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156 Seminoel Rd (vault) JOB ADDRESS E WORD /7 7 / PROPERTY OWNER J( TELEPHONE 2 r/— Q 9 7 CONTRACTOR A--2 , rJ GiJ/e Pv" TELEPHONE PERMIT NUMBER 9,2 DATE / /3/9 IY SPECTIONS: FOOTING SLAB TIE BEAM LINTEL NAILING/SHEA?IENG FRAMPNG/COVER UP PNSTLAI7ON FP/AL BUILDING CERTIFICATE OF OCCUPANCY Fr.FtTRICAL PERMdT4 INSPECTIONS ROUGH FLVAL MECHANICAL PERMITI# INSPECTIONS ROUGH FINAL PLEifaPNG PERMIT4 INSPECTIONS ROUGH/TINDER SLAB TOPOUT WATER/SEWER FINAL NOTES: fl-3o - 9 6 3- 2 4- 0 0 G `no .vric - 01,i-vi-r,„ 1 r- � , CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD r' r� ATLANTIC BEACH,FL 32233 _} INSPECTION PHONE LINE 247-5826 ''.4.0717-119'1' Application Number 09-00000384 Date 3/23/09 Property Address 156 SEMINOLE RD Application type description MECHANICAL HVAC ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc 1 cu 1 ahu Owner Contractor SIEFKEN TOTAL AIR CARE, INC. 156 SEMINOLE ROAD Q/A:NIQUETTE, MICHAEL ATLANTIC BEACH FL 32233 PO BOX 2004 FL 32050 MIDDLEBURG Permit MECHANICAL HVAC PERMIT Additional desc . Plan Check Fee 00 Permit Fee . . . • 79 . 00 Issue Date Valuation . . . • 0 Expiration Date . . 9/19/09 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. 7 4.. ?xfi . CITY OF ATLANTIC BEACH 09- I I I I ti 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 .�,,,, ..Y, OFFICE'(904)247-5826•FAX NO..(904)247-5845 BUILDING-DEPT©COAB.US /� MECHANICAL PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: 2.IS THIS A SUB PERMIT: 3.DATE: ®'(i0 �/�y/p 7 �l- ❑YES PERMIT#: /5 6: Sem ���u/ PROPERTY OWNER: 4.N"MEE 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE: avid .SIerKiA 5<I.�re 331- '/mil V MECHANICAL CONTRACTOR: 7.NAME OF COMPANY: 8 ADDRESS: 7 Dtd kr eAie tee. PD. A ti( Zoo 4, /121, / ALLI j f i- 3z o ST 9 STATE IQ,,F FLORIDA LICENSE NO 10.CELL PHONE: 11.FAX NO: CM-0 19/5� 3,Q. 9c 9-'H f- 3/9'7 9 J-02 V"5-1-5-19 12.EMAIL ADDRESS: 13.OFFICE PHONE: 14. ?�I:51-D ated leiiiAirCmve. ,1i7 . 'joy-X5'.1-SbSU Application is hereby made to obtain a permit to do the work and installations as indicated. I certify 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/af any time after,',work is co / � i(,{L F' "� CONTRACTORS SIGNATURE: /�� L_ is J 1I.SERVICE: 18.CURRE' 15.CLASS OF WORK: 16.BUILDING: ❑ NEW INSTALLATION ❑ NEW ❑ RESIDENTIAL 0'06 F ''IDA BUILDING CODE- D REPLACEMENT OF EXISTING SYSTEM ❑EXISTING ❑COMMERCIAL M 'H'NICAL ❑ALTERATION/ADDITION TO EXIST SYSTEM ❑REPAIR ❑OTHER MECHANICAL EQUIPMENT TO BE INSTALLED: 19. HEAT: ❑ SPACE ❑ RECESSED EI ENTRAL ❑ FLOOR BURNERS: 20.AIR CONDITIONING: ❑ ROOM PLYGENTRAL 21. DUCT SYSTEM: MATERIAL: THICKNESS: MAX CAPACITY: cfm 22. REFRIGERATION: MAX CAPACITY: cfm 23. COOLING TOWER: CAPACITY: gpm 24. FIRE SPRINKLER: NUMBER OF HEADS: 25. LIFT SYSTEM: ELEVATOR: MANLIFT: ESCALATOR: AUTOLIFT: 26. COMMERCIAL HOOD NUMBER: 27. FIREPLACE: PREFABRICATED: MASONRY: 28. IRRIGATION: ❑ PUMP ❑WELL ❑ PIPING 29.GAS PIPING: #OF OUTLETS: ❑GAS AHU: ❑GAS WATER HEATER: 30.OTHER-SPECIFY: SOLAR HEATING, BOILERS,UNFIRED PRESSURE VESSEL,HEAT EXCHANGER OR COIL IN DUCTS ETC. VALUE FOR OTHER ITEMS. 31.COOLING EQUIPMENT: AIR CONDITIONING,REFRIGERATION EQUIPMENT,CONDENSORS,ETC. APPROVING NUMBER OF UNITS DESCRIPTION MODEL# MANUFACTURER TONS AGENCY 1)c Al Pally Oc.114r4J-1-r- .2.5-14 8,9 &:ir `/r/Q- 3 32.HEATING EQUIPMENT: FURNACES,BOILERS,FIREPLACES,AIR HANDLERS ETC. APPROVING NUMBER OF F UNITS DESCRIPTION MODEL# MANUFACTURER BTU AGENCY i Air H air)Ier FV'I6 2ure/c,[-, 3is;4 33.TANKS: TYPE LIQUID APPROVING NUMBER GALLONS CONTAINED MANUFACTURER SERIAL# AGENCY BLDG04 Permit Applicaton Mech:REVISED:12/18/2008 r�`s ' .',f. CITY OF ATLANTIC BEACH A S 800 SEMINOLE ROAD apo) ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number 07-00001660 Date 6/18/08 Property Address 156 SEMINOLE RD Application type description SHED PERMIT Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc SHED Owner Contractor SIEFKEN OWNER 156 SEMINOLE ROAD ATLANTIC BEACH FL 32233 Permit BUILDING PERMIT Additional desc . Permit Fee . . . 35 . 00 Plan Check Fee . . . 00 Issue Date . . . Valuation . . . . 0 Expiration Date . 12/15/08 Special Notes and Comments *A CERTIFIED COPY OF THE RECORDED NOTICE OF COMMENCEMENT MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO THE FIRST INSPECTION. *2004 FLROIDA BUILDING CODE W/ ' 05- ' 06 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. Fee summary Charged Paid Credited Due Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. • rs�"�''� CITY OF ATLANTIC 1;EAC 1, PERMIT —"1.=..,;?-'ViLtr.ie". , BUILDING / ZONING DEPARTMENT APPLICATION # . i V-) ;00 Seminole Road Ailantic Beach,Florida 32233 ✓f /\ (904)247-5800 . ,'>!, (904)247-5845 Fax . wwvv. 2aJ2- APPUCATON • TRACKING FO M REQUIRED DEPT: 0 N PLANNING Property Address: ��b d 1m/7'10 L E fs4'/ z Q N BUILDING P. 0 N PUBLIC WORKS • Applicant: 0V.7t D O0 Y N PUBLIC UTILITIES uL /�-• Y N FIRE DEPT. Project. !f!/.4 Y N PUBLIC SAFETY cn APPROVAL w REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE: uow Y N D.E.P HUFSTETLER PI Y N S.J.R.W.M. CARPER _ Y N ARMY CORPS of ENG CARPER O Y N HOTELS&RESAURANTS HUFSTETLER • APPLICATION STATUS __ __ CIRCLE ONE: SITE BUILDING DA AP REVIEWED BY: INITIAL: DATE: 0 I 0 1 1ST REV I err® S D I /2 ?/--v7 Sq-an or 05,P142- . 1 �,. J r ti-e I 50 Af -t-1,1----0-. AAA?" ii-s4A/1 PLANNING BULL• 1 - 0 1 0 1 2ND REV 10 1 ® I A I14 4� Di PUBLIC WORKS 1 I . 0.1 17 , PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY U 0 1 3RD REV 0; • Return this form to the Buildana Department once you have entered your c i mments into the AS400. -jL'iri,, CITY OF ATLANTIC BEACH 07- I 4) f ,;.;_ 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 i y---___.�° rI►,: r:A .'; OFFICE:(904)247-5826•FAXNO.:(904)247-5845 ""1- 7 BUILDING-DEPT @COAB.US `-`s-Jf:3 '• BUILDING PERMIT APPLICATION DUVAL COUNTY _ � 1.JOB ADDRESS: 2.VALUATION OF WORK: 3.SQ.FT.UNDER ROOF 15 L.. 3+e..;,1,,..,\A- Z-t "_ K 4.LEGAL DESCRIPTION: 5.CLASS OF WORK: 6.USE OF STRUCTURE: X,NEW BUILDING ❑DEMOLITION RESIDENTIAL LOT BLOCK SUB DIVISION El ADDITION ❑CONVERTING USE COMMERCIAL 7.DESCRIPTION OF WORK: ❑ALTERATION ❑ACCESSORY BLDG. 8.FIRE SPRINKLER: ❑REPAIR ❑POOL/SPA ❑YES ❑N/A S�n2c� ❑MOVE ❑OTHER ❑NO PROPERTY OWNER: CONTRACTOR: ARCHITECT I ENGINEER: 9.NAME: 15.COMPANY NAME: 23.COMPANY NAME: 0 a S k.e.,,, 16.NAME: 24.LICENSEE NAME: 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 15!Q v CQM)Aso (2-.C) 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: 404 334 - �-26 (O 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 THE FIRST INSPECTION. IF YOU INTEND EFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER LENDER OR AN ATTORNEY CONTRACTOR OWNER or AGENT (Qualifier Only) (If Ag••t,P wer of Attorney or Agency Letter Required) It 12- ' C I, Signed: Date: Signed: Date: Before me this 1 day of I 2007 in the county of Before me this day of 2007 in the county of Duv of Florida,has pe Wally appe red Duval,State of Florida,has personally appeared c_.)6--7\ 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 accurate. / true and accurate. Notary Public at Large,State of County/ ,Coun of V 1 (� Notary Public at Large,State of ,County of ❑Personally Known ❑Personally Known ktfi'aluced Identifi -'.n- ill.� _ �[c�// ❑Produced Identification- Notary Signature: %�'• � _V'� Notary Signature: . ti `My C ion Expires Feb 14,2010 tt �. • IDD518533 Bondd Natlon_Notary Assn. COAB FORM BLDGO1:REVISED:8/2/2007 Initial Effective Date: 01-01-02 as adopted by Ordinance 90-01-172 Last amended on 08-13-07 by Ordinance 90-07-201 v. Gazebos and similar Structures, not to exceed 150 square feet and ten (10) feet in height for a flat roof or twelve (12) feet in height for a peaked roof; and a minimum distance of five (5) feet from the rear and side Lot Lines. vi. Private Swimming Pools in accordance with Section 24-164. vii. Home Office(but not a Home Occupation). viii.Private ball courts and other similar private recreational Uses. ix. Skateboard, skating, bicycle or similar ramps, for use on private property only, placed or constructed in fixed locations and made of wood, block, concrete or similar materials, provided that these are not located within Required Front Yards or the Street Side Yards on a Corner Lot. Due to excessive noise, which may result from the use of such ramps,time of use shall be limited to the hours between 9:00am and 10:00pm. Such ramps shall be maintained in a safe and good condition, and shall be disassembled and removed from the property if allowed to deteriorate to an unsafe or unsightly appearance. x. Storage and tool sheds, not to exceed 150 square feet and ten feet in height for a flat roof or twelve feet in height for a peaked roof. Only one detached storage or tool shed shall be allowed on any single residential Lot, and such Structures shall comply with applicable Side Yard requirements and shall be a minimum distance of ten (10) feet from the rear Lot Line. xi. Screened enclosures and pool cages with screened roofs or similar non-structural roofs such as awnings and the like, not to exceed 600 square feet and fifteen (15) feet in height and located a minimum of five(5) feet from any side or rear Lot Line. Such detached screened enclosures shall not be allowed in Required Front Yards. xii. Dog houses not to exceed five(5) square feet and five(5)feet in height. xiii.Personal pets, limited to those animals customarily considered as pets, and kept only on the same premises of the occupant(s)of the residential Principal Building. (2) In any Zoning District,except as to private Swimming Pools: All Accessory Uses and Structures shall comply with the Use limitations applicable to the Zoning District in which they are located. i. Unless otherwise specified within this Section, all Accessory Structures shall comply with the Land Development Regulations, including the minimum Yard Requirements applicable to the Zoning District in which they are located. ii. Unless otherwise specified within this Section, Accessory Uses and Structures shall not be located within Required Front Yards and shall not be closer than five (5) feet from any Lot Line. iii. No Accessory Structure shall be used as a residence, temporarily or permanently, except in accordance with Section 24-88, and no Accessory Structure shall be used for any commercial or business purposes unless approved as a Home Occupation in accordance with the provisions of Section 24-159 of this Chapter. iv. Accessory Structures shall not be more than fifteen (15) feet in height, except in accordance with Section 24-88 or preceding paragraph (b) (1) iv. Space within an Accessory Structure shall not be leased or used for any Use, activity or purpose other than those typically incidental to the Use of the Principal Building. 75 MAP SHOWING SURVEY OF I--or 4,/4 4,-10 TjlE //o,PTt/ oc/E-f/,�lLf of Gorlo/5, 54LTt1/R 5Ecr/oN r--,40./ "�t AS RECORDED IN PLAT BOOK /3 , PAGE 8 OF fin CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA 'S RECEIVED NOV 1519 OZ1 WO Q VEA//, City of Atlantic Bea •h /c-c7.4Ar/ER. ' A74,,4' ,e/v ''' Building and Zonin (50' ,7/c,L77-- of Pc/.4 Y) qC N ikl 0 L o r � /3 c).k o N " /oo.oo • 0 k . o .M 0; Cor/C. � K N 4 N f 101: 9��k z vas,. O • • . - I'�Fe of ro 3I.7' (�37� 8• . • . • 1 / .o• 6.5' • 2 - -- i - y[-N •0 cRE6."16- Z a c4R,'.er - ..Ga-/CR \ Q m •, ' ..oRivE• O 1 n• �� _t1m"_-1 /7(o' ti o g lk /- 97V Y' W 8 o X Q / Y V� 4 NJ kl\t . J x} 4.2'• GoT 6/G ZoT a,/5 ‘N: `) 40./' 35•x' �, U\ 90° ief° 4'eN4/,� V 7 N o2 [-/NK FEti/cE/I�. i.1 • • O. /�.GL�' Of 77-/e So/7V/ /2 of c oT 4,/5 N \1 S� A/or /,c/cc u0EO /A/777/5 5'c/ 'V > \ / , /oo• 1 NOTES: 1. This is a boundary survey. 2. Flood zone X" as best ascertained from Flood Insurance Rate Map, canmunity panel no./2orm500O1D dated 4-17-89 3. Bearing datum based on PLAT Book /o, PACE 8 I HEREBY CERTIFY TO:JON,-/✓. ANO CL///CE E.5'f1'(z4 V Leon eiry t-vioe MORra4GE CoR ; CoN77.'JEN7211. 7V?-E 5ERv/CES,,^/C.A5 AGENT' FOR CJ-/ -.46 0 7-i7Z.E /NSC/R.4•-/C4 CCM/'4NY N THAT THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF LAND SURVEYORS, PURSUANT•• • \` FLORIDA STATUTES AND CHAPTER 21 HH-6 Marva• Batik: TO SECTION 472.027 FLOR ): ` t �u FLORIDA ADMINISTRATION CODE. :: ,.. sasW,,,„..",t ig.P,O ,c• , 74e/1/77?-i X Gt/-lAY 2866 MANGROVE AVE. FLORIDA REGISTERED SURVEYOR NO.4470 JACKSONVILLE,FLORIDA Marvin R. Banks (904) 641-2520 SIGNED c '4A./L/�4R>/ 22 19 92 SCALE: ` 29 THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE ABOVE SIGNED 1`r,'`r CITY OF ATLANTIC BEACH PERMIT APPLICATION# Vt \SJ, BUILDING / ZONING DEPARTMENT r 'Y 000 Seminole Road /' s--.: / Atlantic Beach,Florida 32233 1 O :, / (904)247-5800 '"�!GS':1S`' (904)247-5845 Fax a 4(::>?i www.coab.us APPLICATION TRACKING FORM RE* IRED DEPT: firMil f//U 4/77..-n PLANNING Property Address: /.d 0 l i 7d 2 ro BUILDING IrQa PUBLIC WORKS Applicant: 1077 fie 0 Y N PUBLIC UTILITIES IL Y N FIRE DEPT. Project: c3A 24 Y N PUBLIC SAFETY APPROVAL w REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE zw V N D.E.P HUFSTETLER Y N S.J.R.W.M. CARPER 11-1_c / Y N ARMY CORPS of ENG / CARPER O err V N HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS -- CIRCLE ONE: SITE BUILDING DA AP REVIEWED BY: INIT AL: DATE::��i ® ® 1ST REV 1 0 0 I I A I /1'. ` / /do& . • PLANNING 0 0 2ND REV I ® I I I BUILDING PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® I ® 1 3RD REV I ® I 0 I • Return this form to the Buddies Department once you have entered your c,,,mnnents into the AS400. `'L';�i, CITY OF ATLANTIC BEACH 07� 7-1-1-7-1--1 ^-hf 9..;� 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 1;-t t-, w x, ) OFFICE:(904)247-5826•FAX NO.:(904)247-5845 1u': BUILDING-DEPT @COAB.US =`-, BUILDING PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: 2.VALUATION OF WORK:, 3.SQ.FT.UNDER ROOF I5 cc, 5 efY‘)' o,\-Q. k, (I". (Q 5,CLASS OF WORK: 6.USE OF STRUCTURE: 4aEGAL DESCRIPTION: "" '��•`''�� XNEW BUILDING ❑DEMOLITION RESIDENTIAL LOT BLOCK SUB DIVISION ❑ADDITION ❑CONVERTING USE s.g COMMERCIAL 7.DESCRIPTION OF WORK:+ ❑ALTERATION ❑ACCESSORY BLDG. 8.FIRE SPRINKLER: ❑REPAIR ❑POOL/SPA ❑YES CI N/A j1 2�\ ❑MOVE ❑OTHER ❑NO PROPERTY OWNER: CONTRACTOR: ARCHITECT I ENGINEER: 9.NAME 1 15.COMPANY NAME: 23.COMPANY NAME: D0.0,,2 S a.C k.e.." 16.NAME: 24.LICENSEE NAME: 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 15 CQ S er►,.)4‘;o 2 Q Q. 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: 9o4 334 - -1-2C, O 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: -FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER: __ 1 _ (IF OTHER THAN OWNER) g 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 THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. OWNER orAGENT: 'a ° CONTRACTOR z•r.x-^r• (Qualifier Only) (If Ag t P�wer of Attorney orAgency Letter Required) ••� ?':.•':�`� •-_:-yx:•s��• Signed:t( y Date: 12-�-0 Signed: Date: Before me this day of �` 2007 in the county of Before me this day of, 2007 in the county of Duv of Florida,has peispnally appe red Duval,State of Florida,has personally appeared V i b ,, _- 1 i- L g --IN, 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 accurate. / true and accurate. i ,County of V V Notary Public at Large,State of ,County of Notary Public at Large,State of tY , ❑Personally Known ❑Personally Known roduced Identifi .''•n- ❑Produced Identification- � � HAM • Notary Signature: Notary Signature:ry g -�. ��i �� ,o a .u;•� a e ,.,.,rr.. l!