Permit 2143 Francis Ave CITY OF ATLANTIC BEACH
MAY
n 2 200b TREE REMOVAL APPLICATION
t
All applications inmt,be,subm'itted with seven (7)copies and received by 5:00 p.m.on the Friday
ten (10)days prior to the scheduled meeting in order to be placed on the agenda.
INCOMPLETE APPLICATIONS OR INACCURATELY
MARKED SITES WILL NOT BE PROCESSED.
Applicants Name: y 0,
Address: � L
Telephone
Address or Legal Description
Of Tree Removal Site
oe
(If legal description,list closest
cross street
Reason for Proposed
Tree Removal
Has this site been to the Tree Board Before? (Circle) YES NO NOT SURE
Please provide the following information:
SITE PLAN/TREE SURVEY indicating:
a. Existing and proposed structures.
b. Location of utilities and easements as applicable.
c. Location, species and size of all trees with Diameter at Breast Height(D.B.H.) of six inches or
more.
d. Location, species and size of all trees to be removed should be clearly marked with an"X".
e. Location, species and size of all trees to be preserved on-site for replacement must be marked
with brackets"[]".
f. Location, species and size of any proposed new replacement trees marked with a circle"O".
g. Location, species and size of all trees to be preserved on-site with barricading at tree drip line
noted.
ON-SITE REQUIREMENTS:
a. Barricading at tree drip line of all trees to be preserved.
b. Address/legai description must be posted in a conspicuous manner on site.
c. The property corners must be marked by stakes or paint indicating the lot.
d. All trees identified for removal MUST BE MARKED ON-SITE BY RED/ORANGE flagging, paint or
tape.
e. All trees to be preserved on-site for mitigation MUST be marked with BLUE/GREEN flagging,
paint or tape.
800 Seminole Road•Atlantic Beach,FL 32233-5445
Phone:(904)247-5800•Fax:(904)247-5854-www.coab.us
Page 11 of 4 Revised 11/04
RESIDENTIAL PROPERTY
TREES REQUIRING REPLACEMENT:
a. Int rior zone trees requiring replacement: Any tree with diameter at breast height(DBH) of
20" or more.
b. Exterior Zone trees requiring replacement: Any tree with diameter at breast height(DBH)
of 6" or more
c. Champion Trees: Any tree so designated by the Florida Division of Forestry, Department
of Agriculture
d. Exceptional Specimen trees: Any tree so designated by the City Council
INTERIOR AND EXTERIOR ZONE DEFINITION
RESIDENTIAL PROPERTY
EXTERIOR
ZONE
20.0' Rear
Setback
6.
7.5' 7.5'
Side Side S tback
Setba
20.0' Front
Setback
SIDEWALK
�`- PUBLIC
RIGHT OF WAY
PUBLIC WORKS
PUBLIC STREET JURISDICTION
PROTECTED TREES
DBH 6"OR MORE
800 Seminole Road'Atlantic Beach, FL 32233-5445
Phone:(904)247-5800'Fax:(904)247-5854-www.coab.us
Page 3 of 4 Revised 11104
RECOMMENDED TREE LIST
Atlantic Beach Tree Board
These trees are recommended for North Florida if appropriately sited, planted, and cared for. Note that
salt and drought tolerance varies. All trees, including those condsidered drought tolerant, require regular
watering for at least one year.
*American Holly (Ilex opaca) Evergreen, 50 to 100 feet tall, salt tolerant, low drought tolerance, red
berries in winter.
*Bald Cypress (Taxodium distichum) Deciduous, up to 150 feet tall, salt tolerant, wet soil.
*Dahoon Holly (Ilex cassine) Evergreen, to 40 feet tall, salt tolerant, wet soil, red berries in winter.
Drake Elm (Ulmus sp.) Deciduous, to 50 feet tall, not salt tolerant, not drought tolerant.
*Eastern Cottonwood (Populus deltoides) Deciduous, to 80 feet tall, moist soil, salt tolerance unknown.
*Florida Dogwood (Cornus florida)Deciduous, to 40 feet tall, low,salt tolerance, not drought tolerant.
