Permits 1671 Beach Ave TY Of
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ND FOOTINGS MU4T,8E4%$PECTE0 BEFORf" NINO
NOTICE ALL CONCRETE FORMS A
PERMIT VOID SIX MONTHS AFTER DATEOF ISSUE
BUILDING MATERIAL,-RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPAt;E,A-NO MUST BE,!
:,1C4X-ARED UP AND HAULE-DAWAY BY EITHER CONTRACTOR OR OWNER
x
TO 'COMPLY'WItH THE MEICHANICS�LIEN LAW CAN' ROULT IN
RTY - W 'f "PAYIN TW F
�014rx IMPROVEMENTS
T14 R
,EPROPE 0 , G I E
TIO
Ii�i6A6dO'Q'NG TO:APPAOVEDOLANS WHICH ARE PART OF THIS;PeAMIT AND SUBACT TO,
VISI OF LAW.
ION:0040LICABLtOOO ONS,
OOOODW OOODOW =00'14
ATLANTt BEACH WILDING or:PARTME�NT Wit 919", 01 Rcpt: 008M.
Z-F ell
`0
:1111,�,��N"t'AffAb
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BUILDING AND ZONING INSPEC TION DIVISION
Cirf OF ATUMIC MEMN
AT"WIC 8"Col. FLMIDA 112"S
APPLICATION FOR MECHANICAL PERMIT L4N NUMBER
IMPORTANT— Applicant to complete all items in sections 1. 11, 111. and IV.
LOCATION Street A44ress: ---7Z717v s
OF leterseetial Streetv
WILINNG 1
I-- Sob-j;W;s60
If. IDENTIFICATION — To be completed by all applicants.
Is consideration of permit given for doing the work as described in the above statement we hereby agree to Perform said work ;A accordance
with th* *"ochpd plans *Ad specifications which are a part hereof #ad in accordance with the City of Joclisonville ordiaeaces and standards
of good pwactice listed thirraiA.
Af
Nome of Mechanical
cer*"tor 1priat) T,416PEA 9814-1146 It C&3",,6
Home of
IlImperty Owner jq t/
of Owner two of
i@W_A"*t I SA4#21= or Inglaw
Ill. 611411RAL *WORWTM
A. Type of hestinig few:
swco Is OTNU 008TRUCTION wine 0M an
T"118 911111LOWS OR SITKI /W
C3 So—13 LP D No" (3 CwAW Uft
C3 or Y", GIV9"11111111106A OF CONSTRuc"61111
4110110"IT
0 O*W — Unify
IV. AdICHAN" 11PUMINT TO N BIMAUS NATUM OF WW
(P go , P, , to of composeek 00 bad of Als twul LT Anklential of 0 Cminwe1W
11"t a Space a ftessesw ilf COFAW 0 &W E3 Nw swidi-@
A;,Co*dW*.kq: (3 1111teens 13 CeeW &WW4 8-as-h 0
C3 " System; moftM RW"W"W of exletme
ma"ves eap"Ov (3 Nw wouiumn(He-1–al prelkwy wollw"
D It I stise 13 exiew"or sown toullelift 8196WIL
(3 ces"o ft-0- Capeelty 0 00W ap"ry
(3 Aft sle4amews: Number of h"
0 fleaster 0 ho"k a
P" 0W=M*lKy
0 Sonii"
took
0 LOG Am*W
(3 UeAred pmeswe vnw
0 seam Fwab App no bp
a 006W — Specify
Uff AM ZQWMZW
AM CONNnOMM MM RUMIGARATION FQUW1WW
10,V1111111"r VAft
(3
6 S) A
CITY OF
1*4ut4c Vead - 576vt4*
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2395
July 21, 1987
Carol Donneley
220 East Forsyth Street
Jacksonville, Florida 32202
I have inspected the house..at '11q ompliance to the
Coastal Construction Code. Me Coastal ro Mlished by the State
of Florida as of March lst., 1986.0 is enclosed as it was adopted by the
City of Atlantic Beach,
This house is within the Coastal-Construction zone and must meet the
criteria established in the Coastal Construction Code.
Cordially,
& o__ C_
Don C, Ford
Building TnspectoT
cct file
DCF/te
AUG-17-94 WED 10:43 FAX NO. 9047982660 P. 01
(�o C�5 6i—:::- Cop TIC0 cr t)(1-111-
mil/ Iq V/c-' �j
Al"t4 r�/" CH
EROSION'CONTROL LINE %_04*36"24"E. 50.03
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05 01
NO. 1671
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151 FL 0 R Iq FWX
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Mayfair Window and Series 7000 Vinyl Fin Per test reports and certificates from
4. Double hung Door Double H Florida registered professional FL1305
engineer.
1. TW3862 Tilt Double Hung
Window, 129-H-607, H-R30, 3"9-
5/8"W'4-718". 2. TW3052 Tilt-
Wash Double Hung Window, 129
ouble Hung Wood H-607.1, H-R50, 3"1-5/8"x5"4-
Andersen Corporation Window 5/8". 3. Series TW21062 Vinyl FL1091
Clad Tilt-in Duoble Hung Wood
Window w/Impact Glass, 129-H-
650, Missile Level D, Cycle
Pressure+50/-65, 2"1 1-5/8"x6"4-
7/8".
Non-impact: Units to be
installed in accordance with the
tested method of installation as
noted on the Florida Building
500 Series Code"On-line Product Approval"
Aluminum Clad site. 2) Insulated Impact: Units to
Peachtree Doors and Wood 300 Series be installed in accordance with
Windows PVC Exterior/Wood the tested method of installation FL1451 FL3154
Interior or PVC as noted on the Florida Building
Exterior/PVC Code"On-line Product Approval"
Interior site.These units were tested in
accordance with ASTM E 1886-
97 and ASTM E 1996-01,
meeting Missile Level D, Wind
Zone 3 requirements.
Perma-Shield Performance Varies; See DADE
Andersen Corporation Narroline Vinyl Clad NOTICE OF ACCEPTANCE FL1155
Wood Double Hung NUMBERS#99-1210.06
Window
Max Size 48.000 x 81.000 in., H-
C40 (DP+40/-40). Products must
Nfarvin Double Hung be installed per attached FL3735
installation drawings. Not for use
in HVKZ.
Jeld-Wen Double Hung FL4698
5. Fixed N/A N/A N/A N/A
6.Awning N/A N/A NIA N/A
7. Pass through N/A N/A N/A N/A
8. Projected N/A N/A N/A NIA
9. Mullion N/A N/A NIA N/A
10. Wind breaker N/A N/A N/A N/A
11. Dual action N/A N/A N/A N/A
12. Other
CATEGORY1 MANUFACTURER PRODUCT LIMITATION OF USE FL#
SUBCATEGORY DESCRIPTION
C. PANEL WALLS
1. Siding Hardiplank lap siding fiber-cement cladding FL889
2. Soffits Alcoa Home Exteriors, AluminumNinyl Not for use in HVHZ.Design FL2641
Inc. soffit pressures=+71.5/-63.3
3. EFIS N/A N/A N/A N/A
4. Glass Block N/A N/A N/A N/A
CbMPONENTS
FL402
1. Wood connector SimWn Strong-Tie Co Wood Connectors FL474
Anchors FL503
FL538
2.Truss plates NfiTek Industries,Inc Truss Plates N/A FL2197
Trus Joist,A Engineered Lumber FL1630
3. Engineered lumber Weyerhaeuser Business I I I I
Georgia-Pacific Engineered Lumber FL1008
Corporation I I - I I
CATEGORY/ MANUFACTURER PRODUCT LIMITATION OF USE FL#
SUBCATEGORY DESCRIPTION
G.SKYLIGHTS
ICMG SKG-R60 60, max size
1. Skylight Sun-Tek Mfg Impact rated curb r.o. 46 Y2 x 46 Y2, Large missile FL2442
mounted glass Impact rated, 2001 TAS 201,
2. Other I i 202, 203
CATEGORY/ MANUFACTURER PRODUCT LIMITATION OF USE FL#
SUBCATEGORY DESCRIPTION
H. NEW EXTERIOR
ENVELOPE PRODUCTS
2
Authorized Project Agent
(Print itame) (Signattffe)
Company Name: Florida Design Build, Inc.
Mailing Address: 301-B Suite 3 1 Oth Ave N
City: Jacksonville Beach State: Florida Zip Code: 32250
Telephone Number: 904-219-2276 Fax Number: 904-242-8240
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
7 71 ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
V lit
Application Number . . . . . 09-00000040 Date 1/22/09
Property Address . . . . . . 1671 BEACH AVE
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 22300
----------------------------------------------------------------------------
Application desc
REPLACE DECK DOOR WINDOW
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
MANZELLA, KATHLEEN R. FLA DESIGN BUILD INC
1671 BEACH AVENUE 301B STE 3 10TH AVE N
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 757-7087
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 145 . 00 Plan Check Fee 72 . 50
Issue Date . . . . Valuation . . . . 22300
Expiration Date . . 7/21/09
----------------------------------------------------------------------------
Special Notes and Comments
*2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
* Contractor is to supply the Building Dept . with
construction site management plan to show placement of
dumpster & portalet if used, on a plot plan. Nothing to be
placed in city right of way. *
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 145 . 00 145 . 00 . 00 . 00
Plan Check Total 72 . 50 72 . 50 . 00 . 00
Grand Total 217 . 50 217 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
09-
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845
-DEPT@COAB.US
BUILDING
BUILDING PERMIT APPLICATION DUVAL COUNTY
3o
7�m�' 4. t�UCTURE:7,,,'-�,,i.�'�,"C-"",.",I
NEW BUILDING 0 DEMOLITION E31RESIDENTAL
LOT_BLOCK SUBDIVISION 13 ADDITION 0 CONVERTING USE 0 COMMERCIAL
FIRE E
ERAT10N 0 ACCESSORY BLDG.
�1,6,,7,'-QESQRJPTlPN ORWORK:-, L;w�
REPAIR 0 POOL/SPA 0 YEs-1 13 N/A
L-.MOVE 0 OTH ER RNO
QJANN"EFt -�,
PRO ERTY Ad ARCHITECT,1,
9.NAME: 4'S.'-CWPANY"EF- 23.COMPANY NAME:
C_1 16LN!A!!� 24.EICENSEE NAME:
10.ADDRESS. 17.STATE QESI.QRHIA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
7 ) c)3 3 474
, �Q r 26.ADDRESS:
18,ADDRESS
3
I A NO.:
11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHOW-: 27.OFFICE PHONE: 28.FAX NO.:
C 2
%414 0 t yo
13.CELL PHONE: 21 --PHONE: 29.CELL PHONE:
'�c Ll— ;Z'
14.EMAIL ADDRESS: 29.EtAAILADDRESSf 30.EMAIL ADDRESS:
R A
GELEN
IDER"
T
00tHERTHANOWN
31.NAME' 33.NAME. 35.NAME.'
