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Permits 50 Ardella Rd CITY OF ATLANTIC BEACH p�h 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE:(904)247-5800 FAX: (904)247-5805 SUNCOM:852-5800 http://ci.atlantic-beach.fl.us MEMORANDUM April 19, 2001 To: Alan Jensen, Esquire City Attorney From: Maureen Kin �L City Clerk Subject: CDBG Mortgage Note Lillie R. McQueen, 50 Ardella Road When the city does CDBG housing rehab, homeowners are asked to sign a mortgage note for the amount of the repairs. The amount is reduced by 10% each year and after ten years the mortgage note is zeroed out and the property owner owes nothing. However, if the property owner sells the property during that ten year period, then the remaining balance becomes due and payable. I have attached the agreement signed by Lillie McQueen when her home was repaired in 1995. According to the Property Appraiser's records Garry Williams is now listed as the owner of this property. We don't know if Ms. McQueen sold the property or is deceased or what her relationship is with Mr. Williams. Please advise how we should proceed. xc: City Manager Duval County Property Appraiser -Parcel Summary Page 1 of I Parcel Summary - Values from the 2000 Certified Tax Roll RE No.: 0680000 Owner's Name: WILLIAMS , GARRY B ET AL Property Address: 50 ARDELLA RD ATLANTIC BEACH 32233 Mailing Address: 50 ARDELLA RD ATLANTIC BEACH , FL (32233-4306 Property Use: 1292 RES/COMM ZONING Legal description 17-2S-29E .132 PT GOVT LOT 3 RECD O/R 9653-661 Neighborhood: 129241 1292'S MAYPORT Sec-Twn-Range: 17-2S-29E—� JR BK& Page:109653-0661 JIMap Panel: --]556A1 Sale Date: 6/13/2000 No. Buildings:�l Sale Pricer$100.00 Land Value: $5,750.00 Heated Area: 1195 Class Value:1$0.00 Exterior Wall:71 SINGLE SIDING Improvements: $25,700.00 Taxing Authority:JUSD3 Market Value$31,450.00 County Tax_:$228.30 -1 Assessed Value: $31,450.00 School Tax: $270.97 Exempt Value: $0.00 District Tax: Taxable Value:$31,450.00 Other Tax: 11$16.13 —� Sr. Exempt: $0.00 Voted Tax: $20.90 Sr. Taxable: $0.00 Total Tax: —1$636.06 F. Map-It Feedback Tax Bill Feedback Home PRC Map-IT Taxes http://pawww.coj.net/pub/property/RENO.asp?RENUM=172068+0000 04/18/2001 MORTGAGE NOTE Atlantic Beach,Florida For value received, the undersigned Oointly and severally, if more than one), promise to pay to the order of the City of Atlantic Beach, a municipal corporation, 800 Seminole Road, Atlantic Beach, Florida 32233, the principal sum of Seven Thousand Three Ebmimd Eig* and 00/1001'ollars(S7 80 00)being payable in lawful money of the United States of America at 800 Seminole Road,Atlantic Beach,Florida 32233 or at such other address as the holder from time to time may specify by written notice to the maker. Said principal sum shall bear no interest and shall be reduced in amount at the rate of 1/10th per year until reduced to a zero balance at the end of 10 years. Any unforgiven balance shall become immediately due and payable if the maker transfers title to or moves from the premises securing this note within the 10 year period. In the event of the death of the maker of this note, this note shall remain in effect and the principal sum reduced at the above rate of 1/10th per year only if a member of the makers immediate family takes up residence in the subject home,under any other circumstances the note shall become immediately due and payable. This note is to be construed and enforced according to the laws of the State of Florida, and is secured by mortgage on real estate of even date herewith. If default be made in the payment of any of said sums or in the performance of any agreements contained herein, then, at the option of the holder of the same, the principal sum then remaining unpaid shall immediately become due and collectible without notice, time being of the essence of this contract, and said principal sum shall bear interest at the highest rate allowed by applicable law,from such time until paid Each maker and endorser waives presentment, protest, notice of protest and notice of dishonor and agrees to pay all costs, including a reasonable attorney's fee, whether suit be brought or not, if counsel shall after maturity of this