5501 RigelCt 2013 shower CITY OF ATLANTIC BEACH
r �) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002267 Date 3/07/13
Property Address . . . . . . 5501 RIGEL CT
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3000
----------------------------------------------------------------
Application desc
2-shower conversions
----------------------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
NAVAL CONTINUING CARE NCCRF
RETIREMENT FOUNDATION, INC ONE FLEET LANDING BLVD.
1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233
ATLANTIC BEACH FL 322334599 (904) 246-9900
--- Structure Information 000 000 2 SHOWER CONVERSION
Occupancy Type . . . . . . RESIDENTIAL
--------------------------------------------------------------
Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc . .
Permit Fee 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . . Valuation . . . . 3000
Expiration Date . . 9/03/13
----------------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
---------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
-------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------
Permit Fee Total 65 . 00 65 . 00 . 00 . 00
Plan Check Total 32 . 50 32 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 101 . 50 101 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: '5 i01 Ii CAL (-r. A st w!L� 3 2233 Permit Number:
Legal Description Parcel#
3 0�a Floor Area o q.Ft. Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition teratio Repair Move Demolition pool/spa window/door
Use of existing/proposed-structureQ) (circle one): Commercial esidenti
If an existing structure,is a fire sprinkler system installed? (Circle one): N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: (?-) StbW E,c CotJdl(L9teA5 .- AJ" PAS(, ,1n(iC ,tnJ Ad&,41A 6
— 1nlIV-R4ot2 L4 A(, A-r-TKPAKWtJ — AJ6 CµA#k,£ -ra AA J 1,o.40 949Xtt- J& /VIS#%e,9"
Property Owner Information:
Name: NCCRF Address: One Fleet Landing Blvd.
City Atlantic Beach State FL Zip 32233 Phone 904-246-9900 xt.150
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:NCCRF Qualifying Agent: Joshua D. Hatfield
Address: One Fleet Landing Blvd. City Jacksonville State FL Zip 32233
Office Phone 904-246-9900 Job Site/C 11mba 204-246-9900 Fax#904-246-9455
State Certification/Registration# CGC 15211
Architect Name&Phone# .,a. :•
Engineer's Name&Phone# au q JL --
Fee Simple Title Holder Name and Address SE P
Bonding Company Name and Address QUIREME
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do rn 1 - ;onion has commenced prior to the
issuance of a permit and that all work will be performed to meet the standanls o aws sdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is.nts ended or abandoned or a pen5d of.six 6)months at any time after
work is commenced. I understand that separate permits must be secured for Electricar World Plumbing, Signs, Wells,Pools, Ftirnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined th' 7plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be complied with whether sppeer red herein or not. The granting of a permit does not presume to give authority to violate or cancel rhe
provisions of any other federal,state,or local f,w regulating construction or the performance of construction.
Signature of Owner �-- CJ Signature of Contractor dy�
Print Name Joshua Hatfield Print Name Joshua Hatfield
Sworn to and subscrib d before me Sworn and subscribed,before me
this Day of A LC 20 l3 this �Day of NNII A 2c(-E 20
ELIZABETH TESKE ;,�F�: :8�State of Florida ,- ELIZABETH TESKE
No Public =?• •�'=
FOR MH P
-
E My Comm.Expires Apr 5,2013 °'* ► ', pires Apr 5,fOl
•°;= Commission#DD 867829 '=9. °�' Commission#DD 867
�, Bonded Through National NotarRevised O 1.26.lO
Bonded Through National Notary Assn.
rtvi�� City of Atlantic Beach APPLICATION NUMBER
JSP Building Department (To be assigned by the Building Department.)
800 Seminole Road
r� Atlantic Beach, Florida 32233-5445
'r. Phone(904)247-5826 - Fax(904)247-5845
j;il��' E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / Z/ '�L c✓ Department review required YesNo
Building
Applicant: &ad anning &Zoning
�JA
Tree Administrator
Project: 2- S/hGJie- ✓Z� �7.l.S Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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: ff�pproved. []Denied.
(Circle one.) Comments:
BUILDI
PLANNING &ZONING Reviewed by: 4r c Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑D ied.
PUBLIC WORKS Comments:
i
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
1
NOTICE OF COMMENCEMENT
� A
�lG�tvt� r
State of r g� Folio No.
County of COPY
To Whom It May Concern: I ,
-- _ -- ,
" I ftw
The undersigned hereby informs you that improv@i9attmis will be made to-eertain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: `��%� ����C� C—, I AT,L AAnC— kA C tik
Address of property being improved
General description of improvements:
Owner. C (, Address:
A T L A nlTl C
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: AJ.0C -
�� Address: 6 AJr
` r , L� 764
:t Telephone No.: 164 24� -`t`l Fax No:
Surety(if any)
Amount of Bond$
Address:
Telephone No: Fax No:
Name and address of any person mating a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself; designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER / n
,�(� _ `cJ'/ Date:
Signed: Alu,4 Za13 in the Countyo Duval,State
'iefore me this day
Doc#2013056236,OR BK 16276 Page 1944, )f Florida,has personally appeared
Number Pages:1 dotary Public at Large,State of Florida,County f vat.
Recorded 03i05i2013 at 11:31 AM, dy commission expires:
Ronnie Fussell CLERK CIRCUIT COURT DUVAL 'ersonally Known: or
I ABETH TESKE
COUNTY 'roduced Identification:
o ary u lic-State of Florida
RECORDING$10.00 ,:
: My Comm.Expires Apr 5,2013
Commission#DD 867829
Bonded Through National Notary Assn.
j �S a`lt�j1jv�
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
1
Application Number . . . . . 13-00002267 Date 3/07/13
Property Address . . . . . . 5501 RIGEL CT
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3000
----------------------------------------------------------------------------
Application desc
2-shower conversions
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
NAVAL CONTINUING CARE NCCRF
RETIREMENT FOUNDATION, INC ONE FLEET LANDING BLVD.
1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233
ATLANTIC BEACH FL 322334599 (904) 246-9900
--- Structure Information 000 000 2 SHOWER CONVERSION
Occupancy Type . . . . . . RESIDENTIAL
----------------------------------------------------------------------------
Permit PLUMBING PERMIT
Additional desc . .
Sub Contractor . . ASHLEY PLUMBING CO INC
Permit Fee . . . . 69 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/03/13
----------------------------------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 69 . 00 69 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 73 . 00 73 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 �J
JOB ADDRESS' I PERMIT# Z Z
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan �—
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name I acd Phone Number��9 ,d
Plumbing Company Office Phone _ FaxqN �g9C25Z
Co. Address: City State V-1 Zip �22_a
License Holder(Print): State Certification/Registration#0 FC Q 59 W14
Notarized Signature ofLicea older
+
KE R STROBLE { f 20
•- N1Y CON+NIISSIOPI#EE035103 Sworn and scribed before me is
EXPIRES OdOber 17.20+4 Signature of Notary Public
`,, p�gWeNOf9 .com
(407 398-0153
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�
ills)
Application Number . . . . . 13-00002267 Date 3/07/13
Property Address . . . . . . 5501 RIGEL CT
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3000
----------------------------------------------------------------------------
Application desc
2-shower conversions
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
NAVAL CONTINUING CARE NCCRF
RETIREMENT FOUNDATION, INC ONE FLEET LANDING BLVD.
1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233
ATLANTIC BEACH FL 322334599 (904) 246-9900
--- Structure Information 000 000 2 SHOWER CONVERSION
Occupancy Type . . . . . . RESIDENTIAL
----------------------------------------------------------------------------
Permit ELECTRICAL PERMIT
Additional desc . .
Sub Contractor . . BARKOSKIE ELECTRICAL SERVICE,
Permit Fee . . . . 58 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/03/13
----------------------------------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 58 . 00 58 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 62 . 00 62 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
_i C _
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904/)247-5826 Fax(904)247-5845
FoB ADDRESS- �12 Cj (� C-r�_ Pmwr#
dEW SERVICE ❑Overhead ❑ Underground ❑Underground up Pole
❑Residential(Main) Service # of Meters
00-100 amps ❑101-150amps ❑151-200amps ❑ APs
0 Commercial(Main) Service ❑CT Service
00-100 amps ❑101-150amps ❑151-200amps ❑ �s =4
Conductor Type Size
❑Multi Family(Main) Service #of Unit Meters
00-100 amps ❑101-150amps ❑151-200anaps ❑ APs
❑Temporary Pale ❑ amps
SERVICE UPGRADE O amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC-)
❑100 amps ❑150amps ❑200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,SUIL"U'I S,ACCESSORY STRUCTURES,ETC-
Outlets/Switches: _0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/CC Circuits: 0-60amP
/ s 61-100amps
Heat Circuits: # circuits cQ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROTECTS ❑Transformers KVA ❑Motors
❑Swimming Pool ❑ Sign ❑Smoke Detectors Qty
FIRE ALARM SYSTEM (Requires 3 sets of pians&Fire Alarm Checklist)
Qty vohstamps VALUE OF WORK S
REpAIRS/MISCEL LANEOUSon ❑panel Change DOH to UG
❑Replace Burnt/Damaged Meter Can ❑S �Y�P
❑Other: _
or work is suspended or abandoned for sic months- I hereby certify that I hal
pmt void if work does not commence within a sic month period v this work will be complied with whethei
read this application and know the same to be true and corr�ecL All provisions of laws and ordinances go emmg
specified or not The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance oft
construdian.
b oL>
Phone Number
properly Owners Name
1-4-,J /V N' -
Electrical Company t�J�+? �S K�c [ �' office Phone ��!�`f l 3( Fax
State
Co.Address:
�.1
A- 9C-E -Zi Z
City z�?,
/ State Certification/Registration# 3 z3 V
License Holder(Print)_ � 1
Notarized Signature of License Solder / )(
Y v Public StatQ oc Florida Sworn =fN
SCrib=hc
efore me this c, day Of�-�-t —
Notary j� f"�,
o'►f 'i
z c±� Tiffany August Sim Otary _
My commission DD801149
$`a, cxoires 06r2&2012
or a