Permit 1019 Big Pine Key Ll L),-/ �o 4 ��Sq
CITY OF ATLANTIC BEACH, FLORIDA
Approwd by I APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE:— 19
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.
Ai
JOURNEYMAN
ELECTRICAL FIRM: MASTER ELECTRICIAN SIGNATURE
NAME�k-6"tM 901DULLAS ADDRESS: 10A �I� SA P" RFD—B0X—
BLDG.SIZE BETWEEN:
NEW(4) OLD ( REW.
RES.V) APT. I COMM. 11 PUBLIC INDUS. ( )
ADDITION ) TRAILER ( I TEMP.( ) SIGNS ( I —SQ. FT.
SERVICE: NEW(4 INCREASE ( ) REPAIR ( ) FEE
CONDUCTOR SIZE o AMPS I �-Q> COPPER ( ALUM. ( 0-11'
SWITCH OR BREAKER AMPS IPH 3WO )VOLT RACEWAY
EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY ,
FEEDERS NO. SIZE INO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALEDI OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.30 AMPS. 31-100
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 CEIL HEAT: KW-HEAT
-C OVER pHs
1 Due pin I
UD %lf%l TAfM 1 H.P. VOt TAr.r.
CITY OF ATLANTIC BEACH, FLORIDA
Approwd by I APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: :7 1 Zo 3-- 19J�7
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: MASTER ELECTRICIAN SIGNATURE JOURNEYMAN
NAMEJ�� k ADDRESS: I W I NA) RFD-BOX-
BLDG.SIZE BETWEEN:
RES.(-I' APT. I COMM. PUBLIC INDUS. NEWI'--r OLDI REW.
ADDITION I ) TRAILER ( TEMPA SIGNS ( ) SQ. FT.
SERVICE: NEW(W INCREASE ( REPAIR FEE
CONDUCTOR SIZE AMPS COPPER I ALUM. I c-l"
DVOLT
SWITCH OR BREAKER AMPS PH w RACEWAY
EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY
FEEDERS NO. SIZE INO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALEDI OPEN TOTAL
RECEPTACLES CONCEALEDI OPEN TOTAL
0.30 AMPS. AMPS.
SWITCHES ri:-70-0
INCANDESCENT
FLUORESCENT&M.V.
FIXED 1 0.100 AMPS. OVER
APPLIANCES I I I BELL TRANSF.
AIR H.P. RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS ICEIL HEAT: KW-HEAT
0.1 OVER
UnTnue w p VnI TAr.F I pw_Q N( 1 H.P. Vill TAr.F PHS
CITY OF
j*&af& Vead - 7&u�e4 716 OCEAN BOULEVARD
P.0.BOX 26
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2396
April 30, 1987
Third Floor
Pre-Service Section
Jacksonville Electric Authority Building
233 West Duval Street
Jacksonville, Florida 32202
The following final inspections have been made and are satisfactory:
Permit #5256----2235 Beachcomber Trail
Permit issued to Munson & Bryan Electric Company
Permit #5187----1019 Big Pine Key
Permit #5188----1027 Big Pine Key
Permit issued to Adkins Electric Company
Sirncey,
Rene' Angers
Community Development Director
cc: building file
BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT
CITY OF ATLANTIC BEACH, FLORIDA
CERTIFICATE OF OCCUPANCY
WORK SHEET
Date Requested: 5/5/87
Building Contractor: Reyhani,Inc,
Building Permit Number: 8176
Address: 1019$ 1027 Big Pine Key
Legal Description: Lot 35 4 36 Unit I Selva Lakes
Improvements to the above described property have been completed
in accordance with the terms of the permit and is certified to be
ready for occupancy as Dupl ex
Comments:
BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE
DEPARTMENT DATE NOTIFIED: DATE APPROVED: BY
Fire Chief V7
Public Works ...L�L487.......
------ --------
Planning Director ...5�.5 Z.�7
Building Inspector 5/5/87
DEPARTMENT OF BUILDING PERMIT NO.- 8174
CITY OF ATLANTIC BEACH,FLORIDA
PERMIT TO BUILD 82*00 TL
THIS PERMIT MUST BE POSTED ON JOB tV,fn10rKT
Date 12/5/88_19— L 4 31 1 A 2/12-3 4/8
3174 9110CA
Valuation$ Fee$ 82.00 214 3 1 1 A P P 4 (83
a
i onla
This permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
OCEANSTATE
This is to certify that
has permission tolMdd INTALL MT & AC
Classification— RESIDENTIAL _Zone
Rj',4�
Owned by
Lot Block S/D
House No. 1019-1027 BIG PINE KEY
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
4— M
0 Building material,rubbish and debris
zi from this work must not be placed
in public space, and must be cleared
up and ued away by either con-
official.
