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141 15TH sT (VAULT) 17500 PSR-3844 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT 'wwnF:�iA'; ;': �� -_-_ - LOCATION INFORMATION _____- rmit Number: 17500 :ess : 1.41 FIFTEENTH STREET Permit Type: STORM SHUTTERS ATLANTIC BEACH . FLORIDA^322I aGof Fork :NEW --- LEGAL DESCRIPTION - Block: 63 Lot : 4 Twp: 'oast:- . Type :WOOD FRAME Section: 0 Sub-d: '. d: Rnq reposed Use : SINGLE FAMILY Subdivision:MANDALAY Dwellings ; 0 Est , Value: 0 . 00 mr rev. Cost : 3 , 175 .00 Total 'Fees : 60 .00 Amount Paid60 .00 tate Pa:. 995 HI IR;I4'ANE SHUTTERS FEE £?''UBLED WORK COMMENCED PRIOR Tri FER ,7hIER: INI''';RMATICN .__ APPLICATION FEES ._.. ___ ____._ 50 .00 I AM AMES AT 40, AC ?f ;FLORIDA 322 ' hone :ON � ` �# w;IN MATION ;^ r 1,77 arse: FLOR I l rig ;IA ` ONTRArTF, .ddr�.. 11-433 .SIN -,R0AD JRCKSONVIL FLORIDA 32/246 Lic . Cg { 40 +? Exp Woe NOTES: NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION BUILDING MATERIAL, RUBBISH ISH AND AY BY EB HIER CONTRAIL O OR UST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND "FAILURE TO COMPLY WITH THE MECHANICS' LIEN THE MP OVEMENTS.AN T IN THE PROPERTY OWNER PAYING TWICE FOR BUILD ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. $60.00 14 a e: eceip : 01 CHECKS 2017 ATLANTIC BEACH BUILDING DEPARTMENT 88180983221&0 By: CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS MOVING,DEMOLITIONS Owner s) : William Ames Address: 141 15th Street Phone: 247-1896 AtlantTc . , Lot # 4 Block or Unit # 63 Subdivision: Mandalay Contractor: Kenneth Branholm State License # CRC041040. Address: 11433 Saints Rd. Phone No: 641 -7010 City Jax. State FL Zip Code 32246 Describe work to be done: Aluminum Hurricane Shutters Present use of building: Residence valuation of Proposed Construction: $3 , 175 . 00 Proposed use: Residence Is this an addition? NO If yes, what are the dimensions of the added space: NSA ft. X NSA ft. Will the added area be heated and cooled? N 0% New electrical (or increase) ? NO New plumbing fixtures? NO New fireplace? NO New Heat/AC? NO SUBMIT THREE (COMMERCIAIL) TWO (RESIDENTIA.L) COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COM&MCEMMT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR- Signature Si nature OWNER: Date: Signature CONTRACTOR: 6v Date: Sworn to and subscribed before me this�day of 199? My :�� AMY C,VMIUM NOTARY PUB C STATE OF FLORIDA AT LARGE �`Pue��c > eondec! - -�-�--• / �Pe SA*-nrxnam miIolhetitk 1 THE FLORIDA WINDSTORM UNDERWRITING ASSOCIATION WINDSTORM PROTECTIVE DEVICE - PROOF OF COMPLIANCE Class A, B, or C Devices APPLICANT OR INSURED'S NAME:o/1 &Z&,r 4t rimae APPLICATION/POLICY NO. '7 6 S DATE DEVICE(S) INSTALLED: I �2 - 3 — `' AGENT/APPLICANT: The propene address shown in F.3 must match the propem address on the Application for Coverage to %khich this document pertains. Shutter Requirements: This Certifies to the Best of My Knowledge as the Insured. All shutters at the location shown in F 2 of this C. All exterior wall and rood openings. such as doors. windows, sky-form are designed to meet one of more of the lights and gents. of my insured building or unit. if an apartment or following: condominium unit as descnbed in the Declarations. are fully 1. withstand wind pressure that at a minimum protected with STORM SHUTTERS of any style and material meets the American Society of Civil Engineers, designed and properly installed to meet one or more of the criteria ° adopted by requirements listed in section A. Juiv 1988 standards (ASIC' ' �;s8). Dade Countv. Flonda in September 1994. D. Or, as an alternative to a Storm Shutter(s) 2. withstand impact from wind-borne debris in 1. I have foregone a garage door shutter as the manufacturer of the accordance with -at a minimum - the standards earaee door(s) warrants that the door(s) meet a"factor of safety of set forth and adopted by Dade Count- ' tin 1.5" or better. or the r+^ =ITTED to meet that factor September _ an, ct requirement noted in A.2. <�ects withstat the A u I 2fitter as the door(s) meets both South Floris the g quirements described in A. County. Flo. ,/,/�"�ti- Am , (r b /L W\ 3. 1 subject window or other NOTE: Roo �� wall v permanently installed breakawav w n glazi a window or other wall and National Flo( �• ana roof c _ .,, tivonents, meet both the wind pressure other non shUuers openings as required by the and ueoris impact requirements noted in A. Dade County building code. do not have to be protected by shutters. E. I will close and secure my shutters in event of a tropical storm or B. Or. as an alternative to Storm Shutter(s): hurricane affecting my premise(s): and 1. The garage door(s) meets a-factor of safety 1. I have made arrangements for the purpose of closing and of 1.5" or better. or the door is RETROFITTED securing all shutters in my building or unit (if in a multi-unit to meet that factor and the door(s) meets the building) when I am away from the premise or in my absence. debris impact requirement noted in A.2. 