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374 1st St. (vault) FOR OFF CE USE ONLY Date - - - I 0 195- --- ----- Permit # --- 4 $ ----- TOWN OF ATLANTIC BEACH Valuation $ ... ------ -------- Ir- F LORIDA House # -------------------- ------ ------- ---------- --------------- 3 - 7 / ..... ------ 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 this office so that licenses can be verified. Date ---- --------- Id — ---------- -------------- Owner_J4/.­/­­­e­­mi ------ -1 Address --- --- --­---------- ------ ...... --- - ----- ­- - - - - - -- -Telephone No .---------------------------- Architect -------- ------------- _ ---_--------_-- ---------------------------------------------- Address -------- ---------------- --------__-_----- --- ---- -- . Telephone No .------ - - -- -- ---_----__ Contractor Builder- ----------------------------------------- ------ Address ------ ------ ------------------------------------------ - -- T elephone No.... - -- ------------- - - - - - -- Lot No.' E � 4 V(_)'P'K._.BIock No -_--- 7k -------------- ---- Sub Division -------- --------------------------------------------------- .... .-Zone -------_- ----­---- - - --- -- ------ - 37-e ...... - - - - -- Street-------- - - - - -- --------------_-------- Side Between -- -------------------------------------------- and ----------_---------__ --_ Sts. --------- /_11? -A ------- 00 'Almr-o'lae - 1 Valuation $A1 . purpose will building be used ----- -- ------- _Type of construction -- ---------------­-­ ----- A' Dimensions of Building. ---gf _447 Z-0 ---- Dimensions of Lot.IJ777X-J_'� ------- ------_-_ Size of Footings.S. ------------- Size of Piers -. ..._ h of Sills -_ 11 -------- Greatest Sill Span in ft.--. ---------------- _ .... Type RoofM A /9_. How will Building be Heated ?__4044 ----------------- Will Building be on Solid or Filled Ground ?._ ---­----­---­­--- Size of Ceiling Joists ----- rxg ----------­-------------- Distance on Centers -- _-_- 44 ------- --------------- Greatest Span ------ /3 - --- --------_---- Size of Floor Joists --- ------------------------------------- Distance on Centers _..._... - --------------------------------- Greatest Span. .... ------------- ---_-------_-_---- Size of Rafters Distance on Centers J-6-" -- ------__- -- - I 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 Two copies of plans and specifications shall be submitted with application. 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. 3. When steel is in place and ready to pour beam. '4 4. When framing is completed. 5. When rough plumbing is completed, and ready to cover up. 6. When septic tank drain field is I-aid 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. 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 To =fantic Be� ------------- ------------------------------------- --- -- ---- - - - ----- - Signature of Builde ------------- ------ i --- - ----- ........... 0 --------------------- -------------- -------------------------- ----- - ----- ----- Signature of Owner. ---- --- Address - -- ---------------- I CITY OF ATLANTIC BEACH, FLORIDA Approvod by APPLICATION FOR ELECTRICAL. PERMIT i r I TO THE CHIEF ELECTRICAL INSPECTOR: DATE: IMPORTANT NOTICE: I t IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THO FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF. AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS. CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL FIRM: MIRRI1 SWUM i NAME ADDRESS .� / r RFCL X� i BLDG. SIZE BETWEEN: REL APT.( COMM. PUBLIC 1 1 INDUS. V 1 NEW 11 OLD 1 REW. ( 1 ADDITION 1 ) TRAILER ( ) TEMP 1 SIGNS 541 FT. SERVICE: NEW ( 1 INCREASE( REPAIR( Fill .-•-•.•.