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Permits 1725 Beach Ave CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 .4` INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00001739 Date 12/23/08 Property Address . . . . . . 1725 BEACH AVE Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc replace burnt meter jaws ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ WOLFSON, DONALD M. BROOKS & LIMBAUGH ELECTRIC CO 1725 BEACH AVENUE Q/A BROOKS, CHRISTY ATLANTIC BEACH FL 32233 42 WEST 8TH ST. ATLANTIC BEACH FL 32233 (904) 241-9051 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . REPLACE BURNT METER JAWS Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/21/09 ---------------------------------------------------------------------------- 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. CITY OF ATLANTIC BEACH QQ �r r " rfi 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 08- -i V-1.�: _ 1- OFFICE:(904)247-5826•FAX NO.:(904)247-5845 ..��••11 J BUILDING-DEPT@COAB.US rtru}�' ELECTRICAL PERMIT APPLICATION DUVAL COUNTY $ IAF k r 71'110 S , ❑YES PERMIT#: 2 IEL?RJ&JW..► 4.NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE: �up��3 gg TTnn e q ME OF MPANY: ✓ DRESS.: • � cind Li Ch 9.ST TE OF FLO I S V 0^tf^^6 10.CELL PHONE: 11.FAX NO.: 12.EMAIL ADDRESS: 13.0 pklq. 24 /� '\ f 14. 15.Application is hereby made to obtain a permit to do the work and installations as indicCa_teiid.II cert! t all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes nu d voi if w rk is not commenced within six(6) months,or if construction or work is suspended or abandoned for a period of six(6)months t a tim afte wo is commenced. CONTRACTORS SIGNATURE: I16t+L!�,�SS QWQRKk �;� ❑�MMULTI FAMILY-#OF UNITS: ESIDENTIAL GSINGLE FAMILY ❑TEMP SERVICE ❑COMMERCIAL `f'J ❑ADDITION ❑TRAILOR •' ❑ALTERATION ❑SIGN POOLD ❑NEW 05 NATIONAL ELECTRICAL CODE 11REPAIR ❑POOL/SPA 113 REWIRE OTHER: „ a a f v . :ir. ELO�RICA %tar , 20.TYPE OF SERVICE: ❑OVERHEAD ❑ UNDERGROUND UNDERGROUND UP POLE 21.NEW SERVICE: CONDUCTORS PER PHASE: ❑POWER IS ON ❑ POWER IS OFF 22.SIZE OF CONDUCTOR: AMPACITY: ❑COPPER ❑ALUMINUM 23.SWITCH OR BREAKER SIZE: AMPS: PH: W: VOLT: RACEWAY SIZE: 24.EXISTING SERVICE SIZE: AMPS: PH:�_ W: VOLT: RACEWAY SIZE: 25.FEEDERS: #OF AMPS: #OF AMPS: #OF AMPS: 26.LIGHTING FIXTURES: INCANDESCENT: FLUORESCENT&M.V.: 27.FIXED APPLIANCES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: 28. FIRE ALARM: ❑YES ❑ NO 29-31 DO NOT APPLY TO NEW SINGLE FAMILY,MULTI-FAMILY AND ROOM ADDITIONS 29.SMOKE DETECTORS: NUMBER: 30.RECEPTACLES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: 31.SWITCHES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: .t � ' ?Z y r ,.r k l&ILIMT,.IONING� =tw #OF UNITS: COMP. MOTOR HP RATING: AMPS: AT KW:#OF UNITS: COMP.MOTOR HP RATING: AMPS: AT KW: P4'', R� ".... wrki.rh's%aKr,dY.,�+>:s?hkr w�* NUMBER: VOLTAGE: HP: KVA: NUMBER: VOLTAGE: HP: KVA: UNDER 60OV: NUMBER: KVA: OVER 60OV: NUMBER: KVA: DESCRIBE IN A : COAB FORM BLDG02:REVISED: /10/2008 QIP OificeJet 7410 Log for Personal Printer/Fax/Copier/Scanner Information Systems 904-247-5845 Aug 10 2008 3:45PM Last Transaction Date Time Type Identification Duration Pages Result Aug 10 3:43PM Fax Sent 96657372 1:46 2 OK Graham Shirley From: Graham Shirley Sent: Tuesday, December 23, 2008 2:00 PM To: 'Schweizer, Carol M.' Cc: Boyd, Nancy; Jones, Mike Subject: emergency repair 1725 Beach Ave Carol, Permit# 081734, 1725 Beach Ave is ready for power,this was an emergency,the fax is on its way. Shirley L.Graham Building Department 111m is Beach,n sdrahaM*coah.as ,e :x a 4w r s roc �- �1,J5 � �c �tdyt o pp /& S/&� C.ILU � 0-�AA l.eIS r p (Y,n- cC-/v' 1 ��� 3/ � L PROPERTY OWNER NAME: KARFN A DoNAiP M. Wc7LFsoN SERVICE LOCATION ADDRESS: 1'72T QJEACH /NVQ Ca.k.4_ is- io o9 -as-DQE yy9 ATLAN77c 03EAcN oHrr oto Pr-Go PROPERTY OWNER PHONE NUMBER:_ 9D'y-a A4 G.-a844 7 . TENANT NAME:_ /V/A SERVICE NOW: ON CITY WATER ❑ ON LL _ CONVERT FROM ON-SITE SEPTIC SYSTEM TO CITY SEWER: OPTION A: Customer hires own contractor and pays costs. OPTION B: Customer pays costs and hires contractor with City's assistance. (:QPTION C. stoner hires own contractor andfinances costs through the ity o is Beach. - Q +f+W4),-Xurnkey Support. City assists with entir/econversion.9 AhuA+ets c"4j *t%*- C..,*y o-f A-t-Liafi4l C l3!k-t, CUSTOMER SELECT OPTION PREFERRED: ❑ Option A ❑ Option B Xoption CP POption D OWNER'S SIGNATURE: asco ►�. Please return to: TO BE COMPLETED BY CITY: DATE RECEIVED: REAL ESTATE NUMBER: LEGAL DESCRIPTION: PRICE QUOTE: melok—j 7/24/00 CITY OF ATLANTIC BEACH, FLORIDA UTILITY PAYMENT PLAN AGREEMENT PROPERTY DESCRIPTION: OWNER: Donald M. Wolfson 1752 Beach Avenue Atlantic Beach, Florida 32233 RE# 169665 0000 LEGAL DESCRIPTION 15-10 9-2S-29E North Atlantic Beach Unit 01 Pt Govt Lot 7 Recd O/R 5349-1108 Sec 9-2S-29E, N '/2 Lot 22, Lot 23, S 20.04 Ft Lot 24 TOTAL AMOUNT OF AGREEMENT: $5,543.25 This document shall serve as an extended payment agreement between you and the City of Atlantic Beach, Florida for the above listed total amount and for which said amount will be filed as a lien with the Court of the Circuit Court for Duval County, Florida until the entire balance is paid. CHARGES: Sewer Impact Fee $1,250.00 Contractor 3,070.00 TOTAL CHARGES: $4,320.00 Less Down Payment 341.50 Payment of lien filing fee 10.50 TOTAL DOWN PAYMENT: $352.00 TOTAL AMOUNT FINANCED $3,978.50 TOTAL AMOUNT OF LIEN $5,543.25 TERMS: Number of Monthly Payments 120 Due Date: Due monthly with your utility bill Billing Included on utility bill Late Charges 10% Failure to pay all charges will result in the water services being cut-off. Payment Amount $46.19 per month Total Interest over term of loan $1,564.75 LIEN: A lien in the amount of the TOTAL AGREEMENT above shall be executed and recorded against the above referenced property. The owner hereby agrees to pay all recording fees and costs involved with the execution of the lien. Upon payment being made in full,the lien shall be released of record. Please indicate your acceptance of the provisions of this agreement by signing in the place indicated. Your signature signifies your agreement to indemnify and hold harmless the City of Atlantic Beach, Fl., from any and all damages resulting from your failure to timely make the above payments, including reasonable attorneys fees and court costs. The City of Atlantic Beach looks forward to cooperating with you under this agreement. PROPERTY OWNER �, By: i` a 1 �� .� Date: Donald M. Wolfson City of Atlantic Beach Date: -71 Z*&i T7Hanson, City Manager Prepared by and return to: Debra A. Ramsay, Accountant City of Atlantic Beach 800 Seminole Road Atlantic Beach, FL 32233 REAL PROPERTY LIEN The parties have agreed that this LIEN be filed against the real property owned by Donald M. Wolfson, and shall be recorded in the official public records of Duval County, Florida. This LIEN is for financed costs associated with the conversion of a private septic system to public sewer system and including sewer impact fees on the following real property located in Duval County, Florida, more particularly described as follows: RE#: 169665 0000 LEGAL DESCRIPTION: 15-10 9-2S-29E North Atlantic Beach Unit 01 Pt Govt Lot 7 Recd O/R 5349-1108 Sec 9-2S-29E, N '/2 Lot 22, Lot 23, S 20.04 Ft Lot 24 OWNER NAME & PROPERTY ADDRESS: Donald M. Wolfson 1752 Beach Avenue Atlantic Beach, Florida, 32233 This LIEN is to secure payment from Donald M. Wolfson to the City of Atlantic Beach in the amount of$5,543.25. Witness (Sign Name) OWNER: Donald M. Wolfson Witness (Print Name) Yh CITY OF ATLANTIC BEACH Witness (Sign Name) By L Julie B i9rand t Maureen King Witness (Print Name) Certified Municipal Clerk Page 1 of 2 Wolfson Lien STATE OF FLORIDA COUNTY OF DUVAL ''// Sworn to and subscribed before me this)j'--"day of , 2001,by n 0- who are personally known to me tn-prvzit3ee� -as-id mgfiGatioH, and who did/did not take an oath. Notary Public, State of Florida My Commission expires: K SANDRA D.REICHARD COMMISSION 8 CC 741742 EXPIRES:07/14/M2 Y Fla.No tIuY Servica&Bonding Co. Page 2 of 2 Wolfson Lien CITY OF No. r ATLANTIC BEACH When Validated, This FLORIDA Becomes an Official Receipt. h NAME ' 'L -yr , t' )'-�L""' (C I 20--L ADDRESS CITY Li 1, 5-0 o 000- 49 "1 rte.. �00--tido© b0-000o-3`�33� bC� �54� 4o 70 .00 Q„ Gx� ,4-,:Lt 100 -00 00 343 ,�a -Oa ���� 3 As. e e X133 Date: UE8131 h eceiot: ,otal ir"anci#4 CITY OF r'�tla,ctr.'c �eacl - TCtYtfs'�Q M SEMU40LE ROAM ATLANTIC BEACH,FLORIDA 32233-SA45 TELEPHONE(904)247-SBOO FAX(904)247-5905 Date ' C� 00 L FS J N x.253 of.4<14 v�, -rL,*A.)Il c 6ifc(rt Dear Property Owner : The costs to connect your building to the City sewer and/or water system are as follows : Sesser Tap - Labor and Materials to tap into sewer main S Water Tap - Labor and Materials to tap into water main Water Meter .- Cost of Meter S 8 Cross Connection Inspection - Inspection by Public Works to ensure backflow prevention $ 3S' Sewer Impact Fees - Funds future expansionU of the sewer plant $ l s Water Impact Fee - Funds future expansion of the water plant $ C� � Capital Improvement - Funds for improvements , expansion or replacement to water system $ TOTAL COSTS $ '. 