Permit 1212-1223 Jasmine Street ADDRE S S--
BUT 7 nTN,- �2
PERMIT NUMBER
INSPECTIONS : F,'
�)OTTNG
U IN D E R ST :a�B =T�TTME 7 NG
C,T
A
7R,��14171j(7,
('CV7F-TT-�
T N C",IT A- C
F I N7-'-7- 2 77 'L I N 7
E R T I F I F C
ELECTRICAL PERMIT #
1 N S P E C T--3 NSS ROUGH
F I NAT
C HJD,IN T C.!�
ME � j PERMIT #
PL UMr-TN�- PER�AT- 4
N 0 TE S
CT
ITY OF ATLANTIC BEACH
TPUREE REMOVAL APPLICATION
All applications must be submitted with seven(7) copies and received by 5 PM on the Fri&y ten
(I U) dUUrior to the scheduled meeting in order to be placed on the agenda.
*INCOMPLETE APPLICATIONS OR INACCURATELY MARKED SITES
WILL NOT BE PR CESSED.
-1,2
APPLICANT KAME ADDRI�SS "�TELEPHONE
'7 X
ADDRESS OIR I VGAT DESCRIPTION'OF TIU-E REMOVAL SITE
3. REASON FOR PROPOSED TREE REMOVAL: ?(j/67) 6 P).q
4. HAS TIUS SITE BEEN TO THE TREE BOARD BEFORE? OYES ONO ONOTSURE
5. PROPERTY ZONING: ORESIDENTIAL DCOMMERCIAL
6. LIST TREES PROPOSED FOR REMOVAL:
SPECIES DIAMETER DIAMETER MITIGATION
INTERIOR EXTERIQ
0064f Wc 3
11, 311
------------
Diameter at Breast Height(D.B.H.)is measured at 4.5 feet above grade. To accurately determine
diameter, measure the trunk circumference and divide by 3.14. Diameter of multi-trunked trees is
determined by adding together the diameter of each trunk as measured immediately above the
forks.
7. SITE PLANITREE SURVEY indicating:
a) Changes of topographic features such as hills and low areas affecting trees.
b) E)dsting and proposed structures.
C) Location of all trees with Diameter at Breast Height (DBH) of six inches or more.
d) Tree species a nd sizes in DBH.
e) Trees to be removed should be clearly marked with an'W'.
f) Trees to be pre.served on-site for mitiption must be marked with brackets
g) Location, size and species of any proposed new replacement trees marked with a
circle "0".
/h).* Location of ulilities and easements as applicable.
i) Location of trees to be preserved on-site with barri'cading indicated.
8. ON-SITE REQUIREMENTS:
a) , All trees identified for removal MUST be marked on-site by RED flagging,
paint or tape.
b) All trees to be preserved on-site for mitigation WST be marked with BLUE
flagging, paint or tape.
c
The front property comers must be marked by stakes or paint indicating the Lot
Number or Address.
9. INCON[PLETE APPLICATIONS OR INACCURATELY MARKED SITES
WILL NOT BE PROCESSED.
I HEREBY AGREE TO CONTLY WITH ALL PROVISIONS OF CHAPTER 23, ARTICLE 11,
TREE PROTECTION, AND ALL OTHER APPLICABLE CODES AND ORDINANCES OF
THE CODE OF ORDINANCES OF ATLANTIC BEACH.
plicant' ignature Date
Owner's Signature Date
CITY USE ONLY:
�2
Tree Consery oard Chairperson Date
ST
ZECE
IVED
I rea.. ROWWW
FEB '2 6 2601
3ity of Atl an, ic Beach
Building And Zoning
100
4K
i �A
It
D5
C)//,
-6 RA
DEPARTMENT OF PUBLIC WORKS
1200 SANDPIPER LANE
ATLANTIC BEACH,FLORIDA 32233-4319
TELEPHONE: (904)247-5834
FAX: (904)247-5843
SUNCOM: 852-5834
http://ci.atlantic-beach.fl.us
April 30, 2002
Mr. Craig Burkhart
Construction Manager
Beaches Habitat
P.O. Box 50939
Jacksonville Beach, FIL 32240
RE: 1221, 1217 and 1209 Jasmine Street
Dear Mr. Burkhart:
We received your letter dated April 25, 2002 and wish to advise you that the easement
agreement must be shown on the survey, and the survey needs to be signed and
sealed by a Florida Licensed Surveyor. The easement agreement needs to reference
the survey and will be recorded by the City Clerk.
If you have any questions, please contact me at 247-5834.
Sincerely,
Robert S. Kosoy, P.E�
Director of Public Works
Attachment
cc: Jim Hanson, City Manager
Alan Jensen, City Attorney
Sonya Doerr, Community Development Director
Don Ford, Building Official
Maureen King, City Clerk
R S K/21
APR-25-2002 12:45 DONAHOO BALL ?919563 P.01/01
BEACHES HABITAT (0
HABITAT FOR HUMANITY OF THE
JACKSONVILLE BEACHES, INC.
1671 FRANCIS AVENUE
P.O. Box 60939
JACKSONVILLE BEACH, FLORIDA 32240
April 25,2002
PTA FA CSIMITLE 904-24 7-5843
Mr. Bob Kosoy
Director of Public Works
City of Atlantic Beach, Florida
1200 Sandpiper Lane
Atlantic Beach, Florida 32233
Re: 1209Y 1217 and 1221 Jasmine Street
Atlantic Beach,Florida 32233
Dear Mr. Kosoy,
Please be advised that Beaches Habitat will grant to the City of Atlantic Beach a non-
exclusive permanent drainage and utility casemcat on the above referenced lots that is tcn(10)feet
wide along the fmnt and rear lot lines and five(5)f=t widc along the side lot lines,
If you have a form of casement agreement that is used by the City,please provide it to me
at your convenience. Otherwise,I will submit to)rou a form of easement agreement for your review
and approval.
Yours very truly,
Haywood M. Ball,President
HMB/cjs
��MMLINO-*P-Xmf UUMIAM 11MM=Ma&damuitAur Us COAA m nwwo,wpo
TOTAL P.01
DEPARTMENT OF PUBLIC WORKS
1200 SANDPIPER LANE
ATLANTIC BEACH,FLORIDA 32233-4318
1�C, TELEPHONE: (904)247-5834
FAX:(904)247-5843
-5834
SUNCOM:852
http://ci.atlantic-beach.fl.us
C
April 30, 2002
Mr. Craig Burkhart
Construction Manager
Beaches Habitat
P.O. Box 50939
Jacksonville Beach, FIL 32240
RE: 122�1, 1217 and 1209 Jasmine Street
Dear Mr. Burkhart:
We received your letter dated April 25, 2002 and wish to advise you that the easement
agreement must be shown on the survey, and the survey needs to be signed and
sealed by a Florida Licensed Surveyor. The easement agreement needs to reference
the survey and will be recorded by the City Clerk.
If you have any questions, please contact me at 247-5834.
Sincerely,
Robert S. Kosoy, P.E�
Director of Public Works
Attachment
cc: Jim Hanson, City Manager
Alan Jensen, City Attorney
Sonya Doerr, Community Development Director
Don Ford, Building Official
Maureen King, City Clerk
RSK/9?
APR-25-2002 12:45 DONAHOO BALL 7919563 P.01/01
BEACHES HABITAT
HABITAT FOR HUMANITY OF THE
JACKSONVILLE BEACHES, INC.
1671 FRANCisAVENIJE
P.O. Box 50939
JACKSONVILLE BEACH, FLORIDA 32240
April 25, 2002
YTA FA CSTMrLE 904-24 7-5843
Mr. Bob Kosoy
Director of Public Works
City of Atlantic Beach,Florida
1200 Sandpiper Lane
Atlantic Beach, Florida 32233
Re: 1209, 1217 and 1221 Jasmine Street
Atlantic Beach,Florida 32233
Dear Mr. Kosoy,
Please be advised that Beaches Habitat will grant to the City of Atlantic Beach a non-
exclusive permanent drainage and utility easement on the above referenced lots that is ten(10)fee
wide along the front and rear lot lines and five(5) feet wide along the side lot lines.
If you have a form of easement agreement that is used by the City,please provide it to me
at your convenience. Otherwise,I will submit to you a form of easement agreement for your review
and approval.
Yours very truly,
/4`7 krr`�O`�.
Haywood M. Ball,President
HMB/cj s
��- MWCI-*P-W(rIUM4200 HIMM002 M&eg"muALwu W COAS M�R".Wo
TOTAL P.01
DEPARTMENT OF PUBLIC WORKS
1200 SANDPIPER LANE -4318
ATLANTIC BEACH,FLORIDA 32233
-5834
TELEPHONE: (904)247
FAX:(904)247-5843
SUNCOM: 852-5834
http://ci.atlantic-beach.fl.us
Apri130, 2002
Mr. Craig Burkhart
Construction Manager
Beaches Habitat
P.O. Box 50939
Jacksonville Beach, FL 32240
RE: 1221, 1217 and 1209 Jasmine Street
Dear Mr. Burkhart:
We received your letter dated April 25, 2002 and wish to advise you that the easement
agreement must be shown on the survey, and the survey needs to be signed and
sealed by a Florida Licensed Surveyor. The easement agreement needs to reference
the survey and will be recorded by the City Clerk.
If you have any questions, please contact me at 247-5834.
Sincerely,
Robert S. Kosoy, P.E.�
Director of Public Works
Attachment
cc: Jim Hanson, City Manager
Alan Jensen, City Attorney
Sonya Doerr, Community Development Director
Don Ford, Building Official
Maureen King, City Clerk
RSK/Y
APR-25-2002 12:45 DONAHOO BALL 7919563 P.01/01
BEACHES HABITAT (0
HABITAT FOR HuMANITY OF THE
JACKSONVILLE BEACHES, INC,
1671 FRANcisAVENUE
P.O. Box 50939
JACKSONVILLE BEACH, FLORIDA 32240
April 25, 2002
PTA FA CSIMILE 9 04-24 7-5843
Mr. Bob Kosoy
Director of Public Works
City of Atlantic Beach,Florida
1200 Sandpiper Lane
Atlantic Beach, Florida 32233
Re: 1209, 1217 and 1221 Jasmine Street
Atlantic Beach,Florida 32233
Dear Mr. Kosoy,
Please be advised that Beaches Habitat will grant to the City of Atlantic Beach a non-
exclusive permanent drainage and utility casement on the above referenced lots that is ten(10)feet
wide along the front and rear lot lines and five(5) fcct wide along the side lot lines,
If you have a form of easement agreement that is used by the City,please provide it to me
at your convenience. Otherwise,I will submit to you a form of easement agreement for your review
and approval.
Yours very truly,
Haywood M. Ball,President
HMB/cjs
CMVCAIW HIMM2 Mis�ui�Laucr tu Co"m�"",w"
TOTAL P.01
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-SM-FAX 247-SM
PERMIT INFORMATION LOCATION INFORMATION
Permit Number 21587 Address: 1221 Jasmine Street
PermitType: TREE REMOVAL Atlantic Beach, FI 32233
Class of Work: REMOVAL Township: Range: Book:
Proposed Use: SINGLE FAMILY Lot(s): Block: Section:
Square Feet: Subdivision:
Est.Value: Parcel Number.
Improv. Cost: I � ,MWERINEQRMATION. -----
Date Issued: 3/08/2001 Name: Beaches Habitat
Total Fees: Address: P.O. Box 50939
Amount Paid: Jacksonville Beach, FI 32250
Date Paid: Phone, (904)241-1222
Work Desc: No Mitigation
FEES
BEACHES HABITAT
Imp%ctions Rftfer*d
TREE BOARD COMPCIA4�E
NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND
MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE
PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS-
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW,
A NTI EACH BUILDING DEPT.
CITY OF ATLANTIC BEACH
TREE REMOVAL APPLICATION
M ap -on th ri
12fications must be submitted )�dth seven(7) copies and reccived by 5 PM e F _day ten
(10) dgys prior to-the scheduled meeting in order to bc placed on the agenda.
*INCOMPLETE APPLICATIONS OR INACCURATELY MARKED SITES
WILL NOT BE PROCESSED,.
1. �"— #V 0?W–
��M 2�uaaellq32zqv
APPLICANT NA.ME ADDRKSS TELEPHONE
2, P2=1
ADDRESS OR LEdA I DESCR TIO-K OF TREE REMOVAL SITE
3. REASON FOR PROPOSED TREE REMOVAL: 70. ,�3vl6l) oAkf-
4. HAS THIS SITE BEEN TO THE TREE BOARD BEFORE? 13 YES 0 NO 0 NOT SURE
5. PROPERTY ZONING: 0 RESIDENTIAL 0 COMMERCIAL
6. LIST TREES PROPOSED FOR REMOVAL:
SPECIES DIAMETER DIAMETER MITIGATION
MTERI!QR EXTERIOR
04vir ev K, 0A tA,
Diameter at Breast Height(D.B.H.)is measured at 4.5 feet above grade. To accurately determine
diameter� measure the trunk circumference and divide by 3.14. Diameter of multi-trunked trees is
determined by adding together the diameter of each trunk as measured immediately above the
forks.
7. SITE PLAN/TREE SURVEY indicating:
a) Changes of topographic features such as hills and low areas affecting trees.
b) Existing and proposed structures.
c) Location of all trees with Diameter at Breast Height (DB11) of six inches or more.
d) Tree species and sizes in DBH.
e) Trees to be removed should be clearly marked with an'W'.
f) Trees to be preserved on-site for mitigation must be marked with brackets
g) Location, size and species of any proposed new replacement trees marked with a
circle 4,03,1'.
,h) Location of utilities and easements as applicable.
# 0 Location of trees t6 be prese'rved'on-site with barricadifig indicated.
8. ON-SITEREQUIREMENTS:
a) All trees identified for removal MUST be marked on-site by RED ilagging,
paint-or tape.
b) All trees to be preserved on-site for mitigation MUST be marked with BLUE
flagging,paint or tape.
c) The front property comers must be marked by stakes or paint indicating the Lot
Number or Address.
9. *.INCOMIPILETE APPLICATIONS OR INACCURATELY MARKED SITES
WILL NOT BE PROCESSED.
