Permit 243 Belvedere St CITY OF ATLANTIC .BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PRO NE LINE 247-5826
Application Number . . . . . 06-00033928 Date 9/25/06
Property Address . . . . . . 243 BELVEDERE ST
Application type description RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . .11� TO BE UPDATED
Application valuaticn 1000
----------------------- - ------ --------------------------------------------
Application desc I
ADD STEP.S To I S T a�'O dE
------------- - - - - -------------------------------------------
Owner Contractor
--------- ---- ------- - ------------------------
KRUEGER BLASINGAME BUILDING SVC. , INC.
243 BELVEDERB STREE 14286-19 BEACH BLVD. , #365
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
1 (904) 249-1772
------------------------ ---------------------------------------------------
I
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee 17 . 50
Issue Date . . . . Valuation . . . . 0
Expiration Date 3/24/07
-----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
Permit Fee Total 35i*00 35 . 00 . 00 . 00
Plan Check Total 17L50 17 . 50 . 00 . 00
Grand Total 52 !� 50 52 . 50 . 00 . 00
pERMrf Is AppBOVED ONLY IN ACCORDANCE WITI17ALL CITY OF ATLANTIC BEACH OMINANCES AND THE nORIDA
BUILDING CODES.
'�J%J-
CITY OF ATLANTIC BEACH
PLAN REVIEW SHEET
S.Makowski
Building Department Public Works&Public Utilities Departments --E—.Higgin
800 Seminole Road 1200 Sandpiper Lane S. Doerr
Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 R. Carper
(904)247-5800 (904)247-5834 D. Kaluzniak
(904)247-5845 Fax (904)247-5843 Fax Public Safety
PLAN REVIEW CONMENTS
Permit Application# 3-39cP6
Property Address: I& / VE df-jeopi
Applicant:
Project:
This permit application has been:
r V ent.
VIIJ Approved as noted by the Departin
Final application approval ust comve from the Building Department.
Reviewed and the following items need attention:
/* 04 o&;i Z* V/
A
ION
W
Please re-submit your application when these items have been completed.
Reviewed By- Date: lwla
Date Contractor Notified:
f
CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION
(New or Alteration/Additions Residential & Commercial)
Date:
JobAddress: A7*f ae-llede,�e-
Owner'sName:
Address: -�- V e-J C,k-e- Phone:
Contractor:S/016 State License Number: Coge-Lc) �-99--�tj
Address: ;Thyltl Phone: ;2-Y-T- 17-7Z c,-b ?3t-9106
city: State: r-1. Zip: ?.i->S-4Fax: -244- 00'( 7
Describe proposed use and work to be done: Xet,,1- 5-Y5-e-.s �e-, r-e-�� -o-C enxb-f�!)
— k",-:� k AX�L -
Present use of land orbuilding(s):
Valuation of proposed construction: Z�ajo 0
10,
Is approval of Homeowner's Association or other private entity required?//d If yes,please submit with this
Application.
Will this project involve changes in elevation,site grade or any use of fill material,addition of 5%or more to the original
impervious area?
NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this
project.
YES. Approval of the Public Works Department is required prior to issuance of a Building
Permit. The Public Works Department is located at 1200 Sandpiper Lane, AB,Telephone#is (904)249-
5834,Rick Carper,Director.
PROCEDURE: IN ORDER TO EXPEDITE ISSUANCE OF PERMITS, IT IS RECOMMENDED
THAT THE ARCHITECT OR CONTRACTOR OF RECORD COMPLETE THIS CHECKLIST,AS IT
IS DETAILED AND TECHNICAL, AS WELL AS CONTAINS LANGUAGE SPECIFIC TO
ADOPTED CODES. AN INCOMPLETE APPLICXTION AND OMISSION OF INFORMATION WILL
CAUSE A DELAY IN THE ISSUANCE OF PERMITS.
VERIFY ZONING DESIGNATION AND PROPER SETBACKS FOR THE PROPOSED CONSTRUCTION. IF YOU
ARE UNSURE OF THIS INFORMATION,PLEASE CONTACT THE PLANNING AND ZONING DEPARTMENT AT
"4-247-5826.
