Permit Well 320 1st St 2012 C vLtJ
JF1
!II CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
'4" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000346 Date 4/03/12
Property Address 320 1ST ST
Application type description WELL PERMIT
Property Zoning RES SF DISTRICT
Application valuation . . . 0
Application desc
NEW WELL
Owner Contractor
PEAKE LINDSEY CHANTAL HULIHAN TERRITORY
320 1ST STREET P.O. BOX 331268
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 285 -8505
Permit WELL PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 9/30/12
Special Notes and Comments
Seperate permit required for electrical
connection /wiring to new pumps
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 79.00 79.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
; i_: v City of Atlantic Beach - APPLICATION NUMBER
1 ,6 Bu ilding Department / PA (To be assigned by the Building Department.) so
800 Seminole Road 2 e r
o
} Atlantic Beach, Florida 32233 -5445 7 . 0 /4 1 A=
. &
Phone (904) 247 -5826 • Fax (904) 247 -5845
F es , o;i fit E -mail: building- dept @coab.us..--:'------------ Date routed: - 7/ 7 /2_
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Z 0 ki Department required Yes No review re
Property Address: ,� p q
Building
Applicant: hl (c h &'7 Planning & Zoning
Tree Administrator
Project: 1,0f. 11 Public Works
blic U 'Ries _-
u • is Safety
"?-v Fire Services
Review fee $ Dept Signature y :-.--
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: ]Approved. (Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by: Date: !7 2 7 / 7 .
TREE AD IN. Second Review:
[Approved as revised. ❑Denied.
P , : : - Co. ments:
/��JI
. 0 -
P :
illip,
AFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
PUBLIC UTILITIES PLAN REVIEW COMMENTS
Date: 31 c ?)' z Initials:
Project Name / Address: 3 ,�.,� -St Application Permit #: L r 3 q ( -0 . *
Check Box Check
Application Tracking Comments to Add Box to
Comment "Print"
Avoid damage to underground water / sewer utilities. Verify vertical and horizontal location of
utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834.
i ❑
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. ❑ ❑
A sewer cleanout must be installed at the property line. Cleanout must be covered with and ❑ ❑
RT1 concrete box with metal lid. Cleanout to be set to grade and visible.
A reduced pressure zone backflow preventer must be installed if irrigation will be provided or
if there is a private well on the property. Backflow preventer must be tested by a certified ❑ ❑
tester and a copy of the results sent to Public Utilities.
Plans note the building will be unsprinkled. If plans change, any fire line installed must be
metered with a Sensus touch -read meter in a properly sized vault and an appropriate backflow ❑ ❑
preventer installed. Backflow preventer must be tested by a certified tester and a copy of the
results sent to Public Utilities.
If fire sprinkler system is provided, contact Malcolm Clemons at 247 -5839 for backflow ❑ ❑
requirements. At a minimum, will require a double check backflow preventer.
Fire lines must be metered with a Sensus touch -read meter. Meters larger than 2" must be ❑ ❑
installed in a vault as noted in JEA specifications.
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INV 414
-013 v%" &j, ' 012 /7
CITY OF ATLANTIC BEAC
3/ � �l- WELL PERMIT APPLICATION
Date iindfloy Owner' s Name: /" 4 Address: 3 lo •7r r
Well Address (if different than above): S –P—
Well Location on Property (i.e. northeast corner, etc.) C. C .f • iI e d Mae
Well Installation Contractor: 5 C O f H u.J i k ►
2S5 -356;
Contractor License No.: IS 01 Phone(CU - 1) Fax: Mot-OD-to - )3O
Contractor Address: 1 11 A f [ C(n 1 )t v' cf A- [ g (1+i fl c Oc -AGh 1=
52233
Check Use of Well: Domestic Irrigation ✓ Other
# of Wells to be installed: # of Pumps to be installed:
Estimated- Well Depth: 4 10 Casing Depth: Screen Interval fronto 4a
Well Diameter: 1 Yr Casing Material P
Is address currently connected to the City water system? y
Is address currently connected to the City sewer system? y
/ .m 1 4 f '
ates
Has a Well Permit been obtained from the City of Jacksonville? Permi
Does the well require a permit from the St. Johns River Water Management District?
(Not required for wells under 2- inches diameter installed by r ) nt or wells under 6-
inches diameter if installed by licensed well contractor).
If permit is required, note Permit Number and attach a copy.
NOTE: WHENA WELL IS INSTALLED ON YOUR PROPERTY, YOU MUST
INSTALL A REDUCED PRESSURE ZONE TYPE BACKFLOW PREVENTER ON
THE CITY WATER SERVICE, ON THE CUSTOMER'S SIDE OF THE METER.
THE BACKFLOW PREVENTER MUST BE TESTED BY CERTIFIED TESTER
AND A COPY OF THE RESULTS SENT TO THE PUBLIC UTILITIES
DEPARTMENT.
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&OD