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Permirt 5822 Fleet Landing Blvd SS C* of Atlantic Beach Ity 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 is in compliance with the ordinances of the City regulating building construction for the occupancy and use for which the occupancy is classified: Date: July 8, 2009 Permit Number: 08-1305 Contractor: R.P.C. General Contractors Address: 5822 Fleet Landing Blvd. Atlantic Beach, F1 32233 Description of Structure: Residential Permit issued in accordance with: 2004 Florida Building Code Construction Type: V Occupancy Class: Residential R-2 Design Occupant Load: N/A Sprinkler System Required: None Special Stipulations/Conditions: None MICHAEL GRIFFIN BUILDING OFFICIAL CITY OF ATLANTIC BEACH CERTIFICATE OF OCCUPANCY WORKSHEET Date Requested: Contractor Name: Permit #: Property Address: Q_ r"( '6v�r Legal Description: Improvements to the above-described property have been completed in accordance with the terms of the permit and are certified to be ready for occupancy as: ED Single-FamUy Residence M Commercial oxt",PAW Other: L Lowest Floor Elevation: ) Required As Built FFE The following must be completed before issuing Certificate of Occupancy: Department Date Notified Date Approved Approved By Fire Dept. Public Works Public Utilities Building Planning Tree Mitigation Satisfied -,r- CA,-R* - Final Survey with FFE Yes No All Re-Inspect Fees Paid Yes No Termite Treatment Ye s No U�S.DEm-RTMENT OF HQMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008 Federal Emergency Management Agency I Exoires February 28.2009 National Flood Insurance Program Important: Read the instructions on pages 1-8. SECTION A-PROPERTY INFORMATION For Insurance Company Use: Al. Building Owner's Name CONTINUING NAVAL CARE RETIREMENT FOUNDATION,INC. Policy Number A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NAIC Number 5822 FLEET LANDING BLVD.NORTH L City JACKSONVILLE State FL ZIP Code 32233 A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) A PART OF THE ANDREW 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-Residential,Addition,Accessory,etc.) RESIDENTIAL A5. Latitude/Longitude:Lat.30.3577 Long.-81.4102 Horizontal Datum: [] NAD 1927 Z 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 I 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) Q sq ft a) Square footage of attached garage �52 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 0 walls within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A8.b Q sq in c) Total net area of flood openings in A9.b 0 sq in SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION Bl.NFIP Community Name&Community Number B2.County Name B3.State JACKSONVILLE,FLORIDA, 12077 1 DUVAL I FLORIDA B4.Map/Panel Number B5.Suffix B6.FIRM Index B .FIRM Panel B8.Flood B9.Base Flood levation(s)(Zone Date Effective/Revised Date Zone(s) AO,use base flood depth) 0242 E 6116/1999 8/15/1989 X,SHADED X, AE BFE=8 AE,FW 1310. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9. 0 FIS Profile [I FIRM Z Community Determined 0 Other(Descriibe)- Bl 1. Indicate elevation datum used for BFE in Item 139: 0 NGVD 1929 [1 NAVD 1988 [1 Other(Describe) B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? E]Yes NNo Designation Date N/A [I CBRS C]OPA SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) Cl. Building elevations are based on: []Construction Drawings* [I Building Under Construction* 0 Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,Vl 430,V(with BFE),AR,AR/A,AR/AE,AR/Al-A30,AR/AH,ARIAO. Complete Items C2.a-g below according to the building diagram specified in Item A7. Benchmark Utilized SEE NOTES Vertical Datum NGVD 29 Conversion/Comments N/A Check the measurement used. a) Top of bottom floor(including basement,crawl space,or enclosure floor)_ 10.71 [D feet []meters(Puerto Rico only) b) Top of the next higher floor N/A.- 0 feet 0 meters(Puerto Rico only) c) Bottom of the lowest horizontal structural member(V Zones only) N/A. [I feet [I meters(Puerto Rico only) d) Attached garage(top of slab) 1 0.�3 0 feet 0 meters(Puerto Rico only) e) Lowest elevation of machinery or equipment servicing the building N/A. El feet 0 meters(Puerto Rico only) (Describe type of equipment in Comments) f) Lowest adjacent(finished)grade(LAG) 2.2 feet meters(Puerto Rico only) g) Highest adjacent(finished)grade(HAG) 10.5 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. I certify that the information on this Certificate represents my best efforts to interpret the data available. I 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. Certifier's Name ROBERT E.HOLLAND License Number 4242 Title REGISTERED LAND SURVEYOR Company Name R.E.HOLLAND&ASSOCIATES,INC. A A - Address OrAkMFrD S D.AUITE?7 City JACKSONVILLE State FL ZIP Code 32256 Signature V I te 05/22/2009 Telephone (904)260-6300 IMPORTANT:..In these spaces,copy the corresponding information from Section 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 5822 FLEET LANDING BLVD.NORTH City JACKSONVILLE State FL ZIP Code 32233 Company NAIC Number 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 X-CUT IN CORNER OF CONCRETE TRANSFORMER PAD ELEVATION=15.53 SET BY OTHERS;THIS CERTIFICATION IS GIVEN FOR THE SPECIFIC PURPOSE OF DETERMINING THE AS-BUILT 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 THE(1�IRM MAAPS P1 D WERE NOT DETERMINED FROM ACTUAL FIELD ELEVATIONS;NO UNDER FLOOR FLOOD VENTS OR CRAWL SPACES WERE OBIT E7;BFE S Y COJ PERSONEL;NO OUTSIDE AIR CONDITIONER PAD VISIBLE. r �A JETJ MIN Signature 1�lEff IPTVV��4 _V Date 05/22/2009 Check here if attachments SECTIOWE-BUILDING ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE) For Zones AO and A(without BFE),complete Items El-E5. If the Certificate is intended to support a LOMA or LOMR-F request,complete Sections A,B, andC. For Items EI-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters. El. 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 [I meters above or E]below the HAG. b)Top of bottom floor(including basement,crawl space,or enclosure)is 0 feet [I meters above or E] below the LAG. E2. For Building Diagrams 6-8 with permanent flood openings provided in Section A Items 8 and/or 9(see page 8 of Instructions),the next higher floor (elevation C2.b in the diagrams)of the building is _._ []feet [I meters [I above or C]below the HAG. E3. Attached garage(top of slab)is _._ 0 feet El meters 0 above or []below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is _._ []feet 0 meters C]above or E]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? El Yes [] No E] 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 corTect to the best of my knowledge. 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) 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. G1.0 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.) G2.0 A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-issued BFE)or Zone AO. G3.0 The following information(items G4.-G9.)is provided for community floodplain management purposes. IG4.Permit Number I G5. Date Permit Issued I G6. Date Certificate Of Compliance/Occupancy Issued G7.This permit has been issued for: [I New Construction El Substantial Improvement G8.Elevation of as-built lowest floor(including basement)of the building: _[I feet El meters(PR)Datum G9.BFE or(in Zone AO)depth of flooding at the building site: 0 feet [I meters(PR)Datum Local Official's Name Title Community Name Telephone Signature Date Comments n Check here if attachments 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 5822 FLEET LANDING BLVD.NORTH City JACKSONVILLE State FL ZIP Code 32233 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 "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page, following. -AOL FRONT VIEW DATE: 05/21/09 Carbonless Preprinted Page 1 of 11 C01 Turner Main Office.480 Edgewood Ave.S. Tfeasum/Space Coast,Flodda Order: 3314729 Jacksonville,R 