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Permit 1861 Beachside Court rill CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,Ti, 32233 INSPECTION PHONE LINE 247-5826 S Application Number . . . . . 05-00031329 Date 10/14/05 Property Address . . . . . . 1861 BEACHSIDE CT Tenant nbr, name . . . . . . WINDOWS,DOORS, ADDITIONS Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 15000 Owner Contractor -------------------- ---- ------------------------ ROLAND, MATT& ROSE FUTURISTIC HOMES, INC. 1861 BEACHSIDE COURT 13694 BETT DR ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224 (904) 221-0612 -------------------------------- -------------------------------------------- Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 155 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 15000 Fee summary Charged Paid Credited Due ----- ------------ ---------- ---------- ---------- ---------- Permit Fee Total 155 . 00 155 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 155 . 00 155 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING OFFICIAL CITY OF ATLANTIC BEACH !J ` PUBLIC UTILITIES DEPARTMENT 1200 Sandpiper Lane Atlantic Beach,Florida 32233 904 247-5834 (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # —` c3 13-2-9 Property Address: G 0 C9 —Bf 0-6 h s I d`- ,/ Applicant:{Gf rl S C f,a ti-t f Project: 1 -A/D VaZ ;---; Your application is approved as noted by the Public Utilities Department. Final application approval must come from the Building Department. ❑ Your permit application has been reviewed by the Public Utilities Department and the following items need attention: Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions,please call (904) 247-5834. Review Do a K Public Utilities Director Date Si afore Contractor Notified Date CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (Alterations & Additions) Date: j (4, Job Address: Owner of Property: A/1,111 -ul'A�0 &/�2, Address: Telephone: Legal Description: Block Number: Lot Number: J Zoning District: 1'_y,'A-'-- 0 ;�14&ate License Number: Contractor: _1, Contractor Address: Telephone: Fax �Z2 z r2 Z" - I . ­ .1 Pi '-.1 � Ar Describe proposed use and work to be done: 47 'ry Ivft,7„-6-i'li Present use of land or building(s): 1p—e_.2 ""ret' Valuation of proposed construction: _ ' 0 What are the dimensions of the added space: r2klfeet x Cfeet Will the added area be heated and cooled? New electrical or increase in service? Add plumbing fixtures? 'ir` f-*,f, Add fireplace? P Add heating/air conditioning? 4) Is approval of Homeowner's Association- or :!tlier private entity required? If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% ov more to the original impervious area or the removal of any trees? _1�,NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. NO. Applicant certifies that no trees will be removed for this project. YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of.permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. if you are unsure of this information, please contact the Planning and Z*aiug.12apartment-a..-904-;41--5-826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number gy4ilable. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required,written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Ener Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(411,p=plete se of cous1ructiqp plarts-to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic__ Beach,FL 32233 Telepfi_&n_e:(q04)_247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ei.atlantic-beach.fl.us Page 2 Revised 8/04 in addition to construction and engineering detail,plan`s must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. .� 1 hereby certify that all inf tion provided with this application is correct. r/ Signature of owuer: L- le�' r -I' r Date: /J •� I hereby certify that hav rad and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be comp'• rr' with,whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the perform c of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and corr t and that the plans and supportingydata have been or shall be provided as required. Date: Signature of Contractor: Address and contact information of person to receive all correspondence regarding this application(please print). 7 Name:. /'n az Mailing Address:�i s ' ' fL�"y U, a� Telephon�!f�� 1 �':� / y�% Fax, �u.I /a f E-Mail. AS TO OWNER: Sworn to and subscribed before me this , day of -� `11 1 ' ,20 State of Florida,County of Duval Notary's Signatures ,��.��fib,•' . .•`o`"` `�,• LAURA DZAMKD -•••' ^•z Personally known MY COMMISSION#DD 460774 Produced identification EXPIRES:December 3,2DOD Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of 5 '. - '. � ,20 (�}� State of Florida,County of Duval Notary's Signature: ELLE L NHtNiM ❑ Personally known way Am-aftot * �roduced identification • Mlr Cans*ft E*M No 1,M Type of identification produced_FL DL— ro N bin fW4400 8oxweyNonal nose Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.cLatiantic-beach.fl.us Page 3 Revised 8/04 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 60OC-97 Residential Limited Applications Prescriptive Method C NORTH 1 2 3 Smalf!Additions,Renovations a Building systems Department of Community Affairs Compliance with Method C of Chapter 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 6000-97 for additions of 600 square feet or less,site-installed components of manufactured homes,and renovations to Ingle and multifamily residences. Alternative methods are provided for additions by use of Form 6006-97 or 60OA-97. PROJECT NAME: r G ^ . ,r; BUILDER: AND ADDRESS: >' �v ;;' �! t PERMITTING ;�C ` CLIM TE OFFICE: �;, -y;,.j kyr�.;; ZONE: 1 2 []3 OWNER: 1 PERMIT'N0. JURISDICTION NO.: •. ,x.5' 3 j,fl+^� SMALL ADDITIONS TOE (STING RESIDENCES(600 Square feet or less of conditioned area). Prescriptive requirements in Tables 6C-1,6C-2 and 6C.3 apply only to the components of the addition,not 10 the existing building. Space heating,cooling,and water heating equipment efficiency levels must be met only when equipment is installed specifically to serve the addition or is being installed in conjunction with the addition construction. Components separating unconditioned spaces from conditioned spaces must meet the prescribed minimum insulation levels. RENOVATIONS(Residential buildings undergoing renovations costing more than 30%of the assessed value of the building). Prescriptive requirements in Tables 6C-1 and 6C•2 apply only to the components and equipment being renovated or replaced. MANUFACTURED HOMES AND BUILDINGS.Only site- installed components and features are covered by this form.BUILDING SYSTEMS Comply when complete new system is installed. Please Print CK 1. Renovation, Addition, New System or Manufactured Home I. 2. Single family detached or Multifamily attached 2. 3. If Multifamily-No. of units covered by this submission 3. 1,Jh 4. Conditioned floor area (sq. ft.) 4. 5. Predominant eave overhang (ft.) 5;•• /- lle F 6. Glass area and type: Single Pane Double Pane a. Clear glass 6a. sq. ft. ff;,� sq. ft. b. Tint, film or solar screen 6b. sq. ft. sq. ft. 7. Percentage of glass to floor area 7. ,' 8. Floor type and insulation: 8 a. Slab-on-grade (R-value) 8a. R= _ lin. ft. b. Wood, raised (R-value) 8b. R= sq. ft. c. Wood, common (R-value) 8c. R= sq. ft. d. Concrete, raised (R-value) 8d. R= sq. ft. e. Concrete, common (R-value) 8e. R= sq. ft. 9. Wall type and insulation: a. Exterior: 1. Masonry (Insulation R-value) 9a-1 R= sq. ft. ,,2Z. Wood frame (Insulation R-value) 9a-2 R= / %'/r sq. ft. b. Adjacent: 1. Masonry (Insulation R-value) 9b-1 R= sq. ft. 2. Wood frame (Insulation R-value) 9b-2 R= sq. ft. c. Marriage Walls of Multiple Units' (Yes/No) 9c 10. Ceiling type and insulation: a. Under attic (Insulation R-value) 10a. R= sq. ft. b. Single assembly (Insulation R-value) 10b. R= sq. ft. 11. Cooling system' (Types: central, room unit, package terminal A.C., gas, existing, none) 11. Type: SEER/EER: I 12. Heating system': (Types:heat pump,elec.strip,natural gas,L.P.gas, 12. Type: _,f_i gas h.p.,room or PTAC,existing,none) HSPF/COP/AFUE: 13. Air Distribution System': • �" a. Backflow damper or single package systems' (Yes/No) 13a. a . - ►°; b. Ducts on marriage walls adequately sealed' (Yes/No) 13b. 14. Hot water system: 14. Type: _ r: (Types:elec.,natural gas,other,existing,none) EF: • Pertains to manufactured homes with site installed components. I hereby certify that the plans and specifications covered by the calculation are in Review of plans and specifications covered by this calculation indicates compliance compliance with the FI rida Energy Code, with the Florida Energy Code. Before construction is completed,this building will be .F �` * �,.'�„ inspected for compliance in accordance with Section 553.908,F S. PREPARED BY: Kr _ DATE: _ Y y � Energy - I hereby certify that this buildm �s m corn Bance with the Florida Ener Code BUILDING OFFICIAL: � y OWNER AGENT: r17(' �_( ,a:,/�I j!., �{ /S.4'fifr DATEr'o�"'I-�` DATE fes` Revised 1998 Yuluris�it Rowes Ol MrtQO PL2 Roo tY� 4 r �1r C2. f r `- c o 1 Q, SAM FLOYD n r� (904) 221-0612108 --(� '� � ,� tib' (��f'�{"�0;1`-� ��1 � £� ��Lt t✓ �3 � � � S. `f'-6YN � __ s � � � � Ido M P op + Pi iasfee4 pT'O MAUIJFac� i i `•'I 4 ! ( r A� ► y# i Lx ;. �'� $ �> �X i 5 'i N Far,--t C'a�l 1' o l�MT. `ever 8 ,1 per.F oak � . , ; .5 f'� 2So � t' fi I �4a Z! v � TI opt tj P� kzm 'o tFCq- 1A TOpp , llutwil'ok Homes of Awida SAM FLOYD C RC 0 TO (904) 22)-0612 (> 1 -eveo !E F i R Fliov— stiw Bea 7 f Ace�fio c K L I t'j PI-F�a a 32 " E-,/ i liq IV E�r, For) er UN46r qCL TI, � jcjLra,yc- d oo f- Ne-AA&, a?-ar,.,\ l s From s-W S Ta-uid. 150 d Jar- Door 3�6-1 f 1 b-Pa N t _c) 1,++ ;� \A1 tf�l� DP t 5o _ - INST�,t��� t � lop ,` I u'uristit Homes o/Fkrlda y to SAM FLOYD 1904122,E c 0 Y/of8 f MAP SHOWING BOUNDARY SUR I E Y OF L OT 1 BLOCK 1 S SHOWN ON MAP OF 1L'7, AS RECORDED /N ILiGZ800K 4a_ PACES 1141L4C OF THE .0ru DIM CERTIFIED TO: MAXA-u45 G. cIoc)u F ! b o -T �k o -T :3 LA ,asaP•�zv� C16, pMVATE.,EFb�rnEr.rT Vol `- Fi7R t7rtp►�JfKvF� u r u t ES ,A hF�1..tC.GS toy cG — -- 13.0 r M d' r 5-ro rt ycr �- _ w� U it 8 y Clok4c_w� m c�. CITY OF ATLANTIC BEACH BUILDING / ZONING DEPARTMENT ° EWA r� 800 Seminole Road oe J Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # 3/379 Property Address: ! O (9 'BFA-C k,5-)d£ Applicant: Ek j 7—kr I' S/--7 C �'>7 Project: T 77 This permit application has been: Approved F-1 Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: _ Date: A ©� Date Contractor Notified: CITY OF ATLANTIC BEACH ` BUILDING PERMIT APPLICATION (Alterations& Additions) Date: r' } Job Address: Owner of Property: / %�G ! i114 ft? le ` / .,,i-?` Telephone: Address: 1�!- Legal Description: Block Number: _Lot Number:_ _,Zoning District: ra contractor: j.� �'' ' ^ ry r a�, ^'�estate License Number: Contra r F !. r, �r ry ` I _ .y r' ,�.� �,/� � ~� �ri ''i Lit• " !��1% Contractor Address: Telephone: ^,4 f ;�0 r' 1 Fax: � ,� Describe proposed use and work to be done: ken ,�r'�' c�.Grr --(7.��'f �F)�X�;L.p"�+ !� "".�J't. e/`'T�-)�' i/ L,��'" �/�. /�I�). ."�' !',> gip, ./'tZ~i•E �,'�r��. (r.� ' iAL�. r _.� r _ �,tom t'7•'C'il.r� Present use of land or building(s): Valuation of proposed construction: Jt/ What are the dimensions of the added space E'; '=�:' ?%afeet x ,`� j feet Will the added area be heated and cooled? ��� New electrical or increase in service? r' Add plumbing fixtures? 'V P,, Add fireplace? {? Add heating/air conditioning?_ � Is approval of Homeowner's Associatioi, or,:!ther private entity required? 111,""I If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to the original impervious area or the removal of any trees? �O- Applicant certifies that no change in site grade, isnpet'Vious area or fill material will be used on this project. E]YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance Building seance of a NO. Applicant certifies that no trees will be removed fo YES, Removal of Trees will be required for this proJ•ect. r t project Removal Permits to be reviewed bTREE y the Tree ConservMOVAL PEItNIIT IS REQ U anon Board,which.m �D• Tree Doc!#2 O53o10r7, OR BK 127'.17 Page 1305, Numbe; Pages 1 =ifed Recorded!9130'2305 at 122E PM, IIM!:ULLER GL-ERK CIRCUIT CGOUR",T DUVAL COU;'d FY RFCORDiNG' 10,00 NOTICE OF COMMENCEMENT State of FLov-1-J a, Tax Folio No. County of 11(4Vil,L To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the _"b!'o ,,ng information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: '/ ci Address of property being improved: F61 ReOI 'de , General description of improvements: e-V,-NC nvh e v ` u Gc oW)Z /Yl ' Z o o enes, Owner: !P R ,- Address: b _t Owner's interest in site of the improvement: , Fee Simple Titleholder(if other than owner): Name: pr QMeF,,e-& Address: �r Contractor:_r ra fu fi , rte` )'f_ /W—wa Utz=— � Q rc. -Ir{;C. . Address: q Phone No: �4�'�^ i' Fax o:j )_0 z P2 Surety(if any):— ab Address: �/A Amount of Bond S /-)A Phone No: 4,,A Fax No: /(/F7 Name and address of any person malting a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents may be served: Name: _ Address: rg4z Phone No: / _ _+�1 6 -c� , / Fax No: rr In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b�,Florida Statues. (Fill hi at : wMer's option). — Name: 4) Address:T Phone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless different date is specified): r THIS SPACE FOR RECORDER'S USE ONLY r OWNER / Signed:., c J> llt�OL Date: l z? Before me this ;Qt'day of in the County of Duval, State of Florida,has personally appeared sirC7v� (Y)A ?ate Rt-�zo-,-A LAURA OZAMKO Notary Public at Large, State of Florida,County of Duval. MY COMMISSION#DD 460774 My commission expires: EXPIRES:December 3,2007T� Personally Known: �! or Produced Identification• Page 1 of 1 111111111 IN Print Date: 9/30/2005 12:29:03 PM ..`. .... Transaction#: 735042 g " Receipt#: 696080 Cashier Date: 9/30/2005 Jim Fuller 12:28:40 PM Clerk Circuit Court (KPEARSON) Duval County 330 E. Bay Street Rm 103 Jacksonville, FL 32202 (904) 630-2044 Customer Information Transaction Information Payment Summary DateReceived: 09/30/2005 Source Code: BEACH ()FUTURISTIC HOMES OF FL Q Code: BEACH 13694 BETTY DR Return Code: Over the Total Fees $10.00 JAX, FL 32224 Counter Total Payments $10.00 Trans Type: Recording Agent Ref Num: 1 Payments p � CASH $10.00 1 Recorded Items BK/PG: 1278711305 CFN.