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480 Ocean Blvd 2013 kitchen bath remodel CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 Application Number . . . . . 13-00003198 Date 8/06/13 Property Address . . . . . . 480 OCEAN BLVD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 60000 ---------------------------------------------------------------------------- Application desc kitchen bath remodel ------------------------------------------------------------------------ Owner Contractor - ------------------------ ----------------------- NELSON JEFFREY & KIMBERLY M ROSE CONTRACTORS 480 OCEAN BLVD 527 FLORIDA BLVD ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 246-6043 --- Structure Information 000 000 KITCHEN BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee 95 . 00 Plan Check Fee 47 . 50 Issue Date . . . . Valuation . . . . 60000 Expiration Date . . 2/02/14 ------------------------------------------------------------ Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. --------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ------------------------------------------------------ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- --------- Permit Fee Total 95 . 00 95 . 00 . 00 . 00 Plan Check Total 47 . 50 47 . 50 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 146 . 50 146 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road /3 � � V �r Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 Date routed: if 13 fj�• E-mail: building-dept@coab.us City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ��`7'1 ".9/..' • _ D ent review required Yes o Buil 'ng Applicant: O Planning &Zoning Tree Administrator Public Works Project: Public Utilities Public Safety Fire Services Review fee $ i , Dept Signature Other Agency Review or Permit Required Review or Receipt Dateof Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. [:]Denied. (Circle one.) Comments: BUILDIN PLANNING &ZONINGReviewed by: Date:Y-�d°/3 TREE ADMIN. Second Review: QApproved 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 05/14/09 �. <- W REVIEWED FOR CODE COMPLIANCE Ij BUILDING PERMIT APP ICAT� OF ATLANTIC BEACH CITY OF ATLANTIC EACH S FOR DrrIONo s. EjFILE COPY11►• 800 Seminole Road, Atlantic B ch,FL jfDyIREMENTS nor Office (904) 247-5826 Fax ( ft �� J;y: DATE: "s'aol3 ' Job Address• 'L2a 1 "t L a c Permit Number: /,3 - 31? • Legal Description K � '1 Parcel# ( � �� - O Area o 'O � o` t o ooq. 't. q Valuation of Work$ Proposed Work heated/cooled no Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential If an existing structure,is a fir sprinkler system installed? (Circle one): IN o N/A Florida Product Approval# For multiple products use propuct approval orm Describe in detail the type of work to be performed: UP 11GAit, ELIO Property Owner Information: Name: �15 KIFI!JL I Address:,A�O n u 1 fj City Q� State ip " (o tD Phone q04—,,516 ' °11 E-Mail or Fax#(Optional) J.114►►. Contractor Information: ` �J o S Company Name: f a C-0 t'5 1-LC. Qua in Agen 'CU State l Zi Address: CR S r C_-V City N Q p Office Phone Job Site/Cont ct Number C/o — (� S 5 - `1 3 L Fax# State Certification/Registration# C `�7 r Architect Name&Phone# Engineer's Name&Phone# a Fee Simple Title Holder Name and ddress Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. months at This permit becomes null six and workisc ommenced.not I understand that separate permits muor st be conssecured for Electricction or work is al-Work,Plumbing,Sigspended or ns,or aWe11s�P of sx fir ac es,Boiler,tHeatfers, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORRECORDING YOUR NOTICE OF COMMENCEMENT. 1 hereby certify that I hay amined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type pj work will be cohether sppeci:ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other fr a Icnv regulating construction or the performance of construction. Signature of OwnerStgnature of Contractor J,IPrintName G�Q ...................-........ ...5......................... 1Y11. 'g Print Name ... `....... .. ..................................... Before e Before me 20 3 this Day of 2 t is Day of f' Efil1E MERRITT I FlwWo •NTMI N ary Public My Comm.Expires Feb 10,20t otary u > KATRINA HATCHER Commission #t EE 872059 •. er_ C # j% 1 •24.12 4;,n`�'• Sotttlad Through National Notary AsE '-x Expires Ap1810, '�, NBad�dTiwTa/FilnMruana800.'i85.701Y CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003198 Date 8/27/13 Property Address . . . . . . 480 OCEAN BLVD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 60000 -------------------------------------------------------------- Application desc kitchen bath remodel ------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- NELSON JEFFREY & KIMBERLY M ROSE CONTRACTORS 480 OCEAN BLVD 527 FLORIDA BLVD ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 246-6043 --- Structure Information 000 000 KITCHEN BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Sub Contractor . . NELSON PLUMBING CO. INC. Permit Fee 132 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/23/14 ---------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------- Other Fees . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ------------------------------------------------ Fee summary Charged Paid Credited ----Due--- ----- ---------- --------- Permit Fee Total 132 . 00 132 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 136 . 00 136 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION • CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 qo Ph(904) 247-5826Fax (904) 247-5845.TOB ADDRESS• PERMIT# NEW OR PLACEMENT INSTALLATION: Project Value $ TYPE of FIXTURE QTY TYPE of FIXTURE QT' Bathtub I Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan DrinkingFountain SlopSink Floor DrainThre 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 FIXTURE QT' Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shbwer Pan FDrinking SlopSink loor Drain Thre 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.' 0 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 rea, 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 Plumbing Company l (c,�1A br 1 G ffice h e Co.Address: go Z 1S ity State Zip -- License Holder r' t • �S Un tat e 'fi tion/RegistrationASS # ¢'Si�io i y`i�u ��s`t W~ Ider My Comm.Expires Nov 16.2015 Commission s EE 137475 wom and subscribed4Wre'lme s day of 201-- o; 6M1ded firough National Notary Assn. ignature of Notary Public CITY OF ATLANTIC BEACH •-� J 800 SEMINOLE ROAD J r� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 JJlit Application Number . . . . . 13-00003198 Date 8/30/13 Property Address . . . . . . 480 OCEAN BLVD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 60000 --------------------------------------- Application desc kitchen bath remodel --------------------------------------- Owner Contractor - ------------------------ ----------------------- HILL CURTIS V & JENNIFER ROSE CONTRACTORS 440 OCEAN BLVD 527 FLORIDA BLVD ATLANTIC BEACH FL 32233 N PTUNE 6EACH FL 32266 --- Structure Information 000 000 KITCHEN BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL -- ------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Sub Contractor . . DUTCHER ELECTRIC INC 00 Permit Fee . . . . 66 .40 Plan Check Fee Issue Date Valuation . . . . 0 Expiration Date . . 2/26/14 ---------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ____ ----------------------------------------- -------- Other Fees STATE ELEC DCA SURCHARGE 2 . 00 STATE ELEC DBPR SURCHARGE 2 . 00 _ ________ --- Fee summary Charged Paid Credited ----Due--- . 00 _ _ ---------- ----- ---------- - . 00 Permit Fee Total 66 .40 66 .40 00 00 . 00 Plan Check Total • 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 Grand Total 70 .40 70 .40 . 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) 247-582 Fax(904) 247-5845 Cf� OC ll� / PERMIT# JOB ADDRESS' !r JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole ❑Residential(Main) Service ❑0-100 amps [1101-1 50amps ❑151-200amps ❑ amps #of Meters ❑Commercial(Main) Service ❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT 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 F-1-amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps ❑200amps ❑ amps ❑CT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-3 Damps 31-l 00amps 101-200amps Appliances: _q 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 ❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$ Qty volts/amps REPAIRS/MISCELLANEOUS L]Replace Burnt/Damaged Meter Can ❑Safety Inspection F1 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��r1- d-�Ph�i � � L Phone Number 3/ CD - �jZ/ Electrical Company ,1 {� c7�� '� /I C Office Phone.?y�" O Fax Co.Address: Z Z /�'� tion City �%�"X /�G State -Zip ztU License Holder(Print): 5taft Certification/Registration# L/��30/24r24' Notarized Signature of License Holder . � -------- - - - SHIRMYLGnmWe or me this _d f m COMMISSION#DD 957760 a: (PIKES;February 14� e of Notary Public " `''• pF ��`' 3onded Thru Notary Public Un SS, CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003198 Date 9/12/13 Property Address . . . . . . 480 OCEAN BLVD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 60000 ------------------------------------------------------------- Application desc kitchen bath remodel ---------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- HILL CURTIS V & JENNIFER ROSE CONTRACTORS 440 OCEAN BLVD 436 DAVIS ST ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 655-7361 --- Structure Information 000 000 KITCHEN BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL --------------------------------------------------------- Permit . . . . . . MECHANICAL GAS PIPE PERMIT Additional desc . . Sub Contractor . . SAWYER GAS COMPANY Permit Fee 65 . 00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/11/14 ---------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ----------------------------- Other Fees . . STATE MECH DCA SURCHARGE 2 . 00 STATE MECH DBPR SURCHARGE 2 . 00 ------------------------------------------------ Fee summary Charged Paid Credited ----Due--- ----- ---------- ---------- Permit Fee Total 65 . 00 65 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 69 . 00 69 . 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 JOB ADDRESS: � DC91-d 91V.D PERMIT#ji.S � PROJECT VALUE $ ARI# REQUIRED Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only NEW 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 REPLACEMENT 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 Manual J documentation required on residential change out FIRE 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) FIRE PLACES MISCELLANEOUS: Prefabricated Fireplace Qty Automobile Lifts Gas Piping Outlets I Boilers BTU's Elevators/Escalators ALL OTHER GAS PIPING Heat Exchanger Quantity of Outlets �_ Pumps #Vented Wall Furnaces Refrigerator Condenser BTU's #Water Heaters Solar Collection Systems Tanks (gallons) Wells OTHER: ?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 his 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 iot. 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 Name Phone Number Mechanical Company Office Phone� `4 Fax PA- d `7 I �o. Address: at� S , e 2� City Stater'Li Zip _5o2a'!5O License Holder(Print): ' a^'� d b l e.t,/ State Certification/Registration# ;2q o cl O 10 Votarized Signature of License Holder MAPIFNE E.MEHAFFEY Before me this 12 _ day of14 0_bl� ' 2013 MY COMMISSION t FF 016841 EXPIRES:Jury rhru Public Underwriters Signature of Notary Public �-�- BOM67 Notary Underwriters CITY OF ATLANTIC BEACH ss1 J 800 SEMINOLE ROAD r� ATLANTIC BEACH FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003198 Date 10/08/13 Property Address . . . . . . 480 OCEAN BLVD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 60000 ------------------------------------------------------- Application desc kitchen bath remodel ------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- HILL CURTIS V & JENNIFER ROSE CONTRACTORS 440 OCEAN BLVD 436 DAVIS ST ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 655-7361 --- Structure Information 000 000 KITCHEN BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL --------------------------------------------------- Permit . . . . . . MECHANICAL HVAC PERMIT Additional desc . Permit Fee 147 . 00 Plan Check Fee . 00 Issue Date . . . Valuation 0 Expiration Date . . 4/06/14 ------------------------------------------------ Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ------------------------------ Other Fees . . STATE MECH DCA SURCHARGE 3 . 18 STATE MECH DBPR SURCHARGE 3 . 18 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ---------- ---------- Permit Fee Total 147 . 00 147 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 6 . 36 6 . 36 . 00 . 00 Grand Total 153 . 36 153 . 36 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BP822U06 CITY OF ATLANTIC BEACH 10/07/13 Estimated Fees Listing -- Summary Totals 16:40: 17 Application type : SINGLE FAMILY RESIDENCE Job description : SFR Reference location Fee Description Amount DEV REVIEW-SINGLE & 2-FAM 50.00 ENG REV RESIDENTIAL BLD 100.00 UTIL REV RESIDENTIAL BLDG 50.00 STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 PLAN CHECK FEES - SINGLE FAMILY DWELLING 50.00 PERMIT FEES - SINGLE FAMILY DWELLING NEW 100.00 Total 354.00 Press Enter to continue. F3=Exit F7=Print summary F12=Cancel 1 � � � b 00 � o� BP822U05 CITY OF ATLANTIC BEACH 10/08/13 Estimated Fees Listing -- Permit Detail 08:40:53 Job description : SFR Application type : SINGLE FAMILY RESIDENCE Permit type . . . . : SINGLE FAMILY DWELLING NEW Type information, press Enter . Base permit fee . . . . . . 55.00 Plan check fee, percent 127.50 50.00 Total 50.00 X 4.0000 .0010 BLD 50,001-100K 200.00 Bottom Permit total : 255.00 F3=Exit F6=Accept permit F9=Change unit charges F12=Cancel boi MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 13 - 3196 JOB ADDRESS: " 1`bD Q � 1�� r� �� PERMIT# PROJECT VALUE $ ARI# REQUIRED Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only NEW AIR CONDITIONING & HEATING SYSTEM I TA LON Air Conditioning: Unit Quantity _ Tons Per Unit Heat: Unit Quantity BTU's Per Unit Seer Rating Duct Systems: Total CFM REQUIRED REPLACEMENT 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 Manual J documentation required on residential change out FIRE 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) FIRE PLACES MISCELLANEOUS: Prefabricated Fireplace Qty Automobile Lifts Gas Piping Outlets Boilers BTU's Elevators/Escalators ALL 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: ;rmit 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 is 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 t. 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 Name Phone ber [echanical Company Office on Fax �. Address: t P State p icense Holder(Print): e Ce ificatio Regis �n gtarized Signature of License Holder Before me this day of 20 Signature of Notary Public �. CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE-OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR EVIPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826) IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. 4ppo CLw Wyk 46,�L V,- (oo4) zA i I ADDRESS 3e�.� PI UMBER d1Y11'tt`� � RI NAME 10 joR)/i3 S ATURE DATE fore me this day of ✓ 20 1 the county of Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are tr n/d accurate. Notary Public at Large,State of `,County of la Personally Known Pfoduced Identi ira- •. SHIRLEY L.GRAHAM .COMMISSION#OD 957760 - tXPIP,ES:February 14,2014 Notary Signature: �'• a o�¢dt Bonded Thru Nnra ry Public Unaerwraers F:/BLDG/Ovmer-Buildu Affidavit;REVISED: /162009 1N7/13 HP Search lIon e C'>>Modify -S E.P- Double tick on a row to view/print AM certificate. AM certificates are not available for Obsolete AC atd FP equipment. Disclakrer Indoor(W Ar O uantly is used for standard rannghr-st purposes only.Actual values may vary dep xA"on,the hvstalation,rtease refer to the manufacturers installation instructors for proper setting of indoor cod. The energy efficiency ratings on the FnergyGulde,labels provided below w ere determined per Federal Trade Comrssan requrements and Department of Energy standard tests of condenser models corrt ined with the most cc the ratings of a specific cortimnaaon. Model Status of'Active means model-are currently in production.'Discontinued means that the manufacturer has elected to stop producing,yet stack is still available.'Obsolete rrrarts that the rtanufacturrr is required to slop Outdoor lith Indoor Unit Cooling high Healing 47 AMIndoor Indoor Wont Furnace Capacity EERSEER GV3cdy HSF Model Manufacturer TradetBrand Series Manufacttrer(Mz- Model Cod Air Cod Ar Cod Air M Certified Manufacturer GdbdeJ Match) odd (Blah) 1& ) Ref# Status Typr. Nene Name Quarttdy DuantAy2 OuarlAy3 GOOOMA l,L JA W ROL, AMANA OLSTINCrIONS. EVERREST, GOCCWN 5722678 Active Systems OPE H" SSZ14 MANLIFACTLRNr' SS21403618• ASPT36C14A' 1095 33000 12.00 14.00 32000 8.2( AR CO.,LP. CONCITIONW AND FEATINa H40�"AR GOOCW N, JAWROI, AMANA DISTNCTIONS, EVERRFST, GOODMAN 5722692 AetNe Systems OPE HOUR SS214 MANLIFACTLFS4G SS21403618• ASFT42Ot4A• 1745 34200 12.50 15.00 32000 8.51 AR CO.,LP. CONDITI(Xdlf' ----- -- ----------- --- AND HEATING FrBX l AR 6045231 Active Systems XENON XENON SSZ140361B' ASPT36C14A' 1095 33000 12.00 14.00 32000 8.21 6046700 Active Systemc XENON XENON SS21403618' .ASPT42D14A' 1145 34200 12.50 15.00 32000 8.5( Now displaying records 1-4 oil 4 tool r 1 CcnraC lh lTennse^d rind'one I L yen_AHRI G1eOoli Data I tkL2 wnL n,ds Sl1L Copyright O 2013 Am-Conditioning,Healing,and Refrigeration Institute.NI ightsrecery d. vm w.ahridirectory.orglahridirectorVpageslhp/defaLiltSearch.aspX 1WI13 HP Search i "Zo.0 %PH.. d Modify : -port Douhk eiek on a raw to view(print AFRI er7tAicate. AHW certificates are not available for ObisakAn AC and FP egeepmrt. Disdahrier:Indoor Cd Air Quantity is used fm standard rahngltr_ct purposes only.Actual vakus may vary Dep{ ndng m Oe.at rstalatim.(lease refer to the manufacturer's nctalatnn instnrctims for proper setting e1/indoor ural. The energy efficiency ratings on the EnergyCude labels provided below w ere deternin ed per Federal Trade Coat ssion requirements and Departnternt of Energy standard tests of condenser models combined w Kh the most cc the ratings of a specific corrbinauon. Model Status of*Active:means nudels are currently,in production.'Dsco line cf means that the manufacturer has elected to slop producing,yet stock is still avaiabk.'Obsolete'means that the rr6nufactwer it re,4L;icd to stop Outdoor Unit Indoor Unit Cooling High Heating 47 At-" Manufacturer Mx- indoor indoor idm Capacity rx-" Model Manufacturer Trade/Band Sm' t fJodel Cos Ar Cos Ar Cos Air a Btuh) t$2 S®2 Capacity NSF Manufacturer Model Match Ref# Status Type Nn— Nano ) Quantity Ouanhy2 Quantty3 GOODMAN. JANI TROL, AMANA DISTINCTIONS, EV6YiEST, GOODMAN 5796520 Acte Systens ONEHOLR SSZ14 MANLFACTLIVC SSZ140421A' ASPT48Dl4A' 1410 41500 72.50 15.00 40000 8.5e AR CQ,LP. CONDniowsAND Hi54TNG, HNEiGI AR GOODMAN, JANTTROL, ANA IA DISTINCTIONS. EVERREST. GOODMAN 5722679 Active Syshrns ONE HOUR SSZ14 MANIJFACTLRNC SS7140421A• ASPr60D14A' 1410 41500 12.50 1500 40000 S.y AR CO.,LP. CON DRIONNC AND IEATNG, ENERG1 AR 6046750 Active Sytw s XENON XENON W140421A' ASPT48D14A' 1410 41500 12.50 15.00 40000 a51 6046382 Active Systems XENON XENON SS2140421A' ASPT60D14A' 1410 41500 1250 15.00 40000 1i5u Now displaying records 1-4or4total FlOM&I Cc,aC L fnv AHRI Itrcclory❑ata I Hgla•vt thrhes Sirc Copydght 02013 Ali Conddiwing,Healing,and%fdgeralion Institute.All dghlaresened. v.4mNatridrectory.org/ahridirectorVpages/hptdefaultSearch.aspx 1!1 Job: Hill,Atlantic Beach Wry htsoft Project Summary Date: Oct 07,2013 g ACU '• By: Craig C.Brooks Pian: Hill,Atlantic Beach WebREPS, LLC 1892 Commerce Avenue,Vero Beach, FL 32960 Phone 800-810-3280 Fax 888-971-2999 Email sales@xebrepshvac com Web. wNwvvebrepswholesale corn License'CAC0547 Project • • For: Darlene B. Taylor, David Taylor Heating &Air 5465 Cliff Street, Jacksonville, FL 32205 Phone: 904-783-6800 Fax: 904-781-2064 Email: dtachtinc@bellsouth.net Notes: Hill, Atlantic Beach D-sign Information Weather: Jacksonville Inti AP, FL, US Winter Design Conditions Summer Design Conditions Outside db 33 OF Outside db 93 OF Inside db 70 OF Inside db 75 OF Design TD 38 OF Design TD 18 OF Daily range M Relative humidity 50 % Moisture difference 51 gr/lb Heating Summary Sensible Cooling Equipment Load Sizing Structure 13912 Btuh Structure 17236 Btuh Ducts 8984 Btuh Ducts 11432 Btuh Central vent(0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 22897 Btuh Use manufacturer's data y Rate/swing multiplier 1.00 Infiltration Equipment sensible load 28668 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Tight Fireplaces 0 Structure 2072 61 Btuh Ducts 0 Btuh Heating Cooling Central vent(0 cfm) 0 Btuh Area (ft2) 1900 1900 Equipment latent load 11781 Btuh Volume (ft') 17100 17100 Air changes/hour 0.09 0.05 Equipment total load 40449 Btuh Equiv. AVF (cfm) 27 13 Req. total capacity at 0.70 SHR 3.4 ton Heating Equipment Summary Cooling Equipment Summary Make Goodman Mfg. Make Goodman Mfg. Trade GOODMAN Trade GOODMAN Model SSZ140421A" Cond SSZ140421A" AHRI ref 5796520 Coil ASPT48D14 AHRI ref 5796520 Efficiency 8.5 HSPF Efficiency 13.0 EER, 15 SEER Heating input Sensible cooling 29050 Btuh Heating output 40000 Btuh @ 47°F Latent cooling 12450 Btuh Temperature rise 26 OF Total cooling 41500 Btuh Actual air flow 1380 cfm Actual air flow 1380 cfm Air flow factor 0.060 cfm/Btuh Air flow factor 0.048 cf Static pressure 0.47 in H2O Static pressure 0.47 in H2O Space thermostat Load sensible heat ratio 0.71 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2013-Oct-07 14.34 09 wrightsoft RightSuite®Unleersal 2D13 13AA6 RSU16998 Page 1 14CCA .vid Taylor Heating and AinJax,FL 32205-1 rup Calc=MJ8 Front Door faces N Job: Hill,Atlantic Beach Project Summary '1111 i"ihtS�ft Hate: Oct Q7,2013 9 ACU 2 By: Craig C.Books Plan: Hill,Atlantic Beach WebREPS, LLC 1892 Commerce Pwenue,Vero Beach, FL 32960 Phone 800-810-3280 Fax 8W-971-2999 Email sales@"brepshvac corn Web www webrepswholesale corn License CAC0547 Project Information For: Darlene B. Taylor, David Taylor Heating &Air 5465 Cliff Street, Jacksonville, FL 32205 Phone: 904-783-6800 Fax: 904-781-2064 Email: dtachtinc@belisouth.net Notes: Hill, Atlantic Beach Design Information Weather: Jacksonville Intl AP, FL, US Winter Design Conditions Summer Design Conditions Outside db 33 OF Outside db 93 OF Inside db 70 OF Inside db 75 OF Design TD 38 OF Design TD 18 OF Daily range M Relative humidity 50 % Moisture difference 51 gr/ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 12411 Btuh Structure 14830 Btuh Ducts 6497 Btuh Ducts 8433 Btuh Central vent (0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 18908 Btuh Use manufacturer's data y Rate/swing multiplier 1.00 Infiltration Equipment sensible load 23263 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Tight Fireplaces 7299 Btu h Ducts 1948 Btuh Heating Cooling Central vent(0 cfm) 0 Btuh Area (ft2) 1400 1400 Equipment latent load 9247 Btuh Volume (ft') 12600 12600 Air changes/hour 0.11 0.05 Equipment total load 32509 Btuh Equiv. AVF(cfm) 23 11 Req. total capacity at 0.70 SHR 2.8 ton Heating Equipment Summary Cooling Equipment Summary Make Goodman Mfg. Make Goodman Mfg. Trade GOODMAN Trade GOODMAN Model SSZ140361B* Cond SSZ140361B' AHRI ref 4355480 Col ASPT42D14A AHRI ref 4355480 Efficiency 9 HSPF Efficiency 12.5 EER, 15 SEER Heating Input Sensible cooling 23940 Btuh Heating output 32000 Btuh @ 47°F Latent cooling 10260 Btuh Temperature rise 25 OF Total cooling 34200 Btuh Actual air flow 1145 cfm Actual air flow 1145 cfm Air flow factor 0.061 cfm/Btuh Air flow factor 0.049 cfm/Btuh Static pressure 0.40 in H2O Static pressure 0.40 in H2O Space thermostat Load sensible heat ratio 0.72 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2013-Oct-07 14 34 09 wrightsoft Right-Suite®Universal 2013 13.006 RSU16998 Page 2 ACCk _and Taylor Heating and AirlJax,FL 32205-1 rup Calc=MJ8 Front Door faces N