*Laurel Oak (Quercus laurifolia) Semi-evergreen, to 75 feet tall, not salt tolerant, low drought
tolerance.
*Live Oak (Quercus virginiana)Evergreen, to 70 feet tall, salt tolerant, low drought tolerance.
*Loblolly Bay (Gordonia lasianthus)Evergreen, to 70 feet tall, not salt tolerant, moist soil.
*Longleaf Pine (Pinus palustris) Evergreen, to 120 feet tall, salt tolerant, drought tolerant.
Loquat (Eriobotrya japonica) Evergreen, to 40 feet.tall, low salt tolerance, not drought tolerant, bears
edible fruit.
Pecan (Carya illinoinensis) Deciduous, to 100 feet, not salt tolerant, not drought tolerant, produces
.edible nuts.
*Pine, Sand Pine (Pinus clausa) and Slash Pine (Pinus elliottii) Conifer,70 to 100 feet tall, salt tolerant,
drought tolerant.
*Red Maple (Acer rubrum) Deciduous, to 80 feet tall, low salt tolerance, moist or wet soil, fall color.
Red Cedar (7uniperus spp.) Conifer, 50 to 100 feet tall, salt tolerant, drought tolerant.
*River Birch (Betula nigra) Deciduous, to 60 feet tall, not salt tolerant, moist soil, attractive bark.
*Sabal,or Cabbage Palm (Sabal palmetto)Evergreen, to 90 feet tall, salt tolerant, drought tolerant.
*Shumard Oak (Quercus shumardii) Deciduous, to 100 feet tall, not salt tolerant, not drought tolerant.
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Sep 24 01 02: 2Gp Harry McHally 904 247 5872 P• 1
~ Sip 23 01 01: 15p
Building Department' 904-247-5805 P• 1
PrR'�CE 0 U0 TE
APPLICATION FOR WATER ANDIOR SEWER TAF
APPLICANT NAME �E I d & dAeL�=
MAILING ACDRESS 14cV
PHONE NUMBER J<<�D' L��a� DATE S'N
SERVICE REQUESTED
SERVICE LOCATION 101`�
DATE SET TO PUBLIC WORKS '3 G�
DATE RETURNED TO BUILDING DEPARTMENT
PUBLIC WORKS DEPARTMENT
PRICE QUOTE RESPONSE
WATER: --F- 72�� THG7 1wcL3 2JcE
SEWER,.-Ox �' E ,�a►�A�,yT�7uA�y�� skin .�� 2/ 1.3 /.S /AE
OTHER: ff- eo:>ST of
Ai /y'j.
PRICE QUOTE PREPARED B
Siena e - Tr!E
DATE NOTIFIED OWNER
a
5 l 5/2001
y Job Cost Details y �,
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Gruhn May , Inc. N
6897 Philips Parkway Dr- North N
Job Name: Selva Marina C.C.Maintenance Tap Jacksonville, Florida 32256 0
A.13.PO* Pending (904)262-9544 Fax 268.0679 N
G.M.Jobe! Estimate =2r�Y _.-_--
Item Description Q ty, UM Unit Cost Material E u" ent Hours Rate Total x
10"x 6"twye I ea $49.40 $49.40 backhoe 8 $45.00 $360.00
10"femco 2 ea $41.69 $83.20 80.00 Z
10"pipe 13 if $7.02 $91.26 $0.00 L
pipe 13 It $3.38 $43.94 $0.00 3
6"lit6ngs 1 ea $37.70 $37.70 $0.00 n
6"cleanout and box 1 ea $92.30 $92.30 $0.00 m .r
6"hard plug 1 ea $18.20 $18.20 $0.00CC
ry
$0.00 $0.00 Equip. Total $360.00
$0,00 $0.00 cn
$0.00 $0.00 tabor 9
j $0.00 $0.00 Regular 10 $115.00 $11,150.00 ru
$0.00 $0.00 Overtime $0.00
$0.00 $0.00 Labor Total $1,150.09
$0.00 $0.00
$0.00 H.001 iS!R1c2nLr4SjgL_
ateria Total $416.0-0-1Su total 51,51@.Oti
cn
Harry, O
This estimate is for installing a new 6"sewer service to service the Category Totals
maintenance building at the Selva Marina Country Club located Material $416.00 W
at the end of Church Rd. Labor $1,150.00 J
Thanks,Gonion Equipment $360.00 W
m
Al-C(3an'r- S Sub. $0.00 N
Overhead 1a%*L&E $271.80
tlibbilizaticn $0.00
Grand Total $2,197.80
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State License CUC043134 W
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CITY OF
,*Z14e,,Z
800 SEMINOLE ROAD
-- - ATLANTIC BEACH, FLORIDA 32233-5445
TELEPHONE(904) 247-58o0
FAX(904)247-5805
Date
'qtWP, tjr 6!40&LWPfE,
Dear Property Owner: -
The costs to connect your building to the City sewer and/or
water system are as follows :
Sewer Tap - Labor and Materials to tap into
sewer main $ C�
Water Tap - Labor and Materials to tap into a
water main $
Water Meter .- Cost of Meter $ 0 J-06
Cross Connection Inspection - Inspection by
Public Works to ensure backflow
prevention $ 3 S Ofl
Sewer Impact Fees - Funds future expansion.
