18 17th St (vault) PERMIT WORKSHEET Certificate of Occupancyl
Job Address: /� / ?Y, 9- Type Work:
Property Owner: Phone #
Contractor: Phone #
6h4!�n� 5
Permit#: Date Issued:
Tree Permit#
Foundation Permit#
Demolition Permit#
BUILDING ELECTRIC # MECHANICAL # PLUMBING #
Temp.Power#
Footing JEA Release
Date
Temp. Power
Slab Letter Rec1d. Underslab
Tie Beam Temp Pole#
Lintel JEA Release Gas Piping
Date
Nailing/ Water/
Sheathing Sewer
Rough/
Framing Rough Rough Top out
Insulation JEA Release
Date
Electric Mechanical Plumbing
Final Final Final
JEA Release
Date
Drainage Inspection: —71
Pool Permit# Inspections: St�el Final
Elec./Grounding Final
Roofing Permit#
Inspect: N--ailing/Sheathing Final
Fire Inspection: Date Paid:
Failed Inspections:
S
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
"jill INSPECTION EMAIL REQUEST:
Building-dept2coqb.us
Application Number . . . . . 07-00000162 Date 4/05/07
Property Address . . . . . . 18 17TH ST
Application type description RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 128000
----------------------------------------------------------------------------
Application desc
addition to existing structure & bath renovations
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
RICHARDS, JOHN COASTAL CUSTOMS CONSTRUCTION
18 17TH ST SERVICES, INC.
ATLANTIC BEACH FL 32233 306 4TH STREET
ATLANTIC BEACH FL 32233
(904) 333-2735
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 544 . 00 Plan Check Fee 272 . 00
Issue Date . . . . 3/06/07 Valuation . . . . 128000
Expiration Date . . 9/29/07
----------------------------------------------------------------------------
Other Fees . . . . . . . . . WATER IMPACT FEE 40 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 544 . 00 544 . 00 . 00 . 00
Plan Check Total 272 . 00 272 . 00 . 00 . 00
Other Fee Total 40 . 00 40 . 00 . 00 . 00
Grand Total 856 . 00 856 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Building-deptkgoab.us
Application Number . . . . . 07-00000162 Date 3/06/07
Property Address . . . . . . 18 17TH ST
Application type description RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 128000
--------------------- ------------- ------------------------------------------
Application desc
addition to existing structure & bath renovations
----------------------------------------------------------------------------
Owner Contractor
------------------------ ----- -------------------
RICHARDS, JOHN COASTAL CUSTOMS CONSTRUCTION
18 17TH ST SERVICES, INC.
ATLANTIC BEACH FL 32233 306 4TH STREET
ATLANTIC BEACH FL 32233
(904) 333-2735
----------------------- -----------------------------------------------------
Permit BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 544 . 00 Plan Check Fee 272 . 00
Issue Date . . . . Valuation . . . . 128000
Expiration Date . . 9/02/07
----------------------------------------------------------------------------
Other Fees . . . . . . . . . WATER IMPACT FEE 40 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 544 . 00 544 . 00 . 00 . 00
Plan Check Total 272 . 00 272 . 00 . 00 . 00
Other Fee Total 40 . 00 40 . 00 . 00 . 00
Grand Total 856 . 00 856 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
PLAN REVIIEW SHEET Routed to:
Cff.Hufsteffe-r)
Building Department Public Works&Public Utilities Departments
800 Seminole Road 1200 Sandpiper Lane
Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233
P-ublic
(904)247-5800 (904)247-5834 Safety
(904)247-5845 Fax (904)247-5843 Fax
PLAN REVIEW COMMENTS
Permit Application# 01:—
Property Address -7)
Applicant: 0-06t�iyxz &OIX5
Project:
T plication has been:
ed as noted by the Department.
Final application approval must come from the Budding Department.
El Reviewed and the following items need attention:
24z.0 01 : ON&VJoy ; !Sgd lwt 1x=
),�� , 4V1
Q/ I
Please re-submit 2-copies of all revisions. Please re-submit your
revisions to the Department requesting them.
Building Dept, Public Works and Utility information at top of page,
failure to notify the correct department may delay your permit from
being issued. 1- 1
Reviewed By: Date:
Date Contractor Notified:
E C I BUILDING PERMIT APPLICATION
CITY OF ATLANTI(-.
CITY OF ATLANTIC BEACH
FEB 2 0 2 00 PoSeminole Road,Atlantic Beach FL 32233
Office:(904)247-5826 9 Fax: (904)247-5845
Ry-
Job Address: Pen-nit Number:
Legal Description ()q- 2S- Z IE. d6 6c&-Q/U zlrloye Uv 4116y)
K 3 _,j�t
Valuation of Work(Replacement Cost) $An,
• Class of Work(Circle one): New 42S� Alteration Repair Move
• Use of existing/proposed structure(�),�Circle one): Commercial Ke-s-iTe_n_ti_ab
• If an existing structure, is a fire sprinkler system installed? (Circle one): T-es—N-o- /�AaD
• Is approval of homeowner's association or other private entity required? (Circle one): 9e[s
Describe in detail the type of work to be perfon-ned: P301'A-z-0, -Lc,
Property Owner Information
Name: '_T0_LiA + Lynyt Ric-�o-lrl Address: I q 17+-- S4.
City State LLZip 1A 2S1 Phone
Contractor Information:
Name of Company:CONS-�a Ii L,!ST0,-"- 5 Qualif�i Agent:
Address:- L-11's St- city r�,K State i Zip 4,23
Office Phone C(O%-( , '3 3 3, b Site/Contact Number
State Certification/Registration L (_'\_�GV 17!5 44A7 -Office Fax#
Architect Name &Phone# Angela ScLiae(bi q0�(-:Sex-goLiz
Engineer's Name&Phone# _&Tjir;�Lv J�jet',, q cy -3 qg�_q f-3 7
ca"on i he r el`v made to obtain a permi.t to do the work and installations as indicated I certify that no work or installation has commenced prior to the
it and ho 1 work will beperformed to meet the standards all laws regulatin struch.on i.n t 7isju
,�con risdiction. Thispermit becomes null and
a Comm f,
A pp" c �a� t en ed within six(6)months,or ifconstruction or wor i's suspended or a andonedfor eriod ofsix(6)months at any time after work is
is8y- 0 er
,,,d 0 k
,..",C,d. I understand that separate perm its in ust be securedfor Electrical Work,Plumbing,Signs,Wells,Yools,Fu rnaces,Boilers,Heaters,Tanks andAir
Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROP�RTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
lhere cert that1haver ead and examined this application and know the same to be true and correct. Allprovisionso I and ordinances,governing thls,�ype
ofworl-will Pe complied with whether specified herein or not. The granting ofapermit does notpresuine to give authori o 'olate or cancel theprovisions ofany
otherfederal,state, or local law regulatin constructionor eper rmanceojconstruction.
;�g c t
Signature of Property Owner: Signature of Contractor:
SworhJ6 and subscriW Oefore me SworV/o and subs
this I I Day of this j( of
Day Q
Notary Public Ina Notary Public:
MEMORIE NOIA
Y COMMISSION#DD 540618 MSMENOIAN
MYC
EXPIRES:Ay 6,2010 OMMISSION#DD 5018
Swided Thm"ry Poic underwntws EXPIRES:JlAy 6,2010
OMM rft Nory PWc Underwiltws
DO NOT WRITE BELOW TIFUS LINF,: OFFICE USE ONILY
Review ResplqCircle one):
A Disapproved Approved w/ Conditions Review Initials/Date:
P
D velopment Size
Habitable Space 105' Non-Habitable Impervious area Total Area
Miscellaneous Information Conditions/Comments:
Occupancy Group
Zebof Construction
uE (
um. er of Stories
Zoning District _4�L-2,
#Parking Spaces__T_ 11
Max. Occupancy Loa
Fire STnk ers Required
0
Flood one
Revised 12/11/06
17TH STREET
(40 FOOT RIGHT OF WAY)
90*15'8*'
(MEAS)
54.30 (MEAS.),� 90*17;
54.30 (REC) (REC.)
FOUND 1/2"
IRON PIPE
NO ID.
89!48' N ��\
(REC.) F
BRICK
2 3.9' WA
ILL
(3)
w--��RETE"-
22.4' 17'
5,
w
17'
—77"
z
L)
z
Ld
SET PK
171 NAIL & DISK
V)O-� 0
LOT LOT<8 SET 1/2" 2 54.35 (MEAS) CANNADY
X IRON P LB 7080'
PIPE- 8
8 9 4:16N-�'CAN
ADY CONCRE
N DRIVE
LB 7080"1 �?
T V.
88 c;
�WCRIETE U E-
c—'5B9'48'0-' 9015'8"' 0
THREE STORY
(MEAS.) FRAME IDUPLEX (MEAS.)
89.48
�71 RESIDENCE #18 V) 9017' 0
w 44
Ld (REC.)
(REC.)Q
w 0
A/
8
23.0' �i 17.9'
z
90*12'0"'0.2' Lo 89*44#52**
MEAS.)' z (MEAS.)
0
9012 89*43'
6' UTILITY (REC.) 3 .1' (REP.)
EASEMENT FOUND 1"� �ISET 1/2"
IRON PIPE PIPE
NO ID. —4CAT—INUV CANNADY
LB 7080"
0 FOUND 1"
IRON PIPE
9012' 54.40 (MEAS.) 89'43' NO 10.
(REC.) 54.46 (REC)— (REC.)
LOT LOT LOT
13 12 11
REWSED.- FEBRUARY IA 2004, TO Sh
FIELD WE FEBRUARY 8, 2003
FLOOD CER77nCAnON !% _ 02il7ll 15CALE. 1-20
BY GRAPHIC PLOrWG ONLY, THE PROPER7Y SHOW HVM'OV R'rZ., DRAW BY' jaAmCm
LES WWII ZONE., ' x -AS SHOW ON 7W FEDERAL LOT 10, BLOCK 8 FIELD BOOK- N�A JPACE-N �W
EMERGDVCY MANAGEM&T AGENCY NA71OXAL RA W DA TA FILE (14-U 111 9.�A
FLOW INSURANCE PROGRAM, FLOOD AVSURANCE RA7r COORDINA 7E nLf, 0 4-0 2 18 CR 5
MAP(F.I.R.M.)COMULWY PANEL A*120075 0001 D OCEAN GROVE, UNIT NO, I I ARCHIW WMPU7EW Df-W NO.: 2004
MAP REWSED OA7E* APRIL 17, 1989 A -6ADD—FXE. 04-0216.[)WC
F J
APPENDIX 13-D
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
FORM 60OC-04R Residential Limited Applications Prescriptive Method C NORTH 1 2 3
Small Additions,Renovations&Building Systems
,Compliance with Method C of Sub-Chapler 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 60OC-04 for additions of 600 square feel or less,sfte-installed components of
manufactired homes,and renovations to single-and muriple-family residences Alternative methods are provided for additions by use of Form 60OB-04 or 60OA-04.
PROJECT NAME: _R;C,h a.,J-4 Pul;U;J BUILDER:
AND ADDRESS: Is lit S+rt,12_1 PERMITTING CLIMATE
OFFICE:Af IaX,�;,- �tl ZONE: 1720 3 RJI
L-11N
OWNER: L-ti h 4 To Kill,, P- ko,,r JS PERMIT NO..LL__l 1 1 1 1 1 1 JURISDICTION NO.:[=I I I o 10
SMALL ADDITIONS TO EXISTING RESIDENCES(600 square feet or less of conditioned area).Prescriptive requirements in Tables 6C-1,SC-2,and BC-3 apply only to the components ofthe addition,not to
the existing building.Space heating,cooling,and water heating equipment efficiency levelsnust be met only when equipment is installed specifically to seive the addition or is Ming irstalled in
conpriction with the addition construction.Components separating unconditioned spaces from conditioned spaces must meet the prescribed minimum insulation levels.RENOATIONS(Residential
buildings undergoing renovations posting more than 30%of the assessed value of the building).Prescriptive requirements in Tables 6C-1 and 6C-2 apply onlyto the components and equipment being
renovated or replaced.MANUFACTURED HOMES AND BUILDINGS.Only site-installed components and features are covered by this form.BUILDING SYSTEMS.Comply when complete new system is
installed.
Please Print CK
1. Renovation,Addition,New System or Manufactured Home 1. Add o n
2. Single-family detached or Multiple-family attached 2. !Q�
3. If Multiple-family-No.of units covered by this submission 3.
4.
4. Conditioned floor area(sq.ft.)
5.
5. Predominant eave overhang(ft.)
6. Glass type and area: Single Pane Double Pane
a.Clear glass 6a. sq,ft. sq,ft.
b.Tint,film or solar screen 6b, sq.ft. sq.ft.
7. Percentage of glass to floor area 7. %
B. Floor type and insulation:
a.Slab-on-grade(R-value) 8a R lin.ft.
b.Wood,raised(R-value) 8b. R sq.ft-
c.Wood,common(R-value) 8c. R sq.ft,
d.Concrete,raised(R-value) 8d. R sq.ft.
e.Concrete,common(R-value) 8e. R sq.ft.
9. Wall type and insulation:
a- Exterior: 1. Masonry(insulation R-value) 9a-1 R sq.ft.
2. Wood frame(insulation R-value) 9a-2 R sq.ft.
b. Adjacent: 1. Masonry(insulation R-value) 9b-1 R sq.ft.
2. Wood frame(Insulation R-value) 9b-2 R sq.ft.
c. Marriage Walls of Multiple Units*(Yes/No) 9C
10. Ceiling type and insulation:
a.Under attic(Insulation R-value) 1 Oa. R sq.ft-
b.Single assembly(Insulation R-value) 1 Ob. R Di aa�sq.ft.
11. Coolingsystem* 11. Type:
(Types:central,room unit,package terminal A.C.,gas,existing,none)
SEERIEER:
12. Heating systenrl 12. Type:
(Types:heat pump,elec.strip,natural gas,LP-gas,gas h.p.,room or PTAC, HSPF/COP/AFUE:
existing,none)
13. Air distribution systerl
a.Backflow damper or single package systems*(Yes/No) 13a.
b.Ducts on marriage walls adequately sealed*(Yes/No) 13b.
14. Hot water system: 14. Type: E I V-4v.'C
(Types:elec.,natural gas,other.existing,none) EF:
Pertains to manufactured homes with site-installed components.
I hereby certify that the plans and specifications covered by the calculation are in compliance with Review of plans and specifications covered by this paid fall n indicates compliance with the Florida
the Florida Energy Code. Energy Code.Before construction is completed,this buly1ding will be inspected for compliance in
PREPAREOBY:V-Ke,Lry41 Eli;c1l"y' DATE: accordance with Section 553,908,F.&
BUILDING OFFICIAL:
I hereby certify that this building is in compliance with thYFlorida Energy Code:
OWNER AGENT: DATE: DATE:_
FLORIDA BUILDING CODE-BUILDING 13-D.33R
I dBakei- Baker Klein Engineering, P.L.
Klein STRUCTURAL ENGINEERING SERVICES
ENGINEERING,
77,,
November 21, 2006
Ms. Lynn Richards
18 17"' Street
Atlantic Beach, Florida 32233
RE: Richards Addition(BKE Job No. 06-258)
Dear Ms. Richards:
Attached is the Uplift and Product Approval List which may be required for your building permit.
This letter should be attached to your plans prior to submitting to the City of Atlantic Beach.
