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Permit 1380 East Coast Drive $ CITY OF ATLANTIC BEACH x w : -+ r 800 SEMINOLE ROAD J G,. ATLANTIC BEACH, FL 32233 v. ...e INSPECTION PHONE LINE 247 -5826 Application Number 09- 00001244 Date 9/02/09 Property Address 1380 EAST COAST DR Application type description ELECTRIC ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc REGROUND Owner Contractor OLSEN, GEORGE R. AMERICAN ELECTRICAL CONTRACTOR 1380 EAST COAST DR Q /A:GRASS, ROBERT ATLANTIC BEACH FL 32233 5065 ST. AUGUSTINE RD. #3 JACKSONVILLE FL 32207 (904) 737 -7770 Permit ELECTRICAL PERMIT Additional desc . Permit Fee . . . 70.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 3/01/10 Fee summary Charged Paid Credited Due Permit Fee Total 70.00 70.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 70.00 70.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. From:American Electrical Contract 9047371099 09/01/2009 09:19 #036 P.001/001 V sEm „eipriv- too CITY OF ATLANTIC BEACH os-;11111 7 t SEM ROAD. ATLANTIC BEAM FL 32233 .> s '.'„.0111I6 ' OFACE: (904205E26 0 FAX NO.190024?-5345 ,v., ., ,_ , sucoirto•DEFrocons.us ELECTRICAL PERMIT APPLICATION DUVAL COUNTY 1..108 ADDRESIIItkW.O.kvswg.V.--f--X*,,,•;N::,-,:kw4:tqlw tismilveug pologreTA,-, ,..-..;: .!-.., 3. DATE .., • : ' i ,/2 r\ / :-... L. Ec ii -,-- ,e, 0 YES PERMIT 4: ei:::-V.:i; 4F:A -: 7 'Itr- 2 k4 , 44,..;..- .1 *':-.',-*. "! .' - , ' - -,.. 'If ii, t iiiw' -,44-..*: v..' v '-iii i•-:.4 : - ',. .', 4 5. ADDRESS IF DIFFERENT FROM JOS ADDRESS: It PHONE: \) son ,„::::„.,:s i 1.177Tr7)( x , 0/)e -e-. .4,3-.73- 9 STATE OF FLORIDA LICENSE 910 . 9 b 10. CELL PION . 11. FAX NO.: / 12. EMAIL ADDRESS: 13. OFFICE PHONS:75 7 1 14. 15. Application is hereby made to obtain a permit to do the work and instellations as indicated. I certify that all work will be ••• • - • to meet the standards of Wawa regulating construction in this jurisdiction. This permit becomes : an if work Is • • • • • • within six (5) months, or if construction or work is suspended or abandoned for a period of six (6)month ..,.. bme work • •,.1 ,. cad. ir CONTRACTORS sioNATurt k ..."..f _. 0 MULTI FAMILY - # OF UNITS: • RESIDENTIAL latrfiGLE FAMILY 0 TEMP SERVICE 0 COMMERCIAL O ADDITION 0 TRAILOR 0 ALTERATION 0 SIGN r. • OLD 0 NEW 0 '05 NATIONAL. ELECTRICAL CODE 0 REPAIR 0 POOL 1 SPA 0 REWIRE 0 OTHEFt: WAIT ..117=722:Sa741,-1,111i, --.1..-->f,z::.,.-i,,t4.,..,11- 20. TYPE OF SERVICE: 0 OVERHEAD ..= NDERGROUND 0 UNDERGROUND UP POLE 21. NEW SERVICE: CONDUCTORS PER PHASE: 0 POWER IS ON 0 POWER IS OFF 22. SIZE OF CONDUCTOR: - AMPACITY: CICOPPER 0 ALUMINUM 13 . s wim oR BREAKER Ism AMPS: _____ PH: _____ W: VOLT: ______ RACEWAY SIZE: _____ 24. EXISTING SERVICE SIZE: AMPS: Z/ PH: _L_ W: 5 VOLT: 744") RACEWAY SIZE: _LC- 25. FEEDERS: , OF NAPS: * OF_____ AMPS: 0 OF AMPS: 26. UGHTING FIXTURES: INCANDESCENT: r ____:__ FLUORESCENT & M.V.: 27. FIXED APPLIANCES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: _ 28. FIRE ALARM: 0 YES 0 NO 244 DO NOT APPLY TO NEW SINGLE PAMS..Y, NULTI-PAIMLY AND R0041 ADDITIONS a. SMOKE DETECTORS: NUMBER: _____ 30. RECEPTACLES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: 31. SWITCHES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: .,. , ‘ .„: .j :,.,....71,-.,a,x,,,i....-a..,:a..,;:::.„-z.litiz-2.-.tre..M.r.."S---4=1.-1,--.•-V-&_:-.. ). -. -, : ..,,.: :..-..,‘:,.., # OF UNITS: COMP. MOTOR HP RATING ____ AMPS: _ HEAT KW:__ 8 OF UNITS: COMP. MOTOR HP RATING: AMPS: ____ HEAT KW: t,iVi k % . t.";;WrJ,14-4C-A1-.,-;,'"A;-1151U- a=M-"Alia.t..-St...4.7:4i,-Vre.-SiE,MONtaPa%"MiiiMilgtiOnNOM NUMBER: VOLTAGE: HP: ______ KVA: ____ NUMBER VOLTAGE: HP: ______ KVA:. _____ 1-'4 f..1:.'-'1Z4',,•?Zi..?:57....**XL.T.Za1.i.:..,::..:,...:,,L1MMTL-ti-itZ71.,..A.F:1 - f':47- 'tr.: z:: :'., - UNDER 600V: NUMBER: ______ KVA: _________ OVER 600V: NUMBER: KVA ______ 3 . ;4, 4..t.tVY 'It' DESCRIBE IN DET i • 1 4 1/4) it i 0 On di 1 COM FORM BLOOM REVISED: 111012005 * "t k,-k CITY OF ATLANTIC BEACH $' , , ; I 800 SEMINOLE ROAD „ -z, ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 • Application Number 09- 00001201 Date 8/24/09 Property Address 1380 EAST COAST DR Application type description PLUMBING ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc 16 FIXTURES Owner Contractor OLSEN, GEORGE R. DAVID GRAY PLUMBING INC. 1380 EAST COAST DR 8850 CORPORATE SQUARE CT. ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216 (904) 744 -7255 Permit PLUMBING PERMIT Additional desc . Permit Fee . . . 147.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/20/10 Fee summary Charged Paid Credited Due Permit Fee Total 147.00 147.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 147.00 147.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. g . i 800 SEMIN CITY OF ATLANTIC BEACH _ OLE ROAD, ATLANTIC BEACH, FL 32233 O��I OFFICE. (904)247 -5826 • FAX NO.:(904)247 -5845 BUILDING- DEPT�COAB.US PLUMBING PERMIT APPLICATION DUVAL COUNTY Wt ,2 tS Th SJBflP T. J {. ❑ �� �!� ❑ YES PERMIT # QP 4. NAME: 5. ADDRESS IF DIFFERENT FROM JOB ADDRESS. 6. PHONE: • •"sj1 3�z�r 1 .. _.. ��h'. „�,F, Y9'�tiR�"T,W5,1?!'.S"+`�.. {ui :q�„�.: ` ;N .,_': �i .''O . i`y ...,..., a` ,.y a ,-! 7. NAME � 8. ADDRESS' � ° • t � ��� ��lC� �G�{✓ �O�Q ��V ` 11. FAX NO.: 9. STATE FLOFr9,lACF,jaISE © p 10. CELL PHONE: ' is f7 12. EMAIL ADDRESS: //'_ O 13. OFFICEPHONE1g 14. (0 v Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. CONTRACTORS SIGNATURE: `. "t6 Nk � 7 EGF.WORFC .1 ,... e -/ S ,.fir ,,, 4tt cURRE , QDE, 0 EW ❑ '06 FLORIDA BUILDING CODE - PLUMBING P RE - PIPE ❑ OTHER: r y k9. 1IlIMi3E1 t]F, F[ (TURFS s „ L ... mss' ire BATHTUB _ _ SEWER CONNECTION BIDET _ - SHOWERS DISHWASHER SHOWERS PANS DISPOSAL _ _ SINK DRINKING FOUNTAIN _ - WATER CLOSET TANK FLOOR DRAIN WATER CLOSET VALVE HOSE BIB _ WASHING MACHINES ICE MAKER WATER CONNECTION INTERCEPTOR _ - WATER HEATER LAVATORY URINALS LAUNDRY TRAY OTHER (SPECIFY): ROOF DRAIN PERMIT ISSUING FEE: $35.00 TOTAL FIXTURES: I (® x $7.00 (PER FIXTURE) + $35.00 = ftf7 tb BLDG03 Permit Applicatiion Plumb: 12/18/2008 art alt, Aug 20 09 03:08p DAVID GRAY PLUMBING 904 723 5668 P• i 'Fr J f ... ?:f CITY OF ATLANTIC BEACH i n4 �� :�" '4` .4. 800S LA MINOLEROAD.ATLANTICBEAC BEACH. 0��:{�'` 1 (`�' L I � � . OFFICE: ;9W • FAX 6t�17 9ew5 t i' BUkdWILOIN GJ-O EPT@COABOAB.US PLU PERMIT APPLICATION DUVAL COUNTY o No 804 ( : O Elf* C O YES PERMriik .. PNONE. 