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Permit Bldg 2003 Park 2010 CITY OF ATLANTIC 4 � i � BEACH } 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 4 ' .4 .0,219‘ Application Number 10- 00001443 Property Address Date 12/10/10 2001 PARK ST Tenant nbr, name Application type description RESIDENTIAL ALTERATION Property Zoning Application valuation . TO BE UPDATED • 10360 Application desc REMOVE WALLS AND REMODEL BATH FOR HANDICAP ACCESS Owner Contractor JACKSONVILLE HOUSING AUTHORITY 1300 BROAD STREET 3RD LITTLE PIG CONTRACTOR 5078 YERKES ST JACKSONVILLE FL 32202 JACKSONVILLE FL 32205 (904) 318 -7777 Permit BUILDING PERMIT Additional desc . Permit Fee . . . 105.00 Plan Check Fee Issue Date 52.50 Expiration Date Valuation . . . . 10360 6/08/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Other Fees STATE DCA SURCHARGE STATE DBPR SURCHARGE 2.00 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 105.00 105.00 Plan Check Total 52.50 .00 .00 Other Fee Total 52.00 .00 .00 4.00 4.00 .00 .00 Grand Total 161.50 161.50 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. - BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH i`e 800 Seminole Road, Atlantic Beach, FL 32233 , Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 2 03 �/ o `c .�/ /Z 5 .-- t - 4/4.6 �� , / A , Permit Number: l0 / 7 Legal Description Parcel # Valuation of Work $ �� 36 Proposed Area of Sq.Ft. S Ft Proposed Work heated /cooled o n- heated/cooled Class of Work (circle one): New Addition t ..- . c (. ) n Rep Move Demolition • • • • . .i I dow /door Use of existing /proposed structure(s) circle one): Commercial � ' 2 0 T II If an existing structure, is a fire sprinkler system installed? (Circle one): Yes N /,, Florida Product Approval # I il) For multiple products use product approval form DEC 0 8 2010 / c Describe in detail the type of work to be performed: 41 rt ova.: al/t124 S d k d d_ 1-z IT /Y(ale a ,_ -�`-_- - c.L - _ c. R— � ✓� Property Owner Information: / Name: 3 i 4ir. i� j 4/f/ L Address: " L 57 City e Ph E - Mail or Fax # (Optional) ``" � p Phone 6 `,/ S Contractor Information: ,�v , Company � 3 � L / Q I � � P Y Name: �z..6 j'U<,1 ,. Qualify, Agent: - c��L.. 1 4, 1/ Address: 5 't -5t City 14" / office Phone 2Z 4,, Fax V 5 36 3 Job Site/ Contact Number g #f a t e Zip Z z j State Certification/Registration # L 7111! � ,0 Fax 2 --- e0-- 1 Architect Name & Phone # i L , 44 4 E fi ; ,w¢, A ,,c, I. Z 1. ' , i a ;"i i 1 ' ODE 1 t1 ' Engineer's Name & Phone # Fee Simple Title Holder Name and Addre F,..„ ,,.., ., Bonding Company Name and Address SEEP : u �. • . _ . , . t+r: Mortgage Lender Name and Address ; `"" ' "i QUIREMENTS : . , Application is . hereby made to obtain a permit to do e '`' tal I ` ' s i 'ic to 1 , / DATE' - /O erfo o • • , . , . , , and void if work is not commenced within six a nt meet the s tan• a r• " o all aw_ g�ulat ssuance of a permit and that all work will be p g construct in this jurzs• ictzon zs e rmz • - : "`,e --+ vork is commenced I understand that separate .be s� d f or Electi*q "Work, Signs, a We lls, Pools Furnaces, B a t a time ranks and Air Conditioners, etc. rzy titer Boilers, Heaters, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMIVIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. hereb certzjy that I have read and examined this plication and know the same to be true and correct. All provisio of laws and ordinances governing this ype o will be complied with whether specified herein or not. The granting of a permit does not presume t.: rve out- . rity to violate or cancel the , rovisions of any other federal, state, or local law regulating construction or the performance of construction. ' signature of Owner /2.A40-- / Signature of C. ; • - : A le / 'riot Name / i iti. c 1 gi l� 14 1 Tc (l v ,r - Print Name ;woo and subscr r, ed before • e Swo his y o f %L-.1 / , 2 rn ? d befor- me Al; / � O / � 0 this -�' � , of and subscr.