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Permit 5815 Fleet Landing Blvd CITY OF ATLANTIC BEACH �• Y PERMIT CALCULATION SHEET ,s s-• y tl gni>� Date:., Address /7o SPECIAL NOTES WATER IMPACT FEE $ SEWER IMPACT FEE $ WATER METER/TAP $ �J);A CAPITAL IMPROVEMENT$ SEWER TAP $ �� SECTION H PAVING ( ) $ X_?b�_ CROSS CONNECTION $ OTHER $ GRAND TOTAL $_ T J' `} CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD =" ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-dept(q)coab.us Application Number . . . . . 07-00001707 Date 1/03/08 Property Address . . . . . . 5815 FLEET LANDING BLVD Application type description SINGLE FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 370000 ---------------------------------------------------------------------------- Application desc estate home ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ R. P.C. GENERAL CONTRACTORS 248 LEVY RD ATLANTIC BEACH FL 32233 (904) 241-4416 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 1270 . 00 Plan Check Fee 635 . 00 Issue Date . . . . Valuation . . 370000 Expiration Date . . 7/01/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS. 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . CITY RADON SURCHARGE . 53 CAPITAL IMPROVEMENT 325 . 00 ST. CONSTRUCTION SURCHARGE 9. 63 AB CONSTRUCTION SURCHARGE 1. 07 STATE RADON SURCHARGE 10 . 16 SEWER IMPACT FEES 1250 . 00 WATER IMPACT FEE 430 .00 WATER CROSS CONNECTION 35. 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1270 . 00 1270 . 00 . 00 .00 Plan Check Total 635 . 00 635 . 00 . 00 . 00 Other Fee Total 2061. 39 2061. 39 . 00 . 00 Grand-Total 3966 .39 3966. 39 . 00 . 00 PERMff AS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. City of Atlantic Beach Building Department Certificate of Occupancy This Certificate issued pursuant to the requirements of Section 110.2 of the Florida Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: Date: June 12, 2008 Contractor: R.P.C. General Contractors Address: 5815 Fleet landing Blvd., Atlantic Beach, F1 32233 Construction Type: Residential Occupancy Class: Group R-2 Permit Number: 07-1707 IHAEL:!GRIFFIN BUILDING OFFICIA Ski 5 i �i�°p p OMB No. 1660-0008 l.S.CLPARTMENT OF HOMELAND SECURITY ELEVA ��Ci'J CER tl IFIC 1 " Expires February 28, 2009 ederal Emergency i'Jtanagement Agency lationai Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For insurance.Company Use: Building Owner's Name Policy Number A 'CL Conti n U"1 liq ear c e-4 Land vij A2. Building Street Address(i hiding Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company MAIC Number Cm Fiee. n d in4 P51M LLnif *- 5W 1 City AA i an t•G ga ch State r—L- ZIP Code (� 9 OL 3 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) F4Firl 0f L-1-5 I s Z ;,:- _3 AtiPri: -5/� po2W.?e-s 7�n� A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) IC v� ?✓1 1 r n 1 A5. Latitude/Longitude:Lat. Long. Horizontal Datum: ❑NAD 1927 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number A8. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) V sq ft a) Square footage of attached garage 6 _sq ft b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade_ ('9 walls within 1.0 foot above adjacent grade U c) Total net area of flood openings in A8.b `�_ sq in c) Total net area of flood openings in A9.b a sq in SECTION B-FLOOD INSURANCE RATE MAP(FiRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3.State �-� i20ol-1 -®L4Z I- ��y� 1 f /arr`d B4.Map/Panel Number B5.Suffix B6.FIRM index B7.FIRM Panel B8.Flood 89,Base Flood Elevation(s)(Zone Date Effective/Revised Dategne(s) AO,}fie base flood depth) 310. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑FIS Profile ❑FIRM ❑Community Determined ❑Other(Describe) 311. indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑NAVD 1988 ❑Other(Describe) 312. Is the building located in a Coastal Barrier Resources.System(CBRS)area or Otherwise Protected Area(OPA)? []Yes No Designation Date n CBRS F�OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) :1. Building elevations are based on: ❑Construction Drawings* Building Under Construction' MK ZW Finished Construction *A new Elevation Certificate will be required when construction of the builamg is complete. ;2. Elevations—Zones Al-A30,AE,AH,A(with BFE),VE,V1430,V(with BFE),AR,ARIA,ARAE,AR/A1-A30,AP./AH,AR/AO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized Vertical Datum Conversion/Comments Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor) J U N'feet ❑meters(Puerto Rico only) b) Top of the next higher floor _ i Afeet ❑meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) At LXQ feet ❑meters(Puerto Rico only) d) Attached garage(top of slab) /(i C Q feet ❑meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building I U �feet E]meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) _. ®feet []meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) W) feet meters(Puerto Rico only) SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. ❑Check here if comments are provided on back of form.'Flo 0 Certifier's NameLicense Number (a tray C�_P,ls7 I Zo Title Company Name h `y `" State ZIP Code ^} ess /(1(/3 1A ��Cit "!Sr Saw yr�/L �• -3�'�ZI �� a, # 4 Signature n Date c Telephone =EMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions IMPORTANT: In these spaces,copy the corresponding information from Section A. For Insurance Company Use: Building Street Address(including Apt.,Unit,cel Suite,and/or Bldg, No.)or P.O.Route and Box No. Policy Number One FLUE 5!? ^}v State ZIP Code Company MAIC Number Ailu ni' c exctc:h 1. SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community official,(2)insurance agent/company,and(3)building owner. Comments Signature Date ❑ Check here if attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. if the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For items E1-E4,use natural grade,if available. Check the measurement used. in Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawi space,or enclosure)is _❑feet ❑meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is _❑feet ❑meters ❑above or ❑below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see paqe 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _❑feet ❑meters ❑above or U below the HAG. E3. Attached garage(top of slab)is ❑feet❑meters []above or ❑ below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _❑feet ❑meters ❑above or ❑below the HAG. ES. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑Yes ❑ No ❑Unknown. The local official must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,B,and E are correct to the best of my knowledge. iperty Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check he,if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in items G8.and G9. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2. ❑ A community official completed Section E for a building located in Zone A(vdthout a FEMA-issued or community-issued BFE)or Zone AO. G3. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: [] New Construction []Substantial improvement G8.Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum G9.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum 1-ocal Official's Name Title Community Name Telephone Signature Date "omments ❑Check here if attachments FEMA Form 81-31, February 2006 Replaces all previous editions Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit, Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number City State ZIP Code Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with; date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Leff Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. i i Building Photographs See Instructions for Item A6. For Insurance Company Use: Building Street Address(including Apt., Unit, Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number .City State ZIP Code Company NAiCNumber If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with; date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. CITY OF ATLANTIC BEACH PERMIT w ; . SJ BUILDING /ZONING DEPARTMENT APPLICATION# 000 Seminole Road Atlantic Beach,Florida 32233 E�Y'- � ` (904)247-5.00(904)247-5845 Faxv�.coab.us ,� APPLICATION TRACKING FORM REaUIRED DEPT: U Z / / Y N PLANNING Pr�°e;�� Address: �O /��% /9�fch'n4 �JC! Y G BUILDING _ Y I+1 PUBLIC WORKS ABpflIaCaHIl$o / I `--� Y PUBLIC UTILITIES ��_�£ Y NFIRE DEPT. Project: � Y N PUBLIC SAFETY w APPROVAL U❑ REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE: Z a Y N D.E.P HUFSTETLER C7 Y N S.i.R.W.M. CARPER Lu r Y N ARMY CORPS of ENG CARPER O Y N HOTELS&RESAURAN-rs HUFSTEfLER APPLICATION STATUS CIRCLE ONE: SITE BUILDING DA AP REVIEWED BY: INITIAL: D ,TE: ® 1 ST REV PLANNING ® ® 2ND REV Io I El I BUILDING PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® ® 3RD REV ,,,, •n � _ .._ w _ ,va__ea��__,e�---_..e.�—_a._....,,,.�......,. neR...... .,,,.,�•T„a,,,,,A 5crunxnm.a+m,mrnwam,saxnfta a�tafrtn tl-Ih+r� ��. CITY OF ATLANTIC BEACH =s; 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 07 OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPT@1COAB,US ` --'x=5791' BUILDING PERMIT APPLICATION DUVAL COUNTY 40 1OPOD . „; . t ;', ,.• 2 VALUA�TIDN OF WORK„dE Ire+ 3.,M FT.�yUNDERROOF LFT&1,b1!�E r Atlantic Beach, FL 32233/,) 01 G��d� 2at)Al0 G a 6.US AF STRUCTURE. ';. ,��.. 5. TkGAC DES,RRIPTION. ;'. „, , 'SS`gF WORK h, " �` , EYNEW BUILDING ❑DEMOLITION 9YRESIDENTIAL LOT_BLOCK_SUBDIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL T"DESCRIPIJQN OF WORK ❑ALTERATION ❑ACCESSORY BLDG. 8. 1RE%SP.RINKLE _ ❑REPAIR ❑POOL/SPA ❑YES la NIA ❑MOVE ❑OTHER ❑NO PROPERTXWNER CONTRACt'U1� .F; ro ARCHITECTI ETIGINEER3 , . ., .. 