of the sewer plant
Water Impact Fee - Funds future expansion
of the water plant $ '� 9 6 . D 0
Capital Improvement - Funds for improvements ,
expansion or replacement to
water system $ 323 0 o
TOTAL COSTS $
If you have any questions concerning these charges please call
the building department at 247-5826 .
Sincerely,
Q, _.
Don C . For
Building Official
DCF/pah
WATER IMPACT FEE WORK SHEET
ADDRESS: Q/2 12 C1`S Ay F s // o 6/c-c ft"L /
DRAINAGE
FIXTURE UNIT
FIXTURE TYPE VALUE AS LOAD FIXTURES UNITS
Automatic_clothes washers, commercial 3
Automatic clothes washers, residential 2
Bathroom group consisting of water closet, lavatory,
bidet, and bathtub or shower 6 12--
Bathtub
2--Bathtub(with or without overhead shower or whirlpool
attachments) 2
Bidet 2
Combination sink and tray 2
Dental lavatory 1
Dishwashing machine, domestic 2
Drinking fountain — c. 1/2
Floor drains 2
Kitchen sink, domestic 2 �-
Kitchen sink, domestic with food waste grinder and/or
dishwasher 2
Laundry tray (1 ort compartments) 2
Lavatory 1
Shower compartment, domestic 2
Sink 2
Urinal 4
Urinal, 1 gallon per flush or less 2
Wash sink circular or multiple) each set of faucets 2
Water closet,flushometer tank, public or private 4
Water closet,private installation 4
Water closet, public installation 6
TOTAL NUMBER OF UNITS= /
MULTIPLIED x 20
TOTAL$ a9 0
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1.152 SQUARE FEET
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Hem 600 Pat card Cou rl e.Safety Harbor. florid* 34595 a Tdephm s (727) 726-1538 2001 (ALL SZES ARE WMX)
OMNED FIV ZOKS 6 &A � fl-30-00
Y CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877
Permit Number: 22665 Address: 2143 FRANCIS AVENUE
Permit Type: UTILITIES ATLANTIC BEACH, FLORIDA 32233
Class of Work: NEW Township: 0 Range: 0 Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:0
Square Feet: Subdivision: SELVA MARINA
Est. Value: Parcel Number:
Improv. Cost:
Date Issued: 9/12/2001 Name: SELVA MARINA COUNTRY CLUB
Total Fees: 1,985.00 Address: 1600 SELVA MARINA DRIVE
Amount Paid: 1,985.00 ATLANTIC BEACH, FLORIDA 32233
Date Paid: 9/12/2001 ,, , ,.aaP one: 904)246-4827
Work Desc: WATER AND SEWER " , FEES-1� "
R. ,..pA ";F 290.00
MP)91C E�" 1,250.00
O325.00
fw>
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35.00
85.00 N,
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NOTICE NCTI UESTEn AT ION
BUILDING MATERIAL, UBBISH A 1tt8RIS FROM THIS,WORK MUST NOT`B LACI=D IN BLIC SPACE, AND
MUST BE CLEARED UP= ND MAUL WAY BY EITHER CONTRACTOR OR NE
"FAILURE TO COMPLYITH T TIO RE LT IN THE
PROPERTY OWNER PAYI O L I Ill,P
ISSUED ACCORDING TO APPROVED P F I? , MIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISI�
j,
—� Operator: CIERYLE
AT K BEACH UILDI T. Dates 9/12/81 01 Receipts now
Total Paywnt t1
CITY OF
800 SEMINOLE ROAD
-- - -- ATLANTIC BEACH, FU RMA 32 S445
TELEPHONE(900 247-586
FAX(904)2,Y-5805
Date
iOA- fjdo( )
Dear Property Owner:
The costs to connect your building to the City sewer and/ oi
water system are as follows :
Sewer Tap - Labor and Materials to tap into
sewer main $
Plater Tap - Labor and Materials to tap into
water main $
Nater Meter .- Cost of Meter $ (j J.