32205-3776 (772)621-7905 Work Date: 05/26/09 Tuesday T7,T71 Pest Phone:(904)355-M Tampa,Norlda Daytona,Rorlda Time: 07:00 Fax:(904)353-1488 (813)681-6W1 (386)788-8303 map" mcontroll Toll Free:(800)225-5305 St.Marys,G"r9la Route: Wh&Vs Bugging You? �""Ww.1;4 'corn; (912)576-1300 Tech: DKNIGHT Location:1179161 Bill-To:(1285791 The Palms @ Fleet Landing Target Pest: 5822 Fleet Landing Blvd Last Service: Atlantic Beach, FL 32233 Terms NET 30 PO: Qgunty: VAL SERVICE DESCRIPTION PRE-RES FINAL PRETREAT-RESIDENTIAL-FINAL TREATMENT 10/02/08 pretreat date—Mike 352-258-4867 PREPARED 7ZO7109 PECTION TICKET PAGE CITY OF ATLANTIC 16,44:10 SPECTOR: MIKE JONES DATE 7/08/09 ------------ LEACH -Xs_PP-BE---------------------------------------------------- ADDRESS ----- -------- SUBDIV: 5822 CONTRACTOR _p.CPLEET LA__ S PHONE (904) 241-4416 OWNER . r / PHONE I.DING S PARCEL 'ENERA� Co APPL N y RESIDENCE UMBER, 08-()000 ------------------------------------------------------------- T /C-"--,Y_ 13Z.Da 01 DESCRIPTION TYP/SQ REQUESTED RESULTS/COMMENTS -PP-RN1T:__COMPLETED- 'G_)/_--------------------------------------------------------------------- 11 __0j------------- - BD SLAB TIME: 17:00 10/06/08 P Slab inspect Danny 509-1863 "0; ;0" 59 01 10 06/0 mJ BD FILL CELL/TIE BEAM TIME: 17:00 / '5 10 31/ AP -1 / -1 59 /10/3 . 02 8 MJ BD FILL CELL/TIE BEAM TIME: 17:00 11 08 AP cell fill demizing wall Mike 352-258-4867 59 1 1/,. 03 1/08 mi BI) FILL CELL/TIE BEAM TIME: 17:00 /01/08 AP fill cell porch Mike wIRPC Porch 17 OX 12/08/08 Mj BD ROOF SHEATHING TIME: 17:00 12/08/08 AP Mike RPC 98 01 12/17/08 mi BD WIND TIE-DOWN/CONNECTOR TIME: 17:00 12/18/08 AP tie down inspection Mike RPC is 01 12/31/08 mi BD ROOF DRY-IN TIME: 17:00 12/31/08 AP roof dry in Mike RPC 98 02 3/05/09 mi BD WIND TIE-DOWNICONNECTOR TIME: 17:00 3/05/09 AP final tie-downs. WD 01 3/19/09 mi BD WINDOW AND/OR DOOR INSTALL TIME: 17:00 3/19/09 AP WINDOW & DOOR INSTALLATION BUCK AND SCREW IN MIKE RPC 98 03 5/15/09 MG BD WIND TIE-DOWN/CONNECTOR TIME: 17tOO 5/15/09 AP AND WINDOW SCREW OFF 61 01 5/28/09 MJ BD DRYWALL TIME: 17:00 5/28/09 AP SHEET ROCKISCREW IN MIKE RPC rn-,t lls 01 7/08/09 MJ BD CERTIFICATE OF COMPLETION TIME: 17:00 RPC STEVE ----------- -------------------------------------- COMMENTS AND NOTES -------------------------- T&Y-4- U ZL- 'w:, EARLY POWER AGREEMENT & RELEASE CITY OF ATLANTIC BEACH Electric power is requested now under the conditions and terms of this fully executed Agreement&Release Job Address: _ FT 6�(?AA F1 C - LA"01AA6_ OLVIO )4TZAAM Permit No. el _4nR-7 13,00 1 - Service Type(Circle One). Overhead=Underground We,the undersigned General Contractor and Electrician,understand and agree: I. "Early Power" is purely for our construction convenience, it is not required. by Codes and does not substitute for Final inspections or the C/O(Certificate of OccupancyTMat must be issued betore occuparicy, and as such is at the discretion of the Building Official. 2. The City of Atlantic Beach will make a special inspection prior to the early power energizing. All rough inspections must have prior Approval,including meter base connections. 3. Occupancy or use of the new construction before a formal C/O constitutes fraudulent use of the early electric service. Such action is expressly prohibited and penalized by The City of Atlantic Beach Ordinances. A violation of this Agreement shall result in a request for prompt removal of electric service after a twenty-four hour notice. 4. "Early Power"release authority.is the Electrician and/or the Contractor and must not occur before: a. Equi ment,devices and fixtures are installed(or blanked off)safely. b. Pane,�is complete with breakers and cover,and(labeling required at final inspection). c Service connection and grounding is complete. d. The electric system has safely passed through electrical check. e. Meter can is permanently mgiiked with address. f. Temporary aadress numbers displayed(Permanent numbers are required for C/O). 5. This Mly completed form is to be submitted tothe Building Department by hand,mail or fax. 6. Future such Agreements will not be accepted from those who violate any one of the above items. CONTRACTOR DATE PRINT NA---. /:A� Z d14� ELECTRIClAN DATE PRINT NAME 206LLj L 6 1A 6:5 800 Seminole Road,Atlantic Beach FL 32233 Phone:(904)247-5826 Fax:(904)247-5845 hvp://w\v%v.coab.us revised 01 30 09 1 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD A LANTIC BEACH,FL 32233 T INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00001343 Date 9/26/08 Property Address . . . . . . 5822 FLEET LANDING BLVD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc new service ----------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SCOTT PLUMBING COMPANY, INC. 9585 SUNBEAM CENTER DRIVE JACKSONVILLE FL 32257 (904) 268-6309 ---------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc . . Permit Fee . . . . 154 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/25/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 154 . 00 154 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 154 . 00 154 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. p. 2 Se 08 10:43a CITY OF AnARnC BEACH eOO SEMINOLE ROAD,AT1.0MC XACH,FL=33 08-F F OFF :(W4)247-5M 0 FAX W).:(W4)247-W5 SUILDING-OrPTOMB.US PLUMBING PERMIT APPLICATION DUVAL COUNTY ,G71T72— �=(e6ri.4obwa arm 0 NO 09 —1-305- lArWS PERNT- 5-7,6 -01? 4,NAJAF: S.ADDRESS IF DIFFER)--,NT FROM JOB ADDRESS: 6.PHONE: 7.NAME OF COMPANY: 5"Coy_ 14,100?h do. TAK -327-9-7 9.STATE OF FLORIDA LICENSE NO: 10.CELL PHO14E: 11.FAX NO.: C r—C Z_ 904V- Z.,9 -7-1 ecoe 9 40 q - 24 Z-S/7T 12.EMAIL ADDRESS: 13,OFFICE PHONE. 14. 4,eel ig 'reu,lsq fy.&C Application Is hereby made to obtain a permit to do the work and installations as Indicated. I certify that aftwork Wit be parfixined to meet am standards of all laws regulating Construction In this Osdiction. This lIermit b9comes null and vold N work Is not commenced within six(6) monW.or it construction or work Is suspended or abandoned for a period of sbc(6)months at any tlaw after woric is commenced. CONTRACTOFV�SIGNATI IRE: W FLORIDA BUILDING CODE- E3 RE-PIPE PLUMBING PLI C0370 7 H E R: BATH TUB SEWER CONNECTION BIDET SHOWERS DISH WASHER SHOWERS PANS DISPOSAL SINK DRINKING FOUNTAIN WATER CLOSET TANK FLOOR DRAIN WATER CLOSET VALVE Z_ HOSE BIB WASHING MACHINES ICE MAKER WATER CONNECTION INTERCEPTOR WATER HEATER 3 — LAVATORY URINALS LAUNDRY TRAY OTHER(SPECIFY): ROOF DRAIN PERMIT ISSUING FEE: $35.00 TOTAL FIXTURES: x $7.00 (PER FIXTURE) +$35.00 COM FORM SLOM WASED1.itiorem CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00001305 Date 9/24/08 Property Address . . . . . . 5822 FLEET LANDING BLVD Application type description TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 3.00000 ---------------------------------------------------------------------------- Application desc DUPLEX ---------------------------------------------------------------------------- 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 . . . . 1060 . 00 Plan Check Fee 530 . 00 Issue Date . . . . Valuation . . . . 300000 Expiration Date . . 3/23/09 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . CITY RADON SURCHARGE . 55 CAPITAL IMPROVEMENT 325 . 00 ST CONSTRUCTION SURCHARGE 9 . 92 AB CONSTRUCTION SURCHARGE 1 . 10 DEV REVIEW-SINGLE & 2-FAM 50 . 00 STATE RADON SURCHARGE 10 .47 SEWER IMPACT FEES 12SO . 00 WATER IMPACT FEE 460 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1060 . 00 1060 . 00 . 00 . 00 Plan Check Total 530 . 00 530 . 00 . 00 . 00 Other Fee Total 2107 . 04 2107 . 04 . 00 . 00 Grand Total 3697 . 04 3697 . 04 . 00 . 00 PERMIT IS 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 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00000722 Date 10/07/08 Property Address . . . . . . 5822 FLEET LANDING BLVD Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 16000 ---------------------------------------------------------------------------- Application desc REROOF FL 601 . 