2. I certify to the best of my information and belief. that the devices 2. The exterior door meets both the wind certified above are properly installed in compliance with the pressure and debris impact requirements manufacturers installation recommendation and aforementioned described in A. building codes. 3. Window or other wall, and roof opening(s) 3. '-While your failure to comply with any of the above conditions are covered by permanently installed glazing in E.1 and 2 will not result in denial of a claim for loss caused material that. with respective window or other by the penl of Hurricane. Other Windstorm or Hail. we reserve the wall and roof opening structural components. right to discontinue the benefits of this endorsement, including any meet both the wind pressure and debris impact related premium credit. in the event of such failure.' requirements noted in A. / Signature of Applicant Date F. A signature of either a Registered Architect. Regulations and Code"Qualifier" for a Manufacturing Company. Engineer. or Building Code Compliance Oficial is required to venfv section A and/or B. Notary Public to affirm. (Section F continued on page 2) WPD-I (8;98) Page I of 2 FLORIDA GEORGIA CONTRACTORS, INC. 11433 Saints Road Jacksonville, Florida 32246 (904) 641-7010 - Fax (904) 642-9156 State Certified Residential Contractor CR C041040 SALES CONTRACT / QUOTATION Date; Customer Name:,06 -' City, State: Address:--� If H/Ph:--,.�2 , W/Ph: Zip: -2-1 -- 2 k; t Type of Construction: The undersigned Contractor agrees to furnish the following materials, improvements, labor, and/or services: fe 4 44 4 4;4 t 1i r. 7 % DETAILS: C.4'. The seller agrees to use their best efforts to commence work approximately. days from the date hereof and to complete same approximately days from date of commencement for the following cash sales price or time sales price as elected by buyer. owner agrees to pay Contractor for all labor and material and services to be furnished by Contractor to Owner under the terms of this contract. TOTAL JOB Down Payment $ $ Performance Draw Balance Due on Completion $ THIS QUOTATION REMAINS FIRM FOR (30) DAYS FROM DATE OF QUOTATION UNLESS OTHERWISE SPECIFIED AND BECOMES A BINDING AGREEMENT WHEN SIGNED BY THE PURCHASER SUBJECT TO THE CONDITIONS ON THE REVERSE SIDE WHICH ARE MADE A PART HEREOF AND WHICH THE PURCHASER ACKNOWLEDGES THAT HE HAS READ. Purchaser Date Representatiye ;'Date tj'^ Purchaser Date Ossi-Schoenig & Associates 6035 Morrow St. E. #101 Jacksonville FL 32217 Tel: (904) 731-7922 Fax: (904) 739-0725 William & Rebecca Ames Oct 19, 1998 141 15th St Atlantic Beach, FL 32233 RE: Wind Discount Dear Ann, Enclosed is a form that we have received from the Florida Windstorm Underwriting that must be completed before they will credit your policy. Please complete the back and return to our office for processing. Ido not believe that both a qualifier and code official must sign. Just one or the other. If you have any questions, please give me a call. Sincerely, Sharlene Lunsford AU AAM CPIW Personal Lines Representative ti-FLORIDA GEORGIA CON 7 FAC70RS, INC. 11433 SAINTS ROAD iACKSONVILLE, FLORIDA 32246 CERTIFIED CONTRACTOR #CRC041040 TEL: 904 641-7010 FAX: 904 642-9156 September 10, 1998 RECEIVED Mr. William Ames ff�T 2 s" 5998 141 15`x' Street Atlantic Beach, FL 32233 City of Atlantic Beach Building and Zoning Dear Mr. Ames: This letter is to certify that storm protection was placed on your home during the first week in May 1998. Protection consisted of extruded header and sill tracks including removable aluminum panels. This system is installed using Dade County approved anchors. Respectfully, /Jim Couturier Sales Consultant Your Home Improvement Specialist 11679 PSR-3844 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH PERMIT INFORMATION ------ LOCATION INFORMATION Permit Number : 11679 Address : 141 FIFTEENTH STREET ATLANTIC BEACH . FLORIDA n_Type : PLUMBING ---------- LEGAL DESCRIPTION ------- Class of Work : ALTERATION Lot : Block : Section Constr . Type: WOOD FRAME Township: RNC: Proposed Use: UTILITY Subdivision: ATLANTIC BEACH Dwellinqs ., 1 Code: 0 S0 ,00 Estimated Value : 80 .00 Improv . Cost : Tatal ,tFees ', 525 -00 Amort S25 .0( T APPLICATION FEES 5 0Q PERMIT EENTH STREE"; WATI;-4, IMPACTe.FEE -Af4 r FEE FLOE EZjr�- --, - STA AP RAD- ON GAS-H :R - S , MOO RADON CAB 5% 50 .00 ------- IMPROVE. CAPITAL 90 .00 Name: "GRENW-1AR4� IRRICATT. -E "GRULI F StWER 'TAP" " Ad+d-r-s-9s: ASS I NG BRAD N . FL 34205-0731 CROSS CONNECTION 90 .0r, Type: 0 SEC H IMPACT FEE Lic CONST . SURCHARCE SCHARIGN/-AT'L -Rcffs: NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER LY WITH THE MECHANIC'S"FAILURE TO COMP LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT96 TO01 REVOCATIQR0044517 ROB VIOLATION OF APPLICABLE PROVISIONS OF LAW. Date; 4/01/ Rcpt: .100003LO1000 ATLANTIC BEACH BUILDING DEPARTMENT By. CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION: Ig I G FneN r-# OWNER OF PROPERTY: ^mss SKP0E2- PLUMBING CONTRACTOR: Gg45n) Cj_kIU t+ T2 jet GA- n JA CONTRACTOR'S ADDRESS: �j 'jal� Z Mertgai VA L' `�r A--jl l r4 , STATE LICENSE NUMBER: r'�0 Z?