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364 4th Street (vault) CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233-Tel: 247-5826- Fax: 247-5877 R ELECTRICAL PERMIT r PE MIKNFl b3 qA " x ; JN Permit Number: 20787 Address: 364 FOURTH STREET#B Permit Type: ELECTRICAL ATLANTIC BEACH, FL 32233 Class of Work: ALTERATION Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: � ` .OVNE F "Fl Date Issued: 10/12/2000 Name: NELSON, MELISSA Total Fees: 25.00 Address: 354 1 ST STREET Amount Paid: 25.00ATLANTIC BEACH, FLORIDA 32233 Date Paid: 10/11/2000 Phone: 904)249-3037 Work Desc: INSTALL WIRING FOR KITCHEN RECEPTACLES QRK „ M".:.µ: 4 .5»».'.`•', +4' % 3' >* kvYaY 4iy`}y`,5d'a; >••" zA..,"'.. EARLY ELECTRIC COMPANY INC. PERMIT 25.00 FINAL ELECTRIC NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED 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. $25.0014 Date: 18/12/88 81 Receipt: 8082858 CHECKS 2731 86188863221686 ATLANTIC BEACH ILDIN PT. CITY OF ATLANTIC BEACH, FLORIDA �Ar.�by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INVECTOR: DATE: _,L1L — J2 W_La� IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING. WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF,AND IN'ACCORMME WITH THE ELECTRICAL REGULATIONS,CODES AND CITY OF ATLANTIC BEACH ORDINANCES. Xwmv G G e'-D ILSMICAL FIRM: , nl af pAME I! /SSA � Gr, ,�'I� ADDRESS: L��7 , 15 " RFO!_BOX BLDG.SIZE BETWEEN: RES.Ger APT.( ) COMM.I 1 PUBLIC I ) INDUS.i 1 NEW I ) OLD!-ice REW.i ADDITION I ) TRAILER( 1 TEMr.I I SIGNS { 1 So.FT. SERVICE: NEN{ ! INCREASE I I REPAIR( 1 FEE CONDUCTOR SIZE AMPS COPPER I AL SWrfQH OR BREAKRA, AM P W VOLT EXIST.SERV.SIZE AMPS PH W VOLT RAC AY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN I TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0."AMM. i 1,100 AM♦N. swtTc 4zs INCANDESCENT FLUORESCENT A M.V. FIX[D 0.100 AMM. OVR11 APPLIANICZS BELL TRANSF. MR H.l.RATING H.P.RATING CONDITIONING COMP.MOTOR OTHER MOTORS AM►S CEIL HEAT: KW-HEAT •-1 ova MOTORS H.P. VOLTAGE PHS NO. t VOLTAGE PHS MISCEL OUS TRANSFORMERS: UNDER 000 V. OVER 000 V. NO. KVA � NO. KVA NO.NEON TRANSF. NO. VA. MA, MOTOR SIZE SWITCH FLASHER EACH SIGN — FORWARDED s nn � ��� CITY OF >rY�L�i & Qe4c.4-1 / Office of Building Official / REQUEST FOR INSPECTION ff Date 0 ~� FG Permit No. Time A.M. Received RM. J b A s Locality Owner's Name Contractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ oug iring Ci Rough ❑ Air Cond. & ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation ❑ Lintel ❑ Final [7 Sewer ❑ Fire Place El Pre Fab READY FOR INSPECTION Mon. Tues. Wed. Thurs. Friday A.M. _ _ Inspection Made P.M. Ins p or Final Inspection ®� ancy ❑ Date CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road-Atlantic Beach, FL 32233-Tel: 247-5826-Fax: 247-5877 ELECTRICAL PERMIT _ PERMIT INFORMATION— _ _ — LOCATION INFORMATION- Permit Number: 20658 j Address: 364 FOURTH STREET#A Permit Type: ELECTRICAL ATLANTIC BEACH, FL 32233 Class of Work: ALTERATION Township: Range: Book: Proposed Use: SINGLE FAMILY Lot(s): Block: Section: I Square Feet: I Subdivision: ATLANTIC BEACH Est.Value: Parcel Number: --- -- -- Improv. Cost: OWNER INFORMATION Date Issued: 9/20/2000 Name: NELSON, MELISSA Total Fees: 25.00 Address: 354 1ST STREET Amount Paid: 25.00 ATLANTIC BEACH, FLORIDA 32233 — Date Paid 9/20/2000 Phone (904)249-3037 a Work Desc INSTALL RECEPTACLES _ _ CONTRACTOR(S1_ __--- � APPLICATION FEES i6. _ EARLY ELECTRIC COMPANY INC. PERMIT _ 26.00 Inspections Required ired [FINAL ELECTRIC � II i NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED 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. $2`s.88 4 Dv� �� Date: 9!20!89 81 Receipt: 99902,16 �ATLANTIC BEAC BUILDING DEPT. CHECKS 692 .__�____ CITY OF ATLANTIC BEACH, FLORIDA APPLICATION FOR ELKTRICAL PERMIT J TO THE CHIEF ELECTRICAL INSPECTOR: DATE: IR9438TANT NOTICE. IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING. WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PIANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF,AND IWACCORDANCE WITH THE ELECTRICAL REGULATIONS.CODES AND CITY OF ATLANTIC BEACH ORDINANCES. av GLEMICAL NAME LLQ L�,1L, LfG2 AtW11REW. RFD BOX BLDG.SIZE BETWEEN: RES.IA APT.( } COMM.I 1 PUBLIC I } INDUS.( } NEW( 1 OLD Yom' REW.{ I ADDITION I } TRAILER( } TLW.( } SIGNS ( ! SIL FT. SERVICE: NEW i } INCREASE( I REPAIR( } FEE CONDUCTOR SIZE AVMS COPPER AL OR BRJAKER PH W VOLTI EXIST.SERV.SIZE AMPS PH VOLTLg!�Zl' RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED I OPEN i TOTAL RECEPTACLES CONCEALED OPEN TOTAL O- AMM. li-100 AMN. lWITCMi>s INCANDESCENT FLUORESCENT At M.V. F1xac 0.100 AMPS. OVtl1 APPUANCZS BELL TRANSF. AIR H2.RATING H.P.RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT 0-I ova MOTORS H.P. VOLTAGE PHS NO. I N.M VOLTAGE PHS MISCE OUS TRANSFORMERS: UNDER 800 V. OVER sop V. NO. KYA NO. KVA NO.NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHER EACH SIGN FORWARDED � � S DEPARTMENT OF BUILDING } CITY QEF ATLANTIC BEACH " PE1�IT,INObIATI t -- ------- LOCATjON INFORMATION .._,. .. .._,.,. Address: 364_ - '364A, FOURTH-STREET fiyPe: RLIIL ?IEYG ATLANTIC BRACH', FLORIDA 32233 `1aot W ADD-IT 100 L QA4, DESCRIPTION, _..;.. .� ,..� out r . Ty' W(J�1D 'VMS Lot . 2 ��ack Sacki on:, A � ed CS" P TTO/DECR- T'w#ship RNC"* 4 . ' I + de» 0St�kdi<r a oni: ATLANTIC BAS .RrA►. tl. � ted ald $600.100 l oar cost.* $4»f317 .. $,142-. 50 s�ur� $142 -50 TION, - -- APPLI,CA�TION FEES S PERI " 511. 50 `C R`'H STEGE NAfi INTACT E 20 .00 LOR PE Dw AP RACONI OAS-R.R.S. $0 .00 TI, RADON OkS ." . ? � 'APIT . .,.. IMPROVE. "041M RYDRA,VLTC S14ARE $0 00 Type. 1 CROSS! CONNECTION �., ��,� SEC.H, IMPACT FEE SC3 4.Q 'Co iP i f NOTICE ALL CONCRETE FORMS AND FOOTINGS MUST BE INSOJECTED SrEtFORE POURINO PERMIT VOID SIX MONTHS AFTER HATE.OF ISSUE M MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT SEI PLACEDIN PUBLIC SPACE,AND MUST BE [7EJP AND'HAULBD AWAY BY EITHER CONTRACTOR OR OWNER { rIL 01E T3 C+C3APL.Y WITH THE MECHANICS "1, CAN RESULT �N :PAYINGTWICE FORM QUI .C#1 G �.lk�PA01/�t�lEl�TSt" ¢ i 1 IIE -ACt;Of DLNG TO APPROVED PLANS WHICH-ARE PART OF THIS PERMI"f AND- SUBJECT TO REVt)CATIQN FOR ! v#QN OF APPE<ICASL.E POOVISIONS OF LAW. Nfi MACH BUILDING Q PARTMENT14 `EIEIII 99 } CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Z Address 6 4 G YA L = S 7", a/ r( Q)A))- Datea__' Heated Square Footage @ $ _per sq ft = $ Garage/Shed % @ $ er sq ft = $ Carport/Porch \` @ $ per sq ft = $ Deck 5Ci @ $ per sq ft = $ Patio J @ $ per sgft = $ TOTAL VALUATION: $ Total Valuation lst $ Remaining Value $ per thousand or portion thereof TOTAL BUILDING FEE $ + 1/2 Filing Fee $ j (0) Fireplaces @ $15 .00 $ ��— BUILDING PERMIT FEE $ WATER IMPACT FEE $ SEWER IMPACT FEE $_ WATER METER/TAP $ CAPITAL IMPROVEMENT $ SEWER TAP $ ( ) RADON (HRS) .0045 $ ( ) RADON (CAB) .0005 $ SECTION H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ( ) SURCHARGE .0050 $ OTHER $ GRAND TOTAL DUE $ / Z ADDITIONAL PERMITS OR FEES: Mechanical Plumbing Electric/New Electric/Temp ;SwimmingPool Septic Tank Well Sign Finish Floor Elevation Survey ; Other CALCULATIONS and/or NOTES: G E C 2 21993 Building and Zoning CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS Owner(s) : Q-te gA r Address : 3 6th ,+ S7", -Phone : 3 58--1�83!� Lot #-_ Block or Unit # Subdivision: 2--"C- 8" 6( Contractor : Address : Phone No: Describe work to be done: L✓6It#-P-Aqntm 12.0.0 I Present use of building: valuation of Proposed Construction: W .06 Proposed use: !N,% l D2Y AIA 9100--n11% Is this an addition? �!!" If yes, what are the dimensions of the added space: ft . X ft. Will the added area be heated and cooled? A­,)O New electrical (or increase)? New plumbing fixtures? New fireplace? /UONew Heat/AC? il90 SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY , ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: Date: Signature CONTRACTOR: Date: log, J t;� DEC 221993 Building and Zoning `r =r 0� xq S7U Ds cv AsN�.2�02�1�(t `Zoog, '7#7 T i v�- a.) ` 3 • O /- S- 4W404a c! N u F fall vi AF r f �e- r `�` a -. - i ' =•1H r •x8� - ty � .. coT z/ � �. 0 25,, •��. ,.th f . CITY OF ATLANTIC BEACH Fixture Unit Worksheet for Water Impact Fee FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TWENTY DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. BATHROOM GROUP CONSISTING OF SERVICE SINK TRAP STAND WATER CLOSET, LAVATORY & BATH (8) TUB OR SHOWER STALL (6) WATER CLOSET WATER CLOSET, TANK OPERATED (4) VALVE OPERATED (8) BATHTUB/SHOWER (2) URINAL WALL LIP (4) SHOWER GROUP PER HEAD (3) FLOOR DRAIN (1) SHOWER STALL DOMESTIC (2) LAUNDRY TRAY (2) LAVATORY (1) COMBINATION SINK AND TRAY (3) _WASHING MACHINE (3) (o _POT, SCULLERY SINK (4) DISHWASHER (2) 1 WASH SINK EACH SET 00 KITCHEN SINK (2) FAUCETS (2) DENTAL LAVATORY (1) KITCHEN SINK WITH WASTE DENTAL UNIT OR CUSPIDOR (1) GRINDER (3) BIDET (3) URINAL STALL, WASHOUT (4) FLUSHING RIM SINK (8) COMBINATION SINK AND TRAY WITH FOOD DISPOS. (4) URINAL, PEDESTAL, SYPHON JET DRINKING FOUNTAIN (1/2) BLOWOUT (2) LAVATORY, BARBER/BEAUTY SHOP (2) ICE MAKER (1/2) SURGEONS SINK (3) LAVATORY, SURGEONS (2) JACUZZI (2) _URINAL STALL, WASHOUT (4) TOTAL FIXTURE UNITS @ $20.00 EACH �L JOB INFORMATION aA) OWNER BUILDER PERMIT AFFIDAVIT —` State of Florida City of Atlantic Beach - �BEFORE ME the undersigned authority, personally bpp&arwd iY)l( _)-._ - � � .__..----• who upon fizat bwIng duly `worn. deposes and ways& I u�.�_..? � L L-------------- and the legal owner of the toilowing propertys Subdivision Block -_ Lots - Z3 f Z = AKA I am applying for a building permit pursuant ,.o %h• Owner Builder exemption set forth in Florida Statute, Section 469. 107. Florida law requires that Ithave been provided with th& following DISCLOSURE STATEMENTt DISCLOSURE STATEMENT State lav requires construction to be done by licensed' contractors. You have applied for a permit under an exemption to that lay. The exemption allows you, as th* 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 imprc+ve a commercial building at a- cost of 025,000.00 or less. The building must be for your use and occupancy. It way not be built for sale or lease. It you sell or leave more than one building you have built yoursel within one year atter the construction is complete, th lav will presume that you built it for sale or lease,,' which is ai violation of this exemption. Your construction must be done according to building codoi . and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state lav and by county or municipal licensing ordinances. I hereby acknowledge that I have read the above DISCLOSURE STATEMENT and that Y comply with all the requirements for the issuance of an Owner,-Builder permit. Further, affiant sayeth not. Property Ow *r Sworn to ;nd subsc abed Le?ore u+ Rhis _ __ day I 1 CITY OF ATF9? TIC BRACIT PERNIT C&LCULATIOU SHEET Address .�� L Sr ( AO,017- fc'�) Date f;, Heated Square Footage @ $ ,,mer sq ft = $ Garage/Shed �� @ S per sq ft = $ Carport/Porch A @ $� per sq ft = $ �C < Deckt` @ $ per sq ft = $ Patio (�� @ $_ per sq ft = $ TOTAL VALUATION: $_ ('e00' 00 Total Valuation 1st $ Remaining Value $ per thousand or portion thereof TOTAL BUILDING FEE $ + 1/2 Filing Fee $ 7. e (a) Fireplaces @ $15 .00 $ (� BUILDING PERMIT FEE $ �' WATER IMPACT FEE SEWER IMPACT FEE $�^ WATER METER/TAP $ CAPITAL IMPROVEMENT $ SEWER TAP $ ( ) RADON (HRS) .0045 $ ( ) RADON (CAB) .0005 $ SECTION H PAVING ( ) $ HYDRAULIC SHARES $_ CROSS CONNECTION S ( ) SURCHARGE .0050 $ OTHER $ GRAND TOTAL DUE $ ADDITIONAL PERMITS OR FEES: Mechanical Plumbing Electric/New Electric/Temp ;SwimmingPool Septic Tank Well ; Sign Finish Floor Elevation Survey ; Other CALCULATIONS and/or NOTES: C 2 21993 Building and Zoning CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS owners) Address : 3( © :1-36%A 709': 1f Sr Phone :_ Lot $ Block or Unit # 5- Subdivision: Contractor : Address : Phone No: 1 Describe work to be done: Au2 oc -0000 QJECK Present use of building: Z)u®L& Valuation of Proposed Construction: Zoo- Proposed use: '->ftf -F,,2 DfzyU_ t2c --IA Is this an addition?_ �_ If yes, what are the dimensions of the added space: ft . X ft . Will the added area be heated and cooled? /it) New electrical (or increase)? New plumbing fixtures? New fireplace? New Heat/AC? SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: Date: Signature CONTRACTOR: Date: APPROVED GfTY OF ATLANTIC BEACH <,-�ICE ey CITY OF ATLANTIC BEACH Fixture Unit Worksheet for Water Impact Fee FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TWENTY DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. BATHROOM GROUP CONSISTING OF SERVICE SINK TRAP STAND WATER CLOSET, LAVATORY & BATH (8) TUB OR SHOWER STALL (6) WATER CLOSET WATER CLOSET, TANK OPERATED (4) VALVE OPERATED (8) BATHTUB/SHOWER (2) URINAL WALL LIP (4) SHOWER GROUP PER HEAD (3) FLOOR DRAIN (1) SHOWER STALL DOMESTIC (2) LAUNDRY TRAY (2) LAVATORY (1) COMBINATION SINK ANDIITRAY (3) _*WASHING MACHINE (3) G POT, SCULLERY SINK (4) DISHWASHER (2) WASH SINK EACH SET OF KITCHEN SINK (2) FAUCETS (2) DENTAL LAVATORY (1) KITCHEN SINK WITH WASTE DENTAL UNIT OR CUSPIDOR (1) GRINDER (3) BIDET (3) URINAL STALL, WASHOUT (4) FLUSHING RIM SINK (8) COMBINATION SINK AND TRAY WITH FOOD DISPOS. (4) URINAL, PEDESTAL, SYPHON JET DRINKING FOUNTAIN (1/2) BLOWOUT (2) LAVATORY, BARBER/BEAUTY ICE MAKER (1/2) SHOP (2) 1SURGEONS SINK (3) LAVATORY, SURGEONS (2) 7JACUZZI (2) URINAL STALL, WASHOUT (4) TOTAL FIXTURE UNITS @ $20.00 EACH $ JOB INFORMATION Atl S-- D'o-/ F(Q P DEC 221993 Building and Zoning NC,, Xq S�Uns �S14EA/otzgka , cam '7 f? , S r P1 ac- r • ZF • �- s- 4:;.