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
SEWER
WATER
,look
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC REACH, FLORIDA $2233
APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER
IMPORTANT — Applicant to complete all items in sections 1, 11, 111, and IV.
Street Address:
LOCATION
OF Intersecting Streists: Between And
BUILDING
Sub-division— Slet_vp, cma_:r 5
11. IDENTIFICATION — To be completed by all applicants,
In consideration of permit given for doing the work as described in the above statement we hereby agree to perform said work in accordance
with the attachtcl plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards
of good, practice listed therein.
Nme of Mechanical Contractors
Cis"fractor (Wint) Master
Name, of
fropetty Owner
Signature *I Owner Signature of
or AxIthorized Ag*n Architect or Engineer
MRAL !T!�5JXIIION
A, TV"of Iseeting fuel; El.
IS OTHER CONSTRUCTION BEING DONCION
THIS BUILDING OR SITET '.W
0 Cres C3 LF E3 Natural 0 Centmi Utility
IF YES, GIVE NUMBER OF CONSTRUCTION
13 00 PERMIT j
offior — Spoiciff
IV. U804MICAL 11PUIPM111INT TO III INSTALLM NATURE Of'WoRk
(111mvide ftffloos Im of compon"ts on beckcif thk foft) X Residential or -11 Commercial
Hoat 0 SPWA 13 Roc*UW C'nfflall 0 Roor Now Building,
n Fyintinn BUIldina
CITY OF -ATLANTIC BEACH
APPLICATION 'FOR PLUMBING PERMIT
249-2395
JOB LOCATION 1019-1027. Big Pine Key Y')
PLUMBING CONTRACTOR F. W. FAIR PLUMBING COMPANY
LICENSE NUMBERS MP145 State RF0037503
OWNER R. G . M . Properties
BUILDING CONTRACTOR R . G . M . Properties
TYPE OF BUILDING Duplex
2 SINKS 2 SHOWERS
8 LAVATORY 2 WATER HEATERS
2 'BATH TUBS 2
DISHWASHERS
URINALS 2 DISPOSALS
6 CLOSETS 2 WASHING MACHINE
FLOOR DRAINS OTHER
28 TOTAL FIXTURE COUNT X$3. 50 + $10. 00
DATE 12 / 15 / 8 6 TOTAL All�'IOUNT $10 8 .0 0
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE .
DEPARTMENT OF-19"LlEZING 8173
CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO..
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date 12/5/ 19 86
Valuation$ 128'062- 50 Fee$ 496- 50
This permit not valid until above fee has been paid to City Treasurer,and is
subject to 1tion for Violation ofiPplicable proviRns of law.
N_ _. I
This is to certifv t t RE"1k,—I IC I i-�
I I I roef�)
has permission to build T 0 ......0,01W
Classification RESIDENTIAL Zone— PUT)
Owned by RGM —
Lot 35-36 Block Unit I S/D_�ELVA LIXES
J-019–IU27 M& ____ 67��
House No. 12,0 dopy � "19r— -ON
Wr 9-W r—if^1011;w
According to approved plans which ate part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
0 Building material,rubbish and debris
2-1 from this work must not be placed
in public space, and must be cleared
up and hauled away by either con-
tra��r o� owner.
Bu fficial,
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
SEWER
WATER
AW*
CITY OF ATLANTIC BEACH
APPLICATION FOR BUILDING PERMIT
'115 9 ahone.�
0 w n er A d d r e a s
Architect AddressZ
r z i pZ-e
_phone.12 eL
J;,,7,,---
Contractor Pb�k -__phone,22&y
'--�-Zk zi 13
Contractor's License number.................expiration------------
Lot-if--"--Block or Section---------Subdivision...............Zoning--------
Street between--------------and-----------------side-----------
Type Construction----Z--------No. Units----------No. Fireplaces...........
Purpose of Building---------------------------Est. Valuation $--------------
Utility Method - Water------------- Sever------------
Dimensions - Building--------------Lot-------------Size Footings...........
Sz. Pierg3 Sz. SillS-------------Greatest Span Sills-------- ------
Sz. Ceiling Joists---------Distance an Centers---------Greatest Span.......
Sz. Floor Joists ---------Distance on Centers---------Greatest Span-------
Sz. Rafters ---------Distance on Centers---------Greatest Span.......
Method of Heating-----------Solid or Filled Ground---7-------Roof----------
Flood Zone If located within a FLOOD HAZARD ZONE complete page 3
In consideration of permit given for doing the work as described
in the above statement, we hereby agree to perform said work in
accordance with the attached plans and specifications, which are
a part hereof, and in accordance with the building regulations of
Atlantic Beach. The contractor agrees at its expense to provide
the necessary access to the properties being developed over
dedicated City rights-of-way and to clear, clean, grade, and
drain said right-of-way to City
specifications.
Signature Owner Date
--- -------
ac
Signature Con;:7 tor -A C�
page 2
DEPARTMENT OF BUILDING PERMIT NO. A
CITY OF ATLANTIC BEACH.FLORIDA 495 9 50rKTI
PERMIT TO BUILD 7516 11 i;?/0/01
THIS PERMIT MUST BE POSTED ON JOB B 170; -00CM
Dec. 5 86 7516 la ip/11/81
Date 19
128,062.50 495- 50
Valuation$ $
I hu perrnit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
REYRANI, INC.
This is to certify that
has permission to build TOWNHOUSES
Classification RESIDENTIAL Zone PUD
Owned by RGM
35-36 Unit I SELVA LAAC.ES
Lot —Block S/D_
House No. 1019-1027 BIG PINE KEY
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
0. 0 Building material, rubbish and debris
z from this work must not be placed
in public space, and must be cleared
up ang"Aule away by either con-
owner/�.r
cial.
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
fit
SEWtR
WATER
,"Room PLUM131" 1,EKMIT
ELECTRIC pERMIT
BUILDING PEP341T WORKSHEET TEKPOPARY ELECT
_V - $ -3 �'�_S> Lo_
$ -6
e @ .. ��jIer sq ft 00
ft
cated Square FOOtag er sq _z2_6_G
arage/Shed er sq ft
@ $_____--P
arport er sq ft -
orches @ S so ft -
F3LD&,
PLUMBING WOJRKSHEET
SINKS SHOWERS DISHWASHERS
CLOSETS BATH TUBS FLOOR DRAINS
WASHING MACHINE WATER HEATERS DISPOSALS
LAVATORY URINALS OTHER
TOTAL FIXTURE COUNT
FIXTURE 'UNIT'BREAKDOWN
FIXTURE 'UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE
UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY
FIXED AT $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM.
BATHROOM iCROUP CONSISTING OF LAVATORY (1 UNIT)
WATER CLOSET? LAVATORY, AND
BATH TUB OR SHOWER STALL SERVICE SINK TRAP STAND
(6 UNITS) (3 UNITS)
DRINKING FOUNTAIN (31 UNIT) URINAL, WALL LIP
(4 UNITS)
FLOOR DRAIN .Cl UNIT) '
WASHING MACHINE RES.
. URINALP PEDESTAL, SYPHON (3 UNITS)
JET BLOWOUT (B UNITS)
WATER CLOSETS, VALVE OPERATED
WATER CLOSETS, TANK-OPERATED (8 UNITS)
OUNITS)
SHOWER STALL, DOMESTIC
BATHTUB (W/OR W/O OVERHEAD (2 UNITS)
SHOWER) (2UNITS)
BIDGET (.3 UNITS) LAUNDRY TRAY
(2 UNITS)
DISHWASHER C2 UNITS) KITCHEN SINK (2 UNITS)
KITCHEN SINK/WASTE GRINDER
(3 UNITS)
TOTAL FIXTURE UNITS @ .$10.'00. EACH;� pl�0,06
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 SEMINOLE ROAD-ATLANTIC BEACH, FL 32233-TEL: 247-5826-FAX: 247-5877
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 17895 Address: 1019 BIG PINE KEY
Permit Type: FOUNDATION ONLY ATLANTIC BEACH, FL 32233
Class of Work: NEW Township: Range: Book:
Proposed Use: SINGLE FAMILY Lot(s): Block: Section:
Square Feet: Subdivision: SELVA LAKES
Est. Value: Parcel Number:
'Improv. Cost: 450.00 OWNER INFORMATION
Date Issued: 3/10/1999 Name: COPELAND, IVY A.
Total Fees: 50.00 Address: 1019 BIG PINE KEY
Amount Paid: 50.00 ATLANTIC BEACH, FL 32233
Date Paid: 3/10/1999 Phone: (904)354-2600
Work Desc: FOUNDATION PERMIT FOR FUTURE PATIO
CONTRACTOR(S)_ APPLICATION FEES
PROPERTY OWNER PERMIT 50.00
Perr,it Fee Doubled/Work Commenced Prior to
Permitting.