UPLIFT AND PRODUCT APPROVAL:
Hurricane clips and twist straps:
H3=(Prod.Code-FL474.116)Simpson H3 w/(4)8d nails each end-Capacity=455 lb
H8=(Prod.Code-FL1423.7)Simpson H8 w/(5) 10dxl.5"nails each end-Capacity=745 lb
MTS=(Prod.Code-FL474.325)Simpson MTS1 2 w/(7)1 Odxl.5"nails each end-Capacity=1000 lb
HTS=(Prod.Code-FL538.9)Simpson HTS20 w/(24)1 Od nails each end-Capacity= 1450 lb
Flat straps:
MSTA24=(Prod.Code-FL1 901.57)Simpson MSTA24 w/(9) 1 Od nails each end-Capacity= 1640
MSTA36=(Prod.Code-FL1 901.59)Simpson MSTA36 w/(13)1 Od nails each end-Capacity=2135
MSTAM24=(Prod.Code-FL1 901.61)Simpson MSTAM w/(9) 1 Od nails and 5-1/4"x 2-1/4"Titen Screws in Concrete
MSTC28=(Prod.Code-FL1 901.63)Simpson MSTC28 w/(18) 16d sinkers each end-Capacity=3310 lb
MSTC40=(Prod.Code-FL1 901.64)Simpson MSTC40 w/(26) 16d sinkers each end-Capacity=4740 lb
MSTC66=(Prod.Code-FL1 901.67)Simpson MSTC66 w/(38) 16d sinkers each end-Capacity=5855 lb
Heavy girder tiedowns
MGT=(Prod.Code-FL1423.15)Simp MGT w/(22) 10d nials into truss and(1) 1/2"thru-bolt into ftg.-Cap.=3965 lb
PHID2=(Prod. Code-FL503.27)Simp. PHD2 w/(10)SDS1/4x3"screws truss(1) 1/2"thru-bolt into ftg.-Cap.=3610 lb
PHD5=(Prod.Code-FL503.26)Simp.PHD5 w/(14)SDS1/4xY screws into truss(1)5/8"thru-bolt into ftg.-Cap.=4685 lb
HTT16=(Prod.Code-FL503.20)Simp.HTT16 w/(18)16d nails into truss and(1) 1/2"thru-bolt into ftg.-Capa.=4175 lb
HTT22=(Prod.Code-FL503.21)Simp.HTT22 w/(32) 16d nails into truss and(1)5/8"thru-bolt into ftg.-Cap.=5260 lb
HDQ8=(Prod.Code-FL1463.25)Simp.HDQ8 w/(20)SDS1/4X3"screws to truss(l)7/8"thru-bolt into ftg.-Cap.=8235 lb
THAI-2=(Prod.Code-FL474.414)Simp.THAI-2 inverted heavy girder hanger w/(30)1 Od nails into face-Cap.=4135 lb
Face Mount Hangers
LUS28 (Prod.Code FL474.284)Simp.LUS28 w/(6) 1 Od nails into hdr and(4) 1 Od nails into joist-Cap.= 1115 lbs.
HUS26 (Prod.Code FL474.192)Simp.HUS26 hanger w/(14) 16d nails in header(6) 16d nails into joist-Cap.=1550 lbs.
HGUS282=(Prod.Code FL474.139)Simp.HGUS282 hanger w/(36)16d nails(1 2)16d carried mem-Cap.=3220lbs.
HU41 0=(Prod.Code FL1 218.148)Simp.HU41 0 han.wl(14)16d nails in header(6)16d nails into joist-Cap.= 1715 lbs.
Adjustable and Standoff Post Bases
ABU44=(Prod.Code-FL474.21)Simp.ABU44 Adj.Post Base 5/8"Anchor w/(1 2)-16d nails-Capacity 2200 lbs.
ABU66=(Prod.Code-FL1 725.1)Simp.ABU66 Ad.Post Base 5/8"Anchor w/(1 2)-16d nails-Capacity 2300 lbs.
1628 San Marco Boulevard, Suite 13
Jacksonville, Florida 32207
(904) 398-9837 Phone (904) 398-9838 Fax
Column Caps
CC44=(Prod. Code-FL1218.12)Simp.CC44 Column Cap w/(2)5/8"bolts in bm&(2)5/8"bolts in post-Cap.= 1465 lbs.
CC66=(Prod.Code-FL1218.18)Simp.CC66 Column Cap w/(4)5/8"bolts in bm&(2)5/8"bolts in post-Cap.=4040 lbs.
Holddowns
PA51 =(Prod.Code-FL474.335)Simpson PA51 Embedded Anchor w/(9)16d nails-Capacity 2030 lbs.
Anchoring Adhesive
SET=(Prod.Code-FL402.3)Simpson Epoxy-Tie
AT=(Prod.Code-FL2304.1)Simpson Acrylic Tie
Coiled Straps
CS20=(Prod.Code-FL1 901.6)Simpson CS20 20 Ga.Coiled Strap w/(18)8d nails-Capacity 1030 lbs.
Stud Plate Ties
SP1 =(Prod.Code-FL474.384)Simp.SP1 Stud Plate Tie(6)10d nails in stud(4) 10d nails into top plate-Cap.=535 lbs.
SP2=(Prod.Code-FL474.385)Simp.sp2 Stud Plate tie w/(6) 1 Od nails in stud(6) 1 Od nails into top plate Cap.=605 lbs.
SP4=(Prod.Code-FL474.386)Simpson SP4 Stud Plate Tie w/(6) 10dxl.5"nails in stud-Capacity=760 lbs.
SPH4=(Prod.Code-FL538.34)Simpson SPH4 Stud Plate Tie w/(10) 1 Odxl.5"nails in stud-Capacity=1065 lbs.
SPH6=(Prod.Code-FL538.35)Simpson SPH6 Stud Plate Tie w/(10) 1 Odxl.5"nails in stud-Capacity=1065 lbs.
SSP=(Prod.Code-FL1 423.21)Simpson SSP Single Stud Plate Tie w/(4) 1 Od nails in stud(1) 1 Od nail into top plate
Framing Anchors
LTP4=(Prod.Code-FL474.258)Simpson LTP4 Framing Anchor-Capacity=670 lbs.
A35=(Prod.Code-FL474.4)Simpson A35 Framing Anchor-Capacity=450 lbs.
Tension Tie
LTT20B=(Prod.Code-FL474.264)Simp.LTT2013 Tension Tie w/1/2"Anchor and(10)16d nails-Capacity=1750lbs.
Should you have any questions or need additional information, please call me directly at 904-398-
9837.
Sincerely,
Structural Engineer
FL Lic.No. 59386
1628 San Marco Boulevard, Suite 13
Jacksonville, Florida 32207
(904) 398-9837 Phone (904) 398-9838 Fax
Baker Baker Klein Engineering, P.L.
Klein STRUCTURAL ENGINEERING SERVICES
ENGINEERING,P.L.
November 21, 2006
Ms. Lynn Richards
18 17"' Street
Atlantic Beach, Florida 32233
RE: Richards Addition(BKE Job No. 06-258)
Dear Ms. Richards:
Attached is the Uplift and Product Approval List which may be required for your building permit.
This letter should be attached to your plans prior to submitting to the City of Atlantic Beach.
