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Permit Bldg Remodel Interior 2010 °SS S CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 ;y 51119 Application Number . . . . . 10-00001096 Date 9/03/10 Property Address . . . . . . 1921 W SEVILLA BLVD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------- Application desc interior remodel ---------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SCRUGGS JL SMITH CONSTRUCTION 1921 SEVILLA BLVD.W. 12627 SAN JOSE BLVD ATLANTIC BEACH FL 32233 STE 705 JACKSONVILLE FL 32223 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 130 . 00 Plan Check Fee 65 . 00 Issue Date . . . . Valuation . . . . 15900 Expiration Date . . 3/02/11 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS FLORIDA FIRE PREVENTION CODE NATIONAL ELECTRIC CODE ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 130 . 00 130 . 00 . 00 . 00 Plan Check Total 65 . 00 65 . 00 . 00 . 00 Grand Total 195 . 00 195 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 131,11.11AV. PERMIT Al"I'LWAl ION Crn,op A-i'l.AN-1'1(' III:Ull oflicc 0(14)247-4;N-lb 1 :l\(00 1)"47 1 qZ jo /0 .10)Adds-ess; A I A-4it"'Y16vif Ahi WqL�k —6 T -atr I'Sv for sirtictumo.)(cit-cle(one) S let'!lCit'Clewle), -)-;:s N.. A if is it thI-v pt-inkler Ovul irl t;Il SEP 0 2 M13 Iver re lcueue- ea -k it,he Vi-micm. (honer hifiot-miolilln: Cwlltritettw hifijummitill: Cklillimm \,tllwr W,11c". t901)29'-006 Job Malt' mulct\t[milcl 190-11 w, A w, St t14 l � tlr�tiwn IZ� t,la tU tr-� �.:t . f�r-.�r� �f .=� 'n/�f/�� _ D Q9 SEP OZ201 0 V I,pl A ;tppf fir mulith werl.vic. ARN'IN'(; TOOWNER. N-01,14 F.,\ILI RE TO 11114'ORI) A m),ricu. or (*()Nl'.\IEN('El\l ENT MAY RESULT IN N'Ot"IZ PAYING W'WE FOR I\1I1R0V['1IFNTS TO Y(WR PROPERTY. IF N!i)tl I-,TENI)TO OBTAIN FINAN. "CING, CONSI'LT WITI-I Y(WIZ LENDER 014 A N -VI 1'0 R N F,N It E FO R F R F C( R 1)1 N Y t I R NOTI C F OF COSI M E F NT. 6;ft,7-14 I, 1XIN N,, MARIA FE G.SMITH MARIA-FE G.SMITH MY COMMISSION#DO 684363 MY COMMISSION#DO 684363 EXPIRES:July 25,2011 e EXPIRES:July 25,2011 on B e d Thnu Budget Notary Services 0, Bonded Thru Budget Notary Services REVIEWED FOR CODE COMPLIANCE MK CITY OF ATLANTIC BEACH L SEE PERMITS FOR ADDITIONAL REQUIREMENTS AND CONDITIONS. FFILE COPY 1-MVMV;ED BY. -/77 DATE:Z—,)--/e) -. - -- .1. - 1 ATTACHMENT A Lot 11, SEVILLA GARDENS UNIT ONE, a subdivision, according to the plat thereof recorded at Plat Book 45, pages 6 and 6A, in the Public Records of Duval County, Florida. NOTICE OF CONINIENCEN11"NT THE IJ\f)fRSIGNLD heichkait cs nolk.,cifiat impro%olicilts"MR made i„mmw M11 proper s,orad oact orij;tlwe%kAh SE,:4m '111.flma I­III,It[ 713 J 3 or Me Wrida SmWity ,Be Rubulm or", ' " 'I 15 Tis NO`nCE Of COMMENrEME L.43+ 11,,seic/3116clan UI;* Ct-4-01.r" ` 4-11e 42 LI Ike MoV yvanAw I.Dc.,cripiiort o I proi:K�rt} I lepil drs eripliort). lk&—Dcx*— Ipk c,(-'ou Lvj ChiFlt, ;Cini_ S 2,Gencnd dtSe - rij)6i111 Orillfpn`all C11 Cpiie -,C:, rik- rep Carlo d-t_+de, 4-ej r-pj 'SC &Y-Me C :1)Name and address: --'54a-cfr M r "xcwa,idadJ,,,, It fico simple 01,colder tit oilier than k"were c}Interest in propetly Itr"Ictor 19formalion ......-------- a)Naweanddddi JL D no 1:ata N o.(0 p—t-) 0) lilt,01,1MItion 3 F\mite i te a ad ad dre, h)AnwIan(orBjm&_____ 0 Feleph."fle No.: Fax Aa,I Or(, 0.1 ender a)Tia€nc and aaclriss: phone No. 7.W—twis; d posoll of i0lin t°tc"I'lic of ion,e„tice. f r v.h r do umttcnts o ac tv ems ed: a Name and address,: tit Fav No.(Opt- &WWdMwi n5h WmNminupen Ad n SwWI 0,Fh&a Wuw a}Naha aiid address: W TWO=No: Fax No. 9T\piration(late A Notiie (the eapiaaldalt date WARNING T00%\Nf.R- COMMENC EMEwr ARE CONSIDERED IMPROPER PAIL NIEN FS(7ND R(*IU\IqER 7M 1ART I.SECHON 713.13. FLORID\STA I UTIVIS,AND CAN REMIX IN WUR PAYING TUrICK EOR E%IpROYE.)ILNTS-1-0 YOUR PROPERW A NO'"CE OF UOWIENCrE NIENTNIUST RE RVICORDE-D AND POSTED ON T111=.1011 FE IILFORE nir.FIRST INSPECTION, IF YOU INTEND TO Oil I'AIN FINANCING,CONSUL F)Ot It LENDER OR AX ATTORNEY BEFORE COMMENCING X\ORKOR RECORDING YOUR NGHCE OFCOMNIIENCENIEW. -blAvaA ti: tv !.AA�r_)Lo� day of 1, "'Zk1cle A LC Miku_L_ S a, 31101111'ifl, ofticur.Wive, aq- ackcnix)in fact)for ji-IiaOi lfof; rtm irwrul�wl % s, Kilown P/,01"f'v(,d13Cvd Idemillicalion ,4)Idjuranium produced FeLL OR WiAaQnpI1WWMI10Sr" Qn9W2A SwAvISLman,WT rmuchis4paby I die bmIm I One wd he r.•eam and that Me 60,mad in it am ow to the Ali k""Ie4v W bdici� 141 7. DOC 4 2010206741,OR 13K"15355 Page 1634, Number Pages: I Recorded 09/0212010 at 11:28 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00 City of Atlantic Beach APPLICATION NUMBER r Building Department (To be assigned by the Building Department.) 800 Seminole Road �� 9 j r} Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: Z City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: `y-1 /J&" 9111d ent review required Yev No (,,Building-,) Applicant: A64 Sia Planning &Zoning / Tree Administrator Project: (O Public Works Public Utilities Public Safety Fire Services 0/6t��' �� Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: EDpproved. ODenied. (Circle one.) Comments: LBUDIN PLANNING &ZONING Reviewed by: Date: 7­'l-lo to TREE ADMIN. Second Review: OApproved as revised. ODenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09 CITY OF ATLANTIC BEACH y 800 SEMINOLE ROAD + ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00001096 Date 10/06/10 Property Address . . . . . . 1921 W SEVILLA BLVD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 16000 ---------------------------------------------------------------------------- Application desc interior remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SCRUGGS JL SMITH CONSTRUCTION 1921 SEVILLA BLVD.W. 12627 SAN JOSE BLVD ATLANTIC BEACH FL 32233 STE 705 JACKSONVILLE FL 32223 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 167 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/04/11 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS FLORIDA FIRE PREVENTION CODE NATIONAL ELECTRIC CODE ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 51 STATE DBPR SURCHARGE 2 . 51 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 167 . 00 167 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 5 . 02 5 . 02 . 00 . 00 Grand Total 172 . 02 172 . 02 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 24I7-5826/ Fax(904)247-5845 JOB ADDRESS: /�Gf Ol 1 (�: ��I IG lyc� PERMIT#16-Godo �0J9J NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE of FIXTURE QTY TYPE of FIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: TYPE oFFIXTURE QTY TYPE oFFIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower �- Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet - Hose Bibs — Urinal Kitchen Sink _�_ Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater �— Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** **SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** ❑ Other Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name Phone Number Plumbing Company / 7f k-, �',�tiv 17(e- (141116�isl Office Phone 39(aU l Fax ?�� Co. Address: _ � J21W4 Y (.ud City ,�cc�)k_ State(^f Zip �cZp�Uf` License Holder (Print): Q P i41 N_ State Cer­ ' ationlRegistration#C�CoS-_7��C� Notarized Signature of License Holder "_ Thi, SPP.b1k;'J'2% 0 20/�Sworn and subscribed before me �— "� 4 Signature of Notary Public "` i CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J =� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00001096 Date 10/18/10 Property Address . . . . . . 1921 W SEVILLA BLVD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 16000 ---------------------------------------------------------------------------- Application desc interior remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SCRUGGS JL SMITH CONSTRUCTION 1921 SEVILLA BLVD.W. 12627 SAN JOSE BLVD ATLANTIC BEACH FL 32233 STE 705 JACKSONVILLE FL 32223 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL HVAC PERMIT Additional desc . . Permit Fee . . . . 99 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/16/11 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS FLORIDA FIRE PREVENTION CODE NATIONAL ELECTRIC CODE ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE MECH DCA SURCHARGE 2 . 00 STATE MECH DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 99 . 00 99 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 103 . 00 103 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CERTIFIED www.ahridirectory.org —A Ceftificate of Product Ratings AHRI Certified Reference Number: 3718226 Date: 10/15/2010 Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source Outdoor Unit Model Number: N4H336A(G)KE* Indoor Unit Model Number: FSM4X36**** Manufacturer: ARCOAIRE Trade/Brand name: 13 SEER N SERIES R410A HP Manufacturer responsible for the rating of this system combination is ARCOAIRE Rated as follows in accordance with AHRI Standard 210/240-2006 for Unitary Air-Conditioning and Air-Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent,third party testing: Cooling Capacity(Btuh): 34000 EER Rating (Cooling): 11.00 SEER Rating (Cooling): 13.00 Heating Capacity(Btuh)@ 47 F: 34000 Region IV HSPF Rating (Heating): 7.80 Heating Capacity(Btuh)@ 17 F: 22000 Ratings followed by an asterisk(*)indicate a voluntary rerate of previously published data.unless accompanied with a WAS,which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the productis)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the productis)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal and confidential reference purposes. The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated;entered into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual,personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.atiridirectory.org, Air-Conditioning,Heating, click on"Verify Certificate"link and enter the AHRI Certified Reference Number and the date on �. an IL/ and Refrigeration institute which the certificate was issued,which is listed above,and the Certificate No.,which is listed below. ©2010 Air-Conditioning,Heating,and Refrigeration Institute CERTIFICATE NO.: 129316194821083026 MECHANICAL PERMIT APPLICATION CITY OF JACKSONVILLE BEACH JOB ADDRESS: I C1 2 ) W , 5 F-0 L -A 6 LVA ) FERMI INSPECTION REQUEST LINT (904)247-6107 - PROJECT VALUE ©�� NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION Afl- Conditioning: Unit Quantity — f "bons Per Unit � I Ic tt: Unit QuantityM BTU's Per unit_ f�060 Seer Ratino DUCt SVSWI)Is: Total CF 'R QUIRED RI+:I'LAC.EMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity� 'bons Per Unit 1 ICat: F)nit Quantity 1311"s Per Unit Seer Rating _ Duct Svstems: Total CFM _ _ REQUIRED FIRE PREVENTION Hire Sprinkler System Quantity — (Requires 3 sets of plans) Fire Standpipe Quantity (Requires 3 sets of plans) I inderground Fire Main Value — (Requires 3 sets of plans) Fire I Iose. Cabinets Quantity — (Requires 3 sets of plans) Commercial Hoods Quantity (Requires 3 sets of plans) Dire Suppression Systems Quantity (Requires 3 sets of plans) FIRE PLACES MISCELLANEOUS: Prefabricated Fii-eplace Qty --- automobile I_.ifts -- Gi is Piping Cutlets Boilers BTU's Flevators/Escalators All, OTHER GAS PIPING Ileat Lxchan er Quantity of'0utlets _-- Pumps -- l= Vented % all Furnaces Retri,erator Condenser BTU's t7 Nater I leaters _ Solar Collection Systems Tanks (gallons) `'ells OTI-IER: ! ern!iI hccotues void if wnrk is not done during i\ month period. I tierebv certif_� that I h a i c read this application and know the same to he 011e rind correct 111 I�rovisions of laws and ordinances governing this work will he complied vv ith whether spcciticd or not. Fhe permit does not give authority to N iolatc the pr,,�ision;oi'am oth.r ztaW or local law redilation construction or the performance of construction. !';'(Tort\ Owners Name —5 C R-U 6r6---5 Phone Number — — - 1 chanical C'ompam 1:-S F L-'S I+EA-T s �k f 2�SnJ� ---- ----- _..__Offic:e Phone aql -4o77FaxQZ- t. address: _23-�.I MV*a-5 H PO i tJ r R D city �jep ac-g . State FL %ip'J`LZ�(o I-ic-ense Holder (Print): _--�D AvJ t D W , �'_ 5__ _ -- Stt e C'ertifICatio11!R # !Vohiri ed Signature of License Holde — l/ S vorn and subscribed heJore t 1e hi., fz day of DEBORAH A.WH Tb — ' it -e of�Notary 1'ubl' _., � MY COMMISSION#DU `�—___.--__--_ -- --- ;r a EXPIRES:May 21,2011 -v—- Bonded Thru Notary Public Underwriters �.�— � 3 r„Ilr ;rnCn:t:irr Inc v. -i\,vn r t. Rr.nr�rr Pitrgn.117,1nv/O(1;I -)A7 (.tn? 1,r '1,ii . to r .nn