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364 7th St (vault) PERMIT WORKSHEET Certificate of occupancy ::::� Job Address: Type Work: Property Owner: Phone # Emil � GV Contractor: Phone # Permit#: Date Issued: �S c1q ,2 17 7S7 Building Inspections: Footing 5-3.l-o Slab =DL� Tie Beam Lintel Nailing / Sheathing 5•ZS-cN Framing / Cover Up Insulation 5,2-9-oZ4 Final Building Tree Permit# YES NO Electrical Permit# Date/ Copy to JEA Temp, Pole Permit# Date/ Copy JEA Temp. Power Letter Received: YES NO Inspections: Rough Electric Released to JEA S- z "p Temp. Power Released to JEA Temp. Pole Released to JEA Final Released to JEA Gas�l""�1 0�1- zg379 Mechanical Permit# �{ - -Z& Final Inspections: Rough S-Z^7-0 Plumbing Permit# Inspections: Rough / Un derslab M C%� Topout Water/ Sewer Final Drainage Inspection: Pool Permit# Final Inspections: Steel Grounding Finat Roofing Permit# Final Inspections: Nailing /Sheathing Fire Inspection: .� Failed Inspections: ff Date Paid: Date Paid: Ile r s' CITY OF ATLANTIC BEACH .' 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 "r INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028410 Date 11/10/04 Property Address . . . . . . 364 7TH ST Tenant nbr, name . . . . . . WWO REROOF TIMBERLINE Application description . . . ROOF Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2400 Owner Contractor - ------------------------ ----------------------- SMITH, FRANKLIN C. OWNER 364 7TH STREET ATLANTIC BEACH FL 32233 ---------------------------------------------- Permit ROOF PERMIT Additional desc . . . 00 Permit Fee . . . . 136 . 00 Plan Check Fee . Issue Date . . . . Valuation . . . . 2400 Fee summary Charged Paid Credited ----Due--- ----- ---------- --------- Permit Fee Total 136 . 00 136 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 136 . 00 136 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL C[TY OF ATLANTIC BEACH ORD'NANCES AND THE FLORIDA BUILDING fgDES. BUILDING OFFICIAL • .�1lJ� RECEIVED CITY OF ATLANTIC BEACH BUILDING R Z�N'NG CITY OF ATLANTIC BEACH JUN 0 2 2004 ROOFING PERMIT APPLICATIO Date t Job Address: 3C� Owner of Property:'�—; ) L 0 V { Address: L ' S �(,w► . Telephone: - LD Contractor: POO t01 State License Number: C-<--C---0 ,� 7 1 � (' Contractor's Address: Telephone: �(4 QJ_D��i0) Fax: Scope of Work: �'`K1"1b1•�° 2X�S ,/ C,na rQ C� `�� �CAr )�Q(�tvfR� ��,+�J, Deck Slope: I �,''llGreater than 2:12 Less than 2:12 Valuation of work: q o V Product Name(Example:Timberline): I ` r Manufacturer(Example: GAF): 87 C ASTM Designation(s):D Required Inspections: Sheathing and Final Signature of Owner: Date: ^LJ Signature of Contractor4// ka`L; Date: (A AS TO OWNER: Sworn to and subscribed before me this �d day of 20 U� 4 State of Florida,County of Duval Notary's Signature: dMM ,AA ,�;r;/ st JENNIFERSCHWETER ❑ Personally known 6AY COMMISSION#DD 121301 Produced identification � II 1 "'20— Bonded EXPIRES:May 27,2006 Type of identification produced F(/ IV / ZO— Bonded Thru Notary Public underwriters AS T NTRACTOR: Sworn to andn OLI subscribed before me this day of `J Int('1� ,20 • State of Florida,County of Duval Notary's Signature: F Pt WETTE P.R. Personally known OTAR�o My CommExp.3/?JOS ❑ Produced identification PUBLIC " No:CC 083574 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 1 Revised 221/03 Cc: CITY OF ATLANTIC BEACH s BUILDING / ZONING DEPARTMENT S Higgins J s� S. 800 Seminole Road Atlantic Beach,Florida 32233 J (904)247-5800 � 3 (904)247-5845 Fax PLAN REVIEW COMMENTS Permit Application # J1I n Property Address: Applicant: Project: This permit application has been: EP"" Approved ❑ Reviewed and the following items need attention: Please re-submit your application when these items have been completed/. Reviewed By: L L. -2 `L Date: G ��� - S CITY OF ATLANTIC BEACH r PERMIT CALCULATION SHEET Date Addressro Permit fee based on dollar evaluation as indicated on permit application. Heated Square Footage @ $ per sq ft= $ Garage/ Shed @ $ per sq ft= $ Carport/Porch @ $ per sq ft= $ Deck @ $ per sq ft= $ Patio @ $ per sq ft= $ TOTAL VALUATION: $ $ a400 $35.00 1st $1000.00 $ $35.00 Total Valuation $ $ S" Remaining Value Per thousand or portion thereof: CONSTRUCTION TYPE: TOTAL BUILDING FEE $ ��5 ZONING: + '/2 Filing Fee $ FLOOD ZONE: ( ) Fireplaces @$35.00 $ IMPERVIOUS SURFACE: BITII.,DING PERMIT FEE $ WATER IMPACT FEE $ SEWER IMPACT FEE $ WATER METER/TAP $ CAPITAL IMPROVEMENT $ SEWER TAP $ C ( )RADON HRS.0050 $ SECTION H PAVING $ _— CROSS CONNECTION $ ST ( ) SURCHARGE $ OTHER $ GRAND TOTAL DUE $ l� CITY OF ATLANTIC BEACH i 800 SEMINOLE ROAD -� ATLANTIC BEACH, FLORIDA 32233 J V INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00028379 Date 5/26/04 Property Address . . . . . . 364 7TH ST Tenant nbr, name . . . . . . GAS PIPING Application description . . . MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor - ------------------------ ----------------------- NOVAK, WAYNE SAWYER GAS COMPANY 364 7TH STREET 411 PABLO AVENUE ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 246-6471 ---------------------- ----------------------- Permit MECHANICAL PERMIT Additional desc . . . 00 Permit Fee . . . . 70 . 00 Plan Check Fee 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 4. PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. �UILDING OFFICIAL :. CITY OF ATLANTIC BEACH r' MECHANICAL PERMIT APPLICAT N M1 t Date: Property Address: OZ-1 � �=fes Owner: W��r 1 n V PZ Telephone #: Contractor: & "s Telephone #: Contractor Address: G! 5pt c-rp e`K•a�u `� Fax#: In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of good practice listed therein. Type of Heating Fuel: If other construction is being done on this building or site,list the building permit number: ❑ Electric ❑ Gas: _LP Natural _Central Utility ❑ Oil ❑ Other—Specify MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK ❑ Heat _Space _Recessed _Central _Floor Residential ❑ Air Conditioning: Room _Central ❑ Duct System: Material Thickness ❑ Commercial Maximum capacity cfm El Refrigeration ❑ New Building ❑ Cooling Tower: Capacity gpm ❑ Existing Building ❑ Fire Sprinklers:Number of Heads ❑ Elevator: __ Manlift Escalator (Number) ❑ Replacement of Existing System El Gasoline Pumps (Number) 'a. Tanks % (Number) ❑ New Installation ❑ LPG Containers (Number) (No system previously installed) ❑ Unfired Pressure Vessel- ❑ Extension or Add-on to Existing System ❑ Boilers 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 TANKS Nominal Capacity Type Liquid Serial Approving How Many &Dimensions Contained Manufacturer No. A enc 800 Seminole Road • Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800• Fax: (904)247-5845 • http://www.ei.atiantic-beach.fl.us 47 City of Atlantic Beach *** CUSTOMER RECEIPT *** Oper: CKOMOREK Type: OC Drawer: 1 Date: 5/26/04 01 Receipt no: 59110 Description Quantity Amount 2904 27787 BP BUILDING PERMITS 1.00 $335.00 Tender detail CK CHECKS 1188 $35,00 Total tendered $35.00 Total payment $35.00 Trans date: 5/26/04 Time: 11:18:56 M.A.Y 2 6, 2404 CK# 9 �s CITY OF ATLANTIC BEACH SJ 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00027787 Date 5/25/04 Property Address . . . . . . 364 7TH ST Tenant nbr, name . . . . . . REM KIT, PORCH,BATHS, CARP Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 50000 Owner Contractor ------ ------------------ ------------------------ NOVAK, EMILY JADE BLUE SKY CONSTRUCTION INC 364 7TH STREET 2 VIEJO STREET ATLANTIC BEACH FL 32233 ST.AUGUSTINE FL 32095 (904) 249-7263 (904) 806-4019 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Sub Contractor . . DONOVAN HEATING & AIR Permit Fee . . . . 55 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 --------------------------- ------------------------------------------------- Special Notes and Comments REMODEL, 200AMP, 1PH, 3W, 240VOLT INSTALLED 4 DUCT DROPS Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 55 . 00 55 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 55 . 00 55 . 00 . 00 . 00 I 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-K BUILDING OFFICIAL r� l CITY OF ATLANTIC BEACH — a 7 - MECHANICAL PERMIT APPLICATION Date: Owner of Property: Z,4 r ti�va Job Address: 3G N T �fvt e Contractor: Fl k b Ucalj cu In considersrion of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards ofgood pracnce listed therein. III. GENERAL INFORMATION A. Type of heating fuel: B. ❑ Electric IS OTHER CONSTRUCTION BEING DONE ON THIS ❑ Gas: _LP _Natural _Central Utility BUILDING OR SITE? Q�/Z 7 7R 7 ❑ Oil ❑ Other—Specify IF YES,GIVE NUMBER OF CONSTRUCTION PERMIT IV. MECHANICAL EQUIPMENT TO BE NATURE OF WORK ❑ Residential or Commercial INSTALLED ❑ New Building (Provide complete list of components on back of this form) ❑ Existing Building ❑ Heat _Space _Recessed ''Central _Floor ❑ Replacement of existing system ❑ Air Conditioning: Room Central ❑ New Installation(No system previously installed) Q Duct System: Material </yx Thickness Extension or addof to ast g stem Maximum capacity c&n Other-Specify!.?,' ❑ Refrigeration ❑ Cooling tower. Capacity ¢ ❑ Fire sprinklers: Number of heads THIS SPACE FOR OFFICE USE ONLY LIElevator: _ Manlift_Escalator (Number) (Received) ❑ Gasoline pumps (Number) ElTanks (Number) Remarks ❑ LPG containers (Number) ❑ Unfired pressure vessel Permit Approved by Date ❑ Boilers ❑ Other—Specify Permit Fee LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT Number Units Description Model Number Manufacturer Capacity Approving (Tons) Agency HEATING—FURNACES,BOILERS,FIREPLACES Number Units Description Model Number Manufacturer Capacity Approving (BTID Ageng TANKS How Many Nominal Capacity Type Liquid Name of Sepal Approving And Dimensions Contained Manufacturer No. enc 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Phone:(904)247-5800•Fax:(904)247-5845• http•//www.ci.atlantic-beach.tl.us 1/14/03 r CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 �f Jif) Application Number . . . . . 04-00027787 Date 4/19/04 Property Address . . . . . . 364 7TH ST Tenant nbr, name . . . . . . REM KIT, PORCH,BATHS, CARP Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 50000 Owner Contractor ------------------------ ------------------------ NOVAK, EMILY JADE BLUE SKY CONSTRUCTION INC 364 7TH STREET 2 VIEJO STREET ATLANTIC BEACH FL 32233 ST.AUGUSTINE FL 32095 (904) 249-7263 (904) 806-4019 --------------- ------------- ------------------------------------------------ Permit ELECTRICAL PERMIT Additional desc . . Sub Contractor . . EARLY ELECTRIC CO. INC. Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 ---------------------------------------------------------------------------- Special Notes and Comments REMODEL, 200AMP, 1PH, 3W, 240VOLT Fee summary Charged Paid Credited Due Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. Q), ( � qo� BUILDING OFFICIAL • CITY OF ATLANTIC BEACH, FLORIDA APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: OATS: 1z � >Ao�f IMPORTANT NOTICE. IN CONSIDERATION OF PERMIT GIVEN FOR OOING THE WORK AS OESCRISED IN THE FOLLOWING. WE HEREBY AGREE TO PERFORM S.VO WORK IN ACCORDANCE'WITH THE ATTACHEID PIANS AND SPECIFICATIONS. WHICH ARE A PART HEREOF, AND IN-ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. co IAC Ali41%,RASTSECITIRICIAN ELECTRICAL FIRM:y /�� SIGNATUNAME ,L! A* / / OIJ� RFO 80X SLOG_SIZE/ BETWEEN: RES.I' i APT.( 1 COMM.I 1 PUBLIC ( 1 INDUS.I Z NEW ( 1 Ott (If-' I REW. ADDITION TRAILER t I TEMP.( I SIGNS ( I s1c- FT. / SERVICE: NEW FEE I INCREASE( i REPAIR ( 1 CONDUCTOR SIZE Dlj AMPS COPPER I I ALUM. V} SWITCH OR BREAKERD DAMPS PH W OLT �.lv' RACEWAY EXIST.SPRV_SIZE EJO AMP5 PH w 4".T `Y� RACEWAY FEEDERS NO. S7ZE NO. SIZE KO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED I OPEN TOTAL O•]O �NP1. 7 i•100 •l�1S. - 5 w cTCr�Es _ INCANDESCENT 1 FLUORESCENT&M.V. PLxE:0 �•�00 .•,.ry, pvcn APPLIANCES BELL TRANSF. AIR H.P. RATING HP.RATING CONDITIO`ING COMP.MOTOR OTHER MOTORS AMPS CELL HEAT: KW-NEAT D IQYER ` MOTORS H.P. r VOLTAGE PH$ NO. VOLTAGE PHS f MISCELLANEOUS TRANSFORMERS: I UNDER 600 V. OVER 600.V. NO. KV A NO. KV A NO.NEON TRANSF. NO. VA. MA, MOTOR SIZE SWITCH FLASHF-11 EAC:; SIGN ` - 1 FORWARDED 4 s i 1 CITY OF ATLANTIC BEACH i J 800 SEMINOLE ROAD r� ATLANTIC BEACH FLORIDA 32233 INSPECTION PHONE LINE 247-5826 N Jjilt Application Number . . . . . 04-00027787 Date 4/14/04 Property Address . . . . . . 364 7TH ST Tenant nbr, name . . . . . . REM KIT, PORCH,BATHS, CARP Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 50000 Owner Contractor - ------------------------ ------------------ ----- NOVAK, EMILY JADE BLUE SKY CONSTRUCTION INC 364 7TH STREET 2 VIEJO STREET ATLANTIC BEACH FL 32233 ST.AUGUSTINE FL 32095 (904) 249-7263 (904) 806-4019 -------------- ------- ----------------------------- -------------------------- Permit PLUMBING PERMIT Additional desc INSTALL 11 FIXTURES Sub Contractor B & G PLUMBING Permit Fee . . . . 112 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due --------------- -- -------- -- --- ------- ---------- ---------- Permit Fee Total 112 . 00 112 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 112 .00 112 . 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 r . CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION r. "AJll�i' Date: LI - 13 -ay Property Address: 8 9 0 S F'A' t nj o t,kv /2,o Owner: m4am^s N(J6f"T Telephone 9: Contractor: & -- G io(.yw1o�" e u Telephone#: 22 3 -3 58s Contractor Address: 13 9n -) 4 t7—*c 4i Q Loo. 'Fax#: ;223 - 37-To 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: q,"'Re-Pipe y - Z 719 1 Number of Fixtures: I Bath Tubs _� Showers Closets Shower Pans Dishwashers �_ Sinks Disposals Urinals Floor Drains I Washing Machine L4 Lavatory 1 Water Sewer 1 Water Heaters Other Fees Permit Issuing Fee: $35.00 Total Fixtures: /S X $7.00 + $35.00 = /yo. 0 0 800 Seminole Road .Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800 . Fax: (904) 247-5845• http://www.ci.atiantic-beach.fl.us CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH, FLORIDA 32233 V INSPECTION PHONE LINE 247-5826 XJ131 Application Number . . . . . 04-00027787 Date 3/15/04 Property Address . . . . . . 364 7TH ST Tenant nbr, name . . . . . . REM KIT, PORCH, BATHS, CARP Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 50000 Owner Contractor - ------ ------------------ -- ---------------- --- -- NOVAK, EMILY JADE BLUE SKY CONSTRUCTION INC 364 7TH STREET 2 VIEJO STREET ATLANTIC BEACH FL 32233 ST.AUGUSTINE FL 32095 (904) 249-7263 (904) 806-4019 ------- ------- ---------------------------- Permit . . . . . . BUILDING PERMIT Additional desc . Permit Fee . . . . 280 . 00 Plan Check Fee 140 . 00 Issue Date . . . . Valuation . . . . 50000 Expiration Date . . 9/15/04 ------------------------------ Other Fees . WATER IMPACT FEE 480 . 00 Fee summary Charged Paid Credited ----Due--- ----- ---------- ---------- Permit Fee Total 280 . 00 280 . 00 . 00 . 00 Plan Check Total 140 . 00 140 . 00 . 00 . 00 Other Fee Total 480 . 00 480 . 00 . 00 . 00 Grand Total 900 . 00 900 . 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 WAPAYING CR TIPROVISIONS APPROVEDPLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATIONIMPROVEMENTS" APPLICABLE FW. , ( - qW.-K, BUILDING OFFICIAL CITY OF ATLANTIC BEACH : FEB 2 6 2004 BUILDING PERMIT APPLICATION ! (ALTERATIONS/ADDITIONS) i Date: Zj2Z Job Address: 36 5'vovm SrIzCeT Owner of Property: 6^11, A&'IAK Address: 56-1 5FyFwtt9 SV2C&TTelephone: Z41-72- 3 " W 3vivTZ7 Legal Description: Block Number: g Lot Number:— oning District: J19l>f eprL57. C(2 . Contractor: State License Number: VCK 1$U5��7o Contractor's Address: S79- CC 517i4a,-r A= , 3eopq Telephone: 104- OCrv- #D/q Fax: 101' W4-/7Ve Describe proposed use and work to be done: 96MOVEZ EX1SR6,- 131z T a&A2 Cr9/L AW77 /KC2W0,0F4_ &_X(s Present use of land or building(s): 5 % /Z Valuation of proposed construction: A 156.1 What are the dimensions of the added space: feet x DC7 feet Stoma X 16,_0 Will the added area be heated and cooled? yES New electrical or increase in service? Add plumbing fixtures? YE5 Add fireplace? �VU Add heating/air conditioning? /,/J Is approval of Homeowner's Association or other private entity required? IN4) If yes,please submit with this application. Will this project involve changes in elevation,site grade or any use of rill material or the removal of any trees? ❑ NO. Applicant certifies that no change in site grade or fill material will be used on this project. N?fES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building � Permit. R1VU. 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.ei.atlantic-beach.fl.us Page 1 Revised 1/14/03 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. I. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct. Signature of owner: Date: 0� ` v n 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 beingtrue and correct and the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: r 26 Address and contact information of person to receive all correspondence regarding this application (please print). Name: Wlal,4AI 14, /Kd1e/�1N Mailing Address: Z l/!G�/y STS 5i /`moi- rL 3.08�/ Telephone: � � - �� Fax:( , E-Mail: �/i4D1 �ytSla�/ f3�lLSJwTI/.ivt"'T AS TO OWNER: Sworn to and subscribed before me this STN- day of ,20 0 q. State of Florida,County of Duval Notary's Signature: C�z opo-� - Personally knownJEX:NRES. J.MORTON ISSION# OBJ 234235 ❑ Produced identification Sepiemb.1,2007 Type of identification produc AS TO CONTRACTOR: Sworn to and subscribed before me this day of 20 C4� -� State of Florida,County of Duval Notary's Signature: �-Personally known L.J.MORTON El Produced identification wv cc�MMsKx+roan EXPiFtE3`L'=cpf�ndlakP i;istX13 Type of identification producedAdd . . 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 1/14/03 MAP TO SHOW BOUNDARY SURVEY OF THE WEST 30 FEET OF LOT 27 AND THE EAST 30 fff-T OF LOT 29, DLOCK 6, PLAT N0, 1 , SUBDIVISION "A", ATLANTIC BEACH "A", DUVAL COUNTY, FLORIDA. (ACCORDING TO MAP THEREOF RECORDED IN PLAT BOOK 5, PAGE 69 OF THE CURRENT PUBLIC RECORDS OF SAID COUNTY) CERTIFIED T0.• EMILY E. NOW FIRST ALLIANCE BANK STEWART TITLE GUARANTY AND BARTLETT & DEAL PA. SEVENTH STREET (40' WW) FND 1/2%P . : FND 3/4%P �NO SURVEYOR ID 0.1 FENCE 60'(PLAT) NO SURVEYOR ID 77E60.05' 60.00' 377.30' FND 1/2%P S'LY R/W UNE NO SURVEYOR ID 1.0'FENCE- 77E ENCE Lu 4 PICKET 15 11.8' .0' STEPS RICK R STORAGE AREA 0.35'EAST FENCE OF BOUNDARY Qt .c3, 0 8.2' 7.1 oI 16.0 0 n�n N 6.8' LTL 6.8" 2.2' U 12.6 V ~ woo0 CA TE 364 O N 135.3' 4.2 v Q O rn o 7 � SCREENEDAREA4' OVERED O 13.6' - x STORAGEOPEN GRADEIWOOD I OW �� O I "=J0 0 O6.9' PAHO x Z Z 2 9' Q 30'DEED I 30'DEED x AC01UA3L I ACTUAL EAST 30'OF I WEST 30"OF x 6'FENCET 0.4"LOT 29 LOT 27 _6 4' 0.3'EASEW OF LINE OF LINE R E C E I V E D CITY OF BUILDINGCH 8 ZONINLANTIC G i I I WATER IMPACT FEE WORKSHEET ADDRESS: DRAINAGE FIXTURE UNIT FIXTURE TYPE VALUE AS LOAD FIXTURES UNITS Automatic clothes washers,commercial 3 Automatic clothes washers, residential 2 2- Bathroom Bathroom group consisting of water closet, lavatory, }} Bidet, and bathtub or shower 6 1 Bathtub (with or without overhead shower or whirlpool attachments) 2 Bidet 2 Combination sink and tray 2 Dental lavatory 1 Dishwashing machine, domestic 2 Drinking fountain/lcemaker '/2 Floor drains 2 Hose bib 1 Kitchen sink, domestic 2 Kitchen sink, domestic with food waste grinder and/or dishwasher 2 Laundry tray (1 or 2 compartments) 2 Lavatory 1 Shower compartment,domestic 2 M Sink ) 2 Urinal 4 Urinal, 1 gallon per flush or less 2 Wash sink (circular or multiple) each set of faucets 2 i L Water closet,flushometer tank, public or private 4 Water closet, private installation 4 l Water closet, public installation 6 TOTAL NUMBER OF UNITS= z< MULTIPLIED X 20 TOTAL$ 5-e,. ` 1�S" s' CITY OF ATLANTIC BEACH FLOOD PLAIN DEVELOPMENT INFORMATION Location: Type of Development: Flood Zone: Required Lowest Floor Elevation: If building is located within a flood hazard zone, a survey must be made AFTER THE SLAB HAS BEEN POURED, certifying that the LOWEST FLOOR ELEVATION is equal to or above the base flood elevation established for that zone. No final inspection will be made and no Certificate of Occupancy will be issued until the survey is on file with the Building Department. COMMENTS: Applicant Acknowledgement: I understand that the issuance of this permit is contingent upon the above information being correct and that the plans and supporting data have been or shall be provided as required. I agree to comply with all applicable provisions of Ordinance No. 25-7-11 and all other laws or ordinances affecting the proposed development. Applicant's Signature: Date: Department Use: Required lowest floor elevation: As built lowest floor elevation: Survey filed with Building Department: Building Department Representative Revised 1/17/03 DONVAN O 904/241-3785 Since 1987 HEAT ; AIR ML CACO 39761 Fax 241-3745 CACO 58398 315 6th Ave South,Jacksonville Beach, FL 32250 "We Want Your Business... Give Us the Opportunity to EARN IT." Load Calc Summary Wheel System Design Temperature Indoor Outdoor Company Name Donovan Heat&Air Summer 75 94 City JATL.BCH.__ Plan Company Address 315 6th Ave S Winter 70 32 NoF- 50 Company Phone 904 270 COOL 50 %RH F49--1 Grains Type lRetro Home Owne Daily Range IM ID No. lRjack0224200411534 Home Owner 7TH ST. —� Address ome Owner Phone 904-806-4019 System NEW Detailed Summary Room KITCHEN/UTILITY - Edit Delete Sales Person Jackson Chase Equipment CFM —� Summary r View (Heating) Equipment CFM Help (Cooling) Re-Calculate NEW Square BTU Sensible Latent Room Name Peopie Footage He t ng TU Heating g Cooling Cooling Cooling Cooling g Existing g Room Total ITCHEN/UTILITY 2 220 10342 5215 4363 852 190 0 IV/DIN/OFFICE 4 490 27153 11371 9578 1793 417 0 ASTER 1 165 2710 2702 2178 524 95 0 ATH ASTER/GUEST 1 4 7201 35103 117761 95741 22021 4161 0 otals 11 15951 753081 1 310641 256931 0 Make sure to click 'Re-Calculate Values'before continuing 1 Add Robm FCITREC VE OF ATLANTIC 5EACH l!r FEB 2 6 2004 BY: www.donovanac.com Cc: CITY OF ATLANTIC BEACH D. Ford ins J� BUILDING / ZONING DEPARTMENT S. Doerr r { J 800 Seminole Road j • � Atlantic Beach,Florida 32233 (904)247-5800 -- (904)247-5845 Fax FFE C E I V E DY OF ATLANTIC BEACH BUILDING & ZONING PLAN REVIEW COMMENTS FEB 2 6 2004 Permit Application Z-7-7 g-7 BY; Property Address: -_5(o`4 1 Th Applicant: I LL-(PrH t-�OIC d►� Project: This permit application has been: Approved Reviewed and the following items need attention: testi � Pow, S, S Please re-submit your application when these items have been completed. Reviewed By: 4�. Date: n� '� �� MAR-05-2004 FnI 02:36 PM ATL. BCH, PUBLIC WORKS FAX NO. 904 247 5843 P. 02/02 . REC�VED CITY OF ATLANTIC BEACH BUILDING ZCrJING DEPARTMENT OF PUBLIC WORKS nq / 1200 SANDPIPER LAW a 3 G�d'+ aIi.oMICBEACH,FWA1pA37133-4318 rELEPHONB:(904)24'•5834 FAX;(9p4)747.5843 40 SUNCOM:952.5834 � BY .._� httpa/;i.atlantiabeach.A.us PLAN REVIEW COMMENTS FROM THE PUBLIC WORKS DEPARTMENT Permit Application # ..moi ---- Applicant: Address; 3(ct+ Prof ect. _ your application is approved as noted by ytth 8ui lic Works Dep Depa u ent. Final �1 appllcation approval must come from Q t 'c your permit application has been reviewed by .he public Works Department and the following items need attention, Provide impervious calculations. Provide-erosion and sedimentns .control pla �\ Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane, approve your application If you have any Atlantic Beach,FL 32233 in order that we can questior.-s please call(904)2�4i7-5834. n,�r� �Do r 11 a." �Ga 1�"L/►i`"� lam" Reviewed by ,Director of Public Works Date �- Signature Contractor Notified Date,m a s `r • (40' RM9 �� . 60.05' + • :''�' ,/ uj • TOTAL .•: :•.� LOT G.OW.72 SQ 60 0. NOW , . ZM7.7,300,PT • LEGAL 8 THE WEV 3o raT of LOT 27 AMD THC EAST 30 FEET OF LOT 29. KOCK 8, PLATNO.I. SLISOMMM W. 1 (ACCOM84 TO MAP TWKOFRECORK0 01 MAT DOM 5, COUNTY)PA" or T" CUMOD" ftWJC RECOM OF WO . COVERAGE • 1 1 r, LEGAL DESCRIPTION :T OF LOT 27 AND THE EAST 30 FEET OF LOT 29, IVISION "A", ATLANTIC BEACH "A", DUVAL COUNTY, FLORIDA. TO MAP THEREOF RECORDED IN PLAT BOOK 5, -IE CURRENT PUBLIC RECORDS OF SAID COUNTY) JADE BLUE SKY CONSTRUCTION, INC. 2 VIEJO STREET ST. AUGUSTINE, FLORIDA NOVAK RESIDENCE 364 SEVENTH STREET ATLANTIC BEACH, FLORIDA REMODEL 12/8/03 M 8005.DWG F 5EVENTH STREET (40' R/W) FND 3/4%P FND 11211P 60'(pLAT) NO SURVEYOR ID NO SURVEYOR ID nE FENCE 60.05'-- 60.00 FND 1/2%P S'LY R/W LINE 377.30� NO SURVEYOR ID 3 1.0'FENCE vet S/L7 fF/V CE TIE W � o FRONT ORCH 4 PICKET 11'0 16.0' BRICK d: STORAGE AREA 0.35'EAST FENCEo Q OF BOUNDARY CLIb °0 io 7.2 c N 11.8 0 16.0'08.2' CAR PORT x ti I STORY WOOD 2.2' FRAME w N ADDITION W w DWELLING , o � � 6'W0OD GATENO. 364 - O ti 4.2'35.3' 6.8' i Q) O cn p REMOVE 74'i COVERED O SCREEN iv v REMOVE i a AREA GE O W 11.1' OPEN OVE � � �GRADE WOOD O 11.10' _PAT70------� ? � 2 9 A TION cv _ THE WEST 30 FEI 30'DEED 30D££D BLOCK 8, PLAT NO.1, SUB[ 30.03' 30.03' I (ACCORDING ACTUAL ACTUAL PAGE 69 OF T 6 FENCE EAST 30' OF WEST 30' OF 6 FENCE 0.3'EAST LOT 29 LOT 27 IrOF 0 4'EAST OF UNE LINE � x %— � 0.% x x60.0FEN � %PFND 1/2-IP3'FENCE TIE C NO SURVEYOR ID 60'(PLAT) NO SURVEYOR ID � N O � SITE PLAN SCALE <> 1" = 30'-0" B04>>k 11655 Page 2190 5 MIN. RETURN PHQNE# ?D(Q"qV1q NOTICE OF COMMENCEMENT State ofTax Folio No. County of ►i°� To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: � �F�-or�T z7 .9�✓� � EST 3J ��'l Ul''��� Address of property being improved: ���TN S7rLCb'7` General description of improvements: APP AC-0 Flz4x-,T fiWaH� /9PO OW 7z:"Owner: Address: Owner's interest in site of the improvement: 10 q0 Fee Simple Titleholder(if other than owner): Name: Address: ' Contractor: iUllalg-Al a I - �(� Address: Z vfe-c✓o - ST1d - ST.Af/ L 3200 f b� Phone No:/qv4) got, y0/CJ Fax No: C fat ) Surety(if an Address: Amount of Bond$ Phone No: Fax No: Name and address of any person making a loan for the construction of the improvements. Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may served: Name: Address: Phone No: Fax No: In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in -- Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option). _ 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 t different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWN R �!�� ICT ii n- Signed: Date: -n�m �. Before me this Ex-ER ''TN-day of 1'05 in the County ruµru of Duval, State ofFlorida�has peronallya p red HOMO Notary Public at Large, State o 1 r' oa° My commission expires: ^' Personally Known: �' '� or r►.w �.. —S;S^ ;ember tll Produced Identification: t,2007 Ln W I.BDp-3-NOTARY FL Notary Discount Ass=.Co. cn 2 6 Cc: CITY OF ATLANTIC BEACH D. Ford L. Hi ins BUILDING / ZONING DEPARTMENT oerr i� 800 Seminole Road r Atlantic Beach,Florida 32233 R E C E I V E D (904)247-5800 CITY OF ATLANTIC BEACH 904 247-5845 Fax V sill ( ) BUILDING & ZONING MAR 0 3 2004 PLAN REVIEW COMMENTS Permit Application # OBY:X778-1 Property Address: —7 133 :Z-4- ' Applicant: W t C-J to H "ul;;-m KI Project: gEgo-DEL_ [l-rT T=Approved plication has been: ❑ Reviewed and the following items need attention: Please re-submit y r application when these items have been completed. Reviewed By: �I� Date: '"J-Ar—ow MAP TO SHOW BOUNDARY SURVEY OF THE WEST 30 FEET OF LOT 27 AND THE EAST 30 FEET OF LOT 29, BLOCK 5, PLAT NO, 1 , 5U6DIV1510N "A", ATLANTIC BEACH "A", DUVAL COUNTY, FLORIDA. (ACCORDING TO MAP THEREOF RECORDED IN PLAT BOOK 5, PAGE 69 OF THE CURRENT PUBLIC RECORDS OF SAID COUNTY) CERTIFIED TO: EMILY E. NOVAK: FIRST ALLIANCE BANK STEWART TITLE GUARANTY AND BARTLETT & DEAL, P.A. 5EVENTH STREET (40' Fz/W) FND 1 2%p D: FND 3/4%P �NO SURVEYOR lD 0.1 FENCE 60'(PLAT) NO SURVEYOR lD 71E 60.05' 60.00' 377.30' FAD 1 21P S'LY R/W UNE NO SUDOR ID 1.0'FENCE- 17E ENCE TIE /\ 4 PICKET 15.0' STEPS RICK& STORAGE AREA 0.35'EAST EL/ FENCE '•- OF BOUNDARY Q 8.2" 7.2 x '.Vcz�i, 0 16.0 0 N I 6.8' 6.8' I r' 2.2' Luf. o I N = N o v -12.s NO. 364 Q- 1a WOOD GATE I 4.2' O 35.3" cp o, Q ?. o SCREENED 7.4' OVERED O AREA _j = v I 13.6" i8STORAGE O 11.1' OPEN OVE AREA "=30, GRADE000 I =30 W 6.9' i Z 219' 30'DEED 30 DEED x AC>`U3L I ACTUAL FAST 30' OF I WEST 30" OF 6 FENCE fi FENCE LOT 29 LOT 27 0.3'EAST I 0.4"EA$ � OF UNE x OF UN R E C E I V �- D I CITY OF ATLANTIC BEACH ��. 1 9y� I BUILDING 8 Z(-)NING 1 FEB 2 6 2004 FND 112%P�f 0.3'FENCE 77£ %1 60.06' 6'1ENCEJ I�FND 1 /P NO SURVEYOR ID . 160'(PLAT) NO SUII �)tD SIN I MAP AMENDED 11-19-03 TO REVISE CERTIFICATE,' NOTES: SHOW BRICK do STORAGE AREA; SHOW NEW FENCES 1) THIS SURVEY WAS DONE WITHOUT THE BENEFIT OF A TITLE (ABSTRACT ON WEST SIDE OF HOUSE. 2) NORTH IS PROTRACTED FROM PLAT ALL CORNERS FOUND AND REFLAGGED DATE OF SURVEY: 5-18-2000 FB 1136, PGS 77 & 78 DRAWN BY. JMJ CHECKED BY: JMJ LEGEND: 6=DELTA ANGLE PC=POINT OF CURVATURE R/W=RIGHT—OF—WAY PT=POINT OF TANGENCY PB=PLAT BOOK PI=POINT OF INTERSECTION MB=MAP BOOK PRC=POINT OF REVERSE CURVATURE DB=DEED BOOK PCC=POINT OF COMPOUND CURVATURE ORV=OFFICIAL RECORDS VOLUME R=RADIUS ORB=OFFICIAL RECORDS BOOK dw CH=CHORD PG=PAGE L=LENGTH �=CENTERLINE MSL=MEAN SEA LEVEL NTS=NOT TO SCALE F'R I VETT A5 5 O C. SEC=SECTION FNn=FnIIND • � S1 CITY OF ATLANTIC BEACH FEB 2 6 200 BUILDING PERMIT APPLICATION (ALTERATIONS/ADDITIONS) Date:- 1�12Z z3 Job Address: 34',4 5e vEV,`74 57-IZc57- Owner of Property: /,.dVf°tX Address: 364 Sc-►�/�rt>' s�/2'd-K Telephone: -�G�v w 3v c.d/ Z7 Legal Description:-Block Number: g Lot Number: oning District: Contractor: 40111b" MO/ZTON State License Number: (-'G-C 1$OSJ 7C Contractor's Address: Z V14:-Jo S7FEE 57-,4"- fl320 eq Telephone: qo.!�_ � _ qo1</ Fax: doll 924-17 8 Describe proposed use and work to be done: i&MC)bkf;� E7t1SR Oi X/ Tfc r/�{1,cv Asti/2 Ci9/� f�0,2T /Z e--M00 a �x�s 7izv� T S Present use of land or building(s): Valuation of proposed construction: ���J What are the dimensions of the added space: 'moi feet x �b feet X l(,_0 Will the added area be heated and cooled? 1✓ New electrical or increase in service. Add plumbing fixtures? C-5 Add fireplace? it/U Add heating/air conditioning? NJ Is approval of Homeowner's Association or other private entity required? NC) If yes,please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? ❑ NO. Applicant certifies that no change in site grade or fill material will be used on this project. � ES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building � Permit. ®'110. 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.ei.atiantic-beach.fl.us Revised 1/14/03 Page 1 In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner. 1. Current survey showing the property boundary with bearings and distances and the legal description. 2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify any existing structures and uses. 3. If required by the Department of Public Works,a pre-construction topographical survey. 4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies. 5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct. �• Date: ���;'� O Signature of owner: 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 the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: 2 ` Address and contact information of person to receive all correspondence regarding this application (please print). Name: bUIG 14AI k- /—t- � Mailing Address: 1/lG�I� STiet6� rL 3,zo 8,/ Telephone: C v.� - Fax:(40-)/7�/Y. E-Mail: VAO R,4`1 -t//�'13154 S�I4 !/ AS TO OWNER: Sworn to and subscribed before me this 2 $ 714- day of OC-B .20 0 State of Florida,County of Duval Notary's Signature: Personally known L.J.MORTON ❑ Produced identification My COMMisSioN* DD 234239 ExpiRES:September 1,2007 Type of identification produc AS TO CONTRACTOR: wY� s2 S -�°_...._._..�-.-•-'rT + Sworn to and subscribed before me this TIT20 ��. day of State of Florida,County of Duval Notary's Signature: "Personally known =Mpfr.,A, ❑ 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 Revised 1/14/03 Page 2 RECEIV ED CITY OF ATLAN BUILDING &ZONING DEPARTMENT OF PUBLIC WORKS � 1200 SANDPIPER LANE MAR 0 3 2004 ATLANTIC BEACH,FLORIDA 32233-4318 �tl TELEPHONE:(904)247-5834 „•`,, FAX:(904)247-5843 S SUNCOM: 852-5834 BY; http://ci.atlantic-beach.fl.us PLAN REVIEW COMMENTS FROM THE PUBLIC WORKS DEPARTMENT Permit Application # p Applicant: • LU 1 l-L-f Ptt4 O-R-T'T Address: -3C04 -I-r-t+ ST:: Proj ect: 'a:-{CQE-3_ K1T R)PrT"S -- E c�t-� TAT ❑ Your application is approved as noted by the Public Works Department. Final application approval must come from the Building Department. Your permit application has been reviewed by the Public Works Department and the following items need attention: Provide impervious calculations . Provide erosion and sediment control plans . Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane, Atlantic Beach, FL 32233 in order that we can approve your application. If you have any questions please call (904) 247-5834. x,2/1 i� Reviewed by�� n a-, , • .,Director of Public Works Date Signature Contractor Notified Date s d aIt r CITY OF ATLANTIC BEACH FFB 26 (? BUILDING PERMIT APPLICATION (ALTERATIONS/ADDITIONS) Date.- z122 Job Address: 304 k vCv�'N 2>797-E57- Owner >T/Zc5TOwner of Property: EmrG I'kV tL- Telephone: Z41-22-& Address: 36 S5iFvfgl-Y '2��_ W 3v 1,di Z7 Legal Description: Block Number: Lot Number: oning District: Contractor: U&WAkni molaroN State License Number: L'(rC ISO SSt 7 D Z V1C J ST,eCC 5T"4a6- t 3Za _ Contractor's Address: �10� e24-17510jj q Fax: Telephone: q64- �°- Describe proposed use and work to be done: � � Present use of land or building(s): Valuation of proposed construction: /b feet S Aja X /6,� feet x G /-Aze What are the dimensions of the added space: New e--- Will the added area be heated and cooled? electrical or increase in service? - � �(,/ Add eating/airhconditioning? Add plumbing fixtures? Add fireplace. U_ Is approval of Homeowner's Association or other private entity required? N� If yes,please submit with this application. Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees? NO. Applicant certifies that no change in site grade or fill material will be used on this project. [f- ES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building �,�,/ Permit. L iglu, Applicant certifies that no trees will be removed for this project. ❑ YES. Removal of Trees will be reb the Tree Conis servation o Boct. TREE a dMwOh ch met two times each month. VAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewedy Procedure: In order to expedite issuance of permits, please follow all steps andprovide all information as appropriate. Incomplete applications may result in delay in issuance of permit d Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have STEP L Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please contact the praann�ngReal Estate Number available. Property App post-con STEP 2. on Contact the City of r grading, eachplan is)requ'requof Public Works to ired. not required,written vedetermine fication must be provided wction ith this application.) topographical survey o grad g p The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-583 STEP 3. Submit Tree Removal Application if trees are to be removed or relocated Application, Energy Code Forms, Notice of Commencement, Owner/Contractor STEP 4. Please submit Building Permit Affidavit if owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.usRevised 1/14/03 Page 1 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. I. 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,apre-construction topographical survey. L,natural water bodies. 4. Any significant environmental features,including any jurisdictionalsidewalks, wetlands, �o C and other impervious Surfaces. Swimming pools 5. Impervious Surface area calculations: include driveways, sidewalks, p may be excluded from total Impervious Surface. 6. Other information as may be appropriate for individual applications. I hereby certify that all information provided with this application is correct. O Date: Signature of owner: to be and correct. provisions of the laws I hereby certify that I have read and examined this application and know the sameherein or note The granting of a permit does not presume to ordinances governing this type of work will be complied with, whether cal specified 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 the plans and supporting data have been or shall be provided as required. Date: 212. 0 Signature of Contractor: Address and contact information of person to receive all correspondence regarding this application (please print). Name: MORY_ '�_ _ Mailing Address: Z V1GJ� 572tE� 5/ A"` rz Telephone: C � — �l� Fax: y 1751Y E-Mail: .//4AG f a plc M'' FilC N&T AS TO OWNER: Sworn to and subscribed before me this 2 S TW day of State of Florida,County of Duval Notary's Signature: J.MORTON Personally known My coMMISscort# °D 238239 E] Produced identification ExpIRES:September 1,2007 Type of identification produc AS TO CONTRACTOR: Sworn to and subscribed before me this day of � State of Florida,County of Duval Notary's Signature: L.J.P30 "CiJ �- Personally known MY R=D2 ^uR ❑ Produced identification nxr�;1� .= 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-usRevised 1/14ro3 Page 2 MAP TO SHOW BOUNDARY SURVEY OF THE WEST 30 FEET OF LOT 27 AND THE EAST 30 FEET OF LOT 29, BLOCK 5, PLAT NO, 1 , 5UBDIVI510N "A", ATLANTIC BEACH "A", DUVAL COUNTY, FLORIDA. (ACCORDING TO MAP THEREOF RECORDED IN PLAT BOOK 5, PAGE 69 OF THE CURRENT PUBLIC RECORDS OF SAID COUNTY) CERTIFIED TO: EMILY E NOW: FIRST ALLIANCE BANK STEWART TITLE GUARANTY AND BARTLETT & DEAL, P.A. 5EVENTH STREET (40' RIM �.v. fND 3/4%P /fND 112%p rD= NO SURVEYOR ID NO SURVEYOR ID 0.1 FENCf 60 60.0055'' ' AE 60.00' FND 1/211P SLY R/W UNE 377.30' NO SURVEYOR ID �= 1.0'fENCE 71E . I �` 03 Lu 03 � :.o. STEPS � 4 PICKET 15.0 RICK& STORAGE AREA 0.35' EAST FENCE '.. DZ/Q :c�i;^• 11.8 0 8.2� 7,2 OF BOUNDARY 16.0 o a tiTnDV UMn6.8 uL 6.8 1, 2`2 12.6 364 0 Z N o WOOD GATENO 4.2 V 35.3' , SCREENED 74 Q U? % o AREA OVERED O v v I 13.6' �o STORAGE � O 11.1 OPEN OVE AREA GRAOErWOOD I Z �p 6.9' P0 x 2n9. Q I L W � 30'DEED 1 30""DEED ACOA I AC1vAL EAST 30' OF I WEST 30" OF 6'�N T LOT 29 I LOT 27 6 FENCE 0.4'EA$T OF UNE x OF UN � ECEIVE: l4 I o I CITY OF ATLANTIC BEACH BUILDING 8 Z(-)hIING FEB 2 6 2004 x—x—x' x z x x x ' x z— i FND 1/2'lP� 0.3'FENCE AE 60.06 6 FENCE, �FND 1 Ip No SURVEYOR ID 160'(PLAT) NO SU � I N M MAP AMENDED 11—19-03 TO REVISE CERTIFICATE,• NOTES: SHOW BRICK do STOR4GE AREA; SHOW NEW FENCES ON WEST SIDE OF HOUSE 1) THIS SURVEY WAS DONE WITHOUT THE BENEFIT OF A TITLE (ABSTRACT ALL CORNERS FOUND AND REFLAGGED 2) NORTH IS PROTRACTED FROM PLAT DRAWN BY* CHECKED BY: DATE OF SURVEY: 5-18-2000 FB 1136, PGS 77 & 78 JMJ JMJ — CRC LEGEND: D=DELTA ANGLE CE PC=POINT OF CURVATURE R/W=RIGHT—OF—WAY PT=POINT OF TANGENCY PB=PLAT BOOK PI=POINT OF INTERSECTION MB=MAP BOOK PRC=POINT OF REVERSE CURVATURE DB=DEED BOOK PCC=POINT OF COMPOUND CURVATURE ORV=OFFICIAL RECORDS VOLUME R=RADIUS ORB=OFFICIAL RECORDS BOOK dw CH=CHORD PG=PAGE L=LENGTH (E=CENTERLINE MSL=MEAN SEA LEVEL NTS=NOT TO SCALE F'RI VETT A550C. 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CLr SXLL L] r Ill zdcn2� cm �Z:z m p CF-1WW �^ 0 N^ J x W 0+•yJ,N Q N C r Z V M M MS2 ML4� �olJCdz�-'wz7d z C lo n,¢ t S �o 0,I te=a: 1 M M M M M M M M ` .0..10 W Lw7S2!Lill,lazo 2 L �.W W+ S3 -oc3 W O In V. d' v co r t0 In LL L'1 U.U.OW Z O Z W O�J !yJ 7 LA LA ti UJ =WSW^ L7 cn WZ 2U'f 0(LU J7 L7 ZC=LL�W=CL W M N NU I MMM ^yy 0�S�W 5 F O K J J I a- L'72S •-ZW=.' rl W 1wW_ �-¢Z- O � 'zz>`= a • �O 10117 MSOMS2 N U M N N as � �J o"Ju.S�ws a M M M M M I o- r'9 C.1 a r n iZD >- _j J Z W W•--V (nm NN mc'Si woL5 c� LLI Z i JNi+rZ IW 1 1 J 6 C CITY OF ATLANTIC BEACH DEPARTMENT OF BUILDING 800 Seminole Road -Atlantic Beach, FL 32233 -Tel: 247-5826 - Fax: 247-5877 ELECTRICAL PERMIT PERMIT INFORMATION LOCATIONINFORMATION Permit Number: 18725 Address: 3SEVENTH STREET Permit Type: ELECTRICAL ; ATLLAA NTIC BEACH, FLORIDA 32233 Class of Work: INCREASE Township: 0 Range: 0 Book: Proposed Use: SINGLE FAMILY Lots Block: Section: 0 Square Feet: Subdivision: Est. Value: Parcel Number: Improv. Cost: OWNER INFORMATION Date Issued: 8/25/1999 Name: JIM GANN Total Fees: 43.50 Address: � ATLANTIC BEACH, FLORIDA 32233 Amount Paid: 43.50 Date Paid: 8/25/1999 Phone: (904}724-3567 Work Desc: ESS100AMPS-200AMPS1PH3W240V ALUM - SERVICE INCREASE AND AC CONTRACTORS t -=. _ �- APPIICATLON FEES R & R ELECTRIC COMPANY PERMIT �43. 0 Ins ections Re ufre.t FINAL ELECTRIC !ROUGH ELECTRIC NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. —___--- f4®08246 56141 Date: 8/25/99 01 Receipt: 2 CHECKS ATLANTIC BEACH BUILDI PT. 00100003221090 CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 8-23-99 19 IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOINGTHE�WORK ATTACHED AS DESCRIBED IN THE AND SPECIFICATIONS,LOFOLLOWING, HEREBY AGREE TO PERFORM SAID WORK iN ACCORD WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIO S, CODES AND CITY 0 ATLANTIC BEACH ORDINANCES. R & R ELECTRIC OF NORTH FLORID?,, !1C. P. 0. BOX 62238 /x JACKSONVILLE FLORIDA 32:'].9 ELECTRICAL FIRM: MASTER ELECTRICIAN SIGNATURE NAME Scott Gann ADDRESS: 364 7th St. RFD-BOX- BLDG. FD BOXBLDG.SIZE BETWEEN: RES. Vf APT. ( ) COMM- ( 1 PUBLIC ( 1 INDUS. ( 1 NEW ( ) OLD ( 1 REW. ( ) ADDITION ( ) TRAILER ( 1 TEMP. ( ) SIGNS ( ) SO. FT. / FEE SERVICE: NEW ( 1 INCREASE Y� REPAIR ( 1 CONDUCTOR SIZE AMPS D COPPER ( 1 ALUM. (� SWITCH OR BREAKER AMPS PH W LT RACEWAY EXIST.SERV.SIZE (/ �l AMPS PH J W 7�OLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL s1.1oo AMPS. 0.90 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER BELL TRANSF. APPLIANCES AIR H.P. RATING H.P. RATING CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW HEAT 1 GVE6 MOTORS H.P. I VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS I CITY OF Sic, ri, Qe4CA Q Office of Building Official �.3 REQUEST FOR INSPECTION Permit No to / A.M. Time P.M. Received Locality Job Add r ss Owner's Contractor Name PLUMBING MECHANICAL CONCRETE ELECTRIC ❑ Air ond.& ❑ BUILDING ❑ Rough ❑ Heating ❑ Footing ❑ ❑ Top Out ❑ Framing ❑ Temp Pole ❑ Sewer ❑ Fire Place ❑ Slab ❑ Final Pre Fab in Roofing ❑ Lintel Insulation A.M. READY FOR INSPECTION Friday P.M. Wed. Thurs. Tues. Mon. O A.M. P Final Inspection Inspection Made ancy ❑ Certifica Inspector Date f f CITY OF �t�°cu�tic �'eacCi - ��ivaida 3110 SEMINOLE ROAD ATLANTIC BEACH. FLORIDA 31_333-5445 TELEPHONE (90.1)347-5300 FAX (904) 247-5305 -- �. SUNCOM 852-5300 DATE JEA Construction & Maintenance 2325 Emerson Street Jacksonville, FL 32207 Attention: Connie Re- Final Electrical Inspections Dear Connie- Final Inspections on the following locations have been completed and approved- PERMIT NO. ADDRESS i Please call me at 904-247-5825 if you have any questions. Sincerely, i ATLANTIC BEACH BUILDING DEPARTMENT CITY OF ATLANTIC BEACH j MECHANICAL PERMIT 800 SEMINOLE ROAD-ATLANTIC BEACH, FL 32233-TEL: 247-5826-FAX- 247-5877 7 PERMIT INFORMATION` LOCATION INFORMATION -_--� - - -- -- Permit Number: 18703 Address: 364 SEVENTH STREET MECHANICAL ATLANTIC BEACH, FLORIDA 32233 Permit Type: Township: 0 Range: 0 Book: Class of Work: REPAIR Lot (s): Block: Section: 0 Proposed Use: SINGLE FAMILY Subdivision: Square Feet: jr Parcel Number: Est. Value: OWNER INFORMATION _-- Improv. Cost: ---- Name: JIM GANN Date Issued: 8/24/1999 Address: Total Fees: 37.00 ATLANTIC BEACH, FLORIDA 32233 Amount Paid: 37.00 D Phone: (904)724-3567 Date Paid: 8/24119993 Work Desc: 1) HEATPUMP HPS9036 LENNOX 3 U/L; 1 A/H CB30M41 LENNOX 3 U/L 10KW HT APPt LCAMON FEES. j CONT RAGTORtS) PERMIT 37 00 AIR ENGINEERS INC. - - --__-- Inspections-IR ulred- ROUGH MECHANICAL _ FINAL I i NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THISCONORK MUST NOT BE TRACTOR OR OWNERCED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER " AILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY � F 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. $37.0014 Date: 8124/99 02 Receipt: 0082372 — �, �: - CHECKS 28351 ATLANTIC BEA H BUI ING DEPT. 00100003221000 �1a3 BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ` ATLANTIC 119ACH, FLORIDA aalaa APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections I. II, III, and IV. LOCATION Street Address: OF IaFerwcting Skeels: {al.a.n +�an�,c_ Aederr � v WILDING s�►dinitlars 11. IDENTIFICATION — To be completed by all applicants , Ip, consideration of permit given for doing the Work as described in the above statement we hereby agree to pirform Said work In accordance .ith the a"schjd plans and specifications which u• a pert hereof and in accordance With the City of Jacksonville ordinances and standards cJ good practice listed therein. Ma+e of Ltechatical _ �^ Cenheaferl CwbastW (hint) 1 ! t� �nC • Master Home of h..«*yy Ovaer CoH Mel SSC; G r /• 1 S:ralrre of O.tar signature of w Awt"is@4 ASais Architect or Englaser 111. GOOLAL INFORMATION A' T 1 64 inIsrel: 6. 1rM og If OTHER CONSTRUCTION SING DON[ON ® foctric THIS WILDING OR SIT[? C ❑ St—❑ U ❑ Natvrel ❑ CON" UfAfy If Y[S, GIVE NUMBER OP CONSTRUCTION ❑ CN PERMIT ❑ Otb« — Sa»cify IV. w00K4 tICAI IQUWMWT TO ffis 1NSTAIAA NATURE OF WORK (Pvwr o to fitsim list of cempoaeeta at fly of this "I o nesidential or ❑ Commercial © 4sat (3 Sreca ❑ Recaeaosi 0 Contod O ftoo. ❑ New Building 0"Ar C00414io41L►g: O RerIR 13 Ce*Nd ID Existing Building 0Tl+kieeesL LlRiplscement of existing system f�.cl �alores Qleteriel_ e l rs. ❑ New Installation(No system previously Installed). ugh O Extension or add-on to existing system ❑ ' ❑ Other— Specify ❑ Goel:ee lacer•. G�aclly ..._,..,,,.....R..._,.._.,—. .-- i.i•.r+s, ❑ Fw yrinkler+: Nem►er of Ise: ❑ H..e+e. ❑ "of ❑ fcee.l.fa_--•lae.lw►1 flits VACII 004 011111140 UN ONLY ❑ GaoS..ONO" ---(ftvnbarl IR�edee�l ❑ Ta.ktt...`._. (1wtR`er) RerRsria ❑ 04 00a401"n—.. - I WAWA) -- ❑ Uefwd M+wwo ween Ponot l Apia" b1t Data ❑ lloiler• Q Offer — S►sc+hr /srRslf ba LIST ALL RQUIPMENT / AiR CONDMONINC AND REFRIt I ATION EQUItMENT Q�pyy Numb"Vali+ Doatptlow Xodd Number NsalMw sabe ('lbw;) �J t f of I HEATING • FURNACES, BOILERS, FIREPLACES ]habr Vat a Doom Me"Number 11Iif ( kjV CITY OF 1 i Office of Building Official n REQUEST FOR INSPECTION / Permit No. / (O Date CJ A.M. Time P.M. Received ocalitk Job Address t Owner's Contractor Name PLU ING MECHANICAL CONCRETE ELECTRICAL Air Cond.& ❑ BUILDING ❑ Rough Wiring ❑ ❑ Heating Framing ❑ Footing ❑ Temp Pole ❑ Top Out ❑ Fire Place C Re Roofing ❑ Slab ❑ Final ❑ Sewer Pre Fab R ❑ Lintel Insulation READY INSPECTION Thurs. Friday Tues. Wed. Mon. A.M. ., P.M. Inspection Made Final Inspection ❑ v r Certificate of Occupancy Inspector C Date PSR-3844 13767 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH - TPERMT_T INFORMATION -- -------- LOCATION INFORMATION --- -- ---- Permit Number : 13767 Address : 369. SEVENTH STREET Permit Tvve : PLUMBING ATLANTIC BEACH . FLORIDA 32233 Class of Work:ALTERATION --------- LEGAL DESCRIPTION --------- 'rnst r . Tvpe*WOOD FRAME Block : Lot * Tw> : Proposed Use: SINGLE FAMIL`: Section: 0 Subd: Rn-t ' Dwellings : 0 Subdivision: Est . Value: 0 . 00 ?rriprov .. Cost : 0 . 00 Total Fp-! ' ?5 00 Amount 0 �tdaEFt iIVF`� 1t3'TION _ _._ __ --_ _. _. APPLICATION FEE:_ ?IM GANN PERMIT PLANTI ." LEA"H FLORIDA 22 4 ,7- 4 - 2 NTRA:;T0F_ !NFORMAT I ON Name : BIG JOHN PLUMBING INC , A+1r F Rrly 45384 FL 32247 Exp : 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 AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANICS' 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 4FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. Ash 00100003221000 ATLANTIC BEACH BUILDING DEPARTMENT By: CITY OF ATLANTIC BEACH APPLLIC/ATlION FOR PLUMBING PERMIT JOB LOCATION: OWNER OF PROPERTY: S � Y►� ���V\ PLUMBING CONTRACTOR: PI LArr,b�►��-�/lc- CONTRACTOR'S ADDRESS: �2 S� pow-e-rs 14 Z_/4-y F-L 3-2 -all STATE LICENSE NUMBER: C FCU SOScI S TELEPHONE: W-ti - 3SG7 HOW MaY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS _LAVATORIES WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINES FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES: X 3.50 + $15.00 MINIMUM PERMIT FEE = $25.00 SIGNATURE OF OWNER: �f SIGNATURE OF CONTRACTOR: ----------------------------------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834. i CITY OF Office of Building Official / REQUEST FOR INSPECTION Q 'y— Permit No. Date A.M. District No. Time, P. Recery & f r` / — � Z�� Job Address 6Owner's Contractor Name PLUMBING MECHANICAL CONCRETE ELECTRICAL Air.Cond.& — BUILDING — Rough Wiring Rough Heating Framing Footing Top Out ❑ Slab Temp Pole Sewer C Fire Place Re Roofing El —Lintel Final — Pre fab READY FOR INSPECTION A.M. P.M. Wed. Thurs. Friday Mon Tues. A.M. _ P.M. Inspection Made Final Inspection❑ Inspect r Certificate of Occupancy �LDEPAkj-MENT OF BUILDING 09983 CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO. .. ` PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date August 3, 19 R" Valuation$ Fee$ 13 SO This permit not valid until above fee has been paid to City Treasurer,and is T subject to revocation for violation of applicable provisions of law. 'j• n I 1 This is to certify that Joe Gruber Plumbing ')Hd I I oil LIVOUS 600CAC. has permission to X inst311 Pltzmblrig 1 nflfi I i Classification Residential Zone i Owned by Smith Lot Block S/D House No. 364 7th Street According to approved plans which are part of this permit f NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS M AFTER DATE OF ISSUE �--� 4— � O Building material, rubbish and debris zi from this work must not be placed in public space, and must be cleared = up and hauled away by ei jr con- itrpetor or owner. !" Building Official. I FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL I SEWER WATER s CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING_PERMIT JOB LOCATION ���- Ste- , N-'I-A N 7 t 4 u PLUMBING CONTRACTOR o (-� LICENSE NUMBERS C Ef 4:!q: OWNER n- --j F BUILDING CONTRACTOR TYPE OF BUILDING SINKS SHOWERS LAVATORY WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS x WASHING MACHINE FLOOR DRAINS -`'OTHER _TOTAL FIXTURE COUNT . INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE. i JUL151981 CITY OF ATLANTIC BEACH July 14, 1981 City Manager City of Atlantic Beach 716 Ocean Blvd. Atlantic Beach, FL RE: William S. Baisden 364 7th Street Atlantic Beach, FL Dear Sir: As requested by the City Commission of Atlantic Beach during their hearing of my zoning variance request on July 13th, 1981, please accept my letter of intent to construct a covered carport 14' X 20' including a wheelchair ramp at the above referenced location. Although, paralyzed and confined to the use of a wheelchair as the result of an accident substained February 28, 1981, I own a car and am still gainfully employed. In accordance with the recommendations of a "Mobile Team Visit" by the staff of The Cathedral Rehabilitation Center (copy attached) and in order to make the new carport and ramp architecturally pleasing as well as practical for my needs, it is necessary that the building side line set back requirements be violated, specifically from a requirement of 72' to an actual distance of 15". The neighbors contiguous to that property line have been consulted on this matter and have expressed no opposition to this violation. It will also be necessary to violate the front set back requirement, specifically from a requirement of 25' to an actual distance of 22' . Based on assurances received from the building department that the variance would be granted, men and material have been mobilized for construction of the project; therefore, time is of the essence in receiving approval. Sincerely, l..J��' William S. Ba den WSB/mh Encl. MAP SHOWING SURVEY OF THE 30 FLIT OF LOT 27, fM T•riS FAST 30 FEET OF LOT 299 BLOCK. F, ATL:NITIC 13—yCi7, ,I RECORDS PN PLAT BOOK 5, PAGE 69 OF THE MRRDiT FLBLIC R,;CORD;; OF ITVL CCIRiTY, FUJ:L7: .'.. _Al FOc.ND 3�. /LZGN - - � ��.O ' _-- f OU,VD �-9• /QON -?p as 6� 30 �I�-�- �O• ' ZO• -1-o) Sr GOfiST Ok/✓G-] .dR ouT q0 �'- CO[iPreX in i \ ii W i 2N N cow. ` y I b1. ;uavn.vc I x ti:Q, J 1 _ 44 i V ono V o - sroey =AZA ..—E V J v 3;G¢ /D�'✓ ovE Cp—tfr Door ��[ l 0 W,41G p ��I �i�BAK r d O \ C�pl� ? q 14 3 00 I l` v c s e---s ' `( wv00� RAM.- I xI N vo wide ►� A✓ 0 Y �l 0 J •! x � I � �1j � J m I N o p X I 3• CNA/N Giil/,C FENCE �• ZO• QL• K 30. K� -�p ZO fOUN� 3�" 1Rl�N-'� CrJ .O I `--FC(l/�/O /•' r0/V 1 WEI AL CENU MOBILE TEAM VISIT William Baisden April 22, 1981 TEAM ME14BERS: ' 1 . Karen Grubbs, OTR 2. Kathy Stanfield, RPT PURPOSE: 1 . To assess the home for architectural barrier 2. To make equipment reconmrenrlati ons. INTRODUCTION: Mr. Baisden is a thirty-eight year-old male who sustained a fracture dislo- cation of T4-5 secondary to a motorcycle accident on February 28, 1981 . The patient was placed in a Stryker frame and eventually fitted with a thoracic immobilization jacket with cervical attachment. He was referred to Cathedral Rehabilitation Center by Dr. Grand on March 12, 1981 for an intensive paraplegic ►rehabilitation program. Mr. Baisden has progressed steadily within the limita- tions of his brace. NARRATIVE: on Wednesday, April 22, 1981 , the members of the Nobile Team agent to 364 Seventh Street, Atlantic Beach, Florida. Mr. Gaisden c.urrc-rrtly lives in a two-bedroom, Lwo-bathroom house with three entrances. 1;E C 0(•11 1E NDAT I ON S: Front Entrance The front entrance is 13' 5" frons the driveway. There are three steps and a lip up to the front door which add up to 22" from '1, c�,nrd level . The porch is 59-1/2" wide. A ramp is not recommended for this ent►'-:nce. •1'17r -T .r11• ­ r r.• ..r ;-10-BILE TEA11VISIT — ldill ianr Haisden Side Entrance The side door is 29" wide and accessible. There are three steps and a lip to the side door which add up to 26-3/4" from ground level . The distance between the walls on either side of the steps is 36-1 /2" ; length of walls are 48". It is recommended that a level platform 9' long be extended from the side door out with a right angle 26' ramp sloping 1 :12. Ramp should be covered with nonslip surface and have handrails and curb strips on both sides. Pyr. Baisden may want to consider a filled concrete driveway and covered carport. Back Entrance The back door of the house, which leads out to a small porch, is 31 -1/4" wide and accessible. A 3" door lip needs to be smoothed down. The poch door is r 32" wide and accessible. The back porch opens otito a wooden sundeck with a back step that is 15-3/4" and a side step that is 14-1/2" . The existing side- walk on the side of the house is approximately 18' sway from the back step. The sidewalk is 23" wide and not accessible. It should be widened to 36" . It is reconmmended that a 16' wooden ramp sloping 1 :12 be constructed from the porch. A 4' sidewalk %..ould need to be added to connect the ramp with the existing sidewalk. A metal lip should be placed between the concrete and wooden ramp (please see diagram) . Ramp surface should be covered with non- slip surface and have curb strips or handrails oil both sides. Plaster Bedroom Bedroom doors are accessible. The couch must be moved out of this room. It is suggested that the tall dresser be placed where the couch was. Right closet rod must be lowered to 48" above the floor. There is a 34-1/2" wide, 71-1/2" high built-in desk which should be removed to allow accessibility to the bath- room. !•taster Bathroom: Remove partition desk to allow for access into bathroom. Entrance into shower is 27-1/4" wide. Patient would have difficulty entering this shower. Could possibly enter using angled pivot transfer with padded tub seat and would re- quire shower hose extension. Commode would have to be approached with front on transfer with use of padded raised toilet seat and toilet safety frame. !tall mirror needs to be lowered to 36-48" above floor. Sink is 28" high and can currently be approached from front with foucets being accessible. It is suggested that the cabinet under the sink be removed and exposed water pipes be padded for safety. Living Room/Dining Room Living room, dining room and porch doors are accessible. Dining room table is 23-1/2 high and does not provide knee clearance. A table with 32" clearance from the floor to underside of table should be ohtained. Side porch entrance 2 - ti )RILE TEAM VISIT - Williaiu C��is�len h,is a 2-1/2" lip which should be smoothed. f:i tc hen I;itchen is accessible through doorway from hall with the removal of refrigera- tor. Patient may want to cot sider several options: a) slimline refrigerator; b) placing refrigerator in other room; c) reinforce flooring in hallway to support refrigerator: Kitchen is not accessible from (lining room due to lack of clearance between counter and stove. If patient wishes to enter through this doorway, he has the following options: a) remove stove and replace with counter top model ; b) remove counter up to dishwasher to allow clearance. Kitchen sink and countertop microwave are easily reached from wheelchair. L Hall Bathroom Door is 27-1/2" wide and not accessible. It needs to be widened to 30-31 ". Tub can be approached from side using padded tub transfer seat. Co„Liiode can be approached from angle. Transfer can be performed using raised padded toilet seat and toilet safety frame. Sink can be approached from angle but pipes must be insulated. CONCLUSION: I•tr. Baisden' s home is mostly %."heelchair accessible with the major problems being the bathroom, kitchen and entrances. The patient should be independent from • wheelchair level once his brace is removed , ADL sF:ills are attained, and home adaptations are completed. YL Karen Grubbs, OTR - Kathy .Stanfiel'd, RPT KG/psn cc: Medical Records Chart Howard P. Hogshead, M.D. Travelers Insurance Company Physical Therapy Occupational Therapy Social Services Clinical Psychology Ann Latimer, R.N. . Rehal,ilitation Coordinator cg `' 4 L�. •3 1 0 F Q I-it V r 1 � Date..----....._.._..... .._.58 .._._ f Permit *.................. _.- `FAILURE TO COMPglyf I& Valuation :.......... LIEN LAV CAN RESULT IN T PERT ::..._�.. �x......� House . --z DWNER PAYING TWICE FOR _ _ - --- _._._. " � ...................................: .. ... ..�..,. ......----------------- IMPROVEMENTS. APPLICATION FOR BUILDING PERM.*. Application in hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach,Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a Wt of sub-contractors be submitted to this office so that licenses can be verified. Date..... L� _ 1 ........ , Owner._.ko L L cB fIS DEN -----•--.. ddess_36Zr*" 'T .........Telephone No. _ :. e ' ... -- Architect................................................................................................ ddress_ 7LA!VTtG...... .......Telepbone No............................. J okrovd/c GE F/�` 1X/ Contractor Builder._..TQ^? ...... u P iPESS -_ Address---P-._P-.2.../j�!x... y2_ 8_____________Telephone f4o-.2 1 Lot No..(Vt...3Q-•-Lor-2� Block No................8---------...Sub Division....Ri-&IePr ri .... e i� /.-•---..P s :.�9Zone._........----••. .........................................................Street....------------------_Side Between.....................................................and-._...................................................Sta. Valuation i.3j_.BBo_.r..__...For what purpose will building be used....L..................................Type of construction...................................... Dimensions of Building........................................Dimensions of Lot........................................................Size of Footings-.................................... Size of Piers....................................Size of Sills................................Greatest Sill Span in ft...........................Type Roof_._...__...._.._._......_........_... How will Building be Heated?................................................................Will Building be on Solid or Filled Ground?......................._---_-----___- Size of Ceiling Joists........................................... Distance on Centers........... ................................, Greatest Span.___---._.____.-_•----___-____-___.. Size of Floor Joists............................................... Distance on Centers--......-- ................................ Greatest Span---------------_..-__-______--------__--__ " Size of Rafters......................................................Distance on Centers ..... .................................. Greatest Span--------•----------•------••••-•--------•--- " This rectangle is to represent the lot. Locate the building or buildings in the right position. Give distance in feet from all lot-lines and existing buildings. REAR LOT LINE Two copies of plans and specifications shall be submitted with application. Inspections required• s-a"evz;y 1. When steel is in place and ready to pour footing. Z. When steel is in place and ready to pour columns and/or lintel. S. When steel is in place and ready to pour beam. 4. When framing is completed. 5. When rough plumbing is completed,and ready to cover up. 6. When septic tank drain field or sewer is laid but before it is covered. 7. Electrical inspection by City of Jacksonville. FA °Q 8. Final inspection. Note: In case of any refection,re-inspection MUST be called for after corrections are made. FRONT OF LOT 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 building regulations of the City of Atlantic Beach. Signature of Builder.... y--. Addren...P.D'....i3 x `>z 8a' T�o�s..✓.�t z?. Signatureof Owner...............................................................................r Address.................................................................................................... CITY OF. ATLANTIC BEACH 716 OCEAN BOULEVARD ATLANTIC BEACH, FLORIDA ADDENDUM TO BUILDING PLAN Building Location: .36y ? r" 577 t. The attached plan for the above building is approved subject to meeting the following applicable construction requirements: a. Footings shall be continuous monolithic concrete under exterior walls, reinforced with two 5/8" deformed reinforcing rods for one-story buildings and three 5/8" deformed reinforcing rods for two-story buildings. Reinforcing rods shall be placed in the lower one-third of the footings , properly placed and fastened on metal cables with wire. Footings shall be si-x inches wider on each side than the wall above, shall be at least eight inches thick and shall rest on firm soil at least twelve inches below undisturbed soil . b. In hollow masonry unit construction, each unit cell shall be reinforced with at least on No. 4 bar at all conrners, poured and tamped with concrete; such rein- forcing shall be properly tied into the footing and spandral beam. G. All wood truss rafters (roof construction) , shall be securely fastened to the exterior walls with approved hurricane anchors or clips. d. Construction of nearby one-family dwellings, which are duplicates or intensely similar, shall be avoided. Such similarity considers the external configuration and appearance (.i .e. , roof, outer wall materials, window size and design, and other like characteristics) of structures. In accord with the foregoing, similar and shall be at least 500 feet apart if any one similar dwelling is visible from any other similar dwelling. e. The final connection between the house plumb.ing drain and the sewer=service connection (at the property line) must be inspected by the City before being covered. City Manager The undersigned hereby certifies that he has read the above and understands that this addendum takes precedence over any contrary details to the plans and specifications and agrees to comply with the intent of this addendum. Contractor/Owne J Da CITY OF oft1aC - � 4 716 OCEAN BOULEVARD-DRAWER 23 ATLANTIC BEACH. FLORIDA 32233 (904) 249-2395 August 3, 1981 TO THE MEMBERS OF THE BOARD OF ADJUSTMENT: I have been asked to advise you that there will be a meeting of the Board of Adjustment on Thursday, August 13, 1981, at 7:00 PM, to consider the following: The enclosed letter of application from Mr. William S. Baisden, 364 7th Street, Atlantic Beach, Florida, together with a letter from Mr. Baisden's agent, Mr. Tom N. Humphress, Jr. , to construct a covered carport, including a wheelchair ramp, at the above address. Mr. Baisden's proposed construction violates Sec. 28-8, subparagraphs (c) and (d) of the City Code. Respectfully submitted, L I �'/ A. Wikl am Moss City Manager AWM:j 1 (T�LDPAL WEI-MIE1T1M CENTER MOBILE TEAM VISIT William Baisden April 22, 1981 TEAM MEMBERS: ' 1 . Karen Grubbs, OTR 2. Kathy Stanfield, RPT PURPOSE: 1 . To assess the home for architectural barrie)' ;. 2. To make equipment recommendations. I JTRODUCT ION: Ilr. Baisden is a thirty-eight year-old male who sustained a fracture dislo- cation of T4-5 secondary to a motorcycle accident on February 28, 1981 . The patient was placed in a Stryker frame and eventually fitted with a thoracic immobilization jacket with cervical attachment. He was referred to Cathedral Rehabilitation Center by Dr. Grand on March 12, 1981 for an intensive paraplegic rehabilitation program. fir. Baisden has progressed steadily within the limita- tions of his brace. NARRATIVE: On Wednesday, April 22, 1981 , the members of the Mobile Team went to 364 Seventh Street, Atlantic Beach, Florida. Mr. Baisden currently lives. in a two-bedroom, two-bathroom house with three entrances. RECOMMENDATIONS: Front Entrance The front entrance is 13' 5" from the driveway. There are three steps and a lip up to the front door which add up to 22" from ground level . The porch is 59-1/2" wide. A ramp is not recommended for this entrance. q')Z 17AIT nl`r lr r.. .-•�nr- r. .... 1 r. .i- .. r.^ .n . -..r... \ 1-f t MOBILE TEAM VISIT — William Baisden Side Entrance The side door is 29" wide and accessible. There are three steps and a lip to the side door which add up to 26-3/4" from ground level . The distance between the walls on either side of the steps is 36-1/2" ; length of walls are 48" . It is recommended that a level platform 9' long be extended from the side door out with a right angle 26' ramp sloping 1 :12. Ramp should be covered with nonslip surface and have handrails and curb strips on both sides. Mr. Baisden may want to consider a filled concrete driveway and covered carport. Back Entrance The back door of the house, which leads out to a small porch, is 31 -1/4" wide and accessible. A 3" door lip needs to be smoothed down. The porch door is 32" wide and accessible. 1-he back porch opens onto a wooden sundeck with a back step that is 15-3/4" and a side step that is 14-1/2" . The existing side- walk on the side of the house is approximately 18' away from the back step. The sidewalk is 23" wide and not accessible. It should be widened to 36" . It is recommended that a 16' wooden ramp sloping 1 :12 be constructed from the porch. A 4' sidewalk would need to be added to connect the ramp with the existing sidewalk. A metal lip should be placed between the concrete and wooden ramp (please see diagram) . Ramp surface should be covered with non- slip surface and have curb strips or handrails on both sides. Master Bedroom Bedroom doors are accessible. The couch must be moved out of this room. It is suggested that the tall dresser be placed where the couch was. Right closet rod must be lowered to 48" above the floor. There is a 34-1/2" wide, 71-1/2" . high built-in desk which should be removed to allow accessibility to the bath- room. Master Bathroom: Remove partition desk to allow for access into bathroom. Entrance into shower is 27-1/4" wide. Patient would have difficulty entering this shower. Could possibl_I enter using angled pivot transfer with padded tub seat and would re- quire shower hose extension. Commode would have to be approached with front on transfer with use of padded raised toilet seat and toilet safety frame. Wall mirror needs to be lowered to 36-48" above floor. Sink is 28" high and can currently be approached from front with faucets being accessible. It is suggested that the cabinet under the sink be removed and exposed water pipes be padded for safety. Living Room/Dining Room Living room, dining room and porch doors are accessible. Dining room table is 23-1/2 high and does not provide knee clearance. A table with 32" clearance from the floor to underside of table should be obtained. Side porch entrance 2 - MOBILE TEAM VISIT - William Baisden has a 2-1/2" lip which should be smoothed. Kitchen Kitchen is accessible through doorway from hall with the removal of refrigera- tor. Patient may want to consider several options: a) slimline refrigerator; b) 'placing refrigerator in other room; c) reinforce Flooring in hallway to support refrigerator. Kitchen is not accessible from dining room due to lack of clearance between counter and stove. If patient wishes to enter through this doorway, he has the following options: a) remove stove and replace with counter top model ; b) remove counter up to dishwasher to allow! clearance. Kitchen sink and countertop microwave are easily reached from wheelchair. r Hall Bathroom Door is 27-1/2" wide and not accessible. It needs to be widened to 30-31 ". Tub can be approached from side using padded tub transfer seat. Commode can be approached from angle. Transfer can be performed using raised padded toilet seat and toilet safety frame. Sink can be approached from angle but pipes must be insulated. CONCLUSION: Mr. Baisden' s home is mostly wheelchair accessible with the major problems being the bathroom, kitchen and entrances. The patient should be independent from wheelchair level once his brace is removed, ADL skills are attained, and home adaptations are completed. Karen Grubbs, OTR Kath y tantiel'd, RPT KG/psn cc: Medical Records Chart Howard P. Hogshead, M.D. Travelers Insurance Company Physical Therapy Occupational Therapy Social Services Clinical Psychology Ann Latimer, R.N. . Rehahilitation Coordinator L a a e Vi 1 46 F oc AVVI V A, '%,.i Q �, 1 ap,s DEPARTMENT OF BUILDING *7U7 T CITY OF ATLANTIC BEACH,FLORIDA PERM NO. I t R'' PERMIT TO BUILD 4W7 IOU CAC THIS PERMIT MUST BE POSTED ON JOB Via 1 A s/U.0 Iqt� Date AUGUST 3. 19�1 Valuation$ PLUMBING PERMIT Fee$2.00 i This permit not valid until above fee has been paid to City Treasurer,and is subject to revocation for violation of applicable provisions of law. This is to certify that DUVAL PLUMBING 211 NORTH 9TH STREET. JACKSONVILLE BEACH FLORIDA 32250 has permission to b4W RELOCATE 1 LAVATORY 1 CLOSET. Classification RELOCATE PLUMBING Zone RESIDENTIAL Owned by WILLIAM BAISDEN 364 7TH ST. ATLANTIC BEACH FLA 32233 Lot #29 Block #8 S/D ATT ANTI . BRAC14 A House No. 'h� 7TN STRFFT ATT ANTI( nrnru �T nATnX77 �� According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS Z AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS r AFTER DATE OF ISSUE 4-- 01, O Building material, rubbish and debris Z from this work must not be placed in public space, and must be cleared up and hauled away by either con- tractor or owner. A. WILLIAM MOSS Building Official. --------------- FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER Cl TY OF ATLANTIC BEACH APPLICATI ON FOR PLQ!IL) NG ERfd DATE Y LOCATI ON PLU14BI NG FIRM MASTER PLUI,2ER CITY/COUNTY OCCUPATIONAL LICENSE NO. �U STATE CERTIFICATE NO. AP15' dD j :7 BUILDER OR CaNTRACTOR _ TYPE OF BUILDING SINKS SHOWERS LAVATORY x �� WATER HEATERS BATH IDBS DISHWASHERS URINALS DISPOSALS r. CLOSETS Y �.. — WASH)NG IAACHI NE FLOOR DRAINS OTHER --!—TOTAL FIXTURE COUNT I NSTALLATI ON OF PLU431 NG AND F1 XTURES t4UST BE I N ACCORDANCE WI TH THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUIo31 NG CODE.