\ x, I I(,� A16 reb "A &--A- i nf-4-
32 ADDRESS: 34.ADDRESS: 36.ADDRESS:
/-9-01
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
s
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in IN I
jurisdiction. This permit becomes null and void if work is not commenced within six(6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Bolleirs,Heateirs,Tanks, Air Conditioners,etc.
OWNEWS AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning.I will not occupy or use the referenced building or any part therof,until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
g'. C
ONT
(If'Ag
ent�Powerof ttonadybrAgency 'etterRequired)
Signed
Signed: Date, Date:
V d.�of JI-111 the county of
Before me this d. 20 in the county of Before me this 2�0O in
y
Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeE
herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. ':FL true and accurate. L Co nty of
Note Public at Large,State of Countyof —LJ±tq Notary Vu�at Large,State of
OIZY—.onally Known lil<rsonally Known
,OPJDAc;�t n 11 Produced identification-
re: LORIDA
No IN�t�m Rinnatu F F
"AQ M&AiA
1111"ALN'l U't7TXj V V%.,I,)
de
ow
n'
n
cati n
0 MiS�
t 'e:
1jr, Tgir Mm
D Commission #DD474975
FftCOI)F, COMPLLU&N
r*- -w E/,Phs: ' '-.. 3 1
LdL Co.,Inc. C
Bonded-1-171ru A Ll- Crff OF ATLANTIC 13FACH B, d
,A
SEE PERMITS FORADDITIONAL
70 S
BLDG01 Permit Application Bldg:RF=VtS :12118/2008 REQUIREMENTS AND CONDITIONS.
FILF COPY
PRODUCT APPROVAL INFORMATION SHEET FOR StJohns County
Project Name: Permit
Project Address: 0>(Qa_c
k J�q-' A+)-'�' ,
CATEGORY/ MANUFACTURER PRODUCT UMITATION OF USE FL#
SUBCATEGORY DESCRIPTION
A. EXTERIOR DOORS
Maximum Design Pressure Rating:
Therma-tru Fiberglass Door w/wo Single Door-+67.0-67.0 Double FL 1170
sidelites Door-+60.0-60.0(See Door Label
1. Swinging for Variations)
Frenchwood Outswing Patio Door,
��Andersen Outswing Patio Door 129-H-638,Missile Level D,Cycle FL1097
Pressure+50/-65,
2. Sliding Andersen Sliding Patio door See mfg. specs FL1095
FL 1149
FL549 FL542
3. Sectional Clopay Building Garage Door N/A FL1794 FL2581
Products Company FL3026
4. Roll Up NIA N/A N/A N/A
5. Automati NIA N/A N/A N/A
6. Other N/A N/A N/A N/A
CATEGORY/ MANUFACTURER PRODUCT LIMITATION OF USE FL#
SUBCATEGORY DESCRIPTION
B.WINDOWS
Mayfair Window and Series 2110 Vinyl Fin Per test reports and certification by
Florida registered professional FL1303
Door Framed S
engineer.
P+.33/-43 3z.lzz)x
96,Mark 40/50BP DP+50/-60
52.125 x 62,Mark 40/5011P DP
+501-55 52.125 x 75.75,Mark 40/50
DP+35/-35 52.125 x 96,TW DP
+50/-50 52.125 x 77,TV DP+45/-
1. Single hung 50 48 x 96,TW DP+35/-35 52.125
Kinco,Ltd Aluminum Single x 96,TB DP+50/-50 52.125 x 96,
Hung MPSH Miami-Dade NOA#02-
0128.06,All Windows are to be
Installed per Manufacturers
Installation Drawings. Anchor Size,
Type and Spacing are determined by
the type of construction per
Manufacturers Installation
2.Horizontal slider N/A N/A N/A N/A
3. Casement Andersen Corporation Casement N/A FL 1086 FL 1154
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: Z/ Le 2
City web-site: hftp://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Department review required Yes No
Property Address: # '4 --ruilding)
Pffffffing &Zoning
Tree Administrator
42 - 1 d
Applicant: >,A I Public Works
'V
f)��o Public Utilities
Project: I Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: RAepproved. E]Denied.
(Circle one.) Comments_1�6rd#-0('/(jr W ,11 be b I' J_Y�5 n 3 1 60A SirUCk
�3'd-e ry?a #iay ry-) efi t plonj d v m rsle pla(e, m en-f
PLANNING&ZONING
TREE ADMIN. Reviewed by: /1/7 %,a�t Date: /—/?__0 9
U
PUBLIC WORKS Second Review: FlApproved as revised. FIDenied.
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
FIRE SERVICES Reviewed by: Date:
Third Review: DApproved as revised. F�Denied.
Comments:
Reviewed by: Date:
Jan 17 09 11:24a JULIE AND KEN VONTZ 904-249-4359 P.I
IY71 011��;AqCH lqvrl %j t4 fifowill-
AIL-ttt--076- 64��M-C-H
EROGIOWCONTROLLINIE S.04036!2.4"E. 50.03 f
I/Z-ta;f,%PIPE
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96 w ;d FR A Yc
RESIDENCE
NO. 1671
4' CMAIAf
t 39
'y 4,
d; WOOD fAE#C E
AP
0j.
117
FRAME
'g,w000 fc.vcf FLO
cu Isl FLOOR k)
GARA
PATi
000�
--come. COASTAL CONSTRUCTION
PSI CONTROL LINE
2009-01-17 09,37 Vontz Kenneth 9042494359 Page i
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 09-00000398 Date 3/31/09
Property Address . . . . . . 1671 BEACH AVE
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 700
----------------------------------------------------------------------------
Application desc
replace 6ft fence
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
MANZELLA, KATHLEEN R. FLA DESIGN BUILD INC
1671 BEACH AVENUE 301B STE 3 10TH AVE N
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 757-7087
----------------------------------------------------------------------------
Permit . . . . . . FENCE PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/27/09
----------------------------------------------------------------------------
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS.