�.�= !�►,' , 20 A otary `ublic K �• ii r. ; ,; r aA Y k° DALE P. '' .,: , ' y Commission DD f�t20? 0 Notary "uj 14c D ALE P. KIRK ' idD PV PU •.i �� r �-: ar Expires May 2; , ?_01 _ ?.. �� ; � * ,.� x , Commission DD 642 9 0 ' • f �frro r ��� ThrLa TrgyFainlnauran e 50�aas�u s ^� �`i .4 dT Expires May 27, 2011Rev 01.26.10 a' x•.'•F' •4' ' g gndehro Troy Fain lnsura nceBoo " a es- DEC- N-2010 10:23 FROM: CLERK OF COURTS 904 270 1512 TO: 92475845 P:1/1 NOTICE OF COMMENCEMENT (PRIPARE IN DUPLICATE Permit No. /0 / / 3 Tax Folio No. State of County of To whom It may concem: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: Address of property being improved: 2'E?z> p..., /2 57--- 4. 7e"1 g‘.. A __________ ' General description of Improvements: .. .E 4.+.r lik. , --0 - ' °a. / i t■ - ‘ c Pryld.... Owner , • Address - `,� I Z' .Q �.- Owners interest in she of the improvement Fee Simple Titleholder (if other than owner Name Address — / Contractor � L , e 1' C I ,,,.` uG' mo Address O " \ 'L� -^� Phone No. ') g '� ] Fax No. ")• *z t L :d7 Surety (if any) '— / Address Amount of bond S ,—"------ Phone No, it Fax No. _ Name and address of any person making a loan for the construction of the improvements. Name Address Phone No. _ Fax No. Name of person within the State of Florida. other than himself. designated by owner upon whom notices or other documents may be served: Name Address Phone No. '- Fax No, r� • In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06 (2) (b ), Florida Statutes. (Fill in at Owner's option). Name Address Phone No. Fax No. ExplraUon date of Notice of Commencement (the expiration sale is one (1) year from the date of recording unless a different date is spedfled): THIS SPACE FOR RECORDER'S USE ONLY GINNER ry Signed: --'-�^F DAT& l�' / 7/ 6 aMOrc ma this day et In the t Co a Duct. ,$rpt . ar le , hae Personally appeared U — — _ _ — __ I /�l'I 1 -r 1 t / r herein try hlrneelf/ horse and erns kat a miconigr i and dcclar3liD a herein UOC a :tutu :Mir 11 r, OR tlrl 1545U rage 406. arc true and emulate Number Pages' 1 Recorded 12!08.2010 at 09 .28 AM. / / JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY ry Publle at Loop. Stoic or 1 eovnly or RECORDING $10.00 My conmission axpirea: Porn, rally Known or Produced Iegntilicaion 4A r. I(U KLAND DAL{ f i Commission DD 642610 Expires May 27,2011 _ , . . J,.. City of Atlantic Beach A S, Building Department APPLICATION NUMBER 800 Seminole Road (To be assigned by the Building Department.) Ito, ; -0 Atlantic Beach, Florida 32233 -5445 Phone (904) 247 -5826 • Fax (904) 247 -5845 r ra SO E -mail: building- dept @coab.us Date routed: C City web -site: http: / /www.coab.us / �`� APPLICATION REVIEW AND TRACKING FORM Property Address: 2 ©3 De t review required Yes No 3 Building — C ���r l /� Applicant: k: (�{� • g &Zoning � � � � Tree Administrator Project: . lr ' Public Works Public Utilities 10r Public Safety diVe47 Fire Services �re �'�.���� ���,�.�,� '�a�� i�. ' �. `�� '� i ^ � ff �, u t d i � ,n , e,.a� rj�� � }n�e�, ��( ��- p ,� � a� , j� arm r R C �-' k � (' � rt Dept $i 1101, � `` 'r "�t4�,'"' x ' 1 ai� r� a � z an;- 7 �„ Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: �pproved. ❑Denied. (Circle one.) Comments: BUIL15IN PLANNING & ZONING �y Reviewed by: `1 r �., Date: /c3 TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: (Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 ' s' CITY OF ATLANTIC BEACH `� r s � 800 SEMINOLE ROAD } ATLANTIC BEACH, FL 32233 �r �� . INSPECTION PHONE LINE 247 -5826 10- 00001443 Date 12/16/1 Application Number � 2001 PARK ST Property Address 2003 Tenant nbr, name Application type description ALTERATION Property Zoning 10360 Application valuation . . • Application desc REMOVE WALLS AND REMODEL BATH FOR HANDICAP ACCESS Contractor Owner JACKSONVILLE HOUSING AUTHORITY 3RD LITTLE PIG CONTRACTOR 5078 YERKES ST 1300 BROAD STREET JACKSONVILLE FL 32205 JACKSONVILLE FL 32202 (904) 318 -7777 Permit ELECTRICAL PERMIT Additional desc . Sub Contractor . ELECTRIC CITY INC Plan Check Fee 00 Permit Fee . . • • 90.00 0 Valuation Issue Date 6/14/11 Expiration Date . Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. STATE ELEC DCA SURCHARGE 2.00 Other Fees STATE ELEC DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due .00 .00 Permit Fee Total 90.00 90.00 . .00 Plan Check Total .00 .00 4.00 .00 .00 Other Fee Total 4.00 94.00 .00 .00 Grand Total 94.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH i . 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 I _ l PERMIT /• ' 1 'A. C' JOB ADDRESS: :: r NEW SERVICE ❑OYerhead ❑ Underground ❑ Underground up Pole ❑Residential (Main) Service 00 -100 amps ❑ 101- 150amps ❑ 151 200amps ❑ c ps # of Meters - ❑Commercial (Main) Service 0151- 200amps 0 ______ - amps OCT Service amps 00 -100 amps ❑ 101- 150amps Conductor Type Size ❑Multi- Family (Main) Service ❑ c p s # of Unit Meters ❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps — ❑Temporary Pole II ❑ CT Service amps SERVICE UPGRADE 0 - -- - am p s NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ET O C T T Service _____ GP CT ❑ 100 amps ❑ 150amps 0 200amps ❑ P ACCESSORY STRUCTURES, ETC. ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, OOamps _ _____._. 101- 200 Outlets /Switches: ______ 0-30amps _ _ _ 101- 200amps 0- 30amps __31- 100amps ____ Appliances: A/C Circuits: 0-60amps 61- 100amps -- --- -- Heat Circuits: # # circuits @ Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS Smoke Detectors _ QtY ❑Transformers _______ KVA ❑Motors hp ❑Swimming Pool ❑ Sign. ❑ Smo FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qt volts /amps VALUE OF WORK .5 -5 C?D REPAIRS/MISCELLANE OReplace Burnt/Damaged Meter Can Cl Safety Inspection ❑Panel Change ❑OH to UG Other: k '! j that I have thod or e becomes void if work does note within correct month provisions of work is susnded or abandoned laws and ordinances govern g this k months. will be complied with whether read this application and know the e same e to to b b true and true and co P lation construction or the performance of specified or not. The permit does not give authority to violate the provisions of any other state or local law regu construction _ -C2-°--6--- �4c. S6 L'( �ol�s,; ,,r," Phone Number Property Owners Narne _ r 'C r, �. I L � C Office Phone /7.1- Fax 7 y Electrical Company J ,� State Zip 3227/ / hi_ CiX Co. Addss: -��'�- if °cj