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Permit Spa 1486 Begonia 2011 CITY OF ATLANTIC BEACH �, ,,. .2 �� E 800 SEMINOLE ROAD wi ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002223 Date 6/24/11 Property Address 1486 BEGONIA ST Application type description SWIMMING POOL /SPA Property Zoning TO BE UPDATED Application valuation . . . 41000 Application desc INGROUND CONCRETE SPA Owner Contractor PALACE POOLS INC 11655 CENTRAL PARKWAY #313 JACKSONVILLE FL 32225 (904) 221 -1159 Permit SWIMMING POOL Additional desc . Permit Fee . . . 255.00 Plan Check Fee . . 127.50 Issue Date . . . Valuation . . . . 41000 Expiration Date . 12/21/11 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) SWIMMING POOL SAFETY INSPECTION REQUIRED Avoid damage to underground water /sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834. 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 3.83 DEV REVIEW- SINGLE & 2 -FAM 50.00 ENG REV PRE APP > 3 HRS 25.00 STATE DBPR SURCHARGE 3.83 Fee summary Charged Paid Credited Due Permit Fee Total 255.00 255.00 .00 .00 Plan Check Total 127.50 127.50 .00 .00 Other Fee Total 82.66 82.66 .00 .00 PERMIT IS cirPi16 IN ACCORDANCE win .E.El- @ITY OF ATfikNEFIC ORDINANCE@ AND THE FLORIDA° 0 BUILDING CODES. Jai 16 11 12:43p Palace Pools Inc 9049982022 p.1 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH( 800 Seminole Road, Atlantic Beach, FL 322 3 Office (904) 247 -5826 Fax (904) 247 Job Address: 1486 Be onia Street Permit Number. 1/f " Z 2- 3 Parcel Legal Description Lot Hidden Paradise # Floor Area of Sq.Ft. Sq.Ft Valuation of Work S 41,000.00 Proposed Work heated/cooled �. �_ non- heated/cooled Class of Work (circle one): New Addition Alteration Repair i ;AY., olitio peat/spa window /door Use of existing /pro osed structures (circle one): , Commercial . " No N /A If an existing structure, is a structure, sprinkler syst installed? (Cirde one . Florida Product Approval # approval form For multiple products use product app Describe in detail the type of work to be performed: Inground Concrete Spa Property Own Information: Name: Jo • Wal C i t y A t l a n t i c Beach S t a t e FL Zip 32233 Phone 904 -247 -4 E -Mail or Fax # (Optional) (_ it V E: Contra Infor mation: !, 00":47cm--...E..AlaiwAL.-..v.z....;.,:sFot ! Company Name: Palace Pools Inc AX State FL Zip `" .::32246` Address 2265 St Johns 904-998-1811 ad City , .um . or _•in - --.-; •- :— _ _ ;. -. 904 - 998 -2022 Office Phone 904- 998 -1811 r OR CODE 1 u ' • • NCR State Certification/Registration # p l M a w Architect Name & Phone # _. -.. Engineer's Name 8t Phone # 1 �� ►M . r • ►i� r ra . Fee Simple Title Holder Name and Address � = Bonding Company Name and Address Mortgage Lender Name and Address $3 zo1 044 00 : 40. r issuance is e r it made to obtain a permit er o the work � the standards o•� � regulating on in this junsdiction. has commenced rrs i becomes n an d voi of wa ork permit commenced that all work wilt be performed or abandoned for a ad of six /6) months at any time after and is t m en ie not commenced that separate se six (6f to months, nit or mu must e dru u ied f r work is sus Work; Plumbing, Signs, Weld Pa*, Furnaces, Balers, link's. nnJs and Air commenced. 4it C dRiorrerse d id th emits must be secured for F.le WARNING TO OWNER: YOUR FAILURE TO O RECORD �R M ICE OF NTS COMMENCEMENT MAY RESULT IN YOUR PAY YOUR NOTICE OF TO YOUR PROPERTY. IF YOU INTEND TO RE RECORDING YO CONSULT WITH YOUR LENDER OR AN ATTORNEY NCEMENT. this m red herein or not The grannie$ of a permit does not presume to : e authority to violate or cancel the I hereby certify that 1 have read and examined this application and brow the same to be true and construction. f provisions of laws and o>dinances governing t s ons o will be complied with whether a la I regulating construction or the performance of provisions ofmry other federal, state, or local law r+egu 8 .400.01004. f Owner . i . A .rw .. .. Signature of Contractor ignatnre o Print Name Mk . el P _ __ t Name L j � r ' �dC �� Sworn to and 4 4 '' ;:',!. t �'r _ r I , 0 this L . . 4t ice / Savor o and subs bed before me 20 i.. this J Da r ,f 71 �� (10,1.,� � L/ ,. ��_ *ti otary i• Notary Publi' S b*s UP 1t• 2012 Revised 01.26.10 • . sto0 * DO 109440 Doc # 2011132754, OR BK 15630 Page 2192, Number Pages: 1, Recorded 06/16/2011 at 11:40 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 NOTICE OF COMMENCEMENT Permit No. l,/' 7-2-2- 3 Tax Folio No. THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT. 1.Description of property (legal description). till . a) Street (job) A dd r e ss: Sr , A* • j �r� ■ r�'77?!!�� Z 2.General description of improvements: 3.Owner Information a) Name and address: Ct tMt.t 1 44 LiVni � CL,1'. e writ b) Name and address of fee sirhply titleholder (i) other than owner) c) Interest in property 10 O 'o/ Z7 4.Contractor Information a) Name and address: P lAC G .. e,:.. 22 co r) . 3. i h ►i's � b) Telephone No.: " O L r I Fax No. (Opt.) D Z 5.Surety Information w ,,, a) Name and address: b) Amount of Bond: c) Telephone No.: Fax No. (Opt.) 6.Lender a) Name and address: Phone No. 7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served: a) Name and address: b) Telephone No.: Fax No. (Opt) S.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes: a) Name and address: b) Telephone No.: Fax No. (Opt.) 9.Expiration date of Notice of Commencement (the expiration date is one 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 YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. STATE OF FLORIDA COUNTY OF PINELLAS 1 0 . Sigeahac of "or Owner's Author' Officer/Director/Partner/Manager (A-Vat to Print Nam The foregoing instrument was acknowledged before me this I3 day of 20 � ( , by as (type of authority, e.g. officer, trustee, attorney i (name of party on be f of instrument was executed). Personall OR Produced Identification Notary Signature 430),5 ( Type of Identification Produced Name (prin OR Verification pursuant to Section 92.525, Florida Statutes. Under penalties of • r ? ";" • , . .IM1I . the facts stated in it are true to the best of m know 11:) .: ' and that : y ledge and belief. ' � '� �� � � 1 OD MHO FORlSM . A: IIIfMM' OCjnd2010 Signature of N . . n (ping # 10.) Above Q1C1/4.7V1vIn 1 Ktt 1 �.'�V t(IW) I S01 " E 90.�C1 i t--.--0.4' MOE WCkT_. 1 0 7 LsMIT P:7_::: . ! EN PAP- K 1 - 6' W4'11.. FENCE , Q ,. T .. _.._ - - -- 20 `- L �� 16 — itt - i%1 C4 1,1 { • •r- tV Q I 1. 0 Q Z 1 ' . 't�Q . . 0 ° fir F. \ ( . Y t n u , L l-� • �►/ f , , -I fl r • LL i .. 4 24.1' • t I— CC 0 f - - • . 2 ST a 26.8• . j 2.1 -- FRAME - RESIDENCE _- . I '� '- _ I Y ! - +/� :1 t : • k: FIN FL EL' {11.57) ;„ if% !' �+, #1486 f x J E ! �: i ._, CO Piii ; ... . . 7 : i _ ti . I s Z �!- ( 1 n > t t_..•__ ___ � _. ._.._.. I -- i _.. J tfj w Eli �'°a W —.1 ` 8 .- o�► 41 _ el I , _ 10 1 • — �` elm — -+ N01 "11'11 "W • 99.03 • 1O PRIVATE DRAINAGE 1 — _ • _ i , ...\,::: . _EASEMEN 1 10'X1 EASEMENT , r ..• , 1 w/TRANSFORMER ' ( i ON CONCRETE PAD ! -. -- LOT 2 t I LO•T 3 ( .._. ( ! 1 E 1 1 1 1 1 1 ( " ,'s I FINAL SURVEY: 02 - - NOTE: FOUND ALL CO;RNERS- 1 HEREBY CERTIFY THAT ;THIS SURVEY. PERFORMED UNDER MY RESPON DtRECT1ON MEETS .THE • tEGEND: MINIMUM TECHNICAL STANDARDS FOR LAND SURVEYORS IN ACCORDANCE WITH CHAPTER 81017 -6, FLORIDA • FOLAtD OONCI_IE T ADMINISTRATIVE CODE (PURSUANT TO SECTION 472027. FLORIDA STATUTES). AN) FURTHER CERTIFY THAT • 1 }t p now LB _e24 THERE ARE NO VISIBLE ENCROACHMENTS UPON THE SUBJECT PROPERTY EXCEPT AT SHOWN. O B.RL 1704 UNE - R CENTRAL ANGLE NOTE: E LOT SURVEYED HEREON APPEARS TO LIE NITHIN R.000 C AND ASSOCiIA ES.. INC. ' r - me TR. ZONES �X AS SCALED FROM THE FL000 INSURANCE RATE 1643 :1ALDO AVE. JACKSONVILLE. FL, 32207 CH CHORD . MAPS. MAMMUN17Y PANEL NA 17I II75 — 0001 D, DATED 4.17 —RA. ; P.C. Cr • POINT / : P.R.C. PANT OF REVERSE CURVE P.C.C. POINT CF CDWOIA7D CURVE SURVEYED FEBRUARY 28 SCALE; 1 20' 2004. - li Y O.RV:OFFICIAL RECORDS NOODLE SU N t FLORIDA, • -RCP CONCRETE PPE FIELD BOOK 677 PAGES 51. • - '"'� v IIDOD ) JOSE A. 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CD III Ti - II .., ,. - cn III c III r...0.. � 0 cia 3 1 ` 1R0 I D •mac a6 10 i I 14.------------I c e co a a n z 0 co 1 go m E a r ;I E A CO CD OD n "0 Er O. aD "%% 0 E `G ao j CA c N o Fi • • 1 V o ftpr 19 05 02:21p Planning and Development SO4 247 6107 p. 6 .S C -ZI , ,?' . • n Tr N 1 ‘1" • Pi 4 1 1.17 a V S "1 g v •N ill ii ....,,,, 1 (-a 174 fi fi t � ii[ .-i% - "'' ' C am .. -�.. � ''' '- � � \ --P � . / .0 C till r, - -1 ; Ct Cot •. �� a . i is ch d 'th r''' %... 1 6 , . ..; r t. pti X ! 1 Q q 4 tA 10 IA c., c. v FS tail i V V be ' ` S . Si .c , a 2. rtI -s T.--- 6 141 a Z • y a -� � '' t% C G Vi ,. :7.; s ' r :: : . -z i r t : : :: :t.if?...6,..1,..:4..‘,1„..i■i...4-.,..1.....: :::11-4:*:.::: ::-::t:::.:::;1: '' . . ' ... ' , ., . ,4 ' • • -- a 9+ :. .;. • - _ • '.` •` yi. • . . ~ . U . 4 7. . Y s J r , ,. . .; r 3 PREFERRED FAX I NUI FAX NO. : 9049981937 Jun. i2 2006 03: 56PM P1 .rame B . Wh jaunt, F.E. FL #0027689 85.33 Acorn Ridg Court Florida 33625 813489 -7977 Pre felTedAlunlimmi POST AND 'WAIL DETAIL, CONNECTION 10 PAVER DEcK AND FOOTER sumo W M Pat 2. 4"1133 aolge with one 1/4" i$ taPcM oe 4a. INO of 1101 /4 1s2 P!1 1YP tom iukeho Post bum `r`_ Irr• 11S *0480 Rider 9 Zia 11 •• • Or12 12" % • jt , Paws on #3 Nods '44412, !�'�l i� / „ , .. • ' I� JB ' • • • . O O_ o m .Q Q- _ 0 co 3 m 1 cr CO SD v F" O co N 0 0 �C l • o n _I cp Ft) nk VO. 411 cn �3 �G t) cn o co co c O c o 0 0o ao cc CD cQ v o 0 o 0 0 N_-D CD at 0 t° m Atlantic Beach Building Dept. PALACE POOLS INC Joyce Wall (Home owner) RE: Lot Covereage \ 1486 Begonia St Total Lot = 9731 SF Structures and Impervious Surfaces = 2857 SF (29 %) Spa and Deck = 729 SF (7.5 %) Total Coverage with spa and deck 36.5% (50% allowed) -p i "0 MN $ / /1/ NM 1111 ittril/ nom /s;/1/ g * moms i 1 awn ram i g. ,--:, mow u . t ttir ,,, rre1� 1 1111111111111 SUM sr/111 t //1 11r11rrr /e 1111111111111111 'e11rrrrrrl �. �ttttaIi/eei ¶r ri , p c • t i,„-ignamm 4)_,. 1.) ilmusioni ! :l'i /s /i 5 fi ;;� i r iIUII _ d t? mrerrri w 111111111011111 eieeei 5 1 i 11 1111111111111 1111111111111111 r t l,.a.'i ». City of Atlantic Beach �/ "' /Pi/ APPLICATION NUMBER j= " s� Buil Department (To be assigned by the Building Department.) 800 Seminole Road N. : : ,'' '` " 'g"' ' " Atlantic Beach, Florida 32233 -5445 / Phone (904) 247 -5826 •Fax (904) 247 -5845 // ,,,,...,,, E -mail: building- dept @coab.us Date routed: V. / 141 // / City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: � /O � p� 627 i CE S r D e artment review required Yes o G /(� Applicant: (ti<C!' e ?O 0 1--- ' - ping 8, Zoni l :.. ministrator Project: /r6km (On(?rFTL 3 6k--- eublic Work k is Uti i i up Safety Fire Services F eview fee $ gt; r ' ,.aep $ig a ure SF ... 0 " r. F 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: roved. ❑Denied. (Circle one.) Comments: BUILDIN PLANNING & ZONING Reviewed by: �nr Date: 6-17-1/ 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 07/27/10 ,S f--." lam, City of Atlantic Beach r APPLICATION NUMBER , s� Building Department .Q .:it > (To be assigned by the Building Department.) 800 Seminole Road 4/14 ✓ ,T. " ' < -' r. Atlantic Beach, Florida 32233 -544. // ` Z Z Phone (904) 247 -5826 • Fax (90'x° -5845 eo f <L0,-,),..)", E -mail: building- deptc©coab.us Date routed: //a // City web -site: http: //www.coab.us \ APPLICATION REVIEW AND - ACKING FORM Property Address: /qf / I)E 6y7 , e. Sr De artment review required Yes No wilding -) - -- Applicant: fila (f. -- Pe5d L- nning &_Zoni g'' (� Tree Administrator Project: /rc7) Ar)POTZ, P Sp Q-.- Tblic Worly, / i s 13T Safe Fire Services (eviet fee $ T ,. 7 e . � � - ,Sh' 1 w ; Q .., G 'i��� 1 G„ . # f$ � Ix 1 t 'Z`w `- W ''f 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: ['Approved. Denied. (Circle one.) Comments: —AL a A.1._ D BUILDING ' PLANNING & ZONING by: G% � Reviewed by. � Date: U ) 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 07/27/10 rir1/.1r,J City of Atlantic Beach APPLICATION NUMBER : ,S ; '' Building Department (To be assigned by the Building Department.) r a 800 Seminole Road / ' ` r� Atlantic Beach, Florida 32233 -5445 / - Z 22 J ` t Phone (904) 247 -5826 • Fax (904) 247 -5845 / , art 9 ,- E -mail: building - dept ©coab.us Date routed: .I ' /6 11 City web -site: http: //www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /viz, F � 671 , 4 Sr De artment review required Yes No uilding- Applicant: A / a i TOO Z — nning 8�_Zoni ,------" ministrator Project: //r6k 9 Lb/MO/2, S. A, f.ijc c W ork / Utiii P ublic Safety Fire Services 14eyievi: fed ;$x r ; -0 ,, ` 3 4p train a +' * . ,, -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: /: Approved. ['Denied. (Circle one.) Comments: BUILDING L1L- PLANNING & ZONING Reviewed by: Oa X - Date: ( /t 71 f 21 f / TREE ADMIN. Second Review: A roved as revised. ❑ pp ['Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 07/27/10 / •sLA . ;,& City of Atlantic Beach Q APPLICATION NUMBER r.:;' s a� Building Department i ✓( 4 1l • (To be assigned by the Building Department.) v 800 Seminole Road y �� / ^-, ' �'=' Atlantic Beach, Florida 32233 -544 Z // � / Z Phone (904) 247 -5826 - Fax (904) 245 / ,:Z E -mail: bu dept @coab.us �� Date routed: IO / City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: / 1, /5 A Sr De • artment review re • uired Yes No lg -- Applicant: -Ala e g too -- 4 - -nnin• & Zonin•' • ministrator Project: /()c?,? A/ -W rf /Z. 3p d=--- [ ublic Wo__MIIIIIIIIIIMI irraaiiir ral u • is Safety Fire Services _- �. >.. p ... ,�-:- w 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: XApproved. ['Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: Date: 449 ' TREE ADMIN. Second Review: Approved as revised. ['Denied. i PAP' e .. Comments: a cis a li p ,.....,aro• -A / PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10 A L J I -1 "" 1; ' ` CITY OF ATLANTIC BEACH '-'�� �, 800 SEMINOLE ROAD �t J r.) J ° ��`* ° "` ° ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 ____"; Application Number 11- 00002223 Property Address Date 7/15/11 1486 BEGONIA ST Application type description SWIMMING POOL /SPA Property Zoning TO BE UPDATED Application valuation . . . 41000 Application desc INGROUND CONCRETE SPA Owner Contractor WALL JOYCE MARIE PALACE POOLS INC 1486 BEGONIA ST 11655 CENTRAL PARKWAY #313 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225 (904) 221 -1159 Permit ELECTRICAL PERMIT Additional desc . Sub Contractor . HABITAT ELECTRICAL CONTRACTORS Permit Fee . . . 95.00 Plan Check Fee . Issue Date 00 Expiration Date . . 1/11/12 Valuation 0 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) SWIMMING POOL SAFETY INSPECTION REQUIRED Avoid damage to underground water /sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834. 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 95.00 95.00 .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 F LORIDA BUILDING CODES. 1 ''' CIT OF ATLANTIC BEACH +'. 800 SEMINO AAEA I I I I rmo 4 ' c OFFICE: (904)247 -5826 LE ROAD, TL FAX NO NTIC B :(904)247 -5845 CH, FL 32233 l� _4 BUILDING- DEPT @COAB.US ''') js1 ELECTRICAL PERMIT APPLICATION DUVAL COUNTY 1. JOB A RESS: 2. IS THIS A SUB PERMIT: 3. DATE - B O5 O VN ICI., S - P • ❑ NO n /y 1 /J Atlantic Beach, FL 32233 A YES PERMIT #: // elAA,a - ///5 / ! PROPERTY OWNER: L f 4. NAME: 5. ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6. PHONE: \N A q x 117 - 4 /57 8 ELECTRICAL CONTRACTOR: i.N / r C.�E.Gkfl� V 8. ADDRESS.: 00 KAMMOGN ( W, 32 4,1,5 9. STATE OF FLORIDA LICENSE NO: 10, CELL PHONE: 11. FAX NO.: t..t ER- ob0O 3E3 - alatio 12. EMAIL ADDRESS: 13. OFFICE PHONE: 14. 15. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify 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) mo at any time after w k is cQ 1 CONTRACTORS SIGNATUR ' (/'� • OgQd 16. CLASS OF WORK: 17. SERVICE: 18. METER NUMBER: ' ❑ MULTI FAMILY - # OF UNITS: ❑`RESIDENTIAL XSINGLE FAMILY ❑ TEMP SERVICE ❑ COMMERCIAL ❑ ADDITION ❑ TRAILOR 19. BUILDING: 19. CURRENT CODE ❑ ALTERATION ❑ SIGN Jn OLD ❑ NEW ❑ '05 NATIONAL ELECTRICAL CODE ❑ REPAIR XPOOL / SPA ❑ REWIRE ❑ OTHER: LIST ALL ELECTRICAL WORK: 20. TYPE OF SERVICE: ❑ OVERHEAD ❑ UNDERGROUND ❑ UNDERGROUND UP POLE 21. NEW SERVICE: CONDUCTORS PER PHASE: ❑ POWER IS ON ❑ POWER IS OFF 22. SIZE OF CONDUCTOR: AMPICITY: ❑COPPER ❑ ALUMINUM 23. SWITCH OR BREAKER SIZE: AMPS: PH: W: VOLT: RACEWAY SIZE: 24. EXISTING SERVICE SIZE: AMPS: PH: W: VOLT: RACEWAY SIZE: 25. FEEDERS: # OF AMPS: # OF AMPS: # OF AMPS: 26. LIGHTING FIXTURES: INCANDESCENT: FLUORESCENT & M.V.: 27. FIXED APPLIANCES: 0 -30 AMPS: 31 -100 AMPS: OVER 100 AMPS: 28. FIRE ALARM: ❑ YES ❑ NO 29 -31 DO NOT APPLY TO NEW SINGLE FAMILY, MULTI - FAMILY AND ROOM ADDITIONS 29. SMOKE DETECTORS: NUMBER: 30. RECEPTACLES: 0 -30 AMPS: 31 -100 AMPS: OVER 100 AMPS: 31. SWITCHES: 0 -30 AMPS: 31 -100 AMPS: OVER 100 AMPS: 32. AIR CONDITIONING: # OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW: # OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW: 33. MOTORS: NUMBER: VOLTAGE: HP: KVA: NUMBER: VOLTAGE: HP: KVA: 34. TRANSFORMERS: UNDER 600V: NUMBER: KVA: OVER 600V: NUMBER: KVA: 35. MISCELANEOUS REPAIRS: DESCRIBE IN DETAIL: COAB FORM BLDG02. REVISED: 8/13/2007 • • • r