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Permit SFR 1090 Jasmine 2010 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 6/22/11 Parcel Number 170974 -0010- - Property Address . . 1090 JASMINE ST ATLANTIC BEACH FL 32233 Subdivision Name . . . Legal Description . . . Property Zoning . . . TO BE UPDATED Owner Contractor PHILLIPS BUILDERS LLC 904 349 -2999 Application number . . 10- 00000871 000 000 Description of Work . . SINGLE FAMILY RESIDENCE Construction type . . . TYPE 5 -B Occupancy type . . . RESIDENTIAL Flood Zone ZONE AE Special conditions . 2007 Florida Building Code w/2009 revisions Approved Bui =.. g Official VOID UNLESS SIGNED BY BUILDING OFFICIAL CITY OF ATLANTIC BEACH CERTIFICATE OF OCCUPANCY WORKSHEET Date Requested: 44,,4 Contractor Name: Permit #: /O - £ 47 Property Address: / /fie. Legal Description: Improvements to the above - described property have been completed in accordance with the terms of the permit and are certified to be ready for occupancy as: �� Single - Family Residence ❑ Commercial ❑ Other: qi61.. C' Lowest Floor Elevation: `f 1. --C quired As Built FFE The following must be completed before issuing Certificate of Occupancy: Department Date Notified Date Approved Approved By Fire Dept. "44_ _ __ Public Works 4/, C, /i /7x Public Utilities 64 ( / i 6 /, l - , 4' Building „ Planning ‘4 &// 6 Tree Mitigation Satisfied / 00 Final Survey with FFE Yes No < F t.. ' All Re- Inspect Fees Paid V Yes No Termite Treatment Yes No / 0/€ / +- --- rbi V -...-- O i sr NOTICE o of ADDITIONS or CORRECTIONS DO NOT REMOVE JOB ADDRESS DATE /( 7' , ate S f r,.. _ .. 1 y/ THIS JOB HAS NOT BE COMPLE The following addit or corrections shal be made before the 'ob will be acce • t f //ad C; /' ../ 1 r7 1 , ,n,,..4ca' 7,4L ,.-`' ,7 t r 1 0 r h 5.,-,C.4. e, 1 I r t.. s' 'Pc/.1-° - r A, t. r C r ra4, S' 1' it r ev^ i y t 1 -' a $26.110 2 REINSPECT FEE 0 NO CHARGE ; It i s unlawful for any Carpenter, Contractor, Builder or of to cover to cause to be covered, any part lath, earth the work with peo th or other material, until t ing, proper inspector has had amp 1e time to app installation. 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O H M r SD N n O M O h N O> m'1 'D • H a tr 'D • H O • 0 111 W Z 0 , 1 0. P. m b > ` p i< M 0 4. N m J \ I- CO k0 A \ 0o r A r W ,. (-5, G White, Debbie From: Walker, Chris Sent: Wednesday, June 08, 2011 11:54 AM To: White, Debbie Subject: 1090 Jasmine They need to install a clean out at the property line with an RT -1 cleanout box on it. erg wa�Pl#eie City of atlantic £i3eacPc ?Date* &Semen utieitieo Conveyance `.viuioion Dixectan cwa.Men(kcoa8.ws ,1 Peon /904- 247 -5874 sax/ 904 247 - 5872 1 White, Debbie From: Clemons, Malcolm Sent: Wednesday, June 08, 2011 8:49 AM To: White, Debbie Subject: RE: CERTIFICATE OF OCCUPANCY - 1090 JASMINE STREET - 10 -871 Irrigation system installed with no backflow preventer installed. Backflow inspection failed. Malcolm From: White, Debbie Sent: Monday, June 06, 2011 12:40 PM To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika; Doerr, Sonya Cc: Graham Shirley Subject: CERTIFICATE OF OCCUPANCY - 1090 JASMINE STREET - 10 -871 I have a request for a Certificate of Occupancy for 1090 Jasmine, June 7, 2011, pm inspection requested. I have requested a final survey and elevation certificate. Please email me your results. Thanks and have a great week. Debbie White Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX P }L-1-41L) '3 1 White, Debbie From: Nodine, Phil Sent: Tuesday, June 07, 2011 2:57 PM To: White, Debbie