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333 5th St (vault) PERMIT WORKSHEET Certificate of Occupancy Job Address: �5 3 Z) 57--44 ST. Type Work: Property Owner: k'u Cv L-L- ' �ATT Phone # s-74 -+�-t - Contractor: Phone # Permit#: QL4 + 2g z8 Date Issued: —T - u_04 Building Inspections: Footing {6 Ge/ Slab Tie Beam Lintel Nailing / Sheathing 12 Framing / Cover Up -p -oS Insulation 2-/S-DS Final Building '::5 11 I=S Tree Permit# (-- —� YES NO Electrical Permit# 0�' � '$ -VZg Date/ Copy JEtA Temp, Pole Permit# 574 =- Temp. �q 3 5 Date/ CopjEtAo Power Letter Received: YES NO Inspections: Rough Electric Released to JEA Temp, Power Released to JEA Temp. Pole 30- O Released to JEA 0 Final Released to JEA 10 Mechanical Permit# Inspections: Rough Final Plumbing Permit# - Inspections: Rough/ Underslab S! b L4 /- Topout Water/ Sewer final s Drainage Inspection: Pool Permit# — Inspections: Steel Final Grounding Final Roofing Permit# �;r� — Inspections: Nailing / Sheathing �Z - -a5! Final �— Fire Inspection: Failed Inspections: Date Paid: Date Paid: ,1'`1:t' CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 r� Application Number . . . . . 09-00001261 Date 9/17/09 Property Address . . . . . . 333 STH ST Application type description WELL PERMIT Property Zoning . . . . . . . RESIDENTIAL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc NEW WELL ---------------------------------------------------------------------------- Owner Contractor BRYANT, ALLAN WILLIAMS WELL DRILLING INC 333 5TH ST P. O. BOX 330567 ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241-8489 ---------------------------------------------------------------------------- Permit . . . . . . WELL PERMIT Additional desc . . Permit Fee . . . . 55 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/16/10 -------------------------------------------------- -------------------------- Special Notes and Comments A reduced pressure zone backflow preventer must be installed on customer' s side of City water service if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities . ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 55 . 00 55 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 55 . 00 55 . 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 SEP ® 0 2009 APPLICATION NUMBER �S } Building Department (To be assigned by the Building Department.) 800 Seminole Road BY: 9• �G- lQ j Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 OR �r E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Department review required Yes No J /f Building Applicant: /��/ ��l �`rYLS ��� �r�// ��9 Planning &Zoning T— Tree Administrator Project: Pu ublic Utif ty Fire Services i Other Agency Review or Permit Required Review or Receipt Dateof Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: JAP LICATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewedb C l�✓" Date: �`� -�✓ Y TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PUB I WO KS Comments: PUBL- T I IES PUBL AFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 g`J.Vj - SS1 CITY OF ATLANTIC BEACH WELL PERIVHT APPLICATION Datedc( Owner's Name: (Le ti 3 t- ef— Address: Well Address(if different than above): Well Location on Property (i.e. northeast corner, etc.) X6 A T& Well Installation Contractor:Wl/T /,�(A 4'(t-2- Contractor .c Contractor License No.: I Phone: Contractor Address: pZS32 2 Check Use of Well: Domestic Irrigation /' Other Estimated-Well Depth: b f Casing Depth: Screen Screen Interval from/Ltol,`a Well Diameter: Casing Material . Is address currently connected to the City water system? _ Is address currently connected to the City sewer system? ICIIC' Has a Well Permit been obtained from the City of Jacksonville? Al b Permit# Does the well require a permit from the St. Johns River Water Management District? (Not required for wells under 2-inches diameter installed by resident or wells under 6- inches diameter if installed by licensed well contractor).— .1)-() , �-_ If permit is required,note Permit Number. _ and attach a copy. NOTE: WHENA WELL IS INSTALLED ON YOUR PROPERTY, YOU1lMUST INSTALL A REDUCED PRESSURE ZONE TYPE BACKFLOW PREVENTER ON THE CITY WATER SERVICE, ON THE CUSTOMER'S SIDE OF THE METER. THE BACKFLOW PREVENTER MUST BE TESTED BYA CERTIFIED TESTER AND A COPY OF THE RESULTS SENT TO THE PUBLIC UTILITIES DEPARTMENT. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 09-00001375 Date 11/05/09 Property Address . . . . . . 333 5TH ST Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . RESIDENTIAL SINGLE FAMILY Application valuation . . . . 35000 ---------------------------------------------------------------------------- Application desc ADDITION CARPORT AND SHED ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BRYANT, ALLAN RBC HOMES, LLC 333 5TH ST LARRY RICE ATLANTIC BEACH FL 32233 12 PONTE VEDRA CIRCLE PONTE VEDRA BCH FL 32082 (904) 591-0360 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc ADD SUBFEED/PUMP CIR/WIRE CARP Sub Contractor BILL THOMPSON ELECTRIC CO, INC Permit Fee . . . . 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/04/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 90 . 00 90 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 07- I I I I I 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 t� OFFICE:(904)247-5826•FAX NO.:(904)247-5645 BUILDING-DEPT@COAB.US ELECTRICAL PERMIT APPLICATION DUVAL COUNTY i.JOB ADDRESS: s 2r i8''THIS ASLIB PERMITi>. slay... _,..N..,3.DATE 33 -z ��. ,• / OY S PERMIT#: Atlantic Beach FL 32233 PROPERTY OWNER :. :,•,,. _ 4.NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE: ;ELECTRICAL:CONT.RACT.OR.. ME, 7.NAME ITMP S.ADDRESS.:. to 10.CELL PHONE: /1 FAX�" 9.STATE OF FLORIDA LICENSENO: 12.EMAIL ADDRESS' ` _y13.OFFICE PHONE: 14. `L(wf Lzr✓� - I 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 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 is commenced. CONTRACTORS SIGNATURE: 17s ::16.CLASS OF WORK: . ❑MULTI FAMILY-#OF UNITS ESIDENTIAL ❑SINGLE FAMILY ❑TEMP SERVICE ❑COMMERCIAL 18.BUILDING:.- 19.CURRENT,CODE. ADDITION ❑TRAILOR -= ❑ALTERATION ❑SIGN BOLD ❑NEW ' 5 NATIONAL ELECTRICAL CODE ❑REPAIR ❑POOL/SPA ❑REWIRE ❑OTHER: n,m r . .. .. s. UST ►41 20.TYPE OF SERVICE: ❑OVERHEAD ❑UNDERGROUND ❑ UNDERGROUND UP POLE 21.NEW SERVICE: CONDUCTORS PER PHASE: ❑POWER IS ON E3 POWER IS OFF 22.SIZE OF CONDUCTOR: AMPICITY: ❑COPPER ❑ALUMINUM 23.SWITCH OR BREAKER SIZE: AMPS: PH: W: VOLT: RACEWAY SIZE: 24.EXISTING SERVICE SIZE: AMPS:2CL:L PH: _ W: VOLT:- RACEWAY SIZE: 25.FEEDERS: #OF AMPS: Q #OF AMPS: #OF AMPS: 26.LIGHTING FIXTURES: INCANDESCENT: _ FLUORESCENT A M.V-: 27.FIXED APPLIANCES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS: 28.FIRE ALARM: ❑YES ❑NO 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 _32.AIR CON,QITIONINGzi-f du r. '. # #OF UNITS: COMP.MOTOR HP RATING: AMPS: HEAT KW: #OF UNITS: COMP.MOTOR HP RATING: AMPS: HEAT KW: i33I MOTORS: NUMBER:�_ VOLTAGE: HP: Z _ KVA: NUMBER VOLTAGE HP: KVA =TRANS FORMERS,. = UNDER 60OV: NUMBER: KVA: OVER 60OV: NUMBER: KVA: M ELANEOUS REPAIRS DESCRIBE IN DETAIL: j U © h P tf.YN GC`I�i 3 �(/✓i^e 11�dl/ �Ck C- to �- Q �J-QG-e �rtc COAG F RM BLDG02:REVISED:8/13r2007 ��• s�, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 +� INSPECTION PHONE LINE 247-5826 Application Number . . . . . 09-00001375 Date 10/15/09 Property Address . . . . . . 333 5TH ST Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . RESIDENTIAL SINGLE FAMILY Application valuation . . . . 35000 ---------------------------------------------------------------------------- Application desc ADDITION CARPORT AND SHED ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BRYANT, ALLAN RBC HOMES, LLC 333 5TH ST LARRY RICE ATLANTIC BEACH FL 32233 12 PONTE VEDRA CIRCLE PONTE VEDRA BCH FL 32082 (904) 591-0360 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 205 . 00 Plan Check Fee 102 . 50 Issue Date . . . . Valuation . . . . 35000 Expiration Date . . 4/13/10 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2007 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE . *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. --------------------------------------------------------------------------- Other Fees . . . . . . . . . CITY RADON SURCHARGE . 16 ST CONSTRUCTION SURCHARGE 2 . 92 AB CONSTRUCTION SURCHARGE . 32 DEV REVIEW-SINGLE & 2-FAM 50 . 00 STATE RADON SURCHARGE 3 . 08 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 205 . 00 205 . 00 . 00 . 00 Plan Check Total 102 . 50 102 . 50 . 00 . 00 Other Fee Total 56 .48 56 .48 . 00 . 00 Grand Total 363 . 98 363 . 98 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. rte, CITY OF ATLANTIC BEACH 09— I I I I I fi 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 r y OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPTOCOAB.US F, ;0 BUILDING PERMIT APPLICATION DUVAL COUNTY JOBADDRESS: " "- „ "- "• 21:VALUATION OF, RK .,' ' 3.SQ.FT UNDER ROOF 35,o 00 (SSD St 4.LEGAL DESCRIPTION: 5 CLASS OF:WORK', •., fi.U$E;DF STRUCTURE:-• '' ❑NEW BUILDING ❑DEMOLITION 'RESIDENTIAL LOT 14 BLOCK SUB DIVISION 21 ADDITION ❑CONVERTING USE ❑COMMERCIAL DESCRIPTION OF WORK., ❑ALTERATION ❑ACCESSORY BLDG. 8.FIRE SPRINKLER:,•: r_ ❑REPAIR ❑POOL/SPA ❑YES ❑WA Gar a r-1' T 5d ❑MOVE ❑OTHER NO PROPERTY OWNER., C0NTRA C OR ,'-: ARCHITECT/ENGINEER.: NAME: 15.COMPANY NAME: 29.COMPANY NWIE_ 16.NAME: 24.LICENSEE NAME ' r RR 1 CE ,fir 4 . /r►u. ®ADDRE S: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF F ORIDA LICENSE NO.: 333 5 ` cZ c.a 3R Soo? 4,1010 18.ADDRESS: t? 1Y0 n-,2'V Q.L. c r� 26.ADDRW' `j j j 7 �✓���R H,� �'f. P�cN f-L, P V g F1 .7Z 0 j 2_ Ca C ST ` 31-0 Y3 Q OFFICE PHONE: FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: HA NAZED—aZDy 2.x'0 02a 28q -Ij4- 2s ��F3 Q.CELL PHON : 21.CEL PHONE: H 1 E:_ 0 29.CELL PHONF' _�_33 q 37_d�7 1• O cl V EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: r i9S3 0 .mak b rnurrwyr aA FEE SIMPLE,TITLE HOLDER BONDING COMPANY:` ,.,.....�AVt�tNDER.f" (IF OmiFJt'11'IAtJ OWNFJ2) _ ''.i. . , . NAME: 1••1 f 33.NAME: NAME: "A ADDRESS: L• 34.ADDRESS: .ADDRESS: !^ Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation 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 It jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspende4=1t abandoned for a period of six(6) months at any time after work is commenced. I understand that separate permits must be secured f `' Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc. f OWNER'S AFFIDAVIT-I certify that all the foregoing information is accurate and that all work will be done in compliance with all applic laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof,until all inspections are finaled It prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law. rw WARNING TO OWNER: * W 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 COMMENCEM P NE IrAGENT; CONTRACTOR Agent,Po r Attomey or etter Required) (Qdalfier Only) Ok 10 Z Stgn ^�� te: Signed: Date: 0— t� Before m is2 day of v` ` _,2009 the unty of Before me this day of e i 2009 in the o f Lia Duval,State of Florida,has personally appeared Duval,Statef Fp Ion a,has persona peared © U O d el U herin by himself/herself and affirms that all statements and declarations are herin by himself/herself 4d affirms that all statements and declarati s A true and accurate. t\ true and accurate. lo Notary Public at Large,State of �\c" County of V�tO"" Notary Public at La tate of ,County of w 4D ❑Personally ❑ rsonally Known ef, d Identfi ❑Produced I ntification- Notary Signature: Notary Signature: r.r sy tie)oN IeuolleN ,(g v io r+ Q ££59LS aQ#uolsslw , P%"'NDONNA G.HAMBY OIOZ'Vi,ga j sai&3 UolsslW W03 Avyi - (.� rs`y .: MY COMMISSION#DD 783649 eppol j 10 OIL -Dpgnd tie10N BLDG01 Permit Application Bldg ( % , 8120�PIRES:AU9USt 29,2012 , < Bonded Tru Notary Public Undenvdte, WdHV2K) 'l A3121IHS "` W i Seth Meyer Job#: J-09-0361 File#: Salesman: Seth Meyer si Designer: James Bratcher Manning Building Supplies „r;,, Job; Jacksonville,Florida 32256 jaxtruss@mbs-corp.com AliIv, Phone:(904)268-8225 ' Fax:(904)260-2981 Date: 10!2/2009 Bryant Resd Del_ Date: Lot14& 16 Atlantic Beach - -- ___— _______— ___.— Atlantic Beach FL ( Cover Sheet r -- --- ---- ---- --�Truss Level 1. A pmun Panne of - Ono[n®Ineemn Pmduab,Ina Wooffruss Qty Span Description Fitch OHL TC Size Truss O/A Height Weight TC/BC OHR BC Size Ext.Weight 2 22-04-00 T1 4.00/0 00-00-00 2x4 04-11-00 119.0 LB 00-00-00 2x4 238.0 LB 10 22-04-00 T2 4.0010 02-00-00 2x4 05-02-11 120.4 LB 02-00-00 2x4 ��� 1204.0 LB 2 08-00-00 T3 7.00/0 00-00-00 2x4 00-00-00 0.0 LB 00-00-00 2x40.0 LB 4 08-00-00 T4 7/0 02-00-00 2x4 00-00-00 0.0 LB 02-00-00 2x4 -��, 0.0 LB Trusses: 18 Hangers: 0 Jacks. 0 Beams: 0 Piggy Backs; 0 I-Joist: 0 Total Trusses in Package: 18 Rim Board: 0 HomeBASE by Alpine Engineered Products,Inc. Page 1 Of 1 bo H ;.-1 FM— ENC TI-.:..PACKAGE NC`� 1 CGir7 tff_5 YlITIi TIE D=S=`''-!d*a TENT APPLIED i sJ�� T0';Fi!SPROJECT u�G.6 — ��r� IG C> 61 O N Zl Q to U Ll ,.b.ZZ _ . uildin ©mP.., exxts.Gr4u an 0, i4lirley.Drive"Maineg City,'FL..33844 .. . F?tor�sia agin g COrtificate OtAWWriZiiio Tiscnb�rnr: $ Fkar% a Certia�m*tff dut t Ag tbv # :1 �9 .. 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U oc oue�c '3 cic va utaE W Z w _..