Permit Pool 2316 Beachcomber Tr 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001509 Date 10/19/12
Property Address . . . . . . 2316 BEACHCOMBER TR
Application type description SWIMMING POOL/SPA
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 32580
----------------------------------------------------------------------------
Application desc
spa deck resurface pool
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
ADAMEC CHRIS R & TRACIE L SURFSIDE POOLS
2316 BEACHCOMBER TRAIL 313 BEACH BLVD.
ATLANTIC BEACH FL 322336607 JAX BEACH FL 32250
(904) 246-2666
----------------------------------------------------------------------------
Permit . . . . . . SWIMMING POOL
Additional desc . .
Permit Fee . . . . 215 . 00 Plan Check Fee 107 . 50
Issue Date . . . . Valuation . . . . 32580
Expiration Date . . 4/17/13
----------------------------------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE
REQUIRED INSPECTIONS :
*POOL STEEL
*ELECTRICAL GROUNDING AND BONDING
*FINAL (PUMPS MUST BE RUNNING FOR FINAL)
SWIMMING POOL SAFETY INSPECTION REQUIRED
POOL - Wellpoint (if used) must discharge into vegetated
area 10 , minimum from street or drainage feature (swale,
structure or lagoon) .
Roll off container company, if used, must be on City
approved list and container cannot be placed on City
Right-of-Way. (Approved: Advanced Disposal, Realco,
Shappelle ' s and Waste Management . )
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 3 . 23
DEV REVIEW-SINGLE & 2-FAM 50 . 00
ENG REV PRE APP > 3 HRS 25 . 00
STATE DBPR SURCHARGE 3 . 23
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 215 . 00 215 . 00 . 00 . 00
Plan Check Total 107 . 50 107 . 50 . 00 . 00
PERMIT ISO)UbBOVI�BeMLW(PtN(JC-ORDANCE WIVIIA"CITY OF AT"T&6BEACH ORDINANCQPAND THE FLORKALO
BUILDING CODES.
JV1,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
r
Page 2
Application Number 12-00001509 Date 10/19/12
Grand Total 403 . 96 403 . 96 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI, CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION r 1 7,=7
CITY OF ATLANTIC BEACH '" ILE COPY
16 zoiz 800 Seminole Road, Atlantic Beach, FL 32233
ocr I
Office (904) 247-5826 Fax (904) 247-5845
jBy AA C04G_�Z_ TPL- PermitNumber:
Job AddruSS; c7s%_2 11 14
Legal Description 41 OCIEPOI i i� L)NJ i-r I- Parcel# I (o 9 4(o 5 - o o(.oB
Floor Area of sq.Ft. Sq Ft
Valuation of Work S Bal Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition 6D window/door
Use of existing/pro osed structure(s) (circle one): Commercial 4Eesid:e:n]ti
1.
. ; s
If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: P-9 Mmj L- Ej'9611 14 G CUWXEM DEC-](-
>
ts�51a L�L_ N Q-0 5PA k- fZ Gf=PREKE.- A 1�;M I%GG T C
ProlDertv Owner Information:
Name: Ct4RIS -A goc� Address: (a F�ERC 14 AW Q_ -ML
city Aj-LP%"TiC_ 16ir-,AC_ " State R_Zip*B2.2?i--3-Phone 14-4 1 - 151-0/4
E-Mail or Fax# (Optional
Contractor Information:
Company Name: Suzv= LS Qualifying Agent: S
Address: r.-.cA4 city zs�'4 Bcizi State 'P L Zip 8Z,-2�
__ ,j,qjQ- 6(042 -13S Fax# Z4q- &�3 0 1—
Office Phone Job Site/Contact Number�2q - alplob y
State Ceitification/Registration# RCXD
Architect Name &Phone#
Engineer's Name &Phone
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
ade a en d h rkad n la , a ';dica, d e tha no work or installation has commencedprior to the
y i
f
n 'v i st"' 0' s ri u nthisjurisdiction. This permit becomes null
or
e str ctZ riod of sixj6) fter
co
ti s ''
t t s s
0 Vt to 0 ed' 0 iZ' ' 1,
rn e to n he tan a ds a e ating I
s p i, c , .�w �
c k s d d or ab, d ned a e months at any time a
I'g,Signs, 11s, ul
c iio s he y to "a' 0 f u t1b We Pools, urnaces,Boilers,Heaters,
r 0
'stru to'or wo
secure f
0 ctrc I or Plun
e t and h al k e
I I I p6e)months 0, 'o
rl'i t wor w r
A P'i a � p d thi, s
ispuance o a
a vo ,
nd id fwo' is not co w it t
"'k is commenced. understand t'at ep',ate Per.. s b d r Ele a k
Tanks andAir Conditioners,etc.
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 YOVIi NOTICE OF
COMMENCEMENT.
I here certify that I have read and examined this plication and Icnow the same to be true and correct. Allprovisions oflaws and ordinances governing this
wa ied with whether i I herei
type .),�, rk will be compl n or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any otherfederal,state, oil oc ai regulating construction or the pe�fbrmance of construction.
Signature of Owner nAA Signature of Co;tra,ctor
Print Name A.P.ArA.6 .......... Print Name =...................
C.P..Z.1 1e.,... ....... ...... ... .... .... ......... &-rT..........
Sworn to and subscribed before me Sworn to and subscribed before me
this -Q(P Dayof Semp_MzQt�" 20 1:L this cL-2-Day of (�k:UnEER 1201:2
Notaiy P lic CyNf-HIA GRAVENOR 0
MYC 166
OMMISSION#EE 090166 c A GRAVENOR
:()MMISSION#EE09
MYC
EXPIRES:May 3,2015 i: . -. '17bvi� d 01.26.10
EXPIRI
Bonded Thru Notary Public Underwriters
F
Bonded Thru Notary Public Underwriters ES:May 3,20
Doc # 2012226236, OR BK 16105 Page 267, Number Pages: 1, Recorded 10/15/2012
at 01:56 PM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00
a,6
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. TaxFolioNo. KqR423- 0011416
State of 01orida County of Duval -
To whom It may concern:
The undersigned hereby Informs you that Improvements will be made to certain real property,and In
accordance with Section 713 of the Florida Statutes,the following Information Is stated In this NOTICE OF
COMMENCEMENT.
Legal description of property being improved: 0:,1EAP4WfAL_e_ 041-r 1
Address of property being improved:
wn C_
General description of improvements: Swimmin pool 1 ne bet j4e44A;6� e#_'SUr4CtC1e_
-SPA I tt%ALI-A-ri,01,1
Owner AQ^YVNEr-_
Address-;LZ 1(4 :&jPC - 7LL-
Owner's interest in site of the improvement -51n%P1
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor SurfSide Poolls;
Address 313 Beach Blvd. , Jacksonville Beach- FL 32250
Phone No, 246-2666 Fax No. 249-8801
Surety(if any)
Address -Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone 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 Statutes.(Fill in at Owner's option),
Name
Address
Phone 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 OWN
SI,ned� (NA I I/ 'S DATE R-4-11L
Before me this_I.LL_He,,of -2 in the
County of Duval,State of Flo4"ah s"peZ Nppeare�"l 1
�E" 49:�-d—bumc- herein by
,fl he
.r If anel affirms that all statements and declarations herein
are true and so
CYNMGPAVENOR
MY COMMISSION I EE 0911186
EXPIRS&May 3,2015
ft NO"Publij Un§p@—
dJ� tA n L4
u County of A_Xj_LC2.L_
Notary blir al Larg State OfT
m1a io _R
My cc a n expires: 6k
Personally Known or
Produced Identification
This Warranty Deed
Made this 15th day of September AD.19 97 Bk: 8731
by Ron E. Price and Cynthia F. Price, Pq, 148
husband and Wife DocN 97214095
Filed & Recorded
09/24/97
11:19t28
hereinafter called the grantor,to HENRY W. COOK
Chris R. Adaaoc and Traci* L. Adaasc, CLERK CIRCUIT COURT
DUVAL COUNTY, FL
husband and Wife REC. $ 6.00
DEED $1,785.00 C=
RECORD AN)RETURM
whose post office address is: 2316 Beachcomber Trail
At,.Iantic Beach, Florida 32233
Grantees, SON:
hereinafter called the grantee:
(whene"r use4 hemin the term"grantorl andSnatee indude aU the parfieg to thit i1wroment and the
heim lepl repvsentativu and suilps o(W"uak and the viecemort sad assips of corporatices)
Witnesseth, that the grantor,for and in consideration of the sum of$ 10.0 0
and other valuable considerations,receipt whereof is hereby acknowledged,hereby grants,bargains,sells,aliens,remises,
releases,convoys and confirms unto the grantee,all that certain land situate in Duval
County,Florida,viz:
Lot 32, OCEANWALK UNIT ONE according to plat thereof recorded in
Plat Book 42, pages I,IA,IB,IC,ID*lZ and IF, of the current
public records of Duval County, Florida.
SUBJECT TO covenants, restrictions, easements of record and taxes for
w4 the current year.
CD
X
0 Parcel Identification Number: 169463-006S
Together with al!the tenements,hereditaments and appurtenances thereto belonging or in anywise appertaining.
To Have and to Hold, the same in fee simple forever.
And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple;
that the grantor bas good right and lawful authority to sell and convey said bud;that the grantor hereby fully warrants
the title to said land and will defend the same against the lawfW claims of all persons whomwever;and that said land is
free of all encumbrances except taxes acc;ruing subsequent to December 31,19 9 6
In WItness Whereof, the said grantor has signed and sealed those presents the day and yew first above
written.
St. sealed and defivered in our presence:
SCHMAN I&
Z
7-- —&--y Rob W.—Price
REATHER Msciia Cynthia 7. Price
Ili Ynotty Pine Trail
Ronts Ved It. PL A—
FI-S-1
State of Florida
County of Duval
71c forcgoing instrument was acknowledged before me this 15th day of September 19 27
by
Ron R. Price and Cynthia P. Price, husband and Wife
who is personally known to me or who has produced driver's license as identificafiln�
Print Nme: i'�w. C o-m I n 1-7
Nmq Publk MYCommExp.Dec.20,1999
PREPARED BY: Albert 2. Buschman, Jr.myQ*xnatiw-
Buschman, Ahern 6 Persons
2215 9. 3rd Street, 1101
WD-1 Jacksonville Beach, PL 322SO
'/93 Pilo No: 97-701
ADAMEC RESIDENCE
2316 BEACHCOMBER TRAIL
ATLANTIC BEACH, FL 32233
EXISTING IMPERVIOUS AREA:
LOT: 13,819 SQ. FT.
C=
HOUSE: 3,317 SQ. FT. C.231
DRIVEWAY: 1,431 SQ. FT. L&j
REAR YARD WOOD DECK: 337 SQ. FT. .4
REAR YARD CONCRETE PAD: 75 SQ. FT. wmm�
POOL DECK: 1,019 SQ. FT.
POOL: 362 SQ. FT.
- ---------- ------------------
TOTAL: 6,541 SQ. FT.
c�
NEW IMPERVIOUS AREA: 't-
04 r)� z
LOT: 13,819 SQ. FT. z
� u
HOUSE: 3,317 SQ. FT.
DRIVEWAY: 1,431 SQ. FT.
REAR YARD WOOD DECK: 337 SQ. FT.
REAR YARD CONCRETE PAD: 75 SQ. FT.
POOL DECK: 962 SQ. FT.
NEW SPA: 57 SQ. FT.
POOL: 362 SQ. FT.
---------- ----------
TOTAL: 6,541 SQ. FT.
NO INCREASE IN IMPERVIOUS AREA AND IT REMAINS THE SAME
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Performance you can rely on...
with 60 years of experience!
Legacy"' Heaters
Jandy's expertise
and design know-how are
re
flected in the technologically-
advanced Legacy Heaters.
5;,
POOL SIZING GUIDE
molcfef 125 17 5, 250 3;��, 400
A 6,k ek6r�wiclth xj
a,ximurri� re engt
'3 1h,
,T; 0 3 W,,' 0"', 1h '31/2��s�""6 3 0
Wind' M P W�,' Wind MPH, Wind. M PH ',�A.Mnd ',MPH Wind, MPH Mod I*1 11# �.�B 1.TU Input. "W!�Width],::"V"Vent 110U.S I �-H-U.S. Weight
15*F 875 675 1250 925 1775 1325 2300 1725 2850 2125 '1000!*11(kcal) -_An�h9&4,crA.l', Diameter OutdoorSt2ok Indoor Stack Lbslkg
LRzm� : �, �i :,:,��, , ,- ,
I "Inches/cm Inches/cm Inches/cm
20T 675 500 925 700 1325 1000 1725 1300 2125 1600 125 125(32) 15"a (38) 6(15) 18(46) 24"a(61) 145(66)
25*F 525 400 1 750 550 1075 800 1400 1050 1700 1300 175 175(44) 18". (40) 6(15) 18(46) 24".(61) 15771)
30T 450 325 625 475 900 700 1250 875 1425 1075 250 250(63) 22V4 (58) 7(18) 18Y,(47) 25Y� (64) 174(79)
325 325(82) 2671. (68) 8(20) 1 18".(48) 26�i(67) 207
35*F 400 300 1 550 400 775 575 1000 750 1225 900 1
400 399001) 32". (82) 9(23) 21 Yi(55) 1 271/,(70) 1 211 1
'he Pool Sizing Guide shows the maximum pool surface area our Le
nodels will heat based on the temperature difference between the aii r Indoorand
i
emperature during the coldest month the pool is used and the desire pool
r — Outdoor Models
ra
emperature. Figures are based on average wind conditions and avera e
)ool depth.
SPA SIZING GUIDE
Model 75�:_:,
125- 400
'R uired to,Raise_,T6 01
5pa� S'ize'. Time eq MR,3 �;,
200 Gallons 30 Minutes 25 Minutes 20 Minutes 15 Minutes 10 Minutes
400 Gallons 60 Minutes 45 Minutes 30 Minutes 2S Minutes 20 Minutes
600 Gallons
90 Minutes 65 Minutes 45 Minutes 35 Minutes 30 Minutes
800 Gallons 120 Minutes 90 Minutes 60 Minutes 50 Minutes 40 Minutes
nutes 60 Minut intes
1000 Gallons 15OMinutes i110Minutes] 75Mi s FE
-he Spa Sizing Guide details the time required for each model to raise spa
emperature by 30'F.
d
See your Sales Representative
for more information!
�A'X Dd tj/T I Me MAR-12-2009( THU) 09: 56 5 u r f s ide Construction P 001
MAR- 12-2009(T H U 0 8 4 8 5urfside Construct i on FRX)9062662759 P 00 1 /001
1 5 0 9 0 0 1 1? 1 L U I J U i I L W L
ust
77, 7. 7,
114
S P E CIF I E AT 1 0 N 5 - H I r a j et TIA 114., Fitting Thread Length
Output 13 GPM. 12 psi.-1111"Nn?71P,
Hole Size: 11 2 3/8" liule baw
10-4100- 1 112'x 1 112"Siacked Jul Body
Options: Wrnnch 30-3801VV
30-3804 11
Hind Held 16-5303
50-3500
I-lydro jC!tr"
W311 filling AssemUly
Stacked Jet Asvernblles
1 1/'*W'q G;I-,ki;l W'111 Fillinn.
30-3806 3D-3001 10-5100
1 30-380.1 Filling
1 1/4"Ihfmd lr.nqlh
III Anscmbly&50-3500 30-3805 Fyrl),qll 0
3�80 in Woll 1-illing Assunil.ily .... I
10-3800 r.ycUjII/Rrmininq ...30-3806 Eyubjll Heliming KmQ
Rinl Asscinibly
1.205
1 12'�Iip
H d r o j E!t TM e 1/2- Fitting Thread Length
03
1 112-x I 1/2"SaCked Jul bUdy
10-AlOO
3 -3804,Go,
0 1kci
in'!;iip r4�kvl Wall filling
30-3bO4 30-JO03 W.4
Will l'illinq ASSvillblY
3 38o in
30-3803 Filling
iflcluuu�: IU-4 101.151,100 2 112'lNuad Itenuill""'
Jel Assointily& 10 3600
3 EyeDall
1 112'SliD 10'.4i0l)Jet Dod Wall Filling Annrimbly 0
in - wili0iiedu 10-3808 FyAnll/Rnmininq .,30-3806 iEyulj3II Retaiiiinq Ring,
Ring AS30Mh1V
SPECIFICATIONS: H Y d r 0 J et T For 1 1/2" PVC Pipe Ext
,>-- �� g I o n
Output ! 13 GPM, 12 psii�,3/8"Nozzle!
Pipe ze: 1 1/2" PVC 0-410 0 5- 1 1 R'x 1 112"
/I Slicked jel Hudy
Ins: Wall Filling ASsellibly 50-3420
Hand Hold 16-5303 30-4401 Cxlrnded
Voinimi NnnIr
07 vC ripe
nnl Included
Of 10-41 COS includes:
I/F:lip 30-1�0 Fxminded
Vvlqu�i Nozllf,,
(Wwl 1:111ino noi inclo0d)
Will'i U-4601
Volui.LNu"
10-41 DUq 11iown will)
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Page 39
r
City of Atlantic Beach
APPLICATION NUMBER
Building Department 3
(To be assigned by the Building Department)
800 Seminole Road
Atlantic B
each, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
Lit,t I E-mail: building-deptQcoab-us Date routed:
cityweb-site� http:/Avww.coab.us
APPLICATION REVIEW AND TRACKING FORM
r
Property Address: De artment review required- Yes No
-par
Build*
ment review greuiredM
g&Z
Applicant: z
Planning&Zonlerg,
' I —
--l-r' -Acim-ffiffisTr-a-To—r
Project: Fb!l I s
C+;u Wo s
EA�c UM
Public Safety
Ikices
Review fee Dept Signature
cy Review or Permit Required Review or Receipt Date
of Permit rifled
Flordi 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: EqAppmved. ElDenied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed by:----�> Date:
TREE ADMIN. Second Review: E]Approved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised OV27110
City of Atlantic Beach
APPLICATION NUMBER
Building Department
30 800 Seminole Road (To be assigned by 0*Building Department)
4
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(W4)247-5B45
t rot
E-mail: building-dept(Mcoab.us
Cityweb-site: http://www.coab.us FrDate routed. Z,
APPLICATION REVIEW AND TRACKING FORM
Property Address: --W rr'� 0"artment review required Ye No
Applicant: 6-7 &Zoni
_�Ro 40 L-S Planning
61- 1-1r;-Admiin raor
bI
rl
Project: r'-) 1)5 _<ZT;ubAri Wo—fia
'J o DII Me
Public Safety
Fire Services
Review fee Dept Signature
Other Agency Review or Pennit Required Review or Receipt Date
of Permit Verified 8
[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: E3A/pproved. nDenied.
(Circle one.) Comments:
('BU�ILDIN
PLANNING&ZONING Reviewed by: 1`171 Date:_ 10 zs-le7
TREE ADMIN.
Second Review: OApproved as revised. E]Denfdd.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SER\ACES Third Review: DApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised OV27110
e i
-I 'D !
V
N Cit of Atlantic I
y Beach
Building Department APPLICATION NUMBER
I
b assigned by the Building Department)
0 a I
�11 800 Seminole Road (To be
Atlantic Beach, Florida 32233-5445
Phone(904)247-5626 - FaX(904)247-5845
DPW, E-mail: building-dept@?coab-us t ro�
City web-site: http://www.coab.us FEDaterotAe!dgj� Z,
APPLICATION REVIEW AND TRACKING FORM
Property Addres.s: review re uired es No
,%e �rtirnent review re y
11
Applicant: 6 5-; Planning&Zoni
1 Fee P;mini ra or
Ij
Project: 146r, r- Rli orks
1C Itle
Public Safety
Fire Services
IF7M
Review fee $
Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept.of Environmental Protection Of Permit Verified IS
Florida Dept.of Transportation
SLJohnsRi r Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First7ftvlew: Approved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Date: 0/1
TREE ADMIN. —::i
Second Review: ElApproved as revised. E]Denied.
Date:
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SER\ACES Third Review: ElApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 07127110
V ED
City of Atlantic Beach
OCT APPLICATION NUMBER
Building Department .16 2012 1 as - Zd !w
800 Seminole Road (To be assigned by the Building Depitment.)
Atlantic Beach, Florida 32233-5445
J
Phone(904)247-5626 - FaX(904)247-5845
V101- E-mail: building-de"coab.us ffDaate=rotAed. Z--
Cityweb-site. http*lAovww.00ab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: r r"7 1 rrl, Department review required Yes No
widinn 3
Applicant: Pale -Planning&Zoni
U I Fee Administrator
Project: &-5 7"X// -2)j�,C e-' -r-k-
bile Wo �s
c!T_i Mie
Public Safety
Fire Services
9!!!M
Review fee Dept Signature
Other Agency Review or Permit Required Review or Recel Date
of Permit
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
;e OrR
lt:Verifledl
St Johns River Water Management District
Anny Corps of Engineers
Division of Hotels and Restaurants
Division of Aicohofic Beverages and Tobacoo
'co
Other:
A -
APPLICATION STATUS
Reviewing Department First Review: ETAPP E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN. Second Review: ElApproved as revised. E]Denied.
P Comments:
WO
P
PUBLIC SAF Reviewed by: Date:
FIRE SER\M11CfES Third Review: nApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised 07127110
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001703 Date 11/15/12
Property Address . . . . . . 2316 BEACHCOMBER TR
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0 --------------
--------------------------------------------------------------
Application desc
Swimming Pool Elec -------------------------------
---------------------------------------------
Owner Contractor
------------------------
------------------------ DAVID PRUETTES ELECTRICAL SVC.
ADAMEC CHRIS R & TRACIE L 331-8 PARKRIDGE AVE
2316 BEACHCOMBER TRAIL FL 32065
ATLANTIC BEACH FL 322336607 ORANGE PARK
(904) 272-722S
-- -------------------------------------------------------------------------
Permit ELECTRICAL PERMIT
Additional desc SWIMMING POOL ELECTRICAL
Permit Fee . . . . 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date 5/14/13 -------------------------------
------------------------------------STATE ELEC DCA SURCHARGE 2 . 00
Other Fees . . . . . . . . . STATE ELEC DBPR SURCHARGE 2 . 00
---------- -----------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 9S . 00 95 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 99 . 00 99 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERmrr APPLICATION
Crry OF ATLANTIC BEACH
c Beach,FL 32233..
800 Seminole Rd, Atlanti
Ph(904)247-5826 Fax(904)247-5.845
#
W ADDRESS:
14EW SERVICE EDOverhead F-1 Underground ED Underground u.p Pole
OResidential(Main) Service #ofMeters
00-100 amps 0101-150amps 0 151-200amps 0 _�a�ps
Ocommercial(Main) Service -amps OCT Service amps
00-100 amps E1101-150amps 0 151-200amps 0
Conductor Type--------. Size
OMulti-Family (Main) Service 0 151-200amps 0 __amps #of Unit Meters
o0-100 amp:s 0101-1soamp
OTemporary Pole 0 _PMps s 0 CT Service_amps
SERVICE UPGRADE --amp
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC-)
0100amps 0150amps 0 200amps 0 __jamps 0 CT Service-amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES'ETC.
outlets/Switches: 0-30amps -31-100amPs _101-200amps
101-200amps
Appliances: -0-30amps -31-100amps
A/C Circuits: -0-60amps 61-100amps
Heat Circuits: - 4 circuits
Number f Lighting outlets, Including Fixtures:
OTH; hn
S L;LECTRICAL PROJECTS OTransformers-KVA OMotors
wimming Pool 0 Sign OSmoke Detectors—Qty
FIRE ALARM SYSTEM (Requires 3 sets of plans &Fire Alarm Checklist)
Qty—volts/amps VALUE OF WORK$
REpAIRS/MISCELLANEOUS [I Safety Inspection OPanel Change OOH to UG
OReplace Burnt/Damaged Meter Can
OOther: commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
Permit becomes void if work does not — true and correct. All provisions of laws and ordinances governing this work Will be complied with whether
read this application and know the same to be ation construction or the perfonnance of
specified or not The permit does not give authority to violate the provisions of any other state or local law regul
construction.
A,5;(AW-e_ Phone Number
Property owners Name 71�� -7 __7JQ'S__ Fax d26-L 2Dc)l
Electrical Company office Phone
city ow ltew_La State FL- ZIP -�Zo
Co.Address:331-S Ph*tlda� Ave- Certification/Regismation# E0_cW0923
-Zavid ftw,*:e_
License Holder(Print).
NotarizeiLSi ofLI-nseHolder
_�,-i!ature ce
1(0", day of 20 (2
KAREN EWING�W Sworn,and subsciibed before e
I MY COMMISSION 01074229
A" Signature of Notary Public
EXPIRES May 21.2018