Permit Spa 1490 Selva Marina 2011 /7.--- $
0 APPriet4,3 t ` \ CITY OF ATLANTIC BEACH
� ` j 800 SEMINOLE ROAD
J " ATLANTIC BEACH, FL 32233
_____ INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001878 Date 4/06/11
Property Address 1490 SELVA MARINA DR
Application type description SWIMMING POOL /SPA
Property Zoning TO BE UPDATED
Application valuation . . . 25725
Application desc
add spa to existing pool
Owner Contractor
DIAZ SURFSIDE POOLS
313 BEACH BLVD.
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 246 -2666
Permit SWIMMING POOL
Additional desc .
Permit Fee . . . 180.00 Plan Check Fee . . 90.00
Issue Date . . . Valuation . . . . 25725
Expiration Date . 10/03/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
REQUIRED INSPECTIONS:
*POOL STEEL
*ELECTRICAL GROUNDING AND BONDING
*FINAL (PUMPS MUST BE RUNNING FOR FINAL)
Other Fees STATE DCA SURCHARGE 2.70
STATE DBPR SURCHARGE 2.70
Fee summary Charged Paid Credited Due
Permit Fee Total 180.00 180.00 .00 .00
Plan Check Total 90.00 90.00 .00 .00
Other Fee Total 5.40 5.40 .00 .00
Grand Total 275.40 275.40 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
.C+-jv is a440-a..te y- (33 1/ - - _ _ _
, .
.., `L ' ! CITY OF ATLANTIC BEAC ,, ,z ,,, .: , . ) 7
�.•?:, ,,, 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 � ( I � �1J
P� ` 1 OFFICE: (904)247 -5826 • FAX NO.:(904)247 -5845
1 :; ha `'i + '" BUILDING- DEPT @COAB.US
-I 9 ' BUILDING PERMIT APPLICATION DUVAL COUNTY
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LOT K6 BLOCK _ SUB DIVISION ❑ ADDITION ❑ CONVERTING USE ❑ COMMERCIAL
, 7NDESCRiP..TION OF;1NbRIONIII hMO 'i@MISI l d) i 011h INNIII�'�i(d2'I f)IF�lii 1M'i�'�IiI� lili�lilNr' ❑ ALTERATION ❑ ACCESSORY BLDG. Bl FIRE,'SPRINKLEIgleall
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R teSSIIIliii ORROP I: 01/1110itlah hit• t I"wi91':(Ii iilt)) ttt ONIIRACTOR.? al !i ;''' MGM AK SAMAIllfa' ARC.HiTEMENGINEER;` ,N r,, ,,∎'
9. NAME: 15. COMPANY NAME: 23. COMPANY NAME:
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16. NAME: 24. LICENSEE NAME:
...Tel in A C. CC C 't f u.1-
10. ADDRESS: S ELY / /n7A Z,E 17. STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA LICENSE NO.:
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13 e> .eac I A f31��
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11. OFFICE PHONE: 12. FAX NO.: 19. OFFICE PHONE: 20. FAX NO.: 27. OFFICE PHONE: 28. FAX NO.:
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13. CELL PHONE: 21. CELL PHONE: 29. CELL PHONE:
14. EMAIL ADDRESS: 22. EMAIL ADDRESS: 30. EMAIL ADDRESS:
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31. NAME: 33. NAME: 35. NAME:
32. ADDRESS: 34. ADDRESS: 36. ADDRESS:
Application 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 and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc.
OWNER'S AFFIDAVIT - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN A TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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Signed: ■ I ' i+!Alfa ��� Date: ) (( Signed: - - /�/ �'1 Date: 31181 1 I
Before me i - /f '� day of rnsnitGi 2ef17 in the county of Before m= is 1 = • =y • "W ' A 1 , 5pcin the county of
Duval, State • Florida, has personally appeared Zo1 F Duv- , State of Florida, has personally appeared 2011
P 4 t►kwkins 0 t1-L 0_S0-xTT t I
herin by himself / herself and affirms that all statements and declarations are herin by himself / herself and affirms that all statements and declarations are
true and accurate. true and accurate.
Notary Public at Large, State of , County of bt..1 VA-t .. Not9ry Public at Large, State of , County of ✓111'R.r
IV Personally Known 1ff Personally Known
❑ Produced Identifi • ❑ Produced Identiflcatio ar
Notary Signature: LC 44-. _ Notary Signature: TIMM i. _ it
, � t SUSAN H. BUTLER p „
SUSAN H. BUTLER
COAB FORM B :' 61y public -State of Florida :��''� °
`�. Notary Public - State of Florida
• ,I •= My Comm. Expires Sep 3. 2014 r., • My Comm. Expires Sep 3, 2014
y ��� a :F Commission # EE 17886 1 sN. i, o`.'
Commission # EE 17886
'F °f,, , , , , , , , , , t , , , , ' Bonded Through National Notary Assn. ' " ;f e °,`„r:: Bonded Through National Notary Assn.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department)
-- 800 Seminole Road
1,54' V
Atlantic Beach, Florida 32233 -5445
r �s, Phone (904) 247 -5826 • Fax (904) 247 -5845
J�9r E - mail: building- dept @coab.us Date routed. , '
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
J
Property Address: / q9 6 ‘ 7274 i Department review required Ye r No
Buil ing f�
Applicant: !L $ i'4 � o LS Planning & Zoning
Tree Administrator
Project: kb Q 1 {D /� f ?'7 f Oo L Public Works
Public Utilities
Public Safety
Fire Services
, Dept�S�gnattare
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: [rAp ['Denied.
(Circle one.) Comments:
(ILDIN
PLANNING &ZONING Reviewed by: Date: e t - 5 //
TREE ADMIN.
Second Review: EApproved as revised. ❑De d.
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
•
NOTICE OF COM1NCEMENT ,
(PFtEPARE IN DUPLICATE)
Permit No. Tax Folio No,
State of (=c County of 0 ✓ — •
1'o 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 I this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 2.5 _ Z
k rn A >r. /,1,4 cJ N' / v 4
Address of property being improved: G S Et<v`A Iv1►q Q rN OJ
L f- 3 . z-z- 3 3 i i
General description of improvements: 4 > �� ^ _ �� s S `"t'^ �1 "", e L
Owner Di r \Z 1 INN Ic_-L. 4 k—c f'
Address 149 r A } 1 c, eek.C;[ ) t_ 3 Z z 33
Owner's interest In site of the Improvement
Fee Simple Titleholder (If other than owner) _
Name
Address .
)� , Contractor �i'.{d4s11� t" o .s )1� �Al) i f
/ ; Address -tom s [n • j v' 1 fk Snri,(A I ✓`. �Cl 1.._ :Z -�� c:/
i Phone No.C(�C) � • `f''�C Fax 6) ;• Fax No, q0 � , d l� Cj' - 0 r
-' Surety (if any)
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
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 (2) (b), Florida Statutes. (Fill in at Owner's option).
Name
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):
!..:i 7ffillP,‘1 9 ��� CITY OF ATLANTIC BEACH
t '' 800 SEMINOLE ROAD
J �' °r; ATLANTIC BEACH, FL 32233
` INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001878 Date 4/15/11
Property Address 1490 SELVA MARINA DR
Application type description SWIMMING POOL /SPA
Property Zoning TO BE UPDATED
Application valuation . . . 25725
Application desc
add spa to existing pool
Owner Contractor
DIAZ SURFSIDE POOLS
313 BEACH BLVD.
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 246 -2666
Permit ELECTRICAL PERMIT
Additional desc .
Sub Contractor . DAVID PRUETTES ELECTRICAL SVC.
Permit Fee . . . 95.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/12/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
REQUIRED INSPECTIONS:
*POOL STEEL
*ELECTRICAL GROUNDING AND BONDING
*FINAL (PUMPS MUST BE RUNNING FOR FINAL)
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 95.00 95.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 99.00 99.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) X 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: 11 / D V7, f V)/e RC PERMIT # 1 / l ng
NEW SERVICE ❑Overhead ❑ Underground ❑ Underground up Pole •
❑Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps 0101- 150amps 0151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi- Family (Main) Service
0 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.)
❑ 100 amps ❑ 150amps 0200amps ❑ amps OCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: i 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 j.kgCTRICAL PROJECTS
lUcavimming ❑ Sign ❑Smoke Detectors Qty ❑Transfonners KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts /amps VALUE OF WORK $
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑ Safety Inspection ❑Panel Change ❑ OH to UG
❑ Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name 1 GtZ-. M I &ate I Phone Number ,2'I 7 - C g'73
Electrical Company 1 ,U Id ! TL( . fief Gh,Q ` J'ti i OS Office Phone a Fax 3 2
Co. Address: pA t` h c� (C� P AS Stated Zip Ca
�3 �� 1�r1� GQP r� '� Ci � p 32
License Holder (Print): V/ 4, A . %d ':r►",.i / SS : ertification/Registration # 000 a a3
Notarized Signature of License Holder! '
;i t), KAREN EWiNG . Sworn'an. subscribed before me this day of ei. . . 20 i 1
Commissi N OD 790954 !!! ` My Commission Expiriss y j ( a.,(7 H�a N Signature of Notar Public
j g,.Ly
M 1
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001878 Date 4/15/11
Property Address 1490 SELVA MARINA DR
Application type description SWIMMING POOL /SPA
Property Zoning TO BE UPDATED
Application valuation . . . 25725
Application desc
add spa to existing pool
Owner Contractor
DIAZ SURFSIDE POOLS
313 BEACH BLVD.
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 246 -2666
Permit ELECTRICAL PERMIT
Additional desc .
Sub Contractor . DAVID PRUETTES ELECTRICAL SVC.
Permit Fee . . . 95.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/12/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE w/2009 REVISIONS
NATIONALELECTRIC CODE
REQUIRED INSPECTIONS:
*POOL STEEL
*ELECTRICAL GROUNDING AND BONDING
*FINAL (PUMPS MUST BE RUNNING FOR FINAL)
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 95.00 95.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 99.00 99.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 -
r � Ph (904) 247 -5826 Fax (904) 247-5845 -
JOB ADDRESS: 11 / D Se/0 r /e kr) PERMIT # • / 1 — 1 $7g
NEW SERVICE ❑Overhead ❑ Underground ❑ Underground up Pole
❑Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # ofMeters
❑ Commercial (Main) Service -
00 -100 amps 0101- 150amps ❑ 151- 200amps ❑ 'amps ❑CT 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.)
❑ 100 amps ❑ 150amps ❑200amps ❑ amps OCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 1 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 CTRICAL PROJECTS
PS Pool ❑ Sign ❑Smoke Detectors Qty ❑Transfonners KVA ['Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts /amps VALUE OF WORK $
REPAIRS/1VIISCELLANEOUS
❑Replace Buunt/Dainaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑ Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction. (� ,� -
Property Owners Name l) i G1Z.. ) M i �a e / Phone Number .2 1 r7
p i-
Electrical Company ,t) id 114 & €J e C_4 W i cos Office g- Phone Fax 5 25 -837/
Co. Address: 33) O p 0),r10h'd e ill-VV /! City Or-6m q. P '�
State Zip 32 �
License Holder (Print): I/ 1 / Il i ■ S _'I�i // ,ta , ertification/Registration # Ce-000.1 a..3
Notarized Signature of License Holder • -I Tday -
KAREN EW1NG Sworn'an• subscribed before me this of 20 I 1
Commission N DD 790954 My Commission Expirs Signature of Notary Public l ai -` May 21 , 2012 / // � �