Permit 116 Poinsettia Street (vault) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 06-00032047 Date 1/18/06
Property Address . . . . . . 116 POINSETTIA ST
Tenant nbr, name . . . . . . REPAIR BURNED LINE DROP
Application description . . . ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
------------------------ ------------------- -----
HAINES, MARTHA RICHARD F. CARTER
i
116 POINSETTIA STREET 1872 BEACHSIDE COURT �,
i
ATLANTIC BEACH FL 32233 ATLANTIC BEACH :FL 32233
(904) 241-4787
---------------------------------------------------------------7-- ----------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 70 . 00 70 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING OPPICIAL
CITY OF ATLANTIC BEACH
ELECTRICAL PERMIT APPLICATION
Date: _ 00
Property Address:
Owner: Maf4a Telephone #: dV7 1 -7 10
Contractor:
Telephone #: 2-LI
Contractor Address:
14 '7 Wi V MV,6JI Faxg:
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
ordinance and.standards of good practice Us d therein.
Building: Building Type: I Service: If other construction is
L) Trai
Q New 0 Residence 0 Temp. C1 New being done on this budding
)M Old C3 Commercial 0 Signs Q Increase Or site,list the building
0 Re-wire 0 Addition Sq. H, JN( Repair Permit numb��
Conductor Size: ANfPS: COPPER
Switch or f ALUmINUM
i CE
Breaker AMPS PH W VOLT WAY
Existing Service
RACE
Size AMPS PH
W VOLT vvn I &--I
Feeders: NO. SIZE NO N 0 SIZE
Lighting Outlets
CONCEALED
OPEN
Receptacles CONCEALED OPEN
D
11 100 AMPS—
Switches
Incandescent—
Fluorescent &
M.V.
Fixed 0.100 WPS OVER
Appliances BELL
_d.p.RATING TRANSFER.
Air H.P.RATING CEILING �KW-HEAT
Conditioning COMP.MOTOR OTHER MOTORS AMPS HEAT
Motors 0-1 VOLTAGE
PH.. NO. OVE Z I_HP. PHS
UNDER600V
0VER600V
Transformers NO. KVA NO KVA
No.Neon TrTnsf.
Ea._Sign
Miscellaneous
'7-7e—�o
800 Seminole Road -Atlantic Beach, Florida 32233-5445
Phone: (904)247-5800 Fax: (904)247-5845 http://www.ci.atlantic-beach.fl.us
PSC 2000 Series 2410 Log for
Personal Printer/Fax/Copier/Scanner City of Atlantic Beach Bui
904-247-5845
Jan 23 2006 10:30AM
t Transaction
Date Time T)= Identification Dmu�i Ra= RMIt
Jan 23 10:29AM Fax Sent 96657372 1:04 2 OK
ADDRESS
BUILDING PERMIT NUMBER ,
INSPECTIONS
SLAB
FRAMING
COVER
INSULATION
FINAL
CERTIFICATE OCC-E.
ELECTRICAL PERMIT
-2
INSPECTIONS ROUGH
FINAL--
MECHANICAL PERMIT 0
PLUMBING F�RMIT #
NOTES:
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
-------7- BW SEMINOLE ROAD-ATLANTIC SEACH,FL 32233-TEL.- 247-5826-FAX: 247-5877
VI=KMIT INFORMA—ATION
Pe it
rm, Number: 22/49 LOCATION
—Address,--Tj�-76 ,
Permit Type: SIDING INbETTIA S RE- T
Class Of Work: NEW ATLANTIC BEACH, FL 32233
E
Proposed Use: SINGLE FAMILY Township: Range: Book:
Square Feet: Lot(s)-690 Block: Section:
Est. Value: Subdivision: SALTAIR
Improv. Cost: 5,000.00 Parcel Number:
Date Issued: 9/27/2001
Total Fees: 35.00 Name: SMITH, LUR AINE N.
Amount Paid: 35.00 Address: 112 POINETTIA STREET
Date Paid: 9/27/2001 ATLANTIC BEACH, FL 32233
.... .....Phone: (000)0oo-0000
Work Desc: VINYL SIDI G
- W T N1.
N
FEE
ARRY
7GE-1GtR, B
3-5.-00 ,'
-7
"T
T
.........
PECTION
T24,;,H R R TO IN$
NOTICE'4 INSRECTT
-THIS WORK VUST
BUILDING MATERIA SH", ,
M:
C SPACE, AND
it rj "'A -NOT C9b INAUBLI :
MUST BE CLEARED UlkANb HA !
BY EIT K- R CONTRACTOR OR EW
"FAILURE TO COMPL*,j 0
IT14
TION �CRJE LT IN THE
PROPERTY OWNER PA
PfWVE
P
ISSUED ACCORDING TO APPROVE R MIT AND SUBjECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROW
zzz' 135.8814
ATLANTIC BEACH BUILDING DEPT. Date: 9/27/81 61 Rweipt: N%648
CHECKS 1851
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS,
MOVING, DEMOLITIONS
Owner(s) R A-/. AJ e— /Vt ; 7-,4
Job Address. //2. Pc;WSe777A J5— 'vp
1^
Lot# G qO V,- BlockorUnit# Subdivision.,5441-,44(z-
Contractor ztj-
- A� StateLicense#
Address 22e-7p Phone 0 yj' ;7 !
city -Al.-IAvrle State /�'4 ZIP -7z -33
Describe work to be done t1l"'I yl- 5
Present use of building
Valuation of Proposed Construction 0 0 . 0-4
Proposed use
Is this an addition? If yes, what are the dimensions of the added space: ft. X
Will the added area be heated and cooled? New electrical (or increaseL
New plumbing fixtures? New fireplace? New Heat/AC?
SUBMIT THREE (COMMERCIAL) TWO (RESIDENTIAL) COMPLETE SETS OF PLANS,S INCLUDING
SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/
CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR.
Signature of OWNER...
Date:,/ '9- Z-6
Signature of CONTRACTOR Date .2 4
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me this day Of —, 200/
AS TO OWNER: Notary's Signat
SHARON STARLING Personally known
Notary Public,State of Florida 0 Produced identification
z ires Mar.21,2003
y comm.exp
Mn-CC,819398 Type of identificabon produced
HEIDI A.ALEXANDER
My COMMISSION#CC 911693
EXPIRES:February 17,2004
8on1W1T1ruNo1arj,P=Un&rW N
Sworn to (or, e this day of 20
AS TO CON CTgR:- Notary's Signature
ER
:DER
OF i CC 911693 Pe illi`ow
''DER
"�C 911693
AL,
Pr r�fficai#4,,'-
0 orv--- 1", ,,
N CC 911693
rv, E) Fet,;�,ary 17,2004
Type of embrMs
7
PROPERTy DESCRZpTZOV 1j 'j
Lot # iM, Block Section # pl
&Vt /0
Subdivision:
Street Name Ci"y o-� Atlan'Lic C�,�jch
or Address:
Flood Zone: (It in a FLOOD HAZA.RD
area complete page 3)
ABrief Descriptior*
1P
f Wo k: (New/
emo /Add
sition:
ZONZWG MFORMATION Type of Construction: A O�
Zoning Proposed
District: Use:
'�Pc)o
Estimated Value $
Exceptions or Variances
Granted: Materials:
Solid or Filled
Ground: Roof:
Method of He—ating:
OWMM INFORMATION
Property Owner: 10 2411-A I
Phone: ?0-4
MailiniLgAdd-ress 0
Zi'. -322 23
Zip:
CONTRACTOR 2-NFOPivaTio1v
Contractor:—
Mailing Address: Phone: 2112
zip: 3.
STATE LICENSE NO: Expiration
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.
-A .
Owner Signature DATE
Contractor Signature DATE
SWORN BY
OF BEFORE ME THIS DAY
M4.
MARYKMM
........ MyC0M-M-1S-S-10-N-#CG901016
NOTAR Lf EXPIRES:May 8,2004
Bonded Thru Notary PuNic underwnters
2000 - 2001 OCCUPATIONAL LICENSE TAX
LYNWOOP ROBERTS
OFFICE OF I:THE' TAX :COLLECTOR
.1
CITY OF JACKSONi.k
Le
r
TY OF
231 EAST FORSYTH STREET ROOM 1361:i',;JA DUVAL, FLORIDA
11 ,� 01ISONVIl. K.32202-PHONE: (1110036-2080 FAX: 1904)630-1432
Note A pens ty Is Imposed for failure.to koqp��'tols 44ce it h
This 11canse is tv An a t
Misted Our uOu ly 8 Your establishment or place of business,
8000, of��haptsr 770-772 City crol
nance codes.
GEIGER, Rf�,WAYNE
1059 BEACH 8V
#t,-32250
JACKSMVILCt.' '
ACCOUNT��NUMBER:
0-3
LOCATION
APPRESS: 160 tEACH BV
12i
DESCRIPTION:
GAGENT, CO
NTRACTORS
County License Code:
County Tax: N/A
Municipal License Code.: 712:.125�: Municipal Tax:
$100.00
Total Tax Paid:
VALID FROM OCTOBER 1, 2000 TO SEPTEMBER 30, 2001
RCPT #: 001/30/9137/0010/12142000 DATE: 12/13/2000 AMT: $100.00
ATTENTION
'The Following Construction Contractors Require Additional Licenstwe***
ALARM
POOL ALUMINUM/' VINYL
RESIDENTIAL BUILDING ROOFING
ELECTRICAL SHEET METAL SOLAR
MECHANICAL PLUMBING IRRIGATION
GENERAL CARPENTRY WATER TREATMENT
UNDERGROUND UTILITY HEATING AIR CONDITIONING
REFRIGERATION
This Is an Occupational license tax only. It does not permit the licOnS66 to Violate any existing regulatory or zo ng laws Of tt:kO County or City.
Nor does It exempt the licensee from any other license or Permit required by law. This is not a certification of thle licensee's qualification.
c!
TAX COL ECTOR
THIS BECOMES A RECEIPT AFTER VALIDATION
'Westem Surety Company
CONTINUATION CERTIFICATE
Western Surety Company hereby continues in force Bond No, AAAQRKAZ
briefly described as
for
as Principal,
in the sum of IPIV.E TH(X1sAN,1) AN73 NQ/T an
Dollars, for the term beginning
and ending August 27
subject to all
the covenants and conditions of the original bond referred to above.
This continuation�is issued upon the express condition that, the liabili of Wes S sty Com
tY torn ur pany
under said Bond and this and all continuations thereof sh not be m lative and s in no ent exceed
all cu u haH ev
the total,sum above written.
Dated this Q-1 da of MA3E 2000
y
WESTERN SURETY
COMPANY
0A
By
Stephen T, Pat*,Preefdant
THIS"Continuation Certificate"MUST BE FILED WITH THE ABOVE BOND.
Form 9 O-A-10-95
now ME
Westem SuretY Company
CONTINUATION CERTIFICATE
Western Surety Company hereby continues in force Bond No, AAAQR1zr.1z
-------------
briefly described as
for
Principal,
in the sum of$rJy
Z 1HQ[JSAN-7)_ AN'n Nn4100
Dollars, fbr the term beginning
and ending Augunt 27
-UAL—, subject to all
the covenants and conditions of the original bond referred to above.
This continuation is issued upon the express condition that the liability of Wes
tern Surety Company
under said,Bond and this and all continuations thereof shedl not be cumulative and shall in no event exceed
the total.sum above written.
Dated this 0-1 day of May
Y WESTERN SURETY COMPANY
.............
By WN
Stephen T. Pate
President
TH-18 "Continuation Certificate"MUST BE FILED WITH THE ABOVE BOND.
Form 9D-A-10-95
'Western Surety Company
CONTINUATION CERTIFICATE
Western Surety Company hereby continues in force Bond No.
briefly described as rian ,,i rnrjttr
-;tnr r
01111ty of ThIva 1
-----------------------
for
as Principal,
in the sum of rTyE TH
Dollars, for the term beginning
August 97
and ending
JD02—, subject to all
the covenants and conditions of the original
bond referred to above.
This continuation is issued upon the express condition that the liability of Western S
urety Company
under said Bond and this and all continuations thereof shall not be cumulative and shall in no a ent excee
d
the total sum above written.
Dated this day of M
WESTERN SURETY COMPANY
By
n T. Pate,President
Of', p Stephe President
THZ8"Continuation COrtificate"MU8T BE FILED WITH THE ABOVR BOND.
Farrm 90-A-10-96
CITY OF
4V6,4-c Bear.A-q;kWj- ,
4 Office Of Building Official
REQUEST FOR
INSPECTION
Date
Time Permit No.
Received V A.M.
0/
q7
Owne"s Locality
Name
BUILDING Contractor
Framing CONCRETE ELECTRICAL
Footing 11 MBING
Re Rooting 0 Rough Wiring D Rough MECHANICAL
insulation Slab C TemP Pole D Air Cond. &
Lintel p Final Top out E] Heating
Sewer Fire Place
Mon. Tues. READY FOR INSPECTION Pre Fab
Wed. Thurs. A.M
InsPection Made A.M. Friday
InsPector P.M.
oection
inal Ins
Certificate of cupancy _j 1!301
70, (Z,06 Date
LAN
N%.
ORI
Tr
OF
ADDITIONS or CORRECTIONS
DO NOT REMOVE M I
1011 AMIESS DATE
fn' ,,eJS 4:r7 14 /- -S.
THIS JOB HAS NOT BEEN COMPLETED
The following additions or corrections shall be made before
the job will be accepted
Of(M-7-1t)vZ -:5'0 Pf Y
7)
Z'"Il oc ec—
It is unlawful for any Carpenter, Contractor, Builder or other
persons, to cover or cause to be covered, any part of the work
with flooring, lath, earth or other material, until the proper
inspector has had ample time to approve the installation.
After additions or corrections have been
made, call 247-5826, Building Depart- .:ZG/;Z::0/Zn
ment for an inspection. Field Inspectors ELEC
are in the office from 8:00 a.m. to 5:00
p.m._Monday through Friday. BLDG
LAN
t C"')
G;1
ORI
mom
OF
A Iva
JOB ADDRESS DATE
THIS JOB HAS NOT BEEN COMPLETED
The following additions or corrections shall be made before
the job will be accepted
4(31 At dl/t V
AJ1 7- 1Je*;:�-t-7_t 1AJ JVe_0qrv/Z W(�fl,,r
4r
4 0 U 44 14-
'OEC-0 0 rz_
1^4-$15.00 REINSPE T FEE
It is unlawful for any Carpenter, Contractor, Builder or other
persons, to cover or cause to be covered, any part of the work
with flooring, lath, earth or other material, until the proper
inspector has had ample time to approve the installation.
After additions or corrections have been
P SING
made, call 247-5826, Building Depart-
ment for an inspection. Field Inspectors ELEC
are in the office from 8:00 a.m. to 5:00
p.m. Monday through Friday. T