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Permit 193 195 Jackson Road
CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 C E R T I F I C A T E O F O C C U P A N C Y P E R M A N E N T Issue Date 2/05/03 Parcel Number 172129 -0100- - Property Address . . 183 JACKSON RD ATLANTIC BEACH FL 32233 Subdivision Name . . . Legal Description . . . Property Zoning . . . TO BE UPDATED Owner LYLES, THOMAS Contractor H,H, & A CONSTRUCTION Application number . 02- 30022781 000 008 Description of Work . TWO FAMILY RESIDENCE Construction type . . Occupancy type . . . Flood Zone Approved Building Official VOID UNLESS SIGNED BY BUILDING OFFICIAL r ., • R PROPERTY S� k L aa L j PTION Zc'7 6 Pt'�6� 4 -� i,-0 Lot # 13 T v, t x 1 Section #_ ' elIt,'i Block # Subdivision: City of Atlantic Beach Eui:c:ng end Street Name S or Address: ' p �). � P D • DESCRIPTION OF WORK Flood Zone: (If in a FLOOD HAND ________area complete page 3) Brief Description NE(...) 06 Class of Work: R emodel /Additio . ZONING INFORMATION Type of Construction: Zoning Proposed District: Use: Estimated Value $ SD O�G 'cc' Exceptions or Variances Granted: Materials: 0Q Soli or Filled o Roof: Method of Heating: ' a ® �SS OWNER INFORMATION Property Owner: (, � /�c7DR �131 u Mailing Address Phone: 1-( 9 1 �' r- l. a Z1 p' • CONTRACTOR INFORMATION Contractor: . , l Mailin. Addres r : 4 Phone: 2- -C l 46 ( 9 . / �a • 1 A .Zip: or • STATE LICENSE NO: GE C 5 a �� Z (� 7 � () Expiration . Dat e:_________ � I HEREBY CERTIFY THAT I HAVE READ AND E BE TRUE AND CORRECT. ALL PROVISIONS OF THE EXAMINED THIS APPLICATION WILT BE COMPLIED WITH, L PROVISIONS SPECIFIED THE HEREIN AND ORDINANCES LAW D NOT. . THE GRANTING G GOVERNING NGD HIS TYPE THE O W R O I PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF RULES, REGULATIONS, ORDINAIO, OR RANYIFG OF OF A PE ANY FEDERAL, STATE PERMIT DOES NOT CONSTRUCTION OR THE. PERFO LAWS IN ANY MANNER, INCLUDING THE GOVERNNI NG G LOCAL OF ISSUANCE OF THIS PERMIT IS CONTINGENT UPON THE ABOVE INFORMATIONTBEING TR CONSTRUCTION OF THE THAT THE PLANS I UNDERSTAND THAT THE AND SUPPORT G DATA HAVE BEEN OR SHALL BE PROVIDED AS REQUIR�D CORRECT AND Owner Signature / '— DATE ' , • Contractor Signature ...,A,,_ 4 .,ab DATE • SWORN TO AND UBSCRIBED BEFORE ME BY OF ' �r3'9 THIS _LI__ aa DAY 4 " °p ANNALS L MASS a:114.4k.a.1- ' ''04 ten► sretaaRode. L ___I-- . , - 4 My crown. expires AO 8.2°93 NOTARY PUBLIC • it Cram Na CC 824855 tJ `6. ,z . 4.�, „r 1, a 1. ,ti ' � PROPERTY j R � r DESCRIPTION 2 6 Pcr fit' O Lot # 1 ✓ # Section # T J� Subdivision: n City of Atlantic Beach B52i!%a:rg end Z9 r1)114 Street Name 11C z � /y DESCRIPTION OF WORK or Address: /'p�s0�'� �Q (If in a FLOOD HAZARD .Flood Zone: area complete page 3) qq 11 _� Brief Description PI.tJ �OR-I Class of Work: (New/ Remodel /Additio • • ZONING INFORMATION Type of Construction: 77f7 Zoning Proposed • District: Use: 12-(5-10. Estimated Value $ Odt, . c Exceptions or Variances Materials: �� G , Granted: �oN �� (' Sol un d: i or Filled ,{� o Gp ,JG� Roof: I.JC5c)W (-4)-3 Method of Heating: ,, 1 OWNER INFORMATION c Property Owner: T AilAY 41 lez_ eS v� 6- 0� Phone: : u Mailing Address [ / 0 Lb /eDLLe_A RD, h. E c-L Zip: 3 z z ?3. CONTRACTOR INFORMATION Contractor: / Mailin. Address �� �'"`^ Phone: Z _ C� ■ • s A • f Zip: , 1 i f , 2z z 3_ STATE LICENSE NO: CO 7 7,r(3 Date: J Date: 0 G �2 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF THE LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH, WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY FEDERAL, STATE OR LOCAL RULES, REGULATIONS, ORDINANCES, OR LAWS IN ANY MANNER, INCLUDING THE GOVERNING OF CONSTRUCTION OR THE. PERFORMANCE OF CONSTRUCTION OF THE PROPERTY. I UNDERSTAND THAT THE ISSUANCE OF THIS PERMIT IS CONTINGENT UPON THE ABOVE INFORMATION BEING TRUE AND CORRECT AND THAT THE PLANS AND SUPPORT G DATA HAVE BEEN OR SHALL BE PROVIDED AS REQUIRE, • Owner Signature . �` I g� f �2 DATE ) i 6 Contractor Signature .1&* DATE , O O �p{{{ �2m � CRIBED , BEFORE ME BY THIS / iti DAY ,�NOi�OB 04'' ' ANNALEE L MAW. CLRA,uutU, L �. Notary Pubic, State of Aod& r: � � NOTARY PUBLIC 6 Y calm altpiios 8. • A t Com. No. CC 824855 I • , JOB ADDRESS 1 ilif•P' 1 (-1 TYPE WORK - C■ ( PROPERTY. OWNER' filN1 EL, .12,5 TELEPHONE c) ‘ ‘I 1.44 CONTRACTOR - 41iViaj'a4,;,;hUi TELEPHONE c: I • . t ) (../). PERMIT NUMBER ga? DATE /0 e INSPECTIONS: FOOTING SLAB TIE BEAM LINTEL NILING/SHEATHING "11 FRAMEVG/COVYR UP 9, Li INSULATION '11 F1NAL BUILDING D-7--- CERI1FICATE OF OCCUPANCY Noit FT RCTRICAL PERMITli R c I QI - 0 -‘ °1 (- 56 3 / 613 /( 9-31 `H INSPECTIONS ROUGH' sc h 0 1- -- ThvAL, 1 0 MECHANICAL PERMIT# c? 5(2 36) I e.- INSPECTIONS ROUGH 41 ) 11-1 FINAL 0 2. - • PLUMBING PERAIITII ) - LVSPECITO1VS ROUGH/UNDER SfAB 5 1 4 '6 02/ TOPOUT WATER/SEWER FINAL 1210;-7-- NOTES: . _ _.. _...... r nt I_ UL S t.JohnsRiver ��� La . ', am, Water Management District • Kirby 8. Green III. Executive Director r John R. WYNO. AECiGfent 6xCUliae Director („QN--r Post Office Box 1429 • Palatka, FL 321 78 -1 429 • (386) 329.4500 j �tr� /�r��' REGULATION OF STORMWATER MANAGEMENT SYSTEMS I�(/� CHAPTER 40C -42, F.A.C. PERMIT NO. 4g- 031 - 71695 -1 DATE ISSUED:Auaust 14, 2001 A PERMIT AUTHORIZING: A new stormwater system with :stormwater treatment by dry detention with underdrain to serve LaBahia DeLas Palmas, a .59 acre project to be constructed as per plans received by the District on July 16, 2001. LOCATION: Section(s): 17 Township(s): 2S Range(s): 29E Duval County ISSUED TO: Tommy Lyles 13925 Hunterwood Road Jacksonville, FL 32225 This document shall serve as the formal permit for construction and operation of stormwater management system in accordance with Chapter 40C -42, F.A.C., issued by the staff of the St. Johns River Water Management District on August 14, 2001. This permit is subject to the standard limiting conditions and other special conditions approved by the staff. These conditions are enclosed. • This permit is a legal document and should be kept with your other important records. The permit requires the submittal of an As -built certification and may require submittal of other documents. All information provided in compliance with permit conditions should be submitted to the District office from which the permit was issued. An As -built certification form is attached. Complete this form within 30 days of completion of construction of the permitted system, including all site work. . Upon receipt of the As -built certification, staff will inspect the project site. Once the project is found to be in compliance; vith all permit requirements, the permit may be converted to its operation phase and responsibility transferred to the operation and maintenance entity in accordance with Chapter 40C-42.028, F.A.C. o V Cw NINO WilUem Koff, 0+4a1MmN Omelrlaa D. Lone. tp.aIRMAN Jeff KI Janntnea. eacapam Mama ONtenstroar, Tala:uaEN %% MOUf NE MAGI ' OWA NAMANO JACKSONVILLE Mn T. Moore Michael Branch Catharine A. Walton, Cray Albrlpht Oavin G. Graham maWOy reaN,u.gaa M,T.woNN; sPnrgs CART wtc wa.a .MOKRONraLE uui iUf LUU. lulu 704 /JCI 51 JUHN I11VER JACK PAGE 03 Permit issuance does not relieve you from the responsibility for obtaining permits from any federal, state, and/or local agencies asserting concurrent jurisdication over this work. Please note that if dewatering is to occur during any phase of construction or thereafter and the surface water pump(s), wells, or facilities are capable of withdrawing one million gallons of water per day or more, or an average of 100,000 gallons per day or more over a year, and any discharge is to be off-site, you must apply for and obtain a Consumptive Use Permit (40C -2) from the District prior to starting the dewatering, Please contact the District if you need additional information or application materials. Permittee agrees to hold and save the St. Johns River Water Management District and its successors harmless from any and all damages, claims, or liabilities which may arise from permit issuance. Said application, including all plans and specifications attached thereto, is by reference made a part thereof. This permit does not convey to Permittee any property rights nor any rights or privileges other than those specified herein, nor relieve the Permittee from complying with any law, regulation or requirement affecting the rights of other bodies or agencies. All structures and works installed by Permittee hereunder shall remain the property of the Permittee. This permit may be revoked, modified, or transferred at any time pursuant to the appropriate provisions of Chapter 373, Florida Statutes. In the event you sell your property, the permit will be transferred to the new owner, if we are notified by you within thirty days of .the sale. Please assist us in this matter so as to maintain a valid permit for the new property owner. Thank you for your cooperation, and if this office can be of any further assistance to you, please do not hesitate to contact us. Sam C Wilson, SuPs sing Prof Engineer - Jacksonville Department of Water Resources Enclosures: As -built Certification :Form Exhibit A cc: District Permit File Agent: Connelly & Wicker Inc 1711 5th St S Jacksonville, FL 32250 _ _ _ _ �... v.. ...vv J 1 JIJI N♦ 1 \1 VC-IN pit." r 4 t by "EXHIBIT A" CONDITIONS FOR ISSUANCE OF PERMIT NUMBER 42 -031- 71695 -1 TOMMY LYLES DATED AUGUST 14, 2001 1. This permit for construction expire five years from the date of issuance unless otherwise specified by a special condition of the permit. 