1565 Beach Ave 2013 Pool CITY OF ATLANTIC BEACH
s�
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003427 Date 10/22/13
Property Address . . . . . . 1565 BEACH AVE
Application type description SWIMMING POOL/SPA
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 35000
----------------------------------------------------------------------------
Application desc
swimming pool
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
PETWAY, THOMAS F IV & LINDSEY CROWN POOL INC
1911 BEACH AVE P O BOX 5517
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32247
(904) 858-4300
----------------------------------------------------------------------------
Permit . . . . . . SWIMMING POOL
Additional desc . .
Permit Fee . . . . 225 . 00 Plan Check Fee 112 . 50
Issue Date . . . . Valuation . . . . 35000
Expiration Date . . 4/20/14
----------------------------------------------------------------------------
Special Notes and Comments
Avoid damage to underground water/sewer utilities . Verify
vertical and horizontal location of utilities . Hand dig if
necessary. If field coordination is needed, call 247-5834 .
POOL - Wellpoint (if used) must discharge into vegetated
area 10 ' minimum from street or drainage feature (swale,
structure or lagoon) .
Full erosion control measures must be maintained until CO
approval .
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
REQUIRED INSPECTIONS :
*POOL STEEL
*ELECTRICAL GROUNDING AND BONDING
*FINAL (PUMPS MUST BE RUNNING FOR FINAL)
SWIMMING POOL SAFETY INSPECTION REQUIRED
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 3 . 38
DEV REVIEW-SINGLE & 2-FAM 50 . 00
ENG REV PRE APP > 3 HRS 25 . 00
STATE DBPR SURCHARGE 3 . 38
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee �7T++o�taal 225 . 00 0 225 . 00 0,,0 . 00 . 00
PERMIT ISP4WbVV1D'8 lS' I1V�AC &DANCE -PSI, OF A�k;TIC BEACH ORDINANCESOAND THE FLORIO0
BUILDING CODES.
v�J%J
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
=� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Page 2
Application Number . . . . . 13-00003427 Date 10/22/13
Other Fee Total 81 . 76 81 . 76 . 00 . 00
Grand Total 419 . 26 419 . 26 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
t. CITY OF ATLANTIC BEACH )y ( r
FILE COPY
! 800 Seminole Road, Atlantic Beach, FL 32233 �,•_ 19 Il
;; --- Office (904) 247-5826 Fax (904) 247-5845 J
Job Address:
Permit Number: .3--3e-1c;-7 ,
Legal Description L dC Z Parcel # - 77 L/C
Floorrea of Sq.Ft. Nq.tt
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move DemolitionpooUsp window/door
Use of existing/proposed structure(s) (circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No
Florida Product Approval# D Q ly7 2
For multiple products use product approval form U 15
Describe in detail the type of work to be performed: &V(Iti et SEP 18 201
Property Owner Information: ze—
Name: Address:_ _50� rL
City State_Zip Phone
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: C/204_j.1V i✓ S Qualifyin Ag nt: CzC J ite iz K e (,/
Address: c7 ( City State Zip d
Office Phone =4>3Job Site/Contact Number J -7 7 D Fax#
State Certification/Registration# C Il i' /Q/ro`T 7
Architect Name&Phone# S JK(AL,-_J y ,f
Engineer's Name&Phone# P 6A -77�(- a-Z Y 7 p�
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in 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 and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o work will be compl' ith wha4her specified herein or not. The granting of a permit does not presume to jvp 171,1thnrity to violate or cancel the
provisions of any other fe ral, t te, pf Ibcal law regulating construction or the performance of construction.
Signature of Owne Signature of Contractor
. Print Name
Print Name ............. ......��..-7-A1--0q-1... ........ ......................................................... ....... .lj..2. .............................................................
Befor ,n, Bef e ,,
this a s of 20 � c?
this ay of r 200
,�•,•,
PATRrAA B.EDWARDS
ota lie r MY COMMISSION 0 FF 008128 Nota 1 c `
EXPIRES:August 13,2017
l£ EXPIR ust 13,2D17
?, Bonded Thru Notary Public Underwriters ' w undeiwb
Rf,14•`'
DO NOT WRITE BELOW - OFFICE USE ONLY
Applicable Codes: 2010 FLORIDA BUILDING ODE
Review Result (circle one):
Approved Disapproved Approved w/ Conditions
Review Initials/Date:
Development Size
Habitable Space Non-Habitable
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone
Conditions/Comments:
r !- L,Vj
800 Seminole Road
SS Atlantic Beach, Florida 32233
�' s) Telephone(904)247-5800
FAX(904)247-5805
Construction Site Management Plan Compliance
A construction site management plan conforming to Atlantic Beach City Code Sec 6-18
has been approved as a part of this building permit. The Construction site management
plan was approved based upon the following information.
1. Parking plan—parking plan showing how site will be accessed and all onsite
and abutting street parking areas.
2.
3. Location of construction trailers, loading/unloading area and material storage
area.
4. Location of chemical toilet area.(chemical toilets must be kept out of City
right-of-way and not further than 15 feet from structure under construction)
5. Location of dumpster. Dumpster must be from an approved waste company
(in accordance with Chapter 16 City Code) as of 2009 the permitted
dumpsters are Advanced Disposal,Realco Recycling, and
Shappells. Dumpsters will have tarp covers or rigid covers on windy days.
Dumpsters must be removed prior to issuance of Certificate of Occupancy.
6. Traffic control plan, showing access with dimensions, area to be stabilized,
narrative on phasing of construction with adequate parking and delivery of
materials.
7. Site cleanliness. Contractor must have the entire construction site cleaned by
Friday of each week. This means removal of scrap lumber, concrete remnants
and other such construction debris including cans, metal, plastic and paper.
8. Erosion and Sediment Control. Contractor must maintain all elements of the
approved Erosion& Sediment Control Plan (silt fence, catch basin filters, etc.)
until sod or other stabilization has been placed and approved by Public Works.
9. Other activities, where special conditions are identified by the Building
Official.
Failure to comply with the Construction Site Management
Ordinance may result in a Stop Work Order being issued in
accordance with City Code Sec. 6-17 (3)
Revised 5/2009
FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTEC=I0N,.,."1 __"W__,
3900 Commonwealth Blvd.,Mail Station 35
Tallahassee,Florida 32399-3004 FILE
� r
Telephone(850)488-7708
f NOTICE TO PROCEED
Permittee Name* Permit Number: DU-450
Encore Beach Properties, LLC Permit Expires: July 18,2016
c/o Richard G. Skinner,III,AIA
Richard Skinner and Associates,Architects
2245 St.Johns Avenue
Jacksonville,Florida 32204
You are hereby granted final authorization to proceed with construction or activities authorized by this
notice. Authorized work must conform to the project description, approved plans, all conditions of
Chapter 6211-33, Florida Administrative Code, any preconstruction requirements, and all permit
conditions.
Project Description: Construction of a three-story,single-family dwelling, landward garage/guesthouse
and work room,swimming pool, other structures/activities,excavation and placement of fill.
Project Location: Between approximately 335 feet and 420 feet north of the Department of
Environmental Protection's reference monument R-47, in Duval County. Project address: 1565 Beach
Avenue,Atlantic Beach.
Special Instructions: A preconstiuction conference is required. The permittee shall comply with all
permit conditions.
questions regarding this notice should be directed t, the undersigned at the above address.
k_7
vi/aa
cc: Permit File
Permit Information Center
Trey Hatch,Field Inspector
Encore Beach Properties,LLC,Property Owner
-City of Atlantic Beach Building Official
Post Conspicuously 'on the Site
DEP Form 73-131(Updaicd 2/06)
i
STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Division of Water Resource Management
2600 Blair Stone Road-Mail Station 3522
Tallahassee,Florida 32399-3000
F[ A {850}469-7708
PERMIT NUMBER: DU450
PERMITTEE:
Encore Beach Properties, LLC
c/o Richard.G. Skinner, III,AIA
Richard Skinner and Associates, Architects
2245 St.Johns Avenue
Jacksonville,Florida 32204
PERMIT FOR CONSTRUCTION OR OTHER ACTIVITIES
PURSUANT TO SECTION 161.053,FLORIDA STATUTES
FINDINGS OF FACT: An application for authorization to conduct the activities seaward of the
coastal construction control line that are indicated in the project description, was filed by the
applicant/permittee named herein on April 19,2013, and was determined to be complete pursuant to
rule on April 19, 2013. The proposed project is to be located landward of the 30-year erosion
projection and the line of construction established by existing major structures in the immediate
area
CONCLUSIONS OF LAW: After considering the merits of the proposal and any written objections
from affected persons, the Department finds that upon compliance with the permit conditions, the
activities indicated in the project description of this permit are of such a nature that they will result
in no significant adverse impacts to the beach/dune areas or to adjacent properties; that the work is
not expected to adversely impact nesting sea turtles, their hatchlings, or their habitat; that the work
is expendable in nature and/or is appropriately designed in accordance with Section 62B-33.005,
Florida Administrative Code; and that it is an activity or type of construction which the designee of
the Department has authority to approve or deny pursuant to Delegation of Authority, DEP
Directive 137, effective May 14, 2001. Based on the foregoing considerations, the designee
approves the application; authorizes construction and/or activities at the location indicated below in
strict accordance with the project description, the approved plans (if any) and the General Permit
Conditions which are attached and are by this reference incorporated herein, and any additional
conditions shown below,pursuant to Section 161.053(4),Florida Statutes.
EXPIRATION DATE: July 18, 2016
LOCATION: Between approximately 335 feet and 420 feet north of the Department of
Environmental Protection's reference monument R-47, in Duval County. Project address: 1565
Beach Avenue,Atlantic Beach.
PERMITTEE: Encore Beach Properties, LLC
PERMIT NUMBER: DU-450
PAGE 2
PROJECT DESCRIPTION:
Three-Story, Single-Family Dwelling
1. Location relative to control line: A maximum of 135.9 feet seaward, with a seaward,
cantilevered, covered balcony to approximately 138 feet seaward.
2. Exterior dimensions:
2.1. Foundation (pilings): A maximum of approximately 91 feet in the shore-normal
direction by 48 fret in the shore--parallel direction.
2.2. Overall structure: A maximum of approximately 97 feet in the shore-normal
direction, including the seaward cantilevered balcony, by approximately 57 feet in
the shore-parallel direction, including cantilevered balconies on the north and south
sides.
3. Type of foundation: 14-inch diameter augercast concrete piles.
Landward Garage/Guesthouse and Work Room
1. Location relative to control line: A maximum of 62.6 feet seaward.
2. Exterior dimensions: A maximum of 46.7 feet in the shore-normal direction by 25.1 feet in
the shore-parallel direction.
3. Type of foundation: 14-inch diameter augercast concrete piles.
Swimming Pool
1. Location relative to control line: A maximum of 136.2 feet seaward.
2. Exterior dimensions(including coping): 39.3 feet in the shore-normal direction by 16.1 feet
in the shore-parallel direction.
3. Type of foundation: Concrete shell on 14-inch diameter augercast concrete piles and grade
beams.
4. Deck elevation of swimming pool: Varies from+20.0 to+21.0 feet(NAVD).
5. Maximum depth of swimming pool: 6 feet.
6. HP aht of pool deck above existing grade: Varies -f;--T. .approximately 1 to 4 feet.
PERMITTEE: Encore Beach Properties,LLC
PERMIT NUMBER: DU-450
PAGE 3
Excavation/Fill
1. Total volume of excavation: Approximately 310 cubic yards. Volume of net excavation:
None; excavated material to be placed as fill on the project site. See Special Permit
Condition 5.
2. Location of excavation: From 0 feet to 136 feet seaward of the control line, beneath all
structures and for the pool.
3. Maximum depth of excavation: To approximate elevation+12.0 feet (NAVD) for the pool
foundation; a maximum of approximately 6 feet below existing grade.
4. Volume of fill to be placed: Approximately 343 cubic yards. Volume of imported fill:
Approximately 33 cubic yards. See Special Permit Condition 6.
5. Location of fill to be placed: From approximately 15 feet to 205 feet seaward of the control
line.
Other Structures/Activities
1. Demolition and removal of the existing landward concrete driveway. See Special Permit
Condition 4,
2. A frangible, stone paver pool deck and walkways of varying widths, to be attached to the
periphery of the pool and in the vicinity, and located on the south side of the dwelling, are to
be located a maximum of approximately 136.2 feet seaward of the control line.
3. A 6-foot high, frangible masonry retaining/planter wall approximately 40 feet in length is to
be located along the south side of the pool deck, a maximum of approximately 136.2 feet
seaward of the control line.
4. A 6-foot high, frangible wood fence is to be located near the south property line landward of
the retaining/planter wall, a maximum of approximately 103 feet seaward of the control line.
An emergency generator, HVAC unit, pool equipment and shower are to be located within
the fenced area on the south side of the guest houselgarage and pool.
5. Frangible concrete driveways are to be located landward of the dwelling and the guest
house/garage.
6. Four-foot high, frangible masonry retaining walls are to be located along the periphery of
the landward driveways and planting areas.
PERMITTEE: Encore Beach Properties,LLC
PERMIT NUMBER: DU-450
PAGE 4
7. A 6-foot high, frangible wood fence with landward and seaward gates to access HVAC units
is to be located on the north side of the dwelling, a maximum of approximately 79 feet
seaward of the control line.
8. Drainage improvements including catch basins on the seaward side of the dwelling. See
Special Permit Condition 7.
9. Landscape improvements including removal of non-native vegetation and planting of
ornamental and native species landward of the seawall. See Special Permit Condition S.
10. Exterior structural, swimming pool and landscape lighting. See Special Permit Condition
9.
SPECIAL PERMIT CONDITIONS:
1. Prior to commencement of construction activity authorized by this permit, a preconstruction
conference shall be held at the site among the contractor,the owner or authorized agent, and
a staff representative of the Department to establish an understanding among the parties as
to the items specified in the special and general conditions of the permit. The proposed
locations of the structures shall be staked out for the conference. Contact Trey Hatch at
(904)256-1648 to schedule a conference.
2. Construction activity authorized by this permit shall not commence until after the time
period provided in the public notice for the public to exercise any rights they may have
under Chapter 120, Florida Statutes, has expired, or if a hearing is requested, disposition of
the hearing request has been made.
3. Prior to commencement of construction activity authorized by this permit, a temporary
construction fence shall be erected along the perimeter of the permitted activity. The fence
shall remain in place until the construction authorized by this permit is complete. The
optimum siting of the construction fence shall be determined during the preconstruction
conference by the staff representative of the Department so as to provide maximum
protection to the existing native vegetation and dune features located on the site.
4. All rubble, debris, wood, and damaged or broken concrete on the site resulting from this
demolition and construction shall be removed and relocated landward of the coastal
construction control line.
5. All excavated sand material shall be maintained on site seaward of the coastal construction
control line.
6. All imported fill material shall be obtained from a source landward of the control line. All
fill matPriat placed seaward of the control line shall consist of sand that is similar to the
PERMITTEE: Encore Beach Properties, LLC
PERMIT NUMBER: DU-450
PAGE 5
native sand of the placement site in both coloration and grain size and be free of
construction debris,metal, vegetation, organic soils, rocks, clay, or other foreign matter. A
sample of the sand shall be provided to the staff representative of the Department during the
preconstruction conference.
7. No stormwater, pool or other discharges shall be directed seaward or onto adjacent
properties.
8. All plantings shall conform to the approved landscape plan. Plantings shall not include
invasive nuisance plant species such as listed in the Florida Exotic Pest Plant Council's List
of Invasive Species, Categories I and H. (A copy of this list is available on the Internet at
www.fleymorg)
9. All lighting shall be shielded, installed and maintained as depicted in the approved lighting
schematic and cut sheets. No additional lighting is authorized. Pool light illumination shall
be provided by amber or red LED IamDs.
Approved plans are incorporated into this permit by reference.
Done and ordered this tJ day of � ' t 2013,in Tallahassee,Florida.
Attachment: General Permit Conditions
FILING AND ACKNOWLEDGEMENT State of Florida
FILED, on this date,pursuant to 5120.52 Department of Environmental Protection
Florida Statutes,with the designated
Department Cleric,receipt of which is
hereby acknowledged.
` ' Fn, ettstein,Environmental Consultant
Deputy Clerk, Date Coastal Construction Control Line Program
Division of Water Resource Management
<� Y
Doc #! 2013121206, OR BK 16368 Page 48, Number Pages: 2, Recorded 05/14/2013
at 03:28 PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $18.50
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FILE COPS
Prepared by and return to:
G.Alan Howard,Esq. -
Milam Howard Nicandri Dees&Gillam,P.A.
{
14 East Bay Street '
Jacksonville,Florida 32202
QUIT CLAIM DEED
THIS QUIT CLAIM DEED is made as of the 81h day of May, 2013. by and
between ENCORE BEACH PROPERTIES, LLC, a Florida limited liability company,
having a mailing address of 14 East Bay Street, Jacksonville, Florida 32202 ("Grantor")
and THOMAS F. PETWAY, IV and LINDSEY PETWAY,husband and wife,having a
mailing address of 1911 Beach Avenue,Atlantic Beach,Florida 32233("Grantees").
i
4
{
WITNESSETH:
(Whenever used herein the terms "grantor" and "grantee" include all the parties to this
instrument and the heirs, legal representatives, and assigns of individuals, and the
successors and assigns of corporations, trusts and trustees)
Witnesseth, that said grantor, for and in consideration of the sum TEN AND NO/100
DOLLARS ($10.00) and other good and valuable consideration to said grantor in hand
paid by said grantees,the receipt whereof is hereby acknowledged, does hereby remise,
release, and quitclaim to the said grantees, and grantees' heirs and assigns forever, all
the right, title, interest, claim and demand which grantor has in and to the following
described land,situate,lying and being in Duval County,Florida to-wit:
The North Fifteen (15) feet of Lot Eight(8),all of Lots Nine(9) and Ten
(10), and the South Twenty (20) feet of Lot Eleven(11),Block Sixty-two
(62), Atlantic Beach, according to plat recorded in Plat Book 6, page 1,
public records of Duval County,Florida.
TO HAVE AND TO HOLD the same together with all and singular the appurtenances
thereunto belonging or in anywise appertaining, and all the estate, right, title, interest,
lien, equity and claim whatsoever of Grantor, either in law or in equity, to the only
proper use,benefit and behoof of Grantees forever.
No documentary stamp taxes are due and payable in connection with the recording of this
conveyance from a grantor single member limited liability 2 Flonny to the grantees Statutes;Rule which
are the sole members of grantor, pursuant to Section 2
11-2(May 13,2011).
OR BK 16368 PAGE 49
IN WITNESS WHEREOF,the said Grantor has executed this instrument as of
the day and year first above written.
WITNESSES: ENCO 7ACH PR TIES,LLC
By:
Print me:
4"d. FiNANs Thomas F.Petway, ,Manager
Print Name:
STATE OF FLORIDA
COUNTY OF DWAL
The foregoing instrument was acknowledged before me this 8 day of May, 2013,
by Thomas F.Petway, N, as Manager for Encore Beach Properties,LLC,who is ers all
known to me or produced as identification.
[seal]
No"Fab-1"41ftw
4te Name:
kvC�•E*mil31.W? Notary Public,State of Florida
.«� • BandedlM�1IM11�IMItIMtIrAMlI Commission No.
My Commission Expires:
2
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Note opera"l units-maiumum'continualopera"Pressure of
t= ' Based an NSF recommended flow rate for wmsrier�l at-375 GPM Per y�o� imum operating water
50 P51_Pool/spa(battled app0m
t v squarefoot. temperature rmternal hiterl 1WF lb0"Cl-
j Note:No backwash valve required- eta
PLM SERIES FILTERS
ring Information
Product Description Carton kAlt,(Lbs.)
27002-01005 100 Sq_Ft.Replacement Module for PLM100 11 '
27002-01255 125 Sq.Ft.Replacement Module for PLM125 11.5 '
27002-01505 150 Sq.Ft_Replacement Module for PLM150 12
27002-0175S 175 Sq_Ft.Replacement Module for PLM175 13
27002-02005 200 Sq.Ft.Replacement Module for PLM200 14
27002-03005 300 Sq.Ft.Replacement Module for PLM 300 19
U78-820P 2 in.x 1-1/2 in.Pipe Reducer Bushing 8 oz.
27001-01305 Spring Check Valve 1
Dimensions and Performance
PLM300 / NSF
IM
o listed
e
vn
ossa e�
r,rn rrr
KIT 2Z
sur � O trr
i r•trt � i
tsoe�
two
All dimensions shown in inches.
20 , , —
a 18
Z 16 - -
a14
cr12
C _ ;
� 10
! ! /PLM100.
CO) 6 PLM125,
tPLM150,
M 4 - PLM175,
2 -- —PLM200,
PLM300
0 10 20 40 60 80 100120 140 160
FLOW RATE IN GALLONS PER MINUTE
See page 359 for replacement parts.
rsir City of Atlantic Beach, APPLICATION NUMBER
Building Department U (To be assigned by the Building Department.)
t' 800 Seminole Road
Atlantic Beach, Florida 32233-5445 Sp
Phone(904)247-5826 Fax(904)247-5845 920 13
�o t� E-mail: building-dept@coab.us Date routed: O
City web-site: http:/Avww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Al Ch jl/� 2MMMent review required Yes No
Applicant: j'Q !� d0 L$ nnn &Zonin
I'vemints r
Project: /f!t ; aa �- Pubtic WOW
tilitie�:
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
APPLICATION STATUS
Reviewing Department First Review: OApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: ( Date:
TREE ADMIN. Second Review-
. DApproved as revised. ❑Denied.
P W KS Comments:
tk
PUBL UTILITI S
PUB IC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ElApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
stir City of Atlantic Beach APPLICATION NUMBER
Building Department (ro be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233.5445
Phone(904)247-5826 - Fax(904)247-5845
r,`ill E-mail: building-dept@coab.us Date routed:
City web-site: http:Uwww.coab_us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Al 0/7 Qgpar#nent review required Yes No
B
Applicant: _OP 6 W -h d0 S nrnng &Zonin
tfe mtnls or
Project: CLQ �oo L- Public Works
tilitie
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By i
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
APPLI TION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
=BUILDING
PLANNING &ZONING Reviewed by: 0 Date: -d 3-/3
TREE ADMIN. Second Review: [-]Approved as revised. ❑D ied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
20
City of Atlantic BeachAPPLICATION NUMBER
Building Department i
(To be assigned by the Binding Department.)
i' 800 Seminole Road
Atlantic Beach, Florida 32233-5445 ,__
Phone(904)247-5826 Fax(904)247-584 r
E-mail: building-dept@coab.us '9 2413 Date routed:
City web-site: httpa/www.coab.us
APPLICATION REVIEW A PZACKING FORM
Property Address: 45�s- CA ent review required Yes No
/�
Applicant: �( j'0 [V �-, d4 L S nning &Zonin 1
lie mints Vak o r
Project: Public Works
tilitie�_
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments: G✓
BUILDING
PLANNING &ZONING Reviewed by: Date: 6
TREE ADMIN. Second Review-
DApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
Building Department (ro be assigned by the Building Departrnent.)
i' 800 Seminole Road /
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Date
routed: 'tL
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: a a ch �t Qgpaf#nent review required Yes No
B
Applicant: !"0 [,J 7h do S nn g &Zonin
1ree Adminisff5tor
Project: JQo Pubt'ic Works`)
tilitie5_�'
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
APPLICATION STATUS
Reviewing Department First Review: QApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by Date: D
TREE ADMIN. Second Review: QApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
`S f CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
V -nowv" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-204
Job Type: ELECTRIC ONLY
Description: SWIMMING POOL ELECTRIC
Estimated Value:
Issue Date: 1/27/2015
Expiration Date: 7/26/2015
PROPERTY ADDRESS:
Address: 1565 BEACH AVE
RE Number: 170312-0000
PROPERTY OWNER:
Name: PETWAY IV, THOMAS F & LINDSEY,
Address: 1911 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: DAVID PRUETTES ELECTRICAL SVC.
Address: 331 -8 P PARKRIDGE AVE QA DAVID THOMAS PRUETTE
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Swimming Pools $40.00
Trade Permit Base Fee $55.00
Total Payments: $99.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 CJ - GI��GC__20
Ph(9004),247-5826 Fax (904)247-5845 2 2(�
JOB ADDRESS: J�r�S ` �% 1 TTV L PERMIT# I✓"J I�7
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main)Service
u0-100 amps 101-150amps 151-200amps ❑ amps #of Meters
Commercial(Main)Service
❑0-100 amps 101-150amps ❑151-200amps amps LJCT Service amps
Conductor Type Size
I-
-Multi-Family(Main)Service
❑0-100 amps ,101-150amps ❑151-200amps El amps #of Unit Meters
Temporary Pole ❑ amps
SERVICE UPGRADE amps i�=rCT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps t�150amps 200amps amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-I 00amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-l 00amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHE LECTRICAL PROJECTS
wimming Pool i Sign C',Smoke Detectors_Qty ❑Transformers KVA ;Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can Safety Inspection Ci Panel Change ❑OH to UG
Other:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name ;- - _ S Phone Number
Electrical Company V;d PrLA'e�S Office Phone 027d-_769-`�k'-SFaxaQa-_7�1�
Co. Address: •7• <�g � d � City�� I aHe_ State -Zip 3W�
License Holder(Print): ertification/Registration# ELWOZ-f)2_.3
Notarized Signature of License Holder
orn and subscribed before m this��S day of
�•.=:;a= KAREN EWING --- 20
•'= MY COMMISSION f EE174
EXPIRES 219'201g. gnature of Notary Public
7i• •• F�011�1r.Ml� y