BUILDING CONSTRUCTION PLANS
4 SETS OF PLANS
STEP 1. PROVIDE STATEMENT OF COMPLIANCE ON ALL PLANS TO READ SUBSTANTIALLY AS
FOLLOWS:
"THESE PLANS WERE PREPARED AND SHALL COMPLY WITH THE FOLLOWING:
2004 EDITION FLORIDA BUILDING CODE,BUILDING,PLUMBING,MECHANICAL,ELECTRIC.-
800 Seminole Road Atlantic Reach,Florida 32233-5445
Phone: (904)247-5826 Fax: (904)247-5845 - http:Hwww.coab.us
Page 2 Revised 6/06
Address and contact information of person to receive all correspondence regarding this application
(please print).
Name:
Mailing Address: J, 64�4. F2, ?;k4.S-0
fliL�y I i ottj
Telephone: Fax: E-Mail:
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 plans and supporting data have been or shall be provided as
required. Date:
Signature of Owner: p2v.
AS TO OWNER:
AA&
Sworn to and subscribed before me this dayof 20 Q
State of F1 QUu-
04"ft uAll"afte
OWS0111111110M Notary's Signature: 0_0_e� 0,
ISOM1011110
Fwft=.M� El Personally known
.0 57�*Tt?� a Produced identification Gq I _-,>8 -7
'4�jvl'r, oj/;�31 ;)OLO Type of identification produced
L
Signature of Contractor: Date--
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of 120��6
State of Florida,County of Duval Notary's Sigria t:
Personally known
Produced identification
Type of identification produced
L
NoWy Pubk-Soft d FWA
JW CwwbWm Expku Feb U.
Coryni"ion I DD 518W
Bonded By National N=AM.
WOW— — — — —1
800 Seminole Road Atlantic Reach,Florida 32233-5445
Phone: (904)247-5826 Fax: (904)247-5845
Page 4 Revised 6/06
Duval County Property Appraiser-Parcel Infonnation Page I of I
Owner's Name: KRUEGER MARGRID lReal Estate Number: 170505 0000
Property Address: 243 BELVEDERE ST Mailing Address:243 BELVEDERE BV
City: ATLANTIC BEACH ATLANTIC BEACH , FL
Zip: 32233 Zip:
Unit Number:
32233-4108
2006 Exempt Value: $25,000.00
PARCEL DESCRIPTION
jProperty Use:0100 SINGLE FAMILY I(Tr—ansaction Date: 8/4/2003
Transaction price
displayed Is based on
the actual amount of
Legal Description: 10-8 17-2S-29E SALTAIR Transaction Price: $196,500.00 documentary stamps
SEC 1 LOT 460,N 1/2 LOT 461 - paid at the time of
recording.The current
rate is 70 cents per
$100.
iNeighborhood: 941601 SALTAIR NBHD
ISection/Township/Range: 17- [No. Buildings: 1
Otticial Record Book and Page: Heated Area: 1448
112952308 11
,FM—ap Tile: 9417 �fixterior Wall: Tile/Frame Stucco
VALUES AND TAXES FROM 2005 CERTIFIED TAX ROLL
ILand Value: $120,150.00 ---][Taxing Authority: USD3
IClass Value: $0.00 ---]Fc—ounty Tax: $997.44
lImprovements: $103,000.00 [school Tax: $1,255.41
IMarket Value: $223,150.00 [D—istrict Tax: $470.13
lAssessed value: $181,847.00 FOt—her Tax: $78.50
lExempt Value: $25,000.00 [Voted Tax: $66.03
ITaxable Value: $156,847.00
ISr. Exempt: $0.00
isr- Taxable: $0.00 ]FT—otal Tax: $2,867.51
http://apps.coj.net/PA0/Printver.asp?ReNum=170505+0000 9/12/2006
MAP SHOWING BOUNDARY SURVEY OF
LOT 460 AND THE NORTH 1/2 OF LOT 461, SECTION NO. 1, SALTAIR, AS RECORDED IN
PLAT BOOK 10 PACE 8 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
MARGRID KRUEGER
WACHOVIA MORTGAGE CORP.
STEWART TITLE GUARANTY COMPANY
RICHARD T. MOREHEAD, P.A.