�: _My Co ion Expires Feb 14,2010 6 1'I ` .ion#DD 518533 i'`,,,,, "'"°,` Bond = Nationa Notary Assn. COAB FORM BLDG01:REVISED:8/2/2007 MAP SHOWING SURVEY OF GOT 6,/4 4/-/a r/-le ,./o,QTf•/ o/c/E-,'/ALF OF Gard,/5, 5.41..7.4/R 5E•77o/-/ A/o-/ , t AS RECORDED IN PLAT BOOK /0 , PAGE 8 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA T RECEIVçD NOV9519 ' 04 WO Q VEA/L/E- City of Atlantic Bea-h Fo,QMERL>r P4,k,ds' 4✓ - Building and Zonin' (50• ,'/c //T of /A/4 v) aN N�\w 0� L 0 r /3 Dk e N zn 4 in N /00.00 ' �� M ii)R, 0 • Co/./C. . I N G/,,./,y Fe •E 9� ti:: ' ; . +cam 4 /000 0 90" e.z� h .. . . - F�"E 3/ 7" 37�� 1('-°' &s' , 22.0• { 0 SoPEEc/E/� Z cm t \ \ cA2Poei A2✓ +� 0 `�` yb�ecf/ 0 /76.• (k -` -•0 z.z• c b IL k 0 8 xlk �t /- 9ToRV oQ o NJ tl\ 1 °• /„1.4 5�G'..cIR V Q 82 kIl �Z N N tN 1� d 4.2' LoT G/G cor �/5 N. 0 49 /N/-° /50 0 , o , a \ W � 110 �F "INN. v 4 C4// cTNK E ice-/ l i.l (n N o•Z • 0.2• /G2C.a7' of , o t 77-/E 5oc/7W' i/z of c oT to/5 V 1 NJ S� A/or /A/e c uo EO ,x/� J, 'v y N 4 i • /0o' NOTES: 1. This is a boundary survey. 2. Flood zone X' as best ascertained fran Flood Insurance Rate Map, cannunity panel no./Zac7-75-o0ID dated4-(7-89 3. Bearing datum based on PLAT f3ooK /0, PACE 8 I HEREBY CERTIFY TO:Jai J d. Q/✓o c_L'-7O/cE E.5f1,,z4A40 L ecoy, CITY wiDe M0.4TG4GE co/7,°, Co.A/Tit,/ENT44 T/TLE SERV/cES,/.--/C•45 AGen/Ts •••-o C,1-1.t Ca T7TT_ /r/.5//Z4-/< CoM,°<INY THAT THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS AS ; : 4' SET FORTH BY THE FLORIDA BOARD OF LAND SURVEYORS, PURSUANT Marvi • l' . atilt TO SECTION 472.027 FLORIDA STATUTES AND CHAPTER 21 HH-6 ��4\\ k4 iI C. FLORIDA ADMINISTRATION CODE. 2/7er//P`Al'i ir G07-(/'-‘1Y 2866 MANGROVE AVE. FLORIDA REGISTERED SURVEYOR NO.4470 JACKSONVILLE,FLORIDA Marvin R. Banks (904) 641-2520 SIGNED c1/1A/L/.4R)/ 20 19 92 SCALE: / ` 20' THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE ABOVE SIGNED . .. I0 + D NOTICE OF COMMENCEMENT ' Tax Folio No. State of rL ----- County of D.,),Q,:,t To Whom It May Concern: and in accordance with Section 713 of The undersigned hereby informs you that improvements will be made to certain real property, • the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: ;,�o , IJi-l�.l,� rs`� L 3 zZ3 Address of properly being improved: s • - General description of improvements: (�‘:- ' - V� • Address: t� Aril°'"� Owner: lJ c.:--�- \Owner's interest in site of the improvement: Fee Simple Titleholder(if o t h e r t h a n 1 4 3 1 9 2007392605, K 1 431 s Page_T"_ Number Pages:1 Name: Filed&Recorded 1220 2007 at 04:24 PM. L JIM FULLER CLERK CIRCUIT COURT DUVAL Contractor: Z COUNT" RECORDING 510.00 Address: • Telephone No.: Fax No. Surety(if any) Amount of Bond$ I Address: Fax No: Telephone No: improvements Name and address of any person making a loan for the construction of the imp Name: v Address: Fax No: Phone No: on whom notices or other documents may be Name of person within the State of Florida, other than himself, designated by owner upon served: Name: tti%, Address: Telephone No: Fax No: of the Lienor's Notice as provided in Section In addition to himself, owner designates the following person to receive a copy 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: `i'c"`"- Address: Fax No: Telephone No: unless a different date is Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording specified): 1 THIS SPACE FOR RECORDER'S USE ONLY OWNER / _ L, Date: t 2 Signed: in the County of Duval,State . day of Before me this a+il� '�L .;1-Ii-,..1 f 4, Of Florida,has person lly appeared .P�1 County of Duval. ''union Sires Feb Florida '' Notary Public at Large,S e of Florida, ty _°� �,;� �y Cvmion Expires e 1�,2Li0` or• Y,-Z,„-a-....s f7 Commission#DC 51: l' My commission expir��/��, Bonded Bv'+a+�� al�!c' Personally Known:Produced Identifica� ■�j'-j` � lb °00tSV aql oval splaexug®a anoL pa nnua amgq UOA 2310 1.U9r.14115aalaawyt{dt 1kott$a..3 ...3..:-„,.-_ ,.� 1 . 03021A3)=1ai£ 0 \ 0 . 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O F 02 Application/Permit#: ��� � Project Name/Address: / . — Al 4 �C _ iiChec=k B_ag F hcatiOn T�raClang _ � OmIY►BIIt � , } t 4 r � Provide impervious surface calculations. OM Provide erosion and sediment control plans with installation details and maintenance schedule. ❑ Provide drainage plans showing site topography (flow arrows, etc.) management plan, including Right-of-Way Permit if using Er Provide construction site man a g right-of-way for construction parking. Provide a pre-construction topographic survey prepared by a Florida Licensed ❑ Professional Land Surveyor, showing 1' contours. Section 24-66(b) of the Land Development Regulations requires on-site storage for ❑ increased runoff. Provide Delta volume calculations and on-site retention required per Section 24-66(b). (See attached info. Sheet) If on-site storage is required, a post construction topographic survey documenting proper ❑ construction will be required. A Right-of-Way Permit must be obtained. ❑0 A Revocable Encro achment P ennit must be obtained for from street Pool—Wellpoint(if used)must discharge into vegetated area 10' minimum ❑ or drainage feature (swale'or structure) All driveway aprons must be concrete, 5 inches thick,4000 psi,t be esh fro t he ❑ edge of the pavement to the property line.Reinforcing rod the ROW (Commercial driveways—6"thick).d u Any utility cuts in the road must be repairsm GUS Standard Detail Case X and must -' ! repaired g �must be shown on be overlaid 10 feet in each direction fromthe center of the cut. Rep the plans. ❑ 0 IIIII 1 lr r e - .y� � - - _ 1 • { - (`' • ' r ir i I . . ._ . ' .7. 2X4 eA .+' r I 4-- • / , . .. — , . . ' . • •• t:L....C2) 2x 12 iier:.vLr 1 2.� - r .l,V l-�C� F ..rk t-� N'f 5 No-T� 4.6 RI t2.G.i,e } A1, , 14I4t - .ALL GoLLAF -1i5 Ag-5 3.. H. 175. - . 5° ---- • A19175-1i pU M To t2 t7,-4.\/.1 p. x151=i<511 I,9&. �srerlNoLe rfA P ,2�.GVERMEY ARCHITECTS. r JACKSONVILLLE BEACH, FLORA .ATLAN TI G �> �p1 , L • i� (.. ' AA- CITY OF ATLANTIC BEACH sl 800 SEMINOLE ROAD r � ATLANTIC BEACH,FL 32233 `, INSPECTION PHONE LINE 247-5826 -.VIII, Application Number 09-00000016 Date 1/14/09 Property Address 156 SEMINOLE RD Application type description RIGHT-OF-WAY PERMIT Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc paver walkway Owner Contractor SIEFKEN OWNER 156 SEMINOLE ROAD ATLANTIC BEACH FL 32233 Permit DRIVEWAY PERMIT Additional desc . Permit Fee 35 . 00 Plan Check Fee . . . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/13/09 Special Notes and Comments Revocable Enroachment Permit not required for backyard pavers . Fee summary Charged Paid Credited Due Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 1) 041-1 -a't .0 2) n 4 52. ° y) Soro IS ^A) 1r'-11.1 Coo,„. 21-181 F} ` s 500 s t, 44- �c o poS ed 1J c 11C kY.,S-k-k —� 3� % c_zu e. a X 44/4•G 4 ;c Z 3 k �s' r 34.5 Ex�sk Toka( C 2:"4-q 8‘ y' k is, _ 7 2..o — Vr •(205.agk l•x t k L6 5,66. i 18.3 p Im ervious Surface Calculations % Formula 3341 .y if 2.3 %. Find square footage of the following: House footprint Driveway All sidewalks/walkways A/C pads Detached garage/sheds Pool Decking titPatios, terraces and/or decks Add the to �tbotage of the areas listed above then, divide the sum by J the total lot area of the property. T o t 4-( eon of Lo 4 Iork-1•. -‘ of Lo# 61$ -3'1 SCSJ.-V{' C /004 x --s 4 - 50o sycJ-> No.ssc coy¢ro.)t 4 (J )zro$ L,o !sal •S -► 14 2. = 1441-. 3 2 ) Cor•c.^eke. &�\ue- 3O�X 8 . 5 c-4-. 249 £j PL- / ore,o� Ga�ccv�4c t� .a4tS- Q�Z" 1�.o�-S< .. 1 • 1- f- 4 Li' Fs•3P+ - acaour* 10� F‘aic (LAa.0f &1Z.¢ wc , e. „u (.)F &►vA is 8 FA-. 4sz 3 n c .n N1/4..) (c r&ter- i1• PA- x . o F- $ A a P+ on Gf ex+enbs J` f'- ouw 11. 