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200 5th St (vault) PERMIT WORKSHEET certificate of Occupancy Job Address: Zoo 57+ Z:rType Work: Z /D Property Owner: Phone # Contractor: Phone # (-�.�v�..� � s.Nc. 38�• 8to I Permit#: 03 - Z-718-7 Date Issued: IZ -03-O3 Building Inspections: Footing Slab Tie Beam Lintel z v Nailing / Sheathing Framing / Cover Up a ,o3 Insulation Final Building o 'J Tree Permit# YES NO Electrical Permit# Date/ Copy to 03 - a '73aS JEA Temp, Pole Permit# Date/ Copy to JEA Temp. Power Letter Received: YES NO Inspections: Rough Electric la 9.0 3 Released to JEA Temp. Power Released to JEA Temp. Pole Released to JEA Final Released to JEA Mechanical Permit# Inspections: Rough Final Plumbing Permit# _ Inspections: Rough / Underslab Topout Water/Sewer Final Drainage Inspection: �- Pool Permit# Inspections: Steel Final Grounding Final Roofing Permit# Inspections: Nailing /Sheathing Final Fire Inspection: Failed Inspections: Date Paid: Date Paid: °j CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD YJ ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028945 Date 8/30/04 Property Address . . . . . . 200 5TH ST Tenant nbr, name . . . . . . RE-PIPE Application description . . . PLUMBING ONLY Property Zoning . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ RIPLEY, MARGARET STEEG PLUMBING CO. , INC. 200 5TH STREET 1601 MAIN ST ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 249-5191 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . RE-PIPE Permit Fee . . . . 133 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 133 . 00 133 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 133 . 00 133 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. C BL' G OFFICIAL Ft��D CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION � r Date.��y — Property Address: —— Telephone tt j Owner, ! Telephoned./.-� _ Contractor; ! Fax r#: � Contractor Address: � t vee for doing th11e work as described in the above stamen"we hereby egret to perform said work in �consideratiori of permi ci cations wroth am a part hereof and in acairdancc with the Cit, of Atlantic Bcaul, accordance with the attached plans and spa 5 j ordinaiicc and stutdards of good p raeo"listed therein• I lristellation of pltunbing and fixtures must be m aaordanw with the most rcant edition vi the outhem Standard Nlu B � Code. j I if other Construction is bcing done on this building or site. Plumbing Type: New i list the building permit number: O _— � � 1Zc-Pipe -•--•--- -... ` Number of Fixtures; ��Bath Tubs Showers Closets Shower Pans i � Sinks Dishwashers Urinals Disposals — Washing MaChlne Floor Drams --- — �� Water Lavatory Water Heaters Sewer Other s Fees FerWit Issuing Fee: 535.00 \%'f X $7.00 535.00 = Total Fixtures: _ 8 0 Seminole Road 11 it an c.,8�4Sac h t�dj v wv�stiaannttle beach.fl.us Phone: 1904)247-6800 • Fax: f CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 03-00027310 Date 12/12/03 Property Address . . . . . . 200 5TH ST Tenant nbr, name . . . . . . RE-ROOF, I5LB FELT, 30YR Application description . . . ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4370 Owner Contractor - - --- - - -- - - - - - - - - - - - - - - - - ------------- ---- ----- - RIPLEY, MARGARET SHORE ROOFING 200 5TH STREET 914 7TH AVENUE SOUTH ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 241-8842 --------------------------------- --- - - -- -- - -- --- - -- -- -- - - - - - -- - - - - - - - - - ----- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 83 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 4370 Fee summary Charged Paid Credited Due - ---- ---------- -- - -------- - ---------- - - - - - - - - - - - - - -- - - - -- Permit Fee Total 83 . 00 83 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 83 . 00 83 . 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. V O ICIAL " CITY OF ATL.LNTIC BEACH PER`iIT ..CALCULATION SHEET �.ddress �1�1 O S� �' • • D.ate Heated Square Fa•arage @ Her sq ft ..= $ -Ga rage/S.hed @ $ Per .sq .ft = .$ Carp art Parch $ il✓ Ber .s q ft .= Deck $ Her' sq ft = $ Patio @ $ mer : sc ft = $ r TOTAL VALUATION : S .Total Vai,u&ti.an lst $ tao� Rema?Hing Value $S per thousand or ;partich thereof TOTAL BUILDING FEE $ +._1/2 Fil.ing • Fee $ F.irep ia.ces . @ . $15'. OQ. . $, " .BUILDING. PERMIT FEE $_ WATER IML=A.CT ;FEE $ SEWER 'IMPACT.;.FEE $ WATER'METER•/TAP $ CAPITAL .IMPROVEMENT, :$ ..SEWER .TAP._ > $ ( ) •RADON. (HRS) . 0050: $ SECTION H PAVING HYDRAUL.IC ,SHARES $ CROSS CONNECTION $ SURCHARGE .00-90 . $ '.OTHER :$ Q 400 GRAND .TOTAL DBE $ �5 3• ADDITIONAL PERMITS OR .FEES :.,Mechanical Plumbing Electric/New Electric/Temp ;Swimmingpool Septic Tank Well Sign Finish Floor Elevation Survey other, CALCULATIONS and/ar NOTES CITY OF ATLANTIC BEACH cc. Ford. BUILDING / ZONING DEPARTMENT L. Higgins 800 Seminole Road —Doe Atlantic Beach,Florida 32233 (904)247-5800 �• (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # p,�, ;y rj' f(7 Property Address: 6?GO S'I" Applicant: �-Shc re Project: tC 1^F�n JC 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: JZ(lk3 CITY OF ATLANTIC BEACH � �� ROOFING PERMIT APPLICATION rJf3 �' e. Job Address: Owner of Property: 1 rt r � Address: �.i-' �' S r 1 Telephone: Contractor: Ll /1. /�� <<� iz.',c. State License Number: CC C 6 S.'