional
Contractor Information;
Company Name: Clifying Agent:
Address: Citv State zip
Office Phone Job Site/Contact Number Fax#
State Certification/Registration AA�__
Architect Name&Phone#
Engineer's Name&Phone
Z 4f4
'0 1/ /,�,-,N-,
Fee Simple Title Holder Name and Address
Bonding Company Name and Address 4QP, 4' -t_1
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as in d. I certi t no work or installation has commencedprior to the
issuance ofa permit and that all work will be performed to meet the standards ofall law latin truction in this jurisdiction. Thispermit becomes null
and void ffwork is not commenced within six(6)months, or if construction or work is sus or an onedfor a period ofsix months at any time after
work is commenced I understand that separate permits must be securedfor Electric Wo in ,SiknN, F1 idis,Pools, rnaces,Boilers,Heaters,
Tanks andAir ConXtioners,eta
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here certify that I have read and examined,th licati n and know the same to be true and correct. Allprovisions of laws and ordinances governing this
SEn
��work will be coMplied with whether csz fle§herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany otherfederal,state, or local aw regulatin c nstruction or the peTfomance ofconstruction.
Signature of Owner Signature of Contractor
u g d
b g.,
PrintName 7 Af�� Print Name ....................................................................................................................................
..... ....7.............
Swo subscri e before me Sworn to and subscribed before me
this f -c.20/0 this Day of .20
_J
Notary Public Notary Pab—
Revised 01.26.10
DEBORAH X WHITE
My COMMISSION#DD 634126
EXPIRES:May 21,2011
Bonded Thru myuq Pubk UndertAers
-y
N-A-Dy S�j 0
=ZROED IN PLAT BOOK 35, PAGES 35, PAGES 6
:�-RRENT FUSLIC RECORDS OF DUVAL COUNTY. FLORIDA
NAUTICAL BOULEVARD SOUTH
(SO.0' RIGHT OF WAY)
N 22'45'02" E 80.12'
20' BLDG. RESTRICTION LINE
-------------
- -------- -
-----------------
EXISTING, ONE STORY
MASONRY
POSTED #225
Lo
A.C. PAD
c',
Ld
P
cc)
COVERE
DECK
PATIO
LOT 8
BLOCK 4
FRAME
IOPOSED ADDITION
SHED
---————————————————————————————1—————————- ——— ——- ——— -
10' DRAINAGE AND UTILITY EASEMENT
S 22'33'04" E 80,23'
SEC-DON NUMBER 1, SALTAIR
='CH, FLORIDA
PLAT BOOK 10, PAGE 8
AN. FOR ADDITIONAL STRUL' i
RCBERT & CHRIST(NE HANC-'C':
MAP SHOWING BOUNDARY SURVEY OF
LOT 8, BLOCK 4, SEASPRAY, AS RECORDED IN PLAT BOOK 35, PAGES 64 AND 64A,
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
CHRISTINE A. HANCOCK AND WILLIAM E. THOMES
FLAGSTAR BANK
FIRST COAST TITLE SERVICES, INC.
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY
NAUTICAL BOULEVARD SOUTH
(60.0- RIGHT OF WAY)
N 22*32'00" E 80.00' (PLAT) FOUND 1/2-IRON PIPE
FOUND 1/2'IRON PIPE 2" E 80.12' (MEASURED) ;C04TIFICATON
POINT OF CURVATURE NO iZENTiFiCATMN N 22*45'0
N 22*32*00'E
(PLAT)
50.00'
BUILDING RES�ICTVIN LINE
6.2'
13.0'
I X
LLI
Ld
ONE STORY b <
< D. Lu
< LLI MASONRY
0-
POSTED # 225
AIR
CONDITIONER Lo -0
a r-) PAD 00 0
13.1' 0i ci
X� c)) LOT 7
0 13.1' BLOCK 4
WELL c E
PIPE DECK UJI
0
0
0 1. 0
P U*3 00 00
DO -in
'D
LOT 8 V)
co BLOCK 4 V)
z
BL
LOT
OCK8
4
LOT 9
BLOCK 4 2.7
U
10'DRAINAGE AND UTIUTIES E.ASEMENT 1:
0.2'
FOUND /2"IRON PIPE O�V U40 1/2-REBAR
No IOENTI CA, ON S 22-33-04' W 80.23' (MEASURED) A,,,E, 6481'
S 22'32'00" W. 80.00' (PLAT)
SECTION NUMBER 1, SALTAIR
PLAT BOOK 10, PACE 8
NOTES: ACCEPTED BY'
LEGEND:
R - RADIUS —X— FENCE
L = LENG Fri (S
NOTES: REVISIONS
1. BEARINGS ARE BASED ON THE- P A- BEARING OF S 67028100" E ALONG THE
NORTHEASTERLY BOUNDARY LINE OASUTBJECT PARCEL DATE DESCRIPT10N
2. BY GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS LIE WITHIN FLOOD ZONE x AS SHOWN ON THE
NAT10NAL FLOOD INSURANCE MAP DATED APRIL 17, 1989, COMMUNITY NUMBFk i20075. PANEL 0001 D
3. THIS SURVEY REFLECTS ALL EASEMENTS & RIGHTS OF WAY AS PER RECORDED PLAT&/OR TITLE COMMITMENT
IF SUPPLIED. UNLESS OTHERWISE STATED. NO OTHER TITLE VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED
4. THIS SURVEY NOT VALID WTHOUT THE ORIGINAL SIGNATURE AND EMBOSSED SEAL OF THE CER'nFnNG-
JOB # 22342 DATE OF FIELD SURVEY: 10-13-03 DATE OF ISSUE: 10 15-03 1 SCALE: 1- = 20
CERTIFICATE
W REVISION S
._CRIP 110.
NED
2522 Oak Street I HEREBY CERTIFY THAT THIS SURVEY WAS MADE UNDER MY RESPONSIBLE CHARGE
Jacksonville, Florida 32204 AND MEETS THE M NIMUM TECHNICAL STANDARDS AS SET FORTH By THE FLORIDA
BOARD CIF N�AL SURVEYO S AND PIPERS IN CHAPTER BiG17-6,FLORIDA
P
MINIST Z -
(Phone) 904-389-5989 AD IURS NT 0 TI �ZT7ATUTES
(FGX) 904-389-6175
14
7 f MICHAEL . AIELLO
REGISTERED SURVEYOR AND MAPPER #4879 STATE OF FLORIDA
702
LICENSED BUSINESS 6: I --- Li
LAND SURVEYS 0 CONSTRUCTION SURVEYS 0 SUBDIVISIONS
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904) 247-5845
Job Address: .15 Iva U Cq Permit Number: /0
Legal Description Parcel
Valuation of Work eP—
Class of Work(cirele one): New Additio Alteration e Move--D—emolition pool/spa window/door
arair
Use of existing/pro osed structure(s�)(qc66;ne)): Commerel ( Residenti0�)
y N/A
If an existing structure,is it fire sprinkler system installed? (Circle one
Florida Product Approval#
For multiple products use prod ict approval form d-F
Describe in detail the type of work to be performed: 01 .
Property Owner Information:
Name: PhYJ1h I/7r , F kddr ss:, L PD
P 7_
city 6i�g"iate t'Ui hone
E-Mail or Fax# (optional)
Contractor Information:
Company Name: If W Clifying Agent:
Address: —C. State zip
Office Phone Job Site/Contact Number
State Certification/Registration
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication is hereby made to obtain a permit to do the work and installations cis in d I certi t no work or installation has commencedprior to the
issuance ofapermit and that all work will be performed to meet the standard*s offal ulatin truction in thisjurisdiction. Thispermit becomes null
and void ffwork is not commenced within sLx(6)months, or iftonstruction or wor is.sus or andonedfi)r a period ofsix(6)months at.any time after
work is commenced. I understand that separate permits must be securedfor wo ing,Sikns, Welft,Pools,Ftirnaces,Boilers,Heaters,
Tanks and Air Coneffdoners,eta
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby cerofy that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
)f work will be co�nplied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions ofany otherfederal,state, or local law regulatlin c instruction or the peiformance ofconstruction.
Signature of OWMMn Signature of Contractor
Print Name Print Name .......................................................................................................................................
e.r.... .................;7�� T . .....
Swo subscri e before me Sworn to and subscribed before me
this D f 20/0 this —Day of .20
Notary Public ot Public
Revised 0 1.26.10
DEBORAH A.WHITE
My rOMMISSION#DD 634126
EXPIRES:May 21,2011
Bondqd Thru Nory Public Underwrl%Ors
q W1. - , 0 .
