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Permit Sign & Elec 29 Seminole 2011 Zt . x ` ‘ CITY OF ATLANTIC BEACH u .g j 800 SEMINOLE ROAD j ` ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 ""4.011 > Application Number 11- 00001531 Date 2/22/11 Property Address 29 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 It - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Application Number 11- 00001531 Date 2/22/11 Property Address 29 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. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 9 - fern/4,64 !7/ Z ,B•Permit Number: II: — /5 Legal Description oor • ea o q. Parcel # Valuation of Work $O Proposed Work heated /cooled t non :�:. ted /cooled Class of Work (circle one): New Addition (teratiO" Repair Move Demolitio , ool/s , a . ,. Use of existing /proposed structures) (circle one): C door Cf an existing structure, is a fire sprinkler system installed? (Circe one : ResYdential • J,CJN Florida Product Approval # ) 'es No e /A / Ds ' For multiple products use pro uct approva orm ��1 describe in detail the `� typ e o f work to be performed: A Z , r ace / ,,, Z u , / Of r 'roperty Owner Information: /,r /y i , Tame: . ' ' //i/� � i fO / ,• % Address: � .ity x ,tgP-z.o,C( St.'e Zi 's Mail or Fax # (Optional) p, `` A SAO Phone .. 0 : ontractor Information: ;ompany Name: ..! 41-4. address: / ./.., , .,� Qualifying Agent: t�i //It ,�ttc��v/ e )ffice Phone r ! 3-7, 9 1 0 - City _ State' t 7_ Job Site/ Contact Number Fax # --C-__ Zip tate Certification/Registration. # 6/L /SSo2 35 schitect Name & Phone # :ngineer's Name & Phone # ee Simple Title Holder Name and Address .. " t 0 ' , onding Company Name and Address fortgage Lender Name and Address oplication is hereby made to obtain a permit to do the work and installations as indicated I certfy that no work or installation has commenced to the nuance 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 zd void f work is not commenced within six (6) months, or if construction or work is susp ended or abandoned fora eriod of six (6) months at any time after ork is commenced I understand that separate permits must be secured for Electrical - Work, Plumbing, S Wells, Pools, F urnaces, Boilers, Heaters, inks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IlVIPROVENIr TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF zereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this )e of work will be complied with whether specified tY d herein or not. The granting of a permit does not presume to give authori to viola g to or cancel the the ovisions of any other federal, state, o - o all, regulating construction or the performance of construction. gnature of Owner ``( � Signature of Contractor iJ�A.� int Name // ,�{ , r ,6„4,4,______ L {,.v....c . -- A.k.I ..k..`.. v Print Name A$X/ /7! ifilidAlf is 111 01,,,,,414040404r.,--; 1741 ft ��i1 '•:.. Swop .. d subscri. -d . i • - me 4 ' E � T ,�,, : this , � >t a of r , 1. 4 u.lic SE)r ,.. _ . 'ta . t ,, , r,. r wi •' / 7o t l f! I • I �I' $c�' • '�DD I T'IC)NAI; A Y � i Yl� i l lii - i� l �:i --lg i r'" REQUIREME + ' " ° S' February 14, 2014 AND CbNI)1'pIpNS, ? , , B ru Not Fubllc underwrkere 1 REVIEWED BY: I IL C ' r .._ - r " DATE: ^/ ' ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 - Ph (904) 247 -5826 Fax (904) 247-5845 - : LOB ADDRESS: 2'9 c 2 7 / /2O/ e &" c'✓ %7i i C PERMLT -# /! - /5 NEW SERVICE El Overhead ❑ Underground ❑ Underground up Pole - ❑Residential (Main) Service . 00-100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of ❑ Commercial (Main) Service 00 -100 amps 0101- 150amps 0151- 200amps ❑ amps OCT Service amps Conductor Type Size ❑Multi Family (Main) Service ❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters ['Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ 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 @ /0 kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS --> ['Swimming Pool VSign ['Smoke Detectors Qty ❑Transformers KVA DMotors hp FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) . Qty volts /amps VALUE OF WORK $ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection DPanel Change ❑OH to UG 5. Other: tefriace ceels/4. hyie 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. Property Owners Name g li Phone Number 90/7 62 9 a/3 Electrical Company / 11&/i/U //L 21Zc. / 1) Office Phone 90/--ro 9 7..?tilax Co. Address: ,6> 03 1a-eti&,i /L'Q City geZ/X State z�r Zip- License Holder (Print): 7/,64-)1 /✓✓/ ,6 GCd. / L State Certification/Registration # Ei - ( C 3 V Notarized Signature of License Holder / / IF IL. HIRLI Sworn and subscribed before - le ri s 1 a -y , ele .,� 4s I 20 0 +' ' YES' •.,:J14,2014 u 1 .. hru r f uhhr Underwriters I Signature of Notary Pubh, t :1/... v _r oft , - t cy.3 , } -L, N. k P f., ...-....,:....., 4 '11 fir• w \ j qt 1 arAnurArmararArdomordrAi q \ § ',; ,..:1-- .' N . k . l e ‘ GA \t.zi zh ›, 1 x N f N - y ' I {i (3''' I 6■ i cv �i cri j� Q , a F) . ' N4) 3 u r r ■ S U L CV n v OA 0 .,) , - ...."t — -- f ° s&... ----- .____ ----- l f),AP r City of Atlantic Beach APPLICATION NUMBER ., Building Department (To be assigned by the Building Department.) 1 800 Seminole Road 11 � Atlantic Beach, Florida 32233 -5445 // — ` Phone (904) 247 -5826 • Fax (904) 247 -5845 1 r E -mail: building- dept @coab.us Date routed: / City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 9 ii /6 - 7d Department review required Yes / No TT // =uildi • �/ Applicant: /C ' �) D �LJ -� fr - nning & Zonin Tree •hinistrator Project: g. J Public Works Public Utilities Public Safety Fire Services Review fee $�V ` , 474 x ' Dept Si natu red � � ' Other Agency Review or Permit Required Review or Receipt Date 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: proved. ['Denied. (Circle one.) Comments: UILDIN • PLANNING & ZONING Reviewed by: frn Date: c-f- // TREE ADMIN. Second Review: ['Approved as revised. ❑De ied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 f; 1 l, City of Atlantic Beach APPLICATION NUMBER �j1 A Building Dep artment ( b e assigned by the Building Department.) ,l :.. 800 Seminole Road / s� Atlantic Beach, Florida 32233 -5445 / / /6 Phone (904) 247 -5826 • Fax (904) 247 -5845 a"„r ji )'r E -mail: building - dept @coab.us Date routed: / '/1 City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 9 J/'- ) n a 16 / ' cal Department review required Yes No T uildi Applicant: ;? Applicant: K ' >47 IIb 2 i /re, • TFee or Project: (7 ) yl g d— Public Works Public Utilities Public Safety Fire Services OK 9'�" (�� W:4,' "v° ibt� r�!e�9� "��) �ki�� tl� + M, i�ie , # y� ; q �a� ;. N (�a �r *� 5.��j�y,, � vzipr'*-�ry , � ,;; p Ik tis ;� ��d�.�� , k °,ty D Signature °' a� °tip ° ;r t c ,,ot r ` u yl9 `; Other Agency Review or Permit Required Review or Receipt Date 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: eiR w a .ve � L ACC l7 L.a(1 ).1 BUILDING C h al-t& eked +0 Slo S Ids CANNING & ZONING Reviewed by: B�z ��-b"" Date: 1 /`o /2 TREE ADMIN. Second Review: JA roved as revised. pp ['Denied. PUBLIC WORKS Com REV PUBLIC UTILITIES a'Ar il , �i PUBLIC SAFETY Reviewed by: Date: 3 ZOlI FIRE SERVICES Third Review: Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 05/14/09