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Permit 363 Atlantic Blvd Unit 14 Jimmy John's 2010 `SS S CITY OF ATLANTIC BEACH a j 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00001135 Date 10/06/10 Property Address . . . . . . 363 ATLANTIC BLVD UNIT 14 Tenant nbr, name . . . . . . JIMMY JOHN' S SANDWICH Application type description COMMERCIAL INTERIOR BUILD-OUT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 85000 ---------------------------------------------------------------------------- Application desc COMMERCIAL INTERIOR BUILD OUT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SHOPPES OF NORSHORE, LLC DAKENNA DEVELOPMENT 35 MORGAN FARM ROAD 105 S 25TH AVE #33 WESTWOOD MA 02090 LONGWOOD FL 32252 (904) 534-2636 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE I-A Occupancy Type . . . . . . ASSEMBLY ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 420 . 00 Plan Check Fee 210 . 00 Issue Date . . . . 10/05/10 Valuation . . . . 85000 Expiration Date . . 4/03/11 ---------------------------------------------------------------------------- Special Notes and Comments NEED NOC *2007 FLORIDA BUILDING CODE W/2009 REVISIONS FLORIDA FIRE PREVENTION CODE NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Because the only cooking facility shown on the plans is a warming oven, the proposed 50 gpm grease trap will be acceptable. If any future modifications are done to add grilling or frying facilities, an appropriately sized grease interceptor will be required. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 6 .30 STATE DBPR SURCHARGE 6 .30 UTIL REV MODIF OR ROW 25 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due PERMIT IS APPROVED ONL9 NX(700RDANTE 1V1TIT AL[-CITy aF ATI-ANTW-6EACFT O91)INA-WES'AND TN'F-FL'ORrT)A-- BUILDING CODES. �y CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 . 131t Page 2 Application Number . . . 10-00001135 Date 10/06/10 Permit Fee Total 420 . 00 420 . 00 . 00 . 00 Plan Check Total 210 . 00 210 . 00 . 00 . 00 Other Fee Total 37 . 60 37 . 60 . 00 . 00 Grand Total 667 . 60 667 . 60 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITU OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. OCT-6-2010 09:56 FROM:CLERK OF COURTS 904 270 1512 TD:92475645 P:1/1 NOTICE OF COMMENCEMENT (PRFPARF IN DUPLICATE) Permit No. Tax Folio No State of or, .a. County of Duval To whom it may concern: The undersigned hereby informs you that improvements will be made to certain reel property,and In accordance with section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT, ii Legal description of property being improved; t-(PSI nae) — 00o® Address of properly being improved. 36.3 ltlantic Blued. , Suite 14. Atlantic Aear_h. F1_ 32233 General description cfImp rove ments Tenant Improvement `o an a ist-ina commprigial suets Lcr incl.udE new finishes, nlutrlbiiaa HVAC and nlie�c:r.ric. OwnerPORN tJ czIL4<5R§ Address kjr4rJ fn 2 __ c r�I.�.�T�T id C�Z-0 9 0 Owners interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address Contractor Dakenna Develor_rmPnr, Inc. Address 105 29th Avenue 5oulch. Suite L33 Jarkeonville Seach r'1 32250 Phone No, 904-583-5175 _ Fax No 904-24,5-1.1345 Suroly(if any) NIA Add -- Address .... Amount of bond$ N/A Phone No. Fax No _ Name and address of any person making a loan for the construction of the improvements. Name N/-A Address Phone Na. Fax No. Name of person within the State of Florida.other than himself,designated by owner upon whom notices of other documents may be served. Name Address Phone No Fax No. In addition to himself.owner de-ognalos the following person to receive a copy of the Lienor's Notice as provided in Section 713 03(2)(b).Florida Statutes (Fill in of Owneis option). Nnme Address_ Phone No, Fax No. �. Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY NIA' ♦�,^.s signed: _ DATE � - -- 5n, 'me this ! achy of � In Ilia county or Dwat.SYxg of FIomis.nag uef:unally appeared L OC A lU'I U131u1$.OR BK 1 y: ay rage '2tk6, hemin by himsaH!herself and:mPmr,that all statements and dedarallone n herei Number Nage- 1 are true.7nd accur4 Rruorde.d I%W2010 at 09:56 AM, _ jiM FULLER CLERK CIRCUIT COURT DUVAL COUNTY P.ECORDING$10,00 Notary Publirat Large,Siale'or urny �ora� My comntl pion explr►L: - POrannAlly K"' f r Pnxfucgd+rlant+ricanon BUILDING PERMIT APPLICATION 3�i CITY OF ATLANTIC BEACH , 1 800 Seminole Road,Atlantic Beach,FL 32233 Office(904)247-5826 Fax(904)247-5845 Job Address: 3(03 AnAuTZG Fx,yy. Permit Number: Legal Description Parcel# Floor Area of Sq.Ft. Valuation of Work S .O�OD Proposed Work heated/cooled f Z 15; non-heated /cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition /door Use of existing/proposed structure(s)((circle one):. ommercial Residentialm., O 6 If an erisdng structure,is a fire spn kler system ins a one : Yes ECJ N SFP Florida Product Approval# j For multiple products use pr a approva orm Ey da 42010 Describe in detail the type of work to be performed: 10-re-inzoe 'TE-AAM _k d N Property Owner Information: Name: SN©PDAs OF u01'04:.ez!4QZF,;UX, Address- 9S" /r OZ(oAj I FA�Z l ED City Omnownp State Zip (=g0 Phone E-Mail or Fax#(Optional) Contractor Information: ,n r Company Name: AvjeWK)A - Qualifying Agent: fievnts. A Address: CityyzLL 4. tate F1. ZiP f? -j 0 Office Phone ft a-i044- Job Site/C tact Number Qp 4_6;0S_tol Fax# 4V y-tys-1 g! State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# 00 Fee Simple Title Holder Name and Address Bonding Company Name and Address ,f r ZL_r_ Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commencedprior to the issuance of a permit and that alt work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void f work is not commenced within six(6)maurths,or if construction or work is suspended or abandoned for a�enod of sis 6)months at airy time a er work is commenced I understand that separate permits must be secured for Etahtica!R'orAy Plunebiag;Signs, Wtlls,pools, umetes,Boilers,Hrars, Tanks and Ab Con�tloners,etG WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y&fi NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether speci�ed herein or not. T7te granti+tg of a permit does not presume to give authority to violate or cancel the provisions of airy other federal,state,or local law regulating construction or the performance of construction. r GAHULYN iV1L'.,.•.` Signature of Owner NO ry pub AA Ilton Ra of M of Contractor Print Name ame S fore a and subsci' b fore me Cis Day of m a^ 20 JW FORE tatyPub 1 EE PERMITSFOR BEACH NA1 ;;�� BRENDA BUCKLEY QUIREMEN U0 CX `�' �� r MY CpMMISSIpN N DD 87 e 01.26.10 = EXPIRES:March 30,201 Bonded Thru Notary Public Underwriters REVIEWED BY: DATE: 10-4 s s RESPONSE LETTER ROBERT QUINTANA ARCHITECTS 14900 LANDMARK BLVD STE 640 DALLAS, TEXAS 75254 PH: (972) 233-2718 FX: (972) 980-2914 Date: September 30, 2010 To: City of Atlantic Beach, Florida Building Department 800 Seminole Road Atlantic City, Florida 32233 Attn: Mr. Mike Jones / Mike Griffin RE: Jimmy John's — Gourmet Sandwiches 363 Atlantic Blvd. Suite # 14 Atlantic City, Florida 32233 Permit# 10-1135 Response to City Comments dated Sept. 20, 2010 Please accept the following as our written responses to the plan review comments dated 20 Sept 2010: Building Comments: 1. Per discussion with Donna Kaluzniak at the Utilities Department, the 50 gallon grease trap is acceptable. Attached is an email from Donna verifying that it is acceptable. 2. Per discussion with Michael Griffin the exhaust hood details are not required. Attached is an email from Michael verifying that we do not require details. Fire Comments: 1. The 2007 Fire Prevention Code has been listed on sheet A-0. 2. Note #1 under"Fire Marshall Comments" on Sheet A-0 states that light- frame truss- type construction identification signage must be provided. 