3 fl. 6"Mi, 51142007 • , 5,ter-,7 _-r.� �R•?-11T �"?s--.— ,-. .-_ €> ".- - Y, -�c` - 4r..— Rrt-�..#+S MAP SHOWING SURVEY OF - r 4-or 6./4 LINO 721E ,4/0ert/ot/E-A/LlLF of Gor6,/5,5AGT<t/R 6ECt72 ' rio/ AS RECORDED IN PLAT BOOK /° , PAGE 8 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY,FLORIDA • rie L74 V/D • VE,ClA f 1 f o?M E R L Y A i- .4 I/ .- (50' ,,e/ i.,7- a w,4 V) ' i I N aN a w 0,s1 L 0 7 {0 / Z� a ci 0 /00.00 ' � ' i ,� N: Go../C. • I 0 4/A./A-,c-4-,..e.,.-0 . O . T 4 no 57 - '1�, 6.0 - b.5 22.0• I . . _ 7 c)Ci N,..,C) I: sc�E:/E0. - •_ , t- :: Q p „ m ybeGi/ `Q .,ar /vE v Q . ,:,4J . 2.2` I - z 8 8o s+ i^ !,-.4... Q . 4,fir• /Q t/ �. n� �R , . 4.2' • li/.1' ■zi Go ov/Q O N - ' ,s, [ c T d:,/5 .1 o gi r a xl N W e - ts.. t.z...,4c2c, ki °P.Y _ Vii-- -x X X Y W o A n-/E Soc/Tj/ /2 orc c oT 6 i 5 J �VoT /.c/O L c/i7 9 /.c/7z//S 5d.gt,/ -Y 4 4 t ..h i 40 ft line X00• I ` NOTES: koMc Ckon)L2 , bA,-)∎b Si c-eKEn) 1-c1cp.1-1" t I5 (Q Sr/'1‘NULi RD p}T ANTI c_ 11.1- F+ r J�1 -1 s- • • 3s F+. • _ N k OU s e 4- 2.3 c+ 15 eXISTINC7 IUkw Sl+c� �$ NS F+ L. • F—yF�-1 • j�,�f , City of Atlantic Beach APPLICATION NUMBER r �� To be assigned by the Building Department.) Building Department = ( g y 7=-.t. ik.-_' 800 Seminole Road ✓QN S�\` fl g . Q Qa�� 6,� - _, Atlantic Beach, Florida 32233-5445 (J ` Phone(904)247-5826 - Fax(904)247-5845 ® ? �► / "r, 9 r E-mail: building-dept @coab.usQ,9 / Date routed: /h/Q ��;,l City web site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Department review required Yes No /n Building Property Address: /,.. 010I/ �j Planning &Zoning Tree Administrator Applicant: 0 kll 21 ublic Wor 1 ities Project: --7)11,04. 1,04.1 K.to 41,y 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: APPLICATION STATUS Reviewing Department First Review: [Approved. I (Denied. (Circle one.) Comments: 0-{,p_„,r, T p ' 7- qua 1— /�� 6t BUILDING � Q s ,�D / 6/2 zr V f " PLANNING &ZONING iA "i , Reviewed by:1 Date: TREE ADMIN. PUBLIC WORKS Second Review: I lApproved as revised. I (Denied. Comments: PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: I 'Approved as revised. I (Denied. Comments: Reviewed by: Date: ij ),...-- it.572.))i) Jar 51� `lr'-° � CITY OF ATLANTIC BEACH e G-J j=� � CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS s � V~ 800 Seminole Road 904-247-5800 !01,93 Atlantic Beach, Florida 32233-5445 4/A jax 904-247-5845 PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. ^^1I'I 0 72491 Date \.1c 3' - d-8 206 9 PERMIT# ISSUED BY THE CITY Job Address ' 5 C�2 \mac - P--".C.` , � c Permitee: 7`Jam)6 J��C-' - " (� /� Telephone# Permittee Address: 1 S 6 �=� C 3(_Q �& AI - 3 2-2-3 Requesting Permission to Construct: C e/>■en\--/ Putr Lk" to �oL� 6T K'S -- Location: (Reference to Cross-Street) AA I v.,.a.i c 3t6 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. &!C a t 1. rc—yz..�r A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes ( ) No ( ) Date: Bell South Telephone Company Yes ( ) No ( ) Date: Ferrell Gas Yes ( ) No ( ) Date: Comcast Yes ( ) No ( ) Date: 2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of ' — Si Qr. (Contractor's Project Superintendent) located at /S4, c- mho(.:_ ■24)- Telephone#: 3q'--i-2.-loO 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. 6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in impervious area on owner's lot or in the city Right of Way are to be included with this application. (_, 7. This permittee shall commence actual construction in good faith with G- nays. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER Signed: Date: 4 O Before me this 0 day of M w in th County of Duval, State Of Florida, has personally a•peared a.-i. el-Kt-Pa Public at L: •-, - - • - . •:, -I •-∎ ` T My commission e.••ire.'"ue6 Notary Public State of Florida Personally Known: : r h.ri- M ewer. - educed Identification: Oz- 0,c_ _, o` 'y ommission ,11•:. e p ' oi e:' Expires 08/22/2011 (1-< R.O.W.Permit Attachment of for R.O.W. Permit# issued , 200_ Atlantic Beach,FL 32233 Owner's Name: I \& Property Address: 15( Serb ► S Ak lo..\-c(.. ( .,, FL 3 2--233 Subdivision: 3c, -air 5� _k�i �'1 Lot#/Block#: Io+- coil �Z ColS (M:. ) R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this a day of ofy- , 2001, by Atlantic Beach, Florida, a municipal corporation organized and existing under tfie laws of the State of Florida, hereinafter referred to as "CITY" and Dc'--.' ' S " of Atlantic Beach,Florida,hereinafter referred to as"USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above (copies attached). This work is g enerally described as: of tool K Goer % i'``P'""''O"�� Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to USER shall be given by certified mail, return receipt requested, to the following address: /$(o rti The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach, Public Works Department, for said change. The USER shall, at the discretion of the CITY, be requested to submit as-built drawings showing the change within thirty(30)days after the day of completion. This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use limitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. 1 J DATED and SIGNED this day of Jan ry , 200`1 By:Y Property Owner (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this (p day of — etetu ry , 2005; personally appeared before me, a Notary Public in and for slid Co my and State, L) .- I S,.Cfl�,e∎ , the property owner of (. Seb11 no!1 i , Atlantic Beach, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the uses and purposes therein mentioned. di,Zi° r p Notary Public State of Florida `/sE� Charles M Edwards Nota Pulic in for said County and State '� My Commission DD686230 Notary 0„01P Expires 08/22/2011 CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: Ricky L. Carper,Public Works Director For Permits where city sidewalk is impacted, City Manager approval required: Jim Hanson, City Manager Page 2 of 2 £T )Jel CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD \\,\, ,,. Z: ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 ':4Ji3!91> Application Number 09-00000879 Date 6/16/09 Property Address 156 SEMINOLE RD Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation . . . 11000 Application desc REMOVE AND REPLACE EXISTING ROOF FL 479 Owner Contractor SIEFKEN BURGER ROOFING CO. 156 SEMINOLE ROAD 134-1 ERNEST STREET ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32204 (904) 355-2756 Permit ROOF PERMIT Additional desc . REROOF FL479 Permit Fee . . . 85 . 00 Plan Check Fee . . . 00 Issue Date . . . Valuation . . . . 11000 Expiration Date . 12/13/09 1 Fee summary Charged Paid Credited Due Permit Fee Total 85 . 00 85 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 85 . 00 85 . 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 O�- I I I I 7 ,,,-.:. 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 i. OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPT @COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: 2.VALUATION OF WORK: 3.SQ.FT.UNDER ROOF 156 SEMINOLE RD Atlantic Beach, FL 32233 $11.00000 4.LEGAL DESCRIPTION: 5.CLASS OF WORK: 6.USE OF STRUCTURE: ❑NEW BUILDING ❑DEMOLITION ❑RESIDENTIAL LOT 614,N'h 615 BLOCK_SUB DIVISION SALTAIR SEC 1 ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7.DESCRIPTION OF WORK: i ❑ALTERATION ❑ACCESSORY BLDG. 8.FIRE SPRINKLER: REMOVE1.ND REPLACE EXISTING ROOFING. 5) V A "'is ID C REPAIR ❑POOL/SPA ❑YES ❑N/A 2.114 V;I',N,:I C ` " ' c'( ❑MOVE ❑OTHER ❑NO PROPERTY OWNER: CONTRACTOR: ARCHITECT/ENGINEER: 9.NAME: 15.COMPANY NAME. 23.COMPANY NAME. DAVID SIEIt EN BURGER ROOFING CO 5 iff.-Ef.: 16.NAME: 24.LICENSEE NAME- GARY BURGER 10.ADDRESS: STATE OF FLORIDA LICENSE NO CCC032514 25.STATE OF FLORIDA LICENSE NO.: 156 SEMINOLE RD 18.ADDRESS: 26.ADDRESS. ATLANTIC BEACH,FL 32233 134-1 ERNEST ST JACKSONVILLE,FL 32204 11.OFFICE PHONE: 12.FAX NO 19.OFFICE PHONE: 20.FAX NO 27.OFFICE PHONE: 28.FAX NO.: 904-355-2756 _904-358-0733 13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE: I 904-334-7260 904-237-9664 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: DAVID.SIEFKEN(a,TETRATECH.COM BURGERROOFING @BELLSOUTH.NET FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER: OF 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,Wells,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 RECORD_ ING YOUR NOTICE OF COMMENCEMENT. 0 R or AGENT CONTRACTOR (I •gen Power• Attorney or Agency Letter Required) (Qualifier Only) Signed: Date:( - S'C3 ("1(// Signed: A E" Date: /S70 l Before me this 5 day. \,,C C) �') ,2017• in the county of Before me day of ,,,,. 'ICS I ' ,20 'n the county of Duval,State,of Florida,has Re .. Ily appeared Duval,State of Florida as persona appeared „..14::.Nude p,MEREDITH !l�/ v4 4 ti,MEREDITH / / - ,_ MY COMMISSION*DO 406969 ar>w� ,' x'+" "'1.' ' : 1 July 1 2009 herin by himself!herself a S affirms that alt."- an.dec r er n by himself/herself and affirm that all statemer• arBonded lY .ilia 1`:' txPIPI :Ju y 14,2009 'TfOFF1 Bonded Thru Budget Notaa Services true and accurate. 'r, ., V true and accurate. /..,.,F col. Bongld�Tt ru Budget Notary Service s Notary Public at Larg,, State• ,County of 4,W,:_, �N.o(tary Public at A e- tate ,Cdi] i of 4-C7 I. Personally. • / -.-. LJ Personally • r/ ❑Produ. '��•. ��'i� ❑Produced .'-.'•.. •••••. 111 --- Notary Sig-1 '>1�,�.� i��. Notary •.r'' rr _ . -4/ 41111111111P „COAB FORM BLDG01:REVISED:5/28/2009 PERMIT NO.: NOTICE OF COMMENCEMENT • To whom it may concern The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713.13 of the Florida Statutes,the following information is stated in • this NOTICE OF COMMENCEMENT. I Description of property(170596-0000) 156 SEMINOLE RD,ATLANTIC BEACH,FL 32233 10-8 17-2S-29E SALTAIR SEC 1 i generai descriotior±of improvements REMOVE AND REPLACE ROOF. IPP 4 Own,er D4 VID SIFFKEIti Address 156 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 Owner's interest in site of the improvement FEE SIMPLE , Fee Simple Title holder(if other than Owner) Name Address Address ti)vst i Contractor BURGER ROOFING CO. ()`t Address 134-1 ERNEST ST, JACKSONVILLE, FL 32204 Surety (if any) Address Amount of Bond Name of person within the State of Florida designated by owner upon whom notices or other documents may be served Name Address In addition to himself,owner designates the following person to receive a co. .f the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statutes(Fill in at 0 option) Name Address A ,.._. Owner Signature (K.;cc S1 R. Print Owner Name L. S •rn to a). . c ibed before me this�J Doc#2009142098,OR BK 14908 Page 1782, '!,:y / ,2009 Number Pages:1 of fik Recorded 06/16/2009 at 12:41 PM, ■ ./� JIM FULLER CLERK CIRCUIT COURT DUVAL + l•:��. �� COUNTY V �l%MANCa, RECORDING$10.00 ::.•�° N• ary Public �' .•..,�`r R.MEREDITH MY COMMISSION#DO 406969 III EXPIRES:July 14,2009 ',9rF0F Fvc, Bonded Thee Budget Notary Services C17Y OF i� �Q /G Official �a OffES-fFpR INSPEcTION /qa-� REQ� Permit No / 9_, AM ' f Date P. Time / '4 Locality Received / I Job pddre�(Q , - MECHANICAL Contractor PLUMBING 0 I ��i Air Cond.& Owner's ��� ELECTRICAL G Rough G Heating G . Name CONCRET Rough Wiring G Top Out G Fire Place BUILDING G Temp Pole G $ewer Pre Fab G Footing G Final Framing. Slab ❑ P.M. Lintel FOR INSPECTION Friday Re goofing READY Insulation Thurs. Wed. A.M. Tues. P.M. Fin al Inspection G Mon ancy G _ '` � Certificate of Occupancy Inspection Made 0 Date Inspector !•■ CITY OF uildi g O Icial Office of B ECTION REQUEST FOR aOl(� /J Permit No. / , ��� � A.M. Date P.M. , Time /� /� Locality Received J �P //,`J Job Address / _ MECHANICAL /I PLUMBING ❑ Owner's ,�/ h� i ❑ Air Cond.& Rough ❑ Heating ❑ Name CONC'� E h Wiring Top Out ❑ Fire Place ou9 Pole ❑ BUILDING' ❑ Footing Temp ❑ Sewer Pre Fab Qur) Framing ❑ Slab C Final Fe Roofing ❑ Lintel INSPECTION Friday- Insulation READY FOR Thurs. Wed. Tues. A.M. D `, P.M. Mon. l � U Final Inspection❑' Inspection Made ,/ Certificate of Occupancy ❑ Inspector Date CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL PERMIT I TO THE CHIEF ELECTRICAL INSPECTOR: DATE:_ _;' l 0 2-CD0 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, 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 ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. e4- bgpi. '6 t(-x_A( ( t\c(A--,,,,,, E -e�A /k l ice/ ,. ELECTRICAL FIRM: MASTER ELECTRICIAN SIGN TURE JOURNEYMAN NAME 'u 7,-Lvs). _ `01")`C- ADDRESS:, `�CO S&"'`i""'\r �d�0 RFD_ BOX BLDG.SIZE BETWEEN: RES. ( ) APT. ( ) COMM. ( 1 PUBLIC ( ) INDUS. ( ) NEW ( ) OLD 0( REW. ( 1 ADDITION (\) TRAILER ( ) TEMP. ( ) SIGNS ( ) SQ. FT. SERVICE: NEW ( ) INCREASE ( ) REPAIR ( ) FEE CONDUCTOR SIZE AMPS COPPER ( ) ALUM. ( ) SWITCH OR BREAKER AMPS PH W VOLT RACEWAY EXIST.SERV.SIZE 700 AMPS PH _ `) W ‘/L ( VOLT ` ( �� RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.30 AMPS. 31.100 AMPS. SWITCHES INCANDESCENT _ FLUORESCENT&M.V. FIXED 0.100 AMPS. ' OVER APPLIANCES BELL TRANSF. 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 PHS MISCELLANEOUS (� W 1 el--C— oo o- -, N ct C� 1 0''..-1 + TRANSFORMERS: UNDER 600 V. I OVER 600 V. NO. KVA NO. KVA NO. NEON TRANSF. NO. .VA. I 1 MA. I MOTOR SIZE SWITCH FLASHER EACH SIGN FORWARDED $ TOTAL FEES CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233 -Tel: 247-5826 - Fax: 247-5877 ELECTRICAL PERMIT PERMIT PERMWDWORMATION L ONIII4F rn .y _ Permit Number: 20165 Address: 156 SEMINOLE ROAD Permit Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 32233 Class of Work: ADDITION Township: 0 Range: 0 Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: 0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost .; Date Issued: 6/05/2000 Name: JOHN AND CANDICE LEDDY Total Fees: 25.00 Address: 156 SEMINOLE ROAD Amount Paid: 25.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 6/05/2000 Phone: (904)642-3803 Work Desc: WIRE FOR ROOM ADDITION MCCLURE ELECTRIC SERVICE PERMIT 25.00 4 - ROUGH ELECTRIC FINAL ELECTRIC NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION 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 CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. (25.88 14 Date: 6/85/88 81 Receipt: 88622 CHECKS 18888 59 ATLANTIC BEACH ILDING D . 88188883221888 Beach-OF Atlantic Beac 4-4I sda Office of Building Official REQUEST FOR INSPECTION �2 Date / �( Permit No. A.M. Time P.M. Received 4' //` '' "2—Z, Locality Job Addy s / Owner's ♦ / Contract•4,_' I 11 Name " PLUMBING MECHANICAL BUILDI CONC- TE ELECTRICAL ❑ Rough ❑ Air Cond.& ❑ Slab ❑ Rough Pole ❑ Top Out ❑ Heating Framing ❑ Slab ❑ Temp Pole ❑ Fire Place ❑ Insulation Roofing ❑ Final ❑ Sewer Pre Fab Insulation ❑ Lintel READ R INSPECTION PM Tues. Wed. Thurs. Friday Mon. y�j A.M. / Gi — 1---2.— P.M. Inspection Made Final Inspection ❑ Inspector Certificate of Occupancy❑ Date CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 SEMINOLE ROAD-ATLANTIC BEACH, FL 32233-TEL: 247-5826-FAX: 247-5877 PERMIT INFORMATION- LOCATION INFORMATION Permit Number: 19289 Address: 156 SEMINOLE ROAD Permit Type: REMODELING ATLANTIC BEACH, FLORIDA 32233 Class of Work: REMODEL Township: 0 Range: 0 Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: 0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: 20,625.00 OWNER INFORMATION Date Issued: 12/03/1999 Name: JOHN AND CANDICE LEDDY Total Fees: 172.50 Address: 156 SEMINOLE ROAD Amount Paid: 172.50 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 12/03/1999 Phone: (904)642-3803 Work Desc: CLOSE IN CARPORT; INSTALL WINDOWS IN SCREENED IN PORCH CONTRACTORS) -':11 � , ,,.���_ _w6^=- -�. � a APPLICATION FEES OWNER PERMIT 172.50 NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION 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 CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ' f — t177 Date: 12/03/99 01 Receipt: 0015©P1�747 CASH A WP TIC B AC BUILD NG DEPT. c+D100D®32210g0 CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address 1 5-(t. S tirOoL 12.E . `- ( oc POYtel* f CAE Ao✓t ► ) Date )2 _ e" ° g Heated Square Footage 3 ' @ $ 5--,S7 0O per ft = 5 .2 0, (02- �r Garage/Shed @ $ per sq ft = S Oarport/Porcn !a 5 per sq ft = $ Deck @ $ per sq ft = r - 20, (02.1" TOTAL VAL+��A.- - -- •- „ Cs, irocd /spa Total VA 1st $ /VOc. /DO / 00.up Remaining Value TSB pe.. thousand or portion thereof TOTAL BUILDING FEB S / tr,ud + 1/2 Filing Fee $ .S7 Sa ( ) Fireplaces @ 515 , , $ — 0 ' BUILDING PERMIT FEE WATER IMPACT FEE $ SEWER IMPACT EE S CAPITAL IMP;.•='DEMENT S� SEWER TAP S ( ) RADON (HRS ) . 0050 SECTION. H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ( ) SURCHARGE . 0050 5 OTHER $ • GRAND TOTAL DUE s / 7 2' S ADDITIONAL PERMITS OR FEES : Mechanical Plumbing Electric/New Electric/Temp : SwimmingPool Septic Tank ; Well ; Sian Finish Floor Elevation Survey ; Other CALCULATIONS and/or NOTES : CITY OF ATLANTIC BEACH RECEIVED PERMIT APPLICATION REMODEL, ADDITIONS, OR ALT TZQ MOVING,DEMOLITIONS of Atlantic Beach • Building and Zoning Owner(s) : C r}.,v mo Q C.6 L D D y 1-- SO k (V LE b 0■,I Job Address: /3— (o 3 6-.h,1 1,410/13 424) Phone: 2.'f/ —15 il 7 Lot # &/I Block or Unit # Subdivision: .S A-Lri412 Sz c_i-/O ni Mo• Contractor: k)o i,a E O WA/!r 2 State License # Address: j5 (# ,SE.-171/4/t' L6r (?5 Phone No: a.'-t( —?lry 7 city(}rL '/t/tc c. t3cA clf State *I Zip Code 32:2_3-3 Describe,work to be done: 0.1 pSIN �j /.A1 Ln �-p ef-t' 4" /'si-A-04 c) w1 A/3nw s /All Sc it.&-- --Ai i //D - (IV ? b2Ctt` J Present use of building: ho h'1e Valuation of Proposed Construction: Y Cr, 0 0 D Proposed use: Ii vb.. 1 SeA-6.�C%r Is this an addition? Y6.SIf yes, what are the dimensions of the added space: ft. X ft. Will the added area be heated and cooled? y6,5 New electrical (or increase) ? '(t5 New plumbing fixtures? New fireplace? New Heat/AC? SUBMIT THREE (COMMERCIAL) TWO (RESIDENTIAL) COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER 2,L,LA i _i„/i Date: // /5---9, Signature CONTRACTOR: / Date: AS TO OWNER: 1967• / Sworn to and subscribed before me this y of / ,j9, , ranrigr, tu NOTARY PUBLIC AS TO CONTRACTOR: ,, Mona° EXPIRES u. •, :- w COMMISSION#CC553881 Sworn to and subscribed before me this day of :—.��• _ ► �'2 J,',.r4..: somemmTWAMONOWNI NOTARY PUBLIC • ',1%,.:p,4•- 1\,i:•-,- CITY OF r i ,� 661,4 - �� :, 4 800 SEMINOLE ROAD ,i _ ATLANTIC BEACH.FLORIDA 32233-5445 ,'•11 TELEPHONE(904)247-5800 FAX(904)247-5805 SUNCOM 852-5800 CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489. 1 03(7), FLORIDA STATUTES: 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. tT 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. ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER $2,000) BE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES; OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION OF THE OWNER, WHO MUST BE ON i THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS. 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 CLEARLY PROTECTS THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1 099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT I TO $5,000 PENALTY UNDER FLORIDA STATUTE No. 455-228( I). 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. 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-BUILD .R PERMIT. �/ ` L L _ �� "OPERTY OWNER/BV LP R /.S b ,_5- cpli& X 6' -Z y/—‘K ? 2 ADDRESS TELEPHONE SWORN TO AND SUBSCRIBED BEFORE ME THIS Y OF , 19 g N OTA U B L I C Patricia Amonette NOTE: PHRASES UNDERLINED ABOVE MY COMMISSION EXPIREM 4,` .• ! 1 0C r gg1 D(plREs ARE EMPHASIZED BY THE BUILDING 'I.*: i,,,,lR\l :it August 27,2000 DEPARTMENT. 1*. -.71` BONDED NM TROY MIN INSURANCE,INC. 11/24/99 WED 09:14 FAX_3849839 FL CURT TW Ia002 TO 38 Ft T T !V • r\ s A J O V 1E-P-5 E- C� JI-n' (A S9/%%483E7 1 y I" P.61/02 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION ;...:Y FORM 8000-97 Residential Limited Applications Prescriptive Method C NORTH 1 2 a ' Small Additions,Renovation.&8ufl lng Syabnr Department of Community Affairs . . • Compliance a*Method C e/Cinder 6 el ate F�aride .astrz- Er=ror tJfidertoy tide maybe d.ndraat.a BY m r.e a(Fagn a)OGfi1 tQ aed.iorts of aBtl sQuars betels**wheeled comment `"'', d manufactured homes,and ranovatia+a to tingle and mulul.n,Iy residences Alem ive mita*ale Po:4 ed fttr(Idf�5o s by use of goon ep0 -y7 of 6024-S7. •.: ;�' PROJECT NAME: /ff ip AND ADDRESS: � /yI�'U�L� r'-L� BUILDER: f1-r/ , 3 Gut / -? jz3--, PERMRTENG CLIMATE . u.: . OFFICE: ZONE: 1 • L'a. ' 1%.....-4.11': OWNER: F t�ptler N0 JtlpraplC ION tlo: APO SMALL ADOITIONS TO EXISTING RESIDENCES(•• Some feet or less or conditioned use), Preecrtp(ive requirements In Tables 0C-1.0C-2 end 0C-3 apply Doty to the eo components l the e�oort not to or the being tolidirsa in Space neelhq,000Peo.end eater heating equipment efficiency levek moat be met only when spumoni is mewed :. ,- mnlunabn nen the Weldon oenettatlon. Components eeparedrq unoenidoned spooks from ervalttiorleel Immo must meet Rue prescribed minimum insulation levels. RENOVATIONS(Reale/mlel buildings enderpdng rertoretions coping more man 30%of the assnaaed male of the bunding). Prescriptive requirements In Tables eC•t and BC-2 apply oNy to the mnponents and equipment being renovated or replace.,t,WWFACTU IEZ HOMES AND BULDtN33,Onry,e,e. k,palied compenerta end features ere covered by Rae Ionp.BUILDING SYSTEl16 Gandy when cortplate nor spume is billeted. Pleases Print CK N 1_ Renovation,Addition,New System or Manufactured Home 1. _ • 2. Single family detached or Multifamily attached 2. _ 3. If Multifamily-No,of units covered by this submission 3. 4. Conditioned floor area (sq.ft.) 4. 3-2S. 5. Predominant save overhang(ft) 5. n 6. Glass area and type: Single Pane Double Pane ' - -- a. Clear glass 6a. 14 sq.ft. sq_ft- b. Tint,him or solar screen 6b. _,T gq,ft. sq.R. 7. Percentage of glass to floor area 7. t<l• % E;_ Floor type and Insulation: a. Slab-on-grade(R-value) ft - b. Wood, raised(R-value) RECEIVED lfb. R= sq.ft. c, Wood,common(R-value) ec, R= sq ft d. Concrete, raised(R-value) • • ed. R= e. Concrete,common(R-value) NOV 2 4 1999 8e. R= sq ft. 9. Wall type and insulation: a. Exterior. City of Atlantic Beach 1. Masonry(Insulation R-value) Building and Zoning 9a-1 R= sq.ft. 2. Wood frame(Insulation R-value) 9a-2 R= i L' , _3 Zt sq.ft. b. Adjacent. 1. Masonry(Insulation R-value) 9b-1 R, sq.ft. 2. Wood frame(Insulation R-value) 9b-2 R= sq.ft. c. Marriage Walls of Multiple Units'(Yes/No) 9c 10. Ceiling type and insulation: a. Under attic(Insulation A-value) 10a R- S VI> sq ft b. Single assembly(Insulation R-value) 10b_ R , ft. 11. Cooling system' (Types:central,room unit,package terminal A.C.,gas.existing.none) 11. Type: C e4rtt\ _ 12. Heating SEER/EER: Ill g system•: (types:heat pump,else.strip,natural gas,LP.gas, 12. Type: AI tr - N Q gas h.p.,room or PTAC,existing,none) HSPF/COP/AFUE: 13. Air Distribution System': a. Backflow damper or single package systems' (Yes/No) 13a. b. Ducts on marriage walls adequately sealed'(Yes/No) 13b. 14. Hot ender system: 14. 'Type: I-L Fr ir (Types:elec.,natural gas,other.existing,none) SF: n1 /4 'Pertains to manufactured hones with site installed components. , I hereby certify the(the plena and apedNcations covered by the calculation ere In Reim of plane end apedlca)pre centred byftk r+dcUbe mntplien a eith•,_-!-bride Energy Code. - Met the amide Energy k Ors Ottitilp eti be veer war my: • I f (M` all y In -- -S. I hereby certify [ .is in_• .Mal with the Florida Ensr4 - eutz"G aniciaL Owens harm ,'IP �_ ., tL -1- 11/24/99 WED 09:15 FAX 3849839 FL CHRI TW [ 003 TO 93E148313 P.02i02 VIIllae l0 WqO . - v TABLE cC.1;PRESCRiPTNE REWIRE:11M FOR SMALL=MOW($X Si R.ad Low),Rfl 0VATXONI TO SalVIG BUILDINGS MO ETEtIRTAUED COIEONEti1S OF i AMEACNRED HOMES, - MINIMUM MBULATiQN • 'mum INSTALLED COMPONENT INSULATOR 'INSTALLED • ' MIME/if EFFCIEIICY EFPCENcT _ /• ' R-7 Caravel NC-apt SEER 10.0 SEER `t/ Concrete rn Frame,2-x 4- R-11 Frame,2'x 6- R-19 -ergs SEER 9.7 SEER Common,Frame R-11 - 1 Room unit or PTAC EER • 8.5' EER = Common,Masonry R-3 �...��� Under Aolo R-30 N�" � ANY H Single Assembly;Enclosed C Heetpurnp-Spk HSPF . 8.8 HSPF . , 2 Frame R-19 -� Metal Pans R 13 -gee HSPF a BA HSPF . _ LIJ Single Assembly;Open R-10 Room unit or PIMP COP . 27' HSPF/ . _ Common,Frame R-11 COP ■ to Slab-on-grade No Minimum nano*or p'OMna AFIJE . .78 AFUE Raised Wood R-19 Fuel Oh AFLE _ 78 APUE 8 Raison Concrete R-7 6 Common,Frame R-11 r- ; Eisceic ResIstence EF • .98 EF = 1.311. In unconditioned space R-6 % Gas; Natural or LP_ EF . .54 EF o In conditioned apace No minimum Fuel Oil EF • .54 EF - .....r TABLE 642: PRESCRIPTIVE REQUIREMENTS FOR GLASS AREAS IN A0011101115 ONLY -ties Tie 5-8,67 Maximum percentage gam to floor arse allowed is selected• .. .en1. •coefficient Mehahtuam%_ ,Installed%%= _ ' GLASS TYPE,OVERHANG,AND S e ING COEFFICIENT REQUIRED FOR GLASS PERCENTAGE ALLOWED UP TO 20% UP TO 30% UP TO 40% UP TO 50% Single Double Single Double Single Double Slndle Double OH-SC , OH-SC _ OH-SC _ OH-SC , OH-SC OH-SC OH-SC OH-SC 1'-1.0 0'-.90 2'-1.0 1'-.90 2"-.90 3--.90 0'-,8B 1--.86 0 .70 NOT 1'-.70 NOT 2"-.70 0%.65 ALLOWED 0'-.50 ALLOWED 1%.50 0"-A0 SHGC or SC may be obtained from the manufacturer. Single dew SC in 1.0,double dear SC=_90.and single first SC=.86. SHGC..875C TABLE 6C-3 I MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REQUIREMENTS :C Exterior Joints&Cracks 606.1 ,To be caulked,_g seeled,weather-stripped or otherwise sealed. Exterior Windows&Doors 806.1 Max.0.3 cfrNaq.ft window area;.5 chNeq.ft,door area. Sole&Top Plates 8081 Sole plates and penetrations Otrough top plates of exterior walls must be sealed. Recessed Lighting 606 Type iC rated with no penetrations(two a tamadves allowed), M uhi-story Houses 805.1 Air barrier on perimeter of floor cavity between floors. Exhaust Fans 606.1 Exhaust fans vented to unconditioned space shall have dampers.except for combustion _devices with integral exhaust ductwork. Combustion 606.1 Combustion space and water heating systems must be provider"with outside combustion air, Heating except for direct vent appliances. Water Heaters 6121 Comply with efficiency requirements in Table 6-12. Switch or clearly marked dreuft breaker(electric) or cutoff(gas)must be provided- External or built-in heat trap required. Swimming 612.1 Spars 6 heated pods met Neve covers(except solar heated), Nonaatsrteerdud pools mutt have a wools&Spas -pump timer.Gas ape A pool heaters must have minimum thermal efficiency of 78%. Hot Water Pipes 612.1 insulation is required for hot water circulating systems Oncludinp heat r000very unite). Showier Needs 612.1 Water flow must be restiC ed to no more than 2.5 yalkxtt per minute at BO PSIG. j HVAC Duct 010,1 NI AI etc,Offing',meeker:ea/84U1,rmenc am plenum chum be mechanically attached, --� Consvuenon, seared,insulated and Insatlled in accordance with the criteria of Section 610.1. Ducts in office must be insulation&lnieeNstlon -insulated to a minimum of R-6. Air handlers shall not be installed in Mks unless In mechanical closets, HVAC Controls 807-1 Separate roedlty accessible manual or automatic thermostat for each system. GENERAL OARECRO NS; 1. On Tithe IC-1 halm m 8-0110 of Ow trarlaeon ew+p 1004 t etdr ransoret tre tie elkimcy lee sine agotan suing WNW.NI Reim re addends]imaged tae meet a ewes me Reline+vdres NW,Corp lama and!quotient a w OWN Marl rer]award may WWI No* 2 AlhOMONS Or5.Y.be■nnie Se waive d now pee ho amdbad Pm ear n IV aesgat 1s lobos Toil the sae d al pane arlrdoss,*ION plus done we powder prey.Codas re erea d an non Made o teed Om tel ode e t the pleulai M.Won pee n edmq redrew It hie a wed crumbled byte NNW,aulan.orrw r■°ol weed file glees hoer be abraded rated hml to hotel dada WU squared Om area nit oy go mob*Igor treed IIV ae0aon,&INN u>!ICC d pet the omen Pre**lupel pas p rinstapa wafer Milt yardarm essenitet fats ants*6C.2.ProaaNtires ee Dm M re need pea ISihpb a Oxtla pars)ate ee"Min IOM)POW see a MIN aAktct(SC).Fora Ow OM ryes wte s y.h ai tree Owing=friar*alkwee le aredrkd.ilea wevirws and rb ie iraniaary 0 me moor Ws a 4e rum one to m wtifdeded In lie aedaoi do at Pme e b eergy wilt re aware we dwell!earArim nrqufrmuae m Tine aG2 Al new pee h to eel mew re rmulew wa t rose all dal calms In tar Sea rerentenn cabp■y far Main ite oeenorp(01)&Mee F Inalamte pnpeneloeny?Ian rim Ls deal Ism t a oche Arsty urea,ale e.nemm edge der weeny 3 NPNOVATIOIrS ONLY.Rspllwraar plea met b ow rr tvibwiy reoasree,airy gee hype aril tieing reerdut ref Oe rase ter pits sew ewe are vdee keg a ts0 tear eeeme9 tel doe beat saps toe mg came tale then 8 tee Iran sr mono p,dm sew Wiry aetatee rat dd net neat die viola not IS Derr ihre per E- a. W ONG SYSTEMS.Ca py wren my vim k wed rte'ya Mid. S. Cemriere me lbaeaten hammed m b a4 the er meet 1• LI E pane wrelragn P*ihn rwea tor OsM As ere fir .poween".Tech C3.ere Ards dr imilesae]ere. 7, Red.ief end deb Mr URrrfAprerr esreledkar stemma m papa 1. -2- NOV 2 4 1999 City of Atlantic Beach Building and Zoning iLA. 11117 LAWS RAMCO FORM Fs 713.13 1I Native of Criutturttrrinettt 0 ur'�v rY),n.er ouruc ` Iu Whom it mug content: aye 8 397 The undersigned hereby informs all concerned that improvements will be made to certain real tL cri property, and in accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Dnrcrip►ion of property L d t 6.f ci OMl1 / J,14. . v atf-tv C1'v4. —--k J -Y}O qr14r .t.5 , S R-1-7�if.i:�.... .s_t.4....r1.0Ai A i d 4 1 � < fl L (P �' flLvOLc Z.b o 0 as • General description of improvements. C-'0S/N f'N ( p .Q.1t..+ . a' '41/4 , 1I/11/ DV(-J S 'ikI /� • Owner G�.t:!.,1.1.t Ll: ..110y. Address 1,5-10 5.-4:01.1A/die 1 :.-'f• 13 4.-(f- 't."1 3..z--:2-3 3 } Owner's interest in site of the improvement /R if N 59,3,c-6-- 9,3,c. — e 0- 5.- m Fee Simple Title holder (if other than owner) roll,99, 90794 Name Pa e�:••4�.3<.2t0 '. -fi ed i-Recorded Address 12/01/99 04:07:30 PM NENRY••W OOK CLERK CIRCUIT COURT Contractor Q t'Ar C'1I? DUVAL COUNTY TRUST FUND $ i.00 Address. RECORDING $ 5.00 Surety (if any) Address Amount of bond $ Name of person within the State of Florida designated by owner upon whom notices or other documents may b. served: Name Address , In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (F), Florida Statutes. (Fill in at Owner's option). Name Address THIS SPACE FOR RECORDER'S USE ONLY /�yp1�� '� Sworn to and subscribed before me this 4S---- 1.. d. . (®cJ ? 0f., 19 .,/. G4 óL(ix._, 4„, Notary Public r.:V= Patricia Amonette • =.. +a, %. my row-or-::•OH#E CC553881 EXPIRES• edi. d ugust 27,2000 "'';ps rye:°. HOODED rHRU TROY FAIN INSURANCE,INC. PSR 3a44 12 5 3 6 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH - - - -- PEKMIT - - - - --- LOCATION INFORMATION Permit Number : 12536 address : 156 SEMINOLE ROAD Permit Type:RE-ROOF ATLANTIC BEACH , FLORIDA 32233 "lass of Work :NEW LEGAL DESCRIPTION Cons-tr . Type :WOOD FRAME Block: Lot : Twp: Proposed Use : SINGLE FAMILY Section: 0 Subd: Rnar Dwellings : 0 Subdivision: Est . Value: 0 .00 Improv. Cost : 2 ,000 . 00 Total Fe-s,: 25 . 00 Amount s a. - 0 . 00 ? nn6 ---- APPLICATION FEES 25 . 00 Name ; ), _ LEDDY I T t�IL . 1 P 'OAD ; 'I1 FLORIDA I. Fhor.= `E 9 ---- -0' R L`.'R FORMATI Name: AL •HA� t4•NT-ACTING A. JACKSON--- E . FLORIDA 3 •ire - 8 = Exp: r'-p„„ . 1 ' NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 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 CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR THE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT By: Z : ■ AIJk 1'_i '06 i i i W4+i 1 ATL BC:H CITY HHLL. . i CITY OP ALAMO 11,4ACE ROWING G PERKIT EPPL f TION Owner(s) : l,y. �`C�,44 ec . Address: 56 ...(-;#11 4iile fR / i i phone: •Lot O `, Block or Unit f...„ I subdLvision:, . . Contractor: / 4 21,2 Y Y� A 4/i 1 .. .Y. Addrsss:,Y_Og W:Rea,"e-✓ C i City, State and SipM9C-k lv V�//.� �- Ptlone (o 3 Sl0 YYYYA11rY�+YYYIYYIr�IYI Y. YYYYYYY�YYAfrY.YIr YY r 1 State License t c c , .d 4)q Describe work to be performed: iFi ioo _ _ w Valuation of Proposed Constructions,�,,,,_H Materials to be used: 1 _ .- i signature of owner; /v�= .,..:.!�� �3 . Signature of Contractor; - .AW l7MYOT W - I 4 Liability Insurance supplied +l Workers Compensation Insurance Suppli•i4 „f,= License information CC FILM/PAPER SR)E )S TO EXTEND INTO ORIGI Sal PLEASE USE EXTENSIO Manta N COPY 00****** . FOR OFFICE USE ONLY „e--_ "� 7'z— 19 /, .. `, Date �' td. ' #-64.3 `Fee$---'�'/'°� _, . Permit CITY OF ATLANTIC BEACH Valuation $ f` 0I' 4 FLORIDA House #/ .ate +44-o ie••0, APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach,Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can be verified. h, „Z• Date /�J /, 19-- ..I..-- �� i22e*A""''tirifAddress..PO ,�`i,V44 4 /�I.t Telephone N -4`2•7/4 Owrner __t Architect Address Telephone No. Contractor Builde Address Telephone No. Lot No. '-/4- Z- h/Block No. Sub Division Zone u will building Between ��77 and Sts. tA &$i kk i'Type of construction-/-�d!S t'�?1�r Valuation $- V-CJ For what purpose uilding be used _ s� / u y 9 p.. a t yy�� Dimensions of Building-Z X d- Dimensions of Lot 7) )( 1-.(2-O Size of Footings %•14" T� `"�. Greatest Sill Span in ft. Type Roof �4 2e �' Size of Piers Size of Sills p How will Building be Heated? Will Building be on Solid or Filled Ground?---3a2k 4 / �I '2./ n Size of Ceiling Joists 2. )?I , Distance on Centers / , Greatest Span -- Size of Floor Joists .J�b ,Distance on Centers , Greatest Span °..—. If Size of Rafters 2.-X-4 , Distance on Centers / , Greatest Span This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. 6 t Inspections required. 1. When steel is in place and ready to pour footing. W W 2. When steel is in place and ready to pour columns and/or lintel. z z a a 3. When steel is in place and ready to pour beam. E., ( P Fo 4. When framing is completed. �7 1 r . �7 5. When rough plumbing is completed,and ready to cover up. W M W 6. When septic tank drain field or sewer is laid but before it is covered. A s i a cn 7. Electrical inspection by City of Jacksonville. 8. Final inspection. 3 Note: In case of any rejection,re-inspection MUST be called for after corrections are made. FRONT OF LOT In consideration of permit given for doing -the work as described in the above statement, we hereby agree to perform said work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building regulations of the City of Atlantic Beach. �U �-X /�/VA/O Address 1 K t'$ dd '- Signature of Builder--- ' - Signature of Owner Address . U DEPARTMENT OF BUILDING CITY OF ATLANTIC CH' F PERMIT T O BU'LD THIS PERMIT MOST BE POSTED ON JOB Date 24 is X .0 0 Fee$ 5 C3 O tValuation$ 00 aid to City Treasurer, and is subject above fee has been paid 1.... t not valid of applicable provisions This permit violation bject to revocation This is to certify that S3-111— i - E _ has permission to buil ne resident 1$1 Classificatio S/D t1s • •,4 � li Owned by Bloc Lot • art of this permit FORMS Souse N° CONCRETE BE IN" to approved plans which are p NOTICE—ALL k According AND FOOTINGS ORE POURING. SPECTED VOID SIX MONTHS PERMIT DATE OF ISSUE AFTER debris li rubbish and from th material, laced in -------------------1----------------:k 44—' i from this work must not be cleared up public space and must be contractor --�� led away by either and 'milled y y or owner. J63 •t1UGI�t°s �� �� Official. Building ,� CONTRACTOR PERMIT DATE FOR OFFICE NUMBER USE ONLY PLUMBING ELECTRICAL SEWER I woe WATER --------------- \ sMNa► FOR OFFICE USE ONLY • Date -3-.2 Y 19 ..7 Cr • Permit # Fee y$ s, D L-.� .-- CITY OF ATLANTIC BEACH Valuation $._.-.. 2C.2-..v--7J FLORIDA House #---- 0 Cs-'� �. i LfL._.. 4 APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can be verified. 2 !L /i /1 C Al 19 78 Date '�/ )Nil /0 J i i I{11/4/2 � L Mi L-- Owner - Telephone 4 79'4' Architect Address. Telephone No Contractor Builder Address Telephone No. Lot No. Block No. Sub Division Zone Street Side Between ,-__ and Sts. Valuation $ -3 vo For what purpose will building be used.C.a. //rL-�C-7-1 Type of construction Dimensions of Building Dimensions of Lot Size of Footings Size of Piers Size of Sills Greatest Sill Span in ft. Type Roof How will Building be Heated? Will Building be on Solid or Filled Ground? Size of Ceiling Joists , Distance on Centers , Greatest Span Of Size of Floor Joists ,Distance on Centers , Greatest Span PI Size of Rafters , Distance on Centers , Greatest Span I, This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required. Cp 1. When steel is in place and ready to pour footing. W r / 2. When steel is in place and ready to pour columns and/or lintel. z a .a 3. When steel is in place and ready to pour beam. l\^ F� 4. When framing is completed. 1�'.,..., .7 5. When rough plumbing is completed,and ready to cover up. W W 6. When septic tank drain field or sewer is laid but before it is covered. vi A A A q 7. Electrical inspection by City of Jacksonville. 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for after corrections are made. FRONT OF LOT In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building regulations of the City of Atlantic Beach. Signature of Builder Address Signature of Owner._. '?�'�-- � r�F�'''�� Address /-5-6 —5)--"-.1""°--- --(/ 46-)/ DEPARTMENT OF BUILDING PERMIT NO.. CITY OF ATLANTIC BEACH.FLORIDA i v PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB L�iav 6 19 $6 Date j 5.00 T Fee$ 15.00 (double) 1754 t a 6/n6/1; Valuation$ 76g6 .00CAC 5/x5/8; 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. Joyce Windham 374 IA IThis is to certify that I removal of tree; 1 has permission to build \ ficatio0 n Joyce Windham I I Owned by Block —Sro ILot \ ouseNo. • • I r• • :s. + 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 O Building material, rubbish and debris 4�� —� from this work must not be placed in public space, and must be cleared up and hauled away by either con- tract' or ow ne /`-_ wilding Official. II CONTRACTOR I DATE FOR OFFICE USE ONLY WM \ PLUMBING ELECTRICAL SEWER 1.11111111 \ WATER ?*.,.: CITY OF It " a teie Fear% L ev- - \t 716 OCEAN BOULEVARD P.O.BOX 26 3 ATLANTIC BEACH.FLORIDA 32233 TELEPHONE(904)249-2396 APPLICATION FOR TREE REMOVAL PERMIT DATE 5 - G - 0 () Applicant NAME jib\ICe.. W > >l d h a rr - ADDRESS I 5e-m Mote_ . Owner NAME J oV Le Wind harn ADDRES S l 5(.0 S e-m ( n o /e_ Rd . Location of tree if different from owner' s address : Reason for Removal: Q.a-Qi� 4_ �►A '_• 0 - - - -a�A '. '__/- - Rear Lot Line a) a) Z indicate -'1 -.-1 a a possition of „ tree on ,o ° lot '� b w aI b -r., -.4 X Front Lot Line up Building Official