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Permit 1835 Hickory Lane .�., rL` _ ` ; c , CITY OF ATLANTIC BEACH , ; 800 SEMINOLE ROAD 7 ! -, ATLANTIC BEACH, FL 32233 5 INSPECTION PHONE LINE 247 -5826 Application Number 05- 00030919 Date 8/08/05 Property Address OOMOMMOMMMOMMW Tenant nbr, name REPLACE DUCT Application description . . MECHANICAL ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Owner Contractor STORY, GRAHAM N. OCEAN STATE HEAT & AIR 1835 HICKORY LANE 1476 ATLANTIC BLVD. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 249 -8251 Permit W /W /O MECHANICAL PERMIT Additional desc . .00 Permit Fee . . . 110.00 Plan Check Fee . Issue Date . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due Permit Fee Total 110.00 110.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 110.00 110.00 .00 .00 v PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUIL C `r - .,' CITY OF ATLANTIC BEACH " "''r MECHANICAL PERMIT APPLICATION -= Ji31 Date: Y 3 " d Y Property Address: / C Z 35 #4,44..' AmA, Owner: 7 • Telephone #: (2 S 3 p Contractor: ocean E5TOETe. t- I f Q l C T itelg -SZ5 1 prat /�. Fax #: EQQ- A Contractor Address: 14 l� t LQ C \rd In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of good practice listed therein. Type of Heating Fuel: If other construction is being done on this building or site, list the building permit number: < Electric `,,, ❑ Gas: _LP Natural Central Utility ❑ Oil ❑ Other — Specify MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK ❑ Heat _ Space __Recessed _ Central __Floor ti" Residential ❑ Air Conditioning: __Room Central V Duct System: Material V►C* kQa.c{'Thickness 1" ❑ Commercial Maximum capacity goo cfm ❑ Refrigeration ❑ New Building ❑ Cooling Tower: Capacity gpm p^ Existing Building ❑ Fire Sprinklers: Number of Heads ❑ Elevator: _ Manlift Escalator (Number) ❑ Replacement of Existing System ❑ Gasoline Pumps (Number) ❑ Tanks (Number) ❑ New Installation ❑ LPG Containers (Number) (No system previously installed) ❑ Unfired Pressure Vessel ❑ Extension or Add -on to Existing System ❑ Boilers ❑ Gas Piping A Other - Specify /� tr 1 K,et) I Zee ❑ Other — Specify 1 1A_C Or, 17 LIST ALL EQUIPMENT AIR CONDITIONING, REFRIGERATION EQUIPMENT & CONDENSOR'S Approving Number Units Description Model # Manufacturer Ton' s Agency HEATING — FURNACES, BOILERS, FIREPLACES & AIR HANDLER'S Approving Number Units Description Model # Manufacturer BTU' s Agency ai FAXED TANKS Nominal Capacity Type Liquid Serial Approving How Many & Dimensions Contained Manufacturer No. Agency 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Phone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ci.atlantic- beach.fl.us ,,�,,, 1 CITY OF ATLANTIC BEACH r -j . ' - '-'s s 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 - � INSPECTION PHONE LINE 247 -5826 1.. Application Number 04- 00029348 Date 1/03/05 Property Address 1835 HICKORY LN Tenant nbr, name REPL BATH PL,EL,FLOORING Application description . . RESIDENTIAL ADD /RENOVATE /ALTER Property Zoning . . . . . . TO BE UPDATED Application valuation . . . 6000 Owner Contractor STORY, GRAHAM N. J.E.P. CONTRACTORS, INC. 1835 HICKORY LANE 1416 FOREST AVENUE ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 247 -9525 Permit PLUMBING PERMIT Additional desc . 1 FIXTURE Sub Contractor . DERRICK CARTER INC Permit Fee . . . 42.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due Permit ,Fee Total 42.00 42.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 42.00 42.00 .00 .00 i, PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING OFFICIAL DEC. 28,2004 17:28 D.B Carter Plumbing Co. 9097317869 Page 1 cit. cf Htlantic Desch Hu SO4-247 504b p . 1 # 4:::•';'-'71';,,,,),:. , CITY OF ATLANTIC BEACH flip4 PLUMBING PERMIT APPLICATI()N \ . • , •-eic7,71:,i:e.../ . __... . Property Address; 113 s H,L./. 4 .. 0 .,: y _4(th c Owner: . . ...3 r 6z 1 . 