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: l�,Jpr_ML c-csrJT7 J O ti 4C-P Via£� j PPG '�Tl C"r r-00tl b14 - Ou//r 14,1 16.NAME: 24.LICENSEE NAME: r b tg = C—f w w Pc--TT--- )2Af-,DaJ OF:C r30->l 10.A DRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: �TLxln`G d -Fi t'�L 18.ADDRES : 26.ADDRESS: r 3rR�;r33 c� 8 L-cJy 'go to:k.,'�c� cSrrac-moi r4Ti,rTnrnc.OeWA4I F�- 3 33 Wfir- ee)eseupa 0+ 1,7A,01 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: FAX NO.: 27.OFFICE PHONE: 28.kX NO.: 91*-Q4&-910Q 1O Q� 4WI q 'F- 4I-Ll1417;0.p 13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: 576715-9-1u 14 EMAIL ADDRESS: 22.EMAIL ADDR SS: 30.EMAIL ADDRES C�t-i 1- ��/ PCE , )2-' G C- mrtvL� x1©�L� l ruf.� ct� a $FEE pFOTAHe r AW olti E DER .,..c sY t , ,,a .,BONDING CQM Y{`. "r MORTGAGE LENDER`''=0 a „ 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.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 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 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,Wells,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all 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. 222 WARNING TO OWNER: 222 YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST I SPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER or AGENT; x x `", � ,� wCONTRACT012 . . x .,tarva Pbwef of,gttomey or,A9ency Letter R99u'ved) -,� � ,. ` r.m� d Ilei O t ' U safr..,. Signed: Date: /41 ,6Signed: ' Date: /�� / DI �n t Before me this r -day f Clef x fk f 2007 in the county of Before mi? his day of r ti l+t 2007 in the county of Duval,State of ida,has p IV appeared Duval,State o oFida,,has-personally appeared ' herin by himself/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 F1n r 16k ,County of i tc%/a r N,,ott Public at Large,State of �tX i'3 County of Personally Known L�1 Personally Known ❑Produced Identification- ❑Produced Identificatio - Notary Signature: Notary Signature: ,a.urr r<""'"0"" Notary Public State of Florida 1 STACEY BROOKS ;.. ,�= Commission DD 671480 Q ElizabethTeske t��a` Expires August 11,2011 COAB FORM LD ED:�2xY�/z007 is 5/2009 415196 Bon W Th.Trty Fein lneurence 8063g$7p19 4/Q5/7009 Doc # 2007038237, OR BK 13790 Page 88, Number Pages: 3, Filed & Recorded 02/01/2007 at 04:03 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $27.00 THIS INSTRUMENT PREPARED BY AND RETURN TO: JOHN M.WELCH,JR.,Attorney Fla.Bar No.212873 Foley&Lardner LLP One Independent Dr.,Suite 1300 P.O.Box 240 Jacksonville,FL 32201-0240 Permit No.06-00033328 Tax Folio No.169384-0010 NOTICE OF COMMENCEMENT a STATE OF FLORIDA COUNTY OF DUVAL The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Section 713.13, Florida Statutes,the following information is stated in this Notice of Commencement. 1. Description of Property: See Exhibit A attached hereto. The street address of the property is: various 2. General Description of Improvement: Construction of residential buildings and activity center 3. Owner: Naval Continuing Care Retirement Foundation,Inc. One fleet Landing Boulevard Atlantic Beach,FL 32233 4. Owner's Interest in the Site of the Improvements: Fee simple owner. 5. Fee Simple Title Holder(if Other Than Owner): N/A 6. Contractor: RPC General Contractors,Inc. 248 Levy Road Atlantic Beach,FL 32233 7. Surety On Any Payment Bond: Not applicable 8. Any Person Making a Loan for the Construction of the Improvements: JACK.580322.1 OR BK 13790 PAGE 89 Wachovia Bank,National Association 225 Water Street,Third Floor Jacksonville,FL 32202 Attn: Lisa Braman and Lorraine Cross 9. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided in Section 713.13(1)(a)(7), Florida Statutes, which service shall constitute service upon Owner: None 10. In addition to himself, Owner designates the fallowing person to receive a copy of the lienor's notice as provided in Section 713.13(1)(b),Florida Statutes: a. Lender named in Paragraph 8 above. b. Contractor named in Paragraph 6 above. 11. Expiration Date of Notice of Commencement(the expiration date is two(2)years from the date of recording unless a different date is specified): Signed: NAV CONTINUING CARE RETIREMENT FOU TION,INC. By: J s rve Ex cutFve 'rector and Authorized Agent STATE OF FLORIDA COUNTY OF DUVAL Sworn to and subscribed before me this 29th day of January,2007,by John Meserve,Executive s Director and Authorized Agent of Naval Continuing Care Retirement Foundation, Inc., a Florida noj-for- ti profit corporation,on behalf of the corporation. Such person(notary must check applicable box)t7'is/are personally known to me;or O produced a current Florida drivers license as identification;or O produced as identification. [Affix Notary Seat] c✓ ,Lwwi-- A. %&r&dTftN.WyP.bkLWb.a.GAIL 4 TUFPEW (Print or type name] M�'OOMMISSIONIDD286M Notary Public,State of EXPIRES:FftM 19,20M Commission No. My Commission Expires: JACK.580322.1 OR BK 13790 PAGE 90 EXHIBIT A A PART OF THE ANDREW DEWEES GRANT, SECTION 37, AND SECTION 5, ALL IN TOWNSHIP 2 SOUTH,RANGE 29 EAST,CITY OF JACKSONVILLE AND THE CITY OF ATLANTIC BEACH, DUVAL COUNTY, FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCE AT THE SOUTHWEST CORNER OF THAT CERTAIN TRACT OF LAND TO THE CITY OF JACKSONVILLE, BY CONDEMNATION RESOLUTION NUMBER 70- 801-236,AND BEING RECORDED IN OFFICIAL RECORDS VOLUME 3202, PAGES 481 THROUGH 485 OF THE CURRENT PUBLIC RECORDS OF SAID COUNTY,SAID POINT ALSO BEING ON THE EASTERLY RIGHT-OF-WAY LINE OF MAYPORT ROAD AND/OR STATE ROAD NUMBER 101 (A 100 FOOT RIGHT-OF-WAY AS NOW ESTABLISHED); THENCE SOUTH 09°53'10" WEST, ALONG SAID EASTERLY RIGHT OF WAY LINE OF MAYPORT ROAD, A DISTANCE OF 850.00 FEET TO A POINT ON SAID EASTERLY RIGHT-OF-WAY LINE; THENCE LEAVING SAID RIGHT-OF-WAY LINE RUN NORTH 88055'40"EAST,A DISTANCE OF 534.02 FEET TO THE POINT OF BEGINNING FOR THIS DESCRIPTION; THENCE NORTH 14°16'44" WEST, A DISTANCE OF 1.07 FEET; THENCE NORTH 01°04'20"WEST, A DISTANCE OF 119.40 FEET TO THE SOUTHWEST CORNER OF LOT 1, COURTYARDS AT MAYPORT, AS RECORDED IN PLAT BOOK 49,PAGES 67 THROUGH 67C OF SAID CURRENT PUBLIC RECORDS; THENCE NORTH 88155'40" EAST, ALONG THE SOUTH LINE OF SAID PLAT, A DISTANCE OF 598.78 FEET TO THE SOUTHEAST CORNER OF LOT 13 OF SAID PLAT; THENCE SOUTH 09'53'10" WEST, A DISTANCE OF 1158.12 FEET TO A POINT ON THE SOUTH LINE OF SAID SECTION 5, TOWNSHIP 2 SOUTH, RANGE 29 EAST; THENCE SOUTH 89°23'12"WEST ALONG THE SOUTH LINE OF SECTION 5,A DISTANCE OF 482.25 FEET; THENCE NORTH 09°53'10" WEST, DEPARTING SAID Al. SOUTHERLY SECTION LINE, A DISTANCE OF 361.90 FEET TO A POINT OF INTERSECTION WITH THE SOUTHERLY RIGHT-OF-WAY LINE OF MAYPORT CROSSING BOULEVARD (A VARIABLE WIDTH PUBLIC RIGHT-OF-WAY); THENCE ALONG AND AROUND A CURVE IN SAID RIGHT-OF-WAY LINE CONCAVE WESTERLY AND HAVING A RADIUS OF 50.00 FEET FOR AN ARC DISTANCE OF 157.08 FEET TO THE WESTERLY LINE OF LANDS DESCRIBED AND RECORDED IN OFFICIAL RECORDS VOLUME 6032, PAGE 199, OF SAID CURRENT PUBLIC RECORDS, THE ARC OF LAST SAID CURVE BEING SUBTENDED BY A CHORD BEARING AND DISTANCE OF NORTH 09053'10"EAST,A DISTANCE OF 100.00 FEET; RUN THENCE NORTH 09053'10"EAST ALONG THE EASTERLY BOUNDARY OF LAST SAID LANDS, A DISTANCE OF 569.61 FEET TO THE NORTHEAST CORNER OF SAID LANDS DESCRIBED IN AFORESAID OFFICIAL RECORDS VOLUME 6378, PAGE 657; THENCE SOUTH 88055'40" WEST, A DISTANCE OF 92.23 FEET TO THE POINT OF BEGINNING. JACK.580963.1 ,f K ,tl CITY Oft'ATLANTIC C B ACH PERMIT BIDING /ZONIING DE+PAR NT APPLICATION # 000 Seminole Road Atlantic Beach,Florida 32233 D ,lar (904)247-5800 a / 7a (904)247-5845 Fax www.coab.us APPLICATION TRACKING FORM RE IRED DEPT: U Y N PLANNING Property Address: ,O �� /��% �y,,c4„4 ��i/c� z Y �i BUILDING Y N PUBLIC WORKS Applicant: 0 7-y PUBLIC UTILITIES Y N FIRE DEPT. Project:ject: T� �fi Y N PUBLIC SAFETY APPROVAL !LJ v 0 REQUIRED AGENCY: RECEIVED BY: WITIAL: DATE: UJ 1-r- Y N D.E.P HUFSTETLER C7= < Y N S.J.R.W.M. CARPER zY N ARMY CORPS of ENG CARPER O Y N HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS CIRCLE ONE: SITE BUILDING DA AP REVIEWED BY: (J)INITIA : DTE: 1 ST REV PLANNING ® ® BUILDING 2ND REV PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® ® 3RD REV 11 11 �°ieturu this form to the D6lIItlfl ins Department once you have entered your comments into the AS400. OR BK 13790 PAGE 89 Wachovia Bank,National Association 225 Water Street,Third Floor Jacksonville,FL 32202 Attn: Lisa Braman and Lorraine Cross 9. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided in Section 713.13(1)(a)(7), Florida Statutes, which service shall constitute service upon Owner: None 10. In addition to himself, Owner designates the following person to receive a copy of the lienor's notice as provided in Section 713.13(1)(b),Florida Statutes: a. Lender named in Paragraph 8 above. b. Contractor named in Paragraph 6 above. 