Permit Remodel 562 N Nautical 2012 lel
k ;' U CITY OF ATLANTIC BEACH
�-` ! s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000001 Date 1/05/12
Property Address 562 N NAUTICAL BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
remodel baths
Owner Contractor
CERRATO OWNER
562 NAUTICAL BLVD.
ATLANTIC BEACH FL 32233
Permit PLUMBING PERMIT
Additional desc .
Sub Contractor . ALL PHASES PLUMBING
Permit Fee . . . 76.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 7/03/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 76.00 76.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 80.00 80.00 .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: , ki-riti; (04-- PERMIT # /Z _ Q °
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 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 4- 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 /l , ✓� L e (64-4 Phone Number
Plumbing Company 14/( /0,04;7 J4 ° Office Pho e � �� ��� Fax
Co. Address: J 5 /P �Y a7 �'� City Pi('t/h CiLlz 4StateF Zip3ZzJ3
License Holder (Print): s 4 . ` /6/ e State Certification/Registration # &Z 76'73"
Notarized Signature of License
§ 4 1§tibseiibei5 so li s ` : a of / ...Iola 20 �
fn . • UbUC Underwnt: jaimm
Signature o o • :
f
so, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000001 Date 1/04/12
Property Address 562 N NAUTICAL BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
remodel baths
Owner Contractor
CERRATO OWNER
562 NAUTICAL BLVD.
ATLANTIC BEACH FL 32233
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 56.20 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 7/02/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 56.20 56.20 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 60.20 60.20 .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: S b a N 0,v \- c \ 13\ . /3 N PERMIT # ^ �' °
JEA INFORMATION REQUIRED ON ALL PERMITS 1'7 D AMPS 0`.--\ 0 VOLTS 1 PHASE
VALUE OF WORK $
NEW SERVICE n Overhead [)1c1 Underground II Underground up Pole
Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi- Family (Main) Service
1)0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ 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: o-. 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 ❑ 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 ❑ to UG
NOther: li)5.o. \ \e 1) i 'D 00 p cKKtt - h0� - Vu .r). o.n Ea) b0 - \1 room, EA0
t'o• n 5
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 C r r 5 T∎ e IL I no, Phone Number 50 Lk - 13 6
Electrical Company ¶ m'fly ' Ile. E \ecrr i ca \ (, v ,l Office Phone 10 G1-A$5^ 166kFax
Co. Address: 0 .)\ l • •:*\ 1 5i City 3 )4 State -- L, Zip 3D. act
License Holder (Print): C)l r ii ') 5 n 8e r' State Certification/Registration # r =R13o I y
Notarized Signature of • - , 1 6 \lb)- „__ - _,
1 ,Y a SKIRL L. GRAHAM
• 8 l mad s ari i d b - e - me its of ...NA 20 / Z .
a: '�` 4 EXPIRES: February 14, 2014 I gay
o l o Go . : . .T f ru eta Pun.1c :. tern . Public . i 41
‘ Iz CITY OF ATLANTIC BEACH
r s' 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
`` Aaft-i-ke INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000001 Date 1/04/12
Property Address 562 N NAUTICAL BLVD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
remodel baths
Owner Contractor
CERRATO OWNER
562 NAUTICAL BLVD.
ATLANTIC BEACH FL 32233
Permit RESIDENTIAL ALT /OTHER
Additional desc .
Permit Fee . . . 85.00 Plan Check Fee . . 42.50
Issue Date . . . Valuation . . . . 7000
Expiration Date . 7/02/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 85.00 85.00 .00 .00
Plan Check Total 42.50 42.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 131.50 131.50 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
l
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: C Afa,) c.. / g/ v c. Ai Permit Number: 42 — 0
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.F't
Valuation of Work $ 7 0 00 , ' Proposed Work heated /cooled 5 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 Residentia
If an existing structure, is a fire spnnIder system installed? (Circle one): Yes No N /A
Florida Product Approval # di it-
For multiple products use product approval form
Describe in detail the type of work to be performed: la „,,,,.1 1 j ,,, 4 «r cl Irv, a fop r G - i - nx p.s`,
r'iQ 4•115s re-b. le. . / ti —f.:0 E le 4!-
Property Owner
Name: ek r r►, CQ "� Address: S �tx -, -Ctc ( t3L Ai -
City 4 E f a.,-ic a State F/- Zip 3 ? Phone - 0y - 33V 3/5
E -Mail or Fax # (Optional) k C e rr . 2cl e.- / c� eve a 1 ` e o r,-N. Contractor Information: U
Company Name: P Qualifying Agent:
Address: City State ,�..4iia.... - . --
Office Phone Job Site/ Contact Number Fa
State Certification/Registration # DE-COMPLIANCE
Architect Name & Phone # i CJW OF ATLANTIC REACH
Engineer's Name & Phone # SEE PERMITS FOR ADDITIONAL
Fee Simple Title Holder Name and Address REQUIREMENTS AND CONDITIONS.
Bonding Company Naine and Address
Morttgage ender Name and Address REVIEW ISY: /71d D`` M 1 /1
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 a period of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for ElectricalWork, Plumbing, Signs, Wells, Pools, Furnaces, Bo 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 examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with w ether 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 'ng construction or the performance of construction.
Signature of Owner __ U r Signature of Contractor
Print Name 14 i , 1,Q ,r I ) , c... e c aL- Print Name
V
Swor o and 'scri►ed before me Sworn to and subscribed before me
this D. of _„.... ∎► _ - " -_" this Day of , 20
( : SHIRLEY er l Q • HAM �/ � r v . " ° ; _ COMMISSION # DO 957760
Notary ' U a l is `i + Bonded Thru Notary Public lin ' erwater^ - Notary Public
Revised 01.26.10
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154 lY`s
CITY OF ATLANTIC BEACH
( ') �'�" WNER / 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.
G6Z a ,/- l02. -1 glue( . A.. c lef- 33Y- 3 is3
ADDRESS l � I PHONE NUMBER
i\ i b Q f � / . l- ._ C 6 PRINT NAM
..-._? A ` r � �_ 1 Alz_
SIGNATURE DATE
1
Before me this 3 day of �' , 20--in the county of
Duval, State of Florida, has personally appeared herin by himself / herself and affirms that
all statements and declarations are true and accurate. �� /
Notary Public at Large, State of ! L , County of �f� va-v
❑ Perspa Known Identification - ! /3 —5 if- 0 0 -5/1-0
roduced r ll
' A O smrw�y
r4" ° P SHIRLEY L GRAHAM / t a i . . rt�1Y COMMISSION #DC957760 Notary Signatu -: • DD(PIRES: February 14, 2014 i �cnde Thru Notary Public Underwriters
F: BLDG /Owner - Builder Affadavit, REVISED: 4/16/2009
( ' J . City of Atlantic Beach APPLICATION NUMBER
\ ' 1, Building Department (To be assigned by the Building Department.)
800
Atlantic Seminole Beach, Ro Flo ad /2 0D0
. ."" J Florida 32233 5445
} . 5
Phone (904) 247 -5826 • Fax (904) 247 -5845 /751/2—
:,b E -mail: building- dept @coab.us Date routed:
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 6 L /14-1,-7-17'64-4, W /V cI Department review required Ye�/� No
:IA .mg
t/
Applicant: O to 1e-- Planning & Zoning
Tree Administrator
Project: ' c4 4 . - S 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 By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: roved. ❑Denied.
(Circle one.) Comments:
BUILD!
PLANNING & ZONING Reviewed by: /7 Date: / - 3 71
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie .
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