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711 and 715 Selva Lakes Cir (vault) BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT CITY OF ATLANTIC BEACH, FLORIDA CERTIFICATE OF OCCUPANCY WORK SHEET Date Requested: Building Contractor: Reyhani,Inc. Building Permit Number: 9665 Address: 711 Selva Lakes Circle Legal Description: Lot 138 Unit III Selva Lakes Improvements to the above described property have been completed in accordance with the terms of the permit and is certified to be ready for occupancy as ------------ Lowest Floor Elevation: ---------- ---------- ---------- required as built n/a Sales Tax Certificate: ----------------------- date submitted BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE DEPARTMENT DATE NOTIFIED: DATE APPROVED: BY: Fire Chief --------------- --------------- --------- Public Works --------------- --------------- --------- Planning Director --------------- --------------- --------- Building Inspector --------------- BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT CITY OF ATLANTIC BEACH, FLORIDA CERTIFICATE OF OCCUPANCY WORK SHEET Date Requested : Building Contractor : Reyhani,Inc. Building Permit Number: 9665 Address : 715 Selva Lakes Circle Legal Description : Lot 137 Unit III Selva Lakes Improvements to the above described property have been completed in accordance with the terms of the permit and is certified to be ready for occupancy as Dupl ex -------------- Lowest Floor Elevation: ---------- ---------- ---------- required as built n/a Sales Tax Certificate: ----------------------- date submitted BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE DEPARTMENT DATE NOTIFIED: DATE APPROVED: BY: Fire Chief --------------- --------------- --------- Public Works --------------- --------------- --------- Planning Director --------------- --------------- --------- Building Inspector --------------- v Tprtifiratr of orrupaurp CITY OF 00(afta DrVartmrnt of %ijbing Jnoprrtinn This Certificate issued pursuant to the requirements of Section log of the Southern Standard Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances regulating building construction or use. For the following. New Residential Bldg.Permit No.__---9665 5 Use Classification Atlantic Beach _ Group___-- Type Construction Frame Firc District. RGM Properties,Inc, Address__439 Selva Lakes Circle Owner of Building Selva Lakes Unit III 711 Selva Lakes Cird&ty__—__ — Building Address— By:_ -- Rene' Angers Date —— -- Building Official ►O{T IN A CONSPICUOUS PLACE v C�rrtiffiratr of orrupaurg CITY OF owftuc Urpartmrnt of Building Navation This Certificate issued pursuant to the requirements of Section log of the Southern Standard Building Code certifying that at the time of issuance this structure was in compliance with the g building construction or use. For the following carious ordinances regulatin . New Residential Bldg.Permit No. 9665 use classification Atlantic Beach Type Construction Frame Firc Distsict Group T 439 Selva Lakes Circle Owner of Building RGM Propert ies,I�ne. Address__ lva akes Unit III Building Address_ 715 Selva Lak 1rcola�ar_.MeL By:_ Ren eDate: Building--al POST IN A CONSPICUOUS PLACE CITY OF Office of Building Official m, REQUEST FOR INSPECTION �—J( Permit No. ( (C✓ Date District No. TimeP.M. Received Lo lity Job Address s Owner's Contractor Name ING MECHANICAL CONCRETE ELECTRICAL Air.p MBCond.& 71BUILDING Rough Wiring ❑ Rough Heating Framing ❑ Temp Pole ❑ Top Out Re Roofing ❑ Slab Sewer Fire Place Lintel �d Final Pre Fab 1( (A)b Ul READY FOR INSPECTION / A.M. —P.M. Wed. - T urs Mon. Tues. A.M. 7-Y P.M. Inspection Made G Final Inspection Inspector Certificate of Occupancy Date CITY OF ATLANTIC BEACH 1 �.} 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00000845 Date 6/23/08 Property Address . . . . . . 711 SELVA LAKES CIR Application type description RESIDENTIAL OTHER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 777 ---------------------------------------------------------------------------- Application desc INSTALL GARAGE DOOR ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BUSH, HUGH OWNER 711 SELVA LAKES CIRCLE ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee 17 . 50 Issue Date . . . . Valuation . . . . 777 Expiration Date . . 12/20/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE . WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total 17 . 50 17 . 50 . 00 . 00 Grand Total 52 . 50 52 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 1' 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 O OFFICE:(904)247-5826•FAX NO.:(904)247-5645 FilI BUILDING-DEPT@COAB.US l BUILDING PERMIT APPLICATION DUVAL COUNTY 1:JOB ADDRESS:_ '►–[/� 2:VALUATION OF WORK":1 ' 3;:$Q F7.UNDER ROOF+ I �c�r �F52233 DESCRIPTION: S;CLASS'OFWORK: .. ::< 6.USEOF;STRUCTURE' ❑NEW BUILDING ❑DEMOLITION ❑RESIDENTIAL LOT—BLOCK_SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7'DESCRIPTION OF WORK: ❑ALTERATION EI ACCESSORY BLDG. 8.FIRE SPRINKLER: V/ REPAIR ❑POOL/SPA ❑YES ❑NiA 1 1I DW I❑MOVE ElOTHER i El NO PROPERTY OWNER: CONTRACTOR: ARCHITECT/ENGINEER: ,9.-NAA�'M��EE: IynyJ��tiqJ 15.COMPANY NAME: 23.COMPANY NAME: 1,,,�/ `�"" 16. ME: 24.LICENSEE NAME: 10.ADDRESS: 17.STAT F FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 1 r 18.ADDRESS: 26.ADDRESS: 1 �`� 1. FFIC /`iTpt 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30,EMAIL ADDRESS: FEE SIMPLE TITLE HOLDER: BONDING COMPANY. MORTGAGE LENDER: (IF OTHER THAN OWNER):' .:5; ._.. 31.NAME: 33.NAME: 35.NAME: RESS: 34.ADDRESS: 32.ADD36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs,Wells, Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. WARNING TO OWNER: ** YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER or AGENTCONTRACTOR (If Agent,Power of Attorney or Agency tetter Required) (Qualifier Only) I b� Signe Date: Signed: Date: ' Beforme this ay of �,l� j 20Nthe county of Before me this day of 2007 in the county of e Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared herin by himself/herself a affirms that all statements and declarations are herin by himself I herself and affirms that all statements and declarations are true and accurate. true and accurate. Nota Public at Large,State of ,County of Notary Public at Large,State of ,County of Notary ❑Personally Known –}� ❑Personally Known Produced Identification- ❑Produced Identi n- ture Notary Signature CE public-State of Florida ATLANTIC BEACH Notary CITY OF;•=My Commission Expires Feb 28,2010 SEE PERMITS FOR ADDITIONAL nnnF 'LF `a Commission#al otary REQUIREMENTS AND CONDITIONS. � O; Bonded By National Notary Nssn.M BL 0 ISE :11t/ 07 REVIEWIS()I@Y, DATE: D"t) `' CITY OF ATLANTIC BEACH ®WNER / BUILDER AFFIDAVIT I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: 1 D:SCLOSUP.E STATEMENT FOR SECTION 489.103(7),FLOP-IDA STATUTES: 1 I STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. 11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826) IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. yt ADDRESS // PHONE NUMBER PRINT NAME I SIG4z&— JAREDATE I � I Before me this/ day of Az in the county of Duval,State of Florida,has personally appeared herin by himself I herself and affirms that all statements and declarations are true and accurate. �� 1 V I r Notary Public at Large,State of ,County of I.i J JQ l K. CUNNINGHAM ❑Personally Known °LIe(�; Notary Public-State of Florida 10 roduced Identification .1:-My Commission Exp =2+ fres Feb 28, F ; a;r+ • Commission#DD 523638 Bonded BY National Notary Assn. Notary Signat e: COAB FORM BLDG07;REVIS ' B/14/2 SELLA LAKES HOMEOWNERS ASSOCIATION REpUEST)Oft 2C�I3TECTUIUL APPR0VXL This request fonn is to be completed by the HOmeoNrner and subtnittcd to tha(ARC)prior to the commencement of work. ■ THIS SECTION TO BE COMPLETED BY HOMEOWNER Date: r7 aC a7 d 2 ����12!�� 2 ry Lot# / J Name: I.� - Address: j c� Q c� G� Home Phone: of — / �L Other Phone: Contractor: ht-e-j Describe the work to be done: (i.e.screen room.addition. fence, ge�doopL siding,outdoor lights,exterior painting, roof repairs/replacement,gutters,etc.) 1,4, Location: Attach a copy of your survey indicating the location of the work to be done. Describe Location;,49 - Specifications: Attach a copy of4he plans,drawing,picture.specifications(material,color,etc.) All exterior paint must meet SLA specifications. Estimated date of completion: NOTE; Owners are responsible for the conduct of the contractor. You are required to supervise the work being done. You are personally, responsible and liable for any damage done to common property or adjacent property. When required by the City of Atlantic Beach,you are required to provide the ARC with a copy of the building permit_ Homeowners Signature: Date: Date Received by ARC: Date Approved Date Denied ARC Sigrature(s): Comments or conditions: ^Q QN VVII O CNa W qqCK NNO �t AII �i� JNo 1 F�g 7J11 % x r Jill _� ` WO _ o � _ '� ury�H uooa-uaw 7.v�eo ' 8R `KE u� d sip = R� t a j y �i9Sa ~#a 8 A 3 [e lit, ��� r � a°gyp_ � s$� � � F� � a•o ~� L All caOL c o r �talr ?(Sh Y fV4 oil Y a fill N" _ 1m:.. Is, T41k o ry .o oaH.00a m tT MAP SHOWING BOUNDARY SURVEY OF LOT 139 AS SHOWN ON MAP OF SELVA LAKES UNIT THREE AS RECORDED IN PLAT BOOK 44, PAGES 60 THROUGH 608 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. FOR: SHAFFER AND SONS ENTERPRISES BEARING REFERENCE: BEARING SHOWN ON RIGHT-OF-WAY UNE HEREON IS THE SAME AS SHOWN ON THE ABOVE MENTIONED PLAT, SELVA LAKES CIRCLE P.R.C. 4 �j77. (50' R/W) R 0? c 329.9 6, �S• l a 237'31 C,y A g 33' a 1. 7 A ,74,?�'a r• /� ( ! P.R.C. 1, b 7;;1" O L�`',1� w 24 7' P.C. 75 Qj - - r "p. r\ 20 8' � /0. v N r, N 14 \�a •. (p •r- O J. 5' WOOD PENCE 4 CID N TA P J w 0 ,3,4 a 0 a O o 6 00 cD O • 4 9 O 18 Z ti ry 6' WOOD FENCE x__ X X � _X-1 RECEIVED ,a'°, 34.SO' CITY Or-ATLANTIC BEACH 0111 l,n:r^ P 7nN,!NG S83.42'00"W J JUN 1 2008 THE PLAZA (80' R/W) fOUNDAT/OA/ SURVEY /-25-97. AVO re' FoanYJ Acc Po vs. I HEREBY CERTIFY THAT THIS SURVEY, PERFORMED UNDER MY RESPONSIBLE DIRECTION MEETS THE ���GENp; MINIMUM TECHNICAL STANDARDS FOR LAND SURVEYORS IN ACCORDANCE WITH CHAPTER 61617-6, FLORIDA ADMINISTRATIVE CODE (PURSUANT TO SECTION 471.027, r'LORIDA S TA ijTt.S), AND FOR IHER C.CR llf r Ir p"i THERE ARE NO VISIBLE ENCROACHMENTS UPON THE SUBJECT PROPERTY EXCEPT AS SHOWN. • 1/2_ � dtON O 1/2' SET IRON - to 1704 /��� �p�7�ry 7� /�,' ♦MM B.R.I_ 9UkDW RESTRICTION LINE FLOOD CERTIFICATE:lr ICA 1 G: THE LOT SHOWN HEREON S IN FLOOD , CLARSON AND ASSOCIATES,GS, INC. R �KIgL ANGLE ZONE 'X' AS SHOWN ON THE FLOOD INSURANCE RATE 1643 NALDO AVE., JACKSONVILLE, FL, 12207 A ARC LENGTH MAP, COMMUNITY PANEL NO. 120075 - 00010 . DATED 4-1J-69. CHCHORD P.C. POINT OF CURVATURE — P.T. POINT OF RE%OEnSCY SURVEYED APRIL 27_ POINT1995. P.R.c. Pr of ri£vtxsE CURVE R.C.C. POINT OF COMPOUND CURVE FD. FOUND SCALE: = 20CISTERED SURVEYOR N0. 2361, FLORIDA R/w RIGHT-OF-WAY O.R.V. OFMAL RECORDS VOLUME FIELD BOOK 537 PAGE 73 JOSE A. HILL a SCO COLUMN 5150 1, 41 it I 1l o C X ° m ° 0�7 (D X ° N 3 r N + ( o v on�f.�f a m 'D `z a N A c U) Aon T3 0 CD CD m W r ° -o o a CD CD 00 r 0 a o m a n- mai � 3 p� 0 D `° m o5. 0 � v o v o 3 C CD T- o . W ° d r f=p N CD ^ CD CD lJ, CD x (D N \0 Z o 0 o fil a N oEF 0.CL C C7 N N CL CD nO 0 76 70 C', .a o CD wa�a� 3 3 V > > W + N o C) o �vom e TO m CD CD _rl o CD CDEP ° CL N (� Er a o Q 60CD 0 o City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road _ 645 z Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: vI City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM I va �vas rc�� Department review required Yes o Property Address: Building 97ri4 blffk Planning & Zoning Applicant: Public Works D Public Utilities Project: Public Safety Fire Services Review or Receipt Date Other Agency Review or Permit Required of Permit Verified By 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. APPLJCATION STATUS Reviewing Department First Review: Approved. @Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: O Date: C1k"do PUBLIC WORKS PUBLIC UTILITIES Second Review: [—]Approved as revised. @Denied. Comments: PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT CITY OF ATLANTIC BEACH, FLORIDA CERTIFICATE OF OCCUPANCY WORK SHEET Date Requested: August 29, 1990 Building Contractor: RGM PROPERTIES Building Permit Number: 9665 Address: 711 Selva Lakes Circle Legal Description: Lot 138 Improvements to the above described property have been completed in accordance with the terms of the permit and is certified to be ready for occupancy as Single Family Attached ----------------------- Lowest Floor Elevation: --------- ---------- ---------- required as built n/a Sales Tax Certificate: ----------------------- date submitted BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE DEPARTMENT DATE NOTIFIED: DATE APPROVED: BY: Fire Chief --------------- --------- Public Works --------------- --------------- --------- Planning Director --------------- --------------- --------- Building Inspector --------------- CITY OF Office of Building Official REQUEST FOR INSPECTION q� Date ` Permit No. Time A.M. Distr'ct No. Received P.M. Jo dress � �Locality Owner's Name Contractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing - Rough Wiring ❑ Rough ❑ Air.Cond.& Re Roofing ❑ Slab - Temp Pole ❑ Top Out ❑ Heating Lintel _ Final Sewer C Fire Place Pre Fab OR IN ION A.M. Mon. Tues. Wed. (�/l Thurs. Friday RM. e KA? Inspection Made Inspector Final Inspection❑ of Occupan Date CS.,,rrtifiratr of Ornipattry CITY OF t4&ft 4 — Epparbun# of +Vnilding Ansprrtinn This Certificate issued pursuant to the requirements of Section 109 of the Southern Standard Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances regulating building construction or use. For the following. Use Classification SINGLE FAMILY Bldg.Permit No. -3011 Group Type Construction FRAME Fire District. ATLAiyTIC BEAC. Owner of Building RG14 PROP RTIES nddres5_Z15 SELVA LAKES Building Address 715 Sema Lakes Ct mal; Atlantic Beach, FL DON C. FORD Building Official Date: t October 5 1990 POST IN A CONSPICUOUS P"C[ BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT CITY OF ATLANTIC BEACH, FLORIDA CERTIFICATE OF OCCUPANCY WORK SHEET Date Requested : /�/2./9v Building Contractor: Building Permit Number: / �✓ ( I Address: 716- SQ tea- e,S Legal Description: Improvements to the above described property have been completed in accordance with the terms of the permit and is certified to be ready for occupancy as 5,11121/ � ,/ --- -9/--- Li---- Lowest Floor Elevation: _____ ___ ---------- ---------- required as built n/a Sales Tax Certificate: ----------------------- date submitted BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE DEPARTMENT DATE NOTIFIED: DATE APPROVED: BY: Fire Chief --------------- Public Works --------------- --------------- - Planning Director --------------- -----------/---- --------- Building Inspector CITY OF ATLANTIC BEACH x ' 86 FLORIDA August 1, 1990 NAME RGM PROPERTIES ADDRESS 1112 Third Street CITY Neptune Beach, FL 32233 Re-inspect for 711 Selva LakesLot 138 � ) Acct.01-369-9000 $10.00 ATE: 08/01/90 7ME: 12:08 Ph( $10.00 $10.00 When Signed, Dated and Numbered, This Becomes an Official Receipt KR: %626 MAKE CHECKS PAYABLE TO Received Payment CITY OF ATLANTIC BEACH, FLORIDA TREASURER -40 ADDRESS---- / ---ALL ------ ------ ----------------- CONTRACTOR__ —7-- ------�—`�------------------------ OWNER--- ------------------------- BUILDINGMECHANICAL q�Q. PLUMBINGJG01 � 0 ELECTRICAL_ loD R�5- TEMP POLE--------- MISC_------__-- 71�ELECTRICIAN_ . DATE FAILED DATE PASSED TEMP