-2005361067 B (N/C)NOTICE Date:9/30/200512:28:22 PM COMMENCEMENT From: ROLAND MATT ETAL To: COMMENCEMENT INDEXING 3 $0.00 RECORDING 1 $10.00 0 Search Items 0 Miscellaneous Items file://C:\Program Files\RecordingModule\default.htm 9/30/2005 4!x�7s. CITY OF ATLANTIC BEACH fi1 PUBLIC WORKS DEPARTMENT r 1200 Sandpiper Lane ,` c "_ Atlantic Beach,Florida 32233 (904)247-5834 (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # Property Address: A -?F'46 s d Applicant: &:hA r C m Project: Ir—)i tiwrcT�- Your application is approved as noted by the Public Works Department. Final application approval must come from the Building Department. ❑ Your permit application has been reviewed by the Public Works Department and the following items need attention: Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions,please call (904)247-5834. Review d b 'ck Carper,P.E.,Public Works Director Date A h 0 Signature Contractor Notified Date r CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (Alterations&Additions) Date: / � r Job Address: (TK j ��%^ �.'4 i Li'f r:�'j f t ;�J t Owner of Property: Address: ` hone: Legal Description: Block Number: Lot Number: %—Zoning District: Contractor: i r, i ��E' �� '� '�t s l-' ;/eState License Number: C �;�? 40 Contractor Address: -i� r� / � vt-�e fj-(' v'tl i' Telephone:/ X*e 1 / -rb % ,5( �-A Fax: Describe proposed use and work to be done: P E•rr, "7('/ .Gir f=;( C 0,(_ c off''c/ ie; ;f �i7 r= r. / �;'.- i,7 �,1 ,.I,�Sf 1...,.�; l' 46IC4 Present use of land or building(s): Valuation of proposed construction:_ moi r �" What are the dimensions of the added space: -el' �''rI,'Ifeet x �`s £ . feet Will the added area be heated and cooled? New electrical or increase in service? Add plumbing fixtures? Add fireplace?_ Add heatinglair conditioning? Is approval of Homeowner's Associatiov or,:!tier private entity required? If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% ar snore to the original impervious area or the removal of any trees? ANO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. NO. Applicant certifies that no trees will be removed for this project. YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which.meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of,permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zppaent at,_904-2 - $26. In order to correctly verify zoning designation, please have `—' Property Appraiser's Real Estate Number alable. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, FnerZy Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four Q)_gomplete sets of Cops$ruation plans-.to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.stlantic-beach.fLus Page 2 Revised 8/04 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. s� I hereby certify that all inf ationprovided 'th this application-is correct. ,; I r - �• / 1-7 Signature of oww: n i I hereby certify that I hav A ad and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be ccnp1:!:'1 with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the goveming of construction or the perfo c of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and con and that the plans and supportin&ata/hha���ve been or shall be provided as required. 9i. /j Signature of Contractor:_ �.;;���fl, ,�, _.,, Date: Address and contact information of person to receive all correspondence regarding this application(please print). Name: Mailing Address: f'- Z;. C + f ',4 df Telephony! /'• ', u<^, ✓ri .Fax:,/; u/ +u.�� . ''-r�. J " E-Mail: AS TO OWNER: Swom to and subscribed before me this day ofE State of Florida,County of Duval Notary's Signature.'— LAURA ignature' �`"' LAURA DZAMKO Ste°, �:' • � t Personally known MY COMMISSION#DD 460774 Produced identification •a,',o��„r` EXPIRES:December 3,2001 Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of + ' �ti�lrl ,20 (J5. State of Florida,County of Duval �,.{ Notary's Signature:/ + 1��'C�� J� i ` "�r� MCHELLE L.HllMM ❑ Personally known HdWy��-gft41p� © roduced identification t~ • *Q taai b E*w W t,200E Type of identification produced J—L D --• Cn 0 illin OW4400 i BonAea Nedon�l 'note Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.cLatlantic-beach.fl.us Page 3 Revised 8/04 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 60OC-97 Residential Limited Applications Prescriptive Method C NORTH 1 2 3 I'SnilalliAdditions,Renovations 3 Building systems Department of Community Affairs Compliance with Method C of Chapter 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 6ODC-97 for additions of 60D square feet or less,site-installed components of manufactured homes,and renovations to qngle and multifamily residences. Altemative methods are provided for additions by use of Form 60OB-97 or 6o0A-97. PROJECT NAME: : C• - ti BUILDER: rfi ; P ' AND ADDRESS: TIFeX-;r is ty" 'Cf.c �r/ � ! PERMITTING � ;�C ` CLIM TE OFFICE: ZONE: 1 2 F 3 +. . 1 f OWNER: 11-ell , . !+ ��iwr` PERMIT N0. JURISDICTION NO.: 13 16 111 SMALL ADDITIONS TOE (STING RESIDENCES(600 Square feet or less of conditioned area). Prescriptive requirements in Tables 6C-1,6C-2 and 6C•3 apply only to the components of the addition,not to the existing building. Space heating,cooling,and water heating equipment efficiency levels must be met only when equipment is installed specifically to serve the addition or is being installed in conjunction With the addition construction. Components separating unconditioned spaces from conditioned spaces must meet the prescribed minimum insulation levels. RENOVATIONS(Residential buildings undergoing renovations costing more than 30%of the assessed value of the building). Prescriptive requirements in Tables 6C-1 and 6C-2 apply only to the components and equipment being renovated or replaced. MANUFACTURED HOMES AND BUILDINGS.Only site• installed components and features are covered by this form.BUILDING SYSTEMS Comply when complete new system is installed. Please Print CK 1. Renovation, Addition, New System or Manufactured Home 1. N if,4!T ie"d 2. Single family detached or Multifamily attached 2. X01, Lu"',I-y _ 3. If Multifamily-No. of units covered by this submission 3. 1.44 4. Conditioned floor area (sq. ft.) 4. S. Predominant eave overhang (ft.) 51•- %- T 6. Glass area and type: Single Pane Double Pane a. Clear glass 6a. sq. ft. ro 9 sq. ft. b. Tint, film or solar screen 6b. sq. ft. sq. ft. 7. Percentage of glass to floor area 7. l?'0% 8. Floor type and insLtlation: a. Slab-on-grade (R-value) 8a. R= ._ ' lin. It. b. Wood, raised (R-value) 8b. R= _. sq. ft. c. Wood, common (R-value) 8c. R= sq. ft. d. Concrete, raised (R-value) 8d. R= sq. ft. _ e. Concrete, common (R-value) 8e. R= sq. ft. 9. Wall type and insulation: a. Exterior: 1. Masonry (Insulation R-value) 9a-1 R= sq. ft. `,,?2) Wood frame (Insulation R-value) 9a-2 R= i l rid sq. ft. b. Adjacent: 1. Masonry (Insulation R-value) 9b-1 R= sq. ft. 2. Wood frame (Insulation R-value) 9b-2 R= sq. ft. c. Marriage Walls of Multiple Units' (Yes/No) 9c 10. Ceiling type and insulation: a. Under attic (Insulation R value) 10a. R= _ 303 sq. it. b. Single assembly (Insulation R-value) 1Ob. R= sq. ft. 11. Cooling system' (Types: central, room unit, package terminal A.C., gas, existing, none) 11. Type: >fX> `' ? i' SEER/EER: 12. Heating system': (Types:heat pump,elec.strip,natural gas,L.P.gas, 12. Type: Z �_ ► _ gas h.p.,room or PTAC,existing,none) HSPF/COP/AFUE: 13. Air Distribution System': a. Backflow damper or single package systems' (Yes/No) 13a. .- y-,1. b. Ducts on marriage walls adequately sealed' (Yes/NO) 13b. 14. Hot water system: 14. Type: _-jt:X•2 Jy.> (Types:elec.,natural gas,other,existing,none) EF: Pertains to manufactured homes with site installed components. I hereby cert,ty that the plans and specifications covered by the calculation are in Review of plans and specifications covered by this calculation Indicates compliance compliance with the%nda Energy Code. with the Florida Energy Code. Before construction is completed,this building will be PREPARED By. _` .,_-/_�: ,�i DATE: - ! "'%?°• Inspected for compliance in accordance with Section 553.908,F,S. I hereby certify that this buddlnq Is In comp lance with the Florida Energy Code BUILDING OFFICIAL: _ y 1 OWNER AGENT �_ 7�r _} • ' j( /1 a�'- yt�{���� GATE q-' DATE Revised 1998 cuturist c Honks 01 p6T4 gat-n, c To PZa Roor ,, A. off' 1Aa:1 � PC ,,e �d lain SAM FcOYgat-n, ORC� y 1 (904) 22"612 c FL' TI -a -4-c,-6 t8 f/af slapsLO ©� Ne STA S,N 1!1 ev E oeuk{2 palm I ! PAs-er.e�yt'o MF.tIAo E 9E F f 1 SAe U MCco PI s � ` / f i got el ever" xrst,, ' fgarrr, C'efs r, 2 Q 1' p ) �' ' Homes it�rida a Mae s ItflBisttc of �•�CZ � SAM FLOYD CRCD'i0TO JW4) 231.0512 71 d 521 g S r 'Se a10 e At 2 , �o W F I A t s tr¢p M41 d 7o ?a�t-a� &ea rr, ` of �e, s rtA_DT i Ile 32>> J r uNJer 2ara-qt �mV- - - u t' . a ! t r t j TO P -- -------- lT`.`__.. � j! rte' -+- ,. e• �. o h'c d eY 3 aac - tt L) t i j 74P faiqmf.� roetai - 3°6 ,-teed ehim 0 LA f F f 1 e �o�- i 2. � � - ,� , ►��� Gp + 5o � i `1 y!T/n� ; ; t ' INSIA, t r Fica ' 3 e 0 i futuristic Homm of Florida SAM FiQYD t S-tud _342 '.��• *� h (944)2210.612 ' ? ,J t MA P SHO WING, BOUNDA R Y SUR VE Y OF L 0 f J0 BL OCK —L-A S SHOWN ON MAP OF AS RECORDED /N $Br,000K -gs PACES l4•t4G QF rHE C-00 .V CER rPFIED r©. 1 I b 3 a L -T 3 L 03 st13' 1$ 33 pW VA-rE. E*,151<mEuT a rp,o;r r7.6 Ft7R-GQritl.3Al'9E�V`C1l"A"rl o.+J -'--�( ' 1g 13.0 o Q 1J. 7.v' n r H� 5"!"C)R..710 lu.3 > � « C�Gt Lam{/ 'ty 'y4 Cry •p.L V~ �•Q-•L s�.r+l�.T�' �i� CURVE TABLE CURVE LENGTH RADIUS BEARING CHORD DELTA C1 37.33 675.00 N 1' 0" 37.33 '10'09" C2 18.49 25.00 >,F 7' 7" 18.07 1" C3 12.65 45.00 N3 '4 "W 12.61 16' 1` CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD a ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00031327 Date 10/14/05 Property Address . . . . . . 1861 BEACHSIDE CT Tenant nbr, name . . . . . 6FT SHADOW BOX FENCE Application description . . . FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1200 Owner Contractor ------------------------ ------------------------ ROLAND, MATT & ROSE FUTURISTIC HOMES, INC. 1861 BEACHSIDE COURT 13694 BETT DR ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224 (904) 221-0612 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 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 CODV: J. BUILDING OFFICIAL CITY OF ATLANTIC BEACH cc: BUILDING /ZONING DEPARTMENT D. Ford r� 800 Seminole Road L. s Atlantic Beach,Florida 32233 Doerr ri J,3l�' (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # G /3 2- Property Property Address: Applicant: ���"/,� 46 n C Project: & r 117,4eec— This permit application has been: U- Approved ❑ Reviewed and the following items need attention: Please re-submit y pplication when these items have been completed. Reviewed By: X441 Date: /D--,01.3—,--2A- Date ,--2 ' Date Contractor Notified: J CITY OF ATLANTIC BEACH Yl FENCE PERMIT APPLICATION rvo 1=�`� Dater (� PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Job Address: le, Owner's Name: ' ' at Fy Address:} e .� Phone Legal Description: Block Number: Lot Number: l Zoning District: V4,1 Fence Contractor: ri�i,!F r d1 .no_ SA r Address: 1.3---6/5' zo b/i/E' Phone: City: Jca State: r —Fax c? � Type of fence and materials to be used: root ��j 6Z ,j) tC f cn e , (4�1✓�t PS Valuation Of Fence: Interior Lot ❑Comer Lot ❑Dumpster or storage tank enclosure Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application. Tree Protection: O. Applicant certifies that no trees will be removed for the installation of this fence. ❑YES. Removal of Protected Trees will be required for this fence. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board, which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. 1. Attach copy of property survey showing location, height and all distances from property lines of the proposed fence. (Fences shall not be placed within any utility or drainage easements without written permission from the Utility and/or Public Works Departments. Fences shall not restrict any private easement.) Address and contact information of person/to receive all correspondence regarding this application(please print). Name: dYll L UT�'l Mailing Address: L/,z Phone( F�ff) / �� lJf�/c E-Mail: ) 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 - Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.us Page 1 Revised 3/04/04 I hereby certify that I have read and examined this application and attached documentation and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the -0pporting data have been or shall be provided as required. 4_ f i Signature of Owner: Date: AS TO OWNER: Sworn to and subscribed before me this day of <)F'r ,20�( �. State of Florida,County of Duval Notary's Signature: 'N, LAURA DZAMKO Personally known `1 MY COMMISSION#OD 460774 ❑ Produced identification EXPIRES:December 3,2007 Type of identification produced Signature of Contractor: Date: AS TO CONTRACTOR: n Sworn to and subscribed before me this �"t day of �� ,20 State of Florida,County of Duval Notary's Signature:/ v 1 u!"�"A"�"" !'' "' '�' ❑ Personally known N0ftYPdk-MMrdFbft Produced identification �j . kV C 1 �Nllea Erb W t m Type of identification produced ;FL D�-- com" OW4111M Aasw llA 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 Fag: (904)247-5845 • http://www.ci.atlantic-beach.fl.us Page 2 Revised 3/04/04 MAP SHOWING BOUNDARY SUR 1/E Y OF LO 1 BLOCK __L__A S SHOWN ON MAP OF 1 :> AS RECORDED IN IL&YBOOK .8 PACES 114-14C OF rHE .- CER rlFIED TO: mA*r14-)r4s C, 7-LL- .0 : >ya Tt -1)es i.a,rj�16 �1 1 -sF TZ b 7- 1 2� C_- t_4 .� J g' °►�t'UVATE..EF�Et�Et.�T � o p.`� nn.t jIF T t J 13.0 f `ESL J �O? ! h to RJI 16 AFFeN d, !>-ro rc Y W r - Neer �Fc n C 0- e)ij'enAv4 W �i wlr6 JAM ,6 V 7develoPment verMes UXZANFl,.'�^/ division a►d 1!h!r A ti� G regulations,bd 00" approval for the issuenes of pa"YO. 5���` with Florida Building Code 4M ad ttoshw P L' locan. +�ag.and Federat penfiiti must b - � Beach Build�ug, i prior to _ Buildmo P� t' CURVE TABLE CURVE LENGTH RADIUS 8EARINC CHORD DELTA Approve ay. m , eveopmen Cl 37.33 675.Q4 N0 1'SQ"w 37.33 3'i Q' 9" Date'h - C2 18.49 25.Q0 18.07 42'2 '21" C3 17.65 45.00 N35' 5'45"W 12,61 16'06'31'' CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD t> ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028193 Date 5/03/04 Property Address . . . . . . 1861 BEACHSIDE CT Tenant nbr, name . . . . . . REPLACE AIR HANDLER ONLY Application description . . . MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ CAREY, EDWARD OCEAN STATE HEAT & AIR 1861 BEACHSIDE COURT 1476 ATLANTIC BLVD. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 249-8251 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 55 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- -------- -- ---------- ---------- Permit Fee Total 55 . 00 55 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 55 . 00 55 . 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 - BUT51NG OFFICIAL CITY OF ATLANTIC BEACH \\\ MECHANICAL PERMIT APPLICATION Date: LJ l —1 O Property Address: 1 sco I rh�1 c Owner: ellTelephone #• Contractor• ��yy -` Telephone #: 44 Contractor Address: ' ' 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 ordinances and standards of —good practice listed therein. Type of Heating Fuel: If other construction is being done on this building Electric or site,list the building permit number: ,�, IF Gas: —LP !Natural _Central Utility ❑ Oil ❑ Other–Specify MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK Heat _Space Recessedentral _Floor Residential Air Conditioning: Room Central Duct System: Material Thickness ❑ Commercial Maximum capacity cfin Cl Refrigeration ❑ New Building ❑ Cooling Tower: Capacity gPm Existing Building ❑ Fire Sprinklers:Number of Heads ❑ Elevator: __ Manlift Escalator (Number) Replacement of Existing System ❑ Gasoline Pumps (Number) ❑ Tanks (Number) ❑ New Installation ❑ LPG Containers (Number) (No system previously installed) ❑ Unfired Pressure Vessel ❑ Extension or Add-on to Existing System ❑ Boilers ❑ Gas Piping ❑ Other-Specify ❑ Other–Specify LIST ALL EQUIPMENT AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving Number Units Description Model# Manufacturer Ton's Agency HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving Number Units Description Model# Manufacturer BTU's Agency -Z, le `**' �Q TANKS Nominal Capacity Type Liquid Serial Approving How Many &Dimensions Contained Manufacturer No. Agency 800 Seminole Road• Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845• http://www.ei.atlantic-beach.fl.us n 6 Irrigation Meter i; 1861 Beachside Court Lot # 10 1 MATERIAL AND LABOR RECORD OUANTRYMATERIAL USED PRICE AMOUNT 1 411 X 3/4 SPDDLF 12 45 12 4 1 3/4 CORP STOP ----- - _ R . nn 0.0_ 1 3/4 CURB S'T'OP 8 00_ __8. n 2 314 N 3/4" PVC 2n 1 no 1 900 L 20 20 2- d-:-== LNmg — n0_ 12 00 27 72 Sub-Total $7R 77 10% O.H. 88 TQ Flatprial 2 Trucks ($10.00/TRUCK for 6HPS) _ 20 00 120 00 JOB — - — - COMPLETED? YES ❑ NO ❑ DATE BILLED 19 DATE MECHANIC OR HELPER WOnK DONE 11nS. RATE AMOUNT Four (4) men Hand dig (6 hrs 24 51 147 06 30% 0. H. _441 _ 1p c �O APR 2 i? TOTAL MATERIAL COST 86 65 - RI TOTALLABORCOST . y Equip. COSTS OTHER DIRECT COSTS Qjj 00 I a TOTAL COST 482 83 ZZ 7 � al CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (Alterations&Additions) Date: Job Address: rT ,�� 'F i ;C', �r:Ji t�f��1 T r j�/;{4 =1 � t Owner of Property: /�/{/ , / ,G �. P.u/=A 3t i / �i����% i i1c /'�� ' Telephone: $/1i2i Address: '�� Legal Description: Block Number:_ Lot Number: J Zoning District: •*�- Contractor: i9 -t" s�' 9i ,''State License Number: (/"' Contractor Address: �!- � 51 /2"C—e'. k P i' Telephone:6"�'9,4,4Fax:�nor Describe proposed use and work to be done: t r+ r�'P y e r /r_' . fir; .F' 0/1'GA j F %f'�7' Present use of land or building(s): �, �,r,• 1`,°,� �, ,�/� �,�r ,"/ ' Valuation of proposed construction: What are the dimensions of the added space: E ,; :'-.''r1v`Meet x ,`�. feet Will the added area be heated and cooled? �/�, � New electrical or increase in service? ,�_ Add plumbing fixtures? y` , `; Add fireplace?--F = Add heating/air conditioning? j'.) --, Is approval of Homeowner's Association- or,�41_her private entity required? If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or taore to the original impervious area or the removal of any trees? ANO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. NO. Applicant certifies that no trees will be removed for this project. YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which.meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of,permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zpartment a2 904-247826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number qy4ilable. - STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four 1)complete sets of construction plans_to the Building Department, which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(9b4)-247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fag: (904)247-5845 -http://www.ei.attantic-beach.fl.us Page 2 Revised 8/04 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. S. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all inf ation provided Ny'th this application•is correef. • � Signature of awaer: �-�" `.�'"�--.-���'` �.. .