Inspections Required
Footing
Slab
NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
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"
I SSU ED A
^11--C',rDRrL-,%IN1G TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBjECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
$50.Ob 14
Q-- Date: 3/10/99 01 Receipt: 9040080
ATLANTIC BE* UILDING DEPT. CHECKS
00100003221000
R 7 IV PD
E*,%.O
1999
CITY OF ATLANTIC BFJLCH hp
PERMIT APPLICATION REmoDEL, A.Darrroms, em oA±hgkz�tA
MVING"Dmfoz I!rzoNs Building and Zoning
Owner(s) : 1 va A Cou&ULS
, ,Tgr2T )�t.nr).- +
Job Address: -TV I A Phone: 0 0
&7 6' l
Lot # Block or unit # Subdivision:
Contractor: State License 4
Address: Phone No:
City State Zip Code
Describe work to be done:
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) -izo
New plumbing fixtures?/-Z.CL New fireplace?,Uj-ZNew Heat/AC?
_qVM�a.T TMMZ (cC&2wtCzAZ) 2WO f1M5XD=TrAL) CCWLVTX SrTS. Or PLANS, =CLUDXNG
SXTZ PLAN, SURV=, MWwr CoDr jr0TrCX or cood2rCENWT, AND
0 2VC0xTPjkCT R OR.
Da
Signature 0 Date:
Signature CO;NTRA OR:
Date:
AS TO OWNER:
day o 199
Sworn to and subscribed before me this
f;7
NOTARY PUBLIC,,
AS TO CONTRACTOR:
W GC5=1 EM
p&qa 27,2MO
Sworn to and subscribed before me this-
NOTARY PUBLIC
CITY OF
Fead - 5�ivd4
V!,l'A.Vl,l(, 1,
FAX !)114
CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489. 1 03(7), FLORIDA STATUTES:
STATE: LAW REQUIRES CONSTRUCTION 70 BE DONE: BY LICENSED CONTRACTORS. YOU �-(AVE: APPLIED FOR A PERMIT
UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS YOUR
OWN CONTRAC70R EVEN THOUGH YOU 00 N07 HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF.
YOU MAY BUILD OR IMPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE: AND
OCCUPANCY. IT MAY NOT BE allILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF
WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE: LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR
LEASE, WHICH 15 IN VIOLATION OF THIS E--<EMP`nON. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR.
YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR
RESPONSIBILITY 70 MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY
COUNTY OR MUNICIPAL LICENSING ORDINANCES.
ORDINANCES ALSO ALLOW AN OWNER 70 IMPROVE THEIR OWN PROPERTY WHEN 17 IS FOR PERSONAL OR FAMILY
USE, AND LIKEWISE REQUIRE ALL WORK (EXCEF-r MAINTENANCE UNDER $2.000) BE UNDER A BUILDING PERM17 AND PASS
ALL NORMAL INSI=ECTIONS. 7mE ORDINANCE STATES OWNERS MAY PHYSICALLY 00 WORK 7HEM.5ELVES, OR MAY HIR
UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION OFTHE OWNER, WHO MUST BE ON
THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." 7HIS DOES NOT ALLOW USE OF
UNLICENSED CONTRACTORS,
SINCE: OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING [DEPARTMENT SUGGESTS
WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY CLEARLY PROTECTS
,HE CWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR
FORM 1 099 REQUIREMENTS ON THE: WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SueJEcT
TO $5,000 PENALTY UNDER FLORIDA STATUTE No. 455-225( 1). AN 'OCCUPATIONAL LICENSE" IS NOT Ar)E(:)UATE:.
THE: OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE: FLORIDA "CONTRACTORS
CERTI FI CATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE: THE BUILDING DEPARTMENT (247-
Sa26) IF IN DOUBT.
