Permit Addition/remodel 405 Garden Ln 2011 S yLy�.
r l
'�. CITY OF ATLANTIC BEACH
`,. 800 SEMINOLE ROAD
J-2, =-• Z„ ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
JI319
Application Number 11- 00001747 Date 3/01/12
Property Address 405 GARDEN LN
Application type description RESIDENTIAL ADDITION
Property Zoning TO BE UPDATED
Application valuation . . . 35000
Application desc
ADD 644 SF,ALTERATION, REMODEL,PAVER DRIVE & WALKS
Owner Contractor
HAMMONS OWNER
405 GARDEN LANE
ATLANTIC BEACH FL 32233
Structure Information 000 000
Construction Type TYPE 5 -A
Occupancy Type RESIDENTIAL
Flood Zone ZONE X
Permit RESIDENTIAL ADDITION
Additional desc .
Permit Fee . . . 225.00 Plan Check Fee . . 112.50
Issue Date . . . 4/27/11 Valuation . . . . 35000
Expiration Date . 8/26/12
Special Notes and Comments
TO INCLUDE PAVER DRIVEWAY AND WALKWAYS
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Other Fees STATE DCA SURCHARGE 6.75
ENG REV PRE APP > 3 HRS 25.00
STATE DBPR SURCHARGE 3.38
UTIL REV PRE APP >3 HRS 25.00
Fee summary Charged Paid nn Credited Due
PERMIT IS i ' D eY I W 1 FITY OF ATI §TIA 'BEACH ORDINANCE'S ° AND THE FLORID1C nn
O
BUILDING CODES.
` k sA CITY OF ATLANTIC BEACH
Zs 800 SEMINOLE ROAD
0 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Page 2
Application Number 11- 00001747 Date 3/01/12
Plan Check Total 112.50 112.50 .00 .00
Other Fee Total 60.13 60.13 .00 .00
Grand Total 397.63 397.63 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
of Atlantic Beach APPLICATION NUMBER
gilding Department (To be ass by th Buildi g epartment.)
)00 Seminole Road �-
Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 • Fax (904) 247 -5845 Date routed: 3- 3-it
E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 Ale", /-1-1-,-/ Department review required Yes No
Building '�
✓
l )7/°k ' i l Planning &Zoning Applicant:
Project: Tree Administrator ✓
Public Works
Public Utilities ✓
Public Safety /
Fire Services ✓
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation Er (,, r ''
St. Johns River Water Management District Ig L r - s f/
Army Corps of Engineers MAR 0 3 ,),-, I/
Division of Hotels and Restaurants " 1
Division of Alcoholic Beverages and Tobacco ey ._�_
Other:
APPLICATION STATUS
Reviewing Department First Review: IEPDproved. DDenied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by: Date: Y — /S l/
TREE ADMIN. Second Review: Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05114/09
R.E ED
s � City of Atlantic Beach MAR 0 4 2011 APPLICATION NUMBER
, S r x •� Building Department (To be assigned by the Building Department.)
r a C S� 800 Seminole Road 1y: / � " 71
r Atlantic Beach, Florida 32233 -5445 ---
Phone (904) 247 -5826 • Fax (904) 247 -5845
f E -mail: building- dept @coab.us Date routed: •9 f/
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
D review required Yes No
Property Address: ie V
B " ✓
Applicant: ( Planning & Zonin
1 ree • • mirns rator ✓
Project: � Public Works
Public Utilities
Public Safety
Fire Services
w f ee $ �� - . " . . '. if t ep S gna ur �
Revie , , a
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: pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by: � '�z� — Date: 3- y
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
p > / - _ omments:
LICUTLI S
3- � - i
PUBLTU SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
ye l City of Atlantic Beach APPLICATION NUMBER
(r:(1.d411‘
, Building Department (To be assigned by the Building Department.)
_ 800 Seminole Road f /
,j Atlantic Beach, Florida 32233 -5445 l !
Phone (904) 247 -5826 Fax (904) 247 -5845
ost �r E -mail: building- dept @coab.us Date routed: �� /
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property
Address: Id s 6 � Department review required Yes No
Building tr
Applicant' Planning & Zoning I/ Tree Administrator V
Project: � -/ 2 -.(- � _ �� - 4-4 Public Works ✓/
Public Utilities ✓
Public Safety
Fire Services
WeVr4416felfg 774717, � De t� f dire ;k4 , , ,, ,
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:
APPLI ►ATION STATUS
Reviewing Department First Review: 11 A pproved. ❑Denied.
(Circle one.) Comments: r
BUILDING (1./1 314/1
PLANNING & ZONING Reviewed by: Date:
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 05/14/09
-tLAPI- City of Atlantic Beach E`�F+`VED APPLICATION NUMBER
s � : ,' R
<� Building Department (To be assigned by the Building Department.)
