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284 Seminole Rd (vault) (2) BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL.IN NUMBER IMPORTANT — Applicant to complete all items in sections I, II, III, and IV. I, 2 i LOCATION Street Address: U it-, ( tie L /J���O . OF Intersecting Streets: Between 4 7 1 Lejv� 7)i ( /S /t/ t'1r And BUILDING Sub-division IL IDENTIFICATION — To be completed by all applicants 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 attachLed plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards • of good practice listed therein. Name of Mechanical A Con tractors P/ Contractor (Print) Con.-FOf-14b t'N vlrc�yMtp/ 1 Master C/I i L ?j y/ d 7 � Name of V Property Owner Signature A of Signature of or Authorized Agent Agsnt r Architect or Engineer — III. GENERAL INFORMATION A' Type of heating fuel: B. IS OTHER CONSTRUCTION BEINGy/pONE ON a Electric THIS BUILDING OR SITE? I ❑ Gas—❑ LP ❑ Natural ❑ Central Utility IF YES, GIVE NUMBER OF CONSTRUCTION ❑ Oil PERMIT /ch.1G ❑ Other — Specify IV. AMMAN' IMCMANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK (Provide complete list of components on back of this form) [I Residential or ❑ Commercial (a/ Heat ❑ Space ❑ Recessed 0 Central ❑ Floor ❑ New Building W Air Conditioning: ❑ Room ❑ Central ,/Existing Building /d Duct System: Materiel - Thicknese R Replacement of existing system Maximum capacity c.f.m. —/❑ New installation(No system previously installed) ❑ Refrigeration LW Extension or add-on to existing system ❑ Other — Specify ❑ Cooling tower: Capacity g.p.m. ' ❑ Fire sprinklers: Number of heads ❑ Elevator ❑ Menlift ❑ Escalator (number) THIS SPACE FOR OFFICE USE ONLY ❑ Gasoline pump. (number) O ❑ Tanks (number) Remarks ❑ LPG containers 5 (number) ❑ Unfired pressure vessel ❑ Boilers Permit Approved by Date ❑ Other — Specify Permit Fee LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT ty Approving Number Units Description Model Number Manufacturer ( ) XiencY PPeA oLL3AL gNz , J' HEATING - FURNACES, BOILERS, FIREPLACES Capacity Approving Number Unita Description Model Number Manufacturer (BTU) Agency A :r f-IAat►er X841 AzIJ ekt2'_ 3 , f TANKS How Many NoQtnal Capacity Type Liquid Name Of Serial Approving and Dimensions Contained Manufacturer No. Agency • CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233 - Tel: 247-5826 - Fax: 247-5877 PLUMBING PERMIT Permit Number: INFORMATION t . LOCA IOI INiFORMATION ber: 19619 — um Address: 284 SEMINOLE ROAD Permit Type: PLUMBING ATLANATIC BEACH, FL 32233 Class of Work: ADDITION Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s):467 Block: Section: Square Feet: Subdivision: SALTAIR Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION Date Issued: 2/18/2000 Name: BOORAS, CHRISTOPHER L. Total Fees: 36.00 Address: ATLANTIC BEACH, FD 32233 Amount Paid: 36.00 Date Paid: 2/18/2000 Phone: (000)000-0000 Work Desc: INSTALL PLUMBING a E CONTRACTOR-° "" ' .z. ''`, .. :, ,Z�i p �o� . _ WEEK'S PLUMBING COMPANY PERMIT 36.00 _ ., . _ t TOPOUT FINAL NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING N DEBRIS PUBLIC SPACE, A ND MUST BE C EARED UP AND HAULED AWAY BY E THER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION 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-4"- ictereos_____ $36.60 14 '�^—_ Date: 2118/66 61 heceipt: 6635921 ATLANTIC BEACILD T. CHECKS 5466 66tafi632210a6 CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: ;. /(/ cf 1 Le- (2.4.,c-c4 OWNER OF PROPERTY: r►1 t't-fl obit. (3,=.0a4;4-S TELEPHONE NO. PLUMBING CONTRACTOR i e '-J I910,n, 6Y6 -S-Y6 CONTRACTOR' S ADDRESS : f 3 te-a `, joie, f/A. 321-4 'b STATE LICENSE NUMBER: CFCs c$ t c TELEPHONE: 0/6-SY" HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS I SHOWERS LAVATORY I WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS I WASHING MACHINE FLOOR DRAINS SHOWER PANS SEWER WATER REPIPE OTHER TOTAL FIXTURES : x $3 . 50 + $15 . 00 MINIMUM PERMIT FEE - $25. 00 SIGNATURE OF OWNER: ���--9 " . . SIGNATURE OF CONTRACTOR: ( -, 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 1 141 �Q,`�I CITY OF 4 4I1ad'c Beach-4laiuda 9( 10 Office of Building Official REQUEST FOR INSPECTION Date /^ 5( —0 0 Permit No. /93-3 Y Time M. Received M. N C9' W i i : / Claf Jo Address Locality Owne Name 0 4 0 Contra, o .. Ai!1 BUILDING CONCRETE C ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole Top Out ❑ Heating Insulation ❑ Lintel ❑ Final Sewer ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION /// A.M. Mon. ( Tues.D Wed. Thurs. Friday P.M. A.M. Inspection Made `— P Inspector Final Inspection II r - " . • . upancy❑ Date CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233 -Tel: 247-5826 - Fax: 247-5877 ELECTRICAL PERMIT PERMIT INFORMATION LOCATION INFORMATION Permit Number: 19534 Address: 284 SEMINOLE ROAD Permit Type: ELECTRICAL ATLANATIC BEACH, FL 32233 Class of Work: TEMPORARY POLE Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s):467 Block: Section: Square Feet: Subdivision: SALTAIR Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION Date issued: 1/31/2000 Name: BOORAS, CHRISTOPHER L. Total Fees: 25.00 Address: 284 SEMINOLE ROAD Amount Paid: 25.00 ATLANTIC BEACH, FL 32233 Date Paid: 1/31/2000 Phone: (000)000-0000 Work Desc: ESS100AMPS OVERHEAD TEMPORARY POLE [_ CONTRACTOR(S) _ APPLICATION FEES LAWSON ELECTRICAL CONTRACTORS PERMIT 25.00 ( SC) 1 r Inspections Required 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. ATLANTIC BEACH BUILDING DEPT. ' CITY ITY CIF ATI ANTIC REACH V. . DEPARTMENT OF BUILDING 800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL 247-5826-FAX 247-5877 PERMIT INFORMATION_ - LOCATION INFORMATION__ [Permit Number: 19550 �_ A.-trireme: 284 SEMINOLE ROAD —_ Permit Type: ROOM ADDITION ATLANATIC BEACH, FL 32233 Class c cis_rk: ALTERATION own hip Range: Book:trldbb VI Proposed Use: SINGLE FAMILY Lot(s):467 Block: Section: Square Feet: Subdivision: SALTAIR Est. Value: Parcel Number: I improv, Cost: 23,000.00 OWNER INFORMATION'. Date Issued: 2/04/2000 Name: BOORAS, CHRISTOPHER L. Total Fees: 387.50 Address: 284 SEMINOLE ROAD Amount Paid: 387.50 ATLANTIC BEACH, FL 32233 Date Paid: 2/04/2000 Phone: (000)000-0000 Work Desc: CONSTRUCT ADDITION; REFRAME ROOF ETC ` APPLICATION FEES_ CONTitAC:�bR(5...) : .� .: , . . , } , ,_ 'i 87.50 MARK GAUTHIER BUILDING CONTRACTO PERMIT ATER IMPACT FEE 200.00 Inspectfons'Reglilred FOOTING 1SLAB COVER UP I FRAMING i FINAL BUILDING ;INSULATION i 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. Operator: ANIER ti--- Date: 2/87/88 81 Receipt: 8832131 T NTIC BEACH BULL G DEPT. JL Total Payment $387.58 _ CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address 2--AN S6 04/NOL� /'LQ, (froirio ) Date ' � - OCR Heated Square Footage @ $ per sq ft = $ Or Garage/Shedd—@ $ per sq ft = $ Carport/Porch @ $ per sq ft = $ Deck @ $ per sq ft = $ Patio U t I @ $ per sq ft = $ • p0 TOTAL VALUATION : $ 9'3 j 000 j3/ oo a �� (A) $ a `) Tot Valuation 1st $ oo� ,Gw $ Rio . NJ Remaining Value $,S per thousand or portion thereof TOTAL BUILDING FEE $ /-25 .c') + 1/2 Filing Fee $ ( ) Fireplaces @ $15 . 00 $ —CD— BUILDING PERMIT FEE S /27. 5 WATER IMPACT FEE $ op O©. d o SEWER IMPACT FEE $ _ WATER METER/TAP $ CAPITAL IMPROVEMENT $ SEWER TAP $ ( ) RADON (HRS) . 0050 S SECTION. H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ( ) SURCHARGE . 0050 $ OTHER $ GRAND TOTAL DUE $ 3 gs 7 ADDITIONAL PERMITS OR FEES : Mechanical ; Plumbing Electric/New Electric/Temp ; SwimmingPool Septic Tank ; Well ; Sign Finish Floor Elevation Survey ; Other CALCULATIONS and/or NOTES : ' WINIlNCIAt PRIM ING CON.4414i •5 MIN. RETURN PHONE " 22134Cf 'Uutice of Commencement Book 9536 Page 2199 t►R[TARE IN DUPLICATR) 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. /7, Description of property /Y .'2� A2Ce • General description of improvements __ �-F(- � --.il rX Y1 I Owner ('RXI'S' StatfAaii(e 3 OO1Z S f r Address Z gY C5-1411121) CyePi 3c/‘ 322,33 Owner's interest in site of the improvement ®�i•'1C� Fee Simple Title holder (if other than owner) - Name - Address /f/f �Q�� --+�[,/ - -- Contractor __-441+ 2� C�`` i� ---- - r Address E 3�o✓ i ,( SL 'OCAI 6 2P `J` F L 32_i V,6 Surety (if any) -- Address Amount of bond j_ Name and address of any person making a loan for th- construction of the improvements. Name ------- - Address 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 ------------------------------------------------------------------------------------------ In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06 [2] [b], Florida Statutes. (Fill in at Owner's option). Name --------------------------------------------------------------------------------------- Address -------------------------------------------------------------------- - ------ THIS 'FACIE FOR RLCORDER'• WPC ONLY Book: 953327626 Page: 2199 • Fj'4247R00orded Sworn to and subscribed before me this. HENRY Y OOY, il'4D•54 AM CLERY, CIRCUIT COURT g 5 day of d 1 v Vl 11 1 Z-!O� DUVAL COUNTY TRUST FUND 5tk_�� RECORDING $ 1.00 $ 5.00 Notary Public --% MEI MY COMMISSILISSA OA.N W k CC NTER 873833 . :. a= EXPIRES:January 12,2001 4,;10'. Bonded Thru Notary Public Underwriters FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION \\ n( M 6000 97 Rest ent �I t ' te.t pplicati ns Drescriptive Method ( NORTH 1 2 w I FORM 6000 RGJI4GIIL1�1 L.IIIIILG4 ILI,FlIIMQtIVIIJ I• ISmall Additions,Renovations&Building Systems Department of Community Affairs Compliance with Method C of Chapter 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 6000.97 for additions of 600 squOre feet or less,site-installed components of manufactured homes,and renovations to single and multifamily residences. Alternative methods are provided for additions by use of Form 600B-97 Or 600A-97. PROJECT NAME: ?n�o� BUILDER:44 .K ' AND ADDRESS: Jf/ O , tj: PERMITTING CLIMATE 4-1-6- OFFIC947-44,,inC &A4/. ZONE( 1 2 3 Y OWNER: ��--�/� � � ' PERMITNO.: / 95S") JURISDI TI0NNO.: 2lO ( r e^ U re 0 SMALL ADDITIONS TO EXISTING RESIDENCES(600 Square feet or less of conditioned area). Prescriptive requirements in Tables C-1,6C-2 and 6C-3 apply only to the components of the addition,not to the existing building. Space heating,cooling,and water heating equipment efficiency levels must belmet only when equipment is installed specifically to serve the addition or is being installed in conjunction with the addition construction. Components separating unconditioned(spaces from conditioned spaces must meet the prescribed minimum insulation levels. RENOVATIONS(Residential buildings undergoing renovations costing more than 30%4f the assessed value of the building). Prescriptive requirements in Tables 6C-1 and 6C-2 apply only to the components and equipment being renovated or replaced. MANUFACTL ED HOMES AND BUILDINGS.CK Only site- installed components and features are covered by this form.BUILDING SYSTEMS Comply when complete new system is installed. Please rint 1. Renovation, Addition, New System or Manufactured Home 1. • I/crin 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. _ �-- 5. Predominant eave overhang (ft.) 5. 6. Glass area and type: Single Pane rouble Pane a. Clear glass 6a. sq.ft. sq. ft. b. Tint,film or solar screen 6b. sq. ft. sq. ft. •7. Percentage of glass to floor area 7. 1 1 8. Floor type and insulation: a. Slab-on-grade (R-value) 8a. R= lin. ft. b. Wood, raised (R-value) 8b. R= sq. ft. c. Wood, common (R-value) 8c. R= sq.ft. d. Concrete, raised (R-value) 8d. R= sq. ft. e. Concrete, common (R-value) 8e. R= sq.ft. 9. Wall type and insulation: a. Exterior: 1. Masonry (Insulation R-value) 9a-1 R= sq.ft. 2. Wood frame (Insulation R-value) 9a-2 R= j 3 41 - 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 R-value) 10a. R= sq. ft. b. Single assembly(Insulation R-value) 10b. R= sq. ft. 11. Cooling system* r (Types: central, room unit, package terminal A.C., gas, existing, none) 11. Type: 4 SEER/EER:�_ ( -, ---- 12. Heating system*: (Types:heat pump,elec.strip,natural gas,L.P.gas, 12. Type: (` I 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 water system: 14. Type: (Types:elec.,natural gas,other,existing,none) EF: *Pertains to manufactured homes with site installed components. I hereby certify that the •fans and specifications covered by the calculation are in Review of plans and specifications covered by this calculation indicates compliance compliance with the Flail, Energy a... with the Florida Energy Co efore constn. n is co pleted,this building will be PREPARED BY: / % DATE: -LS_QV inspected for compliance i accordance with ton .908,F.S. I hereby certify that this• i Lin•is i complia ce with the Florida Energy ode. 9 BUILDING OFFICIAL �7 OWNER AGENT: I J.t ✓-. '�- DATE r 7 C.�� DATE: 2 - ! - "`� Climate Zones 1 2 3 TABLE 6C-1: PRESCRIPTIVE REQUIREMENTS FOR SMALL ADDITIONS(600 Sq.Ft.and Less),RENOVATIONS TO EXISTING BUILDINGS AND SITE-INSTALLED COMPONENTS OF MANUFACTURED HOMES. MINIMUM INSULATION MINIMUM INSTALLED COMPONENT INSULATION INSTALLED EQUIPMENT EFFICIENCY EFFICIENCY Concrete R-7 Central A/C-Split SEER = 10.0 SEER = (29 Frame,2'x 4" R-11 /3 z -Single Pkg. SEER i = 9.7 SEER = Frame,2"x 6" J R-111 oo Room unit or PTAC EER = 8.5* EER = Common,Frame o Common,Masonry R-3 Single Assembly;Enclosed z Electric Resistance ANY Under Attic R-30 3/6) Electric pump-Split HSPF = 6.8 HSPF = - z Frame R-19 a -Single Pkg. HSPF = 6.6 HSPF = Metal Pans R-13 "' Room unit or PTHP COP = 2.7` HSPF/ _ U Single Assembly;Open R 10 u, i COP Common,Frame R-11 Gas,natural or propane AFUE = .78 AFUE = cc Raised No Minimum Fuel Oil AFUE = .78 AFUE = 0 Raised Wood R 19 O Raised Concrete R-7 Common,Frame R-11 m Electric Resistance EF = .88 EF = , °a Gas; Natural or L.P. EF = .54 EF = In unconditioned space R-6 �` .2 Fuel Oil EF = 54 EF = o In conditioned space No minimum `See liable 6-3.6-7 TABLE 6C-2: PRESCRIPTIVE REQUIREMENTS FOR GLASS AREAS IN ADDITIONS ONLY f Maximum percentage glass to floor area allowed is selected by type,overhang length,and shading coefficient. Maximum%= ep Q Installed%= I GLASS TYPE,OVERHANG,AND SHADING COEFFICIENT REQUIRED FOR GLASS PERCENTAGE ALLOWED 30%UP TO 20% UP TO 30% UP TO 40% UP TO 50% Single Double Single Double Single Double Single Double OH-SC OH-SC OH-SC OH-SC OH-SC OH-SC 1H-SC OH-SC 1"-1.0 0"-.90 2"-1.0 1"-.90 2"-.90 3'- .90 0"-.86 1"-.86 0"-.70 NOT 1"-.70 oft OWED 2"-.50 0"-.65 ALLOWED Cr-.50 AU LOWED "-.40 SHGC or SC may be obtained from the manufacturer. Single clear SC=1.0,double clear SC=.90,and single tint 6C=.86. SHGC .87=SC TABLE 6C-3 MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REQUIREMENTS CHECK Exterior Joints&Cracks 606.1 To be caulked,gasketed,weather-stripped or otherwise sealed. v Exterior Windows&Doors, 606.1 Max.0.3 cfm/sq.ft.window area;.5 cfm/sq.ft.door area. Sole&Top Plates 606.1 Sole plates and penetrations through top plates of exterior walls must be sealed. Recessed Lighting 606.1 Type IC rated with no penetrations(two alternatives allowed). , Multi-story Houses 606.1 Air barrier on perimeter of floor cavity between floors. Exhaust Fans 606.1 Exhaust fans vented to unconditioned space shall have dampers,except for mbustion devices with integral exhaust ductwork. Combustion 606.1 Combustion space and water heating systems must be provided with outside combustion air, Heating except for direct vent appliances. Water Heaters 612.1 Comply with efficiency requirements in Table 6-12. Switch or clearly marked circuit breaker(electric) �/ �r or cutoff(gas)must be provided. External or built-in heat trap required. I Swimming 612.1 Spas&heated pools must have covers(except solar heated). Non-commercial pools must have a Pools&Spas pump timer.Gas spa&pool heaters must have minimum thermal efficiency of 78%. Hot Water Pipes 612.1 Insulation is required for hot water circulating systems(including heat recovery units). Shower Heads 612.1 Water flow must be restricted to no more than 2.5 gallons per minute at 80 PRIG. HVAC Duct 610.1 All ducts,fittings,mechanical equipment and plenum chambers shall be mechanically attached, Construction, sealed,insulated and installed in accordance with the criteria of Section 610.1. Ducts in attics must be Insulation&Installation i nsulated to a minimum of R-6. Air handlers shall not be installed in attics unless in mechanical closets. HVAC Controls 607.1 Separate readily accessible manual or automatic thermostat for each system. GENERAL DIRECTIONS: 1. On Table 6C-1 indicate the R-value of the insulation being added to each component and the efficiency levels of the equipment being installed.All R-values and efficiencies installed must meet or exceed the minimum values listed.Components and equipment neither being added nor renovated may be left blank. glass doors and glass door panels. Double the area of all non- vertical ADDITIONS ONLY Determine the percentage of new glass to conditioned floor area in the addition as follows. Total the areas of all glass windows,sliding g gl P vertical roof glass and add it to the previous total.When glass in existing exterior walls is being removed or enclosed by the addition,an amount equal to the total area of this,glass may be subtracted from the total glass area. Divide the adjusted glass area total by the conditioned floor area of the addition.Multiply by 100 to get the percent.Find the largest glass percentage under which your calculated percentage falls on Table 6C-2.Prescriptives are given by the type of glass(Single or Double pane)and the overhang(OH)paired with a shading coefficient(SC). For a given glass type and overhang,the minimum shading coefficient allowed is specified. Actual glass windows and doors previously in the exterior walls of the house and being reinstalled in the addition do not have to comply with the overhang and shading coefficient requiresients on Table 6C-2. All new glass in the addition must meet the requirement for one of the options in the glass percentage category you indicated.The overhang(OH)distance is measured perpendicularly from the face of the glass to a point directly under the outermost edge of the overhang. 3. RENOVATIONS ONLY. Replacement glass needs to meet the following requirements. Any glass type and shading coefficient may be used for glass areas which are under at least a two foot overhang and whose lowest edge does not extend further than 8 feet from the overhang. Glass areas being renovated that do not meet this criteria must be either single-pane tinted,double-pane clear a double-pane tinted. 4. BUILDING SYSTEMS.Comply when new system is installed for system installed. 5. Complete the information requested on the top half of page 1. 6. Read°Minimum Requirements for Small Additions and Renovations",Table 6C-3,and check all applicable items. 7. Read,sign and dale the"Owner/Agent"certification statement on page 1. -2- . RECEIVED CITY OF ATLANTIC BEACH AN l l PERM"T APPLICATION =CD= ADDITIONS, OR aLTERATIONS ity Of Atlantic Beach MOVING, DEMOLITIONS guiiding and Zoning Owner s) : C C&'S aV.VAC/4 /P, ( 2oDYQs Job Address: Z1t/ SV) l((/,1,0C. ?hone: ?0 - Qr Lot T Block or Unit T Subdivision: Contractor: 4W.-/-' 674.4.474-tele_ State License = CBCOs70YV Address : 3503 '64,0S-tleow pp ?hone No: 7 '2- — goon Cl: ! . -CkS oiJ )(c-C_c-c- 3g-Q Y'( e we r k c - • 4,44 tom'' !r K l cy r G � A i' 1/ (/0n7) /Lt,c 17 404 Oc>a- e C(S'/ a 4C n5'11 - resent use f o _ . u _O_ _ cS 'i ' , wl/l'9(�/UC �"' Valuation __ ccsed o.^.s=-_cc_�__. / p� 3) o0V 49- c�s e _: /11, 36 ,e /$,41-72? / LX)I/ef Is this an ad:_=-on? If Yes, what are the dimensions of the addeC / space: 11 =_ . X qv( ft . ;4i'_'_ the added area be heated and New #‘' �‘--- or increase) . ?yes New plumbing, =_xtures? /E�5 New ace? New Heat/?_C? SUBMIT THRFC' ;COMMERCIAL) TATO (R.�.S:.D rTIA L) COMPLETE SETS OF P.T.ANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOT= OF COMMEYNT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER . Date: /- .2-C---19 0 Signature CONTRACTOR: _ Date: /— 62S-- 00 AS TO OWNER: Sworn to and subscribed before me this ✓C, day of/�J(,�i1V�I/� ja�rq,V/ / 2�D gµY MELISSA A.WINTER • V i/L- �/�/�/l/1' l/L- R lA/ MYCOMMISSION#CC873833 NOTARY PUBLIC is EXPIRES:January 12,2001 AS TO CON' r;.i 4° :Bonded Thru Notary public Underwriters Sworn to and subscribed before me this day of ���a V 2.00 NOTARY PUBLIC •. �■��'''•, MELISSA A.WINTER *;p.s '* MY COMMISSION#CC 873833 EXPIRES:January 12,2001 '�pf ad:` Bonded Thru Notary Public Underwriters CITY OF ATLANTIC BEACH Fixture Unic Worksheet for Water Impact Fee FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WAT°R SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TWENTY DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. BATHROOM GROUP CONSISTING OF SERVICE SINK TRAP S T AND WATER CLOSET. LAVATORY & BATH (8) TUB OR SHOWER STALL (6) Q WATER CLOSET WATE2 CLOSET. TANX OPERATED (4) VALVE OPERATED (3) BATHTUB/SHOWER (2) URINAL URINA� GAL L L.? (.) SHGHER GROUP PER HEAD (3) 3 FLOOR DRAIN (1) O SHOWER STALL DOMESTIC (2) LAUNDRY RY TR.=.y (2) rLAVATORY (1) I COMBINATION SINK ANC TRAY (3) WASHING MACHINE (3) POT, SCULLERY S_./ ;-) DISHWASHER (2) WASH SINK EACH SET OF FAUCETS (2) KITCHEl SINK (2) DENTAL LAVATORY (1) KITC HZ3 SINK WITH WASTE' MENTAL UNIT CR CUSPIDOR (1) GRINDER (3) DID£- (f) URINAL STALL, WASHOUT (- FLUSHING R;.'! SIB (8) COMBINATION SINK AND TRAY WITH 4 FOOD DISPOS. (4) URINAL, PEDESTAL., SY?HON JET DRINKING FOUNTAIN (1/2) BLOWOUT (2) LAVATORY, BARBER/BEAUTY ICE MAKER (I/2) SECP (2) SURGEONS SINK (3) LAVATORY, SURGEONS (2) JACUZZI (2) URINAL STALL, WASHOUT (4) TOTAL FIXTURE UNITS / 0 A $20.00 EACH $ 2 GO, (1 0 JOB INFORMATION O- (/ /`-i//0,eL L' (90t { IOC-/ ...?,. ,' •...1,:r , 1?“i7,7ri,141.sin::)171MIMTVIrl.t .67%.',..':,.. -,:,,Fistifottirri...'...- 4k:4'1:Qv ' • 24440/4?:' ' 'ITV LOT 46 7,.P LA T C F ,:-.`2( •71::,V .'\! ;. .:':',;: -/..iii; 4 re'°ROL'',(, TO THE PLAT THEREOF AS' RECORD.E.D :. 1.V PLAT BCOi.' 10,FA C.17 8, OF ;III' C'T.I.RIEN'T PUBT,IC RECORDS OF DUVAL COUNTY, FLORIDA. -00 $ 10 20 40 R , ...i.:4„,,..,..„.., _______ . Err - 4.w, _ wrimpirm, t4 14 1 4."•A•HIC: CALL .. SCALE 1...70' IAN 3120 LI : NoTEs: II 1. ANGLES ESTABLISHED IN THE F•ELD. 2. FIELD WORK 1/27/92 Builstio zo n cg an IA- ii City of Atlanatic each Prj 41 n . t 6 4, , 0 (c. .. CiV3uCii \,) F FLDAILLGANoTIrCriBcEEACH ES 04 00 PLAT ik3/4.L..L.... ...„4-,------ 5 .0 ' - 4.9 H9' C09ii=UED 6. ..:-...,.....X____ FOUND I/2* !.1 AN LINK FOUND 1/2' 1.P, t.---- 1 1 .--il9"35.0. 90'28'49' ,. '.: • 1......, t 1 4 CH ATN UNK 1°-»1-'1 • • A ._, 24.00' 4' CHAIN LINK FENCE ( .8. \r , i 11.0o. ...)O. ta - ONE STORY G BLOCK •. i JJ *-1-1;,^7-. AND FRAME 4,.., HOUSE NO. 2B4 t.,t p C .) -o , ;I 1 ' •.<1. . ' 5 C..) t6C. ° Li • - .e , . r 0 A.6t, ,,. "--,47,, t..,.1 i• • i CU': 5 ■ ilt.,...7,6oL ; . . 4. 1...›,4..• .--- a 14.70 _____y= 'h' 7 1 ■1.701 • .<! fy 11.4 ... .0 DRIVEWAY ' ELECTRIC LINE X. . • .6 . ,O( ' 1,i.i... .... •4° 901)8'29 Th ;',.ei .' y 01 89'47'42' CT) t 4 - FOUND P.R.M. 'FOUND 3/4' LP. FOUND 1/2" I.P... , ' ', ' '±---- ,-; -* 1- 50 00' PLAT AND COMPUTED 56766 SEL/III.N017,.1"7 (701 R/W) ROAD 14 ( i'ORMERLY SALTAIR BOULEVARD ) i 920049 00/92 - - ------------- ",e Vtlrbi PAM-rtRNAP?TAT PrigNri wit/yaw A/C Pt so I.1-I API? c coviTiostra . •ji .....,.:•-- Pttkr&ENT aafrne#4,t, rci.tre,t„,,-..a wc-oNzso 1,r.-IPIOly l'ApA (.1 .44..4vAil -Pc,r,N4T tr ccw.,}01to:traNa* p.c.c.-rri,-.- G. criscr- .,,,,,r, clipm X EJ. illtrOrjr3 rtnArr 07 prfairlzrr or roworimito .. .. P.I:,0.-It'1 NT OF P.","Y XX"' CUPS!,g' 1FLL-13 wcit _ T.-orrmax. §xxlmnos wow*? nAr-Ixtrillr Or r.42. 4- 6 .",,r. -POINT PP ratANDPAT;,.,• :'-. pr-rAtaw r/r.-row s ri !viz If DX10:17W hInt".7 = 0 -411r0P-IfP 119t.-TquAttr POCI' r00.00 --ro AT S' DVAMS*3 ZOCrrif k: fl t?. A Rit-NW &AGA' .12, -.041.:A ARVI.at 0 DZATtrX3 tin' 1 tr-LcLAVIN'ar72..ItAriVe.A.MEATIV r4uttE...14-NTSIX- _r&ALL:Tzrirdsk.ja422gr 112... ._.r 3 in :-. 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'' 1-6 -9 r 1 . 1 1`� In (i I V 7 • v t, t. t• , I t t C.r ti c 4`it) / IS,i3- n 6 `, �•` y - r t,i� ceoc , f3Cock y 13YS Lb n;. 1 CZ. --C.-t) W I c\� _-- :t bq<' A -i►i' 4'I.�Nt k ' 96E : ; 6A13jE 6XV) l^ a xi 6 I �.. k � Z- ) M vC` 4-.0 <t - V Ci vl = `I f.-, b IcIp c. c V I ' 1— i J �� .c __v t-) — .., 3 -� l7u v) 4 O qi CITY OF ATLANTIC BEACH, FLORIDA ���� • Approved by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: J // le- 261) 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 TILE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL FIRM:6AW ielec red MASTER ELECTRICIAN SIGNATURE�GtJ''�A� gakvIWIJOURNEYMAN NAME -800 Ca . ADDRESS:_? ,J em'7 i 4o/t RFD BOX BLDG.SIZE BETWEEN: /7/42G d / /4/d C 2//d RES. ()() APT. ( ) COMM. ( ► PUBLIC ( I INDUS. ( ) NEW ( ) OLD ( ) REW. ( ADDITION ()() TRAILER ( ) TEMP. ( I SIGNS ( ) SO. FT. SERVICE: NEW ( ) INCREASE ( ) REPAIR ( 1 FEE CONDUCTOR SIZE AMPS COPPER ( ) ALUM. ( ) SWITCH OR BREAKER AMPS PH W VOLT RACEWAY EXIST.SERV.SIZE ,ZQn AMPS / PH 3 w 240 VOLT $ RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES (7 CONCEALED OPEN TOTAL _ 0.30 AMPS. 31.100 AMPS. SWITCHES V J INCANDESCENT C, FLUORESCENT&M. V. FIXED 0.100 AMPS.I ovEn I APPLIANCES It BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CELL HEAT: KW-HEAT 0-1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 II.P. VOLTAGE PHS MISCELLANEOUS /YIOVe fe ft.',C e u-) r e /.67c7/71,Z2/ I HANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA NO. KVA NO. NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHER EACH SIGN • FORWARDED TOTAL FEES CITY OF ATLANTIC BEACH i DEPARTMENT OF BUILDING 800 Seminole Road-Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 ELECTRICAL PERMIT PERMIT INFORMATION- -?� �' � LOCATION-1NFbR# AT`� - •7".5.7-,i---:: Permit Number: 19585 Address: 284 SEMINOLE ROAD Permit Type: ELECTRICAL ATLANATIC BEACH, FL 32233 Class of Work: ADDITION Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s):467 Block: Section: Square Feet: Subdivision: SALTAIR Est. Value: Parcel Number: Improv. Cost: .. ca;OWltNFORMATiON yW 3 : A Date Issued: 2/11/2000 �' Name: BOORAS, CHRISTOPHER L. Total Fees: 26.10 Address: 284 SEMINOLE ROAD Amount Paid: 26.10 ATLANTIC BEACH, FL 32233 Date Paid: 2/11/2000 Phone: (000)000-0000 Work Desc: WIRE FOR ROOM ADDITION _C TRA OR .:ate ^:a pp`" o �.. ,:; :',=:',:'-'-2r LAWSON ELECTRICAL CONTRACTORS PERMIT Y 26.10 �� n 7,74 (L 1 i ,__cj 't_ _ ;<'nspectionsRect ecr._. '" = . 6=1 - ROUGH ELECTRIC FINAL ELECTRIC I 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. $26.18 14 Date: 2/14/88 81 Receipt: 0033415 ATLA TIC BEAC BUILDING DEPT. CHECKS 725 88188883221888 2X4" H2,s 142,5 A 9" ?Q _7 ') . co: e2X4 2M ff2,S (1X94 H2,S •4 x4" 1425 H2,S 57-7,NG COA) 5CALE- /9 ''= '�'o�� -FRAM 1 n)G Lyi 41' -____ 56,00 srli V- ti / _ — 4 4'' 142.,5" 4„ H2,5 ,, d 2 X 9 )w/1 .77_ — — — — — //2,5 I 0 'c}? 1-1-23 >.c.' � c p; ? . /fas C 's 35 ROc TO EX7S / \\ , 1, ‘ 4' 2X4" m r .\ I42,5 I vr-- 2-1-/ 4'' 112,5 Ft:—, (.' 2x4 1 1.12,,5" 5 10" (42.S - `t FOR OOFFICE USE ONLY \ t"' Date__./-/__/1 _f._te)2-19 Permit # "73 I Fee$ .4--J L° CITY OF ATLANTIC BEACH Valuation $ 7 ,--&_,,..) FLORIDA House # 2.--ei _41-"x,"44- 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. Date 5C='e (//�� 0 , 196 i --- Owner/2 ( 67: C-.�• Address_ 5. 3.--,2,.r Telephone Noa.3.,41 Architect Address Telephone No. Contractor Builder —L Address I i Telephone No Lot No Block No. Sub Division 9iQ1-T Alm' ` Zone 52.-1-41.._../2‘44p,..- Street W. Side Between. 40C-104.4'Z and sEwse. `( Sts. Valuation $ •� � For what purpose will building be used /2.1. 4-1-4-1L1 Type of construction 4517 4.141 Dimensions of Building Z`f --E Dimensions of Lot .5"-e> ,�C./ > _.e, _>e Size of Piers Size of Sills Greatest Sill Span in ft. Type Roof__../,,/t/ How will Building be Heated? 64., WA Lk-Et)11.. Will Building be on Solid or Filled Ground? -e.-.4 Size of Ceiling Joists `L __r/ , Distance on Centers / r , Span " Size of Floor Joists 5g-y" ,Distance on Centers , Greatest Span " Size of Rafters i _'74-_ , Distance on Centers l , Greatest Span / 2--- a ,, 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 I W 2. When steel is in place and ready to pour columns and/or lintel. Z 7 z 3. When steel is in place and ready to pour beam. < a 4. When framing is completed. p p 5. When rough plumbing is completed,and ready to cover up. W -7 _ �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. CO 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for after N corrections are made. Y 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 ans and specifications, which are a part hereof, and in accordance with the building regulations of the Cit f tlan ea Signature of Build .ltdi-- __ — Address/ 5.- 3 g 7 /c-..j t Signature of Owner Address • Ct CITY OF ATLANTIC BEACH, FLORIDA I • S3 Approv.d by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE:_,!�'n, 3 I DOc,9 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 FIRM: L A'W f( N MASTER ELECTRICIAN SIGNATURE u..-&. ( �6..Ld1a3yOURNEYMAN NAMES a__ 600rO.5 . ADDRESS:.2ey -sal., nr2/e_ .4ci;. . _ . RFD BOX BLDG.SIZE BETWEEN: M z ,1//a✓1/i l Blue/ RES. ( I APT. ( ) COMM. ( I PUBLIC ( I INDUS. ( ) NEW ( ) OLD ( I REW. ( ) ADDITION ( ) TRAILER ( I TEMP. 0(1 SIGNS ( ) SQ. FT. SERVICE: NEW ( ) INCREASE ( ) REPAIR ( I FEE CONDUCTOR SIZE d 9 AMPS COPPER ( ) ALUM. ) SWITCH OR BREAKER AMPS PH W VOLT RACEWAY _ EXIST.SERV.SIZE AMPS PH W 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 b.10o AMPS. OVER APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CELL HEAT: KW-HEAT 0-1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 II.P. VOLTAGE PHS MISCELLANEOUS r IJ Q • - < I. &' AO 1 TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA NO. KVA NO. NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHER EACH SIGN • FORWARDED TOTAL FEES �10 Se'`•A'S Q 3zz07 O 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: 19486 Address: 284 SEMINOLE ROAD Permit Type: DEMOLITION ATLANATIC BEACH, FL 32233 Class of Work: REMOVAL Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s):467 Block: Section: Square Feet: Subdivision: SALTAIR Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION Date Issued: 1/18/2000 - Name: BOORAS, CHRISTOPHER L. Total Fees:, 100.00 Address: 284 SEMINOLE ROAD Amount Paid: 100.00 ATLANTIC BEACH, FL 32233 Date Paid: 1/18/2000 Phone: (000)000-0000 _ Work Desc: REMOVE WALLS AND ROOF OVER CARPORT CONTRACR(S _ ' y � _ , . A`PP A `:� FEES PROPERTY OWNER - PERMIT 100.00 ,,inspections Relq, .`. ;.� ae 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. 8100.00 14 Date: 1/19/00 81 Receipt: 8027842 ATLANTIC BEACH : ILDING DEP . CHECKS 3395 00100803221888 CITY OF ATLANTIC BEACH PERMIT APPLICATION REM ODEL, ADDITIONS, OR ALTERRPIONS .MOVING, DEMOLITIONS Owner(s) : CA/'i ry/94.° Z- .46700,f Job Address: jogy cc-^''"c4 4� Phone: ;'?O 'l/fq ' Lot * 76l Block or Unit *$ /J4,/- Subdivision: ' Contractor: /17///,---'k.- a0v/hoc 'Z_ State License T _ Address: ?hone No: City State Z_ Code Desc=:be work to ;e acne: 4 MV,,,,, 7 /4 GA OvL'°' GA.:000.4e,. 1~4 -7/r Present use of building: A [l.2J//i D ; J Valuation c_ Proposed Cons__ucZ_o_f_: _ropcsed use: is this an addition? If yes, what are the dimensions of the added . space: ft. X ft.f` . Will the added area be -heated and cooled' New electrical (or increase) ? New plumbing fixtures' New F; .•e^1 ace? New Heat/AC? SUBMIT THREE (COMMERCIAL) TWO (R SI=TIAL) CCMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCDMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: L� Cate: I l et-c2 067 J Signature CONTRACTOR: Date: AS TO OWNER: ��— y / Sworn to and subscribed before me this •a of /�il , Jr/WC)-1 AVAIrdA—t-L■ adrill....--,—NOTARY PUBLIC AS TO CONTRACTOR: — — .. 1-1? _ Patricia A one __ -__ --------- --- - 'yi, a,,,,r ; M1'COMMISSIO ,y-CC � Sworn to and subscribed before me this day of o Aupusty7 se mt F;�p;•q ; BONDED TNRU TROY FAIN INRIooNCE,oc, NOTARY PUBLIC