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Permit Kitchen Remodel 440 Ocean 2011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 �J,3 Application Number . . . . . 11-00002878 Date 11/10/11 Property Address . . . . . . 440 OCEAN BLVD Application type description RESIDENTIAL OTHER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1900 ---------------------------------------------------------------------------- Application desc REMODEL KITCHEN ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HILL CURTIS V JR & JENNIFER J OWNER 440 OCEAN BLVD. ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . REMODEL KITCHEN Permit Fee . . . . 60 . 00 Plan Check Fee 30 . 00 Issue Date . . . . Valuation . . . . 1900 Expiration Date . . 5/08/12 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 60 . 00 60 . 00 . 00 . 00 Plan Check Total 30 . 00 30 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 94 . 00 94 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 'SS S CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002878 Date 11/10/11 Property Address . . . . . . 440 OCEAN BLVD Application type description RESIDENTIAL OTHER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1900 ---------------------------------------------------------------------------- Application desc REMODEL KITCHEN ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HILL CURTIS V JR & JENNIFER J OWNER 440 OCEAN BLVD. ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . RELOCATE PLBG TO KITCHEN SINK Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/08/12 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 62 . 00 62 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 62 . 00 62 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002878 Date 11/10/11 Property Address . . . . . . 440 OCEAN BLVD Application type description RESIDENTIAL OTHER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1900 ---------------------------------------------------------------------------- Application desc REMODEL KITCHEN ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HILL CURTIS V JR & JENNIFER J OWNER 440 OCEAN BLVD. ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . RELOCATE SWITCH IN KITCHEN Permit Fee . . . . 55 . 60 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/08/12 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE ELEC DCA SURCHARGE 2 . 00 STATE PLBG DCA SURCHARGE 2 . 00 STATE ELEC DBPR SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 55 . 60 55 . 60 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 12 . 00 12 . 00 . 00 . 00 Grand Total 67 . 60 67 . 60 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 4 � Y a � H 5 \ ���n }�� � �� I '�,:a�,xi ate"• t .t �f8� * ; CITY OF ATLANTIC BEACH td k (OWNER / BUILDER AFFIDAVIT I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. 4�� (���,,� 316 4 �i l` DDR S PHONE NUMBER L� IN NAME ATU I(�� DATE r/q/ Before me this r Y day of 20Y in the county of Duval,State of Florida,has personally appeared herin by himself/herself and affirms that _Y,_.•�J°'''""" all statements and declarations are t and accurate. pMpNDAWHI�E Notary Public at Large,State of—,�,Coiu/nty_of,� yA1�r'! '' LD MISSION#EE 057349❑Personal) Known � � o . ES:May 2i,2015 Public Underwrites Y 30 u Notary Q-0—roduced Identlfi n- rRY�G�, r A—&W—T14—Z Notary Signat F:BLDG/Owner-Builder Affadavit;REVISED: 4/16/2009 s�a,y;yJCity of Atlantic Beach APPLICATION NUMBER Js Building Department (To be assigned b the Building De artment.) eS� 800 Seminole Road g y_�(/�Q p Atlantic Beach, Florida 32233-5445 j5 D Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: //-/0 —// City web-site: http://www.coab.us ---- ------A-PPLrtCi 1`KM—R€t IEE AND TRAeKM-F@RM-- - -- - - Property Address: �� � ��. - De nt review required Yes No u'din 22 Applicant: Planning &Zoning Tree Administrator Project: l�` 4't-�--� Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: IBUiLDING PLANNING &ONING ��/ Reviewed by: � � Date: C)- TREE ADMIN. Second Review: ❑Approved as revised. ❑D ied. 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 A. Settlement Statement (HUD-1) OMB Approval No.2502-0265 H dhilli�. B.Type of Loan 1.r-] FHA 2.[-] RHS 3.[--] CONV.UNINS. 6.File Number: 7.Loan Number: 8.Mortgage Insurance Case Number: 4.r-] VA 5.F� CONV.INS. 2011-56 C.Note:This form is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent are shown.Items marked"(p.o.c.)"were paid outside the closing;they are shown here for informational purposes and are not included in the totals. D.Name&Address of Borrower: E.Name&Address of Seller: F.Name&Address of Lender. Curtis V.Hill,Jr.and Jennifer J.Hill,husband Elizabeth McQuaid Dechard f/k/a Elizabeth and wife McQuaid Zucchi,a married woman Anna 440 Ocean Boulevard Elisabetta Zucchi,a single woman Atlantic Beach,Florida 32233 503 Cushing Road Newmarket,New Hampshire 03857 G.Property Location: 'H.Settlement Agent: I.Settlement Date: 440 Ocean Boulevard Osborne&Sheffield Title Services,LLC October 27,2011 Atlantic Beach,Florida 32233 4776 Hodges Boulevard,Suite 206 Lot 3,Block 23,Plat No. 1,Subdivision"A" Jacksonville,Florida 32224 Atlantic Beach,Book 5,Page 59,Duval 904-641-8401 fax:904-645-0005 County, Florida i Place of Settlement: Osborne&Sheffield Title Services,LLC 4776 Hodges Boulevard,Suite 206 Jacksonville, Florida 32224 Phone:(904)641-8401 J. Summary of Buyer's Transaction K. Summary of Seller's Transaction 100.Gross Amount Due From Buyer: 400.Gross Amount Due To Seller: 101. Contract Sales Price 525,000.00 401. Contract Sales Price 525,000.00 102. Personal Property 402. Personal Property 103. Settlement Charges to Buyer line 1400 1,172.87 403. Adjustments for Items Paid by Seller in Advance: Adjustments for Items Paid b Seller in Advance: 106. Ci /Town Taxes 406. Cit /Town Taxes 107. County/Parish Taxes 407. County/Parish Taxes 108. Assessments 408. Assessments 120. Gross Amount Due from Buyer- 526,172.87 420. Gross Amount Due to Seller: 525,000.00 200. Amounts Paid by or In Behalf of Buyer: 500. Reductions In Amount Due to Seller: 201. Deposit or Earnest Money 5,000.00 501. Excess Deposit see instructions 202. Principal Amount of New Loan 502. Settlement Charges to Seller Line 1400 43,264.30 203. Existing Loans taken subject to 503. Existing Loans taken subject to 204. Daily interest credit 504 Payoff of First Mortgage Loan-none per seller/none per title. 205. 505. Payoff of Second Mortgage Loan 206. 506. Purchase Money Mortgage 207 507 Portion of Seller's Proceeds to Anna Elisabetta 210,000.00 Zucchi 208 508 Portion of Seller's Proceeds to Elizabeth 269,235.70 McQuaid Zucchi Adjustments for Items Unpaid by Seller: Adjustments for Items Unpaid by Seller: 210. Cit /Town Taxes 510. Cit /Town Taxes 211. County/Parish Taxes 511. County/Parish Taxes 212. Assessments 512. Assessments 213. Per Contract amendment,credit in lieu of repairs 2,500.00 513. Per Contract amendment,credit in lieu of repairs 2,500.00 220. Total Paid b /for Buyer: 7,500.00 520. Total Reductions in Amount Due Seller: 525,000.00 300. Cash at Settlement from/to Buyer: 600. Cash at Settlement to/from Seller: 301. Gross Amount due from Buyer line 120 526,172.87 601. Gross Amount due to Seller line 420 525,000.00 302. Less Amount Paid by/for Buyer line 220 7,500.00 602. Less Reductions Amount due Seller line 520 525,000.00 303. Cash From Buyer: $518,672.87 603. Cash From Seller: $0.00 The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting,reviewing,and reporting the data. This agency may not collect this information,and you are not required to complete this form,unless it displays a currently valid OMB control number. No confidentiality is assured;this disclosure is mandatory.This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: Tv 06"11 �/� Permit Number: Legal Description Parcel# � Floor ea o q. t, t Valuation of Work /y00, 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/pro osed structures) (circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval # r For multiple products use pro uct approval orm Describe in detail the type of work to be performed: t�Cli&42�1_- Property O ner Information: Name: '� V . $4�� /J Ci t�1 Address: h StagZip 322 Phone 44 E-Mail or Fax#(Optional) Contractor Information: Company Name: Qualifying Agent: Address: City State Zip Office Phone Job Site/Contact Number Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work wall 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 susp ended or abandoned for aWeraod of six 6)months at any time after work is commenced. 1 understand that separate permits must be secured for ElectricalpWork,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 YOUR NOTICE OF COMMENCEMENT. I hereby certify that 1 have read and xamined this,application and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied ith hether specified herein or not. The granting of a permit does not presume to gave authority to violate or cancel the provisions of any other Mel ra tat , or local v regulating construction or the performance of construction. A4Signature of Owner Signature of Contractor Print Name Print Name l7G/7 !�, (� ................................................................ ............................................................................................................. Sworft d subs d before m ,.•, Sworn to and subscribed before me t � ay of this Day of _ 20 MMissi # 9 Notary Public e Notary Public 62 F d` Bonded Than No1arY Pubik Revised 01.26.10 ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 .TOB ADDRESS: 040 ece-44 64).—k - PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS / PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole ❑Residential (Main) Service 110-100 amps ❑101-150amps ❑151-200amps []_amps #of Meters ❑Commercial(Main) Service 110-100 amps ❑101-150amps ❑151-200amps ❑ amps [I CT Service amps Conductor Type Size ❑Multi-Family(Main) Service ❑0-100 amps ❑101-150amps ❑151-200amps El—amps #of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps ADDITIONS,REMODELS REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 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 El Swimming Pool ❑ Sign []Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist) Qty volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG ❑Other: Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners NamePhone Number Electrical Company — Office Phone Fax Co.Address: City State Zip License Holder (Print) State Certification/Registration# Notarized Signatur Jim - ID AnA�NroDq ` 117M81II PM:s9s EEITS be re e 's , 1'4 y of -� 20 EXPIRES:May 21,2015fit / � t'.rca'�..,. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax (904) 247-5845 .TOB ADDRESS: PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value $ 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 I 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 Completio�rm. Completed form to be submitted to the Building,Dertment 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 t violate the provisions of any other state or local law regulation construction or the performane of construction. Property Owners Name l �- C/. / �� Phone Number 3Wl Plumbing Company Office Phone Fax Co. Address: A I City State Zip License Holder(Print): A16 ' State Certification/Registration# Notarized Signature o f JV�► }" igaaEE d subscribed befor tis d f 20 EXPIRE$:May 21,2015 Bonded 7hruldowyPubkUrde ure of Notary Public _j:L77�i