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191 Seminole Rd (vault)
I T!..Lyre J� s‘ CITY OF ATLANTIC BEACH . I 800 SEMINOLE ROAD 15- ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00001678 Date 12/04/08 Property Address 191 SEMINOLE RD Application type description ROOF PERMIT Property Zoning TO BE UPDATED Application valuation . . . 4000 Application desc shingle to shingle 30 yr arch. Owner Contractor HENTOSH, MICHAEL HARRISON CONSTRUCTION & 191 SEMINOLE ROAD REMODELING, INC. ATLANTIC BEACH FL 32233 917 1ST AVE. NEW SMYRNA BEACH FL 32169 (386) 689-0689 Permit ROOF PERMIT Additional desc . RE ROOF SHINGLE TO SHINGLE Permit Fee . . . 50 . 00 Plan Check Fee . . . 00 Issue Date . . . Valuation . . . . 4000 Expiration Date . 6/02/09 Fee summary Charged Paid Credited Due Permit Fee Total 50 . 00 50 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 50 . 00 50 . 00 . 00 . 00 I PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ('Kdfri C61-- S-149( •J ,sue"_.,� CITY OF ATLANTIC BEACH � �, ,{:, 08- ---1 `fit ., 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 I I I I CA �t g.. n OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPT©COAB.US ` t°r BUILDING PERMIT APPLICATION DUVAL COUNTY 1 4113JOB,'ADDRESS ..{f 'f+°_ ,.... �1..*. _ � e r'z,,,:M 1 V. "�'. 2 VALUATION OF WQRK,�,o . ?,jt,� ,, 3'!SO FT'_.UNDER ROOFr- .._ ,..t l tom.. �� `l K 52..A.,r1 k IZ J . i8 5Q r ,,,, '&' r, -1. : ! #�+,4M ,5 C ssMtiORKae- r sip t: "^&rY &US�E';OFSTRUCTURE3f .;r' n �p d.;LEGAL DESCRIPTION.•>I o.,f;�'�'�'," �,.- �...._ � >-- `4 r ❑NEW BUILDING 0 DEMOLITION �K� WRESIDENTIAL v 1 /1- Z.S �9 E 4 crn/R SEC I (� �, LO BLOCK SUB DIVISION �/,2 / (S 2,24 j4.� o.9 ❑A DITION ❑CONVERTING USE ❑COMMERCIAL VXDESCRITQN OOyORK M x ?s: g _ - -.r - iA -'' LTERATION 0 ACCESSORY BLDG. -8.FIRE SPRINKLERA te+ q ❑ ❑ SPA I YES `6► 1l'o O ` 5 h l 054,71-0 7�trJ I 3O' Mk❑MOVE_ ❑OTHE R I❑NO L NaT«n. ;_PROPERTYOWNERY a2 ; }- `= CONTRACTOR: :a -r -" , ARCHIECT(.ENGINEER r c„ : 9.NAME: S _ , 6 14 S I 15p.COMPANY NAME: i 23.COMPANY NAME: 16.NAME: 24.LICENSEE NAME: IJ,Vt a atGm WQ.Yrt SO,6 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: i tell Se-v..:..4 kc --e() . Cc_c: 1 32.SY c3 b 18.ADDRESS: FL. a)21G= 26.ADDRESS: ( icv.k.0 OCA 32-1-g? 61('jE6.4 0T 6T, Nc,..3 Cui r,...;itt, 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: (39()(8'-04,gs 13.CELL PHONE: 1.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: ti FEE SIMPLE TITL EHOLDER s l Oerz .._ G C OM Y MORTGAGE LENDER:. 1744 ,-. 0 o rHna Ol*Rt„ .24 , e: t � _7',. : . ;::.i r Pmst5-`:_ 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 or AGENT CONTRACTOR'F ' ' (If Agent,Power of Attorney or Agency Letter Required) >' (O Only) _ - Signed:xe U ' Date: /2-9 a8 Signed: / ' ,r _ 1,41∎1 Date: /2. ' L7'b' 1 ri 6� Before me this r.7 day of l ,20Igin the county of Before me this ` day of 'emu ,20[g to the county of Duval,State of Florida,ha pers9"ally Ippeared Duv State of Flond has pers aaappeared -Qi4A4 .)Gv1.t° I it“/U>Pa,1'ii herin by himself/herself and affirms that all statements and declarations are berth by himself/herself and affirms that all statements and declarations true and accurate. true and accurate. o ry Public at Large,Sta- • 1.. ■■ J %....� otary Public at Large,State o County of � .'.- I Personally Known 4' , y), `1 N • �N DD536835 Personally Known ,/ . (j A�°' 635 ❑ roduced Identificafio w �i� y COMiv1 1 {{{]]]Produced Identification- - ...� ��/ ms • a,r� t 0: Notary Signature: ,�E ! M 1 cow.S, '111,2010 Notary Signature: , . D g • Amor T-- ... ‘4440440T"^ Y Ft. COAB FORM BLDG01:REVISED:1/1012003 NOTICE OF COMMENCEMENT State of 19 Tax Folio No. County of a-( To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: /7-2 5""X46 SALT/4/2 SEC I (-IT ('Z7 1/4' jV 632M-1-5S3 (0,5/ 7 — L3q (2LiFE E-ThYE Address of property being improved: 14\ �1 �; t tL+� '�G�`� ScA. 4 t I Z2'3 3 ,A, __LL General description of improvements: 1Vt tA+J ( ..ci L • Ls 41 a s�� 5Ci...-(/#- rt?-t-�a c3"4'eas'✓.44c, Sj►t,i�leS - 13Afe- -oG.t Owner: SG44' ^ e,l• es%/1/4 Address: "4'` SC'wv►:+.s ` 1Z �. 0414^1-1-6 Rw 31'03 Owner's interest in site of the improvement: 4eh 4 D v U e r Fee Simple Titleholder(if other than owner): v Name:,t)- Contractor: (tit . tLoy-rt svd ty J.o"1 y -✓ / 4 Address: , if /4-T Sr 12 gat.f%/i Telephone No.:6044 B f- bLfq Fax No: Surety(if any) Address: Amount of Bond$ Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: Date: 3efore me this & day o - County of Duval,State s e , )f Florida,has personally appeared LWk� lotary Public at Large,State of Fl o 'da,County of Duval. i" 3 vly commission expirfgs: 2 2. ( 'ersonally Known: oL / or 'roduced Identifcation: /AVAMlea' t1 u : . : 11►►: ar' /I" MY COMMISSION#DD536833 %'{ EXPIRES:Apt it 11,2010 oFw Ft Motley&Faso*A.Fai It ec. -c-',1 O -O -O U O O O E c C a) ¢ 8 a, W a .6 o of oCo o U U - ct 7 = = w > 0 :? o 0 s-■ U 74 O Cz s~ H v, v,° 3 U 6, a t .• H -� .° H o •• �' o te W U o 3 0 A I -O ' 0 Q., :~ " s. o w a ° S A cn � -� LS CA 4 M 00 O, v 2 a o ;; o H U ap U cd CA d C: a) o O :r •o O n CI U 0,w o y L, 0; _ >o O R • e E E, a a � ) ° 6:4 y O '9.2 ,..,. ,_..,I . , +, - ° vs v up p4 O Z VI U q 4. c. a a -i • cu ...o 4 w --∎ N cn d- kn 1/4.r..3 , 4 N • d- v VO t • co o O -1 • •O O s. >O p 4t 71 c.) 0 a N. *, cL % M vik ‘, \a` ,.\ oc: cel 0 0 , E ' A4 a v. ro ,,,,1 i i o A ‘...• cC u . 4 ••2 L o 4. o - •••' `� P. 1 1 a U = `4 2 L' L • CI N CC 0 +5 o t4.1 0 U 0 CS 0 ° ?' 0 3 0 0 L7 c� a4 0, u on an '' a4 4 .- o �, o 0 - 1 0 �. Z �, - w 0 0 -0 au ,_, CA �' a� c� — �' + a) �-, to t} b0 t+ 4. ,_, O 4-I t. 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Z W ~ N aw a, aai - .0 '' a, - C b Q zi v O c�a 'O�' O . = O N I • aft FOR OFFICE USE ONLY DEPARTMENT OF BUILDING Date`197 / CITY OF ATLANTIC BEACH, FLORIDA Permit *VS/ Fee $3 Valuation Application for Permit for HOUSE # A(1_/ , -ti-&, AV. Miscellaneous Alterations, ir and Repairs G g- 7/ D, SgRIBE: 5 C -ca--7 7lrsL : ,,(State if to repair, alter, add to or move building, erect asmings, signs, etc. ) 4-�� 12-" / Building on: •t No. 40 --77 B k No. Sub.Div. Address ' P `, c f Valuati,n $ `3 S_ c� Owner �s Name 4' . ✓. 44 BUILDINGS AND OCCUPANCY Building Use - Residential or Business What Plumbing work to be done? Size of Present Bldg. Size of Extension Lot Size No. of stories now after altered Material of roof Material of Present Building Material of Extension NECESSARY PLANS TO BE SUBMITTED HEREWITH OIL BURNER OR GASOLINE EQUIPMENT Name of Oil Burner or Gasoline Pump Type or Model Name and Address of Manufacturer In connection herewith, application is also made to install:, gal. capacity tank (s) made by of gagge metal ground. (Name of Manufacturer) +tjt`6.ir or Above) (Under or Above) of building. For (Inside or Outside) (Name of Purchaser) FURNISH DRAWING SHOWING ENTIRE LAYOUT ON REVERSE SIDE OF THIS BLANK SIGNS Size Classification (State whether ground, roof, wall, projecting,banner) Material of Construction Illuminated? Type of illumination (State whether Lamps or Neon) Will sign be over public property? SUBMIT DRAWING SHOWING CONSTRUCTION OF SIGN AND METHOD OF HANGING WRITE ADDITIONAL INFORMATION BELOW (For canvas awnings provide dimensioned drawing on reverse ys'' de) COMPLE,TED 91911 DATE, IMPORTANT NOTICE: 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. (Southern Standard Building Code) . Signature of Bu' , or Owne t�i Address?Lf O � " �. .h, ti^''`� Phone No. ^ amoo CITY OF Nicadic Beach,-4h'' Office of Building Official REQUEST FOR INSPECTION o G Date_ -- S' Permit No. A.M. Time M. Received /1)6 L ,(20 Sr' C Locality S Job Address I': O. 1 Owner's Contractor VI /V Name 4121:32. MECHANICAL CONCRETE ELECTRICAL BUILDING r -oug ❑ Air Cond. & Rough Wiring ❑ Heating Framing Slab E Temp Pole ❑ Top Out ❑ Slab ❑ Sewer ❑ Fire Place Insulation Roofing ❑ Lintel Final Pre Fab Insulation },GW ;newt READY FOR INSPECTION,' / A.M. Wed. Thurs. Friday----P'M. Mon. Tues. A.M. © P.M. Irspectior. Made _ s Final Inspection Certificate of Occupancy Date _-- -- --- , ,emu„ PSR-3844 09706 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT INFORMATION -- - -- - - --- - -- LOCATION INFORMATION Permit Number : 9706 ;,..ddress : 191 SEMINOLE ROAD Permit Type : PLUMBING ATLANTIC BEACH . FLORIDA 322:1 Class of Work : ALTERATION LEGAL DESCRIPTION Constr . Type : WOOD FRAME Lot : Block : Section : Proposed Use: SINGLE FAMILY Township : RNG: 0 Dwellings : 1 Code: 0 Subdivision: ATLANTIC BEACH Estimated Value : $0 .00 Improv . Cost : $0 . 00 TotaL7- - - 825 . 00 Amolln* $:' '•' 1 /115 - -- OWNER INFORMATION ---- APPLICATION FEES me: HENTASH PERMIT $25 . 00 191 SEMINOLE ROAD WATER IMPACT FEE $000 ATLANTIC BAAOH , FLOR14A SEWER IMPACT FEE $0 00 Phc.ne - "?.04 ) 246 -4657 WATER METER/TAP $0 . 00 RADON GAS-H.R . S , $0 . 00 CONTRACTOR INFORMATION RADON CAB 5% $0 . 00 Name : ) V AND SON PLUMBING CAPITAL IMPROVE . S0 . 00 Address : 72,5 CIEARVIEW LANE SEWER TAP $0 .00 ATLANTIC BEQACH . FLA. 322 CROSS CONNECTION $0 . 00 License : RF0037856 Type: 4 SEC H IMPACT FEE S0 . 00 CONST . SURCHARGE S0', 00 SCHARGEYATL Br1-1 _ SO 00 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 000000000 000000000 325.00 14 Date: 2/10/95 01 Rcpt: 0031180 By: 1 MR03221000 6690 /1- , - - —— CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: I _ A _ • OWNER OF PROPERTY: f X12. BUILDING CONTRACTOR: PLUMBING CONTRACTOR 75T3 n��, L_,- 4V/ AND ADDRESS: TELEPHONE NUMBER: STATE LICENSE NO: TYPE OF BUILDING: 1 TYPE OF WORK: % ../ I A if L HOW MANY OF THE FOLLOWING FIXTURES INSTALLED • SINKS SHOWERS LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURE COUNT: x $3. 50 + $15.00 = $ INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION BEFORE COVERING UP - (904) 247-5834 PSR-3844 5 .. AEPAItTPAiENT OF BUILDING CITY OF ATLANTIC/ BEACH -_--- PERMIT INFORMATION _-- - - - - - - LOCATLOf i4FDR$A'PUF N ---- Permit Number: 7595 A,°1r1r�ss ' 191 S AAOLE. ROAD Pert it Type: RE-ROOF ATLANTIC BEACH , FLORIDA 3223- '7Ia.ss of Work : NEW LEGAL DESCRIPTION ------- ,ons t r. Type! WOOD FRAME Lot ! 621 Block : Section ! E :oposed Use: SINGLE FAMILY Toy.•*reship RNG: 0 Pellings ' 1 Code : 0 Subdivision ' SALTAIR yr t mated Value : O . !; '.'mr+ rI v ,,f,;;o c,t • S":' o r - "ORATION -- ---- APPLICATION FEES - S H PERMIT X22 G.n . ._MI: :OLE ROAD WATER IMPACT FEE $0 , AIDANTT`C BEACH , FUIPIT ., SEWER IMPACT FEE:e 4,-„,--$4.-0c -4',140 WATER METER/TAP 50 . 00 RADON GAS-H.R. S . $0 .00 ------- CONTRACTOR INFORMATION - RADON__GAS 5% $0 . 00 ""r r7Y -LYNN WTLEY[SEAR" CAPITAL IMPROVE . $0 .00 ':- DCODK ROAD SEWER TAP $0 . 00 - PLORIDA 32803 HYDRAULIC SHARE S0' 00 Tyre! CROSS CONNECTION SEC .H IMPACT CON . SC OTHE, 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 M C FOR BUILDING IMPROVEMENTSiN THE PROPERTY OWNER PAYING TWICE 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 Operator: CRYSTAL Date: 11/30/93 00 Receipt: By « (r �fir'`d Total Payment CITY OF ALANTIC BEACH ROOFING PERMIT APPLICATION Owner(s) : -Lon h Address: l c i 1 Q ,'rl p ll- 1 2 C I • Phone: , L1 L u 3?39 low 1 6 te-E 3244-9i3 (.50 -z390 Lot # , Block or Unit # Subdivision: .l-I-GLir^ sec( Contractor: c3 4ie -y Wi 1.Ey Address: tOg() WOcC1�C-� 2 City, State and Zip O iIl rah I CL ' .3Z803 Phone 407 -g42 - (o346 State License # Ds is-7 l Describe work to be performed: kiD I'ZUt'b c:90 Sip Valuation of Proposed Construction: zIS Oo Materials to be used: Signature of Owner; alt-didi_ce Signature of Contractor: Liability Insurance Supplied Workers Compensation Insurance Supplied License Information J ✓ CITY OF ATLANTIC BEACH BUILDING DEPARTMENT . INSPECTION REPORT OB LOCATION 191 SEMINOLE ROAD PERMIT# 905 "1. ATLANTIC BEACH, FLORIDA 32233 SUBDIVISION )WNER NAME SARA HENTOSH PHONE (904)241-9051 EGAL DESC: LOT BLOCK SECTION PERMIT TYPE ELECTRICAL CLASS OF WORK INCREASE v'" DNTRACTOR BROOKS AND LIMBAUGH PROPOSED USE SINGLE FAMILY DRK DESCRIPTION CS4/0 200AMPS ALUM SB 200 1PH3W 230 VCABLE EXIST 100AMPS 3PECTION REQUIRED 12 FINAL ELECTRIC INSPECTOR AM ..` fE INSPECTED o -6-82 BY"_,Z- ' APPROVED ( '"� REJECTED AMENTS CITY OF ATLANTIC BEACH, FLORIDA t-105'/ Approved by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: <5.30 19 ey 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. may,//_ c�oc-f , , # 4 _ ../„...„, _ I / e ELECTRICAL FIRM: MASTER ELE TRICIAN SIGNATURE JOURNEYMAN NAM- / ,. A'■--../!o:- ADDRESS:/ /1'7-4 /% - RFD BOX BLDG.SIZE BETWEEN: RES. Vi/ APT. ( ) COMM. ( ) PUBLIC ( ) INDUS. ( 1 NEW ( ? OLD ( '-T- ' REW. ( 1 ADDITION ( ) TRAILER ( ) TEMP. ( I SIGNS ( ) SQ. FT. SERVICE: NEW( 1 INCREASE 04 REPAIR ( ) FEE CONDUCTOR SIZE il, AMPS / COPPER ( ) ALUM. (L-r /,i D D SWITCH OR BREAKER c s, D AMPS / PH 3 W e`Zt6 VOLT ` .-- RACEWAY 4. -,40 EXIST.SERV.SIZE ),A) AMPS / PH 3 W VOLT ("414.....-("414.....-`�RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL — 0-30 AMPS. T 31-100 AMPS. SWITCHES INCANDESCENT _ FLUORESCENT&M.V. FIXED 0.100 AMPS. 1 OVER APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT a,S�j ,S' 1 ,o 0-1 1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA NO. KVA NO. NEON TRANSF. NO. .VA. MA. MOTOR SIZE SWITCH I FLASHER EACH SIGN FORWARDED $ TOTAL FEES 37—e)c) 000915 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERNi INFORMATION - LOCATION INFORMATION -— -- Permit Number : 915 Address: 191 SEMINOLE ROAD Permit Type; MECHANICAL ATLANTIC BEACH, FLORIDA 3223:, Class of Work: ALTERATION - LEGAL DESCRIPTION - Constr.. Type: N/A Lot : Block Sect ion: Proposed Use: SINGLE FAMILY Plat Book: Page: 0 Dwellings: 0 Code: 0 Subdivision: Estimated Value: $0. 00 - - --- OWNER INFORMATION - Improv.. Cost ; $0. 00 Name: HENTOSH Total Fees: $20. 00 Address: 191 SEMINOLE ROAD Amount Paid: $20. 00 ATLANTIC BEACH, FLORIDA 32237, D.--tte PM:di P./R -3 Phone: (904)246- 6721 "tiA,it.J12 IJI* EXISTINu SYSTEM 2. 5 TON 164f, CONTRACTOR( ) - APPLICATION FEES - ---- !-JUXHAZ HLATINO & AIR PERMIT 420.ilb$L1 WATER IMPACT FEE $0. 00 SEWER IMPACT FEE forl WATER METER RADON GAS 11, R $0. RADON GAS - 5% $0. 00 WATER TAP $0. 00 SEWER TAP $0. 00 HYDRAULIC SHARE $0. 00 RE-INSPECT FEE $0. 00 ENGINEERING $0. 00 OTHER (I, -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 MECHANICS' 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 FOF VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT By: pe .i PERMIT NUMBER BUILDING AND ZONING INSPECTION DIVISION CITY OF JACKSONVILLE, FLORIDA 49,'64? i APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I, II, III, and IV. I. Street Address: LOCATION And ---- Intersecting Streets: Between - - OF -- - - BUILDING Sub-division --- --- II. IDENTIFICATION — To be completed by all applicants In plans ns alder tiiwh given ich are a part hereof andsindescribed accorrdance the withabove the City tof statement ordinances perform and standards of good practice listed the therreinattached plans and specifications State Certification or / —e9 a y y 5 Mechanical Registration Number ; :: Ar r/ ID/ Number Signature I .. ."4/ ._/ Signature of Property Owners O, ,'\// Architect or Engineer Name .. t III. GENERAL INFORMATION A.Type of heating fuel: B. IS OTHER CONSTRUCTION BEING DONE ON —--_-- _ THIS BUILDING OR SITE? —---- Electric H LP Gas H Natural Gas IF YES, GIVE NUMBER OF CONSTRUCTION 1-7 Oil ❑ Solar ❑ Wood PERMIT --Other-Specify— -_- NATURE OF WORK IV. MECHANICAL EQUIPMENT TO BE INSTALLED A.NATURE OF WORK Condo Apt. H Duplex (Provide complete list of components on back of this form) WHeat: A. a Space B. C Recessed C. Left entral B. ❑ Commercial D. H Floor ❑ Fire Place Li Wood Stove C. ❑ New Building ❑ Air Conditioning: A. it-to-Air Heat Pump D. H Existing Building B. ❑ Water-to-Air Heat Pump C. L7 Straight Water Cool E. i Replacement of existing system D. Li Straight Air Cool F.F. --! New installation (No system previously installed) 71 Duct System: Total Capacity cfm G. L7 Extension or add-on to existing system LI Refrigeration H. H Mobile Home El — g.p.m. -- — Cooling tower: Capacity_______________________ I. H Other. H Fire sprinklers: Number of heads -- L; Elevator ❑ Manlift 1-J Escalator_--__--(number) Li _ (number) THIS SPACE FOR OFFICE USE ONLY Gasoline pumps — (number) (Received) LI Tanks (number) ---- ❑ LPG containers — --- Remarks —_-------------- - L Unfired pressure vessel --__-- ❑ Boilers roved by _ ------Date —_ — El Rangehood Permit App —. — -- 7 Cooking Equipment Permit Fee_----- --- E Water Heater ❑ Gas Piping LIST ALL EQUIPMENT Approving EER A AIR CONDITIONING AND REFRIGERATION EQUIPMENT Ca Agency & COP Description Model Number Manufacturer (Tons) g n enc y — Number Units --- — / �urrerr _ _ Approving HEATING - FURNACES, BOILERS, FIREPLACES Capacity AA Agency Description Model Number Manufacturer (BTU) 9 Number Units _ 0 -- TANKS Name of Serial Approving Nominal Capacity Type Liquid No. Approving How Many y Contained Manufacturer and Dimensions PS-428 FOR OFE ONLY Date / .` 4.- 19 k L1 TA ,,, 1 Qua Permit #k-_ .1--� YFee$ V '^ CITY OF ATLANTIC BEACH Valuation $` a . FLORIDA House # .. i'W --):"Win eVecte 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.Date 21 , 1960 Owner HARRY E. QUEEN Address 962 S' JQENS___BLUF.F_--B9lephone No.____RA5...4f3-4?+ Architect Address Telephone No. Contractor Builder Address Telephone No. Lot No. 6�7 Block No.__ Sub Division SALT AIR SEC,____1 Zone /q D igee�i�tve Side Between and Sts. Valuation $-__5000.00 For what purpose will building be used residence Type of construction CB 21++•8"X1+8 1 Dimensions of Lot 100X 50 Size of Footings 8"x20" Dimensions of Building Greatest Sill Span in ft. Type Roof ��210 thick butt Size of Sills Size of Piers sh Lugles How will Building be Heated? space heater Will Building be on Solid or Filled Ground? .50.13.a. Size of Ceiling Joists 2x6 , Distance on Centers 16" Greatest Span 12• " Size of Floor Joists bpi ,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 7 j 3. When steel is in place and ready to pour beam. o 4. When framing is completed. S 3 5. When rough plumbing is completed,and ready to cover up. W W A 6. When septic tank drain field or sewer is laid but before it is covered. q m 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 t•e attached pl ns and specifications, which are a part hereof, and in accordance with the building regulations of the City o tlantic Beach, ' '� Address Signature of Builder__ "_ --d - r Address 962 STJOIINS---BLUFF_-_RD- JACKSONVILLE, Signature of Owner H' E• '' '' FLA.