2007 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
*ALL FENCES OR ENCLOSURES OF LAND SHALL BE SUBSTANTIALLY
CONSTRUCTED.
*SCHEDULE FINAL INSPECTION ONCE FENCE HAS BEEN COMPLETED.
PERMIT AND APPROVED SURVEY MUST BE AVAILABLE FOR FINAL
INSPECTION.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 35 . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
lidt I I I VV I I./-,Vd M)*4" 11%L-114 VI-/111 oz_ I
16�11 r5iEWCH, 1--2.vr,
-Tt -(T- --I
ER"10WCONTROL L114C 50.03�
City of Atiantic Beach
Planning end Zoning Department
his approval verifies compliancewitti applicable
and other local landi
ev r ulations, but does M cwMftu*
pproval for the issuance of MOW no
th Florida Budding Code sardall other pp
a)
at, State *001 Federal Ir
C4 W be ve signature of V"City
0 h Bullftg Pft tfto=3wM at TT-
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RE'SIDEIVCE
4P
NO- 1671
4' CAPAIAf
9 39
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Prop P&ICE - -WOO
$- a
"/0. 0 S
117 MIN
L' $—ro-Rp Y.
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.COASTAL CONSTRUCTIOw
Vir
PA CONTROL LINE
04005'10"E.
2009-01-1709:37 Voutz Kenneth 9042494359 Page I
CITY OF ATLANTIC BEACH
F7 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 09-
OFFICE:(904)247-5826 0 FAX NO,:(904)247-5645
BUILDING-DEPTGCOAB.US
BUILDING PERMIT APPLICATION DUVAL COUNTY
1.JOB ADDRESS: 2.VALUATION OF WORK 13.SQ.FT.UNDER ROOF
200
4.LEGAL DESCRIPTION: S.CLASS OF WORK 6.USE OF STRUCTURE:
D NEW BUILDING 11 DEMOLITION 1XRESIDENTIAL
4�r -X.
LOT_BLOCK-SUBDIVISION 0 ADDITION 11 CONVERTING USE 0 COMMERCIAL_
7.DESCRIPJION OF WORC 111 ALTERATION 11 ACCESSORY BLDG. &FIR SPRINKLEJR.
1 11 REPAIR Oy_PQOL/Sl 0 YE; 11 N/.A
11 MOVE IM OTHER %--P-f-'e 11 NO
I tROPfJTY OWNE CONTRACTOFL- ARCHITEET I ENGINEM-
9..NAME: V y 15.COMPANY NAMb 23.COMPANY NAME:
16.NAME' 24.LICENSEE NAME:
cl-�
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
14,7 1 �6 pry e, (�Jk- n-,�-4, �;-�4/"
18.ADDRESS&5,,
, J��41 it B,I V 1 26.ADDRESS:
11.OFFICE PHONE: 12.FAX NO.: 9.OFFICE PHQLLE: 0 FAX NO' 27.OFFICE PHONE: 128.FAX NO-:
.12
le,-i-2, , _)�V L'4;LY0
13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE:
%�-t- 5---�-3L-� (a
14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS:
FEE SINIPLE TITLE HOLDEP: BONDING COMPANY- MORTGAGE LENOM
(IF OTHERTRW OV&*M___
31.NAME: 33.NAME: 35.NAME:
1
32.ADDRESS: 1 34.ADDRESS: 36.ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six(6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,ate.
OWNERS AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning.I will not occupy or use the referenced building or any part therof,until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF I
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER or AGENT CONTRACTOR
(If jaegt Power of AMomqr or Agency Leiter Requked) (Qualifier Only)
Signed 1H Date: Signed: Date: 3
Before me this le day of 2009 in the county Of Before me this c^7 day of 2009 in the county of
Duval,State of Florida,has personally appe- V 7�
Duval,State of Florida,has personally appeared t- "
herin by himself/herself and affirms that all statements and declarations are herin by himself I herself and affirms that all statements and declarations are
true and accurate. true and accurate.
State of �K L-
Notary,Public at Large, County of Notary Public at Large,State of County of
Personally Known UrPgrsonally Known
Produced Identificafion- El Produced ldentificafion,- I) -4
Notary Signaturn-OT47 PJ&,V6WA4kX1ZA Notary Signature:
LJA
'Wm,vers Willia-m R (9fowers
Commlssi,-)n #DD47497E
11011ded Th 22 2()09
ru Atlantf,L..6-4 *&Pires: t�,P 22, 200t
BLDG01 Permft Application Bldg:REVISED:12118/2008 Bonded 71iru Atlantic Ct)�,in,
APPLICATION NUMBER
City of Atlantic Beach
Building Department M A P 2 0 0:) (To be assigned by the Building Department.)
'P, 800 Seminole Road
Atlantic Beach, Florida 32233-5445 4
Phone(904)247-5826 - Fax(904)247Z845
DEW) E-mail: building-dept@coab.us Date routed:
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Dpj?!j!"t review required Yes No
Property Address: &NI '46 ruilding—,/._=�
A! &Zon
Tre—elinistrator
Applicant: Tn� n��" ublic Work
g-PE"iCRtfilities
Project: 617- Public Safety
6) 1 Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: XApproved. [-]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:-,,3
TREE ADMIN.
PUBLIC ORK Second Review: []Approved as revised. F]Denied.