I HEREBY ACKNOWLEDGE THAT I HAVE: READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL
THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
ivJ , cw-.�a
P R kb 6 E TT-
-T RTY 04VNER/BUILDER
IV -
Wt9 210 �E��7
VR E IfflS C�� -��dZ-:3--3 TELEPHONE
lcw
SWORN TO AND SUBSCRIBED BEFORE ME THIS_ fy) DAY OFO LjrcA�
NOTARY PUBLIC
NOTE: PHRASES UNDERLINED ABOVE MY COMMISSION EXPIRES:
ARE EMPHASIZED BY THE BUILDING PWcla AM=*
DEPARTMENT. my Comm EXPIRES
SSION 0 GC6Wll
August 27.2000
SOWD THRU TRDY FAIN INSURANCE,INC-
MAP SHOWING BOUNDARY SURVEY OF
LOT 35. 5ELVA �AKrS, An QE(,10PDEr) IN PLAT 1300K 41, PAGF.1 5") AmD S`5,v -D
Of- THE CURRENT PtIni,ir, r7rrO�?:),j OF OUVAL COUNrY, FI.ORIDA,
RE
CCRTIFIED TO:
I V`( A, COPELAND kA A P r" 1999
STFWART 71%17� GUAPANTY COMPANY
RICHARD T. MORCHCAD. P,A. City oi Adan ic 3each
Building and Zoning
BIG PINE. KEY —cup"'
(VAAfADLr vAn"t itirpiT#jF WAY)
;1 AT)
(pt
,3 ji
%�ityli jr
LOT 34 42�'
+
c,
AV
9 LOT .36
x
LOT 35 w BfAC
III OFFICI
I PLAN
in
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in 0
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S 2557'29" vv
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ftrA -Act Art 111AM apt r-c I'Ar
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fi.: Whyr,v RffUtTj A"fASCWjV?1 *MCWTS Or WAY Al P"PECOM6170 PLAII V/rA TME COMIAM)ENT
,f -Ajf1PtW0 vwLLSS 0"RWI�t %1AMD.-0 OTWEA 7�rr YEOWICA110-�IAZ ffCll rrvr,)nvFt,ey nit.uNc)Er:;3ctiE0
t rmls SIUAWY NOT"IUD WM40UT r"C EUI101%1`0 SCAL OF IK CMTV�Ile ��U".yc-'
.101) # 4571 [DATE OF FIELD SURVEY: 5-28-98 DISK ZIP 0 SCALE: 1" — 70'
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LAND SURvEYS 0 CONSTRUCTION SURVEYS 0 SUBDIVISIONS
NNI
LJO"I J�
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00028040 Date 4/06/04
Property Address . . . . . . 1019 BIG PINE KEY
Tenant nbr, name . . . . . . RE-ROOF
Application description . . . ROOF
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3900
Owner Contractor
------------------------ ------------------------
GEIB, LOUISE COPPEN ENTERPRISES
1019 BIG PINE KEY 562 KING STREET
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32204
(904) 338-9757
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 78 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3900
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 78 . 00 78 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 78 . 00 78 . 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.
".!n.� ( . %%%.-
-TFICIAL
BUIELDING 0
ANJ
CITY OF ATLANTIC BEACH
PERMIT CALCULATION SHEET
Date
Address
Permit fee based on dollar evaluation as indicated on permit application.
Heated Square Footage $ persqft= $
Garage/ Shed $ per sq ft= $
Carport/Porch per sq ft= $
Deck $ per sq ft= $
Patio $ per sq ft= $
TOTAL VALUATION: $
r
Ct $35.00 is, $1000.00 $ $35.00
Total Valuation
$ Aq $
Remaining Value Per thousand or
portion thereof-
CONSTRUCTION TYPE: TOTAL BUILDING FEE $
ZONING: + Y2Filing Fee $ :,2,
FLOOD ZONE: Fireplaces * $35.00 $
IMPERVIOUS SURFACE: BUILDING PERMIT FEE $ _4:!5-.
WATER IMPACT FEE $
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT S
SEWER TAP $
C ( )RADON HRS.0050 $
SECTION H PAVING $
CROSS CONNECTION $
ST ( ) SURCHARGE $
OTHER $
GRAND TOTAL DUE $ —TS
Cc:
CITY OF ATLANTIC BEACH D
Hi gins
BUILDING / ZONING DEPARTMENT t=:)
S. Doerr
800 Seminole Road
Atlantic Beach,Florida 32233
(904)247-5800
(904)247-5845 Fax
PLAN REVIEW COMMENTS
Permit Application #
Property Address: )01 (1 - I 7>1 rn f,
Applicant:
Project: re- C,2 C'
This permit application has been:
Approved
r7 Reviewed and the following items need attention:
Please re-submit your application when these items have been completed.