2. Permittee must obtain a permit from the District prior to beginning construction of subsequent phases or any other work associated with this project not specifically authorized by this permit. 3. Before any offsite discharge from the stormwater management system occurs, the retention and detention storage must excavated to rough grade prior to building construction or placement of impervious surface within the area served by those systems. Adequate measures must be taken toprevent siltation of these treatment systems and control structures during construction or siltation must be removed prior to final grading and stabilization. 4. The permittee must maintain a copy of this permit complete with all conditions, attachments, exhibits, and permit modification in good condition at the construction site. The complete permit must be available for review upon request by District representatives. The permittee shall require the contractor to review the complete permit prior to commencement of the activity authorized by this permit. 5. All activities shall be implemented as set forth in the plans, specifications and performance criteria as approved by this permit. Any deviation from the permitted activity and the conditions for undertaking that activity shall be considered a violation of this permit. 6. District authorized staff, upon proper identification, must be granted permission to enter, inspect and observe the system to insure conformity with the plans and specifications approved by the permit. 7. Prior to and during construction, the permittee shall implement and maintain all erosion and sediment control measures (best management practices) required to retain sediment on -site and to prevent violations of state water quality standards. All practices must be in accordance with the guidelines and specifications in chapter 6 of the Florida Land Development Manual: A Guide to Sound Land and Water Management (Florida Department of Environmental Regulation 1988), which are hereby incorporated by reference, unless a project specific erosion and sediment control plan is approved as part of the permit, in which case the practices must be in accordance with the plan. If site specific JUMI KlVtK J{al.K VA(* 0 conditions require additional measures during any phase of construction or operation to prevent erosion or control sediment, beyond those specified in the erosion and sediment control plan, the permittee shall implement additional best management practices as necessary, in accordance with the specification in chapter 6 of the Florida Land Development Manual: A guide to Sound Land and Water Management (Florida Department of Environmental Regulation 1.988). The permittee shall correct any erosion or shoaling that causes adverse impacts to the water resources. 8. If the permitted system was designed by a registered professional, within 30 days after completion of the stormwater system, the permittee must submit to the District the following: District Form No. 40C- 1.181(13) (As built Certification By a Registered Professional), signed and sealed by an appropriated professional registered in the State of Florida, and two (2) sets of "As Built" drawings when a) required by a special condition of this permit, b) the professional uses "As Built" drawings to support the As Built Certification, or c) when the completed system substantially differs from permitted plans. This submittal will serve to notify the District staff that the system is ready for inspection and approval. 9. If the permitted system was not designed by a registered professional, within 30 days after completion of the stormwater system, the permittee must submit to the District the following: District Form No. 40C- 1.181(14) (As built Certification), signed by the permittee and two (2) sets of "As Built" drawings when required by a special condition of this permit, or when the completed system substantially differs from permitted plans. This submittal will serve to notify the District staff that the system is ready for inspection and approval. 10. Stabilization measures shall be initiated for erosion and sediment control on disturbed areas as soon as practicable in portions of the site where construction activities have temporarily or permanently ceased, but in no case more than seven (7) days before the construction activity in that portion of the site has temporarily or permanently ceased. 11. Should any other regulatory agency require changes to the permitted system, the permittee shall provide written notification to the District of the Changes prior to implementation so that a determination can be made whether a permit modification is required. 12. Within thirty (30) days after sale or conveyance of the permitted stormwater management system or the real property on which the system is located, the owner in whose name the permit was granted shall notify the District of such change of ownership. Transfer of the permit shall be in accordance with the provisions of section 40C -612, F.A.C. All terms and conditions of this permit shall be binding upon the transferee. The permittee .,'-J N 1,1 vt -1N. rfUc. LJb transferring the permit shall remain liable for any corrective actions that may be required as a result of any permit violations prior to such sale, conveyance or other transfer. 13. The stormwater management system must be completed in accordance with the permitted and permit conditions prior to the initiation of the permitted use of site infrastructure. The system must be completed in accordance with the permitted plans and permit conditions prior to transfer of responsibility for operation and maintenance of the stormwater management system to a local government or other responsible entity. 14. The operation phase of the permit shall not become effective until the requirements of Condition No. 8 or 9 have been met, the district determines that the system complies with the permitted plans, and the entity approved by the District in accordance with section 40C- 42.027, F.A.C., accepts responsibility for operation and maintenance of the system. The permit cannot be transferred to such an approved, responsible operation and . maintenance entity until the requirements of section 400-42.028, F.A.C., are met, and the operation phase of the permit becomes effective. Following inspection and approval of the permitted system by the District in accordance with section 40C- 42.028, F.A.C., the permittee shall request transfer of the permit to the responsible approved operation and maintenance entity, if different from the permittee. Until the permit is transferred pursuant to subsection 400- 42.028 (4) F.A.C., the permittee shalt be liable for compliance with the terms of the permit. 15. Prior to lot or unit sales, or upon completion of construction of the system, whichever • occurs first, the District must receive the final operation and maintenance document(s) approved by the District and recorded, if the latter is appropriate. For those systems which are proposed to be maintained by county or municipal entities, final operation and maintenance documents must be received by the District when maintenance and operation of the system is accepted by the local govemment entity, Failure to submit the appropriate final document will result in the permittee remaining personally liable for carrying out maintenance and operation: of the permitted system. 16. This permit does not eliminate the necessity to obtain any required federal, state, local and special district authorizations prior to the start of any activity approved by this permit. This permit does not convey to the permittee or create in the permittee any property right, or any interest in real property, nor does it authorize any entrance upon or activities on property which is not owned or controlled by the permittee, or convey any rights or privileges other than those specified in the permit and Chapter 40C- 42.028, F.A.C. - •... - • 1 JUf IIV fcl VCR JNI.I\ rMl7C I7 17. The permittee shall hold and save the District harmless from any and all damages, claims, or liabilities which may arise by reason of the activities authorized by the permit or any use of the permitted system. 18. The permittee shall immediately notify the District in writing of any previously submitted information that is later discovered to be inaccurate. 19. Activities approved by this permit shall be conducted in a manner which do not cause violations of state water quality standards. 