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Permit Sign & Elec 25 Seminole 2011 F11.4A`1:r ,4t z f `i' CITY OF ATLANTIC BEACH ;t< ;t 800 SEMINOLE ROAD 1 — ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 y Application Number 11- 00001530 Date 2/22/11 Property Address 25 SEMINOLE RD Application type description SIGN PERMIT Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc sign w/ elec Owner Contractor BUDNIK AND D ELECTRICIAL CONTR 6703 LAURINA PL JACKSONVILLE FL 32216 Permit SIGN PERMIT Additional desc . Permit Fee . . . 65.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 8/21/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS FLORIDA FIRE PREVENTION CODE NATIONAL ELECTRIC CODE Fee summary Charged Paid Credited Due Permit Fee Total 65.00 65.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 65.00 65.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH � 800 SEMINOLE ROAD 1514, �� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Application Number 11- 00001530 Date 2/22/11 Property Address 25 SEMINOLE RD Application type description SIGN PERMIT Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc sign w/ elec Owner Contractor BUDNIK AND D ELECTRICIAL CONTR 6703 LAURINA PL JACKSONVILLE FL 32216 Permit ELECTRICAL PERMIT Additional desc . Permit Fee . . . 90.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 8/21/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS FLORIDA FIRE PREVENTION CODE NATIONAL ELECTRIC CODE Other Fees STATE DCA SURCHARGE 2.00 STATE ELEC DCA SURCHARGE 2.00 STATE ELEC DBPR SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 90.00 90.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 8.00 8.00 .00 .00 Grand Total 98.00 98.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 4. BUILDING PERMIT APPLICATION 1. CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 2 3 fe in/ fie 4 gC'_ g1 , &a4-41 Permit Number: 1/ - / 53 c Legal Description Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ 5:00 Proposed Work heated /cooled goo non -he - P s I 'C Lg Class of Work (circle one): New c i eratio Repair Move Demolition pool 31 : oil Use of existing /proposed structure(s) (circle one): ommerci Residential If an existing structure, is a fire sprinkler system inst . ircle one): Yes Io N /A By Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: J iii 779`/ /iele li ,''�_', ! __ �:_s,. , �f 1 n/7 t04e 1 x /ate -ohe q xg l�4teI Sig R2uSa t� fi a out BASeBr4 //* /OOH.. / Property Owner Information: f Name: �!/ 7 e , O &`a ` Address: PO . 2t 4/ City State Zip �A2V0 Phone q � 62q q7/3 E -Mail or Fax # (Optional) Contractor Information: / /�` /� ,�/ �/ �/ Com an Na ,�U1/1/f/ an J) t (�f.�► /Y qualifying Agent: ,4 ,�i X /»/ 134'a 'I fr P Y Address: 6703 /.CT..G/.fJ /12 /L- City ittX State Z( Zip .3 Office Phone T fQ y 6 09 7 i5O _ Job Site/ Contact Number /1/1 a4 Fax # State Certification/Registration # gg- /f Architect Name & Phone # Engineer's Name & Phone # Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address 4pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null 2nd void f work is not commenced within six (6) months, or if construction or work is suspended or abandoned fora eriod of six (6) months at any time after work is commenced. I understand that separate permits must be secured for ElectricaL Work, Plumbing, Signs, ells, Pools, Furnaces, Bo Heaters, Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. rhereb certify that I have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing this ype of work will be complied with whether sppecifd herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, stat- . local law regulating construction or the performance of construction. Signature of Owner «_. Signature of Contractor �, . / f ..,■,/.., i ?rint Name / /� �� -- \‘,5-,.. . ..... Print Name /� ,(j' �/U/ ' ;..' ga. ; ;. ;woi and subsc '' - cj-b,. fore me _ -�■ . i d subsc ► =fore me his D- j l (� ; , ■ . 3 ► ► 2► . D FOR T i « C�MP 7 hew► 20 c.„, ' mil , sw j SEE PE t ' 44 1 My c'4 Is'''' e ' I PERMIT �� -;� � 3 f �OtaryP .�C ,, r *: � MYA� ISSIONAbb'�760 •N �� i EXPI..a;:F� �.; i 'n auj �, �w EX' February 14 014 I ; REQUIREMENTS AND CONDITION' i' ` � �' `" f � _ "I"" " � Btib7 Bonded Thru Notary Public U , , 1 4- WED BY: _____— DATE: 01 —�' /? -. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247-5845 JOB ADDRESS: .2 s 9 -, j /'LO /e a ift • geetf PERMIT # 11 / C 3 v NEW SERVICE ❑ Overhead ❑ Underground ❑ Underground up Pole - [Residential (Main) Service am s # ofMeters 00 - 100 amps 0 101 - 150amps ❑ 151 200amps ❑ P 0 Commercial (Main) Service s ❑ CT Service amps 0 0 -100 amps 0101- 150amps 0151- 200amps ❑ am Conductor Type Size ❑Multi Family (Main) Service s # of Unit Meters 00 - 100 amps ❑ 101 150amps ❑ 151 200amps 13 am P ❑Temporary Pole 0 amps SERVICE UPGRADE 0 amps 0 CT Service amps NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.) 0100 amps 0150amps 0200amps ❑ amps OCT Service amps ADDITIONS, REMODELS, REPAIRS, BUILD - OUTS, ACCESSORY STRUCTURES, ETC. Outlets /Switches: / 0- 30amps 31- 100amps 101- 200amps Appliances: 0- 30amps 31- 100amps 101- 200amps A/C Circuits: 0- 60amps 61- 100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS DTransformers KVA ❑Motors hp ❑ Swimming Pool ld1 Sign ❑ Smoke Detectors Qty FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts /amps VALUE OF WORK $ REPAIRS/MISCELLANEOUS DReplace Burnt/Damaged Meter Can 0 Safety Inspection DPanel Change DOH to UG Other: /e92ICLr.P p/2-a/Vf 494z' /Xt' , ' ' -" Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. S?(.4 P � / 9 y Soc 73 Property Owners Name G �� Phone Number 6/1,6/(///k cd D g/ , COn Y Office Phone Fax Electrical Company �� 02,� / 7 D3 Lam / / Na / City c� State Zip 6 Co. Address: f _ , �Sa 3 License Holder (Print): PA- x /ifl ��"- £ State Certification/Registration # 1r� 9 Notarized Signature of License Solder 01 !j' ,r - //7�� Sworn' and subscribed before -- ' sv��;.' y 04, aN R M � /U •4 20 Te .. z. ' , • r uary 14,2014 Signature of Not Public , ,,, r • . Public .. i...0- Sign �Y Jr — % G, (v 0 ; w '�;`: 4' 0,4 it C ►N � , �c drAmil Wt II � tA 0 I � Nirs:APAratdrawasimorAra . \\ (Ak , ,z.„, -;,i _ 1 ' rn fi f. 0 -N CX 0 q!) . . '' > "mo � = I i - 0 0 I. ilifti...11f6 , Z CA e .3 rj " 1 73 ' ems > d M Vi.' .' w?^ l r 4.‘ r cm o co f 1 E. 'i'. ' ON -- 1 0 o y ;f %m'rif, City of Atlantic Beach APPLICATION NUMBER Building Department ( To be assigned by the Building Department.) 3 . .ro 800 Seminole Road /// 4�� s� Atlantic Beach, Florida 32233 -5445 ° ' Phone (904) 247 -5826 Fax (904) 247 -5845 Date routed: ,1)%4 E -mail: building- dept @coab.us City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM S AM r D /z..- To( DD�rtment review required Ye No Property Address: (Buil • 61 b )-15-6 anning & Zonin Applicant: Tree Administrator Elegy Public Works Project: y Public Utilities Public Safety Fire Services # �, ,� r + x1; ,� „ ,f' * a :fzF wm`r sit � Review or Receipt Date Other Agency Review or Permit Required of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ❑ Denied. (Circle one.) Comments: BUILD' PLANNING & ZONING Reviewed by: /T1 Date: a // r� TREE ADMIN. Second Review: Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05114109 City of Atlantic Beach APPLICATION NUMBER ( To be assigned by the Building Department.) (r1LAJ`tr„r4 Building Department / _ � � , s > 800 Seminole Road ;� Atlantic Beach, Florida 32233 -5445 N Pho ne (904) 247 -5826 • Fax (904) 247 -5845 i" r r s' Email: building- dept @coab.us Date routed: � // City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM 6 S AA Cr) d / Tel D artment review required Yes No Property Address: (Buil • r '/ 6 I b 1 6. fanning & Zonin Applicant: Tree Administrator / E1E Ef Public Works Project: Public Utilities Public Safety Fire Services xRe to lli n_, � -lie .. .t PepttS g: atur� x t Review or Receipt Date Other Agency Review or Permit Required of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. Denied. (Circle one.) Comments: e 6 is � _ i c • o ; Ld [xC �,"j- 142, 0 j BUILDING ---" g c i, � ' e { .n GOped Ctak) Cs ISO \ ,� �R°� g/4..e...1 1 4 P LANNING & ZONIN Reviewed by: Date: � 906/ TREE ADMIN. Second Review: Approved as revised. ['Denied. PUBLIC WORKS Comment • nsffilm � ow PUBLIC UTILITIES � /2/1/ PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09