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Permit Addition/Remodel 1163 Beach Ave 2012 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 it Application Number . . . . . 12-00000490 Date 6/07/12 Property Address . . . . . . 1163 BEACH AVE Application type description RESIDENTIAL ADDITION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 2nd story addition and remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ADAMS CHARLES P WORSHAM CONSTRUCTION CO INC 1163 BEACH AVE 2329 URBAN RD ATLANTIC BEACH FL 322335727 JACKSONVILLE FL 32210 (904) 545-2357 --- Structure Information 000 000 ADDITION 452 SF AND REMODEL Construction Type . . . . . TYPE 5-B Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE AO ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ADDITION Additional desc . . ADDITION Permit Fee . . . . 1080 . 00 Plan Check Fee 540 . 00 Issue Date . . . . Valuation . . . . 300000 Expiration Date . . 12/01/12 ---------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of work. -------------------------------------------------------------- Other Fees STATE F�DCA y�7SURCHARGE gp 16 . 20 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITP A'TL�NTCC'BE C&R Akd f THE FLO50 . 00 IDA 0 0 BUILDING CODES. CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD :) = ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Page 2 Application Number . . . . . 12-00000490 Date 6/07/12 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENG REV PRE APP > 3 HRS 25 . 00 STATE DBPR SURCHARGE 16 . 20 UTIL REV PRE APP >3 HRS 25 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 1080 . 00 1080 . 00 . 00 . 00 Plan Check Total 540 . 00 540 . 00 . 00 . 00 Other Fee Total 132 .40 132 . 40 . 00 . 00 Grand Total 1752 .40 1752 .40 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: IIle 3 0c;qir,,0 o4ow' exr- e,a'If2Permit Number: i v Legal Description 1,00.5 _3 51-4eM 444-T e Li�— i+Parcel# 'F' oorl Aea of ' q. t. Sq.Ft Valuation of Work S � " Proposed Work heated/cooled non-heated/cooled ;7 . Ckgo . q's D Class of Work(circle one): Ne Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residenti If an existing structure,is a fire sprinkler system installed? (Circle one): o N /A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: AL-- DNS D 40b i>rsilj w a5e� Rgzii 01 er,-,- ` ken-'-c c/e Property Owner Information: Name: Address: City >.dAn1-rlG1-_Ng gtr4 State ip 377-33 Phone E-Mail or Fax#(Optional) Ie Contractor Information: Company Name:WC)P-544V4 Qualifying Agent: Address: 93.7-!q 4?P_8A.1 P-o, -D City'i State 1::;L Zip Z Office Phone 26f- :14:�5-235? Job Site/Contact Number �©¢ s'7 Fax# State Certification/Registration# 66 G 4>1 t5-® $2 Architect Name&Phone# 44 M yr Y7-Zz 077'7 Engineer's Name &Phone# * *>;�� n2e„n tG s N c cT�.c� Ate e 4 � ill o Fee Simple Title Holder Name and Address Jt' 4 7 Bonding Company Name and Address -VIA Mortgage Lender Name and Address N Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation i fenced 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 jurisdicttoii mit becomes null and void if work is not commenced within six (6)months, or if construction or work is suspended or abandoned for apertod of six any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, urn s, Healers, Tanks and Air Conditioners,eta WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of 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 other federal,state or local law regulating construction or the performance of construction. Signature of Owner Signature of Contract Print Name t.�� r�i.. :��S Print Name ........................ ....... . ............................. TAV-4). �..�....t.G�...G B ...... . Sworn tAand subse 'bed before me Sworn to and subscri ed before me this Day of�) Yl 20 l Z this Day o�7f//y/ �,( 201* SUSAN S.HIBBLE Notary Public Y ° XA Notary Public• State of Florida tart'Public I f p LpppiNEWADE '=My Commission Expires Jun 26,2012Notary P is S �,Qt Florida '� Commission # DD 780057 evl @22137 lty COMM,expires Sept 11,2012 DO NOTiWF.�`r'� BELOW- OFFICE USE ONLY 7p .cable Godes: 2007 F ori a Building Go e w 2 09 Revisions eview Result `circle one): pproved Disapproved Approved ver/ Conditions _eview Initia.ls/Date: ,evelopment Size Cabitable Space Nora-Habitable snpmious area ;_a.donCD CA/DBPR$- discellaneous Infokroation )ccupancy Group PeSd ype of Construction- Number of Stories 2. 7onin g District : ,flax. occupancy Load ire SprinIders Required vi Fl d.Zone A 04 Conditions/Comments: Property Appraiser -Property Details Page 1 of 2 ADAMS CHARLES P Primary Site Address Official Record Book/Page Tile* 1163 BEACH AVE 1163 BEACH AVE 07342-01105 9416 ATLANTIC BEACH, FL 32233-5727 Atlantic Beach FL 32233 ADAMS SUSAN CORSE 1163 BEACH AVE roperoperty Detail Value Summary RE# 170272-0000 2011 Certified 2 n P r Tax District USD3 Value Meth CA Propel3y Use 0100 SINGLE FAMILY Total Building Val $502,675.00 75,149.00 #of Buildings 2 Extra Feature Value $2,700.00 6-116-2S-29E.571 Land Value(Market) $1,710,000.00 $1,710,000.00 Legal Desc. ATLANTIC BEACH Land Value(Aeric) $0.00 $0.00 Subdivision 03108 ATLANTIC BEACH Just(Market)Value $2,215,470.00 $2,187,849.00 The sale of this property may result in higher property taxes.For more information go Assessed Value $2,055,439.00 $2,117,102.00 to Save Our Homes and our Proper Tax Estimator.Property values,exemptions and Cap Diff/Portability Amt $160,031.00/$0.00 $70,747.00/$0.00 other information listed as'In Progress'are subject to change.These numbers are part of the 2012 working tax roll and will not be certified until October.Learn how the Exem ttp ions 1$50,000.00 See below Property Appraiser's Office values property Taxable Value 1$2,005,439.00 See below Taxable Values and Exemptions—In Progress If there are no exemptions applicable to a taxing authority,the Taxable Value is the same as the Assessed Value listed above in the Value Summary box. County/Municipal Taxable Value SJRWMD/FIND Taxable Value School Taxable Value Assessed Value $2,117,102.00 Assessed Value $2,117,102.00 Assessed Value $2,117,102.00 ......... ..... ...... ........................................................................................................ ..................................................................................................... Homestead Exemption(HX) $25,000.00 Homestead Exemption(HX) ;$25,000.00 Homestead Exemption(HX) -$25,000.00 .................................. ......................... ..................................................................................................... Amend 1 Homestead(HB) $25,000.00 Amend 1 Homestead(HB) -$25,.000 .00 Taxable Value $2,092,102.00 ................................................... ......................... ............................................ .................... Taxable Value $2,067,102.00 Taxable Value $2,067,102.00 Sales History Book/PageSale Date Sale Price Deed Instrument Type Code QualifiedIUnqual�ed Vacant/Improved 07342-01105 5/27/1992 $625,000.00 QC Quit Claim Unqualified Improved Extra Features LN Feature-Code Feature Description Bldg. Length Width Total Units Value , 1 FPMR7 Fireplace Masonry 1 0 0 11.00 $2,700.00 Land&Legal Land Le al LN fade Use Description �Q.rllrig. Front Depth Category Land Units Land Value LN Legal Description ,. r. g.. 1 0140 RES OCEAN LD 3 7 UNITS PER AC ARS 2 100.00 200.00 Common 100.00 $1,710,000.00 1 6-116-2S 29E.571 2 ATLANTIC BEACH 3 LOT 3(EX PT RECD D BK 663- 343), 4 LOT 4 BLK 42, 5 LANDS LYING E THEREOF RECD 0/R 7342-1105 Buildings Building 1 Building 1 Site Address Element Code Detail 1163 BEACH AVE ,.. .. .. , Atlantic Beach FL 32233 Exterior Wall 14 14 Wood Shingle Roofing Structure 3 3 Gable or Hip J !fop., Building Type 0102 SFR 2 STORY SOH Roofing Cover 3 3 Asph/Comp Shingle a Year Built 1902 Interior Wall 5 5 Drywall h-1-1 E LE 9 Int Flooring 12 12 Hardwood a Type Gross Area Heated Area Heating Fuel 4 4 Electric '--� Finished Open Porch 1 165 0 Heating Type 4 4 Forced-Ducted rop Finished Open Porch 184 0 Air Conditioning 3 3 Central Finished Open Porch 184 0 Finished Open Porch 1 466 0 Element Code http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1702720000 4/30/2012 Property Appraiser- Property Details Page 2 of 2 Finished upper story 1 1613 1613 Stories 2.000 Base Area 1613 1613 Bedrooms 5.000 Finished Open Porch 54 0 Baths 2.500 Finished Open Porch 54 0 Rooms/Units 1.000 Finished Open Porch 291 0 Finished upper story 1 ( 170 170 Finished Open Porch 170 0 Finished End Porch 120 0 Finished Open Porch (250 0 Total 5134 3396 2011 Notice of Pro osed ProDeft Taxes rutin Millaae Notice Taxing District Assessed Value Exemptions Taxable Value Last Year Proposed Rolled back Gen Govt Beaches $2,055,439.00 $50,000.00 $2,005,439.00 $13,321.02 $13,525.88 $14,454.00 Public Schools:By State Law $2,055,439.00 $25,000.00 $2,030,439.00 $10,692.34 $10,771.48 $11,607.00 By Local Board $2,055,439.00 $25,000.00 $2,030,439.00 $4,996.16 $4,564.43 $5,423.51 FL Inland Navigation Dist. $2,055,439.00 $50,000.00 $2,005,439.00 $68.14 $69.19 $71.39 Atlantic Beach $2,055,439.00 $50,000.00 $2,005,439.00 $6,231.92 $6,675.10 $6,675.10 Water Mgmt Dist.SIRWMD $2,055,439.00 $50,000.00 $2,005,439.00 $821.23 $664.40 $904.25 Gen Gov Voted $2,055,439.00 $50,000.00 $2,005,439.00 $0.00 $0.00 $0.00 School Board Voted $2,055,439.00 $25,000.00 $2,030,439.00 $0.00 $0.00 $0.00 Urban Service Dist3 $2,055,439.00 $50,000.00 $2,005,439.00 $0.00 `$0.00 $0.00 Totals $36,130.81 $36,270.48 $39,135.25 Just Value Assessed Value Exemptions Taxable Value Last Year $2,864,366.00 $2,025,064.00 $50,000.00 $1,975,064.00 Current Year $2,215,470.00 $2,055,439.00 $50,000.00 $2,005,439.00 Property Record Card(PRC) The Property Appraiser's Office(PAO)provides historical property record cards(PRCs)online for 1995-2005.The PAO no longer maintains a certified PRC file due to changes in appraisal software;therefore,there are no PRCs available online from 2006 forward.You may print this page which provides the current property record.(Sections not needed can be minimized.)To rint the past-year cards below,set your browser's Page Set Up for printing to Landscape. 2MI2004I2QUI2QUI2001I2=IIMID33I1997IIMIIM More Information Parcel Tax Record I GIS Mao I Map this proper on Google Maps I City Fees Record http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1702720000 4/30/2012 Qa�jt l Rick Scott Florida Department of Governor Environmental Protection Jennifer Carroll *v Marjory Stoneman Douglas Building Lt. Governor 3900 Commonwealth Boulevard Tallahassee,Florida 32399-3000 Herschel T. Vinyard Jr. Secretary October 10, 2011 Charles and Susan Adams c/o Rebecca H. Mentz,Architect 4655 Apache Avenue Jacksonville,Florida 32210 FILEP_o P 4 ' � r Dear Ms.Mentz: Exemption Notice File Number: CNS—DU-194 EX Property Owner Name: Charles and Susan Adams Project Address: 1163 Beach Avenue,Atlantic Beach Location of Subject Property: Between approximately 4 f eet north and 96 feet south of DEP's reference monument R-48, in Duval County. This is in response to your letter received by the Department on September 22, 2011 requesting a determination that your proposed project for construction of improvements to a single-family residence at the above location is exempt from coastal construction control line permitting. The following information was submitted to the Department in support of this request: site plan, demolition and floor level plans,elevations and photographs. According to the documents prepared by Rebecca H. Mentz,Architect,the proposed work is to consist of construction of a two level addition in the location of a northside sunroom; rebuilding a landward porch as an enclosed addition; relocation of landward entry stairs; construction of new paved walks and driveway landward of the dwelling; and relocation of two HVAC condensers. Based upon my review of these documents, the proposed work constitutes new construction seaward of the coastal construction control line and as such is subject to its regulatory jurisdiction. However, due to the landward location and minimal disturbance associated with the proposed con , the project is not expected to cause a measurable interference with the natural functioning o a- system or cause adverse or other impacts. Subsequently, the Department has determine a sed work satisfies the exemption requirements of Section 161.053(11)(b), Florida Statutes, 62B-33.004, Florida Administrative Code. No coastal construction control line permit is requir Additional exterior lighting is not incorporated into this exemption. It is the responsibility of the applicant to ensure any local permits for lighting have been obtained. All windows and glass doors visible from any point on the beach must be tinted to a transmittance value (light transmission from inside to outside) of 45% or less through the use of tinted glass or window film. No other activities are authorized under this exemption. ri;vvvv.dep.stute,fl.us Rebecca H.Mentz,Architect October 10, 2011 Page Two This determination does not convey or create any property right, or any interest in real property. This determination does not authorize any trespass, entrance upon, or activities on property which is not owned or controlled by you, or convey any rights or privileges other than those specified in this determination and applicable rules and statutes. NOTICE OF RIGHTS This action is final and effective on the date filed with the Clerk of the Department unless a petition for an administrative hearing is timely filed under sections 120.569 and 120.57, Florida Statutes, before the deadline for filing a petition. On the filing of a timely and sufficient petition, this action will not be final and effective until further order of the Department. Because the administrative hearing process is designed to formulate final agency action, the hearing process may result in a modification of the agency action or even denial of the application. Petition for Administrative Hearing A person whose substantial interests are affected by the Department's action may petition for an administrative proceeding (hearing) under sections 120.569 and 120.57, Florida Statutes. Pursuant to rule 28-106.201, Florida Administrative Code, a petition for an administrative hearing must contain the following information: (a) The name and address of each agency affected and each agency's file or identification number, if known; (b) The name, address, and telephone number of the petitioner; the name, address, and telephone number of the petitioner's representative, if any, which shall be the address for service purposes during the course of the proceeding; and an explanation of how the petitioner's substantial interests are or will be affected by the agency determination; (c) A statement of when and how the petitioner received notice of the agency decision; (d) A statement of all disputed issues of material fact. If there are none, the petition must so indicate; (e) A concise statement of the ultimate facts alleged, including the specific facts that the petitioner contends warrant reversal or modification of the agency's proposed actio (f) A statement of the specific rules or statutes that the petitiontends require reversal or modification of the agency's proposed action, including an expl Vjow the alleged facts relate to the specific rules or statutes; and V,* (g) A statement of the relief sought by the petitioner, stating precisely the action petitioner wishes the agency to take with respect to the agency's proposed action. The petition must be filed (received by the Clerk) in the Office of General Counsel of the Department at 3900 Commonwealth Boulevard, Mail Station 35, Tallahassee, Florida 32399-3000. Rebecca H. Mentz,Architect October 10, 2011 Page Three Also, a copy of the petition shall be mailed to the applicant at the address indicated above at the time of filing. Time Period for Filing a Petition In accordance with rule 62-110.106(3), Florida Administrative Code, petitions for an administrative hearing by the applicant must be filed within 21 days of receipt of this written notice. Petitions filed by any persons other than the applicant, and other than those entitled to written notice under section 120.60(3), Florida Statutes, must be filed within 21 days of publication of the notice or within 21 days of receipt of the written notice, whichever occurs first. Under section 120.60(3), Florida Statutes, however, any person who has asked the Department for notice of agency action may file a petition within 21 days of receipt of such notice, regardless of the date of publication. The failure to file a petition within the appropriate time period shall constitute a waiver of that person's right to request an administrative determination (hearing) under sections 120.569 and 120.57, Florida Statutes, or to intervene in this proceeding and participate as a parry to it. Any subsequent intervention(in a proceeding initiated by another party)will be only at the discretion of the presiding officer upon the filing of a motion in compliance with rule 28-106.205, Florida Administrative Code. Extension of Time Under rule 62-110.106(4), Florida Administrative Code, a person whose substantial interests are affected by the Department's action may also request an extension of time to file a petition for an administrative hearing. The Department may, for good cause shown, grant the request for an extension of time. Requests for extension of time must be filed with the Office of General Counsel of the Department at 3900 Commonwealth Boulevard, Mail Station 35, Tallahassee, Florida 32399- 3000, before the applicable deadline for filing a petition for an administrative hearing. A timely request for extension of time shall toll the running of the time period for filing a petition until the request is acted upon. Mediation Mediation is not available in this proceeding. SC ,0 Judicial Review � �D Once this decision becomes final, any party to this action has the right to seek judicial review pursuant to section 120.68, Florida Statutes, by filing a Notice of Appeal pursuant to rules 9.110 and 9.190, Florida Rules of Appellate Procedure, with the Clerk of the Department in the Office of General Counsel, 3900 Commonwealth Boulevard, M.S. 35, Tallahassee, Florida 32399-3000; and by filing a copy of the Notice of Appeal accompanied by the applicable filing fees with the appropriate District Court of Appeal. The Notice of Appeal must be filed within 30 days from the date this action is filed with the Clerk of the Department. N1 U � 0 0 p C7 Zv- 4-+ ok a 12 U) p �i rn bA 09 °' a o ;, , o A vsv� w � v � c� � t� � oo � a � zc� � � xx � � ,� a � xv� ►� C,i C 1 M Vl �C [� 04 T O .-4 fV K1 1 # 7 . # . � � d . % § . � . 2 § g A t ■ . 2 % ■ q ƒ � - � � k ƒ § � 4-4 § o o k U W k / / 2 d 43 ° W Cl; kr; d - . 0 v d O �O w51k -Li . 00 b � -- a �. .� O -0 O O V 0 a a � o � � nn p 4 a O 00 z •� cli Ci 0 ; City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road jU Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax,(904)247-5845 E-mail: building-dept@coab.usDate routed:" City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �� d.Cl 1 De ent review required Yes No uildin Applicant: �i��,�i �4s— (.0, anning &Zoni i Tree Administrator Project: 0 I�A�1004_1e_ ublic Uti' Public Safety Fire Services ^tomU, 9a Ir 's ' ... ii a Ir1k �r w :..I b. ' Other Agency Review or Permit Required Review or ReceiptDate of Permit Verified B Florida Dept. of Environmental Protection Florida Dept. of Transportation St.Johns River Water Management District Army Corps of Engineers —el, Division of Hotels and Restaurants ` Division of Alcoholic Beverages and Tobacco Other: j APPLICATION STATUS 19ec Reviewing Department First Review: ER pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: .S'30'l 2— TREE TREE ADMIN. Second Review: []Approved as revised. ❑Denie . PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: '.pate: FIRE SERVICES Third Review: []Approved as revised. []Denied. xz=:-j �'44' 7 Comments: Reviewed by: Date: Revised 05/14/09 CITY OF ATLANTIC BEACH Building Department r 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 PLAN REVIEW COMMENTS Permit Application # /-'� - V?0 Property Address: //6E'Chi ✓ . Applicant: Ul© r �a Project: ✓ iC �'' d ,� �� This permit application has been: ED Approved Reviewed and the following items need attention: LIP 6) 34Pt`-Aj) PA. Please re-submit your application when these items have been completed. Reviewed By: _ Date: S 21 City of Atlantic Beach k APPLICATION NUMBER ding Department (To be assigned by the Building Department.) r 800 Seminole Road qp� i j Z. Atlantic Beach, Florida 32233-5445 s Phone(904)247-5826 - Fax(904)247-58 14' �t � E-mail: building-dept@coab.us Date routed: 41-26-1-2- City web-site: http://www.coab.us \ `ti\ APPLICATION REVIEW AND TRACKING FORM Property Address: Bnot L,� >/i'` - De ent review required Yes No ,may uildin Applicant: �i�� t�/I�-f, oo anning &Zoni ,►� / �^ Tree Administrator Project: ublic Uti ' Public Safety Fire Services Resew fee,.$. Dept Signature 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. XDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: l� TREE ADMIN. Second Review: JApproved as revised. ❑Denied.PUBLIC WORKS Comments: PUBLIC UTILITIES (/ slid PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 S ' City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 /2- _ � 0 Phone(904)247-5826 - Fax(904)247-5845 / .r s E-mail: building-dept@coab.us L_.Date routed: '�f 6 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z&3 13 4 e� Dg4fPVent review required Yes No ,.y� uildin Applicant: �ie ,� 62111--7 C�.Or anning &Zoni , / Tree Administrator Project: �7`ZQt eytc ub11C_U_tWtiee ' Public Safety Fire Services view- $ Dept Signature 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 ANNING &ZONIN Reviewed by: 0044, /L,"ate: TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES w� PUBLIC SAFETY Reviewed by: Date. FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 rim City of Atlantic Beach APPLICATION NUMBER Building Department � (To be assigned by the Building Department.) s5 800 Seminole Road ' r Atlantic Beach, Florida 32233-5445 APR 272012 Phone(904)247-5826 • Fax(904) Z-5845 Z f E-mail: building-dept@coab.us Y _ Date routed: City web-site: http://www.coab.us '=` APPLICATION REVIEW AND TRACKING FORM Property Address: 3 % d L� De ent review required Yes No uildin Applicant: i�� ( �/7 �= �7, anning &Zoni Tree Administrator Project: � � a ubIic qWliee Public Safety Fire Services Revrlew fee$ DeptSignatpre t 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: PApproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: roved as revised. ❑App ❑Denied. APUBCComments: I 2" Reviewed by: 91 Fire FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. 40 Comments: Reviewed by: Date: Revised 05/14/09 V10 1 , NVId 311S 3(1N3AV H,JV39 z 0 I - -- 100.001 ' , H -— 1s3no (3NII NolaonuISNoo"IV voo) r � 3WVad l p O 03AOW3H 3AI90 Aa1N313AVUS 39 Ol SH3AVd NOIHS JN.IISIX3 d0 3NIl (3NV 3131JON00 d0 3NI1 -7 -- )IHVd Hdo aNV 3AIaa ' AH1N3 313HONOO M3N '� � -r ------" ' HIVISAH1N3000MM3N c i ' a3Aow3H 39Ol Hrols (.0,os ESZ) AH1N3.a00M JNIlSIX3 i i 30VdS a3NO1110N00 A `' !. 03SOlON3 SV {��{i tai r� i c 1s• 1. 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TO BE UPDATED Application valuation . . . . 23000 ---------------------------------------------------------------------------- Application desc 2nd story addition and remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ADAMS CHARLES P WORSHAM CONSTRUCTION CO INC 1163 BEACH AVE 2329 URBAN RD ATLANTIC BEACH FL 322335727 JACKSONVILLE FL 32210 (904) 545-2357 --- Structure Information 000 000 ADDITION REMODEL Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ADDITION Additional desc . . Permit Fee . . . . 165 . 00 Plan Check Fee 82 . 50 Issue Date . . . . Valuation . . . . 23000 Expiration Date . . 12/01/12 ---------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of work. ---------------------------------------------------------------------------- Other Fees STATE FVDCA �7SURCHARGE Fpm r,n2 .48 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL C14) ATR)W, BEjCHP�'A�C CN61'HE FLORIDA 00 BUILDING CODES. CITY OF ATLANTIC BEACH 111 j 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Page 2 Application Number . . . . . 12-00000490 Date 6/04/12 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ENG REV PRE APP > 3 HRS 25 . 00 STATE DBPR SURCHARGE 2 . 48 UTIL REV PRE APP >3 HRS 25 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 165 . 00 165 . 00 . 00 . 00 Plan Check Total 82 . 50 82 . 50 . 00 . 00 Other Fee Total 104 . 96 104 . 96 . 00 . 00 Grand Total 352 .46 352 . 46 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: llll3 cf&PYA6Permit Number: f7-#qo_ Legal Description X O>,$ _-3 i 2,�A'7-LA_rre_i:e.k-Parcel# Floor Area o q. t. Sq.Ft Valuation of Work$ t Proposed Work heated/cooled non-heated/cooled ys Class of Work(circle one): Ne Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structures)(circle one): Commercial Residential-3 If an existing structure,is a fire sprinkler system installed? (Circle one): o N /A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: Aje QN.S p9W0 417D iT',v/-J Z;kCSa-',� Property Owner Inforrmation: Name: L !". Address: �fi ^ City 47'An1-r1G State _ ip 3ZZ33 Phone E-Mail or Fax#(Optional) fjnnV Contractor Information: Company Name: DK t4✓k C�.y�T/Dn��C� Qualifying Agent: ...: . ,...,•. � 4 .:,,,., Address: ZUQ j/,e.8Aj 2.e,4 t> City J State ick Zip z Office Phone 26f- �4_S%Z 357 Job Site/Contact Number�i¢ -,S4,s=z3 s'7 —Fax-# State Certification/Registration# t✓,6 G ©/ f"®dA Z Architect Name& Phone# �� ,rk ,t,( �y{ ,�7'Z 9y - Z 9 O77-? Engineer's Name& Phone# {y� � Fee Simple Title Holder Name and Address ly Bonding Company Name and Address 'VIA Mortgage Lender Name and Address N Application is hereby made 00'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 tt:t!! and void if wot k is not commenced within six(6)months, or if construction or work is suspended or abandoned for apertod of six6)months at at?v time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, urnaces, Boilers, Healers, Tanks and Air Conditioners,et_ WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether speci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state or local law regulating construction or the performance ofconstruction. Signature of Owner Signature of Contract Print Name C.kce.c e 5... ?I A 4c-hPrint Name -S (1. C64 .......................,............................................. I`��.. . -�..�.... �.... .?e . Sworn 14and subse 'bed before me Sworn to and subscripped before me this 30 Day of kl 20 1 Z this Day ofd( __ 2012 rP,,,', _11 Notary Public ,� Notary Public-State of Florida N16tary Public { , LORAINE My Commission Expires Jun 26,2012 Npta P is S Commission# DD 780057 evt�j ;?[ 13]7 '"""� My comm.expires ISO NOT E BELOW - o�FICL Usk ONLY �p cable Codes: 2007 F orida.Buil ing o e 2009 Revisions evzew result (circle ane pp roved Disapproved Approved w/ Conditions eview Initials/Date: Scam-1 22 )evelopment Size (abitable Space y sZ 5.F; Non-Habitable -pervious area �adonJD CA/DBPR$ di-scellaneous Infokmation. )ccupancy Group Res" yge of Construction:' Number of Stories 2- 71oning DistLict : vlax, Occupancy Road Fire Sprin-iders required Flood Zone Conditions/Comments: r Property Appraiser - Property Details Page 1 of 2 ADAMS CHARLES P Primary Site Address Official Record Book/Page Tile# 1163 BEACH AVE 1163 BEACH AVE 07342-01105 9416 ATLANTIC BEACH, FL 32233-5727 Atlantic Beach FL 32233 ADAMS SUSAN CORSE 1163 BEACH AVE roperoperty Detail Value Summary RE# 170272-0000 2011 Certified 2012 In P= Tax District USD3 Value Meth CA ProRgL#y Use 0100 SINGLE FAMILY Total Building Val $502,675.00 75,149.00 #of Buildings 2 Extra Feature Value $2,700.00 6-1 16-2S-29E.571 Land Value(Market) $1,710,000.00 $1,710,000.00 Legal Desc. ATLANTIC BEACH Land Value((Agric.) $0.00 $0.00 Subdivision 03108 ATLANTIC BEACH Just(Market)Value $2,215,470.00 $2,187,849.00 The sale of this property may result in higher property taxes.For more information go Assessed Value $2,055,439.00 $2,117,102.00 to Save Our Homes and our Property Tax Estimator.Property values,exemptions and Cap Diff/Portability Amt $160,031.00/$0.00 $70,747.00/$0.00 other information listed as'In Progress'are subject to change.These numbers are part of the 2012 working tax roll and will not be certified until October.Learn how the Exemptions $50,000.00 See below Property Appraiser's Office values property, Taxable Value $2,005,439.00 See below Taxable Values and Exemptions—In Progress If there are no exemptions applicable to a taxing authority,the Taxable Value is the same as the Assessed Value listed above in the Value Summary box. County/Municipal Taxable Value SJRWMD/FIND Taxable Value School Taxable Value Assessed Value $2,117,102.00 Assessed Value $2,117,102.00 Assessed Value $2,117,102.00 .......... ........................................................................................................ ..................................................................................................... Homestead Exemption(HX) :$25,000.00 Homestead Exemption(HX) $25,000.00 Homestead Exemption(HX) -$25,000.00 .................................. ......................... .................................... ...................... ..................................................................................................... Amend 1 Homestead(HB) $25,000.00 Amend 1 Homestead(HB) $25,000.00 Taxable Value $2,092,102.00 Taxable Value $2,067,102.00 Taxable Value $2,067,102.00 r Sales History Book/Page Sale Date Sale Price Deed Instrument Type Code Qualified/Ungualifled Vacant/Improved M . . ,...,.. . ,. ,., . ...... 07342 01105 5/27/1992 $625,000.00 QC-Quit Claim Unqualified Improved Extra Features LN Feature_..C.ods. Feature Description Bldg. Length lWidt'h-l" TotalUnitsa.. ,.. .,. . ."'rt," , � . . Ne . M, ,., .,, 1 FPMR7 Fireplace Masonry 1 0 0 1.00 $2,700.00 Land&Legal Land Le al _ LN CodeJUseDescription Zo.11.i.og Front Depth Category Land Units Land ValueLN16-1 Legal Description s, ,..�,1 0140RES OCEAN LD 3-7 UNITS PER AC ARS-2 100.00 200.00 Common 100.00 $1,710,000.00 1 16-2S-29E.571 2 ATLANTIC BEACH 3 LOT 3(EX PT RECD D BK 663- 343), 4 LOT 4 BLK 42, 5 LANDS LYING E THEREOF RECD 6 0/117342-1105 Buildings Building 1 Building 1 Site Address Element Code Detail T.T—`7- 1163 BEACH AVE Fop rJ-.L-AP " Atlantic Beach FL 32233 Exterior Wall 14 14 Wood Shingle „ Roofing Structure 3 3 Gable or Hip �foP Building Type 0102 SFR 2 STORY SOH Roofing Cover 3 3 Asph/Comp Shingle u r Year Built 1902 Interior Wall 5 5 Drywall FOP 1 E� 8 Fun, L: Int Flooring 12 12 Hardwood L- A „ s „ Type Gross Area Heated Area Heating Fuel 4 4 Electric �-- Finished Open Porch 1165 0 Heating Type 4 4 Forced-Ducted Fo Finished Open Porch 184 0 Air Conditioning 3 3 Central Finished Open Porch 184 0 Finished Open Porch 1466 0 ElementCode I t --- http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1702720000 4/30/2012 Property Appraiser- Property Details Page 2 of 2 Finished upper story 1 1613 1613 Stories 12.000 Base Area 1613 1613 Bedrooms 5.000 Finished Open Porch 54 0 Baths 2.500 Finished Open Porch 54 0 Rooms/Units 1.000 Finished Open Porch 291 0 Finished upper story 1 1170 170 Finished Open Porch 170 0 Finished End Porch 120 0 Finished Open Porch (250 0 Total 5134 3396 2011 Notice of Proposed ProDertv Taxes rutin Milla a Notice Taxing District Assessed Value Exemptions Taxable Value Last Year Proposed Rolled-back Gen Govt Beaches $2,055,439.00 $50,000.00 $2,005,439.00 $13,321.02 $13,525.88 $14,454.00 Public Schools:By State Law $2,055,439.00 $25,000.00 $2,030,439.00 $10,692.34 $10,771.48 $11,607.00 By Local Board $2,055,439.00 $25,000.00 $2,030,439.00 $4,996.16 $4,564.43 $5,423.51 FL Inland Navigation Dist. $2,055,439.00 $50,000.00 $2,005,439.00 $68.14 $69.19 $71.39 Atlantic Beach $2,055,439.00 $50,000.00 $2,005,439.00 $6,231.92 $6,675.10 $6,675.10 Water Mgmt Dist.SJRWMD $2,055,439.00 $50,000.00 $2,005,439.00 $821.23 $664.40 $904.25 Gen Gov Voted $2,055,439.00 $50,000.00 $2,005,439.00 $0.00 $0.00 $0.00 School Board Voted $2,055,439.00 $25,000.00 $2,030,439.00 $0.00 $0.00 $0.00 Urban Service Dist3 $2,055,439.00 $50,000.00 $2,005,439.00 $0.00 $0.00 $0.00 Totals $36,130.81 $36,270.48 $39,135.25 Just Value Assessed Value Exemptions Taxable Value Last Year $2,864,366.00 $2,025,064.00 $50,000.00 $1,975,064.00 Current Year $2,215,470.00 $2,055,439.00 $50,000.00 $2,005,439.00 Property Record Card(PRC) The Property Appraiser's Office(PAO)provides historical property record cards(PRCs)online for 1995-2005.The PAO no longer maintains a certified PRC file due to changes in appraisal software;therefore,there are no PRCs available online from 2006 forward.You may print this page which provides the current property record.(Sections not needed can be minimized.)To print the past-year cards below,set your browser's Page Set Up for printing to Landscape. M5I2Ml2Ml2QUlKUI2MI nUIn9aIB37 nKlIM More Information Parcel Tax Record I GIS Mao I Mao this property on Google Malls I City Fees Record http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1702720000 4/30/2012 Florida Department of Rick Scott Gover7ior Environmental Protection Jennifer Carroll Marjory Stoneman Douglas Building Lt. Governor b 3900 Commonwealth Boulevard VMSTallahassee,Florida 32399-3000 Herschel T. Vinyard Jr. _ _ Secretary October 10, 2011 Charles and Susan Adams c/o Rebecca H. Mentz,Architect 4655 Apache Avenue71v Jacksonville,Florida 32210 COPY ze Dear Ms. Mentz: L I Laaw Exemption Notice File Number: CNS—DU-194 EX Property Owner Name: Charles and Susan Adams Project Address: 1163 Beach Avenue,Atlantic Beach Location of Subject Property: Between approximately 4 f eet north and 96 feet south of DEP's reference monument R-48, in Duval County. This is in response to your letter received by the Department on September 22, 2011 requesting a determination that your proposed project for construction of improvements to a single-family residence at the above location is exempt from coastal construction control line permitting. The following information was submitted to the Department in support of this request: site plan, demolition and floor level plans,elevations and photographs. According to the documents prepared by Rebecca H. Mentz,Architect,the proposed work is to consist of: construction of a two level addition in the location of a northside sunroom; rebuilding a landward porch as an enclosed addition;relocation of landward entry stairs; construction of new paved walks and driveway landward of the dwelling; and relocation of two HVAC condensers. Based upon my review of these documents, the proposed work constitutes new construction seaward of the coastal construction control line and as such is subject to its regulatory jurisdiction. However, due to the landward location and minimal disturbance associated with the proposed construction, the project is not expected to cause a measurable interference with the natural functioning of tl:c coastal system or cause adverse or other impacts. Subsequently, the Department has determined that the proposed work satisfies the exemption requirements of Section 161.053(11)(b), Florida Statutes, and Section 6213-33.004,Florida Administrative Code. No coastal construction control line permit is required. Additional exterior lighting is not incorporated into this exemption. It is the responsibility of the applicant to ensure any local permits for lighting have been obtained. All windows and glass doors visible from any point on the beach must be tinted to a transmittance value (light transmission from inside to outside) of 45% or less through the use of tinted glass or window film. No other activities are authorized under this exemption. wvviv.clop.stwe,fl.us Rebecca H.Mentz,Architect October 10, 2011 Page Two This determination does not convey or create any property right, or any interest in real property. This determination does not authorize any trespass, entrance upon, or activities on property which is not owned or controlled by you, or convey any rights or privileges other than those specified in this determination and applicable rules and statutes. NOTICE OF RIGHTS This action is final and effective on the date filed with the Clerk of the Department unless a petition for an administrative hearing is timely filed under sections 120.569 and 120.57, Florida Statutes, before the deadline for filing a petition. On the filing of a timely and sufficient petition, this action will not be final and effective until further order of the Department. Because the administrative hearing process is designed to formulate final agency action, the hearing process may result in a modification of the agency action or even denial of the application. Petition for Administrative Hearin A person whose substantial interests are affected by the Department's action may petition for an administrative proceeding (hearing) under sections 120.569 and 120.57, Florida Statutes. Pursuant to rule 28-106.201, Florida Administrative Code, a petition for an administrative hearing must contain the following information: (a) The name and address of each agency affected and each agency's file or identification number, if known; (b) The name, address, and telephone number of the petitioner; the name, address, and telephone number of the petitioner's representative, if any, which shall be the address for service purposes during the course of the proceeding; and an explanation of how the petitioner's substantial interests are or will be affected by the agency determination; (c) A statement of when and how the petitioner received notice of the agency decision; (d) A statement of all disputed issues of material fact. If there are none, the petition must so indicate; (e) A concise statement of the ultimate facts alleged, including the specific facts that the petitioner contends warrant reversal or modification of the agency's proposed action; (f) A statement of the specific rules or statutes that the petitioner contends require reversal or modification of the agency's proposed action, including an explanation of how the alleged facts relate to the specific rules or statutes; and (g) A statement of the relief sought by the petitioner, stating precisely the action that the petitioner wishes the agency to take with respect to the agency's proposed action. The petition must be filed (received by the Clerk) in the Office of General Counsel of the Department at 3900 Commonwealth Boulevard, Mail Station 35, Tallahassee, Florida 32399-3000. Rebecca H.Mentz,Architect October 10, 2011 Page Three Also, a copy of the petition shall be mailed to the applicant at the address indicated above at the time of filing. Time Period for Filing;a Petition In accordance with rule 62-110.106(3), Florida Administrative Code, petitions for an administrative hearing by the applicant must be filed within 21 days of receipt of this written notice. Petitions filed by any persons other than the applicant, and other than those entitled to written notice under section 120.60(3), Florida Statutes, must be filed within 21 days of publication of the notice or within 21 days of receipt of the written notice, whichever occurs first. Under section 120.60(3), Florida Statutes, however, any person who has asked the Department for notice of agency action may file a petition within 21 days of receipt of such notice, regardless of the date of publication. The failure to file a petition within the appropriate time period shall constitute a waiver of that person's right to request an administrative determination (hearing) under sections 120.569 and 120.57, Florida Statutes, or to intervene in this proceeding and participate as a party to it. Any subsequent intervention (in a proceeding initiated by another party)will be only at the discretion of the presiding officer upon the filing of a motion in compliance with rule 28-106.205, Florida Administrative Code. Extension of Time Under rule 62-110.106(4), Florida Administrative Code, a person whose substantial interests are affected by the Department's action may also request an extension of time to file a petition for an administrative hearing. The Department may, for good cause shown, grant the request for an extension of time. Requests for extension of time must be filed with the Office of General Counsel of the Department at 3900 Commonwealth Boulevard, Mail Station 35, Tallahassee, Florida 32399- 3000, before the applicable deadline for filing a petition for an administrative hearing. A timely request for extension of time shall toll the running of the time period for filing a petition until the request is acted upon. Mediation Mediation is not available in this proceeding. Judicial Review Once this decision becomes final, any party to this action has the right to seek judicial review pursuant to section 120.68, Florida Statutes, by filing a Notice of Appeal pursuant to rules 9.110 and 9.190, Florida Rules of Appellate Procedure, with the Clerk of the Department in the Office of General Counsel, 3900 Commonwealth Boulevard, M.S. 35, Tallahassee, Florida 32399-3000; and by filing a copy of the Notice of Appeal accompanied by the applicable filing fees with the appropriate District Court of Appeal. The Notice of Appeal must be filed within 30 days from the date this action is filed with the Clerk of the Department. Rebecca H.Mentz,Architect October 10, 2011 Page Four This determination does not relieve you from your responsibility to comply with the permitting requirements of any other local, state, or federal regulatory agency which has jurisdiction over the proposed activity. The exempted work is strictly limited to that described above. If you have any questions, concerns, or need additional information, please contact Valerie Jones by mail at the letterhead address (add Mail Station 300), or by telephone at 850/921-7849, or by e-mail at valerie.j onesgdep.state.fl.us. Sincerely, Fritz ettstein,Environmental Manager Bure of Beaches and Coastal Systems FW/dw Enclosures cc: Trey Hatch, Field Inspector City of Atlantic Beach,Building Official 9 FORM 1100A-08 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Performance Method A Project Name: Adams Addition and Renovation Builder Name: Street: 1163 Beach Ave Permit Office: Atlantic Beach City, State, Zip: Atlantic Beach , FL , Permit Number: Owner: Jurisdiction: 261100 Design Location: FL, Jacksonville 1. New construction or existing New (From Plans) 9. Wall Types(953.1 sqft.) Insulation Area 2. Single family or multiple family Single-family a. Frame-Wood, Exterior R=19.0 953.14 ft2 b. N/A R= ft2 3. Number of units, if multiple family 1 c. N/A R= ft2 4. Number of Bedrooms 0 d. N/A R= ft2 5. Is this a worst case? No 10. Ceiling Types (385.0 sgft.) Insulation Area 6. Conditioned floor area(ft2) 473 a. Under Attic (Vented) R=30.0 385.00 ft2 b. N/A R= ft2 7. Windows(49.7 sgft.) Description Area c. N/A R= ft2 a. U-Factor: Dbl, default Adjusted 49.65 ft2 SHGC: Clear, default 11. Ducts (combined) b. U-Factor: le ft2 a. Sup:Attic Ret:Attic AH:Attic Sup.R=6,61.88 ft2 SHGC: 12. Cooling systems(combined) c. U-Factor: N/A ft2 a. Central Unit Existing Cap: 90.0 kBtu/hr SHGC: SEER: 13 d. U-Factor: N/A ft2 13. Heating systems(combined) SHGC: a. Electric Heat Pump Cap: 90.0 kBtu/hr e. U-Factor: N/A ft2 Existing HSPF: 7.7 SHGC: 14. Hot water systems 8. Floor Types (385.0 sgft.) Insulation Area a. Propane Cap: 1 gallons a. Crawlspace R=19.0 385.00 ft2 EF: 0.75 b. N/A R= f12 b. Conservation features c. N/A R= ft2 None 15. Credits None Glass/Floor Area: 0.105 Total As-Built Modified Loads: 14.59 PASS Total Baseline Loads: 19.54 1 hereby certify that the plans and specifications covered by Review of the plans and *"THS Sr,� this calculation are in compliance with the Florida Energy specifications covered by this + Code. calculation indicates compliance �-- with the Florida Energy Code. PREPARED BY: �= 5 Before construction is completed DATE: _ -�712 _._. _ this building will be inspected for compliance with Section 553.908 t S Florida Statutes. w I hereby certify that this building, as designed, is incompliance � 5 with the Florida Energy Code. dt) OWNER/AGENT: BUILDINGOFFICU�44L: DATE: ------------ DATE: 1/•`519�lL FILE COPY W j4 2/27/2012 2:09 PM EnergyGauge® USA- FlaRes2008 Page 1 of 5 k PROJECT Title: Adams Addition and Renovati Bedrooms: 0 Adress Type: Street Address Building Type: FLAsBuilt Conditioned Area: 473 Lot# Owner: Total Stories: 2 Block/SubDivision: #of Units: 1 Worst Case: No PlatBook: Builder Name: Rotate Angle: 0 Street: 1163 Beach Ave Permit Office: Atlantic Beach Cross Ventilation: County: Duval Jurisdiction: 261100 Whole House Fan: City, State, Zip: Atlantic Beach , Family Type: Single-family FL, New/Existing: New (From Plans) Comment: CLIMATE V/ IECC Design Temp Int Design Temp Heating Design Daily Temp Design Location TMY Site Zone 97.5% 2.5% Winter Summer Degree Days Moisture Range FL, Jacksonville FL—JACKSONVILLE—INT 2 32 93 75 70 1281 49 Medium FLOORS # Floor Type Exposed Perimeter Wall Ins. R-Value Area Floor Joist R-Value Tile Wood Carpet 1 Crawlspace 75.3 ft 0 385 ft2 19 0 0 1 ROOF / Roof Gable Roof Solar Deck V # Type Materials Area Area Color Absor. Tested Insul. Pitch 1 Hip Metal 406 ft2 0 f12 Medium 0.96 No 0 18.4 deg ATTIC V # Type Ventilation Vent Ratio(1 in) Area RBS IRCC 1 Full attic Vented 300 385 ft2 N N CEILING # Ceiling Type R-Value Area Framing Frac Truss Type 1 Under Attic (Vented) 30 385 ft2 0.11 Wood WALLS Cavity Sheathing Framing Solar �# Ornt _ Adjacent To Wall Type _ R-Value Area R-Value Fraction Absor. 1 N Exterior Frame-Wood 19 262.6000 0.23 0.75 2 W Exterior Frame-Wood 19 356.5299 0.23 0.75 3 S Exterior Frame-Wood 19 141.4000 0.23 0.75 4 N Exterior Frame-Wood 19 103 ft2 0.23 0.75 5 W Exterior Frame-Wood 19 89.61000 0.23 0.75 2/27/2012 2:09 PM EnergyGauge D USA- FlaRes2008 Page 2 of 5 R DOORS # Ornt Door Type Storms U-Value Area 1 W Wood None 0.460000 10.5 ftZ WINDOWS Orientation shown is the entered, asBuilt orientation. Overhang # Ornt Frame Panes NFRC U-Factor SHGC Storms Area Depth Separation Int Shade Screening 1 N Metal Double (Clear) No 0.87 0.66 N 12.15000 1.7 ft 0 in 2 ft 0 in HERS 2006 None 2 W Metal Double (Clear) No 0.87 0.66 N 12.5 ft' 1.7 ft 0 in 2 ft 0 in HERS 2006 None 3 N Metal Double (Clear) No 0.87 0.66 N 12.5 ft' 1.7 ft 0 in 2 ft 0 in HERS 2006 None 4 W Metal Double (Clear) No 0.87 0.66 N 12.5 ft' 1.7 ft 0 in 2 ft 0 in HERS 2006 None INFILTRATION&VENTING ---- Forced Ventilation ---- Run Time Fan Method SLA CFM 50 ACH 50 ELA EgLA Supply CFM Exhaust CFM Fraction Watts Default 0.00036 447 5.67 24.5 46.1 0 cfm 0 cfm 0 0 COOLING SYSTEM # System Type Subtype Efficiency Capacity Air Flow SHR Ducts 1 Central Unit None SEER: 13 42 kBtu/hr 1260 cfm 0.75 sys#0 2 Central Unit None SEER: 13 48 kBtu/hr 1440 cfm 0.75 sys#0 HEATING SYSTEM # System Type Subtype Efficiency Capacity Ducts 1 Electric Heat Pump None HSPF: 7.7 42 kBtu/hr sys#0 2 Electric Heat Pump None HSPF: 7.7 48 kBtu/hr sys#0 HOT WATER SYSTEM # System Type EF Cap Use SetPnt Conservation 1 Propane 0.75 1 gal 30 gal 120 deg None SOLAR HOT WATER SYSTEM FSEC Collector Storage Cert # Company Name System Model# Collector Model # Area Volume FEF None None ftZ DUCTS ----Supply---- ----Return---- Air Percent V/ # Location R-Value Area Location Area Leakage Type Handler CFM 25 Leakage QN RLF 1 Attic 6 50.05 ft Attic 19.25 ft Default Leakage Interior (Default) (Default) % 2 Attic 6 11.83 ft Attic 4.55 ftZ Default Leakage Attic (Default) (Default) % 2/27/2012 2:09 PM EnergyGauge® USA- FlaRes2008 Page 3 of 5 TEMPERATURES Programable Thermostat:None Ceiling Fans: Coolin [[XX]] Jan Feb [[X]] Mar [[X]]A r [[X]] Ma [[X]]Jun IXX Jul [[X]]Aug [[X]] Sep r]Oct IXXI XNov Dec Heating [X] Jan IXXI Feb [X] Mar [X]Apr [X] May (X]Jun �Jul [X]Aug [X] SeP ]Oct Nov Dec Ventin [X Jan X Feb [X Mar [X Apr [X May [X Jun X Jul [X Au [X Se Oct Nov 1XI Dec Thermostat Schedule: HERS 2006 Reference Hours Schedule Type 1 2 3 4 5 6 7 8 9 10 11 12 Cooling (WD) AM 78 78 78 78 78 78 78 78 78 78 78 78 PM 78 78 78 78 78 78 78 78 78 78 78 78 Cooling (WEH) AM 78 78 78 78 78 78 78 78 78 78 78 78 PM 78 78 78 78 78 78 78 78 78 78 78 78 Heating (WD) AM 68 68 68 68 68 68 68 68 68 68 68 68 PM 68 68 68 68 68 68 68 68 68 68 68 68 Heating (WEH) AM 68 68 68 68 68 68 68 68 68 68 68 68 PM 68 68 68 68 68 68 68 68 68 68 68 68 2/27/2012 2:09 PM EnergyGauge® USA- FlaRes2008 Page 4 of 5 FORM 1100A-08 Code Compliance Checklist Residential Whole Building Performance Method A - Details ADDRESS: 1163 Beach Ave PERMIT#: Atlantic Beach,FL, INFILTRATION REDUCTION COMPLIANCE CHECKLIST COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHE K Exterior Windows&Doors N1106.AB.1.1 Maximum:.3 cfm/sq.ft.window area;.5 cfm/s .ft.door area. Exterior&Adjacent Walls N1106.AB.1.2 Caulk,gasket,weatherstrip or seal between:windows/doors& frames,surrounding wall;foundation&wall sole or sill plate;joints between exterior wall panels at corners; utility penetrations; between wall panels&top/bottom plates; between walls and floor. EXCEPTION: Frame walls where a continuous infiltration barrier is installed that extends from, and is sealed to,the foundation to the V _ to��late. Floors N1106.AB.1.2 Penetrations/openings>1/8"sealed unless backed by truss or joint members. / EXCEPTION: Frame floors where a continuous infiltration barrier ✓/ is installed that is sealed to the perimeter, penetrations and seams. Ceilings N1106.AB.1.2 Between walls&ceilings; penetrations of ceiling plane to top floor; around shafts,chases,soffits, chimneys,cabinets sealed to continuous air barrier; gaps in gyp board&top plate;attic access. EXCEPTION: Frame ceilings where a continuous infiltration barrier / is installed that is sealed at the perimeter, at penetrations and J -- seams_------ --- Recessed Lighting Fixtures N1106.AB.1.2 Type IC rated with no penetrations, sealed; or Type IC or non-IC rated, installed inside a sealed box with 1/2"clearance&3"from / insulation;or Type IC with<2.0 cfm from conditioned space, — tested. — - — - Multi-story Houses N1106.AB.1.2 Air barrier on perimeter of floor cavity between floors. Additional Infiltration reqts N1106.AB.1.3 Exhaust fans vented to outdoors,dampers;combustion space / heaters comply with NFPA, have combustion air. OTHER PRESCRIPTIVE MEASURES(must be met or exceeded by all residences.) COMPONENTS SECTION REQUIREMENTS CHECK Water Heaters N1112.AB.3 Comply with efficiency requirements in Table N1112.ABC.3 Switch or clearly marked circuit breaker(electric)or cutoff(gas) _ must be provided. External or built-in heat trap required. Swimming Pools&Spas N1112.AB.2.3 Spas&heated pools must have covers(except solar heated). Non-commercial pools must have a pump timer.Gas spa&pool heaters must have a minimum thermal efficiency of 78%. Heat pump pool heaters shall have a minimum COP of 4.0. Shower heads N1112.AB.2.4 Water flow must be restricted to no more than 2.5 gallons per minute at 80PSIG. Air Distribution Systems N1110.AB All ducts,fittings, mechanical equipment and plenum chambers shall be mechanically attached,sealed, insulated and installed in / accordance with the criteria of Section N1110.AB. ✓ Ducts in unconditioned attics: R-6 min. insulation. HVAC Controls N1107.AB.2 Separate readily accessible manual or automatic thermostat for each system. Insulation N1104.AB.1 Ceilings-Min. R-19.Common walls-frame R-11 or CBS R-3 both N1102.B.1.1 sides.Common ceiling&floors R-11. 2/27/2012 2:09 PM EnergyGauge® USA- RaRes2008 Page 5 of 5 ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE INDEX* = 75 The lower the EnergyPerformance Index, the more efficient the home. 1163 Beach Ave, Atlantic Beach, FL, 1. New construction or existing New(From Plans) 9. Wall Types Insulation Area 2. Single family or multiple family Single-family a.Frame-Wood,Exterior R=19.0 953.14 ft2 b.N/A R= ft2 3. Number of units,if multiple family 1 c.N/A R= ft2 4. Number of Bedrooms 0 d.N/A R= ft2 5. Is this a worst case? No 10.Ceiling Types Insulation Area 6. Conditioned floor area(ft2) 473 a.Under Attic(Vented) R=30.0 385.00 ft2 b.N/A R= ft2 7. Windows— Description Area c.N/A R= ft2 a. U-Factor: Dbl,default Adjusted 49.65 ft2 SHGC: Clear,default 11.Ducts (combined) b. U-Factor: ft2 a. Sup:Attic Ret:Attic AH:Attic Sup.R=6,61.88 ft2 SHGC: 12.Cooling systems (combined) c. U-Factor: N/A ft2 a.Central Unit Existing Cap:90.0 kBtu/hr SHGC: SEER:13 d. U-Factor: N/A ft2 13.Heating systems (combined) SHGC: a.Electric Heat PumpCap:90.0 kBtu/hr e. U-Factor: N/A ft2 Existing HSPF:7.7 SHGC: 14.Hot water systems 8. Floor Types Insulation Area a.Propane Cap:1 gallons a.Crawlspace R=19.0 385.00 ft2 EF:0.75 b.N/A R= ft2 b. Conservation features c.N/A R= ft2 None 15.Credits None I certify that this home has complied with the Florida Energy Efficiency Code for Building 111E Sr4� Construction through the above energy saving features which will be installed (or exceeded) O lfl in this home before final inspection. Otherwise, a new EPL Display Card will be completed ',,,`'` ^ a based on installed Code compliant features. Builder Signature: Date: i Address of New Home: City/FL Zip: , *Note: The home's estimated Energy Performance Index is only available through the EnergyGauge USA- FlaRes2008 computer program. This is not a Building Energy Rating. If your Index is below 100, your home may qualify for incentives if you obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at (321)638-1492 or see the Energy Gauge web site at energygauge.com for information and a list of certified Raters. For information about Florida's Energy Efficiency Code for Building Construction, contact the **Label required by Section 13-104.4.5 of the Florida Building Code, Building, or Section B2.1.1 of Appendix G of the Florida Building Code, Residential, if not DEFAULT. EnergyGauge®USA-FlaRes2008 Project Summa Job: wrightsoft � � By: nEllis I s 1st FI Addtn/Reno y Energy Design Systems, Inc. Project Information For: Adams Addition& Renovation 1163 Beach Ave,Atlantic Beach, FL Notes: Front door faces West. First floor renovation&addition to be serviced by an existing 3-1/2 ton HVAC unit also servicing the existing first floor. Second floor addition to be serviced by an existing 4-ton HVAC unit also servicing the existing second floor. Design Information Weather: Jacksonville, Int'I AP, FL, US Winter Design Conditions Summer Design Conditions Outside db 32 OF Outside db 93 OF Inside db 72 OF Inside db 72 OF Design TD 40 OF Design TD 21 OF Daily range M Relative humidity 50 % Moisture difference 58 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 5251 Btuh Structure 3685 Btuh Ducts 571 Btuh Ducts 744 Btuh Central vent(20 cfm) 0 Btuh Central vent(20 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 5822 Btuh Use manufacturer's data n Rate/swing multiplier 0.98 Infiltration Equipment sensible load 4323 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 805 Btuh Ducts 210 Btuh Heating Cooling Central vent(20 cfm) 0 Btuh Area(ftz) 385 385 Equipment latent load 1015 Btuh Volume(ft3) 3889 3889 Air changes/hour 0.60 0.32 Equipment total load 5339 Btuh Equiv.AVF(cfm) 39 21 Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a Coil n/a Efficiency n/a Efficiency n/a Heating Input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 OF Total cooling 0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0.000 cfm/Btuh Air flow factor 0.000 cfm/Btuh Static pressure 0.00 in H2O Static pressure 0.00 in H2O Space thermostat n/a Load sensible heat ratio 0.00 Printout certified by ACCA to meet all requirements of Manual J 8th Ed. !+- 0- wrigh tst►ft, Right-Suite Residential 6.0.119 RSR29784 2012-Feb-27 14:27:27 .�,z E:\EDS\Current\Residential Manual J\Adams Addition and Renov,1163 Beach Ave,Atl Bch.rrp Calc= Page 2 Project Summa Job: wrightsoftk � � Date: 2127/12 2nd Floor Addtn By: M.Ellis Energy Design Systems, Inc. Project Information For: Adams Addition& Renovation 1163 Beach Ave,Atlantic Beach, FL Notes: Front door faces West. First floor renovation&addition to be serviced by an existing 3-1/2 ton HVAC unit also servicing the existing first floor. Second floor addition to be serviced by an existing 4-ton HVAC unit also servicing the existing second floor. Design Information Weather: Jacksonville, Int'I AP, FL, US Winter Design Conditions Summer Design Conditions Outside db 32 °F Outside db 93 °F Inside db 72 °F Inside db 72 °F Design TD 40 °F Design TD 21 °F Daily range M Relative humidity 50 % Moisture difference 58 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 1449 Btuh Structure 1638 Btuh Ducts 158 Btuh Ducts 331 Btuh Central vent(5 cfm) 0 Btuh Central vent(5 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 1607 Btuh Use manufacturer's data n Rate/swing multiplier 0.98 Infiltration Equipment sensible load 1921 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 204 Btuh Ducts 50 Btuh Heating Cooling Central vent(5 cfm) 0 Btuh Area(ftp 91 91 Equipment latent load 254 Btuh Volume(ft') 937 937 Air changes/hour 0.64 0.33 Equipment total load 2175 Btuh Equiv.AVF(cfm) 10 5 Heating Equipment Summary Cooling Equipment Summary Make n/a Make n/a Trade n/a Trade n/a Model n/a Cond n/a Coil n/a Efficiency n/a Efficiency n/a Heating input Sensible cooling 0 Btuh Heating output 0 Btuh Latent cooling 0 Btuh Temperature rise 0 °F Total cooling0 Btuh Actual air flow 0 cfm Actual air flow 0 cfm Air flow factor 0.000 cfm/Btuh Air flow factor 0.000 cfm/Btuh Static pressure 0.00 in H2O Static pressure 0.00 in H2O Space thermostat n/a Load sensible heat ratio 0.00 Printout certified by ACCA to meet all requirements of Manual J 8th Ed. wrightsaft- Right-Suite Residential 6.0.119 RSR29784 2012-Feb-27 14:27:27 ACCK E:\EDS\Current\Residential Manual AAdams Addition and Renov,1163 Beach Ave,Atl Bch.rrp Calc= Page 1 y V . 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(a ° O ° 00 f+ City of Atlantic Beach APPLICATION NUMBER Building Department (To be ass_igned by the Building Department.) 800 Seminole Road j 4} Atlantic Beach, Florida 32233-5445 7 '7 "• Phone(904)247-5826 • Fax'(904)247-5845 " E-mail: building-dept@coab.us Date routed;" City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1103 13C,.C,o� 44t DejMffbVent review required Yes No �^ 1 ,,yy uildin Applicant: &44S� (��s'T, CSO, arming &Zoni Tree Administrator Project: 7Y�c) ublic Uti' Public Safety Fire Services . �y �g 6wo- � I Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection n 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: `� J APPLICATION STATUS rc til Reviewing Department First Review: Q pproved. ❑Denied. (Circle one.) Comments: CEEP PLANNING &ZONING Reviewed by: Date: S`30-t 2— TREE ADMIN. on Second Review: ❑Approved as revised. ❑Denie . PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 i+1WCITY OF ATLANTIC BEACH Building Department %' 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 PLAN REVIEW COMMENTS Permit Application # / Property Address: ;,4-lyc. „ Applicant: G>'i o r ':�'�4 Project: /-Yr'l T This permit application has been: Approved Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: Date: ?sem`r City of Atlantic Beach APPLICATION NUMBER +� Building Department r� (To be assigned by the Building Department.) 800 Seminole RoadAtlantic Beach, Florida s ' 233-5445 Phone 2 (04)247 5826 3Fax(904)2479 E-mail: building-dept@coab.us Date routed: ��% ~ -2- City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Z& 13�d t review required Yes No �' ,ynuildingl Applicant: �i�s��. t //1�,-f, (TO? anning &Zonind Tree Administrator Project: 6 /44 rnv, ublic Uti' Public Safety Fire Services 136vew fee,$ Dept Signature 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: n o BUILDING PLANNING &ZONING Reviewed by: Date: .r :P TREE ADMIN. Second Review: JApproved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: Z� F FIRE SERVICES Third Review: [Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14109 2t '` City of Atlantic Beach APPLICATION NUMBER Building Department 800 Seminole Road (To be assigned by the Building Department.) Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: !� City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 11(0 / DeOAWMent review required Yes No �p uildin Applicant: Cf4sanning &Zoni Tree Administrator Project: gP_ublic; Uti a Public Safety Fire Services Revtew fee$ -1 00' Dept Signature Y 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: j��Approved. ❑Denied. (Circle one.) Comments: BUILDING ANNING &ZONIN l L� Reviewed by: ate: TREE ADMIN. Second Review: []Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 i City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) a 800 Seminole Road Atlantic Beach, Florida 32233-5445 APR 2 �Z �� Phone(904)247-5826 • Fax(904) Z-5845 '2012 s E-mail: building-dept@coab.us Y _ Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: %� De ent review required Yes No uildin Applicant: anning &Zoni - f Tree Administrator Project: yl4arl / ublic UtiUiee Public Safety Fire Services eview fee $ Dept Signature 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: PApproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. []Denied. 4PUBCComments: ILITIFE Y 2 Reviewed by: Date: FIRE SERVICES Third Review: [-]Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 CITY OF ATLANTIC BEACH s J 800 SEMINOLE ROAD r� ATLANTIC BEACH,FL 32233 J V INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000490 Date 11/02/12 Property Address . . . . . . 1163 BEACH AVE Application type description RESIDENTIAL ADDITION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 -------------------------------------- Application desc 2nd story addition and remodel --------------------------------------- Owner Contractor ------------------------ ---------------___ ADAMS CHARLES P WORSHAM CONSTRUCTION CO INC 1163 BEACH AVE 2329 URBAN RD ATLANTIC BEACH FL 322335727 (904)CKSO JACK357 SONVILLE FL 32210 -- Structure Information 000 000 ADDITION 452 SF AND REMODEL Construction Type . . . . . TYPE 5-B Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE AO -------------------------------------- Permit . . . . . . MECHANICAL HVAC PERMIT Additional desc . . Sub Contractor . . LEGGETT HEATING & AIR 00 Permit Fee . . . . 103 . 00 Plan Check Fee 0 Issue Date . . . . Valuation . . . Expiration Date . . 5/01/13 ------------------------------------ Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of work. _ _ ----------- ----------------------------------- PERMIT XUI�RS"LY LN ACCORDANCE WITH ALL.CITISWJkW-FLANWIiEW44koRtW CNiW)�4 THE FLORAA 0 0 BUILDING CODES. CITY OF ATLANTIC BEACH �► 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Page 2 Application Number 12-00000490 Date 11/02/12 --------------------- ---------------------------- Other Fees . . . . . . . . . STATE MECH DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due --------- ---------- ---------- Permit Fee Total 103 . 00 103 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 107 . 00 107 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 1, 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax (904) 247-5845 3V I�lna J JOB ADDRESS: I ((0 .J GC (' i PERMIT# PROJECT VALUE $ NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity�_ Tons Per Unit • S i Heat: Unit Quantity BTU's Per Unit Seer RatingRE VR RED Duct Systems: Total CFM 3LlO0 REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity Tons Per Unit RE QUIRED Heat: Unit Quantity BTU's Per Unit Seer Rating Duct Systems: Total CFM REQUIRED FIRE PREVENTION Quantity (Requires 3 sets of plans) Fire Sprinkler System uantit (Requires 3 sets of plans) Fire Standpipe Q y Underground Fire Main Value (Requires 3 sets of plans) Fire Hose Cabinets Quantity (Requires 3 sets of plans) Commercial Hoods Quantity (Requires 3 sets of plans) Fire Suppression Systems Quantity (Requires 3 sets of plans) FIRE PLACES MISCELLANEOUS: Prefabricated Fireplace Qty Automobile Lifts Gas Piping Outlets Boilers BTU's Elevators/Escalators ALL OTHER GAS PIPING Heat Exchanger Quantity of Outlets Pumps erator Condenser BTU's #Vented Wall Furnaces RefriSol Collection Systems # Water Heaters Tanks (gallons) Wells OTHER: Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or I cal law regulation construction or the performance f construction. 4'S Phone Number 3 / 8 Property Owners Name Mechanical Company L h G Office Phone q' Co. Address: City 7�0�( State 0 zip 3Dan�l License Holder(Print): State Certification/Registration Notarized Signature of License older A \ Sworn and subscribed before me this day of`1�� 20� =aKATNERINELSignature of Notary P is 10:50:33 a.m. -01-2012 90.1538 8663 Trane Company North Central Florida Dealer Sales Office 8923 Western Way Suite 17 Jacksonville,FL 32256 USA T (9�4)538.8600 F (904)538-8610 7XWEe •ww.:rane.corn- To whom it may concern: This letter is to certify that the system listed below is an approved match with the Trane Company. If you have any questions please feel free to give us a call. 2TWR3042A1000A TAM4AOC48S41SA Thank you, Bryan Taylor Territory Manager 904-538-8627 ingerwi!Rand FROM Leggett Heating & Air, Inc. FAX N0. 9043844893 Nov. 01 2012 10:01AM P2 01-2012 �0"4 L3fi 8863 Trane Company North Central Florida Dealer Sales Offlca 8923 Western WAY Suite 17 Jackson0le,FL 32256 AA 53$8610 �/ T (9�4)538.8600 F i904 f I If WE" uµ.:ranc.corn //03 Am yr l A � To whom it may concern: This letter is to certify that the system listed below is an approved match with the Trane Company. if you have any questions please feel free to give us a call, 2TWR3042AI000A ldet-* TAM4ApC4$S (A) Ja 0—A-/ 4t Thankyou, t .� gy- 2 6►Z Bryan Taylor Territory Manager lyLf�3 904-538-8627 1000 400 Ingersoll Rana FROM Leggett Heating & Air, Inc. FAX N0. 9843844893 Nov. 81 2812 18:88AM P1 Fax Cover Sheet 1,eggett IH[eati np- & Air Conditioning,ng, Inco X60 King Street Jacksonville, Flo 32204 904-384-2612 Fax: 904-384-4893 Send To Attention: Fax Number: �14 From: Date: Pages Inc. Cover Sheet: Urgent_Reply Asap_.Please Comment_For your information Comments: Gam, l l'1'ti ns? Thankyou �r $10.00 NOTICE OF COMMENCEMENT State of Tax Folio No. County of To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: Address of property being improved: 1,l03y*e� General description of improvements: L'T >4"�D�S AOL?D Owner: C,/�1�,Q1 !. -OAyK -1 R- Address: //4! Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Contractor.�X�D Q� 7K G� �`�P-dG-7"/Dal j Address: i Telephone No.: qp!f Fax No: Surety(if any) Amount of Bond S Address: Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Fax No: Phone No: himself,designated by owner upon whom notices or other documents may be Name of person within the State of Florida,other than served: Name: Address: Telephone No: Fax No: In addition to himself owner designates the following,person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: Date:S 2P) e / Before me this 31 day of sara in the County o , Of Florida,has personally appeared r 'S Notary Public at Large,Stat of Florida,Countyof Duved.5�1 ns ��r•�S�y SUSAN S.NIBBLE g :`+p 's Notary public-State of Florida My commission expires:_ 'r c Z(oy ZL�1 Z « •=My Commission Expires Jun 26,2012 personally Known: or Commission#DD 780057 produced Identification: >1J J 11 SS OF ATLANTIC BEACH i� 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 J INSPECTION PHONE LINE 247-5814 PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-PLBG-227 Job Type: PLUMBING ONLY Description: 7 fixtures unit 1165 Estimated Value: Issue Date: 1/28/2015 Expiration Date: 7/27/2015 PROPERTY ADDRESS: Address: 1163 BEACH AVE RE Number: 170272-0000 PROPERTY OWNER: Name: ADAMS, CHARLES P Address: 1163 BEACH AVE GENERAL CONTRACTOR INFORMATION: Name: CRABTREE PLUMBING INC Address: 2351 URBAN RD QA JEFFREY W. CRABTREE Phone: - - FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2.00 Plumbing Fixtures $49.00 Trade Permit Base Fee $55.00 Total Payments: $108.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 1163 Ph(904) 247-5826 Fax(904) 247-5845 JOB ADDRESS: // d S/ a C•( '�-- PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet �- Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory 1, Water Heater —�-- Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** ❑ Other Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name ,4 Phone Number Plumbing Company (�i�,,. 4 Office Phone ?�1'-YL a t Fax ZV5'-f'/s� �� S-/ G ti 3� 2<< City �m State(�Zip Lz Co. Address: State Certi License Holder(Print)• �� ficationlRegistration# Notarized Signature of License Holder_- re me this day of 20 Signature of Notary Public