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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 ..Z /l8Z � o N � n t s� / ..61L \Pe" z' To 5 . 0 6 ( • u!00'4 ' X 'u!00 " 49 ' ^ O 8f L Tir a , - w n ,,„ i :„,,, .'„::.. ta O t „Z-,b l t t L t fv.-vos- ., , ;... ,, L ,,,: . ,.., u!00'9 U£ X •00 'U4 ... 2i3MOHS • 000'9 119 X . u!00 . 0 144 .,,,,,,',.,:: i C r rillifr 13S0-10 O ! � O 'i: • w ■ . . tit , ,,,,,,... . , __ ,,, ...,,,, „,,.... ‘,. .. „Z -,b l �� „ Z - ,O l 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