Cross Connection Inspection - Inspection by
Public Works to ensure backflow
prevention $ 3S,(
Sewer Impact Fees - Funds future expansion
of the sewer plant $
Water Impact Fee - Funds future expansion
of the water plant S 0
Capital Improvement - Funds for improvements,
expansion or replacement to
water system $
TOTAL COSTS $
It you have any questions concerning these charges please call
the building department at 247-5826 .
Sincerely ,
Don C. For
Building Official
DCF/pah
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July 25, 2001
Dear.Selva Marina Members:
The 2001 Men's Member Guest Golf Championship, sponsored by Tom Bush Mazda-Volkswagen-
BMW, is right around the corner and we hope you will join us in what will be the premier golfing
event of the season. This year's event will begin with an optional practice round on Thursday,
September 13 followed with two competitive rounds on Friday and Saturday, September 14 and 15.
Sunday will be used as a rain date if needed. We are pleased to announce that we will once again
be playing five 9-hole matches. A Super-Senior flight of 18 holes per day will be scheduled if there
is enough interest.
The annual cocktail party will be held poolside on Friday night. This year, a contest called "Shoot
for the Bill" will be held only during the cocktail party. A hole of about 100 yards will be set up
with the tee at poolside and the flag on the practice green. Closest member wins a free entry fee to
the tournament and the closest guest will receive a gift certificate. You must be there to win.
On course prizes for this years event will be unique and will help make this one of our most
memorable member guests. Tom Bush Mazda—Volkswagen—BMW will sponsor several "Hole in
One" prizes with the grand prize being a newcar to the first person who registers an "Ace". Aon
Risk Services is also providing another major prize by sponsoring a "Closest to the Pin" on a Par 3.
The winner of that event will have the opportunity to take a single swing at winning one million
dollars.
On Saturday night we will have a Dinner Hors d'oeuvre Station/Dance/Awards presentation with
entertainment provided by the Mystery Band. Chef Stephen has promised an outstanding array of
food and the Club's staff will be ready to take care of your every need.
The fee for this year's tournament will be $375 per team. The price includes, golf, tee gift, buffet
breakfast both Friday and Saturday, box lunch and cocktail party on Friday, and Saturday night
Dinner/Dance and awards.
Enclosed is the entry form along with a summary of the events planned. We are limited to the first
60 teams so don't hesitate to sign up. Please note that until we receive your completed entry form,
you are not entered to play.
We sincerely hope you will make every effort to participate. Look forward to seeing you in
September.
Phil Parry
Tournament Chairman
760% �'e�aa a�i�a D�iae 4t41rtic Bead, lqol-iala 32233 90�-246-4827 Fa 90'1-246-9721
Permit Application/Manufactured Home Installation
Permit#
Applicanjr, 1';6&ame of Licensed Dealer/Installer
Address ft License Number S N 0cxxva-1a
Installation Decal 167
Manufacturer's Name :TAcz)1Dsw
Roof Zone c='�. Wind Zone_
Number of Sectionss-�-Width I'4 Length 4S Year OCCO,Serial #
Site Preparation:
Debris and Organic Material emoval _Compacted fill Page#
Water Drainage:Natural
Swale Pad Other Page#_ 1S-C
Foundation:
Load Bearing Soil Capacity: or Assum 1000 PSF__2 Page#�(S�--C
Footing Type:Poured in Place PortableSize and Thickness C:�o -Page# ]y �
I-Beam or Mainrail Piers: Sin le Tiered�_Double Interlocked Page#
Size of Piers_g`'Ge. )c"P Placement O/C 4 Page# c/f(�
Perimeter Pier Blocking: Size ''t.a.2Q aolacement O/Cr - Page# 3
Ridge Beam Support Blocking: Size Number Page#
Ridge Beam Support Footer Size: Column#1 #2 #3 Page# 7(�
94 #5 #b #7 #8
Center Line Blocking:Number Size Location(s) Page# ?h
.Special Pi$r Blocking: Required(Fireplace,Bay Window,Etc.)Yes No Page#�fes_
'Mating of Multiple Units: Mating Gasket Yes�NoType Used Page#�
Fasteners:
ROOFS Type and Size# Spa(-ing O/C Page# (�-C
ENDWALLS Type and Size# Spacing O%C Page#
FLOORS Type and Size# Spacing OIC Page# /SIC
Anchors:
Type 3150 Working Load^><4000 Working Load Page# 1S=C
Height of Unit: (Top of Foundation or Footer to Bottom of Frame) a`1 Page# S3
Number of Frame Ties,_�LSpacing�j�O/C Angle of Strap y5 Degrees Page# tom!
Number of Over Roof Ties:(If Required) -!aPage# �3
Number of Sidewall Anchors Zone II Zone III Page# S3 _
Number of Centerline Anchors Number of Stabilizer Devices Page#
Vents Required for Underpinning(1 SF/150SF of Floor Area)Number Pagg#Q8
Y0 los
1�2001
Sip
1
CITY OF Xr ANTIC BF AC 3
�S rju� 800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 322',3-5445
TELEPHONE: (904 241 7.5800
FAX:(904)247-5805
SUNCOM: 852-5800
http://ci.attantic-beach.fl.us
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PIER LOADS AT MAIN I-BEAM 3354 LBS/PER PIER (TYP)
6' 6. 6' 6'- `— 6'-- -6' 4'—
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BASED ON 000 PSF SOIL BEARING CAPACITY
NOIE. .THIS LAYOUT IS A BASIC PLAN FOR THIS MODEL AND IS A MAIN 1-BEAM BLOCKING PLAN ONLY. FOR THE REOUIREMENTS
AT SIDEWALLS. MARRIAGE WALLS AND/OR SHEARWALL BLOCKING, REFER TO THE APPROPRIATE PAGES IN THE
SETUP MANUAL. DATE:
SCALE:
NOTE: OTHER PIER SPACING OR PIE`: SIZES CAN BE USED IF THEY MEET 711E REOUIREMENTS Of THE SETUP MANUAL DRO. BY
AND ARE ACCEPTABLE TO THE STATE OR LOCAL JURISDICTION IN CHARGE..
BUILDING INSPECTION DIVISION
CITY OF JACKSONVILLE, FLORIDA
CONTRACTOR' S COPY
MOBILE HOME PERMIT: 47598 . 000
tD
DATE ISSUED: 09/12/01 DATE PAID: 09/12/01 PERMIT FEE: $25 . 00 ,ot "'r
TOTAL FEE: $25 . 00
CONTRACTOR LICENSE: IH0000272 d.b.a.: J&J TRANSIT
FOR: STEVICKS, JERRY L. AT: 2143 FRANCIS AV UNIT 0003
LOT: BLOCK: SUBDIVISION: APPROVED: MPH / ERL
INSPECTION AREA: 5 5 5 INSPECTOR: SMITH, JAMES C. PHONE: 630-2689
NOTICE OF COMMENCEMENT: YESHANDICAPPED ACCESSIBILITY: NO
MH-REPLACE MOBILE HOMES 1
WOOD FRAME
28X48
PERMIT REQUIREMENTS
1. ( )SUBMIT REVISED DRAWINGS, AS INDICATED ON THE PERMIT SET PLANS, AND SECURE APPROVAL PRIOR TO
COMMENCING CONSTRUCTION.
2. ( )SUBMIT TWO SETS OF SHOP DRAWINGS FOR( )STRUCTURAL STEEL ( )PRESTRESSED/POST-TENSIONED
CONCRETE( )WOOD TRUSSES( ) AND SECURE APPROVAL PRIOR TO
ERECTION.
3. ( )SUBMIT THREE SETS OF REVISED ( )LANDSCAPE, ( )IRRIGATION PLANS WITHIN( )WEEKS OF
PERMIT ISSUE AND SECURE APPROVAL PRIOR TO INSTALLATION.
4. ( )SUBMIT THREE SETS OF IRRIGATION SHOP DRAWINGS AND SECURE APPROVAL PRIOR TO INSTALLATION.
5. ( )REQUIRED PROTECTED TREE REPLACEMENT IS ( )CALIPER INCHES.
:THE WORK DESCRIBED HEREIN SHALL BE ACCOMPLISHED IN ACCORDANCE WITH THE PROVISIONS OF THE BUILDING AND ZONING CODES
AND OTHER APPLICABLE REGULATIONS OF THE CITY OF JACKSONVILLE AND THE STATE OF FORIDA,SUBJECT TO THE INFORMATION
SHOWN ON THE APPLICATION,APPROVED DRAWINGS,AND SPECIFICATIONS WHICH ARE MADE A PART OF THIS PERMIT. IF NO WORK IS
DONE ON THE PERMIT DURING ANY SIX MONTHS PERIOD,PERMIT BECOMES VIOD. REQUIRED INSPECTIONS NOT PERFORMED UNDER
THIS PERMIT WILL BE SUBJECT TO DISCIPLINARY ACTION. IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT,THERE MAY BE
ADDITIONAL RESTRICTIONS APPLICABLE TO THIS PROPERY THAT MAY BE FOUND IN THE PUBLIC RECORD OF THIS COUNTY(CITY)AND
THEREIN MAY BE ADDITIONAL PERMITS REQUIRED FROM THE GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,STATE
AGENCIES OR FEDERAL AGENCIES. THE PERMIT HOLDER MUST CONTACT ALL INVOLVED UTILITY COMPANIES TO OBTAIN ACCURATE
LOCATION OF UNDERGROUND UTILITIES IN THE WORK AREA BEFORE COMMENCING ANY EXCAVATION OR SITE CLEARING. A LIST OF
UTILITY COMPANIES FOR DUVAL COUNTY HAS BEEN COMPILED BY THE JACKSONVILLE AREA UTILITY COORDINATING COMMITTEE.
COURTESY COPIES ARE AVAILABLE AT OUR PERMIT COUNTER. NOTICE OF A SEPERATE PERMIT IS REQUIRED TO WORK WITHIN THE
CITY'S RIGHT OF WAY OR EASEMENT CONTACT THE DEVELOPMENT MANAGEMENT 630-1105. THE PERMIT HOLDER SHALL DELIVER A COPY
OF THE PERMIT AND COPIES OF ALL FORMS RECEIVED WITH THIS PERMIT TO THE REAL PROPERTY OWNER.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO
OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE'RECORDING YOUR NOTICE COMMENCEMENT.
COPIES OF THIS PERMIT, A SET OY APPROVED PLANS (IFA AND THE RECORDED NOTICE OF
COMMENCEMENT (OR A NOTARIZED STATEMENT THAT THE NOTICE OF COMMENCEMENT HAS
BEEN FILED FOR RECORDING ALONG WITH A CERTIFIED COPY THEREOF MUST BE POSTED IN A
CONSPICUOUS PLACE ON THE JOB SITE FOR VERIFICATION BY OUR INSPECTORS.
Building Inspection Division Type of Improvement: MH-REPLACE Building Permit No.: 47598 . 000
Plans Examination Routing--Required Inspections Proposed Use: RES : MOBILE HOM Issue Year: 2001
Certificate of Occupancy/Code Compliance ADDRESS: 2143 FRANCIS AV UNIT OO(PPans Rec'd Date: 09/12/01
To request inspections using interactive voice response (IVR) call 630-2973 Building Plans Examiner:
The required inspection for this project have been marked with an "X" in the parenthesis.
