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Permit Addition 1923 Beach Ave 2010 f 1),- t iro `' s TI CITY OF ATLANTIC BEACH .' 800 SEMINOLE ROAD ='ry ATLANTIC BEACH, FL 32233 -44 INSPECTION PHONE LINE 247 -5826 '4y fist 1t }r`' Application Number 10- 00001378 Date 11/23/10 Property Address 1923 BEACH AVE Application type description RESIDENTIAL ADDITION Property Zoning TO BE UPDATED Application valuation . . . 425000 Application desc addition Owner Contractor HASTING TRUST THE GELLATLY COMPANY 41280 RUE JADOTUE P 0 BOX 51393 TEMECULA CA 92591 PENMAN RD JAX BEACH FL 32240 (904) 993 -5014 Structure Information 000 000 Construction Type TYPE 5 -A Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit BUILDING PERMIT Additional desc . Permit Fee . . . 1455.00 Plan Check Fee . . 727.50 Issue Date . . . Valuation . . . . 425000 Expiration Date . 5/22/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Deck work to be done under separate building permit with FDEP authorization for work seaward of CCCL required. Other Fees STATE DCA SURCHARGE 21.83 DEV REVIEW - SINGLE & 2 -FAM 50.00 ENG REV BLDG MOD OR ROW 25.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY gIPSPAAIFIYEAgi AND THE FLORWA. 83 BUILDING CODES. . '1° r ,, CITY OF ATLANTIC BEACH r. ' t ' 800 SEMINOLE ROAD =" ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Page 2 Application Number . . . . . 10- 00001378 Date 11/23/10 Other Fees UTIL REV MODIF OR ROW 25.00 Fee summary Charged Paid Credited Due Permit Fee Total 1455.00 1455.00 .00 .00 Plan Check Total 727.50 727.50 .00 .00 Other Fee Total 143.66 143.66 .00 .00 Grand Total 2326.16 2326.16 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION a CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 1923 Beach Avenue, Atlantic Beach, FL 32233 Permit Number: /0 / 3 9 c? Legal Description Lot 51, North Atlantic Beach Unit 2 Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $425,000.00 Proposed Work heated/cooled 3,220 non - heated/cooled 690 Class of Work (circle one): New ditio Alteration Repair Move Demolition pool/spa window /door Use of existing/proposed structure(s) (circle one): Commercial tesidentia� If an existing structure, is a fire sprinkler system installed? (Circle one): Yes 0 N /A For multiple products use product approval form (see attached) Describe in detail the type of work to be performed: Add approximately 420 above the existing garage on the existing footing. All work is within the existing house envelope and no foundation is being added. Rework the plumbing, electrical, and HVAC and replace all windows and doors. New cedar wall shingles and trim will be installed. Property Owner Information: Name: Melanie & Richard Hastings Address: 41280 Rue Jadot City Temecula State CA Zip 92591 Phone 951- 676 - 8850.""!= E -Mail or Fax # (Optional) socalmelanie @msn.com, Contractor Information: FILE COPY , Company Name: The Gellatly Company Qualifying Agent: William R. Gellatl r Address: 1515 #B Penman Road City Jacksonville Beach Office Phone 904- 246 -9080 Job Site/ Contact Number 904 - 993 -5014 F4 # 904- 24b -9ZUU State Certification/Registration #_ CGCA21737 REVIEWED FOR CODE COMPLIANCE Architect Name & Phone # William A. Leuthold 904 - 389 -5456 CITY OF ATLANTIC BEACH Engineer's Name & Phone # Chris Kathe 808 - 322 -9494 SEE PERMITS FOR ADDITIONAL Fee Simple Title Holder Name and Add same as owner REQUIREMENTS AND CONDITIONS. Bonding Company Name and Address N/A ---- , / lTt'� Mortgage Lender Name and Address N/A REVIEWED BY: _ DATE: is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks and Air Conditioners, etc. 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 OF COMMENCEMENT. 1 hereby certify that I have read and examined this a placation and know the same to be true and correct. All provisions of 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 other federal, state, or local law regula''rn construction or the performance of construction. Signature of Owner ' A / Signature of Contractor t�,, ∎ . \ g , Pr int Name 1 R �i . /. l Print Name Me_eli �/ /-1-71 77 A/6 S �. m aw - R.6 C2. N� . . . ` Swq • o and subsc �fore me Sworn to and subscribed b; ; ;• _ ; LIC -STATE OF I n . this! 1 !A Day of , 20 CO this // Day of Novel* ' Nancy M. Ha 1 " s b r I �malission # EE034462 � W' V / pares: OCT. 23, 2014 Pu. c VVV No ry ul� B1,/ :MM WRU ATIJXI'IC BONDING CO., INC. Revised 01.26.10 CALIFORNIA ALL - PURPOSE ACKNOWLEDGMENT r.zr. .-, c>: c--r: -- - ,- r..-.. ,rcc ,c~: e <. cc r ccr . c. .c „ r--. rz, ---- c xze c re> ,��, '3 J 1 State of California 1 g County of 'rrr sta -e' I F O 1 ° 24la before me, 1 ,t 1 e t d fan etJ / &) I "A, c g Z - Date Here Insert Name and Title of the Officer ,7. S fi personally appeared 1G f 1 Name(srof Signed fi g who proved to me on the basis of satisfactory � evidence to be the personks� whose name.Fs) is /are- 4 subscribed to the within instrument and acknowledged t to me that he/she /they executed the same in g hie /her /their authorized capacityQies°), and that by g - ,,„ MARY FAITH G. VILLANUEVA /}per /their signature on the instrument the ,,. Commission • 1 ®74902 erso or the emit upon behalf of which the r' c i- �s z p Y P fi z _ ,� _ N otary . Public - California z ' " > > p erson(s)acted, executed the instrument. fi ��� Riverside County .• i (' M Comm. Ex ires Dec 26, 2013 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing 4 paragraph is true and correct. WITNESS my hand and official seal. g Signature: 1 Place Notary Seal and /or Stamp Above Signatur Notary Public OPTIONAL e r Though the information below is not required by law, it may prove valuable to persons relying on the document L �J and could prevent fraudulent removal and reattachment of this form to another document. 1 4 p I (C � (J Description of Attached Docer ect ryr g, Document Date: Number of Pages: g Signer(s) Other Than Named Above: g Capacity(ies) Claimed by Signer(s) g g, Signer's Name: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Corporate Officer — Title(s): ❑ Individual 13U3HTffinUmBP3IMT ❑ Individual 3IGH T uNBPRRptT SIGNER ii F51GNER ' ; L ❑ Partner — ❑ Limited ❑ General Top of thumb here ❑ Partner — ❑ Limited CI General Top of thumb here g ❑ Attorney in Fact ❑ Attorney in Fact g El Trustee ❑ Trustee ❑ Guardian or Conservator ❑ Guardian or Conservator 0 ❑ Other: ❑ Other: 0 a 0. Signer Is Representing: Signer Is Representing: 0 © 2008 National Notary Association • 9350 De Soto Ave., P.O. Box 2402 • Chatsworth, CA 91313 -2402 • www.NationalNotary .org Item 85907 Reorder: Call Toll -Free 1- 800 -876 -6827 r THE GELLATLY COMPANY LICENSE NUMBER CGCA21737 1515 -B PENMAN ROAD JACKSONVILLE BEACH, FLORIDA 32250 PHONE: 904 - 246 -9080 FAX: 904 - 246 -9200 TRANSMITTAL TO: City of Atlantic Beach / Building Department FROM: William R. Gellatly DATE: November 12, 2010 RE: Hastings Residence 1923 Beach Avenue Atlantic Beach, FL 32233 To Whom It May Concern, Attached are the following items for permitting the above referred project: Description Copies 1. Notarized Permit Application 1 2. Sealed Plans and Engineering 6 3. Florida Product Approval Sheet 2 4. Energy Calculations 2 5. Landscaping and Tree Removal Letter 1 Thanks, Bill 1 of 1 THE GELLATLY COMPANY LICENSE NUMBER CGCA21737 1515 -B PENMAN ROAD JACKSONVILLE BEACH, FLORIDA 32250 PHONE: 904 - 246 -9080 FAX: 904 - 246 -9200 thegellatlyco @bellsouth.net MEMORANDUM TO: City of Atlantic Beach Building Department FROM: William R. Gellatly DATE: November 10„ 2010 RE: Hastings Residence 1923 Beach Avenue Atlantic Beach, FL 32233 To Whom It May Concern, A landscape plan has not been formalized. The foundation and house footprint are not being enlarged. No existing trees will be removed from the lot as part of this construction permit. Thank you, Bill 1 of 1 Page 1 of 3 Witham Gellatly '''c1 From: Cindy Gardner [cgardner0814 @yahoo.com] Sent: Thursday, April 08, 2010 4:48 PM To: gellatlyco @bellsouth.net Subject: Fw: 1923 Beach Avenue, Atlantic Beach / Statutory exemption language Forwarded Message - - -- From: "Jones, Valerie" <Valerie.Jones @dep.state.fl.us> To: Cindy Gardner <cgardner0814 @yahoo.com> Sent: Thu, April 8, 2010 4:09:46 PM Subject: RE: 1923 Beach Avenue, Atlantic Beach / Statutory exemption language Hi Cindy & Bill, Please see the following guidance I sent out recently to someone regarding work possibly qualifying for an exemption from permitting from the CCCL program. Please call or email me with any questions. Florida's statutes and rules can be found at: https : / /www.flrules.org /Default.asp or http: / /www.leg.state.fl.us /statutes/ „. Coastal Construction Control Line (CCCL) Program / DEP Authority: Chapter 161, Florida Statutes The Legislature wrote this portion of statute (see below) with the intent to describe the types of structures and /or activities that may be considered "exempt” from CCCL requirements by virtue of their minor nature — see Section 161.053(12), Florida Statutes, below. Paragraph (a) is intended by law to be self- executing by virtue of the wording used. Therefore, if an applicant and the local governmental entity believe that the proposed work fits the statutory exemption, a determination by the Department is not required. However, paragraph (b) is not self- executing by virtue of the wording used; i.e., an exemption must be determined by the Department in writing. Paragraph (c) is also not self- executing by virtue of the wording used; an exemption must be determined by the Department in writing as well. Please see the statute section below. Section 161.053(12), Florida Statutes (a) The coastal construction control requirements defined in subsection (1) and the requirements of the erosion projections pursuant to subsection (6) do not apply to any modification, maintenance, or repair to any existing structure within the limits of the existing foundation which does not require, involve, or include any additions to, or repair or modification of, the existing foundation of that structure. Specifically excluded from this exemption are seawalls or other rigid coastal or shore protection structures and any additions or enclosures added, constructed, or installed below the first dwelling floor or lowest deck of the existing structure. (b) Activities seaward of the coastal construction control line which are determined by the department not to cause a measurable interference with the natural functioning of the coastal 4 010.. system are exempt from the requirements in subsection (5). (c) The department may establish exemptions from the requirements of this section for minor activities determined by the department not to have adverse impacts on the coastal system. Examples of such activities include, but are not limited to: 4/9/2010 Page2of3 1. Boat moorings; 2. thru 9. [see statute] I trust this explanation will suffice as sufficient documentation for purposes of local government review. Please feel free to email or call me with any questions. If you do not believe the proposed work fits under the self- executing exemption in paragraph (12)(a), then additional information will be required to be submitted for review of the proposed project so that a determination can be made for either an exemption or some other form of authorization. Sincerely, Valerie Valerie Jones, Permit Manager Coastal Construction Control Line Permitting Bureau of Beaches and Coastal Systems FL Dept. of Environmental Protection 3900 Commonwealth Blvd., MS 300 Tallahassee, FL 32399 -3000 Phone: 850/921 -7849 Fax: 850/488 -5257 vvww.floridadep.org/beaches/ Cover Florida, developed by Governor Charlie Crist and the Florida Legislature, gives Floridians access to more affordable health insurance options. To learn more or to sign up for email updates, visit www.CoverFloridaHealthCare.com. Att P 0 0 4t 6 71 74 i o o L4 a • N vA cci 0 $- iu -o *; u • O 01 VD w O 0 R VI 01 M 4 in 0 00 0 n o N 0 0 ••C r-, ,—, ,—, .-� W RI ta; ww w ww gel an O aU 0 CI • �° `� p , 4 CD Cll .., 0 v] v] H o o up up O • 0 m ct 0 0 �° *4 0 Z - I 0 a o ✓ o C x 0 �bo G. pQ o - O `, •,-. 0 C`-0 o 3 � Q acl H M 0 4 0 C7 - v N U o W al CZ3 rn °: t 0 0 Q. Q. 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New construction or existing New (From Plans) 9. Wall Types (3009.7 sqft.) Insulation Area a. Frame Wood, Exterior R =11.0 2809.00 ft 2. Single family or multiple family Single - family b. Frame - Wood, Adjacent R =11.0 200.76 ft 3. Number of units, if multiple family 1 c. N/A R= ft 4. Number of Bedrooms 4 d. N/A R= ft 5. Is this a worst case? No 10. Ceiling Types (2055.0 sqft.) Insulation Area 2972 a. Under Attic (Unvented) R =1.0 2055.00 ft 6. Conditioned floor area (ft2) b. N/A R= ft 7. Windows(592.3 sqft.) Description Area c. N/A R= ft a. U- Factor: Dbl, U =0.30 592.25 ft2 11. Ducts SHGC: NHGC =0.30 a. Sup: Interior Ret: Interior AH: Interior Sup. R= 6, 386.36 ft b. U- Factor: N/A ft SHGC: 12. Cooling systems (combined) c. U-Factor N/A ft a. Central Unit Cap: 48.0 kBtu /hr SHGC: SEER: 13 d. U- Factor: N/A ft 13. Heating systems (combined) SHGC: a. Electric Heat Pump Cap: 48.0 kBtu /hr e. U- Factor: N/A ft HSPF: 7.7 SHGC: 14. Hot water systems 8. Floor Types (2972.0 sqft.) Insulation Area a. Propane Cap: 3 gallons a. Crawlspace R =11.0 2972.00 ft EF: 0.75 b. N/A R= ft2 b. Conservation features c. N/A R= ft2 None 15. Credits None Total As -Built Modified Loads: 51.89 PASS Glass /Floor Area: 0.199 Total Baseline Loads: 73.01 ..K I hereby certify that the plans and specifications covered by Review of the plans and �. O Tr} S TA r this calculation are in compliance with the Florida Energy specifications covered by this ti rA 0 ,t, 4; Code. E,Q, calculation indicates compliance .