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Permit 94 Lewis St (vault folder) rn � S�- 1 \ � ��� I � � 350 FORo ` )ATE / TIME P.M, M OF PHONE/ t �F MOBILE uj MESSAGE <L4R L) t'�t`1.j utl} TELEPHONED j !A,) F� t7�- []RETURNED YOUR CALL PLEASE CALL �� E]l WILL CALL AGAIN GAME TO SEE YOU y� G WANTS TO SEE YOU }„� SIGNED1154 Duval County Igalth'Department D 418 3l DUVAL COUNTY COURT HOUSE - JACKSONVILLE, FLORIDA FEE $5.00 SEPTIC TAMS PERMIT Name of Owner:,_._ _._ _ ' Address: Atlantic Beach Date: I�'&'L 19 Installation At:fit 17. Blk. 3. D onnsr Rf P Installation 11y: NOTE: This Permit does not guarantee the successful func- tioning of this unit and the occupant will be responsi- ble for its satisfactory sanitary operation at all times. tieptic Tank Capacity: 2-6�0 Gallons. I)rain Field: 160.sq, ft ea 121 x 301 beds withfQar�ei , a. - fe- ` A DIRECTOR-DUVAL C&NTY HEALTH DEPT. CONSTRUCTION :� � B. Castleberry, San. PERMIT TITLE VOID 91X MONTHS AFTER ABOVE DATE IF NOT STARTED i i A._ s 1 t CITY of ATLAN i'i_ BEACH d- $UILDINC OFFICE. v i 17 1 To 7 'X ;'r'tkL/off Fr' Biu ,�'� L7 uL U1E • �I - v r _ —� , , _. cla� IvLC17 ! � C\Z L {ti i l I -- tt_rD rv.. ASR � ti�t.13 � ' — - JctC,: �fah-CH 01, u woo CITY OF AT�.ANTIC t 14 Umber:, Ad4iisi STREET ti its L writ t .' Ty ei: WOOD FR L,cat z,' � .'DESCRIPTOR =� own RHO ,. Cade } 4NPIRR � paues AIMr{4� k' L.os is ry*: ob Addt3.00 r XA IPE , �y x,:- fLOR y{� �y yr{ r "1[tiAAMb"f' l'JQ, s�ijJ�-of }r1✓, y�ry#p kP, *rn.a..r r +en.. '+.r '4w+ 7a� "'fid fid ,i 1.1 V WaiN i LRA-'` m .+,mnµn,.sncnaa as �m»+: .aamnarms `, ew,Tm+amm'' _ . CROSS ILLS, Pt, 1122191 "o pEr 00 I tar - -AL�. r r e No FMIN MutsE CTE0 eEFOAE POURING. a FIEEMIT v $13 MONTHS AISSUE SUILDING AA'A t=R1A >RUBBISH AND DE$RIS 1 ROM THIS-WC?F K MUS NOT BE PLACE171N PUB#�tC SPAGE,I��IQ MAST B� II `.CI: ABED"Ui?AN k`HAULEO AWAY 6'Y EITHER CONTRA, '©1�UR � l+t"" " *FAtLVtt v �tiL � ' �1t14!E 1�r�K QNL� N ISSUI~13 ACF ©INS TCS AI'.PRfJVC?Pk .WHICH ARE"PAflT DF PHIS Pr=RMIT'ANQ SUBJECT T©R1f4CAT1©N FOR Ylf«ATFiIt"CkF; P1tCABL1 #s# 1lIIt11 CSP lkW. LEACH BUILDS ©EPAR, 1 TMEIT 3�� 5 � ^�. � t , w .� v7.r. fir ,•";° � � �, '` r��1�,t 2 ��fi x 5�t;e` "C .•Y. M �, a x, ., a a e i /_l CITY OF ATLANTIC BEACH, FLORIDA log Approved by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: — 7 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 r JOURNEYMAN NAME-- °% PGS- ADDRESS: � RFD BOX BLDG.SIZE BETWEEN: RES. ( 1 APT. ( 1 comm. ( 1 PUBLIC ( 1 INDUS. ( ) NEW ( ! OLD ( 1 REW. (1-r ADDITION ( ) TRAILER ( 1 TEMP. ( 1 SIGNS ( ) SQ. FT. SERVICE: NEW( ) INCREASE ( ) REPAIR FEE CONDUCTOR SIZE AMPS COPPER I 1 ALUM. SWITCH OR BREAKER AMPS PH Wrr�� VOLT n RACEWAY EXIST.SERV.SIZE d AMPS PH W fh4 VOLT -QFW'R�yACEWAY FEEDERS NO. SIZE NO. SIZE I NO. SIZE LIGHTING OUTLETS / CONCEALED OPEN TOTAL RECEPTACLES C CONCEALED OPEN TOTAL 0.30 AMPS. —7-31, 1.100 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M. V. _ FIXED 0.100 AMPS. OVER APPLIANCES BELL TRANSF. AIR N.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CELL HEAT: KW-HEAT 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MI CELLA EOUS c V t DI PAI TMONT t�F �tNa CITI(or Iml TIOV� ATI:AIVTIC H 'LOMTI0l>'ffloux' " I? i10491, ; Pe r rai I : RR-F aQ ` A,TU WT;I C 1OZACA,.. "c Of 40 R990DE rk C3R i t?A32233 Lo R C► 0 Dwrl l _ Cade: Subd %`soxhIR imPrdv` Cost AwNor . �e K. - HUS R C AS. MT ION rifts,"' ft%T,I On " ST `L .r . ... 4AS .S. f .E loop t 001 CAB - MPR,OVE I .00 LPdR'r 31 CiQS, " 'oINCi4t 0,0 Fit " PACT It— 00 �Q�Sv „ FBI va am, NOTICE —ALL CONCRETE PORIsS AND FOOT[NQ& PogfllN� PERMIT"VQIa SIX Iv14NTHS AF'TI R il1ATe,,OF ISSUE UILf31PdG MAtERfAL,fiU881SH ANC3 a.I RR S PF C M TMlS WaRk MIJS 'N Y1 £E;PLACI=O:IN F'U 3LIC'`;aPA E, (+11 MCIST BE "Ct:SARED 11P ANO:HA BY j{ HER CQMTRA' ; R©F3 dWN R. ��+ � L � t: : IAF#EC' �rr�s Lai « �. AS { � .' I 'r I suEo ACCpRalry -ro I rnrl a K� WHICH ARE pAI�T QF THIs PIERMl ANa uE3;lECT T© FOR IQ A`flOM QF APPLICABLE'PROVISION SQl i:�w a CITY OF ALANTIC BEACH ROOFINt3 PBRMIT BPPLI9CI� ION Owner(s) : n Address:— Lpuj,S �l� Phone: Lot # , Bloc or Unit Subdivision: Contractor: Address :- City, State and Zip Phone�� State License # O–L* 0-0 4S�� T11 I Describe work to be erformed: LfV\-V11 )-L a4� �� I � Ekx ) - valuation of Proposed nstruct ' on: . U"-u Materials to be used: Signature of Owner; Signature of Contractor: Liability Insurance Supplied Workers Compensation Insure a Supplied License Information a `l 5� 1 MORTGAGE NOTE Atlantic Beach,Florida For value received, the undersigned (jointly and severally, if more than one), promise to pay to the order of the City of Atlantic Beach, a municipal corporation, 800 Seminole Road, Atlantic Beach, Florida 32233, the principal sum of Seven Thousand Three Hundred Forty and 00/100 Dollars(57,340.00)being payable in lawful money of the United States of America at 800 Seminole Road,Atlantic Beach,Florida 32233 or at such other address as the holder from time to time may specify by written notice to the maker. Said principal sum shall bear no interest and shall be reduced in amount at the rate of 1/10th per year until reduced to a zero balance at the end of 10 years. Any unforgiven balance shall become immediately due and payable if the maker transfers title to or moves from the premises securing this note within the 10 year period In the event of the death of the maker of this note, this note shall remain in effect and the principal sum reduced at the above rate of 1/10th per year only if a member of the makers immediate family takes up residence in the subject home,under any other circumstances the note shall become immediately due and payable. This note is to be construed and enforced according to the laws of the State of Florida, and is secured by mortgage on real estate of even date herewith. If default be made in the payment of my of said sums or in the performance of any agreements contained herein, then, at the option of the holder of the same, the principal sum then remaining unpaid shall immediately become due and collectible without notice, time being of the essence of this contract, and said principal sum shall bear interest at the highest rate allowed by applicable law,from such time until paid. Each maker and endorser waives presentment, protest, notice of protest and notice of dishonor and agrees to pay all costs,including a reasonable attorney's fee, whether suit be brought or not, if counsel shall after maturity of this note or default hereunder or under said