UPLIFT AND PRODUCT APPROVAL:
Hurricane clips and twist straps:
H3=(Prod.Code-FL474.116)Simpson H3 w/(4)8d nails each end-Capacity=455 lb
H8=(Prod.Code-FL1423.7)Simpson H8 w/(5) 10dxl.5"nails each end-Capacity=745 lb
MTS=(Prod. Code-FL474.325)Simpson MTS12 w/(7) 1 Odxl.5"nails each end-Capacity=1000 lb
HTS=(Prod.Code-FL538.9)Simpson HTS20 w/(24)10d nails each end-Capacity=1450 lb
Flat straps:
MSTA24=(Prod.Code-FL1 901.57)Simpson MSTA24 wl(9)1 Od nails each end-Capacity=1640
MSTA36=(Prod.Code-FL1 901.59)Simpson MSTA36 w/(13) 1 Od nails each end-Capacity=2135
MSTAM24=(Prod.Code-FL1 901.61)Simpson MSTAM w/(9)1 Od nails and 5-1/4"x 2-1/4"Titen Screws in Concrete
MSTC28=(Prod.Code-FL1 901.63)Simpson MSTC28 w/(18) 16d sinkers each end-Capacity=3310 lb
MSTC40=(Prod.Code-FL1901.64)Simpson MSTC40 w/(26) 16d sinkers each end-Capacity=4740 lb
MSTC66=(Prod.Code-FL1 901.67)Simpson MSTC66 w/(38) 16d sinkers each end-Capacity=5855 lb
Heavy girder tiedowns
MGT=(Prod.Code-FL1 423.15)Simp MGT w/(22) 1 Od nials into truss and(1) 1/2"thru-bolt into ftg.-Cap.=3965 lb
PHD2=(Prod.Code-FL503.27)Simp. PHD2 w/(10)SDS1/4x3"screws truss(1) 1/2"thru-bolt into ftg.-Cap.=3610 lb
PHD5=(Prod.Code-FL503.26)Simp.PHD5 w/(14)SDS1/4x3"screws into truss(1)5/8"thru-bolt into ftg.-Cap.=4685 lb
HTT16=(Prod.Code-FL503.20)Simp.HTT16 w/(18)16d nails into truss and(1)1/2"thru-bolt into ftg.-Capa.=4175 lb
HTT22=(Prod.Code-FL503.21)Simp.HTT22 w/(32) 16d nails into truss and(1)5/8"thru-bolt into ftg.-Cap.=5260 lb
HDQ8=(Prod.Code-FL1463.25)Simp.HDQ8 w/(20)SDS1/4X3"screws to truss(l)7/8"thru-bolt into ftg.-Cap.=8235 lb
THAI-2=(Prod.Code-FL474.414)Simp.THAI-2 inverted heavy girder hanger w/(30) 1 Od nails into face-Cap.=4135 lb
Face Mount Hangers
LUS28=(Prod.Code FL474.284)Simp.LUS28 w/(6) 1 Od nails into hdr and(4) 10d nails into joist-Cap.= 1115 lbs.
HUS26=(Prod.Code FL474.192)Simp.HUS26 hanger w/(14) 16d nails in header(6) 16d nails into joist-Cap.=1550 lbs.
HGUS282=(Prod.Code FL474.139)Simp.HGUS282 hanger w/(36)16d nails(1 2)16d carried mem-Cap.=3220lbs.
HU410=(Prod.Code FL1218.148)Simp.HU410 han.w/(14) 16d nails in header(6) 16d nails into joist-Cap.=1715 lbs.
Adjustable and Standoff Post Bases
ABU44=(Prod.Code-FL474.21)Simp.ABU44 Adj.Post Base 5/8"Anchor w/(12)-16d nails-Capacity 2200 lbs.
ABU66=(Prod.Code-FL1725.1)Simp.ABU66 Ad.Post Base 5/8"Anchor w/(12)-16d nails-Capacity 2300 lbs.
1628 San Marco Boulevard, Suite 13
Jacksonville, Florida 32207
(904) 398-9837 Phone (904) 398-9838 Fax
Column Caps
CC44=(Prod.Code-FL1218.12)Simp.CC44 Column Cap w/(2)5/8"bolts in bm&(2)5/8"bolts in post-Cap.= 1465 lbs.
CC66=(Prod.Code-FL1218.18)Simp.CC66 Column Cap w/(4)5/8"bolts in bm&(2)5/8"bolts in post-Cap.=4040 lbs.
Holddowns
PA51 =(Prod.Code-FL474.335)Simpson PA51 Embedded Anchor w/(9) 16d nails-Capacity=2030 lbs.
Anchoring Adhesive
SET=(Prod.Code-FL402.3)Simpson Epoxy-Tie
AT=(Prod.Code-FL2304.1)Simpson Acrylic Tie
Coiled Straps
CS20=(Prod.Code-FL1 901.6)Simpson CS20 20 Ga.Coiled Strap w/(18)8d nails-Capacity=1030 lbs.
Stud Plate Ties
SP1 =(Prod.Code-FL474.384)Simp.SPj Stud Plate Tie(6) 10d nails in stud(4) 10d nails into top plate-Cap.=535 lbs.
SP2=(Prod.Code-FL474.385)Simp.sp2 Stud Plate tie w/(6) 10d nails in stud(6) 10d nails into top plate Cap.=605 lbs.
SP4=(Prod.Code-FL474.386)Simpson SP4 Stud Plate Tie w/(6) 10dxl.5"nails in stud-Capacity=760 lbs.
SPH4=(Prod.Code-FL538.34)Simpson SPH4 Stud Plate Tie w/(10) 10dxl.5"nails in stud-Capacity= 1065 lbs.
SPH6=(Prod.Code-FL538.35)Simpson SPH6 Stud Plate Tie w/(10) 1 Odxl.5"nails in stud-Capacity=1065 lbs.
SSP=(Prod.Code-FL1 423.2 1)Simpson SSP Single Stud Plate Tie w/(4)1 Od nails in stud(1) 1 Od nail into top plate
Framing Anchors
LTP4=(Prod.Code-FL474.258)Simpson LTP4 Framing Anchor-Capacity=670 lbs.
A35=(Prod.Code-FL474.4)Simpson A35 Framing Anchor-Capacity=450 lbs.
Tension Tie
LTT20B=(Prod.Code-FL474.264)Simp.LTT20B Tension Tie w/1/2"Anchor and(10)16d nails-Capacity=1750lbs.
Should you have any questions or need additional information, please call me directly at 904-398-
9837.
Sincerely,
Debra P. Klein,P.E.
Structural Engineer
FL Lic.No. 59386
1628 San Marco Boulevard, Suite 13
Jacksonville, Florida 32207
(904) 398-9837 Phone (904) 398-9838 Fax
Page I of 1
John Storkman
From: Jeff Tyrrell UefftyrreIIQ_belIsouth.net1
Sent: Thursday, February 15, 2007 5:27 PM
To: 'John Storkman'
Subject: Richards Res. F1 Prod Vs
Revision PGT Industries Approved
Category: Windows
Subcategory: Horizontal Slider
3-R2 n Industries Approved
Aor., ry: Exterior Doors
ory: Sliding Exterior Door Assemblies
44 Revision PGT Industries Approved
3tory Category: Windows
Subcategory: Fixed
-7072-H Revision PGT Industries Approved
story Category: Exterior Doors
Subcategory: Swinging Exterior Door Assemblies
Revision Plastpro, Inc. / Nanya Plastics Corp. L.F. Schmidt, Approved
Category: Exterior Doors P.E.
Subcategory: Swinging Exterior Door (813) 926-6537
Assemblies
Jeff Tyrrell
Architectural Windows and Cabinets. Inc
327 Tresca Road
Jacksonville, Fl 32225
phone-904-333-0530
fax-904-246-6139
2/19/2007
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material fail�to meet tt 7&'pirements of the appfr4able building code.
This product is approvIRI as described herein,and has been designed to comply with the Florida Building Code,
including the High Velocity Hurricane Zone.
DESCRIPTION: Series'IF60W'Aluminum Fixed Window
APPROVAL DOCUMENT:Drawing No.550,titled"Aluminum Fixed Window Non-Impact",sheets I through
10 of 10,prepared by manufacture,dated 10/24/00 with revision'T'on 05/02105,signed and sealed by Robert L.
Clark,P.E.,bearing the Miami-Dade County Product Control Revision stamp with the Notice of Acceptance
number and expiration date by the Miami-Dade County Product Control Division.
MISSILE IMPACT RATING:None
LABELING:Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and
following statement: "Miami-Dade County Product Control Approved",unless otherwise noted herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no
change in the applicable building code negatively affecting the perfon-nance of this product.
TERMINATION of this NOA will occur after the expiration date or if them has been a revision or change in the
materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any
produa for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply
with any section of this NOA shall be cause for termination and removal of NOA.
ADvERns ber Preceded, "' " de orida, and followed-I iy
the expiration date may �e displayed in advertising�etrattu're&WkaLrnyrporfttionkof t"heM Fis displayed,then it sh,It
be done in its entirety. 95.25" eqyE�ALL PAI&EL HWHT
INSPECTION: A copy (f this entire NOA shall De provid 0 e user by e man acturer or its distributors
and shall be availablef07wspection at thejob site at th K&S�of the Building Official.
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CITY OF ATLANTIC BEACH
-IF
PLAN REV W SHEET Routed to:
U te er
Building Department Public Works&Public Utilities Departments
800 Seminole Road 1200 Sandpiper Lane a
Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233
(904)247-5800 (904)247-5834 PAU iNaFeVy
(904)247-5845 Fax (%X)247-5843 Fax
PLAN REVIEEW COMMENTS
Permit Application#_
/� /
Property Address
Applicant: (1-02&4
Project: 2
This permit application has been:
`Approved as noted by the Department.
Final application approval must coige from the Building Department.
Reviewed and the following items need attention:
Please re-submit 2-copies of all revisions. Please re-submit your
-revisions to the Department requesting them.
Building Dept, Public Works and Utility information at top of page,
failure to notify the correct department may delay your permit from
-being issued. /I
Reviewed By: Date:
Date Contractor Notified:
Y
A BuILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
FEB i) �00,800 Seminole Road,Atlantic Beach Fl,32233
Office: (904)247-5826 9 Fax: (904)247-5845
Job Address: Tk Permit Number:
zi 10 1U C-
Legal Description L 0 q- 2 5 Z iE
d6 Oc&-Qlu tl
ulu, d�h FO 4//00
L
Valuation of Work(Replacement Cost) $
Class of Work(Circle one): New 425� Alteration Repair Move
Use of existing/proposed structure(Is)&ircle one): Commercial 8:e:s�i�entia�
If an existing structure, is a fire spr er system installed? (Circle one): Ye-s--go-
Is approval of homeowner's association or other private entity required? (Circle one): Yes ;MD
Describe in detail the type of work to be performed: S-1 t,-I �,RoaLre_
Property Owner Information
Address
4�Zip JA:X_3_� Phone
N
CZA
Contractor Information:
Name of Co pany: C.Usye— s Qualifyi Agent:
Address: I L,
City State Zip �23
Office Phone QO 3 3 3, 7 Job Site/Contact Number
State Certification/Registration# _L- Cl G 4tA 2S L14,97 Office Fax#
Architect Name &Phone#. Ai%!ggla .9 k&a.-e(bi 50�1-:Sff-11041�
Engineer's Name&Phone# 15cd,6Er
pP he eb made ob ai, a e d rk nd ns a nas a d e tha n o� in�ta a as commencearprior to the
0
w t t 'Or'� sd' 'on
t,
I'-ca" n is r m t t 0 wo a s w'c r"n u t'0 n d is on. T IN permit becomes null and
w re ati, co s r
0 t
i' (6 "on ata time a�ter work is
or a ado, d or 'r ",c s oil, He7
w Eli sOF e ters,Ta k andAir
A 0 to ' n r te t'07 ss s 'd
a�ce a I ernut and th t air, 0 be er ormed me t he Standards o
c on or w
� , or, e
e p o ,a, 0 I'm - g,S.g
'ssu 1 0 s no comm n r wi I i tdr r E k b n , ns, e S, 00
I s 0 co
void f 0 k t e ced th n 6 th , ri
'0_2 ' d. I understand that, arate ermits must be c. e
Condition"s,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR RVIPROVEMENTS TO YOUR PROPI�RTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCENIENT.
I ereb certi thatIhaver ead and examined this application and know the same to be true and correct. Allprovisions oft and ordinances govern!.�g th'
ofwor will e complied with whether�pecifzed herein or not. The granting ofapermit does notpresume to give authori o *olate or cancel theprovisions 107IP4
other dera state, or local law regulating construction or e per rmance qj construction.
1�I
Signature of Property Owner: Signature of Contractor:
Sworp&6 and subscri�ad�efbre me Sworoo and subscri r me
this" Dayor 4-
this
,a Day of
lscri��)
Notary Public Notary Public:
MEMORIE NOLAN]0618
MEMORIE NOLAN I
MY COMMISSION#DID 540618
0
EXPIRES:July 6,2010 My COMMISSION#DD 540618
Bonded Thru Notary Public underwriters EXPIRES:July 6,2010
OMM Pn Notary Public uncle
DO NOT WRITE BELOW TMS LINF,: OFFICE USE 0N11,Y
',eview Result(Circle one):
,hpproved Disapproved Approved w/ Conditions Review Initials/Date:
)evelopment Size
labitable Space Non-Habitable impervious area Total Area
liscellaneous Information. Conditions/Comments:
Occupancy Group
T
,Vpe of Constructi7o—n
ur
umber of Stories
Zoning District
#Parking Spaces
Max. 0 cupanc Load
Fire S�0=rs iequir6d__
ne
Flood one
Revised 12/11/06
17TH STREET
(40 FOOT RIGHT OF WAY)
90'15'8"'
(MEAS)
54.30 (MEAS.) 90*17;
54.30 (REC) (REC.) FOUND 1/2"
RON PIP
F 0 ID.
89*48'
(REC.) BRICK
27.,
23.9' ALK
79.4 3.7'-
3.7' PIC
uj
W 0
z
L.j
L, 16 SET PK
NAIL & DISK w
>
'CANNADY
LOT LOT$WE�SET 1/2- 0 54.35 (MEAS) Y.
1 6.0, �� �, I� I CP LB 708( 8
RON PIPE C
8 9 ot�R'E' 8
z
0
j
j
R K
ICY 5
ALK
7 1'
EV
C
ki.
88 LB 7080" DRIVE 3:W,
ci U E-1
9001
t89*48 0 5080
THREE STORY 0
(MEAS.) FRAME DUPLEX (MEA&) 0
89*48 RESIDENCE #18 90'17'
w
(REC.)'!� (REC.)
4.1' . ..0
w
A/ 3.5
23-0'
L)
zi 89*44!520'
uj
9012*0 .2'
WAS)' z (MEks.)
9012 89*43!
6' UTILITY (REC-) 3o.1, (RE�-) �ISE
EASEMENT FOUND Ro T
N PIPE
IRON PIPE� ; '
'4CAAINUN PENC 'CANNAD�
NO 10. L 7080'
0 FOUND I"
'43 IRON PIPE
90*12' 54.40 (MEAS.) 894 NO ID.
(REC.) 54.46 (REC)- (RCC.)
LOT LOT LOT
13 12 it
REWSM FEBRUARY 14 2004, TO 5
FORUARY 8,:20013,
Na.'04-0218
FLOOD CMW7CAMN CREW CH10r.,D.M. BY:J.A.0
gy mpW PLOT7M OAIILY IW PROPERTY SWWV hV?EIOIV GE N4A
LES WNW ZONE.- ' X 'AS SWWV CAI IW FEDIMAL LOT 10, BLOCK 8 ' IPA
RAW DATA PEt �,.- ?IR RW-1
aWRWCY MAAAWA"T AWWY NAMML CDOROM7E FRE., 34-65muRn
FLOOD AVSURANCE PROGRAM,FLOOD WSURANCE RATE OCEAN GROVE, UNIT NO, 1 ARCHfW O0MPU7ER DISWK NWO.: 20"
MAP".IP.AL)CoAaKNITY PAAFEL Na*120075 0001 0 B.D\VG
MAP DAIM APRIL 17. 1989
K -
CITY OF ATLANTIC.BEACH
PLAN REVIEW SHEET Routed to:
Z Cn.HufsteTer:)
z Building Department Public Works&Public Utilities Departments
T�
4romig, 800 Seminole Road 1200 Sandpiper Lane ---T
Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 j-:ff
(904)247-5800 (904)247-5834 Public-Safety
(904)247-5845 Fax (904)247-5843 Fax
PLAN REVIEW CONMIENTS
Permit Application# �Qb/&112--
Property Address / 7J4- . --
Applicant: Oea�'�z
Project:
This permit application has been:
Approved as noted by the i Department.
Final application approval must come from the Buffding Department.
ED Reviewed and the following items need attention:
oe
Please re-submit 2-copies of all revisions. Please re-submit your
revisions to the Department requesting them.
Building Dept, Public Works and Utility information at top of page,
failure to notify the correct department may delay your permit from
being issued. '".) ,
Date: "00
Reviewed By:
Date Contractor Notified: -rill
FES 21 2007
BY
T--l'
WATER IMPACT FEE WC'RKSHEET
ADDRESS:
DRAJNAGE
4FIXTURE UNIT
RXTUR�TYPE V,
VALUE AS LOAD FDMjRFS UNITS
AUtomadc clothes wn,+Are roGypercial'
3
Autornati�d6�hes washe�s, resiaeniial 2
room group consisting of wlater closet, lavaoiT—
BideL a'nd baLhtuh nrshowAr 6
t2MCUD(YAtn or without overhead showef or whirlp
2
Bidet
2
Combinat on sink and 1:ray 2
—7
Dental lavatory
Flaw Dish-washing machine, domestic 2
Drinking fountairulcemaker
R dra"
oor ins. 2
Hose bib
Kjtc�en sink, domastic
Kitchen.sink, dun&sZc wfth food waste gdn er and/or 2
dishwasher
2
Laundry tray (I or 2-compartT)enLs) 2
Shower oomp&t7ren� domes' dc 2
Sink
2
Urinal
4
Urinal, 1 gallon per flush or less '2
Wash�&nk
circu(ar or mdtple)each set of faucets 2
Water
private 4
Water closet, Drivate Installation
4
Water doset, Pubric instAintinn 6
TOTAL NUMBER
UMTS'
;2—
MULTIPUED X 2o
TOTAL$
CITY OF ATLANTIC BEACH
PERMIT CALCULATION SHEET
Date 2-) Z Permit Number
I "�e2 — *-�'
Address
Contact Name Phone
Heated Square Footage @ per sq ft
Oarage Shed $_ persqft= $
Carport Porch $_ persqft = $
' Deck @ S_ persq ft= $
Patio .@ $ _persqft = $
TOTAL VALUATION: $
Total Ta—Ju7ti—on $
3t
RemaihLing Value perthousand
or portion thereof
CONSTRUCTION TYPE: TOTAL BUILDrNG FEE $
ZONING: + V7 Filing Fee $
FLOOD ZONE: ) Fireplaces@ $35.00 $
D,IPERVIOUS SURTACE:
AB CONSTRUCTION SURCHARGE $—
CA.PITAL DyfPROVENfENT S
CITY WON SURCHARGE S
SECTION H INfPACT FEE $
SEWER RAPACT FEES $
SEWER TAP FEES
ST CONSTRUCTION SU-RCHARGE
STATE RADON SURCHARGE i
WATER CONNECT/METER ONLY S
WATER CONNECT/TAP & METER $
WATER CROSS CONNECTION $
WATER INVACT FEE $ 2129
OTHER $—
GRAND TOTAL DUE:
./13"C",
F
BUILDING PERMIT APPLICATION
I re F
CITY OF ATLANTIC BEACH
FEB 2 o Poo 1800 Seminole Road,Atlantic Beach FL 32233
r
Office: (904)247-5826 9 Fax: (904)247-5845
Job Address: I P) vm&,04.�, Pen-nit Number:
Legal Description 7- (A- 25- z 1E. d6 0c&_Qn,� II-rove- L-)v -18CT-o 4110
Valuation of Work(Replacement Cost) $Zj&5nZ-
r
Class of Work(Circle one): New 42�� Alteration Repair Move
Use of existing/proposed structure(�s)&ircle one): Commercial X rs iWe_nt i-a-t>
in TTo_ /A
If an existing structure, is a fire spri er system installed? (Circle one): Yes
Is approval of homeowner's association or other private entity required? (Circle one): ��es
Describe in detail the type of work to be performed: P30 Cx, SV-wC;VUre_
%ir�i:k2���2 AA 19
Property Owner Information
Name: --l—o 6 - "iel R�It_t-,aijv Address: 19 17+% S4.
city :kl -i,_ teafe State 64
E/-Zip :IA231 Phone YO� 21t& 41U2
Contractor Information:
Name of Company:Lrv.��a� Cusyo- 5 Qualif�in Agent: 44.,_
Address: !�OC-, 1-ftk, St- City 15�, L —State 1
Office Phone C(Ok--( 3 3, 7 7,Z S Job Site/Contact Number -q-q-q, :1 L4 I
State Certification/Registration# V L '12 S 4 4 P7 Office Fax 4
Architect Name &Phone# Ang?,da_ loq- "_1i0q_z
Engineer's Name &Phone#
Application is hereby made to obtain a ermit to do the work and installations as indicated I certify that no work or installation has commenced prior to the
issuance ofapermit and that all work wif,beperformed to meet the standards o all laws regulating constructi.on i.nthisjurisdiction. This permit becomes null and
voidifwork is not commenced within six(6)months, or ifconstruction or wor r"s stiqpended or abandonedfor V0 eriod ofsLx(6)months at any time after work is
commenced. I understand that separatepermits must be securedfor Electrical Work7,Plumbing,Signs,Wells, ools,Furnaces,Boilers,Heaters,TanksandAir
Conditioners,eta
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCENMNT MAY
RESULT IN YOUR PAYING TWICE FOR IWROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
1here certi that1haver.ead and examined this application and know the same to be true and correct. Allprovisions ofl and ordinances governing this
ofwor��-will Pe complied with whether s eci ted herein or not. The nti ofayertnit does notpresume to give authori o 'olate or cancel theprovisions oj ny
otherfederal,state, or local law regul ting construction or t e per r ce qj construction.
gra
ma
ft
and
olate
o
0
rd
in
ca
an
nce
ce
Me-pvr_�o
r
or.
Signature of Property Owner: Signature of Contractor:
t
Sworhid and subscr Pefore me Swor#/o and subscri -ran e
this 1 7 Day of 'e, of
this/( / -0
a Day
Notary Publi Ina Notary Public:
MEMORIE NOLAN MEMORIE NOLAN-
COMMISSION#DD 5
MY 40618
My COMMISSION#DO 540618
EXPIRES:July 6.2010 EXPIRES:July 6,2010
Bonded Thru NoWry Public Underwriters OW"Thfu Notery Public Underwriters
DO NOT WRITE BELOW TMS LINIE: OFFICE USE ON11,Y
�eview Result(Circle one):
Approved Disapproved Approved w/ Conditions Review Initials/Date:
)evelopment Size
labitable Space Non-Habitable Impervious area Total Area
vliseellaneous Information Conditions/Comments:
Occupancy Uroup
Type of Construction
9timber of Stories
Zoning District
#Parking Spaces
Max. Occupancy Load
Fire S rinklers Required
Floo0one
Revised 12/11/06
MAP SHOWING BOUNDARY SURVEY OF
THE SOUTH 48 FOOT OF THE NORTH 100 FOOT OF LOT 10, BLOCK
8, OCEAN GROVE, UNIT NO. 1, THE SOUTH 48 FOOT OF THE
NORTH 100 FOOT, AS RECORDED IN PLAT BOOK 15, PAGE 82, OF
THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTOED TO. JOHN & LYNN RICHARDS
COMMONWEALT74 LAND RTLE INSURANCE COMPANY
RICHARD G. HATHAWAY, PA
PONTE VEDRA 777LE, LLC
LEGEND
0— DENOTES CONCRETE MONUMENr
0 — XNOTES BOUAVARY IRON AS N070
*— DEN07ES NAX AND DISK AS H07ED
X—DENOTES 3'PICKETT FENCE LOVE UNLESS 07HERWSE NOTED
—,I*,--DENOTES PROPERTY UNE NOT TO SCALE
ABBREWA71ONS
A11C — DEN07ES A#?COAD77ONER
(MEAS) — DENOTES FIELD MEASUREMENT
(REr) DENOTES RECORD DIMENDON PER PLAT
J.E.A* DENOTES JACKSONMLE ELECTRIC AUTHORI7`Y
P.B. — DENOTES PLAT BOOK
PC — DEN07ES PAGE
CONC. — DENOTES CONCRETE
(n) — DEN07ES FENCE uAL-INSDE OF RIBZCT PROPERry LINE
(FOL) DENOTES FENCE LOVE ON SUBECT PROPERTY LOVE
(FO) DENOTES FENCE LINE OUTWE OF SU8XCT PROPERTY UNE
p.T —DENOTES POINT or TANGENT
P.C. — DENOTES POINT OF CURVE
p R.C. — DEN07ES POINT OF
P.C.0 — DEN07ES OOVT OF C046-OUND CURVE
LB— DEN07ES UCENSED BUSINESS
PS" — DENOTE'S PROFES90NAL SURVEYOR AND MAPPER
ID DENOTES IDENTIFICA77ON
I.P. DENOTES h1?0N PIPE
L — DENOTES LENGTH
CH — DEN07ES CHORD
CS —DENOTE'S CHORD BEARING
R— DENOTE'S RADIUS
A— DENOTES CENTRAL ANGLE
(INV) — DENOTES INVERSE PER FIELD MEASt4REMENT
(CALC) — DENOTES CALCULATED DIMENSION PER PLAr
PK — DEN07ES PARKER KALON(NAME BRAND)
