Loading...
Permit 1810 George Street PERMIT APPLICATIONYREMOF ODEL, OR ALTS /� DEMOLITIONS ALTERATIONS • Owner(s): /2_ . C Address: (2 G Phone: Lot # Block or Unit Subdivision: L Contractor: 6-(- -� x i��,� d State License # C� 5 3 ? 2 - 2 - Address: U /1 ..,z 2-* O L Phone No : LI 0 Describe work to be done: T €, A • Present use of building: E 1 Valuation of Proposed Construction: Proposed use: e - LQ } i 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 ?_ ___ New fireplace? New Heat /AC? SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER /CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: ,, `. � ..;,, ��. / Date. • Signature CONTRACTOR: (',/- /' Date: c (-T - 2 -7 ~7) . License Supplied: Liability Insurance: Worker's Compensation Insurance: ett • ILA. :11117 LAWS Ice P• 712.13 1il /ewtl AtItire Ormitment 001PA:1i No wPUtATS7 entent �cr f pion it ning Concrrzt3 The undersigned hereby informs all concerned that improvements property, and in accordance with section 713.13 of the Florida will b. mode to min real is stated in this NOTICE OF COMMENCEMENT,` following information Description of proper� ....................� :1...�.:.�..� :..L 2 General description of improvements, Owner t 1 ' : ,1 Address (4 ..�.4r' ,� 4 :..4...».» s ».... «. »... ».- .....»._._» ..»«. «« « ...«« Owner's interest in site of the improvement Fee Simple Title holder (if other than owner) _..� Name Address .» .« •.r... • CaNrador Address ( ....» C - c \ tit i Surety (if any) ._»... « » «.... . . »». »..« Addy.ts « .... ».. » «.. «....... » ».... »... »... »» ... »».IM,«,nl of bead »_ . .. Name of person within the State of Florida de4nwed by owner wpon whom oaf or Cher doawtesos may be served: Name Address. In addition to himself, owner designates the following person as provided in Section 713.13 (1) (F), Florida Statutes. (Fill In to receive a copy at Owner' option). Name Addreu BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC REACH, FLORIDA aeaea APPLICATION FOR MECHANICAL PERMIT CALL4N NUMBER IMPORTANT — Applicant to complete all items in sections I, II, III, and IV. 1 . LOCATION St reet Address: O 1/(.9 6' c " ; OF I•tersecting Streets: Setwen And BUILDING Seb•divisien H. IDENTIFICATION — To be completed by all applicants, in consideration of permit given for doing the work is described in the above statement we hereby agree to perform said work in accordance with the •ttecttpd plans and specifications which are • part hereof end in accordance with the City of Jacksonville ordinances and standards of good practice listed Mersin. Nome et Meche•ic•l MIrocter (Print) trenh••ters C � / il L� Meshy Nome . d 1 � (trsp.rty Owner S orreto , eI OWN*? � Sisseton, of or A.sNserioed Ages* Architect or Engineer 111. MINERAL INFORMATION A Type of hooting tool: B. �Lleefric 1s OTNER CONSTRUCTION BEING DON TNIS BUILDING OR SITE? G �' O 6« — O LP 0 N.tuwl 0 Cwefnt UNIN* O IF YES, GIVE NUMBER OF CONSTRUCTION PERMIT O Oth.r — S IV. IMICNANO;AL UQUMMIfT TO M INVALID w►TVRE OF WORK tr'avid' complete Ed of css.pe...ts sa bed of Nib ) ®' Residential or 0 Commercial Qy' 0 Sp.cs p Ketone/ !TCeetesl 0 Neer 0 New Building �A» C.edslie.i.g: 0 ltsel. rer ILKEXIsting Building pr Sydow 1410 060 it14 .4" 1111416... / 0 • t at existing System I h capacity t ..l New installation (No system previously installed) O g_ tiee • 0 Extension or add-on to existing system O Cosiing Ire,: Capacity 0 Other — Specify O Roe tiprin sys: Number st hom. O Sewer 0 M..tift O 6eeleter tewllbe►1 THIS wACI colt awe U'ai ONLY 0 $see sie •: �" 1'w"'b"1 t fleeel edl • Ite.lst s O Lit: doteisi o (e..lbe,) O U.Aved tresewe vane 0 beam O Other — Specify Mein �- LISP ALL EQUIPMENT • Aa CONDt'I7ONING AND REFIUGERATION EQUIPMENT Number Valli Mold Minsk" Weautasterse C gl i r AI AZZ le , (it? ..� t - :T �r�. --�; _ 1 TEAT NC • FURNACES. MIL/MC FfRRex Area CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: .&7 606,0 J C r OWNER OF PROPERTY: PLUMBING CONTRACTOR 4 / /1 / Zl f7 /ii 6- CONTRACTOR'S ADDRESS: /77Z Za STATE LICENSE NUMBER: ( W/91- TELEPHONE: A(``3 f / HOW MANY OF THE FOLLOWING FIXTURES INSTALLED L SINKS SHOWERS L AVATORY G WATER HEATERS l B ATH TUBS DISHWASHERS URINALS DISPOSALS ` C LOSETS WASHING MACHINE . FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES: x $3.50 + $15.00 MINIMUM PERMIT FEE - $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: !2 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 • CITY OF ATLANTIC BEACH, FLORIDA i D ? y Z Approvod by 1 APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: p 19 9 - 5 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 AT BEACH ORDINANCES. 444---„, l ELECTRICAL FIRM: FIRM: ��jj MASTER ELECTRICIAN SIGNATURE JOURNEYMAN //1 NAME 1 N Ci�E ADDRESS: /lid ighe fz (.1)7 RFD BOX BLDG. SIZE /a ) 1M, 44 ( J� /i BETWEEN: RES. ( ) APT. ( ) COMM. ( ► PUBLIC ( ► INDUS. ( ) NEW ( ) OLD ( ) REW. ( ) ADDITION ( ) TRAILER ( ) TEMP. ( ) SIGNS ( ) SQ. FT. SERVICE: NEW ( ) INCREASE ( ► REPAIR ( ) FEE CONDUCTOR SIZE AMPS 0 74 I/ COPPER ( ) ALUM. 06 SWITCH OR BREAKER 3(0O AMPS / PH 3 W / VOLT -�t ('RACEWAY EXIST. SERV. SIZE /6 D AMPS / PH 3 W 2/0 VOLT s,- e `RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN S TOTAL RECEPTACLES Ai CONCEALED OPEN /V TOTAL 0.30 AMPS. 91.100 AMPS. SWITCHES INCANDESCENT FLUORESCENT & M. V. FIXED 0.100 AMPS. 1 OVER APPLIANCES _ J BELL TRANSF. AIR H.P. RATING H.P. RATING T CONDITIONING COMP. MOTOR OTHER MOTORS AMPS CEIL HEAT: KW -HEAT 0.1 1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P, VOLTAGE PHS . r . MISCELLANEOUS �/I4/`Gril M, �/ f1/j7-. fj41.,re, r I 1111 I CITY OF ALANTIC BEACH ROOFING PERMIT APPLICATION Owner(s): ,g r� // c 4/ Address: • 1 -e_ Y, Phone Lot # , Block or Unit Subdivision: Contractor: // G4arcd.s //f G/( /// Address: -37) /� Q�� /9V--e City, State and Zip 7-7 /gG1C Sp(/ / //-_, ' Z ZZ z_ 3ry a7 State License # Describe work to be performed: R„�y Op/ = / ,/ Valuation of Proposed Construction: 4 >TD'O, Materials to be used: Signature of Owner; Signature of Contractor: ' , r , ¢/ Liability Insurance Supplied Workers Compensation Insurance Supplied License Information /v i , i 1 i i T T ' T 1 } 0C , ,s; 7 ; n / ' R A ' ; i 1 ' ; 1 ! 1 4 i. . i , i -fir i i : 1 + ( ; t r i �; 1 it ,/i1' /,» 4 4 �, o f 4 ' k i;' , rJ I,, o4p nr) I 1 f ' ;W ,)' 17 , 4' c 4' ' 1 i 1 /? 4 /4 � ' ' t� i ! i , ' 1 ' ! 1 I I E . R `' RT BEACH . i � U . „ ; . i � ; . ; i . 1 s ■ • I ' . H • H . 1 1 . , ; 4, i.. l/ c', hs;J f d R pU -r_1 --.-.R ■ _ r I J ! H ; r- i I • i ' i i j r I !C` { N ) :� 0 off _ .3 �`�. y - F ir ` _ _ / �r� -- .. r te' , r � . +^' , he -- „R• ..-- , — - 1; ,,,,; h A,' iii , 1 -‘--- veis/rd � MrtJ1H� o � �~ `� r � �` �� , r...... • K' wt G►V �i irp , .. e1 , 4. r I jt i • N ,...". � � ^ (, , I t3 hr A o f BE 4. <t _r_ �r 4}1NG F1C I L 21 1994 . , : �� (....` , - - r • I • CT.... i *--- .. • . . I , , , , , , , , 3OI.4 .dO b NIQ'7If19 �'� f �. , ' kN AO .11.113 >t • ' 4. 1 -i f . / • ' • /J , . te 'l" - • ' s r dr� fib... — ° � .�, ;. °� „fie 4 . 1l /. - .._. i.� 7 `< t { yy 7 s 6 y i l IS i r4xt}� 4 I , .. 5 //9# 1 p i q .•• ' 1?1 '. ` ) a \ ■ • k µ ihf I f: s A , , , In • r i, i i r h .;5."n / , ,, I ` L l.` L 3 . _ . .i 1 k' �' S.'/ f t t.i :t l ....4 .tom __ 0 .. w ■ T. - .._ . ....- ..r -,. 'X .,....i.....`— .01.:.....x+.+..... r..wr{ 1 ... .... .. . -.e .5 -.. r • /L.A. epsi LAWS AMOCO IONN MN III 712.13 Nixtitt f eammencentent 1 1 11 01111,11 MI IMPLICATit tikt 1111 /02n it mag max= The undersigned hereby informs all concerned that improvements will be made to certain real property, and In accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Des cription of proporty....../...g..../...0.............t................' i...: .... - •••••••••••■••••••••■••••••••••••■■ 0 ...foot we. Immo.. •••••••••••••.....eeo.s...............ONI“A..01••■••e•Iyi.....NN•••••Mfw•••••O•••••*1.e.a.M.NNI....eIMNI.ONNO•••••••*N••■*MMM.*.00•O•Mlw.go•m••••••• .......•••••••••••••...••••••••••••••••••••■•••••••••••••••••••■••••••••••••••••.....•••••• •••••*“....00.1 ••• ••••••••••••■•••••••■••••••••■•••■•••••••“*.e. . •••• ••••••■••••••••••••••••••••••••••••••••■•....•••••••••••••••••••••••■110.011001.00 0 'l al ) ofrioA) • General description of imitrovements.. n Imo. •■•■••••••••••••••••••••■■•••••••••••••■•••■•••••••••■•••••■••••••.•••••••••••••••••••••••••••■•••••• •••••••••••••••••••••••••••••••••.••••••••••••• •••••••••■••••••••••••••••■••••• •■•• M. •••••••■•••••••011000•••••••••••••••••••••••••••••••••••••...0110••••••••••••••••••.... O ....trzat •••••••••••■■••••Im a •••••• ...mows. •••••••••■• wner- .. .. klikati&?....... - - , 15 e rgjac Ackkese. I. ........Q....".. ... .... :a... . ... 00000000 •••••■••■•••••••••••••*.e.motoomm~HeseoloNmosmome••••■■•■••••••••••■••••••••••■•■•• X. O Vieniel interest in ae of the hvorovement...........E..44...: 00000 .....‘ 00000 1220••••••••••114.04.•••■••••••••••••••■Mle••••••••••••01.4140.•••■•••• h. Simalo.Title holder rof ether thee owner) Name (.?..ift--) A - C f .--- ................. .. . . Add rese....................................—.............................. ...... *MOW NO001..0114 0 011...1011••••••••••.....1.104.110•0110 Mo.. • HMO .,..-,. - • C5 C_ C.- ' r f Confrador...............................................».... ............ MIN 00.•••••••••4100011.10.111.1.1NWOON•••941.0110100.m.••14.900W00....”10 Add reall..........,••••••••••••••......;,......0.040.11044••••■•01.0.1.100•••■•■•■■•••••■•••■•• • ••■••••••114. 0601.0••••••••••••••••••••••••••••••••••••9110011.1.1.008.11.0WOODMWAIMO•oWNO 0000 I* S WIlity tif a4Ili......esemeneose....“........•••••••••••••••••■•••.....14.... 0000000000 ..........■••••••••••••••••■••■•...................“1“.........*“........• Address ....................................................Anonns 01 band $...... 0000000 me."90101141.••• NOM41 of person wn the bate .1 Melds designated hy owner upon whem notices or ether documents may b. saris& N ame • • ••••••••••••••:,..•••••••••....1•010.10...1006.0114.100•••••••••••■•1.111.11.110.1. 00000 1.0.41.00..”01.0••••••••••••••••611011.1010•1011011■MOMMOW1111••••~ONMOIMOOMMOWN••••••••••••••••••••••■•••••••••• Add re$1...................................................""m " -- -......„.,,,....."••••••••••••••••11 ...06•04 se..•••••■••••••••••••••••“•■•••••■••••••••••••••■•••NIMOINNWIN.40•00000•INOM0 .....1101..••••• 000 I n addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as providel in Section 713.13 (1) (F), Florida Statutes. (Fill in at Owner's option). N a n . 00000000 ••••••••••••••••••■••••••••■••••••■••••••••••■••••••••••■••••••••••••••••••••••••••••••••••”.••••■••••.••••••••••••••••■••••■•Mw1W80.0.miewm••••••••■••••••••••••••••••••■•••...••••■••••■••■.••••••• • . . . . n ■•••••••••••• Addrailk •-••••••••••••••••■•••■••••••■•••••••••••••■■••••••■•••• •••••••••••••••••••••••••••• ••••••••••••• ...... • ••••■•••r••0•4••••■■•••••••••••■•••••••■••••••••■•■■•••■•■■••••••••••••••••••mommr. M.* mi. 11111A411 FON itieosteture YU ONLY I - - • FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 600C -93 Residential Limited Applications Prescriptive Method C NORTH 1 4 Small Additions and Renovations Department of Community Affairs Compliance with Method C of Chapter 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 600C -93 for additions of 600 square feet or less, site- installed components of manufactured homes, and renovations to single and multifami residences. Alternative methods are provided for additions by use of Form 600B -93 or 600A -93. PROJECT NAME: 13E fOoin be) O.a BUILDER: AND ADDRESS: /g b Geor..6- PERMITTING r CLIMATE ,41-1 q,, - < < � p 322 OFFICE: ZONE: 1 2 3 OWNER: fl ©; O ` r PERMIT NO.: JURISDICTION NO.: » ( A t C SMALL ADDITIONS TO EXISTING RESIDENCES (600 Square feet or less of conditioned area). Prescriptive requirements in Tables 6C -1, 6C -2 and 6C -3 apply only to the components of the