3 (p If you have any questions concerning these charges please call the building department at 247-5826 . Sincerely , Don C. Ford Building Official DCF/pah 08/05/04 City of Atlantic Beach Wolfson Sewer Connection Loan As of 8/19/03 Payment Account Account Code Name # Amount FSCN Sewer Impact Fees-Financed Charges 410-0000-343.52-03 1,090.96 59 Sewer Impact Fees 410-0000-343.52-00 341.50 80 Water Meters-AB 400-0000-343.33-00 85.00 56 Backflow Prevention Inpection-AB 400-0000-343.37-01 35.00 54 Water Connection Charge-AB 400-0000-343.37-00 670.00 57 Water Capital Improvements 400-0000-343.90-00 325.00 Amount paid for Sewer loan 2,547.46 FSCN as of 9/12/03 1,154.75 UB 8/27/03 63.79 Refund Amount 1,090.96 h:\SepticTank\wolfson refund.xls -UT470I01 City of Atlantic Beach 8/05/04 Account History - Combined Inquiry 11:27 : 44 Customer ID: 5935 Name: WOLFSON, DONALD M. Location ID: 5934 Addr: 1725 BEACH AVE Cycle/route 04 99 Amount due . . . . . . . . . 17 . 60 Initiation date 1/01/87 Pending . . . . . . . . . . 00 Termination date Customer/location status . . A Type options, press Enter. 5=Display Trn Trn Reference Running Opt Type Date Description Amount Date Balance BL BILL 10/29/03 CYCLE BILL 17 . 60 11/01/03 34 . 97- BL BILL 9/29/03 CYCLE BILL 17 . 60 10/01/03 52. 57- DT PMT 9/25/03 JLANIER 09250304 70 . 17- 70. 17- CR RFND 9/15/03 REIMBURSEMENT RECURR 1090 . 96 . 00 _ RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 9/01/01 1, 090. 96- RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19.- 10/01/01 1, 044 . 77- RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 11/01/01 998 . 58- RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 12/01/01 952. 39- RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 1/01/02 906. + F3=Exit F5=Adjustments F7=Pending F8=Charges F9=Print history F10=Reference numbers Fll=Payments F12=Cancel F24 More keys ,MR430I07 City of Atlantic Beach 8/05/04 Miscellaneous Receivables Inquiry 12 :26: 09 "Customer ID . . . . 128 Name: Wolfson, Donald M. Last statement 8/02/04 Addr: 1725 Beach Avenue Last invoice 0/00/00 ATLANTIC BEACH, FL 32233 Current balance 2, 132 . 19 Pending . . . . . . . 00 A ACTIVE Special Assessments Type options, press Enter. Combined Detail 5=Display Chg Bank G/L Opt Trans Date Code Description Amount Typ Code Post 11/01/03 BCHO1 Beach Avenue Principal 42 . 37 P N 10/01/03 stmrn Statements Processed . 00 N 10/01/03 BCH02 Beach Avenue Interest 12 . 70 I Y 10/01/03 BCHO1 Beach Avenue Principal 42 . 16 P N 10/01/03 stmrn Statements Processed . 00 N 10/01/03 BCH01 Beach Avenue Principal 1036. 10 P N 9/25/03 PAYMENT 54 . 86- 9/18/03 PAYMENT 1090 . 96- - More. . . F3=Exit F12=Cancel * = Pending CITY OF ATLANTIC BEACH SS J 800 SEMINOLE ROAD -N ATLANTIC BEACH FLORIDA 32233 =' INSPECTION PHONE LINE 247-5826 sst AApplication Number . . . . . 04-00028805 Date 8/04/04 Property Address . . . . . . 1725 BE Tenant nbr, name . . . . . R 1FIXTURE Application description . . . PLUMBING Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ WOLFSON, DONALD M. WILLIAMS BIG BOY PLUMBING INC 1725 BEACH AVENUE 516 11TH AVENUE S ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 241-1880 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 42 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 42 . 00 42 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 42 . 00 42 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ..— ( - IMK B G OFFICIAL CITY OF ATLANTIC BEACH Y PLUMBING PERMIT APPLICATION 77r Date: 0`4 _G I Property Address: Owner: DC'4) Wa Telephone#• Contractor: Cj Telephone#: Contractor Address: c P U 6 �`'" �" ' 1 Fax#: 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, ❑ New list the building permit number: ❑ Re-Pipe 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 Total Fixtures: X$7.00 + $35.00= 800 Seminole Road .Atlantic Beach, Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845• http://www.ci.atiantic-beach.fl.us Revised 1/04 - f CITY OFp No. ATLANTIC BEACH When Validated, This FLORIDA Becomes an Official Receipt. 20-61NAME � � -z ADDRESS j :2 2, -Q-C, Q.-y CITY �j ar qo C4 ;2k-S 41D —0000 - -3(f3. �e� 'a C� ( Jr f, Lt 110 C)00- C � cCo10 -oma -3 3 . 733 to 70Cb •C�C� �' (S-v As' 0 0- t'clD -00 �i`-fir. �r►':�� �J19" -�jvl r Z �'c� ��.�.c�ytic�.-� -,�,��..E � :- �D c. GveratON Dat;F TP Date: UEB/Sf :31 eceiut; LL +Q a 'PLiS4 rf As 7a Vi CITY OF r�t�!a.,ct�c �eacl - 7�OR1.C�Q NO SEMn40LE ROAD ATLAMfIC 3EACX,FLORIDA 72233-Sits TEIXMONE(9041 247-58M FAX(904)247--5805 Date : 7 - �� �o.J wDcFS�N 42000 Aug, TL,4AJ7-1 C /:3EiFCVIL Dear Property Owner : The costs to connect your building to the City sewer and/or water system are as follows : Sewer Tap - Labor and Materials to tap into sewer main $ Water Tap - Labor and Materials to tap into water main $ —' Water Meter .- Cost of Meter $ Cross Connection Inspection - Inspection by Public Works to ensure backflow prevention $ 3.5, Sewer Impact Fees - Funds future expansion of the sewer plant $ / ,2 5-0 Water Impact Fee - Funds future expansion of the water plant $ Cav Capital Improvement - Funds for improvements , expansion or replacement to $ water system TOTAL COSTS $ (p If you have any questions concerning these charges please call the building department at 247-5826 . Sincerely , Don C . Ford Building Official DCF/pah 4 08/05/04 City of Atlantic Beach Wolfson Sewer Connection Loan As of 8/19/03 Payment Account Account Code Name # Amount FSCN Sewer Impact Fees-Financed Charges 410-0000-343.52-03 1,090.96 59 Sewer Impact Fees 410-0000-343.52-00 341.50 80 Water Meters-AB 400-0000-343.33-00 85.00 56 Backflow Prevention Inpection-AB 400-0000-343.37-01 35.00 54 Water Connection Charge-AB 400-0000-343.37-00 670.00 57 Water Capital Improvements 400-0000-343.90-00 325.00 Amount paid for Sewer loan 2,547.46 FSCN as of 9/12/03 1,154.75 UB 8/27/03 63.79 Refund Amount 1,090.96 h:\SepticTank\wolfson refund.xls -UT470IQ1 City of Atlantic Beach 8/05/04 Account History - Combined Inquiry 11:27 : 44 Customer ID: 5935 Name: WOLFSON, DONALD M. Location ID: 5934 Addr: 1725 BEACH AVE Cycle/route . . . . . 04 99 Amount due . . . . . . . . . 17 . 60 Initiation date 1/01/87 Pending . . . . . . . . . . 00 Termination date Customer/location status . . A Type options, press Enter. 5=Display Trn Trn Reference Running Opt Type Date Description Amount Date Balance _ BL BILL 10/29/03 CYCLE BILL 17 . 60 11/01/03 34 . 97- BL BILL 9/29/03 CYCLE BILL 17 . 60 10/01/03 52 . 57- DT PMT 9/25/03 JLANIER 09250304 70 . 17- 70 . 17- CR RFND 9/15/03 REIMBURSEMENT RECURR 1090 . 96 . 00 _ RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 9/01/01 1, 090. 96- RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 10/01/01 1, 044 . 77- RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 11/01/01 998 . 58- RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 12/01/01 952 . 39- _ RC ADJ 9/14/03 QINANCED SWR.CONNECT 46. 19- 1/01/02 906. + F3=Exit F5 Adjustments F7=Pending F8=Charges F9=Print history F10=Reference numbers Fll=Payments F12=Cancel F24=More keys -MR4301Q,7 City of Atlantic Beach 8/05/04 Miscellaneous Receivables Inquiry 12 :26: 09 Customer ID . . . . 128 Name: Wolfson, Donald M. Last statement 8/02/04 Addr: 1725 Beach Avenue Last invoice 0/00/00 ATLANTIC BEACH, FL 32233 Current balance 2, 132 . 19 Pending . . . . . . . 00 A ACTIVE Special Assessments Type options, press Enter. Combined Detail 5=Display Chg Bank G/L Opt Trans Date Code Description Amount Typ Code Post _ 11/01/03 BCHO1 Beach Avenue Principal 42 . 37 P N _ 10/01/03 stmrn Statements Processed . 00 N _ 10/01/03 BCH02 Beach Avenue Interest 12 . 70 I Y _ 10/01/03 BCH01 Beach Avenue Principal 42 . 16 P N _ 10/01/03 stmrn Statements Processed . 00 N _ 10/01/03 BCH01 Beach Avenue Principal 1036. 10 P N _ 9/25/03 PAYMENT 54 . 86- 9/18/03 PAYMENT 1090 . 96- More. . . F3=Exit F12=Cancel * = Pending F y HTE info Group type(F4) AJ Adjusting journal Group date 08/25/04 Accounting period 11 Accounting year 2004 Group description Reclass Wolfson cash receipt Create document N (Y=Yes; N=No) Count entered 5 Debit amount entered 1,990.00 Credit amount entered 1,990.00 Transaction date 08/25/04 Page: 1 of 1 Group number Fund/Account Name Account number Debit Credit Sewer Fund/Sewer Impact Fees 410 - 0000 - 343 52 - 00 995.00 Sewer Fund/Pooled Cash 410 - 0000 - 104 00 - -00 995.00 Water Fund/Water Impact Fee 400 - 0000 - 343 37 - 00 670.00 Water Fund/Water Capital Improvement 400 - 0000 - 343 90 - 00 325.00 Water Fund/Pooled Cash 400 - 0000 - 104 00 - 00 995.00 Batch Count: 5 Control Total 1,990.00 1,990.00 Description: R E C L A S S C A 5 H R E C E I P T F O R 0 6 / 2 8 / 0 1 W O L F S O N Explanation: Reclass cash receipt from Don Wolfson of 1725 Beach Avenue dated 6/28/01.for Utility Payment Plan Agreement(converting from septic to city sewer&well to city water) Prepared by: Approved by: 0 h:idailyuse\finance forms\aje R K Y CITY OF No. AT LA N T ! C B EA C H when Validated, This FLORIDA Becomes an Official Receipt. t° 20--L NAME ° z ADDRESS CITY Lt 11 ;�'► -Q- poi - oov.. 3G� -`�a- o� s 10. Wo> �r ► ts:,�-5 tcov -ovco -3tl,z . 33 Oa D --00 r 1 I g,40 13 3 IV aoerator; M TH Date: VU/31jf IReCeiDt7 :'4tQ3 dS litr M467.89 CITY OF 1�d!axt� i'cacl - 7�D�tC�Q M sUAMOLE 20,W -. ATLAN nc W-%CX FWRWA=34"S TEL MKM 1"Q 24-';�=e FAX(90x)U7-SMS Date: .27 -01 �e�J 4J�cFS�N /7.2S" e.4<o v,� fi TL4*AJ71 C l�11K1'f�' Dear Property Owner : ' The costs to connect your building to the City sewer and/or water system are as follows : Sewer Tap - Labor and Materials to tap into sewer main $ Water Tap - Labor and Materials to tap into water main Fater Meter .- Cost of Meter S �► � Crass Connection Inspection - Inspection by Public Works to ensure backflow prevention $ Sewer Impact Fees - Funds future expansion of the sewer plant $ 1 .2 5 water Impact Fee - Funds future expansion of the water plant $ [� O Capital Improvement - Funds for improvements , expansion or replacement to water system $ a TOTAL COSTS If you have any questions concerning these charges please call the building department at 247-5826 . Sincerely, Don C. Fa d Building Official DCF/Pah CHECK REQUEST ; DATE 08/25/04 VENDOR NO. 5800 PAYEE City of Atlantic Beach .: sx;;. ADDRESS Utility Billing CITY STATE ZIP CODE ACCOUNT DESCRIPTION ACCOUNT NUMBER PROJECT NO. AMOUNT Sewer Impact Fees 410-0000-343.52-00 $86.50 Subtotal from Page 2 TOTAL $86.50 DESCRIPTION OF ITEM OR SERVICE: Per Nelson's conversation with Mrs. Wolfson on 8/25/04-apply overpayment from 6/28/01 to utility bill SPECIAL INSTRUCTIONS: Please attach offsite cash receipt to check&forward to cashiers To expedite processing, please attach adequate documentation to support payment. ADDITIONAL APPROVALS ONLY REQUIRED WHEN CHECK REQUEST IS OVER$500 D. Ramsay 8/25/04 REQUESTED BY/DATE DEPT HEAD/DATE I FINANCE DIR/DATE CITY MGR/DATE H:\dailyuse\finance forms\[offsite cash receipt reconciliation form.xlslreconciliation form i t. ICr Y OF NO. ATLANTIC' SEACH When Validated, This FLORIDA Becomes an Official Receipt. NAME 10X-),n A—&] 20-6.1 ADDRESS CITY LCL pj�,� S4,� 9-r ack ��S 41-D -0000 - 3cfZ3 SvZ -ac7 CS�1� Lt 1 S.. 0 b. a-Q. ook -fly.. .3 Via- 0� C � �jo �s- t str5 f�6 - a-0a ,-OOCO -3�-3 . 33 -QO C.s... O'. Lk t)a--O coo-3`��.3��-ot� <s � 7c .o(s) th �.a r �;A'Q T�.f %aa -bboc�-Z)4 3 ,�� -C)o �S '7� 3 � O C 13 3 14 6z� - , -spf Z JAW S 133 '�7D ��a$�a1 tamator: MI TH Date: 6/waw 31 iscaipt. MEMO-41 Total pareest 81 b7. City of Atlantic Beach Off-Site Cash Receipt Reconciliation Form Revised Forth: 6ro1/04 Date prepared: 8/25/04 Prepared by: D. Ramsay Payment GL Account or Type Accounts Receivable Deposit Code Description Number Amount UP Payment for Utility Bill 5935-5934 86.50 Total Deposit 86.50 Cash ACH Checks 86.50 Money Orders Total 86.50 H:\dailyuse\finance forms\(offsite cash receipt reconciliation form.xislreconciliation form f i rL�l f.f CITY OF ATLANTIC BEACH S� 800 SEMINOLE ROAD } ATLANTIC BEACH,FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 03-00026143 Date 5/27/03 Property Address . . . . . . 1725 BEACH AVE Tenant nbr, name . . . . . . REPLACE CONDENSER Application description . . . MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ WOLFSON, DONALD M. MCCALL CENTRAL AIR GOND. 1725 BEACH AVENUE 2690 ROSSELLE STREET ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32236 (904) 387-6333 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 59 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 59. 00 59 . 00 . 00 .00 Plan Check Total .00 . 00 . 00 . 00 Grand Total 59. 00 59 . 00 . 00 . 00 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. q BUILDING OFFICIAL : w OVILWIM1410, Paw", tic AP MAT ON ICAC. PERMIT IMPORTANT--Applicant to caro!•A It em in sed6u I.If. M. and IV.41 r 1 IalorsaslVaq Sfseoh: ashes � Ash t! Sob-ima e IL IDENTIFICATION—To be completed by al applicants. Is cesdderoties of permit 116*0 for deiRq Me work at deun'b•d In the ahem 6#419m•0 w hereby agree to perform sold work to aeeerdeaco " As atteellpd plant sad specifications which am a pert hereof end im occerd•Me with*'a City of Joclw'B som •ordinances sad steodsrds a/ped practice Gsfed therein. Meme of M"k"Md Matter, Casrashr(rrMf) I ohmMaster of 1% OWh Owsor if�Zo el Owsw Stgm•1we d v AaMsrissd Agee! ArehiHd or EagiReer A. T of hNtinq W: 9. IS OTHER CONSTRUCTION BEING DONE ON Docfric THIS WILDING OR SITET O 6«—O LP O Natural O Central Utility I/VCS,GIVE NUMBER 0/CONSTRUCTION O OA PERMIT O Other --Specify IV. MSCH/MIICAL BQUIPMINT TO Ili INSTALM NATURE OF WORK (Freida complete Ref of coop- boa bad of this k wr) ❑ Residentlal or ❑ Commercial most O Spon O Recce/seed//'�� Ceatmi O hoer ❑ New Building Air Condrtiea;": ❑ Room CG*W' ❑ Existing Building O Duet System: M•ter:at J \ TAic1..� ❑ Replacement of existing aystwn M•timum c•p•city cLw. ❑ New Installation(No system previously InstafteM - ❑ Extension or add-on to existing system ❑ Rahigerefiom ❑ Other—Specify ❑ Coogsq fewer: Capacity q.p�. ❑ Fn sprinklon: Number of hw# ❑ 6evdor ❑ Maalift ❑ Escat•ter (Rsmbar) THIS!PACs 004 OPR=USs ONLY ❑ ""no Pumper (mlmbor) (Roeab+d) ❑ Tem (number) RemeAs ❑ LPG coosHere (Rurnbor) ❑ Usfrod Pretwrs vaoM PermA Approved b:r Dab ❑ DOOM ❑ ONwr—Specify penAit s" LIST ALL EQUIPMENT AA CONDMONltiv AND .Le.FMCERATION EQUI)PIA N'S Ifsssallsr VBITa Desc"vu s Model NUmttoe atswutlaatwwt► C1�BBj � 2 iMATMG•FURNACES.BOILEIIS.FMVLACLS _ __ r 7H�lae T1tieb DwBoe!/tlas Ifi4l Ihtaaftat YatrBLr,efae� l+�sv'4 iANRi saw ' Rlw BfW CiRRa�M ]tBaw�� BM, e CITY OF ATLANTIC BEACH i MECHANICAL PERMIT j j 800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877 --- -- -- —---—! -- LOCATION INFORMATION 7 Permit Number: 24550 Address: 1725 BEACH AVENUE Permit Type: MECHANICAL ATLANTIC BEACH, FLORIDA 32233 Class of Work: ALTERATION Township: 0 Range: 0 Book: ! Proposed Use: s Lot Square Feet: t ) Block: Section: 0 Subdivision: NORTH ATLANTIC BEACH Est: Value: Parcel Number: Improv. Cost: OWNER INFORMATION_- --- — Date issued: 7126I2QQ2 '------ � Name: DON WOLFSON Total Fees: 25.00 ` Address: 1725 BEACH AVENUE Amount Paid: 25.00 Date Paid; 7/25/2002 ATLANTIC BEACH, FLORIDA 32233 Work Desc: INSTALL DUCT WORK fllt �Q �Q�Q-0000 j- - � - --- ---- -- _ RACONTRACTOR Ste` - E CATION_FEES MCCALL CENTL AIR CONDTI -.----1 ti 25.00 x „ ..... tt'�` ^y+YR'.d�' ,yam ,y., tl• ,: � h tip,,`•?'°'�2�.e m �.a„ 'a .ie° � ta» T'1Ls� _ � v v,mwi A — NOTICE4 — � tN*� ION BUILDING MATER{AL;E MUST BE CLEARED U4 � T� fiJ"F I� 1 ,C SPACE, AND FAILURE TO COMPL _ ' • _ � PROPERTY OWNER PA THE ISSUED ACCORDING TO APPROV_ Dj .FOR VIOLATION OF APPLICABLE PRO SUBJECT TO REVOCATION I Oper: CHERYLE Type: OC Drawer: 11, Date: 7/26/02 01 Receipt no: 76747 AC BEAC —BUILDI DEPT - 14 PERNITS-BUILDING 1 $25.001 ---- 66100003221000 1725 BEACH 28031 $25.00 I��rCHC�(S Trans date: 7/21 k fijl?: 1515q:06 BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC.BEACH,FLORIDA SEa'SS APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT—Applicant to complete all items in sections I, 11, III, and IV. I, S' P C' LOCATION Street Address: J OF Intersecting Streets: I ets: Between ' s.'�ay '� And BUILDING Subdivision 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 attochpd 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 a �^/ Contractors Contractor(Print) e�� ��f7 `i� Mnfer Name of I] S Property Owner Q 1 v Signature of Owner Signature of at Authorized Agent Architect or Engineer Ill. GENERAL INFORMATION A. Type of fine fool: B. IS OTHER CONSTRUCTION BEING DONE ON THIS BUILDING OR SITE? Q baa--Q LP ❑ Natural ❑ Control Utility IF VES.GIVE NUMBER OF CONSTRUCTION Q 03 PERMIT Q Closer—SWfl IV.MOCH INICAL I*UIPMENT TO N INVALLED NATURE OF wORK (Pmvkdo complete list of compbrsessts an Md of this forest ❑ Residential or ❑ COmmeTolal. ❑• Heal ❑ Space ❑ Reeewd O t anfiel O PAW ❑ New Building Q Air adsHoning: Q Room Q Central ❑ Existing Building f Sy■tem. Materfal T►icl— ❑ Replacement of existing system Ma■imum capacity 77�� tf J e f m ❑ New Installation(No system previously Installed) ❑ Extension or add-on to existing system Q Refrigeration ❑ Other—Specify Q Cooling (ower: Capacity g W" Q Fire sprinklon: Numbor of heads Q %vaier ❑ Monliff ❑ Eamleter Isumber) THIS SPACE IIOR ON40 WE ONLY ❑:Gmoliso Purnia'- —("umber) Ill"« I Q. Teaks (number) Remarks Q US-0111 lam -_--(number) .. Q Uafired pmoure ve" ►enoN Apprewd by�� Daft Q EeRess ccamWpermit Fee_. Q Other—+1�.� - Z, eT ALL EQUIPMENT AM CONDITIONING AND REFRIGERATION EQUIPMENT � w Number Uae Unite Deriptba Modd Number Hamstaotww t=? HEATING.PURNACES,BOILERS,FIREPLACES pity •VPMVf NumberU Uta DWG"Ptim modid Number 39awAbelaree (am) ACMW TANKS 'gyps m serial ApPrOVIAS am Dbuod=W now)sear U.*= Name No. 12178 DEPARTMENT OF SUI LQIPIG CITY OF ATLANTIC BEACH PERMIT INFORMATION -�___-- _ .. :LOCATION INFORMATION _ --- Permit Number: 12178 Address : 1725 BEACH AVENUE Permit Type.MECHANICAL ATLANTIC BEACH, FLORIDA 3223$ Class o Work:ALTERATION - ---- LEOAL DESCRIPTION - _ -- -. Constr. Type:N/P Block: ' Lot Twpl, Proposed Use, Section`: 0 Subd:n Rnq 0 Dwellings: 0 Subdivision NORTH ATLANTIC BEACH Est . Value. 0 .00 Improv. Cost , >CI19 Total Fees 37 »00 Amount Pa.d: 37 .6O at-t _-Work I) DENSER AND AIR. HANDLER , 'ION -- AIsPL► CA ON FEES ---- Name: D �TM 37 .00i1 Addr kCITY FLORIDA Phone' (} O FORMATIO ------ Name: H , T AIR; Addr 10 to Lio RA0024 Exp Type: NATES; NOTICE ALL CONCRETE FORMS AND FOOTINGS MUST BE INSpIEOTE©BEFORE POURING a PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL,RUBBISH AND-DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBt IG SPACE,AND MUST BE CLEARED UP AND HAULED AWAY Sy EITHER CONTRACTOR OR OWNER I " J41LURE TO COMPLY WITTHE MECHANIC'S LIEN W CAN REjTHEPROPEATYLT IN� OWNER PAYINGTWICE FORT IE UILQ IMPR02r ? yy I; SUED ACCORpINQ TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT ANV "qftREV*= S%�tTI01V OF APPLICABLE PROVISIONS OF LAW. , ATtoANTIC. BEACH BUILDING DEPARTMENT 4 BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BLACH, FLORIDA attain APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I, 11, 111, and IV. 1. LOCATION Sheet Address: �- OF Iaterseafiag Sheets: Between And WILDING suis-divhi•a II. IDENTIFICATION — To be completed by all applicants. to consideration of permit given for doing the work as described in the above statement we hereby agree to pifform said work in accordance with the aHactud 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 Machaaj al (/�/�� t 1 Master Contraat•n � n GaefrK0M I hist ( Name " h*paAyOwaar Sigaatrre of Owner Signature of er AetMariaad Aloof Architect or Engineer 111. G491E INFORMATION A' Ty*o of heating hr•1: e• Is OTHER CONSTRUCTION BEING DONE ON r Eiectric THIS BUILDING OR SITE? T'_7 (❑_ Ga—O V O Natural T" cattrol UNlily IR Y[i. GIVE NUMBER 0I CONSTRUCTION ❑ Oi PERMIT Q 00- — specify IV. M*C►WUGL OQUI MPIT TO E! OWALLID NATURE OF WORK IPm.-4e OW419»Set of compowts o•ted of this"I Residential or ❑ commercial Ig ►bet O Spoce O Roeowod Or Cootp>t O Flow ❑ New Building 111 Asr Coedrfsorsiog: Q Rom io ca." Existing Building w O pwc� sy1fe1 s: moserial Thidess �1. Riplacement of existing system mea:etem wt>+ciN s.fro, ❑ New Installation(No system previously Installed), O Rafrig•wtio• O Extension or add-on to existing system ❑ Other— Specify Cl Coelieg towo+: Gp.cJfy N.RI. ❑ An spoinkfars: NwAw of beadle O E1.vetw O Man{ih O Ewlesse. eRlrer) THIS II►ACE boil ORiCi Yffl CMiLY (3 Gases" O Toah (osttst`or) Renssds 0 LPG 60*% 10416110 O UN&W ppmwo wool Q 11•ien Fom* Appsevd `y I�.a. O OAW — SPK* hnRll a-- UST ALL EQUIPMENT AJIR COND MM14G AND REPRIGEMI70N EQUWMEM' lhatssNtr Usha Dsacilotios Nedd NW"w s 1v WArNG • FURNACES. SOIum, PIRJ?1L.AMS xtmabw valla if..wsa..af.. v.._.-- � - - Cftadlr Amm"Ltlt Ps'tae�a 11982 DEPAI~< MIENT OF BUILDING CITY OF ATLANTIC]BEACH { _ PERMIT INFORMATION -- -,.-_ -- 'LOCATION INFORMATION --------� Permit Number: 1.1982 Address : 1725 BEACH AVENUE Permit sTyp :RE-ROOD"' ATLANTIC BEACH, FLORIDA 3223$ class of Work:Nl --- LEGAL DESCRIPTION -------- Constr. Tyge:WOOD FRAME' Block: Lots Twp` ;01 Proposed Use:SINGLE FAMILY Section': 0 Swbd: Rng; CI Dwellings: Subdivision NORTH ATLANTIC BRACH" Est , Value: 0.60 T " Improv . Cost : 5, 830.00 Total 25 .00 , { Amount a , a' TION APPLICATION FEES. Nam PERMIT 25OQ Addr: tall Pho 1 U FORM R' AT N _ Addr FloTRAIL KSON FLORIDA 32259 L - R > P: I- i { r i t NOTICE--ALL CONCRETE FOR"AND FOOTINGS MUST BE INSPECTED ISEFOAE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL,RUBBISH AND[?IWBRIS;FR4M THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE I CLEARED UP AND HAULED AWAY BY EITH A ONTRACTOR OR OWNER FAILURETO, COMPLY WITH THE MECHANIC'S ,L.IEN LAW CAN RESULT IN TSE PROPERTY O`NER PAYLN TWICE FORtHtSUILDING IMPROVEMENTS 1 I I UED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT `p%"T REV AT � �ATtOI�t�kF;APPLICABLE PROVISIONS OF LAW. tom, � - ATLANTIC BEACH-BUILDING D P TMENT AIV CITY OF ALANT I C BEACH ROOFING PERMIT APPLICATION Owner(s) : Address: /r7,19' 0,EACH Av& . _____Phone: ay& - 0892 Lot # Block or Unit # Subdivision: Contractor: oA*jj*,L R. GRAS2o.J Address: A (eeo iLo7c� u&17 7iRA/` City, State and Zip Phone d8�-0490 State License # Ac-- &021'?'S-1Y Describe work to be performed: R*oeo-ofwi-rw Ata d Fitz ttak-e6LAs-S .9H1^J`LA% . Valuation of Proposed Construction: �S,�a'3� •r� Materials to be used: 40 J . c4-AS5' b A16A?C41Ass s1Y1A1Q &A Signature of Owner; Signature of Contractor: Liability Insurance Supplied Workers Compensation Insurance Supplied License Information CITY OF ATLANTIC BEACH BUILDING DEPARTMENT INSPECTION REPORT JOBLOCATION .1;25 BEACH AVENUE PERMIT# 1348 ATLANTIC BEACH, FLORIDA 32233 SUBDIVISION NORTH ATLANTIC BEACH A OWNER NAME DON WOLFSON PHONE L.. LEGAL DESC: LOT BLOCK SECTION PERMIT TYPE MECHANICAL CLASS OF WORK REPAIR CONTRACTOR AIR ENGINEERS INC. PROPOSED USE SINGLE FAMILY " z a f z i0* WORK DESCRIPTION REPLACE EXISTING HVAC SYSTEM WITH 3 TON TRANE z' INSPECTION REQUIRED IS FINAL INSPECTOR AM DATE INSPECTED v 3� By 'T� APPROVEDEKI REJECTED ❑ COMMENTS noo D9PARTMENT OF BUILDING< ." CITY OF ATLANTIC BEACH -- :»� permitNumber: 1 8 ddre,0 1 BEACH AVENUE' Permit Tye r !lI CI ANICAL, ATLANTIC )BEACH,, I;LORIDA 3 G -1--------- LECA4 ICRXPTION JaiasB 'tir .s Lot: t C xT , a, t ! I'';�r��►+ +� Ir# a" N��: F'��# L�' plat Books P'isret II£nR s 0 Ctad i �ubdivjsjo6t NORTH, ATL:AcNTIC I BEACH L "L d y �l�s a #0. 