Permits 210 Donner Rd DEPARTMENT OF 13UILDING
CITY OF ATLANTIC BEACH
800 Seminole Road-Atlantic Beach, FL 32233- Tel: 247-5826 - Fax: 247-5877
ELECTRICAL PERMIT
Permit Number: 24560 LOCATION INFORMATION
Permit Type: ELECTRICAL Address: 210 DONNER ROAD
ATLANTIC BEACH, FLORIDA 32233
Class of Work: TEMPORARY POLE Township: Range: Book:
Proposed Use: TRAILER Lot(s): Block: Section:
Square Feet:
Subdivision:
Est. Value: Parcel Number:
Improv. Cost: OWNER INFORMATION
Date.Issued: 7/30/2002
Total Fees:* 0.00 Address: 800 SEMINOLE ROAD
Amount Paid: 0.00 ATLANTIC BEACH, FL 32233
Date Paid:
Work Desc: .C Phone: _(904)247-5828
PORARY POWER POLE F )R TRAILEF
CON DDLICATIO FEES�
0.00
..........
.. . ..............
NOTI
BUILDING MATERIA ND
MUST BE CLEA FIE"
FAILURE TO COMI HE
—PROPERTY OWNER P
ISSUED ACCORDING To AP15R _CT TO REVOCATjbN
.FOR VIOLATION OF APPLICABL
A Tic B C BUILDI
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800'Seminole Road-Atlantic Beach, FL 32233- Tel: 247-5826 - Fax: 247-5877
ELECTRICAL PERMIT
PERMIT INFORMATION
Permit Nu LOCATION INFORMATION
Address: 210 DONNER ROAD
Permit Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 32233
Class of Work: TEMPORARY POLE Township: Range: Book:
Proposed Use: TRAILER
Square Feet: Lot(s): Block: Section:
Est.Value: Subdivision:
Improv. Cost: Parcel Number:
Date.Issued: 7/30/2002 OWNER INFORMATION
Total Fees: 0.00 Name: CITY -OVATLANTIC. BEACK
Address: 800 SEMINOLE ROAD
Amount Paid: 0.00
ATLANTIC BEACH, FL 32233
Date Paid:
Phone: (904)247-5828
Work Desc: .CS4/0 OOAMPS 1 P i 3W 240V ?—RWA
LU I LWORARY POWER POLE FO
R TRAILEF
CONTRACTOR(S) PPLICATION FEES�
-P�& L—ELECTRId-
0.00
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166MEAW
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BUILDING MATERIA
MUST BE CLEARE PACE, AND.
FAILURE TO COMP,
iE
PROPERTYOWNERI
ISSUED ACCORDING TOAPPR 5
CT TO REVOCATION
�FOR VIOLATION OF APPL ICABLE
OW
---------------a
A , TIC C BUILDI PT.
Oct 02 01 10: 58a Building Departmert 904-24?-5805 P. 1
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CITY OF ATLANTIC BEACH, FLORIDA 3
APPLICATION FOR ELIC721CAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: It—
IMKIRTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOW)mr.. 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 Cry OF
ATLANTIC BEACH ORDINANCES.
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ELECTRICAL FIRM: MASTER ELECTRICIAN SIGWTURE
NAME.11-;te 4'oEeA 94PW- ADDREM, 4PZ/4e� Z�V—
BLDG.SIZE 1��—BFTVMEN.
RES.(4v AFTA I COMM.I I PUBLIC( I INDUS,I I NEW(�W' OLD i I REW.
AOOITION ( I TRAILER TEMP X) SIGNS ( I sm Fr.—
SERVICE: NEW( INCREASE I I R EPAI 9 FEE
CONDUCTOR SIZE fleo� AMPS COPPER I I ALUM,
SVVITCH OR BREAKER 4�?L4W A�P$ /PH L3 W I -?^OLT *1 RACEWAY
EXIST,SERV.SIZE AMPS PH j W1 VOLTJ RACEWAY
FEEDERS NO. SI ZF !NO. SIZE i NO. SIZE
LIGH'nN OU7LETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0-30 AMPS. i 3t.too Amps.
SWITCH a
iNCANDE.SCENT—
FLUORESCENT&M,V.
APPL�ANCES
BEU TRANSF.
AIR H.P.RATING H.P*RATING
CONDITIONING COW.MOTOR OTHER MOTORS AMPS ICEIL HEAT: KW-HEAT
OVER
N4070RS H.P j VOLTAGE pHs No. VOLTAGE PHS
MISCELLANEOUS
7@A:,ez
TRANSFORMER& UNDER 600 V. OVER Goo V.
NO. I KVA NINO. iKVA
NO.NEON TRANSF. NO. 'VA. MOTOR SIZE SVATCH FLASHER
EACH SIGN
FORWARDIED
TOTAL FEES
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE: (904)247-5800
FAK(904)247-5805
SUNCOM: 852-5800
http://ci.atlantic-beach.fl.us
A-v
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CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
8W SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX.- 247-5377
PERMIT INFORMATION
Permil LOCATION INFORMATION
CN-u-m-6er 244 Address: _:flo'Dbk�ffFP6Z
Permit Type: CONSTRUCTION TRAILER ATLANTIC BEACH, FLORIDA 32233
Class of Work: N/A Township:
Range: Book:
Proposed Use: TRAILER I
Square Feet: j Lot(s): Block: Section:
Est. Value: Subdivision:
Parcel Number:
Improv. Cost:
WNER INFORMATI6N___
Date Issued: 7/17/2002
Total Fees: Name: CITY OF ATLANTIC BEACR-----------!