note or default hereunder or under said mortgage, be employed to collect this note or to protect the security thereof (seal) Name of Maker (seal) Makers Address: 50 Ardella Road Atlantic Beach,FL 32233 STATE OF FLORIDA DOCUMENTARY STAMPS IN THE AMOUNT OF S HAVE BEEN AFFIXED TO THE MORTGAGE SECURING THIS NOTE AND CANCELLED. PRE-CONSTRUCTION CONFERENCE REPORT READ CAREFULLY BEFORE SIGNING I (WE) THE UNDERSIGNED HAVE ON THIS DATE AT PARTICIPATED IN A PRE-CONSTRUCTION CONFERENCE PRIOR TO THE SIGNING OF A CONTRACT FOR THE REHABILITATION OF MY (OUR) PROPERTY. WE ACKNOWLEDGE THAT WE UNDERSTAND THE TERMS OF THE CONTRACT, THE EXPLANATION OF THE b WORK TO BE PERFORMED BY THE CONTRACTOR, THE ROLE OF THE CONTRACT ADMINISTRATOR OF THE REHABILITATION LOAN PROGRAM, AND OUR RESPONSIBILITIES DURING THE CONSTRUCT- ION PHASE. I (WE) HAVE BEEN GIVEN AN ADEQUATE EXPLANATION TO OUR QUESTIONS, IF ANY, AND ARE AWARE THAT ASSISTANCE WILL BE PROVIDED BY THE STAFF OF THE REHABIL- ITATION LOAN PROGRAM IF REQUESTED. WE FURTHER UNDERSTAND AND ACKNOWLEDGE THAT THE REHABILITATION LOAN PROGRAM ASSUMES NO RESPONSIBILITIES FOR THE WORK PERFORMED AND DOES NOT WARRANT ANY WORK PERFORMED. L'" r. gnature of roperty wnert�a-e 9nature UT Property ner to I -- I, THE UNDERSIGNED, HEREBY CERTIFY THAT THE PRE-CONSTRUCTION - ON THIS DATE BETWEEN THE HOMEOWNER(S) , REHABILITATIO CONFERENCE WAS HELD N LOAN PROGRAM CONTRACT ADMIN- ISTRATOR AND MYSELF. I UNDERSTAND THE PROCEDURES TO BE ,FOLLOWED FOR CHANGE ORDERS AND REQUESTS FOR PAYMENT. I UNDERSTAND AND AGREE THAT THE WORK PERFORMED MUST MEET THE STANDARDS OF PERFORMANCE REQUIRED BY THE REHABILITATION LOAN PROGRAM AND ESTABLISHED BY THE REHAB STANDARD PERFORMANCE MANUAL. 71gnat�mo�ontter it a to - I, THE UNDERSIGNED, HEREBY CERTIFY THAT I PARTICIPATED I CON- FERENCE THIS DATE AND THAT I HAVE COMPLIED WITH N A PRE-CONSTRUCTION TH ALL OF THE PROVISIONS OF THE REHABILITATION LOAN PROGRAM PROCEDURAL MEMORANDUM #49. 7/M/P PROCEED ORDS DATE: TO: M / This is to .authorize You to proCeed with work $Pacified in our contract dated for improvement work on the at �-- � property located The 14t4tion amount specified in the Agreement is $ �-O� h Rehab- the Contract. ?lease proceed in accordance with You are to commence work no. later than h n All work shall be completed according g to the Work Writ , Addenda and Se Up, plans, Changepecifications thin- Sixty (60) calendar days ing construction. Y after start- 4 .cSli ame ) of ' mer s) Owner s Signature) (owner a Signature) f ADDRESS: (Local- P? Zic Agency ePresentative) Copy; RLP-143 REHABILITATION LOAN PROGRAM RESPONSIBILITIES OF HOMEOWN AFTER CONTRACT IS SIGNED Until Work Be ins Start Planning �~ tools, equipment head. Plan adequate storage get into and materials. Make arrangements a space for Your property if gements for the contractor' You will not be home durin the contractor t, To avoid mutual confusion g the day. the spokesman to • one member of discuss problems or the family should be questions that may delegated a; If all household members work Y come up. consider household meOr will not be home Live not living designating an agent such as a during the construction, responsible g with you to close friend or neighbor or to make sure the contractor does the tractor's he would do work. rela- in your contract. work exactly YOu are Prepare Y as he stated P your Property Period to send and furnishings There will Your drapes to the g d for the rehabilitation Ings and clothes be dust and dirt from cleaners - wash use this be broken - put all breakable and valuablethe away your curtains. or misplaced. - Protect your furnish- and so they won' t When the Work Be ins Keep your copy of the work description with your Case hand Remember Manager if there Y and refer to it You are responsible is anything you do often. Check work correctly as bid, for ensurin not understand. work must be acceptable to ssistance will be that the contractor does the you. Provided if required but the Try to stay out of th help prevent injuries e a construction area y, especialand allow the workmen room to l ork ildren; this will Tz'y to keep a good relationship again, delegate someone to be the spokesman your family y and the contractor - spokesman for the family. Stop problems before feel it should, or if they start - if something � once and you don't understand it g isn t going the way you too far, get an acceptable explanation or , sPeak to the If the contractor correction before contractor at stop the work and call the Case Mana give you an Progresses acceptable explanation, Expect the unexpected ger for assistance. and exciting - in most cases changes and improvements will be n problems may g to YOU and will give y be uncovered duringYou much pleasure; however, new a change to the contract. Bethe course of the work which may require changes with the contractor and if this should ha Y require required and wh get a good explanation pen � discuss flexible. All y. Try to .visualize what the Chan a of the change Case Manager changes to the contract must be a g will look like. g and must be in writin PProved b Be Y you and your Your contractor is responsible for cannot be present, make sure that he tells ision ofL If he a problem or his workers. questions— l ou who Vo talk to if Win cooperation from the workmen withYou have good water.pre at r.pre of Small n - unexpected pot of coffeeor evarasic n relations. A word gestures j {do �L__ CONTRACTOR'S AFFIDAVIT STATE OF FLORIDA COUNTY OF DUVAL SS BEFORE ME, the undersigned Notary Public, personallyappeared me, eposes an says : Who, being first dulsworn--Ey— That sworn y That on ` , 19 b as owner, an as contractor, enters nto a certain cons ruc on con agreed to provide certain labor and materials for said owner rac w re y sa contracor upon the following described lands belonging to said owner, located in the City of County of ---�........_ and State of Florida, to-wit: That deponent is the of said corporation, herein referred to as the contractor, an as persona y supervised the performance of said contract. That said contract, has been fully and completely performed, and said contractor and all persons , firms and corporations contracting or dealing with , or directly employed by said contractor in connection with said building operation or in connection with said contract, have been paid in full. This affidavit is made in compliance with the provisions of the Uniform Mechanic's Lien Law as approved June 4, 1935, as revised, Laws of Florida , and to enable said contractor to receive his full and final payment from the owner, under the construction contract above referred to. . Subscribed and sworn to before me this t�;'VNTRACTOR PAYMENT REQUEST Homeowner; Payment #1 - 40$ Complete Address: #2 - 80$ Complete . #3 - 100$ Complete Contractor: Amount Requested: $ Contractor: I hereby request an inspection for the amount of $ Pection to receive payment # satisfactorilyhe es I certify that I have b this request and that completed bills cincurrework to and materials furnished in making for labor Justify im- provements have been paid in full to this date. and Attached is a description of the work completed and amount of payment requested by work item. the Contractor' s Signature: --------------- Date: ---------- ------------------------------------- Homeowner: --------------- Homeowner: I/We hereby agree that the work stated b has been completed and approve Y the contractor o the in accordance with the contract and nco ti gents upon cin- spection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. Owner' s Signature: Owner ' s Signature: Date: -Date: ----------------------------------------------------------------------- Rehabilitation Inspector: I hereby certify that I exercised reasonable care to determine that the work performed at the above address meets specifications and was completed in a satisfactory manner: however, neither the undersigned nor Jacksonville HUD is in any wpy responsible for the acts or omissions of the contractor, any subcontractor contractor's' agents or employees, or an any of the other Performing work under the construction gre ment. perThe contractor has provided a release of all liens, if any, in connection with this contract and has provided the proper- tY owner with a copy of each warranty property owner from the contractor oroPerformed. e due the performed. I hereby certify that all work is completed as indicated on the contractor's payment request and recommend to the contractor in the amount of $to Rehab Specialist: Date: ----------- -------------- At 1.00$ completion: I ct_r+4 4C., CHANGE ORDER No. Date of Contract ��— Owner Name: Date Property Address.- Contractor ddress:Contractor Name: Contractor Address: Description of Work Chan e; No. - AMOUNT' CATEGORY: + _ SUM Changes and work affected hereby, are subject to all contract stipulations covenants. This Change Order-is made a part of the contract dated first abovde, parties have hereunto set their signatures: S Contract Price + or - S Change S Total Owner Approval; Date: Contractor Approval: Date: Sr. Rehab Specialist Approval: Date: Program -Ad Approval: Date: Source of Funds: $ Contingency $ $ Owner Contract Copy: mer, Contractor, .Loan file, Technical file Financial Institution (If contract price changed) RLP-155 �T Rev. 12/6 4 HOMEntauER - rpNrRA�TnR ACR �'h1�' tm Property Improvements To: / //JJ (Address) Owner (s) : ------ LL1 - =��-ee-A� ------------------------- (Name) ------------ --------------------- (Legal Descriptione 1• HOLD HARMLESS. Contractor shall agree to defend, indemnify, harmless the Owner, City of Atlantic Beach, Florida from liability and claim for damages because of bodily injury, and hold sickness, disease of loss and expense arising from aCont actorrty damage, s performance under this agreement to improvements install or construct home to be paid out of the proceeds rehabilitation loan. Contractor of the Owner's is acting in the capacity of an independent Contractor with respect to the Owner. 2 . LIEN WAIVERS. Contractor agrees to protect, defend and indemnify, ner from any claims for unpaid work, labor or materials with respecOt nto Contractor' s performance. Final payment shall not be due until the Contractor has delivered to the Owner complete release of all liens for work completed arising out of Contractor's performance, or a receipt in full covering all labor and materials for which a lien could be filed or a bond satisfactory to the Owner indemnifying him against any lien. 3. SCOPE OF WORK. Contractor acknowledges that he has prepared the Contractor' s Proposal (Part II of this Agreement) and that such proposal is accurate and consistent as to the name of the Contractor will undertake, and the price. Contractor acknowledges the performance requirements established in the General Specifications of the Rehabilitation Standard Performance Manual effective June 1, 1982 and warrants that all work undertaken will conform to said specifications . 4 . CONTRACT AMOUNT AND PAYMENT SCHEDULE. The City of Atlantic Beach shall pay the Contractor for the performance of the rehabilitation work, subject to additions and _deductions by approved Change Order, the contract sum of --------- Payme scheduled as follows, subject to the Owner's) tse acceptance not thelll work to be done: Upon completion of 40% of the work, a progress payment of 30% will be made. Upon completion of 80% of the work, an additional payment of 30% of the contract price will be made. Upon completion of .100% of the work, the remaining funds will be disbursed. 5 . TIME OF COMMENCEMENT AND COMPLETION. Owner shall provide written authorization to Contractor to commence work. Contractor agrees to start work ten (10) calendar days after the receipt of the written Notice to Proceed. If the Contractor fails to commence work within ten (10) days of the Owner' s notification to commence, Owner shall have the right to terminate this Agreement. Such notice of termination shall be in writing. executed Change Order. No extra costs will be paid to th when he has neglected to e Contractor rehabilitation work, properly evaluate-- the extent of if an Under no circumstances will the contingency fund, circumstances arisinglzed for work af after the commencement of th totally unforeseen 7. TERMINATION OF AGREEMENT, the work. carry out the work as specifedtunder nthe cparagra tor defaults 1tSc or neglects to fails to perform any provision of the Contractor paragraph OftheWork" r may, after fifteen (15) calendar days written notice, terminate this contract and , select a substitute