LOT 471 LOT 472 LOT 473 LOT 474
50.00' (PLAT) 25.00' (DEED)
FOUND 1/2-IRON PIPE S 10*11'11" W 74.91' (MEASURED) FOUND PK NAIL
NO IDENTIFICATION 0.3'� NO IDENTIFICATiON
, _�_X _!—_x— — — —
ji�l 6 -06
.3'- 25.00' (DEED
x
-LOT 459
T 460 NORTH 1/2 SOUTH 1/2
LOT 461 LOT 461
LO
ILLJ LILI
29.2' 19.3'
U) U)
< WOOD <
< DE K
LILI LLI
0
'CK
STEPS
C%I-xt C) LOT 462
x—
C5 6.8' 12 21COVERED 0) 0
5 ENTRY �D
N
AIR
Ld CONDITIONER
2 ONE STORY PAD
0 T4' MASONRY & FRAME
p
0 POSTED # 243
.0 8' 19.6,
0 J.COVEREDJ-� 00 Ld
ENTRY 4 29.3' 19.2' LLJ
CIO
V)
STEPS.
an a,
5;
0
�2 a' 2DO.00' (PLAT)
x
_2�.00' ED)
FOUND 1/2'IRON PIPE FOUND 1/2-IRON PIPE S 10'03'11'IN FOUND 1/2'IRON PIPE
STAMPED"�144' N 09'58'01" E 74.94' (MEASURED) 1,1.IDENTIFICATION 225.01'(MEASURED) NO IDENTIFICATION
50M' (PLAT) 25,00' (DEED) AP 7
CITY OF
BELVEDERE STREET BUILDL C.; �F E
(50.0' RIGHT OF WAY)
4
NOTES ACCEPTED BY.
LEGEND: By:
R = RADIUS FENCE V
L = LENGTH CONCRETE
NOTES: REVISIONS
I- ARINGS ARE BASED ON THE ASSUMED BEARING OF -_S 80,00,00" E ALONG
BE --------- ------- ----- THE
NORTHERLY BOUNDARY LINE OF SUBJECT PARCEL. DATE F�ESCRIPTION
2. GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS LIE WITHIN FLOOD ZONE ----X AS SHOWN ON TH,
By IONAL 17. 5__P_ ...Q00
NAT FLOOD INSURANCE MAP DATED APRIL 1989, COMMUNITY NUMBER 12067, 4NEL I D
3. THIS SU RVEY REFLECTS ALL EASEMENTS & RIGHTS OF WAY AS PEI RECORDED F"AT 8,/OR PTLE COMMITMENT
IF SUPPLIED. UNLESS OTHERWISE STATED, NO OTHER TITLE VERIFICATION HAS BEE�N PERFORMED BY THE UNDERSIGNED
4. THIS SURVEY NOT VALID WITHOUT THE ORIGINAL SIGNATURE AND EMBOSSED SEAL OF THE CERTIFYING SURVEYOR.
JOB # 21604717FATE OF FIELD SURVEY: 08-04-03 DATE OF ISSUE: 08-05-03 1 SCA,I.E: 1" = 20'
CERTIFICATE
2522 Oak Street I HEREBY CERTIFY THAT THIS SURVCY WAS MADL UNDER My RESPONSIBLE CHARGE
Jacksonville. Florida 32204 AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH By THE FLORIDA
(Phone) 904-389-5989 BOARD OF PROI�SSIONAL SURVEYOPS AND MAPPERS IN CHAPTER,61G17-6.FLORIDA
C T
Fom) 904-389-6175 ADMINISTRATIVE CO
,PV.'PURSUA1,1T TO SFCTIO I,I IDA ATUTES
�4� P471,11 L
ACOM
lik"'141111131 11 MICHAEL/AIELLO
LICENSED USINESS #6702 REGISTERED SURVEYOR AND'�APPER # 4879 STATE OF,&LORIDA
LAND SURVEYS 0 CONSTRUCTION SURVEYS 0 SUBDIVISIONS
FILE COPY
3 6
P1
4
IF
+
Wu-
Lj
�7L
/0, Kr e4t26r
AJ
A P,`
If-0 CITY OF i'�A�,
BUILDII G 7FIQt;
ffl.C-46.
A A/
MAP SHOWING BOUNDARY SURVEY OF
LOT 460 AND THE NORTH 1/2 OF LOT 461, SECTION NO. 1, SALTAIR, AS RECORDED IN
PLAT BOOK 10 PAGE 8 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
MARGRID KRUEGER
WACHOVIA MORTGAGE CORP.
STEWART TITLE GUARANTY COMPANY
RICHARD T. MOREHEAD, P.A.
