Permit Remodel 2243 Beachcomber 2011 set CI
x ^ s s CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002205 Date 7/01/11
Property Address 2243 BEACHCOMBER TR
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 6000
Application desc
REMODEL BATH
Owner Contractor
STEVENS WARD F AND JANE E THE DESIGN & BUILD GROUP, INC.
2243 BEACHCOMBER TRAIL 13412 PEREGRINE ST
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
(904) 294 -2304
Permit W /W /O ELECTRICAL PERMIT
Additional desc . WIRE BATH REMODEL
Sub Contractor . KNIGHT ELECTRIC LLC
Permit Fee . . . 118.40 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 12/28/11
Special Notes and Comments
swo on electrical work on this job no
permit DOUBLE FEE PER MJ
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE DCA SURCHARGE 2.00
STATE ELEC DCA SURCHARGE 2.00
STATE PLBG DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 118.40 118.40 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 12.00 12.00 .00 .00
Grand Total 130.40 130.40 .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 2l( JOB ADDRESS: �� 13 �c ci- (C�Jv1Vj e r- PERMIT # 1 I
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK $
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 Li amps # of Unit Meters
El Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.) /Cq
❑ 100 amps ❑ 150amps 0200amps ❑ amps ❑CT Service amps
IY ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC. 4,,
Outlets /Switches: 0-3 Oamps 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: 7
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
❑ 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 / Phone Number
Electrical Company r 1 � \ _ � � A -C. C , k r t C Office Phone -? l - L / Fax - r) – I x- 13
Co. Address: qv.) \ 1 A-oe . . Cit c k - . r State a L Zip 1 a
License Holder (Print): i'vlar S. \ ertification/Registration #-e)i. laSa -j
Notarized Sys n 1 ' , __ ' -- - - -. ' er t,
DEBORAH AMANDANHIrE
p,tv coMMISS10Pt #EE 057349 orn and subscribed befor- - th is 76?-74— da of •
? EXPIRES: May 21, 2015 day ��— 20 //
4
kx; ed ?hrd Notary public Underwriters - // / / / � j 1 /
: nature of Notary Publi � gra , : ..
R , 1,,, le. ,
Vi CITY OF ATLANTIC BEACH
r, 44 ° . ) 800 SEMINOLE ROAD
11)11,,§ ::-.1 ATLANTIC BEACH, FL 32233
. INSPECTION PHONE LINE 247 -5814
-. . -JJ51
Application Number 11- 00002205 Date 6/15/11
Property Address 2243 BEACHCOMBER TR
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 6000
Application desc
REMODEL BATH
Owner Contractor
STEVENS WARD F AND JANE E THE DESIGN & BUILD GROUP, INC.
2243 BEACHCOMBER TRAIL 13412 PEREGRINE ST
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
(904) 294 -2304
Permit RESIDENTIAL ALT /OTHER
Additional desc .
Permit Fee . . . 80.00 Plan Check Fee . . 40.00
Issue Date . . . Valuation . . . . 6000
Expiration Date . 12/12/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 80.00 80.00 .00 .00
Plan Check Total 40.00 40.00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 124.00 124.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
5) -mr),,, City of Atlantic Beach APPLICATION NUMBER
r s ' '' s Building Department (To be assigned by the Building Department.)
.r 800 Seminole Road y z
...4,,.....1-.) t Atlantic Beach, Florida 32233 -5445 5
. Phone (904) 247 -5826 - Fax (904) 247 -5845 NY
` i"
j/
):(5;D9:• E -mail: building- dept @coab.us Date routed:
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 690 01 — )('/l /I7 b / ✓ L Department review required Ye No
CBuildin
Applicant: E D i n Al /I 9rakr Planning & Zoning
/ Tree Administrator
Project: ?eat .Od�. L , 771 Public Works
Public Utilities
Public Safety
Fire Services
Revie fee $ _ � ; mt .,, � ; ` ig a ttire �. 1 � ,N ,. 1
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:
APPL ATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
( BUILD
PLANNING & ZONING Reviewed by: Date: 6 1/
TREE ADMIN. Second Review: QApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: (Approved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 07/27110
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: a , PA3 ` .. 0 l 3 Permit Number: /l -
Legal Description b , f--c-& Parcel #
Floor Area of Sq.Ft. Sq.l.t
Valuation of Work $ ( CEO0 .- t4® Proposed Work heated /cooled I 0 & non heated /cooled 0
Class of Work (circle one): New Addition Alteration ,' Repair Move Demolition pool/spa window /door
Use of existing /proposed structure(s) (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 form
Describe in detail the type of work to be performed: // ih C�f '
Yp p �� l��t2.cr7w.�• � � �
Property Owner Information:
3
Name: JCt-AA. 5170-e- Ul/3 Address: D a `-H3 . C \A_ c- c -k-K -Lte-N 8 .
City /'' -4, State Zip $' 32Z3 Phone Ci0(4 8 —(o t
E -Mail or Fax # (Optional) j C i F r,.. ,n'S CZ lac . C-, L ,�.- -,
Contractor Information: `J V
Company Name: /ijs 1 rh i4d (?la Aft- Qualifyi g Agent: 2 A ,l C e
Address: 1 3139 C A City oati St ate L Zip 2
i l ty ��.�s �' p 3 s
Office Phone %)4' - 99'Z30 Job Sit;r - ---
State Certification/Registration # i J l fl I I • , a ! 11 , , ! .
Architect Name & Phone # ■✓ P I :.
Engineer's Name & Phone # '
Fee Simple Title Holder Name and Address I . _._ . _ , V , „ ' , ; ' ; . „4 „ ' IN ill I '
Bonding Company Name and Address 1 i' . '
Mortgage Lender Name and Address I �!° �� ('cam y .iy,ws. ;ieL iNvr 7 ,,
Application is hereby made to obtain a permit to do the work and installations as indica e,. certi t at no wor or ins a - a on 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 aperiod of six _(6) months at any time after
work is commenced. 1 understand that separate permits must be secured for ElectricalWork, Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
Tanks 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 YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this . application and know the same to be true and correct. All provisions of laws and ordinances governing this
type 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.
I
nature of Owner : ` Lt . �� Ark r Signature of Contractor ::i:;;;:z
rint Name 0,141 � �� Print Name / p Vk J G r es-�
Sworn o .4d subscrib d before me • • Am, . • . . a crib d bef• re me /
this i • y of _ /A A! 201 1 lam' :0 ∎tif wL�i / 20 /r
anq
■
�t -_/ L fr�w f @n',� : ■ r. r �` cF i :rf' i d '1 ' - f , " =, �
Notary Pu.lic = ' MY COMMISSION4DD tt,, 1 ' , otaYPubli� U�'
*: February , 27 i
y, --:,",...i7: EX PIRES: Februa 14, 2014
7, . fi ev B on de dThru Notary Public Underwriters - " evised 01.26.10
NOTICE OF COMMENCEMENT
_.ut No. /I`d'ol O S .-- 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 d1 cription of property .rid a dr- s if a • 1lable
2. General Description of improvements:
C V �Yv U-( 0.- -1,k -e 7 \e—i7 (.a Vic... • 1/Y' - c( Skc._c--(.. . �._
3. Owner Information: p 3 2 2' >$ j
a) Name and Address: Zt,.n�.e `t U3ce_.n A 5 2,,t cNt & �``E 3 -e_&L,Q k.r. s z-Q "-e , - } c) . j -t
b) Interest in property: 4>i,Z,r n -
c) Name and address of simple titleholder (if other than owner):
4 Contractor Information: -/›....51 // 3 �%C4 (5c .Dr
a) Name and Address: y h I-- c,�x�Y (� �c , (3 �{ max F1 b) Phone Number: °/ ' 23d 3 - 2,225 - -
.11 Surety Information:
a) Name and Address:
b) Phone Number:
c) Amount of Bond: $
6. Lender Information:
a) Name and Address:
b) Phone Number:
I
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 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 EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART
I, 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.
The foregoing instrument was acknowledged before me this i day of
cji 71 , 2Q'/
ArAilit • ."' ilp
Doc # 2011 i 30083. OR BK i 5627 Page 2945 l r t. s
Number Pages: 1 • • ' II: LI1 A l F FLO'I 1 A
Recorded 0613,2011 at 04:22 PM.
JIM FULLER CLERK CIRCUIT COURT DUVAL Print Name: __,d IN . . A . 1 1 . GL.,
COUNTY
RECORDING $10.00 ❑ Personally Known //
?
entification/Type: R 7 " )L •r
y
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the
foregoing and that the facts stated in it are true to the best of my knowledge an belief.
----:- : - 1
= Signature , t SHIRLEY L GRAHAM Si of Property Owner
I % MY COMMISSION It DO 957760 g P rh
EXPIRES: February 14, 2014
y , ' Bonded Du Notary Public Underwriters
Revised 10/1/2009
,, , CITY OF ATLANTIC BEACH A IS
; j 800 SEMINOLE ROAD
j " ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
''4J ;119'''
Application Number 11- 00002205 Date 6/15/11
Property Address 2243 BEACHCOMBER TR
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 6000
Application desc
REMODEL BATH
Owner Contractor
STEVENS WARD F AND JANE E THE DESIGN & BUILD GROUP, INC.
2243 BEACHCOMBER TRAIL 13412 PEREGRINE ST
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225
(904) 294 -2304
Permit PLUMBING PERMIT
Additional desc .
Sub Contractor . STEEG PLUMBING CO., INC.
Permit Fee . . . 90.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 12/12/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 90.00 90.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 94.00 94.00 .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
ADDRESS: a4-`f Y
JOB , t.. ,0. .1, .� � HERMIT ;`/ ' 2 L 05-
NEW OR RE_II____,ANE.INT INSTALLATION: Project Value
TYPE OF FIXTURE On TYPE OF FIXTURE QTY
Bathtub l Septic Tank & Pit
Clothes Washer Shower i
Dishwasher Shower Pan
Slop ink
Floor
Drinking Three Compartment Sink
Floor Sink Toilet A
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers �-
Laundry Tray Water Connected Appliances
Lavatory Z Water Heater
Other Fixtures Water Treating System
RE -PIPE: \ 1 , j
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Dram 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 **
x* SIRWD 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 specs
or not. The permit does not give authority to violate the provisions of any other state or Iocal law regulation construction or the performance of constructs
Property Owners Name 5'Itiv. -5 Phone Number
Plumbing Company ( °fr !r' 1 y Office Phone 4 / 1 ? -- 5) ' /' Fax
Co. Address: k lI ,�
City 4 J State , Zip
License Holder (P t : % A S tate Certification/Reglstration # f /
.,Notarized SSageatur< y s , erase 1/0 .7. i sir
COMMISSION # DD 957760 1
Ii t; s«�ded Iran, ra t is lmiasu 0 cribed befor 4,, d of ti €
Underwnters I l 7 Jr
Signature o ■ otary Publ - _ *" s .b.
ill