1933 Seminole Rd (vault) ACH
LANTIC ]BE
CITY OF AT
OLE ROAD
800 SEMIN
ATLANnC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 06-00033222 Date 6/14/06
Property Address . . . . . . 1933 SEMINOLE RD
Tenant nbr, name . . . . . . 1 CU 1 AHU
Application description . . . MECHANICAL ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor--------------
----------
------------------------ NORTHEAST FLORIDA HEAT & AIR
HOLLEY P.O. BOX 60533
1933 SEMINOLE ROAD JACKSONVILLE FL 32236
ATLANTIC BEACH FL 32233 (904) 389-7458
---------- -----------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . - 87 . 00 Plan Check Fee . 00
Permit Fee . . . . Valuation . . . . 0
Issue Date . . . .
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 87 . 00 87 . 00 . 00 . 00
Plan Check Total . 00 ' 00 . 00 . 00
Grand Total 87 . 00 87 . 00 . 00 . 00
pERMrr LS AppROVED ONLY IN ACCORDANCE wffn Aj�L crff OF ATLANUC 19FACH ORDINANCES AND THE "RIDA
BUMDING CODES.
I'A
CITY OF ATLANTIC BEACH
P�
MECHANICAL PERMIT APPLICATION
Date: 6/2(
Property Address:
Owner: Telephone #: tkg
7 Ic-
Contractor:J"-),"�V-��Cozk yk--� %S:� * Ikk Telephone#:9OLL M3 7003
Contractor Address:5%A� 5xw�s& I�Ll 1--�VLSQM. Fax#: %q-75�3 7oW
In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance
with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of
good practice listed therein.
Type of Heating Fuel: If other construction is being done on this building
or site,list the building permit number:
&--"Electric
0 Gas: —LP —Natural —Central Utility
El Oil
0 Other—.Specify
MECHANICAL EQUIPMENT TO BE INSTALLED NATURE.OF WORK
R"Heat Space _Recessed V'Central Floor Residential
GK'AirCon—ditioning: _Room ��entral —
0 Duct System: Material Thickness — C3 Commercial
C3 Refrigeration Maximum capacity_cfrn Q New Building
0 Cooling Tower: Capacity gpm Q Existing Building
E3 Fire Sprinklers:Number of Heads
• Elevator: -- Manlift Escalator (Number) C3 Replacement of Existing System
• Gasoline Pumps —(Number)
Q Tanks (Number) E3 New Installation
• LPG Containers (Number) (No system previously installed)
• Unfired Pressure Vessel Q Extension or Add-on to Existing System
• Boilers
• Gas Piping C] Other-Specify_
E3 Other– Specify
LIST ALL EQUIPMENT
AIR CONDITIONING,REFRIGERATION EQUIPMEENT&CONDENSOR'S Approving
Number Units Description Model Manufacturer Ton's Agency
N\3f%10qQ LAL-
HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving
Number Units Description Model# Manufacturer BTU's Agency
WAU �Y \�N%UqQ VZU 942,OW UL
TANKS Nominal Capacity Type Liquid serial Approving
How Many &Dimensions Contained Manufacturer No. Agency
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800- Fax: (904)247-5845 - http://www.ci.atiantic-beach.fl.us
BEACH
OF AT NTIC
MECHANICAL PERMIT
800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEU 247-5826 FAX: 247-5877
T-- —Add-riss' SEN 40LEROAD 33
P FORMA ATLANTIC BEACH, FLORIDA 322
I Permit Numbe Range: 0 Book:
Permit'T.ype-. MECHANICAL Township: 0 Section:0
Class of Work: ALTERATION Lot(s): 6B Block:
proposed Use: Subdivision: BEACHSIDE
Square Feet: _Rarqel Number:
C)WNEI1WFO1"MIJO
Est. Value: "a -e: ';����LEE
Improv. Cost: 10/11/2001 19-33 SEMINOLE ROAD
Date issued' 29-00 Address: ATLANTIC BEACH, FLORIDA 32233
Total Fees: 29-00 -1639
Amount Paid: 7, 1' (904)241
D.
10/11/2001
3te Paid: , — --NDF- 16N FEfL.-S -
ffp�LACE CO ENSW -I&A
Work esc: RE 0
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TSr: DEOUESTE A LEA
c- -- -. - -- - AND
NOTICE- (,KLSPEC
CEO IqPUBLIC SPACE
Ila,WORK MUST p4bT LA
Is ROM TJ7
BUILDING MATERIAL6,Re�,,*1-1w- 0 NER -
MUST BE CLEARED THE
RF,6LT IN
;T -
"FAILURE TO COMPLY Ito
)WNER PXVIN
PROPERTY (
RMIT AND SUBJECT To REVOCATION
ISSUED ACCORDING TO APPROVED I 31ONS
FOR VIOLAT OF APPLICABLE PROVI'
Date: 10/11/01 01 Receid: 20027136
CHECKS wj--
ATLANTI BEACH BUILDNzb6PT- 3221000
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
�Tt��TlC-�CH. rl-O.MA 3.431
APPLICATION FOR MECHANICAL PERMIT CALL-iN xUM3EFj
IMPGRTANT—Appiic ant to complete ail items �n sactions 1, 11, 111, and IV.
LOCATICNI
A.4
IIIJILDING
If.KIDENTIFICA,7ICN To be campltIi-ed by all aPplicants,
d.—i6.4 i. th:
-ilk ph.
FIM4.-E. 4
A-k;
Ill. G-EN09-AL INFCIRMATION
A. T1p..4 hi.�z
13 OTHEA C3NISTRUCTION &EING WINE GN
0. B--tri. TH 1 3 AUIL31MG CIR 31TX I
0 G..—0 Ly C: N.t.-I C] C-04 utfilly
[2 Go IF YES. GIVE NUMSEA QPr CONSTRUCTIGH
P"MIT
C]
IV. hdsCHAAr—kL SQUIPM111IN-T ra as INSTAI�Lm NATURE OF WORK
--PWI.110.(--P—.h..i..k i thi.f—I I!R��R.sldentW or E Commercial
H..1 C] Sp.- C] 1-4 C3 C..t-1 Cl p— Cl N..sulidl.0
P�Alr C4-lrfl�i,q: C2 1- Cif,�-C-fraI Ed.tlng auilling
C1 xiiiiing.1.tipm
0 N- (No yul-i pi-iauxly n4tAll.dj
0 E�L.n.l.n r dd�.to exisilng aystem
Oth.,-3p-Afy
R- 9.4.W.— 4-6., .4
C3 B-1.1 Q C3
THIS 2PACI POK Of"Ca USA ONLY
Q-6.
X—A.
C3
[3
0 L.k.. P-i� App--J
ca C---sp-ify
UST ALL SqUIF"AENT
ALK CUNDMOK114G AXU PLEMISERATIGN ZQU1rMF--fT
Numbr Unit. D-�rlvUott Model lt�br K-,d"bur
NZATVIC - FM4ACZ3, 30ILEF-3, Aapr--tw
N-ber UnItA =-OpUan Wo4.1'f�-b-r lta�uf*Aru-w
TANX3
He-xaay Xwb-1 Cxq�lt:7 --T74 LLqui4 Wa�of S--W Ap=
Lod Mtri.-Iona Cnt.Lnd 34-aflat- No-
CITY OF
&44CA-1V&UC&
7 VL93
Office of Building official q
REQUEST FOR INSPECTION
Date Permit No.
Time A.M.
Received P.M.
zli-7i,��-
6cality
Job Address
Owner's co r
Name
CONCRETE LECTRI-AL (:�P ��M MEC�HZIC
TBNI�
,) C
Rough Ej -N
Footing Rou Ir or�6.
Framing Slab E Temp Pole Top Out Heating
Re Roofing El Fire Place
Lintel 0 Final Sewer
Insulation Pre Fab
READY FOR INSPECTION
A.M.
Tues. Wed. Thurs. Friday—RM.
A M.
—P,M.
inspection Made
Final inspection><
1-ispector----- certificate of Occupancy E
Date
CITY OF
A
office of Building Official
REOUEST FOR INSPECTION
Permit No.
A M
Date
--�t 4— V—
Time e, P.M.
Received 01f
Locality
r Job Address
tor
Owner's Contrac
Name MBIN QM�EECHANICAL5
CONCRETE 1-7 Rough Air Cond.
Footing CET!�[- Heating
Framing Temp Pole Top Out Fi Fire Place
Re Roofing Slab Ei Sewer
Insulation Lintel Final Pre Fab
READY FOR SPECTION A.M.
ed.R Thurs. Friday�PM.
Tues.
Mon. A.M.
Inspection Made co Final Inspection E
inspector ertificate of occupancy
Date
CITY OF
B e=4-0;
office of Building official
REQUEST FOR INSPECTION
Date Permit No.
A.M.
Time P.M.
Received
Job Address S
Owner's Contractor
Name <:;:�� PLUMBING MECHANICAL
BUILDING CONCRETE IrIng Rough Air Cond. &
Framing Footing El Temp Pole Top Out Ej Heating D
F-1 Fire Place
Re Roofing 01 Slab Final sewer
Insulation Lintel Pre Fab
READY FOR INSPECTION A.M.
Thurs. Friday_RK
Mon. Tues -A�M
.M.
Inspection Made Final Inspection 7
Inspector- Certificate of occupancy 7
Date
CITY OF
13we.4—
office of Building Official
REQUEST FOR INSPECTION
_q Permit No.
Date
Time M.
Received M.
ity
Job ress
Owner's Contractor
Name
BUILDING ONCRETE ELECTRICAL PLUMBING MECHANICAL
Footing L Rough Wiring Rough D Air Cond. &
0 Temp Pole Top Out 0 Heating
Re Roofing Slab Sewer D Fire Place
insulation --/11 Lintel F, Final Pre Fab
READY FOR INSPECTION
Tues. Wed. (Thur:� Friday M.
Mon.
A.M.
Inspection Made PM.
Final lnspecti;?T-
inspector certificate of Occupancy
Date
12115
PSR-3844
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
----- PERMIT INFORMATION LOCATION INFORMATION
Permit Number : 12115 ddress : 1933 SEMINOLE ROAD
r e ss
10
Permit Type: BUILDING ATLANTIC BEACH , FLORIDA 32233
- LEGAL DESCRIPTION ----------
'lass of Work:ALTERATION Block - Lot * Twp*
Constr . Type:WOOD FRAME
Section: 0 Subd- O Rng,
Proposed Use: vi
Dwellings : Subdivision:
Est . Value : 0 . 0c,
Improv . Cost ! 1 400 -00
Total Fe*41`1 25 -00
MW 25 . 00
ILL QC T M T.T1 TN(' ANPI TNVTT
A,.TION APPLICATION FEES -----25 -00
vERMIT
Addi: ROAD
T�*" BtA FLORIDA 3�
R FORMAT I ON
Uc I,
Name . LUC IN —TISTRUCTION
—241"kT, I t—MV-1,1
ATLANT RACH , FLORIDA 3223-
Exp ,
L i q�-
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
P BY EITHER CONTRACTOR OR OWNER
CLEARED
[E7 UP AND HAULED AWAY
CHANIC'S LIEN LAW CAN RESULT IN
"FAILURE TO COMPLY WITH THE ME G IMPROVEMENTS99
THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDIN
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR
ISSUED ACCORDING TO APPROVED PLANS I
FVIOLATION OF APPLICABLE PROVISIONS OF LAW.
i�Glty ot Atlantic Bch.!
ATLANTIC BEACH BUILDING DEPARTMENT
By: .�ell
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL , ADDITIONS OR ALTERATIONS
DEMOLITIONS
Owner(s) :_Wuk Lee
Address : Phone :
Lot # Block or Unit # Subdivision:__—
Contractor :
Address : 4fO_�(f �SIUO( , PhoneNo: 0_4 31�
Describe work to be done:
��Pyp_
Present use of building : jF 16(effe,
Valuation of Proposed Construction:
Proposed. use:_
Is this I�n addition? MID 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:
-19 -
Signature CONTRACTOR: Date :
09803
PSR-3844
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
----- PERMIT 'INFORMATION -------- LOCATION INFORMATION --------
Address : 1933 SEMINOLE ROAD 32233
Permit Number : 9803 ATLANTIC BEACH , FLORIDA
Permit Type: MECHANICAL -------- LEGAL DESCRIPTION ---------
L
OCAT 10
F-----PERMIT e s , 1 33 SE'
s
AT LANT
LEGAL
Class of Work: ALTERATION Blo c k-, Section:
Lot : Block,
Constr . Type: WOOD FRAME o i
Proposed Use: SINGLE FAMILY Township : RNG7, 0
Dwellings : 1 Code : 0 --Subdivision: ATLANTIC BEACH
Estimated Value : $0 .00
Improv . Cost ' $0 .00
