365 9th St (vault) ('0'4ec"cz /f MAP SHOWING SURVEY OF
Z-14 s 7 9.4' o/C z 0 7 321
.4zz 0,,c- LOT___j_a_..-BLOCK�__xZ AS SHOWN ON MAP OF
RZA 7- -4/0, -f, VZd&ZV_Z51_0& �4_"-A-L�"77C _&eACH__
AS RECORDED IN PLAT BOOK_'57___PAQrL__69,_OF PUBLIC RECORDS OF DUVAL CO., FLA.
F 0 R L Z 4 f-,k-' �h I-A Z,,,FS
6.4 50, 1� 71010' Low-
lv11vr1V
-X- DENOTES FENCE
.0- DENOTES IRON PIPE
I HEREBY CERTIFY THAT THE ABOVE ?Welfl��Z WAS SURVEYED Illy k'
41
ME AND THAT-
IS LOCATED UPON SAME AS SHOWN AND THAT THERE ARE NO ENCROACHMENTS UPON
SAID_A4RJfZ.Z - CIA & ASS�CIATES
SIGNED 195i
c z 7--71�'Z_
SCALE: REGISTERED SURVEYOR 140. FLA.
OREW.4ACKSI:NVILLE 51020S ORDIER NO,._4_7_!!9_:1_L)_
VA 852
FHA t' For accurate register of carbon copies,form Form approved.
J...J5 may be separated along above fold. Staple Budget Bureau No. 63-RO55.9.
completed sheets together in original order.
I
F] Proposed Construction DESCRIPTION OF MATERIALS No- -------------------------------------------------
(To be inserted by FHA or VA)
Under Construction
Propertyaddress --------------------------------------------------------------------- City ------------------------------------------------ State ------------------
Mortgagoror Sponsor ----------------------------------- ------------------------------------------- --------------------------------------------------------------------
(Name) (Address)
Contractor or Builder
(Name) (Address)
INSTRUCTIONS
1. For additional information on how this form is to be submitted, number minimum requirements cannot be considered unless specifically described.
of copies, etc., see the instructions applicable to the FHA Application for
Mortgage Insurance or VA Request for Determination of Reasonable Value, 4. Include no alternates, "or equal" phrases, or contradictory items. (Can-
as the case may be. siderafion of a request for acceptance of substitute materials or equipment
2. Describe all materials and equipment to be used. whether or not shown is not thereby precluded.)
on the drawings, by marking an X in each appropriate check-box and entering 5. Include signatures required at the end of this form.
the information called for in each space. If space is inadequate, enter "See 6. The construction shall be completed in compliance with the related
misc." and describe under item 27 or on an attached sheet. drawings and specifications, as amended during processing. The specifications
3. Work not specifically described or shown will not be considered unless include this Description of Materials and the applicable Minimum Construction
required, when the minimum acceptable will be assumed. Work exceeding Requirements.
1. EXCAVATION:
Bearingsoil,type--------------------------as------------------------------------------------------------------7-----------------------------------------;---------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
2. FOUNDATIONS:
Footings: Concrete mix------2500 as ------ Reinforcing --------------------------------------------
Foundation wall: Material ----------------------::=----------------------- Reinforcing--------------------------------------------------------------------------
,Interior foundation wall: Material------------------------------------------ Party foundation wall ------------------------------------------------------------
Columns: Material and size -------------------------------------------------- Piers: Material and reinforcing-----------------------------------------------
Girders: Material and sizes--------------------------------------------------- Sills: Material ----------------------------------------------------------------------
Basement entrance areaway-------------------------------------------------- Window areaways -----------------------------------------------------------------
Waterproofing--------------- Footing drains ----------------------------------------------------------------------
Termite protection ----------WWI----------------------------------------------------------------------------------------------------------------------------------
Basementless space: Ground cover------------------------------ Insulation------------------------------- Foundation vents ------------------------------
Specialfoundations ------------------------------------------------------------------------------------------------------------------------- ---------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
3. CHIMNEYS:
Material------------------------------------------------------ Prefabricated (make and size) ----------------------------------------------------------------------
Flue lining: Material ------------------------------------- Heater flue size--------------------------------- Fireplace flue size------------------------------
Vents (material and size): Gas or oil heater --------------4 L--------------------------------- Water heater-------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
4. FIREPLACES:
Type: [I Solid fuel; El gas-burning; El circulator (make and size) --------------------------------- Ash dump and clean-out------------------------
Fireplace: Facing ---------------------------; lining ------------------------------; hearth--------------------------------; mantel--------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
5. EXTERIOR WALLS: #9 PUW --- racing. Building pa per or felt--------------------------------
Wood frame: Grade ajXsejes----------------------W C
-----1?jk*
,,,";kner b
Sheathing-------------------------- thickness --- width ------------ solid; El spaced -------------- o. c.;* [-] diagonal; ---------------
Siding------------------------------- grade ----------------- type -------------- size--------------- exposure----------- fastening--------------------
Shingles----------------------------- grade ----------------- type -------------- size--------------- exposure----------- fastening---------------------
Stucco------------------------------- thickness------------ 1. Lath----------------------------------------------------------------;weight---------------1b.
Masonryveneer ---------------------------------------------------------- Sills -------------------------------------- Lintels ------------------------------------
Masonry: Facing -----------------------; backup --------------------------thickness ------------11. Bonding----------------------------------------------------
Doorsills -------------------------- Window sills ----------------------------------------------- Lintels------------------------------------------------------
Interior surfaces: Dampproofing, --,,coats of -----------------------------------------; furring-------------------------------------------- -------
Exterior painting: Material ---------------------------------------------------------------------------------------------------------------;number of-01------
Gable wall constructionA Same as main walls; El other----------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
6. FLOOR FRAMING:
Joists: Wood,grade and species 4-X__ _AP 0"WrWrIother-----------------------------; bridging A-z---&-------; anchors ---------------------
Concrete slab: El Basement floor; El first floor; El ground supported; [I self-supporting; mix ---------------------------; thickness ---------;
reinforcing ------------------------------------------; insulation ---------------------------------------------; membrane --------------------------------------------
Fillunder slab: Material -----------------------------------------------------; thickness ------------ - ------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
7. SUBFLOORING: (Describe underfloorin for sp cial Boors under item 21.)
UZI.
Material: Grade and species---------rx---j_jU_A_�--------------------------------------------; size----------------;type------141W-------------
Laid: E] First floor; El second floor; 0 attic ------------------sq.ft.; El diagonal; El right angles- ----------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
8. FINISH FLOORING: (Wood only. Describe other finish flooring under item 21.)
LocATiox &LE SPEOES T KNESS InTH W"APER
–—– --Q" —,w --4ww— Armw
Firstfloor---------------------------------------------------------------------------------------------------------------------------------------------------------------------
Secondfloor-----------------------------------I--------------------------------------------------------------------------------------------------------------------------------
Atticfloor------- ---------------------sq.ft- --------------------------------------------------------------------------------------------------------------------------------
VA Form V84-1852 —M-63168-6 DESCRIPTION OF MATERIALS
FHA Form 2005
N"01
21. SPECIAL FLOORS AND WAINSCOT:
LOCATION MATERIAL,COLOR,BORDER,SizEs,GAGE,ETC. THRESHOLD BASE UNDERFLOOR
Kitchen---- y1jax-1111,--------------------------------------------------------------------------------------------------------------------
Bath-------
--------------------------—------------------------------------------------ —-------------------mw��M��M����—----------------------------------------
LOCATION MATERIAL,COLOR,BORDER,CAP.Sins,GAGE. ETC. HEIGHT HEIGHT AT TUB HEIGHT AT SHOWER
Z Bath-------- ---------PILK4*4---T116 72*
:4 1----------4!-------
ir- ------------------------------------------------------------- ---------------------------- -----------------------------------------------------------------------------
----------------I----------- ------------------------W-------------------------------------------------I-----------------------------------------------------------------
Bathroom accessories:I!k Recessed; material ---911=14------._--; number 0 attached; material ------------------------; number------
----------------------------------------------------------W------------------------------- ------------------------------------W-----------------------------------------------------
2L PLUMBING:
nXTURE NUMBER LOCATION MAKE FR's FIXTURE IDENTIFICATION No. SIZE COLOR
Sink---------------------------
Lavatory--------------------- ------11-Z-12----al
Water closet---------------- ------oa----wimbis"---Im
Bathtub----------------------1—--11-1 A-1----------
Showerover tub*----------I---W------------------------------------------------------------–----------------------
Stallshower"---------------- -------W------------------------------- ---------------
Laundry trays---------------1k,kAMr--ArA-J1jWA9wwjft- a""i01LJa--Q&VW------------------------------------------------------------
4V"---------------------------- -----
-------------------------------------- ---------- ------------------------------------r------------------------------------ ---------------------------------
----------------------------I--------------------------------------I----------------------------------------------i-------------------------—---------7---
*R-Rurtain rod El Door 0 Curtain rod
Water supply:* Public; El community system; 0 inaividual (private) mystem.
Sewage disposal: Z Public; El community system; 0 individual (privatei system.
*Show and describe individual system in complete detail in separate dra 'in s and specifications according to -requirements.
g
House drain (inside): [J.PCast iron; El tile; 0 other---------------- House wer (outside): El Cast iron; In tile; El other----------–------
Water piping:Z Galvanized steel; copper tubing; El other---------------- --------------------------------------- *Sill cocks,number----
Domestic water heater: Type ------�a
141*---ft-----------------; make and el ------------------------------------------------------
recovery ---------------------- gph. 100* rise. Storage tank: Material -------- -----------------------; capacity ----------------- gallons.
Gas service: E] Utility company; [I liq. pet. gas; El other------------------------------------------ Gas piping: El Cooking; [I house heating.
Footing drains connected to: El Storm sewer; El sanitary sewer;[I dry well. Sump pump ---------------------------------------------------------
-–------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------
23. HEATING:
0 Hot water. 0 Steam. [I Vapor. El One-pipe system. El Two-pipe system.
Radiators. Convectors. E] Baseboard radiation. Make and model ---------------------------------------------------------------------------
adiant panel: Floor; [I wall; El ceiling. Panel coil: Material--------------------------------------------------------------------------------------
0 Circulator. Return pump. Make and model -------------------------------------------------------------------; capacity --------------- gpm.
Boiler: Make and model --------------------------------------------------------- Output ------------------ Btuh.; net rating------------------ Btuh.
0
a
130---------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Warm air: El Gravity. 0 Forced. Type of system -------------------------------------------------------------------------------------------------------------
Duct material: Supply---------------------; return-------------------- Insulation ---------------- thickness --------- [] Outside air intake.
Furnace: Make and model -------------------------------------------------------- Input--------------------- Btuh.; output--------------------- Btuh.
------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------
0 Space heater; [I floor furnace; [Fwall heater. Input --------------------- Btuh.; output --------------------- Btuh.; number units----------
Make, model --------------------------1-ord"-------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------
Controls: Make and types--------------------------------------------------------------------------------------------------------I----------------------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Fuel: 0 Coal; [*oil; El gas; 0 liq.pet. gas; C] electric; E] other--------------------------------------; storage capacity ------------------------------
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Firing equipment furnished separately: El Gas burner, conversion type. Stoker: 0 Hopper feed; [] bin feed.
Oil burner: El Pressure atomizing; [I vaporizing ----------------------------------------------------------------------------------------------------------
Makeand model ------------------------------------------------------------------------ Control ----------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Electric heating system: Type---------------------------------------------- Input------------watts; @ ------------volts; output-----------------Btuh.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Ventilating equipment: Attic fan, make and model ---------------------------------------------------------------------; capacity---------------------cfm.
Kitchen exhaust fan, make and model ---smom-------------------------------------------------------------------------------
Other heating, ventilating, or cooling equipment ------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
24. ELECTRIC WIRING: as 4 P2,849
Service: [I Overhead; n underground. Panel: [I Fuse box; [3 circuit-breaker ------------------------------------ Number circuits ---------
Wiring: 0 Conduit; El armored cable; E] nonmetallic cable; C] knob and tube; [I other ------------------------------------------------------------
Special outlets: El Range; 0 water heater; 0 other-------------------------------------------------------------------------------------------------------------
X1 Doorbell. [a Chimes. Push-button locations --------------------4-------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
25. LIGHTING FIXTURES:
Total number of fixtures -jL2----------- Total allowance for fixtures, typical installation, $---
Nontypicalinstallation ----------------------------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------------------------------------------------------
3 DESCRIPTION OF MATERIALS
FOR OFFICE USE ONLY
Date------- -—-----7Y%95-J--;7
Permit #-----4/76&ee $------
TOWN OF ATLANTIC BEACH Valuation $-----/0-000_0�0-----------
FLORIDA House #------------------------- -------------------------
#.........................
----------
APPLICATION FOR BUILDING PERMIT
/.Or V * f' 6'* //po/ '3 -7--- ---------------------------------------------------------------------
Application is hereby made for theapproval 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 Town of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the Town of Atlantic
Beach and all rules and regulations of the Building Department of the Town 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 Town of Atlantic Beach, Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can
be verified. -:�'
Date----- ---------------------------------1 19---5�f
VOwner------ - ----------------o-------- -----------------------------Address-2:9 --- ---- -- -- - ---- --- elephone No.__'2--Q------Rzt��-?
Archit ------------------------ Address------------------------------------------------------------Telephone No-----------------------------
ddress-----------------------------------------------------------Telephone No-----------------------------
Contractor Builder.-------
-------Q_T�.
n --------------
Lot No------ --------------------Block No-------/_1,�----------------Sub Divisio, ------------------n-----------------------------------------Zone.----------------
Zr --------------------------------------------------'Sts.
;�--------------------------------------------Street------- �'2----------Side Between.------------- ---------------------and
-- ----------Type of construction------_/�--------------
Valuation 5�.For what purpose will building be used-------- -------
-—-------------------
g -----Size of Footings-----
Dimensions of Buildin --- ---------Dimensions of Lot---- ------------------ -
Size of Piers-------itoX_141:51--------Size of Sills-------------1^-V- 45 GTeatest Sill Span in ft------ ----------Type Roof-
How will Building be Heated?------ og�z�-------------------------------------Will Building be on Solid or Filled Ground?---
Size of Ceiling Joists-------- ---------------- Distance on Centers----------------- -_;77------------------ Greatest Span--------------------------------------------
Size of Floor Joists--------------.7-- _,9.....----------Distance on Centers----- ---------------------I Greatest Span-------------------------------------------
Distance on Centers.. ------------------------------_- Greatest Span-------------------------------------------
Size of Rafters------------------- -----------------
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.
1. When steel is in place and ready to pour footing.
Z Z
2. When steel is in place and ready to pour columns and/or lintel.
3. 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 is laid but before it is covered.
7. Electrical inspection by City of Jacksonville.
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called forafter
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 Town o tlantic Beach.
--,Signature of Builden-1. ...... Address-----------------------------------------------------------------------------------------------
�ignature of Own - ------------------------------------- Address----------------------------------------------------------------------------------------------------