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Permit 1843 Oceaan Grove Dr (vault) CITY OF ATLANTIC BEACH 08.; _ 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 n OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPT@COAB.U S f=fa BUILDING PERMIT APPLICATION DUVAL COUNTY tADf#RESS"vlli,F ); a Irk pis qX; E,. _ U q.I AL{lAT1C flPnt1E Ambi i� 1 P Atlantic Beach, FL 32233 N4 & ? V ,, I SCEt1PT104 0""! " „ v . ZUC7tRB. a ^ ❑NEW BUILDING ❑DEMOLITION ESIDENTIAL LOT_BLOCK_SUB DIVISION J CIADDITION ❑CONVERTING USE ❑COMMERCIAL #ERIPT101 17 , �„, LTERATION 11 ACCESSORY BLDG. . RIt1! REPAIR ❑POOL/SPA ❑YES ❑N/A ❑MOVE p ❑OTHER /M 0 )Cr J(r 1 1 ii i)i�li) -..,"�', `�� !a' �d ARC MIT E Oli. „"dr"n .. ,,.. Iii ,saK"a m'a ' NAME: 15.COMPANY NAME: 23.COMPANY NAME: 16.NA 24.LICENSEE (SME: / 10.ADDRESS: 17.STATE OF ORIDA LICENS 0.: 25.STATE OF FLO A LICENSE NO.: C 18.ADDRESS: 26.ADDRESS: ^ /X\ 11.OFFICE PHONE: 112,FAX NO.: 19.OFFICE PHO 20. NO.: 27.OFFICE PHONE: 28. NO.: 3 Zi off^ 13.CELL PHONE: 21,CELL P NE: 29.CELL PHONE: o q - 'J(- tZ 14.EMAIL ADD ss* hot ope s o Mott 22.E7L ADDRESS: 30.EMAIL AD ESS: A�JIt mff' '1. fi t� 01(in . ,,a* { 1 ad u�s0rf 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I 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 Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF 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 NOTICE OF COMMENCEMENT. `� Signed: Date: d Z (J Signed: Date: Before rWe thi JaWday of 20CV the county of Before me this day of 200 In the county of Duval,State of Florida,has personally appeare Duval,State of Florida,has personally appe ed _}_f m /Ylr,"YAk1117 herin by Kimself/herself and affinA that all statements and declarations are herin by himself/herself and affirms thZallstaa and declarations are true and accurate. true and accurate. Notary Public at Large,State of ` County of Notary Public at Large,State ofunty of ❑Personally Known __ ❑Personally Known b/Produced Identification- ❑Produced Identification- ✓ Notary Signatur -- Notary Signature: M. . d Rif lNr CoffwAm m Egku F&29,2010 CanN�Non 1t 0 62M COABFOI No”Am. RM t 'iTYf AT "I' }} j. r� y� +y yy j+� ire&. +� r 4 121 ,AC�04a is� 1443—Oct" r '" ' I+ + fives w tt ud rRAO mel Spiv slion.-Om" -altove. to t-,. ' " X44 toy 1 06 y ITY t 3 SCT �s +�r�y 'i A,i F`t I CATION rlt 0 R R per 0:i 0 ' i j t W"' y#Ay�P( t F# TFiC$��?}Rji�!C�'gMU T N—O!}T��l fACrE� IN 777, }(T{ fWCH ARE PART of r CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: � 06 3 C-I,–E fJ;y r(ZpcU 00 . OWNER OF PROPERTY: INAO , m I K(_ GP\11137. n ` PLUMBING CONTRACTOR: �� }-'ti C i<lJ �� �c= L i2 y SYl V( Z�L4& CONTRACTOR'S ADDRESS: 3( y W J\LLEk� �3L. ;'1 F( STATE LICENSE NUMBER: TELEPHONE: (9—b HOW MAVY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORIES WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINES FLOOR DRAINS SHOWER PANS OTHER of W f-(Z T L -( TOTAL FIXTURES: X 3.50 + $15.00 MINIMUM PERMIT FEE = $25.00 i SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: SFS ----------------------------------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834. r � CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-dept�7a coab.us Application Number . . . . . 08-00000135 Date 2/01/08 Property Address . . . . . . 1843 OCEAN GROVE DR Application type description RESIDENTIAL OTHER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 14000 ---------------------------------------------------------------------------- Application desc REPLACE EXTERIOR WALL ---------------------------------------------------------------------------- Owner Contractor MCLAUGHLIN OWNER 1843 OCEAN GROVE DR. ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee . . . . 100 . 00 Plan Check Fee 50 . 00 Issue Date . . . . Valuation . . . . 14000 Expiration Date . . 7/30/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. *WIND CONNECTORS TO BE ADDED WHERE MISSING. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 100 . 00 100 . 00 . 00 , . 00 Plan Check Total 50 . 00 50 . 00 . 00 . 00 Grand Total 150 . 00 150 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. NOTICE OF COMMENCEMENT State of Tax Folio No. County of 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 NOTI OF CO MME CE / \ Legal Description of property being improved: � C Wc� � lvt o [ Ir, ) Address of property being improved: `VN'4L i f �L ZZ-3 3 General description of improvements: I10, +f &v- 1,ja-�t Owner: L0,V ` 1 n Address: 19)42:;> (�C t?eC Yl lJ ro�1`2 Owner's interest in site of the improvement: r .S Lf b irk L,9-•.- ee . le Titleholder(if other than owner): Name: Co or: Address: Telephone No.QUA{' Vq 1 "L _4 t Fax No: I q �'� " 3" Surety(if any) 1l I K Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself;designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself owner designates the following person to receive a copy of the Lienoes Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) / Name: A+' //A Address: Telephone 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 Signed: Date: Doc#2008020735,OR BK 14360 Page 1674, Before me this day of in the County of Duval,State Number Pages:1 Of Florida,has personally appeared Filed&Recorded 01!28/2006 at 01:32.PM, Notary Public at Large,State of Florida, of Duv JIM FULLER CLERK CIRCUIT COURT DUVAL My commission expires: WAS COUNTY Personally Known- t'" ° K. euNNINGHAm or RECORDING$10.00 Produced Identification: tL.. '. -F Cwmbsim EVkes Feb 28-.20 0 Comn*sion#DD Bonded By NationalrytVota Assn. CITY OF ATLANTIC CLIC BE CH PERMIT I IBUMDI G / ZONING DEPARTAMNT APPLICATION # r� S00 Seminole Road r V� Atlantic Beach,Florida 32233 08 t Al s!�' (904)247-5000 (904)247-5545 Fax www.coab.us APPLICATION TRACKING FORM REQUI DEPT: ���� ��ve Y Y PLANNING Prr® � Addre��: TV1 l N BUILDING rJ F" -' Y PUBLIC WORKS Applicant: ��• P9 PUBLIC UTILITIES Y W, FIRE DEPT. Project: ( / Y N PUBLIC SAFETY w -APPROVAL vREQU, ED AGENCY: RECEIVED BY: INITIAL: DATE: w luli Y ND.E.P HUFSTETLER O D Cf Y N S.J.R.W.M. CARPER w = Y N ARMY CORPS of ENG CARPER a Y; N HOTELS i RESAURANTS HUFSTETLER APPLICATION STATUS CIRCLE ONE: SITE BUILDINQ DA AP REVIEWED BY: INEL: DATE: ® 1ST REV PLANNING BUILDING,/ ® ® 2ND REV PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® ® 3RD REV Pa+- irin f 1hiQ far— ita#h p B$viei iiiiinc Int,?innrAment mice vnu have entered vour comments into the AS400. ' CITY OF ATLANTIC BEACH (OWNER / 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 UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. 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. A DRESS PHONE NUMBER D � � �,�, PRINT VA* 'A V f 12008 SIGriATURE ,, 8 DAT Before me thi day of �I`�1�GWA, ,200t in the county of Duval,State of Florida,has personally appearAO herin by himself/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of 7 V County of K. CUNNINGHAM ❑Personally Known �E' F-L 'D�._ __ = Notary Public-State of j,Produced Identification- My Commtsion Expires FebCommission#OD 523"''^', Bonded By National Nota Notary Sign COAB FORM BLDGV e ` CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD y ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00034248 Date 11/09/06 Property Address . . . . . . 1843 OCEAN GROVE DR Application type description ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4900 ---------------------------------------------------------------------------- Application desc RE-ROOF W/ ARCHITECT. SHINGLE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MCLAUGHLIN, MATT WHITES ROOFING COMPANY INC 1843 OCEAN GROVE DR. 14262 PLEASANT POINT LANE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225 (904) 220-5546 ----------------7----------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 54 .50 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 4900 Expiration Date . . 5/08/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 54 . 50 54 . 50 . 00 .00 Plan Check Total . 00 .00 . 00 . 00 Grand Total 54 . 50 54 .50 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH S PLAN REVIEW SHEET Ro D.Hufstetl Building Department Public Works&Public Utilities Departments oe im— w��F31�r 800 Seminole Road 1200 Sandpiper Lane R.Carper Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 D. Kaluzniak (904)247-5800 (904)247-5834 Public Safety (904)247-5845 Fax (904)247-5843 Fax PLAN REVIEW COMMENTS Permit Application `TLJQ Property Address �L�� �l/V 6ee il,6 Applicant: YV ffl TLE S &, A8:- dK • J11C Project: /&t---&0 F- This permit application has been: El Approved as noted by the Department. Final application approval must come from the Building Department. ED Reviewed and the following items need attention: Please re-submit 2-copies of all revisions. Please re-submit your revisions to the Department requesting them. Building Dept, Public Works and Utility information at top of page, failure to notify the correct department may delay your permit from being issued. Reviewed By: Date: Date Contractor Notified: S XSI r� r Y Jri'� ; .a,k I,� CITY OF ATLANTIC BEACH �r ROOFING PERMIT APPLICATION Date: 11 -7-2006 PLEASE SUBMIT(2)COMPLETE SETS OF PLANS WITH APPLICATION. Job Address: 1843 Ocean Grove Dr. Atlantic Bch, Fl. Owner of Property: Matt McLaughlin P Address: 1843 Ocean Grove Dr. Atlantic Bch, Fl. Telephone: 874-6106 Contractor: White' s Roofing Co. Inc. State License Number: CCC058017 Contractor's Address: 14262 Pleasant Point Lane Jax. F1. 32225 Telephone: 904-220-5546 Fax: 904-743-3677 Scope of Work: Remove existing shingle roof, install new 30 year architectural shingle roof. Deck Slope: 4. 1 2 Greater than 2:12 Less than 2:12 Valuation of work: $4 , 900 . 00 Product Name(Example: Timberline): Timberline Manufacturer(Example: GAF): GAF \ C ASTM Designation(s): Required Inspections: Sha hing and Fin 1 Signature of Owner: 4 1 Date: AS TO OWNER: Sworn to and subscribed before me this day of /Cf jj(f ernes.. ,20­0 �. State of Florida,County of Duval Notary's Signature: C'ad,t c) 0YPj,, DEBBIE J.RITTER j MY COMMISSION*DD498&44 ❑ Personally known `�' ❑ Produced identification �CFi�p EXPIRES: Dec.12,2009 (407)398-0153 Florida Notary Service.com Type of iden' ation produced Signature of Contractor: Date: _ AS TO CONTRACTOR: O Sworn to and subscribed before me this O day of A2� ,20 06 State of Florida.Countv of Duval 4,Vsy'+ DEBBIE J.RITTER Notary's Signature: MY COMMISSION*/30498844 F-1Personally known ;I'OF15-P EXPIRES: Dec.12.2009 (407)393-0153 Florida Notary Servico.com ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 -http://www.cLatlantic-beach.fl.us Page 1 Revised 2/21/03 NOTICE OF COMMENCEMENT State of Florida Tax Folio No. County of Duval To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: 1843 Ocean Grove Dr. Atlantic Bch, F1 Address of property being improved: 1843 Ocean Grove Dr. Atlantic Bch, Fl. General description of improvements: Remove existing roof, install new 30 year architectural shingle roof. Owner: Matt McLaughlin Address: 1843 Ocean Grove Dr. Atlantic Beach, F1. Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Contractor: White's Roofing Co. Inc. (Timothy White) Address: 14262 Pleasant Point Lane Jax. F1. 32225 �vl r7TelephoneNo.: 904-220-5546 Fax No: 904-743-3690 Sarety(if any) Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name: Address: i Telephone 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 Statues. (Fill in at Owner's option) �y Name: 1 Address: Telephone 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 Signed: Date: Before me is A U day in the County of Duval,State Of Florida,has personally appeared o Doc#2006390610,OR BK 13632 Page 1166, Notary Public at Large,State of Florida,County of uval. Number Pages:1 My commission expires: 2-1 -2 oa Filed&Recorded 11/09/2006 at 09:50 AM, Personally Known: or JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY Produced Identification: F v commisslON a oos9ssra RECORDING$10.00 �'0r nook EXPIRES:nee.12.2009 (401)395-0153 R.M.N—ry Smi-com M I A M FDA MIAMI-DADS COUNTY,FLORIDA MMO-DARE FLAGLER BURRING BUIIAING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER STREET,SUM 1603 PRODUCT CONTROL DIVISION MIAMI,FLORIDA 33130-1563 (305)375-2901 FAX(305)375-2908 NOTICE OF ACCEPTANCE(NOA) GAF Materials Corp. . 