'F c S ..Ce_e_.6..C.c___. Telephone #: Contractor: _1.) t i3 ,.C._-__41ce- ritipvi 1; 0 0 . Telephone #: Contractor Address: 3 3<-, :.3 _gok-a-Q r 4 ca . S. 1 Fax #: _7 3) ,-- Ac, 7 „kruk,ii .,,. pv.rtnit given for doing the work itt: deaL:r Med in the above statement. wc be:c:ay agrceTv pesfOTTII Said work in . . uccodunee ■aid, the mitsielmii 01#11 and 5pt.cificat ions whiett are ft put ill'I'Va and in tieeordruree with the thy or mionlic 8,:Jo ' urdinarKal and standards ninigni media. ligta therein. 1 Installation 1,$f phontntnt And Ostures must ht in acemitnnee with the i1u.4 tec.ott edition •t Me SI,utlumi titutidar.1 Plurnbiny i Code. r ----- — PluntbinK Type: 1 I t' Mho* comtructiOn is being done on thib building or situ. U Nog ! lig tlte building ponnit number: tH Re-pith: Et) 2 9) FS ,rvo -j- Number of Fixtures: - Rath Tubs .- — Showers - ..... ._ Closets ... J Siiuwer Pans ___.. Dishwashers Sinks — • . . ....___ . . Disposals _ Urinals .._ Floor Drains Washing Machine , ..._ I .avatory — - Water Sewer _... .. .. Watcr Heaters Other Fees Permit issuing Fee: S35.00 Fetal fixtlircs: i X.57.00 $35.00 = # 2 #00 _......,.... .. . ..._ . .._ _ 800 Seminole Road • Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800 • Fax: (904) 247-5845 • http:/hvem.ci.atlantic-beach.fl.us Reivig14 1/04 nEC 28,2004 17:11 11,0A10A !iTA11.. 0 904 241 S84h Pc.uc 1 v,r, CITY OF ATLANTIC BEACH �' r�' 800 SEMINOLE ROAD 9 a r ,• ° `- ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Application Number 04- 00029348 Date 12/15/04 Property Address 1835 HICKORY LN Tenant nbr, name REPL BATH PL,EL,FLOORING Application description . . RESIDENTIAL ADD /RENOVATE /ALTER Property Zoning TO BE UPDATED Application valuation . . . • 6000 Owner Contractor STORY, GRAHAM N. J.E.P. CONTRACTORS, INC. 1835 HICKORY LANE 1416 FOREST AVENUE ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 247 -9525 Permit ELECTRICAL PERMIT Additional desc . BATHROOM REMODEL Sub Contractor . FIRST CHOICE ELECTRIC Permit Fee . . . 70.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due Permit Fee Total 70.00 70.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 70.00 70.00 .00 .00 , PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING ' ` a S J } ir E y s . 4{1 a b ' 5 BUILDING OFFICIAL t 0y r, , \` 1 CITY OF ATLANTIC BEACH =x;, ELECTRICAL PERMIT APPLICATION ' 3' Date: \ C 'DCc_ (1,4 Property Address: I e e).3c )A k G � Lc ter' L Owner: • 1 ts—°- ° - `r Telephone #: 2- \ -1 g Contractor:' :��L ='_? ' +- II Telephone #: Contractor Address: 7■ V0-1\ e . 'r c � tJ Fax #: Zti l __ cc 1 In consideration of P ermit given for doing the work as described in the above statement, 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 City of Atlantic Beach ordinance and standards of good practice listed therein. Building: Building Type: ❑ Trailer Service: If other construction is ❑ New . Residence ❑ Temp. ❑ New being done on this building Or site, list the building 19C Old ❑ Commercial ❑ Signs ❑ Increase Permit numb ❑ Re -wire ❑ Addition Sq. Ft. ❑ Repair Oil - 2 Conductor Size: AMPS: COPPER ❑ ALUMINUM ❑ Switch or RACE Breaker AMPS PH W VOLT WAY Existing Service RACE Size AMPS 2 C C) PH \ W 3 VOLT Z'4 CS WAY Z Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Receptacles CONCEALED OPEN n 30 AMPS 31 100 AMPS Switches 3 Incandescent 7• Fluorescent & M.V. Fixed 0.100 AMPS OVER BELL Appliances 1 -- - TRANSFER. Air H.P.RATING H.P. RATING CEILING KW -HEAT Conditioning COMP. MOTOR OTHER MOTORS AMPS HEAT Motors 0 -1 H.P. 1 VOLTAGE PH I NO. OVER 1 H.P. PHS UNDER600V OVER600V , Transformers NO. KVA NO. KVA No.Neon_Transf. Ea._Sign n Miscellaneous �j�\', rc v' . '4- - 1 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Phone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ci.atlantic- beach.fl.us 1-.Q.1:rie' CITY OF ATLANTIC BEACH r f 800 SEMINOLE ROAD °. =,u „ , ”' ) ATLANTIC BEACH, FL 32233 . - -, " INSPECTION PHONE LINE 247 -5826 .. s r N ; Application Number 04- 00029348 Date 12/10/04 Property Address 1835 HICKORY LN Tenant nbr, name REPL BATH PL,EL,FLOORING Application description . . RESIDENTIAL ADD /RENOVATE /ALTER Property Zoning TO BE UPDATED Application valuation . . . 6000 Owner Contractor STORY, GRAHAM N. J.E.P. CONTRACTORS, INC. 1835 HICKORY LANE 1416 FOREST AVENUE ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 247 -9525 Permit BUILDING PERMIT Additional desc . Permit Fee . . . 60.00 Plan Check Fee . . 30.00 Issue Date . . . Valuation . . . . 6000 Fee summary Charged Paid Credited Due Permit Fee Total 60.00 60.00 .00 .00 Plan Check Total 30.00 30.00 .00 .00 Grand Total 90.00 90.00 .00 .00 40 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BULLDIN - i # DES. u C , ;,. 1 p BUILDING OFFICIAL • , 4 r11 CITY OF ATLANTIC BEACH �S l ;„ BUILDING PERMIT APPLICATION '°, �°` (Interior Remodel) Date: /f ZQ °- O Job Address: /b 3 s / 1 /cKoR Z'�"E / D y Owner of Property: �r^��/7a� 4 /�'J► he e'- —Cir y Address: G ff ''s%� � t�� 2 41— 5 7 3 0 /�35 K Zi-r, e ,4 6 , e-- 3 ZZ 3 3 Telephoner r� w , -t- Legal Description: Block Num Lot Number: t g Zoning District` i L _ G ro Contractor: JL'P n7 f -$, Ae_-- • State License Number e.E 3 Contractor's Address: / Pre 4v. • J Wepiti ti G 3-2-2-46 Telephone: Z 9 7- 9s' zs Z Z -C 3 z- Fax: 2 -7- // F9 Describe proposed use and work to be done: � a q f54-TN : r 42 i n ee - p I v vv. I "^�' -PIN( 1-, le, , �e. i-4- ID c ,(- i .c. -4 F ca , (A_,,,L 11 4- 4.6„ h ∎s 64-5 , 1 v+%�r& �.GCr2- i ldw , a -) ) � < Present use of land or building(s): ` �� . ^ ) / re: 510/e ; ; � - c? e sc� 4 Valuation of proposed construction: lv New electrical or increase in service? ,it../c.) Add plumbing fixtures? Mp Add fireplace? /tic Add heatin a 1 is Association or other private entity r equir►d ?s,seytt al �;1� , ith this Is approval of Homeowner's P 1 ■ IMAyiaioNbnr�NdAw3 t�rxt1 , P.,;4, application. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner /Contractor Affidavit if owner is contractor, and two (2) complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole Road, Atlantic Beach, FL 32233 Telephone: (904) 247 -5826 In addition to construction and engineering detail, plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Telephone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ci.atlantic- beach.fl.us Page 2 Revised 1/04 "4. ' :;' ' 211 1 1 11 " 1111.11.1.11NISOMIN,......_ Book 12161 Page 1068 RETU 5 Mitt Mil 1 Recordstd "HONE VY ". • 1 72 67 11/23/2004 031301? P/I NOTICE OF COMMENCEMENT IIII FWD Tax Folio No._ Dar„encijaada--__ State of _____________ DUVAL Call 1612011111 t 5.00 County of _________________ MUST FIE $ 1.00 NEC IIDDITIMML $ 4.00 To Whom It May Concem The undersigned hereby stated in this NOTICE OF COMMENCEMENT. haforms you that improvements will be made to certain real property, Ind in accordance with Section 713 of the Florida Statutes, the following informatIon ts 7— -' - 47 - 'ZS - Legal description of property being improved:__. __— Address of property being improved._ ...... g J . ____f_2 .........._...._ — (enera.1 desaiption of improvements. ....;,______ : JA .e.&-V.I.....S.7.74 ---_—_—_—._—_—_—.....— Acidic : Owner' s interest in site of the im ptovernent.__6_ 5 .4EL___________________________________________ Fee Sim ple..Titleholder Of other than _1. Addressl_____$ • 4 1Acid.,_ Contractor Jr/ .4 c ..,,,„: . - i-A, G - 6 r _ Ai 4 , ress: iiii s ) Phone No f Add f : qe 247 15:_z_,g___:" - --- F...axTra7" - .. fot : 7 - -z - 112 - 1 1 fo ,._ S urety (if anyr * ....-•••'------ --------- — i - -- ...ae Address:___ -- Amount of Bond $________,______ Phone No -------- _ x No Name and address of any person making a loan for the construction of the improvements, Name: LAtiet2 i..; 4, --- A dclreas:—W4Slitlid.4.4 Phone No: __ 4 ?I-ma_ r aX No:_ _irlierp..e,.. - tia4- _ Name of person within the State of Florida, other than himself, designated b owner upon whom notices or other documents may be served: _ . Address: ' 4.....112,41.--4 _A-1-1_&01C le .t. ri ._________________. ...___________ In addition to himself, owner designates the following person to receive a copy °lilac Lienor's Notice as provided in Section 713.06(2Xb), Florida Statues. (Fill in at Owner's option). ... .. Adti;WSs:---------------'-------------"-7'-'---""--------- --------,---,------_____,____,____________, . Phone. No: Fax No' ---------------- Expiration date of Notice of Commencement (the expiration date is one (1) year born the date of recording unless a different date is speoitled):_------r------------________________________ (. THIS SPACE FOR RECORDER'S USE ONLY , „... OWNER Date: ( / : „ , : , Y . .e • in 7 • P 7 ' — !.I Before. 0 thrs _AS4 of off) val, State of Florida, has perumall appeared .41fir i il'. . `'' '. . ' ' • .' ' ,-".sze.. .....__________ .,.. ,„. Ciimmano OD &WOW Notary P ic at Carge, State of Mrida, F;ountrol'Ouval. ---------- . '. It A ' • , WOW . Wad Nalar040. I • My commission expires. psz Personally Known:X '...-' - ---------; - 1.-- .44,---Ct? ' 1 ......." Produced identification: -------------------------- vo .....• ,--xx.")1-1/4 ...___________________________. .... M A P S H O W I N G S U R V E Y O F Lot 18, SELVA MARINA UNIT No. 12--C REPLAT, according to the Oat thereof recorded in Plat Book 37, Page 29 of the Current Public Records of Duval County, Florida. , CERTIFIED TO: GRAHAM N. STORY, REGINA C. STORY, COLONIAL MORTGAGE COMPANY, AND TITLE' INSURANCE COMPANY OF MINNESOTA 2 o =; L 4. 'T 1 .1 to 0 Q 1 PP. 304 1 c' . s q ° - a , - O °I" "v' 4 . °l °) . °) S i i.' � ■ • p " ■ it. e../ rNw 4.. p' Cr�.eao) • ,. .._ 'k - K 0 t$. q.• I x . O 5 . 7 1 . o j° 4 7,.j J dt t i G G N t Me N vi: w' as,... . X , t, Y 4 - v' f : I DI 4 l'4 g - s.. d 3 0 3 4) co 3 3 y • r : 1 C ~ ` t o S r" 7 06 ,-..4) , • p4 � a� y : N y m tiY • DI 1 �° \; r 1 V tt A CZ- A t 1. • J \ A .'„\ cam , to 1 v .c, Y ( :., NO ....• © . ;;� ',. t __...• Z 4 ' o Ira u , - a 1 y �,� r te„ s�Q as Ft>. U/," 3 (1....9 13 �..) ""S. e,c1 ° - 3 1 -01" —t a) , 'rs ' m.4. NJ ' W L. c:+ -' 1 ..S to El,l.18; CURTIS !1 KOOKEN, INC. I *obi rrrgiy ►tsst to the Waist GEl+IEFiAIt. NOTES! 04/04/1999 23:24 9042479525 JE PEARSON GEN CONTR PAGE 02 Q. 0 it /(1 C2... i -� J 0 � Lti C-3 �_ `n a cts V C7 - J Q W C " t >i-7-•• S - Q co .. �' Q d o o �' r- (1i I V I St: 1 t d r� N N‘ z„, c.) nn ILI . • 001 , R i ' tis t.... ' 1'o■ .. t.. 0 06. E ".b' . (6* R a %I ' ►"faiyi ibi ; . s M A M . O 1. A kit' w .n. . d Et . . • � , . . . ' .� ,., it r ,I -- fl . • �• i • 1 is .N2D: .., • c 3. \ II , 1 *. 0 : .0« �^� O * . MVO i. ..... "Vi. -- - r _ .. ; � et a' ' � 't � � ''j O i i i • � �•� a. = A 1 e _. R . •. •46.11 '�' "z, (1 \ to !No..... 'r ...,. d IN? ipoi 1 0 • low.. ..•..,...,,, 1 • • i r r R . N u �� p I J Fs • 0 cc: CITY OF ATLANTIC BEACH D. Ford I BUILDING / ZONING DEPARTMENT S. Doerr 800 Seminole Road Atlantic Beach, Florida 32233 (904) 247-5800 44'-1-01319, (904) 247 -5845 Fax PLAN REVIEW COMMENTS Permit Application # fl 4 - a 14-e °- 1 Property Address: 1 8 3 3 1--k - Applicant: r -A c1 R-S Project: - RP - 4=. L t 'T P L t=t- i-- Lc ` This permit application has been: Approved evi wed �h taowin ns - nee d ttention: c kOwt. C i • = 'It 4 es..• 1 ory D L1 12/2, Please re- submit your application when these items have been completed. Reviewed By "' Date: ant cs CA, , Z( (9 foil r 0002461 0 DEPARTMENT OF BUILDING / . CITY OF ATLANTIC BEACH PERMI INFQtt o,TION L.CICATTCIH NF IR$A `ZOU Per* t "ilueer#rrs 2461 Aloft netat/ 163°5 HICKORY LANE P r it Types BI LJI3IRO ATLANTIC REACH, I+LORIDI 322'3 3 CJ at of *lark ALTERATION LEGAL 011 SCRIPTIOH _ _ _ m W Conetr. .Type s WC OI? FRAI°IE: Lot a Ol k s Se�cst on 3 Prta0p reed Un a SXNGL.E FAI�NILY `¢t►neriipi RUG = 0 Dtw+�e� lin{ ee a L? Code O Subdivisi;c n 2 SELVA NARINA Eeetieat.d Value 9 *1000 bray. Cceeet t *0.00 Total F`efireet Art i a - *7. 501 Det .'r 5/22/90 Work Darer t �l AT1C'#NS1 PER PLANE NOT TO CHANOE EXISTING F'ip�CITPRINT , a� r; to ¢ , a ° flATI0N + .,K., . #1 ,' -, ,�r�yy A2 PL.I+D i`UGH F`EEE - �y_ @_ _ �lddr<«� { Y LANE ,r WATER IMPACT FEE *['1.430 "w , `'' i , CH, ' L.CI RIDA 1 33 SEWER lIPAC'1`. P E �' 1 . A �� �� F � itA A`R i .„,,, R. 5. *0. ,t 'fir � y . �ry��yy�y . ott ri y � ` !t � 0 .,� a � l O11Ii : f fiw N RADON 0* vJ 0. 00 A lamer x �I� r x ' , ER z WATER TAP *tat CK3 Addz Ere ee . . 9 bi" SEWER w..TAP 1 .� C HYDRAULIC: SHARE *CI. UO L3 , ,,,, * "YP+e`t 1 RE- INSPECT FEE *0. 