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Permit 644 Beach Avenue ", I I CITY OF ATLANTIC REACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 09-00000629 Date 5/06/09 Property Address . . . . . . 664 BEACH AVE Application type description MECHANICAL HVAC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 CU 1 AHU ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BELL OCEAN STATE HEAT & AIR, INC. 644 BEACH AVENUE 1476 ATLANTIC BLVD. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 249-8251 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL HVAC PERMIT Additional desc . - Permit Fee . . . . 87 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation 0 Expiration Date . - 11/02/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 87 . 00 87 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 87 . 00 87 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. —Ms CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 9 Application Number . . . . . �94-OBOEOA000629 Date 5/06/09 Property Address . . . . . . H AVE Application type description ME ICAL HVAIC ONLY �"� CDAT Property zoning . . . . . . . To BE DATED Application valuation . . . . ----------------------------------------------- ---------------------------- Application desc 1 CU 1 AHU ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BELL OCEAN STATE HEAT & AIR, INC. 644 BEACH AVENUE 1476 ATLANTIC BLVD. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 249-8251 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL HVAC PERMIT Additional desc . . Permit Fee . . . . 87 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . - 11/02/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 87 . 00 87 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 87 . 00 87 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAU,ATLANTIC BEACH,FL 32223 OFFICE:�904)247-5826 0 FAX NO.:W4)247-S845 BUILDING-DEPT@COAB.US MECHANICAL PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: f3c_�t_ A&- XN 0 A-_1an-_ic Beach, FL 3-1233 0 YES PERMIT#: 7777 'PR GWNER: 4.NAME ADDRESS IF DIFFERENT FROM JOB ADDRESS: E.PHONE: 7' 7.NAME OF COMPANY: :8.ADDRESS. &,at*t 3" IY7(. 4+JazPC_ 9.STATE OF FLORIDA LICENSE NO: 16.CELL PHONE: '111.FAX NO.: 1-1.EMAIL ADDRESS: 13.OFFICE PHONE: 14� 2-Vf- 2e J_( -, , I Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that all work will be performed to meet the standards of al) laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months,0'if COnStrUCtiDn or work Is suspended or abandoned for 2 period of six(6)months at any time after work is commenced. CONTRACTORS SIG I>< 'BUILDIN 15.CLASS.01'WORK:�_," 0 NEW INSTALLATION 11 NE f-� L7-tf!'7)6 FLORIDA BUILDING CODE- 'R REPLACEMENT OF EXISTING SYSTEM WEX C C70MMER IAL MECHANICAL )E- 0 ALTERATION'�ADD7ION TO EXIST SYSTEM E REPAIR 11 OTHER EQUIPMENT TOBE-INSTALLED: 19. HEAT: 0 SPACE ORECESSED XCENTRAL 0 FLOOR BURNEPS: 20.AIR CONDITIONING: 0 ROOM kCENTRAL 21. DUCT