LOT 471 LOT 472 LOT 473 LOT 474
50.00' (PLAT) 25.00' (DEED)
FOUND 1/2-IRON PIPE
NO IDENTIFICATION S 10*11'11" W 74.91' (MEASURED)
X FOUND PK NAIL
NO IDENTIFICATION
X X X - - --- -
X
DO. 25 DO- (DEED)
e-
LOT 459
LOT 460 NORTH 1/2 SOUTH 1/2
LOT 461 LOT 461
Ld 9.2' 19.3' L.Li
:D
1— < 00
WDE. <
Ld <
CL -j
STEP 0-
0
0. c� X x— LOT 462
0 12.2' COVERED
ENTRY
AIR 9
LJ CONDITIONER
2
PAD
ONE STORY
0 7.4'
p MASONRY & FRAME
0 POSTED # 243
p
0 TRIED
CDVE
N CD UJI
N R
co N R 29.3' 1 19.2' Ld <
cn
, ..- . .. . :. . L�.. z Of
ST�PS. 0
,en' U)
0
�2 0'
It' X 2DO.00' (PLAT)
25.00 (DEED)
FOUND 1/2-IRON PIPE FOUND 1/2-IRON PIPE s 10,03,11"W FOUN j�WN PIPE
STAMPED"4144" NO IDENTIFICATION 225,01'(MEASURED) NO" A TION
N 09*58'01" E 74.94' (MEASURED
50.00' (PLAT) 25.00' (DEED) CITY OF
BUILDI.
BELVEDERE STREET
(50�0' RIGHT OF WAY)
NOTES� I ACCEPTED BY:
LEGEND:
R = RADIUS —X— = FENCE
L = LENGTH = CONCRETE
NOTES: REVISIONS
1. BEARINGS ARE BASED ON THE --A-S-SUMED _BEARING OF --S 80,00,00" E---ALONG THE
----- ----------
NORTHERLY BOUNDARY LINE OF SUBJECT PARCEL. DATE DESCRIPTION
2. BY GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS LIE WITHIN FLOOD ZONE A SHOWN ON THE
NATIONAL FLOOD INSURANCE MAPDATED APRIL 17, 1989, COMMUNITY NUMBER 123075. 1;�NESL --- 0
3. THIS SURVEY REFLECTS ALL EASEMENTS &RIGHTS OF WAY AS PER RECGRDED PLAT &/OR T!TLE (-nMM TMENT
IF SUPPLIED. UNLESS OTHERWISE STATED, NO OTHER TITLE VERIFICATION HAS SEEN PERFORMED BY THE UNDERSIGNED
4. THIS SURVEY NOT VALID WITHOUT THE ORIGINAL SIGNATURE AND EMBOSSED SEAL OF THE CERTIFYING SURVEYOR.
JOB # 21604--f—DATE OF FIELD SURVEY: 08-04-03 DATE OF ISSUE: 08-05-C 2b'
CERTIFICATE
2522 O.k St-et I HEREBY CERTIFY THAT THIS SURVCY WAS MADE U�DER My RESPONSIBLE CHARGE
Jockso-itle, Florido 32204 AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA
(ph CARD OF PROF
�EfSS$ONAL SURVEYOPS AND MAPPERS IN CHAPTER 6IG17-6,FLORIDA
one) 904-389-5989 BADMINISTR C
(Fox) 904-389-6175 'ATIVE p.PURSUANT TO SECTIO 4;��F RD STATUTES.
fica m
MICHAEL/AIELLO
LICENSED BUSINESS #6702 REGISTERED SURVEYOR AND I�APPER # 4879 STATE OF FLORIDA
LAND SURVEYS 0 CONSTRUCTION SURVEYS 0 SUBDI"SIONS
JOBSITE COPY
/16"I'l
T111
...............................
1 -4 1
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?'?y-,?-I OF
c
A P,";
CITY OF
BUILDI, G '. -FICL.
