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338 6th St. (vault) CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD v ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00032474 Date 3/09/06 Property Address . . . . . . 338 6TH ST Tenant nbr, name . . . . . . CHGE FROM OH TO UG FEED Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor - ------------------------ ------------------------ FORD, DON BROOKS & LIMBAUGH ELECTRIC CO 2002 LAKEVIEW CT. 42 WEST 8TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241-9051 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING OFFICIAL CITY OF ATLANTIC BEACH Y. ELECTRICAL PERMIT APPLICATION Property Address: J� ih Sir e✓f Owner: h �OIr Telephone #: Contractor: Telephone #:2L{ +—Ca C)!51Contractor Address: � �C-{ h ��rpp Fax #• a consideration of permit given for doing the work as described in the above statement, we hereb accordance with the attached plans and specifications which are n art h rfo ordirtan«and standards of P hereof nrid in accordance wi hcWee tC ry of Atlantic Beach nod rUnCe listed therein. Building: Building Type: p � New Trailer Service: Residence O Temp. O tt om r conszmctioc is Old Commercial New beutQ done on this budding Re-wire O Signs O Increase Or site,list the budding O Addition Patn;t � Sq. Ft. O Repair Conductor S�zc AMPS: Switch or PER 71 Aj,LTMINtJM Breaker AMPS Existing Service ,, PH W VOLT RACE Size AMPS 9�Ull PH `V RACE VOLT WAY WAY Feeders NO. SIZE Lighting Outiccs NO SIZE NO SIZE CONCEALED OPEN Rece tacles CONCEALED OPEN Switches incandescent Fluorescent & Y V Fixed 0.100 AMPS A Nantes DYER BELL Air H.P.RATING TRANSFER. Conditionin COMP. MOTOR H'P' RATING OTHER MOTORS AMPS CEILING KW-HEAT HEAT lAotors 0-1 H.P. VOLTAGE PH N0. OVER l H.P. PHS V Transformers NO. KVA v 'sc Ncoo_Transf. NO. KVA Ea S, Y:scellaneous -7jn 0,1 800 Seminole Road • Atlantic Beach, Florida 32233D 5445 Pboae: (904) 247-5800 • Fax: (904) 247-5845 • http://ww'w.ci.atlantic-beat h.(1 us l / HP OfficeJet 7410 Log for Personal Printer/Fax/Copier/Scanner Information Systems 904-247-5845 Mar 31 2006 3:31 PM Last Transaction Date Time Type Identification Duration Panes Result Mar 31 3:29PM Fax Sent 96657372 1:29 4 OK Graham Shirley From: Graham Shirley Sent: Friday, March 31, 2006 3:30 PM To: 'Schweizer, Carol M.' Carol, 338 6th St passed inspection today for overhead to underground service permit#06 32474. Thanks Shirley CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 1.'' ATLANTIC BEACH,FL 32233 f INSPECTION PHONE LINE 247-5826 Application Number . . . . . 06-00032474 Date 3/09/06 Property Address . . . . . . 338 6TH ST Tenant nbr, name . . . . . . CHGE FROM OH TO UG FEED Application description . . . ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ------------------------ ------------------------ FORD, DON BROOKS & LIMBAUGH ELECTRIC CO 2002 LAKEVIEW CT. 42 WEST 8TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241-9051 ---------------------------------------------------------------------------- Permit ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING OFFICIAL CITY OF ATLANTIC BEACH ELECTRICAL PERMIT APPLICATION y. t Date: L-7 Property Address: 5-3? h YJ r✓t Owner: n �O� #: Contractor: Telephone Telephone #:2L{ (—Ca C)51 Contractor Address: o .� -�-(1 `F'I�PP� Fax #• In consideration of permit given for doing the work as described in the accordance with the artached plans ands above statemene we hereby agree to ordinance and standards of nod rs aioe ll eciTed�� which arc a part hereof acid in aocordaer with the perform e Of t►aidCiwork in c Beach Building: Building Tvpe: O � New Trailer Service: Residence O Temp. if other consuuctioc is ! Old Commercial O New being done on this building Z� Re-wire O Addition O Signs O Increase Or site,tis[the binding Para,t number: Conductor Size Sq. Ft. O Repair AMPS: Switch or COPPER ALS Breaker AMPS Existing Service PH W RACE Size AMPS �O� VOLT WAY PH W '3 VOLT2Ao WAY RACE Feeders NO. SIZE L ghung Outlets NO SIZE NO SIZE CONCEALED OPEN Rece tacles CONCEALED OPEN Switches it I Incandescent Fluorescent g 'vl V I Fixed 0.100 APS A licences MOVER ITE LL q'r H.P.RATING H.p RATINO TRANSFER. Condinonin COMP, MOTOR CEILING OTHER MOTORS AMPS KW-HEAT ' HEAT Motors 0.1 H.P. VOLTAGE PH N0. OVER 1 H.P. PHS v Transformers NO. KVA '7o 'veoo_Transf. NO. KVA Ea Sign i 800 Seminole Road . Atlra de Bea 6 Flo�da 322330 Pbooe: (904) 247-5800 . 5 t 9 Fai: (904) 247-5845 . bnp://www.ci.ztlsntic-beac�ifl.us `/10A4^ 'G HP OMoejet 7410 Log for Personal Printer/Fax/Copier/Scanner Information Systems 904-247-5845 Mar 31 2006 3:31 PM Last Transaction Date Time Type Identification Duration Pages Result Mar 31 3:29PM Fax Sent 96657372 1:29 4 OK Graham Shirley From: Graham Shirley Sent: Friday, March 31, 2006 3:30 PM To: 'Schweizer, Carol M.' Carol, 338 6th St passed inspection today for overhead to underground service permit#06 32474. Thanks Shirley i a TI,P,L)T;:F.S S 3 9 C9 13IJI'.DING PERMIT NUMBER Ill INSPECTIONS: FOOTING �� - UNDER SLAB PLUMBING SLAB FRAMING COVER-UP INSULATION FINAL BUILDING ' CERTIFICATE OF OCCUPANCY ELECTRICAL PERMIT # tNSJ'I:C'.CICNS ROUGH FINAL MECHANICAL PERMIT # FLUMBING PERMIT TVOTT?S : ADDRESS----` 3 -- TfC EF %_ b IJ��J Q�----------2- - P -- -- BUILDING PERMIT NUMBER_- 6p 3-� -------------------------------- INSPECTIONS: UNDER SLAB PLUMBING------------------------------- FOOTING---- ------------------------------FOOTING____ 10_/S_ /92-_--__ SLAB---------------------------------------------- FRAMING__Z -/9=93-------------------------------- COVER-UP 2-19-5 3------------------------------- INSULATION_---tI-lq=-_? 3------------------------- FINAL BUILDING Ci - 3 - 95 CERTIFICATE OF OCCUPANCY_9 --- 3_�-3 -------------- ELECTRICAL PERMIT #__ &Z-7 Z ------------------------------------- INSPECTIONS ROUGH-„;P--L--------------------------------------- FINAL /- 2 IF--9-3--------------------------------------------- MECHANICAL PERMIT #---------------------------------------------- PLUMBING PERMIT #------------------------------------------------ NOTES: S 1'- CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 t INSPECTION PHONE LINE 247-5826 i �,- INSPECTION EMAIL REQUEST: Bui1dia6,=dgptAgoab,u Application Number . . . . . 07-00000659 Date 5/15/07 Property Address . . . . . . 338 6TH ST Application type description MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 -------- -------------------------------------------------------------------- Application desc 1 CU 1 AHU ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ FORD, DON HUXHAM HEATING & AIR 2002 LAKEVIEW CT. 2101 FLORIDA BLVD. ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 246-6721 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 71 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/11/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 71 . 00 71 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 71 . 00 71 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ~ITY OF ATLANTIC BEACH - MECHANICALPERMIT APPLICATION . E _ Date: Property Address: Owner: -Fd✓C.!/ Telepbone#: Contractor: j!jz/,2 G %telephone#: cA 1(6-6 Contractor Address: ` Cclt) Fax #: Contractor Signature/� In consideration of permit given for doi the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and speFificati s 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. O'er Electric ❑ Gas: LP _ Natural !/Central Utility 33 ❑ oil � � �4� ❑ Other—Specify MECHANICAL EQUWMENT TO BE INSTALLED NATURE OF WORK rim Heat —Space _Recessed vCentral _Floor (D' Residential 4a- Air Conditioning: Room central ¢Y Duct System: Material r14-Y' ,Thickness ❑ Commercial Maximum capacity cfrn ❑ Refrigeration o New Building ❑ Cooling Tower:Capacity gpm 13 Fire Sprinklers:Number of Heads___ Existing Building ❑ Elevator: _— Manlift Escalator (Number) ❑ Replacement of Existing System ❑ Gasoline Pumps (Number) ❑ Tanks (Number) 127Y---New Installation D LPG Containers (Number) (No system previously installed) ❑ Unfired Pressure Vessel ❑ Extension or Add-on to ExistingSystem ❑ Boilers rni y ❑ Gas Piping ❑ Other-Specify ❑ Other—Specify LIST ALL EQUIPMENT AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving Number Units Description Model# Manufacturer Ton's Agency HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving Number Units Description Model# Manufacturer BTU's Agency Z/ G ✓ p�O TANKS Nominal Capacity Type Liquid Serial Approving How Many &Dimensions Contained Manufacturer No_ Agency 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Phone:(904)247-5800• Fax: (904)247-5845o htin:/ht'vvsv.ci.atlantic-beaclt.fi.us Revised 1/04 Residential System Sizing Calculation Summary FORD FAMILY Project Title: Code Only 338 SIXTH STREET DON FORD HOME ADDITION Professional Version ATL BCH, FL Climate: North 5/26/2006 Location for weather data: Jacksonville - User customized: Latitude(30) Altitude(26 ft.) Temp Range(L) Humidity data: Interior RH 50% Outdoor wet bulb 77F Humidity difference 53 r. Winter design temperature 32 F Summer design temperature 93 F Winter setpoint 70 F Summer setpoint 75 F Winter temperature difference 38 F Summer temperature difference 18 F Total heating load calculation 14573 Btuh Total cooling load calculation 20970 Btuh Submitted heating capacity % of calc Btuh Submitted cooling capacity % of calc Btuh Total (Electric Heat Pump) 164.7 24000 Sensible (SHR = 0.70) 102.3 16800 Heat Pump+Auxiliary(O.OkW) 164.7 24000 Latent 158.1 7200 Total Electric Heat Pum 114.5 24000 WINTER CALCULATIONS Winter Heating Load for 980 s ft VenHlatlon(8%) Load component Load Ducts(2%) Window total 133 sgft 4207 BtuhWlndows(29%) Wall total 1101 sgft 3233 Btuh Infil.(19%) Door total 0 sqft 0 Btuh Ceiling total 1039 sgft 1935 Btuh Floor total 980 sgft 1276 Btuh Infiltration 65 cfm 2729 Btuh Duct loss 357 Btuh Floors(9%) Subtotal 13737 Btuh Cellings(13%) Ventilation 20 cfm 835 Btuh TOTAL HEAT LOSS 14573 Btuh wans(22%) SUMMER CALCULATIONS Summer Cooling Load for 980 s ft Load component Load Window total 133 sgft 6257 Btuh Wall total 1101 sgft 2076 Btuh Door total 0 sgft 0 Btuh Latent Irternal(8%) Ceiling total 1039 sgft 2903 Btuh VerRllation(S%) , Floor total 136 Btuh Windows(30%) Infiltration 57 cfm 1131 Btuh Internal gain 3040 Btuh Int.Gain(,4%) ='l, Duct gain 477 Btuh Sens.Ventilation 20 cfm 396 Btuh Total sensible gain 16417 Btuh Ducts(3%) Latent gain(ducts) 174 Btuh Latent gain(infiltration) 2059 Btuh In}It.(15%) Ceilings(14%) Latent gain(ventilation) 720 Btuh Floors( %) Walls(to%) Latent gain(internal/occupants/other) 1600 Btuh Total latent gain 4553 Btuh TOTAL HEAT GAIN 1 20970 Btuh EnergyGauge®Syst S' It Ad=kPREPARED BY:� qM For Florida residences only DATE: EnergyGauge@ FLRCPB v4.21 fAg ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE SCORE* =85.5 The higher the score,the more efficient the home. FORD FAMILY, 338 SIXTH STREET, ATL BCH, FL, 1. New construction or existing Addition - 12. Cooling systems 2. Single family or multi-family Single family - a. Central Unit Cap:24.0 kBtu/hr _ 3. Number of units,if multi-family 1 _ SEER: 13.00 4. Number of Bedrooms 2 _ b. N/A _ 5. Is this a worst case? No 6. Conditioned floor area(ft2) 980 ft2 _ a N/A _ 7. Glass type and area:(Label regd.by 13-104.4.5 if not default) _ a. U-factor: Description Area 13. Heating systems (or Single or Double DEFAULT) 7a.(Dble Default) 133.4 ft2 _ a. Electric Heat Pump Cap:24.0 kBtu/hr _ b. SHGC: HSPF:7.20 _ (or Clear or Tint DEFAULT) 7b. (Clear) 133.4 ft' _ b. N/A 8. Floor types _ a. Raised Wood,Stem Wall R=19.0,980.0ft2 _ c. N/A _ b. N/A c. N/A _ 14. Hot water systems 9. Wall types a. Electric Resistance Cap:50.0 gallons _ a. Frame,Wood,Exterior R=19.0, 1101.0 ft2 _ EF:0.92 _ b. N/A _ b. N/A _ c. N/A d. N/A _ c. Conservation credits _ e. N/A _ (HR-Heat recovery,Solar 10. Ceiling types DHP-Dedicated heat pump) a. Under Attic R=19.0,980.0 ft2 _ 15. HVAC credits _ b. Under Attic R=19.0,59.0 ft2 _ (CF-Ceiling fan,CV-Cross ventilation, a N/A _ HF-Whole house fan, 11. Ducts PT-Programmable Thermostat, a. Sup:Unc. Ret:Unc. AH:Interior Sup.R=6.0,50.0 ft _ MZ-C-Multizone cooling, b. N/A _ MZ-H-Multizone heating) I certify that this home has complied with the Florida Energy Efficiency Code For Building ZIiE ST Construction through the above energy saving features which will be installed(or exceeded) in this home before final inspection. Otherwise, a new EPL Display Card will be completed based on installed Code compliant features. Builder Signature: Date: a tr Address of New Home: City/FL Zip: ��c0D *NOTE: The home's estimated energy performance score is only available through the FLA/RES computer program. This is not a Building Energy Rating. If your score is 80 or greater(or 86 for a US EPA/DOE EnergyStarTmdesignation), your home may qualms for energy efficiency mortgage(EEM) incentives if you obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at 3211638-1492 or see the Energy Gauge web site at www.fsec.ucf edu for information and a list of certified Raters. For information about Florida's Energy Efficiency Code For Building Construction, contact the Department of Community Affairs at 8501487-1824. 1 Predominant glass type.For actual glass type and areas,see Summer&Winter Glass output on ages 2&4. EnergyGauge®(Version: FLRCP v4.21) FORM 60OA-2004 EnergyGauge®4.21 Code Compliance Checklist Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET,ATL BCH, FL, PERMIT#: 6A-21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE CHECK Exterior Windows&Doors 606.1.ABC 1 1 Maximum:.3 cfm/eft.window area; .5 cfm/sq.ft.door area. 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 from,and is sealed to,the foundation to the top late_..... Floors i 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; j attic access. EXCEPTION: Frame ceilings where a continuous infiltration barrier is - --- -- --- - — -- — ---I installed that is sealed at the Perimeter, at penetrations and seams. Recessed Lighting Fixtures 1 606.1.