1250 Selva Marina Cir 2013 Pool CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003759 Date 12/13/13
Property Address . . . . . . 1250 SELVA MARINA CIR
Application type description SWIMMING POOL/SPA
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9900
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Application desc
new pool
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
PHILLIPS, MICHAEL D OWNER
1250 SELVA MARINA CRL.
ATLANTIC BEACH FL 322335526
----------------------------------------------------------------------------
Permit . . . . . . SWIMMING POOL
Additional desc . .
Permit Fee . . . . 100 . 00 Plan Check Fee 50 . 00
Issue Date . . . . Valuation . . . . 9900
Expiration Date . . 6/11/14
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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 .
Per conversation with Mr. Phillips, pool will be
constructed 10-feet or more from the existing sewer main in
the existing easement .
POOL - Wellpoint (if used) must discharge into vegetated
area 10 ' minimum from street or drainage feature (swale,
structure or lagoon) .
Full right-of-way restoration, including sod, is required.
Roll off container company must be on City approved list
and container cannot be placed on City Right-of-Way.
(Approved: Advanced Disposal, Realco, Shappelle ' s and Waste
Management . )
Full erosion control measures must be installed and
approved prior to beginning any earth disturbing
activities . Contact Public Works (247-5834) for Erosion
and Sediment Control Inspection prior to start of
construction.
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
REQUIRED INSPECTIONS :
*POOL STEEL
*ELECTRICAL GROUNDING AND BONDING
PERMIT IS*? INMD 6RMMA(4WMAl RE N1R TffLMT-F®R AfiTAN4*)BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
r�Jjilt
Page 2
Application Number . . . . . 13-00003759 Date 12/13/13
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Special Notes and Comments
SWIMMING POOL SAFETY INSPECTION REQUIRED
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
DEV REVIEW-SINGLE & 2-FAM 25 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 100 . 00 100 . 00 . 00 . 00
Plan Check Total 50 . 00 50 . 00 . 00 . 00
Other Fee Total 29 . 00 29 . 00 . 00 . 00
Grand Total 179 . 00 179 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH N 0 Vj013
F ILE COPY 800 Seminole Road, Atlantic Beach, FL 32233
- _ x Office (904)247-5826 Fax (904) 247-5845 By
Job Address: I 2_S Y) Se_�v.w- Permit Number: / 3" 3 7 S9
Legal Description Parcel #
Floor Area of Sq.Ft. SqTt
Valuation of Work S q, 9 OCA Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval orm
Describe in detail the type of work to be performed: w/7'"—Ar,�- Q 0
Property Owner Information:
Name:_Kt1C,91►�-6�w•Q� `�` S4ddress: IZS�6
City pr. r3 , State F l,Zip ;37,,'Z73 Phone Q e4 344-'La°Y9
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: C-,14 M%C�!t Qualifying Agent:
Address: City State Zip
Office Phone Job Site/Contact Number Fax-#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
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 well be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void tf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod 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 this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type o1 work will be complied with whether speci ted herein.pr not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of arty?erfederal,state, or 1 l e lati g construction or the performance ofconstruction.
Signature ofSignature of Contractor
Print Name/� J(���
........................................J'............................................. Print Name ........................................................................................................................................
Bef in Before me
thi Da of A✓ 200 this Day of .20
s nM
ubl c �b0 Not Public
:t? wcommlbbluri
7EXPIRES:February 14,2014 �'
Rf 5 d Thru Notary Public Underwriters
Revised 01.26.10
44
CITY OF ATLANTIC BEACH
OWNER / BUILDER AFFIDAVIT F I L E C Q P
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT
LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT
HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
111. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
Zs'y Set✓ t�a�N ►� �� 404 2999
ADDRESS PHONE NUMBER
If 14, f
PRINT NAME e
2
(GNAT DATE
-X
Before me thisday of 1` 20� n the county of
Duval,State of Florida,has personally appeared herin by himself/herself and affirms that
all statements and declarations are true and/accurate. + ♦\,
Notary Public at Large,State of ` v ,County of Dy,y
ersonally Known 'y
DProducedIdentification- a!'.�e$, ;- JENNIFER WALKER
MY COMMISSION#FF 011480
a EXPIRES:April 24,2017
Bonded Thru Notary Public underwriters
Notary Signatu
F:BLDG/Owns-Builder davit;REVISED: 4/16/2009
MAP SHOWING A SURVEY OF
ALL OF LOT 30 AND THAT PART OF LOT 31, LYING NORTHERLY OF A STRAIGHT LINE RUNNING NORTHWESTERLY FROM
A POINT IN THE EAST (FRONT) LINE OF SAID LOT 31 DISTANT 35 FEET SOUTHERLY ALONG SAID EAST LINE FROM THE
NEAREST CORNER OF SAID LOT 30 TO A POINT IN THE WESTERLY (REAR) LINE OF SAID LOT 31 DISTANT 61.73 FEET
SOUTHWESTERLY ALONG SAID WESTERLY LINE FROM THE NEAREST CORNER OF SAID LOT 30, ALL IN BLOCK 1, SELVA
MARINA UNIT NO. 1, AS RECORDED IN PLAT BOOK 23, PAGE 4, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY,
FLORIDA R.AQ,-,THOSEL,ANDS,MDESGRIBED�N OFFICIAL RECORDS BOOK 13331, PAGE 1058.
4 r
LOT
f: as , i 0 13
HOLE OPY
\Fye N83'5FIELD 1 I FOUND 1/2"
NOTES: a" zra"iYF.i•: F 48.13 I „ I IRON PIPE
1) THIS ISA BOUNDARY SURVEY. Nom IRON PIPE FOUND 1E `� 42'00 E "NO CAP"
�
2) NOT ALL IMPROVEMENTS LOCATED BY THIS SURVEY. NO CAP" 0,1' o
3) BEARINGS BASED ON THE EASTERLY LINE OF LOT 30, \��0� 4S ''tt I y O) I
BEING S06'18'00"E, AS PER PLAT. D 0-)cn
4) BUILDING RESTRICTION LINES PER PLAT 1.hl Qi > I
I m O
O0:
LOT s O I
12 I m
z r1
LOT
29
, m
•� x,t I
\�� 15'
,os QP° 74.9' 15'
O FOUND
FENCE POST P J O I
II ON CORNER X9 O
1,.tt.4 X98,1.2 308, I/ 00
Q
�\ 4X99
J ^ 1,� X98 CLEANOUT
LOT � 204A / ��.'.~;.. FOUND/ 1/2"
�° O O 0`V o2��V�v 4� 0O •: .._. IRON PIPE°b Q QP Q 2 h, .':`_ O� "NO CAP"
109 �,/
8 QQ CLEANOUT Q�ht " �! LOT
oa / 30 �(j CHORD BEARING=
S38'42'00"W
•40 �4610., CHORD DIST=63.64'
�.:.:•.:
^F ,�U jzFOUND 538°54'46" `,N 63.60'('IELD)
�� - a,/, ti °IRON REBAR RADIUS=45.00
\� "5488" LENGTH=70.69'
�9 p' 53.8 O _ W
s-
FOUND
\ ,AIL w
NNO ID" 73.1 ' /
0 O )
JI _ 00 N O
a
LOT / o= N� wI Qf
�Lo 0 0
10 04 6�3� „ a PART OF 0 a
/^ oo�
'34' 10 1w 85,( 45.76� , LOt (/)
Ov�o FIELD) o Q
�(,b z
PART OF ��FouND 1/2" ?
N LOT IRON PIPE
/ w "NO CAP"
/ 31 10 =
/ I
CD� Q
CD I L W
- - N 87'35'04_" W 175.81_'
Q
LOT 32 m
a \ Q
>
THE PROPERTY SHOWN HEREON APPEARS --�
TO LIE IN FLOOD ZONE 'Y' AS WELL AS w
CAN BE DETERMINED FROM THE FLOOD U)
INSURANCE RATE MAP COMMUNITY PANEL
NUMBER 120075 0001 D, REVISED APRIL 17,
1989 FOR THE CITY OF ATLANTIC BEACH,
DUVAL COUNTY, FLORIDA. THIS SURVEY WAS MADE FOR THE BENEFIT OF
MIKE PHILLIPS..fN ;
BOUNDARY SURVEY W/ IMPROVEMENTS
JUNE 01, 2007 y1
MAXINE CLAIRE CLARKE, P.S.M.
"NOT VALID WITHOUT THE SIGNATURE AND THE FLORIDA LIC. SURVEYOR and MAPPER No. LS 3117
ORIGINAL RAISED SEAL A FLORIDA LICENSED
SURVEYOR AND MAPPER.."" FLORIDA LIC. SURVEYING & MAPPING BUSINESS No. LB 3672
CHECKED BY: BOATWRIGHT LAND SURVEYORS, INC. DATE: MAY-22-2007
DRAWN BY: CRT 1500 ROBERTS DRIVE SHEET�OF 1
FILE #: 2007-661 JACKSONVILLE BEACH, FLORIDA 241-8550
RFF• 7nn7—and
POOL
DEC 12
FILE COPY
,3o
u NA uC L�, .
FILE COPS ,
ANSUASP-7 2006 Specifies three methods for determining the maximum system-flow rate.Thefollowing
simplified TDH calculation is one of the methods specified.
Simplified Total Dynamic Head (TDH) Calculation Worksheet
Determine Maximum System Flow Rate: Minimum Flow Rate Required: 35 gpm per skimmer
1. Calculate Pool Volume: J�v _x -�� x 7.48 (gal./cubic foot) _/ -S 30
(Surface Area) (Average D th) (vol a in gallons)
2. Determine preferred Turnover Time in hours: x 60 (minutes/ hour)_ -�Q G
(Hours) (Turnover in Minutes)
3. Determine Max Flow Rate: Z3 I 3 �' _ —+ - y
(Volume in gallons)(Turnover Minutes) (Pool Flow Rate) (Feature Flow Rate) (System Flow Rate)
4. Spa Jets: ----rte -- -gpm per jet= -- flow rate.
(Number of jets) (Jet Row) (Total Jet flow Rate)
(For single pump pool/spa combo, use the higher of No. 3 or No. 4 in the following calculations for the pool& spa)
Determine Pipe Sizes:
Branch Piping to be a ,!� inch to keep velocity @ 6 fps max. at ]17 gpm Maximum System Flow Rate.
Trunk Piping to be -7— _inch to keep velocity @ 8 fps max. at, u 3 gpm Maximum System Flow Rate.
Return Piping to be inch to keep velocity @10 fps max. at Z gpm Maximum System Flow Rate.
Determine Simplified TDH:
1. Distance from pool to pump in feet: 3 C)
2. Friction loss (in suction pipe) in 2 inch pipe per 1 ft. @ gpm = ,_*from pipe flow/friction loss chart)
3. Friction loss (in return pipe) in Z- inch pipe per 1 ft. @ Jo 3gpm =�{from pipe flow/friction loss chart)
4. Length of suction pipe.x ft. of head/1 ft of pipe C,9= TDH suction pipe
5. Length of return pipe 0 x ft. of head/1 ft of pipe 1 l3 =TDH return pipe 1
TDH in Piping: .
Filter loss in TDH (from filter data sheet): _
Heater loss in TDH (from heater data sheet): -
Total all other loss: si .
Total Simplified TDH: �Z
Selected Puma and Main Drain Cover:
Z STA-
Pump selection ,r, �-u'.c L�'? using pump curve for Simplified TDH & System Flow Rate
(Pum model and size in Horsepower) 1 S. k. "3 C'
Main Drain Cover e- 4�Ire-r S (System Flow Rate must not exceed approved cover flow rate)
(Make and Model)
Notes: Minimum system flow based on minimum flow per skimmer of 35 gpm.
Determine the Number and TM of Required In-Floor.Suction Outlets:
�7--Check all that apply.
®
T-0"0 2 'Z- suction outlets @ 10'3 gpm max. flow (see note 2)
® ® p 3 suction outlets @ gpm max. flow(
see note 3)
---------� Aquastar Channel Drain @ 316 gpm max. flow rate
o A & A Channel Drain @ 217 gpm w/ 2 port & 278 gpm w/ 3 ports (see note 4)
TDH Calculation Options Total Head In Feet Conversion Chart
For each pump Inches Mercury acuum Gauge
0 2 4 6 8 10 12 14 16 18
(-' Check one 0 0.0 2.3 4.5 6.8 9.0 11.3 13.6 15.8 18.1 20.3
Simplified Total Dynamic Head (STDH) 1 2.3 4.6 5.8 9.1 11.4 13.6 15.9 18.1 20.4 22.7
Complete STDH Worksheet-Fill in all 2 4.6 6.9 6.1 11.4 13.7 15.9 18.2 20.4 22.7 25.0
blanks 3 6.9 9.2 11.5 13.7 16.0 18.2 20.5 22.8 25.0 27.3
4 9.2 11.5 13.8 16.0 18.3 20.5 22.8 1 25.1 27.3 29.6
Total Dynamic Head (TDH) 5 11.5 13.8 16.1 18.3 20.6 22.8 25.1 27.4 29.6 31.9
Complete Program or other calcs. Fill 6 13.9 16.1 18.4 20.6 22.9 25.2 27.4 29.7 31.9 34.2
in required blanks on worksheet& 7 16.2 18,4 20.7 23.0 25.2 27.5 29.7 32.0 34.3 36.5
attached calculations.
8 18.5 20.7 23.0 25.3 27.5 29.8 32.0 34.4 36.6 38.8
9 20.8 23.1 25.3 27.6 29.8 32.1 34.3 36.6 38.9 41.1
10 23.1 25.4 27.6 29.9 32.1 34.4 36.7 38.9 41.2 43.4
11 25.4 27.7 29.9 32.2 34.5 36.7 39.0 41.2 43.5 45.8
12 27.7 30.0 32.2 34.5 36.8 39.0 41.3 43.5 45.8 48.1
13 30.0 32.3 34.5 36.8 39.1 41.3 43.6 45.9 48.1 50.4
Notes: 14 32.3 34.6 36.9 39.1 41.4 43.6 45.9 48.2 50.4 52.7
1. If a variable speed pump is used, use the 15 34.6 36.9 39.2 41.4 43.7 45.9 48.2 50.5 52.7 55.0
16 37.0 39.2 41.5 43.7 46.0 48.3 50.5 52.8 55.0 57.3
maximum pump flow in calculations. 17 39.3 41.5 43.8 46.1 48.3 50.6 52.8 55.1 57.4 59.6
2. For side wall drains, use appropriate side 18 41.6 43.8 46.1 48.4 50.6 52.9 55.1 57.4 59.7 61.9
wall drain flow as published by the 19 43.9 46.2 48.4 50.7 52.9 55.2 57.4 59.7 62.0 64.2
20 46.2 48.5 50.7 53.0 55.2 57.5 59.8 62.0 64.3 66.5
manufacturer. 21 48.5 50.8 53.0 55.3 57.6 59.8 62.1 64.3 66.6 58.9
3. Insert the manufacturer's name and 22 50.8 53.1 55.3 57.6 59.9 62.1 64.4 66.6 68.9 71.2
approved maximum flow. 23 53.1 55.4 57.7 59.9 62.2 64.4 66.7 69.0 71.2 73.5
24 55.4 57.7 60.0 62.5 64.5 66.7 69.0 71.3 73.5 75.8
4. See installation instructions for number of 25 57.8 60.0 62.3 64.5 66.8 69.1 71.3 73.6 75.8 78.0
ports to be used. 26 60.1 62.3 64.6 66.8 69.1 71.4 73.6 75.9 78.1 80.4
5. In-floor suction outlet cover/grate must 27 62.4 64.6 66.9 69.2 71.4 73.7 75.9 78.2 90.5 82.7
28 64.7 66.9 69.2 71.5 73.7 76.0 78.2 80.5 82.8 85.0
conform to most recent edition of 29 67.0 69.3 71.5 73.8 76.0 78.3 80.5 82.8 85.1 87.3
ASME/ANSI Al 12.12.8 and be embossed 30 169.3 1 71.6 73.8 76.1 78.3 80.6 82.9 85.1 87.4 89.6
with that edition approval. 31 71.6 73.9 76.1 78.4 80.7 82.9 85.2 87.4 89.7 92.0
6. Pump&Fitter make, model and location can 32 73.9 76.2 78.4 80.7 83.1 85.2 87.5 89.7 92.0 94.3
33 76.2 78.5 80.7 83.0 85.3 87.5 89.8 92.0 94.3 96.6
not change without submitting revised plans 34 78.5 80.8 83.1 85.3 87.6 89.8 92.1 94.4 96.6 98.9
and TDH worksheet. 1 351 80.9 83.1 L 85.4 i 87.6 r89.91 92.2 94.4 96.7 98.9 101.2
Flow and Friction Loss Per Foot Swimming Pool Specification for:
Schedule 40 PVC Pipe
Velocity-Feet Per Second
Pipe bibs 8 fbs 10 fbs
Size
1. 16 gpm 0.25' 21 gpm 0.66' 26 gpm 0.94'
1.5" 37 gpm 0.16' 50 gpm 0.26' 62 gpm 0.48'
2° 62 gpm 0.15' 82 gpm 0.25' 103 gpm 0.40' Job Address:/
2.5" 88 gpm 0.09' 117 gpm 0.15' 146 gpm 0.23'
3- 138 gpm 0.09' 181 gpm 0.14' 227 gpm 0.23'
4" 234 gpm 0.06' 313 gpm 0.10' 392 gpm 0.15' Permit#
6" 534 gpm 0.04' 712 gpm 0.04' 890 gpm 0.10'
Quiet Efficie M., Durable.
The WhisperRo®pump delivers maximum circulation Performance Curves
efficiency at the lowest operating cost and long,trouble-
free life with minimal maintenance. Our legendary 35 11 "M
3 HP HWI Speed
hydraulic design has been refined over 40 years for 30 100 --2 HP Speed
i� H'
Speed
superior performance. No wonder more than 2 million r AHP High�
Pentair pumps have been selected by pool professionals. Igo
• Unique Rtwld l'diffuser and high-efficiency 15
impeller maximize water flow and energy efficiency 4o ''7
while minimizing turbulence and noise. 10 \
p
* Energy-efficient motor with commercial-grade frame, 5 \
rustproof stainless steel shaft,and permanently ° m60 9D 100 120 140 160
lubricated,sealed bearings for long life. us.G1 pw„,ex
m Available in single-speed and two-speed models. s to c� �n. p2 h«r 3035
Ideal for pool and spa combinations and for Available from:
operating in-floor cleaning systems.
o One-year limited warranty,See warranty for details.
PW*A■
Pool Products'
Because reliability matters most
www.pentairpool.com
Phone!800-831-7133
pl.rrnps filter-s"heaters%heat pumps i aultomation lighting 'deaners i sanitizer-s r water•features r maintenance products
ero9 Part#Pl-222 Q M.� v'
®2009 Pentai YvOlAu Pool and Sm Inc AN 6oMc rwcw,..4
SECTION IV. TECHNICAL DATA
A. Filter Pressure Loss Chart B. Flow Rate Table
PRESSURE LOSS vs FLOW Reddentiaf Commercial
MWdmurn Cartridge Maximum CarMdge
Flow Rates
Flow Rates
' product a saw R am ep11 6 how a hour GPM calf a hotr a hour
160314 5o 50 3,000 18,000 24.000 19 1,140 8810 9,120
t ie0m5 75 75 4,500 27,000 36,000 28 1,680 10,080 13.440
100316 100 100 6,000 36,000 48000 38 2,280 13,680 18,240
a 1009(7 150 150 91000 54,000 72,000 56 13,380 1 20,160 26UMW
t 180.9f 8 200 150 9,000 54.000 72000 75 4,500 27,000 36000
1 (1) Onc GPM per sq.fL shown,+�mcaded flow raft for rcsidential is.5 GPM per sq.4tflft.
(2) Com+mrcul How'r>Me is a maximum of.375 GPM per sq.ft.of filter area.
o ro so �m se
so WIT: Actual system How will
depend on phunbing six and other system components.
2
C. Replacement Parts 1
Item Part Number Deemoon
3, 4
1 98209800 High Flow'manual air relief valve
2 190058 Pressure Gauge
3 178553 Lid,50, 100 sq.ft.filter
4 178561 Lid,75,150,200 sq.ft.filter
5 59052900 Locking Ring asst'.
6 87300400 Body 0-ring 5
7 59016200 Air Bleed Sods Kit
8 59053500 Center Core,50 sq.ft.filter 6
9 59053600 Center Core,75 sq.ft filter
10 59053700 Center Core, 100 sq.ft.(4ter -- - 711 59053800 Center Core, 150,200 sq.ft.filter ----- r�r
12 R173213 Cartridge Element,50 sq.ft.filter 8, 9, 10, 11
13 8173214 Cartridge Element,75 sq.ft.fitter •
14 R173215 Cartridge Element, 100 sq.ft.filter ;; ;
15 R173216 Caftlge Element, 150 sq.fL fitter 12, 13, 14, 15, 16
16 R173217 Cartridge Element,200 sq.ft.fifter
17 178562 Bottom,50 sq.ft.filter
18 178554 Bottom,75 sq.ft.filter 17, 18, 19, 20
19 178563 Bottom, 100 sq.ft.(iter
20 178560 Bottom, 150,200 sq.fL fifter 21, 22
21 86202000 Drain Cap Assy.
22 51005000 Drain Cap Gasket 25
23 39104500 Union Nut"C"Clip 26
24 98212200 Union Nut
25 071426 Union 0-ring FTO Q '
26 79304600 Body,Swivel L-i-VI
24
2
Rev.D 6-26-09 7 P/N 178556
PENTAIR
STARGUARD MAIN DRAINS
'`: _•` '•• StarGuard drains comply with provisions Pentair®StarGuard drains have an
` ..`�:`�- • • •- of the ANSI/APSP 16-2011 standard as industry leading 15.35 square inches of
• .�•� • �•i•�. required by the Virginia Graeme Baker open area for water flow. If you are in an
•:.��; •.��:;• Pool& Spa Safety Act. area where water velocity through the
� `•`=�:`4« �••:'! grate is limited to 1.5 feet/second, the
rs `�*��« +��`•� High quality StarGuard drains are StarGuard covers allow flow rates up to
••:.* �'�- available in white, black, gray, and dark 72 GPM. Other leading competitors
gray as well as a variety of configurations have open areas under 9 square inches
to fit any residential inground pool or that would limit flow to under 42 GPM.
spa installation. Review the specifications
to find the right StarGuard drain model
for your application.
Part Flow Rate Flow Rate Open Area
Description5 00 101 8 8"StarGuard"overwith Long Piro-White 44
500100 8"StarGuard Cover with Long Ring-Black (Single)
0zeoy
500101 8"StarGuard Cover with Long Ring-Dark Gray (Single)
500102 8"StarGuard Cover with Long Ring-Gray (Single;
500140 8"StarGuard Cover with Long Ring-White (2 Pack)
J
500141 8"StarGuard Cover with Long Ring-Black (2 Pack)
500142 8"StarGuard Cover with Long Ring-Dark Gray (2 Pack)
500143 8"StarGuard Cover with Long Ring-Gray (2 Pack)
Part Flow Rate Flow Rate Open Area
DescriptionNumber Walt(GPM) Isq.in.)
15.35
500104 8"StarGuard Cover with Short Ring-Black (Single)
o7�
500105 8"StarGuard Cover with Short Ring-Dark Gray (Single) 3
500106 8"StarGuard Cover with Short Ring-Gray (Single) 4MIIp�IpN� '
500144 8"StarGuard Cover with Short Ring-White (2 Pack) J
500145 8"StarGuard Cover with Short Ring-Black (2 Pack)
500146 8"StarGuard Cover with Short Ring-Dark Gray (2 Pack]
500147 8"StarGuard Cover with Short Ring-Gray (2 Pack)
pentairpool.com
STARGUARU MAIN DRAINS
SAFETY TIPS Continued
Selecting Proper Drain Covers • Backup System Requirements—Suction piping for each pump
must be inspected and will be considered in compliance with the
Each pump will operate at a different flow rate depending on the federal taw if: 11 no submerged drains connect to the pump,or 2)
system and assigned jobs, i.e,filtering,heating,cleaning,spa jets, multiple drains or suction outlets are at least three(3)feet
waterfalls,etc.Once this is understood,the proper suction system apart,or 3)there is a single
part, drain.An unblockable
can be designed and installed. Here are some of the design issues drain includes a sump under the cover that is larger than 18
that must be considered. inches by 23 inches,or a channel type drain with a diagonal
• Maximum system flow. open area of at least 29 inches.
• Drain covers must be rated to handle the maximum system flow. Single-and two-drain systems that fail to meet the listed
requirements must be modified by adding: 11 Safety Vacuum
• Dual-drain and multiple-drain system branch piping must be Release System(SVRS), 2)Suction-Limiting Vent System,3) Gravity
sized to keep water velocity below b feet per second when Drainage System,41 Automatic Pump Shut-Off System,5) Drain
operating at maximum system flow. Branch piping is the suction Disablement, or 6)Other Systems determined by Consumer
pipe between drains, not the pipe leading back to the pump. Product Safety Commission to be equally effective.Another option
• The frame and sump under the drain cover or a field built sump is to split the single drain into a dual-drain system with at least 3
must be included or listed in the cover manufacturer's instructions. feet of separation using properly sized branch piping.
• Drain covers must be attached using the original manufacturer's Codes and Standards
hardware, including mounting frames,sumps,and fittings.
All public pools,spas and wading pools must comply with the
• Do not mix and match covers,frames,and sumps. Only install Virginia Graeme Baker Act. In addition,many state and local
covers on frames,sumps,or field-built sump designs that have governments may have more stringent requirements, codes and
been certified by a nationally recognized testing laboratory as standards which apply to residential and public pools,spas and
being compatible with that specific drain cover. wading pools.These may include the ANSI/APSP 7 Suction
Entrapment Avoidance Standard,the International Code Council's
The Virginia Graeme Baker Pool&Spa Safety Act building codes(which adopt the International Building Code and
of 2007—Summary International Residential Code)and other codes and standards. Be
This federal law was enacted to help prevent suction entrapment sure to consult your state and local building and health codes and
injuries and became effective December 19,2008.The requirements standards for more information.
for public swimming pools,spas,and wading pools are summarized FOR MORE INFORMATION ABOUT'
below and must be met before these facilities can be operated.
• Drain Cover Requirements—New drain covers,fasteners, • Pentair safety and compliance products,
frames and sumps certified to ASME/ANSI Al 12.19.8-2007 visit:www.pentairpooL.com.
must be installed. • Virginia Graeme Baker Pool and Spa Safety Act,
visit:www.cpsc.gov.
• ICC codes,visit:www.iccsafe.org.
• ANSI/APSP-7 Suction Entrapment Avoidance Standard,
visit:www.apsp.org.
4111, PENTAIR
1620 HAWKINS AVE,SANFORD,NC 27330 800.831.7133 WWW.PENTAIRPOOL.COM
All Pentair trademarks and logos are owned by Pentair,Inc.StarGuard'and IntettP0 are registered trademarks of Pentair Water Pool and Spa,Inc.and/or its affiliated
companies in the United States and/or other countries.Because we are continuously improving our products and services,Pentair reserves the right to change specifications
without prior notice.Pentair is an equal opportunity employer.
6/13 Part If P1-092 02013 Pentair Aquatic Systems.Att rights reserved.
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City of Atlantic Beach � .� APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 /c�-7
E-mail: building-dept@coab.us Date routed.-
City
outed:City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /2 S'd Jr_kd- ZIAA. ��� Department review required Yes No
//1� uildin
Applicant: PLMping &Zoni
lftS
ree Administrator
Project: �DD Z_ _ Pu lic
Public Utilities
Public Safety
Fire Services
Review fee $ - Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
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:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
Comments:
Ar—
I
-
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [—]Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
sai� - ► City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building De artment.)
• 800 Seminole Road
Atlantic Beach, Florida 32233-5445
V Phone(904)247-5826 • Fax(904)247-5845 �7
jg• E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z �d if/Vol a�InGl DPning
ent review re uired Ye No
p yu
Applicant: U ��� �' &Zoni
reeministrator
Project: da tPublic
ic
Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
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
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: ❑Approved. E115enied.
(Circle one.) Comments: S •p..e �l a r► 12-o Vfek... c a vvr /t S Pe " I U T-¢e►�+
BUILDI G
PLANNING &ZONING Reviewed by: fr Date: r.2" -!3
TREE ADMIN. Second Review: Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:09
2 2
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
J1Jr,J City of Atlantic Beach APPLICATION NUMBER
a js r p� Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 .31/4
Phone(904)247-5826 • Fax(904)247-5845 ��
E-mail: building-dept@coab.us Date routed:
City web-site: http://wvfw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2 �� Jf_IV4. A4oel4A, ��� Department review required Yes No
uiIdin
Applicant: PlafHing & Zoni
ree Admim trator
Project: �DO Pu lic
Public Utilities
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. enied.
(Circle one.) Comments:
BUILDING
root M.4 6e- c% fm.M roar� ���� to n
LANNJDf &Z Reviewed bDate:
TREE ADMIN. Second Review: pproved as revised. ❑Denied. I
PUBLIC WORKS Comments: 1 �,,p� 10PT `0 )
PUBLIC UTILITIES 1
PUBLIC SAFETY Reviewed Date: [
FIRE SERVICES Third Review: []Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
`c t1 Building Department (To be assigned by the BuildingD2artment.)
800 Seminole Road l05 _
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
�ry �• E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z �� ��l✓� /�ll�ZI;IA ��� De artment review required Yes No
p y uildin
Applicant: Hing & Zon-irtj
ree ministrator
Project: TJ 6 Pu lic
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature Z —
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: [XApproved. ❑Denied.
(Circle one.) Comments:
BUILDING 'rTb—
PLANNING &ZONINGReviewed by
Date:
TREE ADMIN. Second Review: [—]Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
f CITY OF ATLANTIC BEACH
J N) 800 SEMINOLE ROAD
~� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000210 Date 2/12/14
Property Address . . . . . . 1250 SELVA MARINA CIR
Application type description MECHANICAL GAS PIPING
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
RUN GAS LINE TO POOL HEATER.
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
PHILLIPS, MICHAEL D AEI INTERNATIONAL CORP.
1250 SELVA MARINA CRL. 7709 ALTON AVE
ATLANTIC BEACH FL 322335526 JACKSONVILLE FL 32211
(904) 724-9771
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL GAS PIPE PERMIT
Additional desc . .
Permit Fee . . . . 65 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/11/14
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE MECH DCA SURCHARGE 2 . 00
STATE MECH DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 65 . 00 65 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 69 . 00 69 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-58226 Fax (904) 247-5845
.ia ADDRESS: l 5o Sel gra Ma-tloez (.l r PERMIT# -.
PROJECT VALUES ��sE:P'
W AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity _ Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating REQUIRED
Duct Systems: Total CFM _
EPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSATa ALLATION
Air Conditioning: Unit Quantity _ __ Tons Per Unit RF,QUIRED
Heat: Unit Quantity BTU's Per Unit _ Seer Rating------
Duct
ating__ __Duct Systems: Total CFM REQUIRED
RE PREVENTION
Fire Sprinkler System Quantity _ (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity _ (Requires 3 sets of plans)
Commercial Hoods Quantity — (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
1RE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
(las Piping Outlets Boilers BTU's
Elevators/Escalators
OTHER GAS PIPING Heat Exchanger —
Quantity of Outlets Pumps
9 Vented Wall Furnaces — _ Refrigerator Condenser BTU's
Neater Heaters Solar Collection Systems 20
Tanks (gallons) -
Wells
---I_t i _�
;,it becomes void if work does not commence within a sir month period or work is suspended or abandoned for six months.I hereby cert&that
ws and ordinances governing this work will be complied with w
ap?lication and know the same to be true and correct. All provisions of lahether spzc ifi
ot. The permit does not give authority to violate the provisions of arty other state or local law regulation constnrction or the performance of construc-60
Owners Name :
/ehoe l /�l�s_-- Phone Number
1c)•-�;?y ---- ---
Or D 116-/ 60J SLCS Office Phone?Z 11 1711Fax�?/�-3--35-0
.
Chanical Company lqE/ I2-�X
Address: _�'�0 9 /j j-� ----- City �� State � Zi.;?
