340 1st St. (vault) a FOR OFFICE USE ONLY
Date ------ .— 4------------ 1
Permit #_1 _CJ..U- -_Fee $ - -✓.
OF", TOWN OF ATLANTIC BEACH
Valuation $ -- -- •--- ---- --- ----- --- -- - -.."'
F LORIDA House #-------------------------------
cs
--------- - - - - -3 0 -------- --------------------
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 Town of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the Town of Atlantic
Beach and all rules and regulations of the Building Department of the Town 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 Town 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 is office so that licenses can
be verified. �
Date ----- � - ------ - -- - - -- ----- - - - - -- , 19" 1-..�
Owner -i
-:w /_�C� s ---------- -(f L..... - -- Address----------------------------------------------------- - - - - -- Telephone No.-- --•--- - - - - -- --- - - - - --
Architect---- - - - - -- - - - ---- ----- -- --- --- -• - --- -------- - -------- ----- ---- -------- -- - - - - -- -- -- - -- Address- - --- -- ----- - - - - - -- --------------------
----------- Telephone No--- -- --- -- - - -- --- --- - -- - --
Contractor Builder. -'------------- ----- -- -- ----- � ------- Address ------------------ _-- - - -- - - - - --
Lot ----- --- ---- ------- --------- - - - - -- --Telephone No.- - - - - -- -- - Noy- - � Street -- -- ---- - - - - -- - - - -- -Sub Division--------------- - -- - -- -- ------- --- ----- - - - --- -
- -------- -- -- - - -
--- - - -- -------------- ------------ - - - - -- - -- --
/} �/ ,(� - -- - - - - --
-
--- ------ -�! -_... Block No.--- - - - - -- - - -,Side Between_- - - - -- -- ---- - - - - -- ---------- - - - - -- - - - - - -- - - -- and-------- - - - - -- ------------- - - - - -- Zone -----------------
, Sts.
Valuation $_�!0,- ; 0�.._.,For what purpose will building be used..__...�_/ e,�____.__.__.___Type of constructionA djo.t1/'_�'_____._._
Dimensions of Building-A/ '�__6_�✓_- ______- Dimensions of Lot___ ,[_. __ ___ ---------------- Size of Footings .____ p ____-
Size of Piers --- _...._____._... - .._..___.____Size of Sills ------ ________.__. __.__.Greatest Sill Span in ft.______._._._________..Type Roof�� ------------------ ----------- -- ----
How will Building be Heated? f_CL
______________ �?__. 4°Gt ' ___.._Will Building be on Solid or Filled Ground ?______ .� ... .. ........
Size of Ceiling Joists Distance on Centers___ __________.._._..____ r
g , / Gr eatest Span. -------------
Size of Floor Joists- . - - - -.- -�- -.��- --- --- - -- - -- , Distance on Centers --- -_ - -- -------- .------ --- - -- -. - -, Greatest Span-. ----------- .-- -.---------- --------- - - - - -- "
Size of Rafters- --- ---- ------- --L___x___ ------ _.___ -- -.., Distance on Centers .. - .-- `�------------------- - - - --, Greatest Span--------.----------- ---- ------- -.-- -- -- - --- to
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 L LINE
Two copies of plans and specifications shall
be submitted with application.
Inspections required.
1. When steel is in place and ready to pour footing. W
2. When steel is in place and ready to pour columns and /or lintel. a a
3. When steel is in place and ready to pour beam.
4. When framing is completed. p p
5. When rough plumbing is completed, and ready to cover up.
6. When septic tank drain field is laid but before it is covered. q q
7. Electrical inspection by City of Jacksonville. r
8. Final inspection.
Note: In case of any rejection, re- inspection MUST be called for after
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 perform said
work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building
regulations of the Town of Atlantic Beach.
Signature of Builder- - - •-- --- -- ----------- ...... Address-- - -- - -- -- -- -- - ---- ------- ---------- - - - - -- -------------- ------ ----------- - - - - -- -- -- - - - - -- -- -
Signature of 'Owner... - ------ -• - - -- J - - - - -- Address------------- - - - - -- --------------- - - - - -- ---------------- - - - - -- - ------ - - - - -- ---- - - - - -- - - --
Instructions to Builders and Contractors building or working In the
Town of Atlantic Beach
1. No work on any building shall be started without obtaining the
necessary permit.
2. No changes In the approved plan shall be made without the approval
of the building inspector.
3. Inspections: The following inspections shall be called for:
A. Foundation, when steel is in place.
B. Plumbing, rough.
C. Lintle, when steel Is in place.
D. Framing, before any wall covering Is placed.
E. Electrical, City of Jacksonville.
F. Septic tank or, sewer, before covering.
G. Plumbing, final.
H. Final, when all work is complete.
Any concrete poured or work covered without the necessary Inspection
shall be removed or uncovered at the request of the Building Inspector.
4. After the final inspection and upon submission of a drawing showing
the size and location of completed building on lot to the building
Inspector a Certificate of Occupancy shall be issued. No building
shall be occupied before said certificate is issued.
5. Plumbing permit does not cover sewer connection permit.
6. All contractors and sub-contractors shall have occupational license
issued by Town of Atlantic Beach before doing any work within the
Town Limits. Contractors shall furnish certificate of liability
insurance when obtaining license.
7. The penalty for violation of any provision of the Building Code 0.��
of Ordinance #186, shall upon conviction thereof be punished by fine
not exceeding $500-00 or imprisonment for not exceeding 90 days, or
by both such fine and imprisonment.
8. Copies of The Southern Standard Building Code and Ordinance #186
are available at the Town Hall for reference.
9. When a sidewalk exists across front of building lot, said sidewalk
shall be placed in first class condition before final inspection
is requested.
I have read and been furnished a copy of the above instructions
in connection with Building Permit No.
Date J.-S Signed
001094
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
LOCATION INFORMATION
falt Number , 1,094 340 FIRST STREET
Permit Type: BUTLDTH6 ATLANTIC BEACH, FLORIVA
:lass of Work4 REPAIR LEGAL DESCRIPTION
Canes 3r. Type: NIA 8 1 ock . Section
p Use RE - ROOF Pl.at Book: Page- 0
0 Code :xlhdi vision t ATLANTIC BEACH
OWNER INFOR"ATION
a I ue -
Tmpvcov- COst' *2000100 Name- MR. KLEIN
$7.50 Address: 340 FIRST STREET
- IRTf)A 32�
ATLANTIC BEACH, FL( -
$7.50
�cl U
<904)246 1288
APPLICATION FEEL-1
PERMIT
WATER IMPACT FEE
3EWER IMPACT FEE - 60
40SVIIETCK, $0
RADON GAS s6.00
RADON GAS -- 5% 06`�
WATER TAP $0.00
3EWER TAP $0.00
HYDRAULIC SHARE IDO.00
RE--INSPECT FEE 1;0. Of"
ENGINEERING sd.r,,
NOTES:
NOTICE — ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER.
"FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW.
ATLANTIC BEACH BUILDING DEPARTMENT
By:
I "'I I 1 �'ji
fh•1•Y DRrC1111'•r.ion
� >'r�t' �Cctc'l i Co7 ic��i.
710 OCEAN BOULEVARD
Lot N________Block #__ - _ - __ - Section #________ I'.O.BOX2�i
ATLAN11C BEACII, FLORIDA 32233
7 BIXI'llONE (904) 219.2395
Subdivisions ------- ---- -- - ---
--------------- -
Street (lame - /_ DESCRIPTION OF WORK
or Address s ..3 yO
If in a FLOOD HAZARD
Flood Zones .............. area complete page 3. Brief
Description:_ ------- - - - - --
Class of Works
(New/ Remodel /Addition)____ ____ ___ _ __
ZOIIING I14FORIIATIOII
Type of
Constructions ___________ _______ _ _ ___
Zoning Proposed
Districts --------- Uses --------------------- Estimated Value B_ 0 Q Q ______
1�
E xceptions or Materials s______ ___ __ ____ _____ ______
Variances Granted: '
Solid or
------------------------------------- - - - - -- Filled
Grounds ------------- Roofs Y
OWNER IIIFUIII1ATIO14
Method of Ilcatirsps__________________
Property Owners ------- L i /J� --- -------- -- Phones �2 3�
_�.�__ _ -.... _ - — - ----
Mailing 7
Address __,,.2_�Q -16: -5
- - - - -- ------------------------------------- - - - - -- Zi p s ----------- - - - --
CONTRACTOR INFORMATION.
!.� 7/ y •-
Contractors Phones
---- - - - - -- - - --- -- ------------ - - - - - -- ------- - - - - --
Mailing
Address_ L__ - -- -----------
--------- - - - - -- - - -- Zips 2 l
----------------------- - - - - -- - - - --
Expiration
License )lumbers ------------- - - - - -- Date t --------------
In consideration of permit given for doing the work as described
the above statement, we hereby agree to perform said work in
1
accordance with the attached plans and specifications which are
a part hereof, and in accordance with all rules and regulations
of the City of Atlantic Beach.
%,)� �, 1 ► Owner Signature Date __________
Contractor Signaturel�Y1_� --- - - - - -- -Date
��,�.a. `� ------ - - - - --