Permit Remodel 1999 Brista De Mar 2011 i
. r irit'i CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
,,,,o)
...,,,,y '� INSPECTION PHONE LINE 247 -5814
Application Number
11- 00002353 Date 7/19/11
Property Address 1999 BRISTA DE MAR CIR
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . • 9000
Application desc
new bathroom
Owner Contractor
HERED, ROBERT GREAT WHITE CONSTRUCTION INC
1999 BRISTA DE MAR CIR 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
Permit W /W /O BUILDING PERMIT
Additional desc . 55.00
Permit Fee . . . 110.00 Plan Check Fee . .
Issue Date . . . Valuation . . . . 0
Expiration Date . 1/15/12
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 110.00 110.00 .00 .00
Plan Check Total 55.00 55.00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 169.00 169.00 .00 .00
1
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 1 Ci cc c1
3(4.-,\c- rlAC. Otkkekr\k.�'Wc -h V• Permit Number: / / — r P- 7 5'
Parcel #
Legal Description 40/9) t° Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 9UO Proposed Work heated /cooled non- heated /cooled
Class of Work (circle one): New Addition Alteration Repair / Move Demolition pool /spa window /door
Use of existing /proposed structure(s) (circle one): Commercial /�
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: iretze /�o44 tea/ goVIA 'V A " X 7 ( 24 Ned
rah 1.4/1d f %b ve ' / ,i I'd '%t Joo?
Property Owner Information:
Name: Address:
City State _ Zip Phone
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: (i ccJ LAN...k C c:6,.-..A.v,.- kY.c ,t'.nt. Qualifying Agent: °T '_ U kc.��"k
Address: q 3 g-c "A) c e rwa) l -ke, ,4 k-L,C. j 44 403 City �:'- State C=c- Zip 3 go ib
Office Phone 'cam '2.3... itoG'S Job Site/ Contact Number Fax #
State Certification/Registration # C.3c ► ..- (..545"
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address FILE + Bonding Company Name and Address pt „
Mortgage Lender Name and Address U
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation 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 f6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Plumbing, Signs, Wells, Pools, Furnaces, Boilers, 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 E R CODING YOUR NOTICE OF
COMMENCEMENT.
I hereb certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of hereby 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,, f state, or local law regulating construction or the performance of construction.
y-/
Signature of Owner "c.t l . Signature of Contractor - -- r • ��-�V`
g ,/,..4-191 d
Print Name A, / Print Name \ C.y; s C ' cz.a 1-W re
Swor • . bs ri e f�'pp� mESHRLEYL GRAHAM .. 0 -: ' t__:. _!______:_72,' , . ,2, fore me II
this % • • f er ��;� • k' ISSION # D• . .r:.e , :q� S « u1-t l r�
v - • • ISSiok •'95 . r I� ' '
j F eb r � � f+ 73.:
uatvl42ol4 - ' �.. �,
e Public Un derw riters
= 1... �%AG Bon IfITP`i•i�11Y -
Notary •u•lic -
• III Revised 01.26.10
/ NOTICE OF COMMENCEMENT
p -
Permit No. t ( ; S 3 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 descri tion of property d a Z dress if available): � �Givf K iS «c� /, I� . 3? 3
/ft) vsC' /999 � �� r / A (
2. General Description of improvements:
&f/+,rt t adt/ Aim c'ghl r1Ov( 5,4.e, Ta 64-6/42"/ c TG5
,P /l S A#vf( . ' t COIV L, 94A5 / Cha/vfe `",Midas f-rcifv
3. Owner Information:
a) Name and Address:
b) Interest in property:
c) Name and address of simple titleholder (if other than owner):
4. Contractor Information: / I yS7Oj(,U� IG,EP ' liy
a) Name and Address: , , 1 � A/ 11, 4/s,rr'
b) Phone Number: qGy- $3cd ° /657 r ay Fla • 32
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: ii , L,+ ` C ; ,f2r3 pe-F?. ' Cx'c/ a& /JG/,zekvy
b) Phone Numbers of Designated Person: 90 4 i 3t- /A 5 AA' - 3 Z t o
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 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 TICE OF CO NCEMENT. /
Signature bYU�ivnei'xor er's Authorized Officer /Director/Partner/Manager ign. 1 ' Printed Name & Ti e/Oflice
The foregoing instrument was acknowledged before me this l day of 20 1j , by
�� . r - - :� as 10!! for q L •
�' 'Name o ' ers•n) (Authority Type, i.e. Officer /Attorney) (Name of Pty Instrument was Executed for)
C . , - -- - - - --
' ` C ., JENNIFER CRESWIELL i .re e"R
I '� � � sz Notary Public - State of Florida ( NOTA PUBLI STATE OF FLORI A
I . i My Comm. Expires Jan 31, 2015 �Q II■Y� tY�'� C11.41.6,4 1
' ` ' Commission • EE 60113 Print Name.
F Personally Known . __ JJ
i�ldentification/Type: F ' L ewe 4-4-0
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 know ge and belief.
C
ignat atural P er rs son S mg Abo
Revised 10/1/2009
Ad03 3111
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STOP WORK
CITY OF ATLA BEACH
BUILDING AND ZONING DEPARTMENT
NOT ,,,-. -:,
Thi ;buil ha be en inspected and:
General Construct Mechanical
. El. ectrical
Concrete andMasonry }�
-, - , , ---: '3),.. Plumb ❑ Gas Piping
IS' NOT ACCCE`pTED
COR AS NOTE BELOW; BE A N Y FUR THER WORK
�1 F
.O i � d " / ea ',. '� Lf fit- [D�
� � '' NOTICE
,„.„� ,. -. ` ";DO N REMOV "THIS
y � � �� ��� ' 1, > ' Dat e: �'
w
Failure to r to this Notic w ithin 10 days wi ll result in `this violation being" forwarded
...
o the
CODE ENFORCEMENT BOARD.
The posting of this Placard by its. contents shalt serve ' as d ue notice.
a
�, _ - <1 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
- ATLANTIC BEACH, FL 32233
g ... INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002353 Date 7/19/11
Property Address 1999 BRISTA DE MAR CIR
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 9000
Application desc
new bathroom
Owner Contractor
HERED, ROBERT GREAT WHITE CONSTRUCTION INC
1999 BRISTA DE MAR CIR 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
Permit W /W /O PLUMBING PERMIT
Additional desc .
Permit Fee 124.00 Plan Check Fee . . .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/15/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 124.00 124.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 128.00 128.00 .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
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: 1`119 .-- &r'.-s \— . _ Mc,,, C\Kc'.Z.� " CI- 3103 PERMIT # // -- 2 s3
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower 1
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
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 plans)
❑ Lawn Sprinkler System - Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
❑ 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 ilyy y iPeri Phone Number You .? (4 a?
Plumbing Company (ter o L.Ar\• C,1 - it..1•C bOra ter. Office Phone `lrt)4 R Ps I L,54 Fax
Co. Address: 44 % 1 �e c t — ■., -jc) (.. c - c ki r- 3 City tr, State F— Zip 32-11
License Holder (Print): - 7r'Gwib ` c-uo 4 v State Certification/Registration # CPc. r 4 3 8, 3 4 a
Notarized Si; , r,•
? o .,,• - . - 4:0 - - -- -,N.1. -- _
: :(t .':. MY COMMISSION # 00,q57760 of `�J� 20
l p n n d s ubscribed before g n- -this
, o EXPIRES: February 1 '
'�p ;(,yRP' Bonded Thru Notary public Underwriters /
'` _ . . • e of Notary Public ! , „a„,_
4
Great white Construction Inc.
Great white construction takes full responsibility for all plumbing that has been completed at 1999
Brista de Mar Alantic beach, FI. In the understanding the we are responsible for all plumbing associated
with bathroom remodel.
- 7 , 1 -e bvc lc-el- bo Yd
Thank You ,
Travis Slaughter
, j s A CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002353 Date 7/19/11
Property Address 1999 BRISTA DE MAR CIR
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 9000
Application desc
new bathroom
Owner Contractor
HERED, ROBERT GREAT WHITE CONSTRUCTION INC
1999 BRISTA DE MAR CIR 4320 DEERWOOD LAKE PWY
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
Permit W /W /O ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 129.20 Plan Check Fee .00
Issue Date Valuation . 0
Expiration Date . . 1/15/12
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 129.20 129.20 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 133.20 133.20 .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: / ff 73/715779 )6. GJ i PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK $
NEW SERVICE ❑ Overhead n Underground ❑J Underground up Pole
Residential (Main) Service
10 -100 amps 101- 150amps I i 151- 200amps 1 amps # of Meters
'Commercial (Main) Service
10-100 amps 1 H 101- 150amps 1 l 51- 200amps amps CT Service amps
Conductor Type Size
1 Multi- Family (Main) Service
' 10 -100 amps ❑ 101- 150amps 1151- 200amps 1 amps # of Unit Meters
Temporary Pole ' 1 amps
SERVICE UPGRADE [ i amps 1 CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
! 100 amps L -? 150amps 1- 1200amps 11 amps ' 1CT Service amps
ADDITIONS, REMODELS REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 4 7 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 1 Sign 1 I Smoke Detectors Qty I 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 I Safe y Inspection 'Panel Change 1 OH to UG
Other: 07 Q.9- 4( - 3c4f` / '/) A)71-
1
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 r 2 5 6 1 `P r 6) Phone Number
Electrical Company / �% - g S/ ` c% / ( Office Phone5'7// 7j Fax
Co. Address: e-- m'7 >AA -17 i2 Z � City A A State / -3 2
License Holder (Print): i 0 i e . r Arliff , O #(_c2../73C,0 �
Notarized Siggat a �
f.' H _ er - y
ANNA M. DAL I-
;R .pAY'PU,, C #DD085 Sworn ubscrib•ef• e me phis day of 4,C) 20 ': `�' r = Expires 112512013
; ," -s Florida Notary Assn., Inc i Signature of Notary Publ 4 ,l / A `,r
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