° 'I , with the Florida Energy Code. t '`,.. PREPARED BY M it Ens S Before construction is completed I ..,,,. '� D to •151•10 this building will be inspected for : , „`, , .� compliance with Section 553.908 ' * �4 e 1 ' i , � I hereby certify that this building, as designed, is in compliance Florida Statutes. , lry , 4, with the Florida Energy C. • e. WNER /AGENT O BUILDING OFFI IAL in D.- DATE: « DATE: _ /i^ l6- l 6 4 S e LikAgNkUP 10/18/2010 10:21 PM EnergyGauge® USA - FlaRes2008 Page 1 of 6 PROJECT Title: Hastings Residence Bedrooms: 4 Adress Type: Street Address Building Type: FLAsBuilt Conditioned Area: 2972 Lot # Owner: Hastings Total Stories: 2 Block/SubDivision: # of Units: 1 Worst Case: No PlatBook: Builder Name: The Gellatly Company Rotate Angle: 0 Street: 1923 Beach Ave Permit Office: Atlantic Beach Cross Ventilation: County: Duval Jurisdiction: 261100 Whole House Fan: City, State, Zip: Atlantic Beach , Family Type: Single- family FL , New /Existing: New (From Plans) Comment: CLIMATE IECC Design Temp Int Design Temp Heating Design Daily Temp Design Location TMY Site Zone 97.5 % 2.5 % Winter Summer Degree Days Moisture Range FL, Jacksonville FL_JACKSONVILLE_INT 2 32 93 75 70 1281 49 Medium FLOORS V # Floor Type Exposed Perimeter Wall Ins. R -Value Area Floor Joist R -Value Tile Wood Carpet 1 Crawlspace 171.5 ft 0 2972 ft 11 0 0 1 ROOF V Roof Gable Roof Solar Deck # Type Materials Area Area Color Absor. Tested Insul. Pitch 1 Hip Composition shingles 2054 ft 0 ft Medium 0.96 No 19 18.4 deg ATTIC V # Type Ventilation Vent Ratio (1 in) Area RBS IRCC 1 Full attic Unvented 0 1949 ft N N CEILING V # Ceiling Type R -Value Area Framing Frac Truss Type 1 Under Attic (Unvented) 1 2055 ft 0.11 Wood WALLS Cavity Sheathing Framing Solar ` / # Ornt Adjacent To Wall Type R -Value Area R -Value Fraction Absor. 1 S Exterior Frame - Wood 11 849.2399 0.23 0.75 2 W Exterior Frame - Wood 11 481.3199 0.23 0.75 3 E Exterior Frame - Wood 11 657.7199 0.23 0.75 4 N Exterior Frame - Wood 11 820.6799 0.23 0.75 5 W Garage Frame - Wood 11 173.8800 0.23 0.01 6 N Garage Frame - Wood 11 26.87999 0.23 0.01 10/18/2010 10:21 PM EnergyGauge® USA - FlaRes2008 Page 2 of 6 DOORS # Ornt Door Type Storms U -Value Area 1 W Wood None 0.460000 10.5 ft 2 W Wood None 0.460000 10.5 ft 3 W Wood None 0.460000 10.5 ft 4 N Wood None 0.460000 10.5 ft 5 N Wood None 0.460000 10.5 ft 6 W Wood None 0.460000 21 ft 7 E Wood None 0.460000 8.75 ft 8 E Wood None 0.460000 8.75 ft 9 E Wood None 0.460000 8.75 ft 10 E Wood None 0.460000 8.75 ft 11 E Wood None 0.460000 8.75 ft 12 E Wood None 0.460000 8.75 ft 13 E Wood None 0.460000 8.75 ft WINDOWS Orientation shown is the entered, asBuilt orientation. / Overhang V # Ornt Frame Panes NFRC U- Factor SHGC Storms Area Depth Separation Int Shade Screening 1 W Metal Low -E Double Yes 0.3 0.3 N 12 ft 6 ft 0 in 2 ft 0 in HERS 2006 None 2 W Metal Low -E Double Yes 0.3 0.3 N 10.5 ft 6 ft 0 in 2 ft 0 in HERS 2006 None 3 W Metal Low -E Double Yes 0.3 0.3 N 12 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 4 S Metal Low -E Double Yes 0.3 0.3 N 6 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 5 S Metal Low -E Double Yes 0.3 0.3 N 15 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 6 E Metal Low -E Double Yes 0.3 0.3 N 30 ft 9.5 ft 0 in 2 ft 0 in HERS 2006 None 7 S Metal Low -E Double Yes 0.3 0.3 N 12 ft 12.5 ft 0 i 2 ft 0 in HERS 2006 None 8 S Metal Low -E Double Yes 0.3 0.3 N 21 ft 12.5 ft 0 i 2 ft 0 in HERS 2006 None 9 E Metal Low -E Double Yes 0.3 0.3 N 90 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 10 N Metal Low -E Double Yes 0.3 0.3 N 21 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 11 N Metal Low -E Double Yes 0.3 0.3 N 4 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 12 N Metal Low -E Double Yes 0.3 0.3 N 25 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 13 W Metal Low -E Double Yes 0.3 0.3 N 62.5 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 14 S Metal Low -E Double Yes 0.3 0.3 N 20 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 15 S Metal Low -E Double Yes 0.3 0.3 N 50 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 16 E Metal Low -E Double Yes 0.3 0.3 N 8.75 ft 6.5 ft 0 in 2 ft 0 in HERS 2006 None 17 S Metal Low -E Double Yes 0.3 0.3 N 10 ft 5 ft 0 in 2 ft 0 in HERS 2006 None 18 S Metal Low -E Double Yes 0.3 0.3 N 15 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 19 E Metal Low -E Double Yes 0.3 0.3 N 52.5 ft 10 ft 0 in 2 ft 0 in HERS 2006 None 20 N Metal Low -E Double Yes 0.3 0.3 N 50 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 21 N Metal Low -E Double Yes 0.3 0.3 N 20 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 22 N Metal Low -E Double Yes 0.3 0.3 N 45 ft 1.5 ft 0 in 2 ft 0 in HERS 2006 None 10/18/2010 10:21 PM EnergyGauge® USA - FlaRes2008 Page 3 of 6 INFILTRATION & VENTING - - -- Forced Ventilation - - -- Run Time Fan / V Method SLA CFM 50 ACH 50 ELA EqLA Supply CFM Exhaust CFM Fraction Watts Default 0.00036 2806 6.74 154.1 289.7 0 cfm 0 cfm 0 0 GARAGE # Floor Area Ceiling Area Exposed Wall Perimeter Avg. Wall Height Exposed Wall Insulation 1 450 ft 0 ft 68.7 ft 8.4 ft 0 COOLING SYSTEM _V # System Type Subtype Efficiency _ Capacity Air Flow SHR Ducts 1 Central Unit None SEER: 13 24 kBtu /hr 720 cfm 0.75 sys #1 2 Central Unit None SEER: 13 24 kBtu /hr 720 cfm 0.75 sys #0 HEATING SYSTEM V # System Type Subtype Efficiency Capacity Ducts 1 Electric Heat Pump None HSPF: 7.7 24 kBtu /hr sys #1 2 Electric Heat Pump None HSPF: 7.7 24 kBtu /hr sys #0 HOT WATER SYSTEM V # System Type EF Cap Use SetPnt Conservation 1 Propane 0.75 3 gal 70 gal 120 deg None SOLAR HOT WATER SYSTEM V FSEC Collector Storage Cert # Company Name System Model # Collector Model # Area Volume FEF None None ft2 DUCTS V - - -- Supply - -- Return - Air Percent # Location R -Value Area Location Area Leakage Type Handler CFM 25 Leakage QN RLF 1 Interior 6 386.36 f Interior 148.6 ft Default Leakage Interior (Default) c (Default) % 10/18/2010 10:21 PM EnergyGauge® USA - FlaRes2008 Page 4 of 6 TEMPERATURES Programable Thermostat: None Ceiling Fans: Cooling Jan X] Feb X] Mar [X] Apr X] May X] Jun [[X] Jul X] Au X] Se X Oct X] Nov [X Dec Heating L X X] ] Jan L X] Feb L X] Mar [ Apr l X] May [Xi Jun [ X] Jul t X] Aug L X] Sep X Oct l X ] Nov [ X Dec Venting [X] Jan [X] Feb X Mar [X] Apr [X] Ma [X] Jun [[X] Jul [X] Aug [X] Sep :X Oct [X] Nov [X Dec Thermostat Schedule: HERS 2006 Reference Hours Schedule Type 1 2 3 4 5 6 7 8 9 10 11 12 Cooling (WD) AM 78 78 78 78 78 78 78 78 78 78 78 78 PM 78 78 78 78 78 78 78 78 78 78 78 78 Cooling (WEH) PM 78 78 78 78 78 78 78 78 78 78 78 78 Heating (WD) AM 68 68 68 68 68 68 68 68 68 68 68 68 PM 68 68 68 68 68 68 68 68 68 68 68 68 Heating (WEH) PM 68 68 68 68 68 68 68 68 68 68 68 68 10/18/2010 10:21 PM EnergyGauge® USA - FlaRes2008 Page 5 of 6 FORM 1100A -08 Code Compliance Checklist Residential Whole Building Performance Method A - Details ADDRESS: 1923 Beach Ave PERMIT #: Atlantic Beach, FL, INFILTRATION REDUCTION COMPLIANCE CHECKLIST COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHECK Exterior Windows & Doors N1106.AB.1.1 Maximum: .3 cfm /sq.ft. window area; .5 cfm /sq.ft. door area. Exterior & Adjacent Walls N1106.AB.1.2 Caulk, gasket, weatherstrip or seal between: windows /doors & frames, surrounding wall; foundation & wall sole or sill plate; joints between exterior wall panels at corners; utility penetrations; between wall panels & top /bottom plates; between walls and floor. EXCEPTION: Frame walls where a continuous infiltration barrier is V installed that extends from, and is sealed to, the foundation to the top plate. Floors N1106.AB.1.2 Penetrations /openings > 1/8" sealed unless backed by truss or joint members. / EXCEPTION: Frame floors where a continuous infiltration barrier ✓ _ is installed that is sealed to the perimeter, penetrations and seams. Ceilings N1106.AB.1.2 Between walls & ceilings; penetrations of ceiling plane to top floor; around shafts, chases, soffits, chimneys, cabinets sealed to continuous air barrier; gaps in gyp board & top plate; attic access. EXCEPTION: Frame ceilings where a continuous infiltration barrier is installed that is sealed at the perimeter, at penetrations and seams. Recessed Lighting Fixtures N1106.AB.1.2 Type IC rated with no penetrations, sealed; or Type IC or non -IC rated, installed inside a sealed box with 1/2" clearance & 3" from insulation; or Type IC with < 2.0 cfm from conditioned space, tested. Multi -story Houses _N1106.AB.1.2 Air barrier on perimeter of floor cavity between floors. 1 Additional Infiltration reqts N1106.AB.1.3 Exhaust fans vented to outdoors, dampers; combustion space heaters comply with NFPA, have combustion air. OTHER PRESCRIPTIVE MEASURES (must be met or exceeded by all residences.) COMPONENTS SECTION REQUIREMENTS CHECK Water Heaters N1112.AB.3 Comply with efficiency requirements in Table N1112.ABC.3 Switch or clearly marked circuit breaker (electric) or cutoff (gas) must be provided. External or built -in heat trap required. Swimming Pools & Spas N1112.AB.2.3 Spas & heated pools must have covers (except solar heated). Non- commercial pools must have a pump timer. Gas spa & pool heaters must have a minimum thermal efficiency of 78 %. Heat pump pool heaters shall have a minimum COP of 4.0. Shower heads N1112.AB.2.4 Water flow must be restricted to no more than 2.5 gallons per minute at 80 PSIG. Air Distribution Systems N1110.AB All ducts, fittings, mechanical equipment and plenum chambers shall be mechanically attached, sealed, insulated and installed in accordance with the criteria of Section N1110.AB. Ducts in unconditioned attics: R -6 min. insulation. HVAC Controls N1107.AB.2 Separate readily accessible manual or automatic thermostat for / each system. ✓ Insulation N1104.AB.1 Ceilings -Min. R -19. Common walls -frame R -11 or CBS R -3 both ✓ N1102.B.1.1 sides. Common ceiling & floors R -11. 10/18/2010 10:21 PM EnergyGauge® USA - FlaRes2008 Page 6 of 6 ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE INDEX* = 71 The lower the EnergyPerformance Index, the more efficient the home. 1923 Beach Ave, Atlantic Beach, FL, New (From Plans 1. New construction or existing Plans) 9. Wall Types Insulation Area a. Frame Wood, Exterior R =11.0 2809.00 ft 2. Single family or multiple family Single- family b. Frame - Wood, Adjacent R =11.0 200.76 ft 3. Number of units, if multiple family 1 c. N/A R= ft 4. Number of Bedrooms 4 d. N/A R= ft 5. Is this a worst case? No 10. Ceiling Types Insulation Area 2972 a. Under Attic (Unvented) R =1.0 2055.00 ft 6. Conditioned floor area (ft2) b. N/A R= ft 7. Windows" Description Area c N/A R= ft a. U- Factor: Dbl, U =0.30 592.25 ft2 11. Ducts SHGC: SHGC =0.30 a. Sup: Interior Ret: Interior AH: Interior Sup. R= 6, 386.36 ft b. U- Factor: N/A ft SHGC: 12. Cooling systems (combined) c. U- Factor: N/A ft a. Central Unit Cap: 48.0 kBtu /hr SHGC: SEER: 13 d. U- Factor: N/A ft 13. Heating systems (combined) SHGC: a. Electric Heat Pump Cap: 48.0 kBtu /hr e. U- Factor: N/A ft HSPF: 7.7 SHGC: 14. Hot water systems 8. Floor Types Insulation Area a. Propane Cap: 3 gallons a. Crawlspace R =11.0 2972.00 ft EF: 0.75 b. N/A R= ft2 b. Conservation features c. N/A R= ft2 None 15. Credits None I certify that this home has complied with the Florida Energy Efficiency Code for Building 1E sr ,� Construction through the above energy saving features which will be installed (or exceeded) 4,,0 in this home before final inspection. Otherwise, a new EPL Display Card will be completed , `,, e 4 based on installed Code compliant features. R ' ' •" '`� l o : Builder Signature: Date: 0 Address of New Home: City /FL Zip: r 4 , �`' ,� 0a ' WE 11` *Note: The home's estimated Energy Performance Index is only available through the EnergyGauge USA - FlaRes2008 computer program. This is not a Building Energy Rating. If your Index is below 100, your home may qualify for incentives if you obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at (321) 638 -1492 or see the Energy Gauge web site at energygauge.com for information and a list of certified Raters. For information about Florida's Energy Efficiency Code for Building Construction, contact the * *Label required by Section 13- 104.4.5 of the Florida Building Code, Building, or Section B2.1.1 of Appendix G of the Florida Building Code, Residential, if not DEFAULT. EnergyGauge® USA - FlaRes2008 Pro ect Summa Job: -+- wrightsoft � � Date: 10/17/10 First Floor By: M. Ellis Energy Design Systems, Inc. Pro'ect Information For: Hastings Residence 1923 Beach Ave, Atlantic Beach, FL Notes: Front door faces West. Desi • n Information Weather: Jacksonville, Intl Airport, FL, US Winter Design Conditions Summer Design Conditions Outside db 32 °F Outside db 94 °F Inside db 74 °F Inside db 74 °F Design TD 42 °F Design TD 20 °F Daily range M Relative humidity 50 % Moisture difference 51 gr /Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 16672 Btuh Structure 21254 Btuh Ducts 0 Btuh Ducts 0 Btuh Central vent (87 cfm) 0 Btuh Central vent (87 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 16672 Btuh Use manufacturer's data n Rate /swing multiplier 0.99 Infiltration