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Permit 1950 Francis Ave � ?r11%/-f. -, r " CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00031213 Date 9/27/05 Property Address . . . . . . 1950 FRANCIS AVE Tenant nbr, name . . . . . . PORCH ADDITION Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1500 Owner Contractor ----------------- ------- ------------------------ WISE, JOSEPH K. OWNER 1950 FRANCIS AVENUE ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------- ------------------------- ----------------------------- Permit BUILDING PERMIT Additional desc . . Permit Fee 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation 1500 Fee summary Charged Paid Credited Due -------------- --- ---------- ---------- ---------- ---------- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 90 . 00 90 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WII'H ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING OFFICIAL CITY OF ATLANTIC BEACH Cc: BUILDING / ZONING DEPARTMENT ° . Hi ' y t� 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 Wild` (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # d -D2- /3 Property Address: 1 ! �'�-' , tea ► e' -! � Applicant: -.J �'� `l IL)i S Project: 0 cc it `47L".`- '' �31� This pe it application has been: Approved ��Reiewanthowing ite a attention: l b'_' - c,ES (y UJ _ 1P r�rz C. •"Oro Nc LLA LIX Please re-submit your application hen these items have been completed. / Reviewed By: Date: ` Date Contractor Notified: BUILDING PERMIT APPLICATION S-) )1K �/ (Alterations &Additions) Date: Job Address: Owner of Property Address: v L� Telephone: Cu 3 Legal Description: Block Number: Lot Number: 1 2 Zoning District: ,:T)o a Contractor: S G <- F State License Number: Contractor Address: ,{ v t rE- Telephone: �_ %��vt t" Fax: Describe proposed use and work to be done: .2 L (7 v fJ 0 / %/ G' kJ Present use of land or building(s): Valuation of proposed construction: d• 0V What are the dimensions of the added space: feet x feet Will the added area be heated and cooled? CJ New electrical or increase in service? Nom_ Add plumbing fixtures? Add fireplace? Add heatinglair conditioning? 1 Jo Is approval of Homeowner's Association or other private entity required? IVE) If yes, please submit with this application. Will this_project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to the original impervious area or the removal of any trees? []INO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. D40. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 .Fax: (904)247-5845 •http://www.cLatiantic-beach.fLus Page 2 Revised 8/04 m actattton to construction ana engineering aetarl, plans must contain the following mtormauon as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct Signature of owner: 4 ? Date: ! J 3` G� I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: Address and contact information of person to receive all correspondence regarding this application(please print). Name: L-D S E Mailing Address: f }'d _ .2•� c (S' fy F � T < (✓ < , _ Telephone: 7 G �1 3 Fax: E-Mail- AS TO OWNER: Vl�iSR- Sworn to and subscribed before me this }3day of t o -C.vvx.✓� ,20013, . State of Florida,County of Duval ; " '^;' 11 JEANNEM.SHAW Notary's Signature: • r- l .; ;r MY COMMISSION#DD 435986 oa EXPIRES:May 31,2009 Bonded Thru Notary Public underwriters ❑ Personally known roduced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 State of Florida,County of Duval Notary's Signature: ❑ Personally known 4` t ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 http://www.ei.atlantic-beach.fl.us Page 3 Revised 8/04 { i i ' a i rr a � . f '91414 .�i r SEP P ` , i , 4 i i 04 17 f N x inL M t s, Is Am4c,L adv G g 143 c�d�ocfcrc�s� be.✓��_� i. j MAP SHOWING BOUNDARY SURVEY OF LOT 10 BLOCK 10 AS SHOWN ON MAP OF D ONNER 'S REPLA T AS RECORDED IN PLAT BOOK 19 PAGE 16 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLA. CERTIFIED TO: JOSEPH K. WISE SIMMONS ROAD (30' RIGHT—OF—WAY) FOUND CAP L 0 T 11 iO W FOUND 1/2" 1/2- N90' .00 110.00' FOUND 1/2" I.R. k 6080 .8' I.P. NO CAP Z 0.3' G i� W L 0 T 10 . 6' WOOD FENCE � 'f r w O 18.4' • Q LL) � 46.7 _ co m I WE STORY AlU NICE M J . O ? (n 2" P.V.C. S'o' RESIDE ADOREss ,t! 1g50 ` 16.9 WELL L O T 12 ro 20.5' d W m ~ 3.?' �n 3 5.1 12.2' CONC. o `. s _ _ q a O N WOOD N STOOP STEPS CONCRETE o Q w U U' O SHED DRIVEWAY ; 5.5'f 2e1 Q O Q 0 EN STEPS 2' X 3' , Q �, Z O PLASTIC O N % PORCN o A.C. PAD f0 Z X`�'- �QR /__46' WOOD FENCE p 2.00'x2.00' 00 CV OFF-SETS X TOB SET 1/2" SET 1/2- T — — P. #3857(W)� I.P. M3857(W) -0'fi EOW (108.00' I.P. TO I.P.) D_I.T C,H 1'X1' TELE. W RISER SET 1/2 TOB (1 I.P. ,y3857 S90'00'00"W 110.00 B L 0 c K 11 THERE MAY BE ADDITIONAL EASEMENTS AND/OR RESTRICTIONS THAT ARE NOT SHOWN UNDERGROUND ENCROACHMENTS NOT LOCATED �. c„airy TWAT UAY RF FOUND IN THE PUBLIC RECORDS ON THIS COUNTY. r1`�1i`1fl CITY OF ATLANTIC BEACH cc: .� BUILDING / ZONING DEPARTMENT D. Ford qqins„ 800 Seminole Road Oerr Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # OJ-- 3/Z / 3 Property Address: 2967 �J'(� 5 A `' Applicant: je� i [S �- Project: 7o f C D-,o This ermit application has been: Approved F-� Reviewed and the following items need attention: Please re-submit vaur a plication when these items have been completed. Reviewed B Date: 01-/ 3 Y Date Contractor Notified: CITY OF ATLANTIC BEACH \\s� BUILDING PERMIT APPLICATION (Alterations&Additions) J~�rJi�lill i Date: Job Address: Owner of Property: h I St Address: _``1�� r '/`S (/e Telephone: Legal Description: Block Number: ! a Lot Number: / Z Zoning District: J7 0 N Contractor: S!_ _ F State License Number: Contractor Address: S 11 bi != Telephone: S til r, Fax: Describe proposed use and work to be done: _ /,/J() ,2 C (-I ✓-E fJ 0 ! I / 0 AJ Present use of land or building(s): 11 Valuation of proposed construction: • D U What are the dimensions of the added space: feet x feet Will the added area be heated and cooled? Ny New electrical or increase in service? _ Add plumbing fixtures? Add fireplace? p Add heating/air conditioning? �JU Is approval of Homeowner's Association or other private entity required? Na If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to the original impervious area or the removal of any trees? [/NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. E?<0. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as a1mrouriate. Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atlantk-beach.fl.us Page 2 Revised 8/04 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways,sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct. Signature of owner: Date: 9` 13^ eLC I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with,whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: Address and contact information of person to receive all correspondence regarding this application(please print). Name: o rc L-5 r S F_ Mailing Address: J } O _ /-/Z .y C t S 114 y Telephone: a' cl 3 Fax: E-Mail: AS TO OWNER: J oS eQtti �� WiSp_ Swom to and subscribed before me this day of SP—P 200;5 . State of Florida,County of Duval ,,'.;�:**11; JEANNE M.SHAW Notary's Signature: •--! _.: A MY COMMISSION#DD 435966 _ ., Arg EXPIRES:May 31,2009 ❑ p ovally known '• q ,°�`` Bonded rhru Notary PubNd Undenvritera roduced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atiantic-beach.fl.us Page 3 Revised 8/04 3 rJ ss� r l CITY OF ATLANTIC BEACH OWNEWBUILDER AFFIDAVIT Date: Job Address: CHAPTER 489,FLORIDA STATUTES,PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE— OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK(EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER"DIRECT SUPERVISION OF THE OWNER,WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS. SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS-WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER—BUILDER PERMIT. ROPERTY OWNER/BUILDER SWORN TO AND SUBSCRIBED BEFORE ME THIS i 3 DAY OF-s = " 00 JEANNEM.SHAW MY COMMISSION#DD 435986 EXPIRES:May 31,2W9 Fi nded Thru Noury 7ubft Underwriters TARY PUBLIC ' MY COMMISSION EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. SEP NOTICE OF COMMENCEMENT _ State of_ 7 k ew, C, _ Tax Folio No. County of `,Y To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: Address of property being improved: %06c> KGs A,jt General description of improvements: Owner: Address:_ t���-� �tl�►�.r.