addition, not to the existing building. Space heating, cooling, and water heating equipment efficiency levels must be met only when equipment is installed specifically to serve the addition or is being installed in conjunction with the addition construction. Components separating unconditioned spaces from conditioned spaces must meet the prescribed minimum insulation levels. RENOVATIONS (Residential buildings undergoing renovations costing more than 30% of the assessed value of the building). Prescriptive requirements in Tables 6C -1 and 6C -2 apply only to the components and equipment being renovated or replaced. MANUFACTURED HOMES AND BUILDINGS. Only site- installed components and features are covered by this form. Please Print CK 1. Renovation, Addition or Manufactured Home 1. 2. Single family detached or Multifamily attached 2. 3. If Multifamily -No. of units covered by this submission 3. 4. Conditioned floor area (sq. ft.) 4. cq 8e) 1/ 5. Predominant eave overhang (ft.) 5. / 0 6. Porch overhang length (ft.) 6. 7. Glass area and type: Single Pane Double Pane a. Clear glass 7a. sq. ft. /6 sq. ft. L/ Tint, film or solar screen 7b. sq. ft. sq. ft. 8. Percentage of glass to floor area 8. r % t/ 9. Floor type and insulation: a. Slab on grade (R- value) 9a. R= 0 sq. ft. ✓ Al Wood, raised (R- value) 9b. R= sq. ft. ,e. Wood, common (R- value) 9c. R= sq. ft. 4. Concrete, raised (R- value) 9d. R= sq. ft. ,e. Concrete, common (R- value) 9e. R= sq. ft. 10. Wall type and insulation: --- a. Exterior: 1. Masonry (Insulation R- value) 10a -1 R= sq. ft. 2. Wood frame (Insulation R- value) 10a -2 R= 1/ 3/8 sq. ft. ) ■Adjacent: 1. Masonry (Insulation R- value) 10b -1 R= sq. ft. 2. Wood frame (Insulation R- value) 10b -2 R= sq. ft. ,• Marriage Walls of Multiple Units* (Yes /No) 10c g 11. Ceiling type and insulation: a. Under attic (Insulation R- value) 11a. R= / ?g sq. ft. b. Single assembly (Insulation R- value) 11b. R= sq. ft. 12. Cooling system* (Types: central, room unit, package terminal A.C., none) 12. Type: i? o^"' L411i1 SEER/EER: 13. Heating system *: 13. Type: (Types: heat pump, elec. strip, natural gas, L.P. gas, room or PTAC, none) HSPF /COP /AFUE: 14. Air Distribution System *: ,a. Backflow damper or single package systems* (Yes /No) 14a. Ducts on marriage walls adequately sealed* (Yes /No) 14b. 15. Hot water system: 15. Type: (Types: elec., natural gas, other, none) EF: * Pertains to manufactured homes with site installed components. I hereby certify that the lans and specifications covered by the calculation are in Review of plans and specifications covered by this calculation i Les compliance compliance with th- lorid Ener_ ode. with the FIonda Energy Cod - ore const e$i� is plet: bu will be , PREPARED BY: 4.,_ * � _ � � DATE: It) q inspected for compliance i' Tdd.Ii, anncee with S i I ., .S. I hereby at ilding is in Ionda Energy Code. BUILDING OFFICIAL: � \'\ _ OWNER AGENT: !i s / E• l S 4 DATE: ri..T� / 1 CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET ' Address /PO ' 6 ,-,o r 6 S % (tiv00/ 7 Date / - r 4 - /' Heated Square Footage /, V @ $, - 6 1 per sq ft = $ / Garage /Shed c @ $ per sq ft = $ Carport /Porch @ $ per sq ft = $ Deck @ $ per sq ft = $ Patio ' @ $ / per sq ft = $ TOTAL VALUATION: $ / 2_, 7 2-e, `j ' $ l?- Total Valuation 1st $ Rema $ $ j per thousand or portion thereof TOTAL BUILDING FEE $ 7 0 + 1/2 Filing Fee $ 3 s' ( ) Fireplaces @ $15.00 $ - C) BUILDING PERMIT FEE $ WATER IMPACT FEE $ • SEWER IMPACT FEE $ WATER METER /TAP $ CAPITAL IMPROVEMENT $ SEW R TAP (L) RADON (HRS) .0050 $ SECTION H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ m (Ur) SURCHARGE .0050 $ O ER $ () GRAND TOTAL DUE $ /0 1 ' e ADDITIONAL PERMITS OR FEES:Mechanical ; Plumbing Electric /New Electric /Temp ;SwimmingPool Septic Tank ; Well ; Sign Finish Floor Elevation Survey ; Other CALCULATIONS and /or NOTES: • OWNER BUILDER PERMIT AFFIDAVIT. --4-- ts.t.. of Florida ) • • City of Atlantic Brach ) BCF9RE ME, the undersigned authors! --� ^ o r) Y. personally ippearad iwosn, deposes and s•yss who upon fitat being duly • and the legal owner ut the Zollowin 0 property', . r Subdivision ! ) Irma - ' Block ._ AKA " -- Lots • = am applying for • building permit pursuant Lo %he Owner Builder exemption set forth in Florida Statute, Section 469.103. Florida law requires that I have been provided with the foilovinu DISCLOSURE STATENENTs DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for • permit under an exemption to that Iaw. The exemption allows you, as &ha minor of your property, to .act as your own contractor even though you do not have • license. You must supervise the construction yourself. You may build or improve • one ■ or two family residence or • farm outbuilding. Vow may aloe build or iwprov• • commercial building •t scoot et 025, 000.00 or less. The building must be tor your use and occupancy. It may not be built for sale or lease. It you sell or le•be more than one building you hove built yourself within one year mate, the construction is complete, the 1•w will presume that you built it for sale or lease. • which is • violation of this exemption. Vour construction must be done •000rding 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 hive read the above DISCLOSURE STATEMENT and ,that 1 comply with all the requirements ford the issuance of an Owner - guilder permit. Further, •ffiant s•yeth not. Property Owner Sworn to and sub cxibed before we this ar . � . vt im{ - 44.4 -.._ . 191-4/c.-- 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 Eighteen Thousand Five Hundred Thirty and 00/100 Dollars (518,530.00) 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 unforgiven 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 l (seal) Nam- ir aker (seal) Makers Address: 1810 George Street Atlantic Beach, FL 32233 STATE OF FLORIDA DOCUMENTARY STAMPS IN THE AMOUNT OF $ HAVE BEEN AFFIXED TO THE MORTGAGE SECURING THIS NOTE AND CANCELLED. PRE- CONSTRUCTION CONFERENCE REPORT READ CAREFULLY BEFORE SIGNING I (WE) THE UNDERSIGNED HAVE ON THIS DATE AT "f s � PARTICIPATED IN A PRE - CONSTRUCTION CONFERENCE PRIOR TO THE SIGNING OF A CONTRACT FOR THE REHABILITATION OF MY (OUR) PROPERTY. ACKNOWLEDGE THAT WE UNDERSTAND THE TERMS OF THE CONTRACT, THE WE WORK TO BE PERFORMED BY THE CONTRACTOR, THE ROLE OF THE CONTRACT OF THE ACT 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, CT ANY, AND ARE AWARE THAT ASSISTANCE WILL BE PROVIDED BY Q IF 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. ` g nature f nature /:, 9 roperty owner to gnatur o rop erty ner 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. gnature o o• - actor : t e te, S1 f- 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 MEMORANDUM #49. 6(.. ir 7/r�/9 PROCEED ORDER DATE; - 9� T0: - - -�.4 - , • .�� - 22 /4 ti This is to.authorize you to proceed w l � ith work specified In our contract dated for improvement work on the property i�'e.e f " Y located at f • The amount specified in t reement is $ the Rehab - il�tatioa Ag $° the Contract. Please proceed is accordance with You are to commence work no.later than All work shall be completed according to the Work k Wri te"UP► plans Addenda and S pecifications w , Change n Sixty (60) calendar days after start- . ing construction. a me(s) o Owner s) (der s Signature) /ve Owner s Signature) ADDRESS: (Local Pr� i �► Aiency Rep- esentative) Copy • RLP�43 REHABILITATION LOAN PROGRAM RESPONSIBILITIES OF HOMEOWNER AFTER CONTRACT IS SIGNED Until W plaork nin Be ins Start n �~ tools, equipment g ahead. Plan adequate stora ge space fo q pment and materials. for the contractor' get into your property Make arrangements for the contractor t, To avoid mutual be home during the day. the s confusion, one member of the family spokesman to discuss problems or questions that be delegated ma a If all household members Y come up, consider designating work or will not be home durin g the construction, tine not living an agent such r esponsible g with you to as a close friend or nei hbor he would do in make sure the contractor does contractor' e stated your contract. the work exactly work. You are Prepare Y as he stated P your property and furnishings There will Your drapes to the g for the rehabilitation ings and cl pr h b s bly be dust and dirt from the work - wash use this be broken or misplaced. all breakable and valuable items away your curtains. protect your furnish- so they won't When the Work Be ins Keep your copy of the work description handy Ke Ke th your Case Manager if with there Y ing refer to it often. Check you are responsible is a nything you do work Reme correctly are bid. for ensuring not r nders the work must correctly acceptable t o Assistance will be that the contractor does you. Provided if required but the Try to stay out of the construction area help prevent injuries and allow the workm r to Y children; this will Try to keep a m to work. again, delegate good relationship between g someone to be the spokesman for the family family. before they contractor - Stop problems bef • S it should, f if y start - if something can t going the way you t too far, get an acceptable explanation or correction before If the contractor cannot contractor at t oop the work and call contractor Case Manager give it explanation, you an acceptable explanation, for assistance. Expect the unexpected - in most cases changes and and exciting to you and will improvements will be new and may to uncovered during you much pleasure; problems change to the nonvrred. g the course of however, unforeseen changes with Be if this should happen the work which may require a the contractor and get a good explanation prepared of required and why. Try - discuss reg xible. y to . visualize what the change will look the like. All changes to the contract must be approved change Be pproved by you and your Case Manager and must be in writin . Your contractor is responsible for cannot be present, make sure that he tells supervision of his workers. a problem or questions. you who to talk to if If he you have Win cooperation from the workmen with wate rpre Small ne - unexpected pot of coffer .sic human relations. A w�,-� • CONTRACTOR'S AFFIDAVIT STATE OF FLORIDA ) COUNTY OF DUVAL ) SS • BEFORE ME, the undersigned Notary Public, personally a me, C._ _ `�. -`�� t ,✓ � -� G� �' appeared __. epos es an says: , who, being first duly sworn - 'by' That on y ( 19 as owner, an ' as contractor, entere nto a certain cons ruc on contrac w -re• agreed to provide certain labor and materials for said owner u t sa tn contractor upon t described lands belonging to said owner, located in the City ofhe - following County of U and State of Florida, to -wit:` • That deponent is the 42r:i.e. herein referred to as the contractor, and has of said corporation, of said contract. Personally supervised the performance 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 Mechanics 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. • • Subscribed and sworn to before me this C ONTRACTOR PAYMENT REQUEST Homeowner: Payment #1 - 40% Complete Address: #2 - 80$ Complete Contractor: #3 - 100* Complete Amount Requested: $ Contractor: I hereby request an inspection to receive for the amount of $ Payment # satisfactorily completed the necessa wor that I Tk to this request and that all bills incurred for la jusus and materials furnished in makin bOr use and provements have been paid in full to said d and im- Attached is a description of the work completed and amount of payment requested by work item. the Contractor's Signature: Date: Homeowner: I /We hereby agree that the work stat has been completed and approve ed by the contractor in accordance with the contract and n contingent upon c i- 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: Owner's Signature: Date: 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 way 