(/ TELEPHONE: HOW MAIC OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS LAVATORIES WATER HEATERS BATH TUBS DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINES FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES: X 3.50 + $15.00 MINIMUM PERMIT FEE _ $25.00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR• ----------------------------------------------------------------------------- INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994 STANDARD PLUMBING CODE. CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826 SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR TO COVERING UP - (904) 247-5834. p - CITY OF C� 4& Bim- Office of Building Official REQUEST FOR INSPECTION Permit No. O Date Time ' A.M. Received �— Job Address Locality Owner's Contractor —— Name � BUILDING CONCRETE LECT PWMBING MECHANICAL h lLViri ❑ Rough -_ Air & u — Framing ❑ Footing ❑ G Heating Re Rooting Temp Re Roofing ❑ Slab — p Pole Top Out ewer^� r Fire Place Insulation ❑ Lintel C Final J` — Pre Fab READY FOR INSPECTION A.M. Mon. Tues. Wed. Thurs. Friday — Gj A.M. Inspection Made / P Final Inspecj Inspector_ Certificate of Occupancy Date — CITY OF Office of Buildi g O 'tial -; ,y, C- 1 7_�--�cz REQUEST FOR I ECTION / 49 /'o S-5 /4 Date87 77 -p� (j Permit No. Time A.M. fi Received / _ P.M. Job Ad ocality Owner's Na Name_,._ '� Contractor BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL ,ng Footing ❑ Rough Wiring — oug ❑ Air on . Re Roofing — Slab ❑ Temp Pole _ Top Out ❑ Heating Insulation — Lintel ❑ Final _ Sewer ❑ Fire Place El Pre Fab READY FOR INSPECTION Mon. Tues. Wed. Thurs. Friday P.M. A.M. Inspection Made / P.M. Final InspectioKccupar Inspector _ Certificate of cy ❑ Date Fps P t DATE• PRE-SERVICE DIVISION JACKSONVILLE ELECTRIC AUTHORITY 233 WEST DUVAL STREET JACKSONVILLE, FLORIDA 32202 THE FOLLOWING FINAL INSPECTIONS) HAVE BEEN MADE AND ARE SATISFACTORY: ------------ ------------------------------ ------ ------------------------------------------------- ------------------------------------------------- Enclosed are the blue copies of the permits. SINCERELY, (2 BUILBI G INSPECTION DIVISION cc:FILE MC NEILL & SONS FLOORING, INC. P. O. BOX 330088 ATLANTIC BEACH, FL. 32233 January 17, 1996 It is necessary for the air conditioning or heating units to run for the acclimation of wood flooring in the 141 15th Street residence. Failure to acclimate flooring can have adverse gtj . � effects on the finished wood floor . Would you please consider giving the builder , Ross Bremer early power so that this process could begin as soon as possible. Thank you. Sincerely, Mc Neill & Sons Flooring, Inc. Charles E. Mc Neill , Jr. `IAN 181996 � Budding and Zoning `� CITY OF Office Of Building Official _�,,,.J`t,�_R� REQUEST FOR INSPECTIOti � �I Date IFL C t �s Time Received U A.M. / Permit No. Job Address Owner's Name _ calitx BUILDING CONCRETE for Framing ,— ELECTRICAL Re Rooting Footing PLUMBING Insulation Slab MECHANICAL Lintel El Tern Pole Rough O Final Top Out L Air Cond. $ Sewer ❑ Heating Fire Mon. Tues. READY FOR INSPECTION ❑ Pre Falb Ce -Wed.Made — r _Q r` hurs. Friday Inspector I [ J A.M. QPM. P.M. Final lnspectio r Certificate of ccupancy Lr Date CITY OF Office of Building !/ REQUESTF 9 Official Date---/ 2 _ p _q OR INSPECTION /O6 Time -�.—_ 9&>3 Received p� A.M. Permit No. a P.M . Job Address ` S- Owner's S 7-- Locality BUILDING Ing CONCRETE -Contractor Re Roofing Footing ELECTRICAL Insulation %�\• Slab ❑ Rough Wiring ,- PLUMBING Lintel Temp Pole C Rough MECHANICAL =' Final _ Top Out L Air Cond. & READY " Sewer L' Heating Tues FOR INSPECTION Fire Place N Pre Fab Ins Wed. Inspection Made Q f� Thurs. 1 J Friday riday A.M.- - _ A.M. Final Inspection Certificate of Occupancy Date __ e q / DATE: PRE-SERVICE DIVISION JACKSONVILLE ELECTRIC AUTHORITY 233 WEST DUVAL STREET JACKSONVILLE, FLORIDA 32202 THE FOLLOWING FINAL INSPECTION(S) HAVE BEEN MADE AND ARE SATISFACTORY: ------------------------ ------------------------------------------------- ------ ------------------------------------------------- ------- ------------------------------------------------- ------ ------------------------------------------------- Enclosed are the blue copies of the permits. SINCERELY, C_- BUILDING INSPECTION DIVISION cc:FILE i CITY OF O N -7 Ch Office of Building Offici REQUEST FOR INSPECTION / o g 8B Permit No. Date A.M. Time P.M. Received L� r ( � /J Locality Job Address / Owner's Contractor Name Q Y Name PLUMBING MECHANICAL BUILDING CONCRETE ELECTRIC Air Cond. & Rough Wiring C Rough g Footing ❑ TemPole C Top Out ❑ Heating Re Roofing ❑ Slab p ❑ Sewer ❑ Fire Place Insulation ❑ Lintel Final Pre Fab READY FOR INSPECTION A. Wed. Thurs. Friday M, Mon. Tues. A.M. P.M. Inspection.Made Final Inspection ❑ Inspector rtificate of Occupancy Date TRANSMITTAL DOCUMENT FOR JEA DATE: / The following permits have passed "rough" inspection: Permit No. Address B� �C �c,onz�sX�(,kxk� C„®��Cd:esx�cxexap�sa��s. Please update your records accordingly. Thank you, BUILDING CLERK CITY OF ANTIC BEACH ( /vcb CITY OF Off�iceCo� ' Building Official Date REQUEST ESFOR SP T►ON Time Received ►NEC A��InMy.