POLE JEA---------- ----------- ----------- FOOTING ----------- ----------- � � ��ROUGH PLUMBING ----------- � -------- SLAB ----------- ----------- FRAMING ----------- MECHANICAL/FIREPLACE x— -- —a _----____—_ ----------- TOP OUT PLUMBING --__—______ ROUGH ELECTRIC ----------- --- --� FINAL ELECTRIC ----------- ----------- FINAL BUILDING ----------- _____------ ELEVATION SUBMITTED ----------- _________-- CERTIFICATE OF OCCUPANCY ----------- ----------- DATE ORDERED — --------- DATE ISSUED ----------- Trr ifiratr of (Orrupaurp CITY OF out&.4& �Gs- Urpttrtmrnt of 'Nuiiding Nopprfinn This Certificate issued pursuant to the requirements of Section 109 of the Southern Standard Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances regulating building construction or use. For the followin'o. Use Classification Single Family Attached '1199 BIdg.PermitNo. Gmu •CypeCmstrudionT''rame Fire District At�.antic Beach PP.O. Box 657 Owner of Building RGM PROPERTIES—Address— Building Addrm 655 Selva Lakes Cr. L«ality Atlantic Beach, FL DON C. FORD 8/2: /90 Building Official Date: — FM'r IN A CONSPICUOUS P"C[ r r _ CITY OF ATLANTIC BEACH SSS 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 i JF�S)r INSPECTION EMAIL REQUEST: Building-deptncoab.us Application Number . . . . . 07-00000458 Date 4/06/07 Property Address . . . . . . 715 SELVA LAKES CIR Application type description MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 cu 1 ahu ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KNUDTSEN, KEVIN OCEAN STATE HEAT & AIR, INC. 715 SELVA LAKES CIRCLE 1476 ATLANTIC BLVD. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 249-8251 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 79 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/03/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 79 . 00 79 . 00 . 00 . 00 Plan Check Total . 00 . 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. 1 rril Ire .- �,,, CITY OF ATL-�NTIC BLACK , �r�+cn� I CH-A�NC .L PERMIT APPLICATION Date: Property Address: Owner: Telephone 4l: Contractor: c)CjEanl ' 9 � Telephone#: .Contractor Address: 147�, Gai �'�l �l �,� Fax In consideration of permit given for doing the work as described in the above s-mement,we hereby agree w perform said work in accordance with the attached plans and specifications which are a part hereof and k accordance with the City of,Atlantic Reach ordinances and standards of good practice listed therein. Type of Heating Fuei: If other consmiction is being done on this buildma or site,list the btnlding permit number. m/Electric �.;- _ El Gas: LP N=r l 11(. nttal Utility ❑ Oil ❑ Other-Specify MECHANICAL EQUIPMENT TO BE LNSTALLED NATURE OF WORK "at _Space _Recessed UC;e�tral _Floor p/REsidenrial J-`Air Conditioning Room _vC�entral ❑ Duct System: Material Thic'Imess ❑ Commercial Maximum capacity GIM ❑ Rei iQeration ❑ New Bitilding Cooling Tower. Capacir✓ pin ❑ a g E��stinBuilding ❑ Fire Sprinhlers:Number of Heads — / - J ❑ Elevator: -M lift Escalator (Number) 1y Repiac=ne SL E,IStinRSystem ❑ Gasoline Pumps (Number) ❑ Tanks (Number) ❑ New lastalladon ❑ LPG Containers (Number) (No system pry riously installed) ❑ Unfired Pressure Vessel ❑ En,ension or Add-on to Emsting System ❑ Boilers ❑ Gas Piping ---- er- peck- ----—- ---— ❑ Other=Specify LIST ALL EQUIPIYIENT .,UR CONDITIONING,RZlePLIGTRATION EQUIPN t &CONDENSOR'S Approving Number Units De ri tion Model M Manufacturer Ton?s Agency YHEATING-FURNaACE S,BOILER5, rACES cke-A HANDLER'S Approving Number Units Description u 'U.odel m Manufacturer BTVs Agency 6 ,030 30 vo Capacity Serial ,=Approving TAlYKS Nomrnal�apaciry Type.Liquid ppro How Many Dimensions Contained Manufacturer No. 'A..Cv 300 Seminole Road • Atlantic Beach, Florida '23333-5445 Phone: (904)347-5300 . Fas: (904):47-5845 • http:!/www.ci-atlantic-beach_fI_us CITY OF ATLANTIC BEACH i s J 800 SEMINOLE ROAD j r ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00030016 Date 4/08/05 Property Address . . . . . . 711 SELVA LAKES CIR Tenant nbr, name . . . . . . REROOF Application description . . . ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2200 Owner Contractor ---- -------------------- ------------------------ BUSH, HUGH ALLBEIT UNLIMITED ROOFING 711 SELVA LAKES CIRCLE 961 SUPERIOR RD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32258 (904) 294-2378 ---------------------------------------------------------------------------- Permit . . . ROOF PERMIT Additional desc Permit Fee . . . . 68 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation 2200 Fee summary Charged Paid Credited Due Permit Fee Total 68 . 00 68 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 68 . 00 68 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES., BUILDING OFFICIAL CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address JH Lga LAAC-c-5 Com_ Date Heated Square Footage @ L ' ft= $ Garage/ Shed Wr—@ $ per sq ft= $ Carport/Porch @$ per sq ft= $ Deck @$ per sq ft= $ Patio @$ per sq ft= $ TOTAL VALUATION: $ 3.s $ 3.5 Total Valuation 1st $ /oma l(od $ ! Remaining Value per thousand or portion thereof CONSTRUCTION TYPE: TOTAL BUILDING FEE $ L( ZONING: + %2 Filing Fee $ .1 FLOOD ZONE: ( )Fireplaces @ $35.00 $ IMPERVIOUS SURFACE: BUILDING PERMIT FEE $ �'$ WATER IMPACT FEE $ SEWER IMPACT FEE $ WATER METER/TAP $ CAPITAL IMPROVEMENT$ SEWER TAP $ C ( )RADON .0050 $ SECTION H PAVING( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ST( ) SURCHARGE $ OTHER $ GRAND TOTAL DUE: $ � . 3�S rLlJ J� CITY OF ATLANTIC BEACH cc: sBUILDING / ZONING DEPARTMENT D. Ford 1 800 Seminole Road en� Atlantic Beach,Florida 32233 (904)247-5800 R E C E I V E D (904)247-5845 Fax CITY OF ATLANTIC BEACH www.coab.us BUILDING ?� 7nn;iNG PLAN REVIEW COMMENTS AM 1 2005 Permit Application # OSC--0 I (,:, BY: Property Address: `7 1 Applicant: E 17' �a�f-- Project: C 200 TVermit application has been: f Approved following items need attention: (� i2 t t � - tLo 1 e. 0 -Lo 2 VW ? 2� C Please re-submit your application when these items have been completed. Reviewed By: Date: Date Contractor Notified: i RECEIVED as•=�•�i�,, CITY OF ATLANTIC BEACH BUIL nl±uG k ZONING ,n ts1 r CITY OF ATLANTIC BEACH APR 1 2005 r s) ROOFING PERMIT APPLICATI N BY: D Job Address: Owner of Property: f w Address: 711 ✓ Telephone: Z 7,/7,7 0 Contractor: X4111 -1-1 State License Number: CC Contractor's Address: "e-3C o o/ L^/ Telephone: 7 2y /`, 3y- %SSS Fax: Scope of Work: 111:1C jaoc,,r,- e �l039 Deck Slope: Greater than 2:12 Less than 2:12 Valuation of work: -Z Z 67P Product Name(Example: Timberline): A /� Manufacturer(Example: GAF): ASTM Designation(s): P30/ Required Inspections: Sheathing and Final Signature of Owner: Date: y/C jp 2606 Signature of Contractor:� ,,Z,4& Date: MyzA 361 ZcS,55- AS TO OWNER: Sworn to and subscribed before me this day of � h ,2065- State 065State of Florida,County of Duval ac" Wlv�Notary's Signature: o— LAURA HAMMERTON Notary Public, State of Florida ❑ Personally known My Comm. exp. Nov. 28, 2008 ED'roduced identification Y� Comm. No. DD 3748,13 Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this 40 day oK2v/e ,200..5 State of Florida,County of Duval �L Notary's Signature: ❑ Personally known 0.--V. Diana Crawford Produced identification 4: .: MV COMMISSION# DD206237 EXPIRES April 24 2007 Type of identification produced R(NO`• BONDED THRU TROY FAIN INSURANCE,INC Ivo F d y ?%v� Df 1 1,1 ['L-c [..f /l `jJ n , 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.uuss Page 1 Revised 221/03 t: G..., weather Stopper°Integrated Roofing System'has earned the prestigious Good Housekeeping Seal, I whim means that Good Housekeeping stands behind the products _ in this system. `\M\ti0.11.01Y to co..fAf (Beier to Good Housekeeping Good Housekeeping Magazine for its gPromiseprof-oon poll',.: CN6NI n e 11SO if eEFE 4 Timberline"Ultra®Shingles (Available Nationwide) 13/<"x 39%"Metric Class A rating from UL Approx. 80 Pieces/Sq. (English) -- 12"x 3615/6"English Passes UL 997 110 mph Wind Test 4 Bundles/Square CSA A123.5-M90 and CSA A123.5-98 Approx. 256 Nails/Sq. (Metric) ASTM D3018 Type 1 Approx. 320 Nails/Sq. (English) Super Heavyweight design ASTM D3161 Type 1 -ASTM D3462' 5,1/8" Exposure (Metric) Lifetime Ltd.Transferable Warranty Dade County Approved 5' Exposure (English) 110 mph Ltd. Wind Warranty3 Meets Wisconsin Administrative Code For Distinctive Ridgge Capp Shingles,use matching Fiberglass Asphalt Shingle Approx. 64 Pieces/Sq. (Metric) Timbertex"or Pad icRidge"Ridge Cap Shingles Timberline"Select 40-Shingles (Available Nationwide) 13/<<"x 39%"Metric Class A rating from UL Approx. 80 Pieces/Square (English) -- 12"x 3615/,6'English Passes UL 997 Wind Test 4 Bundles/Square CSA A123.5-M90 and CSA A123.5-98 Approx. 256 Nails/Square (Metric) ASTM D3018 Type 1 Approx. 320 Nails/Square (English) Heavyweight design ASTM D3161 Type 1 -ASTM D3462' 5 5/8" Exposure (Metric) 40-Year Ltd. Transferable Warranty Dade County Approved (Tampa only) 5" Exposure (English) 80 mph Ltd. Wind Warranty Meets Wisconsin Administrative Code For Distinctive Ridgge Capp Shingles,use matching Fiberglass Asphalt Shingle Approx. 64 Pieces/Square (Metric) TimbertexR or PaciiicRidge"Ridge Cap Shingles Timberline®30 Shingles (Available Nationwide) 13%"x 39%"Metric Class A rating from UL 3 Bundles/Square -- 12"x 3615/,6"English Passes UL 997 Wind Test Approx. 264 Nails/Sq. (Metric) CSA Al 23.5-M90 and CSA Al 23.5-98 Approx. 312 Nails/Sq. (English) ASTM D3018 Type 1 5 5/a" Exposure (Metric) Standard Weight design ASTM D3161 Type 1 -ASTM D3462' 5" Exposure (English) 30-Year Ltd. Transferable Warranty Meets Wisconsin Administrative Code 70 mph Ltd. Wind Warranty Approx. 64 Pieces/Sq. Metric For Distinctive Ridge Cap Shin es, use Fiberglass Asphalt Shingle Approx. 80 Pieces/Sq. (English) Ridge ICapTShibnegles or Pacific, idge`" Marquis° WeatherMaxO Shingles (Shaded sections indicate availability) 12"x36" 80 mph Ltd. Wind Warranty ASTM D3161 Type 1 -- ---------- Fiberglass Asphalt Shingle ASTM D3462' Class A rating from UL Meets Wisconsin Administrative Code Passes UL 997 Wind Test Approx. 80 Pieces/Square Super Heavyweight design CSA A123.5-M90 and CSA All 23.5-98 3 Bundles/Square co A 30-Year Ltd.Transferable Warranty ASTM D3018 Type 1 Approx. 320 Nails/Square D frl ® 5" Exposure o Royal Sovereign Shingles (Available Nationwide) z � 13'/4'x39'/8" Metric Class A rating from UL Approx.80 Pieces/Square(English) G) m----------- 12"x 36" English Passes UL 997 Wind Test Approx.65 Pieces/Square(Metric) N_ CSA Al 23.5-M90 and CSA A123.5-98 Approx.3 Bundles/Square —ASTM D3018 Type 1 0' Approx.320 Nails/Square(English) design ASTM D3161 Type 1 pp ( g ) eC."HeavyweightZ `ITi% g yP Approx.260 Nails/Square(Metric) G) 25 Year Ltd.Transferable Warranty ASTM D3462' 5"Exposure(English) ':: 60 mph Ltd.Wind Warranty Dade County Approved 55/8"Exposure(Metric) Fiberglass Asphalt Shingle Meets Wisconsin Administrative Code --_ JUMBO Royal Sovereign"Shingles (Shaded sections indicate availability) 17"x 40' 110 mph Ltd. Wind Warranty ASTM D3161 Type 1 --- Fiberglass Asphalt Shingle ASTM D3462' Class A rating from UL Dade County Approved Passes UL 997 110 mph Wind Test Meets Wisconsin Administrative Code Heavyweight design CSA A123.5-M90 and CSA A123.5-98 Approx.48 Pcs/Sq. 25-Year Ltd. Transferable Warranty ASTM D3018 Type 1 Approx.192 Nails/Sq. 71/2" Exposure Sentinel°Shingles (Available Nationwide). 13'/4'x39'/8' Metric Fiberglass Asphalt Construction Approx. 65 Pieces/Square(Metric) ---------- 12"x 36" English Class A Rating from UL 3 Bundles/Square Passes UL 997 Wind Test Approx. 320 Nails/Square(English) ASTM D3018 Type 1 Approx. 260 Nails/Square(Metric) Midweight design ASTM D3161 Type 1 5" Exposure (English) 20-Year Ltd. Transferable Warranty ASTM D3462'(Available from select plants) 55/8" Exposure(Metric) 60 mph Ltd. Wind Warranty Approx.80 Pieces/Square(English) 'All products listing ASTM 3462 are manufactured to meet or exceed at time of manufacture;values from subsequent testing may vary depending on storage conditions. 2 Grand Canyon/Grand Sequoia Installation Note:110 mph warranty applies only when:(a)product is installed using six nails per shingle and(b)product is installed with f any GAF Ridge Cap shingle.Otherwise,wind warranty is 80 mph on Grand Sequoia and 100 mph on Grand Canyon shingles. 3Timberline Ultra Installation Note:110 mph warranty applies only when:(a)product is installed using six nails per shingle and(b)product is installed with Timbertex" Ridge Cap shingles(Note:On the West Coast,any GAF Ridge Cap shingle may be used).Otherwise,wind warranty is 90 mph. 23 CITY OF ATLANTIC BEACH MECHANICAL PERMIT 800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877 PERMIT INFORMATION LOCATIONINFORMATION Permit Number: 22574 Address: 711 SELVA LAKES CIRCLE Permit Type: MECHANICAL ATLANTIC BEACH, FL 32233 Class of Work: ALTERATION Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: SELVA LAKES Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION Date Issued: 8/27/2001 Name: BUSH Total Fees: 37.00 Address: 711 SELVA LAKES CIRCLE Amount Paid: 37.00 ATLANTIC BEACH, FL 32233 Date Paid: 8/27/2001 Phone: (000)000-0000 Work Desc: REPLACE HVAC firCONTRACTOR(S) �' �• APPLICATION FEES OCEAN STATE HEAT &AIR PERMIT 37.00 4.• - „ � � �s�..s'��+ •:a.y '� tea, r'; A. , 4" tit pec Required f FINAL r - � I Ti>1 IFF NOTICE- INSPEc-ri6NS • 1ST BE l AST 24 HOURS RIQFt TO INSPECTION BUILDING MATERIAL, RUBBISFCAND DEBRIS F'RDltlf THIS WORK MUST NOT BE PLACED IN P JBLIC SPACE, AND MUST BE CLEARED UP AND HAULED:AWAY BY EITHER CONTRACTOR OR OVER " "FAILURE TO COMPLY W1TN T \I CONSTRUCTION LIEN L 1 CAN RESIFT IN THE PROPERTY OWNER P�4 ib CE.FbR- UU,.f.�j�1G4MP<bVEMF_�ITS"� ,k ISSUED ACCORDING TO APPROVI`sQ;P6A1SwWIICH ARF�PART OFri P' fff6 AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PRf�t/[,SIU-1S_ `,QF VV, AAA -- __ $37.88 14 Date: 8/27/81 84 Receipt: 8884535 ATLANTIC BEACH BUILDING DEPT 8810888 16W83221888 BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BOAC/.MORIDA 31233 APPLICATION FOR MECHANICAL. PERMIT CALL-IN NUMBER IMPORTANT—Appliccnf to complete all items [n secticns I, II, III, ane IV. 7I. LOC.ITICN Street Addr.u: S q L G� {� p CF Interjecting $bosh: 3.t.... (I ` fijt And DUILDING sus.diviaion i II. IDENTIFICATION —To be completed by ail applicants. In contideretion of pumif given for doing the work at described in the above tletemeAt..hereb a wee to 'Ih the attedVd plain ane roecifiutions which are a part hereof and in sccordance �iih the Cay of Jeciaonrnlema dineneu and said work in eUanaerd. of good.prectfcs listed thvein, Nem*of Meeheeieai ^ I Confnc}on CaAlso r Iprint l y - Name of s ialaster CA ) -y/1 CA ►rope r signatvr w.er w Aut Red Aq.nt 1 I sign.fun of Archif.ct or cn q,nur 111. Ctf ;NFORMAI A. Type of heating(veil S. Is OTHER CONSTRUCTION BEING DONE ON ijaetrie THIS BUILDING OR SITEi /VV ❑ vu—❑ U ❑ Natural ❑ Control Utility ❑ Oil IF YES. GIVE HUMBER OF CONSTRUCTION PERMIT ❑ ofhw—Specify W. WICU1N1CAL IQUI/MINT TO SE INSTALLED NATURE OF WORK IPro►ide Complete IIA of eomponenb on boo of this ferns) Residential or ❑ Commeretal most ❑ Space ,C,, llacanad 9 Contest 0 floor ❑ New Suuding - ,� Ale CondrHeainq: M Room di- Central Nr Elating Building Q ❑ Dad System: 1Aaferiel T11kiaen Replacement of existing system Maximumcapacity ef.m. New installation(No system previously Installed) - (ld/ ❑ SdrigaesHoa Q Extension or add-on to existing system4 r)L) Q Caeilnq feenw: Capacity9� C] Other—Specify V ❑ Are apirniserss Number of heads ❑ Elevator ❑ ManfiN Cl Escalator (namisa►j Q.AaseUna peem� (number) THIS SPACE POLI OMCE USE ONLY ❑ Ta.k (nsmber) . Semerta (� ❑ LPC U ❑ Unfilled pfeesate wool ❑ Permit Approved by pea. . ❑ ONor—Specify Permit Fee LIST ALL EQUIPMENT AOR CONDMONING AND REFRIGERATION EQUU-Am4T AppmViting NtmsberUafta Dataslytl= Nodal Number xisnutaatssrar 1baBlr Agency( ) TLA,12�Car :LIZ A AIV HEATING•FURNACES, BOILERS, FIREPLACES Capfid A"-"M Number t7dta Desorfptfoea Yodel Number maaufaatnrar (2=) Agenoy I(A) 'R TANKS or ]sow many NoQlaal cayantty TY"LLlgsd Nae!a Serial ApE «d Bad Dfmstodona ]Lam>Saottaw No. CITY OF ATLANTIC BEACH IJ 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . 09-00000009 Date 1/06/09 Property Address . . . . . . 715 SELVA LAKES CIR Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 3700 -------------------------------------------------------------------------- Application desc REROOF --------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- KNUDTSEN, KEVIN MOODY' S ROOFING INC 715 SELVA LAKES CIRCLE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32220 (904) 641-9844 ------------------------------------------------------------------------ Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 97 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 3700 Expiration Date . . 7/05/09 ----------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 97 . 00 97 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 97 . 00 97 . 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 09I I I LJ 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 BUI LDING-DEPT@COAB.U S BUILDING PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: 2.VALUATION OF WORK 3.SQ.FT.UNDER ROOF _715 S L 0 Sloo , I C)CO 4.LEGAL DESCRIPTION: 5.CL A S OF WORK 6.USE OF STRUCTURE: ❑NEW BUILDING ❑DEMOLITION ESIDENTIAL LOT_BLOCK_SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7.DESCRIPTION OF WORK: ❑ALTERATION ❑ACCESSORY BLDG. 8.FIRE SPRINKLER: ❑REPAIR ❑POOL/SPA ❑YES ❑N/A ❑MOVE 3'0-,HER HEN 0 NO PROPERTY OWNER: CONTRACTOR: ARCHITECT 1 ENGINEER: 9.NAME:.1 15.COMPANY ME: 23.COMPANY NAME: � 1141 iY Y\ {�n.0 S C04 24.LICENSEE NAME: 16.NAME: 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: -71 5 se 10 Lal(� 18.ADDRESS: 26.ADDRESS: 1,t 6 (`�c Co-�c� e Si,A) 11.OFFICE PHONE: rv;y 12.FAX NO.: l'A 19.OFFICE PHONE:C��� 20.FAX NO.: Q d� 27.OFFICE PHONE:_____[26.FAX NO.: 6Lo-g7g4 ?` L "TTI- 1 +q (F1 I PHONE: Q Opt 21.CELL PHONE: aey 29.CELL PHONE: 14.tMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER: (IF OTHER THAN OWNER) 31.NAME: 33.NAME: 35.NAME: 32,ADDRESS: 34.ADDRESS: 36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. iriNr WARNING TO OWNER: *** YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNERor AGENT CONTRACTOR (If Agent, ower of Attorney or Agency Letter Required) (Qualifier Only) Date: Signed: 16y6T Date: " Signed: 2009 in the county Before Ime this lay of ,2009 in the county of Before me this_U1__day of,_14410 �'of Duval,State of Florida,h s personally appeared Duval State of Florida,has personally K�y f 7l �_,o LJ JJT. herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are true and accuratetrue and accurate. Notary Public at Large,State of�_,County of _ Notary Public at Large,State of ll�L County ofJCi ❑Personally Known ❑Personally Known ❑Produced Iden kation- ri Produced Identification- Notary Signature: Notary Signature: " SHIRLEY L. GRAHAM E SHIRLEY L. GRAHAM ar.,o ,`�: Notary Public- State of Fbrida Notary Public-State of Florida :My Commission Expires Feb 14,2010 y Commission Expires Feb 14,2010= emission#DD 518533 BLDG01 PermitApplicatio Idg ,,. 6/2 Commission#DD 518533 onded By National Notary Assn. onded By National Notary Assn. Jan 06 09 12:04p Moodys Roofing Inc 9047813731 p•1 NOTICE OF COMMENCEMENT State of Tax Folio No. County of To Whom It May Concern The tmdersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section?I3 of the Florida Statutes,the following mfo=2ation is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: � iS �5�i�a Lax s �►'' ,�� 'n Address of property being improved: General description of improvements: ��o�t-it: E3e�ch Owner: Kms,t �,n K„n t C1 +3 Address:_`7 1 c3, La( s c,r- X233 R�n�.k Owner's interest in site of the impro��ement: Fee Simple Titleholder(if other than owner): Name: �1 i s Snrl l M y Contractor: 0 i Address: 6 'C ` C� 0 ' Telephone No Q� (mac{ Fax No: 3 7J Surety(if BUY) Amormt of Bond S Address: Fax No: �#200900'2x76,ORSK14(42 rage 1&11, Telephone No: NcKnber pages:1 Name and address of any person making a loan for the construction of tbe unproven Recorded 01 W'4009 at 11:21 AM, JIM FULLER CLERK CIRCUIT COJR i DUVAL NCOUNTY Name: RECORDING$10.00 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: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Liencr's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: leo: Fax No: Telephone VVVJJJ Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different d v specified): TEES SPACE FOR RECORDER'S USE ONLY" 0 . R � - Date: dh Si ed: day of in the County of DuvaLL State B+° "= NO Pub Pa on,sae,o fPi d � e,State of Florida,Co iy of Duvet. ConrwSion trts: /o i Commis' on or Bo.,ded By Na�i&Ir P ion: CSC'/ Jan 06 09 12:04p Moodys Roofing Inc 9047813731 p.2 Page 1 of 1 1303516* '. Print Date: Transaction#: 1303516 1/6/2009 11:21:16 AM Receipt 9: 1252783 Cashier Date: 1/6/2009 Jim Fuller 11:21:13 AM Clerk Circuit Court (KPEARSO.N) Duval County 3310 E. Bay Street Rm 103 Jacksonville, FL 32202 (904) 630-2044 Customer Information Transaction Information Payment Summary Date Received: 01/06/2009 Source Code: BEACH 0 MOODYS ROOFING INC Q Code: BEACH 216B MCCARGO ST N Return Code: Over the Total Fees $10.00 JACKSONVILLE, FL 32220 Counter Total Payments $10.00 Trans Type: Recording Agent Ref Num: 1 Payments CASH $10.00 P = 1 Recorded Items LOME BKPG: X4742/1831 CFN.-2009002506 Dare:1/612009 M_(N/C.)_NOTICE 11:21:12 AM COMMENCEMENT From: KA UDTSEN KEVIN To.- COMMENCEWNT INDEXING 2 $0.00 RECORDING 1 $10.00 0 Search Items 0 Miscellaneous Items file://C:\Prograrn Files\RecordingModule\default.htm 1/6/2009 J . S, CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD s� j v ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00001717 Date 12/18/08 Property Address . . . . . . 715 SELVA LAKES CIR Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 20000 ---------------------------------------------------------------------------- Application desc stucco repair ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- KNUDTSEN, KEVIN FRESCO CONSTRUCTION INC 715 SELVA LAKES CIRCLE 13703 RICHMOND PARK DR N ATLANTIC BEACH FL 32233 #3407 JACKSONVILLE FL 32224 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit BUILDING PERMIT Additional desc . - Permit Fee . . . . 130 . 00 Plan Check Fee 65 . 00 Issue Date . . . . Valuation . . . . 20000 Expiration Date . . 6/16/09 ---------------------------------------------------------------------------- Special Notes and Comments SHEATHING INSPECTION HOUSE WRAP INSPECTION WIRE LATHE INSPECTION *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. * 1) Wall sheathing insp. , 2) Housewrap insp. , 3) Wirelath insp. * ------------------------------------------------------------------ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 130 . 00 130 . 00 . 00 . 00 Plan Check Total 65 . 00 65 . 00 . 00 . 00 Grand Total 195 . 00 195 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. iy�,y fl City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 • Fax(904) 247-5845 E-mail: building-dept@coab.us Date routed: /Z L14 o City web-site: http://www.coab.us /V�cQ NDC APPLICATION RE ACKING FORM aa�nning a ent review required Ye No Property Address: )/S StIv� qhs (_�ir' ing C C & Zoning Applicant: / r�C� Lid �'ISTi'/�L' - Public Works .F Public Utilities Project: lC CO Public Safety Fire Services Other Agency Review or Permit Required Review or Receipt Dateof Permit Verified By 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: EjApproved. ❑Denied. (Circle one.) Comments:x) Sh�g7��y► - S per./,c)„,,C4/110usP IV fla P _ 'n See c �n QD I N � � ��'�. �ct>✓!,p ice, TP�rf:�°,�. PLANNING &ZONING PUBLIC WORKS Reviewed by: Date: PUBLIC UTILITIES Second Review: ❑Approved as revised. @Denied. Comments: PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: CITY OF ATLANTIC BEACH 08- (. '• f, 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 �� ��^4.,•� �� I OFFICE:(904)247-5826•FAX NO.:(904)247-5645 ILDINGDPERMITQAPPLICATION DUVAL COUNTY 1.JOB ADDRESS: 2.VALUATION OF WORK: 3.SQ.FT.UNDER ROOF 5 j Atlantic 3each, FL 32233 4:LEGAL DESCRIPTION: 5.CLASS OF WORK: 6.USE OF STRUCTURE: ❑NEW BUILDING ❑DEMOLITION 2 RESIDENTIAL LOT_BLOCK_SUB DIVISiON ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7.DESCRIPTION OF WORK: ❑ALTERATION ❑ACCESSORY BLDG. 8.FIRE SPRINKLER: I I ff?Xj'tr PL-P_ to L Q��S 19 REPAIR ❑POOL/SPA ❑YES ❑N/A ❑MOVE ❑OTHERQ NO PROPERTY OWNER: CONTRACTOR: ARCHITECT/ENGINEER: 9.NAME: 15.COMPANY NAME: L 23.COMPANY NAME: l sca [crest/ �C. nL �( �( 16.NAME: 24.LICENSEE NAME: Ke,U Kl (AJ ( Se-:1 i.. rr Lir1�1L/ 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE N0.'. 18.ADDRESS: 26.ADDRESS: 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER: (IF OTHER THAN OWNER) 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces, Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. WARNING TO OWNER: *** YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE TH W -- FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR o LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEME OWNER or AGENT CONTRACTOR (If Age ,Power of Attorney or Agency Letter Required) (Qualifier Only) Z _ Date: 102 \Signed: Date: 4' ',ed: ��` Before me this _day of L�'c� ,2007 in the county of Before me this 12- 2007 in the c ret day of JJ� �i z Duval,Stateof Florida,has ersonally appeared Duval,Stat f Florida,has personally appeared W i herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarati s� O true and accurate. T r true and accurate. Notary Public at Large,State of ,County of Dtl v Notary Public at Large,State of �2- County of ❑Personally Known -L ❑Personally Known ❑Produced Identif - '/ produced Identific ori- [� UJ Not Signature: Notary S A ;� 0.Y P,," orida a.;= AM V UJ a =?. Notary ublic-State of Florida �+ y Com n Exp' b 14;2©1 .*}R �.. .. . s `, 5555 Co sion - .`My Commission Expires Feb 14,2010 ,, Commission #DD 518533 Bonded By Nation I Not Bonded By National Notary Assn. W COAB FORM BLDG01:REVISED:11/6/2007TILI C 0 e'r'r Ov P . t NOTICE OF COMMFNCEWNT State of J�dtJ � Tax Folio No. County of (Deva. 4 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 COMAAENCEMENT. Legal Description of property being improved: Address of property being improved: -7 1� SCS iye, L,c.&&-e,S I C 1:2A f�c n'f �- Re e. L - R,;-a B 3 General description of improvements: fe Aar r l K S O rl w D- tS 6-C W Wc0j Owner: Ke V itn K g Lt d t s e n Address: ( a`S Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Contractor: rr c g c,o - aA Address: /3-)0.3 J�hh y1ayJ 8--k 0� 1 3L4 0 -7 5a cy S os►V/1 1 e. FL, 3 9"9-14f ev V\ Telephone No.: 9d4-G 3 V - 1 S1 Fax No: Surety(if any) Amnimt of Rnnd fi Address: Telephone No: Fax No: Name and address of any person maldng a loan for the construction of the i _ 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: 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: t 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 O 01 Signed` Date: da of r� in the County of Duval,State ..........�, SHIRLEY L.GRAHAM Before me this 1-2. Y Notary Public:State of Florida Of Florida,has personally appeared My Commission Expires Feb 14,2010 Notary Public at Large,State of Florida,Coun of Duval. =;9, "`$ P`, Commission#DD 518533 My commission expires: /� — � F I or Bonded By National Notary Assn. P onally Known: +ced dent Peati CITY OF C) Office of Building Official REQUEST FOR INSPECTION Permit No. � � Date ✓ �/ Timeistri t No. a Received Locality Job Address Owner's Contractor Name PLUMBING MECHANICAL CELECTRICAL -- Air.Cond.& ❑ CONCRETE BUILDING Rough Wiring?/ Rough IeW Heating Framing Footing Temp Pole Top Out Slab - Sewer Fire Place G Re Roofing — Final J Pre Fab Lintel -- READY FOR INSPECTION AM T u s. ` ' , Tues. Wed. A.M. on. �"— P.M. Inspection Made — Final Inspection Inspector Certificate of Occupancy Date CITY OF roma& Teach-574� Office of Building Official A 7 /J&u/ REQUEST FOR INSPECTION Date / —�� Permit No. Time A.M. isfrict No. Received P.M. Locality Job dre s ' Owner's �iYLt J Contractor Name CONCRETE ELECTRICAL LUMBING / MECHANICAL BUILDING P' Air.Cond.& Framing C Footing Rough Wiring G Rough Heating Slab r{ Temp Pole C Top Out Re Roofing _ 1SY,U'►,"�'y n, � Fire Place Lin I Final Sewer G - Pre Fab READY FOR INSPECTION A.M. Mon. Tues. ed. "'!• Thurs. Friday P.M. A.M. P.M. Inspection Made Final Inspection Inspector Certificate of Occupancy Date JOB 5885 V CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL PERMIT April 27 19 88 TO THE CHIEF ELECTRICAL INSPECTOR: DATE: IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WITH ORK AS THE ATTACHED ANS AND SPECED IN THE T CATIONS WING, WE HEREBY AGREE TO PERFORM SAID WORK N ACCORDANCE WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. Adkins Electric, Inc. ass ELECTRICAL FIRM: MASTER ELECTRICIAN IGNA U NAME RGm Properties ADDRESS: 715 Selva Lakes Circle -RFD-BOX- BETWEEN: RFD BOXBETWEEN: 11th St- BLDG. t BLDG.SIZE RES.( ) APT. ( 1 COMM.( 1 PUBLIC ( 1 INDUS. ( 1 NEW( 1 OLD ( 1 REW. l 1 ADDITION ( ) TRAILER ( ) TEMP.( 1 SIGNS ( ) SO. FT. FEE SERVICE: NEW(V) INCREASE ( 1 REPAIR ( 1 �}too CONDUCTOR SIZE AMPS D COPPER ALUM. r.J `' A MPS PH .3 W 30 VOLT RACEWA SWITCH OR BREAKER EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL CONCEALED OPEN TOTAL RECEPTACLES 31.100 AMPS. 0.30 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER BELL TRANSF. APPLIANCES AIR H.P.RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW HEAT 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PNS MISCELLANEOUS -J TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA NO. KVA NO.NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHE EACH SIGN -- FORWARDED TOTAL FEES JOB 5884 CITY OF ATLANTIC BEACH, FLORIDA Approvedby APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: April 27 19 88 IMPORTANT NOTICE: AS DESCRIBED IN THE IN CONSIDERATION OF PERMIT GIVEN FOR DOING T E W�HE ATTACHED PLANS AND SPECIFICATIONS. CATIONSE HEREBY AGREE TO PERFORM SAID WORK IN ACCO ITH THE ELECTRICAL REGULATIONS, CODES AND CITY 0 WHICH ARE A PART HEREOF, AND IN ACCORDANCE W ATLANTIC BEACH ORDINANCES. Adkins Electric Inc. MASE ELECT I IA ELECTRICAL FIRM: NAME Dr•1� Pro;err;es ADDRESS: 71 1 4elva Takes Girl-RFD-BOX- BETWEEN: FD BOXBETWEEN: 11th St. & Plaza Rd. BLDG.SIZE RES.1 T.(� AP1 COMM.( 1 PUBLIC ( ) INDUS. ( 1 NEW ( ) OLD ( 1 REW.( 1 ADDITION1 ) TRAILER ( ) TEMP.11 ) SIGNS ( 1 SO. FT. FEE INCREASE ( SERVICE: NEW l SE ( 1 CONDUCTOR SIZE AMPS 1-5`0 COPPER ALUM. SWITCH OR BREAKER O AMPS / PH W 2JDVOLT RACEW EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 91.100 AllO.90 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M o•loo AMPS. OVER FIXED BELL TRA SF. APPLIANCES H.P.RATING H.P. RATING AT: KW HEAT CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HE AIR 0-1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA NO. KVA NO.NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHE EACH SIGN -- FORWARDED TOTAL FEES _ y4 CITY OF ATLANTIC BEACH `= + APPLICATION FOR PLUMBING PERMIT 249-2395 JOB LOCATION Ci\'Z) 7.T �S PLUMBING CONTRACTOR F. W. FAIR PLUMBING COMPANY LICENSE NUMBERS MP145 State RF0037503 OWNER : �D V'...... BUILDING CONTRACTO4- b TYPE OF BUILDING SINKS �, SHOWERS Yj -LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS i _WASHING MACHINE 1p CLOSETS FLOOR DRAINS OTHER TOTAL FIXTURE COUNT X$3. 50 + $10. 00 pp- C-2 'DATE / / TOTAL AMOUNT �O arm INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. - F ti ' +.'Y'!R't+4C"4N A ' '+..PJ44tt'Mt'/"4f.°.Als+'?4.w.nR-,nYlTll :4 �t DEPARTMENT OF BUILDING PERMIT NO. �+9667 CITY OF ATLANTIC BEACH,FLORIDA PERMIT TO BUILD I nG*r O T THIS PERMIT MUST BE POSTED ON JOB i 03s0fiCKT Date April 26 19 38 2532 i A 4lcf+/�? 9667 010CA(' Fee$ lOS.00 2532 1A 4/26/0 Valuation$ loop, This permit not valid until above fee has been paid to City Treasurer,and is subject to revocation for violation of applicable provisions of law. This is to certify that F Fd Fair Plumbing RF0037503 has permission to Classification New Residential Zone PITD Owned by RGM Pro erties,Inc. 137 is 31_8 -Blocklfnit III S/D col�r� T.akPs Lot ! House No. 711-715 Selva According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 4— P. o Building material, rubbish and debris Z from this work must not be placed in public space, and must be cleared up and hauled away by either con- trac r or ow er. I Building O FOR OFFICE PERMIT DATE CONTRACTOR ! USE ONLY NUMBER PLUMBING ELECTRICAL SEWER l WATER � 1 BUILDING AND ZONING INSPECTION DIVISION q CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I, II, III, and IV. LOCATION Street Address: t�75 SIVO' OF Intersecting Streets: Between And BUILDING Sub-division II. IDENTIFICATION — To be completed by all applicants . In consideration of permit given for doing the work as described in the abcve statement we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards of good practice listed therein. Name of Mechanical Contractors Contractor (Print) S Master `7 Name of Property OwnerQ� IAt". NAV AIU&) Signature of Owner Signature of or Authorized Agent Architect or Engineer III. GENERAL IN116RMATIC111i A' Type of heating fuel: B. IS OTHER CONSTRUCTION BEING DONE ON (Q( metric THIS BUILDING OR SITE? �S�' !❑ Gas—❑ LP ❑ Natural ❑ Central Utility IF YES, GIVE NUMBER OF CONSTRUCTION ❑ Oil PERMIT Q Other — Specify IV. MECHANICAL EQUIPMENT TO RE INSTALLED NATURE OF WORK (Provide complete list of components on back of this form) X Residential or ❑ Commercial Heat ❑ Space ❑ Recessed Pl Central 0 Floor ❑ New Building ❑ Air Conditioning: ❑ Room A Control Existing Building ❑ Duct System: Material Thickness Replacement of existing system Maximum capacity c.f.m. ❑ New installation(No system previously installed) ❑ Refrigeration f�1tllXyl ❑ Extension or add-on to existing system ❑ Other — Specify ❑ Cooling tower: Capacity g.p.m• ❑ Fin sprinklers: Number of heads_ ❑ Elevator ❑ Monlift ❑ Escalator (number) THIS SPACE FOR OFFICE USE ONLY ❑ Gasoline pumps (number) (Reeeiv+d) ❑ Tanks (number) Remarks ❑ LPG containers (number) ❑ Unfired pressure vessel Q bison Permit Approved by Do�� (3 Other — Specify Permit Fee LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT Capacity A Number Unita Description Model Number Manufacturer (Tons) cY Cct')D Vn>►7 3d R 042_ I �— HEATING - FURNACES, BOILERS, FIREPLACES Capacity Approving Number Units Description Mode]Number Manufacturer (BTU) CAPIRA EM Ck Z. t TANKS Now Many Nominal Capacity Type Lquid Name at Serial Approving and Dimeaetoos Contained Manufacturer No. Agency F BUILDING 9666 DEPARTMENT O PERMIT NO. CITY OF ATLANTIC BEACH.FLORIDA PERMIT TO BUILD 52*0n.. T THIS PERMIT MUST BE POSTED ON JOB 52.(0)t1CKT. 7574 1A 6/11q-/Ot Date AUri 1 76 —19- 0013CAC 7574 1 A WIW � Valuation$ Fee$ 52.00 t t3[IC? I This permit not valid until above fee has been paid to City Treasurer, and is subject to revocation for violation of applicable provisions of law. I This is to certify that QCEANSTATE I I �I has permission to 6b �I � Classification New Residential Zone PUD Owned by Tric S�1 ,,, T k S 137 i 138 Block u�T—S/D �I Lot - 1 House No. I According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. j PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 4--�� Z Building material, rubbish and debris from this work must not be placed in public space, and must be cleared up and hauled away by either con- tractor-or on- tractor-or owner. Building Official. E CONTRACTOR 7WATtERM -- I DEPARTMENT OF BUILDING 9665 PERMIT NO. CITY OF ATLANTIC BEACH,FLORIDA PERMIT TO BUILD 5t4.5 514'RCKT THIS PERMIT MUST BE POSTED ON JOB 2530 1 A, 406/8 April 26 iq 88 9665 on-CAC Date 7530 1 A 4/26/ Valuation$ 134,364.00 _ Fee$ 514.50 IOCD This permit not valid until above fee has been paid to City Treasurer,and is subject to revocation for violation of applicable provisions of law. This is to certify that Reyhani,Inc. 439 '301 has permission to build Duplex Classification New Res ident i3.1 Zone PUD Owned by Lot_ 137 f138 Block Unit III S/D Selva Lakes House No. 711-715 Selva Lak s e According to approved plans which are part of this permit C..� NOTICE—ALL' ONCRETE FORMS = AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE Building material, rubbish and debris I --' from this work must not be placed in public space, and must be cleared up and hauled away by either con- t o or owner., k tld ng Official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER i R --- - _ ---- - - YLUt•�h1tJl; YE}t1.1I1• � ' BUILDING PERMIT WORKSHEETELECTRIC PERMIT _ �OS TEMPORARY ELECT. ea ted Square Footage 5 @ $ e sq f t aragetShed _per sq ft - $ arport @ $ per sq ft = $ orches @ $ per sq ft - $ eck @ $ per sq ft = $ ' atio @ $ per sq ft = $ 7, rill TOTAL VALUATION )tal Valuation D to 1st ,mainder Valuation @ $ a.00per thousand or portion thereof TOTAL BUILDING FEE $ , + k FILING FEE $ ,� FIREPLACE @15. 00 00 TOTAL BUILDING PERMIT - -------------------------------------------------------------- -- '- ------- .UMBING PERMIT FEE$ MECHANICAL PERMIT FEE$ ECT. TEI•IPORARY $ ELECTRICAL PERMIT $ TER METER SIZE $ ACCOUNT NU11BER WER IMPACT FEE $ TER CONNECTION $ (@10. 00 per fixture unit) PROVED BY: /3U 342c,(Da TOTAL BUILDING/PLAN FILING FEE $ p� , 5/CTD TOTAL WATER METER CHARGE $ 1'70•CO TOTAL SE14ER IMPACT FEES $ zQ 026 aTOTAL WATER CONNECTION CHARGE $ -- � MISCELLANEOUS CHARGES $ GRAND TOTAL DUE: $ 13 9 5^ 13 f3kD&, PLUMBING WORKSHEET SINKS SHOWERS / DISHWASHERS CLOSETSBA � ----r-- TH TUBS FLOOR DRAINS WASHING MACHINE WATER HEATERS _ DISPOSALS LAVATORY URINALS OTHER TOTAL FIXTURE COUNT FIXTURE UNIT -BREAKDOWN FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. 1_oj�ll BATHROOM CROUP CONSISTING OF LAVATORY (1 UNIT) WATER CLOSET+ LAVATORY, AND BATH TUB OR SHOWER STALL SERVICE SINK TRAP STAND (6 UNITS) (3 UNITS) DRINKING FOUNTAIN (l�k UNITI -� URINAL, WALL LIP FLOOR DRAIN Cl UNIT) (.4 UNITS) 3 WASHING MACHINE RES. URINALP PEDESTALr SYPHON (3 UNITS) JET BLOWOUT (8 UNITS) WATER CLOSETS, VALVE OPERATED WATER CLOSETS, TANK-OPERATED (4UNITS) (8 UNITS) BATHTUB (W/OR W/0 OVERHEAD SHOWER STALL DOMESTIC � (2 UNITS) � ' SHOWER) (2UNITS) IBIDGET (3 UNITS) LAUNDRY TRAY(2 UNITS) DISHWASHER (2 UNITS) KITCHEN SINK (2 UNITS) 3 KITCHEN SINK/WASTE GRINDER (3 UNITS) TOTAL FIXTURE UNITS @ $ 0 EACH, • ,.., .. ..,,U ..,.. 111 y. BUILDING PERMIT WORKSHEETVD.� ELECTRIC PERMIT y TEMPORARY ELECT. c•ated Square Footage WSJ^ q B 4 @ $ er sq ft a $ �U 3ra e Shed �O 7 O 0 g � @ $ _�persgft - $ �3 . 610 9 $ d . 3rp ort @ $ per s ft s arches @ $ per sq ft — $ 2ck @ $ per sq ft - $ itio @ $ per sq ft = $ TOTAL VALUATION $ >tal Valuation Data 1st - ad OD ainder Valuation , @ $ C;�.QCj per thousand or portion thereof /(0 TOTAL BUILDING FEE $ + k FILING FEE $ FIREPLACE @15 . 00 $ co TOTAL BUILDING PERMIT $ - ------------------------------------------------ UMBING PERMIT FEE$ MECHANICAL PERMIT FEE$ QCT. TEMPORARY $ ELECTRICAL PERMIT $ PER METER SIZE $ ACCOUNT NUMBER ,TER IMPACT FEE $ PER CONNECTION $ (@10. 00 per fixture unit) 'ROVED BY: TOTAL BUILDING/PLAN FILING FEE $ TOTAL WATER METER CHARGE , TOTAL SEWER IMPACT FEES 00 TOTAL WATER CONNECTION CHARGE $ , MISCELLANEOUS CHARGES $ GRAND TOTAL DUE: C- i3k1)Czy; PLUMBING WW SHEET SINKS 2 SHOWERS DISHWASHERS. 3 CLOSETS BATHTUBS -� -�- FLOOR DRAINS WASHING MACHINE WATER HEATERS DISPOSALS LAVATORY URINALS OTHER TOTAL FIXTURE COUNT FIXTURE UNIT BREAKDOWN FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. IS BATHROOM GROUP CONSISTING OF LAVATORY (1 UNIT) WATER CLOSET, LAVATORY, AND BATH TUB OR SHOWER STALL SERVICE SINK TRAP STAND (6 UNITS) (3 UNITS) DRINKING FOUNTAIN (11 UNIT) URINAL, WALL LIP FLOOR DRAIN Cl UNIT) (4 UNITS) �T URINALS PEDESTALS SYPHON WASHING MACHINE RES. JET BLOWOUT ($ UNITS) (3 UNITS) WATER CLOSETS, VALVE OPERATED WATER CLOSETS, TANK-OPERATED (4UNITS) ($ UNITS) BATHTUB _,____ SHOWER STALL, DOMESTIC (W/OR W/0 OVERHEAD SHOWER) (2UNITS) (2 UNITS) BIDGET (3 UNITS) LAUNDRY TRAY (2 UNITS) DISHWASHER (2 UNITS) KITCHEN SINK (2 UNITS)13 fi f KITCHEN SINK/WASTE GRINDER i (3 UNITS) TOTAL FIXTURE UNITS @ 0 EACH CITY OF ATLANTIC BEACH APPLICATION FOR BUILDING PERMIT 4 3 9 Jk 4.1 /-gest L// .C-Lc- OwnerlS _Address�QTL .vTis_ c� zip3Z_y,.3_phone.?,v7-a�_ Architect I . GGy��Z/E__Addrese� � _ �-� zip,�yiJo phone.2 Contractor T --��7E9 f�___e Addresse .gya-Cy g czipXZ13 _phone �ti_�y Contractor's License number ay .�1r1 expiration_6 4eP7 Lot_______Block or Section Subdivision---------------Zoning........ Street------------- se ------------- --------------andside ----------- Type Construction-------------- Units---------- Fireplaces -------------- ----------- Purpose of Building_____________ Est. Valuation S -------------- -------------- Utility Method - WaterSewer Dimensions - Building--------------Lot-------------Size Footings___________ Sz. Piere_-__-----___Sz. Sills -_Greatest Span Sills ----------- -_............. Ceiling Joists_________Distance on Centers_________Greatest Span_______ Sz. Floor Joists __-______Distance on Centers--------- Span_______ Sz. Rafters _________Distance on Centers---------Greatest Span_______ Method of Heating-----------Solid or Filled Ground---________Roof __________ Flood Zone.......If located within a FLOOD HAZARD ZONE complete page 3 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 Atlantic Beach. The contractor agrees at its expense to provide the necessary access to the properties being developed over dedicated City rights-of-way and to clear, clean, grade, and drain said right-of-way to City specifications. Signature Owner -_ ,� �� �_Date1 _______ --- Signature Contr ctor_ _ __ te_ 5'�iS//,�1 page 2 4 FLOODPLAIN DEVELOPMENT INFORMATION Type of Development : ............................................ Flood Zone• Required Lowest Floor Elevation: --------------- If building is located within a flood hazard zone (Zone A), 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 effecting the proposed development. Date _ ,�_____Applicant s Signature ---------------------------------.------------------- Department Use Required Lowest Floor Elevation ----------------- As Built Lowest Floor Elevation Survey Filed with Building Department ----------------------------------- Bui] ding Department Representative page 3 CITY OF ATLANTIC BEACH APPLICATION FOR BUILDING PERMIT X39 �ELU.4�il.�T Owner_/ �1`, 2 6 l!4-Zir _Addressj�lr.L6t Tic_}E Architect Address� fT_ X� zip�Lvlo _phoneys Ns: Contractor �f���, � Addrese�Fp�y& _&..&-acs -___zip z�3 _phones! Y+ -r- -- Contractor' s License number 3y��1�"1____expiration=_[ _Z . ___ LotBlock or Section---------Subdivision---------------Zoning........ Street between and_________________side --------- ----------- Type Construction-------------- No. Units----------No. Fireplaces___________ Purpose of Building-_________ __Est. Valuation $--------------- -------------- Utility Method - Water_____________ Sewer Dimensions - Building--------------Lot-------------Size Footings___________ Sz. PiersSz. Sills-------------Greatest Span Sills_______________ Sz. Ceiling Joists--------- Distance on Centers---------Greatest Span_______ Sz. Floor Joists Distance on Centers--------- Greatest Span____ Sz. Rafters Distance on Centers---------Greatest Span_______ Method of Heating-----------Solid or Filled Ground Roof Flood Zone If located within a FLOOD HAZARD ZONE complete page 3 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 Atlantic Beach. The contractor agrees at its expense to provide the necessary access to the properties being developed over dedicated City rights-of-way and to clear, clean, grade, and drain said right-of-way to City specifications. Signature Owner �,�iQ___JL" �19 Date__y1 J�'� Signature Con actor' _ __,�( '�/f/ Date--- page ate__-page 2 i FLOODPLAIN DEVELOPMENT INFORMATION Type of Development : ............................................ Flood Zone: ----------------------- Required Lowest Floor Elevation: _______________ If building is located within a flood hazard zone (Zone A), 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 effecting the proposed development. Date y/' `//"" ___Applicant 's Signature_ _ _��_� JV�� Department Use Required Lowest Floor Elevation ................. As Built Lowest Floor Elevation Survey Filed Filed with Building Department ----------------------------------- Building Department Representative page 3 APPLICATION FOR WATER METER DATE: - --- at����---- CONTRACTOR:_ BILLING ADDRESS: _____ `�3 L _____G� �`�" (�✓�` �'� ------ e--------------"------------------------- SERVICE ADDRESS: a' ,��e-------------------- LOT:_1 _ €#: -------UNIT:--72T`T____SUBDIVISION:'y�� ACCOUNT NUMBER:---_ap /d___________ METER SIZE: /� / --- -------- I HEREBY REQUEST THAT A WATER METER BE SET AT THE ABOVE SERVICE ADDRESS. I UNDERSTAND THAT I WILL BE BILLED FOR TEMPORARY CONSTRUCTION WATER UPON SETTING OF THE METER. I FURTHER UNDERSTAND THAT I AM RESPONSIBLE FOR ANY AND ALL DAMAGES TO THE METER, BOXES, VALVES, LINES, AND ANY PARTS THEREOF, UNTIL PERMANENT WATER SERVICE HAS BEEN ESTABLISHED BY THE CUSTOMER. -------- --------------------------- CONT TO - -- ----- --------------------- ITY OF ATL C BEACH APPLICATION FOR WATER METER DATE'-CONTRACTOR: 7'_ 7' BILLING ADDRESS: y _ _ /D _________________ ------ ---------------------------------------- SERVICE ADDRESS: LOT: _/ JL--- et-cm. ------SUBDIVISION: -- ---- ACCOUNT ACCOUNT NUMBER: METER SIZE:_�-�'/ I HEREBY REQUEST THAT A WATER METER BE SET AT THE ABOVE SERVICE ADDRESS. I UNDERSTAND THAT I WILL BE BILLED FOR TEMPORARY CONSTRUCTION WATER UPON SETTING OF THE METER. I FURTHER UNDERSTAND THAT I AM RESPONSIBLE FOR ANY AND ALL DAMAGES TO THE METER, BOXES, VALVES, LINES, AND ANY PARTS THEREOF, UNTIL PERMANENT WATER SERVICE HAS BEEN ESTABLISHED BY THE CUSTOMER. C . ---------- - -------------- CONTRACTOR ---00FATEAN FIC ------------------ ITEACH 27937 METRO GRAPHICSJACKSOWVILLF,FL CITY OF ATLANTIC BEACH No. 1192 FLORIDA April 26 19 88 NAME Reyhani, Inc. ADDRESS 439 Selva Lakes Circle CITY Atlantic Beach 3 13 n TL 3 130.0!,CKTO 2 '9 II! 4/?6/09 Water Impact Fee #40-343-37001192 $1,060.000ACG Sewer Impact Fee #41-343-5200 P A I. D 2519 $2 070:,©06/©0 10001 APR 2 6 1983 $3,130.00 Lots 137 $ 138 Unit III Selva Lakes 711-715 Selva Lakes Circle 0 y `� s F<-� zx = D M `1 00 Or W U < ;am p L M Z 3 Q W W O 0 (� mm C D m ,~ C� W u Z > o< A '^ C\2 0 z rL 0 N D N W - O zn � " D R1 f r Q N Q w > D W a < MAK m mz z 0 m " N m CITE ^� A C 9 V 2 N J ° kSURER Ir Z m r z0 -1 ZLLN m W vl J U1 A G7 ArZ F- VO J Z to r N 2! a m a F- '1cV- v � m m uwW Gz tW > N rri < M �� 0� < 3 Z 2 < I Z\:) A - < W <Z Mon > m w cr �� WW > ° � ca Z c o = zM ° m zr II �.