I BEREBY AGREE TO COWLY WITH ALL PROVISIONS OF CHAPTER 23, ARTICLE 11,
TREE PROTECTION, AND ALL OTHER APPLICABLE CODES AND ORDINANCES OF
ITE CODE OF ORDINANCES OF ATLANTIC BEACH.
-�tr'-Y� c>?-
ficant's e Date
AZ
�er's`=ignat�ure Date
CITY USE ONLY:
Tree conservation Board Chairperson Date
f N
/3 f
ct ;
61Y
30
A�/
CITY OF ATLANTIC BEACH
TREE REMOVAL APPLICATION
All applications must be 5ubmiaed-yj_th seven(7).copies and received-by 5 PM on the Enday
(�w) qgys prior to the scheduled Meeting in order to bc placed on the, agenda.
*INCOMPLETE APPLICATIONS OR INAC CURATELY MARKED SITES
WILL NOT BE PROCESSED.
1. ---;
&q- ir�SM
APPLICANT NJ(NM ADDRKSS TELEPHONE
2. A316AJO-'�4b ' JOTUAJI—I-C
ADDRESS OR LE(jAI DESCRIPTIO'K OF TREE REMOVAL SITE
3. REASON FOR PROPOSED TREE REMOVAL: ..=/0-Ow��I) oAkf-
4. HAS THIS SITE BEEN TO THE TREE BOARD BEFORE? 0 YES 0 NO 0 NOT SURE
5. PROPERTY ZONING: 0 RESIDENTIAL 0 COMMERCIAL
6. LIST TREES PROPOSED FOR REMOVAL:
SPECIES DIAMETER DIAMETER MITIGATION
INTERIOR EXI
U94VIr 0.4 r, gRIOR
lop
xz_
Diameter at Breast Height(D.B.H.)is measured at 4.5 feet above grade. To accurately determine
diameter, measure the trunk circumference and divide by 3.14. Diameter of multi-trunked trees is
determined by adding together the diameter of each trunk as measured immediately above the
forks.
7. SITE PLAN/TREE SURVEY indicating:
a) Changes of topographic features such as hills and low areas affecting trees.
b) Existing and proposed structures.
c) Location of all trees with Diameter at Breast Height (DBH) of six inches or more.
d) Tree species and sizes in DBH.
e) Trees to be removed should be clearly marked with an'W'.
f) Trees to be preserved on-site for mitigation must be marked with brackets
g) Location, size and species of any proposed new replacement trees marked with a
circle 640),.
Location of utilities and easements as applicable.
i) Location of trees tb be preserved'on-site with barricading indicated.
S. ON-SITE REQUIREMENTS:
a) All trees identified for removal MUST be marked on-site by RF,D hagging,
paint'or tape.
b) All trees to be preserved on-site for mitigation NWST be marked with BLUE
ftging,paint or tape.
c) The front property comers must be marked by stakes or paint indicating the Lot
Number or Address.
9. * INCOMPLETE APPLICATIONS OR INACCURATELY MARKED SITES
WILL NOT BE-PROCESSED.
I HEREBY AGREE TO COWLY WITH ALL PROVISIONS OF CHAPTER 23, ARTICLE 11,
TIZEE PROTECTION, AND ALL OTBER APPLICABLE CODES AND ORDINANCES OF
ME CODE OF ORDINANCES OF ATLANTIC BEACH.
C>7-
' ��Iicant's 'Me.. Date
XI,
Signature Date
CITY USE ONLY:
Tree Conservation Board Chairperson Date
fy I
3,f
I&V
0 .,
144
* ,7*4`4
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
8W SEL41NOLE ROAD-ATLANTIC BEACH,FL 3=-TEL 247-5W-FAX: 247-5877
Permit Number: 21588 Address: 1217 Jasmine Street
Permit Type: TREE REMOVAL Atlantic Beach, F1 32233
Class of Work: REMOVAL Township: Range: Book:
Proposed Use: SINGLE FAMILY Lot(s): Block: Section:
Square Feet: Subdivision:
Est. Value: Parcel Number.
Improv. Cost: W
Daft Issued: WM001 Name: Beaches Habitat
Total Fees: Address: P.O. Box 50939
Amount Paid: Jacksonville Beach, FI 32250
Daft Paid: Phone: (904)241-1222
Work Desc: Remove 37.57 Inches 6f-—0ak Trees Mitigate with 27.4 inch of Oaks on site
-7,
BEACHES HABITAT
�Ons
TREE BOARD COMPLIANCE
NOTICE-INSPECTION$MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND
MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WVITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE
PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"
ISSUED ACCORDING TO APPROVED PLANS MICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
ATPTIC BMCH BUILbING DEPT.
CITY OF ATLANTIC BEACH
TREE REMOVAL APPLICATION
All =fications must be submitted)kt_h seven(7).CODies and reccived by 5 PM on the Enday ten
i u)dus prior to the scheduled meeting in order to be placed on the age
*INCOMPLETE APPLICATIONS OR INACCURATELY MARKED SITES
WILL NOT BE I!RO_CESSED.
1. P "5-6)9 3 FL 3.,2-;V0 A qJ—122-L
APPLICANT NAME ADD"SS "TELEPHONE
2. 7 5A&/'�e ST �- 4 7-44 w C a. F h��3�, , ,
ADDRESS OR LEGAL DESCRIPTION'OF TREE REMOVAL SITE
3. REASON FOR PROPOSED TREE REMOVAL: 0 ?U/
4. HAS THIS SITE BEEN TO THE TREE BOARD BEFORE? C3 YES C1 NO 0 NO
0 NO
5. PROPERTY ZONING: 0 RESIDENTIAL 0 COMMERCIAL
3 q Vol
'�'Jf'
6. LIST TREES PROPOSED FOR REMOVAL: (� t j-
MA
SPECIES DIAMETER DIAMETER MITIG�kTION 0
MTERIQ EX
,TERIOR
fult" ;44V 8
// r �
d
3 1-3.3 7 16
7
.,"I000� R 'oo�
E Tmi Fs 47,-- t/zeo
'To m i-ri o —1URI-kr=
Lf
0 IrE C rt-pf'
Diameter at Breast Height(D.B.H.)is measured at 4.5 feet above grade. To accurately determine
diameter, measure the trunk circumference and divide by 3.14. Diameter of multi-trunked trees is
determined by adding together the diameter of each trunk as measured immediately above the
forks.
�rA S M A) E S 7
------ EC IVED
FEB 6 2001
ity of Ationtc Beach
Building nd Zoning
10.
4�k
C 7-E'
'-z
6RL On
CITY OF ATLANTIC BEACH
D.E-PARTIVIENT OF BUILDING
800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-k-Ax: Z41-6877
IPPA
F�L_"101VIN
Permit Number; 21270 121.3 JAUMINF- STREET
Permit Type: REMODELING ATLANTIC BEACH, FLORIDA 322233
Class of Work: ALTERATION Township: 0 Range: 0 Book:
Proposed Use: OTHER Lot(s)- 1-2 Block: 203 Section.-0
Square Feet: Subdivision: SECTION H
Est Value: Parcel Number:
Improv. Cost.- 3,000.00 ORMAMR,L!E,
Date Issued: 1110/2001 Name- P
Total Fees: 37.50 Address: 1223 JASMINE STREET
Amount Paid: 37.50 ATLANTIC BEACH, FLORIDA 32233
Date Paid: '1110,12001 Phone: (904)247-Z785
Work Desc: REPLACE KITCHEN CABIN-T"A _511IMMALL CER—AI41C TILE THROUGHOUT—
!5_7
Zz
PRO P ERTY-OWNER PERMIT 37.50
un
FINAL BUILDING
NOTICE- INSPECTIONS MUST BE REQUESTEn AT LEAST 24 HOURS PRIOR TO INSPECTION
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED-IN PUBLIC SPACE,AND
MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY
OWNER PAYING TWICE FOR BUILDING IMPROVEMENTSIN
ISSUED ACCORDING TO APPROVED PLANS W141CH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
htog 1/17/in 61 Rweipt$37.5114
AT EACH 4UILDINb-QQPT. OECKS IM7431
RECEIVED
JAN I A 2001
City of Airlantic SeAch
RdMirW -and Z-oqlq#
C-TTY OF ATLANTIC REACH
PERMIT APPL-TCATX01V RMfOrEL., ADD-TTIONS., OR ALTERATIONS
MOVING, DEMOLIT-TONS.
Owner(s) Patricia Frick
Job Address: 1213 Jasmine Street Phone: 247.6785
Lot Block or Unit J Subdivision:
Contractor: self State License # NA
Add.ress: Phone No:
City State Zip Code
Describe work to be done: replace kitchen rahjnPtq- install .ceramic floors
throughout
Present use of building: empty (residence)
Valuation of Proposed Construction: --)C00, r-)0
Proposed use: residence
Is this an addition? No if yes, what are. the dimensions of the added
sp�ace: ft. X ft. will the added area be heated and
cooled? New electrical (or increase).,?
New plumbing fixtures? New fireplace? New Heat/AC?
SUBMIT =u= (CcmMERcjaL) TWO (REESZLENTIAL) CCWL=X 59TS OF FLMS, INCIUDZYG
Sz= PLJLV, Saimr, MORGY Come ,FMRHS, moricz O.F AND
0WWM1C0h-7BAC=M AIT=AVIT, XX 0WHER XS CONMUCTOR.
Signature OWNER:. Oa,;e�cx'-, Date'.-
Signature CONTRACTOR: Date:
AS TO OWNE list Georgia B. Padgett
..Commission#CC 994755
Sworn to a Zzjdcbsb&foM2W6 this- C1 day of jdllgAA�t "20og
Bonded Thru --14 . V
","Mit AtIant4c Bonding Co,Inc. 01W 1,� -�Pd
� Jxh-- ---
TO—TARY 9UBLICU re-s -/,;;t)Aa/0-3
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of 2000.
NOTARY PUBLIC
CITY OF
Vead - �ku�&
800 MUNOLE ROAD
ATLANT1C BEACTL FLORMA 32233-5445
TELEPHONE(904)247-5800
it PAX(904)247-5805
SUNCOM 852-5800
CHAPTER 4as, FLORIDA SYATuTv-rs. PART I 'CONSTRUCT10N CONTRACTING* RF-oUIRCS OwmF-R/BUILDER TO
^Clthowi-ziaoit Tmft LAw:
DISCLOSURE STATEMENT rOR Secnom 4ag. 103(7). FLORIDA STATUTES,
SrATE LAW REOUIREES CONSYRUCTION TO 59E DONE By LICENSED CONTRA=ORS- You HAVE APPUED FOR A PERMIT
umceR Am exEmPnot4 To-Tm^T LAw. THE exEmisrnom ALLOWS You, AS THE OWNER OF YOUR PROPERTY, To Aar As YOUR
OWN CONTRACTOR EVEI4 THOUGH YOU 00 NCT HAVE A LICENSE. YOU MUST SUPERVISE T-1-W-CONSTRUCTION YOURSELF.
YOU MAY 13UILD OR IMPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING- YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST Or $25,0100.00 OR Less. THE nuiwiNg MUST BE rOR-Y0uR use AND
occupAmcy. IT MAY Nor me 13uiLT MR SAD- OR f Proh-pa. IfYOU SELL OR LEASE A BUILDING YOU HAVE 13UILT YOURSELF
WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SAI 9 OR
LEASE, WHICH IS IN VIOLAMON Or THIS CGEMPTION. YOU KAY NOT HIRE AN UHLJCCNSCD PERSON AS YOUR CONTRAC-TOR-
YOUR CoNsTRucnom 14UST OE DONEE ACCORDI14G To THE BUILDING COWS AND ZONING REGULATIONS. IT to YOUR
RESPONSIBILITY TO MAKE SURE THAT PCO
CQUNTY QR MUkIMIPAL LICEM31142 ORDINANCES,
QqD1f4ANCXS ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY wmem rr m irOR PERSIONAL OR frAMILY
use.AND LjxEwvw RrOulpe ALL wonK(xxcepr mmmTaNAmce UP40CR $Z,000) Be UNDER A BUILDING PERMIT AND PASS
THEMSEL ES, R MAY HI
ALL NORMAL INSPECTIONS. 7�ie oRaimAmcw srATZS OWNERS MAY PHYSICALLY 00 wORK v ' 0
UNLICENSED WORKERS PROVIDED SUCH WORK97tS Be UNDER "DIRECT SUPERVISION Oir THE'OWNER. WHO MUST ISC 2"-
T)4C J091 AT ALL 77MCS W"ILE WORK 15 IN PROGRESS BY UNLICENSED TRADES PEOPL-K." Tkis Does mar ALLOW USE or
UNLICENSED CONTRACTORS.
SINCE OWNEM BE UAGLE MR INJURIES To woniwts THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS
WORKIER'S COMPENSATION INSURANCE 13C PURCHASED UNDER THE HOMEOWNERS INSURANCZ POLICY CLEARLY PROTECTS
THE OWNER. OVVN04S HIRING VIORKERS BECOME rMpLoyenz AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX ANPIOR
0 NT RAO
FORM 1099 REQUIREMENTS ON THE WORKKRS THEY EMPLOY ON THEIR IMPR VEME T ES'
UNLICENSED COKTRAQMRS CANNOT BE EMPLOYED UNDER ANY CIFICUmSTANCISS. OWNERS BEING suewzcT
To $5,000 PaNAL-ry UNDER FLoR;DASTATuT9 No. 455-2280 1. AM 'OCCUPAMOM6 LICENSE" IS NOT ADMOU6M.
THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "czFmIncArE OF COMPETENCY" OR THE FLORIDA "CowTRAarons
CERTIrIcATE" To Ascr.RrAin IF A PERSON is A LicziNsco coNTRAcTon. TkLePHoNr-THE BUILDING DEPARTMENT(247-
58Z6) ir IN oounT.
I HeReffy AcKNOWLEEDW THAT I m^vM READ THE Asove DISCLOSURE STATEMENT AND THAT I COMPLY wrrH ALL
THE Rf-OUIRF-MZNT5 FOR The ISSUANCE or AN OwNan-BUILDF-rR PERMIT.
PROPERTY OWNERIBUILDER
1213 Jasmine Street 247 67Rr,
ADDRESS Atlantic Beach, FL 32-27-1--EPHONE
r�h )DAY OF 'A�A (i/M - , .
SWORN TO AND SUBSCRIBED BEFORE ME THIS AIM11-
A.z
(:�4
NotAky PU*jbC
NCTE: PHRASES umoeRUNEDABOvE My COMMISSION EXPIRES:
ARE EMPHASIZED 13Y THE ]BUILDING Gwrgia B. PWW tt
DEPARTMENT. Comirdssion#OC 894755
Expires Dec. 12,2003
Bonded Thru
Atlantic Bonding Go.,Inc.
"Ect
City Of I ich
BuildIng
108
12 36 33 24
12 12
15 W3615 W3315
W1230L DW2430L
15
4 1
96
84
---------------
54
3 42' B30 BB42R
/Z-- 17 65 — 26
30 —7/— 30 45
This is an original design and must Al 101204 Scale maxi.mum Dwg no.
All dimensions&size designations THE -----D—es@—ner —
given are subject to verification on not be released or copied unless PATTY FRICK
job site and adjustment to fit job HOME DEPOT applicable fee has been paid or job 1223 JASMINE ST GERALQ—
conditions. order placed. ATL BCH,FL . Wall/C Line# 1
1051
Z 93
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All dimensions&size designations 7HE This is an original design and must Al 101204 Scale maximum — Dwg no,
given are subject to verification on not be released or copied unless PATTY FRICK uesigner —
job site and adjustment to fit job HOME DEPOT applicable fee has been paid or job 1223 JASMINE ST --G—ERALD —
conditions. order placed. ATI Br.H FI Wall/C Line# 2
3
105W
3 7 7
41 36 341
W ; = I W DW243
DW 93 93 R
24
0 IttB9, B9
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42R, 42L
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15 -30
:1315 9917
108 0 R
W36 0 36"
RE
15 F-3
D
B30,
VVI-2
30�1
NOTE:BECAUSE OF CEILING HEIGHT CABINETS NEED TO BE DROPPED
TO 821N'ELEVATION TO CLEAR CEILING PANELS WHICH WILL MAKE
SPACE BETWEEN COUNTERTOP AND BOTTOM OF WALL CABINETS 161N
APROXIMATELY.ALSO ADD ONE VB24 AND ONE OVER-THE-JOHN CABINET
Al 101204 Scale:maximum!Design 10/04/00 Dwg no.
All dimensions&size designations THE This is an original design and must Date 12/18/00
given are subject to verification on not be released or copied unless
HOME DEPOT a PATTY FRICK
job site and adjustment to fit job pplicable fee has been paid orjob
1223 JASMINE ST Designer
conditions. order placed. ATL BCH,FL GERALD
F 14132b
MAP SHOWING SURVEY OF'
L OT�5 1 i 2., 15L 0(-K 2 0 3
-5F-CT10Q "H*' jQTLi�1KJ71C [5F-C)(-H
Recorded in Plat Book..-J-B-----------Page....34-----------------------------------of. L�LiRREicr------------Public Records of Duval Co., Fla.
5TAK1-'5ELL-----------------------------------------------
--------- ---------
LEGEND R. L. CROASDELL & COMPANY NOT INC.
0 Denotes Iron
x—x—x— Denotes Fence CIVIL ENGINEERI NG SURVEYING Date..-J.uur,11J982.........
P.R.M. Denotes Permanent
Reference Monument 429 East Adains Street Jacksonville, Fla'. Scale 1"
----------------
CERT IF ICAT ION: This survey meets the minimum technical standards Forz-- George 5+ansiell
for a boundary survey as set forth by the Florida Board of Land
�Ljrveyors, pursuant .to Section 427-07, Florida Statutes.
//.7
SIGNED:
7-11-�,�--Z> A/0 V 17
r-e r-k,-r i p-i r-c, M AR e-�4
14 7H "STRF-E-T
0-R/V)
LOTr.
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0
L-Li 102..0* to
00
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L 0 7' 2
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00026875 Date 10/31/03
Property Address . . . . . . 1213 1223 JASMINE ST
Tenant nbr, name . . . . . . SHED FOR 1223 JASMINE ST
Application description . . . SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1400
Owner Contractor
-------------- --- -- ----- -- ----- -- ---------------
FRICK, PATRICIA OWNER
13410 EXNON DRIVE
JACKSONVILLE FL 32258
---------------------------------------------------------- ------------------
Permit . . . . . . BUILDING PERMIT
Additional desc
Permit Fee . . . . 40 . 00 Plan Check Fee 20 . 00
Issue Date . . . . Valuation . . . . 1400
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- -- --------
Permit Fee Total 40 . 00 40 . 00 . 00 . 00
Plan Check Total 20 . 00 20 . 00 . 00 . 00
Grand Total 60 . 00 60 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
BUILDING OFFICIAL
Cc:
CITY OF ATLANTIC BEACH D. Ford
BUILDING / ZONING DEPARTMENT .--C.—Higgins
800 Seminole Road
Atlantic Beach,Florida 32233
-5800
(904)247
(904)247-5845 Fax
PLAN REVIEW COMMENTS
0
Permit Application #
P ro p e rty A d d re s s: IJ 3-t—
Applicant: Palo 6-1 a
Project: -10 )( i o sh,�A.
This per * application has been:
=Approved
Reviewed and the following items need attention:
Please re-submit ur applic o when these items have been completed.
Reviewed By: Date:
X
CITY OF ATLANTIC BEACH
OWNER/BUILDER AFFIDAVIT
Date: q11-2-103
Job Address: laa3 JAISMINE A--rL A Ai—/ tc 13EAr-H FL_ 3 2Z3--3
CHAPTER 489,FLORIDA STATUTES,PART I "CONSTRUCTION CONTRACTING'REQUIRES OWNER/BUILDER TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE
APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE
OWNER OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A
LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE-
OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A
COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE.
OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE
BUILT YOURSELF WITHIN ONE YEAR AFTER TIE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME
THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE
AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO
THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT
PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL
LICENSING ORDINANCES.
ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL
OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000) BE UNDER A
BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY
PHYSICALLY DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE
UNDER"DIRECT SUPERVISION OF THE OWNER, WHO MUST BE ON THE JOB AT ALL TIMES-WHILE WORK IS IN
PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS.
SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT
SUGGESTS-WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE
POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND
SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS
THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT-BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING
SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(l). AN "OCCUPATIONAL LICENSE" IS
NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR
THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR.
TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
PROPERTY OWNER/BUILDER
SWORN TO AND SUBSCRIBED BEFORE ME Tl-US_T;4AY OF 20(�-
JENNIFERSWLUEM
0 P�
EXPIRES:May 21,201A, NO PUBLIC V
Bonded Thru Noltary Pwblic Under*iteM ZMWY41SSION EXPIRES:
NOTE:
CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION
(ALTERATIONS/ADDITIONS)
)2�17> Date:
Job Address: AZ;0 %mide Sr�eEET
Owner of Property: PWrRic,0 ri�icv_
Address: 1;43 JA5t41iv6- 57Rffe__r Telephone: Rq7 —e,-7,3,s7—
Legal Description: Block Number: .7-03 Lot Number: ot Zoning District:
Contractor: NA State License Number:
Contractor's Address:
Telephone: Fax:
Describe proposed use and work to be done: move ldxiD �cjne_d_ in b;+e-
Present use of land or building(s): ct L4,2 i e,x
Valuation of proposed construction: CkecL vatue- `,1100.0
What are the dimensions of the added space: 10 feet x to feet
Will the added area be heated and cooled? N 0 New electrical or increase in service? N
Add plumbing fixtures? No Add fireplace? fj 0 Add heating/air conditioning? y c
Is approval of Homeowner's Association or other private entity required? N a If yes,please submit with this application.
Will this project involve changes in elevation,site grade or any use of rill material or the removal of any trees?
NO. Applicant certifies that no change in site grade or rill material will be used on this project.
YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building
Permit.
25NO. Applicant-certifies that no trees will be removed for this project.
F� YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree
Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate
Incomplete applications may result in delay in issuance of permit.
STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please
contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have
Property Appraiser's Real Estate Number available.
STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction
topographical survey or grading plan is required. (If not required, written verification must be provided with this application.)
The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834
STEP 3. Submit Tree Removal Application if trees are to be removed or relocated.
STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if
owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic
Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atlantic-beach.fl.us
Page 1 Revised 1/14/03
In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being
performed. Scale of drawings should be sufficient to depict all required information in a clear and legible mariner.
1. Current survey showing the property boundary with bearings and distances and the legal description.
2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify
any existing structures and uses.
3. If required by the Department of Public Works,a pre-construction topographical survey.
4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies.
5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools
may be excluded from total Impervious Surface.
6. Other information as may be appropriate for individual applications.
I hereby certify that all information provided with this application is coffect.
Signature of owner: Date:
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 goveming 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 nfles,regulations,ordinances,or laws in any manner,including the
goveming of construction or the performance of construction of the property. I understand that the issuance of this pennit is contingent upon the
above information being true and correct and that the plans and supporting data have been or shall be provided as required.
Signature of Contractor: "A Date:
Address and contact information of person to receive all correspondence regarding this application (please print).
Name: P11-r-r y r—12,1 C 1<
Mailing Address: 1,3 -1_4 5 In i/v c �s
Telephone: -)4'1-V7 Fax: E-Mail:
AS TO OWNER:
t4-)
Sworn to and subscribed before me this 12- day of It—L/v 20
V
State of Florida,County of Duval
Notary's Signature:,'
JENNI R SCHLUETER
M CommiSSION#DD 121301 El Personally known
Y
Z EXPIRES:May 27,2006 D-1produced identification
'Fhru NOWY P
ublic Underwdtets
Bwded
Type of identification produced
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of 20_.
State of Florida,County of Duval
Notary's Signature:
El Personally known
F� Produced identification
Type of identification produced
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 - http-Hwww.ci.atlantic-beach.1l.us
Page 2 Revised 1/14/03
MAP SHOWING SURVEY Oti
LOTt), I..i 2,, 5LOCK 203
6F-CT10Q "H 0TLt:1Q71C
Recorded in Plot Book.--IJB-----------Page....3A................................Of. LLmaiwx...........Public Recard8 of Duval Co., Fla.
..........................I...................................
LIGEND R. L. CROASDELL & COMPANY NOT INC.
o DtAoles Iron Date...J.uuF-11,A9&2-----------
K— CIVIL ENGINEERING & SURVEYING
P.�x—x— Denote 2 Ft"ce
M. Denotes Perm nent
Reference Mon%sment 429 East Adains Street Jacksonville, Fld. Scale I" ---------------
Recer+iFiei: Oc+. 18, I )8Z
CERTIFICATION: This survey meets the minimum technical standards Fort- George 5+onsell
for' a boundary survey as set forth by the Florida Board of Land
SLirveyors, pursuant .to Section 427.07, Fiorida- Statutes.
SIGNED:
14-1714 "'STRLUT
(5 0'R/V)
LOT ce
5LOCK 7Z3
LA
Ld 102.0'
vie
x
J;;
�c
0
E
Li
Lor
t4
.0
C�
-\n
W
IS
7a Dt
m
1; fil-
City ot Atlantic beach
Planning and Zoning DeporbrISM
'Porova; verifies compliance wo
suhdivision and *Met le"I land
ril-IrO regulations, bull don Od IMOFISMU110
"-'ihe issuance of permits. Ceffoll"M
1.),da Building Code and#A~OPP#*"
-!alc �%nd Federal perfrAting f"UV*MWM
by signature of ft My ofAlklefft
S, ';dmq Off)gial prior to the kwisM Of 0
"iw-dir(" �armjt
Approved -'�Y'
Date:-�e "WAN
Cc-
CITY OF ATLANTIC BEACH D'. Ford
>
,IS BUILDING / ZONING DEPARTMENT
800 Seminole Road
Atlantic Beach,Florida 32233
(904)247-5800
(904)247-5845 Fax
PLAN REVIEW COMMENTS
Permit Application # 61 --
Property Address: . 1 -s f-vt S+-,
Applicant: P oL-+V1' (A' (A Gi I c--h---
Project: i 0)( 10
This permit application has been:
�eed �attention.
Please re-submit your application when these items have been completed.
Reviewed By: LfL Date: Y,(�-- 0 3 ,
CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION
(ALTERATIONS/ADDITIONS)
2 -7) i _2�-2
Date:
JobAddress: /;Z,Z3 JAS JtJ6 SrREET
Owner of Property: P4-iR((�jA rl�lcle—
Address: /,Zi3 iA5t41126 _571RC-E7' Telephone: �,7q7 -&-7,3-,—
Legal Description: Block Number: 7_03 Lot Number: A Zoning District:
Contractor: NA State License Number:
Contractor's Address:
Telephone: Fax:
Describe proposed use and work to be done: move ld_x1Q -ske-& co -3;+&_
Present use of land or building(s): cLuplex
Valuation of proposed construction: -Cked vaiue— -11400.00,/
What are the dimensions of the added space: x 10 feet
Will the added area be heated and cooled? New electrical or increase in service?
Add plumbing fixtures? No Add fireplace? N 0 Add heating/air conditioning? 4 c
Is approval of Homeowner's Association or other private entity required? N o If yes,please submit with this application.
Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees?
F7,11 NO. Applicant certifies that no change in site grade or fill material will be used on this project.
El YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building
Permit.
Ef NO. Applicant-certifies that no trees will be removed for this project.
El YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree
Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as avvrouriat
Incomplete applications may result in delay in issuance of permit.
STEP.1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please
contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have
Property Appraiser's Real Estate Number available.
STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction
topographical survey or grading plan is required. (If not required, written verification must be provided with this application.)
The Department of Public Works is located at:1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834
STEP 3. Submit Tree Removal Application if trees are to be removed or relocated.
STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if
owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic
Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us
P2pe I Revised 1/14/03
In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being
performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner.
I. Current survey showing the property boundary with bearings and distances and the legal description.
2. LA)cation of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify
any existing structures and uses.
3. If required by the Department of Public Works,a pre-construction topographical survey.
4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies,
5. Impervious Surface area calculations: include driveways,sidewalks, patios and other Impervious Surfaces. Swimming pools
may be excluded from total Impervious Surface.
6. Other information as may be appropriate for individual applications.
I hereby certify that all information provided with this application is correct.
Signature of owner: Date: q
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 supporting data have been or shall be provided as required.
Signature of Contractor: IVA Date:
Address and contact information of person to receive all correspondence regarding this application (please print).
Name: Plq-r-ry r-tz,CK
Mailing Address: . /-z/,3 j.4 5o//v c
Telephone: ..)4'1-L-7 q,5' Fax: E-Mail:
AS TO OWNER:
Sworn to and subscribed before me this i2— t4� day of
V
State of Florida,County of Duval
Notary's Signature:
TE N1 WHLUETER U
My COMMISSION#DD 121301 0 Personally known
EXPIRES:MaY 27,2006 Q-'Produced identification
Bcw*d 1,hru NrA"Mic UndeWftm
Type of identification produced F—_�, F(1,J_J-G,
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of _,20
State of Florida,County of Duval
Notary's Signature:
El Personally known
0 Produced identification
Type of identification produced
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us
Page 2 Revised 1/14/03
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AGENCY APPROVAL
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Florid2 Manuf3crtred Building 91 3x,W"-14C4 5&ALC, 1/4' -0*
Act cl 1979 Cinstruutloil Codes
and adhere to t1la following
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Const Type vi Rourg M16 (D. (11ri
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Wind Ve1ccrty 1.30 -7//-) VIIC�CAft
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Fire %ting of
Ext.Walls 0 1,,*4.0,CC 04=2 2,j(:-A-j=6T -jDjACjj
a-CC 1.(.OUA-c F-4ryllp'll 111",
//-.10 FLCCR 1051 CJ -XJ
0,
Plan No. H 101 (.5 P95-) 1 11
Nl0w. Floor Load 50 '04'f'l .W- V —1
Acvravaj Date -I.Z-I 4�zc
!.Ict 5:.=t A
S* SME WAU FRAMNG
ALUMINUM UTILITY 13UILDINGS 7-m RoopwAn ffik,,�
FTWIN CITY QUALITY BUILDINGS, INC 5-'r- 1- -0- S:40
P.0, BOX 250 RAIL ROAD AVE. K
TWIN CITY, GA 30471
PHONE (473) 763-2710 RAM SlU
FAX, (476) 763-3554 OVMHANG DETAIL
5LALC- 3/4' 1 ECnON
3-1Cd 4"S MOK
A14411"to tAr-, M1.1
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ITZEL t—HG1HE1ERjNG
ST—
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CONSTRqCTION, WC. ------
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SM REVIEWED SET
MUST BE ON JOB
OF REQUESTED v
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LU ALI, ,To- yx:!. STATE OF FLORIDA
CLIX.0 S.,I
2001-A Dept. ot Community Af:,I;rs
-In Z> AUG 12 1996
ce
64 -114 IF C-y-, APPROVED
3t: .-Ir._� q:��I Ir
SJUVA Msnufactured Su.W�n->
-----------
ALUMTNUM UTILITY BUILDINGS STITZEL EwNEERms
RmQt!_� & CONSTRUCTION, INC.
TWIN CITY QUALITY BUILDINGS, INE R`V:EVI:-D _R
P.D. BOX 250 RAIL ROAD AVE, N, ART L.STITZEL, P.E 0 J,
' TWIN CITY, GA 30471 pATE --CERT.N0__M1—I
PHONE (4-76) 763-2710 PLANNUMMER , H /0/
r- A 1�/ ,A-70C� 74,1—'�554 APPRONTID I
..... .. rA
................. ......... ....... ...... ..............
FOUNDATION MIENSIONS
WCAL Lwl ALL W5
MC= ra TO hAlK
<v ww" rou
............................ ... ....... ...........
TYPICAL FOUNDATION PLAN
FOR SING11, WIDE UNnS 1-br Syr--I IX 00"stlij.
1/4' ba fJ.ftC;�g rASIC-Y.0 To WLLL
.105t AM) W.T,.l 1-1-lcd
VIC t4n 0;
rwn
(A;zr
LF
rHON NOTES:
FOUNDA
L X_- rojO&nC"CC.,j5TRLCTiCK MATrx�i_AIC N$TALLAMI Sr.�V,e:m mow rRCsT tr< l'i CCWN s-lz_--V-11be
ACCCIM-Kc Ifi-lin ALL LP?,X-1—`r VIM J-40 LOC-11 Cccts. 5=t NOT C14=7$*-4'
rCx Ir.,O,C.VW5 Cit
L 0 Z,TZ-COWN STWS TO CC 1 1/4'%JC!V TTPCL I rt(SK 6.Ul=I If< r'-C'rO2 24'OC,S%tl!
),- " CC STATE OF FLOR10A
ATCO STCCL 579-'*�"C"WO OT A 9!CSTCXC3 CNCTittt C9
IvrCT Cohrolt.".C WITM ASIM 22,U3-%.TIE Dowh STX-*$"
I =ON A-A
h.U7WAXC WLL MAYC W152 WCX:Q4C"ACTIT, Dept.of Community AifjirS
CL 0 Z�CACLnO A?(C4095-SMALL hjVC m"WCP."C WICTT.A.,,a S:t—'L
CC 145TA=IN ACCORDANCE'Mill W rLUCfjlCTLv-,X-S SM:XCATICKS. AUG 12 1996
DCSZlf Of CROLHO AKMOR."CLUCha Sin—Irt Lrhr-'K Kir.!E?"0kL'XT(Z
or nrL%r&CIC-TO 6C AS S?:Clr0 OT TrX CgCkt,12 AMCMV!rWtXACTLX:R
;0 CL Ir fCX THE ACTUAL SOL ITPC ENCOUNTERED.Ir ME MOLDINC,OR MLLW SH9RRY'S SHE[
Of CXCLM AMCMORS AXE B-CLOW YMC YALL0 5PCC2X0 AtOY(Tm*AXCMTC^-T/ APPROVED 10110-1 U.S.
M, CIR MUST 9C COMULT0 fOR Ali ALTERNATE k"OJUCC OESICh. Manufactured Su;ld;n-_s
ST. AUGUSTIN
0 4.UIC r9tST TC-DOWN STRAP fROM DOWALLS Slzhot CxCr:o 1/2 TMC 904-824-8878
0 NAX"SPAC14C,t=AYCD.h NO CASE SMALL ANT 5LILONC WE tr5S
3: TKAA TWO STRAP15?CA SDCWALL -SOLD
In
CoMallyr P.T�2,15 ST?
3.ALL r--25 SMALL CC CO"TMXTCO Cr 6'W-W COKX.'TC KA50kgr LHIS OR
COW0Kr*C TO ASTM Cqa MASCNKT LWS SMALL CC LAO tl TTrC N 09 $ 0CLeLe 4,11c,11V Sk, PLATE,
MoRiAx ox covrica vAyr("PACE aotchr ca,- COW-211C PADS
YMM trS USThC,ffR rOOTHC SMALL Of AS DESC14"ED ACOYC.
In
a "allt COKX".0 rOOING Coertc5SNC STX,%Irt 1000 PSI AT 25 DAYS.
CL
7,ALL", rCxcCMCMr 505 5MALL CCV^T Wit A!,Th AGII.CX40C rO,
lChrORCCKXT CARS SMALL OC CCUALLT SPAC,'D AND PLACED WITM Y --------
Ci.CA2jNCC rKOm OOTTOM AND$OCS Or COOTNC,
6.ALL J%XS SMALL AC CA"t0*11h 2,6 STP fkCS%A(TKCATCO%L PLATE&
nAl LCNGTM Or 111CR.
5W.'Oitt PZ95 MAY CC"51AWD LATERALLY C-C-rROK VIC
MAN VIEW SWION
=41ATION 5MOWN ON INC rOUND&TWIN MAN).CCNTCRL?4( Of CACM
Arx MUST K tOCATCO WCTV OCLOW IMC WW CCHICZLNC�
No 150
to. As5urIED SOL acAchc wACity is i�000 r5r,r INC ACTUAL SCL
OCAKtIC WjtCltT 15 tt!�S llfAft 2.000 W.INC AXC"TCCl/thCK3
PIER DTF, A
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fOOINC5 SM&LL CC MACCO ON hCH-ClFAl4UYC SOL ONLY. Z*
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et Syr 92 6 2A'
TYPICAL FLOOR FRAMENG PLAN Asee ta6le
FOR '. 19 OR L7 SINGLE WIDE LTNm Ioe to 0 0.a C 0.0cra.10 IT
j IT
SCALE, 1/4' - 1'-0' JG fIcce JOST CA It ICU of '6
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41
GENERAL NOTES: IF
I A&L ccct SnA"g OFAftr rion In,CCZ15S Ser TMCAL FLOOR FRANM4G PLAN
-nout tc US(
2 "C,.Z14-I-a 2.K,Art or accls. FLOOR FRAMNG DDYEENSSIONS FOR 14! SNGLE WIDE LJNTr
_Q-1C=110.c:C_1 Is L!SS I.-cc W-1!5 'fit III&
.ic4 rLoCt APO A"QA'PC n OCCIS .0s,
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.1��CZI VS`cn INC LO-O-SO sr. C-0, I z-.0, NOTE--
-0 10 wvC to-c- I I--&- I C_a' I z.01 STATE OF FLORIDA
Ctccol-a 12'IT= 11_. I I-Z.1z, 1 T-3, A I_V PL WOOD INSTALLED Oe;t. of Cornmunity Ai.'.'j*.ri
13-5 1 3,_7 117' 1 7.3, 1 1-V PfRPMDICLXAR TO
OC=rA141.5 LA-STC..CZ. FRAMG 15 CLLKO
AND rASTENED TO AUG 12 1996
SMUCTUF,AL NOM: JOISTS.
LCC-TC^ .a
I roof AtW=T IQ cc Vr w:Up't-r 21 1.-,clno�
6 -1 LMT. 8-0'TO 21.0' APPROVED
CC SFr:,I.Z..cc to 5"
s Lcs To at sm, I,-cc Fez ar to%- rc.,r cm 5-0*=1 M�nufxtured Su.;d:n:S
5 LC$ a ar Sm 21'cc,.f=65'TO
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F,
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1-0 Sto=rLKL Kc.'sSaK5.
TRALL 5CRIC 140 SC 2 1/2'.14'COCTUCATra"SfV go-P.C.$ ALUMTNI
nip"CA-65S 4.0 51.0-0#..,<I C.CSSMS r
,0-10a fASIMES S�L K AS rOLLON', TWIN CITY
MR-CrP SC2�. rASICKZ5 IRI ii-S"C9.63 SCR.'.S
Me sc"Rc("$Cc On WrIl-.1 TV. CrI.4 10,L-LP CARACC
C S-Cc
ALLFIFIRI SCRICIR 5�R45 III ITAWR.66 rASIth-'r Do 09 OOu5LC S`IC`nc1 P.O. BOX
M-40 rV. ICCR.�,Izrtm nCCMI I-T
VCZ SQUWAC C11ASC0 CH 4 124*SPIC.
"�t -L�"C.tOMW"�5 LKC$b 5r.-CrCo. TT-.-4.-1 TWD
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SITIEN' HAUED nTNfS:,.: rCLQ comcci From rusin<, DOOR kocAtoft PHON1
"OTC TPAI 1-5 LIST cars no wc(55.aty V-1 Inc FAX,
P02 a COnF%CTC hSTALtATION ALL SnC CLAICO UCMS FLOOR PLAN
An SL41:1 to tocAk Asrsoct'DI'p"Ova. SCALE, 114' - 1-0*
I In(COW�rtc rOLrj0&ncn SL�PPORI�o TC goini 5TSICK
2.R�j St�5 AbO UKRAL ACCC55 TO MC INAMC. ELECrRICAL SYMBOLS: zac-tc- ALL MCIRC.,'COL."CNT SnO_IS
3 CICCIMA VXvCC R00%4r(11-CLUD-4 MOC21)10 Inc DA2nc 01,10-t " oc.1-0.5-1 I'll REVI
0 cu.%Cl wCurvAtIC ljov 10
ELECTMAL NOM: .."In,'C" STITZIEL Emc-INEERING MUST E
(::P %.I-co.tIL6 OF HE(
I ALL CRCUI%u4 taLrnint SmUL be(JOLP,010" 0 VINT r,pI CONSTRUCTION, INC.
AC QRG�Kt.(.InC&Fntop�IC&RUc%(%Of IK
_C
I..."r1cclIc Cc"Intel G --on 50-
a AIL-14 IRIML Bf COICI 11-1-1.C201-A 1-0. ART L.STITZEL, P.E.
I
17,"III ent co"Out
3 1 no'.-UP to Mahe nctc.4"t 05COWC15, W, .(.41C.".601
IKI--t 41 QCKt%1.4%%CAO_O�t TV.n,
0.Ot,4w% b11(h1lattlD UASCI 10 LOCAL AR14.C%CtK>,
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3T- AUGUMnW, M
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0.
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L
A5 NEED
FRAMNG
n.4 5CALr, 1/4* 1--o-
w w
214 TOP 2x4 TOP k
I'A& 1"b P%ErAo. iRu55
AA WALL URD LENOTHS
STUD GRAor WIND 5P1EDjMAXArNGTM
AND 5PACING IN IN ME"
S.Y.P. #2 AT 110 mpH 20 rAL)rf
2-2x4 qG, 5TEE.,
5yr 42 24' O.C. 120 M,P N. qj,
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5.P.r. 42 At q7*
QC
108' KU.(5y? FRAM E) 120 M P T,1'
50,
w
'MITEK' OR 'ALPHE' PLATrs EACH 5W4X[ UNTT WIDTH VAR)C5
V A55EnXY rMfDn!0 f
HYDRALJOCALLY OR OT rROM 6'-0* TO 13'-b gm
re Pj- !-)
ROLLER PRESS Z n
2-18 GA, off. FR&MNG
FLAT IJK��L
LIST:NG cl h9or 5CALE, 311r,* Y-0'
AGENCY APPROVAL +1 OUT5401) Lu
.Se print3 comply Wltjj the 20 GA_
Idi Mantif3dAred guilding 20 GA� 20 GA. FLAT MALI U,
T-BRACE Oi9l)C) I-DRACE w burl)
ri 1979 CJ'Istruct.loll Codes 15 GA. (OUT S")
I adhere to tha followilig FLAT BRACE (OUT500
eria
;onst. Type vi
_�7-20 C-A
)ccupancy bRACNG FATTERK '1: BRAMG rATIERH 'A' T-CkACE
k1lavab)e No.
ty S, or MA~-bLXLCMNG-LENGTH FOR W-B' VADr LR475
Vlnd Veloci go '?P/1 MUTH BRAMNG BRACING
ACING ORAC14C
PATTERN PATTERN DRACM FATTM4 a
-ire R31ing of CA r OPENING PATTERN PATTERN PATTERN
'A' Z. v E. 2 0 CLA.
_xt.Walls -Z-/A, X,
'Un No.S_M-F�rq I I (n+r'rs FLAT 8k.ACf
,
ny M/A N/A
�_RAC"G 5RAC1
P 7 NF
A r�ER PATTI
t 23-112* 30'-3* 50'-0' M/A OUT 5LW-)
Pow. Floor Load
N/A
1 4' 37'-B* 50�-O' N/A
G3, 21'-
Dproval Dite 8.-12-76 1.
72' jq'_2' 34- 4 0' 50--0' N/A 2-20 CJ,
'-0' -10' -0* 1-MAC C
41' 50'
Cr, 12'-0* 22*-0' 32
-DOW (11 INSC�_
kyjAN ANCHOR TE q LOCATION
(51RAP5 ANGLED 45 108, 81-0* 15'-0' 22' T 30-3' 37'-8' +1 oul
MG I_eAACf
f5�&5or I-N:
11D M.P.M. 120 H.P11. FLIT 5kACf
FEET) 0 TE 6 _1846 _�CERT.No - Oil DRACHIG PAT I TM
/0
PIAN NUMDEI;�=_1
C
F.-r iso mph use 41-3 M-A 22(.1,ED A.PPRONTID El — 2-20 Gi.
FLAT M;.Z�
0 h
+I cul SEX)
MOD-LE P" TO SIM MAX" PER P" ART L.STITZEL,P.E. +1
wvrti @ MODIULr ME SPA,j SJFACHG SPAMINC PROFISS1011AL PIGMVP ISN9 2-20 C_
50 r.s.r. eUILDING COUTRACIOR CK 04?;?9 I-DRACE
2'-2 1/2' V-31—M '.--0- 3*-51
V) +!
215 EAs,SAY SMEET,SUITE#5 PHOUE:'(941)683-4277
LAKEIANO.Fk0giaA 33601 FAX:(941)663-0950
ID - 2A
MAU" M&CING LENGTH ACCOROM To FLA, !R f
9e_neirz_j0;1_�t11S 8FACNIS EALIML-Z _.%,
f e '�3 z DRAC14G oN rNowALL MTH NO OPENING r I 5c,.r
ZTE). DETS. z 0) WIDIti or 20 GAUGE I-BRACE 20 GAUGE I-DRACE "mri"es wt Fi3c_ L4ff, 13,,cnfh
UN 5TCFRAAE MXMG OUT501 ONLY OUT54Dr AND IN510C Lo�hd, r4Evi'sed. .2 11-11"z
'ESIDENTIAL LA _�)hV-k ci to P,vi -'se
12'-0' 51NGLE WIDE'UNIT 10-(9-01 50'-0*
'41,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00026523 Date 7/24/03
Property Address . . . . . . 1213 1223 JASMINE ST
Tenant nbr, name . . . . . . REPL KIT CAB, INS FLOORING
Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4000
Owner Contractor
------------------------ ------------------------
FRICK, PATRICIA OWNER
13410 EXNON DRIVE
JACKSONVILLE FL 32258
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 50 . 00 Plan Check Fee 25 . 00
Issue Date . . . . Valuation . . . . 4000
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50 . 00 50. 00 . 00 . 00
Plan Check Total 25.00 25. 00 . 00 . 00
Grand Total 75. 00 75. 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER- -FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS-ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
RT III-T)INCY OFFICIAL
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATL0MC BEACH,FLORIDA 32233-5445
TELEPHONE:(904)247-5800
FAX: (904)247-5805
SUNCOM:852-5800
http://ci.atlantic-beach.fl.us
PLAN REVIEW COMMENTS
Permit Application # Z 5
Applicant: F—R i C' CA A
Address: I D-1 H i �J
Project: ip tL-Stat( =W*yk
cxour application is approved
ur rmit on a n review n items need
id
Please re-submit your application when these items have been completed.
Reviewed by (4
Signed Date
Contractor Notified Date
CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION
(FOR INTERIOR REMODEL)
Date:
Job Address: /.z,?—,3
Owner of Property:
V
Address: Telephone:
Legal Description: Block Number: zo-3 Lot Number: Zon�ingl)istrict: 5EC7-10,v
Contractor: AIA State License Number:
Contractor's Address:
Telephone: Fax:
Describe proposed use and work to be done:
Present use of land or building(s): =L222j��
Valuation of proposed construction: # 0 0
New electrical or increase in service? NO New plumbing fixtures? NO
New fireplace? /\/0 New heating/air conditioning9 /VO
Is approval of Homeowner's Association or other private entity required? Ivo If yes, please submit with this
application.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate
Incomplete applications may result in delay in issuance of permit.
?,��ommencement,113wner/Contractor Affidavit if owner is contractor,
Please submit Buil
and two(2) which is located at the Atlantic Beach City Hall, 800 Seminole
Road,Atlantic B
In addition to con, ing information as appropriate for the type of work being
performed. Scale on in a clear and legible manner.
I hereby certify th
Y�,
Signatme of 0 Date: 71161,13
.........
4
I hereby certify 7'A
e same to be true and correct. All provisions of the laws and
fied herein or not. The granting of a permit does not presume to
ordinances goven,
give authority to
ules,regulations,ordinances,or laws in any manner,includi
ng the
800 Seminole Road Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 - http://www.ci.atlantic-beach.ft.us
Page I Revised 1/15/03
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 supporting data have been or shall be provided as required.
Signature of Contractor: IV4 Date:
Address and contact information of person to receive all correspondence regarding this application(please print).
Name: P,4 M V9 icv-
Mailing Address: 17-1.3 JASMINE 5jr9EE-F ArLAIVrIC 8 6-,q C H 32-,-233
Telephone: _7 47 - �,7 3 5- Fax: E-Mail: r9ickP-qs5-,2 c_s.cr,,,i
AS TO OWNER:
Sworn to and subscribed before me this day of 204-5 .
State of Florida,County of Duval
""I Georgia B. Mot Notary's Signature:
Cornniholon#00 994755
Expires Dec. 12,2003
Bonded Thn Iff/personally known
__1'0". '1____At1anticBondJngCo.,Inc, E] Produced identification
Type of identification produced
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of 20
State of Florida,County of Duval
Notary's Signature:
R Personally known
El Produced identification
Type of identification produced
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Page 2 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us Revised 1115103
CITY OF ATLANTIC BEACH
OWNER/BUILDER AFFIDAVIT
Date:
Job Address: 3 l-)19,5mlfv5 STR'±�E--r AT�,41vTlc 8E4cl-I Icz- -3;?-�2 3 3
CHAPTER 489,FLORIDA STATUTES,PART I "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE
APPLIED FOR A PERMIT UNDER AN EXEWTION TO THAT LAW. THE EXENIPTION ALLOWS YOU, AS THE
OWNER OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN MOUGH YOU DO NOT HAVE A
LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IM[PROVE A ONE-
OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A
COMNIERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND
OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE
BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COWLETE, THE LAW WILL PRESUME
THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEM[PTION. YOU MAY NOT HIRE
AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO
THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT
PEOPLE EWLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIP
LICENSING ORDINANCES.
ORDINANCES ALSO ALLOW AN OWNER TO IM[PROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL
OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK(EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A
BUILDING PERMIT AND PASS ALL NORMAL INSPECnONS. THE ORDINANCE STATES OWNERS MAY
P14YSICALLY DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE
UNDER"DIRECT SUPERVISION OF THE OWNER,WHO MUST BE ON THE JOB AT ALL TROES WHILE WORK IS IN
PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS.
SE'4CE OWNERS MAY BE LIABLE FOR INRJRIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT
SUGGESTS WORKER'S COWENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE
POLICY TO CLEARLY PROTECT THE OWNEK OWNERS HRING WORKERS BECOME ENTLOYERS AND
SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS
THEY EWLOY ON TI]EIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING
SU13JECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO, 455-228(l). AN "OCCUPATIONAL LICENSE" IS
NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR
THE FLORIDA "CONTRACTORS CERTIFICATE' TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR.
TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
I HEREBY ACKNOWLEDGE THAT I RAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COWLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
PROPERTY OWNER/BUILDER
SWORN TO AND SUBSCRIBED BEFORE ME THIS jeDAY F 2 0
NOfAIWPUBLICU gia I Padgett
MY COMMISSION EXPIRES: 0 Won#00 994755
NOTE: PHRASES UNDERLINED ABOVE. Expires Dec. 12,2003
Bonded Thru
is Atlantic Bonding Co.,Inc.
P k
Book 11224 Page 477
NOTICE OF COMMENCEMENT
State of r-L 0 g/P,4 Tax Folio No.
County of 9UV41-
To Whom It May Concern:
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: 3LOCk 20-3 t-o r6 / -t- Z
fir�A/Vrlc SiE"140j . FLofloA
Address of property being improved: 1,4Z3 Jj-�mtivC 67-Rfff
Iq rLAIVri C- t-3 E1q" , F LOP,I 0A
General description of improvements: qep1,kcc- kt'�-c-Ae" cob,e7efs lne.4cili cer,�?k*ku& florkll?-g
Owner: 'PA-rizicm Fqlr-k
Address: fz13 JA_�AvivE sTge-&-7- ATt.41VTIC 6,Efiov , FL
Owner's interest in site of the improveraent: qC--5jPE1VCg-
Fee Simple Titleholder(if other than owner): -4
Name:
Address:
Contractor: IV-A
Address:
Phone No: Fax No:
Surety(if any): IVA
Address: Amount of Bond S
Phone No: 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: A/A
Address:
Phone No: Fax No:
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2Xb),Florida Statues. (Fill in at Owner's option).
Name: IVA
Address:
Phone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
TFUS SPACE FOR RECORDER'S USE ONLY OWNER
oc Signed: Ta-lt-11� 1111"k Date: '711,-' 1,13
0()t.2
I OLIO&
429790 Before me this ff,�-M day 0 JU in the County
477
FiM & Recorded ofD a :StateoflFloridahas �YC4 d'-P,11 eta Vr�(k
07/17/2003 02:58:58 PA
j1h FULLER
CLERK CIRCUIT COURT Noda?rPublic aWLarge, State of Florid' ounty of Duval.
My commission expires:
DUV14L MUM 5.00
RECORDIffi 1.00 Personally Known: t.-- or
TRUST FORD Produced Identification:- Georgia B. Padgett
-qWqt.Gornrnisaion#00 894755
Expires Dec. 12,2003
Bonded Thru
ak—M
NX- ;,"'
'resk%% Atlantic Bending Co.,Inc.
MAP SHOWING SURVEY OP'
LOT�5 I 2� 5L 0(,K 2 03
6F-CT10M "H jQTLjQQT1 (- �5F-C�(-H
Recorded in Plat Book-.--15-----------Page—AA--------------------------.......Of...C.LM"T...........Publit Records of Duval Co., Fla.
f0r:..6F-0;;&E 5TAVJ6ELL
.......................................................
LEGEND
0 Deholes Iran R. L. CROASDELL & COMPANY NOT INC.
I,— x— Denotes Fence CIVIL ENGINKERI.NG & SURVEYING Date..-J.0�j r,..Ll,.l 9.8 7...........
P.�XM—. Denotes Permanent
Reference Monument 429 East Adams Street - Jacksonville, Fid. Scale I" --z. .....30--------------
SZecer+,Fie4: Oc+. 18, I )8Z
CERTIFICATION: This survey meets the minimum technical standards Fort-. George 5+ori5ell
for' a boundary survey as set forth by the Florida Board of Land
.�urveyors, pursuant .to Section 427-07, - Florida- Statutes.
/7
SIGNED:
A10V /7
, 1--P,5 2 1/
RC4Ce-r1r1r-C1: MARe-H 18,117.53
14
(5 0'R/W)
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"UVCH %luuIlty -rroperty Appraiser-Parcel Summary
Page I of 2
iparcel Summary -Current Ownership and Sale Information -Updated Weeklyll
LRE No.: —]FI7-1019 1000 1
lOwner's Na K, PATRICIA ANN B/E __jjUn
lProperty 1213 JASMINE ST it No.
Address: - I
JATLANTIC BEACH F32233 I
IMailing Address,�F1213 JASMINE DRIVE
1ATLANTIC BEACH, FL F32233-1818 I
1Property SINGLE FAMILY
ILegal description.-] 34 38-2S-29E SEC H ATLANTIC BEACH LOTS 1,2 BLK 203
10/R BK 5850-1659
Neighborhood: 003119 ATL BCH SEC H(SFR Sec-Twn-Range: 18-2S-29E
AT H) I I I I
JOR BK& F058-50-1659 _______]jMap Panel: IF556BI
I IFF
ISale Date: [8/31/1984 ngs: 2
ISale Price: 000.00 1 ea: I F_680
IExterior Wall- ALUMINUM
ISIDING
11'areel Summary-Values & Taxes from the 2002 Certified Tax Roll
ILand Value: 1 040.00
---7F—
IClass Value, $0.00
Improvements: 83548.00 xing USD3
I F$ 1 ority:
588.00
IMarket Value, Fcounty Tax:
lAssessed V 716.00 FSchool Tax:
lExempt V 500.00 1 trict Tax: IF$181.49
_____1FOther Tax: IF$28.63
ITaxable Value-7 216.00
ISr. Exemp Fs 0-9 0 ____]rVoted Tax: I F$33,20
JSr. Taxable:.E=F$0.90 I=TotalTax- IF$1,114.91
This page displays values from the 2002 Certified Tax Roll with weekly updates of
ownership & sales.
Map-it maps & data are not updated as frequently as the Tax Roll data and may not
reflect matching information.
Please direct inquiries regarding the maps & data to Map-it Feedback (below).
Map-It Feedback
http://pawww.coj.net/pub/propert-y/RENO.asp?RENUM=171019+1000 7/17/2003
Map Output Page 1 of I
JAXGIS Property Information
7"
12fis 920
1315
126S 1275 1350
12SS 124S
1225 1222
1213
1710191000
1212
1203
1202 1221
Copyrig ht JC)20M C Hy 4wf JwGkwonviN-- FI
Total Acres Plot map Legal Descriptions Flood LandUse Zoning FJVT
RE# Name Address Value Book Panel Zone
T-213 18-034 38-2S-29E Not in
1710191000 FRICK JASMINE ST 114441 018 0203 556B1 SEC H ATLANTIC BEACH Flood
PATRICIAANN B/E
32233 LOTS 1,2 BLK 203 Zone
http://maps.coj.net/WEBSITE/DuvalMAps/toolbar.asp 7/17/2003
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00026664 Date 8/13/03
Property Address . . . . . . 1213 1223 JASMINE ST
Tenant nbr, name . . . . . . 3 FIXTURES
Application description . . . PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application -valuation . . . . 0
Owner Contractor
------------------------ ------------------------
FRICK, PATRICIA CHRISTY FIRST COAST PLUMBING
13410 EXNON DRIVE P.O. BOX 50446
JACKSONVILLE FL 32258 JAX BEACH FL 32240
(904) 247-4419
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 56 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ----- ----- ---------- ---------- ----------
Permit Fee Total 56 . 00 56 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 56 . 00 56 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND 14AULED AWAY BY EITHER CONTRACTOR OR OWNER- "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF TUBS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
BUILDING OFFICIAL
C)
CITY OF ATLANTIC BEACH
PLUMBING PERMIT APPLICATION
Date:
Job Address:
Owner of Property: j()0_+ 'Telephone: D47'tOl R-5
Plumbing Contractor: CHNSTYFIRST COASI PLuMBING, INC.
P. CL Box 50446
Contractor's Address: j4mcjwonv& beack FL 32250
Telephone: ZZ411 -4419 Fax: Z,14 cl—4ce(,r c
State License Number: Caf�.S L_r(4V1
How many of the following fixtures(re-piped or new): -ey
Sinks �_� —Showers Water
Lavatory —Water Heaters Hose Bib
Bathtubs Dishwashers Sewer
Urinals Disposals Other
Closets —Washing Machine Shower Pans
Floor Drains Re-Pipe(List fixtures being re-piped)
Total Fixtures: x $7.00 + $35-00 (Minimum Permit Fee:$35-00)
Signature of Contractor:
k L/
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
800 Seminole Road-Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800- Fax: (904)247-5845- http://www.cLadantic-beach.H.us
RiapA I IIAMI
CITY OF ATLANTIC BEACH
SS
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00026523 Date 8/13/03
Property Address . . . . . . 1213 1223 JASMINE ST
Tenant nbr, name . . . . . . REPL KIT CAB, INS FLOORING
Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4000
Owner Contractor
------------------------ ------------------------
FRICK, PATRICIA OWNER
13410 EXNON DRIVE
JACKSONVILLE FL 32258
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 70 . 00 70 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. -FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH, FLORIDA
... ELECTRICAL PERMIT APPLICATION
TO THE CFHEF ELECTRICAL INSPECTOR: DATE: jy— 200---�
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. F
ELECTRICAL CONTRACTOR: 1,316001<1_15
MASTER ELECTRICIANS SIGNATURE:':�����-
OWNER OF PROPERTY:
JOB ADDRESS: /2-2:3 t-)(9- '5
RES.�\ APT.( ) COMM.( PUBLIC( ) INDUS.( NEW( OLD* REW.(
ADDITION( ) TRAILER( ) TEMP.( ) SIGNS( ) SQ. FT.
SERVICE: NEW( INCREASE( ) REPAIR(
CONDUCTOR SIZE AMPS: COPPER ) ALUM.( ) FEES
SWITCH OR BREAKER AMPS PH W VOLT RACEWAY
EXIST. SERV. SIZE AMPS PH W 2VO&Lf') RACEWAY
FEEDERS NO. SIZE NO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
SWITCHES .30AMPS 31.100 AMPS
INCANDESCENT
FLOURESCENT&M.V.
FIXED 0.100 AMPS. I OVER
APPLIANCES I I BELL TRANSF.
AIR H.P. RATING H.P. RATING KW-HEAT
CONDITIONING COMP.MOTOR OTHER MOTORS A
0-1 OVER
MOTORS H.P. VOLTAGE PHS NO. I H.P. VOLTAGE PHS
MISCELLANEOUS
UNDER 600V /OVER 600V
'TRANSFORMERS: NO. IKVA NO. IKVA
0 IVA
NO-NEON TRANSF. N I MA —MOTOR SIZE
EACH SIGN I SWITCH IFLA
800 Seminole Road *Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800- Fax: (904)247-5845 - http://www.ci.atiantic-beach.fl.us
RevkM01/17411
DEPARTMENT OF MILDING
CITY OP,ATLANTICBEA01-1,
ERMIT ------
er:
A<Id r eas 12231
URE
Ty'pe�: SCREEN .,ENCLOS ATLANTId BEAC
f
0, Work:NEW ----------
LEM. DESCRIPt
Typel:WOOD FRAKE Blotic: L�t,: 2' 'Nip
Suj�d-
�,�Jvrl ol ed Us,e:SINGLE FAMILY An
pos Sectiorl,
0
Subdivision:SECTION H�,.
,est. value#. ,
11 11 �9.00
Am r,�>v. C .4t :,
0 1 1,7$5.00
Tdtal pees 60.00
Vaourit �aid,,;
Dat e Val,
APPL I CATION ,,FEES
-Fg o 44,
ERKI
T-
60 .00 "
E9T
dr: '122
pffiq
IP
gf:
ORIDA � 322
A A,(V
33,
15
1440 mT i ON
ROPE y
i,ddl
Ex-p
Y'
p
"S
A
J�J,
NOTICE-INSPECTIONS MUST-BE,REQUESTED AT LE T ON
AS 24 HOURS P O:IN$PECTI
RIOR T
$UILOING MATERIAL,RUBBISH AND DE$R'IS,FROM THIS WORK MUST, '
NOT BE PLAcED,,11N PUBLIC SPACE,AND
'CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER MUST BE
FAILUAIE.TO COMPLYWITH T'
HE MECHANICS9 UEk LAW CAN RESULT IN
THE PROPERTY OWNER, PAYJ No
OR
7WICe k SOL0,11 G-IMPRONEM"ENTS.
�WHICH ARE PART OF THI;S�PERMITAND, SUOJEC OAE
�S,%)ED ACCORDING-TO APPROV
_ED�PLANS
'VoC
T T,
r_�REACFI SUIL 40
�ATLANT OIN MENT
By
CITY OF ATLANTIC BEACH PERMIT CALCUL TION SHEET
Address 2— c /Lz S je tE F, ^)
D a t e (-S� -
Heated Sauare Footage $ L
_per sa
Garage/Shed $_per sq S
03
CarDort/Porc'n sa
P a r.i o per scr ft
TOTAL VALUATTCN :
0
T-,zal V��iva I tion 1st $ 0
C,
Remaining Value $ 0,-)Der thousand
Yportion thereof
TOTAL BUILDING FEE S-
+ 1/ 2, Filing Fee $ 0- tc,
Fireplaces @ $15 - 00 A
BUILDING PERMIT FEE
WATER IMPACT FEE $
"D\ SEWER IMPACT FEE $
9WATER METER/TAP $
Cool CAPITAL IMPROVEMENT 8
SEWER TAP S
) RADON (HRS) . 0050 Z)
SECTION H PAVING $
HYDRAULIC SHARES $
CROSS CONNECTION $
) SURCHARGE . 0050
OTHER C)
GRAND TOTAL DUE . 0o
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
PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS
MOVI-NG, DEMOLITIONS
Owner(s) :_Patricia Frick
Address: 1223 Jasmine St L:)horie: 904-247-6785 (vvor'K &-2-'3o IA-F-
Atlantic Beach, FL 32233 7�>,7 _S 43
Lot # 2 Block or Unit 4 Subdivision:
Contractor: self
State License # NA
Address: Phone No:
Ciz1v State -Zi-. �oae_
Describe work to be done: installation of screen enclosure
Present use of building: residence
Valuation of Proposed Construction: $1100.00
ProQosed use: residence
is this an addition? YES if yes, what are the dimensions of the added
space: 131911 ft- X 71811 ft. Will the added area be heated and
cooled? NO New electrical (or increase) ?NO
New plumbing fixtures? NO New fireolace? NO New Heat/AC?NO
eeeMHNRe%-�� TWO (RESIDENT-7-AL) COMPLETE SETS OF PLANS, INCLUDING
SITE PLAN NOTICE OF :�bg�WCDIWT_ AND
S'
S
5NERICONTRACTONR =71DAVIT, IF OWNER IS CONTRACTOR.
SiQnature OWNER:
Date:
Signature CONTRACTOR: Date:.
Sworn to and subscribed before me this JU14-, dayof lgqg.
RECEIVED
NOTARt PUBLIC STATE OF �LO�DA A�TLAR�GE �
jUN 16 1998 KAM MASOMMU
W COMMON#CM7W MV0
May 11, IM
City of Atlantic Beach
Building and Zoning MMM T'W T&W IV.
FAN 904 7-
CITY OF
-6) ROAD
VICI-A.\�7C i3EACH. FT,ORIDA
CHAPTER 489, FLORIDA !STATUTES, PART 'CONSTRUCTION CONTRAC-nNG" REOUIRIES CWNE:R/BUILDE:R TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 4a9. 1 03(7), FLORIDA STATUTES:
STATE: LAW RECUIPIES CC)NS7RUC-,7CN TO BE DONE BY LICENSED CONTPACTC�S. YOU HAVE APPLIED FOR A PERMIT
UNDER AN E--<EI0PTION 70 THAT LAW. THE =-XE:mFmCN ALLCWS -CU. AS -HE OWNER '�'F --CRER—, 7C AC7 �-' -1-1-�F�
OWN G3N7RAC-.(:)R Z1,E14 7HCUGH YCU DO NOT HAVE A LICENSE:. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF
YOU MAY BUILD OR IMPROVE A ONE - OR T`WO-FAMILY RESIDENCZ OR A FARM OUTIBUILCING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERG�AL BUILDING AT A COST OF $2 S.000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE: AND
OCCUPANCY. rr .-tAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF
WITHIN ONE YEAR AFTIZIR�7HE: CONSTRUCTION-15 COMPLETE. THE LAW WILL PRESUME -HAT YOU BUILT IT FOR SALZ OR
LEASE, WHICH IS IN VIOLATION OF 7HIS EXEMPTION. YOU MAY NOT HIRE: AN UNLICENSED PERSON AS YOUR CONTIPACTOR..
YOUR CONSTRUC-�CN MUST BE DONE ACCORDING 70 THE BUILDING CODES AND ZONING REGULATIONS. 17 IS YOUR
RESPONSIBILITY 70 MAKE SURE THAT PEOPLE -EO BY STATE LAW AND By
COUNTY OR MUNICIPAL UCENSING ORDINANCES.
ORDINANCES ALSO ALLOW AN OWNER 70 IMPROVE' THEIR OWN PROPERTY WHEN I-, IS FOR PERSONAL OR FAMILY
USE, AND LIKE'WISEPEOUIRE ALI- WORK (EXCEPT MAINTENANCE UNDER $2,C)0C)) BE UNDER A allILDINO PeRmrrANC PASS
ALL NORMAL INSPECTIONS. -1HE ORDINANCE S7-A76S OWNERS MAY PHYSICALLY DO WORK 7HEMSELVES; OR MAY HIRE
UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT, SUPERVISION OF'THE OWNER, WHO MUST BE ON
THE JOB AT ALL T7MES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE:." THIS DOES NOT ALLOW USE OF
UNLICENSED CONTRACTORS.
SINCE: OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING CEPARTMENT SUGGESTS
WORKER'S COMPENSATION INSURANCE: BE PURCHASED UNDER THE: HOMEOWNERS INSURANCE POLICY CLEARLY PROTECTS
7HE CWNER. CwNeps HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO 05SERVE IRS WITHHOLDING TAX AND/OR
FORM 1099 RECUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
To $5,CCC PENALTY,UNDER FLORIDA STATUTE NO. 455-?-?-e( I). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATF.
THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE: OF COMPETENCY" OR THE FLORIDA."CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TE:L-=PHONE: THE BUILDING DEPARTMENT (247-
562e) IF IN DOUBT.
I HEREBY ACKNOWLEDGE THAT I HAVE: READ THE: ABOVE DISCLOSURE STATEMEN7 AND THAT I COMPLY W17H ALL
THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNE:R-BUILDER PERMIT,
�-ROPERTY OWNER/BUILDER
1223 Jasmine St Atlantic Beacti, FL
ADDRESS 7ELEPHONE
247-6785
SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF
NOTARY PUBLIC
NOTE: PHRASES UNDERLINED ABOVE MY COMMISSION EXPIRES: MA\j 1%,A_qqS
ARE EMPHASIZED BY THE: BUILDING
KAM MMSMIGILL
DEPARTMENT.
AMIN EXPiRM
ma 11,low
mmrAm Ywvmo*wwW,M
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RECEIVED
JUN 16 1998
City of Atlantic Beach
Building and Zoning
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APPLICATION FOR WATER AND/OR SEWER TAP
APPLICANT NAME---- 2L----------------- -------------
MAILING ADDRESS
PHONE NUMBERz,'�L6�' ....... DATE___
SERVICE
-)-----------
SERVICE LOCATION
- -------------------
------------------------------------------------
DATE SENT TO DATE RETURNED
PUBLIC WORKS TO BUILD. DPT. __5�2b
DATE OWNER
NOTIFIED
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8A FEB 121992
B- diliding and Zon;n-,
CITY OF ATLANTIC BEACH, FLORIDA
Approved by APPLICATION FOR ELECTRICAL PERMIT
6/- 3; - ? -�i
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: -19-
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.
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ELECTR(CAL FIRM: MASTEA ELECTRICIAN SIGNATI)k -N
Ivj,ivr-
NAME -!�)7/�/��;�%eADDRESS-. 9/4-sf RFD-BOX-
BLDG.SIZE BETWEEN:
RESA APT 0), comm.( PUBLIC INDUS. NEW( OLD ( REW.
ADDITION ( ) TRAILER TEMPA SIGNS ( ) SO. FT.
SERVICE: NEW INCREASE ( REPAIR FEE
.K.
CONDUCTOR SIZE AMPS /-�0 COPPER ALUM. (X)
SWITCH OR BREAKER AMPS --5 w ��, 30 VOLT JCAXA�RACEWAY
EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY
FEEDERS NO. SIZE- INO SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED1 �ly OPEN TOTAL
RECEPTACLES CONC OPEN TOTAL
0.30 AMP 31-100 AMPS.
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100 AMPS. OVER
APPLIANCES BELL TRANSF.
AIR H.P.'RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT
0-1 OVER
MOTORS H.P. VOLTAGE PHS No. 1 H.P. VOLTAGE PHS
MISCELLANEOUS
TAAf4qF0AMFRS-* UNDER 600 V. OVER 600 V.
CITY OF ATLANTIC BEACH, FLORIDA
Approved by APPLICATION FOR ELECTRICAL PERMIT
C7
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 19
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.
z
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ELECTRICAL FIRM: MASTEh ELECTRICIAN SIGNATUAE ��IOURNEYMAN
NAME-&A�PN�r S�A-k-,��t--Z;-/ADDRESS:a/3 uA-5 ' -RFD-BOX
BLDG.SIZE BETWEEN:
RES.( ) APT comm.( PUBLIC INDUS. NEW( OLD ( REW.
ADDITION ( ) TRAILER TEMP-# SIGNS ( I SQ. FT.
SERVICE: NEW( INCREASE ( REPAIR FEE
CONDUCTOR SIZE AMPS 6�'r) COPPERf ALUM.
SWITCH OR BREAKER 19 AMPS 7 W VOLT 411lzr-- RACEWAY
EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY
FEEDERS NO. SIZE INO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.30 AMPS. 31-100 A MPS.
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0-100 AMPS. I OVER BELL TRANSF.
APPLIANCES i I
AIR H.P. RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS_ AMPS ICEIL HEAT: KW-HEAT
0-1 OVER
MOTORS H.P. I VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS
MISCELLANEOUS
TRANSFORMERS: UNDER 600 V. OVER 600 V-
CITY OF ATLANTIC BEACH, FLORIDA
Approved by APPLICATION FOR ELECTRICAL PERMIT 6�
14
TO THE CHIEF ELECTRICAL INSPECTOR: DATE. 19
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.
ELECTRICAL FIRM- MAStER ELECTRICIAN SIGNATURE j6
NAME ADDRESS: 57 RFD—BOX
BLDG.SIZE BETWEEN:
RES.( ) APT.(T) comm.( I PUBLIC INDUSA I NEW( I OLD ( I REW.
ADDITION ( I TRAILER ( I TEMPA SIGNS i I SO. FT.
SERVICE: NEWA INCREASE ( I REPAIR ( I FEE
CONDUCTOR SIZE AMPS COPPER ALUM. Of
71F
SWITCH OR BREAKER AMPS PH 3' W -:�06VOLT. C,44v 'RACEWAY
EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY
FEEDERS NO. SIZE NO. SIZEE:FNO. SIZE
LIGHTING OUTLETS CONCEALED OPEN I-TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.30 AMPS, 31-100 AMPS.
SWITCHES F-77:1
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0 100 AMPS. OVER
APPLI_ANCES =- I I I BELL TRANSF.
AIR H.P!RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS JCE�IL HEAT: KW-HEAT
0-1 OVER
PHS
MOTORS —H.P. I VOLTAGE PHS NO. 1 H.P. VOLTAGE E4�
MISCELLANEOUS
TQAMqr-0RMFRS: UNDER 600 V. OVER 600 V.
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH.FLORIDA PERMIT NO. 5212
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date JUNE 7 - __19 82
Valuations 60,173.10 Fee$ 237,75
This permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
This is to certify that GE STANSELL
551 BEGONIA STREET, ATLANTIC BEACH
has permission to build DUPLEX AS PER RIJANS, SUBMITTED
Classification DUPLEX _Zone RAC
Owned by GEORGE STANSELL
Lot 2 Block 203 S/D—"H"
House No. 1213/1223 JASMINE STREET
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
-n AFTER DATE OF ISSUE
0 Building material,rubbish and debris
z from this work must not be placed
in public space, and musly b.e cle:arie
I c
th
'usy t 0
b,,
U hauled away
rac r ner. b T
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FOR OFFICE PERMIT DATE C06-646TOR [A G/U9/Ul
USE ONLY NUMBER
PLUMBING 52131-5217
ELECTRICAL 1464/3465 6-8-82 GAYCO ELECTRIC COMPAW
SEWER 3801 — T?
WATER
7
Ri
B 12,1 L D I ;(-, Pi�1,"I I
Hl-',ATED SQUARE FOOTAGE $
per s.
CAR-AGE (PRIVATE/SHED) per s.
CARPORT @ per s.
@
PORCHES per s. $
DECK @ $ per s. -S
TOTAL VALUATION DATA. . . . . . . . . . . . . .
-----------
PERRMIT FEES
TOIAL VALUATION DATE lst
REi4xIlNDfR VALUATION
@ cl,l per thousand
or fraction thereof
TOTAL BUILDING PERMIT $
PLUS 1/2 THE BUILDING PERMIT FOR PLAN FILING FEE S
TOTAL FEE DUE
-----------------------------------
PLUMBING PERMIT FEE ELECTRICAL PERMIT FEE
14ATER METER SIZE & FEE
SEWER CONNECTION: SQUARE FOOTAGE FEE
WATER CONNECTION: FIXTURE UNITS @ $10.00 PER UNIT .$
TOTAL BP & PC FEES DUE . . . . . . . . . .$
ACCOUNT NO.
TOTAL WATER METER CHARGE . . . . . . . .$
TOTAL WATER CONNECTION CHARGE. . . .
APPROVED
CITY OF ARZATIC BEACH TOTAL SEWER CONNECTION CHARGE. . . . S
BUILDING 0F;rjCr=,
JUN 1982
GRAND TOTAL DUE. . . . . . . . . . . . . . . . . .
FOR OFFICE USE ONLY
Date-----------------------------------19 ......
Permit *------------------------Fee$........................
CITY OF ATLANTIC BEACH Valuation $--_---_------------------------------------------
FLORIDAHouse *-----------------------------------------------------------
.....................................................................
APPLICATION FOR BUILDING PERMIT ...........................................................................
............................................................................
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlaniic Beach, Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can
be verified. Date..../.. ..n_e .................................. 19J..f—..
Ownen.a.aae,ye............5 'L,.S.a itl...........................Address..5757/...J3 _-IT...Telephone
Architect._'OD.It—..... ............................................Address,...._.................................................._Telephone No.............................
Contractor ---------------------------_..............-------Address..... ...............................Telephone No.7 e_----
Lot No...../.....0 J I----------------------...Block No._49_0_3............Sub Division.....5-7.c.r-------//---------------------------------------------------Zone.............
.........Street...X—29�-5'.7....Side Between., ....................and....9--&— ............sts.
Valuation $...............................For what purpose will building be used........................ ...............Type of construction............................
Dimensions of Building_3V_'_-)e.5-P..'_.......Dimensions of Lot.../D.0_...>(---J_01�.............Size of Footings----
Size of Piers............rr-:�.................Size of Sills...... —--- -- ----------Greatest Sill Span in ft........................Type Roof ...............
How will Building be H,-ated?._,6.!1e_.4Z_C_#.... Building be on Solid or Filled Ground?...��01i_d.................
Size of Ceiling Joists.? ..... Distance on Centers.-........ ................................ Greatest Span........................................... to
Size of Floor Joists....... Distance on Centers.. ....... .- -........ ............... Greatest Span........................................... it
Size of Rafters.................. ................ Distance on Centers. ..... ................... Greatest Span...----------------------------------------- it
This rectangle is to represent the lot.
Locate the building or buildings in the
right position. Give distance in feet from
fl-G. BEACH
IF ATISN"'
all lot-lines and existing buildings.
BUILaINIG OF-F]'CM REAR LOT LINE
Two copies of plans and specifications shall JUN 11 W,
be submitted with application.
Inspections required.
1. When steel is in place and ready to pour footi N
-J I&n-tel.
2. When steel is in place and ready to pour colum, Z Z
n
3. When steel is in place and ready to pour beam. E-4
4. When framing is completed.
5. When rough plumbing is completed,-and ready to cover up.
6. When septic tank drain field or sewer is laid but before it is covered.
7. Electrical inspection by City of Jacksor.ville.
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called for after
corrections are made.
FRONT OF LOT
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said
work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building
regulations of the City of_,"tic Beach
AZ
Signature of Builde .... Address. .........................
Signature of Owner r A-C---- -------- Address.:� ......................................................
CITY OF ATLANTIC bEACH
716 OCEAN bOULEVARD
ATLANTIC BEACH, FLORIDA
ADDENDUM TO BUILDING PLAN
Bu i I d i nq Locat i on:_____
The attached plan for the above building is approved subject to meeting the following
applicable construction requireMents :
a. Footings shall be continuous monolithic concrete under exterior walls, reinforced
with two 5/8" deformed reinforcing rods for one-story bui*ldings and three 5/8"
deformed reinforcing rods for two-story buildings. Reinforcing rods shall be
placed in the lower one-third of the footings , properly placed and fastened on
metal cables with wire. Footings shall be six inches wider on each side than the
wall above, shall be at least eight inches thick and shall rest on firm soil at
least twelve inches below undisturbed soil .
b. In hollow r,-.asonry unit construction, each unit cell shall be reinforced with at
—onNo.-4—bar at—all-c—on-r-ner-s—, poured and tamped with concrete; such rein-
forcing shall be properly tied into the footing and spandral beam.
C. All w ood truss rafters (roof constructi on) , shall be securely fastened to the
exterior walls with approved hurricane anchors or clips.
d. Construction of nearby one-family dwellings , which are duplicates or intensely
similar, shall be avoided. Such similarity considers the external configuration
and appearance (i . e. , roof, outer ,,rall materials, window size and design, and
other like characteristics) of structures. In accord with the foregoing, similar
and shall be at least 500 feet apart if any one similar dwelling is visi-ble from
any other similar dwelling.
e. The final connection between the house plumbing drain and the sewer�service
connection (at the property line) must be inspected by the City before being
covered.
City Manager
e undersigned hereby certifies that he has read the above and understands that this
Jendum takes precedence over any contrary details to the plans and specifications and
rees to comply with the intent of this addendum.
tonTracV&7Owner
--/- 9k-A./ -?
----ba�t e
STA'FE OF FLORIDA
Department of
Health & Rehabilitative Services
5
Duval County Public Health Division
515 West Sixth Street
Jacksonville, Florida 32206
District IV SONV
May 19, 1982
Mr. G. W. Stansell
P. 0. Box 594
Atlantic Beach, FL 32233
Re: Septic Tank Application for
Lots I & 2 Jasmine Street
(S-33875 , serial #517-82)
Dear Mr. Stansell:
Your property at the above location 'has been inspected and found
si,itable for a septic tank installation.
Mien you are ready to make improvements to the property bring your
building permit �pplication or move-on permit application to this
office along with this letter and a septic tank permit will be is-
stied at that time.
If a sanitary sewer becomes available to the property before im-
provements are made no septic tank permit will be issued.
This letter of eligibility expires in twelve (12) months, expira-
tion date __May_lg___19_83_
Very truly yours,
C. E. Douglas, Supervisor
SANITARY ENGIMEERING BRANCH
CED/tk
Attention Building Department:
T'his is not a septic tank permit. Please do not stamp, Building
Permit Application until septic tank permit is 4ssued.
IWO,"
CITY OF
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233,5445
TELEPHONE(904)247-5800
EAX(904)247-5805
February 11, 1993
Ms . Wilhemina Bartley
1223 Jasmine Street
Atlantic Beach, FL 32233
Dear Ms . Bartley:
Our records indicate that you are the occupant of the
following property in the City of Atlantic Beach, Florida:
Lots 1 and Section H
aWa � -
RE#171 4
InvestigAtion of this property discloses that I have found
and determined that a public nuisance exists thereon so as to
constitute a violation of Ordinance Sections 12-1-7 and 21-24 , Code
of the City of Atlantic Beach in that there are abandoned vehicles
continuously present on the property .
You are hereby notified that unless the condition above
described is remedied within ten (10) days from the date hereof ,
the City will tow said automobile at a cost of the work plus a
charge equal to 100% of the cost of the work to cover City
administrative expenses, which will be assessed the property owner
or occupant . If not paid within thirty ( 30) days after receipt of
billing, the invoice amount plus advertising costs , will be
recorded with the Clerk of the Circuit Court as a lien on the
property.
Sincerely,
Karl W. Grunewald
Code Enforcement officer
KWG/pah
cc: City Manager
Mr . and Mrs . Ray Frick
VIA CERTIFIED MAIL
RETURN RECEIPT REQUESTED
CI'fY 01' ALTAH'TIC HCACH
JIT SYST[ '.I
COMPLAINT MANAG[ Nl'.
TAKEN date/time) :
C11-1,P L A I N A N T VA_A_
Last Name First Naino
ADDRESS :
CITY/STATE/ZIP:
TELEPHONE:
COMPLAINT :
16
xj,::�A VA
LOCATION:
PROPERTY OWNERS PHONE:
PROPERTY OWNERS NAME:
DEPARTMENT FORWARDED TO:
COMPLAINT TAKEN BY: DATE/TIME :
�OFFICE USE ONLY
INVESTIGATED: (date/time) ;I'Ve�;1'ev,-�3
ASSIGNED DEPT. /DIVISION: PRIORITY:
INVESTIGATOR: �,_47-
CONDITIONS FOUND: ,e�e
ACTION TAKEN:
CC4LIANCE:
t.-TES:
Placos QUO
APPLICATION FOR WATER AND/OR SEWER TAP
APPLICANT NAME�� 1--ZILe ----
- / -10 3
MAILING ADDRESS-/ I- ----- - ---------
PHONE HUMBER_ DATEg::
--- --------- ------------
93(,
SERVICE REQUESTED
-----------------------------------------------
SERVICE LOCATION /-a 0
-- -- --------------
12-W 7-e 7-/-/ 9,eC AJOCJ
DATE SENT TO ep DATE RETURNED
PUBLIC WORKS��--_9� TO BUILD. DPT
DATE OWNER
NOTIFIED
c:)
09PAOTMIENT Of VIVILP
tNG
CITY OFATLANT10,0EACH
PERMIt ------ ------
LOCATIO
i t uumbei�: :,6392 Address: 1213 4ASXI-
eb t
m i T' 'C ,
C, ype: numnrw� ATUM.1 B
of Work: NEW
LEGAL DES
`Rl Rfl:
mY
Subdiv s �*n- At TION H
Lot:'
c�s dT age
Value: $0-00
im tov- , cost ,
0
t
$18. 50
2/10/93
TER LINE
AND WA
�Apftlmiox FEES
Ad $18 . 50
INS "STREET
MPAC ;0 .00
T
I ORIA, 5", 0 wi PS
UE
7 . 2 e 4,
W'w
DOIN -$0 .00
RA I
-NIPORMATiON RADON 0 'S,
T
Naine,:-. A 5
PLUM a
AM
�#e I
# $0.00
HYDRAOL�I C' ,SHARE
A
$0.00,
c iry�
Vlsvj- RE,IV,S'fvdT,
4 '00
zz
S9C`.,ff:`JR PACT FEE, �Ii
NOT`tCE—ALI,,CONC
AtTE FORMS AND FOOTINGS MUST at IN 9,:POURING
F�ER IT,VOID SIX MONTHS AFTER
DATE:OF4"Ut"
SU
LOING MATE#jAL,,RU6BI$H AN Q�bf�ORIS
'RE, UPAND FROM THIS�WORK MUST N6TSE PLACED,IN.PUBLIC,.SPACE!AND MUST BE
HAULEb
EA 6
AWAY SY EITHER CONTRACTO.R,O'
R OWNER,"
J�A*
'W
WRE' T0:C0M;0LY ,,.,, ITH T!4,E ME64A, i CAN "ESUL'T. I A,
NGr'7W
CS'. UEN
"ROPEF
IC-It,FOR S )4N j
UILDI
MPAOVEME14TS.
4
OVE.D,
ISOU96'ACCOAD'INe-TO APPA p OFTHjSr
UNECT T TION FOR,::
LANS WH
ICH ARE PART
'IE, VISIONS-Of�AK,
-OF-APKICA PRO
B ACH'13UILDIN
0
CITY OF ATLANTIC BEACH
APPLICATION FOR PLL111BING PERMIT
JOB LOCATION:.---J-;�13----
OWNER OF PROPERTY:
----------------------------
BUILDING CONTRACTOR
PLUMBING CONTRACTOR
-------------
AND ADDRESS: AD
--------------------------------
----------------------------------------------
TELEPHONE NUMBER: q3� (a S--�6
--- -----------------------------------------
STATE LICENSE NO: t)3 VS`-----------------7---------
TYPE OF BUILDING: --------------------------------------------
SINKS --------------SHOWERS
LAVATORY --------------WATER BEATERS
BATH TUBS -------------DISHWASHERS
URINALS DISPOSALS
------------ -------------
CLOSETS -------------WASHING MACHINE
FLOOR DRAINS SHOWER PANS
OTHER L)
b0fl- 0(rJb Wfflf�& lot-
TOTAL FIXTURE x $3. 50 015. 00 = $------------
----------------------------------------------------------------
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
DEPARTMENT OF BUILDIING,
CITY OF ATLANTIC OEACH
�',Vo
-PERM IT'-,INPORMATI Oil
!t", ------ WCAT ORMATION ------
mr
OrMi t
Number.. 6375
Addresai't,
ITI 2:i4 11223 JASMTNE , �TRgZT
fermi t Ty , - ES, T
VT L
C 131AM FLORIDA
�111�t� "l-'41ii-t of Work; NEW 32233
WOOD FRtAME, t8"L DESCRIPTION- -----
"Const r Type:..
Lot#.
DU P tX.X
F Section:
0
Tbi;limo�hjp
D#0 2'' ode,,*, 0 ,
_77'' SECTION "n"
Subdivi
ed 'VilUe.
Oor
00
Tot,ai I 045,�00
$4
0
$4045.00
Da
5/4
o� WAT
ZR
SXRV ICE AT� DQPL T I E I N C IrTY ZWER
EX
s
AP
LrCATION PER$
PERMIT
K,
$0.00
'RIVE , , , I I �;I
IMPACT FEE
520.00
0 FLORID
s IXWPA� 'F �,�fp 15 Q 0
2 -k, �be'jl
N 0
H-.'R S 7
N
0,
$0 "00 ,
NPORMATiON
�N, RADON OAS' - 5%
AtIll -'UB V kP
S' D ENT ATER TAP
:$525.00
00'�
............
h4d 0 wz ERr
EW
�T
$O.r.00
AR
HYDRAULIC-OR E
Ty 'r
L cto e
Or IN01tT FEE '00
P It `,� 1 `
S
RC 11 IM -A'
Mr FEE
0 0
50
S:
�7
TE FORI&S A140 r
OTICE,,—ALLPONCRE NGS MUST 09 INSftCytwa
FOOTI .POURING
4FORF
I4SUE
R.hflTVOIOSIXM
ONTHS AFTER DATE,OF
ING MATEF"AL,r9RUB8SHr,ANb DEORIS FROM�tHIS WORj<MUST No
T K 0 IN"PUSLIC�SPACE,AND MUST 13E
CLEARED UPIA
ND HAULED AWAY BY eltHER CONTRACTORbR OWNER
E
TO CO
JCSr
MPLY WITWTHE M 9' LWN, tAW AN RE LT IN
Or. 'CHAN I
PE TY 'a - 11 C
TW C -0 1 tmpf*VEMF
".OR bW , 0:0AYIN -1 E:FO
G
ENTS.""
0 ACCO
PPROVEOPLANS WHICH ARE PART OF THIS PER
RbING TO A "
T ;rl 't,*
MIT-*"D OCA
PROVIS16NO OF LAW.
-OF.APPucAI5LL
Ir, lEACf
71 UIL
B LOIN,(;�DEPARTMENT'
CITY OF ATLANTIC BEACH
Fix�ure Unit Worksheet for Water Impact Fee
FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR
EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER
SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TWENTY DOLLARS
PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM.
BATHROOM GROUP CONSISTING OF SERVICE SINK TRAP STAND
WATER CLOSET, LAVATORY & BATH (8)
TUB OR SHOWER STALL (6) WATER CLOSET
WATER CLOSET, TANK OPERATED (4) VALVE OPERATED (8)
BATHTUB/SHOWER (2) URINAL WALL LIP (4)
SHOWER GROUP PER HEAD (3) FLOOR DRAIN (1)
SHOWER STALL DOMESTIC (2) LAUNDRY TRAY (2)
LAVATORY (1) COMBINATION SINK AND TRAY (3)
WASHING MACHINE (3) POT, SCULLERY SINK (4)
DISHWASHER 2) WASH SINK EACH SET OF
FAUCETS (2)
—�--KITCHEN SINK (2) DENTAL LAVATORY (1)
KITCHEN SINK WITH WASTE DENTAL UNIT OR CUSPIDOR (1)
GRINDER (3)
BIDET (3) URINAL STALL, WASHOUT (4)
FLUSHING RIM SINK (8) COMBINATION SINK AND TRAY WITH
FOOD DISPOS. (4)
URINAL, PEDESTAL, SYPHON' JET DRINKING FOUNTAIN (1/2)
BLOWOUT (2)
LAVATORY, BARBER/�EAUTY ICE MAKER (1/2)
SHOP (2)
iSURGEONS SINK (3) LAVATORY, SURGEONS (2)
JACUZZI (2) URINAL STALL, WASHOUT (4)
TOTAL FIXTURE UNITS @ $20.00 EACH
1-3
JOB INFORMATION 1" A 3
DEPARTMENT OF BUILDING
PERMIT NO.. 5 2 13
CITY OF ATLANTIC BEACH,FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB 14*UU TI,
14*UUCKT I
Date JUNE 9 _19 82
116!0 U I A 6109/U ?14
Valuation$ P7 IMTNr. lzrRMI Fee$ 14.00 lr�i2 1 9 UQCACI i
609U 1 A 6/139/Li i
This permit not valid until above fee has been paid to City Treasurer,and is I UUO
subject to revocation for violation of applicable provisions of law.
This is to certify that R & G PLIMTNG 'COMPANY
1399 7 'RE ACH BLVD JACK20=11 I E 2 n4MDA
has permission to build INSTALL NEW PLUMING AS PER PLANS S-HRMTTTVD
Classification DUPLEX —Zone RAC
Owned by GEORGE STANSEM1.
Lot I & 2 —Block 203 S/D "'H"
House No_ 1213/1223 JASIMNE, STREEI
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
No 0 Building material,rubbish and debris
4-
31 from this work must not be placed
in public space, and must be cleared
up andd hauled away by either con-
ract r owner.
Building official.
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
SEWER
___±�ATER
Aaw
CITY OF ATLANTIC BEA CHl FLORIDA
ro%vd by APPLIC I ATI ON FOR UNCTAICAL PIRMIT
T 0 TTH E C H 1"1 13 irL
F ELECTRICAL INSPECTOR:, DATE:— 19
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOWDOING THEWORK 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�AtCORDANCE WITH MiEtLECTRICAL REGULATIONS, CODES AND CITY OF
,ATLANTIC BEACH ORDINANCES.
014zeo
0
6:,A,V )5��W
EL ItAL FM-. JQURNj, YMAN
4�7
NAME �-ADDRESS.-- - E��RFO------BOX
BLDG.SIZE ogTmEN:
RES. APT.I COMM.I PUBLIC( INDUS.,f NEW i OLDO REW.(
ADDITION I TRAILER ( I TEMPX 'SIGNS ( SM FT.
SERVIM, INCREASE REPAIR I FEE
2"ft9LOR SIZE COPpER:lK ALUM.
AMMPS
PH 3W
OR BREAKER C'� AMPS VOLT RACEWAY
LT Jllj".
' 'PH , , 'W_
W_
7 ......
SIZE
LED OPEN TOTAL
RUIUACLES -CONCEALED OPEN TOTAL
0-30 AMP$, 100 AMPS.
'SWITCHES''
INCANDESCENT,.
FLUORgFENT&M.V.
0-100 AMPS, I vem
AP!wLlAJ4CXS_ SELL TR ANSF.
AIR H.P.,RATING H.P.AATING:�.;
CONDITIONING COW.MOTOR OTHER MOTORS. AMM lC6IL:H9'AT: KWHEAT
(01-1 OVER
MOTORS H.P. VOLTAGE PHS No. VOLTAGE PHS
Ous
MtSCELLAN=
TRANSFORMERS: UNDER SM"W"
OVER,ow V.
C I TY 1, 1 1 IC l'i
APPLICATION j'oi� I ;,-�"!IT
IjAl'f
NEW TYPE OF BUILDlNG
OWNER S NAME
REPIPE -RESIDENTIAL
ADDITION COM�1§_RCIAL
LOCAT-ION
PLUMBING FIRM u ADDRESS 099 ? f\c, L 'u vb
MASTER PLUMBER
please print
CITY/COUNTY OCCUPATIONAL LICENSE NO.
STATE CERTIFICATE NO. F
BUILDER OR CONTRACTOR el #kclsk��k
----------------------------------------------------------------------------------------------
SINKS LAVATORY 2 BATH TUBS URINALS FLOOR DRAINS
CLOSETS SHOWERS WATER BEATERS DISHWASHERS DISPOSALS
1.2,
WASHING MACHINE OTHER TOTAL FIXTURE COUNT
INSTALLATION OF PLUMBING AND FIXTURES MUST
BE IN ACCORDANCE WITH THE MOST RECENT EDITION
OF THE SOUTHERN STANDARD PLUMBING CODE. SMNATURE OF MAS7TER PLUMBER
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * I
FIXTURE UNIT BRF-kKDOVIN
FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT
INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT
TEN DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. SEC. 27-3 (c)
BATHROOM GROUP CONSISTING OF BATHTUB (W/OR W/O OVER SHOWER STALL,
WATER CLOSET, LAVATORY & BATH HEAD SHOWER) (2 UNITS) DOMESTIC (2 UNIII
TUB OR SHOWER STALL (6 UNITS) BIDGET (3 UNITS) LAUNDRY TRAY
C01"IBINATION SINK &' TRAY (2 UNITS)
(3 UNITS) DENTAL LAVATORY
(1 UNIT) KITCHEN SINK
CONBINATION SINK & TRAY W/ DENTAL UNIT OR CUSPI- (2 UNITS)
FOOD DIS. (4 UNITS) DOR (1 UNIT) KITCHEN SINK W/
DRINKING FOUNTAIN (11 UNIT) DISHWASHER (2 UNITS) WASTE GRINDER
FLOOR DRAINS (I UNIT) LAVATORY (1 UNIT) LAVATORY, BARBEE
LAVATORY, SURGEONS (2 UNITS) SHOWERS GROUP PER HEAD BEAUTY PARLOR
SURGEONS SINK (3 UNITS) (3 UNITS) (2 UNITS)
FLUSHING RIM SINK (8 UNITS) SERVICE SINK TRAP POT, SCULLERY
URINAL, PEDESTAL, SYPHON JET STAND (3 UNITS) SINK (4 UNITS)
BLOWOUT (8 UNITS) URINAL, WALL LIP URINAL STALL,
URINAL TROUGH EACH 2' (4 UNITS) WASHOUT (4 UNITS
(2 UNITS) WASH SINK EA SET,
SECTION WASHING MACHINE RES.
(3 UNITS) t : - OF FAUCETS
WATER CLOSETS, TANK- WATER CLOSETS, VALVE (2 UNITS)
OPERATED (4 UNITS) OPERATED (8 UNITS)
TOTAL FIXTURE UNITS
ag da
OF
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LOT CLE--'-RINC
CITY OF
/*(tv� ead - 9&u�(4
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2395
March 16, 1983
Pre-Service Section
3rd Floor
Jacksonville Electric Authority Building
233 West Duval Street
Jacksonville, FL 32202
Dear Sir:
The following final inspections have been made and are satisfactory:
Permit #3464 - 1213 Jasmine Street, Atlantic Beach, Florida
Permit issued to Gayco Electric Co.
Permit #3465 - 1223 Jasmine Street, Atlantic Beach, Florida
Permit issued to Gayco Electric Co.
Sincerely,
John M. Widdows -,e:)—
Building Inspection Supervisor
JMW/lS
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