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330-332 1st St (vault) 1e1e7 MAP SHOWING BOUNDARY SURVEY OF LOT 9 AND TIIE WEST 25.00 FEET 01 LOT 7, BLOCK 2, ATLANTIC BEACH, AS RECORDED IN PLAT BOQI: 5, PAGE 69 111 PUBLIC RECORDS OF DUVAL. COUNTY, FLORIDA. llj ( ��i ! �f .toN / //C � /N � Cam✓ J _ V V t I � .fr.4 0 Or h No. 33 ` � srto v sb. ra Q 3 c n aTa/7YReo.�r H I .� N 0 I\ LiNI � S.� S.✓i \ np H Se. ­ a ' ) 2 3 � "Ale -NO BUILDING RESTRICTION LINE SHOWN ON PLATS A A -THIS PROPERTY LIES IN FLOOD ZONE "X" BY FLOOD MAPS r, 1n94 REVISED APRIL 17, 1989, COMMUNITY PANEL NO. 120075 OOOID Building and Zoning I HEREBY CERTIFY TO'. /OlLL.E ,✓n. ,HO'T TrOrE to rvO,�dj °.•/ 1-,c,' <. 7;r snP. -s-c,S . / THAT THIS SURVEY MEETS THE MINIMUM STANDARDS AS SET FORTH BY THE FLOP OF LAND SURVEYORS, PURSUANT TO SE. FLORIDA STATUTES AND CHAPTER 21 ADMINISTRATION CODE. H. A. DURDEN & ASSOCIATES INC P'PIOIII e�Ow�\ 1 HMO ►DPP V! 1PK MO i�l�_ N LAND /� /JRUfE O(/ROG,✓, u F SURVEYORS DATE M/1:PG// Ile POST OFFICE BOK 50670 SCALE: 2O 1103 SOUTH TH IRO STREET JACKSONV ILLS OE AC H FLORIDA 32250 PHONE 1900249.7261 THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE . ... . .. ...... ell 7 1; ' Y••. JENNIFER SCHWETER ';= MY COMMISSION # DD 121301 EXPIRES: May 27, 2006 Bonded TMU Notary Pubuc underwrtlers - "Uj,r CITY OF ATLANTIC BEACH T r 800 SEN 1NOLE ROAD r ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 Application Number 00- 00000001 Date 2/26/04 Property Address . . . . . . 332 1ST ST Tenant nbr, name . . . . . . REPIPE 3 FIXTURES Application description . . . PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------ - - - - -- ------------------ - - - - -- SABOT, GERRI MARCHAND PLUMBING INC. 330 1ST STREET 2309 TORBAY DRIVE ATLANTIC BEACH FL 32233 ORANGE PARK FL 32073 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 56.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- Permit Fee Total 56.00 56.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 56.00 56.00 .00 .00 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 CONSTRUCTION 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. BUILDING OFFICIAL CITY OF ATLANTIC BEACH �s PLUMBING PERMIT APPLICATION Date: Property Address: 57 s'T 3 3 Owner: © r Telephone Contractor: Telephone #: Contractor Address: Fax #: 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 ordinance and standards of good 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 other construction is being done on this building or site, • Cl New list the building permit number: 9 Re -Pipe Number of Fixtures: Bath Tubs Showers Closets Shower Pans Dishwashers �_ Sinks Disposals Urinals Floor Drains Washing Machine Lavatory Water Sewer Water Heaters Other Fees Permit Issuing Fee: $35.00 Total Fixtures: 3 X $7.00 + $35.00 = 800 Seminole Road - Atlantic Beach, Florida 32233 -5445 Phone: (904) 247 -5800 - Fax: (904) 247 -5845 - http : / /www.ci.atiantic- beach.fl.us PAGE 1 INSPECTION TICKET DATE 9/26/03 PREPARED 9/26/03, 8:26:23 INSPECTOR: LARRY J HIGGINS CITY OF ATLANTIC BEACH ------------------------------------ - - - - -- SUBDIV: ADDRESS . : 330 1ST ST TENANT, NBR: 150 SQ FT SHED PHONE CONTRACTOR : PHONE OWNER SABOT, GERRI PARCEL 169741 -0000- APPL NUMBER: 03- 00026928 SHED PERMIT ---------- --- - - - - -- --------------------------- ---------------------- PERMIT: BLDG 00 BUILDING PERMIT DESCRIPTION REQUESTED INSP COMPLETED RESULT RESU TS /COMMENTS - -- ------- --- - - - - -- --- 10 01 9 26/0 � JH B FOOTING TIME: 08:00 11 CC /n3 ERRI SABOT - OWNER �� 241 -7781 COMMENTS AND NOTES ------------------------- ----- - - - - -- --------------------- PAGE 1 INSPECTION TICKET DATE 5/12103 PREPARED 5�09�03, 16:24:31 INSPECTOR: LARRY J HIGGINS CITY OF ATLANTIC BEACH --------- - - - - -- ---------------------- - - - - -- SUBDIV: ADDRESS . : 330 1ST ST TENANT, NBR: REMODEL TO DUPLEX PHONE CONTRACTOR : PHONE OWNER SABOT, GBRRI PARCEL 169741 -0000 APPL NUMBER: 02- 0002524 TWO FAMILY RBSIDEN ---------------- - PERMIT: ELEC 00 ELECTRICAL PERMIT REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS ----------- 23 O1 512103 LJH - BL FIEAL TIT. 58,00 304.8 �.� ,lam- - ___�__- - - - - -- COMMENTS AND NOTES ----- " '" "'-- '- ---- --- - -- r� r y '�'`]i'� f CITY OF ATLANTIC BEACH 44 W 800 SEMINOLE ROAD w r ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 Application Number . . . . . 05- 00030142 Date 4/21/05 Property Address . . . . . . 330 1ST ST Tenant nbr, name . . . . . . COMPLETION OF DUPLEX Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2020 Owner Contractor --- ------------------------ --------------------- JOHNSON, EDWARD & LAURA DOUGLASS CONSTRUCTION 330 1ST STREET 835 8TH AVE N. ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 249 -0767 (904) 249 -4701 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 45.00 Plan Check Fee 22.50 Issue Date . . . . Valuation . . . . 2020 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- Permit Fee Total 45.00 45.00 .00 .00 Plan Check Total 22.50 22.50 .00 .00 Grand Total 67.50 67.50 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CW. ";a A BUILDING OFFICIAL CITY OF ATLANTIC BEACH Cc. J s D. 'Al `- ,IJ BUILDING / ZONING DEPARTMENT . 800 Seminole Road err Atlantic Beach, Florida 32233 r � j j31} (904) 247 -5800 (904) 247 -5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # -30 H 2 Property Address: 3 U r Applicant: 02 I CO Q'` �CSY1 Project: This permit application has been: 01 / Approved E Reviewed and the following items need attention: Please re- submit your application when these items have been completed. Reviewed By: l Date: 14 (�z0 LO S Date Contractor Notified: RECEIV CITY OF ATLANTIC BEACH BUIL & zoiING CITY OF ATLANTIC BEACH mss, APR 18 2005 BUILDING PERMIT APPLICATION 1 r' (New / Residential & Commercial) LBY: Date: . 411 < /ds Job Address:�� /, Owner's Name: Address: 5 S Phone: �O Legal Description: Block Number: Lot Number: Zoning District: Contractor: State License Number: (✓1?6e,5 Thy �� Phone: Mq -47f) (� Address: / City: d�/V�l�e / � State: r-L Zip: - 3�bG/ Fax: G 'f - 0 C l 1 Describe proposed use and work to be done: �' "E' �!1 c�— IP . y Present use of land or building(s): //v //0f i /e1 Valuation of proposed construction: �O�� Is approval of Homeowner's Association or other private entity required? _Afof yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, addition of 5% or more to the original impervious area or the removal of any trees? e N 0. Applicant certifies that no change in site grade, impervious area or fill material will be used on this project. TI YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. e NO. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board, which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904 - 247 -5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre - construction or post- construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane, Atlantic Beach, FL 32233 Telephone: (904) 247 -5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Phone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ei.atlantic- beach.fl.us Revised 8104 Page 2 DATE (MMIDD/YY) ! AC CER TIFICA TE O L IABI LI TY INSURANCE , 03/30/05 — _ - -- - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER State Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 803 North Third Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Jacksonville Beach, FL 32250 ALTER THE COVERAGE AFFORDED BY THE PO LICI ES BELOW (904)247 - 5599 NAIC # INSURERS AFF ORDING COVERAGE -- -- - _ INSU A: PENN :AMER INS CO INSURED DOUGLAS CONSTRUCTION OF JACKSONVILLE INC INSURER B: - - - -� 835 8TH AVE N INSURER C: - JACKSOVNILLE BEACH FL 32250 INSURER D: _ INSURER E_ COVER _ _ _ — _ - - -- - - THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMIT SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L' POLICY EFFECTIVE, POLICY EXPIRATIONI LIMITS T YP E OF INSURANCE POLICY NUMBER I DATE MWDD/YY DATE MMIDD/YY T I R — - — — EACH OCCURRENCE 100,000 GENERAL LIABILITY DAMAGE TO RENTED 50,000 Y COMMERCIAL GENERAL LIABILITY PAC6434472 11/03/04 11/03/05 PREMISES Ea occurence _ — ; MED EXP (Any one person) 5,000 CLAIMS MADE OCCUR ❑ I PERSONAL & ADV INJURY 100,000 — - GENERAL AGGREGATE 200,000 PRODUCTS - COMP /OP AGG 100,000 I GEN'L AGGREGATE LIMIT APPLIES PER: POLICY IF' PROJECT ❑ LOC �— (— —" COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY I (Ea accident) ANY AUTO ;_' ALL OWNED AUTOS BODILY INJURY ❑ I— SCHEDULED AUTOS (Per person) BODILY INJURY HIRED AUTOS -- NON OWNED AUTOS (Per accident) '� - - -- — PROPERTY DAMAGE (Per acc ident) - — i �— -- — -- AUTO ONLY - EA ACCIDENT GARAGE LIABILITY — Cj r ' ANY AUTO OTHER THAN EA ACC —_ — AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE OCCUR CLAIMS MADE AGGREGATE ❑ DEDUCTIBLE RETENTION WORKERS COMPENSATION AND T RY IMIT ER E LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT OFFICER / MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE, If yes, describe under I E.L. DISEASE - POLICY LIMIT SPE CIAL PROVISIONS below _— — — OTHER i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS I CERTIFICATE HOLDE C ANCELLATION -- — �— SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE CITY OF ATLANTIC BEACH ' EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO ATLANTIC BEACH FL 32233 THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AG�NTS OR REPRESENTATIVES. THORIZED REPRESENTATIVE 7 AU JAN JOHNS i I ACORD 25 (2001/08)✓ ® ACORD CORPORATION 1988 CITY OF JACKSONVILLE BEACH 2004 2005 ------ ---- . .... . OCCUPATIONAL - LI CENSE CITY CLERKS OFFICE 11 NORTH THIRD STREET JACKSONVILLE BEACH, FL 32250 PH (904) 247-6250 FAX (904) 247-6256 License furnished pursuant to Jacksonville Beach Code of Ordinances, No. 95-7628, Chapter 15. Display conspicuously at place of business BUSINESS NAME: DOUGLASS CONSTRUCTION CO OF LICENSE NUMBER 09-12.862 --------- -- jFEE PENALTY TRANSFER i $ 110.00 $ .0c $ .00 CLASSIFICATION: 1751 CARPENTRY LICENSE RESTRICTIONS: HMOC 03-100648 OFFICE ONLY/DBPR LIC# CRC-058296 VALID FROM OCTOBER 1, 2004 TO SEPTEMBER 30, 2005 oe CITY MANAGER CITY CLEi- LICENSE PE IALI T The City of Jacksonville Beach is Committed to the Citizen. First Class Service for First Coast Customers MAILING ADDRESS BUSINESS ADDRESS 835 N 8TH AVE JACKSONVILLE BEACH FL 32250 DOUGLASS CONSTRUCTION CO OF JACKSONVILLE INC,835 8TH AVE 11 JACKSONVILLE BEACH FL 32250 MAP SHOWING BOUNDARY SURVEY OF Lot 9, and the West 25 feet of Lot 7, Block 2, Atlantic Beach, according to the Plat thereof, Recorded in Plat Book 5, Page 69 of the Current Public Records of Duval County, Florida. Certified To: Edward & Laura Johnson Wells Fargo Commonwealth Land Title Insurance Company Richard G. Hathaway, PA / Ponte Vedro Title, LLC First Street (40'R/W) 175.00' 50.00' 25.00 25.00' 4 3 "Light �'P Pale O 00. Conc. v ; \ 1 n \\ Conc. Conc i Patio Drive I 0 r 0.3'(FI) . 260 6 24.7 i o 1 Story Concrete ° I 3 Block Residence # 330 J � 3 O 18.6 0.3'(FQ o r Lo[ 11 0 0 ? N O o n � I M Conc. .— Drive Lo . I 26.8' N A/C LJ 1 °J 15.4 9.3 _ o, o Frame � � J Shed iD m 15.5' 9.3' 3 w c a o v U L 3 L t- h- U O � � 5 ( 0.2'(FO) O 0.2'(FI) 50.00' 4' Chain Link Fence 25.00' �� 25.00' 1/2" LEI #1048 ABBRE VI AT10NS GENERAL NOTES a/c - denotes air conditioner 1. This is a Mop showing B -our ary Surve v . br1 - denotes building restriction line 2. The North Arrow shown hereon is the Assumed direction of North only. (e) - denotes calculated per plot 3. There may be Restrictions or Easements that are not shown on this map that may be found in the eb - denotes chord bearing Public Records of this County or evidenced by title examination. ch - denotes chord distance 4. This survey was performed without the benefit of a title co n commitment. cone. - denotes concrete 5. The property shown hereon embraced by heavy tines is based on a legal descriptim provided by (d) - denotes deed dimension record in public records client. (fi) - denotes fence line inside of subject property line 6. This survey does not reflect or determine ownership. (to) - denotes fence l outside of subject property line 7. Thla survey shows only the above ground indicia, no underground utilities, footers, structures, ar (fol) - denotes fence line on subject property line improvements are shown on this map. id - denotes identification 8. Unless otherwise noted, any portion of the parcel that may be deemed as Wetlands by Slate or iP - denotes iron pipe Government Agencies, has not been determined and any liability resulting therefrom is not the it - denotes iron pin or rebor responsibility of the undersigned. I - denotes arc length distance lb - denotes licensed business (m) - denotes measured dimension made in field FLOOD CERTIFI or substontio led by field traverse measurements (mb) - denotes map book By Graphic Plotting only. the praperty shown hereon ties within zone: - X - nd - denotes raft & disk as shown on the Federal Emergency Management Agency (F E.M.A_) National Flood Insurance Program, orb. - dmotes official records book Flood Insurance Rate Map (F.I.R.M.) Community Pans Number: L20 075-aQ= . arv. - denotes official records volume Mop revised date: Anrl 17. 1989 (p) - denotes plat dimenston shown on record plot p.b. - denotes plot book LEGEND A NAIL AS NOTED p c. - denotes point of curve pg. - denotes page 10 ED. IP SIZE NOTED - NO IO U.O.N. ! FOUND RAILROAD SPIKE pgs. - denotes pages p �o ED. IR SIZE NOTED - NO IO U.O.N. DENOTES LINE NOT TO SCALE ps& - denotes point at reverse curve m - denotes professional surveyor and mapper (� SET 5/8' REBAR CANNADY LB / 7080 DENOTES B_R.L p.t. - denotes point of tongent F0. CM SIZE NOTED - NO ID U.O.N. DENOTES EASEMENT LINE (r /w) d eno tes denotes radi right t of way NAIL AND DISK AS NOTED DENOTES FENCE LINE u.a.n. - denotes unless otherwise noted a ° oo FOUND X -CUT d -G° aO d °�° a DENOTES CONCRETE AREA I hereby certify that this survey was made to the best or my 5783 Mining Terrace, Suite 5 knowledge and belief and meets the Minimum Technical Standards as Field Date: 2 -20 -2005 ���� Jackson 9 2 o 6 O - 32257 set forth IG the Florida Board of Professional Land Surveyors in Chapter fiChapter !e N "�\ Phone: (904)260 -6628 1Gt 7 -6 d (Formerly 21hh -6 O), Florida Job Number: OS- 0318 `\ Fox: (904)260 -0266 Administro . Code, pursuant to Section 472027, orida Statutes. Licensed Business No.: 7080 Field Book: 2(,21 ® EMAIL jwcsurvey9bellsouth.net Page: 1§ Bic Q n nady James W. Connody, Professional Surveyor Mapper, scale: 1" 30 Certificate No. 5586, State of Florida S U R V E Y 1 N (3 Date Signed: 3 -I1 -2005 Unless it bears the Signature and the Original Raised seal of a florida licensed surveyor and mapper, this drawing, sketch, plot or map is for informational purposes only, and is not valid. Page 1 of 1 File No. A -720 PREPARED 703/03, 14:02:21 INSPECTION TICKET PAGE 16 CITY OF ATLANTIC BEACH INSPECTOR: LARRY J HIGGINS DATE 707/03 ------------------------------------------------- ADDRESS . : 332 1ST ST SUBDIV: TENANT, NBR: INSTALL 6 FIXTURES CONTRACTOR : MARCHAND PLUMBING INC. PHONE OWNER SABOT, GERRI PHONE PARCEL . - - - APPL NUMBER: 03- 00026399 PLUMBING ONLY ------------------------------------------------ PERMIT: PLBG 00 PLUMBING PERMIT REQUESTED INSP DESC IPTION TYP/SQ COMPLETED RESULT RBS LTS/COMMENTS - ----------------------------- 45 O1 7/03 LJ FINAL TIME: 08:00 J '�_ -- __�r� REPIPE 759-1484 -------------------------------- - - - - -- COMMENTS AND NOTES -------------------------------- - - - - -- INSPECTION TICKET PAGE 8 PREPARED 6/09/03, 7:22 :32 INSPECTOR: LARRY J HIGGINS DATE 6/09/03 CITY OF ATLANTIC BEACH -------------------- - - - - -- - -- SUBDIV: ADDRESS . : 332 1ST ST TENANT, NBR: 150AMP1PH,3W,120- 240V,SEV PHONE (904) 384 -8062 CONTRACTOR COLEMAN ELECTRIC PHONE OWNER : SABOT, GBRRI PARCEL . - - - APPL NUMBER: 03- 00026012 ELECTRIC ONLY - -- ---------------------------------------------------- - - - - -- x PRINIT: BLBC 00 ILIMIUL P"NIT p REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS 24 01 5/28/03 LJH EL ELECTRIC TEMP SERVICE TIME: 17:00 - - -- 529/03 AP VEA Y POWER, HAVE LETTER 384 -8062 22 O1 6/ 9/03 LJ 01mH. ;1'I#0a; »OA - -- - - -- COMMENTS AND NOTES -------------------------------- - - - - -- Sent by: JetFax M910 408 3560808; 04/14/05 12:04PM;JgffVA_ #718; Page 2/4 or 10:45 FAX 904 i47 VU67 tci�n�v 1 mUnLnLrw A. Settlement Statement U. S' Department of abus O ME No. 2502 -0265 and Urban Development g. 7YFE OF LOAN 6. Pile Number 7. Loan Number 8. Mortgage lns. Case Number 1. L' Ftl.4 2. i1 FrnHA 3. Conv. Unins. 05981b 4, c vA 5. a Conv. Ins. C. Note: This form is furnished to give you a statement of Actual settlement costs. Amounts paid to and by the settlement +igent are shown. Items markzd '(p.o.c.)' Were paid outside the closing; they ate shown berc for informational proposes rind are not included in the cowls. 'Adjustments for itenu Unpaid By Seller' are based on estimated amounts, and are subject to adjustment by Borrower($) avd Seller(s) when 3ctu3l amounts becotrle available. D. Name and Address of Bonower' Stnrl:,er Service$, I *c. (" SSI) 20 S Santa Cruz Avenue, Suite #300. Los Gatos, CA, 95030 E.: Name end Address of Seller. Geraldine Ann Sabot F. Natncc and Address of Lender: Gi, _property Location: f' - '33Q First Street, Atlantic Beach, FL 32233 County: Duval Y. Settlement Date: TT '$�Ldcrn=t Agent N ame and Address A pr il 15, 2005 Richard T. Morebead, P. a. Disbursement Date: Third Street #: Neptune Brach, FL 32266 April 15, 2005 J. Summary of borrower's Traw2ctioa K Snmtaar of Seller's Transaction 100, Gross Amount Due From Borrower 400, Gross Amount Due To Seller .01 Contract Sales rice $300.000.00 401. Contract sales rice $300.000.00 102. 402_ - 103. Settlement char es to borrower lixte 140D 54.478.50 403. - 104. 404. 14 5. 405. Adjmtments for items aid b seller in advance Ad usnn ents for items paid by seller in ad vance 106. {torn to 406. from to 101. from to 407. from to - 0$" c ,from to 408. f 0m. to - 109. ,. -from t4 409, from to 410. It11.4' . 411. 112. >, .;. 412. 1211. - `Gross Amount Due From Borrower 5304,478.50 1420, Gross Araoam I)ue To Seller $300,000.00 °20 r °Arrt Paid By Or In Behalf 0( Borrower 500. Reductions In Amount Due To Seller o1.I osit or earnest rnoney 501. Excess d osit see instructions 2E12: Principal amount of new loan s) 502. Settlement clxr cs to seller line 1400 03 EExisting loans taY.sa sub'cct to 503. irxistine loan s taken subject to ?114 Princ' al amount of tad loan 504. Payoff of loan to Countywido Home Loans 5297,9 _ ,21 10 Interim lntere:t (I st loan ) from to 505. Pa off of loan to Z06. lnteri li=cst (2nd loan ) from to 506 Payot of loan to 107. 50'7. � - -- - 2.08. 1031 a-chance p roceeds $201,224.72 508. 209. 509. r j Ad'usttnrnts for items un aid b seller Adustments for items uu aid b seller 28,6 Prone PloneM Taxes from 1/1/2005 to 4/15/2005 $449.28 510. County Property Taxes from 1/1/2005 to 4/15!2005 5449.2 to 511. from to 2 ter ,fr om to 512, from to 2._ from to 513. from to - Fl.d,. Assumntian #1 interest from to 514. Assumption #E1 inttre9t from to 215. Ms tion #2 interest from to 515. Aswrwtion #2 interest from to 518. 519. 120. Total Paid By/For Borrower $201,674,00 520. Total Reduction Ariaount Due Seller $298.442,49 300. Cash At Settlement FrDmITo Bo 600. Cash At Settlement To/From Seller 301. Gross amount due from bor7owej line 120 $304,47x.50 601. Gross aruount due to seller fte 420 $300 000.00 302. Less amounts paid by/for borrower (line 220 S201 602. Less reductions in amt. due seller lino $20 5293,442.49 7,7 163.-Cash X' From To Borrower 5102,904.50 603. Cash Q To From Seller 51,557.51 IS DtroRTANT TAX INFOR.MA'1CION AND IS BEING FURNISIMI) TO THE DqTERNAL R;E'VEmm SERVICE. IF YOU ;A„r- MQUIRF TO FIL A RET RNN, A NEGLIGE PENALTY OR OTHER SANCTION WILL BE IMPOSED ON YOU IF �.... -...w ...a..r.w ... +v . « vr..... n .ie+nn »,n ��r rn•ssAtl'1"Cn Jet Fax M910 408 3560808; 04/14/05 12:07PM;JgjrV_ #718; Page 4/4 /,;Uu;7 lv:•6J r.-J.& yvy 4 %, Uu90 Additional Sertleutent Chat es 5275.00 1. S vex to IW Cathay SUSti+c , lztc. s02. Pest ins ection to 575.01) 1303. Doc alive /Archive to Ricbmd T. Morehead PA S20.00 1344. Express Payoff to Da 1305. to 306. to 1307. to i 308- to 1309. to 1310. to 1311• to 1312. to 1313. to + 1314. to 1'316. to �R 2, to to to to ?3. to !,' 24. to 1x325. to 26- to to 1;3:23. to 3';3'29. to iwal to to H9. to to �IY"A 3!12. to i?43. to , j,344. to to c•:r. Total Sertlement Charges (enter on lines 103 Section J and 502, Section K ) $4,479 SA ",}iLM -1 Setilerrrnt St tm=t which I have prepared is a and aceuratr account of rWs tr•a octinn. t have caused oT Will cause the funds to be dishurccd in 2eeord -nce "" "- ; Khjs sntcmrr:t. Date. 4/15/2005 ' tMent Agent WARTTNQ,- It iY a Crinv to'kac%✓i rr4kc false sutrtrtcria to the United States on this or Ain other similar form. Penalties upon conviction tin include `ry h�i a fine and iur isonmrnt. For dculls ser: TiUe 18 U.S. Code Scctien 1001 end 5cction 1010. '?`Icsrr!URY reviewo3 the RLM-! Srtticrn rt 5=:ment and to the best of my knowlcdLc and bclid; it is a true and accurate sta ==t of all tsccipts and disburscrnonts rmde f .iy,aecaunl cr by ran in this transaetion. I Ifutther cdrtify that I have rceaivcd i copy of the HUD - Sctllcrt SWLrnent. *srrSetvices, Inc. ( "SSl) � ��a.. Ge din Ann Sabot i >r ice. M mes H asse ff t r. O qu nseior ; ,,� . c 73 FT NOT TO SCALE i � Unit 1 Unit 1 Auto 1 Auto 1 P .r b 51_9ft 26.1ft 24.8ft 38.3ft 12.6ft EXISTING CB / 12.4ft DWELLING TO BECOME UNIT 1 330 FIRST ST ATLANTIC BEACH, ,y� N FL, 32233 N u1 UNIT 2 N r j OWNER Existing Master Bedroom: N i 4 12.60ftX21ft SEALOOORAND GERRI SABOT WINDOW OPENINGS WITH CB OR 2 HOUR FIRE RATED WALL 18.3ft ` a�i Existing ( �) C p� Master Bathroom: LL 240v 12.60 X 8.90 .n AIVE COUNTER 12.60 Office/Kitchen Area 19.4ft x 5.5ft Q Existing Support Column UNIT APPROVED CITY OF ATLANTIC B -ACH Un D �. ING OFFICE Auto 1 a APR 2 0 2015 a � N BY. Living Room /Dining U I Area 32ft x 113..2j1; Auto 2 Cll`(R� D NGNoFF1C CH E I gull_ 32ft NeALe eetZ LEGEND —L 114 INCH :::1 FOOT i NEW SERVICE PANEL �., -SHADED AREA RENOVATED TO BECOME UNIT 2 Room �' _ - UNSHADED AREA TO REMAIN tO 26.3 ft. x 5.5 ft. ~ f _ AS IS AND BECOME UNIT 2 -INDICATED 240M24 VAC OUTLETS WILL BE ADDED 26 .30 DURING RENOVATION CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD 1 r� ATLANTIC BEACH, FLORIDA 32233 M INSPECTION PHONE LINE 247 -5826 02- 00025244 Date 5/07/03 Application Number 330 1ST ST Property Address . . • • • Tenant nbr, name . . . . . . REMODEL TO DUPLEX Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 42384 Owner Contractor -------------- ------------------------ ---------- SABOT, GERRI OWNER 330 1ST STREET ATLANTIC BEACH FL 32233 -------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . 122.50 Permit Fee 245.00 Plan Check Fee . Issue Date . . . . 5/06/03 Valuation 42384 Expiration Date . . 11/02/03 -------------------------------------------- ------ Other Fees . . CAPITAL IMPROVEMENT 325.00 SEWER IMPACT FEES 1250.00 WATER IMPACT FEE 90.00 WATER CROSS CONNECTION 35.00 Fee summary Charged Paid Credited ---- Due - -- ---------- Permit Fee Total 245.00 245.00 .00 .00 Plan Check Total 122.50 122.50 .00 .00 Other Fee Total 1700.00 1700.00 .00 .00 Grand Total 2067.50 2067.50 .00 .00 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 CONSTRUCTION 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. BUILDING OFFICIAL j Imo-' 01 CITY OF ATLANTIC BEACH S S j 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 J INSPECTION PHONE LINE 247 -5826 Application Number . . . . . 04- 00028703 Date 7/20/04 Property Address . . . . . . 330 1ST ST Application description . . . REINSPECTION FEE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor - ------------------------ ----------------------- SABOT, GERRI OWNER 330 1ST STREET ATLANTIC BEACH FL 32233 --------------------------------------------------- Permit . . . . . . REINSPECTION FEE Additional desc . Permit Fee 35.00 Plan Check Fee .00 Issue Date . . . Valuation 0 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- -- Permit Fee Total 35.00 35.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 35.00 35.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. a.. BUILDING OFFICIAL LANl, ��ORIOP OF ADDITIONS or CORRECTIO D• NOT R EMOVE JOB ADDRESS DATE ? 3(0 / e- .s y 30 O THIS JOB HAS NOT BEEN COMPLETED The following additions or corrections shall be made before the job will be accepted X110s /'N L 3Frw� e� �iCEr4T �1o0 / noou W S r. C � f'f r� y � l Ai �1 3A72 �[-F � - � p c� i •21 nj � d � �� � J r r v 7 . � �� 1f CITY OF ATLANTIC BEACH n J s 800 SEMINOLE ROAD `r ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 Application Number . . . . . 02- 00025244 Date 5/07/03 Property Address . . . . . . 330 1ST ST Tenant nbr, name . . . . . . REMODEL TO DUPLEX Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 42384 Owner Contractor - ------------------------ ----------------------- SABOT, GERRI OWNER 330 1ST STREET ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . REPL LINE SIDE OF SERVICE Permit Fee . . . . 70.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- Permit Fee Total 70.00 70.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 70.00 70.00 .00 .00 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 CONSTRUCTION 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. BUILDING OFFICIAL npr cu uj uv:lUa Information Systems 247 -5845 p•I js Ar 1 ,f CITY OF ATLANTIC BEACH, FLORIDA t �' J ELECTRICAL PERMIT APPLICATION © Z TO THE CHIEF ELECTRICAL INSPECTOR: �� DATE: _._._..._...__._.. _ 2 0 — b 3 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDNANCES. ELECTRICAL CONTRACTOR: L L Sry �..•� MASTER ELECTRICIANS SIGNA — G d00 E( OWNER OF PROPERTY: L` I JOB ADDRESS: 3 f! RES,( —t APT.( ) COMM.( ) PUBLIC( } INDUS.( ) NEW( ) OLD( ) REW.( ) ADDITION( ) TRAILER( ) TEMP.( ) SIGNS( ) - -SQ. FT. SERVICE: NEW INCREASE ( ) REPAIR ) CONDUCTOR SIZE AMPS: COPPER ) ALUM,( ) _ FEES SWITCH OR BREAKER AMPS PH W VOLT RACEWAY 12 j C aN dt w 'r EXIST. SERV. SIZE So A AMPS PH .3 W I VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.30AMP5 31.100 AMPS SWITCHES INCANDESCENT FLOURESCENT & M.V. FIXED 0.100 AMPS. OVER — APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CEIL. KW -HEAT CONDITIONING COMP, MOTOR OTHER MOTORS AMPS JHEAT 0 -I OVER MOTORS H.P. VOLTAGE PHS N0. II-I.P. VOLTAGE I PHS MISCELLANEOUS x e , a . rz e O UNDER 600V OVER 600V TRANSFO RINAERS: N0. !KVA NO. KVA _ NO,NEON TRANSF. NO VA I MA MOTOR SIZE SWITCH FLASHERS EACH SIGN 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Phone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ci.atiantic- beach.fl.us Rnvi,M n I n 7101 CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD r� ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 �J13 Application Number . . . . . 02- 00025139 Date 11/07/02 Property Address . . . . . . 330 1ST ST Tenant nbr, name . . . . . . REROOF Application description . . . ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 11900 Owner Contractor ------------------ - - - - -- ------------------ - - - - -- SABOT, GERRI ADVANCED DESIGN SYSTEMS 330 1ST STREET 440 PLUMOSA AVE ATLANTIC BEACH FL 32233 CASSELBERRY FL 32707 (407) 285 -8842 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 135.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 11900 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- Permit Fee Total 135.00 135.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 135.00 135.00 .00 .00 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 CONSTRUCTION LIEN LAW CAN RES THE PROPERTY O PA G TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHIC PART OF rS PE AND JECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. BUILDING OFFICIAL CITY OF ATLANTIC BEACH PERMIT.CALCULATION SHEET Addres Date Heated Square Footage , @� er sq ft = $ Garage /Shed 0 @ $ per sq ft = $ Carport /Porch @ per sq ft = $ Deck _ @ $ per sq ft = $ Patio @ $ per sq ft = $ �fJ c TOTAL VALUATION: r � S 1 etc'' �5• $ 3S .Total Valuation 1st LL,cyc( � Remaining Value $ per thousand or portion thereof TOTAL BUILDING FEE $ + 1/2 Filing Fee $ Z! . ( ) Fireplaces @ $15.00 $ BUILDING PERMIT FEE $ WATER IMPACT FEE $ SEWER IMPACT FEE $ WATER METER /TAP $ CAPITAL IMPROVEMENT. $ SEWER TAP $ ( ) RADON (HRS) .0050. $ SECTION H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ( ) SURCHARGE .0050 $ OTHER $ GRAND TOTAL DUE $ ADDITIONAL PERMITS OR FEES: Mechanical Plumbing Electric /New Electric /Temp ;SwimmingPool Septic Tank Well Sign Finish Floor Elevation Survey Other CALCULATIONS and /or NOTES: RECEIVED NOV 0 6 2002 r ?t City of Atlantic Beach • 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Phone: (904) 247 -5800 • FAX (904) 247 -5805 • http : / /www /ci.atlantic- beach.fl.us PERMIT APPLICATION FOR ROOFING JOB LOCATION OWNER OF PROPERTY C� "�'tl�- ( ��� 6 PHONE # r� CONTRACTOR Ad(/ CONTRACTOR ADDRESS - 710 ,mo ZIP_ 22 0 CONTRACTORS LICENSE NO. ( PHONE # SCOPE OF WORK I�D r-7 A,) L6E2C �/;Af i �ib� c ry, yc> - 17' A " � - YN SLOPE GREATER THAN 2:12 LESS THAN 2:12 ACTUAL VALUATION OF WORK $ Zl, PRODUCT NAME & MATERIAL �� �� ` ? ` I� -. M TO BE USED — —' U / STM DESIGNATIONS) /�_ /✓I to 614 2 3 REQUIRED INSPECTIONS SHEATHING FINAL LIBILITY INSURANCE POLICY SUPPLIED YES NO A P P R O V E D GITY Or ATLANTIC BEACH WORKERS COMP. POLICY SUPPLIED YES NO BUILDING OFFICE CONTRACTOR LICENSE SUPPLIED YES NO NOV Q 6 2002 OCCUPATIONAL LICENSE SUPPL YES NO By: SIGNATURE OF OWNER 0 -AAA SIGNATURE OF CONTRACTOR EFORE ME THIS DAY OF 200 , ,Q.'pY Py yl JENNIFER SCHLUETER MY COMMISSION # DD 121301 �j EXPIRES: May 27, 2006 M ' o V W1�RNo,nry Pubiic Unde wrHars NOTARY PUBLIC 9; JENNIFER SCHLUETER ` v� Ma y # DD 121301 AS � NOTARY PUBLIC a '3 _•_ •.$ Bonded Thru Notary Puh lic 2006 Underwriters f CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD � ;r ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 Application Number . . . . . 03- 00026928 Date 9/23/03 Property Address . . . . . . 330 1ST ST Tenant nbr, name . . . . . . 150 SQ FT SHED Application description . . . SHED PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1500 Owner Contractor ------------------ - - - - -- ------------------ - - - - -- SABOT, GERRI OWNER 330 1ST STREET ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 40.00 Plan Check Fee 20.00 Issue Date . . . . Valuation . . . . 1500 Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- ---- - - - - -- Permit Fee Total 40.00 40.00 .00 .00 Plan Check Total 20.00 20.00 .00 .00 Grand Total 60.00 60.00 .00 .00 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 CONSTRUCTION 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. BUILDING OFFICIAL CITY OF ATLANTIC BEACH cc.. p. F BUILDING / ZONING DEPARTMENT "' s J 800 Seminole Road oeR J Atlantic Beach, Florida 32233 (904) 247 -5800 Al i U i!l >r� (904) 247 -5845 Fax PLAN REVIEW COMMENTS Permit Application # 0 0 (4p Cl a Property Address: Applicant: Project: This permit application has been: Approved Reviewed and the following items need attention: Please re- submit yo ur application when these items have been completed. Reviewed By: Date: q .;0140 !? � !rs r CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (ALTERATIONS /ADDITIONS) f+ Date: /oZ ' ` 00 3 Job Address: 310 0 Et 1z s i 5 z . Owner of Property: 6f- tQ 2 I S l ,a e T Address: 1r 1rz5r Telephone: Legal Descrip Block Number: 4 i' r r L -4:5f c . g P Lot Number: Zoning ` `il Di r 7 ict: z-Z Contractor: y fZ12 1 5 g e "T State License Number: Contractor's Address: 3 f r L R f T „f " q Telephone: C! 04q - ,Z y/_ 7 Fax: Q c Describe proposed use and work to be done: !R f .4rz Present use of land or building(s): Valuation of proposed construction: (S e> 0 What are the dimensions of the added space: 41 1 14 feet x feet Will the added area be heated and cooled ? New electrical or increase in service? U Add plumbing fixtures? k1 y Add fireplace? t Add heating/air conditioning? 9 p Is approval of Homeowner's Association or other private entity required? If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material or the removal of any trees? NO.. Applicant certifies that no change in site grade or fill material will be used on this project. ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. ONO. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board, which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904- 247 -5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre - construction or post- construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane, Atlantic Beach, FL 32233 Telephone: (904) 247 -5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner /Contractor Affidavit if owner is contractor, and four (4) complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole Road, Atlantic Beach, FL 32233 Telephone: (904) 247 -5826 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Page 1 Telephone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ei.atiantic- beach.fl.us Revised 1/14/03 In addition to construction and engineering detail, plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings wed distances and the legal description. 2. Location of all structures, temporary and permanent, including setbacks, building height, number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works, a pre - construction topographical survey. 4. Any significant environmental features, including any jurisdictional wetlands, CCCL, natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with thi plication is correct. Signature of owner: �� Date: I hereby certify that I have read an amined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal, state or local rules, regulations, ordinances, or laws in any manner, including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: Address and contact information of person to receive all correspondence regarding this application (please print). Name: 5,4 13 e r Mailing Address: '3 3 0 Eli 5' S r, ; ,41 L. H F—L 7 Telephone: cl Q Zq 1- 7 7 Fax: 5 A E -Mail: 5A 13 c r y (Le L' O M AS TO OWNER: Sworn to and subscribed before me this day of y v , 20, State of Florida, County of Duval JENNIFER SC ULH -ET Notary's Signature: MY # DD 121301 EXPIRES: May 27, 2006 [Personally known s ......A awdedthru Notary PAC n efS El Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of , 20 State of Florida, County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Telephone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ci.atiantic- beach.fl.us Page 2 Revised 1/14/03 f1 .r It CITY OF ATLANTIC BEACH sill [TILDER AFFIDAVIT OWNER/B Date: C 3 Job Address: Si, A TL.4,y rr c �' .A�f► �� 3 :: 33 CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNERIBUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE- APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOUR ELF. YOU MAY BUILD OR IMPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF TATS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER $2,000) BE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES; OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION OF TILE OWNEiZ, WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS. SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS' WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND /OR FORM 1099 REQUIREMENT'S ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455 - 228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR TELEPHONE THE BUILDING DEPARTMENT (247 -5826) IF IN DOUBT. I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER- BUILDER PERMIT. JENNIFER SCHWETER t v n,;; COMMISSION # DD 121301 ER xPIRES: May 27,2W6 PROP RTY 0 /BUILDER - B-ced Thru Notary Public UrKIMAers SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF ''L 20 q N T Y PUBLI M MMISSION EXPIRES: NOTE: P14RASES UNDERLINED ABOVE. Cc: CITY OF ATLANTIC BEACH D. Ford JS� BUILDING / ZONING DEPARTMENT . iggin 800 Seminole Road sl Atlantic Beach, Florida 32233 (904) 247 -5800 (904) 247 -5845 Fax PLAN REVIEW COMMENTS Permit Application # J 1 3 � d, I Sr Property Address: Applicant: Project: This per ' application has been: Approved F Reviewed and the following items need attention: rn UV Please re- submit your ap cation when these items have been completed. Reviewed By: Date: Q � - Z 0 —0 St `i►;I , ;+ s �r µ CITY OF ATLANTIC BEACH � i 1� BUILDING PERMIT APPLICATION (ALTERATIONS /ADDITIONS) G Date: Job Address: i F f 1 - 2' T S T. Owner of Property: L E a-a 2 1 Address: 3 -3 t1 1 r es Telephone: ' CE .? !� / • ? � '/ Legal Description: Block Number: Lot Number: `I ; Zoning4District: Rs , Contractor: v E !'4 a t � � 13 � T State License Number: Contractor's Address: 3 3 e t= t R f T S t. Telephone: C� �9 c� _ cd /� '7 � ' Fax: g o M Describe proposed use and work to be done: mot r; J t Present use of land or building(s): .5,3 ry F Valuation of proposed construction: 5"C v What are the dimensions of the added space: t' /4 feet x feet Will the added area be heated and cooled? ` y New electrical or.increase in service? Add plumbing fixtures? 1 %, -! y Add fireplace? A! ,r, Add heating/air conditioning? 1 Is approval of Homeowner's Association or other private entity required? - 0 If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material or the removal of any trees? E3 NO. Applicant certifies that no change in site grade or fell material will be used on this project. I ❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building Permit. j.NO. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board, which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904- 247 -5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre - constriction or post- construction topographical survey or grading plan is required (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane, Atlantic Beach, FL 32233 Telephone: (904) 247 -5814 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner /Contractor Affidavit if owner is contractor, and four (4) complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole Road, Atlantic Beach, FL 32233 Telephone: (904) 247 -5826 800 Seminole Road - Atlantic Beach, Florida 32233 -5445 Telephone: (904) 247 -5800 • Fax: (904) 247 -5845 - http : / /www.ei.atlantic- beach.fl.us Pa nn 1 In addition to construction and engineering detail, plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures, temporary and permanent, including setbacks, building height, number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works, a pre - construction topographical survey. 