-• - CONDUCTOR SIZE AM COPP RA EWAY PVI TCH OR BREAKER EXIST. SERV. SIZE AMPS PH W VOLT 5 U RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL ,r ~ RECEPTACLES CONCEALE OPEN TOTAL 0.20 AMM. [at 000 AMEN. SWITCH INCANDESCENT _ t FLUORESCENT III M. V. F LC 0.100 AMPS. ove" APPLIANCES BELL TRANSF. AIR H.P. RATING H.P.AATING CONDITIONING COMP. MOTOR OTHER MOTORS AMPS I CEIL HEAT: KW -HEAT 0.1 OVE MOTORS H.P. VOLTAGE PHS NO. 1 M.P. VOLTAGE PHS MISCELLANEOUS i TRANSFORMERS: UNDER 600'V. OVER 600 V. NO. KVA I ND. I l KVA NO. NEON TRANSF. NO. VA. MA. MOTOR SIZE $WITCH FLASHE j i EACH SIGN ! tr FORWARDED $ TOTAL FEES Q D • i CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT �� .� JOB LOCATION: �� 7-r /�7- x�^ OWNER OF PROPERTY: BUILDING PLUMBING CONTRACTOR AND ADDRESS: ----------------------------' ------------ TELEPHONE NUMBER: ? oo /q_____________________________ STATE LICENSE 0O: _ /" r-� _ qq _ qe _______________________ TYPE OF BUILDING: ------ I _____SINKS _ SHOWERS _____Z ____ N8]'I-J? HGAT6BS _____z____ TUBS __.__ulS8NAS8E8S ------------ URINALS _DISPOSALS / ------ � �7 -____CLOS / _ _NA58lQ6 MACHINE ____________FLOOR DRAINS S8QNG� P&NS OTHEB__ TOTAL FIXTURE COU a $15.uU ------- -q-_ p-~. --_____----_-----------_--------_--------_--_-_ l. I0ST��ATIO0OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODF:' CALL A DAY AHEAD TO SCHEDULE INSPECTIONS -- (904) 247-5826 �/1� �. / CITY OF _ ,� fY&4 ^44c 1.3 � - ��� Office of Building Official INSPECTION REQUEST FOR INSPEC i Date f°Z" fi �� fy Permit No. Tame A.M. Received P.M. Job Address Locality Owner's Name _ _ Contractor BUILDING CONCRETE ELECTRICAL PLUMBING ECHAN� Framing Footing Rough Wiring Rough ❑ Air Cond. & Re Roofing - Slab Temp Pole Top Out ❑ Heating Insulation r Lintel Final Sewer ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION .M. Mon. Tues. Wed. Thurs. Friday _ P.M. A.M. Inspection Made r _ P. M. Final Inspectio I nspector- Certificate of ccupancy Date - -- - - - - -- -- — CITY OF / giui o'f Bu -- cls Official Offw INSP ECTION REQUE FOR �C permit N - 7 A.M Date P.M. Time Lo Received Job Address G MECHA Contractor G' C ond. & PLUMBIN � Air C pwner's ELECTRI Rough Heating N CpNCRETE Roug Airing T Out 0 C Fire Place � Pole Sewer Pre Fab BUILDINC Footing ❑ Fina ❑ A.M n g Slab ❑ Re Roofing Lintel FOR I NgpEC(ION Friday - Insulation R EAD j Thurs. Wed. A.M. Tues. 711 p.M• M i✓J Final Inspection 0 / Certificate of Occupancy Inspection Made Date Inspector �/11�� CI � T , Y ,,. O L F �14 fYLLIW� /S� - �� " Office of Building Official REQUEST FOR INSPECTION 3 2 1 _ 0 6 Permit No. Date `7 A.M. Time P.M. Received Locality Job Addres � ) Owner's k Contractor Name PLUMBING MECHANICAL Rough Wi CONCRETE ELECTRICAL BU ING ❑ Rough ❑ Air Cond. & El Top ❑ Footing ring Out ❑ Heating Fra b El Temp Pole ❑ Fire Place ❑ Re Bootin g ❑ gla ❑ Final [] Sewer P Fab Insulation El Lintel READY FOR INSPECTION M. kTue Wed. Thurs. Friday Mon. A.M. P Inspectio(Made ccupancy Inspecto Certificate o 171 Date CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 SEMINOLE ROAD - ATLANTIC BEACH, FL 32233 - TEL: 247 -5826 - FAX: 247 -5877 PERM - IJ►1FOfJ LOCH Permit Number: 20243 Address: 374 FIRST STREET Permit Type: GARAGE ATLANTIC BEACH, FLORIDA 32233 Class of Work: REMODEL Township: 0 Range: 0 Book: Proposed Use: Lot(s): Block: Section: 0 Square Feet: Subdivision: ATLANTIC BEACH Est. Value: Parcel Numbe Improv. Cost: 5,376.00 0 r Date Issued: 6/20/2000 Name: ADELINE BARRACK Total Fees: 60.00 Address: 374 FIRST STREET Amount Paid: 60.