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175 Seminole Rd (vault) r / 'r— • I W 1 s 1 i i a 1i 1 • c" T I i 1 4 i s ' 01 m 1 4. `emmip FOR OFFICE US Date '7 17` 19 'tD r Permit ..3-__ _.. _._ ...Fee$ I O v CITY OF ATLANTIC BEACH Valuation $ "7 FLORIDA House # 17r1-1-47 Al 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. Sept. 21 19 60 Date Owner HARRY E. QUEEN Address 962 STJOHNS BLUFF #Pephone No. RA5 481+ Architect Address Telephone No. Contractor Builder Address Telephone No Lot No. 629 Block No. Sub Division SALT AIR SEC 1 Zone / / (SALT AIR BLVD Street Side Between and Sts. 5000 00 CB Valuation $ • For what purpose will building be used residence Type of construction Dimensions of Building2 ''8" x)i-8 1 Dimensions of Lot 100x501 Size of Footings 8"x20" g 210 th4ck butt Size of Piers Size of Sills Greatest Sill Span in ft. Type Roof sb.ing es How will Building be Heated? Space heater Will Building be on Solid or Filled Ground? S_011d Size of Ceiling Joists 2x6 , Distance on Centers 16" , Greatest Span 121 " Size of Floor Joists ,Distance on Centers , Greatest Span " Size of Rafters 2x6 , Distance on Centers 16" , Greatest Span 12 " This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required. 1. When steel is in place and ready to pour footing. W W 2. When steel is in place and ready to pour columns and/or lintel. Z Z 3. When steel is in place and ready to pour beam. ''a a 4. When framing is completed. Oa s 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. A A 7. Electrical inspection by City of Jacksonville. 02 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 A e attached plans and specifications, which are a part hereof, and in accordance with the building regulations of the City pf • tlantic Be., ., r? J Signature of Builder i f 0 - -,•--..__ ... Address Signature of Owner I1 'R, E. QUEEN Address 962 STJOHNS BLUFF RD JACKSONVILLE, FLA. ' -f j.1' r CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD j '�` ATLANTIC BEACH, FLORIDA 32233 --- INSPECTION PHONE LINE 247-5826 5,v. Application Number 05-00030097 Date 4/18/05 Property Address 175 SEMINOLE RD Tenant nbr, name REPOUR DRIVEWAY Application description . . RIGHT OF WAY PERMIT Property Zoning TO BE UPDATED Application valuation . . . • 0 Owner Contractor BIRDSONG, GREG OWNER 175 SEMINOLE RD. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 Permit DRIVEWAY PERMIT Additional desc . Plan Check Fee . 00 Permit Fee . . . . 35 . 00 0 Issue Date . . . . Valuation . . • • Fee summary Charged Paid Credited Due 00 . 00 . 00 Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 • PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 44'' /(''P :1\ 0141416,Q514 BUILDING OFFICIAL s==Vp /r1, CITY OF ATLANTIC BEACH ,. g PUBLIC WORKS DEPARTMENT 3 --� 7;_-c,.? 1200 Sandpiper Lane -'4, Atlantic Beach,Florida 32233 w � (904)247-5834 (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # 05' JC7041 Property Address: 1 1 S S Y") ) LJ0LA RI) - Applicant: (C—C1 13 1 )Q D SOM G Project: P LvP ' - OR-1 CT )IQi / 1U•Jr<\11 11( Your application is approved as noted by the Public Works Department. Final application approval must come from the Building Department. ❑ Your permit application has been reviewed by the Public Works Department and the following items need attention: Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions,please call(904) 247-5834. Review b ::•k Carper,P.E., Public Works Director �,, Date 7//4r- ,Signature Contractor Notified Date RECEIV D -� CITY OF ATLANTIC BEACH f ..�?�� CITY OF ATLANTIC BEACH BUILDING 2,7N of \' 7,,,,_ r, _ lr �'I T\� CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WA AND EA;��m '�� 1�T�$ 9fln , / 800 Seminole Road 904-247-5800 �;ti Atlantic Beach, Florida 32233-5445 Fax 904-247-5845 Date 3- 21 _ - BY: , ___.._ PERMIT# c�/�,� ISSUED BY THE CITY Job Address I rP --�C�r►i invi-e. .G� /5°114,3 Permitee: 6_ •i e.t�S -1 Telephone# 904-Z5-F - CS-S---- Permittee Address �j Q j (i t k u k R1- iL .1 c-- nc_i-I 1-- 2Za 3 Requesting Permission to/ Construct: pL2 1._)-€---) -- ewa-:,..,;pJ r ti G.ITy 216,1-I — o+= w '( Location: (Reference to Cross-Street) C-1\2N. 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. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority nP,S1' V°°-61 Yes ( ) No ( ) Date: Bell South Telephone Company 1., .o Yes ( ) No ( ) Date: Ferrell Gas j z�,� L „ Yes ( ) No ( ) Date: Comcast b( SJ "0'4 ' 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 SeFF 3cr?rfs,Sc<-:, (Contractor's Project Superintendent) located at 1-15 .nn,►-,o'L. Qd Telephone#: 9904-237- 5-66� 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 7. This permittee shall commence actual construction in good faith with —7 days. 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 �f Signed: /��_!it —�+ ,"' i�A Date:` b4 ~ 't� : YVONNEM.CALVERLEY L r.: tTa :,- MY COMMISSION#DD 342192 Before me tt �,3`=i'3 Iday of /fte/f Sid the County of Duval, ;a; `:o EXPIRES:July 29,2008 State Of Flo a,has personally appeare ''4?F fA ' Bonded T uNotayP„bl;cundervrfers Notary Public at Large,State of Florida,County of Duval. My commission expires: 1 Li 9 c20° Personally Known: ' or 3'7 / r Produced Identification: f--I_0 6‘3 -63 7-96 - 75---D CITY OF ATLANTIC BEACH PUBLIC UTILITIES DEPARTMENT _,, 1200 Sandpiper Lane f v Atlantic Beach,Florida 32233 (904)247-5834 (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # OS 3q-1 Property Address: 115 5€t ) / N O L2 /20 , Applicant: QF--C - ICJ' t '-D SON Gr Project: �l�l�L� cO1�1�.ti' k)Pc1-1 Dl4 rAl \i Your application is approved as noted by the Public Works Department. Final application approval must come from the Building Department. Your permit application has been reviewed by the Public Utilities Department and the following items need attention: S-o /v —' o% Ta no� �/,cil/�, i17/0j ��1inoo / !-/1, eyic Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions, please call (904) 247-5834. Reviewed y Donna Kaln7niak, Public Utilities Director Date Signature ./n Contractor Notified Date /► / 1 L1//5-/ RECEIVED CITY OF ATLANTIC 05ACH BUILDING &ZONNC rf.- y\\ CITY OF ATLANTIC -.' CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WA AND EAWpfiErITX 9ns 800 Seminole Road 904-247-5800 o,t�� Atlantic Beach, Florida 32233-5445 Fax 904-247-5845 B� I 5-Date � 21 - C PERMIT# ISSUED BY THE CITY Job Address (r ,-�C%n-0r101-e.. (t -,t,. 1501,-1.4.3 Permitee: 6_,-' ___ ie_t• S - 'l Telephone# e4-Z- -cc5,� • Permittee Address -- g j (,q,j i t 1_P- T 1-� c- �c.tf re___ 3,,_3 3 Requesting Permission to Construct: pL2 1--)...---) lHemv�k-,-= J‘ 1 n C TY 2,4Hi-0 WA-'-( Location: (Reference to Cross-Street) 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. A Letter of Notification was mailed to the following Utilities/Municipalities: 11°1'1 a(� Jacksonville Electric Authority n S(r� Yes ( ) No ( ) Date: Bell South Telephone Company L€' c-(S Yes ( ) No ( ) Date: Ferrell Gas �,,� L` „ Yes ( ) No ( ) Date: Comcast b( �� -#4 ' Yes ( ) No ( ) Date: • 4 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 Se FP ve. i3C�-, (Contractor's Project Superintendent) located at 1--i'5 Qd Telephone#: 94-237- S46 -- 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 7. This permittee shall commence actual construction in good faith with 7 days. 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. OW ER / Q / c /�7. !I7 _l I�)fr!1!�e\:—t �, I y-)!�t ti tip•' YVONNE M.CALVERLEY Signed: Date:V LL ' lv t =+, ' .3 MY COMMISSION#DD 342192 Before me this '07,3-.444- day of ,�eit � the County of Duval, �•..��`:; EXPIRES:July 29,2008 State Of Florida,has personally appeare : '�?or';tfi�' Bonded TFwu Notary PubicundenvOlers It, Notary Public at Large,State of Florida,County of Duval. . _ .^, My commission expires: lt 9 07OO`5 Personally Known: ' or G/1;7�/)Z,e / - Produced Identification: r=L 11 /i 3- -63/-96 - 725--. 8 0 0 A 1 o oEl CD 0) Q g g) .g..) - 3 0 . 1 cp o 1// CD_ el \ \\ C1)*m ZIT < 00 0 --I m o a, I ° 02 g o (c) 3 l T 70 5. c 5 3 CO n: cn Q. n73 CD a 8.00" / 3000 psi Concrete o °NI,/ — (2)#3 Rebar —.�- 7-41-- 12.00" • Turn Down Slab Detail 175 Seminole Road Birdsong Residence Scale 1" = 1' P. 01 MAP SHOWING BOUNDARY SURVEY OF LOT 629, SECTION NO I, SALTAIR. AS RECORDED IN PLAT 800K 10. PAGE 8. OF THE CURRENT PUBLIC RECORDS (7F DUVAL COUNTY, FLORIDA CERTIFIED TO: GREGORY I3IRDSON & 5COT 7 BIRDSONG WATSON MORTGAGE COMPANY STEWART TITLE GUA ANIY C MPANY RICHARD T. MO HEAIJ, A. SEMINOLE ROAD (70 0' RICNT Or WA`;) 50,00' t(PI A N 44'53'17" E 50.01' (MEA.SU ED) - -.-•�_ CCNNER Cr INTERS�C1:)N r0uN0 l/3' 17CN PIP(. -. 4 • 's I 0 C'N/� L K FuuNO 1/T IRON OWE rouNG 1/2"RE64H NO 10CNNFIC/ (2N ,.r•. -'suuvt -DUROCN 1049• STAUDCO 'A:1.1 40 uo2- 7137.-- / Oy/GIB' --. ..+�.1j 200.00' (1.4AT) — • N 41'4952• C x „/// . • .• _ I 199.72'(MCASUREO) F- t. f/ r^". LLJ is i Li 74 ns V 7 ••••-•,. . cp'(EREJ ENVY E DJ 7.5' sa.o' 7.e' q C Lii CC CC CI a ONE 5TORY MASONRY & FRAME Y �o.a' W �' POSTED H 175 ry .. _; LOT 630 � _, t. �_. D,e'v�J LOT 628 71r 8 . SQ, co R 0•Q� ' R .d. -X---X s - 0 o.Y' 7.7� 2'.6' ,— . 0 VI AIR © tiP} >, OONyI1ONER �t PAD z Vf )I LOT 629 I 1.2.- -D.2' --X X- H y x .H 1,011/41 I/2' IRON NICE rovN3 1/2"mom PIPE G. 1.2' NO IDENUFIOARON iO iooTIFICATIOli S 44`50'19° W ). LOT 844 I 5b.18' (MEASURED) LOT 842 50'00 (PLAT) LOT 643 NofRS: _;_ACCECTEO RY: -----•_^^.._ .— ..—....-. LEGEND: R RAGIIJS —x--- . rE1NCE .--. L - .ENC'[L1 CONCRETE *.—�'--- '---- -.---. -- --.. NOTES: i_ REVISIONS _.._' r. BfASW GS ARE eases ON THE A5ZVL�EO LSQARIN0 OF — S 49'OO'oo" a ALONG THE CITY OF ATLANTIC BEACH Cc: r s� BUILDING / ZONING DEPARTMENT D. Ford 800 Seminole Road . Doerr J+ k Atlantic Beach,Florida 32233 -' Jl;l, (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # 05- 3cX 9- Property Address: 1-1 5 S E Yr1 I +0 t10- Applicant: Si f2O S �T Project: ,z�L-'fC C (0)71 Ci I 1`-) D t19-N1 This permit application has been: Approved 0 Reviewed and the following items need attention: Please re-submit you applicatio hen these items have been completed. Reviewed By: Date: e Date Contractor Notified: RECEIVED CITY OF ATLANTIC BEACH .i,-,;vim Bll!! nIN^ &ZONING r CITY OF ATLANTIC BEACH , -,, `) CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASE.ME•1 ?006 v _. 800 Seminole Road 904-247-5800 ;�� Atlantic Beach, Florida 32233-5445 Fax 904-247-5845 Date 3- 21 - (-‘4, BY:—V PERMIT# ._. ., ISSUED BY THE CITY Job Address I ( /L 1I1GIL ‘„ %50114.3 _ Permitee: � � -1e_t�Sn►-- -1 Telephone# 9e4-Z3 - 05--� Permittee Address 7E51 (A. A.u_k 2e1 Akt�- "c- .ctf rt.- 3Z0._33 Requesting Permission to Construct: - . '`x` —i~-7 .Le' \4 %J) .J f r..� G r 2161H i-o 1_ (A. A l Location: (Reference to Cross-Street) ,7"-N.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. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority ((11 3-( v Yes ( ) No ( ) Date: Bell South Telephone Company ( e or5 Yes ( ) No ( ) Date: Ferrell Gas j 4?,� Yes ( ) No ( ) Date: Comcast dt � 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 Serr f3cerf ►�cti (Contractor's Project Superintendent) located at 1-t 5 - tN�� 2k Telephone* jM)-237- 5-4.c5- 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 7. This permittee shall commence actual construction in good faith with '' days. 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 ••1tr' YVONNE M.CALVERLEY Signed: (;�t-�it �a1 Date:��a- d MY COMMISSION#DD 342192 Before met is 3 day of �t/t O� the ounty of Duval, H:.�`:; EXPIRES:July 29,2008 State Of Florida,has personally appeare ,R.1W Bonded TiwNolery Public Undenmte's 1 4 Notary Public at Large,State of Florida,County of Duval. ._,1 My commission expires: 7117-41L, I c OU`S Personally Known: or G 121/JLQ / Produced Identification: j=L 0 .84 3.-R -L 3 7"9 6 -725--D 02 co 2 - �T) O O T (p . X, gM o N �- i2 : 02 N Q 8 - 3 fD 0 7 J___ Sy m ` : qqtui //' ;) Eil*Cati : M [ , ..; Jfigral • 6 i % jr z. a i: s 1 [A °a ,g Og ti.1 § g) El. 3' W dH!i$ s s _ ��O. (D {{pp O "enm$ th (p N $3� c c � v (Gl a se'�igii R m O p 8 a 8.00" 3000 psi Concrete 0 • (2)#3 Rebar —NI— 12.00" Turn Down Slab Detail 175 Seminole Road Birdsong Residence Scale 1" = 1' P.0 1 MAP SHOWING BOUNDARY SURVEY OF LOT 62g. SECTION NO 1. SAL FAIR, AS RECORDED IN PLAT 800IC 10. PAGE B. OF THE CURRENT PUBLIC RECORDS OF PUVAL COUNTY. FLORIDA CERTIFIED TO: GREGORY BIRDSON & SCOTT BIRDSONG WATSON MORTGAGE COMPANY STEWART TITLE GUA ANIY C UPANY RICHARD T. MO HEAL, A. SEMINOLE ROAD filit (70.0' RICNT OF WAY) 50,00' t(H A N 44'53`17" E 50.016 (MEASU ED) n T____ CORNER CF INTERJf�TI l MN() l/2' ICON PIPE. : • 'S i 0 E w: L K ,• fuuNO 1/T IRON PIPE rOUNO ■/2-REBAR NO 10E14111%4„,10_' i •, . PEQ D_URDEN 1046 MIMEO 'A:u L.B 8701"• 0.B'� 0.0'-x 200.00" (NEAT) . 9'0Z"E • 19972'(MEASURED) I- LJ , ;, -t1 r ' 'o, It.a 4 Y � t�, El 7.5' ss.o' 7.E' W 5i iY c f� ONE STORY o.e' L� 1–• < MASONRY & FRAME 'f, 4 W POSTED # 175 2 a –x � x- LOT 630 r; _. D,s' LOT 628 °' ado 8 0 C) CO — QX 13Y+.b' ` ' Oti. AIR © 00N0+1'10NER PAD LOT 629 I 1 _. • 0 —0—"0 9. r of LDE; WON ROPE C rout.* I/2 IRON P■PE 03 1.2- NO IDEtiliFiCATiON S 44'50'19" W LOT 644 11 50.18' (MEASURED) k LOT 542 50.00' (PLAT) LOT 643 """`""�- ACCEPTED BY: LEGEND: R = AADIOS —0--- is FENCE I — CENG'M m CONCRETE -- --- —^'--'--—•._._._._ �oTEs: " REVISIONS ASSt/MED s 45'00'00" a A(,OiJC THE - F. 6EAR�,5 ARE RASCE) ON THE GEARING OF ---- P.01_...i i ••• ....---.-- MAP SNOWING BOUNDARY SURVEY OF LOT 629. SECTION NO. I, SALTAIR. AS RECORDFD IN PLAT GOOK IC, I'A.GE S. OF THE CURRENT PUBLIC RECOPEIS Of DUVAL COLNIT, FLORIDA, CERTIFIED TO: CREGOR B;RDSON d( SGOTT BIRDSONG' WATSON MORTGAGE COMPANY STEWART TITLE CUA ANTY C PANY RICHARD T. MO HEAD. .A. SEMINOLE ROAD (70.0' RIGNr or*my) 50.00' 1(PLA N 44'53'171' E 50.01' (MEASU ED) eD16ER�A III r +�.y.--�..-. KRfCCTION FOua.•i/2'NEN ni. -,•j. 5 1 0[�'A E. .. —^•ionvC!Jl" RCN PPE !RIND 1/0. ROAN N8 oEN rrN;4•.0N •;,a ,.• _ TA 'ED PLACER 104r SWAPO'ACAI LO 6/01' 4.6• • 1'8 `.+'.'-. . Oo' O.i 200.00' (PLAT} • N 44Y41T"E II �(/, IOR.T2'(NCASURCO) I • Ce �- CCY[CJ�O EHIRY.,,,,�_.. C1 1•El zs' 1a.o z6' 3 9 d (21 ONE STORY { At w MASONRY di FRAME 1 I`'e Al m POSTED 11 175 1s l LOT E30▪ v _k , as'v LOT 528 9 �+ _ 8 o, to 8 =717. w ... Ok co 2 I W [ o• e' Rp ¢ - CO:�Dih (11 + PAD z I v.) 1 LOT 629 I wi l.or MAW T IRUN PIPE O'1 ="--�Y--...'rte ), Y..+T l' 'O�h•[faN .A NO IVf./10[1'00N I.7 NO lhfflTifCA7P/ S '44 50'19° W LOT 844 1 50.18° (MEASURED) LOT 642 50.00' (PLAT) LOT 643 LEGEND: —,--- R •- 113.EYU1 -•-K— - ma 1 = .EjcT:a - CONCRE'E --. .-r—.-.---'-.'-'.-.—....-_.._- ;40 7EC: RCVI SI ON S 1 REAi4M%ARE BASSO ON THE ASSWED 5EAR.NG or S 45'0000'C ALONG THE — NORTHEASTERLY 10VHOAR•f LINE Of 5(JB:ECT PARCEL 0■1E DESCRIPTION -. 2 6Y sRAPI•RD el0'11N0(7N(.Y THE CAPT10NCD LANDS LIE W11NIk"WOO CCNC 1( AS SNOWH ON THE NATfIN-L RCCO INSURANCE MAP PA.1E0 APIL 17. 1969.CCA4MUNMTY NUM9Ehl3'LEl.1'71NEL 0001 0 1 '.NS SURVEY REFLECTS ALL EASEMENTS & RIGHTS OF WAY AS PER RECOROEC PLAT Y/GR 111L C01.41.1ITV.EI•7 6F SUPPUED.1.34LES5 OTHERW.SE STATED,NO 071!ER 11TLE vERIFICAT.OH HAS BEEN PERF0RIUE0 BY THE UNDERSIGNED :oLS SURVEY NOT VALID WITHOUT THE ORIONCL SIMNATURE AM Ell O0SE0 SEAL OF THE CERTIFYIHI SURVEYOR - "AR B 7.352P DATE nF FIFI D 5URvr r_ 03-03-04 DATE OF ISSUE. 03-01-04 l ?“1,4.1f: 1" _ 2.n CERTIrICATE lS_"I'a ' 2522 Oak 61roat ;HEoE[Ir:try,TWAT THIS SURVE• 1;A!MME UNAER a:NESPOA.SIBI...CRAW* moillAt .ACkeanvlll[,Plorl'ja 32704 MD MEETS THE VRI.NUM'E':"NC.l 5'•NOARDS AS TIT RCRIO ST RST FLORIUA -war (F,'nel 004-70.59-5363 00430 CT PROIfR710T.c1 dbR+ETOR6 1':10 MMTEAS m GAPTdn 61017 d.7•ORbx _y, AONres130wf CaO�S�S...IC suANi To OTT a.)Or ITOPIA TTII..Ifi MrjjgjnAlaIIIIIIIIIII<,L?:. (Fax) 901'-]99-61]9 l k•_ C. CHARLES M. MC 1120514 __- RED TPEO SURVEYOR MIT I.IAPPER i 3502 STAVE OM 001110C •- _ICENSED BUSINESS ,4 6703 • LAND SURVEYS 0 CONSTRUCT1ON SURVEYS 0 SUBDIVISIONS —M, � 1.5-� :.1 � r '1 til;V: 21;'05 03:22 PM 6. -Z To: THE GREGORY GROUP Attn: GREG BIRDSONG Voice; 904-246-6631 Fax: 904-246-6641 Re: Locating facilities in the area of your excavation This is an important. Safety Message from TECO Energy. We are replying to your request to locate our underground facilities in an area where you are planning excavation work. The following is the current status of our facility marking in the area specified in your notification. Ticket number 08054535 is: Clear of Peoples Gas Facilities. If you have any questions about this, call Peoples Gas at 1-877-832-6747. County: DUVAL Place : ATLANTIC BEACH Street: 175 SEMINOLE RD Thank you for notifying Sunshine State One-call of your plans to excavate. Please wait 48 hours before digging, which will allow our locating technicians time to mark our facilities before you arrive on the jobsite. Please respect the temporary marking devices. If markings are no longer visible, or you have questions about the markings, please stop excavating and notify TECO - Peoples Gas at 877-832-6747 . Please dig safely. We ask that you hand excavate through the tolerance zone, which is 24"either side of the temporary pipelines. marking device, to find the exact location of marked 03/ 2005 05:23 PM Ticket status Report trim. ben rat i.uu To : THE GREGORY GROUP 1015 ATLANTIC BLVD u298 ATLANTIC BEACH, FL 32233 RE : Locating. Facilities in the Area of Your Excavation This is an Important Safety Message from Central Locating Services , Ltd . We perform Underground Facility Protection for Various Utility Companies listed below. We are replying to your request to locate Underground Facilities in an area where you are planning excavation work . The following is the current status of our facility marking in the area Specified in your Notification or Notifications . Ticket Number Ticket Information 08054535 : 1?5 SEMINOLE RD County/St : DUVAL , FL Utility: BELLSOUTH / Telephone Status : Marked . 08054535 : 175 SEMINOLE RD County/St : DUVAL , FL Utility : COMCAST CABLE / CATV Status : Marked . If you have any questions or concerns about these responses or status once you reach your Excavation Site , please contact our local dispatch offices at : 352-343-8770 • 'ri�L'I r 1 ,i)' /= ° , CITY OF ATLANTIC BEACH .; " A 'J 800 SEMINOLE ROAD —�' ATLANTIC BEACH, FLORIDA 32233 .3 R-- n,_ INSPECTION PHONE LINE 247-5826 Application Number 04-00028060 Date 4/16/04 1 Property Address 175 SEMINOLE RD Tenant nbr, name INTERIOR REMODEL Application description . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning TO BE UPDATED Application valuation . . . 2500 Owner Contractor BIRDSONG, GREG OWNER 175 SEMINOLE RD. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 Permit ELECTRICAL PERMIT Additional desc . Sub Contractor . 5 STAR ELECTRIC, INC Permit Fee . . . 70 . 00 Plan Check Fee . . . 00 Issue Date . . . Valuation . . . . 0 Special Notes and Comments 150AMP, 1PH, 3W, 240VOLT, SEUCABL RACEWAY Fee summary Charged Paid Credited Due Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 1 I/ 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. C • leAk BUILDING OFFICIAL 1rirormat1on systems 247-5845 p, 1 . Ir CITY OF ATLANTIC BEACH, FLORIDA 4 p 2g0Le0 \ ELECTRICAL PERMIT APPLICATION \1uaas)% TO THE CHIEF ELECTRICAL INSPECTOR: DATE: L.\L 1(D 2064 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. ELECTRICAL CONTRACTOR: 5 I 1..,c7CK1( _ 11.E , MASTER ELECTRICIANS SIGNATUR . OWNER OF PROPERTY: CG l G ' \RU.Sc:3f IOB ADDRESS: \'1 S �C M\Nc;t., . RES. APT.( ) COMM.( ) PUBLIC( ) INDUS.( ) NEW( ) OLD( ) REW.( ) ADDITION( ) TRAILER( ) TEMP.( ) SIGNS( ) SQ.FT. SERVICE: NEW( ) INCREASE( ) REPAIR( ) CONDUCTOR SIZE AMPS: COPPER( ) ALUM.( ) FEES i SWITCH OR BREAKER AMPS PH W VOLT RACEWAY _ c /o SEV c-ABeL EXIST. SERV. SIZE 150 AMPS i PH 3 W VOLT RACEWAY FEEDERS NO. \ SIZE 30A NO. SIZE 1 NO. _ SIZE _ LIGHTING OUTLETS 25. CONCEALED OPEN TOTAL RECEPTACLES CONCEALED ,6p , OPEN I TOTAL 7 I 0.30AMPS _ 31.100 AMPS SWITCHES INCANDESCENT FLOURESCENT&M.V. FIXED ' 0.MMOAMPS. 1 ovER APPLIANCES .3 j BELL TRANSF. AIR H.P.RATING ' H.P.RATING CELL. KW-HEAT CONDITIONING COMP.MOTOR OTHER MOTORS AMPS HEAT 0-i ' OVER MOTORS H.P. VOLTAGE PHS NO. I H.P. VOLTAGE PHS MISCELLANEOUS - . UNDER 600V OVER 600V TRANSFORMERS: NO. KVA _ NO. KVA NO.NEON TRANSF. NO VA MA MOTOR SIZE SWITCH FLASHERS EACH SIGN 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Phone:(904)247-5800• Fax: (904)247-5845. http://www.ci.atlantic-beach.fl.us Reviled m/17/01 ' _ u ,-i 1-j\I-P.Piel f� • c� CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD j ATLANTIC BEACH, FLORIDA 32233 ::7-'77';--,--_,-: INSPECTION PHONE LINE 247-5826 i SIl>� Application Number 04-00028060 Date 4/08/04 Property Address 175 SEMINOLE RD Tenant nbr, name INTERIOR REMODEL Application description . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning TO BE UPDATED Application valuation . . . 2500 Owner Contractor BIRDSONG, GREG OWNER 175 SEMINOLE RD. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 Permit W/W/O BUILDING PERMIT Additional desc . Permit Fee . . . 90 . 00 Plan Check Fee . . 45 . 00 Issue Date . . . Valuation . . . . 2500 Fee summary Charged Paid Credited Due Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total 45 . 00 45 . 00 . 00 . 00 Grand Total 135 . 00 135 . 00 . 00 . 00 4 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. l‘c..), 410‘... ( ' w4k, BUILDING OFFICIAL , Cc. O''''''':-- CITY OF ATLANTIC BEACH a ord , r , BUILDING / ZONING DEPARTMENT i s. Doerr A \ 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 ,i319y. (904)247-5845 Fax PLAN REVIEW IEW COMMENTS Permit Application # O'-+ A 0 Property Address: 11 5 S C I { O Le. Rd , Applicant: (�✓C9 Di'/ Ct S .orY Project: 1 r-I dY Fe 11 e This permit application has been: Er Approved 0 Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: 14 Date: Li(4 Ie L( , 1'.4.0* RECEIVED e 4,4?-,--° CITY OF ATLANTIC BEACH _ A BUILDING 8 ZONING CITY OF ATLA TIC BEACH APR 0 6 2004 I I,' BUILDING PERMIT APPLICATI 1 N (FOR INTERIOR REMODEL) BY: Pr Date: ff."J Job Address: i 75 SEmi t4 al.-. el ArLAA)ric.. tE€Gai FL 32253 Owner of Property: GPrc,e•Poe-j A5.07T" �etce.... `� 3�`I �1�6o..,C_ Address: 7$l CAI&tu-A- a 4iZ.A.?r►t. 'ems, FL Telephone: 90+ Z57 G` Legal Description: Block Number: Lot Number: Zoning District: Contractor: State License Number: Contractor's Address: Abty(E• Telephone: t Fax: Describe proposed use and work to be done: 1.1k Kr rcki dA&Itieii, T .L.. }-T-�; -"—i Vf 1pt eict tem 8$r Li eeorv- t ester .)&,..t 1 Fs, ea7pLAce. Doffs + t cc l ea 7 Present use of land or building(s): S,..stc F4.v4 11...V EAES.i DGIJCt Valuation of proposed construction: ����0 - e o New electrical or increase in service? P Add plumbing fixtures? Y ES Add fireplace? N1C) Add heating/air conditioning? N10 Is approval of Homeowner's Association or other private entity required? 1.10If yes, please submit with this application. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. Please submit Building Permit Application,Energy Code Forms,Notice of Commencement,Owner/Contractor Affidavit if owner is contractor, and two(2) complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. I hereby certify that all information pr. 'ded with this application is correct. Signature of Property Owner: _/.. i!,�a C_•.. Date: 3 / / 7/ I hereby certify that I have read : d examined this application and • e same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with,whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Page 1 Revised 1/15/03 v of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the governing o cons p P Pe�3' above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: r f tN�=' Date: Address and contact information of person to receive all correspondence regarding this application (please print). Name: c C� l�t 2 n` r. (1-1 Mailing Address: .:► C ikv �� l Telephone: ‘k.uJ 7- 7 7— 1 ,(,`.35 Fax: 914-/ '7;4—6P6 i' E-Mail: .1701e-45 ,J AS TO OWNER: Sworn to and subscribed before me this 1 ( day of 4714e-ell ,200?.(. State of Florida,County of Duval CA/ /"a( ' "14a.T.Signature: iMPY t DANA D.WEHBY f;:(,•u .*. MY COMMISSION#CC 937245 4;1._ 4= 4'ersonally known � EXPIRES:July 18,2004 prft�'. Bonded Thru Notary Public Underwriters ❑ Produced identification Type of identification produced AS TO CONTRACTOR: � ��/� Sworn to and subscribed before me this I c 1 day of " ,20 eq. State of Florida,County of Duval Notary's Signature: _ L��1 ".1,1 ❑ Personally known ❑ Produced identification Type of identification produced I ,r,Y.,,,5•, DANA D.WEHBY MY COMMISSION#CC 937245 YI'4'_�,4 EXPIRES:July 18,2004 '.: ;, .I ;,yF s..`;.� bonded Thru Notary Public Underwribr• 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Page 2 Revised 1/15/03 r` , CITY OF ATLANTIC BEACH J V ".,aril>, OWNER/BUILDER AFFIDAVIT Date: 3f i8/oe--1 Job Address: 175 M,..16L,_� -ci ATLAw1TI. ZEAA_“ FL nzzas CHAPTER 489,FLORIDA STATUTES,PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(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. 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. 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 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 TO CLEARLY PROTECT THE OWNER. 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. 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. 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. ■_, .Ili.-AII■ P'OP6. OWNER/BUILDER ikii SWORN TO AND SUBSCRIBED BEFORE ME THIS LI, DAY OF u. C 2064/- . /�.J / ,Fn+r DANA D.WEHBY ` MY C^MMISSION#CC 937245 =.a.. EXPIRES:July 18,2004 N i TARY PUBLIC 1 -•','e of pry°: Bonded Thru Notary Public Undarwrkui - MY COMMISSION EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. FLORIDA Florida Department of Revenue DR 501 \ / Original Application for Ad Valorem Tax Exemption ! R. 12/02 DEPARTMENT _`' OF REVENUE �.L /%/,✓//%} County, Florida Tax year �� C New v Change . Additional Property identification number: % , / -r.yY'✓ Applicant/Co-applicant Name and-Address: 9 Permanent Florida residency required �./ as of January 1 ,/ j;, ,; ";� / ter,, J /7-, $25,000 Homestead exemption*(see additional information) If •/ $500 Widow's exemption 111$500 Widower's exemption ' ' ❑ $500 Disability exemption ❑ Legal Description: / $500 Blind persons exemption ❑ -r' /_ ;7 -7 . - ,/ ;4.Y7 // / $5000 Disabled Veteran ❑ /1/7174 /2/;i/ , ,4� ey Total and permanent disability exemption—Quadriplegics /' Y` (Documentation required) ❑ Service connected total and permanent disability exemption (Documentation required) ❑ Exemption for disabled veterans confined to wheelchairs r. (Documentation required) ❑ Applicant Social Security No.: •; �/_ �/;'-��79�� Total and permanent disability exemption Co-Applicant Social Security No.: (Documentation required) ❑ / * If you wish to apply for an additional homestead exemption (NOTE: Disclosure of your social security number is mandatory. It is required by enacted by local ordinance for persons age 65 and older section 196.011 (1),Florida Statutes. The social security number will be used to verify you must file form DR-501 SC. However,you must either taxpayer identity information,homestead exemption information submitted to property receive,or apply for,the regular homestead to get the 65 appraisers,and intangible tax information submitted to the Department of Revenue. and older additional homestead exemption. If you have Marital status: 7 Single ❑ Married already received regular homestead exemption,you do not ❑ Widow 7 Divorced ❑ Widower need to file another form DR-501. Did you file tax exemptions last year?)/Yes ❑ No Ownership information •I1f no, your last year's address r Percent of ownership /NG Type of deed s�� �/. /./. •`, , Recorded: Book //A9/ Page ,' Date recorded y�// Date of deed ;- j�� Proof of residence for all owners Owner Spouse Other owner Give address of each owner not residing on property Date you last became a permanent resident of Florida Date of occupancy l.:r j'o. Florida driver license number / / (Date) '., (Date) (Date) 3 i !'!/1 'I7. %fi t �,: i ' ` '1 – ' ,'-//-.-/'-..-, Z/`/ ,7i%ij�, - _, Florida vehicle tag number / J ,/ i"'J Florida voter registration number (D'ate) (Date) (Date) (if U.S. citizen) Immigration number (Date) (Date) (Date) (Alien Card—if not a U.S. citizen) Declaration of domicile Res. date Res.date Res.date Date of birth Current employer \ Address listed on your last IRS return I hereby authorize this agency to obtain information necessary to determine my eligibility for the exemption(s) applied for. NOTE: If all information / is not received by March 1st,your application will be processed for whatever exemptions you qualify for on that date. I hereby make application for the exemptions indicated and affirm that I do qualify for same under Florida Statutes. I am a permanent resident of the State of Florida and I own and occupy the property described above. I understand that section 196.131(2), Florida Statutes, provides that any person who knowingly and willfully gives false information for the purpose of claiming homestead exemption is guilty of a misdemeanor of the first degree, punishable by a term of imprisonment not exceeding 1 year or a fine not exceeding$5,000 or both. Further,under penalties of perjury, I declare that I have read the foregoing application and the facts in it are true. i l 1',!•4 hjf^7It mac/ '%I � �• �%j S`, �g�'tatu 6 of applican / Signature of co-applicant ,big ffe-of deputy Date/ ./ / Phone number Entered by ,r1 r S y1P,67c1 d '00,-0,- CITY OF ATLANTIC BEACH Sl .. A t., 800 SEMINOLE ROAD J ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number 04-00028064 Date 4/08/04 Property Address 175 SEMINOLE RD Tenant nbr, name REPL WINDOWS/DOOR Application description . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning TO BE UPDATED Application valuation . . . 1500 Owner Contractor BIRDSONG, GREG OWNER 175 SEMINOLE RD. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 Permit BUILDING PERMIT Additional desc . Permit Fee . . . 40 . 00 Plan Check Fee . . 20 . 00 Issue Date . . . Valuation . . . . 1500 Fee summary Charged Paid Credited Due Permit Fee Total 40 . 00 40 . 00 . 00 . 00 Plan Check Total 20 . 00 20 . 00 . 00 . 00 Grand Total 60 . 00 60 . 00 . 00 . 00 w 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. BUILDIN FFICIAL ' ial bi O • V p n. a. O -cc'85 U 0 Nr mom. O 'CO 1 1 i 1 d0' _pp N M CD Cl) �8-� M O O O CU O Cr)j N j`O ' w w c L ` o aa) cy u_ ILL c 1 O co O co 8 C "0 7:3 Ch A7 8_cc k h ,r c yV rC 0 3 1 1 - 0 ° 1 1 m � rca-11-G✓J�1,4 111 nul IC rmul)i_. .I.D f1 f ,JOG f✓_G r Series 740/3740 Single Hung - 1/2" Flange Frame THIS FENESTRATION PRODUCT COMPLIES WITH THE NEW FLORIDA BUILDING CODE FOR RESIDENTIAL BUILDINGS WITH A MEAN ROOF HEIGHT OF 30 FT. OR LESS, EXPOSURE"B" (WHICH IS INLAND OF A LINE THAT IS 1500 FT. FROM THE COAST), AND WALL ZONE"5" (INSTALLED NEAR THE CORNER OF THE BUILDING). PER ASTME1300, THE CORRECT GLASS THICKNESS, BASED ON THE NEGATIVE DESIGN PRESSURE(DP) LISTED BELOW, HAS BEEN INSTALLED IN THIS UNIT. THE GLASS THICKNESS IS BASED ON ITS' WIDTH, HEIGHT, AND ASPECT RATIO. WIND ZONE: 140 MPH DESIGN PRESSURE (DP): $ 45.0 / - 47.2 THIS PRODUCT MEETS THE REQUIREMENTS FOR STRUCTURAL LOADS,WATER AND AIR INFILTRATION PER ATTACHED AAMA PERFORMANCE LABEL. BE ADVISED THAT IF LOADS ARE PLACED UP TO OR EXCEEDING THE TESTED LEVELS, THIS PRODUCT MAY BE ALTERED IN SUCH A WAY THAT FUTURE PERFORMANCE WILL BE REDUCED. COMPLIANCE MUST INCLUDE INSTALLATION ACCORDING TO MANUFACTURER'S INSTRUCTIONS AND FLORIDA CODE REQUIREMENTS. • BetterBilt, Division of M.I. Home Products Item master number: 600005991000 Rev. 3/19/03 I I -4 FEL-11-2004 12:07 MI HOME PRODUCTS 717 362 7025 P.06 TABLE 1606.28 TABLE 1606.28 6 COMPONENT AND CLADDING WIND LOADS FOR A BUILDING WITH A MEAN ROOF HEIGHT OF161Fa LOCATED IN EXPO !