-4.e4as o IrA4(c cNG- Pitt, Y 4 ° F y d 2S g �. t•1 ii 8' .pNy i3 ----j. J �. DoT L;oT Z A - A a OWNER BUILDER PERMIT AFFIDItViT �' t�tw of Florid• City Of Atlantic Beach �BEFORE N��E• the wwdersi �?')L1_� �R��� � Owed •uthoritl. psrsoAslly •Fw►nr..d iworn, deposes and saysi `-"-•_-• who upon fii.wt being duly OVAlr pot - •••••••------• and the tollowin -•" the level 0 proper � Subdivision 4.4.71v Block AKA --_ ---- ... Lots Lots _e-S rt Z ------ _ as aPplying for s 6WAldiw Builder exemption set to iw tlarAda ttatrt�,uansletionLo 160 Owner Florid• law requires ti►at l #Rowe 60680 providewith the tollawin Dj3CLOSURt lTATtM�NT� d Y DZSCLO7URt STATtNtNT state law requires construstiow to be done by licensed, contractors. lx0wption to thVow have applied for a permit under an at lay. Tho exemption allows Vow, wa tho owner of your property, to -Oct as contractor even thou h your own O you do not have 0 licensr. You must supervise the construction yowrs0lt. You may build or improve a one - or two family residence or a tare outbuilding. Yaw war 0100 build or improve 0 commercial building at a• Soot of •20,000.00 or less, The building must be for your was and occupancy. It way not be built tar sal• or leswe, 29 you sell or 10060 more than one building yaw have built yoursel� within one year otter the oonstruction is complst0, th law will presume that YOW 6%11t At for sale or lease, whish is a violattc of this osecptiow. Your construction must 60 dons ws~dAAg to building sores . and sowing regwlstt400• It responsibility to make aure that people 9"ploy" bar you how! licenses rOOwired by alai• low &wd by Sswntr or municipal licensing ordinances, I hereby acknowledge that 2 have read the above DISCLOSURE STATEMENT and that 1 s Srply with ail the regwirewents ter the Issuance of an OwnOr-wilder peralt. Further, affiant sayeth not. rt0plrty Ow wig sworn- to nd subs ib0dC"�'`�r bolore in his y mpleteitems 1 and/or m • Complete items 3, F for • Print your and 4a&b.additional services. return this card tmoe and address on the reverse I aISO WISh m • Attach Y0t` of this form so that folio to receive the .' does not this form to the front of the we can wing Services (for Permit mailpiece,or on the fee): an ex m • Write"Return Receipt Ra back if �1 • The Return quested" space 1 ; C delivered. Receipt will show to whomthe mailpiece Belo KAddressee's Address ` the article W the article number. m V 3• Article Addressed to: was delivered and the datern 2• ❑ Restricted Delivery n Consult 4a. Postmaster for fee. Article Number 4b. Service 7Ype tu �� l ❑ Regist bered 3d�� ❑ Insured cc �O C°� �ertified ❑ COD Q ❑ EXpressa Mall E3 Return Receipt for 5 Merchandise z 'gnat ee 7. Date Of Delivery l ) r° oWC fi. Si $ Addressee's p ` gnature ge ) and fee is Address(Only if re c '"� paid) quested.. PS Form ' �' 1. December 1991 *U.S.GPO:t8p3-352-714 DOMESTIC RETURN REc�uT �` 77 m c < C 1 �_ (/A S o m Q < 11 N hS � y, .4. a) OL PSti 3"4 I DEhAIR'TMENT OF BUILDING CITY dF A LA NTIC BEACH . . -_. _ .._..__- ` LOC�fi�G}N TN�'CtFA'�'�C�t _ E� k�} GfI�ATZ�3Iri _ . Idurb1 esst FOURTH STREET - --- .� Pe r#ii L Type: PLUMBING :ATLANTIC BEACH, FLORIDA 32233 C1, s's o = work: ALTERATION � + CAL t3ESGRIP'�I t� Cza r ; Type* WOOD FRAMELcat ! ti o s Oct on.�_ 1rIast 'is Oil IN FAMILY Township. RNt3: Q f poll ngs,;,i I Code: 0 Subdivision'., ATLANTIC BEACH value,.* SU U - , � �� y.* �e A0PL CATTON 7 'PERM r Cw STREET EE , 0 .010,01f E ns iaOC Ph a#EI MErfp € d . yn„ l 41 w . ” RADON! AS—H«F S, 0 A SIJ ,. C I'O TI �_-- -- RADON, C�F3 S� 0 0.0 " '[ 9� CAS"II" I,.M.INtE'`. . 4 'Add 3 C' ' ST 'STREET SEER . TAP SIS , e,RS LE}. CS, 3 HYDRAULIC SHAPE, £ ; "YP 9 CRASS i CbHHICTIOI $C3 .IkD I�COTES. � } r i d c r7E 4 NOTICE--ALL CONCRETE FORMS AND FOOTIN'QS MUST BE lN$OECTED BEFORE POURING a PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILOI IG MATERNAL,RUBBISH ANO DEBRIS FROM THIS WORK MUST NOT SE:PLACED:IN PUBLIC SPACE.AND MUST BE CLEARI*D UP AND MAULED AWAY BY EITHER CONTRACTOR OR OWNER `FA RE TO CCIII PLY WITH THE MECHANICS' 1EN. LAW AN RESULT IN bveRVOWNEA PAYING TWICE FOR BUI DPROVEMENTS. �. ISSU� ACCORDING TO APPROVED PLANS WHICH ARE PART Of THIS_PER�uI'II AND SU ACCORDING TOT EOR 5,1014.0f APPLICABLE PROVISIONS.OF LAW. 4 ANTE BEACH BUILpING:0EPA RTMENT , SI CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION• ---�-- /�_. - ---------------------- OWNER OF PROPERTY: L Z_ /c -- ------------------ BUILDING CONTRACTOR: ----------- PLUMBING CONTRACTOR AND ADDRESS: ------------- S� z zo Sj TELEPHONE NUMBER: . -----9 3E- ---------------------------------- - STATE LICENSE NO: � C' 0✓�7(�, � ------ --------------- ------------------ TYPE OF BUILDING: -------------------------------- ------------ - --------------------____________SINKS ___SHOWERS ____________LAVATORY WATER HEATERS ------------BATH TUBS i-_-___ DISHWASHERS SLL*f -URINALS DISPOSALS ____________CLOSETS WASHING MACHINE ------------FLOOR DRAINS --SHOWER PANS OTHER TOTAL FIXTURE ` )UNT: x 93. 