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Permit Remodel Bath 352 5th st `�' CITY OF ATLANTIC BEACH -O p 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 � >r xtj3 4 0.111 f Application Number 11- 00002088 Date 5/16/11 Property Address 352 5TH ST Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7000 Application desc replace tile durarock Owner Contractor PARKER OWNER ATLANTIC BEACH FL 32233 (904) 463 -0252 Permit RESIDENTIAL ALT /OTHER Additional desc . Permit Fee . . . 55.00 Plan Check Fee . . 27.50 Issue Date . . . Valuation . . . . 0 Expiration Date . 11/12/11 Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 55.00 55.00 .00 .00 Plan Check Total 27.50 27.50 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 86.50 86.50 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERIV ET APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 : fob Address: ( P - Permit Number: Legal Description Parcel # Floor Area of Sq.ft. Sq.k t Taluation of Work $ 7 G/ Proposed Work heated /cooled non- heated/cooled rexne :lass of Work (circle one): New Addition Alteration Repair Mov- Demolition pool/spa window /door Tse of existing /proposed structure(s) (circle one): Commercial Residential f an existing structure, is a fire sprinkler system installed? (Circle one ' es No N /A 'lorida Product Approval # 'or multiple products use product approva or rf m )escribe in detail the t ype of work to be performed: C_ .hO. r IY ) ( i 1 (4 h i r 1nC J roperty Owner Information: -� u,1 P 1C_ky- fame: �V4 4 _9 - Par \LW 1�' Address: c ���, � ity 6■ /' .I i .�" - - � State f-= Zip j)-) j Phone - 7 I(/ - Mail or Fax # (Optional) ' ontractor Information: ompany Name: Qualifying Agent: ddress:. City State Zip ffice Phone Job Site/ Contact Number Fax # tate Certification/Registration # rchitect Name & Phone # agineer's Name & Phone # De Simple Title Holder Name and Address onding Company Name and Address [ortgage Lender Name and Address plication is hereby made to obtain a permit to do the work and installations as indicated. I certfy that no work or installation has commenced prior to the uance 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 'd void (work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a_period of six j6) months at any time after )rk is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Hea inks and Air Conditioners, etc WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO1VILVIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ere certify that I have read and examined this opplication and know the same to be true and correct. All provisions of laws and ordinances governing this )e of work will be complied with whether specijied herein or not. The granting of a permit does not presume to give authority to violate or cancel the )visions of any other federa , s . te, or local 10 regulating construction or the performance of construction. gnature of Owner ►�� 1 L . Signature of Contractor 1 � 1 int Name L. A C ' �,� Print Name vorn • and .s =• before me Sworn to and subscribed before me [s / I of , 20 this Day of , 20 i G 1117 Mary 'u. zc Notary Public lb . Revised 01.26.10 CITY OF ATLANTIC BEACH ®WNER / BUILDER AFFIDAVIT I. 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. II. 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. • (j, ADDRFS , PHONE NJMBER PRINT NA �fi1k [ 2- 00 SIGNATU-g I I DATE A ` Before me this Il day of V 20JJ in the county of Duval, State of Florida, has personally appear d herin by himself / herself and affirms that all statements and declarations are / tr ue and ccurate. / Notary P blic at Large, State of T L , County of V V P rsonally Known Produced Went .. ion - 1✓ �� Notary Si � L. rY g n- e: F:BLDG /Owner - Builder Affadavit; REVISED: 4/16/2009 AO MAY -16 -2811 15:12 FROM: TO:92475845 P:1'1 t NOTICE OF COMMENCEMENT Permit No. 1/ - L� e Tax Folio No. State of Florida. County of Duval THE UNDERSIGNED 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. 1. Description of property (legal description o r pe y and address if a 2. General Description of improvements: _ X f /7 /6 c . - ViS 3. Owner information: / a) Name and Address: . l b) interest in property: of. , . . ' c -- ‘1 4f1 . - A Llf c) Name and address of simple titleholder (if other than owner): k,,,, Contractor Information: a) Name and Address: 0 CA.- C b) Phone Number: - is 5. Surety .Information: a) Name and Address: • b) Phone Number: c) Amount of Bond: $ 6. Lender Information: a) Name and Address: b) Phone 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: $. In addition to himself /herself, Owner designates of to receive a copy of the Lienor'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 EXPIRA'I'ION OF T.EIE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, S1CTION 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. The foregoing instrument was acknowledged before me this J4' day of t gy L____ 20 /f ‘"" joiti (____ _ NOTARY PUBI IC, ST .. , OF FLORIDA - ?m ay' m L apn� Print Name: , £`.' 4. MY C0 1SSION * DD 9 } i -7 ' ao % TM i ii 14 4 0 Personally Known .Z 1 : - /____ . '___________ ., j, dentificatioit/Type: Vcri,bcation pursuant to Section 92.525, Florida Statutes. Under penalti - .: 'perjury, declare that I have read the foregoing and that the facts stated in it are true to the best of my knowlidge and beli f. • --t-- 111(1 alli 000. R .0 i o 1(1841d(), OR a r% r 5x302 Page t363, Sin tore of .."'"O .. , • ner `"--------" Number Pages: 1 I \ Rsx , (I L 05/16/2011 at 03.14 PM, JIM FULLER CLERK CIRCUIT COURT RUVAL COUN i'Y RFCORDING $1000 Revised 10/1/2009 S 1 '' r s`, CITY OF ATLANTIC BEACH " % 800 SEMINOLE ROAD ) - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 44?-t- l Application Number 11- 00002088 Date 8/26/11 Property Address 352 5TH ST Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7000 Application desc replace tile durarock Owner Contractor PARKER OWNER r ATLANTIC BEACH FL 32233 (904) 463 -0252 Permit MECHANICAL HVAC PERMIT Additional desc . Sub Contractor . HWK MECHANICAL INC Permit Fee . . . 99.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/22/12 Other Fees STATE MECH DCA SURCHARGE 2.00 STATE MECH DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 99.00 99.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 103.00 103.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 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: gs 5 - ? PERMIT # c PROJECT VALUE $ 1 7 1 9M 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 y Air Conditioning: Unit Quantity / Tons Per Unit J ARI # / 3t.5y5 - 7 REQUIRED Heat: Unit Quantity t BTU's Per Unit .5 Seer Rating /5 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 Pumps # 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 rcw' N /90;e62. Phone Number Mechanical Company • c z ./'/LLE �0 2 ' � D7 4P7F � eC� elitlYZ D 4' • r' Office Phone Fax 0 F !0 99 Co. Address: /59 IJG X t/(JL Cit a /- /x7,9 /V State,- •3 ?" / ` License Holder (Print): i 6- / ' S - srti . • I' egistration # C/IL 474E974 Notarized Signature of License Holder KRISTINA T. WILSON Sworn and subsc '.ed before me t 's (! o day of Al 20 �i Notary Public, State of Florida Signature of Notary Public My comm. exp. April 21, 2012 / Comm. No. DD 780644 This combination qualifies for a Federal Energy rub CE RT I F I E DT. Efficiency Tax Credit when placed in service between Feb 17, 2009 and Dec 31, 2011. www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number: 4385451 Date: 8/26/2011 Product: Split System: Heat Pump with Remote Outdoor Unit - Air - Source Outdoor Unit Model Number: 4TWR5036E1 Indoor Unit Model Number: *AM7A0B30H21 Manufacturer: TRANE Trade /Brand name: XR15 WEATHERTRON Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240 -2008 for Unitary Air - Conditioning and Air - Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh): 37000 EER Rating (Cooling): 12.50 SEER Rating (Cooling): 15.00 Heating Capacity(Btuh) @ 47 F: 33400 Region IV HSPF Rating (Heating): 9.00 Heating Capacity(Btuh) @ 17 F: 22800 " Ratings followed by an asterisk ( ") indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION "AC, The information for the model cited on this certificate can be verified at www.ahridirectory.org, Air - Conditioning, Heating, click on "Verify Certificate" Zink and enter the AHRI Certified Reference Number and the date on en ■■ `' and Refrigeration Institute which the certificate was issued, which is listed above, and the Certificate No., which is listed below. ©2011 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129588384359137500 •