Comments:
PUBLIC TI I
TI I
PUBLIC ETY
FIRE SERVICES Reviewed by: Date:
Third Review: [:]Approved as revised. [-]Denied.
Comments:
Reviewed by: Date:
City of Atlantic Beach APPLICATION NUMBER
Building Department M A P "J0 6 �00� (To be assigned by the Building Department)
800 Seminole Road
Atlantic Beach, Florida 32233-544:
Phone(904)247-5826 - Fax(904��247-5845
I E-mail: building-dept@coab.us Date routed: A(
City web-site: hftp://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
D�;�t review required Yes No
Idin
Property Address: -a ildin a &Zon
�*nning 8,Zoq�l_i
< �np
Tre-e—Administrator
Applicant: s-1 i LJ 16 0, ublic ork
._Pt6q`UtiIities_,>
Project: 617- A-z)Ofn ��dftkO_r Public Safety
V 6 Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: O/Approved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:'_1 Date:
TREE ADMIN. /� -_
PUBLIC WORKS Second Review: FlApproved as revised. DDenied.
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
FIRE SERVICES Reviewed by: Date:
Third Review: FlApproved as revised. DDenied.
Comments:
Reviewed by: Date:
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 09
OFFICE:(904)247-5826 FAX NO.:(904)247-5845
BUILDING-DEPT@COAB.US
BUILDING PERMIT APPLICATION DUVAL COUNTY
1.JOB ADDRESS: 2.VALUATiON OF WORK 3.SQ.FF.UNDER ROOF
4.LEGAL DESCRIPTION: 5.CLASS OF WORK* 6.USE OF STRUCTURE:
11 NEW BUILDING El DEMOLrnON 1RRESIDENTIAL
LOT_BLOCK_SUB DIVISION _r� El ADDITION 11 CONVERTING USE 11 COMMERCIAL
7.DESCRiP)nON OF WORC 11 ALTERATION 13 ACCESSORY BLDG. &FIRE SPRINKLER.
11 REPAIR [y]
;QOL/Si 13 YES 11 N/A
j"A 11 MOVE M OTHER YrOLP-f-e 13 No
VROPITY OWNER: V CONTRACTOR� ARCHITECT I ENGINEER:
9.NAME: V 15.COMPANY NAMb 23.COMPANY NAME
16.NAME' 24.LICENSEE NAME
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
e-�c n-A-4, -Li �i
1 a.ADDRESS& J;L�
, e) 2) Vj 26.ADDRESS:
11.OFFICE PHONE: 12.FAX NO.: tig.OFFICE FAX NO., 27.OFFICE PHONE: 28.FAX NO.:
13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE:
C�o�1- -)-),-? (a-
14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS:
FEE SIMPLE TITLE HOLDER-
OF 17THER THAN 01111116M BONDING COMPANY: MORTGAGE LENDER:
31.NAME: 33.NAME: 35.NAME:
32.ADDRESS: 34.ADDRESS: 36.ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this
juiiscriction. This permit becomes null and void if work is not commenced within six(6) months, or if construction or work is suspended or
abandoned for a period of six(6) months at any time after work is commenced. I understand that separate permits must be secured for
Eleetvical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditionem,etc.
OWNEITS AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof,until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
I OWMER or AGENT CONTRACTOR
(VtM Powerol[ASomelll,orAgency Letter Requed) (Quamier Onty)
U h
Sign.;3-k ZA�& N CZ.4 Dala:-3-1x-�dq Signed: Date:
Before me this /11�� day of "I' ,2009 in the county 0`f Before me thi'sF-;LIY day of 2009 in the county of
Duval,State of Florida,has personally appearew i.,-` Duval,State of Florida,has personally appeared
herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate.
Notary,Public at Large,State Of County of Notary Pyblic at Large,State of County of
12'Personally Known 61pdrsonally Known
El Produced Identification- E3 Produced Identification,-JA/1 r) -4--
Notary SignaturIJ014W PVV",s Notary Signature:
-I AIL%JIUIJA DWA
0 W!,vers William R. b"T'lo-wers
IDI)4-:4975
Expire- -P 22, ;�ooq CommissLn #DD474975
Bonded Thru Atj "- *Expires: �-�,,P 22, 200(
"I',,Gnding Co..Inc.
BLDG01 Permit Application Bldg:REVISED:1211 Moos Bonded Tfum Allianlic co�,Inf
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FIL 32233 09
OFFICE:(904)247-5826 a FAX NO.:(904)247-5845
BUILDING-DEPTOCOAB.US
BUILDING PERMIT APPLICATION DUVAL COUNTY
1.JOB ADDRESS: 2.VALUATION OF WORK: 13.SQ.Fr.UNDER ROOF
71 kJ
4.LEGAL DESCRIPTION: 5.CLASS OF WORK: 6.USE OF STRUCTURE:
11 NEW BUILDING 11 DEMOLITION 19RESIDENTLAL
LOT_BLOCK-SUB DIVISION LA.�^:. 11 ADDITION 11 CONVERTING USE 13 COMMERCIAL
7.DESCRIPTION OF WOft. 11 ALTERATION 11 ACCESSORY BLDG. 8.FIRE SPRINKLER:
13 REPAIR [y]PQOL/S5k
0 YES 13 N/A
W'I 'Len 0 f 0 MOVE In OTHER %-CL6%Z-'e
77-
- I tROtITY OWNER: CONTRACTOR: ARCHITECT JEELUNOG-INEER:
9.NAME: V 15.COMPAN 23.COMPANY NAME:
�NAME;L
10'r 11 j-LD%&"P"5,-�"�'
16.NAME, 24.LICENSEE NAME:
10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
18.ADDRESS& t t6l VI,5+,, 1 26.ADDRESS:
JL
AT)"� C�>et-CL
FAX NO.:
11.OFFICE PHONE: 12.FAX NO.: 9.OFFICE PHQUE 120.FAX NO.:
ILI 27,OFFICE P 77
13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE:
14.EMAIL ADDRESS: 99 EMAIL ADDRESS: 30.EMAIL ADDRESS:
FEE SIMPLE TITLE HOLDER: BONDING COMP I ANY:
L OF OTHER THAN OVVNER) MORTGAGE LENDER:
31.NAME: 33.NAME: 35.NAME:
32.ADDRESS: 34.ADDRESS: 36.ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a pen-nit and that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six(6) months, or if construction or work is suspended or
abandoned for a period of six(6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNEITS AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof,until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER or AGENT CONTRACTOR
(if 1911 Power of Attom or Agency Letter Required) (Qualifier Only)
U-1.
Sign.-k 4f"� kA cl D�ta:--3-49- Signed: Date: 3
Before me this day of 2009 in the county of Before me this day of 2009 in the county of
Duval,State of Florida,has personally appeare Duval,State of Florida,has personally appeared
herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. 9 L true and accurate.
NotgpfPublic at Large,State of County of Notary Pyblic at Large,State of f�k, County of
lff�ersonally Known 0-106'r's'onally Known
0 Produced Identificalion- )IA 11 Produced Identification- A4 /1 4-
Notary Signatur, P Notary Signature: L
lff-�A77 ipayuywu I-
C aTA n X A(0)
'�40,T,vers - -------
L Wi lia 1� owers
-rn
DD4,'497 Commiss'jm #DD474975
Expire-
Bonded Thru Ad 22, 2009 *Expires: 22, 2W(
an'k"ading co.,Inc.
BLDG01 Permit Application Bldg:REVISED:12/1812008 Bmded Thru AtIantir"nding Cm,in.
're City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: hftp://www.coab.us I — J/--,)�dg 2
APPLICATION REVIEW AND TRACKING FORM
Dpj?a"t review required Yes No
Property Address: A6 uildin
Aptfn�ninzoni�n
g8,Z �p
Tree linistrator
Applicant:
PuAACUtilities
Project: 1&7- 1'A7)e-?– Public Safety
Fire Services
Review or Receipt
Other Agency Review or Permit Required of Permit Verified By Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATI TUS
Reviewing Department First Review: [2AO'pr�oved. E]Denied.
(Circle one.) Comments:
BUILDING
P ING &ZONING
Reviewed b
E Y: Date:
TREE ADMIN. IZ-2
PUBLIC WORKS Second Review: FlApproved as revised. RDenied.
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
FIRE SERVICES Reviewed by: Date:
Third Review: FlApproved as revised. F]Denied.
Comments:
Reviewed by: Date:
ii'l City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site, hftp://www.coab.us - J
APPLICATION REVIEW AND TRACKING FORM
Dp
.p,�"t review required YeV No
uildin
Property Address: '46
�_p
Tree"�_W�inistrator
Applicant: T-u—bric\��o�rk
NPu—b4i(Utilities
Project: Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: P/Approved. ODenied.
(Circle one.) Comments:
0��
PLANNING&ZONING
Reviewed by: 1/71 Date: Y'2&,Q
TREE ADMIN.
PUBLIC WORKS Second Review: []Approved as revised. F�Denied.
Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
FIRE SERVICES Reviewed by: Date:
Third Review: F]Approved as revised. FIDenied.
Comments:
Reviewed by: Date:
CITY OF
/*&a&? Ve4d - 94u�(4
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2395
July 21, 1987
Carol Donneley
220 East Forsyth Street
Jacksonville, Florida 32202
1 have inspected the house at 1671 Beach Avenue for compliance to the
Coastal Construction Code., The Coastal Code established by the State
of Florida as of March lst.. 1986, is enclosed as it was adopted by the
City of Atlantic Beach,
This house is within the Coastal-Construction zone and must meet the
criteria established in the Coastal Construction Code.
Cordially,
Don C, Ford
Building Inspector
CC4 file
DCF/te
"N
07 ,
DRPARTMiIENT OF BUIRAIINIG
'CITY OF ATLANTI`C BEACH
'PERMIT INFORMATION ------ - -------- LOCATION INFORMATION -------- -
Verr
V44�1,t` NWhber 8607 '
* 1671 BEACH ,,AVENUZ
Address.
Type: PLUMBING' ATLANTIC :BEACH, FLORIDA 32213
t4ork': REMODEL:
", GAL DESCRIPTION ----------
Cons t r Tlype WOOD FRAME Lot: Block: Section:
ProppOod Use: SINGLE, PAM;tY, Towhship:
RNG: 0
itigs :
Code: , :0 sul�diviSiOn: NORTH ATLANTIC ,BEACH
Zst�46xted' -Value:
1*ili�rov, Cost :
'$57 .00
Total Fees :
7/11/94:
or, HE ING IN REMODELING ,
APPLICATION FEES
N PERMIT, $57 .00
d
AVENUE" �WATER 114PACT FEE $0 00
H I D e�(3 �3 Sim
C i ' FEE04- # so'0qv
FLOR IMPA f
ThP
P,
ox
o
NPORMAT�ON
N�ame:, N E � ATE
PLU., ING TAL IMPROVE. $0 .00
Apt, �tt—aZ6,
,A VIN
StWWTAP to.CFO
JACK I LLE, PL 32223 CROSS CONNECTION
$0 .00
I,i c*r04t.', CPCO 7 ty,
pe; 4 , SEC H IMPACT PEE
P'�, .00
0
CONST..SURCHARGE
0 .