Subject: RE: CERTIFICATE OF OCCUPANCY - 1090 JASMINE STREET - 10 -871 OK for Public Works From: White, Debbie Sent: Monday, June 06, 2011 12:40 PM To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika; Doerr, Sonya Cc: Graham Shirley Subject: CERTIFICATE OF OCCUPANCY - 1090 JASMINE STREET - 10 -871 I have a request for a Certificate of Occupancy for 1090 Jasmine, June 7, 2011, pm inspection requested. I have requested a final survey and elevation certificate. Please email me your results. Thanks and have a great week. Debbie White Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX 1 White, Debbie From: Hall, Erika Sent: Monday, June 06, 2011 3:18 PM To: White, Debbie Subject: RE: CERTIFICATE OF OCCUPANCY - 1090 JASMINE STREET - 10 -871 Debbie, There was no tree permit for this project. Thanks, Erika From: White, Debbie Sent: Monday, June 06, 2011 12:40 PM To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika; Doerr, Sonya Cc: Graham Shirley Subject: CERTIFICATE OF OCCUPANCY - 1090 JASMINE STREET - 10 -871 I have a request for a Certificate of Occupancy for 1090 Jasmine, June 7, 2011, pm inspection requested. I have requested a final survey and elevation certificate. Please email me your results. Thanks and have a great week. Debbie White Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX 1 White, Debbie To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika; Doerr, Sonya Cc: Graham Shirley Subject: CERTIFICATE OF OCCUPANCY - 1090 JASMINE STREET - 10 -871 I have a request for a Certificate of Occupancy for 1090 Jasmine, June 7, 2011, pm inspection requested. I have requested a final survey and elevation certificate. Please email me your results. Thanks and have a great week. Debbie White Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX 1 m r ro ro >4 ro >4 N to r > r r >4 w r r H > ro o n a n ro m m E 0 0 0 - 7 >4 x N m w w 0 o - 0 -4 ro > E ; 0 t i H M n n m m xy xy o roozzo H0 o o 4 x \ rnmH> Kro MMM 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 H t xl r r r r N r r N r H H H H H r r H � C r 0 (0 O >4 �G7 >4 0 > t7 X D X X HH 0(0 M• .. .. .. 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H 10 H M M '0 H > O H '[1 '=1 I- O M H M H Z '1 (0 t o (1)00 0 i M HH 00 En 0 0 0 P Q 0 0 00 0 00 n4 o T 0'00 0 �x� g H bb U U H H H Mzr'*1H• H M. 0r(00' z O'0'"Ix 'MC7 H HH M M MM to M M M H H H O M M a'O mm O { H � M ,0 £ m C H z z n n 0 z v o 0 0 0 £ r0 'G o' £a 00 0' o .ro H ZH3 o M OH H ro M '0 '0 C el C IJ 0 E G0) 00 \ 0 H'0 0 0414 01 0 H 01 ■ (D rt '0 0 (1000' t1 fn •• - Z n 0 0 'OtD m0 '*1 Ha 'O 00 0 0 z 0 O n n H m z n H. " r• 'G Z £ 0 0 H x 10 n Hn re N> xi J H M 3 n n 0 X ro C C >a) H C m t7 MOW •• O' 0 C n H C b ro b ro C a h1 n N'O n z M H o x 0 0 0 0 ro H b b M3 1100 m 0 10 11) Z 0 00 0' U z H H n n 0 C n E 0 m x 0< H M M H H 01 0 C H m m 0 H H 0' .. .. C x ti 0 H H t� H C '40 '1 P. (111 MO 1 m 0 0 (0 7 0 01 H H 0 F r- ' A Z O M R m w Ott 0 HM HP, (0 0 C H 0 M 0 0 N 000 M 0 H Vo H a O' (o • H 0 • 0 ro 0 0 o 11 a 1-.- (11 00 H 0 M M m H 0 HH White, Debbie From: Griffin, Michael Sent: Wednesday, June 15, 2011 4:31 PM To: White, Debbie Subject: RE: 1090 Jasmine St. Looks good, thanks. Mike G. From: White, Debbie Sent: Wednesday, June 15, 2011 4:15 PM To: Griffin, Michael Subject: FW: 1090 Jasmine St. Mike, Elevation Cert attached for 1090 Jasmine. Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX From: Tony f mailto :tonvCtboatwriahtland.coml Sent: Wednesday, June 15, 2011 2:49 PM To: White, Debbie Subject: 1090 Jasmine St. Hi Debbie, the final survey an elevation certificate is attached. Let me know if you have any questions. 