�a�EP �✓ � �5 ovE..T o °'qE�a cdiw�� U > L z oPc aeu S z m a7 � mq�eo dm �\�5om U U C E„ y0 d�p * � zap �e Q m c� 17 o o� s± }r City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department) 800 Seminole Road y Atlantic Beach, Florida 32233-5445 r �� Phone(904)247-5826 • Fax(904)247-5845 E-mail building-dept@coab.usDate routed: o City web-site: W://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 23_; 7- ent review required Ye No Applicant: -V'a of 5 L L annin &Zonin ministrator Project: < �/� lic works is Utilities is fety Fire Services Review fee:$ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept of Environmental Protection Florida Dept of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other. APPUCATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle ane.) Comments: BUILDING PLANNING&ZONING Reviewed by: Date:/0 9'd 9' TREE ADMIN. Second Review: []Approved as revised. ❑D nied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned b the Building Department.) F sd 9 Y 9 s� 800 Seminole Road ti Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: a City web-site: http://www.coab.us ff APPLICATION REVIEW AND TRACKING FORM Property Address: .33_; �-7-Al 7- D ant review required Yes No uil ' Applicant: L L. fanning&Zoning ministrator Project: < �/if lic works 1C Utilities fety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept of Environmental Protection Florida Dept of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLISAtION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: Date: Ad TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14109 r1 CITY OF ATLANTIC BEACH qQ_ " i 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 OFFICE(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPT®COAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY .1 32SO FT..UNDER)?ODF � � ,,, f _. 35,000 -- 150 Sl 1. 4:LEGAt DESCRIPTION; S.:CLASS,OFyyORlG ,.r,r ,.,.:: B=USE,OFSTRUOTURE ti. ❑NEW BUILDING ❑DEMOLITION 'RESIDENTIAL LOT BLOCK 7 SUB DIVISION lI ADDITION ❑CONVERTING USE ❑COMMERCIAL 7s'OESCRIPPOIV OF WORK k a ❑ALTERATION ❑ACCESSORY BLDG. 8,FIRE;$PRINKLER . /• dr Q C T 5 1�td ❑REPAIR ❑POOL/SPA ❑YES ❑N/A l•/ ❑MOVE ❑OTHER NO >;,. 'r .,,• ..r PROP..ERTY OWNER i+ . ..,{ ,: CONTRACTOR ''."ti ` r .y,,:(. ! . rARCHfTECT I ENGINEER. ; NAME: 15.COMPANY NAME 23.COMPANY NnRAE: � N T o s ` ��rr-ter,, 16.NAME 24.LICENSE— E NA I r RR ' cE 8���. 4 �►u ®ADDRE S: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 333 5� S'(tZ 'C' CiZ �.0 39 s OS GY o 1 o_ ` 18.ADDRESS (<'Z �O nJC 26.ADDRES j`-� ���n N"f .j4' "`1.l�tN'C'� L PSGµ �1... P1r.� F'! �z d�Z Ci 5', -, 3�n Y3 (lJ OFFICE PHONE: FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: tJlk NA ?_,a0--0Z_0q o 020 �y� �7:�� ZSY 75 3 Q.CELL PHON : 21.CELL PHONE: 29.CELL PHONF- Z- 0 — 4 59k - 5-31" o 1 EMAIL ADDRESS: 22 EMAIL ADDRESS 30 EMAIL.4DDRESS: r 19 S-3 o_ ' kfr H¢z FEE}SIo7HLER7HANOWNER_ )DER f s�f j 3 _ BONDING COTL MPANY + F 1 i r i n aAtat LtNDER"I a..,}_• ®:NAME: 33.NAME: II NAME WA ADDRESS: 34.ADDRESS: 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 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. ,a s WNE r i4GENT: CONTRACTORS F ' Agent;P r Attomey''o�" ette�Required).`_ , ' }(QUalifier Only) Sign te: Signed: T Date•/0^ S--OGf Before m is aJ day of u` 2009 n the unty of Before me this day of_ e i 2009 in the county of Duval,State of Florida,has personally appeared Duval,State f Flo. a,has persona peared herin by himself/herself and affirms that all statements and declarations are herin by himself/herself ind affirms that all statements and declarations are true and accurate. `\ true and accurate. Notary Public at Large,State of ,County of �?���1 Notary Public at La tate of ,County of ❑ rsonallyKnown `/h (`�\� ❑Personally Vroduced Identifi i 1 V 1i� ❑Produced I ntfication- Notary Signature: Not Signature: ssV tieloN leuolleN dg toy 01 1:E991S no#uoissiw +ate, ./ ;., DONNA G.HAMBY OIOZ'6l qac sandx3 uolsslluwo0 FW'.+� *�� +: k MY COMMISSION#DD 783649 r ' BLDG01 Permit Application Bldg % , 8/20WIRES:August 29,2012 eP�ol�!o alel3 oilgnd tieloN `o?; p v$• Bonded-.hru Notary Public Underwriters WbHVaJ 'l A31211HS NOTICE OF COMMENCEMENT (PREPARE IN PLICATE) Permit No. Tax Folio No. State of County of Al."C i To whom it may concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following Information Is stated In this NOTICE OF COMMENCEMENT. Legal description of property being improved: Lof 14 j- 16 � ��oc,�- -7 - A+I c� 4,L Address of property being improved: S General description of improvements:Add Com-1)a, - c"t-G( S LI Owner. Address- Owner's dd Owner's interest in sate of the improvement Fee�3im Iliitlehoider(if other than owner) •-Narrle— Address- Contractor -6 L Address i 2.. V-c e,;, Ci r j 190 f:-'l -22,c42- Phone 2i ZPhone No._ 9 D L/ Fax No. Surety(If any) Adder Amount of frond$ Phone No. Fax No. Name and address of any person maldng a loan for the construction of the improvements. Name Address Phone No. I I Fax No. Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option). Name ' Address Phone No. Fax No. Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date Is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER ----— — --——---------— — rr+ i th Before e this � day of e has Florida, a! apPg v DOC#2009249302,OR BK 15037 Page 21721, Duval.Sta f �ne 11 Number Pages:1 himset©hersetf and affirms that al statements and declarations herein a`{q?�}G'••, Recorded 10/15/2009 at 10:53 AM, are an rate ' ' JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY 4 A " RECORDING$10.00 9Fs• AV,, y Notary Public at Large,State of .-County of My commission expires: 9 9 Personally Known Or ry Produced Identification CITY OF ATLANTIC BEACH �# 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 "1 Application Number . . . . . 09-00001376 Date 10/15/09 Property Address . . . . . . 333 5TH ST Application type description RIGHT-OF-WAY PERMIT Property Zoning . . . . . . . RESIDENTIAL SINGLE FAMILY Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc DRIVEWAY AND PARKING ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BRYANT, ALLAN RBC HOMES, LLC 333 5TH ST LARRY RICE ATLANTIC BEACH FL 32233 12 PONTE VEDRA CIRCLE PONTE VEDRA BCH FL 32082 (904) 591-0360 ---------------------------------------------------------------------------- Permit DRIVEWAY PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/13/10 ---------------------------------------------------------------------------- Special Notes and Comments Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible . A sewer cleanout must be installed at the property line . Cleanout must be covered with an RT1 concrete box with metal lid. Cleanout to be set to grade and visible . ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 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 APPLICATION NUMBER JSS� Building Departments w (To be.assigned by the Budding Department):m: v 800 Seminole Road Atlantic Beach, Florida 32233- 4�, 1�,>• "` 4�/ Phone(904)247-5826 Fax(90 -5845 "- E-mail: building-dept@coab.us �� Date routed = City web-site: http://www.coab.us APPLICATION REVIEW TRACKING FORM Property Address: 13337;" SDepartment review required Yes No �y LGC Building 4pplicant: B Planning &Zoning Tre strator Project: kri'dPublic Works Public Utilities a ety Fire Services "P 6pp —^ ^ 1 , .. a^r•-Pa'Y' k P� 0. .^.'."ta evlewF#ee$ � � rI� ir1i v pe t C's�'mmPnbo 3srr ai y1„�ASL � �u �y?i AT e..r ...:.t .....ue...P�x�.�.wimn:at - Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: OApproved. [-]Denied. (Circle one.) Comments: BUILDING Ell PLANNING &ZONING Fluviemof�. Date: AY,7-0? TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PU C WKS Comments: B IC I PUBL SAFETY Reviewed by: Date: FIRE SERVICES Third RevieApproved as revised. ❑Denied. CornmentsTIL cop Y Reviewed by: Date: Revised 05/14/09 t c r, CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND-EASEMENTS saw �. 800 Seminole Road 904247-5800 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Date /d �� PERMIT# 3 3 3 S 0 L C ISSUED BY THE CIT`! Job Address 'T Permitee: r Telephone# Permittee Address: /� :�.,L 1� �.� %t �l� �202- Requesting Requesting Permission to Construct: i /`t VV_ tAAQ_4 ��� Or'v� Location: .(Reference to Cross-Street) W.Q S T ('� CO&A I 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes( ) No Date: Bell South Telephone Company yes( ) No ( � Date: Ferrell Gas Yes( ) No (� Date: Comcast Yes( ) No ( ) Date: 2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement-as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida epartment of Transportation Standards and be performed under the supervision of 42/r-" 11 Lt� (Contractor's Project Superintendent) located at A C l rtelephone* 5ci/-A3 G o 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. S. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit. Calculations showing any Increase in impervious area on owner's lot or in the city Right of Way are to be included with this application. 7. This permittee shall commence actual construction In good faith with 5 days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon corppletion. OWNER AAS a,,, gig �- �� �f' ,^%? Dater 2es��` ew,da /qF�S�/pNH�fa� Before m this day of the oun of Du al, " z y ego9�s DDfB3 State Of Florida,has personally appeared `� ��'^� tiaG9,2p�2649 Notary Public at Large,State of F orida,County of Duval. °e^Yd�es My co m.ssio i 5 res, -a� 0 1 a Personally Known: Produced Identification: R.O.W. Permit Attachment of for R.O.W.Permit# issued , 200_ Atlantic Beach,FL 32233 Owner's Name: Property Address: Subdivision: Lot#/Block#: R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of , 200_, by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as "CITY" and of Atlantic Beach,Florida,hereinafter referred to as"USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above (copies attached). This work is generally described as: Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to USER shall be given by certified mail, return receipt requested, to the following address: The depositing of said notice of cancellation in the United States mail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code, and all other land use and code requirements of the CITY, including City Code Section 19-7 (h) which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." Page 1 of 2 The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach, Public Works Department, for said change. The USER shall, at the discretion of the CITY, be requested to submit as-built drawings showing the change within thirty(3 0) days after the day of completion. This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use limitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harnlless by the USER from any of the work herein under the terns of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this �_fl _day of , 200 By. y4pe O her (to be signed in prese e o£the Not ry) STATE OF FLORIDA COUNTY OF DUVAL On this 7?k�y day of d J�� 200 personally appe d be ^N me, a Notary Public in and for aid County and State, fav\�"'� �n �, eDproperty owner of " 3 5A/1 c ��,z , Atlantic Beach, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she 7c,uted the same freely and voluntarily and for the uses and purposes therein mentioned. YDONNA G.HAMSY MY COMMISSION#DD 763649 a€ EXPIRES:August 29,2012 Notary Public in for said County and Stat' R 6ondad Thru Notary Public Underwriters low 1 CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: Ricky L. Carper,Public Works Director For Permits where city sidewalk is impacted, City Manager approval required: Jim Hanson, City Manager Page 2 of 2 City of Atlantic*Beach �? . APPLICATION NUMBER Building Department `' � ,� (To be assigned by the Building Department.) tf 800 Seminole Road Atlantic Beach, Florida 32233-544 fJ !y� Phone(904)247-5826 Fax(90 ,5845 G ©�� Date routed: E-mail: building-dept@coab.us �` .� City web-site: http://www.coab.us APPLICATION REVIEW ANIS` ACKING FORM Property Address: 133 pw Department review required Yes No Building Applicant: D C• ��s Planning &Zoning Tr . . trator Project: Public Works Public Utilities aety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. [Denied. j (Circle one.) Comments: �,� BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: pproved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES ��%J ,> PUBLIC SAFETY Reviewed by~ \_,_ Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 Public Works Plan Review Comments Date: Ol I Initials: _ 10 Project Name/Address: 3 3 3 S Application Permit —137 G Application Wracking-Comments ;toric flm7tieut, Provide impervious surface calculations. ❑ Provide erosion and sediment control plans with installation details and maintenance ❑ schedule. Provide drainage plans showing site topography(flow arrows, etc.) ❑ Provide construction site management plan,including Right-of-VJay Permit if using 0 right-of-way for construction parking. Provide a pre-construction topographic survey prepared by a Florida Licensed ❑ Professional-Land Surveyor, showing 1' contours. Section 24-66(b) of the Land Development Regulations requires on-site storage for increased runoff. Provide Delta volume calculations and on-site retention required ❑ per Section 24-66(b). (See attached info. Sheet) If on-site storage is required, apost construction topographic survey documenting ❑ proper construction will be required. A Right-of-Way Permit must be obtained for use 0 A Revocable Encroachment Permit must be obtained. ❑ Pool—Wellpoint(if used)must discharge into vegetated area 1,0' minimum from ❑ street or drainage feature(swale, structure or lag)on). All concrete driveway aprons must be 5 inches thick,4000 psi,with fibermesh from OOF the edge of the pavement to the property line. Reinforcing rods or mesh are not allowed in the ROW(Commercial driveways—6"thick). Any utility cuts in the road must be repaired using COJ Standard Detail Case X and must be overlaid 10 feet in each direction.from the center of the cut. Repair must be ❑ shown on the laps. P -Roll off container company must be on City approved list and cannot be placed �- on City right-of-way. ❑ _ 0 TRANSMISSION VERIFICATION REPORT TIME 10107/2009 14:53 NAME ATLCBEACH CITY WORKS FAX 9042475843 TEL 9042475843 SER.# BROL7J723782 DATE DIME 10107 14:53 FAX NO. /NAME 92800204 DURATION 00:00:52 PAGE(S) 02 RESULT OK MODE STANDARD ECM CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS i_ 800 Seminole Road 904-247-5800 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 VAI PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Date ��"� PERMIT# Job Address 3-33 33 S D c ISSUED BY THE CITY Pemtitee: Telephone# Permittee Address: /�_ �,,� l�-cG�� C�►U %t �/ �� �24�2- 11� iiC✓ Requesting Permission to Construct: ly'c.- '�nl I as-� v� Location: (Reference to Cross-Street) Q S� l� C00,3+ OSI 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes( ) No Date: Bell South Telephone Company Yes( ) No ( 1 Date: Ferrell Gas Yes( ) No ( L Date: Comcast Yes ( ) No O Date: 2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida epartment of Transportation Standards and be performed under the supervision of a ,,u.. (Contractor's Project Superintendent) located at C r Telephone# 5W-Q 6 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. 6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in impervious area on owner's lot or in the city Right of Way are to be included with this application• 7. This permittee shall commence actual construction in good faith with 5-q days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon corppletion. OWNER41 V� .o` My Sig i Date: 2 Before this day of the un�l of Du al, �,���q�g� 008 State Of Florida,has personally apApeared do `� g<ya r, arya ?9, Notary Public at Large,State of F ride,County of Duval. Personally Known:My A io Q ` ..a9-a o Produced Identification: Y"v 1 t R.O.W. Permit Attachment of for R.O.W. Permit# issued , 200_ Atlantic Beach, FL 32233 Owner's Name: Property Address: Subdivision: Lot#/Block#: R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of , 200_, by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as "CITY" and of Atlantic Beach, Florida,hereinafter referred to as"USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above (copies attached). This work is generally described as: Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to USER shall be given by certified mail, return receipt requested, to the following address: The depositing of said notice of cancellation in the United States snail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code, and all other land use and code requirements of the CITY, including City Code Section 19-7 (h) which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." Page 1 of 2 10/0712009 14:55 9042475843 ATLCBEACH CITY WORKS PAGE 01104 5'. City of Atlantic Beach APPLICATION NUMBER uilding Depa Building Department (To be assigned by.tli�Brtment)_ ¢ 800 Seminole Road (�' ho Atlantic Beach, Florida 32233-544 c� a�j 4a Phone(904)247-8826 Fax(9 x$45 -4, t j' �s►ti v E-mail: building-dept@coeb.us � -;; 4 Date r6'bt d: - } to City web-site: http:thvww.coab.us APPLICATION REVIEW AN ACKING FORM Properly Address: 1M .5"N Si- DeELartment review required— Yes No Building Applicant: l�iS Planning &Zoning Tr trator Project. I P Work Public Utilities ety Fire Services 1901 L R Other Agency Review or Permit Required Review or Receipt pate of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: QApproved. IDenied. (Circle one.) Comments: ^'� e BUILDING PLANNING &ZONING (r� Reviewed by: Date: 1019 TREE ADMIN, Second Review: Approved as revised. ❑Denied. PUBLIC WORKS Comments: / PUBLIC UTILITIES i PUBLIC SAFETY Reviewed by: , Date: FIRE SERVICES Third Review: ❑Approved as revised, ❑Denied. Comments: Reviewed by: Date: :, t9vlaed 05114109 City of Atlantic Beach ,,.. �, ' ��ti APPLICATION NUMBER J~ Building Department ' 1, �• (To be assigned by the Building Department) 800 Seminole Road r� Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5 845\ . E-mail: building-dept@wab.us Date routed: a City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 25_; �_7721 J-r D-opartnxent review required Yes No uil Applicant: /y� L tannin &Zonin ministrator Project: c �/�f� lic works is Utilities is fety Fire Services Review fee$ _ __Dept Signature _ Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ElApproved. Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: Date: TREE ADMIN. Second Review: A roved as revised. pp ❑Denied. PUBLIC WORKS Comments: CM 1`115" PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: OApproved as revised. ODenied. Comments: Reviewed by: Date: Revised 05114109 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Cgs. � Atlantic Beach, Florida 32233-5445 — I -), -2 Phone(904)247-5826 • Fax(904)247-5845 _ E-mail: building-dept@coab.us Date routed: C> " City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address. 3 3 �` `� Department review required Yes No (� Building Applicant: - Planning&Zoning p Tree r Project: es Public Safety Fire Services Review fee$ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other. APPLICATION STATUS Reviewing Department First Review: ElApproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: Date: TREE ADMIN. Second Review: []Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05H4I09 CITY OF ATLANTIC BEACH Ay I_._..,_.I I-.._._..L.. ..,I 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 0�+ OFFICE(904)247-5828•FAX NO.:(904)247-5845 a BUILDING-DEPTQCOAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY 1',1.,`JOBADDRESS ? 1r ,z. r z[ 2 VAL`'U�4T1Qy0FWORK .. 33SQ Ff'UNDERROO �_ �.,:::, 3S1000 6570 2V r: 4';LEGAt:-DESCRIPTION Q� 4„5f`' �.:; a-,-..,�. ,..,F_..'-f .� �, �'{ ,:�'gCLAS$.0��:�NQRK���'��'.,��,x„ :':"� ... .:.';,. ,� ..,: FU STRUCTURE" ❑NEW BUILDING ❑DEMOLITION 1WRESIDENTIAL LOT K, BLOCK -7 SUBDIVISION I1 ADDITION ❑CONVERTING USE ❑COMMERCIAL . TIB'FR -SPINKLE.RDESCRFTION OFWORK ;t„ , ❑ALTERA . Car- 11 REPAIR ❑POOL/SPA 11 YES E3 N/Aa .. .,...; U ❑MOVE ❑OTHER NO x tkt, sr •?PROPERTY OWNER :' d CONTRAG_OR 'h..a T:e.rr. ..r:;'„ ,�.:: . ,'. ARCHfTEET I ENGINEER:. „= NAME 15.COMPANY NAME 23.COMPANY NAME: ALLAN T- O -5 %-^, ✓'-aV n ep 16.NAME: 24.LICENS— E- E NAME: ®ADDRE S: 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 333 5 SWOC �Z �-� 3q !!;OS / o o_ 18.ADDRESS: �'Z Ve<A,-6 C,r- 26.ADDRES "I T Pva F1 gz ajZ `U , e� S; -340 Y3 OFFICE PHONE: FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: tVlac NA —o Zoe{ 0 020 �:� =17:,�� 7—SY 75 j (3 CELL PHON : 21.CELL PHONE: 29.CELL PHONF- z- o - s91 - 53 (110 33q--32-Jl'7 EMAIL ADDRESS: 22 EMAIL ADDRESS 30 EMAIL ADDRESS r' 19r-3 0-Q4, .�-..k b lvwurr�y� a�� c d,V ks1 .FEESIMPLE TITLE HOLDER 1 r WNWn v �A(at LtNDER ���,i�4 x ,. PF.orHetzwwoWntF ` , BONDING COMPANY+i a t 4, y {z a . 0 NAME cG Lf 33.NAME: IID NAME: ADDRESS: 34.ADDRESS: .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 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 WNE r AGENT CONTRACTOR Agent;Po r Attorney or e`'tte Reqwred) ;;(Qual fier Only) _, Sign Signed: Date:�0^ <�`� Before m iSN day of C��2009,lnthe unty of Before me this day of CTS 2009 in the county of Duval,State of Florida,has personally appeared p Duval,State f Flon a,has persona peared herin by himself/herself and affirms that all statements and declarations are herin by himself/herself ind affirms that all statements and declarations are true and accurate. ` true and accurate. Notary Public at Large,State of `� County of l�J� Notary Public at La tate of _,County of ❑ rsonally Known NUJ 47) ❑Persons lly Vroduced Identifica i i 1 1r�� 13 Produced 1 ntificafion- Notary Signature: Notary Signature: =qaj ogeN (g apuo „ ii do' DO uolSslw '16� 3uolsslwwo06y,)_'.« =.: . MY COMMISSION#DD 783649 BLDG01 Permit Application Bldg: `w2o&PIRES:August 29,2012 -ollgnd lveloCorded-.hru Notary Pablic UndenOters A31MIHS ° ; ` CITY OF ATLANTIC BEACH 800 SEMINULE ROAD J� ATLANTIC BEACH,FLORIDA 32233-5455 TELEPHONE: (904)247-5800 FAX: (904)247-5805 SUNCOM: 852-5800 www.coahus May 26, 2009 Mr. Matthew F. Kilcullen Jr. 333 5tn St Atlantic Beach, FL 32233-5345 Subject:Atlantic Beach City Code,Chapter 20,Sec 20-51 Business Definitions. Dear Mr. Kilcullen, Duval County Tax records identify you as the owner of the following property in the City of Atlantic Beach, Florida: A/K/A: 333 5t" St Legal Desc: 05-69 Atlantic Beach Lots 14, 16 Blk 7 Mary Jo O/R Bk 7138-2358 RE# 169862-0000 The purpose of this is correspondence is to serve as an Official Notification of Violation. You have been identified as being in violation of several City Ordinances related to the business of selling vegetables from your garden. While you can give away your produce, you cannot use a residential property as a place of business other than its use as a home office. Additionally, you are also forbidden from selling the produce from a stand, wagon, parked vehicle, container, pushcart or tent upon any street, public property.or vacant private property within the City Limits. To eliminate any undo hardship I am granting you 3 days from receipt of this notification to cease selling and advertising of your produce from your residential property. Furthermore I would remind you of your responsibilities as a homeowner to abide by the regulations of the city, county and state, and that non-compliance can result in fines of up to $500.00-per day, per violation from the Code Enforcement Board. Should you have any questions or concerns involving this matter, you can contact Code Enforcement at(904) 247-5855, Zoning at(904)247-5826, City Clerk- Business License Information (904) 247-5809. ALEXANDER J. SHERRER Code Enforcement Officer C: Assistant City Manager 1 x Zoning Dept , City ClerkA J14q V& yle�f r p e" btu Ve,qgM /e '1 CITY OF ATLANTIC BEACH ' 800 SEMINOLE ROAD 'AA ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 -s Application Number . . . . . 06-00032656 Date 4/05/06 Property Address . . . . . . 333 5TH ST Tenant nbr, name . . . . . . DRIVEWAY Application description . . . RIGHT OF WAY PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ----------- ------------- KILCULLEN, MARYJO/MATT OWNER 333 STH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . DRIVEWAY PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AN BUILDING CODES. BUILDING OFFICIAL CITY OF ATLANTIC BEACH '.` PUBLIC UTILITIES DEPARTMENT ion 1200 Sandpiper Lane J > Atlantic Beach,Florida 32233 (90)247-5834 (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # & - -? 2- (o Property Address: 33 s2j� 7- Applicant: !, /C, �I n Project: r I Ve' tO Your application is approved as noted by the Llic Utilities Department. Final application approval must come from the Building Department. ❑ Your permit application has been reviewed by the Public Utilities Department and the following items need attention: - sr Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. if you have any questions,please call (904) 247-5834. 7ix= ublic Utilities Director Date Signature Contractor Notified Date M a- It' y& CITY OF ATLANTIC BEACH Cc. BUILDING /ZONING DEPARTMENT L. Fords r� 800 Seminole Road . Doerr ` Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # a 4 - Property Address: .33 3 Applicant: I& Project: A This 7Approved it application has been: F-� Reviewed and the following items need attention: Please re-submit yo ap ation when these items have been completed. Reviewed By: G � Date: 7 Date Contractor Notified: CITY OF ATLANTIC BEACH CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AAD EASEMENTS % 800 Seminole Road 904-247-5800 l Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUB IT(3) OMPLETE SETS OF PIANS WITH APPLICATION. Date PERMIr# Job Address—, 3 A ISSUED BY THE CITY �' Permitee: �� -—, 'G � 'N) �j�_ Telephone# Permittee Address: Requesting Permission to Construct na /' Location: (Reference to Cross-Street) 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches_ A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes( ) No I Date: Bell South Telephone Company Yes( ) No Date: Ferrell Gas Yes( } No Date: Comcast Yes( ) No Date: 2. Whenever necessary far the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized . hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shail meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of (Contractor's Project Superintendent)located at Telephone#: _r'--1 U 7-'7 4. All materials and equipment shaff be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. ;:. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit, Calculations showing any increase in impervious area on owner's lot or in th. 2k Riaht of Way are to be inciuded with this arxnllcation. 7. This permittee shall commence actual construction in good faith with days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. 0VWNER .C7t f Signed: Date: Before me this 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: Personally Known: Produced Identification: T 'd SbBS-LJra-t►06 r1H yoeag 3tquet'4d Jo R4T3 es0 :01 so so ueW R.O.W. Permit Attachment of for R.O.W. Permit# issued 12005 �Atlantic Beach,FL 32233 Owner's Name: r rr�rr V -LS C l�;0 Property Address: Subdivision: Lot#/Block#: R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of , 2005, by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as"CITY"and of Atlantic Beach,Florida,hereinafter referred to as"USER'. WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above(copies attached). This work is generally describ as: i ZZ Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty (30)days notice by CITY to the USER, said notice to USER shall be given b certified mail, ret rerleipt requested, to the following address: ,-2.3.3 C;47 �1 The depositing of said notice of cancellation in the United States mail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code,and all other land use and code requirements of the CITY. The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach, Public Works Department, for said change. The Page I of 2 z'd S*9s_L*a_*o6 nH 4oeaa a?luv14LI Jo AIT3 es0 :01 90 90 Jew Mar 06 06 10: 05a City of Rtlantic Beach Bu 904-247-5845 P.3 USER shall,at the discretion of the CITY, be requested to submit as-built drawings showing the change within thirty(30)days after the day of completion. This permit shall inure to the benefit of, and be binding upon, the USFR and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use limitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this---�day of 05. CITY OF ATLANTIC BEACH,FLORIDA, By: a municipal corporation: Pro n By: Jim Hanson, City Manager Attest: Rick Carper,Public Works Director STATE OF FLORIDA COUNTY OF DUVAL Sr On this day of4A C 2005, personally appeared before me, a Notary Public i� n and r laid County and State, the property owner of Atlantic Beach, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the uses and purposes therein mentioned. L 9, By: y Public in for sai unty and State Pro rtv Uwne (to signed in resence of the Notary) Notety Pubis-stele a FWAb '•jMy Com Eton Expires Feb 14,2010 Commission 4 DD 518533 �'or r4Qo�'' Bonded By National Notary Assn. Page 2 of 2 MAP SHO WING BOUNDARY SURVEY OF LOTS 14, >6 ,BLOCK 7 , SUBD/VIS/ON'A",A TLANTIC BEACH AS RECORDED/N PLA T BOOK 5 ,PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA LEGEND/ABBREVIATIONS X--X = CHAIN LINK FENCE CIL = CENTERLINE O---O = WOOD FENCE FND = FOUND IP = IRON PIPE BRL = BUILDING RESTRICTION LINE RB = REBAR NO-ID = NO IDENTIFICA TION PC = POINT OF CURVATURE A = CENTRAL ANGLE PT = POINTOFTANGENCY R = RADIUS R/W = RIGHT OF IVAY A = ARCLENGTH POC = POINT ON CURVE Al = NOT TO SCALE (A) = ACTUAL P = PLAT O � \ryg1 3 �i?ON LINE (/��v ON LINE i LOT 17 g20 v LOT 15 ao LOT 7J Q�yo p, 1.J' LOT 11 ,ellGRAIN 100.00E 0 6' -1 2'PN' ° 1.2' 'J OJ' 0.8' .00' — — I _ _ — 50.00' 20' -r,, / 1.J' LINE ''b o 2.J' FENCE ON PORT. 2.0'77E CONCRETE POOL EOUIP. PAO $• � of SHED ° ❑ Q P O 0 I ° LOT 20 ❑ h WOOD DECK : `! ' ° Cj 2.0' ..M1, O ON LINE 110 ❑ \ ' ° 11.5 I o /�„�/ 0.6' �i O N I I Qj n JIO 7J 0 0 \ Q 0 m Q Q1-STORY MASONRY b I� ` J &FRAMED �T 12, BLOCK 7 fESIDENC£/JJJ o I o 0. 3XJ AC-PAG O v� 121 O 1Q 1 a 4.8' — 4.9 ryo 00 I \Q $ .rx;; 2 0' ON LINE $• JO0.00 TO EAST COAST OR 4' 0.4' 50.00'0. 0.4' 100.00 ° a, J FIFTH STREET RECHECKED AND RECERIIFTED 7-11-200J TO SHOW POOL IMPROVEMENTS (40' RIGHT OF WA Y) 1N4RV R.BANKS I HEREBYCERTIFY TO: MATTHEW 8 MARYJO KILCULLEN nrrn►�r• nn rarr. r...-.-r.,........,..-.,..���.,�.,�.............'�.......,... ..___........,. .,,..__ CITY OF ATLANTIC BEACH Vi}s} PUBLIC WORKS DEPARTMENT �'o n 1'r) 1200 Sandpiper Lane 011/v Atlantic Beach,Florida 32233 / (904)247-5834 (904)247-5843 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # - 2� Property Address: 3 �rx Applicant: Project: r I=the ;:�� Your application is approved as noted tment. Final application approval must come from the Building Department. ❑ your permit application has been reviewed by the Public Works Department and the following items need attention: City sidewalk must remain as is (concrete - smooth) . Owner told by phone Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. if you have any questions,please call(904)247-5834. Reviewe y arper;P.E.,Public Works Director Date Signature Contractor Notified Date /V I Ql6d l& CITY OF ATLANTIC BEACH � CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AAD EASEMENTS 800 Seminole Road 904-247-5800 Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PLEASE SUB IT(3) OMPLETE SETS OF PLANS WITH APPLICATION. Date Job Address 3.� '°'�4 su�sY THE CITY Permitee: Telephone# Permittee Address: 133 -3 r l 1� t . Requesting Permission to Construct na P Location: (Reference to Cross-Street) 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following UtilitieslMunicipalities: Jacksonville Electric Authority Yes( ) No ( Date: Bell South Telephone Company Yes( ) No Date: Ferrell Gas Yes( ) No ( Date: Comcast Yes( ) No ( Date: 2. Whenever necessary for the construction, repair, improvement. maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized . hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shad meet City of Atlantic Beach or Florida Depa nt of Transportation Standards and be performed under the supervision of (Contractor's Project Superintendent)located at 4nn Telephone#: _r-QLy 7-7_C�_,�GI 4. AN materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. ie. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit. C§iculations showing any increase in imyervious area on owner's lot or in the city Right of Slav are to be included with this application, 7. This permittee shall commence actual construction in good faith with days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder,and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER a t Signed: Date: Before me this 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: Personally Known: Produced Identification: I 'd S48S-L4Z-406 no 4oeaH 01-Ue14W Jo R1i3 es0 :01 90 90 Jew R.O.W. Permit Attachment�_of / for R.O.W. Permit# 06 — issued _,2005 Atlantic Beach,FL 32233 72 bs( Owner's Name: ma. � � (C l , Property Address: f 7e6'�7 — Subdivision: Lot#/Block#: R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE. ENCROACHMENT PERNUT, issued on this day of ' 2005, by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as"CITY"and of Atlantic Beach,Florida,hereinafter referred to as"USER'. WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above(copies attached). This work is ge crally describ as: i Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty (30)days notice by CITY to the USER, said notice to USER shall be givenrtified mail, retur9re ipt r uested, to the following address: The depositing of said notice of cancellation in the United States mail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing,or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code,and all other land use and code requirements of the CITY. The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach, Public Works Department, for said change. The Page 1 of 2 z•d Suss-L*,a_*o6 no 4oeaa otlueild 40 RziO eS0 :01 90 90 Jew AIAP SHOWING BOUNDARY SURVEY OF; LOTS >4, >6 ,BLOCK 7 , SUBDIVISION"A",ATLANT/C BEACH AS RECORDED IN PLA T BOOK 5 ,PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA LEGEND/ABBREVIATIONS X---X = CHAINLINKFENCE CIL = CENTERLINE Q---O = WOOD FENCE FND = FOUND IP = IRON PIPE BRL = BUILDING RESTRICTION LINE RB = REBAR NO-ID = No IDENTIFICATION PC = POINT OF CURVATURE A = CENTRAL ANGLE PT = POINT OF TANGENCY R = RADIUS RIW = RIGHT OF IVAY A = ARC LENGTH POC = POINT ON CURVE Al = NOT TO SCALE (A) = ACTUAL P = PLAT r� l3 ON LINE ��/ ON LINE 1I A 9� �a o LOT 17 Q LOT 15 100.00� LOT 13 1.J' LOT 11 of 0• 5 -1 2"PVC GRAIN a ° 1.2' 0,8 — —5.00' — — — I — — — 50.00' 2 0' LINE $ ❑ 23' FENCE ON PORT. 20"77£CONCRETE POOL EQUIP. PAD $ SHED 0 ° 000 i BO ❑ e I P 0 I i ❑ O L + LOT 20 I / \ ° 5 \ ❑ W000 DECK �, ,,� ❑ 2.0' I O CN LINE 1,10 ° ❑ 21.3 p �� 0.8' o d07J N N Q Y Q � 0 Q 1-S7ORY MASONRY �o r FRAMED ti• ti L--or 12, BLOCK 7 0. �£5ID/DENCE/JJ3 0 o If JXJ AC-PAD O 12.1 0 1Q1 K 4.8' — — 24.9' 2.0' BOO OJ - ON LINE $ 0.4' gn nn' JO0.00 70 EAST COAST DR 0.4' 50.00' 0 4' 4'CONCRETE.WALK 100.DU -po yo �J FIFTH STREET RECHECKED AND RECER77FIED 7-11-200J TO SHOW POOL IMPROVEMENTS (40'RIGHT OF WA Y) MAR!' R. BANKS 7� .. INEREBYCERTIFYT0.'MATTHEWdMARYJOKILCULLEN JW7 R. R.4NIfSSURINC I THAT THIS SURVEYMEETS THE MINIMUM TECHNICAL STANDARDS AS SET CITY OF ATLANTIC BEACH 5S, BUILDING / ZONING DEPARTMENT s 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 "fnJ,i (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # C,4 - Property ,4 -Property Address: 3 1 Jam' :ZD: Applicant: Iz I L Cy UUE411 H • Project: This permit application has been: ❑ Approved ❑ Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: Date: CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 1 Application Number . . . . . 04-00028628 Date 8/30/04 Property Address . . . . . . 333 5TH ST Tenant nbr, name INT REM/ADD 1156 SCH/ORAD Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 120000 Owner Contractor ------------------------ ---------------- -------- KILCULLEN, MARYJO/MATT OWNER 333 5TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ------- ------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc INSTALL 15 FIXTURES Sub Contractor STEEG PLUMBING CO. , INC. Permit Fee . . . . 140 . 00 Plan Check Fee 00 -----Issue Date . . . . Valuation 0 -------------------------------------------- Other Fees . Fee summary Charged Paid Credited Due ---------- ---------- ---------- Permit Fee Total 140 . 00 140 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 140 . 00 140 . 00 . 00 . 00 Grand Total 280 . 00 -2.xa,49� . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. IL &CwQFF AL o CITY OF ATLANTIC BEACH a PLUMBING PERMIT APPLICATION Property Address: :.� � - - __...-.......�._ _..._.. Telephone I; owner: _ A I G Telephone #: M Contractor: � i� �`�ti►t /•!�i Fax #: �—Q _ Contractor Address: In consideration of permit�veo for doing the work sa d<seribed in the above statetnatr,we hereby agree to perform raid work in wo=w with the tutaehed plans and specifications which art apart hacof and in accordance with the Cir. of Atlbnric Bene t xo ordinance and standards of good practice listed therein. Installation of plumbing and 6aaure3 must be in accordance wrtlt the roost recent edition of the Southcm Slattdard I'turtt01116 � l^^�- � Code. tf other construction is berg done ort this building or site. Plumbing Type: New 1 list the building permit number: p Re-Pipe i Number of Fixtures: �^ Bath Tubs Showers Shower Pans Closets -- -- Sinks Dishwashers IDisposals Urinals i. washing !M.aCh,1r1C Floor Drains - -- Water Lavatory — Water Heaters 1 Sewer --- - - Other Fees �i Fermit Issuing Fee: $35.00 Total Fixtures: X 57.00 + 535.00 = Atlantic Beach, Florida 32233-5445 800 Seminole Road(904) 247-5845• http1lwww•cl.atlantlG0each.t9.us Phone' (904)247-5800• Fax CITY OF ATLANTIC BEACH a 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 211It Application Number . . . . . 05-00030323 Date 5/12/05 Property Address . . . . . . 333 5TH ST Tenant nbr, name . . . . . . REPLACE FENCE Application description . . . FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 300 Owner Contractor ------------------------ ------------------------ KILCULLEN, MARYJO/MATT OWNER 333 5TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 ---------------------------------------------------------------------------- Special Notes and Comments FENCE LIMITED TO MAXIMUM OF 6 FEET HEIGHT. Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. s %6k, F BUILDING OFFICIAL Cc: CITY Off' ATLANTIC BEACH BUILDING / ZONING DEPARTMENT D. Ford L. Higgins ra 800 Seminole Road . Doerr J Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # Property Address: Applicant: � C I 1 Project: it k e-8� This pEi cation has been: an t e Io o a Ax" Please re-submit yo ap 'cation when these items have been completed. Reviewed By: Date: Date Contractor Notified: CITY DIF A� TJMACH y FENCES POM A''���eATION p MAY 11 200b Date: r �� Job Address: ,33 g Owner's Name: Address: j - { Phone: -' 3 Legal Description: Block Number: Lot Number: Zoning District: Fence Contractor: to c j Address: Phone: City: State: Zip: Fax: Type offence and materials to be used: e S,_S jjf7,1-,1 C•o Valuation Of Fence: j ( Interior Lot ❑Corner Lot ❑Dumpster or storage tank enclosure Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application. Tree Protection: /NO. Applicant certifies that no trees will be removed for the installation of this fence. ❑YES. Removal of Protected Trees will be required for this fence. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. 1. Attach copy of property survey showing location, height and all distances from property lines of the proposed fence. (Fences shall not be placed within any utility or drainage easements without written permission from the Utility and/or Public Works Departments. Fences shall not restrict any private easement.) Address and contact information of person to receive all correspondence regarding this application(please print). Name: .�A a f— T/._-F S Mailing Address: Phone: Fax: E-Mail: 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845 - http://www.ci.atiantic-beach.fl.us Page 1 Revised 3/04/04 4 I hereby certify thatatio provided th this a plicati n is correct. Signature of Owner: L' - 2 Date: i v t Is 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: AS TO OWNER: ] yL Swom to and subscribed before me this / r\ day of C% ,20 IJ State of Florida,County of Duval � r Notary's Signatures /L yL ` � ICY}'..• JENNIFER SCHWETER " MY COMMISSION N DD 121361 Personally kLJ EXPIRES:May 27,2TJ66 ❑ andod7hru Notary P&ie Undatua'W§ Produced Identification �L l Type of Identification Produced �—7 � 1 8 —0 AS TO CONTRACTOR: Sworn to and subscribed before me this day of 720 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced Identification Type of Identification Produced 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845 - http://www.ci.atlantic-beach.fl.us Page 2 Revised 3/04/04 MAP SHO WING B0UNDAR Y SUR VEY OF., LOTS 14, 16 ,BLOCK 7 , SUBDIVISION !A", ATLANTIC BEACH ' , l n -:SO Kit AS RECORDED 1N PLA T BOOK 5 ,PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA 7 LEGEND/ABBREVIATIONS X--X CHAIN LINK FENCE CIL CENTERLINE Q--L7 = WOOD FENCE FND FOUND IP IRON PIPE BRL = BUILDING RESTRICTION LINE RB = REBAR NO-ID = NO IDENTIFICA TION PC = POINT OF CURVATURE A = CENTRAL ANGLE PT = POINTOFTANGENCY R = RADIUS R/W = RIGHT OF IVAY A ARCLENGTH POC = POINT ON CURVE Al = NOT TO SCALE (A) = ACTUAL P = PLAT 29 50 i CN LINE ON LINE LOT 17 � v LOT 73 100O�r- LOT JJ K- D, 1.J' LOT it J -t T"PVC DRAIN , 7� p LT' O.J' 2.3, 3000' T.0' r, / LJ' FENCE ON LINE,-:' POOL EOI/IP• 20'17E CONCRE7E PAD $. SH£D p I LOT To WOOD DECK C� LiV LINE -� ap 1,x0 0 p 21.3 I ^� 0.6' .x0 7J n O / \ 'O^ 1-S70RY MASONRY a I v '` '. .r• L) 0.fESYDENC£/JJJ p I p LOT 12, BLOCK 7 \ , JXJ AC-PAO lay 4.8' — — 24.9 9. �- ON UNE `t'• 04 0.