11. Expiration Date of Notice of Commencement(the expiration date is two(2)years from the date of recording unless a different date is specified): Signed: NAV CONTINUING CARE RETIREMENT FOU IDN,INC. By: J s rve Ex cu live 'rector and Authorized Agent STATE OF FLORIDA COUNTY OF DUVAL Sworn to and subscribed before me this 29th day of January,2007,by John Meserve,Executive .r Director and Authorized Agent of Naval Continuing Care Retirement Foundation, Inc., a Florida nol-for- `) profit corporation,on behalf of the corporation. Such person(notary must check applicable box)121s/are personally known to me;or❑produced a current Florida driver's license as identification;or O produced as identification. QQ,, [Affix Notary Seal] OQV, CIAIL No SI TURP t or type name] = MYCOMMAMIIBSIDN1Do6525 Notary Public,State of EXPIRM-ftnim19,2= Commission No. (, BudMThv NohryPWelhgMniYn My Commission Expires: JACK.5B0322.1 OR BK 13790 PAGE 90 EXHIBIT A A PART OF THE ANDREW DEWEES GRANT, SECTION 37, AND SECTION 5, ALL IN TOWNSHIP 2 SOUTH,RANGE 29 EAST, CITY OF JACKSONVILLE AND THE CITY OF ATLANTIC BEACH, DUVAL COUNTY, FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCE AT THE SOUTHWEST CORNER OF THAT CERTAIN TRACT OF LAND TO THE CITY OF JACKSONVILLE, BY CONDEMNATION RESOLUTION NUMBER 70- 801-236,AND BEING RECORDED IN OFFICIAL RECORDS VOLUME 3202, PAGES 481 THROUGH 485 OF THE CURRENT PUBLIC RECORDS OF SAID COUNTY, SAID POINT ALSO BEING ON THE EASTERLY RIGHT-OF-WAY LINE OF MAYPORT ROAD AND/OR STATE ROAD NUMBER 101 (A 100 FOOT RIGHT-OF-WAY AS NOW ESTABLISHED); THENCE SOUTH 09°53'10" WEST, ALONG SAID EASTERLY RIGHT OF WAY LINE OF MAYPORT ROAD, A DISTANCE OF 850.00 FEET TO A POINT ON SAID EASTERLY RIGHT-OF-WAY LINE; THENCE LEAVING SAID RIGHT-OF-WAY LINE RUN NORTH 88055'40"EAST,A DISTANCE OF 534.02 FEET TO THE POINT OF BEGINNING FOR THIS DESCRIPTION; THENCE NORTH 14116'44" WEST, A DISTANCE OF 1.07 FEET; THENCE NORTH 01104'20"WEST, A DISTANCE OF 119.40 FEET TO THE SOUTHWEST CORNER OF LOT 1, COURTYARDS AT MAYPORT, AS RECORDED IN PLAT BOOK 49,PAGES 67 THROUGH 67C OF SAID CURRENT PUBLIC RECORDS; THENCE NORTH 88155'40" EAST, ALONG THE SOUTH LINE OF SAID PLAT, A DISTANCE OF 598.78 FEET TO THE SOUTHEAST CORNER OF LOT 13 OF SAID PLAT; THENCE SOUTH 09°53'10"WEST, A DISTANCE OF 1158.12 FEET TO A POINT ON THE SOUTH LINE OF SAID SECTION 5, TOWNSHIP 2 SOUTH, RANGE 29 EAST; THENCE SOUTH 89°23'12"WEST ALONG THE SOUTH LINE OF SECTION 5, A DISTANCE OF 482.25 FEET; THENCE NORTH 09°53'10" WEST, DEPARTING SAID SOUTHERLY SECTION LINE, A DISTANCE OF 361.90 FEET TO A POINT OF INTERSECTION WITH THE SOUTHERLY RIGHT-OF-WAY LINE OF MAYPORT CROSSING BOULEVARD (A VARIABLE WIDTH PUBLIC RIGHT-OF-WAY); THENCE ALONG AND AROUND A CURVE IN SAID RIGHT-OF-WAY LINE CONCAVE WESTERLY AND HAVING A RADIUS OF 50.00 FEET FOR AN ARC DISTANCE OF 157.08 FEET TO THE WESTERLY LINE OF LANDS DESCRIBED AND RECORDED IN OFFICIAL RECORDS VOLUME 6032, PAGE 199, OF SAID CURRENT PUBLIC RECORDS, THE ARC OF LAST SAID CURVE BEING SUBTENDED BY A CHORD BEARING AND DISTANCE OF NORTH 09053'10"EAST,A DISTANCE OF 100.00 FEET; RUN THENCE NORTH 09°53'10"EAST ALONG THE EASTERLY BOUNDARY OF LAST SAID LANDS,A DISTANCE OF 569.61 FEET TO THE NORTHEAST CORNER OF SAID LANDS DESCRIBED IN AFORESAID OFFICIAL RECORDS VOLUME 6378, PAGE 657; THENCE SOUTH 88055'40" WEST, A DISTANCE OF 92.23 FEET TO THE POINT OF BEGINNING. JACK.580963A r t CITY OF ATLANTIC BEACH _ 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 O• ( I I OFFICE:(904)247-5826•FAX NO.:(904)247-5845 ` BUILDING-DEPT@COAB.US ~=' =i= BUILDING PERMIT APPLICATION DUVAL COUNTY 2lALUATION OF WOR,K� ' 3.SO.FT._4NDERIROOP. . ,&A At1a tic Beach, FL 32233(f7 3 0,Z'C , �4 LEGAL DESCRIPTJON,z�s. ' ;... <'=, 8. SS OF.WORK G,.,.�u„' �;� 6:"US .AE STRUCTURE. �tTf p_J37c+v,5 NEW BUILDING ❑DEMOLITION RESIDENTIAL LOT-BLOCK_SUBDIVISION Lu/.JSt<t1P2 CN- ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL ixC„j'DESCRIPTION EDF WORK., :.w., w. > �s.:%;, ,. ., ..•- < + ❑ALTERATION 13 ACCESSORY BLDG. 8.(;1RE;SPRINYLE /r _ ❑REPAIR ❑POOL/SPA ❑YES N/A G27;r_�, I DUMC ❑MOVE ❑OTHER ❑NO } ,, PROPERTYiOWNER. CONTRACTOR r., � ,,, ..1 ARCHITECTJaENGINEER..: 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: ,Ji,wnL (.DAtrj f t?i f��.P iii iE PC, C`�,J�zHv C,WrVWC�C t'3E f IfULL 7 j Qom//�7l 1 r FQV 1Ub 19T7 OA1, l de. 16.NAME: 24.LICENSEE NAME: C b ,0 1h x-r PE-� f �a�' yr S 07-1 cf rr �,3 2 t.1'►� M► l7U 10.A DRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: OA16 r��s-r�,`b iAJ6 �s �, G 0��10� R�llrllo 18.ADDRE 26.ADDRESS: 3aai33 60 to n1Cr cSTYze�� Wr+�-119ek5ourz 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28. AX NO.: �iD,V-- q,700ro -_q�. q4 �' ,,41.µy1 e1Q4-Ag1I 4#a'7 13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: 5 !1 !1 14.EMAIL ADDRESS: 22.EMAIL ADDR SS: 30.EMAIL ADDRES C Yrr`3'"Jact PCS QP G. c &V u- �JDptezg L-.itD a FEE S,F o�ER7 OW,EF ER _ ;> a ; BONDING COM+ANY ' ( MORTGAGE LENDER; 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.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 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 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,Wells,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all 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. 222 WARNING TO OWNER: 222 YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST ISPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. eONTRACTOR p4wer of'Atiomay or Agency'Letter Required);; Signed: Date: /162 ✓1 r/167 Signed: f / Date: /' / `l Before me this day f Vey A/; d1> 2007 in the county of Before m6 his J ay of Ff_ 7 l QLP% ,2007 in the county of Duval,State ofida,has p sonally appeared Duval,State o lerida,.has-personally appeared PCre� ;2oD,z,'c-7L)E�S herin by himself/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 Fln r•1'k ,County of Q u✓a t IN ta' Public at Large,State of FI-t_V%4 OPCounty of /)L)`�!-j"L Personally Known Personally Known ❑Produced Identification- n _ ❑Produced Identificatio - Notary Signature: Notary Signature: gin �,.►AY p`°4� Notary Public State of Florida l '1� STACEY BROOKS DD 671480 Elizabeth Teske ' Expires August 11,2011 �M,y��fission DD41519ti ,Pf Z^c ' Expires AugBwxWThruTmy ust It 11,2011&7 19 COAB FORM LD ED: t �l�es tJ�tf0S(ZOO9 Doc # 2007038237, OR BK 13790 Page 88, Number Pages: 3, Filed & Recorded 02/01/2007 at 04:03 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $27.00 THIS INSTRUMENT PREPARED BY AND RETURN TO: JOHN M.WELCH,JR.,Attorney Fla.Bar No.212873 Foley&Lardner LLP One Independent Dr.,Suite 1300 P.O.Box 240 Jacksonville,FL 32201-0240 Permit No.06-00033328 Tax Folio No.169384-0010 NOTICE OF COMMENCEMENT 0 STATE OF FLORIDA COUNTY OF DUVAL The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Section 713.13, Florida Statutes,the following information is stated in this Notice of Commencement. 1. Description of Property: See Exhibit A attached hereto. The street address of the property is: various 2. General Description of Improvement: Construction of residential buildings and activity center 3. Owner: Naval Continuing Care Retirement Foundation,Inc. One fleet Landing Boulevard Atlantic Beach,FL 32233 4. Owner's Interest in the Site of the Improvements: Fee simple owner. 5. Fee Simple Title Holder(if Other Than Owner): N/A 6. Contractor: RPC General Contractors,Inc. 248 Levy Road Atlantic Beach,FL 32233 7. Surety On Any Payment Bond: Not applicable 8. Any Person Making a Loan for the Construction of the Improvements: JACK.580322.1 ,3 vll WATER IMPACT FEE WORKSHEET, . ADDRESS: / U7 DRAINAGE FIXTURE UN17 F MRE'TYP.E VALUE AS LOAD FXMR.ES UN(TS Automatic clothes washers commercial 3 Automatic•dbthes washes,residential 2 Bathroom group consisting of water closet,lavatory, Bidet, and bathtub or shower 6 Bathtub(with or without overhead shower or whirlpool attachments) 2 Bidet 2 Combination sink and tray 2 Dental lavatory Dishwashing machine, domestic 2 FDn'nk',,n fountalr0cemaker h drains 2 bib 1 .2 "y1chen sink, domestic 2 s. Kitchen.sink,dorrxzk with food waste grinder and/or / dishwasher 2 P Laun dry tray 1 or 2 co artrtw s 2 Lavatory1 Shower com wlrnent domestic 2 i Sink 2 I Uftal 4 Urinal, 1 gallon per flush or less ' ,t '2 + Wash sink circular or multiple)each set of faucets 2 Water dose/, flushometer tank, pbbflc or prtyaLs 4 Water dost private Installation 4 U Water closet, pubAc installation 6 TOTAL NUMBER OF UN[TS� MULTIPUED X 24 TOTAL'$ CITY OF ATLANTIC BEACH x:.•J BUILDING l ZONING DEPARTMENT APPLICATION # 000 Seminole Road r= Atlantic Beach,Florida 32233 (904)247-5000 (904)247-5045 Fax www.coab.us APPLICATION TRACKING FORM RE-WIRED DEPT: v Y N PLANNING C% Property Addrew Ljg,,o�,'n4 ��J c� � Y NBUDDING N PUBLIC WORKS Applicant: /`/ 01 Y PUBLIC UTILITIES � Y m FIRE DEPT. Project: &127TE, # -r»i,: Y N PUBLIC SAFE=TY L APPROVAL w U n REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE: Z uJ Y. N D.E.P HUFSTETLER C9 a -Y N S.J.R.W.M_ CARPER = Y N ARMY CORPS of ENG CARPER Y N HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS CIRCLE ONE: SITE BUILDING DA AP REVIEWED BY: INE L: D4TE: 0-" 1 ST REV ® Ejr - �f r,J Z_ 70b T7-1 6 ��l G /fin PLANNING BUILDIN ® 2ND RE PUBLIC WORKS A PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® ® 3RD ,.,. ,n . a. _ •._ ,.x._ am___aa•�_15T_��_.A�.,....-0...,....,...e,..., . 4e c..nr,n un,.ah,n,iwm.,s�l tisr,rnsnm+n aTmOl1WFTIEPlnffQ i"f n fhP A946091_ CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 n OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILD ING-DEPT@COAB.US - F+= ' BUILDING PERMIT APPLICATION DUVAL COUNTY a�OBRDDR��S nqs„ ,S. r Ja r hYJrd IQM Ofi Wp,R1C x "ii.°, 'l`i!F : 3.SQTr t1NDawR `' g/ - F1 L,1rfYsr/7PiD%X/x Atlan�tici Beach, FL 3223312-; 0 e,00, ., A10 '4DSCRIPTION, ' .4O R! UCTtRE:' jEC.:T7 Lr'J 37 co-S EYINEW BUILDING ❑DEMOLITION KYRESIDENTIAL LOT_BLOCK_SUBDIVISION L.y).JSMP2 p ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL RtPt'� CpFItMEALTERATION ❑ACCESSORY BLDG. k 0 _ ❑REPAIR ❑POOL/SPA ❑YES ONIA ❑MOVE ❑OTHER 113 NO PROPS . Mi�n� �' ' � ..cON , rARGHITErte/ 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: Oewft.