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Permit 723 Sherry (vault) BEY A „ r neri++T ":F -` r� \ l.P . /6 City of Atlantic Beach Building Department J 7? 800 Seminole Road sd I , s Atlantic Beach, Florida 32233 Telephone (904) 247 -5800 Fax (904) 247 -5805 www.coab.us Memorandum To: Jim Hanson, City Manager From: Michael Griffin, CBO, CFM /re Building Official, Interim Comm ty Development Director Date: February 6, 2012 Re: Carport at 723 Sherry Drive This is in response to the letter dated January 25, 2012 from Johnny Scott (see attached) related to the shed at 723 Sherry Drive. This is to indicate that the shed at 723 Sherry Drive was legally permitted on December 12, 1991 by the City Building and Zoning Departments. Our Zoning Code in Sec. 24.151 (1) d.(see attached) allows sheds not exceeding six hundred (600) square feet to be situated as close as five feet from the side property line . Also, Sec. 24.17 (see attached) defines a side yard, for a corner lot, as the longest line abutting the street. Therefore, the shed as shown on the attached site plan is in conformance with the City of Atlantic Beach zoning regulations. If you have any questions or need additional information please let me know. „,,, ,,_..... M AP SHOWING SURVEY OF - Lor .a/7, 2 / Ag_...12 5.6 1 of ...1, 61/2e..-/ - 22.,-/ - ,..9,-.7g” AS RECORDED IN PLAT BOOK_O___PAGE__ 4.:r_ -OF PUBLIC RECORDS OF DUVAL CO., FLA. FOR r4_Ze 2 _A_ .124LLY __ N i f ` foaird,f1 - - ti A/ 83 ° d2'Lc� 5 �5 . _ ' Ssf.s "•% �'J' /O' g x ___ � �i t � MO `fincd �+ /in,' F 0.9 T 1 \ ` to yl, 1 l 0 ' 4 � ON X01 y , 4:1 t '0 . m 0 z Ps:` S `' J' I $ �� W 4 .- ` ti•` 1 o • .__ o � , ! N y `0 2' 1 • 1 r64�•_ 54,4.4e 1 , i ( a 7. 77') ( 55) fcee 'rdd. •t'. M. J s V e93 • d2 • ,F• /22, 7 7' f; • /,-o„ CI c0 4 g 7 rV _ '5 i ,e' f 7- - - ---- -- I . 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C I i J V I ` < 1 1 lk �t m '< f fi s PI v 1 r \ 0 �i • D t i J 1 N t l U IA i c , _ • S _ n -I � ' ■ I �: O i g a - CITY OF ...../ reillantic Beach-110141a jda Office of Building Official REQUEST FOR INSPECTION Date J 6, r / ? 7 3 � Permit No. Time cD. , 0 A.M. Received P.M. District No. 7 Job Addres Locality Owner's ' h e / Name Contract or C �.oCd _ BUILDII CONCR ELEC TRICAL PLUMBING MECHANICAL Framing Footing ❑ Rough Wiring ❑ Rough ❑ Air. Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Lintel ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION A.M. Mon. Tues. Wed. urs. ' P.M. A.M. . Inspection Made / P.M. L .� Inspector Final Inspection C3-' Certificate of Occupancy Date J CITY OF 4II Ii - 4 uc Office of Building Official REQUEST FOR INSPECTION Date / ' Permit Mo. l6.____) Time ,�J ,s //� Received ( ' / District No. / Job Address Locality Owner's i Name - C✓ �`T`ti - � �f. L�� - ( . BUILDING CONCRETE ELECTRIC __PLUMBJG MECHANICAL Framing ❑ Footing ❑ Rough ❑ Air. Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Lintel ❑ Fi Place ❑ Pre Fab READY FOR INSPECTION A.M. Mon. Tues Wed. Thurs Friday P.M. ,3 — , c --(.. A.M. — Inspection Made (14..._-__ P.M. Inspector •••••—...— (-- Final Inspection C..../r- ��'� Certificate of Occup ncy ,641 2 Date • CITY OF 41/44itic Beach-1101'k V Office of Building Official / / f /// REQUEST FOR INSPECTION 7 "7 3 ? Date / -- Permit No. Time A.M. Rece' ff i P.M. District No. Job ,. - s e_ocality Owner's •_ s._.___. Name ....n.��. Contractor BUILDING CO RETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Fo. a Rough Wiring ❑ Rough ❑ Air. Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Lintel ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION A.M. Mon. Tues. r7CTed t ' Thurs Friday P.M. Inspection Made J/ _ / c7-- 7 A . M / l lj i Inspector C____ l �' '�- �^ Final Inspection ❑ Certificate of Occupancy Date ?ROPERTY DESCRIPTION CITY OF rtelesittie Feaelt - 76lTa4 _ _oL `' 81ook I -�� Section r M OCEAN BOULEVARD P. O. BOX 26 ATLANTIC BEACH, FLORIDA 32233 iubdiviaton s TELEPHONE 19;34) 249 -2495 ` T Street Name • ' sr Addreeas___ c3__ _ (3e3 -_r. DESCRIPTION OF WORK i If ih a FLOOD HAZARD . lood Zone: area complete page 3. Brief Description s _c�O4�,Q . s ..Q\ y , r _1'"` -- . Class of Mork: A � I Ner /Remodel /Addition) /vim ‘.l TONING INFORMATION • Type of • • Constructions LJ a0 7 E,_ -- :oning Proposed detricts4a5=ZI Uses Estimated Value O 1 ,c:›, _ :xceptions or ariences Granteds • Materials Solid or • Filled OWNER INFORMATION Grounds Roots goi/ R4T) • Method of Meetings —A14 Propert Owner s ?4) /( /.) . / 4 / �^- Mailing 1'G�LJ /1/ L ' Phones ��.5� - :�L1_ ��2 Address lc A3 .65.: 1:1 _. - _- lI:YiL- _ :,1 . -1 ,. Zip, ->1 ? .. CONTRACTOR INFORMATION Contractors , Mailing �` _ Phones . Address J Zips License Numbers Expiration Dates _ • I HERESY CERTIFY THAT I NAVE READ AND EXAMINED Mg APPLICATION AND NUM THE SANE TO SE TRUE & % I A AND CORRECT. ALL PROVISIONS OF TNft LANE AND ORDINANCES GOVERNING THIS TYPE OF WORK VILL S£ COMPLIED WM. WHETHER SPECIFIED HEREIN ON MOT. THE GRANTING Or A PERMIT DOES NOT PRESURc TO r GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS of AMY FEDERAL. STATE OR LOCAL RuL£5. w � - r ♦• REGULATIONS, ORDINANCES. GR LANs IN ANY MANNER, INCLUDINO TNC 0OVERNINO OF CONSTRUCTION sit THE 4N1 ! PERFORMANCE OF CONSTRUCTION OF THE PROJECT. I UNDERSTAND THAT THE ISSUANCE OF TNIS PERMIT IS Q.}r�.�;y; CONTIMOtNT UPON THE AROVE INFORMATION *NINO TRUE AND CORRECT AND THAT TUC PLANS AND SUPPORTING , Tq !aa DATA NAVE NUN OR SMALL .= PROVIIj AS REQUIRED. 41 it:1 � � - . , ,i Owner Signature ° / -- fi - 4 ; ,∎..---._ ... __-0__._... - - � _.,_ Date - - ° °? QJ 4 i ti • f �`i -';` Contractor S f: b , Signature Date . . . i -4 i t 1 • m h. ii . v 0 . . . 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(f) , ,, , 3 , ,.. ■ k i 0 . 4 Li... . 1 0 . h., • >" > I ; 03 1 I 1 3 N ! .s. Z8/0 ,:c. - - - ; 7 Et II ; C79 22 C ' , ii , .., D ‘\I ' 1 0 - i l l ! --,: , -,, k ' .. U) i 1 q 1 ,1-4 __ ' t i ::* ... 0 1 1 t ..•,1 01- - --"' 4 e ‘.3 \--.... •Nit \ I I ! 0 , .. N . c'N ■ _ ' \t• \ .v. ' \ -.... ' 0 - s, I 1 W *C t ' ,_. <..,, .....-- (I) la- CL i 1 1 b- ‘1\ -, 1 1 -- ;.,s___•,- --- t. . i ,. 1 . " 1 i o 0 1 i . t.s...- ;:\ ... 4: ‘ \ 1 \ t • \ I:, ■ ' z ... ,.: , ....„,_ I-- 1 Z ._.... I. <—.. 1 J .N, o 1 11 I \ , i) Z ..../ -------'---. \1:,, ,.----' __--- A - - 0 % if 1 __----- ---- _....--- NJ O T X ' :1 ...../ ..-.) _.---."----- . . , . 1 (j) < .,, ------------ 1 4 ..... _ • OWNER BUILDER PERMIT AFFIDAVIT State of Florida ) ' City of Atlantic Beach ) BEFORE ME, the un reigned authority, personally Y pi+earrd - -= - - -• who upon fir at being duly sworn, deposes nd says i ` I ' -- ----- t/lJ L��C�- owner of the following property; and the legal • Subdivision - Block -' Lot AKA - -- I am applying for a building permit pursuant ,.o the Owner Builder exemption set forth in Florida Statute, Section 489.103. Florida law requires that I have been provided with the following DISCLOSURE STATEMENT; • DISCLOSURE STATEMENT •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 more than one 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 • violation of this exemption. Your construction must be done according to building codes and zoning regulations. It is your reaponsibility to make sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. 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. Further, affiant sayeth not. • }� P roperty Owner Svorn to and subscribed beforW me this -P _ 1,03 day of -k - - -• 19 qt. NOTARY PUBLIC __ , , A1,1,..,,,v ,,_r ,,,,L' . A ;-- -I- ..:_-) , ' Y . i At ' 0_ k■-,G."N,5 ..... „ o.... __..... .,..) ' . . , D --. . , . , . . , . • f , , .', . . 1 ; . ., , \ 1 -JEPARTMENT OF BUILDING 1 j CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date 28 JUNE 19 _8.2_ I Valuation $ 3950.00 Fee $ 24.00 This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of law. 1 This is to certify that T'RRMALAR INDUSTRIES OF FLORIDA 8841 - 1 ATLANTIC BLVD., JACKSONVILLE, FLORIDA 32211 has permission to build INSTALL VINYL SIDING OVER ALL WOOD AS PER PTANS SIIRMTTTF:f) _ Classification STNl:T F'AMTTY Zone RA Owned by RARRARA i)AT,iY t Lot Block S/D House No. 72 1 STIRRRY LANE According to approved plans which are part of this permit NOTICE —ALL CONCRETE FORMS 2 AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS „ AFTER DATE OF ISSUE material, Building mate , rubbish and debris .i from this work must not be placed in .u. • space, and must aare4 .. an• • . I ••d away by � Uconjl ** tract er. c?4�tUULKTD i !;'° i ", 28/ 32 r` �I"t:I �{ Af 7Q e B ilk ing ctlftit8/13i FOR OFFICE PERMIT DAT CONTRACTOR USE ONLY NUMBER 1 PLUMBING ELECTRICAL SEWER I WATER FOR OFFICE USE ONLY Date I. ... . L19 Fe---- CITY OF ATLANTIC Permit # Fee $ ', Y d NTIC BEACH Valuation $ FLORIDA House #... a_ " , 8P g_ , r APPLICATION FOR BUILDING PERMIT ay Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner - Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub - contractors be submitted to this office so that licenses can be verified. Q Date Q ,,u, , 19.. Owner 1 � �C.-f � Address _- ;2.3.s?_ . � �✓ _. 2 ,- _Telephone No. :l. �lr .. � .- 111 2gPitZrt 10 Address J �-�' 1 4ho:: No. Contractor Builder..219 ///--; Q ! .s/4,_ � $p�ddress..� T J1~l;~c 7 e -hone No.. .. ,,pp Lot No. Block No. Sub Division Zone /ex- Street Side Between and Sta. � � Valuation $., 5`�Sd� For what purpose will building be used Type of construction Dimensions of Building Dimensions of Lot Size of Footings Size of Piers Size of Sills Greatest Sill Span in ft. Type Roof How will Building be Heated? Will Building be on Solid or Filled Ground? Size of Ceiling Joists , Distance on Centers , Greatest Span Of Size of Floor Joists , Distance on Centers , Greatest Span ,, Size of Rafters , Distance on Centers , Greatest Span „ iiifr e.ev.•_.e C -- G?t .-e ze, ti a -' u/ This rectangle is to represent the lot. Locate the building or buildings in the t APPROVED right position. Give distance in feet from all lot -lines and existing buildings. TY OF ATLANTIC BEAM REAR LOT LINE -UJILDING OFFICJE Two copies of plans and specifications shall be submitted with application. '�f AA'',, 2' Inspections required. W'Ii� �'' `.. 1. When steel is in place and ready to pour footing. 2. When steel is in place and ready to pour columns and/0 • _ > dr/ At ��% z 3. When steel is in place and ready to pour beam. a j 4. When framing is completed. o 5. When rough plumbing is completed, and ready to cover u • . 3 6. When septic tank drain field or sewer is laid but before it is covered. q W 7. Electrical inspection by City of Jacksonville. v2 oz 8. Final inspection. Note: In case of any rejection, re- inspection MUST be called for after corrections are made. FRONT OF LOT In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building regulations of the City f Atlantic Be . Signature of Builder id../0 7 __,. _ Address Signature of Owne Address k ' ►LA. 71 :41437 LAW AMMO AAO FORM AOe ►s . Nortire of gnu mrntrutaent OW 111 DUPL•CAY .) fa Whom it nugg tante= The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT.' �/� r/ Description of property �t � =�P`ti� s ....) A/ ��.G� ».. ».» ....» »... ».... 777 .. ...._Z5:- • t' ..,... General description of improvements... » � / � / .» » »...,,»...», », O wner ,Er.(.. c... ...... Add ress... /�..�.r ' �� »» :..».........»...... ......... .................._... » Owner's interest in site of the improvement -.4. " er .:?y 6 u„&r)., Fee Simple Title holder (if other than owner) Name ».. »...» » Address ...». ».»..... »»... ».»......» » ». ».... Contractor Add ress' .» • » . ..................»»..»... ..... Surety (if any) .» .....»_ ... »»».»»»..»..» .....»».... Address .. ». Amount of bond $... »_ ....... ----- Name of person within the State of Florida designated by owner upon whom notices or other documents may b. served: Name ... ...... ». ...........»...........»..» ». »..... Address. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (F), Florida Statutes. (Fill In at Owner's option). Name W. SOW Address t -rte= ,v� iii , kJ 4�-6 _/ 5-76):72;4/A Address '7_2 3 S ffr_ e $c V 4 r' ( ff a T/ ox) y Heated Square pare F 7 q Footage @ $ per sq ft = $ Garage /Shed @ $ per sq ft = $ Carport/Porch Ala 0 @ $ / 3.0 0 per sq ft = $ Deck c 0 O. • 0 0 @$ per sgft =$ cp Patio - @ $ per sq ft = $ TOTAL VALUATION: $ 6 (2 C'C ) e1 ` y- c c1 •$ 7 - c c Tota l Valuation 1st $ 6 c2c1 -/-/ / C 61 ci-r' .. 4/2) Remainder Valuation '$,-5 per thousand or portion thereof Total Building Fee $ z•C�' ADDITIONAL PERMITS and /or FEES REQUIRED + 2 Filing Fee $ . ° 6; G Mechanical+ 0 Fireplaces @ 15.00 $ ) Plumbing BUILDING PERMIT kEE $ (; • G'Z Electric /New Electric /Temp Septic Tank BUILDING PERMIT $��.( Z) Well WATER METER CHARGE $ Swimning Pool SEWER IMPACT r $ -- G Sign WATER IMPACT FEE $ 6 Water Connection © MISCELLANEOUS $ — 0 - - Sewer Connection °'`� $ — b Water Meter $ Elevation Certificate GRAND TOTAL DUE $ � C - c - CALCULATIONS and /or NOTES ti 4732 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH :.: - LOCAT /DN I N)~ CIRMATION PER$1T I T ONNATI ON _ . _ Pere rit Number: 4732 Addrear3: 723 SHERRY DRIVE Permit Type; BUILDING ATLANTIC BEACH, FLOR 3223 Clang of Work: ,ADDITION LEGAL DESCRIPTION _. Ccartstr. Type z WOOD FRAME Lot a Block`: Section' proposed Use: SINGLE FAMILY Tcownship: RNG O D 1 Code: 0 Subdivision Estimated Value :" 05200.00 Improv. Cot < 060. Total ee a #60. . , A * 06 0. 00 mc�u�.> x � r r r "= 7/9_ .. RPORT P ' PLANS APPLICATION F'EE'S LLY 3, PERMIT' *60.00 _ = RY DR W► DRIVE IMPACT F1r 0*. 0(3 Address ��'� I' 1» S S+* N RADON GAS R. S. 00.00 " Tr . NFORMAT' ON RADON GAS - 5 *0.00 NER WATER TAP 00.00 Ad i SEWER TAP 0.00 HYDRAULIC SHARE 80, 0 ? RE-INSPECT FEE L Type: 1, SSEC.. H ItIPACT `EE ,„ a $0.'4 c , : '-- P `,,b'4f�, s , NOTES NOTICE — ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CC'tNTRACTOR OR OWNER "FAI LURE TO COMPLY WITH THE MECHANICS' LIEN LAIN CAN RESULT IN THE PROPERTY OWNER PAVING TWICE FOR BUILDING I11PRROVEMENT PAID ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJ TO REVOCATION FOR b t � VIOLATION OF PROVISIONS OF LAW. � C 1 7 ���� City 01 Atlantic Bch ATLANTI BEACH BUILDING DEPARTMENT ' ,t CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION . FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 7)•-'''' / 2- 19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. 1 &4 J 4 'e /#" "' ev e" t e ok ) ` A ;...::1'; 4. ITN C- l + Yt + -`': ` , ELECTRICAL FIRM: MASTER EL - RiCIAN SIGNA JOURNEYMAN( NAME 1, 4w S / M ADDRESS: 72 Si4te A( RFD BOX BLDG. SIZE BETWEEN: RES. APT. ( ) COMM. ( 1 PUBLIC ( 1 INDUS. ( 1 NEW ( 1 OLD ( ) REW. ( 1 ADDITION ( ) TRAILER ( ) TEMP. ( 1 SIGNS ( 1 SO. FT SERVICE: NEW ( ) INCREASE REPAIR ( ) FEE CONDUCTOR SIZE 79 AMPS Z 'G''' COPPER ( 1 ALUM. Pc) 1. S ` X21 SWITCH OR BREAKER .1 4) AMPS / PH .� W / � � � VOLT .S A AY ( c •. OZ.) EXIST. SERV. SIZE /C.�` 'I AMPS / PH 3 W ' VOLT w RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.30 AMPS. , 31.100 AMPS.] SWITCHES INCANDESCENT FLUORESCENT & M. V. FEXEb 0.100 AMPS. OVER APPLIANCES 1 j BELL TRANSF. AIR H.P. RATING H.P.,RATING CONDITIONING COMP. MOTOR OTHER MOTORS AMPS CEIL HEAT: KW -HEAT 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 N.P. VOLTAGE PHS MISCELLANEOUS DEPARTMENT OF BUILDING (� 7 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. "✓ - PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB 27.00 T1. 170nCKrr Da te Feb 8 , 19 88 651 !� 1 1� F1/09/81 9471 .nrncnrr. Valuation $ 5,000.00 Fee$ 27.00 G 1 a 1 n "I /09M 1rrCi This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of law. This is to certify that BARBARA DALLY 723 Sherry Drive has permission to build Stnra go. Shit in rAar, patch rrof and remodel kitchen Classification Residential Zone Owned by Barbara Dally Lot Block S/D House No. 723 SHERRY DRIVE According to approved plans which are part of this permit NOTICE —ALL CONCRETE FORMS S AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 0' 4 O Building material, rubbish and debris -1 fr om this work must not be placed in public space, and must be cleared 2 up and' frsauled away by either con- tractor or owner. '''''' I 41 72. 2 ( '44 L. A-1 J Build' • : fficial. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING 1 ELECTRICAL SEWER WATER ROO,. 41111* • CITY OF AaLA.NTIC BEACH APPLICATION TO PAM ADDITIONS OR ALTERATIONS Owner to 4. q I l Address - 2 0 )-:t, ca L,A,. 1)-r, Phones 4 is% Architect ' "'•' Address • Phone Contractor, 6 p 7 e. Address o Phone Contractors License /Certification Nurbers • Expiration Date PLoperty Address 7 t �" + Zoning Lot 1E Block or L dt Subdivision Valuation of Construction $ J e co ur Type of Construction Describe Work to be Performed Rei fr i ,/ A Materials to be Used C hi e S' Present Use of Buiidi ng : . /t) 2 W Proposed Use of Building bi Flood Zocie /- r , e _ Dimensions of New Area: U a vz... I OEA1ED /) GARAGE OR S1ORAGE t , r X 40 r CARPORT OR PORCH ---�` IECK .--- • PATIO NUMBER Will there be an increase in nuttier ,ox: tits? • Will there be a decrease in nuwber of units? • Any additional pluibing fixtures? Any new fireplaces? SUBMIT 'Its) CUt 1PLEIE SETS OF PLANS INCLUDING SIZE PLAN Signature OWNER f �° l Date g- 178 Signature CDNiI AG1UR r a ,Xt' Date i f • Address 7 ,3 C ft i= (- 1` y S To Q 4-6 r S IJ Heated Square Footage @ $ per sq ft = $ Garage /Shed V_ @ $ �� per s . ft = �� p sq $ Carport /Porch @ $ per sq ft = $ Deck @$ per sgft =$ Patio @ $ per sq ft = $ TOTAL VALUATION: $ C7 C1 Total Valuation 1st $ Remaind6 Valuation $2,.c, per thousand or portion thereof Total Building Fee $ 1 ci ADDITIONAL PERMITS and /or FEES REQUIRED , + 2 Filing Fee $` Mechanical Fireplaces @ 15.00 $ _ Plumbing BUTT .DING 'PERMIT FEE $ r Electric /New Electric /Temp Septic Tank BUILDING PERMIT $ Well WATER METER CHARGE $ Swimming Pool SEWER IMPACT FEE $ Sign WATER IMPACT FEE $ Water Connection MISCELLANEOUS $ Sewer Connection $ Water Meter $ Elevation Certificate GRAND TOTAL DUE $ CALCULATIONS and /or NOTES f t ° I fr. ?\ . i E / 1 !, t K I r Y i ', e ` t i 4 7 f 1 { , y p.ppR :1 CITY OK ?' 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