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ANY WELL MUST, BE
IN COMPLIANCE WITH
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ANY SEPTIC TANK MUST BE
IN COMPLIANCE WITH
MPS TABLE 6-15.2
PLOT PLAN SCALE
FOR
LOT �_ BLOCK_ ._ �^"� 2
IN
ED SIMS RESIDENTIAL DESIGN SERVICES
ORANGE PARK, FLORIDA 32073
////&ss,, CITY OF
fYIge4,c,4-rt
Office of Building Official
REQUEST FOR INSPECTION
�J -0
Date / _ n — O Permit No.
Time A.M. C
Received `[ P.M.
/ S
Job Add r ss /�c�� ( CLocality
Owner's lity
Owner's
Name Y� Contractor
BUILDING CONCRETE ELECTRICAL PLUMBING MEC ANICAL
Framing Footing ❑ Rough Wiring ❑ Rough ❑ Air Cond. & r;
Re Roofing Slab ❑ Temp Pole ❑ Top Out ❑ Heating
Insulation Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑
Pre Fab
READY FOR INSPECTION
A.M.
Mon. Tues. Wed. Thurs. Friday P.M.
A.M.
Inspection M e ` 7- a� P.M.
InspectoFinal Inspection r 1-1
Certificate of Occupancy ❑
Date
CITY OF ATLANTIC BEACH
,.-I! L�l/' 800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
S51 TELEPHONE:(904)247-5800
r J FAX:(904)247-5805
S) SUNCOM:852-5800
!1 —r http://ci.atlantic-beach.fl.us
r/
DIM,DIM,
June 17, 2002
TO: JACKSONVILLE ELECTRIC AUTHORITY
PROPERTY APPRAISER'S OFFICE
ATLANTIC BEACH WATER DEPARTMENT
UNITED STATES POSTAL SERVICE
PLEASE BE ADVISED THAT THE FOLLOWING ADDRESS HAS BEEN CHANGED:
Old Address New Address
1545 Seminole Road 1545 East Coast Drive
PLEASE ADJUST YOUR RECORDS ACCORDINGLY.
Sincerely,
C
Don C. Ford, C.1 0.
Building Official
Schlueter, Jennifer
From: Ford, Don
Sent: Friday, June 14, 2002 4:32 PM
To: Schlueter, Jennifer
Subject: RE: Joe Reynolds etc.
-----Original Message-----
From: Schlueter,Jennifer
Sent: Friday,June 14, 2002 3:29 PM
To: Ford,Don
Subject: Joe Reynolds etc.
Pat using Jen's computer
Also, there are two electrical permits i.e., 219 and 219-1 East Coast Drive.
Another matter, John Pratt came in again re 1 S inole Ro His house is completely on East Coast Drive and
is requesting that you change the address Te+epho -4066
CITY OF ATLANTIC BEACH
IT
APPLICATION FOR PLUMB
S �
JOB LOCATION: TELEPHONE NO•�_�3
OWNER OF PROPERTY: INC.
PLUMBING CONTRACTOR DAVID GRAY PLUMBING, Jacksonville , FL 32216
DRESS 8850 Corporate Square Cour n J 721_i2il
CONTRACTOR' S RDD r ,U 22586/436 TELEPHONE:
STATE LICENSE NUMBER: Lrl
ING FIXTURES INSTALLED
HOW �Y OF THE FOLLOW SHOWERS
SINKS WATER HEATERS
LAVATORY DISHWASHERS
BATH TUBS DISPOSALS
URINALS WASHING MACHINE
CLOSETS SHOWER PANS
FLOOR DRAINS WATER
SEWER OTHER
REPIPE
x $3 . 50
TOTAL FIXTURES:
MINIMUM PERMIT FEE - $25.00
BI
SF SIGNATURE OF OWNER:
"F SIGNATURE OF CONTRACTOR: avid ra -----------------
ISS ----------
_ - T BE IN ACCORDANCE WITH
FOF NSTALLATIOC OF PLUMBING AND FIXTURES
HERN STANDARD PLUMBING CODE.
I
THE MOST RECENT EDITION OF THEIONS - (904) 247-5826
CALL A DAY AHEAD TO SCHEDULE INSPECT
MUST BE ,LED INTO PUBLIC WORKS FOR INSPECTION
SEWER CONNECTIONS
PRIOR TO COVERING UP - (904) 247-5834
AT �,�
PSR-W" 09778
OMOO °Ibb "A) U4 o)�xl0Am DEPARTMENT OF BUILDING
' 00g CITY OF ATLANTIC BEACH
----- PERMIT INFORMATION --- -- LOCATION INFORMATION - -
Permit Number : 9778 Address : 1545 SEMINOLE ROAD
Permit Type: UTILITIES ATLANTIC BEACH . FLORIDA 32233
Class of Work.: ADDITION --------- LEGAL DESCRIPTION ---------
Constr . Type: N/A Let : Block : Section:
Proposed Use: UTILITY Township: RNG: 0
Dwellings : 1 Code: 0 -ubdivision:
Estimated Value: SO .00
Improv . Cost : 80 .00
Total Fees : 5585 .00
Amount Paid: 5585 .00
Date P'aido 3/ 2/95
t{ nrk FR?" ER SYSTEM [NSTALL 314" IRRIGATION METER
----------- OWNER INFORMATION ---- APPLICATION FEES -----
Name , FILZ BRAT:Aa PERMIT S25 .001,X
Address - 154'_: SEMINOLE ROAD WATER IMPACT FEE 50 . 00
ATLANTI`" BEACH . FLORIDA 32 :. ' SEWER IMPACT FEE x0 .00
Phone : rX304; 22' - �82F, WATER METERITAP S525. 00 —
RADON "AS-H .R . S . SO . 00
- ----- CONTRACTOR INFORMATION ---- RADON CAB 5% 50 - 00
Name: AMEPICAN WELL & IRRII"ATI,�'N ',1C CAPITAL IMPROVE . $0 . 00
Address - 2151 THE WOODS DR!' SEWER TAP $0 .00
TA^.KSON"ILLS , FI, 32246 CROSS CONNECTION 535 .00
, Type : SEC H IMPACT FEE $0 .00
CONST . SURCHARGE 50 .00
SCHARGE/ATL. BCH
NOTES:
NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
R
`,',FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN
T14E PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS"
n
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW.
�, O000000 000000000 125.00 14
ATLANTIC BEACH BUILDING DEPARTMENT Date: 3/02/95 01 Rcpt: 0035818
W60003221000
By: j
�' -------------
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS
DEMOLITIONS
owner(s): k,111 ,Q..�
Address : S_ Phone :
Lot # Bloc or Unit # Subdivision:
Contractor :
State Licensed
Address : `? l/--wc/r� -Phone No: ;g 50
Describe work to be done:
Present use of building:
Valuation of Proposed Construction:
Proposed use: J fQ
Is this an addition? /If yes , what are the dimensions of
the added space: ft . X ft . Will the added area
be heated and cooled? New electrical (or increase)?
New plumbing fixtures? New fireplace? New Heat/AC?
SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY,
ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR
AFFIDAVIT, IF OWNER IS CONTRACTOR.
Signature OWNER: Date:
Signature :4
Date:
License Supplied:
Liability Insurance:
Worker' s Compensation Insurance:
CITY OF
Office of Building Official
REQUEST FOR INSPECTION
Date
(�� Permit No.
Time
eiwd A District No.
Locality
Job Address
OwnK'$ Contractor
CONCRETE CTRICA PLUM I `AWHANlC
Framing Footing ❑ Rough Wiring `fes pou0h —
/��[\ ❑ Temp Pole /❑` Top Out Escorting
Re Roofing u Stab Fire Plus
Untel ❑ Final ❑ Pre Fab
READY FOR INSP
W rs. ( FrfWjy P.M.
Mon. Tues. �G
Inspection Made P.M.
inspector Final Inspection❑
Csrtitieate of Occupancy
Date
BOLT
Ts / 30
MAP SHOWING SURVEY OF
LOT 3, BLOCK 7, ATLANTIC BEACH PARKWAY UNIT NO. 2, AS RECORDED IN PLAT BOOK 15, PACE 83 OF
THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
On/ /PES?L. E57 TE
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NO BU/LO/NG QES>R/CT/ON G/n/E BY PLAT.
Ty/S PROPERTY G/ES /1V FLODO ZOn/E "C"I-V17'/CN
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y° �� #ifirtt#r of Orrupaurp
CITY OF
%par#mpn# of +VAbing Jn,oprr#inn
This Certificate issued pursuant to the requirements of Section 109 of the Southern Standard
Building Code certifying that at the time of issuance this structure was in compliance with the
various ordinances regulating building construction or use. For the following.
use classification Single Family Bldg.FennitNo. 7519
Atlantic Beach
Group Type Construction Fire District.. --
Owner of Building Cornelius Const Address'--
Building Address 1545 Seminole Road locality_Atlaa c Beach Parkway II
Rene' Angers Bre--�------�+!r— O
Building Oficial Date March i2 . 1907
i
POET IN A CONSPICUOUS !LACE
{
l
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BUILDING, PLANNING AND ZONING INSPECTION DEPARTMENT
CITY OF ATLANTIC BEACH, FLORIDA
CERTIFICATE OF OCCUPANCY
WORK SHEET
Date Requested: March 25, 1987
Building Contractor: Cornelius Construction
Building Permit Number: 7519 "
Address : 1545 Seminole Road
Legal Description: Lot 3, Block 7, Atlantic Beach Parkway Unit II
Improvements to the above described property have been completed
in accordance with the terms of the permit and is certified to be
ready for occupancy as
SINGLE FAMILY
Comments:
BEFORE ISSUING CERTIFICATE OF OCCUPANCY THE FOLLOWING MUST BE COMPLETE
DEPARTMENT DATE NOTIFIED: DATE APPROVED: AB .
Fire Chief 3/25/87 ------
3/25/87 ---
Z�
Public Works --------------- --4 ---- -�� - - ---
Planning Director 3/25/87
--------------- -�- �------- ------
Building Inspector __ 3/25 /87
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F r"
UTILITY AGREEI`M
(Water and Sewer)
THIS AGREEMM, made and entered into this 28th day of
February 1986 , by and between the City of Atlantic Beach,
Florida, a municipal corporation, hereinafter referred to as "City", and
Cornelius Construction, P.O. Box 201, Atlantic Beach, FL 32233
and its successors and assigns herein referred to as "User".
TAEREAS, User owns land in Duval County, Florida, described as
follows: 1545 Seminole Road, Lot 3, Block 7, Atlantic Beach Parkway II
and
WHEREAS, User plans to develop said land by constructing 1
buildings, 1 residences and/or other improvements thereon
consisting of A single family home and
WLEUMAS, The City is the owner of a water plant, water distribution
system, sewage treatment system and sewage collection plant in the
vicinity of the above described property; and
VJHERFAS, User will need water and sewer service, and User desires
City to furnish same; and
WHEREAS, City is willing to operate such water and sewage treatment
system so that all buildings constructed on User's property by User may
have furnished to them water and sewer service, subject to all terms
and conditions of this Agreement.
'NOW, THEREFORE, in consideration of the premises and other good and
valuable considerations and in consideration of the mutual covenants and
conditions hereinafter contained, the parties hereto agree as follows:
(2)
1. Upon the terms and conditions herein contained, the City agrees
to provide potable water and domestic sewer services to the User's Property.
The term "domestic sewage" used in this paragraph and referred to
throughout this Agreement is defined as follows: Hunan waste including
liquids and solid matter carried from plumbing fixtures normally carried
off by drains and sewers, and except where specifically excluded bath
and toilet wastes, laundry wastes, kitchen wastes and other similar
wastes. It does not include commercial or industrial waste.
2. City agrees that after User has connected to the system,
thereafter City will provide, at its costs and expense, but in
accordance with other provisions of this Agreement, including rules and
regulations and rate schedules, sewer service and water service to
User's Property in a manner conforming to reasonable requirements of
public governmental agencies having jurisdiction over City's water and
sewer operations.
3. User shall, at its costs and expense, install all of the potable
water distribution and domestic sewage collection lines which may be
required on User's property, including engineering cosh to connect City's
plant to the User's property, and all other facilities necessary to make it
possible for the City to provide adequate potable water and domestic sewage
service.
If buildings more than two stories in height are constructed on the
User's property, the User, at its own expense, agrees to furnish to the
City, any equipment which may be necessary for pumping potable water to the
additional height with associated back-flow preventers,
(3)
At all times during the construction of the potable water and domestic
sewer lines and related equipment, the City shall have access to the construction
and the right to inspect the construction to insure that the lines and related
equipment are being installed in accordance with the plans and specifications
approved by the City.
User shall construct the domestic sewage disposal lines in such a
manner as to insure that no water from air conditioning systems, ice machines,
swinming pools or any other form of condensate water shall flow into the
domestic sewage disposal lines of the City and nothing other than sewage in
its strictest sense shall be discharged into the domestic sewage disposal
system of the City. City shall inspect all connections made by contractors,
plumbers, builders, etc. to any portion of the sewer system that discharges
into the sewage collection system owned or operated by City or contemplated
to be owned and operated by City under the terms and conditions of this
Agreement prior to being covered up.
City shall only be obligated and will only provide water and sewer
service to User's property upon 100% completion of all terms and conditions
of this Agreement.
4. User shall pay a planning and inspection fee in order to defray
all actual costs to City of preparing and executing this Agreement, including
any attorney's fees; and conducting the inspection and testing of the
installation of the User's Extens ion; and all other administrative costs
incident to accepting the User's extension, Said fee shall be equal to one half
of building permit fee.
5. User shall pay City a "Sewer Impact Fee" of $1,035.00 per residential
unit and a water impact fee of $10.00 per fixture unit/or as otherwise
(4)
provided in the City's Code of Ordinances,
6. The City shall provide water and sewer service to User's property
upon payment to City of the standard meter charges as provided in the City's
Code of Ordinances ($85.00/ 5/8 x 3/4 inch meter) ,
7. Payment of the Sewer In-pact Fee, Water Impact Fee, Planning/
Inspection Fee and Water 1,1eter Charges, shall be made in full at the time
City approves the plans.
8. In the event, at a future date, City's charges, rate schedules
or fees are revised, subject to the operating rules and regulations and
approval of governmental authorities having jurisdiction, then in that
event, User and/or assigns shall pay the charges, rates or fees then in
effect on date of payment.
9. Hydraulic share of main extensions-payment or refund;
User recognizes that water or sewer utility service to th User's
property is provided by the use of a main extension and other improvements
constructed by a prior developer and that User is obligated to refund to
said prior developer User's share of the cost of said main extension or
other improvements. Accordingly, User shall pay its pro rata share of the
cost of said main extension or other improvements to City. Said pro rata
share shall be based on Developer's percentage of the hydraulic capacity
of said extension or other improvements. For the purpose of this Agreement,
the cost of Developer's said hydraulic share shall be $ N/A
With respect to utility facilities installed by User to which future
developers connect directly, and in consideration for monies expended by
User toward said facilites, City shall refund to User, or User's successors
or assigns, solely from monies collected from said future developers, said
(5)
future developer's pro rata share of the cost of said facilities, Said refunds
shall be calculated on the basis of the hydraulic capacity and demand of said
future developer whenever feasible, The refund obligation of City hereunder
and the benefits to User related thereto shall expire five (5) years from the
date of execution of this Agreement, Said refund shall be made to User within
sixty (60) days of the receipt of payment by City from a future developer,
10, If any damage is done by User, its agentsR or employees, to
the existing potabldwater lines or domestic sewer lines of City or other utilities
CATV, electric, phone, or the potable water lines or domestic sewer lines installed
pursuant to this Agreement, during or after the installation thereof and by reason
of construction work, User shall at his expense, make such repairs as are required
to restore said potable water or domestic sewer lines to the condition which existed
before such damage occurred, but in the event User does not restore said potable
water or domestic sewer lines (but this clause shall not be construed as to
require the City to make such reparis or restoration) , User shall provide the City
and its agents adequate access and facilities for the making, of said repairs. All
costs incurred by the City in making such repairs shall become immediately due
and payable and shall be considered in all respects the same as if said charge had
arisen in connection with the rendition of the regular services of the City,
11. Notwithstanding any provision of this Agreement, the City shall have no
obligation to provide sewer services to any customer producing sewage which is
unusually burdensome, unusually costly to process or substantially detrimental to
the sewage system.
12. This Agreement shall be beinding upon the parties hereto, their
successors in interest, grantees, transferees and assigns, In the event User
transfers any part of the User's property, it will cause its transferee to comply
in all respects with the provisions of this Agreement.
13. In the event the City sells either its sewer treatment plant or
collection system or its water treatment plant or water distribution
system to any goverryiental body or any other purchaser, then, in such
events, this Agreement shall terminate as to the City on any protion sold
and all of its obligations or liabilities hereunder shall cease and
determine for that portion sold.
14. The City may shut off the water to the User or any other person
and refuse to accept sewage from the User or any other person if the User
or any other persons shall fail to pay any sums due hereunder when the
same becaue due and payable. Nothing herein contained, however, not any
action taken by the City in pursuance hereof shall impair any other remedy
which the City might have, at law or equity, for breach of this Agreement
by Owner or any other person.
15. City does not guarantee an uninterrupted supply of water for any
purpose or water at any particular pressure for any purpose and reserves
and shall have the right to shut off the water in its main at any time for
the purpose of making repairs or extensions or for other purposes incidental
to its water supply and will not be responsible for any damage caused by law
pressure. City shall have the right to turn off water service at the main
where the User has been found to be useing water illegally, and to assess
a fee for restoration of service.
16. The City shall have the right to assign and transfer this Agreement
at any time provided, however, that no such assignment or transfer shall
impair the rights or increase the obligations to the User or any other
person pursuant to this Agreement.
(7)
17. Unless sooner terminated as provided herein, the initial term
of this Agreement shall be 15 years. After the initial term of 15 years
from the date of the execution of this Agreement, the terms of this
Agreement shall automatically be renewed for successive terms of five (5)
years each, unless written notice of termination of this Agreement is
provided by either party hereto, not less than ninety (90) days prior
to the coimnencement of any such renewal period.
18. It is expressly agreed and understood between User and City that
there are no other written or verbal agreements applicable herein between
User and City.
19. This Agreement may be amended and modified from time to time
as necessary by mutual written agreement of the parties hereto.
IN WITNESS WHEREOF, the User and the City have caused these
presents to be executed the day and year first above written.
Signed, sealed and delivered in the presence of:
s
titn s/
pity 0 t antic Bdac es
s
DEPARTMENT OF BUILDING PERMIT NO.- 7520
CITY OF ATLANTIC BEACH.FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date 2/28 19 86
i
Valuation$
Fee$ 59-00
I
This permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
i
This is to certify that FlUll PIP ffffll
rgen?CKT
!, X097 5 in-57s',
has permission to Install 1utTtbin
(I r) I e
I MIL
Classification Residential Zone
Owned by peggy Cornelius
Lot_ Block S/D
House No. 1545 Semiiole Road
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
t AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
_� �----► o Building material, rubbish and debris
zi from this work must not be placed
in public space, and must be cleared
up and,,hauled away by either con-
tract gr owner.
��fficial.H
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
i
SEWER
WATER
1
CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
JOB LOCATION
PLUMBING CONTRACTOR
LICENSE NUMBERS
OWNER
BUILDING CONTRACTOR
TYPE OF BUILDING i
SINKS SHOWERS
LAVATORY WATER HEATERS
cy� BATH TUBS DISHWASHERS
URINALS DISPOSALS
CLOSETS ___LWASHING MACHINE
FLOOR DRAINS OTHER
_ /�ITOTAL FIXTURE COUNT
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE.
I
I
DEPARTMENT OF BUILDING 7521
PERMIT NO...
1 CITY OF ATLANTIC BEACH,FLORIDA
1 PERMIT TO BUILD
I a
1 THiS PERMIT MUST BE POSTED ON JOB 114 oon T
i
Date 2/28 19 86 44,00rKT
8958 I 1
/22/9
i Valuation$
Fee$ !,�' "�--- 7521 •00M
0955 1 4 1 /P2/13
This permit not valid until above fee has been paid to City Treasurer,and is 1 nno
subject to revocation for violation of applicable provisions of law.
This is to certify that
'I I
lhas permission tonU Install Meat Air
� I
I! I Classification Residential zone
Owned by Peggy Cornelius
Block—____---5/D
Lot
House No. 1545 Sem ole Road
According to approved plans which are part of this permitNOTICE—ALL CONCRETE FORMS I
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS 1I
-n AFTER DATE OF ISSUE
M Building material, rubbish and debris
—�� z from this work must not be placed
i in public space, and must be cleared
up and hauled away by either con-
trattor ` owner.
I Building Official.
i
I
CON ACTOR
FOR OFFICE
PERMIT DATE
USE ONLY NUMBER
PLUMBING
II
i ELECTRICAL
i
i
SEWER
WATER
I
I
i
..
` BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FLORIDA 32233
APPLICATION ICOR MECHANICAL PERMIT CALL-IN NUMBER
IMPORTANT — Applicant to complete all items in sections I, II, III, and IV.
Street Address: S-
N
LOCATION
OF Intersecting Streets: Between And
BUILDING
Sub-division
II. IDENTIFICATION — To be completed by all applicants
In consideration of permit given for doing the work as described in the abcve statement we hereby agree to perform said work in accordance
with the attached plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards
of good practice listed therein.
Name of Mechanical ��� Contractors
Contractor (Print) C)Ct� �/-t�� Mester -tA� ^
Name of
Property Owner 1 Lf j
Signature of Owner Signature of
or Authorized Agent Architect or Engineer
Ill. GENERAL IN MA ON
A' Type of heating fuel: B.
IS OTHER CONSTRUCTION BEING DONE ON
Electric THIS BUILDING OR SITE?
❑ Gas—❑ LP ❑ Natural ❑ Central Utility
IF YES, GIVE NUMBER OF CONSTRUCTION ��
❑ Oil PERMIT
❑ Other — Specify
IV. MBCHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK
(Provide complete list of components on beck of this form) Residential or ❑ Commercial
Heat ❑ Space ❑ Recessed K Central O Floor New Building
❑ Existing Building
Air Conditioning: ❑ Room
Control r
nuCa i�;f4i' � El Replacement of existing system
Duct System: Metairie' -�� Thickness
�,� New installation(No system previously installed)
Maximum capacity 1 l`'v c.f.m.
❑ Extension or add-on to existing system
❑ Refrigeration Ej
Other — Specify
❑ Cooling tower. Capacity 9-P-M.
❑ Fin sprinklers: Number of heads -
❑ Elevator ❑ Manlift ❑ Escalator (number) THIS SPACE FOR OFFICE USE ONLY
❑ Gasoline pumps (number) (Ree«wd)
❑ Tanks (number) Remarks
❑ LPG containo's (number)
❑ Unfired pressure vessel
Permit Approved by Ds+a
❑ Boilen
0Permit Fee
Other — Specify
LIST ALL EQUIPMENT
AIR CONDITIONING AND REFRIGERATION EQUIPMENT Capacity Approving
Number Unit, Description Model Number Manufacturer (Tons) I►gea
Z-
CITY OF
office of Building Official
REQUEST FOR INSPECTION
Date ✓ Permit No.
Time A'M. District No.
Received �—P.M.
' Locality
Job�ddress A�
l[Owner's Contractor EV," ,�1-
Name
BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL
Footing E) Rough Wiring E] Rough ❑ Air.Gond.& ❑
Framing ❑ g ❑ Temp Pole Top Out ❑ Heating
Re Roofing ❑ Slab Fire Place ❑
Lintel ❑ Final L, Pre Fab
READY FOR INSPECTION A.M.
Mon. uWim, Thurs.
A.M. Friday P.M.
es
-��
Inspection Made "7 u
Final Inspection I& i
Inspector
certificate of Occupancy--
Date
CITY OF
.f t 44r? Eeai - 9&ud4
716 OCEAN BOULEVARD
— ----- ---- P.O.BOX 25
ATLANTIC BF,ACH,FLORIDA 32233
�. TELEPHONE(904)249-2396
March 25, 1987
Third Floor
Pre-Service Section
Jacksonville Electric Authority Building
233 West Duval Street
Jacksonville, Florida 32202
The following final inspections have been made and are
satisfactory:
Permit #4816 - 1545 Seminole Road
Permit issued to Brooks & Limbaugh Electric Company
Permit #4574 - 1050 Seminole Road
Permit issued to John Gearhard
Sin Ierely,
I
Rene' Ang re
Community Development Director
cc:building file
CITY OF
ATLANTIC BEACH No. 3550
FLORIDA
Tan 1Lj, 19 $Z
151n.Co TIL ,
NAME 51 no!nCKTU
9739 1A 0/02/07
ADDRESS - •r0rACC
9736 1R 2/02/07
CITY +0001
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13AA85.00
TF.�t ME'Tr spa
46AAUR P-7 390.00
47/SE6TA P 1,035.00
$1,510.00
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CITY OF
fQ, ttic
Office of Building Official
REQUEST FOR INSPECTION
Permit No.
Date / / A.M.
District No.
Time P.M.
Received /J .
�IHy
Job Address
Owner's Contractor
Name PLUMBING MECHANICAL
BUILDING CONCRETE ELECTRICAL v ❑ Air.Cons S ❑
,�' Bough Wiring El Rough Heating
Framing ❑ Footing Temp Foie ❑ Top Out ❑ Fire Place ❑
Re hoofing ❑ Slab .��
Lintel ❑ Final ❑ Pre Fab
RE Y FOR INSPECTION A.M.
Thurs.
Friday P.M.
Mon. Tues.
_
P.M
Inspection Made
Final Inspection❑
inspector Certificate of Occupancy
Date
CITY OF ATLANTIC BEACH, FLORIDA
Approvod by APPLICATION FOR ELECTRICAL. PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE:
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK
O HE AS ATTACHEDDESCRIBED
IN THE PLANS ANDS SPEING, SE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
ELECTRICAL FIRM MAS,,TE11R ELECTRICIAN SIGNA RE
NAME GO/ei���l(JS �tJ 7;eV��(BDRESS: ��y� S��/,004�' A FD BOX
BLDG.SIZE BETWEEN:
RES.04APT. ( 1 COMM. ( 1 PUBLIC ( 1 INDUS. ( 1 NEW�9 OLD ( 1 REW. ( 1
ADDITION ( 1 TRAILER ( 1 TEMP. ( 1 SIGNS ( 1 SQ. FT.
FEE
SERVICE: NEW INCREASE ( 1 REPAIR ( 1
CONDUCTOR SIZE O b AMPS2 COPPER ( 1 A_LU�M. ISO
SWITCH OR BREAKER DO AMPS PH -3 W � ,�OLT 25� ,
RACEWAY --7
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 0.100 AMPS. OVER
BELL TRANSF.
APPLIANCES
AIR H.P. RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW HEAT
OVER
MOTORS H.P. I OLTAGE PHS NO. 1 H.P. VOLTAGE PHS
MISCELLANEOUS
..wino cnn v 7F OVER 600 V.
41
CITY OF ATLANTIC BEACH
► APPLICATION FOR BUILDING PERMIT r 27 1986
Owner Ru uUs �onl-sT. Ca. Address Q i �%M �H j_,
Architect Address zip Phone
Contractor (c—'VIA Address p, p, z o I zip 3 z L S 5 Phone 2_g I-a b Y9
Contractor's License Number Expiration Date Copy on File
Lot Block or Section # Subdivision f}TLANI)C
Between and T" side R s-r
Streetgsr CoH.;T ll�""
Valuation $ )a5' 7 0 0 ` ` Type of Construction E-, R m
Purpose of Building L ._i_ F n)�y Number of Units ; Fireplaces
Utility Service: Water cr-Y Sewer
If the City if providing water or sewer service, do we need to make taps? F_5
Dimensions : Building L W x 5G, r Lot s o x i I o Size Footings ►2 x 2 Ll W 2*'-S R
Sz. Piers Sz..� Sills Greatest Span Sills
Sz. Ceiling Joists Distance on Centers Greatest Span
Sz. Floor Joists Distance on Centers Greatest Span
Sz. Rafters Distance on Centers Greatest Span
Method of Heating Li F_c-TRic. Solid-Filled Ground f , Roof com P. f t4?M&-E S
Flood Zane If located within a FLOOD HAZARD complete page 2
SUBMIT: Two complete sets of plans, including a detailed site plan.
Florida Energy Efficiency Code Sheets
Recent Survey
Inspections Required:
1. When steel is in place and ready to pour footings.
2. When steel is in place and ready to pour columns/lintel.
3. When steel is in place and ready to pour beam.
4. When framing, mechanical, plumbing, electrical, fireplace, is completed and ready
to cover up.
5. Final inspection. SETBACKS
NO INSPECTION WILL BE MADE IF BUILDING CARD IS NOT POSTED ON JOB.
In case of rejection, reinspection MUST be called for after Rear Lot Laze
20
corrections are made.
In consideration of permit given for doing the
work as described in the above statement, we
hereby agree to perform said work in accordance c�
with the attached plans and specifications,
which are a part hereof, and in accordance
with the building regulations of Atlantic Beach.
Signature Owner � � if , o'-A'W-. `
Signature Contractor.
6Z 61 e
Yront Lot Line
r
' FLOODPLAIN DEVELOPMENT INFORMATION
Type of Development : aG L- rFM L--Y New Building
Alterations to Existing Building
Flood Zone
Required Floor Elevation
Actual (as built)Lowest Floor Elevation
If located within a flood hazard zone (zone A) a survey must be
made after the slab has been poured, certifying that the "lowest
floor elevation is equal to or above the base flood elevation
esta is a or that zone.
No Final Inspection will be made and No Certificate of Occupancy
will be issued until the survey is on file with the Building Department.
COMMENTS
Applicant acknowledgement : I understand that the issuance of this
permit is contingent upon the above information being correct and
that the plans and supporting data have been or shall be provided
as required. I agree to comply with all applicable provisions of
Ordinance No. 25-7-11 and all other laws or ordinances effecting
the proposed developemnt.
Date Applicant 's Signature
-----------------------------------------------------------------------
Department Use
Survey filed with the Building Department on
Certified Lowest Floor Elevation
Required Lowest Floor Elevation
Building Department Representative
FLORIDA ENERGY EFFICIENCY CODE
4 FOR BUILDING CONSTRUCTION
r ! SECTION 9—RESIDENTIAL POINT SYSTEM METHOD CLIMATE ZONES
FORM 900-A-84 DEPARTMENT OF COMMUNITY AFFAIRS NORTH 1 2 3
This form may be used to demonstrate compliance with the Energy Code for new single-family detached or multifamily attached dwellings under Section 9
of the Energy Code. An alternative to this method for single-family detached dwellings, and multifamily attached dwellings of three stories or less, is
provided in Section 10 of this Code.Only dwellings which are above ground frame(wood siding, brick veneer,etc.)or concrete wall type construction may
be calculated using Sections 9 and 10.Other types of construction must comply under Section 4 or Section 5 of this Code.Additions to existing residential
buildings shall comply with the requirements of Section 10 of this Code.Detailed information on how to complete this form may be obtained from your local
building department or the Department of Community Affairs, Energy Code Program,2571 Executive Center Circle East,Tallahassee, Florida 32301.
PROJECT NAME PERMITTING OFFICE: PT-c— me-AC}k
AND ADDRESS: CIRCLE CLIMATE ZONE: 1 3
BUILDER: y _ L V PERMIT NO.:
OWNER: JURISDICTION NO.: Cc / C
GLASS AREA AND TYPE
DETACHED IF MULTIFAMILY. NO. OF UNITS CLEAR TINT,FILM,SOLAR SCREEN
LIN COVERED BY THIS CALCULATION:
SEPARATE CALCULATIONS ARE REQUIRED SGL SGL
FOR EACH WORST CASE UNITTYPE.CHECK IF ❑
ATTACHED THIS CALCULATION REPRESENTS A WORST '1 DBL DBL
u CASE CONDITION. d� IF
NET WALL AREA AND INSULATION CONDITIONED CEILING INSULATION
CBS R= FRAME R= FLOOR AREA UNDER ATTIC
SGL.ASSEMBLY
FT=-.M.El 10-101 Mygl�� R= [fN.�] R
COOLING SYSTEM PRIMARY HEATING SYSTEM (� PRIMARY HOT WATER SYSTEM
CENTRAL NONE ❑ ELECTRIC STRIP ❑GAS ❑ NONE I�/ I ELECTRIC RESISTANCE ❑ SOLAR
VSj
F] ROOM ❑ OIL Ll SOLAR HEAT RECOVERY ❑ GAS
PACKAGE TERMINAL AC a HEAT PUMP:COP = ❑ DED. HEAT PUMP:COP = ❑ m
EER//SEER = F ❑OTHER: ❑OTHER:
CALCULATED E.P.I.: CALCULATED E.P.I.MUST NOT EXCEED 100 POINTS
In accordance with Section 553.907 F.S., I hereby certify that the plans Review of the plans and specifications covered by this calculation indi-
and specifications covered by this calculation are in compliance with the cates compliance with the Florida Energy Code. Before construction is
Florida Energy Code. completed, this building will be inspected for compliance in accordance
with Section 553.908, F.S.
OWNER/AGENT: BUILDING OFFICIAL:
DATE: DATE:
9A I PRESCRIPTIVE MEASURES(Must be met or exceeded by all residences.) _ —
MINIMUM REQUIREMENTS CHECK TO INDICATE
COMPLIANCE
COMPONENTS
REQUIREMENTS
WINDOWS 903.I MAXIMUM OF 0.5 CFM per LINEAR FOOT OF OPERABLE SASH CRACK.
DOORS 903.1 MAXIMUM OF 0.5 CFM PER SQUARE FOOT OF DOOR AREA.INCLUDES SLIDING GLASS DOORS.
EXT.JOINTS 8 CRACKS 903.1 TO BE CAULKED,GASKETED,WEATHER-STRIPPED OR OTHERWISE SEALED. --
CEILING INSULATION(903.9) MINIMUM OF R-19.
WATER HEATERS(903.2) MUST BEAR ASHRAE STANDARD 90-80 LABEL OR A MAX.4 WATT/SQ.FT.STAND-BY LOSS.SWITCH
OR CLEARLY MARKED CIRCUIT BREAKER(ELECTRIC)OR CUT-OFF VALVE(GAS)MUST BE
PROVIDED.
SWIMMING POOLS(903.3) IF HEATED BY OTHER THAN SOLAR,MUST HAVE POOL COVER DESIGNED TO MINIMIZE HEAT LOSS.
ALL NON-COMMERCIAL POOLS MUST BE EQUIPPED WITH A POOL PUMP TIMER.
HOT WATER PIPES(903.4) INSULATION IS REQUIRED ONLY FOR RECIRCULATING SYSTEMS. IN SUCH CASES,PIPING HEAT
LOSS SHALL BE LIMITED TO A MAX.OF 17.5 BTU /H PER LINEAR FOOT OF PIPE(SEE 504.4).
SHOWER HEADS 903.5 WATER FLOW MUST BE RESTRICTED TO NO MORE THAN 3 GALLONS PER MINUTE.
HVAC DUCT CONSTRUCTION CONSTRUCTED IN ACCORDANCE WITH INDUSTRY STANDARDS AND LOCAL MECHANICAL CODE.
(903.6) DUCTS IN UNCONDITIONED SPACE MUST BE INSULATED TO A MINIMUM R-4.2.
HVAC CONTROLS 903.7 A SEPARATE,READILY ACCESSIBLE MANUAL OR AUTOMATIC THERMOSTAT FOR EACH SYSTEM.
1
FORM 900-A-84 CLIMATE ZONES ? 2 2 J
9C DESIGN CREDIT POINTS(CP) 9D HEATING SYSTEM CREDIT POINTS
CEILING FAN IN COND.SPACE(max 5 CP) 1 { NATURAL GAS/PROPANE HEATING 16.0
MULTIZONE A/C SEPARATED BY DOOR 5 OIL HEATING 12.8
CROSS VENTILATION(1 CP per room) 1
WHOLE HOUSE FAN(min.1.5 cfm/s.f.) 5
WOOD STOVE 7 9E DESIGN PENALTY POINTS
FIREPLACE WITH OUTSIDE COMBUSTION AIR 2 WASHER AND DRYER IN COND SPACE
TOTAL GLASS OPENS LESS THAN 40% 5
9C TOTAL(not to exceed 12 points) FIREPLACE WITH INSIDE COMBUSTION AIR 5
9F WINTER OVERHANG FACTOR (WOF) 9F SUMMER OVERHANG FACTOR SOF
FEET N NE E SE S SW W NW FEET N NE E SE S SW W NW
0-0.9 1.00 0.98 0.99 0.74 0.71 .0.82 0.93 1.00 0-0.9 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00
0.98
0.77 0.84
3-3.9 1.00 0.98 0.99 0.81 0.79 0.87 0.9�.00 3-3.9 --l-.TO' 0.95 0.8 20.86 0.95 0.86 00- 0.95
4-4.9 1.00 0.98 0.99 0.84 0.83 0.89 0.94 1.00 4-4.9 1.00 0.91 0.84 0.80 0.82 0.80 0.84 0.91
5-5.9 1.00 0.99 1.00 0.87 0.87 0.92 0.95 1.00 5-5.9 0.99 0.88 0.79 0.76 0.79 0.76 0.79 0.88
6-6.9 1.00 0.99 1.00 0.90 0.90 0.93 0.96 1.00 6-6.9 0.99 0.85 0.75 0.73 0.78 0.73 0.75 0.85
7-7.9 1.00 0.99 1.00 0.93 0.94 0.96 0.97 1.00 7-7.9 0.99 0.83 0.72 0.70 0.77 0.70 0.72 0.83
8-8.9 1.00 0.99 1.00 0.95 0.96 0.97 0.98 1.00 8-8.9 0.99 0.81 0.70 0.68 0.77 0.68 0.70 0.81
9-9.9 1.00 1.00 1.00 0.97 0.98 0.98 0.98 1.00 9-9.9 0.98 0.79 0.68 0.67 0.76 0.67 0.68 0.79
10-10.9 1.00 1.00 1.00 0.99 0.99 0.99 0.99 1.00 10-10.9 0.98 0.77 0.66 0.66 0.76 0.66 0.66 0.77
11-11.9 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 11-11.9 0.97 0.76 0.64 0.64 0.76 0.64 0.64 0.76
12 UP 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 12 UP 0.97 0.75 0.63 0.64 0.76 0.64 0.63 0.75
9G HEATING SYSTEM MULTIPLIER (HSM)
COP 2.5-2.6 - 2.9-3.0 3.1-3.2 3.3-3.4 3.5&UP
HEAT PUMP HSM .40 j, .37 .34 .32 .30 .29
SOLAR HEATING SYSTEM (BACKUP ACTION) x (BACKUP SYSTEM HSM)
ELECTRIC STRIP HEAT 1.0
NATURAL GAS/PROPANE/OIL 1.0(SEE TABLE 9D FOR CREDITS)
PTAC&ROOM HEAT PUMPS MINIMUM COP 2.2.HSM FOR COP 2.2- 2.4= .45.
SEE TABLE ABOVE FOR COP> 2.4
9H COOLING SYSTEM MULTIPLIER (CSM)
ELECTRIC EER/SEER 7.8-7.9 8.5-8.9 9.0-9.4 9.5-9.9 1 10.0-10.4 10.5-10.9 11.0-11.9 12.0-UP
CSM .83 .81 0.76 0.72 0.68 0.65 0.62 0.59 0.54
GAS COP 0.40-0.4 .49 0.50-0.54 0.55-0.59 10.60-0.64 0.65-0.69 0.70&UP
CSM 1.50 1.25 1.20 1.09 1 1.00 0.92 0.89
MINIMUM SEER/EER LEVEL 7.8 FOR STRAIGHT COOL OR HEAT PUMPS;MINIMUM OF 7.5 EER FOR ROOM UNITS AND PTAC.
FOR ROOM UNITS AND PTAC CSM FOR EER 7.5- 7.7= .87.SEE TABLE ABOVE FOR EER> 7.7.
91 1 HOT WATER CREDIT POINTS(HWCP)
ELECTRIC RESISTANCE WATER HEATER 0
GAS WATER HEATER 10
INSTANTANEOUS WATER ELECTRIC 4.5
HEATER GAS 12.6
ELECTRIC BACKUP 6.7
HRU(A/C)WATER HEATER GAS BACKUP 13.9
ELECTRIC BACKUP 9.7
HRU(HP)WATER HEATER GAS BACKUP 14.5
HEAT PUMP WATER HEATER COP 1.60-1.89 1.90-2.19 2.20-2.49 2.50-2.79 2.80-3.00
(DEDICATED HEAT PUMP) CREDIT POINTS 9.0 11.4 13.1 14.4 15.4
OVERALL SOLAR FRACTION* 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0
SOLAR c= ELECTRIC BACKUP 2.4 4.8 7.2 9.6 12.0 14.4 16.8 19.2 21.6 24.0
HOT WATER ,R GAS BACKUP 11.4 12.8 14.2 15.6 17.0 1 18.8 19.8 21.2 22.6 24.0
*PERCENT OF ANNUAL HOT WATER PROVIDED BY SOLAR SYSTEM - 100=OVERALL SOLAR FRACTION
4
Address / 41 S Si��-f�iVOl_ AE
Heated Square Footage @ $ _�q . p o per sq ft = $
Garage/Shed @ $ �% , O c) per sq ft = $ 32,0. 00
Carport/Porch s f @ $ , p5 Der sq ft = $
Deck @ $ per sq ft = $
Patio /8 - @ $ 9. D-j�) per sq ft = $ 919 , y D
TOTAL VALUATION: $ �'a,5-? . 10
.$ lam , 50
Total Valuation 1st $ 5O, D X
3zS-�► , t $ Brea. 00
Remainder Valuation .p(per thousand or
portion thereof
------------------------------- Total Building Fee $ )9 a- 150
ADDITIONAL PERMITS and/or FEES REQUIRED + 2 Filing Fee $ 9
Mechanical ; Fireplaces @ 15.00 $ ) 5 , 00
Plumbing ✓- BUILDING PEFu ffT FEE $
Electric/New
-------------------------------------------------
Electric/Tenp ✓
Septic Tank BUILDING PERMIT $ z O
Well WATER METER CHARGE $ 8S . O o
Seng Pool SEWER IMPACT FEE $ I O Lam . O O
Sign WATER IlKPACT FEE $ 35C) , 00
Water Connection MISCELLANEOUS $
Sewer Connection $
Water Meter $
Elevation Certificate _
GRAND TOTAL DUE $
----------------------------------------------------------------------------------------------
CALCULATIONS and/or NOTES
PLUPIBING WORKSHEET
SINKS ;` SHOWERS DISHWASHERS
_ CLOSETS I BATH TUBS Q FLOOR DRAINS
_ WASHING MACHINE I WATER HEATERS DISPOSALS
41 LAVATORY _ URINALS O OTHER
g
TOTAL FIXTURE COUNT /
FIXTURE UNIT BREAKDOWN
FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE
UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY
FIXED AT $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM.
1� BATHROOM GROUP CONSISTING OF LAVATORY (1 UNIT)
WATER CLOSET, LAVATORY, AND
BATH TUB OR SHOVER STALL SERVICE SINK TRAP STAND
(6 UNITS) (3 UNITS)
DRINKING FOUNTAIN (� UNIT) URINAL, WALL LIP
(4 UNITS)
FLOOR DRAIN (I UNIT) t
I WASHING P;ACHINE RES.
URINAL, PEDESTAL, SYPHON (3 UNITS)
JET BLOWOUT (8 UNITS)
I I WATER CLOSETS, VALVE OPERATED
WATER CLOSETS, TANK-OPERATED (8 UNITS)
(4UNITS) l
y l SHOWER STALL, D02•lESTIC
U BATHTUB (W/OR W/O OVERHEAD (2 UNITS)
SH01;ER) (2UNITS)
(.f LAUNDRY TRAY
BIDGET (3 UNITS) (2 UNITS)
_ DISM-:ASHER (.2 UNITS) 1 KITCHEN SINK (2 UNITS)
D_ KITCHEN SINK/l•:ASTE GRINDER
(3 UNITS)
, 5 X TOTAL FIXTURE UNITS @ $10.,00 EACH
II
CITY OF ATLANTIC BEACH, FLORIDA
Approved FOR ELECTRICAL PERMIT
PP b Y APPLICATION
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 19 �
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.
30 -
ELECTRICAL
3P -ELECTRICAL FIRM: MASTER ELECTRICIAN SIGNATURE JOURNEYMAN
NAME 6,62KV4:L140-S 6010S ADDRESS: LSy� U(��C /6 FD BOX
BLDG.SIZE BETWEEN:
RES.(; APT. ( 1 COMM. ( 1 PUBLIC 1 1 INDUS. ( 1 NEW ( 1 OLD ( 1 REW. ( )
s cuL"etI09-0
ADDITION ( 1 TRAILER ( 1 TEMPO SIGNS ( ) SQ. FT.
SERVICE: NEW INCREASE ( 1 REPAIR ( ► FEE
CONDUCTOR SIZE 616J AMPS 27�- 6 COPPER ALUM. ( ► Q U�
z j It
SWITCH OR BREAKER AMPS PH J W ���VOLT r RACEWAY
EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY
FEEDERS NO. SIZE_7NO. SIZEE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.90 AMPS. 31•100 AMPS.
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100 AMPS, OVER
APPLIANCES BELL TRANSF.
AIR H.P. RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT
0-1 OVER
MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS
MISCELLANEOUS
IminrR ann V OVER 600 V.
CITY OF
Office of Building Official
REQUEST FOR INSPECTION C
Date—/— CD — Permit No. 7S C)
Time
Received 4 `� P.M. District No.
/. -V-r SE" (NO f-C /fib .
Job Address Locality
Owner's
Name tractor
BUILDING CONCRETE ELECT IC PLUMBI MECHANICAL
Framing ❑ Footing ❑ ❑l/ ��� Air.Cond.& ❑
Re Roofing ❑ Slab ❑ Temp Pole p� Top Out ❑ Heating
Lintel ❑ /K Fire Place O
Pre Fab
READY FOR INSPECTION A.M.
Mon. CTu Wed. Thurs. Friday P.M.
Inspection Made
Inspector Final Inspection❑
Certificate of Occupancy
Date