- c-Oki ' .i ui ti.IC,C-PTA .I )2 PC, C E)JMeJi C,WrP-lac /JOE �fZ�L.L �-rl 2-%.1C-xtr FC)L-)k ORrr OAf I Ide- 16.NAME: 24.LICENSEE NAME: , 8 : f2er P 10.A DRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: ONE rZC�f'L /Zj ia�-/��ta/D, cae, 0 DU) /r/ 18.ADDRE 26.ADDRESS: 3a�t�3 AAJO &0 ick ice/�/t� 6ML-Ei raTzMM r7l 13 c44, PP- 3A-A33 Gr�r';�hes/6t), P /'IQot 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28. AX NO.: �a� � t� 99Do D#• )•,44A'1 7/ •d �� 'IJ�• trd Cv©3! 13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDR SS: 30.EMAIL ADDRES ' ceM POSE G '1 M&02-L :t C� nJc)ft JIVLA-.r-o EEaIMPLF� 1 I.I (tfir " SpNI}11` C1 M1 9 "tr M4RCLs'AVCsE a t; ',0 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.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 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 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,Wells,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all 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. 222 WARNING TO OWNER: 222 YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 'Iii Signed: Date: /a d 7 Signed: ? Date: /• / D'1 Before me this day f 0-.c taut 2007 in the county of Before m is day of A - 2007 in the county of Duval,State of da,has p sonally appeared Duval,State o Sbnally appeared herin by himself/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 r10 r i�k ,County of Q 4✓A I Not Public at Large,State of ►Z-L '�6 County of Personally Known ❑/Personally Known ❑Produced Identification- ❑Prq�gty��f Identificatio - Notary Signature: �- Notary Signature: r aim STACEY BROOKS �.►'��re`o4 Notary Public State of Florida ='� '= Commission DD 671480 $R Expires August 11,2011 Elizabeth Teske 4 ,�. • M �pp ission DD415196 COABFORM LD ED:'�y /2 ''rljf;,. BaM�dTluuTmyFolnMeuenpB003BS7t119 E �Iress 04/05/2009 Doc # 2007038237, OR BK 13790 Page 88, Number Pages: 3, Filed & Recorded 02/01/2007 at 04:03 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $27.00 THIS INSTRUMENT PREPARED BY AND RETURN TO: JOHN M.WELCH,JR.,Attorney Fla.Bar No.212873 Foley&Lardner LLP One Independent Dr.,Suite 1300 P.O.Box 240 Jacksonville,FL 32201-0240 Permit No.06-00033328 Tax Folio No.169384-0010 NOTICE OF COMMENCEMENT v STATE OF FLORIDA COUNTY OF DUVAL The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Section 713.13, Florida Statutes,the following information is stated in this Notice of Commencement. 1. Description of Property: See Exhibit A attached hereto. The street address of the property is: various 2. General Description of Improvement: Construction of residential buildings and activity center 3. Owner: Naval Continuing Care Retirement Foundation,Inc. One fleet Landing Boulevard Atlantic Beach,FL 32233 4. Owner's Interest in the Site of the Improvements: Fee simple owner. 5. Fee Simple Title Holder(if Other Than Owner): N/A 6. Contractor: RPC General Contractors,Inc. 248 Levy Road Atlantic Beach,FL 32233 7. Surety On Any Payment Bond: No(applicable 8. Any Person Making a Loan for the Construction of the Improvements: JACK.580322.1 OR EK 13790 PAGE 89 Wachovia Bank,National Association 225 Water Street,Third Floor Jacksonville,FL 32202 Attn: Lisa Braman and Lorraine Cross 9. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided in Section 713.13(1)(a)(7), Florida Statutes, which service shall constitute service upon Owner: None 10. In addition to himself, Owner designates the following person to receive a copy of the lienor's notice as provided in Section 713.13(1)(b),Florida Statutes: a. Lender named in Paragraph 8 above. b. Contractor named in Paragraph 6 above. 11. Expiration Date of Notice of Commencement(the expiration date is two(2)years from the date of recording unless a different date is specified): Signed: NAVAL CONTINUING CARE RETIREMENT FOlExauttiver ION,INC. By rve 'rector and Authorized Agent STATE OF FLORIDA COUNTY OF DUVAL Sworn to and subscribed before me this 29th day of January,2007,by John Meserve,Executive Director and Authorized Agent of Naval Continuing Care Retirement Foundation, Inc., a Florida n($-for- profit corporation,on behalf of the corporation. Such person(notary must check applicable box) is/are personally known to me;or O produced a current Florida driver's license as identification;or O produced as identification. [Affix Notary Seal] 0JI� rd+ULQ N#DDMM [Print ry type name] MYCOIdMI8SI0N�DNotary Public,State of EORES:F&umyCommission No. My Commission Expires: JACK.580322.1 OR BK 13790 PAGE 90 EXHIBIT A A PART OF THE ANDREW DEWEES GRANT, SECTION 37, AND SECTION 5, ALL IN TOWNSHIP 2 SOUTH, RANGE 29 EAST,CITY OF JACKSONVILLE AND THE CITY OF ATLANTIC BEACH, DUVAL COUNTY, FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCE AT THE SOUTHWEST CORNER OF THAT CERTAIN TRACT OF LAND TO THE CITY OF JACKSONVILLE, BY CONDEMNATION RESOLUTION NUMBER 70- 801-236,AND BEING RECORDED IN OFFICIAL RECORDS VOLUME 3202, PAGES 481 THROUGH 485 OF THE CURRENT PUBLIC RECORDS OF SAID COUNTY, SAID POINT ALSO BEING ON THE EASTERLY RIGHT-OF-WAY LINE OF MAYPORT ROAD AND/OR STATE ROAD NUMBER 101 (A 100 FOOT RIGHT-OF-WAY AS NOW ESTABLISHED); THENCE SOUTH 09°53'10" WEST, ALONG SAID EASTERLY RIGHT OF WAY LINE OF MAYPORT ROAD, A DISTANCE OF 850.00 FEET TO A POINT ON SAID EASTERLY RIGHT-OF-WAY LINE; THENCE LEAVING SAID RIGHT-OF-WAY LINE RUN NORTH 88055'40" EAST,A DISTANCE OF 534.02 FEET TO THE POINT OF BEGINNING FOR THIS DESCRIPTION; THENCE NORTH 14°16'44" WEST, A DISTANCE OF 1.07 FEET; THENCE NORTH 01°04'20"WEST, A DISTANCE OF 119.40 FEET TO THE SOUTHWEST CORNER OF LOT 1, COURTYARDS AT MAYPORT, AS RECORDED IN PLAT BOOK 49,PAGES 67 THROUGH 67C OF SAID CURRENT PUBLIC RECORDS; THENCE NORTH 88°55'40" EAST, ALONG THE SOUTH LINE OF SAID PLAT, A DISTANCE OF 598.78 FEET TO THE SOUTHEAST CORNER OF LOT 13 OF SAID PLAT; THENCE SOUTH 09°53'10"WEST, A DISTANCE OF 1158.12 FEET TO A POINT ON THE SOUTH LINE OF SAID SECTION 5, TOWNSHIP 2 SOUTH, RANGE 29 EAST; THENCE SOUTH 89°23'12"WEST ALONG THE SOUTH LINE OF SECTION 5, A DISTANCE OF 482.25 FEET; THENCE NORTH 09153'10" WEST, DEPARTING SAID SOUTHERLY SECTION LINE, A DISTANCE OF 361.90 FEET TO A POINT OF INTERSECTION WITH THE SOUTHERLY RIGHT-OF-WAY LINE OF MAYPORT CROSSING BOULEVARD (A VARIABLE WIDTH PUBLIC RIGHT-OF-WAY); THENCE ALONG AND AROUND A CURVE IN SAID RIGHT-OF-WAY LINE CONCAVE WESTERLY AND HAVING A RADIUS OF 50.00 FEET FOR AN ARC DISTANCE OF 157.08 FEET TO THE WESTERLY LINE OF LANDS DESCRIBED AND RECORDED IN OFFICIAL RECORDS VOLUME 6032, PAGE 199, OF SAID CURRENT PUBLIC RECORDS, THE ARC OF LAST SAID CURVE BEING SUBTENDED BY A CHORD BEARING AND DISTANCE OF NORTH 09053'10"EAST,A DISTANCE OF 100.00 FEET; RUN THENCE NORTH 09053'10"EAST ALONG THE EASTERLY BOUNDARY OF LAST SAID LANDS, A DISTANCE OF 569.61 FEET TO THE NORTHEAST CORNER OF SAID LANDS DESCRIBED IN AFORESAID OFFICIAL RECORDS VOLUME 6378, PAGE 657; THENCE SOUTH 88055'40" WEST, A DISTANCE OF 92.23 FEET TO THE POINT OF BEGINNING. JACK.580963.1 r y Y ,; P:. 1 E ,P r i 1J1'ri CITY OF ATLAN'T'IC BEACH PERMIT �. .,,•. BUILDING /ZONING DEPARTAIENT APPLICATION# ' 000 Seminole Road Atlantic Beach,Florida 32233 (904)247- 800 (904)247-5845 Fax vvww.coab.us APPLICATION TRACKING FORM RE IRED DEPT: /4 / Y N PLANNING Property A¢�H�Y"e��e �� /��% L�/�c4 n 4 �/✓C� z Y N' BUILDING Y N PUBLIC WORKS Applicant: 0 Y PUBLIC UTILITIES ��T£ Y MFIRE DEPT. Project: �� Y N PUBLIC SAFETY w APPROVAL 0❑ REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE: Z Lu Y M D.E.P HUFSTETLER C7 < Y N S.J.R.W.M. CARPER _ Y N ARMY CORPS of ENG CARPER O Y N HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS CIRCLE ONE: SITE BUILDING DA AP R ED BY: INITIAL: DTE: ® ® 1ST REV 9DI ® ® 2ND REV PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® ® 3RD REV ,r,. ,n . m _ .._ aA__ 'mA__°A9°__l5T_.�..,..A.-.,.-6.........,e......... 16e...,,... .wnn�r..ntwm„t�•ttmTA n•d+,rtTirtV0.4FdR A¢HA f�'Q Eiipl�'!(A'�RRIFb F:0.�F:41��_ CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 O _ •7 I ( ) I I sy OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BU ILD I NG-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY 1 JOBIADDRESS; 2 VAL :. .FT.UNDERf ., Atlantic Beach, FL 32233 �� `?4,LEGAL DESCRIPTION.. 5 C SS OK WORK L`i ? u l 6;US OF STRUCTURE:: t ... �s ,,, -r:. , ,JeG--n of-J,3 7 UINEW BUILDING ❑DEMOLITION 1131RESIDENTIAL LOT_BLOCK_SUBDIVISION LL: JS)ijp2 c5041 ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7:'DESCRIP'rION_OF WORK",,: ,. ❑ALTERATION ❑ACCESSORY BLDG. 8.F1RE.SPRINKLE ❑REPAIR ❑POOL/SPA ❑YES 0 N/A ❑MOVE ❑OTHER ❑NO r PROPERTY OWNER ..- CONTRACTOR, i;s ,:ARCHITECT/ENGINEER..c >€ 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: rJfWML "Airi J 01,;J111,C - 2 PG ce JfD f.L 'Tlh�G7t I7�FOLJAJ�RT7(�d/r 141C. 16.NAME: 24.LICENSEE NAME: b 8 FLEer"L4-W for more12�t�� 'C� oc--Q cm-n7 (3&�eLi K 16.A DRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: f1TLrjxl r7 G a18.ADDRES : 26.ADDRESS: 3aa3 3 J146 L-c✓,/P-� 60 to..k j'&Iq (s r aee �z�'-m ri c..��,a-c.��, �z 3��33 E'�-ir�a-!►�`�5�3�2 PH- l�l' l 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28. AX NO.: `D*-a41--1,7 c) 9© 9 g1Di`-' 41.41 74, 1/& 717• a4l-dl (aD3( 13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: 904, 516715-111u 14.EMAIL ADDRESS: 22.EMAIL ADDR SS: 30.EMAIL ADDRES C'.J17�7U✓1C-�2tt +��C�� PC-� 2J-' G e�� mrtvLL ��It�Et.��21-tvi-L- FEE$FoPHERmlaruowNERDER BONDING COMPANYnktV`�F N MORTGAGELENDER 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.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 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 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,Wells,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all 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. 