50 « $15. 00 = S JVD ----------------------- ----------------------- INSTALLATION OF PLUMBINr AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904 ) 247-5826 CITY OF Ast' Vead - 57&u-da 800 SEMINOLE ROAD ----' --- - ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE(904)247-5800 FAX(904)247-5805 November 30 , 1993 Mr. Samuel D. Kredell Diamond Real Estate 1840 Atlantic Boulevard Jacksonville, FL 32207 Re: 364-368 Fourth Street Dear Mr. Kredell : Receipt is acknowledged of your $200 .00 bond in connection with the above property. You are in violation of Chapter 6-16 of the Code of Ordinances of the City of Atlantic Beach and Chapter 103.7 . 2 (work commencing before permit issuance) of the Standard Building Code. Please be advised that if the application for building permits are not applied within thirty (30) days this matter will be turned over to the Code Enforcement Board. Sincerely, k) 41— C Don C. Ford Building Official DCF/pah cc: City Manager VIA CERTIFIED MAIL RETURN RECEIPT REQUESTED v a O 0 m m i co C•J to m # !} 0 �c (; O # U3 E! o Ul Lo i T i 1=3 i E { Y3� � i } k ! � OD # Z # T G^ O i �1 I rr, --; i k 4 f 4 ;i ZO 1 } k { j } } O } i y �-1 } rQ } k � � O O, t Ln i • iarpon " irCORR 1840 :Mantic Blvd. • Jackso�nvillc, 1"1, 32207 • 904_398-4834 November 24 , 1993 CITY OF ATLANTIC BEACH Atlantic Bch. ,FL. 32233 RE: 364-368 Fourth Street TO WHOM IT MAY CONCERN: I understand that the decks/porches at the above mentioned address is in non-conformance with the building codes of Atlantic Beach. I would like to place a $200 .00 ( two hundred) bond to ensure that the corrections will be made to bring the property up to the code restrictions. Thank you for your consideration in this matter. Sincerely, Samuel D. redell 5,j �1 13 te to k(`( P 0 V 2 41993 Building and Zoning CITY OF ��__ �� AA fY&aa4C B�-YtL * 4 Office of Building Official REQUEST FOR INSPECTION Date �[ -- Permit No. ` Time /o Q A.M. d ReceiveP1M�[1�' 1,/ I 161 136 Job Address oc lily , Owner's Name Contractor BUILDING CONCRETE EL RI PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air Cond. & ❑ Re Roofing ❑ Slab 11 Temp Pole ❑ Top Out ❑ Heating Insulation G Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION A.M. Mon. Tues. Wed. Thurs. Friday P.M. —A.M Inspection Made M. Inspector__ % Final Inspection ❑ Certificate of Occupancy ❑ Date 6-13 DATE: PRE-SERVICE DIVISION JACKSONVILLE ELECTRIC AUTHORITY 233 WEST DUVAL STREET JACKSONVILLE, FLORIDA 32202 THE FOLLOWING FINAL INSPECTION(S) HAVE BEEN MADE AND AkE SATISFACTORY : �,4/za 1 -36" U h f --------------------------------------------------- --------------------------------------- -- ------------------------------------------------- Enclosed are the blue copies of the permits. 73RELY, BUILDING INSPECTION DIVISION cc: FILE CITY OF Office of Building Official REQUEST FOR INSPECTION Date r�3 } Permit No._,/,5R3 /�_/� Time �/ /S A.M. District No. 4 Received L Th Locality Job/Ad ass �fj�/ Owner's / CSC. Lt cContractor Name / BUILDING CONCRETE ELECTRICAL PLUfG^BING MECHANICAL Framing L1Footing El RoughWiring 1:1Air.Cond.& ❑Heating Re Roofing 11 Slab El Temp Pole U, Top Out ❑ Fire Place ❑ Lintel ❑ Pre Fab READY FOR INSPECT N A.M. Mon. Tues. Wed. Ttiurs. Friday P.M. M. Inspections Made M. nspectgr Final Inspect i 9n Certificate of Occupancy ` r � Date 6345 010PAR t'MEfiIT OF 8u11.01140. a CITY OF ATLANTIC BEACH . ATI ON TOMRKATIM, :r 6345 Address 3 6 4 FOURTH STREET R � t Type .tMATANT,IC BEACH, FLORIDA 32233 of Work: :NEW UW,AL r DESCRUTION � ,q ' �r Type, WOOD FRAME Lot , A l o�' S SI i ori a 'I code, Stibdivisi6tvi' ATLANTIC BEACH, ed Va I u : .0 91 to tov. Cost 1. Fees un P, # qrx e i € aM � , �, T' E �sr� k T R IMPACT FEE o H 0 i,H p PORI DA A-223.1; S'EWZR IMPACT FEE � ' $0. 00 I} c� b YSWA ME o o r ° I E"0RMATqON 0 ,e: MB H A'' ZRI TAP a 00 ` . . . A SEER TAP . 4 QAC 4. .- � � � fly m aR,E-IROW ' "E E W H, IMPACT FEE 01 ' .€+ RwAx'�4&'s»�a°�att"•, "d:�.�a jw OAN k 7 1994 GlrY OF ATLANTIC Bon , NaD1'10E--ALL C4NC111E tE FOAMS AND:FOCITINCI MUST BE INSkCTE©'BEFOR9 POUF INO, r PERMIT VOID SIS(MONTHS AFTE DAT,fx OF'ISSUE k ° BUtI.OI G MATERIAL,RUBStSH ANIS DEBRIS IFR,OM THIS WORK MUST NOT BE'PLACE0 IN PUBLIC SPACE,ANIS MUST BE CLEAR O UP ANO HA.0 EL AWAY BY EIThFER 016 NO OWNER ra.l'A1.URS TO, 60 PL.Y WI'T14 THE MECHANICSA SEN. . SAN RESLlL.T,IN 141 PROPER"�Y OWNER;P,A YING TWICE FOR SUIS 011211 �it�Y MEN'fiS.�� BUECt ACCORDING TO APPROV _PLANS WHICH'ARE PART OF THIS PER AIT ANO°SUBJECT TO REVOCATION F01 VI6,LA ION OF APPLICABLE PROVISION$OF LAW. ,-.-,`,OLANTIC BEACH SUILOINt3 t) ART ENT CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION:__ _!4 ______________________________ OWNER OF PROPERTY: BUILDING CONTRACTOR: PLUMBING CONTRACTOR _, ----__ ------------------------- AND ADDRESS: -------------------------------------------- TELEPHONE NUMBER: _C �__a/_ 1_ �'_____-___-__ STATE LICENSE NO: ______ ------ TYPE OF BUILDING: ___---------SIKHS ---------__ --SHOWERS LAVATORY _WATER HEATERS ------------BATH TUBS DISHWASHERS ____________URINALS DISPOSALS _____CLOSETS _____________WASHING MACHINE ____________FLOOR DRAINS SHOWER PANS OTHER_______________ TOTAL FIXTURE COUNT: x $3. 50 + $15. 00 = S___________ ------------------------------------------------------------------ INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 ..► Ak A4ANAGMENTSER ICES Aft O '� a C n m p m p z z c 1 ci O co CD m ° ti 0 o m 0 O -i m z �\ ° w m Z r° y i a y n Q CD A W cn z o r n0 x [7 m x N r W r -Oi N n [� z 1p) m _ c fm CO 0 y y 0Z � m a E0 0 N ZMZ z [0 W ��► M = W o q0 co w ; O $ m ~Zm ° O D> m c m ~n C m a' 3 0 O aCo # 5C m O m .. z Ul m � p M O w -M b 0 W W m o $ Ej G] H oAft ANk H r C CITY OF ATLANTIC BEACH, FLORIDA App. ,by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: Q19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HERESY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. (p 0 ELEAFRM: 1 SIJOURNEYMANGNATURE NAM ADDRESS: _RFD BOX BLDG SIZE BETWEEN: RES.G( APT.l 1 COMM.( ) PUBLIC( 1 INDUS.( 1 NEW( 1 OLD{! REW.l 1 ADDITION( 1 TRAILER( ) TEMP.( 1 SIG S ( 1 'SQ.FT. SERVICE: NEW( k INCREASE( REPAIR ( ► FEE Com.1<JCTOR SIZE AMPS COPPER ALUM. MnUH OR BREAK 'R AMPS PH W RACEWAY E1.X SERV.SIZE Q AMPS PH W 2e) VOLT RACEWAY FEE RS NO. SIZE IND. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL REC , ACLES CONCEALED OPEN TOTAL 0•30 AMPS. 91.100 AMPS:' SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER APPWANCEs BELL TRANSF. AIR H.P.RATING H.P.RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: -KW-HEAT 0-1 OVER MOTgRS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS t 1 LLANEOUS May 14, 1990 TO CHIEF DAVID THOMPSON FROM DOH C. FORD, CODE ENFORCEMENT OFFICER C RE ABANDONED PROPERTY Please have the following vehicles tagged with a 10 day notice at ►;, tr ?1�'! 1. 1971 Chevelle, Georgia plates, RCH-696, 1989. (GREY) 2. 1967 GMC Pick-up, Georgia plates, RI-6592, 1989. (BROWN) 3. 1964 Chevy Malibu, No Tag, under a cover. 4. 1968 Chevelle, No Tag, under a cover. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00000534 Date 4/22/08 Property Address . . . . . . 364 4TH ST A Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc WIRE UTILITY SHED ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HARMER TIETJEN TECHNOLOGIES 364 4TH STREET #A 51 WEST 7TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 270-0070 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/19/08 ---------------------------------------------------------------------------- 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. CITY OF ATLANTIC BEACH 08— 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 �> OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPT@COAB.US ELECTRICAL PERMIT APPLICATION DUVAL COUNTY ° d Lxlill +.vnA 3 ,A NES PERMIT CJ 7 —/6�� 4.NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE: q 76 7.NAME OF COMPANY: 8.ADDRESS.: 1AW 5/ c;5f 7i�ST— 9.STATE OF FLORIDA LICENSE NO: b Z `'1 10.CELL PHONE: Z f er- %z Q 3 11.FAX NOo 12.EMAIL ADDRESS: ll//77 13.OFFICE PHONE: 14 G( z G -Z:-o4 t f00 o CSL CO k 15.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 ork 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 ' er work' enc d. CONTRACTORS SIGNATURE: ❑MULTI FAMILY-#OF UNITS: ARESIDENTIAL ❑SINGLE FAMILY ❑TEMP SERVICE [3 COMMERCIAL 7q7- /(� 3 AADDITION ❑TRAILORA � . .r,.s',c . ✓,f, a 13 ALTERATION 13 SIGN OLD ❑NEW 13'05 NATIONAL ELECTRICAL CODE ❑REPAIR ❑POOL/SPA ❑REWIRE ❑OTHER: .Y i�, a�.,�;;z�t roar„✓....,� +�•',3 9 Cdr_a.i�' � H a ,+, ``�,. ,� ,�ryw=7;,s�;< ��, �:.. ,�., '�,w`,< €r: ,�9„, �S a, �. :§ q�f�:`re�,� °���`,°.•� * A.���,��N' ,`$ ed 20.TYPE OF SERVICE: OVERHEAD ❑ UNDERGROUND ❑ UNDERGROUND UP POLE 21.NEW SERVICE: CONDUCTORS PER PHASE: POWER IS ON ❑ POWER IS OFF 22.SIZE OF CONDUCTOR: AMPACITY: ❑COPPER ❑ALUMINUM 23.SWITCH OR BREAKER SIZE: AMPS: PH:_� W:�_ VOLT: (7 RACEWAY SIZE: 24.EXISTING SERVICE SIZE: AMPS: J PH: W:___3_ VOLT:__Z.W RACEWAY SIZE: 25.FEEDERS: #OF AMPS: #OF AMPS: #OF AMPS: 26.LIGHTING FIXTURES: INCANDESCENT: FLUORESCENT&M.V.: 27.FIXED APPLIANCES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: 28.FIRE ALARM: ❑YES PJNO 29-31 DO NOT APPLY TO NEW SINGLE FAMILY,MULTI-FAMILY AND ROOM ADDITIONS 29.SMOKE DETECTORS: NUMBER: 30.RECEPTACLES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: 31.SWITCHES: 0-30 AMPS:_ 31-100 AMPS: OVER 100 AMPS: „.x��' -r e ”„ d , .��r r �!' F '` 6 ,¢ r _„ #OF UNITS: COMP.MOTOR HP RATING: AMPS: HEAT KW: #OF UNITS: COMP.MOTOR HP RATING: AMPS: HEAT KW: P ,+r..,§.Cr"'�,ru a a,• a ,„r ,fir^� tM r �r„, ,a,,,e".�Ps.,.a., r 3.�*..Pr r ;.,�.. NUMBER: VOLTAGE: HP: KVA: NUMBER: VOLTAGE: HP: KVA: � 3 �,s,' .�4 "�s, ,� •€`P xr,r” � �rr� �t�; �m )i s, �;+ r„„ z�� D d,?�- UNDER 60OV: NUMBER: KVA: OVER 60OV: NUMBER: KVA: DESCRIBE IN DETAIL: V T-1 C-f;-rte COAB FORM BLDG02:REVISED:111012008 T �./ ��y rf�� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 w �., j` Application Number . . . . . 08-00000984 Date 7/22/08 Property Address . . . . . . 363 4TH ST Application type description DEMOLITION (ENTIRE BUILDING) Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc complete demo of house ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MCMILLIN, HERBERT W. A SALVAGE AND HAULING INC 363 4TH STREET ROBERT K PROPHET ATLANTIC BEACH FL 32233 7431 IMPALA LA JACKSONVILLE FL 32244 ---------------------------------------------------------------------------- Permit . . . . . . DEMOLITION PERMIT Additional desc . . Permit Fee . . . . 100 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/18/09 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 100 . 00 100 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 100 . 00 100 . 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 08 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 n OFFICE:(904)247-5826•FAX NO.:(904)247-5845 Fr -. 11 BUILDING-DEPT@COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY Atlantic Beach FL 32233 LEGAL DESCRIPTIO >. 5.CLASS'OF:iWORK .w:": . ,. .,.i:?r,5 ... .;.ter.. c, • 6:USE"Op STRUG7URE.' ❑NEW BUILDING ❑DEMOLITION RESIDENTIAL LOT BLOCK SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL ,7:DESCRIPTION'{ .WORK.::? °..'. [3 ALTERATION ❑ACCESSORY BLDG. 8:FIRE SPRINKLER, ❑REPAIR ❑POOL/SPA ❑YES ❑N/A ❑MOVE ❑OTHER ❑NO , PROPERTY OWNER CONTR/IGTOR' ARCHITECT 1 ENGINEER Q �� M��,�l�►; 15.COMPANY NAME: Min 23.COMPANY NAME: 9.NAME: M TAC- 16.NAME: {� 24.LICENSEE NAME: 10.ADDRE SN; �(G�(i 54:h.A� 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 18.ADDRESS'� Y � 22 26.ADDRESS: PL 'L71 M��F 11.OFFICE PHONE: 12•FAX NO•: 19OFF,EjHONE-1942 0.FAX NO.: 27.OFFICE PHONE: 28.FAXNO.: 13.CELL PHONE: q�d=//01? Q�NV 21.CELL PHp�e�78 9Z 29.CELL PHONE: 14,EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: 7v FEE:SIMPLE TITLE HOLDER BANDING COMPANY 9 ' ;'a MORTGAGE LENDER t r v .. (IFOTHERIHANOWNER) ...,1.; 31.NAME: 33.NAME: 35.NAME: 32.ADDRESS: 34.ADDRESS: 36.ADDRESS: 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 of a permit and 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. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. WARNING TO OWNER: ** YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RE SUOLFT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOURNT. LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM r F . CONTRACTOR OWNER or AGENT I e:. . k ;9r,. t. „±<,QualifierOnl Agant,Power o�f//Att�o�,heyof,Agaricy tetter Required) <,. Signed: Vk• o - Date: -7 2,2' 69' Signed: Date: Before mets day of 2007 in the county of Before me this day of ,2007 in the county of Duval,St Florida,has personally app red Duval,State of Florida,has personally appeared 6" m� amwS herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are true and accurate. true and accurate. Notary Public at Large,State of .County of J 4- Notary Public at Large,State of County of ❑Personally Known ❑�,,Personally Know i BLKoduced Ide ❑Produced Identification- Notary Signature: •r' •o, Notary Signature: =y� = Co if DD 518533 ' �Y;��Y.'s, edaWll Nob Am. COAB FORM BLDG01:REVISED:11/6/2007 f( � ...•.r t (fj�r CITY OF ATLANTIC BEACH l � 800 SEMINOLE ROAD A'j ATLANTIC BEACH,FL 32233 f�/�/ INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00031762 Date 12/08/05 Property Address . . . . . . 364 4TH ST A Tenant nbr, name . . . . . . REROOF Application description . . . ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 9800 Owner Contractor - ------------------------ ----------------------- FOX, LAURA WHITES ROOFING COMPANY INC 364 4TH STREET #A 14262 PLEASANT POINT LANE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32225 (904) 220-5546 --------------------------------------------------------- Permit ROOF PERMIT Additional desc . . Permit Fee 120 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 9800 Fee summary Charged Paid Credited Due ----------------- ---------- --- Permit Fee Total 120 . 00 120 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 120 . 00 120 . 00 . 00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BU[ FIC .,L , CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address 3'& E ! f Date j z --T � Heated Square Footage @ $S -per sq ft= $ Garage! Shed `'' @ $�T per sq ft= $ Carport/Porch "'@ $ per sq ft= $ Deck @$ per sq ft= $ Patio @$ per sq ft^ $ TOTAL VALUATION: $ C7 86(D 3S $ 35 Total Valuation I' $ levy $ 14 Remaining Value $S per thousand or portion thereof CONSTRUCTION TYPE: TOTAL BUILDING FEE $ $ 0 ZONING: _ + V2 Filing Fee $ o FLOOD ZONE: ( )Fireplaces @ $35.00 $ IMPERVIOUS SURFACE: BUILDING PERMIT FEE $ tZo WATER IMPACT FEE $ SEWER IMPACT FEE $ WATER METER TAP $ CAPITAL IMPROVEMENT.$ SEWER TAP $ C ( ) RADON .0050 $ SECTION H PAVING( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ST( ) SURCHARGE $ OTHER $ GRAND TOTAL DUE: $ 120 6w ter,.X 11 f CITY OF ATLANTIC BEACH c« BUILDING / ZONING DEPARTMENT C- H d gins800 Seminole Road err i Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # 05--,517U Property Address: v k t? Applicant: Project: rff�'f— This permit application has been: Approved r7 Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: l Date: cz Date Contractor Notified: CITY OF ATLANTIC BEACH i J � ROOFING PERMIT APPLICATION t Date: r l Job Address: � S� A �hA C- 1y d, Owner of Property: v Address: '� Q_ Telephone: Contractor: K State License Number: ('f C, Contractor's Address: 1 S� �� 0. �� 4 a 5 Telephone: O - Fax: Scope f Work: n" s r t -P Deck Slope: Greater than 2:12 Less than 2:12 Valuation of work: Product Name(Example: Timberline):_ _ -- Manufacturer(Example:GAF): t!ri_ r\ — ASTM Designation(s): !/ Required Inspections: Sheathing and Final Signature of Owner: Date: AS TO OWNER: �" �� i Sworn to and subscribed of 20 ed before me this State of Florida,County of Duval Paula Drake Dear, Notary's Si _ �--- *Cpff"scinn#DD:1975 `w Exphvs Aprii 8, 20013 Personally known io�e�aiai •'^ 6""I"� A0070t" ❑ Produced identification Type of entification produced --�� Signature of Contractor: Date: �4 - AS TO CONTRACTOR: Sworn to and subscribed before me this day of I State of Florida, County of Duval C m_ �„ Notary's Signature: //// `� 6`�`Y( "ka.:Paula Drake Dean personally known 2� Commission#DD397559 ❑ Produced identification Expires April 8, 2009 Type of identification produced � d Troy tiM In"Sn"'Ine.600 76&7019 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ei.atiantic-beach.R.us Page 1 Revised 2/21/03 NOTICE OF COMMENCEMENT State of Tax Folio No. 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�'}this NOTICE OF C EMENT. �( C' A Legal Description of property being improved: (2` l 6 �n 7t 1T Address of property being improved: 10 S �^ I`� Gen description of improvements: +'1l C� n r 1 c. `e S 1 Q Owner: Address: �f Owner's interest in site of the improvement: V\p r Fee Simple Titleholder(if other than owner): Name: Contractor: n C- Address: CP G/"Ccs Telephone No.: Fax No: `S � Surety(if any) w ,, +of Rnnr�P. Address: Doc#2005443736,OR BK 12326 Page 1857, Telephone No: Fax No:_ Number Pages-1 Name and address of any person making a loan for the construction of the Filed 8 Recorded 12/06/2005 at 12:03 PM,J00 PULLER CLERK.CIRCUIT COURT DUVAL COUNTY Name: RECORDING$10.00 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: Telephone 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: Telephone 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 j —4 Signed• Date: Before me&s_ _day of in the County of Duval,State Of Florida,has personally appeared Notary Public at Large,State of Florida,County of Duval. My commission expires: Otf PVA_ Paula Drake Dean Personally Known: or ,0 ;Commission#DD397559 Produced Identification: Expires April 8, 20097019 �J►�\� OF goncWdTroy Fsin-InWll",1MG,