A� =,E7a,,--EQ !N PLAT BOCK 35, PAGES -,5, PAGES 6- AND 5�'�
;R�ZSNT PUBLIC RECCRDS OF DUVAL COUNTY, FLORIDA
\�AUTiCAL E30ULEVARD SOUTH
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CITY OF ATLANTIC BEACH
'MS
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Building-dept(�coqb.us
Application Number . . . . . 07-00001416 Date 10/10/07
Property Address . . . . . . 225 NAUTICAL BLVD
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
------------- -------------------------------- ---------- -- -------------------
Application desc
miscl fixtures
---- --------------------------------------------- --------- - ----- - -----------
Owner Contractor
--------------- --- --- --- ---- --- --- ---- ----- - ----
HANCOCK, CHRISTINE A. OCEAN ELECTRICAL CO. , INC.
225 NAUTICAL BLVD. SO. PO BOX 50737
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 249-3112
------------------------- ------------------- - - --- -------- ----- ----- ---------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/07/08
--- ---------- ------------- - ----------------------------------- --------------
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.
CITY OF ATLANTIC BEACH 07M FT-1-M
800 SEL41NOLE ROAD,ATLANTIC BEACH,FL 32233
OFFICE:(OD4)Z47-SM 0 FAX NO-4904)247-65`15
BURDING-DEPTOCOAMUS
ELECTRICAL PERMIT APPLICATION DUVAL COUNTY
I-'
7--1121i tl,
0 NO
/vh 0 YES PERMITM 10
Atlantic Beach, Vj 32233
w �'..' 1 777
&ADDRESS IF
DIFFERENT FROM JOB ADDRESS. PHONE:
4.NAME.
.2 le–'aJ it
Rq (q
'ANON
18.ADDRESS.:
7.NAME OF COMPANY.
- i� x,� 11.FAX NO.:
9.STATE OF FLORIDA UCENSE NO. 10.CELL PHONE:
ONF-* 14.
12.EMAILADDRESS: 13.OFFICE PH
15.Application Is hereby made to obtain a permit to do the work and installations as Indicated. I cartity that all work-will be performed tD meet
the standards of all laws regulaft construction In this jurisdiction. This permit becomes null a I work is not commenced vAthin six(6)
ndoned for a period of six(6)months work is commenced.
months,or If construction or work is suspended or at)a
CONTRA=ORS SIGNATURE:
QFVVORK
0 MULTI FAMILY-#OF UNITS: XKS—IDENTIAL
LE FAMILY E3 TEMP SERVICE [3 COMMERCIAL
DITION 0 TRAILOR
•ALTERATION 0 SIGN NEW ONAL ELECTRICAL CODE
•REPAIR a POOL/SPA
77
20.TYPE OF SERVICE: 0 OVERHEAD 0 UNDERGROUND 0 UNDERGROUND UP POLE
pill
ER
CONDUCTORS PER PHAfo 0 POWF-k�4055ii 13 POW IS OFF
months
-no EfCTRI
13 OTHER
21.NM SERVICE:
22.SIZE OF CONDUCTOR: AMPICRY: OCOPPER OALUMINUM
PH! VOLT:�-- SIZE:
23.IWIT.CH,OR BREAKER SIZE: AMPS: :,. RACEWAY
24.EXISTING SERVICE SIZE: AMPS: PH: W: VOLT: RACEWAY SIZE:
0 0 AMPS #OF AMPS:_ *OF, AMPS.
25.FEEDERS: I F -===Z:-- 11 —
toglUGHTING FIXTURES: INCANDESCENT: FLUORESCENT&M.V.:
0.30 AMPS: 31-10QAMPS.-���, OVU,.J 00AM -8.1����
27.FIXEDAPPLIANCES,
28.FIRE ALARM: 0 YES 0 NO
2941 Do NOT APPLY TO NEW SINGLE FAMILY,MULTI-FAMILY AND ROOM ADDITIONS
dOSMOKE DETECTORS; NUMBER: ........
4WRECEPTACLES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMP$:
6,3q AMPS:. 7 OVER46.6 AMP�;
!9SWITCHES: IMP
ey =TAIR P" IN
#OF UNITS: COMP.MOTOR HP RATING: AMPS: HEAT KW.
