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395 6th St interior remodel 2013 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 Application Number . . . . . 13-00003177 Date 8/05/13 Propertj Address . . . . . . 395 6TH ST Application type description RESIDENTIAL ALTERATION Propert Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 40000 ------------ --------------------------------------------------------------- Applica ion desc INTERIOR RENOVATION ------------ --------------------------------------------------------------- Owner Contractor -------- ---------------- ------------------------ PEEK CATHERINE CONWAY PARKER SIGNATURE HOMES & DEVELOPMENT 395 6TH STREET 731 DUVAL STATION RD ATLANTIC BEACH FL 32233 STE 107-417 JACKSONVILLE FL 32218 (904) 759-9867 --- Structure Information 000 000 INTERIOR RENOVATION Occupancy Type . . . . . . RESIDENTIAL ------------ --------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . . . 250 . 00 Plan Check Fee 125 . 00 Issue Date . . . . Valuation . . . . 40000 Expiration Date . . 2/01/14 ------------ --------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL S ICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ------------ --------------------------------------------------- Other Fees . . . . . . . STATE DCA SURCHARGE 3 . 75 STATE DBPR SURCHARGE 3 . 75 ------------ --------------------------------------------------- Fee summary Charged Paid Credited Due ------- ---------- ---------- ---------- ---------- ------- Permit Fee Total 250 . 00 250 . 00 . 00 . 00 Plan Check Total 125 . 00 125 . 00 . 00 . 00 Other 'Fee Total 7 . 50 7 . 50 . 00 . 00 Grand Total 382 . 50 382 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. f -A. BUILDING PERMIT APPLICATION r CITY OF ATLANTIC BEACH Seminole Road Atlantic Beach, FL 32233 FILE C Py 1 Boos JUL312013 1 Office (904) 247-5826 Fax (904) 247-5845 w - q�:. B Job Address: 1-7tS Permit Num Legal DescriptionParcel# oor Area o q. t. q. t Valuation of Work$ Proposed Work heated/cooled_ non-heated/cooled _ Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/pr truct=ap�provaltorm Commercial Residential If an existing str cture,i a fire ? (Circle one): Yes No N/ Q Florida Product A roval# $ I 1 �j For multiple pro u e proDescribe in detail the ty e of w Property „er inff orm tion: J� 3q r7, Name: /T'I r 2r� ! £ Address: �} City Stat Zip hone E-Mail or Fax#(Optional) Contractor Informatiun Company Name: H �c- 5 Qualifyin Agent: t II Zip — Address: -� City 1/L State Zi Office Phone Job Site/Contact Number ��9 •qtf e�Fax# State Certification/Regis t ation# G C- Architect Name&Phone# A-U OY Engineer's Name&Phone# " on Fee Simple Title Holder Name and Addre s Bonding Company Name and Address Mortgage Lender Name nd Address made to obtain a permit to do the work and installations as indicated. 1 cert tharno wok tis uaisdictio."I+�is ern it b :ob to onhe Application is hereby P. issuance of a permit and thatll l work will be performed to meet the standards of all laws regulating co 1. and void rf work is not comme iced within six(6)months, or if construction or work is suspended or abandoned for tod oohs, urnaces, oil t enters, work is commenced. I under tand that separate permits must be secured for Electrical Work,Plumbing,Signs, Tanks and Air Conditioners,4 1c. YOU WARN NG TO OWNER: R FAILURE TO RECORD A NOTIUR PAYING TWICE FOR IMPRVE NTSC COMMENCE ENT MAY RESULT INTO OBTAIN FINANCING CONSOULT WITH TO YOUR PR PERTY. IF YOU INTEND YOUR LEN ER OR AN ATTORNEY BEFOMERRETCORDING YOUR NOTICE Of COMMENCE 1 hereo,yYork certify that I have 11 be complie read and w'th whether�t eciaedlhertein or not.n and Theesamg tinting of a pee to be true rm 'm doesnd cnot. �prll esumis eio to grons ns ovwsa enc a tho� to laws a vaolntegor cancel rtthte hP J provisions of any other feder 1,state, or local law regulating construction or the performance of construction. Signature of Owner - Signature of Contractor 1....:...... ,/ Print Name k....... .................. ►� ................................................................ Print Name ..........&kjpftn.i�.............. ...9:,............................. Befor Befo e 3 this ay f 20 this Ray of ��A/'L� 20 f No ,�ai�ERwAu�! N ota s.; :8.omr4w y COM MISSIOM#Fr o11480 EXPIRES:April 24.2077 R ised 10.24.12 �; -v--:1 Tin Homy weuo DO NOT WRITE BELOW- OFFICE USE ONLY pp ica e Codes: 2(UO FLORIDA BUILDING CODE Review Result circle one : Approved Disapproved Approved w/ Conditions Review Initials ate: Development ize Habitable Spac Non-Habitable Impervious are Miscellaneous Information Occupancy Group Type of Construction Number of Stories Zoning Distric Max. Occupan y Load Fire Sprinklers Required Flood Zone Conditions/Comments: ►.%LyP, J� 800 Seminole Road s1 Atlantic Beach, Florida 32233 r s) Telephone(904)247-5800 J FAX(904)247-5805 ~�J'ti Construction Site Management Plan Compliance A construction site management plan conforming to Atlantic Beach City Code Sec 6-18 has been approved as a part of this building permit. The Construction site management plan was approved based upon the following information. 1. Parking plan—parking plan showing how site will be accessed and all onsite and abutting street parking areas. 2. 3. Location of construction trailers, loading/unloading area and material storage area. 4. Location of chemical toilet area.(chemical toilets must be kept out of City right-of-way and not further than 15 feet from structure under construction) 5. Location of dumpster. Dumpster must be from an approved waste company (in accordance with Chapter 16 City Code) as of 2009 the permitted dumpsters are Advanced Disposal, Realco Recycling, and Shappells. Dumpsters will have tarp covers or rigid covers on windy days. Dumpsters must be removed prior to issuance of Certificate of Occupancy. 6 Traffic control plan, showing access with dimensions, area to be stabilized, narrative on phasing of construction with adequate parking and delivery of materials. 7 Site cleanliness. Contractor must have the entire construction site cleaned by Friday of each week. This means removal of scrap lumber, concrete remnants and other such construction debris including cans, metal, plastic and paper. 8 Erosion and Sediment Control. Contractor must maintain all elements of the approved Erosion & Sediment Control Plan (silt fence, catch basin filters, etc.) until sod or other stabilization has been placed and approved by Public Works. 9 Other activities, where special conditions are identified by the Building Official. Failure to comply with the Construction Site Management Ordin nce may result in a Stop Work Order being issued in accordance with City Code Sec. 6-17 (3) Revised /2009 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 'J 800 eminole Road ^ � ! 7 -7 U Atlan is each, Florida 32233-5445 Phon (904)247-5826 • Fax(904)247-5845 Date routed: E-ma I: building-dept@coab.us City eb-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: / C�/ v7— Department review required Yes No ildin n � �s Bu Applicant: E /!'! Planning &Zoning PP Tree Administrator Project: �� /Q� Q 7/7-6y-) Public Works Public Utilities Public Safety Fire Services Revi w fee$ Dept Signature Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B Florida Dept.of Environmental Protection FlorldE Dept.of Transportation St.Jot ins River Water Management District Army Corps of Engineers Divisic n of Hotels and Restaurants Divisi n of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: BApproved. ❑Denied. (Circle one. Comments: BUILDING PLANNING&ZONING Reviewed by: Date: 3 TREE ADMIN. Second Review: [Approved as revised. _]Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/74109 L�prwa�c+.Mrr «w'rrR«a;iar•are�x�ruveunsrr� NOTICE OF COMMENCEMENT FILE C �7�7 (PREPARE IN DUPLICATE) P No. �^ 3l / / Tax Follo No. ��F 9 sf wtrn:w�a7nm ssu":rsaisc <. Sta of �- County of UyQ To i Mom it may concern: The undersigned hereby Informs you that improvements will be made to certain real property,and In ace irdarme with Section 713 of the Florida Statutes,the following Information Is stated In this NOME OF COI IMENCEMENT. Legi d description of property being improved: n ' P ii QQ Address of property being improved: J J �w 'c 1JC 33,133 General description of improvements: �• QCa r0 `�w— O 110 w24 T�E C1 Address 3T5 J J s . I g i L-7 Owners interest In site of the improvement. Fee imple Titleholder(if outer than owner) Nam3 dress \ Cont actor r 11(R. U UC tA rp P s e�� (' a n,c,- tr•n( dress-7 1 o, f A w. '3Lu 4 hone No. 7,5`i 7 8[ti/ Fax No. Sm V(!f any) dress Amount of bond$ F how No. Fax No. Narne and address of any person making a loan for the construction of the improvements. Name dress P lone No. Fax No. Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other dor may be served: Name Address Phone No. Fax No. In addition to himself,owner designates the following person to receive a copy of the Lienors Notice as provided in Sect% 713.06(2)(b),Florida Statutes.(Fill in at Owners option). Name At dress P1 one No, Fax No. Expiration date of Notice of Commencement(the expiration date Is one(1)year from the date of recording unless a dfillarerd date Is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: G" �.�� DATE In the Doe#2013199046,OR K 16475 Page 727, qty of Duval.�of Via,has personally appeared Number Pages:1 herein by Recorded 07/31/2013 at 1:43 PM, him W herselrand of inns that all statements and declarations herein Ronnie Fussell CLERK IRCUIT COURT DUVAL are true andaaurate COUNTY RECORDING$10.00 County of L allor , 8wrdedThruNotary.Rum underwriters_ .._.. _.... ...... ._.... . . CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J " ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 fit Application Number . . . . . 13-00003177 Date 8/15/13 Property Address . . . . . . 395 6TH ST Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 40000 ---------------------------------------------------------------------------- Application desc INTERIOR RENOVATION ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PEEK CATHERINE CONWAY PARKER SIGNATURE HOMES & DEVELOPMENT 395 6TH STREET 731 DUVAL STATION RD ATLANTIC BEACH FL 32233 STE 107-417 JACKSONVILLE FL 32218 (904) 759-9867 --- Structure Information 000 000 INTERIOR RENOVATION Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL HVAC PERMIT Additional desc MOVE AIR HANDLER REPLACE DUCT Sub Contractor DONOVAN HEATING & AIR Permit Fee . . . . 75 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/11/14 ---------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE MECH DCA SURCHARGE 2 . 00 STATE MECH DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 75 . 00 75 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 79 . 00 79 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax (904)247-5845 10B ADDRESS: V� Ste' PERMIT# 13 —3 -7 PROJECT VALUE $ 61002 ARI# REQUIRED _Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only STEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity Tons Per Unit Heat: Unit Quantity BTU's Per Unit Seer Rating Duct Systems: Total CFM REQUIRED ZEPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity Tons Per Unit Heat: Unit Quantity BTU's Per Unit Seer Rating Duct Systems: Total CFM 105 ' cFrv\ REQUIRED IRE PREVENTION Fire Sprinkler System Quantity (Requires 3 sets of plans) Fire Standpipe Quantity (Requires 3 sets of plans) Underground Fire Main Value (Requires 3 sets of plans) Fire Hose Cabinets Quantity (Requires 3 sets of plans) Commercial Hoods Quantity (Requires 3 sets of plans) Fire Suppression Systems Quantity (Requires 3 sets of plans) IRE PLACES MISCELLANEOUS: Prefabricated Fireplace Qty Automobile Lifts Gas Piping Outlets Boilers BTU's Elevators/Escalators kLL OTHER GAS PIPING Heat Exchanger Quantity of Outlets Pumps #Vented Wall Furnaces Refrigerator Condenser BTU's #Water Heaters Solar Collection Systems Tanks(gallons) Wells )THER: _ �0V.,V1 cxobvn c Ari!41.4YcjVzi .}- la"�� l vc S ermit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read Tis application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or ot. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. 'roperty Owners NameO cl_ rox- .3 ce x Phone Number 2,16 -_656 l ✓Iechanical Company a,)6Office Phone Zy1 37YP' Fax 2VI 37,6 :o. Address: 315 ` pvf 5' City J &-A, State Zip ZZS�G .icense Holder(Print): fi✓l rt„- N o State Certification/Registration# rd 69 7W/ Votarized Signature of License Holder �. �,.. ...... /S`r .•:r RICHARD TOMPKINS Before me this day of v.r 20_x_ Commission#FF 040399 a€ Expires July 29,2017cSignature of Notary Public C r't =, .F yv h��` Banded Thru Tray Fein Inwrane 800.385-70t9 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD JATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003177 Date 8/15/13 Property Address . . . . . . 395 6TH ST Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 40000 ---------------------------------------------------------------------------- Application desc INTERIOR RENOVATION ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PEEK CATHERINE CONWAY PARKER SIGNATURE HOMES & DEVELOPMENT 395 6TH STREET 731 DUVAL STATION RD ATLANTIC BEACH FL 32233 STE 107-417 JACKSONVILLE FL 32218 (904) 759-9867 --- Structure Information 000 000 INTERIOR RENOVATION Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Sub Contractor . . LORE ELECTRICAL CONTRACTORS Permit Fee . . . . 82 . 20 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/11/14 ---------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ---------------------------------------------------------------- Other Fees . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00 STATE ELEC DBPR SURCHARGE 2 . 00 ------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ----- Permit Fee Total 82 . 20 82 . 20 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 86 . 20 86 . 