� p�'� Ft-7��c{-� F�. 4�.�.�3 Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Address: Contractor: Address: Phone No: Fax No: Surety(if any): Address: Amount of Bond$ Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents may be served: Name: Address: Phone No: Fax No: In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in -- Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option). Name: Address: Phone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLYOWNER Signed: A,�&/"Z;_Q Date: 7-- l.3 6 Befo me thi day ofin the County of Duval, State of Florida,has personally appeared_3 vy-VV, 1C.l,a�R Notary Public at Large,State of Florida,County of Duval. My commission expires: l 97,__ Personally Known: or Produced Ident' JEANNE M.SHAW =•i MY COMMISSION#004306 dt EXPIRES:May 31,2009 Booded Thru Noury PU*Ur4orwftm MAP SHOWING BOUNDARY SURVEY OF LOT 10 BLOCK 10 AS SHOWN ON MAP OF DONNER 'S REPLA T AS RECORDED IN PLAT BOOK 19 PAGE 16 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLA. CERTIFIED TO: JOSEPH K. WISE SIMMONS ROAD (30' RIGHT—OF—WAY) FOUND 1/2" q� {[ /ropy I.P. NO CAP 4.J�,.B f , Tl :� "e9 y o. enc Bee Am*0 and Zonkp rMnettl Ttria met vsrt�ee wl�r coning, subdivision and of r local development regulations, turf not constitute approval for the issuance of perm Compliance with Florida Building Code and>!d ther applicable local, State and Federal perfnittI g requirements must be verged by signature of th 'Cl,of Atlantic Beach Building Official prior to t Ssuance of a L 0 T 11 Building Permit Approved By: �O orn evel ment ire a Date: W FOUND 080 N90'00'00„E 110.00, FOUND 1/2" D I.R. # 6080r6' I,P. NO CAPD.sGZ L 0 T 10 W FENCEOOtoO U .. Q N Q O a6.T N w Q DO I ONE STORY ALUMINUM a L3.2' SIDING RESIDENCE Z V) O L 0 T 12 ro ADDRESS f 1950 p0.5' 16'9 a Q 35.1 12.240NI coNc m W m O NWOODSTOOFSTEPS CONCRETE 0wO SHED DRIVEWAYOO 5.5. 261riNO STEPS 2. x �� .0 Q O PORCH PLASnc O O O Z xN " o A.C. PAD M Z �6' WOOD FENCE p 2.00'x2.00' fn X N OFF-SETS —0 TOB i _ _ TOB SET 1/2" SPT 1/2"#385 W) (108.00' I.P. TO I.P.) P. #3857(W) SET 1/2 — Ow 1'X1' TELE. RISER I.P. #3857 59000,00"W TOB 0.00, Li 8 L 0 C K 11 THERE MAY BE ADDITIONAL EASEMENTS AND/OR RESTRICTIONS THAT ARE NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS ON THIS COUNTY. LINnrRCRALINn rNCRAArWUrNTC NnT I nrerrn `� \ �,,��� � k � �� �� � , � r � ', � � �' � � j '���,. � �� 1 �\ 6 ��+�� ,;\\ �e ,, � � , , , �:; ,\ ,,, � �, � � , �� � , � � � i��. �� �� t l., ��� �i \.,.. �'�'�� �� ,�;. ,, {. i \ �` �1 ���,� � �� ������ '��A �� �� �� � �,, r: 1 y , ? s i a i 4 t n EN r, ell ac- �V W s as e r o I 0 P P r R � #.f4, r n 5 3 E I I i j t 1 9 j r E 3 E C'f U%z5 COB l , � E s e u- , A/ 7 V/� � 4 i t 103;8 PWW4a DEPAFCTMENT of BUILDING CITY bF ATLANTIC BEACH . - -------- LOCATION 101OWT I0N y. p RML INFORMATION - Permi -Number" . ��0,8 Address. 1:950' - C� � ASE DE Permit ME : IAi� CAL ATLA 1 $EA H, A'L XIDA 3223,3 i of �Work. ' ALTRRA TON r ARAN Lot : ,P � 33 S1`o6k:.: . t W ; : � + � SINGLE FAMILY 'township., RNA:. �? � riXings. I code. 0 Subdivision: DONNER ZstfI"ted Value: $0.00 Total Fees: , 84 .00 Amount $0 .00 Wc�xk . NTRAL I EAT AND AIR IN RUV RI IAa 00 VT ­OF Atid AVI N > ' 'DATER IMPAOT"' VE-9 $Q .0-0 pAI rt CR `FLOI7 3 SIF EE RAICNA�S �--_- -- BION CAH �t3 .�Q game: RS' A Q ANI? CAPITAL IMPROVE. 0.0 'tliLL�E, PSS 32211. CROSS Ci0N"IKC' Ib,N 0.00 Li RNC 1 Types 3 SEC H ;IMMIO101s, 11 4�} CONST.!t ,RC`#AR£�L '; 00 :VOTES:` 141GTiCE—ALL CONCRETE E F ?HA�S.AND FOOTING MUST�INSRECTED AFORE Rl PERMIT VOID SIX MONTHS AFTER,DATE OF 15,x. lE F3U[L: NG MATERIA!,RUBSISH AND DEBRIS FROM THIS WORK MUST NOT BE;PLAGEl !N FIJBL#C S#A►G AAICI MUS CLI~AA#ECti UP AND HAULED AW4Y 81l EITHER CONTRACTOR OR OWNER yy�1�rr Vii/s � � .;� � MECHANICS PI'S L�F�MIM 0L t�I�I 10" Tw ffTQ"APA'I4?Vf©PIANS WHICH ARE PART OF THIS PERMIT Alb SLf�+ TTt � T# I A 'UCABL E PFtC)1/I510NS OF LAW. . A H BUILDING DEPARTMENT Am auk �Fl MORTGAGE NOTE Atlantic Beach,Florida For value received, the undersigned (jointly and severally, if more than one), promise to pay to the order of the City of Atlantic Beach, a municipal corporation, 800 Seminole Road, Atlantic Beach,Florida 32233,the principal sum of Jw t Thousand Two Hundred Sixty-Six and 00/100 Dollars (S20' 62 6.00) being payable in lawful money of the United States of America at 800 Seminole Road, Atlantic Beach, Florida 32233 or at such other address as the holder from time to time may specify by written notice to the maker. Said principal sum shall bear no interest and shall be reduced in amount at the rate of 1/10th per year until reduced to a zero balance at the end of 10 years. Any unfbrgiven balance shall become immediately due and payable if the maker transfers title to or moves from the premises securing this note within the 10 year period. In the event of the death of the maker of this note, this note shall remain in effect and the principal sum reduced at the above rate of 1/10th per year only if a member of the makers immediate family takes up residence in the subject home,under any other circumstances the note shall become immediately due and payable. This note is to be construed and enforced according to the laws of the State of Florida, and is secured by mortgage on real estate of even date herewith. If default be made in the payment of any of said sums or in the performance of any agreements contained herein, then, at the option of the holder of the same, the principal sum then remaining unpaid shall immediately become due and collectible without notice, time being of the essence of this contract, and said principal sum shall bear interest at the highest rate allowed by applicable law,from such time until paid Each maker and endorser waives presentment, protest, notice of protest and notice of dishonor and agrees to pay all costs, including a reasonable attorney's fee, whether suit be brought or not, if counsel shall after maturity of this note or default hereunder or under said mortgage, be employed to collect this note or to protect the security thereof (seal) Ame of Maker (seal) Makers Address: 1950 Francis Avenue Atlantic Beach,FL 32233 STATE OF FLORIDA DOCUMENTARY STAMPS IN THE AMOUNT OF S HAVE BEEN AFFIXED TO THE MORTGAGE SECURING THIS NOTE AND CANCEU.ED. PRE-CONSTRUCTION CONFERENCE REPORT READ CAREFULLY BEFORE SIGNING I (WE) THE UNDERSIGNED HAVE ON THIS DATE AT l� PARTICIPATED IN A PRE-CONSTRUCTION CONFERENCE PRIOR TO THE SIGNING OF A CONTRACT FOR THE REHABILITATION OF MY (OUR) PROPERTY. WE ACKNOWLEDGE THAT WE UNDERSTAND THE TERMS OF THE CONTRACT, THE EXPLANATION OF THE WORK TO BE PERFORMED BY THE CONTRACTOR, THE ROLE OF THE CONTRACT ADMINISTRATOR OF THE REHABILITATION LOAN PROGRAM, AND OUR RESPONSIBILITIES DURING THE CONSTRUCT- ION PHASE. I (WE) HAVE BEEN GIVEN AN ADEQUATE EXPLANATION TO OUR QUESTIONS, IF ANY, AND ARE AWARE THAT ASSISTANCE WILL BE PROVIDED BY THE STAFF OF THE REHABIL- ITATION LOAN PROGRAM IF REQUESTED. WE FURTHER UNDERSTAND AND ACKNOWLEDGE THAT THE REHABILITATION LOAN PROGRAM ASSUMES NO RESPONSIBILITIES FOR THE WORK PERFORMED AND DOES NOT WARRANT ANY WORK PERFORMED. r � 5 ��,Slgnatj&e of Property wnertOa e2 Signature of Property Owner to --------------------------------------------------------------------------------- I , THE