#OF UNITS: COMP.MOTOR HRRATING: AMPS: HEAT KW:
71
"T
NUMBER- VOLTAGE: HP: KVA:
. NUMBER: VOLTAGE: HP: KVA:
'&, ---
pe
UNDER 600N(' NUMBER: KVN.
OVER 600V* NUMBER: KVA:
DESCgfw�
DETAIL.
COAS FORM W.06M REVISED'SMMW
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5826
INSPECTION PHONE LINE 247
Application Number . . . . . 09-00000268 Date 2/25/09
Property Address . . . . . . 225 S NAUTICAL BLVD
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
rewire room
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
HANCOCK' CHRISTINE A. MCCLURE ELECTRICAL CONTRACTORS
225 NAUTICAL BLVD. SO. Q/A:MCCLURE, ROBERT (BOBBY)
ATLANTIC BEACH FL 32233 PO BOX 51368
JAX BEACH FL 32240
(904) 237-4701
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/24/09
- ---------------------------------------------------------------------------
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.
CITY OF ATLANTIC BEACH 09-
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845
BUILDING-DEPT(MCOAB.US
ELECTRICAL PERMIT APPLICATION DUVAL COUNTY
11.JOB ADDRESS: 2.IS THIS A SUB PERMIT: A 3.DATE
ONO
13 YES PERMITM /0
PROPERTY OWNER:
4.NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE:
S/)"
ELECTRICAL CONTRACTOR-
7.NAME OF COMPANY: 8.ADDRESS.:
C
9.STATE OF FLORIDA LICENSE NO: 10.CELL PHONE: 1 11�FAX NO.:
'12.EMAIL SS: 13.OFFICE PHONE: 14.
15.Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that all work will be performed to meet
the standards of all laws regulating construction in this jurisdicfion. This permit becomes null and void if work is not commenced within six(6)
months,or if construction or work is suspended or abandoned for a period of six(6)months at an time alftlerwoor�kis=coced.
CONTRACTORSSIGNATLIR5:
16.CLASS OF WORK: 11.SERVICE: 18.METER NUMBER:
0 MULTI FAMILY-#OF UNITS: lj�ESIDENTIAL
X SINGLE FAMILY 0 TEMP SERVICE 0 COMMERCIAL
AADDITION 0 TRAILOR 19.BUILDING: 19.CURRENT CODE:
El ALTERATION [3 SIGN OLD E3 NEW [3'05 NATIONAL ELECTRICAL CODE
[3 REPAIR E3POOL/SPA 10 REWIRE 10 OTHER:
LIST ALL ELECTRICAL WORK:
20.TYPE OF SERVICE: 0 OVERHEAD O(UNDERGROUND 0 UNDERGROUND UP POLE
21.NEW SERVICE: CONDUCTORS PER PHASE: 0 POWER IS ON [3 POWER IS OFF
22.SIZE OF CONDUCTOR: AMPACITY: OCOPPER 0 ALUM)NUM
23.SWITCH OR BREAKER SIZE: AMPS: PH: W: VOLT:_ RACEWAY SIZE:
AMPS: LT: 2.10 RACEWAY SIZE:
24.EXISTING SERVICE SIZE- Z�0<7 P H: W: VO
25.FEEDERS: #OF- AMPS:- #OF- AMPSi- #OF- AMPS:
26.UGHTING FIXTURES: INCANDESCENT- FLUORESCENT&M.V.:
27.FIXED APPLIANCES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS:
28.FIRE ALARM: [3 YES 0 NO
zq-3i DO NOT APPLY TO NEW SINGLE FAMILY,MULTI-FAMILY AND ROOM ADDITIONS
29.SMOKE DETECTORS: NUMBER:
30.RECEPTACLES: G-30 AMPS: .. 31-100AMPS: OVER 100 AMPS:
31.SWITCHES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS:
32.AIR CONDITIONING:
#OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW--
#OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW.
33.MOTORS:
NUMBER: VOLTAGE: HP: KVA:
NUMBER: VOLTAGE: HP: KVA:
34.TRANSFORMERS:
UNDER 60OV: NUMBER:- KVA:
OVER 60OV: NUMBER: KVA:
36.MISCELANEOUS REPAIRS:
DESCRIBE IN DETAIL:
kj'j i,&6
BLDG02 Permit Application Elec:REVISED:12/1812008