- / Perm No. 'Job Address �J Owner, Name SU►LDlNO Locality Re Framing CONCRETE Contractor goofin Elctor Insulation g ❑ Footing Slab ❑ ELECTRICAL �^ C' ❑ Lintel ❑ emgh Wiring ❑ PLU BIND Mon. L-7 Final Pole ❑ Bough �\'}_�� Nlrl.IANIC ❑ p Out \Alf AL Tues. Sealer ❑ Cond. g EAOY FOR INSP ❑ Heating Inspection Made ewer Fire Place t' Wedgy ❑ Inspector � �� `' J Thurs. Pre Fab A.M. Friday -PM. _PM Final Inspection ❑ Certificate of Occupancy Date CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL. PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 19_,15 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. BILL THOMPSON ELECTRIC CO., INC, P. 0. BOX 330150 ATLANTIC BEACH,FL 32233.0150 , ELECTRICAL FIRM: MASTER ELECTRI SIGNATURE d JOURNEYMAN NAME AQ.Ll AILe-I- l&e-r— ADDRESS: / z// � ,> RFD BOX BLDG.SIZE BETWEEN: APT. ( ) comm. ( 1 PUBLIC ( ) INDUS. ( ) LD REW. Q ADDITION ( ) TRAILER ( ) TEMP.( ) SIGNS ( 1 SQ. FT. SERVICE: NEW ( INCREASE ( REPAIR ( ) c(�iLC� FEE CONDUCTOR SIZE AMPS ZOO COPPER ( ALUM. Z � SWITCH OR BREAKER ZCt9AMPS PH W � OLT RACEWAY- z-4,0 ACEWAYz-cf C>' EXIST.SERV.SIZE LP O AMPS PH 3W /i c�VOLT RACEWAY FEEDERS NO. SIZE IND. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED OPEN TOTAL RECEPTACLES CONCEALED OPEN TOTAL 0-80 AMPS. 81.100 AMPS. 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 ICEIL HEAT: KW-HEAT --7 � r 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. I KVA NO. IKVA NO. NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHER EACH SIGN FORWARDED f TOTAL FEES PSR-3844 10 810 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH - - PERMIT INFORMATION - ---- LOCATION INFORMATION --------- ?rmit Number : 10810 cress : 141 FIFTEENTH STREET Permit Type: PLUMBING ATLANTIC BEACH , FLORIDA 32233 lass of Work : REMODEL --------- LEGAL DESCRIPTION ---------- Constr . Type : WOOD FRAMELot : Block : Section: Proposed Use: SINGLE FAMILY Township: RNG: 0 wellinas : 1 Code : 0 F division: ATLANTIC BEACH 7.stimated Value: $0 .00 Improv. Cost : $0 . 00 Total Fees : $67 . 50 Amount Pa $67 . 50 rate 'Pit' 21!95 REM0T -_-- OWNER INFORMATION --- -- -- - APPLICATION FEES ----- Name : ROEL- EREMER PERMIT $67 . 50 iress 141 FIFTEENTH STREET WATER IMPACT FEE $0 .00 ATLANTIC EEA H , FLORIDA :2 SEWER IMPACT FEE on Phone, ,' 904 ) 249 - 51q1 WATER°°; ,1TAP .. , RADON GAS-H .R. S . $0 . 00 ------ CONTRACTOR INFORMATION RADON CAB 5% $0 . 00 Name: ST EL PLUMBING CAPITAL IMPROVE . $0 . 00 wev: ddress°.,,°, 1�Q1�°.MIS STREET ,SLR°.SAP, � ATLANT ,EACH FLORIDA 321- " CROSS CONNECTION $0 . 00 -ense, .FC,0371��,. Type: 4 SEC H IMPACT FEE °aye 9 CONST. SURCHARGE 'SO .00- - SCHARGE/PTL.BCH. nn NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. Date: 9/21/95 01 Rcpt: 0085433 ATLANTIC BEACH BUILDING DEPARTMENT DECKS 11716 00100003221000 By: CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION : q1 /� it/ t OWNER OF PROPERTY : Q< <A' PLUMBING CONTRACTOR �f��-t PmI CG CONTRACTOR' S ADDRESS: Ile, ltil�/�- 5 f STATE LICENSE NUMBER: (f Fri)3 71?4 TELEPHONE: /g HOW MANY OF THE FOLLOWING FIXTURES INSTALLED l SINKS I SHOWERS LAVATORY ' WATER HEATERS Z BATH TUBS DISHWASHERS URINALS f DISPOSALS L3 CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES : x $3 . 50 + $15 . 00 MINIMUM PERMIT FEE - $25 . 00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: 4, 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 i PSR-3844 10817 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ---- PERMIT INFORMATION ------ - ------- LOCATION INFORMATION ------- ermit Number: 10817 Aress : 141 FIFTEENTH STREET Permit Type: MECHANICAL ATLANTIC BEACH , FLORIDA 32233 lass of Work : NEW ---------- LEGAL DESCRIPTION ------- Constr . Type: WOOD FRAME t : Block : Section: Proposed Use : SINGLE FAMILY Township: RNG: 0 �wellinas : 1 Code: 0 ubdivision: stimated Value: $0 . 00 Improv . Cost : 50 . 00 Total Fees : $65 . 00 Amount Patti: 565 . 00 ?' r -ENTPAL HFm r �"Tr TN EXISTING HOME ------ _ OWNER INFORMATION --- --- ---- APPLICATION FEES -- Name , ER 'MER, PERMIT 565 . 00 dress - 1.41 FIFTF7,NTH STREET =CATER. IMPACT FEE $0 . 00 :,T'LANTIr- PEACH , FLORIDA SEWER IMPACT FEE 00 Phone: f ;SER RADON GAS-H.R. S . ,� ;NTFAR "'TOR INFORMATIOAI:' -- RADON CAB 5% $0 . 00 Name: AIR ENGINEER INC . `7APITAL IMPROVE. $0 .00 Tress : 10947 RICH FI Vn . SEWER TAP . ► w.fl... ?AX .F1 CROSS CONNECTION _K $0 .00 _ense. MHAR-6- * iype : SEC H IMPACT FEE $0 .00 CONST . SURCHARGE a . NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. QQQQQWW QQQQQWW $6100 14 Date: 9/22/95 01 Rcpt: 00&%74 ATLANTIC BEACH BUILDING DEPARTMENT CHECKS 15795 00100003221000 By: BUILDING .AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH ATLANTI6 BEACH, FLORIDA 32233 APPLfCATiON ,FOR MECHANICAL PERMIT CALL-IN NUMBER ' IMPORTANT Applicant to complete all items in sections I, II, III, and IV, I, k i Ff Y k LOC�ITION Street Addreisl OF In#eriectlny Streetsl Between . 6UILDING,I An Subdivision Ile`''IDENTIFICATION To be completed by all applicants, in conilderation:01_permit given for.doing the work as described in the above statement we hereby agree to perform said work In accordance with the.'Ittachpd plans and Ipecifications which are a port hereof and in accordance with the City of Jacksonville ordinances and standards of good.proctice listed therein, /' , Name`of Mechanical Contactors Contractor (Print) '• . ING, Master t Name of Property Owner Signature of Owner / Sign or Authorised?,gen1 ature ofA. Archllect or Engineer Ilt. GENERAL INFORMATION') l.' A. Type heating fuel 6. l EltcMc IS OTHER CONSTRUCTION BEING DON ON J THIS BUILDING OR SITE7 ❑ Gas 0 L? O' Netute p.l Q Central Utility ❑ 011 a i IF YES, GIVE NUMBER 0f CONSTRUCTION t I PERMIT �p\Q 1-Q ❑ Other. Spedfy IV. M,M.ANlCAL EQUIPMENT T0'81 INSTALLED r=osldeF•WORK ,(Provide complete liit of componenh on Mck of this form) ntlalor O Commercial L7�'^Heat;, "❑ Space ❑ ,ReceSW l�ntnl t7 Floor ,0, NZ Bulldln' Conditioning ❑ Room ci Central tld' Exlsting l3ulldlnp WDuct Sys hms Maternal •„ Thickneu 9----Now, R�placomont of existing system .,Mexlmum ca cl '' Installalion No s stom rovlousl Instal:odP9tY t � fI. Y previously ) ❑ Refrigeration O Exlonsion or add-on to existing system ❑ Cooling towrrrl Gpecity 9,p m, O Other - Specify Q Fin`tprinkbni Number`of h��d� Q Elevator ❑ 'MenIIR17 'Escalator"_,,,.,,,.,_ (number) THIS SPACE FOR OFFICE USE ONLY t O Gasoline pumps,_,__ (number) D,.Tank r _....,_(number) ' Remarks Q� lPG conbinen (number) ' O'',Unfired pressure vessel (�• Sellers' Permit Approved by Dot- Specify Permit h- LIST•ALL EQUIPMENT _ AIR.CONDITIONING AND;,REFRIGERATION EQUIPMENT 27umberUai� DesarIpUon 3Code1 Number 7danuteicturer card App y u HEATING` FURNACES,'BOMERS�!IREPLACE,Sct .,. 1, .Number Vaib 4 • Descrlpthioa " 3Co4e1 Number Yazsutacturtr (TU)Y -14 TANKS . <�• +`� Row Ming Naal�nal Cspacity Z�pe L1qu1d Name of Serial Appproving Lad Dlmmssiou Contalnod ZCanufaoturer No. Apncy PSR-3844 10494 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ----- PERMIT INFORMATION --- LOCATION INFORMATION -------- Permit Number : 10494 Address : 141 FIFTEENTH STREET Permit Type : BUILDING ATLANTIC BEACH . FLORIDA 3223:' Class of Work : REMOVE ---------- LEGAL DESCRIPTION --------- Constr . Type: WOOD FRAME Lot : Block: Section: Proposed Use: SINGLE FAMILY Township : RNG: 0 Dwellings - 2 Code: 0 Subdivision: Estimated Value: $0 . 00 Improv . Cost : $0 . 00 Total Fees : $50 . 00 Amount Paie $50 . 00 7/21/05 work �" � i��r ^47 INTERIOR OF DUPLEX STRUCTURE TO CONY . TO SFR ------ ---- OWNER INFORMATION ------- -- ---- APPLICATION FEES ----- Name : ROSS BREMER/KAREN PERRIN PERMIT $50 .00 Address : 141 FIFTEENTH STREET WATER IMPACT FEE $0 . 00 ATLANTIC BEACH . FLORIDA 32233 SEWER IMPACT FEE $0 ,.00 F1-icr.e904 2,46-92128 WATER METER/TAP 0 .to RADON GAS-H .R . S. $0 .00 -- ---- CONTRACTOR INFORMATION ---- -- RADON CAB 5% $0 .00 Name : PROPERTY OWNER CAPITAL IMPROVE . $0 .00 Address - SEWER TAP 50 .00 CROSS CONNECTION $0 .00 License ` Type ' I SEC H IMPACT FEE $0 .00 CONST . SURCHARGE $0"00 SCHARGE/ATL.BCH. $x .00 NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. ATLANTIC BEACH BUILDING DEPARTMENT By: CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL , ADDITIONS OR ALTERATIONS pp DEMOLITIONS Owner(s) : . � .v Address : /Y/ 1 Ste` 57' ATL- G'e_aeX1 -Phone: 4) Lot # Block or Unit # Subdivision: Contractor : Se i9e-S State License # A/M Address : V �R- Phone No: /L-�i4 Describe work to be done: denzollfiaiv Oo' eX15-J1A16_- SjeaCi Cnof i a-Aide ceh-j ,b&"zn� 411 f � o�vE2 -fa .4cc pss 6Ps f a 46 4-eq,- S 2 — W.na 4- wa-s vel l2q ( .Sep /9s 4 .60 PI-&A 'A)7u 19 s INCr ,n Present use of building: SjJQ9241Mj 4 Valuation of Proposed Construction: �e��/<�� 9 � .00(� • Proposed use: SiNG/E Ftt/f+itc./ dWf_/1fAs> 91- Is Is this an addition?1V o If yes , what are the dimensions of the added space: ft . X ft . Will the added area Z be heated and cooled? New electrical (or increase)? New plumbing fixtures? New fireplace? New Heat/AC? SUBMI'P AN, SURVEY , E NOTI FACTOR A OR. Signature OWNER: jil_tiJt. ,��/�/L!�✓ Date: y-s Signature CONTRACTOR: Date: License Supplied: N/A Liability Insurance: NIA Worker ' s Compensation Insurance: /lull' o� CITY OF ATLANTIC BEACH, FLORIDA Approved by APPLICATION FOR ELECTRICAL PERMIT TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 1- 14- 19 /�D 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. @ILL THOMPSON ELECTRIC CO., INC, P. 0. BOX 33Q150 e ATLANTIC BEACH FL 3 2 - ELECTRICAL FIRM: MASTER ELECTRICIA SIGNATURE //5tF SAN NAME elRrn Ey- ADDRESS: �I 15fh S6 • 7P/6 RFD BOX BLDG.SIZE BETWEEN: RES. ( ) APT. ( ) comm. ( ) PUBLIC ( ) INDUS. ( 1 NEW ( ! OLD ( 1 REW. ( ) ADDITION ( ) TRAILER ( ) TEMP" SIGNS ( ) SQ. FT. SERVICE: NEW�J INCREASE ( ) REPAIR ( ) FEE CONDUCTOR SIZE Cp AMPS COPPER ( ALUM. Z 46 /tO SWITCH OR BREAKER AMPS PH W VOLT RACEWAY 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 AMPS. SWITCHES INCANDESCENT FLUORESCENT&M.V. FIXED 0.100 AMPS. OVER APPLIANCES i L I BELL TRANSF: AIR H.P. RATING H.P. RATING CONDITIONING COMP. MOTOR OTHER MOTORS AMPS ICEIL HEAT: KW-HEAT 0.1 OVER MOTORS H.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS MISCELLANEOUS TRANSFORMERS: UNDER 600 V. OVER 600 V. NO. KVA NO. IKVA NO. NEON TRANSF. NO. VA. MA. MOTOR SIZE JSWITCH FLASHER EACH SIGN FORWARDED $ TOTAL FEES PSR-3844 10655 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH ----- PERMIT INFORMATION ------ -------- LOCATION INFORMATION -------- Permit Number : 10655 Address : 141 FIFTEENTH STREET Permit Type : PLUMBING ATLANTIC BEACH . FLORIDA 3223: Class of Work: ADDITION ---------- LEGAL DESCRIPTION --------- Constr . Type: WOOD FRAME Lot : Block : Section: Proposed Use: SINGLE FAMILY Township : RNG: 0 Dwellings : 1 Code : 0 Subdivision : ATLANTIC" BEACH Fstimated Value : 50 . 00 Improv . Cost : $0 .00 Total Fees : $64 .00 Amount Paid : 564 .00 Date Pa,,i: 8/21/95 Work Des:- . : P'LUMBINC- IN REMODEL - - ---- OWNER INFORMATION - - APPLICATION FEES ----- Name : BREMER PERMIT $64 . 00 F.--ilress : 141 FIFTEENTH STREET WATER IMPACT FEE SO .00 ATLANTIC BEACH . FLORIDA 32 . SEWER IMPACT FEE $0 . 00 lrho, 3e : ( 904` -14c)--5191 WATER METER/'TAP 50 . 00 RADON GAS-H .R . S . $0 .00 ------- CONTRACTOR INFORMATION - RADON CAB 5% 50 . 00 Name : STFEG PLUMBING CAPITAL IMPROVE. 50 .00 Address : 1601 MRIN STREET FEWER TAP $0 . C-_ ATLANTIC BEACH FLORIDA 32233 CROSS CONNECTION $0 .00 License ' ^F'"0371`_)r Tyne: 4 SEC H IMPACT FEE $0 .00 CONST . SURCHARGE $0 .00 SCHARGE/ATL . BCH SO 00 NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYINGTWICE FORTHE BUILDING IMPROVEMENTS" .a ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR E VIOLATION OF APPLICABLE PROVISIONS OF LAW. 000000000 000000000 $64.00 14 Date: 8/21/95 01 Rcpt: 0077344 ATLANTIC BEACH BUILDING DEPARTMENT CHECKS 11603 ,s 00100003221000 BY: CITY OF ATLANTIC BEACH APPLICATION FOR PLUMBING PERMIT JOB LOCATION : OWNER OF PROPERTY :— _ S A�e4 PLUMBING CONTRACTOR CONTRACTOR' S ADDRESS: IGo� l�,�ih ,Sf TELEPHONE: STATE LICENSE NUMBER: HOW MANY OF THE FOLLOWING FIXTURES INSTALLED SINKS SHOWERS � > _LAVATORY L/ WATER HEATERS BATH TUBS / DISHWASHERS URINALS DISPOSALS CLOSETS WASHING MACHINE FLOOR DRAINS SHOWER PANS OTHER TOTAL FIXTURES: x $3 . 50 + $15 .00 MINIMUM PERMIT FEE - $25 . 00 SIGNATURE OF OWNER: SIGNATURE OF CONTRACTOR: BE IN ACCORDACE W INSTALLATION OF PLUMBING AN FIXTURES MUST STANDARD PLUMBINGN CODEITH THE MOST RECENT EDITION OF THE SOUTHERN STAN 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 1 16690 PSR-3844 DEPARTMENT OF BUILDING CITY OF ATLANTIC BEACH --- - PERMIT INFORMATION Fs4 ION INFORMATION -------- Permit --• --' Permit Number: 10690 FIFTEENTH STREET Permit Type: BUILDING NTIC BEACH , FLORIDA32233 -------- - Class of Work: REMODEL GAL DESCRIPTION -"onstr . Type• WOOD FRAME ock: 63 Section: hip: RNG: 0 Proposed Use: SINGLE FAMILY MANDALAY Dwellings : 1 Code : 0 Estimated Value : $1233$02 . 00 Improv . Cost : Total Fees : $938 .00 Amount Paid: $938 .00 ----------- OWNER INFORMATION --------- ---` APPLICATION FEES $779898 ..40 0 Name: ROSS BREMER AND KP.REN PERRL WATERT IMPACT FEE $140 , 00 Address ' 1502 'BEACH AVENUE SEWER IMPACT FEE $0 . 00 ATLANTIC BEA,"_H . FLORIDA 3•- WATER METER/TAP So' .00 Phone ' 9 '4) 246--92280 . 00 RADON GAS-H.R . S . $ ------- CONTRACTOR INFORMATION RADON CAB 5% $0 . 00 Name ' FR( PEF1'Y OWNER CAPITAL IMPROVE . S0 . 00 SEWER TAP 56 , 00 Address ' CROSS CONNECTION 80 . 00 Type: 1 SEC H IMPACT FEE License. CONST - SURCHARGE SOHARG,E/ATL .BCH . - NOTES: NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE BT MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND MUST BE C A UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER E2 D3 "FA RE TO COMPLY WITH THE MECHANIC'S LIEN LAW CAN RESULT IN THE ROPERTY OWNER PAYINGTWICE FORTHE BUILDING IM ISSUE- rCORDING TO APPROVED PLA OF LAW.WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOL)gFN OF APPLICABLE PROVISIONS _��• Date: 8/29/95 01 Rcpt: 007877146 i� + DECKS ATLANTIFBEACH BUILDING DEPARTMENT 00100003221000 By: CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET Address STC �7 2��oDE( Date �Q $ S��C� Heated Square Footage ._@ per sq f t 3 @ $ / Q�per sq ft = $ Garage/Shed ��8gy Carport/Porch @ $ per sq ft = S Deck _@ $ 9 Q per sq ft = Patio @ $ per sq ft = $ TOTAL VALUATION : L'L&O•o o s �o Total Valuation 1st 00 C-) $ o0 Remaining Value per thousand or portion thereof TOTAL BUILDING FEE $ 3-2 cv + 1/2 Filing Fee (0 ) Fireplaces @ $15 . 00 $ D � 9kb v BUILDING PERMIT FEE $_ ` WATER IMPACT FEE $ SEWER IMPACT FEE S �� WATER METER/TAP $ V CAPITAL IMPROVEMENT $ . _0- SEWER TAP $ ( ) RADON (HRS) .0050 $_ SECTION H PAVING .( ) $ HYDRAULIC SHARES $ CROSS CONNECTION S ( ) SURCHARGE . 