-1 15/1 Contractor's Address: 7 "r° Ja 2/c- s z t L F i 5 l=/ 3 2 2 S" Telephone: -�y1 " � Fax: _ `/ 3 Scope of Work: de i7 u•�1= I S i��=, .�. ;� i�� I f 3 C, 'S Deck Slope: S. /L Greater than 2:12 ✓ Less than 2:12 Valuation of work: Product Name(Example:Timberline): 'Ii,'lM rU /�f•' �'�S Manufacturer(Example:GAF): —"�c:> ASTM Designation(s): t d t Required Inspections: Sheathing and Final Signature of Owner: Date: Signature of Contractor: r� Date: AS TO OWNER: Sworn to and subscribed before me this(� day of ,20 State lq,�ida.Qt1i 74RfDnu1 �,Y • HOLLY OZBURN Notary's Signature: .1.� Notary Public- Stats of Florida •_ Mycormftslon "�13,2006 Personally known Comrniselon S DD142145 produced identification Bonded By National Notary Assn. Type of identification produced AS TO CONTRACTOR: C Sworn to and subscribed before me this day of N G}Ll t'A j hf�_Il ,2003. State of Florida,County of Duval Notary's Signature: �- y -uw4 ti%GN lvwt;§N FH P"UN 01,tti1,aa r Uol*atwwoo Personally known on Int ON n*jX3 'J AN =' '_ ❑ Produced identification apNold 10 UM-2I?fnd IJ14ON ` N!lf18zo Ailom .� � Type of identification produced �`''�+M� 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.adantic-beach.fl.us Page 1 Revised 2/21/03 F- ► ljV:r sty CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 08-00000586 Date 6/12/08 Property Address . . . . . . 200 5TH ST Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 37724 ---------------------------------------------------------------------------- Application desc window replacement ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ RIPLEY, MARGARET FLORIDA GEORGIA CONTRACTORS 200 5TH STREET 11433 SAINTS ROAD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32246 (904) 641-7010 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit BUILDING PERMIT Additional desc . . Permit Fee . . . . 220 . 00 Plan Check Fee 110 . 00 Issue Date . . . . Valuation . . . . 37724 Expiration Date . . 12/09/08 ---------------------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 220 . 00 220 . 00 . 00 . 00 Plan Check Total 110 . 00 110 . 00 . 00 . 00 Grand Total 330 . 00 330 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PERMIT CITY OF ATLANTIC BEACH INC/ ZONING DEPARTMENT APPLICATION r� 000 Seminole Road /) _ a��/„ Atlaniia Beach,Florida 32233 U (�/ (904)247-59-00 (904)247-5845 Fax www.coab.u9 APPLICATION TRACKING FORM 4REQ6UIRqED DEPT: PLANNING Property Address: BUILDaNG PUBLIC WORKS Applicant: �j, � �r,2A�,�1 � Y N . PUBLIGUTILITIE5 Y N FIRE DEPT. Project: mu Y N PUBLIC SAFETY w •APPROVAL v NREQUIRED AGENCY: RECEIVED BY: INITIAL DATE Z D.E.P HUFSTETLER CD S.J.R.W.M. CARPER Lu i ARMY CORPS of ENG CAP,PO Nf3TELS RESAURANTS HUFSTETI-ER APPLICATION STATUS _ CIRCLE ONE: SITE BUILDf DA AP REVW IEED BY: INITIAL: DATE:p- ® 1ST REV ® � �� -!�3©per a • PLANNING ® ® 2ND REV :J31_JILDING PUBLIC WORKS PUBLIC UTILITIES FIRE DEPT. PUBLIC SAFETY ® ® 3RD REV CITY OF ATLANTIC BEACH JY r ., ► WINDOWS,SKYLIGHTS, GARAGE DOORS,HURRICANE SHUTTERS Ist'f.4w...l^ Date: Job Address: rmlo Owner: Address: oZ D d P Q Phone: 70l 7F' Legal Description: Block Number: •- Lot Number: _ Zoning District: n , Contractor. in o_ll24 State License Number: (� Address: 2 Phone: city- State: V + Ci ) S te: zip: Fax: Describe proposed use and work to be done: Present use of land or building(s): Valuation of proposed construction: ' 3 #7; 11A t4 . 60 Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application. Required Building Data: Mean Roof Height_ (ft) Building Width So (ft) Building Length (ft) Roof Slope Window Height ?J (ft) Window Width (it) Window Elevation from Grade S (ft) / Measurement from corner of building to window a'�_(ft) Number of windows being installed 3 9 �1t�QG{G� ��,-� Q tum j n uX4— Boof Height VI D FOR CODE COMPLIANC: LANTIC BEACH RE EE PEERMAT FOR ADDITIONAL IREMENTS AND CONDITIONS. REVIEWED By: DATE: -?O4-09 - 800 Seminole Road •Atlantic Beach,Florida 32233-5445 one: (904)247-5800 • Fax: (904)247-5845 httpa/wrvw.ci.atlantic-beach.ft.us Page 1 Revised 1/27103 ILE C01 t FPy SirBS-G-Ira-troB na 4oeag ox4uei7.0 3o Rit3 dub :20 So 61 08a proiat+ bpp r �a 1 MI® � MIAMI-DADS COUNTY,FLORIDA METRO-DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER STREET,SUITE 1603 PRODUCT CONTROL DIVISION MIAMI,FLORIDA 33130-1563 (305)375-2901 FAX(305)375-2908 NOTICE OF ACCEPTANCE (NOA) www.buldingcodeonline.com PGT Industries 1070 Technology Drive Nokomis,FL 34275 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials.The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA)to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below.The Miami-Dade County Product Control Division(In Miami Dade County)and/or the AHJ (in areas other than Miami Dade County)reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke,modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein,and has been designed to comply with the Florida Building Code,including the High Velocity Hurricane Zone. DESCRIPTION:Series SH-700 Aluminum Single Hung Window-L.M.I. APPROVAL DOCUMENT: Drawing No.4040-20,titled"Alum.Single Hung Window,Impact",sheets 1 through 11 of 11,dated 9/1/05,with revision B dated 11/13/06,prepared by manufacturer,signed and sealed by Robert L.Clark,P.E.,bearing the Miami-Dade County Product Control Approval stamp with the Notice of Acceptance number and approval date by the Miami-Dade County Product Control Division. MISSILE IMPACT RATING:Large and Small Missile Impact Resistant LABELING:Each unit shall bear a permanent label with the manufacturer's name or logo,city, state and following statement: Miami-Dade County Product Control Approved",unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any product,for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County,Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA#05-1018.01 and consists of this page 1 and evidence pages E-1,E-2 and E-3,as well as approval document mentioned above. The submitted documentation was reviewed by Manuel Perez,P.E. NOA No.07-0322.06 Expiration Date: March 23,2011 }�A1" 1 ...YytlyMpy, Ire.. v e Approval Date: June 07,2007 Page 1 i, FILE COPY " PGT Industries NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Manufacturer's die drawings and sections. 2. Drawing No 4040-20, Sheets 1 through 11 of 11,titled"Alum.Single Hung Window, Impact", dated 9/1/05, with revision B dated 11/13/06,prepared by manufacturer, signed and sealed by Robert L. Clark,P.E. B. TESTS 1. Test reports on 1)Air Infiltration Test,per FBC,TAS 202-94 2)Uniform Static Air Pressure Test,Loading per FBC TAS 202-94 3)Water Resistance Test,per FBC,TAS 202-94 4)Large Missile Impact Test per FBC,TAS 201-94 5)Cyclic Wind Pressure Loading per FBC,TAS 203-94 6)Forced Entry Test,per FBC 3603.2 (b) and TAS 202-94 along with marked-up drawings and installation diagram of an Aluminum Single Hung Window, with fin frame,prepared by Fenestration Testing Laboratory,Inc.,Test Report No.FTL-4957,dated 10/03/06, signed and sealed by Edmundo Largaespada, P.E. 2. Test reports on 1)Uniform Static Air Pressure Test, Loading per FBC,TAS 202-94 2)Large Missile Impact Test per FBC,TAS 201-94 3)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of an Aluminum Single Hung Window, with fin frame,prepared by Fenestration Testing Laboratory,Inc.,Test Report No. FTL-4958,dated 10/03/06, signed and sealed by Edmundo Largaespada, P.E. 3. Test reports on 1)Uniform Static Air Pressure Test, Loading per FBC,TAS 202-94 2)Large Missile Impact Test per FBC,TAS 201-94 3)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of an Aluminum Single flung Window,Impact,prepared by Fenestration Testing Laboratory,Inc.,Test Report No. FTL-5063, dated 11/21/06, signed and sealed by Edmundo Largaespada,P.E. 4. Test reports on 1)Large Missile Impact Test per FBC,TAS 201-94 2)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of Aluminum Single Hung Window,Impact,prepared by Fenestration Testing Laboratory,Test Report No. FTL- 4645, dated 08/11/05, signed and sealed by Edmundo Largaespada,P.E. (Submitted under previous NOA#05-1018.01) Manuel Per P. . Product Control Ex er NOA No.07-0322.06 Expiration Date: March 23,2011 Approval Date: June 07,2007 E-1 PGT Industries NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED 5. Test reports on 1) Air Infiltration Test,per FBC,TAS 202-94 2)Uniform Static Air Pressure Test,Loading per FBC TAS 202-94 3)Water Resistance Test,per FBC,TAS 202-94 4)Small Missile Impact Test per FBC,TAS 201-94 5)Cyclic Wind Pressure Loading per FBC,TAS 203-94 6)Forced Entry Test,per FBC 3603.2(b) and TAS 202-94 along with marked-up drawings and installation diagram of an Aluminum Single Hung Window,Impact,prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTL-4647,dated 08/11105,signed and sealed by Edmundo Largaespada,P.E. (.Submitted under previous NOA #05-1018.01) 6. Test reports on 1)Uniform Static Air Pressure Test,Loading per FBC,TAS 202-94 2)Large Missile Impact Test per FBC,TAS 201-94 3)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of an Aluminum Single Hung Window, Impact,prepared by Fenestration Testing Laboratory,Inc.,Test Report No. FTL-4648, dated 08/10/05, signed and sealed by Edmundo Largaespada,P.E. (Submitted under previous NDA#05-1018.01) 7. Test reports on 1)Large Missile Impact Test per FBC,TAS 201-94 2)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of Aluminum Single Hung Window,Impact,prepared by Fenestration Testing Laboratory,Test Report No. F TL- 4649,dated 08/11/05, signed and sealed by Edmundo Largaespada,P.E. (Submitted under previous NOA#05-1018.01) 8. Test reports on 1)Air Infiltration Test,per FBC,TAS 202-94 2)Uniform Static Air Pressure Test,Loading per FBC TAS 202-94 3)Water Resistance Test,per FBC,TAS 202-94 4)Small Missile Impact Test per FBC,TAS 201-94 5)Cyclic Wind Pressure Loading per FBC,TAS 203-94 6)Forced Entry Test,per FBC 3603.2(b) and TAS 202-94 along with marked-up drawings and installation diagram of an Aluminum Single Hung Window,Impact,prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTL-4650,dated 