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1527 Richardson Lane (vault) PERMIT WORKSHEET certificate of occupancy Job Address: Type Work: --� Property Owner: 4 Phone # �eac-t-l�.s 4--�►r3�,-�-r 2�l� l 2 ZZ- Contractor: Phone # Permit#: 28to I Date Issued: s - 9 -o4 Tree Permit# Foundation Permit# Demolition Permit# BUILDING ELECTRIC Ze(o I p MECHANICAL Zg�e 14--� PLUMBING Z q 101 O 9-I-o�- Tem .Power# Footing R-15-•04 JEA Release Date Temp. Power Slab Letter Rec'd. Underslab Tie Beam Temp Pole# Lintel JEA Release Gas Piping Date Nailing/ j/ / Water/ Sheathing II�SlOK 71d5t4C,4?-/ /Z- ��a Zn/5 csa7re l2� ac� Sewer Roughl Framing �Iy 104 Rough �a��y�o� Rough � �� Icy Topout Insulation JEA Release Date Building l�1 Electric 5/����5 Mechanical Plumbing Final , Final Final Final JEA Release 1 /`j Date / W Drainage Inspection: Pool Permit# _ Inspections: Steel Final Elec./Grounding Final Roofing Permit# Inspect: Nailing/Sheathing Final Fire Inspection: Failed Inspections: Date Paid: CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 -Jill Application Number . . . . . 08-00001377 Date 10/22/08 Property Address . . . . . . 1527 RICHARDSON LN Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 6ft and 4 ft stockade fence ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BEACHES HABITAT OWNER ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/20/09 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *ALL FENCES OR ENCLOSURES OF LAND SHALL BE SUBSTANTIALLY CONSTRUCTED. *SCHEDULE FINAL INSPECTION ONCE FENCE HAS BEEN COMPLETED. PERMIT AND APPROVED SURVEY MUST BE AVAILABLE FOR FINAL INSPECTION. *EMAIL INSPECTION REQUESTS TO BUILDING-DEPT@COAB.US Avoid damage to underground water/sewer utilities . Verity vertical and horizontal location of utilities . Hand dig if necessary. If field coordination is needed, call 247-5834 . There is an 8" diameter sewer main that runs directly behind the house, and sewer service coming from the house to the main. Hand dig only in this area. Be advised that if the sewer system in the City easement needs repair or replacement, the fence may be taken down at the owner' s expense. See attached drawing. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 (P,rlan Check Total �r, . 000 r, . n0 n0 . 00 . 00 PERMIT IS AP 4IT 8;MN ACCORDANCE WI111PA'LL�CITV OF ATLI;TIC%EACH ORDINANC PAND THE FLORIDA 0 BUILDING CODES. Public Utilities —Distribution & Collection Date: Initials: Project Name/Address: Application/Permit#: C)?)— Check.Box Agplicaiott'T'racking Comments To.sldd 'Comment Avoid damage to underground water/sewer utilities. Verify vertical and horizontal r location of utilities. Hand dig J necessary. If field coordination is needed, call 247- 5834. Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. ❑ A sewer cleanout must be installed at the property line. Cleanout must be covered with ❑ an RTI concrete box with metal lid. Cleanout to be set to grade and visible. A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested ❑ by a certified tester and a copy of the results sent to Public Utilities. Plans note the building will be unsprinkled. If plans change, any fire line installed must be metered with a Sensus touch-read meter in a properly sized vault and an appropriate ❑ backflow preventer installed. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. If fire sprinkler system is provided, contact Malcolm Clemons at 247-5839 for backflow ❑ requirements. At a minimum,will require double check backflow preventer. Fire lines must be metered with a Sensus touch-read meter. Meters larger than 2" must ❑ be installed in a vault as noted in 7EA specifications. /'OG 1ZAa4"v . ❑ 2 c�G�.r,�.c�-`tel �-� -�-� �ie ,�Z��c�r-� '`.�' ❑ - ��rzzdZ. a.6fu-��D�cccul�%-� . ❑ F:T1anReviewComments-PU.doe City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) ` 800 Seminole Road /2 Atlantic Beach, Florida 32233-5445 d Phone(904)247-5826 • Fax(904)247-5845 f LA /00- '-DID, E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us 11 f APPLICATION REVIEW AND TRACKING FORM Property Address: /�a7 c��-� &-n Bui nt review required Yes No _P Tannin &Z ' g Applicant: ��.�'1�� s Pu tic Utilities .Project: k) 6 ety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: sok .• r6ne_& o BUILDING_.__.- � sewe/C. /ire "Ao h„ �Ca� _ P ANNING ZONI /�, 6Z C W RKS �l��/��y y '/" �• Reviewed by: Date: B� •-�9 UTIL T Second Review: ❑Approved as revised. ❑Denied. Comments: PU I TY FIRE RVICES Reviewed by: Date: Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Cit of Atlantic Beach ri �e,. Y ,,,� APPLICATION NUMBER Building Department rtP o (To be assigned by the Building Department.) 800 Seminole Road y � Atlantic Beach, Florida 32233-5445 7 Phone(904)247-5826 • Fax(904)247- `ti � 531y� E-mail: building-dept@coab.us `" ��� , Date routed: �O City web-site: http://www.coab.us `� APPLICATION REVIEW AND TRACKING FORM Property Address: �7 „ �, _/ » �� D nt review required Yes No ` c.�/ c Bui Applicant: annin &Z g s -, , ,,,., „> ,. . ;,,,. : . , ;, ; , , ,Pu lic:Utilities. Project: `vlt� �, e y Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: (Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING J Reviewed by: Date: PUBLIC WORKS PUBLIC UTILITIES Second Review: QApproved as revised. ❑Denied. Comments: PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: CITY OF ATLANTIC BEACH sa 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 08- r i OFFICE:(904)247-5826•FAX NO.:(904)247-5845 B UI LD ING-DEPT@COAG.US BUILDING PERMIT APPLICATION DUVAL COUNTY VALUATION OF WORI4r t, .,`,,.:. _: 3 SQ FT_,UNDER ROOF E Atlantic Beach, FL 32233 4;.f EGAL DESCRIPTION„a,a u, r°...::. S CLASS OFiWORK;°,€ic+ a .w.;: 6.USE OF STRUCTURE ❑NEW BUILDING ❑DEMOLITION SIDENTIAL LOT_BLOCK,SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL a 7i'OESCRI.TION'OF WORK t . ;;' „'r,'. ❑ALTERATION ❑ACCESSORY BLDG. B FIRif SPRINKLLR! ❑REPAIR ❑POOL I SPA 11YES ❑NIA 11MOVE ER ❑NO KW a`,:i ,. ,.:;ARCHiT,ECT!ENGINEER,a 9.NAME: 11 15,COMPANY NAME: 23.COMPANY NAME: e Y11 ; 16,NAME: 24.LICENSEE NAME: 10.ADDRESS:V 17,STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: I sa.7 R c,k o'dP. /Ifflat �1' e—n G�/)V- 6� 18.ADDRESS: 26.ADDRESS: 11.OFFICE PHONE: AjJ� 12,FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 13.CELL 4QNE-_^ 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: $IMRLFTITLE HOLDER BONDING COMPANY alr�a >U MORTGAGE LENDER n w R s.:jtF OTHEr�THAN OWMER) ;t. .. ,.e .se:.;.; ,793. . ,r .. .'!J .:;5 >r y ,a t x.C, .,;FEE u 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 const=riction 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. **k 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 y xf, OWNER ofAoAGEN ` red) yONTt•R, Ao, > �eyoge yLerRequiC7QR k w (OtialtfierOnly) , Signed. u ate: Signed: Date: Before me this, day of 2007 in the county of Before me this day of ,2007 in the county of Duval,Sta o'Florida,has personally a p red Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all state ents and declarations are herin by himself/herself and affirms that all statements and declarations are true and accurate. �- f / true and accurate. Notary Public at Large,State of ,County ofa(� Notary Public at Large,State of ,County of ❑Personally Known 1, 0 Personally Known Induced Identific fion- ❑Produced Identification- Notary Signature: Notary Signature: Notary Public-State of Florida '» ;hly Commission Expires Feb 14,2010 Commission#DD 518533 F Bonded By National Notary Assn. COAG FORM BLDG01:REVISE . 17, City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) s 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: buildin -de t coab.us Q J,37J Cit Y hftp://www.coab.us hft ://www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM /�� " �� D nt review required Yes No Property Address: /U7Q�!' -11» L�7 Bui anninp &Z_0AiKg Applicant: s .. :.. ....... . . :... .. :. .. . . :. ,.Public.Uti sties Project: Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle Comments: =BUIMING PLANNING &ZONING PUBLIC WORKS Reviewed by: Date:/O_a'n PUBLIC UTILITIES Second Review: QApproved as revised. ❑Denied. Comments: PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: [-]Approved as revised. ❑Denied. Comments: Reviewed by: Date: V. City of Atlantic Beach APPLICATION NUMBER a t Building Department (To be assigned by the Building Department.) ` 800 Seminole Road �� Atlantic Beach, Florida 32233-5445 7 Phone (904)247-5826 • Fax(904)247-5845 —' �o; E-mail: building-dept@coab.us LQ City web-site: http://www.coab.us Date routed: APPLICATION REVIEW AND TRACKING FORM lea 7 2Ch Ar 1�.Zn Z D nt review required Yes No PropertyAddress: Gy Bui Applicant: Q�()"jj Pra-Knina &Zonda s .. ..: , ..u lic. tilities._IE ..,,. , ety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: proved. @Denied. (Circle one.) Comments: BUILDING CANNING &ZONIN PUBLIC WORKS Reviewed by: �o�-�U.�� Date: PUBLIC UTILITIES Second Review: QApproved as revised. @Denied. Comments: PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: r M a a r r r 1615 1610 e N M M 1565 01550 K M 4 P M t N 1540 N r p 1525 I r 1530 M M M M 1520 r" "'r%� CITY OF ATLANTIC BEACH O "�i, 800 SEMINOLE ROAD,ATLANTIC BEACH,FL ov- 32233 I I I I V7 , r� OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING B �CTiJFiI�}° UILDING PERMIT APPLICATION DUVAL COUNTY J'JOB ADDRESS:i' 2.VALUATION flF WORK, ,,, 3,SQ FT.;UNDER ROOF',, Atlantic Beach, FL 32233 „4:LEGAL DESCRIPTION,t„..';.. ,.. d^ ,i7777777777 5:iCLASS OR.`WORI<r ,! 6.USEiOF STRUCTURE. ❑NEW BUILDING ❑DEMOLITION BlqrSIDENTIAL LOT_BLOCK_SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL r'7"DESCRI TION'QEW- ORK: 11 ALTERATION 11 ACCESSORY BLDG. 8;F.IRE SPRINKCI R,. ,T. . 114 REPAIR ❑POOL/SPA ❑YES ❑N/A Pf 11MOVE ER ❑NO PROPERTY.OWNER �,;� „Irt.:CONTRACTOR. s . , , �a t ARCHITECT I ENGINEER: v.. 9.NAME:,JL 15.COMPANY NAME: 23.COMPANY NAME: v;a-0,V e EJ 16.NAME: 24.LICENSEE NAME: 10.ADDRESS: 17,STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: �sa-? �i C-kakkoA LPL Nla N i i 6G L/ict 18.ADDRESS: 26.ADDRESS: 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 177MO.: 27.OFFICE PHONE: 28.FAX NO.: 13.CELL 4 FE* 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: r n FEE SFaPL r�tE TtrAowN�RDER .,$ * . ” ` BONDING COMPANY "M N, 3 MORTGAGE LENDER 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. gay �' OWN'ER or GEN7twll n : - r . ,�,, CONTRACTORS Po of A o nay or game,r Required)' ,, ri (Qualifr Only), :;k ,� Signed. ate: ! Signed: Date: Before me this�_day of 2007 in the county of Before me this day of 2007 in the county of Duval,Sta of Florida,has personally a p red Duval,State of Florida,has personally appeared Li-?,A�1 herin by himself/herself and affirms tha ipntq 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 Knowntion- 11 Personally Known I�duced Identifi ❑Produced Identification- Notary Signature: Notary Signature: ` . Notary Public-State of Florida ;My Commission Expires Feb 14,2010 °s Commission#DD 518533 F Bonded By National Notary As COAB FORM BLD G01:REVISE . e 1L��i l CITY OF ATLANTIC BEACH 08 $ gzr %'• p,1'581, 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 I wI I�4 r t OFFICE:(904)247-5826•FAX NO.:(904)247-5845 a BUILDING-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY JOB P,DDRESSr.;,r, _ r..:; :r..._ ': ?., ` ` ., 2.YALUATION30FFT:IJ,NDER ROOP .;�. .. t Atla tic Beach, FL 32233 „A;CEGALDESCRIP..TION, n.o:, L..:'. .,,i. 5,`,CLAS50F:WORIS"tis;?., .,r4. :':. .i ..n:. B.:USEOFSTRUCTURE ❑NEW BUILDING ❑DEMOLITION RlIrSIDENTIAL LOT BLOCK SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL ot 7i DESCRI TION QR WORK <' ❑ALTERATION El ACCESSORY BLDG. 8.FIRE'SPRINKLBR+, t , ❑REPAIR ❑POOL I SPA ❑YES ❑N/A ❑MOVE QeTVER ❑NO t'ROPERTY:°OWNER:?:, CONTRACTOR ;ARCHITECT I ENGINEER 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: '.�h.A.rino n k VA., 1 E' YA 16.NAME: 24.LICENSEE NAME: 1 10.A;DRESS: 17•STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: la n i i e—n G�!)Q 43-318.ADDRESS: 26.ADDRESS: Iff 11.OFFICE PHONE: {/�` 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: J28.FAX NO.: 13.CELL 2QNE' 3 21.CELL PHONE: 29.CELL PHONE: 14,EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: FEE SIMPLE�TITLE HOLDER BONDING COMPANYG�' s+ New , y MORTGAGE LENDER 'M t4' tFOTHEITHANOWNERY. `` �.� n cF r.. ?m4� *1. �,. .U., - ...i ,: rl. .... .. .. , ..,, 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. jx NTRACTOR� j ,> OWNER o1"AGENT rya CO i of A o ney of ge tQ r Regwred)' (Odalifiei Only) , . Signed. ate: Signed: Date: Before me this_�day of2007 in the county of Before me this day of 2007 in the county of Duval,Ste of Florida,has personaiiy a p red Duval,Stare of Florida,has personally appeared herin by himself/herself and affirms that all statelnents 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 A 14(� Notary Public at Large,State of County of ❑Personally Known13Personally Known � Iduced Identific tion- ❑Produced Identification- Notary Signature: I Notary Signature: SWIR65Y 6,G-11-1,11 WA Notary Public-State of Florida ='. »•Wy Commission Expires Feb 14,2010 Commission#DD 518533 Bonded By National Notary Assn. COAB FORM BLDG01:REVISE . C E R T I F I C A T E O F O C C U P A N C Y P E R M A N E N T Issue Date . . . . . . 5/19/05 Parcel Number . . . . . - - - Property Address . . . 1527 RICHARDSON LN ATLANTIC BEACH FL 32233 Subdivision Name . . . Legal Description . . . Property Zoning . . . . TO BE UPDATED Owner . . . . . . . . . BEACHES HABITAT Contractor . . . . . . BEACHES HABITAT 904 241-1222 Application number 04-00028610 000 000 Description of Work TWO FAMILY RESIDENCE Construction type . . . Occupancy type . . . . Flood Zone . . . . . . Approved . . . . . . . C� Bui ding Off cia VOID UNLESS SIGNED BY BUILDING OFFICIAL Building, Planning & Zoning Inspection CITY OF ATLANTIC BEACH Department CERTIFICATE OF OCCUPANCY WORKSHEET Date Requested: Contractor Name: Permit#: 0 r!j 2 L I Property Address: r Legal Description; r Ct Y �- fi>lL LS Improvements to the above-described property have been completed in accordance with the terms of the permit and are certified to be ready for occupancy as: ❑ Single-Family Residence ❑ Commercial 1 Other: 1 Lowest Floor Elevation: e�2 Required As Built The following must be completed before issuing Certificate of Occupancy: Department Date Notified Date Approved Approved By Fire Dept. - Public Works - l'1 _ b ^ _ 7 - o Public Utilities - _0. — _ Planning Dept. D tr-0L-7-0,57- 0 S -7 Ct5 Building Dept. S� _ 2 7- Final Survey with FFE �es ❑ No All Re-Inspect Fees Paid L� Yes 0 No r; CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 X319)`' Application Number . . . . . 04-00028610 Date 8/09/04 Property Address . . . . . . 1527 RICHARDSON LN Tenant nbr, name . . . . . . NEW DPLX/RAD1105/SRCH1105 Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 59503 Owner Contractor ------------------------ ---- -------------------- BEACHES HABITAT BEACHES HABITAT P.O. BOX 50939 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 (904) 241-1222 ---------------------- ------------------------------------------------------ Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 8/06/04 Valuation . . . . 59503 Expiration Date . . 2/03/05 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . CITY RADON SURCHARGE . 27 CAPITAL IMPROVEMENT 325 . 00 ST CONSTRUCTION SURCHARGE 4 . 97 AB CONSTRUCTION SURCHARGE . 55 STATE RADON SURCHARGE 5 .24 SEWER IMPACT FEES 1250 . 00 WATER IMPACT FEE 370 . 00 WATER CONNECT/METER ONLY 85 . 00 WATER CROSS CONNECTION 35 . 00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total . 00 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 2076 . 03 2076 . 03 . 00 . 00 Grand Total 2076 . 03 2076 . 03 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. tto. 16K • BUILDING OFFICIAL CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD I4 ' Lr ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028610 Date 11/11/04 Property Address . . . . . . 1527 RICHARDSON LN Tenant nbr, name . . . . . . NEW DPLX/RAD1105/SRCH1105 Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . 59503 Owner Contractor -------------- - --- ------ ------------------------ BEACHES HABITAT BEACHES HABITAT P .O. BOX 50939 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 (904) 241-1222 -- --------------- ---- ---- -- ------------------ ------------- ------------------ Permit . . . . . . MECHANICAL PERMIT Additional desc NEW HVAC Sub Contractor OCEAN STATE HEAT & AIR Permit Fee . . . . 71 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ------------ ---- - --- ------- ---------- ---------- ---------- Permit Fee Total 71 . 00 71 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 71 . 00 71 . 00 . 00 . 00 a PERMIT IS OVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUII.DING D BUILDING OFFICIAL. i ky #y . � CITY OF ATLANTIC BEACH MECHANICAL PERMIT APPLICATION Date: Owner of Property: - Job Address: /S•)"7 e^w ey Contractor: Oc_agv S7-,A A/G- F.a,t. �� y<9- r.9 fe 9, In consideration of permit given for doing the work as described in the above statement we hereby auee to perform said work in accordance with the attached plans and specifications which are a port hereof and:n accordance with the City of Atlantic Beach ordinances and standards of good pmcnce listed therein. I III. GENER11, INFORMATION � V rype of heating fuel: B. (t- Electric (S OTHER CONSTRUCTION BEING DONE ON THIS D Gas: _LP _Natural _Ccntral Utility BUILDING OR SITE" S/G$ ! :I Oil Z Other-Specify IF YES.GIVE`lL%i ER OF CO STRUCTION PERMIT �o IV. t MECHANICAL EQtJIP1tE`iT TO BE NATURE OF WORK Zt� INSTALLED • [tasidenttai or � Commercial New Building (Provide complete f ist of components on back of this form) J E=hng Building (�- Heat _Space _Recessed XCemrai Floor r, Repiammeat of Misting system t+3— .-Xir Conditioning oom Xcen 0, New Installation(No system previously installed) CI_ Duct System: Material ick11es3 I a Q Extension or add-un to Misting system Ma:-Utnumcapacrty CSn D Other-Specify D Refrigeration Q Cooling tower. Capacity D Fire sprinklers: Number of heads THIS SPICE FOR OFFICE USE ONLY Q Elevator: _ ManliB_Escalator (Number) Q Gasolim pumps (Numb) (Received) DTanks (Number) Remarks a LOG containers (Number) Q Unfired pressure vessel a Boilers Permit Approved by Date Q Other-Specify Permit Fee LIST;ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT Number Units Description Model Number Manutac.'turer Capacity Approving (Tons) Agency - Ct»l/ _ w L HEA -NG-FURNACES.BOILERS.FIREPLACES Number Units Description Model Number ytanutacaues Capacity Approving (STU) Ast /J! TANKS How Many Nominat Capacity Type Liquid Name of Serial Approving And Dimensions Contained Manufactumr No. Agency 809 Seminole Road•Adande Beach.Florida 322 544S Phone:(904).47-5804•Fax:(494)2.37-5845• hrt�:r/www.LLatfandc-beach H.us,I-ww.LLatiandc-bewfLH.us 1/14193 800 SEMINOLE ROAD,ATLANTIC BEACH,FLORIDA 32233 FAX(904)247-5845 CITY OF ATLANTIC BEACH Fax To: Carol Schweizer,JEA From: Building Department Fax: (904)665-7372 Pages: 2(including cover sheet) Phonw. (9(4)665-6521 Date: 10/26/2004 Re: 1525 Richardson Lane CC: N/A ®Urgent ❑ For Review ❑Please Comment ❑Please Reply ❑Please Recycle e Comments: I could not find an application in the file, but I did find a Temp-pole permit in the system that was issued on July 2,2004. PLEASE ATTACHED FAX CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD } ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028592 Date 10/26/04 Property Address . . . . . . 1525 RICHARDSON LN Tenant nbr, name . . . . . . TEMP POLE Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ----------- ------------- ------------------------ BEACHES HABITAT BEACHES ELECTRIC SERVICES INC. 9430 LITTLE JOHN ROAD 214 COKESBURY CT. JACKSONVILLE FL 32208 GREEN COVE SPRINGS FL 32043 (904) 629-3182 --------------------- ------- ----------------------- ------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . 7/02/04 Valuation . . . . 0 Expiration Date 12/29/04 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 MY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUHAIN?0Cf BUILDING OFFICIAL CITY OF ATLANTIC BEACH s ) 800 SEMINOLE ROAD J ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028609 Date 8/17/04 Property Address . . . . . . 1525 RICHARDSON LN Tenant nbr, name . . . . . . NEW DPLX/RAD1105/SRCH1105 Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 59503 Owner Contractor ------------------------ ------------------------ 13EACHES HABITAT BEACHES HABITAT P.O. BOX 50939 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 (904) 241-1222 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc NEW 150AMP, 1PH, 3W, 240V Sub Contractor CMA ELECTRICAL CONTRACTORS Permit Fee . . . . 95 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 95 . 00 95 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 95 . 00 95 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 'Q, C a lom-k BUILDING OFFICIAL i FROM GRANGER)( PHONE NO. 9047640038 Jul. 24 2004 11:11AM P2 �412604 X9.44 oU�i4-f.L ZL �C�'�,t GAS .�, iia: 3.+'.�►C.:t�f F)I.ORMA, ' APPLICATION FOR MLECTRICAL oR; DATE: tN CO?,�sjnzr kTION OF?WdT 01VEN FOR DO=THE WOU AS DESUMED IN THE FOt.I,Q11M,WE HEREBY A.-ME TO yE 2o?u SAID WMX IN ACCCRDMM MT7q THE AT'lACM PLANS AND SPKMCAI'TOK WCH ARE A PART MMI F, wo TNA=OVANtE 1s1M airs BLSGM"UOrX4TIONS,CODES AND Ct"Y Q?AT3-ANTIC SEACi ORDINANM. BLECTECAL FIA1: MASTER ELECTRIC URE: OVV: RS NAl+A2: &W -.Amt rogs- ADDRESS. /8 tf r &L 1p, - -.ox— BLDG,StiE MS-(* AP-,-( ) CC)ivfW > k USLIC( ) ]AUS.( ) NEW( OLD( ) REW4 ) ADDITION( ) TF A LER ) TRIO-( ) SIGN( ) SQ.FT. SERVICE: NZw _:� »CKEAsZt REP coN1)UCT0R s= AWS: co A;.� r- ss SWITCH OR BREAK3A A8•7Li_�-/��;`� W �OLT .C*EiYAY EXIST.SMV, SLZE AMFS $ W YO�T RACEWAY FEBDUS NO. S:?' NO. SITE LIG�G 06"MATS . GuNCEALE1D OPEN TOTAL MCMACLES CONCEALED . OPS TOTAL 3t.104 S�'I'rCr3E �CANDE6C'�Nl` + . 10 F?XFA GC1kn1.FvdU:t7 i 171MR IMOTORA i AICS -.�...a+-T_-..-.....�1w•.�wr++��w...wwnw�.�r.rw.•..�w.r+�.ww..r. rw.. .r-.-. ..w...r_...•r.1.RM.M�— _—_.wlAi.i1M.MY�+.��_.r- ! •.-n.a...-aT 7 r77— M.P.. 7V www. M.P., I VO;.TAGE. p1m ?IQ, 1 mr. VOLTAGE PIi3 � Misc'7LT A. ..OT;9 ER 500V ov Bg 600V � TRANSFOR14tLS- NO, J KVA _ NO �VVA �N0 R r MA MOTOR—MR-7 BCH f FLASMS I � I - .� uy� CITY OF ATLANTIC BEACH S;> 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028610 Date 8/17/04 Property Address . . . . . . 1527 RICHARDSON LN Tenant nbr, name . . . . . . NEW DPLX/RAD1105/SRCH1105 Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 59503 Owner Contractor ---------- ---- ---------- ------------------------ BEACHES HABITAT BEACHES HABITAT P .O. BOX 50939 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 (904) 241-1222 ---------------------- ------------------ ------------------------------------ Permit . . . . . . ELECTRICAL PERMIT Additional desc NEW 150AMP, 1PH, 3W, 240V Sub Contractor CMA ELECTRICAL CONTRACTORS Permit Fee . . . . 95 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 95 . 00 95 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 95 . 00 95 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. C q-0%K B DING OFFICIAL FP,011 GRANGER) C PHONE NO. : 9047640038 Jul. 24 2004 11:13AM P5 071/-7.12M4 13:44 914',:'9'`:1222 x"'. -r.,. iw;u:1... Cj'fY' OF ATLANTIC BEACH, FLORIDA A3PPLiCA,TXON FOR ELECTRZCA..L PERMIT tOT>M CI•�ELErMUCA1.1MSP$CTOPQ :)ATE:_.7 r ��: 1WATANTND1"SC ; Ila MNSMRATION CW PMET OVEN PQR DOING THE WOPUK A 0*,tCPZW 1N T%M FOLLCIW04,Wt 21ggt8'8Y AGUE TO FFRFMM SArb WoR1F:N AI oXnANC'i: WITH TFC A-rTACHM pt.ANS ANp 3P33CMA110M.WWH AM A PART H W''F. h-ND IN AGCORDAN02W- -q TNT'1a,SCTR1C.AL R9aVL.6T1oh8,C013Effi RTS CITY OF A'M AN-,IC UACH OF-DIN AW2S. 21-1=MCAL YM—M: MASTER�I.EC Qb1�,T[J!RE: e ;ILDC. RgS. } Ap'z.( 3 try .( } Pu Lio( } u S.c ) NEW( } 0LA( REw.( � =1710N( 9 7R.ATS,x±R{ SERVICE: ��I£tiN1CAR�8. RF.F CONDUCTOR SIS AMPS; COPPER ALL'A+t. I � Swt.TCH OR gREAK�E�t l*�' .?►�Svvl,T RACEWAY BxT.s . SMV.,T AM�s - T i a' voL RAwA 110M1NG vL�"C'uETs =NCEAUM. OPEN TOTAL RECEPTACLES CONCEALED TOTAL - Q30N11f'9 szafrlaTt�:}D�sA-EaN•M i .—�..1.r.,...T_....._..•.�. - -- - FLOSCENT a M.V. FIXED APPLIANCES 11 LL T-AANSI±, A H.P.RATING EP.RAT NO c z{w•1a C01:'Yi:'.-14('701k Fyfmoyk -'r ,�'.P�! 's ! x i C ov- ��'�tS S I TZ1, ( vOLTACS FJ1,9 NO. ! .P. VOLTAGB PHS OVER 600V : No. V a NO. RVA ....-,--. ..,.. N ! MOTOR -,1ZE I SWITCH I FLAS�MR$ i ��� CITY OF ATLANTIC BEACH c 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028610 Date 9/01/04 Property Address . . . . . . 1527 RICHARDSON LN Tenant nbr, name . . . . . NEW DPLX/RAD1105/SRCH1105 Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 59503 Owner Contractor BEACHES HABITAT BEACHES HABITAT P.O. BOX 50939 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 (904) 241-1222 -------------------------- ---------------------------- ---------------------- Permit . . . . . . PLUMBING PERMIT Additional desc 11 FIXTURE Sub Contractor ADVANTAGE PLUMBING Permit Fee . . . . 112 . 00 Plan Check Fee . 00 Issue Date . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 112 . 00 112 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 112 . 00 112 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. s G OFFICIAL s CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION Date: Property Address: o6 e- a.44-V s—,) 4+JC Owner: ( tTelephone#: 9my Contractor: 441/ON�6&7 P10)) Telephone Contractor Address: }C ^, 1 Fax#: 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 listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: If other construction is being done on this building or site, New list the building permit number: O Re-Pipe Number of Fixtures: Bath Tubs Showers Closets Shower Pans Dishwashers Sinks Disposals Urinals Floor Drains �_ Washing Machine Lavatory Water Sewer Water Heaters Other Fees Permit Issuing Fee: $35.00 Total Fixtures: _ X$7.00 + $35.00 = � - 800 Seminole Road •Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800 • Fax: (904) 247-5845. http:/lwww.ci.atlantic-beach.fl.us Revised 1/04 CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Date: 9?1 Y '0 Address 112- Heated Heated Square Footage // @$ _ Z per sq ft = $ S�460 Garage he @$ _�_per sq ft = $ / 0 Carport/Porch es @$ 1 per sq ft= $ el- Deck @$ per sq ft= $ Patio @$ per sq ft = $ TOTAL VALUATION: r $ � e. Total Valuation $ Remaining Value $ . per thousand or portion thereof CONSTRUCTION TYPE:7= TOTAL BUILDING FEE $ ZONING: R S-Z + `/Z Filing Fee $ FLOOD ZONE: _�C _ ( ) Fireplaces @$35.00 $ IMPERVIOUS SURFACE:7— BUILDING PERMIT FEE $ WATER IMPACT FEE $ -370 SEWER IMPACT FEE $ o WATER METER/T AP $ Q� CAPITAL IMPROVEMENT$ 12 SEWER TAP $ — 0 - C - OC Q14 I) RADON HRS .0050 $ SECTION H PAVING ( ) $ — O - CROSS CONNECTION $ 3 S� ST(flaS') SCtRLFlA1ZG S OTHER $ GRAND TOTAL DUE: $ 1/13/03 CITY OF ATLANTIC BEACH J � BUILDING / ZONING DEPARTMENT Doerr r 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # 0 4-- 20o(p 10 Property Address: �-5 ,2---1 r-,/-4 Applicant: f??CO-C t S Project: Vj L'kJj This permit application has been: ❑ Approved ❑ Reviewed and the following items need attention: Please re-submit your application lenthese items have been completed. Reviewed By: %--, ( t - Date: K- ) �� CITY OF ATLANTIC BEACH C,,PFoBUILDING / ZONING DEPARTMENT s :_e err 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application 2-L�314 Property Address: Applicant: \ Project: t° UJ Ci This permit application has been: Approved Reviewed and the following items need attention: Please re-subnyour applicati when these items have been completed. Reviewed v . �:'`��' : ' Date: .Tal CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (FOR NEW SINGLE FAMILY RESIDENCE AND I8� DUPLEX CONSTRUCTION) Date: 6�)7�ol Job Address: �2�,1� t Gr L'4�E re..9a�. � �c ;7--t- 3,3 Owner of Property: it Address: Telephone: Legal Description: Block Number: /5' Lot Number: Zoning District: ��✓.JfI? r��y�e- Contractor: c� e 5 ,�c3 1,; �r State License Number: Contractor's Address: M,7/ A�G i / f 1�M) L g�..rt, y'z -'z 2 33 Telephone: 2VI- Fax: 2_3tJ— _-/3/<1 Describe proposed use and work to be done: L, r Present use of land or building(s): Valuation of proposed construction: Is approval of Homeowner's Association or other private entity required? W 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? ❑ O. 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 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, please 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.atiantic-beach.fl.us Page 1 Revised I/14/03 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 survev 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 information provided with this application is correct. —2 ef7 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: D ^�V Date: `b Address and contact information of person to receive all correspondence regarding this application (please print). Name: �A�-�1 Fih (e!:3, Mailing Address: 147 Telephone: 11/ /Z.Z2 Fax: 4?-Y- Z41/— 1/3r© E-Mail: AS TO OWNER: Sworn to and subscribed before me this day of �-- �� ,20 L/ State of Florida,County of Duval +� MYCO 'ERSCHLUETER Notary's Signature: IA. : ,o�. SSION#DD 121301 ' Pf .. EXPIRES:May 27,2006 ruNotarypublicUnderwriters Personally known ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of � '�— -- 200 LZ State of Florida,County of Duval Notary's Signatu s ''...... JENNIFER SCHLUETER =.: MY COMMISSION#DD 121301 ersonally known �' a= EXPIRES:May 27,2006 � a�• ❑ Produced identification 'F pF ho Bonded T. Notary pubGo Underwriters Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Page 2 Revised 1/14/03 S'�,f'^ > CITY OF ATLANTIC BEACH FLOOD PLAIN DEVELOPMENT INFORMATION j+�la�I Location: ��41z c, �v.R�,�� Type of Development: Flood Zone: x Required Lowest Floor Elevation: 6 If building is located within a flood hazard zone, a survey must be made AFTER THE SLAB HAS BEEN POURED, certifying that the LOWEST FLOOR ELEVATION is equal to or above the base flood elevation established for that zone. No final inspection will be made and no Certificate of Occupancy will be issued until the survey is on file with the Building Department. COMMENTS: Applicant Acknowledgement: I understand that the issuance of this permit is contingent upon the above information being correct and that the plans and supporting data have been or shall be provided as required. I agree to comply with all applicable provisions of Ordinance No. 25-7-11 and all other laws or ordinances affecting the proposed development. Applicant's Signature: Date: 3� Department Use: Required lowest floor elevation: As built lowest floor elevation: Survey filed with Building Department: Building Department Representative Revised 1/17/03 DEPARTMENT OF PUBLIC WORKS 1200 SANDPIPER LANE Rce` ATLANTIC BEACH,FLORIDA 32233-4318 TELEPHONE: (904)247-5834 FAX: (904)247-5843 SUNCOM:852-5834 http://ci.atlantic-beach.fl.us PLAN REVIEW COMMENTS FROM THE PUBLIC WORKS DEPARTMENT Permit Application # } Lel o Applicant: 7 Q Address: l 5a /�t C i')Qr01-g0/I Proj ect: lUAQi Your application is approved as noted by the Public Works Department. Final application approval must come from the Building Department. ❑ Your permit application has been reviewed by the Public Works Department and the following items need attention: _. Spot elevations on site plan do not show lot draining to — _ street as required by 24-66 (a) -- show site regrading plan. — Site delta storage / volume calculations required by 24-66 (b) . CC► VAC' 0q Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions,please call (904) 247-5834. Reviewed by k Carper, P.E., Public Works Director µ Date Signature Contractor Notified Date fr �1 DEPARTMENT OF PUBLIC WORKS fc� 1200 SANDPIPER LANE 3 ATLANTIC BEACH,FLORIDA 32233-4318 :c a ik TELEPHONE:(904)247-5834 J` FAX: (904)247-5843 - T SUNCOM: 852-5834 http://ci.atiantic-beach.fl.us UVJ PLAN REVIEW COMMENTS FROM THE PUBLIC UTILITIES DEPARTMENT Permit Application # � --- lG Applicant: q Address: 1 ��'� ► G� r S�� ( /� „ lwroject:. y cAAJ' Your application is approved as noted by the Public Utilities Department. Final application-approval must come from the Building Department. o Your permit application has been reviewed by the Public Utilities.Department and the following items need attention: G''?crN-=-ze Gtr `� !'``< ��•c��f�o , Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions please call (904) 247-5834. Reviewed al Public Utilities Director Date Signature Contractor Notified Date -7'lcS