73-75 4th St West (vault) (2) ffi
CIT`! 4F
14� c �eatl - 77�viida
800 SE MNOLG ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE(904)247-5800
ZMC(904)247-5805
SUNCOM 852-5800
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 CONTRAcToR5. YOUHAVE APPLIED FOR A PERMIT
UNDER AN EcEMPTION TO THAT LAW. THE EXEMPT70N 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 OP $25,0040.00 OR L—. 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 TONING REGULATIONS. IT 15 YOUR
RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AHO BY
COUNTY OR MUNICIPAL UCENSING ORDINANCES.
ORDINANCES ALSO At OW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN R IS FOR PERSONAL OR FAMILY
USE, AND LJKEW/SE 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 MIRE
UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER 'DIRECT SUPERVISION OF THE OWNER. WHO MUST HE ON
TME JOB AT ALL TIMES, WHILE WORK 15 IN PROGRESS BY UNLICENSED TRADES PEOPLE.' 714M DOES NOT ALLOW USE OF
UNLICENSED CONTRACTORS.
SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS
WORKERS COMPQISATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY CLEARLY PROTECTS
THE OWNER. OWNERS HIRING W;ORKEP5 BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WTTI•IHOLDINO TAX AND/OR
FORM 1 099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO $5,000 PmTY UNDER FLORIDA STATUTc NQ, 4S5-225(1). AN 'O CUPATIONAL LICENSE' IS NOT ADEQUATE.
THE OWNER SHOULD PHYSICALLY SEE THE COUNTY 'CERTIFICATE OF COMPETENCY' OR THE FLORIDA 'CONTRALTORS
CmwnpICATE' TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. 71mLEPHOWE THE BUILDING OEPARTMENT (247-
5826) IF IN DOUBT.
I HEREBY ACKNOVK. DGE THAT I HAVE RCAD TH OSURE STATHMENT AND THAT I COMPLY WITH AL1.
THE REOUIREM FOR THE ISSUANCE OF AN OWN $UtL�ER P fT.
PRO OWNER/BUILDER
ADDRESS TELEPHONE
SWORN TO AND SUBSCRIBED BEFORE ME THIS C5`--0 DAY F �.� IG C
NOTARY PU UC Y r GEORGIA A.HORN
NOTE. PHRASES UNDERLINED ABOVE MY COMMA ION FIRES: _ '`': OMMISSION#DD 030526
ARE EMPHASIZED BY THE BUILDING • EXPIRES:June 3,2005
DEPARTMENT.
�P(h�. doodad Thru Notary Public underwriters
J CITY OF "�
• ask-f
�t a,oC,Y,
Office of Building ic I 2 -�
RE VEST FOR INS E IOA� -2 �
2 �3�Zn
Date 1 rmit N
Time M.
Received �' P.M.
Job Address Y Locality
Owner's' {R
Nam Contractor
CONCRETE ��_CT + PLUMBING MECHANICA
❑ Footing ❑ Rough Wiring ❑ g ❑ Air Cond.& ❑
Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating
❑ Final Sewer El Fire Place ❑
Insulation ❑ Lintel Pre Fab
REA9 INSPECTION A.M.
Mon. Tues. _
Thurs. Friday P.M.
A.M.
P.M.
Inspection Made
Final Inspectiop�
Inspector Certificate of Occupancy ❑
Date
p1LANTj�,
FlOR10a
OF
AD—DIT71ONSor • " •
D• NOT REMOVE
JOB AOMESS OATS
43 wes—i 4"' G I
THIS JOB HAS NOT BEEN COMPLETED
The following additions or corrections shall be made before
the job will be accepted
5 eel_ 105— PLt""S0 t
yet
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I t4i5-t(a-(, 6Tr
Sem 05 F(ac .
40 1 A5V-U ?tel S Z IZ
Se /o$ g"Apt E5
15.00 REINSPECT FEE
It is unlawful for any Carpenter, Contractor, Builder or other
persons,to cover or cause to be covered, any part of the work
with flooring, lath, earth or other material, until the proper
inspector has had ample time to approve the installation.
After additions or corrections have been ;rEL
UMPmade, call 247-5826, Building Depart-ment for an inspection. Field Inspectors Ec
are in the officefrom 8:00 a.m.to 5:00 BLDG
p.m. Monday through Friday;
Vo
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RIES
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BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FLORIDA 32233
APPLICATION FOR MECHANICAL PERMIT
IMPORTANT—Applicant to complete all items in sections I, II,III, and IV.
I. Street Address:
LOCATION OF Intersecting Streets:Between Ad----z774
BUILDING
d —
BUILDING Sub-division
H. INDENTIFICATION—To be completed by all applicants.
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
ordinances and standards of good practice listed therein.
Name of Mechanical Contractors
Contractor(Print) 6(l Q/�/ Q -lOrI Master
Name of Property 1
Owner Cl / 0 d7 rl
Signature of Owner Signature of
Or Authorized Agent Architect or Engineer
III. GENERAL INFO ATION
A. Tof heating el: B.
� Electric IS OTHER CONSTRUCTIOIJBE111G DONE ON THIS
CF Gas: _LP Natural _Central Utility BUILDING OR SITE? iU
❑ Oil
❑ Other—Specify IF YES,GIVE NUMBER OF CONSTRUCTION
PERMIT
IV.
MECHANICAL EQUIPMENT TO BE NATURE OF WORK
INSTALLED Residential or Commercial
New Building
(Provide complete list of components on§aeloaf this form) Existing Building
Heat _Space _Recessed _ entral _Floor Replacement of existing system
Air Conditioning: Room Central ❑ New Installation(No system previously installed)
❑ Duct System: Material Thickness Cl Extension or add-on to existing system
Maximum capacity cfm ❑ Other- Specify
C3 Refrigeration
❑ Cooling tower. Capacity Rpm
❑ Fire sprinklers: Number of heads THIS SPACE FOR OFFICE USE ONLY
❑ Elevator: _ ManliB_Escalator (Number) (Received)
❑ Gasoline pumps (Number)
❑ Tanks (Number) Remarks
❑ LPG containers (Number)
❑ Unfired pressure vessel Permit Approved by Date
❑ Boilers
❑ Other—Specify
Permit Fee
LIST ALL EQUIPMENT
AIR CONDITIONING AND REFRIGERATION EQUIPMENT
Number Units Description Model Number Manufacturer Capacity Approving
Tons Agency
s e� A- °z�1CA ✓ ��
HEATING—FURNACES,BOILERS,FIREPLACES
Number Units Description Model Number Manufacturer Capacity Approving
T enc
TANKS
How Many Nominal Capacity Type Liquid Name of Serial Approving
And Dimensions Contained Manufacturer No. Agency
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N
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APPROVE r.,
CITY OF ATLANTIC BEACH
BUILDING OFFICE j
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DEPARTMENT OF BUILDING
" CITY OF ATLANTIC BEACH
PZPAIT; I1wiPDX"TIO�f;. �».,:... - LOW 1,011 INFORMATION,
. _.._ .�
` c E ��►�dress� 7 C�TB E�'ItE�T WEfi
` V I I1IE ATLANTIC' BEACH t FLORIDA . a2213,
LEGAL DESCRIPTIO9
, ;ARIL Tcaw�a
' ship r Rid
� . `Ca o' Subdi
vix , SECICA
3 ' .. D .
0,0
o
2$0 00
14110 u
i 2,5 U :CIC
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BION __� A`PPLICATION FEES
4
.w. s�
° ENI ' $C .00
A + r UT IACTFE>I " o „.
All
I DAF
SE A
RADON CCAS-11 9",z
hr
0t00
TION ~ - _-_ RADON Q S $0 .00
AIS ORX, I� R WATER,.'PAP " «C}13
SEWER TAP' $0.00
rt= iDB 3LI ARE C 00
& k ,` TY 'e: O CAP TA.L� IXPROVE.
to k.QC3
g �I7."{ yy�iX. IMPACT FES � �3
M1w' dTi �.„.,, m.�ua.,,�w ,,.mc.�>s.%.
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NOTIG'E AL UNCI ETE FORM”
ND FOOTINGS MUST St,INBP,ECTEb sEFDFiE PQURING
#�ERl�t1iT VOD SIX MONTHS AFTER DATE OF ISSUE `
,. t1'!L '.NG MATER A1„R 8 31SH°AI�1O ES IS FROM THIS WORK MUST NOT 81i PLACED,IN PUBLIC SPACE,AND MUST BE
'< C1.EA �i D UP AN1 M{tlli E 'A �k1� '( THER CONTRACTOR OR OWNER
t# ` LURE:1' A .1f 1H THE MECHANICS' LIEN 'LAW CAN RESULT IN
. # PRt P � `� PAYING TWICE FOR BUI DII�iG tMPRQYEM'.ENTS."
ISSU " ACC4I p.1 ni [ APP UEF PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION'FOR',,
17
xt
! . " 10 Of AP 14: of LAW.
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rC1TA1 toil
AT.AN1CM REACH� DI DE{ARTMENT
*JIM,
., sod
CITY OF
�t�itc� t ectcr� _ �7�oni�
300 S£ivIINOLE ROAD
ATLANTIC 86ACH. FLORIDA 32233.5,14,
TELEPHONE (904)247-5800
FAX(904) 247-5305
SUNCON 352-5300
DATE
r�
JEA Construction & Maintenance
2325 Emerson Street
Jacksonvilte, FL 32207
Attention: Connie
_ Re: Final Electrical Inspections
Dear Connie:
Final Inspections On the following locations have been completed and approved:
PERMIT NO.
{ ADDRESS
ri
� f
Please calf me at 904-247-5826 if you have any questions.
Sincerely,
ATLANTIC BEACH BUILDING DEPARTMENT
jKANNU tILL NU.R• 19io MAN SHJWINU HUUNIIAHY SUHVL Y Uh l
LO:Aow 2 AND 3, BLOCK 77, a@CTIQN "H", A'1LANTI( CH, AS KBCOKDLD 1N PLAT
BOON �8, PAGE 34 OF THE PUBLIC RECORDS OF DUVAL -..JNTY, FLORIDA.
uA magr ROAD
ITAT£ROAD 4•/4 /t0',F/64qT•Of•°14Y
Z r f°��o, ��� f�E LOT 7 GLOM 50
LOT 7 BLOCK 3l
fJOTN
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LOT / I LOT
BLOCK 76 I ca
LOT Z o o L OT Z o o W
BLOCK 76
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CONCRETE I+/A4K
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LOT¢ f3Loc,e 74 x tnfAvofo�
tilt AARA 'o//ARE ANT
/P LOT¢ BLOCK 77
I
NoTfs: I
ALL INTERIOR BOUNDARY ANGLES ARE 90°00'00"
'.NO BUILDING RESTRICTION LINE SHOWN ON PLAT, THERE
ARE RESTRICTION LINES BY ZONING AND THERE MAY BE
EASEMENTS THAT AFFECT THIS PROPERTY THAT ARE RECORDED
IN THE PUBLIC RECORDS OF THIS COUNTY THAT ARE NOT
SHOWN ON THIS SURVEY.
'.THIS PROPERTY LIES IN FLOOD ZONE "X" WHICH IS THE
AREA DETERMINED TO BE OUTSIDE THE 500 YEAR FLOOD
ACCORDING TO FEMA FLOOD MAP REVISED 4/17/89,
COMMUNITY PANEL NO. 120075 0001 D.
I° ,mAxa FDR THE 6ENff/T Of:
ti1ic�.ao.T.c �yQav!; ��
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DU\�9EN LAND
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CITY OF ATLANTIC BEACH i
MECHANICAL PERMIT
8W SEMINOLE ROAD—ATLANTIC BEACH,FL 32233—TEL: 247-5826—FAX: 247-5877 a
_^PEtMf `fN '!t?i --
-LOCA FOUVFTO - - -
Address: RTH STREET WEST
C.Permit-Number: 22406 ATLANTIC BEACH, FL 32233
Permit Type: MECHANICAL Township: Range: Book:
Class of Work: NEW Lot(s): Block: Section:
Proposed Use: SINGLE FAMILY Subdivision:
Square Feet: Parcel Number:
Est. Value: Q`'iN �iCATION
Improv. Cost: Name: SERGIO OUTEIRAC
Date Issued: 7/25/2001 s; 75 FOURTH STREET WEST
Total Fees: 47.00 Addres
47.fl0 ATLANTIC BEACH, FL 32233
Amount Paid: 725/2001 Phone: (904)249-0002
Date Paid:
Work Desc: NEW HVAC = - kP L CATII<3N E5
CONTE _ _ PERIIIIIT ; 47.00
SOUTH RN COMFORT HEATING„$�AIR
1.
73
- x
NOTICE, INSPEC ,, UST
BE REIESTEi1AT,LEAST 24 HOURS PR_ (�R TO INSfCTiON
:
BUILDING MATERIP++' RUBBISH DEBRIS 1!!OM THIS WORK MUST NOT BE GED IN BLlC SPACE,AN
---- ---
MUST BE CLEARE_Dl)p AND;HA t p AWAY BY EITHER CONTRACTOR OR O ER
"FAILURE TO COMPIL �WITH T . NST . CTION LIEN - .CAN REST IN THE
., I
PROPERTY OWNER P G _0AW VVINTS .
. ..�` � .
ISSUED ACCORDING TO APPROVED PA, � R R j wF T� AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PRI1S -
_ 1
f/ $47.N iii
late: 7/26/8181 Receipt: 9976235
ATL TIC iS ACH BUILDING DEPT. OECKS __ ,tT
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IS
l CITY OF ATLANTIC BEACH
.• 1 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
--
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
�xi } Building-deptAcoab.us
Application Number . . . . . 07-00001030 Date 7/19/07
Property Address . . . . . . 73 75 W 4TH ST
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . RES GEN MULTI-FAMILY
Application valuation . . . . 0
------------------- --------------------------------------------
Application desc
SAFETY INSPECTION
-------------------------------------------------------------------
Owner Contractor
------------------------
-------- ----------------
MOYANO,ALDO BARKOSKIE ELECTRICAL SERVICE,
75 WEST 4TH STREET INC.
ATLANTIC BEACH FL 32233 48 S . PENMAN ROAD
JAX BEACH FL 32250
(904) 246-4731
----------------------------------------------------------- ----------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/15/08
----------------------------------------------------------------------------
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.
Jul 19 07 11:09a BARKOSKIE ELECTRIC (904)249-8017 P•1
CITY OF ATLANTIC BEACH
ELECTRICAL PERMIT APPLICATION
Date:
Property Address:
Owner: --�y �"` y'A*%j0 Telephone#: 336 81 2`3
Contractor
'G�l e, Tekphone#• 74%4- 3/
I
Contractor Address: .J� ETf Fax#:
Contractor S' tura:
In consideration of permit given for do' work described in the above statement,we hereby agres to perform said wotit in
aceordanc a with the attached pians and specifications which are a part hereof and in accordance with the City of Atlantic Beach
ordinance and standards of good, listed therein. !t oilier consnaction is
Building: Building Type: O Trailer ' = being done on this building
❑ New me-Residence U Temp. O New Or site,Um dw building
W"�old O Commercial o Signs ❑ Increase Pmitnwnber.
❑ Re-wire Q Addition Sq.Ft. ❑ Repair ----
CondvcWr Size: AMPS: COPPER ALUMINUM
RACE
Switch or VOLT WAY
Breaker AMPS PR W
Existing Service RACE
S� AMPS PH W .' VOLT WAY
Meter
Number
Feeders: NO. SIZE NO SIZE NO SIZE
Lighting Outlets
CONCEALED OPEN
R les CONCEALED OPEN
Switches
Incandescent
Fluorescent &
M.V.
Fixed 0.100 AMPS OVER BELL
Appliances TRANSFER.
Air HY.RATING H.P.RATING CEILING KW-HEAT
Conditioning COMP. MOTOR OTHER MOTORS AMPS HEAT
Motors 0.1 H.P. VOLTAGE PH NO. ' OVER i H.P. PHS
l
wi�ttFOov _ ovFa 6o0v
Transformers NO. KVA NO. KVA
NoNeon_Tiansf.
Ea. Si 0
Miscellaneous
800 Seminole Road-Atlantic Beach,Florida 32233-5445
Phone:(904)247-5804• Fax: (904)247-5845 -Izesc:t. .u' Revised 1/04