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390 Plaza (vault) CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233 -Tel: 247-5826 - Fax: 247-5877 PLUMBING PERMIT ER IT:I FARM TION;:k LQ AT ON-IN`F RM,ATION Permit Number: 21064 Address: 390 PLAZA DRIVE Permit Type: PLUMBING ATLANTIC BEACH, FLORIDA 32233 Class of Work: ALTERATION Township: 0 Range: 0 Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section:0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: Date Issued: 11/29/2000 Name: GRAGE Total Fees: 29.00 Address: 390 PLAZA DRIVE Amount Paid: 29.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 11/29/2000 Phone: (904)246-6721 Work Desc: FOUR FIXTURE REPIPE C I`tRA R r P FES ROTO-ROOTER SERVICES COMPANY PERMIT 29.00$ S f t „.r�--:,,, seS f'fie' yWYtyt ti f"`v 9x be yt• ti. ��F' FY' - Y^5' a Iw.GE S_ FINAL Y NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. j(1 (� $29.0114 Gam. : ti Date: 11/29/88 81 Receipt: 8915218 ATLANTIC BEACH BUILD NGUEPT. 88180683221888 3878 Oct- 16-98 08: 28A P . 01 CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT ,TOB LOCATION: a0 __ OWNER OF PROPERTY: , C ifaci , PLUMBING CONTRACTOR: 4n-k' ) - gp&ev- CONTRACTOR'S ADDRESS:,2azi�, L�, o 1 4�t (�yr t STATE LICENSE NUMBER:cj,/�pq TELEPHONE:� � • G l HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORIES WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINES FLOOR DRAINS SHOWER SHOWER PANS OTHER!! TOTAL FIXTURES: X 3:50 + $15.00 MINIMUM PERMIT FEE a $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: .� �,.......- ---------------------------------------------------------------------------_- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834. w�wwwwwww�rww CITY OF ATLANTIC BEACH ` DEPARTMENT OF BUILDING I 600 Seminole Road -Atlantic Beach, FL 32233 -Tel- 247-5826- Fax: 247-5877 M PLUMBING PERMIT Permit PERIVI�� ,f!QR il`AT1OH - - L GATiQN E QRiI�ATlt3t�f Number: 21136 Address: 390 PLAZA DRIVE Permit Type: PLUMBING ATLANTIC BEACH, FLORIDA 32233 Class of Work: ALTERATION Township: 0 Range: 0 Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section:0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: v .` , OWNER AT ,- Date Issued: 12/13/2000 Name: GRAGE Total Fees: 25.00 Address: 390 PLAZA DRIVE Amount Paid: 25.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 12/13/2000 Phone: (904)246-6721 Work Desc: ADDENDUM ADDING LAV, TUB, WATER HEATER & CLOSET SEE#21064 -y ,4 7°R/S6i1-i`w zA ROTO-ROOTER SERVICES COMPANY PERMIT 25.00 i TOPOUT FINAL NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. $n.Be 14 Dues 12/14/N L!1 Receipts 9III&M ATs 3179 NTIC BEACHBUILD PT. 9li�BA9B3L"'c1L191 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J rt ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00000633 Date 5/09/08 Property Address . . . . . . 390 PLAZA Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2500 ---------------------------------------------------------------------------- Application desc GENERAL REPAIRS ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GRAGE, H. WELMER OWNER 390 PLAZA ATLANTIC BEACH FL 32233 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 45 . 00 Plan Check Fee 22 . 50 Issue Date . . . . Valuation . . . . 2500 Expiration Date . . 11/05/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. --------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 45 . 00 45 . 00 . 00 . 00 Plan Check Total 22 . 50 22 . 50 . 00 . 00 Grand Total 67 . 50 67 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. s frr CITY OF ATLANTIC BEACH 0 8- . t'y 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 c3 OFFICE:(904)247-5826•FAX NO.:(904)247-5845 w BUILDING-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY x ✓ i4 i, 1� `'r", �,'ri 9�w HpM{4: .f ' .. i u�i �'. X i y'Pd•'��.., h , ,. �w 1 ,,� tr..o�„3�*,r'•� a f��. , ^ H 354, /„ „ 7es.: .: Atlantic Beach, FL 32233 ©� � .... ❑NEW BUILDING 11 DEMOLITION ESIDENTIAL LOT_BLOCK_SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL t♦E Y1/fJRkit " h�����H . ,��q 1'�b �`.i4001 ❑ALTERATION ❑ACCESSORY BLDG. xfi f��G^ REPAIR ❑POOL/SPA ❑YES [3 NIA /y /� A l 1(z` ❑MOVE ❑OTHER ❑NO #�RUPtt .,. ;,: Ian= d,Hk3w+ !, l r 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: MA I'm 16.NAME: 24.LICE SEE NAME: 10.ADDRESS: t 17.STATE OF FL RIDA LICENSE NO.: 25.STATE NORIDA LICENSE NO.: 390 R 'C/4 18 ADDRESS: 26.ADDRESS: ATL .-� L 11.OFFICE P 12.FAX NO.: 19.OFFICE PHONE: 0.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: M13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: / 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: Ilerel pyuli'n e5 ? FI {+e, �`i{H'i; r� �HHi���i �e'� � FU nlni�i;-�X. �� ��liji^ :i, X�IIH' HV6.`�i� i''X,'IIH��. w' a'x-"li N "; iE a, '.,�7���i l.r; 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced Within six(6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. WARNING TO OWNER: > YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING_ YOUR NOTICE OF COMMENCEMENT. 2n' �(fi���ii a�iidi��`��Ii ? low ., X r iY rd�i�� �,�j..l' u X q �� iiatl II il" it 'y, �u , C Signed: e: Signed: Date: Before me this day of ,2007 in the county of Before me this day of ,2007 in the county of Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are true and accurate. true and accurate. Not#Public arge, County of Notary Public at Large,State of County of Personally ,,ARv P.( ❑Personally Known ❑Produced Ida ificat S l LEY L. GRAHAM ❑Produced Identification- i Notary Sig e o Notary Si ° 518533 E Tod I By National Notary Assn. CITY OF ATL,NnC BEACH r SEE PERMITS FOR ADDITIONAL y to/poy REQUIREMENTS AND CONDITIONS.BFRILGERE REVIEWED BY: S ^d DATE ! Nj YjL,•- CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. 390 ` ?4ea &_-a. -a 4 rit 233 ADDRESS PHONE NUMBER PRINT NAME GO oog SIGNATURE J AT Before me this day of 2007 in the county of Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are true and accurate. NZer.oralyoo Public at Large,State SHIRLEY L.GRAHA `. p,AY P`e. l ;=o� = Notary Public-State of Florida ❑Produc Ide ioation- 10 ` Commissi D 518533 on ed By National Notary Assn. Notary S' to COAG FORM BLDG07;REVISED 8/14120 CrFY OF ATLANTIC BEACH PERMIT fri J ?y G/ZONING DEPARTMENT APPLICATION s1 000 Seminole Road C• ��• U!l/�� �.:_-��.*-:• Atlantis Beach,Florida 32233 J;iil � (904)247-00-00 (904)247-50045 Fmi APPLICATION TRACKING.IN FORM REQUIRED DEPT: q N PLANNING Property.address p�./D �I42 Q./ � � � BUILDING Y N PUBLIC WORKS Applicant- b�r77.UC� 0 Y N . PUBLIC UTILITIES C Y N FERE DEPT. ProjecaA169 IV � K-ate Y N PU6UC SAFE TY w -APPROVAL �j❑ REQUIRED AGENCY. RECEIVED BY: INITIAL DATE Z_� Y m D.E.P HUFSTETLI=R ¢Z 0�cY Y N S.J.R.W.M. CARPER Lu z Y ISI ARMY CORPS of ENG CARPER o Y N HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS _ CIRCLE ONE: SITE BUILDI DA AP ZREVIEVVED BY: INITIAL: DATE: ® IST REV ® �'C' of) 5--9-o?- PLANNING ' ® 2ND RE1f BUILDING PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY .® ® 3RD REV ® � ' � 1�a C CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00000665 Date 5/14/08 Property Address . . . . . . 390 PLAZA Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2000 ---------------------------------------------------------------------------- Application desc reroof ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GRAGE, H. WELMER OWNER 390 PLAZA ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit ROOF PERMIT Additional desc . . Permit Fee . . . . 40 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 2000 Expiration Date . . 11/10/08 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 40 . 00 40 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 40 . 00 40 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH �s5k 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 08- OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 BUILDING-DEPT@COAB.US Fi BUILDING PERMIT APPLICATION DUVAL COUNTY !pe,ADORFss `I .1+�4ATIoNA+4.m 3�st3; N Io . 3 O /� Atlantic Beach, FL 32233 Z-000 4E {SGA12,'DESOfAI I; �.`_> : rise°Wo` s 7si~4 STs�i cru ; ❑NEW BUILDING ❑DEMOLITION ARESIDENTIAL LOT_BLOCK`SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL DSSCIRIPT1011,CIi tIH^ ,, ❑ALTERATION ❑ACCESSORY BLDG. IRE`SPRIt�tSi r REPAIR ❑POOL/SPA ❑YES N/A ❑MOVE ❑OTHER 113NO W-XW� K 'RRO,PEfffY OWNER ,1P Vis. » #,k �• ,... 3 r-ONaTR MMI. Oo . %NVW#MARWTlBWENQINEE 1 9.NAME: / 15.COMPANY NAME: 23.COMPANY NAME: 16.NAME: 24.LICENSEE NAME: 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENS 0.: ,390 PLA A 18.ADDRESS: 26.ADDRESS: 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHON 28,FAX NO.: 13.CELL PHONE: 21,CELL PHONE• 29.CELL PH E: 14.EMAIL ADDRESS. 22.EMAIL DRESS: 30.E L ADDRESS: FL E �� ileraHf+!x(9+� r� FLTQ N E , .., 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6) months, or if construction or work is suspended or abandoned for a period of six(6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ow R��. ; ��� • � . �eawtedi�� Signed:` $40Signed: Date: Before me this day of 2007 in the county of Before me this day of ,2007 in the county of Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are true and accurate. true and accurate. Notary Public at Large,State of County of Notary Public at Large,State of ,County of ❑Personally Known ❑Personally Known ❑Produced Identification- ❑Produced Identification- Notary Signature: Notary Signature: COAB FORM BLDG01:REVISED:11/6/2007 CITY OF �'S e'' r see c,of. 4&6^4c BwcA-99laud6 Office of Building Official oI REQUEST FOR INSPECTION ^ // Date 2 Permit No. Time A.M. Received P.M. Ar d Job Address Locality Namers �r e Contractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Air Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Top Out Heating Insulation ❑ Lintel ❑ Final Sewer ❑ Fire Place ❑ �� � Pre Fab READY FOR INSPECTION Mon. Tues. Wed. Thur 7 Friday P.M. A Inspection Made Inspector - Final Inspection ❑ Certificate of/Occupa�ncO� Date Oct-26-98 08: 28A N , U1 CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: OWNER OF PROPERTY: .� PLUMBING CONTRACTO . CONTRACTOR'S ADDRESS:2Le& lam. 2j k-,. Q p STATE LICENSE NUMBER C � C, TELEPHONE: RI-1 I HOW MANY OF THE FOLLOWING FIXTURES INSTALLED ` 9 6 SINKS SHOWERS c.DQ-m(k 1 LAVATORIES 1 WATER HEATERS Z ,C 1 BATH TUBS DISHWASHERS �� ��..pp ` URINALS DISPOSALS l>�n, 1 CLOSETS WASHING MACHINES ,)C FLOOR DRAIN S SHOWER PANS OTHER ✓ �✓��'���1.. TOTAL FIXTURES-. X 3:50 + $15.00 MINIMUM PERMIT FEE _ $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: -------------------------..___------------------------------------------------ INSTALLATION OF PLUMBING ANN FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834. CITY OF 4&4a& Be4cA-0;4m Office of Building Official REQUEST FOR INSPECTION Date '© Permit No. 2 D Time A.M. Received PM. S,70 r/g 7-4 Job Address Locality Owner's G e^4 R Name `p Contractor BUILDING CONCRETE ELECTRICAL PLUMBI MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Air Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION Mon. Tues. Wed. ThurS. Friday A. Inspection Made ,--_ Inspector nal Inspection ❑ Certificate of Occupancy❑ Date PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FL. Project Name: Permit# Project Address: As required by Florida Statute 553.842 and Florida Administrative Code 913-72,please provide the information and product approval number(s)for the building components listed below as applicable to the building construction project for the permit number listed above. You should contact your product supplier if you do not know the product approval number for any of the applicable listed roducts. Information regardingstatewide product a royal may be obtained at: www.floridabuildin .or . Category/Subcategory Manufacturer Product Description Limitation of Use State# Local# A.EXTERIOR DOORS 1. Swinging 2. Sliding j 3:Sectional 4.Roll up 5.Automatic 6. Other B.WINDOWS 1. Single hung 2.Horizontal slider 3.Casement 4.Double hung 5.Fixed 6.Awning 7.Pass-through 8.Projected 9.Mullion 10.Wind breaker 11.Dual action Category/Subcategory Manufacturer Product Description Limitation of Use State# Local# C.PANEL WALL 1. Siding 2. Soffits 3. EIFS 4. Storefronts 5. Curtain walls 6.Wall louvers 7. Glass block 8.Membrane 9. Greenhouse 10. Synthetic stucco 11. Other D.ROOFING PRODUCTS 1.Asphalt shingles 2.Underlayments 3.Roofmg fasteners �� 4. 5.RaUt-up-reefrrrg 6.D adified rnen 7. Single ply roofing 8.*aeA%Ltilea- 9. in i on 10.Waterproofing 11. W4QdA4ftg} SMMkrs 12.-Ree€mg--st= 13.L ui fing 14.C ats 15.Roofik ad u n S Tr 00'a t (a M 16. Spray applied ol)j=thane roo 17. Other Category/Subcategory Manufacturer Product Description Limitation of Use State# Local# E. SHUTTERS 1.Accordion 2.Bahama 3. Storm panels f 4. Colonial 5.Roll-up 6.Equipment 7. Other F. STRUCTURAL COMPONENTS 1. Wood connector/anchor 2. Truss plates 3.Engineered lumber 4.Railing 5. Coolers-freezers 6. Concrete admixtures 7.Material 8. Insulation forms 9.Plastics 10.Deck-roof 11. Wall 12. Sheds 13. Other G. SKYLIGHTS 1. Skylight MAP SHOWING SURVEY OF IAT Us THE EAST 10 FEET OF LOT 143, AND THE W&aT ONE-HALF OF LOT 39, BLACK 109 ATLANTIC BEACH, Ai RECORDED IN PLAT BOOK 5, PAGE 69 OF THE CURRENT PUBLIC RECORUJ OF DUVAL COUNTY, FLO RIDA. MER R A!.'E Tt-/F ,c'L A Z A C8o'�rv� AWWO 112"I OA/-y 8,) �r'fOL/NO 112-IRON h V I ` ( 25.x' '-• a•v/4� r-1 j I O �I yj POw'CN i !; I f4AME '3 I o " I 5Pl./T-4 avei.'an I I � �. Q '•c' RE 5/06NGE vi I � 0 � � � i,••I No. 390�I ,°'a to b ` i Q ;�'• i •�� V V KT/ON N I � O O i\ 44 j I � ° o y V V 6 OLw o CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 J v INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-dept a,coab.us Application Number . . . . . 07-00001149 Date 8/14/07 Property Address . . . . . . 390 PLAZA Application type description MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ----------------------------------------------------------- --- Application desc INSTALL 1 CU -------------------- ----------------------------------------------- - - Owner Contractor - ---------- -------------- ----------------------- GRAGE, H. WELMER PERFECT-CLIMATE HEATING AND 390 PLAZA AIR CONDITIONING, INC ATLANTIC BEACH FL 32233 11210 PHILLIPS INDUSTRIAL BLVD JACKSONVILLE FL 32256 (904) 646-1020 -------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 59 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/10/08 ---------------------------------------------------------- --- ------ ---------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ------- --- Permit Fee Total 59 . 00 59 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 59 . 00 59 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Yf1L�,t. CITY OF ATLANTIC BEACH 1 v MECHANICAL PERMIT APPLICATION, VIAs v� Date: Property Address: 3q® P1 o a Owner: l` kar —1 e., Telephone#: 9 o O-1 Contractor:PeK A t Telephone#: (0 Ll co - I Quo Contractor Address: ( 0. o � Fax#: aba r Contractor Signature: JW/ 0 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 City of Atlantic Beach ordinances and standards of good practice listed therein, Type of Heating Fuel: If other construction is being done on this building A( Electric or site,list the building permit number: ❑ Gas: _LP `Natural _,Central Utility Cl Oil ❑ Other—Specify­ MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK ❑ Heat _Space _Recessed 1 Central —Floor D Air Conditioning: _Room Central Residential D Duct System: Material Thickness D Commercial Maximum capacity cfim D Refrigeration D New Building D Cooling Tower:Capacity l;Rm Existing Building ❑ Fire Sprinklers:Number of Heads D Elevator: __ Manlift Escalator (Number) � Replacement of Existing System Cl Gasoline Pumps (Number) D Tis (Number) D New Installation D LPG Containers (Number) (No system previously installed) D Unfired Pressure Vessel ❑ Extension or Add-on to Existing System ❑ Boilers ❑ Gas Piping D Other-Specify ❑ Other—Specify LIST ALL EQUIPMENT AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving Number Units Description Model# Manufacturer Ton's Agency HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving Number Units Description Model# Manufacturer BTU's Agency TANKS Nominal Capacity - Type Liquid Serial Approving How many &Dimensions Contained Manufacturer No, Agency 800 Seminole Road 0 Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845 9 htta://www.ci.atiantic-beach.n.us Revised 1/04 Aug 13 07 02:58p Perfect Climate Htg&Air 904-262-7703 p.2 CITY OF ATLANTIC BEACH MECHANICAL PERMIT APPLICATION. :1 (�{ Date: Property Address: 2>q c) Owner: CkarTelephone#: rl y01-10 Contractor: Uwalt rTelephone k LpL o- (0 Contractor Address: 1 Fax#-.-. &Da - r)f)03 h Contractor.Signature: in cooswkntion of permit giver for doing the work m daaibed in the above statement,we herby eVa to peimm said work in sccordame with the ansched ptms ad specifkatm which err a pert hereof wnd in scco nkoce wA the C ity of Atlantic Beech ordionm and standards of listed therein. Type of 1kating Fush If other construction is being done on this building or site,list the boding perarit number. .� Electric O Gas: UP Natural Central Utility v Oil • Other-S MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK Cl Heat ^Space _Recessed ,,Central —Floor pt Rte; t7 Air Coning Room Central o Dud System: Material !Thickness a Commercial Maximum capacity cfm O ]:teEtige;ration D New Building O Cooling Tower:Capacity Oleg Building v Fire Sprinklers:Number of Heads Q Elevator: __ Mium Escalator (Number) Replacement of Existing System O Gasoline Pumps (Number) o Tanics (Number) O �kw lnostaltation o LPG Containers (Number) trio rys"previously installed) O Unfired Pressure Vessel O Extension or Add-on to Existing System O Boilers O Gas Piping O Other-Specify a other-Specify. LIST ALL F&TWMZNT Ant CONDITIONING.RZFRIGlAA71ON EQUSMENT&CONDENSOR'5 Approving Number Unks Description MGM N Macufaehsrr Toa's AWncy etnSer �s 123 a..r � 3 L.- MATING—6TO ACES,BOILERS,FIRE?LACES do Ant HANDLER'S Appy Number Unih Descriplim ModelY Marwfsaurrr BTU's Agatcy TANKS Nominal Capacity - Type Liquid 3aial Approving Kww dt Diaratsions Contsined Maauficaner No. Agmey 800 Seminole Road•Atlantic Beach,Florida 32233-5N5 Phone:(904)247-5800• Fax: (904)247-5845 9 httP://wwwxLatlantie-beach.fl.as Revised 1104 JOB ADDRESS A2 ,Qt f� TYPE WORK j. ti-i l `� 1 PROPERTY OWNER tJ� FPHONE ` CONTRACTR _P u�z_CSL TFLF' WOKE PERMIT NUMBER 3[c)l 093[c) DATE �l INSPEMONS• FOOTING SLAB TIE BEAM L,TNM 1VAll�V�SSFA�'1312VVG FRAMING/COVER VP INSULATION FINAL BUILDING CERTIFICATE OF OCCUPANCY ELECIRIC.AL PERADI# - INSPECTIONS ROUGE' FINAL MECHANICAL PERMIT# INSPECTIONS ROUGE FINAL PLUMBING PERAfin .INSPECTIONS ROUG YA7NDER SLAB TOPODT WATF.R&EWER FINAL r� o DEFWMEW OF SuiLm, CITY C} ATLANTIC .. ; PERMIT �, I A ` ? Hr&��' TCSS tc�e�r li2'�6+� Address . 39th, TFtIVE ATLANTIC, CK C01L -------- -Constr.. TTp wCCI 1 5 section: yyNjq 0 i' y y }: Est Val 0: 00 00 mpro' ,v Cost 25*00 meant 5.tit} � Pate oil # De +w « e APPLIC&TION '01985 —T... - -- —_» ' Athe. LOR I,DA e >a PIL 32250 71G Exp., FORMS MD Ft>QT1N S IJS"T OR O!PSCM$IEFOR9 PWRV PEF3MIT 1/a1D SIX MONTHS AFTER DATE CF ISSUE S#ltE.t)�MA�1`Ef? A., AND DEBRIS FROM THIS WORK MUST NOTBF lit'AC DIN PUBLIC SPACE,AID M ST 8E LE{1 tEa uP Aft kjp4kED AWAIT ICY gtTHER CMTRACVA OR OWNER #� "fly ME HAM'S ��� ' ' C THE 8u1 Al C}AC C t 31 IG TC)A E,Q PLANS WHICH ARE PART OF THIS PERMIT AND,SUWECT TO,In c �� C3f A ICA81�E # ItSlt {31'tAw. plate t<t;I171% �1 Receipts � 1 lilt B � MENT T21-9 .:5_ "�- BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC 09ACN, ILORIDA aaaaa APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT -- Applicant to complete all items in sections I, II, III, and IV. i. � / zt LOCATION Sheet Address: OF lagraeatiag Streal►: biween And WILDING 11. IDENTIFICATION — To be completed by all applicants , I. coms;oere+ion of poratit given for doing the work as described in the above statement we hereby agree to perform said work in accordance .,t% the artactyd plea► sad spocificoGons which are a pert hereof and in accordance with the City of Jacksonville ordinances and standards of good pectic• listed tkereia, Mamma ►aKkuKal Ceatraaters C..f.ec+w (►rat) Molter ��`l ssmomJ mp y Fnper'ty Owner i VWoo m of Owner Signature of or Aoa►arined Agent Architect or Englaeer III. 6049LAL 04FORlMI M A' Type of Isoet" fwf: B. IS OTHER CONSTRUCTION vaIMO DONE ON THIS DUILOING OR SITE? 0 G«—O V O Me" I?r—Gattei utally 1/ YES, GIVE NUMBER OF CONSTRUCTION O Oi PERMIT 0 096- — spoc4 V. tr>111110'tletlCAl RP►1U/tl01M TO iiia SWALAI NATURE O/WORE( (y'o"de s:orepiMo 4 o k ee b"of tied 6*I )Z Residential or ❑ Commercial fist O Sues O &•wend �r cs"w O new O Now puiNNng 0 Air C+'ddies%M: O Reeve O Ce" 03 Existing lbuftng 0 owe. $rte: •• ' , ?MA N`� 1�f Ri tisco rent of existing system me"em a"Pec+ttl slam, O New Installation(No system previousy,InstItgod). Q Roo 4000foa O Extension or add-on to existing system O 0.94,69 "Wee CAP"* O other- tspecly 0 Fre spinHon: NwM. of L—A. O Noroter O woad► O It l 0 t:.e.lk.. P 140%6 j nes VA" wR o,Ilea un over 0 T•.+� ,_._;taaattlilsr) rR.rsiss+) ROOM$ 0 LPG spaga;o (atoas�er) 0 voted Plum" wt 0 flea«•. h11aA AMr...ai ttar sea. 0 09h.► — $Posh PwaRi►sl.. L Fr ALL tqt p"XNT AM CDNDrrk*O MG AND RA'PRXNMATM RQtVIEMr II+..tsar tJew Owrttpebsls We" i+wsftw akwAbobwwIsti.aj t t!�TtIiG • tvu+ACEi. 60KE R& IFUM ACIi c . ,► an..w.r vt.1t. >aae Me" 11'IV) AE= CITY OF 4&a 4'c BeacA-14 Office of Building Official REQUEST FOR INSPECTION Date ✓ ~�^ 9 Permit No. 5 919 0 Time —� A.M. l Received v Qistrict No. 90 ;Zit Job Address Locality Owner's ✓�f Name .fA es Contractor (2"AZ92� ILD CO CRETE ELECTRICAL PLUMBING MECHANICAL g ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air.Cond.& ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Lintel ❑ Fire Place ❑ Pre Fab READY FOR INSPE A.M. Mon. Tues. Wed. hurs.14� Friday P.M. A M Inspection Made Inspector Final lnspecti- Certificate of Occupancy C.STGW.d6S Sf/Ea Date �*y DEPAwrtA NT OF BUILDING CITY OFATLANTIC'BEACH f _.. PERMIT IHP'C3RMATId,N ��.._� ..W �..� LOCATION INFORMATION '- _�-�_--_�, 1' xaat t Humber s $930 Aa:Idr+�a�a�s 3S0 F0,i STRZET roil Ty t BUILDING ATLANTIC` BItiAGHrFLORIDA � O zal 4:t Work: SHED ,.� LRI AL d3I~15C 22PTTCiN .,. —.,.._--- no r. Type: WOOD MAKE, Lott � 1 ' Blocl�,t' 1CI ��a�t3a�n *"opos ed USe x UTILITY BUILDING Tor«rnalih3 p tRHG: 'D r .11i ng's t 0 gbdo t 0 Subdiit ao:ion a ATLANTIC BEACH Ri # ^d V�lt►a�t 14,4.00 I*prr v. Cott t 00.00 Total F at'', $30.00 030.00 I?aat / 10.2 iga�k to K 12' DELUXE ESTATE, STORAGE BAIRN NATIONAPPLICA"�`ICIN FEES , ..� d ?cI STOUT WATER IMPACT FNS $0.0 I CR, `LCIRID�� ," S lh,,A FE C " � s �� �"�r"� �fiN RA NFORMATXbN -- RADOH GAS „ 5% $01 Maala ae t 0 Y NSR WATER ' TAS SO«'O r .... ry . ;. . S RR "d"A I .. _ $0, HYDRAULIC SHARE, SC3. E} L a `yFr t' 1 RE�-1 Pte'' "� At3.O ' SE '** I- 'ACI'" FRS e i �w NOTICE ALL CONCRETE FORMS ANE?FOOTtMGS MUST IIIE INSPECTEt!BEf0RE POURING PERMIT VOID SIX MONTHS AFTER DATE(OF ISSUE SIJI{,OING MATERIAL,RUBBISH AND oEbRIS FROM THIS WORK MUST NOT SE PLACED IN OUSLIC`SPACE,AND'MU T'BE CL AR O QPANQ HAULED,AY:AY,BY EITHER CONTRACTOR OR OWNEA;'. 77 77� aAILVRE T COMPLY WITH THE MECHANICS'` LIEN LAW CAN, RESUL , I'N E tiCPElTYViAf11 { TWICE FCR BUti ►il�f IiPR ► 1i1ENT V TIG 0AT : r ISS #EO'ACCORbIN{3 TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND T TO REV PC7R UIO ATION OF'APPUCASLE PROVISJONS OF LAW. ; AT TIC BEACH 8UILDING,aE?AR MENT ro f Address A A Heated Square Footage -ner sq ft = $ G a r ag $ /1� 66 per sq ft = $ 13 IN00 Carport/Porch $ -- per sq ft = $ Deck $ per sq ft = $ Patio $ _per sq ft = $ TOTAL VALUATION: 0 t, Total Valuation 1st $ Rmainder Valuation $ ; per thousand or portion thereof -------------------------------------------- Total Building Fee ADDITIONAL PEP,'-aTS and/or FEES REQUIRI� + k Filinc, Fee Mechanical Fireplaces @ 15.00 Plumbing BUILDING, PEPUMIT FEE $ Electric/New ------------------------------------------------- Electric/Tem Septic Tank BUILDING PER= $ Well WATER METER CHARM $ SE1,,7ER LMPACF FEE $ Pool 14ATER DTACT FEE $ Sign MISCELLANEOUS Water Connection Sewer Connection Water Meter Elevation Certificate (RAM TOTAL DUE ---------------------------------------------------------------------------------------------- CALCULATIONS and/or NOTES WOD-1 Phillips Hwy JA j Jacksonville�07 V FAX 904-443-6243 l„orEl as�xwio awr »n ��rr a l.� , . ^ ` CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS Owner (s) � Address- _ 19Pbuoe;_ Lot # 1� 8 �� or Unit S��di�� �oo � _ _ ------------------ Contractor :— ________________Cootraotor :_ _ i)eeoxibe work to be doue: _ _______ ________________________________ � _____________ Pzeoeot use of building -. -, IeA 5���_____-__-_-______________ Valuation »_],rg�jl���d_C��������i���-� -' ------------------------- Proposed use: ------ is this an addition? �/_�� If yes, what are the dimensions of the added ��ooa�; It. D _ft. Will the added area ' be heated and 000led?_ ^J^` ___ New eleotrioel (or inrreeee) �_���� New plumbing fixtures?_°�` New fireplaoeYA/m_0ew Reat/ACY_ A/ -___ SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. ` ��~ ��-- Signature OWNER: ---I/ W0EB: _ Dt_�_�� m e�__��e��_�=�= Signature CON7RACTOB: ___ Dmte,___________ �o 0 ON SEP 281992 � Zoning ` uUvu/ng and Axa ST --�S C C- S 2, K /-2X4 .;GISTS ROOF BREiKS 6'0Z 2X4 D)V" T LL,, .i�! � G v I 'd 5411 t m --.S.B- R00= DECK .3; -7— Z APPROVEDrim�vr rry OF ATLANTIC BEACH BUILDING OFFICE SEP 2 8 199 SEP 2 8 1992 Building and Zoning 2X4 TOP PLATE tfNNER 76 SEP 2 , ex—L, -,�9 SEAL SIDIAr I. I I I NG 1 \_2X6 STUPOI PAIL !X4------- TRIM 2X4 M PT TE 09 Ir U4 TREATED--� \1-2X4 BOX E'-E',;0,ON RUNNE'S SILL FRONT ELE\ATION FRONT WALL_SECTION s NEW DELUXE ESTATE T` 1 2.=1'-O' HEARTLAND WUSTRiES 1-;3-69 2x4 =.,.-,a 'oars Ti t APPROVED CITY Of ATLANTIC BEACH -- BUILDING OFFICE SEP 28 1992 �; E� 8 ?'92 Building a^d Zo i'mi, Y� ((ff\ ---- ---- --- ----- 2X4 Box. VIAS_�t�T ION 1 HEAR7L41vD INOUSTAIE'S ( ?•ua from 5t I e'Sk 3YO F-/q r. AL ti i 0 qt / t � G' Ay o4,v �g �At Loi 5p1 Lof —Lot�j C� 9 Via Y - SEP 281992 Building and Zoning Froma ;M' ( Rc'�,sk 3YO Nag 13 l e-1 . y4t l ' I I f � « I 4PG`O •� L°T 59� L Q ` SEP 281992 Building and Zoning r OWNER BUILDER PERMIT AFFIDAVIT stutr ut Florida f City of Atlantic Beach ) BEFORE ME, the underslgned authority, personally apFearvd ---------- who upon tix"t batnV duly sworn, deposes and sayai / G _1il-� -- ------------ and the legal owner of the toowin* property Subdivision Block __ `�� _...... Lots `I ../�•� A _- AKA - I am applying for a building permit pursuant Lo the Owner Builder exemption not forth in Florida Statute, Section 489. 103. Florida law requires that Y have been provid&d with thv tollowiny DISCLOSURE STATEME11T i DISCLOSURE STATEMENT .State law requires construction to be done by llcensed contractors. You have applied for a permit under an ixemption to that law. The exemption allows you, as the owner of your property, to ,act as your own contractor even though you do not have • license. You must supervise the construction yourself. You may build or improve a one - or two family residence c.r a farm outbuilding. You may also build or imprc►ve a commercial building at a cost of 025,000. 00 or less. The building must be for your use and occupancyo it may not be built for sale or lease. If you well or kine more than one building you have built yourself within on• year atter the construction is completet the law will presume that you built it for sale or lease, which is a violation of this exemption. Your construction must be done according to building codes and zoning regulations. It is your responsibility to wake sure that people employed by you have licenses required by state law and by county or municipal licensing ordinances. I hereby acknowledge that I have read the above DISCLOSURE STATEMENT and that I comply with all the requirements for the issuance of an Owner-Builder permit. Further, affiant cayeth not. Pruperty Owner Sworn to and aubscribwd before a this __-- day 3 9�j C � D��'AHTI�iEN"f 4F �3Q1#�SIN�3 4� trI OF ATLANTIC 61 ASH luff 90,- PLAZ ..,. .: t " s ` ,MAlll � ATL�4> "I+ ACH ,' `i.QRI1A' i Le 00' MON YP DOD FRO Lc t9i sectiows ' .d- U" 1 " C .l . ` """ rte ' RXGC3 . l ngis sStWiv + gra . coo " t F' " .t ? 07 '00 ry ASI©- Int a 41T, 00, FEES orl so r r f1"L0R 0A a2233 Eph � t P � 33 R0,.Ob AJ 1110 1, :A#CIS`' �V i 40 � '1 jo JAC Ir ,00 RAC}+C m .00 ' k cf� i NOT1GAALL CONII;, _ f%),R S AMD RCiO'�Nes mus'r E: l f� ?tIE1 C31tip ?t FtiM4, r PERMIiT V61D SIX MONTHS AFT pAT `bF iS i om 3t.Qi MATO C,RU� IH RIC3 II*tRIS FR{3M THIS MUST N©7 BE PLAT Its ttr9kj.1i 3 gE A E:D UP AND, A J 3NTRACTOR OR OWN�fl � Y. � E MECHANIC A .iSl . ! ICE 4:0 OIN ACC CRI # 'a T©� PR� o PLAtVS WHICH ARE PART ©F TRIS WERMiTNtEFt9C I Atm 4F A IGABL I C3 1 1 ?+iS -LAW. i " - A7 7tG BI:A i iLt?INC D PART`MEN1 h BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH 96 ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I, II, III, and IV. i. 40CATION Street Addre$S: 3 9 OF Intersecting Streets: Between And BUILDING $ub-divi#ion 11. IDENTIFICATI N — To be completed by all applicants . In 'tonsideretiort of ermit given for doing the work as described in the above statement we hereby agree to perform said work in accordance with the attacl�adans and specifications which are a.part hereof and in accordance with the City of Jacksonville ordinances and standprds of good.-practice listed therein. Nemo of Mechanical Contractors Contractor (Print) if/>- AT v► r`w Master Rp 10 Nome of hepo+ty Owner Siynalure of Owner Signature of or Aefho izod Agent Architect or Engineer Ltt. 48411RAI. IN MATION A, Type,of heating fuel• 8. IS OTHER CONSTRUCTION BEING DONE ON /sex Elatfdc THIS BUILDING OR SITE? 1 ( Gu—❑ LP 1 ❑ Natural ❑ Central Utility IF YES, GIVE NUMBER OF CONSTRUCTION 0 on PERMIT Q ;Otjw — Specify 11% AONCKViKAL N"ftENT TO SS INSTALLED NATURE OF WORK (Previde ebmplah list of components ca back of this form) Residential or ❑ Commercial Haat ❑ tPece ❑ RwmmW y Central O P~ 0 New Building i4ir Comittioniagc E3 f" Cent Existing Building ow System: Materia Thickne� 9C Replacement of existing system I�lasimum Clpacify CARL 0\New installation(No system previously instailled) Q ttefrrgeration ❑ Extension or add-onto existing system ❑ Other — Specify (' cooling_tower {Capacity Q Fire sprinklers: Number of hes. Ele+rater Q I';Manlift ❑ Ewla/or ieumber) THIS SPACE 004'OFFICE USE ONLY CI .6asoHne pumps}. (number) (Received) (number) Re"As Q LPG containers , (number) Q tJnfited,Pleasure,`rWuel Q Permit Approved by Dohs .., Q Otlw Specific Permit Fee MST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT y Stnmber unit# Deeerlpt ift Model Number Manutaeturer ( ) AgOMW /Z6 Np p 3 `� 77 41141 Id Q a d r 3 h �r 09PARTM NT Of'E WL61Nt r CITY CSF ATLANnC E�EAGH Addie PLANASTS ' RII ATLAN `T9 " tea P' OFt2 : ..Q ek; ,4 T� may. wypy .y� y��^.■/�/�)�yy M M!.M uw M rl--- L i M M L"�L ';R 1M.F�M#i .Yk iw 'iui aIM.w.Mf W.yr Lr. Nle . `� LA's • slocS'QCti®1lI. l�* OIN�My y• Surhdicn: "A' LANT R9CR % ai rC1$tsd i 4M V fir i Y.. L X. $tov. rCos40'.00 Total Fees,r ." ACt37tt. PJ1C := .2 21 .;5 " y yg� 4 "rr k a i►4✓T TIYr 4 p � T ! rt v �0 FLORIDA 32253 $ IMPAC'' i R NST 7Omfro 1011f � One, SER 4F ..T�� r " ` $0.0 ARC:R" IMP T1 # .Q iMaw nmw n i } Y- I• 4( 1 7" Ono NOV i TV,fit RMO-AN©FOOTINGS,MUST #Ni�P�s�II` !�#lEl�t?RE i�►U#itN6 i 3 'PE VOID`SIX MONTHS AFTER C}ATI=`O IS±3i1f rY• IOW 'itISa MATERIA ,;RUE3S SH AND DESAIS FROM THIS WORK MUST NUT,BE PLACI~I I.hi PUBLIC SPACE,AND MU T 8E CL „ Et3 UP AND HAULED AWAY,BY EITH R"CONTRACTC}Fi OR ta1M1t1�ER .. ' . T lI P »Y WITH TH MtCHANIGS' ' CION RESU1. IN CEL FOR 'INER PAYING �4 EI '•�iCCi{3RQI#�1 " C©,API�RC?VEQ PLANS,WHICH ARE PART OF THIS ISE"FII411"P A1�II SUSJ, REVUCAT R VC�►T# N OF AtAE3LE fRC�VISIf?N! +C?F LAW. dlii7 "liT{ATIpEACH,I"3Ui Q�INi# (?ARTlV{ENT 4 s 'A'AA4f ii A CITY OF ATLANTIC BEACH PERMIT APPLICATION ROOFING owner(s): �_JQE1r� P�-- — Address: �Phane: 4/,1 C Lot # F,oBlock or Unit Subdivision Contractor: Address: Phone: State License No. Describe work to be done: Materials to be used: Signature OWNER: —Date: Signature CONTRACTOR: CITY OF ATLANTIC BEACH APPLICATION FOR ROOFING PERMIT BUILDING OWNER �Gc%�rr/e/` �1"�°�ri PHONE JOB ADDRESS— LOT 0 DDRESSLOTH y// BLOCK OR UNIT H /p SUBDIVISION CONT'RACT'OR �E' PIIONE ADDRESS LICENSE NUMBER EXPIRATION JOB VALUA'T'ION MATERIALS: �' f l y��d� �h�.�q les `T� ���/- �--� � •�=���`.�.�`�`. SIGNATURE OWNER �_._ DATE SIGNATURE CONTRACTOR - pA'T.E DEPARTMENT OF BUILDING Q V CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO. 8863 y PERMIT TO BUILD 7,5n T THIS PERMIT MUST BE POSTED ON JOB 7,SOCKT Date July 9 __1987 i97 t A 7/09/0 9063 40CAt Valuation$ 1,500.00 Fee$ 7.50 597 ! A 7P19/13 l 011O This permit not valid until above fee has been paid to City Treasurer,and is subject to revocation for violation of applicable provisions of law. This is to certify that H Welmer Grage has permission t1VW re-raQf Classification RCS idem ial Zone 111 Owned by H Welm r Grage Lot E 10'-43 Lot 41 W 2S'-39 Block 10 S/D House No. 390 Plaza According to approved plans which ate part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE -----► 4---� o Building material, rubbish and debris _ from this work must not be placed in public space, and must be cleared up and hauled away by either con- tra-tor or own t < Building Official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER