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364 W 3rd St (vault) j CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD rj ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 �• >Als, �4 ( Date 9/22/06 Applicata n uer I �� j . 06-00033954 Property' dd e �s , t 364 W 3RD ST Applicatiin e deicript ' n PLUMBING ONLY Property Zon nn '. TO BE UPDATED -----Application --- -- -- --------------------------------------------------- Application desc I install 4fixtures---------------------------------------------------- ------------------------- Owner Contractor -------------- --------------------- _ ---------- GIBSON PAUL SEEBECK PLUMBING 351 KILINE RAOD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32246 (904) 249-2810 (904) 993-6498 -- -------- ---Permit . PLUMBING PERMIT Additional desc . • Plan Check Fee . 00 Permit Fee . . . ; 63 . 00 0 Issue Date I Valuation . . . . Expiration DTto -- " h 13 1/0----------------------------------------- Fee summa argue Paid Credited ------------- Due --------- ' --�-- -- -- -- ---------- ---------- ---------- i ! 63 . 00 00 .00 Permit F e Total ' ' 6 00 00 00 . 00 Plan Check Total • 00 . 00 Grand Total 63 . 00 63 . 00 . 00 I i ' ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA PERMIT IS APPROVED ONLY ACCORD CE BUILDING CODES. CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION h�Jiil�r Date: 9'2 2- - o woProperty Address: 3C� / 3 Owner: 60 60, Telephone#• Contractor: }�j9�� -SCL' ,1� CGS Telephone#: Contractor Address: 3�S '�'' ��(" Fax#: Contractor Signature: 25� 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: If other construction is being done on this building or site, >a —New list the building permit number: ❑ Re-Pipe Number of Fixtures: 1 Bath Tubs Showers Closets Shower Pans Dishwashers Sinks Disposals Urinals Floor Drains Washing Machine Lavatory Water Sewer Water Heaters Sprinkler System Other *See attached sheet see For Backflow and Irrigation procedures Fees APO I h/ ATF- oo Permit Issuing Fee: $35.00 Total Fixtures: ---�---- X$7.00 + $35.00= 800 Seminole Road •Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800 • Fax: (904) 247-5845. http://www.ci.atlantic-beach.fl.us Revised 9/06 CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD �j ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 ryJ31� Application Number . . . 04-00027626 Date 2/06/04 Property Address . . . . . . 364 W 3RD ST Tenant nbr, name . . . . . . POOL ENCLOSURE Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 13075 Owner Contractor ---- ------ - --- - - -- -- -- - - - - -- ---- -- - --- - -- -- ---- - HARMER, DAVID TROPICAL ENCLOSURES INC . 926 N. 9TH AVENUE ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 249-2810 (904) 241-2298 - --------------- - -- -- -- ------ -- - - ---- - - - -- - - ---- -- -- - - - --- ---- -- --- --- ------ Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 100 . 00 Plan Check Fee 50 . 00 Issue Date . . . . Valuation . . . . 13075 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---- ------ -------- -- Permit Fee Total 100 . 00 100 . 00 . 00 . 00 Plan Check Total 50 . 00 50 . 00 . 00 . 00 Grand Total 150 . 00 150 . 00 . 00 . 00 04 a 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 ARE PART OF THIS P�WT AVD SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. BUILDING OFFICIAL CITY OF ATLANTIC BEACH Cc: D. Ford .> BUILDING / ZONING DEPARTMENT ins J 800 Seminole Road Derr J Atlantic Beach,Florida 32233 (904)247-5800 R E G �fsfY ? (904)247-5845 Fax CITY OF ATLANTIC BEACH BUILDING &ZON.',,G JAN 3 0 2004 PLAN REVIEW COMMENTS Permit Application # 04 - 7Z^7(c, 2l 4""-- Property Address: Cx—) . 1�.i7 . —• Applicant: P( C-A( Project: C_ CL—C)7) t�Tz� This permit application has been: EEApproved El Reviewed and the following items need attention: Please re-submit y61►r application w n these items have been completed. Reviewed By: Date: �f'-6 "Lo s st1 i7 D CITY OF ATLANTIC BEACH JAIL 3 0 2004 BUILDING PERMIT APPLICATION (ALTERATIONS/ADDITIONS) i BY: Date: ��C Job Address: Owner of Property: / Address,_-6y w &dwsT Telephone: — /Q Legal Description: Block Number: O) Lot Number: I Z Zoning District: Contractor: tate License Number: Contractor's Address: Td72 // /�y�►f� , �/,,��l!1�1 `?� Telephone: Fax: Describe proposed use and work to be done: Present use of land or building(s): Ot '/ Valuation of proposed construction: /3Q�51 " What are the dimensions of the added space: tp feet x ��feet Will the added area be heated and cooled? New electrical or increase in service? IF New plumbing fixtures? New fireplace? New 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? 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. ,eNO. Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT 1S 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 1 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. �gnature of owner: AQLe- ��(� 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 • r 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 Con or: ��'"� Date: 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 L 20OL/ State of Florida, County of Duval ROY ROCKHOLD Notary's Signature: Comm#DD0121151 • 3� Expires S272ooe ❑ Personally known _ ,A, 4 Bonded thru(800)432-4254: ❑ vyvF '1 Produced identification w` Florida Notary Assn..Inc • °••'•"'•••••••••••••••••••••••••••••••••••• Type of identification produced VLA.- AS TO CONTRACTOR: Sworn to and subscribed before me this ( � day of (a 200 State of Florida, County of Duval 'bn O OO•.O••••ONO••....... UN.� ROY•ROCKHOLD Notary's Signature: Comm#DD0121151 YP • Expues 5/27/2008 ;?-Personallyknown Bonded thru(800)432-4254. ❑ Produced identification Florida Notary Assn.,Inc : s••••••••.•••• "'••••••••••.••• 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 3D VIEW Cage Master 2000 CopyRight 1991-1999 Wilson Software Corp.Englewood,Florida 01-29-2004 Customer : HARMER ta 'it, ti 11z u't> tt�/ L+W tRi vq tt� 'Z 3�� / � taL � p•Or d5.6 V fit, �9 OZ r' b tit, `iv t�q U4 3 04 vq faL yt2 �• A MAP SHOWING, 1.•061..aCK ..10/AS SHOWN•.O ;' _ *47Z *41rle ,86Ae# - ice. AS RECORDED IN PLAT BOOK PAGE -1y Cif n,:i��.i;, Rrc-OROS OF DU !1 : CO.� F1.+4. FOR CYNT,V/A vi 4V pw �,�t�ts - Ftaoc cFAT1F1'CM �11iE"WF�� 10 79 FJA of"O" S=�111WRO tr tw pWN NttT To 8E 10 A FWW MM WL �o STREET rso• J Boz• o' ,o ,� ��„�, .moo•� � •oZ• �7• •RI'•• � t 0 q � 41 ;t d ^ N ^ ss• , �SrO.QY .rv,4�E v O `V _ �✓I��"EAVES � wit • /��.�0 .raa• 3/. 7' /I.Z' Its A. Q Q� O V � P Vity 01 Atlantic Beachb v Si o' Ptam*V and Zoning Depart" 4 1% -This approval verMea C zoning, subdivision land t� development regulation,*A, :sAetlttde approval for the issuanr s.,• with Florida SuNding Cc ?ppiioaDia local, State and Fe` is i Beach Buildi /00Z. o s�T��'� a1• Building Pe Approvedily: O T 3 Date: /- . .4...... _ B L O C K Oro TM RWMY owns s MATH THE.w11ft VOW TW FLOROM 11VyM"jRKUWT0*ECVM4M1 ' 1 HEREBY CERTI FY THAT TH[ AaOVE iP ,L1 ><J "RVZy E0 YY LEGEND: Mt AND THATrJVAT 600f :.. • ,yam ... .,. •. �ywuM coRwl� 15 LOCATED WON SAME AS SHOWN AND THAT THERQ ARE NO �b�4*01M ~ SAID �,y vo CLARSON Ali ASSOC�A. 1Ni �I�oNVKI<i. :.:'�Ati s SIGNED VARY tt! 19in— i SCALE:--/SZO sTswco svwsTpw Cc: CITY OF ATLANTIC BEACH D. Ford BUILDING / ZONING DEPARTMENT Ioel f f 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 vS2s31 (904)247-5845 Fax RECEIVED i CITY OF ATLANTIC BEACH I BUILDING 3 7-GN1N0" ! PLAN REVIEW COMMENTS ,JAN 3 0 2004 Permit Application # C)4 — Z-7(Z(v Property Address: 3'T-- Applicant: l C��. �iJ�pSyWCS Project: 'Rpo L �iJLI�SQ� This pe mit application has been: Approved R iewed the followinb ' ed attention: Please re-submit your application when these items have been completed. Reviewed By: L4L Date: RECEIVED tv1TY Or ATiANl-Iv BEACH BUILDING & ZONING CITY OF ATLANTIC BEACH JAN 3 0 2004 BUILDING PERMIT APPLICATION' (ALTERATIONS/ADDITIONS) ' BY: Date: Q Job Address: Owner of Property: / Address Telephone: Z5�2— ze/Q Legal Description: Block Number: Lot Number: Z Zoning District: Contractor: / j/ tate License Number: Contractor's Address: Telephone: /"ZZ Fax: Describe proposed use and work to be done: Present use of land or building(s): Valuation of proposed construction: 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? New plumbing fixtures? New fireplace?T New heating/air conditioning? Is approval of Homeowner's Association or other private entity required?T If yes, please submit withthisapplication. 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. Ie 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. 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 1 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. _*'gnature of owner: AOA�,A Le k4la C/ 7e� Date: / O� I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of the laws and • ,v 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. 1 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 Con or: °y Date: Z-2 Address and contact information of person to receive all correspondence regarding this application (please print). Name: Mailing Address: Telephone: Fax: E-Mail: s AS TO OWNER: Sworn to and subscribed before me this day of L !'V 20 . State of Florida, County of Duval ROY•"••"@lessee Notary's Signature: ComteZ,4�� KHOLD DD0121�1S Expires&27/2006 ❑ Personally known ®':' ed Bondthn,(800)432-a2 :ue EJProduced identification „a w Florida Notary Assn.,Inc sees@...sees........a.....4.4.46••••86••••as Type of identification produced �� AS TO CONTRACTOR: Sworn to and subscribed before me this e7— of ( 1200/. State of Florida, County of Duval �mnuu�u m u000 uw•u u uuuo�wq ROY ROCKHOLD Notary's Signature: `"tidy p COTrn*DD0121151 Expires 5=200e personally known ' FAS Bonded tiru(800)432-4264. Produced identification Suu��:iiu��u�nF�ut Asan.,In. :❑ 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.f.us Page 2 Revised 1/14/03 CITY OF ATLANTIC BEACH r 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 J131>f' Application Number . . . . . 04-00027505 Date 1/30/04 Property Address . . . . . . 364 W 3RD ST Tenant nbr, name . . . . . . NEW POOL Application description . . . POOL Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 33000 Owner Contractor ------------------------ -------- ---------------- HARMER, DEBRA CLIFT & CO POOLS & SPAS P.O. BOX 702 9340 ARLINGTON EXPRESSWAY ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225 (904) 249-2810 (904) 855-0019 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc WIRE FOR POOL Sub Contractor SIKES ELECTRICAL CONTRACTOR Permit Fee . . . . 75 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- --- ---- --- ---------- --- ------- Permit Fee Total 75 . 00 75 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 . Grand Total 75 . 00 75 . 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 VIT CITY OF ATLANTIC BEACH ' f ELECTRICAL PERMIT APPLICATION s) Date: Property Address: C� CT- Owner: - Y, d'vl ✓� Telephone#: C-1U oZ Contractor , /� /'1 L C Telephone #: �2 3_7 + � Contractor Address: F D<�"7 _-zc7Hs l 6�-_, -if _36f2 Fax#: S l�l" 2 23 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. Building: Building Type: ❑ Trailer Service: If other construction is ❑ New Residence ❑ Temp. ❑ New being done on this building )a Old ❑ Commercial L3Si ns ❑ Increase or site,list the building $ Permit number: ❑ Re-wire ❑ Addition Sq.Ft. ❑ Repair Conductor Size: AMPS: COPPER ALUMINUM Switch or RACE Breaker AMPS PH W VOLT WAY Existing Service ,� RACE Size AMPS e�7� PH W VOLT WAY �r Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Receptacles CONCEALED OPEN 0 10 AMPS 31 100 AMPS Switches Incandescent Fluorescent & M.V. Fixed 0.100 AMPS OVER BELL Appliances TRANSFER. Air H.P.RATING H.P. RATING CEILING KW-HEAT Conditioning COMP.MOTOR OTHER MOTORS AMPS HEAT Motors 0-1 H.P. VOLTAGE PH NO. OVER 1 H.P. PHS UNDER600V OVER600V Transformers NO. KVA NO. KVA No.Neon_Transf. Ea._Sign Miscellaneous 5L�/IM 800 Seminole Road• Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845 • http://www.cLatlantic-beach.fl.us ' 1 .a� CITY OF ATLANTIC BEACH J Sty 800 SEMINOLE ROAD j ATLANTIC BEACH,FL 32233 �r INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00029233 Date 11/03/04 Property Address . . . . . . 364 W 3RD ST Tenant nbr, name . . . . . . REPLACE MAIN PANEL Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ---------------- -------- ------------------------ HARMER, DAVID BILL THOMPSON ELECTRIC CO, INC 364 WEST 3RD STREET P .O. BOX 330150 ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 249-2810 (904) 249-5601 ------- ----------------- ------------------------- --------------------------- Permit ELECTRICAL PERMIT Additional desc . . 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 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 14,k BUILDING OFFICIAL . id. , CITY OF ATLANTIC BEACH ELECTRICAL PERMIT APPLICATION L.. Date: /� d Property Address: 70/ c/ /Z//' Owner: lef,11,l2— gle�_ Pxl— Telephone#: Zf/'0k/� Contractor: BILL UOMPSON BMW Telephone Contractor Address: F. G. BOX 330130 Fax ATLANTIC BECHO ft SIUMM 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. Building: Building Type: ❑ Trailer I Service: If other construction is ❑ New ,[_Residence ❑ Temp. ❑ New being done on this building Old ❑ Commercial ❑ Signs ❑ Increase Pr�'IIumb�building ❑ Re-wire ❑ Addition Sq. Ft. ,35L_ Repair Conductor Size: AMPS: COPPER El ALUMINUM El Switch or RACE Breaker AMPS PH W VOLT WAY Existing Service ?�f RACE Size AMPS 0&rP PH W VOLT /Z-0 WAY Feeders: NO. SIZE NO SlZL- NO SIZE Lighting Outlets I CONCEALED _ ! OPEN i Receptacles CONCEALED j OPEN I i Q 10 AMPS I I 100 AMPSI Switches Incandescent Fluorescent & M.V. Fixed 0.100 AMPS OVER BELL -A liances TRANSFER. Air H.P.RATING H.P.RATING CEILING KW-HEAT Conditioning COMP.MOTOR OTHER MOTORS AMPS HEAT Motors 0-1 H.P. VOLTAGE PH NO. OVER 1 H.P. PHS LJNDER600V OVER600V Transformers NO. KVA NO. KVA No.Neon_Transf. Ea Si Miscellaneous 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Phone:(904)247-5800• Fax: (904)247-5845 • http:Uwww.ciatlantic- each. us Tropical Enclosures Inc 2479241 p- 1 S MIN. RETURN �/�-�� Vcp 2004032151 PHONE# ��l � �8 Pa e: 11608 Pa e: 2489 NOTICE OF COMMENCEMENT Filo�30R200rde11:39;50 AM JIM FULLER 0 bj State of Tax Folio NobL� CIRCUIT � CU T COURT 00 County of 5.00 RECORDING . S N TRUST FUND $ 1.00 To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,'and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMr�rENCEMENT. 0 Legal description of property being improved:�r Address of property being improved: � \ J Y General description of improvements: 0 0 Own er: Address:-, Owner's interest in site of the improvement:__ Fee Simple Titleholder(if other than owner): Name: Address: Con tractor. v Address: Phone No: Fax No: Surety(if any): Address: l Amount of Bond$ Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents maybe served: Nam e: Address: Phone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in _ Section 711 (2)(b),Florida Statues. (Fil in at wner's option). Name: Address: Phone No-. Fax No: Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY O R / '` Signed: GC/�iiDate: !" QT Before me this ZZ day of in the County mf5uval. State of Florida, has personally appeared Notary blic at Large,State oflerida, v "„""� My commission expires: Personally Known: e = _ ExmsW7120oe = or Produced Identification: = sona.amn,(800)4324254: ;_. s............................................i • j Imo•'-L`Ir� CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD r� ATLANTIC BEACH, FLORIDA 32233 ~ INSPECTION PHONE LINE 247-5826 Dill" ' Application Number . . . . . 04-00027546 Date 1/21/04 Property Address . . . . . . 364 W 3RD ST Tenant nbr, name . . . . . . GAF TIMBERLINE D3161 Application description . . . ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 5250 Owner Contractor ------------------------ ------------------------ HARMER, DEBRA MONAHAN ROOFING 2050 KING CR S ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 249-2810 (904) 242-8246 --------------------------------------- ------- - ----------------------------- Permit ROOF PERMIT Additional desc . . Permit Fee . . . . 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 5250 ---------------------------------------------------------------------------- Special Notes and Comments MUST CALL IN FOR A SHEATHING INSPECTION! Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 90 . 00 90 . 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 Cc: CITY OF ATLANTIC BEACH . Ford BUILDING / ZONING DEPARTMENT L. Hi ins ;s4 S. Doerr 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 -r: �C (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # Jit - c { (P Property Address: G Applicant: In Project: Rt -0 Uri This permit application has been: Approved - �� El Reviewed and the following items need attention: �—J a; V G GL CIF ®cx aZ— 'a a.-^ Please re-submit your application when these items have been completed. Reviewed By: L—k Date: l 6)G1 D - FRECEIVED ATLANTIC BEACH iNG & ZONING 2 0 2004 r r BY: : E City of Atlantic Beach 800 Seminole Road•Atlantic Beach,Florida 32233- Phone:(904)247-5800•FAX(904)247-5805 •http://www/ci.atlantic-beach.fl.us PERMIT APPLICATION FOR ROOFING ci JOB LOCATION 9 W -� OWNER OF PROPERTY DO b bi C h 0-r r-\c- � PHONE# 2 `1 `► - 2 i O CONTRACTOR CONTRACTOR ADDRESS 2-,c:,5 C l< c 2 'L o Ck < c ZIP -3 _�z. G, C. CONTRACTORS LICENSE NO. R C (�G`'l -7Lt C� PHONE# 2 4 2-- Z`� i SCOPE OF WORK c- rc c-P%- L'r%V4, { DECK SLOPE Li Z GREATER THAN 2 : 12 LESS THAN 2 : 12 ACTUAL VALUATION OF WORK $ E> ? b G PRODUCT NAME&MATERIAL TO BE USED &-R.F '7T, m be r k,,r\ -4- ASTM DESIGNATION(S) 0-3 REQUIRED INSPECTIONS SHEATHING FINAL LIBILITY INSURANCE POLICY SUPPLIED YES NO WORKERS COMP.POLICY SUPPLIED YES NO CONTRACTOR LICENSE SUPPLIED YES NO OCCUPATIONAL LICENSE SUPPLIED YES NO SIGNATURE OF OWNS IC SIGNATURE OF CONTRACTOR SWORN TO& SUBSCRIBED EFORE ME THIS � C, DAY OF 200 JlJ'* "v.4 an Thomas L Monah AS TO OWNER * My Commission"':TOTARY PUBLIC �,N, Expires February 02,20 DAVID PEACOCK AS TO CONTRACTOR NOTARY PUBLIC G2'z�L �'� -� 'c,State of Florida My comm. exp. Aug. 18, 2006 Comm. No. DD 143129 R g _ �c — `�el2 ', Rook 11589 Page 1445 5 Wilui. j � NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State of County of To whom it may concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated In this NOTICE OF COMMENCEMENT. Legal description of property being improved: 3�� J�� 6 -2 L C. c t- 1 G i-i ci Q Address of property being improved: (Cl,A i c. tic' General description of improvements: fz� e ; o hGH z -� F.F SSC I Owner 0o bb < tAc--- r-n-.e %r Address 3G.Lt We (- Owner's interest in site of the improvement i C)c, Fee Simple Titleholder (if other than owner) Name Address �e_ CC�s_.ed h-r Contractor c a r ex, c:: L, Address L U S' o ic: c� C (Z Y.S�.P Ccti,1 ¢C3_ VN Phone No. `-t - 8 Z c't Fax No. `-t Z rs Li Q� Surety(if any) Ni I V)- Address Amount of bond $ Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name Address Phone No. Fax No. Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06 (2) (b), Florida Statutes. (Fill in at Owner's option). Name Address Phone No. Fax No. Expiration date of Notice of Commencement(the expiration date is one (1) year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER / Signed:' g,"1,i,-le'7'/ , 'y Date: Thomas L monahan Before me this day of -j c^ d`1 in the Omission CC901385 picas Fe►xuary 02,2004 County of Duval, State of Florida, has personally appeared rd Eit pq p_ 196?$ otary Public at Large, State of lorida, County of Duval BooY,: �l � My commission expires: pa e: IL 0,45 Personally Known or Filed & Recorded 01;35:01 Ph 01/20/2004 Produced Identification JIh FULLER CLERK CIRCUIT COURT DUVAL COUNTY $ 5.401 RECORDING TRUST FUND C '^7 OF ATLAZIT I C BEACE 'P=E hI T ..CA LCUL.a T ION• SEEET -.Address 3 C:, 12P E2.ate 2-1 'i'O Heated Square Pa.orage @ $ ne_ sc Garage/shed � $ cer .sa .ft = -5 Deck a C S mer* sq ft = fi -• Patia �a M ner : sa ft = S TOTAL VA.LURT.ION : 5 SZ►5� 3 s $ 36 -Total Valuation Lst 5 l�►.o �- S :Remaining Value $„S per thousand :..or. ;partian; :thereof -TOTAL BU` 1itrNG' FEE $ o . . +..1/2 Filing', Fee ..- .. F.ir.epla.ces . @ ..$15..Ga. $. . `.: BUILDING. PERMIT FEE WATER IMPACT FEE .$ S . •SEWEF� :IMPt1CT'.: FEE . • 'j;WP,;TER' METER/TRP .. $ . CAPITAL .IMPROVEMENT, '$ ..SEWER .TAP: $ ( ) RADON (HRS) .GQ5Q S. SECTION H PAVING ( ) S HY73RAUL.IC .SI�. RES S CROSS CONNECTION, $ (' ) �SURC:L�RGE .Cosa. $ •,GR81`TIS .TOTAL D UE .$ . •ADDITIONRL PERMITS OR '.FEES :.,Mecliani..cal ing ElectriC/Neer Electric/Temp ;Swimm__gPaal Septic Tan!t ; Well Siga Finis FL=7 Elevati on SurveyOther• CALCULATIONS azd/o r NOTES CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD j ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 03-00027441 Date 12/29/03 Property Address . . . . . . 364 W 3RD ST Tenant nbr, name . . . . . . RAISE SLAB & EXTEND OUT Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2910 Owner Contractor ------------------------ -------------- -- -------- HARMER, DAVID OWNER 364 W 3RD ST ATLANTIC BEACH FL 32233 (904) 249-2810 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 45 . 00 Plan Check Fee 22 . 50 Issue Date . . . . Valuation . . . . 2910 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 City of Atlantic Beach CUSTOMER RECEIPT *** Oper: DSMITH Type: OC Drawer: 1 Date: 12/29/83 61 Receipt no: 22226 Description Quantity Amount 27441 BP BUILDIN6 PERMITS 1.00 $67.58 Tender detail CK CHECKS 2456 $67.50 Total tendered $67.50 Total payment $67.50 Trans date: 12/29/03 Time: 16:24:54 M THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED t OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN 'E FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. BUILDING OFFICIAL CITY OF ATLANTIC BEACH . Ford BUILDING / ZONING DEPARTMENT S SJ 800 Seminole Road Doerr s� Atlantic Beach,Florida 32233 :s (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # C .3 - ,---,2 'T X14/ Property Address: �(r q !1', '—J ,Sf Applicant: (A tla1-ty 6, Project: rCar E / ,h (r '�'l } EX � 'r� �l ;�2 This permit application has been: Ga Approved Reviewed and the following items need attention: Please re-submit you appl7 :7=-Date: n have been completed. Reviewed By: ,/Z ',7.b '"� 1 t 9CITY OF ATLANTIC BEACH FE BUILDING PERMIT APPLICATION (ALTERATIONS/ADDITIONS) Date: 18 -De.o- 03 Job A dress: 75 ,- 3 rJ S�r c,.t + I anj-i E) c J) FL- 3 z2 3 3 Owner Piyrt ctv i c� �rct �c�t-me r Address: l� . 3�� S F t -'l xG� FL 3 Z Z 33 Telephone: C 2-4 - 2-9 JC Legal Description: Block Number: 1 O 1 Lot Number: I d- Z Zoning District: Contractor: bcLu d 14 car r,,,-e r State License Number: — Contractor's Address: SG 4 Q - 3`-d S-t- S} I c,-,-Lc 3eu c-" F f- 3 Z-z 3 3 Telephone: C10,4 2g9 -2-is10 Fax: 90q - 2-Lt-7 L+0"7q- Describe proposed use and work to be done: t-ct i ,e- S 1 c, C� - +�c�i e s 'l nu �k+e"�c� 'n u 1,Jr- Present use of land or building(s): COye recd pon ch Valuation of proposed construction: Z c /0 ,0c What are the dimensions of the added space: 2.4- feet x I(o feet Will the added area be heated and cooled? n/u New electrical or increase in service? /✓0 Add plumbing fixtures? n/d Add fireplace? A10 Add heating/air conditioning? / 10 Is approval of Homeowner's Association or other private entity required? /yo 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? [�KNO. 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 Telephone: (904)247-5800 •Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.us Page 1 Revised 1/14/03 w 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 info tion provided with t is application is correct. Signature of owner: Date: 3 eG 61,3 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 an rrect and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: G Date: 01� G Address and-contact information of person to receive all correspondence regarding this application (please print). Name: �QUtd �`E0.rme� Mailing Address: 3 Co q U3 _ 3 r d St (a ct.,.no-c Telephone: 9Cby - Z4ct-Z k1 Fax: Qo4 - Z.t-L-i-40-74 E-Mail: 4o-r-m 1ci5-1 @ Pe.tlso,' k.ne i- AS TO OWNER: Sworn to and subscribed before me this day of �- 20 �. State of Florida, County of Duval Notary's Signatur . JENNIFER SCHLUETER ' = MY COMMISSION#DO 121301 . EXPIRES:May 27,2006 ❑ Personally known BaxWThruNoaryPublic Underwriters D"Produced identification Type of identification produced ��-' Yi✓ n loStP��'� � Lf AS TO CONTRACTOR: � , Sworn to and subscribed before me this day of e G 2005. State of Florida, County of Duval Notary's Signature: JENNIFER SCHLUEfER '' Y n MY COMMISSION#DD 121301 ❑ Personally known Produced identification F�PIRES:May 2 ,2006 > BwdedThruN013, 1i�Undarwriters Type of identification produced s� 800 Seminole Road • Atlantic Beach, Florida 32233-5445 Telephone: (904)247-5800 • Fax: (904)247-5845 • http://www.Ci.atiaDtic-beach.fl.us Page 2 Revised 1/14/03 w. 1 r J �r CITY OF ATLANTIC BEACH OWNER/BUILDER AFFIDAVIT Date: I `l Dec. O 3 Job Address: CHAPTER 489,FLORIDA STATUTES,PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER 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 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 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 THE OWNER,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 REQUIREMENTS 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 I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISS CE OF AN OWNER-BUILDER PERMIT. 0.0 t cz� O �e.�J rte- 0.r n'1 E.r PROPERTY OWNER/BUILDER � SW THI3 l , M•'E" JENNIFER SCHLUEER DAY OF 2 �� ; MY COMMISSION#00121301 y' EXPIRES:May 27,2005 • Bon W lb,Notary " \ Pwwc u xlernr tarn Vc L I EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. ct N � . x c � T r _ s d i N 37 o s CL I s ct I i ` ►1 -o c� Q ' vi { j x C I 09 LU ! W , 6r > _ 60 i► FLOOD CERTIFICATE: ACCORDING TO THE F.I.A.OFM-A. FLOOD HAZARD BOUNDARY MAP,THE SUBJECT PROPERTY 19 SHOWN NOT TO BE IN A FLOOD HAZARD ZONE. S TREE T FD/a /oz. 0 . ♦ 9 °' 347" 1 '3 o. h QJ'.ti .6 V ♦ ♦ R 1. 9, 9. ZG.6 � � q• ti B./' 4s. a' O OwEL L i t/G o O ,.EAVES Alp 35G Q O /77' Zao o Al >c Ci y,,f/O' 31. 7' � Q. City of Atlantic Beach Planning and Zoning Department 7_V This a P Pf"approval verifies compliance with a ate Q zoning, subdivision and other ioca< id l`wJ _A_ development regulations, but does not co! ate r�.t�1C. approval for the issuance of permits. Compo ce with E{orida Building Code and all 16ther appiic ble V Q. �^c'>• local.::S!ate and Federal permitting requir4?n nts must be verified by signature of the City ofQ11 tic e 4� /► Beacl B�.ilding:Off prior to the issuanU f a v l( U// Building i'ermit� Appri-vec By: A _ C:omrrm, lity Deve:opment :i Date' oe .. /02_ O. V ` 0 T 3 O B Z o C .r /0/ ' r F/NAL SUR✓E S/ Z•20-84 . " ;, r41G RawS. TMS SURVEY COMP .IES WITH THE NUNNIUY THE FLORIDA WARD(W L AD SURVEYORS,PURSUANT TO tEt:TION 472.027. I HEREBY CERTI FY THAT THE ABOVE GA w u 3 ,'x , a u , >�ci I3Y LEGEND: OH/EL G/N�'r .. �a ntc ; wrorr ME AND THAT THE Ott +:_,. IS LOCATED UPON SAME AS SHOWN AND THAT THERE ARE CITY OF ATLANTIC BEACH �. Ford) BUILDING / ZONING DEPARTMENT �S-eosins r J 800 Seminole Road . Do J � Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # C ,�> Property Address: Ltd 3rd Applicant: ��. V 146,/ rn F r- Project: This permit application has been: Approved Reviewed and the following items need attention: Please re-submit your application when these items have been completed. A / Reviewed By: L_, Date: CITY OF ATLANTIC BEACH E,GP�, ILDING PERMIT APPLICATION C. OO�NG 200` (ALTER.ATIONS/ADDITIONS) e 2 2 Date: 18 �e-C C-3 ,*P Job dress: .-tom. 3 r� �r Owner Pow5r. au i ca b�c� c� me r Address: 1 'C� 1-e"k L 3Z2- 33 Telephone: q 4 2y+q - Z-91D Legal Description: Block Number: 1 0 1 Lot Number: Id Z Zoning District: Contractor: !7. Cc V,d a r r— State License Number: Contractor's Address: 4 CQ 3`_`j S+- P+ Ic,,--,4�c keuc_" FL 3zz33 Telephone: Rb(4 21lq -2810 Fax: 90q - 2-17 - `+y"7`1- Describe proposed use and work to be done: r-Ci i s CL, S I C_13 G -3 C c-I')e s 'Lri i e_k+eod o Ld- Present use of land or building(s): CCVe (-CJ PC)r c h Valuation of proposed construction: � Z What are the dimensions of the added space: 24_ feet x I CL feet Will the added area be heated and cooled? /10 New electrical or increase in service? /Ae C Add plumbing fixtures? n/6 Add fireplace? A/0 Add heating/air conditioning? zoo Is approval of Homeowner's Association or other private entity required? ^-'o If yes,please submit with this application. Willproject involve changes in elevation,site grade or any use of fill material or the removal of any trees? this 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. 9NO. 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 1 Revised 1/14/03 i 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 info tion provided with 's application is correct. Signature of owner: Date: 0. 1913 �ec 0,3 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 an rrect and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: �----= Date: C W Address and contact information of person to receive all correspondence regarding this application(please print). Name: L cap;t d 14Cr,r rYT-e r— Mailing Address: 3 Cs 4 tD . .3 r`1 St Y 1 c�n�t c 3e a c k t__ 3 Z Z 3 3 Telephone: c10y - Z4ct-Z k+a Fax: Qo q - 2 q-1-'-f 0_7q E-Mail: }OL r m I G 5 7 @ Bei l so`�-�-k,ne t AS TO OWNER: Sworn to and subscribed before me this 3A day of "� ,20 State of Florida,County of Duval Notary's Signatur ,. EE� _:ENNIFERLLUEUTEMMISS01 Personal) known XPIRES ❑ Yd Thru Noters [ Produced identification L J` Type of identification produced t �- 1)Ll n t0 Lf AS TO CONTRACTOR: Sworn to and subscribed before me this day of DC C- ,206 . State of Florida,County of Duval Notary's Signature: i ffm NNIFER DO 128301 ❑ Personally known U_" '44-5127 2006 Produced identification rwr,ters Type of identification produced S licUnde 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 1/14103 ss1 CITY OF ATLANTIC BEACH OWNER/BUILDER AFFIDAVIT Date: 1c- 3 Job Address: ✓�'I 1� . 3�`� 1 13c f L 3 Z z 3 3 CHAPTER 489,FLORIDA STATUTES,PART I "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER 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 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 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 THE OWNER,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 REQUIREMENTS 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 I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT 1 COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSCE OF AN OWNER-BUILDER PERMIT. 60, c� 0rcl 14ac'n-r PROPERTY OWNER/BUILDER S W THI83�3DAY OF j�— ,, JENNIFER SCHWETER MY COMMISSION q D0121301 ?a `` EXPIRES:May 27,2005 *C01M=1SVSI0NE)XGPIRES: NOTE: PHRASES UNDERLINED ABOVE. J s� 5 CITY OF ATLANTIC BEACH FLOOD PLAIN DEVELOPMENT INFORMATION Location: L,04- I + Z_ 31 oc-K 10 l Sec.---ion N Type of Development: Kc Si ae✓)-h0- Flood Zone: C Required Lowest Floor Elevation: If building is located within a flood hazard zone, a survey must be made AFTER THE SLAB HAS BEEN POURED, certifying that the LOWEST FLOOR ELEVATION is equal to or above the base flood elevation established for that zone. No final inspection will be made and no Certificate of Occupancy will be issued until the survey is on file with the Building Department. COMMENTS: Applicant Acknowledgement: I understand that the issuance of this permit is contingent upon the above information being correct and that the plans and supporting data have been or shall be provided as required. I agree to comply with all applicable provisions of Ordinance No. 25-7-11 and all other laws or ordinances affecting the proposed development. Applicant's Signature: Date: Department Use: Required lowest floor elevation: As built lowest floor elevation: Survey filed with Building Department: Building Department Representative Revised 1/17/03 or,'-- 5 MIN. RETURN Book 11538 Page 2250 PHO NE -�'O NOTICE OF COMMENCEMENT State of F 1 o r-r d c�- Tax Folio No. County of 0c.,a c,,-1 To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: Go I- I f Z 61ocK 101 Sec-4-1-bn H Address of property being improved: 3624 Q 3J`l General description of improvements: r-a kse-- `�kck-b and -8-44-eod o,a+ / o-+e r Owner: 4)cXy d 14 u c-mer— Address: 3Cc Lo . 3" 5-�- C- ac_k Fes- 3 z z 3-2> Owner's interest in site of the improvement: o me c>wVne c Fee Simple Titleholder(if other than owner): Name: Filed & Recorded Address: 12/1%1/2003 02:01:42 PH HN HtLER Contractor: owNCr CLERK CI:RC1111 C011RT Address: DOVAL COUNTY Phone No: Fax No: RECORDING f 5.00 Surety(if any): IRUSI FURY -V ' 00 Address: Amount of Bond S Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents maybe served: Name: Address: Phone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in -- Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option). Name: Address: Phone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY _ �f O NER ` /� d3 Signed: Date: Before m this 4�?2A day of in the Co'nty of Du al, State of Florida,has personally appeared aV t JEANETTE M.DEAN " Notary Public at Large, State of FloridaX of Duval. ;.: .: MY COMMISSION#OD 082018 EXPlRES:Janua 23,2006 My commission expires: of Bonded ThruNotary Public Undenvriters Personally Known: or Produced Identification: �L CY Tropical Enclosures Inc 2479241 p. l 5. AKIN. RETURN �/T-�Q� - �� ,,4.200,032151 ookPHONE# 24/ 2�� Page: 11608 y Page: 2489 NOTICE OF COMMENCEMENT Filed 01/36R2004de11:39:50 AM JIM FULLER State of Tax Folio NobL��C�FUIT COURT m County of •? — RECORDIAG . f 5.00 N TRUST FUND f 1.00 To Whom It May Concern: Cn C The undersigned hereby informs you that improvements will be made to certain real proper y, and in accordance a with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. O Legal description of property being improved: ZI� `4 Address of property being improved: General description of improvements: Ant-Y— 51-495 0 0 Owner: / _ Address: , �, i, 7 Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): M Name: �J Address: Contractor: (� Address: Phone No: Fax No. Surety(if any): Address: T Amount of Bond S Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents may served: Nam e: Address: Phone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.13 (2xb),Florida Statues. (Fil in a wner's option). Nam e: Address: Phone No: Fax No: Expiration date of Notice of Commencement (the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY ll OW R / ` • Signed: /��.1°.�},�.`� �'T Before me this ZZ day of cjiRh-> in the County lef5uval. State of Florida,has personally appeared Notary blit at Large,State of f-la•ida; ? vaf•• My commission expires: Personally Known: c = rxcimssrtr2ooe i or Produced Identification:_@g,= iN gc,4w rwu(WO)43(WO)432-4264:.32'(WO)432-4264:.Florida n ...i 's............ ..... ......... CITY OF At4wAe Feael - i��Cvctda 716 OCEAN BOULEVARD -- ------- ----- P.O.BOX 25 ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-2395 May 20, 19ESB Mrs. Cynthia Gibson P. O. Box 702 Atlantic Beach, Florida 32233 RE: 651 WEST THIRD STREET Dear Mrs. Gibson, In order that we may serve you better we have found it necessary to change your house address. Your new address is: 364 WEST THIRD STREET ATLANT.LC BEACH, FLUI?lDA 32233 Please see that the new numbers are installed on the front of the house and on the electrical meter can. By copy of this letter we are notifying the Atlantic Beach Fire Department, Atlantic Beach Utility Billing Department and the Jacksonville Electric Authority. We apologize for any inconvenience this may cause you. If you have any questions please feel free to call. Sincerely, Rene' An r Community Developm Coordinator cc: ABFD, AB Utilities, JEA Pre-service Commissioner W. I. Gulliford, Jr. City Manager, Fellows City Clerk, Tucker Dorothy Kerber ZZ� CITY OF tfct�stcc t�,eac�i - ��o7c:da 716 OCEAN BOULEVARD P.O.BOX 26 -- -- ATLANTIC BEACH,FLORIDA 32233 TELEPHONE(904)249-3'i95 February 28 , 1984 Pre-Service Section 3rd Floor Jacksonville Electric Authority 233 West Duval Street Jacksonville , Florida 32202 Dear Sirs : Please be advised that Mrs . Cynthia Gibson has requested that her address be changed at her new house. The address presently is - 356 Camelia Street , Atlantic Beach. i The new address will be 651 West Third Street ,Atlantic Beach. I will instruct the owner to make the necessary change on the house and the meter . Si ncrely, Rene' Angers Building & Zonin epartment t J CF a tJJ �J 1 CITY OF ATLANTIC BEACH IS f 800 SEMINOLE ROAD r ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 -dF319 Application Number . . . . . 09-00001281 Date 9/11/09 Property Address . . . . . . 364 W 3RD ST Application type description MECHANICAL HVAC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------------------------------------------------------------------- Application desc 1 wood fireplace ------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- SETZERS & COMPANY ALAN SETZER 7660 PHILLIPS HIGHWAY JACKSONVILLE FL 32241 (904) 731-4100 --------------------------------------------------------------- Permit MECHANICAL GAS PIPE PERMIT Additional desc Permit Fee 60 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/10/10 ------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- -------- Permit Fee Total 60 . 00 60 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 60 . 00 60 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 08` 7 �_� '�•` 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 J OFFICE.(904)247-5826•FAX NO.-..(904)247-5845 BUILDING-DEPT@COAB.US MECHANICAL PERMIT APPLICATION' DUVAL COUNTY 1,JOB ADDRESS: 12.IS THIS A SUB PERMIT: 3.DATE: v r ,� ID4lo I <s4 ❑YES PERMIT#: 19 -9-9 PROPERTY OWNER: 4.NAME 5 ADDRESS IF DIFFERENT FROM JOB ADDRESS- 6 PHONE.W y CCAS -Lt c;6 -f - Y 7 MECHANICAL CONTRACTOR: 7.NAME OF COMPANY �_ 8 ADDRESS SRtz Q1Uj LQ t� Ph,, t a5 'T_ 9 STATE OF FLORIDA LICENSE'N0. 10 CEcPHONE., 11.FAX NO, 12.EMAIL ADDRESS. OG V 13.OFFICE I}'PHONE 14. J Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months,or if construction or work is suspended or abandoned for a period of six(6)months at any time after work is commenced. CONTRACTORS SIGNATURE: 15.CLASS OF WORK: 16.BUILDING: 17.SE E: 18.CURRENT CODE: ❑NEW INSTALLATION ❑NEW SIDENTIAL ❑'06 FLORIDA BUILDING CODE- r f<EPLACEMENT OF EXISTING SYSTEM 4-l?<STING ❑COMMERCIAL MECHANICAL ❑ALTERATION/ADDITION TO EXIST SYSTEM ❑REPAIR ❑OTHER MECHANICAL EQUIPMENT TO BE INSTALLED: 19. HEAT: ❑ SPACE ❑ RECESSED ❑ CENTRAL ❑ FLOOR BURNERS: 20.AIR CONDITIONING: ❑ ROOM ❑ CENTRAL 21. DUCT SYSTEM: MATERIAL: THICKNESS: MAX CAPACITY: Cfm 22. REFRIGERATION: MAX CAPACITY: Cfm 23. COOLING TOWER: CAPACITY: gpm 24. FIRE SPRINKLER: NUMBER OF HEADS: 25. LIFT SYSTEM: ELEVATOR: MANLIFT: ESCALATOR: AUTOLIFT: 26. COMMERCIAL HOOD NUMBER: 27. FIREPLACE: PREFABRICATED: MASONRY: 28. IRRIGATION: ❑ PUMP ❑WELL ❑ PIPING 29. GAS PIPING: #OF OUTLETS: Cl GAS AHU: ❑GAS WATER HEATER: 30.OTHER-SPECIFY: SOLAR HEATING, BOILERS,UNFIRED PRESSURE VESSEL,HEAT EXCHANGER OR COIL M DUCTS ETC VALUE FOR OTHER ITEMS 31.COOLING EQUIPMENT: AIR CONDITIONING REFRIGERATION EQUIPMENT,CONDENSORS ETC. NUMBER APPROVING OF UNITS DESCRIPTION MODEL# MANUFACTURER TONS AGENCY CI �. 32.HEATING EQUIPMENT: FURNA E B ILERS,FIRELACES.AIR HANDLERS ETC. NUMULK APPROVING OF UNITS DESCRIPTION MODEL# MANUFACTURER BTU AGENCY 33.TANKS: TYPE LIQUID APPROVING NUMBER GALLONS CONTAINED MANUFACTURER SERIAL# AGENCY COAB FORM BLDG04:REVISED:1/102008 S, CITY OF ATLANTIC BEACH •� J 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00027505 Date 1/15/04 Property Address . . . . . . 