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Permit 255 Plaza (vault)
491 pppgTMENT 0r'8U�L01Nti CITY{gyp ATLANTICT INFORMATION BfrACH yP 'PER 111 4" Addie a PLAZA . STREET r. it Tpp x. E: Ham` ATLANTIC' BEACHr FI.�r IIIA23332 C 1dr ' ti LA ., t �h I PTT{IH �: + P► 1r rigs i. : icn1.o RAs C1CUt� H1 r, * ar h p o $joL BEACH PKWAYSubdivipio ATLANTIC 0 -000 Y coati $0.00 'I' *Zi.: 50 So mou *22.1 17 k, rk + APPlYICATIfIH ` ,.. wk �' R P I T x. :5(7 Ar "x'HHY I"PAC E C. p i ADON CAS"I . Vit.%'o#w,�7� .. ADO GAS Ooe TAP 00 RACTIT N AST >.. -SEWER TAP $0.00 . AC K . . , 21 H'IAFtAULIC SHARE: pp ,. } IN Pte: .. ` , CC. k L ;. H '3CI PACT F . �3. . • � u :,mx. :.�' ,a � a. QTS': 4 `NgTiC Ai:t.G 1wtCI 1> ## MS AND FOOTING, MIH3'��I C7E.�BrRFt��#�P�UFtiN�G s ty P>:RMIT v©I©six ONT' AFTER DATA OF rssur` UIr k7rNG nnAT R4 1BAIS FROM THIS WORK MUST rV�� r��PI_AreE0 IN PUBLIC,SPACE,AND MUST BE CLrwAF E17 uP . HAULF-7 AwA r r r4 CONTRACT©R OR OWNER 4 { ` A Ltl r T µ � FlJ' THS M,E MAN C, �.:1:�1�1 �.A1�1/ SAN ���lJl:T IN ' R ►ET " t3 �R ►�►1ING #CE. a BU . N t�l1P � I iw. iqC G?R Dthlt3 TQ APP t V E7'PLANS wHrCH ARE PART OF THrs'P RAA T ASN D �usJ sVocATi fl i# TI'0 111 LI ABLE &*o s."o LAW. ATLANTrC BEAtt gtJr�rir*aG pPjRTME[+ET t ' CITY OF ATLANTIC BEACH PERMIT APPLICATION ROOFING Owner(s): Address: �r5� /// � s7G Phone: 1^7 3 Lot # Block or Unit #_ Subdivision / /.,91-�f rrid,2 y Contractor: Address: y3,Zo Phone: U State License No. C L L 03 y ? y Describe work to be done: Materials to be used: // Signature OWNER: ' / Date: Signature CONTRACTOR:___ '{ TMESISAGIC MESISAGii A.M. FOR D TIME P.M. J M ED OF PHONE AREA CODE UMB EX SIGN E ALL.. MESSAGE 9 WlLL C L GAI r SEE YOU SEE YOU SIGNED'"`- FORM 4006 V tl� ry +- A.M. (FOR V P.M. M � PHONED OF PETURNED /'y V YOl1F1 CALL PHONE_ S �` PLEASE CALL MESSAGE_ t!. 4LL CALL CAME'TO SEE YOU WANT5 TO SEE YOU SIGNED .; TOPS FORM 4006 , 4857 09PALRTMENT 4F BUILDING ' CITY OF ATLANTIC BEACH PP't1 EMIT I PORNATIE3N _« .,_ » - LOCATION INFORMATION 1Porvwi . Otber t 41 ; 7 Addrem 800 C,A'VAL.L A ROAD & 830 Permit ` Y RE-ROOF` ATLANTIC REACH FLORIDA 32233 C ► ifi�rkt NEW- - _ _., �. LEGAL DESCRIPTION r Type: , W000 FRAME Lots , B.Lcaak t Seetion a d° U INGILE FAMILY � Ta�r�, ��� RxGr C k 1 . Cade x C 5ubdivi pion i Di ir ,�a l sEtI at6d Val"3 00.00 jmpj�o Costs $0.00 Tatem L 022..3E f 111ac u $22. � s APF'L.ICATIEH FELS PERMIT 5.22..30 dlddx�+�r' _,; liter iC�Alr9 11I' HPA '1' F`L BC.CIS r� ' ;� ADO ,. E AS—H. R.S. �R7.Ir .fM•+x.... *0.E0 p..» RADON GAS,: aw 5% r yl - d µ. �". # TAS' $01-00. SER: TAP Eta. r F`L. FEYDRAUL�IC SHARE $Q.00 t I ac ', '�°Vi a CL; T"USPEC, FEE :Df� Kim T � h1E3tES a, z } NOTICE ALL.CONCRETE FOR�WIS AND!FOOT.INC SOUST SE 148PECT D 6i:FQRE POUR1'NG a Pr}RIVft 1/fl10 SIX MONTHS AFTER DATI 'fJF ISSUE BUILDING MATERIAL,RUSBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED 1N PUBLIC SPACE,AND MUST BE CLEANED UP AND 1-tAULED AWAY BY EITHER,CONTRACTOR OR OWNER. # �IILURE Tt� L W TH THE MECHANICS' LIEN I.AW CAN RESULT IN : . TO I�I�C�RI�RTY �?'�I�:E'I� �`#�►1FING TWICE ��I`� I�UIIw��N i t1�1�'I�t�'VE�III�I�'I'S." ISSUED ACCORDING T4,APPRb)/EQ.I''I AM.S WHICH ARE PART OF THIS PERMIT AND SUBJECT TO R V ATION FOR YI LATION OF A'PPLICA9Le PRE3V1 1ON5 OF LAW. JAM 2 JkTLANTIC.BEACH'BULD1Nt3DERARTMENT Of Wait V , City CITY OF ATLANTIC BEACH PERMIT APPLICATION ROOFING Owner(s): �' � Address: <& G � �� X,7/-_Phone: Lot # Block or Unit # Subdivision ' f Contractor: ,- 7 Z�l //A \/�f��=y / Address: Phone: 7 / 3 State License No. Describe work to be done: f`F'/ ' � Materials to be used: 6,c j > 0 12 Signature OWNER: ' Date: Signature CONTRACTOR: / r nn __�����,� /CITY OF ` �/ fY+ "4.0 AilGrsifi 4- -T Office of Building Official REQUEST FOR INSPECTION Date L / J GJ Permit N . Time A.M. Received �{ • ✓ /1 Job Addres Locality Owner's _ Name Contractor BUILDING CO CRETE ELECTRICAL PLU ING CHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rou ❑ Air Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ READY FOR INSPECTION Pre Fab Mon. Tues. Wed. Thurs. Frida p,M,\ A.M. Inspection Made ��' 6��t A.M. —t- P.M. Inspector Final Inspectionn'} Certificate of O cupancy ❑ Date CITY OF ATLANTIC BEACH a MECHANICAL PERMIT 800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877 _ PERMIT INFORMATION _ LOCATION INFORMATION _______ Permit Number: 22956 Address: 255 PLAZA DRIVE Permit Type: MECHANICAL ATLANTIC BEACH, FL 32233 Class of Work: ALTERATION Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: ATLANTIC BEACH Est. Value: Parcel Number: Improv. Cost: --- - OWNER INFORMATION— -- - - �� Date Issued: 10/31/2001 Name: CHAPLAIN, ROD Total Fees: 51.00 Address: 255 PLAZA DRIVE Amount Paid: 51.00 ATLANTIC BEACH, FL 32233 _Date Paid: 10/31/2001 _ Phone: (000)000-0000 -Work Desc: REPLACE HEAT PUMP AND AIR HANDLER_ T CONTRACTOR(S) APPLICATION FEES SOUTHERN TECHNOLOGIES OF J 51.00 AW<. Ao x � �. � yi ffi pp > YF FINAL s � ,.a3" 9, Wt7i ,� �i' ���' •yam t 17 .P Y 'Il' '$ iri 4'+R — NOTICE... ET LTIrIR ..PtC '4NP TION _ BUILDING MATERIAL, liFlSIA t �.� 1P LIC SPACE, AND MUST BE CLEAREDR# -£3k --- — "FAILURE 70 COMPL ��i'�' �, ' i #,A IN THE. PROPERTY OWNER PROr — `-1 ISSUED ACCORDING TO APPRO T, t ND SUBJECT TO REVOCATION ' FOR VIOLATION OF APPLICABLE PR p� ;= 1 — -- ------ - $51.1111114 ATLANTIC BEACH BUILDING DEPT. htee:s18/31!61 61 Receipt: BMW3481 J-------- ------------— -- - - -- --- ------- - 68IB88M�- - �1 BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC•SACH.IrLORIGA]ax]] APPLICATION FOR MECHANICAL PERMIT cALLdN NUMBER IMPORTANT—Applicant to complete all items in sections I, II, III, and IV. I. �7 LOCATION S11-1 Addr•oI OF Iwl.n•.finq slr..bl A. BUILDING h.••nG.G I�y�T7 A.d y i - Sr6.dl•isbn Il. IDENTIFICATION —To be complated by all applicants. Iw coM• •fl•'en d(131... pvmil qi•.n Ior deinq Ph- .sari •s d.,arib•d i rhe b Oh IM p n. nd sp•eillc•fi.ns .hick •• • •rf ho.al • ... it.t•rw•n1..h•• y 9 o/good.pncfk• lid.d Ihv.in. � P •.d in •ec.rd•we• with rhe Clly of J•eb.n ll• ordln.ne.s sed si-J.M. G46a.1v (yAnfl // // C�•! C•.fr.cfar. ►r.p.rty O.w.r � C. ��Y Sl�w.pn •(O.•v w Arlh•rlr.d Aq.nl Si�n.ler. o! M.hilwt ar Englw..r GENERAL INFORMATION A. T77.16.11.1 Ir.ls 8. 13 OTHER CONSTRUCTION sE1N00 ON THIS AUI401NG OR SITE? ❑ �""a Q. V [3N.N.1 C3C..tr.t utility ❑ cg IF YES, GIVE MUMMER OF CONSTRUCTI011 ❑ Other specify PERMIT IV. lwlscmMN?C LI,SQUI/M!R TO EE INSTALLED NA7y RE OF WORK - (I'm-iJ.complete Ilst.(c op.wseh.4 64th.1 this(enwl O—G/ Rseldent{sl or ❑ Commercial Ip' Neal ❑ spa" ❑ !["es"A jj0'Ce.lnl O yew ❑ NOW Building ❑ Air Gwddlewl"q' ❑ Aeo. lids G"f^l ❑ Esdsling Building act di SysMwe Idalsri. L On iehn..a- �Rsplaeam.nt al 4xlslUg 472tem M'd'm""s Capacity ❑ New Installatlon(No system prwloualy Inelalled) ❑ Aa(ri*ossoo ❑ Extemdon or add-on to•slating system ❑ Codlssq teem Gp..1ty, t•W"• ❑ Other—specify ❑ Rn sp.lwhl.rss Nrm6.e .( hoo j. ❑ E;—.la. q M.nllh ❑ (wrwlbvl C3.444.14.prns.+ I.rm6ws THIS 3►AC4 FOE Or"CE USE Ot/L7 ❑.• Took, (nrwsLdrl Ill--+eed1 [3 LIC east4l•..wL � tl.sn.rhs larme.fl ❑ Us(Ird pss"we_am ❑ .S"liss" /semi) App .j 6P D.I- ❑ OIAw Sp.dly I.rwsil t~ LIST ALL BQ(TIPMENT AM CONDMOMNC AND AEPRICERATION EQt1pAtENT XtanlKUalra DeacsrlpNoa XodelNumberL1 ApP*o►� Xaasrtaalunr ( 1 ��a��a1s HLAMNG ]FURNACES, BOILERS, pMEMA@y 17mUnite s1Ca D.esripllae X0d.1 Xaautac4ur.srjr Noosper TANKS =%7 TY"� Naane Cd "�r�l Approvim conX+aataotua.r Na ; CITY OF ATLANTIC BEACH SS1 r+ 800 SEMINOLE ROAD ATLANTIC BEA _ CH,FL 32233 INSPECTION PHONE LINE 247-5826 �UY�J'r Application Number . . 06-00034372 Date 1/05/07 Property Address . , 255 PLAZA Application type description. RIGHT OF WAY PERMIT Property Zoning . . . . . TO BE UPDATED Application valuation . . . . 0 Application desc - INSTALL PAVERS -------------------------------- Owner Contractor ------------------------ ------------------------ JANSEN OWNER 255 PLAZA ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 Permit . . . . . . DRIVEWAY PERMIT --------------------------------- Additional desc . . Permit Fee . . 35 . 00 Plan Check Fee . 00 Issue Date Valuation 0 Expiration Date . . 7/04/07 --------------------------------- Fee summary Charged Paid Credited Due ------ ---------- Permit Fee Total 35. 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35. 00 35 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. _ 1 Lll >>JQ CITY OF ATLANTIC BEACH PLAN REVIEW SHEET Routed to: D.Hufstetler Building Department Public Works&Public Utilities Departments 4 . �Js31�r 800 Seminole Road 1200 Sandpiper Lane R.Carper Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 a uzni (904)247-5800 (904)247-5834 Public Safety (904)247-5845 Fax (904)247-5843 Fax PLAN REVIEW COMMENTS Permit Application# J�3 Property Address �GA'Z A Applicant: d'� Project: This permit application has been: t / 1/07 Approved as noted by the b/G jKS Department. 1 Final application approval must come from the Building Department. Reviewed and the following items need attention: Provide paver detail (type to be installed) . Solid surface pavers is 100% impervious. Provide details/dimensions of driveways . Maximum driveway width is 20 feet. Circular drive not allowed for lot with <100 ' frontage. (City Code Sec. 19-7 (f) ) . Maximum impervious coverage of right-of-way is 500 . (City Code Section 19-7 (a) ) . 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 beim issued. Reviewed By: Date: � /I- l� Date Contractor Notified: DEC Todd& Diana Jansen 255 Plaza Street Atlantic Beach, FL 32233 December 18, 2006 Attn: Ric Carper Ni ', Public Works Dept RE: Permit App # 06-34372 Dear Mr. Carper: After reviewing your Plan Comments &after speaking with our architect, Harley Parkes, we have changed the paver coverage for our driveways. We were unaware of the change to the impervious % of pavers packed in sand. Enclosed, our new drawings propose a"ribbon" or strip driveway of pavers lined in concrete (100% impervious by Code). A paver walkway between the two drives is also proposed. Total proposed impervious is 50%of lot size. There will be no circular drive & the right of way impervious is not an issue with this new proposed plan. Detail: East ribbons measure approx. 191 sqft West ribbons measure approx. 220 sqft Walk-way measures approx. 112 sqft Please let us know if you have comments/questions. Thanks for your time! Diana Jansen TeL (904) 993-0922 Fax. (904) 249-0996 HomeByDee@Hotmail.com ' s'ST''" CITY OF ATLANTIC BEACH r s, CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS 800 Seminole Road 904-247-5800 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Date I �._qpct PERMIT# Job Address 2,5;�_ P LA7A ST_ ISSUED BY THE CITY Permitee: D -:::S_A-1J ery Telephone# loq—qq3 - 0 f.2�9 Permittee Address: PL-6-2A S� Requesting Permission to Construct: oujefs Vldkive-I,J Location: (Reference to Cross-Street) P L AZ C` C&sr tc-7 �}}u- 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipaliti es: Jacksonville Electric Authority Yes <Date- Bell South Telephone Company Yes Ferrell Gas Yes Comcast Yes 2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of o W h e K- (Contractor's Project Superintendent) located at Telephone#: 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. 6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in impervious area on owner's lot or in the city Right of Way are to be included with this application. 7. This permittee shall commence actual construction in good faith with o?0 days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. S rL OWNER _, s�` ° �:y NoWr public-SIMS d Fbft Jz - fob • M Corrpnisaion Expires Feb 11,2010 Signe�me ate: =.�, a`.= Commission OD 518533 Before is day of in the County of Duval, •" Bonded By National Notary Assn. State Of Florida,has personal a p red Notary Public at Large,State f F onda,County of Duval. My commission expi ! Personally Known: Produced Identification: R.O.W.Permit Attachment of for R.O.W.Permit# issued , 2005 Atlantic Beach,FL 32233 Owner's Name: RN S f Property Address: a.L y Za, Subdivision: Lot#/Block#: R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE. ENCROACHMENT PERMIT, issued on this day of 20(x. :y Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as "CITY" and of Atlantic Beach, Florida,hereinafter referred to as"USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above(copies attached). This work is generally described as: 'SnIb !!a a :A#'(*/-s Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to USER shall be given by certified mail, return receipt requested, to the following address: The depositing of said notice of cancellation in the United States mail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing,or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes,Land Development Code, and all other land use and code requirements of the CITY. The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach, Public Works Department, for said change. The Page 1 of 2 USER shall, at the discretion of the CITY, be requested to submit as-built drawings showing the change within thirty (30)days after the day of completion. This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use limitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this day of 9-(m 2005. CITY OF ATLANTIC BEACH, FLORIDA, By: a municipal corporation: rope rtyOwner Jim Ha on, City Manager Attest: / Q Ric e , Public Works Dire for STATE OF FLORIDA COUNTY OF DUVAL On this day of . t G , 200k personally appeared before me, a Notary Public in and for said County and State, 2/<n¢ the property owner of azS5 24-z-4— , Atlantic Beach, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the uses and purposes therein mentioned. '_tA L CP-7)_I By Notary ublic in r said my and State Property Owner (to be signed in presence of the Notary) \�p Y L.GIRAHM gs Notify PubWC-9W of Flodde •.my Coion Expka Feb 14,2010 fnmiss Commission#DO 518533 •'�0"f"" Bonded By National Notary Assn. Page 2 of 2 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00031299 Date 10/06/05 Property Address . . . . . . 255 PLAZA Tenant nbr, name . . . . . . 1ST & 2ND FLR ADDITION Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 150000 Owner Contractor ------------------------ ------------------------ JANSEN,DEE GENESIS BUILDING CORP 255 PLAZA 2158 MAYPORT RD. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241-0320 -------------------------------------------------- ----- --------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 695 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 150000 Fee summary Charged Paid Credited Due ----------------- ----------- ---------- --- ------- ---------- Permit Fee Total 695 . 00 695 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 695 . 00 695 . 00 . 00 . 00 Y PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING OFFICIAL CITY OF ATLANTIC BEACH zf} PERMIT CALCULATION SHEET Date: /O- .5-- O S Address o2 J-J- 4,4A Z A d.0671 T/0 4) Heated Square Footage 17 7�_@ $ per sq ft= $ Garage/ Shed @$ _per sq ft= $ 0 Carport/Porch @�Jkl l per sq ft = $ Deck @ $ per sq ft = $ per sq = $ Patio O @ $ P q ft TOTAL VALUATION: $ lfv 660 Total Valuation 1St $ Remaining Value $ . per thousand or portion thereof CONSTRUCTION TYPE: - TOTAL BUILDING FEE $ ZONING: 04-2- + `/2 Filing Fee $ _ FLOOD MPERVIOUS SURFACE:ZONE: _�_ (� ) Fireplaces @ $35.00 $ J= Dy I < BUILDING PERMIT FEE $ WATER IMPACT FEE $ SEWER IMPACT FEE $ -0 - WATER OWATER METER/TAP $ -0 - CAPITAL O -- CAPITAL IMPROVEMENT$ -0 SEWER TAP $ C Po I) RADON HRS .0050i; SECTION H PAVING ( ) ^0 CROSS CONNECTION jr ST(97y) SURCHARGE $ i/ OTHER $ GRAND TOTAL DUE: $ 1/13/03 WATER IMPACT FEE WORKSHEET r " � ADDRESS: �^J /N DRAINAGE FIXTURE UNIT FIXTURE TYPE VALUE AS LOAD FIXTURES UNITS Automatic clothes washers, commercial 3 Automatic clothes washers, residential 2 Bathroom group consisting of water closet, lavatory, 1 Bidet, and bathtub or shower 6 / Bathtub(with or without overhead shower or whirlpool attachments) 2 Bidet 2 Combination sink and tray 2 Dental lavatory 1 Dishwashing machine,domestic 2 Drinking fountainAcemaker %Z Floor drains 2 Hose bib 1 Kitchen sink, domestic 2 Kitchen sink, domestic with food waste grinder and/or dishwasher 2 Laundry tray (1 or 2 compartments) 2 Lavatory1 1 Shower compartment domestic 2 1 Sink 2 Urinal 4 Urinal, 1 gallon per flush or less ' 2 Wash sink(circular or multiple)each set of faucets 2 Water closet,flushometer tank, public or private 4 Water closet, private installation 4 Water closet, public installation 6 TOTAL NUMBER OF UNITS= MULTIPLIED X 20 TOTAL$ Q Tr (Alterations& Additions) Date: 2 Z o r'' Job Address: 2 5""S �Z''t` 15,; (� Owner of Property: �c c`' �1�Zvi Telephone: Address: Zs ` Lot Number: Zoning District: Legal Description: Block Number: t��''3�'-3 i�r����� _State License Number: +=��- tz Contractor: 6 Contractor Address: �/S�_ Telephone: 2 Fax: Describe proposed use and work to be done: Present use of land or building(s): � `J� -DValuation of proposed construction: feet What are the dimensions of the added space: feet x�� Will the added area be heated and cooled? 1/c� New electrical or increase in service? Add plumbing fixtures? L Add fireplace? N o Add heating/air conditioning? is approval of Homeowner's Association or other private entity required? if yes, please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? PNO. Applicant certifies that no change in site grade or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. �NO. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE Md which OVAL meRets two timeQUIREh month. . Tree Removal Permits to be reviewed by the Tree Conservation nurogriate. Procedure: In order to expedite issuance of permits, please follow all steps and provide a►1 information as a Incomplete applications may result in delay in issuance of permit. per setbacks for the proposed construction. if you are unsure of this information, pie-se STEP 1. Verify zoning designation and prohave contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, p Property Appraiser's Real Estate Number available. of ine if a or STEP 2. Contact the City of Atlantic Beach Department epis ed. t(If not bequi relic quired written verks to ifi ation must be provided pre-construction with this application.)p topographical survey o grading, p The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-58 34 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. which is located at the Atlantic STEP 4. Please submit contractor, Building four 4 complete sets of construction plans totice of Co theBuilding Department,nt, owner/Contractor Affidavit i owner is contractor,an ( ) Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone.(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 - Fax: (904)247-5845 •http://www.ci.stiantic-beach.n.us Revised 1104 Page 2 ing In addition to construction and engineering ng de sufficient plans depict allrequiredortnthefoollo ion in a rmationd s appropriat erfor the type of work being performed. Scale of drawings should survey showing the property boundary with bearings and distances and the legal description. 1. Current all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify 2. Location any existing structures and uses. 3. If required by the Department of Public Works,a anypre-jurisdictional wetlaonstruction nds,CCCL,natural water bodies. 4. Any significant environmental features,including any j driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools 5. Impervious Surface area calculations: include may be excluded from total Imp rvious urface. individual applications. 6. Other information as may be appropriate for 1 hereby certify that all informati p vided with this application is correct. Date: `�._-�---- Signature of owner: be and orrect. All ovisions of the laws I hereby certify that I have read and examined this application and know the same m or note The granting of prermit does not presume to ordinances governing this type of work will be complied with, whether specified here give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the d that the issuance of this permit is contingent upon the governing of construction or the performance of construction of the property. I understan above information being true and correct and that the plans and supporting data have been or shall be provided as required. Date: Signature of Contractor Address and contact information of person to receive all correspondence regarding this application(please print). Name: r-- Mailing Address: Telephone: E-Mail: 63 " Svc s u.dr fFc�'3 -. 7(4—cam 3 Zia Fax: 2�-f(— o 3 2-Ce AS TO OWNER Sworn to and subscribed before me this 2U day of 2 ��'Y'""'� ' �/. '• State of Florida,dun of lD.u4PE -- te of Florida Notary's Signature: Notary Publlic+Sta My COMM.exp. ()Cl. 19,2007 COMM.NO.DD 259726 .ff Personally known ❑ Produced identification Type of identification produced AS TO CONTRACTOR: of �� ��� ,20 Sworn to and subscribed before me this�:_1� day State of Florida,County of Duval WILLIAM L.POPE Notary's Signature: Notary Public, Slate of Florida ❑ Personally known My comm. exp. Oct. 19,2007 ❑ Produced identification Comm. No. DD 259726 Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 -http://www.ci.atiantic-beach.fi.us Revised 1/04 Page 3 CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (Alterations & Additions) x >' Date: �h 2�o r Job Address: 2 s_s_` ply Owner of Property: Address- Z3 S� /�r�Z S� Telephone: Legal Description: Block Number: Lot Number: Zoning District: Contractor: C State License Number: eZ13(- lz S—v z.,-z- Contractor Address: — Telephone: 2 1�/ 0? Fax: 7 L// -03 2.6 Describe proposed use and work to be done: Present use of land or building(s): X CC 4 Valuation of proposed construction: `J0 i What are the dimensions of the added space. '3 Lffeet x feet Will the added area be heated and cooled? Kr"3 New electrical or increase in service? conditioning?Add plumbing fixtures? �L 3 — Add fireplace. AJy Add heating/air g• --�— Is approval of Homeowner's Association or other private entity required? If yes, please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? gpNO. Applicant certifies that no change in site grade or fill material will be used on this project. ❑YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. NNO. Applicant certifies that no trees will be removed for this project. ❑YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, pie-se contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atlantic-beach.fl.us Revised 1/04 Page 2 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. I. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all informati p vided with this application is correct. Signature of owner: Date: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the 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 federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor J-�e-O Date: 6 L..,-6 Address and contact information of person to receive all correspondence regarding this application(please print). Name: Mailing Address: Telephone: 7,L1-4P 3 2J Fax: 2<-f t— C 3 i 4 E-Mail: �'<<4tw��� 5��G1 s 6"'°.�t c'3.G.s..1 AS TO OWNER: Sworn to and subscribed before me this Z day of�� ,20 10 '� State of Florida,County Du L.APE — Natary Public, State of Florida Notary's Signature: My comm. exp. Oct. 19, 2007 0oMm,No.DO 259726 �' Personally known ❑ Produced identification Type of identification produced AS TO CONTRACTOR: �7--- Sworn to and subscribed before me this L, day of �� ( >20 State of Florida,County of Duval WILLIAM L. POPE Notary's Signature: Notary Public, State 01 Florida My comm. exp. Oct. 19,2007 ❑ Personallyknown Comm. No. DO 259726 produced identification Type of identification produced 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 •http://www.ci.atiantic-beach.fl.us Revised 1/04 Page 3 CITY OF ATLANTIC BEACH C« D. Ford BUILDING / ZONING DEPARTMENT i99ins 800 Seminole Road 1 Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # d - 12- ? 1 Property Address: CP P /-� 2-0----- Applicant: a 5-S ',3 L de Project: ,41 b I:5f *xJ 2h This permit application has been: Ud' Approved Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: LaP- Date: R Zg l0 5 _ Date Contractor Notified: CITY OF ATLANTIC BEACH Cc: BUILDING / ZONING DEPARTMENT 800 Seminole Road oerr Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # .6 /2 9 Property Address: a 71H Z a----- Applicant: Project: 4-,66 IST 4-n d 2nd Fl00 r5 T=Approved ation has been: Reviewed and the following items need attention: Please re-submit r plication when these items have been completed. Reviewed By: Date: Date Contractor Notified: Oct 20 2005 4: 12PM HP LASERJET FAX 904-241 -0326 p. 2 NOTICE OF COMMENCEMINT Tax Folio No. tiaYAtY a�F..,..�, r1 ro whom>t May Concern: TIO undaMped hereby informs you the Improvvanents will be made to certain reel pmpetty,•md in accordance with Sectlog 913 of the Florida Stattaea,the lbllowing Ltfarmstion is noted in this N077CB,OF CoboaNC$1KENT, Legal dese4ption OfPtopenY being improved; LaG . Ad;Zdjwwpfny beingimproved., e- . Deawal des1wiption of Improvements• I•J Owner A r• a? Owner's itileat is site oaf the tmprowtrtentt +rOdwa.e Fee S{mpleTitleholder(ifother than owner), •"•" Name: t0- Addrew --• . ' ontraaeor:: � ��. Addmu Phone : 1 -O sw Fax No: Surety(ifaur): Addresa� •- Amount of and S Fhae aro: Fix No: �-•�-�-- _..,.r� Name sad a0MM of any person malting slow the coastruet om of thezoo-ismenis. Name: AiddrZl �. Phone --� Fax No: Name of the State o F ds other tan hhimself;designated by owner upon whom nWon or other doeemenq>posq-be earved�• Name: A ase , Phone N 74—x No: In addition himself,owner designates the fbUowitt SectionNWi 719;5 Z g Person to receive a copy of the Lienar s Notice as provided is _. 6( )(b),-Florida statues. (Pill in at•ownar s option). Addmu,'I Pbone N : Fax No: Ixpitation of Notice of CommeneaatGnt ON expiration date is one(1)your from the date of recording unless a Oft rent dip u sp elfled): -- THIS SFAP$FOR RBCORDRR'S•USI ONLY OWNIR Signed• Lam. Date- ex- Before mol day of in the County of Duval. S ser Flora v{ 11 Notary Public at Large,Stifte of Plorfd&County oflbuviL MY oohaFiesiep,�ires: Dec 1t X06300719,OR BK 120= Pegs 1625, �a11y Know or Number Ppes:lratification: Flied d Recorded 10f20t2006 at 010 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY WILLIAM L POR RgooROINCS10,00 Notary pUblit;, Stat#of Fonda 1 j t�C.M.alto.Oct,19,2007 . �'d1�A,N0.tJ0 tSA726 EnergyGauge®4.0 FORM 60OA-2004 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Whole Building Performance Method A PrPermitting Office: Atlantic Beach Corp. oject Name: Jansen Addition Builder: Genesis Building Address: 255 Plaza Street j City, State: Atlantic Beach, FI Permit Number: Owner: Todd & Dee Jansen Jurisdiction Number: 261100 Climate Zone: North New construction or existing Addition - 12. Cooling systems 2. Single family or multi-family Single family _ a. Central Unit Cap:24.0 kBtu/hr - g y SEER: 13.00 3. Number of units,if multi-family 4. Number of Bedrooms 1 - b. N/A - 5. Is this a worst case? NO - - 6. Conditioned floor area(ft') 974 fi' _ c. N/A - 7. Glass type and area:(Label reqd.by 13-104.4.5 if not default) - a. U-factor: Description Area 13. Heating systems (or Single or Double DEFAULT) 7a.(Dble Default)286.0 ft= _ a. Electric Heat Pump Cap:24.0 r _ i HSPF:7.6.60 - b. SHGC: (or Clear or Tint DEFAULT) 7b. (Clear)286.0 ft' - i b. N/A - 8. Floor types - a. Slab-On-Grade Edge Insulation R=0.0,68.0(p)ft - c. N/A - b. Raised Wood,Post or Pier R=19.0,87.0ft2 - - c. N/A - I 14. Hot water systems 9. Wall types a. Natural Gas Cap:30.0 gallons - i R=19.0,487.0 ft' _ EF:0.63 _a. Frame,Wood,Exterior I b. Frame,Wood,Exterior R=11.0,804.0 ft= b.N/A - c. N/A - - d. N/A _ c. Conservation credits - e. N/A _ (HR-Heat recovery,Solar 10. Ceiling types - DHP-Dedicated heat pump) R=30.0,773.0 ft' 15. HVAC credits MZ-C,PT,MZ-H a. Under Attic - b. N/A _ (CF-Ceiling fan,CV-Cross ventilation, c. N/A - HF-Whole house fan, 11. Ducts - PT-Programmable Thermostat, a. Sup:Unc. Ret:Unc. AH(Seated):Attic Sup.R=6.0,75.0 ft M7_-C-Multizone cooling, b.N/A - MZ-H-Multizone heating) i Total as-built points: 14719 PASS^ �+c Glass/Floor Area: 0.29 Total base points: 15261 r"/��7�7 I _ I hereby certify that the plans and specifications covered by Review of the plans and ,TUE STAT this calculation are in compliance with the Florida Energy specifications covered by this Code.Q,h4_y'ryy((� l IS , calculation indicates compliance PREPARED BY: with the Florida Energy Code. '"" Before construction is completed DATE: this building will be inspected for _ I hereby certify that this building, as designed, is in compliance compliance with Section 553.908 with the Florida Ener CdWV Energy i Florida Statutes. cob OWNER/AGENT: BUILDING OFFICIA : DATE J,/� � DATE: Z 1 Predominant glass type.For actual glass type and areas,see Summer&Winter Glass output on pages 2&4. EnergyGauge®(Version: FLRCSB v4.0) FORM 60OA-2004 EnergyGauge®4.0 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 255 Plaza Street,Atlantic Beach, FI, PERMIT#: BASE AS-BUILT GLASS TYPES .18 X Conditioned X BSPM = Points Overhang Floor Area Type/SC Ornt Len Hgt Area X SPM X SOF = Points 18 974.0 20.04 3513.4 Double,Clear N 1.3 19.5 80.0 19.20 1.00 1530.0 Double,Clear N 1.3 16.5 21.0 19.20 1.00 401.3 Double,Clear W 1.3 14.0 6.0 38.52 1.00 230.1 Double,Clear S 1.3 6.0 16.0 35.87 0.89 511.9 Double,Clear S 1.3 4.5 11.0 35.87 0.82 322.4 Double,Clear E 1.3 11.5 25.0 42.06 0.99 1045.3 Double,Clear N 1.3 7.0 50.0 19.20 0.97 929.4 Double,Clear N 1.3 9.0 35.0 19.20 0.98 661.2 Double,Clear W 1.3 6.0 10.0 38.52 0.94 361.1 Double,Clear W 1.3 6.0 32.0 38.52 0.94 1155.4 As-Built Total: 286.0 7148.0 WALL TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood, Exterior 19.0 487.0 0.90 438.3 Exterior 1291.0 1.70 2194.7 Frame,Wood,Exterior 11.0 804.0 1.70 1366.8 Base Total: 1291.0 2194.7 As-Built Total: 1291.0 1805.1 DOOR TYPES Area X BSPM = Points Type Area X SPM = Points Adjacent 0.0 0.00 0.0 Exterior Wood 110.0 6.10 671.0 Exterior 110.0 6.10 671.0 Base Total: 110.0 671.0 As-Built Total: 110.0 671.0 CEILING TYPES Area X BSPM = Points Type R-Value Area X SPM X SCM = Points Under Attic 773.0 1.73 1337.3 Under Attic 30.0 773.0 1.73 X 1.00 1337.3 Base Total: 773.0 1337.3 As-Built Total: 773.0 1337.3 FLOOR TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Slab 68.0(p) -37.0 -2516.0 Slab-On-Grade Edge Insulation 0.0 68.0(p) -41.20 -2801.6 Raised 87.0 -3.99 -347.1 Raised Wood, Post or Pier 19.0 87.0 0.77 66.6 Base Total: -2863.1 As-Built Total: 155.0 -2735.0 INFILTRATION Area X BSPM = Points Area X SPM = Points 974.0 10.21 9944.5 974.0 10.21 9944.5 EnergyGauge®DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCSB v4.0 FORM 60OA-2004 EnergyGauge® 4.0 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 255 Plaza Street,Atlantic Beach, FI, ADDRESS: #: BASE AS-BUILT Summer Base Points: 14797.8 Summer As-Built Points: 18171.0 Total Summer X System = Cooling Total X Cap X Duct X System X Credit = Cooling Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points (System - Points) (DM x DSM x AHU) (sys 1:Central Unit 24000 btuh,SEERIEFF(l3.0)Ducts:Unc(S),Unc(R),Att(AH),R6.0(INS) 18171 1,00 (1.09 x 1.147 x 1.05) 0.263 0.902 5676.2 14797.8 0.4266 6312.7 18171.0 1.00 1.318 0.263 0.902 5676.2 EnergyGauge T^" DCA Form 60OA-2004 EnergyGauge4D/FlaRES'2004 FLRCSB v4.0 FORM 60OA-2004 EnergyGauge®4.0 WINTER CALCULATIONS Residential Whole Buildinq Performance Method A - Details ADDRESS: 255 Plaza Street,Atlantic Beach, FI, PERMIT#: BASE AS-BUILT GLASS TYPES .18 X Conditioned X BWPM = Points Overhang Floor Area Type/SC Ornt Len Hgt Area X WPM X WOF = Point ,18 974.0 12.74 2233.6 Double,Clear N 1.3 19.5 80.0 24.58 1.00 1965.9 Double,Clear N 1.3 16.5 21.0 24.58 1.00 516.0 Double,Clear W 1.3 14.0 6.0 20.73 1.00 124.5 Double,Clear S 1.3 6.0 16.0 13.30 1.08 229.1 Double,Clear S 1.3 4.5 11.0 13.30 1.18 172.1 Double,Clear E 1.3 11.5 25.0 18.79 1.01 473.1 Double,Clear N 1.3 7.0 50.0 24.58 1.00 1229.9 Double,Clear N 1.3 9.0 35.0 24.58 1.00 860.3 Double,Clear W 1.3 6.0 10.0 20.73 1.02 210.8 Double,Clear W 1.3 6.0 32.0 20.73 1.02 674.5 As-Built Total: 286.0 6456.3 WALL TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood,Exterior 19.0 487.0 2.20 1071.4 Exterior 1291.0 3.70 4776.7 Frame,Wood, Exterior 11.0 804.0 3.70 2974.8 Base Total: 1291.0 4776.7 As-Built Total: 1291.0 4046.2 DOOR TYPES Area X BWPM = Points Type Area X WPM = Points Adjacent 0.0 0.00 0.0 Exterior Wood 110.0 12.30 1353.0 Exterior 110.0 12.30 1353.0 Base Total: 110.0 1353.0 As-Built Total: 110.0 1353.0 CEILING TYPES Area X BWPM = Points Type R-Value Area X WPM X WCM = Points Under Attic 773.0 2.05 1584.6 Under Attic 30.0 773.0 2.05 X 1.00 1584.6 Base Total: 773.0 1584.6 As-Built Total: 773.0 1584.6 FLOOR TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Slab 68.0(p) 8.9 605.2 Slab-On-Grade Edge Insulation 0.0 68.0(p) 18.80 1278.4 Raised 87.0 0.96 83.5 Raised Wood, Post or Pier 19.0 87.0 0.88 76.2 Base Total: 688.7 As-Built Total: 155.0 1354.6 INFILTRATION Area X BWPM = Points Area X WPM = Points 974.0 -0.59 -574.7 974.0 -0.59 -574.7 EnergyGauge®DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCSB v4.0 FORM 60OA-2004 EnergyGauge®4.0 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 255 Plaza Street,Atlantic Beach, Fl, PERMIT#: BASE AS-BUILT Winter Base Points: 10062.0 Winter As-Built Points: 14220.1 Total Winter X System = Heating Total X Cap X Duct X System X Credit = Heating Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points (System - Points) (DM x DSM x AHU) (sys 1:Electric Heat Pump 24000 btuh ,EFF(7.6)Ducts:Unc(S),Unc(R),Att(AH),R6.0 14220.1 1.000 (1.069 x 1.169 x 1.05) 0.449 0.902 7519.7 10062.0 0.6274 6312.9 14220.1 1.00 1.306 0.449 0.902 7519.7 EnergyGauge TM DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCSB v4.0 FORM 60OA-2004 EnergyGauge®4.0 WATER HEATING & CODE COMPLIANCE STATUS Residential Whole Building Performance Method A - Details ADDRESS: 255 Plaza Street,Atlantic Beach, FI, PERMIT#: BASE AS-BUILT WATER HEATING Number of X Multiplier = Total Tank EF Number of X Tank X Multiplier X Credit = Total Bedrooms Volume Bedrooms Ratio Multiplier 1 2635.00 2635.0 30.0 0.63 1 1.00 1522.76 1.00 1522.8 As-Built Total: 1522.8 CODE COMPLIANCE STATUS BASE AS-BUILT Cooling + Heating + Hot Water = Total Cooling + Heating + Hot Water = Total Points Points Points Points Points Points Points Points 6313 6313 2635 15261 5676 7520 1523 14719 PASS yO.�ZHB ST,g��O EnergyGauge TM DCA Form 60OA-2004 EnergyGauge@/FlaRES'2004 FLRCSB v4.0 FORM 60OA-2004 EnergyGauge®4.0 Code Compliance Checklist Residential Whole Building Performance Method A - Details ADDRESS: 255 Plaza Street,Atlantic Beach, Fl, PERMIT#: 6A-21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHECK Exterior Windows&Doors 606.1.ABC.1.1 Maximum:.3 cfm/sq.ft.window area; .5 cfm/sq.ft.door area. Exterior&Adjacent Walls 606.1.ABC.1.2.1 Caulk,gasket,weatherstrip or seal between:windows/doors&frames,surrounding wall; f foundation&wall sole or sill plate;joints between exterior wall panels at corners;utility penetrations;between wall panels&top/bottom plates;between walls and floor. EXCEPTION:Frame walls where a continuous infiltration barrier is installed that extends from,and is sealed to,the foundation to the top plate. Floors 606.1.ABC.1.2.2 Penetrations/openings>1/8"sealed unless backed by truss or joint members. t-.• EXCEPTION: Frame floors where a continuous infiltration barrier is installed that is sealed to the perimeter, penetrations and seams. Ceilings 606.1.ABC.1.2.3 Between walls&ceilings;penetrations of ceiling plane of top floor;around shafts,chases, �. soffits,chimneys,cabinets sealed to continuous air barrier;gaps in gyp board&top plate; attic access. EXCEPTION:Frame ceilings where a continuous infiltration barrier is installed that is sealed at the perimeter,at penetrations and seams. Recessed Lighting Fixtures 606.1.ABC.1.2.4 Type IC rated with no penetrations,sealed;or Type IC or non-IC rated,installed inside a sealed box with 1/2"clearance&3"from insulation;or Type IC rated with<2.0 cfm from conditioned space,tested. Multi-story Houses 606.1.ABC.1.2.5 Air barrier on perimeter of floor cavity between floors. c.... Additional Infiltration reqts 606.1.ABC.1.3 Exhaust fans vented to outdoors,dampers;combustion space heaters comply with NFPA, have combustion air. 6A-22 OTHER PRESCRIPTIVE MEASURES(must be met or exceeded by all residences.) COMPONENTS SECTION REQUIREMENTS CHECK Water Heaters 612.1 Comply with efficiency requirements in Table 612.1.ABC.3.2.Switch or clearly marked cir L..- breaker(electric)or cutoff(gas)must be provided. External or built-in heat trap required. Swimming Pools&Spas 612.1 Spas&heated pools must have covers(except solar heated). Non-commercial pools must have a pump timer.Gas spa&pool heaters must have a minimum thermal efficiency of 78%. Shower heads 612.1 Water flow must be restricted to no more than 2.5 gallons per minute at 80 PSIG. tr-- Air Distribution Systems 610.1 All ducts,fittings, mechanical equipment and plenum chambers shall be mechanically attached,sealed,insulated,and installed in accordance with the criteria of Section 610. Ducts in unconditioned attics: R-6 min.insulation. HVAC Controls 607.1 Separate readily accessible manual or automatic thermostat for each system. �. Insulation 604.1,602.1 Ceilings-Min. R-19.Common walls-Frame R-11 or CBS R-3 both sides. `— Common ceiling&floors R-11. EnergyGauge TM DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCSB v4.0 ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE SCORE* =81.3 The higher the score,the more efficient the home. Todd & Dee Jansen, 255 Plaza Street, Atlantic Beach, FI, 1. New construction or existing Addition - 12. Cooling systems 2. Single family or multi-family Single family - a. Central Unit Cap:24.0 kBtu/hr - 3. Number of units,if multi-family I - SEER: 13.00 - 4. Number of Bedrooms 1 _ b.N/A - 5. Is this a worst case? No - - 6. Conditioned floor area(ft') 974 ftz _ c. N/A _ 7. Glass type I and area:(Label reqd.by 13-104.4.5 if not default) _ a. U-factor: Description Area 13. Heating systems (or Single or Double DEFAULT) 7a.(Dble Default)286.0 ft2 - a. Electric Heat Pump Cap:24.0 kBtu/hr - b. SHGC: HSPF:7.60 - (or Clear or Tint DEFAULT) 7b. (Clear)286.0 ft' _ b.N/A - 8. Floor types - a. Slab-On-Grade Edge Insulation R=0.0,68.0(p)ft - c. N/A - b. Raised Wood,Post or Pier R=19.0,87.Oftz _ - c. N/A - 14. Hot water systems 9. Wall types a. Natural Gas Cap:30.0 gallons _ a. Frame,Wood,Exterior R=19.0,487.0 ft' - EF:0.63 _ b. Frame,Wood,Exterior R=I 1.0,804.0 W - b. N/A - c. N/A - - d. NIA - c. Conservation credits - e. N/A - (HR-Heat recovery,Solar 10. Ceiling types DHP-Dedicated heat pump) a. Under Attic R=30.0,773.0 W - 15. HVAC credits MZ-C,PT,MZ-H - b. N/A - (CF-Ceiling fan,CV-Cross ventilation, c. N/A _ HF-Whole house fan, 11. Ducts PT-Programmable Thermostat, a. Sup:Unc. Ret:Unc. AH(Sealed):Attic Sup.R=6.0,75.0 ft - MZ-C-Multizone cooling, b. N/A - MZ-H-Multizone heating) 1 certify that this home has complied with the Florida Energy Efficiency Code For Building 4-TUE ST,,9� Construction through the above energy saving features which will be installed(or exceeded) = - �o in this home before final inspection. Otherwise,a new EPL Display Card will be completed �,' �,��''� ` s, �'4•� based on installed Code compliant!ea7tues./� Builder Signature: ��„x� /� Date. Address of New Home: zS�� �- 57- City/FL Zip: � ((��• /`-Z• 72-11ZZ33 j�'epDwE *NOTE: The home's estimated energy performance score is only available through the FLA/RES computer program. This is not a Building Energy Rating. If your score is 80 or greater(or 86_for a US EPA/DOE EnergyStarTudesignation), your home may gualifyfor energy e#iciency mortgage(EEM) incentives ifyou obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at 321/638-1492 or see the Energy Gauge web site at www fivec.ucf edu for information and a list of certified Raters. For information about Florida's Energy Efficiency Code For Building Construction, contact the Department of Community Affairs at 850/487-1824. 1 Predominant glass type.For actual glass type and areas see Summer&Winter Glass output on ages 2&4. PnergyGaugeg(Version: FLRC 1B v4.0) RIGHT-J LOAD AND EQUIPMENT SUMMARY First Floor Add Energy Design Systems Job: 9121105 1065 Oak Vale Rd,Jacksonville,FI 32259 Phone:904-287-5339 Fax:904-287-1258 Email:energydesignsystems@gmail.com Project • • For: Todd &Dee Jansen Addition 255 Plaza Street, Atlantic Beach, FI Notes: 201 sq ft first floor addition serviced by existing unit Desigin Information Weather: Jacksonville, Mayport Naval, FL , US Winter Design Conditions Summer Design Conditions Outside db 39 OF Outside db 92 OF Inside db 72 OF Inside db 72 OF Design TD 33 OF Design TD 20 OF Daily range L Relative humidity 50 % Moisture difference 65 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Building heat loss 10180 Btuh Structure 6489 Btuh Ventilation air 0 cfm Ventilation 0 Btuh Ventilation air loss 0 Btuh Design temperature swing 3.0 OF Design heat load 10180 Btuh Use mfg. data n Rate/swing multiplier 0.97 Infiltration Total sens. equip. load 6295 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Internal gains 230 Btuh Ventilation 0 Btuh Heating Cooling Infiltration 1809 Btuh Area(ftp) 201 201 Total latent equip. load 2039 Btuh Volume(ft') 2010 2010 Air changes/hour 2.46 1.23 Total equipment load 8333 Btuh Equiv. AVF(cfm) 82 41 Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a n/a n/a n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Heating temp rise 0 OF Total cooling 0 Btuh Actual heating fan 0 cfm Actual cooling fan 0 cfm Heating air flow factor 0.000 cfm/Btuh Cooling air flow factor 0.000 cfm/Btuh Space thermostat n/a Load sensible heat ratio 0 % Printout certified by ACCA to meet all requirements of Manual J 7th Ed. AL wre0Htsoft Right-Suite ResidentialTM 5.0.66 RSR29784 2005-Sep-21 10:01:12 ACOA C:\Documents and Settings\customer\My Documents\Wrightsoft\Genesis,Jansen,255 Plaza St..rsr Page 1 RIGHT-J LOAD AND EQUIPMENT SUMMARY Second Fir Add Energy Design Systems Job: 9/21105 1065 Oak Vale Rd,Jacksonville,FI 32259 Phone:904-2B7-5339 Fax:904-287-1258 Email:energydesignsystems@gmail.com Project • i For: Todd &Dee Jansen Addition 255 Plaza Street, Atlantic Beach, FI Notes: 201 sq ft first floor addition serviced by existing unit Design Information Weather: Jacksonville, Mayport Naval, FL , US Winter Design Conditions Summer Design Conditions Outside db 39 OF Outside db 92 OF Inside db 72 OF Inside db 72 OF Design TD 33 OF Design TD 20 OF Daily range L Relative humidity 50 % Moisture difference 65 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Building heat loss 12031 Btuh Structure 15196 Btuh Ventilation air 0 cfm Ventilation 0 Btuh Ventilation air loss 0 Btuh Design temperature swing 3.0 OF Design heat load 12031 Btuh Use mfg. data n Rate/swing multiplier 0.97 Infiltration Total sens. equip. load 14740 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Internal gains 460 Btuh Ventilation 0 Btuh Heating Cooling Infiltration 1845 Btuh Area(ft') 773 773 Total latent equip. load 2305 Btuh Volume(W) 7962 7962 Air changes/hour 0.63 0.32 Total equipment load 17045 Btuh Equiv.AVF (cfm) 84 42 Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a n/a n/a n/a Efficiency n/a Efficiency n/a Heating Input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Heating temp rise 0 OF Total cooling 0 Btuh Actual heating fan 0 cfm Actual cooling fan 0 cfm Heating air flow factor 0.000 cfm/Btuh Cooling air flow factor 0.000 cfm/Btuh Soave thermostat n/a Load sensible heat ratio 0 % Printout certified by ACCA to meet all requirements of Manual J 7th Ed. AL Wr10Ht50ft Right-Suite Residentia"5.0.66 RSR29784 2005-Sep-21 10:18:02 AM C:\Documents and Settings\customer\My Documents\Wrightsoft\Genesis,Jansen,255 Plaza St..rsr Page 1 .Se*it 8y: BISSELL 8 ASSSOCIQTTES; 9043984980; 117 Oct 01 1 :25PM;Job 749;Page 1!1 NOW- 10/17/01 MUMADA .R � ►>� Attprll 8 Associates lea. ,zest. A S1tr--mm Mdtk -�Olt 3515 iisodriaks Avo. U#'[1 'AFFO�1Y1 P .arta ►, Jack*Qnvillo n 32707 Phone: 904-396-1711 lraxs904-394-4"D M f0R0ai0 _IL :� 'l�Qx'911r� ��ir+ta hsa�ira c � ll�l �ast a!.Jsyt, is aron�rs • 16 �1EiMp: TNIF�tCl�csniM�{A1C$+h1ZlD�AMIIVNEYiEttMliiVt+lieMMIA. MOVE 1KN�C4!!!�0(1 7�QflCi�YMn1i1AAp/s arra►r�.+�wagar�aanonaF�rnr�rxaec�+ehvoelrfar:ta� + al�nl�r�,Af. �►wM: ►w1 MAY PGRtAw,TMMOLAM iAPPMMtrtNErOUMDltadMr n►+e} iaALL?t pCLUNIO ANDC P"TwimGrok ►+ rOs.�Ce�s.A6�i�liyAT(teM�3e lrbvi�+MAr wi4!E�FI OSr�W CtAet10. TYftlO*#1RNhifIC! 1�ONCYl111lR 6fe11Fl; oeMe�u►s UAte mr oc ;1.. aao 000 A xCows"P Afi lLLVALMY 00940ase24 10/210/24/02 wsrcnNwiae ";s m 14100,000 000 pw00 ut 4 ' wAft a 1 000"000 *-2,-000,000 GM AoMSATE LOW A PLOS r®t j tprig'1;110001000 POLCY LOC ALMAMM uc UAeruYr ANY Nino ALLOWSMOAVMG 6CNEO M AJEOS ►+a�:oavraa -� aeras v NUTW �OPClt'FY OMAN � tl�aopde�y + • o�rfAta`w"u'r Mao*a,( 4044cww, 4. Alfti kUro _ tA;~cC � 190CrwktlMMJtY ey1GHOpC1Ird�1C6 � oocuR I A CLAM MAW A*QecoAt _ ..._... _�. VIVOINfAft aoa.tr MIM no x'mKo"w uAaury t�tAc+a s s".t,.o •a� a LL.OMAN •rM grtpwt 7 i i os CER'11Fi0A18a liOtDRR i� ,eop� ,eNtNu�o: setteeer . '.; ' T4i1R041 ?'�rae!ii�t�udV�glMltoraua.tit tnbtrr*wrnu► aCs7t+ + Qr.7N1rilew,Rf64�[�OMM9RTaww .DA,1t1 20 limos It Cleaners r :116 adifff ►"isuewftwmTo"aI&t.WOVIAru�s•oto00O-Ast For sos� into, please aoetac� agent at 9049-3916-1711WAWW+M*atii@'t�M ►irlo�scnt ar�wrwrweMrts�tw ,nt,woexreae zs3 iw�n i f SEP-10-2001 12:U;2 � 7 Mt►V/�{,!� G�}`%�� '��,-,j'ri�41��71,rNll ,I �}, � �)1�,�,_iJ'�IL� I'� ���1�. � � 1 (r ;l' s ,'� •!• uNtt(r4RvilUlYv) vaoouccR !i _.. : E,a, rT I,,!. ;' 'N'l''`� ,,I 3/6/2001 rl. I. I t AS A., ER I PAVCHEX AGENCY,INC. bNLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TFII$ CERTIFICATE DOES NOT AMEND, EXTEND OR P.O.BOX 1603 ALTER THE COVERAGE AFFORDED BY THE POLIOS BELOW. 72 PERINTON PARKWAY _ COMPANIES AFFORDING COVERAGE FAIRPORT,NY 14450-7503 COMPANY A HARTFORD CASUALTY INSURANCE CO. - COMPANY PAYCHEX BUSINESS SOLUTIONS,INC. �e 911 PANORAMA TRAIL SOUTH ROCHESTER,NY 14623 I COMPANY C COIAPANY + D 'COVERAGES ''ti tls,i II 'Lf' '-.III •ti�: I i wv I :tl I;i�•.,,G•., .:a' r , Till$IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEENIISSUEb TOrTHE YVSUREDUNAMkO A80VE FOR THE POIiCY PERIOD iNDiCATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTR4CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY Bc ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED 8 Y THE POLICIES OESCRiBED HEREIN IS SiJBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CAMS, CO • YPE OF INSURANCE POLICY NUMBER POuCY EFFECTIVE POLICY EXPIRATION LIP DATE(IAKaWT1 DATE pU DDfM LIMITSsGENERALL IUTY I BODILY INJURY O-X $ COMPREHENaVeFORM @07JYIWURYA00 E Hp UNDER ROUN RATIONS PROPERTY CAMAOE OCC^ $ uNDERGROunn N EXKOSION&COLLAPSE HAZARD + PROPERTY DAMAGE AGO i PRGOUCTS/COMPLETEDDPER BI b PD COMBINED OCC S CON'RACTI AL 61 d PD COMBINED AGOS 'NOE7ENDENT CONTRACTORS c PERSONAL INJURY AGO BROAD FORM PROPERTY DAMAGE! '��'— PERSONALIN:VRV —� AUTOMOBILE LIABLI TY IJODILetatrr,Y DV IURY 15 ANY AUTO (Per P ALL OW N10 AUt03(Private Pabst ALL GWN60 AUTOS 1 U �gODILf INJURY f cPerecaitlelk) : (Other 7MIn Ptwelr nasseneery { w IVAEO AUTOS I H ?,'ON- VVNE0AUTOS I "CPf.RTY0AMAOE �S N CiARAGEL.A6ILITY , :C'LERTYD146E I — COMBINED S EXCESS LUt L-177 EACH OCCURRENCE S 'UMBRELLA FORM 1 At3lREGATE �S OTHER THAN UfABRELLA FORM 7*'—'- WORKER'$COMPENSATION ANDTORY a Ec. A IEMPLOYE"'LIABILITY Ol WN J71900 L E 1� —t00001/01/2001 12131/2001 EL EACH ACCUDEN !THE PROFRI;TM rx INCL ! EL 04SEASE•POLICY LIMB S�� 0� OFFICERS ARE. E CCt El DISEASE-EA ENPLOYEF E 1 IotHaR {ONLY THOSE EMPLOYEES LEASED TO BUT NOT ;SUBCONTRACTORS OF: ISEE RE: BELOW DESCRIPTION OF OPERATIONG&OCATIONSIVEHICLESISPEC)AL ITEMS RE: SOUTHERN TECHNOLOGIES OF JACKSONVILLE,INC, CERTIi=KATE .,:alRC, I� pL,vI ,.._.. .'t: 11.,a:. .. I �I ,' ,I - t:.',� ,I,1 :. ...v:,M �ST i. I,b III.,!�_.u�...'�L. ..�� E. ... ..I !i':1 -.�• till' II...I•. SHOULD ANY OF TK ABOVE DESCRMED POUCIES BE CANCELLED BEFORE TME EXPIRATION DATE THEIISOF, THE ISSUINO COMPANY WILL ENDEAVOR TO MNL SOUTHERN TECHNOLOGIES OF JACKSONVILLE 30 DAT3 WIBTTMN NOnCETO TI(FCERT,FICATENOLOERHAMEDTO THE LEFT, 5121 BOW DEN ROAD#311 BUT FMVRE TO MAIL SUCH NOTICE SHALL IMPOSE ND OSU"TION OR UAMUrY JACKSONVILLE,FL 32216 OF ANY IQM UPON THE C ITS ABENT3 OR =PRE3ENTATNEb. AUTHO pm N G AC RD'CORPORATION•1986 TOTAL P.02 STATE OF FLORIDA ACt 8 8.111�19 DEPARTMENT O OUSTNESS AND PRDFESSIU AL „REGULATION ` A -CO57 518 06 15120,00 9"02193 93 CLASS A CERTIEFTED .AIR CIM€! CLNTR HANKS♦ MART'S RAY SOUTHERN TECHNOLOSIES OF JACKSON i I S C E 2 T T F I E D under the provisions of Ch. 4 sj" FS., JC Expira0,n Date: A+ 32+ 2012 4 � SSN OR FEDERAL TAX# Acct Number: 137522-0000-0 L County Code: 000-005 Description: QUALIFYING AGENT, CONTRACTORS NATURE OF BUSINESS k1 V� IF YOU HAVE CHANGED YOUR LOCATION ADDRESS, PLEASE FILL IN Y E ZONING CERTIFICATE NO. DIST 1 MOBILE: OUT OF TOWN:[] Adjusted Tax Due Pa b Se 30 Oct-10% Nov-15% Dec-20% Jan-25% COUNTY TAX(CC 14) N/A N/A N/A N/A N/A MUNICIPAL TAX(CC 13) $100.00 $110.00 $115.00 $120.00 $125.00 Total Due #; }3t; $1 10.00 $11 1 15.00 $120.00 $125.00 Acct: 13752200000 001 02 9113 00322 000913 03 100.00 ` . 09/13/00 0/L REGULAR PAYMENT Signature & Date: 16821 0000100000000'0000013.75220.OQ001.314 . ^--^1 EDATIn!yAI 1 CS` JSC ADiD} IrAT1I1M G/1DRA ,Il �,IA ACCOUNT NUMBER: 137522-0000-0 An occupational license when required is due and payable before first engaging or managing any business. An ocoupational license shall not give any person the right to violate any other law or ordinance. Application is hereby made for an occupational license for the privilege of engaging in the business, profession or occupation herein described and I solemnly declare under penalty or perjury that the foregoing information relating to number of devices, number of accommodations or employees, value of stock or merchandise, zoning certification is to the best of my knowledge and belief true and correct. Please make any appropriate address changes or corrections below. Mailing Address: Physical Location of Business: HANKS, MARTY RAY 04 SOUTHERN TECHNOLOGIES OF JACKSONVILLE PEDDLER OF SERVICE512-1 f 21 Q_��W. S'�,J�) 5121 $owd eo,, -V,4. 542.-311 '" <,blx, 3221 fp cJax >rc. 3-2 (o SSN_r';.f ;=">pAL TAX; Acct Number: 137521-0000-4 L- — - - ---- I I County Code: 307-001 r� Description: CONTRACTOR, ALL TYPES NATURE OF BUSINESS v IF YOU HAVE CHANGED YOUR LOCATION ADDRESS, PLEASE FILL IN Y NEW NTNG CERTIFICATE NO. DIST 1 MOBILE: OUT OF TOWN: Adjusted Tax Due 1pbySep 30 Oct-10% Nov-15% I Dec-20% I Jan-25% EMUNICIPAL TAX(CC 14) $11.25 $12.38 $12.941 $13.50 $14.06 TAX(CC 13) $51.25 $56.38 $58.94 $01.501 $64.06 ' Total Due $68.76 $71.88 $75.00 $78. 12 Acct: 13752100004 001 02 9113 0033 000913 03 62.50 09/13/00 G/L REGULAR PAYMENT Signature & Dater 17387 000005 125000001 1251375?100,004.1314• tli.vev-2Jv1 vvCJP.-iTiVi`vi^-iL. i.:vEx:wC 60.01.i^,.ATlni'a FvDRA 4A.rQd ACCOUNT NUMBER: 137521-0000-4 An occupational license when required is due and payable before first engaging or managing any business. An occupational license shall not give any person the right to violate any other law or ordinance. Application is hereby made for an occupational license for the privilege of engaging in the business, profession or occupation herein described and I solemnly declare under penalty or perjury that the foregoing information relating to number of devices, number of accommodations or employees, value of stock or merchandise, zoning certification is to the best of my knowledge and belief true and correct. Please make any appropriate address changes or corrections below. Mailing Address: hysical Location of Business: SOUTHERN TECHNOLOGIES OF 04 JACKSONVILLE MARTY RAY HANKS PEDDLER OF SERVICE '1464 6*94 nT A 5121 6owden c�G�k - 3 I CITY OF ATLANTIC BEACH — - DEPARTMENT OF BUILDING 800 Seminole Road-Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 ELECTRICAL PERMIT PERMIT INFORMATION___ -------- __ _ LOCATION INFORMATION --- Permit Number: 22968 - Address: 255 PLAZA DRIVE Permit Type: ELECTRICAL Class of Work: INCREASE ATLANTIC BEACH, FL 32233 Proposed Use: SINGLE FAMILY Township; Range: Book: Square Feet: Lots): Block: Section: Est. Value: Subdivision: ATLANTIC BEACH j Improv. Cost: Parte! Number: _ — _ _ Date Issued: 11/02/2001 - OWNER INFORMATION Name: CHAPLAIN, ROD Total Fees: 41.00 Address: 255 PLAZA DRIVE Amount Paid: 41.00 Date Paid ATLANTIC BEACH, FL 32233 11/0212001 Phone: O 000 - Work_Desc ES$100AMPS-200AMPS 1PH3W 240V PVCRW ALUM �S OINCREASE AND AC --- __ ___--- ----CONTRA_CTORtSL_ AMERICAN ELECTRICAL CONTRAC77 APPLICATION FEES__ - - - � 41 "" �w 3 �Y` k ; l A y�t - [ AF k FINAL ELECTRi(� -- '� 1yJ'.7n�'rs' `T"•6.L.pr ya � '+y y•n `�. 5 r i a " „�. 2k,4 }; �.. - '� ge'w�d, - �- LA. �� t+`'•'�rs�4 } �"� �- sv 4 1r` -��'�+s a� 'fin, .e:;t -_—.-. ......-.—.—._—..__-_—.—.__� 'Hew -. � � .f+.vf �a+ ��`R'lT '� 'q! �5 '� 81 ��• NOTICE - IN _ CTI TME T A 24 HOR . €IWPECTION BUILDING MATERIAL. (JB$tSl'I r ----- MUST BE CLEARED NCT EE?dN LIC SPACE, AND LT -- -- _ �AYB # FG3R aW FAILURE TO COMPL 4 PROPERTY OWNER PA Ii11 A IN THE ISSUED ACCORDING TO APPRO --- =OR VIOLATION OF APPLIC H T ! ND SUBJECT TO REV ABLE PR OCATION r ATLANTIC BEACH BUILDING DEPT. t4 Date: 11/95/8181 Receipt: 8988 M 5u8s ----- ---___-__ CHECKS CITY OF ATLANTIC BEACH, FLORIDA Avvrowd CV APPLICATION FOR ELECTRICAL PERMIT ' TO THE CHIEF ELECTRICAL INSPECTOR: DATE: /J 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. Allwr ,am oec.Jo,o ELECTRICAL FIRM: MASTER ELECTRICIAN SIGNATURE JOURNEYMAN NAME 164 1 ADDRESS: `1 �� 61 BOX W ��t I, BLDG.SIZE BETWEEN:—� 47 RES.(Vl APT.( ) comm.( ) PUBLIC( ) INDUS.( ) NEW( i OLD REW.( ) ADDITION I ) TRAILER ( ) TEMP.( ) SIGNS ( ) SQ.FT. SERVICE: NEW( ) INCREASE J.,� REPAIR( 1 FEE CONDUCTOR SIZE `7' AMPS r 20 COPPER ALUM. SWITCH OR 13REAKER CJ ) AMPS PH W zV( /OLT � RACEWAY EXIST.SERV.SIZE p AMPS PH _7?W ��Z VOVOLT ,V 4-KACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS I CONCEALED OPEN I TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.90 AMPS. 1•100 AMPS. S W ITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. IOVER APPLIANCES BELL TRANSF. AIR H.P.RATING H.P.RATING Q CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CELL HEAT: KW-HEAT o r 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS U e VIO TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. I KVA I.I NO. KVA NO.NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH I FLASHER, EACH SIGN FORWARDED S TOTAL FEES CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233 - Tel: 247-5826 - Fax: 247-5877 PLUMBING PERMIT _---..------PERMIT INFORMATION � - " LOCATION INFORMATION Permit Number: 23009Address: 225 PLAZA DRIVE -__— Permit Type: PLUMBING ATLANTIC BEACH, FL 32233 Class of Work: ALTERATION Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: {� — - 01NNER INFOR1111ATION a -II Date Issued: 11/12/2001 Name:- CHAPLIN, ROD Total Fees: 45.50 Address: 225 PLAZA Amount Paid: 45.50 ATLANTIC BEACH, FL 32233 Date Paid 11/13/2001 �_ Phone: (000)000-0000 Work Desc: INSTALLL PLUMBING _ CONTRACTOR(S) v_.__ --- APPLICATION FE_ES _ j DAVID GRAY PLUMBING, INC. PERMIT 45.50 I i Inspections RequiredFINAL --- I NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION j I BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC j 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 FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. - - i f I i ,l $45.5014 1 ATLANTIC BEAC BUILDING DEPT. Date: 11/14/81 91 Receipt: 8911898 CHECKS 3718 , CITY OF ATLANTIC =CH APPLICATION FOR PLUMBING PERMIT JOB LOCATION:_�� �l.Z2Q 5-V OWNER OF PROPERTY: (24-laOj, TELEPHONE NO. PLUMBING CONTRACTOR DAVID GRAY PLUMBING, INC. CONTRACTOR' S ADDRESS: 8850 CORPORATE SQUARE CT. JACKSONVILLE, FL. 32116 STATE LICENSE NUMBER: CFC 022586/436 TELEPHONE: 724-7211 HOW MANY OF THE FOLLOWING FIXTURES INSTALLED I SINKS SHOWERS Z LAVATORY WATER HEATERS I BATH TUBS DISHWASHERS URINALS DISPOSALS 2 CLOSETS J WASHING MACHINE FLOOR DRAINS SHOWER PANS SEWER WATER REPIPE OTHER TOTAL FIXTURES: x $3.50 + $15.00 MINIMUM PERMIT FEE - $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: (70 David GAY ----------------------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834 a D CITY OF ATLANTIC BEACH S11 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Jjilt Application Number . . . . . 04-00028733 Date 8/06/04 Property Address . . . . . . 255 PLAZA Tenant nbr, name . . . . . . 4 ' FENCE Application description . . . FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 250 Owner Contractor -- -------------- -------- ------------------------ CHAPLIN, DIANA OWNER 255 PLAZA ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ------------------------------------ ---------------------------------------- - Permit . . . . . . FENCE PERMIT Additional desc Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 . 00 g PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING OFFICIAL MAP SHOWING SURVEY OF I,0`1' g , EXCEPT THE WEST K. OSFEP�GFH�REOF� THEOCURRENTTPUBI,IC RECORDSBEACH AOF4VDUVAL AS RECORDED IN PLAT BOO , COUNTY , FLORIDA. w (�✓o x.v> 7-h"9 o k' 1� i op°°'"p"M" applembf '"�� 1 f+oc l lana yed es ub �b 19. sow With Fbrip t Pew local, Stat the Of must be vb the N• e Beeyc�i . 10.i su Pa tt. /0) EP S un e t 57-019 y 0 Cc: CITY OF ATLANTIC BEACH D. Ford BUILDING / ZONING DEPARTMENT wins r ssY S. Doerr J 800 Seminole Road J Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # ©H - 2�S1 J� Property Address: Applicant: i COY) 01- Ct In Project: * This permit application has been: ❑ Approved ❑ Reviewed and the following items need attention: Please re-submit yourplication whe 'tese items have been completed. !� 730--e) Reviewed By: Date: � CITY OF ATLANTIC BEACH =� FENCE PERMIT APPLICATION Date: dZ O Job Address: �" Pla Owner's Name: n Address: � �t' Phone: Legal Description: Block Number: Lot Number: Zoning District: Fence Contractor: pek Address: Phone: City: State: j�Zip: Fax: Type of fence and materials to be used: Valuation Of Fence: 0 > terior Lot ❑Corner Lot ❑Dumpster or storage tank enclosure Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application. Tree Protection: MO. Applicant certifies that no trees will be removed for the installation of this fence. YES. Removal of Protected Trees will be required for this fence. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. 1. Attach copy of property survey showing location, height and all distances from property lines of the proposed fence. (Fences shall not be placed within any utility or drainage easements without written permission from the Utility and/or Public Works Departments. Fences shall not restrict any private easement.) Address and contact information of person to receive all correspondence regarding this application(please print). Name: CVIA � Mailing Address: 2p55 �1 l Ct Z ►- S+- 1f! Q Phone: @49 — 1 Q qyo Fax: ��/ Ca E-Mail: 0 C kdee 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 . Fax: (904)247-5845 • http://www.ei.atlantic-beach.fl.us Page 1 Revised 3/04/04 I hereby certify that all inf tion provided with this application is co ec h Signature of Owner: te- I hereby certify that I have read and examined this application and know the same t e true and correct. All provisions of the 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 federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: AS TO OWNER: Sworn to and subscribed before me this C9, day of 20 State of Florida,County of Duval \ Notary's Signature: 00 ❑ Personally known JENNIFER SCHLUETER ; '�Y rye:- roduced Identification (,; ., MY COMMISSION#DD 121301 EXPIRES:May 27,2006 /+ !' [� ';p PF-Wl Bonded Thru Notary Pubiic Underwriters Type of Identification Produced L V A Li 61,— — 1 �7. `G"1 `-1-1 1" AS TO CONTRACTOR: Sworn to and subscribed before me this day of 20 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced Identification Type of Identification Produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845 . http://www.ci.atlantic-beach.fl.us Page 2 Revised 3/04/04 Map Output Page 1 of 1 JAXGIS Property Information I 4 142 3, 4 ti 1 348 21S � �, -- �Copyriq ht 4Cj 2M-C Ry of hmc aonr U--Flip Total Plat ap Flood RE# Name Address Value Cres Book Panel Legal Descriptions one LandUse oning NT HAPLIN 55 15-61 16-2S-29E flood ot in 170348 000 DIANA ELENAPLAZA 30200 .10000000149 558 4 ATLANTIC BEACH PARKWAY PT LOT 2233 LOT 8 EX W 6FT BLK 1 one http://maps.coj.net/WEBSITE/DuvalMAps/toolbar.asp 7/26/2004 CITY OF ATLANTIC BEACH BUILDING / ZONING DEPARTMENT 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax PUBLIC SAFETY PLAN REVIEW COMMENTS Permit Application # 04- z8-7 3--!s Property Address: 'ZSS 'T:L^-z A Applicant: l D 1 CL Project: his permit a lication has been: Approved f3� Reviewed and the following items d attention: Please re-submit your application when these items have been completed. Reviewed By: Date: CITY OF ATLANTIC BEACH f` FENCE PERMIT APPLICATION S3 ` -4 --- s Date JUL 2 3 204 ' Job Address: I Owners Name: 1,,,v Address: 2..S25- 'Pto Phone: —'2 Legal Description: Block Number: _Lot Number: Zoning District: Fence Contractor: lywr1Qlt- -i-fl' o a kk Address: Phone: City: ++•• State: Zip: Fax: Type of fence and materials to be used: U/ofl � Valuation Of Fence: Interior Lot ❑ Comer Lot !!!"'��� ❑Dumpster or storage tank enclosure Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application. Tree Protection: O. Applicant certifies that no trees will be removed for the installation of this fence. YES. Removal of Protected Trees will be required for this fence. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow-all steps and provide all information as aoproariate. Incomplete applications may result in delay in issuance of permit. 1. Attach copy of property survey showing location, height and all distances from property lines of the proposed fence. (Fences shall not be placed within any utility or drainage easements without written permission from the Utility and/or Public Works Departments. Fences shall not restrict any private easement.) Address and contact information of person to receive all correspondence regarding this application(please print). Name: �1J%Qra C1110.p�� MailingAddress: -Z55- e(GC 7-0— "S�- Q Phone: a ` 1 1 C) q `� Fax: / 9 E-Mail: 1) e � CSC'19 ��VY(LL�(•C a� 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845 - http://www.ei.atiantic-beach.fl.us Page 1 Revised 3/04/04 I hereby certify that allinf fion provided with this application is co ec r Signature of Owner: te• I hereby certify that I have read and examined this application and know the same t e true and correct. All provisions of the 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 federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: AS TO OWNER: Sworn to and subscribed before me this day of—__ bJ`�1 ,20 . State of Florida,County of Duval 4AAqu Notary's Signature: _ ❑ Personally known JENNIFER SCHLUETER MY COMMISSION DD 121301 � roduced Identification EXPIRES:May Public 2006 v1 115'- 1 �®C xP.;ia•' Bonded Thru Notary Public Underwriters Type of Identification Produced F� C/1 '..'Li TO CONTRACTOR: Sworn to and subscribed before me this day of 120 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced Identification Type of Identification Produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 - Fax: (904)247-5845 - http://www.ci.atlantic-beach.fl.us Page 2 Revised 3/04/04 MAP SHOWING SURVEY OF LOT 8, EXCEPT THE WEST 6.00FEET THEREOF, BLOCK 1, ATLANTIC BEACH PARKWAY, AS RECORDED IN PLAT BOOK 15, PAGE 61 OF THE CURRENT PUBLIC RECORDS OF DUVAI. COUNTY, FLORIDA. I Block > yeoges o•k _]f-��0�'� (o ✓���..t'�y,. Fcri�nAjOO' i iLfaiiPiPE Nos,c) I m p fl o �p � W p3 /a L� o.l u o � /-sro,-y 0 mock-l o :` s RES/v�`i✓c'6" ��� /✓o. Z55 R c � ��� force Ope:.,Rm f (` 0 m \ � `�C\�With Overhead o z-7 001 NmT To Sc.e<E � \IG°Q°N i�' '�'... fzri✓o/"�`.;gFC�Ne z.v.i S7—,1:; E-&--7 ¢o' ,e/GNT- nF WAX /- THIS IS A BOUNDARY SURVEY, V.NO BUILDING RESTRICTION LINE SHOWN ON PLAT, THERE ARE RESTRICTION LINES BY ZONING AND THERE MAY BE EASEMENTS THAT AFFECT THIS PROPERTY THAT ARE RECORDED IN THE PUBLIC RECORDS OF THIS COUNTY THAT ARE NOT SHOWN ON THIS SURVEY. 3,THIS PROPERTY LIES IN FLOOD ZONE "X" WHICH IS THE AREA OUTSIDE THE 500 YEAR FLOOD ACCORDING TO FEMA FLOOD MAP REVISED 4/17/89, COMMUNITY PANEL NO. 120075 0001 D. S7�itie er TiT<C 1-7 P�i✓Ty Ld. /�iG i%Q eo 7 Mo Q�NE'tlo, 4. pp�C�N LAND SlJR V� EYORS INC. SDU �3 . .o.QOFESS/Gi'�/G,L<}�l�f'r/K✓E+Df{/�./674f<o,�i�7a DATE: IVOVEMBE2 29, /994 POST OFFICE BOX 50670 1 703 SOUTH THIRD STREET SCALE: JACKSONVILLE BEACH, FLORIDA 32250 (904) 249-7261 FAX.(904) 247-1252 THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE ABOVE SIGNED. Map Output Page 1 of 1 JAXGIS Property Information J -- — 905 a I US I i I au 2-SS ac 4 -k- - 1 34,80 n i 86 so %Ca r' hi � .2Db'2�it of.bcl®onvillG,FI'i �.-- lood E# ame Address Value cies gook Panel 926 Total Plat aPLegal Descriptions Pone Land Usefning ENT HAPLIN 55 15-61 16-2S-29E Not in 170348 0000[DIANA ELENA PLAZA 230200 .10000000149 5584 ATLANTIC BEACH PARKWAY PT LOT 4 Flood 32233 LOT 8 EX W AP Zone http://maps.coj.net/WEBSITE/DuvalMAps/toolbar.aSD 7/26i2nna DEPARTMENT OF B ILDING 21 CITY OF ATLANTIC BEACH, FLORIDA V 1 5 3 Is PERMIT TO BUILD PERMIT No. THIS PERMIT MUST BE POSTED ON JOB Date— 8 1 1 O/?6 19 Valuations— 2.4 O O p O Fee 6 O O This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of Lw. This is to certify that Ed__wArsyr K;r,rar has permission to build Addition to residence Classification r e s i d e n c e Owned by Edward s. Koren ' n Lot 8 Block I SSD Atl. Bch. Pk House No 255 Plaza Road According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIR MONTHS AFTER DATE OF ISSUE O Building; material, rubbish Z and debris „� from this work must not be placed in Public space, and must be cleared up and hadled away by either contractor or owner. R. C. Vogel Building OfffeLl. FOR.OFFICE PERMIT USE ONLY NUMBER DATE CONTRACTOR ------------ PLUMBING ELECTRICAL SEWER WATER i111W FOR OFFICE U8 ONLY Date �..... .. .....19 ...... 6� Permit #----..-•--------•--•----Fee$-- CITY OF ATLANTIC BEACH valuation $..Zaav FLORIDA House #•- f .......... .............. APPLICATION FOR BUILDING PERMIT 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. Date......... ............................................................ 19.7 6o Owner... .EO-YJ ------------------__-------Address-25-7 PGA Z A � ----------- ...... .... Q ............Telephone No...A.q �..�AA Architect . L� A76 - =- - --------------------------•----------------•--.-------•------•-------- ress,...._ 2!-E...................................Telephone No-..........---•------•--•---- Contractor Builder-..- �......-----•--•---•----•-•-----------------•--••-----_--Address........ .'k�................................................Telephone No.- LotNo--------6-------------------••-----------------.._Block No------------1-------------------Sub Division---------------_-------------------------------------------------------------Zone................. ------------------------------------------------------Street_.PLO)Z A:------'Side Between.---------------------------------------------------and......................................................Sts. 00 Valuation $---z.09®_--`---_For what purpose will building be used...)Y_aVS!_24�.�r�.................Type of construction...W-A2Q..F dF� Dimensions of Building S Size of Footings= - Dimensions of Lot ..�La........50................ gs-----. ......••---------------- Size of Piers.----------. --------------------Size of Sills-------+l---------------------Greatest Sill Span in ft......15................Type Roof.slH.J.'t1G ........... How will Building be Heated?..__.- .-_..�'u ............._.....................Will Building be on Solid or Filled Ground?.....�. L- J.')................. Size of Ceiling Joists.... ................... Distance on Centers--........ Cfa--"•-.-•------------.----.-, Greatest Span....... _A............................ » Size of Floor Joists---I _._-tq............•.._•__......_.. Distance on Centers.......--'/�.............................. Greatest Span........iv.�.-............................ " Size of Rafters-------- x ---------------------.' Distance on Centers....... ------...--•--------..., Greatest Span.......fc2................................ This " This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. A G't Inspections required. 1. When steel is in place and ready to pour footing. 2. When steel is in place and ready to pour columns and/or lintel. a Z 3. When steel is in place and ready to pour beam. 4. When framing is completed. 0.Q 5. When rough plumbing is completed,and ready to cover up. 6. When septic tank drain field or sewer is laid but before it is covered. A 7. Electrical inspection by City of Jacksonville. 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for after corrections are made. 5n, 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 of tlantic Be ch. �. r1 Signature of Builder. --...... *�...� ...--•---...... Address..._ � wi ..........-----•---•------------- Signature of Owner......TM ".£. ...... ................................. Address....�21:"'........�. ..................................................... 4 R I e r ti g x n --�--, +g 1::...._;._._ 9 ��� __ � �� .. �.�1 . __ ___.� �.e�. �� _ .� g XX gk[A—_ S I x f p J+ jr � � 444 Yv y1 1 e f9[3 .,.®..�..o„o,��d�w..ex....,.� ! i} _#� d �p111 j � � g � � � � ___ ._.__ 3 ill .7 � ' � � — .�... ..,....w„. ,,,,,,,. I -._,. w:�aw m. p ; s. � �� 1 � - f � — ���- S � f a ga � � � n -j f 4 I i 1f a a � , q � k 3 t { S FOR OFFICE USE ONLY Date....................................19 ...... CITY OF ATLANTIC BEACH Permit #-----------............Fee $----I---------_-------- Valuation $ FLORIDA House #- •------•-•----••--------.... APPLICATION FOR BUILDING PERMIT .------•----------••----------------•----••----------------•-------......... ---------------------------------------------------------------------------- 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. Date......................................................................... 19............ Owner--------------------------------------•----------------------------------------------------------Address.............-------------------------------.--------------Telephone No............................. Architect.------•-------------------------------------------------------------------------------------Address,----------------_----_------------------------------...Telephone No.................. ------ ContractorBuilder-----------------------------------------------------------------------------Address.-----------••-•------------•-•-------•--------------•---Telephone No..-------•---------------- LotNo------------------ --------------------------Block No..--.-.------.-----------------Sub Division----------------------------------------------------------------------------_Zone--------------- ------I----------------------------------------- ------------•-----------------•----•----------••----------------------Street--------------- ---:Side Between.....-------------- -----.and--------_-----......................................Sts. Valuation $..---.----------................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-----------------........................... of Size of Rafters-------------------------------------------....... Distance on Centers. ---- --- ------------ ----••- .., Greatest Span.---------......-......................... to This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing. W 2. When steel is in place and ready to pour columns and/or lintel. Z x 3. When steel is in place and ready to pour beam. 1 4. When framing is completed. F 5. When rough plumbing is completed,and ready to cover up. 6. When septic tank drain field or sewer is laid but before it is covered. W W A A 7. Electrical inspection by City of Jacksonville. r`n 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 of Atlantic Beach. Signatureof Builder................................................................................ Address...........................--............-------- Signatureof Owner...............-------------------------------------------------=--------------.. Address.............•............................................ MAP SHOWING SURVEY OF LOT 8 , EXCEPT THE WEST 6 . 00FEET THEREOF, BLOCK 1, ATLAN'T'IC BEACH PARKWAY, AS RECORDED IN PLAT BOOK 15 , PAGE 61 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. 8/o c 1 �� Zoe Dep d �i✓o r.vJ yecigcs +\ 9, ub onmm `" 0.3 �� 0 NEn. with f for BuNrt and all otf� h 5 j o local, Stat t muss be ve a gnaw a ofthe of Attinft of o �00 guiPe ti unky Do t • 3/.z \\ N D o s r /�'/O Z� x .i i', � \ ,\�� fiom�O/se•n Poa f v w,fh o��„timed g '\�Sp�i'M'er sys 1e m VT c��r ;��cq r • N°T To Sa.cLE �� � �G°Q�N .���C�J ' cy. . fcri,�n/"�c�,-,o�(✓o z v,� — 00 -- /ftov,oi 4o' RiGNT- OF-wAy THIS IS A BOUNDARY SURVEY. 7-NO BUILDING RESTRICTION LINE SHOWN ON PLAT, THERE ARE RESTRICTION LINES BY ZONING AND THERE MAY BE EASEMENTS THAT AFFECT THIS PROPERTY THAT ARE RECORDED IN THE PUBLIC RECORDS OF THIS COUNTY THAT ARE NOT SHOWN ON THIS SURVEY. 3. THIS PROPERTY LIES IN FLOOD ZONE "X” WHICH IS THE AREA OUTSIDE THE 500 YEAR FLOOD ACCORDING TO FEMA FLOOD MAP REVISED 4/17/89, COMMUNITY PANEL NO. 120075 0001 D. .Gt-,r.lv tvr i/r:r c Ano ri► .4-- C