Permit 16 E Dutton Island Rd PERMIT WORKSHEET Certificate of Occupancyl
Job Address: Type Work:
Property Owner: Phone #
P(Z('SES "zq9-(-)-I Rs-
Contractor: Phone #
C> r---3
Permit#: c-)4- zss-zc) Date Issued:
Building Inspections: Footing
Slab
Tie Beam
Lintel
Nailing Sheathing
Framing Cover Up
Insulation
Final Building
Tree Permit# YES NO
Electrical Permit# Date /Copy to
I Z 2,S-Zo 1EA '9
Temp, Pole Permit# Date/ Copy to
I JEA
Temp. Power Letter Received: YES NO
Inspections: Rough Electric t r---o4 Released to JEA 1�5-1-7:64
Temp, Power Released to JEA
Temp. Pole Released to JEA
Final Released to JEA
Mechanical Permit# 04- zt IR
Inspections: Rough �g-1 1-04 Final 01 O�j
Plumbing Permit# c-) Z�R R 2-0
Inspections: Rough Underslab I 1 04, ToFout
Water Sewer Final
Drainage Inspection:
Pool Permit#
Inspections: Steel Final
Grounding Final
Roofing Permit# I I
Inspections: Nailing Sheathing Final
Fire Inspection:
Failed inspections: Date Paid:
Date Paid:
Jr
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00028820 Date 8/05/04
Property Address . . . . . . 16 E DUTTON ISLAND RD
Tenant nbr, name . . . . . . HANDICAPPED BATHROOM
Application description . . . COMMERCIAL INTERIOR BUILD OUT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 21000
Owner Contractor
------- -------------- --- ---- --------------------
OWNER
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 135 . 00 Plan Check Fee 67 . 50
Issue Date . . . . Valuation . . . . 21000
----------------------------------------------------------------------------
Other Fees . . . . . . . . . WATER IMPACT FEE 120 . 00
WATER CROSS CONNECTION 35 . 00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 135 . 00 135 . 00 . 00 . 00
Plan Check Total 67 . 50 67 . 50 . 00 . 00
Other Fee Total 155 . 00 155 . 00 . 00 . 00
Grand Total 357 . 50 357 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING
CODES.
QA�'G 0 CML
CITY OF ATLANTIC BEACH
PERMIT CALCULATION SHEET
Date:- 0, -
Address 'Do 7—(6 A� #�^J P &//�P LC4S7 -
Heated Square Footage @ per sq ft= $
Garage Shed A, 0 0< _persqfl=
Carport Porch per sq ft $
r
Deck $ per sqft=
Patio @$ per sq ft $
TOTAL VALUATION: /19
Total Valuation
ist $
Remaining Value $ per thousand
or portion thereof
CONSTRUCTION TYPE:7�� TOTAL BUILDING FEE $
ZONING: g:=1,-, + 1/2 Filing Fee $
FLOOD ZONE: (c� Fireplaces @$35-00 $
IMPERVIOUS SURFACE: -7 -3�1'tZ-
ap,
BUILDING PERMIT FEE $
WATERIMPACTFEE $ 4 ,2 0
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT$
SEWER TAP S
C ( ) RADON HRS .0050 $
SECTION H PAVING ( ) $
CROSS CONNECTION $ ?S—
ST( ) SURCHARGE $
OTHER $
GRAND TOTAL DUE: $
1/13/03
Cc:
CITY OF ATLANTIC BEACH For
L. Higgins
BUILDING / ZONING DEPARTMENT S. Doerr
800 Seminole Road
Atlantic Beach,Florida 32233
(904)247-5800
(904)247-5845 Fax
PLAN REVIEW COMMENTS
Permit Application # C)4 - 7-88Z-0 I va—
Property Address: t (-.a D 07-T-0 4
Applicant: LLC--
-TAJT,6,1f61t 6V fc-0,00 r—
Project:
This permit application has been:
Approved
Reviewed and the following items need attention:
Please re-submit your application when these items have been completed.
Reviewed By: 1 2 Date:
CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION
(Interior Remodel)
r j IT
Date:
Job Address: ;;--
Owner of Property:
Address: /cl;z Telephone: �2,V 9--0 7 85-
Legal Description: Block Number: Zoning District:
Lot Number: Y,13L,2;3
Contractor: State License Number:—ev�w
Contractor's Address:
Telephone: zya,"-e— Fax:
'o
Describe proposed use and work to be done:
cz;C4A0?eL-1
%.C'I
Present use of land or building(s):
Valuation of proposed construction: rw e9-1,con
New electrical or increase in service? Add plumbing fixtures?
Add fireplace? /VO Add heating/air conditioning? 72—yjS /9
is approval of Homeowner's Association or other private entity required? AV If yes, please submit with this
application.
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.
Please submit Building Permit Application,Energy Code Forms,Notice of Commencement,Owner/Contractor Affidavit if owner is contractor,
and two (2) 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:(904)247-5826
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.
800 Seminole Road -Atlantic Reach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us
Page 2 Revised 1/04
I hereby certify that all information provided with this application is correct.
Signature of Property Owner: Date:
I hereby certify that I have read 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 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.
Signature of Contractor: Date:
Address and contact information of person to receive all correspondence regarding this application(please print).
Name:
Mailing Address: INZ _S,>e
4,-s ofn7 57—Mee!7 dA::Z.
Telephone: 079'_V_ Fax: a;24 6 E-Mail: %7� 2(r
Bel
AS TO OWNER:
Sworn to and subscribed before me this day of 2004
State of Florida, County of Duval
s Signature:
TIFFANY HOEY
MY COMMISSION#D0241765 7Personally known
EXPIRES:AUG 17,2007 Produced identification
Bonded through Advantage Notary Type of identification produced
AS TO CONTRACTOR:
Sworn to and subscribed before me this q7� day of Avnk-)ST- 20
State of Florida,County of Duval
N ta 's Signature.
TIFFANY HOEY 7Personally known
MY COMMISSION#DD241765 D Produced identification
EXPIRES:AUG 17,2007 Type of identification produced
(&Bonded through Advantage Notary
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us
Page 3 Revised 1/04
CITY OF ATLANTIC BEACH
0Y
OWNER/BUILDER AFFIDAVIT
Date: 775 —Q !y
Job Address: ze-1, 2U7rc>%) 2:24.0d �&t4�p L_;;�-
CHAPTER 489,FLORIDA STATUTES,PART I "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE
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 CONTRACTOR EVEN THOUGH YOU DO NOT 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
COMNIERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE-AND
OCCUPANCY. IT MAY NOT BE BUILT 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 IS IN VIOLATION OF THIS EXEMPTION.'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 TO 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 TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL
OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000) BE UNDER A
BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY
P14YSICALLY DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE
UNDER"DIRECT SUPERVISION OF THE OWNER,WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN
PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS.
SINCE OWNERS MAY BE LIABLE FOR INRJRIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT
SUGGESTS-WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE
POLICY TO CLEARLY PROTECT TTIE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND
SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS
THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING
SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(l). AN "OCCUPATIONAL LICENSE" IS
NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR
THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR-
TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
I HEREBY ACKNOWLEDGE TTIAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
;loliRTY O,*`NER/f3UILDER
.L%L
SWORN TO AND SUBSCRIBED BEFORE ME THISO DAY OF
TIFFAW HOEY
N-0—TWY—"L I C MY COMMISSION#[)D241765
MY COMMISSION EXPIRES: EXPIRES:AUG 17,2007
NOTE: PHRASES UNDERLINED ABOVE. "Po Bonded through Advantage Notary
uz�--,
IS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00028820 Date 8/11/04
Property Address . . . . . . 16 E DUTTON ISLAND RD
Tenant nbr, name . . . . . . HANDICAPPED BATHROOM
Application description . . . COMMERCIAL INTERIOR BUILD OUT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 21000
Owner Contractor
-- ---------------------- ------------------------
OWNER
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc INSTALL 2 FIXTURES
Sub Contractor STEEG PLUMBING CO. , INC.
Permit Fee . . . . 49 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 49 . 00 49 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 49 . 00 49 . 00 . 00 . 00
PERNET IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING
CODES.
UELDING OFFICLkL
CITY OF ATLANTIC BEACH
PLUMBING PERMIT APPLICATION
Date:
Property Address: A
Owner: J�f Telephone
Contractor: Telephone #:
Contractor Address: Fax #:
in consideration of permit given for doing the work as described in the above stateracrit,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
ordinance and standards of good practice fisted therein.
Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing
Code.
Plumbing Type: If other construction is being done on this building or site,
New list the buildin n urn ber:
/10( Re-Pipe �!31
U V
Number of Fixtures:
Bath Tubs Showers
Closets Shower Pans
Dishwashers Sinks
Disposals Urinals
Floor Drains Washing Machine
Lavatory Water
Sewer Water Heaters
Other
Fees
Permit Issuing Fee: $35.00
Total Fixtures: X $7.00 + $35.00
800 Seminole Road - Atlantic Beach, Florida 32233-5445
Phone: (904) 247-5800 - Fax: (904) 247-5845- http:/twww.cl.atiantic-beach.fl.us
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
............. ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00028820 Date 8/09/04
Property Address . . . . . . 16 E DUTTON ISLAND RD
Tenant nbr, name . . . . . . HANDICAPPED BATHROOM
Application description . . . COMMERCIAL INTERIOR BUILD OUT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 21000
Owner Contractor
------------------------ ------------------------
OWNER
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc NEW 100AMP SVC
Sub Contractor BROOKS & LIMBAUGH ELECTRIC
Permit Fee . . . . 104 . 20 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
------------ ----- ---------- ---------- ---------- ----------
Permit Fee Total 104 . 20 104 .20 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 104 . 20 104 . 20 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING
CODES.
