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Permits 41 Ardella Rd
CITY OF ATLANTIC BEACH BUILDING AND PLANNING 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 r TELEPHONE: (904)247-5826 FAX: (904)247-5845 www.coahus December 5, 2006 Carol Wright 41 Ardella Road Atlantic Beach, Florida 32233 Re: Mortgage Note for CDBG funded rehabilitation services to 41 Ardella Road Dear Ms. Wright: In reply to your phone message; yes, the amount your CDBG funded rehabilitation loan has been reduced by ten percent (10%) each year. A total of$8,747 was spent on your home. At the end of 2006, the balance on your note will be $4,375.00. Should you plan to sell your home, please contact the City so that this information can be provided to the closing agents in order to avoid any delay at closing. Sincerely, Sonya B. Doerr, AICP Community Development Director CITY OF ATLANTIC BEACH "► 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE:(904)247-5800 r' FAX:(904)247-5805 ° 3 SUNCOM:852-5800 http://ci.atlantic-beach.fl.us February 26, 2002 Carol Wright 41 Ardella Road Atlantic Beach, Florida 32233 Re: HVAC warranty Dear Ms. Wright: Following our last conversation, I contacted Sun State Enclosures, and advised Marty Barker that you believed your HVAC unit was not working properly. Mr. Barker has since contacted me and has informed me that he sent two different HVAC contractors to your residence to inspect the unit. Both reported that the unit is working properly. Mr. Barker acknowledged that this unit did in fact shut on and off a bit louder than some residential units, but that the unit was functioning properly and normal for that system. While the City will make every reasonable effort to insure that contractors act in accordance with the warranty, the City has no authority to authorize payment for repairs not related to the grant contract or the approved change orders. The City of Atlantic Beach paid the contractor a total of $8,747.00 for repairs to your home, but the contract executed related to the rehabilitation of your home is an agreement between you as homeowner, and the contractor. Future repairs and any warranty issues must be resolved between you and the contractor, as the City is not a party to the warranty agreement. Sincerely, Sonya . Doerr Community Development Director Sun S to ure s Inc. Lic # CGC 060939 7534103rd Street Jacksonville, Fl. 32210 (904) 908-4000 To: Sonya Doerr Subject: Carol Wright Per our conversation, I'm sending you a note outlining the events at Ms. Wright's house. Shortly after the unit was installed she called our office telling us that when her unit turns off it makes a loud sound. We sent Professional Touch AC, who installed it originally,back to take care of it. The technician called back and said that"the unit did turn off a little louder than some units,but the manufacture would not replace it for that reason. There has to be an operating problem with the equipment(the system not cooling or heating correctly). This did not satisfy her and she continued calling and complaining. So we called East Coast Heating and Air conditioning to check the system out. Their technician called back and said the exact same thing that Professional Touch AC had said. Another time she called and said that some plumbing work that we had done was leaking. We sent the plumber back out(Voshell Plumbing)to take care of this. He called back and said that it was not any of our work or anything connected to our work. It was a fosset that had started leaking but he went ahead and fixed it for her. Now I have paid two AC service call charges and a Plumbers service charge and there has not been anything wrong with the work that has been done there. The day that she called you, she had called us again about the AC unit and she was told that if a technician was sent again and it was determined that nothing was wrong with it that she would have to pay the service charge. She then started using profanity and hung up. Then shortly we got the call from you. We do feel obligated to correct any deficiencies with our work for one year. But we have already paid to fixed something that did not have anything to do with our work and twice had AC technicians out for a unit that works fine but sounds a little louder than normal when it turns off. There is nothing that can be done for that. Thanks for your help in this matter. If there is anything else that I can help you with or if you have any other questions related to this please feel free to call again. x CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE:(904)247-5800 1�•� i FAX:(904)247-5877 SUNCOM: 852-5800 http://ci.atlantic-beach.fl.us Psi FILE ca MEMORANDUM TO: Jim Hanson City Manager FROM: Sonya B. Doerr, AICP Community Development Director DATE: January 22, 2002 REGARDING: Audit comments related to Fiscal Year 2000-2001 Community Development Block Grant(CDBG) projects Because the combination of unspent funds from previous grant years resulted in an amount which triggered certain federal auditing requirements, the City's first audit review related specifically to CDBG funds was required this year. The audit resulted in two comments related to review of the 2000-2001 Fiscal Year CDBG grant projects. Comment#1 • Proper Verification of income eligibility All houses rehabilitated as part of 2000-2001 were located with CDBG designated project area. During the transition of staff and the relocation of offices, some information related to the individual houses and grant recipients that were selected for participation in the program was apparently misfiled or lost. Individual grant recipients have been asked to again provide additional documentation of income for grant year ending September 30, 2001. 78 Forrestal Lane, South: Income verification received for Anna Rivera 860 Amberjack Lane: Income verification received for Neomi Rouse 751 Sailfish Drive: Recipient Edna Spillers passed away during renovation of residence. The estate has now been settled, and residence left to niece, Lena Ikner. Consulting with City of Jacksonville HUD office to determine proper procedures.) 41 Ardella: Carol Wright (Spoke with Ms. Wright, advised she would mailed tax return. Have not received as of today.) 1 B' Proposed Remedy Income eligibility of any Fiscal Year 2002-2003 grant recipients will be verified in accordance Section 8 Low and Moderate Income Limits as established for CDBG Program participation and in accordance with procedures established by U.S. Department of Housing and Urban Development HUD and City of Jacksonville Community Development Division. Individual files will be established and maintained for each project and each grant recipient. Concurrence from City of Jacksonville HUD office verifying income eligibility will be documented and maintained in each file before any release of funds. Comment#2 • Failure to file all required Monthly Status Reports (pale 66) A brief narrative report is required to be filed on a monthly basis to document progress of projects throughout the grant year. Lapse in certain administrative procedures, including the submission of all Monthly Status Reports, occurred during vacancy of staff position responsible for oversight of Community Development Block Grant projects. New staff has coordinated with City of Jacksonville staff to provide an end of the year report addressing all projects and the expenditure of FY 2000- 2001 funds. (See attached letter.) Proposed Remedy Monthly Status Reports will be submitted with each Cash Request Form for Fiscal Year 2002-2003 projects. Submittals to City HUD office will include Monthly Status Report and Cash Request Form attached to all financial documentation supporting the request for reimbursement. cc: Nelson Van Liere, CPA Finance Director 2 PRELIMINARY DRAF1 SCHEDULE OF FINDINGS AND QUESTIONED COSTS IN ACCORDANCE WITH OMB CIRCULAR A-133 CITY OF ATLANTIC BEACH, FLORIDA ATLANTIC BEACH, FLORIDA (Concluded) 3. Findings and Questioned Costs For Federal Awards Required to be Reported Under Section .510(a) of OMB Circular A-133 (Concluded) Questioned Costs Findings (Concluded) 01-1 Grant No. 5629-21 - Year Ended September 30, 2001 (Concluded) Effect - Failure to complete and/or file monthly status reports on a timely basis may give cause for further payments to the City being withheld. $ 0 Recommendation - Procedures should be implemented to appropriately monitor responsible City personnel to ensure that specific grant requirements are being complied with. Total Questioned Costs $ 114,722 67 PRELIMINARY DMFL SCHEDULE OF FINDINGS AND QUESTIONED COSTS IN ACCORDANCE WITH OMB CIRCULAR A-133 CITY OF ATLANTIC BEACH, FLORIDA ATLANTIC BEACH, FLORIDA (Continued) 3. Findings and Questioned Costs For Federal Awards Required to be Reported Under Section .510(a) of OMB Circular A-133 Questioned Costs Findings Department of Housing and Urban Development Community Development Block Grant/Entitlement Grant - CFDA No. 14.218 01-1 Grant No. 5629-21 - Year Ended September 30, 2001 Condition - Documentation of verification of low-to-moderate income status could not be located for one selected participant. In (� addition,verification of income status for four other participants was not current. Criteria - Eligibility for the program requires family income to be between low and moderate income levels as determined by the Department of Housing and Urban Development (HUD). Effect on Condition-The cost of the assistance may be disallowed. $ 114,722 Cause of Condition - It appears that procedures were not in place to ensure that potential participants requalify for Community Development Block Grant (CDBG) funds when such income verification is outdated. Also, documentation was apparently not filed correctly for the one instance mentioned above. Recommendation-The City of Atlantic Beach, Florida should again verify the eligibility of the recipients whose documentation either could not be located or was outdated. 01-1 Grant No. 5629-21 - Year Ended September 30, 2001 Condition-Monthly status reports were not always being completed and filed with the City of Jacksonville, Florida (grantor) as required by the grant agreement. Criteria - Internal controls should be in place to ensure that all grant requirements are being adhered to. 66 1999/2000 Applicants for Housing Rehabilitation NAME ADDRESS PHONE (home/work) 1 Willie Pearl Hobbs 410 Sargo Road 246-6857/247-6414 2 Orpah Jackson 15 Simmons Road 246-2856 3 Rudene Muse 1855 Mayport Road 241-1674/246-9443 4 Ana Rivera 78 Forrestal Circle South 249-1137 wiv 5 Neomi Rouse 860 Amber ack Lane 246-3862/247-5996 6 James & Mary Smith 85 Edgar Street 246-7823/223-9116 7 Edna Spillers 751 Sailfish Drive 249-2486/246-4442 8 John & Lillie Wingfield 45 Robert Street 246-7793 U1,441 9 Carol Wright 41 Ardella Road 247-9692/645-5788 Y✓ .= 10 Carolyn Pittman Blake 464 Irex Road 242-9862 Proposed 2000/2001 CDBG Budget Organization: The City of Atlantic Beach Project Name: Donner Subdivision Revitalization Program SOURCE AMOUNT USE CDBG $ 60,000 Rehab 4 Homes CDBG $ 5,000 Part-time Rehab Inspector CDBG $ 13,000 Part-time Recreation Coordinator CDBG $ 12,000 Program Manager CDBG $47,000 Installation of Sewer line on Ardella Road CDBG $ 13,000 Septic Tank Abandonment Assistance CDBG $ 1,000 Program Operating Supplies City of Atlantic Beach $ 5,000 In-kind Code Enforcement, Mowing, Drainage Work Total CDBG $151,000 Total Project $156,000 October 11, 2000 City of Jacksonville Department of Planning &Development Community Development Division Attention: Tom Garwood The Florida Theater Building 128 East Forsyth Street Suite 600 Jacksonville, Florida 32202 RE: CDBG Contract# 5629-17 Dear Tom, Enclosed please find the 2000/2001 CDBG contract, complete with four original signature pages included. Also enclosed is a copy our final reimbursement report originally submitted September 18, 2000. If you have any questions, please do not hesitate to call me. Thank you for your continued assistance. Sincerely yours, George Worley Community Development Director Enclosures ATTACHMENT C Page 1 MONTHLY STATUS REPORT TO: Community Development Division CONTRACT NO. 5629-17 421 West Church Street Jacksonville.Florida 32202 REPORT NO. 9 RECIPIENT: City of Atlantic Beach,Florida PROJECT: Rehabilitation/Utility Improvements/CDC Activity REPORT PERIOD: 8-15-2000 to 9-15 -2000 Date Submitted 9-18-2000 PERSON FILLING OUT REPORT: Georgie Worley,II PROGRESS REPORT:Describe progress to date on: A.Funding a licensed part-time Rehabilitation Inspector to coordinate and ensure proper rehabilitation of selected homes. Contractor selected. Home inspections completed. Bids advertised. B.Rehabilitation of a minimum of 3 homes of income-eligible,owner occupied residents in the Donner Redevelopment area. City will request these be carried forward into next contract year for completion. C. Providing a Recreation Coordinator for Donner Park. Providing organized recreational program for 30 to 60 low and moderate income persons in the area served by the park. Providing statistical information on number of unduplicated persons served. Recreation coordinator in place and programs on-going. Overall recreation programs are monitored by the Recreation Director. D. Providing administrative costs for a Donner Community Development Corporation office Manager to coordinate the Donner CDC activities and oversee the program compliance. Position will remain vacant until next contract year. E. Providing operational costs for the Donner CDC consisting of the reimbursement of utilities and supplies. .Expenses are reviewed,paid and reimbursement requested through contract cash reimbursements on a monthly basis for utilities as provided by this contract. ATTACHMENT C Page 2 F. Installing 600 linear ft.of sidewalk on the east side of Francis Ave. Project will complete a sidewalk loop through target neighborhood. G.Installation of sewer main on Ardella Road. Completed. ATTACHMENT C Page 3 HOW FUNDS WERE SPENT: A copy of all canceled checks and bank statements during that report period must be attached to the monthly report to verify the payment of previously submitted invoices and billings. Account for all checks,including any voided checks. SUPPLEMENTARY SUPPORT: Please describe matching and in-kind contributions received during this report period: Grass cutting and debris cleanup ongoing through Atlantic Beach Public Works Department Code Enforcement on going ADDITIONAL COMMENTS: I certify that to the best of my knowledge the data reported is correct. Signed: Date: Name: Georgie Worley,II Title: Community Development Director SNCKso PLANNING AND DEVELOPMENT DEPARTMENT �r Community Development Division v ° �LORI�Q' December 19, 2001 Ms. Sonya Doerr, Community Development Director City of Atlantic Beach 800 Seminole Road Atlantic Beach, Florida 32233 Dear Ms. Doerr: RE: Program: Atlantic Beach Projects Amount: $334,072.09 CDBG Contract Number: 5629-21 Closeout Monitoring Report On Friday, December 7, 2001, Jacqueline Dukes monitored the above referenced program for compliance with CDBG regulations. Ms. Dukes reviewed the following: 1. Programmatic performance 2. Financial management and accountability 3. Program reporting and compliance documentation Ms. Dukes indicated that although monthly reports were not submitted on time, an annual report was submitted for each project's expenditure and accomplishment. It is our understanding that this was due to the resignation of the community development director and the delay in filling that position. It is my understanding that a director has been hired and technical assistance has been provided by Ms. Dukes. We recommend that all monthly reports and expenditures be submitted to the Community Development Division as required by contract. Also that all bid specifications must be coordinated and reviewed with our Labor Standards Officer, Marion Weiss. If you have any questions regarding this report, please contact me or Ms. Dukes at 630-7030. S' ereI , ouglis B. Brown Chief DBB/jd/gmp Florida Theatre Building, Suite 600, 128 East Forsyth Street, Jacksonville, Florida 32202-3325 Telephone: (904) 630-7030 Fax: (904) 630-4626 E-mail: JaxPlanning.coj.net .r CITY OF ATLANTIC BEACH r; 800 SEMINOLE ROAD cJ ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE: (904)247-5800 FAX:(904)247-5877 ` SUNCOM: 852-5800 http://ci.atlantic-beach.fl.us CORRECTIVE ACTION PLAN CITY OF ATLANTIC BEACH, FLORIDA ATLANTIC BEACH, FLORIDA U.S. Department of Housing and Urban Development The City of Atlantic Beach, Florida respectfully submits the following corrective action plan for the year ended September 30, 2001. Name and address of independent public accounting firm: Purvis Gray& Company 222 N.E. 1St Street, Gainesville Florida 32602 Audit Period: October 1 2000—September 30 2001 Outlined below are the findings and responses to the SCHEDULE OF FINDINGS AND QUESTIONED COSTS IN ACCORDANCE WITH OMB CIRCULAR A-133 for the fiscal year ended September 30, 2001. The findings are numbered consistently with the numbers assigned in the schedule. FINDINGS - FEDERAL AWARD PROGRAMS AUDITS Department of Housing and Urban Development Community Development Block Grant/Entitlement Grant 01-1 Housing Rehabilitation Assistance to Low-to-Moderate Income Persons- CFDA No. 14.218 Reportable Condition: Documentation of verification of low-to-moderate income status could not be located for one selected participant. In addition, verification of income status for four other participants was not current. Eligibility for the program requires family income to be between low and moderate-income levels as determined by the Department of Housing and Urban Development (HUD). The cost of the assistance may be disallowed. It appears that procedures were not in place to ensure that potential participants requalify for Community Development Block Grant (CDBG) Rinds when such income verification is outdated. Also, documentation was apparently not filed correctly for the one instance mentioned above. Recommendation: The City of Atlantic Beach, Florida should again verify the eligibility of the recipients whose documentation either could not be located or was outdated. Action Taken: Since the date of the exit conference, the low-to-moderate income status has been re-verified and current income verification documents have been obtained for four of the five recipients referred to in this finding. The fifth recipient is deceased, and we are conferring with our City Attorney to determine the proper course of action. Copies of the documentation received are attached. This documentation supports the allowability of the cost expended, as it demonstrates that the recipients qualify under the grant program based on income eligibility. Mortgage notes were signed by all the recipients prior to inception of the work, allowing for reimbursement on a pro rata basis within ten years, if the recipient's eligibility status changes. I have met with the employee responsible for obtaining the low-to- moderate income status documentation and discussed the importance of completing and properly filing this documentation. In the future, I will be responsible for verifying that the income status documentation is current, prior to commencement of the rehabilitation work. One copy of the income verification form will be maintained in the Community Development Director's office and a second copy will be maintained in the City Clerk's Office, with the respective grant year contract and other applicable grant documentation. 01-2 Monthly Status Reports-CFDA No. 14.218 Reportable Condition: Monthly status reports were not always being completed and filed with the City of Jacksonville, Florida (grantor) as required by the grant agreement. Internal controls should be in place to ensure that all grant requirements are being adhered to. Failure to complete and/or file monthly status reports on a timely basis may give cause for further payments to the City being withheld. Recommendation: Procedures should be implemented to appropriately monitor responsible City personnel to ensure that specific grant requirements are being complied with. Action Taken: We concur with the recommendation. The following procedures will be implemented immediately: The City Manager will meet with the Community Development Director monthly to review the Monthly Status Report. He will initial each report, signifying his review, prior to submission to the City of Jacksonville HUD office. If a vacancy or extended absence occurs in the Community Development Director position, the City Manager will immediately notify City of Jacksonville HUD of any change in grant administration personnel, and the City Manager will be responsible for ensuring that the grant requirements are complied with. If the U.S. Department of Housing and Urban Development has questions regarding this plan,please call me at(904) 247-5800. Sincerely yo , J' Hanson City Manager 1 City of Atlantic Beach CDBG Housing Rehabilitations FY 2000/01 Recipient Address Amount Spillers, E. 751 Sailfish Drive $31,190.01 Rivera, A. 78 Forrestal Circle N 31,093.50 Blake, C. 464 Irex Road 28,530.51 Rouse, N. 860 Amberjack Lane 15,160.80 Wright, C. 41 Ardella Road 8,747.00 Total $114,721.82 X71-t zaoz 7 's7z 200 & ��7 ,loos" q7 200`7 3�d° cdbg01rehabs " .. CONTRACTOR PAYMENT REQUEST % Payment #1 - complete 1��2 1 Homeowner. Address: ( Payment #2- Comple C4z ---2 l Adandc Beach;Florida 32233 Payment#3-10096 Compkie 2 Contractor. �S C Amount Requested alf...l...f......r......................\\wa.........flis a.rrlrl a.►l►f r............ arf.rrfarrlaf! Contractor. I hereby request an inspection to receive payment#-I--for the amount of I certify that I have satisfactoily completed the necessary work to justify this request and that all bills incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. Attached is a description of the work completed and the amount of payment requested by work item. Contractor's Signature Date. CeD 7 O !lf.aff.f..r•f ...........f.rr\\! ••.rf.r.rlf..............ar.r.laf.alr\al as lalfaflf•f rffli..arar Homeowner: I We hereby agree tbat the work stated by the contractor has been completed and approve Payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount dishwsed jnU be based on the findings of that inspection. Owner's Signature , Date: a..alf\fr.lr:wrlr.irararffr♦rafrlrffarrrrrrrr.arr•r/f•rrrf.af•rafrrrrrfarrerf afffrr►rf►rfaaa Rehabilitation Inspector. metre I hereby certify drat I exercised reasonable cam to determine that the work performed at the above address le for the specifications and was completed in a satisfactory manner however',neither.the undersigned nor Jacksonville HUD is in any way responsible acts or omissions of the contractor,any subcontractor,or any of the contractor's agents or employees,or any other person pedorminng work under the construction agreement. The contractor has provided a release of all liens,if any,in connection with this contract and has provided die pfoperty owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. Rehab Inspector. Date:__ -- a.f.r.\.rafff.. friar.a.........................,.....,........r....r..r.a►.fwa r.faf rral.all lrr.r air Approved Forward to Fmw=Deparisnent for payment this date. Date Director, R ilitatioa Loan Program Date ' 10 -A.mcGroup V / poq # PO # 4 5- A.m c un un 4 PPrcvz:l / Date � Approval / Date CL2 411,Io, Approval I44.1 Date itL-25-2901 98:508 FROM: TO:2475845 P:1/1 Fox : 9097T9=3 _ �" 18 '93 11:18 I:D E,; j$aoi Eletaaoaeax: i�••�' f !. i's�wsnt N!_9!!!s C�an.�i ;..._ . � =i" ta y ' pit r.of .AtLa L Beach Adtlteaa.: ••�� �' ng--and Zoning csrrw.r: trllEd .. .......•...............:.........:............................_._.._....._.............,...•....... Cotsrs�+t� 16aebp ta�.ratt ave t....ca�e pa�tarwt ver..,.:�-�6,r dae aaaaatK d % ,.�r `� �• S� _ �teti4r dot I ba a+ri$ct�eiy aotrWd•d Ibe wa •Y •rab M3mWry M6,arat OVA thm 00 bMs ire iia pia o iticterad rw J&M r od aw!atolr61 is Awwdm l E•amiss am m=winaiir ad qraaetaau Ildladitlrat. 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I:a.ladar'�sem._ .: Due-t:' ___ ....................................... .......................................................... lltwawwom UWt lwd1►Ates dat rm&stood*ehadattamm>m IWA CO "W t.nt1 t poramm w dog ie w=d=m wide Ila:ceaaoot tarl.:wdoylata+";IN$I c` a awd eemscmeaao by tie tea• L is Immaoetl Oat do amw a wmd.tkbwsw we M towd'r dee i Nrww intmiNfe• Ades awwk ra ,_..r• •r .... .---- "'.r + ..•.••a..............♦...................,.......a......•...a.........•,..•a....v.•...•.0•.• itelyd tadatt Irptattus d=Wm a MMF4 r. : �nmtr . 1 inn"aetirf tfNt 1 ateteital taaarrldaaw la.ldaa�C t1oM the wmrR petlboaial p iltli)it is srr��rapawrilde for dmVw wW■M aw&pMW 6n PdWWM mo mw however.wmlw rdu WWMV%PW"rJw&WMmft seta nroiwiaaiana ai an eoritae .a$* miewr r,ar awr.af dw eaatewsws mens or ampbetch or atgr Wier Iwaaft p fAttIN!ig work va&t for ouw�t vetimw eseeawet IrIK eewtedarha prwWw r mawm of ep Beat.if atq.in mm wdi.w wink Ilia cwwrct wd levet I the r"Imad' uwnet"M a eopp d eo eb w.nwq or b ser doa 1 1 amw Gas deo amm a w rot Omb peafonowtawd wwta►halemen — : 2+borwd w lrtrwne o.l.•lem �arc p yams dek dose. - 31-v AUG G 12t, K Group # / Req / PO # a S Arnount14t 2001 provai / Date App:oval t flame, AM DEPT` Y No. _ Date ofCcroact 03-7-o'/ Daae C) 3 Owner Nam,— COMI h/�;Q 4 hopartyAddrmc ijrdea Contrador Name . �r1 Ct-esr,�r� art G Caot<actor Address F IZZalk L-11 74 91 W, fr-1-3 Z Z l�Ntmnber 9y1f'�fG�"d itrtion of Work C;haace: AMOLTNT: CATEGORY: (Please Type) 7o MFrtc 0/7 plfr SPA 401-)e ' %�a 7s/ Ntwsf-I?e Place �,�;�- Pa i i14 ;.a� alb qo,� 064t -.Q)C c.