Plumbing Required ( 1 Electrical Required ( ) Mechanical Required ( 1 Landscape Required ( 1 Fire Marshall Required ( ) Building Required ( X)
Re q'd Insp Req'd Insp Req'd Insp Req'd Insp Req'd Insp Req'd Insp
Cede Inspection Type Cede Inspection Type Cede Inspection Type Cede Inspection Type Cede Inspection Type Cede Inspection Type
Foundation Phase
( ) 01 NOC on file ( 1 01 NOC on file ( ) 01 NOC on file 1 X) 01 NOC on file
1 1 05 Rough ( 1 04 Electical Slab ( 1 06 Mechanical Slab ( 1 03 Tree Barricade 1 1 02 Deep Foundation
( 1 50 Underground Service ( 1 21 Swimming Pool
Coverup ( ) 08 Footing
( 1 12 Slab-Partial
( 1 20 Slab
( 1 52 Pre-Demolition Safety
Framing Phase
( ) 28 Top-Out ( 1 26 Cover-up ( ► 05 Rough ( ) 11 Framing-Partial
( ) 31 Water & Sewer ( ► 38 Picture On File ( ) 14 Pressure Test ( ) 16 Tie-Beam
( ) 29 Re-Pipe (Underground) ( ) 23 Roof Sheathing
( 1 05 Rough(Overhead) ( ) 18 Framing
1 ) 51 Swimming Pool ( 1 53 Reroofing
Grounding ( ) 57 Open FL Framing
( ) 58 Wall Sheathing Insp.
( 1 59 Fill Cell
Interior Phase
( 1 13 Insulation-Partial
( ) 19 Insulation
( 1 70 Partial Rated Wall
( ) 22 Rated Wall
( ) 34 Handicap Accessibility
( ) 46 Lathing
Final Phase
( 1 25 Temp. Final (comm. only) ( ) 25 Temp. Fini (comm. only)I ( 1 25 Temp. Final (comm. only) ( ) 17 Landscape/Zoning ( 1 45 Fire Safety Final ( 1 47 Partial Curtain Wall
( 1 09 Final ( ) 32 Trailer Temp. Final ( ► 09 Final ( 1 54 Fire Alarm Test Report ( 1 48 Final Curtain Wall
1 ) 44 Early Power (SF as only) ( 1 55 Fire Pump Test Report ( ► 49 Threshold Insp. Report
l 1 09 Final
( ) 65 Temp. Final (comm. only)
( 1 80 Health Dept.
Septic System Final
( ) 09 Final
This is a list of the minimum required inspections for this project:There may be other inspections required. Failure of this
list to include a required inspection,does not grant you permission to proceed without obtaining your inspections.
Revised Date: 08/13/99
Permit Application/Manufactured Home Installation
Permit#
Applican �,�Name of Licensed Dealer/Installer _)A me 5
Address License Number 1 N ocxaraa a-
Installation Decal 16-1'I'd 1
Manufacturer's Name �AGa1DsQJ
Roof Zone Wind Zone
Number of Sections Width_L44 Length 4� Year d1GY.z9�Serial # j6C,
Site Preparation:
Debris and Organic Material emoval _Compacted fill Page# 1 =C
Water Drainage:Natural_ Swale Pad Other Page
Foundation:
Load Bearing Soil Capacity: or Awum 1000 PSF2 �� Page#
Footing Type: Poured in Place Portable.2< � s_ -
Size and Thickness c�-'� -Page#
I-Beam or Mainrail Piers: SinPP��Ie Tiered _Double Interlocked Page# 7)-4F
Size of Piers Pc"Past Placement O/C 4 Page#_ h, q fr
Perimeter Pier Blocking: Size "OaU ac Vlacement OIC E3 Page# 3
Ridge Beam Support Blocking: Size I
Number Page #
Ridge Beam Support Footer Size: Column#1 #2 #3 Page# 7(a
#4 #5 #6 #7 #8
Center Line Blocking:Number Size Locations) Page# ?h
Special PiV Blocking: Required(Fireplace,Bay Window,Etc.)Yes No Page#_1
'Mating of Multiple Units: Mating Gasket Yes..S<fNo Type Used Page#�.
Fasteners:
ROOFS Type and Size# Spaeing O/C Page#
ENDWALLS Type and Size# Spacing _ OIC Page# '
FLOORS Type and Size# Spacing OIC Page#�
Anchors:
Type 3150 Working Load._ 4000 Working Load Page#
Fr1 S
Height of Unit: (Top of Foundation or Footer to Bottom of ame) a y Page#
Number of Frame Ties�Spacing Sj O/C Angle of Strap �{S Degrees Page# t3
Number of Over Roof Ties:(If Required) -� Page#
Number of Sidewall Anchors Zone II Zone III Page# S�
Number of Centerline Anchors Number of Stabilizer Devices Page#
Vents Required for Underpinning(I SF/150SF of Floor Area)Number Pag�# 8
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o� AN fOR tMIS M0� g4jII SIOCKtNG. REFER 7Hf SE`up tbANUAI.
j IS ^ SASlc ' wAllS ANOIOR n1E REOUIREMENtS Oc
NOtE. .�It S OE 118. MARRIAGE USED I( T{EY µFEN C"ARGc.
SETUP MANU a1E`� SIZES ,UR150
Al. CAN aE ICTION
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typTE: OTHER Fl AGLE?t 1811
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CITY OF
>'4�'�xrcG �ecLGlc - T�i��zi�
8W SEM NOL1;ROAD
ATLANTIC BEACH, FLC RMA Jl S445
TEL MONS(900 247-58C
FIX(904)24'-5805
Date :
Dear Property Owner:
The costs to connect your building to the City sewer and/oi
water system are as follows :
Sewer Tap - Labor and Materials to tap into
sewer main $
Water Tap - Labor and Materials to tap into _
water main $
Water Meter .- Cost of Meter S ��
Cross Connection Inspection - Inspection by
Public Works to ensure backflow
prevention $
Sewer Impact Fees - Funds future expansion
of the sewer plant $ 2�0 .
Water Impact Fee - Funds future expansion
of the water plant S d 0
Capital Improvement - Funds for improvements ,
expansion or replacement to
'323- 0water system $
TOTAL COSTS $ I �� H • ��
If you have any questions concerning these charges please call
the building department at 247-5826 .
Sincerely ,
Don C. For
Building Official
LCF/pah
a •d RnRR- -b OG swagsRs uo t 4ewioJu I eLS ;0 Z[ c' 2nd
CITY OF ATLANTIC BEACH, FLORIDA
Approwd by APPLICATION FOR ELECTRICAL. PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 04-j- v 19 f.0
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.
2_< FYZ
-avf""A M'c"
LECTRICAL FIRM: MASTER ELWTlICIAN SIG"�Ii_
NAMG _5*� I,` .
2�N��rrr�1 ADDRESS: 1�� •"''�r������*-��- RFD BOX
BLDG.SIZE BETWEEN-
RES.I
ETWEEN:RES.1 1 APT.( 1 COMM. PUBLIC-( ! INDUS.1 1 NEW t ) OLD 1` ! REW.l I
ADDITION( ) TRAILER t ! TEMP. ( 1 SIGNS ( ) SO.FT.
SERVICE: NEW
�( / INCREASE ( 1 REPAIR ( 1 FEE
CONDUCTOR SIZE `C AMPS '2-CX) COPPER ALUM.
1 �
SWITCH OR BREAKER AMPS PH23LVOLT RACEWAY
EXIST.SERV:SIZE AMPS PH W VOLT RACEWAY
FEEDERS NO. ' SIZE NO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED ; OPEN TOTAL
1111CWPTACLES' CONCEALED OPEN TOTAL
0.80 AMPS, 81.100 AMPS,
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
PLIANCE:3 BELL TRA#YSF.
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. 1 H.P. VOLTAGE PHS
MISCEUANEOUS