Total Fees ' $25 -00
Amount Paid ' S25 -00
Date paiij, 3/
Work LEE
---- APPLICATION FEES -----
P
OWNER INFOFRMATION PERMIT $1415 .00
"A
I a ru e � pR1_DPERTY OWNER
M nL WATER IMPACT FEE $0 .00
Audress : 1931� SEMINOLE Rr0,1AD $0 .010
C Lr)RIDA S, - -
SEWER IMPACT FEE
ATLANTIC BEACH , FLORIDA
WATER METER/TAP $0 . 00
Phone: RP.DCN GAS-H ,R - S .0 .00
------- CONTRACTOR INFORMATION RADON CAB 5% $0 . 00
-APITAL IMPROVE. SO .00
Name HUXHAM HEATING & AIR SEWER TAP $0 .00
BEACH BOULEVARr CROSS CONNECTION 150 .00
.ddress '
jAcKSONVILLE BEAt7F FT_ SEC H IMPACT FEE so � ocl
Licens�- R A r`v 2 43 5 2 Type ' Cn-NST , SURCHAR(-',E S0 .00
SCHARGE/ATL - ECH ,
NOTES:
NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE
FBUILDING MATERIAL, RUBBISH AND DEBRIS
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
CHANIC'S LIEN LAW CAN RESULT IN
"FAILURE TO COMPLY WITH THE ME NG IMPROVEMENTS95
THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDI
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW. -fN0hX0) N9KK*W1 sr,,,(Ki 14
ATLANTIC BEACH BUILDING DEPARTMENT 3/07i% 01 Rept: 0OXMI
17-57
By
OF
Al", ArV-
014fice, 01 Building Offici3l
P,EQUEST FOR INSPECTION
Permit No.
Date
Time
Received
19313 Locality
93
Job Add
owner's Contractor
N a m e IG C JCAL
EL LUIVIBIN ME
BU ING cONCRETE Rough Air Cond. &
ea ing
Footing F� Top Out
Framing Slab Temp Pole Fire Place
Re Rootin Lintel Final — Sewer Pre Fab
insulation T
READY FOR INSPECi ION AAL—
Wed Thurs.
F d
Mon. :qTues A.M. .9
Inspection Made Final inspection
C C
ertificatc of occupancy
D O."t
ate k
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC MEACH, FLORIDA 322*2
APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER
IMPORTANT — Applicant to complete all items ;n sections 1, 11, 111, and IV.
LOCATION Street Address: Fly-,("I&&
OF Intersecting Streets: Between —A"
BUILDING
Sub-div;s;on
11. IDENTIFICATION — To be completed by all applicants ,
In consideration of porm;t given for doing the work as described in the above statement we hereby ogre* to perform said work ;A accordance
With the ottachpd plans and specifications which orts a part hereof and in accordance with the City of Jacksonville ordinances and stamclords
of good practice listed therein.
Nome of Mechanical Contractors
cointroctor 1 print) Lll_� Matter
Name Of
IlImporty Owner
sligio0wre of Owner signature of
or Authwixed Agent Architect at ling1weer
Y
Ill. CANERAL INFORMATION
A. Type of 6"firig W: IS OTHER CONSTRUCTION 991NO DONE ON
E3 Bectric THIS BUILDING OR SITE I X�s
0 "—0 LP 0 Natural 0 Central MAY IF Y9S, GIVE NUMBER OF CONSTRUCTION
(3 09 PERMIT
0 C"4W — Specify
IV. MICKAOICAL IQUWMINT TO K INSTAII MATURE OF WORK
(P go completo list of com p n"s"ft on boa of thk%m 1 0 Residential or 0 Commercial
C]- Host 0 Space 0 Recoe"d 0 C**W 0 Flow 0 Now Building
C) Ak Condrhioning: 0 Room 13 Control C3 Exleting Building
13 Duct Sysftm: Meftr4l 0 pliplaCeITWIt Of existing Iryallern
Maximum capacity 40AL 0 Now installation(No system PrOVIOustY InGtOROM
E) R011*f Tir- Extension or add-on to existing system
0 Other— Specify
0 Cooling Capacity
0 Pro *6nklom: Numbor of h"
[3 Eiovatw [3 Monlift [3 Escolotof, THIS VAICI FOR 0111"C111 UM ONLY
C) 64*0900 pumps (number)
C) Toah (numbor) Renwh
LPG coa%i on---
13 U*fw*d preuvre, N� IsenrA Aplprovod bjk.___ Dal&
C) 1-9 ni
0 00w — Specify Permit
UST ALL EQUIPMENT
AM CONDITIONING AND REFRIGERATION EQUUWLNT
Number Unfits Deocrtptka MOM NUMber scanuttetww (T1011111111)
09795
PSR-3844
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
PERMIT INFORMATION ---- ---- - -- LOCATION INFORMATION --------
9795 Address : 1933 SEMINOLE ROAD
Permit Number ! ATLANTI(2�*BEACH . FLORIDA 3223-1
LOCAT 1 0'
93
7_ ��re -S3 E
ATLANT T��
permit Type: ELECTRICAL L G
------- LEGAL DESCRIPTION ---------
.--lass of Work: ADDITION Lot . Block : Section:
o
Lot ,
Constr . Type: WOOD FRAME T j p
Township : RNG,
proposed USe7 SINGLE FAMILY bdivi i
pwellinas ' 1 Code: Subdivision:
Estimated Value : $0 .00
1- 90 .00
Improv . Cost :
525 -00
$25 .00
Am-
---- APPLICATION FEES
- --------- OWNER INFORMATION PERMIT 925 -OCI
kTION ---
Na-,rje : WANDR LFF D WRTEP 1MPAICT FEE
AddreEs - 1933 SEMINOLE ROAD 7 SO_ .rCN
FLOF 2
'Tr :3-
33 2-13' SEWER IMPACT FEE
ATLRNTIC EEACH : FLORIDA - - -
WATER METER/TAP
Phone , SO -00
RADON GAS-H �R_ S -
CONTRACTOR INFORMATION RADON CAB 5%
CAPITAL IMPROVE,
a-o.e : ALI� SERVICE ELECTFT.1'
SEWER TAP _00
F, BOX 16694 'ONNECTION $0 .00
CROSS C
jj�,,'_KSC�NVILLE , FL 32245-6t,-- SEC H IMPACT FEE
Type' 0 CONST. , sU1;,,-'HARGE
SCHAR9E/ATL .B1_"H .
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 MOUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
CHANIC'S LIEN LAW CAN RESULT IN
"FAILURE TO COMPLY WITH THE ME NG IMPROVEMENTS99
THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDI
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW.
000000000 000000000 $25.00 14
Date: 3/06/95 01 Rcpt: 0036565
MR03221000 14145
CITY OF ATLANTIC BEACH, FLORIDA
Approved bv APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE:
IMP013TANT 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.
Al-L
ELECTRICAL FIRMA!: MASTER F ECTIlICIANSIGNATUR JOURNEYMAN
NAME 6JAA)POA ADDRESS: __RFD_BOX
BLDG.SIZE BETWEEN:
n ES.PO APT. ( COMM. PU13LIC INDUS. t I NEW. OLDO REW.
ADDITION TRAILER ( TEMP. ( SIGNS SO. FT.
SERVICE: NEW ( INCREASE ( REPAIR ( FEE
CONDUCTOR SIZE AMPS COPPER ALUMJ
SWITCH OR DREAKEn AMPS PH Wl VOLTI RACEWAY
EXIST.SERV.SIZE AMPS PH wl VOLTI RACEWAY
FEEDERS NO. SIZE INO. SIZE No. SIZE
LIGHTING OUTLETS CONCEALED OPEN I
TOTAL
RECEPTACLES
CONCEALED OPEN TOTAL
0-30 AMP13. St-100 AMPS
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100 AMP0. ov
APPLIANCES I I BELL TnANSF.
AIR H.P. RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: I(W-HEAT�
0-1 OVER
MOTORS H.P. I VOLTAGE PHS No. I II.P. VOLTAGE PHS
MISCELLANEOUS
TnAM_5'PnPmrn_'�- iiKinrprnnv "i
PSR-3844 10061W0000100 09664
IM2W *jd3s 00 96/20/2 :a4ebEPARTMENT OF BUILDING —
?L 903 000000000 �00000000-
CITY OF ATLANTIC BEACH
----- PERMIT INFORMATION -------- LOCATION INFORMATION
Permit Number : 9664 Address : 1933 SEMINOLE ROAD
Permit Type : BUILDING ATLANTIC BEACH � FLORIDA V7"
Class of Work: REMODEL --------- LEGAL DESCRIPTION ---1 8
Constr . Type : WOOD FRAME Lot : 6B Block , 1 Section
Proposed Use, SINGLE �FAMILY Township- RNG:
Dwellings : 1 Code. 0 BEACHSIDE
CU
Estimated Value: � S7560 . OQ
improv . Cost : so .
To t F
Amount Pai -l ^
r—
WFNEL PI-)RCIR14 BREAKFAST FC�OM K, PFM-'-)r)F1 - 9SE I
OWNER INFORMATION ---- APPLICATION FEES
ame R'--�BERT WANDA LEE PERMIT
193-3 SEMINOLE ROAD WATER IMPACT FEE
�'TLAN71 .1' REACH , FLORIDA 32' 3-', SEWER. IMPACT FEE
� 904 ', -' 41 1639 WATER METER!TAP
RADON GAS-H .R� S �
------- CONTRACTOR INFORMATION RADON CAB 5% $0 . 05
Name: CONSTRUCTION -IAPITAL !MPRIDVE � $0 i.00
it e Er * 241 ATLANTIC BLVD. SEWER TAP so �0C)
ATLANTIC BRACH . FLORIDA 327-13 CROSS CONNECTION 80 .00
4 SEC H IMPACT FEE 50 ,00
er.S,7- : Type:
CONST . SURCHARGE
SC-RARr-4E'/ATL BCH
NOTES:
000000000 s.09 78
0o0000000 Rcpt-. 0028541
Date: 2/02/95 00
NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
t=
ING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE
C ED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
1 2 c'--
964 LURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN
T1 PROPERTY OWNER PAYING TWICE FOR THE BUILDING IMPROVEMENTS
I ION FOR
ISTUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERM T AND SUBJECT TO REVOCAT
VELATION OF APPLICABLE PROVISIONS OF LAW.
000000000 0000W" $75.00 14
ATLAMTIC BEACH BUILDING DEPARTMENT Date: 2/02/95 00 Rcpt: 002M
CASIi
00100003221000
By:
CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET
Address /C(rk�o L& ltc,0.
Date
Heated Square Footage @ $ 5�--00 per sq ft = 9 C-)
Garage/Shed @ $ 0 per sq ft =
Carport/Porch @ $ per sq ft =
,,;t 0-Cc
Deck $ ft = $
per sq
Patio @ $ per sq ft = $
TOTAL VALUATION : $
To�al Valuation 1st $
, , Fj,� 6� 0 -� 3S,00 $-
Remaining Value per thousa�d
or portion thereof
TOTAL BUILDING FEE $
+ 1/2 Filing Fee $
( ) Fireplaces @ $15 - 00 $
BUILDING PERMIT FEE $ '7
WATER IMPACT FEE
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT $
SEWER TAP $
( 1e6) RADON (HRS) .0050 $ 03-
SECTION H PAVING ( $
HYDRAULIC SHARES $
CROSS CONNECTION $
SURCHARGE .0050 $ A
- a/ - . 0
OTHER $
-76
GRAND TOTAL DUE $ L6 0
ADDITIONAL PERMITS OR FEES: Mechanical_; Pluimbing
Electric/New Electric/Temp_;SwimmingPool
septic Tank_ Well Sign Finish Floor Elevation
Survey ; Other_
CALCULATIONS and/or NOTES:
JAN 19 1995
Building and Zoning
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL , ADDITIONS OR ALTERATIONS
DEMOLITIONS
owner(s) : Ldanda 1,6C
Address : 522 V1 It 0-Ph..e :
Lot # Block or Unit # Subdivision:
Contractor : Oonl�_e
Address : A44M�c 5�Aone No:
Des be work to be done:
-P v - OVY
r�nv � �ijleifne6t 4.
Present use of building:
Valuation of Proposed Construction:
Proposed use:
Is this I 4n addit,ion? VeS If yes , what are the dimensions of'
the added space : ft . x ft . Will the a*dded area
be heated and cooled? New electrical (or increase) ? Y10
New plumbing fixtures? InO New fireplacelf)�O 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:
ED
Signature CONTRACTOR: -0-prmj,� ,�Ch
clry Llt X
pLA'NNING 8,
20
s.713.1 J F.S. RECORDERS USE ONLY
Aft.1- 92 NOTICE OF AF
COMMENCEMENT
(REOLARED IN DUPLICATE)
The undersigned hereby informs all concerned that Improvements will be made
to certain real property, and in accordance with section 713-13 of the Florida Statutes
(Revised 1-1-92),the following information is stated: APPLICANT LEAVE VOID
Legal Description of Property: & A-
General Description of Improvements:
Owner Name (printed):
Address: 161,-?:� -5("10,1011f
Owner's interest In Property: 100410
Fee Simple Title holder(if other than Owner)
Name (printed):
Add ress-
Contractor(printed); lj�7JM,CY70
Address: I�A- AV t
Suv-,ty (if any) (printed): __Amount of bond
Address:
Person or Lender making a loan for construction of Improvements:
Name (printed):
Address:
WARNING: OWNER CONSULT LENDER OR ATTORNEY BEFORE RECORDING THIS NOTICE OF COMMENCEMENT.
Person within the State of Florida designated by Owner upon whom notice or other documents may be served:
Narne:
Address:
In addition to himself, Owner designates the following person to receive a copy of the Uenor's Notice as provided in
Ser-tion 713.06 (2) (B), Florida Statutes (Fill in at Owner's option).
Natne (printed):
Address:
Date Signed
Owner Signature
�-k-r
(o-A b.)A ty,
, _) 7 , L Cr in County Of State
Ownw Nwm OMted) _mod
I FRI W 0 kMrr7L&AM it
r
N/1AP SHOWING SURVEY OF
LOT (OB —BLOCK I SEACPSIDE
AS RECORDED IN PLAT BOOK 4*2 PAGE 14-14c- OF THE CURRENT PUBLIC RECORDS OF C)LIVAL
COUNTY, FLORIDA Review of the fom7ft
Is hereby acknowlGdgel
L O'T 2 LOT -6
S-00'31' 00"S . 40.0c;
'0" E"EUT POZ D1Z:0QA(X ,
71LI
Fouwc) 3115 0 r� WOOD Fcuum
Imbw Roo (T-(P1CAL)'Z- IrZOLI PIPIF
W C.0 r>
0 IP
0
0
9.9 0
14
>t :__-_- T
40 Its- mclE
3-1- OW U1,4V
3 N
0 OD 4',4 4"
1-)LU COWC- V__
I:4-j 2 Al C
0 PA
'j 3_j Z-5700-( 02
FIZAI-1 E (I
7_55 . F]2.3*'gL
LOT LD A 1933 B.-7 LOT 7A
cov
LU E w-T*,mLXE
0
0
(r
N
vi
EASrzHEW'T FOC' LATTICE F:CwC'E
FVUCE SE'WSZS
X__0_-1�4 1
01
VOW LID 'I'l
jr4ou PIPE U 00* 31' 00 W- 40-coc)' Irtow PIPE
P Iw*T OF Iq
c_Q Mv A-TIJ ME A V:
0
SC- MIKIOLE KOAD
(5EHI�JOLE (3E-AC-14 V-D. [5-e PLAT
I OC; IZICHT OF WAY )
NOTE:
THERE MAY BE ADITIONAL RESTRICTIONS THAT APPLY
THAT ARE NOT SHOWN ON THIS SURVEY BUT MAY BE FOUND
NOMS: IN THE PUBLIC RECORDS OR FACILITIES OF THIS COUNTY
1. This is a boundary survey.
2. Flood zoneK as best ascertained from Flood Insurance
Rate Map, ccmTiunity panel no.vzovis-000,D dated 4 -1'7-Z9
3. Bearing dat= based on EA5T V-1W LIUE OF SeMlWaLS
m vzyq,L T---,
t4
i Ll" (00" u' 4-6-
APPROVED
CITY OF AfLANHC BEACH
BUILDING OFFICE
1 1995
ByL-
and
SCALE: I\ APPROVED BY: DRAWN BY F—14,c-
DATE: c� REVISED
L
DRAWlNG NUMBER
INA
�J> rz -j 0%
I.J
)U
5 y
6. 1�w e a-r-o vw P-1
"r-0 L CL e A< "a 0 C,vs: -4
v
Lx
y-I Te 41spr- %40"
-29,4
lw%,rm
fA--v-
IG�,c -srT I Co
4-t 4 -FO%'v'
6 S 1,70V
7DE
DRAWN BY
SCALE: REVISED 1�
DATE:
RAWING NUMBER
VA-T
DRAWN By't_:14�r-
SCALE: 14%' APPROVED BY: REVISED
DATE:
2- CC
IDRAWING NUMBER
800 SEMINOLE ROAD
ATLANTIC REACH,FT-
INSPECTION EMAIL R-EQUEST:
Application Number
Appiication type description ROOF PERMIT.
Property Zoning . . . . . . . TO PP TJPT-�,A�rVn
Z";T, v
------------------------------------------------------ -----------
APPlication desc
------ ------------------------ -------------------- - - -- -------
Owner
HOLLEY
DOmESTIC DESIGNS
1933 SEMINOLE ROAD
-- - .f
FERNANDINA BEACH FL 32034
(904) 321-0626
- ----------- ----- - -
Plonp nvnvTm
desc
Permit Fee 4 0 Pla.-.
. . . . 2200
L;,;!L e 6/01/08
------------------------------------------- - ----------------- - --------
Fee summar%r
- ------ ---------- ---------- ----------
Permit Fee Total 41 . 00 41 . 00 -00
Plan Check Total
41. 00 . 00 .00
Wiltz.1 LN A;�UUKU,;ACE VMH ALL un'Y OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH 07-
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
F7 OFFICEi(904)247-5826 0 FAX NO.:(904)247-W5
BUILDING-DEPT@COAB US
BUILDING PERMIT APPLICATION DUVAL COUNTY
1.JOB ADDRES& 1 2.VALUAI ION OF WORK �Q F�TUNBER ROOF
113-3 Atlantic Beach, FL 3223 3 :Z:7-pf, ap I SE OF STRUCTURE
4-LEGAL DESCRIPTION. 5 CLASS OF WORK 6�U
0 NEW BUILDING 0 DEMOLITION )9 RESIDENTIAL
LOT_BLOCK_SUB DIVISION 0 ADDITION 0 CONVERTING USE -[I COMMERCIAL
7 DESCRIPTION OF WORK: 0 ALTERATION [I ACCESSORY BLDG. 8.FIRE SPRINKLER:
;9 REPAIR OPOOL/SPA 0 YES El N/A
0 MOVE CIOTHER —,8NO
PROPERTY OWN CONTRACTOR: ARCHITECT/ENGINEER:
9 NAME 15.COMPANY NAME. 23 COMPANY NAME
16 NAME: 24.LICElqSEE NAME
10.ADDRESS 7.STATE OF FLORIDA LICENS!�Vo/ 25 STATE OF FLORIDA LICENSE NO
'ov - 10,
18.ADDRESS 26 ADDRESS.
11.OFFIC-E PUDNE 12 FAX NO.: 19 OFFICE PHONE: 20,FAX NO.: 27. PHONE. 28,FAX NO.:
13.CELL PHONE 21.CELL PHONE: 29.C,��HONE:
-2;X02 30.E��ADDRESS:
14.EMAIL ADDRESS: 22.EMAIL ADDRESS:
—FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER:
(IF OTHER THAN OWNER)
31 NAME 33,NAME, 35
32.ADDRESS 34,�DRESS: SS:
'136.;��E
T5--rreTCV7 111duv LU UV10111 0 V�11 it LV MU Ulu VVVFK�TFU 111�L011aLIOTT=C --y 11— 110 Wc
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating Construction in this
j.urisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Wells,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
222 WARNING TO OWNER: 222
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER or AGENT CONTRACTOR
Uf PAent,Power of Attorney or Agency Letter Required) J/9/I Y� /) (Qualifier Only)
/My yof
Signed Dale: A5,10 Signed: Date
Before me this d Of ZE01 f
d.
is
Before'A�sy f r 2007 in the county of s pe[5onal y appeared
D State of Florida,IT ;.nallCy ppe. Duval,Nt,of Florida,ha
herin by himself/herself and affirms that all statements and declarations are henn by himself/herself and affirks that all statements and declarations are
true and accurate. true and accurate. ic� L
Notary Public at Large,State of_,County of Notary Public at Large,State of & County of
Ea"Personally Kri EI Personally Kno 6 -11�
El Produced Identification- [141r-oduced Iden'711c t n :�3
Notary Signature: Notary Signte: -.. .. P I
F R-A I
P State of Florida
W Commi ion ires Feb 14,2010
y
01104, Carhy*DD0534375 nD 518533
COAB FORM BLDG01 REVISED:12/3/2007 - E M2010 Bonded By National Notary Assn.
BMW by(800)4U.Q54
FlorWe Ndary Assn.,Inc
.............................