State Certification/Regis
one tration#.�g�' '.___.._. . -
(:ens,:Holder(Print): g
�fcrrfzerl Signature of License IfoldP.a�� 4-�_ -- ----'----� '
Svvurtt and subscribed be ore ie this _ -�_-_._ S
of
-,� �r <
=--,� Notary Public State of FloridaSignature of Notary PUbllchanie Renee McGuireommisWn FF 033716
Nres OW112017
' 1r3
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
oil �•
Application Number . . . . . 13-00003759 Date 2/20/14
Property Address . . . . . . 1250 SELVA MARINA CIR
Application type description SWIMMING POOL/SPA
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9900
----------------------------------------------------------------------------
Application desc
new pool
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
PHILLIPS, MICHAEL D OWNER
1250 SELVA MARINA CRL.
ATLANTIC BEACH FL 322335526
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Sub Contractor . . DAVID PRUETTES ELECTRICAL SVC.
Permit Fee . . . . 95 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/19/14
----------------------------------------------------------------------------
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 .
Per conversation with Mr. Phillips, pool will be
constructed 10-feet or more from the existing sewer main in
the existing easement .
POOL - Wellpoint (if used) must discharge into vegetated
area 10 ' minimum from street or drainage feature (swale,
structure or lagoon) .
Full right-of-way restoration, including sod, is required.
Roll off container company must be on City approved list
and container cannot be placed on City Right-of-Way.
(Approved: Advanced Disposal, Realco, Shappelle' s and Waste
Management . )
Full erosion control measures must be installed and
approved prior to beginning any earth disturbing
activities . Contact Public Works (247-5834) for Erosion
and Sediment Control Inspection prior to start of
construction.
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
REQUIRED INSPECTIONS :
*POOL STEEL
PERMIT IS BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
N� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
rvJi31��
Page 2
Application Number
13-00003759 Date 2/20/14
----------------------------------------------------------------------------
Special Notes and Comments
*FINAL (PUMPS MUST BE RUNNING FOR FINAL)
SWIMMING POOL SAFETY INSPECTION REQUIRED
-----
00
Other Fees
_ STATE ELEC DCA SURCHARGE 2 •
STATE ELEC DBPR SURCHARGE 2 . 00
_ ________ -----
Fee summary Charged
Paid Credited
_ _ ----------
----------
----------
- . 00
Permit Fee Total 95 . 00 95 . 00 00 . 00
Plan Check Total • 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00
Grand Total
99 . 00 99 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 3
` PERMIT#
JOB ADDRESS: dsD
.
VALUE OF WORK S
E] Underground [�Underground up Pole
NEW SERVICE [3 Overhead amps #of Meters
Residential(Main)Service 151-200amp
�, s �-
0-100 amps 101-150amps - amps
Commercial(Main)Service cps CT Service
:j0-100 amps -101-150amps
,;151-200atnps
Conductor Type
Size
In Service cps #of Unit Meters
,Multi-Family(Ma' ) C�151-200amps ____--
u0-100 amps [_',101-150amps
CTemporary Pole
amps CT Service amps
SERVICE UPGRADE L_ —
RE
NEW FEEDER(ADDITIONS,ACCES 2OoSpTRUCTUan'ETC.)
-;CT Service_______amps
❑100 amps ❑l 50amps
ETC.
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS'ACCESSORY STRUCTURES,1-200amps
0-30amps -____.____31-100amps ---101-200amps
outlets/switches: __ _____31-I00amps ____--
Appliances: —0-30am61-1
___
A/C Circuits: 0-60amps# circuitsk`'�'
Heat Circuits:
Number of Lighting Outlets, Including Fixtures:
OTHER ECTRICAL PROJECTS '_Transformers KVA )Motors hP
wimming Pool Sign ❑Smoke Detectors Qty
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORD S
Qty volts/amps
pAIRS/MISCELLANEOUS .Safety Inspection Panel Change JOH to UG
Replace Burnt/Damaged Meter Can
U,',other:
period or work is suspended or abandoned for six months. I hereby certify that I have
All provisions of laws and ordinances governing this work will be complied with whether
permit becomes void if work does not commence within a six month
read this application and know the same to be true and coop the provisions of any other state or local law regulation construction or the performance of
specified or not. The permit does not give authority c�
construction. pPhone Number 2�'-oZ�� /
4 �i �� 5 a_ _'70-1 � Fax
Property Owners Name office Phone
� �Z Zi
Electrical Company CityC)D 0 l`-& State P =`
31_ Hd Ave z� ,
Co. Address: Sta ertification/Registration#
License Holder(Print): /J
Notarized Signature of License Holder/ ��% f 20�
,._ . ..
KAREN EWING. Sworn and subscribed before me this Y
Public
;•; MY coMM�s+� 174 Signature of Notary
`' EXPIRES Mnl 21.2016
1 tw!sd'edts>►