Permit 1859 Forsyth Ct PERMIT WORKSHEET Certificate of Occupancy[ U 1
Job Address: --- Type Work:
18 5`� ��-�Yl� Cy.t. Ne to P Pl✓
Property Owner: Q �_ . Phone #
Contractor: Phone # 74-1
Permit#: Date Issued:
Building Inspections: Footing
Slab -
Tie Beam
Lintel
Nailing / Sheathing 3 ,i s c)
Framing / Cover Up
Insulation g y.C,
Final Building 2�l
Tree Permit# �- YES NO
Electrical Permit# , Z?8 Date/ Copy toF 3
JEA '.5
Temp, Pole Permit# Date/ Copy to
1 71 JEA
Temp. Power Letter Received: YES NO
Inspections: Rough Electric Released to JEA
Temp. Power Released to JEA
Temp. Pole Released to JEA
Final Uj 7,q 101 Released to JEA ?
Mechanical Permit# .d
Inspections: Rough Final til7
Plumbing Permit# $'j
Inspections: Rough / Underslab Topout
Water/Sewer Final
Drainage Inspection:
Pool Permit#
Inspections: Steel Final
Grounding Final
Roofing Permit#
Inspections: Nailing /Sheathing Final
Fire Inspection:
FaileckInspe:.tions: Date Paid:
Date Paid: "'
Building,
Planning &
Zoning
Inspection CITY OF ATLANTIC BEACH
Department CERTIFICATE OF OCCUPANCY WORKSHEET
Date Requested: (.4 ( 2-L I I
Contr ,tor Name: V---3C Ck-
a
Permit #: 0�
Property Address: ) 3�39
Legal Description: L-i ` �k� 1�L��s 1oyr-
Improvements to the above-described property have been completed in
accordance with the terms of the permit and are certified to be ready for
occupancy as:
Single-Family Resident - Commercial - Other: T)L,�V UY-
Lowest Floor Elevation: 2�
Required As Built
The following must be completed before issuing Certificate of Occupancy:
Department Date Notified Date Approved Approved By
Fire Dept. -
Public Works
Planning Dept. C' - Z s' v Y -Z'S' - n"Building Dept.Dept. ca f G. • 2 S- - d Y
Final Survey with FFE Yes No
All Re-Inspect Fees Paid Yes No
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
C E R T I F I C A T E O F O C C U P A N C Y
P E R M A N E N T
Issue Date . . . . . . 6/24/04
Parcel Number . . . 172123-0000-5 -2
Property Address . . . 1859 FORSYTH CT
ATLANTIC BEACH FL 32233
Subdivision Name . . .
Legal Description . . .
Property Zoning . . . . TO BE UPDATED
Owner . . . . . . . . . BEACHES HABITAT
Contractor . . . . . . BEACHES HABITAT
904 241-1222
Application number 04-00027587 000 000
Description of Work TWO FAMILY RESIDENCE
Construction type . . .
Occupancy type . . . .
Flood Zone . . . . . .
Approved . . . . . . . tri- '
Building Official
VOID UNLESS SIGNED BY BUILDING OFFICIAL
y
r f 4',
f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00027823 Date 3/03/04
Property Address . . . . . . 1859 FORSYTH CT
Tenant nbr, name . . . . . . NEW, 150AMP, 1PH, 3W, 240V
Application description . . . ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
------------------------ ------------------------
BEACHES HABITAT BEACHES ELECTRIC SERVICES INC.
1671 FRANCIS AVE. 214 COKESBURY CT.
ATLANTIC BEACH FL 32233 GREEN COVE SPRINGS FL 32043
(904) 241-1222 (904) 629-3182
------------------------- - --------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 95. 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date 11/12/04
Fee summary Charged Paid Credited Due
- ---------------- ---------- ---------- ---------- ----------
Permit Fee Total 95 . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 95 . 00 95 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MLJS'1'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.
BUILDING OFFICIAL
,•42JM :
PHONE NO. : 9047640038 Mar. 04 2004 11:27AM P3
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CITY OF ATLANTIC BEACH
S 1 800 SEMINOLE ROAD
JATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00027587 Date 1/27/04
Property Address . . . . . . 1859 FORSYTH CT
Tenant nbr, name . . . . . . DPLX W/1857 RAD/SCHG 1105
Application description . . . TWO FAMILY RESIDENCE
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 59503
Owner Contractor
- - - --- -- - - - - - -- - - -- - - - - - - - - - - - - - - -- - - - - - - - - - - - - -
BEACHES HABITAT BEACHES HABITAT
1671 FRANCIS AVE . P.O . BOX 50939
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 241-1222 (904) 241-1222
-------- ---- - -- - - - -- ---- - -- - --- ----- -- - - - - - - - - - - - - - ---- - --- - - - - - ------ - -----
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 300 . 00 Plan Check Fee 150 . 00
Issue Date . . . . Valuation . . . . 59503
----- ------ --- ---------- ------ - ---- --- - - ----- - - - - -- ---- - -- - - - - - - - - ---- - -- - --
Special Notes and Comments
Approved by PW per providing an Erosion
and Sediment Control Plan.
