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Permit 1964 Francis Ave CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00034258 Date 11/14/06 Property Address . . . . . . 1964 FRANCIS AVE Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc install 9 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MARCHAND PLUMBING INC. 10139 BOOKWOOD FOREST BLVD ORANGE PARK FL 32073 (904) 759-1485 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 98 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/13/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 98 . 00 98 .00 . 00 .00 Plan Check Total . 00 . 00 .00 .00 Grand Total 98 . 00 98 . 00 . 00 . 00 196 Z • ?/99 " - 99907 PERMIT IS APPROVED ONLY IN ACCORDANCE WrrH ALL CITY OF ATLANPiC BEACH ORDINANCES AND THE FLORIDA BUR DING CODES. Is; CITY OF ATLANTIC BEACH ` PLUMBING PERMIT APPLICATION Date: t Property Address: Owner: e�S r I 0 a-) Telephone#: Contractor: QCl^7t�C. P(U�b Ina, Telephone#:--159 ~ 1t4y Contractor Address: V 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. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: If other construction is being done on this building or site, ❑ New list the buil ing permit n ex:, ❑ Re-Pipe C 4 O Number of Fixtures: _ Bath Tubs Showers _ Closets Shower Pans _ Dishwashers Sinks Disposals Urinals Floor DrainsWashing Machine _ Lavatory Water Sewer <W Water Heaters Sprinkler System Other Fees Permit Issuing Fee: $35.00 Total Fixtures: X$7.00 + $35.00= 800 Seminole Road-Atlantic Beach, Florida 32233-5445 Phone: (904)247-5800- Fax: (904)247-5845- http://www.ci.atiantic-beach.fl.us Revised 1/04 A PERMIT WORKSHEET Certificate of Occupancy Job Address: Type Work: Iq V6 Property Owner: Phone # �/Jrl � Tffarn�5 Contractor: )-'At ��-�� Com �Permit#: Date Issued: I� 7. 6,5" Building Inspections: Footing IS .1. 0 Slab Tie Beam Lintel Nailing / Sheathing Framing / Cover Up Insulation Final Building Tree Permit# +-� YES NO Electrical Permit# r - 3 b Date/ Copy to JEA Temp, Pole Permit# � � Date f Copy to JEA Temp. Power Letter Received: YES NO Inspections: Rough Electric Released to JEA Temp. Power Released to JEA Temp. Pole Released to JEA Final Released to JEA Mechanical Permit# Inspections: Rough Final +� Plumbing Permit# IT Inspections: Rough /Underslab Topout Water/ Sewer Final Drainage Inspection: Pool Permit# Inspections: Steel Final Grounding Final Roofing Permit# I— I Inspections: Nailing /Sheathing Final (�— Fire Inspection: Failed Inspections: Date Paid: Date Paid: ¢ z It City of Atlantic Beach Building Department Certificate of Conditional Occupancy This Certificate issued pursuant to the requirements of Section 110.2 of the Florida Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: Date: May 11, 2007 Contractor: The Laney Company Address: 1964 Francis Avenue Occupancy Classification: Duplex Permit Number: 05-33054. David K. H fstetler Building Official QTY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00033460 Date 7/10/06 Property Address . . . . . . 1964 FRANCIS AVE Tenant nbr, name . . . . . . INSTALL HEAT PUMP Application description . . . MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ TROPIC AIRE OF NORTH FLORIDA 9969 OLD KINGS ROAD JACKSONVILLE FL 32219 (904) 719-9600 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 59 . 00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 59 . 00 59 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 59 . 00 59 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WI'T'H ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD s� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 I Application Number . . . . 06-00033908 late 9/14/06 Property Address . . . . 1964 FRANCIS AVE Application type description PLUMBING ONLY Property Zoning . TO BE UPDATED Application valuati n 0 --------------r-- ------ ---------------------------- ----------------------- Application desc 3/4 IN METER AND qAP ------------------- - ----- ----------------------- --- ------------------------- Owner Contractor ------------------------ ----- --- ---------------- THOMAS CITY OF ATLANTIC BEACH ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . 9/14/06 Valuation . . . . 0 Expiration Date . . 1 3/14/07 --------------- --------- - ---------------------- - --------------------------- Other Fees . . . . . . . WATER CONNECT/TAP & METER 525 . 00 ------------------------ --------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- --------- ---------- -- ---- - --- ---------- i Permit Fee Total . 00 . 00 . 00 . 00 Plan Cheek Total . 00 . 00 . 00 . 00 Other Fee Total 525 . 