mortgage, be employed to collect this note or to protect the security thereof (seal) Name of Maker (seal) Makers Address: 94 Lewis Street Atlantic Beach,FL 32233 STATE OF FLORIDA DOCUMENTARY STAMPS IN THE AMOUNT OF S HAVE BEEN AFFIXED TO THE MORTGAGE SECURING THIS NOTE AND CANCELLED. PRE-CONSTRUCTION CONFERENCE REPORT READ CAREFULLY BEFORE SIGNING I (WE) THE UNDERSIGNED HAVE ON THIS DATE AT PARTICIPATED IN A PRE-CONSTRUCTION CONFERENCE PRIOR TO THE SIGNING OF A CONTRACT FOR THE REHABILITATION OF MY (OUR) PROPERTY. WE b ACKNOWLEDGE THAT WE UNDERSTAND THE TERMS OF THE CONTRACT, THE EXPLANATION OF THE WORK TO BE PERFORMED BY THE CONTRACTOR, THE ROLE OF THE CONTRACT ADMINISTRATOR OF THE REHABILITATION LOAN PROGRAM, AND OUR RESPONSIBILITIES DURING THE CONSTRUCT- ION PHASE. I (WE) HAVE BEEN GIVEN AN ADEQUATE EXPLANATION TO OUR QUESTIONS, IF ANY, AND ARE AWARE THAT ASSISTANCE WILL BE PROVIDED BY THE STAFF OF THE REHABIL- ITATION LOAN PROGRAM IF REQUESTED. WE FURTHER UNDERSTAND AND ACKNOWLEDGE THAT THE REHABILITATION LOAN PROGRAM ASSUMES NO RESPONSIBILITIES FOR THE WORK PERFORMED AND DOES NOT WARRANT ANY WORK PERFORMED. gnatur�eo ftope�rtyWer gnature of Property Owner Date � --------------------------------------------------------------------------------- I , THE UNDERSIGNED, HEREBY CERTIFY THAT THE PRE-CONSTRUCTION CONFERENCE WAS HELD ON THIS DATE BETWEEN THE HOMEOWNER(S) , REHABILITATION LOAN PROGRAM CONTRACT ADMIN- ISTRATOR AND MYSELF. I UNDERSTAND THE PROCEDURES TO BE FOLLOWED FOR CHANGE ORDERS AND REQUESTS FOR PAYMENT. I UNDERSTAND AND AGREE THAT THE WORK PERFORMED MUST MEET THE STANDARDS OF PERFORMANCE REQUIRED BY THE REHABILITATION LOAN PROGRAM AND ESTABLISHED BY THE REHAB STANDARD PERFORMANCE MANUAL. rgnature of Contrqptor & Title Date ---------------------------------------- --------------------------------------- 1, ------------------- I, THE UNDERSIGNED, HEREBY CERTIFY THAT I PARTICIPATED IN A PRE-CONSTRUCTION CON- FERENCE THIS DATE AND THAT I HAVE COMPLIED WITH ALL OF THE PROVISIONS OF THE REHABILITATION LOAN PROGRAM PROCEDURAL MEMORANDUM #49. PROCEED ORDER DATE: I TO: f�le�CA,yte%✓ � (�e�, G This is to .authorize you to proceed with work specified in our contract dated for improvement work on the property located at 1. i Tr'e2 . The amount specified in the Rehab- il�tation Agreement is . Please proceed in accordance with the Contract. You are to commence work no. later than All work shall be completed according to the Work Write-Up. plans, Change Orders, Addenda and Specifications within- Sixty (60) calendar days after start- ing construction. CU nVII &19-A)C� b 6- ame(s) of owner(s) ( er s Signature) (Owners Signature) ADDRESS: ( 0 1 u c Ag nc Rep sentative) Copy: RLP-143 REHABILITATION LOAN PROGRAM RESPONSIBILITIES OF HOMEOWNER AFTER CONTRACT IS SIGNED Until Work Begins Start planning ahead. Plan adequate storage space for the contractor' tools, equipment and materials. Make arrangements for the contractor t, get into your property if you will not be home during the day. To avoid mutual confusion, one member of the family should be delegate6 a; the spokesman to discuss problems or questions that may come up. If all household members work or will not be home during the construction, consider designating an agent such as a close friend or neighbor or rela- tive not living with you to supervise the contractor's work. You are responsible to make sure the contractor does the work exactly as he stated he would do in your contract. Prepare your property and furnishings for the rehabilitation - use this period to send your drapes to the dry cleaners - wash your curtains. There will probably be dust and dirt from the work - protect your furnish- ings and clothes - put all breakable and valuable items away so they won' t be broken or misplaced. When the Work Begins Keep your copy of the work description handy and refer to it often. Check with your Case Manager if there is anything you do not understand. Remember you are responsible for ensuring that the contractor does the work correctly as bid. Assistance will be provided if required but the work must be acceptable to you. Try to stay out of the construction area, especially children; this will help prevent injuries and allow the workmen room to work. Try to keep a good relationship between your family and the contractor - again, delegate someone to be the spokesman for the family. Stop problems before they start - if something isn't going the way you feel it should, or if you don't understand it, speak to the contractor at once and get an acceptable explanation or correction before it progresses too far. If the contractor cannot give you an acceptable explanation, stop the work and call the Case Manager for assistance. Expect the unexpected - in most cases changes and improvements will be new and exciting to you and will give you much pleasure; however, unforeseen problems may be uncovered during the course of the work which may require a change to the contract. Be prepared if this should happen - discuss changes with the contractor and get a good explanation of the change required and why. Try to .visualize what the change will look like. Be flexible. All changes to the contract must be approved by you and your Case Manager and must be in writing. Your contractor is responsible for supervision of his workers. If he cannot be present, make sure that he tells you who to talk to if you have a problem or questions. Win cooperation from the workmen with good basic human relations. A word of appreciation - unexpected PP p pot of coffee or A�=�� CONTRACTOR'S AFFIDAVIT STATE OF FLORIDA } COUNTY OF OUVAL } SS WORE ME, the undersigned Notary Public, personally appeared who, being first duly sworn by - me, 2eposes and says: e That on - 199 as owner, an as contractor, entered nto a certain construction contract w re y said contractor agreed to provide certain labor and materials for said owner upon the following described lands belonging to said owner, located in the City of , County of and State of Florida, to-wit: That deponent is the of said corporation, herein referred to as the contractor, and has personally supervised the performance of said contract. That said contract, has been fully and completely performed, and said contractor and all persons , firms and corporations contracting or dealing with , or directly employed by said contractor in connection with said building operation or in connection with said contract, have been paid in full . This affidavit is