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-story Houses__ —_ 6_06.1 ABC1.2.5 Air barrier on perimeter of floor cavity between floors. --- --- -_ —- p P comply Additional Infiltration reqts 606.1.ABC.1.3 j Exhaust fans vented to outdoors,dampers;combustionspace heaters com I with NEPA, have combustion air. 6_A-22 OTHER PRESCRIPTIVE MEASURES(must be-met or_exceeded by all residences. COMPONENTS SECTION REQUIREMENTS CHECK Water Heaters 612.1 Comply with efficiency requirements in Table 612.1.ABC.3.2. Switch or clearly marked cir breaker(electric)or cutoff(gas)_must be provided. External or built-in heat trap mired.__ l Swimming Pools&Spas 612.1 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 {r�] efficiency of 78%. / l Shower heads 612.1 Water flow must be restricted to no more than 2.5 gallonser 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 tSeparate readily accessible manual or automatic thermostat for each system v 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. EnergyGauge Tm DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 FORM 60OA-2004 EnergyGauge®4.21 WATER HEATING & CODE COMPLIANCE STATUS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET,ATL BCH, FL, 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 2635.00 5270.0 50.0 0.92 2 1.00 2635.00 1.00 5270.0 As-Built Total• 5270.0 CODE COMPLIANCE STATUS BASE AS-BUILT Cooling + Heating + Hot Water = Total Cooling + Heating + Hot Water = Total Points Points Points Points Points Points Points Points 5630, 5454 5270 16354 1 4672 4633 5270 14576 PASS yOj-T 11E Sr4., J tr EnergyGauge TM DCA Form 60OA-2004 EnergyGauge®/FIaRES'2004 FLRCPB v4.21 MAP SHOWING BOUNDARY SURVEY DF, LOT 17, BLOCK 7, ATLANTIC BEACH AS RECORDED IN PLAT BOOK 5, PAGE 69 OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. SIXTH ( 6th ) STREET 40' RIGHT-OF-WAY a� r 4'ConereAe S�dewa/k Found Fe„Iron Pipe ,,No/D) Z46 6""45 3/Q�e1a/k rx' o.q o' /O Cap I •,'_ (P 5�/4400.o //7 S/deWa//t I� co ILS ^ N I L-MFIac�aG LL! > Co Vere N c •. W a 5.9 2� . 15.5'• 0 cr- An "r 9 u U) o L0CK � � Q3 NOTES , 8`O � �; :�.. /. ALL INTERIOR BOUNDARY ANGLES ARE 90000-00-1. 43 p i 2.NO BUILDING RESTRICTION LINE BY PLAT,BUT h c � (n = THERE MAY BE RESTRICTION LINES OR EASEMENTS (� Q THAT AFFECT THIS PROPERTY BY ZONING OR u W Z Wcr RECORDED IN THE PUBLIC RECORDS OF THISCOUNTY O v LV SURVEY,THAT ARE NOT SHOWN ON THIS Z 0 0 0 o 3 THIS PROPERTY APPEARS TO LIE IN FLOOD ZONE v •'X•'BY FLOOD MAPS REVISED 4/17/1999, rr.) COMMUNITY PANEL NO.120075 0001 D. 1^ 15.9' 2e.a' :15.5'• h by V Atlantic Bea ` ood Deck/ „ • \ Pbnni% and ZQMV Department lick oppw M vorMles G*Mpftnw with opplicab / I zOninp, subdivision and other local land , , J o -,j 1d*V*I0Pfn*ffl tsquioNons, but doss not constitut Co'ncDrive approVat tut the ksuanoe permits .Compliance $ u whh Florida 0ulkft Cods and a!1 other appiieab : �- tocaL 1111tole and Federal permitting uiremento 3 Abe Vet�tq by elpaturs of�City of Atianti � ; Qfnpy ,r', . prior to the issuance of a 54 soudbv Peraked t� FAMEY APeVed�' e nor GA246E a .. /0 Story ti Oar e a [/ drr�rlers �d dti�c� � a0 95� F6und'l2"1ronPipe 00 (.3 1048) ,�aCtc o � 4awCoc� —.50- 00 CO ^0 J ' V6! Wood Fence LOT 20 SOT C8 OT /6 B L 0 c 7 PREPARED FOR THE BENEFIT OF: MAP SHOWING BOUNDARY SURVEY DF,, Q LOT 17, BLOCK 7, ATLANTIC BEACH AS RECORDED IN PLAT BOOK 5, PAGE 69 OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. SIXTH ( 6th ) STREET 40' RIGHT-OF-WAY 4'Conerete Sdewa/k Founr/%2"/ron PiS/decva/k E0.41 (No/D)P/scrd eJ�S Set Disk�e oo !D Cap I PLS/GT4) In 5/aewa//c N ' Li Z. Co vered u 16 Porch a Q V' 5.9 ZA 4' 0 19 i ` ) : 8OCK W 3 NOTES U :�.. /. ALL INTERIOR BOUNDARY ANGLES ARE 90.00'00", 1 OD '• 4:'. Q 0 y w w 0) ,� c . . lA U) i 1.NO BUILDING RESTRICTION LINE BY PLAT,BUT THERE MAY BE RESTRICTION LINES OR EASEMENTS hN Q THAT AFFECT THIS PROPERTY BY ZONING OR e W Z ,' ': w Cr (D RECORDED IN THE PUBLIC RECORDS OF THIS ��+ �{ O COUNTY THAT ARE NOT SHOWN ON THIS O v O :•, •• O SURVEY, 1. ... 3 THIS PROPERTY APPEARS TO LIE IN FLOOD ZONE 9 7"BY FLOOD MAPS REVISED 4/17/1989, COMMUNITY PANEL NO.120075 0001 D. 'A ' 5.9' 2�.a' •:1.5.5"• ood Deck/ \ �II 2°.as 54' 1 2-STORY FRAME 4 G.4R46E N Gauge 2 nQ Li nq di artery �AIL 00.25, �° boa Found'he Iron Pipet•o N t e�; ,�cc t (LB 1048) o• G� o ��``C°c qN iL 16 -50' 00ix—x —z Ir.--&I Wood Fence L 0 T 20 I * 4, 0,7- C8 L 0 T /(a RE(7.,1-71'v' 'FELD% L 0 c K 7 MAY 19 1999 PREA4RED FOR THE BENEFIT OF: CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE:(904)247-5800 FAX:(904)247-5805 SUNCOM:852-5800 - http://ci.attantic-beach.fl.us Date: ;L - y Name: 0 A.) F0 rt 0 Address: 33 J" G r s f • `" /4fQ Fl/ C21 OJ The cost to connect to the City sewer and/or water system are as follows: Sewer Tap—Labor and Materials to tap into sewer main (Estimate from Public Utilities) $ Water Tap—Labor and Materials to tap into water main Q (From Ord. 22-28) $ Water Meter—Cost of Meter (85.00) $ Cross Connection Inspection —Inspection by Public Works to insure backflow prevention (35.00%"—Ord. 22-28(a)) $ 3 v Sewer Impact Fees—Funds future expansion of the sewer plant Q (1250.00 each living unit—Ord. 22-17-0) $ Water Impact Fee—Funds future expansion of the water plant -2 Fvf-c 6.+7#S + / SND w E< /y ,x 20 (From Building Dept. —Ord. 22-29 FLA. Plumbing Code) $ Capital Improvement—Funds for improvements, expansion or replacement to water system (325.00 —Ord. 22-28) $ Q TOTAL COSTS $ DCF/js MAP SHIDWING BOUNDARY SURVEY OF- LOT 17, BLOCK 7, ATLANTIC BEACH AS RECORDED IN PLAT BOOK 5, PAGE 69 OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. SIXTH ( 6th ) STREET 40' RIGHT—OF—WAY • 4 eanereleS�rJcwa/k Found%p"Iron Pipe (No/D)oNgeed Z8 6645 SroEwra/,E 0 4'j SC/Di k°O oo /n Sidewalk co • W Covered Q' W e Porch Q 5.9 ' ' 28 4 15.5' 8 '9 , U) c LST ( Q3 LOCK NOTES :NOTES ; `O f O — _ O 3 /. ALL INTERIOR BOUNDARY ANGLES ARE 90.00'0011. Z QD o O 2.NO BUILDING RESTRICTION LINE BY PLAT,BUT � '^ � In 2 THERE MAY BE RESTRICTION LINES OR EASEMENTS N %1 0 THAT AFFECT THIS PROPERTY BY ZONING OR c W 7Z W cr RECORDED IN THE PUBLIC RECORDS OF THIS Ov DL o COUNTY THAT ARE NOT SHOWN ON THIS O V SURVEY. O 3 THIS PROPERTY APPEARS TO LIE IN FLOOD ZONE "X"BY FLOOD MAPS REVISED 4/17/1999, COMMUNITY PANEL NO.120075 0001 D. 5.9' 28.4' ~ ood Deck • ' \ %'Cona Drive J / , 2-STORY FRAME IC ;AJE6 ea�g Quo° 21 story [iv/ngar�arters date° JOS }-ouM'hZ"Iron PipeI° •o N pq Kee (lB ..� 4p,�N°�jyc SO' W • x1.0 s- f--6' Wood Fence L O T 20 L 017- 18 L OT /(a .v B L. O cV Eli K N1 A I` 1 9 1999 PREAARED FOR TUE BENEFIT OF: ('.itv nr atlnn+ir ©---I- �d.NO [7E1301C404✓ 4C�4 2/W, APPROVED ,27, 7 CITBUILDING OF O OFNTIC FICE, OCT 21 1992 �� II I V� Ire!►, , 1 R/ �.�L-`�� .�— --y-:I�` ..... ..�..,aR•.ri/..� �ISTGo 2.STG71�t1''_ � i G\clPNN�N' �3,,�1e�r3'L To r� bEGMdUsHEG.., I i - _ , :a_ ,AT LA IJ Y1G e;C H PL , K:A MK P i P . ;, CITY OF ATLANTIC BEACH 800 SENUNOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 s Application Number . . . . . 06-00033104 Date 6/02/06 Property Address . . . . . . 338 6TH ST Tenant nbr, name . . . . . . RM ADD/PORCH/ADD 2ND FLR Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 65000 Owner Contractor ------------------------ ------------------------ FORD, DON OWNER 2002 LAKEVIEW CT. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 452 . 00 Plan Check Fee 226 . 00 Issue Date . . . Valuation . . . . 98000 Expiration Date . . 12/02/06 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . ST CONSTRUCTION SURCHARGE 4 .41 AB CONSTRUCTION SURCHARGE .49 WATER IMPACT FEE 315 . 00 WATER CROSS CONNECTION 35 . 00 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 452 . 00 452 . 00 . 00 . 00 Plan Check Total 226 . 00 226 . 00 . 00 . 00 Other Fee Total 354 . 90 354 . 90 . 00 . 00 Grand Total 1032 . 90 1032 . 90 . 00 . 00 PERMiT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING OFFICIAL ..%'1."x`'1 . i+ SSl ' CITY OF ATLANTIC BEACH OWNER/BUILDER AFFIDAVIT Date: / .2 - .S O S- Job Address: ,j 3 CHAPTER 489,FLORIDA STATUTES,PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.1030,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 TIE, OWNER OF YOUR PROPERTY, TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF YOU MAY BUILD OR IMPROVE A ONE- OR TWO FAMILY RESIDENCE, OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. ORDINANCES ALSO ALLOW AN.OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES; OR MAY HIRE UNLICENIjF 1D WORKERS PROVIDED SUCH WORKERS BE UNDER"DIRECT SUPERVISION OF THE OWNER, WHO MUST BE-Ci 4 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 EMI10Y ON THEIR IMPROVEME111T 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 ISSUANCE OF AN OWNER-BUILDER PERMIT. . .` c PROPERTY OWNER/BUILDER SrIVQ alMSCRI BEFORE ME THIS 2 00, JEANNE M.SHAW MY COMMISSION#DD 435986 a EXPIRES:May 31,2009 TZ-- Bonded Thru Notary Public Underwriters N ARy PUBLIC .. /I�u�-( NOTE: PHRASES UNDERLINED ABOVE. COMMISSION EXPIRES: 3I CITY OF Office of Building Official t / REQUEST FOR INSPECTION ` '/ ( < Permit No. � Date Time / A.M. Received d PM. �/ 337 Job Add r Locality Owner's Name _ �� " —__. —_. Contractor BUILDING CONCRETE L PLUNf�� MECHANICAL FramingFooting Rough`Hiring Rough Air Cond. & rl Re Roofing i 7 Slab Temp Pole Top Out E Heating Insulation F Lintel Final Sewer Fire Place r Pre Fab READY FOR INSPECTION A.M. Mon„ Tues. Wed. Thurs. Friday A.M. Inspection Made _- 4/ � �3-------- -----P.M. Final Inspection Certificate of Occupancy i_. Qate .----- ----- CITY OF fQ��wsuC /3 - Office of Buil ng Offici f _ W 3J 77SU REQUEST FO INSP CTION 1-7 � / _i -� Date Permit No. Time A.M. Received PM. 33S- Ek Joa Address Locality Owner's Nam �Jnngcto,�.K UILDING CONCRETE ELECT UMBi MECHANICAL Framing Footing ❑ oug Rough L7� Air Cond. &Re Roofing Cj Slab C Temp PoleTop Out Heating Insulation ❑ Lintel Cl Final ❑ Sewer ire Place ❑ READY FOR INSPECTION Pre Fab 'A/,M�/� Mon. (Tues` Wed. Thurs. Friday p,M— �� Inspection Made A.M.� ��., P.M. Inspector G3t�iCY Final Inspection ❑ Certificate of Occupancy ❑ Date CITY OF Office of Building Official REQUEST FOR INSPECTION Date 117 Permit No. Time A.M. Received RM Job Address Locality Owner's Name Contractor r raLDING CONCRETE ELECTRICAL PLUMBING MECHANICAL m, g ❑ Footing ❑ Rough Wiring ❑i Rough ❑ Air Cond. & ❑ Re Roofing �❑ _ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Insulation /��/ Lintel ❑ Final ❑ Sewer ❑ Fire Place ❑ READY FOR INSPECTION Pre Fab Mon. Tues. AC Wed. Thurs. Friday p ;M ) A.M. Inspection Made 1'7 — PM InspectorFinal Inspection El Certificate of Occupancy ❑ Date 11�� /CITY OF n f' &an4-c BwcA-I&W44r Office of Building Official REQUEST FOR INSPECTION Date " f ? " 1 _' _ Permit No, Time A.M. Received P.M. J Job Address Locality Owner's Name .;rl,' j�� /`_/ —Contractor _C. ICC -BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing I Rough Wiring 1-i Rough Air Cond. & CI Re Roofing ❑ Slab I I Temp Pole C' Top Out ❑ Heating Insulation Lintel El Final I- Sewer ❑ Fire Place Pre Fab READY FOR INSPECTION A.M. Mon. Tues. / Wed. Thurs. Friday P.M. Inspection Made RM. ' Inspector _ -.-Final Inspection Fi Certificate of Occupancy Date CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Date G ' 2 ' d C Permit Number Address 3 3 g Co S7- /4 T/o&J 2 Contact Name o'i Phone Z U Heated Square Footage g' @ $ /00 per sq ft=$ © O CD Garage/Shed @ $ per sq ft=$ Carport/Porch @ $ per sq ft=$ Deck @ $ per sq ft=$ Patio @ $ per sq ft=$ TOTAL VALUATION: $ O d Total Valuation 1st $ Remaining Value $ per thousand or portion thereof CONSTRUCTION TYPE: [_ TOTAL BUILDING FEE $ ZONING: Z +'/2 Filing Fee $ FLOOD ZONE: r Oireplaces @$35.00 $ IMPERVIOUS SURFACE: CZc��S rntrc AB CONSTRUCTION SURCHARGE '5,r6 $ �.2 r�Fcoo/t' CAPITAL IMPROVEMENT $ CITY RADON SURCHARGE—AKAt– $ SECTION H IMPACT FEE $ SEWER IMPACT FEES $ d SEWER TAP FEES $ ST CONSTRUCTION SURCHARGE $ STATE RADON SURCHARGE $� WATER CONNECT/METER ONL $ WATER CONNECT/TAP&METER $ n WATER CROSS CONNECTION $ 2 S-- WATER IMPACT FEE $ OTHER $ GRAND TOTAL DUE: $ 1/13/03 ,,rtLlr � CITY OF ATLANTIC BEACH Cc D. Ford rj BUILDING / ZONING DEPARTMENT in r) 800 Seminole Road err r Atlantic Beach,Florida 32233 r1 J,il�f (904)247-5800 (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # Property Address: Applicant: 1 ft a—Djw Olt CL) C. rCL Project: 40Mobr on itgh -5 ThisP ermit application has been: 5 Approved C7� Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: L44- [A- Date: �J I/D61. Date Contractor Notified: 0 - rSy�lrv,. CITY OF ATLANTIC BEACH r J, BUILDING PERMIT APPLICATION (Alterations & Additions) Date: S 3 0 - 0 Job Address: Owner of Property: , \ 0 N A .D E D o rL A t-+ r o(2- Q Address: 5 N F Telephone: t Ll t- ,'2 0 O Legal Description: Block Number:_ Lot Number: t rT Zoning District: !Sec Contractor: (rj L F ,2 State License Number: Contractor Address: Is &ti!^ Telephone: k) ( fa Fax: Describe proposed use and work to be done: f1 7D 80 O r Tho�Ff� coo S6 1Z Present use of land or buil mg(s): Valuation of proposed construction: � 9? �© What are the dimensions of the added space: 3 feet x_2 feet Will the added area be heated and cooled? YE S New electrical or increase in service? YF— Add-plumbing FAdd-plumbing fixtures? Y�J Add fireplace? /V p Add heating/air conditioning? Is approval of Homeowner's Association or other private entity required? A. 0 If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to the original impervious area or the removal of any trees? [/NO. Applicant certifies that no change in site grade, impervious area 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. "N O. 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.stlantit-4ach.fl.us Page 2 Revised 8/04 `J T . w In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all infoon provided with this application is correct. Signature of owner: , ' Date: /z ' S - 03 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: Li/�� r Date: Address and contact information of person to receive all correspondence regarding this application(please print). Name: N /V\— Mailin g Address: Telephone: Farr: E-Mail: AS TO OWNER: 'Po Sworn to and subscribed before me this 5t"` day of 2005- . State of Florida,County of Duval IEANNE M.SHAW Notary's Si afore: COMMISSION#DD 435986 EXPIRES:May 31,2009 Personally knovAi rn,u Notary public Underwritere ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 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 Telephone: (904)247-5800 -Fax: (904)247-5845 -http:i/www.ci.atlantic-beach.fl.us Page 3 Revised 8/04 Doc#2005461398,OR BK 12958 Page 1023, Number Pages:1 0� Filed&Recorded 12/19/2005 at 11:38 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00 �) NOTICE OF COMMENCEMENT State of Lc.o A t D �I" Tax Folio No. County oft, , To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: k o r 1 `7 D L K 7 6 .D L&A- J rV- 344-C 1 f Address of property being improved: 3 3 — 7" General description of improvements: �9 xJ Q C 00 s o�r..fi �F lcoo r r Tr o a/ Owner: C--D Co z r N (' rtto rl Address: 33 6a r"`' S r A T�- �+N T� c / Fc _ 32233 Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): 4& Y r z'' r �ll Name: 'k,"iR AddressE� r' X r-f r �=;��' / e–t >; it.d., l� 1 �C It: l� Contractor. t,.�,J f i'z- C 0,-,r .j �'o,rc o �( Address: -332 ,.`- Sr .- .4 rz.*oJrt c AS(FAC Y FL . 3 2 Z 33 Phone No: 9©v'- 2 Y t- P-2 0 O Fax No: Surety(if any): Address: Amount of Bond S Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: _ Fax No: Name of person within the State of Florida,other than-hipuyself,designated by owner upon whom notices or other documents may be served: Name: Address: Phone No: Fax No: In addition to himself,owner designates the following person to receive a copy.of the Lienor's Notice as provided in -- Section 713.06(2xb),Florida Statues. (Fill in at Owner's option). Name: Address: Phone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): a t& C THIS SPACE FOR RECORDER'S USE ONLY Signed: ` .— O!NJ Date: Before me this— day of m the County (/ of Duval,State of Florida,has ersoually appeared�"1 ., J;0C% JEANNE M.SHAW No lic at Large,State of Florida,County of Duval. MV C OMMIS$ION#DD My commission expires: 31 EXPIRES:May 31, Personall nown or 8-ftd Thru Ndery PWNc lkMenw �----y p� Produced Identification: � FORM 60OA-2004 EnergyGauge®4.21 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Whole Building Performance Method A Project Name: DON FORD HOME ADDITION Builder: DON FORD Address: 338 SIXTH STREET Permitting Office: ATL BCH City, State: ATL BCH, FL Permit Number: Owner: FORD FAMILY Jurisdiction Number: Climate Zone: North 1. New construction or existing Addition - 12. Cooling systems 2. Single family or multi-familySingle family - a. Central Unit Cap:24.0 kBtu/hr - 3. Number of units,if multi-family 1 _ SEER: 13.00 - 4. Number of Bedrooms 2 - b. N/A - 5. Is this a worst case? No - - 6. Conditioned floor area(ft') 980 ft2 _ c. N/A - 7. Glass type I and area:(Label reqd.by 13-104.4.5 if not default) _ a. U-factor: Description Area 13. Heating systems (or Single or Double DEFAULT) 7a.(Dble Default) 133.4 ft' _ a. Electric Heat Pump Cap:24.0 kBtu/hr - b. SHGC: HSPF:7.20 - (or Clear or Tint DEFAULT) 7b. (Clear) 133.4 ft' - b. N/A _ 8. Floor types - a. Raised Wood,Stem Wall R=19.0,980.0W c. N/A b.N/A - - c. N/A - 14. Hot water systems 9. Wall types a. Electric Resistance Cap:50.0 gallons - a. Frame,Wood,Exterior R=19.0, 1101.0 ftz _ EF:0.92 b.N/A _ b.N/A _ c. N/A - - d. N/A - c. Conservation credits e. N/A - (HR-Heat recovery,Solar 10. Ceiling types _ DHP-Dedicated heat pump) a. Under Attic R=19.0,980.0 W 15. HVAC credits - b. Under Attic R=19.0,59.0 ft' - (CF-Ceiling fan,CV-Cross ventilation, c. N/A - HF-Whole house fan, 11. Ducts - PT-Programmable Thermostat, a. Sup:Unc. Ret:Unc. AH:Interior Sup.R=6.0,5 0.0 ft MZ-C-Multizone cooling, b. N/A - MZ-H-Multizone heating) Glass/Floor Area: 0.14 Total as-built points: 14576 PASS SS Total base points: 16354 r!-1 I hereby certify that the plans and specifications covered by Review of the plans and Z8s sT this calculation are in compliance with the Florida Energy specifications covered by this O� _ ATF Code. / calculation indicates compliance PREPARED BY: with the Florida Energy Code. r- _ Before construction is completed � DATE: r� -� � c�� , � this building will be inspected for t tr I hereby certify that this building, as designed, is in compliance compliance with Section 553.908 rti y� with the Florida Energy de. Florida Statutes. COD WEA OWNER/AGENT: k BUILDING OFFICIAL: DATE: LDATE: 1 Predominant glass type. For actual glass type and areas,see Summer&Winter Glass output on pages 2&4. EnergyGauge®(Version: FLRCPB v4.21) FORM 60OA-2004 EnergyGauge@ 4.21 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET, ATL BCH, FL, 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 .18 980.0 20.04 3535.1 Double,Clear E 1.0 5.0 33.3 42.06 0.95 1328.7 Double,Clear E 1.0 4.0 9.3 42.06 0.91 357.1 Double,Clear S 1.0 2.0 6.7 35.87 0.66 158.6 Double,Clear N 4.0 6.0 12.0 19.20 0.78 179.3 Double,Clear N 4.0 8.0 17.8 19.20 0.83 284.1 Double,Clear N 1.0 5.0 15.0 19.20 0.96 276.9 Double,Clear W 1.0 2.0 13.3 38.52 0.73 374.0 Double,Clear W 1.0 3.0 6.0 38.52 0.85 196.3 Double,Clear NE 1.0 5.0 10.0 29.56 0.95 281.8 Double,Clear NW 1.0 5.0 10.0 25.97 0.96 248.2 As-Built Total: 133.4 3684.9 WALL TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood,Exterior 19.0 1101.0 0.90 990.9 Exterior 1101.0 1.70 1871.7 Base Total: 1101.0 1871.7 As-Built Total: 1101.0 990.9 DOOR TYPES Area X BSPM = Points Type Area X SPM = Points Adjacent 0.0 0.00 0.0 Exterior 0.0 0.00 0.0 Base Total: 0.0 0.0 As-Built Total: 0.0 0.0 CEILING TYPES Area X BSPM = Points Type R-Value Area X SPM X SCM = Points Under Attic 980.0 1.73 1695.4 Under Attic 19.0 980.0 2.34 X 1.00 2293.2 Under Attic 19.0 59.0 2.34 X 1.00 138.1 Base Total: 980.0 1695.4 As-Built Total: 1039.0 2431.3 FLOOR TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Slab 0.0(p) 0.0 0.0 Raised Wood,Stem Wall 19.0 980.0 -1.50 -1470.0 Raised 980.0 -3.99 -3910.2 Base Total: -3910.2 As-Built Total: 980.0 -1470.0 INFILTRATION Area X BSPM = Points Area X SPM = Points 980.0 10.21 10005.8 980.0 10.21 10005.8 EnergyGauge®DCA Form 60OA-2004 EnergyGauge®/FIaRES'2004 FLRCPB v4.21 FORM 60OA-2004 EnergyGauge®4.21 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET,ATL BCH, FL, PERMIT#: BASE AS-BUILT Summer Base Points: 13197.8 Summer As-Built Points: 15642.9 Total Summer X System = Cooling Total X Cap X Duct X System X Credit = Cooling Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points (System - Points) (DM x DSM x AHU) (sys 1:Central Unit 24000 btuh,SEER/EFF(13.0)Ducts:Unc(S),Unc(R),lnt(AH),R6.0(INS) 15643 1.00 (1.09 x 1.147 x 0.91) 0.263 1.000 4672.4 13197.8 0.4266 5630.2 15642.9 1.00 1.138 0.263 1.000 4672.4 EnergyGauge TM DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 FORM 60OA-2004 EnergyGauge®4.21 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET, ATL BCH, FL, PERMIT#: BASE AS-BUILT GLASS TYPES .18 X Conditioned X BWPM = Points Overhang Floor Area Type/SC Ornt Len Hgt Area X WPM X WOF = Point .18 980.0 12.74 2247.3 Double,Clear E 1.0 5.0 33.3 18.79 1.02 640.2 Double,Clear E 1.0 4.0 9.3 18.79 1.04 181.0 Double,Clear S 1.0 2.0 6.7 13.30 1.64 146.1 Double,Clear N 4.0 6.0 12.0 24.58 1.01 298.8 Double,Clear N 4.0 8.0 17.8 24.58 1.01 441.5 Double,Clear N 1.0 5.0 15.0 24.58 1.00 369.1 Double,Clear W 1.0 2.0 13.3 20.73 1.08 298.8 Double,Clear W 1.0 3.0 6.0 20.73 1.04 129.7 Double,Clear NE 1.0 5.0 10.0 23.57 1.00 236.3 Double,Clear NW 1.0 5.0 10.0 24.30 1.00 243.3 As-Built Total: 133.4 2984.7 WALL TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood,Exterior 19.0 1101.0 2.20 2422.2 Exterior - 1101.0 3.70 4073.7 Base Total: 1101.0 4073.7 As-Built Total: 1101.0 2422.2 DOOR TYPES Area X BWPM = Points Type Area X WPM = Points Adjacent 0.0 0.00 0.0 Exterior 0.0 0.00 0.0 Base Total: 0.0 0.0 As-Built Total: 0.0 0.0 CEILING TYPES Area X BWPM = Points Type R-Value Area X WPM X WCM = Points Under Attic 980.0 2.05 2009.0 Under Attic 19.0 980.0 2.70 X 1.00 2646.0 Under Attic 19.0 59.0 2.70 X 1.00 159.3 Base Total: 980.0 2009.0 As-Built Total: 1039.0 2805.3 FLOOR TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Slab 0.0(p) 0.0 0.0 Raised Wood,Stem Wall 19.0 980.0 0.80 784.0 Raised 980.0 0.96 940.8 Base Total: 940.8 As-Built Total: 980.0 784.0 INFILTRATION Area X BWPM = Points Area X WPM = Points 980.0 -0.59 -578.2 980.0 -0.59 -578.2 EnergyGauge®DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 FORM 60OA-2004 EnergyGauge®4.21 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET, ATL BCH, FL, PERMIT#: BASE AS-BUILT Winter Base Points: 8692.6 Winter As-Built Points: 8418.0 Total Winter X System = Heating Total X Cap X Duct X System X Credit = Heating Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points (System - Points) (DM x DSM x AHU) (sys 1: Electric Heat Pump 24000 btuh,EFF(7.2)Ducts:Unc(S),Unc(R),lnt(AH),R6.0 8418.0 1.000 (1.069 x 1.169 x 0.93) 0.474 1.000 4633.5 8692.6 0.6274 5453.8 8418.0 1.00 1.162 0.474 1.000 4633.5 EnergyGaugeTm DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 FORM 60OA-2004 EnergyGauge®4.21 WATER HEATING & CODE COMPLIANCE STATUS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET,ATL BCH, FL, 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 2635.00 5270.0 50.0 0.92 2 1.00 2635.00 1.00 5270.0 As-Built Total: 5270.0 CODE COMPLIANCE STATUS BASE AS-BUILT Cooling + Heating + Hot Water = Total Cooling + Heating + Hot Water = Total Points Points Points Points Points Points Points Points 5630 5454 5270 16354 1 4672 4633 5270 14576 PASS � O4ZIiS STA? IV tr 1MC0 EnergyGaugeTm DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 FORM 60OA-2004 EnergyGauge®4.21 Code Compliance Checklist Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET,ATL BCH, FL, PERMIT#: 6A-21 INFILTRATION REDUCTION COMPLIANCE CHECKLIST COMPONENTS SECTION REQUIREMENTS FOR EACH PRACTICE _ _ _ -- CHECK Exterior Windows&Doors 606.1.ABC.1.1 Maximum.3 cfm/sq_ft._window-area:_5 cfm/sq.ft.door area. 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 from,and is sealed to the foundation to thetwo _plate. Floors 606.1.ABC.1.2.2 Penetrations/openings>1/8"sealed unless backed by truss orjoint 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 story Houses__._ 606.1.ABC 1.2.5 Air barrier on perimeter of floor-cavies between floors. Additional Infiltration reqts 606.1.ABC.1.3 Exhaust fans vented to outdoors,dampers;combustion space heaters comply with NFPA, have combustion air. 6A-22 OTHER PRESCRIPTIVE MEASURES Lust be met or_exceeded-by_all residences.___ COMPONENTS SECTION REQUIREMENTS CHECK Water Heaters 612.1 Comply with efficiency requirements in Table 612.1.ABC.3.2.Switch or clearly marked cir 1 breaker(electric)or cutoffJgas)must beprovided. External or built-in heat trap_required.- j Swimming Pools&Spas 612.1 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 efficient of 78% Shower heads 1612.1 Water flow must be restricted to no more than-2.5_gallonsper 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. I HVAC Controls 607.1 Separate_readily 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-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE SCORE* =85.5 The higher the score,the more efficient the home. FORD FAMILY, 338 SIXTH STREET, ATL BCH, FL, 1. New construction or existing Addition - 12. Cooling systems 2. Single family or multi-family Single family - a. Central Unit Cap:24.0 kBtu/hr - 3. Number of units,if multi-family 1 - SEER: 13.00 - 4. Number of Bedrooms 2 - b. N/A - 5. Is this a worst case? No - - 6. Conditioned floor area(ft') 980 ft2 - c. N/A - 7. Glass type and area:(Label reqd.by 13-104.4.5 if not default) a. U-factor: Description Area 13. Heating systems (or Single or Double DEFAULT) 7a.(Dble Default) 133.4 ft' - a. Electric Heat Pump Cap:24.0 kBtu/hr b. SHGC: HSPF:7.20 - (or Clear or Tint DEFAULT) 7b. (Clear) 133.4 ft' - b. N/A 8. Floor types - a. Raised Wood,Stem Wall R=19.0,980.0W - c. N/A - b.N/A - - c. N/A - 14. Hot water systems 9. Wall types a. Electric Resistance Cap:50.0 gallons - a. Frame,Wood,Exterior R=19.0, 1101.0 ftz - EF:0.92 _ b.N/A - b.N/A - c. N/A d - - d. N/A _ c. Conservation credits _ e. N/A _ (HR-Heat recovery,Solar 10. Ceiling types DHP-Dedicated heat pump) a. Under Attic R=19.0,980.0 ft' - 15. HVAC credits - b. Under Attic R=19.0,59.0 ftz - (CF-Ceiling fan,CV-Cross ventilation, c. N/A - HF-Whole house fan, 11. Ducts PT-Programmable Thermostat, a. Sup:Unc. Ret:Unc. AH:Interior Sup.R=6.0,50.0 ft - MZ-C-Multizone cooling, b. N/A - MZ-H-Multizone heating) I certify that this home has complied with the Florida Energy Efficiency Code For Building �g S8F Sr.4�� Construction through the above energy saving features which will be installed(or exceeded) in this home before final inspection. Otherwise, a new EPL Display Card will be completed based on installed Code compliant features. �� ""' Builder Signature. Date: �� y Address of New Home: City/FL Zip: f�00D We *NOTE: The home's estimated energy performance score is only available through the FLA/RES computer program. This is not a Building Energy Rating. If your score is 80 or greater(or 86 for a US EPA/DOE EnergyStarwdesignation), your home may gualify for energy efficiency mortgage(EEM) incentives if you obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at 321/638-1492 or see the Energy Gauge web site at www.fsec.ucfedu for information and a list of certified Raters. For information about Florida's Energy Efficiency Code For Building Construction, contact the Department of Community Affairs at 850/487-1824. 1 Predominant glass type.For actual glass type and areas,see Summer&Winter Glass output onages 2&4. EnergyGauge®(Version: FLRCP9 v4.21) Residential System Sizing Calculation Summary FORD FAMILY Project Title: Code Only 338 SIXTH STREET DON FORD HOME ADDITION Professional Version ATL BCH, FL Climate: North 5/26/2006 Location for weather data: Jacksonville - User customized: Latitude(30) Altitude(26 ft.) Temp Range(L) Humidity data: Interior RH 50% Outdoor wet bulb 77F Humidity difference 53 r. Winter design temperature 32 F Summer design temperature 93 F Winter setpoint 70 F Summer setpoint 75 F Winter temperature difference 38 F Summer temperature difference 18 F Total heating load calculation 14573 Btuh Total cooling load calculation 20970 Btuh Submitted heating capacity % of calc Btuh Submitted cooling capacity % of calc Btuh Total (Electric Heat Pump) 164.7 24000 Sensible (SHR = 0.70) 102.3 16800 Heat Pump +Auxiliary(O.OkW) 164.7 24000 Latent 158.1 7200 Total Electric Heat Pum 114.5 24000 WINTER CALCULATIONS Winter Heating Load for 980 sqft) Ventilatlon(6%) Load component Load Ducts(2%) Window total 133 sqft 4207 Btuh / I- Floor dows(29%) Wall total 1101 sqft 3233 Btuh InfIL(f 9%) Door total 0 sqft 0 Btuh Ceiling total 1039 sqft 1935 Btuh total 980 sqft 1276 Btuh Infiltration 65 cfm 2729 Btuh Duct lass 357 Btuh Floors(9%) Subtotal 13737 Btuh ngs(f 3%) Ventilation 20 cfm 835 Btuh w°ns(z2%) TOTAL HEAT LOSS 14573 Btuh SUMMER CALCULATIONS Summer Cooling Load for 980 s ft Load component Load Window total 133 sqft 6257 Btuh Wall total 1101 sqft 2076 Btuh Door total 0 sqft 0 Btuh Latent Internal(M) Ceiling total 1039 sqft 2903 Btuh Vertilation(5%) ., Floor total 136 Btuh V1Andows(30%) Infiltration 57 cfm 1131 Btuh Internal gain 3040 Btuh Into°'"(,4%) ;. Duct gain 477 Btuh Sens. Ventilation 20 cfm 396 Btuh Total sensible gain 16417 Btuh oucts(3%) Latent gain(ducts) 174 Btuh Latent gain(infiltration) 2059 Btuh Infil.c,5%) Ceilings(14%) Latent gain(ventilation) 720 Btuh Latent gain(internal/occupants/other) 1600 Btuh FI ors(t%) walts(,o%) Total latent gain 4553 Btuh TOTAL HEAT GAIN 20970 Btuh EnergyGauge®System i ng c_ PREPARED BY(,-'. T�' T O For Florida residences only DATE: 1 EnergyGauge® FLRCPB v4.21 � r �rL�rf� CITY OF ATLANTIC BEACH Cc: r � BUILDING / ZONING DEPARTMENT D. FONL c . in 800 Seminole Road oerr Atlantic Beach,Florida 32233 (904)247-5800 (904)247-5845 Fax www.coab.us Y" PLAN REVIEW COMMENTS Permit Application # O(o=M)I n4 Property Address: s4?)U l01 51 I l F+ Applicant: rA , � rA(--0- r- 1/m d" C1 Tbr J-) Project: Um -qdkr� (I Ph r kti '4 Btor D i T=Approved -plication has been: Reviewed and the following items need attention: Please re-submit you applic ion when these items have been completed. Reviewed By: Date: Date Contractor Notified: L'J ;1 rir�lrw' CITY OF ATLANTIC BEACH BUILDING PERMIT APPLICATION (Alterations & Additions) Date: Job Address: Owner of Property:�� o N n 1~ p o .4 c� f' 0('k 0 Address: S N rt F Telephone: ;I L/(- .F2- 0 Q Legal Description: Block Number: _Lot Number: t Zoning District: S E C A- Contractor: r) L,_,�-es r--I(L State License Number: �q Contractor Address: S k K F_ Telephone: Fax: Describe proposed use and work to be done: A -pp ft?8 ��/ $ C o�0 e T�a I is f> <PiC�` coo N S lcoz Present use of land or buil mg(s): Valuation of proposed construction: �*-( ,�_ on () What are the dimensions of the added space: 3 b feet x ;2 feet Will the added area be heated and cooled? VES New electrical or increase in service? YF— Add EAdd plumbing fixtures? YF--J Add fireplace? No Add heating/air conditioning? 1(F S Is approval of Homeowner's Association or other private entity required? A-)O If yes, please submit with this application. Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to the original impervious area or the removal of any trees? Eq/NO. Applicant certifies that no change in site grade, impervious area 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.atiantic-beach.fl.us Page 2 Revised 8/04 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations:include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all info 'on provided with this application is correct. Signature of owner \ Date:_ 2 J 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: Sokolr Date: ' Address and contact information of person to receive all correspondence regarding this application(please print). Name: /� /V\— Mailing Address: Telephone: Fax.: E-Mail: AS TO OWNER: Swom to and subscribed before me this rj day of 20 0S_ . State of Florida,County of Duval t��=��1..�«ro.�.r..se;-+� 1Notary's Signature: �- NNE M,SHAW P,vy r-OMMISSION#DD 435986 EXPIRES:May 31 2009 Personally lmo @andetl 7hru Note ry Publio Underwdtere ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Swom to and subscribed before me this day of ,20 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 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atiantic-beach.fl.us Page 3 Revised 8/04 V FORM 60OA-2004 EnergyGauge®4.21 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Community Affairs Residential Whole Building Performance Method A Project Name: DON FORD HOME ADDITION Budder: DON FORD Address: 338 SIXTH STREET Permitting Office: ATL BCH City, State: ATL BCH, FL Permit Number: Owner: FORD FAMILY 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 Cap:24.0 kBtwnr - 3. Number of units,if multi-family 1 - SEER: 13.00 4. Number of Bedrooms 2 _ b. N/A - 5. Is this a worst case? No 6. Conditioned floor area(ft') 980 w - a N/A - 7. Glass type and area:(Label reyd.by 13-104.4.5 if not default) - a. U-factor: Description Area 13. Heating systems (or Single or Double DEFAULT) 7a.(Dble Default) 133.4 ft' _ a. Electric Heat Pump Cap:24.0 kBtu/hr - b. SHGC: HSPF:7.20 (or Clear or Tint DEFAULT) 7b. (Clear) 133.4 ft' - b. N/A _ 8. Floor types _ a. Raised Wood,Stem Wall R=19.0,980.0W - c. N/A b. N/A _ - c. N/A _ 14. Hot water systems 9. Wall types a. Electric Resistance Cap:50.0 gallons - a. Frame,Wood,Exterior R=19.0, 1101.0 ftZ _ EF:0.92 - b.N/A - b.N/A - c. N/A d. N/A - c. Conservation credits - e. N/A - (HR-Heat recovery,Solar 10. Ceiling types _ DHP-Dedicated heat pump) a. Under Attic R=19.0,980.0 ft 15. HVAC credits - b. Under Attic R=19.0,59.0 ftZ _ (CF-Ceiling fan,CV-Cross ventilation, c. N/A _ HF-Whole house fan, 11. Ducts _ PT-Programmable Thermostat, a. Sup:Unc. Ret:Unc. AH:Interior Sup. R=6.0,50.0 ft MZ-C-Multizone cooling, b. N/A - MZ-H-Multizone heating) I II - -- - --- -__- points:_- - PASS - --I 14576 � Glass/Floor Area: 0.14 Total as-built Total base points. 16354 I hereby certify that the plans and specifications covered by Review of the plans and ZHBST this calculation are in com 'ance with a Florida Energy specifications covered by this ..yyp4 _ 9TH Code. calculation indicates compliance PREPARED BY. with the Florida Energy Code. Before construction is completed a d DATE: :5` a C(i this building will be inspected for tr I hereby certify that this building, as designed, is in compliance I compliance with Section 553.908 with the Florida Energy e. Florida Statutes. WE OWNER/AGENT: BUILDING OFFICIAL: -- -- 3 DATE: S O - 0lb DATE: 1 Predominant glass type. For actual glass type and areas,see Summer&Winter Glass output on pages 2&4. EnergyGauge®(Version: FLRCPB v4.21) FORM 60OA-2004 EnergyGauge® 4.21 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET,ATL BCH, FL, 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 .18 980.0 20.04 3535.1 Double,Clear E 1.0 5.0 33.3 42.06 0.95 1328.7 Double,Clear E 1.0 4.0 9.3 42.06 0.91 357.1 Double,Clear S 1.0 2.0 6.7 35.87 0.66 158.6 Double,Clear N 4.0 6.0 12.0 19.20 0.78 179.3 Double, Clear N 4.0 8.0 17.8 19.20 0.83 284.1 Double, Clear N 1.0 5.0 15.0 19.20 0.96 276.9 Double,Clear W 1.0 2.0 13.3 38.52 0.73 374.0 Double,Clear W 1.0 3.0 6.0 38.52 0.85 196.3 Double,Clear NE 1.0 5.0 10.0 29.56 0.95 281.8 Double,Clear NW 1.0 5.0 10.0 25.97 0.96 248.2 As-Built Total: 133.4 3684.9 WALL TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood,Exterior 19.0 1101.0 0.90 990.9 Exterior 1101.0 1.70 1871.7 Base Total: 1101.0 1871.7 As-Built Total: 1101.0 990.9 DOOR TYPES Area X BSPM = Points Type Area X SPM = Points Adjacent 0.0 0.00 0.0 Exterior 0.0 0.00 0.0 Base Total: 0.0 0.0 As-Built Total: 0.0 0.0 CEILING TYPES Area X BSPM = Points Type R-Value Area X SPM X SCM = Points Under Attic 980.0 1.73 1695.4 Under Attic 19.0 980.0 2.34 X 1.00 2293.2 Under Attic 19.0 59.0 2.34X1.00 138.1 Base Total: 980.0 1695.4 As-Built Total: 1039.0 2431.3 FLOOR TYPES Area X BSPM = Points Type R-Value Area X SPM = Points Slab 0.0(p) 0.0 0.0 Raised Wood,Stem Wall 19.0 980.0 -1.50 -1470.0 Raised 980.0 -3.99 -3910.2 Base Total: -3910.2 As-Built Total: 980.0 -1470.0 INFILTRATION Area X BSPM = Points Area X SPM = Points 980.0 10.21 10005.8 980.0 10.21 10005.8 EnergyGauge®DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 FORM 60OA-2004 EnergyGauge®4.21 SUMMER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET, ATL BCH, FL, PERMIT#: BASE AS-BUILT Summer Base Points: 13197.8 Summer As-Built Points: 15642.9 Total Summer X System = Cooling Total X Cap X Duct X System X Credit = Cooling Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points (System - Points) (DM x DSM x AHU) (sys 1:Central Unit 24000 btuh,SEER/EFF(13.0)Ducts:Unc(S),Unc(R),lnt(AH),R6.0(INS) 15643 1.00 (1.09 x 1.147 x 0.91) 0.263 1.000 4672.4 13197.8 0.4266 5630.2 15642.9 1.00 1.138 0.263 1.000 4672.4 EnergyGaugeTm DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB A.21 FORM 60OA-2004 EnergyGauge® 4.21 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET, ATL BCH, FL, PERMIT#: BASE AS-BUILT GLASS TYPES .18 X Conditioned X BWPM = Points Overhang Floor Area Type/SC Ornt Len Hgt Area X WPM X WOF = Point .18 980.0 12.74 2247.3 Double,Clear E 1.0 5.0 33.3 18.79 1.02 640.2 Double,Clear E 1.0 4.0 9.3 18.79 1.04 181.0 Double,Clear S 1.0 2.0 6.7 13.30 1.64 146.1 Double,Clear N 4.0 6.0 12.0 24.58 1.01 298.8 Double,Clear N 4.0 8.0 17.8 24.58 1.01 441.5 Double,Clear N 1.0 5.0 15.0 24.58 1.00 369.1 Double,Clear W 1.0 2.0 13.3 20.73 1.08 298.8 Double,Clear W 1.0 3.0 6.0 20.73 1.04 129.7 Double,Clear NE 1.0 5.0 10.0 23.57 1.00 236.3 Double,Clear NW 1.0 5.0 10.0 24.30 1.00 243.3 As-Built Total: 133.4 2984.7 WALL TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Adjacent 0.0 0.00 0.0 Frame,Wood,Exterior 19.0 1101.0 2.20 2422.2 Exterior 1101.0 3.70 4073.7 Base Total: 1101.0 4073.7 As-Built Total: 1101.0 2422.2 DOOR TYPES Area X BWPM = Points Type Area X WPM = Points Adjacent 0.0 0.00 0.0 Exterior 0.0 0.00 0.0 Base Total: 0.0 0.0 As-Built Total: 0.0 0.0 CEILING TYPES Area X BWPM = Points Type R-Value Area X WPM X WCM = Points Under Attic 980.0 2.05 2009.0 Under Attic 19.0 980.0 2.70 X 1.00 2646.0 Under Attic 19.0 59.0 2.70 X 1.00 159.3 Base Total: 980.0 2009.0 As-Built Total: 1039.0 2805.3 FLOOR TYPES Area X BWPM = Points Type R-Value Area X WPM = Points Slab 0.0(p) 0.0 0.0 Raised Wood,Stem Wall 19.0 980.0 0.80 784.0 Raised 980.0 0.96 940.8 Base Total: 940.8 As-Built Total: 980.0 784.0 INFILTRATION Area X BWPM = Points Area X WPM = Points 980.0 -0.59 -578.2 980.0 -0.59 -578.2 EnergyGauge®DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 FORM 60OA-2004 EnergyGauge@ 4.21 WINTER CALCULATIONS Residential Whole Building Performance Method A - Details ADDRESS: 338 SIXTH STREET,ATL BCH, FL, PERMIT#: BASE AS-BUILT Winter Base Points: 8692.6 Winter As-Built Points: 8418.0 Total Winter X System = Heating Total X Cap X Duct X System X Credit = Heating Points Multiplier Points Component Ratio Multiplier Multiplier Multiplier Points (System - Points) (DM x DSM x AHU) (sys 1: Electric Heat Pump 24000 btuh,EFF(7.2)Ducts:Unc(S),Unc(R),Int(AH),R6.0 8418.0 1.000 (1.069 x 1.169 x 0.93) 0.474 1.000 4633.5 8692.6 0.6274 5453.8 8418.0 1.00 1.162 0.474 1.000 4633.5 EnergyGaugeTm DCA Form 60OA-2004 EnergyGauge®/FlaRES'2004 FLRCPB v4.21 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 05-00030457 Date 6/09/05 Property Address . . . . . . 338 6TH ST Tenant nbr, name . . . . . . REROOF Application description . . . ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 600 Owner Contractor ------------------------ ------------------------ FORD, DON OWNER 2002 LAKEVIEW CT. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 53 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 600 Expiration Date 10/06/05 Fee summary Charged Paid Credited Due ------ ---------- ---------- ---------- ---------- Permit Fee Total 53 . 00 53 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 53 . 00 53 . 00 . 00 . 00 BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. BUILDING OFFICIAL CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address Date (� ©s Heated Square Footage @$_ per sq ft= $ Garage/Shed @$ per sq R= $ Carport/Porch @$ per sq ft= $ Deck @$ per sq ft= $. Patio @$ per sq ft= $ TOTAL VALUATION: $ �o©D 3.�• $ 3� Total Valuation 1 A $ o Remaining Value $ .-per thousand or portion thereof CONSTRUCTION TYPE: TOTAL BUILDING FEE $ 'S ZONING: + '/z Filing Fee $ L!E FLOOD ZONE: ( )Fireplaces @ $35.00 $ IMPERVIOUS SURFACE: BUILDING PERMIT FEE $ �3 . WATER IMPACT FEE $ SEWER IMPACT FEE $ WATER METERITAP $ CAPITAL IMPROVEMENT$ SEWER TAP $ C ( ) RADON .0050 $ SECTION H PAVING( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ST( ) SURCHARGE $ OTHER $ oa GRAND TOTAL DUE: $ �3. �S, �elrly, CITY OF ATLANTIC BEACH Cc: ` BUILDING / ZONING DEPARTMENT LD. Higgins r� 800 Seminole Road S. oerr U Atlantic Beach,Florida 32233 .a (904)247-5800 __....... (904)247-5845 Fax i��i Ei www.coab.us C11 re 7 PLAN REVIEW COMMENTS JUN `I 2005 _ E Permit Application # c)5- sc>q `�,-7 , Property Address: 3.5E> oTti 'E�f- Y Applicant: k7 �o Project: t�o r This p rmit application has been: Approved Reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed By: (,((4- Date: w f Date Contractor Notified: rt �TV jV- CITE' OF ATLANTIC BEACH ROOFING PERMIT APPLICATION s MY 312005, Date: or Job Address: ST Owner of Property:�_ o rJ f^o A O Address: 3 3 g Co T=� S f Telephone: 2 Lf 2 00 Contractor: LA N r,OL- State License Number: N - Yk Contractor's Address: S hti F 4S h.60 U L Telephone: /V //V Fax: Aj Scope of Work: rz P c +c F R o G F-0 oils If)F//J 6 OA) (LA-2k6 F p.2 ti /Zj Deck Slope: ! = 1 2- Greater than 2:12 Less than 2:12 Valuation of work: fs. 600 .00 Product Name(Example: Timberline): <1:L V F_ pG E Xo L c ri co IQo o F w 6 Manufacturer(Example:GAF): Gy AN s C o R N(N G ASTM Designation(s): F 109 Required Inspections: Sheathing and Final Signature of Owner: Date: S - 3 , Signature of Contractor: N T_ Date: AS TO OWNER Sworn to and subscribed before me this day of r ,20 State of Florida,County of Duval f Notary's Signature: V r Py' JENNIFER SCHLUETER MY COMMISSION#DD 121301 rn EXPIRES:May 27,2006 lam'r�rsonally known aFQ Bonded rMu IVo9an�Pi.hltc a Wa wrkers ❑ Produced identification Type of identification produced AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 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 Telephone: (904)247-5800 •Fax: (904)247-5845 •http://www.ci.atlantic-beach.fl.us Page 1 Revised 2/21/03 ►t.A. $S• 7 LAWt ►t 713.13 Ite Ofict Of Qrjamnwnrvnwnt 004►wts W ou►U9AT40 `�u fnhum it tutucerit: _-' The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statute; the following information is stated in this NOTICE OF COMMENCEMENT. Description of property...k o.T.......