(Psi) Effectivel wind l Basic Wind Speed V(mph•3 second gust) area Zone3 (ft2) 85 90 100 110 I 130 I 140 150 Roof Angie>0-10 degrees I i 1 . 0,5 2' 10.5 -25.9 12.4 •30.4 14,3 •35.3 16.5 a 1 10.0 10.0 -13.0 10.0 •14.6 1C:0 -18.0 10.0 -21.8 1 20.0 10.0 -12.7 • 10.0 -14.2 10.0 -17.5 10.0 .21.2 10.0 1 -25.2 11.6 -29.6 13.4 -34.4 15.4 .39.4 1 50.0 10.0 -12.2 10.0 -13.7 10.0 •16.9 10.0 -20.5 10.0 I -24.4 10.6 -28.6 12.3 -33.2 14.1 -38.1 1 100.0 10.0 •11.9 10.0 -13.3 10.0 •16.5 10.0 -19.9 10.0 -23.7 10.0 -27.8 11.4 -32.3 13.0 -37.0 2 10.0 10.0 -21.8 10.0 •24.4 10.0 -302 10.0 -36.5 10.5 ( -03.5 12.4 -51.0 14.3 -59.2 16.5 •67.9 2 20.0 10.0 •19.5 10.0 -21.8 10.0 -27.0 10.0 -32.6 10.0 -38.8 11.6 -45.6 13.4 -52.9 15.4 -60.7 2 50.0 10.0 -16.4 10.0 -18.4 10.0 •22.7 10.0 -27.5 10.0 I .32.7 10.6 -38.4 12.3 -44.5 14.1 •51.1 2 100.0 10.0 -14.1 10.0 -15.8 10.0 -19.5 10.0 -28.1 10.0 -33.0 11.4 .38.2 11.4 -38.2 13.0 -43.9 3 10.0 10.0 •32.8 10.0 -36.8 10.0 -45.4 10.0 -55.0 10.5 -65.4 12.4 -76.8 14.3 -89.0 16.5 -102.2 3 20.0 10.0 -27.2 10.0 -30.5 10.0 -37.6 10.0 -45.5 10.0 I -54.2 11.6 -63.6 13.4 -73.8 15.4 -84.7 3 50.0 10.0 -19.7 10.0 -22.1 10.0 -27.3 10.0 -33.1 10.0 -39.3 10.6 -46.2 12.3 -53.5 14.1 -61.5 3 100.0 10.0 -14.1 10.0 -15.8 10.0 -19.5 10.0 -23.6 10.0 ( -28.1 10.0 -33.0 11.4 -38.2 13.0 -43.9 Roof Angle>10-30 degrees 1 1 10.0 10.0 -11.9 10.0 -13.3 10.4 -16.5 12.5 -19.9 14.9 I -23.7 17.5 -27.8 20.3 -32.3 23.3 -37.0 1 20.0 10.0 -11.6 10.0 -13.0 10.0 -16.0 11.4 -19.4 13.6 ( -23.0 16.0 -27.0 18.5 -31.4 21.3 -36.0 1 50.0 10.0 -11.1 10.0 -12.5 10.0 -15.4 10.0 -18.6 11.9 f -22.2 13.9 -26.0 16.1 -30.2 18.5 -34.6 1 100.0 10.0 -10.8 10.0 -12.1 10.0 -14.9 10.0 -18.1 10.5 -21.5 12.4 -25.2 14.3 -29.3 16.5 -33.6 2 10.0 10.0 -25.1 10.0 -28.2 10.4 -34.8 12.5 -42.1 14.9 , -50.1 17.5 -58.7 20.3 -68.1 23.3 •78.2 2 20.0 10.0 -22.8 10.0 -25.6 10.0 -31.5 11.4 -38.2 13.6 -45.4 16.0 -53.3 18.5 -61.8 21.3 -71.0 2 50.0 10.0 -19.7 10.0 -22.1 10.0 -27.3 10.0 -33.0 11.9 f -39.3 13.9 -46.1 16.1 -53.5 18.5 .61.4 2 100.0 10.0 -17.4 10.0 -19.5 10.0 -21.1 10.0 -29.1 10.5 -34.7 12.4 -40.7 14.3 -47.2 16.5 -54.2 - 3 10.0 10.0 -25.1 10.0 -28.2 10.4 -34.8 12.5 -42.1 14.9 , -50.1 17.5 -58.7 20.3 -68.1 23.3 -78.2 3 20.0 10.0 -22.8 10.0 •25.6 10.0 -31.5 11.4 -38.2 13.6 -45.4 16.0 -53.3 18.5 -61.8 21.3 -71.0 Q 3 50.0 10.0 -19.7 10.0 -22.1 10.0 -27.3 10.0 -33.0 11.9 t -39.3 13.9 -46.1 16.1 -53.5 18.5 -61.4 3 , 100.0 10.0 -17.4 10.0 -19.5 , 10.0 -24.1 10.0 29.1 10.5 I -34.7 12.4 -40.7 14.3 -47.2 16.5 -54.2 Z Roof Angle>30-45 degrees 3' 1 10.0 11.9 -13.0 13.3 -14.6 16.5 -18.0 19.9 -21.8 23.7 -25.9 27.8 -30.4 32.3 -35.3 37.0 -40.5 1 • 20.0 11.6 -12.3 13.0 •13.8 • 16.0 -17.1 19.4 -20.7 23.0 •24.6 27.0 -28.9 31.4 -33.5 36.0 •38.4 I-• 1 50.0 11.1 ' -11.5 12.5 -12.8 15.4 -15.9 18.6 -19.2 22.2 , -22.8 26.0 -26.8 30.2 31.1 34.6 -35.7 1 100.0 10.8 -10.8 12.1 -12.1 14.9 -14.9 18.1 -18.1 21.5 -21.5 25.2 -25.2 29.3 -29.3 33.6 -33.6 2 10.0 11.9 -15.2 13.3 -17.0 16.5 -21.0 19.9 -25.5 23.7 1 27.8 •35.6 32.3 -41.2 37.0 -47.3 2 20.0 11.6 •14.5 13.0 -16.3 16.0 -20.1 19.4 -24.3 23.0 ` -29.0 27.0 -34.0 31.4 -39.4 36.0 -45.3 Si 2 50.0 11.1 -13.7 12.5 -15.3 15.4 -18.9 18.6 -22.9 22.2 -27.2 26.0 -32.0 30.2 -37.1 34.6 -42.5 2 100.0 10.8 -13.0 12.1 -14.6 14.9 -18.0 18.1 -21.8 21.5 4 -25.9 25.2 -30.4 29.3 -35.3 33.6 -40.5 7 �( 3 10.0 11.9 -152 13.3 -17.0 16.5 -21.0 19.9 -25.5 23.7 -30.3 27.8 -35.6 32.3 -41.2 37.0 -47.3 C 3 20.0 11.6 -14.5 13 0 -16.3 16.0 -20.1 19.4 -24.1 "23.0 I -29.0 27.0 -34.0 31.4 -39.4 36.0 -45.3 ` V1 3 50.0 11.1 -13.7 12.5 -15.3 15.4 -18.9 18.6 .-22.9 22.2 -27.2 26.0 -32.0 30.2 -37.1 346 -42.5 3 100.0 10 8 -13.0 12.1 -14.6 14.9 -18.0 18.1 -21.8 21.5 -25.9 25.2 -30.4 29.3 -35.3 33.6 -40.5 WWall CZ0Sie:} -"GOR14E fk •ltw100 w" r 4 10.0 13 0 -14.1 14.6 -15.8 18.0 •19.5 71.8 -23.5 25.9 •28:1 30.4 -33.0 35.3 -38.2 40 5 •43.9 4 -20.0 12" -13.5 13.9 -15.1 17,2 i 7 20.8 -22.6 24.7 -26.9 29.0 -31.6 33.7 -36.7 38.r •4e.. 4 50.0 11.6 -12.7 1 13.0 •14.3 16.1 -17.6 19.5 -21.3 23.2 -25.4 ,27,2 -23.8 31.6 -34.6 35.2 -39.7 r, 4 10..0 11.1 -12.2 12.4 -13.6 15.3 -16.8 18.5 -20.4 22.0 -24.2 25.9 -28.4 30.0 -33.0 34.4 -37.8 34.7 30.4 -40.7 35.3 -47.2 .!:›4... _ g � 13.0 -17.4 14.6 -19.5 18.0 -24.1 "21.8 -29.1 (}x}' ...0.o 5 ..0 ' 12.4 -16.2 13.9 -18.2 17.2 -42.5 26.8 -27.2 •.7 -32.4 29.0 -38.0 33.7 -44.0 ad. u._ 5 5 50.0 100.0 11.6 -13.5 12 13.0 -15.1 15.3 -18.7, 18.5 22 6 22 0 -26.9 25.9 •31.6 I 31.6 -36.7 34.4 -42.1 -For SI: 1 ft2=0.0929 m2, 1 mph=0.447 m/s, 1 psf=47.88 N/m2. •1 For elective areas or wind speeds between those given above the Ioad.may be interpolated,otherwise use the load associated with the tower elective area 2 Table values shall be adjusted for height and exposure by rnultiplyirg by adjustment coefficients in Tab's 1606.20. 3 See Figure 1606.2(c)for location of zones. • ••a Plus and minus sigrs signify pressures act ng toward and away from the bai:dirg surl;ces FLORIDA BUILDING CODE -BUILDING h- 11-2LiU4 12tk1.7.1. MI HUME PRODUCTS 717 362 71725 F. .'17 TABLE 1606.2C-TABLE 1606.2D TABLE 1606.2C 0 ROOF OVERHANG COMPONENT AND CLADDING DESIGN WIND PRESSURES FOR A BUILDING WITH MEAN ROOF HEIGHT OF 30 FEET LOCATED IN EXPOSURE B(psf) Basic Wind • =d v( •ph-3 second gust) Effective Wind Area Zone (ft2) 90 1 110 120 130 140 150 Roof Angle>0-10 de•r=: 2 1 21.0 -25.9 -31.4 37.3 •3.8 5. : -58.3 2 0 -20.6 -25.5 -30.' -36.7 -43.0 -• ..9 -57.3 2 1 ,0 -19,8 -24.4 -29 • -35.1 -41.2 •7.8 -54.9 3 10 -34.. -42.7 -5 .6 -61.5 -72.1 -83.7 -96.0 3 20 -27 -33.5 -•'.5 -48.3 -56.6 -65.7 -75.4 3 100 ..0 -12.2 4.8 -17.6 -20.6 -23.9 -27.4 Roof Angle> 10 30 degrees 2 10 -27.2 -33.5 -40.6 -47.3 -56.7 -65.7 -75.5 2 20 -27.2 -33.5 -40.6 -.:.3 -56.7 -65.7 -75.5 2 100 -27.2 -33.5 -40.6 48.3 -56.7 -65.7 -75. 3 10 -45.7 -56.4 -68.3 -81.2 -95. -110.6 -1 ..9 3 20 -40.5 -50.0 -60.5 -72.0 -8•.. -98.0 12.5 3 I 101 -28.4 -35.1 -42.4 -50.5 -5 .3 -68.7 -78.9 Roof Angle> 3■ - •'. degrees 2 10 -24.7 -30.5 -36.9 -43.9 51.5 -59.: -68.6 2 20 -24.0 -29.6 -3 '. -42.6 -50.0 -5-.a -66.5 2 100 -22.2 -27.4 •c.2 -39.5 -46.4 .3.8 -61.7 3 10 -24,7 -30.5 -36.9 -43.9 -51.5 -59.8 -68.6 3 20 -24.0 -29.6 -35.8 -42.6 -50.0 -58.0 -66.5 3 100 -22.2 -27.4 -33.2 -39.5 :6.4 -53.8 -61.7 For SI: 1 psf=47.88 N/m2, 1 ft2=0.0929 m2, 1 mph=0.447 m/s. Note:For effective areas between those given above the load may be interpolated,otherwise use the load may be interpolated,otherwise use the load associ- ated with the lower effective area. TABLE 1606.2D HEIGHT AND EXPOSURE ADJUSTMENT COEFFICIENTS Mean Exposure Roof Height - B C D 15 1.00 1.21 1.47 20 1.00 �1.=9i 1.55 , .5 1.00 WO 1.61 .50 . 1.00 .•1 1.66 35 1.05 1.4 1.70 40 1.09 1.49 1.74 45 1.12 1.53 1.78 50 1.16 1.56 1.81 55 1.19 1.59 1.84 60 1.22 1.62 1.87 Note:All table values shall be adjusted for other exposures and heights by multiplying by the above coefficients " „ ftH/ 4IAL� Wa-k VP MEAt\) RcOf +-I T. I FLORIDA BUILDING CODE-BUILDING CaRAVE - FEB-11-2 004 12: 11 MI HOME PRODUCTS 717 362 7025 P.08 (§) • Series 165/3000 Single Hung and Fixed Windows BeeiuuL • • Series 740174413740 Single Hung and Fixed Windows Dooxs AND WINDOWS • Series 168/3168 Horizontal Slider and Fixed Windows • Series 680 Horizontal Slider and Fixed Windows NOTE: SEE INDIVIDUAL TEST REPORT(S) FOR DP RATINGS AND MAXIMUM ALLOWABLE SIZES. INSTALLATION INSTRUCTIONS FOR "APPROVED FOR FLORIDA" ALUMINUM FIN WINDOWS BetterBilt Windows & Doors appreciates your recent purchase of a maintenance free prime window, which will not rust, rot, mildew, or warp. This is a quality product that left our factory in good condition — proper handling and installation are just as important as good design and workmanship. Please follow these recommendations to allow this product to complete its function. 1. Handle units one at a time in the closed and locked position and take care not to scratch frame or glass or to bend the nailing fin. Place a continuous bead of caulk on the back side of nail in (mounting flange). 2. Set unit plumb and square into opening and make sure that there is 3/16" + 1/16" clearance around the frame. Fasten unit into opening in the closed and locked position, making sure that fasteners are screwed in straight in order to avoid twisting or bowing of the frame. Make sure that sill is straight and level. Check operation of unit frequently as fasteners are set. 3. Use # 8 sheet metal or wood screws with a minimum of 1" penetration into the framing (stud). Place first screws (two at each corner) 3" from end of fin. For positive and negative DPs (design pressures) up to 35, do not exceed 24" spacing of additional screws. For DPs from 35.1 to 50, do not exceed 18" spacing. 4. Caulk entire perimeter of fin to mounting surface joint and caulk over screw heads. Note: this step can be eliminated if 4" wide adhesive type flashing is used (sill 161., jambs 2"d., head 3`d.). 5. Fill voids between frame and construction with loose batten type insulation or non-expanding aerosol foam specifically formulated for windows and doors to eliminate drafts. The use of expanding aerosol type insulating foam, which can bow the frame, waives all stated warranties. 6. Remove plaster, mortar, paint, and debris that has collected on the unit and make sure that sash/vent tracks and interlocks are also clean. Do not use abrasives, solvents, ammonia, vinegar, alkaline, or acid solutions for clean-up, especially with insulated glass units as their use could cause chemical breakdown of the glass seal. Take care not to scratch glass; scratches severely weaken glass and it could eventually break from thermal expansion and contraction. Clean units with water and mild detergent. - CAUTION - BetterBilt Windows & Doors or its representatives are unable to control and cannot assume responsibility for the selection and placement of their products in a building or structure in a manner required by laws, statutes, and/or building codes. The purchaser is solely responsible for knowledge of and adherence to the same. BetterBiii window products are not provided with safety glazing unless specifically ordered with such. Many laws and codes require safety glazing (tempered glass) near doors, bathtubs, and shower enclosures. Also be aware of other code requirements such as emergency egress and structural/energy perforrnancg. C . Corporate Headquarters: � ';�•;., !�,, '� . www.mihp.com M.I. Home Products 650 West Market St. ti`: .• .... ; „ - • Gratz, PA 17030-0370 ''1 221 - • • (717) 365-3300 —T� Rev.7-24-03 �1 vc y Z9 Z ova �'., '. '`( TOTPL P.OE a4 r 0" ' r ° , CITY OF ATLANTIC BEACH '' J 800 SEMINOLE ROAD j ti ATLANTIC BEACH, FLORIDA 32233 ''� s ,,, -,° INSPECTION PHONE LINE 247-5826 Application Number 04-00028057 Date 4/06/04 Property Address 175 SEMINOLE RD Tenant nbr, name INTERIOR DEMO Application description . . DEMOLITION Property Zoning TO BE UPDATED Application valuation . . . 0 Owner Contractor BIRDSONG, GREG OWNER 1 175 SEMINOLE RD. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 1 Permit DEMOLITION PERMIT Additional desc . Permit Fee . . . 100 . 00 Plan Check Fee . . . 00 Issue Date . . Valuation . . . . 0 Fee summary Charged Paid Credited Due Permit Fee Total 100 . 00 100 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 100 . 00 100 . 00 . 00 . 00 1 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. c . ilgialikw BUILDING OFFICIAL I S, `,r " 4 ) CITY OF ATLANTIC BEACH DEMOLITION PERMIT APPLICATION 011 1) Date: /1/4/0 LI Job Address: 175 1 Joi..E al • E Owner of Property: G-,eca� }i�j,ewtX•� -•- Sp....? "tebsc,3C Address: Telephone: *4 237-4.6 5-S Legal Description: Block Number: Lot Number: Zoning District: Contractor: 3,iEe.. State License Number: Contractor's Address: Telephone: Fax: Describe proposed use and work to be done:12!w„cdE—{ wo.)eu...1G � CSA+� a0L�UQen STade •Ico / 1 e...4 .ci E., „► Lid �rti..s. w r Tea c.�A¢c> K.ic4 eiJ Present use of land or building(s): c'4.1,I 14-40.-►.c Y eeSiD'63.)c.e=- Is approval of Homeowner's Association or other private entity required? / If yes, please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? NO. Applicant certifies that no change in site grade or fill material will be used on this project. ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ,RN 0. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. STEP 1. Attach Tree Removal Application if trees are to be removed or relocated. j14.. I hereby certify that all• le filiation provided with this application is correct. /G/4/ Signature of Owner: AA. e :1 v� Date: 1, II hereby cejtify that I ave read and examined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Page 1 Revised 1/14/03 r ■ Signature of Contractor: Date: Address and contact information of person to receive all correspondence regarding this application(please print). Name: 0,AnE IE)ue. 1 Mailing . /'7 –S—eirI&eL� e I f Telephone: 94 4 'Ls? Fax: E-Mail: 1)era song Q bye.secs`���14a'' AS TO OWNER: ,/ J Sworn to and subscribed before me this day of ") )1 y i,'1 , ,2009 . State of Florida,County of Duval < :E.,%--,.:R SCHLUETER Notary's Signatur- .1. It�A + SC;:T?d#DD 121301 ^•...,�� = EXPII.1: .,ay 27,2006 ❑ Personally known •t; ,, : 3u;M.,':,;;ery Publicundenwiters [g---produced identification Type of identification produced {Ci 3 oZ-- 7-01-)--II -335—0 AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 . State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 • Fax: (904)247-5845 .http://www.ci.atlantic-beach.fl.us Page 2 Revised 1/14/03 i . 'I �� ,_ `S z CITY OF ATLANTIC BEACH y: = J 800 SEMINOLE ROAD 1-4.... >a; ,. s) N , ;41 ATLANTIC BEACH, FLORIDA 32233 \\ .. INSPECTION PHONE LINE 247-5826 4'401119' Application Number . . . . . 04-00028010 Date 4/05/04 Property Address 175 SEMINOLE RD Tenant nbr, name RE-PIPE 4 FIXTURES Application description . . PLUMBING ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Owner Contractor BIRDSONG, GREG KING PLUMBING CONTRACTORS INC 175 SEMINOLE ROAD PAUL T. KING ATLANTIC BEACH FL 32233 6900 PHILLIPS HWY, SUITE 50 JACKSONVILLE FL 32216 (904) 296-2568 Permit W/W/O PLUMBING PERMIT Additional desc . Permit Fee . . . 126 . 00 Plan Check Fee . . . 00 Issue Date • • • • Valuation . . . . 0 Fee summary Charged Paid Credited Due Permit Fee Total 126 . 00 126 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 126 . 00 126 . 00 . 00 . 00 r 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. ."‘..- c q1BA**, BUILDING OFFICIAL Mat. 31 04 02: 59p p• 1 CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION (/ Date: I 1 I Property Address: 4J$ sy�r7 i/t..o /P z O w n e r. g /_ ,�, -d. Telephone#: ‘51-64 Contractor: ��i.�,-. i� r T. Telephone#: , 2 Contractor Address: 6 5/G 0 # 4 i// .P. "'Fax#: .21 ‘'/S-02/ In consideration of permit given for doing the work as described in the above st.211r matt.we hereby agrooe to perform said work in accordance with the attached plies and specifications which are a part hereof and in accordance with the Coy of Atlantic Beach ordinance and standards of good practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: if other construction is being done on this building or site, Cl New list the building permit number: ja Re-Pipe Number of Fixtures: Bath Tubs _ Showers - / Closets Shower Pans Dishwashers / Sinks Disposals _ Urinals Floor Drains Washing Machine Lavatory Water Sewer Water Heaters Other Fees Permit Issuing Fee: $35.00 Total Fixtures: V X$7.00 + $35.00= b 3 . 424-" s_ 800 Seminole Road-Atlantic Beach,Florida 32233-5445 Phone:(904)247-5800- Fax: (904)247-5845- httpJiwww_ciattantic-beach.fl.us DEPARTMENT OF BUILDING 3 3 0 8 f PERMIT NO. r CITY OF ATLANTIC BEACH, FLORIDA 1k PERMIT TO BUILD E THIS PERMIT MUST BE POSTED ON JOB Date 3/ / 19 f i 50.00(Fonee) Valuation$ Fee $ C`'• ' This permit not valid until above fee has been paid to City Treasurer,asurer, and is of subject to revocation for violation of applicable provisions This is to certify that-------MI chc-iel E. MI II or _ has permission to buil a 4' Fence I � f I Tt Res i dent i a l 7.nne ClaS31f1Catlp € € Owned by M chaei E. Mi l l er , _ S/D i Bloc.+ Lot j House No 175 Seminole Road I According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS i t AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIR MONTHS AFTER DATE OF ISSUE — _► • ■ A ∎ 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 contractor or owner. f[[ R. C. Vogel Building Official. I PERMIT DATE CONTRACTOR ■ FOR OFFICE NUMBER USE ONLY PLUMBING MN 1i ELECTRICAL SEWER 111111111 1 I WATER i FOR OFFICE USE/, A� 7 ONLY Date.. ' 19 / " a Permit # `,! Fee$ - CITY OF ATLANTIC BEACH Valuation $ �`� / ,/�/ FLORIDA House #-/Q'�PRp p/e �£1 CITY OF ATLANTIC BEACH APPLICATION FOR BUILDING PERMIT MAR $ 1937 //�i/� -rice f Application is hereby made for the approval of the detailed statement of the plans and speci: ati.ns - - • •••• .• •r 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. M�9,eC /4 IV , 19 7 7 ,,A Date 91*-- '/ Owner „`�CNA41- E. ill�4.4-_4R Address /7S sE/1',�!/1/o LE___gD.Telephone No°2 .2 7 /3 Architect Address. Telephone No. Contractor Builder Address Telephone No. Lot No. Block No. Sub Division Zone Street Side Between and Sts. //�� .f 7i�O 0 VFor what purpose will building be used--Cr-ed, e)) Type of co¢ E h4 h Valuation $...f-- -- -- '� Dimensions of Building Dimensions of Lot...._...'SO-..X /00 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 " Size of Floor Joists ,Distance on Centers , Greatest Span If Size of Rafters , Distance on Centers , Greatest Span If 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. 01 Inspections required. . 1. When steel is in place and ready to pour footing. W W Z 2. When steel is in place and ready to pour columns and/or lintel. a �-35 I a 3. When steel is in place and ready to pour beam. F, H 4. When framing is completed. S 5. When rough plumbing is completed,and ready to cover up. W --v-- • �•• W 6. When septic tank drain field or sewer is laid but before it is covered. A A 7. Electrical inspection by City of Jacksonville. p 8. Final inspection. 9E-6� 71i .�l Note: In case of any rejection,re-inspection MUST be called for after . 1 corrections are made. W 4-- FRONT OF LOT 50'—•P 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 ::r Address ',11 c • •- Address �� E-A[bN t m C, j� 4D Signature of /�!