222 WARNING TO OWNER: 222 YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST I SPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER orAGENTCONTRACTOR g Power of Atto`mey br Agency Letter Re9uifecl v, Signed: Date: /-Id I7 Signed. Date: /' / 01 Before me thisWida, day f b-,e ex 6c; 2007 in the county of Before m� his / day of 0 r'- /Q'_ 2007 in the county of Duval,State ofasp sonally appeared Duval,State o egda,.has•pers`onally appeared herin by himself/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 r10 P' ,County of Q ce V A f Notayy Public at Large,State of n- tom?%6ecounty of bL)V!�Z Personally Known 10 Personally Known ❑Produced Identification- ❑Produced Identificatio - Notary Signature: Notary Signature: a+KK STACEY BROOKS 201r�Y"Ge4n Notary Public State of Florida Commission DD 671480 Elizabeth Teske Expires August 11,2011 MY/$jglission DD415196 COABFORM LD Elizabeth tyres 4/05/2009 ps;,, �` B=WThiuTmyFWnImffanwW0--36557019 Doc # 2007038237, OR BK 13790 Page 88, Number Pages: 3, Filed & Recorded 02/01/2007 at 04:03 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $27.00 THIS INSTRUMENT PREPARED BY AND RETURN TO: JOHN M.WELCH,JR.,Attomey Fla.Bar No.212873 Foley&Lardner LLP One Independent Dr.,Suite 1300 P.O.Box 240 Jacksonville,FL 32201-0240 Permit No.06-00033328 Tax Folio No.169384-0010 NOTICE OF COMMENCEMENT a STATE OF FLORIDA COUNTY OF DUVAL The undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with Section 713.13, Florida Statutes,the following information is stated in this Notice of Commencement. 1. Description of Property: See Exhibit A attached hereto. The street address of the property is: various 2. General Description of Improvement: Construction of residential buildings and activity center 3. Owner: Naval Continuing Care Retirement Foundation,Inc. One fleet Landing Boulevard Atlantic Beach,FL 32233 4. Owner's Interest in the Site of the Improvements: Fee simple owner. 5. Fee Simple Title Holder(if Other Than Owner): N/A 6. Contractor: RPC General Contractors,Inc. 248 Levy Road Atlantic Beach,FL 32233 7. Surety On Any Payment Bond: Not applicable 8. Any Person Making a Loan for the Construction of the Improvements: JACK.580322.1 OR BK 13790 PAGE 89 Wachovia Bank,National Association 225 Water Street,Third Floor Jacksonville,FL 32202 Attn: Lisa Braman and Lorraine Cross 9. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided in Section 713.13(1)(a)(7), Florida Statutes, which service shall constitute service upon Owner: None 10. In addition to himself, Owner designates the following person to receive a copy of the lienor's notice as provided in Section 713.13(1)(b),Florida Statutes: a. Lender named in Paragraph 8 above. b. Contractor named in Paragraph 6 above. 11. Expiration Date of Notice of Commencement(the expiration date is two(2)years from the date of recording unless a different date is specified): Signed: NAV CONTINUING CARE RETIREMENT FOU TION,INC. \�' — By: J srve Ex cudve lector and Authorized Agent STATE OF FLORIDA COUNTY OF DUVAL Swom to and subscribed before me this 29th day of January,2007,by John Meserve,Executive Director and Authorized Agent of Naval Continuing Care Retirement Foundation, Inc., a Florida no)-for- profit corporation,on behalf of the corporation. Such person(notary must check applicable box) is/are personally known to me;or❑produced a current Florida driver's license as identification;or❑produced as identification. [Affix Notary Seal] �f y "La TURPEN [Print or type name] WOOMMIBSIONIDD2B65E5 Notary Public,State of EXPIREB:Fftgg19,20W Commission No. Th"Na°ryR°1e�dx"�Y° My Commission Expires: JACK.580322.1 OR BK 13790 PAGE 90 EXHIBIT A A PART OF THE ANDREW DEWEES GRANT, SECTION 37, AND SECTION 5, ALL IN TOWNSHIP 2 SOUTH,RANGE 29 EAST, CITY OF JACKSONVILLE AND THE CITY OF ATLANTIC BEACH, DUVAL COUNTY, FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCE AT THE SOUTHWEST CORNER OF THAT CERTAIN TRACT OF LAND TO THE CITY OF JACKSONVILLE, BY CONDEMNATION RESOLUTION NUMBER 70- 801-236,AND BEING RECORDED IN OFFICIAL RECORDS VOLUME 3202, PAGES 481 THROUGH 485 OF THE CURRENT PUBLIC RECORDS OF SAID COUNTY, SAID POINT ALSO BEING ON THE EASTERLY RIGHT-OF-WAY LINE OF MAYPORT ROAD AND/OR STATE ROAD NUMBER 101 (A 100 FOOT RIGHT-OF-WAY AS NOW ESTABLISHED); THENCE SOUTH 09°53'10" WEST, ALONG SAID EASTERLY RIGHT OF WAY LINE OF MAYPORT ROAD, A DISTANCE OF 850.00 FEET TO A POINT ON SAID EASTERLY RIGHT-OF-WAY LINE; THENCE LEAVING SAID RIGHT-OF-WAY LINE RUN NORTH 88055'40" EAST,A DISTANCE OF 534.02 FEET TO THE POINT OF BEGINNING FOR THIS DESCRIPTION; THENCE NORTH 14°16'44" WEST, A DISTANCE OF 1.07 FEET; THENCE NORTH 01'04'20"WEST, A DISTANCE OF 119.40 FEET TO THE SOUTHWEST CORNER OF LOT 1, COURTYARDS AT MAYPORT, AS RECORDED IN PLAT BOOK 49,PAGES 67 THROUGH 67C OF SAID CURRENT PUBLIC RECORDS; THENCE NORTH 88°55'40" EAST, ALONG THE SOUTH LINE OF SAID PLAT, A DISTANCE OF 598.78 FEET TO THE SOUTHEAST CORNER OF LOT 13 OF SAID PLAT; THENCE SOUTH 09°53'10" WEST, A DISTANCE OF 1158.12 FEET TO A POINT ON THE SOUTH LINE OF SAID SECTION 5, TOWNSHIP 2 SOUTH, RANGE 29 EAST; THENCE SOUTH 89°23'12"WEST ALONG THE SOUTH LINE OF SECTION 5, A DISTANCE OF 482.25 FEET; THENCE NORTH 09153'10" WEST, DEPARTING SAID ;. SOUTHERLY SECTION LINE, A DISTANCE OF 361.90 FEET TO A POINT OF INTERSECTION WITH THE SOUTHERLY RIGHT-OF-WAY LINE OF MAYPORT CROSSING BOULEVARD (A VARIABLE WIDTH PUBLIC RIGHT-OF-WAY); THENCE ALONG AND AROUND A CURVE IN SAID RIGHT-OF-WAY LINE CONCAVE WESTERLY AND HAVING A RADIUS OF 50.00 FEET FOR AN ARC DISTANCE OF 157.08 FEET TO THE WESTERLY LINE OF LANDS DESCRIBED AND RECORDED IN OFFICIAL RECORDS VOLUME 6032, PAGE 199, OF SAID CURRENT PUBLIC RECORDS, THE ARC OF LAST SAID CURVE BEING SUBTENDED BY A CHORD BEARING AND DISTANCE OF NORTH 09°53'10"EAST, A DISTANCE OF 100.00 FEET; RUN THENCE NORTH 09053'10"EAST ALONG THE EASTERLY BOUNDARY OF LAST SAID LANDS, A DISTANCE OF 569.61 FEET TO THE NORTHEAST CORNER OF SAID LANDS DESCRIBED IN AFORESAID OFFICIAL RECORDS VOLUME 6378, PAGE 657; THENCE SOUTH 88055'40" WEST, A DISTANCE OF 92.23 FEET TO THE POINT OF BEGINNING. 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Ofm Dmwomem Dom aaf l.rN+;w.AQUNPwM+torlly.trlea+w.M.ttk r_ _ 0s Dm«.ro Dw.n >...rrostdrrr Mrar Can.wriy tnr.r Tdw— atpwb.. Dab _... commoft arc hrrLf rt�rlr[ . FEMA Farm{i-31.Fftnmy 2006 ni cls d pr AMA sdimm MAY-18-2009 12:52P FROM: R E HOLLAND 904-646-3272 TO:2475845 P.2 U.S. ATRAwOFHOMELANDsEcuRrN ELEVATION CERTIFICATE WeNO.I660.0008 Federal&raperncy Msnagerrront Agency Expires February 28.2W9 National Flood Insurance Program Important Read the instructions on pages 14 SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owners Name CONTINUING NAVAL CARE ARREwAENT FOUNDATION,INC. Policy Number 112. BuildkV Sbset Address(Including Apt,Unk,Sults,and/or Bldg.No.)or P.O.Route and Box No. Company MAIC Number $915 FLEET LANDING BLVD.NORTH City JACKSONVILLE State FL ZIP Code 32233 A3. Vmperty Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc) A PART OF THE ANOREW DEWEES GRANT,SECTION 37,AND SECTION 5,ALL IN TOWNSHIP 2 SOUTH,RANGE 29 EAST,DUVAL COUNTY,FL A4. Building Use(e.g..Residential.Non-Reaktentlel,Addition.Accessory,etc.) $ L A5. LalitudeiLongitude:Lot.30.3571 Long.411.410Q Hart=ntaI Datum: O NAD 1927 0 NAD 1983 A8. AtleCh at bast 2 photographs of the building it the Certificate is being used to obtain flood insurance. A?. Building Diagram Number 1 AS. For a building with a crawl space or endosure(e),provide A9. For a building with an attached garage,provide: a) square rootage of crow apace or anclosuro(e) Q sq ft a) Square footage of attached garage Kd sq R b) No.of potmenont flood openings In the crawl space or b) No.of permanent flood openings In the attadnad garage endosum(s)walls wilhln 1.0 bot ebm adjacent grade Q walls within 1.0 That ebove adjacent grade Q c) Total net area of Rood openings In AS.b 2 eq in c) Total Trot area of flood openings In Ag.b Q aq In SECTION 9-FLOOD INSURANCE RATE MAP(FIRM(INFORMATION B1.WIP Communky Name&Community Number 82.County Namestate JACKSONVILLE,FLORIDA, 12077 IXNAL FLORIDA $4.MsplPWWd Number 85.Suflix 08.FIRMA Index 07.FIRM Panel 88.Flood 09.One Flood Elevation(s)(Zone Dahl EAbCtbeAtevised Date Zones) AO,use base flood depth) 0242 E 8/18/1999 8116/1999 X,SHADED X. AE BFE a 8 AE FW 8111 Indicate 00 sokuce of the Base Flood Ebvedon(BFE)dots or base lleod depth entered in Item 89. O FIS Profile O FIRM ®Community Determined 0 Other(Dowbe) B11. Indicate ebvstion datum used for SFE in Ilam 89: t j NOW 1929 O NAVO 1988 0 Other(Describe) 612. Is the building located in a Coastal Battler Resources SystemRS)aro@ or Odretwdss Prolecied Aron(OPA)? OYes ®No Designation Date Wer �CBRS O OPA SECTION C-13UILDING(ELEVATION INFORMATION(SURVEY RECUIRED) Cl. Building elevations are based on: j]Corwtnretbn Drw~ O Building Under Conshuctlorr ®Finished Conetnrelion •A new Elevation Cw fleate will be regaled*nen owilliu afon of the budding is comptata. C2. Elevetbils-Zones A1,A30,AE,AN,A(with BFE),VE,V1430,V(with BFE),AR,ARA,AR/AE,AWAI,AX AR/AH,AR/A0. Complete item C2." below according to the building diagram specified in Item AT Benchmark Utilized SEE NOTES Vertical Datum NGVD 29 ConversionxAmmenb M Check the measimment used. a) Top of bottom floor(Including bosemenl,crawl space,or enclosure fleor) IQ.g 011091 0 mebrs(puerto Rico only) b) Top of the nerd hiphsr floor WA. 0 feet 0 maters(puerto Rioo only) c) Bottom of the lowest horizontal structural member(V Zones only) WX OW 0 meters(Puerto Rico only) d) Attached garage(top of slab) 10,30 0 test 0 maters(Puerto Rico only) e) Lowest eievatlon of machinery of