----------------- ---------------------- ------- -- --- ------ - ---- -- --- - - -------
Other Fees . . . . . . . . . CITY RADON SURCHARGE . 27
CAPITAL IMPROVEMENT 325 . 00
ST CONSTRUCTION SURCHARGE 4 . 97
AB CONSTRUCTION SURCHARGE . 55
STATE RADON SURCHARGE 5 . 24
SEWER IMPACT FEES 1250 . 00
WATER IMPACT FEE 370 . 00
WATER CONNECT/METER ONLY 85 . 00
WATER CROSS CONNECTION 35 . 00
Fee summary Charged Paid Credited Due
- ---------- -- - -- - ---- --- --- ----- - -- -- - ---- -- - - - -------- --
Permit Fee Total 300 . 00 300 . 00 . 00 . 00
Plan Check Total 150 . 00 150 . 00 . 00 . 00
Other Fee Total 2076 . 03 2076 . 03 . 00 . 00
Grand Total 2526 . 03 2526 . 03 . 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 PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00027587 Date 3/01/04
Property Address . . . . . . 1859 FORSYTH CT
Tenant nbr, name . . . . . . DPLX W/1857 RAD/SCHG 1105
Application description . . . TWO FAMILY RESIDENCE
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 59503
Owner Contractor
--------- --- --------- --- ------------------------
BEACHES HABITAT BEACHES HABITAT
1671 FRANCIS AVE . P .O . BOX 50939
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 241-1222 (904) 241-1222
--------- ----- ------------------------------------- -------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc INSTALL 13 FIXTURES
Permit Fee 126 . 00 Plan Check Fee . 00
Issue Date . Valuation . . . . 0
T
------- --------------t------------------------------------------------------
Special Notes and Comments
Approved by PW per providing an Erosion
and Sediment Control Plan.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 126 . 00 126 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 126 . 00 126 . 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.
BUTLDMG OFFICIAL
W06 uoijismboy :pue3 6506 seoueilddy
u• ., •,;
u
M�l
CITY OF ATLANTIC BEACH
PLUMBING PERMIT APPLICATION
Date: /' ` , (� j
Job Address:
Owner of Property:1 LL Telephone:
Plumbing Contractor:
Contractor's Address: /�% 7/ f %fid t �
Telephone: _ ��� / /i' Fax:
2:
=State License Number:
How many of the following fixtures (re-piped or newt'
Sinks Showers Water
Lavatory ,_Water Heaters f Hose Bib
^Bathtubs Dishwashers 1 Sewer
Urinals Disposals Other
Closets
. Washing Machine Shower Pans
Floor Drains Re-Pipe(List fixtures being re-piped)
Total Fixtures: x $7.00 + $35.00 = C� ' (Minimum Permit Fee: $35.00)
Signature of Contractor
Installation of plumbing and fixtures must be in accordance with the most recent edition of the
Southern Standard Plumbing Code.
Call a day ahead to schedule inspections: (904)247-5826
Ify
CITY OF ATLANTIC BEACH
IS 800 SEMINOLE ROAD
1 ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00027587 Date 3/23/04
Property Address . . . . . . 1859 FORSYTH CT
Tenant nbr, name . . . . . DPLX W/1857 RAD/SCHG 1105
Application description . . . TWO FAMILY RESIDENCE
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 59503
Owner Contractor
-
------------------------
- ----------------------
BEACHES HABITAT BEACHES HABITAT
1671 FRANCIS AVE . P .O. BOX 50939
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 241-1222 (904) 241-1222
--------------------------------- ------- ------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . .
Sub Contractor . . OCEAN STATE HEAT & AIR
Permit Fee . . . . 71 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
------- ---------------------------------------------------------------------
Special Notes and Comments
Approved by PW per providing an Erosion
and Sediment Control Plan.
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 71 . 00 71 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 71 . 00 71 . 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.
s
BUILDING FICIAL
J`�>> CITY OF ATLANTIC BEACH
MECHANICAL PERMIT APPLICATION
Date: 3 i8'v `/
Property Address:
Owner: " 4eK--,4-r /6�l�I"P`� 01 Telephone#:
Contractor: cQ.. 5 i 4 h,(ir"W<- Telephone #: -`4j-d?9
Contractor Address: /+'76 Fax#: -'-q 9 (f7YJ
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 City of Atlantic Beach ordinances and standards of
good practice listed therein.
Type of Heating Fuel: If other construction is being done on this building
or site,list the building permit number:
ie''Electric
❑ Gas: _LP _Natural _Central Utility O y„ 75477
❑ Oil
❑ Other–Specify
MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK
Cl'Heat _Space _Recessed _entral —Floor C>'Residential
Zr-Air Conditioning: _Room -Central
O—IIuct System: Material hickness ❑ Commercial
Maximum capacity edO cfm
❑ Refrigeration Z'�-New Building
❑ Cooling Tower: Capacity gpm ❑ Existing Building
❑ Fire Sprinklers:Number of Heads
❑ Elevator: Manlifi Escalator (Number) ❑ Replacement of Existing System
❑ Gasoline Pumps (Number)
❑ Tanks (Number} 3---'New Installation
❑ LPG Containers (Number) (No system previously installed)
❑ Unfired Pressure Vessel ❑ Extension or Add-on to Existing System
❑ Boilers
❑ Gas Piping ❑ Other-Specify
❑ Other–Specify
LIST ALL EQUIPMENT
AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving
Number Units Description Model# Manufacturer Ton's Agency
/ u✓ 02 y Z v`
HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving
Number Units Description Model# Manufacturer BTU's Agency
oZy
.TANKS Nominal Capacity Type Liquid Serial Approving
How Many &Dimensions Contained Manufacturer No. Agency
800 Seminole Road•Atlantic Beach, Florida 32233-5445
Phone: (904)247-5800• Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.us