08/11/05,signed and sealed by Edmundo Largaespada, P.E. (Submitted under previous NOA#05-1018.01) 9. Test reports on 1)Large Missile Impact Test per FBC,TAS 201-94 2)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of Aluminum Single Hung Window,Impact,prepared by Fenestration Testing Laboratory,Test Report No.FTL- 4649,dated 08/11/05, signed and sealed by Edmundo Largaespada,P (Submitted under previous NOA#05-1018.01) Manuel Per , E. Product Control E a er NOA No.07 22.06 Expiration Date: March 23,2011 Approval Date: June 07,2007 E-2 PGT Industries NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED 10. Test reports on 1)Uniform Static Air Pressure Test,Loading per FBC,TAS 202-94 2)Large Missile Impact Test per FBC,TAS 201-94 3)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of an Aluminum Single Hung Window,Impact,prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTL-4646, dated 08/11/05, signed and sealed by Edmundo Largaespada,P.E. (Submitted underprevious NOA#05-1018.01) 11. Test reports on 1)Large Missile Impact Test per FBC,TAS 201-94 2) Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of Aluminum Single Hung Window,Impact, prepared by Fenestration Testing Laboratory,Test Report No.FTL- 4723, dated 10/05/05, signed and sealed by Edmundo Largaespada,P.E. (Submitted under previous NOA#05-1018.01) C. CALCULATIONS 1. Anchor Calculations and structural analysis,complying with FBC-2004,dated 12/18/06,prepared, signed and sealed by Robert L. Clark,P.E. Complies with ASTM E1300-02 D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office(BCCO). E. MATERIAL CERTIFICATIONS 1. Notice of Acceptance No.05-1208.02 issued to E.I. DuPont DeNemours for"DuPont Butacite®PVB"dated 01/05/06,expiring on 12/11/10. 2. Notice of Acceptance No.03-0827.08 issued to Solutia Inc. for their"Solutia Interlayer"dated 03/04/04,expiring on 03/04/09. F. STATEMENTS 1. Statement letter of conformance and no financial interest,dated 03/16/07, signed and sealed by Robert L. Clark,P.E. 2. Statement letter of code compliance,dated 10/12/05, signed and sealed by Robert L. Clark,P.E. G. OTHER 1. Notice of Acceptance No.05-1018.01,issued to PGT Industries for their Series SH- 700 Aluminum Single Hung Window—L.M.I.,approved on 03/23/06 and expiring on 03/23/11. anue1 P.E. Product Contr 1 Exa 'ner NOA No. - 22.06 Expiration Date: March 23,2011 Approval Date: June 07,2007 E-3 W _ N C)V MNWD1 W V� c n.� G W t W 0 i i V1 i i i °' Z W W N J: iNZZO ZD�ZUO1-UZI tw'J wN0 Q eg 0 J O Z,W w n r w s � u Q wz d �NpW O 0 zN mwwww' -Z0 Z w 5 w J w o Q x O z a I d< S O O D w>x a w U Q w LL o fa wF ¢ N a w Ua x p d w w D 5 `��` 5 w w N w g y r 4 LL N w¢ 7 N ¢ J L7 00. W O 6 ¢¢ p N w zx C9 % w p w o Z mm L7 .�. 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QQ ih N r Z Q 25 a! p _.._ o� 1 LLL d f WI U = J -.Eo W2 d Q OF Uc ® Q o O z o as ® z LO J8r5W pLL U�W ZOV p O -aZ ° a� 4W O- U en ® � = ZQ�j 1wLu z 0 Ci Lu �Z LLJ Lu WW Fc � a W n-0� �x �— Y 4a W W O ...•• U O > W H Uz Wiz` xw ow Z J m U 8pp ' 1 F Z z o Q e Q -� W n W o`^�p f'�"�•: Q I Q N U Q m M x Q 0 `yd Zm0 in O0Z Y 8W 8 ® Ci 03 MIAMI�OADE MIAMI-DARE COUNTY,FLORIDA a METRO-DARE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER STREET,SUITE 1603 PRODUCT CONTROL DTVISION MIAMI,FLORIDA 33130-1563 (305)375-2901 FAX(305)375-2908 _NOTICE OF ACCEPTANCE (NOA) www buldinQcodeonline-com PGT Industries 1070 Technology Drive Nokomis,FL 34275 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials.The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA)to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below.The Miami-Dade County Product Control Division(In Miami Dade County)and/or the AHJ(in areas other than Miami Dade County)reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner,the manufacturer will incur the expense of such testing and the AHJ may immediately revoke,modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein,and has been designed to comply with the Florida Building Code,including the High Velocity Hurricane Zone. DESCRIPTION: Series PW-701 Aluminum Fixed Window—L.M.I. APPROVAL DOCUMENT:Drawing No.4259-4,titled"Aluminum Picture Window,Impact",sheets 1 through 12 of 12,prepared by manufacturer,dated 7/14/03,with revision`B",dated 4/4/07,signed and sealed by Robert L.Clark,P.E.,bearing the Miami-Dade County Product Control Revision stamp with the Notice of Acceptance number and expiration date by the Miami-Dade County Product Control Division. MISSILE IMPACT RATING:Large and Small Missile Impact Resistant LABELING:Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and following statement: "Miami-Dade County Product Control Approved",unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product,for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT:The NOA number preceded by the words Miami-Dade County,Florida,and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA 0 03-1105.01 and consists of this page 1 and evidence pages E-1 and E-2,as well as approval document mentioned above. The submitted documentation was reviewed by Manuel Perez,P.E. NOA No.07-0418.06 Aft Expiration Date: February 19,2009 Approval Date: June 21,2007 Page 1 f FILE COPY PGT Industries NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Manufacturer's die drawings and sections. 