—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
NOTICE
PERMIT VOID SIX MONTHS AFTER DATE,.OF ISSUE
_,.,�'SUILDINGMATSRIAL,RUBBISH AND.DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE
:,�,,,'CLEARSO,UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
'!TAILURE T
0 LymtH HE MECHANICS' LIEN LXW
0 qOMP
CAN RESULT IN 1
TH-E RTY WNER PAYING Mite f:0RLsUIL0,tNG
EMENTS.'
IS$ D"AC
UE C0RDfNG,LTOAPPRQVE PLANSL WHICH ARE PART,OF THIS PERMIT AND SUBJECT TO REV
LI OCATION FOR
�"�'�-T'!'VVIOL,ATIONOFAPP CABLE PROVISIONS OF,LAW.
ATLANTIC A(,','HL BUILDING DEPARTMENT 0
/ij0000000'L
/9401
07.0014
14"1 ,
00k ,
By—
z
7 ge i%. � 4W
-7
CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
JOB LOCATION:
PLUMBING CONTRACTOR:
LICENSE NUMBEB: rFco jl-7-7-r
OWNER
BUILDING CONTRACTOR:
TYPE OF BUILDING:
I - SINKS SHOWERS
LAVATORY WATER HEATERS
BATH TUBS DISHWASHERS
URINALS
------ DISPOSALS
CLOSETS WASHING MACHINE
........ FLOOR DRAINS
OTHER
TOTAL FIXTURE COUNT: --Z�,Z- x $3 . 50 $15 , 0(=:
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE
WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING
CODE.
4-W44
8805
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
------- PCATION INFORMATION -------
PERMIT INFORMATION, 7
-mi t
P,e r Oumber, 8805 ss :
Addre, 1671 BEACH AVENUE
Pe ripi t Type ELECTRICAL
ATLANTIC BEACH, FLORIDA 322�3
Class ot Work; ALTERATION ---------- LEGAL DESCRIPTION -------
Type: WOOD FRAME Lot ., Section:
ed, Use, SINGLE FAMILY
pq os
RNG. 0
I code- 0,
subdivision:
EstivItated Value:
lmprov. Cost:
:$0.00
-Total Feea : $2 3 , 40
Amo�ant_ id: S23� 44�
'UTLETS". RECEPTACLES AND: SWITCHES
-"' APPLICATION FEES
ON --------
ew4q,
ERHI $2 3 4
Name
F P
�p T
Ad
*VENUE, WATER IMPACT FEE , $0 .Of)
EACH, FLORIDA 122
S FEE
71
F 3 '11, 1, $110 1
TAP
t"I" im, 4ACR
T INFORMAT;ON ------ RADON CAt 5%
Itte LECTR I C;'�COMPANY CAPITAL IMPROVE.
Add SS . ' ' 36 vp STREE SEWER TAP
`2 CROSS CONNECTION $
License:
Type. 0 *T FEE
SEC H IMPAr io o 0
�CONST.SURCHARGE
4o
SCHARGE/ATL.BCH
-NOTES'
4
NOTICE—ALL CONCRETE,FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
bVILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST'N
OT BE PLACED IN PUBLIC SPACEj AND MUST BE I
CLEARED UP AND,HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE,FOR BUILDING IMPROVEMENTS.99
ISSUED-ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR',i
il��,Vjq�ATION OF APPOCABLE PROVISIONS OF LAW.
0
AtANT)�BEACH 13UILDING DEPARTMENT P)
0,1
!7 7
'Al L,
CITY OF ATLANTIC BIEACH, RORIDA
APPLICATION FOR ELECTRICAL PIRMIT
in isiE C$IIEF ELECTnICAL INSPECTOR: DATE
IMrOnTANT NOTICE:
114 COUSIDEIIATIOU or Prnmir covEN FOR DOING IIIE WORK As DESCRIBED IN IIIE rOLLOWI"G, WE
111PERY AGREE io PEnronm SAID WORK IN ACCORDANCE Willi IIIE ATTACIIED PLANS AND SPECIFICATIONS,
VVIII('11 ARE A PART IIEREOr,AND IN ACCORDANCE WITH Illf ELECTRICAL REGULATIONS,CODES AND CITY OF
ATtA?1TIC FIFACII ORDINANCES.
2 7
ELECT AICALf IFIM: MAST Ea ELILI:LT RICIAIJ 5143NATURS JOURNEYMM
NAME ADDRESS: AJ�L RFD—BDX—
SLOG.SIZE BETWEEN:—
nEs. APt.I I comm.I I PUBLIC I I INDUS.I I NEW I Ir OLD KEW.I I
ADDITION I I TRAILER I I TIM1110.I I SIGNS I ) $0.FT.
SERVICE: NEW I I INCREASE I V, REPAIR FEE
CONDUCTOR SIZE AMPS COPPER ALUM.I I I T
SWITCH OR BREAKER AMPS PH W L't A MWAY
EXIST.SERV.SIZE AMPS PH_ VOLT RACEIAY
ruofns NO. SIZE i NO. size No. SIZE
LIGIII-ING OUTLETS FONCEALED OPEN TOTAL
RECE.PTACLES CONCEALED1 I OPEN I TOTAL
SWITCHES a i5;�ie— a I-too AMPS,
INCANDESCENT
FLUORESCENT&-M.V.
rixto
ArPLIANCES BELL TRANSF.
Ain II.P.FIAT ING H.P.RAT ING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT
MOTORS H.P. VOLTAGE PH$ NO. I N.P. TAGEI PHS
MISCELLANEOUS
TRANSFORMERS: UNDER 6W V. OVER11mv.
