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'�r I S?TgQ'IIflq tTVkl(IUVlq -ADfl?io Imp Xpliaa o; si SIIIL iVIP o 1 V I -mel jo suoisi.Aoad aigeaildde 3o uoiaetoiA J03 uo!jeaonaj oa i-fgns s!put'iainseai j.fup of p!ed uaaq seg aa}anoge Ipun pcieA jou jcuuad sigl SL I $aad 'L$uopenleA 6I OZ/OT Qjgj 9OF NO 431SOd 391Sf1W 11Wd3d SIHl a-iine of IIwa3d ON 1IWH3d vaINO-IJ'Hov3e ouNv-11v JO Allo (J �/ 'JN1aiina d0 1N3W.LHVd3a PERIV T - WORKSHEET Certificate of Occupancy Job Address: � Type Work: Property Owner: Phone # 241- 2 Contractor: 6 LOP Phone # Permit#: D5. -Z Date Issued: Tree Permit# Foundation Permit# Demolition Permit# BUILDING ELECTRIC MECHANICAL PLUMBING Tem .Power# Footing JEA Release Date Temp. Power Slab Letter Rec'd. Underslab Tie Beam Temp Pole# Lintel JEA Release Gas Piping Date Nailing/ Water/ Sheathing Sewer Rough/ Framing (C! • 0 Rough �, '�j•C Rough Topout Insulation JEA Release Date Building Electric Mechanical Plumbing Final Final Final Final JEA Release Date Drainage Inspection: Pool Permit# Inspections: Steel Final Elec./Grounding Final Roofing Permit# Inspect: Nailing/Sheathing Final Fire Inspection: Failed Inspections: Date Paid: — � CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD u .:.N. ..,,. ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00029606 Date 5/10/05 Property Address . . . . . . 1802 HICKORY LN Tenant nbr, name . . . . . . 121X221ADDITION Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 20000 Owner Contractor -- ---------------------- ------------------------ OLOFSSON B . /JOHNSON, S OWNER 1802 HICKORY LANE ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . AIR DUCTS Permit Fee . . . . 55 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 55 . 00 55 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 55 . 00 55 . 00 . 00 . 00 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. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. I 05/03/2005 09:49 9042413745 DONOVAN PAGE 01 cxTX OF ATLAN'TxC BJEACIR -~ PERMIT APPLICATION [. y,` L r N4ECH` �� DSLC'. rill v s SEN' owner of PropartY l 1,, 'Vi- /,00 Z IGK�R Job Address: �oso d COa gCtOl: tamchl Web a�oa 1Oaf Alh"A Beach yed.h Iha above rta aeoe�d+oea wish a City ° 9aoJt 4� do pig_tZ,eh an!t�rA bdeof atuf 10 ou the tdf+ohad OCR, t>ed u ordhwoaftae0 0 DONE ON TKS Is S C�'�COSSTR% ION 81 t om---— . G NERAL W s�� Sult.oMo oa sM7 UCTloN A. at ' ALF •Naott� ,�"'N•Uttllty 1f`Yp•OI VS NV'4H�Of CONST o OC�_spexib.--- "`- woax * li e0°aplOte lW ' To �flt�reaa �, °aw s IV S ' " MEC5ANICAL til d `B � gas ryrVAM IWWtue) rnpLdFluor Oa•p►a�*ar ° wCto addus"S-- O of Campo oO 14At S+oe Ropm calla� _ _ p cad yam' �lyWv a R Oti fiC1d USE ONLY µt Ksge"e Ceoewty JL5 5YACt�etved) O Coow wwcr µurobat of liteb�) to F44 iwwdo% wain O Elevsmr: µsaw palar�� Q Tanta wlnPr��'�m �uroCot) pe��lt AOv�•eY bY�-•�� wee vdry T'eN111 Vee�w o 0O 5p'.lh Caq6ry WOfOYLsi 1,IS'r4sLL dNWGPMENT M+a�at"'rw � l N EQ)„u{�el Nuosbct Teas , id/Ir pttoe Nu�tbet acne �o j w� owle litN aaecity ^pProvl+si SS.gptLE LACt;s�el NUWW ►rt'ou6actutet ST TiN -FA DauriPtlo° ptueabott7°iv ^ppro+iai Sonat ave Nut/e of NO, TY9° A"'d Nt�,utaauny y Nouti'ai capacity Cvetrt ad HOWOtmonsiow pyok RA+d•Awad acY�Pbrid+3�71i•5� 111410 9a 147 �� 01) 3, poor%:l9lW)X17•SbOd CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD >, ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00030910 Date 8/08/05 Property Address . . . . . . Tenant nbr, name . . . . . . WIRE ADDITION Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ OLOFSSON, BEN FIRST CHOICE ELECTRIC 1802 HICKORY LANE 716 VALLEY FORGE RD. N. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 241-1331 ---- ------------------------------------------------------------------------ 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 s PER IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUI C4 1A ODES. A BUILDING OFFICIAL r2�1`lfi�, CITY OF ATLANTIC BEACH w -2 f ELECTRICAL PERMIT APPLICATION Date: 's S Property Address: Owner: �� (� �o� Ccl� Telephone#: Contractor: Telephone#: Contractor Address: 71�,Vlo_ l �Y �( Fax #: Contractor Signature: 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: O Trailer Service: If other construction is ❑ New U� Residence ❑ Temp. ❑ New being done on this building Old ❑ Commercial O Signs ❑ Increase Or site,list the building O Re-wire ❑ Addition Sq.Ft. ClRepair Permit nua9 'b 16 Conductor Size: AMPS: COPPER ALUMINUM Switch or Breaker AMPS RACE PH W VOLT WAY Existing Service RACE Size AMPS PH W VOLT WAY Meter Number Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Rece tacles CONCEALED OPEN Switches Incandescent 7j Fluorescent & M.V. Fixed 0.100 AMPS OVER BELL Appliances AirTRANSFER. H.P.RATING H.P.RATING CEILING KW-HEAT Conditionin COMP.MOTOR OTHER MOTORS AMPS HEAT Motors 0-1 H.P. VOLTAGE PH NO. OVER 1 H.P. PHS UNDER600V 0 R600 Transformers NO. KVA NO. KVA No.Neon_Transf. Ea. Si Miscellaneous 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845• httn///www.ei.atlantic-beach tl us Revised 1/04 �x `S CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00029606 Date 2/04/05 Property Address . . . . . . 1802 HICKORY LN Tenant nbr, name . . . . . . 121X221ADDITION Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 20000 Owner Contractor ------------------------ ------------------------ OLOFSSON B. /JOHNSON, S OWNER 1802 HICKORY LANE ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ----------------- ----------------------------------------------------------- Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 130 . 00 Plan Check Fee 65 . 00 Issue Date . . . . Valuation . . . . 20000 Fee summary Charged Paid Credited Due ---------------- - ---------- ---------- ---------- ---------- Permit Fee Total 130 . 00 130 . 00 . 00 . 00 Plan Check Total 65 . 00 65 . 00 . 00 . 00 Grand Total 195 . 00 195 . 00 . 00 . 00 PERMTT IS APPROVED ONLY IN ACCORDANCE WrM ALL MY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. �p BUILDING OFFICIAL i/ 'r )F irk „i ..•;` r ;�;� SL:1�' 4� CITY OF ATLANTIC BEACH SAN 7 app BUILDING PERMIT APPLICATION • ' (Alterations& Additions) 1 Date: Job Address: �fJ�� N l G 1�1 a✓�1 �I�1�-" �L L ,-a, Owner of Property: -�/-t.SGr� C� r1 �'1 /-��' �►TyLO -3' Address:_�_ Oo2-- iG U Yu 1--ci✓1Telephone: L17-,2-.2s& Legal Description: Block Number: Lot Number: Zoning District: Contractor: _KD U)n e,r- State License Number: �y Contractor Address: Gt M Telephone: Fax: +� Describe proposed use and work to be done: 1 I�- ` ACI ` i otl as 12r,- I=Lln4 Present use of land or building(s): I i MCf(_,1��'S �C I� Valuation of proposed construction: no C� What are the dimensions of the added space: feet x feet Will the added area be heated and cooled? C:?�-s New electrical or increase in service? Add plumbing fixtures? )VO Add fireplace? D Add heating/air conditioning? Is approval of Homeowner's Association or other private entity required? ND If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to the original impervious area or the removal of any trees? ®NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ®NO. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. 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. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atlantic-beach.fl.us Page 2 Revised 8/04 PSC 2000 Series 2410 Log for Personal Printer/Fax/Copier/Scanner City of Atlantic Beach Bui 904-247-5845 Jan 312005 9:41AM Last Transaction- D= Time T = Identificatio Duration Pales Resul Jan 31 9:39AM Fax Sent 92491531 1:27 2 OK r' CITY OF ATLANTIC BEACH ei3a . OWNER/BUILDER AFFIDAVIT Date: Job Address: /60 o r'' Co rn CHAPTER 489,FLORIDA STATUTES,PART 1 "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 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. THE 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-WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 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 COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. PRO13ERTYOER �}1//�2 -D6-q- 5-3 -689D SWORN TO AND SUBSCRIBED BEFORE ME THIS-;7 DAY OF 206 ,,. YVONNE M.CALVEIM MY COMMISSION#DD 342192 EXPIRES:429,2008 Z � ry9f. ,�,ry PW*Und&vWm ARY PUBLIC Y COMMISSION EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. f• �'1''flr, CITY OF ATLANTIC BEACH Cc: 1.1 BUILDING / ZONING DEPARTMENT D.Ford s J } 800 Seminole Roads oe— �ud .x`V Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS JAN12 7 2005 Permit Application # os - zq(o G(o Property Address: 180' 4 (Ul�t Applicant: (�) UP SSO�J ( C)W_►J'c(Z Project: (�-� 1221 A0 O I l �►.� This per it application has been: Approved LXAP evi a nd win s ed attention: 1 �� US Please re-submit your application when these items have been completed. c Reviewed By: `w Date: Doc#2005025140,OR 6K 12252 Page 1219, Number Pages: 1 Filed&Recorded 01/20!2005 at 01:49 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00 �- i NOTICE OF COMMENCEMENT State of f�-O r j L+ C� Tax Folio No. County of P uyctl 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. 5-<-- L Legal description of property eing improved: L U� ,�� C+ IZ!a i&I 4 uti l o , -G Address of property being improved: I P26J, i Q L L3 General description of improvements: -+ S ' -i Sa Owner: $ 0 14 Si Address: q Owner's interest in site of the improveme ,6 d Fee Simple Titleholder(if other than owner): ame: L r Address: Z Pc y P2 +j�_y Contractor: Q W V\e_it4 C'r Address: /� Phone No: q01-1 ' .