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500 Cruiser Lane 2013 interior remodel CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003235 Date 8/14/13 Property Address . . . . . . 500 CRUISER LN Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 11000 ---------------------------------------------------------------------------- Application desc INTERIOR REMODEL ------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- MCPHERSOM, JOHN K OWNER 1433 PONTE VEDRA BLVD PONTE VEDRA BEACH FL 32082 --- Structure Information 000 000 INTERIOR REMODEL Occupancy Type . . . . . . RESIDENTIAL --------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . 105 . 00 Plan Check Fee 52 . 50 Issue Date . . . . Valuation . . . . 11000 Expiration Date . . 2/10/14 ------------------------------------------------------------------ Special Notes and Comments NEED NOC 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 105 . 00 105 . 00 . 00 . 00 Plan Check Total 52 . 50 52 . 50 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 161 . 50 161 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH d� 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 500 Cruiser Lane Atlantic Beach, FL 32233 _Permit Number: Legal Description 35-64-172S-29E Seaspray Lot 22 Parcel# 170703-036 Floor Area ot 1620 Sq.Ft. Sq.Ft Valuation of Work Proposed Work heated/cooled 1620 non-heated/cooled //j 000. 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 fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval # For multiple products use product approval orm Describe in detail the type of work to be performed: Interior upgrade to include floor covering/appliances/repair sheetrock/paint/ , f e 404ior vinyl cirlinQ Property Owner Information: Name: John K. McPherson Address:1433 Ponte Vedra Blvd ,. .�. .._ City Ponte Vedra Beach State FL Zip 32082 Phone 904-285-9155 E-Mail or Fax#(Optional) Contractor Information: Company Name: Qualifying Agent: �, a` . < Address: City State Zip Office Phone Job S' Contact Number Fax# State Certification/Registration# Architect Name&Phone# CODE COMPLI NCE Engineer's Name&Phone# My 0-F A_1_1A_NT4C BEACH Fee Simple Title Holder Name and Address SE Bonding Company Name and Address REQUIREMENTS AN Mortgage Lender Name and Address DATE: Application is hereby made to obtain a permit to do the tion has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all aws regulating construction fiction. This permit becomes null and void tf work is not commenced within six(6)months, or if construction or work is suspended or abandoned fora period of six(6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaters, 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 BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type o 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 other federal,state, or local law regulat' ction or the performance of construction. Signature of Owner qianature of Contractor Print Na Print Nam �/ ..�.P................................................................. .........0... .... . ..... .. ........` '...................................... Swo to and subscribed before me _ Sworn to an su sc ibed before me this qD y of 2011 this J!�'_Day of 2013 Ift- moo Nota MATT SEMI ;;w;; otary Pu6rR SENN I• MY COMNaSSION#ff 137271 3 MY C014M�MSSION#EE 137271 Revised 01.26.10 .' VMS:Octow 11 2015 " ' �sy! ;+► ' ''� .;� EXPIRES:October 11,2015 . ,,,,e 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 IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. ¢. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT ' IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT 6 . 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 . I LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL, LICENSINGV ORDINANCES. �F ".� a f II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. _ Iran., 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. C1 IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER N ~� CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICP L 1 SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACT R CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE -H BUILDING DEPARTMENT(247-5826) IF IN DOUBT. p V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOS R w O ; STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE O Al = r. 2 OWNER-BUILDER PERMIT. V OU ADDRESS PHONE NUMBER PRINT f O W SIG �—__ x DATE O U ✓ p� Before me this 1; day of �) �•I ,20 i5 in the county of if jJ'"" val,State of Florida,has personally appeared herin by himse f/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of L County of ❑P onally Known MATT SENN ;�y!'• �!'!;' 0 Produced Identification- My COMMISSION#EE 137271 -';� ..•;moi Y✓ r Notary Signature: :?• °< •.AyGOMMI EXPIRES:February 14,2014 F'.BLDG/Owner-BuilderAfiadavit REVISED:4/16/2009 ) ''�• _4� -fondrdThruNotaryPublieUndewrlter City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) r 800 Seminole Road 7.' J �7 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us I ;;;m APPLICATION REVIEW AND TRACKING FORM Property Address: Q �/"/,�/S�1 (!'�'� Dqpartnw4t review required Ye No pp uilding Applicant: anning &Zoning D Tree Administrator Project: ��/Q 1L- �'/ud(�£G Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection aV J Florida Dept. of Transportation �Q n St.Johns River Water Management District V Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: roved. []Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: 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 05/14/09 s �S�`•-L`1,r�N CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD !� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003235 Date 8/15/13 Property Address . . . . . . 500 CRUISER LN Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 11000 ---------------------------------------------------------------------------- Application desc INTERIOR REMODEL ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MCPHERSOM, JOHN K OWNER 1433 PONTE VEDRA BLVD PONTE VEDRA BEACH FL 32082 --- Structure Information 000 000 INTERIOR REMODEL Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc CHANGE TUB TO SHOWER Sub Contractor DAVID KOUTZ LLC Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/11/14 ---------------------------------------------------------------------------- Special Notes and Comments NEED NOC 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 62 . 00 62 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 66 . 00 66 . 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)247-5826 Fax(904) 247-5845 JOB ADDRESS: 500 CRul SCRS Lv�)►.5e� PERMIT# - �23 tjL. 13C.N 'F t. 3'z'z-33 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 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 MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System Number of Heads ❑ Well ** ** SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** q/0ther d0NV6 % l) &I-1-10 i V6 'Td R J51?'O44JCP- Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.1 hereby certify that 1 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 jow a ` DE e (`I►C P�) C 1'J Phone Number �y 1-a�O Cal Plumbing Company 'DAV i D Kos►;L- %.t c- Office Phone 5`►l-t3 5lA Fax1�KDu�G H��Mglt, Co. Address: VL. q THW- IxrROve City d .P State "FL Zip 32fl�3 License Holder (Print): IDA- 0 K o ;-1, State Certification/Registration#GF44 412 b \a Nota..Z na uire�o Qcense 0 er r. �+rcolrrrssloa i MIG �� day of q�us 20 orn and subscribed before me gnature of Notary Public CITY OF ATLANTIC BEAI s) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 fit Application Number . . . . . 13-00003235 Date 11/18/13 Property Address . . . . . . 500 CRUISER LN Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 11000 ---------------------------------------------------------- Application desc INTERIOR REMODEL ------------------------------------------------------------ Owner Contractor - ------------------------ ----------------------- MCPHERSOM, JOHN K DSM RENOVATIONS LLC 1433 PONTE VEDRA BLVD 1433 PONTE VEDRA BLVD PONTE VEDRA BEACH FL 32082 PONTE VEDRA BEACH FL 32082 (904) 285-9155 --- Structure Information 000 000 INTERIOR REMODEL Occupancy Type . . . . . . RESIDENTIAL ------------------------------------------------------ Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Sub Contractor . . BEACHES ELECTRIC SERVICES INC. Permit Fee 63 . 60 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/17/14 --------------------------------------------------- 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 ----- ---------- ---------- Permit Fee Total 63 . 60 63 . 60 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 . 00 Grand Total 67 . 60 67 . 60 . 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 (904) 247-5845 O p �,n-� PERMIT 3� JOB ADDRESS: .� C C��--�S� JEA INFORMATION REQUIRED ON ALL PERMITS f�Q _AMPS C`�O VOLTS PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead ❑ Underground 0 Underground up Pole ❑Residential(Main) Service ❑0-100 amps El 101-150amps ❑151-200amps ❑ amps #of Meters ❑Commercial(Main) Service ❑0-100 amps 11 101-150amps ❑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 El—amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps ❑200amps ❑ amps 0 C Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: ( 0-30amps 31-100amps 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 PROJEC ❑Swimming Pool ❑ Sign moke Detectors Qty ❑Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$ Qty volts/amps REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH 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. Z �.e1 t $� Property Owners Name 6S-- q1-5 s � `�,^, -- Phone Number Electrical Company �0`-0 fA� - � c JL Office Phone (o 2q- 3( rs - Fax 4 0(o-0 6v 3 City 1 -- C— C S State EL Zip 20 y Co.Address: Z H ��`�-� C-A License _ J� istration# Notariz Ls�! arc'��0L. ®l eYPIP.[S:February 14,?.014 0 d;ydeondid Thru Notary Public Underwrre me this d Signature of Notary Publi