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 6/20/2000 Phone: (904)768 -6166 Work Desc: CONVERT CARPORT TO GARAGE/REPLACE ROTTEN WOOD r PROPERTY OWNER PERMIT 60.00 1151 I , a . , w COVER UP FRAMING FINAL BUILDING i I NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED U AND HA AWAY BY EITHER C ONTRACTOR OR O WNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY O WNER 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. (68.88 14 Date: 6/28/68 81 Receipt: 886738 CHECKS 1861 ATLANTIC BEACH UILDING PT. 88188883221888 CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address 7 <� 7 C CArZ P©2 f a r. c Date Heated Sauare Footage — _D.er sa t hed arage/ @ $ per sq t 9 W rport 9 Porch f-?(c5T(f - 3 per sq f t Deck @ $ per scr Patio Sa f: t TOTAL VALUATION: - A, 06 Tot Valuation 1st $ /00�2 C/u Remaining Value $6 per thousand or portion thereof TOTAL BUILDING FEE elo + I Filing Fee Fireplaces @ $15.00 BUILDINiG! PERMIT FEE WATER IMPACT FEE SEWER IMPACT FEE WATER METER /TAP 1-4 CAPITAL IMPROVEMENT SEWER TAP RADON (HRS) C,050 SECTION H PAVING HYDRAULIC SHARES CROSS CONNECTION $ ) SURCHARGE . 0 0 0 8 T OTHER $ 0 GRAND TOTAL DUE , 6 0 'w ADDITIONAL PERMITS OR FEES: Mechanical P1 umbing,_ Electric/New Electric"Temp :SwJ..mm,-'ngPoo,, Septic Tank We Sign Floor Elevation Survey Other CALCULATIONS and/or NOTES: A? E r � 4 i 2 S 2000 CITY OF ATLANTIC BEACH City of Atlantic Beach PERMIT APPLICATION REMODEL, ADDITIONS, OR AL �� �Oning MOVING, DEMOLITIONS Owner (s) : d =1 /JI/ "RUCK Job Address 3 z 2�MT -Sr, Phone: a 7"02 Lot # �Q Block or Unit # o c, Subdivision: Contractor: State License # Address: 5 � �'I l� Phone No: City 5 m State m �� Zip Code Describe work to be done: CM 1 9 08' TO R 'E&ficlAl G ROT Vvo o D Present use of building: . C A k PO R 7 Valuation of Proposed Construction: Proposed Use: if //l" A G Is this an addition? #6yC 5If yes, what are the dimensions of the added space: , ft. X ft. Will the added area be heated and cooled? U New electrical (or increase)? New plumbing fixtures ?-N-O— New fireplace? 46 New Heat /AC? !V U SUBMIT THREE (COM4ERCIAL) TWO (RESIDENTIAL) COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMONCENENT, AND OWNER /CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: LLyy� —��(� Date: Yb 6YV Signature CONTRACTOR: Date: a � ���J • thisv� r � Layy of 2000. ( Z FD NOTARY PUBLIC �� 6 �zq� E fl- 0E►'Z �F- `� ° C �-- e this day of "" " "�, POW& Anno �cpIRE.> MY C " August 27. 2000 BBIIBEB ruai 7afIV FA INSURANCE INC. NOTARY PUBLIC° MAP SHOWING SURM OF ELY ! of LOT. ... - -... REC -------- -EA----- SU....?- D1V1S?O_tyr/.... I ' 2. Cl�oo Recorded in Plat Book.... ----- page... .•,'of Current Public Records of Duval Co., Rla. D NJi N u 1�1 City of Atlantic Beach For. - - -- 4 ......... ._. Y Iz-, Iv E Y 4 0` P, / \V 75 14fo.93 TOSH Lri./�Y Cn,IV) f 2g' �'�� J d+ F 0 s. a' z_4.1' z o. 4•' I S�on,Y Lj 0 GONG. P5L1P I t` OW b.1._ LINC-1 4� �J v o COVF-P��.L-f) T�Al:-I" 'L 42 I y l N ,V O Ary w ° � V\ o •, a V :o l i 0y . 1 S' 1 50 , 5 1530 4•-22 W. --7 I HEREBY CERTIFY that the above survey was made by me and there . - F AP- - N0 .... ......... encroachments. Dated------ - - - - -- - 195.8 . - - -- i w 1 , \` „. •" Scale :................................ .... ................... C. H. Baker Jr., Reg. Surveyor, Cent. 16 o ...... _... indicates iron corner found, Reg. Engineer, Cert. 3266 Florida. set, and!or verified. CrrY OF ATLAI BEACH OWNER BUILDER PERMIT AFFIDAVIT STATE OF FLORIDA COUNTY OF DUVAL BEFORE ME , THE J n UNDERSIGNED AUTHORITY, PERSONALLY APPEARED BEFORE ME RnL ��N � i j� /C �� � WHO BEING / B ^ Y MME FIRST DULY SWORN, DEPOSES AND SAYS: 1 AM THE LEGAL OWNER OF THE FOLLOWING PROPERTY: 3 �7 /" "�/( i3L� r1_ ?2�2 3j CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING REQUIRES OWNER /BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.1 03(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 YOURSELF 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 THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENCED 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 UNLICENCED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION OF THE OWNER, WHO MUST BE ON THE ✓OB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENCED TRADES PEOPLE. " THIS DOES NOT ALLOW USE OF UNLICENCED 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 CLEARLY PROTECTS THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND /OR FORM 1 099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. UNLICENCED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE No. 455-228(l). 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 15 A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247 -5826) IF IN DOUBT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER - BUILDER PERMIT. (26� e,,j��� PROPERTY OWNER/ B ILDER 32f ADDRESS �/ TELEPHONE SWORN TO AND SUBSCRIBED BEFORE ME THIS L� DAY OF O /,2000. .NOTE: PHRASES UNDERLINED ABOVE 1 ARE EMPHASIZED BY THE BUILDING NOTARY PUBLIC ��� "vw���., PQtlicle mim �,n.. i v]r�IRE DEPARTMENT. MY COMMISSION EXPIRES: MV COMMISSION N CC66086 INF ; <c qi BONDED THRU TROV PAIN INAIJRAN�� i P Pi k'/ C K, A 0 1 Af9 r 3 7 7 F1/1 S T 5 7 - - 11 Sour T o o v R - L,�_� o U 1'Y Dow / ��_� = �i� . -- G X 36 -- , _C A G t D a o R T N q - -- - - — - -- City of Atlantic Beach � I O NO \01 41 � l @ a LI I Q I I CA I Z I f j iI x" Lr N _u O -U I 3 P N d- -� o G 7 �a L a t~x� �►� wJI R A F CF PR , RSA 2 S 2000 City of qt BUildin lQ '''ic Beach - and Zoning CITY OF ATLANTIC BEACH 4 800 SEMINOLE ROAD s ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 03- 00026091 Date 5/15/03 Application Number 374. 1ST ST Property Address - REPLACE EXISTING COND. Tenant nbr, name . • • ' . . MECHANICAL ONLY Application description - TO BE UPDATED Property Zoning - 0 Application valuation - Contractor Owner ----------- - _ ____ __ BARRACK, GROVER C. ASBURY HEAT AND AIR CO INC 374 1ST STREET 221 COKESBURY CT ATLANTIC BEACH FL 32233 GREEN COVE SPRINGS FL 32043 (904) 282 -8700 ___ ---- - - - - -- Permit . . . . . . MECHANICAL PERMIT Additional desc . • Plan Check Fee .00 Permit Fee 67.00 0 Valuation Issue Date . Fee summary Charged Paid - Credited ---- - - -- --- - ------ --------- ---- - - - -- ----- - - - - -- 67.00 67.00 .00 - Permit Fee Total •00 .00 . 00 .00 Plan Check Total . 00 .00 Grand Total 67.00 67.00 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 WHICH ARE PART OF THIS PERMIT AND PAYING SUBJECT TO REVOCATION FOR VIO ATION O ISSUED F APP APPLICABLE PROVISIONS OF LAW. PLANS RI Itm]WG OFFICIAL r >f CITY OF ATLANTIC BEACH S� MECHANICAL PERMIT APPLICATION Date: Owner of Property: � rt �2 D2 �l n 4qc Job Address- ():tfA4L ­) �� Contractor: C 4 Co ti t 1 / - 3 Y In consideration of permit given for doing the work as describtd4fAhe aFovi statement, we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of good practice listed therein. III. GENERAL INFORMATION A. Type of heating fuel: B. ❑ Electric IS OTHER CONSTRUC BEING DONE ON THIS ❑ Gas: _LP _Natural _Central Utility BUILDING OR SITE? - 1 1�► ❑ Oil ❑ Other -Specify BQ,0-k (2 UOA IF YES, GIVE NUMBER OF CONSTRUCTION f�— PERMIT IV. MECHANICAL EQUIPMENT TO BE ' ,NATURE OF WORK INSTALLED f� Residential or Commercial ❑ New Building (Provide complete list of components on back of this form) ❑ Existing Building ❑ Heat _ Space _ Recessed — Central _ Floor L3 Replacement of existing system ❑ Air Conditioning: Room Central ❑ New Installation o ❑ Duct System: Material Thickness (N system previously installed) l y ❑ Extension or add -on to existing system Maximum capacity cfm ❑ Other- Specify ❑ Refrigeration ❑ Cooling tower: Capacity Ap m ❑ Fire sprinklers: Number of heads THIS SPACE FOR OFFICE USE ONLY ❑ Elevator : _ Manlift _Escalator (Number) (Received) L1 Gasoline pumps (Number) ❑ Tanks (Number) Remarks ❑ LPG containers (Number) ❑ Unfired pressure vessel • Boilers pQ Permit Approved by Date �YMJI • Other - Specify Permit Fee LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT l Num er Units Description Model Number Manufacturer Aped ty Approving (Tons) Agency - 60 i �4 HEATING - FURNACES, BOILERS, FIREPLACES Number Units Description Model Number Manufacturer Capacity Approving BT Agenc TANKS How Many Nominal Capacity Type Liquid Name of Serial Approving And Dimensions Contained Manufacturer No. Agenc 800 Seminole Road • Atlantic Beach, Florida 32233 -5445 Phone: (904) 247 - 5800 • Fax: (904) 247 -5845 • h ttp : / /www.cLatlantic- beach.fl.us 1/14/03 Instructions to Builders and ConAtrac tors 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 oi". of Ordinance #186, shall upon conviction thereof be punished by wine 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 Sign PSR 3844 9351 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ERMIT INFORMATION ------ ------- LOCATION INFORMATION --------- ­rmit. Number7 9351 .1dress: 374 FIRST STREET Permit Type: MEf_'HANICAL ATLANTIC BEACH, FLORIDA 3223 ass- )f Work ALTERATION ---------- LEGAL DESCRIPTION ---------- cnst . Tvve WOOD FRAME ^t: B I ock: Section: Fropcged Use! SINGLE FAMILY Township: RNG,* 0 aelli s: 1 Code: 0 "Ibdivision: ATLANTIC BEACH , .stima:ed Value SO 1 00 Imp ov. Cost: 90.00 T tal Fees* $41.00 Am unt ftid: 841.00 77,7­0. OWN,E4 INFORMATION APPLICATION FEES N am VZLINZ 1 BARR7 , v_ ­ v1 PERMIT 541.00 .ddressv: STREET WATER'' IMPACT FEE *T SEACli . FLOP. TrA 1 n SEWER IMPACT FEE phonk: WATER METED /TAP RADON GAS S0.00 CO$,TRA;j'TOR INFORMATION RADON CAB 5% $0.00 M1, AIR ENGINEERS INC. CAPITAL IMPROVE. S0.0A 1094 BEACH BLVD, SEWER TAP .;0.0n JAX.FL_11206.246 CROSS CONNECTION $0.00 6 Tvr z e: SEC H IMPACT FEF CONST.SURCEARGE FCHARGE/ATL_BCH. 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." 1 ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. 000000000 000000000 $41.00 14 ATLANTIC BEACH BUILDING DEPARTMENT Date: 11/15/94 00 Rcpt: 0011658 DECKS 11042 By: 6085 PSH-3844 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ­EiiMIT INFORMATION LOCATION INFORMATION "'ermit 6085 tddress: 374 FIRST STREET permit Type: PLUMBING ATLANTIC BEACH, FLORIDA 32233 jass c3f Work: REPAIR LEGAL DESCRIPTION Constr. Type: WOOD FRAME .ot: Block: Section: Proposed Use: SINGLE FAMILY Township: RNG; 0 ?wel I ings - I Code: 0 -;ubdivision: ATLANTIC, BEACH ..:stimated Value: $0. ou Im rov. Cost: $0.00 tal Fees* $18.50 A Yid: $18.50 pnt(ll p 5/92 ,'MATION APPLIC F ATION EES ----- Na e: BA - $18.50 Addr _37 FIRST STREET WATER IMPACT FEE $0.00 'R 1 �;o on SEW re )� IMPACT FEF FLORIDA 3'' ,*TIC, BEACH, I A TZR RAV COf(j RACTOR INFORMATION RADON GAS 5% Name: "VE,_F0(3US PLUMBING WATER TAP $0.00 c, - 1 Address- 9,400 AT1,ANTIC BLVD. #4 SEWER TAP $0.00 JACKSON I VILLE, FL, 32225 HYDRAULIC SHARE $0.00 CFC0_4443� Type- 0 RE-INSPECT FEE ()._00 SEC.H IMPACT FEE $0.00 OTHEP rEp 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." %SSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT Ta-REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT By CITY OF ATLANTIC BEACH, FLORIDA F __ 4p'ov*d by APPLICATION FOR ELECTRICAL, PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: November 1 19 94 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 ACCORDA E WITH THE LECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. R & R ELECTRIC OF NORTH FLORID: ?, INC. P. 0. BOX 62238 k 4 JACKSONVILLE FLORIDA 32.21.9 ELECTRICAL FIRM: MASTER ELECTRICIAN SIGNATURE JOURNEYMAN NAME Adeline BArrack ADDRESS: 374 1st. St. -RFD-BOX- BLDG. SIZE __ BETWEEN: RES. IX) APT.( ) comm.( 1 PUBLIC ( ) INDUS. ( 1 NEW( 1 OLD( ► REW. ( 1 AODIT ( ) TRAILER( 1 TEMP.( ) SIGNS 1 ) SQ. FT. SERVICE: NEW( 1 INCREASE(_) REPAIR ( ► FEE CONDUCTOR SIZE G AMPS COPPER ( ► ALUM. (� `S ,OC) D SWITCH OR BREAKER AMPS PH W OLT RACEWAY EXIST. SERV. SIZE Z b O AMPS Z PH W J� LT RACEWAY FEEDERS NO. SIZE I ND. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.30 AMPS. 31.100 AMPS. SWITCHES INCANDESCENT FLUORESCENT & M. V. FIXED 0.100 AMPS. OVER APPLIANCES BELL TRANSF. AIR H.P. RATING H.P. RATING CONDITIONING COMP. MOTOR OTHER MOTORS AMPS I CEIL HEAT: KW -HEAT a ,so (� D 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS 1 ;PrvirP TnrrPa -,P• Heat A/r TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA I NO. I KVA NO. NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH I FLASHER EACH SIGN FORWARDED I�rO b TOTAL FEES �� CITY OF Pr CY Office of Building Official REQUEST FOR INSPECTION Date C — — ` Permit No. e Time A.M. Received PM. 3 sT st 7 ob Address Locality Owner's �JJ Nam ractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough ❑ Air Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION A.M. Mon Tues. Wed. Thurs. Friday PM. P hil. //� A.M. _ Inspection Made Inspector Final Inspection 11 Certificate of Occupanc E:1 J �— Date DATE: PRE - SERVICE DIVISION JACKSONVILLE ELECTRIC AUTHORITY 233 WEST DUVAL STREET JACKSONVILLE, FLORIDA 32202 THE FOLLOWING FINAL INSPECTIONS) HAVE BEEN MADE AND ARE SATISFACTORY: - 2 /sue 51;2e127" - - - - -- ------------------------------------------------- - - - - -- ------------------------------------------------- - - - - -- ------------------------------------------------- Enclosed are the blue copies of the permits. S ELY, BUILDING INSPECTION DIVISION cc:FILE BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 82259 APPLICATION ,FOR MECHANICAL PERMIT - CALL-IN NUMB R I IMPORTANT --Applicant to complete all items in sections I, II, III, and IV. I• Streot Address: LOCATION OF Intersecting $treats; Between And OX C BUILDING Subdivision II. IDENTIFICATION — To be completed by all applicants, in consideration of permit given for doing the work as described in the above statement wa hereby agree to perform said work in accordance with the attechpd plans end spocificotions which ore a port hereof and in accordance with the City of Jacksonville ordinances and standards of good•.pr.ectice listed therein. Name of Mechanical _ V Contractors Contractor (Print) i Master Name of � Property Owner 4T I O U 7 C b Signature of Owner Signature of or Authori:ed,Agent Architect or Engineer III. GENERAL INFORMATION t A. Type of hating fuel; B. IS OTHER CONSTRUCTION BEING DONE ON �+t�c THIS BUILDING OR SITE7 ❑ Gas — ❑ LP ❑ Natural ❑ Central Utility ❑ Oil IF YES, GIVE NUMBER OF CONSTRUCTION I PERMIT I ❑ Other — Specify I• IV. MECHANICAL EQUIPMENT TO It INSTALLED NATURE OF WORK 1 (Provide complete list of components on back of this form) -2" Residential or 11 Commercial f _Heat ❑ Space C3 Recessed . 0 Gentnol O Floor ❑ New Building Ej< Conditioning: C3 Room Contrelxisting Building ❑ Duct System: Materia Thickne L2 Replacoment of existing system Maximum capacity c. {,m, ❑ Now Installation (No system previously Installed) ❑ - Refrigeration "" ❑ Extension or add-on W existing system ❑ Cooling tower. Capacity g p.M ❑ Other -- Specify ❑ Fire sprinklers: Number of head ❑ . Elevator ❑ Monlift ❑ Escalate (number) THIS SPACE FOR OFFICE USE ONLY ❑ : Gasoline pum (number) (mod) ❑,• Tank (number) Remarks ❑ ' LPG containe (number) ❑ Unfired pressure vessel ❑ • . ioUers Parmif Approved lb Do Q ' Other — Specify Pormit Ft LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT c��Approving ` 0 NumberUW4 Description Model Number Manufacturer (T aacc11 Y ons) 1 HEATING • FURNACES, BOILERS, FIREPLACES Number Units ription Modal Number Manufacturer (BTU)Y Approving ,r k TANKS Bart► Many Nominal Capacity Ty" L W." Name of Sena) Approving aAd Dimensions Contalned Manufacturer No. Agency lJ r 's J CITY OF ATLANTIC BEACH sa 800 SEMINOLE ROAD J ; ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247 -5826 Application Number . . . . . 