00 525 . 00 . 00 . 00 Grand Total 525 . 00 525 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. i. I i 1 r uilding, anning & ningspection CITY OF ATLANTIC BEACH epartment CERTIFICATE OF OCCUPANCY WORKSHEET Date Requested: 6/ • o 7 Contractor Name: ��E L�ii✓Ey Cp Permit #: D� • 3/�Z (� Property Address: -r at 5 � Legal Description: Improvements to the above-described property have been completed in accordance with the terms of the permit and are certified to be ready for occupancy as: ❑ Single-Family Residence ❑ Commercial Other: _A ale K - 2�?# by&e- /,6 m � Lowest Floor Elevation: Required As Built The fotlowtrig must be completed befog issuing Corti ftcate of Occupancy: Department Date Notified Date Approved Approved By Fir Ac.�• f 07 Public Works ` -0 Planning Dept. Building Dept. Final Survey with FFE ❑ Ye [�No .All Re-Inspect Fees Paid Yes E] No r uilding, anning & oning spection CITY OF ATLANTIC BEACH epartment CERTIFICATE OF OCCUPANCY WORKSHEET Date Requested: �• �� Contractor Name: �� l/�i✓f Ca Permit #: 5-- .3/..-5`2 -7 Property Address: 9& P6-4-77 ei S f- Legal Description: Improvements to the above-described property have been completed in accordance with the terms of the permit and are certified to be ready for occupancy as: ❑ Single-Family Residence ❑ Commercial // 14 Other: >r ooh /— Lowest Floor Elevation: Required As Built The following must be completed before issuing Certificate of Occupancy: Department Date Notified Date Approved Approved By Fire lcs / 1 D�7 Public Works Planning Dept. Building Dept. Final Survey with FFE ❑ Yes [2r No All Re-Inspect Fees Paid ll�' Yes ❑ No Graham Shirley From: Walker, Chris Sent: Friday, January 12, 2007 1:29 PM To: Graham Shirley Subject: RE: Final co inspection Everything looked good here except they need to install an RT-1 sewer clean out box over the clean out at the property line. I called the Laney company and left a message to have this done and call me back. From: Graham Shirley Sent: Thursday,January 11,2007 4:34 PM To: Carper,Rick; Kaluzniak,Donna; Nodine,Phil; Deming,James;Walker,Chris Cc: Matthews,Carlene; Lanier,Joyce Subject: Final co inspection ELSIE THOMAS/LANEY COMPANY REQUESTED A FINAL CO INSPECTION FOR 1962 AND 1964 FRANCIS AVE 05 31526,05 31527 SHE CAN BE REACHED AT 389 6752 SHIRLEY 1 Graham Shirley From: Graham Shirley Sent: Thursday, January 11, 2007 4:34 PM To: Carper, Rick; Kaluzniak, Donna; Nodine, Phil; Deming, James;Walker, Chris Cc: Matthews, Carlene; Lanier, Joyce Subject: Final co inspection ELSIE THOMAS/LANEY COMPANY REQUESTED A FINAL CO INSPECTION FOR 1962 AND 1964 FRANCIS AVE 05 31526,05 31527 SHE CAN BE REACHED AT 389 6752 SHIRLEY 1 Graham Shirley From: Clemons, Malcolm Sent: Friday, January 12, 2007 10:50 AM To: Kaluzniak, Donna Cc: Graham Shirley Subject: RE: Final co inspection No irrigation. OK Malcolm From: Kaluzniak,Donna Sent: Thursday,January 11, 2007 4:37 PM To: Clemons,Malcolm Subject: FW: Final co inspection From: Graham Shirley Sent: Thursday,January 11,2007 4:34 PM To: Carper,Rick; Kaluzniak,Donna;Nodine,Phil; Deming,James;Walker,Chris Cc: Matthews,Carlene; Lanier,Joyce Subject: Final co inspection ELSIE THOMAS/LANEY COMPANY REQUESTED A FINAL CO INSPECTION FOR 1962 AND 1964 FRANCIS AVE 05 31526,05 31527 SHE CAN BE REACHED AT 389 6752 SHIRLEY 1 Mitch Branch &Associates, Inc. A Permit& Site Support Service Company 6114 Goodman Road, Suite 2 Jacksonville, Florida 32244 Office904-317-0010 Fax 904-317-0111 Cell 904-703-3807 Nextel 158*28*5494 State License#1H0000635 October 26, 2005 Rick Carper City Of Atlantic Beach Public Works Department 1200 Sandpiper Lane Atlantic Beach, Florida 32233 Dear Mr. Carper; I'm the permitting agent for the property owner & The Laney Company involving Permit application # 05-51479 , 64 Francis Avenue. The property owner is combining 'h of lot 9 with lot 10 & 'h of lot 9 with lot 11. The duplex for lot 11 is a future structure which will be pursed in the coming months. However, the property on wants to graded and prepared lot 11 at the same, so it will be ready for the foundation work when the building permit is issued for this structure. I hope this clarifies your concerns regarding the duplex for lot 11. Also, I will provide a revised drainage plan showing the 6" grade/ 100' for the drainage swale for lot 9. Thank you for your cooperation in this matter. Should you have any questions or concerns regarding the above, please contact me. 7 Sincerely, Mitch Branch cc: The Laney Company Elsie Thomas CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ti ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00033300 Date 6/19/06 Property Address . . . . . . 1964 FRANCIS AVE Tenant nbr, name . . . . . . NEW SERVICE Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ THOMAS MCCLURE ELECTRICAL CONTRACTORS P.O. BOX 51368 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 (904) 249-9061 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA WELDING CODES. s J CITY OF ATLANTIC BEACH r ELECTRICAL PERMIT APPLICATION Date: �/11/0 (D Property Address: —/q(04 62 !61-5 )w, _ Owner: !�b AS Telephone#• Contractor: , A G�6k,-' 2-k- 6 Telephone#• Contractor Address: 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: Bt3Wing Type: ❑ Trailer ServJ¢e: If other construction is New pp�� Residence ❑ Temp. [0/New being done on this building Or site,list the building ❑ Old ❑ Commercial ❑ Signs ❑ Increase Permit number: ❑ Re-wire ❑ Addition Sq.Ft. ❑ Repair Conductor Size: AMPS: COPPER ALU1v1INUM Switch or ,( RACE Breaker AMPS �� PH W "f VOLT c)3 b WAY Existing Service RACE Size AMPS PH W VOLT WAY Meter Number Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN ...Receptacles CONCEALED OPEN Switches Incandescent Fluorescent & M.V. Fixed 0.100 AMPS OVER BELL Appliances TRANSFER. Air H.P.RATING H.P.RATING CEILING KW-HEAT Conditioning COMP.MOTOR OTHER MOTORS AMPS HEAT Motors 0-1 H.P. VOLTAGE PH NO. OVER I H.P. PHS UNDER600V OVER600V Transformers NO. KVA NO. KVA No,Neon_Transf Ea._Sign Miscellaneous 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845• http://www.ei.atiantic-beach.fi.us Revised 1/04 CITY OF ATLANTIC BEACH sem' PERMIT CALCULATION SHEET Date: Address L 24, I el 4-AJ C C.S FTJ Heated Square Footage 0 @ $. � �d per sq ft= $�?,774 Garage / Shed @$ per sq ft = $ Carport/Porch @ $ per sq ft= $ Deck @ $ per sq ft= $ Patio @ $ per sq ft = $ TOTAL VALUATION: $ rz "779 Total Valuation 1St $ Remaining Value $ . per thousand or portion thereof 'ONSTRUCTION TYPE: TOTAL BUILDING FEE $ ZONING: I + V2 Filing Fee $ FLOOD ZONE: , Xe— ( ) Fireplaces @ $35.00 $ —D IMPERVIOUS SURFACE: BUILDING PERMIT FEE $ i ,-WATER IMPACT FEE $ V Jr0 o/SEWER IMPACT FEE $ WATER METER/TAP $ v/CAPITAL IMPROVEMENT$ 3 Z j SEWER TAP $ t. -,C(lOYORADON HRS .0050 $ SECTION H PAVING( ) $ — 0— CROSS O— CROSS CONNECTION $ .3 y' ,,,ATVb,y0) SURCHARGE $ OTHER $ GRAND TOTAL DUE: $ IJUM CITY OF ATLANTIC BEACH PUBLIC UTILITIES DEPARTMENT 1200 Sandpiper Lane 1 Atlantic Beach,Florida 32233 (904)247-5834 (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # V 31,5� Property Address t(J� �r�� •� Q V�VV U V Applicant: t) Project: r Vl bCA(1 1�t Your application is approved as noted by the Public Utilities Department. Final application approval must come from the Building Department. ❑ Your permit application has been reviewed by the Public Utilities Department and the following items need attention: .4rG W S f be !' Je errhas e o Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions;please call (904) 247-5834. Rev' e by Donna uzniak, Public Utilities Director / Date ! —31—Oe Signature Contractor Notified Date L � ., CITY OF ATLANTIC BEACH r� 1 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 r ` INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00031527 Date 11/07/05 Property Address . . . . . . 1964 FRANCIS AVE Tenant nbr, name . . . . . . NEW MODULAR DUPLEX Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 87776 Owner Contractor ------------------------ ------------------------ THOMAS, ELSIE THE LANEY COMPANY P.O. BOX 72 - ORTEGA STATION ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32210 (904) 389-6752 ---------------------- ------------------------------------------------------ Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 462 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 87776 Expiration Date . . 3/07/06 ----------------------------------------------------------------------------. Other Fees . . . . . . . . . CITY RADON SURCHARGE .26 CAPITAL IMPROVEMENT 325 . 00 STATE RADON SURCHARGE 4 . 94 SEWER IMPACT FEES 1250 . 00 WATER IMPACT FEE 450 . 00 WATER CROSS CONNECTION 35 . 00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 462 . 00 462 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 2065 .20 2065 .20 . 00 . 00 Grand Total 2527 . 20 2527 .20 . 00 . 00 PERNUT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUIILDING OFFICIAL Graham Shirley From: Matthews, Carlene Sent: Tuesday, November 22, 2005 4:53 PM To: Graham Shirley Subject: 1962 & 1964 Francis Ave Shirley, I received permits 05-00031526&31527. Does not show meter amount. Just needed to verify if these fees included meters and are they 3/4"please. Thanks and HAPPY THANKSGIVING...............Carlene 1 WATER IMPACT FEE WORKSHEET ADDRESS: I cl G iC pus !/F DRAINAGE FIXTURE UNIT FIXTURE TYPE VALUE AS LOAD FIXTURES UNITS Automatic clothes washers,commercial 3 Automatic clothes washers, residential 2 Bathroom group consisting of water closet, lavatory, 12— Bidet, ZBidet, and bathtub or shower 6 Bathtub(with or without overhead shower or whirlpool attachments) 2 Bidet 2 Combination sink and tray 2 Dental lavatory Dishwashing machine,domestic 2 Z Drinking fountai cemaker Yz Floor drains 2 Hose bib f 2— l^%itchen sink, domestic 2 Kitchen.sink, domestic with food waste grinder and/or Z dishwasher 43 C_-- 2 Laundry tray(1 or 2 compartments) 2 Lavatory 1 Shower compartment domestic 2 Sink 2 Urinal 4 Urinal, i gallon per flush or less 2 Wash sink(circular or multiple)each set of faucets 2 Water closet,flushometer tank,public or private 4 Water closet,private installation 4 Water closet, public installation 6 TOTAL NUMBER OF UMTS-- 1-2.J MULTIPLIED X 20 TOTAL$ (7 CITY OF ATLANTIC BEACH c BUILDING /ZONING DEPARTMENT D.Fo W i99ins } 800 Seminole Road o u, * x r Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS --7 Permit Application # Property Address: Iq (04- F r Q k.C 2rQy-cym) Applicant: 711'L V J I Project: fAbd.u.(a,r` -pi4 LX This permit application has been: Approved El Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: yl:�� Ce Date: Date Contractor Notified: Map Output Page 1 of 1 JAXGIS Property Information I� .� 2" 165 1983 g 183 1980 16S ,919 iS 55 110 tf 1970 g 185 165 110 s �� n 1881 1968 55 55 35 33 53 93 � � . � JDD ,885 .. 1915 63.60 55 1S + 83 — 2— 1689 7841 } 63.00 J 56 55 ss 35 35 55 1693 —-— - — i 2025 -- -- ---- --- -- 6100 33:00 35A0 33310 35.00 13.66 35.00 M96 1697 ,95. " II s ii �I 126A0 40 60 i 89:86---_"=->39.93—-_ __;�I 1950 Ii 1935 ;4 Iz $ 1975 MAX 93.80 55AD 55.00 35A0 990 I' 191512 largo ,968 125:00 rjl! R 1931 1915 56.10 � �Cop"a 4C12002C4yofJeWamd6e,f1 Q 146ft Total fat Map flooc dE# ameddress Value cres oak ane► egal Descriptions eand UseNOMAS 10064- 19-16 17-2S-29E in 172168000 LSIE LYNN 938 .47 1099 56A1 ONNERS R/P PT LOT 2d Zone 2233 OTS 9,10,11 BLK http://maps2.coj.net/WEBSITE/DuvalMAps/toolbar.asp 7/1/2005 Graham Shirley From: Carper, Rick Sent: Thursday, October 27, 2005 11:42 AM To: Ford, Don Cc: Graham Shirley; Cunningham, Kerri; Kaluzniak, Donna Subject: Permit No. 05-31478 &79 Talked yesterday with Mitch Branch, permitting agent for these properties. Confirmed his permit application is incorrect, in that it request a permit for construction on lot 10 and southern 1/2 of 9, but plans submitted are for lot 11 and northern 1/2 of 9. This may affect house numbers assigned (62 &64 Frances). Also question on house numbers-home immediately to north of Lot 11 is 1968 Frances, home to south of Simmons Road is 1954. Shouldn't addresses be in 1900 series? Ricky L. Carper, P.E. Director of Public Works/City Engineer City of Atlantic Beach 1200 Sandpiper Lane Atlantic Beach, FL 32233 rcarper@coab.us PLEASE NOTE: Florida has a very broad public records law. Your e-mail communications may be subject to public disclosure. i CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION CHECKLIST (New/Commercial &Residential) APPLICATION CHECKLIST/REQUIRED SUBMITTALS Building Application Form v/2. Four(4)complete sets of plans including detailed site plan --/ 3. Recent survey nr�4. Owner/Builder Affidavit(required when owner acts as contractor) ✓5. Energy Sheets 6 Recorded Notice of Commencement ,1 l 'r �'!zN' n' aC.( -`'7'V�t Tree Removal Application if trees are to be removed or relocated A$. Provide Drainage Plans �,'9. Provide Erosion and Sediment Control Plan 1.10. Construction Site Management Plan SCHEDULED INSPECTIONS Requests for inspections are taken from 8:00 a.m. to 5:00 p.m. Monday through Friday at 247-5826. Requests can be scheduled after hours by leaving a message on the voice mail system. Inspections are made the following working day; please specify a.m. or p.m. inspection. When calling in an inspection, please have the permit number, job location and type of inspection needed. Inspections are scheduled as follows: 1. Footing 2. Under slab plumbing/sewer/electric 3. Slab 4. Cover up: Framing, Rough Electric, Mechanical and Plumbing. (This is different from other jurisdictions) 5. Insulation 6. Final Inspection(includes drainage,trees, landscape and site inspection) Finished floor elevation survey required prior to issuance of Certificate of Occupancy. BUILDING CARD MUST BE POSTED OR NO INSPECTIONS WILL BE MADE. Concrete cannot be poured and work cannot be covered up until the building card is SIGNED by the inspector. You may be required to uncover any work that has not been inspected. It is the responsibility of the BUILDER/CONTRACTOR to post the building card. A fee of$35.00 is charged for all re-inspections. NOTE: This application may be subject to covenants and restrictions for the permitted property. The enforcement of the covenants and restrictions are the responsibility of the homeowner's association. 