ILDINIG OFFICIAL
CITY OF ATLANTIC BEACH
ELECTRICAL PERMIT APPLICATION
Date:
Property Address: 16 75" oCe�
Owner: Telephone#:
Contractor: &kL 4,od Telephone#:
Contractor Address: Fax#:
ln 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
ordinance and standards of good practice listed therein.
Building: Building Type: Q Trailer Service: If other construction is
being done on this building
New Q Residence E) Temp. >RC—New Or site,list the budding
Q Old 'fi(,Commercial u Signs Q Increase Permit number:
Lj Re-wire Q Addition Sq.Ft. C3 Repair
Conductor Size:-X;-ANTS: 0 Q COPPER ALLNUNUM
Switch or RACE
Breaker AMTS ad PH W VOLT WAY
Existing Service RACE
Size AMPS PH W VOLT WAY
Feeders: NO. SIZE NO SIZE NO SIZE
Lighting Outlets
CONCEALED OPEN
Receptacles CONCEALED OPEN
0 10 AMPS I I I On AMPS
Switches
Incandescent
Fluorescent &
M.V. E3
Fixed 0.100 AMPS OVER BELL
Appliances / —F'o 4--,Nv TRANSFER.
Air H.P.RATTNG H.P.RATING CEILING KW-HEAT
Conditioning COMP. MOTOR OTHER MOTORS AMPS HEAT
Motors 0-1 H,P. VOLTAGE PH NO. OVER I H.P. PHS
V 91 4 " I
UNDE 600V V19 4 W; )CA4 L4:2-
-OVER600V
Transformers NO. -rKVA NO. KVA
No.Neon Transf.
Ea._Sign
Miscellaneous
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800- Fax: (904)247-5845 * bttp://www.ci.stiantic-beach.fl.us
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00028820 Date 8/06/04
Property Address . . . . . . 16 E DUTTON ISLAND RD
Tenant nbr, name . . . . . . HANDICAPPED BATHROOM
Application description . . . COMMERCIAL INTERIOR BUILD OUT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 21000
Owner Contractor
------------ ------------ ------ ------------------
OWNER
---------------- ------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc NEW HVAC
Sub Contractor RIX MECHANICAL INC.
Permit Fee . . . . 155 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
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
COD&S.
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
MECHANICAL PERMIT APPLICATION
Date:
Property Address: L k _T,�)4,4 Rd,
Owner: e,V K Z_C, Telephone#:9&1-t22�J'?-Q70
Contractor* )X rn)5rd4b L4 Cd L _N C_ Telephone#: 902J-Q 2JI?
Contractor Address: 77W_sSTr 5
u-I i 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 aye a part hereof and in accordance with the City of Atlantic Reach ordinances and standards of
good practice li3ted therein,
Type of Heating Fuel. If other construction is being done on this building
3-/'Electric or site,list the building permit number:
• Gas: _L.P —Natural —Centrul utility
• oil . 0± 000980C�Lo
• Other-SpeciLy
MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK
w(I'-Heat _Space Recessed i,-6entral Floor U Residential
�W" ir Conditioning: Room L"Central
ADuctSystern: Mat�n_7all�kCV(30�7(ZOThickness R-6 ar,Commercial
• Refrigeration Maximum capacity--'y 000 cfin W"-Ncw Building
• Cooling Tower:Capacity _gprn Cl Existing Building
• Fire Sprinklers:Number of lieads
• Elevator: Manlift Escalator_(Number) 0 Replacement of Existing System
13 GaSGline iu—mis _(Nuntber)
• Tanks —(Number) M,-'New Installation
• LPG Containers (Number) (No system previously installed)
• Unfired Pressure Vessel 0 Extension or AAd-on to Existing System
• Boilers
• Gas Piping U Other-Specify.
• Other-Specify
LIST ALL EQUIPMENT
AM CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSORIS Approving
Number Units Description Model# MULL&Ctum Ton's Agency
co/V C4�JRICK t4
HEATING-FURNACM DOELERS,FMPLACES&AER ELANDLERIS Approving
Number Units Description Made(# Manuftturer BTU's Agency
a= AHL4 Ld!�2,62ELAQ /0 -tA L,
TANKS Nominal Capacity Type Liquid Serial Approving
How Many &Dimensions Contained Manufttarcr No. Agency
800 Seminole Road-Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800- Fax: (904)247-5845 - bttp:]/www.ci.adantic-beach.!Lus
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AUG 0 5 2004
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EDGE OF ASF
CONCRETE V
PIROPOSED
HANDICAP '
: 6! PARVJNG SIGN
OFFICE FUTURE RENTAL
1 ,500 S.F. 3,500 S.F.
FFE=15.05 FFE=15.05
0
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111 0
to
WAREHOUSE
10,000 S.F.
FFE=15.05
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