�2.....«...... ..� «�. ...... xl Q r T..«..............«......I` _ _ .....................................................................«...:z.....«.»............«...........»........«.....«...«.............«.«««...«««. .................................«........................................»...»«..«.....«..».................................«..........«...«.....»..._.«...«.. General description of improvements...«...........r».......................:........ 71.) a C i4 /Z U &) S o�7 H F v4-,S % S ............ . ........ .............. .......«.. «...........« f ..•....... ....................................«...................................................................................................... ..«.w.. ......• Owner.........:E).&O........(..........�. , !1.r ....................... .......................................... C........ 3 ..Address . «..«»............«..._....._...r._.... . ....._...... ........«.......... ...r�............................«.«».....»..«. - ».._...... Owner's interest in site of the unproven w................... .�....c� .....««»...»».........«»... Fee Simple Title holder (if other then owner) Nam*.............I............................. ......1.....�-............«.................................................:......«.............. Addros&.....«.................................................................»»...»......«.......................... ».........«»«........«....«« Contractor.................................«.......«.«».»........»...............»».....»........ »«.......................«.........«.......«.»«....«« Addrew....«.....«.........»......«.................».....»............».............»»............................««..... ...«..........«............... Surety (if any).._.................A—.).....,1«..�........»».«......««.........................»....».«.«».............». Address.....»».»».»......»««.«.............»........«..».........................»...........»»............««........«_.«.»..«....«A+aad of`ond —�...___. Name of person within the State of Florida des*Wed by owner upon whom mom or etfter&Owmrs owy be served: 1 / Mame.................................».....C„` ...,1..� .....»...»..»«.«......»..»....»................«............««..«._........ Address...................»..............................««.. . In addition to himself, owner designates the following person to receive a dopy of the Lienors Notice as provided in Section 713.13(1) (F), Florida Statutes. (Fill In at Owner's option). Nam.......................«................................................. ».....»»...«...«.................«............«.......«.«»... I CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING BUILDING PERMIT j I " E WIT INFORMATION LOCATIONINFORMATION Permit Number: 17750 Address: 338 SIXTH STREET Permit Type: REPLACEMENT PERMIT ATLANTIC BEACH, FLORIDA 32233 Class of Work: GARAGE Township: 0 Range: 0 Book: Proposed Use: Lot(s): Block: Section: 0 Square Feet: Subdivision: ATLANTIC BEACH Est. Value: Parcel Number: 'Improv. Cost: OWNER INFORMATION Date Issued: 2/04/1999 Name: DON C. FORD Total Fees: 5.00 Address: 338 SIXTH STREET Amount Paid: 5.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 2/04/1999 Phone: (904)241-8200 Work Desc. REPLACEMENT PERMIT CONTRACTORS APPLICATION FEES PROPERTY OWNER PERMIT 5.00 � I i I I f ,,:inspections<Re uired i NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. I I i' �— Date: 2/84/99 81 Receipt: 883 681 ATLANTIC BEACH UILDING DEPT. CHECKS 1242 88188883 lBAN DEPARTMENT OF BUILDING BUILDING PERMIT PERMIT INFORMATION LQCATKAN'INFORMATION. Permit Number: 17751 Address: 338 SIXTH STREET Permit Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 32233 Class of Work: GARAGE Township: 0 Range: 0 Book: Proposed Use: Lot(s): Block: Section: 0 Square Feet: Subdivision: ATLANTIC BEACH Est. Value: Parcel Number: Improv. Cost: OWNERINFORMATION Date Issued: 2/04/1999 Name: DON C. FORD Total Fees: 25.00 Address: 338 SIXTH STREET Amount Paid: 25.00 ATLANTIC BEACH, FLORIDA 32233 Date Paid: 2/04/1999 Phone: (904)241-8200 Work Desc: WIRE GARAGE CONTRACTORS APPLICATION FEES PROPERTY OWNER PERMIT 25.00 i i i I I � I Ins ections Re wired ROUGH ELECTRIC FINAL ELECTRIC I NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. I I I AT NTIC BEAC BUILD DEPT. $25.0014 Date -2J84/94 61 Rweipts 811131G9� CHECKS 1282 88188883221888 } CITY OF ATLANTIC BEACH, FLORIDA AVP.Ov.d by APPLICATION FOR ELECTRICAL. PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE:— C 7 19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF, AND IN'ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. Q&--),v2 `��>�.� G F o A V o©0 3© 2 ELECTRICAL FIRM: MASTER ELECTRICIAN SIGNATURE JOURNEYMAN NAME�o,-) ADDRESS:; RFD—BOX— BLDG. FDBOXBLDG.SIZE a y 7`• 2 2 BETWEEN: RES. APT. ( ) comm. ( ) PUBLIC ( ) INDUS. ( ► NEW( ! OLD ( 1 REW. ( ) ADDITION TRAILER ( ) TEMP. ( ) SIGNS ( ) SQ. FT. SERVICE: NEW( ) INCREASE ( ) REPAIR FEE CONDUCTOR SIZE AMPS COPPER ( ) ALUM. ( ) SWITCH OR BREAKER d AMPS PH W VOLT RACEWAY EXIST.SERV.SIZE J-0 AMPS PH W VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0.30 AMPS. 31.100 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER APPLIANCES FBELLTRANSR�F. AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT O-1 OVER MOTORS H.P. VOLTAGE PHS NO. III.P. VOLTAGE PHS MISCELLANEOUS L s sT TM A LIMITED PARTNERSHIP f R 1 _� (-^ �I t Sig CD M. i` A�r ---� OQ' OFA �t Job Name 0Aof C Job NumbeA jw*D" ry Ar. Locationinp!6� Sheet Irof Technical Representative By Date TM �V4V)W, �-V 0., M A LIMITED PARTNERSHIP T i f f Y r �Col 5 ,Q da►' Job Name ago es Job Number Almowe wra Location r / t Sheet 4 of ",,hnicaf Representative By Date 304814 MAP SHOWING SURVEY OF LOT 17, BLOCK 7, PLAT NO. 1 , SUBDIVISION "A", ATLANTIC BEACH, AS RECORDED IN PLAT BOOK 5, PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. FoUt\ID I/21 Ft?Otil PIPE Cj ix-rH GJT(ZE6T 0JA 0 ' Y (st �Zc{g (40' 21GHT--oF\VAT' conic ea Te '+_'oUNtj Srerriwe, hEt �X-cur ��O p610EwAt,K STONES q ll.Y A�a I �I•�' � CjPLIT RAIL AKq ENc� mo �foraf-�dx�oUT FOUh40IRON PN (D(#L.R. ' 5TA2T \YIRe FF-Mr-C- 1) EhIGE 1) THIS IS A BOUNDARY �'� _ 28.4' 13, SURVEY. Z -pePoe H a� � - - - I } 2) ALL INTERIOR ANGLES = _ I AT BOUNDARY CORNERS ARE 900. 3) THIS PROPERTY APPEARS - / U. TO LIE IN FLOOD 'LONE 'X' .. � 0 Q y-L) �\ O BY FLOOD MAPS REVISED 7:3 M - APRIL 1.7, 1989, '\y. �E COMMUNITY PANEL NO. 0 � �`� 3 I 120075 0001 D. z d Q x 1R 4) NO BUILDING rr,v' 15 111 5 RESTRICTION LINES BY Ul�'H' PLAT. we c) lli !vl \YcrJp Fl;►1GE j � v z rat ;��' A1TAG H 69 T 1� Pew " Woor7 OEG� SEP 2 4 1992 F15H POND or x Building and Zoning I �TePS \YOOO FF.,t 66 04 1 CAIX1.4 N4� ►�19 N � I f ',ET 1/2 120 o V1126 Fou uD 1/2 �IRoo a C lu I �(5' KGFERENGE) 11 pe -0.35 >J. F I N'3 I1 ( L Ri. 10,#8 E 0. l5 E. (WIVE ) 19.0_ 2•d I.o 9.6 - — — -- — r I IPALO TREE 00 C0006v- ° 1.7' t Kx 5Er I/21gC)0 I RauNr) I/? " IRON PIPE PIPE 0.2'� ( # 1704) G woor7 FChIGE / \ 1HFRFAv L'Fo'Tm-v Tom. OAT blr. A Ir_cC.-,. ..-� CITY OF iftia a Ve d 7&UW4 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 TELEPHONE(904)247--5800 FAX(904)247-5805 Chapter 489, Florida Statutes,Part I 'CONSTRUCTION CONTRACTlN(y requires OwnerBuilder 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 the 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 aWervige the inn .--'f. You may build or improve a one-family or two-faily residence or a farm outbuilding. You may also build or improve a commercial building at a cost of$25,000 or less. The building r%U be for y 1r own =and occupence. It may not be built for sale or lease. If you sell or lease more than one building you have built yourself within 1 year after the construction is complete,the law will presume that you built it for sale or lease,which is a violatioin of this exemption You may not hire n-an you contractor, Your construction must be done accord' to building urng codes and zoning regulations. It is your responsibility to make sure that people employed by you hav licerLes r iii d by state tnm id b, coo or municipal licensing ordinances. Ordinances also allow an Owner to improve their own property when it is for personal or family use,and ll'kemse 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 ma ii're r<ndi need wo pis provided such workers be under "direct s}"rvisi on of the owner,who must be on rob site at all times while work is in progress by unlicensed trades people." ?his does not allow use of unlicensed contractors. Since owners raav be�ie forte'•Mes to workers they hire,the Building Department suggests Worker's Compensation insurance be purchased,unless the homeowners insurance policy clearly protects 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 work- ii.. c orklicerLed cganctors rannnt beemployed uridpr ami 'r �.►,uiM=. owners being subject to$5,000 penalty under Florida Statute No.455,228(1). An'Oc=atlonal T.icenRp'is not ade The owner shouldsicall see the co 'Certificate of Competency'or the Florida'Contractors Certificate'to ascertain if a person is a 1 censed contractor..TTelephone the Department(247-5826)if in doubt. I hereby acknowledge that I have read and understand all the above on this l day of_Ma,& , 199 (_�2r A 7D ro 12-S Witness,Building Dept.Employee Owner/Builder 33 Address NOTE: Phrases underlined above 10 ,L( - 2- e-("1— F2 p u are emphasized by the Building Phone Department, OF ATLANTIC BEACH PERMIT APPLICATIONYREMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS Owner(s) : Q C =0 © Address : Phone• P 0 Lot # Block or Unit # Subdivision: Contractor: State License # �V Address • AJ Phone No:_�� Describe work to be done: CS U c- A-c; 47.X Th`KI c 0 a-t Present use of building: Valuation of Proposed Construction: 00 Proposed use: 2 6 ( (!�— Is this an addition?—Z If yes , what are the dimensions of the added space: o;2 O ft . X _ 2 -:-- ft . Will the added area be heated and cooled?__ New electrical ? (or increase) . New Plumbing fixtures?-Li New fireplace? /-/6 New Heat/AC? M _ p SUBMIT COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER CONTRACTOR. Signature OWNER: Date: Signature CONTRACTOR: N-4 License Supplied: Liability Insurance: e � / Worker's Compensation Insurance: OSS-3644: F11858 DEPARTMENT OF BUILDING CITYOF"ATLANTIC BEACH PIP"flNATIQI'4 - - L4C- AT I ON I NFORNAT I ON Per erw 1186 Address. 338 SIXTH STREET -------- Pit Ty :I3UT"L }IiIG ATLANTIC BEACH r FLORIDA 32233 C1 of wcark:Nl V _.------- LEGAL DESCRIPTION -__ __ - Cram r T :WsOI P'RAtE ~B1 alk: Lot:17 Twp: 0. Prrala sled U a`,�«pARAGIE/CARPORT Section: Q Subd: Rnq: a bwe1ling' _ Subdfvi i an:ATLANTIC BEACH "Alt EAtw value: 'tit? Improv. Cost.* 6, 200 .W 411ta 67 . ' Amount S? . 50 IONAP LICATION FEES N ami "..I T 67 .50 FLORIDA Pho , f R 01��TI f Name PR R yg Lic' " EPL / J iSiaF' . rv+'xm6 6 dwa0h F✓eaa`,wk-. op.'ws:5p R�t,•'A7 z•( 9f�Y��"t'%tist'zR+S;ND°l3 j } NOTES, NOTICE--ALL"CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SiX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP A D- AULED`AWAY BY EITHER CONTRACTOR OR OWNER "FAIL RET COMPLY' WITH.THE MECHAIUIC'S �.IEN LAW "CAN RE 1LT N F� „ t3fEI " Y tl 'ItEI 'PAYIN TWICE F��R T'�'IE BUI#.t�llii IMS RY�MENT� t UBi� C4" RDING TO APPROVE©PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TORE t ARPLICABLE`PROWWNS OF LAW. 41 11 . ATLANTIC H[3t]iLDING By. { CITY OF ATLANTIC BEACH PERMIT CALCULAT ON SHEET Address 33 E7– Date iDate S- % Heated Square Footage@ $_ per sa It = $ Garage/Shed �(G Sper sa ft = $ Carport/Porch __per sq ft = $ _ Deck t :� Cd $ per sq ft. = $ Patio per sq ft = $ da TOTAL VALUATION : Total V a l iga t i o n 1 s t $ -- /�% � � ----- -�------�— Remaining Value $ -,r-per thousand o� portion thereof TOTAL BUILDING FEE $ y o + 1/� Filing Fee (p) Fireplaces @ $15 . 00 $ BUILDING PERMIT FEE $_ - S70 WATER IMPACT FEE $,_ SEWER IMPACT FEE $ WATER METER/TAP $ CAPITAL IMPROVEMENT $ SEWER TAP $ ( ) RADON (HRS) . 0050 $ SECTION H PAVING ( ) $ HYDRAULIC SHARES $ CROSS CONNECTION $ ) SURCHARGE . 0050 $ OTHER $ GRAND TOTAL DUE $ ADDITIONAL PERMITS OR FEES : Mechanical Plumbing Electric/New Electric/Temp ; SwimmingPool Septic Tank Well Sign_ Finish Floor Elevation Survey Other CALCULATIONS and/or NOTES : 10593 DEk"ENT OF BUILDING -CITY,00 ATLANTIC BEACH, t . :: ... P INFORMATION N _. _... .._ , LOCATION INIFORMATIOR -------- LOCATION t sa r» -100,31 Addross�* 338 '.SIXTH ST. *1t : CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITIONS owner(s) : 1") &N C r O It 19 fL Address: 3 )1 --�-?- Phone: 11(-eF2-nC1 Lot # Block or Unit # Subdivision: Vt0 rt < cQ-f Contractor: A.' F rz-- State License # A-1 { Address: Phone No: Describe work to be done: !� u o 12 d C/- /�r�'O/Z0,' Present use of building: Valuation of Proposed Construction: Proposed use: /Z r /�9/16, f'_ w IT L4 E)PS'r!�/�►'1.r Is this an addition? If yes, what are the dimensions of the added space: Pft . X � ;-- ft . Will the added area be heated and cooled? /V 6 New electrical (or increase)? New plumbing fixtures? __ SNew fireplace? New Heat/AC? A.10 SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER: - C` Date: Signature CONTRACTOR: Date: License Supplied: Liability Insurance: Worker's Compensation Insurance: 1 4 OWNER BUILDER PERMIT AFF2DAYIT'"�, toter of Florida City of Atlantic Beach BEFORE ME, the undersigned authority, personally •`Wrarnd --- +--- ......-- who upon tisst boAng duly avorn, deposes and says& • - �' /Z 4 . and the legal owner of the following property& Subdivision �.� _ 1-C Block ..........T AMA :y�� ju X5 I so applying for a building permit pursuant Lo . the Owner Builder exemption set forth in Florida Statute, Section 401. 103. Florida law requires that I ,have been provided with ths, following DISCLOSURE STATEMENT& DiSCL03URE STATEMENT Mate Sew requires construction to be done by licensed contractors. You have applied tar a permit under an ***option to that law. The exemption allows you, as tho owner of your property* to ,act as your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - or two family residence ter a farm outbuilding. You may also build or improve a commercial building at a cost of 025,000.00 or less. The building must be ter your use and occupancy. It May not be built tar sale or loss•. If you all or ieabe more than one building you have built yourself within one year after the construction is compieto# the law will presume that you built it for sale, or lease. which is a violation of this o&&emptien. Your. construction must be done according to building codes and zoning regulations. It is your responsibility to wake sure that people employed by Vow have licenses required by state law and by county or municipal licensing ordinances. I hereby acknowledge that I hwe read the above DISCLOSURE STATEMENT and that I comply with all the requirements for the issuance of an Owner-builder permit. Further, affiant sayeth not. Property Owner Sworn- to and subaffibod beton me this - • 304914 MAP SHOWING SURVEY OF LOT 17, BLOCK 7, PLAT NO. 1 , SUBDIVISION "A", ATLANTIC BEACH, AS RECORDED IN PLAT BOOK 5, PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. FOU►.ID I 1120i.1 PIPE n' Y r'I&HT-Or-WT') co,ice6Te ouN►j SrEpPItJC� cU•Tt r :+ 61DEwA1�K / 5TaN65, Ctll.'r 150. -3.2' _ 3'i 15.9 SCK � :1. HU11fig Faut.1 D I/L x--K x Ir-ON PIPE `I-G, SPLtt RAIL�� (No. GAP) °� FENGE pa. ��iaNp 'X'-.CUT _ o.2�S 6 a•Z'�V. � F:00140 112" I90H PIPE N �` (0 L 10116 I '�TAF-T \YIPe FENGE 1) THIS IS A BOUNDARY SURVEY. w P H co Z - - - 2) ALL INTERIOR ANGLES i AT BOUNDARY CORNERS V - LD _ p ARE 900. � r , z J�l 3) THIS PROPERTY APPEARS / IL TO LIE IN FLOOD ZONE 'X' r y- °Q BY FLOOD MAPS REVISED APRIL 17, 1989, 0 � COMMUNITY PANEL NO. 0 w�3 120075 0001 D. Q 7 4 Q Q 4) NO BUILDING _ RESTRICTION LINES BY - t 611 PLAT. PoZGH \ �Yoo 0 Ofr�K a?v 6, MIML? F�.1GE r ?2 ArWrtEp !b 4C x Wool DEG!✓ CC ' '� MA50tdef SEP 2 41992 v r6H POND X % srY. / TgPs Building and Zoning I,ANpIN� U. i \Y000 FEtitcc ►s3'"Eav�S � �' — 18.0 :,;. , w x o� CHIMNEY - 0 2 3 I U a N t I 'W' I/2 I Qo tJ VI PI; FouNp V2" IRON I N u-`� i (5' KEFEREr1GE) PIPE -D.35,1.1. I N p I I ( l,.g. 1048) rs o. ly'E. 0.3245) i9•� •d I.o °•8. o.Io' PALO TREE 00 CaeNElz 1.71 56t 1/2 I Rohl I\FdUN O I/? IRO P I PE 1704) ' b WOO 12 FEhj Ocr - 19`?� clry Office o f oF- ti °me, _ �;��U� T �$uildln9 Oflieial �! _ riot, q. Owner, Job Address 1 Permit No. N 5 BV SDI NG -� Framing _ Re Roofing G =w�YE Locality - lnSulatior, C] Footing Contractor Stab E�FCTR/Cq� _ Lintel fon, l emp pgh ole PCUIN M� Fnat ole Rough G InsPection Mad Tues. RFADy FOR INS i stew Out SME oHgNI CAS e Pir nd. lnspoctor _ Wed. �CTID'v Fire Pluc, Pre ab [? Final in M spection C Certificate of Occupancy Date MICMEW OF ` B • DATE JOB ADDRESS THIS JOB HAS NOT BEEN COMPLETED The following additions or corrections shall be made before the job will be accepted c $15.00 REINSPECT FEE it is unlawful for any Carpenter, Contractor, Builder, or other persons, to cover or cause to be covered, any part of the work with flooring, lath, earth or other material, until the proper inspector has had ample time of approve the installation. After additions or corrections have been [ELEC UMBING made, call 247-5826, Building Depart- ment for an inspection. Field Inspectors are in the office from 8:00 a.m. to 5:00 DG p.m. Monday through Friday. '09 41 ." gab 5i$c'ry WARTMENT OF BUIL ING, CIT W ATLANTIC$EACH PvmL ' NI TION LOCATION, IN'To - `ION st � at Ty' � �t A' k�N` `N��i FLORIDA. 3 1 ` . itG� 5 ' + i - .. z .. .., 7 '. I?rid d ? ACECAI?ORwxh +'* ENa {? subdivi i,6tv AT ` * ria Tot � 3,245,01 - 0 . P17 r. Mom M ,. - 09 Ar. _ s SNC TV . oeld 03 ,X0 N $0, Kr pl.y{ s ;*0' aa22}}, i h A SEC I~T P " ' r'N0101 - t - fir, �s , I f, N�ITIGE`...• ►►t.N. IIv FQFiMS AND FOOTINGS DUST INSFr*CTI~I 81 +I)N 'Pti PERMIT V6 SIX MONTHS AFTER DATE OFISSUE . k Bl tt, fi U MATERIAL, RUBBISH MDDEBRIS FROM THIS WORK MUST NOT'.BE EDIN PUSL IC SPACE,AN®Ml1ST BE LAI, uP ANS HRUL b AWAY BY ITHs4 CONTRACTOR Oft OWNER ` ► � .' ITH THE ME HANIVS J*NG TMICE FORTH ill IE `.ACC©RDING TU APPRf3VEl PLANS WHICH ARE,PART OF THIS PERMIT ANP SU$JECT TQ REVOCATION VIAL 4 nN C>F APE LiCABLE PRovil s i NS(7F,LAW, } Al"LANT ;E #CH>BUILE INIa I EPA F TMI=NT . kh 4) E $Y• , t fi CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT c. JOS LOCATION: ? S t -> %- OWNER OF PROPERTY: I ) 4 a' C- BUILDING CONTRACTOR: k) 112- PLUMBING CONTRACTOR AND ADDRESS: TELEPHONE NUMBER: STATE LICENSE NO: C" c 3 c ;2 TYPE OF BUILDING: r, TYPE OF WORK: HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS L_�►VATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS Alf OTHER TOTAL FIXTURE COUNT: .........x $3.50 + 815.00 = $ " 5 3 --------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION BEFORE COVERING UP - (904) 247-5834 /nCITY OF ®� / 4 /S 9& � rf Office of Building Official G ,3 6 F' REQUEST FOR INSPECTION 7 �� .� Permit No. Date �! A.M. Time s� G P.M. Received • `� Locality JobfAd',dress Owner's H�. _ LZ l Contractor �:N7aC6A�_MECNameCONCRETE ELECTRICAL PLUMBINGDING--- "---h—d - Air C n ' ❑ Footing ❑ Rough Wiring Roug L Heafing'�'_..-' Framing Temp Pole L Top Out Re Roofing L Slab Final =1 Sewer ❑ Fire Place El Insulation ❑ Lintel Pre Fab READY FOR INSPECTION A.M. Thurs.' Friday P.M. Mon. Tues. Wed. A.M. _i__P.M. InspectionMade Final Inspection Inspector Certificate of Occupancy L Date tCITY OF waG scaceltn ; 800 SEMINOLE ROA() A'iL,ANTiC BEACH,FLORIDA 32233-5445 TELEPHONE(904)247--5$00 FAX(904)247-5805 AT EMi(�ust 2 , 1.993 TO Jk RSONVIL.,LE ELECTRIC AUTHORITY CITY OF ATLANTIC BEACH WATER DEPARTMENT UNITED STATES POST OFFICE PLEA-SF £;F Ar,)VISL:D THAT THE FOLLOWING ADDRESS HAS BEEN DELETED : OLD ADDRESS NEW ADDRESS 338 -1 6th Street None (Garage Apartment was demolished) I t : ?3P..Idr?; YOUR ?I:.^ORL)S ACCORDINGLY . SINCERELY, DON C . FORD BUILDING OFFICIRL � q � DEPARTMENT OF BUILDING �. PERMIT 'I NFOX AT ION - ' -CMT*aF ATLANT{G 9EAC+ LOCA I I CSN INFORMATION - ., w Pe mid Type: MECHANICAL , ATLANTIC PEACH. FLORIDA 32233 C1 of, Work; .ADDftIO -------- `LEOAL DESCRIPTTON; _.»:. �___� . Con tr. Type: WOODFRAME Lot. Block», Section P c a d > r STNCLE FA:MI L T ► . ►�,P* RNC T�we111ngs I Cod0 0 Subdivisions �iT�A�t�IC BEACH I «Ptov. Coat a $0 .00 Total Fees» mount Paid 94,7 :.00 L ate Paid. 2/ >3193 k L ,CENTRAL SEAT AND AIR . w 31 � . m . ATI --------- 'APPLMATIOl FELE STREET a t '� �d WATER IMPAC FEL X43 a 4. H 3 'L+�RIi�'a�^ 2 u 3 �� s�SIt IMPACT, FEE, $01.60' WATER 'METVA $0 .00 g f R 4A - R.'S r f $0 13th Iii T HIW, T ..A R ,z.^x, ^ rN Adel �a 'SIC NL°VI•i SLOWER TSP 0 ,00 CTI �FL� DA 3 2 2 If RA 1� � BH E t�..00. License A T ,. .� RE,-INSPECT ..FEN £ " FC.H IMPACT FEE, 0 .00 � OTHER $0 .00 41 T_ NOTE$: 7 ,NOTICE—ALL CONCRETE FOOMS AND F©OT114GS MUST BE INSPECTE0 86FORE POURING a 'PERMIT VOID SIX MONTHS AFTER PATE OF;ISSUE G.WTERIAL,RUSSI'SH AND DEBRIS FROM THIS-WOAX MUST NOT.BE PLACE[i IN PUBLIC SPACE,ANIS-MUST BE J. � CLEA" UP AND HAUI.En AWAY BY EITHER CONTRACTOR OR OWNER. Csa �S. A Lt RE T"! t)MI` LY WITH THE lECHANIGS' Ue, L,�1N;CAN: RESULT AN TiPR!?PFRT (` iNRPAYING 't`w�CE . Bu1L# Nt31M ' TI[Ea,E3i A!I 1isuq,) ACCORDING TO APPR 'VED PLANS WHICH ARE PART Of THIS.PERMIT AA1D SU REVOCA ?R, VIOLA ON 0 APF* I+��I I.E P 'OVISIQNS 01*LAW, AILANTNC BEACH.SVILDING,DEPARTMENT BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTIC BLEACH, FLORIDA 3XX33 ' APPLICATION FOR MECHANICAL- PERMIT - CALL-IN NUMBER IMPORTANT •— Applicant to complete all items in sections I, 11. III, and IV. LOCATION Street Address: OF . Intersecting Street : Between And BUILDING Sub•46hion II. IDENTIFICATION — To be completed by all applicants In contidarstion of,permit given for doing the wort as described in the obeve statement we hereby •gree to re•lo••n Iaid .o•c •• a::: aa•:a with the sttackgd plans and specifications which are a port here*( and in accordance wish the City of Jacitonv;l'o ordinemcos a•v t•a•sr•or of good practice listed therein. Name of Mechanical Contractors Contractor Irrial) r vq'4"yMatter CACnV Name of Property Owner sigaafure of O Signature of or Autkorh* igen Architect or Engines 111. MIRAONFO A Type.of Aeafing Not: B. IS OTHER CONSTRUCTION KING POV ON Hectric THIS BUILDING OR SITE O Gec—O V O Natural O Centel Utility IF YES. GIVE NufAmen OI CONSTRUCTION ❑ Oi r PERMIT 3 ❑ Other — specify IV. MACHAN16Art WUIPMWT TO 61 INSTALLED NATURE OF WORK (Irer ids complete Pat of ewponemh on back of this forms) Residential or 1`1 Commercial k Heat ❑ space C] Roceued (( Gntml O Floor New Building Air Co4iflooing: (3Room control O Existing Building D O Replacement of existing system Ded system: Melotia ggt Twek Q, Mosi mom capacity J'tr c f nt, !S4 New Installation(No system previously Installed) ❑ RdrigetoHers VD Extension or add-on to existing system C3 C0001 loom: COPecity I-Pin. ❑ Other— Specify_ ❑ Fire grinkien: Number of MadL.. 17 Efevolo. ❑ Manlift ❑ Ewloter Imumbor) THIS WACO FOR OFFICE US! ONLY 'Q 640900 Pum;@ (numbod (RoteMd) 0 Teaks,.. (nulmbor) Remarks ❑ LPG come� (numbarJ C) U*&Od prow"vassal ❑ Mriwra Permit Approved by Dna• Q Otter — SW* Pormit Fee UBT ALL EQUIPMENT ALR C'ONDITIOMNG AND REFRIGERATION EQUIPMENT 1'fineites Veitea Deserlatim MO&I Number 1[attule>ctttnr tY A 110trltlj / Z �?� Q s`" CITY OF ATLANTIC; BEA, H, FLORIDA AMnmder APPLICATION FOR ILECTRICAL .PRRMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THO FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED FLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF. AND IWACCORDANCE WITH THE ELECTRICAL REGULATIONS.CODES AND CITY OF ATLANTIC BEACH ORDINANCES. ELESIRICALFORM: NAME ! 1/� / D/� /� ADORE : irw ---RFD—...SOX BLDG.SIZE BETWEEN: RES.1 AFT.( 1 COMM.i 1 PUBLIC t 1 IND .t 1 NEW t I OLD 1 REW.(4-- AODITION t ! TRAILER( I TEMP.1 I slow1 1 l FT.�. SERVICE: NEW 11 INCREASE 1 1 REPAIR 1 1 `:. FEE CONDUCTOR SIZE AMPS COPPIiR I ALM t I BREAKER0-"TCH OR 2XIST.SERV.SIZE AMPS OL SA(l flasmy FEEDERS NO. SIZE IND. SIZENO. SIZE,:.. LIGHTING OUTLETS CONCEALED OPEN TOTAL f RECEPTACLES 25el CONCEALED OPEN TOTAL 0.00 AMM. 1 01.100 AMM. SWITCH BS 1 715 INCANDESCENT FLUORESCENT D M.V. FIX90 0.100 AMPS. IOVO11 �� APPS IANCKS BELL TRANSF. AIR H.P.RATING H.P.,RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS ICEIL HEAT: KW-HEAT a� ov MOTORS H.P. VOLTAGE PHS NO. 110- VOLTAGE PHS MISCELLANEOUS T�rYlCAOYCeQ. .,�,l�lw aM•U wu..w��.. 6436, DEPARTMENT OF BUILDING CITY OF ATLANTIC 9EACH. k RMIT INFORMATION , � ��. _ _ . . �� _ LCC,��` ON INPO�ATIOI41 • riui, N h Addeels 3 3S S I XTA STREET '' *it, Type*. : PLUM131NO ATtaANTI C REACR FLORIDA . ' , «s pa o 4 I+ " . °'"*''1 '* k w ,. « a l x �i"E`�.r`MT »w . ..— . .-, " n :r. - .,WOODType r :WOOD FFM Lot * Setion: c : STNOL FAMILY '�r�s�� P� �tNC r . iy7yr� ,p µye gyp{ } 4e w. 4 h 9 3' TC . R e �IIATII? t - . --- APPLICATION r s P QIP pe H PT 00 MREL ctt, PLOA-1,6A 322 S } . IMPA "T F $0.00 WATER METER ' .iADCN ASN R v S' ' t R , RADON" � Are �kn t? 'STREET SRWLR TAP ; ACH °L RICA 3 33 HYDRAULIC SHARE r WT CT FZE , N0, f° 77 kF Y NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUSTBI:1N 1?sfi" f pSFoMm P RING R. PERMIT VOID SIX MONTHSAFTER DATE OF ISSUE 3tIILt?I 4 MATERIAL,`RIIBBISH AND DEBRIS FROM THIS,WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE �LARIID UP AND MAULED AWAY BY EITHER CONTRACTOR OR OWNER a 41FA ,"R9, TO COMPLY WITH THE. MECHANICS' LEEN tom!fV .,J UL.T IN THE 06PEATY TY O1NER PAYt IG TWICE Ft FI SUIl.I 140 tM NTS." a EUA RD1N0 TO,A#�#►RQVED PLANS WHICH ARE PART OF THIS PERMIT AND J TIOR ON F LATH API'LICAELI* 'ROVISIONS OF LAW. , ATLAN tI§-60.CH.BUILDING DEPARTMENT E CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: PLUMBING CONTRACTORS LICENSE NUMBER: Q f OWNER: BUILDING CONTRACTORS ' TYPE OF BUILDING: SINKS SHOWERS -1-.LAVATORY / WATER HEATERS w � (._BATH TUBS DISHWASHEQS URINALS / DISPOSALS Z CLOSETS WASHING MACHI.NE FLOOR DRAINS � OTHER TOTAL FIXTURE COUNTS / + :15.00 I rr----- .---- .r.....}.--------------wraw---------------ter---------r------r---------- (INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE HOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. i r BUILDING AND ZONING INSPECTION DIVISION' CITY OF ATLANTIC BEACH ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL- PERMIT -- CALL-IN NUMBER IMPORTANT -- Applicant to complete all items in sections I, II, III, and IV. 1. .333 � �� S� � LOCATION Street Address: _ 9C OF • Infersecfing Streets: Between And BUILDING Subdivision Il. IDENTIFICATION -- To be completed by all applicants In consideration of permit given for doing the work as described in the abcve statement we hereby agree to pone— said wo,i ac:_•oe-:e with the attach9d plans and specifications which aro a pert hereof and in accordance with the Crty of Jacksonvd'e ordinances ago ,-e-oa•as of good practice listed therein. Nance of Mechanical ConMacfon Contractor (Print) l �� L MosierI M" Name of If Property Owner p [bit n Qr Signature of Owner Signature of O or Authorized Agent Architect or Engineer 111. 6018tAL INFORMATION A. Type-all heating fool: B. IS OTHER CONSTRUCTION BEING 013M &K ❑ Electric THIS BUILDING OR SITE Y �/ 01-Ges— ❑ Nohrrel Q Centre)Utility Q OR 1F YES. GIVE NUMBER OF CONSTRUCTION V PERMIT ❑ Other — Specify IV. MICHANICAL E9UIPIs1IW TO M INSTALLED NATURE OF WORK (Pre•i&complete kf of component om bed of this form) N< Residential or [_1 Commercial O Neat ❑ Space Q Recessed O Contaal O Floc ❑ New Building O Air Conditioning: ❑ Room ❑ Control Existing Building O Dtrct System: Material Thick•••— ❑ Replacement of existing system Maximum capacityr fps. ❑ New Installation(No system previously installed) O Refrigaefien ❑ Extension or add-on to existing system ❑ Cooling fewer: Capacity ❑ Other — Specify_ Q Fina sprinkhsn: Number of heap Q Elevator Q Manliff Q Eteabte► (Number) O GosoFine pumps (number) THIS SPACE POR OFFICE USE ONLY (RaooMd) Q Tank (number) Remarks O LK centei••K (number) O U*&qd pressure vetrN 0 80aws Permit Approved by Dam 0 Olhor — Sw* Permit F•• LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT lhmsber Vatter Dsrcrtpt/ot>I Yodel Number ![astufacl swr ty A rvvftg 304814 MAP SHOWING SURVEY OF LOT 17, BLOCK 7, PLAT NO. 1 , SUBDIVISION "A", ATLANTIC BEACH, AS RECORDED IN PLAT BOOK 5, PACE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. Fouwo 1/2 + WOO PIPE Gj I X"rH rrt2E15T 0.28, 0.E a.o3' w. (4o' O&HT-oF-\Vdt') (# �Zqh ) Ga,,ceETe -eoUO 5T6rrIIJrb gET ' x-cur 61DEwAt,K / �7T'aNCS SLI / J50.0 a.�o .50.00 ► ,tea q_a� �" FOIA W9 1/0 400.0 Ir-ai PI P6 `1•�' LjPUT RAIL (No. GAP) q� FENGE x pow ��OUPID X-GUT o.2'�i 6 o•Z'�V. + Fouw;' 1/2" 0 dJ IKON PIPE cv � �' (#t.•g. 1010) N I 5TA2T \YIRE'. F60GE 5q 15. 5 1) THIS IS A BOUNDARY SURVEY. to C, (] P012 H I y 2) ALL INTERIOR ANGLES U " - x Q AT BOUNDARY CORNERS ARE 90°. _ 3) THIS PROPERTY APPEARS u. N-� ,4 TO LIE IN FLOOD ZONE 'X' V '>- �; O BY FLOOD MAPS REVISED APRIL 17, 1989, COMMUNITY PANEL N0. Q 120075 0001 D. Q 0 Q Q d1 0.5 z W 4) NO BUILDING RESTRICTION LINES BY P SG�EtSH 3 x x PLAT. q Ila. ?+ r x \ kY \ WOOL? F6"ce �Yooc mu--K r ?�2� ArrhCtt6'O 7a a�w z WO07 �EG1� IL MA Wef 5 E P 2 4 1992 W F�,H POtJD z Building and Zoning sTr STEPS \ 6 \YaaO FE5I.160 �alloiN� I>3 EAv�s 0.4' � CHIMNEY 0 il►l9 N + CIA Ix 1.4 ' , s� d� �� x �+ 2.3 t SET 1/2 1I?otd V1 PE U 1 N o 4 d I (g >Z6rW600E) FOUNW V2" IRoO U- 0-3 r,71 1J. 19.OI Z r71 +.o E v. l5' E. 03245) _ _ 0.8 0.1 PALMI TREE 00 C00146- O.S' 1.7' Y O_� �v -x 5 Er I/2" 1�otJ I FoUN p I/� " 1 Roo P I PE X PIPE (#$ �. IO�t$) �x 0.95' S. L O.Q' 6 G W000 FCNGE w I HEREBY CERTIFY TO: PAT RIGI A. J EFFIZI C5 1 d OWNER BUILDER PERMIT AFFIDAVIT Stute Of Florida ) City cog Atlantic Beach ) BEFORE ME, the undersigned authority, personally ippvarvd - _ ..FH1c.,a--------------- who upon 919"t b#1rw duly sworn, deposes and says$ I• 4__ L ;_ , `j— t�_/_�--D ..__..______• and the legal owner of the tollowinO property$ Subdivision T� r�--&;T( C`- Block _ _____ _ Lots__ AKA I am applying for a building permit pursuant , o the Owner Builder exemption set forth in Florida Statute, Section 489. 103. Florida low requires that I .have been provided witte the following DISCLOSURE STATEMENT$ DISCLOSURE STATEMENT estate 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 air your own contractor even though you do not have a license. You must supervise the construction yourself. You may build or improve a one - or two family residence or a farm outbuilding. You sway also build or improve a commercial building at a cost of 823,000.00 or less. The building must be for your use and occupancy. It may not be built for sale or lease. It you sell or leabe more than one building you have built yourself within one year atter the construction is complete, the low will presume that you built it for sale or lease, which is a violation of this exemption. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed by you have licenses required by state lar► and by county or municipal licensing ordinances. I hereby acknowledge that I have read the above DISCLOSURE STATEMENT and that I comply with all the requirements for the issuance of an Owner-Builder permit. Further, affiant cayeth not. Property Owner Sworn- to and subscribed before me this _ �____ day FLA 1141 LAWSFS 111-13 RAMCO FORM XU of Claminrarrinent 4PR9VAA6 W VU/LICA7[1 fvl�Imt 1! > emu"= The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Description of property......�....'U.�.......r..............�.�..M.��. ......... ..!'(. ..........'.......L..o... ......»....................... ................Y....»..».......... ..............: ..=. f . t................»............. .......................................... ..- ... ... ............................................ .................................................................»...........»....»...................................... ».............................».... ........»............................... »...»............................_.....................................»................».... ...................9»..... ................ Gerwal dewiption of improvements.......X..0.............../.P......................,'<........4��....U.».....�°.»....»»....e'' .»�:.............. ................,,......».»...»...................._..»............».................................... ro Owner....... ........... .A.:544.............`........ ..r`.. ............................................................................. .......».................................. /►ddr:u...... .................. 4 cit F v. E. J..................�.�..»..»...........»....»».....................»......»........................ Owners kdarod in site of the improvement...........r a ....�,4'.................I- . ...................:5. ................... Fee Simple Title holder Of other than owner) Wme... ..Q...l! ....»..» .:........ �..4.. .................. Addresa........c7�.. d. .....................» .t�f.. E V.1.. . .................. :..T:......................................»..»...........»........».......».......... Centredor..».»» _.»P.ja.-............»........................................ ..................................................».....»..»»........................................... Add►.ea..,........».._...»»..»..........»...... .............»...»....»................................................................................ »..»..»»...».....»...»»»..._......._.».»....» SuretyW snyt* .._....»....!v .....»...... ................................................................»....................... Addr«e......._. ...........»....»...».....»............»».....»..................................................»............................Amount of bad =...»... �.�..�.... Nerve of 0aen whKn the State of Florida designated by owner upon whom notice or other &0m*nts mar be eerVe& el�►,a...»». In clition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in,S�ect• 713.13 I1) (F), Florida Statutes. (Fill in at Owner's option). Neste... ....»...�!.. ..». ..........................».............................................................................................. . ...».»..»....»....... ............... ► . ..►�.............. ..... ... ..».......................... ........ _....... ......_ _......._.._............. _.».... ......_..... .. .. ... ......... .. sisaoRoee•e ws eN4v I /l CITY OF h&tic Be=A-0;&u'4& Office of Building Official REQUEST FOR INSPECTION Date P /" Permit No. Time A.M. Received 1_ District No. 60 /' Add r s " L lily Owner's Job Name Contractor BUILDIN �S,,[ NC�03 ELECTRICAL PLUMBING MECHANICAL Framing ❑ tinRough Wiring ❑ Rough ❑ Air.Cond.S ❑ He Roofing ❑ abTemp Pole ❑ Top Out ❑ Heating Lintel ❑ Fire Place ❑ Pre Fab READY FOR INSPEC A.M. Mon. Tues. Wed. Thu rs. Friday-P.M. Inspection Made 17 P.M. Inspector Final Inspection❑ Certificate of Occupancy Date .� v 6003 DEPAOITMENTOF BUILDING CITY OF ATLANTIC BEACH „ .FERI4I7' INFORMATION .: .. � -- LOCATION, INFORMATION .. . Por*it NUmbe Address: 338 TXTH 'STREET PO't*it Typo s P014DATION ONLY ATLANTIC BEACH `FLORIDA 32233 Wer)c t RRIQI ".L L. UA ` TiERI PTION �. _ C6,sjjWtr. Tyre z WOOD It RA34I Lot: Block s Section,.* Proposed Uso t SII GLE FAMILY 'Townshipt RNG3 a 0 Dwol near. Cad a 0: Bubciivi iari.` J�TLANTIC BEACH :Et3 ted Valet 50.;00 rev. Cwt tt �Ota $250,00 - Det I ! ')92 - r 1 I� D A T.:(qA PER PLANE . ... . , AfiIt3N � , , � ` � °' ___- ;API'i.ICA"TCIi PES --�--�- IT � PERMIT tom' Ac Eit. t . STREET >�AT INPACTI FEE $0.00 FLORIDAg FLORIDAFBI I. Q, 4 ".'air,t?` r P.d e'GS��',« n,Vlop KA RADON GAS--H, R. S. $0.00 t� I+aR rAr N �-� RADON CCAS Sx $0. 00 Iar t OP R WATER "TAP l # � m", TAP, #�.tit} HYDRAULIC SHARE $0.00' 00 Typo: 1 P2E�TNEP=T'SEE �. a SEC. IMPACT SEE � ap t+CIES.Al""l NOTICE ALL CON RIETVFORMS AND FOOTINGS MUST BE INSPECT I=1�BEFORE POURJNG �k v PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE $UIU)i"'G MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT$I:PLACED"IN PUBLIC SPACE,AND MUST BE FLEA UP AND.HAULED?*WAY,BY EITHER CONTRACTOR OROWNeR. UFIE, TO, Ct;►A SLY WITH THE MECHANICS' 4-If 'lAW,CAN RESULT . RtPERTY= 1�IlNER PA'1(lIVG TWICE Ft)R B'lIt. IICi' IIIPti/EM1iTS," ' 4.IIMi1tt8 tit I4t�il tSSUE-s ' 6 ACCORDINt ,TO APPROVED PLANS WHICH ARE PARTOF THIS PERMIT AND-SEVOCATIO VIOLA IV tkPAPPOCABI EPfiaVISION.S OF L.AW. fit► 1TI:AN`CI BEACH BUILDING DEPARTMENT BY, $710 DEPARTMENT OF BUILDING" CITY OF ATLANTIC BEACH> .' PERMIT INFORMATION -- -------- LOCATION INFORNATIOI+t - F'.erm. t Numbers 5710 Addre»s 338 -i' SIXTH STREET Permit it Ty s P9U LOING ATLANTIC BEACH, FLORIDA 3IZ2331,1 +C 6*0 of Work% REMOVE ----- LEGAL DESCRIPTION C611jitr. 'Types WOOD FRAME Lots Blocks Sections Prinkmed Ust% BINGL FAMILY Townships RAIGs C Dw 1 room s 1 Cade s O Subdivieian s ATLANTIC BEACH Hmtioat d Value: 00 I> prov. Coats S0.00 `Total Fpm: 4wou ��x s 85Ci»Qla Da�t�i. 7/24/92 W +rk ' AR1E APARTMENT O » ATION ----. AFPLICAT'IOM FEES -- -- .ww , R " , IES .. ��, ' PERM I TD.t}O Add STREET WATER IMPACT FEE ,. , *0.00 CH, FLtIEEIID/� � 3 �I�PA FEE,, �tO,reOt }wap. . ; �.., � o v�v 62A `"� i.N,ty+:"4xF RADON CTAS-H. R. S. _ *O.00 R 0 MATT RADON GAS $0. 00 ' Nimes ISP Ty, WATER TAP $0.00 Addr+ s . ten,. SEWER .,1"AT,,. ,. ., HYDRAULIC SHARE $0. 00 r Types 1 RE-INSPECT FEE ,: *Q. OCD ` SEDC. H IN-PACT FEE $0. 00 NOTES: r NOTICE ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOtD SIX MONTHS AFTER DATE OF ISSUE x 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 TQ COMPLY WITH THE MECHANICSLIEN LAW CAN RESULT IN TI E PROPERTY"OWNER PAYING TWICE,FOR BUILDI1101AL 1{A ISSUE ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUSj REVOCATI A) F 1lIO 1 ON OF APPLICA6LE;PRO VISIONS OF LAW, $.00 eA ATLANTIS BEACH,BUILDiNG DEPARTMENT Bx: CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS DEMOLITION Owners) :__v, Address:_ s ---'� t/k-jl'� --_-S�----- .___Phoned L( 3-- _ Lot #______ Block or Unit #t______ Subdivision: ----------------- Contractor: ----- ------ Contractor: (��a i_ ___ _ Describe work to be done:--- s�0�1� ___--- --------------------------------------------------------- ------ ------------------------------------------------------ Present use of building Valuation ---- 'All -� ----- ------------------------------- ------ Proposed use:------- - - ------------------------------ -- --- _ �' Is this an addition?_ / ---- If yes, what are the dimensions of the added space: ft. X ---------ft. Will the added area be heated and cooled?___-____ New electrical (or increase) ? New plumbing fixtures? ,- New fireplace? New Heat/AC? SUBMIT_ THREE-w.CGNPLET&-SETS-_.OF_PLANS,__CLMDING_SITE_PLAN, SURVEY, ENERGY CODE FORM , �E �F C (C p��T� i�ND - pWNERZCONTRACTOR AFFIDA,V-ITj-.--I-F_-;"6--1-S-WNTRACTOR. Signature OWNER: _ Date: -Zy_-J�___ Signature CONTRACTOR:I�--------------------------- Date: i 'r'\Jlj CITY OF ATLANTIC BEACH 800 SENIINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Building-depcoab.us Application Number . . . . . 07-00001693 Date 12/17/07 Property Address . . . . 338 6TH ST Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc WIRING FOR ADDITION ------------------------------------- ------------------------- ----- --------- Owner Contractor ------------------------ ------------------------ FORD, DON OWNER 2002 LAKEVIEW CT. ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee. . . . . 47 . 80 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/14/08 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 47 . 80 47 . 80 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 47 . 80 47 . 80 . 00 . 00 PERMIT 1S APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH 07� . VI s t 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 OFFICE:(904)247-5826•FAX NO.:(904)247-5845 BUILDING-DEPT@COAB.US fill ELECTRICAL PERMIT APPLICATION DUVAL COUNTY A -r w s:: �.'.,..w'. 3°6�r` ;2iISiTH15A"SUBR�ERMIT"�a° ESI' 5..�1 ., 5 ...,' ,tie. 3 DATE_..a H �.,..'..9«Qq V j3P 4 Sr. ONO Atlantic Beach FL 32233 OYES PERMIT#: g1RFROMER9fO :. , . . "N',i3. . ..`�.r. 4.NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE: 1'J 0y 2c/7-XPoa ;a,EL�CIriAl:rtiMTRACOR,�a ..�i:(, s n..a .,3 3... 41 .�u.. s�Nix )�°°'r,x�,: n,.� �e �', ._..... .,...:...a. 7.NAME OF COMPANY: 8.ADDRESS.: /V - G w ws a.A 9.STATE OF FLORIDA LICENSE NO: 10.CELL PHONE: 11.FAX NO.: /3u- CD600307- 12.EMAIL ADDRESS: 13.OFFICE PHONE: 14. 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 work is commence CONTRACTORS SIGNATURE: 16: LASS�OF WQl�K;'1° 13;:5 ICI:w l4 d a .i ��3 ,` 0.� '18�METER,NUM8EIt.'. .a ❑MULTI FAMILY-#OF UNITS: 5rRESIDENTIAL ❑SI E FAMILY ❑TEMP SERVICE ❑COMMERCIAL ADDITION ❑TRAILOR 19:BUILDIN �„j�, a,� „ ,�,;,, 19�CURRENT CODE"ru"L6.141��',j ,'. ❑ALTERATION ❑SIGN ❑OLD ❑NEW ❑'05 NATIONAL ELECTRICAL CODE ❑REPAIR ❑POOL/SPA ❑REWIRE ❑OTHER: e.'„c c e s z� S a a .."v% '„; 9.;ea ,uge .Ph 3 C.�'�§n r.�a..rm 9a ry0l��+lis.pxgg.,_ �. �„�4.�- �.,--a LIST�.h.ELL�,��IC,AL WpRK.��^��. ��93"'k�.m m 20.TYPE OF SERVICE: ❑ OVERHEAD arGNDERGROUND ❑ UNDERGROUND UP POLE 21. NEW SERVICE: CONDUCTORS PER PHASE: POWER IS ON ❑ POWER IS OFF 22.SIZE OF CONDUCTOR: a 6) AMPICITY: &COPPER ❑ALUMINUM 23.SWITCH OR BREAKER SIZE: AMPS: ;2 C PH: W: VOLT: RACEWAY SIZE: 24.EXISTING SERVICE SIZE: AMPS: OU PH: W: VOLT: RACEWAY SIZE: 25. FEEDERS: #OF AMPS: #OF AMPS: #OF AMPS: 26. LIGHTING FIXTURES: INCANDESCENT: _ FLUORESCENT&M.V.: 27. FIXED APPLIANCES: 0-30 AMPS:_L�_ 31-100 AMPS: Q OVER 100 AMPS: U 28. FIRE ALARM: ES ❑ NO 29-31 DO NOT APPLY TO NEW SINGLE FAMILY,MULTI-FAMILY AND ROOM ADDITIONS 29.SMOKE DETECTORS: NUMBER: .7- 30.RECEPTACLES: 0-30 AMPS: / 2- 31-100 AMPS: OVER 100 AMPS: 31.SWITCHES: 0-30 AMPS: 6 31 3,.. 31-100AIOMNIPNS�a:" OVER 100, AMPS: " �� 4" i y.� T` y ° 2A1RZ0NPI #OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW: #OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW: 9.- NUMBER: VOLTAGE: HP: KVA: NUMBER: VOLTAGE: HP: KVA: ”..• ., -w. 1,34 TRANSFORMERS , UNDER 60OV: NUMBER: KVA: OVER 60OV: NUMBER: KVA: a...'eF�x°a ura°E.,r a .? .",r r n...? .._ ,.:,,_4 ,:..r °;p.. r..,.. Ids 3$::M ISGElANE0U5 REp,�I R$„1 :i, DESCRIBE IN DETAIL: COAB FORM BLDG02:REVISED:8/13/2007 S yVJ1, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: Buil_dirj t:ogb.U5 Application Number . . . . . 07-00000696 Date 5/21/07 Property Address . . . . . . 338 6TH ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 7 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ FORD, DON OWNER 2002 LAKEVIEW CT. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 84 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/17/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ------ --- ---------- Permit Fee Total 84 . 00 84 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 84 . 00 84 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. rs� 1i`1�1J, CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION Date: s-- 21- 07 Property Address: 3 Cs =� ,S i Owner: :1)v,., o o Telephone#: 4/1-f2 o 0 Contractor: 0 ^j r Telephone#: Contractor Address: '`— Fax#: Contractor Signature: In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: If other construction is being done on this building or site, ❑ New list the building permit number: 9/ Re-Pipe Number of Fixtures: Bath Tubs Showers Closets Shower Pans Dishwashers Sinks Disposals Urinals Floor Drains Washing Machine Lavatory Water Sewer Water Heaters Sprinkler System Other *See attached sheet see For Backflow and Irrigation procedures Fees Permit Issuing Fee: $35.00 Total Fixtures: T7 X$7.00 + $35.00 = 800 Seminole Road -Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800 - Fax: (904)247-5845- http://www.cl.atlantic-beach.fl.us Revised 9/06 CITY OF Office of Building Official REQUEST FOR INSPECTION ex— REQUEST ! Permit No. ! Time A.M. 3 Received P M. District No. �c t— , Job Address Locality Owner's �� ELECTk�CAL tBUILDINGCONCRETE PLUMB G MECHANI AL Footing ❑ Re Roofing ❑ Slab ❑ Temp Pole 9 Top,Out Heating ` l Lintel ❑ Fire Place ❑ READY FOR INSPECTIONPre Fab �� A.M. Mon. Tues. W4d• Thurs. Friday .P.M. Inspection Made A.M. P.M. Inspector :a a �, ,r�,�.:.. „�,. Final Inspection❑ Certificate of Occupancy (/� Date '0034 4 a M 0111P IAENT©I BUt.L.DING C1 F ATLANTICBEACH' { - :kRM`I' INFO - LOCATION OH IAYFDR IA''ICIN .: . _-.;� ` t �#U*b#t 6034, Addreos t 5 STH STREET t, TY a T ATLANTIC 'SEACA, FLORIDA 322311" Cl>t1 � ► Werk r A@ION --------- LEGAL DESCRIPTIO _w ` CoAstt TyI t ;,VOOD FRAME Lrat: 17 Block t 7 Section: aged Uwe:, �tOLS 'PAMI'L3 Township: RNIB: O Subdivision t Atlantic Reach loprov p"i i 11 Total -1 eek t *585:00 1,,Awot; ,00 �Ol �d'92 .2411611addition and, reacdel -existing ` qRMATION, APPLICATION, FEES � :, PERM' a`T*EET, ATER IMPACT FEE t3«0£1 ACH. FOR �t3 R T1"!P' T FkfrQ IF 711 {� RADON OAS-H. R. S. SCI.Q3 �eWATER "'APt « Add , �Nt "'A ' , r3: . . HYDRAULM SNARE D.{}C °i �*• Typei RE-INSPECT SEE 00 SEC« H IMf�ACT F'EE �OO 11 A' m NOTES: , , a . f C NOTICE-•ALL.CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING k j i PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE 4CIIC DING MATERIAL,RUSSfSH AND DEBRIS FROM THIS WORK MUST NOT$E PLACED IN-PUBLIC SPACE,AND MUST BE ^` CCCAAI UP AND.HAULS6 AWAY BY EITHER CONTRACTOR OR OWNER f# AI # ETD Ct I<A L.Y WITH YHE .N ECHANICS' LIEN LAW �/#N RESULT IN $t0PER'TY 0WNSR PAYING TWICE.FOR SUId IMPRbvEMENT74 ' a I"LIEL?,ACCORDING TO APPROVED PIANS WHICH ARE PART OF THIS PERMIT:AND SUSJ CATION OF•APPLICABLE-PROVISIONS OF LAW. ATLANtId"S'EACK BUILDWG DEPARTMENT £T Ix _ ,' CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS ON ALTERATIONS DEMOIATIONS Owner(s) : 21 Address: Phone: 0 Lot #--L X- Block or Unit # SubdiviLAun : -- Contractor:__--_Q Describe work to be done: --- Aa- X- A) ------------------------------------ Present use of buildino :-_SiA;(OS�...Z-4- :M-1,4.y— Valuation of ProposedCo struction: -- LP------------- Proposed use:---- Is this an addition?--,y If yes, what are the dimensions of the added space: -ft. X Will the added area be heated and cooled?--Yi- - New electrical (or increase) ? &k_ New plumbing fixtures?Vf--5 New fireplace?/V New Heat/AC? SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR. cr Signature OWNER: 11 ? Date: Signature CONTRACTOR: Date: ;2 ,3 APPROVED ti i `V CITY OF ATLANTIC BEACH BUILDING OFFICE OCT 2110-92 EP 2 31992 Qg__1?Idq"L. Building and Zoning Address Heated Square Footage -- --- —( $-------- Der sq ft = $ ---------__--- Garage/Shed $ per sq ft = Carport/Porch $ —__per sq ft = $ _--- ----- -- Deck @ $ yer sq ft = $ Patio @ $ per sq ft = $ TOTAL VALUATION: �� 0 z. G' _ $ f cS Total Valuation 1st $ Reminder Valuation $ per thousand or portion thereof -------------------------------------------- Total Building Fee ADDITIONAL PERMITS and/or FEES REQUIRED + 2 Filing Fee M�echanical Fireplaces @ 15.00 $ — ©-- — Plumbing ; BUILDING PEPUNIIT FEE $ Electric/New -------------------------------------------------- Electric/Tem _ Septic Tank BUILDING PERMIT $ j WellWATER METER CHARGE $ Stdnming Pool SEWER IMPACT FEE $ — Sign --� 14ATER IMPACT FEE $ 2 _--- Water Connection MISCELLANEOUS $ _ Sewer Connection ~_ $ ----- Water Deter — $ --_ Elevation Certificate �— GRAND TOTAL DUE $ c�' ---------------------------------------------------------------------------------------------- CALCL'LATIONS and/or NOTES CITY OF ATLANTIC BEACH Fixture Unit Worksheet for Water Impact Fee FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TWENTY DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. BATHROOM GROUP CONSISTING OF SERVICE SINK TRAP STAND WATER CLOSET, LAVATORY & BATH (8) TUB OR SHOWER STALL (6) WATER CLOSET WATER CLOSET, TANK OPERATED (4) VALVE OPERATED (8) BATHTUB/SHOWER (2) URINAL WALL LIP (4) SHOWER GROUP PER HEAD (3) FLOOR DRAIN (1) SHOWER STALL DOMESTIC (2) LAUNDRY TRAY (2) LAVATORY (1) COMBINATION SINK AND TRAY (3) WASHING MACHINE (3) _ POT, SCOLLERY SINK (4) DISHWASHER (2) WASH SINK EACH SET OF KITCHEN SINK (2) FAUCETS (2) DENTAL LAVATORY (1) KITCHEN SINK WITH WASTE DENTAL UNIT OR CUSPIDOR (1) GRINDER (3) BIDET (3) URINAL STALL, WASHOUT (4) FLUSHING RIM SINK (8) COMBINATION SINK AND TRAY WITH FOOD DISPOS. (4) URINAL, PEDESTAL, SYPHON JET DRINKING FOUNTAIN (1/2) BLOWOUT (2) LAVATORY, BARBZR/BEAUTY ICF. MAKER (1/2) SHOP (2) SURGEONS SINK (3) LAVATORY, SURGEONS (2) JACUZZI (2) URINAL STALL, WASHOUT (4) TOTAL FIXTURE UNITS_ @ $20.00 EACH $ JOB INFORMATION FLORIDA ENERGY EFFICIENCY CODE FORM 1000-C-91 FOR BUILDING CONSTRUCTION SMALL ADDITIONS Section 10-Residential Prescriptive Compliance Method Climate Zone AND RENOVATIONS Department Of Community Affairs NORTH 1 2 b Compliance with Section 10 of the Florida Energy Efficiency Code may be demonstrated by use of Form 10000-91 for additions of 600 square feet or less, and renovations to single and multifamily residences.Alternative methods are provided for additions by use of Form 1000A-91 or 900A-91. PROJECT NAME: /p BUILDER: � /ZZ AND ADDRESS: 3 �� PERMITTIN CLIMATE L t OFFICE: Tx40TIC lcC ZONE: 1 ❑2 ❑3�* OWNER: PERMIT JURISDICTION NO.: NO.: J Q NEW CONSTRUCTION CONDITIONED[]j� SO NEW GLASS AREA AND TYPE ADDITION units covered by I#Multifamily,number of FLOOR AREA 0 FT. Clear Tint Film Solar Screen,go this submittal: PREDOMINANT EAVE OVERHANG Single-� SO.Single- �SO �j' MULTIFAMILY ATTACHED LENGTH E OFT. pane FT. pane FT SINGLE-FAMILY DETACHED ❑� PORCH OVERHANG Double SQ.Double- Sol � enaneF IN I FOR ADDITIONS ONLY WALLTYPE A D INSULATION CEILING TYPE AND FLOOR TYPE AND INSULATION WOOD FRAME MASONRY INSULATION WOOD MASONRY EXTERI R: EXTERIOR: UNDER ATTIC:' RAISED: RAISED: PERCENTAGE R= ` R. T1 — _ O R .6 R= Mfl OF GLASS ADJACENT: ADJACENT: SINGLE COMMON: COMMON:TO FLOOR:m % R=' ❑.❑ R= ❑•❑ ASSEMBLY: R=❑.❑ R= .❑ R= ❑❑ COMMON, m.❑ COMMON: �•� COMMON: R= R= SLAB-ON-GRADE: (—(� R= R= I I L DUCTS COOLING SYSTEM HEATING SYSTEM HOT WATER SYSTEM n Unconditioned ❑Central ❑Electric Strip Heat Electric ❑Solar Space ❑RoomEl 1 atural Gas Heat Recovery F F71Natural Gas Other +`–'"' ❑ R= .p [�PTAC ❑Fuels 11 Other Fuels Dedicated Heat Pump In Conditioned Room Unit/PTHP ❑ ❑No New System ❑None ❑No New System ElEF=,� SF/EF= ce ❑None No New System R= •❑ SEER/EER=� � R� COP/HSPF/AFUE M.[] I Ij NUMBER OF BEDROOMS I hereby certify that the pI and specifications covered by the calculation are Incompliance with Review of plans and specifications covered by this calculation indicates the Florida Energy Code compliance with the Florida Energy Cods. Before construction Is completed,this PREPARED By: \ DATE: Z-� building will be inspected for compliance In accordance with Section 563.908,F.S. I hereby Certify that thle b I n9 b to co Ilen the rlda E Cods, BUILDING OFFICIAL: OWNER AfNT; DATE: 072 ATE: TA8LE*0Aj MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REQUIREMENTS CHECK Windows 904.1 Maximum of 0.34 CFM per linear foot of operable sash crack includes sliding lass doors Exterior&Adjacent Doors 904.1 Maximum of 0.5 CFM per sq.ft.of door area:solid core,wood panel,insulated or glass doors only. Exterior Joints&Cracks 904.1 To be caulked,gasketed,weatherstripped or otherwise sealed. Sole&TOP Plates 903.2 Sole plates and penetrations through top plates of exterior wails must be sealed. Infiltration Barrier 903.2 Infiltration barrier must be installed in exterior walls&raised wood floors. Interior Joints&Cracks 903.2 All openings in interior surfaces of'ceilings and exterior walls must be sealed. Fireplaces 903.2 Fireplaces must have flue dampers,glass doors and outside combustion air intakes. Exhaust Fans 903.2 Exhaust fans vented to unconditioned space shall have dampers,except for combustion devices with integral exhaust ductwork. Combu n 903.2 Combustion space and water heating systems must be provided with outside combustion air, Heating except for direct vent appliances. Water Heaters 904.2 Comply with efficiency requirements in Table 9-7A. Switch or clearly marked circuit breaker(electric) or cutoff(gas)must be provided. 'External or built-in heat trap required. Swimming 904.3 Spas&heated pools must have covers(except solar heated). Non-commercial pools must have a Pools&Spas- pump timer.Gas spa&pool heaters must have minimum thermal efficiency of 78%. FnHVAC*Duwct Pipes 904.4 Insulation is required only for recirculating systems,including heat recovery units. In such cases, piping heat loss shall be limited to a maximum of 17.5 BTUH per linear foot of pipe. eads 904.5 Water flow must be restricted to no more than 3 gallons per minute at 80 PSIG. 904.6 All ducts,fittings,mechanical equipment and plenum chambers shall be mechanically attached, ion, sealed,insulated and installed in accordance with the criteria of Section 904.6. Ducts in unconditionec Insulation&Installation space and air handlers located in attics must be insulated to a minimum R-4.2 (R-6 after 1/1/92). HVAC Controls 904.7 Separate readily accessible manual or automatic thermostat for each system. Renovetlons Only Glass 1003.0 Meets the requirements of sec. 1003.0. See step 3 of page 2 of this form. -1 s 6355, DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PER14I 711051MATION ------ E—0c J if I6� i1framw ION + . `t Number: + 35Ii ls Addre� : SIXTH STREET ';fie "mi't Type: MECHANICAL ATLANTIC BEACH", FLORIDA 32233 Clash of Work: ALTERATION ------..-»_ LRGRI DESCRIPTION .. .._-. -_. Constr . Type: WOOD FRAME Lot': Block: Seotion L n ,U a SI cOi :F IL Tol"tnshi ' RNO 0 Esti. ated# Value: St3 .0C3 Subdivisxcan; AT ANTIC BEACH 1 nProv. Cost: t6.06 '), Total Fees. $25.00 " Amount Paid: $25100 Date r,Paid, 2/ 1/93 kk` . PIPING IN ATION Nt PERMIT 90 �: �7 �TREET { R [ n Ad 1"fT IMPACT PER 5� }Q k H, FLORIDA 3M3, SLOWER IMPACT FEE $0 .00 Peri 00 {{ }Y METEi }*� ` d R'i'1J i �t �y.11 + . 'o "' ' OW DW TER TAP .00 $0 .00 ldc r aa; .h RET, SOOTH SEWER TAP $4 .04 ,IANC VILLE BEAIfL,... 3 " TyPe. HYDRAULIC-$HARE _�._ .u._ 0,0a RL INS ECT PEE $0-00 SEC.H IMPACT FEE .00 �psr. OTHER 0 . O m nm $(r q iI[ p NOTICE--ALL CONCRETE ROAMS AND FOOTINGS MUST BE IN$P"ECTEO B'EF'ORE PDURINC PERMIT VOID SIX MONTHS AFTER DATE OF fl,SSUE " AU14DI 46 MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED 1N PUBLIC SPACE,ANIS MUST BE CL' AR UP.AND HAULED AWAY BY EITHERCONTRACTOR OR OWNER FAILURE 1't? COMPLY WITH THE MECHANICS LIEN LAW CAN RIESUI.T IN THS, 'R PER`fY .WNER PAYING TWICE FOR BUIL-DINt M eta 1� 6 ` 1, RDING TO APPROVED PIANS WHICH ARE PART OF THIS PERMIT AND SUBJ RE VOCATiI� R �! #� t "@APPLICA9LE Pi#OVI$ION FS OF LAW. LN a 5 m ATLANT10BEACH BUILDING DEPARTMENT CITY OF /� � � � // fY+LLI�iZizt•� /3eG� 4-&7&u-c& Office of Building Official REQUEST FOR INSPECTION c � Date , I Permit No. Time A.M. Received P.M. District No. 3 367 rc S 7 Job Address Locality Owner's `'y Name Contractor BUILDING CONCRETE C' PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air.Cond.& ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ElHeating Lintel 1:1 //EU s' (/ ? Fire Place ❑ Pre Fab READY FOR INSPECTION Mon. Tues. Wed. Thurs. A.M. Inspection Made /— �' P.M. Inspector Finallnspection)� Certificate of Occupancy Date DATE: PRE-SERVICE.' DIVISION JACKSONVILLE ELECTRIC AUTHORITY 233 WEST DUVAL STREET JACKSONVILLE, FLORIDA 32202 THE FOLLOWING FINAL INSPECTIONS) HAVE BEEN MADE: AND ARE SATISFACTORY: ----- 1 S-I-NCS ELY, 1, �G BUILDING INSPECTION DIVISION cc:FILE