NO. KVA NO. JKVA
1`40�NEON TRANEF. NO. VA. MA. MOTOR SIZE 2WITC" FLASHER
EACH SIGN
70TALrifi 0 0—
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS
DEMOLITIONS
Owner(s) : T
Addre.ss:. Z' F/ Phone:
Lot #- Block or Unit # Subdivision:
Contractor: j E10
4zo -sbarrk
Address : JA-10�664cg P�6, Phone No:
Describe work to be done: 0-r-;Jun" 47't0M AU
Present use of building:_
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 hoated and cool*d? Now 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 OWNER: 4, Date:
Signature CONTRACTOR: Date :
CITY OF ATLANTIC BEACH PER14IT CALCULATION SHEET
Address
Date
Heated Square Footage @ $_per sq f t = $
Garage/Shed $_per sq f t = $
Carport/Porch @ $_per sq ft = $
Deck 001 $ ft = $
_per sq
Patio @ $ per sq ft = $
TOTAL VALUATION: $ .2(o 0 00�
a(qz 6C CD /J-- s
Total Valuation ist $ zooel
ar,00 C) / C3-0 $ /aj-. C",
Remaining Value per thousan�
or portion thereof
TOTAL BUILDING FEE $ 7 q0—-Z;D
+ 1/2 Filing Fee $ 76
( ) Fireplaces @ $15 . 00 $ 16
BUILDING PERMIT FEE s— 2to
WATER IMPACT FEE $
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:
LA 1*7 L^W& *^"GO room A"
$ 713.13
411rr ]of C=tUrnrjeUWnt
4"19PA46 W PUPLICAYBO
zo 614=11 it Utq rWW=
The undersigned hereby informs all concerned that improvements will be made to certain real
property, and in accordance with section 713.13 of the Florida Statutes, the following information
is stated in this NOTICE OF COMMENCEMENT.
Description of property........ ......... ......... 7-i�.........
—....I.............
............................................................... ..........................................I.............................................................
.............I..................................................................................................................................................... ..........................
........................................ ................................................................................................................................ ......................
Gerwral Joscripfion of imwovemetot.......... ........... .................................. ..................
........................................................................................I.......................................................... .....................................
..........................................................................................................I.........I......................................................................................
Owner ......lZeAt.-I&AS.........j...... ............................................................................................................................
Adclross........Aki�,/..........I..... .........C....W......A ......4'go.!��l ....e./: --Jl��. ,, ..�� � ............
Owner's irdered in Me of the kWovwme........Fe-6..... ...............................................................................
Fee Simple We hoWar (if wher than oww)
Kame�..............................I............................................................................................................................................................................................
....................................................................................................................................................... ..........................
Contrador....... Jal.-W........ .........................................................................................
0
Adarea......4Z-q.....4.z!��45e.........$Tt..... .........i�wmq............%
Ja .......
swoty (it any)..................................................................................................................I........................
.................................................... ............. ................ ..........................
N&M@ Of P*am wtfvn #6 Stale of Pwkie deaw.Wed hy oww qw whm inlic � or alim doommes Way
be serve&
Nam.............:...................................... .......... ...................... ......................
Ad&os&.......................................................................... ......................................................................................--......................................
In addition to himself, owner designates the following person'to receive a copy of the Lienoes Notice
as provided in Section 713-13 (1) (F), FlorWa Statutes. (Fill In at Owner's option).
Nome..............I....................................................................................................................................................
AJ&*ss...............................................................................................................
............. ...........
A
PSK-3044
An,
8991
lit
_77—
twi T INFORMATION
INV
4� ORM ,ION
--mi t Number : R991
p AiII 71
v
l6w
rmit, ,Type: BUILDIN(;
� OLORIDA 322,13
Of Work - REMODEL
Type. WOOD MWE LOTION ------t-�-
'Ott"I Ot
on.,
led use� S I NdLg`�
f I Ly
T64
Code: RNO
Dwel I
0 suwiv
v%I I ue
$,26Q00.0
'0
Ov $0.00
TO
00 ,
41:9,4,
AND kZP
�—L 010-ENT, 0, DOORS
-TION
ION
2,ltl�
4d
WATU: X$P-A,T
so 00
T QK; '%,Pt.OR I D
40,
'00
tof,
NPORMTi6
OROVEI.
4,
s�
jACK M(aH, FL 3Z,�,54
cRoss I c
NECTI-N�Nt
IMPAMPEZ
Type, 1
SIRC H
CONM $URC-NARGE 0
:N IES:
NOTICE-ALL CONCRETE AND FOOTINGS MUST BE INSPEC
TED BEFORE POURING
n R% MIT VOID
SIX MONTHS AFTER DATE OF ISSUE
47
'sutWING MATERIAL,RUBBISH,AND DEBRIS FROM THIS WO
R K MUST NOT�BE PLAC,ED IN PUBLIC SPACE,AND MUST BE
ED U0AND HAULED AWAY BY EITHER CONTRACTOR 00 OWNER
FAILURE TO COMPLY,WITH THE MECHANICS LIEN LAW CAN 'RESULT IN i
THE�PROPERTY,OWN E R' PAYING TWICE, FOR41UILDIN
G IMPROVEMENTS.9t
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT,AND SUBJECT TO REVOCAT
'VIOLATION OF APPLICABLE PROVISIONS OF LAW. ION FOR
�t,ATLAN'ft EACH BUILDING DEPARTMENT 000000000
RcO 0076976
Date, $210.001,4
8/24
By: