469 Skate Rd (vault) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 08-00000680 Date 5/27/08
Property Address . . . . . . 469 SKATE RD
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 800
----------------------------------------------------------------------------
Application desc
REMOVE DOOR REPLACE WINDOWS
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
WALKER, VIRGINIA TRI-STAR CUSTOM BUILDERS
469 SKATE ROAD 5800 BEACH BLVD
ATLANTIC BEACH FL 32233 #203-415
JACKSONVILLE FL 32207
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------------
Permit BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee 17 . 50
Issue Date . . . . Valuation . . . . 800
Expiration Date . . 11/23/08
----------------------------------------------------------------------------
Special Notes and Comments
*2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE .
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total 17 . 50 17 . 50 . 00 . 00
Grand Total 52 . 50 52 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach
UP
PERMIT APPLICATION NUMBER
(To be assigned by the Building Department.)
Building Department
800 Seminole Road
Atlantic Beach, Florida 32233-,9445
Phone(904)247-5826 - Fax(904) 247-5845
E-mail: building-dept@coab.us L Date routed:
City web-site: http://www.coab.us
BUILDING PERMIT REVIEW AND TRACKING FORM
Property Address: SeAt 7-f XCI DepArtment review required Yes No
ildin_g_)
4u L
PTa—nning &Zoning
Public Works
Applicant: 1,0-1 &S2
Project: lAtay'E ba'al 41A Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: E]Approved. �<Denied.
e op-Q.
(Circl Comments., W f In AiV 7Pr4 -11 ")q.3 a *Iac' Spec 3 4::;Vrn
n8/�i ee r
46,0f,td&c4- Am-o va w iykd o 4., To e tt, ir-x d
603 1P147jfeV%a'k0ft-
PLANNING &ZONING
PUBLIC WORKS Reviewed by: 177. jcr�- Date: 5119-0cp
PUBLIC UTILITIES Second Review: FlApproved as revised. F]Denied.
Comments:
PUBLIC SAFETY 0 U
0
FIRE SERVICES
Reviewed by: Date:
Third Review: EApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
BuILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Sominole'Road,Atlantic Beach FL 32233 2008
Office: (904)247-5826 o Fax: (904)247-5845
Job Address: 4kT---, 724 Permit Number:
Legal Description
Valuation of Work(Replacement Cost) $ 606"00
• Class of Work(Circle one): New Addition (A--Iterat-i-o-� Repair M
M
• Use of existing/proposed structure U�s) Circleone): 'CUM—mercial A- 1A."fl5d
n in installed? (Circle one)- Yes 0 N/A
If an existing structure, is a fire sp er syste CT
• Is approval of homeowner's association or other private entity required? ( ircle o*ne : Yes
Describe in detail the type of work to be performed:
jn5 'D ooe-s Ald J' a.,4,n� VA ve le-
0
Proverty Owner Information
Name: U/,*lk"z- Address: ele 5.,k#- 7-e
City 7jVj.-.,s Re- -F,," State&Zip_L;4�3�Phone
Contractor Information: t;4Ae.5 Qualifying Agent.-e-20-74 C.-O
Name of Company: -711 s I-AA- �5 44.-It ..
Address: 571do -Bl,,b 403-4jr City tv- State f�� Zip .3 2--Zx,,-7
Office Phone 7 2-4- 3 5-5"2 Job Site/Contact Number 62e--3 7 9 kt
State Certification/Registration# e-RC 05-0 A 9 1' Office Fax 2 2,457-13-
Architect Name&Phone#
Engineer's Name&Phone# 71 C744 !f 1-4 CA 5
Application is hereby made to obtain a permit to do the work and installations as indicated Icerti thatnoworkor
fy_
installation has commencedprior to the issuance ofapermit and that all work will beperf9rmed to meet Me standards ofall
------- fwork is not commencedwithin six(6)
e ecomes null and void i
r gul ix (6) months at any.time after work is
'�w
months or Work, Plumbing, Signs, Wells,Pools,
comme�ce
Furnaces,
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CONDAENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IWROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
i hereby cert��that I have read and examined this a Ucation and know the same to be true and correct. Allprovisions9f
laws and ordinances governing this type ofworkwi be complied with whether specified herein or not. Thegrantingofa
permit tdivoes not presume to give authority to violate or cancel the provisions �)f a y other federal, state, or local law
regulating construction or the performance of construction.
Sig nature of Property Owner: Signature of Contractor:
F
Sworn to and subscribed before s�rorpto and subscribped before aZ 60
this 1.,e' Day of this I-'- Day of A/T. .
E)RVVEDAFOR CODE COMPL C
- to F I C BMaub
M5WPE*MITS FOR DITIONAL 0 ffRorW
Marsha P Hao
ONDMONS. My Commission DD588284
Ex0res i Oil 8/2010
03 Cu 15 Y: -I M E)Ores 10/18/2010
DATE: -.;13
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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 08-00000680 Date 6/02/08
Property Address . . . . . . 469 SKATE RD
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 800
----------------------------------------------------------------------------
Application desc
REMOVE DOOR REPLACE WINDOWS
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
WALKER, VIRGINIA TRI-STAR CUSTOM BUILDERS
469 SKATE ROAD 5800 BEACH BLVD
ATLANTIC BEACH FL 32233 #203-415
JACKSONVILLE FL 32207
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee 17 . 50
Issue Date . . . . Valuation . . . . 800
Expiration Date . . 11/23/08
----------------------------------------------------------------------------
Special Notes and Comments
*2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total 17 . 50 17 . 50 . 00 . 00
Grand Total 52 . 50 52 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
w
<
'EK 5Hf ET
ificjuration
IGN 5PECIffICATION5
C)PJDA BUILDING CODE(FBC)-RE51DENTIAL,A5CE 7-02, 2001 ND5,ACI,ATIC,AWPA,
FD 10-99
,NCY: KE51DENTIAL GROUP K-3(ONE-AND TWO-FAMILY DWfLLING5)
4LOAD5:
TPIU55:
IORD 20 P5F LL,BOTTOM CHORD 10 P51'LL
lOR.D 7 P5F DL,50TTOM CHORD 5 P5f DL
'CONVENTIONAL FRAME:
0
LOAD 2 P5F ILL, 1 0 P5f DL
LOAD 20 F5f LL, 10 P5F DL 3
WITH 5TOPAGE 30 P5F
5 WITHOUT 5TOKAGE 10 P5F
5
HORD 40 P5F LL,BOTTOM CHORD 0 P51'ILL
HORD 10 P5F DL,BOTTOM CHORD 5 P5f DL
ZONE:X g
DDITIONAL INfORMATION PER 2004 f5C - K
I T
,PRO ECTION FOP,ENCL-05ED E)E5fGN5:
IING PROTECTION 15 REQUIRED FOP DE51GN WIND 5PEED5 120 MPH
EATEK.
kCT PE515TANT COVERING MEE-TING THE PEQUIREMENT5
D 12,A5TM E 188G,A5TM If 199G.,OR MIAMI-DADE
1.202, 203. PKODUCT5 MU5T MEET THE REQUIKEMENT5
LARGE M1551LE Tff5T,OR
OF WOOD 5TRUCTUPAL PANEL5 MIN. 7/1 G'AND A MAX.
5PAN OF 8'. APPLICABLE FOR MEAN ROOF HEIGHT5 LE55 THAN 45AND
WIND 5PEEDS 140 MPH AND LE55.
EL5 5HALL BE PRECUT TO ATTACH TO THE FRAMING 5URROUNDING THE E
G AND PREDR.ILLED A5 REQUIRED W1 ALL HARDWARE PROVIDED. (3
HARDWARE MU5T BE PERMANENTLY ATTACHED. Lu �n
5TPUCTUKAL PANELS 7/1 G" FA5TENEP 5PACING(INCHE5)
PANEL LENGTH PANEL LENGTH PANEL LENGTH PANEL LENGTH
ER,(EMBED 2") L < 21 21<L <4' 4'<L < 0 <L <8' >
0 -L
DD 5CRfW5 IG, 10, 5.
)OD 5CREW5 I G" 12'
5CRfW`5 I G, IG, G"
0
D ZONE INfORMATION 0
76
ONENTS*CLADDING PRE55URE5
(P5f)
0
(Y u
INTERIOR ZONES END ZONES W
0 5f 25.9 28. 1 25.9 34,G
0 5f 24.4 27.0 24.4 32.5
)05f 22.9 25.7 22.9 20.4 WIL
----Mr-
�O 5f 24. 1 22.0 27.0 05-12-08
SCALE
DYL
NSION Of END ZONE IN fT. 4.0 080512
ZONE 15 LOCATED AT 5UILDI COKNEK5
1
2.23 WOOD
A. Wood framin6j shall be in accordance with f DC - Residential Section III except as noted in these. plans. 8
B. All wood members exposed to weather or in contact with masonry, concrete, or 5011 shall be pre55ure-treated.
C. All framinq anchors and connectors shall be Simpson or equal.
D. All prefabricated structural trusses shall be certified by the truss manufacturer's recy5tered en6jineer.
2.2324 fA5TENING5
The fastener Schedule for Structural Members in Table RG02.3(1)shall be Used UX0. in these plans.
All framincj anchors and connectors shall be manufactured by Simpson or e6jual unle55 otherwise noted.
All metal connections and fabrications shall comply with A15C specifications.
