Permit 361 Main St (vault) C BEACH
IS CITY OF ATLANTI
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Building-dept2coqb.us
Application Number . . . . . 07-00000352 Date 3/26/07
Property Address . . . . . . 361 MAIN ST
Application type description ROOF
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2000
----------------------------------------------------------------------------
Application desc
roof repairs
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
SHAUGHNESSY, MAUREEN OWNER
361 MAIN STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 40 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 2000
Expiration Date . . 9/22/07
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 40 . 00 40 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 40 . 00 40 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
51-ILI 71�11�
BuILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 * Fax:(904)247-5845
Job Address: T-- Permit Number:
Legal Description
Valuation of Work(Replacement Cost) $
• Class of Work(Circle one): New Addition Alteration epa- Move
• Use of existing/proposed structure(�) revap Residential
0 (Circle one): Comme
If an existing structure, is a fire spnnKier system installed?(Circle one): Yes No N/A
Is approval of homeowner's association or other private entity required?(Circle one): Yes No
Describe in detail the type of work to be performed:
r--R-Pla U , r6y)-� 6
Property Owner Information
N
Crty
Contractor Information:
Name of Company: .6iVIth�-7k Qualifying Agent:
Address: city- State Zip
Office Phone Job Site/Contact Number
State Certification/Registration# Office Fax#
Architect Name&Phone#
Engineer's Name&Phone#
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or
installation has commencedprior to the issuance qfapermit and that all workwill be per/ormedto meet Me standards ofall
laws regulating construction in thisjurisdiction. Thispermit becomes null and void ifwork is not commenced within six(6)
monthi, or yi construction or work is suspended or abandonedJor a period 9f six (6) months at any time after work is
commenced. I understand that separate permits must be securedfor Electri6al W64, Plumbing, Signs, Wells,Pools,
Furnaces,Boilers,Heaters, Tank andAir 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.
iherebycerti that I have read and examined this apolication and know the same to be true and correct Allprovisions9f
laws and ortinances governing this type ofwork wX be complied with whether specified herein or not. Thegrantinjo
ra
I
permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or loca aw
regulating construction or the performance ofconstruction.
Sig nature of Property Ownevoaq/21e,
SW s c e Signature of Contractor:
thimaDay of Sworn to and subscribed before me
t this_Day of
Notary Public. Notary Public:
REVISED 03.
Special Information for Owner/Builders
DISCLOSURE STATEMENT for Section 489.103(7),Plorida.Statutes:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE By LICENSED CONtRACTORS.
YOU HAVE APPLIED FOR A PERWr UNDER AN EXEMPTION TO THE LAW
The exemption allows you as the owner ofyour property,to act as your own contractor even throughyou.do not have
a license.t You must gMprvi e the construction yourselt You may build or improve a one-family or two-family
is
residence or a farm outbuilding. You may also build or finprove a commercial building at a cost of$25,000 or less.
The building must be for your own use and occupancy. It may not be built for sale or lease. Ifyou sell or lease more
thari one building you have built yourselfwithin.one(1)year after the construction is complete,the law will presunie
that you built it for sale or lease,which is a violation of this exemption. You may not hire an un-licensed-mubun=
contractor. Your construction must be done according to building codes and zoning regulations. It is your
ibility to make sure that the people pMl
respond _oyed hy you have licenses reguired by state law and by g9un
or
municipal licensim ordinances
In addition,the owner must supervise construction and becomes liable and responsible for the employees hetshe hires. This
responsibility includes,but may not be limited to:
1. Workers Compensation,for workers injured on the job.
2. Social Security Tax must be deducted from employee's wages and matched with ownee s funds.
3. Federal Wittliholding.
Since owners must be liable for iniuries to workers they hire,the Building Division suggests Workers Compensation
Insurance be purchased unless the homeowners insurance policy clearly protects the owner Owners hiring workers
become employers and should also observe IRS withholding tax Form 1099 requirements on the workers they employ
on their improvement work.
Un-licensed contractors cannot be mpIMLed under M circumstances. Owners are subject to a$5,000 penalty under
Florida Statute#455.288(l)instigated via Building Division citations. An 9"cu ationd License is riot @Ld�e. The
ownex should physically see the county Certificate of Competency or the Florida Contractors Certificate to ascertain a
person is a licensed contractor. Telephone the building Division(247-5826yin doubL
1�7b thatl have read a�n, understand all the above on this Dayot
Z22 M�,
OwnerB Addres's
M409 L--sEi -, M . C,/�
T AU 9 e5 J
7
Print Name Telephone Number
STATE OF FLORIDA:
COUNTY OF DUVAL
Before me personally appeared -27?o.,et t SA A4. V to me well known to be the individual and
-fflmr4h/)f-55
owner builder described in and who executed this instrument andseveraUy a6mowledged the execution thereofto be his own free
art and deed as such owner builder hereunto authorized. ace -7
WITNESS my hand and official seal this2rday of,1h.#4Atl t'c Beach.-Co an State aforesaid.
#1 Atl t:Oc B
LI
IN409TARY PUBLI _PJ51)FLORID
N
A
Notar� Print Name7: .4
imy con)f I,- C, 44,2010
MY P-OA4NUSSION E)MIRES:
gunded NTrersonally Known
V W. [i Identification:
CITY OF N! 2796
ATLANTIC ISEACH'
FLORIDA
6/28/91 19—
NAME Home Chase Mortgage
ADDRESS P. 0. Box 31055
CITY- Laguna Hills, CA 92654
Charges for Removal of Weeds-Growth-Debris from
Lot 3 and South 40 feet Lot 2, Block 105, Sectio H
a/k/a 361 Main Street, Atlantic Beach, FL 5.00
5.00
C)
Go
When Signed, 'afed and Numbered, This becomes a fficial Receipf
lil ,74/om
MAKE CHECKS PAYABLE TO R" Paym*nf
CITY OF ATLANTIC BE CHI FLORIDA TREASURER
N 0 T I C E T 0 A B A T E
TO PUBLIC WORKS DEPARTMENT Date:-- ' IEW-17,.1921
IL ........
WEED ABATEMENT Ex] NUSIAHCE ABATEMENT I I
Property Address: 361 Main Street ----------------------------------------
Legal Description: Lot 3 and South 40 feet Lot 2, Block 105, Section H
-----------------
Property Owner: Home Chase Mortgage
---------------------------------
Mailing Address: P. 0. Box'31055, Laguna Hills, CA 9,��"y a
�:�L-----------
---------------------------------------------------------
Type of Work: --- cutting weeds and grass ---------------------------------
Lot Size:
Ordered By:
Effn_T_or_c_e_m_en_t__
Don C. Ford,j?je 7ir(
icer
TO ZONING DEPARTMENT Date Work Performed:
EQUIPMENT EMPLOYEES *-- -3--- * hrs. --
-----------
* hre. 2
2. .,q
3. 0
# hrs. ovOM"
t. ovo,"
4- -- -------------------- * hro
Comments: - -------------
Signed:
Superintendent, 14VU-b-Hic---Wo-r-k-s
--------------------------------------- ------------------------
COST COMPUTATION
- ------ - ---- - ------ -
1 --No. -of----Fiquipment---I -No. ----i-Amount---I -Sub---l-Admin. -I---------I
I Employees I Used I Hours I Per Hour I Total 1 100% 1 TOTAL I
I ------------ I -------------I-------- ----------- -------I --------I---------I
I I y
3 1 1 z
------- --- ---------I
I I
------------I-------------I--------I---------- I-------I--------- I ---------I
I I I I I I I
I------------I ------------- I--------I---------- ------- --------I---------I
I I I I I I
I------------ I ------------- I --------I ---------- ------- --------I---------I
I
TOTAL BILLED:__0 4-"-/-L
Date Billed:---------------- Date Payment Received:
CITY OF
"Ay 3 199,
gead - 9&zed4 716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2395
hii.ls, CA
Zi, t�
�_� L (y At
U,
I- L i7l t I d tJ
A
and df-Le" mii,.ed il I, L
t:1 L i� v i o i a Li u,,j
�-Illd �Al�'It
Y':�u -I� i,-e �r c---,h y lit-;1� 1 '� i t
tlhu- iCity will t�mt_?dy Lh.L�_ ("'t ;Aw wc'� ".
c
I I s fe C.'q u Ll i 1�u 1U(J% t:�.L Ll�k"
v t-'. vi�'I 1_1 I k t
"j wi t h I
Llt�;I"'�pt t:1 I I�1 I to, t!i(.. ki
w I b t-�, ci L c--,J1 a--- a I c
Y
L,;!!� 'Alt' t'3
w Lc"'. I ht�' A t 3
L L_" tl i_l
("J
C-ity
N 0 T I C 9 T 0 A B A T E
TO PUBLIC WORKS DEPARTMENT Date:_- .'L 7,
1991
WEED ABATEMENT EXI NUSIAHCE ABATEMENT I I
Property Address: ...16L Main Street ----------------------------------
Legal Description:.... Lot 3 and South 40 feet Lot 2, Block 105, Section-H---------
Property Owner: Home Chase MortgjLjL�--- -----------------------------------
Mailing Addresss P. 0. Box*31055, Lajaij�_Ejlls, CA ---------
--------------------------------------------------------
Type of Work: cuttjp6
_!iS.(j�_�_and grass .................................
Lot Size: -------------------Ordered By 3-Q-Lr� ( i- - - -------
Don C. V-0FCTJ-- 'Un-Torcement
INCH
TO ZONING DEPARTMENT Date Work Performed3
------I------
EQUIPMENT EMPLOYEES hrs.
2w. 144 dVJ * hre.
0
noll'-
3. * hre.
4. * hro.
---------------------- )0k
Comments:
-7-7----- ----------------------------------
S i g n e d 3 ------
Superintendent., '�U�Hii�-Worka
------------------------
COST COMPUTATION
--- -- ------ - ------ - --- - ------ -
1--No. -of-----I-Eq-uipmeni---I-NO. ----l-Amount---1-gub---i-Admin. -I--------- I
I Employees I Used I Hours I Per Hour I Total 1 100% 1 TOTAL I
------------I-------------I-------- ---------- ------- --------I ---------I
Y'�.50 -"e I I
41 /.5�z 1--------- I
------ --------
------------I------------- --------I ------- -------- ---------I
------------ ------------- -------- ---------- ------- -------- ---------
------------ ------------- -------- ---------- ------- -------- ---------I
I
TOTAL BILLED:---j ----------I
Date Billed: ----------- Date Payment Received:...................
CITY OF
Te4d 716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2396
May 22' 1991
HOME' MOrtqul(W
bc—lel;lct
P. 0. Box 3105ti
Lnquna Hills, CA 3105',j
Dt--,.-ir Sir--
I'I U. thc�, LJWIIL�;
I ieucjid.- indicate th�iL YOU aic- ul Lht,�
propterty in the GiLy of A-Liantic Bt-,ach, Fh)L i�dti :
LuL *-A arid South 40 leeL Lut- �, UJL)ck 1W,i
Section H a/k/a 36.1 Miiin SLjt-t-L.
A n investigatioll ol tllif� pl-clp(.�l ty 1, hZ'IVL'
fuuxid and detexmined that. i.i public nu.1Laiwe lh( '] C'Ul� cll,' t,,-'
L--,W-l-3t'iLUtL- a violation L)I S C?G t i L)11 12. 1 U I Ult, ('(jut- co At,J c.t;t.) c
arld that WeedE:: �.lre continuc.iu.-,ly piei:�eiit un tht- piupeit,y.
You are hereby nutilit�,d t I i a t u f i I Llit, c..'oltdition ilbove
dt.-SL.-libC-d i-- I-E.-MC-died within keven (7 ) dziy,.� lAura L,li(-. date
the City will i-eatt2dy Lhis U0xiditiot. �iL, 3 U-1 Lht-, woik plu�:
I��1.1 g 4? Cqual tu 100% of the (.,L)-;t ol t.t W WLIT k t(l (-0 V L-1 I C:-1,t
d;n j.z i I s L r i,�i L i v c- f-xpenssc..'�-" Which w i.1 j be L c-.,�. (?d Lh(-, pl cipt.-, ty
CD w r I(�f or occupi.111L. If not paid wiLhirs thji t,y ( �-u dilyt' aJtL-..l
�-c-c,eipL ol bill�tiiq, t-he Invoic.c. i�v;ounL plut:
wiLl be po,3ted a,- a li(-"rl 011 tll(-
withill f::ev(.-?1l (7) days -fium tht:. dat(� i'lz-jy
wl i'LLell tecjue�'�t t.0 tlic, City LJ tht-, C-iLy (d At J �i ri tj c
13 ea c 11 for a hear ing befox e 0141t I)L�dy, fUl tl(�' �1111 (11 'l-h(lWJ l;Lj
L I i;i t. thL' t-lb0VL- listed corlditioll Ll u j i u L �(11'1;(,..i- li 1,t c pub! I
t I u i�':;u I I c;c
ely,
L)Ll f I C'. F C)f LJ
�;(-lcjk 1-:11 ful
City marlaqk�'l
CITY OF ATLANTIC REACH
SPECIAL INVESTIGATION
TO BE FILLED OU /BY COKPLAINTANT
DATE
ADDRESS
LOCATION
COMPLAINT
OWNER OF PROPERTY
SIGNATURL-OF COMPLA PHONE f
0- ow
--------------
��41L FOR O"Ics USX ONLY
DATE OF INVESTIGATION INVESMATOR
CONDITIONS FOUND
ACTION TAXEN
COMPLIANCE-
NOTES.#
4
CITY -OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS
DEMOLITIONS
Owner (s)
Address: c_ Phone:
......... -------I----------
Lot Block or Unit #Jg�5 Subdivision:
1560
C o n icr a c to
7r
Describe work to be done:---
flou-C-1
---------------------------------------------------------------------------
---------------------- 7--------------------------------- --------
Present use of building :_.�o ---------------------------------
Valuationof Proposed-Cons que t ion: ---------------------- ---------------
Proposed use:-----------------------------------------------------
Is this an addition?--------- If yea, what are the dimenoions of
�Ibe added space:----------ft. X Will the added area
I.,
be heated and cooled? New electrical (or increase) ?-----
New plumbing fixtures?---- New fireplace?----New Heat/AC?--------
SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY.
ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND � OWNER/CONTRACTOR
AFFIDAVIT, IF OWNER IS CONTRACTOR.
Siqnature OWNER Date:-----------
Signature Date:---------
�/j iw_�
3242 17
$HO!"q BOUNDARY SURVEY OF
7'AT 51007"IV WrifiT Dr Z,07' r,09,C7A:!f-X Wl;r,-'l Z,07"3, szoeA� 105, 5&-e-rloAl
"W" 47ZAW7-le,
AS RECORDED IN PLA T BOOK 16 __pA GEs -3 4 OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA
CER 77FIED FOR: 7-AVA4-4.5% Izesr aam.4A�ry rl;rze ec.
Mmwa%SfiMy*A"
*wzy Acm
361 Main St.
(�W-z y
/OZ.001
L44
L44
3r.0'
36 OAIA* s;rogy
IZA4-fdr JW1A1kfZd"
3.r.e.' 4Z.3-
A
;r 3
0.6, Z.od. e,
4
NOT VAUD UNLESS EMBOSSED W7H -'*AL 00F INE UNDERSOVED.
I HEREBY CER77FY THAT TNE-!!�0-7" SHOWN HEREON IS IN 7HE SPECIAL FLOOD HAZARD ZONE— AS SHOWN
ON FLOOD INSURANCE RATE AdAP 00c'/ FOR d7-Z,4AJ7-1e ",4eW, FLORIDA, DA TED 4-17-89
TRIT-STATE LAND SURVEYORS, INC -
8411 BAYMEADOWS WAY SUITE #2, JACKSONOLLE, FLORIDA 32256 (904) 7,31-7235
LECEND I HEREBY CER77F-Y THAT THE ABOVE LANDS WERE SURVEYED UNDER MY I
A CONa MON RESPONSIBILE SUPEROSION AND DIRECTION, THAT THERE ARE NO
PON COR ENCROACHMENTS EXCEPT AS SHOWN AND THAT 77JE SURVEY SHOWN
(MT W"i W I LS 414�) HEREON MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY
nNCE THE FLORIDA BOARD OF LAND SURVEYORS PURSUANT TO SECT70N
AROW OCR.(FOUND) 472.027, FLORIDA STATUTES-
0 CROSS CUT
.PEL HUXDkVG RES7RICnON UNE
Sw7 EASEwENT LARRY G. EDDY, P.L.S. No. 4144
1W RIGN T-OF-WA Y
OV. COPUM AREA SCALE.
j CDVTMWE
/C AM CONN77011MG PAD otl VEYORIYA TE OF F7 ORIDA
RAOM DISTANCE DATE.-
ccwQm7r
/93 PC- 5-3 nR[-)E-R M0 2-167
CITY OF
Ve4d - 57&u�(4
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2395
MEMORANDUM
May 6, 1991
To: William flowell/project Marlaqer St.?(-tLou H
From: Don Ford
R e Code Enforcement
Enclosed is a copy of a complaint refor'r-Ltiq tu hic1h weeds at
361 Main Street. The complainant has reque-.ted that 1 notily the
property owner- to have the gras.-� atid WL�(.'(AF; CUL. P1 I y the
riqht-of-ways of Section H axe hiqher' than L11c. at th-LE�
location and most areas in Section H are twu Lt.i Lhree leet
Please address this problem aL; soon as pu-ssible.
DCF/pa
cc. : City Manager
f:7,, 77'� MEN*OF BUILDING,
OART
C ilty Of ATLANTIC SWH,
LOCATION INFOR14ATTION ---------
PERMIT)", INFORMATION '�--
Nu:,.il��"I Addres,.4,: 361 'MA
p3mit er: 130791
ATLANTIC BEACH '11091DA:
ELECTRICAL
� ,ermit TYPO-
------ - LEGAL DZSCRI#TI1O0,1
Cliss of work ALTERATION
Blocko. Lot '
0"Ons;t 0400DIPRAME
T 1 0 iu
*e
P*oposed 8'0:SINGLE PAMI LY section-.
Subdiv CTION 'H'
V, Dwellings- 01
-4-�,Est- VAIU41
ov, Cost 0 .00
Iftr
A; Total F a O's
25-00
kmount,
' Date
D4 HEAT AND A/C UN ITS"
Ropk D4
411
------�-- APPLICATION FEES -----------
T 25
S11
A:ev- 1,
,
*x
3 2 2 3,3
FLORIDA
aivar ",;X
a
40ne,
R, FORMATIOP
N;me: AL E CTRIC qO
69
4dr. P ' "to
N
.........-11,11.1 1 -4""'FL-"3 694
J
Xxo:
k,4,0040.v
e mt��-- ,�I , i
FM
P
c
4
E POURI a
N jEFdftM$AN0F00TINQSMU6T9E T' 0 IWOR 00
OTIO r1r ALL CONORIST
SSUE
PERMIT VOID SIX MONTHS AFTER DATE,OF-I
NG MA TV,RIAL,RUBB ISH AND DEBOIS FROM THIS WORK MUST NOT BE PLAC D IN PUBLJC SPAd E,AND MUST BE
ED'up,� HAULED AWAY 13-Y EITHER CONTRACTOR OR OWNER
*'FAILUO'C10, COMPLY, WITH THE MECHANICS' LIEN 1AW CAN��AESULT IN,
'ITH T,ly- PRO
y
,R, P
It PRO N - " - L eNTS.
,A �OW f ING TWICETOR SU NG
F R- ' -
ACCOAOING TO I APPROVED PLANS WHICH ARE PART OF,THIS PERMIT AND SUBJECT T6,Af V 0,
T I F
NO
PLICABLE PROVOONS OF LAW.
CksoiLoiNG DEPARTMENT
tLANTIC BEA
CITY OF ATLANTIC. B.EACH, FLORIDA
AcK�rwoecl by APPLICATION FOR ELECTRICAL PERMNIT
TO THE CHIEF ELEMICAL INSPECTOR: DATE:
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WL
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PlANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES, ArD CITY OF
ATLANTIC BEACH ORDINANCES.
All Se_rv4&-.e JElectri(_
ELECTRICAL FIRM: _MASTERIE�LE6fRICIAN
NAME ._'5k4U�jk AD�ESS- 3&1 _S-rree_-T
BLDG.SIZE BETWEEN: es-t I-J S-(ree7 4; tt/, �r4 S7fee'r
RES. APT.( comm.( PUBLIC INDUS. NEW OLD I REW�
ADDITION I ) TRAILEFI ( TEMP. ( I SIGNS ( I FT.
SERVICE: NEW I INCREASE ( REPAIR I FEE
CONDUCTOR SIZE AMPS COPPERJ AlUm.
SWITCH OR BREAKER AMPS PH W VOLT RACEWAY
EXIST.SERV.SIZE AMPS PH -3 W 241() VOLT RACEWAY
I OL
FEEDERS NO. SIZE INO. SIZE
LIGHTING OUTLM CONCEALED OPEN TOTAL
RECEPTACLES *-so AMPS. CONCEALED-.- OPEN TOTAL
SWITCHES
0'*o Al
INCANDESCENT
FLUORESCENT&A&V.
r
FIXED 0-100 ov
APPLIANCES
BELL TRANSF.
AIR H.F.RATING H.P. RATING
CONDITIONING COW.MOTOR OTHER MOTORS AMPS CEIL HLEAT: KW-HEAT
Z
7-S
MOTORS OVER
H.P. VOLTAGE PHS NO. I H.P. VOLTAGE' .. Plis
VISCELLANE F F;;i
ci -r a-0
TRANSFORMERS: UNDER 600 V. OVER 600 V.
V
NO.- K-VA NO. KVA
NO. NEON TRANSF. NO. VA. MOTOR SIZE SWITCH
EACH SIGN VLfA,' E8
FORWARDED
TOTAL FEES
PS� 4
DEPARTMENT OF SUILDWO.
CITY OF ATLANTIC 13EACH
PERRIT INFORMATION ------ ------- LOCATION INFORMATION ---------
14rmit .Numberz 13'046 Address: U
1 MAIN STREET
Pe rmi t' Type-MECHANTCAL ATLANT�x C ,119ACR
FLORIDA 32233
al ass of t4brk*.NZW ------ T216N ------
LE13AL DESCR 1 P
Constr. Type:WOOD FRMS Blocki �Lo't : Twp: 0
FAMILY
rop6s ed 'Vt e S I NOLE
Section'#* Rng: 0
Dwe'llings* 0 Subdi
visioxi SECT ION H
0:.,o 0
mprov. Cott :
Total fti 47 .00
Amo4nt
p NO tw o", te". sereee, iof7
'APPLICATION FEES
Ni
PERMIT
47 .00
A A44
#dr:
a FLORIDA
P 0 0
A
R ORMAT 101
OF c
#�e
AR
AR
AR
AR 0 ;'t
1 30, ON
1 BbVL9iA'RD NORTH
4ACX$O FLORIDA 32211
,_ES.
NOTIC#—ALL CONICRtTIE FORMS AND FOOTINGS MUSTS
PE8M(TVO1D SIX MONTHS AFTER DATE OF ISSUE
BUILDING MATEMAL,RUBBISH AND DEBfl4S.FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,)AND MUST BE
' HAULED AWAYBY' EITHER CONTRACTOR OR OWNER'
CtEAREb uPANjD
LU E H
R, 0 1COM PLY WIT THE. MECHANICS!:LIEN LA " '4`0
W .CA 1,14ULT IN
TY DI
;H PRO EA,PAYING TWICE. FORBUIL RGIM
COR
1,%UED AC NGG TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT 600now
FOR
LAT) YF�E
V J CABLE PRQVISjQNS OF LAW.
442,22
WJV610
77-
AT��A�TIC
77,'77
BUILDING AND ZONING I'NSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FLORIDA 32233
APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER
IMPORTANT Applicant to complete all items in sections 1, 11, 111, and IV.
Street Address: 4-1"0 e,
LOCATION ?Z 4 I—q
OF Intersecting Streets: Between And
BUILDING
Sub-division
11. IDENTIFICATION — To be completed by all applicants ,
In consideration of permit given for doing the work as described in the above statement we hereby agree to perform said work in accordance
with the attacked plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards
of good.practice listed therein.
Name of Mechanical Contractors
Contractor I Print) A I/- �cl-X Master C A ( C)
Name of
Property Owner 61-A 0 m- A_1� le�S
Signature of Owner Signature of
or Authorized Agent Architect or Engineer
Ill. 4MERAL INFORMATION
A, Type of heating fuel:
IS OTHER CONSTRUCTION BEING DONE ON
J�-Elioctric THIS BUILDING OR SITE7
C3 Gas—0 LP [3 Natural C3 Control Utility
IF YES, GIVE NUMBER OF CONSTRUCTION
C] Oil PERMIT
C3 OtIter — Specify
IV. MICH�NICAIL EQUIPMENT TO BE INSTALLED NATU -WORK
(P v, complete list of components an back of this form) 1708 e=d'e n t I a I o r 0 Commercial
0 Space C) Recessed 0 Central 0 Flow 11 New Building
��'Conditioninq: E3 Room (3 Central 0 Existing Building
%-Dvct System: Material Thickness L Peptafe—ment of existing system
Maximum capacity c.f.m. 211"New Installation(No system previously Installed)
Cl Refrigeration El Extension or add-on to existing system
0 Other - Specify
0 Cooling tower: Capacity 9-pi".
C] Fire sprinklers: Number of heads
0 Elevator 13 Monlift E3 Escalato (number) THIS SPACE FOR OFFICS USE ONLY
0 Gasoline pumps -(number)
(3 Tanks (number) Remarks
LPG containe
Unfired pressure vessel
(3 Boilers Permit Approved Defe-
b Other — Specify Permit Fee
1J8T ALL EQUIPMENT
AM CONDITIONING AND REFRIGERATION EQUIPMENT
C& Approvilng
,_Padty
Number Units Debeription Model Number Manufacturer (T*fA) AC=Cy
C'.3 4573"07 3-4-0tXiv I y-z- C12 L_
HEATING - FURNACES, BOILERS, FIREPLACES
capsicity AMMftg
Number Units Description Model Number Manufacturer (VTU) ASWW
A:ZAJ�' -0 i 1A 0 1 JOS>— 01L_
TANKS
Now Many NmAnal Capacity Type Uquid Name of Serial Approving
and Dinminsions Contained Manufacturer No. AVaCy
FOR OFFICE USE ONLY
Date......//__..7Y_r195._9
A, 71/ - '00
Permit #A/f /Fee$...
1-..............
TOWN OF ATLANTIC BEACH Valuation ..............
'Affilk
FLORIDAHouse #------------------------------------------------- ------
5-6-1........" ia--- -----
APPLICATION FOR BUILDING PERMIT -----------------------------------------------------------------
-----------------------------------------------------------------------
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the Town of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the Town of Atlantic
Beach and all rules and regulations of the Building Department of the Town of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the Town of Atlantic Beach, Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can
be verified. V
Dat------ --------------------------------
--------I--- --—------------Address---
-37- Z- WF4,Vk,Q_'_-----Telephone NojC ...q
---------------------- ---------
Architect_)6-x"- ------------------------------Address---Z_i,
Contractor Builder'&-a Y 24y---- -------Address------_.i--------- I-------...... --------------Telephone No..--.---If#---------------
Lot No.;----- ___Z--- 3 -----------------Block No.___14?45�---------------Sub ------Zone.---------------
-------------
------s-—A 7------------------Street----AJC�T!+_.Side Between---a------ ------------------------------and---- I ------�Sts.
Valuation $------------------------------Yor what purpose will building be construction-iC-CPA-IZ.--S-.-,A.N.Y-iF-
- - i�-------Type of
Dimensions of Building.4-0___'?L_4-_Z-------------Dimensions of Lot--- -------------------Size of Footings------------------- ----------
Size of Piers_--------------------------------Size of Sills------------------------------Greatest Sill Span in ft-------------------__---Type Roof.------------- --------------
How will Building be Heated?---------------_-------------------------------- ------Will Building be on Solid or Filled Ground?----------------------------------------
Size of Ceiling Joists----------------------------------------- Distance on Centers---------- -------------------------------- Greatest Span.------------------------------------_-_- I I
Size of Floor Joists-------__--------------__------------------Distance on Centers.-------- -------_-----------------.-., Greatest Span------------------------------------------- It
Size of Rafters-------------------------------------------------.., Distance on Centers....... --------------------------- Greatest Span----------------_-----------_-------.... ..
This rectangle is to represent the lot.
Locate the building or buildings in the
right position. Give distance in feet from
all lot-lines and existing buildings.
REAR LOT LINE
Two copies of plans and specifications shall
be submitted with application.
Inspections required.
1. When steel is in place and ready to pour footing.
2. When steel is in place and ready to pour columns and/or lintel. Z
3. When steel is in place and ready to pour beam.
E-1
4. When framing is completed.
5. When rough plumbing is completed,and ready to cover up.
6. When septic tank drain field is laid but before it is covered.
7. Electrical inspection by City of Jacksonville.
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called forafter
corrections are made.
FRONT OF LOT
In consideration of permit given for doing the work aif described in the above statement, we hereby agree to perform said
work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building
regulations of the Tow-nAJ Atlanti B-ea .
2— -----------------------
-------------------
. ....... . .....t�
... ......
Signature of Builde!A�_ t Y" o ........ Address7z
Signatureof Owner- ------------------__-----------------------_ ----------- ------------------- Address--------------------------------- --------------------------------------------........
Instructions to Builders and Contractors building or working in the
Town of Atlantic Beach
1. No work on any building *hall be started without obtaining the
necessary permit.
2. No changes in the approved plan shall be mido without the approval
of the building inspector.
3. Inspectionst The following inspections shall be called for*
A. Foundation, when steel Is in place.
a. Plumbing,, cough.
C. Lintle, when steel is in place.
D. Framing, before any wall covering is placed.
R. Electrical, City of Jacksonville.
F. Septic Tank or Sewer, before covering.
G. Plumbing, final.
H. Final, when all work is complete.
Any concrete poured or work covered without the necessary inspection
shall be removed or uncovered at the request of the Building Inspector.
4. After the final inspection and upon submission of a drawing showing
the size and location of completed building on lot to the Building
Inspector a Certificate of Occupancy shall be issued. No building
shall be occupied before said certificate is issued.
5. Plumbing permit does not cover sower connection permit.
6. All contractors and sub-contractors shall have occupational license
issued by Town of Atlantic Beach before doing any work within the
Town Limits. Contractors shall furnish certificate of liability
insurance when obtaining license.
7. The penalty for violation of any provision of the Building Code or
of Ordinance #186, shall upon conviction thereof be punished by fine
not exceeding $500.00 or imprisoment. for not exceeding 90 days, or
by both such fine and imprisonment.
8. Copies of The Southern Standard Building Code and Ordinance #186
are available at the Town Hall for reference.
9. When a sidewalk exists across front of- building lot, said sidewalk
shall be placed in first class condition before final inspect-ion
is requested.
I have read and been furnished a copy of above instructions
in connection with Building Permit No.
Date Signed L/."
4--A- 4L-
OT
METF-R DATE INS"Nil.3.1,U) 7- 3-
7�
C'Cl A111:2 1-e
CITY OF
ATLANTIC BEACH No. 5402
FLORIDA
6/6/ —19 79
NAME Ralph Kinman
ADDRESS 361 Main Street
CITY Atlantic Beach
Acct.# 40-0343-3700 Water Connection Charge 243-33
-H
When Signed, Dated and Num6ered, This Becomes an Official Receipt
MAKE CHECKS PAYABLE TO Received Payment
CITY OF ATLANTIC BEACK, FLORIDA TREASURER
CITY OF
"me, &&4 - Rdia"
716 OCEAN BOULEVARD—DRAWER 25
ATLANTIC BEACH. FLORIDA 32233
June 5, 1979
FROM: City of Atlantic Beach, Florida
P. 0. Drawer 25
Atlantic Beach, Florida 32233
TO: Mr. Ralph Kinman
FOR EXTENSION OF WATER SERVICE TO 361 Main Street, Atlantic Beach
Extension Cost $ 133.33
Meter Charge 85.00
Per Fixture Unit Charge 110.00
TOTAL AMOUNT DUE $ 328.33
WILLIAM S. HOWELL JAMES E. MHOON ALAN C. JENSEN L. W. MINTON, JR. CATHERINE G. VAN NESS
Mayor-Commissioner Commissioner Commissioner Commissioner Commissioner
BILL M. DAVIS OLIVER C. BALL MRS. ADELAIDE R. TUCKER CARL STUCK[ RICHARD HILLIARD
City Manager City Attorney City Clerk-Treasurer-Comptroller Chief of Police Director of Public Works
and Fire Department
1< PM VN
SENDE orplete items 1 and 2 when additional services are desired, akd cohioeto its a
�and 1. 19 9 1
Put your ad&ess in the"RETURN TO"Space on the reverse side.Failure to do this wi r ant ' ro
from being returned to you.The return receiRt fee will provide you the name of the verson ' and
ft date of deliverX. For addifflonal tees the tollowing services are available.Consult postmRMFfor tees
and eck box(es)for additional service(s)requested.
1.)M%Show to whom delivered date,and addressee's a 0 es. 2. El Restricted Delivery
Tiw� V I (Extra charge)
3. Article Addressed to: 4. Article Number
Type of Service:
0 Registered Insured
;kCe�lfied COD
, 'I Ret n Re t
Ex s aj for AlerchanTs,
z il Always obtain signature of addressee
or agent and DATE DELIVERED.
5. Signature —Addrds4e 8. Addressee's Address (ONLY if
x requested and fee paid)
6. Sig rik,—Ment
i 01
a
ow ate if D
r
iForm 38 A%181 "T *U.S.G.P.O.1909-238-816 DOMESTIC RETURN RECEIPT
111 _
CITY OF
.4&6a4-c Be=4-494ukal
Office of Building Official
REQUEST FOR INSPECTION
Date Permit No.
Time A.M.
Received PM..
2
Job ddre ality
Owner's
Name Cl actqT-
BUILDI/ C04CRETE LECT PLUMBING MECHANICAL-)
Framing Footing Rough Wiring Rough
Re Roofing Slab
Temp Pole 0 Top Out E Heating
Insulation Lintel Final — Sewer Fire Place E
Pre Fab
READY-F.W INSPECTI Friday—_gA MD
Mon. Tues. 0&-r -
Inspection Made P.M.Final Inspecti
lnspecto.r_ Certificate of�X..pancy
Date