4 NANfE: S. ADDRESS W DIFFERENT FROM J08 ACCR °..a 4 1. sv iii T. w ua� OF a r9 k.14-1 9. STA'E �N� V a. AOO S 8 7 0 (Pie IJp; �y✓0 10. CELLPHCNE 11 FAX "O 72 3 .5 6O F LO 1 G 12. EMAIL ADCRESS: 13. (OFFICE PNONE: l ; `i �� �rC ♦ Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes nul and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any lime after wort is commenced. CONTRACTORS SIGNATURE + f / / :1tC — _ • ❑ 0 FLORIDA DD BUI t=c.'-..-00:•:;.•ETt ❑ W PLUM8IPIG RE -PIPE b rives ��r OGp /�� PLUMBING 'y'.'! ` .. ... • : �y. '-- .'Y t_-.f3. ?ai w .."". .4 W'U,MEIERI F 0 .Sf-r_; ?XITk: ; .1 f_'Fi= ,,` -�':4 :.. '•.T. =.. BATH TUB _ _ SEWER CONNECTION BIDET — - SHOWERS DISH WASHER SHOWERS PANS — DISPOSAL . _ , - SINK DRINKING FOUNTAIN __ _ WATER CLOSET TANK FLOOR DRAIN WATER CLOSET VALVE HOSE BIB _ WASHING MACHINES ICE MAKER WATER CONNECTION INTERCEPTOR ,_, WATER HEATER LAVATORY URINALS LAUNDRY TRAY OTHER (SPECIFY): ROOF DRAIN -. ..�. - . »_. ' r'i =."a z: -1 tom$' ra.•rg__ ;z ^ t SCI `. .. ^-. ...:>yD[ ,te £ .4,- - I $ _ . r p - -. ..... ; : - PERMIT ISSUING FEE: $35.00 TOTAL FIXTURES: 16 x $7.00 (PER FIXTURE) + $35.00 = fk'T E6 SLDG03 Permit A dcatilon PIum7. 17/18/2002 8P ,Sg. *PIG JO 1:> CITY OF ATLANTIC BEACH , % 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 4 INSPECTION EMAIL REQUEST: Building- dept@coab.us Application Number 08- 00000763 Date 6/03/08 Property Address 1380 EAST COAST DR Application type description RESIDENTIAL OTHER Property Zoning TO BE UPDATED Application valuation . . . 1100 Application desc INSTALL GARAGE DOOR Owner Contractor OLSEN, GEORGE R. OWNER 1380 EAST COAST DR ATLANTIC BEACH FL 32233 Permit BUILDING PERMIT Additional desc . Permit Fee . . . 40.00 Plan Check Fee . . 20.00 Issue Date . . . Valuation . . . . 1100 Expiration Date . 11/30/08 Special Notes and Comments *2004 FLROIDA BUILDING CODE W/'05 -'06 SUPPLEMENTS. 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Fee summary Charged Paid Credited Due Permit Fee Total 40.00 40.00 .00 .00 Plan Check Total 20.00 20.00 .00 .00 Grand Total 60.00 60.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. S�,y,J APPLICATION NUMBER s �i City of Atlantic Beach (To be assigned by the Building Department.) 3 •. Building Department �j 4 � 800 Seminole Road C � Atlantic Beach, Florida 32233 -5445 CO ' Phone (904) 247 -5826 Fax (904) 247 -5845 11_I , o,ii% E -mail: building- dept @coab.us Date routed: City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM / 3 F ad - C w . Department review required Ye✓ o Property A ddress: Building Planning & Zoning (/ Applicant: Garet) n 1 � Public Works v' Public Utilities v -.L Project: n � ��� V is ., � Public Safety Fire Services Review or Receipt Date Other Agency Review or Permit Required of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPyCATION STATUS Reviewing Department First Review: 016Approved. ❑Denied. (Circle one.) Comments: C -- BUILDING PLANNING & ZONING PUBLIC WORKS Reviewed by: Date: 6 3— 08 PUBLIC UTILITIES Second Review: ['Approved as revised. DDenied. Comments: PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: ['Approved as revised. ❑Denied. Comments: Reviewed by: Date: ' (:ITV OF ATLANTIC BEACH _ 800 SEM ITV ROAD, ATLANTIC BEACH, FL 32233 ;�.� OFFICE: (904)247 -5826 • FAX NO.:(904)247 -5845 `z' - x BUILDING-DEPTOCOAB.US n Q I l I 1 T BUILDING PERMIT APPLICATION UV ---- : -..- w .. .- 2 , - i .1 i' 'J . i? t r .: - ` 1 ,a, E L _E D A R- _ ... _____::_ z COUNTY �` _ (,.1. ° � - _ _ . 4.7,..,..... : tom ..� ----- iii � eh ■ 4 I U• S"-° -7 r�-Y Z �e .Xtc� _ . ( ,.. :.c- ti " - c •. a`f .: -..._. ,.. 7: ...., < � �� ❑ NEW BUILDING • ❑ DEMOLITION ❑ RESIDENTIAL LOT BLOCK SUB DIVISION ❑ ADDITION ❑ CONVERTING USE ❑ COMMERCIAL ❑ ALTERA110N ❑ ACCESSORY BLDG. r ' _�' j '�` - _ . "- s4.r,r;. . - o .. - . ] _. ..�v _ .'...._".� . _. ._ ._.. ❑NIA � IC REPAIR ❑ POOL ! SPA 0 YES ....01 J / • o y ` ❑ MOVE ❑ OTHER 0 NO _ V - Y , " c$ - c7 k` r '""_._' :; :: #��,,Tai•p�c ..,��- rl l C - � . --�. NAME: 15. ■ • MPANY NAME: 23. COMPANY NAME: 8eXige cen 16. ■ • 24. LICENSEE NAME: 10 SS: 17. STATE • FLORIDA UCENSE NO.: 25. STATE OF FLORIDA UCENSE NO.: 18. ADDRESS: 26. ADDRESS: 1. E 112. FAX NO.: 19. OFFICE PHONE: 20. FAX NO.: 27. OFFICE PHONE: 128. FAX NOS r 29. CELL PHONE 133 � . CE 21. CELL PHONE 14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS: C s© a t la N : 33. NAME 35. NAME: 31. NAME . 32. ADDRESS: 34. ADDRESS: 36. ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all taws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bolters, Heaters, Tanks, Air Conditioners, etc. OWNER'S AFFIDAVIT - t certify that an the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. *** WARNING TO OWNER: YOUR FAILURE RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS PROPERTY. OF RDED AND POSTED ON HE JQ SE COMMENCEMENT MUST BE RECORDED SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR . . LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 4 iai.. -e' r- 6i F " � Y v, e .. , FrI tf._ ,-_.. .. -i. 1 f`Ji ltt ? ..- E , :0 ; , ,:_ - _,:-_-:-?::: 3 _ ?-: - 7i Sign lerge Date: • g • DV Signed: Date: Before me ■ r' day of d Wk-" ( , 204i a county of Before me this day of , 2007 in the county of Duval, State of Florida, has personally appeared Duval, State of Florida, has personally appeared &-' 3C )- e -n herin by himself 1 herself and affirms that all statements and declarations are herin by himself / herself and affirms that all statements and declarations are true and accurate.- true and accurate. Notary Public at Large, State of 1 , County or Ivl.Va) Notary Public at Large, State of , County of ❑ Personally Known -rte ❑ Personalty Known ❑.PreSoced Identlficatlon - C L.- ❑ Produced ldentlfl. • _ No S a __ s —TS - o _ Note Signature: • I >t ,u a • AM - - ry IF * " °0 gva.. vi • cm um/ . - Ru.uututIIIVi I CE 6 .ray Notary P tale ""Ma - . ' ^--- .- I CITY OF ATLANTIC' BEACH • My ommission Explr ,-- i ' - *'"eg,,e = 'r„:;; ..•3 ,. L SEE PERMITS FOT ADDITIONAL ;,•. � ; Commission # D + 1 REQUIREMENTS AND CONDITIONS. �. FoF FAQ•` Bonded By Nations if i COAB FORM BLDGO - ■ - - A • t REVIEWED BY :___ DATE :, 6b' 3'` 3 " . . , , � .... . '.,....m.. (,,/! ,51 J� ' asZ '�t t y a � � , � CITY OF ATLANTIC BEACH : t �% WNER / BUILDER AFFIDAVI4T " Cr31) I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER / BUILDER TO ACKNOWLEDGE THE LAW: I 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 COMMERCIAL 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 HWE 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. II. INJURY LIABILITY; 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 TO CLEARLY PROTECT THE OWNER. III. IRS WITHHOLDING; 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. W. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455 - 228(1). 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. V. ACKNOWLEDGEMENT; 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. n Zj 2 0 e �} .ST C041-1 D R. w C ,/4 I L 3c i-i /2„-Li q- 1'1 1 3 ADDRESS PHONE NUMBER G e 0 /2— et ' R. 0 L S C PRIN AME 06., La.?.6t, SI NnTU, E tnp Li.ATE ii Before me this % � day of J(l./) _ , 20o in the county of Duval, State of Florida, has personally appeared herin by himself / herself and affirms that all statements and declarations are true and accurate. County of ^g��` e �n f Notary Public at Large, State of T'(. , Coun �V Y l/� "a " "� • K. CUN :,,,,,, SM Y P � , . «`� ^ Notary P ublic - St ate of Florida CI Personally Known y �� T �� • : • M Commissi E x V » l pins Feb 28,2010 duce Ident cation - l — * � ! _ i • * • � ° , i F � Com missi on D D 523 6 38 Bonded B N ational Notary Assn. Notary Sig COAB FORM BLDG07; REVISED: 8/14/2 MAY. 29. 2008 7 ; 01 AM STANDARD PRECAST NO. 5657 P. 2 • STRUCTURAL SOLUTIONS, p.A. Structural Engineering' • Investigations • Consulting .GARAGE DOOR STATIC PRESSURE TEST REPORT Garage Door No.: IRC- 6016. 130 -15 Test Date: 1 11/25/2002 - Project No.: 02 -073 Des Pressures: +25.6 psf, -29.1 psf Report Date: . 8/18/2005 Test pressures: +38.4 psf -43.7 psf _ Test Location: Atnarr Garage Doors, I(ernersville, NC ASCE 7-98/02 Criteria: 130 mph, Exposure B, 30' Mean Roof Height, 5' in Edge Strip , Witnessed By: Danny Joyner - Amarr Garage Doors; Thomas L. Shelmerdine, PE - Structural Solutions, P.A. pescrintion of Test Specimen: • A 16' -0" wide x 7 -0" high residential steel sectional garage door, one (1) section wide by our (4) sections high, each section being 2" inches thick by 21" high galvanized steel sheet. Each section wasreinforced with two (2) 3 "x 20 gauge galvanized steel strut located atthe top and bottom of each section. The door sections were connected together with one (1) 14 gauge galvanized steel end hinge at each end stile and one (1) 14 gauge galvanized steel center hinge at each of the five (5) interior stiles as shown on the drawing. Garage door Model No. 600 manufactured by Amarr Garage Doors was used in the test. The test unit is furt described on drawing IRC- 6016 - 130 -15. Manner of Testing The specimen was tested for static pressure structural performance in substantial conformance with the procedures described in DASMA 108 "Standard Method for Testing Sectional Garage Doors - Determination of Structural Performance Under Uniform Static Air Pressure Difference ", and ASTM E330 "Standard Test Method for Structural Performance of Exterior Windows, Curtain Walls, and Doors by Uniform Static Air Pressure Difference ". Both positive and negative pressures were tested. . The specimen was installed in an enclosure measuring approximately 4' deep, 9' high, and 20' long. The enclosure was framed with shop welded steel angles and covered with 3/4" thick plywood. The door was covered with plastic sheeting to prevent leakage of air pressure. At one end of the enclosure, a "Dwyer" Series 477 Digital manometer was attached to measure pressure inside the enclosure. Two duct fans were attached iu series to the enclosure with fle*ible ducting to provide the positive and negative pressures. Test Procedure: • The specimen was subjected to the above pressures for the following durations. Positive pressure was applied on the extetior face of the door first, and then negative pressure was applied. Step 1: Preload the door to 50% of the Design Pressure and hold for 10 seconds. Step 2: Unload the door for 1 to 5 minutes. Step 3: Load the door to 100% of the Design Pressure and hold for 60 seconds. Step 4: Unload the door for 1 to 5 minutes. Step 5: Load the door to 150% of the Design Pressure (which equals 100% of the Test Pressure) and hold for 10 seconds. Step 6: Repeat 1 through 5 above for negative pressure. Observations: No failures occurred as a result of the noted loadings. The door remained operable after both positive and negative tests. Summary: - The 16' x 7' Model 600 as described on. Drawing IRC -6019- 130 -15 meets or exceeds the testing criteria as described above. By comparison to the construction of the 16' x 7' Model 600, the following doors also meet or exceed the above testing criteria, when constructed in accordance with Drawing IRC - 6016- 130 -15: ' • • 16' x 7' Model 950 doors (which are constructed of thicker 24 gauge steel in lieu of 25 gauge steel) • 10' to 16' wide Model 600, 650 and 950 doors with heights of 6' ..6" through 14' -0" Submitted by: etnurru ri f . 4 , : 1 • f ± 665 • ' L 17o STRt��e�SO - ` • • Thoma s 7%Shelmerdine •PE PE #0048579) .r�•6T of . ,• -' '41;�•� st f M v.,enue • Greensboro, North Carolina 27410 • (336) 956 -2686 ■ Fax (336) 856 -2687 • Y. 29. 2008 7:02AM STANDARD PRECAST O. 5657 P. 4 • M --1 T � 3 9999° r_ '1 A 6 1 a l 9 -4 ,4 Ill r. • 4=1444144 4 4 ,114 1 41 0 i “444ggggggAggr, I lia _ ,,,,, . , 1. gz r_..,...fti N N 444444 11x Ito .,_ ,1419uN: aaat�aabaaaaaeaaa " - ,sl s _ . 414 4444444444444444'1' saagesteet .sews _i ii m z 0Q�8 »88�t68 °tC8ffi g 11 1 .71 11:1 EntAZR4gtalaigaS i 5 � L n ,,, $111 $ ' el l ::::::!::::444 1 i u p ; ,..„ a 'I Irl ••• t Z• 11 o Z - $$A 4$4$$4-�, 44 `, 194 4$1.4! 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I ' I I a i w tre i y g" air 'f I » lei 11.1 It li r i* 11 ii 1 ril lif er• 5. Pi 1 fp e w il l _Levy/ 4 ite,4 1: 1 ® Mid 6 i E Eft r �� I .�� ", " . � ; Oz 1 r W il 111 t 1 Y . Y , iF� �I , .� V ' - 1 i i1 ' 0 , a8 . 1111 £" ff11-y , s IT gL ti • i Ike ' _ ii J A � � �� pgi Y'. ' � a ! r cn�i Iii . ■■N e 1 a P I iiir P 1 1. a I PPP P > A' �¢ . 1 •11.7 i ou 0.01 iil 1 1 `a 1 'wl N pH h IP:1 ILL : 18 I $ x p 1 1 I - 1 la qi! -1 1111-M— r /8/11(11 0 14.1 .. - 0 ;r1 M 4141.-R1 w � k14 0 1 M E sm. g . .mie t NI IP% I i g vs lila s R IRP 14 t 1 4 :. 11 i t r gr � 0- i Nu. 4 0 �'' k g5, 1 i r i q + rr X43. .r•`� V q i AU . � PSR 3844 I D PARTMENT BUILDING CITY OF ATLANTIC BEACH • .�- 1?ERMIT It4 't7Fti14ATION �-_ . _. _..__ LC?CATICN TIN PORMA'11 ©N - - , Permit Number: 141:77 Address 1380 EAST COAST DRIVE r m" it Type: RL -ROOF ATLAN!'IC BEACH, FLORIDA 32233 OIals cif 'Work: ALTERATIofi - L1E_AL DESCRIPTION __ . `c ztstr. Type :W0OD FRAME Si ck: Lot: Tarp: 0 , Proposed Us e :SINGLE FAMILY sect on: i?? Subd: Rng: E3 Dwellings, Q Subdivision: Est. Value: p.€} Imprav Cast : 7 T'c ta1 Fe 25.00 Amount, �* m 25.00 �. ION APP4 I 25.00 I F EES Addy: 1 ?aT DRIV ., p B '' � ''''''I FL 3 I DA 3 � , , - x � ` , � #F ��, }, � � �` �° �/�° x rr r u� ��' 8 `e� a�i� � 6 r��` ■ " [ '� �� a ad c S v; "" .tt ' �" !'� � , � 4.''''''''' `c �` c . Etta �,�^ as h ,"• `^�^ � .A. t F �F v s �a �¢ te' t , ----- � � "C3FtMATIQ�t w Nslxie 13A1Oi EL RA "T N ,, 5o ' yr , ?t R I 1 DA 32259/ : a' I i rt 1 S5� 3 E Jiffy /f p4. .:.m.un*T'wb i � E � J - s� " 1 ! r a w �� ,� �w c. NOTES: ' Lst NOTICE — . ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 1 BUILDING MATERIAL, RUBBISH AN D DEBRIS FROM THIS WORK MUST RIOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY 8Y EITHER CONTRACTOR OR OWNER 64 FA - SLUR E TO COMPl Y WITH THE MECHANICS LIEN LAW CAN RESULT IN 'SHE :PROPE W ER PA NG TWIC' OR BU LL IN IMPROVEMENTS." ISSUED AC CORDIN G TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJ TO REVOCATION FOR ' VIOLATION OF APPLICABLE PROVISIONS OF LAW. . 14 ATLANT EACH BUILDI D ARTMENT l8 M 218813 � 1�3 CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS Owner (s ) : Ec, « S ,/ Address : /3eo &4S7 c)4S7 OR. 474 a qei{ Phone : Lot # Block or Unit # Subdivision: Contractor: p 4,.// L 1 (;,c),qS -To State License # iQ C. j ,ps Address : aWjp PoX/(GN7 72A /L Phone No ,zb'Pj - OA°/d' Describe work to be done : R R �F !a� i 7A 'c .Y4*R. { c7uege. 3 s E2./.4frekS . Present use of building: gt.5/6 ,v7 0/. Valuation of Proposed Construction: 02/9.0-7. Proposed use: Is this an addition? oc.o 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)? New plumbing fixtures? New fireplace? New Heat /AC? SUBMIT THREE (COMMERCIAL) TWO (RESIDENTIAL) COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER /CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: Date: Signature CONTRACTOR: g Date: 6/22 / �``j License Supplied: / Liability Insurance: Worker's Compensation Insurance: Permit No. NOTICE OF COMMENCEMENT RAMCO FORM 400 Tax Folio No. Fs 713.13 State of Florida County of ) y The undersigned hereby gives notice that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. Legal description of property (include Street Address, if available) 1.3 arc) £437 cOAS7 ORIVte. Book 8639 Pg 241 474,41‘71c L3 E Act PL . General description of improvements At Lito-o1G tail,/ `Icy 1d4,C F S/S/iNG403 . (32 SC2khgES Owner G E oR`F o LS EJI Address /ZOO *AST c..:: 7, URINE A 7 c 434AGK fG . Owner's Interest in site of the improvement Fee Simple Title holder (if other than owner) Name Address "tractor DANIEL R. G RA5X J/ V ' tidress 46,11 foX,'4 '7 TRA /L j f4CkSan/V/GLE 1 ft.. 32.24.1 Surety Address Amount of bond $ Any person making a loan for the construction of the improvements: Name Address Person within the State of Florida designated by owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes. Name Address in addition to himself, owner designates Of to receive a copy of the Llenor's Notice as provided In Section 713.13(1)(b), Florida Statutes. Expiration date of Notice of Commencement (the expiration date 1 year from the date of recording unless a different date is specified). r i THIS SCE FC CDRDER'S USE ONLY x Lam` ✓p' �o3((ss33 99 Signature of Owner CD Doc# 97123317 daeC / v� SEnv Filed & Recorded Printed Signature of Owner _ 06/05/97 03:15:30 P.M. Sworn to and subscribed before me this day of HENRY W. COOK CLERK CIRCUIT COURT /l _ , 19 q 7 DUVAL COUNTY, FL /' ? ' REC. $ 6.00 .2 _' 4... Z �_-..ii;.,.._ a— ' otary P blic _ r ,,_::,,,,,= FRANCES RODRIGUEZ Noe ',in. w e , .PP. c- • c . ' *E , . .« MY COMMISSION • CC 'I'• Printed Notary Signature *. „, , EXPIRES: February 21, 1999 R ' 49onded Tbru Notary Pub1IC un irb, mission expires —2 -GP/ f . �" FOR OFFICE USE ONLY 'D ate � 1_--C� 195- Permit # -4 7JJ- /Fee $ 4 TOWN OF ATLANTIC BEACH ' j '�' ° v A P- Valuation $ __._ s! �Q FLORIDA House #,..., APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the Town of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the Town of Atlantic Beach and all rules and regulations of the Building Department of the Town of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner- Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the Town of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub - contractors be submitted to this office so that licenses can be verified. f Date �� , 196 Owner 6e'g e Address Telephone No. Architect f1 -ecia Address Telephone No. Contractor Builder 4 /22 . 0 Address Telephone No. Lot No f7 IX A/ 1 0 _ _ 1 7 : . Block No. / Sub Division - / ! # � l Zone /, e -.Q. - `'J TL // QG!S7 • S treet Side Between and Sts. Valuation $_ 13. . ,1''C�o For what pu pose will building be used /"� ,5 Type of construction_ _ -_ Aitf2/I /1 I` Dimensions of Building 4.11X - -Y- Dimensions of Lot Size of Footings g Y `10 Size of Piers /roar Size of Sills .:._ /2cc' Greatest Sill Span in ft ----- Type Roof _4r .�1._r1 X76 �° How will Building be Heated? _ /_.p1C a1 A- Will Building be on Solid or Filled Ground? __ . • __ _ {L_ Size of Ceiling Joists ' !S 6 , Distance on Centers l6 " , Greatest Span f7" �� " Size of Floor Joists / , Distance on Centers , Greatest Span / 77 Size of Rafters ' .-----.. 16( - - -Se. , Distance on Centers /6 '' , Greatest Span / 1 / g rf " This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot -lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing. W W 2. When steel is in place and ready to pour columns and /or lintel. Z Z 3. When steel is in place and ready to pour beam. :711 ''i 4. When framing is completed. 0 5. When rough plumbing is completed, and ready to cover up. 6. When septic tank drain field is laid but before it is covered. A q 7. Electrical inspection by City of Jacksonville. ro 8. Final inspection. Note: In case of any rejection, re- inspection MUST be called for after corrections are made. FRONT OF LOT 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 the Town • ' Atlantic Beach. Signature of Builder._. Address Signature of Owner /___ = : _ i i -._ffA Address