° '7 Fax No del —/.S U t Sure any): � l ty('if 0 Address: Amount of Bond S Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents maybe 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 Statues. (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): THIS SPACE FOR RECORDER'S USE ONLY ER Signe4me _ Date:Beforis ay of �� in 6ounty Jason Arsenault of Duval St a of lorid has af so/p�all a ed � My Commission 00136245 �/O t o p aR Expires July 18,2000 Nota Public art—Large, State o Florida,County of Duval. My commission expires: Personally Known: or Produceentificati0 . > CITY OF ATLANTIC BEACH Cc. BUILDING / ZONING DEPARTMENT D.Ford 800 Seminole Road Doe J k � x Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS JA F, � P Permit Application # C)5- Z9 (o Property Address: e0z C.ILpZ(4 1.--I Applicant: ��. Or 5So 1.1 u Co ls�rz � t Project: f 2 x ZZ 1 T(p►I This pe pplication has been: APpF Jived v/ 'Z g--c9 Z�- ev ew nd t e fol s need attention: Please re-submit your app 'cation when these items have been completed. Reviewed By: Date: RECEI VED CITY OF ATLANTIC BEACH rs 'lr,, BUILDING &ZONING CITY OF ATLANTIC BEACH JAM 2 7 2005 BUILDING PERMIT APPLICATION t� (Alterations & Additions) BY: 1 Date: 6t� Job Address: �-f j G k Dor" Owner of Property: S L4 eSG n h ✓1 / /- ' �'► CLO t'—"-�Cr''7 Address: /t430,2.- G �G'? Telephone: -It17- �b Legal Description: Block Number: Lot Number: Zoning District:'' / Contractor: _ 1)n L r^ State License Number: Gam/ Contractor Address:— !!�>GL'yn q— Telephone: Fax: Describe proposed use and work to be done: I. 1 1 A d '0 . e L :S:'c4\ n ' Present use of land or building(s): /"l 1 MQ I- QC-SI Ql�inC e Valuation of proposed construction: no n What are the dimensions of the added space: 1,4 feet x feet Will the added area be heated and cooled? C!?�s New electrical or increase in service? Y&S Add plumbing fixtures?NO Add fireplace? No Add heating/air conditioning? Is approval of Homeowner's Association or other private entity required? _ If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to the original impervious area or the removal of any trees? ®NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ®NO. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation�Board,which meets two times each month. 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. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.cLatlantic-beach.fl.us Page 2 Revised 8/04 FORM 60OA-2001 FLORIDA ENERGY EFFICIENCY CO - FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Crrn �� Residential Whole Building Performance Method A ', Project Name: OLOFSSON1 Builder: UNK Address: 1802 HICKORY LN Permitting Office: ATLA IC BEAMz rq City, State: ATLANTIC BEACH, FL 3223 Permit Number: cr z Owner: MR OLOFSSON Jurisdiction Number: 2611 O Climate Zone: North 1. New construction or existing Addition — 12. Cooling systems 2. Single family or multi-family 4ingle family _ a. Central Unit Cap:52.0 kBtu/hr _ 3. Number of units,if multi-family1 _ SEER: 10.00 _ 4. Number of Bedrooms A 3 _ b.N/A _ 5. Is this a worst case? No _ — 6. Conditioned floor area(ft2) 2166 ft2 c.N/A _ 7. Glass area&type Single Pane Double Pane a. Clear glass,default U-factor 0.0 ft' 0.0 ft2 _ 13. Heating systems b.Default tint 0.0 ft2 0.0 ft2 _ a. Electric Heat Pump Cap:52.0 kBtu/hr _ c. Labeled U or SHGC 0.0 ft2 347.0 ft2 HSPF:7.00 — 8. Floor types b.N/A _ a. Slab-On-Grade Edge Insulation R=0.0,190.0(p)ft _ b.N/A c.N/A _ c. l a _ 9. Wall Wall types _ 14. Hot water systems a. Frame,Wood,Exterior R=11.0,1176.0 ft2 = a. N/A b.N/A — _ 4 c.N/A b.N/A d.N/A e. N/A c. Cons 'on -ts _ 10. Ceiling types _ ( overy,Solar a. Single Assembly R=20.0,252.0 ft2 _ DIOWicated heat pump) b.Under Attic R=30.0,1914.0 ft2 _ 15. HVAC credits PT,CF, _ c.N/A (CF-Ceiling fan,CV-Cross ventilation, 11. Ducts _ HF-Whole house fan, a. Sup:Unc. Ret:Unc. AH:Garage Sup.R=6.0,10.0 ft _ PT-Programmable Thermostat, b.N/A MZ-C-Multizone cooling, MZ-H-Multizone heating) Glass/Floor Area: 0.16 Total as-built points: 21277 PASS Total base points: 21328 1 hereby certify that the plans and specifications covered Review of the plans and zxs sT by this calculation are in compliance with the Florida specifications covered by this o4 = aT�° Energy Code. calculation indicates compliance PREPARED BY: with the Florida Energy Code. Before construction is completed a DATE: this building will be inspected for i I hereby certify that this build g,Ics designed, is in compliance with Section 553.908 f�,c compliance with the Florida Energy Code. Florida Statutes. `` °°we OWNER/AGENT: BUILDING OFFICIAL: la�i DATE' DATE: _ a: 1A bS EnergyGauge®(Version: FLRCSB v3.30) FORM 60OA-2001 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 1802 HICKORY LN,ATLANTIC BEACH, FL,32233- PERMIT#: BASE AS-BUILT GLASS TYPES .18 X Conditioned X BSPM = Points Overhang Floor Area Type/SC Ornt Len Hgt Area X SPM X SOF= Points .18 2166.0 20.04 7813.2 Double,SC=0.70 H 0.0 0.0 24.0 52.38 1.00 1257.2 Double,SC=0.39 S 0.0 0.0 90.0 12.32 1.00 1108.5 Double,SC=0.27 E 1.0 8.0 42.0 9.28 0.99 385.1 Double,SC=0.23 W 1.0 5.0 12.0 6.29 0.95 71.7 Double,SC=0.36 W 1.0 6.0 15.0 12.12 0.97 176.1 Double,SC=0.57 S 1.0 8.0 42.0 19.91 0.98 819.Q Double,SC=0.36 S 1.0 7.0 36.0 11.05 0.97 385.9 Double,SC=0.36 S 1.0 5.0 24.0 11.05 0.91 241.4 Double,SC=0.51 E 0.0 0.0 6.0 20.88 1.00 125.3 Double,SC=0.36 E 0.0 0.0 8.0 13.62 1.00 109.0 Double,SC=0.36 N 1.0 5.0 24.0 4.04 0.96 93.3 Double,SC=0.43 N 5.0 7.0 12.0 5.84 0.77 53.7 Double,SC=0.36 W 1.0 5.0 12.0 12.12 0.95 138.1 As-Built Total: 347.0 4964.2 WALL TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood,Exterior 11.0 1176.0 1.70 1999.2 Exterior 1176.0 1.70 1999.2 Base Total: 1176.0 1999.2 As-Built Total: 1176.0 1999.2 DOOR TYPES Area X BSPM = Points Type Area X SPM = Points Adjacent 0.0 0.00 0.0 Exterior Wood 21.0 6.10 128.1 Exterior 21.0 6.10 128.1 Base Total: 21.0 128.1 As-Built Total: 21.0 128.1 CEILING TYPES Area X BSPM = Points Type R-Value Area X SPM X SCM= Points Under Attic 2166.0 1.73 3747.2 Single Assembly 20.0 252.0 5.51 X 1.00 1389.2 Under Attic 30.0 1914.0 1.73 X 1.00 3311.2 Base Total: 2166.0 3747.2 As-Built Total: 2166.0 4700.5 FLOOR TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Slab 190.0(p) -37.0 -7030.0 Slab-On-Grade Edge Insulation 0.0 190.0(p -41.20 -7828.0 Raised 0.0 0.00 0.0 Base Total: -7030.0 1 As-Built Total: 190.0 -7828.0 EnergyGauge®DCA Form 60OA-2001 EnergyGauge®/FlaRES'2001 FLRCSB v3.30 FORM 60OA-2001 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 1802 HICKORY LN,ATLANTIC BEACH, FL,32233- PERMIT#: BASE AS-BUILT INFILTRATION Area X BSPM = Points Area X SPM = Points 2166.0 10.21 22114.9 2166.0 10.21 . 22114.9 Summer Base Points: 28772.5 Summer As-Built Points: 26078.8 Total Summer X System = Cooling Total X Cap X Duct X System X Credit = Cooling Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points (DM x DSM x AHU) 26078.8 1.000 (1.090 x 1.147 x 1.00) 0.341 0.902 10042.9 28772.5 0.4266 12274.4 26078.8 1.00 1.250 0.341 0.902 10042.9 EnergyGaugeTm DCA Form 60OA-2001 EnergyGauge®/FlaRES'2001 FLRCSB v3.30 FORM 60OA-2001 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 1802 HICKORY LN,ATLANTIC BEACH, FL,32233- PERMIT#: BASE AS-BUILT GLASS TYPES .18 X Conditioned X BWPM Points Overhang Floor Area Type/SC Ornt Len Hgt Area X WPM X WOF= Point .18 2166.0 12.74 4867.1 Double,SC=0.70 H 0.0 0.0 24.0 23.17 1.00 556.0 Double,SC=0.39 S 0.0 0.0 90.0 21.88 1.00 1969.5 Double,SC=0.27 E 1.0 8.0 42.0 25.68 1.01 1088.4 Double,SC=0.23 W 1.0 5.0 12.0 26.76 1.01 325.5 Double,SC=0.36 W 1.0 6.0 15.0 25.67 1.01 388.3 Double,SC=0.57 S 1.0 8.0 42.0 19.09 1.00 801.7 Double,SC=0.36 S 1.0 7.0 36.0 22.35 1.01 809.8 Double,SC=0.36 S 1.0 5.0 24.0 22.35 1.06 566.8 Double,SC=0.51 E 0.0 0.0 6.0 23.24 1.00 139.4 Double,SC=0.36 E 0.0 0.0 8.0 24.76 1.00 198.1 Double,SC=0.36 N 1.0 5.0 24.0 27.32 1.00 656.5 Double,SC=0.43 N 5.0 7.0 12.0 27.00 1.01 328.5 Double,SC=0.36 W 1.0 5.0 12.0 25.67 1.01 312.3 As-Built Total: 347.0 8140.8 WALL TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood,Exterior 11.0 1176.0 3.70 4351.2 Exterior 1176.0 3.70 4351.2 Base Total: 1176.0 4351.2 As-Built Total: 1176.0 4351.2 DOOR TYPES Area X BWPM = Points Type Area X WPM = Points Adjacent 0.0 0.00 0.0 Exterior Wood 21.0 12.30 258.3 Exterior 21.0 12.30 258.3 Base Total: 21.0 258.3 As-Built Total: 21.0 258.3 CEILING TYPES Area X BWPM = Points Type R-Value Area X WPM X WCM= Points Under Attic 2166.0 2.05 4440.3 Single Assembly 20.0 252.0 1.81 X 1.00 457.2 Under Attic 30.0 1914.0 2.05 X 1.00 3923.7 Base Total: 2166.0 4440.3 As-Built Total: 2166.0 4380.9 FLOOR TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Slab 190.0(p) 8.9 1691.0 Slab-On-Grade Edge Insulation 0.0 190.0(p 18.80 3572.0 Raised 0.0 0.00 0.0 Base Total: 1691.0 1 As-Built Total: 190.0 3572.0 EnergyGauge®DCA Form 60OA-2001 EnergyGauge®/FlaRES'2001 FLRCSB v3.30 FORM 60OA-2001 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 1802 HICKORY LN,ATLANTIC BEACH, FL, 32233- PERMIT ; BASE AS-BUILT INFILTRATION Area X BWPM = Points Area X WPM = Points 2166.0 -0.59 -1277.9 2166.0 -0.59 -1277.9 Winter Base Points: 14429.9 Winter As-Built Points: 19425.3 Total Winter X System = Heating Total X Cap X Duct X System X Credit = Heating Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points (DM x DSM x AHU) 19425.3 1.000 (1.069 x 1.169 x 1.00) 0.487 0.950 11234.1 14429.9 0.6274 9053.3 19425.3 1.00 1.250 0.487 0.950 11234.1 EnergyGaugeTM' DCA Form 60OA-2001 EnergyGauge®/F1aRES'2001 FLRCSS v3.30 FORM 60OA-2001 WATER HEATING & CODE COMPLIANCE STATUS