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Permit Remodel 1923 A Beach 2011 A kisl CI 1 f CITY OF ATLANTIC BEACH 0 800 SEMINOLE ROAD J ,r � �1 ATLANTIC BEACH, FL 32233 Fl i O > � � INSPECTION PHONE LINE 247 -5814 .rs4 Application Number 11- 00002745 Date 10/12/11 Property Address 1923 BEACH AVE A Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 63000 Application desc windows, doors exterior trim Owner Contractor HASTINGS THE GELLATLY COMPANY 1923A BEACH AVENUE P 0 BOX 51393 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 (904) 993 -5014 Permit RESIDENTIAL ALT /OTHER Additional desc . Permit Fee . . . 332.00 Plan Check Fee . . 166.00 Issue Date . . . Valuation . . . . 63000 Expiration Date . 4/09/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Other Fees STATE DCA SURCHARGE 4.98 DEV REVIEW - SINGLE & 2 -FAM 50.00 STATE DBPR SURCHARGE 4.98 Fee summary Charged Paid Credited Due Permit Fee Total 332.00 332.00 .00 .00 Plan Check Total 166.00 166.00 .00 .00 Other Fee Total 59.96 59.96 .00 .00 Grand Total 557.96 557.96 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. IdUILVJf rLK1V11'I' INITLICA CITY OF ATLANTIC BEACH ` 800 Seminole Road, Atlantic Beach, FL 32233 "' A Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 1923 Beach Avenue, Atlantic Beach, FL 32223 Permit Number: ' Legal Description Lot 51, North Atlantic Beach, Parcel # Unit 2 ' �'� � " Floor Area of Sq.Ft. approx. 1400 • J. . $ Valuation of Work $ 63,000 Proposed Work heated /cooled non- ' !► • : /coded approx. , 150 — --1. - porch Class of Work (circle one): New Addition Alteration(Repair Move Demolition pool/spa window /door Use of existing/proposed structure(s) (circle one): Commercial cRgsident'al If an existing structure, is a fire sprinkler system installed? (Circle one): Yes o N /A Florida Product Approval # will use form For multiple products use product approval o Describe in detail the type of work to be performed: Remove and replace the windows, doors, siding, and exterior trim. All work is to the existing structure. No new foundation or work outside the existing footprint. Property Owner Information: Name: Melanie & Richard Hastings Address: 41280 Rue Jadot City Temecula State CA Zip 92591 Phone 951- 676 -8850 E -Mail or Fax # (Optional) socalmelanie @msn.com Contractor Information: Company Name: The Gellatly Company Qualifying Agent: William R. Gellatly Address: 1515 Penman Rd., Suite B City Jacksonville Beach State FL Zip 32250 Office Phone 904- 246 -9080 Job Site/ Contact Number 904 - 993 -5014 Fax # 904 - 246 -9200 State Certification/Registration # CGCA21737 Architect Name & Phone # William A. Leuthold 904- 389 -5456 Engineer's Name & Phone # Chris Kathe 808 - 322 -9494 Fee Simple Title Holder Name and Address same as owner Bonding Company Name and Address N/A Mortgage Lender Name and Address N/A 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 sir (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical World 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 BEFORE RECORDING YOiJR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this a plication and lauow 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 reg. lalin: construction or the performance of construction. (, Signature of Owner /,/ (' '� 4 Cv� r ti ` �- Signature of Contractor°, ` Print Name / (6 7{--A-- �k.(G P rint Name 1 t' Ct (\A ( l i ( Swo . and ubsc:bee b- ore I e S worn t . i ' ' ila • - 7 . t o an sub dr b efore t f — [. th o X f f - H , ''.M ._ Y 201 {' o rilA 4 EY . �y 1 Alliffig ----- otary bhC o r 7:11:deci:4717uSici°Ft ebru i►�, � ' r 1C a ary 14, 2014 . ` , KELLIE FULLER LL ' .:°'''..!:::''' `°' � YNubli cunderw ri te l �,. ,► � COMM. # 1941865 +A R: ised 01.26.10 N . : - NOTARY PUBLIC-CALIFORNIA N `� � � / RIVER SIDE Cowin Mr Coin . EMP. SEPT. 8, 2015'` -s= .r City of Atlantic Beach r 1 r :�� Building Department APPLICATION NUMBER (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233 -5445 J 1 - Phone (904) 247 -5826 • Fax (904) 247 -5845 � 7 W0" E-mail: building- dept @coab.us Date routed: r�' /!1 /%/ City web -site: http: / /www.coab.us / APPLICATION REVIEW AND TRACKING FORM Property Address: / ' --1 /r -A Department review required Yes No / Ouilding --j �7 Applicant: / t 4zz ll ?/r tan &Zoning Tree rninistrator Project: /t- 7) e l / j s L. Public Works Public Utilities - / i j j j y) Public Safety Fire Services Review fee $ - ; i Dept; Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection /0/1/20 1 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: `LANNING & ZONING Reviewed b : /' «C7/ Y il �� yr Date: �G TREE ADMIN. Second Review: (Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: pApproved as revised. ❑Denied. Comments: FILE cno Reviewed by: Date: Revised 05/14/09 IL E C OPY y ! 4 .N:r i , ; , City of Atlantic Beach APPLICATION NUMBER IfrnDepartment j 1 , Building (To be assigned by the Building Department.) ^ �. 800 Seminole Road r. Atlantic Beach, Florida 32233 -5445 Phone (904) 247 -5826 • Fax (904) 247 -5845 it 0 E -mail: building- dept @coab.us Date routed: �p // City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /9c' 4'ta e h ,4 ref - ft Depedment review required Yes No uildinc Applicant: T//6 4Zzd.-7L* �D/I�` y tannin & Zoni / Tree dminis rator Project: t / Th be ix - D-Po es Public Works Public Utilities 10 0 Tr/in Public Safety Fire Services I tam fl t ' H'N� 4 h F�' G � � �, 8 �* " � W E ' 9�a f Id h fg �} ,ry�1 n �;,. � � � y� [ f T III �. E *41-47b V ee $ I��'?I. t�� .fir "k , �'k�"� ��P�'*i!+G ��j "�P';h."U ept ina 1 "'�ii :iF.uh + � °`� �. ��� � , 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: Q pproved. ❑Denied. (Circle one.) Comments: BUILDIN PLANNING & ZONING Reviewed by: /7 Date: /0 - 10 --/' 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 05/14/09 THE GELLATLY COMPANY LICENSE NUMBER CGCA21737 1515 -B PENMAN ROAD JACKSONVILLE BEACH, FLORIDA 32250 PHONE: 904 - 246 -9080 FAX: 904 - 246 -9200 thegellatlyco @bellsouth.net MEMORANDUM TO: City of Atlantic Beach Building Department FROM: William R. Gellatly DATE: October 6, 2011 RE: Hastings Guest House 1923 Beach Avenue Atlantic Beach, FL 32233 To Whom It May Concern, The foundation and house footprint are not being enlarged. No existing trees will be removed from the lot as part of this construction permit and landscaping is being installed as part of the main house project already permitted. Thank you, Bill 1 of 1 Page 1 of 3 William Gellatly From: Cindy Gardner [cgardner0814 @yahoo.com] Sent: Thursday, April 08, 2010 4:48 PM To: gellatlyco @bellsouth.net City of Atlantic Beach Planning and Zoning Department Subject: Fw: 1923 Beach Avenue, Atlantic Beach / Statu ory exemption language Ms approval vermei compnance r lth applicable zoning, subdivision and other local and development regulations, but does not constitute approval for the issuance of permits. Compliance with Florida Building Code and all other applicable Forwarded Message - - -- local, State and Federal permitting requirements From: "Jones, Valerie" <Valerie.Jones @dep.state.fl.us> Beach Building Official must be u pr or to the City ance of a Building To: Cindy Gardner <cgardner0814 @yahoo.com> Building Permit alb Sent: Thu, April 8, 2010 4:09:46 PM Approved By: e Subject: RE: 1923 Beach Avenue, Atlantic Beach / Statutorypwmption l anguage e l u;i�e tor Hi Cindy & Bill, Please see the following guidance I sent out recently to someone regarding work possibly qualifying for an exemption from permitting from the CCCL program. Please call or email me with any questions. Florida's statutes and rules can be found at: https : / /www.flrules.org /Default.esp or http: / /www.leg.state.fl.us /statutes/ Coastal Construction Control Line (CCCL) Program / DEP Authority: Chapter 161, Florida Statutes The Legislature wrote this portion of statute (see below) with the intent to describe the types of structures and /or activities that may be considered "exempt" from CCCL requirements by virtue of their minor nature — see Section 161.053(12), Florida Statutes, below. Paragraph (a) is intended by law to be self- executing by virtue of the wording used. Therefore, if an applicant and the local governmental entity believe that the proposed work fits the statutory exemption, a determination by the Department is not required. However, paragraph (b) is not self- executing by virtue of the wording used; i.e., an exemption must be determined by the Department in writing. Paragraph (c) is also not self- executing by virtue of the wording used; an exemption must be determined by the Department in writing as well. Please see the statute section below. Section 161.053(12), Florida Statutes (a) The coastal construction control requirements defined in subsection (1) and the requirements of the erosion projections pursuant to subsection (6) do not apply to any modification, maintenance, or repair to any existing structure within the limits of the existing foundation which does not require, involve, or include any additions to, or repair or modification of, the existing foundation of that structure. Specifically excluded from this exemption are seawalls or other rigid coastal or shore protection structures and any additions or enclosures added, constructed, or installed below the first dwelling floor or lowest deck of the existing structure. (b) Activities seaward of the coastal construction control line which are determined by the department not to cause a measurable interference with the natural functioning of the coastal system are exempt from the requirements in subsection (5). (c) The department may establish exemptions from the requirements of this section for minor activities determined by the department not to have adverse impacts on the coastal system. Examples of such activities include, but are not limited to: aioi ')nt Page 2 of 3 1. Boat moorings; 2. thru 9. [see statute] I trust this explanation will suffice as sufficient documentation for purposes of local government review. Please feel free to email or call me with any questions. If you do not believe the proposed work fits under the self- executing exemption in paragraph (12)(a), then additional information will be required to be submitted for review of the proposed project so that a determination can be made for either an exemption or some other form of authorization. Sincerely, Valerie * * * * * * * * * * * * * * * * * * *, * * * * Valerie Jones, Permit Manager Coastal Construction Control Line Permitting Bureau of Beaches and Coastal Systems FL Dept. of Environmental Protection 3900 Commonwealth Blvd., MS 300 Tallahassee, FL 32399 -3000 Phone: 850/921 -7849 Fax: 850/488 -5257 www.floridadep.org/beaches/ Cover Florida, developed by Governor Charlie Crist and the Florida Legislature, gives Floridians access to more affordable health insurance options. To learn more or to sign up for email updates, visit www.CoverFloridnHealthCare.com. CITY OF ATLANTIC BEACH L PLAN REVIEW SHEET Building Department 800 Seminole Road Atlantic Beach, FL 32233 904- 247 -5826 PLAN REVIEW COMMENTS Permit Application # / 2 7 y 5" Property Address / /3e c f /cc. -e Applicant: l,6 . el / fl C'o Project: 1 /'i' -1 '+10 4 ProoK S -PJc /e tia/Z P/ )1-► Review Result (Circle one): Approved Disapproved Approved w /Conditions Review Initials/Date Development Size: Habitable Space Non - Habitable Miscellaneous Information : Occupancy Group Type of Construction Number Of Stories Max. Occupancy Load Fire Sprinklers Required Flood Zone Tod /2/r BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 4J 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 A /�@ U .� „ 1 Job Address: 1923 Beach Avenue, Atlantic Beach, FL 32223 Permit Number: /1 n ,� Legal Description Lot 51, North Atlantic Beach, Unit 2 Parcel # 06 ZOii 1/1 Floor Area of Sq.Ft. approx. 1400 • :: Valuation of Work $ 63,000 Proposed Work heated /cooled non- ,••.,. l I ro r _ .. Class of Work (circle one): New Addition Alteration CRepair Move Demolition pool/spa window /door Use of existing/proposed structure(s) (circle one): Commercial sidentiat If an existing structure, is a fire sprinkler system installed? (Circle one): Yes o N /A Florida Product Approval # will use form For multiple products use product approval orm Describe in detail the type of work to be performed: Remove and replace the windows, doors, siding, and exterior trim. All work is to the existing structure. No new foundation or work outside the existing footprint. Property Owner Information: Name: Melanie & Richard Hastings Address: 41280 Rue Jadot City Temecula State CA Zip 92591 Phone 951- 676 -8850 E -Mail or Fax # (Optional)_ socalmelanie @msn.com Contractor Information: Company Name: The Gellatly Company Qualifying Agent: William R. Gellatly Address: 1515 Penman Rd., Suite B City Jacksonville Beach State FL Zip 32250 Office Phone 904 - 246 -9080 Job Site/ Contact Number _904- 993 -5014 Fax # 904 - 246 -9200 State Certification/Registration # CGCA21737 Architect Name & Phone # William. A. Leuthold 904 -389 -5456 .,,.4/46~41,,1r,,,, Engineer's Name & Phone # Chris Kathe 808- 322 -9494 Fee Simple Title Holder Name and Address same as owner - Bonding Company Name and Address N/A r i L E copy Mortgage Lender Name and Address N/A ! 66.. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or iris' nsta atton s commence 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. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Weis, Pools, F urnaces, 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 BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this p 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 rovisions of any other federal, state, or local law re • . latin • construction or the performance of construc Signature of Owner A ' - Signature of Contractor Print Name it /6 7. 07- Alb Print Name # 1 '' . (,AN « ( 11� (1 SWOT • and e ubsc b ore e Sworn b.�efor• •.e . ' lla ; •f O , [ 1. r z t A_ y of': 20C Al / v ?HiR EYC G _ jv.�� �— ' otary ' blic _ fi r non F�bivl _,AAH "p � .r o- fRES: Feo t r' ;OPu i is KELUE FULLER _”' °f3 ryN °btcUntl � ''‘,:i--.4.-- . ► _; CohtM. # 1947865 t i ised 01.26.10 In NOTARY PUBLIC•CALIORNIA w 4 RIVERStOE C OUNTY — MY CoNN. Ez►. SEPT. 9, 2915 Page 1 of 3 William Gellatly From: Cindy Gardner [cgardner0814 @yahoo.com] Sent: Thursday, April 08, 2010 4:48 PM To: gellatlyco @bellsouth.net Subject: Fw: 1923 Beach Avenue, Atlantic Beach / Statutory exemption language Forwarded Message - - -- From: "Jones, Valerie" <ValerieJones @dep.state.fl.us> To: Cindy Gardner <cgardner0814 @yahoo.com> Sent: Thu, April 8, 2010 4:09:46 PM Subject: RE: 1923 Beach Avenue, Atlantic Beach / Statutory exemption language Hi Cindy & Bill, Please see the following guidance I sent out recently to someone regarding work possibly qualifying for an exemption from permitting from the CCCL program. Please call or email me with any questions. Florida's statutes and rules can be found at: https : / /www.flrules.org /Default.asp or http: / /www.leg.state.fl.us /statutes/ Coastal Construction Control Line (CCCL) Program / DEP Authority: Chapter 161, Florida Statutes The Legislature wrote this portion of statute (see below) with the intent to describe the types of structures and /or activities that may be considered "exempt" from CCCL requirements by virtue of their minor nature — see Section 161.053(12), Florida Statutes, below. Paragraph (a) is intended by law to be self- executing by virtue of the wording used. Therefore, if an applicant and the local governmental entity believe that the proposed work fits the statutory exemption, a determination by the Department is not required. However, paragraph (b) is not self- executing by virtue of the wording used; i.e., an exemption must be determined by the Department in writing. Paragraph (c) is also not self- executing by virtue of the wording used; an exemption must be determined by the Department in writing as well. Please see the statute section below. Section 161.053(12), Florida Statutes (a) The coastal construction control requirements defined in subsection (1) and the requirements of the erosion projections pursuant to subsection (6) do not apply to any modification, maintenance, or repair to any existing structure within the limits of the existing foundation which does not require, involve, or include any additions to, or repair or modification of, the existing foundation of that structure. Specifically excluded from this exemption are seawalls or other rigid coastal or shore protection structures and any additions or enclosures added, constructed, or installed below the first dwelling floor or lowest deck of the existing structure. (b) Activities seaward of the coastal construction control line which are determined by the department not to cause a measurable interference with the natural functioning of the coastal system are exempt from the requirements in subsection (5). (c) The department may establish exemptions from the requirements of this section for minor activities determined by the department not to have adverse impacts on the coastal system. Examples of such activities include, but are not limited to: aionn1 n Page 2 of 3 1. Boat moorings; 2. thru 9. [see statute] I trust this explanation will suffice as sufficient documentation for purposes of local government review. Please feel free to email or call me with any questions. If you do not believe the proposed work fits under the self- executing exemption in paragraph (12)(a), then additional information will be required to be submitted for review of the proposed project so that a determination can be made for either an exemption or some other form of authorization. Sincerely, Valerie * * * * * * * * * * * * * * * * * * * * * * * * * Valerie Jones, Permit Manager Coastal Construction Control Line Permitting Bureau of Beaches and Coastal Systems FL Dept. of Environmental Protection 3900 Commonwealth Blvd., MS 300 Tallahassee, FL 32399 -3000 Phone: 850/921 -7849 Fax: 850/488 -5257 www.floridadep.org /beaches/ Cover Florida, developed by Governor Charlie Crist and the Florida Legislature, gives Floridians access to more affordable health insurance options. To learn more or to sign up for email updates, visit www.CoverFloridaHealthCare.com. THE GELLATLY COMPANY LICENSE NUMBER CGCA21737 1515 -B PENMAN ROAD JACKSONVILLE BEACH, FLORIDA 32250 PHONE: 904 - 246 -9080 FAX: 904 - 246 -9200 thegellatlyco @bellsouth.net MEMORANDUM TO: City of Atlantic Beach Building Department FROM: William R. Gellatly DATE: October 6, 2011 RE: Hastings Guest House 1923A Beach Avenue Atlantic Beach, FL 32233 To Whom It May Concern, Attached are the following items for permitting the above referred project: Description Copies 1. Notarized Permit Application 1 2. Sealed Plans and Engineering 3 3 Unsealed -P1a4 s and Engineering- f dcliver-ec sepafatoly4. —F- 4. Florida Product Approval Sheet 4 5. Landscaping and Tree Removal Letter 1 6. DEP Letter 1 Thank you, Bill 1 of 1 OCT-12 -2011 11:21 FROM: CLERK OF COURTS 904 270 1512 TO:92475945 P:1/1 !4 Doe # 2011221202, OR 6K'15738 Page 355. Number Pages: 1 Recorded 10112!2011 at 11:38 AM, JIM FULLER CLERK CIRCUIT COURT DIJVAL NOTICE OF COMMENCEMENT, COUNTY RECORDING $10.00 Permit No, (L� a , Tax. Folio No. THE UNDERSTGN1'sD 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 intormation is provided in this NOTICE OF COMMENCEMENT. 1.Descriptien of property (legal description): Lot 51, North Atlantic Beach Unit 2 a) Street (lob) Address: 1923A Beach Avenue, Atlantic Beach, FL 32233 2.Gcncral description of improvements: Remove and replace the windows, doors, siding, and exterior trim. All work is to the existing structure. No new foundation or work outside the existing footprint. 3.Owncr Information a) Name and address: Melanie and Richard Hastings, 41280 Rue Jadot, Temecula, CA 92591 b) Name and address of fec simple titleholder (if other than owner) c) Interest in property: Fee Simple . 4.Contractor Information t° e 6 I,a) Name and address: The Gellatly Company (William R. Gellatly), 151.5 Penman Rd_, Suite B., Jacksonville Beach, FL 32250 t ° V'r b) Telephone No.: 904 -246 -9080 Fax No (Opt.): 904- 246 -9200 5.Surcty information a) Name and address: N /A, b) Amount of Bond: ^ c) Telephone No_: Fax No. (Opt.) 6.Lendcr a) Name and address: N/A 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: N/A b) Telephone No.: Fax No. (Opt.) 8.1n. addition to himself, owner designates the following person to receive a copy of the tienor's Notice as provided in Section 7I3.13(1)(b), Florida Statutes: a) Name and address: N/A b) Telephone No.: Fax No. (Opt.) 9.Expiration date of 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 DE RECORDED AND POSTE!) 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 NOTI E OF COMMENCEMENT. • STATE OF ammo DA _ COUNTY OF DUVAL, 10, „ , Signature o1'Owner orOwner'q Authorized Officer/Director artner/Managcr L C - Print Name T.h .fore instrument was acknowledged instrknowleddge foie me this t� day of CDC , 2011 , by � nl } f g rte — f authority, e.g. officer, trustee, attorney in fact) for (name o f• ii • , . , If of whom instrument was executed). Personally Known OR Produ� den Notary Signature _, Type of Identification Produced 11 cffJ ,_ ame (print) r 1 'HIE w if' //''�� OR Verification pursuant to Section 92.525, Flo ' • • 5 .. . rider penalties of perjury, I declare that T have read the foregoing and that the facts stated i t a true the best -of my .•i + : . • - _ PORMStMOC ,rvnd20l0 r Mk Signature nr Natural Person Signing (in t int # 10. ,ove ,4 )(ELLIE FULLER 1 . . _ , � CoAIM.I 9947865 w ” a` " WAY w911C•CAtIFO MA fn ` f Rrvaaarolt Carton • _ •.r MY COMM. E. SEPT. 9, 20t5 Q .. o o It 74 0 a w d A ° a.) a4 CS 3-1 0 O • . o 4t W 'ti § p �+ N 00 et tr) 00 N — x CO 0 04 4 • V y Cw•, 1 C. A H w U U O CL) i U V) V) 1 LAO i �� y � n o n r.4 v) �' co O U w bA a CL) tl) (1) 0 Lam i Q. y a O ......— V] VI C/) Cn A. , r.-3 ii cn c'' O O ; ,t © O Z ¢ bA L." 1 O. ° A N d i ': A &t, t. t. g a as � 3 a Q ` GO • w O b ,WA, w Q O 6 Q., Q. cn ��� A 4 z ( t __' n c' . •- S ^o O ,, 3 o z 0 c a C7 5 A. 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U a A ) .5 U U 2 L F+ U O ik.. , ' ‘ re (-- CITY OF ATLANTIC BEACH 0 800 SEMINOLE ROAD :.) z ATLANTIC BEACH, FL 32233 ' INSPECTION PHONE LINE 247 -5814 C),l3 >% ____ Application Number . . . . . 11- 00002745 Date 1/25/12 Property Address 1923 BEACH AVE A Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 63000 Application desc windows, doors exterior trim Owner Contractor THE GELLATLY COMPANY P 0 BOX 51393 JAX BEACH FL 32240 (904) 993 -5014 Permit PLUMBING PERMIT Additional desc . Sub Contractor . NORTH SHORE PLUMBING LLC Permit Fee . . . 153.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 7/23/12 Special Notes and Comments also interior wiring *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Other Fees STATE PLBG DCA SURCHARGE 2.30 STATE PLBG DBPR SURCHARGE 2.30 Fee summary Charged Paid Credited Due Permit Fee Total 153.00 153.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.60 4.60 .00 .00 Grand Total 157.60 157.60 .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: l / c)3 - keteA 11 (/ A • PERMIT # i ( — 27 L) 5 NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTR' Bathtub t Septic Tank & Pit Clothes Washer 1 Shower Dishwasher Shower Pan .- Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 3 Hose Bibs 2. 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 a"' vinlate the provisions of any other state or local law regulation construction or the performance of construction. //72 Property Oers Name h n g 5 7 % Phone Number Plumbing Company i'V D ,-t H t '.e-" 7/ u 6 • ' Off Phone Fax Co. Address: City J )11.0 State Fl, Zip License Holder (Print): \-L. 51„mr --- v,,rv, ) al State Certification/Registration # C-FC_ 1' 14473 l ► \ Notarized Signature of Lice — — .: : - =_ .�., �fb4„, _ 1 ( N. � ` , . y ' . d e h of 20 /Z- Balled Thru Nota Public Underwriters i / � S A S \yx "�' CITY OF ATLANTIC BEACH s3 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 N Application Number 11- 00002745 Date 1/31/12 Property Address 1923 BEACH AVE A Application type description WINDOW AND /OR DOOR Property Zoning TO BE UPDATED Application valuation . . . 63000 Application desc windows, doors exterior trim Owner Contractor THE GELLATLY COMPANY P 0 BOX 51393 JAX BEACH FL 32240 (904) 993 -5014 Permit MECHANICAL HVAC PERMIT Additional desc . Sub Contractor . ENVIRONMENTAL A/C SERVICES,INC Permit Fee . . . 95.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 7/29/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Other Fees STATE MECH DCA SURCHARGE 2.00 STATE MECH DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 95.00 95.00 .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 FLORIDA BUILDING CODES. AMU LEM This combination qualifies for a Federal Energy C E RTI FI E DTM Efficiency Tax Credit when laced in service www.ahridirectory.org between Feb 17, 2009 and Dec 31, 2011. Certificate of Pro Ratings AHRI Certified Reference Number: 4385450 Date: 1/31/2012 Product: Split System: Heat Pump with Remote Outdoor Unit - Air - Source Outdoor Unit Model Number: 4TWR5030E1 Indoor Unit Model Number: *AM7A0C36H31 Manufacturer: TRANE Trade /Brand name: XR15 WEATHERTRON Manufacturer responsible for the rating of this system combination is TRANE Rated as follows in accordance with AHRI Standard 210/240 -2008 for Unitary Air - Conditioning and Air - Source Heat Pump Equipment and subject to verification of rating accuracy by AHRI- sponsored, independent, third party testing: Cooling Capacity (Btuh): 32200 EER Rating (Cooling): 13.50 SEER Rating (Cooling): 16.25 Heating Capacity(Btuh) @ 47 F: 29600 Region IV HSPF Rating (Heating): 9.50 Heating Capacity(Btuh) @ 17 F: 17700 *Ratings followed by an asterisk ( *) indicate a voluntary rerate of previously published data, unless accompanied with a WAS, which indicates an involuntary rerate. DISCLAIMER AHRI does not endorse the product(s) listed on this Certificate and makes no representations, warranties or guarantees as to, and assumes no responsibility for, the product(s) listed on this Certificate. AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s), or the unauthorized alteration of data listed on this Certificate. Certified ratings are valid only for models and configurations listed in the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI. This Certificate shall only be used for individual, personal and confidential reference purposes. The contents of this Certificate may not, in whole or in part, be reproduced; copied; disseminated; entered into a computer database; or otherwise utilized, in any form or manner or by any means, except for the user's individual, personal and confidential reference. CERTIFICATE VERIFICATION 111C10, The infomtation for the model cited on this certificate can be verified at www.ahridirectary.org, Air- Conditioning, lnsti ng, click on "Verify Certificate" link and enter the AHRI Certified Reference Number and the date on .■ •' which the certificate was issued, which is listed above, and the Certificate No., which is listed below. and Refrigeration ln5tltute ©2012 Air - Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 129725087185607094 MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: /S 3 4 —' /9vz- t 0 PERMIT # / / —moo uS' PROJECT VALUE $ '--) 1 46e) . NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity Tons Per Unit Heat: Unit Quantity BTU's Per Unit Seer Rating Duct Systems: Total CFM REQUIRED REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI # H 3g sv Air Conditioning: Unit Quantity 1 Tons Per Unit .2 , 5" REQUIRED Heat: Unit Quantity BTU's Per Unit z',, mc) Seer Rating t s Duct Systems: Total CFM i o 00 REQUIRED FIRE PREVENTION Fire Sprinkler System Quantity (Requires 3 sets of plans) Fire Standpipe Quantity (Requires 3 sets of plans) Underground Fire Main Value (Requires 3 sets of plans) Fire Hose Cabinets Quantity (Requires 3 sets of plans) Commercial Hoods Quantity (Requires 3 sets of plans) Fire Suppression Systems Quantity (Requires 3 sets of plans) FIRE PLACES MISCELLANEOUS: Prefabricated Fireplace Qty Automobile Lifts Gas Piping Outlets Boilers BTU's Elevators/Escalators ALL OTHER GAS PIPING Heat Exchanger Quantity of Outlets Pumps # Vented Wall Furnaces Refrigerator Condenser BTU's # Water Heaters Solar Collection Systems Tanks (gallons) Wells 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 Mechanical Company l'7?L7.024,.wor AZj2 (,)n4 l4-72azc`3 Office Phone2 -75 ZO Fax) '5 X76 Co. Address: V/0 eV/2--z-IS ik4M A ea City .¢,v State30- Zip ?)-„1.57..- . License Holder (Print): ,_/ il; , .' S . to Certification/Registration #C,dc 7 d 45 A vs- Notarized Signature of License Holder , , / �/ j Sworn and subscribed before me this \ day of , _,_ _ 20 \'Z yg KAY VEGA NAVARRO Signature of No �� Ic _'""_ -.,, ` .r -• Commission # DD 972187 ��_ ,. .. a ' i t s • Y 4 Expires July 17, 2014 4 11111 " 81;,,, 9ondadThru Troy Fan Insurance 800 .385.7019