13 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PROFESSIONAL SUNSHINE ROOFING 1017 IRELAND DR DELTONA FL 32725 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 110 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 16000 Expiration Date . . 4/05/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 110 . 00 110 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 110 . 00 110 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. M- CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 08- OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 BUILDING-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: 2.VALUATION OF WORK: 13.SO.".UNDER ROOF 5?Qa F It e4- Laridi 051 Slyd Pr+(antir- br-hy r-L 5;IX,3 A I Lo, 0 00 i2' Q05 4.LEGAL DESCRIPTION: 5.CLASS OF WORK:- 6.USE OF STRUCTURE: 0 NEW BUILDING 0 DEMOLITION 9i TESIDENTIAL LOT_BLOCK-SUB DIVISION 0 ADDITION 0 CONVERTING USE 0 COMMERCIAL 7.DESCRIP'n0N OF WORK: 11 ALTERATION 11 ACCESSORY BLDG. 8.FIRE SPRINKLER. 0 REPAIR 13 POOL/SPA 13 YES ChT/A- 0 MOVE MfTHER ONO PROPERTY OWNER: CONTRACTOR: ARCHITECT I ENGINEER: 9.NAME: 15.COMPANY NAME: 13,COMPANY NAME: SL4r_IShlr)C No,yal contintAinyafe- 9-eHrernen+ Prokssioyal FoL,LndaHon, -Tno- albo, 16.NAME: 24.LICENSEE NAME: 9,c-e+- r,9 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: Oyr Ree+- L-anclin� 6 lvc( 18.ADDRESS: 26.ADDRESS: A+-1 ar\t'ic 6110ni FL 3D�;13 3 11.OFFICE PHONE: 112.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 9N-.-qi- c)qo 1 1 13.CELL PHONE: 21.CELL PHONE: 29 CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER: (IF OTHER THAN OWNER) 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 Fas 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 FINANCIOG, CONSULT WITH YOUR LENDEAQR AN ATTORNEY BEFORE RECORDING YOWRINOTICJE OF COMMENCEMENT. OWNER or AGENT flDNTRACTOR Power of Attorney or A4ency Letter Required) I I(Qualifier Only) 1�.igned:m7< Date: 9-60'0)? Signe Date: )0--7-0 9 f E . e thi day 4er+ej-nber _,2006in the county of Before me 4is tk" day of ()r+hbCX POO nty of 14eTrin the cou 't I onally appeared Duval,State of Florida,has personally appeared Duval,State of o has 3-ohn ACSevve- Santos 14-crr)qncLt---;- 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 a o r I st a,County of DLtV 4- Not P Ubl'C at Large,State of FJOI`101a ,County of WV A-f M�l5ersonally Known 17ersonally Known 0 Produced Identification- 0 Produced Identification- Notary Signature: 41 a Notary Signature: 4elwl� y JENNIFER SNOW JENNIFER SNOW Notary Public-state of FWWa yp 1,:, Aug 23,2009 , Notary Public-State of Fbrida CO -14iily Commission Expires Aug 23,2W9 Cwnmiss&#D0464853 Commission#OD464853 Bmided By Naftial AWL % #4#4 1 - SwIded By National Notary Assn. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00001305 Date 12/01/08 Property Address . . . . . . 5822 FLEET LANDING BLVD Application type description TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 300000 ---------------------------------------------------------------------------- Application desc DUPLEX ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ R. P. C. GENERAL CONTRACTORS 248 LEVY RD ATLANTIC BEACH FL 32233 (904) 241-44 16 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 87 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/30/09 ------------------------------------------------ ---------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 87 . 00 87 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 87 . 00 87 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. NOV-,I-2008(TUE) 10:18 Peninsular Mechanical Contractor (FAX)727 572 0978 P. 006/006 D CITY OF ATLANTIC BEACH MECHANICAL PERMIT APPLICATION S6 Z2— PU7'Loll"" �IV'b Date: w%, ,"Z S7-Zt�4-2 ap _6E ZA-5 Property Address: =V Owner. La*'04'iP Telephone cS-7 13 Contractor.,Fyvn.�. ipa Telephone#: . NOZI a. Contractor Address: &,W Fax _q;"-7 to cossirictation of permit given rar doing the work as described in d10 above SWFX�t.wi hereby arm 10 porform iiiii work in accordsitcc with tbc sanchad plans and specificittions which are a Put hmof EW in pecordana with the City o(A"it Read ordinances and standards or _good VL*�limed thereln. Type of nesting Fuel: if otber construction is being done on Ws buildin �r ziectric or site,list the buil(gag peirmit number 9 0 Gas: _LP __�qeurai —central Utility o P, r-S 0 5 0 Oil W_Other-Specify MECHANICAL EQUIPMENT TO BE INSTALLED ATURE OF WORK Heat _Space _Recessed yeentral —Floor Residential Air Conditioning: —Room Central 7e Duct System: Mxterial_'Q!t4_ 00-Thickness _QV�L 0 Commercial mum canacity---------chn New Building 13 Refrigeration 0 Cooling Tower Capacity 0 Existing Building 0 Fire Sprinklem Number of Heads 0 Elevator. __ M&nl1ft___Pcalatot�._. (Numbef) 0 Rcpkwcmcnt of Existing System u Gasoline Pumps New Installation a LPG Contaiojrj� Number) (No 3ystern roeviowly installed) 0 Unfired Pressure Vessel U Extimion.or Add-on to Existing System a Boilers 0 Gas Piping 0 Other Spc4i 0 other—Socci LIST ALL EQUIPME14T AM CONDMONING,RESUGERATION EQUIP.KENT&C9M1gr4WR3 AppFaving Number Units Description . Model I 'Manuhmm Ton's Agenty V�qi-zj� C=140 C-5. T1- �4e� L.A 1 *1JrAT1NC—'P1WAC1MB01l1XP&F11REPLACES AOL 9ANDLER-S Approving Number Units Dacription Model 0 Mahurocturcr BTIJ'a Agency WKS Notaind Capacity —Ty—pe Lioptid serial Approving How Many 4-Dinmadc" CorAlliNd No. AM!X 800 Seminole Road-Atlantic Beach,Florida 32233-5445 Phone;(904)247-5800- Fax: (904)247-5845* http://www.cLadsntic-beach.it-us City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us 0, City web-site: hftp://www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM ss: 2 Z I— Department review required Yes No Property Addre n6i!� Building i2 Planning &Zoning Applicant: Public Works Public Utilities Project: Public Safety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco APPLICATION STATUS Reviewing Department First Review: DApproved. (Circle one.) Comments: BUILDING PLANNING &ZONING PUBLIC WORKS Date: PUBLIC UTILITIES Second Review: Comments: PUBLIC SAFETY FIRE SERVICES I :e: Third Review: []Approved Comments: Reviewed by: Date: BUILONG PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 ri,119 Office:(904)247-5826 9 Fax: (904)247-5845 lob Address: 5820 Fleef Lcilndinq Blvd Permit Number: 1j ,egal Description A Pcy-f &C I-OtS 1 4 Q [)iv i Von 3 And rews Dcu3V3 C-A'rar* Valuation of Work(Replacement Cost) $ -XO , DOC Class of Work(Circle one): Addition Alteration Repair —M-py- C Cir Use of existing/proposed struct c IN ui r e pre-s) cle one): Commercial (.Residentpia 7o • If an existing structure, is a fire sprink er system installed? (Circle one): Yes • Is approval of homeowner's association or other private entity required? (Circle one): Yes �Do )escribe in detail the type of work to be performed: Villa horm C(Awtu, �?0105 'SF-: I �ropert-y Owner Information NeLvql ContinikinclOW Rttirtmayt Fbmnd&fton, Tne- ,4ba- ��'d 111 C1 Address: Cm Ftt.C+ kAriallrl Nvd 'ity--A:b&ntf c, — State RZip&��,-b Phone qDq- Q 1 - 9909 �ontractor Information: �ame of Company: Q0- 6icncr al ftfractors., T�ie- Quaiif�i A),ent: Pe-* iegariqtAcd kddress:-0-?jg Lfvy Qd city State FLJ _Zip 52P.,36 )fficePhone qpW-,,24j-q4j (,o Job Site/Contact Number q Oq- �219 955�P ')tate Certification/Registration# C67 C 0 q 0 U L'7 OfficeFax4 qD14- �?L11 - LH4J krchitect Name & Phone # NO 1KCr 6 HU11 ASSOC c, Mih-e Hull 7 11-,9U3- Fq le q 'ngineer's Name &Phone# -S L4k&aS ;t A&SO C -Tim Lu a as q c�-3 q4-3o YD I i a"'on he e ade to bla n erm it to I p!,b 0 ' - po'c c f is r by"d that a I 'k e e gsuan e 0 apermit an wo �vl p 6 " i ,,d id fok is not commenced_thin six "'k is""",ed. I understand that eparate indAir Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT qAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF V'OU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY 3EFORE RECORDING YOUR NOTICE OF COMMENCEMENT. hereb certify that I have read and examined this application and know the same to be true and correct. Allprovisions of laws and ordinances governing!lus 1�1'yl iveauth rity to violate or cancelthe provisions ,Te 0'work will be complied with whether specifiedherein or not. The granting ofa permit does not presume tog any otherfederal,state, or local law regulating construction or the performance of construction. Signature of Property Owner: a4 Signature of Contractor: Sworn to and subscribed before me Swom- to and subscribelbef�rre e this*'6+h Day of Au A- .206V thisAO'Day of Phkago- Notary Public: Notary Public: Z.1. JENNIFER SNOW JENNIFER SNOW State of FW4s yp" Notary Pubk Notary Pubk-State of FIoWe !My CWWW"ExOm Aug 23,2= 90y Corrrftsion ExpIres Aug 23,2W9 Conwillion I DD46M C*TdnbWw 0 DD464853 #sow An do I3yN@1"=Awn. fill Sonded%le-M - NoWyAlon. DO NOT WRITE BELOW THIS LINE: OFFICE USE ONLY '.eview Result(Circle one): h /-I City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: Cityweb-site: http://www.coab.us 1 9 APPLICATION REVIEW AND TRACKING FORM SS: C5A Department review required Yes No Property Addre C4 Building Planning &Zoning Applicant: ;el _F_j4!4 6/77jleA0_An!3 Public Works /I I Public Utilities Projicil: Public Safety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept.of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: FfApproved. E]Denied. _(C�ircle Comments: PLANNING &ZONING PUBLIC WORKS Reviewed by:—JM Date..C/—/ -0 PUBLIC UTILITIES Second Review: F]Approved as revised. []Denied. Comments: PUBLIC SAFETY FIRE SERVICES Reviewed bF i I F C Date: Third Review: E]Approved as revised. FlDenied. Comments: Reviewed by: Date: BuILDING PERMIT APPLICATION :01 CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach FL 32233 Office: (904)247-5826 9 Fax: (904)247-5845 fobAddress: 591-1 fleze�- LcknCtinj 6tvc( Permit Number: .egal Description A- Pa4 09 Lo45 16 0 -0 D(visioyl 3 Andre-ws Cewem Cnran 4- Valuation of Work(Replacement Cost) $ 30c�DOC). 00 • Class of Work(Circle one): ' e' Addition Alteration Repair Move--, Circ • Use of existing/proposed Strl.[Ctu�reFs�) (( cle one): Commercial • If an existing structure, is a fire sprink er systern installed? (Circle one): Yes No • Is approval of homeowner's association or other private entity required? (Circle one): Yeas �E) )escribe in detail the type of work to be performed: 6)r)ole Home, �roperty Owner Information Naval (In"ntOnj Care, Qe.+1r,*nxM Fewndation j xi)C db4 qame: r-lfe4 Landly)g Address:— One F[C& Uncilriq Blvj �ity Maylvi C, 6&61 State fL Zip 62,93A Phone 904-o941-9 9 0& -ontractor Information: �arne of Company: K P -3CYYrQJ C011MODYSTm Qualifying Agent: e ri L P, ( P-b I�Dct ILtiCS kddress: a4q Levv Rd city Ai-lanfic tate F(�' Zip _-6aa,33 )fficePhone qpq <941- 4L411P Job Site/Contact Number 9 0 'T. goKa 3tate Certification/Registration 4 C,6qC, 040(09 Office Fax 4 %rchitect Name &Phone# No el A er 0 001 P,&SuC I V4V X i�e Elul 1 1,10- Qhaj- 8 ,n(-y;nPPr'-z'NTqmP ,9rP1inni- fi ljlpa,� A,c�rno,.' -rfrn LjOdA Cl 0'4— .-Aq 1._:in/a n City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 Vi IF) E-mail: building-dept@coab.us Date routed: Cityweb-site: hftp://www.coab.us I I APPLICATION REVIEW AND TRACKING FORM Property Address: Department review required Yes No Building Applicant: Planning &Zoning Public Works Public Utilities Project: Public Sa fety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: 7Approved. E]Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING PUBLIC WORKS Reviewed by: Date: PUBLIC UTILITIES Second Review: DApproved as revised. []Denied. Comments: PUBLIC SAFETY FIRE SERVICES Reviewed by: F11 E 11-11PY -Date: Third Review: FlApproved as revised. F]Denied. Comments: Reviewed by: Date: BuiLDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seniinole Road,Atlantic Beach FL 32233 Office: (904)247-5826 * Fax: (904)247-5845 �obAddress: 59.21 Flee+ Landinq Blvd Permit Number: 1i ,egal Description Pt Par+- 0-P- Lo4s ) 4 Q , Division 5 AnctreAoS Dewces Gron+ Valuation of Work(Replacement Cost) $ &01, UU0 • Class of Work(Circle one): Addition Alteration Repair • Use of existing/proposed structure(s) Circle one): Commercial (;R e�s i0dve,�1 i a? 6s____ No If an existing structure, is a fire sprink er system installed?(Circle one): es C'�j Is approval of homeowner's association or other private entity required? (Circle one): Yes oD )escribe in detail the type of work to be performed: Villa Horne oiz 5 S F 3roperty Owner Information Noxo,l Con-nnuinq con omxnxn� F6Ur1dCL_hDnj::7--nr_ dbcL �ame: fl-e-ci I-Mct!" Address: One Flext kandinq Hyd �ity P�fjanfjc bcocpi State ELZip 3o-2,-�� Phone -ontractor Information: �ame of Company: &C 6tcrxra� CewilranfMs r4C Qualifying Agent: fe-b P_cdri-qu-as kddress: -QLW Lx_vL4 12,d -City i9j-tc(j*ic Sckj State Ft Zip 3 -1-3 )ffice Phone 9o4 -A I- 441(p Job Site/Contact Number itate Certification/Registration# C��siC 04001 19 —OfficeFax # 90z4- 0q1-1f4 -_)7 krchitect Name & Phone # Noel ?-cr * tiull ASSOC-orne. rAjjAtj4"I1 rjIj-,qU3-F4j (V� ingineer's Name &Phone # ',I Li,,t04LS4- A_1-S0C_ ' 1'1'ry) LL,(oq5 q o q- 3ci(,- 3D4.E) Ipplication is hereby inade to obtain a perinit to do the work and installations cis indicated. I certify that no work or installation has commenced prior to the Ysuance ofaperniit and that all work will beperfornied to nzeet the standards ofall laws regulating construction in thisjurisdiction. Thispertnit becomes null ind void ifwork is not commenced within six(6)nionths, or i(construction or work is suspended or abandonedfor a period o six(6)months at any tinie after i,ork is conzinenced. I understand that separate perinits must be securedfor Electrical Work,Plunibing,Signs, Wells,Pools,Arnaces,Boilers,Hearers,Tanks indAir Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT VIAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF �'OU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY 3EFORE RECORDING YOUR NOTICE OF COMMENCEMENT. herebv certify that Ihave read and examined thisf hplication and know the sanze to be true and correct. Allprovisions la sand ordinances Foverning this e I vpe ofivork will be complied with whether specifie hereinornot. The granting oj'a perin it does not presuni e to give au ori to violate or cance the provisions ing cons ru I.' or the petforniance ofconstruction. V any otherfederal, state or local law regidat' t c Jfn r: SiViature of Property Own( _4�� Signature of Contractor::= Sworn to and subscribed before me Sworn to and subscrib/d�f�ore ::/' this.21*'t"Day of -A-Lxgl this,2(a�Day of A-uau�k 3? I.; Notary Public: 413"_ ILI Notary Public: Na—A.&M.0, - V JENNIFER SNOW Ry P". I JENNIFER sNOW A.�- 411 0 Notary Public-State of Florida y g r _�,fk PV&r., loridjog 23j 2 Notary Public-State of Florida 23. 3 8 1] ku ZM 164:]n 85 y Commission Expires Aug 23,2009 SW Commission Expires Aug 23,2M9 5 Commission#DD464853 otary Ass Commission#DD464853 Bonded By National N ry W '10 Bonded By National Notary AM. U DO NOT WRITE BELOW THIS LINE: OFFICE USE ONLY ',eview Result (Circle on 7- Vis CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00001305 Date 10/15/08 Property Address . . . . . . 5822 FLEET LANDING BLVD Application type description TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 300000 ---------------------------------------------------------------------------- Application desc DUPLEX ---------------------------------------------------------------------------- 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 . . . . 1060 . 00 Plan Check Fee 530 . 00 Issue Date . . . . 9/24/08 Valuation . . . . 300000 Expiration Date . . 4/04/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1060 . 00 1060 . 00 . 00 . 00 Plan Check Total 530 . 00 530 . 00 . 00 . 00 Grand Total 1590 . 00 1590 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES.