472 Royal Palms Dr (vault) CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877
'FORM
P15RMIT- INFORM—AT-1 L ATION'IN ATION
Permit Number: 22667 Address: 472 ROYAL PALMS DRIVE
Permit Type: STORAGE SHED ATLANTIC BEACH, FL 32233
Class of Work- NEW Township: Range: Book:
Proposed Use: SINGLE FAMILY Lot(s):16 Block: 17 Section:
Square Feet: Subdivision: ROYAL PALMS
Est. Value: Parcel Number:
Improv. Cost: 1,000.00
_IWORMATtON
Date Issued: 9/13/2001 Name: ROGELIO ROMAN MENDEZ
Total Fees: 30.00 Address: 472 ROYAL PALMS DRIVE
Amount Paid: 30.00 ATLANTIC BEACH, FL 32233
Date Paid: 9/13/2001 7731
one: (904)241-
Work Desc: STORAGE SHED- MUST-iMAJINTAI 2-Q' FRONT-R�R PROPE
CONTRACT-0919
IT
PROPERTY OWNER �'p 30.00
'AR
V
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q- Q
�N
NOTICE-1NSPECTI JRt O�
ST, '��TT,",�4 1 IQ R TO INVECTION
�Jr
BUILDING MATERIAL, RUBB.fSHXf46'6EBRIS FIROMI!'HIS WORK MUST NOT BE,, INJPPUBLIC SPACE,AND
.,,iLACED
MUST BE CLEARED UP D�HAUMA'1;W 13Y_EITH I CONTRACTOR ORR,"R
.�. -notj.
-FAILURE TO COMPLYWITA Ida REP&T IN THE
I T
its
PROPERTY OWNER PAYI
_k
ISSUED ACCORDING TO APPROVED PISZ� F%-,P,4
W.6FlAl' MIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISI?jh�i�6R
$36.014
AT TIC BtAcH BUIL[JINGIMEPT.
hte: 9/13/91 61 Receipti IM63
WILL~
R E C 17""h-D
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTEAA&S,?L101
MOVING, DEMOLITIONS Cit-y of Atlantic Beach
uuildinE7
. and Zoning
Owner(s)_2�2 C', c-z- jc9r, /y i)z
Job Address,// 7.2- LL/v\x 5 1)tf�_Phone 7
Lot# /i�l Block or Unit# Subdivision �(:,Z&L &�qj-,M-5 /�/y "T
Contractor V7
State License Z��b/
Address )7, Phone
city -7- &.E q State Zip -,2
Describe work to be done R 1-( '717r
Present use of buildin 02
Valuation of Proposed Construction
Proposed use -I-P, 5-1-r -,e ),2 We,> J-!fVl) )-AWAI 1�(' Y
Is this an addition? If yes, what are the dimensions of the added space: ft. X ft.
Will the added area be heated and cooled? N 0 New electrical (or increase)
New plumbing fixtures? 1Y New fireplace? N Z7 New Heat/AC?
SUBMIT THREE (COMMERCIAL)TWO (RESIDENTIAL) COMPLETE SETS OF PLANS,S INCLUDING
SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/
CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR.
,-�;? 7
Date:
NER
Signature of OW
Signature of NTRACTOR Date
NTRAC
STATE OF FL 71
COUNTY 07F
Sworn to'(or affirmed)and subscribed before me this day of 0
AS TO OWNER: Notary's Signature.
GEORGIA A.HOPN �6e nally knowr/
Prjmy commiSSION#DD 030526 uced Identification
EXPIRES:June 3,W
Bonded Thru Notary Pubk Underwritees
Type of identification produced
Sworn to (or affirmed) and subscribed before me this day of 200
AS TO CONTRACTOR: Notary's Signature
0 Personally known
11 Produced Identification
Type of identification produced
Auto
CITY OF
Vead - 800 SElvffiNrOLE ROAD
ATLANTIC BEACH,FLORMA 32233-5445
TELEPHONE(904)247-5600
FA,'((904)247-5805
SUNCOM 852-5800
CHAPTER 4a9, FLORIDA STATUTC5. PART I 'CONSTRUC1710f4 CONTRACTING' REQUIRES OWMalwBUILDER TO
^CrU40W' EDGE The LAW:
DISCLOSURE STATEMENT FOR SECTION 4ag. 1 03(7). FLORIDA STATUTES:
SrATm LAW REQUIRES CONSTRUCTION To Be DOME By UCEI�,SED CONTRACTORS. you HAVE APPLIED FOR A PERt4lT
UNCeR A14 ED(EMPTION TO THAT LAW. THE EXEMPTION ALLO%vS YOU, AS THE OWNER ofr YOUR PROPERTY, To ACT AS YOUR
OWN CONTR^CTOR &VFN THOUGH YOU DO Mar HAVE A LICENSC. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF.
YOU MAY BUILD OR IMPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU KAY ALSO BUILD OR
IMPROVIE A COMMEFtCIAL BUILDING AT A COST OF $Z5,000-00 OR LESS. THE muit-pimg musr BE FOR YOUR USE AND
OCCUPANCY. IT MAY NOT Be allILr FOR SkI OR LEASK- IF YOU Set t OR LEASE A BUILDING You KAvc BUILT YouFtszLir
WITHIN ONE YEAR Ap7rR THE CONSTRUCTION IS Cob4PLCM- THE LAW WILL PqE5UlME THAT YOU BUILT IT FOR SAL-- OR
LEASE. WHICH 13 IN VIOLATION OF THIS E)MMF�ncm. YOU MAY NOT HIRE AN UKLICEMSCD PERSON AS YOUR rawrRACTOR.
YOUR CONSTRUCTION MUST BE COME ACCORDING TO Tme BUILDING CODES AND ZONING ReauLATioNs. IT is YOUR
RESPONSIBILITY TO MAKE SURE THAT PCOPLE EMPLOYED By YOU HAVE LICENSES REQUIRED BY STATIE LAW AMD BY
COUNTY OR MUNICIPAL WCCNSING ORDINANCES.
ORDINANCES ALSO A'1 Qw AN QwmeR TO 'mPR0vC THCIR OWN PROPERTY wmzN rr Is FOR PERSONAL OR FAMILY
USE. AND LJ#MMSC REQUIRE ALL WORK (=CZP7-M^IHTENANCC UNDER $Z,OCC) Be UNDER A au#LDiNG PeRmrr AND PAss
ALL NOR14AA- )NsPmcnams. 7)4-- cRatmAmce TrATzs owmmis MAY pHYsjcALLy 00 WORK 7-HrmseLvES; OR mAy tjjR
UMUCXNSCD WORKERS PROVIC60 SUC.4 WORKERS; ac umor-R 'cmecr supeRvisroom or rHe owNcjq. "o mus-r sic ON
THE �105 Ar A" 77M WHILE WORK IS IN PROGREZ5 BY UNILIC&NSED TRADES PCOPL-M.' -T)qtS DOES mcrr ALLow USE op
LINLICENSIED CONTRACTORS.
aNCE OWNEM MAY Be LIAMILE FOR INJURIM TO WORKERS THEY HIRE, THE ElUILMING DEPARTMENT SUGGESTS
WORKER'S COMPENS^T10" INSURANCE 131.1 PURCHASED UNDER THIC HOMCOW"MRS INSURANCE POLICY CLEARLY PROTECTS
THE CVMER. (OWNERS HIRING W'ORKERS BEC,OMr- ItmPLOYMAS AND SMOULD ALSO OnsExtvm IRS wrrHMOLDING TAX Amo/oR
FoRm 1099 REQUIRIZMENTS ON THC WORKERS THEY CIMPILOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CowrgAcTORS CANNOT Be EIMPI-OYCO UNDER AMY CIRCUM:5TANCCS. OWNERS BEING SUEWECT
.0 $5,C0Q PENALTY UNDER Ft-owmA S-rATuTc No, 455-225(11. AjA 'QccuF-A710m^L 1jrmmsc" IS NOT ADEQUATZ.
THE awmeR SHOULD PHYSICALLY sex -nje r rmNc R THm FLORIDA "CONTRACTORS
.OuNTy �Cp Te OF Compe. y, a
�RT,pjcA
CEFITIFICATZ' To Ascwq-rAiN IF A PERSON 15 A LICENSED CONTRACTOR. TtLePHONE THE Buit-coma Omp^RrmcmT (247-
58?-151 lor IN DOUR".
HzRgmy AcKmowumcc THAT I mAve READ THE Aeow DOCLOSUfRE STAMEMENT AND THAT I comFm-y*Trm ALL
THE RZOUIRCIMENTS FOR THE ISSUANCE OlF AN OwNmrt-auit-ocR PamArr.
GEORGIA A.HM
4--1' 64-,01
MY COMMISSION#DD WM
PR60EMY OWNEWBUILDER
EXPIRES:June 3,2005
P
BMW Thru NDtary PUbk UndBfWftn
e�"r
ADORE—nS TELEPHONE
SWCFZN TO AND Tmrz
BEFORE ME y OF
�t77
NOTAJ�Y Puij ,c
NOTE: PHRAsms uNoCRUNCD AzOvm MY C pp-1
ARC EMPHASIZED my THIE allkLMING PMMI----ZI40N EXPIRES:
DEPARTMeNT.
74,
MAP SHOWING SURVEY OF
7- C�� iif:�&27- e-A-11 7- 0,4
AS RECORDED IN PLAT BOOK :5�1 , PAGE---ZC,,14i2---l-->OF PUBLIC RECORDS OF DUVAL CO.. FLA.
APPROVED
CITY OF ATI ANTIC BEACH
ING K 7l000.: rjr
SE 12 2001
A-1
Q() By
z'E5.
-7.- 7 7
NJ
Lh
2 2011
—7—
-PLOT
%-ALE. At;
13 C-W.
LOT
'PLA"T 1300y.,
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0002771
DEPARTMENT OF 13UILDING
C ITY OF ATLANTIC 1EACH
INFORINATION
PERINI T INFO*"ATION' LOCATION
�2771
*it Number' Ad4rems% 472 ROYAL PAL" DRIVE
Permit Tytow It OTHER ATLANTIC SeACH, FLORTDAI 32233
C son ox works REPAIR -4------- LEGAL 09SCRIPTION ---
onstr. Types H/A Lott Slock s
roposed UAW% SINGLE FA"ILy Twoiwohlp I *Not 0
ollIngus I Codoi Or SuOlvlslons ROYAL P4LK
a t1mated V*luvs *0.00
Improv. . Coatt *0.00
r 50
*7. 50
Awou ki
..........
7/26/90
'A
4Z
j D ;1A
'�A
t"'_ 7
PL
NATION AP XCATION FEES
id
V_
PAL" DRIVE WATER ItIPACT FEE *O.iW
$0.C)o
;122'3 $11 Imp
pits: 6"llk'
fl, FLORIDA COO AC
P h
A
RADOM 13AS-ft. R.0. $0.00
POR"ATION A
R DON o�s - 5% *0.00
No me 1 (3 _ORA�iW WATER TAP (�D
Im MAL
ST, SEVER- TAP
JACK ZLLV, FL. 32209 HYDRAULIC SMARE-
*0.00
L CCCO Type 1 1 RE-I xspiccT FEE: 1w".00
SEC.N IMPACT FEE
*0
VF
NO tES:
NOTICE—ALL CONCRETE FORMSAND FOOTINGSMUSTBE INSPECTED BEFORtPOURING
PERMIT VOID SIX MONTHS AFtER DATE OF'ISSUE
BUILDING MATERIAL, RUBBISHAND DEBRIS FROM THIS WORK MUST NOT 13E PLACED IN PUBLIC SPACE,AND MUSTBE
EARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR C,)WNER,
F
AILURE TO COMOLY WITH THE MEC ANICS' LIEN LAW CAN RESULT'IN
THE PROPERTY OWNER PAYING TWICE OR 'BUILDINGIMPRffl
&A E
--ft no
LIED CORtjING TO APPROVED PLANS WHICH ARE PART,',�F THIS PERMIT AND SUBJEC VOCAti iN f6ll
c
OLATI N OF APPLICABLE PROVISIONS OF LAW.
.. ................
CH BUILDING.DE TMEN
17 171'
CITY OF ATLANTIC BEACH
APPLICATION FOR ROOFING PERMIT
BUILbING OWNER 90,911jo Jrj,"4j-A4We7, PHONE
JOB ADDRESS
LOT#- BLOCK OR UNIT # SUBDIVISION
CONTRACTOR A C PHONE
ADDRESS 333 G
Al (2,9,y,1 S�-
LICENSE NUMBER- C(-C-Q,�j!26V ...�EXPIRATION
JOB VALUATION $
MATERIALS:
Ao 3r
SIGNATURE OWNER PATE
SIGNATURE CONTRACTOR DATE 2/-2 S'/9e)
cl/
6004 1 KA1,-, I uUt'Y
SEARS, ROEBUCKAND CO. ,,- No. SALESCHECK NUMBER
STORK Wo.
STORE ADDRESS CITY STATE ZIP CODE PHONE
:;I'V
7r1c "--6r-z;166
Ak 8 PHONE OFIFICE PHONE
USTOMER'S KAME fig
ller/
3DRESS STATE ZIP CODE
ZAREST CROSS STREET 1'NSTALLATION ADDRESS IF DIFFERENT CITY STATE MP CODE
SKETCH Show roof imasum"Onts fixAldlng rNa
03 agmes to arrange installation of: Shade out any part of roof(s)not to be covwed
Show locatm of gitiws,d~Wouts, owhang and thm
pe Roofing
Show location of any roof Agaks
... ........
,lor:
-As show less variation in shade due to light reflection than solid colors. Black
0
1W,mWly has some shade variation.
be installed on a / story house. Rise IN 12". . . . . . .
06 �e /:-�:
�pe Roof: XShingles QAain, or
pble, or t Mansard, or
,WSZut-up -LJ ip, or 0 Gambrel
I11110—
Low Slope(2' Rise up to 4") Rise IN 12"
Built-up (Must be und!q-) IN 12"
Valley type N. FT.
ADD VEN11LATION per Sketch
Ade
.:ate ventilation consists of I Sq. Ft. Free Open Area for every 150 Sq,
F attic floor space(50%located at ridge, and 50% at eaves).
ISTING ROOFING consists of—j—layers of
Contractor will ,, 4,
Apply over existing shi s.CAUTION:New shingles will conform to uneven-
ness of existing deck M/or shingles.
Cut off and haul away tabs of existing asphalt shingles to provide a smoother
more wm deck, apply shingles.
-if
ff
n'g ' ettl
molli to the Wk,—cover with No. 15 felt, apply shingles.
OF LEAKS -0 Existing leaks are indicated on sketch.
TTEN OR DETERIIORATEO WOW-No charge has been made for replacin rotten
deteriorated wood unless specifically statW under special instructions.1f �qch
0 0,4i
-Witions are found during installation,an additional charge will be made in writing
ng a seprate form.
GLITTERING Special Aw
:RIPTION) Instructions e
will be installed as shown on diagram. r2e:
WERliAM AND TRIM
(COLOR AND DESCRIPTION)
will be installed as shown on diagram.
JSTAWATION ESTIMATED .1 understand that this is only an estimated date and I will be con-
0 BE WEEK OF -tacted prior to this date to schedule the actual installation date.
l(CASH PRICE) (DATE)
Customer can buy .rding
]For information rcegla.
at this price until: your installation
I SC ACIMCP SUBMITTED BY 1—d�ez�
i SALESPER§01K_1 APPROVED BY(MGR.)
1 POC El (ADDMONAL PROVISIONS OF:TF-IIS PROPOSAL ARE STATED ON REVERSE SIDE.)
0 0/Yo
(5ATF)
(CUSTOMER'S SIGNATURE) (SPOUSE'S SIGNATURE)
sale is made in location other than Sears premises, YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY
ME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THE TRANSACTION. SEE THE
"T
ACHED NOT`ICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT.
E'Jjc.t�
CITY OF ATLANTIC BEACH
BUILDING DEPARTMENT 216-f ts
INSPECTION REPORT Royal Palo
ROYAL rhLn DRIVE PERMIT#
He rLanjDA 32233 SUBDIVISION IL
JOB LOCATION ArLA,4'Trc ISEAC %.504)2
'14DE'z PHONE j5uXLDrNu
OWNERNAME fto"'L ZO Itionht, RE PERMIT TYPE
LEGAL DESC: LOT BLOCK SECTION CLASS OF�IVORK rAn'LY
PROPOSED USE
CONTRACTOR onangL- r0oX j.:Lne - re-rOOX
EnClOWe All
WORK DESCRIPTION INSPECTOR
1;5
I SPEC-%)"iREQUiRED
N APPROVE REJECTED
D
DATE INSPECTED� BY
COMMENTS
llowing provisions being included
This plan approved subject .tO the fo
in the building:,
ction, each unit cell shall be
_qn
cons
ow mas�on uni I orners; poured
I n �j t all c
at least one NO- 5 bar a rly
reinforced with inforcing shall be prope
and tamped with concrete; such re :)od truss rafters—
tied into the footing and gpandrel beAm. All wl
ened to the exterior
ro f cOnstru on shall be securely fast E.2tinqa shall
ct'on hurricane anchors or clips-
walls with approve" te under exterior walls, reinforced
be continuous monolithic concre
with two 5/81, deformed reinforcing rods for one-
story buildings and three 5/81, deformed reinfor- APPROVED
cing rods for two-stOrY buildings. Reinforcing CITY of ATLAN7 I FIG BEACH
rods shall be placed in the lower one-third of BUILDINC OFFIC"E,
the footings, properly placed and fastened on 41 -
" D .7
metal saddles with wire. Footings shall be 20 ate...... ....
wide and 8" thick minimum.
3 '_ W ,- ( qw-i
17 �7 mom
CITY OF ATLANTIC BEACH, FLORIDA
Appm-d by — APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE, Auau§t 22 19 90
IMPORTANT NOTICE:
AS DESCRIBED IN THE FOLLOWING, WE
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
ER 0008818
-tL—ECTRICAL FIRM:McClure Ele WN I 10 U C NVMU A
c MASTER ECTRICIAN$1410
4AME Mendez ----ADDRESS: 472 Royal Palm Dr. -RFD—BOX
OLDG.SIZE BETWEEN:
ES.X) APT. Comm.I PUBLIC INDUS. NEW( OLD REW.
*DDITION I TRAILER ( TEMP.I I SIGNS ( SO. FT.
FEE
SERVICE: NEW( INCREASEI REPAIR:(
ONDUCTOR SIZE AMPS COPPE&L I ALUM.
JIWITCH OR BREAKER AMPS PH w VOLT L_RACEWAY
AMPS 1 PH 3 W 2130 VOLT SEu RACEWAY ZL4v
,jXIST.SERV-SIZig; 100
i
VEEDERS IND. SIZE NO.- SIZE
IGHTING OUTLETS CONCEALED OPEN TOTAL
MECEPTACLES CONCEALED OPEN AMPS. I TOTAL
1 0.30 AMPS.
I SWITCHES
IINCANDESCENT
IFLUORESCENT&M.V.
0 100 AMPS._V_0VER
FIXED
BELL TRANSF.
APPUANCES
0 IR H.P.RATING H.P.RATING
10NDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT] KW-HEAT
0-1 OVER
1 H.P. VOLTAGE PHS
,,M0TORS
H.P. VOLTAGE PHS No.
M'SCMAR -ogate pann-I and mn-f-pr
n%lcm ann v
1678
0002
DEPARTMENT OF B61LDING
AA CITY OF ATLANTIC 5EACH
...........
PERMIT INFORMATION ------ --- ---- LOCATION INFORMATION
P lei t 'Numbor s AcItItemat 472 ROYAL PALM DRIVE
ATLANTIC BEACH, FLOR
IDA 4:2233
wralt Typos BUILDING,
Olt ----
C 31 AL DESCRIPTI
as of Work ALTERATION ---------- LEO
C natr. Ty s CONCRETE Loti
Ot
-d 0 PLE FAMILY
P opowe M
R 01 P'01"
on oy
Dw 111nows"", des 0 ubOlviml
'ZR
UNA 2�m'6'144� ';41�'
"i'717S Ad,
r 00�
00
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m
*45.
so
1w
Al"R�"111
W6* Do gfr
pgo
part Chm�p
00:f line
"0' �j"
10�V4�'
APPLICATION
",f ORMATION
Y WATER IMPACT FEE *0.00:
A4 IVE
00.0a;
FL t'b 3:223-Z SEW99 �IJIPACT,,FEE
LA CHI,
WATEft ,01 R
.004")' 7731 TER
RADON OAS-". RO S.
N --- RADON, GAt 59
FORMATZO
WATER TAP
0,
'121
4-'K ER, T P
A ifv i
11,Ark mtl"10 lk t
a 5116�3400006 Tipw I Re- 1461PUCT PICK *0.0
*0, 001
OTHER, *0. 00
NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFtrER.DATE OF ISSUE
AC AND M16ST BE
ILDING MATERIAL,RUBBISH AND,DEBRIS FROM THIS WORK MUST NOT,BE PLACED IN PUBLIC SP E
EARED UP AND HAULED'AWAY BY EITHER CONTRACTOR OR TWNER.
'T IN
FAILURE TO COMPLY WITH THE MEC ANICS' LIEN LAW CAN RESOL 95
HE PROPERTY OWNER PAYING TWICE OR BUILDING IMPROVEMENTS.
M T
SUED ACCORDING TO APPROVED PLANS WHICH ARE PART PF THIS PER IT AND SUBJEf&,J0 REV06*100
OLATION,OF APPLICABLE PROVISIONS Of LAW. TaKRED
C
P
Dw
RECEIPT MWR,- #A#%
ANTIC H BUILDrG.DE
C
,E
Address
H�q�-Square Footage ___per sq ft = $ 79-
e2��e �ed per sq ft =
$
Carport/Yorch @ $ per sq ft = $
Deck @ $ per sq ft = $
Patio $ per sq ft = $
TOTAL VALUATION: $ 0 —/0
0-o
Total"Valuation Ist $ 0 0 C) ,-00
' Valuation per thousand or
portion thereof
----------------------------------I Total Building Fee $ S 0--S70
PER4ITS and/or FEES REqJIRED I
+ k Filing Fee $
Fireplaces @ 15.00 $
Mechanical
Plumbing BTjULDING!PERAiT FEE $
Electric/New
Electric/Temp
Septic Tank BunDim PER4IT $
Well WATER I= CHARGE
swimming Pool SEWER IMPACr FEE $
Sign WATER IMPACr FEE $
Water Connection NISCELTANEOUS $—
Sewer Connection $
Water Meter $
Elevation Certificate
GRAND TOTAL DUE $
----------------------------------------------------------------------------------------------
CALCLJLATIONS and/or NOTES
cai�
E:l
DiQ E
C eMEI-v 7-
a CX-
J)e 311
�q R�l G'Z' EAq T
MAP SHOWING SURVEY OF
e-A-111-1- 21,4
AS RECORDED IN PLAT BOOK VLPAG PUBLIC RECORDS OF DUVAL CO., FLA.
FOR
/7
7-
N
A P P L I C A T 1 0 N F 0 R B U I L I N G P E R M I T
CITY OF
Ve4d - 57&U�&
REQUIRED SUBMITTALS
716 OCEAN BOULEVARD
Each application for building P.0.BOX 25
permit will be accompanied by ATLANTIC BEACH,FLORIDA 32233
two complete sets of plans, including TELEPHONE(904)249-2395
a detailed site plan Indicating location
of utilities, parking, size of yards and
other pertinent data; one set of Florida Energy
Efficiency Code sheets; recent survey (on new construction)
SCHEDULE OF INSPECTION
Requests for inspections will be accepted from 8:00 AM until
4:30 PH. All inspections will be made the following working day.
1. Footing
2. Rough Plumblng/Sewer
CALL IN WITH PERMIT
3. Slab NUMBER FOR EACH
TRADE
4. Framing, Rough Electric,
Mechanical, Top Out Plumbing
5. Insulation
6. Final Inspection/Issuance of Certificate of Occupancy
------------------------------------
BUILDING CARD MUST BE POSTED OR NO INSPECTION WILL BE MADE
Pour no concrete or cover any work until
building card is SIGNED by the inspector. You
will be required to uncover any work that has not
b been inspected.
W'Le'
e
$10 fee is required for all re-Inspections.
CITY OF
PROPERTY DESCRIPTION
eav-41 - 9&u�(4
716 OCEAN BOULEVARD
Lot �--Block ---Section P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
-S TELEPHONE(904)249-2395
Street Name- j4�4 L-vl�'-16- DESCRIPTION OF WORK
or Addressi a? �
If in a FLOOD HAZARD
Flood Zone: X-------area complete page 3. Brief
Description:....... --------
Class of Worki
(New/Remodel/Add1t ion)
ZONING INFORMATION
Type of
Construction:-
Zoning is- Proposed Forl Estimated Value $ -3 000-06
District: use------ ------- -----------
Exceptions or �j_l
Materials:
Variances Granted: ......... KOOF
Solid or
------------------ ------ ------------ Filled Roof:
Ground:
OWNER INFORMATION
Method of Heating:..... ------
Phone:
Property Owner:--- C��D E
Mailing
Address -- ---------
L S� Z i p: �2 3
CONTRACTOR INFORMATION
Contractor:--------------------------------------------- Phone:..............
Mailing
Address: ------------------
------------------------------------------------ Zip:---------------
Expiration
License Number:......................................... 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 T E
ONSTRUCTION OF THE PROJECT. I UNDERSTAND THAT THE ISSUANCE OF THIS PERMIT IS
PERFORMANCE OF C
INFORMATION BEING TRUE AND CORRECT AND THAT THE PLANS AND SUPPORTING
CONTINGENT UPON THE ABOVE
DATA HAVE BEEN OR SHALL BE PROVIDED AS REQUIRED.
Owner Signature --------------------------------Date------------
Contractor Signature Date
-------- ------------
All --------------------
FLOODPLAIN DEVELOPMENT INFORMATION
Type of Development;
Flood Zone:
Required Lowest Floor Elevation:
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.
Date--------------Applicant's Signature
----------------------------------------------------
Department Use
Required Lowest Floor Elevation
As Built Lowest Floor Elevation
Survey Flied with Building Department
-----------------------------------
Building Department Representative
page 3
CITY OF ATLANTIC BEACH
APPLICATION FOR BUILDING PEMIT
Owne
r z
Architect X, L� hone_22 ,.�
Address zip_Phone—
Contractor� Addres-1-
Y, 14—. #P3a.2.�Phone 7'�'f
Contractor's License Nurber —M-7-��
Expiration Date Copy on File '
Lo t it
—Z4:�_Block or Section Subdi-visi
ty Zoning
Stree Between c, fe 7-Y�q,, d
side
Valuation $ 7� T 0 —
ype of Construction (- - � <�
Purpose of Build'ng-----------__Nuirber of Units__L Fireplaces— /Y 0
Utility Service: Water ewer
--Y-Ll-—1- S
If d-ie Cicy if providing water or sewer service,' do we need to moke taps? t",
Dinr-mions: Building Lot
. . -----2�_Size Footings
Sz. Piers Sz. Sills Greatest Span Sills
Sz. Ceiling joists Distance on Centers Greatest Span
Sz. Floor Joists Distance on Centers Greatest Span
Sz. Rafters 77—
Method of Heating Distance on Centers —Greatest Span
�,;-`��,,,,�,;, Solid-Filled Ground Roof r-,
Flood Zone 2 /�
... If located within a FLOOD HAZARD conplete page 2
SUBMIT: Two conplete sets of plans, including a detailed site plan.
Florida Energy Efficienciy Code Sheets
Recent Survey
Inspections Required:
I. Mien steel is in place and ready to pour footings.
2. Mien steel is in place and ready to pour c0lums/1111,tel.
I Mien steel is in place and ready to pour beam.
4. When framing, mechanical, plu-nbing, electrical, -fireplace, is conpleted and ready
to cover up.
5. Final inspection.
NO INSPECTION WILL BE MADE, IF BUILDING GQ� IS NOT POSTED ON JOB.. SETMCKS
In case of rejection, reL-ispectim MUST be' called for after Rear Lot Line
corrections are made.
In consideration of perndt given for doing the
work as described in the above statement, we
FJ-
-orm said work in accordance 0- FJ-
thereby agree to perf m
with the attached plans and specifications,
w1iich are a part hereof, and in accordance rt
with the building regulations of Atlantic Beach.
(D
(D
Signature Owner
Signature Contractor
-------------
FOR OFFIC 7,UqE ONLY
Date-------37-11.7 9 ......
CITY OF ATLANTIC BEACH Permit #-I'llf.........Fee$.....
Valuation $...... ---606)-b
1 4.......4...............
FLORIDA
House #
............................................................................
APPLICATION FOR BUILDING PERMIT
............................................................................
............................................................................
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automdtically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlanfic Beach,Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors he submitted to this office so that licenses can
be verihed.
Date-440.-�4/----A-2 ....1191.Z.
�e---------------------------
Owner"As,40,�Wd� '401 ------------Telephone No..743k-,�-e-,W
Architect............................. ........................... ----------Address,.......................... .....................Telephone No.............................
Contractor Builde .. .... ... ----- ' �? - ' 3
---------Address-fX Ye� ---------Telephone No,2 0.k4A ----0
loot No-------------/6-------------------------Block No-------- ........... Sub ..Zone...........
---1W4A4A- ------------Street...----h/---------Side Between.. and..
------------------------- .. .. . ...........St
$--------------------------------For what purpose will building be used,
Va uat�! -! -Type of construction.. ...........
Dimensions of Building'a-44 V------444 .... �-4� --
J .4N- ------- of Lot--- :5......Size of Footings....
Size of Piers.----- ---------------------Si
iz�of Sill �-----------------------------Greatest Sill Span in ft.-...----------------Type Roof-. . ...... .. .... ....-
"1z I ..
How will Building be Heated?— &ZI/---------------------Will Building be on Solid or Filled Ground?- ................
Size of Ceiling Joists----------------------------------- Distance on Centers.----...... -------------------------------- Greatest Span............. ........................ )v
Size of Floor Joists----------------------------------------...... Distance on Centers.......... --------------------------- Greatest Span............................................
Size of Rafters..... -------- ------------ Distance on Centers-.,... A�.................... Greatest Span---------
,..2--------------------------
This rectangle is to represent the lot.
Locate the building Or buildings in the
right position. Give distance in feet from
all lot-lines and existing buildings.
REAR LOT LINE
Two copies of plans and specifications shall
be submitted with application.
Inspections required.
1. When steel is in place and ready to pour footing.
2. When steel is in place and ready to pour columns and/or lintel. Z
3. When steel is in place and ready to pour beam.
4. When framing is completed.
5. When rough plumbing is completed,and ready to cover up. 13 - 2
6. When septic tank drain field or sewer is laid but before it is covered.
7. Electrical inspection by City of Jacksonville.
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called for after
corrections are made.
FRONT 6f LOT
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 building
regulations of the ity At an * B ch
C * ea
Signature of Builde .. ....... ....... ............ Address.
Signature of Owner 4. ............... Address....... ..............
J.............................
CITY OF ATLANTIC BEACH
APPLICATION FOR rLUMBING PERMIT
EERTMIT NO . - Lf� Date : 2—
LO"'-"AT I ON� se"1z Street
LOT NO . —BLOCK NO ._ Z S/D
0 W N E R 7—
MASTER FLUMBER,
4 /2
A _6�Al
13U It Bldg.
BUILDER OR CONTRACTORD?FL Ll 0 Perm1t-N- jo,./Y�/ `!
TYPE OF BUILDING PE-Sl' 2--) ,z-i/<�z-
�ZLSIk�KS / LAVATORY / BATH TUBS URINALS /CLOSETS
FLOOR DRAIDS SHOWERS WATER HEATERS DISH4ASHERS
DISPOSALS OTHER
TOTAL FIXTURES 1 . 0 0 0
NO WORK MUST BE DONE UNTII A FEMIIT HAS BEEN FROCURED
PLANS AND SFECIF ICA TIONS must show a plan and description of the
size .-and , location of all the scil and vent pipes, and the number and
location of all fixtures , (in accordance with Ord4Lnance nn. 188 of
the City cf Atlantic Beach, Florida ) must be shown cn back of appli-
cation and be approved by the Plumbing Inspector.
DRA9 PLAE AND SIECIFICATION OF ABOVE PLUMBING ONB.�'.CK.
Approved by
Plumbing Inspector
Date
(FCJZ OFFICE USE ONLY)
ROU(-TH-IN INSPECTED /- �'d -
--REIVARP.S
FIIiAL INSPECTION: CERTIFIOATE ISSUED: