192-198 Sylvan Dr (vault) Romano Roofing Services Inc.
P.O. Box 330337 Atlantic Beach,Fl. 32233
(904)-246-5649/FAX: (904)-247-9040
awa.&-A9.1- 4->;,l
To the City of Nq�tww Bjmlii,
The work preformed at 192 Sylvan Dr has been 100%completed to the very best
of our ability, and we take ftill responsibility for it. We feel that there shouldn't be any
complications and would like an inspection ASAP. If you have any questions concerning
this matter please feel free to give me a call @ 904-571-6142
Thank you for your time,
Joseph . omano,
3 0
Presi e -Romano Services
GLORIA J.CASTERLINE-McLAUGHL,
My COMMISSION*CC976739
EXPIRES:December 8,2004
1 F,11107
m llrtcz,,,;—
R -E 0 E I E 0
0
CITY OF ATLANTITCC" RE�CH
JUL 12 2004
BY:
Romano Roofing Services Inc.
P.O. Box 330337 Atlantic Beach, Fl. 32233
(904)-246-5649/FAX: (904)-247-9040
To the City of V�fieach, J w-7
The work preformed at 198 Sylvan Dr has been 100%completed to the very best
of our ability, and we take full responsibility for it. We feel that there shouldn't be any
complications and would like an inspection ASAP. If you have any questions concerning
this matter please feel free to give me a call @ 904-571-6142
Thank you fo your time,
n '
ou 10 yo 'm
oman
om
Joseph J. mano
Preside omano§ervices
lip6C ZR A J.CASTERLINE-�M&AUGHL,
IN6
V.-W MY COMMISSION#CC976739
EXPIRES:December 8,2W4
R R E C E V E 0
:�F:ACH
CIT-Y OF ATLANT'(��
B1
, 7
B
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AT��
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JUL 11
2 2004
B Y.
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'C JUL 12 2004
Y'
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
I r jilt INSPECTION EMAIL REQUEST:
Bui1dinjz-dept(&coqb.us
Application Number . . . . . 07-00001115 Date 8/08/07
Property Address . . . . . . 198 SYLVAN DR
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 650
----------------------------------------------------------------------------
Application desc
REPLACE/REPAIR DECK
---------------------- ------------- --------- -------- ------------------------
Owner Contractor
-------------- --- ------- ------------------------
DOWNS, TERESA A. OWNER
198 SYLVAN DRIVE
ATLANTIC BEACH FL 32233
-------------------------- Structure Information 000 000 -----------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------- -----
Permit BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee 17 . 50
Issue Date . . . . Valuation . . . . 650
Expiration Date . . 2/04/08
------------------------------------- ------------- --------------------------
Special Notes and Comments
*2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE .
*EMAIL INSPECTION REQUESTS TO: BUILDING-DEPT@COAB.US
------------------------ ------------------ --------------- -------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total 17 . 50 17 . 50 . 00 . 00
Grand Total 52 . 50 52 . 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 PERMIT
BUILDING / ZONING DEPARTMENT APPLICATION #
800 Semi ole Road
Atlantic Be
ach,Florida 32233 -7-
(904)247-5800
(904)247-5845 Fax
wNvw.coab.us
APPLICATION TRACKING FORM
REQUIRED DEPT:
Y—N PLANNING
BUILDING
Property Address: Z /f/N
N PUBLIC WORKS
Applicant: 0 Y N PUBLIC UTILITIES
Y N FIRE DEPT.
Project: C)!R Y N PUBLIC SAFETY
APPROVAL
REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE:
Y N D.E.P HUFSTETLER
w
z
w Y N SJR.W.M.D. CARPER
0(D
Y N ARMY CORPS of ENG CARPER
Y N HOTELS&RESAURANTS HUFSTETLER
APPLICATION STATUS A
CIRCLE ONE: SITE BUILDING DA AP INITIW:
D El 1 ST REV I El L id
PLANNING
BUILDINJI" 2ND REV
PUBLIC WORKS
PUBLIC UTILITIES
FIRE DEPT.
3RD REV E]
PUBLIC SAFE I y
Return this form to the Building Department once you have entered your comments into the AS400-
CITY OF ATLANTIC BEACH 2233 �01 07-1q]
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 3
OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845
BUILDING-DEPT@COAB.US
T
BUILDING PERMIT APPLICATION DUVAL COUNTY
1.JOB ADDRESS. 2.VALUATION OF WORK: 3.SQ.FT.UNDER ROOF
00
4 L DESCRIPTION: ;I q gz- 5.CLASS OF WORK� 6.USE OF STRUCTURE:
W/ " f 0 ---r I I - 11 NEW BUILDING 1:1 DEMOLITION ESIDENTIAL
I-OrOOBLOCK-SUB DIVISIONJi 5 a-4 5 ed c-�� 11 ADDITION 0 CONVERTING USE MERCIAL-
7.DESCRIPTION OF WORK: 19A� 0 ALTERATION 0 ACCESSORY BLDG. ER:
2 EPAIR ADC\C 1:1 POOL I SPA []'YES I -Pa�q/A
' '�V�� ql�'0- tl-*k
11� k �� oS�r-'Af� kv 0 MOVE 0 OTHER 0 NO
PROPERTY OWNER: CONTRACTOR: ARCHITECT/ENGINEER:
9.NAME: 15,COMPANY NAME 23.COMPANY NAME:
--r4eve5 it 16.NAME: 24.LICENSEE NAME:
10.ADDRESS: Iq I L i AJ 17.STATE OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LICENSE NO.:
/c7,f SjL(/,q),j 18.ADDRESS: 26.ADDRESS:
T717;0.: 19.OFFICE PHONE: 27.OFFICE PHONE: 28.FAX NO.:
11.OF44QE PHONE:
13.CELL PHONE: 21.CELL PHONE: 29.CELL PHONE:
17 A L? 3#12-/ -
14.EMAIL ADDRESS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS:
FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER:
(IF OTHER THAN OWNER)
31.NAME 33 NAME. 35 NAME
32.ADDRESS: 34.ADDRESS: 36.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 this
jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNER*S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER or AGENT CONTRACTOR
(if Agent,Poy
,4er-ofAtto�ney or Agency Letter Required) (Qualifier Only)
s� Signed:
ey!I&O- Date:
Before me this day of LM'I th V -2007 in the county of Before me this_day of ,2007 in the county of
Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared
U.u3 c
herin by himself/herself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate.
N t Public at Large,State of'-I�-�AO- ,County of UAWO-t- Notary Public at Large,State of_,County of
Kr.-nally Known 11 Personally Known
md`uced Identification- 13 Produced Identification-
Notary Signature: Notary Signature:
DONNA J.MYLOU,
MY COMMISS ION 0 DD 231232
EXPIRES:August 28,2007
IV *
53*d Thru Bude Notary Servfcc-s
COAB FORM BLDG01:REVISED:8/2/2007
Special Information for Owner/BuAders
DISCLOSURE STATEMENT for Section 489.103(7),Florida Statutes:
STATE LAW REQUMES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS.
YOU E[AVE APPLIED FOR A PERAHT UNDER AN EXEWTION TO THE LAW.
The exemption allows you as the owner of your property,to act as your own contractor even through you do not have
a license.� You mu t supenvise the construction yourself. You may build or improve a one-family or two-family
residence or a farm outbuilding. You may also build or improve a commercial building at a cost of$25,000 or less.
The building must be for your own use and occupancy. It may not be built for sale or lease. Ifyou sell or lease more
g -
than one building you have built yourselfwithin one(1)year after the construction is complete,the law wfll presume
that you built it for sale or lease,which is a violation of this exemption- You may not hire an un-licensed person as
your contractor. Your construction must be done according to building codes and zoning regulations. it is your
responsibility to make sure that the people gamployed by you have licenses Muired by law and by cojja�o
-municipal licensing ordinances-
In addition, the owner must supervise construction and becomes liable and responsible for the employees hejshe hires. TIES
responsibility includes,but may not be limited to:
I. Workers Compensation,for workers injured on the job.
2. Social Security Tax must be deducted fi7om employee's wages and matched-with owner's funds.
3- Federal Withholding.
Since owners must be liable'for ipiuries to workers they hire,the Building Division suggests Workers Compensation
Insurance be purchased unless the homeowners insurance policy clearly protects the owner. Owners hiring workers
become employers and should also observe IRS withholding tax Form 1099 requirements on the workers they employ
on their improvement work.
Un-lice'nsed contractors cannot be emDloyed under any circumstances. Owners are subject'Loa$5,000 penalty under
Florida Statute#455.288(l)instigated via Building Division citations. An OcqupationalLicens-p is not adequate. The
owner should physically see the county Certificate of Competency or the Florida Contractors Certificate to ascertain a
person is a licensed contractor. Telephone the building Division(247-5826�f in doubt-
Ihe��acknowled that I have read and understand all the above on this 4 Dayof,*
H g i)a
Owner Builder Signature Address
---r— *L1 C�q,�-4 u t
Lexe 5-J9
Print Name Telephone Number
STATE OF FLORIDA:
COUNTY OF DUVAL
Before me personally appeared LU WC; WULL h--UUVVJA LkJ Ul- Ulk, 111�lvl��L
owner builder desc ribed in and who executed this instrument and severally ackno;�Iedged the execution thereofto be his own free
act and deed as such owner builder hereunto authorized.
WITNESS my hand and official seal this 11 day of, -ANJI atAtlaatic each--COUa-LyTd State aforesaid.
DONNA J.MYLOD NOTARY PUJkLIC,STATE OF FLORIDA
My COMMISSION#DD 231232 PrintName: _X�N ft- Nhupo
EXPIRE8:Augu.st 28,2007
A h(V18 (2-g(0
*t�*Ty S*os COMMSSIONEXPIRES:
Personally Known
Ei Identification:
x x
Tr—
Fowler
4uro
File--tAAv4%A�nc pfocr To f
2
6/C-
q)( 4 corwr
o V,,
S�A
axis
SS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00028510 Date 6/22/04
Property Address . . . . . . 192 SYLVAN DR
Tenant nbr, name . . . . . . REROOF
Application description . . . ROOF
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1700
Owner Contractor
------------------------ ------------------------
RENTSCH, JOE ROMANO ROOFING SERVICES
192 SYLVAN DRIVE P.O. BOX 33037
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249-5096 (904) 246-5649
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 1700
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 60 . 00 60 . 00 . 00 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 60 . 00 60 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING
CODES
-A
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
PERMIT CALCULATION SHEET
Date (V
Address S4 L%/A" D�Z
IxPermit fee based on dollar evaluation as indicated on permit application.
Heated Square Footage $ persqft= $
Garage/Shed $ per sq ft= $
Carport/Porch $ per sq ft= $
Deck $ per sq ft= $
Patio $ per sq ft= $
TOTAL VALUATION: $
$ $35.00 ist $1000.00 $ $35.00
Total Valuation
e- 499:1. $
$ Tw, $ 5 .
Remaining Value Per thousand or
portion thereof.
CONSTRUCTION TYPE: TOTAL BUILDING FEE $
ZONING: + V2Filing Fee $
FLOOD ZONE: ( ) Fireplaces * $35.00 $
IMTERVIOUS SURFACE: BUILDING PERMIT FEE $
WATER IMPACT FEE $
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT $
SEWER TAP $
C ( )RADON HRS .0050 $
SECTION H PAVING $
CROSS CONNECTION $
ST ( ) SURCHARGE $
OTHER $
GRAND TOTAL DUE $ G0.
CITY OF ATLANTIC BEACH Cc:
Q—EoLd
BUILDING / ZONING DEPARTMENT
S. Doerr
800 Seminole Road
Atlantic Beach,Florida 32233 R E
(904)247-5800 C E I V E D
(904)247-5845 Fax CITY OF ATLANTIC BEACH
BUILDING &ZONAG
E C
0 A
—��F T[
B Ul LDINC
J11 1K I ,
UN 2 12004
PLAN REVIEW COMMENTS
t
Permit Application # <D4- BY:
Property Address:
Applicant:
Project:
This permit application has been:
IEI�Approved
Reviewed and the following items need attention:
Please re-submit your application when these items have been completed.
Reviewed By: 4 Date: (a b I/or-f
R E.0 E IV ED
CITY OF ATLANTIC BEACH
BUILDING&ZONING
CITY OF ATLANTIC BEACH JUN 2 12064
ROOFING PERMIT APPLICATION.
BY:
Job Address:
Owner of Property: Tel hone: QOLI - (0
Address:
Contractor: State License Number:
Contractor's Address: 'Q
Telephone: r4
Scope of Work: L
Deck Slope: Greater than 2:12 Less than 2:12
7-
Valuation of work:
Product Name(Example:Timberline):
manufacturer(Example: GAF):
ASTM Designation(s):
Required Inspections: Sheathing and Final
N,/'Signature of Owner: (11�1'11 "k Date:
signature of Contractor: Date
AS TO OWNER:
20
Sworn to and subscribed before me this day of
State of Florida,County of Duval
Notary's Signature:
V%Y'4�,GWRIAJ.CASURLit4&MclAU(jH,.
El Personally known
My COMMISSION#CC 976739 uced identification
EXPIRES:December 8,2004 C3 Prod
Type of identification Produ-ed
AS TO CONTRACTOR.
Sworn to and subscribed before me this day of �/a��e_
State of Florida,County of Duval /7
Notary's Sipature:
0 Personally known
CASIERLINE-MCLAUGHL
"OVPA%,GLORIAJ.CASTULINE-MCLAUG
4 01 P�%GLORIA J. Produced identification COMMISSION#CC 976"'1
My COMMISSION*CC 976739 my
cation prod ced --7-35j-w--V - EXPIKMM"
Type of identification prod
EXPIRES:December 8-2004
ROO Seminole Road Atlantic Beach,Florida 32 3-5445
1L---IL A
4
MW. RETURN
PtiON� NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
co Permit No. 'Tax Folio No.
State of County of
To whom it may concern:
CrI The undersigned hereby informs you that Improvements will be made to certain real property, and in
fo accordance with Section 713 of the Florida Statutes, the following Information is stated In this NOTICE OF
CL COMMENCEMENT.
ro Legal description of property being improved: 9,� -�,"'Z,-
Address of property being improved: IQZ-
0
0
General description of improvements:
Owner V,rvk–sc)-)
Address jqz- 'Ski I V0 r) D(Z
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor-
AddressA--,� *��Q+n —C>+. Fb� - 3zzas
Phone No. Fax No. 2-460 /(Q qZ
Surety(if any)
Address Amount of bond $
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
in addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06 (2) (b), Florida Statutes. (Fill in at Ownei's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one (1) year from the date of recording unless a
different date is specified):
THIS SPACE FOR OW R
Signed: Date: 4/
6 Of Ae,�
Before rn�this/ day in the
oc 1
001.2004
. I 8fff 0875 County of Duval, State of Florida, has personally appeared
Page: 2148
Filed I Recorded
06/21/2004 10:36:49 AN
JIM FULLER Notary Public4t/l arge, State of Florida, County of I Duval
CLERK CIRCUIT COURT
DUVAL COUNTY My commission expires:
RECORDING 5 0
TRUST FUND 1:08 Personally Known Q1QRIAI-CAsTERUN&McLAU HL' 0
COPY FEE 1. MyC0Wmj5sI0N#MQ707
CERTIFY 1.88 Produced Identification
REC ADDITIONAL $ 4.00
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
-5826
INSPECTION PHONE LINE 247
Application Number . . . . . 04-00028511 Date 6/22/04
Property Address . . . . . . 198 SYLVAN DR
Tenant nbr, name . . . . . . REROOF
Application description . . . ROOF
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3150
Owner Contractor
------------------------ ------------------------
DOWNS, TERESA A. ROMANO ROOFING SERVICES
198 SYLVAN DRIVE P.O. BOX 33037
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 246-5649
----------------------------------------------------------------------------
Permit . . . . . . ROOF PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 3150
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 " 00 . 00 . 00
Grand Total 75 . 00 75 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING
CO
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
PERMIT CALCULATION SHEET
Date 6 . ;Z (
Address
KPermit fee based on dollar evaluation as indicated on permit application.
Heated Square Footage $ persqft= S
Garage/Shed $ per sq ft= $
Carport/Porch $ per sq ft= $
Deck $ per sq ft= $
Patio $ per sq ft= S
TOTAL VALUATION: $
$ $35.00 is, $1000.00 $ $35.00
Total Valuation
$ ;I��z , $ 6 $
Remaining Value Per thousand—or
portion thereof.
CONSTRUCTION TYPE: TOTAL BUILDING FEE $
ZONING: + Yz Filing Fee $
FLOOD ZONE: ( ) Fireplaces * $35.00 $
IMPERVIOUS SURFACE:
BUILDING PERMIT FEE $
WATER IMPACT FEE $
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT S
SEWER TAP $
C ( )RADON HRS.0050 $
SECTION H PAVING $
CROSS CONNECTION $
ST ( ) SURCHARGE S
OTHER $
GRAND TOTAL DUE $
Cc:
CITY OF ATLANTIC BEACH D. Ford
BUILDING / ZONING DEPARTMENT
S. Doerr
800 Seminole Road
Atlantic Beach,Florida 32233
R E C E I V E D
(904)247-5800 CITY OF ATLANTIC BEACH
(904)247-5845 Fax BUILDING &ZONING
JUN 2 12004
PLAN REVIEW COMMENTS r
BY:
Permit Application # 04— L--�J
Property Address: I C1 ca 14h=120'k� 'L�z
Applicant: 2—ottAop 'r�Fyl,)G
Project: a—(z.()
This permit application has been:
Ey' Approved
E:1 Reviewed and the following items need attention:
Please re-submit your application when these items have been completed.
Reviewed By: 4 Date: w-;, (0 q
R E 0 E I V L)
C11Y OF ATILANTIC BEACH
BUILDING &Z(DN,!NG
CITY OF ATLANTIC BEACH JUN 2 12004
ROOFING pERMIT APPLICATIO -0
BY:
Date:
Job Address:
Owner of Prop":
Address: -J qb Teb phone: (0
contmetor: V)cj�%n State License'.4umber:
Contmctorls Address:
Fax:
Telephone: -a
scope of Work: A
n&.
De.ck Slope: Greater than 2:12 Less than 2:12
—7-77-4
Valuation of work:
Product Name(Example:Timberline):
manufacturer(Example:GAF):
ASTM Designation(s):
Required inspections- Sh"g and Final DO&
Signature of Owner:
/y\
Signature of Contractor: paitJ 61171"'1
AS TO OWNER.
'bed before me this day of 2.0_�fd
Sworn to and subscn
State of Florida,County of Duval
Notary'sSi e:
0 pers6nally known
LORIM.CASTER1,11415-McLAUGHL,
0 Produced identification G ISSION*CC W76739
MYCOMM
Type of identification Produ ed A EA.PIKES.L)CCeMDer 5.
OF
AS TO CONTRACTOF-
'bed
sivorn to and subscn before me flAs day of
State of Florida,County of Duval
Notary's Silva aturrl�, 10
Personall�known
Produced identification LINE-McULIGHL,
I gpWk%, GWRI[ALCASER
Type of identification Prod'I md My COMMISSION#CC 976710
-a"'40 EXPIRES:December 8,2004
"
goo Seminole Road -Atlantic Beach,Florida
5 MIN. RETURN
PHONE#,&-70,---NOT10E OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
CU To whom it may concern:
(1)
01 The undersigned hereby informs you that improvements will be made to certain real property, and in
(d accordance with Section 713 of the Florida Statutes,the following Information Is stated in this NOTICE OF
Q. COMMENCEMENT.
M Legal description of property being improved: A!
CID
cc
rq
V4
.Y Address of property being improved:
0
60 -
Iz General description of improvements:
Owner T��Wns
Address 1 Q :ci 1.1\rj n
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
Name
Address
ypntractor inc
Address
Phone No. q6Q - ?-L)(10- Fax No. Cq- 04(2-�)-
Surety(if any)
Address Amount of bond $
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other
documents may 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
Section 713.06 (2) (b), Florida Statutes. (Fill in at Owner's opbon).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one (1) year from the date of recording unless a
different date is specified):
THIS SPACE FOR R'EC6Rbkk'S OStdislLy- OWN EIR
Signe��, Date-
Doc# 200Am00a76 X, Before me this day of in the
Boo I" County of Duval, State of Floricla, has personally appeared
Pa e: 2149
Filed & Recorded
06/21/2004 10:36:49 AN
JIM FULLER 'Ile
CLERK CIRCUIT COURT Notary PubliA/t Large, State of Florida, County of Duval
DUVAL COUNTY
RECORDING S 5.00 My commission expires:
TRUST FUND $ 1.00
COPY FEE $ 1.00 Personally Known or
CERTIFY $ 1.00 Produced Identification 40 N/g, ninglA I CASTFRLINMOAUGH.
REC ADDITIONAL $ 4.00
MY COMMISSION 0 CC976730
EXPIRES:December S.2W4
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 06-00034041 Date 10/16/06
Property Address . . . . . . 198 SYLVAN DR
Application type description RIGHT OF WAY PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
repair existing driveway
---------------------------------------- ------------------------------------
Owner Contractor
------------------------ ------------------------
DOWNS, TERESA A. OWNER
198 SYLVAN DRIVE
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . DRIVEWAY PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/14/07
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 35 . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
\N , I
CITY OF ATLANTIC BEACH
PLAN REVIEW SHEET Routed to:
S.Makowski
Building Department Public Works&Public Utilities Departments L. Higgins
—01M, 800 Seminole Road 1200 Sandpiper Lane
Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233
C;ak>
a ..iak
(904)247-5800 (904)247-5834 a uzniak
(904)247-5845 Fax (904)247-5843 Fax Public Safety
PLAN REVIEW COMMENTS
Permit Application #
lqqProperty Address
Applicant:
Project:
This permit application has been-
EK Approved as noted by the Department.
Final application approval must come from the Building Department.
E:1 Reviewed and the following items need attention:
1----7 -�%
C UA)ly
Please re-submit 2-copies of all revisions. Please re-submit your
revisions to the Department requesting them.
Building Dept, Public Works and Utility information at top of page,
failure to notify the correct department may delay your permit from
being issued. ,41,
qo;�' I I
Reviewed By: Date:
Date Contractor Notified:
R E Q E I V E
CITY OF ATLANTIC BEACH
BUJI-DING ,� ZONING
OCT 10 2006
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY/<i�V EASEMgNTS
800 Seminole Road 904-247-5800
Atlantic Beach,Florida 32233-5445 ���F.. 904-247-�a6'
PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION.
Date lo-cfo -bG
PERMIT 4
Job Address L i,/ci,_r, 1�)r :?—;::c ISSUED BY THE CITY
Permitee: Telephone#
C
Permittee Address� k93 _SA �V V'- A-Irlli,c.4� C,
ermi
Requestingio on to Construct:
rr.',r, &tfee-AF +0!113CAi Con A:e-
Locatioc.: (Reference to Cross-Street). _10�v I
1. Applicant declares that prior to E'ng this application he has ascertained the location of ail existing dfities,
both aerial and underaround 4aind the accurate locatiorls are shown on the sketchnIz
A -7
,Letter of Notification was mailed to the following Utilities/Miunicipalities: ,'7q4i57ZC)
Jacksonvilie Electric Authority Yes (-� No Date: ZZ>-66 -6 6-
Bell South Telephone Company Yes(i--) No Date:
Ferrell Gas "'es N,1 No Date�
Comcast
Yes(w-�- No DaL-.
construmon. repair, improvement, mainteirance, safe and eticierit operation,
VVhenever necessary lor th- L I
alteration or relocation Of 211. or any portion of said street or easement as determir.ed by the Director of PLiblic
Works, any or all of said poles. wires, pipes. cables or other faciAies anid appurtenances authorized
�--ereunder. S,1211 be immediately removed 1rom, said street or easement or reset or relocated hereon as
-ecuired by the Director of -ublic VVorks. and at the expense of the Pe!-1.11ittee u,-,.Iess reirnbursemen� is
authorized.
3. All work shall meet City ol Atlantic Beach or Flor�da De
p rtm. ert f T ar,-portat;on Standards and be
oerformed under the supervisi n of F3e 166A,7 hs o i itractcr's Proiect
-Sucerintendent) located at < Q_&j, &j%.P,._Te1,ephcne#: 29L-1-152
L4. Ali materials and equipf-rient sha,l be suoject to'inspection by:L-Ile Clirect-Or of PLiblic Works or his desigr.ee.
5. All city ;property shall be restored to its criginal condition as far as practi.-21, in keepirg with city specifications
=-no the mann�r satisfactory to the city.
A sketch of olans covering details of this installation, as well as, a copy of a recent survey shall be made a
oart of this permit- shiowing anxi incr,�asa j.1, �ri.1�3a.-Vi07;s :�kla:z C�_
OV111718;*s lo in the cKv
uded y!ith :his
7. 1 his permittee shall commence actual construction in good faith with days. If ti-ie beginning date i's
more than 60 days firom date of permit approval, then per-miftee must review the permit with the Director of
Oubiic Works to make sure no changes have occurred in the area that would affect the permitted construction.
3. It is understood arid aareed that ithe righ-ts and Privileges herein set out are graritted only to the ex7'ent of the
City's right, title and interest in. the land to be entered upon and used by the holder, and the Holder will, at all
'imes. assume all risk ol and indemnify. defend, and save harmless the City ol Atlantic Beach from and
against any and ail loss, damage, and �ost of expenses arising in any manner of the exercise or attempted
exercises by-,he holder of die afor said riqhis and p.-rivileges.
,e i -
1 The Director &' Public k/Vcrks shall be notiifed twertv-four 124) hours prior to stardng work and ?gain
imme012teN.,iAgon completion.
,Y.Y P,�� iw.,taq PualiC State of Florida
0 -
1 eresa S Clark
m�,'ornmission DD403353
lot,,',"" -.',
Signed -1 A AD Q. -A Dateld-q-1zool.", Pius�3!06/2009
Before me ihis rfi+h— day of 0 r, A�q in the County of Duval.
State Of Flond2l.has peisbnally appeared
Notary Public at Large.State of Florida,County of Duval.
My commission expires. :::Yoduced Identific Personally Known: V E5
ation:
cl
DAVID A VENLIE
�Xo.am,JWII/ 0,4," 4 VE)
_T
t>.
co' -
96
:7.77
17 03�' 17.0 2
28-oz,
N
0
07
N /99 A/i7 19 2
0 Al
R 7
/7-09' /7-0
t
27
5-9-09
45. 05,
z 0 7' 701
THERE ARE NO VISIBLE EASEMENTS TO OUR KNOWLEDGE EXCEPT FOR THOSE SHOWN.
9 co RAY, COURSON a ASSOCIATES LEGEND
Q PROFESSIONAL LAND SURVEYORS BEARINGS BASED ON
38 EAST 17th STREET PROPERTY SHOWN HEREON LIES WITHIN FLOOD
0 ZONE - AS PER F.E.M.A. FLOOD RATE MAPS
P. 0. BOX 3280
A JACKSONVILLE, FLA. 32206 0 SET [RON PIN OR PIPE
0 FOUND IRON PIN OR PIPE
9 0 4-3 5 3-6 4 7 6 0 SET CONCRETE MONUMENT
5 FOUND CONCRETE MONUMENT
TO BE
HEREBY CERTIFY THE INFORMATION DEPICTED HEREON 4�S SET WOOD HUB & TACK
IN COMPLIANCE' WITH FLORIDA STATUTES, CHAPTER 472, AND X CROSS-CUT OR DRILL HOLE IN CONCRETE
TO MEET, OR EXCE THE IN 'U TECHNICAL STANDARDS 4— FENCE
M I '
V LOR D T S�C I
"�tM U
FOR LAND SURVE N , FLOR D Y TUTT�ES, CHAPTER 21HH-6,
,�f T T
AND GEORGIA ST T S, V�ER 180-7 JOB NO. 10206-0 DATE 'y
By'. DRAFTSMAN
FLORIDA CERTIFICATE NO.7�if�9 SCALE
GEORGIA CERTIFICATE NO- 2272
f SS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Building-dept&cpab.us
Application Number . . . . . 07-00001114 Date 8/08/07
Property Address . . . . . . 192 SYLVAN DR
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 650
-------------------------------------------------------------- --------------
Application desc
REPAIR/REPLACE DECK
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
RENTSCH, JOSEPHINE OWNER
192 SYLVAN DRIVE
ATLANTIC BEACH FL 32233
-------------------------- Structure Information 000 000 -----------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------------
Permit BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee 17 . 50
Issue Date . . . . Valuation . . . . 650
Expiration Date . . 2/04/08
----------------------------------------------------- -----------------------
Special Notes and Comments
*2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE .
*EMAIL INSPECTION REQUESTS TO: BUILDING-DEPT@COAB.US
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total 17 . 50 17 . 50 . 00 . 00
Grand Total 52 . 50 52 . 50 . 00 . 00
jqj S1 tA4
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH PERMIT
BUILDING / ZONING DEPARTMENT APPLICATION #
800 Seminole Road
(904)247-5800
Atlantic Beach,Florida 32233
(904)247-5845 Fax
www.coab.us
APPLICATION TRACKING FORM
REQUIRED DEPT:
Y N PLANNING
Property Address: M Sv/va--�) z y BUILDING
N PUBLIC WORKS
Applicant: 0 ,"'Y N PUBLIC UTILITIES
Y N FIRE DEPT.
LLL Y N PUBLIC SAFETY
Project:
APPROVAL
U) REQUIRED AGENCY: RECEIVED BY: INITIAL: DATE-
UJ
w 5 Y N D.E.P HUFSTETLER
z
w Y N SJR.W.M.D. CARPER
0 (D
< Y N ARMY CORPS of ENG CARPER
Y N HOTELS&RESAURANTS HUFSTETLER
APPLICATI ON STATUS
CIRCLE ONE: SITE BUILDING DA AP INITIAL: 4ATJ.
El 1ST REV 10 1 0
PLANNING
BUILDING: E] 2ND REV E]
PUBLIC WORKS
PUBLIC UTILITIES
FIRE DEPT.
E] E] 3RD REV I El
PUBLIC SAFE I y
Return this form to the Building Department once you have entered your comments into the AS400.
4 -�� f913 :�Aj
CITY OF ATLANTIC BEACH P +I I
07-1
800 SEMINOLE ROAD,ATLANTIC BEACH,Fl-32233
M r L.- t- � V
OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845
C17Y5F ATL-AN7-
BUI1-DlNG-DEPT@COAB.US
DUVAL COUNTY
BUILDING PERMIT APPLICATION
1.JOB ADDRES& 2.VALUATION OF WORK:
I/ qA -5,/)Va 6-5-0 . d �
4&jAj,DESCRIPTItN: 5.CLASS OF WORK: 6.USE OF SlIkOCTURE:
W1 - [I NEW BUILDING 0 DEMOLIT FRESIDENTIAL
Sk-K I SUB DIVISION �(2 It 11 ADDITION 0 CONVERT N
10
LOITU INGUSE, 171COMMERCIAL
7.DESCRIPTION OF WORK: 11 ALTERATION 0 ACCESSORY BLDG. &FIRE SPRINKLER:
ErREPAIR [I POOL/SPA 0 YES PTNIA
0 MOVE El NO
0 OTHER
PROPERTY OWNER: CCONTRACTOR: ARCHITECT/ENGINEER:
9.NAME: 23.COMPANY NAME.
11,COMPANY NAME
00 16.NAME: 24.LICENSEE NAME:
10.ADDRESS 17.STATE OF FLORIDA LICENSE NO.: 25,STATE OF FLORIDA LICENSE NO.:
lq,g Df-)�e
)846 '3zl� 18.ADDRESS: 26.ADDRESS:
ep,
11,fff4QE PHONE: 0.: 19.OFFICE PHONE: 20.FAX NO.: 27.OFFICE PHONE: 28.FAX NO.:
C)AA-Scick('0 T� 1 1
13.CELL PHONE: 21.CELL PHONE: 29,CELL PHONE:
30.EMAIL ADDRESS:
14.EMA41,ADDRESS: 22.EMAIL ADDRESS:
FEE SIMPLE TITLE HOLDER: BONDING COMPANY: MORTGAGE LENDER:
(IF OTHER THAN OWNER),
31.NAME: 33 NAME 35.NAME:
32.ADDRESS: 34.ADDRESS: 36.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 this
jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER or AGENT CONTRACTOR
(If Agent,Power of AttorrRy or Agency Letter Required) (Qualifier Only)
Signed: DI Date: Signed: Date:
Before ie this�dayof N IQ 2007 in the county of Before me this_day of 2007 in the county of
Duval,State of Florida,has personally appeared Duval,State of Florida,has personally appeared
herin by himself I[�erself and affirms that all statements and declarations are herin by himself/herself and affirms that all statements and declarations are
true and accurate. true and accurate.
ZN t Public at Large,State of:Z3,,�j 0-,County of Notary Public at Large,State of_,County of
rysonally Known 0 Personally Known
CI Produced Identification- 11 Produced Identification-
Notary Signature: Notary Signature:
'�'Ry puk DONNA J.MYLOD
MY COMMISSION#DD 231232
EXPIRES:August 28,2007
Buidad Thm Budo Notary Serviceq
COAB FORM BLDG01:REVISED:91iM
Special Information for Owner/Builders
DISCLOSURE STATENIENT for Section 499.103(77),Florida Statutes:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS.
YOU HAVE APPLIED FOR A PFMHT UNDER AN EXEMPTION TO THE LAW.
The exemption allows you as the owner of your property,to act as your own contractor even through you do not have
a license.- You mu t supervise the construction yourself. Yon may build or improve a one-family or two-family
residence or a farm outbuilding. You may also build or improve a commercial building at a cost of$25,000 or less.
The building must be for your own use and occupancy. It may not be built for sale or lease. Ifyou sell or lease more
thm one building you have built yourselfwithin one(1)year after the construction is complete,the law wi-11 presume
that you built it for sale or lease,which isa violation of this exemption- You may not hire.an un-licensed person as
your contractor. Your construction must be done according to building codes and zoning regulations. it is your
responsibility to make sure that the people emploved by.you have licenses Leguired by state law and by coLm or
municiDal licensing ordinances-
In addition,the owner must supervise construction and becomes liable and responsible for The employees helshe hires. This
responsibility includes,but may not be limited to:
1. Workers Compensation,for workers injured on the job. er's funds.
2. Social Security Tax must be deducted fi7om employee's wages and matched-with own
3. Federal W-ithholding-
Since owners must be liable'for ipiuries to workers they hire,the Building Division suggests Workers Compensation
=:, r s ',workers
Insurance be purchased unless the homeowners insurance policy clearly protects the owne . Owner hiring
become employers and should also observe IRS withholding tax Form 1099 requirements on the workers they employ
on their improvement work.
Un-lic&nsed contractors cannot be employed under qmy circumstances. Owners are subject'LO a$5,000 penalty under
Florida Statute#455.288(l)instigated via Building Division citatio�s—. An Occupational License is not adecrua .
ite The
owner should physically see the county Certificate of Competency or the Florida Contractors Certificate to ascertain a
person is a licensed contractor. Telephone!he building Division(247-5826�f in doubt-
I hereby acknowledge that I have read and understand all the above on this Day ofAu-
v-
U
ownpaf6DRuilde iggnature
61 a Z/
dos e4A ,t7 e za",P]�,:5cl-) Telephone Nuinber
Print Name
STATE OF FLORIDA:
COUNTY OF DUVAL
to rae We,,
-44— —4
LL tal LU U "Aul V __L
Before me personally appeared ONI iI,a
owner builder described in and who execut6d this instrument and severally ackaowledgedthe execution thereofto be his own free
act and dead as such owner builder hereunto authorized.
UnL an
WITNESS my hand and official seal this day od%UcA atAtlantic Bile ch.-County d State aforesaid.
SL
T YPI 'IC.S TE 0
N TARY PUEjt- ,STATE 0 FLORIDA
DONNAJ.MYLOC I
MY C�MMISSJON 0 DD231232 PrintNama:
EXPIRES:August 28,2007 F'..
Ro�dW T� ry?rvices CONMSSIONEXPIRES
ersonally Known
fpcI fication:
denti
jj\
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 09-00000910 Date 6/24/09
Property Address . . . . . . 197 SYLVAN DR
Application type description MECHANICAL HVAC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
1 cu 1 ahu
----------------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
CRAIG OCEAN STATE HEAT & AIR, INC.
197 SYLVAN DRIVE 1476 ATLANTIC BLVD.
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 249-8251
----------------------------------------------------------------------------
Permit MECHANICAL HVAC PERMIT
Additional desc . .
Permit Fee . . . . 75 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/21/09
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 75 . 00 75 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 75 . 00 75 . 00 . 00 . 00
PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
06/24/2009 08:02 FAX 9042498949 OCEAN-STATE-A/C 4 AILANIiL-VCAL,n WJ
CITY()F ATLANTIC BEACH 09-
SM SEMINOLF ROAD ATLANTIC 5EArS.FL 32233
OFFIM.(SK247-MG 0 FAX NO:JW4)247�5545
BUILDIN64YE-PTOGOADIV&
MECHANICAL PERMIT APPLICATION DUVAL COUNTY
'T
77NO""'A
Qy
u yes PFRMIT% G12
-7
6,PHONE:
b ADORFSS IF DIFFERENT FAOM JOS ADORCSS
A NAME
f EC
0.A DORIEU..
7.NAME OF COMPAt4Y "7A 44&A- 4-*qe'
6,STATE OF FLQPIDA LICGNSr NO JC CELL PHONE. 11,FAX NO
13 OFFICE PHONE
12 FIANILADDRESS: $70 y-e vt-Z.V-,T
Application IS MefObY made to obtain a permit to do the work and IrIStaliations as indicated I CO"that all work will De performed to meet the
This permit tecomes null nd void if work Is not commenced within six(6)
standards Of Oil la— regulEffing construction In this luri"iction Ix Me er d-
montrts,or If construe6on or Work Is suepenW or abandoned for a period of 3
1.FAX NO
FAp lion IS he, y.6mi�'woob'a"In"
I
p .11 Ir
Of
standards i
",trm ru 0 or I_
k , u
If c OnSt
CONTRACTORS StGNAT E.
j3jRr!_zr,7:"��W. J i�Ft?..77-7--_17%WWO-I EN L A DUILDING CODE-
C)NEW IINb I ALLA I I%J N 0 NEW MECHANICAL
;VREPLACFMENT OF EXISTING SYSTEM �MISTING 0 COMME
0 ALTERATION/ADDITION TO EXIST SYSTEM L3 OTHER
C)REPAIR
BURNERS:
Q SPACE C) WCENTRAL 0 FLOOR
19.HEAT:
20.AIR CONDITIONING: ROOM JECENTRAL THICKNESS: MAX CAPACITY'. 01TI
21.DUCT SYSTEM' MATERIAL� Ofm
22.REFRIGERATION: MAX CAPACII QPM
23.COOLING TOWER: CAPACITY:—
24.FIRE SPRINKLER, NUMBER OF HEADS: MANLIFT. ESGALA I UR: AUTOLIFT:
26.LIFT SYSTEM: ELEVATOR.—
2s.COMMERCIAL HOOD NUMBER.— MASONRY:
27.FIREPLACE; REFABRICAT In 0 PIPING
26.IRRIGATION: 0 PLIM, EJ L-A-�AMU: 0 GAS WATER HEATER'.
79.GAS PIPING: 0 OF OUTLETS:
30.OTHER -SPECIFY:
SOLAR HEATING. BOILSRS,UNI'"D
pME55URE VESSFIL,HEAT F_XCMANGER
VALUE FOR OTHER ITEMS:
OR COIL INDUCTS LTC
it 7!11'�. �A', I=T's i Email PROVIN
F.,cl: 19yr C
TONS AGENCY
NUmGER DgSCAIPTION MODEL MANUFACTURER
OF VNITS 3-z" 1-%
Z15
L "r AF
oFSCRIPTION MOCIELO MANUFACTURER
OF UNITS 7- er
"".7=77 7.
MANUFACTURER SIERIAL* AGEN7Li
NUMBER GALLONS NTAINE
OLDG0,pe",Appst.n mc.b RFvisrD.i2j�&2008
41�9Vc7 �D
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
OFFICE:(904)247-5826 0 FAX NO:(904)247-5845
BUILDING-DEPT@COAB,US
DUVAL COUNTY
MECHANICAL PERMIT APPLICATION
2.IS—THIS A SUB PERMIT: 3.IJA I r.:
1.JOB ADDRESS: -=PERMIT'.
JOB A�= X NO
0 YES PERMIT#: V/0
PROPERTY OWNER:
ADDRESS
1*4 NA: 5.ADDRESS IF DIFFE 6.PHONE
NAME
,TO
-- �i MECHANICAL CON ACTOR:
7.NAME OF COMPANY. S.ADDRESS.
/1/76 il`u� A.A�" Fr- 3Z-Z'41.-
10 CELL PHONE. 11 FAX NO.
9.STATE OF FLORIDA LICENSE NO.
12.EMAIL ADDRESS: 13 OFFICE PHONE: 14
!Foy-0 yf-zz-T)
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. This permit becomes null�,@nd void 'if work is not commenced within six (6)
months,or if construction or work is suspended or abandoned for a period of six My ime a er r Ise d.
CONTRACTORS SIGNAT E:
16.
IB.CLASSOFWORK: BUILDING. 4
0 NEW INSTALLATION 0 NEW LNI L Li uo ,—BUILDING CODE
TREPLACEMENT OF EXISTING SYSTEM EXEXISTING 0 COMMER _MECHANICAL
0 ALTERATION/ADDITION TO EXIST SYSTEM [I OTHER
0 REPAIR
MEEHANZAL EQUIPMENT T
19. HEAT: OSPACE 0 RECESSED— WCENTRAL 0 FLOOR BURNERS:
20.AIR CONDITIONING: El ROOM ErCENTRAL THICKNESS: MAX CAPACITY: Cfm
21.DUCT SYSTEM: MATERIAL:=,,
22.REFRIGERATION: MAX CAPACITY:—ctm
23.COOLING TOWER: CAPACITY: _qpm
N UMBER 0�HEADS
24.FIRE SPRINKLER: NUMBER OF HEADS: AUTOLIFT:
MANLIFT
ELEVATOR: MANLIFT: ESCALATORi
25. LIFT SYSTEM:
L 0 UM
26.COMMERCIAL HOOD NUMBER:
-27. FIREPLACE: PREFABRICATED: MASONRY: -
28.IRRIGATION: 0 PUMP 0 WELL 0 PIPING
—29.GAS PIPING: #OF OUTLETS:— 0 GAS AHU: 0 GAS WATER HEATER:
30.OTHER-SPECIFY:
SOLAR HEATING, BOILERS,UNFIRED
PRESSURE VESSEL.HEAT EXCHANGER VALUE FOR OTHER ITEMS:
OR COIL IN DUCTS ETC I
—3J.;GOOL
IING�EAQUIPMENT:
',EQUIPMENT� 'ONDENSORS,
AIR CONDITIONING REFRIGERATI ET APPROVING
trU M B—ER TONS AGENCY
OF UNITS DESCRIPTION MODEL# MANUFACTURER
zn+u; 3 -%0
32.HEATING-EQUIPMENT:
FURNACES— B—OQLER—S FIREPLACES AIRHIANDLERSETC�
APPROVING
—NUMBER MODEL# MANUFACTURER BTU AGENCY
OF UNITS DESCRIPTION —
-e,- .30 3 3G
E�
TYPE 1 33.TAINKS: IN
ENUMBER GALLONS CONTAINED MANUFACTURER SERIAL# AGENCY
BLDG04 Permit Applicaton Mech:REVISED:12/18/2008
Ir -
It
IS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 08-00001631 Date 11/25/08
Property Address . . . . . . 198 SYLVAN DR
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
remodel bathroom
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
DOWNS, TERESA A. OCEAN ELECTRICAL CO. , INC.
198 SYLVAN DRIVE 13725 BEACH BLVD # 17
ATLANTIC BEACH FL 32233 JAX BEACH FL 32240
(904) 249-3112
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 70 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . S/24/09
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 70 . 00 70 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
F7 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 08
1 i OFFICE:(904)247-5826 0 FAX NO.:(904)247-5845
BUILDING-DEPT@COAB.US
ELECTRICAL PERMIT APPLICATION DUVAL COUNTY
1.JOB ADDRESS: 12.IS THIS A SUB PERMIT: 3.DATE
0-�ES PERMITM 0'p-60 00 0?
4 ��2 2 3�175� I
PROPERTY OWNER:
4.NAME: 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS: 6.PHONE:
C'- Al J, , i-;e-: I I
ELECTRICAL CONTRACTOR:
7.I*ME OF COMPANY: 11,ADDRESS.:
9.STATE OF FLORIDA LICENSE NO: 10.CELL PHONE: 11.FAX NO.:
L7 C- / 3 o(-) / a <ir-) /
12.EMAIL ADDRESS: 13.OFFICE PHONE: 14.
--2 V� - :3
15.Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that all work will be performed to meet
the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)
1 1
months,or if construction or work is suspended or abandoned for a period of six(6)monthyt�V- ime after work is com enced.
CONTRACTORS SIGNATUR Z��
16.CLASS OF WORK: 17.SERVICE: 18.METER NUMBER:
• MULTI FAMILY-#OF UNITS: QIRESIDENTIAL
•SINGLE FAMILY 0 TEMP SERVICE [I COMMERCIAL
EZ"ADDITION [3 TRAILOR 19.�21LDING. 19.CURRENT CODE:
0 ALTERATION [I SIGN 1�40 L D 0 NEW 0'05 NATIONAL ELECTRICAL CODE
0 REPAIR 0 POOL SPA 0 REWIRE 0 OTHERi
LIST ALL ELECTRICAL WORK:
20.TYPE OF SERVICE: 0 OVERHEAD 0 UNDERGROUND 11 UNDERGROUND UP POLE
21. NEW SERVICE: CONDUCTORS PER PHASE: 0 POWER IS ON 0 POWER IS OFF
22. SIZE OF CONDUCTOR: AMPACITY: OCOPPER 0 ALUMINUM
23.SWITCH OR BREAKER SIZE: AMPS: PH: W: VOLT: RACEWAY SIZE:
24.EXISTING SERVICE SIZE: AMPS: PH: W: VOLT: RACEWAY SIZE:
25. FEEDERS: #OF- AMPS:- #OF- AMPS:- #OF- AMPS:
26. LIGHTING FIXTURES: INCANDESCENT: FLUORESCENT&M.V-:
27. FIXED APPLIANCES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS:
28. FIRE ALARM: 0 YES 0 NO
29-31 DO NOT APPLY TO NEW SINGLE FAMILY,MULTI-FAMILY AND ROOM ADDITIONS
29.SMOKE DETECTORS: NUMBER:
30. RECEPTACLES: 0-30 AMPS: 31-100AMPS:- OVER100AMPS:
31. SWITCHES: 0-30 AMPS: 31-100 AMPS: OVER 100 AMPS:
--- 32.AIR CONDITIONING:
#OF UNITS: COMP. MOTOR HP RATING: AMPS: HEAT KW:
OF UNITS: COMP. MOTOR HIP RATING: AMPS: HEAT KW:
33.MOTORS:
NUMBER: VOLTAGE: HP: KVA:
NUMBER: VOLTAGE: HP: KVA:
34.TRANSFORMERS:
UNDER 60OV: NUMBER: KVA:-
OVER 60OV: NUMBER: KVA:-
35.MISCELANEOUS REPAIRS:
DESCRIBE IN DETAIL:
COAB FORM BLDG02:REVISED:1/10/2008
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5826
INSPECTION PHONE LINE 247
Application Number . . . . . 08-00001546 Date 11/13/08
Property Address . . . . . . 198 SYLVAN DR
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
3 fixtures
----------------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
DOWNS, TERESA A. JAMES JOLLY PLUMBING
198 SYLVAN DRIVE 1108 NORTH 24TH ST.
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(9 04) 24 1-96 03
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 56 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/12/09
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 56 . 00 56 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 56 . 00 56 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH 07- ;
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 1 J
OFFICE:(904)247-5826 e FAX NO.:(904)247-5845
BUILDING-DEPT@COAB.US
PLUMBING PERMIT APPLICATION DUVAL COUNTY
'211&
fj1r4QEF DDR THI!57A';SUI3,PERM
0 NO
OYES PERMIT#:
Atlantic Beach, FL 32233
"AMM
4.IN 5.ADDRESS IF DIFFERENT FTM JOB ADDRESS. 6.PHONE:
/0:31
7.NA10-OF COMPM I— B.ADDRESS.: Aq
A J It Q 6 :,)-- kt'k 21
9. FLOJR1 JA17NS'bNO: 10.CELIJHONA �,M 11.FAX NO.:
12.EMAIL ADDRESt:' 13.OFF P 19 14.
Application is hereby made to obtain a permit to do the work and installations as indicated I certinat all work will be performed to meet the
standards of all laws regulating construction in this jurisdiction. This permit becomes null and 1, work is ript-,prnmenced within six (6)
im aft
months,or if construction or work is suspended or abandoned for a period of six(6)months at any i5�er worki� menced.
y tim after work mence
CONTRACTORS SIGNATURE: Z'
'9 "M -mqkffixWi�-1 - - 'M_
14!,NATUREIOFWORIC-.V,4#A$&%=-W*r, A�,PtIRRENTjIqODE�I.QWRFAVW
[0 NEW 0'06 FLORIDA BUILDING CODE-
PLUMBING
11 RE-PIPE 0 OTHER:
MW .19--NUMBER,OF,FIXT41REF
BATH TUB SEWER CONNECTION
BIDET SHOWERS
DISH WASHER SHOWERS PANS 08
DISPOSAL SINK
DRINKING FOUNTAIN WATER CLOSET TANK
FLOOR DRAIN WATER CLOSET VALVE
HOSE BIB WASHING MACHINES
ICE MAKER WATER CONNECTION
INTERCEPTOR WATER HEATER
LAVATORY URINALS
LAUNDRY TRAY OTHER (SPECIFY):
ROOF DRAIN
. 20.PLUMBING PERMIT FEES:.
PERMIT ISSUING FEE: $35.00
TOTAL FIXTURES: x $7.00 (PER FIXTURE) + $35.00
BACKFLOW PREVENTER REQUIRMENTS:
TYPE OF FACILITY MINIMUM TYPE OF PROTECTION
Breweries, Distilleries, Bottling Plants D.C.V. A.
Car Wash with recycling system and/or Wax Eductor R.P.
Chemical Plants R.P.
Dentist Office R.P.
Film Laboratory or Processing Plant R.P.
Food or Beverage Plant D.C.V.A.
Hospitals, Clinics, Medical Buildings R.P. (Parallel)
Irrigation Systems D.C.V.A. or R.P.
Laboratories R.P.
Laundries & Dry Cleaning Plants D.C.V.A
Machine Tool Plants (Health or System Hazard) R.P.
Machine Tool Plants (Pollutional Hazard) D.C.V.A.
Metal Processing Plant (Health or System Hazard) R.P.
Metal Processing Plant (Pollutional Hazard) D.C.V.A.
Nursing Homes R.P.
Packing Houses or Rendering Plants R.P.
Pesticides (Exterminating Companies) P.V.B. Overhead fill
Petroleum Processing Plant R.P.
Petroleum Storage Yard (Health or System Hazard) R.P.
Petroleum Storage Yard (Pollutional Hazard) D.C.V.A.
Piers, Docks or Waterfront Facilities R.P.
Power Plants R.P.
Radioactive Material Plants R.P.
Restaurants with Soap Eductors and/or Industrial Type Disposal R.P.
Sand and Gravel Plants D.C.V.A.
Schools with Laboratories A.V.B.
Swimming Pools with Piped Fill Line A.G. at pool
Sewage Treatment Plants R.P.
Sewage Pumping Stations D.C.V.A.
Tall Buildings over three stories R.P.
Veterinary Establishments R.P.
Commercial facilities: Due to frequent occupancy change all commercial facilities
require a minimum RPZ on the service.ln addition to and including those types of
facilities listed above, an approved backflow prevention device of the type designated
shall be installed on each domestic water service connection to any premises containing
the following real or potential hazards.
MINIMUM TYPE OF PROTECTION
Premises having an auxiliary water system not connected to public water system R-P
Premises having a water storage tank, reservoir, pond, or similar appurtenance
RIP
Premises having a steam boiler, cooling system, or hot water heating
system where chemical water conditioners are used RP
Premises having submerged inlets to equipment R.P.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 08-00001503 Date 11/13/08
Property Address . . . . . . 198 SYLVAN DR
Application type description RESIDENTIAL ADDITION/ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 7000
----------------------------------------------------------------------------
Application desc
bath addition
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
DOWNS, TERESA A. SONSHINE CONSTRUCTION, INC.
198 SYLVAN DRIVE 910A 3RD STREET
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 249-1776
--------------------- Structure Information 000 000 ----------------------
Construction Type . . . . . TYPE 5-A
Occupancy Type . . . . . . RESIDENTIAL
Flood Zone . . . . . . . . ZONE X
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . . Valuation . . . . 7000
Expiration Date . . 5/12/09
----------------------------------------------------------------------------
Special Notes and Comments
*2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS .
2004 FLORIDA BUILDING CODE - RESIDENTIAL.
2005 NATIONAL ELECTRICAL CODE.
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
*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
Roll off container company must be on City approved list
and cannot be placed on City right-of-way.
--------------------------------------------------- -------------------------
Other Fees . . . . . . . . . CITY RADON SURCHARGE . 30
ST CONSTRUCTION SURCHARGE 5 .40
AB CONSTRUCTION SURCHARGE . 60
STATE RADON SURCHARGE 5 . 70
WATER IMPACT FEE 140 . 00
----------------------------------------------------------------------------
PERMIT IS-APPROVED ONLY IN ACCORDA ITH LL CITY OF ATLANTIC BEACHCORD TAtNcEg AND THE FLORIDA
BUILDINCk'(FME§ummary MawrgV Paid re 1 e Due
00,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Page 2
Application Number . . . . . 08-00001503 Date 11/13/08
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 65 . 00 65 . 00 . 00 . 00
Plan Check Total 32 . 50 32 . 50 . 00 . 00
Other Fee Total 152 . 00 152 . 00 . 00 . 00
Grand Total 249 . 50 249 . 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 RF IUMBER:g�i-i�
'CT T
D � 0
�ffg r �If7g I epa qfiflii�
Building Department gr
800 Seminole Road NOV 0 6 2008
Atlantic Beach, Florida 32233-5445
Fax(904)2�'7-5845
Phone(904)247-5826
E-mail: building-dept@coab.us IBY:-----
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
9 g 'SV ZVfn Dep nt review required Yes No
Property Address: ajjqA�,
50"i-I d i
On ing___
Applicant n to, ubl*
ic Utir
_it
"or oject: Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Floridd 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: FlApproved. ImDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
PUBLIC WORKS
PUBLIC UTILITIES Second Review: RVApproved as revised. OlDenied.
Comments:
PUBLIC SAFETY 4&-p
FIRE SERVICES Reviewed by: Date:-
Third Review: DApproved as revised. F�Denied.
Comments:
Reviewed by: Date:
NOTICE OF COMMENCEMENT
state of Tax Folio No.
County of
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved:
Address of property being improved:
,Q
General description of improvements: A�4dp 14,0z
Ile�,4
Owner: Address: jk-)
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: Pt
Address: AA66t�
Telephone No.: 74,417-41 Z?-2 6 FaxNo:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himselt designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
in addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
TMS SPACE FOR RECORDER'S USE ONILY OVMR,-�
Date: N 0 V
efore me this (,4+,r\ day of_ 0 in the 6ounti of Duval,State
00c#2()0&z-8-jq09.OR BK 14698 Page 463. f Florida,has personally appeared -7 eCe-5 C-- �p C5 Lo(1,5
Number Pages�1 otary Public at Large,State of Florida,County of Duval.
Recorded 111 4i2008 at 09:46 AM, ly commission expires:-X S Z 0 1 k
JIM FULLER CLERK CIRCUIT COURT DUVAL or
,monally Known:
COUNTY -oduced Identification: Ir L- - A2--
.00 SUSAN K 3ULLIVAN
0 5
W cOMM �)!N I"DD7017 T2
IRE' 05.2 1 1
.c.
RECORDING$10
W COMMISS113N N DD701752
EXPIRES:AugM 05.2011
1-800-3-NOTARY F1,N�-y Dj=Wfij AUN,CO3
CITY OF ATLANTIC BEACH
PERMIT CALCULATION SHEET
Date 11/7/08
Address: 198 Sylvan Dr.
Permit Application No: 08-1503
Notes: Water impact fee for additional WATER IMPACT FEE $ 140.00
fixture units for bathroom addition.
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT $
SEWER TAP $
CROSS CONNECTION $
OTHER $
GRAND TOTAL $ 140.00
-APPLLQ._g-L0
WV14 Q M B
City of Atlantic Beach
I di-figMpArtmeh. t.
Building Department NLIV 608
800 Seminole Road
Atlantic Beach, Florida 32233-5445
..................
Phone(904)247-5826 Fax(904)
E-mail: building-dept@coab-us
City web-site: hftp:/Mww.coab.us
APPLICATION REVIEW AND TRACKING FORM
V##n De nt review required Yes No
Property Address: uildi
n ing
Applicant: ubl*
�Utili
-or I oject1."1�:1- Public Safety
Fire Services
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
9g
4
CAW)
St.Johns River Water Management Distdnct
t
Army Corps of Engineers
rDivision of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APP ICATIONSTATILIS
pprov d.
Reviewing Department First Review: 'Approved. [:]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
PUBLI WO S Reviewed by:--jaz- Date:
PUBLI U ;1E S Second Review: FlApproved as revised. []Denied.
L
Comments:
PUBLIC AFETY
FIRE SERVICES
Reviewed by: Date:
Third Review: F-JApproved as revised. F]Denied.
Comments:
Reviewed by: Date:
City of Atlantic Beach -Water Impact Fee Worksheet
Address: Permit App. No. Date:
198 Sylvan Dr. 08-1503 11/7/2008
No. Total Fixture
Fixture Type Value as Load Fixtures Units —
Automatic Clothes Washer, Commercial 3 0
Automatic Clothes Washer, Residential 2 0
Bathroom Group -consisting of water closet,
lavratory, bidet, and bathtub or shower 6 0
Bathtub (with or without overhead shower or
whirlpool attachments) 2 0
Bidet 2 0
'i�ombination Sink&Tray 2 0
Dental Lavratory 1 0
Dishwashing machine, domestic 2 0
Drinking fountain/Icemaker 0.5 0
Floor Drains 2 0
Hose Bib 1 0
Ritchen Sink, domestic 2 0
Kitchen Sink, domestic with food waste grinder
and/or dishwasher 2 0
Laundry Tray (1 or 2 compartment) 2 0
-Eavratory 1 1
Shower Compartment, Domestic 2 2
Sink 2 0
Urinal 4 0
Urinal, 1 gallon per flush or less 2 0
Wash Sink(circular or multiple), each set of faucets 2 0
Water Closet flushometer tank, public or private 4— 0
4 1 4
Water Closet, Private Installation
Water Closet, Public Installation 6 0
Total Number of Units 7
multiplied by$201Unit $140.00
Total Impact Fee $140.001
CITY OF ATLANTIC BEACH 08-
800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
-5826 0 FAX NO.:(904)247-5B45
OFFICE:(904)247
BUILDING-DEPT@COARUS
BUILDING PERMIT APPLICATION DUVAL COUNTY
VALUATI)N OF WORK: 3-SQ.FT.UNDER ROOF
1.JOB ADDRESS: ou,��5.....
USE C
C] LT'ON RES
E3 ERTNG USE 0 COIV
SS Y'LD I FIRE
EWO
)a ADDRESS
'�o 62
q 6.U5L OF STRUCTURE.�_-.�.1W
4.LEGAL DESCRIPTION: 5.CLASS OP WORK: RESIDENTIAL
11 NEW BUILDING 0 DEMOLITION
'LO ADDITION CONV
)EtADDITION El CONVERTING USE F-1 COMMERCIAL
LOT BLOCK SUB DIVISION LT Tl 0 'C 8.FIRE SPRINKLER:
0 ALTERATION El ACCESSORY BLDG.
n"'A 0 , YES
7.DESCRIPTION OF WORK: El REPAIR [I POOL/SPA E]YES N/A
Ai��/A" 0 MOVE E]OTHER 1-5ewo
CONTRACTOR: I ARCHITECT I ENUINEER:
PROPFIRTY OWNER: COMP I
9.NAME: 15;�MPANY NAME: 23.COMPANY NAME.
) L'C S M
OA%46A)l 6�� 24-LICENSEE NAME:
Ile 16. ME. AZZAJf4��
17.c�TATE OF FLORIDA LICENSE NO.: 25.STATE OF FLO RIDA LICENSE NO-:
10.ADDRESS:
265.ADDRESS:
18.ADDRESS: /V
27 OFFICE PHONE
11.OFFICE PHONE: 1172-FA�7 NO.: OFFK�E PHONE 20 FAX N 27.OFFICE P ONE: 28.FAX NO.:
1 CELI_4PHONE� 21.CELL PH 29.CELL PHONE:
30.EMAIL ADDRESS:
.EMAIL ADDR SS: ca 22 EMAIL ADDRESS:
,Q- —re-e- MORTGAGE LENDER:
Mt:Z.1PfflArL_-TITLE HOLDER: BONDING COMPANY:
31.NAME: (IF OTHER THAN OWNER) 33.NAME: 35.NAME:
32.ADDRESS: 34.ADDRESS: 36.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 perTnit and that all work Will be performed to meet the standards of all laws regulating construction in this
jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate pennits must be secured for
Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
OWNER'S AFFIDAVIT- I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER. YOUR
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
NER'S AFFIDI
Pa s reg ul atin g co,
nor to obtan"g a
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
OWNER or AGENT ONTRACTOR
Lr r r" U (QualifierOnly)
Qua
(if Agent,Power of Attorney or Ager��Cjj"r Required)
Signed: Date:_ Signed: Date: n f
Before me this day of 2007 in the county of Beforee me t is day of 1 2007 i the county o
Duval,State of Florida,has personally appeared
[Duval,State of Florida,has personally appeared
herin by himself/herself and affirms that all statements and declarations are herin by himself i herself and affirms that ail statements and declarations are
true and accurate.
true and accurate. 2 kunty of
Notary Public at Large,State of County of N ota Public at Large,State of
PP�ers.nally Known
'c
El Personally Known
El Produced ldentificafio
El Produced Identification-
Notary Signature: Notary Signatu
1 10
S"lie 8 0 0
T_TTS�r'�_Je!.11011 IL'uO!!eN All la"'011
us
Ga uo'sG'wwoo
ZS'9 .
19 CC#U01
OLOZ,V�qaj sajidx3 UOISSIWWOO AVq=--
COAB FORM BLDG01:REVISED:V1012008
eppolj lo qle�S-oilqnd A,11210N
V4VHV'd0 1 A'31'dIHS
City of Atlantic Beach APPLICATION NUMBE-R
._.Z�To be assJgped,j?yjh.0 pui!on
rtment.)_
g Depa.
Building Department .............
800 Seminole Road
Atlantic Beach, Florida 32233-5445
-5845
Phone(904)247-5826 - Fax(904)247
E-mail: building-dept@coab.us Date routed:
/j/. X9
City web-site: http://www.coab.us f I
APPLICATION REVIEW AND TRACKING FORM
-4 De nt review required Yes No
Property Address: uildi
n Ing
Applicant: ubl*
Utili
roject: Public Safety
Fire Services
Review or Receipt
Other Agency Review or Permit Required of Permit Verified By Date
Florida Dept.of Environmental Protection
Florida Dept.of Transportation -
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Divisi Dn of Alcoholic Beverages and Tobacco
Other:
APPLICA TATUS
Reviewing Department First Review: EKP__P`roved. E]Denied.
(Circle one.) Comments:
BUIL Q
NNING ONING Reviewed by:-.z Date:
PUBLIC WORKS
PUBLIC UTILITIES Second Review: F_�Approved as revised. DDenied.
Comments:
PUBLIC SAFETY
FIRE SERVICES
Reviewed by: Date:
Third Review: DApproved as revised. DDenied.
Comments:
Reviewed by: Date:
CITY OF ATLANTIC BEACH 08- LLLI-LLJ
-233
BOO SEMINOLE ROAD,ATLANTIC BEACH,FL 32
D4)247-5826 0 FAX NO.:(904)247-5845
OFFICE:(9
BUILDING-DEPT@COAB.US
DUVAL COUNTY
BUILDING PERMIT APPLICATION
2.VALUATION OF WORK: SQ.FT-UNDER ROOF
1.JOB ADDRESS:
M-* /�-o 0
4
5. LASS Or WORK: 6.USE OF STRUCTURE:
4.LEGAL DESCRIPTION: El NEW BUILDING [I DEMOLITION RESIDENTIAL
LOT BLOCK SUB DIVISION RtADDITION El CONVERTING USE 0 COMMERCIAL
0 ALTERATION El ACCESSORY BLDG. B.FIRE SPRINKLER:
7.DESCRIPTION OF WORK: []POOL/SPA 0 YES NIA
7-7--, 0 REPAIR 0 OTHER 1-jqNO I
t&,�r El MOVE AKL;H1 I ECT I F-NUINt:t:r,:
ROPERTY OWNER:
P CONTRACTOR:
9�NAME: 1 NY NAME 23.COMPANY NAME:
�,MPA
4 ---
24.LICENSEE NAME:
ki j 16.
P, 7777?tEE
125 STATE OF FLOR,DA LICE
ENSE NO.:
17. TF OF FLORIDA LICENSE NO.: 25.STATE OF FLORIDA LIC
10.ADDRESS' &T��Af�
C le 1 /1 F,
YZ a14 Af 18.ADDRESS: /j- 26.ADDRESS:
;C 27.UFFICE PHONE: 28.FAX NO.:
11.OFFICE PHONE: 12-FAX NO.: 12.OFFIQE PHONE: 2 0 F AX N?/,/? 21
TIOMY 11171- -1 7&�
1 CELL PHON 21.CELL PH Njo
29.CELL PHONE:
EMAIL ADDR SS: 22.EMAIL ADDRESS: 30.EMAIL ADDRESS:
MORTGAGE LENDER:
FEE SIMPLE TITLE HULDER: BONDING COMPANY:
31.NAME: (IF OTHER THAN OWNER) 33.NAME: 35.NAME:
32.ADDRESS: 34-ADDRESS: 36.ADDRESS
Application is hereby made to obtain a permit to do tie 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 this
jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or
abandoned for a period of six (6) months at any time after work is commenced. I understand that separate pennits must be secured for
Electrical Work,Plumbing,Signs,Wells,PoOls,Furnaces,Boilers,Heaters,Tanks, Air Conditioners,etc.
is accurate and that all work will be done in compliance with all applicable
OWNER'S AFFIDAVIT- I certify that all the foregoing information
laws regulating construction and zoning. I will not occupy or use the referenced building or any part therof, until all inspections are finaled and
prior to obtaining a certificate of occupancy or Completion issued by the building official,as required by law.
WARNING TO OWNER.
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING WCE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
CONTRACTOR
OWNER or kGENT (Qualifier Only)
(if Agent,Power of Attorney or Agency Letter Required)
Signed: Date: Signed: Date
Before me this_day of 1 2007 in the county of Before me this_day of 07 in the county of
Duval,State of Florida,has personally appeared Duval,State of Flodda,has personally appeared
herin by himself i herself and affirms that all statements and declarations are
herin by himself/herself and affirms that all statements and declarations are rue and accurate.
true and accurate.
Notary Public at Large,State of County of N ta Public at Large,State of unty lfw--
pnrs-nally Known
El Personally Known c b.
El Produced Identification- 0 Produced ldentific�abo
Notary Signature: Notary Signature:
ussV Aie!110N I!euO!IeN A8 PaPuO8
U991,9 Ga#UOISSIWIXOD
00 AV,
COA3 FORM BLDG01:REVISED:V1012008 olo�'V[qal sajidx3 uOlsslww
eppol�jo KEajei�S3 -oilqnd WON
V V
WHV�30 1 A'�I'd I H S
CITY OF ATLANTIC BEACH 32233 0 8
NTIC BEACH,FL-
Boo SEMINOLE ROAD,ATLA
-5826 0 FAX No.:(904)247-5845
OFFICE:(904)247
A,,
BUILDING-DEPT@COAB-US DUVAL COUNTY
BUILDING PERMIT APPLICATION SQ.FT.UNDER ROOF
2.V,47LU—ArION A`OFWQW-
-30B ADDRESS' ,M�* / ;-0 —Pi ICTI.RE
C 6.US OF
/ q�) �s 5.CLASS OF WUK RESI
4.LEGAL DESCRIPTION: 0 NEW UILDiNG El DEMOLITION COMMERCIAL
$�ADDITION El CONVERTING USE 8.FIRE SPRINKLt=M:
LOT BLOCK—SUB DIVISION [I ALTERATION 0 ACCESSORY BLDG� [I YES N/A
0 POOL/SPA
7.DESCRIPTION OF WORK: REPAIR 0 OTHER 0
MOVE ARCHITECT I ENGINEER:
C RACTOR:
PROPEK I Y UvvNER1 15, MPANY NA /'7 3.COMPANY NAME:
9.NAME: A)-t -J� 24.LICENSEE NAME:
16. ME:
W 25.STATE OF FLORIDA LICENSE NO:
17.cWAT OF FLORIDA LICENSE NU.::
t
10.ADDRESS. 17-- 26.ADDR
18.ADDRESS:
;C V6 W 0— 27.OFFICE PHONE: 28.FAX NO-�
12.FAX NO.: I OFFI E PHONE 20 FAX * -Z I,- —
.OFFICE PHON 7 21A 29.CELL PHONE:
2 C'E
1, , LL
Z
CELLWON ' )7 0.EMAIL ADDRESS:
22.EMAIL ADDRESS:
EMAIL ADDR SS: ca5ti MORTGAGE LENDER:
Q- e- BONDING COMPANY:
FEE S LE TITLE HIL)LULK: 35,NAME
(IF OTHER THAN OWNER) 33.NAME:
31.NAME: 36.ADDRESS:
,ADDRESS
32.ADDRESS: as indicated. I certify that no work or installation has
Application is hereby made to obtain a perml to do the work an ins et the standards of all laws regulating construction in this
of a permit and that all work will be performed to me if construction or work is suspended or
commenced prior to the issuance if work is not commenced within six (6) months, or its must be secured for
jurisdiction. This permit becomes null and void time after work is commenced. I understand that separate perm
abandoned for a period of six (6) months at any lers,Heaters,Tanks, Air Conditioners,etc.
Electrical Work Plumbing,Signs Wells,Pools,Furnaces,Boil that all work will be done in compliance with all applicable
OWNER'S AFFIDAVIT- I certify that all the foregoing information is accUrate-111- therof, until all inspections are finaled and
d zoning. I will not occupy or use the referenced building or any part
laws regulating construction an occupancy or completion issued by the building official,as required by law.
prior to obtaii ing a certificate.of WARNI G TO OWNER: *** RESULT IN YOUR
COMMENCEMENT MAY
YOUR FAILURE TO RECORD A NOTICE OF OUR PROPERTY. A NOTICE OF
PAYING TWICE FOR IMPROVEMENTS TO Y D ON THE JOB SITE BEFORE THE
COMMENCEMENT MUST BE RECORDED AND POSTE G CONSULT WITH YOUR
AIN FINANCIN , 'EMENT.
FIRST INSPECTION. IF YOU INTEND TO OBT OUR NOTICE OF COMMENC
LENDER OR AN ATTORNEY BEFORE RECORDING Y CONTRACTOR
OW R or AGENT . d) (Qualifier Only)
(It Agent,Po�l,�Attomey or Agency Letter Requ (0 0 Signed I —Da
S1111 Before t is_day of —1 007 in the county Of
Before me his CV day of 1QjO\Jf_MbL1?_ 200%in the county of Duval,State of Florida,has personally appeared
Duval,State of Florida,has personally appeared
T—e�cL 'Z�> herin by himself/hersell an affirms that all statements and cleciarations are
�X� 'I c
herin by h it/herself and affin-nS that all statements and declarations are true and accurate� unty Of
true and a=ate. \.DL%o A,County of ks..Q A L. N ota ubtic at Large,State of
Notary Public at Large,State Of personally Known
0 Personally Known - 0 Produced IdentificatO
,2151.duced Identification- Notary Signature:
Notary Signature:
L&J
AK" RMAN
# D643668 -ussV kielON leuoreN A13 PaPuog
DFORCODE U921,9 00#UOISSIWWOO
5,2011
LUOO AVI
CITY OF AnANT 1.Not'ary Disco Assoc.Co OLOZ,Vl,q@3 saiidx3 u01ss1w'
�c
eppol�10 @IEIS-oilqnd
X'31dil-Is
REQLTIREMENTS AND CONDITIONS.
REVIEWED BY:Ai�t— DATE:Z"Z
City of Atlantic Beach AP.PLICATION NUMBER
C
L ;
(To be assigned by the Building Department.)
Building Department
800 Seminole Road
3-5445
Atlantic Beach, Florida 3223
-5845 FDate Eroputped:
Phone (904)247-5826 - Fax(904)247
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
—4— Dep nt review required Ye No
Property Address: Is uildi
an ing
Applicant: ubl*
lic Utili
Safety F7
Project: *PubIViCSafety
Other Agency Review or Permit Required Rev
of Pei
Florida Dept. of Environmental Protection
Rev
of P e,
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps�f Pnnini-ers
Division of Hotels and Restaurants
IDivision of WAlcoholic Beverages and gTobacco
- I
APPLI wATION STI AAT1 L
rov
Ap ed
FReviewing Department First Review: Approved.
(Circle one.) Comments:
PLANNING &ZONING D a t e:
Reviewed byi
PUBLIC WORKS
PUBLIC UTILITIES Second Review: FApproved as revised. MDenied.
Comments:
PUBLIC SAFETY
FIRE SERVICES
Reviewed by: -Date:
Third Review: MApproved as revised. MIDenied.
Comments:
Reviewed by: -Date:
CITY OF ATLANTIC REACH
APPLICATION FOR PLUMBING PERMIT
Aw , / '
JOB LOCATION:— t�lz 5y4w jq1'
OWNER OF PROPERTY: TELEPHONE NO.24q-,�6q('
PLUMBING CONTRACTOR DAVID GRAY PLUMBING, INC.
CONTRACTOR' s ADDRESS : 8850 Corporate Square Court , Jacksonville , FL 32216
STATE LICENSE NUMBER: CFCO 22586/436 TELEPHOME: (904) 721-7211
HOW MANY OF THE FOLLOWING FIXTURES INSTALLED
SINKS SHOWERS
LAVATORY WATER HEATERS
BATH TUBS DISHWASHERS
URINALS DISPOSALS
WASHING MACHINE
CLOSETS
FLOOR DRAINS SHOWER PANS
SEWER WATER
REPIPE OTHER
TOTAL FIXTURES:____& x $3 . 50 $15 . 00
MINIMUM PERMIT FEE - $25. 00
SIGNATURE OF OWNER:
SIGNATURE OF CONTRACTOR::_
vi ay
-----------------------------------------------------------------
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING CODE.
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826
SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION
PRIOR TO COVERING UP - (904) 247-5834
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 Seminole Road - Atlantic Beach, FL 32233 - Tel: 247-5826 - Fax: 247-5877
PLUMBING PERMIT
o��i
WWII 192 SYLVAN DRIVE
Permit Number: 20015 Address
Permit Type: PLUMBING ATLANTIC BEACH, FL 32233
Class of Work: ALTERATION Township: Range: Book:
Proposed Use: SINGLE FAMILY Lot(s): Block: Section:
Square Feet: Subdivision:
Est. Value: Parcel Number:
Improv. Cost:
Date Issued: 5/05/2000 Nam RENTSCH, JOSEPHINE
Total Fees: 43.00 Address: 192 SYLVAN DRIVE
Amount Paid: 43.00 ATLANTIC BEACH, FL 32233
Date Paid: 5/05/2000 Phone: (000)000-0000
INSTALL MBING
PERMIT 43.00
DAVID GRAY PLUMBING, INC.
��o Wfflww�MM
FINAL
NOTICE - I NSPECTIONS, MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC
SPACE, AND MUST BECLEARED UP AND HAULED AWAYBY EITHER CONTRACTOR OR OWNER___
"FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY
OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"
ISSUED ACCORDING TO APPROVED P LANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE-PROVISIONS OFLAW.--
$43.0014
Date: 5/08/00 01 Receipt: 0055107
CHECKS 19969
ALTLANTIC BEACH BU LDING �T. 00100003221000
CITY OF
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(904)249-2395
APPLICATION FOR TREE REMOVAL PERMIT
DATE z
Applicant
NAME 4,,),v-&�
ADDREST-
Owner
NAME
ADDRESS
Location of tree i.f different from owner' s address :
Reason for Removal :— /-�/z 0 06 - 0 "(d ae- 6,4 61�
14 onz OFF OF /(VDt4/K
Rear Lot Line -
OJ
indicate
possition of G 0,F51
tree on 0 0
lot F-A 1-4
0)
10 j
Front Lot Line
Building Official
et of Lot 700 , as shown on the Plat of Saltair , SecLion
The. Easterly 54 .95 fe ok 10 , Page 16 of the Current public Records of
IINO. 3 , as recorded in Plat Bo
Duval County, Florida .
A VEN LIE
D,4 VIO (go 4 V,--
C
Ic,
90
WOOV
C CON
ON
57-Y. IW,4Af Z7 Vj.
5 7 V CO
Alp 19:2
IT 013' 7.02'
415-05'
0 7- 694 0 701
0
0<
96�
DEPARTMENT OF BUILDING PERMIT NO. 7975
CITY OF ATLANTIC BEACH.FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
August: 26P
A 19—
Date stnCAC
no fee 1292 9/n,11/0
Valuation$------—Fee$-------—
This permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of l2w.
SOSEPBINE E. RENTSCH
This is to certify that 192 Sylvan Drive ------
(1) partiall7 dead tree
re,11ove one rom roa ay
has permission to bM 11 1" aprox.
(scrub-oak- ne)EE to side 11, -
residential Zone
Classification Josephine E . Rentsch
Owned by--- 700 Block Sect. 3 sa) Saltair
Lot part &f RIVE
House No. 192 SyLVXN D
According to approved Plans which are part of this permit
NOTICE—ALL CONCPETE FOPMS
AND FOOTINGS MUST BE IN-
SPECTED BEFOP-E pOURING.
PEP,MIT VOID Six MONTHS
AFTEP, DATE OF ISSUE
;a rubbish and debris
0 Building material, ot be placed
z &om this work must n
in public space, and must be cleared
nd,,�auled away by either con-
utrFcat wnel.
uilding official
CONTRACTOR
PERMIT DATE
FOR OFFICE ER
USE ONLY NUMB
PLUMBING
————————————
ELECTRICAL
SEWER
WATER
CITY OF
736 OCEAN' BOULEVARD
DRAWER 25
ATLANTIC BEACH, FLORIDA 32233
TELEPHONE (904) 249-2395
February 24, 1983
Pre-Service Section
3rd Floor
Jacksonville Electric Authority Building
233 West Duval Street
Jacksonville, FL 32202
Dear Sir:
The following final inspections have been made and are satisfactory.,
Permit #3590 - 192 Sylvan Drive
Permit Issued to United Electric Company
Permit #3591 - 198 Sylvan Drive
Permit Issued to United Electric Company
Sincerely,
Ix
�jo
Widdows
Building Inspection Supervisor
JMTAT/ls
cc: File
CIT"Y OF ATLANTIC BEACH FLORIDA
INSPECTIONS
BUILDlNG PEPJIIT NO.V ELECTRICAL PERMIT NO.0
PLUMBING PERMlT NOJ_
'��7 C"' ivll-?Al
JOB ADDRESS 1?02 <7
CONTRACTOR
OW'N E R
FOUNDATION
FOOTlNG
SLAB
PLL7-IBING (R)
TOP-OUT
SEWER
TEIMP-POLE
ELECTRICAL (R)
ELECTRICAL (F)
FR-AMING
PLUIMBING (F)
LINTEL/BEAM
COLIJIMN
STEEL
SHOOT GRADES
LOT CLEARING
OT' HER
FINAL 1'.'SPECTIO,
CITY OF
1314IC4
'I office I Building Official
REQUEST FOR INSPECTION
-3 Permit No.
Date M District No------
Time
Received II' lity
job, Ad ress
/ \- I actor
P III I 1 11 '1 Contr HEATING
owner's", I L5�Ly ___ PLUMBING
EL Fpugh ......
at
Name ECTRICAL ........Vin
BUILDING PLAWERING 0 Rough ........ 0
.0 Wire ...........0 Rpygh W�'ng Final .. . ....C3 Water Heater
r
,h W,:,,g
Foundation 0 Fini C] Sewers
�*.�.[] ��thtcIh-'�� Fixtures --C] Gas ...
chimney r Motors ....... Cesspool
Cl a 0
Framing KBrown ... .... TeMP-Pole Top-out
inal ..... Finish Final Inspection r Water
F P
Footing Wallboard .....C3 A.M.
Stab .......0 P.M.
L 'be'3m ...0 READY FOR INS7!
T!7 Fri.
h
Intel C r
W d ff-T h1u rS- A.M.
Mon. Tues. 2;7:� P.M.
Inspection Made e- L�
inspector
CITY OF
A 13earA4,04y
office of Building official
REOILIEST FOR INSPECTION
Date— Permit No. Z?Z:VD,/e4-1—
Time District No.
Received
-------- �dd,e ss� IF
0wnerL' —y,X:../ S �--) Contractor MECHANICAL
Name ELECTRICAL PLUMBING Air.Cond.& 0
BUILDING CONCRETE Rough
Rough wiring Heating
Framing Footing Pol Top Out Fire Place 1-1
Re Roofing Stab L1 Temp e Pre Fab
Lintel A.M.
READY FOR INSPTL*10N, Friday P.M.
Wed. s
Tues. ur�
Mon. CL Am.
P.M.
2
Inspection Made
Final Inspection
inspector Certificate of occupancy
Date
jg 6
CITY OF
Offi" f Building Official
REQUES� FOR INSPECTION -------
permit No- ---------
2-
Date District No
Time 17
Received Locality
JOD Address ------
S 0�A) _Contractor PLumBING HEATING 0
Owner' ELECTRICAL .... 0 Rough
0 Rough
Name PLASTERING ��o Final
BUILDING * C] Rough Wir�ng ��o Final .. ...... .C] water kea
Foundation ....0 Wire ... .... Finish wiring ...0 sewer ......* C]
0 Lath -- .... Fixtures - * 0 Gas
Chimney -.*,*,o Scratch ........ Motors ........0 CessPOO
Framing .... jD Brown ..........0 Temp�pole .... Top-Out .. ....0
Final ...... - ' 0 Final inspection-0 Water .... 0 A.M.
Footing .....��Wnailslbhoard .....
Stab ........-b Fri.
Lintel Beam ... MADY FOR INSPECTION P.M.
(!W!e�d' Thurs. A.M.
Mon. Tues. Z_ P.M.
Inspection Made
Inspector—
CITY OF
4&a4dw 13ea4CA-&7&UC&
Office of Building Official
REQUEST FOR INSPECTION
Date _ A2 Permit No.
Time
Received District No.
Z!2 ZZ!5� r -
Job Address Locality
Owner's
Name z,-) s A) Contractor le�r 4��
BUILDING PLASTERING ELECTRICAL PLUMBING HEATING
Fo unclation ....0 Wire .......... Rough Wiring Rough ........4?--ff._.gh ........
Chimney ......0 Lath .......... Finish Wiring Final .........0 Final ........ .LI
Framing .......0 Scratch .......[3 Fixtures .......0 Sewers ........(-] Water Heater
Final .......... Brown ........C] Motors ........E] Gas ..........M
Footing ....... Finish .........E] Temp-Pole .....C] Cesspool ......
Slab 6,-*-C3 Wallboard .....C] Final Inspection.[] Top-out .......
Lintel earn ... Water .........
READY FOR INSPECTION A.M.
Mon. �es. Wed. Thurs. Fri. P.M.
7 2- A M
Inspection Made P:M:
Inspector
z-
CITY OF
./,?A2
Yq&a4d4*C Beac4-Qauk&
Office of Building Official
REQUEST FOR INSPECTION
Date Permit No.
Tj me
Received— - District No.
12�2
Job Address 10, Locality
Owner's
Name — e116)z24e1,) —Contractor
BUILDING PLASTERING ELECTRICAL PLUMBING HEATING
Fou nclation ....[I Wire .. .......0 Rough Wiring E3 Rough ........C] Rough ........
Chimney ...... Lath ..........0 Finish Wiring .[:] Final .........El Final ........ .
Framing ....... Scratch .......E] Fixtures ..�....Ej Sewers ........C] Water Heater
Final ..........E] Brown ........C1 Motors ........[:] ags. ..........F-1
Footing .......Ej Finish ......... Temp-Pole .....Lj' Cesspool ......F-1
Slab E) Wallboard Final Inspection.L] Top-out .......E]
Lintel Water .........F�
Y FOR INSPECTION A.M.
Mon. Tues. (�W�el, Thurs. Fri. P.M.
A.M.
Inspection M.H. P.M.
Inspector—
Cl TY G F I c
/4TLj_f�ATl_014 FOR P-1 -t I t I T
6"7
DATE---Jj--
L C,�!�T I ON—
PLU14:31111-7 FIR!A_
J-'.�.STER PLUI-2ER' twr-
CiTf/C:Y,'.','-IY Cf,-_-U-ATlO.'ZAL LICE16E
S fAT E CERTI F I al%T E NO.
B'JI LDER OR CUNITRACTOR
T-.PE OF BUILDING
LA",'ATORY 1ATER HE-ATERS
DI SVI-,'ASPERS
---URI 11!1�ts .2 —DI SPOSALS
_--a—CLOSETS
---FLOC)R D��M NS
_T OT A L F I XTUR E COU14T
I NSTALLATI CN CIF PILL1431 NG AND Fl XTURES I-','JST BE I N AMORDANCIE WI -PH THE: r"10ST
RECEINT ED) TI GN OF THIE SWTHERN STANDARD PLLr.Bl NG CODE.
C ITY 0 F Al I I I C (-I]
WATER CO,';.-;Ec-I i C I!.-t R G E
DATE----
LOCATION
0*�-NER
-NothL—t-)S —W i U; AJ
PLU�'-!BING FIRM I
!-!A-STER PLU�'I':,ER
`UILDER OR CONTP-ikCIOR A)
TYPE OF BUILDING–___Dy/ol-,e
BATHROOM GROUP Co-,.,slsTl?4G OF SPO'�`-E'R STALL, DO,�-ESTIC 2 U�.'ITS)
WATER CLOSET,LAVATORY '14D BATH
TUB OR SHCT^'ER STALL- (:6U-NITS) SHC-:-ERS GROUP PER FEkD 3 U�,'! FS)
BATHTUB ( WITH OR WITHOUT OVER SUR'G-HONS SINK ( 3 UNITS)
HEAD SH0*-,TFR) (2 U�NITS)
BIDET (3 UNITS) FLUSHING RIM SI NK ( 8 UINI TS
CO��BINATION SINI� AND TP-AY ( 3 U41TS) SERVICE SINTI, TRAP S7.1211D ( 3 U�--iTS
CO."BINATION SIN-K AliD TRAY W/IFOOD DIS. POT,SCULLERY SIN,-K ( 4 UNITS
4 Units) URINAL, PEDESTAL,SYF;jON JET
BLOWOUT. ( 8 UNITS
DF-,,.'T.AL UNIT OR CUSPIDOR ( 1 UNIT)
DEN7A-L L!,VATORY UINIT) URINAL, WALLL LIP ( 4 UNITS)
URINAL STALL, WASHOUT ( 4 UNITS)
DRINKI'NIG FOU'N7AIN UNIT)
DISFWASHER ( 2 UNITS) URINAL TROUGH EACH 21SEC-iloll"
( 2 U71,ITS)
FLOOR DRAINS I UNIT) WASHIING 11-ILACHINE RES.' ( 3 UNITS)
KITCHEN SINK 2 UNITS,%" WASH SINK EACH SET OF FAUCETS
KITCHEN SIN-K W/WASTE GRINDER ( 2 UINITS )
( 3 UNITS) WATER CLOSETS, TAN-K- OPERATED
LAVATORY I UN I T ( 4 UNITS )
WATZ'R CLOSETS, VALVE OPERATED
I-,'-VATORY .EARBFR,BEAUTY PA-RLOR 8 UNITS
2 UN I TS
T-AXATOFy , I-AkUNDRY TRAY ( 2 UNITS
�L _ ( 2 UNITS)
Job #5122
CITY OF ATLANTIC BEACH, FLORIDA
Appro APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: �j 19
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, 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 ELECTRICAL REGULATIONS, CODES AND CITY OF
AGNTIC BEACH ORDINANCES.
ELECTRICAL FIRM: �MAS ER ELECTR dIAN SIOATURE JOURNEYMAN
-V
NAME W.R. Wilson ADDRESS: 198 Sylvan Drive -RFD-BOX-
BLDG.SIZE BETWEEN:
RES. ( I APT. 0 COMM. PUBLIC INDUS. NEWi I OLD ( I REW.
ADDITION ( I TRAILER ( I TEMP. ( I SIGNS I I SO. FT.
SERVICE: NEW(A INCREASE ( I REPAIR FEE
CONDUCTOR SIZE 210 AMPS 190 COPPER I I ALUM.
SWITCH OR BREAKER 150 AMPS PH 7) W 27)CYOLT CableRACEWAY
EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY
FEEDERS NO. SIZE NO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.30 AMPS, 31-100
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0 100 AMPS OVER
APPLIANCES BELL TRANSF.=
AIR H.P. RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT
I
0-1 OVER
MOTORS H.P. VOLTAGE PHS NO. I H.P. VOLTAGE
MISCELLANEOUS
TRANSFORMERS: UNDER 600 V. OVER 600 V.
No . KVA NO. 1KVA
NO. NEON TRANSF. N� MA. MOTOR SIZE SWITCH I FLASHER
EACH SIGN
FORWARDED
S
TOTAL FEES �40.00
Job Y5122 CITY OF ATLANTIC BEACH, FLORIDA
Approved by APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE:— lov. 17 ' 19839
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, 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 ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
0-�
'�ASTER ELECTOItIAN SIGNATURE JOURNEYMAN
ELECTRICAL FIRM: 11A
NAME d--g- Wilsnni ADDRESS: 12? -RFD—BOX—
BLDG.SIZE BETWEEN:
RES. ( ) APT. COMM. PUBLIC I INDUS. NEW ( OLD ( REW.
ADDITION I I TRAILER ( ) TEMP. ( ) SIGNS ( ) SQ. FT.
SERVICE: NEW�O INCREASE ( ) REPAIR FEE
CONDUCTOR SIZE :2-10— AMPS COPPER I ALUM.U)
SWITCH OR BREAKER AMPS t PH 3 W '30 VOLT RACEWAY
EXIST.SERV.SIZE AMPS PH w VOLT RACEWAY
FEEDERS NO. SIZE NO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN ITOTAL
RECEPTACLES CONCEALED ITOTAL
'0* SIZE NO* TN
4ETS OPEON
�PEN
SWITCHES 0.30 AMPS. 31-100 AIMPST.
INCANDESCENT
k
FLUORESCENT&M.V.
FIXED 0 100 AMPS. OVER FBELL TRANS=F.
APPLIANCES r
AIR H.P,.=RATINGH.P. RATING
CONDITIONING COMP.MOTOR OfHER MOTORS AMPS CEIL HEAT: KW-HEAT
0.1 OVER
MOTORS H.P. I VOLTAGE PHS NO. I H.P. VOLTAGE PHS
MISCELLANEOUS
TRANSFORMERS: UNDER 600 V. OVER 600 V.
NO. KVA NO. IKVA
NO.NEON T R ANSF.' NO. VA. MOTOR SIZE SWITCH FLASHER
EACH SIGN
KV'
VA-
FORWARDED
$40.00
TOTAL FEES
GITY OF ATLANT141 BEASH, FLORIDA
Approved by APPLICATION FOR ELECTRICAL PERMIT
17 , l,)(92
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: ov. 19
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHzCH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
AGNTIC BEACH ORDINANCES.
�lf% f%l A ki _11)l IRNFV
ELECTRICAL FIR klFR SIGNATURE
NAME 1.4 lZ_3104 J I r,914 -ADDRESS: 192 Sylvan Dr. -RFD-BOX-
BLDG.SIZE -BETWEEN:
RES. ( ) APT.I comm. ( PUBLIC INDUS. NEW ( OLD ( REW.
ADDITION ( TRAILER TEMP.+',,4 SIGNS SQ. FT.
FEE
SERVICE: NEW ( INCREASE ( REPAIR (
CONDUCTOR SIZE X!, AMPS COPPER ALUM.
SWITCH OR BREAKER 0 AMPS PH 5 W VOLT RACEWAY
EXIST.SERV.SIZE AMPS PH W LT RACEWAY
t:V:O
FEEDERS NO. SIZE NO. SIZE SIZE
OPEN
LIGHTING OUTLETS CONCEALED 4 TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
_'0 AMPS.
-100
0.30 AMPS
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
0-100 AMPS. OVER
FIXED FBELL TRANSF.
APPLIANCES
ELL TR�ANSF=.
H.P. RATING H.P. RATING
A:I R 0 MOTO W-HEAT
IL HEAT, KW HEAT
C Co ITI 0 OTiHER MOTORS AMPS CEIL HEAT: K
O:NDITIONING COMP.MOTOR
OVER
MOTORS H.P. I VOLTAGE PHS NO. I H.P. VOLTAGE P
W'ISCELLANEOUS
TRANSFORMERS: UNDER 600 V. OVER 600 V.
NO. KVA NO. - KVA
NO.NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHER
EACH SIGN
FORWARDED
TOTAL FEES
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DEPARTMENT OF BUILDING PERMIT No. 5720
CITY OF ATLANTIC BEACH,FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
Date NOVEIMER 16 19 82
Valuation$ IIIECHANICAL Fee$ 70-00
This permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
This is to certify that DENNIS hEATING AND AIR CONDITIONING
1880 ST. JOHNS BLUFF ROAD, SOUTH, JACKSONVILLE, FLORIDA
has permission to build INSTALL HEATING & AIR CONDITIONING AS PER PLAN
SUBMITTED.
Classification DUPLEX Zone RG-1
Owned by W. R- WILSON
Lot 700 Block S/D SALTAIR
House No. 1921198 SYLVAN DRIVE
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
100 0 Building material, rubbish7and Aebrili
zi from this work must nothe.pjAOOT
in public sp,1'Sq1,.,a-d mp!q tri�JqT?4
up and�ou e(�a- ay by eithie
J
Y61
trac o�rnrr.
Q 4
Building Official.
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
SEWER
WATER
BUILDING AND ZONING INSPECTION DIVISION
CITY OF 1JLANTIC BEACH, FLORIDA
APPLICATION FOR MECHANICAL PERMIT
IMPORTANT-Ap
. plioant to complete all if*ms in soctiom 1. 11, 111. and IV.
On 72- 6.twee - St. bod- St.
LOCATION (P4.,A. s...th. East, welt) (AAddr*u) (Imfersoctiftq Street%)
OF
EUIlMiNG Lot No No- Sub-di.4s;oa
(state portion of 64 if 6u 04A full los--Attac� 6gal d*l�cripi;on per dvos! in duplicate if necessary)
11. ME OF PROPOSED I�JECHMICAL WORK - AX epplicants cewnplofe N-rtz A - D
A. USE OF 9VILDING owsbullip
RESIDENTIAL Is. Private lindiv;dj*l. corporet;cm.
X o4c.)
1. 0 One fem;ly, 11. 0 Utilit-y 16. [3 PuSlik I Fed-sral. Vote or local 90yonwwo"I
T..,,or more Urnily 12. 0 Sc". rib-rarv,
Ent v num6a.-of roc'mt other oclucatio"I C. NATUkE OF WORK
3. 0 Trans;ehf. Wet. motsol, 17. New 1.3di.9
roomirig house- 13. C) Store. miamarri'llt
Enter nurn6or of unift Othor It. 0 Existing bv;td;*q
4. 0 Other residential 14. OTHER-SPECIFY 19. Iteplac&merif of elitf;*g totem
20. New ;rIttolletion (No�vofom Fr*v;vnly 6slowl
NON-PIESIDENTIAL 21. 0 Eztons;c"�cw isddt-on to existing rr--tv".
S. 0 Amusarnent, mcrosfional 22. 0 Oliw-Specify
6. 0 CAulrrh. other religious
7. 0 Industrial
1. 0 Garage, torv;c* station
9. 0 Holp;ial. institutional L TYPE OF IUILC446
3& Number of
to. 0 Office, 6ami. professional 37. 0 Wood I rem*
D. MECHANICAL EQUIPMENT TO 9E INSTALLED 39. 0 Mao-on-f and wood
(Provide complete list of compo-ments on bock of this form) 39. 0 Peinomed concrete
23. Furnace: 0 Space 0 Roc&"*d b�. Control 0 Fkw 40. 0 Structural stool
24.' Air ComcliConing: 0 Room 'ta Central 'M'� ,A -
�i 1)L4 t I f 41. 0 Other
25.'� Duct Sysiom: Material ;Cj
Maz;murncapocity - c.fin.
26. 0 Ral'69oration
THIS SPACE FOR OFFICE USE ONLY
27. 0 Cooling tower: Capacity 9-pin-
29. 0 Fire sprinkler%: Number of hoad.-
29. 0 Elsvafcw 0 Mantiff C] Escalato (number)
30. 0 Gesol'ine pumpi- (humber)
31. [:] Tanks (number) Remarks
32. 0 LPG c*nfa;n*r&-(number)
33. 0 Umf;F*d pressure v*uol Permit Appro,*J by Dato.-
34. 0 Boilers
Permit
35. 0 Other - Sp*--ify
Ill. GENEXAL INFORMATION
A. Type of heating fuel. B. Is OTHER CONSTRUCTION BEING DOME ON
42.,v Voctric THIS BUILDING OR SITE?
43. 0 Gas-0 LIP 0 Natural C,*Afral utility IF YES, GIVE NUMBER OF CONSTRUCTION
44. 0 Oil PERMIT
4S. 0 Ot+w - Sp*.cify
IV. IDENTIFiCATION To be complatod by all applicants
In coews;dstsfion of . for doing A* wart as dc-scr;bod ;R the above staternerit we bersby agree to Perform said wo'k in acc"rco
.iA the stiach*j plan 7..1'%"peciftcat;ons which are a p4krf hereof and ;a accordance with the City of Jacksonville oedi"rices &PA stendards
of good practice I*istod therisin.
Nsr-�* of M&Chsmical Signature of
Coitr*Oor (Print) qyl-, '�V/'er Contractor A,3ont
74, 104
Ovraor (Print) 6 lei Address
S;qn4tvra of Owner Signature of
or Au"orized Agent Architect cw Engineer
Form 21-51-1
/0'I'LICA'110N YOK 1-I.KMIT
DATE
F - S r,AmE NEW TYPE Of BUILDING
REPIPE RES]_DENTIAL
LOCATION ADDI T1 ON COMMERCIAL
PLUMBING F]RM
ADDRESS-
M�ASTER PLUMBER
please print
CITY/COUNTY OCCUPATIONAL LICENSE NO.
STATE CERTI F]CATE NO.
BUILDER OR CONTRACTOR.-
---------------------------------------------------------------------
SINKS LAVATORY -------------------
J, BATH TUBS URINALS FLOOR DRAINS
CLOSETS SHOWERS WATER HEATERS DISHWASHER�' DISPOSALS
WASHING MACHINE OTHER TOTAL FIXTURE COUNT
INSTALLATION OF PLUMBING AND FIXTURES MUST
BE IN ACCORDANCE WITH THE MOST RECENT EDITION
OF THE -SOUTHERN STANDARD PLUMBING CODE. SIGNATURE OF 11ASTER PLffflikR
FIXTURE UNIT BREAKDOwN
FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DE_)-A' ND FOR EACH WATER FIXTURE UNIT
INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE '1S HEREBY FIXED AT
TEN DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. SEC. 27-3 (c)
BATHROOM GROUP CONSISTING OF BATHTUB (W/OR W/O OVER - SHOWER STALL,
WATER CLOSET, LAVATORY & BATE HE-AD SHOWER) (2 UNITS) DOMESTIC (2 U,\I
TUB OR SHOWER STALL (6 UNITS) BIDGET (3 UNITS) LAUNDRY TRAY
COMBINATION SINK & TRAY (2 U`N1TS)
(3 UNITS) DENTAL LAVATORY
CONBINATION SINK & TRAY W/ (I UNIT) KITCHEN SINK
FOOD DIS. (4 UNITS) DENTAL UNIT OR CUSPI- (2 UNITS)
DOR (I UNIT) KITCHEN SINK W/
DRIN-KING FOUNTAIN (3-5 UNIT) �4 DISMIASHER (2 UNITS) WASTE GRINDER
FLOOR DRAINS (I UNIT)
LAVATORY, SURGEONS (2 UNITS) LAVATORY (1 UNIT) LAVATORY, BARBE-1
SHOWERS GROUP PER'HEAD BEAUTY PARLOR
SURGEONS SINY, (3 UNITS) (3 UNITS) (2 UNITS)
FLUSHING RIM SINK (8 UNITS) SERVICE SINK TRAP POT, SCULLERY
URINAL, PEDESTAL, SYPHON JET STAND (3 UNITS) SINK (4 UNITS)
BLOWOUT (8 UNITS) URINAL, WALL LIP URINAL STALL,
URINAL TROUGH EACH 2' (4 UNITS) WASHOUT (4 UNIIS
SECTION (2 UNITS) WASHING MACE11NE RES. WASH SINK F-A SE-�
WATER CLOSETS, TA-NK- (3 UNITS) OF FAUCETS
OPERATED (4 UNITS) WATER CLOSETS, VALVE (2 UNI TS)
OPERATED UNITS)
TOTAL FIXTURE UNITS
FOR OFFICE USE ONLY
Date...................................19 ......
Permit #........................Fee $........................
CITY OF ATLANTIC BEACH Valuation $.............................
..........................
FLORIDAHouse #...............................--------------------------
.........................................................................
APPLICATION FOR BUILDING PERMIT
...................
..............................................
-Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
-building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can
be verified.
Date Z............. me
Owner..... .....................................Address .......... ..... .........Telephone
Architect.......
................Address,.......Z
........................................Telephone
.......... ...............
Contractor Builder..... .4�1 - ------
........... .....................Address......... ..... . .................................Telephone
sce 7/c"-' -=
Lot No....... ........ _-Bi k-Ne -3. Sub Division
0'4.��.......;q...-I_..- .... . ..........Zone................
E/z VE
7- /'V
............................................................Street........................Side Between.....................................................and......................................................Sta.
Valuation -For
_�kat�p ose will building be used._,'.''7!.... of construction-
'yp
Dimensions of Building. .....Dimensions of Lot_..ff�. ..........................Size of Footings------fn...Z.yf..............
Size of Piers-------- .............Size of Sills........ZIK__�.........Greatest Sill Span in .............Type Roof_,�...'=,;e................
How will Building be Heated?........45- ......................Will Building be on Solid or Filled Ground?.... ...........
Size of Ceiling Joists......................................... Distance on Centers............ ...........I Greatest Span---- .....................
Size of Floor Joists.-'.,Y,./.;:,7........................... ............................
......Distance on Centers.. ..451....... .......... Greatest Span.....Z�,A
Size of Rafters ..................................................... Distance on Centers ..........I................. Greatest Span.......................................
This rectangle is to represent the lot
Locate the building or buildings in the
A?-PROVED right position. Give distance in feet from
�!'VJY OF A'[[,�JJTIC BEACH all lot-lines and existing buildings.
pUILDING OPFiCE: REAR LOT LINE
Two copies of plans and specifications shall
be submitted with application.
Inspections required.
1. When steel is in plam and ready to pour footing.
2. When steel is in place and ready to pour columns andA6 :i�? Z
1/0 1 aw- 1
3. When steel is in place and ready to pour bearn. 04
4. When framing is completed.
5. When rough plumbing is completed,and ready to cover up.
6. When septic tank drain field or sewer is laid but before it is covered. Q
7. Electrical inspection by City of JacksOLville. U2 rn
8. Final inspection. 14
Note: In case of any rejection,re-inspection MUST be called for after
corrections are made.
FRONT OF LOT
In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said
work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building
regulations of the City o tian 6,6 0 lVo.4 7 r/, -57.
Be
Signature of Builder .... .......... ..........t#............... Address... ...............
-/, - �_X�-------- ........
Signatureof Owner..../ ....0................. ....................... Address........... .................................................................
C I TY OF ATLANI I C !�'14CH
716 OCIAN BDULEVARD
ATLANTIC BEACH, FLORIDA
ADDENDUM 10 BUILD114G PLAN
-.6uilding �ocat ;on:_ I
The attached plan for the above building is approved subject to meeting the following
appl ;cable construction requirements:
a. Footings shall be continuous- monolithic concrete under exterior walls, reinforced
with two 5/8" deformed reinforcing rods for one-story bui'ld;n!gs and -three 5/8"
deformed reinforcing rods for two-story buildings. Reinforcing rods shall be
placed in the lower one-third of the footinas , properly placed and fastened on
metal cables with wire. Footings shall be six inches wider on each side than the
%..all above, shall be at least eight ;ncbes thick and shall rest on firm soil at
least tv4elve inches below undisturbed soil .
b. In hollow masonry unit constriction, each unit cell shall be reinforced with at
Te2st on No. 4 bar �_�—a) ] conrners, poured and tamped with concrete; such re;n-
forcing shall be properly tied into the footing and spandral beam.
C. All- .vjood truss rafters (roof construction) , shall be securely fastened to the
exterior with approved hurricane an��hors or clips.
d- Construction of nearby one-family dwellings, %-.,h;ch are duplicates or intensely
similar, shall be avoided- Such similarity cons;6ers the external configuration
and appearance (i . e. , roof, outer %-.,all miaterials, %-.-indov-,! size and desion, and
other like characteristics) of structures. In accord with the foregoing, similar
and shall be at least 500 feet apart if any one similar dwelling is -vis�ble from
any otber similar dwelling.
e. The. final Connection between the house plum.bing 6rain and the se,�--erzserV'-;c:e
connection (at the property line) must: be inspected by the City before being
covered.
City Panacier
undersigned hereby certifies that he has read the above and understands that this
endurr. takes precedence over any contrary details to the plans and specifications and
ees to comply with the intent of this addendum-
C on t r'a c t o r/0�-.rn e r
Date
L
THIS NOTICE MUST BE GIVEN TO PROPERTY OUTNERS BEFORE CONSTRUCTION BFCINS.
Warning to Property Owners
Please read this notice caretully. it may save you from paying
twice for commercial or residential repairs, improvements, or
new construction exceeding $2500.
gince vou or your contractor have applied for a building permit for work to be done on Droperty
w-med by you, you should be aware of the following: -
Any person who furnishes labor (a contractor, subcontractor, or laborer)
or supplies materials for repairs, improvements or new construction may
be able to file a claim (called a lien) against your pronerty if he has
not been paid in full by your contractor. Even though you have paid the
contractor in full, you may be liable to those who have not been paid by
the contractor.
In order foz your payments to your contractor to be "propei payments," there are certain steps
you may take in accordance with Florida's Mechanics' Lien Law. Although these steps are
optional, they may afford you some protection should a lien be placed on your property.
7F
:3 >
1. As soon as you make an agreement with a contractor and before any 0 ;0
E: Z
work is begun, file a Notice of Commencement with the Clerk of the 1H
Circuit Court. The form for this notice may be obtained through nC3
your *local building permit office, bank, or lending institution; or W ,
n 0
see Section 713.13, Florida Statutes, which specifies information
required on the Notice of Commencement.
0
=
2. Post 6 certified copy of the Notice of Commencement in a conspicu-
Z
ous place on the front of the property where the work will take 0
place. The notice must be posted before any work is started, but
0
not more than thirty days before work is begun. 0
0
0
3. Upon completion of the work, require a sworn, notarized statement Z- 3 3
(affidavit) from your contractor stating that be has paid all bills
for labor and materials or listing the names of persons or firms 3
that have not been paid and the amount due each of them. - Require
this affidavit before making final payment to your contractor.
For added protection, you may request that your contractor furnish you with a performance
and/or payment bond. Such a bond can be obtained by you, or by the contractor for you, through
most general lines insurance agents. While the cost of the bond will be borne by the owner, it
Drovides the best protection available against the possibility of having to pay twice.
If vou have further questions, consult private legal counsel immediately. The Department of
Agriculture and Consumer Services (phone toll-free in Florida, 1-800-342-2176) or your local
consumer protection agency may be able to give you further information, but cannot give you
legal advice.
THIS INFORMATION IS PROVIDED AS REQUIRED BY LAW. THE DEPARTMENT OF AGRICULTURE AND CONISUMER
SERVICES AND YOUR LOCAL BUILDING PERMIT OFFICE ASSUME 140 RESPONSIBILITY IN THIS REGARD. FUR-
NISHING TH IS INFORMATION IN NO WAY IMPLIES THAT YOUR CONTRACTOR IS UNRELIABLE.
This public document was promulgated at a cost of one cent per copy to
inform Floridians about provisions of F.S. 713.135(b) as required by law.
CS80(--,,o
MAP SHOWINS SURVEY OF
Lot 700, as shown on the Plat of Saltair , Section No . 3 , as recorded in Plat
Boo� 10, Page 16 of the Current Public Records of Duval County , Florida .
For : W. R. Wilson
"�w
OAVIO 50 /) A VENLIE
(,,cOO,W"L,v A40W AVZ-)
N W
gov
0 7' 70/
APPROVED
�jy OF AT[i�NTIC, BEACH
quill-E)I.NG, O,F—iICS
RA Ys A41L L ER 0 .4-650CIA rE.6
o O&rVO7',F5 AfFr,4L SrWNE SEr PROrE551C,'IvI,41 C,4AIO 54IRVEYOR5
* OFMOrES AfErAZ 5r4KE AMINO 38 Z-.45r /7 rN Sr)q-cEr
j4CAe5OAWZLF, A-ZOQ10A
* OENOMS AFRAMNENr REAERENCE MOM VqOAIE -753 6471L
*-x-x---* OrmorEs AkAICE
11"LAF 1 06 NO 1020'50
511,21-rY 19.L2- I'z -'0 B
OR'4'7'SA"m CIIECACAFIO Oy - T�
4. Fla7 eg. Surveyo�r Cort. No. 38z'
DEPARTMENT OF BUILDING PERMIT No. 5718
CITY OF ATLANTIC BEACH,FLORIDA
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB
NOVEMBER 5
Date 19
..e(07. 7.5-
Valuations 70,180-90 Fee$ -U6w-7-5--
This permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
This is to certify that W. R. WILSON
1650 NORTH STREET, LONEWOOD, FLORIDA
has permission to build DUPLEX AS. PER PLANS SUB1.1ITTED.
DUPLEX I RG-1
Classification Zone
Owned by— W. R. WILSON
Lot 700 Block ------- S/D SALTAIR SEC.
House No. 192/198 SYLVAN DRIVE
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
4 10 .4 10, 0 Building material, rubbis4 d*b
Z-4 from this work must no�r'e
in-pub ce, and in i
up qTed away ei
tra o wrier. o00CAC
913
Building Official.
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING 3718 11-18-82 B & G PLUMBING COIIPA14Y
ELECTRICAL 3590/91 11-18-82 UNITED ELECTRIC COMPANY
3611 - TP
SEWER
WATER
LIECHANICAL 57-40 11-16-82 DENNIS HEATING & AIR CONDITLj
,Now,
loel
DEPARTMENT OF BUILDING PERMIT NO. 7859
CITY OF ATLANTIC BEACH,FLORIDA
PERMIT TO BUILD T
24900 T
THIS PERMIT MUST BE POSTED ON JOB P4*00CKT
June 27 , 86 5940 1 A 6/?7/8
Date 19- C
78b9 000CM
4,000 -00 24.00 5 9 40 it 6/27/8,
Valuation$ Fee$
This permit not valid until above fee has been paid to City Treasurer,and is
subject to revocation for violation of applicable provisions of law.
TERESA DIDWKS
This is to certify that 198 S
has permission to build Sun Room (Porch) as per plans
variance granted by BOA on 6-19-86
residentla Zone
Classification__�
Teresa Downs
Owned by 700 Block Sect 3 S/D Saltair
Lot- 198 Sylvan Drive
House No.-
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING-
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
M
4-- 10. 0 Building material, rubbish and debris
zi from this work must not be placed
F-1 in public space, and must be cleared
up and I d y by either con-
'�auwl awa
e
t] ner.
4-Y
B u . 0
u' in Official.
FOR OFFICE PERMIT DATE CONTRACTOR
USE ONLY NUMBER
PLUMBING
ELECTRICAL
SEWER
WATER
CITY OF ATLANTIC BEACH
APPLICATION TO MAKEADDITIONS OR ALTERATIONS
Phone
Owner P� �2�&4,)AAS Address
Architect Address Phone
Contractor W 1QF_(2-- Address-- Phone
Contractors License/Certification Nunbers--
Expiration Date
Property Address Zoning
Lot # ' ' , Blcok or Unit Subdivision '��_ _L779zv-
Valuation of Construction $ Type of Construction
Describe Work to be Performed /0 X
Materials to be Used ct &-t
Present Use of Building �'f f.3 I-F_ A—"
P--O?Osed ltj�-.e of B1_1il
Flood Zone
C/ty 0
SUOF
Dimensions of New Area: '4rt4Nrjp'-- 0
HEATED
SnPORC�H
"C'A'=Peff-tR
IDEL(�
YAIM— YES NO
Will there be an increase in nunberof units?
Will there be a decrease in nun-ber of units?
Any additional plunbing fixtures?
Any new fireplaces?
S=T J�C COMPLETE SETS OF PLANS INCLUDING SITE PLAN
Signature Mujt� —Date-6 —C�
Signature CONMCIOR Date
Address
I
Heated Square Footage @ $ er sq ft. = $
Garage/Shed @ $ _per sq ft = $
Carport/Porch @ $ er sq ft =
Deck @ $ per sq ft = $
Patio @ $ Der sq ft = $
TOTAL VALUATION:
00
Total Valuation Ist
,2 , �(-)6 600
Reminder Valuation �$36-oper thousand or
--------------- --------------- portion thereof Total Building Fee
-------------
ADDITIONAL PERMITS and/or FEES REQUIRED + k Filing Fee
Fireplaces @ 15.00
Mechanical
BUUDING 3!PERNIT FEE $
Plurbing
Electric/New -------------------------------------------------
Electric/Tmp BUILDING PERMIT
Septic Tank WATER I= CHARGE
Well SEWER IMPACT FEE
Swimning Pool WATER IMPACT FEE
Sign NISCELLANEOUS
Water Connection
Sewer Connection
Water Meter
Elevation Certificate GRAND TOTAL DUE V.
----------------------------------------------------------------------------------------------
CALCUIATIONS and/or NOTES
4.1
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All
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141 e;
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Olt
OF AR-N,
13UILDING or
JUN 2
7 loo
4d,
MA P SHOWIN�9 . SURVEY '.
`in ' P la t
C 700 , as shown on the Plat of Saltair , Secfton No. 3 , as recorded
RecQrds ' of Duval County,, Florida..... ,.
p� 10, Page 16 of the Current Public
For : W. R. Wilson
A.
DAVID AYENLIF
aqm"L Y A4,qW. A Vc)
I OV
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S
N
0 . 701
CITY OF
4&a4c BeazzA—4;&W*4&
office of Building official
REQUEST FOR INSPECTION
Date Permit No.
Time A.M.
Received P.M� District No.
'Job Address Locality
Owner's
Name contractor OP&JAj F-
BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL
Framing El Footing Li Rough Wiring Rough Ll Air.Cond.& 1:1
Re Roofing EJ Slab 11 Temp Pole Top Out El Heating
Lintel F1 Final Fire Place E)
Pre Fab
READY FOR INSPECTION A.M.
Mon. Tues. Wed. Thurs. Friday—P.M.
A.
Inspection Maae M.
Final Inspection
Inspector ,< 1+19j)17
Gertificateof Occupancy
Date
CITY OF-
A Office of Building Official
REQUEST FOR INSPECTION
Date (0 Permit No. 729 Y47
Time A.M.
Received P.M. District No.
Job Aclaress Locality
Owner's
Name—Contractor
BUILDING CONCRETE ELECTRICAL PLUMBI�G MECHANICAL
Footing 0 RoughWiring El Rough 0 Air.Cond.& 0
Re Floof Ing 0 Slab 0 Temp Pole D Top Out 0 Heating
Lintel El Fire Place 0
Pro Fab
READY FOR INSPECTION A.M.
Tues. Wed. Thurs. Friday—P.M.
-2 A.M.
Inspection Made P.M.
Inspector Ll L Final Inspection 0
Certificateof Occupancy
Date
CITY OF
4&44d4C Beac.4-&;&V-4&
Office of Building Official
REQUEST FOR INSPECTION
Date Permit No.
TIM A.M.
Recei ed P.M. District No.
v 14 Aj 2Z
Job Address Locality
Owner's ��n LI) 0 S
Name— Contractor
BUILDING CONC ELECTRICAL PLUMBING MECHANICAL
Framing -7 (:�oo�tin. LJ Rough Wiring -- Rough El Air.Cond.& 11
Re Roofing El Slab X Temp Pole E Top Out El Heating
Lintel E3 Fire Place El
Pre Fab
READY FOR INSPECTION A.M.
Mon. Tues. Wed. < T�hu r s '2 ' 3 1) F r i d ay—P.M.
Inspection Made
Inspector Final Inspection El
Certificate of Occupancy
Date