Reviewed By: LE Date: z,[i/()
CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
Date,-
Job Address:
owner of Property:
Address: - 06 A PO P Tedlepho,
- -
Contractor: (-C)/Q -0.R ±:jSkfd-57f'1';o�,e 15 State License Number:
,4 - jr�
Contractor's Address: . -z- < V\-R
Telephone:_ Fax:
Scope of Work:
Deck Slope: Greater dma 2:12 Less than 2:12
Valuation of work: -3,5-0 d
Product Name(Example:Timberline): Reval
Manufacturer(Ex=ple:GAF): 1/-2 14 /:!
ASTM Designation(s): 7 /'6 /
Required Inspections: Sheaj�gn"Jnio Final
Signature of Owner: Date:
tA7
Signature of Contractor: Date.- 0
AS TO OWNER:
Sworn to and subscribed before me this 2
day of 2001/
r
State of Florida,County of Duval
-40 N& Juke Williams Notary's Sipature:
MY COMMilliblon 002M i person
ExPire3 000ber 21.2007 PersionaQ inown
Produced identification
Type of identification produced
AS TO CONTFUCTOR:
Sworn to and subscribed before me this day of
State of Florida,County of Duval Notary's Signature-
Me WIlliame
ef my commission DD2803411 Aff�Pcrsonally knoi
4*0
ExpWa OMW 21,Z)07 F-1 Produced identification
Type of identification produced
800 Seminole Road Atlantic Beacb,Florida 32233-5445
Page I Tellepbone: ("4)247-5600 Fax: (904)247-5845 -http:/twwwcLatiantic'-beach.R.uS,,",,,2121103
MIN. RETURN NOTICE OF COMMENCEMENT
PHONE# 'A 3%
Permit number Tax Folio number
B..k 11733 Page 1395
STATE OF FLORIDA
COUNTY OF DUVAL
THE UNDERSIGNED hereby gives notice that improvement will be made to certain real property,and in accordance with Chapter 713,Florida Statutes,
the following information is provided in this Notice of Commencement.
i. Description of prop": 10 19 Big Pine Key Atlantic Beach,FL 32233
2. General description of improvements:Roof
3. Owner information:
a. Name and Address:
Louise Gelb 1019 Big Pine Key Atlantic Beach,FL 32233
b. Intrest in property: Doc# 2004114010
Owner Book: 11733
c. Name and address of fee simple titleholder(other than owner): Pa e: 1395
Filed & Recorded
04/05/2004 09:07:01 AN
4. Contractor's name and address: Coppen Enterprises JIM FULLER
562 King St.Jacksonville CLERK CIRCUIT COURT
LV. DUVAL COUNTY
,a. Phone Number b. Fax Number RECORDING $ 5.00
WN TRUST FUND $ 1.00
W.- .0 4733
5. Surety information:
a. Name and address:
b. Phone number: c. Fax number: b.Amount of bond:
6. Lendees name and address:
7. Person within the State of Florida designed by owner upon whom notices or other documents maybe served as provided by 713.12(l)(a),Florida
Statues.
Name and Address:
a. Phone Number: b. Fax Number
8. In addition to himself/herself,owner designates —of to receive a copy of the Lienoes Notice as provided in
Section 713.12(l)(b),Florida Statutes.
9. Expiration date of Not' fC ment(the expiration date is on (1)year from the date of Recording unless a different date is specified)
Signature of Owner:
Sworn to and sulbS9MDeWd before me this_��_Iday of
Notary: 00V
Known personally/ID shown: DL
My commission expires:
f 9* Julie Wiffiarris
4 * MY Commission DD26034,
pL/ Expires October 21,2DO7
j
DEPARTMENT OF BUILDING 8175
PERMIT NO.-
CM OF ATLANTIC BEACH,FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date 12/5/86 19 0111,00 T
Valuation$ -Fee$ 4�*-'-)�108. )0 111.00CKT
7794 1A 12/23/8
This perrnit not valid until above fee has ban paid to City Treasurer,and is 8175 40CAC
subject to revocation for violation of applicable provisions of law. 7794 1 tA 12/23/9,
11�1
This is to certify that F.W. FAIR PLUMBING COMPANY
has permission to b INSTALL PLUMBING
Classification RESIDENTIAL Zone
Owned by RGM
Lot— 35-36 —Block I s SELVA LAKES
HouseNo. 1019, 1027 BIMINE KEY
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
4 01 4 10 0 Building material,rubbish and debris
zi from this work must not be placed
in public space, and must be cleared
up and hauled away by either con-
�'t C r o ner.. /*
ef
Buil g cial.
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLy NUMBER
PLUMBING
ELECTRICAL
SEWER
WATER