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Permits 1987 Beach Ave ANTIC BEACH CITY OF ATL 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 -5826 INSPECTION PHONE LINE 247 -C Application Number . . . . . 04-00028329 Date 5/20/04 Property Address . . . . . . 1987 BEACH AVE Tenant nbr, name . . . . . . HVAC Application description . . . MECHANICAL ONLY Property Zoning . . . . . . . RESIDENTIAL SINGLE FAMILY Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ SCOTT, WILLIAM W. DONOVAN HEATING & AIR 1987BEACH AVENUE 315 SIXTH AVENUE SOUTH ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 241-3785 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 79 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 79 . 00 79 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 79 . 00 79 . 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), C , ii-U-11 ING OFFICLA1 CITY OF ATLANTIC BEACH MECHANICAL PERMIT APPLICATION Date: e;', Owner of Property: Job Address: 1��7 Contractor: ZI)CCyW 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 ordinances and standards of good practice listed therein. 111. GENERAL INFORMATION A of heating fuel: B. &r Electric IS OTHER CONSTRUCTION B�ING DONE ON THIS C1 Gas: —LP —Natural —Central Utility BUILDING OR SITE? Ll Oil Ll Other—Specify IF YES,GIVE NUMBE��ONSTRUCTION PERMIT IV. MECHANICAL EQUIPMENT TO BE NATURE OF WORK Q Residential or Commercial INSTALLED 0 New Building (Provide complete list of components on back of this form) El Existing Building 0 Heat _Space _Recessed --Central I-laor Replacement of existing system Ll Air Conditioning: Room— <� 11 New Installation(No system previously installed) 0 Duct System: Material Thickness Q Extension or add-on to existing system U Refrigeration Maximum capacity________cfrn ZI Other-Specify LJ Cooling tower: Capacity ______gpm 0 Fire sprinklers: Number of heads THIS SPACE FOR OFFICE USE ONLY L3 Elevator: _ Manlift_Escalator_(Number) (Received) U Gasoline pumps _(Number) Q Tanks (Number) Remarks 0 LPG containers umber) 0 Unfired pressure vessel Permit Approved by Date 13 Boilers U Other–Specify Permit Fee LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT Number Units Description Model Number Manufacturer Capacity Approving (Tons) Agency '7 HEATING–FURNACES,BOILERS,FIREPLACES Number Units Description Model Number Manufacturer Capacity Approving (BTU) �gency TANKS How Many Nominal Capacity TypeLiquid Nameof Serial Approving And Dimensions Contained Marnifitcrurer No. Agency 800 Seminole Road e Atlantic Beach,Florida 32233-5445 Phone:(904)247-5800 o Fax:(904)247-5845 9 http://www.cLatlantic-beach.1l.us 1/14/03 9 City of Fitlantic Beach *** CUSTOMER RECEIPT *** 'Per- CKOMOREK Type: OC Drawer: I Date: 3/24103 Of Receipt no: 45603 Descri t'o aty Amount 293, , IM10 BP BUILDING PERMITS 1 $150.0 Tender detail CK CHECKS 2470 $150.N Total tendered $156.N Total payment $150-00 Trans date: 3/24/03 Time: 16:08%38 0002644 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ., PERMIT INFORMATION ------ P?rmit Number 2 -- ------ LOCATION XINFORhATION 2644 Aodreess, 1987 BEACH AVE. Permit Typot UTILITIES -ATLANTIC BrAcm, C.I.aen og Work i N/A FLORIDA 32233 I� -- -------- LEGAL DESCRIPTION Onatr. Typet N/A Lctx B I ocjc 'r0PQvwd U009 SINGLE FAMILY Sectlons Tovofthipt RUG's 0 Difellings; 0 Codes 0 SubdIvision, Eptimated Valuot *0.00 Xmprov. Cost t *0. 00 Total Few*,; *245. 00 Amount P*A"&' $24S.00 Date P, 0 Work ACCT tan=, APPLICATI ----- `77 0 Nam* Addreas PERMIT �*,Q.00 ON FgE_q WATER Jx" ,,,,ACT F #10011,00 ift "W" p FLORIDA 3 VA "E"') , - , ", , phone kk hp,_ 4� *85.00 Con RADON GAs-N. R. *0.00 TCW�lpr " - S. MATZOH ------ Names RADON 6AS - 5% *0.00 Ad Ire 0 Pub I f�sWorki,�,`,,Oept. WATICR ,TAp� ,, - SEWER TAP *0.00 HYDRAULZC SHARg Type: 0, *O��,Oa, RE-xNSPECT Fee 00 NE9ftZ"G po NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER.bATE 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 1k, THE PROPERTY OWNER PAYING TWICE FOR BUILDING,IMPROVEMENI 4 S.` ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND T TO RE\§*IQN FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTI,CAACH BUILDIG DEP�RTMENT Sy. 0002644 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT IfIFORMATIOff LOCATION TNrOPMATIC)" PfA N-utiffbe-x I 2(n44 1987 BEACH AIVE. Pei'tulf- Typet UTI L I TI EO ATI�-ANTTC LAEACil. FLA.-CRIDA Of Wv1p. t N ii LEGAL LIESCRIPTIOU T,onsti . Tyr-set N A f- 6100-.- 2�ieQ t -1 OPDX;ed USE-'. SIMULE FAMILY Townshipt. k h C, i D) ve I I i n 9 0 C 6 d 0 Clu bdi v i si c,,rl F-9 'Li Wa-t,vLj Val UL�, $0� 00 Improv. $0. 00 Total Feeui Amouuit, Paidi $24'5. (10 Date Paidi 6/28/90 WMI, Dc-sc. . INSTALL 3/4* METER ACCT 1902,45 OWNER I RF09MA TION APPLICATION FEES Namet CHUCK BALDWIN PeRMIT $0. oc) AdJr ess 1 1987 BEACH AVE. WATER IMPACT FEE 160.66 ATLANTIC BEACH, FLORIDA SEWER IMPACT FEE $0.00 WATER METER ock RADON GAS-H. R. S. 00 CONTRACT(JR INFORMATION RADON GAS � 5 $0. 00 WATER TAP �6()1 00 PublIcsWorks Dept. SEWER TAP t$0. 00 HYDRAULIC 'S ff A R U $0. 00 T y Fwc- 0 ftEr-INSPECT FEE SO. oo ENC31NECRING *0, ,oc) OTHER ,to. 00 NOTES: NOTICE —ALLCONCRETE FORMSAND FOOTINGS MUSTBE 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.35 ED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND".�,CT TO RE4,C" _%ON FOR ATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC�8EACH BUILD G DEP�RTMENT By-, 0002644 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH OPONT7 Turn - ------ LOCATION INFORMATION --------- PERMIT INFORMATION ------ Permit Number-. 2644 A dress% 1987 BEACH AVE. Permit Typet UTILITIES ATLANTIC BEACH, FLORIDA 32233 Class Of Work: N/A - -------- LEGAL DESCRIPTION ---------- Constr. Type: H/A L Blockt Section% roposed Use% SINGLE FAMILY Tovnehip: RHO; 0 D ellings: 0 Codez 0 Su division% E timated Value: $0.00 Improv. Cost: $0. 00 Total Fees: $245. 00 Amount Paid% $245. 00 Date Paid% 6/28/90 W rk Desc. : INSTALL 3/4w METE A LOC yd "'98 _ATL L B Tovn Su io _ divis n . ---------- OWNER INFORMATION --------- ---- APPLICATION FEES ----- Name% CHUCK BALDWIN PERMIT $0. 00 Ad renaz 1987 BEACH AVE. WATER IMPACT FEE 0160. 00 ATLANTIC BEACH, FLORIDA 32233 SEWER IMPACT FEE $0. 00 hone: WATER METER $85. 00 RADON GAS-H. R. S. $0.00 -- ---- CONTRACTOR INFORMATION ------- RADON GAS - 5% $0. 00 Home; Publjc:�Works Deptt WATER TAP $0. 00 Ad ress: SEWER TAP $0.00 HYDRAULIC SHARE $0.00 Ll ense; Type: 0 RE-INSPECT FEE $0. 00 ENGINEERING $0.00 OTHER $0. 00 NOTES: NOTIC E—ALL CON C RETE FOR NIS AN D FOOTI N GS M UST B E I NSPECTE D B EFORE POU R I NG 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 THE I MECHANICS' LIEN LAW CAN RESULT IN "FAILURE TO COMPLY WITH E FOR BUILDINGMIMfROX 55 JIffil TS- THE PROPERTY OWNER PAYING TWIC IDA ION DR ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT ANDIff"CT TO RE\["ON FOR DM U L L EA D R NG ED U M P AT A E N R D IA H L A U R L U E6 DBI AS W 6 1 H FA URE To COM I HE PROPERTY OW ISSU ED ACCORDI NG To APPR VIOLATION OF APPLICABLE PROVISIONS Of LAW. ATLANTI CH BUILDt DEP RTMENT "TIC JOB COPY By: Ltt____ CITY OF ATLANTIC BEACH, FLORIDA Approv*d by APPLICATION FOR ELECTRICAL PERMIT / / 7 TO THE CHIEF ELECTRICAL INSPECTOR: DATE: —19M IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL FIRM:j2A1?V A4jlv, MASTER ELECTRICIAN SIGNATURE/4;ZZt:o"z&..' 4� NAME ADDRESS:- RFD_BOX_ BLDG.SIZE- 00 S I— BETWEEN: A/0-A op fec-ci-, RES.�f APT. ( ) COMM. ( PUBLIC ( I INDUS. ( I NEW( ) OLD k) REW. ADDITION ) TRAILER ( TEMP.I ) SIGNS ( ) —SO. FT. SERVICE, NEW( ) INCREASE,(kf REPAIR I ) — FEE CONDUCTOR SIZE AMPS JC)0 COPPER f ALUM.1)0 SWITCH OQ4R_EA_KE_R__) �10 -' AMPS I PH .3 w 2� 6VOLT S'e", RACEWAY EXIST.SERV.SIZE /00 AMPS PH -3 W VOLT 5f"k RACEWAY FEEDERS NO. SIZE IND. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN— TOTAL 0.30 AMPS. 31-100 AMPS SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS— AMPS ICEIL HEAT: KW-HEAT 4 , 30 1OKw 0-1 OVER MOTORS I VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS TRANSFORMERS: UNDER 600 V. OVERSOOV- 001193 DEPARTMENT OF BUILDING , CITY OF ATLANTIC BEACH FO 41:10 'PtR"IT IN RNA u --------- LOCATIOU INFORMATION, Pormit Address;' 19$7 BEACH AVENUE Permit ::*,rYi>e I MECHANICAL ' ATLANTIC, REACH, FLORIDA 32233 Claos of Work s UEW � LE13AL DESCRIPTION C6natr. Type: R/A Block% Proptimed Umej SIM61,C FAMILY, Plat Bookz : Page$ 0 t 0, Code I �O Subdivisictoi mati'mated V61003 ------- OWNER INFORMATION. - improv,# Con't 1 *0. 60 NOM42 MR. ' SCOTT Total wes 2�,, 040. 00 Addresel 19a? BEACH AVENUE Alwo ATLANTIC BEACH, FLORIDA 32233 Do 2#6 TOM NVAC SYSTEM ft 40,00 rL �i, - ----- 4 00CY �0s PLXCATIOM FEES LE $40. QQtj2 1A 2,/1 S 1 17 WATER IMPACT FEE 0 00CA kG ,,.gm ' SEWN FEE �q ,"0" , R RADON GAS H. R. So, in -�2 4, 0 6 RADOU ,GAS "� . 00 "p, MATER TAP $0. 00 SeWER TAO $0. 00 HYDRAULIC, SHARE *a.00 R -INSPECT Fite $0,000 low QT" 4 up NOTES: NOTICE —ALL CONCRETE,FORMS AND FOOTINGS'MUST BE IN$PECTED,BEFORE POURING PERMIT VOID SIX MONTHS AFTERDATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED I N PUBLIC SPACE,AND MUST BE 'CLEARED UP�AND HAULED AWAY BY,EITHER.CONTRACTOR OR OWNER. "FAILURELTO COMPLY,WITH THEM ECHAN ICS' LIEN ,LAW CAN RESULT IN- THE PROPERTY O.WNEft�PAYING TWICE FOR BUILDING IMPROVEMENTS." ISSUED ACCOAbiNG TO APPROVED'PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR ,�,�vip!�ATIIP�:0,F�,APPLICABLE PROVISIONSQF LAW. ATLANTI CHBVILDIN EPA M T�: Ile J* BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BEACH. FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to completeall items in sections 1, 11, 111, and IV. Street Address: LOICATION OF Intersecting Streets: Between And BUILDING Sub-division 11. IDENTIFICATION — To be completed by all applicants. 59 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 attachpd plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and stan.clards of good..practice listed therein. Name of Mechanical Contractors Confreefo Aj Mesta, I— Name of Property Owner Sig ature of Owner Signature of or= Agent Architect or Engineer fit. CMIERAL INFORMATION A, Type of heating W: B. IS OTHER CONSTRUCTION BEING DONE ON 0�e"c THIS BUILDING OR SITE? I N(::� C3 Gas—C3 LP 0 Natural 0 Central Utility IF YES, GIVE NUMBER OF CONSTRUCTION 13 on PERMIT 10 other — Specify IV. VWK4W" BWIP~TO 81 INSTALLID NATURE F WORK (PmvW*complete list of components on back of this foftl Zesidential or 'El Commercial 0--'Noat 0 Space 0 Recessed "tral 0 Flow C3 Ne Building xist "rCoodrtlooirw C3 Room Mll�trol ;-Z Ing Building pk-Vuc� SY00 m: Material Replacement,of existing system ow Installation(No system previo-u-0y.1i Mo3rafflum capacity 0 Extension or add-on to existing system 0 Refrigeration 0 Other — Specify Cooling tower. capacity 9-Pift. E3 Fire iiprinlklom: Number of heads 0 Govater 0 Monlift [3 Ewaleto (number) THIS SPACS 00011 OFFKM USIII ONLY C3 Ganfine pumps —11numbed (ReaeliVIGIIII TO (number) Remarks (3 LM wnfoi"" .(number) Unfirw pre"ure MW Permit Approved by Date— C3 1111OHM Other — Specify Permit ugr ALL zquipmzNT AM CONDIT]IONING AND REFRIGERATION FQUMENT C*Padty Appfffft mmurivaft De"Apuft No"N=bw Kilmufactmr (TO") ASMW� rI I -T'."rui, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 09-00001098 Date 7/30/09 Property Address . . . . . . 1987 BEACH AVE Application type description ROOF PERMIT Property Zoning . . . . . . . RESIDENTIAL SINGLE FAMILY Application valuation . . . . 4400 ---------------------------------------------------------------------------- Application desc REROOF FL 96317 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SCOTT, WILLIAM W. ROMANO ROOFING SERVICES 1987 BEACH AVENUE P.O. BOX 33037 ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 246-5649 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 52 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 4400 Expiration Date . . 1/26/10 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 52 . 00 52 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 52 . 00 52 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. TICE OF OOMMENCEMENT (PRERAR UCATE) Permit Tax Folio .5twe Ott= County of UWE) Folio n ty of To whom it eonCOTW The undomlyii�d here Info""you that ln�provarnontv;will be worle to certain mail progie oil? In accordanoo with Seetion 7 2 of tl%Florida Statute$,the following information Is stated in this O'Ti EOF COMMENCEMENT. Legal pdon of prWri tiuig hr%mved; as - aq n Address Of KODerty b In oved; General description of Imp ements. Owner Address OWnel's Interesk In situ uf Improvtmont 1 Ssre4'�si*w' 'mPr— S'nw Fee SimoleTitteholder(iff o erthan*wner) Name Address j Contractor 1-"L ';-, +Z11'_'-h L LW 'j4 Addre PC 9=--Q� 4 Phone No. Fax No. Surety(if any) Address _�_Amount of bond Phone No, FaxNo. Name and address of any rson making a loan for"construction of the improvements. Name Address Phone No. Fax No. Name of person within the tale of FloAda,other than himself,designated by owner upon whom notims omer documents may be served ht*Me-T Address Phone No. Fax No. In addition to himself,ow designates the folloW ing person to reoelve a copy of the Lianoes Notice as p vided ini &ectivpi 713-OG(2)(14)),Flo dtk Statutes.(Fill in at Owner's oDtiov). Name— Address Phone No. Fax No, IFYpiration date of Notice Commencement(the expiration date Is one(1)year from the d cordin unless a different date is sper;lfled THIS SPACE FOR RE RDER'S USE ONLY OMER qy � -DATE Sefore me ithis_day of w- County of Duval,.5k*of FWda,ho por-ugly appwad in by DATIR isid druinsthat all 518twiwity so dwjam� ain am Doc#2009180830,OR BK'I 4966 Page 270, Number Pages: I Nulwy F4WIc at Lcyac,Gluto of CnUnty Recorded 07/30/2009 at 02:16 PM, 705: Z(, JIM FULLER CLERK CIRCUIT COURT DUVAL Peisomilly Known -7� COUNTY Prodw*d ldentkAtrm RECORDING$10.00 iNdtary Public,Tift County,Georgia My Commission Expires Oct.16,201 CITY OF A NTIC BEACH NO OCACH,rL=122 08.i; &)o 5F-MI1401.9 ROAD,�ATIAbl OFFICE;(904)247-5&�6 0 FAX NO.�(t)04)247-5845 SVILDING-PEPTOCOAB,US BPILDING PERMIT APPLICATION DUVAL COUNTY . ... L W -Fis www ��VAUVAXJWHWFW—AWI MMM '0 7 lcit4IL 3 ch, FL 3223i 0 n Nr=w RL111 OING 11 rJEMOLITION MIOSIDENTIAL LOT BLOCK SUB DIVISION Ll ADDITION RYING 0 COMMrRCIAL 0 CONVE USR ALTERATION 0 AGGE5WRY BLOO. EPAIR POOL�SPA 11 YES NiA OVE OTHER COMPANY NAME; 1 09P*1 4CAV IR NAMR 2.4.LICENSEE—NAt& 10.A13DRESSt V.STATE OF FLqfRIDA_YCENSE NO. 25,$TATE OF FLORIDA LICE ENO,: /-0 ,5-7 Am-k 1&ADDRESSi 26,ADDRES& 14 77/4 5,Z4.6:6 -AID "ell 11.OFFICE PHONE! 112. OF;PHQNFT 20.FAX NO 27.OFFICE PHONE: 28,FAX NO.: 12--Xq/ - /-501r I.I.CELL PHQNF- 21.CELL PHONE; 117 ery -s-qr 29.CELL PHCNF;; 14,EMAIL ADDRESS' 22.EMAIL ADDRESS: 30.EMAIL ADDRESS;- laws WIN ft 31.NAME: 33,NAME! 35.NAME; I LIT,-1- 32.ADDRESSt 34.ADURFSS; 36,ADDRESS: S5' ADOwss 34 Aoo� A ca ma a V4 a it to do the —rk pplication is horet)y made Lu urilain a It to do the work and inetallations as Indleatowt. I cartity that no �ork or ;nstaflation has work MMMWnCW piniot W the iSsuanee of a permit nd that all work will be performed to meet the standards of all laws regulpting construction in this com "" S 6 ct Mr jurisdiction. This permit becomes null an�d v Id If work is not commenced within six(6)months, or if construction work is suspended or hs Nn M after w a ea period 0 �l a t e abanelonecl tor a perjoo of six(j5) Illul U,14 at iany time after wotic l�ir, Comme,nead. I understand that separate 1) �Its must be secured for an ,Sig . 