03- 00027264 Property Address Date 11/21/03 Tenant nbr, name 374 1ST ST REPLACE ROTTING ROOF WOOD Application description . . . RESIDENTIAL ADD /RENOVATE /ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1500 Owner Contractor BARRACK, GROVER C. __ TWO M CONSTRUCTION 374 1ST STREET 1308 7TH STREET NORTH ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 --- - - - - ( 246 -1529 Permit - • BUILDING PERMIT -- ------------------------- Additional desc . . Permit Fee 40.00 Plan Check Fee Issue Date 20.00 Valuation 1500 Fee summary Charged Paid ____ Credited Due - - -- ----- ----- -- ______ ___ ____ Permit Fee Total - - -- Plan Check Total 40.00 40.00 .00 20. .00 Grand Total 00 20'00 .00 .00 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. Y r B GO FICIAL _. CITY OF ATLANTIC BEACH D. `�s u BUILDING / ZONING DEPARTMENT Higgins j sl 800 Seminole Road S. Doerr Atlantic Beach, Florida 32233 (904) 247 -5800 ^��13 (904) 247 -5845 Fax PLAN REVIEW COMMENTS Permit Application # 03 - Property Address: 3 — o ! - 1- "S+ Applicant: - Tw u M n +r u o lr o n Project: ����[�rp !'C -Ir nc� f WO'DaG This permit application has been: Q Approved Reviewed and the following items need attention: Please re- submit your application when these items have been completed. Reviewed By: L Date: j I �2 (0 r j CITY OF ATLANTIC BEACH !i'�r�ir� 'rJ " w vf• frA BUILDING PERMIT APPLICATION 18 2003 (ALTERATIONS /ADDITIONS) Date: 1 ) y O Job Address: 3754 5 re z k � Owner of Property: fI dl / ` h ,�Q r'h e y�- Address: J 2 ), / S �' $" ft' �^ ,� - Telephone: Legal Description: Block Number: Lot Number: Zoning District: Contractor: j' �,l r r� /� ! �� {� State License Number: [; ,8 Contractor's Address: _ Telephone: �!� ) �4 13 z Fax: Describe proposed use and work to be done: �','S �- E r 1 r Sf h _1.�o dl Pro X 2. S Zo - ,< J eft jg"t- da;CA Be atr Present use of land or building(s): ,` k t, 'FAb s _ - Ik k C >p f 7s aj 9 .7 / Of Valuation of proposed construction: Ir!) ah What are the dimensions of the added space: feet x feet Will the added area be heated and cooled? New electrical or increase in service? Add plumbing fixtures? Add fireplace? Add heating /air conditioning? 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? ONO. 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. CJNO. 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 Telephone: (904) 247 -5800 • Fax: (904) 247 -5845 • http : / /www.ci.atiantic- beach.fl.us Page I 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 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: 7/, Date: I hereby certify that I have read and examined 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: f ' Date: / / 1 . 7 e_.3 Address and contact information of person to receive all correspondence regarding this application (please print). Name: Mailing Address: Telephone: Fax: E -Mail: AS TO OWNER: / Sworn to and subscribed before me this day of V71 Ut4 200 State of Florida, County of Duval `1pfiYPV'�, Gwen E. Dasher e _Commission # CC 954808 Notary's Signature: _'•. Expires Aug. 28,2004 ' • • Bonded Thrn ❑ ''.11101F �;•`' Personally known nn,%� Atlantic Bonding Co" Inc ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this l� ' day of I V d L P_ VV1 , 20 State of Florida, County of Duval Notary's Signature: "%111,,, ,. b ra '., Gwen E . Dasher ❑ Personally known Commisslon # CC 934808 ❑ Produced identification r °. A :' Bond Type of identification produced " AWwt �.