T)c-
Yl#"
A Al
CITY OF
ES
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIODA 32233
TELEPHONE(904)249-2395
-1!3 8-9---- RE! 243 Belvedere Street
61
Lot 46o & No. 1/2 Lot 4
Saltair Section I
Johannes Meijer ------------ 170505
461 Pavonia Avenue
- --------------------------
Jersey city. NJ 07306
Atlantic Beach, Florida 32233
Dear Atlantic Beach Resident,
We have determined that the following conditions exist on your
property, constituting a violation of-Section � Twelve of the
Atlantic Beach Code of Ordinances%
U
Junked and/or inoperable motor.,,vehicle(s)
Weeds and/or grass above tvelve,,(121 ) inches
Trash, garbage or debris in ' rd.,'
1 1 Unsafe building or structuro
I&I Outdoor storage of icebox, refrigerator,
stove, glass, building inaterials,,� etc.
Improper storage of recreationall,ivehicle
Other;---------------------- ---------------
Please take appropriate steps to correct the "i above conditions
within seven (7) days from the date of this "notice. If you have
questions regarding this notice please -call,�,cur - office.
Thank you in advance tar your cooperationa�li:�`.� i�
zL
CITY OF ATLAHTIC BEACH
CODE EHFORCEMERT OFFICER
'lop
MY OFNIItMIC BEACH
ODLE VIOIATION FORM
Date./n // 62
Address and/or Location of Violation
CaMPIAINT
Owner /or(i-nant- of Property '74 &Z�
U
OF OCXVLXWNY-���� Pbone#
A
SIM
ADDITESS
--------------------------------------------------------------------------------
Date of Investigation 10-16 p!Z_ Investigator-C�V�'....
Conditions Found
Action Taken
�Coapliance
NUM:
—o s
CITY OF
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2395
February 14, 1983
Pre-Service Section
3rd Floor
Jacksonville Electric Authority Building
233 West Duval Street
Jacksonville, FL 32202
Dear Sir:
The following final inspections have been made are are satisfactory;
Permit #3864 - 243 Belvedere Street, Atlantic- Beach, Florida.
Permit issued to Bill Thompson Electric Co, (B,T.E.C.I.)
Permit #3863 - 357 Sargo Road, Atlantic Beach, Florida
Permit issued to Bill Thompson Electric Co. (B.T.E,C,I,)
Sincerely,
qq'-� �-g ,
John M, Widdows
Electrical Inspection Supervisor
JMW/lS
cc: File
Address F-
Heated Sq�are Footage @ $ yer sq ft = $
Garage/Shed @ per sq ft = $
Carport/Porch @ $ er sq ft = $
Deck @ $ �er sq ft = $
Patio L @ per sq ft = $
TOTAL VALUATION: $
Total Valuation Ist $
Remainder Valuation $ per Hi3u and or
portion thereof
-------------------------------------------- Total Building Fee $
ADDITIONAL PERI-1ITS and/or FEES REQUIRED + k Filing Fee $
Mechanical Fireplaces @ 15.00 $
BUILDING PERMIT FEE S
Plurrbi.ng
Electric/New
-------------------------------------------------
Electric/Temp BUILDING PERMIT $
Septic Tank WATER NETER CHARGE $
Well
Swimdng Pool SENM IMPACT FEE $
Sign WATER IMPACT' FEE $
Water Connectim MISCELLAMUS $
Sewer CoTmection 6�9 0104U
Water Meter
Elevation Certificate
GRAND TOTAL DUE $
-------------------------------------------------------------------------------------- ------
CALCULATIONS and/or NOTES
FEB 2 4 1992
Bui"dimor and 7;nr,',;,-
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS
Owner(s) :
----------- -------
Address Phone:.24��--e!:!2--------
Lot #--��b---Bl--ock or Unit #4fj Su�divioion:.,�4'YA'e-----------
Contractor: 51ell�r-------------------
Describe wori-it-0-be done:
----------------------------------------------- -
Present use of building:_ 915,Jr--71 -------------------------------
Valuation ------------------------------------------------ -
Proposed use:----------------------------------------------------
Is this an addition?--------- If yes, what are the dimensions of
the adde6 space:...2-2 ft. Will the added area
ft. X ...
be heated and cooled?---�4& New electrical (or increase) ?-
New plumbing fixtures?-/-�� New fireplace? ,.:.�--New Heat/AC?---4Z----
SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY,
ENE*ay-��MS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR
AFFIDAVIT, IF OWNER IS CONTRACTOR.
A
Signature OWNER: Date:
-44Lt�'- 7 z ------------- -----------
Signature CONTRACT R: -----------
Date:
0
4L
FEB 181992
1161 i n 9 and Zor.i.nig-,
0
4 01
FEB 181992
Bu an d L7,
zv
74,
om
IJ- FEB 1 81992
LOT 459 LOT 471
FOUND 1/2"IRON PIPE 000.12�FIELD) FOUND Ve IRON PIPE
L.&4144 NO CAP
890 58'2d' 89055'43"
LA TICE PIERCE
ui FET
Nei
Z4.1
CONCRETE
15.3'
U) STEPS
0 W LOT 472
0 a ..
I. LOT 460
M4.0 1 I.A W
HCRETE STEPS 0
z
_j- W us FUME STOOP
uj !tj 0
C) Z co
> Z' 0
-to W u.
0. 02*
31: w M 111 itg j p P—eeW
_0 &aek tbe
I !"A' ;2 Ll - re o-1�
THE NORTH V2 OF LOT 461
ui 4'LATTICE
r FENCE
890 59'57" 1C CHAIN LINK FENCE 90-05'52' "0'3'
ui — v— lip LOT 4T3
0 2JO"- .W-7r-Z--P-4 100.00 SET P.K.M04L&DISK IR 0
I.1#0 CAP L.&3972 0.3' A'p
ui
0
> LOT 461,EXCEPT THE NORTH V2 9
ui
m 100.06
LOT 462 1-01 4r4
NOTES
- THIS IS A BOUWARY SURVEYt
lei NO BUILDING RESTRICTION LINE PER PLAT.
ANGLES AS PER FIELD SURVE#,
NORTH PROTRACTED FROM PLAT.
DAVID STREET
(FORMERLY PARK AVENUE)
THE PROPERN SHOW HE3&M APPEARS TO LIE IN FLOOD ZONE "X* (AREA OUTSIDE 500 YEAR FLOOD
PLAIN) AS WELL AS CAN BE DETER41NED FROM THE "FLOOD INSURANCE RATE MAP" FOR ATLMTIC
-BEACH, FLORIDA.
I HEREBY CERTIFY TO JCKW K. SCOTT, AND FIRST AMERICAN TITLE THAT I HAVE SURVEYED THE
THAT THIS MP IS A TRUE AND OCM;SCT REPRESEWATION
,,JAMS AS SHOWN IN ME ABOVE CAPTION AND
"W.-tIAT'SURVEY AND TfW'THE SURVEY REPEES&MEP HEIaM MM`TS�THE MINIMM TECHNICAL STAN-
THE FLORIDA Axmms-mvrivE CODE CHAPTERt 21-M-6 AND THE FLORIDA LAM TITLE ASSOl- J:
CIATICN.
JU,-
FEB 181992
i'!d i
E B 1
in g an d Z o P,ik rizg,
--- ---- ------------
9 v
iv-
oc ,
ei
lo
----------
------------
1�4
4v
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: J%TF C_ MASTER ELidTRICIAN SIShATURE JOURNEYMAN
_?'st Q i�Q -RFQ_BOX
NAME D_12(la ADDRESS�A "Xia I ve d P 1 p
BLDG.SIZE BETWEEN:
RES.0 APT.( I COMMA I PU13LIC I INDUS.I NEW( I OLD( REW.( I
ADDITION TRAILER ( TEMP.I SIGNS ( SO. FT.
SERVICE: NEW( INCREASE1 REPAIR (X FEE
CONDUCTOR SIZE AMPS COPPER I ALUM.Ue� lo
SWITCH OR BREAKER AMPS PH W VOLT RACEWAY
EXIST.SERV.SIZE AMPS PH W "#VVT RACEWAY
014
11NO.
LIGHTING OUTLETS CONCEALEDI OPEN TOTAL
RECE.PTACLES CONCEALEDI OPEN TOTAL
1 0.30 AMPS. 31-100 AMPS
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100 AMPS. I OVER
APPLIANCES' I I IBE LL TRANSF. I
AIR H.P.RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT
0-1 OVER
MOTORS H.P. VOLTAGE PH$ NO. 1 H.P. VOLTAGE PHS
MIRMAREOUS
TRANSFORMERS: UNDER 600 V. OVER 600 V.
NO. KVA NO. lKVA
NO.NEON TRANSF. NO. VA. M A. MOTOR SIZE SWITCH FLASHER
EACHSIGN
FORWARDED
TOTAL FEES