� Date: I hereby certify that I havAcad and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be comply,? with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the perfo c of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and corr and that the plans and supportinodata have been or shall be provided as required. ^• �, r�` j Signature of Contractor: + Date: ., Address and contact information of person to receive all correspondence regarding this application(please print). Name:. Mailing Address: /'e f I' L' J i! I Telephony Fax./7"zr'-% ` E-Mail: AS TO OWNER: Sworn to and subscribed before me this , day of i N State of Florida,County of Duval Notary's Signature:_ E LAURA OZAMKOPersonally known MY COMMISSION#DD 460774Produced identification ; EXPIRES:December 3,?0;3 i Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this ` � day of 5 CVk.6,r1/1_V)kL ' ,20 State of Florida,County of Duval Notary's Signature: mcau 1„MUM= ❑ Personally known I�yPuhk-9Y4tdFlotid� []�oduced identification • ltiy CanpM�lon EON Nor 1.� Type of identification produced EL DL_ nole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •bttp://www.cLatiantic-beach.fl.us Page 3 Revised 8/04 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FOR,V 60OC-97 Residential Limited Applications Prescriptive Method C NORTH 1 2 3 Small Additions,Renovations&Building systems .Department of Community Affairs Compliance with Method C of Chapter 6 of the Florida Energy Efficiency Code maybe demonstrated by the use of Form 6000.97 for additions of 600 square feet or less,site-installed components of manufactured homes,and renovations to 4ngle and multifamily residences. Alternative methods are provided for additions by use of Form 6008.97 or 600A-97. PROJECT NAME: � G ^ t �,,�; BUILDER: -a id Irk ly, yr9jP" AND ADDRESS: -� C t.; '�r r+ ./ { PERMITTING f-r CLIM TE OFFICE: 04. 'iz-1 Gyres:.; ZONE: 1 F�2 []3�i OWNER; r r [? t�>^,! PERMIT NO. JURISDICTION NO.: I` 1 SMALL ADDITIONS TOE (STING RESIDENCES(600 Square feet or less of conditioned area). Prescriptive requirements in Tables 6C-1,6C-2 and 6C-3 apply only to the components of the addition,not to the existing building. Space heating,cooling,and water heating equipment efficiency levels must be met only when equipment is installed specifically to serve the addition or is being installed in conjunction with the addition construction. Components separating unconditioned spaces from conditioned spaces must meet the prescribed minimum insulation levels. RENOVATIONS(Residential buildings undergoing renovations costing more than 30%of the assessed value of the building). Prescriptive requirements in Tables 613-1 and 6C-2 apply only to the components and equipment being renovated or replaced. MANUFACTURED HOMES AND BUILDINGS.Only site- installed components and features are covered by this form.BUILDING SYSTEMS Comply when complete new system is installed. Please Print CK 1. Renovation,Addition, New System or Manufactured Home I. 'Pv 4'4�=714),j 2. Single family detached or Multifamily attached 2. /ty,-14: 3. If Multifamily-No. of units covered by this submission 3. CyFi 4. Conditioned floor area(sq. ft.) 4. _ 5. Predominant eave overhang (ft.) 5,•- �.. �' 6. Glass area and type: Single Pane Double Pane F: a. Clear glass 6a. sq. ft. d sq. ft. b. Tint, film or solar screen 6b. sq. ft. sq. ft. 7. Percentage of glass to floor area 7. 110110/0 ? 8. Floor type and insulation: F a. Slab-on-grade (R-value) 8a. R= Y J tin. ft. b. Wood, raised (R-value) 8b. R= sq, ft. c. Wood, common (R-value) 8c. R= sq, ft. d. Concrete, raised (R-value) 8d. R= sq. ft. _ e. Concrete, common (R-value) 8e. R= sq. ft. 9. Wall type and insulation: a. Exterior: 1. Masonry (insulation R-value) 9a-1 R= sq. ft. ') Wood frame (insulation R-value) 9a-2 R= ✓f %'/rit- sq. ft. b. Adjacent: I. Masonry (Insulation R-value) 9b-1 R= sq. ft. 2. Wood frame (Insulation R-value) 9b-2 R= sq. it. c. Marriage Walls of Multiple Units' (Yes/No) 9c 10. Ceiling type and insulation: �j a. Under attic (insulation R-value) 10a. R= -d- _ -; S�c sq. ft. b. Single assembly (Insulation R-value) 10b. R= sq. ft. 11. Cooling system` (Types: central, room unit, package terminal A.C., gas, existing, none) 11. Type: ?_X SEER/EER: 12. Heating system": (Types:heat pump,elec.strip,natural gas,L.P.gas, 12. Type: �J1 gas h.p.,room or PTAC,existing,none) HSPF/COP/AFUE: 13. Air Distribution System`: , y a. Backflow damper or single package systems` (Yes/No) 13a. ; ' y b. Ducts on marriage walls adequately sealed" (Yes/No) 13b. > 14. Hot water system: 14. Type: (Types:elec-, natural gas, other,existing,none) EF: Pertains to manufactured homes with site installed components. I hereby certify that the Plans and specifications covered by the calculation are in Review of plans and specifications covered by this calculation indicates compliance compliance with the%nda Energy Code. with the Florida Energy Code. Before construction is completed,this building will be PREPARED BY: S t A __ DATE- �=_��!.�'� Inspected for compliance in accordance with section 553.908,F.S. I hereby certify that this buiidm�is in comp ianc�lorida Energy Code BUILDING OFFICIAL: OWNER AGENT: r /r<��'-,•_[ J! .i1r3 DATE �' �C<�'" DATE ---� -�- Revised 1998