00 E lf OINEERI #C3 *0.00 had � 1' °,, , "' ;» - , g„dri'� t - i5 ,-s ,,, ,, ,t a a �' x .9.$ 9 /HER .,. �" #0. . 9 # a";� �� &e n s J q sa.. ru b � � `' r k . ,r _vt NOTES: NOTICE -ALL CONCRETE' FO AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF I SUILDING MATERIAL, RUBBISH AND DEEIRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO CCIMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS TIMIC': 83 :t7 ICI >. ISSUED ACCORDING TO APPROVED PLANS WHICH A RE PART OF THIS PERMIT AND SUBJ - . ;?; REVOCATIC�; R !OLATION OF APPLICABLE PROVISIONS OF LAW. r'(Y ql MITI . ATLANTI +;® CH BUILD! G D ` ENT OWNER BUILDER PERMIT AFFIDAVIT State of Florida City of Atlantic Beach ) BEFORE ME, the undersigned authority, personally appeared _ �. 'i1/ 4,m N. 5, ro�� F who upon first being duly sworn, deposes and says 4r► , and the legal owner of the following pr perty : Subdivision CJ ! Cl 1214.— �. ____ Block _ __ Lot _ J, AKA __L _ - - - I am applying for a building permit pursuant to the Owner Builder exemption set forth in Florida Statute, Section 489.103. Florida law requires that I have been provided with the following DISCLOSURE STATEMENT: DISCLOSURE STATEMENT State law requires construction to be done by licensed contractors. You have applied for a permit under an exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - or two family residence or a farm outbuilding. You may also build or improve a commercial building at a cost of $25,000.00 or less. The building must be for your use and occupancy. It may not be built for sale or lease. If you sell or lease more than one building you have built yourself within one year after the construction is complete, the law will presume that you built it for sale or lease, which is a violation of this exemption. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. I hereby acknowledge that I have read the above DISCLOSURE STATEMENT and that I comply with all the requirements for the issuance of an Owner- Builder permit. Further, affiant sayeth not. Pr•pt ty Ok er Sworn to and subscribed h 4' a r a ma + hi m ad d t „cm" rrN;�`!f' St'i•i' sis. 0/0.06c.3 Address , . J i c . . ' �N 1 : , c; % ` , r t S hi '.,';,•its ` `' Heated Square Footage �,j� f iltP$ p er.sq ft = $ • Garage /Shed ��'� ��� @ $ ` . p , s q ft = $ Carport /Pordi • cf l A 'P @ $ . ' per sq ft = $ Deck @ $ per,sq ft = $ Patio ( ' s '1 @ $ ' ' per sq ft = $ 0 1OTAL VALUATION t $ 7.010- � —`� . r A , ' ota auaton •• 1st$ ' i� r 1 $ Remainder Valuation . • . ' '$ . per thousand or • • . • portion thereof �' °�, Total Building Fee $ ' ADDITIOIWAL PEItILLTS and /or PIES REQUIRED , ` '' s-r� • //'"�'�� + i Filing Fee ' . $ a U Mechanical ( , Fireplaces @ 15.00 $ P1uthing '. BUILDING'PERMIT FE $ 'z <0f Electric /New • f ' _ .. Electric/Temp np . ' �' .. . Septic Tank , • BUILDING PERMIT $ 7 •i Well . • 1 WATER MEIER CI IARGE $ • Swiiiiitiug 1'001 SEWER R IMPACT FEE $ • Sign ,• WATER IMPACT FEE ' $ • Water Cotutecticm MISCELLANEOUS $ • •+ fa , $ , f j Sewer Connection : • : •• i 1 , ; • Water Meter : , E1cvrtLi.ou Cc! Lific;ila . • • ' ► ; '. :',. ,• l : , GRAND..2ONAL DUE $ / Ste' . CALCULATIONS and /or NOi ; • ' ''s j' f '! 4 i ` , f' i iF tl ,� j a t , ' t r, s I 4(-"C fLAi1U -- / , / f • . . . ( : i •�11, , . i r , I ; , . - 2 { - ---11 - . I .. — , - ; ' .• • . • h . i ‘. • • 1,1 , i ... 1 ,: 1, : . .. .' . .• ; „.• .. . : . ...,.1 , l f . .• , 1 ; : i i. ..; L : ,,,' il. 40. . ..: 1 : . . , 1 : 1 1 i;i . , . . . • + .., .; • 1 • • P DESCRIPTION • �' ( VI , itra(r `c'C -0C4Cl - ?t07tctfa. Lot R I 710 OCEAN fOUI.EVARD Block I! Section * r.O.130X2r, _ ATLANTIC I1£ACII, FLORIDA 32233 Subdivision: LSE- 1 -N /� Azt�►"'1 - UN v c re.. C,,, TELEI'IIGl4E(9041249.2395 Street Name I)•3S i4`GY- ,� `1 DESCRIPTION OF WORK N i . or Address: i" If in a FLOOD HAZARD . 2Ng'tYiLL_ 12.0c Flood Zone: area complete page 3. Brief �I � D �� • Description: S 0 1 Pb- !sLNS.S -'2 • Class of W.rk: 1 E I) • <Hew/ :model Addition} ZONING INFORMATION MAY 2.1 1990 • Building and Zoning Construction:__f2A'L.. Zoning Proposed g • District: Use: . Estimated Value $ 0C->CD 'CPC, - T - -- • Exceptions or • Materials: _�. �c . O /T" Vwrinncen O :•o --- • Solid or Filled • Ground: Roof: » OWHER IIIFORHATIOH Method of Heating: N/IN Property Owner: &'" K -1a7 ST Fth one: 24 '"S�� • Moiling _ �- ^7 Address 1 3� N\C.�G,Q.�_ L1 (:::: • OP-C.1 [ C 1 j - 16 E) Z. • • ` `-A WC- 1 . ec � r Zip: 322 CONTRACTOR INFORMATION ' 1v I l 6-1-f--. • • Contractor: Mailing Phone: • • Address: Zip: Expiration License Number: Date: • • I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATIOII AHD XHOW THE SAME TO DE TRUE AND CORRECT. ALL PROVISIONS OF THE LAWS AHD ORDINANCES OOVERRINO THIS TYPE OF WORK WILL DE ''.!:4 1,t,, ,�1' '' COMPLIED WITH, WHETHER, SPECIFIED HEREIN OR HOT. TIIE ORANTINO OF A PERMIT DOES NOT PRESUME. TO j � r OIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY FEDERAL, STATE OR LOCAL RULES, 4,4 :1t i'4' REOULATIONS, ORDINA OR LAWS IN Any MANNER, INCLUDIIIO THE GOVERNING OF CONSTRUCTIOU OR TOE .•, , ' PERFORMANCE OF CONSTRUCTION OF THE PROJECT. I UNDERSTAND THAT THE ISSUANCE OF THIS PERMIT IS - sN ry. CORTINOEIIT UPON THE ABOVE IUFORM TION BEING TRUE A 0 CORRECT AHD THAT THE PLANS AND SUPPORT/NO x %,' • . � � DATA HAVE BEEN OR SHALL BE PROVI 3 REOUI ED. kI / D I Y 1 C err/ I .f ) i Owner Signature 17 – C ) •, : :A �/_� _- _ Date t1 • I , �h• j: Contractor Signatu a Date I f 1 • • • • MAP SHOWING BOUNDARY SURVEY OF • k . . LOT _ BLOCK —AS SHOWN ONMAP OF ' SEL Z4' MAR /A/A. - Cht/ /T /2_C 4 . AS RECORDED IN PLAT BOOK 8 7PAGE 29 OF PUBLIC RECOR OF DUVAL CO.. FLA. FOR C AI RLES COLL /ER j Say , / 1 NOTE: EA ' /N6S S// U/14/ .Y e 'EO.v ,F4 E TO sAvo PLAT Of , ry y ,c. _ (/ //T / ?- C. • , ',",: -'-7177.77:1,,,,-4,-.77,:.4.: J - 7 - , i ,,, , ,...,,,.... , , , ,.. ,..... , -....- .: ,,-.,,..:: . ' .N D/z L.E • ,:: - .- , .. ,,-. _be e * ,., .,-- , ,A.,. ' .. ■I''''''''''''''..ix:-4.)64,,,*: • i t 1,r ..,,,. t.-LLI:r AV.,,,;: ' ' '.. ; ) ' 1 . 4 . ei.el - * . -. ; ' � •,, '7- . • I Coll • • (O 3 • I ,�3 . r Q LL t � 0 14 • li. �- o ° `` � p � .-- ® dz fl o1 t ' �.. o Ns. rn Q o e J - - - - s.e- V o j y W !^ n % y �\ ki is X11 � ‘ r I li -,‘: z " NJ Qo .t 1 V C1+ h e • ~ k ki �. 4 7) II) r 1 V �Q i .iN4 1:". t% ■ s.o W f , :20 O . .. .�•viy, a�. � Q V S 8.9-35-07 e!/ -7� 9S Q cn for / . , `► Q 4 it • 1 6861 A IN / / v. I � f , z . y I 7' 7.. r ; s ; 2 u „. i -,-= d 1 Q �� 4 i- J !� k ,,\ ' - .. ' '.., ,: i cf I 01 ' ••3 - E vl oz u3 _ -_. _- . I. � �� p �� • .) '-- P Q Q � �� p Gs OE >N . 0 r x • ' p . r ,O • % CtTY OF ATLANTIC BEACH ROOFING PERMIT APPLICATION JOB LOCATION: / 3 5 f/ ,PC k6, La OWNER OF PROPERTY: fit J ,S r20 /1 P CONTRACTOR: P a ,n 7-r/` 4 c� j 6 ,..., CONTRACTOR'S ADDRESS: . 3 6 L171 Oree/ T'Ce- / / J C /O S 0 k I/ II ( F/ ZIP: 3 2 2. '1 STATE LICENSE NUMBER: "C D 0 S 7 ¥ f TELEPHONE: I 2 -- G L/0 S DESCRIBE WORK TO BE PERFORMED: g O S Arrov e i S4 ; .� (p (/?ei - VALUATION OF PROPOSED CONSTRUCTION 1 ( i MATERIALS TO BE USED: S 4 / ...-- S / SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: i yam/ _, SWORN TO AND SUBSCRIBED BEFORE ME THIS /� DAY OF --e e. 19/ 7 C - 5 - /-"--r !A - e 6(19 i 7 # NOTARY PUBLIC Liability Insurance Supplied Workers Compensation Insurance Supplied Contractor License Information Supplied Occupational License Information Supplied PSR.3844 .., . ,,r. iI r ' 15684 DEPARTMENT OF BU1t.DINGi CITY OF ATLANTIC BEACH 1` : _ - - - - PE1JIIT INFORMATION - - - -..- " - -- LOCATION INFORMATIOR -- - i Permit Number: 15684 Address: 1835 HICKORY LAN Permit TYPe : RE -- RQO? iTLANTIC BEACH, FLORIDA 3'2233 class of w :NE - _ LEGAL I#ESCRIPTI01 eonstr. Type :WO01J FRAME �81eck: _ Lot: �Twg : � ' Proposed sed Use. Section: 0 Subd :0 Rng: v. ,' :, I}we sings: Subs ivision: t'll E t, talue: 0.0 Im pr v . ' Cost: •, 49 . +x? 3 Total `ees • 25 . I I l; ', Amount Paid t er 25.00 '. t ante t;*‘", " `, ,, � �k7f 1997 ''- � ; � Ti ON T ,4'r , k. " APFLIC F EES .�._ 1 Name �" w. , q .„ T� T ' � 2 5 . a 9 #,' ' ° B , PLOP IDA 32 �. '4 " + � Sa¢ . r ' ! . , ;t �d,: „Ito, r _ ... C i . A R ' oRMAT I O I *me : J p C; i . CQMP i / , by 1 '° ` A4 a p `i ,�' � m C . � 7 . � '� ""eke .., r , ± ,...� .,. �.�. J,., ,.o �.� s , ���, ..a % mars .,�� . �, � ���.��. � ii N } I I NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE l' CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER i "FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN , 1 THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS." ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT REVOCATi VIOLATION OF APPLICA ' PROVISIONS OF LAW. Dates i2l17l97 TO 91 Rec eipt: 416)19312.4 193 :. ATL EACH BUIL { A ' INGPARTMENT i BY ,r { i _......__J ", Trrof itatr of (fir CI TY OF icy • R"' BPpM2'tlliPnt of 1uil�ttZt J118pPr f tit11 T i+w N This Certificate issued pursuant to the requirements o Building Code certifying {n t. l Section 109 of the Southern Standard that at the time of issuance this structure was in compliance with .0"— � : r various ordinances regulating building the construction or use. For the following; Use Classification r j .(^ �( i Bldg. Permit No. _ Group 'f T Construction Fire District C __. � aI /4 T/e /, 7 — f I Owner of Building { C /� MS 49.. _^f�� Building Address _ I ,; C / /� ` � / /, Address _ _ - �— ,IR� � 1- ---- yT —!__ Locality 'S N /v/ /sy - A _ 8 N. � Building Official `w`S By 1ll '/tf tL ai i u. v. Date: L ''"X, �=— )er . .,,,. POST IN A CONSPICUOUS PLACE \ 1 DEPARTMENT OF BUILDING 49116000 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date FEBRUARY 3 19 82 20b.78 Tl 7 463.33 288. ?5 A88•ISCKTC Valuation $ Fee $ + 7U6 IA 2/03/IA pp r This permit not valid until above fee has been paid to City Treasurer, and is 1 i O ��++pr�e t 1 LrKt subject to revocation for violation of applicable provisions of law. i 7; b IA 2/C3/8C This is to certify that ANDRESEN BUILDERS 14407 RUM KEG COURT, JACKSONVILLE, FLORIDA has permission to build SINGLE FAMILY HOME AS PER PLANS SUBMITTED Classification SINGLE FAMILY Zone PUD Owned by ANDRESEN BUILDERS Lot 18 Block 12 —C SD SELVA MARINA House No. 1835 HICKORY LANE According to approved plans which are part of this permit NOTICE —ALL CONCRETE FORMS 1 AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS „ AFTER DATE OF ISSUE - -♦ 4 - - ■ 0 Building material, rubbish and debris -1 from this work must not be placed in public space, and must be, leared up and hauled aw y 4 er con- =r tractor4 . wn : . / Building Official. FOR OFFICE PERMIT DATE - ONTRACTOR �„✓' USE ONLY NUMBER PLUMBING 4915 2 -2 -82 B & G PLUMBING COMPANY. INC. ELECTRICAL 3355/3356 1- 25-82. FERRIS ELECTRIC COMPANY SEWER WATER - (TY DESCRIPTION Li I 1 VI' rlt Fscaa - i lozin Lot 1 I Block N Section 7100 CEANBOULEVARU 1'. O. IIOX 25 ATLANTIC UEACII, FLORIDA 32233 Subdivisions --! -- 1 -\ � - \��I� "� (.)\-)k- 12 TELEPHONE (904)2.19.2395 • Street Name \ or Address s 18 -5 L-i ■ C \(c.,v _ Lk--11::: DESCR IPTION OF WORK If in a FLOOD NAZARD Uyv, J A_� , � QT h_ SC-2L�•JI_:- -ICJ jz•i' t\sv4_-). Flood Zones area complete page 3. B ri e f cJZLL,ti \�>)�L G LJ Description: _ P� =Z \ �. • • • Class of Work: (New/Remodel/ dditionl" ZONING INFORMATION • • Type of _ Constructions 1 -7 W`n Zoning Proposed Districts Use: Estimated Value $ 1! Exceptions or MatErrials: irYP V(--' ' Vws•inncon Grouted' Solid or Filled pk��5 ^ G round: Roofs 5�` N /, , OWNER INFORMATION Method of 1leating s h proper o wner s _o\V'�\� IN � + ' , 5�7.� Phones Moiling IA / n��� �`_- ��} _ Jn Address 1 Z?'>3S vc. �GZ\ - 1 L_ I .• GF(- /5 I - I ()CJL Zip: 32Z? • CONTRACTOR INFORMATION 1 ` 7ChJQ --. • Contractor: Moiling Phones Address: Zips Expiration License Numbers Dates I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AIID KNOW THE SAME TO RE TRUE AND CORRECT. ALL rnovxsIOIls OF THE LAWS AHD ORDINANCES GOVERNING TIIIS TYPE OF WORK WILL RF. `'�, J1f4 COMPLIED WITH, WHETHER, SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME. TO 1. / f'S` +► GIVE. AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY FEDERAL, STATE OR LOCAL RULES, _ ,',l�l`,• REOULATIONS, ORDINANCES, OR LAWS IN ANY MANNER, INCLUDING THE GOVERNING OF CONSTRUCTION OR THE .'; ::,IA.,. "' ,.,• PERFORMANCE OF CONSTRUCTION OF TIIE PROJECT. I UNDE• TAND THAT THE ISSUANCE OF TIIIS PERMIT IS . I'.l:s CONTINGENT UPON THE ABOVE INFORMAT •N .EING TRUE AND , '•RRECT AND THAT THE MARS AND SUPPORTING f �%' A.0 , DATA HAVE BEEN OR SHALL BE PROVIDE) — REQUIRE 1s ,� i ' ; / �� {1 l f' 74Ik q+ f � ` �Y , r. � i Owner Signatur D lq 1 r ,� • e F�;.: Contractor Signature Date • Address ! 3 � D p ` - 1 i4 1 1= Heated Square Footage — @ $ per sq ft = $ Garage /Shed / f O @ $ / g 5 per sq ft = $ 3, 33e,, c. ) Carport or (cwomous c 306 @ $ � d per sq ft = $ J `/ b 3 370 Deck /6 2._ j/ @ $ 6.. 90 per sq ft = $ i / ‘77 S Patio @ $ per sq ft = $ TOTAL VALUATION: $ !AO>, 9C s?,( / 6? Total , Valuation lst $ l x .. 'j $ 80 0 Caw Remainder Valuation $ flper thousand or portion thereof f5, Total Building Fee $ ADDITIONAL PERMITS and /or FEES REQUIRED + k Filing Fee L. Mechanical / Fireplaces @ 15.00 $ m- --- Plumbing BUILDING PERMIT FEE Electric/New Electric /Temp Septic Tank BUII,DING PERMIT $ S . Well WATER MEN CHARGE $ Swimming Pool SEWER IMPACT J EE $ Sign WATER. IMPACT FEE $ Water MISCELLANEOUS Sewer Connection U 4 / S /bn /c.e $ - 9. 5 Water Meter Elevation Certificate GRAND TOTAL DUE $ 99, 70 CALCULATIONS and /or NOTES Ae - GRAHAM N. STORY 1835 HICKORY LANE ATLANTIC BEACH, FLORIDA 32233 904-249-5 730 ' 74 I-b office 791-1682 Mr. Don C. Ford Building Inspector City of Atlantic Beach 716 Ocean Boulevard Atlantic Beach, Florida 32233 Dear Mr. Ford: Enclosed for your review is my building permit application to construct an addition to my house. The addition would be comprised of a screened—in deck area and a glass greenhouse. The structure would be platform construction on concrete piers . There would be no heated or A/C space. I am currently arranging for are electrician to pull a permit for the electrical work. I previously received permit fl 2461 from your office to install a door and skylight which you inspected on July 3, 1990. If you have any questions please call me at the office. However, I will be out of town until September 24, 1990. I hope this is satisfactory and if not I look forward to hearing from you. Sincerely, Graham Story PIicrER7'Y DESCRIPTION 1.1 1 i of Lot a -- __Block a TT'�� il`CCCgC - �] �f -- - - - - -_ s ection a •''-- f t ?Cate( - 71G OCEAN 13OULF,VU Subdivisions_ ( L L/ y L '�4+{\ 1'. 0.HUx2t -_ J N l i �_� A7'LAN7.1C 13EAC1(, 1"GOIIIUA 32233 ` -- ^ -- TELEI'11UNE �D04� 249.23AR95 Street !lame Ap or Address :_ 1Q3c [Ato _____ DES CRIPTIONI OF WORK I# n a FLOOD ' __ -- -` y ,, NA2ARD ..)",,, j � Flood Zones ____- -- -area complete page 3. BC �_fF - � r P ry Brie/ 1 '-•-•L \ De scription : L -2 C -� 2011ING Class of Works I NFORMATION (Kew/Remodel/ ddition) Zoning . • Type of Con structions _ D istrict: P roposed _�_ �,`___ E --------- Use :_ -- - - - -- ---- - - - - -- Estimated Value $ 0C T xceptions or -- V�rinnc�n (Iron 1____ •-- -- _____- . :t.►rI, ICN \Pig f:_ :t __ -- ------------ Solid or _ - ---- `- J-- - - OWNER Gro �' F • IIIFORMATI01{ unds - - - - -- - - -- - : _vN \ N1,C_L • Property ��(� Method o! I:rating J c, ..., Boiling C _ ^ _ - - - -- Address ] --- -- 14 \CG L - - Phones _ 2� --------- ------------- - - -- -- ------- - - - - -__ Z : _ 3 2 _ ' - CONTRACTOR I NFORMATION -_ - -__ Contractor: Mailing --------------- - -- Address: _ - - -___ Phones License Numbers - ^--- _-- __ ^ -` -- --- - - -- -~ Expiration - - -- -" Date: I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND RNOW THE SAME TO DE TRUE ` � 1 ��vt, AND CORRECT. ALL PROVISIONS OF THE LAWS AHD ORDINANCES GOVERNING THIS TYPE OF MORN WILL RE t ,t 1 COMPLIED WITH, WHETHER, SPECIFIED HEREIN OR HOT. THE ORANTING OF A PERMIT DOES NOT PRESUME. TO N '' I M OF AUTHORITY TO VIOLATE On CANCEL THE PROVISIONS OF AI:Y FEDERAL, STATE OR LOCAL RULES, \ �( 1' ! RFDULATIONS, ORDINANCES, OR LAWS IH ANY MANNER, INCLUDING THE GOVMIMI OF CONSTRUCTION OR THE ► P �F0 OF CONSTRUCTION OF THE PROJECT I UNDE TAHD THAT THE ISSUANCE OF THIS FERMIT 13 H THE ABOVE INFORNAT H l�REUIR SING TRUE AND RRECT AND T HAT THE PLANS AND SUPPORTING • X1 �� 1 �y,.Y1't�� kW , . I LL EE PROVIDE ,