0050 $ OTHER $ GRAND TOTAL DUE $ �� ADDITIONAL PERMITS OR FEES: Mechanical Plumbing Electric/New Electric/Temp ; SwimmingPool Septic Tank Well Sign Finish Floor Elevation Survey Other CALCULATIONS and/or NOTES: FLA, tsss LAWS itA�O resod ye ►s Iis.13 Mt►AAi IM PUPLWAVsI fahom it MR = The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statutes, the following information is stated in this NOTICEOF COMMENCEMENT. / �t es Dcription of properr�►....»l�/A_'f.....«1.»x.....1 4 S?G.1.�...4� �?.r...,N.. ..ti,N.� �.�.�1 N .. U..... �?.F......T Hr......... ��...s'. »! ? '...». ��. L.t.�,........ _FLA........... »..�1.».._.»._. .z�............. ...........»..�.... ...................».........» General descriptioe of kwrov«nMMa -. '� L%!v.......... ...»..feo. �� ...2c�nlr�c��.... �`P 'f......Td .!¢.................... LcJEC_„C �J .,........._ .<r�(PrOv, P1_bM_ej1u6t....ELECa_2�c ST2uC7U2E (,C)ii` CN (,(Jr1U�D Nc7 /k4 .r..•..0.ODC. -ry `M�K C» /? .'... o' c ES�Th%t r I4ff:9'XLS'a' . Ow sfF„ ....... �? tt ....... ......... / f.=E.N.......... E/'..r'..�^ ner. ....................»...»»......» »................. Addreu.!` '�r DOO/4.....». ..� »....�� . ..f ......ivc..............................».»....».• ..» .....»....... Owners interest in site of the kwoveawd...•Q ,/v AjE,, 6A14k)1e1Y00P fee Simple Tide holder (if other 1h0+ owner) .S. fir' r c- �+: .. ...P,..Q. t »............................._. .._...».... Name............... »...... ... ................................ . . Address.----.....•. .»._....»..............»..................................................................................•.».......... ».»......»...»_.... ... ._» ». .... ».._ »»_ eordre'd. ..... » ..•.».»..............».»...........................................I........._._ ..»...».»....._ .. _ Addrett_. .... »... ».............»....._. ...................I.......I.»»....... ».. . »»»_.... ..» wren► .«+r�.».. ..»».»........».........»»».»............»..»........................................».»...»...». .......» »_ »... ...»..._...................._........» ..»..»....»»_.... .. ..Aaiourr of borA �...» .._.. ». Name e1 parser within dw Slag* of fooride dadpwod by owrw upon whoa ratios: or Ww doamenis MY i» served Name ..... ....»..»..............................». _ A�rtss....._... ._ _.__ �..».. .. .»..... ...._...»..... .»»•................................»......»....•.....»......................»_ ».». .......»......»..._.... In addition to himself,owner designates the following person to receive a copy of the Lienors Notice as provided in Section 713.13(1) (F), Florida Statutes. (Fill in at Owner's option). t mww............ t...... .5.».l`� ?. .........._»...»»........»..».... _».»....».. .. .».....»...»......» »..... Address.............._...._......................._.....................»»....»................................._.._.. •. ......_._ ... THIS NA"FOR ASCOQf/SR'e Yea GMV l Ctwnw Sworn to and before twe •••. '»»- »» .:........................ .. . » ..fl.......» F IU; A%OJNV fL TAR STATE OF F LQR F UBM %ly corrin Exp 10017 CITY OF ATLANTIC BEACH Fixture Unit Worksheet for Water Impact Fee FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TWENTY DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM. BATHROOM GROUP CONSISTING OF SERVICE .SINK TRAP STAND WATER CLOSET, LAVATORY 6 BAH (8) TUB OR SHOWER STALL (6) WATER CLOSET WATER CLOSET, TANK OPERATED (4) VALVE OPERATED (8) BATHTUB/SHOWER (2) URINAL WALL LIP (4) SHOWER GROUP PER HEAD (3) FLOOR DRAIN (1) SHOWER STALL DOMESTIC (2) LAUNDRY TRAY (2) _LAVATORY (1) COMBINATION SINK AND TRAY (3) fWASHING MACHINE (3) POT, SCULLERY SINK (4) DISHWASHER (2) WASH SINK EACH SET OF FAUCETS (2) KITCHEN SINK (2) DENTAL LAVATORY (1) KITCHEN SINK WITH WASTE DENTAL UNIT OR CUSPIDOR (1) GRINDER (3) URINAL STALL, WASHOUT (4) BIDET (�) COMBINATION SINK AND TRAY WITH FLUSHING RIM SINK (8) FOOD DISPOS. (4) URINAL, PEDESTAL, SYPHON JET DRINKING FOUNTAIN (1/2) BLOWOUT (2) LAVATORY, BARBER/BEAUTY ICE MAKER (1/2) SHOP (2) SURGEONS SINK (3) LAVATORY, SURGEONS (2) JACUZZI (2) URINAL STALL, WASHOUT (4) TOTAL FIXTURE UNITS � @ $20.00 EACH $ L/ r)� o JOB I14FORMATION SM: 5W community TR-UG-TIMM -pa V EFFICIM Y ff" tod Fj ORI OM CIYI�! -, ". perforwdoce ne A 'q - ! whole 00.1if"tilIg gpemer de a 1.1 C," .1 -93 It / ,, -R.,, Kb!i &R 6- IC11BATE FVRH 6004 . I I',Ujj,,qC jVfWE-- Plan 2085 bq- ins.'_-Rff-T F TING 2L/ 311-1 741 15th Atlantic Sea Yn AM9 ADORESS awach, F7. jorr''cl 1.1,iny I Atlantic C-K j,PEW T oi. da","ItIVO Y Or I Ojt'l 3. 2. single can y ly.,NO, of units liv4. 3. if Malt'" big a wwrst MY If ly, 1"." 5.. r, I I ed ft. 6 100 5. typtlitio0ed "0" a OR."Phday A 6. Predominant eavo ""oable Paae .hang length ft. Me At_ pwpch ovel �oyh'n, '31 9� I a">q I " -_ and 1yPe.'-' 0" q f L 0.00s q f t Glass Mod' O"Osqft "J dSS' c I"e a 00 b. or s0idl .00 ft it t"r ,d insulation: IwA qW.Rv 0. 397.00 sqft C`!�r?i, yy l 9, Floor WW _:.ajt' (R-value' '1"1&pjm&LU slab o1I 91.1 In-value OCC8 wood, 80d insulation: R V1, ?"'ype area -va I de,' q f tYe t ;v'a� 0j': Owe (Insulation R a, Exterf,,, ,,tjon R-Vdlae) fob-2 9011-00, 9 WWodl Msulo A djauel anti jjd.Pz3&00 il.l`lelliay Opt, _Qtjon A'Vjjj'j.j4ffj H= On . !] cilJci alp 0.15 A J cation) 1 /-�' ;ts (10bu ition '3'.oo Dig 13VOO1.£1]Y system 13. TYPe: Central 12. 50 SAO ellI ng -AW 14 �j4ed IS' "yed I i ny SYS 1, 7 5. Electric 0 88 15.HO t *d L t"' TO q--overy Cjv 16.HOt dits:a, He PY fP) 2 ot 3 VW. Ut S 17. in I tra t"of f(CrFaf CQ1 ci el I n y Fan. u v- 1S,,,,I'vAC t,,Cedits RO-Attic radid''It hoi.ise I'dO, ) 98. 15 q2"Mul tkooe19. -c-�-eed 700 t"0101s) 1 9W. 34066. 56 not e"< points .'1706.80 T�*,itd,,' As-svilt I qb.. b. Total Base ir1X lite.,? ----------------------- --....-------------------------------------------------------------------- -.1 fica tions Ile plans W --------- -ad R, view f T - -ad-an faulto ,&,t the plans a, 'IV this calcul ve i ed t.; HefwbY certify Flo I!G7d iI�&f ,mollance N" specifications covereo by s L-05b; Q1 Before construction 's Nf ti i` are in Compliance Witv IV/ F,loj,jda Eaf--VV) U pliance in accocad WL EERS, ING I /� c. L1";`d'iaY �NGIN Pfi'EPAREO Sr...... - ....... 5 F- nA -lw Flol1d.O X1] comelidoce *,�t-h ONIIER BUILDER PERMIT AFF IDAVIT =tbt4�- of Florida ) City of Atlantic Seach ) BEFORE ME, the undersigned authority, personally ippwarwd --------------------- who upon fisat teir&v duly ----�------ wor n, deposes and say2s s I, /L91A/ --- -----' and the legal owner of the following propertys Subdivision LoT - -M41u D ALA Lj _----- Block AKA �-�--� .. Sr - /4T-L:A JlIL [}�•�CII I am applying for a building permit pursuant :o its+ Owner Builder exemption set forth in Florida Statute, Section 489. 107. Florida law requires that Irhave been provided witto thr tollaviny DISCLOSURE STATEME11T& DISCLOSURE STATEMENT estate leu requires construction tc, be done Ly 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 c.r a term outbuilding. Y�� ammy costiot •Z31000rO0iorr`lessvdp • commercial building The building aunt be for your use and occupancy. It may not be built for sale or lease. If you sell or leak• more than one building you have built yourself within one year atter the construction is co-Plete, the law will presume that you built it for sale or Ivaour , whish i■ s violation of this exemption. construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that people employed bcount have license 0 municipal required by state law and by Y licensing ordinances. 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. Further, affiant sayeth not. POwner Svorn to and subscribed &,•lore me his _� _ _ da� ..L. r NOTARY PUBLIC - My Commission Expires& 'M0 'R FA TRICIA A tiIONETTE ^L�` STATE OF FLORIDA LSC My Comm Exp COMM N'SR 22 017 L! 2 1995 J.01ding and Toning CITY O LANTIC BEACH PERMIT APPLICATION EMO E ADDITIONS OR ALTERATIONS EMOLIIT,0 owner(s): � 055 131Ze/AA0J , KA(2-Eti )097" Address : l,�>OZ 13EAcN ,4Ug7 AT/-f onC 6pae"1� Lot # J� Block or Unit # l�3 Subdivision: A4'1UDA'L ,4-V Contractor : -t--L State License # /44— Address :- I A-Alf E fl S &/50ye Phone No. +"c A3 A3v,c Describe work to be done:_ AE44O.DC---L. A10A)—00A4PLIAM-' (TO 240AI'A/d-) Do PLS /N ro Si m c1,6- "til r Ljj 5)21N G' A-/t fVSX EA45 -4/` E -- U F' _70 CODE- /4fC7`�CS was Present use of building: )?ES �7U lotEX Valuation of Proposed Construction: 00, 000 Proposed use: /A1AL F F,4APL_j1 eE' /D,�5A1C�E_ Is this an addition? If yes , what are the dimensions of the added space: ft . X ft . Will the added area 7c), ccs be heated and cooled? New electrical (or increase)? � CcY•�3- _ New plumbing fixtures? New fireplace? New Heat/-AC? S L.t)/Pj 'LJ cvAn u1 Uw,TS SUBMIT THREE--M " F'� S ET$ - OF PLA �CLUDI � NOTIOE_ _! ENCEMENT, 4W OWNER ' . N AFFIDAVIT, IF OWNER IS CONTRACTOR. Signature OWNER:- Date: Date: / S Signature CONTRACTOR: ,gAgaate: License Supplied: 1A AJ Liability Insurance: ,, Worker' s Compensation Insurance: 1995 guild;ng and Zoning 1/23/95 CITY OF ATLANTIC BEACH 11 :36:02 CMR007 SPECIAL INVESTIGATION CMN007 COMPLAINT # 2502 COMPLAINT DATE: 95/01/23 ASSIGNED DEPT/DIV: 00 00 PRIORITY CODE: 0 COMPLAINT TIME: 11 :26:39 TAKEN BY: KARLGRUN COMPLAINANT: ANAONYMOUS , ADDRESS: ATLANTIC BEACH FL 00000 PHONE: 904-000-0000 EXT : LOCATION: 141 15TH ST ATLANTIC BEACH FL 00000 OWNER: NESS COMPLAINT DESC: STRUCTURE IS BEING OFFERED FOR SALE AS A DUPLEX IN A � SINGLE FAMILY ZONE DATE OF INVESTIGATION: 95/01/23 INVESTIGATOR: FORD �--- ------------------------------------------- ___ ____________________ CONDITIONS FOUND: AS PER COMP ACTION TAKEN: OWNER WAS CONTACTED BY DON FORD,OWNER HAS PROVIDED ORIG INAL DEED INDICATING THAT IT HAS BEEN A 2 FAMILY SINCE 1960 COMPLIANCE: NOTES: ADDRESS ( BUILDING PERMIT NUMBER /y INSPECTIONS: FOOTING UNDER SLAB PLUMBING �I - Z Z SLAB FRAMING COVER-UP INSULATION FINAL BUILDING 3 a2 —�fo CERTIFICATE OF OCCUPANCY ELECTRICAL PERMIT # l' O 7 TQ INSPECTIONS ROUGH1n�ce/ FINAL MECHANICAL PERMIT # PLUMBING PERMIT # NOTES: ��a o� �°'r'a