UNDERSIGNED, HEREBY CERTIFY THAT THE PRE-CONSTRUCTION CONFERENCE WAS HELD ON THIS DATE BETWEEN THE HOMEOWNER(S) , REHABILITATION LOAN PROGRAM CONTRACT ADMIN- ISTRATOR AND MYSELF. I UNDERSTAND THE PROCEDURES TO BE FOLLOWED FOR CHANGE ORDERS AND REQUESTS FOR PAYMENT. I UNDERSTAND AND AGREE THAT THE WORK PERFORMED MUST MEET THE STANDARDS OF PERFORMANCE REQUIRED BY THE REHABILITATION LOAN PROGRAM AND ESTABLISHED BY THE REHAB STANDARD PERFORMANCE MANUAL. do,--c -"q, A gnature —ofZ `� Contri rfii tete to --------------------------------------------------------------------------------- I , THE UNDERSIGNED, HEREBY CERTIFY THAT I PARTICIPATED IN A PRE-CONSTRUCTION CON- FERENCE THIS DATE AND THAT I HAVE COMPLIED WITH ALL OF THE PROVISIONS OF THE REHABILITATION LOAN PROGRAM PROCEDURAL MEMO DUM #49. PROCEED ORDER DATE: Z/t 4Z .3 TO: Af�XA.yro(e✓ .4SGLCf H 1 Jt✓6/ 2 f DINV2 , Sur fe 2 / G ° YJ1LPf FL- 3 Z 2 This is to .authorize you to proceed with work specified in our contract dated / for improvement work on the property located at CLIye<-f u The amount specified in the Rehab- il�tation Agreement is $ Q, Z�G.OQ Please proceed in accordance with the Contract. You are to commence work no.later than . All work shall be completed according to the Work Write-Up, plans, Change Orders, Addenda and Specifications within- sixty (60) calendar days after start- ing construction. AA/1'5f ame(s) bf ef(s) OwnerJ6 sig tore) e s ignature) ADDRESS: Z 11 ( ocal- Pub c 4g,ency Rep seatative) . ' Copy; RLP-143 REHABILITATION LOAN PROGRAM RESPONSIBILITIES OF HOMEOWNER AFTER CONTRACT IS SIGNED Until Work Begins Start planning ahead. Plan adequate storage space for the contractor' tools, equipment and materials. Make arrangements for the contractor t� get into your property if you will not be home during the day. To avoid mutual confusion, one member of the family should be delegated a: the spokesman to discuss problems or questions that may come up. If all household members work or will not be home during the construction, consider designating an agent such as a close friend or neighbor or rela- tive not living with you to supervise the contractor' s work. You are responsible to make sure the contractor does the work exactly as he stated he would do in your contract. Prepare your property and furnishings for the rehabilitation - use this period to send your drapes to the dry cleaners - wash your curtains. There will probably be dust and dirt from the work - protect your furnish- ings and clothes - put all breakable and valuable items away so they won' t be broken or misplaced. When the Work Begins Keep your copy of the work description handy and refer to it often. Check with your Case Manager if there is anything you do not understand. Remember you are responsible for ensuring that the contractor does the work correctly as bid. Assistance will be provided if required but the work must be acceptable to you. Try to stay out of the construction area, especially children; this will help prevent injuries and allow the workmen room to work. Try to keep a good relationship between your family and the contractor - again, delegate someone to be the spokesman for the family. Stop problems before they start - if something isn't going the way you feel it should, or if you don't understand it, speak to the contractor at once and get an acceptable explanation or correction before it progresses too far. If the contractor cannot give you an acceptable explanation, stop the work and call the Case Manager for assistance. Expect the unexpected - in most cases changes and improvements will be new and exciting to you and will give you much pleasure; however, unforeseen problems may be uncovered during the course of the work which may require a change to the contract. Be prepared if this should happen - discuss changes with the contractor and get a good explanation of the change required and why. Try to visualize what the change will look like. Be flexible. All changes to the contract must be approved by you and your Case Manager and must be in writing. Your contractor is responsible for supervision of his workers. If he cannot be present, make sure that he tells you who to talk to if you have a problem or questions. Win cooperation from the workmen with good basic human relations. A wn -A of appreciation - unexpected pot of enffoo -- - CONTRACTOR'S AFFIDAVIT STATE OF FLORIDA COUNTY OF DUVAL SS BEFORE M£, the undersigned Notary Public, personally appeared �� , who, being first duly sworn by me, deposes and says : That on � TL�(y M , 19 , as owner,and as contractor, entered nto a certain construction -contract whereby sa ontractor agreed to provide certain labor and materials for said owner upon the following described lands belonging to said owner, located in the City of /Item_ ✓, County of and State of Florida, to-wit: That deponent is the of said corporation, herein referred to as the contractor, and has personally supervised the performance of said contract. That said contract, has been fully and completely performed, and said contractor and all persons , firms and corporations contracting or dealing with , or directly employed by said contractor in connection with said building operation or in connection with said contract, have been paid in full . This affidavit is made in compliance with the provisions of the Uniform Mechanic's Lien Law as approved June 4, 1935, as revised, Laws of Florida , and to enable said contractor to receive his full and final payment from the owner, under the construction contract above referred to. 1Zk#ke4-"4 kA/4 Zn'i ewA"" to kaf^"a Ma tide c,;ONTRACTOR PAYMENT REQUEST Homeowner: Payment #1 - 40% Complete�� Address: #2 - 80% Complete #3 - 100% Complete_____, Contractor: Amount Requested: $ ----------------------------------------------------------------------- Contractor: I hereby request an inspection to receive payment #_ for the amount of $ I certify that I have satisfactorily completed the necessary work to justify this request and that all bills incurred for labor used and materials furnished in making said repairs and im- provements have been paid in full to this date. Attached is a description of the work completed and the amount of payment requested by work item. Contractor' s Signature: Date: ----------------------------------------------------------------------- Homeowner: i/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon in- spection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. Owner' s Signature: Date: Owner' s Signature: Date: ----------------------------------------------------------------------- Rehabilitation Inspector: I hereby certify that I exercised reasonable care to determine that the work performed at the above address meets specifications and was completed in a satisfactory manner; however, neither the undersigned nor Jacksonville HUD is in any wqy responsible for the acts or omissions of the contractor, any subcontractor, or any of the contractor's' agents or employees, or any. other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the proper- ty owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. I hereby certify that all work is completed as indicated on the contractor' s payment request and recommend payment to the contractor in the amount of S Rehab Specialist: Date: ----------------------------------------------------------------------- At 1.00% completion: CHANGE ORDER No. Date of Contract Date Owner Name: Property Address: Contractor Name: _ Contractor Address: Description of Work Change: AMOUNT: CATEGORY: No. -- SUM Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order•is made a part of the contract dated first above, parties have hereunto set their signatures: $ Contract Price + or - $ Change $ Total Owner Approval: Date: Contractor Approval: Date: Sr. Rehab Specialist Approval: Date: Program .Administrator Approval: Date: Source of Funds: $ $ $ Contingency Owner Contract Copy: Owner, Contractor, -Loan file, Technical file Financial.Institution (If contract price changed) RLP-155 Rev. 12A HOMEOWNER - CONTRACTOR AGREEMENT Property Improvements To: -- _- 1rc2Yt C!