11"P ol , aces, *110. Electrical Work,Plumbing,Signs,Wells,P ols,Furnaces,8*111ers,Heaters,Tanks, Air Conditioners,etc. OWNER'$AFFIDAVIT-I certify that all the re Ding Information 115 acoLrate and that all work will be done In compliance with all applicable (am regulating Construction and zoning- I willi-nGeupy Or Use th,I e rortst en iued building or any part therof until all In pecr6ons are finaled and p6or to obtaining a oeffificate of occupancy ol��OMPJ@tion!,sued I;IX the building Official,as required by law.' WARNINd TO OWNER: YOUR FAILURE TO RECORD NOTICE OFOMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROV MENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE ECORDED AND POSTED ON THE JOB SITE WORE THE FIRST INSPECTION. IF YOU I TEND TO OVAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORRMKY EFORE RECORDING YOUR NOTICE OF COMMENCEMENT. A,044, Signed: —a=,, ate:—7/-,7/0 Signed; ate: setore me im Lidy 0 2007inthocritintya Before me this ay of 2007 In the county of Z _ZV d 1 Duval,State of Florida,has petsonalty appeared Duval,State of Flodda,has personally uppeared ally 7Oppear(.5,d, me t. harin by hirnselfthmelfaAd affirms thatall stateme tr,and declaral;ions are herin by himselfl hmalf ana alfirmS That all SlaLuluvj-Is and derelaro0orLs aro true and accurate. true and accurate.. I Notary Public at Large,.5tale ot Cuu lly of Notory Public Pt large,State of Cc ty of dik u 11 Parrional-w Known 0 ftrronally Known E3 Producpd Idalltific*1 qrk 0 Produced identification- NotarySignatwrw X --14 NoOry Signattire: Notary Public,Tift CountV,Georgia My Commission Expires Oct,15,201 COAB FORM 50001.,REVISED:1116/2007 1 PSR-3844 15203 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT INFORMATION ------ ------- LOCATION INFORMATION -------- Permit Number: 15203 Address - 1987 BEACH AVENUE Permit Typ'e:DRIVEWAY ATLANTIC BEACH, FLORIDA 32233 Class ot Work:REMODEL ---------- LEG,AL DESCRIPTION .—:-------- - Constr . Type:CONCRETE Block: Lot : Twp: O � Proposed Use,. Seotion: 0 Subd:O Rng:' 0 Dwellings : 0 Subdivis,ion.NORTH ATL BCH Est , Value: 0.00 Improv.. Cost * 0.00 Total 25.00 Amount 25.00 A J-X-ft d% W-ck Q All! 10"UM, --------- - - ,10 _4 e ------- 10 N APPLICATION FEES 7, 0A 00 PERMIT 25. Name.,-,* N Addr ., 4 P B C*11'4 FLORIDA 3 2,114 Pho C ORMATION R P Name- RO ZRTY',-,,'j;"NER Addr,.- Exp: T -W" NOTES:, NOTICE-INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS'PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DIEBRISFROM THIS WORK MUST NOT BE PLACED IN PUBLICSPACE,AND MUSTBE 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 OFAPPLICABLE PROVISIONS OF LAW. ,XV, ATLANTICAISACH BUILnJNG 42P3 By: _t�, CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS MOV:rNG,DEMOLITIONS Owner (s) Address: hone: Lot Block or Unit Subdivision: Contractor: State License Address: Phone No: City State- _Zip Code Describe work to be done: A 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 heated and cooled? New electrical (or increase) ? New plumbing fixtures? New fireplace? New Heat/AC? SUBMIT T71= 3r. TWO N LETE SETS OF PLANS, 12,7CLUDING (=DO E 7 rCoN SITE PLAN, SURVEY, EXIMIGY CC NOTICE OF 7, AND OW2TERICONTRACTOR AFFIDAVIT, I=F is 2JPAcT 17R. Signature OWNER: Date: Signature CONTRACTOR: Date: 19 Sworn to and subscribed before me this day a RECEIVED NOTARY PUBLIC STATE OF FLORIDA AT LARGE tpy rp� Pafflda Amonette 4" My COMMISSION#CCMW81 ORRES 1997 ,T. August 27,20DO city Of Atlantic Beach BONDEDTHRU TROYFAIN INSURANCE,INC, Building and Zoning