20. At a minimum, all retention and detention storage areas must be excavated to rough grade prior to building construction or placement of impervious surface within the area to be served by those facilities. To prevent reduction in storage volume and percolation rates, all accumulated sediment must be removed from the storage area prior to final grading and stabilization. 21. The operation and Maintenance entity shall submit inspection reports to the District two years after the operation phase permit becomes effective and every two years thereafter on District Form EN -46. The inspection form must be signed and sealed by an appropriate registered professional. • • • .... �..,. ......� .. . �... .. ....0 ucu. 1 Jljr11V f[1VGR Jtal I\ r'f-Ut fld Notice Of Rights 1. A person whose substantial interests are or may be determined has the right to request an administrative hearing by filing : a written petition with the St. Johns River Water Management District (District), or may choose to pursue mediation as an alternative remedy under Sections 120.569 and 120.573, Florida Statutes, before the deadline for filing a petition. Choosing mediation will not adversely affect the rights to a hearing if mediation does not result in a settlement. The procedures for pursuing mediation are set forth in Sections120.569 and 120.57, Florida Statutes, and Rules 28- 106.111 and 28- 106.401 -.405, Florida Administrative Code. Pursuant to Chapter 28 -106 and Rule 40C- 1.1007, Florida Administrative Code, the petitiop must be filed at the office of the District Clerk at District Headquarters, P. O. Box 1429, Palatka, Florida 32178 - 1429 (4049 Reid St., Palatka, FL 32177) within twenty -six (26) days of the District depositing notice of District decision in the mail (for those persons to whom the District mails actual notice) or within twenty -one (21) days of newspaper publication of the notice of District decision (for those persons to whom the District does not mail actual notice). A petition must comply with Chapter 28 -106, Florida Administrative Code. 2. If the Goveming Board takes action which substantially differs from the notice of District decision, a person whose substantial interests are or may be determined has the right to request an administrative hearing or may choose to pursue mediation as an alternative remedy as described above. Pursuant to District Rule 40C- 1.1007, Florida Administrative Code,the petition must be filed:at the office of the District Clerk at the address described above, within twenty -six (26) days of the District depositing notice of final District decision in the mall (tor those persons to whom the District mails actual notice) or within twenty -one (21) days of newspaper publication of the notice of its final agency action (for those persons to whom the District does not mail actual notice). Such a petition must comply with Rule Chapter 28 -106, Florida Administrative Code. 3. A substantially interested person has the right to a formal administrative hearing pursuant to Section 120.569 and 120.57(1), Florida Statutes, where there is a dispute between the District and the parry regarding an issue of material fact. A petition for formal hearing must comply with the requirements set forth in Rule 28- 106.201, Florida Administrative Code. 4. A substantially interested person has the right to an informal hearing pursuant to Sections 120.569 and 120.57(2), Florida 'Statutes, where no material facts are in dispute. A petition for an informal hearing must comply with the requirements sat forth in Rule 28- 106.301, Florida Administrative Code. 5. A petition for an administrative hearing is deemed filed upon delivery of the petition to the District Clerk at the District headquarters in Palatka, Florida. 6. Failure to file a petition for an administrative hearing, within the requisite time frame shall constitute a waiver of the right to an administrative hearing (Section 28 106.111, Florida Administrative Code). 7_ The right to an administrative hearing and the relevant procedures to be followed are governed by Chapter 120, Florida Statutes, and Chapter 28 -106, Florida Administrative Code and Section 40C- 1.1007; Florida Administrative Code. ...... • i iur- U 7 Notice 01 Rights 8. An applicant with a legal or equitable interest in real property who believes that a District permitting action is unreasonable or will unfairly burden the use of his property, has the right to, within 30 days of receipt of notice of the District's written desision regarding a permit application, apply for a'special master proceeding under Section 70.51, Florida Statutes, by filing a written request for relief at the office of the District Clerk located at District headquarters, P. 0. Box 1429, Palatka, FL 32178 -1429 (4049 Reid St., Palatka, Florida 32177). A request for 'relief must contain the information listed in Subsection 70.51(6), Florida Statutes. 9. A timely filed request for relief. under Section 70.51, Florida Statutes, tolls the time to request an administrative hearing under paragraph no. 1 or 2 above (Paragraph 70.51(10)(b), Florida Statutes). However, the filing of a request for an administrative hearing under paragraph no. 1 or 2 above waives the right to a special master proceeding (Subsection 70.51(10)(b), Florida Statutes). 10. Failure to file a request for relief within the requisite time frame shall constitute a waiver of the right to a special master proceeding (Subsection 70.51(3), Florida Statutes). 11. Any substantially affected person who claims that final action of the District constitutes an unconstitutional taking of property without just compensation may seek review of the action in circuit court pursuant to Section 373.617, Florida Statutes, and the Florida Rules of Civil Procedures, by filing an action in circuit court within 90 days of the rendering of the final District action, (Section 373.617, Florida Statutes). 12. Pursuant to Section 120.68, Florida Statutes, a person who is adversely affected by final District action may seek review of the action in the District Court of Appeal by filing a notice of appeal pursuant to the Florida Rules of Appellate Procedure within 30 days of the rendering of the final District action. 13. A party to the proceeding before the District who claims that a District order is inconsistent with the provisions and purposes of Chapter 373, Florida Statutes, may seek review of the order pursuant to Section 373.114, Florida Statutes, by the Florida Land and Water Adjudicatory Commission, by filing a request for review with the Commission and serving a copy on the Department of Environmental Protection and any person named in the order within 20 days of adoption of a rule or the rendering of the District order. 14. For appeals to the District Court of Appeal, a District action is considered rendered after it is signed on behalf of the District, and is filed by the District Clerk. 15. Failure to observe the relevant time frames for filing a petition for judicial review described in paragraphs #11 and *12, or for Commission review as described in paragraph #13, will result in waiver of that right to review. ....♦ -.V. J ■ NJLv. JI LVI n• 1 \1 YLI\ UMUI\ 1 I lU Notice Of Rights Certificate of Service I HEREBY CERTIFY that a copy of the foregoing Notice of Rights has been sent by U.S. Mall to: Tommy Lyles 13925 Hunterwood Road Jacksonville, FL 32225 at 4:00 p.m. this 14th day of August, 2001. A°P. LA 6 D' 'sio o - ermit Data S 4 s aria Lewis, Director St. Johns River Water Management District Post Office Box 1429 Palatka, FL 32178 -1429 (904) 329 -4152 Permit Number: 42- 031- 71695 -1 .+,.r vu „emu J 1 ,JUI 111 1 '.1 VLIN aJr1lN� r 1-R7G 11 Henry Dean. Executive Di4 Jahn R. Wefts. AseieteXI executive 011 :M P°, ° ° '" POST OFFICE BOX 1429 PALATKA, FLORIDA 32178 -1. TELEPHONE 204- 329.4500 1.900. 451 -7106 SUNCOAA 904 - 860.4500 TOO 904 - 329.450 T00 6UNCOM 860.4450 WATER ' FAX (8aeculiw) 32 epsq 9.4125 (L 329-4485 (Pem:mng) 329-4319 (Adm matwlv'Tnsnc.) 329- ;':,,. ":�c:...• . t;i•. SOMME CENTEaS IMMO Ei.77IEN d 6la E. eawh SVGA 777515arledews Way PERMITTING: OPERATIONS; DISTRICT 007467. Fluids 32601 gun 102 305 Ea600ye 2733 N, Wickham Mae :07.697.4300 .ra<a omaN. Raid• 32266 MslwN.. F7Ma 32901 Ms owns. P1a625 1- 677.329.1658 904.7361270 40746644944 407. 762,3100 FAX 407.657.435' 1.800.162 - 1563 1-100. 216 - 326' Too 407 - 7574102 700 407.1574110 PAX 504. 