made in compliance with the provisions of the Uniform Mechanic's Lien Law as approved June 4, 1935, as revised, Laws of Florida , and to enable said contractor to receive his full and final payment from the owner, under the construction contract above referred to. CF.erv.3hn.1 nn�l ewnr.w fn hnfnra me this �;,JNTRACTOR PAYMENT REQUEST Homeowner: Payment #1 - 40% Complete________ Address: #2 - 80% Complete_______ #3 - 100% Complete Contractor: Amount Requested: $ ----------------------------------------------------------------------- Contractor: I hereby request an inspection to receive payment # for the amount of $ I certify that I have satisfactorily completed the necessary work to justify this request and that all bills incurred for labor used and materials furnished in making said repairs and im- provements have been paid in full to this date. Attached is a description of the work completed and the amount of payment requested by work item. Contractor' s Signature: Date: ----------------------------------------------------------------------- Homeowner: I/We hereby agree that the work stated by the contractor has been completed and approve payment to the contractor in accordance with the contract and contingent upon in- spection and concurrence by the Rehabilitation Inspector. It is understood that the actual amount disbursed will be based on the findings of that inspection. Owner' s Signature: Date: Owner ' s Signature: Date: ----------------------------------------------------------------------- Rehabilitation Inspector: I hereby certify that I exercised reasonable care to determine that the work performed at the above address meets specifications and was completed in a satisfactory manner; however, neither the undersigned nor Jacksonville HUD is in any w#y responsible for the acts or omissions of the contractor, any subcontractor, or any of the contractor's' agents or employees, or any. other person performing work under the construction agreement. The contractor has provided a release of all liens, if any, in connection with this contract and has provided the proper- ty owner with a copy of each warranty or guarantee due the property owner from the contractor for work performed. I hereby certify that all work is completed as indicated on the contractor' s payment request and recommend payment to the contractor in the amount of $ Rehab Specialist: Date: ----------------------------------------------------------------------- ,t 1.00$ completion: CHANGE ORDER No. Date of Contract Date Owner Name: Property Address: Contractor Name: Contractor Address: Description of Work Change: AMOUNT: CATEGORY: No. - SUM Changes and work affected hereby, are subject to all contract stipulations and covenants. This Change Order'is made a part of the contract dated first above, parties have hereunto set their signatures: $ Contract Price + or - $ Change $ Total Owner Approval: Date: Contractor Approval: Date: Sr. Rehab Specialist Approval: Date: Program .Administrator Approval: Date: Source of Funds: $ $ $ Contingency Owner Contract Copy: Owner, Contractor, .Loan file, Technical file Financial institution (If contract price changed) RLP-155 Rev. 12/& HOMEOWNER - CONTRACTOR AGREEMENT Property Improvements To: ---+- -- =e=r'`��S -------------------------- /' (Address) Owner (s) . ---t-�� 'rg--- �� ---------------------------- (Name) ------------ - -------------------- (LegalDescription) 1 . HOLD HARMLESS. Contractor shall agree to defend, indemnify, and hold harmless the Owner, City of Atlantic Beach, Florida from liability and claim for damages because of bodily injury, death, property damage, sickness, disease of loss and expense arising from Contractor s performance under this agreement to install or construct home improvements to be paid out of the proceeds of the Owner's rehabilitation loan. Contractor is acting in the capacity of an independent Contractor with respect to the Owner. 2 . LIEN WAIVERS. Contractor agrees to protect, defend and indemnify, Owner from any claims for unpaid work, labor or materials with respect to Contractor' s performance. Final payment shall not be due until the Contractor has delivered to the Owner complete release of all liens for work dompleted arising out of Contractor's performance, or a receipt in full covering all labor and materials for which a lien could be filed or a bond satisfactory to the Owner indemnifying him against any lien. 3. SCOPE OF WORK. Contractor acknowledges that he has prepared the Contractor' s Proposal (Part II of this Agreement) and that such proposal is accurate and consistent as to the name of the Contractor will undertake, and the price. Contractor acknowledges the performance requirements established in the General Specifications of the Rehabilitation Standard Performance Manual effective June 1, 1982 and warrants that all work undertaken will conform to said specifications . 4 . CONTRACT AMOUNT AND PAYMENT SCHEDULE. The City of Atlantic Beach shall pay the Contractor for the performance of the rehabilitation work, subject to additions and deductions by approved Change Order, the contract sum of-------------($--_y iql! Q� _____ -) Payments will be scheduled as follows, subject to the Owner's acceptance of the work to be done: Upon completion of 40% of the work, a progress payment of 30% will be made. Upon completion of 80% of the work, an additional payment of 30% of the contract price will be made. Upon completion of .100% of the work, the remaining funds will be disbursed. 5. TIME OF COMMENCEMENT AND COMPLETION. Owner shall provide written authorization to Contractor to commence work. Contractor agrees to start work ten (10) calenda.ar days after the receipt of the written Notice to Proceed. If the Contractor fails to commence work within ten (10) days of the Owner' s notification to commence, Owner shall have the right to terminate this Agreement. Such notice of termination shall be in writing. executed Change Order. No extra costs will be paid to the Contractor when he has neglected to properly evaluate_. the extent of the rehabilitation work. Under no circumstances will the contingency fund, if any, be authorized for work other than totally unforeseen circumstances arising after the commencement of the work. 7. TERMINATION OF AGREEMENT. If the Contractor defaults or neglects to carry out the work as specified under the paragraph "Scope of Work" or fails to perform any provision of the Contractor documents, the Owner may, after fifteen (15) calendar days written notice, terminate this contract and , select a substitute Contractor. If the expenses of finishing the work exceeds the unpaid balance on this contract, the Contractor shall pay the difference to the Owner. If the Owner fails to perform any applicable provisions of the Contract, the Contractor may, after fifteen (15) calendar days, terminate the contract and recover from the Owner payment for all work satisfactorily completed including reasonable profit and damages . 