Equipment sensible load 21042 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 2483 Btuh Ducts 0 Btuh Heating Cooling Central vent (87 cfm) 0 Btuh Area (ft 1499 1499 Equipment latent load 2483 Btuh Volume (ft 12682 12682 Air changes /hour 0.30 0.15 Equipment total load 23525 Btuh Equiv. AVF (cfm) 63 32 Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a Coil n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 °F Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0.000 cfm /Btuh Air flow factor 0.000 cfm /Btuh Static pressure 0.00 in H2O Static pressure 0.00 in H2O Space thermostat n/a Load sensible heat ratio 0.00 Bold/italic values have been manually overridden Printout certified by ACCA to meet all requirements of Manual J 8th Ed. -- wrightsoft Right -Suite Residential 6.0.119 RSR29784 2010 - Oct -18 20:33:44 ACC, E: \EDS \Current \Residential Manual J \Hastings Residence, 1923 Beach Ave, Atlantic Bch.rrp Calc = M Page 2 Project Summary Job: 4 wrightsoft � � Date: 10/17/10 Second Floor By: M. Ellis Energy Design Systems, Inc. Pro'ect Information For: Hastings Residence 1923 Beach Ave, Atlantic Beach, FL Notes: Front door faces West. Desi • n Information Weather: Jacksonville, Intl Airport, FL, US Winter Design Conditions Summer Design Conditions Outside db 32 °F Outside db 94 °F Inside db 74 °F Inside db 74 °F Design TD 42 °F Design TD 20 °F Daily range M Relative humidity 50 % Moisture difference 51 gr /Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 17746 Btuh Structure 20898 Btuh Ducts 0 Btuh Ducts 0 Btuh Central vent (86 cfm) 0 Btuh Central vent (86 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 17746 Btuh Use manufacturer's data n Rate /swing multiplier 0.99 Infiltration Equipment sensible load 20689 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 2209 Btuh Ducts 0 Btuh Heating Cooling Central vent (86 cfm) 0 Btuh Area (ft') 1473 1473 Equipment latent load 2209 Btuh Volume (ft') 12371 12371 Air changes /hour 0.34 0.17 Equipment total load 22897 Btuh Equiv. AVF (cfm) 70 35 Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a Coil n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 °F Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0.000 cfm /Btuh Air flow factor 0.000 cfm /Btuh Static pressure 0.00 in H2O Static pressure 0.00 in H2O Space thermostat n/a Load sensible heat ratio 0.00 Bold/italic values have been manually overridden Printout certified by ACCA to meet all requirements of Manual J 8th Ed. w- 4.14- vvrightsaft Right -Suite Residential 6.0.119 RSR29784 2010 - Oct -18 20:33:44 AC E: \EDS \Current \Residential Manual J \Hastings Residence, 1923 Beach Ave, Atlantic Bch.rrp Calc = M Page 1 FORM 1100A -08 D FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Performance Method A Project Name: Hastings Residence Builder Name: The Gellatly Company Street: 1923 Beach Ave Permit Office: Atlantic Beach City, State, Zip: Atlantic Beach , FL , Permit Number: Owner Hastings Jurisdiction: 261100 Design Location: FL, Jacksonville 1. New construction or existing New (From Plans) 9. Wall Types (3009.7 sqft.) Insulation Area 2. Single family or multiple family Single- family a. Frame - Wood, Exterior R =11.0 2809.00 ft b. Frame - Wood, Adjacent R =11.0 200.76 ft 3. Number of units, if multiple family 1 c. N/A R= ft 4. Number of Bedrooms 4 d. N/A R= ft2 5. Is this a worst case? No 10. Ceiling Types (2055.0 sqft.) Insulation Area 6. Conditioned floor area (ft 2972 a. Under Attic (Unvented) R =1.0 2055.00 ft b. N/A R= ft 7. Windows(592.3 sqft.) Description Area c. N/A R= ft2 a. U- Factor: Dbl, U =0.30 592.25 ft SHGC: SHGC =0.30 11. Ducts b. U- Factor: N/A ft2 a. Sup: Interior Ret: Interior AH: Interior Sup. R= 6, 386.36 ft SHGC: 12. Cooling systems (combined) c U- Factor: N/A ft a. Central Unit Cap: 48.0 kBtu /hr SHGC: SEER: 13 d. U- Factor: N/A ft 13. Heating systems (combined) SHGC: a. Electric Heat Pump Cap: 48.0 kBtu /hr e. U- Factor: N/A ft HSPF: 7.7 SHGC: 14. Hot water systems 8. Floor Types (2972.0 sqft.) Insulation Area a. Propane Cap: 3 gallons a. Crawlspace R= 11.0 2972.00 ft EF: 0.75 b. N/A R= ft2 b. Conservation features c. N/A R= ft2 None 15. Credits None Total As -Built Modified Loads: 51.89 PASS Glass /Floor Area: 0.199 Total Baseline Loads: 73.01 I hereby certify that the plans and specifications covered by Review of the plans and *".�-11- 115TA . , this calculation are in compliance with the Florida Energy specifications covered by this , "w "° 'o f: ,:a 3 ' Code. calculation indicates compliancer`�f,, I , y, ° _ with the Florida Energy Code. i fw ~.� +� PREPARED BY __ cal ►t - fl l S -- -___ Before construction is completed I�,,,, DATE: _ !10.1$' 10 ____ this building will be inspected for r c.7 i , t:... compliance with Section 553.908 t ' 't 0 I hereby certify that this building, as designed, is in compliance Florida Statutes. '- .�, ' .,4 4, with the Florida En g C \ ,� , 1 7. OWNER/AGENT BUILDING OFFICIAL: 7 1 2 )-- DATE: - --- VS ____. DATE: //" /6 /C' S,��_ - - -- - - - -- 10/18/2010 10:21 PM EnergyGauge® USA - FlaRes2008 Page 1 of 6 r� ay City of Atlantic Beach r APPLICATION NUMBER 'S r 1 Building Department (To be assigned by the Building Dep rtment.) � ' u • 800 Seminole Road /d 7 "_�� F� Atlantic Beach, Florida 32233 -5445 Phone (904) 247 -5826 • Fax (904) 247 -5845 /� � "1":1.0 c E -mail: buildin de t coab.us Date routed: City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM e Address: % 3 I A 6 h i-y.... rtment review required yr No Property �•. �// ' �_lanning & Zoning Applicant: � 4 Q // r/ 7 ® - - �� a or r ublic Works Project: 4 ►_ . is Utilities ublic afety Fire Services Ad "� 7�t !''"'� �4 � ,,. ry �r �, � f' i `�',mh k,��� �'�ry` 3 � %° r ' E , r t� 5� i-CS "t * t Dept, " y. 1 N ;' a Est m k Review or Receipt Date Other Agency Review or Permit Required of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: (3l.11LDI NG PLANNING &ZONING Reviewed by: Date:// 7 /0 TREE ADMIN. Second Review: Approved as revised. DDeiVed. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 NOV -17 -2010 12:45 FROM: CLERK OF COURTS 904 270 1512 TO:92475845 P:1 /1 Doc 7 Alt utbO V R 6K.15490 gape 2299, Number Pages 1 Recorded t t: t7/2010 at 1 1 :49 AM. JIM FULLER CLERK. CIRCUIT COURT DUVAL COUNTY NOTICE OF COMMENCEMENT, R.,ECOP,DING 510.00 Permit No. f0 — ! 07 0 Tax Folio No. _ THE 1JND.I:RSTGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is pmvided in this NOTICE OF COMMENCEMENT. !Description of property (legal description): A portion of Florida Government Lot 4, Section 17, Township 2 South, Range 29 East, Jacksonville, Dual a) Street (Job) Address: 482 Stewart Avenue, Atlantic Beach, FL 32233 2.fieneral description of improvements: Construct approximately 41.4 s.f. of bathroom and storage area inside the existing warehouse. 3,Owncr information a) Name and address: BBT investors LLC (Tim Shea), 2251 St. Johns Bluff Rd. S., Jacksonville, FL 32246 b) Name and address of fee simple titleholder (if other than owner) _ c) Interest in property _ 4.Contractor lnlinmation a) Name and address: The Gellatly Company (William R. Gellatl.y), 1515 Penman Rd., Suite B, Jacksonville Beach, FL 32250 h) Tcicphone No.: 904-246-9080 Fax No. (Opt) 904 246.9200 5, rcty Information a) Name and address: N/A b) Amount of Bond: e) Telephone No.: _ Fax No. (Opt,) 6.Lerdcr a) Name and address: N/A Phcmc No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other doctunents may be served: a) Name and address: None Fax No. (Opt.) b) Telephone No.: 8.1n addition to himself, owner designates the following person to receive a copy of the Lienor's'Notice as provided in Section 713.13(1)(b), Florida Statutes: a) Name and address: None b) Telephone No.: _ Fax No. (Opt) .. ... 9.F,xpiration date of Notice of Commencement (the expiration date is one year from the date of recording unless a different date is Specified): WARNING TO OWNER: ANY PAYMENTS MADE 13Y Tli OWNER AFTER THE EXPIRATION OF THE NOTICE OF SECTION 713.13, COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART i, S FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR lMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF IF YOU INTEND TOO TAN CONSULT FINANCING, CONSU YO ON R LENDER NE OR AN ATTORNEY [i�l IF YO Y BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE 0.F COMMENCEMENT. STAit QR V nA 0 COUNT' O F it'tt 4 � 4 10. = ' j s. Signeture or Owner or Owners Authorized OfficcrlDirecKxlPertncr /M Pri m:Nnmc The foregoing instrument was acknowledged before me this ,?5 day of _A (1sU sr 2010 by -fpisiatil S,r,'e 4 as /B A N�4G,w' M m N ... _.... (type of authority, e.g. officer, trustee, attorney in fact) for (name of pares on behalf of w m instrn . t t.ewecule d). Personally Known l/ OK Produced Identification Notary Signature Type of Identification Produced . Name (print) 19471 e7 3 OR Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, 1 dec • , = ,rr the fats stated in it are he best of my knowledge and belief. i�'; i "'fs'r � , MY 60MM 1 610 r Co 81Yree> EXPIRES: Ws: r04MN /l4UC.r.d2oln .. - p,Un"� — � . Si¢naturc o1' NamMl. Person tiigning (in line t1J.) Above af. Ba wcatruNO � �� �- Graham Shirley From: Carper, Rick Sent: Monday, November 22, 2010 8:45 AM To: Graham Shirley Subject: RE: Permit App. for 1923 Beach Ave. $25 From: Graham Shirley Sent: Monday, November 22, 2010 8:44 AM To: Carper, Rick Subject: FW: Permit App. for 1923 Beach Ave. Rick what is your charge for this permit ?? From: White, Debbie Sent: Monday, November 22, 2010 8:41 AM To: Graham Shirley Subject: FW: Permit App. for 1923 Beach Ave. Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX From: Carper, Rick Sent: Monday, November 22, 2010 8:41 AM To: William Gellatly Cc: 'Melanie Hastings'; Showman, Lisa; White, Debbie Subject: RE: Permit App. for 1923 Beach Ave. Bill, I have approved this application with comments on Rolloff requirement and FDEP permit for deckwork to be documented on the remodeling permit. Rick From: William Gellatly f mailto :aellatlyco(abellsouth.netl Sent: Monday, November 22, 2010 8:29 AM To: Carper, Rick Cc: 'Melanie Hastings' Subject: RE: Permit App. for 1923 Beach Ave. Thanks Rick. We will proceed with the remodeling and look to permit the decks seperatly.Do I need to do anything to close the loop so we can pick up a permit? We would like pick it up before the holiday. Please advise. Bill From: Carper, Rick fmailto:rcarperCa>coab.usl Sent: Monday, November 22, 2010 7:53 AM To: aellativcoabellsouth.net Cc: thegellatlyco @bellsouth.net; Griffin, Michael; White, Debbie; Showman, Lisa Subject: FW: Permit App. for 1923 Beach Ave. Bill, Amasons is not an authorized rolloff provider in AB. They are well aware of our requirements, but have chosen not to get a franchise permit to operate in this city. Authorized providers are: Advanced Disposal, Realco and Shappelles. The decks, as proposed, do not meet the exemption requirements of 62B- 33.004 (attached) and will require a permit from FDEP (contact Trey Hatch - 655 - 1765). Because you indicate design may change, it would probably be best to separate the decks and just do this permit as remodeling as you stated. Rick Ricky L. Carper, P.E. Public Works Director /City Engineer City of Atlantic Beach 1200 Sandpiper Lane Atlantic Beach, FL 32233 rcarper(a,coab.us PH: (904) 247 -5834 Fax: (904) 247 -5843 From: Showman, Lisa Sent: Monday, November 22, 2010 7:45 AM To: Carper, Rick Subject: FW: Permit App. for 1923 Beach Ave. From: William Gellatly [ mailto :gellatlyco@bellsouth.netl Sent: Monday, November 22, 2010 5:52 AM To: Showman, Lisa Cc: 'Melanie Hastings'; rearper @ coab.us Subject: RE: Permit App. for 1923 Beach Ave. Thanks Lisa. We normally use Amasons for our dumpsters. Are they approved by the city? Fortunately we have a spot out of the way and not on the ROW that we can spot our dumpster so location won't be a problem. Also, my clients are considering reworking the proposed deck area as part of their overall landscaping /hardscaping plan .That plan won't be started until the first of the year and we are ready to start the remodeling now. The deck permits are "deck specific" and we would like to apply for a permit after all of this is finalized so we don't have to modify our DEP permit if the deck areas do change. Will the remodeling permit be issued with a "hold" on the deck until this part of our overall plan can be worked out? If this is a problem we would propose removing the decks from remodeling permit and submitting separately for the decks. Please advise. From: Showman, Lisa f mailto:Ishowmancacoab.usl Sent: Friday, November 19, 2010 3:52 PM To: aellatlyco @bellsouth.net; the Cc: White, Debbie; Graham Shirley Subject: Permit App. for 1923 Beach Ave. Permit application 10 -1378 for 1928 the addition at Beach Avenue was denied by Public Works with the following comment: "FDEP Permit required for new construction deck work seaward of CCCL. Provide copy of Permit." 2 Also, FYI — Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Any questions or comments may be addressed to Rick Carper, Public Works Director, at rcarperPcoab.us. Thank you, Lisa Showman Administrative Assistant No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.449 / Virus Database: 271.1.1/3262 - Release Date: 11/18/10 07:37:00 No virus found in this incoming message. Checked by AVG - www.avg.com Version: 8.5.449 / Virus Database: 271.1.1/3269 - Release Date: 11/21/10 19:35:00 3 City of Atlantic Beach APPLICATION NUMBER c2i= ,r Building Department (To be assigned by the Building Dep rtment.) 5 5 Atlantic Beach, Florida 32233 -5445 //d r Phone (904) 247 -5826 •Fax (904) 247 -5845 Email: building-dept@coab.us Date routed: m m. City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: / % c 3 L a 6 !/ / ►' e=' Department review required Yes No p 2 �.uil ink_ / Tanning & Zoning') f Applicant: / � Q //r/7 d/�1 � ` ublic Works Project: is Utilities) Public Sa ety Fire Services r :D B : e f $ ' 5 , ` . 9 : ) DePf 7 G!9- W °_. 7 Review or Receipt Other Agency Review or Permit Required Permit Verified By Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: BUILDING // / . ANNING & ZONING Reviewed by: / %ate: c (6hO1Q TREE ADMIN. Second Review: Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 LAN- City of Atlantic Beach a" S riff, Building Department R CI.41,TV ` D APPLICATION NUMBER . 5'1 9 p (To be assigned by the Building Deg tment.) tl ' � 800 Seminole Road IVUV 1 2010 /� / - i,' ),,, :i; , Atlantic Beach, Florida 32233 -5445 / / v Phone (904) 247 -5826 • Fax (904) 2478$5 !, " E -mail: building- dept @coab.us Date routed: 1 •%� City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: / 9, 5 leA6/1 A De ent review required Yes No 2 // � i y 6/y1i-71y / Applicant: tanninon ree a fo g &Z in Project: �/ 94 ublic Works ,�PUI5ii Utilities — Public Safety Fire Services Ree..eeV "., fi.. r, �� Yijje.�.� xsl afar A� = & .! , Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By - Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING l� l �= Reviewed by: Date: l JO TREE ADMIN. Second Review: [1]Approved as revised. ❑Denied. P WOR4 S Comments: / o --- PUBLI SA ETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 l.f.v. or . City of Atlantic Beach R ECEIVED APPLICATION NUMBER '� ; f 1 Building Department IVU d 1 7 2010 (To be assigned by the Building Dep rtment.) J it , in:. � ; { f 800 Seminole Road /� -- � , / (((// s., Atlantic Beach, Florida 32233 -544' Phone (904) 247 -5826 • Fax (904 • s • - — , w r E -mail: building- dept @coab.us Date routed: City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property % t Address: / 3 it tie ,4 / lye Department review required Yes No i ,E Q //1/ y Applicant: & / y — Tree uais rafor 3 Project: i ublic Works _, is utilities public afety Fire Services of ®amp., -` .. plii0i naf C z . Review or Receipt Date Other Agency Review or Permit Required of Permit Verified By - Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ['Approved. [Denied. (Circle one.) Comments: BUILDING 11/4.12_ v PLANNING &ZONING Reviewed by: Date: /0 7/1 TREE ADMIN. Second Review: MApproved as revised. ['Denied. PUBLIC WORKS Comments: 410// - G-,w 1,,N1 1► /44 PUBLIC UTILITIES �� `fie. - G ' 0 �� ` O•f1C- S2s�• Of—CS-CI. V �a� Date: // 1LJ/ 6 PUBLIC SAFETY fi'�'`k w) Reviewe by: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 05/14/09 AI ' RS CITY OF ATLANTIC BEACH =�} 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 ti INSPECTION PHONE LINE 247 -5826 Application Number 10- 00001378 Date 1 Property Address 1923 BEACH AVE /24/11 Application type description RESIDENTIAL ADDITION Property Zoning TO BE UPDATED Application valuation . . . 425000 Application desc addition Owner Contractor HASTING TRUST THE GELLATLY COMPANY 41280 RUE JADOTUE P 0 BOX 51393 TEMECULA CA 92591 PENMAN RD JAX BEACH FL 32240 (904) 993 -5014 Structure Information 000 000 Construction Type TYPE 5 -A Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit PLUMBING PERMIT Additional desc . Permit Fee . . . 209.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date . . 7/23/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Deck work to be done under separate building permit with FDEP authorization for work seaward of CCCL required. Other Fees STATE PLBG DCA SURCHARGE 3.14 STATE PLBG DBPR SURCHARGE 3.14 PERMIT I FPRI�W LY IN ACCORDAlcC 1V{ P�LL CITY OF A`I'> AIC BEACH `trd PVr AND THE FiN@DA BUILDING CODES. frL'17' r.„,s4 A, :,,, CITY OF ATLANTIC BEACH r) 800 SEMINOLE ROAD 0 ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Application Number 10- 00001378 Date 1/24/11 Permit Fee Total 209.00 209.00 Plan Check Total . .00 .00 .00 .00 .00 Other Fee Total 6.28 6.28 .00 Grand Total 215.28 215.28 .00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: ‘ 'S V &rAc vim, V PERMIT # t 0 — i 3 - h? NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub 3 Septic Tank & Pit Clothes Washer / Shower Dishwasher I Shower Pan illho Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs �, Urinal Kitchen Sink 1 Vacuum Breakers Laundry Tray 1' Water Connected Appliances Lavatory l- Water Heater Z / Other Fixtures Water Treating System f RE -PIPE: 'f/ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: newer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑ Lawn Sprinkler System - Number of Heads ❑ Well ** ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. ** ❑ Other Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name t'(\ 2 d- N ? S OS N , --e. Phone Number , Plumbing Company t o tk11 S' G'o r Q.- � r v - v ., i , r Office Phone 76 y - So 66 6 Fax '7 6 4/ - SO 7 G Co. Address: City State Zip License Holder (Print): M o r+ 1.. S ke r PI x,,,,,.,10 e c.o.) State Certification/Registration # C / t 2. ee �}3 Notarized Signature of License Holder .. 1...- • 0 NN Sworn and subscribed b SoM o 4 EQ - ti;. o 20 , FXPIRE F:. • ;. y l t 4 " Signature of Notary Pus xr r `' ` A ' '' rites — # CITY OF ATLANTIC BEACH , 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 ts) INSPECTION PHONE LINE 247 -5826 Application Number 10- 00001378 Date 2/22/11 Property Address 1923 BEACH AVE Application type description RESIDENTIAL ADDITION Property Zoning TO BE UPDATED Application valuation . . . 425000 Application desc addition Owner Contractor HASTING TRUST THE GELLATLY COMPANY 41280 RUE JADOTUE P 0 BOX 51393 TEMECULA CA 92591 PENMAN RD JAX BEACH FL 32240 (904) 993 -5014 Structure Information 000 000 Construction Type TYPE 5 -A Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit MECHANICAL HVAC PERMIT Additional desc . INSTALL 2 NEW 2.5 TON SYSTEMS Permit Fee . . . 183.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 8/21/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Deck work to be done under separate building permit with FDEP authorization for work seaward of CCCL required. Other Fees STATE DCA SURCHARGE 21.83 DEV REVIEW - SINGLE & 2 -FAM 50.00 ENG REV BLDG MOD OR ROW 25.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITYWIATEAlaUtELATMADRSITSROMRSE THE FLORID. 18 BUILDING CODES. 0 4!"#,, I CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD '- ') ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Page 2 Application Number 10- 00001378 Date 2/22/11 Other Fees STATE MECH DCA SURCHARGE 2.75 STATE PLBG DCA SURCHARGE 3.14 STATE ELEC DBPR SURCHARGE 2.18 STATE MECH DBPR SURCHARGE 2.75 STATE PLBG DBPR SURCHARGE 3.14 STATE DBPR SURCHARGE 21.83 UTIL REV MODIF OR ROW 25.00 Fee summary Charged Paid Credited Due Permit Fee Total 183.00 183.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 159.80 159.80 .00 .00 Grand Total 342.80 342.80 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: /1,7 3 j 4/- ,91/ffiil PERMIT # 0- / ? PROJECT VALUE $ 4 ,914,evo NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity Tons Per Unit Heat: Unit Quantity BTU's Per Unit Seer Rating REQUIRED Duct Systems: Total CFM REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION # L TION v Air Conditioning: Unit Quantity 2 Tons Per Unit 2.4" REQUIRED Heat: Unit Quantity keetwaatait BTU's Per Unit zo 000 Seer Rating 1 S Duct Systems: Total CFM j. g- -, REQUIRED FIRE PREVENTION Fire Sprinkler System Quantity (Requires 3 sets of plans) Fire Standpipe Quantity (Requires 3 sets of plans) Underground Fire Main Value (Requires 3 sets of plans) Fire Hose Cabinets Quantity (Requires 3 sets of plans) Commercial Hoods Quantity (Requires 3 sets of plans) Fire Suppression Systems Quantity (Requires 3 sets of plans) FIRE PLACES MISCELLANEOUS: Prefabricated Fireplace Qty Automobile Lifts Gas Piping Outlets Boilers BTU's Elevators/Escalators ALL OTHER GAS PIPING Heat Exchanger Quantity of Outlets Pumps # Vented Wall Furnaces Refrigerator Condenser BTU's # Water Heaters Solar Collection Systems Tanks (gallons) Wells OTHER: Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name /�flsr_rP6, < A--77.61ri&E Phone Number Mechanical Company 17v2,¢aNst'nr Ar/W 4p.,,1 - Ct- Y.ze4-z —Office Phone215 -c Fax i -GVn q Co. Address: S1) /D CyAne - PL,42A ,6..Q2,��F City i - State ft- Zip Pa .� License Holder (Print): \\ ,; . \�. ›.., N y • / Sta Certification/Registration # ' Os7scal Notarized Signature of License Holder / + 4 Sworn and subscribed befo a this `1 day of \--,;o),- ---N 20\\ EGA NAVARR P�-•,, KAY VfJ Signature of Not ary Publiz~ } ~ > _ ��� Commission # DD gn "` "= 2014 972187 "�\ '* ;�;- I, Expires July 17, , , , m • " 1 �9", R6 , , " Thr, T Fanmwrance V�/ This combination qualifies for a Federal Energy Efficiency Tax Credit when placed in service ru ...� CERTIFIED TM between Feb 17, 2009 and Dec 31, 2011. www.ahridirectory.orq Certificate of Product Ratings AHRI Certified Reference Number: 3516778 Date: 2/22/2011 Product: Split System: Heat Pump with Remote Outdoor Unit - Air- Source Outdoor Unit Model Number: 4TWR5030E1 Indoor Unit Model Number: 4TEE3F40B1 Manufacturer: TRANE Trade /Brand name: XR15 WEATHERTRON Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240 -2006 for Unitary Air - Conditioning and Air- Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh): 31000 EER Rating (Cooling): 13.00 SEER Rating (Cooling): 16.00 Heating Capacity(Btuh) @ 47 F: 29200 Region IV HSPF Rating (Heating): 9.00 Heating Capacity(Btuh) © 17 F: 15200 • Ratings followed by an asterisk (') indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or t e9 unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ahridirectory.org, �� Air- Conditioning, Heating, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on A. a -' and Refrigeration Institute which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2010 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129428783388838162 • � CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD t"' • ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Application Number 10- 00001378 Date 3/07/11 Property Address 1923 BEACH AVE Application type description RESIDENTIAL ADDITION Property Zoning TO BE UPDATED Application valuation . . . 425000 Application desc addition Owner Contractor HASTING TRUST THE GELLATLY COMPANY 41280 RUE JADOTUE P 0 BOX 51393 TEMECULA CA 92591 PENMAN RD JAX BEACH FL 32240 (904) 993 -5014 Structure Information 000 000 Construction Type TYPE 5 -A Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit ELECTRICAL PERMIT Additional desc . LOW VOLTAGE SYSTEMS Permit Fee . . . 90.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 9/03/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Deck work to be done under separate building permit with FDEP authorization for work seaward of CCCL required. Other Fees STATE ELEC DCA SURCHARGE 4.18 ��++��.,,�� STATE ELEC DBPR SURCHARGE 4.18 PERMIT'P �PTl �ai�NLY IN ACCORD�YI'60E1� ALL CITY OF4 44ITIC BEACIgbfifililillgtiS AND THE litifitIDA BUILDING CODES. I `z CITY OF ATLANTIC BEACH '' %' 800 SEMINOLE ROAD J to . * ° ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Page 2 Application Number 10- 00001378 Date 3/07/11 Permit Fee Total 90.00 90.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 8.36 8.36 .00 .00 Grand Total 98.36 98.36 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION 4 �� 06 CITY OF ATLANTIC BEACH ('Z 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: ; `= i , Q &C a ✓ e i R it L 1 ' L.- PERMIT # r) / 2 Q JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE V A L U E OF WORK$ L 7044 NEW SERVICE ❑ Overhead ❑ Underground UT Underground up Pole ❑Residential (Main) Service 00 -100 amps ❑ 101- 150ainps ❑ 151- 200amps ❑ amps # of Meters ❑ Commercial (Main) Service ❑0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT Service amps Conductor Type Size ❑ Multi- Family (Main) Service ❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.) ❑ 100 amps ❑ 150amps ❑ 200amps ❑ amps ❑CT Service amps ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC. Outlets /Switches: 0- 30amps 31- 100amps 101- 200amps Appliances: 0- 30amps 31- 100amps 101- 200amps A/C Circuits: 0- 60amps 61- 100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS ❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑ Transformers KVA ❑ Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts /amps VALUE OF WORK $ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can II Safety Inspection ❑Panel Change DOH to UG Other: 1-4,14/ l/® hk Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name K 1 C 1 a iA d tc S 4 l� t{ 9 Phone Number Electrical Company G 5 ,j .L' u►^1 if 5 S -it m 4 1(, Office Phone 7d -71.f L Z i i / OFax €11N-72C-4G17 Co. Address: LI 6 3 �rt S CA K 6 tc City 3C(( State Zip 322, 2 -$ License Holder (Print): 1-( ✓` _// 4, _ 1 State Ce ation/Registration # CF PO%PO0 1 7 • Notarized Signature of License Ho s e ' � _ GANDACE YARBR Sworn and subscribed be .re me this - 7''' day of >7 c L. 20 // Notary Publicc, , Flora State of Florida My comm. exp. July 15, 2013 Signature of Notary Public Let, ' , 2.(�t,sc• Comm. No. DD 903147