Permit Well 2206 Laughing Gull 2011 ; CITY OF ATLANTIC BEACH
<� s 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00001872 Date 5/27/11
Property Address 2206 LAUGHING GULL CIR
Application type description WELL PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
new well
Owner Contractor
ETHERIDGE DESTIN WELL AND PUMP, INC
2206 LAUGHING GULL CIR P 0 BOX 413
ATLANTIC BEACH FL 32233 MACCLENNY FL 32063
(904) 739 -8216
Permit WELL PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 11/23/11
Special Notes and Comments
Seperate permit required for electrical
connection /wiring to new pumps
A reduced pressure zone backflow preventer must be
installed if irrigatin will be provided or if there is a
private well on the property. Backflow preventer must be
tested by a certified tester and a copy of the results
setnt to Public Utilities.
Backflow preventer must be installed on the customer's side
of the meter on the City water service.
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 79.00 79.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PREPARED 4/06/11, 15:47:14 PAYMENTS DUE RECEIPT
CITY OF ATLANTIC BEACH PROGRAM BP820L
APPLICATION NUMBER: 11- 00001872 2206 LAUGHING GULL CIR
FEE DESCRIPTION AMOUNT DUE
STATE DCA SURCHARGE 2.00
WELL PERMIT 75.00
STATE DBPR SURCHARGE 2.00
TOTAL DUE 79.00
Please present this receipt to the cashier with full payment.
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CITY OF ATLANTIC BEACH
WELL PERMIT APPLICATION
. Date 3{ 3/ - /I
OwnesName: -Tay 06 Adder- a 6L0 L0u CO- c-� "5 Cruz1 C-
Well Address (if different than above): 9)m C
Wen Loci on Property (Le. northeast corner, etc.) (Vo r`rh' £ I4-S 7"
'GtTeil Installation Contractor: Dr5
Ti L. &3 / Dr; 11 ini5
Contractor License No.: X059 Phone: � y 737 S x FAX: cl /#2. S 5
Contractor Address: Fv 1 N. Li L (n CC Lt rung L 32
Check Use of Well: Domestic litigation V Other
Estimated- welt Depth: 40 30 &leen interval from. to
I
Well Diameter ( it Casing Material U �• -
Is address currently connected to the City water system?
Is address qtly connected to the fly sewer system.? ft S
H a s a W e l l P e r m i t been obtained f r o m t h e C i t y of Jacksonville? Pest # P"1 .
Does the well fire a permit from the St. Johns River Water Management District?
(Not required for wells under Zees diameter installed by residue or wells under 6-
inches d�ueter if installed by licensed well contractor). NIFI
if permit is required, note Permit Number A )4 and attach soapy.
NOTE: WHEN A WELL LS INSTALL DONYOURPROPERTY,YOUMEST.
INSTALL A%F.D . ' _;�� : x }Mil _ sf�� rWP. .54 tea ON
ME an WATER SERVICE. CPI CliSTOMERW SIDE OFTEN
ME BAICKFLOw PREYENT.ERMUSTBE TESTED BYA CERTIFIED
ANDA COPY OF THE RESULTS SENT TO THE PUBLIC UTII.17TES
DEPARTMENT.
FILE COPY
. 990Z£i8Z 161 6 u!II!ap IIBM sursep
Sunday, April 03, 2011 10:48 PM destins well drilling 1 -912- 843 -2055
p,01
Page 1 of 1
I sent this smiler. Hopefully It's right. They requested the pressure gauge.
From Jeremy DeeLIri <Jet err Weetlr Qydioo.rornf View Contact
To: de rom
Destins Well Drilling & Pw.np Services
Work Proposal
Job; 1" 1/4 Deep Semen Well Pach:nge
1 Horse Power Package Includes The Straits SNE 20 Jet Pump, 1" 1/4 Deep Screen Well, 2 Gallon Bladder Tank, 3/4" Howe Bibb, Pre Formed Concrete Pump Pad, 1"
1/4 Check Vrrlve, Preusure Gauge, Rigid Galvanized Header Otr The Discluage OFPwnp, 1" Boll Valve, Also Free Ir ig;Kon Hook Up Willi Buck Flow In Place.
Package Price With Penult: 1,630.00
Thank You,
Jeremy Deetin.
http: / /us.mg3.mail. yahoo.com /dc /launch7. gx =1 &.rand= Su8jollhic7leik 4/3/2011
City of Atlantic Beach
Building Department
be APPLICATION NUMBER
(To assigned by the Building Department )
800 Seminole Road
f9
Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 Fax (904) 247 -5845
y E -mail: building- dept @coab.us Date routed "# t/
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z l / 9 9' £ 'L Department review required Yes No
Building
Applicant: �s -� AiLLG , /Jir Planning & Zoning
Tree Administrator • Project: /V k ) j3 LC PublicWorks
d Utilitie
Public Safety
Fire Services
;+Su Y'"". s-. r' a hn ''�c +a r ''r iais� a Y• s r ^t ,h'ia4 J -a y .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
1
Reviewing Department First Review: Approved. ['Denied.
(Circle one.) Comments: X
BUILDING
PLANNING & ZONING
Reviewed by: Date: � 8
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
P, ORKS Comments:
ittervel -77710::0:0100,
PU: IC AFETY
Reviewed by: Date:
FIRE SERVICES Third Review: [Approved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
i � , - ,-,i- l r ,„
, ? , CITY OF ATLANTIC BEACH
I 800 SEMINOLE ROAD
„3
C ATLANTIC BEACH, FL 32233
,; INSPECTION PHONE LINE 247 -5814
Application Number . . . 11- 00002145 Date 5/27/11
Property Address 2206 LAUGHING GULL CIR
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
PUMP CIRCUIT FOR WELL
Owner Contractor
ETHERIDGE ELECTRIC PLUS
2206 LAUGHING GULL CIR 5358 LOSCO ROAD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32257
Permit W /W /O ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 180.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 11/23/11
Other Fees STATE ELEC DCA SURCHARGE 2.70
STATE ELEC DBPR SURCHARGE 2.70
Fee summary Charged Paid Credited Due
Permit Fee Total 180.00 180.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 5.40 5.40 .00 .00
Grand Total 185.40 185.40 .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: a J ( Lc V q , j v■..j G J \ ` C \ r PERMIT #
NEW SERVICE ❑Overhead ❑ Underground ❑ Underground up Pole
❑Residential (Main) Service
El 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 -1 00 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 ❑ CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 0- 30amps 31- 100amps 101- 200amps
Appliances: 0- 30amps 31- 100amps 101- 200amps
A/C Circuits: 0- 60amps 61- 100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑ 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 2 I
❑Other: VYv\ ( 1 C C v li --P/9"/176 � ) 2
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� CA) /JO Phone Number 3 — 6775 — Q 775
Electrical Company L\ ec4 C 1 C t US 'Inc Office Phone e i � -. 7. -7 Fax
Co. Address: C 3 S . I ` \ \ S C ° d a , City j Ci X , State\ • Zip
License Holder (Print): W \ \ \ c v N Ti S ie , r - WSb i I State Ce ification/Registration #
INV Notarized Signature of License Holder 4 P ,
S 1 .0 1'. '� Nl 'c� ., . i ' • day � 7 ,y 20 l
' * ^ v GfJMMISSIDN N D� � � � —% f
1
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