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 property owner from the contractor fr ° work perfoe e de the performed. I hereby certify that all work is completed as indicated on the contractor's payment request and recommend a to the contractor in the amount of $ P Yment Rehab Specialist: Date: At 1 completion: T nor4.4C.. ii_ CAGE ORDER No. Date of Contract Owner Name; Date Property Address: Contractor Nam Contractor Address: Descri tion of Work Chan e: No. - AMOUNT: CATEGORY. SUM Changes and work affected hereby, are subject to all contract stipulations covenants. This Change Order is made a part of the contract dated first a bove. parties have hereunto set their signatures: p ations and $ Contract Price +or - $ Change $ Owner Approval: Total Date: Contractor Approval: Date: Sr. Rehab Specialist Approval: Date: Program Administrator Approval: Date: Source of Funds: $ Contingency $ $ Owner Contract t Copy; Owner, Contractor,. Loan file, Technical file Financial Institution (If contract price changed) RLP -155 Rev. 12 /E ii4MEOWNE2 - CC1llEAC 2. Property Improvements To: - /� (Address) Owner (s) : /C LZ Ke/4Z (Name) � b (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 full covering all labor and materials for which a erforman 1 en could be filed or t in 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 ($ 53° vv scheduled as follows, subject to the Owner's n ot the l 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) calendar 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. mom_ . Order. Change Or executed Cha ex nd when he has neglected No extra costs will be rehabilitation work. to properly paid to the Contractor Under no Y evaluate_ -the extent if any, be authorized circumstances will the contingencyffund, circumstances arising for work other than totally g after the commencement of the work. unforeseen 7. TERMINATION OF AGREE ca ouI the work a 5 E NT. If the Contractor defaults or fails oo specified under the paragraph "Scope neglects to perform any provision of the Contractor documents, the e O " e may, after fifteen (15) calendar days written notice, the this contract and select a r. exenses of finishing substitute Contractor. � terminate this g the work exceeds the unpaid balance on this contact, the Contractor shall pay the difference to the Owner. perform any applicable If the Owner fails to after fi (15) provisions of the Contract, the Contractor may, atom the Owner (1a calendar days, terminate the contract and recover payment for all work satisfactorily completed including reasonable profit and damages. 8 . WARRANTY. For good and valuable consideration agrees to provide a full one -year warranty to�the the y agrees here which extend to subsequent Owners of the property warranty shall extend to subsequent Ownes to be rehabilitated. The the 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 qualit y, s in workmanship or materials or deficiencies subject tof contained in this paragraph. Contractor and Owner agree, however, that the warranty set forth in this paragraph shall apply only to deficiencies and defects as to which the Owner or subsequent such shall have given written notice to the Contractor, at its principal ( place of business, within one 1 qu Owners from the ate of final payment. The Contractor further warrants that failure Contractor's by the Contractor to respond to valid complaints by Owners, that causes additional damages to the p operty are oalso subsequent 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 its dpsinnoo 4-„ -,_�_ �L_ . 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 Borrower for the performance of work financed in enter f or ° in y par t t with the proceeds of this loan. 12d. INTEREST OF OTHER LOCAL PUBLIC OFFICIALS. N ing body of the locality in which the o member of the govern- is situated, and no other property to be rehabilitated cises any 'functions or respons b lit es of connection wi° extb with thhe e administration of the loan shall have any interest, direct or indi- rest, in the proceeds of this loan, by the Borrower for the performance or in any contract entered into nce 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. N � ,A of ; �^ C,.../ 44C._ kart K � Contractor iCAcfr1 f� Name(s) o CTIL - 11 t ° Signature of C actor t Si nat ,, � 9 o�jOwner Date A . ■ - -- _ ATTACHMENT 1 EQUAL EMPLOYMENT OPPORTUNITY -CLAUSE 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 or 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: ment, upgrading, employ - pgrading, demotion, or transfer; recruitment or recruitment adver- tising; layoff, or termination; rates of a P Y 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. 11246 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 noncompriance with crimination clauses of this contract or with any the nondis- Y of such rules, regula- tions, or orders, this contract may be cancelled, terminated or in whole or in 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 be imposed and remedies invoked as r sanctions provided i 11246 of September 24, 1965, or by rule, n Executive Order No. 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 regulations or orders of the Secretary of labor issued pursuant to o 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 "Standard 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. 2. The goals for female participation arm A O. -_ _ • BID FORM RANDY RHONE ALEXANDER W. BALFE IN CERTIFIED BUI • • (Home Owner) ?F�yy (Con y� SQ 1 ,136 p _4 . 1810 GEORGE STREET 32216 (Address) (Address) (Phone) Material Specifications Material Labor 1. ROOF: Tear off and replace all deteriorated wood and metal components Install 30# felt paper and 20yr shingles. 2. WINDOWS: Install pre- finished single hung units with screens at all openings. 3. ELECTRICAL: Rewire house completely including all fixtures, 0 200 amp panel and exterior service. 4. STUCTURAL: Tear out and replace all deteriorated joists, plates, and studs at kitchen and bath areas, 5. PLUMBING: Re -plumb completely, 17 7 v including all kitchen and bath 7 v fixtures. 6. KITCHEN: Hang sheetrock, tape & finish. Texture ceiling. Install 3/4" subfloor and vinyl floor cover' ng. il4L2 < J 2 Install trim and pre- finished upper and base cabinets. Prep and paint walls and trim to a semigloss finish. 7. BATHROOM: Hang sheetrock, tape and finish. Install 3/4" subfloor & �� u vinyl floor covering. Install trim sc.� including luan passage door with hardware. Prep and paint walls. Subtotals: $ 71)-2 $ C'7o Totals: $ (Date) (Contractor orE.]dderSignature) BID FORM A LEXANDER W. BALFE, INC. CERTIFIED BUILDING CONTRACTOR RANDY RHONE 101 CENTURY 21 DR. SUITE 21 JAC KSONVILLE, FL 32216 FL (Home Owner) (Contractor or Bidder) • PAGE 2 (Address) (Address) (Phone) Material Specifications IIIIIIIIIIIIIIII 7. (CONT.) ceiling and trim to a Labor semigloss finish. 8. REAR BEDROOM: Hang sheetrock, tap: and finish. Texture ceiling. Install 3 2_5- trim. Prep Z P and paint walls (flat) and trim (semigloss). 9. INSULATION: Insulate attic space to R -19 with blown in fiberglass. ' /� 10. ENTRY DOORS: Install pre -hung _ steel door units at front and rear s y including hardware, threshold, acrylic finish and metal storm doors 11. HVAC: Install complete central /‘ /v heat pump and air conditioning syste,. ( V r In vinyl siding a . ' m trim. -C- 24?/.2/.-- Subtotals: $ � $ Totals: 3; 3 -- a) 7 — -I'S- Arc (Date) (Contracto l;•rEidderSignatur e ) mwmolimmommommalmumm • 6 rn r N IN ., ,6 D ` In 0 -� O -o ff S. v _ 4 -• •-t- c N a 0 * �Q�1 CZ) ZNZ� n vN C..) z v o �' V v ; y v ) Q U S I M , � V V N o 0 I N N O M b �l �o , , O, ■ r . I ' 1 1' c'') (� o W N N A ' N N A a . c. o n b . � �, (-9 V 'N N N N '' N N a> y B 3 1 �' - "6 b b `..3 n�i pi° 4") O V] y y Q p 4 0 4 ( c . ° , i .� o Q `,) W `� o c, .v o '° w o o, M V f Q N in 0 00 p Do C1: a � a) 0 g W t 'L7 H Q R7 O U 0 "d ° p A y cra 0 .-, 4; . a a v) v) 3 3 3 w v v 3 x o • W • a P A ±'