(" J,10 5 e06 Nl cosy` Chs>ges and work affected hereby,are subject to all omtrad.stipuiattoru and covenants. 'Ibis C barge Ordr is made a pact of the contract dated fast above,parties have hereunto set their signatures. V,�//a g37 - Canttact Prim , DateCharive To,, Group 9/ Req # ownrr Dam Amount Approval / Date <— or ApprovalDate �' Approval >:Date c� Rehab SpecialistAn� - Date: � Approval / Program Admin strawy App rowd: Dat,- 3. 0 ` 1 Source of Furxis: a a contingency owrAw Contract copy:C wm.Contractor,Loan se,Tecbmad file,financial Institution(If contract price d=wd) Cates^ories of chances• 1.Bidden damages PAI D 4.Tmie extension a.Deletions of non-required items or unusual allowances ZOUt 4.Required items that were mimed an initial inspection MAY 0 9 S.Equal substitution of material or alternative cure for deficiency at same or lesser price 6.Totally unforeseen circumstances arising after coo meacemanent of worm CK# � quval County Property Appraiser- Parcel Summary Page 1 of 2 Parcel Summary -Values from the 2001 Certified Tax Roll IRE No.: 172077 0000 Owner's Name- PAY NE , SARAH WASHINGTON ESTATE Property �41 ARDELLA RD Unit No. Address: ATLANTIC BEACH 32233 Mailing Address: C/O CAROL A WRIGHT ATLANTIC BEACH , FL 32233-4305 Property Use: 1292 RES/COMM ZONING Legal 17-2S-29E PT GOVT LOT 3 RECD O/R 2464-599 description: Neighborhood: 129241 1292'S MAYPORT -Range: 17-2S-29E OR BK& Page 02464-0599 1Map Panel: I556A2 Sale Date: 7/7/1965 No. Buildings: I1 Sale Price: $300.00 Land Value: $5,750.00 Heated Area: I910 Class Value: $0.00 Exterior Wall: CONCRETE BLOCK Improvements: $30,400.00 Taxing USD3 Authority: Market Va 1$36,150.00 1 County Tax: $24.50 Assessed Value: $28,473.00 School Tax: I$28.77 Exempt Value: $25,000.00 District Tax $10.53 Taxable Value: $3,473.00 Other Tax: I$1.73 Sr. Exempt: $0.00 Voted Tax: $2.12 Sr. Taxable. $0.00 Total Tax: I$67.65 This page displays values from the 2001 Certified Tax Roll with weekly updates of ownership & sales. Map-It maps & data are updated & maintained by COJ-GIS, not the Property Appraisers Office. Please direct inquiries regarding the maps & data to Map-it Feedback (below), not the Property Appraisers_Office. http://pawww.coj.net/pub/property/RENO.asp?RENUM=172077+0000 2/6/2002 OF ATLAN t )�t CITY00 SEMI OLE CH ROAD ATLANTIC BEACH,FLORIDA 32233-5445 ` TELEPHONE:(904)247-5800 FAX:(904)247-5877 ;. � SUNCOM: 852-5800 http://ci.atlantic-beach.fl.us January 14, 2002 Carol Wright 41 Ardella Road Atlantic Beach, Florida 32233 Re: Verification of income for 2001 CDBG grant recipients Dear Ms. Wright: The City of Atlantic Beach is in the process of wrapping up our files for houses that were renovated as part of last year's Community Development Block Grant (CDBG) project. Federal auditing regulations require that we have proof of income eligibility for all recipients of grant funds. In reviewing our files, we have discovered that this information has not been kept as required or has been mis-filed. Please bear in mind that your eligibility to have received grant funds for renovation of your residence is not in question. This was determined prior to work being done on your house. In order comply with these audit requirements, please provide a copy of your Tax Return for the year 2000, or some other document that verifies your income. If you wish to come by City Hall, I will be glad to make a copy of this for you, or you may return a copy to me in the envelop provided. I appreciate your help, and please feel free to call me at 247-5817 with any questions. Sincerely, Sonya S. Doerr Community Development Director This information is being furnished to IRS.If you are required to file a tax return,a negligence penalty/ether sanction may be Imposed on you if this Income Is taxable&you fail to report it. Cop r C For EMPLOYEE'S RECORDS 2000 OMB No. Copy 2 To Be Filed With Employee's State 2000 OMt 1545-0008 �dtice to Em to ea. 1545 L.. C or,Local Income Tax Return s�Gn�rol number 1 Wages,tips,other comp. 2 Federal Income tax withheld a Control number 1 Wages,tips,other comp, 2 Federal income tax wlthhelo 7842 . 81 606 .28 7842 . 81 606 .28 4 3 Social security wages 4 Social security tax with held 4 3 Social security wages 4 Social security tax with held b Employer I D number 7 8 42 . 8 1 486 .32 b Employer I D number 7842 . 81 486 .32 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 5 Medicare tax withheld 59-3542817 7842 . 81 113 .71 9-3542817 7842 . 81 113 .71 c Employer's name,address,and ZIP code c Employer's name,address,and ZIP code N Florida Auto Inc . N Florida Auto Inc. P.O. Box 8623 P.O. Box 8623 Jacksonville FL 32239 Jacksonville FL 32239 d Employee's social security number d Employee's social security number 265-80-0466 265-80-0466 e Employee's name,address,and ZIP code a Employee's name,address,and ZIP code Carol A. Wright Carol A. Wright 41 Ardella Road 41 Ardella Road Atlantic Beach FL 32233 Atlantic Beach FL 32233 7 Social security tips 8 Allocated tips 9 Advance EIC payment 7 Social security tips 8 Allocated tips 9 Advance EIC payment 10 Dependent care benefits 11 Nonqualified plans 12 Benefits included in box 1 110 Dependent care benefits 11 Nonqualified plans 12 Benefits included in box 1 13 See instrs.for box 13 114 Other 13 See instrs.for box 13 14 Other 15 Statutory employee Deceased Pension plan Legal rep. Deferred comp. 15 Statutory employee Deceased Pension plan Legal rep. Deferred comp. 18 State Emplr.'s state I.D.# 17 State wages,tips,etc. 18 State income tax 15 State Empir.'s state I.D.# 17 State wages,tips,etc. 18 State Income tax 19 Locality name 20 Local wages,tips,etc. 21 Local Income tax 19 Locality name 20 Local wages,tips,etc. 21 Local income tax Form W-2 Wa a and Tax Statement Dept.of the Treasury--IRS Form W-2 Wage and Tax Statement 39-1908847 Dept.of the Treasury--IRS 0 BW24U� NTF 27229 5249 39-1908647 Copyright 2000 Greatland/Nelco LP 4UPPERFI *NTF 0492 3066 J HOMEOWNER-CONTRACTOR AGREEMENT Property Improvements To (Address):_ 41 Ardella Road — - Owner (s) Name (s): Carol Wright_- Legal Description: —_--_ --- --- - - --- 1 . HOLD HARMLESS: Contractor shall agree to defend, indemnify, and hold harmless the Owner, City of Atlantic Beach, Florida from liability and claim for damages because of bodily injury, death, property damage, sickness, disease of loss and expense arising from Contractor's performance under this agreement to install or construct home improvements to be paid out of the proceeds of the Owners rehabilitation loan. Contractor is acting in the capacity of an independent Contractor with respect to the Owner. 2. LIEN WAIVERS: Contractor agrees to protect, defend and indemnify, owner from any claims for unpaid work, labor or materials with respect to Contractors 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 Contractors 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 tlhe performance of the rehabilitation work, subject to additions and deductions by approved Change Order the contract sum of ($ 5.237.00)payments will be scheduled as follows, subject to the City and the Owner's acceptance of the work done: Upon completion of 33%of the work, a progress payment of 33%will be made. Upon completion of 33%more of the work, an additional payment of 33%of the contract price will be made. Upon completion of 100%of the work, the remaining funds will be disbursed. 1 of 6 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 Owners notification to commence, Owner shall have the right to terminate this Agreement. Such notice of termination shall be in writing. The Contractor agrees to complete the work within sixty (60) calendar days after the commencement of work pursuant to the date of the Notice to Proceed. If completion is delayed for reasons beyond Contractor's control,the Contractor shall provide timely notice to the Owner of the reasons for such delay. It shall be the Contractors obligation to substantiate its claim by adequate documentation. 6. CHANGE ORDERS: Except in an emergency endangering life or property no changes in the work shall be made by the Contractor unless he has received a prior written order signed by the Owner and Authorized by Community Development Director of the City of Atlantic Beach. The contract sum and the contract time may be changed only by a properly executed Change Order. No extra costs will be paid to the Contractor when he has neglected to properly evaluate the extent of the rehabilitation work. Under no circumstances will the contingency fund,if any, be authorized for work other than totally unforeseen circumstances arising after the commencement of the work. 7. TERMINATION OF AGREEMENT: If the Contractor defaults or neglects to carry out the work as speed under the Paragraph"Scope of Work" or fails to perform any provision of the Contractor documents, the Owner 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,the Contractor shall pay the difference to the Owner. If the Owner fails to perform any applicable provisions of the Contract,the Contractor may,after fifteen (15)calendar days,terminate the contract and recover from the Owner 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 shall extend to subsequent Owners of the property to be rehabilitated. The warranty shall extend to subsequent Owners of the property to be rehabilitated.The warranty shall provide that improvements, hardware and fixtures of whatever kind or nature installed or constructed on said property by the Contractor are of good quality, and free from defects in workmanship or materials or deficiencies subject to the warrant 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 Contractors 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. 2of6 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 designee to complete the rehabilitation work financed in whole or in part with this loan. 12c. INTEREST OF PUBLIC BODY PERSONNEL: No member of the governing body of the Public Body who exercises any functions or responsibilities in connection with the administration of the loan and no other officer 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 governing body of the locality in which the property to be rehabilitated is situated, and no other public official of the locality who exercises any functions or responsibilities in connection with the administration of the loan 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. 3of6 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 I agrees to abide by the Equal Employment Opportunity 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. _ Sunstate Enclosures Inc. Carol Wright-- Name right_Name of Contractor Name (s) of Owner (s) Signature of Contractor Date Signature of Owner Date !O • P. Tide (if officer of Corporation) Signature of Owner Date 3 1-���l k4/% V) 41 Ardella Road Address of Contractor Address of Owner (s) WiYnesMed by 11ate itne by Date 4of6 ATTACHMENT I 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 national origin. The contractor will take of conative 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:employment,upgrading,demotion,or transfer,recruitment or recruitment advertising,layoff',or termination;rates of pay or other forms of compensation; and selection for training,including apprenticeship. The contractor 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 die contractor, state that all qualified 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 contracting officer, advising the labor union or workers'representative of the contractors commitments under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of die 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 relevant orders of the Secretary of Labor. 5.The contractor will furnish all information and reports required by Executive Order No. 11246 of September 24, 1965, and by the rules,regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his books, records, and accounts by the contracting agency and the Secretary of Labor for purposes of investigation to ascertain compliance with such rules,regulations and orders. 5of6 ATTACHMENT 1 Page -2- 6.In the event of the contractor's noncompliance with the nondiscrimination clauses of this contract or with any of such rules,regulations,or orders,this contract may be canceled,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 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 enforcing 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. 8. T'he offerers or bidder's attention is called to the"Equal Opportunity Clause"and the "Standard Federal Equal Employment Opportunity Construction Contract Specifications" set forth herein. 9. The goals and timetables for minority and female participation, expressed in percentage terms for the contractors 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 participation are 6.96 for each trade. 6of6 General Requirements PREPMAINT EXTERIOR-SPOT PAINT Remove all loose and scaling paint All surfaces shall be pressure washed and all surfaces caulked and puttied before installing primer coat All surfaces shall receive one(1)prig coat and one(1)finish coat(Z coats total). All paint shall be applied according to manufacturer's specifications.All lead based paint that may be existing shall be removed completely. "No"lead-based paint shall be used whatsoever. AL REPLUMB HOUSE COMPLETE—DUE TO LOW WATER PRESSURE Replumb all horizontal and vertical supply lines front water meter including a new main shut-off valve and new hose bibbs.All work shall conform to the local plumbing codes and shall be permitted and inspected accordingly. I � - SERVICE HVAC SYSTEM Clean and service the existing HVAC system by a licensed mechanical contractor. Any defective parts shall be replaced as required for proper and safe operation of unit All work shall be warranted for one(1)year after completion. � AL Kitchen REPAIR CEILING Repair the damaged areas of the ceiling as per standard trade practices. All repairs shall match the existing ceiling finish. l � REPLACEJINSTALL TILES Repiacefinstall VCT tiles as per standard trade practices and following all local ordinances.Tile color to be selected by homeowner. (� SF - Bathroom REPAIR SINK Repair existing bathroom sink so that there is no further leak. All work shall be done as per the plumbing code and adhere to local ordinances. / RA Total REHABILITATION LOAN PROGRAM RESPONSIBILITIES OF HOMEOWNER AFTER CONTRACT IS SIGNED Until Work Begins Start planning ahead. Plan adequate storage space for the contractors tools, equipment and materials. Make arrangements for the contractor to get into your property if you will not be home during the day. To avoid mutual confusion, one member of the family should be delegated as the spokesman to discuss problems or questions that may come up. If all household members work or will not be home during the construction,consider designating an agent such as a close friend or neighbor or relative not living with you to supervise the contractors work, You are responsible to make sure the contractor does the work exactly as he states he would do in your contract. Prepare your property and furnishings for the rehabilitation,use this period to send your drapes to the dry cleaners, wash your curtains. There will probably be dust and dirt from the work,protect your furnishings and clothes,put.all breakable and valuable items away so they won't be broken or misplaced. When the Work Begins Keep your copy of the work description handy and refer to it often. Do not ask for work to be done if it is not written in the work description. Check with the City Hall if there is anything you do not understand. Remember you are responsible for ensuring that the contractor does the work correctly as bid. Assistance will be provided if required but the work must be acceptable to you. Try to stay out of the construction area, especially children, this will help prevent.injuries and allow the workmen room to work. Try to keep a good relationship between your family and the contractor again, delegate someone to be the spokesman for the family. Stop, problems before they start , if something isn't going the way you feel it should, or if you don't understand it, speak to the contractor at once and get an acceptable explanation or correction before it progresses too far. If the contractor cannot give you an acceptable explanation, stop the work and call the City Hall for assistance. Expect the unexpected,in most cases changes and improvements will be new and exciting to you and will give you much pleasure;however,unforeseen problems may be uncovered during the course of the work which may require a change to the contract. Be prepared if this should happen , discuss changes with the contractor and get a good explanation of the change required and why. Try to visualize what the change will look like. Be flexible. All changes to the contract must be approved by you and the City and must be in writing. Your contractor is responsible for supervision of his workers. If he cannot be present, make sure that he tells you who to talk to if you have a problem or questions. Win cooperation from the workmen with good basic human relations. A word of appreciation , an unexpected pot of coffee or even a pitcher of cold water. Small gestures like these usually produce more efficient and better workmanship. Last but not least. The work must be acceptable to you and must be done in accordance with the contract documents. Make sure that you know what is being done to your home and that you are getting exactly what the work description states. City of Atlantic Beach - 247-5817 CONTRACTOR'S AFFIDAVIT STATE OF FLORIDA SS COUNTY OF DUVAL BEFORE ME, the undersigned Notary Public, personally appeared who,being first duly sworn By me, deposes and says: That on , 19__, as owner, and as contractor, entered into a certain construction contract whereby said contractor agreed to provide certain labor and materials for said owner 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, and has personally supervised the perfonnance 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 _day of , 19 Notary Public, State of Florida at Large, My commission expires: CHANGE ORDER No. -- Date of Contract-- ___-- _-- Date__—____---__-- Owner __---- Property Address ----- -- - ----- Contractor Name:--- -_--_-- - -------------- Contractor Address:— ___—_—_—___ Phone Number,_,_— --- Description of Work Chante: AMOUNT: CATEGORY: (Please Type) SUM Changes and work affected hereby,are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first above,parties have hereunto set their signatures. $— _Contract Price +or" $------- - Change $-------__—_-- Total Owner Approval:`- -- -- Date: Contractor Approval: ___-- ------_ -- Date:--------_—_-- Rehab Specialist Approval:— ^—_—___ Date: Program Administrator Approval:---_----__ Date: Source of Funds: $ _ $ $- --- Contingency Owner Contract Copy:Owner,Contractor,loan file,Technical file,Financial Institution(If contract price changed) Categories of changes: 1.Hidden damages 2.Time extension 3.Deletions of non-required items or unusual allowances 4.Required items that were missed on initial inspection 5.Equal substitution of material or alternative cure for deficiency at same or lesser price 6.Totally unforeseen circumstances arising after commencement of work MORTGAGE NOTE Atlantic Beach, Florida For value receive the undersigned (oindy and severally,if more than one),promise to pay to the order of the City c Atlantic Beach, a municipal corporation, 800 Seminole Road, Atlantic BeacN Florida 32233, the principal sum c $_5,1'3 :90 being payabW in lawful m ey of the nited States of America at 800 Seminol Road,Atlantic Beach,Florida.32233 or at such other address as the holder from time to time may specify by written notice t the maker. Said principal sum shall bear no interest and shall be reduced in amount at the rate of 1/10th per year unt reduced to a zero balance at the end of 10 years. Any unforgiven balance shall become immediately due and payable if d: maker transfers title to or moves from the premises securing this note within the 10 year period. In the event of the death( the maker of this note,this note shall remain in effect and the principal sum reduced at the above rate of 1/10th per year only a member of the makers immediate family takes up residence in the subject home, under any other circumstances the nod shall become immediately due and payable. This note is to be construed and enforced according to the laws of the State of Florida, and is secured mortgage on real estate of even date herewith. If default be made in the payment of any of said sums or in the performance of any agreements contained herein, then at the option of the holder of the same, the principal sum then remaining unpaid shall immediately become due and collectible without notice, time being of the essence of this contract, and said principal sum shall bear interest at the highest rate allowed by applicable law,from such time until paid. Each maker and endorser waives presentment, protest, notice of protest and notice of dishonor and agrees to pay all costs,including a reasonable attorney's fee,whether suit be brought or not,if counsel shall after maturity of this note o: default hereunder or under said mortgage,be employed to collect this note or to protect the security thereof. L kk �-\�—\ �—, q ��t Name of Maker (seal) Signature of Maker Date: Maker's Address:, A ' '��� C `\� V STATE OF FLORIDA DOCUMENTARY STAMPS IN THE AMOUNT OF$ HAVE BEEN AFFIXED TO THE MORTGAGE SECURING THIS NOTE AND CANCELLED. PROCEED ORDER iy DATE ` � � TO: Sunstate Enclosures` This is to authorize you to proceed with work specified in our contract dated for improvement work on the property located at . The amount specified in the Rehabilitation Agreement is $ i 2 -02 . Please proceed in accordance with the Contract. 1 You are to commence work no later than t - 0 1 All work shall be completed according to the Work Write-Up, plans, Change Orders,Addenda and Specifications within Sixty (60) calendar days after starting construction. Name(s) of Owner(s) (Owner's Signature) (Owner's Signature) ADDRESS: (Local Pdl6iic Agency Re sentative) Copy: M MORTGAGE NOTE Atlantic Beach, Florida For value receive the undersigned (jointly and severally,if more than one),promise to pay to the order of the City< Atlantic Beach, a municipal corporation, 800 Seminole Road, Atlantic Beach, Florida 32233, the principal sum c $_5,237.00 being payable in lawful money of the United States of America at 800 Seminol Road,Atlantic Beach,Florida 32233 or at such other address as the holder from time to time may specify by written notice t the maker. Said principal sum shall bear no interest and shall be reduced in amount at the rate of 1/10th per year uni reduced to a zero balance at the end of 10 years. Any unforgiven balance shall become immediately due and payable if 1. maker transfers title to or moves from the premises securing this note within the 10 year period. In the event of the death c the maker of this note,this note shall remain in effect and the principal sum reduced at the above rate of 1/10th per year only a member of the makers immediate family takes up residence in the subject home, under any other circumstances the not shall become immediately due and payable. This note is to be construed and enforced according to the laws of the State of Florida, and is secured mortgage on real estate of even date herewith. If default be made in the payment of any of said sums or in the performance of any agreements contained herein, then at the option of the holder of the same, the principal sum then remaining unpaid shall immediately become due and collectible without notice,time being of the essence of this contract, and said principal sum shall bear interest at the highest rate allowed by applicable law,from such time until paid. Each maker and endorser waives presentment, protest, notice of protest and notice of dishonor and agrees to pay all costs,including a reasonable attorney's fee,whether suit be brought or not,if counsel shall after maturity of this note a default hereunder or under said mortgage,be employed to collect this note or to protect the security thereof. Name of Maker Lc' (seal) Signature of Maker Date: Maker's Address: STATE OF FLORIDA DOCUMENTARY STAMPS IN THE AMOUNT OF$ HAVE BEEN AFFIXED TO THE MORTGAGE SECURING THIS NOTE AND CANCELLED. PROCEED ORDER f DATE _ TO: Sunstate Enclosures This is to authorize you to proceed with work specified in our contract dated for improvement work on the property located at . The amount specified in the Rehabilitation Agreement is $ 1 2 '3--Z,e7t� . Please proceed in accordance with the Contract. You are to commence work no later than 0-13 - 12 - 01 All work shall be completed according to the Work Write-Up,plans, Change Orders,Addenda and Specifications within Sixty (60) calendar days after starting construction. 16 Name(s) of Owner(s) (Owner's Signature) (Owner's Signature) ADDRESS: (Local Pdfhc Agency Re sentative) Copy: CONTRACTOR PAYMENT REQUEST Homeowner:--------_—.---------—_ —----- —_ Payment #I-33%Complete--_--- Address:______________ - Payment #2-33%Complete------_--_ Atlantic Beach,Florida 32233 Payment#3-100%Complete___-__---- Contractor: ---------------------------------------- Amount Requested$--_-----_----_-__ Contractor: I hereby request an inspection to receive payment#---------for the amount of$—_-------------- I certify that I have satisfactorily completed the necessary work to justify this request and that all bills incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. Attached is a description of the work completed and the amount of payment requested by work item. Contractor's Signature:-------- ----------------------- Date:------------------------------ #r###}YY##!+##*YYR**##*f##w#Y###Y###*##*Ylir###!f###!###}Y#f4f###f###f f*##+#f#*##R#ff#}!ff##*+f#!+f* Homeowner: I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. Owners Signature-------------------------------------------- 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 way responsible for the acts or omissions of the contractor,any subcontractor,or any of the contractor's agents or employees,or any other person performing work under the construction agreement. The contractor has provided a release of all liens,if any,in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. Rehab Inspector: -------------------------------------------- Date:------------------------------- w+wrwef#ww}w##4*###w+***!r#}#*###rww#+w##!w+►#:!}}}}w!}}#}}##**+###!!r#fwl+f}r!##w##Y+#wlf+##++##x++ Approved. Forward to Finance Department for payment this date. ---------------------------------_—___-------- --------- Date----------------------- Director, Rehabilitation Loan Program Proposed Remedy Income eligibility of any Fiscal Year 2002-2003 grant recipients will be verified in accordance Section 8 Low and Moderate Income Limits as established for CDBG Program participation and in accordance with procedures established by U.S. Department of Housing and Urban Development HUD and City of Jacksonville Community Development Division. Individual files will be established and maintained for each project and each grant recipient. Concurrence from City of Jacksonville HUD office verifying income eligibility will be documented and maintained in each file before any release of funds. Comment#2 • Failure to file all required Monthly Status Reports (page 66) A brief narrative report is required to be filed on a monthly basis to document progress of projects throughout the grant year. Lapse in certain administrative procedures, including the submission of all Monthly Status Reports, occurred during vacancy of staff position responsible for oversight of Community Development Block Grant projects. New staff has coordinated with City of Jacksonville staff to provide an end of the year report addressing all projects and the expenditure of FY 2000- 2001 funds. (See attached letter.) Proposed Remedy Monthly Status Reports will be submitted with each Cash Request Form for Fiscal Year 2002-2003 projects. Submittals to City HUD office will include Monthly Status Report and Cash Request Form attached to all financial documentation supporting the request for reimbursement. cc:Nelson Van Liere, CPA Finance Director 2 PRELIMINARY DRA19 SCHEDULE OF FINDINGS AND QUESTIONED COSTS IN ACCORDANCE WITH OMB CIRCULAR A-133 CITY OF ATLANTIC BEACH, FLORIDA ATLANTIC BEACH, FLORIDA (Concluded) 3. Findings and Questioned Costs For Federal Awards Required to be Reported Under Section .510(a) of OMB Circular A-133 (Concluded) Questioned Costs Findings (Concluded) 01-1 Grant No. 5629-21 - Year Ended September 30, 2001 (Concluded) Effect - Failure to complete and/or file monthly status reports on a timely basis may give cause for further payments to the City being withheld. $ 0 Recommendation - Procedures should be implemented to appropriately monitor responsible City personnel to ensure that specific grant requirements are being complied with. Total Questioned Costs $ 114,722 67 CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877 .r LOAIONtAICN _MIT RM O Permit Number: 21602 Address: 41 ARDELLA ROAD Permit Type: BUILDING ATLANTIC BEACH, FLORIDA 32233 Class of Work: REPAIR Township: 0 Range: 0 Book: Proposed Use: Lot(s): Block: Section:0 Square Feet: Subdivision: DONNER Est. Value: Parcel Number: Improv. Cost: 5,237.00 ' k, h` .,: M R,INFO M Date Issued: 3/12/2001 Name: CAROL WRIGHT Total Fees: Address: 41 ARDELLA ROAD Amount Paid: ATLANTIC BEACH, FLORIDA 32233 Date Paid: 3/12/2001 Phone: (904)721-3436 Work Desc. CDBG/ Misc. Repairs & Plumbin MEW� MAT SUNSTATE ENCLOSURES PERMIT 0.00 FINAL NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION 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. / C0614 r Date: 3/22/61 61 Receipt: 6644564 AT TIC B&tH BUILDING DEPT. DECKS CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS MOVING, DEMOLITIONS Owner(s) : COL O Li11P Job Address:�� / phone: 7- 96�� S ' Lot # ,3 Block or Unit # f/ /•Sq Subdivision: /o�/'7 6r' /rG// GGr -3 Contractor: //��S(.c/l Sj�/ifLL'� �/%GLoSk/'CS State License Address: �!»"�l�I/PC� ��'f[.� �J Phone No: City 01A4'/Io e 4a"Ak State �L Zip Code Describe work to be done 11Ud r2t_' l/Glb Pe&jm h add Ni/-SG Present use of building: Valuation of Proposed Construction: S 3 Proposed use: Re-:!o) CsldLoI7 T Is this an addition? 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 TMRZE (CObOMRCTAL) TWO (RESZ=iTZAL) CC"LETE SETS OF PLANS, Z2YCLUDING SITZ PLAN, SURVEY, ENERGY CODE E17RMS, NOTICE OF G�hm�7CENT, AND OWWR/CONTRACTOR AFTIDAVIT, IF OWNER IS CONTRAGTCR. Signature OWNER: Date: �y Signature CONTRACTOR- Date: FpL ` 003'-'73-7 13-e-) AS TO OWNER: Sworn to and subscribed before me this day of 2000. NOTARY PUBLIC AS TO CONTRA�CTO � MAUREEN KING Swc1' b'� i4rd$ H�,_XNO]2 fore me this day of /XQ C/, ,200it. My Commiwori ExP'ros Mor?Commission k CCM18 & NOTARY PUBLIC Duval County Property Appraiser-Parcel Summary Page 1 of 2 Parcel Summar -Values from the 2001 Certified Tax Roll RE No.: 770000 Owner's Name• PAYNE , SARAH WASHINGTON • ESTATE Property 41 ARDELLA RD Unit No. Address: ATLANTIC BEACH 132233 Mailing Address: C/O CAROL A WRIGHT ATLANTIC BEACH ,FL 32233-4305 Propert Use: 1292 RES/COMM ZONING Legal 17-2S-29E PT GOVT LOT 3 RECD O/R 2464-599 description: Neighborhood: 129241 1292'S MAYPORT Sec-Twn-Ran e: 17-2S-29E 1 OR BK& Pae 02464-0599 JIMap Panel: I 556A2 Sale Date: 7/7/1965 No. Buildings: I 1 1 Sale Price: $300.00 Land Value: $5,750.00 Heated Area: 910 Class Value: $0.00 Exterior Wall: CONCRETE BLOCK Improvements: $30,400.00 Taxing JJUSD3 IlAuthority: Market Value, $36,150.00 County Tax: JF$24.50 Assessed Value: $28,473.00 ISchool Tax: IF$28.77 Exempt Value: $25,000.00 IlDistrict Tax: IF$10.53 Taxable Value: $3,473.00 10ther Tax: JF$1.73 Sr. Exem t: $0.00 IVoted Tax: JF$2.12 Sr. Taxable: $0.00 1 Total Tax. JF$67.65 This nage disolays values from the 2001 Certified Tax Roll with weekly updates of ` W a i �► i It v-7ISO --„ Its Ci. 09 � Va. i o 'Ilk# 01/25/1999 14:31 6455972 ATLANTIC MTR PAGE 03 (ZA" FINANCIAL SURVEY COMMUNrry DEVELOPMENT BLOCK GRANT PROGRAM Date; I 1 1.Homeowner(s)Name: 2. Address of House: A 3. Telephone Number(s)where you can be reach during the day or early evening: �(Other) 4. b person completing survey the Head of Household? _ 5.Age of Head of Household 6. Is the Head of Household: female'' male ? A minority? yes no 7. Number of handicapped living in household N. -6 8. Total number of rooms in household S— 9.Number of persons living in household(other than Head of Household): Age 0-5 years Male Female Age 6.17 years Male Femalo Age 18-39 years Male Female Age 64 and over \ Male Female 10.Water supply is from: City- Well Other(list) 11. Sewer service is by: City Septic Tank Other 12. Docs your toilet flush? Yca� No 01/25/1999 14:31 6455972 ATLANTIC MTR PAGE 04 I Page 2 Financial Survey Community Development Block Grant 13. Have you had sewer or septic tank problems? yes no If yes,which of the problems have you experienced? a. Foul odor b. Seepage of septic tank into yar o. Backed up houwWd plumbinixes d. Other Do the problems increase during periods of heavy rain W? yes no 14. Is there hot running water in the household? yes\ no Is there cold running water in the household? yes no 15. Do you have a complete kitchen(water, cooking,refrigeration)? yes- no 16. On the chart below, circle your household's family size. Is the total annual income of your household: more than less thati. a income level shown below for your household size? Family Size-Number Annual Income Level 1 $11850 $13 5 3 $15,250. 4 $16,950. 5 S 1 S,000. 6 $19,050. 7 $20,150. 8 or more $21,200. 17. Are you on a fixed income(Social Security, SSI,Retirement)yes no`s 18.List income sources) 19. Do you : own rent your home? If you own your home,please present a copy of your warranty deed and a most recent utility bill (water or etectric)l as proof of ownership and residency with this survey.. If you rent your home,please present a copy of your lease with this survey. Signature of Homeowner(s): 01/25/1999 14:31 6455972 ATLANTIC MTR PAGE 05 I INCOME VERMCA11ON FORM PART 1. To be filled out lican to ee: licant/Em i APP P oY eeName: Address: Social Security Number:__ 2 " �y I hereby authorize release of my income information to the City of Atlantic Beach,Florida. Applicant/Employee Sianatur c - � Date PART 2. To be filled out by Social Securi Administration HRS or the Em 10 ' S_S. Administration,HRS or Employer: Please complete the following and return the requested inforaration to the Director of Community Development, goo Seminole Road, Atlantic Beach, Fl., 32233. Applicant/Employee's name: Gross amount of income pard monthly. 4f Q C 0 J Employment to be continued?Yeses No If no, please explain to er Si tire: itle: EmP Y 8nat Employer Telephone Niu": Date: City of Atlantic Beach, Florida 800 Seminole Road Atlantic Beach,Florida 32233-5445 Telephone(904) 247-5800 Fax (904) 247-5805 Suncom 852-5800 City of Atlantic Beach Housing Rehab Program Bid Proposal Notice to the Homeowner and Contractor. This bid should be submitted in confidence and should not be revealed to the other contractors.Evidence of a collusive bid shallbecause for non-acceptance by the Program. Date: Contractor: Property Owner:Carol Wright Property Address:41 Ardella Rd.Atlantic Beach,Florida 32233 L the undersigned contractor,having inspected your property,as listed above,understand the eft and character of the work to be done.I propose to firmish all labor,materials and equipment necessary to accomplish the work as stated in the attached bid specifications and work description for the rehabilitation of your property. My total Bid Proposal for all items listed on my attached work description is All work proposed as described will comply with the City of Atlantic Beach's Building Codes and will conform to the Property Rehabilitation Standard Specifications and Guidelines.Ifthis proposal is accepted,I will obtain all required building permits prior to starting constriction. I propose to commence the work within 10 consecutive calendar days from the date of award of a contract and a Notice to Proceed and will complete the work within 45 calendar days after starting the work. Company Name Signature and Title of Officer Date SELECTION OF CONTRACTOR AND BID PROPOSAL Uwe the owners)of the above listed property have read and understand the rehabilitation work to be accomplished in accordance with the work write-up and Specifications attached to the below listed contractor'bid proposal. Contractor selected: Bid Price$ signature of owner date witness date signature of owner date witness date Owner Carol Wright Address: 41 Ardella Rd Atlantic Beach,Florida 32233 Phone Number: (904)247—9692 Date: April 10,2000 Time: 4:35 PM PROPERTY DESCRIPTION Address: 41 Ardella Rd Atlantic Beach,Florida 32233 Dwelling Type: block Floors: single story Number of Rooms: 7 Area: Other Contents: Inspector: Mr.Bernard A.Wilson Date Inspected: March 30,2000 Approved: Date Date BLUDING DESCRIPTION Date: April 10,2000 Time: 4:35 PM Inspector: Mr.Bernard A.Wilson Address: 41 Ardella Rd Atlantic Beach,Florida 32233 Number of units: Dwelling type: Stories: single story Construction Type: block Other Comments: General Requirements PREPlPAINT EXTERIOR-SPOT PAINT Remove all loose and scaling paint All surfaces shall be pressure washed and all surfaces caulked and puttied before installing primer coat All surfaces shall receive one(1)primer coat and one(1)finish coat(2 coats total} All paint shall be applied according to manufacturer's specifications.Alt lead based paint that may be existing shall be removed completely. "No"lead-based paint shall be used whatsoever. AL REPLUMB HOUSE COMPLETE—DUE TO LOW WATER PRESSURE Replumb all horizontal and vertical supply Imes from water meter including a new main shut-off valve and new hose bibbs.All work shall conform to the local plumbing codes and shall be permitted and inspected accordingly. I AL SERVICE HVAC SYSTEM Clean and service the existing HVAC system by a licensed mechanical contractor. Any defective parts shall be replaced as required for proper and safe operation of unit All work shall be warranted for one(1)year after completion. � AL Kitchen REPAIR CEILING Repair the damaged areas of the ceiling as per standard trade practices. All repairs shall match the existing ceiling finish REPLACE/INSTALL TILES Replace/install VCT tiles as per standard trade practices and following all local ordinances.Tile color to be selected by homeowner. Q SF - Bathroom REPAIR SINK Repair existing bathroom sink so that there is no further leak. All work shall be done as per the plumbing code and adhere to local ordinances. / EA Total CONTRACTOR PAYMENT REQUEST w4^ Homeotivuer: CAROL A. WRIGHT Payment #1 -33%Complete — Address: 41 ARDELLA ROAD Payment #2-33%Complete Atlantic Beach,Florida 32233 Payment#3 - 100%Completes Contractor: BARNETTE CONSTRUCTION, INC. Amount Requested— Contractor: I hereby request an inspection to receive payment# _for the amount of S I certify that I have satisfactorily completed the necessary work to justify this request and that all bills incurred for labor used and materials furnished..in making said repairs and uuprovements have been paid in Rill to this date. :1 Attached is a description of the work completed and the amount of payment requested by work item. Contractor's Sig Date: Homeowner: IIWe hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that ' spection. Owner's Signature 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 way responsible for the acts or omissions of the contractor,any subcontractor,or any of the contractor's agents or employees,or any other person performing work under the construction agreement. The contractor has provided a release of all liens,if any,in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contracto for work Q q Rehab Specialist Date: L (5 G **************************************************************************************************** Program Administrator: I hereby agree that the work stated by the contractor has been completed and approve payment to the contract . Program Administrator: Date: Approved. Forward to Finance Department for payment this date. i Date Director, chab station an Program fi 17,105 , DEPARTMENT OF BODING CITY OF ATLANTIC seAcH. -- PERMIT INFORMATION -_---- LOCATION INFORMATION -------- ermat Number: I.'92f�5 A Id 41 .ARDELLA ROAR Per mit "' :eP3+UMB�'NO ATLANTIC C BEACH r FLORIDA 32233 Class of . Work:`ALTSRAT'ION --- L OAL DESCRIPTION -, - Constr. Type WOOD',TRAME Block« Lot: Twp D Proposed U; : Section: D 1 A5Abd:0 Rng 0 Subdivi*ion:DONNER improv. cost;- Tota €est : QO Amount P D t e; R.orke a w APPLICATION FEES -- - ttw y C 25 .'S4 Add$ Y # D 'AT, 3223 &c 22 '�� � 5 &1 gwAw' `41 CON ATION {----- flame: SAAWE T T I O�N,al , ATLANTI H FL S e: r � vqq.f�47". NOTES: NOTICE -INSPECTIONS MUST BE REQUESTED AT LEAST 14,114OURt PRIOR TO INSPECTION 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 � 4 FAILURE TO COMPLY :WITH THE MECHANICS.' LIEN„ LAW CAN RESULT IN THE PI�OP15RT1C`C 1 NLI LAYING TWICE F+C? U1LflING`IMPROVEMENTS." (S$UED ACCORDING TO APPROVED PLANS WHICH:ARE PART OF THIS'PERMIT AND SUBJECT TO REVOCATION VIOLATION OF APPLICABLE PROVISIONS OF LAW. , ¢w 14` receipts . ATLANTIC BEAACH BU I AIN' EPARTMIENT S Byt CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBINU l,E:lcf11 '1' JOB LOCATION: /7'f. OWNER OF PROPERTY : _ C d BUILDING CONTRACTOR :_ A !e PLUMBING CONTRACTOR AND ADDRESS: - - TELEPHONE NUMBER: STATE LICENSE NO: CCD-3- _� 2Y_ _ TYPE OF BUILDING: --------/----SINKS C _LAVATORY Wn'1'l:F� HEATLI( ; _______L___BATH TUBS ------------URINALS UitiPOSAI_:� _____CLOSETS •WASf1jNts MAC:IIINE:' ____________FLOOR DRAINS "'HOWER PANS 01'HE}t TOTAL FIXTURE COUNT:_____ _ __ x $3. 50 OU -------------------------------------- --------------------- ---- INSTALLATION OF PLUMBING AND FIXTURES. MUST BE 1N ACCORDANCE' Wil'}i THE MOST RECENT EDITION OF THE SOUTHERN STANDAND 11I.0MNltib colt:. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - 17170 re UEPA►RTMf~NT oP BUILDING CITY OF ATLANTIC BEACH - P ERM I T I INFO IAT I ON », _--- Lt?CA"F I ON I NFORNAT I OIC srmit Number: 17170 Aldr��s: 41 ARWELLA ROAD Permit type:ELECTRICAL ATLANTIC , EACH, FLORIDA 32233 Class of Workc'REPAIR -------- 'LEGAL DESCRIPTION -- Constr. Type:WOOD FRAME Bl S IC: cit: Tag, Proposed Use: Sectiow. 0; Subd:0 Rng: 0 Awed l incus 1 Subdivi i on:DC3NNER Est . Value 0.00 Improv. Cost : 0.00 Total Fees : 25.00 Amount Pa,` 25 '00 Date Ps, $ ork Desc: .. ------ � ' ��� R -;? �.. APFL I CA's I ON FEES E" 2 QO Cdr; D AT k ORTDA 32233 hone, etc � � CON BION lame: A 0.E. EL I CONS' C?RS .. JACKSONVIL FL 32210 .,. E00 0 + : NOTES NOTICE -INSPECTIONS MUS BE REQUESTED AT LEAST;24 HOUR'S PRIOR TO INSPECTION BUILDING MA'T'ERIAL, 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 TCS !LY WITH THE IIECNANI LIEN ;LAW CAN RESULT IN PROPERTY OWN NG tTHE i ,6 � O � .to tSUED ACCORDING TO APPAdVED PLANS WHICKARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR Vl& TION OF APPLICABLE PROVISIONS'OF LAW. # ATLANTA BEACH BUILD NGPAfTTMENT By: WORK III A( I IIc !I If, 1 n PAI( I III Itl'c1IOF, ANDII n(i(,ORI)nrl(;()1WI 1 I I(III IMI 11 C I I(IC nl. IiIIGUI Al1OIISnI! A l l nhI I If, (ICn(;l! Olil)INAN(A:S. 7/2 E EC l li!Cnt- IAHM: _---- nSIEI► ELE( 1rIICIANSIG_n1UIlE ----- - --- - - NAME _ _CgYZC -..W.(�► AOUIIESS:__�1 BLDG. SIZE --- --- BETWEEN: TIES. API, ( ) COMM. ( 1 PUBIJC ( I INO(IS. ( I NEW ( ► of.[) 1�(i AUDITION ( I I11AILL11 ( ! TEMP. 1 1 SI(;NS ( ) SU. f 1. SE II VICE: rJLW 1 ) iFJCIIFnSF ( ) I{EPAlll ( ) CONOUCIUIISIZE _. AMPS CUI'I'till ( /ICBM. I SVYIIUlf MI BI{EhKLIt 11h11'S EXIST. SLAV. SIZE Ah11'S Pl I w VOL I IIAULWAY FEFIIE[Is N0. ,IZt NO. ,, _ ,ILr. rJO• SI1I L I G I I I INc U1)1 LF I5 ruNCEnt_I:O EN OI - 1OIAI. IIECEPTACLES - - CUNCEAI LO vPl_N _ _ _ IulAt, IBV n1.11'6 I swI►t lley INCANIIESCEPJ f FLUU11E.SCEN I & M. V 1 IXFO Ar''P( IAIIC:F9 A111 ( BE►_(_ T IIANSr--. IIA I IrJ(; I1.1'. IIA I IN(; CUNI)I IIUtJIrJ(; C0101IIA MUIUit 0 11 M I MOfoil!; AMPS CEI(_ IMAI : KW II[:nf 0-1 - h1U1(JIi5 VOL rnt;E OVtlt --_-- r'lls No . 1ILP. VOLTAGE L MISCLLLArJLUU; _'Ir( Lo 111ANSFUI1MEItS: UNUETI (i0U V, - - - --- UVE11 GOO V. ---- - _ NO. KVn NO. KVn NU. tJEUN TF{nNSF. _ NU. Vn, �MA, MO ()If SIZE SWI Ulf FLASIIFII EACH SIGiJ I E0IIWn(11)E1) R I(ItnE f[I-S. CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS MOVING,DMfOLITIONS Owner(s) : �j ( l { q '7 Address: ""i Phone: U_ DC L `!1 ` ` v Lot #� — Block or Unit # Subdivision: Contractor: JQ"rmakk4L State License # G{liL Address: 4eG{fj J7L Phone No: .12<r�-IFF.57 City State /_Y Zi c Code 32'7V Describe work to be done: Present use of building: s� �lz l valuation of Proposed Construction:(, Sn Proposed use: is this an addition? 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 =U= (CGMMMCIAL) TWO (RESIDENTI.AL) COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, IIJERGY CODE FORMS, NOTICE OF CcmaNC-$ffNT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. 57'Q76 OF F4-0 9(.PA j country or .1w� Sianature OWNER: Date: l � Signature CONTRACTOR: Sworn to and subscribed before me this day of19 Qa FDL � l3(oS3-73'?-SR'�330 Q-�-y►� � NOTARt PUBLIC STAYE FLORIDA AT LARGE FAL iL W 623- (OI- 4q'S M11M�MM�i Maa�h�lc•�d1�piM! IIQ►� # 696T '•� k DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH 1 __. PERMIT .INFORMATION - LOCATION INFORMATION rmit Number: 16967 A drew: 41 ARLtLLA ROAD, { Permit Type:REMODELINO ATLAN' IG BEACH F}w,t?i LL}A 32233 lass of Work:REMODEL ..--_ 'LEGAL; I3 St✓RfPTI4N' ... . . _:....�.._ Constr. Type:'WO?OLD FRAME Black: List: Q PrOpa ed tTse: section: Rng: c? Dwel linga : 1 Subdiviii on.DOXNER Est'. value; 0.0.0 f Improv. cott : 9 x-304.00 -Total Fees . 0!.60 Amount P d* 0.0€ PT.L Dateaw I Arlt } ac" O VEMENTE _ > --� �� >' ' IATO � E w - time: CAROI E� 0.00 'q,,�, �y/y ATL �� A� '79 'LOR IDA 3 2 3 - �„�, � ,:.}`iAT off .L . ilo•Lae: �� � �� k� sp� y'1r4”" CON � Tt ;,r• ItMAT I ON €� me: EARN , E `CISTRON INC, _ 1 ddr: -447- T � ,C,., tUb : ., ATW TIO, �lExp FL 3 33 I r Is ! i" 't Ae2filx s�) '�• "'f.' �#rmx WibWrn^W NOTES. i I t NOTICE INSPECTIONS MUST BE REQUESTED AT LET;4,HCNJRS PRIQI TO INSPECTIt3N i 1 i BUILDING MATERIAL, RUBBISH AND DEBRIS FI40M THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,ANO MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR'OROWNER "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN f THE PROPERTY OWNER PAYING TWICE FOR .OUILC?INtIMP. l ROVEM. NTS " { ISSUED ACCORDING TO APROVED PLANS WHICH ARE PART OF THIS PERMIT AND SCI8JECT TO 14 VOCATION FOR VIOLATION OF APPLICABLE' PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT '1 v' FLA. 1947 LAwsIVAAYCO►on"Y• rs 713.13 'ter of J"CPAA.W OUPLICAT99 Co Whom it to mem V) The undersigned hereby informs all concerned that improvements will be made to certain real in .4 property, and in accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Cn D•suiption o1 property.......1. .......2. ...:. ��.............P.L.........�� c�0...........»�- c } ... ............5 «s ...«... ?,ll�...... ................. ........ »� ............................................».......«..»«.»....................................... .5.... MIN.....RETURN «......«...............«....................»...................................................«................................«..«................. oPHONE # j.......................»..».......................,....................................................«............................ ...................... o ...... n - � «.,.. .. General description of improvm•nts...»»......1` ,�,c� .......,�.Y : lis, :: '::?: .t.'A.........902%.».»..........................«......» « Dac# 98 197821 ... ...................................................................«.............................................................................«... .i.LtaA... ....Ree,crdL tt........................... 08/13/98 ......I.. .................................................»................»..............»...................................................................HEhtRY...W12:30:00 00 R.,M.............................. ... CLERK CIRCUIT COURT Own•r.... � c�.o.....................} ..,.......... »C ............................................... CAL COUNTYs....EL............................ . ' "re ipA F,, S�.»........«.»........................................ Owner's iN•rest in site of the improvement....... .......«................................«................»..»............«..................... l c fee Simple Title kidder (if other than owner) Name...........io...............................................I........................................................................................................................................................... Addr•ss......«........................................................................»...............................................«.......................................................«.............................. .................................................«.«........««............................. AJ&"&....Lj ,.1.«»:..1..'.t.S:tid f..........L. «...... .4. ......«.5.............«T..l.�» a.��:«.»Yl..�.�.»��....«1......4:..............« ` Surety (if anY)..»1 .» ......«...»........................«............................................................................«......«........«.......«................»».».. ..».» I►ddr.ss......»»«»..»...»»»...«.......«».....«.«........»..........««......................«............««..........«................ nlow of bond $...................».......... Name of person within the State of Florida designated by owner upon whom notioa or other domn&- s may be served: ............_..«.».......»......... ...«...«....».....................................................«»................. ..«...............«..«.«...»..»«...............». Addr•sf.............. .....« ...............»......»..«....»....«.....«......... »..............................................»................................»............................................... In addition to himself,owner designates the following person to receive a copy of the Lienors Notice as provided in Section 713.1311) (F), Florida Statutes. (Fill In at Owner's option). ............».....»..............»........«»...............««...»............«..«....».........«...«....«.»..«...........«.........«........«.......«..«»..«.......«..«........... Address .• •�Acs.►owi�cono.............................................................._.._.. ...»......_............... «».»......».................».._...... an-e wss ONLY t ti. f>ou" noon lank► WAIN*CPTj Loentfle �r.:...� cow.."MR.emu..a....sea --------------------- A --- - - ---- --- Bath- __� i�..�`.s`._ �_� _ _r_-««.«_ _-«� ._-. r •__---- --_T_14.�__ «(..'.�.�'�.' - - .................................. 3"INSL.w caw tielwm%CAr.fmm a►..rate. Nno w stirs.:?u. Knout AT VIKOW r Bathr.. f�,BA�I.S� --------------- --- --- Datt►to to aaea.wri a�Recessed;mar w._..... ems.._ ~:number ?n-;��► ;material---� .__;number ---.------.--.�---- ------ -------- --------------..r«_._. _r-_--_._....... __._««_ --------------------- -----___-- --- 3L rWMtMIM: FIMM Names t eel"W IeAM 1[n r Farman Iaeetva Atior No. (WM i,avatory._ _ .« _._1_ « t8.' d-.._- _«S ! _ _.-_-.« _ ..!!__9.9 ..«..._______«.-.-.«-- -_-•-- ........ ..._.... Waterabaa--r--r -- r M_.._ __'_• 0 _.. #s./�44-•—•---««.._-_•-_«- ------------ -------- ---» -«- B athtnb_...__�-« ........t � STAfl1�B► .P__.U f--------------- ----------------------- 31xow+er over tu1►�.__ - "-------- - '.«:._._._.«_.___«"..-- -t l..Jt4.i_Q------ ----------- ---------......... ....... ....... stallabanrer'• -- -- --- -- - --- -------- ---------- -- --------------------- ------------------ -w_ Laundrytrays..-------- _.._ - - --- --»noon--• - _- ------------------------------------------ ------------ ._�. -------- ---- - ' 'Curtain rad . '•❑ Dow o Curtain rod W&Ur supply.. inaividual disposal a, C; Ca munity system;Wit► D❑individual((private) system.*3- Gam/ 'k' - * sad"w*s itwitF� "meat in a«.plets detail int&"#vt.draw"Ws tied speci;toaft to rog'Wr Oeftte. Boors drain (Inside):g Cast iron; O oe: O otbor--._.- Bones sewer (outside): ❑Cast iron;%tile,0 otter........_........ Water piping: pt Calvanisrd steel; O copper tubi; 0 other -...... .......-._--«_.-�..................« Bill cocks,number.....2r-_ Daraestic water beater: Type _hU19 AALXIC.-- -__._; mate and modely a�? Q uBLl ..1mL7i ► ki:C.....1t:j�L_._ -e to (�i.9SS..1.thL cR..SZ�1E r�__.....; capacity____-4A_�a1ww recovery --_---_.._...«. �p�h.100• rim Storage task: Maternal Gas service: 0 Utility a wspany; 0 Ii%pet.gas; ❑otber CAN piping: 0 Cooking; ❑ bonne heating. Footing drains aoanedad to: 0 Stioem Mover: o sanitary fewer;o dryNN L Sunup pump ----..«-- .«.»-_-- ._........ .._--...«—_ noon. .—. --«.«_.. til. WATWs: Blot water. 0 Sbsam. O Vapor. 0 One-pipe 87stem. 0 Two-pipe 7utem. 0 Radiators 0 CauTeetors. O Baseboard radiation. Make and model---------------------------- _-_----_---------------- Itadtsnt panel: 0 Flo';O wall;0 est Panel 0011: Material-------------------------------- ........--._ ..............».... _ ❑ Circulator. 0 Return pump. Malta and model ---------------------------------------------- .._--; capacity »--- - SOL Butler: Kelm and model -. -------------------------------- Output.....-r--------Btnb.; set rating -----»«-----Stub. 'Waft air: 0 Gravity. 0 Forced. Type of system.«.....-......_------------------------ Duct - -----------Duct material: Supply__._._...�._...-•i return r.-----_._«---- Insulation thickness ------ ❑ Outside air intsk e. P%u7u -. Make and model -.----.-_«-..............--------------- Input - -Btuh.;output..... ---------- - Btr�b. O - Space beater, 0 >�tnrnaae; �wai1 beater. atu -Input-1� .�.1: _r- h.;output_.,..i'� L"�'.Btnh.; number units Make,mode ���..4 __ -. .� _...... .. '. C.' s� �"`'�'+' 7''Mat�eared tyleef .«__ t'�':��.�'.3C_.ar.,'_-Lti_/..___-. -�" ...L��«.�G.:!`_as._---«J. ol_t►:L.._ .Gi_Lc�.+ ... .....— ---------------•-«_ --'----- ------------------------------------------------------------------------------ _ .Fuel: ❑Coal; ❑oil; o res; Cit 119•PeL 9"; O electric; o other--- --------------r_ ----------; storage capacity Firing equtpment furnished separately: ❑ Gas burner, conversion type. Stoker: 0 Hopper teed; o Din teed. Oil burner: 0 Pressure atomising; ❑ vaporizing ------------_..._-...-«......................................................... _.«_«.._..__._�.. Makeand model ---------------------- ----------------------------------------- Control --------------------------------.-.................. ._-._.-_« _. _--- -_ -------------------------------------------------------------------------- zleatric heating system: Type - ------ InPut __ _.. . .ratter Volt*; eUtpvt .._,_. _ _Btast►. --------- -----.._.r ........_.......-_.«. `500 r DESCRttWN OF MATERIALS' ,�. d►T,oN: � . Loc►�low Ts M KA"MIL.A.T"%AM VWM"or 116"AU TMW Y.ros a..UNe W!'iaololr... s > ; ceili � .... ...~. .Fi .:ck4at . ss ---- - ------------ ---- .-- ----- ------ -------------------------------------------------- -- - - ------------------ ----- - ---- ------ ------------------ - . - - - V. U Mc""Nousk (ce+asy WOO dIV4U%#iwataridth,4q19fpW*% erW"trUoNaa hams not shown ol"whara)--------------------_. Q-- -- ---- - -•------•---------------------- - ---•---•--- - -- . "as :�_1 _.. _.._..� :.,.. ! . -.---•--- ------• ---•---- - -- --- -- - -------------___;.. ,�.i:..•--------------- . •--,.�----.------------.-- - •---------- --•-------------- - - -------- .-.-=---- _ .._...A_- • ---- ---- - -- . ----- ------ -- ----------------------- - --------------------------------- NAMM/ANt (Mwk owF&d..•d )-------. .---&IA.QY). ! +._"�.$�.-= -- - _._ .. - -------------------------------------- .................................................................................... ....................................7---------------------------------------------------- ... ...... ....... ...... ................... ._._ _.... --- ......-•----•. - .. .......................•....................................... .._......_..----.._.. _... -- -•- -NOAL IQWYOR: (Ifek sMhdd w s>rh a d oedW-) vognman bliaia .. ... » _ Number ............. Autacnatie washer........z...................__........ .. i<%dwm rsgp.*.LL .. ._'3i2--J lid.-,.GLS,...- ------------ Clothes drier- - . . -----------........................................--- ... .:.....:...»..._.»...:Y.�.��.--......... Other----__-------_----------------------------------------------------.. Dishwasher :-_........- .. .._....... ..............-........................................ Garbage-disposal emit ----------- -- .___•_.._.._. __........ ......•-••--•--•---••------••• .......-•-.. .._.... ......... ---•.. ___..._» ......-•-- ------------.---------------- ---------- - - --------- .............. .._»._......_ ----.------------------- -------------------------------------------..__.._..-__ ..... ..........._------------ -------------•--------------- -----------•----------------------------------------------------- -------------------------------- IIIIIIAM ?4_/0-.-.)P ..................._.........•- ---- - -- ........•..._..... .. .--...-•----.._ ........ . _ - -_......................-..---»__-..----------•-. ...................................... _... ------- ------------- --- -- --------------..................._. _.................. .__....� »..._.__.,.-... -......................_....._........-.....__._......................................... . ,,,,...,�......_.. __ .. .....»........_...........-....... ..........-------••---•- -- ........... ----..---•- wan An "* wAYfs Width...A.°— ew material............... thbloww..... ... Surtading material......._4:°-^!.�:... _.;thickness.4 -', nftt walk:Width_+_I Mstwial S_o!i .: . .;tltidonae..4.01Ser ioe walk: Width------ Material.. . .. .;thicknow. " Ob": Material tread. _. "; risers........ Cheek walls----------------------------_.......... ........:._ . _.�.,....:..� _ -....»_..._. _... _-............... ...•-• •-•-_.. . -_.... ..._ ........ 5 s wd dooff i rieoehssws, hw"of itams such ar Umos st r"dtup, d"insos O teteh " rvtnisbey we"twwR s+ 0e.� ►s ++s•) :....� -•.... .-K_,».................... ._...r_.__._ _._---•._. ........------. ---• •-------- --------...._... ...... -..»r+-ww....M.._...:w .-_- --------•-..... -1_•••----._ •--------------------------------------.•..............--•----...-----•------ . ._....._. ...-........--- ...-.�...---- ..---•----------.•................-.---------•-•---.....---------------•-••----.......... .._.._ LAMSCAPW*, lL&"W, AND"N" itlAIN"& TOWU , ''&JAi0F>arA yard;0 W&ink;0 row yard to ........................... feet behind main building. — sem- Im... ti:wt lh,.nt.nd------------- it side v._..................: SL w►r yard ar.1._........ __..... 1,A1 CITY OF A[-I*At,I'TIC BEACH COMPLAINT MANAGEMEHT SYST[ :1 TAKEN ( date/time ) : CCHPLAINANT : Last Nam© First Namo ADDRESS : - CITY/STATE/ZIP: TELEPHONE: COMPLAINT: . LOCATION: PROPERTY OWNERS PHUNL: PROPERTY OWNERS NAME: DEPARTMENT FORWARDED TO: COMPLAINT TAKEN BY: DATE/TIME: 'OFFICE USE ONLY INVESTIGATED: (date/time) ASSIGNED DEPT. /DIVISION: INVESTIGATOR: PRIORITY: CONDITIONS FOUND: ACTION TAKEN: CCHPLIANCE:, t, TES . CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS e DEMOLITIONS Owner(s) : -f- Address : Address : �� ( <��� �� _ .1c;� Phone: � 2- Lot Lot # Block or Unit # Subdivision: Contractor: Address:/c� t � � �r . R �:a� i� Phone No• a Describe work to be done: -i ��., ',.jr 14,F .-- ;��1, 7- DADns� . 'a f o v cls cL i ��'v�4 a / Present use of building: Valuation of Proposed Construction: k' 7 7S-: Proposed use: ` Is this an addition? 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. Signature OWNERuw� Date: 3 Signature CONTRACTOR: Date: PSA-3844 ` 338 DEPARTMENT OFA;BUILDING CITY OF ATLANTIC BEAC14 ^� PTT 'IN"rORI+iATION -� - LOCATION INFORMATION ------ --- " ,Unb I . �' 7336 Acldres : 41 ARDELL , �ROAD, Ty-pe':! BUILDING ATLANTIC BEACH, FLORIDA 32233 REMODEL I4EI�At� DI SCRIPTIO*` ,..._w in t. .g'�'. "TY.p� WOOD `FRAME Lot ' $l oak: �e�t i ozY " P !fid t3 e� ' IVGLE FAMILY 0 I Code: ° 0. Subdivtsl,onDONNER Value: $7075. 601 'a Coy t~, g $0-00 i,.. A. tt FeS .00 it 4 3 S, RE'AI.t rt O' BLITaATION 7 ROOF sHINOLES A.t �1�k �iilfr ��...nr y. w,r aiw .w.�.w..w r ERM I T a{1 P C� ' ' .. IDA. $� . . f W ATER METZR,/TAP $0 .pt? ADON, GAS-H $0 .00 CGN 'RAC. y ON API"T > IMPROVE. 0 .00 Ia ,; 8 1_UT"kt S ROAD BNRR "TRAP 0 .00 ADON L 2207 YDRAU IC SRARE SCI .0 en :e b Elouc CONNECT ION $Q 6 I`IOTES r, NOTICE--ALL'CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE 00 ISSUE. BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "'FAILURE TO C�'3�kAPLY WITH THE II�E!CHAN CS LIEN LAW CAN RESULT IN Tii PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS." iS UED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS, PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT SER -G j 1993 Py. �""' .� City of Atlantic Bch; FOR OFFIICE USE ONLY Date pl D J...Fee ......19 .V./$ Permit #................. 7 d S CITY OF ATLANTIC BEACH Valuation $...... .......... ..... ..................... FLORIDAHouse #-----•�I............•••........ APPLICATION FOR BUILDING PERMIT ••••-- Application In 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 Cty of Alantc Beach, Florid , and all ons of the Laws of the of Florida, all dinances of the y of Atlantic Beachi iand all rtulesia d regu ationsaof the Bulding1Depart Department of the City of eAt antic Beach, t shall be complied whether herein specified or not. ding Permit is automatically responsible r regard-embarrasment ascertain that all sub- The Contractor or Owner-Builder who has been issued a Buil contractors tintermediateengaged nlicensed oBeach,f Atlanfic . To prevent ida or final inspect os it insuggested that alist of sub- ntra Ing orsrdelay be submitted to this office so that licenses can B be verified. Date..............................64-..1."=....!l....................... s Owner...............................p .Y./Y.. .................................................Address.....ff/........... .A? �.�.fx.. Telephone No............................. Architect................................................................................................Address.............................-----..........................Telephone No............................. Contractor Builder............/Y 1.R..s.1.tg�/F. 5...............................Address......&. 4..L.S:. !.t.� !f.. .taTelephone No...'2.?.L..G..S �.Y. Lot No..................'Y............................. Block No......./...?...................Sub Division......... .........L{ :.t �..j�' .......Zone................. ........... /4,B ll.d 4 tr.f.9...........Street............ . .......:Side Between.....AW..Y.�P..AA-A.........R-D.......and......................................................Sts. Valuation $.... .S:.Q.F.t.�..Q.0...For what purpose will building be used...bAv...!'k#:/.•/1..........Type of construction...h' A-.5,91V.. •.X....... Dimensions of Building...2-4"..A...1A...........Dimensions of Lot..... ...1.1..5..:.Q................:Size of Footings....�'....?.(..Za................. Size of Piers......."'.......................Size of Sills................................Greatest Sill Span in ft...........................Type Roof.-COAI.pf,.3S........... How will Building be Heated?.Gay ee.�• a.•%! �?I•r:'4 =., ttbF.Will Building be on Solid or Filled Ground?........ ................ Size of Ceiling Joists......r.4A.53AF5............ Distance on Centers.........��.............................. Greatest Span...... .......•.....•.......... Size of Floor Joists...............................................Distance on Centers..-....... ................................. Greatest Span............................................ to toSize of Rafters............................................. .................................... Distance on Centers........ .................................. Greatest Span............................................ This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing. W x 2. When steel is in place and ready o pour columns and/or lintel. z a 3. When steel is in place and ready to pour beam. 4. When framing is completed. 5. When rough plumbing is completed,and ready to cover up. W W 6. When septic tank drain field or sewer is laid but before it is covered. A 7. Electrical inspection by City of Jacksonville. W � 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for rafter corrections are made. FRONT OF LOT 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 specififttions, which are a part hereof, and in accordance with the building regulations of the City of tlantic Beach. Signature of Builder.. ... .�.:.P" #. :gc :*s:__ ewe...........;........." Address..._G.s../.5� IG.St� !- 4!�,---dRX--•-F�'! Signatureof Owner. . Address---------------------------------------------------------------------------------------•------•---- Is�aiwil C alnla�iaa DEEfrltrTION MATERIALS ao. ................................... ....... .. a*be hum"014=4 or VA) U Gi11111C M) 'row arddrsu .... ... ......... . . ........ City ................................................ State.................. � ► a SPOOW». . .A:,.:.. . . .J11 :f;......q Q.t. .... . .... .. ... . . . ... ............. Caltiwctor Or Sdddo o ......... P. ?.. 1.1-A:C.: .................... ..... ........................ i�aima) �........................................ INSTRUCTIONS 1. Pw own* -W i"FameNom em hw#A form it to be,mebmritlad, mamba wish er► rogrir amoot be ommoklorea wdsii spaCiiieolh dger►bsd Of"pk% sk« see the W0118ASIN ypisaile h Na 'f:FfA Applioetiem fw k leelydt as oltarmetas, "or ogmr, phrom or"be. aeahadistory awe�bRosx. (tow MAartp�s iw ►ee Roga!rfey Ds of ltsuseb olo Vadis, sideretwo of a foq"O far omaptoom of rboituft wtek iob of "mpwI M the b,�d ►Mrttwlod.l � ' !.Orsipibs aM i�eh►ioh end �it bs'wad. aibetbar er met shasre aR tbs dninrie�. by�ee X '04 ep�ropriela oho 4mm ow oMorinf i. Mslrre �i9wdwa rogMind et Mo owd of this form. *0 imfoemretier►a�o+�fa aoah goes. Irv**"is inedsgwto,sefu"&s k Tho eomstrnetien "I busted IN Compliance with lbs ►elakd mwe."Card lamribr wader it"17 or ON on if -t-d Asst, drowinps amd sposNi GOomm,oa d dwias pme sins. TM spaci$cot ens & We" del r dssarled or demes will so/ be sensidond W&U inchrde"Dosaripti"of Mrtsriels aid 6a appUoAle Minimum Condmfioa agoi►od. whop th th W"i mom "o"Wh t "m be ammo& rll'ort asasodi" Itsgw►amsak. 1. RX"%'AT OMs (/ -..r. .--««-.«—««----- -«_-«.-.-«--»_.. . --__-..-.-«_ __-_---«..---------------------------------------------------------- 2. «_-«.»«« . -____.__ «»__-_-»-» --_» . 1......«........... Reinioreine. -------�. k--4----�----•--- -«....................... Foundation wall: MaterialLO C_&.......... ..._ .. »- -__--- interior foundation wall:Material Party foundation wail...._ ....--_ - ._. _..... _... . , Coltmmm: Notarial and dee--------- Plars: Material and reinforcing------------------------ --- --.. b hOm: Material and sbas ». ------ «.................««�� sills: material------ -------- -------------- »-------- -- - Bsssment entrance u1sway «« ......... ..........-`-.... Window areaways_- ------ - -------. -- .. - - WaldrProo"C AAW..r.-.. . L9.t4-Bz_»............. Footing drains. .. ----• ----- ------ --------......... Tsrn�itep:oteep+oaeSl�7.,.1. ?Sa ScstblA�SSi�.�.A ._Sx_._ _. l.s�t- : ------------–---- --- ---------------------- - - Saaregeallees+spsmGround scrap......«....« ............. Insolation............................. Foundation rent -----------–-----– SpasITos datloaa «-...«...w..«...-«.«.-.–...................................«......................... ...............----------------------- --««-«_.«----------------- ---------------- --------- ............................------- ------ -- ------------- -------------- - ----_ ----.-_ – -«------«-•-•---«-------------- - ---«---- ---- i. C"U" tTit Notarial ..«_...« « « «. .._ Prefabzieatsd (wake Cad sits) _ -- -------«-« Plus lining: KataW_ .._..«. _---_-».._. Beater Plea dam.............. ...... Fireplace due also« ..-- `AmW (material vaad,sW): Cama or oil bestir................. ..,...«........._.-_« .-..... Water beater........... .._. «.» -- ----------- ---«....._«.....»..................-..._.......... .... «..�._----.... ._...-- ----- « » A. R�lLAR�,i Type:©Solid ftd;O mus;0 circulator(m"s rad sirs) .----«_ - ---__ - Ash dump and clean-out.._ ... Fireplace: Facing ....».__ _, Smog _« ._ «------;hearth,..: _»_ ..w...._._; mantel...« _ ........ «« RliTuiwl� _..._.. . .«... .__«.... . .« .. _.«.«........ . ... .. . wnl,w Head fracas:'arads aed speoisr. ------..».............................. 0 Corner bracing. Building paper or felt �--- -�_--_«««µ_---. e tttiag----------------'C-------«.;thickness ---------;width-_. ... _.; © solid; ❑eim� ------------" o.C.;�-]. agonal; --------------- Siding--- ................ grade... ............ ; type__._»_- _, mise---------«•-«;exposure- , -.. �" e""'g---------- . _ _..« ----- -..—.; seta►.- - -- .; type.-_...._«.. .; rise ..--_--- exposure._..._.....;fastening. ---. ._. Aft WMaaoasyveneer ».. ..........«.......«................... LiAtei. 'aa. M. Mosenry Facing A"—; thick.... backup»««.. _....-...»-_..r ,I' •.— -_»w_- Door sills..N-WC5- ___-_- Window tills.mow 4M�.------t'.-Qh ...�is....... Lintels-__---.�Q.�.�.a._�_�.----L------- ------- taterlor aarfasrs: Dapprooass. coats of ......... lnrriag _P1.:Ij 1 LX.1-1-------------- _ Ilaadsrlor palatines Material._.Eli. rf.------.Lam esu-7_ .Qr'N. ........... - -------------------=number of coats t,'1"waU contraction:p Same as nszfa walls;�other..,e� ..'»._..�L .tfr P_A.�..�.hQ�.��?7_�,�t1c'.��----------------------- - « _-----_------- «-------------------------------------------- -------- -------------- -r................................................... Jobs: Wood,*rads and spe—«-------------«-«__._.__;other._._..._......... .....«; bridging ---------- -----; anchor------« -----. n .t.s.. rn sa......-_a w...... ea a_.r W...d ........_.A...��_.�. rj . _j_ 2 SAA or.( . lie, ,o- t DESCRWYM O MATNUALS . '. 1. IXRt!Ilow RRAMNiIit Studs:Wood,grade sad voclas 2. 1,12 Sive and spacing 2x re! g si,• Ot1we 2 x d 14" o .C,, Joists: Wood,trade cad _.....«_... Other. 11 NOW 111"INi: laftsrs:Wood,.grade and sped:: ._ ... Roof trove (see detail):Grade SW spse1e841_.2.P. I IS IL ROOPUM $beiathirtt: Grade and:pease:_:«.G�!'----- `yo_««M',$�....«.;sh. __4_+_... .;t7ps _»_•_««: solid; O apaeei •,ae. .aWl......_ _;weiR!►t or tbiekoW?.35_-;'aim*..._...... ;fastealn�. Stain or palet .._..«._... _..:.. __»�« Underlay ._«„_...____.____. _«...:__.» „ „-•-- --...__»».«. Buiftoap I M nibs .«..»«»: __ number of plies----- -;surfacing material Plaakfar: Material _._..g1..UA1�UlAl«. -- _-- .-; gate or weight ❑ prove dope; 1 swan gosrdr ...._. .« .___._.._ ------------------•----------------------- - --.»«:�__ 1I6 611TTIMS ANTI 001MNfMOtlTiis Gotten:Materialgage or weight Dom: 1[sterIal ---- -- - -:pts or weight---».,_�..;alae......._.»:.«t stupe number Downspoub connected te: O Storm n+ww; O sanitu7 rawer; p dry-wall. 1 Splash blocks: Katerial and sive Mdr.a_-1,4t:. * 14. tr/1TN /1110 p1.A:T51: -' -- --------..................... ............------ lAth t” walks„0 callings: Material�_.._....--« -i weight or thickness.. ..__._.. Pltrter: Costs--; Dry-wall 11 walls,19 milia s: Materw.�.Y.PStli&.—.-;thiekosso_ilk_ .;finish AAMOXA—».:_;Joint treatmsro Z 4 .. ..,....................... .»_...».»««_. ._._« __..«...._...�_..».»..«...«..».»_-- - --- ------ IR OD00"IS ii (PeW..s0ppr,sic.) toe.o WA"/UnM ane AsruM" assw::e lunge MAismuc Am Awwvma 1i.1NTD1110R AND TD1Ms »"..�. _ «.«.» .,_ ___._.� »_._«....................... Doors: Type ; Mtww .._.»1QQpA.. _« ._» ;thickness.Ay_a' Does trim: ; material�1i 0012 Base: 'type tiMIL22 L.-;material .YL ft ._..;sine.1A.A: tlx: DowniHil.l.Ai.. .:»_��ARH t 13.. ; trim Other otos (oes:,twe end le"M) 47. WWDOWSS Windows: Type..AVj b11.N.tl.««.;now wh thickness---------..-- Gkaw: Grade ___2 ia., 5:...__.; D each weights: O balances,type ----------------- ----.- bead llashft -------------- Trim Type _. ; material - ...... Paint------------------------------- number coats Rsat�wrnlrippfn�: Type Y1tkY.6 material------ ----------- ------------- Storm each,number saams: Tall; O half,;bM•.-------«- -. _.-.------; number--------- _; sProw cloth material 4WAA�L..... Dns ms"t windows:Type_ »_.... «_._;mahsial .._»««»._---_--- -; ❑ecreelu,number.......«.; ❑ Storm sash.number..... Sadat WhWI ars _ ._» .:««_._ ' ----..».»---------------. «. .-... ».»......_«.»._«»« 1 o�itrinoa :>IRiatterLt:..YL tD..............;widttr.3° .;thiakruss l ". !'rams:YaterW-WDM.;thicksw ." Otter entraua doors:I[otp'ia1«..«1�........»»«....;width».�s.b .;thiakmess..1�t". Tr�asssr I[a0irxlal n.«..»!:««.;,thilioaell/. ' Head flashing,.......... .......«.««« » Weatheretrlpping: T7Pe.U'.Btl1&„..Eti;QtiZJL .; saddles. .i tAl........„..; Map -doors:ThSskn ss A1' $«";number...i..._..;scram cloth malarial."Ullits.». Storm doors:Thickness-._00;number Coartde:aaoa stem and sarson doors: Thickness_.....";number_._»..; magma clash material ......-...._......................._._............. 8>v*n: ❑Singed;X ilws& kl'd t p«.« _ wQXXQ....«_..................... Lon na .....VaGt ta.L3«. .. ..«.....�.. astario�r millwork: Grads arm species..,,.....�1....�s�s.L.i..._..«.«.. Paint RA-1.16....U.lt�'�C.l...._...«-....; gumbar•eNq.�i. .............. .............................................................»...«..........«..............................................«_. ._..«- IR CAINIM AND WTil M MAlht b 111itahan eabb"ta.MW units Material ViAO1L..:..Ed.47jQJiL ...rAMQ.ti—....i lineal feet of s Wvu«.....«.«:abet width l.�e.. r � tie.'• - _. � .. z a N i V , w � 'x t<s, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000651 Date 5/24/10 Property Address . . . . . . 41 ARDELLA RD Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ----------------------------------------- Application desc SERVICE INCREASE TO 200 AMPS OVERHEAD -------------------------------------------- Owner Contractor _ ------------------------ CHRISTY BRIAN LIMBAUGH ELECTRICAL CONTRAC 200 15TH ST 42 WEST 8TH STREET JAX BEACH FL 32250 ATLANTIC BEACH FL 32233 (904) 241-9051 ---------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . SERVICE CHANGE TO 200 AMPS Permit Fee . . . . 105 . 00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/20/10 ------------------------------------------------ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ----- Permit Fee Total 105 . 00 105 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 105 . 00 105 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach,FL 32233 Ph(904 247-5826 Fax (904) 247-5845 / JOB ADDRESS: 41 G rde I In I ZU PERMIT# • NEW SERVICE Overhead ❑ Underground ❑ Underground up Pole ❑Residential(Main) Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters ❑Commercial(Main) Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps Conductor Type Size ❑Multi-Family(Main) Service ❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE VO�ps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps ❑200amps ❑ amps ❑CT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-30amps 31-100amps 101-200amps Appliances: 0-30amps 31-100amps 101-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS ❑Swimming Pool ❑ Sign ❑Smoke Detectors^Qty ❑Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans &Fire Alarm Checklist) Qty volts/amps VALUE OF WORK$ REPAI /MISCELLANEOUS // eplace Burnt/Damaged Meter Can ❑Safety Inspection /C�Panel Change ❑OH to UG / ther: l l jl d 14 ��eol period or work is suspended or abandoned for six months. I hereby certify that I have Permit becomes void if work does not commence within a six month read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. �t Tl � �C3 t,RUSYJ (rn Phone Number �41—L441CA Property Owners NameC I _ Electrical Company_ LI 11( � 4-+�__ jq tr ` e Phone CiC 4-Z-q1' 1� x , i f rQQ City A�I �(1� iC"�c Mate"FI Zip'l2� Co.Address: 42- License Holder(Print): State Certification/Registi s&Ynn7. ,9-6 Notarized Signature of License Holde Swornand subs ibe bef this �� day of 20 I� Signature of Notary Public. LCA� 0 A &4