Contractor. If the expenses of finishing the work exceeds the unpaid balance on this contract, b Contractor shall pay the difference to the Owner, the perform any applicable provisions of the Contract,I the Contr ctorlmay, after fifteen (15) calendar da s from the Owner Y , terminate the contract and recover payment for all work satisfactorily completed including reasonable profit and damages, 8• WARRANTY' For good and valuable consideration, the Contractor hereby agrees to provide a full one-year warranty to the Owner, which shal extend to subsequent Owners of the property to be rehabilitated. The warranty shall extend to subsequent Owners rehabilitated. The warranty shall provide thaeof the property to bed or constructed on said improvements, hardware t and fixtures of whatever kind or nature install Property by the Contractor are of good quality, and free from defects in workmanship or materials or deficiencies subject ^to the warranty contained in this paragraph. Contractor and Owner agree, however, that the warranty set forth in this paragraph shall apply only to such deficiencies and defects as to which the Owner or subsequent Owners shall have given written notice to the Contractor, at its principal place of business, within one (1) year from the date of Contractor's final payment . The Contractor further warrants that failure by the Contractor to respond to valid complaints by the Owner, or subsequent Owners, that causes additional damages to the property are also subject to the warranty contained in this paragraph. 9. ARBITRATION. If a dispute arises as to the validity of a complaint not satisfied under the warranty clause of this contract, a panel of three (3) independent professionals shall be chosen by the City of Atlantic Beach to arbitrate the dispute. The panelists shall be ' chosen on a rotating basis. The finding of the panel shall be irrevocably final, conclusive, and binding on the Homeowner and the Contractor. 10 . SUB-CONTRACTORS. Contractor agrees that all warranties contained herein shall apply to all work performed under the Contract, including that performed by any sub-contractor. 11 . ACKNOWLEDGMENT. The above warranties are in addition to, and not in limitation of, any and all other rights and remedies to which the Owner, or subsequent Owners, may be entitled, at law or in equity, and shall survive the conveyance of title, delivery of possession of the property, or other final settlements make by the Owner and shall be binding on the undersigned notwithstanding any provision to the contrary contained in any instrument heretofore or hereafter executed by the Owner. 12 . INTEREST OF CERTAIN FEDERAL OFFICIALS. No member of or delegate to the Congress of the United States, and no Resident Commissioner, shall be admitted to any share or part of this Agreement or to any benefit to arise, from the same. 12b.BONUS, COMMISSION,OR FEE. The Borrower will not pay any bonus, commission, or fee for the purpose of obtaining the Government' s approval of his application for this loan, or any other approval or concurrence required by the Government or its desianAp i-^ Homeowner-Contractor Agreement cont'd or ' employee of the Public Body who exercises such functions or responsibilities, shall have any interest, direct or indirect, in the proceeds of this loan, or in any contract entered into by the Borrower for the performance of work financed in whole or in part with the proceeds of this loan. 12d. INTEREST OF OTHER LOCAL PUBLIC OFFICIALS. No member of the govern- ing body of the locality in which the property to be rehabilitated is situated, and no other public official of the locality who exer-b cises any 'functions or responsibilities in connection with the administration of the loan shall have any interest, direct or indi- rect, in the proceeds of this loan, or in any contract entered into by the Borrower for the performance of work financed in whole or in part with the proceeds of this loan. 13. CIVIL RIGHTS. The Grantee agrees to abide by the spirit and intent of the Civil Rights Act of 1964, as amended, and the Civil Rights Act of 1968, as amended, and the anti-discrimination provisions of Chapter 120 of the City Ordinance Code, in that its operation under this contract is free of discrimination against its employees, persons, or groups of persons on the basis or race, color, sex or national origin. 14. EQUAL EMPLOYMENT OPPORTUNITY. The Grantee agrees to abide by the Equal Employment Opportunity Clause for Contracts subject to Execu- tive Order Number. 11246, as described in Attachment 1, attached hereto and made a part thereof. 15. LEAD BASE PAINT HAZARD ACT. The Grantee agrees that no lead based paints or substances containing lead shall be used in any part of this project. Treatment necessary to eliminate immediate hazards shall, as a minimum, consist of the following: a. All surface conditions identified as immediate hazards shall be thoroughly cleaned (washed, sanded, scraped, wire brushed or otherwise cleaned) so as to remove all cracking; scaling, peeling, chipping and loose paint on applicable surfaces. Such surfaces that have been so treated shall then be repainted with two ( 2) coats of a suitable non-leaded paint. b. Where the paint film integrity of the applicable surface cannot be maintained, the paint shall be completely removed or the surface covered with a suitable material such as gypsum wall board, Plywood or plaster, before any repainting is . undertaken. Name of Contractor — 1MJ� 41�4Le ' Names) of Owner(s) Signature of C ractor Date Signature of Owner Date 11 ATTACHMENT 1 EQUAL EMPLOYMENT OPPORTUNITY _CLAUSE FOR CONTRACTS SUBJECT TO EXECUTIVE ORDER 11246 During the performance of this contract, the contractor agrees as follows.; 1 . The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or nation- al origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to the following: g employ- ment, u pgrading, demotion, or transfer; recruitment or recruitment adver- tising; layoff, or termination; rates of pay or other forms of compensa- tion; and selection for training, including apprenticeship. The contrac- tor agrees to post in conspicuous places, available to' employees and applicants for employment, notices to be provided by the contracting Officer setting forth the provisions of this nondiscrimination clause. 2. The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all quali- fied applicants will receive consideration for employment without regard to race, color, religion, sex or national origin. 3. The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency con- tracting officer, advising the labor union or workers ' representative of the contractor's commitments under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The contractor will comply with all provisions of Executive Order No. 11246 of September 24, 1965, and of the rules, regulations, and rel - vant orders of the Secretary of Labor. e ATTACHMENT 1 Page -2- 6. In the event of the contractor's noncompliance with the nondis- crimination clauses of this contract or with any of such rules, regula- tions, or orders, this contract may be cancelled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts in accordance with procedures authorized in b Executive Order No. 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order No. 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. 7. The contractor will include the provisions of Paragraph ( 1 ) through ( 7) in every sub-contract or purchase order unless exempted by rules, regulations, or orders of the Secretary of labor issued pursuant to Section 204 of Executive Order No. 11246 of September 24, 1965, so that such provisions will be binding upon each sub-contractor or vendor. The contractor will take such action with respect to any sub-contract or purchase order as the contracting agency may direct as a means of enforc- ing such provisions including sanctions for noncompliance; provided, however, that in the event the contractor becomes involved in, or is threatened with, litigation with a sub-contractor or vendor as a result of such direction by the contracting agency, the contractor may request the United States to enter into such litigation to protect the interests of the United States. The offerer's or bidder's attention is called to the "Equal Opportu- nity Clause" and the "Standard Federal Equal' Employment Opportunity Con- struction Contract Specifications" set forth herein. The goals and timetables for minority and female participation, ex- pressed in percentage terms for the contractor's aggregate work force in each trade on all construction work in the covered area, are as follows: 1 . The goals for minority participation are 21. 8% for each trade. 2. The goals for female particinati_nn =,o A nQ r___ PSR-384 10618, i D PARTM INT OF 8i C�iNi „ CITY OF ATLANTIC B l ----- PEI IT INFORMATION, - ,Permit NFtTIQN -Permit UUMber; JQ619LOCATION �OCAII4N I NPORT�4M "_ ._;Addr*ss t SO ARLSLLPROAD P rm3 �yPLUMBING ATL AN'TT Hof ;FLORIDA 32 C.l mass oWork; R32 ZMODZLL ,.�.:� : ., LEGAL DESCRIPTION ' w i00t3 PSE ----------- use: � INOLV FAMILY Lit c II� ® ks Section. `c�wr> '__ IJwI Iris r Code ► sLi p. RRC , 0' Estimated ' Xu®r Subrl �rf si cin DC�At>!�iIR X4.00 Improv. cost, ►<t}b `atail. 'eels ?r 00. Att $0.00 a ~ a Work " UM9ING IN HUD REMODEL p'. »..`. AEPLI It VIZE0fPSUll w. AdA 1I;OADi«tA� �i�PACT PEE $0 .00 !00 '' "PL4I33 y{ P > u 3liFiR'7,., 77iaR 00, LeE.0 OA ILL} , PL 1222 CC3Aii ECTIO { .44 .xr L ref PC . S �. PACT P0.00 vs t" * 17 NOTES. NOTIOE ALL.Ct?IVCREi'E.FORMS AND FOOTINGS MUST se'l BEFORE POURING PERMIT VOID SIX MONTHS AFT ER IDATE OF'ISSUE, BUILDING MATERIAL,RUBBISH ANt DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC,SPACE,AND MUST BE CLEARED UP AND HA6LED AWAY $Y EI 'Z lb' TRA GTQR CR QWNEF . ccF1!1ILIJ1'L .0 PLY TH 1 HE MECHhANIC1 CA' NN AEULT IN INQT ICE FORTH 1L IC 1Mpl ENT " ISSUED AC04Rp}NG TQ APPROVED FLANS WHICH ARE PART QF THIS nR,MIT AND SUBJECT TO REVOCATION FOR , VIOL ATION OF A0P :PR4tilSIQN ,QT LAW. ATLANTICBEACH$U1LDING DEPARTMEN`G, B CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBINGIPERMIT JOB LOCATION: OWNER OF PROPERTY: PLUMBING CONTRACTOR !Jh CONTRACTOR'S ADDRESS: ���� /�� r�/s-r STATE LICENSE NUMBER:- _ 7...Z.�k_TELEPHONE: HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS OTHER__ TOTAL FIXTURES: x $3.50 + $15 .00 MINIMUM PERMIT FEE - $25 .00 SIGNATURE OF OWNER: SIGNAT.UkE OF CONTRACTOR: ----------------------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - ( 904) 247-5826 SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - ( 904) 247-5834 t CQ P5R•3844 DEPARTMENT OF SUILDINQ CITYOF ATLANTIC BEACH -�.._., . , .�. ,. . LOCAT I OPI N�XMIT ORA�Permit Number: ION - ----_-,L028 So ARDELLAL Permit ' ROAD YVe: XLZCTC°RICAI« ATLANTIC BEACH, FLORIDA 32233 Class of, 1 Wt 1~k: , REMODEL, DESCRIPTION =- -- Constr, Tyl>*:' WOOD FRAME Lots ���► Sectian; FrQpas+Iad use. SINOL.Z P *c ILY �'©�rn�siaip: R 0 }3we } i Crade: ! Subdivii s On I3NBIt R81LAT Estimated value. 40000 ImPr �. Cc�a3t $0.00 TotalPots: $0 .00 Amt Paid. S0:00 cr PERMIT y# .0 .�wp Add A '. NATER I3[ 'A,CT F919 0.00 BCH, FLORIDA 32233, SST -IMPACT' R» � 0.00 Flr $ �A aRA ON- -------: � RAI1t33R tm + s �I �Rc I rr� ::CAPITAL :IMPROVE. '$0.00 , Addie ►" LCL AVIS. Baa X0 .00 . SEWER R T $0, 00 . License: 01 4 , T`�pt; 2,� .. SRC �I A R $0.00 COSI". URCRA}RO? �� s� SCITna ATS SG"H. � ,0»00 00 �' 'a 0� p P., s ��� 4 .a ae w.,c ,,p , ✓,. :A rarr amw �e ,," t °°s Ra, eaza a ,." 4 NOTES; NOTICE ALL CONCRETE FORMS AND FOOTINGS MUST SE-IN5I�ECTEd SIaFORE POURING PERMIT VOID`SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPADE,AND,MUST BE CLEARED UP AND HAbl-0 AWAY BY EITHER`CONTRACTOR OR OWNER "FA LURE ' QI Ct MPL,Y°WITH THE MECHANICS LIEN LAW CAN, RESULT IN THE PROPERTY OWNER PAYING TWICE Ft��iT H�'�U#�a?ING IN�I�ROVE ANTS'= ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT ANC?SUBJECT TO REVOCATION FOR -SOLATION OFAPPLICABLE PROVISION. OF LAW. A LANTIC BEACH BUILDING DEPARTMENT B "g iv-VSiG 3u:"^�i5+itt550-xp"C P6 1 't Vh°N f L d i.r w,r31'L�a: h S t ksv�A['aitu. �.`�1Y,, CITY OF ATLANTIC BEACH, FLORIDA 1 0 Approved by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE:. 2� 19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL/FIRM: n MASTER ELECTRICIAN SIGNATURE JOURNEYMAN NAME— / /��� "� ADDRESS: <760QCG � RFD BOX BLDG.SIZE BETWEEN: RES. ( ) APT. ( ) comm. ( ► PUBLIC ( ) INDUS. ( 1 NEW ( ! OLD ( 1 REW. (G/ ADDITION ( ) TRAILER ( ► TEMP.( ► SIGNS ( ) SQ. FT. SERVICE: NEW( ) INCREASE ( ) REPAIR ( ► FEE CONDUCTOR SIZE AMPS COPPER 1 ) ALUM. SWITCH OR BREAKER AMPS PH W VOLT RACEWAY EXIST.SERV.SIZE QU AMPS / PH 3 W OLT cic- /RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES _ CONCEALED OPEN TOTAL 0.30 AMPS, 31.100 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M. V. FIXED 0.100 AMPS. OVER APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP. MOTOR OTHER MOTORS AMPS CEIL HEAT: KW HEAT 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCE LANEOUS Z ..G TRANSFORMFRs• 10416 DIEPARTMiNT OF BUILDING I CITY OF ATLANTIC B ►►CH . 0 t >wt . .. .._..�.. -.• L,OCA I.0" INP'©R T O Permit.. ` e : . 4 4 6 Add>fi*B$: 0 ARDZLLA �`RZ ZT 8Q LD'I RCI AT ANl I C aE—H `>u 9R I DA 32233 C1 .�s N k RI MC31�»L ----__:. .:.,. ffiOAL DEBCR _-------- C n I~« *Pe WOOD+ Lr��:« H I oca Sect�an s Rr +poSe+ BIBhtIL. "+ tr .2+,: PC. p .in Code 0 `u�d��i�a�t���� �QIiNB� r a 4 V*Iue. $7390 00 T re, a : $0.00 to00 Rot, ' I- k; „^^ APPLICATIONaP`ik�R"i .�..».w,.. AdN � 4� I't' $0.00 TZ 10.00 OA CT PER, * � PE ►6 R $0" Nam L;I BA t INC. CAPITAL IXPROVE. tl .BO SHOR. �. PL 32207 7 C OSS CON39CTION So,.00 N. .e� +, C Q Typ+ t l SEC I'ELr $4.0�J .CO X .00 «, ' . M $ NOTES: N4T110E ALL CONCRETE FORMS AND FOOTINGS MUST BE INSAtCTI 181EIr iRE P©URINE. PI*RMIT VESID SIX MONTHS AFTER`'DATE OFISSUE t BUILDING At1ATFFiIAt.+RUBBISH AND DEBRIS FROM TI.IIS:WOhK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE . CLEARED UP AND HAULED AWAY B'Y'EITHEFI CONTRACTOR OR OWNER ; "I='A1LUR ° TO COMPLY WITH,THE ,NIECHA I 'S LIE �A�vl RE'SU1.T fia�l THE PROP :�(�� ,PAY�N TWICE FORTHE SUIL IH r IMS �N x TS 1.S11=p 4CC¢IQ1NCi TOAPPFit?VID PLANS WHICH ARE PARI t7F TH1S PERMIT AND SUBJECT tEVC ION FOR X k AT10N OF�APPLICABLEPROVISIONS:Oft LAW. A tANTiC BEAC14 BUILDING DEt+i� �' Q e , W } t r ' OF ATLANTIC BEACH PERMIT APPLICATIONYREMODEL, ADDITIONS OR ALTERATIONS / DEMOLITIONS owner(s): � Address:_ � rl �i ; �- Phone: Lot #______ Block or Unit # Subdivision: Contractor: fT L � ,��4- State License # ✓� - Z Address : Phone No• Describe work to be done: �� - ., r- /lT cC r 77 Present use of building:__ �- Valuation of Proposed Construction:_ Proposed use: mss, �,�e_ ` _ Is this an addition? rll If yes , what are the dimensions of the added space: ft . X ft . Will the added area be heated and cooled? New electrical (or increase)? New plumbing fixtures? New fireplace? New Heat/AC? SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. y r Signature OWNER: ' Date: Signature CONTRACTOR: Date License Supplied: Liability Insurance: Worker's Compensation Insurance: • ��OttfP Of '�OI11t11e1l�Clil�!►t � . • 1►aw�►wa aM wraMAnt To whom It may oocwwpu r TTe undarslenad horebr Injonana rou that lmprorotnonta will be snado to'osrta sccordsnla real P"PlIrtY. and In or COee with section 713.13 of the ItarWa Statute the following wormallorr to stated M thk ?lOTICt I�UrtTNCJ<JILNT. Daacslptlon of pf"11 — SINGLE STORY WOOD DWELLING LOCATED AT ".' . •w_r««»-- _•-err•»r»»..r,r------- --- �_»»_._—,__r ARDELLA ROAD ATL BCH FLA. �^ . _---r---•--------r__-«----rrr-r__-r-r_wM•-»...--- ----r-w•r» «r- Conaral deacrlpUon of Improvements —NEXT i PA,TNT-i ELCTRICAL:KITCHEN CAB. Owner -------Ir.II.L.IE._McQLLF.k.DL-._-- --- Addreae _.� 50 ARD .T.T.A •R�PI�-sT�t�.NT�C. ,_FLA. Owners Inters4l In dte of the Improraaeat ---—----------- roe Blmple T1Ue bolder (11 other than owner) ------ Name Cootrsotor --.-ALEXANDER W. BALFE ' INC. Address __»-1 Q]__�WZZMr.Z1r_DR-R,L7E JAX=� FLA_--32216 •--_--_ Our•y (u ary�) »----------------«»r-rww-w-•...-•-.�» • w—rM-_»----r--- t of bond �_-- _r..-r-w-,. Nsrne aad addrsu of any perwa nuking a loan for the coaetruct6o of 16 Imptorrrnentt. Name - _w_----------------------------------r-----------------------•--------- _- Addreaa ______ «-•--------.rr•-«r-rrr._w-.r»�—r.-r._-»--- an+ bo�terrd: wkbla the Stats or F1orWa, other thsw htaWKI dalBnsted br *wart upon,whom amiarr or other docwTtmu Name ,»»------- -----•r.�-.--._-- Addren In addition to himself, owner deslgnatee the lollowlnr pwao+' t* receive Is 9oP7 of the Usaces Hotks Its prorJdod In B*cUon 717.01 (3) IN, tJorlda Qtatutes. (nu to at owner,& option), Name ----—------------- THIS a►AOa/Oa ABC?"Dga.o Yet M%lt '—••»-._.