0
Address: 800 SEMINOLE ROAD
Amount Paid:
ATLANTIC BEACH, FL 32233
Date Paid: 7/16/2002
il 904)247-5828
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-FAILURE TO COMPL
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1 r PROPERTY OWNE R P Ay"
ISSUED ACCORDING TO APPROVED
AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROV %
ILD DEPT.
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City of Atlantic Reach- 800 Seminole Road - Atlantic BLach,Florida 32233-5445
Phone: (904)247-5800- FAX (-904)247-5805- bttp:/Ywww/CiAtiantic-beach.n.us
BUILDING PERMIT APPLICATION
FOR SINGLE-FAMILY OR TWO-FAMILY(DUPLEX) CONSTRUCTION
(INCLUDING NEW CONSTRUCTION, REMODEL, ADDITIONS
AND ALTERATIONS,MOVING OR DEMOLITION)
DATE 0
JOBADDRESS 2—io
uj Ili EK t Cf_21(6r1.) �- 0Q.)k2ea=
APPLICANT__ e-Tr I c-(>&M
ADDRESS jlo� '96"'.4-S PHONE- 2S%- 01SS.9._.
LEGAL DESCRXPTI ON: BLOCK NUMBER LOTNUMBER ZONING DISTRICT
e";��
CONTRACTOR —1 . I STATE LICENSE NUMBER C_GA1_
ADDRESS )10 � 16-61-cl$4 -2-M. )PHONE 7-,s I - C)99 9
CITY 3 - _�_% —STATE _FL_ ZIP 31"(. FAX
DESCIME PROPOSED USE AND WORK TO 8E DONE
IrMi-ECk- R9!L -ry+g�
PRESENT USF,OV LAND OR)BUILDING(S) Kea%aa�-TA
VALUATION OF PROPOSFD CONSTRUCTION
_ ___ pj/N
Is this an addition? If yes,what are the dimensions of the added space; —feet by—,—feet
Will tbe added area be heated and cooled? New electrical or incrcase in service?
New plumbing Extures? New fircplace9 New beating/air conditioning?
Is approval or Homeowner's Association or other private entity required? If yes,pleasc subx�t with this application.
PROCEDURE: (In order to expedite issuance Of permits, please follow all steps and pKg,_ de
inform2boo as a all
STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure ofthis information,please
contact the Planning and Zoning Departmcnt at 904-247-5817. In order to correctly verify zoning designation,please have
Property Appraiser's Real Estate Number availablc-
3TEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction
topographical survey is required. (If not required, written verification must be provided with this application.) The
Department ofPublic Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Tclephonc:(904)247-5834
STEP 3. Pleasc submit Energy Code Forms, Notice of Conimencernent, Owner/Contractor Affidavit if owner is contractor, and
foxir(4) complete sots of construction plans to the Building Depa,ti, nt, which is locatcd at the Atlantic Beach City Hall,
800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
In addition to constroction and engineering detail,plans must contain the following information as appropriate,- for the type of work
being performed. Scale of drawines should be sufficient to dcpict all required information in a clear and legible manner.
1. CurTeat survey showing the property boundary with bearings and distances and the legal description,
2. Locatior) of all structures, temporary and permanent, including sctbacks, building height, number of stories and
square footage, Identify any existing structures and uses.
3. Existing aiadlor proposed driveways.
4. If required by the Department of Public Works,a prc-construction topogmphical survey,
5- Any significant environmental features, including anyjurisdictional wetlands,CCCL,natural water bodies.
6. Impervious Surface area calculations. (Swimming pools way be excluded from total Impervious Surface.)
7. Other information as may be appropriate for individual applications-
I HEREBY CERTIFYTHAT ALL INFORMATION PROVIDED WITH THIS APPLICATION IS CORRECT.
SICNATURE OF OWNER ) -- DATE
I HEREBY CEWfIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND
rokkk.cm ALL PROVISIONS OF THE LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITIJ, WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NO-r PRESUME To GIVE AUTIIORJTY
TO"OLATE OR CANCEL THE PROVISIONS OF ANY FEDERAL,STATE OR LOCAL RULES. REGULATIONS,ORDINANCES,OR
.:,AWS IN ANY XANNER,INCLUDING TITE GOVERNMG OF CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION OF
THE PROPERTY. I VNI)ERSTAND THAT THF ISSUANCE OF THIS PERMIT IS CONTINGENT UPON THE ABOVE INFORMATION
WJNC TRUE AND CORRECT ANDTHAT THE PLANS AND SUPPORTING 'DATA HAVE BEEN ORSHALL BE PROVIDED AS
REQUIRED.
SIGNAXURE OF CONTRACTOR DATE
ADDRESS AND CONTACT JNFORMATION OF PERSON TO RECEIVE ALL CORRESPONDENCE REGARDING
THIS APPLICATION (PLEASE PRINT)
NAM E
MALLING ADDRESS
PHONE FAX E-MAM
SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF 4
3TATE Of FLOMA,COUNTY OF DUVAL
NOTARY'S SIGNATURE
-Tj U--
ASTO OWNER: Personally known
Produced idcritification.
Type of identification produced
IS TO CONTRACTOR: El .Personally known
JZ Produced identification
jENt4IFERSCViLU9ER Type of identification produccdEU-DL,,
My CC)MMI$SION#DD 121301
27,2006
EXPIRES:May
BmdPd Thru Notary Pubfic un&rwMels