1361 Alps Rd. Wayne,NJ 07470 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Product Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below.The BCCO(In Miami Dade County)and/or _ the AHJ(in areas other than Miami Dade County)reserve the right to have this product or material tested for quality assurance purposes.If this product or material fails to perform in the accepted manner,the manufacturer will incur the expense of such testing and the AHJ may immediately revoke,modify,or suspend the use of such product or material within their jurisdiction. BCCO reserves the right to revoke this acceptance, if it is determined by 13CCO that this product or material fails to meet the requirements of the applicable building code.. This product is approved as described herein,and has been designed to comply with the Florida Building Code, including the High Velocity Hurricane Zone. DESCRIPTION:Timberline 30 RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any product,for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT:The NOA number preceded by the words Miami-Dade County,Florida,and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA#01-1203.07 and consists of pages 1 through 4. �� �� The submitted documentation was reviewed by Frank Zuloaga,RRC NOA No.:04-0305.03 Expiration Date:02/21/07 Approval Date:04/22/04 Page 1 of 4 ROOFING SYSTEM APPROVAL Category: Roofing Sub-Category: 07310 Asphalt Shingles Materials Dimensional Deck Tyne: Wood 1. SCOPE This revises GAF Timberline 30 as manufactured by GAF Materials Corp described in Section 2 of this Notice of Acceptance. 2. PRODUCT DESCRIPTION Product Dimensions Test Product Descriution Specifications Timberline 30 131/4'x 393/sp TAS 110 Fiberglass reinforced heavy weight asphalt roof shingle,with a laminate profile 3. EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date Underwriters Laboratories,Inc. TAS 107 OINK45803 04/13/94 Center for Applied Engineering TAS 100 257989 04/01/97 Center for Applied Engineering ASTM D3462 257989 05113/97 PRI Asphalt Technologies,Inc. TAS 100 GAF-044-02-01 01/13/04 Underwriters Laboratories,Inc. TAS 107 04NK04273 02/20/04 4. LIMITATIONS 4.1 Fire classification is not part of this acceptance;refer to a current Approved Roofing Materials Directory for fire ratings of this product. 4.2 Shall not be installed on roof mean heights in excess of 33 ft. 4.3 All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 9B-72 of the Florida Administrative Code. S. INSTALLATION 5.1 Shingles shall be installed in compliance with Roofing Application Standard RAS 115. 5.2 Flashing shall be in accordance with Roofing Application Standard RAS 115 5.3 The manufacturer shall provide clearly written application instructions. 5.4 Exposure and course layout shall be in compliance with Detail'A',attached. 5.5 Nailing shall be in compliance with Detail B',attached. 6. LABELING 6.1 Shingles shall be labeled with the Miami-Dade Logo or the wording'Miami-Dade County Product Control Approved". 7. BUILDING PERMIT REQUIREMENTS 7.1 Application for building permit shall be accompanied by copies of the following: 7.1.1 This Notice of Acceptance. 7.1.2 Any other documents required by the Building Official or the applicable code in order m NOA No.:04.0305.03 Expiration Date:02/21107 Approval Date:04/22/04 Page 2 of 4 to properly evaluate the installation of this system. S. MANUFACTURING PLANTS 8.1 Tampa,FL DETAIL A DECK FULL 5th 17"OFF 41h 11"OFF 3rd 6"OFF 2nd FULL 1 St NOA No.:04-0305.03 Expiration Date:02/21/07 Approval Date:04/22/04 Page 3 of 4 DETAIL B 39-3/8" Release 17-1 Tape 6 fasteners 7-" 7-" 134" 1' 1. 82 74" 5-5/8" Front Side(Maximum Slope 12:12) 39-3/8" Release 8fasteners 72" 71. Tape 2 1° 134' 1 6" 5-5/8" Front Side(Maximum Slope 21:12) Tab Sealant ll 1 , 2 1— � 1/2" Back Side END OF THIS ACCEPTANCE NOA No.:04-0305.03 Expiration Date:02/21107 Approval Date:04/22/04 Page 4 of 4 CITY OF ?1TIJUTTIC =21CH APPLIMATIO?V FOR FLC3.�SING 2.r.''' ATIT LOCATION: OWNTER 07, PROPERTY: G ELEPH(DNE ?L:,M3lrr'Z CONTRACTOR LARRY TEAGUE PLUMBING CO14TR_ACI0R' S RnDRESS: pp��+ .4u.4 �" _TF LICENSEILr.+BER 4A7PTELr'_?H3iiE g � HOW MANY OF THE FOLLOWING FIXTURES INSTALLED S I2TICS SHOWERS LAVATORY MATER HEAT-RS _.-SATE _U3S D1S ti.'a_SiiEF.S �RINAlS DISPOSA`•:S CLOSETS WAS =:IG TM`_?C'HiNTE FLOOR DFAINS S' OWER PiLNS S-WER WATER �REPIPE OTHE—F, TOTAL FIXTURES: x $3. 50 515. 00 MINIMUM PERMIT FEE - $25. 00 SIGNATURE OF OWNEfING-Z SIGNATURE Or CCNTINSTALL.AmIC.I OF PFIXTURES MUST B3 N ACCCP,UANC- WITH I iE MOST RECENT EDITION OF THE SCUT'siERi1 STA�DARIC PLUb13IPTG CODE. CALL A DAY AHEAD TO SCFtEDULE INSPECTIONS — (9041 247-582c SEWER rOr'tiECTIONS Nr:ST BE CALLED INTO P ,'BLIC fTORKS FOR INS??CTIGC: PRIOR TO COVERING UP — (904) 247-5834 CITY OF ATLANTIC BEACH — DEPARTMENT OF BUILDING 800 Seminole Road - Atlantic Beach, FL 32233 - Tel: 247-5826 - Fax: 247-5877 PLUMBING PERMIT I _ PERMIT INFORMATION ` — _ LOCATION INFORMATION _ i Permit Number: 19908 Address: 1843 OCEAN GROVE DRIVE II Permit Type: PLUMBING ; ATLANTIC BEACH, FL 32233 Class of Work: ALTERATION Township: Range: Book: i Proposed Use: SINGLE FAMILY Lot(s): Block: Section: 1 Square Feet: Subdivision: OCEAN GROVE Est.Value: Parceti Number. Improv. CostOWNER INFORMATION Date Issued: 4/19/2000 Name: MCLAUGHTON, HOPE I Total Fees: 25.00 I Address: 1843 OCEAN GROVE DRIVE Amount Paid: 25.00 ATLANTIC BEACH, FL 32233 Date Paid: 4/19/2000Phone: (000)000-0000 _ - rkD-- - esc: ---- — -- Work REPIPE ---- _ __ _—_CONTRACTORS) - -- APPLICATION FEES LARRY TEAGUE AND SONS --j—PIER! IT 25.00 i i i i I 1 Inspections Re aired --.--- t I j NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION _-----____---._ __ _— 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 CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION i FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. QNTlC­L—CZU!lLE5I _- -p -- f25.8814 T, Date: 4/19/88 81 Receipt: 8851213 CHECKS 8277188397 11766 09PAWMENT OF BUILDING CITY OF ATLANTIC a ACH sem_ PEW0, INFOR TION ------- LOCATXON INFORNATION ;__-__. mi Number: X1755 Address,* 1843 OCEAN GROVE DRIVE �e' rni Tye *PENCE � ` � `IC, BEACH, P`I►Ol�I�}1� 32233 C ss ,of Work,-ALTERATION ,..: _,...» .. ,LEGAL DESCRIPTION . .. . _ .__ nst r; Ty0e:WOOD FRAME Lot : B I ock: Section: 4 ;rop, Pad Ue: Play Soak. Page:O Dwe i i w, Subdivi si on:OCEAN GROVE Est . VCA * 'lyyT p �✓ w+M we.w iwr,uMt JW w.'w iz, :.i NPO 4 I O rov. Cost; Rare RM GANT Total F 1€3.00 Address 1,84 ,OCEAN GROVE DRIVE I ryAmo ux� 10.00 , A LAXT I C BEACH, PLO I W 32213 Aiju "44-Ty. jaws, RI'Aus ..„«.,. .w .. . IT .. 'APPLICATION PERS w,...�......._ .� .. .amu_{ .41 f ry . f - r e py '. „waxaxrnwk:4wC apa ti onsRequired ` Inspecations Requ r+ad' ' Inspections Requ recd x NOTICE ALL CONCRETE F4RIISANO FOOTINGS MUST.BE INSPOMD BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 80 LOING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NbT B PI.ACPD IN PUBLIC SPACE,AND MUST BE Ci RED UP ANC)MAULED AWAY BY t", EA CONTRACTOR OR OWNER LURE COMPLY WIT" THE MECHANIC'S 1..1EN LAW CAN RES 1N PRC P "Y NER ' NGT1 'IC 131 'TN E 11 'R V E1 TS" D ACCORDI G T'O APPROVED PLAINS WHICH ARE PART OF THIS PERMIT ANC'?SUBJECT TO RE'ft—A,= 3tls ON OF APPLICABLE PROVISIONS OF LAW. .AT NTYC EACH.SI!ILDIING DEP RTMENT �t z APPLICATION FOR FENCE PERMIT Owners Haas -- �. h a �-- _-" - Phone Job Address---, --- -s---LC- ------------------ LotBlock and/or Unit ♦------------Subdivision Contractor if different from owner_ ----------------------------------------------------------- o Valuation of fence rCorner or 4nterior lot --------- Type construction �t'!1C 2 ���c���c-� ---------- ------------------ Show location and height of fence as well as location of streets). Owner si nat• e � Date � �L� Contractor signature.................................Date t 1.1580 DEPARTMENT OF,BUILDING CITY OF ATLANTIC BEACH PERMIT, I NFQRNAT I DN '» LOCATION, I NFORMAT I CSN P f it Numb I3 Sf Cr Address,-,: liS43 0CZAN GROVE DRIVE rPer Tait TYPE BUILDING ATLANTIC BEACH , FLORIDA 32233 C ss �of Wotk w REPAIR L OAL DESCRIPTION nIr r . Ty +e r W OD F'R,AME Leat ; B l c? k Section: oposed Tie. SINGLE FAMILY Tdwnshi RNG. D l"lin r 1 Code 0 Sud vis- on' OCEAN GROVE Ci ted Vilne. $100,0 .00 ,Improv. COAL; 80.00 Total +yes * $37 . 0 Amo D, 3 12/0,6' W`irk LACE ROTTEN T-111 RAFTERS, TION " _ ...SA PDICA' ION "EEE .:-- , � RET S37. 50 B GROVE DR VE WAT IMPACT FEE N yq "- RP V pe A WON GAS-H.R.S. $0.00 . . + T NFOON� ---- � CAB 5%� C $0.00 Name T PSOWTRACTCR CAPITAL IMPROVE, 0100 ILLS BEACH, FL 32250 CROSS ONNZCTION WOO TP ;. I SES HiPACT FSE flf CQN ST w$URCHARqE S 4 I I NDTICE- ALL CON, FORII�tANa F TINt4S MUST 8>w INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE;OI={S UP I3 DING MATER L RU B1SM ANIS DEBRIS"FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUS : d ., ABED UP A'0 Eta AWAY 8Y EI`tFt fi C'ONTRACTOR.4R OWNER Ly:WITH, THE MECHANIC!S. LWN'. LAW CAN RESIO."s ,IN of KPAYINOTWIC 'IMP I EL1 ACCORDING TO APPROVED"PL.ANS WHICH ARE PARI'OF THIS PERMIT AND SUBJECT TO RE FjgN FCS Tn my U>. TION OF AP LICABLE PROVISIONS OF LAW. t til „'`4 : AT` TIC B H SUILD111G PART' NT f CIr/TY OF ATLANTIC BEACH PERMIT CALCULATION SH ET Address Date Heated Square Footage @ $_ _ er sq ft = $ Garage/Shed @ $ er sq ft = $ Carport/Porch / @ $ er sq ft = $ Dec}; Cd $ �er sq ft = $ 0 � Patio @ S der sq ft = $ TOTAL VALUATION : � $ ls� Q b $ Total Valuation 1st $ / O©o� CIO Remaining Value $ doper thousand Wportion thereof TOTAL BUILDING FEE $ � p° + 1/2 Filing Fee $ / -2 -S-O ( ) Fireplaces @ $15 , 00 S BUILDING PERMIT FEE WATER IMPACT FEE $�,_ SEWER IMPACT FEE $ WATER METER/TAP $ CAPITAL IMPROVEMENT SEWER TAP $ ( ) RADON (HRS) .0050 $__ SECTION H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ( ) SURCHARGE . 0050 $ OTHER $ GRAND TOTAL DUE $ 3 3 ADDITIONAL PERMITS OR FEES : Mechanical ; Plumbing _ Electric/New Electric/Temp ; SwimmingPool Septic Tank Well Sign ' Finish Floor Elevation Survey Other CALCULATIONS and/or NOTES: ? 0 7 1996 CITY OF ATLANTIC BEACH '�1Z�TEft�4T�8�s�Oning PERMIT APPLICATION REMODEL , ADDITIONS OR DEMOLITIONS owner(s) : ICP �C.� / Address : t J CPhone:-.2-70- /f 3 Lot # Block or Unit # Subdivision: Contractor: �I�A,'LDaTOsa� State License # Address : /1-7( ��.L1 i _ (/7� Phone No: y� -D31��yS3T/3 Describe work to be done:_ ZaVVe ip 4A�� 77- 11 a W Presen use of building: Valuation of Proposed Construction: Zzmalx) Proposed use: Is this an addition? If yes , what are the dimensions of the added space: ft . X ft . Will the added area be heated and cooled? New electrical (or increase)? New plumbing fixtures? New fireplace? New Heat/AC? SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY , ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: Date: Signature CONTRACTOR: Dater 7 License Supplied: Liability Insurance: �� �� � pP P Z�P��\cc,0Fvjct Worker's Compensation Insurance: /�� e`aN 119go, MaR By 12136 ixPAR miw Of BUILDING CITY OF ATLANTIC BEACH E_ PERM-1 INPORNATIQN - -- LOCATION INFOROATIO � m N=bn t. 12135 Ad�ire s. 1843 -OCEAN GROVE DRIVE 1 Permit Type.PLfiMBIN4 XTLANTIC BEACH, FLORIDA .32233 C ass of Work.ALTERAtlOf; - - -- LICDESCRIPTION ----------- nstr Ty e.WOOD PRA4E 81ack: ot: TwP �# it caposd Ude: Section: Subd.C? Rnq wei i ing s. I 0 .00 Subdivl is C RAi --,GROVE, Est , Vail Prov. co t :. Q:DU Total Fe "s. 25.0 aunt ' 25�'0 Date i TX SEWER _ . o - APAT3ii 'FEES A25.00 . OVE ISR I VIE FLORIDA P n =5, WON I 9 ------- N, 8. ER w0 N a JACKSON. E EL 32205 C. 3$. `_ T N, f 4 N©TICE--~ ALI.,CANCR F©"AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMrr Volo SIX MONTHS AFTERDATE OF ISSUE BUI, N6 MATERIAL,;RUBBISH AN©'DE13RIS FROM"THIS WORK MUST NOT BE PIACEQ itd PUBi.lc SPACE, " C RE£1 PPAND H14ULE>J AWAY BY EITHER CtNTRACTQR DR OWNER AND MUST BE E M COMPLY WITH THE MECHANIC'S LIEK LAW AN Ut,T IN PRPf OWNS T II E FC?RTHS � ROVEM NT !S 13#CC{)R# TO APPROVED PLA WHICH ARE PARI'OF THIS PERMIT A T RE i ' OFA CABLE PAOVISlCJi�i8 OF LAW. ��- �► ;BEACH BUIIa.D1NG EPARTMEN'T dW POF .7��V / CO, 0,4\a vi 0 ,4 ?uluoZ pue 2uipl,!ng 9661 0 4-1 0 T-T J, P14 j -XI Cyl C7 ---------------------- �31 *f Y t 1 IX, i s� r' V E 0�N B1015 GUARDRAILS B1015 .1 GENERAL All unenclosed floor and roof openings, open and glazed sides of landings and ramps, balconies or porches which are more than 30 inches (762 mm) above finished ground level or a floor below shall be protected by a guardrail . Guardrails shall form a vertical protective barrier not less than 42 inches (1067 mm) high. Open guardrails shall have intermediate rails or ornamental pattern such that a 6-inch (152 mm) diameter sphere cannot pass through any opening. A bottom rail or curb shall be provided that will reject the passage of a 2-inch (51 mm) diameter sphere. Construction of guardrails shall be adequate in strength, durability and attachment for their purpose as described in B1608 .2 . EXCEPTIONS: 1 . Guardrails are not required on the loading side of loading docks . 2 . Guardrails shall be permitted in conformance with requirements for specific occupancies in B1018 . B1015 .2 GLASS Glass guardrail components shall comply with B2405 .5 . 11654 DEPARTMENT OF BUILDING CITY©F ATLANTIC BEACH - - PERMIT- INFOXMATIO _ .-----. LOCATION INFORMATION -- -- rimi t Allmbet*- 11654, Address .a : OCEAN GROVE DRIVE Perm : ELECTRLCAI, ATLANTIC BEACH, FLORIDA 32233 ads of 'Work. ALTERATION DESCRIPTION --------- ons t r. Type WOOD p kLost: � Black: Section: rdoosod, Use: SINGLE FAMILY Township: RNG: 0 411 isngs: 1 Code*. 0 Subdivia iow :OCEAN GROVE Improvw )COSt: �Ba'OW Tota, $25.00 Alto " $25.0-0 , rk TI�STS IN, REMODEL, y� t �e �± M' T1,00 '«. .....,«. AIs PI�,ICATI4M I`Ei�i�7 ..w .++. r+ ass PI TT' $25.08 N GROVE DRIVE NA'T IMPACT FEE `-$0.00 T FLOR I FIDE 4 4 i n 9 A Awpm RAD OAS-H.R.S. to.00 oil ft, ». NF`D� ON � �,..._ .� RADON, CAB 5% $0 .00 N ne: T D ECTRtC ONTR3� t3R CA)'ITAL IMP'Rt?VE. $0.00 JAS ILII ; FI,'« 3:2247 CROSS CONNECTION 0.00 ' p+ ': 4 SEC -H IMPACT FES .00 CONST SURCHARGE E 44 t U i > d 4 i NOTICE -ALL CotcnTE FoRm AIVQ Ft -nN GS MUST BE INSPE 1?.BEFpRE pQURING PERMIT Ut3ID SIX MONTHS AFTER QAN UF.ISSUE 843. IMG MATT R(A ,BLED AH Y 0 DEBRIS FROM THIS WORK MUST NOT$E.PLACED IN PlJSLIC SPACE,AND MUST BE C RED UP AND HAULEQ AWAY BY EITHER CRITRAGTAF#OR OWNER IlURI T OMP I Y W#1`H H. MECHANIC'I ;LIEN LAW CAN BE LT N T PI �P�E `fiY+C IMI R f 'AYINt+aTWICE FORTHE I I ILa IMG IMPROVEMENTS ED ACCbRDII TC APPRavED PLANS WHICH ARE PARI OF THIS PERMIT AND SUBJECT TO RE I vI " TION©F APP ICAII.E I�R411SICS( Iw LAViF :� �"0 A' Er 10 0=100 ACH SULDING DEPARTMENT k CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: L�1 19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMITS GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID ORK 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. 4 l ELECTRICAL FIRM: MASTER ELECTRICIAN SIGNATURE JOURNEYMAN NAME -ADDRESS:- 1e±3 cl�a17 RFD_1_.__BOX i BLDG.SIZE BETWEEN: RES.(a APT. ( I COMM.( 1 PUBLIC ( ) INDUS.1 ) NEW( ! OLD ( 1 REW. ( ) ADDITION ( ) TRAILER ( ) TEMP. ( I SIGNS ( I SQ.FT. SERVICE: NEW( ! INCREASE ( 1 REPAIR ( ) FEE CONDUCTOR SIZE AMPS COPPER ( ' ALUM. SWITCH OR BREAKER AMPS PH W VOLT RACEWAY EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.90 AMPS. 81.100 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 1 0.100 AMPS. OVER APPLIANCES ,: BELL TRANSF. AIR H.P.RATING H.P.RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CELL HEAT: KW-HEAT I 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS II MISCELLANEOUS TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA I I NO. lKVA NO.NEON TRANSF. NO. VA. MA. I MOTOR SIZE SWITCH FLASHER EACH SIGN FORWARDED $ TOTAL FEES 4 i PSR -- 11627 i E 60A TMENT OF BUILDING CITY OF ATLANTIC BEACH ,. .. PERMIT INFORMATION -- -- -- - -.. .... 14CA►T I ON I AIP`E)�tM T I QN -- .�.-ww- Fiux ier: 1162Z Address: 1843 OCEAN GROVE DRIVE P rTrii Pe; RE-RQ€I' ATLANTIC BEACH, FLORIDA 32233 as$ of Work: ALTERATION ---.:,._r*�.;�, . »----- -_� LWAL DESCRIPTION I PT I ON onst.r.. TY'pe: WOOD FRAME Lot Block: Section: raPOse U;ae; SINGLE PAtMIL Township: RAtGr t}, ellings . 1 Code: ( Subdivision:, OCEAN GROVE t imated Vsi1ue; S1#31 D.DC Imptv. �oatk Total Fees. "$25.00 Amc t 1 $2.5.00 BA239 . W rk A '& ROOF USING MODIFIED BITUMEN APPLICATION FEES .... .,«... QTY OF PE'RM,IT $25A0 A • ROVE ORI TATER IMPACT ELLE WOO O ACH i, FLORIDA 2 S IMPAC FEE .Dfl P -� Q A AIS ..,._. T IiPC $MAT O »_.. . RADON CAS 5 $0 .00 Iat#1 N PING CAPITAL IMPROVEr $0.00 A deal; ` 13r RASRAW ROA 233 CROSS CO NECTION 80 .00 L cense: RCS 9 type,. DSEC H IMPACT FEE $0.00 CONst.SURCHARGE 00 SCRARGZ/ATL.INCH $0. Q Nth S: y : t i NOTICE-�ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPZO IIO BEFORE POURING PERMIT40 SI)C'MONTHS AFTER DAT`I= }F ISSUE B `'DING MATERIA.,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CL RED UP AND MAULED AWAY BY EITHER C4NTRACTQR OR OWNER LUREM COMPLY WITH THE MECHANIC'S ,LIEN SAW CAN RE LT IN,. I�'�IC�PE 1 OWNe PAY'IItiI TWICE FORTH SI�ILI�INt� PRC�YEMEI�I'I' " IS ED ACCQRDING;TO APPROVED PIANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TQ REVOCATF FOR VI ON OF APPLICABLE PROVISIONS OF LAW. Jm3,ll! ►:�tt 44 ���� A; TIC BEACH BU LPING DEPARTMENT OEkYtKI4+DI000 CIT? OF ALANTIC BEACH ROOFING PERMIT APPLICATION Owner(s) : ar . Address: Oc eC� ­\ S Phone Lot # Block or Unit # Subdivision: Contractor: Address: 'A_76 Sc 1 l- City, State and Zip r„� G x Phone 2 i 00 State License # Describe work to be performed: r o Valuation of Proposed Construction: Materials to be used: Signature of Owner; Signature of Contractor: Liability Insurance Supplied Workers Compensation Insurance Supplied License Information s z CITY OF ATLANTIC BEACH PERMIT APPLICATION ROOFING y Owner(s): 14.e,.j O` 1Zo u r ke. Address: )TA's ocle AN Gfoye- Phone: N1,p Y Lot # Block or Unit # Subdivision b, _ r - Contractor Sc Au lf2. Rao0' iW6 6F*p11XvV 1A16 Address-, alb IV (3�'`�' '.5rre e--lk Phone: State License No. CC Co98� r: Describe work to be done: A /&v ' LL Materials to be used: 6) jZr ? Signature OWNER: Date Signature CONTRACTOR: / ,g i s, -a MY OF ATLANTIC PY-AGi OOuE VIOLATION FORM Date Address and/or Location of Violation CCHPIAINr: Owner and/or Tenant of Property ` -e '� .. � c- �'OIL SIGNATURE OF OOIVII URW Pbone#,.� � ADDRESS -------------------------------------------------------------------------------- Date of Investigation /a-� z Investigator ' Conditions Found Action Taken Comliance IMES: t ` CITY OF Office of Building Official REQUEST FOR INSPECTION Date "- l � Permit No. 316/ Time Received n Job Address ocality Owner's Name Contractor BUILDING CONCRETE ELECTRICAL /r ,-,P MBING MECHANICAL Framing G Footing ❑ Rough Wiring � Rough ❑ Air Cond. & Re Roofing G Slab ❑ Temp Pole O Top u ❑ Heating Insulation G Lintel ❑ Final G Sewer Fire Place re Fab READY FOR INSPECTION Mon. Tues. Wed. Thurs. Friday P.M) _ A. Inspection Made Inspector Final Inspection D ` Certificate of Occupancy Date //����// nnCITY OF //��//���� �� __ N . '. le-' �I 4a,44 Office of Building Official REQUEST FOR INSPE Date / t -- -- Permit No. Time /,Of f 00 A.M. (� Received } Job Add r s Locality Owner's Contractor �_ UILDIN CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing _l Rough Wiring ❑ Rough ❑ Air Cond. & ❑ Re Roofing ❑ Slab CJ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel C' Final ❑ Sewer ❑ Fire Place Pre Fab READY FOR INSPECTION A.M. Mon. Tues. Wed. Thurs. Friday P.M. A.M. Inspection Made P.M. Inspector Final Inspection Certificate of Occupancy ❑ Date J�/Ci�vv-tcy C�E�cic�,= ) ,5foW----J-,4 tr CITY OF riId4od4C J3e.Q•f iL-"t Office of Building Official REQUEST FOR INSPECTI Date Permit No. Time A.M. Received P.M. Job 6ddryss Locality Owner's Na Contractor BUl � CONCRETE �ICAL-) PLUMBING MECHANICAL taming ❑ Footing Rough ❑ Air Cond.& ❑ Re Roofing ❑ Slab ❑ Temp Pole Top Out ❑ Heating Insulation 71 Lintel ❑ Final C Sewer ❑ Fire Place Pre Fab READY FOR INSPECTION a.M. Mon, Tues. Wed. Thurs. Friday A.Inspection Made Inspector Final inspection ccupancy Date