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Permit 464 Irex Road CITY OF ATLANTIC BEACH ` DEPARTMENT OF BUILDING 800 Seminole Road - Atlantic Beach, FL 32233 - Tel: 247 -5826 - Fax: 247 -5877 ELECTRICAL PERMIT I1 ° Address: 4 64 iREX ROAD Permit mber: 21839 A TLANTIC BEACH, FLORIDA 32233 Permit Type: ELECTRICAL Township: 0 Range: 0 Book: Class of Work: INCREASE Proposed Use: SINGLE FAMILY Lot(s): Block: Section: 0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: Date Issued: 4/27/2001 Name: CAROLYN PITTMAN Total Fees: Address: 464 IREX ROAD Amount Paid: ATLANTIC BEACH, FLORIDA 32233 Date Paid: 4/27/2001 ,.„ ,, 'e.' (904)241 -8529 Work Desc: 200 AMP. 1 PH /3W/240 NCREA E F ° i , ,.. AMP 's 0.00 v �L> ALLEN DEES ELECTRIC I ..de t \ ,,,,,,,, rt , '''''' . ' - atlsi.l.' ,4 :If:. , ..: , y w' n . • T k } •� �Hb N a n . 4 g R "° tk, " , "fig .w`' ,� � 4 l' \ p -, ;i 4, !": °, 4,1 4-`,0"'4, : ., " . 4 ,*70 .........-‘,. ,i, ,, '' '''' - 4 "„ "", ,.., '''''' It 4. .'"' . - �y 4 3 . 1. i ' ' ., ;' > ' ,...V ir ks 9 ' a�SP ii Fa. 1 FINAL ,, y � _, ; r � ,., ---1 . ,..4, -':'-`„ %.';''' ,0--- '...„,' , r, -r - 4 , "!%: , ;.°=...A'''1.. - ,; , *Ar ' ' , 4.- 1 14 0 t, 3, „,,,,,,,,,,„ ,,,,,,..0„.,,,,,,„,,--, ,..., ..,,,,,p3.4,3„...„ . „. .„:,,,,1,,, ,, ...x ',t', ',k . t :' '� '$ y ' `�< ' � '�° . e t ; y e s .�;,a NOTICE - IN ECTION ` . `.. RI JESTED Ai LEAST 24 HOURS . ` IOR TO ` SPECTION BUILDING MATERIAL, BBISH A 4 *EBRIS FROM THIS WORK MUST NOT B ����� D IN° BLIC SPACE, AND MUST BE CLEARED UP " ", D HAULED AY BY EITHER CONTRACTOR 0":' '; NER � >� � R > � LT IN THE "FAILURE TO COMPLY IT T r> • ` �� '" VN . PROPERTY OWNER PAYI :. IC - O ISSUED ACCORDING TO APPROVED P T F RMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISION * " k c < , � AT ' NTIC : . CH BUILDING DEP . CITY OF ATLANTIC BEACH 4 DEPARTMENT OF BUILDING 800 Seminole Road - Atlantic Beach, FL 32233 - Tel: 247 -5826 - Fax: 247 -5877 I ELECTRICAL PERMIT 1 I, PERMIT INFORMATION `' L OCATION INFORMATION Permit Number: 21839 Address: 464 IREX ROAD Permit Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 32233 Class of Work: INCREASE Township: 0 Range: 0 Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: 0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION' Date Issued: 4/27/2001 Name: CAROLYN PITTMAN Total Fees: Address: 464 IREX ROAD Amount Paid: ATLANTIC BEACH, FLORIDA 32233 , , -.. , (904)241-8529 Date Paid: 4/27/2001 - . Phon (904) -I Work Desc: 200 AMP.1 PH /3W /240 VOLT iNCREASE FROM "1OQ AMP PLIGATI FEES !ALLEN ' CONTRACTOR(S) s , V R IT ' , °M= M DEES ELECTRIC y _ :,�. [ FINAL -- °, ., , "w . -� �- 5 : I CE - INS'ECTION NOT +.T E3EREQUESTED AT LEAST 24 HOURS�RIOR TO IS 1. BUILDING MATERIAL, F4 JBBISH A PB - DEBRIS FROM THIS WORK MUST NOT B- `'LACED IN/UBLIC SPACE, AND MUST BE CLEARED UP AND HAULEt�°AWAY BY EITHER CONTRACTOR 0 ' NER "FAILURE TO COMPLY T Q �� • • , ': ' W R A LT IN THE PROPERTY OWNER PAYINt, , NICEEO _0 IP ISSUED ACCORDING TO APPROVED P . W RiPT F . J RMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISION • - w. / 1 r,�, - iii , 1., c__---±-,'-'-----:-.1, ' �. ' t x `_1 1 -- - ATLANTIC gACH BUILDING DEPT. t aaroeTAINT Notice: A 1N CO Is1oe aTIOR OF PERMIT GIVEN FOR DOING TH6 WORK AR D€ CRIED is The PoU.Owne. at : . EREBY AGREE TO PERPOISE SAID N WHICH ARE A rA ART HEREOF. 1UORlC� R A WIT �� REGULATIONS' WOES AND env OF ATLANTIC MON ORDINANCES. ELicTFoCAL N savant S sa o C 71--11 11E& O1 APT. ( I COMM. t 1 MAX ( ) INOUs. ( I NEW I 1 OLD ( 1 ReW. I ) . %. A OFFFON O TRAILEN ( 1 Two, 4 1 slaty$ ( 1. SO. F. SERVICE: NEW ( 1 INCREASE t+Q ' name () . PEE --_ WI '71) 0 COFI(R • � &-. • IMPIKIIIM . i RACLWAV t.1:1. . _.1. _ _ v04) - I RAi:lIINAV PE HA ND. SIZE NO. DES No. Am taelFroie OuTLATi 1 OLINCEOGAD I OPEN TOTAS. , ReASTACLN i COIN OPEN I TOTAL . 1 4so mare. ' r i.,e...,.. •wIT41■111 `� • MSOAI !VENT �' " PWOOPlCIOVT • M. V. I • rut to, tea wrA� t oval 1 APr.�.,llret! 1 } *ILL TRAMP. AIR 14). RATAN N). SATING • CONDITIONING COMP. MOM ► ' OTHER IPOTORS ANN CEIL HEAT: IIIVONAT 1 •i fILP.j VOLTA0O VOi.PM NO. WS ' TRANIlFOIIMlfM r uN8N:R V. OVER *00 V. NO 1 (VA NO. A NO. Nemm THAW . lb. IMO. ' VA. TMA. i MOTOR SNU SrNTCM ( PPLAINS* lACH SAN . ! ' T 1 1 '� _ J P0RWARDEO _ /G $ f vrwA• s..+ 1/".6. ' CC- * ** REC 2002038 145718 H71730E0 DAG7 CIPQYAB PQAB (F -HOC ) * ** SOCIAL SECURITY ADMINISTRATION Date: February 7, 2002 Claim Number: 443- 24 043 Name: CAROLYN PITTMAN CAROLYN D PITTMAN 464 IREX RD ATLANTIC BCH FL 32233 -3904 You asked us for information from your record. The information that you requested is shown below. If you want anyone else to have this information, you may send them this letter. • Information About Current Social Security Benefits Beginning December 2001, the full monthly Social Security benefit before any deductions is $ 1055.40 We deduct $54.00 for medical insurance premiums each month. The regular monthly Social Security payment is $ 1001.00 (We must round down to the whole dollar.) Social Security benefits for a given month are paid the following month. (For example, Social Security benefits for March are paid in April.) Your Social Security benefits are paid on or about the third of each month. Information About Past Social Security Benefits From November 2001 to November 2001, the full monthly Social Security benefit before any deductions was We deducted $50.00 for medical insurance premiums ea.t The regular monthly Social Security payment was $ 978.00 (We must round down to the whole dollar.) Date of Birth Information The date of birth shown on our records is October 27, 1936. Type of Social Security Benefit Information You are entitled to monthly benefits as a dependent of the wage earner. If You Have Any Questions If you have any questions, you may call us at 1- 800 - 772 - 1213, or call your local Social Security office at 904 - 730 -5555. We can answer most questions over the phone. You can also write or visit any Social Security office. The office that serves your area is located at: SOCIAL SECURITY SUITE 100 3733 W UNIVERSITY BLVD JACKSONVILLE, FL 32217 If you do call or visit an office, please have this letter with you. It will help us answer your questions. 4 'A/tC'E41\lehl., CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 SEMINOLE ROAD - ATLANTIC BEACH, FL 32233 - TEL: 247-5826 - FAX: 247-5677 PERMITINFOROATION LOCATION INFORMATION Permit Number. 21597 Address: 464 IREX ROAD Permit Type: BUILDING ATLANTIC BEACH, FLORIDA 32233 Class of Work: ROOF Township: 0 Range: 0 Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: 0 Square Feet: Subdivision: Est Value: Parcel Number Improv. Cost: 15,893.00 = OWNER 1tATION 1 Date Issued: 3/09/2001 Name: CAROLYN PITTMAN Total Fees: Address: 464 IREX ROAD Amount Paid: ATLANTIC BEACH, FLORIDA 32233 Date Paid: 3/09/2001 Phone: (904)241 -8529 Work Desc: CDBG Re -Roof CONTRA (S . F {; z y e.` . , � FEES SUNSTATE ENCLOSURES PERMIT 0.00 inspections Restitired FINAL NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. �, k � l" " f.88 14 AT L 4 2 IC E CH BUILDING DEPT. Date: 3/22/e1 61 Receipt: 9644563 CHECKS Niel 132218 C'/ CITY OF ?laws& ,Beach, 4141sda Office of Building Official REQUEST FOR INSPECTION Date (PA o Permit No. Time A.M. /' 5 " Received P.M. 1 16 4/ — .L/'ex Job Address Locality Owner's /� / Nti` Ufa �nc� /c.SirrP� Name C-� dreip- / �A'v ( g /axe) Contractor .� BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION A.M. Mon. Tues. Wed. Thurs. C Friday_.— .40/ A.M. C D/3 — /L;/; j Inspection Made .` / P.M. ' Final Inspection ❑ Inspector Certificate of Occupancy ❑ Date S'31' - S'570 (of I) . CITY OF 1 111aalic QearA - Office of Building Official REQUEST FOR INSPECTION `.1 C 0 ' L_J Permit No. � 46 - 5 1 . 7 Date • - Time "a A • Received 3 1:,.,...,t4. JoblAddres locality �� Owner's / —1� N _ (, Contractor BUILDING CONCRETE ELECTRICAL 'PLUMBING ' MECHANICAL ram, ❑ Footing ❑ Rough Wiring ❑ oug ❑ Air Cond. & ❑ Re Roofing l ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ Pre Fab � REA FOR INSPECTION A.M. Mon. f !S / Wed. Thurs. e� d.. ,, Thurs Friday P.M. / 7603061 ' P.M. Inspection Made � ��- .4.,-.. �� ' A�i� Final Inspection ❑ Inspector /� j '� Certificate ` of Occupancy ❑ fv i, { i`ei 4/4 Date �j 23 / A � CITY OF ri1aa Qeac4 - Office of Building Official REQUEST FOR INSPECTION Date 41- / — 4 / Permit No, 2 15? 7 Received A.M. Received 41 P l E: 0 q6 Job Address Locality /� '' i re u/ Owner's Contractor Sit sT 11 �/ _ ` ► e c)13-;37,5 CBUILDIN CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel alw.41(4)3EADY Final ❑ Sewer ❑ Fire Place ❑ Pre Fab ,1 O fr e � 1 r /s ei FOR INSPECTION Mon. •flies, / Wed. Thurs. riday A. Let S+ Inspection Made � �■ 4:141. Inspector /1' . VAI�W�� Final Inspection ❑ , 411111r Dat Certificate of Occupan ❑ Date _ - -- - - - - _ - - - - - - --- - - -- Yr SEND INVOICES TO:, , ,ij PURCHASE ORDER .4 't 41 71 CITY OF ATLANTIC BEACH t P.O. NUMBER DATE ) I T ii 9 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233-5445 025245 04/10/01 ■ TELEPHONE (904) 247-5880 CHANGE -- 3 4Tilge FAX (904) 247-5819 VENDOR: SHIP TO: DATE CHG- 05/08/01 [SUN STATE ENCLOSURES INC - 1 1 CITY OF ATLANTIC BEACH - 1 3477 WHITE WING ROAD ATTN- BUILDING DEPARMENT ORANGE PARK, FL 32073 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 L IL __I C VENDOR # DATE NEEDED TERMS REQUISITIONED BY 3293 04/10/01 NET JB/DFORD F.O.B. CONTRACT NO. ACCOUNT NO. PROJECT REQ. NO. REQ. DATE 11010055158300 24100 04/10/01 LINE No QUANTITY UOM ITEM NO. AND DESCRIPTION UNIT COST EXTENDED COST ************************k*********k * * CHANGE ORDER * * * **************k******************** 1 5237.00 DL CDBG HOUSING REHABILITATION-8 1.00 5237.00 OWNER OCCUPIED RESIDENCES 41 ARDELLA ROAD 2 15161.00 DL 860 AMBERJACK LANE 1.00 15161.00 3 21312.00 DL 78 FORRESTAL LANE SOUTH 1.00 21312.03 4 15393.00 DL 464 IREX ROAD 1.00 15893.00 5 7313.00 DL 751 SAILFISH DRIVE 1.00 7313.00 6 .00 410 SARGO ROAD .00 .00 PER BID 0001-4 APPROVED BY CITY COMMISSION 2/12/2001 7 3510.80 DL CHANGE ORDER -1-ARDELLA RD 1.00 3510.00 HVAC REPLACEMENT AND OUTSIDE FAINTING 8 2100.00 DL CHANGE -1-464 IREX RD 1.00 2100.00 9 2500.00 DL CHANGE ORDER -2-464 IRE RD 1.00 2500.00 WOODWORK AND TILE 10 2100.00 DL qlpg -3-464 IREX RD 1.00 2100.00 11 23877.00 DL CHANGE O INSTALL E 3; , R 1.00 23877.0 AC '3 UNIT-3 TON PAINT KITCHEN/LAUNDRY ROOM ■ I NOTICE P.O. NUMBER MUST APPEAR ON ALL 4 - ‘ A:..- - INVOICES, PACKING LISTS, LABELS, PURCHASING NT BILLS OF LADING AND CORRESPONDENCE. FEDERAL TAX ID# 59 PURCHASE ORDER IS INVALID WITHOUT AUTHORIZED STATE TAX EXEMPT# 26 PURCHASING AGENTS SIGNATURE. PURCHASE ORDER IS VOID ONE YEAR FROM DATE OF ISSUANCE. CONTROL NO.: 24268 PSR-3924 IMUITC ticninno DIAIL CIAI A Alf^C fICICCAI Intl:JAM-RA=1\1T CITY OF ATLANTIC BEACH � ' 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 -5445 TELEPHONE (904) 247 -5800 A FAX: (904) 247 -5805 SUNCOM: 852 -5800 - °''"" http: / /ci.atlantic- beach.fl.us • MEMORANDUM Friday, May 25, 2001 To: Sun State Enclosures From: Don C. Ford Subject: Changes to CDBG Housing Re -Hab Program 2001 The following items have been approved as change orders for the 2001 Housing Re -Hab Program: 1. Remove Hobbs house at 441 Skate Rd. from the program, as Ms. Hobbs would not allow workers on the premises. 2. Change order for $5,937.50 at 464 Irex for repaint living room, dining room, and entrance way. Paint eves, facia, and soffit. Repair electrical. Repaint both bathrooms. Remove wooden shelves. Replace wooden decking and paint to match house. 3. Change order for $23,877.00 at 751 Sailfish Dr. to: install new rolled roofing, replace outside A/C init (3 tons), repaint kitchen and laundry room, repair ceiling in family room, new electrical wiring and fixtures in kitchen and laundry room, repaint living and dining room ceilings, install new kitchen cabinets with sink, replumb water heater, install new flooring in kitchen and laundry. 4. Change order for $9,781.50 at 78 Forrestall Circle So. to: install new kitchen cabinets, install new plumbing in kitchen, remove wall mounted oven and stove top and replace with a single unit, rewire as needed for kitchen appliances. Please proceed with these items as soon as possible. The substantial completion date is June 15, 2001. Cc: File ✓ City Manager CONTRACTOR PAYMENT REQUEST . Homeowner: Gato`y/ 1) LO e l.396aYment � n- Control e? t • Address:. 7�'/ /E' � J Payment 12 - 33% Complete Atlantic Brach. Florida 32233 Payment#3 - 100% Complete Contractor: S� � �� G�� SQL/. � <i� C Amount Requested $42.2_1_ / • • Contractor. I hereby request an inspection to receive payment # 1 for the amount of i 4;91 (/ . I certify that I have satisfactorily completed the necessary work to justify this request and that all bills incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. Attached is a description of the work completed and the amount of payment r by w item. Contractor's Signature: 7 Dale: /o /'e • Homeowner. I/We hereby agree that. the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings . of that inspection. • Owner's Signature C _ . 1 ` 7 .. , . Date: • • Rehabilitation Inspector. • I hereby certify that I exercised reasonable care to determine that the work performed at the above address meets specifications was completed in a satisfactory manner however, neither the undersigned norJacksonville HUD is in any way responsible for the acts or omissions •of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement. The contractor has provided a release of all Liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the pro . - owner 4 • i • the contractor for work performed. „Si ., Rehab Inspector s _ 411k.. Date: 7 -� — 4Q1. • Approved. Forwand to F Department for payment this date. • • • Date Director, Rehabilitation Loan P • gram Grou• # /Req# PO# -- Amount Loui Approval / Da - 6, 1 , .. Approval / Dat l Q VC!. - 1 l c c Approval / • ( CONTRACTOR PAYMENT REQUEST aroG n .eGaKe. Payment #1 -3396c -- Address: ' y`*/ --' � le o Payer #2 - 33% Complete 5 4 970 ' Atlantic Beach, Florida 32233 Payment #3 - 100% Completc Contractor: 5 U /1 5/4 / e �/ GiaS S ��� / p Amount Requested tC7 hereby request Contractor I an inspection to receive payment # iV for the amount of $ .3 9 7 - t I certify that I have satisfactorily completed th wry work to justify this request and that all bills incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. Attached is a description of the work a mpl and the amount of payment requested by work item. � -'-'- Date: " C �/ / ^ t 7 al / . Contractor's Signature: _ . • Homeowner I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in • accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. `r Owner's Signature r 4 A. / i / ; - — Date: Rehabilitation Inspector: . ' ' . . ' '' - .. .. • • • , I hereby certify that I exercised reasonable raze to determine that the work performed at the above adds ss meets rrable for the specifications and was completed in a satisfactory manner however, neither the undersigned n 3 ackaoaville HUD is in any way �pO acts or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. Rehab Inspector. ��.�// %� i�� t ate: 7 — JO — D` .Approved. Forward to Fri Department for payment this date. Date y - 3 0-0 / . Director, on L, O Z -' RE C . ... Date H - - a t • Group # / Req # PO ��z�� Q °�C3�z � ��arri -.A 1 21 7 RECEIVED CrtY of Attar -�= a Arnc I Ting an "T�„in= Ap ova! / Da te y / 30 o A 0 1 P A L _ E EfV ED Approval 1 Date 3a /UP DEP MAY 0 1 - 2u A MA 0 tip l Appro e — CK #1 DEPT CONTRACTOR PAYMpNT REQUEST Homeowner: ( 0J G / ! C/a tee Payment #1- 3$% Comp Address: 4/ 7 e V s 0 payer #2 - 3396 Complete , Atlantic Beach, Florida 32233 Payment #3 - 100% Compled 40 9Z‘7 . Contractor. • • .. • Amount Requested $ J . / — � . Contractor I hereby request an inspection to receive payment # —7 for the amount of $ p 1 have sansfacton'ly compl eted 17 ( . I certify that I leted the necessary work to justify this request and that all bills incurred for labor used and furnished in making said repairs and improvements have been paid in full to this date. Attached is a d e s c r i p t i o n • • • ' ir co, .. -.': , the amou t of payment requested by work item. Contractor's Si — Date: 0 7 - 0 /- © / Homeowner I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on thefindings of that inspection. / I Owner's Signature • ' r,.:.1.rek. - T Date: • Rehabilitation Inspector: rrrcets I hereby certify that I exercised reasonable care to deter mine that the work performed at the above address for the specifications and was completed in a satisfactory manner however, neither the undersigned Jacksonville HUD is in any way responsible acts or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. % ` Date: ����.7 Rehab Inspector. .✓ . . • Approved. Forward to Finance Department for payment this date. • • I "x'7.0 / • s yZL. Date • Director, Rebabilitatr ; • Loan Program . ., Date - 1 - < < - ► ,.- ,. PAID Group # / Reg # /POId;,a 5 F Amount � %c V \ . k.i JUN 1 d rill • . prove,* l Data CK 3 1 #, _. Approval 1 Date t .. 0 L 1111 o i _ Approval I , • ►`��� .K. for 1 C CHANGE ORDER No. �. Date of Contact 03 -07-0 / Date o VGL/ c Owner Name Caret y/7 UGet Property Address: I /‘ ./eAt D Contactor Name: .5 S172 ‘ SC1 /Y C Xfri Contractor Address: 3'Y77G k/,`n0 g0 52t7J phone Number 9 yl flrziation of Work Chaace• AMOUNT: CATEGORY: (Please Type) ` 1 �r p L U iy b fi k�faen 5 ;n /c //, ha5 Ci 1��an S �< 9 W tit in , o NAP arty M1 us/ be • Ms N P Con t° l ainsewer Line Ne / 54x( Par in MO* ' W ' °''' 94d showz°r' DCA.,/) S (des and work affected hereby, are subject to all contract stipulations and covenants. This Change Or is made a part of the contract dated first above, patties have hereunto set their signatures. $ I e5 432 Contract Prise + - $ a, /e). e° Change $ 71" Date 53 - 0 1 - A Owner Approval: C �, 1,�� �� i J Group # / Req # / PO J � 4 ""' %� Datt;:© -o9-o/ Amount d 100,00 Contractor Approval: �r Rehab Specialist Appal: / * Date: S-- 3-of Approval / Date '- Program AdmimstcaoorApproval: Iran Dart S_ 3 — 4 ( Approval / D a Ap • t•. t: !. Source of Funds $ $ $ Contingency Owner Contract Copy: Owner, Contractor, Loan file, Technical file, Financial' Ins*ihttion (If contract price changed) Catenaries of chances: 1. Bidden damages 2. Time extension P A 3. Deletions of non - required items or unusual allowances 4. Required items that were missed an initial inspection �� 5. Equal substitution of material or alternative cure for deficiency at same or lesser price Mg 0 S 2 6. Totally unforeseen circumstances arising after commencement of work ( c . CHANGE SPIDER No. Date of Contract 03 ''' 6 7 D ` Date O`/ G /` - 6 .` f Owner Name a / 217/i [?Lai// Property Addresx 9qg :A'6 R o • - Contractor N 244 avCc/eS . Contractor Address: 3 71 % ti '/.;97 c/ ) Phone Number ?ef - yae Description of Work Change: ✓ AMOUNT: CATEGORY: (Please Type) CJ7 � w -.71--"5" - Z.� 1.(160D u/d/`,� P e `e 2 mil w4411 � "°` , Ti l / e . . e 171e p Ala 5.kt 13gA/ -rtor e/ fi, . C 0rrc'T f ` fl $ / M � .. , .. • .. . 1 /ear /e *Clef i Si. r 5Mil . L . Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first above, parties have hereunto set their signatures. • $ /4913.e.- Contract Price p ` 4 3 + or - $ a , Change 2 S a o S 1 1,3 93 . Total 3-0 9 Date . S' 3-o l Owner Approval: Date: • , ` ' O # a s�� 4 Contractor Approval: _ -- Date: 0 y- 0/ Group G / Rog # ,fir a.500, e Rehab SpecalistApp Approval: ...inv.- ...--......0" D 5 ai nay 3 . -0 ) Approvci / Due Program `�'°°° ' ° ' Approval / Date Source of Funds: $ $ s Approval / Dat Co Owner Contract 1 Co py' Owner, Contractor, Loan file, Tedn ical file, Finandal Institution (If o�trac t price changed) / . Categories of chaaees: 1. Hidden damages , D 2. Time extension 8. Deletions of nor- required items or unusual allowances 4. Required items that were missed on initial inspection Y 9 S. Equal substitution of material or alternative cure for deficiency at same or lesser price 6. Totally unforeseen circumstances arising after commencement of work ., ,. CK � `� • • • f GE' 21218 1126- ofContract e 3 - G / Date C 4 / — ,,2' 7' c1 Owner Name Ca Poi /1 13 ak • 0311tradcrNaineS '4n 5A17 - A/C60fti n°s-- -,,' Co x Address: 3 977 1-4 /it" L Phooie Number 9a$ - v Descxintion of Work Chance: AMOUNT: =ATFEORY: (Please Type) 41/ ° ceecf e, ' c R ePtaCe 6 Ced/1i 5 d�e/ 5'er/ice F/'0/'? yomce um Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first above, patties have hereu nto`set their signatures. . / D ski 6 CouatractPrice 20 j q ? +or_ s q �,/t! °" c t 0° st / Vg T«gi 2c 3 I D r -3 -DJ Owner Ate • ,t not Group # / Req # l - • Contactor approval: _ _1 0 , 67 7- Amouhwt ) 100 09 , Rehab Specialist Approvak /_ �. '�. Date Q ' .- "Of Approv.:i I D to �-' Program Administrator A Date i f — 3 0 - O f Approval / Dates Approval / • �� 11 • Suave of Funds $ $ $ Contingency Owner cones Copy: Owner, Contractor, loan file, Tedmical file, Financial Institution Of conuait. price clanged) RECEIVED . C of chances: I. Hidden damages APR 3 .t p • 2. Time extension 8. Deletions of non - required items or unusual allowances � 4. Required items that were missed on initial inspection A/ P . FIT Q 2001 5. Equal substitution of material or alternative cure for deficiency at same or lesser price MAY 0 6. Totally unforeseen circumstances arising after commencement of work CK # `�.� - I CLANG ORDER ,. No. if s . -- ,-- ' Date ci Contract a 3 -0 7 0 / Die GS 2 l l G/ Owner Nan= , . - 4 ' III , /1 Tito! ke Propoty Addle i G - - zZ Y Corer Namo .4 / ac: a: C -0 A/fr.5 ,T--, • HOC. Add 3 "..77 I/4 4e Lt/r'n, £ Phone Number r'0 f - yam *+ 'vti� of Work AMOLJNI'; C'•'4T mORY: (Plea Type) �!7 /�i hni�" a �h C e Gc.a�/ ��Paynt and Rte/ ;l` Livid f1 *147q+ a -ile cr.ild �Cr`a op j Sot i1 e -)R-a Ai* r SC t 1 r'cf 14 Group # / Req # / `o # aS� 5 et 1 30 �at 5 ASR • �� w/i tt .z s h eiC Amount fi"� Approval / D�tc . —.-- dec��n �e�t:cce p/�C c� ° u�'� ° A / Datc A ° ° a `� Pa n f Approval !Dat �T -� ' ch and work affected hereby, are subject to all contract stipulations and cove:Nu ts. This amp Order is made a part of the contract dated feat a bove, parties have hereunto set their signatures. S /- =' Contract rice" ea #1 .1100.00 +or- $ 5;1 Z,S7 change 4PP. pa 50, .00 - 3 a- 1oo,0 �, o w -1 g 30.5 ._ _-� _ L G 7011, OD Owner' Approval � t . , , i t r . a Dal e: ..5 0 ` -C' f - Lf � r • . CA A..,.. Date: " 7' 0 4 Rehab Specialist Approval: II M S - Dates 6 - r - e p Ad errallri Dates C - e - 0 ( &i4 13 913.0 • ....,.......---.--...----•---... Source of Funds: $ S $ Contract -rlh. 4 '' 0 , � 30 Copy: Owner, Contractor, Loan file, Technical file, Financial Institution Of contrail price changes) ('aww:eS of Chan PAID 1 1. Bidden damages 2. Time extension . I t ' $ j��i� 3. Deletions of non - required items or unusual allowances I AI 4.. R items that were missed on initial inspection i 5. Equal substitution of material or alternative cure for deficiency at same or lesser price CK # `` T om , -( 6. Totally unforeseen circumstances arising after commencement of work /1 /4 CONTRACTOR PAYMENT REQUEST REC' • ‘,„ p er: Cet/OL n P (/a lie Pam # 3396 Coatplete r J/ --r CI of Address: v � — ,�" Payment Beach c #2 - 33� Atlantic and Zoning Atlantic Beach. Florida 32233 Payment #3 - 100% Co9mplet e • Contractor: , S Contractor 41/7 ! i'z'r 0/1ci -E eves ,ZnG Amount Requested / 37..SC aims nebeR Contractor: I hereby request an inspection to receive payment # 3 1 for the amount of S certify that I have satisfactorily completed the necessary work to justify this request and that all bills incurred for Tabor used and materials furnished in making said repairs and improvements have been paid in full to this date.. • Attached is a description of the earnplued and the amount of payment requested by work item. Date: Q 7 _ . c � -a./ Contractor's .Signature: Homeowner: I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. � - r)wneer's Signature Date: Rehabilitation Inspector: I hereby certify that I exercised reasonable care to determine that the work performed at the above address Ie for the specifications and was completed in a satisfactory manner however, neither the umdersigned nor Jacksonville HUD is in any way responsible ads or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other persc n performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. „/ > —arrow a: .:� �/ Rehab Inspector: Dte /` Approved. Forward to Finance Department for payment this date. Date 7 - (Z —0 / Director, Rehabilitato an Program • CHANGE QRDER Date of Contract a 3 ' 0 7 - G / . Date C G q — " 7- e, Owner Name Cc (o/ /1 (IL a Property Addrese C4 • c Nn 5 GUI .5 4 7 A/CGcsfrCeS C ner can ef Addtese 3 977 �4r 5 , Z�Z Description of Work Cl AMOUNT; CATEGORY: Meese Type) .� ' eCf /C- e Piace semc e Fo Wolie • • • ELM CAS and work affected . hereby, are subject. to all cantraci stipulations and covenants. This Cie Order is made a part of the t dated first above, parties have he ewuto'set. their signatuzs. • / � ` 6f Pike 20 O ?3 + $ „voo.w. - r 0 0 sit / 793-4° otai 2 S� 3 / e t Dat 5 - 3- o) Owner • Group # / Req # / - • 2sa y caaQactor : .. . o ' / o? O( Amount g 10 OP sp t „/ _ -11110 Date 4 '"730 Approve! / Bete '< roval / DateP5 • G Approval / , i` ft. r, Source ofPundit $ _ $ • $ y Owner Contract Copy: Own, car, Laos Me, Technical rue, Financial Boa w RECEIVED J, Categories of chanson i. Hidden damages s. APR 3 : A 1 p Time extension • 3. Deletions of non- required items or unusual allowances 4. Required items that were miaaed on initial inspection A/P P MA T 5. Equal substitution of material or alternative cure for deficiency at same or lesser price Y 0 S lfl01 6. Totally unforeseen cirasmsdaces arising after commencement of work 6roRF <c- 2 �i 4 ' /y` PM 3 � aoo« MAP SHOWING BOUNDARY SURVEY OF . LOT q BLOCK t t AS SHOWN ON MAP OF .AY O P * P.I.+�..1 0 r i • - OY.e.`• 17,sA-.' S L, r--) IT - T - ‘4._i 0 Al.... AS RECORDED IN PLAT BOOK 3 1 PAGES ! 1 40E' OF ME PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA CERTIFIED FOR: (t .. c C.- rr.-'="-- v E + r7w L F -:s"r A.- �..e rt- i `.....� T, C. is. Go. • ltiaA'r'Soi._L 't- 0��o��..i °I / & q 6-6 - iro:„...... e a>14-er- / , ‘ei-a--k-c . tf, ICJ ()"1 Ka '07,....' a0.[pj 1 r r o • K 7_,..( .ca h' i Ala.:, d r(i ) . .. - At; ` . .i 1 - 's • C31...A—. • N Iii ��- 0 0 7....,... o0 z p4 10 t0 , , •• • • • . 7,::.:: , . : • ...... „., 4. . • . -,0 , ::., : ,.. , 4 :z'..° ■.. •' A • (i . • . ) • • • /0 3 1 8: p'-1 ° Ito dt,.'' G PJO. 40S RECEIV • FEB 2 1998 1 1.•.E.. yc_.,, fi- ...0s.o City of Atlantic Beach (to a' r__..(i._i Building and Zoning NOT VALID UNLESS EMBOSSED WI771 SEAL OF 7NE UNDERSIGNED. BEARINGS BASED ON t ( "-- 1 LINE AS SHOT nit- DAnorono cUnwM JJFRFnA1 APPFARC Tn 1 I WITHIN Fi nnn HA7ARD 70NF •• K• AS SCALED FROM FLOOD an- MORTGAGE NOTE Atlantic Beach, Florida For value receive the undersigned (jointly and severally, if more than one), promise to pay to the order of the City of Atlantic Beach, a municipal corporation, 800 Seminole Road, Atlantic Beach, Florida 32233, the principal sum of $ , being payable in lawful money of the United States of America at 800 Seminole Road, Atlantic Beach, Florida 32233 or at such other address as the holder from time to time may specify by written notice to the maker. Said principal sum shall bear no interest and shall be reduced in amount at the rate of 1 /10th per year until reduced to a zero balance at the end of 10 years. Any unforgiven balance shall become immediately due and payable if the maker transfers title to or moves from the premises securing this note within the 10 year period. In the event of the death of the maker of this note, this note shall remain in effect and the principal sum reduced at the above rate of 1 /10th per year only if a member of the makers immediate family takes up residence in the subject home, under any other circumstances the note shall become immediately due and payable. This note is to be construed and enforced according to the laws of the State of Florida, and is secured mortgage on real estate of even date herewith. If default be made in the payment of any of said sums or in the performance of any agreements contained herein, then at the option of the holder of the same, the principal sum then remaining unpaid shall immediately become due and collectible without notice, time being of the essence of this contract, and said principal sum shall bear interest at the highest rate allowed by applicable law, from such time until paid. Each maker and endorser waives presentment, protest, notice of protest and notice of dishonor and agrees to pay all costs, including a reasonable attorney's fee, whether suit be brought or not, if counsel shall after maturity of this note or default hereunder or under said mortgage, be employed to collect this note or to protect the security thereof. c - , Wk‘ Name of Maker ± _ ±'�_,! 1 _ _ (seal) Si e of Maker 1.4 t AGENDA ITEM #8C JULY 09, 2001 STAFF REPORT AGENDA ITEM: Community Development Block Grant housing re hab program change orders. SUBMITTED BY: Don C. Ford DATE: July 1, 2001 BACKROUND: The Community Development Block Grant program has two change orders requested from staff to complete the rehab of two houses at 464 Irex Rd. and 78 Forrestal Circle So. RECOMMENDATION: The staff has reviewed the proposed change orders and recommends approval. ATTACHMENTS: 1. Change order number 1 for 78 Forrestal Circle South 2. Change order number 4 for 464 Irex Rd. 3. Report on changes. REVIEWED BY CITY MANAGE : A NDA ITEM NO. 7/9/0 AGENDA ITEM #8C JULY 09, 2001 Monday, July 02, 2001 To: City Commission From: Don C.Ford Building Official Subject: Community Development Block Grant Program change orders for 464 Irex Road and 78 Forrestal Circle Due to the elimination of one of the contracted houses in the CDBG housing re -hab program, we have revisited the housing rehab for two houses that are not completed in the program. The house at 410 Sargo was eliminated from the program because the owner would not allow the contractors employees on thepremises on two separate trips. Mrs. Hobbs, the owner, has opted to drop out of the program. We had budgeted $15,622 for this house. This has created excess funds of $15,662. The change orders listed in this report area costs neutral to the City of Atlantic Beach as we are using the funds from the 410 Sargo Rd. house.The items the contactor has listed inthe change orders were in the original lists of possible items to be repaired /replaced but were eliminated due to the limited amount of funds in the program. Some of the items were missed by the re -hab inspector in the initial lists of repairs. Cc: File City of Atlantic Beach, Florida 800 Seminole Road Atlantic Beach, Florida 32233 -5445 Telephone (904) 247 -5800 Fax (904) 247 -5805 Suncom 852 -5800 City of Atlantic Beach Housing Rehab Program Bid Proposal Notice to the Homeowner and Contractor: This bid should be submitted in confidence and should not be revealed to the other contractors. Evidence of a collusive bid shall be cause for non - acceptance by the Program. Date: Contractor: Property Owner: Carolyn Pittman Blake Property Address: 464 Irex Rd, Atlantic Beach, Florida 32233 I, the undersigned contractor, having inspected your property, as listed above, understand the extent and character of the work to be done. I propose to fiunish all labor, materials and equipment necessary to accomplish the work as stated in the attached bid specifications and work description for the rehabilitation of your property. My total Bid Proposal for all items listed on my attached work description is ($ ) All work proposed as described will comply with the City of Atlantic Beach's Building Codes and will conform to the Property Rehabilitation Standard Specifications and Guidelines. If this proposal is accepted, I will obtain all required building permits prior to starting construction. I propose to commence the work within 10 consecutive calendar days from the date of award of a contract and a Notice to Proceed and will complete the work within 45 calendar days after starting the work Company Name Signature and Title of Officer Date SELECTION OF CONTRACTOR AND BID PROPOSAL Uwe the owner(s) of the above listed property have read and understand the rehabilitation work to be accomplished in accordance with the work write -up and Specifications attached to the below listed contractor' bid proposal. Contractor selected: Bid Price $ signature of owner date witness date signature of owner date witness date Owner: Carolyn Pittman Blake Address: 464 Irex Rd. Mantic Beach, Florida 32233 Phone Number: (904) 242 — 9862 Date: April 10, 2000 Time: 12:36 PM PROPERTY DESCRIPTION Address: 464 Irex Rd Atlantic Beach, Florida 32233 Dwelling Type: block Floors: single story Number of Rooms: 6 Area: Other Contents: Inspector: Mr. Bernard A. Wilson Date Inspected: March 30, 2000 Approved: Date Date BUILDING DESCRIPTION Date: April 10, 2000 Time: 12:36 PM Inspector: Mr. Bernard A. Wilson Address: 464 Irex Rd Atlantic Beach, Florida 32233 Number of units: Dwelling type: Stories: single story Construction Type: block Other Comments: General Requirements REPLACE ROOF SHEATHING Replace all rotted or damaged roof sheathing. New sheathing shall match existing sheathing. All work subject to open roof inspection by the Building And Zoning Inspection Division. All work shall conform with the building codes and shall be permitted and inspected accordingly. SF REPLACE SHINGLE ROOFING Replace all shingle roofing with FHA approved shingles, felt, and metals. Mfr's specs.and local bldg. Codes shall be adhered to. All areas of new flashings shall be sealed and step - roofing nails shall not penetrate underside of sheathing. Color selection of shingles by Owner. Contractor shall give (7) yr. labor warranty and (20) yr. Mfr's warranty in writing to Owner. SF REPLACE RAFTER TAILS Replace all rotted/damaged rafter tails using pressure treated materials. New rafter tails shall match the existing rafter tails. All work shall be done as per standard trade practices. EA REPLACE FASCIA BOARDS Replace all rotted/damaged fascia boards using pressure treated materials. New fascia boards work shall match the existing fascia boards. All work shall be done as per standard trade practices. All joints shall fit tight and shall be caulked properly after installation. LF REPLACE SOFFIT Replace all rotted/ - damaged soffit using exterior grade Plywood and screening for ventilation. Include all required trim. New soffit shall match the existing soffit. All work shall be done as per standing trade practices. SF PREP/PAINT EXTERIOR COMPLETE Remove all loose and scaling paint. All surfaces shall be pressure washed and all surfaces caulked and puttied before installing primer coat. All surfaces shall receive one (1) primer coat and one (1) finish coat (2 coats total). All paint shall be applied according to manufacturer's specifications. All lead based paint that may be existing shall be removed completely. "No" lead -based paint shall be used whatsoever. SF REPLACE WINDOW(S) Replace the window(s) with a single hung pre - finished aluminum window, induding screen. All windows shall be installed, plumbed, leveled, and caulked on the interior - exterior. Window shall fit the opening properly with no excessive gaps. Repair all walls after installing window. Accepted: Pan — American, Croft, Anderson, Pella. EA INSTALL EXTERIOR LIGHT FIXTURE(S) Install exterior light fixture(s). Fixtures shall be installed as per the electrical codes and permitted and inspected accordingly. EA REPLUMB HOUSE COMPLETE Replumb all horizontal and vertical supply lines from water meter including a new main shut -off valve and new hose bibbs. All work shall conform to the local plumbing codes and shall be permitted and inspected accordingly. AL REPLACE ENTRY DOOR (S) Replace the entry door with a solid core Luan door, Iockset, weather - stripping, and threshold. Door shall be installed, leveled, and plumbed. All work to be done as per standard trade practices. The face sides and all edges of door shall be sealed. Door shall be weather-tight after installation. FRONT EA Master Bathroom REPLACE SHOWER FIXTURES Replace the shower fixtures and diverter valve including shower head and arm. Acceptable manufacturers: 1. Delta, 2. Gerber. EA REPLACE VANITY, TOP & FIXTURES Replace the existing vanity with a new Vanity base cabinet, Formica or simulated Marble top and backsplash, faucet, p -trap, Drain, supply lines, and cutoff valves. Unit Shall be trimmed and caulked properly. All Work shall be done according to the plumbing Codes and shall be permitted and inspected Accordingly. Size of vanity to be installed shall be specified in bid. Cabinet: Tri-PAC, Merrilat, Faucet: Delta, Gerber, and Crane. EA REPLACE EXHAUST VENT Replace the existing exhaust vent. Unit shall be installed as per the electrical codes and permitted and inspected accordingly. Accepted manufacturers: 1. Nutone, 2. Kitchen Aide, 3. Braum EA Hall Bath REPLACE SHOWER FIXTURES Replace the shower fixtures and diverter valve including shower head and arm. Acceptable manufacturers: 1. Delta, 2. Gerber. EA REPLACE VANITY, TOP & FIXTURES Replace the existing vanity with a new Vanity base cabinet, Formica or simulated Marble top and backsplash, faucet, p -trap, Drain, supply lines, and cutoff valves. Unit Shall be trimmed and caulked properly. All Work shall be done according to the plumbing Codes and shall be permitted and inspected Accordingly. Size of vanity to be installed shall be specified in bid. Cabinet: Tri -PAC, Merrilat, Faucet: Delta, Gerber, and Crane. EA REPLACE EXHAUST VENT Replace the existing exhaust vent. Unit shall be installed as per the electrical codes and permitted and inspected accordingly. Accepted manufacturers: 1. Nutone, 2. Kitchen Aide, 3. Braum EA Master Bedroom REPLACE/INSTALL DOOR TRIM Replace/install missing door stop trim. New trim shall match existing. All work shall be done as per standard trade practices and adhering to local ordinances. LF Bedroom # 1 INSTALL BY -PASS DOORS Install by -pass door, including hardware, at the closet. All work shall be done as per standard trade practices and adhering to local ordinances. EA Bedroom # 2 INSTALL BY -PASS DOORS Install by -pass door, including hardware, at the closet. All work shall be done as per standard trade practices and adhering to local ordinances. EA Bedroom # 3 INSTALL BY -PASS DOORS Install by -pass door, including hardware, at the closet. All work shall be done as per standard trade practices and adhering to local ordinances. EA Bedroom # 4 INSTALL BY-PASS DOORS Install by -pass door, including hardware, at the closet. All work shall be done as per standard trade practices and adhering to Local ordinances. EA Total • • CITY OF , ,,J�_" I , re�4tele - 9ea�Ga� F \ T' 800 SEMINOLE ROAD , - -- - - - ATLANTIC BEACH, FLORIDA 32233 -5445 TELEPHONE (904) 247-5800 FAX (904) 247 -5805 INCOME VERIFICATION FORM TO: Employer - Social Security Administration HRS • I, &P,e Z2Z hereby authorize the City of Atlantic Beach, Florida, to verify my income. Please provide the requested information to the Director of Community Development, at the above address. Thank you for your cooperation: and assistance. Signed: L Date: ! / . Address: "7' r • /vc yov Telephone: aka- FINANCIAL SURVEY COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM 1. Name of person completing survey: _ QM 2. Address of House: ° f' _ __ -! 3. Is person completing survey the Head of Household? yes no L/ 4. Age of Head of Household: !�✓ 5. Is Head of Household; female % male a minority? yes __4„/ _ no 6. Humber of handicapped living in household _ 7. Total number of rooms in household Y 8. Number of persons living in household (other than Head of Household): Age 0 -5 years Male Female Age 6 -17 years Male Female Age 18 -39 years Male Female Age 40 -63 years Male Female Age 64 and over Male Female 9. Water supply is from: City // Well Other (list) 10. Sewer service is by: City _k/ Septic Tank Other 11. Does your toilet flush? yes � no 12. Have you had sewer or septic tank problems? yes no If yes, which of the problems have you experienced? a. foul odor b. seepage of septic tank into yard c. backed up ho sehold plumbing _�- d. other .1L11 _- JQ _4i2L Do the problems increase during periods of heavy rain fall? yes no 13. Is there hot running water? yes no Is there cold running water? yes no 14. Do you ha a complete kitchen (water, cooking, refrigeration)? yes t- no , 1 CONTRACTOR PAYMENT REQUEST - - . �;- �� :y - H omeowner: c.,at0` -p I/ 1 { A k" 3.3ayment I - Comp) 2 l 7,�7 . Addles*: 4/ ,,g P/J Payment 112 - 3396 Complete • Atlantic Beach, Florida 32233 Paymenti3 - 100% Complete • Contractor: ‹Lin £ 1G`iS -f //°S 244 Amount Requested S l • e 7 67 Contractor . I hereby request an inspection to receive payment #f 1 for the amount al' S 4;91 ‘/ . I certify that I have satisfactorily completed the necessary work to justify this rtquest and that all bills incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. Attached is a description of the work completed and the amount of payment requested by work-item, • Contractor's Signature: . / 7. ._ -. r/Q 9 Date: • Homeowner: I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. Owner's Signature C -,; tld Date: Rehabilitation Inspector; I hereby certify that I exercised reasonable care to determine that the work perforined at the above address meets specifcations•and was completed in a satisfactory manner however, neither the undersigned norJacksonviie HUD is in any way responsible for the acts or omissions •of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the pro . - owner . • .. the contractor for work performed. Rehab Inspector. � ` < "'4Q' ' • i Date: Approved. Forward to F , - . • Department for payment this date. • • Date Director, Rehabilitation Loan P ogram • e = - 01 L. Grou , # / Req # PO # _ — Amount • -* As' . , : Approval / Da • ! .:.; 1 j ad • Approval / Dat = 4 l ;, * L l - 1 Approval / * -- ( CONTRACTOR PAYMENT REQUEST ` . met: r' aro/. yil [ a Payment #1 - 8396 Conspiete Address: . 9t-9 Pk A D P #2 -8896 Complete. Atlantic Beach. Florida 31428$ Payment #3 - 100% Complete Conusctor. S 4 A S/4 / v .. e�.Sl/1,�r< Amount Requested WSa / Z / y eon: I hereby r quest an inspection to receive payment # E for the amount of $ S? 9 ' `' ` I eettify that I have satisfactorily completed the neoeaaauy work to justify this request and that all bills . incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. • Attached is a demotion of the work and the amount of payment requested by work item. Contractor's Signature: Darn: g • Homeowner: I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in • accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. • , Owner's Signature — Date: • • • Redhabil ration Inspector• I hereby certify that I exercised reasonable cast to determine that the work performed at the above address meets specifications and was completed in a satisfactory manner however, neither the undersigned nor jacksonville HUD is hi any way responsible for the acts or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. % .ins.- a a te : , Rehab Inspector. � �•�� . • • Approved. Forward to Finance Department for payment this date. Date 1 " 3 0 - 0 Director, Llitation Loan P gram � REC " ,�ee y Q Z(ZL `� - a • '- • Date LI - - 0 t zUU1 Group # / Req # PO 2 5 2 -q� APR 3 4 D` CO of Atlas -i �?a�� Amc�::t � RECEIVE ���ing � ' AP 30 �P A r L 't arid, ApFr oval / Date . y 3 0 0 • E EIVED Approval / Date ,a - MP DEP MAY 1 Li!!►i -7 MA Cl 1c m Appro • CK # DEPT CONTRAC'T'OR PAYMENT REQUEST • - / / L: 7/ y � j/ Q ( a i " o - Payment #1- 33% Complete l! L' X _ Address:. p �� Payment #2 - 3896 complete , Aydautic Beach. Florida 32233 Payment #3 - 100% Comple14,1 . Contractor: • • . . ' . _ • . „ • Amount Requested $ 3 - 2 q 7. ‘7 Contractor: I hereby request an inspection to receive payment # for the amount of $ .12 q 2 47 . I certify that 1 have satisfactorily completed the necessary work to justify this request and that all bills incurred for labor u sed and mater ials fi rniahed in making said repairs and improvements have been paid in full to this date. / Attached is a desczipdon ., - r' co , . • - . - ., . the amount of payment requested by work item Contractor's Si..' , -`"'�! — � ' Date: 0 7 — 0 , r © ! Homeowner: I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed ; be based on the findings of that inspection. Date: • Owner's Signature • _ ,. _....!.....1.01.1 - _�_ Rehabilitation Inspector: . I hereby certify that I exercised reasonable care to determine that the work performed at the above address meets specifications and was completed in a satisfactory manner however, neither the undersigned nor Jacksonville HUD is in any way responsible for the acts or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement The contactor has provided a release of all liens, if any, in connection with this contract and has provided the propert} owner with a copy of each warranty or guarantee due the property owner from the contactor for work performed. Rehab Inspector: . - _ _ _ - Date: 7X/Zarr • • Approved. Forward to Finance Department for payment this date. . • 4 _1 ........ - k.... ( Date 7 - �' ( - 0 / • Director, Rehabilitat . '• Loan Program • j- ., . Data. - 7- -1 -v1 p A 1 arrielialimallielib Group # / Rag # / PCB 0 JUN��1 Amount ` c\ k.i . prays! / Dam CK ,,,3 Approv al / Data 'e r, ?J L '1 f 01 .... Approval / , , . Mg /o, s. • . CFLANG EQRDER No. D aft o f c axdrac t 03 G7 Date 3 /C Owner Name Ca/My/7 aka ke Property Mike= 1 / 4' 9 R D Coda•Nauia Sufi .f/ iVG(G (Gf/te S Zf7 Q Contractor Address: � /.., l✓ /! , ' r� 52d • J phone Number 7'� - Description of Work Cha u e: AMOUNT: CATEGORY: (Please Type) p t U M h %n 9 CA en 5in/c l; �e ha5 Cal6Wcd Main s'eider 01 ��� a� , � eP�.t o a art M1 use be )Let Nis N Ne P d N 4 r 4 y in M # Lille fro°ri �lld S l A'a.,/) 0 - • Changes and voak affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a pert of the contract dated first above, parties have hereunto set their signatures. $ /093 42 ContractPie +ar- $ Change / r°�ronl Date ,c-3_ a l ' A Approval: Owner 4 Qy - Date: Group # / Req # / PO al..5a ContractorAppraval: Date: eg 4A 0 V_ o / Amount c9t 1 X ,00 Rehab Specialist Dates S 3 ' - �/ Approval / Date PrragrannAatorAppcwal: ran D -. 3,0 ( Approval / D -- of Ap •I • t 7 ,, Somme of Funds: $ $ $ Contingency Owner Contract Copy: Owner, Contractor, Loan file, Technical file, Financial Institution (If contract price dinged) Cateeorieg of ciranars: 1. I•i'idden damages �. Time extension p A 0 8. Deletions of no - required items or unusual allowances 4. Required items that were missed on initial inspection 0 , 5. Equal substitution of material or alternative cure for deficiency at same or lesser pricc ss t11� a 9 Z� . 6. Totally unforeseen circumstances arising after of work 1�'► CK# • • a ale rt No. • Dale of contract 03'67-0 ( Date Off/ -0 G /-0.( Owe Name: 4 a I2 1 y/1 j ? i a k e - Property Addresu q 'q - 77Eg c ? D • Contractor Nam= epri_Mhe • / /� C 3 ( Ll/� (i!/� �� E / Prone Number or Me Description of work Change: AMOUNT.. CATEGORY: (Please Type) .�T�`�� Z'� �, fig! t^J //art - Peftoce Ra Hro 1300 ct/aC( (744 We will 1 ito • yam 7 o r 17/e pi Ala .c.kr 13R'fk/oo itarde/ A9 • C al't�c `itt fk M .� 1 �Pett(e N►a51el L 5k.o r • 51a# , • (ranges and work affected hereby, are subject to all cons a.ct stipulations and covenants. Tins Cie Order is made a part of the contract dated first above, parties have herettmt o set their signatures. • $ /jaB '9. . contracthioe t - 4 4 3 + or . $ a � Change Sd c $ I %,3 °' Total _-D 1 4 `1 3 I s Owner Approval: Date: Date • .0 Group : / R�q# C Apps - Date: © l,/ ' 0/ �� 0 / S _ 3 _ © � Amour Rehab sperm Approval: .� Date: �- , / , � ��'�" i I • Dam •._� 2 Approve! / Dote Progr�cnAdtnrinistr,mr • ,1 ���` Approval s"... oval / Date \ • Spann of Funds $ $ $ Approval / D t r/AL__ Contingency Owner Contract 1 . Owner, Contractor Loan tnid tie, Finanrial Institution (If contract price charged) / Cam" � file, Ted Catesories of chances: 1. Hidden damages p A 1 D 2. Time extension 8. Deletions of non - required items or unusual allowances 4. Required item's that were missed on initial inspection j y i 9 2001 5. Equal substitution of material or alternative cure for deficiency at same or lesser price 6. Totally unforeseen circumstances arising after commencement of work • - ( f • C ANGE ER No Date of Contact a' 3 - G / Date G 6 / - .. 7 61 Owner Name. Cc foiy4 CG aka Property ,.Addrs C4 Z"W • Contactor Names 5 Ii/ 57 CGC t u/L i C CcamadarAddress: 3977 l'. 4, l--- /fl9I 0 iz Ph e Number 9a $ - Va DiM+ntimr of work cairssg AMOUNT: CATEGORY: Q (Please Type) ;// ° s-GeiC / e. • PePiace �/�e/ SerfCc from • , yamie Oran and work affected hereby, arc subject to all contract stipulations and covenants. Tins Change Order• is made a part of the aoutrad dated first above, parties have hereunto'set their • • 0th 5�i 2 © J 4 ? 3 _ 0 S 9I' -4 T«si 2f I / Dat ) � 5 - 01 Owner Ap no al:.. • • • Date Group # / Req # / ai..trL.a.., ......_ Contractor Approval: _ - 1 C7 Y o 7- Amount —. -r git2 ,122 Rehab SpecialistAppovalk / _ e Date , 4 4 " . ": 3 O '" Approvc4 Dwte Engrain Adtni.nistraMr Approval: Desert Y— 3o..--or Approval / Dates • Approval / a 1 YI• Sou= of Funds: S S $ Coniingenw Owner Contras Cop Owner, Contactor, Loan 6k, Technical file, Financial Institution (If =matt pia &angel) RECEWED '- c4lcurories of charges,: I. Hidden damages APR 3 , D S. Time extension A. 1 8. Deletions of non-required items or unusual allowances /� 4. Required items that were missed on initial inspection A/ P D . 5. Equal substitution of material or alternative cure for deficiency at same or lesser price P tat 0 9 200 1 . 6. Tot ally unforeseen circumstances arising after commencement of work CK #`,�— No. r - Datedag 0 3-07 0 I Date aS .2 . OW= Nano a.`/,l/'D , /1 ii/ 1/17a4 /31g - C . s As: 0 4•1/Z5 , /7G. C .7Y77 144e Y'7 E) Phone Number Tor ,c c i $ °n of Work CWmma AMOUNT: CATEGORY Meuse Type) �JlCd7 !)i h lli n lam/"► at nd 0�J /'atn ce t f/ �e PAr n f a /td Re/Cr G lvi a� °j a�C a }� zt -�-7q fa,* L'�` ct /Jai � Cr'a a�cd 504.i.-- Date , - /q- a .- `� M/ sc 6 jecfZ C a�� s 0°1'4 13°(1.° ,� 5 Group # / Req # / - • , ee rnf u t � �fC Amount Sq ` _ • Da ot,ie ieref • • Approval / CMto . ._._. �eP(ACe C � 'u(' Approval / Date - _AO 0 • and Point f � , Approval / Dat _ i , M 1 1141) (merges and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first a bove, parties have hereunto set their signatures. $ /50 Contract Price i ea #1 .1100.00 +or . $ 3;9 3 c .irp. .2.5a .00 . s h -1, # , 5 b opt - ,r1' 3 ;- loo ,00 , Owner Approval.. 1 ; , . , & 7OD,O0 I ..:.l ' D� - S "3 Q • - � f - 4 "f 1 to _ , .., - i Date: C, 7 -61 rJ 131: 0 c«t�A� � ►i r _� ( • � i2� X03750 R Specialist Approval: , �✓. ' Date: 6 - .. • • i Date G ®C 64' 1 c ) 0 13. e) Program Administrator . ,—„,–___ Source of Funds: S $ - Owner 3 Contract 1 _____........---- r _ • t # .A0 5 30 ,� Copy: Owner, Contractor, Loan file, Technical file, Financial Institution Of contract prim changed) ' ifs: PAID 1. Hidden damages 2. Time encteasiao . JUL t 1 1t1U] 8. Deletions of non-required items or unusual allowances A 4. Required items that were missed on initial inspection 5. Equal substitution of material or alternative cure for deficiency at same or lesser prim CK # LA J 6. Totally unforeseen circumstances arising after commencement of work 7 .' ' . c\./ .1, CONTRACTOR PAX1 FNT REQLiria RE !:. " , - .. ' : .1..• ,;r. ,a cminr: C'ciriL 4 P T /a /tee Payment #1- 3996 Complete L�` //� — < Ci of Atlantic Beach Address: < v 7 � Payment 112-3396 11'.',8;,.; } ci;inc-.trnd-ion; Mantic Beach. Florida 32288 Payment #8 -- 110096 Complete Contractor. ,..5 5 of 7 0I/C1 (ir S Z nG Amount Xeriu $ Pl?7,30 j t grs f C o n t r a c t o r . I hereby reques t. an inspection to receive payment # for the amount of $ F 3 7..b . I certify that I have satisfactorily completed the necessary work td,juatify this request and that all bills incurred for labor used and materials furnished in making said repairs and improvements have / been paid in full to this date. - Attached is a description of the ... > , pleted and the amount of payment requested by work item. •` Da ' Q 7 O •t'. l Contracto?s.SignatUre _ Homeowner: I/We hereby agree that the work stated by the contractor. has been completed and approve payment to the contractor in • accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. i ... Signature C-d -./ 1244-f..--- • D ate: : . Rehabilitation Inspector: I b eCe b y certify that 1 exercised reasonable care to determine that the work performed at the above address for the spec ifuations and was completed in a satisfactory manner however, neither the undersigned nor Jacksonville HUD is in any way responnige acts or omissions of the contractor, any sribcontrac tor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. f - : --'� mss. e // Date: Rehab Inspect= / Approved. Forward to Finance Department for payment this date.. • . alp.:;.-n Date 7 - ( ^ . Director, RehabilitaProgram • f Duval County Property Appraiser - Parcel Summary Page 1 of 2 Parcel Summary - Values from the 2001 Certified Tax Roll RE No.: 171426 0000 Owner's Name: BLAKE , CAROLYN PITTMAN Property Address: 464 IREX RD ,Unit No. ATLANTIC BEACH 32233 Mailing Address: 464 IREX RD ATLANTIC BEACH , FL 32233 -3904 Property Use: 0100 SINGLE FAMILY Legal description: 31 -16 38- 2S -29E R/P OF PT OF ROYAL PALMS UNIT 2A LOT 9 BLK 11 (Neighborhood: 943807 ROYAL PALMS Sec -Twn- Range: 17 -2S -29E OR BK & Page: 10156 -1522 !Map Panel: 556A4 Sale Date: 8/28/2001 No. Buildings: 1 Sale Price: $100.00 Land Value: $16,800.00 Heated Area: 1372 Class Value: $0.00 Exterior Wall: CONCRETE BLOCK Improvements: $53,870.00 Taxing Authority: USD3 Market Value: $70,670.00 County Tax: $216.68 Assessed Value: j$55,710.00 School Tax: $254.34 Exempt Value: 1$25,000.00 District Tax: f$93.12 Taxable Value: $30,710.00 Other Tax: $15.37 Sr. Exempt: 1$0.00 Voted Tax: $18.76 Sr. Taxable: $0.00 Total Tax: $598.27 This page displays values from the 2001 Certified Tax Roll with weekly updates of ownership & sales. Map -It maps & data are updated & maintained by COJ -GIS, not the Property Appraisers Office. Please direct inquiries regarding the maps & data to Map -It Feedback (below), not the Property Appraisers Office. c .: rte, Map -It Feedback ■ Payment Feedback Home PRC Map -IT Taxes Appraisal Feedback http: / /pawww.coj. net /pub /property/RENO.asp ?RENUM= 171426 +0000 2/6/2002 City of Atlantic Beach CDBG - Rehab House Analysis © 5/10/01 Vendor Sun State Enclosures PO # 25245 Original Change Location Bid Orders Total 41 Ardella Rd $5,237 $3,510 $8,747 860 Amberjack Lane 15,161 15,161 78 Forrestal Lane S 21,312 6,901 * 28,212 464 Irex Rd 15,893 6,700 22,593 751 Sailfish 7,313 7,313 410 Sargo Rd 15,662 15,662 $80,578 $17,110 $97,688 Budget 1 I LI .2S Amount Available $7,312 / / 1 OY(. Z- 7AAA-i (-°I * Requisition # 24393 awaiting approvals and addition to PO # 25245 File: cdbgrehabs0l ATTACHMENT B Page 7 CASH REQUEST FORM CDBG Name City of Atlantic Beach Request Number 2 Address 800 Seminole Road Contract Number 5629 -21 Atlantic Beach, FL 322 Phone Number (904) 247 -5886 5822 Tax ID No. 26- 02- 107391 -54C Fax Number (904) 274 - 5877 Date Submitted 5/30/01 1. Contract funds received to date $ 0.00 2. Contract funds disbursed to date $ 53, 524.74 6. Contract funds previously requested but not yet received. $ 23,034.53 4. Amount of this request $ 30,490.21 All contract funds must be disbursed within three days of receipt. If line 2 does not equal line 1, please explain. Atlantic Beach Donner Revitilization (1055) Requested This Line Item Budget TO Date Request Balance LB.1. Contract Services $ 64,702.01 $ 23,034.53 $ 30,490.21$ 11,177.27 Totals $ 64,702.01 $ 23 034.53 $ 30,490.215 11,177.27 COMMENTS Bank Bank of America Account# 2101205719 I certify that the data above is correct and the amount of the cash requested does not exceed current needs. Signed : 'J Date 5 73 1 /01 Title D ty Finance Dir for City of Atlantic Beach CDBG Grant FY 2000/01 Contract #: 5629 -21 Draw #: 2 Project: Atlantic Beach Donner Revitalization (1055) Description: Rehab Houses Invoice Check Check # # Date Amount Payee Description Payment 1 42072 05/02/01 5,053.60 Sun State Enclosures N. Rouse, 860 Amberjack Payment 2 42072 05/02/01 5,053.60 Sun State Enclosures N. Rouse, 860 Amberjack Payment 2 42072 05/02/01 5,297.67 Sun State Enclosures C. Blake, 464 Irex Road Payment 1 42072 05/02/01 2,437.67 Sun State Enclosures E. Spillers, 751 Sailfish Payment 2 42072 05/02/01 2,437.67 Sun State Enclosures E. Spillers, 751 Sailfish Change Order 1 42234 05/09/01 3,510.00 Sun State Enclosures C. Wright, 41 Ardella Road Change Order 1 42234 05/09/01 2,100.00 Sun State Enclosures C. Blake, 464 Irex Road Change Order 2 42234 05/09/01 2,500.00 Sun State Enclosures C. Blake, 464 Irex Road Change Order 3 42234 05/09/01 2,100.00 Sun State Enclosures C. Blake, 464 Irex Road Total $30,490.21 City of Atlantic Beach r) in 044.074 800 Seminole Road Atlantic Beach, Florida 32233-5455 INVOICE INVOICE , PURCHASE PROJECT ACCOUNT AMOUNT NUMBER DATE ORDER NO. NUMBER NUMBER 04/30I200 025245 110-1005-515,33--00 5,35 AMBE -2 04130/2001 025245 110 '••1005 -515.3'3 -00 f. R E X - 2 04/30/2001 025215 1 10 -1005-515.3-30 5,297.67 04/30/2001 02524_ 110-1005-515.S 2,437.7 04/30/2001 025245 110-1005-515 . '33- GO 2,437,67 . . „ . GROSS $*****20 7 80 .7 1 DISCOUNT 1 NET . ,.. ,•• .- -, -._ .............-- ....... ...-.- -..••• . , • " . • ''..'- ' • a. ' ' .' . 4'. ' ''• L. " • '.'"'- .'.' . ''.... ' .-.L . ' • L • ...- " • • . .• ... .....• ......, ,.`. -..- .-..",.., ..- ..... ....-..,,,, ,.. .-.,.., ■ ■-, ".' .• ,,,,, • ' . ..... L A ..1..,...VW . , WARNING'THIS CHECK IS PROTECTED BY MICROPRINTING AROUND THE BORDER AND ON THE SIGNATURE LINES" ' :itt:' : ..5=: t- '.. , ,:i:_ili - 7 :,. - ; I --- - -- Z - ;';Ii:_;'-1::: - = : :=' . - - :; - ": 7- -Ir.: ' i :=:::::-*:: 3: :; - 2:::; 2::,_ti% ': 1.--3 '2"- :: 1= ::,- 1:"-;11.,„ ,1;'_ f: -'--' :-:--...' . ''-'-----:: ' '-. t!:- _=•<=.. -.- f -: ;=i '---- ' :f- ' i ..,; , ,_,.,.'..,, _,.:1?_7: _ , - : , ' :.----„ _ ,.:7:---t .,1.- cfon 72 if 7 Attantt13eacrt>-;_-- -_-:-,--_,.: • ,- . -, ' • :-.--,',:,-_,---- - _,-.. v v ------.:;'-:t=i--- , ' '•,..;•;;.- ' "' ' , j:- • • - .800 - Serninole Road ' . .,.• '. ' .?:' .. . . I .,:&„,_.., : ....•.. -., . - .AttadhaBeach,Floriilaz.32233:15_455 ,,-. ---... , _ : .--,-_-._. _.,.. ..- .,,-..__ ._ . i . . ...,:.,,,„ ,..„.., , _ ...... ,,_, _, :_ , , .,,,, , ,. -.-__, _ .,.- ._.:, .-, .. . ' - - ,, ' - _7" - -- --. -r , • ,- ;:::...;' . , ;k . : . . -. 4.. ' . •■!-_:- ...i": VfINIDOITNIIMBER ,-. 71 ,-i: si . ,r:,-.... :..-:-7.;, -,-...• ,::: 1: ...;:- - z. ._:•:.--. -..- 4•1:0•KNUMBEFf.. - 7:,-_-.: - f.-;1. ,..-.:.-.'.. Neris.:1410LINTS: • -,;:::::: - ..:7',.:• .- ... . ! : -=',.---,., :•:-.=,-.. .:,-;--.-..- 7, -.• --.-;::-,: ----.- .-:- - .... - -:=7 - - ,::::..5:.,:- ---7 _ _ 7 ,---. , ,,n= ' .. ., , L;1. - -, - - ,:, - . :. - ::. - _,:7 •:, ; - . - ...;::: - i--- .: , .1 3 29 .5.--.,- r.: . .,.-_- , 2 , 2 , • ,. -- - - - - i -, 7. - .4=, - _-Z42:an--- : -:-::-.- - 1 -- .47*-* *41-11:::=$. a EL 1! 1 i n OUS Alta' Trtii4 -•, i i7i,KTY. AND -- -*-7i * *I *lc - k*:**' ' -' 3 7 11 : V [ = r ilani 4 6 C` N.A. .'; f.4,14-4.-,. t; t ' --';:';'''. =4:±e ST01 E Weter*URI-S - -Ott"' : ' -;==' . ' '`."-='-: '''. j- -- --- - :: - -: - -- ' • ' •:- :. ' . • ,.. ' .•. • . 3477 tintITE WING )AD : " • . . ' • 1 , ,, -:..A ,•,--7,--t--1 ,..---,--, ,-' •-.,,,,--:: ..: 77, ------ 1 '-::'-:-:‘ ''.-4-,:. • :.1 '''-- ::::,* 1 4 Att.GE, - ARK. EL - - _--.. ,3,,i)7.4.:-•,..,:: ---,-.:,„ • -.;-;•:,::-• .'4.4,11„,_,., ,i r',,,, . 'rg.----';.7,--i- - . ;•=% r,,- -_-:-.--: _ : - ' '."-- ' ;Z- '- 7 4 7 - ...2,: '% ' tl" -:{-.4v .7.!. - - --•7=-: - .- :•-•.-.- i 1 1...,;:- • . .i;:i.,,,i, - ;...,,;, :ri-- ::,.-- ' 7 ,_ .,- ., , , - , -- - ,- 0 , -. ,-,:, -,-; , :-,:,,, ,,,;. 7.7, -,.-,: ; :::,..,;.;-; ,;>,__,- .,:.:1 9,":4# ,;„- :.`., _., 7 ' '-' ...: =".eil -=.::--.::_ -2 „,- • `i 7:;;;, , a, -7: 7.7.,',1." ,•, , - .;;.:=FA-- - . , -.1, _,Z 1 .. _:: _=-.- 1 i' ,-:; . ,,kff '-.....r .„ AlloRizemko. k ;::::::::. -.--;2:.-:;--.- .--.---=: ,- . ,....-.; - --",-- --- . - . --,.---;:-:--..- ',-----:.--------.--,------ :7---- --;-',:!.,';,-- - .. z"; , ' . - - 1-'1 = • k,lt I '-',::,:: :',-:::- ' : ';: - . 7 ;':::',7 ' . .;:7.. . , . :',.=:: fZ=: ,":::-.:'. - I n't I n kt itC37 ?V wa ss orrw as t a aw a....monueu........wouonmaaorelmonsatumme..........x..1.*assumno.............e...... , amommamousonloimuncrnocnaan.......,1.................nows.nweue....nmarem , ........................moumwemsronmouoymoonnessmIxamervomaturworm.. 1 ■ . . . , 1 • CONTRACTOR PAYMENT REQUEST f w : / Ab 1 IC O (4 Payment #1 - 3396 Complete J' S 0'517 6-*" Address: (2 (4 - n - 'o Payment #2 - 3396 Complete Atlantic Beach, Florida 32233 Payment #3 - 10096 Complete Contractor: -C I4 ,.1 4 G / f Amount Requested $_� S 3. 4 4-0 Contractor. I hereby request an inspection to receive payment a for the amount of $ 3 ' 67 -- 5 -- 3 ..S. I certify that I have satisfactorily completed the necessary work to justify est and that all bills incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. Attached is a description of e wo . completed and the amount of payment requested by work item. �— � 3 - a ( Contractor's Signature: _ Date: Homeowner. I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings that inspection. Owner's Signature___ Al f ' v L U � % ' ! _ Date _ i i - ,7 -0 t Rehabilitation Inspector. I hereby certify that I exercised reasonable care to determine that the work performed at the above address meets specifications and was completed in a satisfactory mannex however, neither the undersigned nor Jacksonville HUD is in any way responsible for the acts or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. Rehab Inspector: _ -- i! • - - - -- Date:_ 1 —_SO O/ - • Approved. Forward to Finance Department for payment this date, t, C1 ,, C Date y 3 0 - v Director, Rehabilitation Lo Program Date q--01 L.:1h_ me;._" \ Grc4:: / 2ozi 0 PO # ; 2 4 1,5 -- FlECEIVEb PAID Ait.:, :. :::1 c • , . s APR 0 �t,�� MAY 0 2 20 01 Apprc ; l / a�:� • �� 3EC 11/ D 2::;:::: MAY 0 • r , A/P DEPT • CONTRACTOR PAYMENT REQUEST r ' Homeowner. A/ e° Pi/ ka,(se Payment #1 -3396 Complete _ Address: ,F40 - /)M ` ve( �a CSC Payment #2 - 33% Complete SOS 3. to Atlantic Beach, Florida 32233 Payment #3 -10096 Complete ! / / _1 C�G',SG/ /1 °S Amount Requested $ -G s / -3_ (� G Contractor. __ Contractor. I hereby request an inspection to receive payment for the amount of $ Q S3. (c I certify that I have satisfactorily completed the necessary work to justify est and that all bills incurred for labor used and materials famished in • said repairs and improvements have been paid in full to this date. Attached is a description of the w. compl .. and the amount of payment requested by work item. Contractor's Signature: 4,011111111W Date: (:-.7 —/ Q Homeowner. I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the 1 '�1 : of that inspection. net's Signature ` �J / O C - - -- Date: y —� 7 —C I _ Rehabilitation Inspector. I hereby certify that I exercised reasonable care to determine that the work performed at the above address meets specifications and was completed in a satisfactory manner however, neither the undersigned nor Jacksonville HUD is in any way responsible for the acts or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. • Rehab Inspector __ ,� _� ,_ ate• T "3' D/ Approved. Forward to Finance Department for payment this date. t - --ti C. - Date r 3 0^ 0 f Director, Rehabihtauon Loan Pro , Date CI- 36-0 LI T g .'rnt`. - a Grc:.: / rioi : / 00 j19TZc-(\ , PAID Am�:_::.i .. • _ • RECEIVED A pp,�,' / C� o o Al: APR 3 0 'IUUI Pt,.,, ^ 2 2001 Approval / Date #O 0( CeIvED K # e j12 Approv: Date ,t;, Y U 1 zut,1 A/P DEPT A/P DEPT CONTRACTOR PAYMENT REQUEST ( (CrO / c�/7 RGa. X� Payment #1-33% Complete S 6 , - ueowtter . G'/ -- y Address: / �" / , C E l D Payment #2 - 33% Complete, 5 ,2 9 7 � Atlantic Beach, Florida 32233 Payment #3 - 100% Complete —,r Contractor: i & f - Ch: — Amount Requested p ? / / 7 Contractor. I hereby request an inspection to receive payment # d for the amount of $ 5/07 9 7 - ' • I certify that I have satisfactorily completed the necessary work td justify this request and that all bills incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. Attached is a description of the work c mplete and the amount of payment requested by work item. Contractor's Signature:_____ ______ Dater C f/ g 7 G/ - - • Homeowner. I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. Owner's Signature _ Date:— --------- - - - -- t Rehabilitation Inspector: .. ' , . . . I hereby certify that I exercised reasonable care to determine that the work performed at the above address meets specifications and was completed in a satisfactory manner however, neither the undersigned nor Jacksonville HUD is in any way responsible for the acts or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing work under . the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the property owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. Rehab Inspector: _ -- -� - • ' _ a te : --- 3c, / -- Approved. Forward to Finance Department for payment this date. ..-_-- Q_ '- Date y - 3 0 0/ „g,.>%'..."------ . Director, e t itation Loan Pr gram ` re O ^� .� _ a REC , Date y - - a t . '� 15.2-qr. °R 3 i UU1 Group # / Req # PO RECEIVED `C� acn 2 4 7 . 6 City o f Atlai ' ,°�,irg Arncu ' n x �/ 3 0 o APR 3 a ' P A 1 w ink a , APF' ova / �ae2 E EiVED Approval /Date 36 , f 3EP r 1 V n l Lt1Ui �u 4l Appro - . — — CK# 1-1-)-01P-, "j, DEPT + i , CONTRACTOR PAYMENT REQUEST • ( d P I / P a nt # 1- 33% Complei o / -� 7 peowner. O il/ - / .5/ � hG - .g Y► • - Address: 7 '/ - - ii ' ' _ Payment #2 - 33% Complete 1� 7 3 7 Atlantic Beach, Florida 32233 Payment #3 - 100% Complete SGfri_i °./"..-47:51(#.1.---5...-2-317C Amount Requested $ 7 �7� 3 Contractor. — Contractor: 1 hereby request an inspection to receive payment # I/Z for the amount of $ certify that 1 have satisfactorily completed the necessary work td justify this request and that all bills incurred for labor used and materials furnished in making said repairs and improvements have been paid in full to this date. Attached is a description of the irk completed and the amount of payment requested by work item. s Signature: - r . • Contractor' gn Date: ' — Homeowner. I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon inspection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based the findings of that in; . - Lion. , � rlwner's Signature `/i AI"' . . I - - - -- __ Date:__ r -- - ( . Rehabilitation Inspector: is I hereby certify that I exercised reasonable care to determine that the work performed at the above address me, specifications and was completed in a satisfactory manner however, neither the undersigned nor Jacksonville HUD is in any way responsible b fforr d the acts or omissions of the contractor, any subcontractor, or any of the contractor's agents or employees, or any other person performing uner the construction agreement. The contractor has provided d release wner from the contractor Con cton connection work with this contract and has provided the property p owner with a copy of each warranty or guarantee the property Rehab Inspector. N____ y - - -- --- ---- Date: `.f Ol — Approved. Forward to Finance Department for payment this date. c ..0 ...„„_,----. C--_ Date 3 ©. - 0 ) • Director, Rehabilitation Loan Pr gram L . O " IA ���_ P A 1 D Date Li "_ Grc� :. " / G � -� ;� PO �2 SZ� /� APR .� 0 �t,t o�i MAY 022001 L��, ,#5... 3 ReceivED CK# ��CEP Ar. ` U D-0-1 �- �.. ��3 b o - �►pa�ov�.� / C�a�e . �EGEIV Approval / Date 00/ Approval /,Dat 0 1 �UU1 042234 --- , i t c y B80eo0af ( 1' t' cs e t n : a i on n i t a Beach ACCOUNT AMOUNT f . ,. PROJECT NUMBER PURCHASE Atla NUMBER INVOICE ORDER NO. INVOICE DATE 8 3-00 NUMBER , 00 0 C 3 2 2 : 51 1 1 0 :1 5 . -:: 025245 110-1005 83 03/27/200 -- 110-1005-515- 2 500 0C ARDE-001 04/04/2001 025245 110-1005-515.83 IREX -001 04/04/2001 025245 110-1005-515'83-00 , IREX-0O2 IREX-0O3 04/27/2001 025245 OTfiA'' NoN=NEG i d -1.L-P-)1.-C- NET DISCOUNT E SIGNATURE LINE s*****10,210.0C _., . ..... E BORDER AND ON THE GROSS PRINTING AROUND uli$:::**10,210.0C WARNINGTN IS CHEeKISPRCTECTED BY MICRO ROUND TH ::t4.2_,_,_ i4t _--' -...: :-77-:.= --;:-- :=•-'7,..,7- ' ',. • - -A7--'4;,' 7'.`•---' - ' ' • • • '' : :f,80 t*k4t AtiantfC Bea ... :- .-5---- - , -, - - . -- • ,,,,, ---:—...,,,,,,----M-rff-J-- _,„ ...," 1 .,,,, 1 ,,, ,i;Riacf,,,,:.. • ,',.-„ , , •, ' -•;::' ,- : ••,, ,,, . 2i.:,7 ...- --_-,,, , ,,_,,,-t4--- .7- 7 _ -=._ ;,- 0 :1 - k r - _!- -- --;-----_, - , Y4 '..;_... : 7 5,46: - ;;;,..- -,, ,',_:--, , ,-....',. : - , ' z--.4:: '1, ---,:-.----7.;.„,„ ,„-..,- :. • „, „.,...., ..Atiagtt-gteaeb*-17-1014- .._. ..:=1_ .!,r -!-., . 71- ' -„,., ,,,,,,, ----K oyter: ..--.--:7 .-,-;;..." -.- ri.:4 .,.----,-- -.;. 47F.-Z,, ,;: ''''---:- ' --- ...„,1 -_-_ . :4;-1,: _;.-:; , ;---k..---- bATE ,--,;I.,_..:kirc.?,..-,,..-„,;:t.-,,, ., - -.::-. "--...,- .,.-----.::T 1_,"- . :=7 t:-------,71, i.---- ,./-Z,,i7:,,-.'1..r,"- -N.. - !",, :- ,,,-- ,.:_,,,r.isittx7ICR. 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Cf::;:=': ..'-: , =± 14fttS; *::, -,..:. 72_7:-....T,..4.-,,,-_,T: 0 ' 7Z-:--r .<, 2,"-: , : ' e -.."itulit Tr ,-- Etc -, .. r"°'''' vilar-a-Fr.-- 1 . ?,3- A- . 1 4 • ...:14?';:,..--.1.,:---;-, .,.,,,,-.,,, i n Ia - R040 - .,-.,. „,7,i :. k ..11*1 1 1 11 ,7- _ -,7 7 ,,,,-, L .!- kp..- : , : :_ 2; : • ', ' .,:.:. - 34! 1 0 - ' ' 4 ” . . • .. . _ _3a421 1 ;, .:._, ' . ' '74'7''1‘ .'' ..1/4.:;,, ' . ' 4ita fts e i' z '... P *Rik. kk ,--,,,-:-.7,_ , !; - :1 - _ -- :_;?: 71.4 .'Z'; , ', ' ;7-'7--. 4- -i.,.; : --..-7.1--:_. ria;:;-_-, -.1-=N:f , ,- -i , it ----: - -_,--._-_: :1,,,•:...- t ---------,, .Z -:.1- :i: jrINC17-4tif,T7 •-•=';:=KIL-.......--"Zi=V ':,•7-..f-'-;"- AT:1 '' : .. , =st - .4k , :., '-r--:•k"'-:'::::,,,,.17,t;,,,,,,. ; ';_'1,;•::-Z ,:: ' '''t•-;-::•:-: . - .i-•:' :-.,f;':'-'1' :,.._•:7:7:• ..:=IT::-..x.„-'•-•', ''; ''.-- ' ''':---'s AMCMIZE - •.. :-- '.. ' 7''' -'';--1,..,:-'-• '''''''' — ---1 ANZ: '' ' F , k,le 4 ' • '::-*,..`',.''',.., L -72- 47, --- '• , ,'_ ' - ' i ---- -7,' ';-:',. ' --.-;---:---: ' z'r. -_-_„,- --,..;,- -;:-:,,7-:, • , ", ' -: '.....iii,1";': .- ' ' - - . f.,:s-V l-- - 1.7; N V , -.'17=7-Z -'•-•,.. , ,:-.-1.,-,... ,-4 : : :,.." . ':' . • , ',":.:'_27-: iteW;:f"---"' *--.1-! .,,' 3 . 1 ,... r 3 in c 1a 74• „.,..:--,, „.--;.., .,..,. 7--- ;:Z7;, - •, - .', • • '-'''' ,..'",--::::..,-,.7-‘,--- ' ". ,"#-•-.4!" ' ,,,.4.' m* ' e kw- sr uw -0. ' i , t ire, 3 0001,1 4 r ill -,..-7,,,r,,--,,.-:-': .•, ,-"- ,-. - 0.4 s a a ilf,.- .,-, --,.....—_,........._---- to u . , . .. ....... . . • _ - - CHANGE ORDER No. 1 Date of Contract 0 . 3 - / -d' / Date 3 - a / 0 1 Owner Name: ca/ l liM3 4 Property Address: ij/ q t dtt //a e D Contractor Name: 574n c/a 0/1 151=! re 5 t Contractor Address: ,x 4e Wing 17C� / t/ Y / �G . Y 2 7 7 Phone Number / 95 Description of Work Change: AMOUNT:. CATEGORY:. (Please Type) n 1/R C • - tivg. c S 1--eq k,'i Mucil fr oil Per A ��e �P 7Z Mws1 ace op/11- f fI -i )n c3Uf �'�De cc House Nlc&S7 f3e f e/%1A Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contrail dated first above, parties have hereunto set their signatures. $ 4 -232 Contract Price / +or. $ ,3S /G, Change Date 3 " $ 7�� Tot1 Group # / Reg # 7 Amount Date: y - ln ' I OwnerApproval: Approval / Date Contactor Approval: . Date: Approval / Date T a t Rehab Specialist Appro _�� / � , / Date 3- ( Approval / • = -� - , Program Administrator Approval: OM Date: - 3 - 0 ( ' I Source of Funds: $ 3 $ Contingency Owner Contrail Copy. Owner, Contractor, Loan file, Technical file, Financial Institution (If contrail price changed) • Categories of changes: 1. Hidden damages p I D 2. Time extension 3. Deletions of non - required items or unusual allowances 20t]1 4. Required items that were missed on initial inspection MAY 1 5. Equal substitution of material or alternative cure for deficiency at same or lesser price .��,,,, 6. Totally unforeseen circumstances arising after commencement of work CK # • CHANGE ORDER No. Date of Contract 03 - 0 7' / Date 0 9 u Owner Name: C Q/ V L y /1 U4 Property Address: /4 y/C RD Contractor Name: ,S 4/ y 1 YM ELJ ` 6 <617? C f : ,h � /, Contractor Address: 3 t 7t4 , /e W;n9 Rn re f r -�. 50 Phone Number T 7 Description of Work Change: AMOUNT: CATEGORY: (Please Type) kt eti 5inK 114e )145 cao,P ed Ve awl 5e v t kioe. 4 ptovihinD M use Qc Eef Aced. inla 54 €r Drain Nas No Nap 1 alici MIL be atitad ) main5etveicine N S4 /` 1944 `askie Dori 9()cl S 400/rf' Diaz is sum Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first above, parties have hereunto set their signatures. $ W 93. Cantu Price +or - $ Otf, Change $ 17 99 ? Date ■3 - a / A G roup # / Reg # / PO x5_45 Owner Approval: (3.4.41,4 � ,.t -e-�►� Date: Contractor Approval: � : a q -c 9 - o / Amount d� IX ,00 Rehab Specialist Approval: ��0 _ Date: �"" O/ Approval / Date '< -, Program Administrator Approval: tI - ( Approval / D- of Date: Ap• • - • Source of Funds: $ $ $ Contingency Owner Contact Copy: Owner, Contractor, Loan file, Technical file, Financial Institution (If contract price changed) Categories of changes: 1. Hidden damages 1 2. Time extension p 3. Deletions of non - required items or unusual allowances 4. Required items that were missed on initial inspection NIA S. Equal substitution of material or alternative cure for deficiency at same or lesser price mg(0 9 6. Totally unforeseen circumstances arising after commencement of work P1 CK #��' - CHANGE QRDER No. 04 Date of Contract o3 �C 7- v ( Date o G ‘/-6 Owner Name: Ca 01 [? e7 � . Property Address: 9 P/ -.-- R Contractor Name: j /;1/1 7L EVae'- -- C(/ Contractor Address: 3 /77 r ;le 11" ;n� I / Phone Number ? 476.-- V 1 - Descrintion of Work Change: � AMOUNT: CATEGORY: (Please Type) TL'( /� .� 1/(1)26D IA/°/i L Peftgee POH"C --6 Af n rack!' 13 ak/Wwi 4/0( ((d We will 71 (e aa t° 71Z9 0 e Me n if ma Sir Bql - /- /tor Je/ . c o rrCcf f'» /-e ri . Ilia ke-f-tie 1\11aS1et Dag 51 flier sM i( , SUM Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first above, pries have hereunto set their signatures. $ /4 -- Contract Price 41- 14 3 + or - $ a/ * Change S e) $ 1 0/3 V . °� Total 2-0. ` Date / s' 3 -01 Owner Approval: , ~4... / Date: OF) rysi45- Date. 0 y- �� Ol Group r, / Rog # # of Contractor Approval: �_-_ — / a 1 50o , DO Rehab Specialist Approval: / .sl / a Date: 5 3 / ,`l Date: .r` 3 _0) APProvCI i Dote Program Administrator Appro • a • Approval / Date ' S7-77 Source of Funds: $ $ $ Approval / Dat 6 . Contingency Owner Contras / Copy: Owner, Contractor, Loan file, Tedrnic l file, Financial Institution (If contract price dranged) / Categories of changes: 1. Hidden damages ID 2. Time extension PA 3. Deletions of non - required items or unusual allowances 4. Required items that were missed on initial inspection MAY 0 9 2001 S. Equal substitution of material or alternative cure for deficiency at same or lesser price 6. Totally unforeseen circumstances arising after commencement of work CKIL , t r CHANGE ORDER No. 3 Date of contact e 3 -0 7 " G / Date C Gf — 0 7 Cl Owner Name: f cal /7 l am / " a i Property Address: Vi‘ Z Contractor Name: / l/ln ,S /' TU l . /t/C C,'C�/ /e s" 3� " Contractor Address: 3 977 1 =-' ` /k i-J/` / 9 "(2 Phone Number ‘ - Description of Work Change: AMOUNT: CATEGORY: /� (Please Type) 1 t .6 s. -6- y /ei c R ' Se/' /jCC �.1cm 5vj W OM Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first above, parties have hereunto set their signatures. $ �l .9 �Contact Price Oj 14 ? 3 + or - $ 1 A Change f 0 ° $i r/ - 39 93 -‘ 1 Total c 3 / Dat f S-3-0/ Owner Approval: Date: Group # / Roq # / PO # )5� 45 Contactor Approval: _ _--., Date: A IYI o 1.8 f :'7 __ I, t Rehab Specialist Approval AP Date: 4 / '"3O -0/ Approv; i / G :to Approval;,- /_ ........./ . Program Administrator Approval: di ___ _ Date: 11— 30-40r Approval / Dates Approval / • �� it; , Source of Funds: $_ $ $ Contingency Owner Contract Copy. Owner, Contractor, Loan file, Technical file, Financial Institution (If contract price changed) RECEIVED Categories of changes: APR Hidden damages APR 3 Ti : -" t D 2. Time extension 3. Deletions of non - required items or unusual allowances 4. Required items that were missed on initial inspection AfP D pr. Av 0 Q 2001 O �� 5. Equal substitution of material or alternative cure for deficiency at same or lesser price Nt 6. Totally unforeseen circumstances arising after commencement of work CK # ..-:= •n w k 800 SEMINOLE: P. _ N I JMBE f r� - DA �y • s f :: - : \ " .. �It ��' r, -- _ LAY' - _ - -: � � _ . �'- -- •' -, :, L- ...'- :-'.-. -:::-*..---:,-''.-1,''.,..','::::.1.:,".7.1.:7:•'.. '.....i.f,:-;:;..-:':::--?;.-:-...:::';;;1_;:.:::;;;:.1.1.:::.:::::...:'.:::'-:,' .. --:, - -'; . ' .... , ;.,:. - . VENDOR * . DATE NEEBEE TERM NE fl • r _ kk - • Accts N t E ti'�"` 6.141-:. .'.� Hex : QUAN ; UO f TEM NO. A ND: OES�.Ff l3.' - i T C OS T 7 + ' '. :.: a1�'�irA k�lWct k , *,,k;l *4ii * AU b** *air : z - k. ' 177"" iS. 7�' SE''" ';!".''�": ' " ' ` ,. 523, L E,. � .- , L. r"T A 1 - . . 1. !". 3' _zit ' ac� ' ! ' ELL --. t - _ + qty yw}�,... {�, _ `�" f < • J4 i5 :'9 !!L, 4 '. t E. . �; . c. • s 5 D L ' - ?5t SAT.FI ',a fRi1. 3 a • • s �# SA 0 O ° : 1 _0 1 rh o t 8 . ` 4 a 1 , 2O I. + . 351 Q CAP GA -�' Et..: ° R Y4 ' '.. .. . '%. ENT AC1 OU ...I Vi " _ � • • 3 } ' Q `. D L CC nyy HkP&G E . . -1- r EX- D' -''',. - :' fl ,� p f !...'••• c � A .. tiT : � � e ELE . AOttvE PA CKING. S Cr EASE PURL iAfSI e B!!t S OF E.AtF�ING• AND. COR tES NDENCE FEDERAL. TA JEW-. S 841 E QRDE t [ n ET f A ORS. STATE TAX EXEMP 16139 - 40. PI RCfAS G E S I JRE ETIR SE ORO !S VOID O NEw V E 3 s' ' LATE. NC _ e01TAOt'NQ: Fax : 9047799323 Apr 13 '93 11 :39 Sun Sta ores, Inc. Lic # CGC 060939 7534 103rd Street Jacksonville, FL 32210 (904) 908 -4000 Mrs. Pittman 464 Irex Atlantic Beach Fi. Change Order: Scope of work to be performed. 1. Repaint and Repair 1,ivinb Room, Dinning Room, and Entrance Way 2. Paint Eve, Fascia, and Sofits 3. Take Down Wall Paper in Hall Bath Room and Repaint Entire Bath Room. 4. Take Down Wood Shelf Total Cost: 54,115.00 CHANGE QRDER No. -7 • Date of Contract 03 - 0.7 ( Date 63 3 Q� / r O Owner Name: CO / (;)/ y (l !� Property Address: L/ 7 /�-- e Contractor Name: 6 ct i ,< S 7 7 ! 1, ' rri rC C 1i / r $ tic Contractor Address: 3W 4/ / /9 1/) G',77 307- 7y Phone Number 9475- " Description of Work Change: AMOUNT: CATEGORY: (Please T J i -,0/.0/4))//) cede pef we will e s h, Il [,4,/ a6I1 DM (0 title .(1 ictikcile/1 s //7 P(ol; (1, a c e.4A ea - p( , ,1 SUM Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first above, parties have hereunto set their signatures. 1 az $ / ) 0 " �' Contract Price + or - $ E 6-9 �- Change $ � s Total t / 4 / ! /� Date: Owner Approval: \--C 1.t, ✓ • / ; I Contractor Approval: • Date: _ Rehab Specialist Approval: ' Date -- . Program Administrator Approval: Date: Source of Funds: $ $ $ Contingency Owner Contract. Copy: Owner, Contractor, Loan file, Technical file, Financial Institution (If contract price changed) . 'dden dama;es 2. 'Time extension 3. Deletions of non - required items or unusual allowances 4. Required items that were missed on initial inspection 5. Equal substitution of material or alternative cure for deficiency at same or lesser price 6. Totally unforeseen circumstances arising after commencement of work CHANGE ,ORDER • �± No. / Dat of Contract G 3-07- C/ l Date Owner Name: CG (G/ 4 P/ �/ i ta I3l q Ic e Property Address: �J / Contractor Name: Sass e7 53 7 Ci S G1/ " e' Contractor Address: 7C / I Jk ]'hone Number / ' e ) Description of Work Change: AMOUNT: CATEGORY: (Please Type) i?erof i� f a nJ RCIA ;r '(//4 � �� l�iwii <9 �I � ot4I Ili/Pc/lee b (-./ fa i ,i> t ve cx4d p Gait j So ee /L;n t /o/ gq (e i tGr t e Po w/1 14.2,e 5 et ea a e' • � dl fia(f fDIfC4 ,� SUM Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order is made a part of the contract dated first above, pasties have hereunto set their signatures. $ '' (/ L� 3 Contract Price + or - $ ' 3 / 1 :7 Change eti $,740/ 0 3O 3 Total Owner Approval: A., '` s i:. a ; I t Imo Date: , S" -- 3 0 '.