pCp —DENOTE'S PERMANENT CONTROL PONT
GENERAL NOTES
1. TMS IS A MAP SHOWNG B"DARY SURVEY
2. No BEARINGS SHOWV HERECK ANGLES SHOjW HEREON REPRESENT FIELD MEASURED DATA.
NORTH ARROW SHOON HEREON PR07RACTED FROM PLAT
3. THERE MAY BE ADO1770NAL RES7R1CT700VS OR CASEMENTS 774AT ARE NOT SHOON ON THIS
MAP INA T MAY BE FOUND IN THE PUBLIC RECORDS OF TMS COUN rY OR EVIDENCED By 77 ILE EXAMINA 770N-
4 THIS SVRvry wAS PERFORMED WTHOUT THE BENEFIT OF A 777LE COMMITWDYT,
5. THE PROPERTY SHDON HEREON EMBRACED By HEAvy LOVES IS BASED ON A LEGAL DESCRIP77ON
PROWDED BY Ciff)VT
6. T,#S SURWY DOES NOT REnECr OR DETERMINE OWVERSMP-
7. THIS SWVFY SHOWS ONLY THE ABOVE GROUND OVDICIA NO UNDERGROUND UTTL'TES�
FOOTERS, SIRUCTURFS� OR AFROVEMENTS ARE SHOON ON THIS AMP
a UNLESS 07HERWSE NOTED, ANY pORTON OF THE PARCEL THAT MAY BE DEEMED AS
HEMANDS BY STATE OR GOVERNMENT AGENCIES, HAS NOT BEEN DETERMINED AND ANY
LIABILITY RESULIZNG THEREFROM IS NOT THE RESPONSIBILITY OF THE UNDERSIG?�ED
UNLESS IT BEARS THE SIGNA TURE AND 7HE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURWYOR AND MAPPER, THIS ORA WNG,
SKETCH, PLA T OR MAP IS FOR INFORMA 77ONAL PURPOSES ONL Y, AND IS 61Q—T VALID.
OW IMPROVEMENTS
I HEREBY CiERTFY THAT THIS SURVEY WAS MADE TO THE BEST OF MY 11
KNO#LEDGE AND BELIEF AND MEETS THE MMIMUM TECHNICAL STANDARDS AS -ILE NO. B—113
SET FORIH By 7HE FLORIDA BOARD OF PROFESSIONAL LAND SURVEYORS AV T T5783 Mining Terrace, Suite 5
a
Jacksonville, Florida 32257
CHAPTER 6107— 0(FORMERLY CHAPNER 21HH-6.0), FLORIDA ADMINISTRATIVE l -3
14 26C_623
)260_026'
CODE, TO SECTION4�iO27, FnL S TA 77J TIES Phone: (904)260-6628
Fox (904)260-0266
ess . 0,0
Licensed Business No.: 7080 W Cannady
ell _th-n.,
B Y. EM—AIL: jwcal0bellsouth.not SURVE:yll-4C3 1114C .
,44MES w CANNADY STATE OF FLORIDA,
PROFESSIONAL MRVEYLV&MAPPER, C4ER77F7CA7r No. 5586
APPENDIX 13-D
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
FORM 60OC-04R Residential Limited Applications Prescriptive Method C NORTH 1 2 3
Small Additions,Renovations&Building Systems
-Compliance with Method C of Sub-Chapter 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 60OC-04 for additions of 600 square feet or less,site-installed components of
manufactured homes,and renovations to single-and multiple-farnily residences.Alternative methods are provided for additions by use of Form 5008-04 or Sl
PROJECT NAME: ii A-,% h1A�i ;1 lf-� Bull DER:
�S PERMITTING CLIMATE
AND ADDRES r es-1 OFFICE:At1C,,X4;(_ ZONE: 1 [] 2 [�] 3
OWNER: L_uiV%_ 4 To I,,, P_ r i
'\V-� F�_k __Kv�,r L. PERMIT JURISDICTION i
SMALL ADDITIONS TO EXISTING RESIDENCES(600 square feet or less of conditioned area).Prescriptive Teqxrements in Tables 6C-1,SC-2,and K-3 apply only to the components otthe addition not to
the existing building.Space heating,cooling,and water heating equipment efficiency levels must be met only when equipment is installed specificallyto servethe addition or is being installed in
con�unction with the addition construction,Components separating unconditioned spaces from conditioned spaces must meet the prescribed minimum insulation levels.RENO%TlONS(Residential
builli undergoing renovations costing more than 30%of the assessed value of the building),Prescriptive requirements in Tables 6C-1 and 6C-2 apply only to the components and equipment being
renovated or replaced.MANUFACTURED HOMES AND BUILDINGS.Only stle-installed components and features are covered by this form.BUILDING SYSTEMS.Comply when complete new system is
installed.
Please Print CK
1 Renovation,Addition,New System or Manufactured Home i..Aaf d,+,on
2. Single-family detached or Multiple-family attached 2. S; ,,q I V ,
3
3. If Multiple-family-No.of units covered by this submission 4.
4. Conditioned floor area(sq.ft.) 5.
5. Predominant eave overhang(ft.)
6. Glass type and area; Single Pane Double Pane
a.Clear glass 6a. sq.ft. sq.ft.
b.Tint,film or solar screen i sq.ft. sq.ft.
7. Percentage of glass to floor area 7. % ll,4p
B. Floor type and insulation:
a.Slab-on-grade(i 8a R=-b- lin.ft.
b.Wood,raised(R-value) 8b. R sq.ft.
c.Wood,common(R-value) 8c. R sq.ft.
d.Concrete,raised(R-value) 8d. R sq.ft.
e.Concrete,common 8e. R sq.ft.
9. Wall type and insulation:
a. Exterior: 1. Masonry(insulation R-value) ga-1 R sq.ft.
2. Wood frame(Insulation R-value) ga-2 R sq.ft.
b. Adjacent: 1. Masonry(insulation R-value) 9b-1 R sq.ft.
2. Wood frame(Insulation R-value) 9b-2 R sq.ft.
c. Marriage Walls of Multiple Units*(Yes/i 9C
10, Ceiling type and insulation:
a.Under attic(insulation R-vaiue) 1 Oa. R= sq.ft.
b.Single assembly(Insulation R-value) 10b. R= sq.ft.
11. Coolingsystem* 11. Type: 4li t,-,
(Types:central,room unit,package terminal A.C.,gas,existing,none) SEER/Il
12. Heating system* 12. Type:
(Types:heat pump,elec.strip,natural gas,LP-gas,gas i room or PTAC, HSPF/CO FUE
existing,none)
13. Air distribution system*
a.Bacldlow damper or single package systems*(Yes/No) 13a.
b.Ducts on marriage walls adequately sealed*(Yes/No) 13b.
14. Hot water system: 14. Type: 1V'L*Vj C_
(Types:elec.,natural gas,other.existing,none) EF:
Pertains to manufactured homes with site-installed components-
I hereby certify that the plans and specifications covered by the calculation are in compliance with Review of plans and specifications covered by this calculation indicates compliance with the Florida
the Florida Energy Code. Energy Code.Before construchon is completed,this building will be inspected for compliance in
PREPARED BY:0_VNUV E PJI �O DATE:t� 0 accordance with Section 553 908.1
I hereby certify that this building is in com;liance with tAlounda Energy Corl BUILDING OFFICIAL:
OWNER AGENT: DATE:_ DATE:
FLORIDA BUILDING CODE-BUILDING 13-D.33R
Y Z 16 a
"k AL I
1MV A IkT "W'WrIfIrIll IQILWUU'V
XV12d V X-L:j V T &JJLJLX:dM_:d JL
e.