" t 800 Seminole Road MAR 0 41011 / 2 2
Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 Fax (904) 243-Y$45
"��'t3 >� E -mail: building- dept @coab.us Date routed:
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 4 J Department review required Yes No
Building
Applicant:
Planning & Zoning
� Tree Administratr ✓"
Project: //4 �`� " Public Work;
ublic Utilities ✓
Public Safety
Fire Services ✓
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: _ 4pproved. Denied.
(Circle one.) Comments:
•
BUILDING �
PLANNING & ZONING Reviewed by: Date: ?/ 'i
/ //
TREE ADMIN. Second Review: Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: / Date: Oki/
FIRE SERVICES Third Review: Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: `fit `J - C \CrN Lns Permit Number: // — / 7 9 7
Legal Description L * � --S" &t R ` � �., VA rn(2 'v A Parcel #
loor Area o Sq.�t. Sq.la't
Valuation of Work $ OOO Proposed Work heated /cooled ((to non heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
Use of existing /proposed structures) (circle one): Commercial Residential
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use product approval od rm
Describe in detail the type of work to be performed: — X,1T1 0 / l'•}'/.i� S ?E7Z. ,Pf—do i
( / `i
Property Owner Information:
[Name: Z,1 ,,. -.w Address: & 7�, & ARAer\ (--A)
.Pr' \'. �e� r State: k Zip Phone (204, 4-! a - L- U.
E - Mail or Fax # (Optional)
Contractor Information:
72ompany Name: Qualifying Agent:
Address: City State Zip
)ffice Phone Job Site/ Contact Number Fax #
State Certification/Registration #
architect Name & Phone #
- 2ngineer's Name & Phone #
i ee Simple Title Holder Name and Address
3onding Company Name and Address
vlortgage Lender Name and Address
1pplication 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
ssuance 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
rnd 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
vork is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, S Wells, Pools, Furnaces, Boilers, Heaters,
ranks 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 YOhR NOTICE OF
COMMENCEMENT.
hereby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
vpe of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
,e. "'VAV "::. "0.Y <<'..Y .Y�Y4v:aw.crv¢•'!!11 REShc.dur
ignature of Ownei Signature of Contra or
* � FILE C 0Py
rent Name 4}a... - s. kNA Uy Print Name
',wo •.'
Oand subsci ib7) ore met' / :"r"",,,,,
iis Day of 20� et
''' . 'y .
CITY OF ATLANTIC BEACH
Tot Public = *; ; ; '. 1 ' •' MISSION # DD 634126
dry \Totaiy PubE PERMITS FOR ADDITIONAL
Rl . Bond EXPIRES: u U nn de r w mers NDI
REQUIREMENTS AND (� '���TS2.6.10
.rt. evise
REVIEWED BY:
7/c/1/41 / /- /C - r q-irin d77 S DATE: 3J/
j CITY OF ATLANTIC BEACH
____,)
t,� IP% WNER / BUILDER AFFIDAVIT
,., ;tl il! .
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING" REQUIRES OWNER / BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT
LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE — OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT
HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
11 INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND /OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455- 228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT (247 -5826) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER— BUILDER PERMIT.
t— V o� G l...+v ctikAN , ,e 3ei, Q t o a Lkaa- qua t
ADDRESS PHONE NUMBER
:, • M IN/V C" C 7
PRINT NAME
- ter.... 3/3
;1
SI '' TURE DATE
Before me this ' ✓ day of 2/1 in the county of
Duval, State of Florida, has personally appeared herin by himself / herself and affirms that
all statements and declarations are true nd accurate.
Notary Public at Large, State of , County of
[Q Personally Known liN � t)k5orAW A, WHITE 6 a ( , U Produced Identification - MY l,t')t § C7 34126
.� t k IF r � ?V? 2011
X14.4614___ A r' E A _ ■ � ulc Underwriters
Notary Signature:
F: BLDG / Owner - Builder Affadavit; REVISED: 4/16/2009
AO.
�. • • �� ++ ++ • -r i r
mum : L,Lt1KK ur c UURTS 904 270 1512 70:92475845 P:1
•
NOTICE OF COMMENCEMENT
Permit No. f/ /7 'Yl7
Tax Folio No.
State of Florida, County ofDuval
THE 1,JNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
I. Description of propert (legal description of properly and address if available):
c.. � • a' 1 Q 14
2. General Description of improvements: I G
3. Owner Information:
a) Name and Address: �� s , A q C .sR
b) Interest in property: e � 4 ^ L�l ': L1�
c) Name and address of ample titleholder (if other than owner):
4. Contractor information: ,
a) Name and Address: `& .4 .A. n �r� L aD' C r\kvr.
b) Phone Number:_ \ — y. „
5. Surety Information:
a) Name and Address: Ai (A
b) Phone Number:
c) Amount of Bond: $
6. Lender Information:
a) Name and Address: sc
b) Phonc Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a) Name and Address:
b) Phone Numbers of Designated Person:
8. In addition to himself/herself, Owner designates of to receive
a copy of the I,ienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
a) Name and Address:
b) Phone Number of person or entity designated by owner:
9 Expiration date of Notice of Commencement (The expiration date is one (1) year from the date of Recording unless a
different date is specified:
WARNING TO OWNER ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART •
1, SECTION 713.13, FLORIDA STATUTES, AND CAN 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 ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
ry re
The foregoing instrument was acknowledged before me this day of .,/'!An!h 204
j r
KAREN P DEVIiT
1 MY COMMISSION N EEOPIUNS N • TARP PUBLI ) ,STA — OF O ' ' 5
• EX AutiUM23.2014 Print Name:
(40?) .0,cs
..ersonally Known
n Identification/Type:
•
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that T have read the
foregoing and that the facts stated in it are true to the best of my knowledge and belief
000 g 1u 1104de59, vrt 8 K 1 57.,1 paga.,ay �J•�r%A ro 111 Ow. Owner {� .
Number Pages 1
Signature of Property Owner
Rpoorac5 o3K)3i2ot 1 at 10•55 AM.
FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RGGOR nINCi 510 00
Revised 10/1/2009
FORM 1100A -08
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
Florida Department of Community Affairs Residential Performance Method A
Project Name: Addition, 405 Garden Lane Builder Name:
Street: 405 Garden Lane Permit Office: Atlantic Beach
City, State, Zip: Atlantic Beach , FL , Permit Number:
Owner: Jurisdiction: 261100
Design Location: FL, Jacksonville
1. New construction or existing New (From Plans) 9. Wall Types (882.0 sqft.) Insulation Area
2. Single family or multiple family Single - family a. Frame - Wood, Exterior R =19.0 882.00 ft
b. N/A R= ft
3. Number of units, if multiple family 1 c. N/A R= ft
4. Number of Bedrooms 0 d. N/A R= ft
5. Is this a worst case? No 10. Ceiling Types (236.0 sqft.) Insulation Area
6. Conditioned floor area (ft 360 a. Under Attic (Vented) R =30.0 236.00 ft
b. N/A R= ft
7. Windows(147.5 sqft.) Description Area c. N/A R= ft
a. U- Factor: Dbl, U =0.40 *Adjusted 147.50 ft
SHGC: SHGC =0.40 11. Ducts
b. U- Factor: N/A ft2 a. Sup: Attic Ret: Attic AH: Attic Sup. R= 6, 72 ft
SHGC: 12. Cooling systems
c. U- Factor: N/A ft a. Central Unit Cap: 48.0 kBtu /hr
SHGC: SEER: 17.5
d. U- Factor: N/A ft2 13. Heating systems
SHGC: a. Electric Heat Pump Cap: 48.0 kBtu /hr
e. U- Factor: N/A ft
HSPF: 9
SHGC:
14. Hot water systems
8. Floor Types (236.0 sqft.) Insulation Area a. None
a. Slab -On -Grade Edge Insulation R =0.0 236.00 ft
b. N/A R= ft2 b. Conservation features
c. N/A R= ft2 None
15. Credits None
Glass /Floor Area: 0.410 Total As -Built Modified Loads: 10.12 PASS
Total Baseline Loads: 15.43
' S ' ,
I hereby certify that the plans and specifications covered by Review of the plans and . ,,, '''52.
YY\ \
this calculation are in compliance with the Florida Energy specifications covered by this � v f a
Code. `'p`(l,att� J calculation indicates compliance r,, y,
�'QQ with the Florida Energy Code. °
PREPARED BY �sve. ell 5 Before construction is completed I tow, ,. v
DATE: 4.11. it this building will be inspected for t 0 , ,0., J,b'
compliance with Section 553.908 .�
1 hereby certify that this building, as designed, is in compliance Florida Statutes. ' ? ' ,,;
with the Florida Energy Code. A AA , ' O w ' ,, -
OWNER /AGENT: BUILDING OFFIC L: , 'a'y
DATE: - DATE: et
w
1 FILE COP
A.
.
4/11/2011 1:53 PM EnergyGauge® USA - FlaRes2008 Page 1 of 5
PROJECT
Title: Addition, 405 Garden Lane Bedrooms: 0 Adress Type: Street Address
Building Type: FLAsBuilt Conditioned Area: 360 Lot #
Owner: Total Stories: 2 Block/SubDivision:
# of Units: 1 Worst Case: No PlatBook:
Builder Name: Rotate Angle: 0 Street: 405 Garden Lane
Permit Office: Atlantic Beach Cross Ventilation: County: Duval
Jurisdiction: 261100 Whole House Fan: City, State, Zip: Atlantic Beach ,
Family Type: Single - family FL ,
New /Existing: New (From Plans)
Comment:
CLIMATE
IECC Design Temp Int Design Temp Heating Design Daily Temp
Design Location TMY Site Zone 97.5 % 2.5 % Winter Summer Degree Days Moisture Range
FL, Jacksonville FL_JACKSONVILLE_INT 2 32 93 75 70 1281 49 Medium
FLOORS
V # Floor Type Perimeter R -Value Area Tile Wood Carpet
1 Slab -On -Grade Edge Insulation 31.9 ft 0 236 ft 0 0 1
ROOF
V Roof Gable Roof Solar Deck
# Type Materials Area Area Color Absor. Tested Insul. Pitch
1 Hip Composition shingles 256 ft 0 ft Medium 0.96 No 0 22.6 deg
ATTIC
V # Type Ventilation Vent Ratio (1 in) Area RBS IRCC
1 Full attic Vented 300 236 ft N N
CEILING
# Ceiling Type R -Value Area Framing Frac Truss Type
1 Under Attic (Vented) 30 236 ft 0.11 Wood
WALLS
# Ornt Adjacent To Wall Type Cavity Sheathing Framing Solar R -Value Area R -Value Fraction Absor.
1 N Exterior Frame - Wood 19 302.3999 0.23 0.75
2 W Exterior Frame - Wood 19 97.20000 0.23 0.75
3 E Exterior Frame - Wood 19 306.8999 0.23 0.75
4 S Exterior Frame - Wood 19 175.5 ft 0.23 0.75
4/11/2011 1:53 PM EnergyGauge® USA - FlaRes2008 Page 2 of 5
DOORS
# Ornt Door Type Storms U -Value Area
1 N Wood None 0.460000 10.5 ft
2 N Wood None 0.460000 10.5 ft
WINDOWS
Orientation shown is the entered, asBuilt orientation.
Overhang
V # Ornt Frame Panes NFRC U- Factor SHGC Storms Area Depth Separation Int Shade Screening
1 N Metal Low -E Double Yes 0.4 0.4 N 21 ft 14 ft 0 in 2 ft 0 in HERS 2006 None
2 W Metal Low -E Double Yes 0.4 0.4 N 12.5 ft 1.3 ft 0 in 10 ft 0 in HERS 2006 None
3 N Metal Low -E Double Yes 0.4 0.4 N 4 ft 1.3 ft 0 in 2 ft 0 in HERS 2006 None
4 W Metal Low -E Double Yes 0.4 0.4 N 12.5 ft 1.3 ft 0 in 2 ft 0 in HERS 2006 None
5 N Metal Low -E Double Yes 0.4 0.4 N 40 ft 1.3 ft 0 in 2 ft 0 in HERS 2006 None
6 N Metal Low -E Double Yes 0.4 0.4 N 20 ft 1.3 ft 0 in 2 ft 0 in HERS 2006 None
7 S Metal Low -E Double Yes 0.4 0.4 N 37.5 ft 1.3 ft 0 in 2 ft 0 in HERS 2006 None
INFILTRATION & VENTING
- - -- Forced Ventilation - - -- Run Time Fan
V Method SLA CFM 50 ACH 50 ELA EqLA Supply CFM Exhaust CFM Fraction Watts
Default 0.00036 340 6.30 18.7 35.1 0 cfm 0 cfm 0 0
COOLING SYSTEM
_ # System Type Subtype Efficiency Capacity Air Flow SHR Ducts
1 Central Unit None SEER: 17.5 48 kBtu /hr 1440 cfm 0.75 sys #0
HEATING SYSTEM
V # System Type Subtype Efficiency Capacity Ducts
1 Electric Heat Pump None HSPF: 9 48 kBtu /hr sys #0
HOT WATER SYSTEM
V # System Type EF Cap Use SetPnt Conservation
None None
SOLAR HOT WATER SYSTEM
FSEC Collector Storage
Cert # Company Name System Model # Collector Model # Area Volume FEF
None None ft2
4/11/2011 1:53 PM EnergyGauge® USA - FlaRes2008 Page 3 of 5
DUCTS
/ - - -- Supply - - -- Return - - -- Air Percent
V # Location R -Value Area Location Area Leakage Type Handler CFM 25 Leakage QN RLF
1 Attic 6 72 ft Attic 18 ft Default Leakage Attic (Default) c (Default) %
TEMPERATURES
Programable Thermostat: None Ceiling Fans:
Cooling Jul [[X an J [X]] Feb ((X] Mar [[X] Apr ((X] May ((X]] Jun [[X] Jul X] Aug [[X] Sep [ O [( Nov IX, Dec
Heating EX� Jan [X] e
Feb [X] Mar [X] A r A [X] May [XX] Jun Jun [X] Jul tXi Au X] A ug [ Se S ep lX] Oct Xct ] O c t [X] Nov X Dec
Venting X Jan [X Feb [[ Mar [[X] [[X] May [[]] [[X] [ [[X] [[X] Nov X' Dec
Thermostat Schedule: HERS 2006 Reference Hours
Schedule Type 1 2 3 4 5 6 7 8 9 10 11 12
Cooling (WD) AM 78 78 78 78 78 78 78 78 78 78 78 78
PM 78 78 78 78 78 78 78 78 78 78 78 78
Cooling (WEH) AM 78 78 78 78 78 78 78 78 78 78 78 78
PM 78 78 78 78 78 78 78 78 78 78 78 78
Heating (WD) AM 68 68 68 68 68 68 68 68 68 68 68 68
PM 68 68 68 68 68 68 68 68 68 68 68 68
Heating (WEH) AM 68 68 68 68 68 68 68 68 68 68 68 68
PM 68 68 68 68 68 68 68 68 68 68 68 68
4/11/2011 1:53 PM EnergyGaugee USA - FlaRes2008 Page 4 of 5
FORM 1100A -08
Code Compliance Checklist
Residential Whole Building Performance Method A - Details
ADDRESS: 405 Garden Lane PERMIT #:
Atlantic Beach, FL,
I NFILTRATION REDUCTION COMPLIANCE CHECKLIST
COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHECK
Exterior Windows & Doors N1106.AB.1.1 Maximum: .3 cfm /sq.ft. window area; .5 cfm /sq.ft. door area.
Exterior & Adjacent Walls N1106.AB.1.2 Caulk, gasket, weatherstrip or seal between: windows /doors &
frames, surrounding wall; foundation & wall sole or sill plate; joints
between exterior wall panels at corners; utility penetrations;
between wall panels & top /bottom plates; between walls and floor.
EXCEPTION: Frame walls where a continuous infiltration barrier is /
installed that extends from, and is sealed to, the foundation to the
top plate.
Floors N1106.AB.1.2 Penetrations /openings > 1/8" sealed unless backed by truss or
joint members. /
EXCEPTION: Frame floors where a continuous infiltration barrier V
_ is installed that is sealed to the perimeter, penetrations and seams. _
Ceilings N1106.AB.1.2 Between walls & ceilings; penetrations of ceiling plane to top floor;
around shafts, chases, soffits, chimneys, cabinets sealed to
continuous air barrier; gaps in gyp board & top plate; attic access. ✓
EXCEPTION: Frame ceilings where a continuous infiltration barrier
is installed that is sealed at the perimeter, at penetrations and
seams.
Recessed Lighting Fixtures N1106.AB.1.2 Type IC rated with no penetrations, sealed; or Type IC or non -IC
rated, installed inside a sealed box with 1/2" clearance & 3" from
insulation; or Type IC with < 2.0 cfm from conditioned space,
tested.
Multi -story Houses N1106.AB.1.2 Air barrier on perimeter of floor cavity between floors.
Additional Infiltration reqts N1106.AB.1.3 Exhaust fans vented to outdoors, dampers; combustion space
heaters comply with NFPA, have combustion air.
OTHER PRESCRIPTIVE MEASURES (must be met or exceeded by all residences.)
COMPONENTS SECTION REQUIREMENTS CHECK
Water Heaters N1112.AB.3 Comply with efficiency requirements in Table N1112.ABC.3
Switch or clearly marked circuit breaker (electric) or cutoff (gas)
must be provided. External or built -in heat trap required.
Swimming Pools & Spas N1112.AB.2.3 Spas & heated pools must have covers (except solar heated).
Non- commercial pools must have a pump timer. Gas spa & pool
heaters must have a minimum thermal efficiency of 78 %.
Heat pump pool heaters shall have a minimum COP of 4.0.
Shower heads N1112.AB.2.4 Water flow must be restricted to no more than 2.5 gallons per
minute at 80 PSIG.
Air Distribution Systems N1110.AB All ducts, fittings, mechanical equipment and plenum chambers
shall be mechanically attached, sealed, insulated and installed in
accordance with the criteria of Section N1110.AB.
Ducts in unconditioned attics: R -6 min. insulation.
HVAC Controls N1107.AB.2 Separate readily accessible manual or automatic thermostat for /
each system. ✓
Insulation N1104.AB.1 Ceilings -Min. R -19. Common walls -frame R -11 or CBS R -3 both
N1102.B.1.1 sides. Common ceiling & floors R -11.
4/11/2011 1:53 PM EnergyGauge® USA - FlaRes2008 Page 5 of 5
ENERGY PERFORMANCE LEVEL (EPL)
DISPLAY CARD
ESTIMATED ENERGY PERFORMANCE INDEX* = 66
The lower the EnergyPerformance Index, the more efficient the home.
405 Garden Lane, Atlantic Beach, FL,
1. New construction or existing New (From Plans) 9. Wall Types Insulation Area
2. Single family or multiple family Single- family a. Frame - Wood, Exterior R =19.0 882.00 ft
b. N/A R= ft
3. Number of units, if multiple family 1 c. N/A R= ft
4. Number of Bedrooms 0 d. N/A R= ft
5. Is this a worst case? No 10. Ceiling Types Insulation Area
6. Conditioned floor area (ft 360 a. Under Attic (Vented) R =30.0 236.00 ft
b. N/A R= ft
7. Windows *' Description Area c. N/A R= ft
a. U- Factor: Dbl, U =0.40 {Adjusted 147.50 ft
SHGC: SHGC =0.40 11. Ducts
b. U- Factor: N/A ft a. Sup: Attic Ret: Attic AH: Attic Sup. R= 6, 72 ft
SHGC: 12. Cooling systems
c. U- Factor: N/A ft a. Central Unit Cap: 48.0 kBtu /hr
SHGC: SEER: 17.5
d. U-Factor: N/A ft2 13. Heating systems
SHGC: a. Electric Heat Pump Cap: 48.0 kBtu /hr
e. U- Factor: N/A ft2
HSPF: 9
SHGC:
14. Hot water systems
8. Floor Types Insulation Area a. None
a. Slab -On -Grade Edge Insulation R =0.0 236.00 ft
b. N/A R= ft2 b. Conservation features
c. N/A R= ft2 None
15. Credits None
I certify that this home has complied with the Florida Energy Efficiency Code for Building EST ,
Construction through the above energy saving features which will be installed (or exceeded) �,�`' 0 �
in this home before final inspection. Otherwise, a new EPL Display Card will be completed k „ ` t 0 '”
based on installed Code compliant features. ' ; ; � a s
Builder Signature: Date: . c a u , , _e. ..
Address of New Home: City /FL Zip: s,..'11, �� �g
— D C . 1
*Note: The home's estimated Energy Performance Index is only available through the EnergyGauge USA -
FlaRes2008 computer program. This is not a Building Energy Rating. If your Index is below 100, your home
may qualify for incentives if you obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at
(321) 638 -1492 or see the Energy Gauge web site at energygauge.com for information and a list of certified
Raters. For information about Florida's Energy Efficiency Code for Building Construction, contact the
**Label required by Section 13- 104.4.5 of the Florida Building Code, Building, or Section B2.1.1 of Appendix G
of the Florida Building Code, Residential, if not DEFAULT.
EnergyGauge® USA - FlaRes2008
4 wrightsoft 9 Project Summary Job:
Date: 4/11/11
Entire House By: M. Ellis
Energy Design Systems, Inc.
Pro Information
For: Addition
405 Garden Lane, Atlantic Beach, FL
Notes: Front door faces North. Addition to be conditioned by a 4 -ton unit also conditioning the
existing residence.
Desi • n Information
Weather: Jacksonville, Intl AP, FL, US
Winter Design Conditions Summer Design Conditions
Outside db 32 °F Outside db 93 °F
Inside db 72 °F Inside db 72 °F
Design TD 40 °F Design TD 21 °F
Daily range M
Relative humidity 50 %
Moisture difference 58 gr /Ib
Heating Summary Sensible Cooling Equipment Load Sizing
Structure 11341 Btuh Structure 9239 Btuh
Ducts 917 Btuh Ducts 1267 Btuh
Central vent (33 cfm) 1438 Btuh Central vent (33 cfm) 741 Btuh
Humidification 0 Btuh Blower 0 Btuh
Piping 0 Btuh
Equipment load 13696 Btuh Use manufacturer's data n
Rate /swing multiplier 0.98
Infiltration Equipment sensible load 10977 Btuh
Method Simplified Latent Cooling Equipment Load Sizing
Construction quality Average
Fireplaces 0 Structure 678 Btuh
Ducts 304 Btuh
Heating Cooling Central vent (33 cfm) 1283 Btuh
Area (ft 360 360 Equipment latent load 2265 Btuh
Volume (ft 3240 3240
Air changes /hour 0.61 0.32 Equipment total load 13242 Btuh
Equiv. AVF (cfm) 33 17 Req. total capacity at 0.85 SHR 1.1 ton
Heating Equipment Summary Cooling Equipment Summary
Make Make
Trade Trade
Model Cond
Coil
Efficiency 0 HSPF Efficiency 0 EER
Heating Input Sensible cooling 0 Btuh
Heating output 0 Btuh @ 47 °F Latent cooling 0 Btuh
Temperature rise 0 °F Total cooling 0 Btuh
Actual air flow 529 cfm Actual air flow 529 cfm
Air flow factor 0.043 cfm /Btuh Air flow factor 0.050 cfm /Btuh
Static pressure 0.00 in H2O Static pressure 0.00 in H2O
Space thermostat Load sensible heat ratio 0.83
Printout certified by ACCA to meet all requirements of Manual J 8th Ed.
"— wrightsaft` Right -Suite Residential 6.0.119 RSR29784 2011 - Apr -11 13:53:52
ACCP. E: \EDS \Current \Residential Manual J\ Blue Stone Const, Addition, 405 Garden Lane, Atl Bch.rrp Calc Page 1
Equipment Summary Sheet
Job Name: Addition
Address: 405 Garden Lane, Atlantic Beach
Zone: Whole House (Existing & Addition)
Equipment Brand: Trane
Air Hander Model Number: 4TEE3C06
Condenser Model Number: 4TWZ0048
Total Cooling Capacity in BTUs: 44,500
Total Sensible Capacity in BTUs: 33,375
Total Heating Capacity in BTUs: 42,500
SEER: 17.5 HSPF: 9
\� CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
J - ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
0.319'
Application Number . . . . . 11- 00001747 Date 5/20/11
Property Address 405 GARDEN LN
Application type description RESIDENTIAL ADDITION
Property Zoning TO BE UPDATED
Application valuation . . . 35000
Application desc
ADDITION 644 SF ADDITION, ALTERATION, REMODEL
Owner Contractor
HAMMONS OWNER
405 GARDEN LANE
ATLANTIC BEACH FL 32233
Structure Information 000 000
Construction Type . . . TYPE 5 -A
Occupancy Type RESIDENTIAL
Flood Zone ZONE X
Permit PLUMBING PERMIT
Additional desc .
Sub Contractor . STEEG PLUMBING CO., INC.
Permit Fee . . . 69.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 11/16/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 69.00 69.00 .00 .00
Plan � Check T Total q . n 00 a . n 0 n 0 . 00 . 00
PERMIT IS 2141OVEDF& e Y "IR R &ORDANCE WITH LP �ITY OF ATLANTIC BEACH ORDINANCE 9ND THE FLORIDA
BUILDING CODES.
j ?,
?,;
. ,, CITY OF ATLANTIC BEACH
s 1. 800 SEMINOLE ROAD
t3 , --, ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
' 1 ' .4. J.131 9'
Page 2
Application Number 11- 00001747 Date 5/20/11
Grand Total 73.00 73.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
806 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247-5845
JOB ADDRESS: 05
IS � . j 4, , I►A. , PERMIT tr // r /7/
NEW OR REPLACEMENT INSTALLATION: Project Value
TYPE OF FIXTURE On TYPE OF FIXTURE OTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan 0
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Ur=:nal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs _ Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
•
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of pi:
❑ Lawn Sprinkler System - Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspectioi
❑ 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
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 speci
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 constructs
Property Owners Name /o , /4 Phone Number «i "0(. '
Plumbing Company 5l-°�- /2b Gr1' Office Phone . 42 Fax1 /t2
Co. Address: , . .0i).., f9 City ,Ai- ge State Zip
License Molder (Print): _ .6-V7,19/ 52 State Certification/Registration #t
Notarized S'ignat , ., �.. ,, --- - Ar„
s 1- • t° IMMIS P
* F,, ROIY�d ( i r ib edb d ay f -77)/7 4 v4 • Bonded 7hru Notary Public Undervaiters f ` \ r
-- :. _. - Notary Public 4 P AI
•
r V
°��� CITY OF ATLANTIC BEACH
.,.■ "I4 51 800 SEMINOLE ROAD
, ATLANTIC BEACH, FL 32233
M INSPECTION PHONE LINE 247 -5814
Jn %)'�
Application Number 11- 00001747
Date 9/12/11
Property Address
405 GARDEN LN
Application type description RESIDENTIAL ADDITION
Property Zoning TO BE UPDATED
Application valuation . . . 35000
Application desc
ADDITION 644 SF ADDITION, ALTERATION, REMODEL
Owner Contractor
HAMMONS OWNER
405 GARDEN LANE
ATLANTIC BEACH FL 32233
Structure Information 000 000
Construction Type TYPE 5 -A
Occupancy Type RESIDENTIAL
Flood Zone ZONE X
Permit MECHANICAL HVAC PERMIT
Additional desc . NEW DUCT AND CHANGE OUT SYST
Permit Fee . . . 135.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date . . 3/10/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Other Fees STATE MECH DCA SURCHARGE 2.03
STATE MECH DBPR SURCHARGE 2.03
Fee summary Charged Paid Credited Due
Permit Fee Total 135.00 135.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.06 77 4. .00 .00
�4
PERMIT IS I dEDT I ]IN ACCORDANCE WPFA 9 ALP IITY OF A t 1C: EACH ORDINANCE n ( IND THE FLORIDA °
BUILDING CODES.
MECHANICAL, PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: (1 \ , l., N) ( , c -- A, PERMIT # C
PROJECT VALUE $ ' - cp
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Unit Quantity Conditioning: ARI #
g Q ty , Tons Per Unit n REQUIRED
Heat: Unit Quantity BTU's Per Unit Seer Rating t
Duct Systems: Total CFM REQUIRED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets
# Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
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 � S Phone Number qo%.` c-l'� "_L- LL dC (
Mechanical Company O L2,) v\ e t2 Office Phone Fax
Co. Address: City State Zip
License Holder (Print): State Certification/Registration #
Notarized Signature of Licence Ned , '5..
'inY DEBORAH AMANDA WHITE _ ��_
- '* MY COMMISSION # EE 057349 S orn and subscribed before , i s ,/ d, y of �� , 20�
,.� s EXPIRES: May 21, 2015 /
Pf ,'.' Bonded Thru Notary Public Undervirite - Ya afore of Notary Public / 1 I� 71/f/ f
CITY OF ATLANTIC BEACH
f ( OWNER / BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING" REQUIRES OWNER / BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT
LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY. TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE - OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING
MUST BE FOR YO TR 4R AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
All ER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT
HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
11. INJURY LWBIUTY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND /OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455- 228(1). AN `OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT (247 -5826) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER- BUILDER PERMIT.
ADDRESS
C o-k, C\ .0--......, ..--,01/4--) \C) 'L-- 2. -,
PHONE NUMBER
PRINT NAME
SIGNATURE
DAs -2�� \'-- \\
Before me this / I
y day of � 1
� 202in the county of
Duval, State of Florida, has personally =,:„17= = red herin by himself / herself and affirms that
all statements and declarations are .r : t • accurate.
Notary Public at Large, State of County of
6 .:V.& , . RC 4 naY ...t.s 4YrdM . q{
rsonany Krawn ; fit^"' e: E ,� rl l ;OA MAN AH A A W1-1111: Pa
Produced Identification Yr MY v '4 A ION D EE 057349 1
w I
/ o� LYF I, May t. - -1 c 15 1
'/ ` ` � B uusr,_ hru Notary Public tr x 1 !s Notary Signature:
I FBLDG /Owner - Builder Affadavu REVISED: 4/16/2009
l ', CITY OF ATLANTIC BEACH
r, ) 800 SEMINOLE ROAD
j 7 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
, :� t
Application Number 11- 00001747 Date 9/21/11
Property Address 405 GARDEN LN
Application type description RESIDENTIAL ADDITION
Property Zoning TO BE UPDATED
Application valuation . . . 35000
Application desc
ADDITION 644 SF ADDITION, ALTERATION, REMODEL
Owner Contractor
HAMMONS OWNER
405 GARDEN LANE
ATLANTIC BEACH FL 32233
Structure Information 000 000
Construction Type TYPE 5 -A
Occupancy Type RESIDENTIAL
Flood Zone ZONE X
Permit ELECTRICAL PERMIT
Additional desc . MISC WIRING
Sub Contractor . MCCLURE ELECTRICAL CONTRACTORS
Permit Fee . . . 79.60 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 3/19/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 79.60 79.60 .00 .00
Plan Check Total .00 .00 .00 .00
PERMIT IS CittHOYEWERELYTOVIII&ORDANCE WITH4ALO IITY OF ATLA4T1B UEACH ORDINANGF XND THE FLORIDAP 0
BUILDING CODES.
p,.f! ,\ \t
�S J
1� CITY OF ATLANTIC BEACH
77 A r) 800 SEMINOLE ROAD
j _ ;;" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
' ..s 013 3
Page 2
Application Number 11- 00001747 Date 9/21/11
Grand Total 83.60 83.60 .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) 247 -5826 Fax (904) 247 -5845 ,
JOB ADDRESS: (.� j ( e,c.` l d\ PERMIT # (('" f �"
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS O a ) VOLTS ( PHASE
VALUE OF WORK $ Os,
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑ Residential (Main) Service
❑ 0 - 100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
❑0 - 100 amps ❑ 101- 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
11
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.) i/ A 1 J))./
❑ 100 amps ❑ 150amps ❑200amps ❑ amps ❑ CT Service amps
(1-60‘ p7'
ADDITIONS, REMODEL, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC. (�
Outlets /Switches: ( -1 0- 30amps 31- 100amps 101- 200amps e/
Appliances: 0- 30amps 31- 100amps 101- 200amps �` �,
A/C Circuits: 3 0- 60amps 61- 100amps ``\T'�\
Heat Circuits: # circuits @ kw oP
Number of Lighting Outlets, Including Fixtures: (.
OTHER ELECTRICAL PROJECTS / \" ‘,,‘.14:-
❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑ Transformers 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 Names hone Number
6
Electrical Company Office Phone Fax
Co. Address: City State Zip
License Holder (Print): . '0'� c- w 4.. 2 7.,„)--12 1 , State C • icatio Registration # C Cxpc S i
Notarized , ty" _ _ _ - • • • - � �_ — = r
s r v0 and sub scribed before ►- `� day of 20 / l E XPIRES: May 21, 2015
i Tina Notary Public Unde =rs I r i 1 � /
F , ,....k. may.-. - !-• J Lure of Notary Public