equipment servicing the building I O fast 0 motors(Puerto Rico only) (Describe type of owip rent in Comments) 0 Lowest adjacent ftlelw d)grecs(LAG) j:•4 ®fast Q maters(Puerto Rion orgy) g) Higtnest soacent(1Intshed)grade(HAG) 12.2 0 fret O meters(puerto Rico sty) SECTION D-SURVEYOR, GEN INEER,OR ARCHITECT CERTIFICATION This oadflcatlart is b ba signed and sealed by a lend surnyor,ertpinea�r�or ardkkect aut alzed by law to car*elevation Information- l o&IW NW f>re Infornmid n or Oris Cartlllcate rspreaarrta my best efforts to kthrpret ft Cab ovo#abkis. I wrderatarrd that any Gslae slaismant may be pwNshabb by ffrre or bnpilsonment under 18 U.S Code.Section loaf. sy��a� r'�� ''• ® Check here Ifoarrrrrm are provided on back orfbrm. Certifbr's Name ROBERT E.HOLLAND License Number 4242 TO REG RED LANDhURVEYOR Company Name R.E.HOLLAND a ASSOCIATES,INC. -46 Address 9 . UITE 1 NVI Civ JACKSOLLE Seine FL ZIP Code 32258 <� Signature 400111111111111 Telephone (904)2110.8900 ;r MAY-18-2009 12:52P FROM: R E HILL904-646-3272 TO:2475845 P.3 1111110r,WAKIn these spays.copy the cormE! I Mfonnation from Ser mon A For Insurance Company Use: Building Sheet Address(Including Apt.,Unit.Suit,andtor Bldg.No.)or P.O.Route and Box No. Policy Number $815 FLEET LANWNG BLVD.NORTH City JACKSONVILLE State FL ZIP Code 32233 Company MAIC Number SECTION D-SURVEYOR,EIMMIEEIly OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certlflcale for(1)community offldel,(2)Insurance any,and(3)building owner, Cammenb X-CU7 N COMMER OF CONCRM TRANW*VMRAD ELEVATION-15.53 SET OTHERS;THIS FICIITI IS GIVEN POK THE SPECIFIC PURPOSE OF DETERMINING THE AS-IWILT ELEVATION OF THE FINISHED FLOOR;NOTE ALSO THAT THE PROJECT SITE IS UNDER CONSTRUCTION-THE FLOOD ZONE LINES SHOWN ON THE SURVEY MAP WERE DETERMINED BY GRAPHICALLY PLOTTING THE ZONES FROM JAKMAPS D WERE NOT DETERMINED FROM ACTUAL FIELD ELEVATIONS;NO UNDER FLOOR FLOOD VENTS OR CRAWL SPACES WERE INE" COJ PERSONEL;NO OUTSIDE AIR CONDITIONER PAD VISIBLE. SignatureDate 5 Check here If dtachrnsnM SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT RfOUIRED)FOR ZONE AO AND ZONE A(VATHOLIT BFE) For Zones AO and A(without BFE),complete Items E1-E5. I the Certificate b Intended to support a LOMA or LOMB-F request,complete Ssctbons A.B. and C. For Items E1-E4,use natural grade,If avellablee. Chock the measurement used. M Puerto Rico only,enter meters. E1. Provide elevation fnMrrradon for the following and check the apprWalle boxes to show whslher the elevation Is above or below the highest agaow Waft(HAG)and the lowest adjacent grads(LAG). a)Top of bottorn floor(Induding basement,crawl space,or eondosure)b ❑fast ❑nate ❑above or❑below the HAG. b)Top of bottom floor(h%*x1khg bases neent,crawl specs.or eadosure)is ❑feat ❑maters ❑above or❑ below the LAG. E2. For Willing Diagrams f}.8 whit permanent hood openings provided in Section A nems 8 aWor 9(am_pop 8 of betrucilm),the nerd higher floor (elevation C2.b M the diagrems)of the bulkong is ❑fest ❑malars ❑above or ❑below the HAG. E3. Attached gamse(top of slab)Is ❑sec ❑meters ❑above or ❑below the HAG. E4. Top of t>istjorm of machbmy andfor equipmsmt secvM%the bxdift j is ❑lest ❑meters ❑abon or❑below the HAG. E5. Zone AO only: F no food depth number is available,is the top of the bottom floor ebvabed in accordance with the comrmunity'a floodptavt management orMnance9 ❑Yea ❑ No ❑ Unknown. The local cMdel must car*this Information In Section G. SECTION F-PROPERTY OWNER LOR OW�R'S REPRESENTATIM CERTIFICATION i r, The property owner or owner's authorized representative who completes Sections A.B.and E for Zone A(without a FEMAassued or community-issued 8FE) or Zone AD must sign hero. The sfalemswb in Speelorrs A,A and E am corned to pis best of my knowledge. Properly Owrals or Owners Aattortmd Represartatho a Name Address city State ZIP Cods Signature Dabs Telephone Comments n Chair halt It alta SECTION G-COMMUNITY INFORMATION(OPTIONAL) Tho local olNcial who les authorised bylaw or ordinance to administer the community's fbodphfn management ordinance can cornph"Sections A.B,C WE), and 0 of this Elevation Certificate. Complete the applicable tem(t)and sign below. Cfreclt the measurement used in items 68.and 09. 01.❑ The information In Section C was taken from other documentation that has been signed and oveled by a licensed surveyor,enphaar,or architect who is sunerized by law to certify elevation Information. (Indicate the swim and date of the elevation date in Qts Comments area below.) G2.❑ A community oMdel completed Section E for a briding located len Zone A(without a FEMA49sued or conn BFE)or Zone Aa. G3.❑ The following iniormation(Items 04.-G9.)is provided for corninu.ky floodplain management purposes. 04.Permit Number --f—G5. Deb Permit Issued G8. Dew Cerifilcob Of Complionce/Ooeupancy Issued 07.This permit has boon issued for ❑New Construction 0 Substantial Improvement G8.Etwedon of ss-bulk lowest floor(Including basement)of the bundkW _0 feet ❑meters(PR)Datum 139.WE or(in Zone AO)depth of flooding at Qe building site: ❑feet ❑meters(PRE Daum Local onurs Name Tft Community Name TOote Signature Data Comments n Check here ir attachments MAY-18-2009 12:53P FROM: R E HOLLAND 904-646-3272 TO:2475845 P.4 8 � Building Photographs See Instructions for Item AS. For kaurence Company Use: 8uang Stn3et Address(including Apt,Unit Suit,andkw Bldg.No)or P.O.Rabe and Boot No. Pricy Number 5815 FLEET LANDING BLVD.NORTH City JACKSONVILLE State FL ZIP Code 32233 Company NI11C Nurnber if using the Elevation Certificate to obtain NFIP food insurance, aft at least two building photographs below according to the instructions for Item A8. identify all photographs with:date taken; 'Front View"and*Rear~;and, if required, "Right Side View" and "Left Side View.' If submitting more photographs than will fit on this page, use the Continuation Page, fig• tSr, l r� FRONT VIEW DATE: 03/05/09 MAY-16-2909 12:53P FROM: R E HOLLAND 904-646-3272 TO.2475845 P.5 A k Building Photographs Continuation Page For Insurance Company Use: Building Street Address(including Apt.,Unit Suite,and/or Big.No.)or P.O.Route and Box No. PoU y Number 5815 F'IM LANDING BLVD.NORTH City JACKSONVUE State FL ZIP Code 32= Corr w NAILNumber If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with:date taken;"Front View'and"Rear View";and, If required,"Right Side View"and"Left Side View.' REAR VIEW DATE: 03/05/09 '✓L-4 VA .S.CEPARTivie:»!TF,?r HOUiELAND SECURITY ELEV 5TMWI CER T�NCA I E OMB No. 1660-0008 aderal Emergency Management Agency I Expires February 28. 2009 ational Flood Insurance Program Important: React trie instructions on pages 1-8. SECTION A-PROPERTY Ii1tFORMATION For Insurance Company Use: Al. Building Owner's Name A 3A F�-,-Zqp. Policy IVumber AW 1 Cor\ u C TvknAxr.. 42. Building Street Address(including Apt.,Unit,Suite,andlor Bldg.No.)or P.O. Route and Box No. Company NAIC Number Sats` 0 c'_ % ��..,�,n 4-VA City State FL ZIP Code 43. Pr perty Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) j� ��ri D� lo7S / f 2 D.V t s r�- 3 /��Ore 4 Dewke 5 G��►,•-T" 44. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) jee5 r d ,frit�;2 45. Latitude/Longitude:Lat. N &Z-Z I-2`j Long.W 43 i`-2 - 3S Horizontal Datum: ❑NAD 1927 Eii.1VAD 1983 46. Attach at least 2 photograph o the building if the Certificate is being used to obtain flood Insurance. 47. Building Diagram Number M. For a building with a crawl space or enclosure(s),provide: A9. For a building with an attached garage,provide: a) Square footage of crawl space or enclosure(s) (3 sq ft a) Square footage of attached garage 2�Sj sq It b) No.of permanent flood openings in the crawl space or b) No.of permanent flood openings in the attached garage enclosure(s)walls within 1.0 foot above adjacent grade 0 walls within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b sq in c) Total net area of flood openings in A9.b sq in SECTION 8-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION 31.NFIP Community Name&Community Number B2.County Name B3.State B4.Map/Panel Number B5.Suffix B6.FIRM Index B7,FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 12-v 0-7-1 C)Z4Z E 1985 AEF 10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. ❑FIS Profile XrFIRM ❑Community Determined ❑Other(Describe) 11. Indicate elevation datum used for BFE In Item 69: 9 NGVD 1929 ❑NAVD 1988 ❑Other(Describe) 12. Is the building located in a Coastal Barrier Resources.System(CBRS)area or Otherwise Protected Area(OPA)? ❑ Yes YL No Designation Date []CBRS ❑OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) 1, Building elevations are based on: ❑Construction Drawings" ❑ Building Under Construction' 79 Finished Construction 'A new Elevation Certificate will be required when construction of the building is complete. ?. Elevations-Zones P,1-A30,AE,AH,A(with BFE),VE,V1430,V(with BFE),AR,ARIA,ARAE,AR/A1-A30,AR/AH,AR/AO. Complete Items GZ.a-g below according to the building dia ram specified in Item AT Benchmark Utilized C;,5 P6. 15C Vertical Datum 14 G Conversion/Comments Check the measurement used. a) Top of bottom floor(Including basement,crawl space,or enclosure floor) (O ©feet ❑meters (Puerto Rico only) b) Top of the next higher floor hl .113 ❑feet ❑meters (Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) hJ .A ❑feet ❑meters (Puerto Rico only) d) Attached garage(top of slab) 1 .Zc.1©feet ❑meters (Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building 1 V 20©feet ❑meters (Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) _. feet ❑meters (Puerto Pico only) g) Highest adjacent(finished)grade(HAG) /m .1 feet ❑meters (Puerto Pico only) SECTION D-SURVEYOR,ENGINEER, OR ARCHITECT CERTIFICATION chis certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation reformation. I certify that the information on this Certificate represents my best efforts to interpret the data available. understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code,Section 1001. Check here if comments are provided on back of form. ;ertifiersName ^/,q Fr A, k/ /,/Ass License Number itie Company Name fin.. O Sc.,r vF�C.- d Q 4/v�,. �T _ addresshu U City State ZIP Code Signature /J� Date G Telephone I _..._ 5 _MA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions _ 4 IMPORTANT: in these spaces,copy the corresponding Information from Section A. For Insurance Company Use: Building Street_Address(inc)uding Apt„Unit,Spite,and/or Bldg,No.)or P.O. Route and Box No. Policy Number 'I I S 6"42 F 1 7" •� r o. n T3 L VD - City State ZIP Code Company NAIC Number 32 4 32Z SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED) Copy both sides of this Elevation Certificate for(1)community offiicial,1(2)insurance agent/company, and(3)building owner, Comments n , 4 c1 Q 'IR r Cc_)l Signature Date ❑ Check here If attachments SECTION E-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED) FOR ZONE-AO AND ZONE A (WITHOUT BFE) For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade(HAG)and the lowest adjacent grade(LAG). a)Top of bottom floor(including basement,crawl space,or enclosure)is _❑feet ❑meters ❑above or ❑below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)Is —❑feet ❑meters ❑above or j❑ below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Sectio A Items 8 and/or 9 (see a e 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _[feet meters ❑ above or (below the HAG. E3. Attached garage(top of slab)is ❑feet Q meters M above or M below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is `Q feet ❑meters ❑above or ❑below the HAG. E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? ❑ Yes [] No ❑unknown. The local ofrcial must certify this information in Section G. SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENT ATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE) or Zone AO must sign here. The statements in Sections A,6:and E are correct to the best of my lrrrowiedge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments ❑Check;here if attachments SECTION G-COMMUNITY INFORMATION(OPTIONAL) (he local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E), and G of this Elevation Certificate. Complete the applicable Item(s)and sign below. Check,the measurement used in Items G8. and Gs. 31. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who is authorized by law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below,) 32. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued SFE)or Zone AO. 33. ❑ The following information(Items G4.-G9.)is provided for community floodplain management purposes. G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued 37.This permlt has been issued for: [] New Construction ❑ Substantial Improvement 38,Elevation of as-built lowest floor(including basement)of the building: ❑feet ❑meters(PR) Datum 39.BFE or(in Zone AO)depth of flooding at the building site: ❑feet ❑meters(PR) Datum Local Official's Name Title Community Name Telephone Signature Date Comments ❑Check here If etfaehments FEIVIA Form 81-3'1, February 2006 Repiaces ail previous editions , n Suildng Photographs See Instructions for Item A& For Insurance Company Use: Building Street Address(including Apt.,Unit, Suite,and/or Bldg. No.)or P.O, Route and Box,No. Policy Number ,City State ZiP Code Company NAIC Number if using the Elevation Certificate to obtain NF'IP flood insurance, affix at least two building photographs below according to the instructions for Item A6. identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. f CITY OF ATLANTIC BEACH r, s� 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00000611 Date 5/07/08 Property Address . . . . . . 5815 FLEET LANDING BLVD Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc early power/SINGLE PHASE 200 AMPS 240 VOLTS ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ AMERICAN ELECTRICAL CONTRACTOR Q/A:GRASS, ROBERT 5065 ST. AUGUSTINE RD. #3 JACKSONVILLE FL 32207 (904) 737-7770 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 300 . 00 Plan Check Fee . 00 Issue Date . . . . 5/02/08 Valuation . . . . 0 Expiration Date . . 10/29/08 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 300 . 00 300 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 300 . 00 300 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 11 It CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 'j ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 07-00001707 Date 5/02/08 Property Address . . . . . . 5815 FLEET LANDING BLVD Application type description SINGLE FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 370000 ------------------------------------------------------ ---------------------- Application desc estate home ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ R. P. C. GENERAL CONTRACTORS 248 LEVY RD ATLANTIC BEACH FL 32233 (904) 241-4416 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc INSTALL FIXTURES Sub Contractor AMERICAN ELECTRICAL CONTRACTOR Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . 2/06/08 Valuation . . . . 0 Expiration Date . . 9/28/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. ---------------------------------------------------------------------------- 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. APR-29-2008 11:36 AMERICAN ELECTRICAL CONT 7371099 P.02 EARLY POWER AGREEMMNT RELEASE ' R 8 cffy OF ATLANTIC BEACH B Y,_----�--------- Electric power is roqueatod naw under the conditions and teams of this fully executed Agrnameant&Ralessa Job Addzess: $ IaS F1ee4- l-4441n!j Wyd A44&n -ir- beach, FL 3-j333 Permit w O 7—0 0 00 l'1 d 17 Service Type(Circle One); Overhead Ugdergrdund '%re, the undersi&med Geaefal Contractor and Blectrieim,understand "d agree: I. "Early porrr" ie ur�iy for our coastruetion convenience, it is not required. 6y Codcs and does not substitute Far FinalTnspeetions or the CIO(Certificate of Occupancy)that must be issued before occupancy, sttd as suets is at the discretion of dw$uildmg O$YciaL 2. T-ho City of A';mba Beac:b will make a special inspection prior to the early power ennmrgizing. All rough mspoctions must have prior Approval,including meter base connections. 3. Occupancy or use of the new gonstruotion before a formal C/O consti�irtes fraudulent use of the early electrican seance, Such aztign is expressly prohibited and penalized yb r The City of Atlautjo Beads Ordinances. A violation of tb.is Agreement shall result in a request for prompt removal of electric service aftr a twenty-four hour notice. 4. "Early Power"release autharity is the Bleotrician acad/or the Contractor and must aot occur before: a. Equipment,devices and fuctrttes are installed(or blanked off)safely, b. Pagel is complete)Ott breakers and cover,and(labeling required et final inspection). c.- Service connection and grounding is c=plete. d, The electric Qystom has safe[,passed through electrical check_ e. Meter can is ermaneutl marked wt address. f Temporary address numbers displayed(Pe wimerlt numbers are required for C/O). 5.,' Pay 300, administration fee,,, arty reinspection fees and any outstanding requkcui ats must be satisfied prior to re Dasa. 6. This fully completed form is to be suhmittrsd to the Building Department by hand,.mail or fax. 7. Future such Agree eots ' I not be accepted from those who violate anyone of the above items. CONT1tACTOR DATE PRINT NA_v1B ?F+e- W-o /Ues _ PRINT NAMIE � 800 Scmiaols Road,Atlantic Beach F'I,32233 Pbono:(904)7,47-5826, Fax.C904)247-5345 LIME( y7y0l:oeb,g rovised 11,29.06 TOTAL P.02 HPdfficej®t 7410 Log for Personal Printer/Fax/Copier/Scanner Information Systems 904-247-5845 Mar 13 2008 1:52PM Last Transaction Date Time Type Identification Duration Pages Result Mar 13 1:51 PM Fax Sent 96657372 1:21 3 OK r CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD �r ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-deptt�coab.us Application' Number . . . . . 08-00000092 Date 1/18/08 Property Address . . . . . . 5815 FLEET LANDING BLVD Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 11000 ---------------------------------------------------------------------------- Application desc new roof ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PROFESSIONAL SUNSHINE ROOFING 1017 IRELAND DR DELTONA FL 32725 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 85 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 11000 Expiration Date . . 7/16/08 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 85 . 00 85 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 85 . 00 85 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. V �. CITY OF ATLANTIC BEACH / oO Opp . 1i 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 a Ij' v I I OFFICE:(904)247-5826•FAX NO.:(904)247-5845 0 BU I LDI NG-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY J j yALtiA koN O t+k+ FT,# f�`J F�,W} o- xado ntic Beach FL 32233 p�,/4/y, 3�l✓ ✓gyp �y �ht F-WO�I't. 9 I� 3 +f+. ,2 M� n i'.. �i,TV fA ... EW BUILDING ❑DEMOLITION g RESIDENTIAL LOT_BLOCK_SUB DIVISION ❑ADDITION ❑CONVERTING USE COMMERCIAL ,: Mckiprotopwaak t Fh i( ❑ALTERATION ❑ACCESSORY BLDG. 4 O ❑REPAIR ❑POOL/SPA ❑YES ❑N/A t. n°!,r 4,.