3. General Note # 16 on A1.1 and Fire Marshall Comment note #2 on sheet A-0 both state that tactile signage shall be located at each exist door requiring an exist sign. 4. The electrical single line diagram on sheet E-2 has been revised to show an exterior disconnect for electrical service. Should you have any questions or comments you may contact Chris Cooper at (480) 268-2900. Thank you. Krista Isaacson From: Chris Cooper Sent: Tuesday, September 28, 2010 10:25 AM To: Krista Isaacson Subject: FW: App. 10-1135 Jimmy Johns From: Kaluzniak, Donna [mailto:dkaluzniak@coab.us] Sent:Tuesday, September 28, 2010 10:06 AM To:Jones, Mike; White, Debbie; Griffin, Michael; Graham Shirley Cc: Chris Cooper Subject: App. 10-1135 Jimmy Johns All, the proposed 50 gal. Grease trap is acceptable for the Jimmy Johns Restaurant at 363 Atlantic Blvd. because the only cooking facility is a warming oven. If any future modifications are made to add grilling or frying facilities, an appropriately sized grease interceptor will be required at that time. Thanks, Donna Donna Kaluzniak Utility Director City of Atlantic Beach 902 Assisi Lane Atlantic Beach, FL 32233 PH: 904-270-2535 FAX. 904-242-3475 dkaluzniak(c ccoab.us Please note: Florida has a very broad public records law. Most written communications to or from city officials regarding city business are public records available to the public and media upon request. Your e-mail communications may be subject to public disclosure. Krista Isaacson From: Griffin, Michael [mgriffin@coab.us] Sent: Tuesday, September 28, 2010 10:07 AM To: Krista Isaacson Cc: Jones, Mike Subject: RE: Jimmy Johns-Permit# 10-1135 Attachments: image001.png Krista, I could not tell from the kitchen elevation if a cooking surface was included. Please disregard the comment.Thanks Michael Griffin,CBO,CFM Building Official 800 Seminole Road City of Atlantic Beach,Florida 32233-5445 mgriffin@coab.us Telephone 904-247-5813 Fax 904-247-5845 htta://www.coab.us/ From: Krista Isaacson [mailto:kristai@arizado.net] Sent:Tuesday, September 28, 2010 1:05 PM To: Griffin, Michael Cc: Chris Cooper Subject: Jimmy Johns-Permit# 10-1135 Mike, Per your plan check comment. Relative to permit number 10-1135 for Jimmy Johns in Atlantic City. I spoke with Mike Jones about the exhaust hood requirement and explained that there is no cooking in this establishment.The Fire Marshall did not require a hood. Mike Jones indicated we probably would not need a hood but asked that we verify with you. If you could please get back with as soon as possible I would greatly appreciate it. Thank You, Krista AnzaDoE Krista Isaacson 6910 East Chauncey Lane Suite 105 Phoenix,AZ 85054 Phone:480.268.2900 Fax:480.268.2905 kristai0arizado.net i yS1ay;yfy City of Atlantic Beach APPLICATION NUMBER �S Building Department (To be assigned by the Building Department.) 800 Seminole Road j � Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 �- �� E-mail: building-dept@coab.us Date routed: /p City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: *-)i/7e, W Pc s Department review required Yes No uiIding Applicant: �£���A-, vZ Z6 m k7 g ree minis rator Project: /777"toe e. 7_1�n Q-A 7- itcVOo'rR /--rn I)/-a Vf/tel TS ic i Public Safety �S 71-W ,�192c n 7— ire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: APPLICATION STATUS Reviewing Department First Review: ®pproved. ❑Denied. (Circle one.) Comments: BUILDI PLANNING &ZONING Reviewed by: Date: /4—`l-/0 TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) t� 800 Seminole Road /0 r' Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 • Fax(904)247-5845 !•Jii `�` E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: / fn/7 e^, = Department review required Yes No uilding Applicant: f3 �£���4, t Vr-Z,p m6 pg aft Tre,67 minisrator Project: /������ �- 7�n 4--A is orks-�, is iii �i'jCf" r� YE���T� public Safety lv, L,c� f S"R 49u T— ire Services Review fee $. Dept Signature Other Agency Review or Permit Required Review or Receipt Date 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: APPLICATION STATUS Reviewing Department First Review: ❑Approved. Denied. (Circle one.) Comments: yes BUILDING PLANNING &ZONING q Reviewed by: Date: / TREE ADMIN. Second Review: ❑UJ'a'QJs1%'. nied. PUBLIC WORKS Comments: PUBLIC UTILITIESPUBLIC SAFETY Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 i :r City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road /Q —1/3,�` Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 • Fax(904)247-5845 rA3 E-mail: building-dept@coab.us Date routed: / City web-site: http://vmm.coab.us APPLICATION REVIEW AND TRACKING FORM lr7z Property Address: G �'tia Department review required Yes No uilding Applicant: ree 7 0 minis rator Project: /717:k 7 Q 7is or is i i i Public Safety ,5— �9qu nT— ire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: APPLICATION STATUS Reviewing Department First Review: ❑Approved. Denied. (Circle one.) Comments: yes BUILDING q PLANNING &ZONING Reviewed by: Date: / a TREE ADMIN. Second Review: ❑Approved as revised. e� (s' Fin PUBLIC WORKS Comments: L� L/ PUBLIC UTILITIESj�, PUBLIC SAFETY Reviewed by: By Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 i r Fop- JtMM� J-ORN 's !. PC FE'(Z ENce 7fe' lav 7 f'1,ag toA Ftp-c7 Pre JeN<<an1 C©DE PRouipe �- If t'�"- RRANE 7-Rus s-7"Yfi' CoAs TRuc7? 1 aN lDEft7i Ft 5+ iJ S IGIv,+GE PE2 F4C- 674-60- 0031012 FRO 0-1 A+ LtCEn/sG-,p CA)GrN6Ef2 d2 TftTirlCC TW1i S�tcf� S i 2 u c7-wR 9" o es rJ ©7' me- T-ffE bEElAi ri't-D N © 6 3. c%LCC St N Sry.�GL dc L-octY7 b 41 E;f c;�I E-x 17— book An oul e/NG 3. 't. PRO 140 mEt,. ns i2 THCE F'1t?C' DEFF 7-o O IS CD/VNEGI 7-7fE 6 L SEt� vrC �� N- FP74 1 , ! l. t . -7. 1 . 7 f City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) Y t 800 Seminole Road /Q 3,�` Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: � i C'r �y Department review required Yes No uilding �i� �£����, y ��LCiQm g Applicant: —re—e—Ad minis rator Project: /-/17- ��'° �. ��� ��►✓ is ork is Uriii =iltra VE ,t rS Pubic Safety &e Gcj ,e „7'" ire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: APPLICATION STATUS Reviewing Department First Review: ❑Approved. [—]Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09 �IL'lyr�J, City of Atlantic Beach ; APPLICATION NUMBER J Building Department ; (To be assigned by the Building Department.) iso �-- 800 Seminole Road r� 2"110 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us r_ --_ Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �> i�.G ���/ Department review required Yes No uilding Applicant: �£��� 4, -� Vii /��y71 9 reeminis rator Project: 7-:k xf ��, ��� a T is orks� Public Safety A ,e,17U 7 Tire Services Review fee $ Dept Signature Xe— Other e -Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: APPLICATION STATUS Reviewing Department First Review: Approved. @Denied. (Circle one.) Comments: BUILDING \ PLANNING &ZONING Reviewed by: Date: 9/ > >� TREE ADMIN. Second Review: DApproved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 BP250U01 CITY OF ATLANTIC BEACH 10/05/10 Application Tracking Step Selection by Revision 08 : 20 : 38 Application number . . . . : 10 00001135 Address . . . . . . . . . . : 363 ATLANTIC BLVD UNIT 14 RE number . . . . . . . . . . 169730-0000-14- Application type . . . . . COMMERCIAL INTERIOR BUILD-OUT NCR OLD ACCOUNT NUMBERS . . . Tenant name, number . . . . JIMMY JOHN' S SANDWICH Type options, press Enter. 2=Change 4=Delete 5=View 6=Fast log 8=Action log maintenance 9=In/out maint Path ---- Rey Dates --- - Action Summary - Opt Agency description Rev Step Req In Est Cmpl Last Type By _ BUILDING DEPT. A 01 Y 10/04/10 10/04/10 10/04/10 AP MJ _ FIRE DEPT. A 01 Y 09/30/10 10/04/10 09/30/10 AP SLG _ PUBLIC UTILITIES A 01 Y 09/20/10 10/04/10 09/20/10 AP LS PUBLIC WORKS A 01 Y 09/21/10 10/04/10 09/21/10 AP LS Bottom F3=Exit F5=Land inquiry F6=Add F7=Revisions F8=Misc info inquiry F9=Corrections report F10=View 3 Fll=Sort by agency F24=More keys k City of Atlantic Beach APPLICATION NUMBER Building Department rJ "° o be assigned b the Building Department.) 800 Seminole Road i R 9 Y 9 Atlantic Beach, Florida 32233-5445 - Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM 0 Property Address: �i �»,l�'� ,yc Department review required Yes No uilding Applicant: �£ ->>�, V��,pmin f 9 Tree min— rator Project: /y i a;xf i is ork is ifi�s7 Public Safety y'-Ou n 7— ire Services Review fee $ Dept Signatu �;a Other Agency Review or Permit Required Review or Receipt Date 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: APPLICATION STATUS Reviewing Department First Review: ]Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by Date: TREE ADMIN. Second Review: [-]Approved as revised. ❑Denied. P Comments: U I I I PUBL SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 Public Utilities Plan Review Comments Date: to Initials: Project Name/Address: 3(�3 �;G +�a, Application Permit#: (o :Check Box ,Application Tracking Comments to Add -Comment Avoid damage to underground water/sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call ❑ 247-$834. Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and ❑ visible. A sewer cleanout must be installed at the property line. Cleanout must be covered ❑ with an RTl concrete box with metal lid. Cleanout to be set to grade and visible. A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be ❑ tested by a certified tester and a copy of the results sent to Public Utilities. Plans note the building will be unsprinkled. If plans change, any fire line installed must be metered with a Sensus touch-read meter in a properly sized vault and an ❑ appropriate backflow preventer installed. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. If fire sprinkler system is provided, contact Malcolm Clemons at 247-5 83 9 for backflow requirements. At a minimum,will require double check backflow ❑ preventer. Fire lines must be metered with a Sensus touch-read meter. Meters larger than 2" ❑ must be installed in a vault as noted in JEA specifications. BUILDING PERMIT APPLICATION i CITY OF ATLANTIC BEACH 1 3 800 Seminole Road,Atlantic Beach,FL 32233 Office(904)247-5826 Fax(904)247-5845 Job Address: 3103 �TIAOTZG ?xvV.. .5utyrE 14 Permit Number: Legal Description Parcel# Floor a o Q. t. Sq.Ft Valuation of Work S 4b-000 Proposed Work heatedlcooled IZ 15 non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition s 'a w/door Use of existing/proposed structure(s)(circle one):. ommercial Residential, ,.., O If an existing stracture,is a fire sprinkler system ins a one): Yes E c� N Florida Product Approval# SEP 14 For multiple products use pr u approvalform gy X410 Describe in detail the type of work to be performed: T E d tj N Property Owner Information: M Name: 5N©Ppm OF �{��g�-(�Q�, L(�—Address: 55- AYOZAN) FAICM ��I7 City 10es-rnfivop State"AZip j249Phone E-Mail or Fax#(Optional) Contractor Information: dCompany /�Name: /� Qualifying Agent: (OQL�1S �7lGZNS Address: CityAC f ez��r*AAtate_E_Zip_ ZLso Office Phone - 4-44tp Job Site/C tact Number Fax# 4V y-tyS-1$S�5 State Certification/Registration# fl CC 1-51(219 K Architect Name&Phone# 64 Engineer's Name&Phone# —%&O—n00 Fee Simple Title Holder Name and Address Bonding Company Name and Address ,, Mortgage Lender Name and Address /� /A/,r,7,- Application is hereby made to obtain a permit to do the work and installations os indicated I 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 laws regulating construction in this jurisdiction. This permit becomes null and void:f work is not commenced within six(6)months, or:f construction or work is suspended or abandoned for a penod of six6)months at any time after work is commenced I understand that separate permits must be secured for Electrical Work;Plumbing,Sig�rs, WelLc,Pools, rtrnaces,Bailers,Heaters, T�and Air Condltforters,etc WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER.OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I here certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether speci d herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of airy other federal state,or local law regulating construction or the performance of construction_ y, GrNaYsJLYtl IlJGl EE 1'7 n i .. ..._. ..._ Yl �PubllcSignature of Ower t Sig �ture of Contractor 4.. men Ra of mossaehasItts Print Name mo •� .. ... _. ..-. .Exp. 5/1 d►11ffirint Name . t _. . OP ..•�-Ax x�t95..---- ...._......_.._.. .... Sworn to and subscrn before;ne SwoT and subsc ' fore me this_J 3 Day of ` Y 20 u this / Day of 20 Notary Public N a�'•,"•., BRENDA BUCKLEY �iv`�rt111 �a1i°3z c:xa MYCOAIMISSIONkDD875 a ed 01.26.1` "` EXPIRES:March 30,201 Bonded Thru Notary Public Undonvriters f . • • _ f • • : . . - -. . apS uoilonilsuooaniaaai i 6rSlie aA3 ii,r, ' pii� rfni M LO £S £Ze $ ! £t7 O£6t.0£. sal6a ou aa� Pdom i� L•v i aI6o0E):0 OZ w y. E a k .. .�.,. �._ +is • ,, -`tib,� a �. • ztF � A • .� a �:v �rte. # ,.'. n e � . x fir` « a y F 1�« ,. . , ££ZZ£ Ij '4aea8 ollu,eliV 19 �i�ue(ld.>£9£. x WA S r� T� a� A , r ♦ s > : , r '� ` ,�..♦ ..�. .. r � Vii" _ � 4 +�-♦•} �� �a ,9. .s ;,�. a t a� a: ..., .. . �. •gyp,; st set . .xM _ .�. ads,•." '.. ` • • 4 • 3 r • • r :# _ _ i ````�«`'`� ra�{. �_..a, ; ? X34 fi. t 9t � • • • , r s