Residential Whole Building Performance Method A - Details ADDRESS: 1802 HICKORY LN,ATLANTIC BEACH, FL, 32233- PERMIT#: BASE AS-BUILT WATER HEATING Number of X Multiplier = Total Tank EF Number of X Tank X Multiplier X Credit = Total Bedrooms Volume Bedrooms Ratio Multiplier 3 2746.00 0.0 3 1.00 2746.00 1.00 8238.0 As-Built Total: 0.0 CODE COMPLIANCE STATUS BASE AS-BUILT Cooling + Heating + Hot Water = Total Cooling + Heating + Hot Water = Total Points Points Points Points Points Points Points Points 12274 9053 0 21328 1 10043 11234 0 21277 PASS 04Z8Ta ST,928 fill G7 tr EnergyGaugeTM' DCA Form 60OA-2001 EnergyGaugeO/FlaRES'2001 FLRCSB v3.30 FORM 60OA-2001 Code Compliance Checklist Residential Whole Building Performance Method A - Details ADDRESS: 1802 HICKORY LN,ATLANTIC BEACH, FL,32233- PERMIT#: 6A-21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHECK Exterior Windows&Doors 606.1.ABC.1.1 Maximum:.3 cfrn/s .ft.window area: .5 afm/s .ft.door area. Exterior&Adjacent Walls 606.1.ABC.1.2.1 Caulk,gasket,weatherstrip or seal between:windows/doors&frames,surrounding wall; foundation&wall sole or sill plate;joints between exterior wall panels at corners;utility penetrations;between wall panels&top/bottom plates;between walls and floor. EXCEPTION:Frame walls where a continuous infiltration barrier is installed that extends from and is sealed to the foundation to the top plate. Floors 606.1.ABC.1.2.2 Penetrations/openings>1/8"sealed unless backed by truss or joint members. EXCEPTION:Frame floors where a continuous infiltration barrier is installed that is sealed to the perimeter,penetrations and seams. Ceilings 606.1.ABC.1.2.3 Between walls&ceilings;penetrations of ceiling plane of top floor;around shafts,chases, soffits,chimneys,cabinets sealed to continuous air barrier,gaps in gyp board&top plate; attic access.EXCEPTION:Frame ceilings where a continuous infiltration barrier is installed that is sealed at the perimeter,at penetrations and seams. Recessed Lighting Fixtures 606.1.ABC.1,2.4 Type IC rated with no penetrations,sealed;or Type IC or non-IC rated,installed inside a sealed box with 1/2"clearance&3"from insulation;or Type IC rated with<2.0 cfm from conditioned space tested. Multi-story Houses 606.1.ABC.1.2.5 Air barrier on perimeter of floor cavity between floors. Additional Infiltration reqts 606.1.ABC.1.3 Exhaust fans vented to outdoors,dampers;combustion space heaters comply with NFPA, have combustion air. 6A-22 OTHER PRESCRIPTIVE MEASURES must be met or exceeded by all residences. COMPONENTS SECTION REQUIREMENTS CHECK Water Heaters 612.1 Comply with efficiency requirements in Table 6-12.Switch or clearly marked circuit breaker electric or cutoff as must be provided.External or built-in heat trap required. Swimming Pools&Spas 612.1 Spas&heated pools must have covers(except solar heated).Non-commercial pools must have a pump timer.Gas spa&pool heaters must have a minimum thermal efficient of 78%. Shower heads 612.1 Water flow must be restricted to no more than 2.5 gallons per minute at 80 PSIG. Air Distribution Systems 610.1 All ducts,fittings,mechanical equipment and plenum chambers shall be mechanically attached,sealed, insulated,and installed in accordance with the criteria of Section 610. Ducts in unconditioned attics:R-6 min.insulation. HVAC Controls 607.1 Separate readily accessible manual or automatic thermostat for each system. Insulation 604.1,602.1 Ceilings-Min.R-19.Common walls-Frame R-11 or CBS R-3 both sides. Common ceiling&floors R-11. EnergyGaugeTm DCA Form 600A-2001 EnergyGauge®/FlaRES'2001 FLRCSB v3.30 ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE SCORE* =83.8 The higher the score,the more efficient the home. MR OLOFSSON, 1802 HICKORY LN, ATLANTIC BEACH, FL, 32233- 1. New construction or existing Addition - 12. Cooling systems 2. Single family or multi-family Single family - a. Central Unit Cap:52.0 kBtu/hr - 3. Number of units,if multi-family 1 - SEER:10.00 - 4. Number of Bedrooms 3 - b.N/A - 5. Is this a worst case? No - - 6. Conditioned floor area(ft2) 2166 ft2 c. N/A - 7. Glass area&type Single Pane Double Pane - - a. Clear-single pane 0.0 ft2 0.0 ft2 - 13. Heating systems b. Clear-double pane 0.0 ft2 0.0 ft2 - a. Electric Heat Pump Cap:52.0 kBtu/hr - c. Tint/other SHGC-single pane 0.0 W 347.0 ft2 - HSPF:7.00 - d.Tint/other SHGC-double pane b.N/A - 8. Floor types - - a. Slab-On-Grade Edge Insulation R=0.0,190.0(p)ft - c. N/A - b.N/A - - c. N/A 14. Hot water systems 9. Wall types - a. N/A _ a. Frame,Wood,Exterior R=11.0, 1176.0 ft2 - - b.N/A - b.N/A - c. N/A - - d.N/A _, c. Conservation credits - e. N/A (HR-Heat recovery,Solar 10. Ceiling types - DHP-Dedicated heat pump) a. Single Assembly R=20.0,252.0 ft2 - 15. HVAC credits PT,CF, - b.Under Attic R=30.0,1914.0 ft2 ! (CF-Ceiling fan,CV-Cross ventilation, c. N/A HF-Whole house fan, 11. Ducts - PT-Programmable Thermostat, a. Sup:Unc. Ret:Unc, AH:Garage Sup.R=6.0,10.0 ft - MZ-C-Multizone cooling, b.N/A MZ-H-Multizone heating) I certify that this home has complied with the Florida Energy Efficiency Code For Building Construction through the above energy saving features which will be installed(or exceeded) 04TH ST,tT� in this home before final inspection.Otherwise,a new EPL Display Card will be completed ' .,, s,0*'o based on installed Code compliant features. Builder Signature: Date: a Address of New Home: City/FL Zip: coD wed° *NOTE. The home's estimated energy performance score is only available through the FLARES computer program. This is not a Building Energy Rating.If your score is 80 or greater(or 86 for a US EPADOE EnergyStarr"'designation), your home may qualify for energy efficiency mortgage(EEAV incentives ifyou obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at 3211638-1492 or see the Energy Gauge web site at www.sec.ucf edu for information and a list of certified Raters. For information about Florida's Energy Efficiency Code For Building Construction, contact the Department of Community Affairs at 8501487-1824. EnergyGauge®(Version:FLRCSB v3.30) Job: Project Summary Date: Entire House By: DONOVAN HEATING AND AIR CONDITIONG 315 8 TH AVE SOUTH,JACKSONVILLE BEACH,FL 32250 Phone:904.241-3785 Fax:904-241-3745 Email:bill(mdonovanac.com Web:www.donovanac.com Project • • For: OLOFSSON 1802 HICKORY LANE,ATLANTIC BEACH, FL 32233 Notes: Design Information Weather: Jacksonville, Mayport Naval, FL, US Winter Design Conditions Summer Design Conditions Outside db 25 °F Outside db 96 of Inside db 70 °F Inside db 72 of Design TD 45 °F Design TD 24 °F Daily range L Relative humidity 55 % Moisture difference 52 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 38304 Btuh Structure 31043 Btuh Ducts 4532 cfm Ducts 5187 Btuh Central vent(0 cfm) 17 Btuh Central vent(0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh AED excursion 0 Btuh Equipment load 42854 Btuh Use manufacturer's data n Rate/swing multiplier 1.01 Infiltration Equipment sensible load 31353 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 1 (Average) Structure 3977 Btuh Heating Cooling Central vent(0 cfm) 0 Btuh Area(ft') 2166 2166 Equipment latent load 4645 Btuh Volume(ft') 17328 17328 Air changes/hour 0.35 0.35 Equipment total load 35998 Btuh Equiv.AVF(cfm) 101 101 Req.total capacity at 0.70 SHR 3.7 ton Heating Equipment Summary Cooling Equipment Summary Make Trane Make Trane Trade XE 1000 Weathertron Trade XE 1000 Weathertron Model TWRO48D Cond TWR048D Coil TWE042C14-B Efficiency 7.6 HSPF Efficiency 10 SEER Heating input Sensible cooling 31500 Btuh Heating output 44500 Btuh @ 47°F Latent cooling 13500 Btuh Temperature rise 26 °F Total cooling 45000 Btuh Actual air flow 1575 cfm Actual air flow 1575 cfm Air flow factor 0.037 cfm/Btuh Air flow factor 0.051 cfm/Btuh Static pressure 0.10 in H2O Static pressure 0.10 in H2O Space thermostat Load sensible heat ratio 0.87 Bold/ltallc values have been manually overridden Printout certified by ACCA to meet all requirements of Manual J 8th Ed. !�C� wr�gF�tsoft Right-Suite Residential 5.9.35 RSR39613 2005-Feb-0214:49:53 /4IC.t+P� C:\My Documents\Wrightsoft HVAC\OLOFSSON1.rrp Calc=MJ8 Orientation=N Page 1 Short Form Job: Date: Entire House By: it DONOVAN HEATING AND AIR CONDITIONG 315 6 TH AVE SOUTH,JACKSONVILLE BEACH,FL 32250 Phone:904241-3785 Fax:904-241-3745 Email:bill@donovanac.com Web:www.donovanac.com Project • • For: OLOFSSON 1802 HICKORY LANE,ATLANTIC BEACH, FL 32233 Design Information Htg Clg Infiltration Outside db (°F) 25 96 Method Simplified Inside db(°F) 70 72 Construction quality Average Design TD(°F) 45 24 Fireplaces 1 (Average) Daily range - L Inside humidity(%) - 55 Moisture difference(gr/Ib) - 52 HEATING EQUIPMENT COOLING EQUIPMENT Make Trane Make Trane Trade XE 1000 Weathertron Trade XE 1000 Weathertron Model TWRO48D Cond TWRO48D Coil TWE042C14-13 Efficiency 7.6 HSPF Efficiency 10 SEER Heating input Sensible cooling 31500 Btuh Heating output 44500 Btuh @ 47°F Latent cooling 13500 Btuh Temperature rise 26 OF Total cooling 45000 Btuh Actual air flow 1575 cfm Actual air flow 1575 cfm Air flow factor 0.037 cfm/Btuh Air flow factor 0.051 cfm/Btuh Static pressure 0.10 in H2O Static pressure 0.10 in H2O Space thermostat Load sensible heat ratio 0.87 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ft2) (Btuh) (Btuh) (cfm) (cfm) sun room 252 13225 12142 486 616 Rooml 1914 29611 18901 1089 959 Entire House d 2166 42837 31043 1575 1575 Other equip loads 17 0 Equip. @ 1.01 RSM 31353 Latent cooling 4645 TOTALS 2166 42854 35998 1575 1575 Soldrialle values have been manually overridden Printout certified by ACCA to meet all requirements of Manual J 8th Ed. wrightsoft Right-Suite Residential 5.9.35 RSR39613 2005-Feb-02 14:49:53 ACCA C:Wy Documents\Wrightsoft HVAC\OLOFSSON1.rrp Calc=MJ8 Orientation=N Page 1 fA� CITY OF ATLANTIC BEACH Ss1 -' 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028574 Date 7/02/04 Property Address . . . . . . 1802 HICKORY LN Tenant nbr, name . . . . . . CONCRETE PATIO Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 3825 Owner Contractor ------------------------ ------------------------ OLOFSSON,B. /JOHNSON S . OWNER 1802 HICKORY LANE ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 247-2256 ------------------------- --------------------------------------------------- Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 50 . 00 Plan Check Fee 25 . 00 Issue Date . . . . Valuation . . . . 3825 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 50 . 00 50 . 00 . 00 . 00 Plan Check Total 25 . 00 25 . 00 . 00 . 00 Grand Total 75 . 00 75 . 00 . 00 . 00 F PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING C DES. s BUILDING OFFICIAL Cc: irL,Jrv, CITY OF ATLANTIC BEACH D. F -� BUILDING / ZONING DEPARTMENT oe J s$ r 800 Seminole Road ' ? Atlantic Beach,Florida 32233 U (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # C y=L - 7-2 S-7`i- Property Address: 180 Z C fC 1 Applicant: LV F55at�� I >=t Project: m►JCR-�T� �Zl This permit application has been: w/Approved Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: Date: l ( � CITY OF ATLANTIC BEACH 1 !L BUILDING PERMIT APPLICATION (Alterations & Additions) Date: Job Address: 1 U 0J i G k d--!A L n✓t c� Owner of Property: 1—Jk_—,-nj 44 Z- --ea Stain --�o h Iq Address: !9 �G ®✓' �-t/vi G Telephone: ,,2.1717 —.�.�Sb Legal Description: Block Number: Lot Number: Zoning District: Contractor: 0 WAfe:rr" �- (),461 SSyr► State License Number: Contractor Address: X60 2t/4 G*U D✓'!El L dzi k3 Telephone: /7—2 S Fax: Describe proposed use and work to be done: "�' 01 Present use of land or building(s): Wows.-/c Valuation of proposed construction: What are the dimensions of the added space: / feet x / feet and I. e 12 Will the added area be heated and cooled? h O New electrical or increase in service? I'1® Add plumbing fixtures? h o Add fireplace? y► V Add heating/air conditioning? �h p Is approval of Homeowner's Association or other private entity required? _ ►p If yes, please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? 9 NO. Applicant certifies that no change in site grade or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ®NO. Applicant certifies that no trees will be removed for this project. YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. 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. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Page 2 Revised 1/04 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with ththis application is correct. n Signature of ownep! ��Jr��[/G�// Date: �6 L 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 being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: Address and contact information of person to receive all correspondence regarding this application(please print). Name: A e'riy iE 640,4'SS c)t1 Mailing Address: I&A g%L L ter' H C,.ei vt Telephone: Pl — ,2,2 S`G Fax: E-Mail: AS TO OWNER: 01) Sworn to and subscribed before me this day of ,20 State of Florida,County of Duval Notary's Signature: " ,1, A1,t -V' / JENNIFER SCHLUETER ❑ Personally known *. SAY COMMISSION t DD 121301 produced identification a., EXPIRES:May 27,2006 Ronded-mruNMrypuuicUnaermritets Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 J Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atiantic-beach.fl.us Page 3 Revised 1/04 J STL ' CITY OF ATLANTIC BEACH OWNER/BUILDER AFFIDAVIT Date: Job Address: c, 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 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. THE 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'WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 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 1 COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. JENNIFER SCHWETER MY COMMISSION#DO 121301 EXPIRES:May 27,2008 PROPERTY O RBUILDER M Bart�eATttruNolary?ubllcUrrderwritars SWORN TO AND SUBSCRIBED BEFORE ME THIS D Y OF20 N T tY PUBLI MttOMMISSION EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. Hook 11901 Page 1709 Doc# 2004212632 Book: 11901 NOTICE OF COMMENCEMENT filed &eorded � 06/28/2004 01:46:41 GM State of /"�C�✓'' c, Tax Folio No JIM FULLER II rrnicr County of_��UGr MIN. RETURN DUAL COUNRTY RECORDING $ 5.00 To Whom It May Concern: PHONE# TRUST FUND $ 1.00 REC ADDITIONAL $ 4.00 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 ofroperty being improved: L 14 44S 46ytz'ik U� /hGP OF SG LA G c Address of property being improved: O - G y General description of improvements: e `v jAlith Foe-Le=,z3 ��'jvt4 oi. Owner: 'G D SCs Y� 4 Address: G L 2 Z 3 Owner's interest in site of the improvem t: Fee Simple Titleholder(if other than owner): Name: `mei All A0 Cr S Address: Contractor: , Address: Phone No: Fax No: Surety(if any): Address: Amount of Bond$ Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents maybe 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 Statues. (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): THIS SPACE FOR RECORDER'S USE ONLY ER Signed Date:_ 1 lr Before me this ay of � , 3-oy-fintheiCounty of Duval, StatenfElo a,has personally appeared 00"0. Jason Arsenault My Commission OD136245 Notarj4ublic at Large, State oflori County of Duval. Nar1014 EkpiraJuly 18,2WO My commission expires: Personally Known: eor Produc entificatio L p� p �� ,�Q?o Cc: i rLy;Jv CITY OF ATLANTIC BEACH or r BUILDING / ZONING DEPARTMENT gtDs ^� ss� oer i J 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 . oft,9' (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # 0(4 - 2 q5�� Property Address: SO C JCC A2 L A-qt-SE Applicant: 6e0a'I Project: �ts f��C CZE'T�c Cl This permit application has been: Approved Reviewed and the following items need attention: Please re-submit your applicati when these items have been completed. c Reviewed By: Date: d 7 y ��d ,, ' �' "" CITY OF ATLANTIC BEACH P, JUL 1 2004 EBUILDING PERMIT APPLICATION "~ (Alterations & Additions) BY: - - iIN -- I Date: (o- 5p- Og Job Address: P;6 W cj/s1 (-, e n e— / Owner of Property: �ns •� ,5 c,c S c;.� 3c),6 vq Address: /6011 k;!clp d`�L Q i e Telephone: 7 Legal Description: Block Number: Lot Number: Zoning District: Contractor: �+1/h cif ,�c�� ( �tj d SSar� _ State License Number: _ 7' Contractor Address: mog , Le4-k3 'e- Telephone: A') 2�256 Fax: Describe proposed use and work to be done: C3 n P d r^ -- Present use of land or building(s): Woc, ftY Valuation of proposed construction: $ 3 g s- -r--r What are the dimensions of the added space: / ,°,Z feet x / feet q l 2 Will the added area be heated and cooled? ho New electrical or increase in service? h a Add plumbing fixtures? h o Add fireplace? y) 0 Add heating/air conditioning? In 0 Is approval of Homeowner's Association or other private entity required? kl d If yes, please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? ®NO. Applicant certifies that no change in site grade or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ® NO. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. 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. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2, Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.cLatiantic-beach.fl.us Page 2 Revised 1/04 as i . �✓C_..' � d 17 7 � �-""�� j a.�' +fes. �^.. pd/ 3 p s-z FIL E COPY IL E Y CITY OF ATl-M,,J3C )',YlACH joll'LICA'1101, FOR WA'JER CUT-INS. . . . FOR CUT-IN AT DE APPLICATION IS HEREBY MA UNITS. 'JHE FOLl-OWJ'ZG ADDRESS FOR___ cuT-IN CFARGE OF S7 RE ET NO. BLOCK SUBDIVISION cf" ACCOUNT NuBER ----"AILING ADDRESS IIF NO. DATE 1"-,,STAILED IER CITY OF 7vjwi ljilc j,"pPIA(17,,TJON FOR (51-:.-ER r cz,,r i ON. SU-:5DIVISION I Oki I f_JT PD. ,j,Y-PE OF 31011IDT-NG t ,J- BUD_DEEG DEPAFT=� CITY OF rrtic �eac� - ��'mtida 716 OCEAN BOULEVARD P.O.BOX 25 ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-2395 March 1 , 1984 Pre-Service Section 3rd Floor Jacksonville Eelctric Authority 233 West Duval Street Jacksonville, Florida 32202 Dear Sirs : The following final inspection has been made and is satisfactory: Permit #3805 - 987 Atlantic Blvd. , Atlantic Beach Permit issued to All-Florida Electric ' Company. Permit #3818 - 1802 Hickory Lane , Atlantic Beach Permit issued to Bivins Electric Company. Sincerely, John M. Widdows Building Inspection Supervisor JMW:ra j CITY OF ATLANTIC BEACH, FLORIDA. ApWo"dbVAPPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORKIN 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, RM: MARS IM MWER-ELECTRIGIA1 DAMEChljib .'13 gA __..ADDRESS:.��. ._gl�, ""`•t �� RFD------BOX BLDG.SIZE BETWEEN: RES.I i APT.( 1 COMM.( 1 PUBLIC I 1 INDUS.I 1 NEW OLD I 1 REW.( ) ADDITION( 1 TRAILER I ? TEMPX SIGNS ( 1 SO. FT. SERVICE: NEW( ) I CREASE( 1 REPAIR ( 1 FEE CONDUCTOR SIZE AMPS COPPER I ALUM.tk SWITCH OR BREAKER IPH W VOLT CAbk RACEWAY EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY FEEDERS` NO. SIZE NO SIZE- NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.30 AMPS, Si.1O0 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V FIXED 0.too AMPis, OVER APPLIANCES BELL TRANSF. AIR H.R.RATING H.P.RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS roenteentanaeFZ�e. A— I IrdnJR Am V OVE AM V. �r CITY OF Fcad - � h• 716 OCEAN BOULEVARD J _ _ P.O.BOX 25 ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-2395 r INSPECTION � `j LOG BUILDING PERMIT # ELECTRICAL PERMIT PLUMBING PERMIT MECHANICAL PERMIT JOB ADDRESS O CONTRACTOR 17 77 0T"i ER CALLED IN INSPECTED INSPECTED JEA APPROVED REJECTED Foundation "00*ooting S 1 ab -- Plumbing (R) )_2_r 7 Top-Out — Electrical (R) Electrical (F) Temp-Pole Plumbing Final Framing Sewer Lintel/Beam Other FINAL INSPECTION PSHa s PAATM N1`Of NU1fi WING CITY OF ATLANTIC S AGM - � axxlr INFORMATION _�_�_^ ...._,._, L OCAT 0WINFORMATION I?�rrltli Nu b r.; 7S57 Addre'I . 1S02 HICKORY LANE Permit Type - BUI'LDLN0 ATLANTIC BRACH, .FLORIDA 32233 � of, tori. SHED �_..,�� .�� , LEGAL DESCRIPTION ' `.,Ooni T pe WOOD FRAME , Lot : � B 1 sack� S+�ct�cin OEel SHED Tawnship, I I itt, � i c6d(a: � Subd3 V i I ioh d s+ws k"�sVA MARINA „ :esti*aced value- $0.00 I�Q Gv, Cast , t}.{1 T" ata1 $30 .,00 t Un $34 .00 rl+r > 2X 12' SHED PER P LINAI 4 „ ...... _ , .:,... APPLICATION EELS r „__-- TION, PERMIT "$30 ,00 I dx� ` A<. T LANE 1E� �,4th 4ATE IMPACT I'L4R I T}A S FEE NADaP f)AS�-II R.S. WOO 1 ------ RADON CAB 5% $4 .4.4 I OP R CAPITAL; IMPROVE, RC1,tat} HYDRAUL,IC SHARE SD'.I7Q is Types 1 `CROSS CONNECTION 4 *Q4 SEC.H IMPACT .FEE �4 4b IOU A f 771, k i i i t Nt T#GE-ALL CONCRETE FOAM$JAND FOOTINGS MU$T'SIE INSPECTOR BEFORE POURING f PERMIT VOID SIX MONTHS AFTER DATA QF ISSUE BUILF).MI,G MATERIAL,RUBBISH ANDDEBRIS'PROM THIS WC7RK MUST NOT$E PLACED(W PUBLIC SPACE,AND MUST BE CLEAREP UP At D,HAULE0 AWAY BY EITHER.CONTRACTOR OR OWNER r , `TA1U1R� TCI GC1N��LY �VITM THE NI�C�#�AICS LIEN LAW CAN ;RESULT IN "TPI, C ERTYtNER PAYING TWICE Fo BIr ILOING IVIA VEMENTS.'� Y*3 ED DING TC, ,IAPPROVED PLANS WHICH ARE PART�OF THIS PERMIT AND SUBJECT TO� REVOCATION FOR : VltlL kT 1:OF APPLICABLE�PROVIStO1 S df LAW. k 00000w 00000m $M.00 14 ATLANTIC B ,qCH BUILDi pEpp;RTMEIVT 2/16/9# {tri Illr{3t: 00mm DEN.� ^ r , a '#.Alfga o (9 ET F F E3 101994 Building and Zoning CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS Owner(s) : Address : �"'�o a -Phone: \ $G �� Lot # Block or Unit # Subdivision:__ Contractor: ` l�r�-c. Address : Phone No: Describe work to be done: Present use of building: Valuation of Proposed Construction: Vr�uu), Proposed use: �N%_"`i- Is this an addition? \C-\C If yes , what are the dimensions of the added space: ft . X ft . Will the added area be heated and cooled? \S_11\0 New electrical (or increase)? New plumbing fixtures? New fireplace?TN a New Heat/AC? 4U O 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: �y Date • �) f )y ( C"� Signature CONTRACTOR: Date: PPR0.J84PG1 �y 9 rrwrVlli'SnwM'Mw 1NM1R.�M+M�IYfY+�MYM' frM�iltlKSTfN'YYw�+M'vfv!e,I111�.'.YR}R.6�NYiiM� +•?R 1NG SURVEY OF LOT 2I SELVA MARINA U T NO.. 2-C REPLAT AS RECORDED -,R T- B-0 3J PAGE 29� OF THE CURRENT PURL RECORDS OF DUVAL COUNTY, FLO Al FEB 101994 Building and Zoning 141ex'0A v /.A Ale. I FOr tp + / 14 Bl,1�iNG 3 A3 o0-,r vzAf f Q� Lar I •1+ h 11''AtY fff = 49 rt'E3� 3G' ' W60 f 0' Ive /'•'.� �a, `n��ryC,\C\.r ,y -�.� mow'"""` I HEREBY CERTIFY THAT THE PROPERTY SHOWN HEREON IS IN FLOOD ZONE "B" AS SHOWN FOR OFFICE USE ONLY Date. . .. .............................19 ...... Permit # .Fee $........................ CITY OF ATLANTIC BEACH Valuation $...................................................... FLORIDA House #.. ...... APPLICATION FOR BUILDING PERMIT ....................... Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can be verified. p Date_. 7- JrC� .-.- ---... 19.�.'j.. /G�lfj �-n/2 Addrea Q...19 !j7i...N. �#x ....Telephone O -nera ......... . ................... Architect.-•---- .....�!3Ekr_.. ......'Q GN'+o_Op-------................... .s .... ... Telephone No..--.-..-- ----•-. Contractor Builder -Addre � as. ............Tele hone No.- - ---•3-...v._. ......... Lo...----•-•------�./.........................Block No ;Nlj ...IZc ....Sub Division-5;r�'V/y...../� ro, ---Zone---- Stree . Side Between .Y.--j-- 3 ............. and.. Sts- ... Valuation $...............................For what purpose will building be use d.,� !.!:C ....Type of construction.. ... Dimensions of Building,'.�7X-�,L�X.Z� '4��i'y imensions of8x--- ...fix/ro.✓✓.•_---Size of Footings....................------......._... Size of Piers.....-- ------ -- ze of Sills--------- -- - -------.Greatest Sill Span in ft.........`'.`_...._------.Type Roof.... ..-.. 2 ..!"u '....._....Will Building be on Solid or Filled Ground?.........1____. How will Building be Heated �'Z- ��'�/_-.........."'"- Size of Ceiling Joistsd4F<;'t.'O---.--- SSS.., Distance on Centers........7-*..._......................, Greatest Span.......Xa_............................ " Size of Floor Joists---•------•------------------------------- Distance on Centers.. ....... .-- •--..................... Greatest / I .aSpan.......r r ---•------•---••-•------•- Size of Rafters------ F -----� Distance on CentersZ ....... ...........-....., Greatest Span--•-� ............................. rectangle is to resent l:p Locate the building or buildings n the rACright position. Give distance in feet from all lot-lines and existing buildings. _ REAR LOT LINE Two copies of plans and specifications shall 1 �� / a•t be submitted with application. Inspections required. -_ 1. When steel is in place and ready to pour footing. W W 2. When steel is in place and ready to pour columns and/or lintel. 3. When steel is in place and ready to pour beam. a a A Ho 4. When framing is completed. 5. When rough plumbing is completed,and ready to cover up. J ` W 6. When septic tank drain field or sewer is laid but before it is covered. A N A 7. Electrical inspection by City of Jacksonville. 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for after corrections are made. FRONT OF LOT In consideration ermit en for doing the work as described in the above statement, we hereby agree to perform said work in accord ee a tacked plans and specifications, which are a part hereof, a in accordance with the building regulations of a C' of B Signat uil Address...... � � ' ".. ` ��( - .. --......'..._....dok• Signature o1 Owner. .. . . /-".:..._... .......................- Address... ©. ... ,.z.-...... -37,Z-50 -- --I OT: _ . _ . _ _ _ :'EcIlAN 1 CAL: _ 1:1-1;C:'I It I CAL: BUILDING NNG pl.-Ic-11 T 1,(,)i:}'SHEET _ �-: - - -- Per sq. ft. _ /jrl, J lil:A'l FD SQUARE FOOTAGE: y/_l ,�-___ @ $ l R_ - - @ $ �� .. ` ---- -- — P C;f�R,�GE (1'Rll'A7'E/SHED) : per sq. ft. __ _ -- __ -- f C".FPORT: --- - - - @ $ -- ---- - --- ----- Per sq. ft. _ $- ---- - -- PORCHES: @ $ -- - per sq. ft. _ $ ----- -- DECK: @ $ per sq. ft. _ $ - Pt,'iIO: _ _ _ @ $ -- - -- ------ - --- ---- Per sq. ft. _ $- —/- - TOTAL VALUATION: - PERMIT FEES —-- -------- `TOTAL VALUATION DATA 1 s t - --,�- , per thousand RE.•.AI:�DER VALUATION @ $ �•U�J or portion thereof TOTAL BUILDING PFrLMIT FEE. . . . . . . . . . . . . . . . . . . . . . . . . _ . . . • $/ PLUS 2 THE BUILDING PERMIT FOR PLAN FILING FEE. . . . . . . . . . . $_ g •a_�_ i TOTAL FEE DUE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -------------------------------------------------------------- --------------------- --dO--- a--70 , 75 M-E LAICAL Pi:FalIT FEE: PLL:`BING PERMIT FEE: $_ _ ----- ------ ELECTRICAL RESIDENTIAL: $ —— ELECTRICAL TE'0RARY: $_-- ------_-__-_- NATER _IETER SIZE: FEE: $_�p+ SEWER CONNECTION CH_4RGE: SQUARE FOOTAGE: FEE $ ©D l AAIER CONNECTION CFARGE: FIXTURE UNITS _�— @ $10.00 PER UNIT: $ sem L--- ACCOUNT NO. : �^ --,-r-,` _-- --- --- -------------TOTAL BUILDl':G/PLAN FILING FEES: ,r' _ RO ED BY: �j 4iTl R 1 TOTAL WATER IETFR CHARGE: $ D��'•C�O r 21!!-^i JCi Cr j_��4kvfi TOTAL t:ATER CO`:`:ECTION CYARGE; TOTAL SEWER CO'-.-ECTION CHARGE: 79 k GRAND TOTAL DUE: $/ 6,50'- CITY OF AILANTIC BEACH APPLICATION FOR PLUMBING PERMIT DATE _ NEW TYPE OF BUILDING OWNER'S NAME REPIPE RESIDENTIAL LOCATION ADDITION COMMERCIAL -- APPROVED PLUMBING FIRM ADDRESS GETY � ` �t+ �IBEACH MASTER PLUMBER _ please print 44 CITY/COUNTY OCCUPATIONAL LICENSE NO. STATE CERTIFICATE NO. BUILDER OR CONTRACTOR ---------------------------------------------------------------------------------------------- SINKS LAVATORY BATH TUBS URINALS FLOOR DRAINS CLOSETS SHOWERS WATER HEATERS DISHWASHERS DISPOSALS WASHING MACHINE OTHER TOTAL FIXTURE COUNT INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. SIGNATURE OF MASTER PLUMBER FIXTURE UNIT BREAKDOWN 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 TEN DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. SEC. 27-3 (c) BATHROOM GROUP CONSISTING OF BATHTUB (W/OR W/O OVER SHOWER STALL, WATER CLOSET, LAVATORY & BATH HEAD SHOWER) (2 UNITS) DOMESTIC (2 UN TUB OR SHOWER STALL (6 UNITS) BIDGET (3 UNITS) LAUNDRY TRAY COMBINATION SINK & TRAY (2 UNITS) (3 UNITS) DENTAL LAVATORY (1 UNIT) KITCHEN SINK COMBINATION SINK & TRAY W/ DENTAL UNIT OR CUSPI- (2 UNITS) FOOD DIS. (4 UNITS) DOR (1 UNIT) KITCHEN SINK U DRINKING FOUNTAIN (2 UNIT) DISHWASHER (2 UNITS) WASTE GRINDER FLOOR DRAINS (1 UNIT) LAVATORY (1 UNIT) LAVATORY, BARB LAVATORY, SURGEONS (2 UNITS) SHOWERS GROUP PER HEAD BEAUTY PARLOR SURGEONS SINK (3 UNITS) (3 UNITS) (2 UNITS) FLUSHING RIM SINK (8 UNITS) SERVICE SINK TRAP POT, SCULLERY SINK (4 UNITS) STAND (3 UNITS) URINAL, PEDESTAL, SYPHON JET URINAL STALL, BLOWOUT (8 UNITS) URINAL, WALL LIP WASHOUT (4 UNI URINAL TROUGH EACH 2' (4 UNITS) SECTION (2 UNITS) WASHING MACHINE RES. WASH SINK EA S (3 UNITS) OF FAUCETS WATER CLOSETS, TANK- WATER CLOSETS, VALVE (2 UNITS) OPERATED (4 UNITS) OPERATED (8 UNITS) TOTAL FIXTURE UNITS \tab APi' RG'' E tD My 0� V E;N`:iG BEACH �4ILtJ1idG fri=iC 'ONS PLL."SBING WORKSHEET �r SINKS SHOWERS DISHWASHERS — CLOSETS _ BATH TUBS FLOOR DRAINS ( WASHING MACHINE _ WATER HEATERS DISPOSALS LAVATORY _ URINALS OTHER (�$ TOTAL FIXTURE COUNT 11`" r _ FIXTURE UNIT BREAKD01dN 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 $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WIATER SYSTEM. pC BATHROOM GROUP CONSISTING OF p2 LAVATORY (1 UNIT) WATER CLOSET, LAVATORY, AND BATH TUB OR SHOWER STALL _ SERVICE SILK TRAP STAND (6 UNITS) (3 UNITS) DRINKING FOUNITAIN (Z UNITZ _ URINAL, WALL LIP (4 UNITS) FLOOR DRAIN (I UNIT) [;ASHING 7•iACHINE RES. _ URINAL, PEDESTAL, SYPHON (3 UNITS) JET BLOWOUT (8 UNITS) WATER CLOSETS, VALVE OPERATED _ ,WATER CLOSETS, TANK—OPERATED (8 UNITS) ` (4UNITS) SHOWER STALL, DOMESTIC _ BATHTUB (W./OR W/O OVERHEAD (2 UNITS) SHOWER) (2UNITS) LAUNDRY TRAY BIDGET (3 UNITS) (2 UNITS) DISHWASHER (2 UNITS) _ KITCHEN SINK (2 UNITS) KITCHEN SINK/WASTE GRINDER (3 UNITS) TOTAL FIXTURE UNITS l $10.,00 EACH -- ---- -- MAP SI-MING SURVEY OF LOT 21 SELVA MARINA UNIT NO. 12-C REPLAT AS RECORDED IN PLAT BOOK 37 , PAGE 29 OF fHE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA . y LAAJe— so- �v a ti Lor 20 +� V<a 1/',a Ali r b Lo7-- t2 �O MAXIAJA [.ouir �O B D D 70• �1 vQ MQRi.VA /. j�� l4cry ac Fuv. ED Cp�1CH iJG Vii:=,'[C 1 3 e?33 %"E 04 FLORIDA MODEL ENERGY EFFICIENCY CODE ; FORM 902 FOR BUILDING CONSTRUCTION 808 GRAHAM SECTION 9/9H POINTS METHOD CLIMATE ZONES A °e....++ GOVERNOR DEPARTMENT OF COMMUNITY AFFAIRS NORTH 1 2 3 41 PROJECT NAME �' ' '``` t—' JURISDICTION AND ADDRESS T 2/ Un/i i ZIP ZONE BUILDS �yCiG /am v,7/ PERMIT NO. OWNER /�`N .*eG.+kfr �O4-� JURISDICTION NO. ,` 97A TISTICS IF MULTI-FAMILY, NO. OF UNITS GLASS AREA AND TYPE F RENOVATION COVERED BY THIS CALCULATION: CLEAR TINT OR FILM . F-1 ADDITION (SEPARATE CALCULATIONS REQUIRED r-�-- r SOL SGL MULTI FAMILY FOR EACH WORST CASE UNIT TYPE.) SEC. H901.1 DOL 1_..1._M DB L GROSS WALL AREA AND INSULATION CONDITIONED CEILING INSULATION CBS R= FRAME R- FLOOR AREA UNDER ATTIC SGL. ASSEMBLY 1115 E21 jI 11191I R LLLL�J,� R- COOLING SYSTEM PRIMARY HEATING SYSTEM PRIMARY HOT WATER SYSTEM CENTRAL 0 NONE F-1 STRIP GAS Fl NONE 1214ESISTANCE SOLAR UNITARY 0 OIL SOLAR HEAT RECOVERY GAS EER-SEER s I is a HEAT PUMP: COP - ®�® DED. HEAT PUMP: COP -tom OTHER: OTHER, MAX. E.P.I. ALLOWED_ (from 9A), Q CALCULATED E.P.I.+ CHECK IF COMPLYI "ALTERNATE PRESCRIPTIVE COMPLIANCE APPROACH" (SEC. 993.11)* RTIFIED BY: i �-a - 0 FORM COMPLETION DATE �CE- (owner/agent) /" ', CHECKED BY: buildsna official 9A MAX. E.P.I. ALLOWED (CALCULATED E.P.I. MUST NOT EXCEED VALUE SHOWN BELOW) CONDITIONED 901- 1101- 1301- 1501- 1701- 1901- 2101- 2301- FLOOR AREA 0-900 1100 1300 1500 1700 1900 2100 2300 ABOVE BASE E P 1 120 115 110 1 105 100 95 90. 85 80 ' A/C EFFICIENCY LESS THAN 8.0 EER/SEER (7.5 HEAT PUMP) -10.0 DEDUCTIONS IF MULTI-FAMILY: COMMON WALLS (maximum of 5 points) - 2.5 IF MULTI-FAMILY: COMMON CEILING and/or FLOOR (maximum of 12 points) - 6.0 TOTAL DEDUCTIONS BASE E.P.I. DEDUCTIONS MAX. E.P.I. ALLOWED COMPUTE MAX. E.P.I. ALLOWED *RESIDENCES WHICH COMPLY WITH THIS CODE BY THE "ALTERNATE PRESCRIPTIVE COMPLIANCE ! APPROACH" 11. 903. SECARE REQUIRED TO MEET OR EXCEED ALL MINIMUM PRESCRIPTIVE t ) LEVELS INDICATED BY SHADED BLOCKS ON THIS FORM, AND ALL OTHER APPLICABLE PRESCRIPTIVE REQUIREMENTS LISTED IN TABLE 9B. THE E.P.I. FOR A HOUSE COMPLYING „.., UNDER THIS METHOD IS NOT CALCULATED BUT WILL BE THE MAXIMUM E.P.I. ALLOWED FOR �> THAT HOUSE SIZE AS SHOWN ON TABLE 9A. THE STATISTICS SECTION ABOVE SHALL BE COMPLETED AND SUBMITTED TO THE LOCAL BUILDING DEPARTMENT. > '>> INFILTRATION: windows/doors 903.1 HVAC DUCT CONSTRUCTION WATER HEATER - ASHRAE LABEL - 903.2 PIPING INSULATION SWIMMING POOLS 903.3 HVAC CONTROLS 903.7 SHOWER FLOW RESTRICTORS 903.4 HVAC SYSTEM EFFICIENCY SECTION 903.8 CEILING INSULATION 903.10 1 RESIDENTIAL CALCULATION FORM 902 CLIMATE ZONES 1 2 3 COMPONENT WINTER GROSS SUMMER GROSS WINTER I SUMMER NET AREA x WPM = POINTS NET AREA x SPM = POINTS R7 ! 19.3 1.1 .5 CONCRETE R 4-5.9 15 9.9 N R6 & UP 13.1 92 J J Q FRAME #. " 7.8 a�, 2 y 3 OR R19-25.9 4.9 5;6 BRICK R26 & UP 3.6 _ 4.2 VENEER COMMON 7.8 2 ,5 ...:...:.... Vlil«tyliIA1« :.;. ® 247.7 36.4 INSULATED 235.5 14,5 O STORM DOOR 124.4 29.0 0 COMMON 61.9 4.5 191 5.5 JOSq.3-5 UNDER R22-29.9 4 1 5 ATTIC R30 & UP 3.3 7 C3 2 R 6-7.9 1 4.2 14.9 J R 8-9.9 10. 11 .3 W SINGLE R 10-1 1.9 9.2 U ASSEMBLY R 12-18.9 6 7 0 NO ATTIC cJ 5 .5 COMMON 4.8 1 .5 R 0-6.9 15,5 4 v R 7-10.9 6.5 2 1 a WOOD 1.*118:1 5. 1 .8 c R19 & UP q 1 . W , Q� R 0-2.9 1 g,.q OJc R 3-5.9 1 2A A. 7 LLZ R 6-10.9 2 O CONCRETE # >' y> ! : 622 R19 & UP 4.4 1 .6 O COMMON 4.8 1 .5 W EDGE INSULATION PERIMETER WPM 92.7Jt�7 R 3-5.9 g NZ PERIMETER R 6 & UP O 46.4 2 r W'rNTER i SUMMER ii 2 3 OR AREA SGL DBL WOF GWP OR AREA SINGLE DOUBLE SOF GSP 9F CLR TIN CLR TIN 9F _N _ � 157.4 120.8 __ 1 g`_ N 146 1 3 120 101 NE 157.4 _1ZQ_ _ NE 221 9 E �� 57 4 12 � q 5 E 289 242 5 SE _ 7.4 1 SE 26 189 S ai3 1 1 .4 -_ L S ^ s 1 190 160 6 134 0��6SIo3 SW r 1 120.6 - SW 2-6.1-12J-9- 2 189. a W aQ. Lo 157.4 12 8 Q _L W a , 2 242 251 209 cc NW_ _ 7.4 12 8 NW 221 1 1 0 159 N= H 79. H 408 43 360 _ J� J u z o z o o _ :::.: <:: :..::..... .........; 011010,11v ............, •:.... ; »:: :•.?:;•M H = HORIZONTAL GLASS ISKYLIGHTS). FOR SC OTHER THAN 0.83 SEE �.,rll�� #lR.:?.:� M:;M��?:: ........::....::{:.::..;....ii?.,;...;...;.:?:.:_v...•...;.;�?.:......::..::.::...n....:,....;nv::•:i::..::.v..::::::::...;..::5y::• <:. i� i ::.k1lt. .. �.1. 'll�l'iE' SEC. 902.Zd TOTAL GROSS WINTER POINTS TOTAL GROSS SUMMER POINTS y R = 3.5 -7711.15 ?5�"7S ) R = 3.5 �-r•- R = 5.0 1.12 R = 5.0 1.12 V J p g R - 6.7 1.091 1R = 6.7 1.09 f , 1.00 :• 1.00 ?.. 1, HSM FROM 9G 7Cj x as CSM FROM 9H DIVIDE BY DIVIDE BY FLOORTIAREA CNDIONEDJ� �� WINE©OIN S ED F NDITOOR(AREA ON 3(, or UM ERS POINT CALCULATE E.P. I. WINTER POINTS I SUMMER POINTS HOT WTR PTS CREDIT POINTS I PENALTY POINTS + 3 0 191 (9C) . 190►+ IgE1= . FEWER TOTAL POINTS ARE ENCOURAGED FOR MAXIMUM ENERGY SAVINGS 9C DESIGN CREDIT POINTS (CP) 9D I HEATING SYSTEM CREDIT POINTS CEILING FAN IN COND SPACE Imex 5 CPI 1 NATURAL GAS/PROPANE HEATING 16.0 MULTIZONE A/C SEPARATED BY DOOR 5 OIL HEATING 12.8 er CROSS VENTILATION 0 CP proom) - WHOLE HOUSE FAN (min.1.5 cfm/S.f.) 5 WOOD STOVE 7 9DE E SIGN PENALTY POINTS FIREPLACE with outside combustion air 2 WASHER AND DRYER.IN COND SPACE 3 TOTAL GLASS OPENS LESS THAN 40% 5 9C TOTAL (not to exceed 12 points) FIREPLACE W/ INSIDE COMBUSTION AIR 5 if3 d G�.I E 6L( 1 i:,; r I �•� � CC 1:'.S i tR pl_i.1 :-ER �� t i/:"�.::, i-1 �;�»�:,•,-.� I c:•':�,� L I G�,._>C CJD, _ - STh7E Cl-uT1 F I CAlc `j0. CTCA r r r , 1 UR lac JAN 3« der s — � I -S �:7A -S Ft r' -. I „STILA T I CNI - - - - r,•.D FI }:►i;ZcS i•;�Jj� �_ t ►' - �,. _ _ I' r - r;,17 cel 1) 0:,1 C; SO'JJ-L—o RN SRD r Ll^.•31 ;::S G�J=- BUILDING AND XONING IN.SPEC T ION DIVISION CITY OF A'1LANTIC BEACH, FLORIP,A / Af 1f L_'CAT'Oi' I OR MECHANICAL PERMIT - -- WR7r2T,!*-NT--rppl!coant to cornplate all items in sGCtiom t, II, III, a - nd IV. t. lC LO^,..+�TItJf�' On--- Sid• of �---__f'C_ OQ.� � b.},r..,� St. ..a (North. South, Eerf. Wont) (Addreu) _ St. O" (Infvrsecfissq Str•.h) QUILDINt� Lot No._ 9iock Ne__ Sub divir.o� (Stats perfi.am of Ioi if lass tF.sn fvil lot--,l}}sds {ogal d.scrip4;on per dwd' in duplic.,f• if nocds.�+ary) !l. TY� OF PROPOSED M*a+ NIC,,AL \k'ORK -- All applicants complete Nr+s A -- D A. USE OF BUILDING R. OWNERit I► RESIDENTIAL 15�rrvafe (individval, ��ryorotion, IX'One f.miy I1, ❑ Utility ++profit institution. tt..) 2. ❑ Tvo cr mars umiy- 12. ❑ S6*0,1. G0;-ery, (Frtdenl, State or local 9o++rnrw•wt) Enter numbsr of roomer other sducaf;onef KE OF WORK 3. ❑ Transient. Adel, r*+ofel, C. NATU rcomi.!g Pause - 13. ❑ Store, msrtamtile 17.)<New ISv;w;nq Enter num6or of un:h Othw 16. ❑ E:isfin4 6vildissq. 4. ❑ Otherresidantial _ 14. ❑ OTHER-SPECIFY It. ❑ RepJacemcnt of eaisting aysMns -- 20.>� Ne. inftetlefion (Novystssm Fraviovsly iwsterod) NON-R.ESIOZNTV;L 21. ❑ Ext"-.;on or srd-on to eaiafinq rtsf&m. 5• ❑ /tmutament, rscr.atF�nal 6. - i 22. ❑ 0,*er ❑ Clsurci,, otfier religious 7. Q Indus!riel 1. ❑ Garage. iLrvic! s`cficr, 9. [,1 Hospitel, institutrsnel ` � E Tyre OS dUILD9+0 10. ❑ OfficR, bank, profossic.'al 36. ❑ Numlbsr of stories__.._ 37. ❑ Wood from• D. 4•l CHAPICAL KUIPk4r1%''T TO RE INS7ALLED 38. ❑ tlasonrT end wrod I (Prov:de :omp!etss I't! Cr ccmppn:ah o. I;cct of this fxrn) I 34. ❑ I'sinforted ccncrets 23.)<%rnace: ❑ Space ❑ Rcctisssd XCentral O f6or 40. ❑ St.-vctursl steel 24- /,;r Conditioning: ❑ I!oomn r C•ntrel It 4I• ❑ Ctfcr25. kDucf Iit)r✓srt fd41 mtrn Cl s4tity._� U_� ch". - - 26.. ❑ Refrigeration --- 27. ❑ Coo!inq tower. Csoacity _ -r q.. THIS VACS FOR OFF+Cf USE ONLY {+Zerro:wd) 2t. ❑ Rre srnr;,i!ers: N,-6-Ar of Aeads - 24. ❑ Elevator ❑ manlilf ❑ Escelsfor_ ___(nYml6er) 30. u 6esne pumps___ ___ _{numEier) 31. ❑ Tezts_ ___(number) Remarks 32. ❑ LPG containers (ns rsber) 33. ❑ Unfired prauuro veusl Permit Approved by Dates- 34. [:] Ro+bn 35. ❑ Other - Spc+cify Permit Fra _ A. Type of heating fuel: _ B, IS OTHER CONSTRICTION BEING DOME Ok R 4j.KNattric THIS BUILDING OSITE? PSH-3844 DUB 1 DEPARTMENT OF SUILO NQ CITY 01=ATLANTIC BEACH ' rml '' 1 E R4OI°`. Addy+ w aIOKO �' .L I9, Clots of 13it� lsI �#TbANTIC BIAC ILQRIbA ons t r„ bescRip't -0 WOOD. P" � . Lot Pr , ++ d tJe�> . iNQLZ II�Y S�cti4n.. DV411 n . 1 . Tc"*hi P, R" f ,: 0. estimated value:` Qt} Subdittl lc��'� Improv. cost to 00 , $21. 50 -$ 50 71771P- �1 421. 1♦ 50Lyq $0 Y , 99,99 9 'WA AP SO i,00 Name:: p .. y Adtl �' �T fth °H � .1 LLQ a " 5 . ►Q CROSS, CtJNN'Z, �Idti t4. Q Lim a T ' t l If IMP A 2 P�I� P � .Dt� CONS '. $U*CR�GIr {� NOTES.• i NOTICE -ALL CONGRI `i'E FOR IS AND F' OOT' INGS A4 BI*mSPlr I 'E E +pRE POURING :. PERMIT VOID SIX MONTHS AFTER DATE OF ISStJI " BUlLtTiNG MATERIAL,RUBBISH ANDbEBkIS FROM THIS'W©RK'MUST Nb BE PLAGEp.tN"PUSL""#C SPACE,.AIVI�MUST BE CLE -D UP AND HAt1LE®AWAY BY ElTMER CONTRACT©R 4R C}1AtNLR "FAA RE `Cp0 C.o�s��'�."� ��N SHE MECHANICS ��V LA�1l �1 � U��' ��1 IgUl PIN ISS, a, COR ptl`iG TD APF?Rt�1/ ©PI ANS U1IHlCH ARE PART OF THIS PfRMIT AND SUIIECT TO REVOCATION FOR I � C3F AI LICAJSL PROVtsp!�I OF LA4lV � AT�ANTIG BEACFI Oft.DIN DEPARTMENT Ap By t 000 CITr OF ALANTIC BEACH (' ROOFI/N�G PERKIT APPLICATION Owner(a) : J U cz-r.► !/ y r P e Address: - / Hr cfc rd� Phone: Z�� -j J�1 Lot #_, Block or Unit # Subdivision: Contractor: 71 � f r�n Address: 10 6 /Q'-61�� f T City, State and Zip__ a �l a 0 L'I er�� F1 _Phone_Ly y Z d S� State License # /� C U '�-o7 Y C- Describe work to be performed: Valuation of Proposed Construction: 2- y 910-°— Materials to be used: //fl rov ecf Signature of Owner; Signature of Contractor: Liability Insurance Supplied Workers Compensation Insurance Supplied License Information PSR-3B4d 0998,5 DEPARTMENT OF SUIT OtNG CITY OF ATLAINTIC BEACH PER T I ntpok IAT I ON .. . r LC►GaT Ca 'ON I It€ 4Rt AT 4N Ver= . Number: � 9485 ,._.�.-..�. Addres 1`802 HICX0R-Y LANE Kermit fi : .1 ,B BT iG ATL�.NTIC BEAC H ) LQRZT}A 322 3 k: ALTER fTONG C) 1 >r 'I!`'�pe: ` } p1t iss. Lot : 9 1 66k Section.* 0 Iir s COde 0, Subdiv3.sjon';, A" LANTIC BRACH- ' Istimat ed,-Val ue: impr ov. Cost".' ' "Y L ♦..do Total: Ama �a .d T109 -t PERMIT Add ea ' LANA HT .00 T CH rL"C9R � a �� Flt10+ NA' F leiTAS # tAt np gx - ,$0. . ��1v D 8lWZlYAP 1148, yJ to.00 oss to eCT'IO tiq se _ , 'I'?I+ r ;w SEC. H IMPAC' FRS 4}t� R, E w %TL,SC NOTES." i NC?TtOE -AI.L CONCRE`[E ORMS AN©FOOTINGS MMT 61E PECTEO,BEFORE 'DURING PERMIT VOID SIX MONTHS AFTER.DATE OF ISSUE 'IS, S,tJILt 1 a MATEI !AL,RUBBIaH'ANb ISIS,FROM THIS WORK MUST NOT 13E PLACED"IN, PUI3LIC'SPAGS;ANO MUST BE ^ CLEAREt UP AND HAULED AWAY Sl+'EITHER CONTRACTOR OR OWNER ` CompLY I THE MECHA,N V I I I LAiN E L ' N TWICE TH F4RT�iE B JI D11 ar.CI I 1/EIUI N '' � I IYI�=AGGOF 111dC TC)AF�PR( VEI RI:ACNS:ItVHtGH ARE PART OF THiS 0ERMjT AIgD SUBJECT Tp"REUC)GATI,C}N FC1R VlCIsI A I C F;I I t?I I ABI:E PRt V SIQI�tS"'OF LAW. a AT >BI=ACH,BtJILbINGDEPARTMENT 14 4 . CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT p JOB LOCATION, Ic OWNER OF PROPERTY: E rg_LQ_,C. p� BUILDING CONTRACTOR: ` )&7U-- PLUMBING CONTRACTOR __Z] ' S AND ADDRESS: TELZPHONE NUMBER: 9_,�q 10 0 STATE LICENSE NO: CFC 048326 TYPE 0! gU I LD I NO: G TYPE Or WORK: ROW MANY OF THE FOLLOWING FIXTURES INSTALLED d SINKS BHOiilCRfi LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PAWS OTHER I Ke (' 1_ TOTAL FIXTURE COUNT: x $3. 50 + $15.00 = $ ------------ _ INSTALLATION OF PLUMBINO AND PIXTURICS MUST BE ^IN -ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN BTANDARD' PLUMBING CODE, CALL A DAY ARZAD TO SCHEDULE INSPRCTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLRD INTO PUBLIC WORKS FOR INSPECTION BEFORE COVERINO UP - (904) 247-5834 CITY OF ATLANTIC BEACH, FLORIDA 1 ►Ov"bV APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: +�A UAtVT _t9,ISAL , 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. ELECTRICALIRM: M91M LTW, M8MR E 1 CI SIGUnof NAME ChlicL laMmmw ADDRESS: E !S I?r>J "no--RFD----BOX SLOG.SIZE BETWEEN: RES. APT.I I , COMM.t ! PUBLIC t 1 INDUS.( I NEW>d OLD t ) REW.t 1 ADDITION( ) TRAILER t I TEMP.t ! SIGNS I I SO,FT. SERVICE: NEW i I INCREASE( i REPAIR ( i' FEE 'CONDUCTOR SIZE d AMPS 2bQ COPPERI I A UM. o0 TCH OR BREAKER S I PFI W VOLT CAbIC, WKWAY EKIST.SERV.SIZE VAPS PHW VOLT RACEWAY FEEDERS NO. SIZE IND. SIZE NO, SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0-30 AMPS. 31.100 AMPS, SWITCHES INCANDESCENT FLUORESCENT&M.V. MIXED 0.100 AMPS. I *VCR APPLIANCES BELL TRANSF. AIR H.P.RATING H.P.RATING CONDITIONING ,' COMP.MOTOR OTHER MOTORS AMPSIcEILHEAT:rKW-MEAT 01 a1 MOTORS " H.P. VOLTAGE PHS NO.' f N►P• VOLTAGE PHS MI�LLANEOUS TRANSFORMERS: UNDER MM V. OVER;fw V,' 04 40 1z FD bi of OE .0c f. o) r VO '00) C,(, ZQC of C,;0 3 170 3 NV Lu Of I Of 1 01 LA r, UI LU c I Ol pt rJ CSI 001 .......... 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KIRKWOOD & ASSOC. 6210 Arlington Road Jacksonville, Florida NOTES TO GENERAL AND SUB-CONTRACTORS. . . . . . . . . General Notes : (1) Assume soil bearing pressure of 95 PSI, if less. . bring to the attention of the general contractor or designer. (2) All contractors shall meet or exceed all local, state, FER, VA, or governing building codes and regulations. (3) General Contractor shall verify quantity, size, and lo- cation of all floors, ceiling, roc* etc, openings for mechan- ical, electrical, plumbing work with the appropiate t4ade and provide shown and required openings for completion of work. (4) General Contractor shall verify all dimensions, partitions locations, floor elevations, ceiling height, etc. IN FIELD and be responsible for same. (5) All interior dimensions are O.C. except for masonary. All exterior dimensions on periphery minus trim and finish or brick veneer unless otherwise noted. (6) All interior walls except masonary or otherwise indicated shall be drywall extending from floor to ceiling. FOUNDATION NOTES: (1) All concrete to be 2500 PSI or stronger. (2) vapor-Barrier (Sheet Film) shall be placed between slab and sand (fill) . NO HOLES Continuous seal required. (3) Fill sand compacted to 95/ proctor. (4) All footings re-enforced with #5 rod continuous and as indicated. (5) Four (4) inch or greater slab re-enforced with #10 6X6 Wise welded mess and 12" thickened -'edge where indicated. (6) All earth returned to orig. or indicated grade following completion of work. NO JUNK FILL. . . ELEVATION NOTES: (1) All exterior finishes selected by owner shall be approved by contractor and/or designer. (2) Soil to be treated by BONDED apllication for termite protection. (3) Spark retainer on chimney. (4) Closed valley roof joints. (5) All sealants to be non-drying/non-hardening type. (6) Finished floor level shall be a minimum of 12" above finished grade. R. KIRRIiv'OOD & ASSOC. (cont.) MECHANICAL NOTES: (1)' Provide heating and air conditioning systems as per spec. (2) Meet or exceed all local, state, FHA, vA, or other governing codes. (3) Provide air exchange systems or other required systems and be responsible or same. PLUMBING NOTES: (1) Provide required outlets and connections for applicances and equipment as shown or required for water and sanitation needs. (2) Meet or exceed all local, state, FHA, VA or governing codes. (3) And be responsible for same. e 't A44 S-'L_ Vq HRR -r < / -G �td ` +�ece " _ Lv7' so , &L V9 �jRoNR ..x..�- S&L VR t`fRRi.A/A ON 7" 44 1V 0 /14Z IVICKOh�v - aA) f� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD _ ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number 03-00025546 Date 2/27/03 Property Address . . . . . . 1802 HICKORY LN Tenant nbr, name . . . . INSTALL CONCRETE WALKWAY Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1700 Owner Contractor ------------------------ ------------------------ SUSAN JOHNSON & BENGT OLOFSSON OWNER 1802 HICKORY LANE ATLANTIC BEACH FL 32233 (904) 247-2256 ------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 40 . 00 Plan Check Fee 20 . 00 Issue Date . . . . Valuation . . . . 1700 Fee summary Charged Paid Credited Due ---- ---------- ---------- Permit Fee Total 40 . 00 40 . 00 . 00 . 00 Plan Check Total 20 . 00 20 . 00 . 00 . 00 Grand Total 60 . 00 60 . 00 . 00 . 00 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. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. BUILDING OFFICIAL f i`1 jJ CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 : ,. TELEPHONE: (904)247-5800 �^} FAX:(904)247-5805 } � SUNCOM:852-5800 http://ci.atlantic-beach.R.us µ V PLAN JREI W COMMENTS Permit Application 90 - 5uc y(, Applicant: S, Address: C� /<c� Project: �� w Your application is approved ❑ Your permit application has been reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed by_ _ Signed Date 2 D Z Contractor Notified Date tS_ 1 7, - CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATIO ALTERATIONS/ADDITIONS) - Date: Job Address: /501 L Q✓1 c Owner of Property: c-cS41�1 ,1 �,�'►n 5 a � e nog,- 0L0EsSa s,1 Address: / �G /4 1 G K o r c4 L G hC Telephone: 14 7-,2.2 SC Legal Description: Block Number: Lot Number:--- A Zoning District: Contractor: State/License Number: Contractor's Address: /66 A`tL4✓1& Telephone: Fax: Describe proposed use and work to be done: Gon e_- yJ CITY tJF A7R� L) GJILDING OF FILE Present use of land or building(s): Valuation of proposed construction: czVjq,,6� SEB 2 1 Z� What are the dimensions of the added space: feet x feet : G• Will the added area be heated and cooled? &16 New electrical or increa emrser . !-..b.l.O— New plumbing fixtures? No New fireplace? 14 6 New heating/air conditioning? 9 G Is approval of Homeowner's Association or other private entity required? &16 If yes,please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? 9 NO. Applicant certifies that no change in site grade or fill material will be used on this project. ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ®NO. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. 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. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at:1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 'STEP 3. Submit Tree Removal Application if trees are to be removed or relocated STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us Page 1 Revised 1/14/03 �t addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with hearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided wi thisap ' tion is correct. Signature of owner: 00 _;& �/� Date:AV 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 being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: 2JzLe/0-�, Address and contact information of person to receive all correspondence regarding this application (please print). Name: Mailing Address: Telephone: Fax: E-Mail: AS TO OWNER: Sworn to and subscribed before me this day of FC1 20n State of Florida,County of Duval C Notary's Signature: Fujj =ct Y PYU. JENNIFER SCHLUETER *: *: MY COMMISSION#DD 121301 ❑ Personally known �. o= EXPIRES:May 27,2006 �hoduced identification ,.....�' Bonded Thm Notary Public Underwriters � Type of identification produced >w I�DL-0 — AS TO CONTRACTOR: U Sworn to and subscribed before me this day of ii}j ,20 State of Florida,County of Duval /n/ Notary's Signature: W,A, '4/ :�i'tey• JENNIFER SCHWETER ❑ p rsonally known +. .. MY COMMISSION#W 121301 � p= EXPIRES:May 27,2005 Produced identification "6.,. of Bonded Thru Notary Publir.Underrvritec Type of identification produced � � 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ei.atiantic-beach.ft.us Page 2 Revised 1/14/03 CITY OF ATLANTIC BEACH OWNER/BUILDER AFFIDAVIT Dater �' oa 3 Job Address: IL - a r y G u e CHAPTER 489,FLORIDA STATUTES,PART 1 "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 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. THE 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 WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 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 COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. r PROPERTY O RB R TQ Abd RE ME THI OF �� 20 COMMISSION#DD 121301 EXPIRES:May 27 2006 1 Bonded Thru Notary Public Underwriters NCFAJKY PUBLIC MMISSION EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. M �J CITY OF ATLANTIC BEACH r. r1r 800 SEMINOLE ROAD J3 ATLANTIC BEACH,FLORIDA 32233-5445 T TELEPHONE: (904)247-5800 FAX:(904)247-5805 SUNCOM:852-5800 http://ci.atlantic-beach.fl.us 1 AN RP I W COMMENTS Permit ation # C5 y Applicant: Address: cl 1-7 C Project_ 0 cn cre4-e � CV Your application is approved o Your permit application has been reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed Signe 4 -�-- DateU Contractor Notified Date 0_3^ � �� RECEI \ Ea CITY OF ATLANTIC BEACH +� BUILDING & ZONING J ted. CITY OF ATLANTIC BEACH FEB 1 2003 BUILDING PERMIT APPLICATIO (ALTERATIONS/ADDITIONS) BY-. ,,yy Date: �cro Job Address: l80 i G bCG ✓ L- G✓t Owner of Property: S'c rc54 OLo�ssQ Address: 1 eo 2 H;G p d c t j�c�h� _____ Telephone: Legal Description: Block Number: Lot Number: J Zoning District: Contractor: 15<r_nay 4 01-0 f 5 so, State License Number: A/4 Contractor's Addrress: J� �`�'h4✓� Liv Altg01 Telephone: P-17—�_)5% Fax: Describe proposed use and work to be done: GanG✓c - t1)a�1c��4o�yf Eh� nc� Present use of land or building(s): Valuation of proposed construction: What are the dimensions of the added space: feet x feet Will the added area be heated and cooled? Nd New electrical or increase in service? New plumbing fixtures?g- New fireplace?9- New heating/air conditioning? G Is approval of Homeowner's Association or other private entity required?�If yes,please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? 9 NO. Applicant certifies that no change in site grade or fill material will be used on this project. ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. .® NO. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. 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. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at:1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 "STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 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 1/14/03 Ing addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided wit this aUpocation 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 being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: .2 As lU-z. Address and contact information of person to receive all correspondence regarding this application (please print). Name: Mailing Address: Telephone: Fax: E-Mail: AS TO OWNER: Sworn to and subscribed before me thisday of T 20C�3 State of Florida,County of Duval Notary's Signature, W;Y'N' JENNIFER SCHLUETER � = MY COMMISSION#DD 121301 ElPersonally known 'o= EXPIRES:May 27,2006 (��oduced identification Bonded Thru Notary Public Underwriters p� Type of identification producedL AS TO CONTRACTOR: U Sworn to and subscribed before me this day ofi� 20 State of Florida,County of Duval Notary's Signature: A]" JENNIFER SCHLUETER MY COMMISSION#DD 121301 ❑ Personally known u EXPIRES:May 272006 [ Produced identificationC/w � Bonded ThruNotary Public Underwriter Type of identification produced .�vr 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Page 2 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us Revised 1/14/03 sf1 CITY OF ATLANTIC BEACH OWNER/BUILDER AFFIDAVIT Date: Job Address: 4//,G k o r y /_qL,,e CHAPTER 489,FLORIDA STATUTES,PART 1 "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 THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE— OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR WROVE 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 REOUIRFD 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. TEE 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 1S 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 WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 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 COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. PROPERTY O r RB 'R TO AIf RE ME THIS AY OF f:;P_/0 209- N 09- N COMMISSION#DD 121301 P; °P•• Bonded EXPIRES:Thru May 27,20 Underwriters NLFAI,Y PUBLIC MMISSION EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. M I V r + ( FORM 902 CLIMATE ZONES 123 9 F WINTER OVERHANG FACTOR (WOF) 9 F SUMMER OVERHANG FACTOR (SOF) FEET N NE E SE S SW W NW FEET N NE E SE 5 SW W NW ---- ---- ---- ------- ---- ---- ----- ---- ---- ---- ---- -- 0-0.9 1.00 0.98 0.99 0.74 0.71 0.82 0.93 1.00 0-0.9 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1-1.9 1.00 0.98 0.99 0.75 0.73 0.83 0.93 1.00 1-1.9 1.00 1.00 0.99 0.98 0.97 0.98 0.99 1.00 2-2.9 1.00 0.98 0.99 0.77 0.76 0.84 0.94 1.00 2-2.9 1.00 0.98 0.94 0.92 0.91 0.92 0.94 0.98 3-3.9 1.00 0.98 0.99 0.81 0.79 0.87 0.94 1.00 3-3.9 1.00 0.95 0.89 0.86 0.85 0.860.89 0.95 4-4.9 1.00 0.98 0.99 0.84 0.83 0.89 0.94 1.00 4-4.9 1.000.91 0.84 0.80 0.82 0.80 0.84 0.91 5-5.9 1.00 0.99 1.00 0.87 0.87 0.92 0.95 1.00 5-5.9 0.99 0.88 0,79 0.76 0.79 0.76 0.79 0.88 6-6.9 1.00 0.99 1.00 0.90 0.90 0.93 0.96 1.00 6-6.9 0.99 0.85 0.75 0.73 0.78 0.73 0.75 0.85 7-7.9 1.00 0.99 1.00 0.93 0.94 0.96 0.97 1.00 7-7.9 0.99 0.83 0.720.70 0.77 0.70 0.72 0.83 8-8.9 1.00.0.99 1.00 0.95 0.96 0.97 0.98 1.00 8-8.9 0.99 0.81 0.70 0.68 0.77 0.68 0.70 0.81 9-9.9 1.00 1.00 1.00 0.97 0.98 0.98 0.98 1.00 9-9.9 0.98 0.79 0.68 0.67 0.16 0.67 0.68 0.79 10-10.9 1.00 1.00 1.00 0.99 0.99 0.99 0.99 1.00 10-10.9 0.98 0.77 0:66 0.66 0.76 0.66 0.66 0.77 11-11.9 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 11-11.9 0.97 0.76 0.64 0.64 0.76 0.64 0.64 0.76 12 UP 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 14 UP 0.97 0.75 0.63 0.64 0.76 0.64 0.63 0.75 9G I HEATING SYSTEM MULTIPLIER (HSM) HEAT PUMP COP 2.2-2.3 2.4-2.5 1 2.6-2.7 2.8-2.9 3.0-3.1 3.2-3.3 3.4 8 UP HSM 0.45 0.42 0.38 0.36 0.33 0.31 1 0.29 SOLAR HEATING SYSTEM (BACKUP SYSTEM FRACTION) x (BACKUP SYSTEM HSM) ELECTRIC STRIP HEAT 100, NATURAL GAS / PROPANE 1.0 (SEE TABLE 9D FOR CREDITS) OIL 1.0 (SEE TABLE 9D FOR CREDITS) '_9H COOLING SYSTEM MULTIPLIER (CSM) EER/ ELEC. 6.8-6-917.0-7.417.5-7.9 ; .;,<_u.:, ' 8.5-8.919.0-9.419.5-9.9 10.0-10A I 10.5-10.911.0-11.9 12.0-Up CSM 1.00 1 0.93 1 0.87 1 0.81 1 0.76 1 0.72 1 0.68 0.65 0.62 1 0.59 1 0.54 COP 0.40-0.44 0.45-0.49 0.50-0.54 0.55-0.59 0.60-0.64 0.65-0.69 0.70 8 UP " GAS CSM 1.50 1.25 1.20 1.09 1.00 0.92 0.89 *ALTERNATE PRESCRIPTIVE COMPLIANCE APPROACH MINIMUM AIR CONDITIONER EFFICIENCY LEVEL 8.0 SEER/EER FOR STRAIGHT COOL OR 7.5 FOR HEAT PUMPS. NOTE: EER a COOLING MODE COP x 3.413=ARI RATED COOLING OUTPUT IN STUN + TOTAL WATTS CONSUMED 91 HOT WATER CREDIT POINTS (HWCP) ELECTRIC RESISTANCE WATER HEATER 0 GAS WATER HEATER 10 INSTANTANEOUS WATER ELECTRIC 4.5 HEATER GAS 12.6 HRU (A/C) WATER HEATER ELECTRIC BACKUP 6.7 GAS BACKUP 13.9 HRU (HP) WATER HEATER ELECTRIC BACKUP 9.7 GAS BACKUP 14.5 HEAT PUMP WATER HEATER COP 1.60 - 1.89 1.90 2.19 220 2.49 2.50 - 2.79 2.80 - 3.00 (DEDICATED HEAT PUMP) CREDIT POINTS 9.0 11.4 13.1 14.4 15A SOLAR OVERALL SOLAR FRACTION* 0.1 0.2 0.3 0.4 0.5 0.6 0.7 02 0.9 1.0 L- v. ELECTRIC BACKUP 2.4 4.8 7.2 9.6 12.0 14.4 16.8 19.2 21.6 24.0 HOT WATER o z o GAS BACKUP 11.4 12.8 14.2 15.6 17.0 182 19.8 21.2 22.6 24.0 v d L-PERCENT OF ANNUAL HOT WATER PROVIDED BY SOLAR SYSTEM _ 100 - OVERALL SOLAR FRACTION' 4