Permit 539 Atlantic Blvd Ai� MENT
1 0
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TJO NO
CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
JOB LOCATION: _532 Ail,-;,n7�'c_ el
OWNER OF PROPERTY: Ar,&ftl -*"I 1/10:�
PLUMBING CONTRACTOR [),f4 rk W_
CONTRACTOR' S ADDRESS:
STATE LICENSE NUMBER: TELEPHONE: --v.V,9�,-2'0 yo
HOW MANY OF THE FOLLOWING FIXTURES INSTALLED
SINKS SHOWERS
-LAVATORY
F WATER HEATERS
BATH TUBS DISHWASHERS
____PRINALS DISPOSALS
CLOSETS
:::z�.WASHING MACHINE
FLOOR DRAINS SHOWER PANS
OTHER
TOTAL FIXTURES: x $3 . 50 + $15 .00
MINIMUM PERMIT FEE - $25 .00
SIGNATURE OF OWNER:
r�_l C-171-
SIGNATURE OF CONTRACTOR:
.4L
-------------------------------------------v--------------------
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE.
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - ( 904) 247-5826
SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION
PRIOR TO COVERING UP - ( 904) 247-5834
CITY OF
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(W4)249-2396
April 26, 1985
Pre-Service Section
3rd Floor
Jacksonville Electric Authority
233 West Duval Street
Jacksonville, Florida 32202
Peraft IY4435 - 539-A Atlantic Boulevard, issued to Brooks and
Linbau&h Electric Conpany, was addressed incorrectly.
Please be advised that the correct address for pernEt 114435
is 537 Atlantic Boulevard.
Since];4y,
Rene' Angers
Planning & Zoning
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
0 ATLANTIC BEACH, FLORIDA 32233 to 7
APPLICATI N FOR MECHANICAL PERMIT CALL-IN W111
/FtR
IMPORTANT — Applicant to complete all items in secxlons 1, 11, 111, and IV.
Street Address:. 5- 3 51" jef—
LOCATION
OF Intersecting Streets: Between And
BUILDING
Sub-division
11. IDENTIFICATION — To be completed by all applicants.
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 attac4d plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards
of good,-practice listed therein.
Name of Mechanical Contractors
Contractor (Print) Master
szo
Nome of
Property Owner 7-a A o 1_5�
!!*Aafure of Owner Signature of
uthorm-ed Agent Architect or Engineer
III. GENStAL INFORMATION
A, Type of hoofing fuel: B. IS OTHER CONSTRUCTION BEING DONE ON
E3 Boctric THIS BUILDING OR SITE?
0 Gas—(3 LP [3 Natural E3 Central Utility
IF YES, GIVE NUMBER OF CONSTRUCTION
C] on PERMIT
0 Other — Speek
IV. MWKAWWAL IPUIPMINT TO U INSTAUM MATURE OF WORK'
(Prowwo complete list of componooft on back of this form) 0 Residential or 11 Commercial
(3, Host 0 Space 13 Recessed 13 Contmil 0 Flow 0 Now Building
C3 Air Comittioning: 0 Room 13 Control Existing Building
13 Duct System: Material T hicknon— Replacement of existing system
Maximum capacity cf.m. ow Installation(No system previously Installed)
0 Extension or add-on to existing system
n Othe r— Specify
Q CAolinq fewer- Capacity I-pi".
0 Fire Ilprialiliers: Number of hee
(3 Movalor 0 Walift 0 Escaleto (number) THIS VACR 0OR OFFM UR ONLY
C3 G*Win*PU P-9 —(number) (RoeskW)
(3 (number) ItemeAs
13 LM contaim (number)
a Unfired prossure yaw
Pormi* Approved by, Doto
(3 1*111M
011w — Specify Pormit
PDT ALL EQUIPMENT
AUt CONDMONING AND REFRIGERATION EQUIPMENT
AM*Vbg
NUMber Unft DantpU04 Ko"NUMber Kwuractuff
a 2 v 7 r—,
54 2-:2- 44
CITY OF ATLANTIC BEACH
PLICATION FOR PLUMBING PERMIT
OWNER'S NAME /)A)
LOCATION C/
MASTER PLUMER �f
STATE/COUNTY OCCUPATIONAL LICENSE NO.
CERTIFICATE .NO-
'10 2-3 .
CONTRACTOR 65fita,_
TYPE OF BUILDINGLa�6 &JARLLZC
-SINKS _SHOWEKS
JAVATORY -L-WATER HEATERS
BATH TUBS DISHWASHERS
URINALS DISPOSALS
-CLOSETS WASHING MACHINE
_2,S_FLOOR DRAINS LOTHER
ITOTAL FIXTURE COUNT
INSTALLATION OF' PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH.THE MOST RECENT
EDITION OF THE SOUTHERN STANDARD PLUMBING CODE.
CITY OF ATLANTIC BEACH
APPLICATION FOR BUILDING PERMIT
Owner ini'm D C-A-R__-, Address '5 3q 0 Aflo--4;c D Yd, Phone
Architect - Address Phone
contractor H64_)1,o_o, Address2O. 7_� 3q IVRf)"�- Phone,'4/-
License Number C 6 5gt�� - Expiration Date
Lot # Block # Subdivision -Zoning
Street Between and side
Valuation $ 16t eVd Ad Purpose of Building&�-
ALjrA)lt Type Cons t.
Dimensions : Building -Lot Sz.Footings
Sz.Piers Sz. Sills -Greatest Span Sills
Sz. Ceiling Joists Distance on Centers Greatest Span
Sz.Floor Joists Distance on Centers Greatest Span
Sz. Rafters Distance on Centers Greatest Span
Heating Solid-Filled Ground Roof
Flood Zone If located within a FLOOD HAZARD ZONE fill out
reverse of this application.
Inspections Required:
1. When steel is in place and ready to pour footing.
2. When steel is in place and ready to pour columns/lintel.
3. When steel is in place and ready to pour beam.
4. When framing, mechanical , rough plumbing and fire place
is completed and ready to cover up.
5 . Rough electrical,.
6. Final inspection.
In case of rejection, reinspection MUST be called SETBACKS
for after corrections are made .
In consideration of permit given for doing Rear Lot Line
the work as described in the above statement,
we hereby agree to perform said work in
accordance with the attached plans and rn
specifications , which are a part hereof, and
in accordance with the building regulations M APPROVED M
L
of the City of Atlantic Beach. t_1 CITY GF
0 0
rt rt
Signature OWNER
Signature BUILDER
Front Lot Line
ADDRESS 1-11ECHANICAL PERMIT#
PLUIBING PERMIT
BUILDING PERMIT WORKSHEET ELECTRIC PERMIT
TEMPORARY ELECT.
Heated Square Footage loocoo,L L/n @ s Per sq ft = $
Garage/Shed @ ____per sq ft = $
Carport @ $ per sq ft = $
Porches @ $ per sq ft = $
Deck @ $ per sq ft = $
Patio @ $ per sq ft = $
TOTAL VALUATION $
r 00
A $
Total Valuation Data ist $ ,2- Of 0a e
6f (/."Cv $ >2
Remainder Valuation @ $ per thousand
or portion thereof
TOTAL BUILDING FEE $ L5
+ 32 FILING FEE $
FIREPLACE @15 . 00 s
TOTAL BUILDING PERMIT $ 0
--------- ------------ ------------------------- -----------------------------------
?LUMBING PERMIT FEE$ MECHANICAL PERMIT FEE$
'-LECT. TET-1PORARY $ ELECTRICAL PERMIT $
,J'ATER METER SIZE ACCOUNT NUMBER
;EWER IMPACT FEE $
JATER CONNECTION $ (@10 . 00 P-er fixture unit)
�-PPROVED BY: TOTAL BUILDING-/PLAN FILING FEE $ On-,
TOTAL WATER METER CHARGE $
0 V E D TOTAL SEWER IMPACT FEES $
11�1";`i;;�', P;,"ACH
TOTAL WATER CONNECTION CHARGE $
MISCELLANEOUS CHARGES s
GRAND TOTAL DUE: s
LZ _z
enn"
40
Q4
0 2,
ILL
Ji
oe
OL
Qj-
7�4
--7 rL
D
PLUMBING WORKSHEET
L
NKS SHOWERS DISHWASHERS
CLOSETS BATH TUBS FLOOR DRAINS
WASHING MACHINE WATER HEATERS DISPOSALS
LAVATORY URINALS OTHER
TOTAL FIXTURE COUNT j�ro
FIXTURE UNIT *BREAKDOWN
FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE
UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY
FIXED AT $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM.
BATHROOM GROUP CONSISTING OF LAVATORY (I UNIT)
14ATER CLOSET, LAVATORY, AND
BATH TUB OR SHOWER STALL SERVICE SINK TRAP STAND
(6 UNITS) (3 UNITS)
DRINKING FOUNTAIN (!I UNITI URINAL, WALL LIP
FLOOR DRAIN Cl UNIT) (4 UNITS)
WASHING MACHINE RES.
URINAL, PEDESTAL, SYPHON (3 UNITS)
JET BLOWOUT (�8 UNITS)
WATER CLOSETS, VALVE OPERATED
WATER CLOSETS, TANK-OPERATED (8 UNITS)
(4UNITS)
SHOWER STALL, DOMESTIC
BATHTUB (!�/OR W/O OVERHEAD (2 UNITS)
SHOWER) (-2UNITS)
LAUNDRY TRAY
BIDGET (3 UNITS) (2 UNITS)
DISHWASHER C2 UNITS) KITCHEN SINK (2 UNITS)
KITCHEN SINK/WASTE GRINDER -11?i4p
(3 UNITS)
TOTAL FIXTURE UNITS $10. 00 EACH
CITY OF ATLANTIC BEACH, FLORIDA
Approwd by APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE i a- -o
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES,AND CtTY OF
ATLANTIC BEACH ORDINANCES.
'sleoole_�- i
ELE RiCAL FIRM: MASTER ELECTRICIAN SIGAATURE JOURNE-YMAN
-
NAME 61214 1'9t"(!81- -ADDRESS: 22" F0_BOX
BLDG.SIZE BETWEEN:
RES.( ) AFT.I I PUBLIC( INDUS.( NEW( REW.
ADDITION ( TRAILER I TEMP.1 SIGNS ( _SO.FT.
SERVICE: NEW t ) <:l:NCjR:EA:,S:E:&Q REPAIR ( FEE
CONDUCTOR SIZE 200 AMPS COPPER I A ALUM. 00
SWITCH OR BRIALCER 0?00 AMPS PH .3 W -2(1'9voLT
EXIST.SERV.SIZE VOLT ?'6'k&/EiZY
410 AMPS _Z PH 3W
FEEDERS NO. SIZE IND. SIZE NO. SIZE
LIGHTING OUTLETS 7 CONCEALED1 OPEN 7 TOTAL
RECEPTACLES CONCEALE OPEN TOTAL
1 0-30 AMPS. 31,100 AMPSJ
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100AMPS, OVER
APPLIANCES 7 BELL TRANSF.
AIR H.P. RATING H.P.RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS ICEIL HEAT: KW-HEAT
c_
0-1 OVER
MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS
MISCELLANEOUS
oc)
TRANSFORMERS: UNDER MV. OVER SOO V.
CITY OF
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE(904)247-5800
FAX(904)247-5805
SUNCOM 852-5800
February 19, 1998
Dash RipRocks
Mrs. Lisa Um
539 Atlantic Blvd.
Atlantic Beach, F1 32233
Dear Mrs. Ulm:
Our records indicate that you are the proprietor of the following business in the City of Atlantic
Beach, Florida:
Business Address : 539 Atlantic Blvd./Bar&Lounge
BusinessName : Dash RipRocks Nending Machines
After,investigation of this location and business it has been determined that there is no current
license issued by the City of Atlantic Beach, Fl. City Ordinance Chapter 20, Section 20-52 and
20-54 require that a current license be maintained during the duration of your business.
You are hereby notified that unless an occupational license is issued by the City of Atlantic Beach
within five days from the date of your receipt of this notice, you will be subpoenaed to appear
before the Code Enforcement Board.
Applications for licensure are available from the Atlantic Beach City Clerk. Any questions should
be directed to that office @ 904-247-5821.
Sincerely,
41-
'?arl W. Grunewald
Code Enforcement Officer
cc: Public Safety Director
City Clerk
Fire&Building Depts.
Via/hand delivery
cec: 7301
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POLICE DEPARTMENT: AFTER THE NOTICE HAS BEEN DELIVERED PLEASE
RETURN THIS RECEIPT TO THE CODE ENFORCEMENT OFFICE. THANK YOU.
CODE ENFORCEMENT
CITY OF ATLANTIC BEACH
RECEIPT OF NOTIFICATION
'�7
1 � -A SERVED NOTIFICATION TO :
DASH RIPROCKS /LISA ULM
539 ATLANTIC BLVD.
ATLANTIC BEACH, FL 32233
this V1 day of- nL � 1998.
At 10-�"l A.M.(&
TIES NOTIFICATION WAS IN REFERENCE TO : NON-COWLIANCE OF CITY
ORDINANCE CHAPTER 20, SECTION 20-52 & 20-54.
Z'
SIGNATURE OF SERVER: I
SIGNATURE OF RECEIVER:
DATED: t1KIq
PLEASE RETURN TO THE CODE ENFORCEMENT OFFICE. THANKS....
February 13, 1998
MEMO Public Safety Director Thompson
FROM Karl Grunewald, Code Enforcement Officer
REFERENCE : Non-Compliance letter to Dash RipRocks
Please have the following letter hand delivered by an officer within the next 24 to 48 hours.
DASH RIPROCKS /LISA ULM
539 ATLANTIC BLVD.
ATLANTIC BEACH, FL 32233
Also, please return the attached Receipt of Notification form to the Code Enforcement Office.
Thank you for your continued cooperation. Your help in this matter is greatly appreciated.
Slirvexe-Ly,
Karl Grunewald
Code Enforcement Officer
KWGJggh
enclosures
CITY OF
'4a�
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE(904)247-5800
oo Ar�� FAX(904)247-5805
SUNCO'M 852-5800
February 19, 1998
Dash RipRocks
Mrs. Lisa Um
539 Atlantic Blvd.
Atlantic Beach, F1 32233
Dear Mrs. Ulm:
Our records indicate that you are the proprietor of the following business in the City of Atlantic
Beach, Florida:
Business Address : 539 Atlantic Blvd./Bar& Lounge
BusinessName : Dash RipRocks Nending Machines
After investigation of this location and business it has been determined that there is no current
license issued by the City of Atlantic Beach, Fl. City Ordinance Chapter 20, Section 20-52 and
20-54 require that a current license be maintained during the duration of your business.
You are hereby notified that unless an occupational license is issued by the City of Atlantic Beach
within five days from the date of your receipt of this notice, you will be subpoenaed to appear
before the Code Enforcement Board.
Applications for licensure are available from the Atlantic Beach City Clerk. Any questions should
be directed to that office @ 904-247-5 82 1.
Sincerely
�aAiz�rrr�W �Gr�un-e owa I d
Code Enforcement Officer
cc: Public Safety Director
City Clerk
Fire&Building Depts.
Via/hand delivery
cec: 7301
LotI T Ur PtIL^M19%0 &06-r"05a
DEPARTMENT OF BUILDING
800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877
Pe M' ITj"F-0fWAM- M C BOULE RD
Pe %it Nu ber: 21224 Address: 539 ATLANTI
Permit Type: DEMOLITION ATLANTIC BEACH, FLORIDA 32233
Class of Work: REMOVAL Township: 0 Range: 0 Book:
Proposed Use: Lot(s): Block: Section:0
Square Feet: Subdivision: ATLANTIC BEACH
Est. Value: Parcel Number:
Improv. Cost: 8,000.00 OWN J A' 'ON
rR W
Date Issued: 12/29/2000 Name: JOHN GREEN
� 6 1
Address: 539 ATLANTIC BLVD.
Total Fees: 100.00 L
Amount Paid: 100.00 ATLANTIC BEACH, FLORIDA 32233
Date Paid: 12/29/2000 Phone: 04)737-5570
Work Desc: ON
-FEIES
11i W
C #�aww��-E
ECOWO—WASTE, IN,C. PERMIT 100.UU
om
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.
A TI 4A"
TLANTIC BEACH UIL
Receipt: 022828
CHECKS 16177
08180003221@00
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERAT101VS
MOVING,DEMOLXTXONS
Owner(s) :_.D�-.
Address: n9
C— 61 LC� Phone:
Lot # Block or Unit # Subdivision: SAO-t V-
Contractor: �-Or-j6WAS—it-_ 17c<,
State License tilia
Address: 3 I )p b6p-tva ?'C Phone
City State 'rl Zip Code�ia�)
Describe work to be done:
Present use of building: ipr#�JT
Valuation of Proposed Construction:
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 TMUM (CObftXRCXAL) TWO (RLrsxDzNTXAL) COMpLETE SETS OF PLANS, INCLUDING
SITE PLAN, SURZ;, I GY CODE FORMS, NOTICE OF COMENCEMENT, AND
OWNERICONTRACTOR . 'I V211T, IF OWNER IS CONTRACTOR.
Signature OWNER: Date:---/ 0/ /�f I/Po
Signature CONTRACTOA Date:
V
Sworn to and subscribed before me this
day 0'—�"&/'r
Audrey E Long
]k —*MY commiles1m CC79M N O�4RAP U Zf"TATE (5F RIDA AT LARGE
Expires December Z 2002
IF, GORDY'S
537 Atlantic Blvd
Atlantic Beach, FL
Existing Storage Room
1 1/2" Dia Grab Bar @36"—,
AF �A
V 6"
HC Toilet
--------- -----1--CL
18" Min
61 011
HC Lay.
w/ Lever
Faucets
__j L__I
Set Closing Door
with Lever Handle
IA IE
6' 0"- APR 17 1995
Building and Zoning
Restroom to Comply with Fla. H.C. Accessibilty Requirements Manual
PSR-384,4, j
10
01EPARTMEUT OF BUILDING
CITY
aefi�, H
OF'ATLANTIC 0
ION INT-OR"TION
PERMIT 110�0", Atxofii, ---------
LOCaT
Permit Nu�ub*r 10028 Address
:-539 OUANTIC BLVD.,
: BEACH, PILORIDA 32233
- Permit �Tlype BUI�LDTXP ATLAAJ �C�
4,71 ass of Work: ADDITION
14ZOAL DESCRIPTION ---------- -
ccihstr. Type: MASO RY, /BRICK
Lot A I Section;
Proposed, Use: RZSTAURANT� Town' hi
RNG, 0
Dwell 0 Code t Subdivision: ��014 -Atl . Bch.
kstimate'di" value: $0�00
Improi�. Cost: t,3000-00
Am 'T.50
Tot,
. 50
(N."ag K�gp 7,g, W,
ES
ON APPLICATION TZ
+ E.
4 , F
' Nddre TIC BLVD.. =19PAC Fez 1000- 20.0,0
A
T WO 7ni
Pi a 71 5�70
K $0 ,00
It.S, $0.00
$0.Q0
RADON, CAS 5%
Oa'�me
E
-OhiI VAIL-4*04W n--w-
z sS4 1 C
A re R.
*49RI .,TAP
JA ILLZ, 322'57
LA CROSS CONNECTION 0 .06
xP0.1 '0 StC�l 9 IMPACT FEE 4" 0, 00
Li 9�1611'z a IR0
C�Wqx d,
-1w, 61
SCHAR E ATLiBCH. .....
NOTES:
N"6E:'� 'ALL 1POt40RFteFOam,,6AN0 FOOtINGS MU eg'ff4$PjE
Sir CT9q,,,8EFORE POUA04G
A
SIX MONTHS AFTER,DArE F
D ISSUE
I ING MATERIAL,RUBBISH AND OESIRiS FROM THIS WORK MUST NOT, PLAQEP,1NrPU8UC SPACE,AND MUST BE
ED L11PAND HAULED AWAY BY,6THER,CONTRACTOR OR OWNER
THE'MEC=. WEN LAW,CA -,R-15SULT'IN
I'LURE!TO, COMPLI, WITH
N
NIE
PROPERTY OW, ,R,0AYINGTWIC SUILDINQ IMPROVEMENTS
D,ACCOSDINGTO APPROVEPLPLAN8 WHICH ARE PART OF THIS PERMI T A�b SUBJECT TO REVOCATION FOR
TIONOFAPPLIQABLEPROV MOFlAW.
$37,.50 14
ATLATtC BEACH BUILEANG�O TMENTI :, 000000wi,000000000
was oj� kpt: 004M7
3137-
t000
LBY
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS
DEMOLITIONS
owner(s)
Address:-53cl
' phone:
Lot #_ Block or Unit # Subdivision:
Contractor:-- 11e12,.rAe_e_ AQo_1-:S1xA.1
State License # C.6; r-,c>117108
Address: 917,.:S- Phone No:7-37-5--f- 76
-J,fx -Z'� 32-.25-7>
Describe workjto be done: An 'A.,,,nVC�W
Present use of building:
Valuation of Proposed Construction:
Proposed use: 67 a-e,
Is this an addition?__Z(_,10 If yes, what are the dimensions of
the added space:_ /J.4- ft. X ft. Will the added area
be heated and cooled? AIIA New electrical (or increase)?
New plumbing fixtures? Y-15 Now fireplace?_S/o Now 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 OWNER:L2;5iE� Date:
Signature CONTRACTOR:
Date:
License Supplied: 0
, ��j �N
Liability Insurance: %�T
Worker's Compensation Insurance: APR 17 199
B uild
!ingandZoning
CITY OF ATLANTIC BEACH PIMIT CALCULATION SHEET
,,4/k�,D(C#9 W 61�rty 044
Address 3 TL etj 1-( C- 4e- Cj-P
Date
Heated Square Footage @ $_per sq ft = $
Garage/Shed 41 0 tj @ $_p e r s q f t =
—71
t3
Carport/Porch t, V. @ s. per sq ft = $
F7
Deck @ $_per sq ft = $
Patio
$_per sq ft = $
TOTAL VALUATION: s
13 10 0 0, (9 lo / S-, 0 Q $
Total Valuation ist $ /000-00
40 - 00 $ /0 ,C) 0
Remaining Val'ue $s-.00 per thousand
or portion thereof
TOTAL BUILDING FEE $ 19 Is-, 0 10
+ 1/2 Filing Fee $ 12 . S 0
( ) Fireplaces @ $15. 00 $-- 0
BUILDING PERMIT FEE $ 3 7. rO
WATER IMPACT FEE $ 1-9-6 0
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT $
SEWER TAP $
) RADON (HRS) .0050 $
SECTION H PAVING $
HYDRAULIC SHARES $
CROSS CONNECTION $
) SURCHARGE .0050 $
OTHER $
GRAND TOTAL DUE $
ADDITIONAL PERMITS OR FEES: Mechanical_; Plumbing-_
Electric/New Electric/Temp_;SwimmingPool
Septic Tank Well Sign Finish Floor Elevation
Survey Other
CALCULATIONS and/or NOTES:
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DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO.6 7 4 4
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date-_ &ril 23, 19 85..
Valuation$ IYFICHMICAL Fee$ 10-00 1000 T
IU*OOCKT�
This permit not valid until above fee has been paid to City Treasurer,and is qG77 14 4/23/85
subject to revocation for violation of applicable provisions of law. 6744 .00CAC
I " 4 4.42140
This is to certify that ODA= SHM MEM
has permission to**id— INSTMI, OM BAM SMY HDW SYST94
Classification Ummexcial Zone CG
Owned by Ja.Ux Boche
Lot Block—S/D,
House No. 53c)-A Atlantit- Boulgiu-nm
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
4— ;a
P, 0 Building material, rubbish and debris
z
i from this work must not be placed
L__ in public space, and must be cleared
up and hauled away by either con-
tractor or owner.
J01M M. Widdmm
Building Official.
FOR OFFICE PERMIT
__�LSE ONLY NUMBER DATE CONTRACTOR
PLUMBING
ELECTRIC
AL
SEWER
WATER
Alow
TL
DEPARTMENT OF BUILDING *U I
CITY OF ATLANTIC BEACH.FLORIDA 7619 fr7� P1
PE �No. I
RN!r .
PERMIT TO BUILD 71a 19 4
THIS PERMIT MUST BE POSTED ON JOB Inca
Date
Valuation$ PLUMIX
Fee$ 3V+.
This Permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable Provisions of law.
This is to certify that B&G PUMING
has permission to bM INSTALL TIJIMIM
Classification- 11,311141:11 14 �
Owned by Jac Zone—
Lot Block
House No. 539-A C aoulevara_�S/D���
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
A
ND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
of------------ ;U
0 Building material,rubbish and debris
z
i from this work must not be placed
in public space and must be cleared
up and hauled'away by either con-
It Owner.
FOR OFFICE PERMIT Building Official.
USE ONLY NUMBER DATE CONTRACTOR
PLUMBING
ELECTRICAL
SEWER
WATER
low
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