2. Drawing No. 4259-4,titled"Aluminum Picture Window, Impact", sheets 1 through 12 of 12, prepared by manufacturer,dated 7/14/03, with revision`B", dated 4/4/07, signed and sealed by Robert L. Clark,P.E. B. TESTS 1. Test reports on 1)Uniform Static Air Pressure Test,Loading per FBC, TAS 202-94 2)Large Missile Impact Test per FBC, TAS 201-94 3)Cyclic Wind Pressure Loading per FBC, TAS 203-94 along with marked-up drawings and installation diagram of alum. fixed windows of different shapes, prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTL-3835, dated 07/18/03,signed and sealed by Joseph Chan,P.E. (Submitted under previous NOA#03-1105.01) 2. Test reports on 1)Air Infiltration Test,per FBC,TAS 202-94 2)Uniform Static Air Pressure Test,Loading per FBC, TAS 202-94 3)Water Resistance Test, per FBC, TAS 202-94 4)Large Missile Impact Test per FBC, TAS 201-94 5)Cyclic Wind Pressure Loading per FBC, TAS 203-94 along with marked-up drawings and installation diagram of an aluminum picture window, prepared by Fenestration Testing Laboratory, Inc., Test Report No. FTL- 3850, dated 07/31/03, signed and sealed by Joseph Chan,P.E. (Submitted under previous NOA#03-1145.01) C. CALCULATIONS 1. Anchor verification calculations and structural analysis, complying with FBC-2004, prepared by manufacturer,dated 4/13/07, signed and sealed by Robert L. Clark,P.E. Complies with ASTM E1300-02 D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office(BCCO). E. MATERIAL CERTIFICATIONS 1. Notice of Acceptance No. 02-0828.15 issued to E.I. DuPont DeNemours for"DuPont Butacite PVB Material" dated 11/21/02, expiring on 12/11/05. 2. Notice of Acceptance No.01-0205.02issued to Solutia,Inc.for"Saflex/Keepsafe Maximum" dated 5/17/01, expiring on 5/21/06. Manuel P rex, .E. Product Control iner NOA No.07-0418.06 Expiration Date: February 19 2009 Approval Date: June 21,2007 E-1 PGT Industries NOTICE OF ACCEPTANCE. EVIDENCE SUBMIT'T'ED F. STATEMENTS 1. Statement letter of conformance,dated April 13,2007, signed and sealed by Robert L. Clark,P.E. 2. Statement letter of no financial interest,dated April 13,2007, signed and sealed by Robert L. Clark,P.E. G. OTHER 1. Notice of Acceptance No. 03-1105.01,issued to PGT Industries for their Series"PW- 701"Aluminum Picture Window-LNU, approved on 02/19/04 and expiring on 02/19/09. 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O O O O O O O O 00 480HONV C6 C = �z 3 w b n o in b o to o b , ZU Z_ : O 9 `rte° m o^o m zQ LLLL fV j P � MIAMFIaAL�E MIAM-DADE COUNTY,FLORIDA METRO-DARE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER STREET,SUITE 1603 PRODUCT CONTROL DIVISION MIAMI,FLORIDA 33130-1563 NOTICE OF ACCEPTANCE (NOA) www.buildinecodeonliae.com PGT Industries,Inc. 1070 Technology Drive Nokomis,FL 34275 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials.The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA)to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below.The Miami-Dade County Product Control Division(In Miami Dade County)and/or the AHJ(in areas other than Miami Dade County)reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AM may immediately revoke,modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein,and has been designed to comply with the Florida Building Code,including the High Velocity Hurricane Zone. DESCRIPTION:Series"SGD-730"Aluminum Sliding Glass Doors—L.M.I. APPROVAL DOCUMENT:Drawing No.4406-1,titled"Alum. Sliding Glassboor,Impact",sheets 1 through 17 of 17,dated 4/15/05 with revision E dated 4/12/06,prepared by manufacturer,signed and sealed by Lucas Andrew Turner,P.E.,bearing the Miami-Dade County Product Control Revision stamp with the Notice of Acceptance number and expiration date by the Miami-Dade County Product Control Division. M1SSII.E IMPACT RATING:Large and Small Missile Impact Resistant LABELING:Each unit shall bear a permanent label with the manuf tc;urees name or logo,city,state and following statement: "Miami-Dade County Product Control Approved",unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the perfoumance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product,for sales,advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA#OS-0526.05 and consists of this page 1 and evidence pages E-1,E-2 and E-3,as well as approval document mentioned above. The submitted documentation was reviewed by Manuel Perez,P.E. NOA No 06-0523.03 Expiration Date: November 11,2009 =F Approval Date: August 3,2006 �ePage I d ik4 Fri E Cap n PGT Industries.Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED A. DRAWINGS 1. Manufacturer's die drawings and sections. 2. Drawing No 4406-1, Sheets 1 through 17 of 17,titled"Alum. Sliding Glass Door, Impact", prepared by manufacturer,dated 4/15/05 with revision E dated 4/12/06, signed and sealed by Lucas Andrew Turner,P.E. B. TESTS 1. Test reports on 1) Uniform Static Air Pressure Test, Loading per FBC, TAS 202-94 2)Large Missile impact Test per FBC,TAS 201-94 3)Cyclic Wind Pressure Loading per FBC, TAS 203-94 along with marked-up drawings and installation diagram of aluminum sliding glass door, prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTI, 4454, dated 01/31/05, signed and sealed by Edmundo Largaespada,P.E. (Submitted under NOA # 04-0622.02) 2. Test reports on 1)Air Infiltration Test, per FBC, TAS 202-94 2)Uniform Static Air Pressure Test, Loading per FBC,TAS 202-94 3)Water Resistance Test, per FBC, TAS 202-94 4)Large Missile Impact Test per FBC, TAS 201-94 5) Cyclic Wind Pressure Loading per FBC, TAS 203-94 6)Forced Entry Test, per FBC 2411 3.2.1 (b)and TAS 202-94 along with marked-up drawings and installation diagram of aluminum sliding glass door, prepared by Fenestration Testing Laboratory,Inc., Test Report No.FT1.4524, dated 01/31/05, signed and sealed by Edmundo Largaespada, P.E. (Submitted under NOA #04-0622.07) 3. Test reports on 1)Air Infiltration Test, per FBC, TAS 202-94 2)Uniform Static Air Pressure Test,Loading per FBC,TAS 202-94 3)Water Resistance Test,per FBC, TAS 202-94 4)Large Missile Impact Test per FBC, TAS 201-94 5)Cyclic Wind Pressure Loading per FBC,TAS 203-94 6)Forced Entry Test, per FBC 2411 3.2.1 (b)and TAS 202-94 along with marked-up drawings and installation diagram of an aluminum sliding glass door, prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTI-4159, dated 03/25/04, signed and sealed by Edmundo Largespada,PE. (Submitted under NOA#04-0622.07) manuel Pe .E. Product Control E am er NOA No 0 .03 Expiration Date: November 11,2009 Approval Date: August 3,2006 E-1 PGT Industries,Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBMITTED 4. Test reports on 1)Air Infiltration Test, per FBC,TAS 202-94 2)Uniform Static Air Pressure Test,Loading per FBC, TAS 202-94 3)Water Resistance Test, per FBC, TAS 202-94 4)Large Missile Impact Test per FBC, TAS 201-94 5)Cyclic Wind Pressure Loading per FBC, TAS 203-94 6)Forced Entry Test,per FBC 2411 3.2.1 (b)and TAS 202-94 along with marked-up drawings and installation diagram of an aluminum sliding glass door, prepared by Fenestration Testing Laboratory, Inc.,Test Report No. FTL-4161, dated 03/26/04, signed and sealed by Edmundo Largespada,P.E. (Submitted under NOA#04-0622.07) 5. Test reports on 1)Large Missile Impact Test per FBC,TAS 201-94 2)Cyclic Wind Pressure Loading per FBC,TAS 203-94 along with marked-up drawings and installation diagram of an aluminum sliding glass door, prepared by Fenestration Testing Laboratory,Inc.,Test Report No. FTL-4163, dated 03/25/04, signed and sealed by Edmundo Largespada, P.E. (Submitted under NOA#04-0622.07) C. CALCULATIONS 1. Anchor Calculations and structural analysis, complying with FBC-2004, prepared by manufacturer, dated 5/12/06, signed and sealed by Lucas A. Turner,P.E. Complies with ASTM E1300-98/02 2. Anchor Calculations, and structural analysis,dated 05/23/05,and last revised on 07/22/05, prepared, signed and sealed by Lucas A. Turner, P.E., 3. Anchor Calculations and structural analysis, complying with FBC-2004, prepared by PGT Engineering, dated 06/17/04, signed and sealed by Lucas A. Turner, P.E. (Submitted under NOA #0¢0622.07) 4. Revised Anchor Calculations, and structural analysis, prepared by PGT Engineering, dated 10/08/04, signed and sealed by Lucas A- Turner, P.E. (Submitted under NOA # 04-0622.07) D. QUALITY ASSURANCE 1. Miami Dade Building Code Compliance Office(BCCO). Manuel Perez,P. Product Control ' e NOA No 23 Expiration Date: November 11, 009 Approval Date: August 3,2006 E-2 PGT Industries,Inc. NOTICE OF ACCEPTANCE: EVIDENCE SUBNHTTED E. MATERLAL CERTIFICATIONS 1. Notice of Acceptance No. 01-1204.01 issued to E.I. DuPont DeNemours, for"Sentry Glass®Plus" dated 1/17/02,expiring on 1/14/07 2. Notice of Acceptance No. 01-0205.02 issued to Solutia, Inc. for"Saflex/Keepsafe Maximum" dated 05/17/01,expiring on 05/21/06. 3. Notice of Acceptance No. 00-1212.04, issued to E.I.DuPont DeNemours for their "DuPont Butacite®PVB", approved on 02/15/01 and expiring on 12/11/05. F. STATEMENTS 1. Statement letters of conformance and"No financial interest",both dated 05/23/05, signed and sealed by Lucas A. Turner,P.E. G. OTHER 1. Notice of Acceptance No. 05-0526.05,issued to PGT Industries, Inc. for their Seriers "SGD-730 Aluminum Sliding Glass Door, approved"on 08/25/05 and expiring on 11/11/09. 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RESIDENTIAL SINGLE FAMILY Application valuation . . . . 0 --------------------------------------------- Application desc DEMO INTERIOR WALLS/REAR WALL & ROOF -------------------------------------------------- Owner Contractor - ------------------------ ----------------------- DENAZARIE, WAYNE WINWARD CONSTRUCTION INC. 2485-6 MONUMENT RD. 1015 ATLANTIC BLVD STE 130 JACKSONVILLE FL 32211 ATLANTIC BEACH FL 32233 (904) 838-4619 -------------------------------------------------------- Permit . . . . . . DEMOLITION PERMIT Additional desc . . Permit Fee . . . 100 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/15/08 --------------------------------------------------------------- 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 0 OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILD]NG-DEPT@COAB.US BUILDING PERMIT APPLICATION OUVAL COUNTY s Aa f„ z. 1i1 UA flgN t7F w�3RKc 3 ss; T I , /_ 3 / u // jf ❑NEW BUILDING DEMOLITION ui6 LOTdBLOCK b SUB DIVISION f�c /t ❑ADDITION CONVERTING USE ❑ALTERATION ❑ACCESSORY BLDG.❑REPAIR ❑POOL/SP A ❑YES ❑N/A d_6/054G♦ AUYZil MOVE ❑OTHER Ile"7 N 9 NAME: 15.COMPANY NAME: 23 COMPANY NAME ,,/ 16.NAME: !� ` 24.LICENSEE NAME: G� c.ct�`.t / c/.c+ VU/i _IJ 10.ADDRESS: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 18.ADDRESS: 26.ADDRESS: 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20,FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 05 13. 13.CELL PHONE 21.CE L PHONE: 29.CELL PHONE: /Z- 915/- -1S3 oq 6"? 5,��1 14 EMAIL ADDRESS / 22 EMAIL ADDRESS: 30 EMIL ADDRESS Wi('�</1A r� ( �✓ �c3^�CL�T e� GJnI` Ci[J t(3�f/�ICl4' COMS VC! o.-� Gv� �` a`F H Bf3if1Dlt1 Ct71 " Y 7 � 1* � 31.NAME 33.NAME: 35.NAME: 32.ADDRES 34.ADDRESS: 36.A S 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 RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. r, ' NF err1"�' 1 , ie ;a � J4 Of Ag h Ot tC kK ert jr,�Httdr a krad) Sig d' �..Date: � Signed Date: !�- Before m s ay of 20 in the county of Before me this day of tist-C 20 the county of Duval,State of Florida,has pers ally appeared Duval ate o da, bas rs ally appeared AQ!Q 1 W T,eq herin by himself/herself and affirms that all statements and declarations herin by himself/herself and affirms that all statements and declaration true and accurate. true and accurate. ARp 9r nn Notary Public at Large,State f ry Public at Large, ofP NN N ISSIO bf �A MY C N iISSlO � Personally Known ,� 1dlRGA M Personally Known s �� .�. t:XP 'LC3':: pril l 1,2010 F_hLM ,S((4N#DD536835 ❑Produced Identification• rt,kss«, roduced Identification � ,i T Notary Signature: Notary Signature: COAB FORM BLDG01:REVISED:1/10/2008 CITY OF ATLANTIC BEACH S 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 `r��J3iJf" Application Number . . . . . 03-00027325 Date 12/02/03 Property Address . . . . . . 200 5TH ST Tenant nbr, name . . . . . . 200AMP, 1PH, 3W, 240VOLT, PVC Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ RIPLEY, MARGARET AMERICAN ELECTRICAL CTR 200 5TH STREET 5065 ST.AUGUSTINE RD #3 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32207 (904) 737-7770 --------------------------------------------------- - -- --- ---- ------- -------- Permit . . . . . . ELECTFTCAL 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 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 12/02/2003 12:29 9047371099 AMERICAN ELECTRICAL PAGE 01 S@p 22 03 02: S1p Information Systems 247-5845 P. 1 CI'T'Y OF ATLANTIC BEACH, FLORIDA fl , ELECTRICAL PERMIT APPLICATION TO THE CHIEF ELECTIUCAL INSMCTC& DATE: _.2D II4ORTAW NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THY,, WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH TIC- ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS,CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELECTRICAL CONTRACTOR: MASTER ELECTRICIANS SIGNATURE: r' �'� OWNER OF PROPERTY: I TZ_ 308 AI�dItESS' f h ,�T1T�l=T RESV) APT.( ) COMM.( ) PUBLIC( ) INDUS.( ) NEW( ) OLD( ) REw.( ) ADDITION( ) TRAILER( ) TF•W-( ) SIGNS( ) SQ,FT. SERVICE: NEW( INCREASE PAIK CONDUCTOR SIZE AMPS: COPPER ALUMI .FEES SWITCH OR BREAKER AMPS I'N W VOLT RACEWAY EXIST.SERV.SIZE �qj� nM�5 PH w oLT RACEWAY FEEDERS N0, SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED I OPEN TOTAL RFrEPTACLES CONCEALED OPEN T,OTA.L 0,30AMM 31.100 AWS SWITCBES INCANDESCENT FL O URESC.ENT do M.V. FIXED o.10o wnsPs. I OVER APPLIANCES BELL TRANSF. A 17t KP.RATING H.P.RATING CEIL. KW-HEAT CONDITIONING COMP.MOTOR OTHER MOTORS AMPS MAT 0-1 OVER MOTORS H.P. VOLTAGE PIIS N0, 1 H.P. VOLTAGE PHS MISCELLANEOUS %1 UNDER 6001V IOYER dooV TRANSFORMERS: NO. KVA NO. KVA Pi .NE N TRANSF. NO VA I M� MQTQRSIZ$ I SWITCH F ASIIERS EACH SIGN 800 Seminole Road•Atlantic Beach,Florida 32233.5445 Phone:(904)247-5800• Fax: (904)247-5845• httpa/www.eLsttlectio-boseh.D.us Aey"WM/I�M1 4 c4 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD y ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 z Jai Application Number . . . . . 03-00027187 Date 11/06/03 Property Address . . . . . . 200 5TH ST Tenant nbr, name . . . . . . OVER FRAME OPEN DECK Application description . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation 12400 Owner Contractor - --- --------------------- ----------------------- RIPLEY, MARGARET KENDALE, INC . 200 5TH STREET 4501 BEVERLY AVENUE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32210 (904) 384-8611 ----- ------------- ------------------------------------ Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . 95 . 00 Plan Check Fee 47 . 50 Issue Date . . . . Valuation . . . 12400 Fee summary Charged Paid Credited Due ------- - --------- ---------- ------- - -- -- --- - ---- ------ Permit Fee Total 95 . 00 95 . 00 . 00 . 00 Plan Check Total 47 . 50 47 . 50 . 00 . 00 Grand Total 142 . 50 142 . 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 D. F BUILDING / ZONING DEPARTMENT oer 800 Seminole Road Atlantic Beach,Florida 32233 may; (904)247-5800 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # O 3 . 67 Property Address: 2 o c� 5 :IN:;F- Applicant: D^C NC Project: E Opz:� iV r L- This permit application has been: 1�' Approved ❑ Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: 1 Date: r City of Atlantic Beach 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 FAX (904)247-5805 • http://www/ci.atlantic-beach.fl.us BUILDING PERMIT APPLICATION FOR SINGLE-FAMILY OR TWO-FAMILY (DUPLEX) CONSTRUCTION (INCLUDING NEW CONSTRUCTION, REMODEL, ADDITIONS AND ALTERATIONS, MOVING OR DEMOLITION) DATE to— a 4 —o? JOB ADDRESS a-oo APPLICANT Dr . rA P_ t C- ADDRESS a-O AO F` S♦. -4-�p�✓�`f1 C� B+ mcg i PHONE: A L4( — a-1 LEGAL DESCRIPTION: BLOCK NUMBER a3 LOT NUMBER (o ZONING DISTRICT CONTRACTOR CrS p/ KP.r da l Q-, ( Vt G• STATE LICENSE NUMBER CG c o 415 S as ADDRESS 1+6701 1Qe l er LA A J -•- PHONE 3;94+—'3U (1 CITY Uo..c�V_9OV1\M(& STATE V-t- ZIP 3aat0 FAX 4 CH'L C_ Yy L.t: 2 z-c - 21 l.-c; DESCRIBE PROPOSED USE AND WORK TO BE DONE ¢.r+-rag06 CkP_Gk- rooF 15N„1 o+M is PRESENT USE OF LAND OR BUILDING(S) VALUATION OF PROPOSED CONSTRUCTION �• t 1 o O Is this an addition? V\O If yes,what are the dimensions of the added space: feet by feet Will the added area be heated and cooled? VSO New electrical or increase in service? V\O New plumbing fixtures? r\.o New fireplace? V\d New heating/air conditioning? V\O Is approval or Homeowner's Association or other private entity required? Y\0 If yes,please sul mit with this application. WILL THIS PROJECT INVOLVE CHANGES IN ELEVATION, SITE GRADE OR ANY USE OF FILL MATE AL? 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. PROCEDURE: (In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.) 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 904-247-5817. 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 6/18/02 ur Please submit Ener Code Forms,Notice of Commencement,Owner/Contractor Affidavit if owner is contractor,and e'R(4> Atlantic (f STEP 3. ete P1 Energy sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Semt Beach,FL 32233 Telephone: (904)247-5826 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. Existing and/or proposed driveways. 4. If required by the Department of Public Works,a pre-construction topographical survey. 5. Any significant efivironmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 6. Impervious Surface area calculations. (Swimming pools may be excluded from total Impervious Surface.) 7. Other information as may be appropriate for individual applications. I HEREBY CERTIFY THAT ALL INFORMA I N PROVIDED WITH THIS APPLICATION IS CORRECT. SIGNATURE OF OWNER DATE /`P ` 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 AND CORRECT AND THAT THE PLANS AND SUPPORTING DATA HAVE BEEN OR SHALL BE PROVIDED AS REQUIRED. SIGNATURE OF CONTRACTOR DATE A ADDRESS AND CONTACT INORMATIO OF PERSON TO RECEIVE ALL CORRESPONDENCE REGARDING THIS APPLICATION (PLEASE PRINT) NAME C�Ne>r0_"'Vn MAILING ADDRESS 450 t t r ¢lPHONE 3$14Lp t FA3 - E-MAIL 4- 10 ra`un SWORN AND SUBSCRIBED BEFORE ME THIS c)� � DAY OF 06�p f 'e r -t 2-o 0 3 STATE OF FLORIDA,COUNTY OF DUVAL NOTARY'S SIGNATURE �� AS TO OWNER: (Personally knownfir" LORI MARIE PREv�i'iT El Produced identification MY COMMISSION#CC 94W56 Type of identification produced '� OF P 1.8043NOTARY FL Wxy SeMce&Bonding,Inc. AS TO CONTRACTOR: [Personally known ❑ Produced identification Type of identification produced 6/18/02 "tWY�+Aedu�cd. d'. City of Atlantic Beach 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904) 247-5800 FAX (904)247-5805 • http://www/ei.atlantic-beach.fl.us BUILDING PERMIT APPLICATION FOR SINGLE-FAMILY OR TWO-FAMILY (DUPLEX) CONSTRUCTION (INCLUDING NEW CONSTRUCTION, REMODEL, ADDITIONS AND ALTERATIONS, MOVING OR DEMOLITION) DATE (,O- a 4 —O? JOB ADDRESS *_oO 6'w' S+ A+I ck^4v 6 ea ch APPLICANT br .. IM2-A—P-t-D It ADDRESS 0-0 AO S+. o t o v-✓ U Be_MCll PHONE: -14 a g LEGAL DESCRIPTION: BLOCK NUMBER a 3 LOT NUMBER Cp ZONING DISTRICT CONTRACTOR -ba R_ Cr'S p / KP.r da l ( ✓t G• STATE LICENSE NUMBER CG G 04 S5 aD-- ADDRESS 1+6701 AeW t?r-( n A-"-- PHONE 3$1--8 It (I CITY_UAc-�SOVIJW& STATE PG _ ZIP FAX 3H—7cP 4 co ZZ c - 2-9 G 5- DESCRIBE PROPOSED USE AND WORK TO BE DONE UIQ -+-ra iM e, O e—el deGk- ('00� PRESENT USE OF LAND OR BUILDING(S) VALUATION OF PROPOSED CONSTRUCTION i , o O Is this an addition? 1^O If yes, what are tl•.e dimensions of the added space: feet by feet Will the added area be heated and cooled? t^o New electrical or increase in service? ill New plumbing fixtures? Y\.O New fireplace? V\O New heating/air conditioning? V`1,0 Is approval or Homeowner's Association or other private entity required? h O If yes,please submit with this application. WILL THIS PROJECT INVOLVE CHANGES IN ELEVATION, SITE GRADE OR ANY USE OF FILL MATENO. A 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. PROCEDURE: (In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.) 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 904-247-5817. 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 6/18/02