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( m a __ Z Z L.lOS ° A - -- �(� ,00'05 3„00,9 q v m G) ', p Q 0 Q ( a13u .00 3 „i' .£I.LOS ) 6 C m ) n ° p zl oN nZ z r-• D * —1 odoa 011811d 03nvd AVM 30 lHOla ,06 ,� _ m 'x273 1 332J1S 3NIWSVP r ° X // CW C < 0 N A ny = C O 23 ' D0 1> - 4 :UD - fV r o z � D � o mm O V r m O Z� z > r. 00 :m v r) I 0 X (n 2 K K X C7 >� m Z -_ D • 2aV) m - o Ko >O r = o F• rp'�CKNOCIVV= OD ca Fn --I • m. - Z ia7 ..r.0 m� m E : - : - ) r - C m D ( Tt C7 o 03 - z Z 0 >ZON =Xx) Oo P c z 13 m m -m 0 m CO O r0D .-.O m TI W r --1 mr /)Z o_ cm n� u.) co 0 D D DZ O Z,' GI 0 S V Cm o-0 TI N N X CO U 03 Z X X m N f � CITY OF ATLANTIC BEACH CERTIFICATE OF OCCUPANCY WORKSHEET Date Requested: Contractor Name: /o- E� #: / Permit �Y G Property Address: /° 1 ° � --- <Yr.. Legal Description: Improvements to the above - described property have been completed in accordance with the terms of the permit and are certified to be ready for occupancy as: ❑ Single- Family Residence ❑ Commercial ❑ Other: Lowest Floor Elevation: Required As Built FFE The following must be completed before issuing Certificate of Occupancy: Department Date Notified Date Approved Approved By Fire Dept. Public Works Public Utilities Building Planning 7/.6 I Tree Mitigation / / Satisfied ley I4 G "'c Final Survey with FFE Yes No All Re- Inspect Fees Paid Yes No Termite Treatment Yes No . x 0 Cr woQ ¢ rn to d W 5= , N ^ W 0 - z � m tn • _ 0 M `O O ix � 1- �m 0 0 O W O 8d O W C J 0 LLJ a. 0 0 (x W Zz 1- w w Jd m N W Ow = Q w Q W 0 re W Q xI-- w - JW>-in_. = d 13.1 La Z N Z 01 - ► - F - � QO S (nD O Zw 0 m Qp ( O(n� °�w1� 0 2 0 = U 0 Q0M 0 it_ V j � z } 0 Q c o U J p w. - .1... p > E w p . v a 0 LAN. 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V' a = WI- ,._o to U W - p g� 1� x Vi 0 0 Z .� E2 0 1 . 0 0 0 . � � . N - w x < W I �C ( V n x ``-� u^i e � � � 0 (� z La O O ^ w N > - 5 K 179 m 1... w C a N 0 0tx z a N g . .-5 to o o it 25' BUFFER PER THE �� OF ATLANTIC BEACH �� w < / T [CITY o u / /// N ° z a Za j O tli N01'16'00 'W 50.00 < (N01'18'42 "W 50.01' FIELD ) m 0 0 BEGONIA STREET > w WW 5 0' RIGHT OF WAY UNIMPROVED PUBLIC ROAD z N W 6 White, Debbie From: Walker, Chris Sent: Friday, June 17, 2011 9:47 AM To: White, Debbie Subject: RE: 1090 Jasmine Yes the RT -1 is there. From: White, Debbie Sent: Friday, June 17, 2011 9:31 AM To: Walker, Chris Subject: RE: 1090 Jasmine Malcolm want me to have him call him about this. He told me yesterday he was leaving City Hall to go and install it. Is your part okay? Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX From: Walker, Chris Sent: Friday, June 17, 2011 8:50 AM To: White, Debbie Subject: RE: 1090 Jasmine The RT -1 box is there but there is not a backflow preventer. He needs to have that. From: White, Debbie Sent: Thursday, June 16, 2011 4:20 PM To: Walker, Chris; Clemons, Malcolm Subject: 1090 Jasmine The contractor has says he has installed the backflow on the sprinkler system and applied for the permit and says he has installed the RT1 box. Could you guys verify and let me know the results of your inspection. Thanks, Debbie Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX 1 White, Debbie From: Clemons, Malcolm Sent: Friday, June 17, 2011 2:34 PM To: White, Debbie Subject: RE: Certificate of Occupancy Inspections Debbie, 1090 Jasmine has backflow preventer installed.lnspection OK. Malcolm From: White, Debbie Sent: Friday, June 17, 2011 7:59 AM To: Clemons, Malcolm Subject: RE: Certificate of Occupancy Inspections Thanks, let me know about 1090 Jasmine. Says he installed the backflow. Thanks again, Debbie Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX From: Clemons, Malcolm Sent: Friday, June 17, 2011 7:57 AM To: White, Debbie Subject: RE: Certificate of Occupancy Inspections Backflow inspection ok.Malcolm From: White, Debbie Sent: Friday, June 17, 2011 7:49 AM To: Clemons, Malcolm Subject: FW: Certificate of Occupancy Inspections Malcolm, Have you checked the backflows at 125 and 127 Jackson Road? Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX From: Walker, Chris Sent: Friday, June 17, 2011 7:46 AM To: White, Debbie Subject: RE: Certificate of Occupancy Inspections I send someone over there first thing this morning. From: White, Debbie Sent: Friday, June 17, 2011 7:45 AM 1 To: Walker, Chris Subject: RE: Certificate of Occupancy Inspections Great, 1090 had some issues and they said they corrected them. ? ?? Thanks, Debbie W Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX From: Walker, Chris Sent: Friday, June 17, 2011 7:45 AM To: White, Debbie Subject: RE: Certificate of Occupancy Inspections I told someone a few days ago that 125/127 were good to go. I will let you know about 1090 today okay? From: White, Debbie Sent: Friday, June 17, 2011 7:43 AM To: Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm Subject: Certificate of Occupancy Inspections I have three pending c /o's all approvals except Public Utilities as follows: 1090 Jasmine Street 125 Jackson Road 127 Jackson Road Please email me your results. Thanks, Debbie W Debbie White CITY OF ATLANTIC BEACH BUILDING DEPARTMENT (904) 247 -5826 (904) 247 -5845 FAX 2 W w w w w H ro 'o H ? ro O n› no iP N rd ro b Z Z 0 U a M \ -, \ rntlHO kro o 0 0 0 0 0 0 o 0 z r PM 02 .a w N r r w 0 H ro n nz z m m m m m-. .( -. 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O C 01(1(110 r t" 0 no H H 2 • oH•trw H m 1 1'11 rorom on H 0 0 w 0 0 0 ro0 000 t1N m 0.( 0 0 ( 2 N Mod 44H a H o m V1 k < Z O H 0 m 'b 0 .. .. m - na a m rt 0 m a 10 m m k H 2 rt 0 o 0H th (D ry 1-1,111P rr H 9 w 0 a • H. r H z 0 A a - a r 0 0. V) rt rt 0 0 m N O P) P. ID CD o m rr H 0 w a rt rr rt m 0.0 0 rt m m rr r^ w�� _ � >b N• H 0 rt0 % 'o H t1 t1 Cr M rt 0 a ry m P H O 0',1 0 0 0 0 m m ID ry p • N N N co \ M H N H w • 2TMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE 1 OMB No. 1E Expires Mar ergency Management Agency tod Insurance Program Important: Read the instructions on pages 1 -9. t SECTION A - PROPERTY INFORMATION P r t 0°mPa ng Owner's Name SCOTT HULIHAN rljc Nw ber `5 'ii' ` '' ng Street Address (including Apt, Unit, Suite, and/or Bldg. No. ) or R oute and Box_No. ,0 n nk1 1 C I n1( VINE STREET 16 9d P.O. J4 S/y/ /kJ E ATLANTIC BEACH State FL ZIP Code 32233 arty Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) OCK 180 & LOT 3, BLOCK 179, ATLANTIC BEACH SECTION "H" (PLAT BOOK 18, PAGE 34) ng Use (e.g., Residential, Non - Residential, Addition, Accessory, etc.) RESIDENTIAL de /Longitude: Lat. 30° 19' 57.16" N Long. 81° 25' 24.54" W Horizontal Datum: ❑ NAD 1927 ® NAI h at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. ng Diagram Number 1A building with a crawlspace or enclosure(s): A9. For a building with an attached garage: quare footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage N/A o. of permanent flood openings in the crawlspace or b) No. of permanent flood openings in the attache( ,closure(s) within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A otal net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A ngineered flood openings? ❑ Yes ►:l No d) Engineered flood openings? ❑ Yes 2 SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION community Name & Community Number B2. County Name B3. State BEACH 120075 DUVAL FL 'Panel Number B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevi 075 0001 D Date Effective /Revised Date Zone(s) AO, use base flo N/A 04/17/89 "X" SHADED N/A ate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ] FIS Profile ® FIRM ❑ Community Determined ❑ Other (Describe) ate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) N/A building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes El (nation Date ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) ig elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construc r Elevation Certificate will be required when construction of the building is complete. ions — Zones A1-A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1 -A30, AR/AH, AR/A0. Complete (ter according to the building diagram specified in Item A7. Use the same datum as the BFE. mark Utilized Vertical Datum NGVD 1929 rsion /Comments Check the measurement used. op of bottom floor (including basement, crawlspace, or enclosure floor) 7.6 ® feet ❑ meters (Puerto Rico only) op of the next higher floor N /A. ❑ feet ❑ meters (Puerto Rico only) ottom of the lowest horizontal structural member (V Zones only) NIA. ❑ feet ❑ meters (Puerto Rico only) ttached garage (top of slab) DETACHED. ❑ feet ❑ meters (Puerto Rico only Dwest elevation of machinery or equipment servicing the building 7.2 ® feet ❑ meters (Puerto Rico only) )escribe type of equipment and location in Comments) Dwest adjacent (finished) grade next to building (LAG) 6.7 ® feet ❑ meters (Puerto Rico only) ighest adjacent (finished) grade next to building (HAG) 6.9 ® feet ❑ meters (Puerto Rico only) owest adjacent grade at lowest elevation of deck or stairs, including N /A. ❑ feet ❑ meters (Puerto Rico only) tructural support SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION ication is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation n. I certify that the information on this Certificate represents my best efforts to interpret the data available.! <d that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001.0 k here if comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Yes ❑ No Name DONN W. BOATWRIGHT, P.S.M. License Number LS 3295 iSIDENT Company Name BOATWRIGHT LAND SURVEYORS, INC. \-#' N 500 Rio a R S DRI E City JACKSONVILLE BEACH State FL ZIP Code 32250 Date 06/10/2011 Telephone (904) 241 -8550 m 81 -31, Mar 09 See reverse side for continuation. Replaces all pre. NT: In these spaces, copy the corresponding information from Section A. F,'titYbe Co eet Address (including Apt., Unit, Suite, and /or Bldg. No.) or P.O. Route and Box No. ?W INE STREET ,, '° 4TIC BEACHState FL ZIP Code 32233 Cortt1 t`OQ titorbe SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) ;ides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A5 INFORMATION IS APPROXIMATE AND DETERMINED FROM GOOGLE EARTH. :2e ELEVATION TAKEN ON TOP OF PLATFORM FOR A/C UNIT. Date 09/17/2010 ❑ Check here if ON E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOL AO and A (without BFE), complete Items E1 -E5. If the Certificate is intended to support a LOMA or LOMR -F request, complete Sectio Items E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. :le elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest (HAG) and the lowest adjacent grade (LAG). D of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HI of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the V uilding Diagrams 6 -9 with permanent flood openings provided in Section A Items 8 and /or 9 (see pages 8 -9 of Instructions), the next hi ation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. led garage (top of slab) is . ❑ feet ❑ meters ❑ above or ❑ below the HAG. f platform of machinery and /or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG. AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain m ance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G. SECTION F - PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION y owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA- issued or community -i: must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. vner's or Owner's Authorized Representative's Name City State ZIP Code Date Telephone ❑ Check here SECTION G - COMMUNITY INFORMATION (OPTIONAL) ;ial who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, I Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8 and G9. information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or e authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) ;ommunity official completed Section E for a building located in Zone A (without a FEMA- issued or community- issued BFE) or Zone AC following information (Items G4 -G9) is provided for community floodplain management purposes. Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued rmit has been issued for: ❑ New Construction ❑ Substantial Improvement in of as- built lowest floor (including basement) of the building: ❑ feet ❑ meters (PR) Datum (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters (PR) Datum nity's design flood elevation ❑ feet ❑ meters (PR) Datum al's Name Title Name Telephone Date ❑ Check here 181 Mar 09 Replaces all pre% rn o OVO8 3nand a3n0adwlN0 AVM JO 1HOI8 O9 m < v 1332:11S V IN003 �� 0 0 ( 01313 ,10'09 M„Zt',BL I,ON ) o 00 M „00,9L.LON D 0 ro x -- 0 m v � -v o ro / .Z C I m o t� v N / /// n O D m 'row H OV3a 011NV11V 30 1.113 : m x I ” 6 N 3H1 213d a333n8 ,SZ II m V' o 1 9 0 m y o O Z 1 Z rTI D N= z 03 w Al C 6 op O < D m Gi v X N" N O O 9‘, °i Ln 0 0 A m `- (fl m tri W A W fn V1 V1 N • O r 0 0 4. y N S O N 0 = N rn I. m = m 2 • -._. d x ,o V m A Z O W 0 7z, O I g N --I Z , . D D t m o i s �, GO (I) O = AC D A - r Dz OD A m O ° O ( D N � m�'� ITI v� ? 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"Early Power" is purely for our construction convenience, it is not required by Codes and does not substitute for Finallnspections or the CIO (Certificate of Occupancyjtfiat must be issued before occupancy, and as such is at the discretion of the Building Official. 2. The City of Atlantic Beach will make a special inspection prior to the early power energizing. All rough inspections must have prior Approval, including meter base connections. 3. Occupancy or use of the new construction before a formal C/O constitutes fraudulent use of the early electric service. Such action is expressly prohibited and penalized by The City of Atlantic Beach Ordinances. A violation of this Agreement shall result in a request for prompt removal of electric service after a twenty -four hour notice. 4. "Early Power" release authority is the Electrician and/or the Contractor and must not occur before: a. Equipment, devices and fixtures are installed (or blanked off) safely. b. Panel is complete with breakers and cover, and (labeling required at fmal inspection). c. Service connection and grounding is complete. d. The electric system has safely passed through electrical check. e. Meter can is permanently marked with address. f. Temporary address numbers displayed (Permanent numbers are required for C /O). 5. This fully completed form is to be submitted to the Building Department by hand, mail or fax. 6. Future such Agreements will not be accepted from those who violate any one of the above items. CONTRACTORPfrIUil P5 &J J42( p('S e-_, L- C DATE mil/ y i 2 / / + PRINT NAME mI 6=1 �L 1� ` L(il OS � , P / i.1 L / ELECTRICIAN DATE /, 1 l2 201( PRINT NAME 7-. K"v i r 800 Seminole Road, Atlantic Beach FL 32233 Phone: (904)247 -5826 Fax: (904)247 -5845 http: / /www.coab.us revised 11.29.06 Ar- CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 '±' . 0 31 % Application Number 10- 00000871 Date 8/09/10 Property Address 1090 JASMINE ST Application type description SINGLE FAMILY RESIDENCE Property Zoning TO BE UPDATED Application valuation . . . 127412 Application desc new home Owner Contractor PHILLIPS BUILDERS LLC 1250 SELVA MARINA ATLANTIC BEACH FL 32233 (904) 349 -2999 Structure Information 000 000 Construction Type TYPE 5 -B Occupancy Type RESIDENTIAL Flood Zone ZONE AE Permit ELECTRICAL PERMIT Additional desc . TEMP POLE Sub Contractor . DANCIN ENTERPRISES INC.(ELEC) Permit Fee . . . 90.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/05/11 Special Notes and Comments VERIFY FINISHED FLOOR ELEVATION SURVEY /CERTIFICATE WAS PROVIDED PROPERTY IN A FLOOD ZONE FINISHED FLOOR ELEVATION SURVEY REQUIRED AT SLAB INSPECTION FINISHED FLOOR ELEVATION SURVEY REQUIRED AT SLAB INSPECTION 25 -foot wide natural vegetative buffer required on west side of lot. No clearing or development is permitted in this area. Buffer must be shown of final survey for CO and deed restriction must be recorded. See attached. *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS PERMIT IS API'RtlV E T IP&L4 Y4 aQNC I' 'ITW PQ OTATWI F E 1Cg ai lWl S AND THE FLORIDA BUILDING CODES. �r °� CITY OF ATLANTIC BEACH �� s z 800 SEMINOLE ROAD j r x .; ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 - C S) Page 2 Application Number 10- 00000871 Date 8/09/10 Special Notes and Comments * AN ELEVATION CERTIFICATE SHALL BE SUBMITTED BEFORA A FRAMING INSPECTION CAN BE PERFORMED.* A twenty -five foot wide natural vegetative buffer must be provided on western side of lot. No clearing or development is permitted in this area. Buffer must be shown on survey submitted with request for Certificate of Occupancy. Deed resriction must be recorded. See Attached for guidance. Garage to be moved 5 -feet to the west. Approved for zoning only; must meet flood zone requirements per Bldg. Dept. Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. Fee summary Charged Paid Credited Due Permit Fee Total 90.00 90.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 90.00 90.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. f s , CITY OF ATLANTIC BEACH = .� 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 4 "4,01.119 . '" Application Number 10- 00000871 Date 8/09/10 Property Address 1090 JASMINE ST Application type description SINGLE FAMILY RESIDENCE Property Zoning TO BE UPDATED Application valuation . . . 127412 Application desc new home Owner Contractor PHILLIPS BUILDERS LLC 1250 SELVA MARINA ATLANTIC BEACH FL 32233 (904) 349 -2999 Structure Information 000 000 Construction Type TYPE 5 -B Occupancy Type RESIDENTIAL Flood Zone ZONE AE Permit ELECTRICAL PERMIT Additional desc . Sub Contractor . DANCIN ENTERPRISES INC.(ELEC) Permit Fee . . . 115.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/05/11 Special Notes and Comments VERIFY FINISHED FLOOR ELEVATION SURVEY /CERTIFICATE WAS PROVIDED PROPERTY IN A FLOOD ZONE FINISHED FLOOR ELEVATION SURVEY REQUIRED AT SLAB INSPECTION FINISHED FLOOR ELEVATION SURVEY REQUIRED AT SLAB INSPECTION 25 -foot wide natural vegetative buffer required on west side of lot. No clearing or development is permitted in this area. Buffer must be shown of final survey for CO and deed restriction must be recorded. See attached. *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS PERMIT IS API QNC ITII4PQ oTgailigfitEgiRckliAWANWM AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ; ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 4 ' 01079. Page 2 Application Number 10- 00000871 Date 8/09/10 Special Notes and Comments * AN ELEVATION CERTIFICATE SHALL BE SUBMITTED BEFORA A FRAMING INSPECTION CAN BE PERFORMED.* A twenty -five foot wide natural vegetative buffer must be provided on western side of lot. No clearing or development is permitted in this area. Buffer must be shown on survey submitted with request for Certificate of Occupancy. Deed resriction must be recorded. See Attached for guidance. Garage to be moved 5 -feet to the west. Approved for zoning only; must meet flood zone requirements per Bldg. Dept. Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A sewer cleanout must be installed at the property line. Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible. A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. Fee summary Charged Paid Credited Due Permit Fee Total 115.00 115.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 115.00 115.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION 0 `' d ` T N CITY OF ATLANTIC BEACH .l 0 ~ 9 _7 / 800 Seminole Rd, Atlantic Beach, FL 32233 r' Ph (904) 247-5826 Fax (904) 247 -5845 � JOB ADDRESS: ID 70 S c� , A. r ] t - e e4,,/Ld, ' c ffe'tic � I� rL PERMIT # NEW ERVICE Overhead n Underground n Underground up Pole esidential ( in) Service / [10-100 amps ❑ 101- 150amps yi_51-200amps ❑ amps # of Meters ❑Commercial (Main) Service ❑O -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps ❑CT Service amps Conductor Type Size ."°" ( 4,— ❑ Multi- Famil (Main) Service ❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps am s # Unit Meters ❑ Temporary Pole ❑ amps t\ei0J CA1V SERVICE UPGRADE ❑ amps ❑ CT Service . ps NEW FEEDER (ADDITIONS, ACC SSORY STRUCTURES, ETC.) ❑ 100 amps ❑ 150amps .. v 9 Damps ❑ amps ❑ CT Service amps ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC. Outlets /Switches: 5 30amps 31- 100amps 101- 200amps Appliances: 0- 30amps 31- 100amps 101- 200amps A/C Circuits: 0- 60amps 61- 100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: /S OTHER ELECTRICAL PROJECTS ❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts /amps VALUE OF WORK $ REPAIRS/MISCELLANEOUS ❑ Replace Burnt /Damaged Meter Can ❑ Safety Inspection ❑ Panel Change ❑ OH to UG ❑ Other: Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. p an Y &•• -C_ I f c� - G Property Owners N e Pk i l I l S 23v ( ( c) t ( Phone Number 7.0 f '3' l / Electrical Com t ✓� � Fit I f p i 1 S e � Office Phone WI �n` /(c� -10 1 Fax 701/ 9'k, ' rp9i y S -L � Co. Address: 35 O 3C. -4Z. L c& ,. 1 f City ,Jc .c k5VA V; 1( State Ft .Zip 3 b z License Holder (Print): 10 Ck. . • iim T� State Certification/Registration # X00001 Notarized Signature of License Holder pro- .,�Y t 'k, PATRICIA D. HURD ti 4) " " .. c MY COMMISSION ii DO 915722 Sworn and subscribed before is / day of /`� �i S 7� 20 / # ?., � r J 4 '!' �e EXPIRES: a T u B e i d9 m ��M 2 s Signature of Notary Public rFor C(�L /