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1761 Seminole Rd (vault) PREPARED 9/18/03, 8 :07:21 INSPECTION TICKET PAGE 8 CITY OF ATLANTIC BEACH INSPECTOR: LARRY J HIGGINS DATE 9/18/03 ------------------------------------------------------------------------------------------------ ADDRESS . : 1761 SEMINOLE RD SUBDIV: TENANT, NBR: REPLACE EXISTING HVAC CONTRACTOR AIR ENGINEERS INC PHONE (904) 641-2333 OWNER SHADDEN, E. B. PHONE PARCEL 169636-0400- - APPL NUMBER: 03-00026198 MECHANICAL ONLY ------------------------------------------------------------------------------------------------ PERMIT: MECH 00 MECHANICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT R ULTS/COMMENTS *'4 01 9/18/03 LJH E FINAL TIME: 08:00 q.(E L� 641-2333x38 ------------------------------ COMMENTS AND NOTES -------------------------------------- CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD r� ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 03-00026198 Date 6/02/03 Property Address . . . . . . 1761 SEMINOLE RD Tenant nbr, name . . . . . . REPLACE EXISTING HVAC Application description . . . MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ SHADDEN, E. B. AIR ENGINEERS INC 1761 SEMINOLE ROAD 10947 BEACH BLVD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32246 (904) 641-2333 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 79 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Parmir FAa Tn1-al 79 . 00 79 . 00 . 00 . 00 . 00 . 00 . 00 . 00 79 . 00 79 . 00 . 00 . 00 City of Atlantic Beach aft CV0 ER RECEIPT aaa Oper: DSMITH Type: OC Drawer: 1 A Da6/12/83 11 Receipt no: 62656 De iption 26198 Qty Amount BP BUILDINS PERMITS 1 179.18 Tender detail C1( D ED(S 34189 179.M Total tendered 179.88 Total payment 179.18 Trans date: 6/82/13 Time: 9:22:34 M THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED R OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN . —CE 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. 5 -'�4 t•W... y d BUILDING OFFICIAL 6/a BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC e1ACH, FLORIDA 31,133 APPLICATION FOR MECHANICAL PERMIT CALLINNUMBER IMPORTANT—Applicant to complete all items in sections I, II, III, and IY. I. . LOCATION St.. Addnn: L OF Ixt.rr..n.q sl...h: A.....nr�A,d WILDING s.sal.+a.nUlf II. IDENTIFICATION — To be completed by all applicants, fn anud.nfio. o! p.rmH qi..n for doing th• —1, a d.rcri6.d in Ih. .bo.. rt•r..n flh th• •If.ched pl.n •nd rp.ullulionr which .,r h•..ol •"d •Cc d..c•n..;Ih 11...6y.qr.. ro p ill. u7d .ori le .ccerd.nc• o!good.pr.ctic• li.t.drjh ��� p '" Ciry o!J.c6on.ill. o.dln•nc.r •nd .t•nd•rdr N.rw• •(M•<h••I<.1 n C.nfnclen Gnk.•1•r (hlnll C I /�, Mnf.r q /� Pre p.rty O—r Slge.len of ow..r v «Aefhsrhsd Aq•el A ehil.ef er Engln.•r III• GENERAL INFORMATION A. Type e(M.tlnq Nish B. IS OTHER CONSTRUCTION ■EING DOME ON THIS BUILDING OR SITE? ❑ Gu—0 L! ❑ N.t.nl ❑ C.ntnl Utnity ❑ Op lF YES, GIVE NUMBER OF CONSTRUCTION PERMIT ❑ Olhsr—sp.cify Iv. MtgCiUNr-AL OQuipm rT TO is INSTALLED NATIJ}►E OF WORK 1►nv(de wrepl.t.tilt of compon•nh o.b•d of this 6-1Q/Reeidentlel or ❑ Commerclal Heat ❑ Sp•c. ❑ Add C3scawC..tnl C) p_ ❑ New Building fd A1r C°•drlbninq: ❑ Roorw Q Gafrel ,�Exlsling Building .rn: ❑ Ded Sy.lM.Nri.I Thidn.•. Id''Haplac•ment of existing system M•.Imvm -p—ity rjm ❑ New Insiallatlon(No system pfwlousiy Inatailed ❑ I(.(riq..K— ❑ Extension or add-on to existing system ❑ Coellnq *o .. Gp.city ❑ Other—Specify ❑ fin grinllsnr N.r.►.r e( h«d. ❑ Eie•.fw Q M•nlih ❑ Eauls Fsr (n.rwb.rl . ❑.Geson.e psrnn. Is.rnbsrl THIS SPACA POR OFFICA USA ONLY Q. Tui. l.rn.r1. ❑ Llri�Oe�11 te1eMl (nYTb.!( ❑ Ilehrsd prove—w.rer ❑ lefren P—i) Appre+•d by D.ta D C!Iher—sp«Ih y.nwir F.. LISP ALL EQUIPMENT Ant CONDCIIONING AND REFRIGERAT70N EQUIPMENT Caped Ntmaber Valti DeeariDUoa m Modal Nuber Maaurzar urer (�.e)r 3tv 14 HEATING - FURNACES, BOILERS, PIREpLACES dye d[ Number Vnita U.earlDtSaa Mod.t Munber ][uuleaLtev (I Iy .�m7 E17 4 T/ZAA;e TANES now][any NambMi Bad No.Type LTr►d Nasoa of serial Appro.inA Contained ][aanfaatcasr No. Ascncr n � ���� /CITY OF 4&40 w /3 - Office of Building ff4al REQUEST FOR INSPECTION Date / �^ Permit No. Time / A.M. ReceivedP.M ( ~ . Job r ss Vality Owner's Name Contractor — BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL 11 Framing El Footing = Rough Wiring C 11Air Cond. & ❑ Re Roofing 11 Slab Temp Pole Top Out ❑ Heating Insulation ❑ Lintel _ Final ❑ Sewer Fire Place 7— e e Fab t READY FOR INSPECTION � Mon. Tues. � Thurs. Friday A:M: S A.M. Inspection Made PM. Inspector Final Inspection III Certificate of Occupancy C Date PSR-3844 12997 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH - --- PERMIT INFORMATION ----- ------- LOCATION INFORMATION Permit Number: 12997 Address : 1761 SEMINOLE ROAD Permit Type:PLUMBING ATLANTIC BEACH , FLORIDA 32233 "lass of Work:ALTERATION -- ------ LEGAL DESCRIPTION --------- Constr. Type:WOOD FRAME Block: Lot : Twp: Proposed Use: SINGLE FAMILY Section: 0 Subd: Rna - Dwellinas : 1 Subdivision: Est . Value: 0 - 00 Improv . Cost : 0 .00 Total Fees: 25 . 00 Amount Pail? 25 . 00 ` WNER INFORMATION - --__._ _. _ _ _ ____._ -_ APPLICATION FEES -- - - "lame: ELIZEBETH SHADPEN PERMIT ^ c nn Addr . 1751 SEMINOLE ROAD A?'LANTIC BEACH . FLORIDA 32233 - ----- CONTRA'"TOR INFORMATION !Name: B f< O FLUMBINO Addr: 13997 BEACH BL:'E JACKSONVILLE , FL 32224 *_ _Fr022593 ExTj 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 FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. $25. 0 1- i t: 001676, CHECKS °C ATLANTIC BEACH BUILDING DEPARTMENT 98100003221©00 By: t CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION : 1-161 's Fm 2oAz OWNER OF PROPERTY : PLUMBING CONTRACTOR Cl p�,��n� b �� C'o rny CONTRACTOR' S ADDRESS: 'l3L V r .i ACI<S(1 L)i C FL 3a,�, STATE LICENSE NUMBER: C,F C G d a 5(,1 3 TELEPHONE: 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 515k)OC TOTAL FIXTURES : x $3 . 50 + $15 . 00 MINIMUM PERMIT FEE SIGNATURE OF OWNER: 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 PRIOR TO COVERING UP - ( 904) 247-5834 CITY OF 4&44dC neaIC4-vnn�� i Office of Building Official REQUEST FOR INSPECTIO Date � Permit No. Time Z Lyt A.M. Received CJ P.M /"7 6a,) x Job Add ss ocality Owner'srJ Name Contractor BUILDING CONCRETE ELECTRICAL PLUMBING ` ECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough Air Cond. & ❑ Re Roofing ❑ Slab G Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION Mon. Tues. Wed. Thurs. Friday -PAM -� A.M. Inspection Made 0 P.M. c �► Inspector Final Inspection ❑ Certificate of Occupancy ❑ Date //��11i/__ ,,{{..-- CITY OF nn//�� 1Y+L 4a4c B�-49&Uk Office of Building Official REQUEST FOR INSPECT Date v / Permit No. Time A.M. Received P.M. Job Address Locality Owner's �V 4e* /_r 1 Name Contractor rL BUILDING CONCRETE ELECTRICAL2R. !� MEC ANICAL Framing 11 Fooling El Rough Wiring ❑ ❑ Air Cond. &Re Roofing ❑ Slab ❑ Temp Pole r Heating Insulation ❑ Lintel ❑ Final ❑ ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION Mon. Tues. Wed. J Thurs. Friday �i� A.M. Inspection Made ✓ P.M. Inspector Final Inspection t7 Certificate of Occupancy I-- Date "Date _ _ PSR-3844 I W DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT INFORMATION -- - - - - -- - - LOCATION INFORMATION ----- `-ermit Number : 11902 "address : 1761 SEMINOLE ROAD Permit Type : PLUMBING ATLANTIC BEACH, FLORIDA 32233 "lass of Work:ADDITION --------- LEGAL DESCRIPTION ---------- Constr . Type:WOOD FRAME Block: Lot : Twp: C Proposed Use: SINGLE FAMILY Section: 0 Subd : Rna . Dwellings : 1 Subdivision: Est , Value: 0 . 00 Improv . Cost : 0 .00 Total Fees : 25 . 50 Amount ,E .n � 25 . 50 natA F iMj21F Q �1996 WG- __..____ _ nWNER. INFOI?MA,TION --_ ._-.�. _-- APPLICATION FEES ----- P4ame. =E-LI:�F,BExH SHADD N PERMIT 25 . 50 �.dde w ?""1 SEMTNO , ROAD 'U, BgAtH - FLORIDA Phone ------ AC�( _ INFORMATION dame: mo PL�i ING JACKSON E BEACH . FL L i c F 0192Q Exp : 8/31/1? T v p-o'., 4 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 PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCAT�11Fy� i VIOLATION OF APPLICABLE PROVISIONS OF LAW. Date: 5/:19/96 01 Rcpt: 0055604 CMEKS 7693 00100003221000 ATLANTIC BEACH BUILDING DEPARTMENT By. -/�� CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: f OWNER OF PROPERTY: L/ lE� SAff b z�c(\j PLUMBING CONTRACTOR: 60 CONTRACTOR'S ADDRESS:�j C7� ��c,Y�� Com/_ Q o�- (C� STATE LICENSE NUMBER: TELEPHONE: z �� HOW MKVY OF THE FOLLOWING FIXTURES INSTALLED r SINKS SHOWERS I LAVATORIES WATER HEATERS ' BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINES FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES: X 3.50 + $15.00 MINIMUM PERMIT FEE _ $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: �li( ------------------------ ------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834. 's CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD . , ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 -�r11319;a Application Number . . . . . 09-00000319 Date 3/10/09 Property Address . . . . . . 1761 SEMINOLE RD Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4200 ---------------------------------------------------------------------------- Application desc reroof fl 5444 . 7 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SHADDEN, E. B. ARLINGTON BEACHES ROOFING 1761 SEMINOLE ROAD 1327 TUTTER ST ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211 (904) 744-8888 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 51 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 4200 Expiration Date . . 9/06/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 51 . 00 51 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 51 . 00 51 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Permit No. Tax Folio No. State of FT ORTDA _ County of D AL To whom it may concern: •• _ operty#and In The undersigned hereby Informs you that Improvements igprov the followingWill information is �mm NOTICE OF accordance with Section 713 of the Florida Statutes COMMENCEMENT. . . Legal description of property being improved: l �� I EM 1 AJQ -E AUT 1 Address of property being improved: E l General description of improvements: RE–ROOF PREP , BY: c_arz�s Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) N/A Name Address NZA Contractor ARLINGTON BEACHES ROOFING INC. Address 1327 TUTTER STREET JACKSONVILLE FLORIDA 32211 Phone No. 744-8888 Fax No. 74S-0000 Surety(if any) N/A _amount of gond Address N/A Phone No. N/A Fax No. N A Nama and address of any person making a loan for the cpnStiL WOn of the improvements. Name N JA Address A P Fax No. N/A hone No. N/A Name of person within the State of Florida.other than himself,designated by owner upon whom nod=or outer aocuments may be served: Name Address N/A Phone No. N/A Fax No. N A In addition to himself.owner designates the following person to receive a copy of the Usnor's Notice as provided in- Section 713.06(2)(b),Florida Statutes. (Fill in at Owner's optwn). Name N/A Address N JA Phone No. N/A Fax No. N/A Expiration date Of Notice of Commencement(the expiration data is 0R8(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: / in the Doc#2009053285,OR BK 14800 Page 2333, Before me this — day o Number Pages:1 Count'�uval.State of .has personally appeared_.... Recorded 03/0512009 at 01:14 PM, s ' CITY OF ATLANTIC BEACH ROO.FING PERMIT APPLICATION asi•' , Date: Job Address. / 76 C A-7//VU Owner of Prepwty: Z= Address: Telephone: Contractor ARLINGTON BEACHES ROOFING,IN State License Number: CCC 1325530 Contractor's Address: 1 327 TOTTER STREET JACKSONVILLE, FL. . 32211 Telephone: 744-8888 FaA._745-0000 Scope of Work. RE–ROOF' l' �2L SISI fiM S• 25 ur �ASS »Mn57&-2 -21a ' Deck Slupe: S Greater than 2:12 ✓ Less that;2:12- Valuation of work: $ Product Dame(Examplc.Timberline): .Manufacturer(Example:GAF): ASTM Designation(s): FL 9'79,�, Requires!Inspections: Sheathing and Fina! Sig»aturi:of Owner- ace: Signature of Contractor: Date: AS TO OWNER. Sworn to and subscribed before me this day of State of Florida.County of Duval Notary's Signa U BARBARA BOZPMAN © Personalty * * MY COMMISSION#DD 719609 R1 PMdueed identification EXPIRES:May 17,2012 Type of identificatism produced FL ur4 cF��e ft*Tw Budget Notary BefVw AS TO CONTRACTa r` Sworn to and subacribod before me this— -�— day of ��- State of Florida,County of Duval Naary's Si gARBARABom" * My COMMISSION#DD 71� Personalty kno * EXPIRES:May 17,20 Produced identification .�°jForfld a g�dTMBu%etNo gSeMm Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5900 •Fax:'(404)247-584 •http:/twww.ci.stlantic-beach.fl.w rags 1 titvuo:?/21t03 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-dept@coab.us Application Number . . . . . 07-00001631 Date 12/04/07 Property Address . . . . . . 1761 SEMINOLE RD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc SEWER REPLACEMENT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SHADDEN, E. B. CHRISTY FIRST COAST PLUMBING 1761 SEMINOLE ROAD P.O. BOX 50446 ATLANTIC BEACH FL 32233 JAX BEACH FL 32240 (904) 247-4419 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 42 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/01/08 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 42 . 00 42 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 42 . 00 42 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES Dec 04 07 09:27a Brian D. Christy 904-249-4660 p.1 rf` CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION Date: I a y Property Address: —7(D I Owner: Telephone#: 7 Contractor: f'I T u Telephone#: Contractor Address:1Fax Contractor Signature: in consideration of permit gives for doing the work as described in the above statement,we hereby agree to perform said wont in accordance with the attached plans and speci5cationrs which art a part hereof wad in accordance with the City of Atlantic Beach ordinance and standards orgood practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: if other construWon is being done on this building or site, Q New list the building Permit ntnnber. O Re-Pipe Number of Fixtures: Bath Tubs Showers Closets Shower Pans Dishwashers Sinks . Disposals Urinals Floor Drains Washing Machine Lavatory Water j Sewer Water Heaters Sprinkler System Other Fees Permit Issuing Fee: S.35.00 Total Fixtures: X$7.00 + $35.00= 800 Seminole Road-Atlantic Beach,Florida 32233-5415 Phone:(904)247.5800- Fax: 1904)247-5845- htkp:Nwww.ciadandc4wach.fiAw Revised 1104 ,�3 `S CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 �JfI> INSPECTION EMAIL REQUEST: Buildin�dept&gab.us Application Number . . . . . 07-00001639 Date 12/06/07 Property Address . . . . . . 1761 SEMINOLE RD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ----------------- ---------------------------------------- --- ---------------- Application desc SEWER IMPACT FEE -------------------------------------- ------------- - ------ -- ---------------- Owner Contractor --------------- --------- ------------------------ SHADDEN, E. B. OWNER 1761 SEMINOLE ROAD ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . . 00 Plan Check Fee . 00 Issue Date . . . . 12/06/07 Valuation . . . . 0 Expiration Date . . 6/04/08 -------------------------------------------------------- ----- --------------- Other Fees . . . . . . . . . SEWER IMPACT FEES 1250 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total . 00 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 1250 . 00 1250 . 00 . 00 . 00 Grand Total 1250 . 00 1250 . 00 . 00 . 00 �Kill, z- PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Doc#2007362409,OR 6K 14277 Page 1868, Number Pages:4 Prepared by and return to: Filed&Recorded 11/20/2007 at 12:00 PM, Debra A. Ramsay, Accountant JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY City of Atlantic Beach RECORDING$35.50 800 Seminole Road Atlantic Beach, FL 32233 REAL PROPERTY LIEN The parties have agreed that this LIEN be filed against the real property owned by Elizabeth B. Shadden, and shall be recorded in the official public records of Duval County, Florida. This LIEN is for financed costs associated with the conversion of a private septic system to public sewer system and including sewer impact fees on the following real property located in Duval County, Florida, more particularly described as follows: RE#: 169636 0400 LEGAL DESCRIPTION: 20-20 09-25-29E Ocean Grove Unit No 2 S '/2 Lot 44 OWNER NAME: Elizabeth B. Shadden 1761 Seminole Road Atlantic Beach, Florida 32233 PROPERTY ADDRESS: 1761 Seminole Road Atlantic Beach, Florida 32233 This LIEN is to secure payment from Elizabeth B. Shadden to the City of Atlantic Beach in the amount of$7,042.41. 'n Witness (Sign Name) "ER: Elizabeth B. Shadden l�.S pt rJ 0 C-M Witness (Print Name) CITY OF ATLANTIC BEACH Witness ign Name) By CITY CLERK: Donna Bsseyfu Witness (P int Name) Page 1 of 2 Shadden Lien STATE OF FLORIDA COUNTY OF DUVAL Sworn to and s�-' nKA"e.,U cd before me this day of Nov&,*ier , 2007, by E-112,q-b e f-h who is personally known to me or produced L D L 5 35 v 2,2.-2, 3 9 c 1 O as identification, and who did not take an oath. t Notary Public State of Florida My Commission expires: -- MANCYE$ALLEY **MnM1M i W2M40 Page 2 of 2 Shadden Lien CITY OF ATLANTIC BEACH, FLORIDA UTILITY PAYMENT PLAN AGREEMENT PROPERTY DESCRIPTION: OWNER: Elizabeth B. Shadden 1761 Seminole Road Atlantic Beach, Florida 32233 PROPERTY ADDRESS: 1761 Seminole Road RE#: 169636 0400 LEGAL DESCRIPTION: 20-20 09-25-29E Ocean Grove Unit No 2 S '/2 Lot 44 TOTAL AMOUNT OF AGREEMENT: $7,042.41 This document shall serve as an extended payment agreement between you and the City of Atlantic Beach, Florida for the above listed total amount and for which said amount will be filed as a lien with the Court of the Circuit Court for Duval County, Florida until the entire balance is paid. CHARGES: Sewer Impact Fees $1,250.00 Contractor Amount 4,511.00 Filing Fees 35.50 , TOTAL CHARGES: $5,796.50 TOTAL AMOUNT FINANCED $5,796.50 TOTAL AMOUNT OF LIEN $7,042.41 Number of Monthly Payments 120 Due Date Due monthly with your utility bill Billing Included on utility bill Late Charges 10% Failure to pay all charges will result in the water services being cut-off. Payment Amount $58.69 per month Total Interest over term of loan $1,245.91 Interest Rate 4.00% LIEN: A lien in the amount of the TOTAL AGREEMENT above shall be executed and recorded against the above referenced properties. The owner hereby agrees to pay all recording fees and costs involved with the execution of the lien. Upon payment being made in full, the lien shall be released of record. Please indicate your acceptance of the provisions of this agreement by signing in the place indicated. Your signature signifies your agreement to indemnify and hold harmless the City of Doc*2007362409,OR BK 14277 Page 1868, Number Pages:4 Prepared by and return to: Fled&Recorded 11/20/2007 at 12:00 PM, Debra A. Ramsay, Accountant JIM FULLER.CLERK CIRCUIT COURT DUVAL City of Atlantic Beach COUNTY RECOP.DING$35.50 800 Seminole Road Atlantic Beach, FL 32233 REAL PROPERTY LIEN The parties have agreed that this LIEN be filed against the real property owned by Elizabeth B. Shadden, and shall be recorded in the official public records of Duval County, Florida. This LIEN is for financed costs associated with the conversion of a private septic system to public sewer system and including sewer impact fees on the following real property located in Duval County, Florida, more particularly described as follows: RE#: 169636 0400 LEGAL DESCRIPTION: 20-20 09-25-29E Ocean Grove Unit No 2 S `/2 Lot 44 OWNER NAME: Elizabeth B. Shadden 1761 Seminole Road Atlantic Beach, Florida 32233 PROPERTY ADDRESS: 1761 Seminole Road Atlantic Beach, Florida 32233 This LIEN is to secure payment from Elizabeth B. Shadden to the City of Atlantic Beach in the amount of$7,042.41. Witness (Sign Name) WNER: Elizabeth B. Shadden y O C M 04 n Witness (Print Name) (^I CITY OF ATLANTIC BEACH Witness ign Name) By Z CITY CLERK: Donna Bgssey N Witness (P int Name) Page 1 of 2 Shadden Lien Atlantic Beach, FL, from any and all damages resulting from your failure to timely make the above payments, including reasonable attorneys fees and court costs. The City of Atlantic Beach looks forward to cooperating with you under this agreement. PROPERTY OWNER Zl/ kBy i, Date: El''abeth B. Shadden CITY OF ATLANTIC BEACH By: Date: Jim Hans n, City Manager Elizabeth B. Shadden 1761 Seminole Road RE#169636-0400 Loan 5,796.50 Total Payments 7,042.41 Rate 4.00% Total Interest 1,245.91 Mos 120 Total Principal 5,796.50 Principal Interest Payment Payment# Amount Amount Amount Balance 5,796.50 1 39.37 19.32 58.69 5,757.13 2 39.50 19.19 58.69 5,717.64 3 39.63 19.06 58.69 5,678.01 4 39.76 18.93 58.69 5,638.25 5 39.89 18.79 58.69 5,598.36 6 40.03 18.66 58.69 5,558.33 7 40.16 18.53 58.69 5,518.17 8 40.29 18.39 58.69 5,477.88 9 40.43 18.26 58.69 5,437.45 10 40.56 18.12 58.69 5,39&89 11 40.70 17.99 58.69 5,356.19 12 40.83 17.85 58.69 5,315.36 13 40.97 17.72 58.69 5,274.39 14 41.11 17.58 58.69 5,233.29 15 41.24 17.44 58.69 5,192.05 16 41.38 17.31 58.69 5,150.67 17 41.52 17.17 58.69 5,109.15 18 41.66 17.03 58.69 5,067.49 19 41.80 16.89 58.69 5,025.70 20 41.93 16.75 58.69 4,983.76 21 42.07 16.61 58.69 4,941.69 22 42.21 16.47 58.69 4,899.47 23 42.36 16.33 58.69 4,857.12 24 42.50 16.19 58.69 4,814.62 25 42.64 16.05 58.69 4,771.98 26 42.78 15.91 58.69 4,729.20 27 42.92 15.76 58.69 4,686.28 28 43.07 15.62 58.69 4,643.21 29 43.21 15.48 58.69 4,600.01 30 43.35 15.33 58.69 4,556.65 31 43.50 15.19 58.69 4,513.15 32 43.64 15.04 58.69 4,469.51 33 43.79 14.90 58.69 4,425.72 34 43.93 14.75 58.69 4,381.79 35 44.08 14.61 58.69 4,337.71 36 44.23 14.46 58.69 4,293.48 37 44.38 14.31 58.69 4,249.10 38 44.52 14.16 58.69 4,204.58 39 44.67 14.02 58.69 4,159.91 40 44.82 13.87 58.69 4,115.09 41 44.97 13.72 58.69 4,070.12 42 45.12 13.57 58.69 4,025.00 43 45.27 13.42 58.69 3,979.73 44 45.42 13.27 58.69 3,934.31 45 45.57 13.11 58.69 3,888.74 46 45.72 12.96 58.69 3,843.01 47 45.88 12.81 58.69 3,797.14 48 46.03 12.66 58.69 3,751.11 49 46.18 12.50 58.69 3,704.92 fAseptic tank\amort schedule Elizabeth B. Shadderi 1761 Seminole Road RE#169636-0400 Loan 5,796.50 Total Payments 7,042.41 Rate 4.00% Total Interest 1,245.91 Mos 120 Total Principal 5,796.50 Principal Interest Payment Payment# Amount Amount Amount Balance 50 46.34 12.35 58.69 3,658.59 51 46.49 12.20 58.69 3,612.09 52 46.65 12.04 58.69 3,565.45 53 46.80 11.88 58.69 3,518.65 54 46.96 11.73 58.69 3,471.69 55 47.11 11.57 58.69 3,424.57 56 47.27 11.42 58.69 3,377.30 57 47.43 11.26 58.69 3,329.87 58 47.59 11.10 58.69 3,282.29 59 47.75 10.94 58.69 3,234.54 60 47.90 10.78 58.69 3,186.64 61 48.06 10.62 58.69 3,138.57 62 48.22 10.46 58.69 3,090.35 63 48.39 10.30 58.69 3,041.96 64 48.55 10.14 58.69 2,993.41 65 48.71 9.98 58.69 2,944.70 66 48.87 9.82 58.69 2,895.83 67 49.03 9.65 58.69 2,846.80 68 49.20 9.49 58.69 2,797.60 69 49.36 9.33 58.69 2,748.24 70 49.53 9.16 58.69 2,698.72 71 49.69 9.00 58.69 2,649.02 72 49.86 8.83 58.69 2,599.17 73 50.02 8.66 58.69 2,549.14 74 50.19 8.50 58.69 2,498.96 75 50.36 8.33 58.69 2,448.60 76 50.52 8.16 58.69 2,398.07 77 50.69 7.99 58.69 2,347.38 78 50.86 7.82 58.69 2,296.52 79 51.03 7.66 58.69 2,245.49 80 51.20 7.48 58.69 2,194.28 81 51.37 7.31 58.69 2,142.91 82 51.54 7.14 58.69 2,091.37 83 51.72 6.97 58.69 2,039.65 84 51.89 6.80 58.69 1,987.77 85 52.06 6.63 58.69 1,935.70 86 52.23 6.45 58.69 1,883.47 87 52.41 6.28 58.69 1,831.06 88 52.58 6.10 58.69 1,778.48 89 52.76 5.93 58.69 1,725.72 90 52.93 5.75 58.69 1,672.79 91 53.11 5.58 58.69 1,619.67 92 53.29 5.40 58.69 1,566.39 93 53.47 5.22 58.69 1,512.92 94 53.64 5.04 58.69 1,459.28 95 53.82 4.86 58.69 1,405.45 96 54.00 4.68 58.69 1,351.45 97 54.18 4.50 58.69 1,297.27 98 54.36 4.32 58.69 1,242.91 99 54.54 4.14 58.69 1,188.36 fAseptic tank\amort schedule Elizabeth B. Shadden' 1761 Seminole Road RE#169636-0400 Loan 5,796.50 Total Payments 7,042.41 Rate 4.00% Total Interest 1,245.91 Mos 120 Total Principal 5,796.50 Principal Interest Payment Payment# Amount Amount Amount Balance 100 54.73 3.96 58.69 1,133.64 101 54.91 3.78 58.69 1,078.73 102 55.09 3.60 58.69 1,023.64 103 55.27 3.41 58.69 968.37 104 55.46 3.23 58.69 912.91 105 55.64 3.04 58.69 857.26 106 55.83 2.86 58.69 801.43 107 56.02 2.67 58.69 745.42 108 56.20 2.48 58.69 689.22 109 56.39 2.30 58.69 632.83 110 56.58 2.11 58.69 576.25 111 56.77 1.92 58.69 519.48 112 56.96 1.73 58.69 462.53 113 57.14 1.54 58.69 405.38 114 57.34 1.35 58.69 348.05 115 57.53 1.16 58.69 290.52 116 57.72 0.97 58.69 232.80 117 57.91 0.78 58.69 174.89 118 58.10 0.58 58.69 116.79 119 58.30 0.39 58.69 58.49 120 58.49 0.19 58.69 0.00 f:\septic tank\amort schedule 11/07/2007 17:02 2443455 PAGE 01 PROPOSAL 10 CHRISTY FIRST COAST PLUMBING INC, P.O. SOX 50446 JACKSONVILLE BEACH, FL 32240 247-4419 (Office); 249-4660 (Fax) CFC068487 PROPOSAL. November 5,2007 Beth Shadden 1769 Seminole Road Atlantic Beach, FL.32233 Hm*248-3746 WK#244-3979 Fax#244-454 Re: $09tic Abandonment anfi Sear Tle In Run 39' 4' Schedule 40 PVC sewer line. Plumber is not responsible for sod or landscape worm needed . Bid price of job inoludes pump out fee and fill dirt for 1 tank abandonment, No downstream pollution or impact fees are included. Removal of drain field is not Included, Plumbing permit fee is included in bid price of job. Remove ocncrete & cut 16' x 26'4" & compacted good concrete replacement. 1 Cleanout Box installed, DVW to be Schedule 40 4" PVC. Cleyanouts as required by code. Water taps, sewer taps and any other city charges, other than plumbing perm It, to be billed to and peld for by owr .ar/builder. A signed copy of this contract must be in our possession before the mentioned work COMITances, Draws to be paid within 5 days of invoice date, If not paid, a service charge of 1,5% of the unpaid balance per month (18% annum) plus all cost of colisction, including attorney's fees Incurred in the event of legal action will be assessed. No plumbing vAIl be performed unless or untlt prior billings for this job have been paid. Page 1 of 2 4 11/07/2007 17: 02 2443455 PAGE 02 Christy First Coast Plumbing, Inc. will warranty our craftsmanship (InStGUtion only Of products and materials) for one year after completion of;ob. Products and material provided by Christy First Coast Plumbing, Inc. will carry the manufacturer's own warranty as applicable on defective products. The term °defective" shall not be construed as embracing damage that arises from misuse, negligence, Acts of Gad, normal wear and tear Or failure to fellow operafing or clean(ng instructions. Warranty work will be performed during regular working hours between 8.,00 a.m, and 5:00 p.m., Monday through Friday, except on holidays. We propose to furnish pipe and labor in eccordance with the above prices and speolflcadons for the sure of Four>09GAlid Flys Hundr q6,Eleven. atlara DRAWS: Total to be paid upon completion of Brian D, Christy, Presideni/Owner pate The above prices, specifications and conditions are satlsfaelory and are hereby accepted. You have authorization to perform the work as specified above. Sig,hplure ate Our proposal Is subject to any industry standard price increases. Page 2 of 2 Duval County Property Appraiser - Parcel Summary Page 1 of 2 Avrw cojtr Home a Departments > Property Appraiser> Duval County Database Search Parcel Information Printable Version Owners Name: SHADDEN ELIZABETH B Real Estate Number: 169636 0400 Secondary Name: Property Address: 1761 SEMINOLE RD Mailing Address: C/O ELIZABETH SHADDEN POSR City: ATLANTIC BEACH 1761 SEMINOLE RD Zip: 32233 ATLANTIC BEACH , FL Unit Number: Zip: 32233 2008 Exempt Value: $25,000.00 PARCEL DESCRIPTION Property Use: 0100 SINGLE FAMILY Transaction Date: 1/10/1997 Transaction price displayed is based on the actual amount of Legal Description: 20-20 09-2S-29E OCEAN GROVE Transaction Price: $100.00 documentary stamps paid at the UNIT NO 2 S1/2 LOT 44 - time of recording.The current rate is 70 cents per$100. Subdivision: 3097 OCEAN GROVE UNIT 02 Section/Township/Range: 092529 No. Buildings: 1 Official Record Book and Page: 08526-0603 Heated Area: 1763 Map Tile: 9409 Exterior Wall: Tile/Frame Stucco VALUES FROM 2007 TAX ROLL Agriculture Land Value: $0.00 Taxing Authority: USD3 Land Value: $135,000.00 Building Value: $135,930.001 View Parcel Tax Record Extra Features Value $3,233.001F- =Tot 3,233.00 Total Improvement Value $139,163.00 Tax Estimator Market Value: $274,163.00 Assessed Value $126,270.00 Exemptions Total $25,000.00 1,tt„-//ann¢ cni netJPAO/RENO.asD?RENUM=169636+0400 11/13/2007