730 -5257 FAX 4 07.722 -4757 Too 9044 -»00 Too 4174 22.5305 Holders of General Permits Dear Permittee: Please be advised that the District has not published a notice in the newspaper advising the public that it is issuing a permit for this proposed project. Publication, using the District form, notifies members of the public (third parties) of their rights to challenge the issuance of the permit. If proper notice is given by publication, third parties have a 21- day time limit on the time they have to file a petition opposing the issuance of the permit. If you do Rat publish, a party's right to challenge the issuance of the general permit extends for an indefinite period of time. If you wish to have certainty that the period for filing such a challenge is closed, then you may publish, at your own expense, such a notice in a newspaper of general circulation within the affected area. A copy of the form of the notice and a list of newspapers of general circulation, usually used by the District, is attached for your use, however, you do not have to use only those newspapers listed. This publication need only occur once. Once the notice is published, the newspaper will return to you an affidavit as proof of publication. To complete your file with the District, submit this original affidavit of publication to: • Gloria Lewis, Director Division of Permit Data Services P. O. Box 1429 Palatka, EL 32178 -1429 Enclosed is a sample package used for newspaper noticing by the District. The package includes: 'Page 2 - A copy of an example notice that District staff uses is included to provide guidance on the language to be used in the notice. This language satisfies the legal requirements for noticing. `Page 3 - A copy of a sample notice to be published is also included. Complete this form with your permit information and submit to a newspaper of general circulation. "Page 4 - The name, address, telephone number and facsimile for newspapers • of general circulation are provided. This is the newspaper typically used by the District to advertise permits that are issued by the Governing Board. It f can be of further assistance, please contact me at (904) 329 -4235 or Mary McKinney at (904) 329 - 4400. • Sinc rely, c Gloria Lewis, Director • Division of Permit Data Services • WUIIem Koh, CHAIRMAN Ometrias D. Long, •OCE CHAIP1'AAN Jell K. Jennings secerrARV Duane Oltenstroer. rnEAsUP6 MEL50uaNE macs APOPKA AMMAN0 5WOtEau10 Dan Roach Revised $e ptember11/1Dt?De M. Segal Oils Meson Clay Albright Retd Hughes F6Ie4440,NAe(A614 Hipds/d3I / - otder5 of C46686yt • ST. AUGUSTINE 545T LAKE wig, 0wx/ONA 66AC4 ... v. ..r• . -.-.ua au • au Jug fJU uL1.Jf .71 ourui R1 VCR r r_ 1G - EXAMPLE FORM - NOTICE OF AGENCY ACTION TAKEN SY THE ST. JOHNS RIVER WATER MANAGEMENT DISTRICT Notice is given that the following permit was issued on 11/27/95: ACME HOMES CO., INC.,. 1201 W. 15 Street, Palatka, FL 32177, permit # 42 -107- 0001. The project is located in Putnam County Section 23, Township 07 South, Range 34 East. The permit authorizes A SURFACE MANAGEMENT SYSTEM ON 20 ACRES TO SERVE A SINGLE- FAMILY RESIDENTIAL SUBDIVISION known as Blue Meadows. The receiving waterbody is ST. JOHNS RIVER. The file(s) containing the application for the above listed permit is available for inspection Monday through Friday except for legal holidays, 8:00 a.m. to 5:00 p.m. at the St. Johns River Water Management District (District) Headquarters, 4049 Reid Street, Palatka, FL 32178 -1429. A person whose substantial interests are affected by the District permitting decision may petition for an administrative hearing in accordance with sections 120.569 and 120.57, Florida Statutes, or may choose to pursue mediation as an alternative remedy under section 120.573, Florida Statutes, before the deadline for filing a petition. Choosing mediation will not adversely affect the right to a hearing if mediation does not result in a settlement. The procedures for pursuing mediation are set forth in section 120.573, Florida Statutes, and rules 28- 106.111 and 28- 106.401 - .404 Florida Administrative Code. Petitions must comply with the requirements of Florida Administrative Code Chapter 28 -106 and be filed with (received by) the District Clerk located at District Headquarters, Highway 100 West, Palatka, FL 32177. Petitions for administrative hearing on the above application(s) must be filed within twenty -one (21) days of publication of this notice or within twenty - six (26) days of the District depositing notice of this intent in the mail for those persons to whom the District mails actual notice. Failure to file a petition within this time period shall constitute a waiver of any right(s) such person(s) may have to request an administrative determination (hearing) under sections 120.569 and 120.57, F.S., concerning the subject permit. Petitions that are not filed in accordance with the above provisions are subject to dismissal. Because the administrative hearing process is designed to formulate final agency action, the filing of a petition means that the District's final action may be different from the position taken by it in this notice of intent. Persons whose substantial interests will be affected by any such final decision of the District on the applicant have the right to petition to become a party to the proceeding, in accordance with the requirements set forth above. Revised September S. 2000 2 kI: /pds/data/Holders of General Permits . ,�.�.. ..r.v.. i rK7G 1J NOTICE OF AGENCY ACTION TAKEN BY THE ST. JOHNS RIVER WATER MANAGEMENT DISTRICT Notice is given that the following permit was issued on (Name and address of applicant) permit # . The project is located in County, Section , Township South, Range East. The permit authorizes A SURFACE WATER MANAGEMENT SY$TEM ON ACRES TO SERVE known as . The receiving water body is • The file(s) containing the application for the above listed permit is available for inspection Monday through Friday except for legal holidays, 8:00 a.m. to 5:00 p.m. at the St. Johns River Water Management District (District) Headquarters, 4049 Reid Street, Palatka, FL 32178. -1429. A person whose substantial interests are affected by the District permitting decision may petition for an administrative hearing in accordance with sections 120.569 and 120.57, Florida Statutes, or may choose to pursue mediation as an altemative remedy under section 120.573, Florida Statutes, before the deadline for filing a petition. Choosing mediation will not adversely affect the right to a hearing if mediation does not result in a settlement. The procedures for pursuing mediation are sot forth in section 120.573, Florida Statutes, and rules 28- 106.111 and 28- 106.401 -:404 Florida Administrative Code. Petitions must comply with the requirements of Florida Administrative Code Chapter 28 -106 and be filed with (received by) the District Clerk located at District Headquarters, Highway 100 West, Palatka, FL 32177. Petitions for administrative hearing on the above application(s) must be filed within twenty -one (21) days of publication of this notice or within twenty - six (26) days of the District depositing notice of this intent in the mail for those persons to whom the District mails actual notice. Failure to file a petition within this time period shall constitute a waiver of any right(s) such person(s) may have to request an administrative determination (hearing) under sections 120.569 and 120.57, F.S., concerning the subject permit. Petitions that are not filed in accordance with the above provisions are subject to dismissal. Because the administrative hearing process is designed to formulate final agency action, the filing Of a petition means that the District's final action may be different from the position taken by it in this notice of intent. Persons whose substantial interests will be affected by any such final decision of the District on the applicant have the right to petition to become a party to the proceeding, in accordance with the requirements set forth above. • Revised September 3. 2000 3 Hipds/datalHolders or Qeneral Permits uu /iur �uui lU. to 7U4-1.3U-0.40( 5I JOHN Klvt_K JALK t'Al7t 14 N EbWSPAPEA ( OSCEOL.A ::. • P. 0. Box 2831 Little Sentinel Daytona Beach, FL 32115 Legal Advertising i ALACHUA The Alachua County Record 904-252-1511/fax 904 - 252 -6735 P. 0. Box 2833 Legal Advertising INDIAN RIVER Orlando, FL 32802 • Vero Beach Press Journal P. O. Box 806 407- 420- 5160/fax 407- 420 -5011 Legal Advertising Gainesville. FL 32503 POLK P.O. Box 1268 Lakeland Ledger Publishing Co. 352- 377 -24 /fax 352.338 -1986 • Vero Beach, FL 32960 Legal Advertising I BAKER ` Baker County Press 561 - 562 - 2611 /fax 581- 978 -2366 P. O. Box 40B Legal Advertising 1 LAKE Lakeland, FL 33802 Daily Commercial P. 0. Sox 598 I PUTNAM Legal Advertising Palatka (Daily News Maclenny, FL 32063 P. 0. Drawer 7 Legal Advertising 904 - 259- 2499/fax 904 - 259 -6502 Leesburg, FL 34748 P. O. Box 777 1 BRADFORD Bradford County Telegraph 352 - 787- 0902/fax 352. 385 -1951 Palatka, FL 32178 Legal Advertising 1 MARION 1 904 - 312- 6200/fax 904- 312 -6664 P.O. Drawer A Ocala Star Banner, Legal Advertising Sr. JOHNS P. 0. Sax 490 SL Augustine Record Starke, FL 32901 Ocala, FL 32670 Legal Advertising 904 - 964- 6305/fax 904 - 964 -8628 n g 352. 867 - 4010 /fax 352-867 -4126 P. 0. Sox 1603 BREVARD Florida Today, Legal Advertising 1 NASSAU ( SL Augustine. FL 32084 News - Leader, Legal Advertising P. O. Box 363000 904- 829 -6568 /fax 904 - 829 -6884 511 Ash Street Melbourne, FL 32936 SEMINOLE Fernandina Beach, FL 32034 Sanford Herald 407 - 242- 3500/fax 407- 242 -6618 904- 261- 3696/fax 904 - 261 -3698 CLAY Legal Advertising Clay Today, Legal Advertising T OKEECHOBEE 300 North French Avenue • Okeechobee News P. O. Box 1209 Sanford. FL 32711 Orange Park, FL 32073 Legal Advertising 407- 322- 2611/fax 407- 323 -9408 P. 0. Sox 638 904- 2694033/fax 904- 242 -6618 VOLUSIA Okeechobee, FL 33472 1 DUVAL News Journal Corporation Florida Times Union ORANGE Legal Advertising Sentinel Communications Legal Advertising P. O. Box 2831 P Legal Advertising P. O. Box 1494 4 Daytona Beach. FL 32120 P. O. Box 2833 Jacksonville. FL 32231 904- 252- 1511/fax 504- 255 -6735 904- 359- 4321/fax 904-359 -4180 Orlando, FL 32802 407- 420- 5160 /fax 407-420-5011 1 FLAGLER Flagler Tribune. c/o News Journal Revised Seprember S. 2000 4 FL/Ns/data/Holders oil General Permits -_• _• __'_ -V - _ V �� •�� ��v. :JI JVI 11'1 1 \1 VLR JNt,R rM Z. 1D FORM EN - 4UC F.A.C. • AS -$ CERTIFICATION PERMIT NUMBER: _ —• PROJECT NAME: I HEREB Y CERTIF.( THAT ALL COMPONENTS OF THIS STORMWATER MANAGEMENT SYSTEM HAVE BEEN BUILT SUBSTANT,LALLY RV' ACCORDANCE WITH THE PERMITTED PLANS AND SPECIFICATIONS. THESE DETERMINATIONS HAVE BEEN BASED UPON ON- SITE OBSERVATION OF THE SYSTEM CONDUCTED B Y ME OR BY MY AUTHORIZED AGENT. SIGNATURE NAME" (Please Print) • • I1TL E DATE • • COMPANY /AGENCY COMPANY/AGENCY ADDRESS CITY, STATE, ZIP CODE TELEPHONE NUMBER WITHMT 30 DAYS OF COMPLETICY OF THE SYSTEM, SUBMIT TWO COPIES OF THIS FORM to: • DIVISION OF PERMIT DATA tSERVICES - . _ ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.O- BOX 1 -29 PALATKA. FL 321 78 - 1429 vV/ 1V/ LVVl 1U.1V JUY- fJU' -DGOf �I JLN1I`/ RJ. vttc JAL. rcwt jb ST. JOHNS RIVER WATER MANAGEIINT DISTRICT Construction Commencement Notice ST. JOHNS RIVER WATER MANAGEMENT DISTRICT Post Office Box 1429 Palatka, FL 32178 -1429 PROTECT: PHASE: • I hereby notify the St. Johns River Water Management District that the construction of the surface water management system authorized by Environmental Resource Permit No. bas cornmenced/is expected to commence-. on 199_, and will require a duration. of approximately months weeks days to complete. It is understood that should the want texrn extend beyond one year, I am obligated co submit the Annual Status Repo for Surface Water Management System Construction form no. 40C -4.900(4). . PLEASE NOTE: If the actual construction comineneext nt date District staff should be so notified in writing in order to satisfy permit conditions. Permittee's or - Title and Company Date Authorized Agent's f • • . . • Phone Address -� • For Nv sot ;.soo(J) uw +w c.uu+ /U. AU J UY — f JO f J I JUrIN Kl VLK JAUK ri. t 1 • FORA! EN -45 JUC -1. F.A.C_ MSSW /STORNEW A.TER2 AS -BUILT CERTIFICATION BY A REGISTERED PROFESSIONAL* PERivIITNUMBER: • PROJECT NAME: INSPECTION DATE(S): 1 HEREBY CERTIFY THAT ALL COMPC)NENTS OF THIS STORNIwATER MANAGEMENT SYSTEM HAVE BEEN SLUT SUBSTANTIALLY IN ACCORDANCE WITH THE APPROVED PLANS AND SPECIFICATIONS AND IS READY FOR INSPECTION. ,AN'y SUBSTANTIAL DEVIATIONS (NOTED BELOW) FROM THE APPROVED PLANS AND SPECIFICATIONS 'WILL NOT PREVENT THE SYSTEM FROM FUNCTIONING GN COMPLIANCE WTTH THE REQUIREMENTS OF CHAPTERS 40C-4. 40C-tl. OR 4QC-42. F.A.C. ;.as APPLICABLE), WHEN PROPERLY M.AINTAJNED AND OPERATED. THESE DETERMINATIONS HAVE BEEN BASED UPON ON -SITE OBSERVATION OF THE SYSTEM CONDUCTED SY ME OR BY MY DESIGNEE UNDER MY DIRECT SUPERVISION AND/OR :NlY REVIEW OF AS- BUILT PLANS CERTIFIED BY A REGISTERED PROFESSIONAL OR. LAND SURVEYOR LICENSED IN THE STATE OF FLORIDA. • NAME (please print) SIGfNATURE OF PROFESSIONAL • • COMPANY NAME FLORIDA REGISTRATION.N J? 1BER • COMPANY ADDRESS DATE • CITY, STATE, ZIP CODE • • TELEPHONE NUMBER (Ant Ste) • SUBSTA►1TtAL DEVIATIONS FROM THE APPROVED PLANS AND SPECIFICATIONS: • • • • 'NOTE ATTACH TWO COPIES OF AS -SUILT PLANS WHEN THERE ARE SUBSTANTIAL DEVIATIONS) , VITHIN 30 DAYS OF INSPECTION OF THE SYSTE SU8\117TWO COPIES OF THIS FORM TO: • • DIVISION OF PERMIT DATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.O. BOX 1429 • PALATKA. FL :2178 -1429 A RECl5TEI2ED PROFESSIONAL r5 DEFINED SUESZCT10N 40C - 42 021(1) AS "A PROFESSIONAL REGISTERED IN FLORIDA `� iTH TIC EC_SS.:RY EXPERTISE IN THE FIELDS OR HYDROLOGY. DRAINAGE. FLOOD CONTROL EROSION AND 'SEDIMENT CONTRO A TOR:.IWAT£R POLLUTION CONTROL TO DESIGN .A.ND CEaTlFY STORN.IWATER MANAGEMENT SYSTEMS". •CAMpLF_S OF REGISTBpp ItOFESSIGN..LS MAY INCLUDE PROFESSIONAL ENG ?? " ERRS LICENSED UNOCR CHAPTER 471. F,S.. PROFESSIONAL LANDSCAPE ,aRCH ICEI4SED UNDER CHAPTER ■si, FS.. AND PROFESSIONAL GEOLOGISTS LICENSED UNDER CHAPTER 492. F.S., WHO mAyE TN): REFERV4"'" U LLB, uu / +U / LUU.L 1U.1U 7U4 ( 3U - OG O I I JUt11V K1VLt JAUK VAUt 113 • • FORM EN-4 48C-4, 40C .41, F.A.L`, 40C -40, Revised 1214/96 MSSW STORMWATER REGISTERED PROFESSIONAL'S* INSPECTION REPORT PERMIT NUMBER: PROJECT NAME: INSPECTION DATE(S): INSPECTION RESULTS: (CICIC ONE) I HEREE Y VERIFY 'NAT 1 OR MY DESIGNEE UNDER MY DIRECT SUPERVISION HAVE INSPECTED THE SYSTEM AT THE ABOVE REFERENCED PROJECT AND THAT TIRP SYSTEM APPEARS TO BE FUNCTIONING III ACCORDANCE WITH THE REQUIREMFMS OF THE PERMTI' AND CHAPTERS 400-4, 40C -41. OR 40C-42. F.A C., (AS APPLICABLE). THE FOLLOWING NECESSARY MA.II I ENANCE WAS CONDUCTED: • T HERESY CERTIFY THAT I OR MY DESIGNEE UNDER MY DIRECT SUPERVISION EAVE INSPECTED THE SYSTEM AT THE ABOVE REFERENCED PROJECT AND THAT THE SYSTEM DOES NOT APPEAR TO BE FUNCITONING 1N ACCORDANCE WITH THE REQUTRE 1ENTS OF IT3E PERMIT AND CHAPTERS 40C-4, 40041, OR 400112. F.A.G. (AS APPLICABLE), I HAVE INFORMED THE OPERATION AND MAINTENANCE ENTT Y OP TEE FOLLOWING: (A) THAT THE. SYSXBM.:.DOES. NOT APPEAR TO .B & FUNCTIONING PROPERLY, (B) THAT MAINTENANCE IS REQUIRED TO BRING THE SYSTEM INTO 'COMPLIANCE: i42417 (C)'F - MA NTENANCE.MFASUIR.ES. ARE NOT ADEQUATE TO BRING. 'Y SYSTEM INTO COMPLIANCE, THE 'SYSTEM MAY HAVE TO BE • REPLACED OR AN ALTERNATIVE DESIGN CONSTRUCTED SUBSEQUENT TO DISTRICTS.' APPROVAL.. NAME (please print) SIGNATURE OF PROPE3SIONAL COMPANY NAME FLORIDA R.EGIS'IRATION NUMBER COMPANY ADDRESS • DATE CITY, STATE, ZIP CODE • TELEPHONE 'NUMBER . (AEU Sad) WITHIN 30 DAYS OF COMPLETION OF THE SYSTEM, SUBMIT TWO COPIES'OPTEES FORM TO: DEPARTMENT OF RESOURCE MANAGEMENT DIVISION OFPER'MTTDATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P_0. BOX 1429 PALAT KA, ,PT.. 32178 -1429 " A• REGISTERED PROFESSIONAL 15 DEFINED IN SUBSECTION 40C- 42027(1) AS "A PROFESSIONAL REGISTERED IN FLORIDA WCI t. tECESSARY EXPERTISE m THE FIELDS OR HYDROL aGY, DRAINAGE. FLOOD CONTROL. EROSION AND saimmarr CQji(IgAL. AND TORMWATER'POLLUTION CONTROL' TO' RESIGN: AND 'CERTEE1 - STORMWA ER: NACEMENT,.,WST,EMS-; OF• --REGI D 'ROFESSIONALS MAY INCLUDE PROFESSIONAL ENGINEERS LICENSED UNDER CHAPTER 471. F.S.. PROFESSIONAL LANDSCAPE ARCM .ICNNSED UNDER DiAPTER 411. FS, AND PROFESSIONAL GEOLOGISTS LICENSED UNDER CHAPTER 492. FS_ WHO HAVR THE REFERENCED ICILt3. 3RM 400 - 1.01(1.1) uo . O/ LUO1 lU: LO 7U4 1 317 — bit) 51 JUHN WIVER JACK 19 • 40CGZ x-47 Revised 1+9 • STATEMENT OF INSPECTION REPORT PERMIT NUMBER: PROJECT NAME: INSPECTION DATE(S): • • STORMWATER MANAGEMENT SYSTEM INSPECTION RESULTS.: (CHECK ONE) I HEREBY VERIFY TH•ATI OR MY AUTHORIZED'AGENTEAVEINSPECTED THE 'SYSTEN AT :THE:ABQVE REFERENcD PROJECT AND THAT IT APPEARS TO BE FUNCTIONING ACCORDING TO THE- REQUIREMENrS r AND C P'TF„R 40C.42, FA.C. THE FOLLOWING NECESSARY MAINTENANCE WAS.CONDUCTED: • I HEREBY CERTIFY THAT I OR MY AUTHORIZED - AGENT HAVE.INSPECIED TT SYSTEM. AT THE ABOVE REFERENCED PROJECT AND THAT 11E SYSTEM DOES NOT APPEAR TO • BE FUNCITONINQ -IN COMPLIANCE WITH TJ RHQU'S:.' THE PER .HET AND'CHAFIER 40C-42, FAC.''IUNDERSTAND T$B FOLLOWING: (A) THAT MAINTENANCE IS REQUIRED Tb- HRI3kiG THE SYSTEM INTO COMPL1ANC E AND (B) IF MAINTENANCE MEASURES ARE NOT ADEQUALTE TO BRING THE SYSTEM INTO COMPLIANCE. USE SYSTEM MAY HAVE TO BE REPLACED OR AN ALTERNATIVE DESIGN 'CONSTRUCTED :SUBSEQUENT TO DISTRICT APPROVAL. I Wfl.L CONDUCTTEZ FOLIAWING MAINTENANCE WITHIN LIm • SIGNATURE - DATE. . NAME (please ,print) TITLE • C OMPANYrnGENCY NAME PRONE • ADDRESS ' WITHIN 30 DAYS OF INSPECTION OF THE SYSTEM, SUBMIT WO•COPIES OF THIS FORM TO: DMSIOtN• OF PERMIT DATA SERVICES ST. JOHNS RIVER WATER MANAGEMENT DISTRICT P.O. BOX 1429 PALATKA. FL 3217E -1429 • • )12114 40C-1.161(16) _wg7/t //97 uu, auk J. I. U. i u JD•4 � JU - DLO( '1 JUf11V R1VLR J t•1td\ I"HUL ztJ • St. Johns River Water Management District Annual Status Report for Surface Water Management System Construction (Required whenever consnuction duraaon exceeds one (I) year) ST. JOHNS RIVER WATER MANAGEMENT D1ST Post Office Box 1429 Palatka, FL 32178 ; 1429 'ERMIT NO. • 'ROJECT NANCE :_ PHASE: • 4 Contro fracture( �$ Sl % of ComDletigp Date of Anticipated Dam of # 2 Completion Completion • • • nc`+mark Description (one per major control aauctn • • Surface amid . % of t ornoletio0 Moroi anticipated d Consolation CDreolcrion • Pees) • • rch(es) w>Ve(s) flltr Tiench y Areas) i rm(s) • • • • PrincNatne Phone • Perrsu tee's or ..uthorized Tide acid Conapaay' Due Agent's Signature • Address �^ • Vi c, . - . , �,, _6 Richard Graves Electrical Contracting �s � ��� 6515 Beach Blvd Unit 4 `904'721 "2626 Jacksonville, FL 32216 ELECTRICA! CONTRACTING g`/' ✓� 'Z ERO410ss2(3 9 09 _ .2 8y_ 7955 - act/ g 0 Z.,.