2.2307. 1 51LL5 ON CONCRETE
Where 51115 on concrete are Used, typical anchor b0It5 shall have a minimum diameter of 112" wl 2x2x3/1 G
minimum washer and a minimum embedment of 7" in concrete. Anchor b0It5 are required at the followincj locations:
A minimum of(I) anchor bolt shall be provided within G to 12 mchC5 of each end of each plate and a minimum
of(2) anchor bolts per plate.
Anchor bolts shall be located within 12" of corners and at maximum 5pacm6J5 of 2' o.c. t
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05-12-08
z
DYL
----1MMW-
080512
2
L .........J!
EX15TING CMU BLOCK
EXTERIOR WALL5 TO REMAIN
TYPICAL
ow
z
1�
EX15TING RE51DENCE TO REMAIN
4
EX15TING CMU 13LOCK
EXTERIOR WALL5 TO REMAI—N -7
TYPICAL Ir—
(s)
EX15TING CONCRETE —i
LINTEL T EMAIN
2:1
(2)3030
0
NEW CMU BLOCK
KNEE WALL
REMOVE EX15TING 0 -e
5LIDING GLA55 DOOR5
U)
IN5TALL NEW
1(2) 3030 VINYL WINDOWE
.2
5TRUCTURALFLAN
DVL
05-12-08
---9mr-
SCALE
�Wv v DYL
DUVAL COUNTY RE51DENTIAL CO�
5TRUCTURAL - Garacje, Door Reca
Dff
5QUARE fOOTAGE INfORMATION : DE51G�:
CONDITIONED 5FACE FIR5T FLOOP N/A 5.F. 9 r)Yn)A
APA,54,
CONDITIONED 5PACE 5ECOND FLOOR N/A 5.f. OCCUF
CONDITIONED 5FACE(ADDITIONAL) N/A 5.f. DESH
GARAGE(UNCONDITIONED 5PACE) N/A 5.F. ROO
N/A 5-f- TOP
UNENCL05ED 5PACf TOP I
LOT AREA(EXCLUDING WETLAND5 AND N/A 5.F. KOOJ
BODIE5 OF WATM RAFTIl
5TRUCTURE HEIGHT AND # Of 5TORIE5 CEIUJ
A Tj
mAxIMUM HEIGHT OF THE 5TRUCTURE IN FT. 20 ATT
NUMBER Of 5TORIf5 FLO
TOP
TYPE Of CON5TRUCTION TOP 1
TYPE V-13 FLOO
UNPROTECTED
UN5PRINKI-ED
OPENII
MATERIAL INfORMATION 1. orl
AND G
2. imi
ROOFING(MATERIAL 5HALL MEET THE THE REQUIREMENT5 OF CHAPTEP 9, OF n,�
TA5 2
FLORIDA BUILDING CODE-RE51DENTIAL). Of TH
2. UE
PANEL
DE51G
3. PA
OrENI
4. AL
wool
fA5TE
#8 W(
#ICY
1/4'U
WIND ZONE INIFORMATION
NOTE:TH15 5TRUCTURE HA5 BEEN DE51GNED IN ACCORDANCE WITH, M
AND MEET5 THE REQUIREMENT5 OF 5ECTION I GOG OF THE
2004 EDITION Of THE FLORJDA 13UILDING CODE. CON
TH15 BUILDING 15 LOCATED IN THE WIND BORNE DEBRI5 REGION 51ZE
BUILDING: ENCL05ED 5TRUCTUPE 0-
5A51C WIND 5PEED(M.P.H.-3-SECOND GU5T) 120 21-
1 51-
WIND IMPORTANCE FACTOR >
BUILDING CATEGORY 11
WIND E)(PO5URE CATEGORY 13 DIN
INTERNAL PRE55URE COEFFICIENT&CF" +/-0. 18 ENE
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 08-00000690 Date 5/27/08
Property Address . . . . . . 469 SKATE RD
Application type description RESIDENTIAL OTHER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3677
----------------------------------------------------------------------------
Application desc
REPLACE WINDOWS
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
WALKER LOWE ' S HOME CENTERS INC
469 SKATE ROAD PETER CAFARO/CONTRACTOR
ATLANTIC BEACH FL 32233 4948 TELSON PL
ORLANDO FL 32812
(904) 486-4701
----------------------------------------------------------------------------
Permit BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 50 . 00 Plan Check Fee 25 . 00
Issue Date . . . . Valuation . . . . 3677
Expiration Date . . 11/23/08
----------------------------------------------------------------------------
Special Notes and Comments
*2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE .
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50 . 00 50 . 00 . 00 . 00
Plan Check Total 25 . 00 25 . 00 . 00 . 00
Grand Total 75 . 00 75 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
13 1 \ -
City of Atlantic Beach PERMIT APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: Llt5
City web-site: hftp://www.coab.us
BUILDING PERMIT REVIEW AND TRACKING FORM
Property Address: 40qnW_e Department review required Yes/ No
a& Building
M6 —Public Works
Applicant: Louk5--, /& Planning &Zoning
Project: &OLIvi t0ind&05- Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLPATION STATUS
Reviewing Department First Review: &Approved. F�Denied.
(Circle one.) Comments:
PLANNING &ZONING
PUBLIC WORKS Reviewed by: /71 ko�� Date: S
CL
PUBLIC UTILITIES Second Review: []Approved as revised. FIDenied.
Comments:
PUBLIC SAFETY
FIRE SERVICES
Reviewed by: Date:
Third Review: [:]Approved as revised. FIDenied.
Comments:
Reviewed by: Date:
R E C F :
CITY 'i -.11I.- I-T-n
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
OFFICE:(904)247-5826 0 FAX NO.�(904)247-5845
BUILDING-DEPT@COAB.US M i �4A 0 0 8�
BUILDING PERMIT APPLICATION DUVAL COUNTY
51%
`00, OB ADDRESS A ORK� 3.§Q,,�P�NDER ROOF,:
W AL
QV LATION OF W
JV A 7.
TXLA--Iantic Beach, FL 32233
,1�4.'LEGAL bESCRIPTION" ",""7 5:�CLASS OF WORX0:z�'" 6.VSE OF STRUGTtJiREi,',.A717
0 NEW BUILDING )CRESIDENTIAL
LOT--� BLOCK SUBDIVISION 11 ADDITION EI CONVERTING USE 11 COMMERCIAL
C3 ALTERATION 11 ACCESSORY BLDG.
.#g,,,bESCRIPTI0N,*..6F WOFOCIW,�.� 8"FIRE SPRINKLER
0 REPAIR 11 POOL 11 YES 0 N/A
KE-?L.A-e-C-- 11 MOVE OTHERk ela,1,;,,"4iD NO
PROPIERTYOWNIERW,:� :-�'ARCHITECTI ENGINEER:.
9.NAME: 15�COMPANY NAME 23 COMPANY NAME
I ie-�A40nc
pefopi,b wru-leg-yz leg=
16.MME: 24,LICENSEE NAME.
AWA
10.ADDRES& 17.STA�OF LOBIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.
-7
qC-9 -F _ 4
18.AQJ 26 ADDRESS:
1.,2
&--flcH 01-4. 3aZ,33
11.OFFICE PHONE- 12.FAX NO.: 19 OFFICE PHONE: 120.FAX NO;: 27.OFFICE PHONE� 28.FAX NO:
5-
13.CELL PHONE: 2,1-,CELL P&54. <�ae 29.CELL PHONE:
14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30,EMAIL ADDRESS:
-05,,PM
M11,2! 614 r, ARA��141. W
�TGAG §YDER
1§(IF OTHEA THAN 6� V
31.NAME. 33.NAME 35.NZE:
32.ADDRESS. 34.ADDRESS 36.ADDRESS:
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells, Pools,Furnaces, Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNER's AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR-NOTICE OF COMMENCEMENT.
TM14
'a,
1-1
Koir,.AGENTj
IE
-M
.N
r�A�
g rj�M,
Signed: kn:�Q—& Date: Signed: Date: 11�
I 4:L d f
Before me this ayo 20(el�the county of Before me A��RVIllay of 1fiW 20JZ the county of
Duval,State of Florida,has personally appLred Duval,State of Florida,has personally appeared
Ahn-fVnief 15MOAjr
herin by himself I herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate. Tuvaj
Notary Public at Large,State of-5a\—", ountyof�)�--�i4�s Notary Public at Large,State of FL County of
0 Personally Known 11 Personally Known
[af<oduced clku4cation- -7 3 la -7 Ix Produced Identification-
Notary Signature; --,-o Notary Signature:
June Co D FOR CODE COMPLI 9. CUNNINGHAM
is! n#DI Notary Public-State of Florida
F A C BEAC A
0 WyCommission Expires Feb 28,2010
6 F 0 Z
1E I "I"ONA,
Commission 0 DD 523638
REQUIREMENTS AND CONDITION ss
S Bonded By National Notary Assn.