-1 Contractor Appro . • j 7 - 0 C • r Date: Rehab Specialist Approval: / 4 ! Date: _ C Program Administrator Appro .: (WAN Date: Cs - e -01 Source of Funds: $ $ $ Contingency Owner Contract Copy: Owner, Contractor, Loan file, Technical file, Financial Institution (If contract price changed) Categories of changes: 1. Hidden damages 2. Time extension 3. Deletions of non - required items or unusual allowances 4. Required items that were missed on initial inspection 5. Equal substitution of material or alternative cure for deficiency at same or lesser price G. Totally unforeseen circumstances arising after commencement of work PROCEED ORDER DATE ? - 0 ` TO: Sunstate Enclosures____ This is to authorize you to proceed with work specified in our contract dated — — - for improvement work on the property located at - . The amount specified in the Rehabilitation Agreement is $ 1,5 OY:3 . Please proceed in accordance with the Contract. l You are to commence work no later than _ 0 3 - G ( - -- All work shall be completed according to the Work Write -Up, plans, Change Orders, Addenda and Specifications within Sixty (60) calendar days after starting construction. Si J3lci Q1 Name(s) of Owner(s 1 1) (Owner's Signature) (Owner's Signature) ADDRESS: (Local Pu. is Agency Representative) Copy: MAP SHOWING BOUNDARY SURVEY OF LOT q BLOCK 1 i AS SHOWN ON MAP OF AT 0 f=' PA—it.--r or g- O V Ad - • P L..r %'5 L, h--1 rr Tk. 0 .4.r AS RECORDED IN PLAT BOOK 3 I PAGES o ' OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA CER T7FIED FOR: C--u ..c..c_ .1 E . Ge -amt--r R-rr ,,.....s.. —L. Fi_...s-r .o- - -- , c...s., 77,-,_e_ c' tS. C-o . J 5os -G s-' OS (So sr-kJ e. 1 / 1 P q L-6 --........... / , 1 LJ 0, ° I(v'OZ tti_J 80. cc, -S . °' • x " 7 .1 y ° a/ ,O V- T�1G_..• Ffsnn•T 4 -�G.L, F- % 4 it CS � `0 . .,H z_.1 AD w1 Wi ri, ;, • 4 Z.,44:. p 6 � (1 ti o � ^ .b.0 K ! 0 ,1 8 . m 7-.:t- 4 zR a 9 1„ t o 1 :p�, 5 cn ' f. 0 J �n . 0: r..'a ' d • � 3%g-, 1 ° d d t .---41I q--t o �co ' o -e,. ' e. so. co5'_" . RECE FEB 2 1998 ( r--.. k.,,, �.o•..c) City of Atlantic Beach ( G° - ' ( v -' Building and Zoning NOT VALID UNLESS EMBOSSED WITH SEAL OF THE UNDERSIGNED. BEARINGS BASED ON f ( `"---- 1 LINE AS SHOI 1 THE PROPERTY SHOWN HEREON APPEARS TO LIE WITHIN FLOOD HAZARD ZONE )4 AS SCALED FROM FLOOD - -- �. A - i -,_on • • CITY OF ATLANTIC BEACH PERMIT APPLICATION REMOD.eL, ADDITIONS, OR ALTERATIONS MOVING, DEMOLITIONS Owner : Ca ro l y4 Slake Job Address: '7G G/ 7 Aux Q D Phone: cfF6a Lot # I Block or Unit # // Subdivision: byZ Pa //15 /4n,/ 2M Contractor: 3 4 fl SfCtf�1//G /o$k/ fG State License #CGC 0 6093` Address: 3 Y» /,,// i it/iny (, Phone No: City Grc(ri9 e Palk State /( Zip Code Describe work to be done: f1' 4D A At) / e &7 -( Present use of building: Worn '2 Valuation of Proposed Construction:4 /S' 5'93 - Proposed use: (&s /p/eeyotin,/ Is this an addition? /V C If yes, what are the dimensions of the added space: ft. X ft. Will the added area be heated and cooled? New electrical (or increase),? New plumbing fixtures? A/0 New fireplace ? /Ve)New Heat /AC? JV SaBM =T =Rim (C) TWO (RESIDENTIAL) COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF CribibIENCEMENT, AND • OWNER /CONTRACTOR A,EFZDAVIT, IF OWIZER IS CONTRACTOR. Signature OWNER: Date: Signature CONTRACTOR: � Date: 0, -0 AS TO OWNER: Pl L Z -1 1:0 -7 37 - 3 77— =-;73- 213 Sworn to and subscribed before me this day of 2000. ♦_p — ` I r ` ` _ + y NOTARY PUBLIC AS TO COI T,T , Nptnirknic l',",01100 �' . .ln4 sa te, b fore me this c itz day or a-.c , 200$' 4 Come o 4 CC720781 NOTAR PUBLIC 1-44-j . .00/ . 0 # b vl Sg t TIC . + � rd t -e. i NI */ x 7 CITY OF ATLANTIC BEACH SPECIAL INVESTIGATION i ?1 4 12 (0 0 00 0 TO BE FILLED OUT BY COMPLAINTANT DATE Une, 4 iqq 1 ADDRESS 4)4 ---- t x R , 4 atv C. ,a-9 LOCATION • 4 Rim,s Aral COMPLAINT 11; r 41., a F 4 C 04,1_4 1 OS '111: . i £,' l a( r�1 ii A '. '1. ■ ' %.i%. _ _ ir' S ' L - o 1( , horn OWNER 0 PROPERTY 10C) .ra i i I O ) ii I. al nar ,` 0J( au oVkinr SIGNATURE OF COMPLAINTANT 4Ct ' 3- PHONE # FOR OFFICE USE ONLY DATE OF INVESTIGATION 112) 1 Ce 1 INVESTIGATOR t CONDITIONS FOUND ,rV , Q, u.2 ACTION TAKEN COMPLIANCE t.1111t. -,., .. e, NOTES: , k t" d4 �, f �ry )',4 1 Jr Ylll t,,,.,4 Building and Zoning 565522 MAP SHOWING BOUNDARY SURVEY OF LOT q BLOCK t % AS SHOWN ON MAP OF AT OG' (=>.•-tr,�T O iZ- OVA - -- PA`-r'S L.) , -_, IT Ti.,_1O .d.. AS RECORDED IN PLAT BOOK 31 PAGES''' 1 �C" OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA CERTIFIED FOR: C_ .r i___A E. C.� (t-so (.._-../ v .. 1" { Tr �. F c.__:s-r ,c.. Esc— , c.A.,� T-R ., ( G-o . 1...---1 -.N.. t--•• o tiL 'J OS tk.o Z E. _ A _ (8 LJ 0 1 ° U.., 0Z �1.....J So.to� 0 . 43 . • ✓ 0 a/ ,a �J T',C�• E'S -..- -r ' c�_ Zy� S J� _, t - -smi . (3t_s __ 4 : O Z Z �o.o di zLl•a iU % /'` te r, 1 o 0 • ... 3r6 d O - o --- --a \f • lj c7 .co ' oZ'' &.....-- So. toy RECEVE FEB 2 1998 [ r-,., y.-_. C_..oa•..c) City of Atlantic Beach (mac ' ` -( _i Building and Zoning NOT V-ILV UNLESS EMBOSSED N??N. SEAL OF THE U.NDER.SIGNED. BEARINGS BASED ON t -1 LINE AS SHOW THE PROPERTY SHOWN HEREON APPEARS TO LIE WITHIN FLOOD HAZARD ZONE )4.-... - AS SCALED FROM FLOOD �..-, A _ c-1 _ can NOTICE OF COMMENCEMENT TO WHOM IT MAY CONCERN: The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Description of Property L{G G( .. L 2 K /9 ' r :.9 Al T ' 3 2 33 General Description of Improvements /pi A -i T g- NEN g J..;oA,, i Owner AI 72-5 C PA- - A) i T T /"? Address: '- . r2 u � Owner's interest in site of improvements: /40 `/ Fee Simple Title Holder (if other than owner) /r _ Name /v/ Address Surety (if any) Address Amount of Bond $ Name of person within the State of Florida designated by owner upon whom notices or other documents may be served: Name QLJ is1 F/1 ' c_A2 1 r Y7 rt n - JJ Address qb /Z r9 Ai✓T7 .4 F 6 - In addition to himself, owner designates the following person to receive a copy of the Leinor's Notice as provided in Section 713.13(1)(F), Florida Statutes. (Fill in at Owner's option). Name 7/4' Address: Owner Sworn to and subscribed before me this day of , 19 9 cItte 1 Nota, .. RUTH E. YERKES Notary Public - State of Florida My Commission Expires Dec 15, 2001 Commission T CC702459 CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS MOVING, DEMOLITIONS Owner(s): S G n- 2 o L- yA) f ! 7'/✓( Address: 1 /1-E X k 1� r 6¢- M Phone: Lot # Block or Unit # Subdivision: Contractor: OI✓,'f_ 2 State License # A/b4- Address: Phone No: City State Zip Code Describe work to be done: E 6E 4-A/D /11 )9‹. -P Al I Z P , ti 7 (Ai 1TC_j- f L4v,J 2 2 7 kJ / /Ai ify, > ".1i S T ILL) LTJ2R Present use of building: /ZE ,J („e Valuation of Proposed Construction: i o v Proposed use: /JC Q Is this an addition? NC.) If yes, what are the dimensions of the added g space : ft. X ft. Will the added area be heated and . 1 cooled? ik)& New electrical (or increase) ? "AD QQP G I. N ew plumbing fixtures? AO New fireplace? »New Heat /AC? N P �F \c� G� r , ' O ,c SUBMIT THREE (COI RCIALLTWO SIDENTIAL) COMPLETE SETS OF PLANS, I •' NG SITE PLAN, 3i '1', ENERGY CODE FORMS, NOTICE OF COMMEN. v ' , AND OWNER /CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: a', - 1y ,y[! Date: c/2 f G I ' Signature CONTRACTOR: /t//41- Date: Sworn to and subscribed me this / 62 day of , 194 RECEI\D 2 Ft! 1 99a NOTAR PUBLIC STATE, OF FLO IDA AT LARGE o f Atlantic Beach ! RUTH YEtKi:$ City and Zaning I Notary Public - State of Florida �31�il I My Commission Expires Dec 15, 2001 Commission * CC702459 1 ,p CITY OF `; Sea �C � 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 -5445 \1 � TELEPHONE (904) 247 -5800 AR FAX (904) 247 -5805 SUNCOM 852 -5800 CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REQUIRES OWNER /BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489. 1 03(7), FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH 15 IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER $2,000) SE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES; OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS SE UNDER "DIRECT SUPERVISION OF THE OWNER, WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS. SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY CLEARLY PROTECTS THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND /OR FORM 1 099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE No. 455 - 228(I ). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA. "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247- 5826) IF IN DOUBT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER PERMIT. PROPERTY 0 ER /BUILD 1 -( (.0 ir /i iZ )q(' e,5- 24 , ADDRESS TELEPHONE SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF 1 92 'K F ar NOTA' Y PUBLIC NOTE: PHRASES UNDERLINED ABOVE MY COMMISSION EXPI S: • ARE EMPHASIZED BY THE BUILDING DEPARTMENT. Lk.; 14J9 City of Atlantic Beach, Florida 800 Seminole Road Atlantic Beach, Florida 32233 -5445 Telephone (904) 247 -5800 Fax (904) 247 -5805 Suncom 852 -5800 HOMEOWNER/CONTRACTOR REHABILITATION AGREEMENT This Agreement dated this the day of 2000 is between located at and Carolyn Pittman Blake , for the construction of property improvements at 464 Irex Road, Atlantic Beach, Florida 32233. Whereas, the Contractor is in the business of residential construction and is willing to provide such services to the Owner and whereas, the Owner desires to use those services. Now, therefore, in consideration of the mutual covenants and promises contained herein, the parties hereto agree as follows: 1. SCOPE OF WORK. Contractor acknowledges that he /she has prepared the Contractor's proposal (attached to and made part of this Agreement) and that such proposal is accurate and consistent as to the name of Contractor, scope of work that the Contractor will undertake, and price. Contractor acknowledges the performance requirement established in the write -up and warrants that all work undertaken will conform to said specifications. 2. PROJECT DESCRIPTION. Contractor agrees to furnish all labor, materials, equipment, permits, licenses and services for the proper completion of the Project in accordance with the attached work write -up and specifications. Contractor guarantees that materials supplied will be as specified in the attached specifications and all work performed will be completed in a workmanlike manner according to standard trade practices. The Contractor will post at the job site all permits required to renovate the project. 3. HOLD HARMLESS. Contractor shall agree to defend, indemnify, and hold harmless the Owner and the City of Atlantic Beach. Florida from liability and claim for damages because of bodily injury, death, property damage, sickness, disease or Toss and expense arising from Contractor's performance under this Agreement to install or construct home improvements to be paid for out of the proceeds of the Owner's rehabilitation loan. Contractor is acting in the capacity of an independent Contractor with respect to the Owner. 4. LIEN WAIVERS. Contractor agrees to protect, defend and indemnify Owner from any claims for unpaid work, labor, or material with respect to Contractor's performance. Final payment shall not be due until the Contractor has delivered to the Owner complete release of all liens for work completed arising out of Contractor's performance or a receipt in full covering all labor and materials for which a lien could be filed or receipt of a bond satisfactory to the Owner indemnifying him against any lien. 5. CONTRACT AMOUNT. The Contractor shall be paid for the performance of rehabilitation work, subject to addition and deductions by approved Change Order, the contract sum of dollar's ($ ). 6. PAYMENT SCHEDULE. Payment will be made as follows subject to the Owner's acceptance of work complete: (a) Contractor shall submit a Contractors Payment Request form signed by the homeowner. Upon completion of 100% of the work, all funds will disburse. (b) Prior to issuing any payment, all work in place will be verified and approved as completed in accordance with all codes and program standard by the City. A partial and/or full release of lien must be submitted with each draw request. 7. CONDITIONS OF PAYMENT. The Contractor acknowledges and agrees that the City will not be obligated to make disbursements unless and until the following conditions are satisfied: (a) There is no default under this Contract, the Loan Agreement, the notes, or the Mortgages (as defined in the Construction Loan Agreement). (b) The City, or its designated agent, has received a completed request for disbursement in the form to be approved by the City. Such request may, at the City's option, be required to be accompanied by any one or all of the following: (1) Proof of paid and unpaid construction bills for materialmen and subcontractors which show full payment (except for holdbacks) of such bulls then due and payable, except those covered under the current draw request. (2) Lien waivers for all work and materials as required by the title insurance company for the issuance of endorsements, except those covered by the current request. (3) Any inspection reports, architectural certificates with respect to the stage of completion of the Project, and such other proof as the City may reasonably require to establish that construction progress has been made in compliance with the plans and specification. (4) The current status of accounts of Contractor and its subcontractors, materialmen, and laborers fumishing labor, materials, or services in the construction of the Project. (5) Advice from the City or its agent that all construction work already performed on the Project is in full compliance with the plans and specifications. (6) Advice from the title insurance company that a search of the public records discloses no change in the condition of the title to the Property which is unacceptable to the City. (c) The City will not be obligated to make the last disbursement unless and until it has received the following documentation: (1) Approval by local governmental authorities having jurisdiction of the Property or the Project that the Project has been completed in accordance with all applicable laws, rules, ordinances, and regulations. All permits must be final by the Building Inspection Division. (2) Advice from the City, the lending institution, or its agent that the Project has been completed in accordance with the plans and specifications. (3) Final lien waivers, Owner's and Contractor's affidavits required under the Florida Construction Lien Law. (4) A complete release of all liens arising out the Contract or receipts in full covering all labor, materials, and equipment for which a lien could be filed, or a bond satisfactorily to the City indemnifying the City against any lien arising under the Florida Construction Lien Law in connection with the Project. (5) If applicable, a satisfactory Wood Destroying Organism (WDO) Report from a licensed pest control agency. 8. TIME OF PERFORMANCE. Owner shall provide written authorization to Contractor to commence work. Contractor agrees to start work within calendar days after receipt of a written Notice to Proceed. If Contractor fails to commence work within twenty (20) days of the date of the Owner's notification to commence, Owner shall have the right to terminate this Agreement. Such notice of termination shall be in writing. Contractor agrees to satisfactorily complete all work on or before (not to exceed from the date work commences). If completion is delayed for reasons beyond Contractor's control, Contractor shall provide timely notice to the Owner of the reasons for such delay. If such good cause is claimed by the Contractor, it shall be Contractor's obligation to substantiate his claim by adequate documentation. If Contractor fails to satisfactorily complete the work by the Completion Date (as extended, if applicable), Contractor shall pay to the City of Atlantic Beach as agreed upon, liquidated damages the sum of Per day from and after the Completion Date until the work is completed. In the event Contractor shall fail to complete work within the agreed upon period and fails to provide evidence of good cause for such delay, or abandons the Project, Owner shall have the right to declare Contractor in default. In such event, Owner shall be responsible for providing written notice to Contractor by registered mail of such default. If contractor fails to remedy such default within 15 calendar days of such notice, Owner shall have the right to select a substitute Contractor. If the expense of finishing the work exceeds the unpaid balance of this Contract, the Contractor shall pay the difference to the City of Atlantic Beach. 9. SUBCONTRACTORS. Contractor agrees that all subcontractors will be bound by the terms and conditions of this contract insofar as it applies to their work and that all the warranties contained herein shall apply to all work performed under the Contract, including that performed by Subcontractors. Contractor will furnish in writing to the City a list of all subcontractors proposed for the principal portions of the Project. Contractor will not employ any subcontractor to whom the City may have a reasonable objection, nor will Contractor assign this Contractor without the written consent of the City. 10. RESPONSIBILITIES OF CONTRACTOR AND SUBCONTRACTORS. (a) Contractor will supervise and direct the construction of the Project using his best skills and attentions. (b) Contractor will provide Owner with evidence that it has secured and paid for all licenses and permits necessary for the proper execution of the Project, and upon completion of the Project will provide evidence that all the work has been inspected and approved by the appropriate building officials. (c) Contractor agrees that ALL work shall be completed in a professional manner and shall be carefully inspected by him/her for completeness prior to requesting a final inspection. Contractor acknowledges that City of Atlantic Beach shall conduct one "final inspection" to create a short punchlist, if required, and one follow -up inspection. (d) Contractor will not employ any person(s) on the Project who are unqualified or unskilled in their assigned tasks or duties. Contractor will not allow any employee to work upon the job site who cannot perform his assigned tasks and duties in a professional manner. (e) Contractor will be responsible for the acts and omissions of all employees, and all subcontractors, their agents and employees, and all other persons performing any work on the Project. (f) Contractor at all times will keep the Property free from accumulation of waste materials or rubbish caused by his/her work. (g) Contractor will permit the City to examine and inspect the construction work performed under this Contract at any reasonable time. (h) Contractor will furnish Owner with the names, addresses and telephone numbers of the firms to be contacted for service to any appliances or other equipment installed or repaired on the Property, and guarantees and warranties covering appliances and equipment installed or repaired under this Contract. (i) Contractor will be responsible for the protection of all supplies, materials, equipment, completed work, and incomplete work at the job site during the Contract period. 11. RESPONSIBILITIES OF OWNER. (a) Owner will permit contractor the reasonable use of existing utilities such as electricity, heat, water and sewage necessary for the proper execution and satisfactory completion of the Project. (b) Owner will cooperate with Contractor to facilitate the performance of the work including the removal and replacement of rugs, covering, furniture and clothing, if necessary. Contractor will not be held responsible for damage caused by Owner or any occupants. (c) Owner will be responsible for the proper use and care of the Property, including all equipment and appliances. (d) Owner will confer with the City's authorized representatives prior to issuing instructions to Contractor conceming the work or changes to the work. (e) Owner will allow Contractor access to the Property during usual working hours on regular workdays (i.e., Monday through Friday, 7:00 a.m. to 6:00 p.m., and Saturday, 8:00 a.m. to 5:00 p.m.). Now work will be performed on Sundays unless agreed to by the Owner and Contractor. 12. RIGHTS OF THE CITY UNDER THE REHABILITATION PROGRAM. (a) Contractor will allow the City's authorized representatives to perform periodic inspections of the work while it is in progress to determine if it is proceeding in accordance with this contract. (b) Contractor understands and agrees that the City has the authority to reject work which does not conform to this Contract, local municipal codes, or adopted program or rehabilitation standards. (c) The participation of the City hereunder will in no way alter, amend, or impair the rights, duties and obligations of the Owner and Contractor to each other under this Contract. The assumption of any responsibility by the City in no way releases Owner of its responsibilities under this Contract, or transfers any responsibility to the City for the performance of the services to be performed under this Contract. (d) In consideration of the City agreeing to assist in financing the Project, the Owner and Contractor agree to indemnify, hold harmless and defend the City and its officials, agents and employees from and against all claims, actions, losses, damages, injuries, liabilities, costs, and expenses based upon injury or death to persons or damage to property arising out of, resulting from, or incident to this Contract, unless the same is occasioned by the sole negligence of the City. 13. CHANGE ORDERS. Except in an emergency endangering life or property, Owner and Contractor expressly agree that no material changes or alterations in the description of work or price provided above shall be made without a prior written order signed by an authorized representative of the City. The Contract Sum and the Contract Time may be changed only by a Change Order approved by the City. No extra cost will be paid to Contractor if it has neglected to evaluate properly the extent of the rehabilitation work. 14. PERMITS AND CODES. Contractor agrees to secure and pay for all necessary permits and licenses required for Contractor's performance and to adhere to applicable local codes and requirements whether or not covered by the specifications and drawings for the work, including any Contractor registration requirements. 15. INSURANCE. The Contractor and subcontractors will at their sole expense maintain adequate insurance coverage for liability and workers compensation as required by state law. Proof of such insurance coverage must be provided to the Owner and the City of Atlantic Beach Program Administrator. 16. WARRANTY. For goods and valuable consideration, Contractor hereby agrees to provide a full one -year warranty to the Owner, which shall extend to subsequent owners of the property to be improved. The warranty shall provide that improvements, hardware and fixtures of whatever kind or nature installed or constructed on said property by the Contractor are of good quality, and free from defects in workmanship or materials or deficiencies subject to the warranty contained in paragraph provided. Contractor and Owner agree, however, the warranty set forth in this paragraph shall apply only to such deficiencies and defects as to which Owner or subsequent owners shall have given written notice to the Contractor, at his principal place of business, within one (1) year from the date of Contractor's request for final payment. A seven -year warranty will be provided on the labor on all shingle roofs installed, with 20 -year manufacturers guarantee on the shingles. A five -year warranty will be provided on labor and materials on all built- up roofs. 17. REMOVAL OF DEBRIS. Upon completion of work, Contractor agrees to remove all construction debris and surplus material from the property and leave the property in a neat and broom clean condition. • DISPUTES. All claims or disputes between the Owners and it of or related to the work shall be decided by arbitration in R PUBLIC BODY construction industry arbitration rules of the American Arbitration 2 PUBLIC OFFICIALS. ain, unless the parties mutually agree otherwise. The Owner and ;es or agents, no member nit all disputes or claims, regardless of the extent of the work's ms or responsibilities with mcan Arbitration Association/Better Business Bureau unless the ter, shall have any :e otherwise. Notice of the demand for arbitration shall be filed in proceeds thereof, for work party to this Agreement, and shall be made within a reasonable time the Agreement. risen. The decision rendered by the arbitrator shall be final, and ntered upon it in accordance with applicable law in any court having stance provided under this the arbitrator's award is in a sum which is less than that which was ►mmission for the purpose by the Contractor, the arbitrator may award costs and attomey's sistance. ontractor. If the award of the arbitrator is in a sum greater that that settlement by the Owner, the arbitrator may award costs and ion to, and not in limitation or of the Owner. subsequent owners, may of title, delivery of KICKBACKS. Neither the Contractor nor any of its officer, e Owner and shall be ants, representatives, employees or parties in interest has in any e contrary contained in red, connived or agreed, directly or indirectly with any other Bidder, mit a collusive or sham Bid in connection with the Contractor for id has been submitted or to refrain from bidding in connection with rtes Government or its in any manner, directly or indirectly, sought by agreement or ned on the Property. The cation or conference with any other Bidder, firm or person to fix any States, or any of their ►st element of the Bid price or the Bid price of any other Bidder, or to ments, papers, and ollusion, conspiracy, connivance or unlawful agreement, any !rant or loan program for e City of Atlantic Beach or any person interested in the proposed ;criptions. All such records e or prices quoted are fair and proper and are not tainted by any letion of the Project. connivance or unlawful agreement on the part of the Bidder or any tatives, owners, employees, or parties in interest, including this ants and represents that it nd Contract General that the work to be and provisions of each of s of all applicable ms hereof): CONTRACTOR AND OWNER HEREBY ACKNOWLEDGE ACCEPTANCE OF THIS AGREEMENT: Owner Date Owner Date Address of Property to be improved: 464 Irex Road, Atlantic Beach, Florida 32233 Contractor Date Address 1 11'0 • °' 251 , 0'10 1 711 1 51 4'1 51 171 01 1 f r- 5 i —I v _. _ — 0 N T ,o m 1 z 0 ro fl o 4 [oo P-Li.1 K I q 11'9 a � I 1 ._ r ` ... _... -.. — — L v Y !; A 12 i .{ 1*, tt 7 Hi �j t.-- z11 n b O X 3 I v 5 r. rn E ,_ 1 ri i ° P : g 4 3.1 c zit If z i Ci j -1 i t —‹ -1-- i irt r 3 1 t ... c..) a t i 3. b m 1 F7 i — — tan , r x 35 I Z �i °'" _1 70 n m x m • S.