00 - OWNERTNI�'CI�A�TIC�lI< I +0x Fay. ,�' + .#Ip W Axa DO" "I�CIIwF' fIN j Tot's I roost , *20'.00, ddr*o ; 117, 25 :SEACki AVENUE ° Amount P x " �. 20. � ATLANTIC 0EACH�s FL�t�I I A;" 322:33 � Phones t 3 AC _ ' S'E'EK W TH "3 Tox T'RANE" APPE C WT0ON FEES t q f'M. uF ar A itVk 5 ,; fER M ACT FEE *0 CIS? Nni E1TER, r1FyER I14P'ACT FEE ��. #�t9.'� i ' v • y,�`n 4aRpm m yhtV H4✓V? ''° Jy�}� ire {,µ { A, �' y, aAWw W'iMdr�e��$�i`y ADO" OAS ra s � a4 I iwC T' 0. 00 r ticA " _ - � �,41, EWER TAP "Y`Di�J4MIC SHARE-, �►i`�iiD l .I XWOPECT FEE *0. 00 I o An"K l{3 G# EER N'tI 0.-00 I T`HER ' �t " 0L 'r ° r�v6�'. t .saw", ' s� , `ii*�ue,. "xapz=m.a. °.rs, ak ,5 .�.u+ 'aW ,:. '` NOTES:- NOTICE ALL CONCRETE FORMS AMD FOOTINGS MUST BE INSPECTED BEFORE POURING PERMITVOID SIX MONTH AFTER DATA OF ISSUE BUILDING MATERIAL,RUBBISH AND.DEBRIS FROM THIS WORK MUST NOTBE PLACED IN PUBLIC SPACE,AND MUST B , CLEARED UP AND HAULEDAWAY BY EITHER CONTRACTOR OR OWNER. 6'FAILUR� TES CC�IWiRL�.!I�iTH THE MECHANICS"LIEN LAIN CAN RESULT it�l 11 THE PROPERTY OWNER PAYING TWICE AOR BUILDING IMPROVEMENTS," 1SSUEI� ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND.SUBJECT TO.REVOCATION Ff�? �`�l►OLATIOKOF APPLICABLE PROV151ONS OF LAW. A?LA 8 B , INC DEPARTMi~NT i $yFy rw*' OuI348 DEPARTMENT OF SUILO NGjy, CITY OF ATLANTIC BEACH �rIV� „Yra .. 5�%s ' � r � aP' .w i+,r' u� ;• r < ,' y, G ° _ m NdTES. 4 } r < oewl S NOTICE=ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING i PERMITVdID SIX MONTHS AFTER.DATE OF ISSUE 'BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MIDST BE CLEARED UP AND'HAUi.ED AWAY BY EITHBt Gp'NTRAGTOR OR OWNER: FAILUMEITO GC)MPL' t1TI+1 THE MECHANICS' LIEN LAW CAN RESULT IN THE it # CRERT t" 1ANSR SING TWICE FC}R IL�IpING IMPRQVt11 ENTS." ISSUED AGCC3RDtIVG T0;APPROVED PLANS WHIGH,ARE PAPT-dF THIS PEFRMIT AND SUB.IEGT TO REVOGATIdN F©R VIOLATION,OF APPLICABLE PROVISIbNS.bF LAW. ' ATLANTIC PEACH BUILDING DEPARTMENT �y: ' 001348 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH NOTES: NOTICE -ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE MECHANICS' 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. ATLANTIC BEACH BUILDING DEPARTMENT By. JOB COPY 001348 DEPARTMENT OF BUILDING' CITY OF ATLANTIC BEACH r r NOTES: r NOTICE -ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THERROPERTY 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. ATLANTIC BEACH BUILDING DEPARTMENT By. CONTRACTOR COPY r BUILDING AND__ZONING INSPECTION DIVISION / '= CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections 1, II, III, and IV. 1. LOCATION Street Address: �� OF Intersecting Streets: Between And `' ' c�rT. BUILDING Sub-division 11. IDENTIFICATION - To be completed by all applicants In consideration of permit given for doing the work as described in the abcve statement we hereby agree to perform said work in accordance with the attached plans and specifications which are apart hereof and in accordance with the City of Jacksonville ordinances and standards of good practice listed therein. Name of Mechanical Contractors Contractor(Print) Master Name of Property Owner Signatura of Owner Signature of w Authorised Agent Architect or Engineer III. GENERAL INFORMATION A, Type of hosting fuel: B. IS OTHER CONSTRUCTION BEING DONE ON -G/6 tric THIS BUILDING OR SITE? ❑ Gra—❑ LP ❑ Natural ❑ Central Utility IF YES, GIVE NUMBER OF CONSTRUCTIO Q Oil PERMIT O Other — Specify IV. M/CHANICAL EQUIPMENT TO RE INSTALLED NATURE OF WORK (Provide cbmpl*to list of components on back of this form) Er-'Residential or ❑ Commercial 'E3, Heat ❑ Space ❑ Recessed O Central O Row 1:1 Now Building ids .1�ndltioning: 13 Room Contra) Z Existing Building Duct System: Material Thickness Replacement of existing system Ma,ureum sapasify, e.f.m. ❑ New,installation(No system previously Installed) Refrigeration ❑ Extension or add-on to existing system ❑ Other — Specify 13 Cooling tower: Capacity g.p.m. (3 Fins sprinklers: Number of heads E3 Elevator ❑, Monlift ❑ Escalator (number) THIS SPACE POR OFFICE USE ONLY Gosolise pumps (number) (Reeaiwd) a Tanks. (number) Remarks Q LPG contain eK (number) (� Unfired pressure verse► Permit Approved by Doh Q /oilers Q Other —Specify Permit Few LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT Catty nA� NumberVnits Deacdption ![oda)Number Manufacturer (TOW