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Permit Remodel Hall Bath 1927 Beachside Ct 2012 t CITY OF ATLANTIC BEACH t) 800 SEMINOLE ROAD �� yx, ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 12- 00000271 Property Address Date 3/26/12 1861 BEACHSIDE CT Application type description RESIDENTIAL OTHER Property Zoning TO BE UPDATED Application valuation . . . 10000 Application desc REMODEL HALL BATHROOM Owner Contractor WHITTINGTON WILLIAM R & NANCY OWNER 1861 BEACHSIDE CT ATLANTIC BEACH FL 32233 - -- Structure Information 000 000 REMODEL HALL BATHROOM Occupancy Type RESIDENTIAL Permit ELECTRICAL PERMIT Additional desc . Sub Contractor . ISLAND ELECTRIC OF THE FIRST C Permit Fee . . . 60.40 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date . . 9/22/12 Other Fees STATE ELEC DCA SURCHARGE 2.00 STATE ELEC DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 60.40 60.40 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 64.40 64.40 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: (& ) RA WI SI A E (.-r. PERMIT # / ` -00000 . - 2- 1 % JEA INFORMATION REQUIRED ON ALL PERMITS '2i7 v AMPS 170 / VOLTS / PHASE VALUE OF WORK $ • g 0o . 4as' NEW SERVICE ❑ Overhead n Underground nT Underground up Pole ❑Residential (Main) Service 110 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters ❑ Commercial (Main) Service ❑0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps ❑CT Service amps Conductor Type Size ❑Multi- Family (Main) Service 00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters ETemporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.) ❑ 100 amps ❑ 150amps 0200amps ❑ amps E] CT Service amps ADDITIONS, REMODELS REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC. Outlets /Switches: /19 0- 30amps 31- 100amps 101- 200amps Appliances: 0- 30amps 31- 100amps 101- 200amps A/C Circuits: 0- 60amps 61- 100amps Heat Circuits: # circuits @ k Number of Lighting Outlets, Including Fixtures: 1' OTHER ELECTRICAL PROJECTS ❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty LI Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts /amps VALUE OF WORK $ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑ Safety Inspection 11 Panel Change ❑OH to UG ❑ Other: 8A Am et :l M o t(— 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 /► 4- Pi 15 , W) A L) u t✓ TON) Phone Number Electrical Company 15 t A N E (....,E CT 2t G Office Phone 2 '(6' TO 3'S Fax z cI (' 341 i Co. Address: L Z ff 5Th A') ■O - , JA)(. eal , City J . 8. State FL4 Zip 32257 License Holder (Print): ,,, kW N S J N a • gr State Certification/Registration # ISO I3'( 3A Notarized Sign ,. - .___._� .____...-- ..._.__ _ .A. •.a, .0 ... SHIRLEY L GRAN ' ' � . :; MV COMMISSIO Q {�ss n subscribed be ere me this ' , day o A/ a '� C `? 20/2 - sa . EXPIRES: Feb 4 1 , ov F °° Bonded Notary Thru tary Public derwriters - - Underwriters air ' _ _ _ _ __ _ _._ .__.:-. f Notary Publ.,, .._ , , , CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J . , .... ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 - OE 5 Application Number 12- 00000271 Date 3/12/12 Property Address 1861 BEACHSIDE CT Application type description RESIDENTIAL OTHER Property Zoning TO BE UPDATED Application valuation . . . 10000 Application desc REMODEL HALL BATHROOM Owner Contractor WHITTINGTON WILLIAM R & NANCY OWNER 1861 BEACHSIDE CT ATLANTIC BEACH FL 32233 - -- Structure Information 000 000 REMODEL HALL BATHROOM Occupancy Type RESIDENTIAL Permit RESIDENTIAL ALT /OTHER Additional desc . REMODEL HALL BATHROOM Permit Fee . . . 100.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 10000 Expiration Date . 9/08/12 Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 100.00 100.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 104.00 104.00 .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: /7 / -5c4MS/ be cotter "id L 32233 Permit Number: y�2� Legal Description 12'/4 Oq "ZS"2/IE. I3 Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ S'' /t k Proposed Work heated /cooled non- heated /cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /door Use of existing /proposed structure(s) (circle one): Commercial Residential If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A Florida Product Approval # For multiple products use product approval form �' Describe in detail the type of work to be performed: - 'fie 514 °j - and c /.4Ce i k/ iE--eS Property Owner Information: lv7 let - ' ' (, / T Name: i �e�Nt f "Y�lu/ A. �l/h �t i�M Address: ��Cffs /AEC City A/p v Stated Zip 322;33 Phone (qH) 24 E -Mail or Fax # (Optional) RUT 1 7M/O. C6Y.r! 1 ray = 104- 331 - 1,379' Contractor Information: Company Name: Qualifying Agent: Address: 1 City State Zip Office Phone Job Site/ Contact Number Fax # State Certification/Registration # Architect Name & Phone # Engineer's Name & Phone # - Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and 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 pernzit 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 f6) months at any time after work is conznzenced. I understand that separate permits must be secured for Electrical IFork, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that 1 have read and examined this and know the sane 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 - • eral. state, or local law regulating construction or the performance of construction. Signature of 0 Signature of Contractor Print Name Wil'I/i Cy l df f? /J€7 7V Print Name Swor t. . subscr Sworn to and subscribed before me thi Day of 20 / this Day of / , 20 ./ Notary Public DEBORAH AM Notary Public =+A MV COMMISSION # EE 057349 E XPIRES: May 21, 2015 Eia�ded Notary Public Underwriters Revised 01.26.10 � Z4 1 ,c. w 3.1'x. O9is-2) CITY OF ATLANTIC BEACH ®W NER / 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 REOUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. I1. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND /OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY_UNDER FLORIDA STATUTE NO. 455 - 228(1). AN "OCCUPATIONAL LICENSE' IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247 -5826) IF IN DOUBT. V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER- BUILDER PERMIT. 44/ BE,4cHS/hE CDWQT 1 46 R..32233 90 Z4z -D /TO ADDRESS , PHONE NUMBER 441777. j -2,u L V/ a//.2--- IGNATU - / DATE Before me this / day of / , 20 in the county of Duval, State of Florida, has personally appeared herin by himself / herself and affirms that all statements and declarations Waccurate. Notary Public at Large, State of , County of d f*: gtMCt; DE BORAH ❑ Personally Known ( f Z /� 22 '��� ft4YCQMM « bN EE ��� chi l Jo� L7 J 7 •� w - -0 t he EXPIRES: INe '0'7349 �.P� ca on- dedThrU 21 , 2015 , Pu ndenvritem Notary Signature: F:/BLDG /Owner- Builder Affadavit REVISED: 4/16/2009 NOTICE OF COMMENCEMENT State of r�I I )s,4 Tax Folio No. County of /)(.f VAL 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: 42-14 O'9 - 2 S 2 E .13 B £ 4i -f1 s i)N E Address of property being improved: /26 / /3 E;4C is /At CvU R'r; ,41 It 66 461 FL ,3233 General description of improvements: . 7% Ye S6 /ii4-- A4 A' r/,a4ee 4 -tee rj Owner: G(/i7 /ie e Aielklel A. WhagAgfityi c Address: / f eEi9�S/bc CT; kiILLt.g1G A FL 322 ?3 wner's interest in site of the improvement: Fe St* >LE Fee Simple Titleholder (if other than owner): Name: Contractor: (0 /e/i/c,Q li !/ILLh4nt e. f ,4Ak( A. Will rri Ai 47 Address: /,%( & P ! W S , , b e co U Q7" ' T G 5NTi c t%4 tf FL 22 3.. / 1 3 Telephone No.: (704) 24Z- 0/76 Fax No: (9'4) 33T- g37q Surety (if any) Address: A...na,..t o f Rnnd t Doc # 2012052938, OR BK 15876 Page 448, Telephone No: Fax No: Number Pages: 1 Name and address of any person making a loan for the construction of the im Recorded 03/12/2012 at 11:31 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL Name: COUNTY RECORDING $10.00 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 Lienor's Notice as provided in Section 713.06(2)(b), Florida Statues. (Fill in at Owner's option) Name: 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 1) Ati:,-- R. Lvi () l+/L � Signed: ' Date: 12 m. 2012- Before me t 1't'* � day of /Vla. rc � in the County of Duval, State Of Florida, has personally appeared rte,/: /I; o,,,,a £ i J I , : f F 7,43 t o ,n r . Notary Publk Stab of Florida N otary Pu blic at Large, Stat o Flor County of Duval. �1 D a v i d Willett My commission expires: 3 H! 2 016 +J My Commission EE 175885 Personally Known: or or Expires 03/04/2016 Produced Identification: D r", v e r s 1.. ce nsp Par S tw.te. o f. rio ri lcL, !i \(s v 1 CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD j ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 tOF3 S}V Application Number 12- 00000271 Date 3/14/12 Property Address 1861 BEACHSIDE CT Application type description RESIDENTIAL OTHER Property Zoning TO BE UPDATED Application valuation . . . 10000 Application desc REMODEL HALL BATHROOM Owner Contractor WHITTINGTON WILLIAM R & NANCY OWNER 1861 BEACHSIDE CT ATLANTIC BEACH FL 32233 - -- Structure Information 000 000 REMODEL HALL BATHROOM Occupancy Type RESIDENTIAL Permit PLUMBING PERMIT Additional desc . RELOCATE AND REPIPE Sub Contractor . TDG PLUMBING Permit Fee . . . 153.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 9/10/12 Other Fees STATE PLBG DCA SURCHARGE 2.30 STATE PLBG DBPR SURCHARGE 2.30 Fee summary Charged Paid Credited Due Permit Fee Total 153.00 153.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.60 4.60 .00 .00 Grand Total 157.60 157.60 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: « to k ile eicl s; de err PERMIT # Z___ NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE -PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub 2 Septic Tank & Pit Clothes Washer _ Shower Dishwasher 1 Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 2 1 Hose Bibs _� Urinal \ Kitchen Sink 1 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 fmal inspection. ** ❑ Other Q Q LocA4e. d 'Fi'h .. t teJ ..N. i� AO'lit (1AA Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name L e J (4:1 +∎. f l v — `-✓ ■ Lk: 4 4 ••••• C /N Pt n cl Phone Number Plumbing Company T C S k . • , • • . • ‘ • :vi 'rt. c O f f i c e Phone S ) 4 41 Fax3lo'1 - (4'S3' Co. Address: LA 4 2 L Lo.i s D (t.. City TS State r L, Zip £312.2 c. License Holder (Print) R-Pt.3 ► , Coq : n Q State ertification/Registration # F'FC -(42., x.2 Notari • fr.' a ,, :r7 . 7fr'l- -. er r-'� J �x: '" MY COMMISSION # EE 057349 J � • EXPIRES: May 21, 2015 OM and subscribed before me this day of )11/A—L-- 20 ( . Pl`„� Bon ded thru Notary Public Underwriters 1 -" . ignature of Notary Public Ci