`G��li'Itl�"+✓r'+ic '' 5:Mi$" ur i ' 8 i�.1 ii F ii cw-''Y� i) MOVE ❑OTHER NO i ! �i 9.NAME: 15 COMPANY NAME: , 23.COMPANY NAME: 16.NAME: 24.LICENSEE NAME: .50ilohz, 10.ADDRESS: 17.STATE OF FLORIDA LICENS NO.: 25.STATE OF FLORIDA LICENSE NO.: 18.ADDRESS fV/7-7 zre JA, 26.ADDRESS: 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHO 120.FAX NO.: 27,OFFICE PHONE: 28.FAX NO.: 13.CELL PHONE: 21.CEL6 PHONE:_ ` - N fi�� 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: /f/ 30.EMAIL ADDRESS: rbc `3�K�U ✓ �o L, , e iL i%. ii]jrai.i (� III�IIi t; � IF, 31. .II � ` hh ro r 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.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 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 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,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all 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 TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. iii nib Iiiil�tl4' 7 �r�'ii Wal Iii .. Ii�w i� lir s,� Ili g iii ill"4c;a (�i�" f,� wr��l�l �1 kk m� ) '4��Uae 1 �, k ; 6""'d4d �., sill Signed: Date: Signed: Date: Before me this day of ,2007 in the 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 herin by himself/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 County of Notary Public at Large,State of ,County of ❑Personally Known ❑Personally Known ❑Produced Identification- ❑Produced Identification- Notary Signature: Notary Signature: COAB FORM BLDG01:REVISED:1/8/2008 ,r t j 't1 CITY OF ATLANTIC BEACH -� 800 SEMINOLE ROAD s� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-deptncoab.us Application Number . . . . . 07-00001707 Date 2/06/08 Property Address . . . . . . 5815 FLEET LANDING BLVD Application type description SINGLE FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 370000 --------------------------------------------------------------- ------------- Application desc estate home ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ R.P.C. GENERAL CONTRACTORS 248 LEVY RD ATLANTIC BEACH FL 32233 (904) 241-4416 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc INSTALL FIXTURES Sub Contractor AMERICAN ELECTRICAL CONTRACTOR Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/04/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS. 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. ---------------------------------------------------------------------------- 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. q.y. CITY OF ATLANTIC BEACH _ 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 O•7 I ( I I OFFICE:(904)247-5826•FAX NO.:(904)247-5845 B U I LDI NG-DEPT@COAB.US f ELECTRICAL PERMIT APPLICATION DUVAL COUNTY 58i ' �� YES PERMIT M — I Ul -/O ntic Beach FL 32233 7-7 4.NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE: �al ., BMW 7.NAME OF COMPANY: 8.ADDRESS.: �-,y j, 9.STATE OF FLORIDA IC N E NO: 10.CELL PHONE: 11.FAX O• —109 L 09 2 EMAIL ADDR S: 13.OFFICE PHONE: 14. `alt Elt 15.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 null and void if work is n commenced within six(6) months,or if construction or work is suspended or abandoned for a period of six(6)month any time /afte, wor commenced. CONTRACTORS SIGNATURE: w t o,�"•:, 1 w,�e. '. ❑MULTI FAMILY-#OF UNITS: RESIDENTIAL 11 SINGLE FAMILY ❑TEMP SERVICE ❑COMMERCIAL ❑ADDITION ❑TRAILORe ❑ALTERATION ❑SIGN ❑OLD ■NEW ❑'05 NATIONAL ELECTRICAL CODE ❑REPAIR ❑POOL/SPA ❑REWIRE THER: •.e 20.TYPE OF SERVICE: ❑OVERHEAD M UNDERGROUND ❑ UNDERGROUND UP POLE 21.NEW SERVICE: CONDUCTORS PER PHASE: ❑ POWER IS ON 10 POWER IS OFF 22.SIZE OF CONDUCTOR: AMPACITY: ❑COPPER III ALUMINUM 23.SWITCH OR BREAKER SIZE: AMPS: PH:_A_ W: VOLT" RACEWAY SIZE: Fir,_ 24.EXISTING SERVICE SIZE: AMPS: PH: W: VOLT: RACEWAY SIZE: 25.FEEDERS: #OF AMPS: #OF AMPS: #OF AMPS: 26. LIGHTING FIXTURES: INCANDESCENT: FLUORESCENT&M.V.: 27.FIXED APPLIANCES: 0-30 AMPS:—(P 31-100 AMPS: OVER 100 AMPS: 28.FIRE ALARM: ❑YES ❑ NO 29-31 DO NOT APPLY TO NEW SINGLE FAMILY,MULTI-FAMILY AND ROOM ADDITIONS 29.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: #OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW: #OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW: NUMBER: VOLTAGE: HP: KVA: NUMBER: VOLTAGE: HP: KVA: UNDER 60OV: NUMBER: KVA: OVER 60OV: NUMBER: KVA: 77ART 77, DESCRIBE IN DETAIL: Ad kvY,/(-- R6o C- Uio COAB FORM BLDG02:REVISED:9126/2007 Cl CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-deptnc� oab.us Application Number . . . 07-00001707 Date 2/07/08 Property Address . . . . . . 5815 FLEET LANDING BLVD Application type description SINGLE FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 370000 ----------------------------------------------------- ----------------------- Application desc estate home ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ R.P.C. GENERAL CONTRACTORS 248 LEVY RD ATLANTIC BEACH FL 32233 (904) 241-4416 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . W/W/O MECHANICAL PERMIT Additional desc INSTALL HP Sub Contractor PENINSULAR MECHANICAL Permit Fee . . . . 118 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/05/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 118 . 00 118 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 118 . 00 118 . 00 . 00 . 00 PERMIT,Is APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. FEB-07-2008(THU) 09.06 Peninsular Mechanical Contractor (FAX)727 572 0978 P. 001/001 CITY OF ATLANTIC BEACH MECHANICAL PERMIT APPLICATION Date: z 7 - Property Address: y'�SJ6� �'�� l-1^%'j�t2,IVI") Owner. IJ 60F XU(_., jRR r Q—, LtN►))Ar Telephone#• Contractor: MO" �ti%%^4 Telephone#: -777- S"73 - i/SZZ Contractor Address: 1;�&9 J P 1 U i�) Fax#: '727-572 —tom-'Y7 Contractor Signature• ,_*,_4l_,,�,K� In eonsidtration of permit given for Oing the work as Acritscd in the aixive statemcni,+ve hereby agree to perfoml said work in accordance with the anucbud plans ant) which are n pan hereol'and in uccord:mce with the City ol'Allantie Reach ordinances and standards ul' rood onctice listed therein. Type or 11caling fuel: ll'other constnrclion is IaeinE,clone on this building or site,list the building permit number: U Elcoric ❑ Gas: _I,P ,Natural _Central Utility ❑ oil /- � __._.. Other—Stl,61Y 6-EG " 1 `4 I V MEC LAICAL EQUIPMENT TO BE YNSTALLED ~NATURE OF WORK >ff Heat _Space _Rcccti:.c:d 5Q:enlral ^floor Residential 'td Air Conditioning: _Room Central �t Duct System: ❑ Commercial Maximum capacity /1/4241 cfiT O R�frigcration ❑ Nc+v Building ❑ Cooling Tower:Capacity gplTl ❑ lixisting Building, ❑ Fire Sprinklers-Number of Heads G Elevator: __ Msnlift L'scalatot- ___(Number) ❑ Itcplacemcni of Existing Syslern o Gasoline Pumps Y (Number) C 'tanks (Number) New Installution ❑ I,.PG Containers --...--(Number) (Nu systern previously installed) ❑ Unfired Pressure Vessel ❑ Extension or Add-on to Existing System ❑ Boilers U Gas Piping ❑ other-Spccify_ ❑ other-Specify LIST ALL P. U&MENT AIR CONDITIONING,itURICERATION EQUIPMENT 6 CONDENSOR'S Approving Number Univ Dcscription Mudel 11 Manufycurrcr Ton's Agency JC S HLATINC—FURNACES,BOILERS,FIREPLACES&Alit IIANDLEWS Approving Number Uuils Description Model 11 Mamrlbcntrcr U•I'U's Artncy 'TANKS Nontioal Capacity Type Liquid Serial Approving Hou M;tinc &Dimcnsions ('4winined Manufacturer No. Agency 800 Seminole Road-Atlantic Beach,Floridn 32233-5445 - Phone: (904)247-5800• Fox: (904)247-5845- http://www.ci.ntiantic-beach.fl.us Revised 1/04 CITY OF ATLANTIC BEACH 800 SENUNOLE ROAD \j ATLANTIC BEACH,FL 32233 1 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-deptai- _,coqb.us Application Number . . . . . 07-00001707 Date 1/04/08 Property Address . . . . . . 5815 FLEET LANDING BLVD Application type description SINGLE FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 370000 ---------------------------------------------------------------------------- Application desc estate home ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ R.P.C. GENERAL CONTRACTORS 248 LEVY RD ATLANTIC BEACH FL 32233 (904) 241-4416 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc INSTALL 20 FIXTURES Sub Contractor SCOTT PLUMBING COMPANY, INC. Permit Fee . . . . 175 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/02/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS. 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 175 . 00 175 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 175 :00 175 . 00 . 00 . 00 PERMIT-19 APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES CITY OF ATLANTIC BEACH _ 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 07 �� OFFICE:(904)247-58260 FAX NO.:(904)247-5845 m ,:F BUILDING-DEPT@COAB.US PLUMBING PERMIT APPLICATION DUVAL COUNTY J 81 S �ICE'r 1.14ivD/NG 8 ✓l7. ❑NO 70?4Atlantic Beach FL 32233 .LYES PERMIT#: 07- 17o,7- 4. .NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE: 7.NAME OF COMPANY: 8.ADDRESS.'. saott t UA4b S't uNlo&-Am eexAcooe Die 9.STATE OF FLORIDA LICENSE NO: 10.CELL PHONE: 11.FAX NO.: 6Fel 0191 i 1oy - 2V4 - 2-414( I'Dq - Zbg -,393 12,EMAIL ADDRESS: 13.OFFICE PHONE: 14. -fi'ECC.[S 4414&411P 90Y - 264 -G3nq 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 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 aft ork is commenced. CONTRACTORS SIGNATURE:OIN — EW 6 FLORIDA BUILDING CODE- 0 RE-PIPE PLUMBING ❑OTHER: BATH TUB SEWER CONNECTION BIDET SHOWERS DISH WASHER 2- SHOWERS PANS DISPOSAL I SINK DRINKING FOUNTAIN Z- WATER CLOSET TANK f FLOOR DRAIN WATER CLOSET VALVE HOSE BIB L WASHING MACHINES ICE MAKER T WATER CONNECTION INTERCEPTOR WATER HEATER LAVATORY URINALS LAUNDRY TRAY OTHER(SPECIFY): ROOF DRAIN PERMIT ISSUING FEE: $35.00 TOTAL FIXTURES: �� x $7.00 (PER FIXTURE) + $35.00 - COAB FORM BLDG03:REVISED:1/3/2008