FILE C, VH
REVIEWED BY
k — DATE:
V
Wind-borne Debris Protection Affidavit
7-
(Date)
City of Jacksonville Permit No. B-
Building Inspection Division Address
214 North Hogan St,Room 225
Jacksonville,Fl 32202
1 understand that State law requires that windows replaced in a Wind-borne Debris Zone be installed with impact glass or be provided
with another approved method of wind-borne debris protection. I recognize that the structure involved is located in a Wind-borne
Debris Zone. I am in the process of having windows replaced which require this protection but have elected to not have the required
protection installed by the contractor installing the windows. I am requesting to be given until the date shown below to install the
required window protection that I have listed. I understand that if I do not install the required window protection I will be in violation
of State law and that the City of Jacksonville Building Inspection Division may take action to include,but not be limited to,fines,
withholding any further permits to this address,and/or termination of utilities,until such time as the window protection is installed. I
also understand that my insurance company may not reimburse me for damages suffered due to the lack of required window protection.
I agree to have the required window protection installed by: �,o - e - jQ C)R
(15ate)
I will be using the following material to provide the window protection: (check one)
A.V Plywood per the Florida Building Code
B_ Other approved method:
(Description)
If"B"provide Florida Product Approval Number
H Insurance Company_AL L S 7,4 7'Lc
=� If, 0)4A�
(Signature of property owner)
Before me this'l day of
In the County of Duval,State of Florida,Y personally appeared
Herein by himself/herself and affirms all statements and declarations herein are true and aceurate.
S, of
5;�;� , Notary Public at Large,State of_!E
C"X , 4
Pe—rsonally known or Produced Identification ID Type Cj
June Codner-KongQuee
DD541266
Commission#
r$p Expires April 17, 2010
About lax-I want to...-I am...-Services-Departments
�1% Bonded Troy 4#%4Cfl"jW 4k6*f.0gt93obs
630-CITY(2489)-Site Policies-Webmaster- 2002 City of 3acksonville
E C E i V E 0
CITY OF ATLANTIC BEACH
19- 2008
PV
2 of 2 4/13/2008 2:41 PM
ie in,---x 0
co ,4* net
0P.C4,11 Aebs-19 Jol'the 01y ol Jacksonyllis.Fbijda
SUBJECT BULLETIN G-05-08 WIND—BORNE DEBRIS PROTECTION AFFIDAVIT (Go BACK)
DATE 4/2/2008 7:29:00 AM
FROM Thomas H.Goldsbury,P.E.,C.B.O.
E20LIL ADDRESS
PHONE
VIA
TO All Permit Applicants
CONTENT April 2,2008
MEMORANDUM
BULLETIN G-05-08
To: All Permit Applicants
From: Thomas H.Golclsbury,P.E.,C.B.O.
Chief,Building Inspection Division
Subject: Wind-borne Debris Protection Affidavit
This Bulletin is regarding window/door replacement on existing single family homes located in the wind-borne debris region. When a
homeowner has decided to install the required wind-borne debris protection either himself/herself,or is hiring another contractor other
than the one replacing the windows/doors,the attached Wind-borne Debris Protection Affidavit will be required prior to issuing the
window/door replacement permit.
XC: James Schock
Lesley Davidson
I of 2 4/1 3/700R?-41 PM
Florida Building Code Online Page I of 4
FLORIDA OEPAPTIVIIEN. T OF a 0
BCIS Home Log In Hot Topics Submit Surcharge Stats& Facts Publications FBC Staff BCIS Site Map
Product Approval
USER: Public User
Produa A roval Menu >Product or Application Search >Application-W > Application Detail
FL # FL4328-R3
COMMUNITY PLANNING
Application Type Revision
HOUSING&COMMUNITY
DEVELOPMENT Code Version 2004
Application Status Approved
kEMERGENCY
MANAGEMENT Comments
k OFFICE OF THE Archived
SECRETARY E C E i
I CITY OF ATLAN71C 9. EACH
Product Manufacturer Pella Corporation "INJr, " 7�N�; 'Ir'
Address/Phone/Email 102 Main St. 1 L-4 2000
Pella, IA 50219
(641) 621-3494
robinsonsj@pelia.com LIP—
Authorized Signature Aaron Ryan
ryanaj@pella.com
Technical Representative Todd Umbel
Address/Phone/Email 2000 Proline Place
Gettysburg, PA 17325
umbeltp@pelia.com
Quality Assurance Representative Todd Umbel
Address/Phone/Email 2000 Proline Place
Gettysburg, PA 17325
umbeltp@pelia.com
Category Windows
Subcategory Single Hung
Compliance Method Certification Mark or Listing
Certification Agency Window and Door Manufacturers Associati(
Validated By
http://floridabuilding.org/pr/p�_app_Ldtl.aspx?param=wGEVXQwtDqulaWBOwvld3kJpq5zSA5QHwe... 5/15/2008
Florida Building Code Online Page 3 of 4
IlEvaluation Reports
11 Created by Independent Third Party
4328.3 1 ries 10 (411-H-720.03/.07) Vinyl Flange Sir
lWindow
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No 1-1-4328—R3—C—CAC—Pella CC-L.p-df
Approved for use outside HVHZ: Yes Quality Assurance Contract Exph
Impact Resistant: No
Design Pressure: +50/-50 Installation Instructions
L4328 R3 II FLORIDA P.E. DRAW
Other: H-R50 (3ft Oin x 7ft 6in), H-R50 (914mm
x 2286mm). Configurations of glass conform to 414A.pdf
ASTM E 1300-02. Verified By: Warren Schaefer 4413-r
Created by Independent Third Party
Evaluation Reports
Created by Independent Third Party
r�8.4 (411-H-721.00/.03) Vinyl Flange Sir
IlWindow —
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL4328R3—C—CAC Pella CCL-.Ddf
Approved for use outside HVHZ: Yes Quality Assurance Contract Exph
Impact Resistant: No
Design Pressure: +55/-55 Installation Instructions
Other: H-R55 (4ft 4-1/8in x 5ft 2in), H-R55 FL4328_R.3 II FLORIDAP.E. DRAW
(1321mm x 1575mm). Configurations of glass '-414A.pdf
conform to ASTM 1300-02. Verified By: Warren Schaefer 4413E
Created by Independent Third Party
Evaluation Reports
Created by Independent Third Party
r�8.5 eries 10 (411-H-721.01/.04) Vinyl Flange Sir
!Window
Limits of Use Certification Agency Certificate
Approved for use in HVHZ: No FL4328R3 C—CAC—Pella-CCL.r)df
Approved for use outside HVHZ: Yes Quality Assurance Contract Expli
Impact Resistant: No
Design Pressure: +50/-50 Installation Instructions
Other: H-R50 (4ft 4-1/8in x 6ft lin), H-R50 FL4328 R3 11 FLORIDA P.E. DRAW
(1321mm x 1854mm). Configurations of glass 1414A.pdf
conform to ASTM E 1300-02. Verified By: Warren Schaefer 4413-E
Created by Independent Third Party
Evaluation Reports
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P 429 393 829
RECEIPT FOR CEI'ITIFIEbWAIL
NO INSURANCE COVEPAGE PROVIDED
NOT FOR INTERNAIIONAL MAIL
CITY OF fSee Reverse)
a,
co --------1��
t d N
st-&X
00
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I., ode
ostage 1�
Certified Fee
December 8. 1989
'pecial Delivery e
Mr. and Mrs. Ronald Walker Restricted Delive ry Fee7 I er
.14
469 Skate Road 11--1 hmnn
Atlantic Beach, Florida 32233 Return Receipt sho
RE: Royal Palm Subdivision Watermain Replacement
City of Atlantic Beach, Florida
Dear Homeowner:
At approximately 11:00 a.m. , December 6, 1989, the construction crew
replacing your water meter felt elecirical shocks and observed electric
sparks arching between metal parts. The City's resident observer
immediately halted work until the Jacksonville Electric Authority (JEA)
arrived and disconnected your electric meter. With the electric meter
disconnected, the construction crew completed the installation of the
water meter and the JEA also installed a new electrical service to your
residence. However, I have been informed by the resident observer that
the electrical service replacement did not solve the problem and that a
dangerously excessive electrical charge still exists in your water
service line.
During the electrical service replacement, the JEA service crew told the
City's resident observer that you would be notified by JEA of this
situation. However, we feel it is our civic duty to also inform you of
this and to suggest that you have your electrician investigate this
matter further. Please be advised that there does appear to be a very
serious electrical problem with the wiring in your house and we strongly
suggest that you immediately take the necessary steps to ensure the
safety of yourself and others.
Should you have any questions please feel free to call.
Sincerely,
?D a ac '-'
City �anager
KDL/dst.
CERTIFIED MAIL P429 393 829
IFCID� DIT
19U
IA .
o>e
December 7, 1989
TO: Kim Leinbach/City Manager
FROM: Roger Stanley/Gee and Jensen
RE: Water Main Replacement in Royal Palms
At approximatley 11:00 am, December 6, 1989, the job superinten-
dent, James Garrison, informed me that his crew that is making the new
service connections to the existing Water Meters on Skate Road have felt
'Ishocks" while working on the Water Meter at 469 Skate Road.
Work was halted at the address until the JEA arrived and disconnected
the Electric Meter, thus allowing Scott Plumbing to complete the install-
ation of the new Water Service. The JEA has installed a new service to
this residence, but eletrical problems reportedly still ekist.
I personally observed electric sparks arcing between metal parts at
this meter. City personnel informed me that this problem has happened
before when making a repair at a residence in an older neighborhood. Also,
the work crew has reported "tingling" at other water meters, but this is
unconfirmed.
