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Permit 720 Plaza (vault) CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 PLUMBING PERMIT 709A Permit Number: 22132 Address: 720 PLAZA STREET Permit Type: PLUMBING ATLANTIC BEACH, FL 32233 Class of Work: IRRIGATION/DRAINAGE Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: Est.Value: Parcel Number: Improv. Cost: Date Issued: 6/11/2001 Name: MARIE VALARD Total Fees: 25-00 Address- 720 PLAZA STREET Amount Paid: 25.00 ATLANTIC BEACH, FL 32233 Date Paid: 6/11/2001 Phone: (000)000-0000 Work Desc: IR-R—IGATION SYSTEM _0 "IM-l""I", L'102_' ""`�_"'�' 77 7,,� HULIHAN TERRITORY/SCOTT HULI! PERMIT 25.00 40 0r C, -4 A.1 5 X NOTICE- IRSPt QUESTED AT LEAST 24 HOURS041IR TO I PECTION QT BUILDING MATERIA RUBBI I' DEBRIS FROM THIS WORK MUST BE PLAjaD IN PUBLIC SPACE, AND MUST B L .AND HAULED AWAY BY EITHE , RACTO OR OWNER RE T IN THE )MPL'�w* "FAILURE TO CC 7H 0 PROPERTY OWNER !"_ ISSUED ACCORDING TO APPROVED F� IT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISI $25.0014 TIC RtACH BUI DING DEPT. Date: 6/ii/sj @I Receipt: 8063851 CHECKS CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road-Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 PLUMBING PERMIT A Permit Number: 22130 Address: 395 SIXTH STREET Permit Type: PLUMBING ATLANTIC BEACH, FL 32233 Class of Work: REMODEL Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: Est. Value: Parcel Number: 01-4 Improv. Cost: -- WNW Date Issued: 6/1112001 Name: DR. AND MRS. PEEK Total Fees: 32.50 Address: 395 SIXTH STREET Amount Paid: 32.50 ATLANTIC BEACH, FL 32233 Date Paid: 6111/2001 Phone: (904)246-5561 Work Desc: RE-PIPE -7777 STYLES SMITH PLUMBING PERMIT 32.50 4 Y-� NOTICE- INSPECTIO�0-, BE REQUESTED AT LEAST 24 HOURS PFIOR TO INSPECTION BUILDING MATERIAL�, RUBBISH`�,AND DEBRIS FROM THIS WORK MUST BE PLA19ED IN PUBLIC SPACE, AND MUST 1315-CLEAREI 1 71 1 LLP-AND HAULED AWAY BY EITHE�XTRACT94R OR OWNER "FAILURE TO COMPLY tMTH WAX441DWdAN REOd LT IN THE PROPERTY OWNER PAY1"41CIrFOF"=UjL6tNry IMPIr0�8i ISSUED ACCORDING TO APPROVED PZAW WP4GWAR PIAOT-&`!�j��6T AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVIS16-WOF-IAW_-,_.�� $32.5814 ATLANTIC BUILDING DEP Date: 6/11/81 81 Receipt: 8063846 �OCH CHECKS 3163 CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road-Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 PLUMBING PERMIT 01" r7A 040819 Permit Num r: 22131 Address: 1605 BEACH AVENUE Permit Type: PLUMBING ATLANTIC BEACH, FL 32233 Class of Work: ADDITION Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: ATLANTIC BEACH Est. Value: Parcel Number: Improv. Cost: EA Date Issued: 6/11/2001 Name: JENNESS, MRS. Total Fees: 29.00 Address: 1605 BEACH AVENUE Amount Paid: 29.00 ATLANTIC BEACH, FL 32233 Date Paid: 6/11/2001 Phone: (000)000-0000 Work Desc: ADD NEW FIXTURES STYI ES SMITH PLUMBING ��',IPERMIT 29.00 w7l St" 40 40- V1 X 1 NOTICE- IfkPECTIO REQUESTED AT LEAST 24 HOU'�8'1'41R TO I"PECTION 'jy BUILDING MATER\IALtRUBBISR� �"�'I"DEBRIS FROM THIS WORK MUST BE PLA��. D IN PUBLIC SPACE, AND MUST Bl��LEARE ,AND HAULED AWAY BY EITHE NTRACTG OR OWNER "FAILURE TO COMPLY' RE T IN THE PROPERTY OWNER PAYl 0 A ISSUED ACCORDING TO APPRO,��D F IT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIO P OVISIO� Al ATL�eNTIC,PtACH BUILDING DEPT. $29.8014 ReceiPt: 0063846 CITY OF ATLANTIC BEACH MECHANICAL PERMIT 800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877 01 Permit Number: 22129 Address: 465 BEACH AVENUE Permit Type: MECHANICAL ATLANTIC BEACH, FL 32233 Class of Work: NEW Township: Range: Book: 5 Proposed Use: SINGLE FAMILY Lot(s):4/5 Block: 19 Section: Square Feet- Subdivision: ATLANTIC BEACH Est. Value: Parcel Number: Improv. Cost: 7 Date Issued: 6/11/2001 Name: LOVETT, W. RADFORD 11 Total Fees: 131.00 Address: 1 INDEPENDENT DR. SUITE 1600 Amount Paid: 131.00 JACKSONVILLE, FL 32202 Date Paid: 6/11/2001 Phone: (904)634-0077 Work Desc: NEW HVAC SYSTEM 7 7F WMAO" OCEAN STATE HEAT&AIR PERMIT, 131.00 At 4`1 NNNN 1-47 1.J NOTICE', INSPEC ST BE REQUESTED AT LEAST 24 HOURS PRI TO INSPECTION BUILDING MATERIAL,RUBBISHIODEBRIS FROM THIS WORK MUST NOT BE EDIN PUt3LIC SPACE,AND W MUST BE CLEARED UP AULED AWAY BY EITHER CONTRACTOR OR 0 VR C AND H "'FAILURE TO COMPLY WITH T ONSTRUCTION LIEN AN RESU�T IN THE PROPERTY OWNER PAYING r*0E AUj�DING I EIIIENTS" LA ISSUED ACCORDING TO APPROWQ P 8,ItCH' PF�Hl ND SUBJECT TO REVOCATION IT S F 4SA81S F too FOR VIOLATION OF APPLICABLE PRt Date: 6/11/91 81 $1310014 ATL�NTIC(S(EACH BUILDING DEPT. Receipt: 6i�63�847 CHECKS 16459 0610000322A08 CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road-Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 PLUMBING PERMIT A --T7 �7.000 WWI_ Permit Number: 22128 Address: 385 FIFTH STREET Permit Type: PLUMBING ATLANTIC BEACH, FLORIDA 32233 Class of Work: REMODEL Township: 0 Range: 0 Book: Proposed Use: Lot(s): 38 Block: Section:0 Square Feet: Subdivision: ATLANTIC BEACH Est.Value: '-Pa,rcel Number: - — -W Improv. Cost: ", ---ovel OF M Date Issued: 6/11/2001 Name: JACK BENNETT Total Fees: 71.00 Address: 681 ATLANTIC BOULEVARD Amount Paid: 71.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 6/11/2001 Phone: (904)246-4964 Work Desc: NEW PLUMBING FIXTURES ,NVkV ow ,Em 7- 77 AM DARLEY'S PLUMBING INC 'PERMIT 71.00 06 UL MEM Iff NOW, 7- ---------- !F NOTICE INSPECTIO BE REQUESTED AT LEAST 24 HOURS PF�bR TO INSPECTION IN PUBLIC BUILDING MATERIAL;1,RUBBISH A,�ND DEBRIS FROM THIS WORK MUST E&4NT`BECPTLA( D SPACE, AND MUST Bt�,CLEAREDAAND HAULED AWAY BY EITH OR OR OWNER *TH 15 -"*-9vM=u R LT IN THE FAILURE TO COMPLY P RO P E RTY OWN E R P.A.Y.1. C6*OP48UiLPM% IOPO* NS�W R4 P �&^%AA ISSUED ACCORDING TO APPROVED P APT F kiS-WRMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PRO $71.0814 ATLA CB H BUILDING'DEPT. Date: 6/11/111 81 Receipt: @K3849 CHECKS CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 PLUMBING PERMIT Permit Number: 22132 Address: 720 PLAZA STREET Permit Type: PLUMBING ATLANTIC BEACH, FL 32233 Class of Work: IRRIGATION/DRAINAGE Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: Date Issued., 6/11/2001 Name: MARIE VALARD Total Fees: 25.00 Address: 720 PLAZA STREET Amount Paid: 25.00 ATLANTIC BEACH, FL 32233 Date Paid: 6111/2001 Phone: (000)000-0000 Work Desc: IRRIGATION SYSTEM �H`ULIHAPN TERRITORYISCOTT HULIFIAN PERMIT 25.00 �V- A: 4 v tr 77, W Z I ai x- -A' 'N NOTICE- INSPECTIO"-1 BE REQUESTED AT LEAST 24 HOURS PF,*bR TO INSPECTION 1411 f0l" BUILDING MATERIA,RUBBISH-AND DEBRIS FROM THIS WORK MUST BE PLAdED IN PUBLIC R SPACE, AND MUST Br=-CLEAREO�W-AND HAULED AWAY BY EITHE , S NTRA�T A OR OWNER "FAILURE TO COMPLY WITH Ats! RE'06 IN THE PROPERTY OWNER PAY14Q UICWFO"UIL ,, rp IIIIIPICO�F Nte' 64P4R % ISSUED ACCORDING TO APPROVED P WHt0ieARr*fPA*RT4F J'U�MIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PRO�V=SIOMSV-10*F� V h.Z- y $25.0014 ATt�INTIC PEACH BUILDING DEPT. Date: 6/11/91 81 Receipt: 0863851 CHECKS 290 00180803221800 CITY OF ATLANTIC BEACH APPLICATION FOR PLM�SING PERMIT JOB LOCATION : PAI g?- OWNER OF PROPERTY: QAL_6�/_1_TELEPHONE NO. PLUMBING CONTRACTOR CONTRACTOR' S ADDRESS : - STATE LICENSE NUMBER: TELEPHONE: HOW MANY OF THE FOLLOWING FIXTURES RE-PIPED OR NEW SINKS SHOWERS LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS SEWER WATER RE-PIPE (LIST FIXTURES BEING REPIPED) Z5W vl- OTHER 4 TOTAL FIXTURES : x $3 . 50 + $15 . 00 MINIMUM PERMIT FEE - $25 . 00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR:_(�_ �,I ----------------------------------------------------------------- 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 C127 OF ArLANTXC` BEACH APPLXCATZON FOR FLUMZNG PERMIr JOB LOCATION: 70T OWNER OF PROPERTY TELEPHONE NO. �4 PLUMBING CONTRACTOR CONTRACTOR' S ADDRESS.-�',C), R I, Q q(4 STATE LICENSE NUMBER: rCj�05-6t(JV41 TELEPHONE: HOW MNY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS SEWER WATER REPIPE OTHER TOTAL FIXTURES: x $3. 50 + $15. 00 MINIMUM PERMIT FEE -(�$�25. 0O SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR:--�f AA ----------------------------------------------------------------- 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 CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road - Atlantic Beach, FL 32233 - Tel- 247-5826 - Fax: 247-5877 PLUMBING PERMIT PERM—IT NFORMATION _____��:�QQA�TQN�1NF6_R_MXT_10N I Peiii�it_Number: 17917 1 Addie_s_s- 7fo—FYL��2,�"6F�I�� 1 Permit Type: PLUMBING Class of Work: REPAIR ATLANTIC BEACH, FL 32233 Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: ROYAL PALMS Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION Date Issued: 3/17/1999 Name: SHELL, Total Fees: 25.00 Address: 720 PLAZA DRIVE Amount Paid: ATLANTIC BEACH, FL 32233 Date Paid: 3/17/1999 Phone: (904)350-9111 Work Desc.�RE P�LAC E S�Ew E E-EL I N CONTRACTOR(S) APPLICATION FEES �R_OTO-ROOTER SERVICES COMPANY PE R IV r1T_ 25.00 Irl NA_L Inspections Required 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. $25.8014 Date: 3/17/99 81 Receipt: 0042846 ATLANTIC BEAC5H BU DING DEPT. CASH 08100003221008 UC't-16-98 08: 28A P.01 CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: ` az OWNER OF PROPERTY: PLUMBING CONTRACTOR: CONTRACTOR'S ADDRESS: STATE LICENSE NUMBER: ...C-FC_UA41 9 TELEPHONE: HOW MQY OF THE FOLLOWING FIXTU -SINKS -LAVATORIES BATH TUBS -URINALS CLOSETS -FLOOR DRAINS OTHER TOTAL FIXTURES, X 3.50 + $15. MINIMUM PERMIT FEE - $25.00 SIGNATURE OF OWNER*.- SIGNATURE OF CONTRACTOR: e-7 7;? ----------------------------------------------------------------------------- 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) "447-5834. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00001662 Date 12/03/08 Property Address . . . . . . 720 PLAZA Application type description ROOF PERMIT Property Zoning . . . . . . . . TO BE UPDATED Application valuation . . . . 2500 ---------------------------------------------------------------------------- Application desc reroof ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BOTTOMS, ROBERT L. OWNER 720 PLAZA ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 42 . 50 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 2500 Expiration Date . - 6/01/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 42 . 50 42 . 50 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 42 . 50 42 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD,ATLANTIC BEACH.FL 32233 08- OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 --LLLJ� BUILDING-DEPTOCOAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY Z, 1.0 77M; - 0 0 NE BUILDING 11 DEMOLITION ESIDENTIAL L T BLOCK SUB DIVISION TW 0 ADDITION M 13 CONVERTING USE COMMERCIAL 0 ALTERATION 0 ACCESSORY BLDG. *EPAIR OPOOL/SPA U YES 13 N/A fAA 0 MOVE 11 OTHER t4q 0 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME* e ---1h'AeQ0')U 4i\rn clu 16.NAME: 24.LICENSEE NAME (fiock V—vi%rv— Lfaou�') 10.ADDRE§S: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 1`110 Flnck.' — p�fl6L'Jt(_ 18.ADDRESS: 26.ADDRESS: 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE:----T I I .FAX NO.: 13-WPHONE:,;� 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: AME: 4 1 N Le�0 33.NAME: 35.NAME: 1312ADDT�'LC '--4-1�� 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 TWCE 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 ATTOR,N, EY BEFORE-RECORDING YOUR NOTICE OF COMMENCEMENT. F R 11",W5 Signed: D.te� Signed: Date: Before me this day of' 200,Oin 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 hehn 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. —�;V CZL tr e and accurate. Notary Public at Large,State of County of Notary Public at Large,State of_,County of_ 11 Personally Known El Personally Known adproduced ldentifi<n, 13 Produced Identification- Notary Signature: Notary Signature: Bit I I SHIRLE - GRAHAM Notary Public-State of Florida CCAB FOR !on Expires Feb 14 20 10 Ommission#DO 51853� orhmi�4 Bonded By National Otary Assn. I N 95M 1j, CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT 1. 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 STATUTE7. 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. 11. 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(l). 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. rl �0 00 w" ADDRESS tHUNL NUMBER rl,l k�ilsfie N (Ad PPNT NAME SIGNATURE DATE Beforemethis `W1101dayof—j>e,& 2007 in the county Of Duv"tate of Florida has personally appeared &L herin by himself/herselfand affirms that all statements and declarations are true and accurate. Notary Public at Large,State of .3)IJ,v CL County of SHIRLEY L G)l z'4l ' V&-, RAHAM z op 'toS Notary Public-State of Florida 0 Personally Known � I roducedide -My Commission Expires Feb 14,2010 ntification- -,I-L z Commission#DD 518533 Bonded By National Notary Assn. Notary Signatu (_ ,e.1�_ "�C COAB FORM BIDG07;REVISED: 8/14/2007 -A > ELECTRICAL PERMIT BUILDING AND ZONING INSPECTION DIVISION NUMBER P�7 I FLORIDA F APPROVED BY CITY OF APPLICATIO N FOR ELECTRICAL PERMIT IMPORTANT - Applicant to complete all items in sections 1, 11, ill, and M e '27 LOCATION STREET ADDRESS:_ 7 OF INTERSECTING STREETS: BETWEEN UM E 0 BUILDINITG AND NUM83ER OF CONSTRUCTION PERMIT M0131LE HOME PERMIT NUMBER CHARACTERISTICS OF PROPOSED ELECTRICAL WORK - All applicants complete Parts A - C A. USE OF BUILDING RESIDENT B. OWNERSHIP ��L NON-RESIDENTIAL FAMILY 14.[3-1=rRIVATE (INDIVIDUAL, CORPORATION, WO 6. 0 AMUSEMENT, RECREATIONAL NONPROFIT INSTITUTION, ETC.) 2. T OR MORE FAMILIES 7. CHURCH, OTHER RELIGIOUS 1-5-0 PUBLIC (FEDERAL, STATE, OR LOCAL ENTER NUMBER OF UNITS- 8. INDUSTRIAL 3. TRANSIENT HOTEL, MOTEL, 9. GARAGE, SERVICE STATION GOVERNMENT) ROOMING HOUSE 10. OFFICE, BANr,. 4. ENTER NUMBER OF UNITS- PROFESSIONAL C. NATURE OF WORK MOBILE HOME 5. C3 OTHER RESIDENTIAL 11. SCHOOL, LIBRARY, 16. [3 NEW BLDG. 20. NEW SERV. EDUCATIONAL 17. Cr--OLD BLDG. 21. INCR. SERV. 12. STORE, MERCANTILE 18. E] REWIRE 22. REPAIR 13. OTHER 19. E] ADDITION 23. C] SIGN 111. ELECTRICAL WORK TO BE DONE Permit fee 24. NEW SERVICE: $ CONDUCTOR SIZE AMPS COPPER ALUMINUM SWITCH OR BREAKER AMPS-PH-W-VOLT-RACEWAY 25. EXISTING SERVICE SIZE: /Z� AMPS--,/ PH Wd,Q VOLT 4&-&, RACEWAY 26. FEEDERS: NO._SIZE_NO._SIZE NO. SIZE 27. LIGHTING OUTLETS: NO. CONCEALED- -OPEN- TOTAL 28. RECEPTACLES: 0-20 AMPS 21-50 AMPS 51-100 AMPS OVER 100 AMPS 29.. SWITCHES: 0-30 AMPS 31-100 AMPS 30. LIGHTING FIXTURES: INCANDESCENT FLUORESCENT & M. V. 31. FIXED APPLIANCES: 0-60 AMPS-61-100 AMPS-OVER 100AMPS 32. BELL TRANSFORMERS: 33. AIR CONDITIONING: NUMBER COMP. MOTOR OTHER MOTORS AMPS CEILING HEATING HP RATING HP RATING HEAT KILOWATTS ot 34. MOTORS OR GENERATORS: ( 0-5 HP ) ( OVER 5 HP NUMBER VOLTAGE PHS NUMBER VULTAGE RHS 35. TRANSFORMERS: (UNDER 600 VOLTS) (OVER 600 VOLTS) NUMBER-KVA NUMBER KVA 36. SIGNS NEON TRANSFORMERS: NUMBER-MOTOR SI ZE-SWITCH- FLASHER- INCANDESCENT LAMPHOLERS: NUMBER .. . . . . . . . . . . . . . .. . . . . . .. . . . . . . . . . . . . . . . .. . ANA Am Alk w U H w w cc u W u z (4 H 0 1 �.c LJ CC U) W 0 > z a- 3: a LL w v b 0 cn 0 0 > w 0 cri U) CL �1: CC < 0 w w -j cr m 0 CL C) (L CC CL (1) Cc CL w 0 CL z < Z L) 0 w LU uj 3: CL CL W20 In (.)�- (L a. pUA 4 cc z IL -W a: 0 cl 0 0 u Z LU M IL cli m U. U) E- 0 < z 2 u 0 0 m W u uj (1) Ul Ic u H X: z C4 < H E— 0 u 0 0 W 0 CD 0 .4 u H 14 0 u Ul u E'� .3 F- > w o z 0 p 0 a. w w z w Fr cc 0 U) 2 L) 0 0 z w < U) U) 0 CL < z w 0 w U) z L) x 0 < 0 z w 0 cc y w I-- w z z CL F- (D 0 U) < 0 0 w 0 0 -j (.) Aft ow AW. 93OIA83S IN3V4E)VNVVY NOUVWSOANI CITY OF ATLANTIC BEACH, , FLORIDA Approv"by FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 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 IWACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. 1?7�Pj ECECTRICAL FIR 4: Advanced gg M&ITER ELEMICIAN SIGN61URg i JO NAME Bottoms -ADDRESS: 720 Plaza Dr, -RFD-------BOX BLDG.SIZE BETWEEN: Sherry Dr RE&(X) APT. ( COMM.( I PUBLIC I INDUS.I NEW( OLD( REW. ADDITION I TRAILER TEMP.( SIGNS ( -SO. FT. FEE SERVICE: NEW( INCREASE 0() REPAIR CONDUCTOR SIJE 4/9 AMPS QO COPPER I ALUM,( )o "TCH OR BREA ER 290 AMPS PH 3 w 240 VOLT RACEWAY EXIST.SERV.SIZE 60 AMpS PH 3 W 240 VOLT ACEWAY NO. SIZE FEEDERS NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0-30 AMPS, 3 1 1010 AMPS, SWITCHES INCANDESCENT FLUORESCENT&M.V. 1 0.100 AMPS, OVItR FIXED ANSF. APPLIANCLS�, : BELL TiR 'AIR H.P.RATING T ING MOTOR OTHER MOTORS CONDITIONING AMPS CEIL HEAT- KW-HEAT 3 21 10 OVER M -ORS TA E"- NO. I VOLTAGE PHS OT PHS MOLEXNEOUS T UNDER SM V I TRANSFORMERS. OVER 600 V. I DZPAR7VENT CITY OF ATLAN-r, ()r IWILDING PERMIar C BEACH. FLORIDA THis PERMI'r MUSrTo "U,,LL) '*ERIWIT Mo. 4539 BE POSTED ON JOB Date_�..,, Valuation peralit not -lid until ab Pee oubject to Vocation forove foe has beet, Paid to C. 'rh' violation Of applicable Pro"Y Troa�u`Or, and to certify tha Vision. of I. permission to builill Pa ril-111 as required b Classificatio Bldg. Rest:ric owned by. Obert L. 130ttoms Lol_�� House NO, AccordinA,o to aPPrOved Pla R0 aj us which are 13art of t;his Permit NOTICE—ALL AND FOOTI CONCRETE pOR3fS SPECTED BENGS MUST BE IN_ PORE POTJRING. PERMIT VOID SIX X 'AFTER DATE 0 3fONTHs 0 P IQSTJE z Buildinx material, rubbish aj I from this Work Id debris must not be Placed In Public sPace, and must be I - and hatiled away by either c eared up or Owner. contractor Davis FOR OFFICE USE ONL PERMI-r NUml3VR DATE 119 1W�j PLUMBING CONr*;kdgoR ELECTRICAL SEWER AM$* Date......�� —7 CITY OF ATLANTIC BEACH Permit FLORIDA $.....i�4=14..Co................. APPLICATION FOR BUILDING PERMIlr V ....... ........... bAxpP1dfiezi&Xt10n is hereby nWA6 for the*PPMVW Of the deWW statAment of t&e Via= --------------- or other structure described. 7Ws application Is made in compliance and specifications herewith submitted for the the City of Atlantic Beach, Florida, and all provisions of the Laws of and conformity with the Building Ordi"nes of Beach and All rules and regulations of tha Building Department of the State Of Florida,all Ordinances of the City Of Atlantic herein specified or not. the City Of Atlantic Bomb, shall be complied with, whether The Contractor or Owner-BWder who contractors engaged by him an duly licanshe"dibn seheasued a Build'n't Permit'a automatically responsible to ascertain that all sub. Ing Intermediate or final Inspections it is suggested City of Atlanjic Beach,Florida. To prevent delay or embarreament regsrd. be vwffls& MM& Hat of subcontractors be submitted to this 0" so that Hem" can 4 -- Data PV Owner..PA4��I' ........... ... . A9...................I....... Architect..............5fior ............................Addre"-1 ..... ...........Telephone Contractor Builder....... 10........ e ........Address..........................................................Telepbon* No........................... .................... Ut NO..................Z.V................ ?.:� .............Address................. ........................Telephone No............................ ....Block NO...........91...............Sub Division.... .................... ......StreOt.........................Side Between................ ................................Zone................ .....................................ILE&...................... Valuation Ir5-W!J2a....Yor what purpose will building be used........................................7!ype of eonxb L7 Dimensions of Building............... ..................... -Dimensions Of Lot........ a'" of Plers....................................Size of Si ..... ..........181110 of Poo ..................................... How will Building be lls ..........................Greatest Sill Span in ft..........................Type Root..................................... Sks of Ceiling Joists..Heated T... ......... .................Will Building be on Bond or Filled Ground?..................... ......................................... Distance on Centers SIN of Floor Jolats..............................................,Distance on Centers........... . .......... Greatest lipm........................................ " Sl"of Wtere.................. ................................ Greatest Spaw........................................... . ----------------I--------------------0 Distance on Centers........ .................................. Greatest 8p&W '6e�;k rectwge Is to represent the lot. 4 14Z the b dhW or bizildings in the Motht Irtion. Give distance in fast from . 4 w and ezisting building& Two C09100 of Plans and specificutions XW REAR LOT LDM be submitted with appUe&ti*L Inspections require& 1. When Steel Is In plus and ready to pour footing. L When steel Is In place and ready to Pour columns 8 3- When steel Im In place and ready to pour beam. U 4. When framing in complete& 5- When rough,plumbing is completed,and ready to cmQ;Y Of ATLANTIC BEACH 6- When septic tank drain field or sewer is laid but before it N .ville. 7. M*ctrfCW inspection by City of Jacksor A OPPIWO V E D S. Final luspectim CITY OF ATLANTIC BEACH I 13LIf ING OFFICE 3UI I NG OFFICE 1 1 Note: In e4m of any rejection,re-inspection MUST be maw for corrections an made. 5 0 ork FRONT OPLOT� In consideration Of Permit given for doing the work Ot work In accordance with the attached plans wW a gres 'an we hm!by agres to perform "M regulations Of the City of Atlantic BftcL s Part hereof, and in MeordAnce-with the building Signature of Builder..... -7**--, -- - ill. Address Signature of Owner....A . ........ ... Address....720.... ...QA"' 0 --o Z!< C-1 0 CID m rm NNA X -1.1.............. -1-777 A 41 0 rma 3w 7N kA In th AA k,4 -S� Lk CV 0 m MAP --�HOWING SURVEY IL'T 13, BLOC& 81 ROya PALMS UTNIT 7dCv AS -R-XCFj)a- ) IN PLAT BOOK 30, PAGS3 W, 91-11. GF 7HE CUHREINT F1,13LIC OF DIT-IAL OGU!jTyv FLCRI:),%. 4 7' :Z72 7-",/z I'A --Tlr7 -7, 1p C.4 A:� -:Zen 179 �ITIZ, 7- 7 - -----� ;r or ;?0 7- op*p.,!�647CII