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 - Fax: (904)247-5845 - http://www.ei.atiantic-beach.fl.us Page 1 Revised 8/04 OWNER'S AUTHORIZATION FOR AGENT Jo/?Y-5 /��z G?C �r is hereby authorized to act on behalf of LIS 1, Z 2220 ?&-S the owner(s) of those lands described with the attached application, and as described in the attached deed or other such proof of ownership as may be required, in applying to the City of Atlantic Beach, Florida, for an application related to a Development Permit or other action pursuant to a: ❑ Zoning Variance ❑ Appeal ❑ Use-by-Exception ❑ Fence or Pool Permit ❑ Rezoning ❑� Sign Permit r / t Plat or Replat Other AUTHORIZED BY: Signature of Owner Print Name Signature of Owner Print Name IC-7&Y Address gC)y 6,0 7-/ y S" Telephone Number THIS SPACE FOR RECORDER'S OWN USE ONLY !LU USHER CAREY Be this f SNday of t C C my of Duval, COMMISSION DD26 44 State Of Florida,has personally appeared �5/ T/,,7 0 S Notary Public at Large, State of Florida, County of Duval. EXPIRES 11124/2007 My commission expires: BONDED THRU I.8"'NOTARM' Personally Known: or Produced Identification: t- CITY OF ATLANTIC BEACH s BUILDING PERMIT APPLICATION (New/Residential & Commercial) � Date: Job Address: I Z Owner's Name: C/,5/6 7�('mos r Address: Ave- Phone: 6;r'I*V 60 7- Legal Description: Block Number: �� Lot Number: `� ` a'U g P Zoning District: Contractor: %J< � F�� ,L t� �c. c r.,i State License Number: Al Address: CJ}C �' c % �' ") t�, r `�. �t i ..�. Phone: City: State: FCZip: . lL% Fax: ; Cf it Describe proposed use and work to be done: 19?(.?�T(f.f°rte Present use of land or building(s): Valuation of proposed construction: Is approval of Homeowner's Association or other private entity required? I?% If yes, please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material, 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. 1'ES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ❑W. 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 Phone: (904)247-5800 • Fax: (904)247-5845 - http://www.ci.atiantic-beach.1l.us Page 2 Revised 8/04 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. Provide drainage pians. 7. Provide erosion and sediment control plan. 8. Any other documents requested by Building Dept.,Planning Dept.,Public Works and Public Utilities. Address and contact information of person to receive all correspondence regarding this application(please print). Name: Mailing Address: Telephone: (lr� �I i/7-6.sr9/C Fax' '3' �`�/ -'.'//, E-Mail I hereby certify that I have read and examined this application and attached documentation 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. s Signature of Owner:� L_0 °'_ Date: AS TO OWNER: Sworn to and subscribed before me this /174 � day of { V f { f ��?� ;.:._�,7�"'t'' ,20 State of Florida,County of Duval C J •� fi f rr, REN Notary's Signature. aHELI.I LiC USHER OAF R.Of�p NOTARY PURL COMMISSION#DD2697'� j— rsonally known SIRES 1112412007 ,Ot4oWneU i.W-NOTARY' d identification yp of identification produced f L, Signature of Contr or: Date: -7 161 AS TO CONTRACTOR: Sworn to and subscribed before me this yI'-�'_'l y of State of Florida,County of Duval Notary's Signatures. ( l_� SHELLI USHER CAREY a NOTARY pU9LIC.STATE OF FLOMW COMMISSION#D0269744 Personally known EXPIRES 11/24!2007 SoNOEOTHRu14W'NOTARYI Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 Fax: (904)247-5845 • http://www.ei.atiantic-beach.fl.us Page 3 Revised 8/04 William J. Kalker, Jr. , P.E. Consulting Engineer 33 Rockwood Lane Monroe, Connecticut 06468 203/261-1167 July 27, 2005 Mr. Walt Clements f Precision Modular 309 E. 4th Street Ocilla, GA 31774 SUB: Approval Of Model PRE-51DFL (Wyngate 01 Duplex) For 130 MPH, EXPC Locations In Accordance 2001 Florida Building Code To Whom It May Concern: This letter certifies that the subject model approved for 130 MPH, EXPB locations is also acceptable for 130 MPH, EXPC loc- ations when the following limitations are satisfied: (1) The building cannot be located on the upper half of an isolated hill or escarpment which satisfies all of the following: tip Q V� hill or escarpment is higher than 30', and P` Q average slope of hill exceeds 10%, and • • hill or escarpment has no obstructions to wind movement by topographic features for a distance from top of hill or escarpment equal to 50 times the height of the hill or r J U L 2 9 2005 0 escarpment or one mile, whichever is less (A ( (2) The buildings mean roof height cannot exceed 15' � above grade. ?