4. Any significant environmental features, including any jurisdictional wetlands, CCCL, natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct. Signature of owner _J< Date I hereby certify that 1 have read an fined this application and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal, state or local rules, regulations, ordinances, or laws in any manner, including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: Address and contact information of person to receive all correspondence regarding this application (please print). Name: i? f? t J h t3 ,r- Mailing Address: 3 2 E ' 1 5 , f S t L'T (_ A N _ , L � f/1 [. t-► ,�� , 3 4�t �� � - Telephone: q& - ,kq f- 7 7 I Fax: 5 A Al E -Mail: & S ,A O c T 0 GLA , , p tee AS TO OWNER: Sworn to and subscribed before me this 2 —� day of 20 State of Florida, County of Duval ---- Notary's Signature:, ii JENNIFER SCHLUETER MY COMMISSION # DD 121301 ,�, EXPIRES: May 27, 2006 l� Personally known B Tr" Noarrww)kc ❑ Produced identification ''ype of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of 20 State of Florida, County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Page 2 Telephone: (904) 247 -5800 • Fax: (904) 247 -5845 . http : / /www.ci.atiantic- beach.fl.us Revised 1/14103 I _4 75FT 34 30 W..70 330 330 Auto 1 Auto 2 50 so 28.10 58.80 2.00 29.01) DUPLEX DWELLING AT 330 FIRST ST, ATLANTIC BEACH FL, 32233 19.00 OWNER: GERM SABOT 5190 w 130.00 130.00 332 Auto 1 332 Auto 2 .30 7. � New Shed: PIER AND POST C ity Of " Beach FOUNDATION 8 STICK FRAME Planning anc .,ring Department PLYWOOD SIDING 15 DEG SLANT R This approval verifies mpliance with applicable 1500 x10.00 zoning, subdivision and other local land 4400 development regulation , but does not constitute approval for the issuen of permits. Compliance . ,000 with Florida Building Co a and all other applicable local, State and Feder I permitting requirements must be verified by Sig Lure of the City of Atlantic _.__......_._.__.__._ . ............._.___._..._...._t, Beach Building Offici to the i"uanca Building Permit. Existin srred: mm To BE DEMOLISHED Approved By: lszoxl000 SHED ommun opmen 1 70 Date: - .._........... _ _:_ ::_ RENOVATION E. 70 I 75FT { IOft. O.Oin. •. _.. 4 O 0 0° '' r Lo Al Tin i I c i t k. jJ a . ° O (DD O n a O m � 2 j o to 6ft. 10.00in__ n 4 2Ut y r » 1 1 r— I � � c ,. 4 y • m 3 roi °v m % __�. . .. ... ... DO . E ,p y O n ftfto OI D C ~• ;~, O :3 m Pol. rn co 0 C �' rn mAl n � � O i I � - o0 8ft O.Oin. N � X \ .. n� cn X cn Mn r Q M -n 0 o 0 3 7 Q CD o . CD -1 3 C � o & 2, N 37 jr a •�` o CO m o tO OD 1Oft O.Oin. z '1 o ' I I I I I 10ft. O.Oin. 0 i r' I i o i f 3 I 1 a N o Q - - -- - 3 N o w3 Map Output Page 1 of 1 JAXGIS Property Information 3 12it 1 17'4 3 3 3" 340 � SU ti -- -�,5-, --rte -- � 337 325 3�s � 361 3 IL - - --- 344 302 me y I 3" I y 1. ti 341 333 331 3" 3S y 3 I � _ ............ �- - — 363 42 372 3+63 Cop}r!phtI -C) 20M -C Kyof Jxi®onvillq. FI 0 Total Plat ap Flood RE # Name Address Value Gres Book Panel Legal Descriptions one LandUse Zoning ENT S ABOT 330 21- 2S -29E Not in 169741 0000 ERALDINE ANN FIRST 296200 0.22 0002 562 1 ATLANTIC BEACH Flood 32233 1 W 25FT LOT 7,LOT 9 BLK 2 Zone http: / /maps.coj. net /WEBSITE/DuvalMAps /toolbar.asp 9/22/2003 1 1Vl] CITY OF ATLANTIC BEACH ,.� 800 SEMINOLE ROAD 3 ;t ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 r Application Number . . . . . 05- 00030142 Date 5/05/05 Property Address . . . . . . 330 1ST ST Tenant nbr, name COMPLETION OF DUPLEX Application description . . . TWO FAMILY RESIDENCE Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2020 Owner Contractor ------------------------ -------------------- ----------- - - - -- JOHNSON, EDWARD & LAURA DOUGLASS CONSTRUCTION 330 1ST STREET 835 8TH AVE N. ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 249 -0767 (904) 249 -4701 --------------------------------------------------- Permit ELECTRICAL PERMIT Additional desc CHANGE OUT FIXTURES Sub Contractor AMERICAN ELECTRICAL CONTRACTOR Permit Fee . . . . 70.00 Plan Check Fee .00 Issue Date Valuation . . . , 0 Fee summary Charged Paid Credited Due - - - - - -- ---- - - - - -- Permit Fee Total 70.00 70.00 Plan Check Total .00 .00 .00 .00 Grand Total 70.00 70.00 .00 .00 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 CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH T OF THIS PERMIT ANUSUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. k'')OW e k -k BUILDING OFFICIAL CITY OF ATLANTIC BEACH ELECTRICAL PERMIT APPLICATION �, r ,. Date: 5— V5 Property Address: Owner: — ff _ r Telephone 4 Contractor: 6 0 11 n l ���j�l(I �'N11 -�,C OjTelephone. #: ?j Contractor Address: ()e ��� Fay #: I Tn corsideratiott of permit g er, far dein.g the work as described in the above statement. we hereby agree to perform said •., ,; - � axordartce with the attached plays and speci cations which are a part hereof and fir, accordance with the C'itt of �± .• - ordinance and standards of g ood ractice }fisted therein. lan.�. Be:: -- I g: StriIdin I Suildina'TyPe; ❑ Trailer