-- - FCETVED. nr.T 1 8 2002 flo ji-e 0.,,A-- 6 al Cettes-e' beej--- B .0 6 ,5/4,4„3 cy,,,,,,,,_ 0„ "� 04 —o a a (. 50,33 SZ i7 `J j , 0 // a' toz APPROVED )7 y " t, ,/ ifr A5/9.2, CITY. OF ATLANTIC BEACH BUILDING OFFICE t/ # ( 23i9/ i .7S „ CSC: d 1D` 173 // 1/ -0 g3 /7 // n it ;. 3/ 8 5' BYE /gs " ;pc isa,✓ Ad iG 3/ 5iy (A ).R. .,„.;,e) .-frt ,4-0-e- 7-1•- 0 , V et-'--47f-e i.,,,,e d l e _ z _,... .9.4. -& 6 1..k) p /2 /4").4"--- -r.L1,71-4,9 erYA- aficiech"-- ' ct.,/i cr- , (AP S / , ft rte rip ' 4 b L1 'r ' AVID FRANCIS MAROVICH �y � ?� ' � MY COMMISSIOIVCC966312 ' EXP Sep +Y 7, 2004 1-800.3-NOTARY FL NoGrI Service & Bonding, Inc. , c; 3 / -- S CITY OF ATLANTIC BEACH, FLORIDA A„wa.d by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE rPe,-, Z 0 N Zee / IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING. WE . HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN 'ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. t., X 7-J7/ E LECTRICAL FIRM: ELECTRICIAN SIGNATURE )OjJRNEYJAN / / - ri /A . ADDRESS: f / c ' *5 0''' , S RFD,_._,__BOX BLDG. SIZE A 0, Le 'BETWEEN: RES. (I APT. I 1 COMM. ( 1 PUBLIC ( ) INDUS. ( ) NEW l 1 OLO ( 1 REW. ( ) ADDITION ( ) TRAILER ( ) TOW. ( ) SIGNS r ) E 50. FT. SERVICE: NEW ( 1- /// INCREASE ( 1 REPAIR ( 1 FEE CONDUCTOR SIZE y - A_S / CO COPPER 1 ALUM. 1 -'t / SIRTCH OR BREAKER / ,S 0 AMPS / PH 3 W .0 (Id VOLT RACEWAY EXIST. SERV. SIZE AMPS PH W VOLT RACEWAY FEEDERS NO. SIZE I NO. SIZE I NO. SIZE LIGHTING OIJTI.ETS r7 CONCEALED OPEN TOTAL RECEPTACLES ?' CONCEALED OPEN TOTAL SWITCHES 1 i / 1 st.foo AYM. i INCANDESCENT FLUORESCENT a M. V. FIXED 1 o.voo motel ova. 1 1 APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP. MOTOR OTHER MOTORS AMPS CELL HEAT: KW-HEAT i 2.-- - 3 J ,ti 4.' .1 1 OVER MOTORS H.P. 1 VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS TRANSFORMERSe UNDER 600 V. OVER 600 V. NO. KVA ' NO. KVA NO. NEON TRANSF. IRO. VA. I MA. _ MOTOR SIZE 'SWITCH I FLASHERt EACH SIGN I r 1 I FORWARDED Q om° � « Richard Graves Electrical Contracting K Gs le-, 6515 Beach Blvd Unit 4 / ` 9ox;-. RIC , Jacksonville, FL 32216 ELECTRICAL CONTRACTING ER0005820 November 6, 2002 r ` / ,,e,Z' / - ,doct 6,J e "fra i % ( 7. zfr---e"' e l- Ilf (II j/qc / k i ef :g.d., tt)J"'- ert u)-e- Xaf . / - i6 Lic. ,u,t,,, 04-,.....9 -,,, - -6,i a 1."1--e/t--- tet e2 .Y e,e , f , ' / , j-rt- °-- 2jv j c le i j 0 1 / (1--(1--e/ 1 bl --G. e 1'z - - - �;� G L9 " -ot-ig -o O 1. " =_ MY CMSION d 8 p� ;�,, ` < EXPIRES May 2 - - 2006 12301 1 F d , " ��,� bonded 1'hru Notary Publ Underwriters r 710-/ BUILDING, PL- INNING AND ZONING INSPECTION DEPARTIWENT CITY OF ATLANTIC BEACH, FLORIDA CERTIFICATE OF OCCUPANCY WORX SHEET Date Requested: 1 t / 02- Building Contractor: 13 (-' :;'Y-\5-\-Y- U C4--)ay Building Permit Number: '2._ 8 •• Address: q5' Jc4C/1 dy" P4 Legal Description: Improvements to the above described property have been completed in accordance with the terms of the permit and is certified to be ready for occupancy as DupLe%_ Lowest Floor Elevation: required as built * * * * * * * BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE DEPARTMENT DATE NOTIFIED DATE APPROVED BY Fire Public Works L-t_-_ f 13 c Planning &uilding BUILDING, PL4NNING,4ND ZONING INSPECTION DEPARTMENT CITY OF ATLANTIC BEACH, FLORIDA CERTIFICATE OF OCCUPANCY WORX SHEET Date Requested: 1 t �2— Building Contractor: !! 3yt'°s Co,' S7 rU c f'OsiTh Building Permit Number: �- S Address: J S cJ COOK Legal Description: Improvements to the above described property have been completed in accordance with the terms of the permit and is certified to be ready for occupancy as Due Lliv Lowest Floor Elevation: required as built * * * * * * * BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE DEPARTMENT DATE NOTIFIED DATE APPROVED BY Fire Public Works -- (33 t Planning &wilding 2 "d J 2 6 v CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 C E R T I F I C A T E O F O C C U P A N C Y P E R M A N E N T Issue Date 2/05/03 Parcel Number 172129 -0100 - Property Address . . 185 JACKSON RD ATLANTIC BEACH FL 32233 Subdivision Name . . . Legal Description . . . Property Zoning . . . TO BE UPDATED Owner LYLES, THOMAS Contractor H,H, & A CONSTRUCTION Application number . 02- 30022782 000 007 Description of Work . . TWO FAMILY RESIDENCE Construction type . . . Occupancy type . . . Flood Zone Approved C ' pp Building ffic 1 VOID UNLESS SIGNED BY BUILDING OFFICIAL CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 C E R T I F I C A T E O F O C C U P A N C Y P E R M A N E N T Issue Date 2/05/03 Parcel Number 172129 -0100- - Property Address . . 183 JACKSON RD ATLANTIC BEACH FL 32233 Subdivision Name . . . Legal Description . . . Property Zoning . . . TO BE UPDATED Owner LYLES, THOMAS Contractor H,H, & A CONSTRUCTION Application number . 02- 30022781 000 008 Description of Work . TWO FAMILY RESIDENCE Construction type . . Occupancy type . . . Flood Zone Approved � (y , C/ ; Building Official VOID UNLESS SIGNED BY BUILDING OFFICIAL CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 C E R T I F I C A T E O F O C C U P A N C Y P E R M A N E N T Issue Date 2/05/03 Parcel Number 172129 -0100- - Property Address . . 185 JACKSON RD ATLANTIC BEACH FL 32233 Subdivision Name . . . Legal Description . . . Property Zoning . . . TO BE UPDATED Owner LYLES, THOMAS Contractor H,H, & A CONSTRUCTION Application number . 02- 30022782 000 007 Description of Work . TWO FAMILY RESIDENCE Construction type . . Occupancy type . . . . Flood Zone Approved PP �- Building ffic 1 VOID UNLESS SIGNED BY BUILDING OFFICIAL • FLOODPLAIN DEVELOPMENT INFORMATION Location:: Type of Development: Flood Zone: Required Lowest Floor Elevation: If building is located within a flood hazard zone, a survey must be made AFTER THE SLAB HAS BEEN POURED, certifying that the LOWEST FLOOR ELEVATION is equal to or above the base flood elevation established for that zone. No final inspection will be made and no certificate of occupancy will be issued until the survey is on file with the Building Department. COMMENTS: 1 Applicant Aclosowledgment: I understand that the issuance of this permit is contingent upon the above information being correct and that the plans and supporting data have been or shall be provided as required. I agree to comply with all applicable pro ' ions of Ordinance No. 25 -7 -11 and all other . o ordinances affecting the proposed dev op . . Date "! `6 . 0 Applicant's Signature Department Use: Required Lowest Floor Elevation As Built Lowest Floor Elevation Survey Filed with Building Department Building Department Representative r CITY OF ATLANTIC BEAC 1 ` � j % DEPARTMENT OF BU — 1 f 800 Seminole Road - Atlantic Bead h, FL 32233 - 247 - 5826 -Fax: 247 -5877 ELECTRICAL PERMIT ___ -- _ -- PERMIT INFORM-ATJOt1'. -- LO CATION INF OR11114T ON Permit Number: 23193 � �� — Address: 183 JACKSON BEACH ROAD Permit Type: ELECTRICAL ATLANTIC , FL 32233 Class of Work: NEW Township: Range: Book: Proposed Use: SINGLE FMLY(ATT) Lot(s): Block: Section: Square Feet: Subdivis Est. Value: Parcel Number: I Improv. Cost: OWNER INF ORMATION Date Issued: 12/21/2001 Name: LYLES, THOMAS Total Fees: 45.00 Address: 60 ARDELLA ROAD Amount Paid: 45.00 ATLANTIC BEACH, FL 32233 Date Paid: 12121 /2001 P ' . n -''_ g 0000 -0000 Work Desc: NEW 150AM COIN NEW 1 T OR _ ` :� < .. ?ION FE RICHARD GRAVES ELECT :4 -� '. . „— 45.00 - -,- - f 2 " \-‘ +- � 1 - S �"ti max P`P* tk x • .> ° , fi r . h, ..."' ,t �7 -- i }.. t. �g i4: "' NNN 4 , y is t C r a r � r n C ro 13 s �G e . , -F . cs 3 a `` it t'�35 Y .jx .mot ■ RO ELE CT 1 - 1 :4_,' :'' t - w �,, -, . �� ,� 4 .. '' .� �� 4 �" ,, `, `mo ,v 'P �a4 �« %;4Nt- f =.f ' . -- , y w.. t .r €.`R> r y rf . a asp. ';- a-�r"� � -mow � ., � s� - y _ NOTICE - INS °° `I I ON a ` RE , 2UEST ED AT LEAST 24-� PR T INSPECTION BUILDING MATERIAL, R JR ISH AI�IC � 5 � MUST N N. PLAC PUBLIC S PACE, AND MUST BE CLEARED UP A _ r ' , Y CONTRAC " .. 'FAILURE TO C OMPLY WI ; `H y ' T ° I A k SU LT IN THE PROPERTY OWNER PAYING = 1 ' <` S ISSUED ACCORDING TO APPROVED PLANS W +� THIS PERMIT ANQ SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.' _ i K5. 1!4 Date: 12/21/81 81 Receipt: 882 52 822 ATLANTIC BEACH BUILDING DEPT. DECKS 1 -- — — - 88188A83221 -; 8188A83221 1 Hams, Patricia From: Ford, Don Sent: Monday, August 26, 2002 3:53 PM To: Harris, Patricia Subject: RE: Plumber should pull the permit. Original Message---- - From: Hams, Patricia Sent: Monday, August 26, 2002 2:50 PM To: Ford, Don Subject: Please call Bob Alligood - 626 -5900. Donna at Public Works has approved the revised sewer plan for Jackson Street. What is his next step? 1 Hug 21 02 03:50p Connell & Wicker Inc. (904)241 P- r y y c 7 0 i N 1 N ei 5TH tet South INC- L Jacksonville Beach, FL 32250 www.cwieng.com 1 I _ - 4 (t e,,, Bob Alligood ,,,.." .4...,..e. t 't ,„ - Project No 0101-33 From: Brian E. Kientz Mail? 0 Yes No Fax #: (904) 241-8111 Pages: 2 (Incl. Cover) Date: 8/21/2002 3:52 PM CWI Fax No.: (904) 241-1126 CWI Voice No.: (904) 249-7995 MESSAGE: As discussed, Donna w/ City of Atlantic Beach has approved this revised sewer plan for LaBahia. Please call if you have any questions. /iir'+" ',e' ots 4n r ft4 t , City et AII.roic Beach Bu; add Zoning j.\01\0101-33\WORDPRO\FAX082102 ALLIGOOD. DOC .Aug 21 02 03:50p Connelly & Wicker Inc. (904)241 - 1126 p. C l I ! I S 89 E .10" PINE 110.00' _y( -- ..i -9-9— % — % — % 020 -1 PINE TV.- % x r: " ON? PINE W l j 4' CHAIN LINK I { x I p i uii'c, FENCE W/ GATE N x z0" V _ . - . - o � O � ." ■ ,, j. .' ( 2,2 1 .2°). -x z-- x— x —x —>< O cri o * O � + H BELOW GRADE 15" PALM 0 • o Ir �. FLUSHING am. 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Value: Parcel Number: Improv. Cost: OWNER INFORMATION _ Date Issued: 12/21/2001 Name: LYLES, THOMAS Total Fees: 45.00 Address: 60 ARDELLA ROAD Amount Paid: 45.00 ATLANTIC BEACH, FL 32233 Date Paid: 12/21/2001 = 00 000 -0000 Work Desc: NEW 150AMPS S .�� CONTRACT a __0','-!--1-1'1'-‘1:' , r ATION FEES _ j I RICHARD GRAVES ELECTRI' ` � :-� 45.00 � 4 T r. ` Wp,-- i Q" A � X 11 SiWSt ... L'S .7- , .--_ f � � � � � T a • �� � fir, . „,,-.._..-.:1 _ e 4 lS . '3i . � : 'r.N�`i �J ' AL Y.'f '' ,., - '�'- � {� l' ..0 :1 7... ::. � � ROUGH ELECT . 1.{ , :r te t _ — __ ”` '� � � � .emu � a �� �. , �., � a � «J4 ti ` 6 s v a �" .cs y. ^g r`�„ a t & 's ,4 t . sY�'G�': y �w' ss � #t�r"�.i+. �:?.� K� �? w c,� ��`. .^Ta tm 3: � �" ?. . �- a Y Z V ti ?;. = 4 r s .. g 3 ' k.,:a ( " _ fit: 4 z w ti NOTICE - INS" --.---% TIONS , , E E e AT LEAST 2 4 HOUR „� R ICDR , T a SPECTION BUILDING MATERIAL, R _i ' SH ND i IS FROM - THI MUST N O PLACE 3 h ' UBLIC SPACE, AND MUST BE CLEARED UP A f HAULER -; E NT A - ' . f : FAILURE TO COMPLY W - C it ST _ �� 1014 a t- ULT IN THE PROPERTY OWNER PAYING a , : , e i ' Nj . ,R - 10 S" • ISSUED ACCORDING TO APPROVED PLANS v - 'IS PERM T AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. I II $45.88 14 { -� t t Date: 12/21/81 81 Receipt: 8821528 ATLANTIC BEACH BUILDING DEPT. CHECKS f822 — — ___ - -- 18181883221888 CITY OF NTIC BEACH FLORIDA ATLA , Approved br APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 490'1- Za Z / IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING. WE . HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND INACCORDANCE WITH ELECTRICAL REGULATIONS, CODES AND CRY OF ATLANTIC BEACH ORDINANCES. 3 z i /, 2 z 7 F' Z_ i 1 Wt 4/ (gy,c/P3 R Wl...€4---( ELECTRICAL FIRM: . MASTER ELECTRICIAN TTURE JOUR/el/MA 4 NAM /}. uc, .�. -- ADDRESS: / S ----- ' RF X f BLDG. SIZE � X BETWEEN: RES. (V( / DotI.e> APT. ( 1 COMM. ( 1 PUBLIC ( ) INDUS. ( 1 NEW 1 1 OLD 1 1 REM. ( ) ADDITION 1 1 TRAILER 1 1 TEMP. 1 SIGNS (` 1 MX FT. SERVICE: NEW 1 1 . INCREASE ( ) REPAIR ( 1 FEE CONDUCTOR SIZE . .i AMPS / Ili r • R ALUM. SNITCH OR BREA 4 4 '43 a yo T IIIILIMI EXIST. SERV. SIZE AMPS PH © VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLET'S Ma CONCEALED OPEN TOTAL RECEPTACLES 3O CONCEALED OPEN TOTAL SWITCHES v1' , INCANDESCENT FLUORESCENT St M. V. FIX= O. tOO AMPS. APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP. MOTOR OTHER MOTORS AMPS CELL HEAT: KW - HEAT iiiiiiiiiiiiii 04 0118 MOTORS H.P. VOLTAGE PHS NO. 10.t VOLTAGE PHS MISCELLANEOUS TRANSFORMER& UNDER 600 V. I OVER 600 V. - NO. KVA 1 NO. KVA NO. NEON TRANSF. NO. VA. MA. I MOTOR SIZE SWITCH EACH SIGN 1111111111111 1111111111 FORWARDED e _ - CITY OF ATLANTIC BEACH ,„ E 247-5826 - FAX: 247-587 DEPARTMENTH FL 32233 3 . U T IL L: D 24 IN -5 G 800 SEMINOLE ROAD - ATLANTIC BEAC 247-5877 , ''''I''''''''''' ''' ''' ' ' . - ' '''''''''''''''''PERMIT',IN .ORM T ,,,:::,,,-...;,,-.,,_:: ,,,,,,•-n,._,-,,,,,,,,..,:, .., .,, d. ,•:r..,,eil.s.;'.s::'-'...LO13 JACKSON ROAD 'INFORMATION_ , Permit Number: 22781 Permit Type: DUPLEX RESIDENCE ATLANTIC BEACH, FL 322 Class of Work: NEW Township: Range: Proposed Use: SINGLE FMLY(ATT) Lot(s): Block: Section: S Square Feet: Sub division _ ,, _ .,,,, ,,,,,,„;:•?::. :..,;, Est. Value: Parcel Number: - ' OWNER iNFORMATION1 Date Issued: 10/04/2001 I,T,,,7;,,.-s.,,:,,,,-.7,:,,:";,;',--,-5',,OW ,. .- . 57,030.00 Improv. Cost: 2,614.86 ' ' ' ' ' ' 1- A ' ci N d a r e m s e::; ' 6 L 0 Y L ET L O M D Total Fees: Amount Paid: 2,614.86 ATLANTIC CH, FL 32233 Date Paid: 10/04/2001 Phone: ( (O 0)0OO - BEA Work Desc: CONSTRUCT 438.00 ORts - : -- " , !1: - ,' , & - „,:; , :.,'.t.:0,,vg,7idip,x,i.14,, , ,,,,,- ,1!...'; - r ,.,,,, , . ,,,,,.,,,,.,,,,, .,,, coNTRACT , 1: , : , ..:4,••. .,, ..: ..• : •::,,,,,, -.p. ., ,...c„... -...:. ,• : • il P 470.00 BREW CONSTRUCTION INC. ,,.0.",!..'1,',.,;0..1H-,72,.'''..-....•-. :,: u 2L , ., .4 ,,I ,,,,,, 1,250.00 e,wER. MPA -..- T EE .. ,,,;,,,,,-. N,..,, : ,:, ,, tv , or• •. • . ..• ' ''• • — ..- ,,, • • •:' • ":",' „ fr:IN-A: •'•iz:i. 85.00 WATR•'METIROAR .••• :,, :•:?i4 •:,,,,, •. :::, '•• :. ,..0 , ,:)-,,•:,.,,.: .„:;•:;,,,, E ..-....„.. :..,.,,,....-„...-• .,..,- . •.1,;.. . . :::••„,%. 5.63 - 1,vp.r.„, A,..i R S ,,,.•: i.,.:, .:. .-',:•% flrit'St4- '"!:•:, :''.'.. '''. ,,...t.:t,k . ,.. ' .: : ' : :,.. '.,t, 0.30 t CAPJTAL .,104;i :00 - 1 , 4:tAasw;, ,,,,,, k,i.-,: . -,,:" •' - . 4, '':; ,,, •,,,,, -4z- 4 , ,,, , •••••:- • •. l ift 0,1^ i• '... '-'., 'lk.f LvIN , : :F) ,:' IMPR '''" -4 ,•% : ,: : : • •;ii,..4-..',:., 325.00 41 " 44 k 4 P A " ; ,' 44 ' 1 '''''' ..- - ''''''''''' .• , , 1*`:'- ,-, N : .- -',', •A, it- l : :',,-,•:,":•;:., ' `i .."' ''•• , ,-;10''' ,1• 3500 4 0 ' :;.1,, . f:' •..' .rtRuss•cv174.04= - , , ,, , f- , :..r. - 4, ,..,„ •..„,v,,,,:. :...:•„4„..,..,,,,„...."1...„4..p,,,„4,„.,,,..,.A•„,:-...;:t:a::•,•,..,,,,, :: •,:,......_ . •:. :.:•,, ; ; ,„ti , •., " %,.. ':,.,, 534 „ ',z1iF.,.‘.,T":-..,,,,k.,-,;;,:..;,.,:‹f.,-7.1',44,... iiteiNST BUR C ''' . ': ''' ' g''' '• '''''' -,•^# 4 : :' 1, a3;;" . ,A1.1.0'40,•'-•Aj:5:'',;-:-:;i:MI4V. ' '' 44 4 ' ' ' ''.. '' ''''' '-'* :'*". ' 1.4SCHARQEJAILBCW.g.ap 059 ..1 :t4. ;. - •-': ''''''::Th'•"' -:' . ••n: : : ,:.:,=„• 1 .,..41' . " ' ' : - ,' ''''frA, :. .■'.A1:44 ': ' r''' • ' `. ' 1 :'''' . 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A ,,i• , l' '-' ; • : . e ft ,,, ,,,:te., 11144.iie ;;74,,,,,,,41.,:'''''V: :...i''' '-',"-:',' J' ' .' •• ''' A„,: ',, _43, ,„K.,,..740a7.$0, .V ' .: - .' 4 '0 , ,Q , ;•;' , '" , ':t - NY:4 ,, ,,4Cie.V '-* - • ''W ' ''';-: '''''' - "- - i „ . „ , , , , , ,,-,-.N .- .:'..swr' 4,'„,,1„•?>:'14.,Y;,,,; t iig iW;Mkr'• , .%aii`I'V•"•41";''',Afiai:,•: • :!? - 31rf,41''r4-'; "..t ..'4•:'''''"!''' :4-',',;-,',,i,:•:',.•k;ti,$•,&.•,SE.Wi.:.,i;!1,:",t',":;;;':-.714,',14:4:nnP$.14:eV g...00'. .!' * ; .' '',... ':-.:•;,:;',Z,,t;,,,;;;,,I:,:•;';''t:Z:i--tftit:ftifillItaltlfEitl:4;;.0:54.i'''::,:.F"' , , ,..-•,,',,,. .,,,,;:,;•,-: cf. ?•?...4=-••'''-*°.;;:g5gie•:`f-ji,',V.kf-jNitir:A4';'.1'4,11•11. :;.'. ' 1 ii4' sLABRA$,i t: .•,,i4 1 ,,H--.::::. ::: ;,, :::?L'747.',, , i !.:', ..0 LONG' TREE BARRICA 'tiVatiffir04..:,0t1P Izt:2-1NA.,'.:?•:.ti,:xttl:k.,97P34ni.3.:.::!4:, FRAMING E ,.,.*::. : ‘,.. -. ' " , --- ett.e,ATT4 - tvw.n4V m 7 -0.Nt.,,,,T,..,zgf.;,,f-'1,,,v,,..,0 :,10 '' . ":'.:. . ' FANCY :i.k '.. :"'-`:'` Ali:'N' : f, ':.: 'N?:.%i'' 41',V4N4fOi,44.;i4?4111; k!' p CERTIF/OCCUPANCY ' Aii:1-01,574*-: '-:14.1t,V,giAitt-iP*44VAXI-g4td4'igiArz-4.40teg:tiitgl1.0,4gft,:":7..,,,,,INO...t: 1 : ......, s„ ,......,. titi:Ft„,,0.4„;:1,,,„, ,4.0...:.1:1 -1,0., -.,, ::::: =, .-.••,....,..:i ..4.,..: .x,.. , ,T,-. . , ..1h, ,,, ,, ,, ,,,, , ,,,.. •..„,_ .." , r,„ . ,,, „„;. citt• N$RECT1ON NOTICE4i1 N‘PgP T 7v,11:77"..,..,.:7::'7;;,,P;PFF,S1:E..k.:°:A,:;•...T.,•:,.,.::r8 H OU RS BUILDING MATERIAL •,.: • . x . ::, ,...,. •.:-..!,Atj , '.' .." • .. : ''''': ' ' - ' ' f UE_; 4R 61 . 7'' FROWTHIS OR WOR MUST N OT e„. ., i IN U ISH,'''..'600,e8RIS:'.-- . '.-, . .. ....„ . ipw BY EITHER CONTRACTOR OR . „ v ,, . AY OV , 0 Fz,..... „...„,.,,,... P ;C eLIC SPACE, AND MUST BE CLEARED uFI:iplp , .,..„ .:,.. • -.•:.,!::1: ,.:?•::::',:•:,..:::L-.::'....:•::::•,•::7,•,-..,:: ,,,,,•:.:1,,,,,,tiiii'Az:..,:•.:,•:,..•••:,•':---,,,,:'• IN THE . .i r Ave. , : , ..4.1kesuile-r. '''Ii'• STRUOTION LIEN ,.. : z:•,,tai, „..,., , r . "FAILURE TO COMPL;r77 . ;•,;,, .....•::: . : PROPERTY OWNER PAYING itja...--'' .ffinistt-OXEIVIEitTSV 1■1,..P'1•14,0 , : .,1......9 , ,rt:B•sr... iii 1.. .:b::.:... 4,.. •,...e..,„...,. ".::. . •' ' ' ' 41RE;PAT : ...,... P, 1,"$,,,,,, , 'r''tt' '1 7 ISSUED ACCORDING TO APPROV ., : )! AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PRO SiQNS , 1AL'...A.,,,. . . Operator: DIERYLE , 1 c...--... e _...,416... ?Ot:1 Zynet 11 Rfte441 ATLANTIC BEACH r•UILDIN = PT. CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address / 6 3 /}-c (,4,3 G (J Date 9 -0 Heated Square Footage i)9(0 @ $ Y7" .per sq ft = $ SS ., tgz. Garage /Shed d @ $ ° per sq ft = $ Carport /Porch � @ $ / per sq ft = $ 7-6 Deck O @ $ per sq ft = $ Patio 81? @ $ 6 per sq ft = $ TOTAL VALUATION: $ s / 03 5 ,030 ) G 0 $ 26 o . Total Vn 2at i on 1st $ S , pp O $ 3 . Remaining Value $4,.coper thousand of portion thereof TOTAL BUILDING FEE $ % 9 Z. + 1/2 Filing Fee $ / y c, ( ) Fireplaces @ $15.00 $ BUILDING PERMIT FEE $ 4/3 8 WATER IMPACT FEE $ L/70 SEWER IMPACT FEE $ /ZS — a WATER METER /TAP $ F S CAPITAL IMPROVEMENT $ 2 .t"" SEWER TAP (I44) RADON (HRS) .0050 $ 5T 37 3b SECTION H PAVING ( ) $ —0 HYDRAULIC SHARES $ CROSS CONNECTION $ 3S (// ff) SURCHARGE .0050 $ 6 3 c (/S - 5 OTHER $ GRAND TOTAL DUE $ 2 , ( 1 50 ADDITIONAL PERMITS OR FEES: Mechanical ; Plumbing Electric /New Electric /Temp ;SwimmingPool Septic Tank ; Well ; Sign Finish Floor Elevation Survey ; Other CALCULATIONS and /or NOTES: CITY OF ATLANTIC BEACH MECHANICAL PERMIT 800 SEMINOLE ROAD - ATLANTIC BEACH, FL 32233 - TEL: 247 -5826 - FAX: 247 -5877 • s nx , 3` 4 ,PERMIT INEORMAT,I.ON .'r . , . , {', , ..LOCATION INFORMATION .. , . N5 . ;" r Permit Number: 23236 Address: 183 JACKSON ROAD Permit Type: MECHANICAL ATLANTIC BEACH, FL 32233 Class of Work: NEW Township: Range: Book: Proposed Use: SINGLE FMLY(ATT) Lot(s): Block: Section: Square Feet: . • Subdivision: • Est. Value: Parcel Number: Improv. Cost: TeS ''' ° . OWNER INF"ORMATION „' 3 1 , Date Issued: 12/28/2001 Name: LYLES, THOMAS • Total Fees: 47.00 Address: 60 ARDELLA ROAD Amount Paid: 47.00 . • . :':•1 ATLANTIC BEACH, FL 32233 Date Paid: 12/28/2001 p0 - 0000 Work Desc: INSTALL HVAC s ”, M 7 r r� Ott s P TIOIV FEES * ,r 4 x sk... .r � . , a �,� =:_CONTRACTOR „ � � .. t . ARLINGTON AIR CONDITIQa G �`. - r r , f 47.00 i f4 y et .! ' f ?�, F A d p y" N w i, ` '& > y .# r ,� T.5r . t r Lit- r �. c , ,,ti ,iti' ;- �f: t F ' - :2 e " " -4. � y ! ti ed 5 .. :: -..‘:::::,::::.".:,..:: ..,-4 !,;:.: , ,-..,-.. A., * It. . ,, " t ar f , � i '3-r r a r r a F � 1.. " y O ro ' t - 3 �r s i 1r ° y , FPM w s to ° 4 3 fi u 1 > jai 5 i i i ' : nwi i x i�w " # A . .f:::\ R!'� •h. Y . l Ar , " 'iY'MS y .. ' � y q �k LF } � � . � � k� � y .. y i x R crna a �e ``,.:S +' 4 , w e +t$k y . B 'f ; .o :. 4 „ ¢ .t F .,8 t ;„,.;,,,,..,,c f ROUGH MECH,cN , 4 ;.o <, KV 1 ` tw u �t z 6 f Y, ` r "�'r blY A' S'' y . t � 1 '. A ' ,4 iM1�,� r° p ,',1' I x f�, F t ) J A'd.Y 3Y � AO � y1 ti { "� h id ��^�yL� a L�. N ] dt��h fi . G'7f1 � 5` F # � � ��]���'N7� L 'ikti, '0•a�. y r .- r a €"' . s i r jii T .r, „ fi 1 a' x. v a F,t v . ,h �� .°� ; fir-. -k i �✓ - y L: 5 5.. — NOTICE - I 5 .P T1C3; g BE REQ-UESTED AT LEAST 24 HOURS IOR TQ 1 PECTION BUILDING MATERIAL, R ' BISHAN .6, RIS ORK MUST N! � E :1 .704ED .!'l PUBLIC SPACE, AND • MUST BE CLEARED UP A i HA ItE1D gl Y,EI R CONTRACT ° y . OWN E F . . "FAILURE. TO COMPLY W 4: H IV 4 . tl L IE t SULT IN THE PROPERTY OWNER PAYING . 7 `� ;B. L E', ` . -I ' P w ,�__ -'STS" ISSUED ACCORDING TO APPROVED PLANS W -. THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. • f47.88 14 6de Date: 12/31/81 81 Receipt: 8823141 ATLANTIC BEACH BUILDING DEPT. CHECKS 12496 88180803221808 , • BUILDING AND ZONING INSPECTION DIVISION clrf OF ATLANTIC 9EAC aThnnc aGC>., ' 3s333 APPLICATION FOR , MECHANICAL PERMIT CALVIN VJ.N9iiR 1 1. IMPORTANT -- ,A - Clican . iac'ions !, II, III, and i /. �.. rm.cier3 ail it ^s LCGTION I shear Add•.. • CF :.Ln.. St... hr 3.....•.. r7 /~ - 7 4 - 17 < ILI(JING /2 x l�O, ti P ,wd \/ 1 II. IDENTIFiCATICN — To be _cmciered by as apciican`s L. cowaid•.•Pio. of permit q;..w to. Ja;,.. Ph. . w t , . ha �a . w .. ,t./o• .. a..•4 •q..• la a..lor. laid •cooed• +e• ..lh :h• atteesrd ai. d o. o. .. .cillcaua,. ..•ci. •.• p• r " , o• «a.dT , ..c. .d, .h. �;ly .i J•1ua,.lif• ar nano• and .los s er, of gaod.ar.c:ic• ;...d Ih•..iw, c......r.. (rriw 1 , r j j '/, .1 ki 4 ,4/ „ I c.w:r•.1•.. •I 1 / ten , ] Pm...1y o.,•• ri1., G, uS / /�5 • ! I e / ((0 S 6 99_3 I se A•rh i„J Ag.wl / J {')/ t i.�,•r. r of . . I L I Attila ? •r Engi,•er ! « r III. CE3VE�UL lNFCR1r1 N f A. . 7� .f h..tiwg St•i; I (I (24.ctrie _ I! .37:4Z71 �NaTRU CCIar ICING aOrlL 014 • T)413 7u Il CIMC aR 3I'L L' N.n,•l C a,rr.■ Utility J [. CY I P If TLS, CI VL hIUM /E� !' tr A7� - ';ACTION C Older — So.ogy C. +a/1T '/ Z 3O I V. utaCN.41 GL SC ulnorfr To Il INS ALLFn , NATURE Of WORK ( woo p:.■• II.i of con.paw.wh .w Simi of 'hi. ;arm) T./ p.siOSnt;si or re Nut 0 Sp.. C Commercial la• Q l.cnu•d Id�.w,lnl .. F1o> f � Vev 3�iIGlnO . C Ai.. Cawdn;..iwq: 0 Rte.. 0. C. L 0 Existing 3utlalnp � �! ^^0 f•h^• ;cie.. Q ,, P•• of .oioling aystsm M ••imrn ca p•uty �� UY 1•w :nalulatIon (No sy•t.m ;rsrlaualy ;n.1.11.07 0 ldrlg... Pi.. C Estsn.lon at aoCan :a •alsllnp system ,. C Cooling vro.: Cap.dty 0 Ctn.. — 9a.ufy • 0 Rr. 9.4.al.rst Mr..1... el )1«J• 0 E... C M•.IlF Q a ^"1•r.. !..8.....) • TTs IS 71AC1 POl 0 fR4C7 USi OMC.T C . G...ilw• •••p• ....heal 0 LPG o..t.;..•. (n•.nb..l • 0 U•l*..J prom........ 0 Won t.....;) Appr...d . CIO* .ti 0 O+b.. -- Sp.cily 1. nil e.. L.' AT • savit?MIN (` a A.01. CONDi::ONI.s1C AND AEPASCF.lATTON t4SlaHErr /( / Maribor L•alts D.rar1ptloq Yodai Nuatt Capaett7• JFpro.�r lfaaufaatus. I:'r.el J i.4 li MATING • FUR.NACE , 30IIEA T.L" g, PTA-S _ Number a Was D.orlp na Xod.l :Nam b.r Yu c utatarer B J� i =i =j /WM'EM�Ii i_ 0 0 0 .1r TAN33 Neer 1Ia.la7 1 0 . .l Cap.oltr r?. ;1quid ;fame of Salo( Apprv.it,E aa 'd r�s�dma Coat -aimed lfaaaZaa curer Na. �t�� CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road - Atlantic Beach, FL 32233 - Tel: 247-5826 - Fax: 247-5877 PLUMBING PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 24157 Address: 183 JACKSON ROAD Permit Type: PLUMBING ATLANTIC BEACH, FL 32233 Class of Work: NEW Township: Range: Book: Proposed Use: SINGLE FMLY(ATT) Logs): Block: Section: Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION Date Issued: 5/28/2002 Name: LYLES, THOMAS Total Fees: 64.00 Address: 60 ARDELLA ROAD Amount Paid: 64.00 - r : ATLANTIC BEACH, FL 32233 Date Paid: 5/24/2002 - ' ph : ..- 4 .00-0000 Work Desc: 1 . • 1 Y 1 -7 • -; .5 '''' - —,. '''' , , At' '`:?1,;,,, ION FEES DOBSON CONSTRUCTIO -- - - - , - -4,..1-. ; '-,--. , 64.00 - -'''' -<5.4114',. t r ik* : *-• , ..:4 , -- _ -,4* - ',, - -- 4 \4, .-, ft:- , , -, i f „,41,-:" -- --.- - A- 4 i 1 -tArgl,fir,.-.:10' 4 .ti..4e taxAA-Ai4 - A 111Naltrsty.r7 ' .; , ,': - . - MIS - , " -:11114i ," * " t15 " . ''' NOTICE - IN -. - 110 ' I ih4;i - lteatjesTalAT LEAST 24 MU - - :toR SPECTION BUILDING MATERIAL, ' ,:litiStt . rii 0.''' ;=''''',,,. ' R00141.S 0 - , "'' NOTE - d' CED IN PUBLIC SPACE, AND MUST BE C.-- . R 11 11 . ) " ; ' i i i 4'4 ' 4 '.. ' ,, c 'Z' T ' OR OR OWNER 'FAILURE TO COMPLY WIT R 0 it . - . - ESULT IN THE , PROPERTY OWNER PAYING - - NTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. Oper: MAILER Type: OC Drawer: 1 tc C. ' / Date: 5/28/82 86 Receipt ao: 61417 14 PERKITS-NILDIN 1 $64. N ! ATLANTIC BEAC BUIL G DEPT. N188183221881 1 183 JXX911 Rae CK CHECKS 1326 9128.88 Traps date: 5/28/82 Time: 16;49:51 CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: /D 3 ,774 C,t OWNER OF PROPERTY: 77yc) vf'1 Pi 1 ' Y"65 TEL. PLUMBING CONTRACTOR: 1) o a S C 0 w%. /^"C CONTRACTOR'S ADDRESS: V/ /47072 Gam /20 STATE LICENSE NUMBER: CFCv 30 TEL. 2- ((p D ( C/___ HOW MANY OF THE FOLLOWING FIXTURES SINKS RE -PIPED OR NEW SHOWERS LAVATORY / WATER HEATERS Z BATH TUBS DISHWASHERS URINALS DISPOSALS ) CLOSETS / WASHING MACHINE FLOOR DRAINS SHOWER PANS ( r SEWER / WATER RE -PIPE (LIST FIXTURES BEING REPIPED) OTHER TOTAL FIXTURES: X $3.50 + $15.00= (94 MINIMUM PERMIT FEE: $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: ,/ , , `:• /. INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247 -5826. t r CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 SEMINOLE ROAD — ATLANTIC BEACH, FL 32233 - TEL: 247 -5826 — FAX: 247 -5877 PERMIT INFORMATION LOCATION INFORMATION = ; Permit Number: 22782 Address: 185 JACKSON ROAD Permit Type: DUPLEX RESIDENCE ATLANTIC BEACH, FL 32233 Class of Work: NEW Township: Range: Book: Proposed Use: SINGLE FMLY(ATT) Lot(s): Block: Section: Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: 57,030.00 .,; OWNER INFORMATION , u„ ,... �.. Date Issued: 10/04/2001 Name: LYLES, THOMAS Total Fees: 2,614.86 Address: 60 ARDELLA ROAD Amount Paid: 2,614.86 ATLANTIC BEACH, FL 32233 Date Paid: 10/04/2001 Phone: (000)000 -0000 Work Desc: CONSTRUCT NEW DUPLEX ,REBtDENGERE, PLANS HSF 1186 w CONTRACTOR S) f� "' s .,` %'� r. }} p � APPLICATION. FEES arfi.., _ *„ BREW CONSTRUCTION INC. PERMIT , 438.00 D 7 1M PAO IFE 470.00 % " I MPeCT F 1,250.00 ins *ATII TERIAP 85.00 7; a 5.63 0.30 CI PJTAL IMF Rf E �: 325. `ROSS CONNECTION 1 35.00 ._ r z I�IS T SURCHARGE 5.34 } a� f S HA REATL B-I x- • 0.59 a�a e ra# 1 TREE BARRICADI=S` c �w sc, , .� . COVER UP IV' 1 u�� ° � FNIVA : BUI (DING 4 # 4'+i.. '�s r s•w 8 y '� a P �' b a R ,jnk x CERTIF /OCCU ,y. R.ANCYt � .. �', k3� k ��' �e S��I �� y �s �. {,�,d.'C h+ x � �� � z � rrw "� �. k ` e, e �P c • x �R 0. ih , z : w i 1 ;4 �. L' �, S K I x .ti" � k , -s q �Ar �a'� u� �t �' s xcz�x� s , � ^re�.,� � � 1 NOTICE'' INSPECTIPNS' " ^ STr BE REE t;lE:7TED AtLEASF 24 HOCIRS PRIOR TO IN ERECTION r .;; �� BUILDING MATERIAL; RUBBISP D�I fS Ff�Q11�YTHIS WORK MUST NOT � BE P CED IN P U BLIC SPACE, AND MUST BE CLEARED UPria;HALItttlAWAY BY EITHER CONTRACTOR OR O1 f 1ER z �4 "FAILURE TO COMPLi WITH tSTR T1ON LIEN CAN RES IN THE PROPERTY OWNER PAYING Ti ,FO " 4 L IENI N TS' ISSUED ACCORDING TO APPROV' I„A'I i �WFttGGH R f'�iT F P AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PRO I'3tQ IS.O 4 W ' • Ilk • — Operators c$ERYI..E Dates 19/We1 11 Receipts 61115971 ATLA'� BEACH BUI DING DEPT. tool Point >r2614.1b