8. WARRANTY. For good and valuable consideration, the Contractor hereby agrees to provide a full one-year warranty to the Owner, which shall extend to subsequent Owners of the property to be rehabilitated. The warranty shall extend to subsequent Owners of the property to be rehabilitated. The warranty shall provide that improvements, hardware and fixtures of whatever kind or nature installed or constructed on said property by the Contractor are of good quality, and free from defects in workmanship or materials or deficiencies subject '^to the warranty contained in this paragraph. Contractor and Owner agree, however, that the warranty set forth in this paragraph shall apply only to such deficiencies and defects as to which the Owner or subsequent Owners shall have given written notice to the Contractor, at its principal place of business, within one (1) year from the date of Contractor' s final payment . The Contractor further warrants that failure by the Contractor to respond to valid complaints by the Owner, or subsequent Owners, that causes additional damages to the property are also subject to the warranty contained in this paragraph. 9. ARBITRATION. If a dispute arises as to the validity of a complaint not satisfied under the warranty clause of this contract, a panel of three (3) independent professionals shall be chosen by the City of Atlantic Beach to arbitrate the dispute. The panelists shall be chosen on a rotating basis. The finding of the panel shall be irrevocably final, conclusive, and binding on the Homeowner and the Contractor. 10 . SUB-CONTRACTORS. Contractor agrees that all warranties contained herein shall apply to all work performed under the Contract, including that performed by any sub-contractor. 11 . ACKNOWLEDGMENT. The above warranties are in addition to, and not in limitation of, any and all other rights and remedies to which the Owner, or subsequent Owners, may be entitled, at law or in equity, and shall survive the conveyance of title, delivery of possession of the property, or other final settlements make by the Owner and shall be binding on the undersigned notwithstanding any provision to the contrary contained in any instrument heretofore or hereafter executed by the Owner. 12 . INTEREST OF CERTAIN FEDERAL OFFICIALS. No member of or delegate to the Congress of the United States, and no Resident Commissioner, shall be admitted to any share or part of this Agreement or to any benefit to arise, from the same. 12b.BONUS, COMMISSION,OR FEE. The Borrower will not pay any bonus, commission, or fee for the purpose of obtaining the Government's approval of his application for this loan, or any other approval or concurrence required by the Government or ii-c rlo­4n--- ---- ' Homeowner-Contractor Agreement cont'd or ' employee of the Public Body who exercises such functions or responsibilities, shall have any interest, direct or indirect, in the proceeds of this loan, or in any contract entered into by the Borrower for the performance of work financed in whole or in part with the proceeds of this loan. 12d. INTEREST OF OTHER LOCAL PUBLIC OFFICIALS. No member of the govern- ing body of the locality in which the property to be rehabilitated is situated, and no other public official of the locality who exer-" cises any 'functions or responsibilities in connection with the administration of the loan shall have any interest, direct or indi- rect, in the proceeds of this loan, or in any contract entered into by the Borrower for the performance of work financed in whole or in part with the proceeds of this loan. 13. CIVIL RIGHTS. The Grantee agrees to abide by the spirit and intent of the Civil Rights Act of 1964, as amended, and the Civil Rights Act of 1968, as amended, and the anti-discrimination provisions of Chapter 120 of the City Ordinance Code, in that its operation under this contract is free of discrimination against its employees, persons, or groups of persons on the basis or race, color, sex or national origin. 14. EQUAL EMPLOYMENT OPPORTUNITY. The Grantee agrees to abide by the Equal Employment Opportunity Clause for Contracts subject to Execu- tive Order Number. 11246, as described in Attachment 1, attached hereto and made a part thereof. 15. LEAD BASE PAINT HAZARD ACT. The Grantee agrees that no lead based paints or substances containing lead shall be used in any part of this project. Treatment necessary to eliminate immediate hazards shall, as a minimum, consist of the following: a. All surface conditions identified as immediate hazards shall be thoroughly cleaned (washed, sanded, scraped, wire brushed or otherwise cleaned) so as to remove all cracking, scaling, peeling, chipping and loose paint on applicable surfaces. Such surfaces that have been so treated shall then be repainted with two ( 2) coats of a suitable non-leaded paint. b. Where the paint film integrity of the applicable surface cannot be maintained, the paint shall be completely removed or the surface covered with a suitable material such as gypsum wall board, plywood or plaster, before any repainting is . undertaken. �'t.�E�r•-�e� (.✓ ��G� 1�c 1.�.�1 t��' 4� �J �f� � C''� t4--1 Name of Contractor Na e(s) of Owner(s) SigMature of Cont r for Date atiognnattttu�re of Owner Date ATTACHMENT 1 EQUAL EMPLOYMENT OPPORTUNITY _CtiUSE FOR CONTRACTS SUBJECT TO EXECUTIVE ORDER 11246 During the performance of this contract, the contractor agrees as follows: 1 . The contractor will not discriminate against any employee or applicant for employment because of race, color, religion, sex, or nation- al origin. The contractor will take affirmative action to ensure that applicants are employed, and that employees are treated during employment, without regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to the following: employ- ment, upgrading, demotion, or transfer; recruitment or recruitment adver- tising; layoff, or termination; rates of pay or other forms of compensa- tion; and selection for training, including apprenticeship. The contrac- tor agrees to post in conspicuous places, available to' employees and applicants for employment, notices to be provided by the contracting officer setting forth the provisions of this nondiscrimination clause. 2. The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all quali- fied applicants will receive consideration for employment without regard to race, color, religion, sex or national origin. 3. The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice, to be provided by the agency con- tracting officer, advising the labor union or workers' representative of the contractor' s commitments under Section 202 of Executive Order 11246 of September 24, 1965, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. The contractor will comply with all provisions of Executive Order No. 11246 of September 24, 1965, and of the rules, regulations, and rele- vant orders of the Secretary of Labor. ATTACHMENT 1 Page -2- 6. In the event of the contractor' s noncompliance with the nondis- crimination clauses of this contract or with any of such rules, regula- tions, or orders, this contract may be cancelled, terminated or suspended in whole or in part and the contractor may be declared ineligible for b further Government contracts in accordance with procedures authorized in Executive Order No. 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order No. 11246 of September 24, 1965, or by rule, regulation, or order of the Secretary of Labor, or as otherwise provided by law. 7. The contractor will include the provisions of Paragraph ( 1 ) through ( 7 ) in every sub-contract or purchase order unless exempted by rules, regulations, or orders of the Secretary of labor issued pursuant to Section 204 of Executive Order No. 11246 of September 24, 1965, so that such provisions will be binding upon each sub-contractor or vendor. The contractor will take such action with respect to any sub-contract or purchase order as the contracting agency may direct as a means of enforc- ing such provisions including sanctions for noncompliance; provided, however, that in the event the contractor becomes involved in, or is threatened with, litigation with a sub-contractor or vendor as a result of such direction by the contracting agency, the contractor may request the United States to enter into such litigation to protect the interests of the United States. The offerer' s or bidder' s attention is called to the "Equal Opportu- nity Clause" and the "Standard Federal Equal' Employment Opportunity Con- struction Contract Specifications" set forth herein. The goals and timetables for minority and female participation, ex- pressed in percentage terms for the contractor' s aggregate work force in each trade on all construction work in the covered area, are as follows: 1.' The goals for minority participation are 21.8% for each trade. 9 Tha rrnal c fnr famal a Hart t ni r+a+,f ---- a — - B I I FOR CYNTHIA BATS (Home Owner) (Contractor or Bidder) 94 LEWIS STREET (Address ) (Address ) (Phone) Material Specifications Material Labor 1. ROOF: Tearoff and replace all IJ s deteriorated wood and metal components 1 ' Install 30# felt paper and 20 yr shingles on sloped portions and a torch down roof on rear porch. 2. SIDING: Remove and replace all deteriorated siding and trim with consistent material. 3. EXTERIOR PAINT: Prep and paint 7c the exterior completely with two coats of low-luster finish. 4. WINDOWS: Replace roll-out windows (2) with single-hung aluminum units. U Repair broken panes, replace damaged and missing screens, and caulk all seams on remaining windows. 5. EXTERIOR DOORS: Install deadbolts repair strikeplates, and weather V S strip front and rear doors. 6. ELECTRICAL: Troubleshoot and �- repair wiring and fixtures, install receptacle in bathroom. fs 7. KITCHEN: Replace sink, fixtures and drain plumbing. Repair lower cabinets. Subtotals : $27145- $ Z7Y s-- Totals : Ys-- Totals : $ (nate) (Cont ractororE .dderSignature) SID FORM CYNTHIA BATS (Home Owner) (Contractor or Bidder) PAGE 2 (Address ) (Address) (Phone) Material Specifications Material Labor 8. BATHROOM: Replace sink and vanit �S ? including plumbing. Caulk tub to be watertight. 9. LIVING ROOM: Repair water damage _ sheetrock and match texture. 10. REAR PORCH: Re-screen completel including trim. 11. ELECTRICAL SERVICE: Replace mastL weatherhead, and lines. - � C_z Subtotals : 1 �'� $ S J � Totals : $ yo (Date) (ContractcrorBidder Signature) BID ADJUSTMENT 94 Lewis Street The following adjustment to the Bid is acimowleged: 1)Add Central Heat Pump/AC unit: Comm Dev'elop`mentecDir for D e Contractor Date ome Owner. —LDfite FOR OFFICE USE ONLY Date-----4- _.2�...........19 o Permit ----Fee t ....... 10 CITY OF ATLANTIC BEACH0 Valuation $..X,.......................................... FLORIDA House #------%_�:.........4ew-1-.5.......57" ------------------------------............................................ 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 Atlantic 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........._-•-••---------------------- 19/ Owner---------- Of ---- --------------------------------- 4----- ------ ----------Address------------------------------------------------------------Telephone No. --_-_---------__ Architect-------....... ----------------------......................... Address---------------------------------------------------------..Telephone No. ------------- Contractor Builder........ ed 0M!f5..*69fsh------f/42 ......lAkelephone No- ------ - ----------------------------------------------------------- -2 �> M. Lot No.............1_7-----------------------------Block No.--•---e2-------------------Sub Division-------- -----------------R/1,­-------._..._Zone--.--6---kx--- ------kArw-IS----------_-------Street----------- -----Side Between...... Y---. _A/----------ag;e!7-9_ ?__C-------..........................Sts. YO of Valuation ......For what purpose will building be used-....._5�-------- ---------Type of construction. Dimensions of Building_��._' ��Z----------------Dimensions of Lot._//7 .........-------Size of Footings___9_'x zo- ---------------------------- Size of of b-__.--__-.Greatest Sill Span in _____________Type Roof.X&4.................;' How will Building be Heated?_--- -----_-_-------Will Building be on Solid or Filled Ground?_._. ........------- Size of Ceiling Joists_-_ ----------- Distance on Centers.24p,# pGreatest Span_----//------- .......... -2 A"/_ Distance on Centers.... ------------------------------ Greatest Span--------- Size of Floor Joists----- -------------------------------------- ----------------- ii Size of Rafters-------------Z--- -- ------ ------------ Distance on Centers.....-2.. -------------I Greatest Span-------------------------------------------- This pan_--------------------_-___----------- This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing. 2. When steel is in place and ready to pour columns and/or lintel. Z Z � 3. When steel is in place and ready to pour beam. 4. When framing is completed. F, E- <C1 5. When rough plumbing is completed,-and ready to cover up. 2 2 6. When septic tank drain field or sewer is laid but before it is covered. Apy al;A 7. Electrical inspection by City of Jacksonville. 8. Final inspection. F1 Note: In case of any rejection,re-inspection MUST be called for after corrections are made. X D /I IN 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 plansInd eel J* atl� MISare a part hereof, and in accordance with the building regulations of the City of Atlantic Beach. Signatureof Builder....... ........... dress---------------------------------------- ----------------- ---------------------------- --- ..... ---- ----- Signature of Owner....... ;------= Address-----------------•--------•-------.--------•---•--------•------------------. ---------------- DEPARbALNv i OF BUILDING 5 71 CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date SEPTEMBER 8 19 82 Valuation$ 121 474+00 Fee$ 61.50 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 HOTTSINGER CONSTRUCTION COMPANY P. 0. Box 39, Neptune Beach, Florida 32233 has permission to build CDBG REHAB CASE NO. 81-09 Classification SINGLE FAMILY Zone RC-1 Owned by MATTIE BRANCH Lot 17 Block 3 S/D DO ' House No. 94 LEWIS 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 „ AFTER DATE OF ISSUE —♦ —� O Building material, rubbish ; briT -1 from this work must not�� I54 in public spate jind mp� e9 M tn u 9 -fay by eitl a eAt frac W, n1 A 9/08/8 000 ! • Building Official. FOR OFFICE PERMIT DATE "CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER ,111�Mz FOR OFFICE USE ONLY Date....................................19 ------ CITY OF ATLANTIC BEACH n Perit *........................Fee$........................ Valuation $............................----_--------------_-- FLORIDA House #......./ ...... ............... .................. APPLICATION FOR BUILDING PERMIT </J� ...................;:27_34t;..................................... ................................... 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 Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submit to this office so that licenses can be verified. Date...............Tr -------------------------------------------- Owner--- _-------__-----Address.. c-...................Telephone No............................. . ........................................----------..---_-_----.-......Address,,.,...... ...........................................Telephone No---------................... L`j Contractor ...Address...u:.- ....................T�ephone No..2-+.q_VQ3, -7 .....-5_--_-_---- --- Sub Di Lot No.........i ....... --------------_------_Block No.. visi .16!�...... --------__........Zone.................. ........1q ..--..Street.._--- ---------Side Between....... ----------- ............And.... ---------------------- -----...Sts. pur building be used... ................Type of construction_--...... Valuation 77..---...For what pose will ....... Dimensions of Building- 1_4.....Dimensions of Lot..... Size of Footings--- .............................. Size of Piers.'e.4.f. -- -----Size of is. Greatest Sill Span in ft__--.,,*------------...Type Roof.S'6_1.�..L_--—-------- - - How will Building beH,-,ated?G-4:S a..#..... --------_--Will Building be on Solid or Filled Ground?......`...........................- Size of Ceiling Joists- ------- Distance on Centers._.:._--- ------------............ Greatest Span...___........_..._..........._..........-_. Size of Floor Joists_...Z. ............. Distance on Centers.. .2- -----_----------------_--- Greatest Span._.._g................................... Size of Rafters....... _�, ------ - ------------- Distance on Centers ..... -------------I Greatest Span ............................... This rectangle is to represent the lot. Locate the building or buildings in the APPROVED right position. Give distance in feet from OITY OF Vfti.NTIC KAN all lot-lines and existing buildings. CUILDfiNG OFFiou REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing. ince 2. When steel in in place and ready to pour columns r in J. Z 3. When steel is in place and ready to pour beam. 4. When framing Is completed. 5. When rough plumbing is completed,and re 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. rn 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 Atl ntic e ........ ........... Signature of Builder.. .. ..... .....�.A...(---------------------- Address .......... ..... Signatureof Owner...................................................... ...................... Address 91. JJ-WJS S]KLET )'PEC WORK DESCRIPTION COST 7-B ROOF Check roof and repair for leaks, replace deteriorated rafters and fascias on back of house, see Plan #1 for locations 6-A 6-E PORCHES Replace deteriorated back porch, see Plan #1 for size and closets 15-A SEWER Install 4" PVC line from septic tank to city sewer 2-B TANIK Remove top of tank, put lids in tank & fill with dirt. (SEPTIC) I 8-B EXT. DOORS Replace front door with Scotty's ?jr'NN-EU-90 Jailhouse steel door. Back door to be ;',EE-EU-44 Crossbuck steel door, Furnisl & install Alum. Screen doors with closers front and back door. n_G PAINTING Clean, sand and caulk all exterior wook, apply two coats layte exterior house paint. Color to be selected by owner. 15--B 'IERMITE Treet permises for termite (Subterranean) . Provide renewable certification or bond. 2 CLEAN-UP Upon completion of all work, the contractor is to clean up and haul off all materials, trash and etc. 15-A SEWER Contractor is not to include cost of Sewer tap fee in his bid. 9-B DRYWALL All drywall on partitions and sidewalls is to be removed. Ceilings are to be checked, filled, and sanded to receive a finish stipple coat. Sidewalls & partition will be replaced with 2" regular drywall except over tub in bath, where green board will be used. All drywall will be taped, sanded and finished for painting. S-A FRAMING Frame in heat room as shown on Plan #1. 2'4" x 3'4" inside dem. for 2'0" door. Return air grill in door and back wall. 8-A HALL Lower hall ceiling to 7'0" to accomodate beat ducts to be CEILING installed to each room, see plan for location of registers. 8-A DUCTS Cut holes through drywall from hall to each room for ducts. 15-B HEAT UNIT Furnish and install 37,000 B.T.U, Gas fired furnace complete with ducts as shown on plan with controls. Vent furnace out through roof. 9-C CERAMIC TILE Furnish and install new 44 x 44 -thin -set ceramiC:tile -over tub only. Install four bath fixtures. 8-C FRAMING- Check bath room and kitchen floor joist for deteriorating, FLOOR replace joist and sub flooring. Use 5/8 underlayment in bath and kitchen to receive vinyl tile. 8'_-09 94 LEitiIS STKEET ADDr:LSS ?EC AREA WORK DESCRIPTION COST 9-C VINYL TILE Install vinyl tile in bath and kitchen. Be sure 5/8 underlay- ment has been installed. Not to exceed $9.00 per sq. yard. 7 INSULATION Before drywall is hung insulate all exterior walls with 32" bats. Ceiling to have 6" bats or blown-in. 8 DOORS All interior doors are to be replaced with pre-hung units except for closet doors which are to be bi-folds. Install new base to match trim on doors. Install shelving as shown on Plans. New finish hardware to be used on all doors. 8-B CABINETS Reuse kitchen cabinets, repair as needed. Furnish new formica top. 15-A PLUIMBING Furnish and install gas water 30 gal. as shown on plan. Reconnect kitchen sink and run hot & cold water to water heater. Vent water heater thru rough. 9-G PAINTING All interior walls to have two (2) coats vinyl laytex paint. Wood work to have two (2) coats stain. Windows to be caulked outside and inside. 16 ELECTRICAL Furnish new light fixture over sink and center of kitchen, porch light on back porch and 1 hall fixture. Profit & overhead. J A J, rT S 94 LEWIS STREET, ATLANTIC BEACH, FLORIDA r MATTIE BRANCH re 246-3390 81-09 Y OF V. -'K: Exterior work includes repairing of roof caulking, windows, new front and back porch� k po h with steps. Extend sewer line from septic tank to city sewer. Paint exterior of house two coats exterior laytex. Interior work includes rework all ceilings sand & stipple. Rcmove all drywall from partitions and side walls. Install 32" bats in all outside walls. Hang & finish, all new dr-,,wall to receive two coats laytex. Woodwork will be painted two coats stain same as doors. Install oil fired furnace with ducts to each room. Lower ceiling in hall to seven feet, install ducts over drywall ceiling. Build new heat room as shown on floor -7-.Fn. Replace all interior doors with pre-hung door units. Put all new base in to match door tri- . Drywall in bath is to be green board, over tub only. Install creamic tile over tub, furnish E install 4 bathroom fixtures, furnish & install vinyl tile over underlavment in 'kitchen & hath. PeDlace all floor joist that are deteriorated and replace in kitchen & bath over underla-,---ent and 1-2" sub-floor. Rework kitchen cabinets & install new formica top. Re—paint all drywall two coats vinvl Paint. All interior wood work to be stained at completion of work. The contractor will clean up outside of house and haul off. Treat premises for termite (subterranean) . Provic renewable certification or bond. 1A T-I i f 4:00 PM AUGUST 31, 1982 CITY HALL CITY OF ATLANTIC BEACH, FLORIDA 1, -1 e d: Work completed must adher'e to applicable General Specifications, unless otherwise noted in the work description (includes materials & workmanship) . All material quantities are approximate and each bidder must visit job site and estimate quantities for his bid. The terms approximate and approximately, for the purpose of this job, shall be + - 10% of the amounts and quantities listed for each item in the work description. Scope of work includes labor, materials, equipment, drawings (if necessary) and services for the pre Per completion of the rehabilitation of the above identified property. CITY OF ATLANTIC BEACH, FLORIDA ay APPLICATION FOR ILKTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE:2-- 1x-_._5._ C7 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORD IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF,AND IN'ACCORDANCE WITH THE ELECTRICAL REGULATIONS, COMES AND CITY OF ATLANTIC BEACH ORDINANCES. Com. . IL ECTRICAt FIRM: R EL NAMEnT _ DORESS;T f+..zJ f 4) FD-BOX- BLDG. D BOXBLDG.SIZE " 42, 6:: BETWEEN: RES.0/Vl APT.( 1 COMM.I l PUBLIC( I INDUS.( I NEW( I OLD( 1 REW.1 I ADDITION( ) TRAILER I 1 TEMP.( I SIGNS ( ► SO.FT. SERVICE: NEW( 1 INCREASE ( 1 REPAIR ( I FEE- oR 81ZE AMPS COPPER I ALUM. MftTCH OR BR KER PH W VOLT RACEWAY Y EXIST.SERV.SIZE AMPS PH W VOLT ACEWAY FEEDERS NO. SIZE NO.. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL . RECEPTACLES CONCEALED OPEN TOTAL 0.30 AMPS, 31.100'AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS: I OVER APPLIANCES BELL TRANSF. AIR H.P.RATING ".P. RATING . CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. I N•P• VOLTAGE PHS MISCELLANEOUS TRANSFORMERS: UNDER SIX)V. OVER 600 V. �yoy� CITY OF ATLANTIC BEACH NOTICE TO OWNER AND ALL PERSONS INTERESTED IN THE ATTACHED PROPERTY This property, to wit: Make: Model: Color: Tag#: State: VIN#: Located at: is improperly stored in violation of Chapter 21 - 24 - (a) and must be removed within ten (10) days or, if the property is a boat, thirty (30) days of this notice; otherwise it shall be presumed to be abandoned property and will be removed and destroyed by order of the City of Atlantic Beach. If the property is a motor vehicle or boat, the owner will be liable for the costs of removal and destruction. Dated: Time: Signed: Title(Include Badge/ID#) Any inquiries may be directed to the department indicated: CODE ENFORCEMENT OFFICE CITY OF ATLANTIC BEACH 800 Seminole Road Atlantic Beach, FL 32233 (904) 247- 5855 <76ke't ` CITY OF (�/ -� v,. ��5-ssSo Office of Building Official �r l% REQUEST FOR INSPECTION Date �` I Permit No. Time A.M. Received y Job Address J Loc 'ty Owner's / Name — Contractor BUILDING CONCRETE �-�RLCAL , PLUMBING MECHANICAL Framing - Footing Rough Wiring C Rough D Air Cond. & Re Roofing E Slab Temp Pole Top Out ❑ Heating Insulation _ Linte! Final D Sewer ❑ Fire Place Ei Pre Fab READY FOR INSPECTION A.M. Mon. Tues. a Wed. Thur. Friday P.M. �,,.__ ��S.r•-- A.M. -s;.ectio Made1-1p _ 7 �_�. a!Inspection D acro_ _ / 1 jCertificate of Occupancy D ✓ �t Date _ BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT --- Applicant to complete all items in sections I, II, 111, and IV. LOCATION Sheat Address: OF Intersecting Streets: Between /1 /*A And WILDING Sub-division II. IDENTIFICATION -- To be completed by all applicants, 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 ettachpd plans and specifications which are a pert hereof and in accordance with the City of Jacksonville ordinances and standards of good practice listed there;n. Name of Mechanical Contractors Caoo1►actor )hint) 5' fr Master !l Hansa of Mperty Owner Sfgeature of Owner Signature of or Authorised Agent Architect or Engineer 111. GWRAL IN A' Typ of MaBng fu•1: B. IS OTHER CONSTRUCTION BEING GONE N ,;> c c THIS BUILOING OR SITE1 Q 6u—❑ LF O Natural O Contral Utility IF YES, GIVE NUMBER OF CONSTRUCTION Q Oil PERMIT Q Other — Specify IV. hIRCMANICAL EQPUIFMMR TO RE INSTALLED NAT F WORK (►,evil•complete 60 of compon•mts on beck of thin form! Residentlal or ❑ Commercial Neat (3Spec• ❑ Recessed WT mftvl D Hoer ❑ New Building cr'�;►Conditioning: O Room ja"'&trel Er--Existing Building Q Duct System: Material Thick 0— Replacement of existing System Metiinuni capacity elm. ❑ New installation(No system previously Installed) Q Extension or add-on to existing system Q R•frigerefion ❑ Other-- Specify Q Cooling tower: Capacity Q Firs sprinklers: Number of heap Q Elevator O Mamlift O EwlatoTHIS VACS POR OFFICE USE ONLY Q 64dine puma• (rwmb•r) (Itse Ir•i) Q T•ekt (number) Remarks Q LPG c msiwL (mumb•r) Q Unfired preuuro wase Q 1111 ni Fermi► /Approved by Iota Q Other — Specify ►emit e.. LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT Number Vnits Dwcslpttat Yodel Number manulaatnnr, (T111411111111- t f CITY OF YOffice of Building Official REQUEST FOR INSPECTION Date �— ` , Permit No. Time Q A.M. Received P.M. -7 Job Address / Locality Owner's� ►► ww Name _ Contractor —_.. BUILDING CONCRETE SAA PLUM NG MECHANICAL` Footing Roing Ci Rough ❑ Air Con`T & t �Roofin Slab _ Temp Pole ❑ Top Out ❑ Heating C Lintel _ Final ❑ Sewer CI Fire Place ❑ Pre Fab READY FOR INSPECTION Mon. Tues, Wed. Thurs. Friday P.M. A.M. Inspection Made _ ' ��� P.M. Inspector__ �, _ Final Inspection Certificate of Occupancy ❑ Date DATE: PRE-SERVICE DIVISION JACKSONVILLE ELECTRIC AUTHORITY 233 WEST DUVAL STREET JACKSONVILLE, FLORIDA 32202 THE FOLLOWING FINAL INSPECTIONS) HAVE BEEN MADE AND ARE SATISFACTORY: -------------------- ------------------------------------------------I 1 --- --------------------------------------------- ------------------------------------------------ ------------------------------------------------ Enclosed are the blue copies of the permits. SINCERELY, j - 'LL '7 BUILDING INSPECTION DIVISION cc : FILE 1 i 10411 i ts E DEPART MENT OF BUILDING CITY OF ATLANTIC BEACH PARK I ON 10-4 I NFORMT I ON Address. 94' LI�WI�S �'TRB�'!; - t it f K 8V LL 13 ` r "� .fr » N L► ATLANTIC TLAT I C.7JS C�t �a0 >rkR ODEL " OLICq7 E.Ir L+.nA..w.-..3.. 2..3...1..3 :' Lot: oc Se t 10 cSed" FI L ,r. e I a F . I Tb�€n s hi p� LiNC a b Slmated, V ?t �f �$ Isx rov. Cott. $0.,00( Total ` a `t BB.00 Am r 00 D, . r D ��, tAi I �T IOB .. . A$1.`L ItAT IOC 010 Ad FBRMI " $0. . " "IL'T 1RATER IMPACT LB t3. PLORID 2 S B 4{3 p IlLFAL" E $0.00 �r _ � a .�«. 'T F IAT N - RA N �7 name�i "'` RADON CAB 84.{ t IAI,F ,$MC M �� ► I'I'AI» IAIII?lS �IL. $t? .4t? A44 I�ity6;` .SIOy)�' vwk'aSXraffi" �'ki3X =5 {j ;P�.'a'�m�v9wk'wk+'�Daus'.Mc:.^"t#�Avassva.:w;y#':ve..aa<:,aexrdMF.�ma ,.. is i CIBC iplC.} A7at w��jT ^/j x rCROSS �O I OTION Btu.4t1 ._ TypeI SRC` "IA:CT I�1 Bt? r t?Q CONST#$VRC A t 00 F. S �C ATS.' $Q ,+ 1T' " n as 4r , . � NOTES; NOTICE--ALL.CQN BfiE FORMS AND FOOTINGS MUST BE INSPECTED 13L�-"�?6�Iw A!OURtNG PERM IT VOID SIX MONTHS AFTER DATE OF ISSUE OLE MATERIAL,RUBBISH AND DEBRIS FROM THIS'W©RK MUST NOT BE PLACED IN PUE3LtC SF'AGI AND CLI~ARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER MUST BE RE; TQ COMPLY 'WITH THE I�ECHJ�IVI�'S LIEN LAIN C IU ( . :; �QPEI 'Y �' `hIE hAINa TWICEC�R THE BUIL,®III IIVI " yEl "" � ISSUED ACCORDENG TO APPROVED,PLANS WHICH ARE PART OF THIS PERMIT ANCS: CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS Owners) G V A -4 - / I Address :— t4 L P c-t) f=S 2 ZPhone Lot Block or Unit # Subdivision: Contractor 4 L i7-�X Grp - �a-C G �`Y► rw State License # Address : C A-�4t-/l Phone No: Describe work to be done: /YiL�.t Present use of building: Tr �s Valuation of Proposed Construction: Proposed use: - Is this an addition? If yes , what are the dimensions of the added space: ft . X ft . Will the added area be heated and cooled?� New electrical (or increase)? New plumbing fixtures? New fireplace? New Heat/AC? SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY , ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER. ct Date: v - Signature CONTRACTOR: �� Date: 2— License —License Supplied: Liability Insurance: Worker's Compensation Insurance: lotice of �o�i►�i►eiteera�eiit To whom it ane♦ essHrtwr The undecalsned l.ereby lalotwts you that Impreva»ents will be anode to eectala real properly, and In accordsnes with secilon 113.13 of the Fkwida Statutes, taw tollewind IsUotsnatton Is staled to this 140riC t or C O"t f c""T. SIGLE STORY WOOD FRAME DWELLING LOCATED AT _»»q�..,.LFak�L�.►�r_,��.SF+F�L�.-AT.L+��.�iF+BAH,t.,..k'LA..�......_.._--_--___.� aemral desulptloa of lmptoYenneats ..-ROOF *�,EXTS--PAINT. ELECTRICAL --« «-w- owrw ...... .U1HTwA+BAT.S __.._...._.....__------•-- -•- A449e1e w� 94 LEWIS STREETATLANTICBEACHIFLA.M_ owrAes tnlort»t in sits of the knproverusnt ......---..-------------..-..-------—----«____-___.�.,�_.___. Too Simple T1Ue holder (U oibw thou Owner) Name «._--__»r. ___-__ ....._-----......._-_---__..--•---.. ...-.-..«_..._... ».._---------------------- -� Address _.« _ «-------«._. --_-__-_.«.....�_..«..«..--- «_.......�.�._._._ coatraotorNc.........................._.....,_.AddrOss .._10 1 kjT_URY 21DR VE 211 JAX.-„ FLAB- 32216 !Surety (U uq) ---------------_•_ ..............__._......a.».-... «._»_...._.« »-... Addressof bond ;_._..-_.......»__ Nuns bad add:sN of any Palo* making a lova for the comtrixt”of the tmptovattuntt. Naute -...._---------------------------------------r•.------......---------------------_«..___..._ Addnu -----------------------------------.................. .._...�...____�__.. Ns"" of pctboa wkhta the &M of MOMS, otbet thea MUMK, du4aaud 17 owner upon whoa rwtloa of other dowmenu XVI be tarred: Name Addrsa ___.�.....__. ....«.. In sddltloa to himself, owner dosl3nat" the followtaff pe "A to recetre s Copt Of the I.lsaoe a Notks ss provided In Bectlon 113.04 (31 (bj, rlorlds Btatutse. (rw la 3t owner,& optloa). t- THIS SFAGS r"ANC-900".8 Ys"attlll n