�_JJy�3!� ------- (Address) Owner (s) ---1N_L,.e----------------------------- (Name) b --------------------------------------------------- (Legal(Legal Description) 1. HOLD HARMLESS. Contractor shall agree to defend, indemnify, and hold harmless the Owner, City of Atlantic Beach, Florida from liability and claim for damages because of bodily injury, death, property damage, sickness, disease of loss and expense arising from Contractor s performance under this agreement to install or construct home improvements to be paid out of the proceeds of the Owner's rehabilitation loan. Contractor is acting in the capacity of an independent Contractor with respect to the Owner. 2 . LIEN WAIVERS. Contractor agrees to protect, defend and indemnify, Owner from any claims for unpaid work, labor or materials with respect to Contractor' s performance. Final payment` shall not be due until the Contractor has delivered to the Owner complete release of all liens for work completed arising out of Contractor' s performance, or a receipt in full covering all labor and materials for which a lien could be filed or a bond satisfactory to the Owner indemnifying him against any lien. 3. SCOPE OF WORK. Contractor acknowledges that he has prepared the Contractor' s Proposal (Part II of this Agreement) and that such proposal is accurate and consistent as to the name of the Contractor will undertake, and the price. Contractor acknowledges the performance requirements established in the General Specifications of the Rehabilitation Standard Performance Manual effective June 1, 1982 and warrants that all work undertaken will conform to said specifications. 4 . CONTRACT AMOUNT AND PAYMENT SCHEDULE. The City of Atlantic Beach shall pay the Contractor for the performance of the rehabilitation work, subject to additions and deductions by approved Change Order, the contract sum of ---------------- ------------------------- ($-4�-4---- -GAO ) . Payments will be scheduled as follows, subject to the Owner' s acceptance of the work to be done: Upon completion of 40% of the work, a progress payment of 30% will be made. Upon completion of 80% of the work, an additional payment of 30% of the contract price will be made. Upon completion of .100% of the work, the remaining funds will be disbursed. 5. TIME OF COMMENCEMENT AND COMPLETION. Owner shall provide written authorization to Contractor to commence work. Contractor agrees to start work ten (10) calendaz days after the receipt of the written Notice to Proceed. If the Contractor fails to commence work within ten (10) days of the Owner' s notification to commence, Owner shall have the right to terminate this Agreement. Such notice of termination shall be in writing. executed Change Order. No extra costs will be paid to the Contractor when he has neglected to properly evaluate-- the extent of the rehabilitation work. Under no circumstances will the contingency fund, if any, be authorized for work other than totally unforeseen circumstances arising after the commencement of the work. 7 . TERMINATION OF AGREEMENT. If the Contractor defaults or neglects to carry out the work as specified under the paragraph "Scope of Work" or fails to perform any provision of the Contractor documents, the Owner may, after fifteen (15) calendar days written notice, terminate this b contract and , select a substitute Contractor. If the expenses of finishing the work exceeds the unpaid balance on this contract, the Contractor shall pay the difference to the Owner . If the Owner fails to perform any applicable provisions of the Contract, the Contractor may, after fifteen (15) calendar days, terminate the contract and recover from the Owner payment for all work satisfactorily completed including reasonable profit and damages . 8. WARRANTY. For good and valuable consideration, the Contractor hereby agrees to provide a full one-year warranty to the Owner, which shall extend to subsequent Owners of the property to be rehabilitated. The warranty shall extend to subsequent Owners of the property to be rehabilitated. The warranty shall provide that improvements, hardware and fixtures of whatever kind or nature installed or constructed on said property by the Contractor are of good quality, and free from defects in workmanship or materials or deficiencies subject �to the warranty contained in this paragraph. Contractor and Owner agree, however, that the warranty set forth in this paragraph shall apply only to such deficiencies and defects as to which the Owner or subsequent Owners shall have given written notice to the Contractor, at its principal place of business, within one (1) year from the date of Contractor's final payment . The Contractor further warrants that failure by the Contractor to respond to valid complaints by the Owner, or subsequent Owners, that causes additional damages to the property are also subject to the warranty contained in this paragraph. 9. ARBITRATION. If a dispute arises as to the validity of a complaint not satisfied under the warranty clause of this contract, a panel of three (3) independent professionals shall be chosen by the City of Atlantic Beach to arbitrate the dispute. The panelists shall be ' chosen on a rotating basis. The finding of the panel shall be irrevocably final, conclusive, and binding on the Homeowner and the Contractor. 10 . SUB-CONTRACTORS. Contractor agrees that all warranties contained herein shall apply to all work performed under the Contract, including that performed by any sub-contractor. 11 . ACKNOWLEDGMENT. The above warranties are in addition to, and not in limitation of, any and all other rights and remedies to which the Owner, or subsequent Owners, may be entitled, at law or in equity, and shall survive the conveyance of title, delivery of possession of the property, or other final settlements make by the Owner and shall be binding on the undersigned notwithstanding any provision to the contrary contained in any instrument heretofore or hereafter executed by the Owner. 12 . INTEREST OF CERTAIN FEDERAL OFFICIALS. No member of or delegate to the Congress of the United States, and no Resident Commissioner, shall be admitted to any share or part of this Agreement or to any benefit to arise, from the same. , 12b.BONUS, COMMISSION,OR FEE. The Borrower will not pay any bonus, commission, or fee for the purpose of obtaining the Government' s approval of his application for this loan, or any other approval or concurrence required by the Government or i t.q Ane i n - + Homeowner-Contractor Agreement cont'd or ' employee of the Public Body who exercises such functions or responsibilities, shall have any interest, direct or indirect, in the proceeds of this loan, or in any contract entered into by the Borrower for the performance of work financed in whole or in part with the proceeds of this loan. 12d. INTEREST OF OTHER LOCAL PUBLIC OFFICIALS. No member of the govern- ing body of the locality in which the property to be rehabilitated is situated, and no other public official of the locality who exer-b cises any 'functions or responsibilities in connection with the administration of the loan shall have any interest, direct or indi- rect, in the proceeds of this loan, or in any contract entered into by the Borrower for the performance of work financed in whole or in part with the proceeds of this loan. 13. CIVIL RIGHTS. The Grantee agrees to abide by the spirit and intent of the Civil Rights Act of 1964, as amended, and the Civil Rights Act of 1968, as amended, and the anti-discrimination provisions of Chapter 120 of the City Ordinance Code, in that its operation under this contract is free of discrimination against its employees, persons, or groups of persons on the basis or race, color, sex or national origin. 14. EQUAL EMPLOYMENT OPPORTUNITY. The Grantee agrees to abide by the Equal Employment Opportunity Clause for Contracts subject to Execu- tive Order Number. 11246, as described in Attachment 1, attached hereto and made a part thereof. 15. LEAD BASE PAINT HAZARD ACT. The Grantee agrees that no lead based paints or substances containing lead shall be used in any part of this project. Treatment necessary to eliminate immediate hazards shall, as a minimum, consist of the following: a. All surface conditions identified as immediate hazards shall be thoroughly cleaned (washed, sanded, scraped, wire brushed or otherwise cleaned) so as to remove all cracking; scaling, peeling, chipping and loose paint on applicable surfaces. Such surfaces that have been so treated shall then be repainted with two (2) coats of a suitable non-leaded paint. b. Where the paint film integrity of the applicable surface cannot be maintained, the paint shall be completely removed or the surface covered with a suitable material such as gypsum wall board, plywood or plaster, before any repainting is undertaken. ,fit- J� W ✓Sg -- J Name of Contractor Names) cff Owner(s) Signature of Contra r Date C/SignzoWee of Owner Date ATTACHMENT 1 EQUAL EMPLOYMENT OPPORTUNITY -LAUSE FOR CONTRACTS SUBJECT TO EXECUTIVE ORDER 11246 During the performance of this contract, the contractor agrees as follows: 1 . The contractor will not discriminate against any employee o'r applicant for employment because of race, color, religion, sex, or nation- al origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to the following: employ- ment, upgrading, demotion, or transfer; recruitment or recruitment adver- tising; layoff, or termination; rates of pay or other forms of compensa- tion; and selection for training, including apprenticeship. The contrac- tor agrees to post in conspicuous places, available to' employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. 2. The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all quali- fied applicants will receive consideration for employment without regard to race, color, religion, sex or national origin. 3. The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency con- tracting officer, advising the labor union or workers ' representative of the contractor' s commitments under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous Places available to employees and applicants for employment. 4. The contractor will comply with all provisions of Executive Order No. li246 of September 24, 1965, and of the rules, regulations, and rele- vant orders of the Secretary of Labor. ATTACHMENT 1 Page -2- 6. In the event of the contractor' s noncompYiance with the nondis- crimination clauses of this contract or with any of such rules, regula- tions, or orders, this contract may be cancelled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further Government contracts in accordance with procedures authorized in Executive Order No. 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order No. 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. 7. The contractor will include the provisions of Paragraph ( 1 ) through ( 7) in every sub-contract or purchase order unless exempted by rules, regulations, or orders of the Secretary of labor issued pursuant to Section 204 of Executive Order No. 11246 of September 24, 1965, so that such provisions will be binding upon each sub-contractor or vendor. The contractor will take such action with respect to any sub-contract or purchase order as the contracting agency may direct as a means of enforc- ing such provisions including sanctions for noncompliance; provided, however, that in the event the contractor becomes involved in, or is threatened with, litigation with a sub-contractor or vendor as a result of such direction by the contracting agency, the contractor may request the United States to enter into such litigation to protect the interests of the United States. The offerer' s or bidder' s attention is called to the "Equal Opportu- nity Clause" and the "Standard Federal Equal- Employment Opportunity Con- struction Contract Specifications" set forth herein. The goals and timetables for minority and female participation, ex- pressed in percentage terms for the contractor's aggregate work force in each trade on all construction work in the covered area, are as follows: 1 .` The goals for minority participation are 21.8% for each trade. 7 Tho nr%71c fir -FemoI - r-Y}4r4r-4-:-- i n- - . - 4 , ALEXANDER W. BALFE, INC. CERTIFIED BUILDING CONTRACTOR 101 CENTURY 21 DR.,SUITE 211 JACKSONVILLE,FL 32216 JOSEPH WISE (Home Owner) (Contractor or Bidder) 1950 FRANCIS (Address ) (Address ) (Phone) Material Specifications Material Labor 1. ELECTRICAL: Completely rewire O ( C(v house including all fixtures. Instal new electrical service including weatherhead and 200 amp panel. 2. PLUMBING: Completely replumb �`Z Z -2- house 2house including all kitchen and bathroom fixtures. Inc',act Hc,,UH 3. STRUCTURAL: Tear out and replace deteriorated joists, plates, and studs at bathroom and rear bedroom. 4. BATHROOM: Install 3/4" subfloor and vinyl floorcovering. Hang : new , t sheetrock, tape and finish. Install J -7 6 1 trim including a laun door unit with hardware. Prep and paint walls, ceiling and trim to a semigloss fini h. 5. KITCHEN: Install 3/4" subfloor and vinyl floor covering. Install FJ pre-finished cabinetry, upper & base. 6. REAR BEDROOM: Install 3/4" sub- c: flooring. Hang new sheetrock, tape and finish. Texture ceiling. Install trim including luan door unit with hardware. Prep & paint walls and tri 7. IMUpLe IBM_Clnsulate attic space 1 S 3 5 to R-19 with blown in fiberglass. Subtotals : $ 1 y i $ 9 Totals : $ (Date ) (Contractor orEiddArSignature) ALEXANDER W.BALFE, INC. CERTIFIED BUILDING CONTRACTOR 101 CENTURY 21 DR.,SUITE 211 JACKSONVILLE,FL 32216 JOSEPH WISE (Home Owner) (Contractor or Bidder) PAGE 2 (Address) (Address ) (Phone) Material Specifications Material Labor 8. WINDOWS: Replace windows in kitchen bath and rear bedroom with pre-f inisl,ed single hung units. Caulk all seams to be weathertight. 9. ENTRY DOORS: Install a pre-hung steel door unit with hardware, thres- hold, storm door, acrylic finish. Repair steps at front entry. Install } weatherstripping and pressure treated wood steps at rear entry. 10. HVAC: Install complete central Z heat pump and air conditioning syste . 11. FRONT BEDROOM: Hang new sheetroc tape and finish. Texture ceiling. Install new trim. Prep and paint walls (flat) and trim (semigloss) . 12. HALLWAY: Hang new sheetrock, tap ( u and finish. Texture ceiling. Install O new trim. Prep and paint walls (flat) and trim (semigloss) . ) _ 1 nstall n Tiny , /� clla- sidin .uminum Subtotals : $ �`�f�f0 $ O Totals : $ < Zrz 2 (Date) (Contracts c.i dderSignature} TITLE FIRST LAST ADDRESS TELEPHONE Co,)- rae4-cr D Mrs. Cynthia Bats 94 Lewis Street 246-4311 OrP ah ,JacKson a �L6- £�S7o Mr. Charles Campbell 320 Dudley Street 246-2748 �5a/-fie.) La w e-e-itc-e..- O►-Pah J a ckso� - ��6- a$Sb Mrs. Ruby Jennings 40 Dudley Street 249-2450 Mrs. Lola Mae Johnson 2013 Mealy Street 246-0364 Co rn ejiaS) Mrs. Ruth Jones 26 Edgar Street 247-3969 DY�qh Jackson Mrs. Lillie McQueen 50 Ardella Road 247-9417 C f ) P-d bz*4- La ),(en co-- 2 6 a3 7 Mrs. Mary Mitchell 1850 George Street 249-7441J once- FYeemctt,- ;:�0-119D Mrs. Louise Pollard 150 Ardella Road C�O VA eh US) i r I je-s 241-62f it Mr. Randy Rhone 1810 George Street 246-8460 C Octl�--) Mrs. Christine Sanders 30 Ardella Road 247-8573 LCP r q e-1I-a5�� I T . Mr. Mack Stanford 1860 George Street 2494635CCOrne/)US) �Y1C�Pa. Jftr+l�o(l r ���- 3 Mr. Theodore Wells 95 Robert Street 246-3513 f�,f..Fe) sen e_ - -��(6 39 0 - Mr. John Wingfield 45 Robert Street 246-7793 Lgjc jf,-) ---Q/ej?e !7✓a ffen- S�E�.39/Q 07y-f" JaC,f O-) Mr. Joseph Wise 1950 Francis Avenue 241-0816 LBaIre dobe,+ Lacure, BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC tat<ACN, FLORIDA 024,88 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT -- /applicant to complete all items in sections I, 11, 111, and IV. LOCATION Shoo/ Address: J /� OF letonestial SheeN: Sotwooe ��//�s �"G� ���� Aed WILDING ser-div:siee 11. IDENTIFICATION — To be completed by all applicants, In consideration of permit given for doing the work as described in the above statement we hereby agree to perform said work in accordance with the ottochld plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards of good practice listed +heroin. Noses of k4shasisol i 1 celHfeefefs �� �%// C.Mlres/M (fsrinl) 5� Mader / 4 (.�7 / Home 44 hOpoly owsof "C' errof owow SleMtsue of =sod Agent / /` ArshiMet or Eagioser 111. 64NUAL NiltORb1A A. Two Nal W; 0. Is OTMIJI c"STINICTION @at"$oONi N THIS OU1k.0114e oft SITE mile� Q Go—O tt O Nolvael O c«tral Ufty / top vss. slut+IwMsat or coNsa►llueTlelt O 01 PEIMIIT O other — spss* IV. Ailemk"lCAL BOLgpmw TO E4, OWAUSr"Moldon oR wOIIK Ihev w.00o lint s sewposook es bad of*A Bowl tlal or ❑ commercial tteet o saws O Rosmwd D c—a" o neer ❑ New eu my �t).et syetss,: moowW0 1Mslssw.�/' _., O of existing system "Sa moa eepodhr 40AL ar"New Installation(No system previously Installed► D ❑ Extension or add-on to existing system ❑ ottw—spooity Q Ceer-g new«: Cwelty tM� Q Five wisillm: k%WAW of ►--A. Q 111weter O meolm O - --• - - Inellt�sfl ��••�'• TIN:slt+Am f+tiR Olt#Isi ilei QUAY D Task tww►.d Remelts O Lee- Iwsi«i Q US&W puuew vmw %&a 106mill Apps ed 46 DwhL_ O 0001, — Se«IM fwtw/6a„ <� U&T ALL I M IPMiNT AM CONDrIlONM AND RlAIGLRAflON zQurmw ThssMr Volk Des4,l�tMa 0+001 ZIWIIMr t WAMG • PURAIAM: BOURN. MUXACU CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 SENNOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877 PERMIT INFORM iT I LOC TION IN?(1p$ CATION Permit Number: 21063 Address: 1950 FRANCIS AVENUE Permit Type: DRIVEWAY ATLANTIC BEACH, FLORIDA 32233 Class of Work: ALTERATION Township: 0 Range: 0 Book: Proposed Use: Lot(s): Block: Section:0 Square Feet: Subdivision: SECTION H Est. Value: Parcel Number: Improv. Cost: OWN R I fORMA ON Date Issued: 11/29/2000 Name: JOE WISE Total Fees: 25.00 Address: 1950 FRANCIS Amount Paid: 25.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 11/29/2000 Phone: (000)000-0000 Work Desc: RIGHT OF WAY PERMIT FOR RIVEWAY; APPROVED AS NOTED Y B.KOSOY 11/29/01 CONT ORS T fe" PROPERTY OWNER PERMIT 25.00 s ions R ui PUBLIC WORKS NOTICE-INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. $25.N 14 Date: 11/38/88 81 Receipt: 8815378 c.,... CASH ATLANTIC BEACH 6 LDING T. N188883221888 t b CITY OF ATLANTIC BEACH CONSTRUCTION PER 1N c TY RIGHTS'OF WAY AND EASEMENTS DATE _' / PERMIT NO. ISSUED BY THE CITY JOB ADDRESS— —� % ) /'A'f PERMITTEE )t + -)c'• PERMITTEE ADDRESS 'TELEPHONE NO. REQUESTING PERMISSION FROM THE CITY OF ATLANTIC BEACH TO CONSTRUCT Lf r, _ LOCATIONS: (REFERENCE TO CROSS-STREET) 1 `7 Ia ILC �j A G`G I . APPUCANT DECLARES THAT PRIOR TO FILING THIS APPLICATION HE HAS ASCERTAINED THE LOCATION OF ALL EXISTING UTIUTIE5, BOTH AERIAL AND UNDERGROUND AND THE ACCURATE LOCATIONS ARE SHOWN ON THE SKETCHES. A LETTER OF NOTIFICATION WAS MAILED TO THE FOLLOWING UTIUTIES/MUNICIPAUTIES: JACKSONVILLE ELECTRIC AUTHORITY YES ( ) NO ( ) DATE: BELL SOUTH TELEPHONE COMPANY YES ( ) NO ( ) DATE: FERRELL GAS YES ( ) No ( ) DATE: MEDIA ONE CABLE TV YES ( ) NO ( ) DATE: 2. WHENEVER NF-CF-55ARY FOR THE CONSTRUCTION, REPAIR, IMPROVEMENT, MAINTENANCE, SAFE AND EFFICIENT OPERATION, ALTERATION OR RELOCATION OF ALL. OR ANY PORTION OF SAID STREET OR EASEMENT AS DETERMINED BY THE DIRECTOR OF PUBUC WORKS, ANY OR ALL OF SAID POLES, WIRES, PIPES, CABLES OR OTHER FACILITIES AND APPURTENANCES AUTHORIZED HEREUNDER, SHALL BE IMMEDIATELY REMOVED FROM SAID STREET OR EASEMENT OR RESET OR RELOCATED HEREON AS REQUIRED BY THE DIRECTOR OF PUBUC WORKS, AND AT THE EXPENSE OF THE PERMITTEE UNLESS REIMBURSEMENT IS AUTHORIZED. 3. ALL WORK SHALL MEET CITY OF ATLANTIC BEACH OR FLORIDA DEPARTMENT OF TRANSPIRATION STANDARDS AND BE PERFORMED UNDER THE SUPERVISION OF (CONTRACTOR'S PROJECT SUPERINTENDENT) LOCATED AT TELEPHONE NO. 4. ALL MATERIALS AND EQUIPMENT SHALL BE SUBJECT TO INSPECTION BY THE DIRECTOR OF PUBUC WORKS OR HIS DESIGNEE. 5. ALL CITY PROPERTY SHALL BE RESTORED TO ITS ORIGINAL CONDITION AS FAR AS PRACTICAL, IN KEEPING WITH CITY SPECIFICATIONS AND THE MANNER SATISFACTORY TO THE CITY. 6. A SKETCH OR PLANS COVERING DETAILS OF THIS INSTALLATION SHALL BE MADE A PART OF THIS PERMIT. 7. THIS PERMITTEE SHALL COMMENCE ACTUAL CONSTRUCTION IN GOOD FAITH WITHIN DAYS FROM THE DAY OF SAID PERMIT APPROVAL AND SHALL BE COMPLETED WITHIN DAYS. IF THE BEGINNING DATE IS PERMITT MORE THAN 60 DAYS FROM DATE OF PERMIT APPROVAL, THEN EE MUST REVIEW THE PERMIT WITH THE DIRECTOR OF PUBUC WORKS TO MAKE SURE NO CHANGES HAVE OCCURRED IN THE AREA THAT WOULD AFFECT THE PERMITTED CONSTRUCTION. B. IT IS UNDERSTOOD AND AGREED THAT THE RIGHTS AND PRIVILEGES HEREIN SET OUT ARE GRANTED ONLY TO THE EXTENT OF THE CITY'S RIGHT, TITLE AND INTEREST IN THE LAND TO BE ENTERED UPON AND USED BY THE HOLDER, AND THE HOLDER WILL, AT ALL TIMES, ASSUME ALL RISK OF AND INDEMNIFY, DEFEND, AND SAVE HARMLESS THE CITY OF ATLANTIC BEACH FROM AND AGAINST ANY AND ALL LOSS, DAMAGE, AND COST OF EXPENSES ARISING IN ANY MANNER OF THE EXERCISE OR AtTEMPTED EXERCISES BY THE HOLDER OF THE AFORESAID RIGHTS AND PRIVILEGES. 9. THE DIRECTOR OF PUBUC WORKS SHALL BE NOTIFIED TWENTY-FOUR (24) HOURS PRIOR TO STARTING WORK AND AGAIN IMMEDIATELY UPON COMPLETION. SUBMITTED BY: (PLACE CORPORATE SEAL IF APPUCABLE) SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY 0all NOTARY PUBLIC AFF(d no f ed - S�� !Z�✓ se ._ (( Z'r 0.6 PSH-3844 107 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH -�- PERMIT INFORMATIOFI ------ -------- LOCATION I14FORMATION- -- Pernn' t Number: 10793 Address: 1950 FRANCIS AVENUE Pemmit, Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 32233 class of Work: ALTERATION ---------#_ Lx"L DESCRIPTION -- ----__- Constr . "Type: >►1OOD FRAME;. Lot: Slodk: Section: Proposed Us�e�: SINOLL PI%MILY Tr��rrish�p: RIyO: 0 Dwellings: Code: subdivision -DONN:NR Estimated Value: ,so 00 Improv, Cost: Total Fees : ' $0 .00 Amount SO. o Dat Work I3e EAS NNID HUD REHAB ------ O�TII�N -___--- _ �..., APPLICATION FEES .... . PERMIT CIT OF N #� �. 8 AVENUE WATER IMPACT FEE M.00 A,d F CI!, , OR�131 3 S IMPAC FES so ,09 p A A .'. .. NFORM T 0I4 -- RADON CAB 5% '> $0 .00 ,...Nam-6: ' AS OTRICA ONTRACT NO CAPITAL IMPROVE. $0 .00 Address: , , A E . JAC ILLS, L 32207 $0 .00 ` L een ER99 Type2 SEC B IMPACT FEE $0 .00 CONST,SURCHARGE 00 SCRARG .ATL.BCH $0 . NOTES: NOTICE--ALL CONCRETE FORMS AND FOOTINGS MUST 991I0ECTI5MBEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT SE PLA ED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER 6oNTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S IIEK, LAW CAN RESULT IN THE PRO PERTY !"N R=�'YINQTWICE Ft ATH ESU ILRING IMP C' VEMENTS" ISSUED ACCORDING TO APPROVEDPLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR Y Ot ATION OF APPLICABLE PROVISIONS OF SAW. All G _� CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: /1:7 19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL FIRM MASTER ELECTRICIANN SIGNATURE JOURNEYMAN NAME____OJt��___7 ADDRESS: /` � J RFD BOX IF BLDG.SIZE BETWEEN: RES. O APT. ( ) COMM. ( ) PUBLIC ( ) INDUS. ( 1 NEW( ! OLD ( 1 REW. ) ADDITION ( ) TRAILER ( ) TEMP. ( ) SIGNS ( ) SQ. FT. SERVICE: NEW( ) INCREASE ( 1 REPAIR ( 1 FEE CONDUCTOR SIZE AMPS COPPER ( ALUM. SWITCH OR BREAKER AMPS PH W VOLT RACEWAY EXIST.SERV.SIZE 0 O AMPS PH 3 W �Y� VOLT �f"RA E W A Y FEEDERS NO. SIZE IND. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN I TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.30 AMPS. 31.100 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. I H.P. VOLTAGE PHS MISCELLANEOUS VEHICLE TOWING AND/OR NOTICE OF IMPOUNDMENT 1.VEH.YEAR 2.MAKE 3.MODEL 4.C.E.C.# REPORT ATLANTIC BEACH CODE ENFORCEMENT 5.COLOR 6.TAG NUMBER STATE YEAR 800 Seminole Road • 247-5800 �— A 16.WAS VEHICLE IMPOUNDED? 7.VEHIC IDENTIFICATION NUMBER RYES ❑NO THE OWNER HAS BEEN NOTIFIED OF THIS ACTION S.OWNER'S NAME(LAST,FIRST,MIDDLE) YES ❑NO NOTIFICATION BY PLACARD 9.OWNER'S ADDRESS CITY STATE 1 it i+✓la �M�'��?SO�— J C1 ❑NOTIFICATION BY PLACARD AND U.S.MAIL 10.DAY,DATE,TIME OF OCCURENCE 17,ARTICLES TAKEN FROM VEHICLE(MUST BE PLACED IN PROPERTY ROOM) 11.LOCATION VEHICLE REMOVED FROM NUMBER 18.INVENTORY AND CONDITION OF VEHICLE 12.NAME OF WRECKER FIRM YES NO YES NNO� 13.ADDRESS VEHICLE REMOVED TO RADIO STRAIGHT WIRED � TAPE DECK KEYS IN LOCK 14.REASON VEHICLE TOWED TAPES( ) DOORS LOCKED 44 4/V ,5v, E T? C.B.RADIO TRUNK LOCKED SPARE TIRE VEHICLE DAMAGE TOOLS AREA OF DAMAGE ❑NA 15.RELEASE OF VEHICLE BATTERY E)I HAVE PAID ALL CHARGES TO THE TOWING COMPANY AND REQUEST MY VEHICLE BE RELEASED. OTHER ITEMS ❑(HAVE PAID ALL CHARGES TO THE TOWING COMPANY AND REQUEST A HEARING. ❑I HAVE NOT PAID CHARGES BUT REQUEST A HEARING AND UNDERSTAND THAT MY 19.THE INVENTORY OF THIS VEHICLE IS CORRECT VEHICLE WILL NOT BE RELEASED UNTIL THE CONCLUSION OF HEARING. DRIVER SIGNATURE AUTHORIZATION TO RELEASE VEHICLE 20,HEARING DATE TIME: Date: Code Enforcement Officer HEARING OFFICER FINDINGS: SIGNATURE OF HEARING OFFICER 21, IMPORTANT NOTICE TO OWNER-IMPOUNDED VEHICLES A. You are hreby notified that the above described vehicle is being impounded pursuant to Atlantic Beach City Ordinance Number a— . Towing and storage charges will be assessed against your vehicle. You may elect to: 1. Pay towing and storage charges to the towing company; 2. Request a hearing as to the propriety of the impoundment and as to the owner's liability for charges; 3. Pay the towing company and storage charges and then request a hearing as stated in #2. B. Failure by the owner to request a hearing within five(5)days after receipt of this notice may act as a waiver of his right to a hearing and may result in the placing of a lien against the motor vehicle for the towing and storage charges without a further notice to the owner. C. It will be necessary for the owner to obtain a vehicle release at the Atlantic Beach Code Enforcement Office before the vehicle can be claimed. Proof of ownership and payment of charges to the towing company must be presented at the time of the release. 22.OFFICERS NAME 23.1,D.NUMBER 24.SUPERVISOR I.D.NUMBER 0/ COPIES: White-Atlantic Beach Code Enforcement Department Canary-Release Copy-Wrecker Company Pink-Owner Copy r. 5 10620 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH Permit Number".' 10620 Addre*s; 1050�,fABCTS; AV UR Permit T�'po: PLUMBIN AT TIC BIRCH, PI,O7!�I>wIA 3223 C a$s of Work. REMODEL _ _,. �..�...�� L�4 L DESCRIPTION ' Constr. Type: 1�OOD FRIWS Lot: Bl,c�ok; Section,. Proposed, Use; SINGLE: rAMILY ip:; RHO: Q t+w+ 1'IinS Cord : subdivision:- ' E Estimated value .+ t Improv, Cost; $0 00 $0.00 Amount Paid: $0 .00 D M 2011 IM28 Him P .9 c PERMIT _ $0.Ott B€ d � `' AVHUB WATER 1B,B $0.00 AG#i t I*LOI ILIA 32233 I,ACT 'PER $0.00 �_, � ,t ow � 1 `iEa QN � RADON' CAB % $0.00 iBIR +" .' CAP,ITAL I3�pFtt�VB. #13 .13U Iddrs : ] L .» 1V BB ' A $B r flt? nSe: !ZrC 9�B pe. 0 S # �3 OT ABE D x>. COL RCBAB#3 0.f3O' Sm .Sc�O /1 T> 1I. ,.tQ #VOTES. NOTICE--ALL CONCRETE CORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL', RUBBISH AND DEBRIS FROM THIS WORK MUST N4T SE-PLACED IN PUBLIC SPACE,ANIS MUST BE CLEARED UP ANE7 HAULED AWAY BY'FITHER`CONTRACTOR OR OWNER "FA[LURE TCS CO PLr 11U#TH THE MECHAIW 'S LIEN LA's SAN RESULT IIV THE RR PERTY OW F�PAYINOTWICE FORTHE E I I WOR �/EMENTS" . IS UED.ACcok)ING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO AgVocA oo ©N ESP APPi.ICABLE PROVISIONS OF LAW. 4 r ATY:ANTIC BEACH BUILDING DEPARTMENT f CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: OWNER OF PROPERTY: // PLUMBING CONTRACTOR 6/t2 LG^ZG� of CONTRACTOR' S ADDRESS: 1�7� ZGG•�� _ft c�(fa STATE LICENSE NUMBER: D 6 j'� TELEPHONE: HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORY WATER HEATERS _BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES: {O x $3 . 50 + $15.00 MINIMUM PERMIT FEE - $25.00 SIGNATURE OF OWNER: SIGNATUkE OF CONTRACTOR: Zz�� ----------------------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - ( 904) 247-5826 SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834 PSfl•9844 x 10484 DEPARTMENT OF SUILOING CITY OF ATLANTIC BEACH �...... F i " 1�tPCa��' IO OC ATION T N>I' � ION .._ �..w �.. Permit Ntxttt � : I04 ." Addr ss. ,�. " PRXNCI 8 ,n", Permit; T ge: B> ILI3III£ A 'L� 'IC ,S ACH, PLQRIDA 32233 class ca W+ark: R 4I ffiL 00CR.II�'�ION Constr . ` Type: WOOD RUE - Lot : , E.1,bok: section*. I? e11 I code E subdivision: DON P. Estimated 'Value- � � � $2£b000.00 Improv. Cost: ?.00 Total F es, $0,100 AMO ` $0,00 00 E . worIC R�101 EL a l A`I"Ifll�i "PLIC 'I'IC? 1 E . „:... ... ... a. PrWIT to.00 lid re�3s CI $TI ZkTI�PACT P�II $0.00 `LO' � P f, S.! mks lk 9/�/� ON RAD WOO CA N Ctle I+ R 13 1LF IMPROVE $0 .00 PL 32207 Ctt'Q�B'S CQNI' cTI.ON C? 00 L e + '; Type: SSC R I dT FEE �., � ,Ott OCII�IST•� U tMoot Std X00 NOTES: ` ` " t .F t 'E NOTICE-ALL CONCRETE FORMS AND FOOTINGS MUST SE INSPECI`I:D 1�EFOI�E'I�oURING i PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE f f BUILDING MATERIAL, RUBBISH AND©EBRIS FROM THIS WORK MUST NOT;BE PLACED IN PUBLIC SPACE,AND MUST BE C CLEARED UP AND HAULED AWAY BY I`fHE i C, RACTOR OR OWN f�R "-FAILURE Tl7 CC}II�P"LY WITH THE MECHANIC LIEN LAW CAN RESULT 'IN THE PROPERTY-OWN, PAYINGTWICE FORTHE BUILDING IMPR�"�EMENTS °SUED-AOGCRflING TO APPROVED PLANS WHICH ARE PART OF THIS PEl3MI T AND SUBJECT TCF RE�ATIOt ;F # UI{3L I tON o API CABLEPROVISIONS OF LAW. r , ATLANTIC BEACH BUILDING DEPARTMENT" � . CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS Owner(s) : .✓ �S Address :- /(� S-6) 1t`/asa�� c�c s- .fT -Phone: Lot # Block or Unit # Subdivision: Contractor: x �tl !<_ � 1 117,4 C.--�C ,.7,1c State License # C.Z C 2-' AddressU C-c-1.14 44 2_1 f'�,L � � I) Phone No: Describe work to be done: ko n r) ✓,4-�.'~ _-7's Present use of building: &'f C. Valuation of Proposed Construction: 2 CD .IFi,ti Proposed use: d� �s-` en 1� ,-fC Is this an addition? If yes , what are the dimensions of the added space: ft . X ft . Will the added area be heated and cooled? New electrical (or increase) .? New plumbing fixtures? c/ New fireplace? New Heat/AC? SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: Date: 2-/f' 2 r Signature CONTRACTOR: � `� / Date: ?- License Supplied: Liability Insurance: Worker's Compensation Insurance: ILA. 1*61 Muse re"do* ro 11$.11 006ft"0 sorra T" to fahow it The undersigned hereby kilo m sM oo memd that inoiamnents will be mede to certain real property, and in acoordence, with notion 713.13 of the Florida Stamm #w following Infamution is stated In this NOTICE OF COMMENCEMENT. 'L-)_(�j/ -, 14 Dewo"n of P"Wly e- ------ ..........L- ............. ............. General milpim of 1p w ..,............... ........... < u-e- Owner's bored in Oe of#0 hop a amd fee &at* Tide fi@Ww I#edw lim*Wmd r k' e cow"mr— Addpm (4- &NOY wy,.. ....... Address of bow No" of Ira VAdda dw Swe of mull dedpow by *wow wpem VAM mom w SAW anow"my be In addition to hkrdMf,owner dulmnel"*4 pw to nniw a co"of to Lienors Notice as provided In Section 713.13 111 (F),Florida Stawas. I F,111 In at Owner's optioni. 846 DEPARTMENT OF BUILDING CIN OF ATLANTIC BEACH - PERMIT' I N FORMAT`I ON - - LOCATION I NFORMA'T I ON` - ' Pettit lrnb�x : 6845 A d d r e-s s,.: 19-150, FRANCISAMIE Permit Type: BUILDING ATLANTIC - -BPFGHx FLORIDA 22 Class of W rk, SHED ---------- ----LB�i1�I, DESCRIPTION Coristr,, TY�e: WOOD FRAMELot , , S�`� k� Section* £�rvlrc�s +r Use:: SHED Township: RNC. 0 Dwellings, I, Code$ 0 Subdivis oh SECTION H Estimated Value X2'00 ,06 {' r Improv. Cost. . $0 ,00 tF`k Total $ . 5 Y Aanou *n $22 . 50 V. g y n 4 FFF ,a w f 1 EiV APPLICATION FEES W"6'., kt� 22 E ? . 50 Addr%ss z S AVENUE „ ���I'T���'AC'1' FER � �$0 .00ONEW .r �$ Ph F ` �'4,{. .. , _ RA ON 'OAS-H R.S. $0 .00 �'..:. t FORMATI Y RADON CAR - 5% I~TOP OWNER �� �x Wryy� �y yy {�f� 0 e $EWER TRP + HYDRAULIC SHARE ,�D Type I CAPITAL IMPROVE ,� s �a ' °a` �'�' Y,«w•u-. st4 ° 0 OTHER . 5. 4 'NOTES: NOTICE ALL CONCRETE Ft RIAS AND FOOTINGS MUST 6E''INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE K If tllLt I 1 a MATERIAL,RUI�BISH AND DEEfRIS FFifJM THIS WQR14 MUST�#OTSE PLACED IN PUBLIC SPACE,AND MUST BE LEARED.UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER k F ��Ai1.Ui E TO C 3MP#.Y 1N#TH 'Y HE MECHAt�NICS' LAW CAN RESULT IN E THE PROPERTY ?WN A PAYING TWIGE +t i B'!,!'#1. VCi #NIRROYEMENT$." ' Is tIED ACCORDING TO APPROVED RLANS WHICH'ARE PART OF THIS PERMITAND SUB ST TO.RI;VOG�A fOOR VIOL AITIt:1N OFAPF"CICABLE,PROy1SIt3NS OF LAW, II I i1E ti ? 'ATLANTIC CH BUILD' G DEPT MEN t , CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS Owner(s):- -, l� Address �QS� — W[]�Cf J Phone Vl Lot # _M Block or Unit # Subdivi.sion:�__ Contractor :--o (:82�-ec r-- Address : Address : �4 S� � dl/ f S (�'L Phone Describe work to be done:. Present use of building : ,._ Valuation of Proposed Construction: `' Proposed use:.ST iC"A G F S /h 07 Is this an addition? /00 If yes , what are the dimensions of the added space:, _ ft . X ft . Will the added area be :heated and cooled? New electrical (or increase)? New plumbing fixtures? New fireplace? New Heat/AC,?___..__.____.____. SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY , ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT , IF OWNER IS CONTRACTOR. Signature OWNER: . �- Date :__2 Signature CONTRA ,TOR : _ __ Date I CITY OF ATLANTIC BEACH BUILDING PERMIT CALCULATION SHEET Address Date S Heated Square Footage pry@ $_per sq ft = Garage/Shed Z @ $_per sq f t = Carport/Porch -A @ $_per sq f t = Deck fes@ $ per sq f t Patio Q j @ $__per sq ft TOTAL -VALUATION: $ Total Valuation 1st Remaining Value $ per thousand or portion thereof TOTAL BUILDING FEE + 1/2 Filing Fee Fireplaces @ $15 .00 BUILDING PERMIT FEE BUILDING PERMIT $ '2 WATER CONNECTION $ z SEWER CONNECTION WATER METER/TAP CAPITAL IMPROVEMENT RADON (HRS) .0095 RADON (CAB) .0005 SECTION H PAVING HYDRAULIC SHARES OTHER GRAND TOTAL DUE ADDITIONAL PERMITS OR FEES: Mechanical­­_; Electric/New_.__Electric/Temp_,___;SwirwiiingPooI Septic Tank WellI Elevation Sign—­.--yijj: Fj-j E411oor Ele Survey CALCULATIONS--and/or-'-NOTES:- 6F I i s F j4 3qq i i i � f pi i I . . I OWNER BUILDER PERMIT AFFIDAVIT i S tbttr of Florid Ib > City of Atlantic B*act► ) BEFORE M , the undersigned authority, personally ipwaarvd 7e—: 'c^��=s . ., ___-_______ ____• who upon first b*ir,v duly sworn, deposes and tsakys t I, _- r=�1X�-l -��------ --_ -_---------_• and the legal owner of the Sollowino propertyt Subdivision Block _ Lots AKA I am applying for 4 building permit pursuant , o she Owner Builder exemption set forth in Florida Statute, Section 489. 107. Florlda law requires that I rhave boon provided wilt, tt,sr following DISCLOSURE STATEMENT% DISCLOSURE STATEMENT-State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property* to ,act as your sawn contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - or two family rosidence c,r a farm outbuilding. You may also build or improve, a commercial building at a cost of $23,000.00 or less. The building must be for your use and occupancy. It may not be built for sale or leave. If you sell or leaWo more than one building you have built yourself within one year after the construction is complete# the law will presume that you built it for sale or lease, which is a violation of this exemption. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. I hereby acknowledge that I have read the above DISCLOSURE STATEMENT and that I comply with all the requirements for the issuance of an Owner-Builder permit. Further, affiant sayeth not. raper y Owner Sworn to and subscribwd before m this ��_ __ day 5867 - ' DEPARTMENT OFEUILDING CITY OF ATLANTIC BEACH - PERMIT INFORMATION:——- ------ LOCATION INFORMATION Permit INumber: 5863 Address: 19$0FRANCIS Permit Type: RE-ROMP ATLANTIC BEACH, FLORIDA 32233 Class of Work: REPLACMT PERMIT ---------- LIILIIAL` DERCI~tIPTION ---..----_-- Cobstr. Type: WOOD FRAME Lots Block_: 10 Section Proposed Use s 'SINGLE FAMILY Township RNG 0 Dwellings t O Codes O Subdivislorim' dormer Estimated Values $0. 00 Improv. + : E0.00 To *22. 50 'B19 Work D ` b MA"TIONAPPLICATION FEES ams a j�(' y� �k � PSE 'i` �j tr �''R-�`i �g,��.�:tk2(2.Sr0 -K4R i A 13'x " A !" �S E ,Pfrf r RrxK ;C B {CH,, FLORJ � F 1"ton,* � >ItATER ME'T`ER $0.00 � RADON ,GAS H. R. S. S0.00` ------ SIT OR INFORMA" RADON OAS 5% $0.00 Address g . OVER TAP , #0. .; e. � H`Y6RAVLIC SHARE .00 e Type 0tE-I1EEC" F'EE . LIO oa NO r �1 5 rs t �d c ,fig ad NOTICE--ALL CONCRETE FORMS AND FOOTINGS MUST GE 114OPECQED BEFORE POURING M IT kill , 21 _ PERMIT VOID SIX MONTHSAFTER DATE OF ISSUE. 6ING MATERIAL,RUBBISH AND'DSSfliS FROM THIS WORK MUST NOT SE PLACED.IN PUBLIC SPACE,AND,MUST BE @ RED,UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER 'j i€C A ✓r 4h AILURE"TCS C0'l1APLY WITH THE M.ECNANICS' L'lEN LAW CAN RESULT IN : PROPERTY OWN�R PA���NG " NICE O SOIL1'N IMPRC3VEME14TS #� 'AID TION DATE: OW09/ge 14MI V040 v" ISD ACCORDING:tO APPROVED FLANS WHICH ARE PART OF THIS PERMIT AND'SUB REVOCATI }iR x LA" tON% 1 - '00LICABLE PROVISIONS OF LAW. ATtANt ACH BUIL NG DE RTMENT: CITY OF ATLANTIC BEACH PERMIT APPLICATION ROOFING owner(s): C) Address: ✓�SJ X7 1�1111CLCir— Phone: Lot # Block or Unit # Subdivision Contractor: 66,) xj Address: lq-H r Phone: State License No. 2 � Describe work to be done: 1�S`` l - Materials to be used: 174 11U Signature OWNER: ' rZ� Date: Signature CONTRACTOR: OWNER BUILDER PERMIT AFFIDAVIT Stbtr• of Florida City of Atlantic Beach BEFORE ME, the undersigned authority, personally ippearwd --------- who upon firat being duly `worn, deposes and says$ I, _ l S -------- _, and the legal owner of the following property$ Subdivision _-_- Block __�-� �__-•-_.... Lotsw_ �t _. - - AMA -•----- --�.__ .. ......_ -- I am applying for a building permit pursuant I.o the Owner Builder exemption not forth in Florida Statute, Section 489. 103. Florida low requires that I .have been providad with thr following DISCLOSURE STATEMENT* DISCLOSURE STATEMENT State lav requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to ,act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - or two family residence or a farm outbuilding. You may also build or improve a commercial building at a cost of 025,000. 00 or less. The building must be for your use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have built yourself within one year after the construction is complete, the law will presume that you built it for sale or lease, , which is a violation of this exemption. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. I hereby acknowledge that I have read the above DISCLOSURE STATEMENT and that I comply with all the requirements for the issuance of an Owner-Builder permit. Further, affiant sayeth not. q Propsrrty Owner Sworn- to and sub cribed befo me thi ___ d y