RS/kr
cc: Don C. Ford/Director Public Services
1989
Budding and Zoning
PSR-3844 7022
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
PERMIT INFORMATION -------- LOCATION- INFORMATION ----------
�-'erm t Number : 7() -)-�
1 — Address : 469 SKATE Rf..�AD
Permit Type: RE-R1-'OF ATLANTIC BEACH , FLORIDA 322133�
'lass of Work: NEW ----------- LEGAL DESCRIPTION ----------
Constr . Type: WOOD FRAME :.Ot , Block : Section*
Proposed Ilse : SINGLE FAMILY Township * RNG, r,
-�wellings ! 1 "odr- 0 -,ubdivi sion :
Estimated Value, 90 �00
Improv . Cost : 50 .00
Total Fees ; $22 . 50
Amoul- $22 . 50
E Rf'V�F WITH 19FW FT� A
OWNER INFORMATION APPLICATION FEES -----
"'22 - 50
3me- , RC)N WALJ�ER PERMIT
WATET
469 SKATE ROAr t, ,IMPACT FEE 1-40 . 00
4 `T, FEE $0 .00
LTLANTIC BEhCH , FLORIDA 3223 �5EWBIR- IMPAw
27 r WATER n MtTER- -p,r
2
RADON GAS-H .R . S .
------- CONTRACTOR INFORMATION RADr)N GAS - 5% IS0 , 00
Name: WILLT I S ENTERPRISES (�fl' 7A' WATER TAP �;0 .00
d d r e ss SEWER TAP 80 . 00
- HYDRAULIC SHARE SO .00
1 :7 e ax e J�COO 4,4 Type , C� CAPITAL IMPROVE.
S E C.H IMPACT FEE 0
"40 .00,
NOTES:
NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.95
V;EIUHIION DATE: 07/07/93
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AN�RkBJECT -ffMEWIIAMON FOR
$22.50
VIOLATION OF APPLICABLE PROVISIONS OF LAW. TENDERED $22.50
EMME $.00
RECEIPT NIMR: 094619
ATLANTIC BEACH BUILDING DEPARTMENT
By:
CITY OF ATLANTIC BEACH
PERMIT APPLICATION, ROOFING
Owner(s
Address: LA L (zi-T E
Phone:-_Iq
Lot # Block or Unit Subdivision
Contractor:
Address: '5C) ,)._ MZL( -j2D i Phone: 2- 1
State License
Describe work to be done::20- -- -26t'%Cr-oL'-
Materials to be used: �71,n4 �oL%A�C- L�)bex
Signature OWNER: Date:
Signature CONTRACTOR: Za �
FOR OFFICE USE ONLY
Date- -.�V-------------19 7e)
Permit # '17,46...Fee
CITY OF ATLANTIC BEACH Valuation _5 .............
--------- ----------
FLORIDA House #----- ............................
............................................................................
APPLICATION FOR BUILDING PERMIT
............................................................................
Application is hereby-made for the -approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can
be verified. / �2 - 9 - �70
Date.... ..................................................................1 19------------
T, �2?
---- ---------------------------------Address-,t0" 'W1 115; ---- ---------Telephone No- ------------------------
...............................
Owne -- ----- ------------ - - - ---------
Architect.............-----__----_--- Addres&-----------------------------------------------------------Telephone No---------_----_-----------
_...... .....
2- ---------- ---------------
�01-. ._ ____ ---------Address........__------------------------------------------------Telephone No------------_---------------
Contractor Builde,,,--.,,-,-,r------------ -------- ---- ----------------
Lot No.....-3--------------------------------------_Block No.----/-g----------------- Sub Division,�O�--- ------- -----------------------------Zone-----------------
':!�"/ ------ reet...4��-----Side Between—----------------- -- --------------------and. ............. ------- -----------------------Sts.
--J------------------------C�------ St
Valuation
----------------.-..For what purpose will building be used---- ----------------------- -----Type of construction- ---_----_--_- --------------
... 41-0 ' - P , �7�_.
Dimensions A T mg_75�'�4 4 f -Size of Footings...... ------------
vi E, ---... ..................Dimensions of ------------------------------
Size of Piers-----------—-------_------------Size of Sills_-----------7��-------Greatest Sill Span in ft------------—------------Type Roo""e�
-------jr ---------------
----------;---
How will Building be Heated?.../U-W ----------------------------------------
G,-----------------------I------------- ----------------Will Building be on Solid or Filled Ground?::��
Size of Ceiling Joists---- ---------------------------------, Distance on Centers----------- --------------------------------I Greatest Span.-------------------------------------------
Size of Floor Joists-----------—----------------------- Distance on Centers---------............................... Greatest Span---------...............................
Size of Rafters.------------- --------------- Distance on Centers..... ........................... Greatest Span-------/.:2-
.....................................
This rectangle is to represent the lot.
