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Permit Pool 1440 Beach 2012 1 �_� CITY OF ATLANTIC BEACH ` s) 800 SEMINOLE ROAD "")7,, fi ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 " ..- Jail" Application Number 11- 00003052 Date 1/06/12 Property Address 1440 BEACH AVE Application type description SWIMMING POOL /SPA Property Zoning RES SF DISTRICT Application valuation . . . 40000 Application desc NEW POOL Owner Contractor SAIG SURFSIDE POOLS 1440 BEACH AVENUE 313 BEACH BLVD. ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 246 -2666 Permit SWIMMING POOL Additional desc . Permit Fee . . . 250.00 Plan Check Fee 125.00 Issue Date . . . Valuation . . . . 40000 Expiration Date . 7/04/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE REQUIRED INSPECTIONS: *POOL STEEL *ELECTRICAL GROUNDING AND BONDING *FINAL (PUMPS MUST BE RUNNING FOR FINAL) SWIMMING POOL SAFETY INSPECTION REQUIRED Pool -- Wellpoint (if used) must discharge into vegetated area 10' minimum from street or drainage feature (swale, stucture or lagoon). Other Fees STATE DCA SURCHARGE 3.75 ENG REV PRE APP > 3 HRS 25.00 STATE DBPR SURCHARGE 3.75 Fee summary Charged Paid Credited Due Permit Fee Total 250.00 250.00 .00 .00 Plan Check Total 125.00 125.00 .00 .00 Other Fee Total 32.50 32.50 .00 .00 Grand Total 407.50 407.50 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. s� -=swf ,. City of Atlantic Beach APPLICATION NUMBER (-- '` \ 0 � Building Department (To be assigned by the Building Department.) * � — 800 Seminole Road "� ` �' Atlantic Beach, Florida 32233 -5445 //" al6 2 - n. Phone (904) 247 -5826 • Fax (904) 247 -5845 . .„,...40 11 19% - E -mail: building- dept @coab.us Date routed: Z 29 City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: J'/'/ It ! J ,41/ f D ent review required Y No uildin V Applicant: x S-ia 4. PO 6 /3 CPSnning & Zonm Tree AAministrafor Project: c i 7' ■ 7 D 6/ (iVE ublic Wart is i i ie 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: Q UILDIN PLANNING & ZONING Reviewed by:'► Date: / _ .7— Z' TREE ADMIN. Second Review: _Approved as revised. ❑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 :51 �i, : . City of Atlantic Beach APPLICATION NUMBER ;� ?� f B uilding Department (To be assigned by the Building Department.) N ., 800 Seminole Road �' .' Atlantic Beach, Florida 32233 -5445 // — a-6 5Z Phone (904) 247 -5826 • Fax (904) 247 -5845 0;;1y v E-mail: building-dept@coab.us Date routed: 2. Z 9 City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /3/4/6 / Z E a. e A ,4v f D patent review required Yes No (� uildin , Applicant: c� LCD S 6 — P6 6/.5 fanning & Zonin Tree Administrator Project: SA) % D 6 / (/VEW) ublic is i i le 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 , ,c' f . j 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: BUILDING PLANNING & ZONING Reviewed by• Date: /3 TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. p4 1 �r� • • S Comments: 4 : I UTILITIES PU:LIC AFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. f Denied. Comments: Reviewed by: Date: Revised 05/14/09 M A P O F S U R V E Y LOT 6, BLOCK 60, MANDALAY, AS RECORDED IN PLAT BOOK 10, PAGE 11 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA BEACH AVENUE 40' RIGHT —OF —WAY PAVED PUBLIC ROAD / /---- _.,777 . 50.02' FOUND 1/2" IRON . FOUND 1/2" IRON r LT FOUND 1/2" IRON FZAS 0 N * PIPE (NO CAP) - _ PIPE (NO CAP) PIPE (NO CAP) i O 6; _� � ,o`' 100.9 BY PLAT POWER POLE �9j0. ES E ' I 9 rn I ( 100.01' FIELD ) 1 w c o F. . i I Z w C ONCRETE I-- • 5� �� . d yd , ' V 0` 1I WALK W 1 W .1 T FLOOR - -- ,2ND - FLD. w NCREJE --' WooD -DZ o? my p City of Atlantic Be �c "' _� � � a a � 1- -. H Planning and Zoning Dee bi 34.2' 0 Hance 7.3' (n approval verifies c an d other 'local and 1 This app subdivision ns lute I J zo ul ations, but does 'IA -rice 7 LOT 5, BLOCK 60 deVtop reg, emits I able a approva for the lssu C o de p and all , a e u pre ents N a with Florida and Fe deral erm e q ti p local, and F e i 1 of A antic j State must be v erified by S9 n ature o t � r $ an e WO STORY 1 Oft' iai pricy a Beach B u ildi ng 3 FRAME 60• y °- Building Per.. � � I I o i1 g \ -- 7 ESIDENCE r ` � t, Ap p ov d B mu .eve o•_l�j .ie 1440 ' ` o - < 1 Date: / y >- U) W To r 8 -, _ m LOT 9, BLOCK 60 . 0.8' 0 1 W PO v -x 34.2 7.3 v 1 I ir r ' - -- - -- I o 0.7' Como. D Y ' ) r cLs. -/ •� Q IJ - A 311J J Q :.• j x f¢e.q, .. : •w®a. wnu tw+n.wrtito�r 4 t` ' LOT 4, BLOCK 60 3 � 9 4 L 8 bZ , .„,y t - S f: � ' 40 095 � 1� 1 051 "ION 7,,,(1,;/400 . , 8? ri, a d9 d9 - - — 4�b� � "d �'d Sao���3t�` ..� 'r. Vaasso .0r7 N .s76adv7 'i ,. ?J d 6' WO0i FENCE ' s. fr0.3' FOUND PIPE (NO 2 IRON 4' CHAIN LINK FENCE x� 0.6� DISC LB & 50.35 (50' BY PLAT) LOT 8, BLOCK 60 LOT 7, BLOCK 60 LOT 3, BLOCK 60 NOTES: 1. THIS IS A BOUNDARY SURVEY. Q 10 20 40 2. ANGLES ARE AS PER FIELD SURVEY. 3. THE NORTH ARROW WAS PROTRACTED FROM THE PLAT. SCALE: 1" = 20' .1 r, ,rnr- A nr- A," MI u, n,1.," nr Tn,n ki ■ ir.,r-e. AM nr-n SX\, : City of Atlantic Beach APPLICATION NUMBER Building Departme (To be assigned by the Building Department.) r j � 800 Seminole Road �� r Atlantic Beach, Florida 32233 -5445 t /1 — 6-2— , Phone (904) 247 -5826 • Fax (904) 247 -5845 Y Z 9 -� , a „ E -mail: building- dept @coab.us Date routed: City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /1/4/6 / tt i h ,4V f D ._ . .sent review required Yes No P O r: uildinq r Applicant: �CC �r1�,4 6. 6 /S 4 • lanning & Zonin• Tree Administrator Project: c / J 0 6 (NEW) -••ic1 Public Safety Fire Services Review fee $ Dept Signature i Review or Receipt Date Other Agency Review or Permit Required 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: Approved. ❑Denied. (Circle one.) Comments: �"-” l� n �l BUILDING `( PLANNING & ZONING . Date: #/ Reviewed by: TREE ADMIN. Second Review: QApproved as revised. ['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 r s+, t\ i» City of Atlantic Beach APPLICATION NUMBER � (To be assigned by the Building Department.) • . Building Department j r. � 8 Seminole Road 1/- 6-.2- , Atlantic Beach, Florida 32233 -5445 ~ Phone (904) 247 -5826 • Fax (904) 247 -5845 /Z /Z 9 `' �� �v E -mail: buildin de t coab.us Date routed: ,� , � .,» City web -site: http:///www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: / /L e h 4 g D pent review required Yes No uildinq � Applicant: .Sit,e frib L` 6 6 /.S Tanning & Zonin Tree Administrafor Project: cyGi3 i `7 D d / (NEW) blic Works is i i ie Public Safety Fire Services Review fee $ Dept Signature Review or Receipt Date Other Agency Review or Permit Required 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: APPLI ATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: PLANNING & ZONIN Reviewed by: A-- 6, Date: Z -/t TREE ADMIN. Second Review: Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. (Denied. Comments: Reviewed by: Date: Revised 05114/09 . ti f . ;ti ,; r �sL+�� CITY OF ATLANTIC BEACH .ea � ' I 13 I 1 Id- � •• 800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 ' ''- ', 3-„. 1 •1:;7:, y v 3 a ` OFFICE: (904)247 -5826 • FAX NO.:(904)247 -5845 .....)10,..,:z � r.t BUILDING- DEPT'COAB.US ,. • =iJ BUILDING PERMIT APPLICATION DUVAL COUNTY 1 .. JOB ADDRESS: '::r 2' VALUATION 05WQRK 1:3.1.§Qi'Fil'UNDER.ROOF /lige J3 6,44ft AVM yo, s 4! LEGAL DESCRIPTIONf i; ' "r ,, I,: `.5_CLASS;OP.woRK % ,, „ • 6 USE;OP:STRUCTURE :,, r'. ❑ NEW BUILDING 0 DEMOLITION *RESIDENTIAL ❑ ADDITION ❑ CONVERTING USE - • ' ` - ' LOT t� BLdCK� SUB DIVISION MA'Y A' L/9' .i ❑ ALTERATION ❑ ACCESSORY BLDG. ° i'FIRE:SPRINKLER. C 2 7: DESCRIPTION" OFVNORK ,p El REPAIR POOL /SPA 4 11' YES Sw� rnM I A/ C. V0 ❑ MOVE ❑OTHER NO -: 15,COM CTOR 1.•: i7 aa N ARCHI :` PRQPERTYOWNER , . CONTRA „ E NEER Y 1 s; PANY NAMES $ oe F, 23, COMPANY NAME: I...4 Poi '] 9. NAME. / e. ?G �� (p (Z �Pp (-S 0 4 U z z ors 1 F� 16. NAME K 24. LICENSEE NAME 4 44 Z C -Jot/0 c. Sco a MM 10. A D D R E S S : 1 7 . STATE OF FLORIDA LICENSE NO.: 25. STATE OF FLORIDA , IC MR: 5 2 V CJC 'I'/ o L) UAo A '4 )C. j! • F L • 3 2.z - .33 18. ADORNS' S 0 z o_ gL LJ 0 .. 26. ADDRESS: W ..( 714-L9d),. 32z.Co i A g 11. OFFICE PHONE: X 12. FAX NO.: 19. OFFICE PHONE: 20. FAX NO.: G 27. OFFICE PHONE: ti: C4 Q. 2 �• .S• 03 2 /C ( j - q..gg0 I H F 6 -, Ni: S G6 )g 13. CELL PHONE: 21. CELL 904 29. CELL PHONE: O n W I^ ri 14. EMAIL ADDRESS: 22. EMAIL ADDRESS: � .►�,� 30. EMAIL ADDRESS: ^ C .' c yrg►i residcr s t' r Y m F EE SIMPLE jITLE' "HOLDER BONDING' COMP NYt ' MORTk A ? (IF OTtiFJt TFigN a . ,.. ..,. •. 31. NAME: [ 33. NAME: 35. NAME: vex ' g 36. ADDRESS: 32. ADDRESS: 34. ADDRESS: , Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that nq ' ' ' 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 , - . abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured • a Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks, Air Conditioners, etc. ,,r OWNER'S AFFIDAVIT - I certify that all the foregoing information is accurate and that all work will be done in compliance with all applica•) laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled as • Moe + prior to obtaining a certificate of occupancy or completion issued by the building official, as required by law. s i **fir WARNING TO OWNER: *** YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR 1. • PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF I Lai COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR ,� LENDER OR AN ATTORNEY BEFORE RECORDING YOUR _!-t ICE OF COMMENCEMENT ( If M 1OVIINER or AG t .. x , ,,;_ , r xR C TRACTOR" ` ,I r. ,��.- • A .Powerof AHomey: Agency L Required) `-s `.0 _ r ( Q u ar Ny) Si 7,r/ 9/1 . - - • 2- Signed: •, " Date: 4 - -// r A� ( '� Before • - d- of ��n� - � , 20� in the county of Before i s day of *TJ " i�! !_ , 2018 in the coun of Duval. I- •f Flo ' +a, has personally appe red Duval, ' = F te of Florida, has personally appeared Gre 5 SA i s ri C*w C C. c'- herin by himself / herself and affirms that all statements and declarations are herin by himself / herself and affirms that all statements and declarations are true and accurate. l true and accurate. Notary Public at Large, State of T L , County of �V 'J $kL- Notary Public at Large, State of V L , County of � Uvrt.i.- ❑ Personally Known Err ersonaily Known �jr 0 ❑ Produced (dent fi ton - Produced Identification - � i,. btr'� IA �+ S� O • �Q� • � ��. Notary Signature: C.A.V.Ih•5 Cywa.u.a*nvf U. Notary Signature: Cie- e.6.4,..•..• -+-'�' .� a i' N-r r j'j•�7b. � �/C�YyNTT�HIIApGR1AAVENOR " ry�'?!�ir1 C�RAVENOFt /41 ry, r COM MISSION ; .44:,:71k, : _ -'*.,' . :+g ii EE 090186 . 3, h ry ;nragd!aSiLh�• "--..1,:.:I0166 :�� EXPIRES: May 3 2015 m ,. EXPIRES: May 3, 2015 h ponder' TMrr Public Underwriters M " •ice Bonded 'Nu Notary Public UnderwtNars BLDG01 Penn) ppm....,...,..,,... I"_jr� " 1 •• - Doc # 2011278902, OR BK 15809 Page 275, Number Pages: 1, Recorded 12/29/2011 at 09:26 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. 1 o7 )- Tax Folio No. 1 714'te I – 00-00 State of Flor .da County of Dux a1 To whom it may concern: The undersigned hereby informs you that Improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: /.4T G DGOGtG 4e) MAr✓ Address of property being improved: I 'APO [3i. 4 - if- .4-✓1. General description of improvements: Swimming pool installation Owner GR£G 54( G Address 14Yo rAIibe.A A- E-. (9- Tc,A.JTic,l34, F'i-. 34.7 -3 Owner's interest in site of the improvement Fee Simple Titleholder (if other than owner) Name Address Contractor Surf Side Pools Address 313 Beach Blvd., Jacksonville Beach, FL 32250 Phone No. 246 -2666 Fax No. 249 -8301 _ Surety (if any) Address Amount of bond $ Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name Address Phone No, Fax No."� = —n Name of person within the State of Florida, other than himself, designated by owner upon whom notic r o r documents may be served: 1 ,�//�� ■■ Name 60 AddressIi Phone No. _ Fax No. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06 (2) (b), Florida Statutes. (Fill in at Owner's option). Name Address Phone No. Fax No. Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signer •ATE Sefor - . - in the County o •uv I, Slate of ' .nda, has pr. - onally appeared �Yci Pere in by -- srself end �; , - •, ti I ns herein are True and accura r hf CYNnMAf VENOR MY COMMISSION 1 EE 0901 &) i 1 EXPIRES: May 3.2015 Oatlk The N o t a r y- Ib er# irs r ....t Notary Public al 1 arge, Slate of (= 1... County of My commission expires' ._ Personally Known Or Produced Identification Dr. Lic,itd -- 4''M -21117- ja - � 4-9, � t----"` Phone (904) 247 -5826 Fax (904) 247 -5845 7 City of A Beach APPLICATION NUMBER � Building Department (To be assigned by the Building Department.) 800 Seminole Road J r) Atlantic Beach, Florida 32233 -5445 /1 3 V }- :!,0 11 19%- E -mail: building- dept @coab.us Date routed: 2 9 City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /'/ i Leh ,41/ D parrtanent review required Yes No uildin ~ Applicant: Si S--/IS 6 — PO 6/5 tanning & Zonm Tree A minisfra or Project: c j i - 77-+ — p o Q / (NEW) , ublic Work is iiie 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 ..,1/1,/ 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: BUILDING PLANNING &ZONING Reviewed by Date: /4 TREE ADMIN. Second Review: A roved as revised. ❑ pp [Denied. P_1 T WO: Comments: Way : I UTILITIES / PU : LIC AFETY Reviewed by: Date: FIRE SERVICES Third Review: [Approved as revised. (Denied. Comments: Reviewed by: Date: Revised 05/14/09 A .a Performance you can rely on... with 60 years of experience! Legacy' eaters r s 7x+ �:_ + Jandy's expertise p "� : ,`* r �Rdf 0 r_ and design know how are } °x k „ a yrt 4,* -•+ww q �.a L`� s s ^. d 4 m � " reflected in the technologically - ' ' `'�` s • • 7 a 3 ca w 1 y E � r advanced L e g acy H eaters. d i a j 1� � r "wokt...*.i.M4,..et-ir.),' r,''';',1*.,417,44k1-'41!";:.::'," 1--tr:':;',7 " - 417,1 � .. sr fig � ':V n '7 a pa n �' ," 4 '1R x ","� 7 : T POOL SIZING GUID _ e��s,, �" Model 125 1 175 1 250. l 325 l 400 Maximum Area H eater (width x length) Temp 0 3'h 0 3 Y 0 3 %z 0 3 /z 0 3 /z a Wind MPH Wind ;MPH Wind MPH Wind MPH W _MPH Model BTU Input "W" Width "V" Vent "H" U.S..: "H "U.S. � Weight 15 ° F 875 675 1250 925 1775 1325 2300 1725 2850 2125 LRZE / # 7 o0 (kcaI) Inches /cm Diameter Outdoor Stack Indoor Stack Lbs/kg LR2M Inches /cm .Inches /cm. , Inches/cm 20 °F 675 500 925 700 1325 1000 1725 1300 2)25 1600 125 125 (32) 15''e (38) a(15) 18(46) 2a''e(bl) as(66) 25 °F 525 400 750 550 1075 800 1400 1050 1700 1300 175 75 (44) 18''e (40) b (15) 18 (4,) 24''e (61) 57 71) 30 ° F 450 325 625 475 900 700 1250 875 1425 1075 250 250 (63) 2234 (58) 7 (18) tai (47) 25/ (64) 1/4 p9) 35 °F 400 300 550 400 775 575 1000 750 1225 900 325 325 (82) 26'5 (68) e (20) 8 'e (48) 26;z (67) 207 (94) 400 399 (101) 32''a (82) 9 (23) 21' (55) 27/, (70) 231 (105) The Pool Sizing Guide shows the maximum pool surface area our Legacy -- models will heat based on the temperature difference between the air ... w, , Indoor and °° temperature during the coldest month the pool is used and the desired pool Outdoor Models Li— temperature. Figures are based on average wind conditions and average I pool depth. ,, SPA SIZING GUIDE r ® {� Model 125 175 250 325 400 • — �`..►r.: Spa Size Time Required to Raise Temp 30° ' • Y om► i• ' 200 Gallons 30 Minutes 25 Minutes 20 Minutes 15 Minutes 10 Minutes R 1 6 400 Gallons 60 Minutes 45 Minutes 30 Minutes 25 Minutes 20 Minutes 600 Gallons 90 Minutes 65 Minutes 45 Minutes 35 Minutes 30 Minutes -, , L °, 800 Gallons 120 Minutes 90 Minutes 60 Minutes 50 Minutes 40 Minutes ,u — 1000 Gallons 150 Minutes 110 Minutes 75 Minutes 60 Minutes 50 Minutes The Spa Sizing Guide details the time required for each model to raise spa temperature by 30 °F. . ALL JANDY PRODUCTS WORK See your Sales I c'prescelttcItt�ve z • SEAMLESSLY TOGETHER nfornial10111 JandyControl Systems for more i 1 ' manage our complete line of ,, ? , I technologically advanced products. Pumps •Filters • Heaters • Heat Pumps • Controls P and y Lights • Lights • Water Purification • Valves • Water Features • Water Leveling Ap Q Cleaners • In- Floor • Pool Covers • Accessories * P ,o . „„ r. USA: 1.800.822.7933 • Canada: 1.888.647.4004 • www.jandy.com • info @jandy.com -ParanHount Pool and Spa Systems Page 1 of 2 \f00.0 cw . D ararnount 11 ,E. ,,, ,, 1 IN n_cnprz oLrAts4iNG :- (.., omi 1.11,, :,ier*sel.64. ' OREE712...M=Kr ''' • ..--'?.: 01017441 th s gtkatikttt J tAgtidlitA 7 44 1 S , . 54 . 42 01, 4 31 3 1COERtv."Af-VVA19 . -. ....... --.....„..„,.... , , , , . , ..,V ;?-. %. ,.,..s , lo .':.. c• -, ,r,arentr'SATIA: s lin• ;11. , :e. IR' kk - ../AraZgAM'atliferzirt' , .".y.7 4. P.Mg , 07414.,... :44%00- 44 ,j. en 1,.. . 4;' 4, ..r !;;;;L'Wr . • Iffrztv''':41 .... .• .... .- ..i ' ... 4 , - , .: .. , .,:,.., 44 4 ,1-T.N.:4 ‘, Alro• - "VOMP4604:400:;.1 177:::., 7--7 z: 7 777711 . . ' ' .. • ''' •,'' Or"''2' r ',. : ... • • ' . •. 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ONLINE CPO ERING li I C li It0 S It f ETV 905P , ... '''-' • . " • ' . ' Y..,.06.- ' - .7 6 • : : ' 1 : , 4.: , 14-' ,. :: , , .,.:-. : -' is. • • , , •":'" • ,^ ',..4., s l'e;:'''''`Pg'44../PR.14:::: us) - Ft. 00 R c.1_ l: A r! INI G . TEN1.5 • . • .• ' • .! ..-..- ' .. ' .s....... • . . .• , -- PARAMOUNT'S PATENTED SDX HIGH FLOW SAFETY DRAIN: NOW , ..' , .A.TE R PURIFICATION COMPLIANT WITH THE VIRGINIA GRAEME BAKER POOL AND SPA SAFETY :,.., cox ri.vEP ACT 2008. . :•3 Z. INFf.".) 011Ev. Max • SDX is a high flow suction outlet suitable for use as a wall fitting and also as a floor drain when debris removal is not a concem. A "Retro" version is available to bring ,..,- M1.17.21S0:‹ 1‘0,111C.; PCdNIS :.- existing suction outlet covers Into compliance with the new law. SDX Retro fits ,, SON VELOCIT e C.A1.•:".iit.=nON SD if Retro existing plaster rings up to 10 In diameter. ,, CEPTIFIC.47 .,: , .r.i' , :.f: , NP•••::AMir,' SCOPOOI SDX boasts a flow rating of 200 gpm on the floor and 192 gpm on the wall.making it compatible with most residential pumps up to 3 hp. SDX has a 1.485 feet per second 1 Tr: FI:A1tiRF.:5 velocity at the opening at a maximum listed 200 gpm. , ;N •071 : - ';''''''''..''P' . ...,. PLPI AC.E I' NOZZLEF, li.'N'. 1w' ..,`.':(:."-: io e„ .-g,', ,.... •;. ::.. I ... .... t- :■•'1.i••, •:33.4 .- 'S.i- VA , s• , I., .e.,:ir Ct.),•„,.., SPA IFIE.1:1,P)' `....:,.... icl;:;`,1•:.: , , • • .'..,'” , -.' ,::::',-,, ,..q):%''' - ---''',(/ • ri. .._ ''' ■.'',A A .-... ; 'i:T,p-,--._.:,, •-: . JetPaks : bict 1100 iArElf OPMN • , ,••,... e•';\ • ••;•.■ • .4;7:.I... i A if Pori .-7,--.... • • '` . -4.- ' -** ::::. ki: . : , : : ... . !..P2',,r-r .• . , • --• 4r t AUT0M.ATIC WATER LEVELER . 1*4e' \ Al1Z19.8, ,: : P.,••••';:.:;•te.ii, : ......,........"' Ls ......"..: . ,,,,, ,,,... ,,:::.„,,..., ,,„ s,:.,.7.,,,''',':' 1::•. . CENTi: IFIN3A I. WATER FILTRATION . . 'MDX A. SDX DRAINS ARE . ,.... • s • :,: i 4).', 5 ''"....;:'. ,7 .1` . ..-. . :;- COMPLIANT WITI-I THE VIRGINIA ' ILL PRODUCT LINES BROCHURE ' 't• • : ...k GRAEME BAKER ACT 2008. ;?? • :.1 :,. C : , . ,, ; . T. ..., ..,..• : ( i t . i i ...... .. . . • . , 1,AyARRANTY REGISTRATION '. . i : 4 ' ''''VV3':ii.' • ...lc ..,,,,,,...., , ,-9 :.,Y..,:•.:,r.,,,,,oViM,,,,Z,4-t.%C",,,,P.• ' • • FEATURES AND BENEFITS . • NO SUMP REQUIRED- No need to chisel out a sump to meet the1.5 times the pipe diameter sump depth requirement. . . SDX has a 1.485 feet per second velocity at the opening al a maximum listed 200 gpm. . . • Approved as a bulkhead fitting so the safety is In the cover and plate. • Patented 'ribbed" design achieves high flow with sixty 'mini" drains :! • Suction doesn't transfer if one area Is covered . , • Dome shape to prevent a peel by a swimmer • Anti-vortex shield blocks contact with direct suction • SDX retro can be Installed as a single cover with en SVRS Installed on the line. • "Retro" version fits existing suction outlets up Co 10" In diameter • •Stainless steel security screws • Secondary support plate secured to protect the sump and fittings • With a flow rating of 200 gpm on the floor and 192 gpm on the wall SDX is compatible with pumps up to 3 hp. In most cases this eliminates the need to calculate the system totaLdynarnIc head. SDX has a 1.485 feet per second velocity at the opening at a max:rnum listed 200 gpm. - ., '. ■ • '• '-' 'DESCRIPTION ''' • if MAX FLow:FLoow.•.. 1 . MAX FLOW WALL ;. 'tt•vo'SDX High Flow Sefely.Drains 1 200 gpm (756 Ipm) . 11 192 gpm (726 Ipm) . I Three S.DX_High Flow Safety Drains I 300 gprn (1136 iprn) 11 288 gpm (1090 Ipm) 1 .. . I Four SDX High Plow Safety Drains I 400 gpm (1514 Ipm) t 11 384 gpm .0456 Ipm) . • . - - " . - , . • ., Meets National anti-entrapment requlrements •. .,...', , • , -, ' . . • : - . ASME A112.19.8 - 2007 Listed . . . . . • . . '. .... • . , • ' . ' , ' -..■ • ,. . .. .. ...., • , 4/1 4%2009, . http.//lVww.lparamonnt.com/products/sdx/ . .,,.. CS Filters - Compact, Versatile Durable Jandy's line of CS Filters are available in four sizes; 100, 150, 200, and 250 square foot models. The CS 'L 1• Clean /D I j , C������ r� li \ Filter is constructed of high impact, corrosion and Snap Ring c;;llp��p P ressure Gauge e r 1 e Air Release UV resistant thermoplastic that can weather even the /I. Valve Pressure Gauge harshest operating conditions. The single element Adapter - 0-Ring Set To P �•0 P cartridge is made of the finest RemayTM material for � -� Assembly 1 superior filtration. The lid features ergonomic handles 1 ` making removal easy and comfortable. The Jandy CS 0-Ring, \ single element cartridge filter is designed to provide Tank Top `r / ultra clear filtration in a compact, easy to maintain body. Easy to Read � Pressure Gauge s� Breather ,� w/ Clean /Dirty i, - Ergonomic — Cartridge Element Snap Ring I I �, Handles for Simple Tube - } Lid Removal j :; i • . ' ,:•• . .• ,t . . ' ; .6'' ,li, 1110 Corrosion & 1 UV Resistant 2" by 2%2" 1 •%11 Thermoplastic Tank Bod 1 " Universal � ' y / l ._ Unions /) Inlet Diffuser with t' 0-Ring O -Rin , Locking Tab • "' ' 'Designed for Ergonomic 4 ' ''�+ , Bottom Housin g Locking Ring ° Jandy's Versa � • \ Assembly for Ease of � Plumb`"' System 0 1 Service ; ! '' . g ' - Single Element Tailpiece, C ap& Union Nut Set /'\ i( Cartridge made of � 0�� II 410 Remay material -- %-- I Strong Base will�� 0 1 Easily Mount to p Y S Filters Equipment Pad S Specifications for Jand C .., I. • MODEL NUMBER CS100 CS150' CS200'1 CS25+ ' CS DIMENSIONS P Filter Area (sq. ft.) 100 150 200 250 • — 14 - Max. Flow (gpm) 100 125 125 125 _ n te Six Hour Capacity (gal.) 36,000 45,000 45,000 45,000 Eight Hour Capacity (gal.) 48,000 60,000 60,000 60,000 _____ w Normal Start Up Pressure (psi) 6 -15 6 -15 6 -15 6 -15 io' 11 IU__ iiiii lii Max. Working Pressure (psi) 50 50 50 50 yI]_ Height ("A") 32 I 32 421" 42'1" k-` „ „„ ... , .w.w.M�.:.- ...m«.,.,..mm.,.., arm .,.mx...,- an.,,,n,.,a+M.,.�. „e:<r.rti...•..uu.waw..e,. •. umwaµ�.r.,e,.. a d , t - t i • - - — : ALL JANDY PRODUCTS WORK SEAMLESSLY TOGETHER x- I I ; • 1 - ._ Jandy Control Systems • • = -• manage our complete line of technologically advanced produc Jafld 7 Pumps • Filters • Heaters • Heat Pumps r© Controls • Lights • Water Purification • Valves • Water Features • Water Leveling • Cleaners • Accessories .707.77..8200 • ww. "and .com • info @'and .com • ©2+08 Jand Pool Products Inc. . , a Jandy Two -Speed Pumps — The Best Value for Your Money STEALTH PUMP DIMENSIONS " : SPECIFICATIONS FOR JANDY TWO -SPEED PUMPS ■ A' ► Model HP Voltage Amps Pipe Carton en gall 16 :I Number Size Weight • ' I 4 - _'_ ' TWO- SSPEED PUMPS iI Ii —� _, — ' y 230 7.2/3.0 2 -2Yz" 48.7 lbs. 29 =' / `_ 'I� ® PHPF1.5-2 230 10.0/3.5 2 -2Yz" 52.9 lbs. 30' /a" Imo 15 1 _ tluiu- PHPF2.0 -2 2.0 230 11.0/4.0 2 -2'/2" 62.3 Ibs. 29 103/8' PHPM1.5 -2 ® 230 7.2/3.0 2 -2Y2" 48.7 Ibs. 29 ii 1i3 li PHPM2.0 -2 2.0 230 10.0/3.5 2 -21/2" 52.9 lbs. 30'/ IIP II I PHPM2.5 -2 ® 230 11.0/4.0 2 -2Yz" 62.3 Ibs. 29 ® I`wwii11"` -II9 t' -4- 14'/ TWO - SPEED STEALTH PUMPS 11 ► SHPF1.0 -2 1.0 230 7.0/3.0 2 -21/2" 45 lbs. 321/4' Front Edge of Union to Center of Bolt Holes SHPF1.5 -2 ® 230 10.0/3.5 2 -2Y2 " 57 lbs. 32 r J iIIII SHPF2.0 -2 2.0 230 11.0/4.0 2 -2' /z" 64 lbs. 33 , , —. —.-° � 1�� SHPM1.5 -2 ® 230 7.0/3.0 2 -2Yz" 45 lbs. 32 /, I Hi SHPM2.0 -2 2.0 230 10.0/3.5 2 2Yz" 57 lbs. 32 t II� II ! SHPM2.5 -2 ® 230 11.0/4.0 2-21/2' 64 Ibs. 33 1 03/8" t os PERFORMANCE %y t - l � i 100 STEALTH PERFORMANCE CURVES 9 Pump with Sweep Elbow Bolt Hp zo 4 Pum Holes, ° p/n SEAQL1001 Center to Center N 8o SHPP ? /SH x S HpP' / 'HP 1 �s PIusHP PUMP DIMENSIONS , . . ��� L z = 50 , E I - .F 1 40 _ �J• o � 1— I.._ I_ L- !o SHP 2 L IN SPE D T , , , i i ; Ir— l _ r°- SHP - 2L b OW SPE __ III - SHPM 1.• 2 LIOWW SPA D SHPM2 0.2 COW - SP -� I . / - SP ED ` - 14 �� �r / l �l� j r 0 0 50 100 HPF1.52 LOW SP ED 200 ∎ ) I lim Flow Rate (GPM) 8'/8" ' FO II� ' I _ _ PI PERFORMANCE CURVES - r tk �� II 100 I E _ w. Am .,wul� 1 i,l PHH I - t_ f 11 - -- 81 L� �/P I._ _ I r Pp f yp ; Front Edge of Union to x 1, 1 d %,9 - L, Center of Bolt Holes w Z /p HP ' w ° ' .2 f— 9'/8" —F- H P I - r lf : w - S 2 1 1 LL 8o- 4 — �� r � 1 - :11".'L _ .. � III � i r 0 H PH M SPEED LOW - - • \ . .__ t-- -_.- --- / � � ��JJ�i # I - t 1 44z , o H PHPF 2 SPEED LO om � l B/e 2 � ] PP PF2S E E" O — 2.OH • PH • F2 PEED O r 'N - ..VIM . • , 2. H PH M 2iSPEED LOW _ —jl" Flow Rat 5 1t (GPM) " 150 200 �! / , e � PIusHP Pump with 9 " Sweep Elbow Bolt Holes, Center p/n SEAQL100I to Center h; • ~ ALL DANDY PRODUCTS WORK ,. SEAMLESSLY TOGETHER - - Jandy Control Systems " manage our complete line of :J 4 technologically advanced products. N and a s NSER14 7 Pumps •Filters •Heaters •Heat Pumps •Controls Qe � Lights • Water Purification •Valves •Water Features •Water Leveling NSF glO us ° Cleaners • In -Floor • Pool Covers • Accessories s'E 1.800.822.7933 • www.jandy.com • info @jandy.com • ©2009 Zodiac Pool Systems, Inc. Rx Oate/Time MAR 09:56 Surfsioe Construction P 001 MAR 08:48 Surfside Construction (FAX)90d2062759 P 001/001 ISO 9001 li L .. ..'.../..':' ITT' 051 r:YP.S' :...... .• ' •• • . : ' : ..'" ••••••': "••••, — .,' . :-:•7 7.. \...,--... .• ' ' t" • .,',:i••:;.:,...;::',•:•::.A.!io'r,;:r$:,:.i.;(.qpi'it.fr,,,..3:;',..u;';.::::,....::::.......,••;;,,:;6.•_:,....•:....:,.•., ....:..:''.....'::•••, • : • , ' ;,.. vitemytint..... ; ..emit4.4.,, 0,- .;f0.7:11.1i:T.,„•to..T.,.;:,..:porelgifyiigvpristppneetttie.,:=4;;i0.5i;;.!..:1.,,•!.q.urt;ivi-owycw:41tiwoi:.*4•13,011104:wo,f4,..ye,T ,;14 tarlam,... .. .,!.,,.,..;.,t4 eit......ipqm=,,,..5„.. .,,,„, • ■; : ko:Pliga.:: , ..:titi , knskv•Metloi.14;!.,,X:.,,, i ar,. , !,. :. . Arif „, ,.., p; 1 .01!,!■'tki! • • ,;,:„?111:Villri=i=ipViNaileOL•1■0:44pSftielnrliallrirellge.A1 :i1;1:i:4::ortagg.■;!;.1.1,::i.bi;;;:..4:i1:*;::01.iN.;::Icia4it,".Vag...i1;4:17i.. ..ittle2A.....411$,AWAYam.14.1i...:1,:40,:v.dii'iMlib!WiNot4V400:171,41.1:toltrAmMaa;■.:4:111,.'1"pag0:6444aeizaAa4A2latzgW,./.0:TOMOS 0 SPECIFICATIONS: Hydro Jet TM 1 1/4" Fitting Thread Length Output : 13 GPM, 12 psi, 3/0" IN1077in Hole Size: 1.1::0 2 3/8" l iu l e . saw ..,,.:t.,/ ..,,;:9 tt' ....-" 10-4100 • I 1/2" x 1 1/2" Stacked Jel Body t..,,.......v.ti!.....,,,• '4,e,c;!;/: ./<*" Options: Wronch 30-3801W ' tt".t : .. m ',A?:', ..•• . 30-3804 Gat..kel Hand Held 16-5303 .'. 101..,':■,-1'.Q,' 'Ilia' : ' 50-3500 Hydro Jot"' ',.:.Y;:'?■'41r(0.,,i.P;VAS / Wall Filling Assembly Stacked Jet As!:■,2rnblies i i . :.4 ,; It .. , ., . • 11/2' ShD CirAtt:1 Wail Iminn ... ( 30-3804 30-3001 10-5100 ----- J.. I (/ • .....,---.. 9) ••:,-.:. ■ \ 3 80 in . ,11.. , • ...... I — '3: /...) incliidcs! 10 Slacked r.1 Anscmbly 50-3500 & Kill Eilliny Assenlbly 30.3801 Filling .I •..' I Ur ihrcad 1050Th 10-3000 Eyc0011/Rciaining OA 911 . ....30 Fyrthall .. ..‘‘. . ..30-3806 Eyeball Helaiiiiii8 Hina kin ASsernl)ly • '. 1 205 f 1 10-41.00.,lel.BuilY 1/7 oiri willl No171 ; TM Hydro Jet 1/2° Fitting Thread Length -3.035 in.- c ..,--- 10-4100 • 1 1/2 x 1 1/2" Slacked Jet Body , . 2,,,;, .. :Ii. 30-3804,5ockcI 1 in" ',hp 1,Askiti Wall Filling - v•E5r • . ! • ' 71SAI IL ... ' ..../ 30-3804 30-3003 .'t,qAi ..' .. ';'4:'4'W: * 10-3000 , .'. ‘iV,,,•• ' /,.... ,i4k • V ASSelltlY / ' (( 4e ,,,I, . ,., 4 . I ; , - pti 3 pirn . ?),11i4-lkse.,C1,1),rit : .::, ' • : i_.. , 3 380 in , .4!,,e4..4.,,;.■. 10-5300 • • i ' l .....- . - •• — • 30.3803 Filling •-• ( includes: 10-4•101.1Glacked 2 1/2' Ililead 10118111 2.55 Jet Assembly & 10.3600 ,. 1 1/2* slio 1.1_4100 Jot Body 3.1135 in - willi.NiiItli: Wall rifling Avtombly ••., 30-3805 Eyeball • ...-.... 10-3808 F.yohnll/Rrttaining - ' * / -... 30-3806 Eyeball Flawing Ring Hing AssonThly ' SPECIFICATIONS: Hydro JetT For 1 1/2" PVC Pipe Ext gIon Output : 13 GPM, 12 psi. 3/8" Nozzle Pipe tie: 1 1/2" PVC . 10-41005 • 1 irc x 11/2' Opl ns: Wall Filling ASSeMbly 50-3420 • ',... Slacked Jel Budy Hand 1.101d 16-5303 (''''', (./.5'. / ) \ \ )(-... ..' 30.4401 Cx1rnded • 1 ..) ., Vnnruri Nnnln ,,,;>4 /0 -. '.1. ,., .. • CV Pipe 1,4ev 1 1/2 .;1$1) ■._ . . / • not included .:----•••• 10-4100S includes: & • .4 4 I \..,_.••• 1 1/2 slip 30-4401 Fxr(tridnd . • . 40 (wa FIllint, not incltidFfd) • . (7 '. ' J1'.1.1 vim 10-4601 ,;,•• . ) ;:7.:-. - ,. ./CD , 0 . VIS1,1111PLEICUL I" ' 4-ftl 1 1/2' Op , -1L.' • k_ 10 DOS Shoo wIII1 50-3420 - 1 1/2" PIS • 1 L3,0 5 ili _4, 1) '' . (5) ., . .._.... 5 0 ti vv i y a n i i p r n i n u n ino Wall Filling Assomblv fuulluill 1 1 G Page 39 t; .• 1 L.)/ (69 SrCti •'fi l 1/ 7C)7. :: : - t y ...,w,.. . , , CITY OF ATLANTIC BEACH 1 � 800 SEMINOLE ROAD a . -4 ATLANTIC BEACH, FL 32233 * �, INSPECTION PHONE LINE 247 -5814 Application Number 11- 00003052 Date 1/11/12 Property Address 1440 BEACH AVE Application type description SWIMMING POOL /SPA Property Zoning RES SF DISTRICT Application valuation . . . 40000 Application desc NEW POOL Owner Contractor SAIG SURFSIDE POOLS 1440 BEACH AVENUE 313 BEACH BLVD. ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 246 -2666 Permit ELECTRICAL PERMIT Additional desc . Permit Fee . . . 95.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 7/09/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE REQUIRED INSPECTIONS: *POOL STEEL *ELECTRICAL GROUNDING AND BONDING *FINAL (PUMPS MUST BE RUNNING FOR FINAL) SWIMMING POOL SAFETY INSPECTION REQUIRED Pool -- Wellpoint (if used) must discharge into vegetated area 10' minimum from street or drainage feature (swale, stucture or lagoon). Other Fees STATE ELEC DCA SURCHARGE 2.00 STATE ELEC 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. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 �� �� /� PT Ph (904) 247 -5826 Fax (904) 247 -5845 ' ..,.._ Toffs ADDRESS: I [ 'l 4 `- =''�d 1 V . PERMIT - # )I 3Cs NEW SERVICE DOverhead ❑ Underground ❑ Underground up Pole ['Residential (Main) Service 00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters ❑Commercial (Main) Service 00 -100 amps 0101- 150amps 0151- 200amps ❑ amps OCT Service amps Conductor Type Size ❑Multi Family (Main) Service ❑ 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 ❑ CT 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: OTHELECTRICAL PROJECTS ‘tors wi mming Pool 0 Sign ❑Smoke Detectors Qty ❑Transformers KVA L /• hp FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts /amps VALUE OF WORK $ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Dam ged Meter Can ❑Safety Inspection ❑Panel Change DOH 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 Name ./a.19 Phone Number Electrical Company t v;d Prilaf4 k n . • �e'� 5 - Offce Phone c 7 ��5 Fax5a9'�371 Co. Address: 33) - ftt the € Pty-- City OM AV_ . 12:11* State F Zip32c ""ense Holder (Print): b 1/id PtU' - -` _,,,,r //r State Certification/Registration # u')Z9 �3 tvotarized Signature of License Holder , '"'� ,.��;� "!V E W IN G Sworrrand subscribed before m I 's I 0 da of 201. ` t c,. r , DD 790964 y My Come > : Expiaes , ; May 2 i , 2 i� + 2 Signature of Notary Public '' it LY7 .." WING ,i' � Commissi- N DD 054 ., ., M Commi sion Expire h,,,, „,.. May 21, 2012