*. 0+, 300.00 to EAST C015T DR In 30.00' M*cRf'T.WALK 100.00 F/FTN STREET RECNEMM AND RECER17RED 7-77-2OOJ TO SHOW POOL IMPROI£M£N75 (40' RIGHT OF WA Y) MA,??V, �R.B/INXS /HEREBY CERTIFY TO.MA77HEW&MARYJ0K/LCIILLEN C'II1Pllti' Ao �ntr r,...r,,,,�<.,.�..,-..,,�_�.,....._...-•---------- - - ti f CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD !� = ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 09-00000361 Date 3/20/09 Property Address . . . . . . 333 5TH ST Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 200 ---------------------------------------------------------------------------- Application desc Oft chicken wir fencing for garden ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KILCULLEN, MARYJO/MATT OWNER 333 5TH STREET ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit FENCE PERMIT Additional desc 4 FT CHICKEN WIRE FENCE (TEMP) Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/16/09 ---------------------------------------------------------------------------- Special Notes and Comments *ALL FENCES OR ENCLOSURES OF LAND SHALL BE SUBSTANTIALLY CONSTRUCTED. *SCHEDULE FINAL INSPECTION ONCE FENCE HAS BEEN COMPLETED. PERMIT AND APPROVED SURVEY MUST BE AVAILABLE FOR FINAL INSPECTION. *EMAIL INSPECTION REQUESTS TO BUILDING-DEPTQCOAB.US ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------- ------ ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. , r City of Atlantic Beach APPLICATION NUMBER 1s �? Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Q Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: 18 City web-site: http:Uwww.coab.us APPLICATION REVIEW AND TRACKING FORM n- DeRprtment review required YoK No Property Address nin &Zoning Tree Administrator Applicant: �ru is flitie Project: (,. Public Safety /� Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. ODenied. (Circle one.) Comments: (BUI:LD�IN PLANNING &ZONING Reviewed by: Date: 3 TREE ADMIN. PUBLIC WORKS Second Review: ❑Approved as revised. ❑Denied. Comments: PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: City of Atlantic Beach APPLICATION NUMBER i f r Building Department (To be assigned by the Building Department.) 'y t 800 Seminole Road Atlantic Beach, Florida 32233-5445 Q Phone(904)247-5826 • Fax(904)247-5845 iJily? E-mail: building-dept@coab.us City web-site: http://www.coab.us Date routed:p://www.coab.us APPLICATION REVIEW AND TRACKING FORM n— De artment review required Yes No 3 Sr Property Address: 33 " Bu nin &Zoning Tree Administrator Applicant: u is i itie Project: i Q �� Public Safety fi�l_ � Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: pproved. ❑Denied. (Circle one.) Comments: rprPUBLIC NNING &Z G Reviewed by: Date:TREE ADMIN. UBLIC WORKS Second Review: DApproved as revised. ❑Denied. Comments: UBLIC UTILITIES SAFETY FIRE SERVICES Reviewed by: Date: Third Review: DApproved as revised. DDenied. Comments: Reviewed by: Date: "° "� rs '��'i• CITY OF ATLANTIC BEACH n Gr t j(1 T' ,t 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 09 G r r OFFICE:(904)247-5826 @ FAX NO.:(904)247-5845 BUILDING-DEPTQCOAB.US BUILDING PERMIT APPLICATION DUVAL COUNTY 1''JOB ADD_ SS: "• 2:VALUATION OF WORK Q.FT UNDER ROOF- S4- > (9 - e 4 LEGAL DESCRIPTION;" 5.CLASS'OF WORK '' e.USE OF STRUCTURE: ❑NEW BUILDING ❑DEMOLITION ❑RESIDENTIAL LOT_BLOCK_SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL ,vx 7.bESCRIPTION OF YORK:• - • c' ❑ALTERATION ❑ACCESSORY BLDG. 8.FIRE SPRINKLER:'• 'r.t 0 ❑REPAIR ❑POOL/SPA ❑YES ❑WA ` ❑MOVE ❑OTHER 13 NO .,-, PROPERTY O.WNERi CONTRAC OR:` ARCHITECT I ENGINEER: 9.NAME: 1 VOMPANY NAME: 23.COMPANY NAME: �/�}� 16.NAME: 24.LICENSEE NAME: 110.'AD'DRESS: `1 u l 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: .333 S� 18.ADDRESS: 28.ADDRESS: P�t(-—�dn 11.OFFICE PHONE: 12.FAX NO: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE 28.FAX NO.: 13.'p�E: -) 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: FEE SIMPLE TITLEHOLDER BONDING COMPANY MORTGAGE LENDER .• (IF OTHER THAN OWNER), ., 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. ,t 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. ( i 0 NER AGENT' '= / CONTRACTOR If Po m e cy Le Re uir ` (Qualer Only) Signed: te: Signed: Date: Before me this day of G ­2009 in the county of Before me this day of 2009 in the county of Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared i I gZAA 10 herin by himsel herself and affirms that all statements and declarations are herin by himself I herself and affirms that all statements and declarations are true and accurate. true and accurate. Notary Public at Large,State of�� County of Notary Public at Large,State of ,County of ❑Personally Known /L q �( ❑Personally Known Produced Identification 'L L Z� 1 � � �v' ❑Produced Identfcation- Notary Signature: __,• Notary Signature: ° Notary Public State of Florida NanccyyE�E Bailey ora f oi�rL 12 745822 BLDG01 Permft II o R MAP SHOWING BOUNDARY SURVEY OF LOTS 14, 16 ,BLOCK 7 , SUBDIVISION"A",ATLANTIC BEACH AS RECORDED INPLATBOOK 5 ;PAGE 69 OF THE CURRENTPUBLIC RECORDS OF DUVAL COUNTY, FLORIDA LEGEND/ABBREVIATIONS X—X = CHAIN LINK FENCE M CENTERLINE L7.—L7 = WOOD FENCE END = FOUND IP = IRONPIPE BRL = BUILDINGRESTRICTION LINE RB = REBAR NO-ID = NO IDENTIFICA TION PC = POINT OF CURVATURE A = CENTRAL ANGLE PTPOINT OFTANCENCY R RADIUS R/W = RIGHT OF WAY A = ARCLENGTH POC = POINT ON CUR VE Al NOT TO SCALE (A) = ACTUAL P PLAT 1yl 0.v UNE °I �1.t�S1 . aN"M" t ,1 "� I LOT 17 '��J LOT 13 , , 100.00e LOT 13 ' y I.J. LOT 11 a 6' 1-1112*PVC ° 1.1' J 0.8. — — �• — — — I — — — 5000. 2.0' T• 1.J' FENCE ON L� $$- PORT 23 PAD $. 11t761O I 2.0'DE CONCRETE POOLIAP EO . p 0 0 LOT 20 0000 DECK 20.' ON UNE ° 21.1 air, j o as' °—°—°—°—°— 71 Q 1-STORY AIASOMY b �ffi ',�,•'��": ' J a pEggDy�I� o �o L�T 12 BLOCK 7 3Xld_AC-PAD ''>'; 0 fit tat 4.8' - - -16 24.9' _..,, 20' �J ON UNE $ a4' J0000 7D EAST COAST DR 0.4' 50.00' a4' 100.00 - � to� �J FIFTH STREET RECHECKED AND RECERTIFIED 7-11-200.7 TO SHOW POOL N/PROWA1ENTS t(40'RIGHT OF WAY) !NARY R.A4NA I NERESYCER77PY M.,MA77HEW&MARYJO/MCULLEN MURYEPiC�RS,INC 77:IAT7N/SSURVEYMEE7SrwMI"Isf,too __ r_ City of Atlantic Beach APPLICATION NUMBER -'7 t� Building Department (To be assigned by the Building Department.) P 800 Seminole Road ✓ �7� , Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(90.4�47-5845 E-mail: building-dept@coab.us = Date routed: /g City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM n- De rtment review required Yes No Property Address: 333 �� �/��� / Bu nin &Zoning Tree Administrator Applicant: �ll�/y�ie Pu u is litie Project: 'WPublic Safety ?Nalil Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: [Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING TREE ADMIN. 4� Reviewed by: Date: �S PUBLIC WORKS Second Review: DApproved as revised. ❑Denied. Comments: PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES Reviewed by: Date: Third Review: DApproved as revised. ❑Denied. Comments: Reviewed by: Date: rp CITY OF ATLANTIC BEACH 09' I I I I I (g( y 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 BUILDING-DEPT@COAB.US -,I pooat-Q BUILDING PERMIT APPLICATION DUVAL COUNTY 2.VALUATION OF WORK. 3.SO.VJOB ADDRESS:.: FT UNDER ROOF- '5,4t.LEGAL DESCRIPTION. 5.CLASS OF WORK § 6;USE OF STRUCTURE: ❑NEW BUILDING ❑DEMOLITION ❑RESIDENTIAL LOT,_BLOCK,_SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7.DESCRIBTION OF ORK:. ` [3 ALTERATION ❑ACCESSORY BLDG. 8:FIRE SPRINKLER..• ❑REPAIR ❑POOL/SPA ❑YES ❑N/A ` ❑MOVE ❑OTHER ❑NO PROPERTY OWNER: CONTRACTOR: ARCH 9 ARCHITECT]ENGINEER: NAME: 1 OMPANY NAME: 23.COMPANY NAME: P'RE ( / 18.NAME: 24.LICENSEE NAME 10, DSS: J /1\ ` U l 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 3,33 �� ' 18.ADDRESS: 26.ADDRESS: 11.OFFICE PHONE: 12.FAX NO.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 78.FAX NO.: —Rbb-PI4 21.CELL PHONE: 29.CELL PHONE: 13 14.EMAIL ADDRESS: �— 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: FEE SIMPLE TITLE,HOLDER BONDING COMPANY ,t MORTGAGE LENDER:, `(IF OTHER THAN 01NNER) 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 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. O NGENT' CONTRACTOR -,.. Ifl P m ge cy Le R uir (Oualer Only) Signed: te:—3 V Signed: Date: Before me this day of C 2009 in the county of Before me this day of ,2009 in the county of Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared M&-,C t^ T--(2 ki.I t. —e tJ herin by himsel 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 ✓ Notary Public at Large,State of County of �❑,-yP,.,ersonally Known /� 'f / /� ❑Personally Known pa.,�roduced Identincation L L L.. ve'T 2-4 - �J ' �v` ❑Produced Identification //Notary Signature: Notary Signature: Notary Public State of Florida Nancy E Bailey BLDG01 Permit I ado f `R > D2745822 MAP SHOW/NO BOUNDARY SURVEY OF LOTS 14, 16 ,BLOCK 7 , SUBD/VIS/ON'A",A71ANT/C BEACH AS RECORDED/N PLA T BOOK 5 -PA GE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA ILEGEND/ABBREVIATIONS X—X = CHAINLINKFENCE CIL CENTERLINE D.—O = WOOD FENCE FND = FOUND IP — IRONPIPE BRL - BUILDINGRESTRICTION LINE RB = REBAR NO-ID - NO IDENTIFICA TION PC POINT OF CURVATURE A CENTRAL ANGLE PT POINTOFTANGENCY R = RADIUS RIW RIGHT OF IVAY A = ARC LENGTH POC POINT ON CURVE /V NOT TO SCALE (A) = ACTUAL P = PLAT I �\M19l b!�Av LOT 17mJ v LOT 15 O 'o0.QO COT 13 ~O��oJ D� LJ' LOT 1/ A 6' -1 *P�DR L2' AJ' 14, $ 23' Pwr pOO,COLO- Ra, IItlCn � I ?.0'T1E L13VCRE7E IINCE ONoI 904 01� P Lor 20 o lcl f'. u \ 2O' I O av ow -� Iso A6' +e' 13-0-13-0-0— Q) —O—O 0—O—Q Q ffi ffiQ3 (Q�,\ 1-S�WRYr MASONRY Iti .:_.:,t ,:.: ;::`'.'•;` "J v, ❑ A7• C£/JJ3 O IO .;ts:.�....::•:;:':,:�,.+:«..:.!°• 14-Dr 1.2 BLOdC 7 \\\ ^ 3X3 AC-PAOCj lgl ldl � t\Ilo 24.9' ' _ 'A::,; �6 •� ' 20 ON LINE $• A4' 0.4' Moo. At' JOA00 70 EAST COAST AR 1 00.00 �o �J FIFTH STREET RCaffafW AND RCCERAFAED 7-11-2003 To sYNOW POOL NPROWUMrS (40'RIGHT OF WA Y) 1iLIf�RV R.Br�NBS 1 HEREBY CER77FY TO.'MATTHEW d MARYJO KXCULLEN SUR INC 771AT7}IISSUR VEYMEETS TH, Miniu+iu�X City of Atlantic Beach [0ate PLICATION NUMBER Building Department igned by the Building Department.) 800 Seminole Road r� %".. t. Atlantic Beach, Florida 32233-5445 Y��Phone(904)247-5826 • Fax(904)247-5* E-mail: buildin -de t coab.us �'9 P @ ted: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Delpiartment review required Yes No BU Property Address: 333 �'w Snin &Zoning Tree Administrator Applicant: &2&_Ai= P u isolitie Project: Public Safety Fire Services Receipt Other Agency Review or Permit Required Review or Dateof Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: *Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: � Date: TREE ADMIN. PUBLIC WORK Second Review: QApproved as revised. []Denied. Comments: PUBLIU LITI PUBLI AFETY FIRE SERVICES Reviewed by: Date: Third Review: FApproved as revised. ❑Denied. Comments: Reviewed by: Date: CITY OF ATLANTIC BEACH -� - 09- I I I I I 600 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845 BUILDING-DEPTGCOAB.US _>> BUILDING PERMIT APPLICATION DUVAL COUNTY 1. J08 ADDRESS: 2.VALUATION OF3.54.FT UNDER ROOF ,>'4 LEGAL DESCRIPTION. 5.CLASS WORK S.USE OF STRUCTURE: ❑NEW BUILDING ❑DEMOLITION ❑RESIDENTIAL LOT BLOCK_SUB DIVISION ❑ADDITION ❑CONVERTING USE ❑COMMERCIAL 7 DESCRIPTION OF ORK.. ❑ALTERATION ❑ACCESSORY BLDG. S.FIRE SPRINKLER. ❑REPAIR ❑POOL/SPA ❑YES ❑N/A ❑MOVE ❑OTHER ❑NO ;PROPERTY OWNER: CONTRACTOR: ARCHITECT I ENGINEER: 9.NAME + / 1 VOMPANY NAME: 23.COMPANY NAME: 24.LICENSEE NAME: Ia 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.: 10.ADDRESS: �r/] ^`, / �V 26.ADDRESS: 18.ADDRESS: 11.OFFICE PHO E: 12.FAX NO: HONE:19.OFFICE P20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.: 13 �: 21.CELL PHONE: 29.CELL PHONE: 14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS: FEE SIMP,LE TITLE;HOLDERE BONDING COMPANY MORTGAGE LENDER:. (IF OTHER THAN ONMER)' 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 RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR RDED AND POSTOPERTY. A ED ON THEN OB SITEOTICE COMMENCEMENT MUST BE RECO BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. O NER" AGENT' CONTRACTOR :. If P` m e cY Le Re uir Qua P-= Signed: te: V Signed: Date: Before me this day of G 2009 in the county of Before me this day of 2009 in the county of Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared mokc herin by himsel 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 Notary Public at Large,State of County of ❑Personally Known r (� ,7(� ,�y//� 11 Personally Known 'Produced IdentificationL L K ` 1 • ❑Produced Identification- Notary Signature: Notary Signature: ��Ply =Bailey BLDG01 Permit 1 'G � � MAP SHOWING BOUNDARY SURVEY OF LOTS 94, >6 ,BLOCK 7 , SUBDIVISION"A",ATL4NTIC BEA CH AS RECORDED IN PLA T BOOK 5 ;PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA LEGEND/ABBREVIATIONS X—X = CHAIN LINK FENCE CIL CENTERLINE Q--V - WOOD FENCE FND FOUND IP IRON PIPE BRL B UILDING RESTRICTION LINE RB REBAR NO-ID - NO IDENTIFICA TION PC s POINT OF CURVATURE A m CENTRAL ANGLE PTP OINTOFTANGBNCY R s RADIUS R/W RIGHT OF WAY A - ARC LENGTH POC POINT ON CURVE Al - NOT TO SCALE (A) s ACTUAL P a PLAT Iy� fc av LOT 17 `q �J v LOT 15 100.Op LOT!J �J D" I.J. LOT It _ 0 6. -I •PVC OR aB. _ �• _ _ _ I _ _ SQ 00' 1,O' 23' FENCE� $, +' ° 2.0'AE CLWCR£IF POOL E �I 9°�� ° � I P 0 O LOT 2o ::}-1.• I 00OD DL� :. :,:.:. ,: SCG oN Lm 110 a6' +te• J f °-°-°-O-O- a0 73ad ad Q 1-smr MASONRY `i I Y' - •^ L Lr) aOENct/JJ7 o Io (- JXJ AC-PAD J VIN . 4d• _ — 14.9' d1 20' F6 �� ON LINE . Q4, - 04 04, 300.00 TO EAST COAST OR SQ 00' 100.000 FIFTH 5 TREEr RECNECY"AND REMM70 7 11-XW rO-91OW POM 1MPROWMENTS (401 RIGHT OF WA Y) MAR R.BANS' IHERESYCERTIPYTO.'MATTHEWSMARYJO/(ILCULLEN SURl�EPURS;PNC rHAr MIS SURVEYMEETS THF"MIA4101,_ CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5455 TELEPHONE: (904)247-5800 FAX: (904)247-5805 SUNCOM: 852-5800 www wab.us t.J131 March 13, 2009 Mr. Matthew F. Kilcullen Jr. 333 5" St Atlantic Beach, FL 32233-5345 Subject: Atlantic Beach City Code,Chapter 6,Buildings and Building Regulations. Dear Mr. Kilcullen, Duval County Tax records identify you as the owner of the following property in the City of Atlantic Beach, Florida: A/K/A: 333 5th St Legal Desc: 05-69 Atlantic Beach Lots 14, 16 Blk 7 Mary Jo O/R Bk 7138-2358 RE# 169862-0000 The purpose of this is correspondence is to serve as an Official Notification of Violation. You have been identified as being in violation of the Florida Building Code, Sections 109.1 and 105.1, and under Atlantic Beach City Code: Chapter 6, Sec 6-16 Adoption of Florida Building Code. 1. Installing a garden fence without a permit. 2. Failing to have the required inspection. While responding to a complaint, the City's Code Enforcement Officer identified that the aforementioned work had been accomplished without proper permits or inspections. To eliminate any undo hardship I am granting you 5 days from receipt of this notification to either apply for a permit through the City's Building Department or remove the non-permitted fence. Furthermore I would remind you of your responsibilities as a homeowner to abide by the regulations of the city, county and state, and that non-compliance can result in fines of up to $500.00 per day, per violation from the Code Enforcement Board. Should you have any questions or concerns involving this matter, you can contact Code Enforcement at (904) 247-5855, Building & Permits at (904) 247-5826. ALEXANDER /SHERRER Code Enforcement Officer C: Assistant City Manager Zoning Dept Building Dept h � a F , M ' ro� rr Aw v, 1 f'L,j Al t ^ CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 t Jlil�? Application Number 04-00028952 Date 8/31/04 Property Address . . . . . . 333 5TH ST Tenant nbr, name . . . . . . GAS PIPING Application description . . . MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation 0 Owner Contractor --------------------- --- -- ---------------------- KILCULLEN, MARYJO/MATT WESTERN NATURAL GAS 333 5TH STREET 2960 STRICKLAND STREET ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32205 (904) 387-3511 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. s OFFICIAL CITY OF ATLANTIC BEACH r' CHANICA PERMIT APPLICATION Date: Property A dress: -57 20 S7 7— Owner: Owner: A',47T /`L f L C LL�'�/ Telephone#: Contractor: 1,( ES76X^l All"-&XoV ( q; ;x Telephone#: 3S7- Contractor 7-Contractor Address: 291(c)0 Fax#: —?,?7•- Q 3y In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of good practice listed therein. Type of Heating Fuel: If other construction is being done on this building / or site,list the building permit number: W"Electric ❑ Gas: _LP _Natural _Central Utility r� 000 Z ❑ Oil ❑ Other–Specify MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK O Heat _Space _Recessed _Central —Floor 9"" Residential ❑ Air Conditioning: —Room _Central ❑ Duct System: Material Thickness O Commercial Maximum capacity cfm O Refrigeration O New Building ❑ Cooling Tower:Capacity gpm W1 Existing Building O Fire Sprinklers:Number of Heads Cl Elevator: _– Manlift Escalator (Number) c3 Replacement of Existing System El Gasoline Pumps (Number) ❑ Tanks (Number) 12( New Installation GI/ LPG Containers (Number) (No system previously installed) O Unfired Pressure Vessel ❑ Extension or Add-on to Existing System O Boilers V Gas Piping ❑. Other-Specify — Q Other–Specify LIST ALL EQUIPMENT AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOWS Approving Number Units Description Model# Manufacturer Ton's Agency HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving Number Units Description Model## Manufacturer BTU's nAgency TANKS Nominal Capacity Type Liquid Serial Approving How Many &Dimensions Contained Manufacturer No. Agency s 3:7 .v. 800 Seminole Road-Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800- Fax: (904)247-5845- http://www.ci.atiantic-beach.fl.us f. S'% , jam, CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD v ATLANTIC BEACH, FLORIDA 32233 = INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028935 Date 8/27/04 Property Address . . . . . . 333 5TH ST Tenant nbr, name . . . . . . TEMP POLE Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------ ------------------ --- --------------------- KILCULLEN, MARYJO/MATT BROOKS & LIMBAUGH ELECTRIC 333 5TH STREET 41 2ND STREET -WEST ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241-9051 -- ------------------ -------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . 60AMP, 1PH, 3W, 240V Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. G OPTICIAL CITY OF ATLANTIC BEACH r ELECTRICAL PERMIT APPLICATION V) 1.J,'i Date: Property Address: 333 7-111b 1 S -r(-t , Owner: /Z I< L Cy/-&C-A) Telephone Contractor: v1- 4� Gf �� Telephone#: Contractor Address: q,2 L57— 572 f S-%- Fax#: 2V9-0703 070 In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Building: Building Type: ❑ Trailer Service: If other construction is ❑ New ❑ Residence ❑ Temp. ❑ New being done on this building ❑ Old ❑ Commercial E3Si ns ❑ Increase Or site,list the building Signs Permit number: ❑ Re-wire ❑ Addition Sq.Ft. ❑ Repair "T-02>° 1049 Conductor Size: AMPS: COPPER ALLfMINUMEl Switch or / RACE Breaker AMPS PH l W VOLT") WAY Existing Service RACE Size AMPS PH W VOLT WAY Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Receptacles CONCEALED OPEN 0 30 AMPS I I 100 AMPS Switches Incandescent Fluorescent & M.V. Fixed 0.100 AMPS OVER BELL Appliances TRANSFER. Air H.P.RATING H.P.RATING CEILING KW-HEAT Conditioning COMP.MOTOR OTHER MOTORS AMPS HEAT Motors 0-1 H.P. VOLTAGE PH NO. OVER 1 H.P. PHS UNDER600V OVER6 0V Transformers NO. KVA NO. KVA No.Neon_Transf. Ea. Sign Miscellaneous 800 Seminole Road-Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845 - http://www.ci.atlantic-beach.fl.us �} CITY OF ATLANTIC BEACH 11 I 800 SEMINOLE ROAD -� ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Vials) Application Number . . . . . . 04-00028628 Date 8/27/04 Property Address . . . . . . 333 5TH ST Tenant nbr, name . . . . . . INT REM/ADD 1156 SCH/ORAD Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 120000 Owner Contractor -------- ---------- ------ ------------------------ KILCULLEN, MARYJO/MATT OWNER 333 5TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 -----------7- --------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc 200AMP, 1PH, 3W, 240V Sub Contractor BROOKS & LIMBAUGH ELECTRIC Permit Fee . . . . 105 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due --------- -------- ---------- ---------- ---------- ---------- Permit Fee Total 105 . 00 105 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 105 . 00 105 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. s DING OFFICIAL :51 CITY OF ATLANTIC BEACH s� ELECTRICAL PERMIT APPLICATION �Ji3 Date: r perty Address: ,ner: Telephone#:tractor: r;,QaS ��� �� ��` Cv Telephone#: �' O Contractor Address: 57Fax#: In consideration of permit given for doing t e work as described in t e above statement, we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Building: B 'lding Type: ❑ Trailer Service: b other on this buil is ❑ New -` Residence ❑ Temp. New being done the this building Or site,list the building Old ❑ Commercial ❑ Signs ❑ Increase ❑ Re-wire ❑ Addition Sq.Ft. ❑ Repair Conductor Size: AMPS: C)o COPPER ALUMINUM Switch or RACE Breaker AMPS ��v PH t W VOLT WAY Existing Service / RACE Size AMPS 90U PH ( W VOLT WAY Feeders: NO. SIZE NO SIZE NO SIZE Lighting Outlets CONCEALED OPEN Receptacles CONCEALED OPEN 0 30 AMPS 11 100AMPS Switches Incandescent Fluorescent & M.V. Fixed 0.100 AMPS OVER BELL Appliances TRANSFER. Air H.P.RATING H.P.RATING CEILING KW-HEAT Conditioning COMP.MOTOR OTHER MOTORS AMPS HEAT Motors 0-1 H.P. VOLTAGE PH NO. OVER 1 H.P. PHS UNDER600V OVER600V Transformers NO. KVA NO. KVA No.Neon_Transf. Ea. Si n Miscellaneous 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845 • http://www.ci.atiantic-beach.fl.us CITY OF ATLANTIC BEACH 5,= 1 800 SEMINOLE ROAD r ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 14 / Application Number . . . . . 04-00028628 Date 7/22/04 Property Address . . . . . . 333 5TH ST Tenant nbr, name . . . . . . INT REM/ADD 1156 SCH/ORAD Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 120000 Owner Contractor - ----------- ------------- ----------------------- KILCULLEN, MARYJO/MATT OWNER 333 STH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ----------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 520 . 00 Plan Check Fee 260 . 00 Issue Date . . . . Valuation . . . . 120000 ------------------------- Other Fees . . ST CONSTRUCTION SURCHARGE 5 . 20 AB CONSTRUCTION SURCHARGE . 57 WATER IMPACT FEE 140 . 00 WATER CROSS CONNECTION 35 . 00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- -- Permit Fee 'dotal 52Z .ZZ 52t) .00 .bfl zc Plan Check Total 260 . 00 260 . 00 . 00 . 00 Other Fee Total 180 . 77 180 . 77 . 00 . 00 Grand Total 960 . 77 960 . 77 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. t ILDING OFFICIAL 12A CITY OF ATLANTIC BEACH S1 PERMIT CALCULATION SHEET Date:. Address 3 33 3- c o _c Heated Square Footage @ $ per sq ft = $ Garage/ Shed @ $ _per sq ft= $ � P Carport/Porch *$��P per sq ft = $ O Deck U 5 @ $ per sq ft = $ Patio @ $ per sq ft = $ TOTAL VALUATION: $ 1,200000 Total Valuation 15` $ Remaining Value $ . per thousand or portion thereof CONSTRUCTION TYPE: LL TOTAL BUILDING FEE $ ZONING: S-'Z- + 1/2 Filing Fee $ FLOOD ZONE: ( ) Fireplaces @ $35.00 $ _ O IMPERVIOUS SURFACE: y�, BUILDING PERMIT FEE $ WATER IMPACT FEE $ !yd SEWER IMPACT FEE $ p WATER METER/TAP $ U CAPITAL IMPROVEMENT$ Q SEWER TAP $ y pFF C,A0e — C ( O ) RADON HRS .0050 $ SECTION H PAVING ( ) $ p CROSS CONNECTION $ S STQ I SG) SURCHARGE $ OTHER $ GRAND TOTAL DUE: $ 1/13/03 WATER IMPACT FEE WORKSHEET ADDRESS: ` :ST DRAINAGE FIXTURE TYPE FIXTURE UNIT VALUE AS LOAD FIXTURES UNITS Automatic clothes washers,commercial 3 Automatic clothes washers, residential 2 Bathroom group consisting of water closet, lavatory, Bidet, and bathtub or shower 6 Bathtub(with or without overhead shower or whirlpool attachments) 2 Bidet 2 Combination sink and tray 2 Dental lavatory 1 Dishwashing machine,domestic 2 Drinking fountainAcemaker y2 Floor drains 2 Hose bib 1 Kitchen sink, domestic 2 Kitchen sink,domestic with food waste grinder and/or dishwasher 2 Laundry tray (1 or 2 compartments) 2 Lavatory 1 Shower compartment domestic 2 Sink 2 Urinal 4 rUdnal, 1 allonper flush or less 2 h sink(circular or multiple)each set of faucets 2 r closet,flushometer tank,public or private 4 Water closet,private installation 4 Water closet, public installation 6 TOTAL NUMBER OF UNITS= MULTIPLIED X 20 TOTAL$ c 0 i L1, CITY OF ATLANTIC BEACH ¢ .S BUILDING / ZONING DEPARTMENT D. For St a 800 Seminole Road oer Atlantic Beach,Florida 32233 (904)247-5800 J,3l� (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # OZBC�Zo.� � Property Address: Applicant: 1'el Lil-U L L Project: DD �EM ty �j�t 5?1 tJH, <E This permit application has been: Z�- Reviewed and the following ite s need atte 1/7 Please re-submit ur lication when these items have been completed. Reviewed By: Date: d MAP SHO WING B0UNDARYSUR!/FyOF.� FL TS 14, 16 ,BL OCK T , SUSD/V/S/ON 'A", A TLANTIC BEACH AS RECORDED/At PLA T BOOK 5 ,PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA r--r - CIMIN UAW F£NLF_ FNO FOUND rV0 - RUOD FENCE BRIBUILDING RFSIRIC77ONLIAE IP IRON PIPE NO-1D - AIOIPENTTP CA77ON RB ' RER.4R A - M£MLANGLE PC - POINT OFCIlR I ATURF. R - RADIrls PT ' P0INTOFT4)VGFW'Y A - ARCLENG771 Irl" - RIGHT OF ITAY i = NOTTO.ACALE POINTOFCMA7TIRE CF- ERLINE PRC' POINT OFRE177PSE CUR 7E O� I �ti91 sl1.2' I#&- ON O I❑ �l� yo r l hON LINE' I1 �LOT 17 Yom/) LJ' (O"17 cor!s 100.CL 1 cor IJo of QJ' 5.00'❑-❑ -❑--❑ °-- �- -❑-❑-❑-❑-a - C.VI L/NE •$ ❑ Z J, 5000' 2.0' J' Q�- POR7. ._.;•••.$� SOD _ ?.0'AE CCNCRE7E 74.0' "-tl 00 ❑ 0 I ❑ 9�0 _ " I ❑ LOT 70 P O I ❑ O L ❑ I � ❑ DECK ._J �o _ ❑ 2.0' I O aN uNc -� m IJ - _ _- ❑ 21.5' 0.6o-j v I .. 0 A B' JJ ^ v n _ A\ O O I-VZWY MASONRY 'g k h A FRAMED Qp �p ,.�� LOT 1Z BLOCK 7 1 .WJ AC-PAD w I _ 4.9' 24. qo 20, / al LrNE `�- --a 4' •� Q 4. 5Q 00' 300.00 TO EAST COAST DR 0.4 - ' 100.00, $J FIFTH STREET (40' RIGHT OF WA Y) MWRlV �? BANKS /HEREBY CER TIF TO: MATTHEWBMARY✓OK/LCULL EN 1 / [[ z U�URlfz WR,ti_ AMC THATTHI.C.4/lRVF'V'AAFFTCT"I AA/ A1111I--A-wi nr....,...... .---- i CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (Alterations & Additions) 'l Date: Job Address: Owner of Property: 3 Address: j 3 3 ��h v��� +) B c-), Telephone: Legal Description: Block Number: ,L%ot Number: Zoning District: Contractor: gn � S �t� j 1 I� (/)�i) State License Number: Contractor Address: Telephone: Fax: Describe proposed use and work to be done: op F U i;� ro - A1,-> Ty 1 JU Q Present use of 1 or building(s): ` 1 ✓vn A L_ Valuation of proposed construction: �L O , G r% O o cf 0s �: �' o Qf aA c� r1 C e What are the dimensions of the added space: 4 aCl feet x feet D vl lei,IS. Will the added area be heated and cooled? S New electrical or increase in service? Add plumbing fixtures? x I le Add fireplace? Add heating/air conditioning? 161 Is approval of Homeowner's Association or other private entity required? �_ If yes, please su mit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? aNO. 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. NO. Applicant certifies that no trees will be removed for this project. YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have Property Appraiser's Real Estate Number available. STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction topographical survey or grading plan is required. (If not required, written verification must be provided with this application.) The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated. STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atlantic-beach.fl.us Page 2 Revised 1104 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct. Signature of owner: li Date: _VC." I b 70 U, 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: Address and contact information of person to receive all correspondence regarding this application(please print). Name: Mailing Address: Telephone: Fax: E-Mail: AS TO OWNER: Sworn to and subscribed before me this " day of ,206-4 State of Florida,County of Duval �MiF>a. M:r'rs DAVID J.ABRAHAM i� Notary's Signature: My COMMISSION#DD 138284 EXPIRE&July 31,2006personally known •;F o?� Bonded Thru Notary Public Underwriterx -�,.,,�,. ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of A ,206 `--4 State@gRyyW _ DAVID J.ABRAHAMUA MY COMMISSION#DD 138284 Notary's Signatur _.r EXPIRES:July 31,2006 •;;e :�;o?•`° Bonded Thru Notary Public underwriters _ ersonally known Produced identification Type of identification produced 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.cLatlantic-beach.fl.us Page 3 Revised 1/04 �t?S I 1yrl� AJf [S)S ' CITY OF ATLANTIC BEACH OWNER./BUILDER AFFIDAVIT Date: r� Job Address: , �,j � � 1, �-/� &/ CHAPTER 489,FLORIDA STATUTES,PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR RAPROVE A ONE- OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER"DIRECT SUPERVISION OF THE OWNER,WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS. SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS-WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE 41S . OF AN OWNER-BUILDER PERMIT. Q. UILDER %OTAR SWORN T�oijADAV RAHAMTHISF 20b. c% MY COMMISSION 4 DD 138284,•. EXPIRES'July 31,2006':;� Bonded Thru Notary Public underwriters LIC MY COMMISSION EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. 5 RETURN Book 11897 Rage 2254 PHONE# ac# 2U(l 9915 NOTICE OF COMMENCEMENT ook; 118 97 Pagge: 2254 Filed & Recorded State of i Tax Folio No. 06/25/2004 01:10:11 PN County of9—t=3-nK& CLERK CIRCUIT COURT DUVAL COUNTY To Whom It May Concern: RECORDING f 5,00 TRUST FUND $ 1.00 The undersigned hereby informs you that improvements will be made to certaiHEAADPJo�gW , ani in acMance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: 10,1 `7 k of (�, .�Ain!� Address of property being improved: :5 4" j General descriptio of improve entsZe m - Lauld IiA. Z e ,e in ' /00"- weer: k � (� e w r ►r cernS. Address: (tet, r c_ wner's interest in site of the improvement: V ^ ;en ;r Fee Simple Titleholder(if other than owner): Name: Address: Contractor: Address: Phone No: Fax No: Surety(if any): Address: Amount of Bond S Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents maybe served: Name: Address: Phone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option). — Nam e: Address: Phone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY NE C` Signed/ 6rDate: -3 �T Before me sOflri day of in a County r. ID J.A of Duval,State o ,hasersona appeared DAVID J.ON#D 1 \, ' ��ki MY COMMISSION#DD 138284 A'.c 'o EXPIRES:July 31,2006 Notary Pub t Large, S t f F�rid County of Duval. ' 1F;;o°C, BendedThruNotary PiGu�e�riters My commission expires: It— Personally Known: a or Produced Identification: �_ FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Whole Building Performance Method A Project Name: Addition-Remodel for the Kilcullen's Residence Address: 333 5th Street Permitting Office: City, State: Atlantic Beach, FL 32233-000 Permit Number: Owner: The Kilcullens Jurisdiction Number: Climate Zone: North 1. New construction or existing Addition _ 12. Cooling systems 2. Single family or multi-family Single family - a. Central Unit 3. Number of units,if multi-family 1 Cap:60.0 kBtu/hr - SEER: 12.00 _ 4. Number of Bedrooms 2 b. N/A - 5. Is this a worst case? No _ - 6. Conditioned floor area(ft2) 395 ft2 c. N/A - 7. Glass area&type - a. Clear-single pane 0.0 112 _ 13. Heating systems - b. Clear-double pane 0.0 ft2 a. Electric Heat Pum c. Tint/other SHGC-single pane - p 0Cap:54.0 kBtu/hr _ .0 ft2 d. Tint/other SHGC-double pane 241.0 ft2 b. N/A HSPF:9.00 - 8. Floor types _ a. Slab-On-Grade Edge Insulation R=0.0, 140.0(p)ft c. N/A b. N/A - _ c. N/A - 14. Hot water systems - 9. Wall types - a. LP Gas a. Frame,Wood,Exterior R=11.0, 1305.0 ft2 Cap:40.0 gallons - b. N/A - EF:0.65 c. N/A - b. N/A - d. N/A - - e. N/A - c. Conservation credits 10. Ceiling types - (HR-Heat recovery,Solar - _ DHP-Dedicated heat pump) a. Under Attic R=30.0,395.0 ft2 I5. HVAC credits b. N/A - PT,CF, _ c. N/A - (CF-Ceiling fan,CV-Cross ventilation, 11. Ducts HF-Whole house fan, a. Sup:Unc. Ret:Con. AH:Interior - PT-Programmable Thermostat, Sup.R=6.0,30.0 ft - MZ-C-Multizone cooling, b. N/A MZ-H-Multizone heating) Glass/Floor Area: 0.61 Total as-built points: 10541 PASS Total base points: 12240 I hereby certify that the plans and specifications covered Review of the plans and by this calculation are in co liance with the Flo ida specifications covered by this oj-TIM sr4 Energy Code. .12(t&066 i calculation indicates compliance w�, '°� =' °�, PREPARED BY: with the Florida Energy Code. Be fore construction is completDATE: a ed this a av building will be inspected for I hereby certify that this building, as designed, is in compliance with Section 553.908 compliance with the Florida Energy Code. Florida Statutes. c0 OWNER/AGENT: BUILDING OFFICIAL: s Q..- e' DATE: DATE: EnergyGauge®(Version: FLRCSB v3.22) --- - a SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 333 5th Street,Atlantic Beach, FL, 32233-000 PERMIT#: BASE AS-BUILT GLASS TYPES .18 X Conditioned X BSPM = Points Overhang Floor Area Type/SC Ornt Len Hgt Area X SPM X SOF= Points .18 395.0 20.04 1424.8 Double,Tint N 2.0 2.0 39.0 15.78 0.71 437.4 Double,Tint E 2.0 2.0 96.0 33.76 0.52 1678.2 Double,Tint S 2.0 2.0 88.0 28.87 0.52 1322.4 Double,Tint W 2.0 2.0 18.0 30.99 0.53 295.8 As-Built Total: 241.0 3733.8 WALL TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood, Exterior 11.0 1305.0 1.70 2218 55 Exterior 1305.0 1.70 2218.5 Base Total: 1305.0 2218.5 As-Built Total: 1305.0 2218.5 DOOR TYPES Area X BSPM = Points, Type Area X SPM = Points Adjacent 0.0 0.00 0.0 Exterior Insulated 63.0 4.10 Exterior 258.3 63.0 6.10 384.3 Base Total: 63.0 384.3 As-Built Total: 63.0 258.3 CEILING TYPES Area X BSPM = Points Type R-Value Area X SPM X SCM = Points Under Attic 395.0 1.73 683.4 Under Attic 30.0 395.0 1.73 X 1.00 683.4 Base Total: 395.0 683.4 As-Built Total: 395.0 683.4 FLOOR TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Slab 140.0(p) -37.0 -5180.0 Slab-On-Grade Edge Insulation 0.0 140.0(p -41.20 -5768.0 Raised 0.0 0.00 0.0 Base Total: -5180.0 1 As-Built Total: 140.0 -bT68.0 INFILTRATION Area X BSPM = Points Area X SPM = Points 395.0 10.21 4032.9 395.0 10.21 4032.9 EnergyGauge®DCA Form 60OA-2001 EnergyGauge®/FlaRES'2001 FLRCSB v3.22 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 333 5th Street,Atlantic Beach, FL, 32233-000 PERMIT#: BASE AS-BUILT summer Base Points: 3563.9 summer As-Built Points: ------------- -- _ _____ _ __ ___ 5158.9 Total Summer X System = Cooling Total X Cap X Duct X System X Credit = Cooling Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points —-- ------------------ (DM x DSM x AHU) 1-000 3563.9 0.4266 1520.4 515899 1 00 (10811 128 x 091)00.284.284 0.902 1494.1 .902 1494.1 EnergyGaugeTm DCA Form 600A-2001 EnergyGauge®/RaRES'2001 FLRCSB v3.22 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 333 5th Street,Atlantic Beach, FL, 32233-000 PERMIT#: BASE AS-BUILT GLASS TYPES .18 X Conditioned X BWPM = Points Floor Area Overhang Type/SC Ornt Len Hgt Area X WPM X WOF= Points .18 395.0 12.74 905.8 Double,Tint N 2.0 2.0 39.0 14.91 1.02 592.2 Double,Tint E 2.0 2.0 96.0 10.43 1.29 1286.9 Double,Tint S 2.0 2.0 88.0 6.05 2.73 1454.3 Double,Tint W 2.0 2.0 18.0 11.87 1.17 249.3 As-Built Total: 241.0 3582.7 WALL TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood, Exterior Exterior 1305.0 3.70 4828.5 11.0 1305.0 3.70 4828.5 Base Total: 1305.0 4828.5 As-Built Total: 1305.0 4828.5 DOOR TYPES Area X BWPM = Points. Type Area X WPM = Points Adjacent 0.0 0.00 0.0 Exterior Insulated Exterior 63.0 12.30 774.9 63.0 8.40 529.2 Base Total: 63.0 774.9 As-Built Total• 83.0 529.2 CEILING TYPES Area X BWPM = Points Type R-Value Area XWPM X WCM = Points Under Attic 395.0 2.05 809.8 lUnderAttic 30.0 395.0 2.05 X 1.00 809.8 Base Total: 395.0 809.8 As-Built Total: 395.0 809.8 FLOOR TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Slab 140.0(p) 8.9 1246.0 Slab-On-Grade Edge Insulation Raised 0.0 0.00 0.0 0.0 140.0(p 18.80 2632.0 Base Total: 1246.0 As-Built Total: 140.0 2632.0 INFILTRATION Area X BWPM = Points Area X WPM = Points 395.0 -0.59 -233.0 395.0 -0.59 -233.0 EnergyGaugeO DCA Form 60OA-2001 EnergyGauge®/FlaRES'2001 FLRCSB v3.22 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 333 5th Street,Atlantic Beach, FL, 32233-000 PERMIT#: BASE AS-BUILT Winter Base Points: 8331.91 Winter As-Built Points: Total Winter X System = Heatin - -----------_--- 12149.1 Points Multi tier g Total X Cap X Duct X System X Credit = Heating P Points Component Ratio Multiplier Multiplier Multiplier Points -- --- ------------ — (DM x DSM x AHU) 8331.9 0.6274 12149.1 1.000 (1.060 x 1.169 x 0.93) 0.379 0.950 5039.5 5227.4 12149.1 1.00 1.152 0.379 0.950 5039.5 EnergyGaugeTm DCA Form 60OA-2001 EnergyGauge®/FIaRES'2001 FLRCSB v3.22 WATER HEATING & CODE COMPLIANCE STATUS Residential Whole Building Performance Method A - Details ADDRESS: 333 5th Street,Atlantic Beach, FL, 32233-000 PERMIT#: BASE AS-BUILT WATER HEATING Number of X Multiplier = Total Tank EF Number of X Tank X Multiplier X Credit = Total Bedrooms Volume Bedrooms Ratio Multiplier 2 2746.00 5492.0 30717.0 0.65 2 1.00 2003.82 1.00 4007.6 As-Built Total: 4007.6 CODE COMPLIANCE STATUS BASE AS-BUILT Cooling + Heating + Hot Water = Total Cooling + Heating + _ Points Points Points Points Points Points Hot — Po Points 1520 5227 5492 12240 1494 5039 4008 10541 PASS 0.j THE Sr9����.s+ i a i 6 f EnergyGaugeTm DCA Form 60OA-2001 EnergyGauge®/RaRES'2001 FLRCSB v3.22 Code Compliance Checklist Residential Whole Building Performance Method A - Details [.ADDRESS. 333 5th Street,Atlantic Beach, FL,32233-000 PERMIT#: 6A-21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE Exterior Windows&Doors 606.1.ABC.1.1 Maximum:.3 cfm/sq.tt.window area .5 cfrn/sq tt door area. CHEC Exterior&Adjacent Walls 606.1.ABC.1.2.1 Caulk,gasket,weatherstrip or seal between:windows/doors&frames,surrounding wall; foundation&wall sole or sill plate;joints between exterior wall panels at corners;utility penetrations;between wall panels&top/bottom plates;between walls and floor. EXCEPTION:Frame walls where a continuous infiltration barrier is installed that extends / Floors -- ---.----___-- from, and is sealed to,the foundation to the top plate. _ Floors 606.1.ABC.1.2.2 Penetrations/openings>1/8"sealed unless backed by truss or joint members. EXCEPTION: Frame floors where a continuous infiltration barrier is installed that is sealed / to the perimeter penetrations and seams. Ceilings 606.1.ABC.1.2.3 Between-walls&ceilings;penetrations of ceiling plane of top floor;around shafts, chases, soffits,chimneys,cabinets sealed to continuous air barrier;gaps in gyp board&top plate; attic access. EXCEPTION:Frame ceilings where a continuous infiltration barrier is - — -- installed that is sealed at theperimeter,at penetrations and seams._ Recessed Lighting Fixtures 606.1.ABC.1.2.4 Type IC rated with no penetrations,sealed;or Type IC or non-IC rated,installed inside a sealed box with 1/2"clearance&3"from insulation;or Type IC rated with<2.0 cfm from / - - -- -----_ ___ conditioned space,tested. _ ✓ Multi storms Houses _ 606.1.ABC.1.2_5 Air barrier on-penpiter of floor cavit r�between Additional Infiltration reqts 606.1.ABC.1.3 Exhaust fans vented to outdoors,dampers;combustion space heaters comply with NFPA --- have combu ,stion air. — / A-22 OTHER PRESCRIPTIVE_MEASURES(must be_met or exceeded-by residences COMPONENTS SECTION REQLIIR_ _EMENTS. - - - -- ---- Water Heaters 612,1 _ CHEC Comply with efficiency requirements in Table 6-12.Switch or clearly marked circuite p Swimming Pools&Spas 612.1 breaker(electric)or cutoff(gas)must brovided. External or built-in heat trap required. &h Spas heated pools must have covers(except solar heated).Non-commercial pools must have a pump timer.Gas spa&pool heaters must have a minimum thermal Shower heads 612.1 'Water flow must be restricted to no more than 2.5 gallons per minute at 80 PSIG Air Distribution Systems 610.1 All ducts,fittings,mechanical equipment and plenum chambers shall be mechanically attached,sealed, insulated,and installed in accordance with the criteria of Section 610. --- Ducts in unconditioned attics:R-6 min. insulation. HVAC Controls 607.1— Se Grate readil accessible manual or automatic thermostat for each system_ —� Insulation ---� ---- 604.1,602.1 Ceilings-Min.R-19.Common walls-Frame R-11 or CBS R-3 both sides. Common ceiling&floors R-11. EnergyGaugeTM' DCA Form 60OA-2001 EnergyGaugeO/FlaRES'2001 FLRCSB v3.22 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 02-00025162 Date 11/12/02 Property Address . . . . . . 333 5TH ST Tenant nbr, name . . . . . . RAISE HOUSE Application description . . . MOVING STRUCTURE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 8000 Owner Contractor ------------------------ ------------------------ KILCULLEN, MARYJO/MATT LARUE HOUSE MOVERS 333 5TH STREET 315 S . VERMONT STREET ATLANTIC BEACH FL 32233 GREEN COVE SPRINGS FL 32043 (904) 264-1107 -------------------------------------------------------- Permit . . . . . . MOVING PERMIT Additional desc . . Permit Fee . . . . 100 . 00 Plan Check Fee . 00 Issue Date . . Valuation . . . . 0 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 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. ,Q , ( - IK, BUILDING OFFICIAL Mar 06 06 10: 05a City of Atlantic Beach Bu 904-247-5845 p.3 USER shall,at the discretion of the CITY, be requested to submit as-built drawings showing-the change within thirty(30)days after the day of completion. This permit shall inure to the benefit of, and be binding upon, the USFR and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use limitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this ! day of , S. CITY OF ATLANTIC BEACH,FLORIDA, By: a municipal corporation: Pro n� Jim H n,Ci anager Please Sign&Retum Attest: Ric arper,Public Wo6sZirecto_r STATE OF FLORIDA COUNTY OF DUVAL Sr On this S/ day of 4A C , 2005, personally appeared before me, a Notary Public inand for id County and State, , the property owner of 3a3 5-7-M ! Atlantic Beach, Florida, known to the to be the person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the uses and purposes therein mentioned. L ) - Cq-,. L_� � 'f, —./By: X y Public in for sai unty and State Pro y Uwne (to signed in resence of the Notary) ray N*B4FAWMad ph" �Z 5 0 g Com imb;Exp1m Fab 14, •= Comn*Wn It DD slitW , Bonded By National NoWy Ann. Page 2 of 2 rGZ. ry� C V C "of Atlantic Beach 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 FAX (904)24775805 • http://www/ci.atiantic-beach.1l.us B..T11 DING PAAR.1'�ILIi AP PLAY-C ..i11JN FOR SINGLE—FAMILY OR TWO—FAMILY (DUPLEX CONSTRUCTION (INCLUDING NEW CONSTRUCTION, REMODEL, ADDITIONS AND ALTERATIONS, MOVING OR DEMOLITION) JOBADDRESS S �'���" DATE APPLICANT ADDRESS / . Ki/ PHONE: fJ �'�% LEGAL DESCRIPTION: BLOCK NUMBER._ LOT NUMBER ±&jONING DISTRICTft ' CONTRACTOR Id. k < STATE LICENSE NUMBER CA r— ADDRESS 5 w PHONE Ivy 7,2R�— l"y CITY Ll� �SOGyc� STATE - ZIP W FAX —'701— c2�— 5&0 DESCRIBE PROPOSED USE AND WORK TO BE DONE r � Clr i2 a PRESENT USE OF LAND OR BUMDING(S) VALUATION OF PROPOSED CONSTRUCTION s ? ?a 5. Is this an addition? If yes,what are the dimensions of the added space: feet by feet Will the added area be heated and cooled? New electrica':or L-ICaasc New plumbing fixtures? New fireplace? New heating/air conditioning? Is approval or Homeowner's Association or other private entity required? %j' ace g.`},,,..it *hi application. p Ifyes,please t . -ith s appli at�on. WILL THIS PROJECT INVOLVE CHANGES IN ELEVATION, SITE GRADE OR-ANY USE OF FILL MATE' [�vt�. 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. rR0CEDURE: (in order to expedite issuance of p permits, please follow all steps and provide all information as appropriate.) STEP 1Ve fy�••^_•^iIIg de&ig.^•2h;n a,w proper set�3C1.� r il;� rCpuS�d �'v'i,SirLLGiiOri. If you are unsure of'u`iiS IrifG7rilaitOTl, please contact Che 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 R/02Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Please submit Energy Code Forms.Notice of Commencement,Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole Road, Atlantic Beach,FL 32233 Telephone:(904)247-5826 �` in addition to construction and engineering detail, pans must contain the following infoi7n4or5 as appropriaie 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 environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 6. Tampers^aTTs Sa r*;ic,arta_calculations. (Swim. ming pools may be excluded from total impervious Sur±'ace 7. Other information as may be appropriate for individual applications. I HEREBY CERTIFY THAT ALL INFORMATION PROVIDED WITH THIS APPLICATION IS CORRECT. SIGNATURE OF OWNERy` L .r "�> ( ► , t DATE P 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 .r-, •y, r^"'STT' cr�r r. n. IrtiPt,, !')b NOT TLTL` l`D NT /'► DTDT?TT` C`, N PRESUME TCl �.f ATT n iTV .. TH, ,HEE ::.. SPE,CIFIED _.LRXI . ? N T __ TE s<�Q.,_IltvC.OF A PERMIT DOE NOT ,_ TVI'. ,._.TgORTT 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 PERFORM NCE Or 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 SX.PPORTING DATA HAVE BEEN OR SHALL BE PROVIDED AS REQUIRED. t, SIGNATURE OF CONTRACTOR , DATE ADDRESS AND CONTACT INFORMATION OF PERSON TO RECEIVE ALL CORRESPONDENCE REGARDING THIS APPLICATION (PLEASE PRINT) NAME (e/2 60411 - MAILING ADDRESS /S-'Sp t}-L VP�i�O/j�cJ!'. Ag,,re/1 t Dl ��j�5 D� PHONE g0L1-aV- 33)? FAX 'TDLI- �8`y"�� E-MAL 14rkG hDItIJ40VGf.S � �7dlSCJtt�h►h� SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF_ 4QY�AXbQ 4 �nD STATE OF FLORIDA,COUNTY OF DUVAL NOTARY'S SIGNATURE AS TO OWNER: ,,Personally known ❑ Produced identification ' '•• MICHELE E.JOHNSON Type of identification produc I. MY COMMISSION B CC 827512 j� Bonded Thru Nehry Public UrMerw-dws AS TO CONTRACTOR: CV Personally known ❑ Produced identification Type of identification produced ` Ctaudis Rand'Anderson 'Y My Commission 00110321? ,¢ Exp m Oetober 8,2006 118/02 r, CITY OF ATLANTIC BEACH s 800 SEMINOLE ROAD j ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 �yJs3 Application Number . . . 02-00025159 Date 11/12/02 Property Address . . . 333 STH ST Tenant nbr, name . . . . . . 971FOOTER/FOUNDATION ONLY Application description . . . FOUNDATION ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 8000 Owner Contractor ------------------------ ------------------------ KILCULLEN, MARYJO/MATT LARUE HOUSE MOVERS 333 STH STREET 315 S . VERMONT STREET ATLANTIC BEACH FL 32233 GREEN COVE SPRINGS FL 32043 (904) 264-1107 ---------------------------------------------------------------------------- Permit FOUNDATION ONLY Additional desc . . Permit Fee 105 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 105 . 00 105 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 105 . 00 105 . 00 . 00 . 00 } Y 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. ,,Q, , ( - I'k,­_ BUILDING OFFICIAL CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address 3 3 3 S� " f T _ 6LO v QPA r j of t 7- .Date- .Date / / / 1` O "2,--- Heated Square Footage @ $ per sq ft= $ Garage/ Shed @$ per sq ft= $ Carport/Porch @$ per sq ft= $ Deck @$ per sq ft= $ Patio @ $ per sq ft= $ TOTAL VALUATION: $ r O D o 0 3J� $ 3S Totaf Valuation 1St $ 100 c7 0 0 U 33 $ 3 S Rem ening Value per thousand or portion thereof CONSTRUCTION TYPE: TOTAL BUILDING FEE $ O ZONING: + %2 Filing Fee $ 3 3s FLOOD ZONE: O Fireplaces @ $15.00 $ CD IMPERVIOUS SURFACE: BUILDING PERMIT FEE $ f O WATER IMPACT FEE $ SEWER IMPACT FEE $ WATER METER/TAP $ CAPITAL IMPROVEMENT$ SEWER TAP $ C ( ) RADON M50050 $ SECTION H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ST( ) SURCHARGE $ OTHER $ GRAND TOTAL DUE: $ f p CEIVED NOV a 8 2002 B of Atlantic Beach 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 FAX (904)24775805 • 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) {., l DATE JOB ADDRESS 53.3 J.r '55 Cw 1 APPLICANT I1 LP /Yl U cSD 5 ADDRESS 31Y6, Y.41 D PHONE: D ✓?c'3I7 LEGAL DESCRIPTION: BLOCK NUMBER— 7 LOT NUMBER J /-� / ZONING DISTRICT r CONTRACTOR < STATE LICENSE NUMBER CA ADDRESS �+ C-A Vfyaog� 5 PHONE CITY`r L LYS , VAcl STATE F_� ZIP WO FAX /O41— — L%pq i DESCRIBE PROPOSED USE AND WORK TO BE DONE, ��/lq � ��,� / �yt q 41-7 a 4 PRESENT USE OF LAND OR BUILDINGS) VALUATION OF PROPOSED CONSTRUCTION r Is this an addition? _—_ If yes,what are the dimensions of the added space: feet by feet Will the added area be heated and cooled? New electrical or increase in service?' New plumbing fixtures? New fireplace? New heating/air conditioning? Is approval or Homeowner's Association or other private entity required? If yes,please sub 't with this application. WILL THIS PROJECT INVOLVE CHANGES IN ELEVATION, SITE GRADE ORANY USE OF FILL MATE &KO. 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 6/18/02 Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834 STEP 3. Please submit Energy Code Forms,Notice of Commencement,Owner/Contractor Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department, which is located at the Atlantic Beach City Hall, 800 Seminole Road, Atlantic Beach,FL 32233 Telephone:(904)247-5826 " 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 environmental 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 INFORMATION PROVIDED WITH THIS APPLICATION IS CORRECT. SIGNATURE OF OWNER f DATE L� 4 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,AUTHORTTY 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 Si PPORTING DATA HAVE BEEN OR SHALL BE PROVIDED AS REQUIRED. SIGNATURE OF CONTRACTOR DATE V �0, ADDRESS AND CONTACT INFORMATION OF PERSON TO RECEIVE ALL CORRESPONDENCE REGARDING THIS APPLICATION (PLEASE PRINT) NAME 0PIFA&C MAILING 17o+ ADDRESS 33/S (/Sou+-L 1r12or� PHONE o o&J 3317 FAX 'TV E-MAIL 14ricG hU iSt—440V40 IQe dlscu f nen SWORN AND SUBSCRIBED BEFORE ME THIS DAY OF /�OY� �t)Da . STATE OF FLORIDA,COUNTY OF DUVAL NOTARY'S SIGNATURE AS TO OWNER:,,. Personally known 1µY'%"• MICHELE E.JOHNSON ❑ Produced identification - My COMMISSION N CC 827512 Type of identification produc 74rwe-",,-",, Banded Thru WZ; Fub i;j;w"'k" AS TO CONTRACTOR: Personally known [] Produced identification Type of identification produced �r Ciaudla RBne'AMWW 17 . Aj E*m OckAw 8.2006 6/18/02 Book 14734 Page 2216 NOTICE OF COMMENCE MPDNT (�i—-TV FD IrREFME W DUPLICJ7F� Permit No. Tax Follq,No. Slate of t:aonly of _ NOV 0 8 2002 To whom it may concern; _ Tho undersigned hereby Informs you that Improvomqy ants will bo made to certaln real property,and bs - : accordance with Section 717 or the Florida Statutes,the following Information Is stated In this NOTICE OF l�1 COMMENCEMENT. Legal Oesaiylion of properly b ing improved: // i ! .i�7C. �q AddVA 0 ss of omoorty being Improved;Z-0 •S 1 �/ 82•Uf�, Gonoral description of Improvomonls;_�a,(�L �,{(� d- qffl ty`"' Owner 7 T i `GL I 1IJ( JI --- — ,2 p Address �'1 a•1 & Owner's interest in silt of the knprovomonl Fee Simple Titleholder(If other than owner) Name Address p n/ Convector,—A M.OLe— Address 3 U`u �•" '^"�,,,- 1—e"-- ///'''��� p Phone No. No. '•� � — +sJ Surety of ony) L �L •`//\J1 Address `� .' AmoontofboQndcS .(�f �yl Phone No.Q*V --,ay"� `�.�-�•• Fax No. Namo and address of any person making o ben for the conslructlon of the Improvon)vnts, Name C Address �Y`1 Phone No. Fox No. Q Name of person within the State of Florida,other than himself,designated by owner upon whorl nodcos or other documonts may Ue servoj: �-•� Name (� 1 \ A0drasS Pxi Phone No. Fox No. In addition to himself,ownor designalos the following person to recolve a copy of tho Usnot's Notice as provided In section 710.00(2)(b),Florida Statutes.(Fill In at Owners option). Name a Address Phone No. Fax No. Expiration data off Nolloo of Commencemont(tire bxpiratlon dale Is one(1)year from the date of recording unless a I"' different Cato Is 3peci0od): llii5 SPACE FOR RECORDER'S VSE ONLY WNERc Signe Wit: eoloro me lhi of M the CdJnly of Duval, els of Flo(id a, o ally appoared �oc 21042473 34 502S Notary Public at Largo.Slate of Florida, ovnty of Dwal 00 : Pae: 2216 My commission expires: Filed & Recorded Porso^ally'Knovn a `-10/28/2002 02:47:47.•PM Producod Idenlllication JIM FULLER CLERK CIRCUIT COURT , DUVAL.000NTY MICHELEE.JOHNSON RECORDING $ 5.00 Mir COMMISSION N CC 827512 TRUST FUND $ 1.00 ) COPY FEE $ 1,00 �+t EXPIRES:July 5,2003 V/ CERTIFY 1 1.00 herded Thru Notary Public Underwriters This instrumentre aced b.,• I P F � RECORD AtVD f;t:TURN TO: FOR_ftEGQ8ilE8- Keith Watson Matthew F.Kilcullen,Jr. { Law Offices of Keith Watson 333 Flfth S'soet r 6825 Lillian Road Atlantic Beach,Florida 32233 Jacksonville,Florida 32211 ! RE PARCEL ID#: 1691162-0000 ! BUYER'S TIN: 057-48-5593 ilei 1 t" RCCO"S This Warranty Deed made the 28th day of June, 1991 by F. Donald Tappin arid.Helen E.Tappin, his wife " hereinafter called the Grantor; to Matthaw F. Kilcullen,Jr,and Mary Jo Kilcullen, his wife whose post office address is: 333 Fifth Street, Atlantic Beach, Florida 32233 hereinafter called the Grantee: (Wherevei!.; e d herein the teem"grantor"and"grantee"include all the parties to this instrument and the heirs,lo;ai rep(esentatives and assigns of individuals,and the successors and assigns of corpo(ations.) Witnesseth: That the Grantor,for Lind in consideration of the sum of $10 and NO/100 Dollars and other valuable considerations, receipt whereof Is hereby acknowledged, hereby grants, bargains, sells, aiiert,�, rernises, releases, conveys and confirms untu the Grantee, all that certain land situate in Duval County, Florida, viz: Lots 14 and 15, Block 7, A FLAN i'IC BEACH, according to plat thereof as recorded in Plat Book 5 page 69`pf the current public records of 1Juval County, Florida. [1(JCt1Ml iifdt5<�` , STAMP TAXI cD _.p .._.__ H029 29 C� ii r) l� SUI)JUt tO o&ienant3, restrictions and easoments of record if any; however, this reference thereto:5��, t ) not operate to relmposr�w- trw. - "�,r•, Together witI,all tfitr ,ono .ents, hereditaments and appurter-,ances thereto belonging or 1n anyN!se apper- taining. To I-lave aria. to Hold the sarne in fee simple forever. And the Grantor hereby covenants with said Grantee that the Grantor Is lawfully seized of said-land in fee sirriple; that the Grantor has good right and lawful authority to sell and convey said land; that the Grantor Yiereby fully warrants the title to said land and' wlll defend the same against the lawful claims of all persons whomsoever�)and at 0 said land Is free of all encurnbr�ncos, except taxes accruing subsequent to December 31, 1990. rn C 1111 Wit.11e5S W1101:0fW the said Grantor has signed and sealed these presents the day and) ear ' t��. r" abovo written. 2 t C-11 1.0 Signed, sealed and delrvw'ed lir our presence: i� Lin F.foo id appin � 41t e f l L. S. I fen E.Tappin — Y�(;tt1/ts