`' ����� Bonding Co., Inc. 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 1114103 Nov 21 03 11:15a P.1 CITY OF JACKSONVILLE BEACH 2003 - 2004 � OCCUPATIONAL LICENS CITY CLERK'S 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: TWO "M" CONSTRUCTION COMPANY LICENSE NUMBER 04 -2242 FEE PENALTY_., TRANSFER - - -� $ 220.00 $ 0 0 $ o CLASSIFICATION 1522 CERT BUILDING CONTR LICENSE RESTRICTIONS DBPR LIC# CBC- 058256 VALID FROM OCTOBER 1, 2 003 1 TO SEPTEMBER 30, 2004 CITY MANAGER CITY CLERK LICENSE'3PE IALI T The City of Jacksonville Beach is Committed to the Citizen. First Class Service for First Coast Customers MAILING ADDRESS BUSINESS ADDRESS 1122 S 9TH ST JACKSONVILLE BEACH FL 32250 TWO "M" CONSTRUCTION COMPANY 1308 7TH STREET NORTH JACKSONVILLE BEACH FL 32250 Licensing Portal -Licensee Details ragG 1. v► IL 'WFAVdde.eom . TM Log On DBPR Home I Online Services Home I Help I Site Map 08:14:44 AM Public Services Search for a Licensee Licensee Details Apply for a License View Application Status Licensee Information Apply to Retake Exam Name: RUSSELL, SHARON ELIZABETH (Primary Nan Find Exam Information TWO M CONSTRUCTION COMPANY (Alterna Name) Find a CE Course Main Address: 1225 HOWARD ROAD File a Complaint JACKSONVILLE, Florida 32218 AB &T Delinquent Invoice Lic. Location: 1122 9TH STREET SOUTH & Activity List Search JACKSONVILLE BCH, FL 32250 User Services Duval Renew a License Change License Status License Information Maintain Account License Type: Certified Building Contractor Change My Address Rank: Cert Building View Messages License Number: CBCO58256 Change My PIN Status: Current, Active Licensure Date: 12/03/1997 View Continuing Ed Expires: 08/31/2004 L N N Term Glossary Special Qualifications Effective Date RE Online Help Bldg Code Core Course Credit View Related License Informatio View License Complaint Terms of Use I I Privacy Statement https:// www. myfloridalicense. com/ licensing /w sp;j sessionid= PEOIIONOBEGHkKj9f... 11/18/2003 3612 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH F✓iiMIT INFORMATION LOCATION INFORMATION 374 FIRST STREET permit Number. 3612 ATLANTIC BEACH, FI�URIDA pc Type- RE-ROOF - - - - - - -- - - LEGAL DESCRIPTION Glass of Work: NEW Lot: Block: Section: Prop sed Use: SINGLE FAMILY Cons r. Type: WOOD FRAME Township: RNG: 0 Dwellings: 1 Code: 0 Subdivision: Fstimated Value: $0.00 Improv. Cost: $0.00 Total Fees: $22.50 Amount Paid: $22.50 P a tc3 Paidt 4/ 8/91 WITH FIBERGLAS: SHINGLE ("1WNER INFORMATION -- APPLICATION FEES Na ne: likt3. BARRACE' PERMIT $22.50 r S'T' WATER, IMPACT FEE $0.00 ATLANTLC BEACH, FLORIDA SEWER IMPACT FEE $0. CIO Phr) - t904)733-283!5 WATER METER $0.'. RADON GAS-H.R.S. $0.00 CONTRACTOR INFORMATION RADON GAS - 5% $0.00 Name: DIBBLE ROOFING COMPAP' WATER TAP $0.00 Address: 3525 MORTON STREET SEWER TAP $0.00 1 JACKSONVILLE, FL. 3221'/ HYDRAULIC SHARE $0.00 �ice I se: RC0035393 Type: 0 RE INSPECT FEE S0.00 SEC.H IMPACT FEE $0.(; OTHER 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 NILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN OROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS." qDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR OPLICABLE PROVISIONS OF LAW. 'ING DEPARTMENT CITY OF ATLANTIC BEACH PERMIT APPLICATION ROOFING owner(s): Address: 1 Phone: Lot # Block or Unit # Subdivision Contractor: Address: S aGN` , Phone • 2 3 Q J� State License No . 0 Describe work to be done: Materials to be used: 6_4_1 i Signature OWNER Date: Signature CONTRACTOR: ,