20 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph(904 .247-5 826 Fax(904) 247-5845 RE6 PERMIT# JOB ADDRESS: 241-� M ,� JEA INFORMATION REQUIRED ON ALL PERMITS 21"-D AMPS Z qy VOLTS PHASE VALUE OF WORK$ b Coo U NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole ❑Residential(Main)Service 00-100 amps ❑101-150amps ❑151-200amps amps #of Meters ❑Commercial(Main) Service 110-100 amps ❑101-150amps ❑151-200amps amps OCT Service amps Conductor Type Size ❑Multi-Family(Main)Service ❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE []_amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps 11200amps ❑ amps 0C Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: /Z 0-30amps 31-100amps 101-200amps Appliances: 4 0-30amps 31-100amps 101-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJEC 11Swimming Pool ❑ Sign VSmoke Detectors lQty ❑Transformers KV A ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can []Safety Inspection ❑Panel Change ❑OH to UG ❑Other: Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name r.1t, Phone Number q Electrical Company �'-4, C�,.fi► . �/C Office Phone 27? //y3 Fax s� Co.Address: 21D // Ace-Ue elyd City'P1/S State �KZip _?20,Pz— License Holder(Print): Z-0 fl tate Certification/Registration#&1Z/30/30 26 Notarized S' *. .; dMMIS®ION#DoIBufur a this PIRE5:February 14,2014 or F .3onded Thru No wy Public u ers ,,, e of Notary Pub CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �r 1119 Application Number . . . . . 13-00003177 Date 8/26/13 Property Address . . . . . . 395 6TH ST Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 40000 ---------------------------------------------------------------------------- Application desc INTERIOR RENOVATION ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- PEEK CATHERINE CONWAY PARKER SIGNATURE HOMES & DEVELOPMENT 395 6TH STREET 731 DUVAL STATION RD ATLANTIC BEACH FL 32233 STE 107-417 JACKSONVILLE FL 32218 (904) 759-9867 --- Structure Information 000 000 INTERIOR RENOVATION Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc . . Sub Contractor . . CUSTOM PLUMBING AND TILE Permit Fee . . . . 83 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/22/14 ------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ----------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 83 . 00 83 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 87 . 00 87 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 � Ph (904) 247-58266 Fax (904) 247-5845 Jos j ADDRESS: ` � �' PERMIT# 13-5177 NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank& Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink / Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: TYPE OF FIXTURE QTY TYPE OF F/XTURE QTY Bathtub Septic Tank& Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection." ❑ Other Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate t1orovisions of any other state or local law regulation construction or the performance of construction. Property Owners Name CPhone Number _ Plumbing Company 1 !moi /��'''c Office Phone 9&G " 7 Fax �-- Co. Address: �P7�Q �{ r�� 2)"Z City State .Ce- Zip � Zz Z 6 License Holder(Print): S L State Certification/Registration# Notarized Si er ,•�Y'•sE 20a =:° *: MY COMMISSION#DD 957760 0 * = EitPIRCS.February tA� nd subscribed be f s "' $ BondedThNNotaryPublic � �'" Signature of Notary P l CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003394 Date 9/10/13 Property Address . . . . . . 395 6TH ST Application type description ELECTRIC ONLY Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc LOW VOLTAGE ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- PEEK CATHERINE CONWAY PARKER PRO TECH SERVICES ENTERPRISES 395 6TH STREET P O BOX 54580 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32245 -------------------------------------------------------------------- Permit ELECTRICAL PERMIT Additional desc ALARM Permit Fee . . 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/09/14 --------------------------------------------------------------- Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00 STATE ELEC DBPR SURCHARGE 2 . 00 ------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 94 . 00 94 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd,Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax(9004) 247-5845 .TOB ADDRESS: �QJ.S� � /-% '_J � � 64/ X, PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole ❑Residential(Main)Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters ❑Commercial(Main)Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps Conductor Type Size ❑Multi-Family(Main)Service ❑0-100 amps ❑101-150amps 151-200amps ❑ amps #of Unit Meters El Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps 0200amps ❑ amps ❑CT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-3 Damps 31-l 00amps 101-200amps Appliances: 0-30amps 31-100amps 101-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS El Swimming Pool ❑ Sign ❑Smoke Detectors_Qty El Transformers KVA El Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG ❑Other: i P Lr/ �' Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name//� / Phone Number Electrical Company /"/'o -��Gti'v�cc'9 F-^T: ��C Office�P—hone 22 7- Co.Address: 0 �� SW.4'd City ✓ax State Zip 32 �f License Holder(Print): ' State Certification/Registration Notarized Signature of License Holder=E .PX:4/5�2 emethisday of 0 . � SHIRLEY L GRAHAM AMMISSION#DD 9577 r. .fir ;FIRES:Februery 14,201 ig ature of Notary Public cndM ThN Notary PuDiic UndenarRers