Locate the building or buildings in the
right position. Give distance in feet from
all lot-lines and existing buildings.
REAR LOT LINE
N
Two copies of plans and specifications shall
be submitted with application. Ilk
Inspections required.
1. When steel is in place and ready to pour footing.
2. When steel is in place and ready to pour columns and/or lintel. Z Z
3. When steel is in place and ready to pour beam. 04 04
4. When framing is completed. '('r" E-4
5. When rough plumbing is completed,and ready to cover up.
6. When septic tank drain field or sewer is laid but before it is covered.
7. Electrical inspection by City of Jacksonville.
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called for after
corrections are made. Z)
FRONT OF LOT
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said
work in accordance with the attached I s and specifications, which are a part hereof, and in accordance with the building
regulations of the City of Atlanti each
Signature of Builder __ __.. ------------- .. .... .......... ... Address. ------------
Signatureof Owner- ---- ------------------------- Address--------------------------------------------------------------------------------------------- ----
FOR OFFICE USE ONLY
Date--------------------------------_19 ......
ermit #------------------------Fee $...............--------
CITY OF ATLANTIC Kitt,
3)0 V 97 aluation $-------------_......................................
FLORIDAHouse #-----------------------------------------------------------
OF ATIARTIC BE
A'H
APPLICATION FOR BUILDING PERMIT
------------------------------------*------*-------------------------------
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can
be verified.
Date-------------------------------.............. ................... 19------------
....................................Address-Y10-1------SX4��...J4.0_--------------------Telephone
Architect----------------------------------------....... ------------ Address,-----------------------------------------------------------Telephone No.............................
ContractorBuilder......... Address............................................................Telephone No----_----------------------
LotNo---------------------------------------------------Block No--------------------------------Sub Division-------------------------------------------------------------------------------Zone-VA-34
---------------------------------------------------------Street---- --- ---------------Sid B t -----------------------------------P.AJ;iL�and.- ---------------- ts.
Valuat
ion $ .........For what purpose will building use ---------- . ...............Type of�n�s��ei-o4m.--e. ---------------------
Dimensions of Building----------------------------------------Dimensions of Lot--------- .............................---Size of Footings......................................
Size of Piers- _-----------------------Size of Sills---------- -------- ----Greatest Sill Span in ft-------_------------_---Type Roof--------------------------------------
How will Building be Heated?---------------------------------- -------------_--Will Building be on Solid or Filled Ground?----------------------------------------
Size of Ceiling Joists-------- _----------------- ----------, Distance on Centers............................................. Greatest Span............................................
-4�Size of Floor Joists-_3-1*44.-1----COF404--, Distance on Centers...... .... ................................. Greatest Span_----------------------------------------_
Size of Rafters-t; - __O'L."."Jo Distance on C nters ------------------------------------- Greatest Span--------- ------ --_--_-------_---_
F, QL,%,n,L eos4- y- V F This rectangle is to represent the lot.
Locate the building or buildings in the
right position. Give distance in feet from
all lot-lines and existing buildings.
REAR LOT LINE
Two copies of plans and specifications shall APPROVED
be submitted with application. CITY OF ATLA BEACH
Inspections required. 'BUILDI FFIcE.:
B
U
I
LD
A
BE
FFIcF�'H
1. When steel is in place and ready to pour footing. 9
2. When steel is in place and ready to pour columns and/or lin Z
3. When steel is in place and ready to pour beam.
4. When framing is completed. B I co,'14
y P
,tk
5. When rough plumbing is completed,and ready to cover up.
r
it i
6. When septic tank drain field or sewer is laid but before it is covered.
7. Electrical inspection by City of Jacksonville.
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called for after C1-J�6
corrections are made.
FRONT OF LOT
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perturm said
work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building
regulations of the City of Atlantic Beach.
Signatureof Builder................................................................................ Address---------------_-------- ------ ------------------------------------------------------
Signatureof Owner---- - - ---------------------------------------------------------------------- Address------------......... .........------------------................................................
DEPARTMENT OF BUILDING
3835
CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO.-
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date 9/8/78 19
Valuation $ 189.00 Fee $ 5,00
This P—it not valid until above fee has been paid
to City Treasurer, and is
a-jbject to revocation for violation of applicable provisio,us of law.
This is to certify that Johnnie W. Kizer
has permission to build to construct a roof over existing parkim
slab
classification residential Zo
Owned b
Lot Block –S/D
House No. 4169 Skate lZoad
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
4 00 0 Building material, rubbish and debris
z from this work must not be placed in
public space, and must be cleared up
and hauled away by either contractor
or owner.
Davin
Building official.
FOR OFFICE PERMIT
USE ONLY NUMBER DATE CONTRACTOR
PLUMBING
ELECTRICAL
SEWER
WATER
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