Sewer 1969 Beach Ave 2011 yrs CITY OF ATLANTIC BEACH
1 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00000501 Date 5/24/11
Property Address . . . . . . 1969 BEACH AVE
Application type description SYSTEM DEVELOPMENT CHARGE RESIDENTIAL (S
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------
Application desc
SEWER DEVELOPMENT CHARGE
-------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
GREIDER, JACK OWNER
1969 BEACH AVENUE
ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . ADV PMT-SEWER IMPACT FEE
Additional desc . . SYSTEM DEV CHARGES ONLY
Permit Fee . . . . . 00 Plan Check Fee . 00
Issue Date . . . . 5/24/11 Valuation . . . . 0
Expiration Date . . 5/24/11
----------------------------------------------------------------------------
Other Fees . . . . . . . . . SEWER SDC-SYSTEM DEV CHG 4050 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total . 00 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4050 . 00 4050 . 00 . 00 . 00
Grand Total 4050 . 00 4050 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
!�lbv
4} CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00000501 Date 5/24/11
Property Address . . . . . . 1969 BEACH AVE
Application type description SYSTEM DEVELOPMENT CHARGE RESIDENTIAL (S
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
---------------------------------------------------------------
Application desc
SEWER DEVELOPMENT CHARGE
-----------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
GREIDER, JACK OWNER
1969 BEACH AVENUE
ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . ADV PMT-SEWER IMPACT FEE
Additional desc . . SYSTEM DEV CHARGES ONLY
Permit Fee . . . . . 00 Plan Check Fee . 00
Issue Date . . . . 5/24/11 Valuation . . . . 0
Expiration Date . . 5/24/11
----------------------------------------------------------------------------
Other Fees . . . . . . . . . SEWER SDC-SYSTEM DEV CHG 4050 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total . 00 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4050 . 00 4050 . 00 . 00 . 00
Grand Total 4050 . 00 4050 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
=�' ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00002164 Date 6/02/11
Property Address . . . . . . 1969 BEACH AVE
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
---------------------------------------------------------------------
Application desc
SEPTIC TO SEWER
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Owner Contractor
------------------------ ------------------------
GREIDER, JACK DAVID GRAY PLUMBING INC.
1969 BEACH AVENUE 8850 CORPORATE SQUARE CT.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
(904) 744-7255
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 11/29/11
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 62 . 00 62 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 66 . 00 66 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 08 10 12:54p Information SystemsCITY 0 904-247-5845 p,1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: M0`'7 1&2140 A14 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 Fvaujw QTY TYPE OF FbrTURE 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
NUSCELLANEOUS:
of Sewer Replacement ❑Back Flow Presenter ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plass)
❑ Lawn Sprinkler System Number of Heads ❑ Well
**SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
WfOther Sk-pre- 7"- v- #Q3t A,JD9qMan Ava NintL ll a� ',434jw, Q,
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 end 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 2E1 el Phone Number r(C&�S�e
Plumbing.Company avid Gray Plumbing, Inc. Office Phone 'IWW 17-�
Fax_77-3-5-al
085"(Jrporate
Co. Address: _ 18Qk&9l;vi1te,Florida 32215 City State Zip
License Holder(Print): — D4460RAY State Certification/Registration# (_'f x 01-7-5,96
Notarized Signature of License Holder
Swom and subscribed before me this a of 20�
Signature of Notary Public ,
�ov"Y♦ o Y Public State of Florida
• 1� R Major
Commission EE032510
�'�or r�ea Expires 12/20/2014
White, Debbie
To: Ramsay, Debra; Calverley, Yvonne; Matthews, Carlene
Cc: Kaluzniak, Donna; Walker, Chris
Subject: Septic Sewer Approved Inspection
1963 Beach Avenue Permit#11-2163 and 1969 Beach Avenue Permit#11-2164 both are approved and connected to
sanitary sewer system....
Debbie White
CITY OF ATLANTIC BEACH
BUILDING DEPARTMENT
(904) 247-5826
(904) 247-5845 FAX
1
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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00002180 Date 6/07/11
Property Address . . . . . . 1969 BEACH AVE
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
circuit for lift station
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
GREIDER, JACK FIRST CHOICE ELECTRIC
1969 BEACH AVENUE 716 VALLEY FORGE RD. N.
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 241-1331
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/04/11
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 79 . 00 79 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: j l�� F�� \_ {�J�_, PERMIT#
NEW SERVICE ❑Overhead ❑ Underground ❑ Underground up Pole
❑Residential (Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps []_amps # of Meters
❑Commercial (Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family (Main) Service
110-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: -Z. 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts/amps VAL UE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑Other: C )LA-
Permit
Lfi 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 . r, 1 C _ Y c c� ✓ Phone Number—Z-41- 13 3)
Electrical Company �s Qrr-C (' �6 �•r t ���,�- Office Phone Fax
Co.Address: `7 1 L, o kl \j-Fz,sY5g 1s- City ,o ,�.,-, `1,,.State r Zip zz-
v
License Holder(Print): e,,,s:� _ State Certification/Registration#
Notarized Signature of Lice t<,
,� ty w COMMI 1ON DD 95778.7
* wg seaa:bed efore me
of 20/1
1X�• +�Q;a'� Bonded Thru Notary puhNc underwriters
U lic