SYSTEM: IMATERIAL:- THICKNESS: MAX CAPACITYi ctm 22.REFRIGERATION: MAX CAPACITY: CfM 23.COOLING TOWER: CAPACITY: gprn 24.FIRE SPRINKLER: NUMBER OF HEADS: 25. LIPT SYSTEM: ELEVATOR: MANLIFT: ESCALATOR: AUTCLIFT: 26.COMMERCIAL HOOD NUMBFR: 27.FIREPLACE: PREFABRICATED: MASONRY: 28.IRRIGATION: 0 PUMP ED WELL 0 PIPING _:v, 29. GAS PIPING: #OF OUTLETS: 0 GAS AHU: 0 GAS WATER HEATER: 30.OTHER-SPECIFY: SOLAR HEATING, BOILERS,UNFIRED PRESSURE VESSEL,HEAT EXCHANGER OR COIL IN DUCTS ETC. VALUE FOR OTHER ITEMS: "AlZaGOLIN UIPMENTi�`��'-`, 4 _R GtR '0 S�!IIFTT)` r_94��W K7�r`,A`tW,,tON Nft R"EF'I R I NUMBER APPROVING OF UNITS DESCRIPTION MODEL# MANUFACTURER TONS AGENCY 6"n ?_s7l M,4TYZ 3. 5- ARM 1 114 AiT c32.��HEATING -QU ENjT..' 1';�� .-F 'Q�S._:BOILE 'OA �'_AIR�HA 'T' RS FIREP?.'CES, ND NUMBER OF UNITS DESCRIPTION MODEL# MANUFACTURER BTU AGENCY wy(Aff b-6 oz- 9X__1 A I YFIE LM�11) AI'fN0VIN(3 NUMBER GALLONS CONTAINED MANUFACTURER SERIAL 4t AGENCY COAB FORM BLDG04:REVISED:9/13/2007 �v . ia rflA JV4Z4dUS43 OCEAN-STATE-A/C + ATLANTIC-BEACH Q001/002 C"OF ATLA)MC BEACH MONOU RW.ATLANTIC W-ACH,I-L MU 07- OFFM MWP4?-Wft 0 PAR%9zM&;M'f4JML W"Ne-DE"ecoa.us #t,W4, _ MECHANICAL PERMIT APPLICATION OUVAL COUNTY A&- AEI&Ptiq jAjRh,__tL 32233 0 YES PIRMIT 0: S/16/OF �:_,T""771 WX AwL 6 .4- Ala 4%1.- &jdg. AL &STAVE Of KOWA UtOft Not C&L PHONE: 11.PAX N - Z rf WE Poo Appheakm ir.hareby made to OWain a pervnil to do the work and installations A&indicated� I ce"that aK work wili be parf*M*d to gh"t the StandARIA of Ok Ift"reguMN cwwhm*v In 06 OWcton. This pwrAl beconvs null Ond void It wark is not COfflohenced wfthin six(a) monft,or if conmckm or work IS wApanded or aWn0oned tor a patiod of abc(6)months xt any time afor work is cammanoad. C3 NEW WSTALLATION 0 NEW qM FLORIDA RUILDING CODE. Tj REPLACEMEW OF 005TING SYSTFM QrEXIS NG IAL MECKAMCAL Q ALTERATION i AWITION TO EXIST SYSTEM 6 13 REPAIR tNG 0 IAL 0 OTHER D SPACE 13 RECESSED %*CENTRAL 0 FLOOR JB ERS. 20.AIR CON017TIONING; 0 ROOM_ _JVCENTRAL cfm 21,DUCT SYSTEM: MATERIAL: THICKNERS.__ MAX CAPACITY-. 22.REFRIGERATION. MAX CAPACITY: afm 23.COOUNG TOWER: CAPACITY: _9pm 24.FIRE 111PRINKLEft: NUMBER OF HEADS: 25.LIfT SYSTEM; ELEVATOP, MANLIFT; ESCALATOR. AUTOUFT; 26.COMMERCIAL HOOD NUMBF-R: 27.FIRYmPLACE: PREFAFIRICATED; -MASONRY: 28.IRRISATION. a PUMP 0 WELL Q PIPING --v Z9.GAS PIPING: 4 OF OUTLETS: 93 GAS AHU., 13 GAS WAMER HEATER. 30.OTHER-SPECIFY- KKM WATM 1092R8,UWW40 VZOMMEATOCCHOAM r ONUM004TOETC. VAUX FOR QTW ITOM-1 APPROVOJM 0!t F�"" DESCMPTXW moo&a MAKWACTURER TONS ?%Mae" M"FACtOAM STU AFp Numa6ft dALUM CONTAM0 MMUFAMPM MI&I AQtNV- PERMIT WORKSHEET Certificate of Occupancy Job Address: Type Work: _A 0,4 Property-Owner: Phone # Contractor: Phone # L4(,,S- 4Z3Z- Permit#: (L:)4- ze B-79 Date Issued: a- z_--3 Tree Permit# Foundation Permit# Demolition Permit# BUILDING ELECTRIE_ MECHANICAL PLUMBING ?jqjj Temp.Power# Footing JEA Release Date Temp. Power Slab Letter Rec'd. Undersiab Tie Beam Temp Pole# Lintel JEA Release Gas Piping Date Nailing/ Water/ Sheathing Sewer Rough/ Framing Rough 04 Rough Topout Insulation JEA Release Dq Date Building Electric Mechanical Plumbing Final Final 4 Findl Final JEA Release Date Drainage Inspection: Pool Permit# Inspections: Steel Final Elec./Grounding Final Roofing Permit# F_ Inspect: Nailing/Sheathing Final Fire Inspection: c-aiiee inspections: Date Paid: CITY OF ATLANTIC BEACH IS 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 65 a 1 Application Number . . . . . 04-00028958 Date 9/24/04 Property Address . . . . . . 664 13EACH AVE Tenant nbr, name . . . . . . ADD 2 LIGHTS & 1 FAN Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor --------------- -- ------- --- ---- ----------------- BELL, RALPH ERICKSON ELECTRICAL CONTRACTOR 12027 BEACH BLVD. ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32246 (904) 641-9090 ---------------------------------------------------------------------------- Permit ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. .PAL Alan", BUILDING OFFICIAL 161JI16112M4 13:38 9046419838 ERICKSON ELECTRIC PACE 02 CITY OF ATLANTIC BEACH, FLOREDA APPLICATION FOR ELECTRICAL PERMIT TO THE CWEF ELECTRICAL INSPECTOR.: DATE: 20 IMPORTANT NOTICF; IN CONSIDERA77ON OF PEMT GIVEN FOR DOING THX WORK AS DUCRIDED IN THE FOLLOWING.WE HEREBY AOREE TO PERYORM SAW WORK IN ACCORDANCE WITH THE A77ACHED PLANS AND SPMFICATiONS, WHICH ARE A PART KEREOF, AND IN ACCORDANCE WITH TVIE ELECTRICAL REGULATIONS,CODES AND CITY OF ATLANTIC REACH ORDINANCES. f-j?j/Q)-,tao f,�Ue- ' 191 ELECTRICAL FIRM: MASTER ELEC N S ATURE: OWNER.S NAMIE: ADDRESS; v!AMD -BOX— BLDG. SIZE I RESX APT.( COMM.( PUBLIC( INDUS.( ) NEW( ) OLD( PEW.( ADDITION)< TRAILER( ) Ne.( ) SIGNS( ) SQ,FT. Aop__A &ij-r< I FAA1- SER E: INCREASE( ) REPAIR( I_ CONDUCTOR SIZE AWS: COPPE ALUM.( ) FEES SWITCH OR BREAKER AMTS PH W VOLT RACEW AY EXIST. SERV. SIZE AMPS PH W VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO, SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES I CONCEALED OPEN TOTAL I 0.30AMPS I 31300AWS SWITCBES . INCANDESCENT FLOURESCENT&M.V. FIXED oToo Amm. I OVER APPLLA,NCIES I BELL TRANSF. AIR H.P.RATING H.P.RATING CEIL. KW-HEAT CONDITIONING COMP.MOTOR OTHER MOTORS AMPS I HEAT 0.1 OVER MOTORS H,F. VOLTAGE PHS NO. I H.P. VOLTAGE PHS MISCELLANEOUS UNDER 600V OVER 600V TRANSFORKERS: I I NO. IKVA NO. i KVA NO.N'EON TRANSF. NO I VA I MA [!;i� SIZE I SWITCH I FLASHZRS EACH SIGN U0mcd 5120/2002 9046419838 ERICKSON ELECTRIC PAGE 01 IM27 BEACH BLVM,JACKSONVILLE,FL=46 TELEPHONE: (WM)041-QW,FAX")641-9M ERICKSON ELECTRICAL CONTRACTORS, INC. ftx Tog Cky Of Adar&c B&xh k" CoNw Rhodw Fam 247-5845 p"em 4 p1m Data 91jr4jW ft CC., Utgod 0 F8r 1111011118m 0 IMose Conment 13 Pkams Reply 13 Plimmew Recycle E DOING A VERY SMALL JOB AND WONDERED IF THE HAVE TO PULL A PLEASE A[M$ THROUGH ON THE TELEPHONE. YOU. a—&U-44 P.4� �/a PSC 2000 Series 2410 Log for Personal Printer/Fax/Copier/Scanner City of Atlantic Beach Bui 904-247-5845 Sep 012004 1:40PM Last Transacti Da Time jyp—e Identification Duratio Pa= Resul Sep I 1:39PM Fax Sent 96657372 0:58 2 OK 111:11d 9046419838 U2(VJLI 4UU.4 A.A..WW ERICKSON ELECTRIC Lm"as rom "Now XWWA PAGE 04 rang I va a 0 On DBPR Nome I Onulne siervices"ame I "elp I oft map Public Services Search for a Licensee Litensee Detsib Apply for a License View Appilication Status Lkwimm gnftrmo*m Apply to Retake Exam Name: EXICKOON, FWWK W(Pdxmv now) Find Exam trithrmation IRICOMN 11LEMUCAL COMM 101C(Amrs Find a CE Course No") File a Complaint TRI COUNTY BLECT1112CAL CONTRACTOR*, INC. (AW0010 Mom) AB&T Delinquent Invoice Main Address: 12029 OBACH BLVD Activity Ust Seerch 3ACKWNVILLE,Ph"ide 32244 user servicw License Mailing: 12029 OWN fLv0- Renew a License "Fulf IFL S32" Change Ucanse Status Lie. Location. 12221 PHNOM BY Maintain Account 3ACKBOVIVOLLIp PL S22LO Change My Address Desvel View Messages UP 1 too 21-fte isaft" Change My PIN License Type: awt. NkMft**1 colarecoom(5Q View Continuing L-d Rank: cWt limb go License Number; 1101111111320 Status: CWT610,Pcdvo Term Glossary Lkensure Deft: 04119/1092 Expires-, 01111/31/20" online Help Vig_w Reintg0jir formation YjeW =O&C C MgWnt L i Terms of use I I FInvacy StmMent hUps.-/Avww.myfloidalicam.c*mAicamire/wil3jgpjmgooid=ELGNBDOFFOBCkKJOf...- 9/1/2004 A.7.JO 'J04b419838 ERICKSON ELECTRIC PAGE 03 fRICKSON ELECTRICAL CONTRACTORS, INC. v-im PHONE W41-641-91M 7981 120M BEACH BLVD JACKSONVILLE,FL W246 "1427M31 DATE VoAY THE OROER OF A t7 DOLLARS Oce=de lf* FOR 116007913LI'm 1:0631L162761: 00 313 2 7 IS CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 �-A-,Z INSPECTION PHONE LINE 247-5826 Application Number 04-00028879 Date 8/30/04 Property Address . . . . . . 664 BEACH AVE Tenant nbr, name . . . . . . REMODEL BATH/ADD RAMP Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 10000 Owner Contractor ----------------- - --- --- ------------------------ BELL, RALPH COASTAL ATLANTIC INC PO BOX 49190 JAX BEACH FL 32240 (904) 465-4232 ------------ ---------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc INSTALL 3 FIXTURES Sub Contractor C.W. WOOD PLUMBING Permit Fee . . . . 56 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due -------- -------- - -- -------- ---------- ---------- ---------- Permit Fee Total 56 . 00 56 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 56 . 00 56 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. VILI)EW Aft, ',wQFNQb- CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION Date: 04&%uak- Sk Ll 9 0o4 Property Address: Lo(bL4 9 egLc_�% 4veru.LL Owner: GL 12�n Telephone#: wo�&-4)L3,;L_ I Contractor: C . W. WOL-A Plum6nA Telephone#: 'I V4 -to too i Contractor Address: j 126 "RomnW Ja*30�Qll 'Fax#: _743 -1-730 _j In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: If other construction is being done on this building or site, 0 New list the building permit number: 0 Re-Pipe Oq 2 99-19 X Number of Fixtures: Bath Tubs Showers Closets Shower Pans Dishwashers Sinks Disposals Urinals Floor Drains Washing, Machine Lavatory Water Sewer Water Heaters Other Fees Permit Issuing Fee: $35.00 0 Va Total Fixtures: 3 X $7.00 + $35.0A & i 800 Seminole Road- Atlantic Beach, Florida 32233-5445 V 0TOAW Phone: (904) 247-5800. Fax: (904) 247-5845,, http://Www.cl.atlantic-beach-fl-tis CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 r 1,519 Application Number . . . . . 04-00028879 Date 8/23/04 Property Address . . . . . . 664 BEACH AVE Tenant nbr, name . . . . . . REMODEL BATH/ADD RAMP Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 10000 Owner Contractor ----------------- ------- ------------------------ BELL, RALPH COASTAL ATLANTIC INC PO BOX 49190 JAX BEACH FL 32240 (904) 465-4232 ----------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 80 . 00 Plan Check Fee 40 . 00 Issue Date . . . . Valuation . . . . 10000 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 80 . 00 80 . 00 . 00 . 00 Plan Check Total 40 . 00 40 . 00 . 00 . 00 Grand Total 120 . 00 120 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ILDING OFFICIAL CITY OF ATLANTIC BEACH Cc: D. Ford BUILDING /ZONING DEPARTMENT cz�w�� S. Doerr 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # 04 - Z -7 9 Property Address: Applicant: Project: (Sr-UTA This permit application has been: V'-�Approved �e �e �t �follow�ijt!ms need attention: > (.A Lec aT((5 es-� �q�6-Lj T 2e C)(:!4,- G)F Rp� -e�o ui�r%�pli&fion when these items have been completed. Reviewed By: Date: S( Cc: CITY OF ATLANTIC BEACH D. Ford L. Higgins BUILDING / ZONING DEPARTMENT 800 Seminole Road =o e Atlantic Beach,Florida 32233 (904)247-5800 3 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application 4 OH Property Address: —U(P�j Applicant: Go%'�:t /61-k AtINYIH C- P roj ect: This permit application has been: E:1 Approved 1:1 Reviewed and the following items need attention: r-DI Please re-submit your application when these items have been completed. Reviewed By: Date: X X X a X CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233-5445 Telephone: (904)247-5800 Fax: (904)247-5845 hftp://ci.atlantic-beach.fl.us FAX To: .. Fax#: From: Date: Pages: Re: C4 ci, "-e- E Urgent EXFor Review Please Reply X a N N N X a u X Notes: a CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (Alterations& Additions) Date: Job Address: \-N 4E Owner of Property: X OF V;F_L_L_ Address: 5At4,F_ Telephone: :2 Lt 3-A� -2, Legal Description: Block Number: Lot Number: Zoning District: Contractor: V_F K KKSS�t= State License Number: C%>-00.<:200!? Contractor Address: Telephone: 45- Y13-2— Fax: 7 �7_ qs5p Describe proposed use and work to be done: 90 57�!U'VVy-,"�L_ kffNDM�> sau&kk� F n� # "> 18-311A, on J It rAop i_zl L_ AND b i�A� Present use of land or building(s): P-t-:5- A, Cr Valuation of proposed construction: 10,000. - What are the dimensions of the added space: feet x feet Will the added area be heated and cooled? New electrical or increase in service? Add plumbing fixtures? N JC> . Add fireplace? y-J,0 - Add heating/air conditioning? Is approval of Homeowner's Association or other private entity required? If yes,*please submit with this application. 7 b s project involve changes in elevation,site grade or any use of fill material or the removal of any trees? NO.i Applicant certifies that no change in site grade or fill material will be used on this pyoject. F1 YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. [�(NO. Applicant certifies that no trees will be removed for this project. D YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as apl)ropria Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us Page 2 Revised 1/04 0011U/ZUFN 23:18 9048218400 COASTAL PAGE 01 AO 1114 .0 2,'7,.1-. STATE OF FLORIDA OF -BU91NESS J= PROP29410NAL ItEGULATION CCKSTRUCTION MUSTRY LICENSING BOAM 'Q#L04Q-j5Ql0;V0 SE dilcmi-E MR 12004- fg_�Unvsl Fc(;cO-S 2 0 09 The (MORAL coNTRACToR Named bulov X9 'CllX!rlr'lXD Under the provisions of ch&vtikk=' r .1. 7 ZxpLration date: AUG 310 20MMF,'If X'SNOT LAN C-04ST9 lC.'Xwc Pi 0 BOX FLUT 1:6210 0xv 17ACKS LLE BEACH FL 32240 JIB ty GOVE DIAM c TU b]SPLAY AS REOUTAFO BY LAW 08/16/2004 10:02 9046453805 HOLMES ORGANISATION PAGE 01 ACQRD CERTIFICATE OF LIABILITY INSURANCE OP ID OAT11111111wooffm) -COAST-A 00/16/04 PRMCER THM CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHM UPON THE CERTIFICATE The Holms Organisation of FL HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 4494 Southaide Blvd. , 101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Jacksonville 1% 32216 Phone: 904-645-3804 Fax-904-643-3805 INSURERS AFFORDING COVERAGE NAIC 0 INSURER A; Mid Continent Casualty Coastal Atlantic Ina INSURER 0; Hartfocd Insuramce Co 29424 INSURER C! 'PO Mz"'16219 WBURER 0: Jacksonville Beach EL 32240 INSURER 6; COVERAGE$ THE POLICIES OF INSURANCE LISTED BELOW 64AVE BEEN ISSUED TO THE INSURED NAMED A13OVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CAINTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND OONDITIONS OF SUCH POLICIES.AGGREGATE LIWTS SHOWN MAY HAVE BEEN PEOLIC110 BY PAID CLAIMS. MON �M 7kfjT-M LTR TYPE OF MURANCIF POLICY NVMwR LIVITTS GENERAL LIABILITY EACH OCCURRENCE 000000 A X COMMERCIAL GENERAL LIABILITY 000538556 02/20/04 02/20/05 1 � " �.) S 50000 CLAW MADE FXJ OCCUR MED EXP("-"-nl 1 5000 PFRSONAL&ADV INJURY s300000 GENERAL AGGROGATE $ 600000 OWL AGGRECATE LIMIT APPLIES PER: PRO DUCTS-COMPfOP A043 3600000 7 POLICY 7 JE"C'T- m LOC AUTOMDOILS 161ABIL" COMISINED SINGLE LIMIT ANY AUTO (92-dckwil) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS IPWPW—) HIRED AUTOS BODILY INJURY NON-OWNGO AUTOS Iper awk!") PROPERTY DAMAU S (P&moddentl GARAGE LIASUM AUTO ONLY-FA ACCIDENT S ANVA OTH8 R THAN EA ACC 0 ALT ONLY. A00 I MIXISM111111IRCILLA UAINLff-f EACH OCCURRENCE 9 OCCUR CLAAMS MADE AGGREGATE S S DEDUCTIBLE RETENTION — --- X14=_, j"F11 4 WORKERS COMPE10ATIO"AND ER EMPLOY41PS'LUMLITY 21MZGD3919 02/12104 02/12/05 EL SACH ACCIDENT 5100,000 Amy PROPRiMpipmTNERIEXECUTWE OFFICERIMEMBER EXCLUDED? E.L DISEASE-EA EMPLOYSE1 I 10 D,000 1A - S E e I ZLIPMC VA641 OWN 8 b a 10 w E.L.DISEME-POLICY LIMIT I S S 0 0 1 a 0 0 -*THE" DMRRM OF QFMA"nONS I LO"TIONS WEIMLES I EX1CLUZ10k6--WDED MY 6146a–MSEW I SPECIAL PRONRIONG Fax: 247-3945 CERTIFICATE HOLDER CANCELLATION CITYATI. SWULD ANY OF TING ABOVE DUCIRMED POLICIGS 91-GANCELLED BEFORE THE 0MRATION DATE TWERSOF.THE OWING INSURIERWILL ENDEAVORTO MOML 10 DAYS WRITTW N NOTICE TO THE CERTIFICATE HOLDER NAIIIII10 TO THE LEFT�BUT FAILUFM To 00 30 SMALL City of Atlantic Beach WPOSE NO OBLIGATION OR LIAMILITY OF ANY FANG UPO"THE INSURER,ITS AGENTS OR 800 Saminale Rd. REPRESFATATIVEIL Jacksonville FL 32233 p- AUTH RITIMMENTATM 7 r.'A A �6 k I ACORD 25(20DII08) - 6 ACORD CORPORATION Its$ 08/12/2004 22:31 9048218400 COASTAL PAGE 01 August 17, 2004 Don Ford City of Atlantic Beach Re: Renovations/Permit Application Dear Mr. Ford, I am aware that the renovations requested on my permit do not meet with the ADA requirements. Sincerely, (�' a$D'� Ralph W. Bell 664 Beach Avenue Atlantic Beach, Florida 32233 241-3312 Room OP*;12/2004 03:07 9048218400 COASTAL PAGE 02 -07 0 Ut C-3 LL C-,i 0 00 N w 0-cr 0 > -0, C13 (D CL ID 0 0 0 0 E E CL E (D oj > 46 hL 7 < fA 0 r I d, 4b M -ILI to co (D 006 - d co C-C e f rE FILE COPY Z I 4VU4 t3d:v 1 9048218400 COASTAL PAGE 04 02 Id z ILI 3 0 Lu ILI it vemus Page I of I Log On DBPR Home I Online Services Home 1 Help 1 Site Map 09.-35.-41 Al Public services Search for a Licensee Licensee Details Apply for a License View Application Status Licensee Information Apply to Retake Exam Name: MASSEY, KENNETH ALAN (Primary Name) Find Exam Information COASTAL ATLANTIC INC (Alternate Name) Find a CE Course Main Address: POST OFFICE BOX 49190 File a Complaint JACKSONVILLE BEACH, Florida 32240 Lic. Location: P 0 BOX 50218 AB&T Delinquent Invoice JACKSONVILLE BEACH, Fl. 32240 &Activity List Search user services j,',,, License Information Renew a License Change License Status License Type: Certified General Contractor Rank: Cert General Maintain Account License Number: CGCO52009 Change My Address Status: Current, Active View Messages Licensure Date: 11/28/1990 Change My PIN Expires: 08/31/2006 View Continuing Ed Special Qualifications Effective Date Term Glossary Bldg Code Core Course Credit Online Help Qualified Business License 02/2012004 Required View Related License Information View License-Comolaint Terms of Use I I Privacy Statement https://www.myfloridalicense.com/licensing/wll3jsp;jsessionid=IFN4NKOEODFJOkKj9f-zl 8/16/2004 .1'2:34 9048218400 COASTAL PAGE 02 5-MK RETURN Book" 11989 page�: tmq PHONE�4Lq�-qql I NOTICE OF COMMENCEMENT State of Tax folio No, . County of tjVXL- To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real propeity,and in accordance with Section 713 of the Florida Staft9es,the following information is statcd in this NOTICE OF COMNMNCENMNT. Legal descriotion of prop"being improved66 --RA '14 V A N I%c- -1;? F"L Address of property being improvo: ra&!j JEtoCA KQV. A-1N-AA%T1C- --MAC-4 M- General description of improvements: Rtmo DgL- I owner: -"LPA Address: fifi it fg�� C &A Owner's interest in site of the improvement: *VAZ Fee Simple Titleholder(if other than owner): Name: ,'Address: Contractor: C:-CA-':�—#A L- A:-, Z- Address:--Be, 061F. Phone No: 90% j-,k R- q g I !I Fax No:- go�A ":I t q- t-f 6 5; Surety(if any): Address: Amount of Bond S Phone No: Fix No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself,je-sipated;-y owner upon whom notices or other documents may be served: Name. Address; Phone No: Fax No: In addition to himself,owner designates the following person to receive a copy of the Licnor's Notice as provided in Section 713.06(2)(b),Florida Stahm. (Fill in at Owner's option). Name:' Address: Phone No- Fax No: Expiration date of Notice of Commencement(the expiration datcits one(1)year from the date of recording unlessa diftent date is specified): DIANA 9.VO"ERSIFUUN Notary Public,State of Florida comm,expires April 30,20M TMS SPACE FOR RECORDER'S USE ONLY Comm.No.00 RIM Siped:_ Date,. -0 Log,101 Before me ihis 13 day of Q ov 4 in the Coun S%W4278 of Duval,State of Florida,has per na Ppeared Part 2 ij I ed Fi W A 29*1 C FV 06/16/0" MA201 AN Notary Public at Large..State of Flofida,County of Duval. JIN FUMER My commission expires: MM CIRWIT CM Personally Known: or VAIAL COW FEn N JIG 5.00 Produced Identification-, TMW no 1.00 RM ANITIWL S 4.00 40k, w w 0: Cl: 14 H .3 m u .4 0 u OD z 0 H k Ed cr. En 0) 4J w z w 0 0 a. 3: LL w d, 0 U) C (n 0 ES U) CL w m < 0 a) > x w :) — w -j cc 0 a. (1) 'a. 0 cr w Z z UJ UJ 0 w x a. (L U) 4J z CC 0 < > Z IL z 0 W 4:c z w m U. M u 0 z z u Ix 0 H It- > u 1% w w w A (n w 0 j u =1 14 H 0 1% In > u U. 4c u W > k N tj w -3 m w u w 4-) x cl x lb w I z S N 0 :D 16- 0 CL w w z 4c WC4 2 0 0 z U) 0 z 0 LU z < 0 z w 0 x I w cr w MA z z CL ,3: 0 0 0 w 0 0 0 Aft lob" CITY OF ATLANTIC BEACH, FLORIDA Approwd by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE:—.7-7 7- 19cc:y IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN'ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. / 7 (90c y-,as--o ELECTRICAL FIRM: jl&qiR ELACTRICIAN SIGNATURE JOURNEYMAN NAME L�� ADDRESS: —RFD—BOX v BLDG.SIZE BETWEEN: RES/pl� APT.( comm.( PUBLIC INDUS. NEW( OLD( REW. ADDITION ( ) TRAILER TEMPA SIGNS ( ) —SO. FT. SERVICE: NEW( INCREASE ( REPAIR ( FEE CONDUCTOR SIZE AMPS COPPER ALUM. SWITCH OR BREAKER AMPS PH Wl VOLT RACEWAY EXIST.SERV.SIZE AMPS PH 3, W 40 VOLT RACEWAY FEEDERS NO. SIZE IND. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL SWITCHES 0.30 AMPS. 31-100 AMPS MOTORS H.P. VOLTAGE PHS, NO. H.P. VOLTAGE PHS T SIGNS NO.NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHER EACH SIGN I I i ___ I I I