� W C !'lZ� (3) The building must be constructed with a 5/12 roof pitch (the 7/12 roof pitch and mono--pitch �RNER. GP truss specified on the approved drawings are not acceptable). The standard 5/12 mono-pith truss to be used in the main roof areas must be SHM291402 designed by Universal Forest Products. All other truss installation specifications are the same as those specified on the approved drawings. (4) The building must be constructed in the factory in accordance with the structural specifications ap- proved by the state authorized third-party agency for 130 MPH, EXPC design wind pressures. The third- party must certify that the construction of the building in the factory satisfies this requirement. This letter must be reviewed and approved by the state authorized third-party agency (HWC) to be valid and acceptable to the local building official. If you have any questions regarding this memo, please do not hesitate to contact me. Very truly yours, Wi"Kker, E. cc: Mr. S. Francis/HWC (Third-Party) FLORIDAFFI I. R BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Whole Building Performance Method A Project Name: PRE-51DFL Builder: Address: PRE-51DFL SOUTH Permitting Office: Cit�r, State: Permit Number: Ovvner: Jurisdiction Number: Climate Zone: South 1. New construction or existing New - 12. Cooling systems 2. Single family or multi-family Single family _ a. Central Unit Cap:60.0 kBtu/hr _ 3. Number of units,if multi-family 1 - SEER: 12.00 _ 4. Number of Bedrooms 6 b.N/A 5. Is this a worst case? Yes _ 6. Conditioned floor area(ftz) 2080 ft' c. N/A _ 7. Glass area&type Single Pane Double Pane _ a. Clear glass,default U-factor 0.011, 0.0 ftz _ 13. Heating systems b. Default tint 0.0 ftz 0.0 ft! _ a. Electric Heat Pump Cap:56.0 kBtwl r _ c. Labeled U or SHGC 0.0 ftz 204.5 ftz HSPF:6.60 _ 8. Floor types - b.N/A a. Raised Wood,Stem Wall ftz b. N/A c. N/A _ c. N/A 9. Wall types - 14. Hot water systems a. Frame,Wood,Exterior R=13.0,1412.0 ftz - a. Electric Resistance Cap:50.0 gallons _ b. Frame,Wood,Adjacent R=0.0,208.0 ftz T EF:0.97 _ c. N/A b. Electric Resistance Cap:50.0 gallons _ d. N/A _ EF:0.97 _ e. N/A c. Conservation credits _ 10. Ceiling types - (HR-Heat recovery,Solar a. Under Attic R=30.0,2080.0 ftz DHP-Dedicated heat pump) b. N/A 15. HVAC credits _ c. N/A (CF-Ceiling fan,CV-Cross ventilation, 11. Ducts HF-Whole house fan, a. Sup:Unc. Ret:Unc. AH:Attic Sup.R=6.0,200.0 ft PT-Programmable Thermostat, b. N/A MZ-C-Multizone cooling, MZ-H-Multizone heating) Glass/Floor Area: 0.10 Total as-built paints: 38050 Total base points: 00507 I hereby certify that the plans and specifications covered Review of the plans and by this calculation are in compliance with the Florida specifications covered by this ��1�UE s��21 Energy Code. calculation indicates compliance y „"�� _� '`o • � ��`+ ��'��, with the Florida Energy Code. PREPARED BY: Before construction is completed � DATE: this building will be inspected for I hereby certify tl�'at this building, as designed, is in compliance with Section 558 908 compliance with the Florida Energy Code. Florida Statutes. �otr WE Plan lits. C1WNER/AGEIVT: BUILDING OFFI Od Ey JA Es�. I.Y{7�Pda' .DATE o DATE e ' EnergyGauge@(Version:FLRCSB v3.30) _ A xrt6�ad to Csati,dttz Plalla Examiner Fk)rida License No.SMP-12 a vvvvvvi • wv e SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: PRE-51 DFL SOUTH, , , 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 2080.0 32.50 12168.0 Double,U=0.48,Clear W 0.0 0.0 30.0 64.08 1.00 1922.5 Double,U=0.48,Clear W 0.0 0.0 16.7 64.08 1.00 1067.6 Double,U=0.48,Clear E 0.0 0.0 150.0 70.94 1.00 10640.7 Double,U=0.48,Clear S 0.0 0.0 3.9 60.89 1.00 237.5 Double,U=0.48,Clear N 0.0 0.0 3.9 34.70 1.00 135.3 As-Built Total: 204.5 14003.7 WALL TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Adjacent 208.0 1.00 208.0 Frame,Wood,Exterior 13.0 1412.0 2.40 3388.8 Exterior 1412.0 2.70 3812.4 Frame,Wood,Adjacent 0.0 208.0 3.40 707.2 Base Total: 1620.0 4020.4 As-Built Total: 1620.0 4096.0 DOOR TYPES Area X BSPM = Points Type Area X SPM = Points Adjacent 0.0 0.00 0.0 Exterior Insulated 80.0 6.40 512.0 Exterior 80.0 6.40 512.0 Base Total: 80.0 512.0 As-Built Total: 80.0 512.0 CEILING TYPES Area X BSPM = Points Type R-Value Area X SPM X SCM = Points Under Attic 2080.0 2.80 5824.0 Under Attic 30.0 2080.0 2.77 X 1.00 5761.6 Base Total: 2080.0 5824.0 As-Built Total: 2080.0 5761.6 FLOOR TYPES Area X BSPM = Points Type .R-Value Area X SPM = Points Slab 0.0(p) 0.0 0.0 Raised Wood,Stem Wall 19.0 20.80.0 -0.40 -832.0 Raised 2080.0 -2.16 -4492.8 Base Total: -4492.8 As-Built Total: 2080.0 -832.0 INFILTRATION Area X BSPM = Points Area X SPM = Points 2080.0 18.79 39083.2 2080.0 18.79 39083.2 EnergyGauge®DCA Form 60OA-2001 EnergyGaugeOtFlaRES'2001 FLRCSB v3.30 S SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: PRE-51 DFL SOUTH, ,, PERMIT#: BASE AS-BUILT Summer Base Points: 57114.8 Summer As-Built Paints: 62624.5 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) 62624.5 1.000 (1.073 x 1.165 x 1.08) 0.284 1.000 24025.2 57114.8 0.4266 24365.2 1 62624.5 1.00 1.350 0.284 1.000 24025.2 EnergyGauge"m DCA Form 600A-2001 EnergyGauge®/FIaRES'2001 FLRCSB v3.30 a a.. tease Wvaai ! 4.VV A WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: PRE-51 DFL SOUTH, , , 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 2080.0 2.36 883.6 Double,U=0.48,Clear W 0.0 0.0 30.0 2.09 1.00 62.8 Double,U=0.48,Clear W 0.0 0.0 16.7 2.09 1.00 34.9 Double,U=0.48,Clear E 0.0 0.0 150.0 1.43 1.00 214.4 Double,U=0.48,Clear S 0.0 0.0 3.9 1.27 1.00 4.9 Doubie,U=0.48,Clear N 0.0 0.0 3.9 2.47 1.00 9.6 As-Built Total: 204.5 326.6 WALL TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Adjacent 208.0 0.50 104.0 Frame,Wood,Exterior 13.0 1412.0 0.60 847.2 Exterior 1412.0 0.60 847.2 Frame,Wood,Adjacent 0.0 208.0 1.70 353.6 Base Total: 1620.0 951.2 As-Built Total: 1620.0 1200.8 DOOR TYPES Area X BWPM = Points Type Area X WPM = Points Adjacent 0.0 0.00 0.0 Exterior Insulated 80.0 1.80 144.0 Exterior 80.0 1.80 144.0 Base Total: 80.0 144.0 As-Built Total: 80.0 144.0 CEILING TYPES Area X BWPM = Points Type R-Value Area X WPM X WCM = Points Under Attic 2080.0 0.10 208.0 Under Attic 30.0 2080.0 0.10 X 1.00 208.0 Base Total: 2080.0 208.0 As-Built Total: 2080.0 208.0 FLOOR TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Stab 0.0(p) 0.0 0.0 Raised Wood,Stem Wall 19.0 2080.0 -0.10 -208.0 Raised 2080.0 -0.28 -582.4 Base Total: -582A As-Built Total: 2080.0 -208.0 INFILTRATION Area X BWPM = Points Area X WPM = Points 2080.0 -0.06 -124.8 2080.0 -0.06 -124.8 EnergyGauge@ DCA Form 6004 2001 EnergyGauge®tF1aRES'2001 FLRCSB v3.30 rvr��v� tivvn ,�vv r WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: PRE-51 DFL SOUTH, , , PERMIT#: BASE AS-BUILT Winter Base Points: 1479.6 Winter As-Built Points: 1546.6 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) 1546.6 1.000 (1.099 x 1.137 x 1.14) 0.517 1.000 1138.3 1479.6 0.6274 928.3 1 1546.6 1.00 1.425 0.517 1 .000 1138.3 EnergyGaugeTA° DCA Form 60OA-2001 EnergyGaugeS/FIaRES'2001 FLRCSB v3.30 WATER HEATING & CODE COMPLIANCE STATUS Residential Whole Building Performance Method A - retails ADDRESS: PRE-61 DFL SOUTH, , , 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 6 2369.00 14214.0 50.0 0.97 6 0.50 2149.20 1.00 6447.6 50.0 0.97 6 0.50 2149.20 1.00 6447.6 As-Built Total: 12895.2 CODE COMPLIANCE STATUS BASE AS-BUILT Cooling + Heating + Hot Water = Total Cooling + Heating + Hot Water - Total Points Points Points Points Points Points Points Points 24365 928 14214 39507 24025 1138 12895 38059 PASS a _-ICUES ow cow WE EnergyGaugeTm DCA Form 60OA-2001 EnergyGaugeO/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. PRE-51 DFL SOUTH, , , 1. New construction or existing New - 12. Cooling systems 2. Single family or multi-family Single family - a. Central Unit Cap:60.0 kBtu/lu - 3. Number of units,if multi-family I - SEER: 12.00 - 4. Number of Bedrooms 6 - b.N/A _ 5. Is this a worst case? Yes - - 6. Conditioned floor area(ft2) 2080 ft2 c. N/A - 7. Glass area&type Single Pane Double Pane - a. - 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:56.0 IcBtulhr - c. Tint/other SHGC-single pane 0.0 ft2 204.5 ft2 - HSPF:6.60 - d. Tint/other SHGC-double pane b.N/A - 8. Floor types - a. - a. Raised Wood,Stem Wall R=19.0,2080.Oft2 - c. N/A - b.N/A - - c. N/A 14. Hot water systems 9. Wall types - a. Electric Resistance Cap:50.0 gallons - a. Frame,Wood,Exterior R=13.0,1412.0 ft2 - EF:0.97 - b. Frame,Wood,Adjacent R--O.O,208.0 ft2 - b.Electric Resistance Cap:50.0 gallons - c. N/A - EF:0.97 - d. N/A c. Conservation credits - e. N/A (HR-Heat recovery,Solar 10. Ceiling types -,-,. DHF-Dedicated heat pump) a. Under Attic R-30.0,2080.0 ft2 _ 15. HVAC credits - b. N/A - (CF-Ceiling fan,CV-Cross ventilation, c. N/A HF-Whole house fan, 11. Ducts - PT-Programmable Thermostat, a. Sup:Uric. Ret:Unc. AH:Attic Sup.R=6.0,200.0 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) 04IM ST,g in this home before final inspection.Otherwise,a new EPL Display Card will be completedti based on installed Code compliant features. Builder Signature: Date: Address of New Home: City/FL Zip: coD � *NOTE: The homes 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 BnergyStarrmdesignation), your home may yualify for energy efficiency mortgage(EEM)incentives if you obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at 321/638-1492 or see the Energy Gauge web site at"W fsec.ucf edu for information and a list of certfed 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) 41MW ----------- SIMMONS CITY OF ATLANTIC BEACH S� � PUBLIC WORKS DEPARTMENT 1200 Sandpiper Lane Atlantic Beach,Florida 32233 (904)247-5834 ujo (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # 05"31 Property Address t o4 Fr Q(/( �' �-, u e yj ttL Applicant: Ny�jpavtW Projecy.2 o-4 od u i ar- --p- Your application is approved as noted by the Public Works Department. Final application approval must come from the Building Department, 1 U (� Your permit application has been reviewed by the Public Works Department P ` and the following items need attention: Permit application is for lots 9 & 10 . Plans show new structure on lot 11. Swale to be graded at 0. 5o slope. (6" / 100 ft . ) from flume to flume. Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions,please call (904)247-5834. Rev iewe by Carper, P.E., Public Works Director Date Signature Contractor Notified Date Ac-Vpj /0&—& CITY OF ATLANTIC BEACH cc: F' r x . BUILDING/ZONING DEPARTMENT . Ford n� 800 Seminole Road L. ins F' ; Atlantic Beach,Florida 32233 ' err P M�3f3 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # �`J " �! 4.70( Property Address:N% W 4 t'( V '5— a,V f qC) Applicant: .--MC t LawW Project: (Q,�44 ' This permit application has been: Approved C-1 Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: Date: Date Contractor Notified: CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION �� ~9 (New/Residential & Commercial) Date: �1/; - Job Address: �� (1/ 2 ` / r Cis Qr, Owner's Name: Address: / f"✓� �� r' /7 t/ Phone: q'1JV 60 7- f, Legal Description: Block Number: +! Lot Number: Zoning District: Contractor: �!. fState License Number: Address: 0010 /510K _7�? /f1flf 1't 5 c Phone: = r ! j , City: State: PC Zip: 3�10 Fax: Describe proposed use and work to be done: f7I(, 'Gl" Present use of land or building(s): i, '`r" r.'"-1 fc a/6 Valuation of proposed construction: 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, addition of 5% or more to the original impervious area or the removal of any trees? ❑NO. Applicant certifies that no change in site gr:Ae, impervious area or fill material will be used on this f project. [ YES. See Step 2 below. Approval of the Public Wri,rks 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)247-5825 800 Seminole Road .Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 - Fax: (904)247-5845 - http://www.ci.atiantic-beach.fl.us Page 2 Revised 8/04 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. 5. Provide drainage plans. 7. Provide erosion and sediment control plan. 8. Any other documents requested by Building Dept.,Planning Dept.,Public Works and Public Utilities. Address and contact information of person to receive all correspondence regarding this application(please print). J Name: MailingAddress: t 'f?C✓'ill f 7 11'° 301 'DI-2,11 Ze � i/' Telephone: Q726f- ._ / / Fax: {f �/`��` "�� E-Mail I hereby certify that I have read and examined this application and attached documentation 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 Owner: Date: -_ AS TO OWNER: Sworn to and subscribed before me thisday of �� :f �_, ,20 ��`'�,�' State of Florida,County of Duval Notary's Signature: 3HEUU1 USHER onF FLEA ,tiOTARY pUBUC- �COMMISSION#DD269744EXPES 1112412007 rsonally known BONDEDIRT U i_"e WyTAR 1 d identification yp of identification produced Signature of Con or: Date: 9b 14 5 AS TO CONTRACTOR: Sworn to and subscribed before me this `f l' 1 y of 206 5 State of Florida,County of Duval SHELLI USHER CAREY Notary's Signatw e: ;� {J{� .� NOTARY PUBLIC-31ATE OF FLORIDA COMMISSION#DD269744 Personally known EXPIRES 11/24/2007 BONOWTHRU1408'WTARY' _ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 Fax: (904)247-5845 • http://www.ei.atiantic-beach.fl.us Page 3 Revised 8/04