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Permit Remodel Repairs Bath Sunroom 5119 Polaris 2012 r l!iA'`J " 1 = CITY OF ATLANTIC BEACH s 800 SEMINOLE ROAD j ATLANTIC BEACH, FL 32233 b4 INSPECTION PHONE LINE 247 -5814 Application Number 12- 00000096 Date 1/26/12 Property Address 5119 POLARIS CT Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7900 Application desc remodel /repairs bath sunroom Owner Contractor NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 1 FLEET LANDING BLVD 6771 SHINDLER DR ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222 (904) 838 -9179 Permit RESIDENTIAL ALT /OTHER Additional desc . Permit Fee . . . 90.00 Plan Check Fee . . 45.00 Issue Date . . . Valuation . . . . 7900 Expiration Date . 7/24/12 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 90.00 90.00 .00 .00 Plan Check Total 45.00 45.00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 139.00 139.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 51tq Pota.ej Cotu4- Permit Number: X0 — 96 Legal Area of Sq.Ft. Sq.Ft Valuation of Work $ i P Proposed Work heated /cooled non - heated /cooled Class of Work (circle one): New Addition Alteratio' Repair Move Demolition pool /spa window /door Use of existing /proposed structure(s) (circle one): - • mercial Residenti _ If an existing structure, is a fire sprinkler system installed? (Circle one): - es •o N /A Florida Product Approval # For multiple products use product approval form ` Describe in detail the type of work to be performed: v,, �\ C, b , hs c:oR�� 1' S-t CCU► 1 vta `is , ' ,d( V •-- A CN M ; to ifi 1 CS ( Nei coo ,v1 Owner Information: r Name: NCCRF Address: One Fleet Landing Blvd. City Atlantic Beach State FL Zip 32233 Phone 904 - 246 -9900 xt.150 E -Mail or Fax # (Optional) Contractor Information: Company Name: North River Builders Qualifying Agent: Joshua M. Hogan Address: 6771 Shindler Drive City Jacksonville State FL Zip 32222 Office Phone 904 - 838 -9179 Job Site/ Contact Numb 9U4 -x3s-' _: _:— - - - -- •»M , :.,'. - State Certification /Registration # CGC1518918 REVIEWE DR comp', C.QMPT,14Nr - - ' -, - Architect Name & Phone # _ II 11 e . . ,,.., it : u7 , 11 ? Engineer's Name & Phone # , , .. p .I e . _• II ' 1 Fee Simple Title Holder Name and Address r. • _ • ; ■ .r 1.•11 _ e , i. r e . , � ' Bonding Company Name and Address Mortgage Lender Name and Address REVIEWED BY: 1h DATE % 5 'r 2 - 11i 2- Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has comm'ef{ce.,„ , to`' X issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This p it :. • es 4 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) month t . ' ,i.y e ter work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces ,oilers .1 'a r$ Tanks and Air Conditioners, etc. y WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE 0 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 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 log 1 law regulating construction or the performance of construction. r ". A� Signature of Contractor Signature of Owner g Print Name Joshua Hatfield Print Name Joshua M gan Sworn to and subscribed before me Sworn to and subscribed before me this Day of _ _ _ _ 20 this Day of , 20 ELIZABETH TESKE /" .....g._ 41 ma - _ !•K Y P V : •• _ _ �� ILam, / ' _ ot.,1 Public l ;r' �;` got ., P ; 2 + - ' Notary Public • State 01 Florida • My Comm. Expires Apr 5.2013 , • , • � - • '.• My �pmm. Ex i $ 8511019 z;� y �; Commission Ar 00 867829 q yo .' TA'ss `; ° • ' •'F��FLO?: 8829 ' C �s # 87 1 Bonded Through National Notary Assn. ,.. 9onded Through National Notary Assn. !:1A,/• t' City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) x:--).% 800 Seminole Road /2 - d.096;1 Atlantic Beach, Florida 32233 -5445 Phone (904) 247 -5826 • Fax (904) 247 -5845 / h r E -mail: building- dept @coab.us Date routed: ! ,�c 1 2-- City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: :� / / 9 Td / 5 e, De ent review required Yes No uilding ) Applicant: , E\re jIi es & Zoning Tree Administrator Project: 'ar (/ Public Works / ,� /�/ Public Utilities 1 � Public Safety /'I i0 o rn Fire Services moti 2 '4 Review or Receipt Other Agency Review or Permit Required of Permit Verified By Date 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: C UILDI PLANNING & ZONING Reviewed by: 7/1 Date: / 70 2— 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 07/27/10 ,, \\ CITY OF ATLANTIC BEACH ,� s) 800 SEMINOLE ROAD J *� �� - ' ATLANTIC BEACH, FL 32233 ' � INSPECTION PHONE LINE 247 -5814 Jn Application Number 12- 00000096 Date 1/26/12 Property Address 5119 POLARIS CT Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7900 Application desc remodel /repairs bath sunroom Owner Contractor NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 1 FLEET LANDING BLVD 6771 SHINDLER DR ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222 (904) 838 -9179 Permit PLUMBING PERMIT Additional desc . Sub Contractor . ASHLEY PLUMBING CO INC Permit Fee . . . 69.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 7/24/12 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 69.00 69.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 73.00 73.00 .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 q JOB ADDRESS: S II q F /e 6.4.4.4-., v PERMIT # / Z 1 NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower 2- Dishwasher Shower Pan Drinking Fountain Slop ink 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 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 nj.,Q }- LO I A-) Phone Number Plumbing Company fl V [ AI (Pi IAM ji r J j Office Phone 6 104 "3g3 Fax qpi 399 Co. Address: i IJ'1 Ott..,-.) 'I Q b 1 S ai+ City 36 State F6, Zip 322 i q l // License Holder (Print): ks < ' // tate Certification/Registration # 057 'O Notarized Signature of License / I Ho - r �i�� 3 �. 7 �.��<MY PY � � fr#7 D 1 i _. , �'p"d, �b f i e this day o ` 20 T ' � .' txPIRES: Februaa �r qq,, t 4 I iS MIL j ? 4 , fr N iA CITY OF ATLANTIC BEACH A j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 �JF3 Application Number 12- 00000096 Date 2/07/12 Property Address 5119 POLARIS CT Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7900 Application desc remodel /repairs bath sunroom Owner Contractor NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 1 FLEET LANDING BLVD 6771 SHINDLER DR ATLANTIC BEACH FL 322334599 JACKSONVILLE FL 32222 (904) 838 -9179 - -- Structure Information 000 000 REMODEL BATHROOMS Permit ELECTRICAL PERMIT Additional desc . Sub Contractor . BARKOSKIE ELECTRICAL SERVICE, Permit Fee . . . 57.40 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 8/05/12 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 57.40 57.40 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 61.40 61.40 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERmIIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247-5845 5845 - - JOB ADDRESS: J /41 �OL� f ( i PERMrr # / 2 96 NEW SERVICE ❑Overhead ❑ Underground ❑ Underground up Pole ❑Residential (Main) Service 00 -100 amps 0101- I50amps 0 151 200amps 0 amps # of Meters ❑Commercial (Main) Service 00-100 amps 0101- I50amps 0151-200amps ❑ amps ❑CT Service am Conductor Type Size [Muhl-Family (Main) Service 00-100 amps 0101- 150amps ❑ 151 200amps ❑ amps # of Unit Meters ['Temporary Pole 0 amps SERVICE UPGRADE 0 amps 0 CT Service amps . NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.) ❑ 100 amps 0150amps 0200amps ❑ amps OCT Service amps ADDITIONS, REMODELS REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC. Outlets/Switches: I 0- 30amps 31- 100amps 101- 200amps Appliances: 0- 30amps 31- I00amps 101- 200amps . A/C Circuits: 0- 60amps 61- 100amps Heat Circuits: # circuits ® kw Number of Lighting Outlets, Including Fixtures: 2 - OTHER ELECTRICAL PROJECTS - °Swimming Pool ❑ Sign ❑Smoke Detectors Qty ❑Transformers KVA ❑Motors FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts/amps VALUE OF WORK $ REP US OReplace Bumt/Damaged Meter Can OSafety Inspection OPanel Change 00H to UG ,Other: T PLAt DO/ 1 Cep e,2 WA-T. 72 �'-72,41 !2_ Permit becomes void if wait does not commence within a sic milt period our work is suspended or abandoned for six months. I hereby �y that I bavf lead this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be died with whether specified or not The permit does not give authority to violate the provisions of any other state or local law regulation constrndioa or the paiormance of suction. - . - Property Owners Name 6E7- LA D 1 td4 Phone Number 2ik `i'9O 0 Electrical Company JL D5 K ( < <.. 1 r. C Office Phone Z-44 `F 7 3 ( Fa ao) "7 Co. Address: q 3 SPA-E--1n_ ,Lk-t. j City A i't State IIz Zi ` S7) License Holder (Print):..) ' .- / r• 4 *_ State CertificationlRegistcatio # (3 00 3 8? Notarized Signature of License Holder 1 0 40 i Notary Public State or Florida Sworn -. ' f subscribed before me thus 10 day of )"t 20 . r , �o TiEtany ney ca August C'� y m ss+on D08011 49 Signature ° of Notary Public - � �'""'` S _Asu k '4. 7„," Excites 06rn/2012