364 W 3RD ST Tenant nbr, name . . . . . . NEW POOL Application description . . . POOL Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 33000 Owner Contractor - ------------------------ ----------------------- HARMER, DEBRA CLIFT & CO POOLS & SPAS P.O. BOX 702 9340 ARLINGTON EXPRESSWAY ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225 (904) 249-2810 (904) 855-0019 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc Permit Fee 195 . 00 Plan Check Fee 97 . 50 Issue Date . . . . Valuation . . . . 33000 Fee summary Charged Paid Credited Due ----------------- ---------- ---- ------ ---------- --------- Permit Fee Total 195 . 00 195 . 00 . 00 . 00 Plan Check Total 97 . 50 97 . 50 . 00 . 00 Grand Total 292 . 50 292 . 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 Cc: CITY OF ATLANTIC BEACH .F- BUILDING / ZONING DEPARTMENT s. oeR s 800 Seminole Road Atlantic Beach,Florida 32233 J (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # L,� • Z -`� S Property Address: -4 L.�) ==' �4 Applicant: -i Project: 11C U- e-,Z-, This permit application has been: roved Reviewed and the following items need attention: Please re-submit you ppli n when these items have been completed. Reviewed By: G�(/1�- Date: Mar 24 03 02: 31p Building Department 247-5845 p. 1 =� CITY OF ATLANTIC BEACH POOL PERMIT APPiICATION Date: Job Address: 3t j+ IA Z,-d Si- &e1,1 F— Owner of Property: �2•b.r� rJG,,-r-C-f _ Telephone: �4 9 -a�� b Pool Contractor: Contractor's Address: qzy l7 >A lr)s-fo rl . Telephone: q)kS-�--U01 9 Fax: C ��4, ' 0 40 9 9 State License Number: Valuation of proposed construction: ��v'�C7 Gallons: 01 SITE PLAN FTRECEIVED front OF ATI�gNTIC BEACH BU!LDING &ZONING JAN 12 2004 I. I LBY: rear Signature of Owner: Signature of Contractor: 800 Seminole Road - Atlantic Reach,Florida 32233-5445 Phonc: (904)247-5800- Fax. (904)247-5845 - http://www.ei.atlantic-beach.tl." Revised 1/14/03 cc.. X CITY OF ATLANTIC BEACH BUILDING / ZONING DEPARTMENT s o S 800 Seminole Road J � Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # { - 7 5C S Property Address: �)Lr M �,J . -3rd -S4 Applicant: C"-(, 07-f- rt on ?O61S Project: a(;�n This permit application has been: Approved Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: Date: V\yb Mar 24 03 02: 31p Building Department 247-5845 p. 1 .� hl r l CITY OF ATLANTIC BEACH _67, 9" POOL PERMIT APPLICATION Date: Z l a .-©3 Job Address: 3(01-f IA r-d Sv. 4+1a,+-c &ch, F-L- J2-Z33 Owner of Property: ��.(�� G� �M _Telephone: J-4 q -a t?1 b -c + Co ri1 . CI: + - CI; �-� Pool Contractor: � Contractor's Address: Telephone: 90y)kS1 'U(�1 9 Fax: � 0 � State License Number: __(�-p C% Valuation of proposed construction: 93100y'6)Gallons: SITE PLAN RECEIVED front CITY OF ATLANTIC BEACH BUILDING &ZONPNG JAN 12 2004 I BY: rear Signature of Owner: Signature of Contractor: $00 Seminole Road- Atlantic Reach,Florida 32233-5445 Phone: (9.04)247-5800- Fax: (904)247-5845- hitp://www.ei.stlantic-beach.fl.us Revised 1/14/03 nar c-r ua ue: o,tp bui ,loins ueparcment e41-bu45 p. 4 OWNER'S AUTHORIZATION FOR AGENT G /" - C� ;+ is hereby authorized to act on behalf of _-Debca , the owncr(s) of those lands described within the attached application, and as described in the attached deed or other such proof of ownership as may be Tcquired, in applying to the City of Atlantic Beach, Florida, for an application related to a Development Permit or other action pursuant to a: ❑ Zoning Variance ❑ Appeal ❑ Use-by-Exception © Fence or Pte]Permit �❑ Rezoning ❑ Sign Pcrmit ❑ plat or Replat ❑ Other BY: e Sigma of Owner Jkb o � r e,. -�ct t.r,e-,*" - Print Name Signature of Owner Print Name Telephone Number State of Florida county of Duval Signed sw rn before me on this 3. By By_ . rl y `()- Identification verified: Y v`` CaNd Oath sworn: _ Ycs No Si nature MY taw P`;Wa �BE ER D.CLIF7 -- #. CC g EXPIRES:March 14,2004 �s Bonded Thru Notary Public Underwriters .a+.tlr•Y K 6E 10 x155 5-77 MC65676 MAP SHOWING 90ZW iqR LOT-42 BLOCK _AOLAS SHOWNt0 P 17 _ 4r_L_4417-lc S,6_401 AS RECORDED IN PLAT BOOK /00 PAGE -•?'y or P..,hL..ic fR -oRDS :)F L)lu,.'P: FOR_C YW711114 G/8S0.41 POOL NOTES: ° - 1•kms tt_.. .� > SEE ATTAGN£D POOL PLAN FOR WATER DEPTH. > S££ ATTAGH£D POOL PLAN FOR DIMENSIONS TO ALL COVERED 5TFUI TURES. > S££ ATTACHED POOL PLAN ,4D FOR ANTI-ENTRAPMENT AND r S TREE r (so �.tv) $ARRI£R CODE GOMPUANGE. r`O/O /��• O f0 /P fo iP� /07' 0 q b ►� 44 1AN K ti 0 ,h 347' /79' QJ Z� 9' " rz � 4 .. y P O 9. L d./' 45' O N N 0 N Q Q eC3 IAIL _ Q DEC N v O r 2'3' POO L LF3' o � v a o 0 IL sfr/,o ■ /02 0 L O 7- 3 ti 0 .B [ O C K /0/ 2 2D 8/1 /NAL S,11RVE __ _ ----�— RTIFICATE: THIS SURVEY COWLIES WITH THE MINIMUMT FORTHtfB`Y THE FLORIDA A CTI D SURVEYORS,PURSUANT TO SEON 472027, ------------- LEGEND: I HEREBY CERTI FY THAT THE ABOVE L14AIIr WAb f.URVEYEp BY M E A N D T H A T TNS —. *Q.RUN CORawa IS LOCATED UPON SAME AS SHOWN AND THAT THERE ARE NO E"ROA.0 hT0 SAID CLARSON AND ASSOCIAT °a'`"' v*AIiE 1843 NALDO A JJuCf(isI _LIE. I` SIGNED �A^iyARY 2 y, 19 B3 SCALE: ~- Z�' __ STERED SURVEYOR- ^"I1 K&E 1$0193 S-77 MCUM$ VAMP } v e . MAP SHOW► NG 901/NDiWi41 LOT142 BLOCK _ OLAS SHOWN, O P r• AS RECORDED IN PLAT BOOK 78_—PAGE -3V Or P�-'SL.IC H£C'ORDS OF C:i!.!'r '�0., rL'4A, FOR_C YN7.4114 G'/BSO,V POOL NOTCS: '01 -1 > S££ ATTACHED POOL PLAN '{ FOR WATER DEPTH. > S££ ATTACHED POOL PLAN FOR DIM£NS10NS TO ALL COV£R£D 5TFJ16TIJF.£S. > S££ ATTACHED POOL PLANR7 FOR ANTI-£NTF-APM£NT AND 3 S-REE r ASO P,fv� 6AF•W£F• CODE COMPLIANCE. c.7� v.3 - /07' 0: fit N • J�'.• �� tAKK I 0 ° 347' /7 9' ;'�s''.-4 e. 'S\ v Q Z�9' zG.G //.D' r,z• � 4 `� 0 d 0 �6• /Sro.QY F.P,�lME � g. Nj o O „E.4,v—C M °' l�� a /77, O °e 10.31 31. 7' Mr, •v a Q \ Q DEC K � ana 20"le ;local of Aftntic aM � applicable POO L lana rapulalloos. btR Not constitute far to iquanca of Compliance Fbrlda aladldfrp Coda and odw appftble -- $00 ekl Fadwal 44uirements V~be rCity of Atlantic am"P a )of a -4- wad AM OkA.4 m \, N26 ao yam• v /a2 O' QQ SOT 3 0 J L 0 C K /O/ Z•20.84 _„.__ ._ -,.v*,�rE.: �c�L'.aJL: ALL`�'.Pl�n/S. F/NAL SUMP✓E —"--- RTIFICATE: THIS SURVEY COWLIES WITH THE MINIMUM T ..WW T-F0ATi+Q3Y THE FLORIDA BOARDD SURVEYORS,PURSUANT TO SECTION 472027. LEGEND: HEREBY CERTIFY THAT THE ABOVE '� WA,&UR rEY Eo BY Y'NE _4H/EL G/.VG t Z ME AND THAT _ _— — - - - - t IhSiR0N CORMal% IS LOCATED UPON SAME AS SHOWN AND THAT THERE ARE NO EV&ROAe%*hT*,A , SAID SAND CLARSON AND ASSOCIAT §woa:%lw 5.awr6 11"3 NALOO A lAcr1aowwl SIGNED 14v11A1qY 24, I g e3IN SCALE. / 20 _ STEREO SURVEYOR, � � y $s +n myj�� gn� 9 m m rn � e 30> . _j_ p T Z p9 �O 04g a z� 23 02 p f , 0 w 4 N O< D N O = ��68o S S g r Gl N GI an N =A m m _ o m (. K 15 4 X Lu WIMP "d G H 9 r 0 0 3'-0' 5O r'w�+ o E� § a �" zea`° �qa, � �a 0Qq; day � q�F >3> ° 0"O '° 4R =S� J m n^ M r IS x a xz Z Z� 2t A 6�Ao 94{ra v v m K2 a ezdm. �ra1n �O u00 1 F oo me m�l" a 17 Z o Z , W00 . - . P MO gg RHOIVlit o HE" A05 xn[f ro n p `J tela' Fnro EO,'MW gwgO1qOa 3� ca],�q >.i �_m .Hpx.'otam000 a `� eaiv�� x z 04M! ttg, lz.5 Wim„ co" rma -� reg yg Nomioi ahpb a N Q S r 1 N E,�!' .a RIM;; 2 i O � ��"_F�� > � p>OR > a112025 � ig ,9"° t� [yggy (�y�[�+0tl`1(� Oyxa yy e�5' {T�{i�� o i g �O m ��,.p.�{(1 `K yxx +�y3v CLQ vy ZY� '�tn +'7.'~"U C1x S��CtO^p (�,ar" .��' y0 '►+ "'� o Ey'° Mx O G t'°O^y' wt x•� H td�� Rt ldR7o O vgi�v l " A. 0:1 0 � CREATING A LESS STRESSFUL LIFESTYLE ro ! .v1STANDARD RESIDENTIAL CLIFT POOL AND/OR SPA COMPANY DESIGN ti n M � 0 i r Z N (p i-o 0 I D Z wD`D fn m m w^ � w � V CI1 V O N D 1 r r Z mm T O A D 0 z D -r m� z .0--4 a z ' �'D 0K cnm_ z mz ^ z / 0 0 lzi r v V V V V vl -gym # Ioo T mm A y a m a C � Z N> A as a Z rtl N 14 ti Qi o mo m 2 ti � 70 m A °� (T O Z m W 0 'n 0 0 m N 3 v 0-0 m S cn H ca m rw0 D vI ZS 9e 3 m S O-4 TTI Z Z m w mD nm �r 3 N p p CREATING A LESS STRESSFUL LiFESME SHALLOW - DEEP - SHALLOW p D %CELI F�co TYPICAL STEEL LAYOUT FORj o SHELL WITH DEPTHxommA UNDER 7ft. o Hook 11583 Page 219 5 IMIN. RETURN PHONE �� ° �� NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio No. State of County of To whom it may concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes, the following information Is stated In this NOTICE OF COMMENCEMENT. /� Legal description of property being improved: Lo 4- I Z 11�_� C�- I l`� _,Sc,Gj-t o n 1-4 Address of property being improved: 3t, 4- Vim( �<c� ��- � f 10,%+ate �c 1-�, CZ 3 ZZ33 General description of improvements: -- Owner _DC`7 r c2, Address (,J . 3 "d Owner's interest in site of the irnprovernent Fee Simpie Titleholder(if other than owner) Name Address n ontractor r—c r c: N C ; f LI t-Ti- -d- Cc Address a 3 G Phone No �Ct ��5 S - y L' I �i Fax No. 0 C Surety(if any) Address Amount of bond $ Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name Address Phone No. Fax No. Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06 (2) (b), Florida Statutes. (Fill in at Owner's option). Name Address Phone No. Fax No. Expiration date of Notice of Commencement(the expiration date is one (1) year from the date of recording unless a different date is specified): I ora ar•AGE FOR RECORDER'S USE ONLY OWNER Signed: A �c 46 0' � Date: ,/�� D-J q O{� O0156$3 Before me this �day of 7` 127n the ooY.:X19 County of D al, State of Florida, has person ly appeared Gage: i? n Filed d Recorded Ol/15/2004 lZ:5b:58 GM 1Ih FULLER CLERK CIRCUIT COURT Notary Public at Large, State of Florida, County of Duval DUVRL COUNTY $ 5,00 RECORDING $ 1.00 My commission expires: _,•� y ---- TRUST FUND $ 1.00 P" Uuq or GOGY FEE Personally Known Ti, ��• �°=_ rvcorutrnlSS10rltrcc�r�n�33 o, EXPIR v arcn 14 7. Produced Identification ;ondedThruNOWYPuorcU°'' C � ii CITY OF ATLANTIC BEACH PERMIT BITING / ZONING DEPARTM[ENT APPLICATION "r 100 Seminole Road J " s'•:a- Atlantic Beach,Florida 32233 �— �` (904)247-5-000 (904)247-5845 Fax www.coab.us APPLICATION TRACKING FORM REQUIRED DEPT: ( Y N PLANNING Property Address: , ,�� . 5r - z Y N BUILDING Y N PUBLIC WORKS Appficante0 Y N PUBLIC UTILITIES xv Y N FIRE DEPT. Project: I Y N PUBLIC SAFETY w APPROVAL REQUIRED AGENCY: RECEIVED BY: INITIAL DA w� Y N D.E.P HUFSTETLER C3 Y N S.J.R.W.M_ CARPER _ Y N ARMY CORPS of ENG CAPPER o Y N HOTELS&RESAURANTS HUFSTETLER APPLICATION 9TAT4§!,-! _ CIRCLE ONE: SITE BUILDING A Ap ' REVI D BY: INITIAL: D TE: ® ® 1ST RFV fPLANNINGG ® ® �2ND ® 0 PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® 3RD REV ' 8ro a3a s-ea 4@nia fro au tr►Tpi4?111irvil dna Vlengrtment fBmee van have entered FIour comments into the AS400. PREPARED 1/25/08 , 10 : 53 : 30 PAYMENTS DUE RECEIPT CITY OF ATLANTIC BEACH PROGRAM BP820L ---------------- ------- --- -----------,--- ------- ---- -------- - -- - - ----------- APPLICATION -- ------- ---- -------- - -- - - ----------- APPLICATION NUMBER: 07-00001050 364 W 3RD ST FEE DESCRIPTION AMOUNT DUE ---------------- ---- --- - --------- ------ - - --- - - ---- ------ - - - --- - --- - --- -- - -- RE-INSPECTION FEE 35 . 00 TOTAL DUE 35 . 00 Please present this receipt to the cashier with full payment . f w D� �I i 3 � A 1 a Z 1 � I y r 4 3 . � a c o� { Y N 3 � a r O • o oo • • �0 D Q' I 7 8 v� r 00 c, N VI (� ° 4-1 tA n = o N M � l N 3 ' N - It O X f� C X ,l Lh u ` Q 1 ��M.. �1 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 .J1> INSPECTION EMAIL REQUEST: Building-dept&coaKus Application Number . . . . . 07-00001050 Date 1/08/08 Property Address . . . . . . 364 W 3RD ST Application type description SHED PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2500 -------------------- --- ------------ ------------ - ------- -------- ----- - ------- Application desc new shed ---------- ----------- --- - ----- - ------ - --- - ----- - - ----------- ---------------- Owner Contractor ----------- ----- ---- ---- -- ---- - ----------------- HARMER, DEBRA OWNER ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 249-2810 ----------- ---------------------------- ------ - ----- - -- -------------- - -- ----- Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 45 . 00 Plan Check Fee . 00 Issue Date . . . . 7/30/07 Valuation . . . . 2500 Expiration Date . . 1/26/08 --------------------------------------------------------- ------------------- Special Notes and Comments Must maintain five feet from side and rear property lines . *EMAIL INSPECTION REQUESTS TO : BUILDING-DEPT@COAB.US ----------- ---------------- -------------------- ----------------------------- Fee summary Charged Paid Credited Due -------------- - -- ----- ----- - --------- -------- - - ---------- Permit Fee Total 45 . 00 45 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 45 . 00 45 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION �s r S' J CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 Office: (904)247-5826 ■ Fax: (904)247-5845 I VM3 Permit Number: 0 �Da Job Address: W. �t , Legal Description i BY, �-- Valuation of Work(Replacement Cost) $ Z5-&6 ■ Class of Work(Circle one): � Addition Alteration Repair Move ■ Use of existing/proposed structures Circle one): Commercial Residential ■ If an existing structure, is a fire sprmler system installed?(Circle one Yes No ■ Is approval of homeowner's association or other private entity require ? (Circle one): es o Describe in detail the type of work to be performed: Ajar s/a/6 -�'ra-me� e1-2 Property Owner Information Name: LA VI D el Ef&,f q mF Address: ��'`� G(J• s� City State-;�/Zip 2�1.�.�3 Phone 9d -Z -Z8/ Contractor Information: Name of Company: Z -fie OG(JAlle t- Quali Agent:. 014 f-14em r� Address: City C'fl State Zip 30?—J3 Office Phone l- 3X �7- Job Site/Contact Number d V-Z ZZ"Id State Certification/Registration# Office Fax# Architect Name&Phone# Engineer's Name&Phone# Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commencedprior to the issuance o�f a ermit and that all work will be performedto meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void ework is not commenced within six(6) .months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, ,signs, Wells,Pools, Furnaces,Boilers,Heaters, Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. thereby certtf that I have read and examined this application and know the same to be true and correct. All provisions of 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 other federal, state or local luw regulating construction or the rf rman e o onstruction. I {� Signature of Property Owner: Signature of Contractor: Sworn to and subscribed before me Sworn to and subscribed be re me this'Zo Day of kAkA ,2oothis2c) Day of L NotaryPublic: Gj ",�•• "••••'••..... •• 'R1 tic: NIFER SIAt LVE� n/! r S•/vCrsn ;&,ry ,,= Comm#DD0689782 Expires 8/27/2011 REVISED 03.05.07 5)v,.--r!u,-e of= �' ,f FWI&No*y Am.,Inc into n..uuuu.....n.uwnuuonuuu.uu.i U»(y 3 Ro. S TRee T /oZ. 0 , fo i9.7' 1 Q Q 0 .h 347' TA o. �a Z, �y ct 9, L9 p 9' ti B./' 4.s' O 4/P 35l IV) /77' ?4.0' a p4 Q City of Atlantic Beach Planning and Zoning-' psrbmj7n v O This. approvat'.Verifile dtfmpNatlOe Mdlh / r t� 1_ zonng...subdlJision and other lo `) development regulations, but does nM appFovai for the issuance of permits. C with Fiorida Building Code and all other d V local, State and Federal permjtting regs must'be verified by siggnetgne of the Cityo )° Bach BL>ilding Officifii pri8r to issutBuilding Permit. � O Approvgdi By: O eve pool$ Date;' fV 5Fr4v Z O 7- C) L O C F/i1/AL SU.PI/E'Y___2_-_20.84__ __ .�4=.;� :: .•�r�G �.t�awS. RTiFICATE: THIS SURVEY COMPLIES WITH THE MINIMUM T - T'1FORTIkY TB I!E FLORIDA TV AR L D SURVEYORS,PURSUANT TO SECTION 472.027, CAti 1 HEREBY CERTIFY THAT THE AsovE _;0 FVseY F,1) 8 y I EGEND: ME AND THAT Tf+NE fsf4p bfS—fAoc cT REVS- ;,A!oNUMENT IS LOCATED UPON SAME AS SHOWN AND THAT THERE ARE NO E1*4I&R0A ri SAID_GAND CLARSON AW, ASSOCIAT ,/,4NdARr 2y 1843 NAL00 A". JACtrsow*gLLE, SIGNED -- -- — i 9 B3 -- t r✓/". SCALE: : ZD _- ._ STEREO 5.1.111VEKCR 3 — STREET �sa•R Ao coo <y 7 V.3• '. .. o , est 9• O N z� A SToAQY P4ti1E' /77' O - Q 0 tQ 4 - --- - �XID /oZ Q, COT 3 0 CERTIFICATE: THIS SURVEYCOMI'LlLS WJTI~I il'It� JNIMUM TJr ' T "� �` � F "iF fiT` ` " TI W F ORIDA 90ARf'�(FUND SURVEYORS,PURSUANT'1'4 CTtOA1472.OZ7, ° �.: . CAti, EGEND: I HEREBY CERTI FYTHAT THE AsovE. ... ;' Vz ,mo 8,r ME AND THAT THE 4H/ELGfNG 5x <., a IRETF MONUMENT IS LOCATED l?PpK SItMtX AS SH+Q'VIFM ANta 'fH;AT THERE ARE NO E"RO.A SAID GRNP +CLARSON ANo ASSOCIAT 1111 NALQO A JACMAONVIL4E, SiGNE-D -1,4MlJR.Ry 2S! r SCALE: 1 M STEREG SUP,UF_YG R- ,`, i P!J- CITY OF ATLANTIC BEACH PERMIT BUILDING / ZONING DEPARTMENT APPLICATION # 800 Seminole Road Atlantic Beach,Florida 322337(904)247-5800 (904)247-5845 Fax www.coab.us APPLICATION TRACKING FORM �p100 Ob T� �Property Address:: G 61=1B Applicant: �7"!f7'/It�� - 1'2 W Ali N BLIC UTI r,� ✓ Y FIRE DEPT. Project: �}7/ Y N PUBLIC SAFETY C/) APPROVAL LU U o REQLR<QAGENCY: RECEIVED BY: INITIAL: DATE: Z= N D.E.P HUFSTETLER 0-5 O N S.J.R.W.M. CARPER UJ _ Y N ARMY CORPS of ENG CARPER I- O Y N HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS CIRCLE ONE: SITE BUILDING DA AP REVIEWED BY: INITIAL: DATE: 1 ST REV PLANNING ® ® 2ND REV ING PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® ® 3RD REV Return this form to the Building Department once you have entered your comments into the AS400. I 1—I 'VP BUILDING PERMIT APPLICATION s CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 Office: (904)247-5826 • Fax: (904)247-5845 Job Address: (tel! r4 I Permit Number: Legal Description vve Valuation of Work(Replacement Cost) S ZSR Y ■ Class of Work(Circle one): Addition Alteration Repair Move ■ Use of existing/proposed structure Circle one): Commercial Residential ■ If an existing structure, is a fire spr er system installed?(Circle one): Yes No LA ■ Is approval of homeowner's association or other private entity required? (Circle one): es o Describe in detail the type of work to be performed: ,-ur s/ad f -Fran-�e Property Owner Information / Name: VI D /�c dl>' 4iP12W Address: -76 City StateZip 3_Phone 9d -Zy� Contractor Information: Name of Comp y: ,/Me owl?e r QualiA ent:. Address: .3C CityP 1State Zip 3Oz33 Office Phone Z- 3S 17_ Job Site/Contact Number 96 V-2�Z9 Z2'1d State CertificatWIRegistration# Office Fax# Architect Name &Phone# Engineer's Name&Phone# Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance o�fa permit and that all work will be erformed to meet the standards of all laws regulating construction in this jurisdiction. TFeis permit becomes null and void i.f work is not commenced within six(6) months, or construction or work as suspended or abandoned for a period of six (6) months at any time after work is commencedf I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells,Pools, Furnaces,Boilers,Heaters, Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. t hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of 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 other federal, state or local law regulating construction or the rf rman e of construction. I ..ti t Signature of Property Owner: Signature of Contractor: Sworn to and subs ribed before me Sworn to and subscribed be re me this 20 Day of l o this 2 C Day of ,S,i\:1 CaCC rl Notary Public: G-yr �� /.,MY YYYYkYYl1!!klYbkSlYk'rklY 'PL111lic: � NIFER SILV Al, '�Jc nn verS 'n Comm#DD0689782 Expires 6/27/2011 REVISED 03.05.07 o 9 �-NV Florida NotaryAsan.,Inc C 'rynnn, 17 nnunul uul.....YmuuuuYYnulluu.� 3 S TREE` 7" X29 X02 D In �6 ;dpi Cp r�p4� S�K�t rA 1 V. Z5�9' n. 4 r~ 39' Zlo.le' O p• 49 O 44 � v 55°bP Q ' /7.7' 317 i1 MTA/ V V sk QQ C O T - O E CERTIFICATE: THIS SURVEY COMPLIES WITH THE MINIMUM Tiirq r °„ . ' �"00 TI pE FLORIDA A�RO OF LAID SURVEYORS,PURSUANT TO SECTION 472.027, S. I HEREBY CERTIFYTHAT Tqt AO:a�v: � ''v' '� r'D a, , IIEGEND: ME AND THAT (xT ' 110,a0NUM�HT IS LOCATED UPON SAME AS 5H�?`YI/N A`M0 TH;A,,T# THERE ARE Mid Ei4�8FtGA �p t f , SAID GRND LARSON AND ASSOCIAT JOU NALDO A JLLE, SIGNED] ,,XA/UABN 241, 1 g Q3 t Z 40r f_ L^" - STEREO SURNE'i R `,,••� I , _ u. CITY OF ATLANTIC BEACH PERMIT f BUILDING / ZONING DEPARTMENT APPLICATION # 800 Seminole Road �~ Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us APPLICATION TRACKING FORINT REQUIRED D � � Y N P G Property Address: dam( .dam- z Y N Applicant: Gly A/,f BLIC UTI N FIRE DEPT. Project: li1.1 0 [ Y N PUBLIC SAFETY LU APPROVAL 00 REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE: Z UJ Y N D.E.P HUFSTETLER ¢ � 0Y N S.J.R.W.M. CARPER rlx _ Y ARMY CORPS of ENG CARPER O Y HOTELS&RESAURANTS HUFSTETLER APPLICATION STATUS CIRCLE ONE: SITE BUILDING DA Al? REVI ED BY: INITIAL: ATE: �M ® 1ST REV ®LtE 7 �� V 7 PLANNING BUILDING ® ® 2ND REV UBLIC WO UTILITIES FIRE DEPT. PUBLIC SAFETY ® ® 3RD REV Return this form to the Building Department once you have entered your comments into the AS400. BUILDING PERMIT APPLICATION - " CITY OF ATLANTIC BEACH r 800 Seminole Road,Atlantic Beach FL 32233 Office: (904)247-5826 ■ Fax: (904)247-5845 Job Address: W. = Permit Number: Legal Description? Valuation of Work(Replacement Cost) $ ■ Class of Work(Circle one): Addition Alteration Repair Move ■ Use of existing/proposed structures (Circle one): Commercial Residential ■ If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No ■ Is approval of homeowner's association or other private entity required? (Circle one): VeIsL' o Describe in detail the type of work to be performed: ID,u r �5-1a d ra m�/ e;'2 C/dS�. Property Owner Information / Name: OAt%/D � De&,Zgl V,4(nn f& Address: �� Z City Zj:Z1 ACh State�aZip Phone 9641-Z"19- Contractor d -Zy9 -Contractor Information: Name of Company: D/Y9e ouJ� Qua1iA ent:. Address: 36City rr State Zip 30ai3 Office Phone 6-412-23a Job Site/Contact Number 9G V-Z}cl Z,-el State Certification/Registration# Office Fax# Architect Name&Phone# Engineer's Name&Phone# Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commencedprior to the issuance o�f a ermit and that all work will be erformed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6) months, or if construction or work is suspended or abandoned for a period of six ((6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical >I'ork, Plumbing, Signs, yells,Pools, Furnaces,Boilers,Heaters, Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CONUMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Thereby certify that I have read and examined this application and know the same to be true and correct. All provisions of 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 other federal, state or local llaw regulating construction or the rf rmane o onstruction. I �- F Signature of Property Owner: Signature of Contractor: . �armcr Sworn to and subs ribed before me Sworn to and subscri ed be re me this 20 Day of l o this 2.v Day of Notary Public: �7n �� .ININYNYYEYttYEitlk!{ttENEk%Nt '1°aklic: NIFER SILVEAMN ri ►' S:�versn S,�yv6'".,, Comm#DD0689782 �( Expires 6/27/2011 REVISED 03.05.07 �u of -3 WOr FloridaNomryassn..i� rls�a eOG -Tl 17 Au....uuuetrasevnonNNNuun nuu uN Ro S TRE f 7" X47 ' � Q 0 `e SENKc` h V ti0 ' .ry 34.7' +e.t' 41 179' 4 /r.o' zz 24f 9, .. 9• 2�. ` e• 9. 24e./' 4.s• a o • N e 7' _ . 15) 71 2 Q o q� � •. x'`90 5ET/P SEF fo /4OZ. aFi. ro Cor 3 K - 0 .B t o c /01 F/NAL SURt/EYZ_2d .40 CERTIFICATE: THIS SURVEY COMPLIES WITH THE MMIMt I T , TI IE FLORIDA ABR LAZ11D SURVEYORS,PURSUANT TO SECTION 17'1027, v I. EGEND: t HEREBY CERTI FY THAT THE *$.QV,E`LAN1 Si ;dE y ;;;D 2Y ' ME AND THAT THE. F--�iPE ONfELG/N!r 7k� �aNUMENT :F 6 IS LOCATED UPON SAME AS SHOWN xNlD rHA,,T THERE ARE NO E%*R0AC $•a " ^ SAID ANP " CLARSON AND ASSOC;II`t ' A ► _ 1843 NALDO A . JACrA LL2. Viqll1A.4M 2y 9 SIGNED SCALIE: O d STERED SUR XE XC R-ry � I,