InMes Ve____e_nT%
b-1 "V u.-
goo Seminole Road 12100 Sandpiper Lane
Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233
(904)247-5800 (9o4)247-5834 Pubfic Safety
(904)247-5845 I�ax (904 __i Fax
PLAN REVIEW COMMENTS
Permit Application#
f -7�4
Property Addrezis i a
Applicant:
Project:
his permit application has been:
Approved as noted by the 1--w-, - Department.
W Final application approval must come from the Building Department.
'031 1 7
Ut Reviewed and the following items need attention:
Unable to determine extent of addition from plans provided.
Provide impervious surface area calculations .
On-site storage of increased runoff required if increasing
impervious surface area by 10% or more.
Please re-submit 2-copies of all revisions. Please re-submit your
revisions to the Department re
Building Dept, Public Works and Utility information at top of qlpage,
failure to notify the correct department may delay your permit from
being issued. a-,P 11111
Reviewed By. -PW V7--- Date: 67-
7 R_F,C I-V 7ED
Date Contractor Notified: 41,2Y2;��2 1 200
FEB 2 1 Z007
BY:
I -7TH STREET
(40 FOOT RIGHT OF WAY)
90-1598001
(MEAS.)
54.30 (MEAS.),- 9017'
54.. (REC.)
FOUND 1/2"
IRON PIPE
ag*4a, NO ID,
(REC.)
BRICK
23.91 WALK 27.5'
u
8-
.4 3.7
.8'
w
z
LOT
LOT6 Wo SET 1/2 0
8 SET PK 0 U) w
Ix
9 2&RON PIPE. 54. (MEAS) NAIL & DISK Ld
.3.5 "CANNADY 6
CANNADY >
LB 7080" CP L13 7080.
0
NCRE
C; -DRIVE.
-09'48'0"
C;
(MEA&N THREE STORY i, - .. ,.. . +. .:, .. X=
-' ' :'
a9*48V FRAME DUPLEX ,1 90 U E-4
RESIDENCE #18
(REC.) (MEAS)
0
4T. 9017' <0
A (REC.) w rzq
23.0'
uj 17.9"
9012*0*'30
lw� .2'
uj aw"952as
(MEAS.
6' UTILITY 12 4S)
EASEMENT go aq-4,3v
REC. 30
3' FOUND S LO 30.1, (REg)
IRON PIPE 'It
NO ID. 4 CHAINLINK FE SET 1/2"
CE IRON PIPE
CANNADY
LB 70801,
9012 40 E & 0 FOUND I
3% (REC.) 89-43 IRON PIPE
54.46 (REC)- (REC. NO ID.
,OT
13 LOT
12 LOT
1
"CA 70V
Wto aft y rmr PROP&ry saw Awmw REWSED.-
VANA X *AS SNOWV O)V Fr&%Wy 14 2001� ro ,MW IMPM
AAN�W TAG&Cy(.r "C FWD?At
n0QD EAEk) VA 70,AL FELD 4A7E-FEBRUARY 8, 200.3
WSLfMNM RA IE LOT-to, BILOCK8 KA
CA 7E. AF'Rry PAACL 1-0 120075 0001 .'04-0218 . 1 -20
IL 17, lgag A ay-J A. sz
0 CEA N GR 0 v,= N A PAGE N
c/i
WVlTN0, 4- C4
04,-0218.CR
-021B.DVVG : 2004
CADD FJWZ..04 7ER
T
BuILDING PERMIT APPLICATION
J
P
CITY OF ATLANTIC BEACH
FEE3 ? 2
00�00 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 9 Fax: (904)247-5845
Permit Number:
Job Address: I Pj, I -I Tk 15�kCCE dG1 C
Legal Description 7- Oq- 25- Z 1E. 66 L1 C&-Q,,u t-Irlove- Uv i -18r—lo ov
�6� lo -M
Valuation of Work(Replacement Cost) $
• Class of Work(Circle one): New 4�� Alteration Repair Move
• Use of existing/proposed structure(�)
E �Circle one): Commercial jtCs-iJe—nt1ab
If an existing structure, is a fire sprumer system installed? (Circle one): 7-e-s--I'To- I:A&
Is approval of homeowner's association or other private entity required? (Circle one): 9es
Describe in detail the type of work to be performed: 0CJS-11", st-w4ure- 1
%��k)�,�QK&��u EQ,412 f'4
Property Owner Information
Name: �nko - Lyvti Ro-t--0,VjV Address: 19 17 S4.
city State
_aZip 1.&IS1 Phone iott 2,f6 LIgIA?
Contractor Information:
Name of Company:CIO N Qualif��ijz Agent: rot-,, �Ukkt44
Address: !�Ocn -a�, ST- city A--IS State Zip '-S e,Z3
Office Phone Cfo%-1 3 3, 7 7 t b Site/Contact-Number qTL-1. :2 1-M A;�5
State Certification/Registration# (�7 L 7S 44A7 Office Fax#
Architect Name &Phone# Anpgla- ELk;j&.e(k 50 go 19
Engineer's Name &Phone# '136Jct�- �16�, go!y-3fl?-qk�/7
s he el n de b a n a d k and a nd a d that n a a'on has commenced prior to the
This
p a ns a 0 n
i t
w t permit becomes null and
a s re 'in cons r on n t' is c on.
(6 mo't ata time a�tesr work is
S oil,S,He7
a e ters,Ta k
r
ns n 0, lioFof B
�or a d d or er
"07, d
i r erm" rm the wor e an aa
beper 0 ed t�mee'th t d rd o
A c "on it to 0 r w
dh a 0 k
,, 'o co tr�
u a a rm n e ct "rw
,ce 0 "no Comm
d k ed th 6 th e e
"i w' _ I,n t rt _ c " ' ()' 3 or i to or u - .n andAir
'o' enced , d a d that ep.rtevenut,must be c.red or Elcl,,al ork PIUMUng, 'gn, s 00s
Conaitioners,etc.
WARNMG TO OWNIER: YOUR FAILURE TO RECORD A NOTICE OF CONEMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR RVIPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Ihere certi that I have read and examined this application and know the same to be true and correct. Allprovisionso I and ordinances,governi.ng this't
,Ype
Zwill Pe complied-with whether s eci led herein or not. The granting ofapermit does notpresulne to give authori o 'olate or cancel thepravisions qj any
P if
ofwofedera state, or local law regul tin construction or t e per rmance qj construction.
other 11
Signature of Property Owner: Signature of Contractor:
SworhJ6 and subscrjW�efore me Swor#/o and subs -ri e r ne
this I / Day of Iko U,�7� :� j /
c
this I
�a Day of
Notary Public:
Notary Public zt/-;
MEMORIE NOLAN
MY COMMISSION#DD 540618 MEMORIE NOLAN
EXPIRES:July 6,2010 My COMMISSION#DD540618
Bwdod ThrU Wftly Mic Underwrft- EXPIRES:July 6,2010
I W*d ft NoWry"ic Underwdters
DO NOT WRITE BELOW THIS LINIE: OFFICE USE ONILY
,eview Result(Circle one):
Approved Disapproved Approved w/Conditions Review Initials/Date:
0'ev,
z;lopmeilt Size
labitable Space Non-Habitable Impervious area Total Area
4iscellaneous Information Conditions/Comments:
Occupancy Group
e of Construction
ber of Stories
Zoning District
#Parking Spaces
Max. O�cupancv Load
Fire Sprinklers Required
Flood Lone
Revised 12/11/06
CITY OF ATLANTIC BEACH
SS
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
—ro)j 19 Building-dept(icoab.us
Application Number . . . . . 07-00001670 Date 12/21/07
Property Address . . . . . . 18 17TH ST
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . .. . . TO BE UPDATED
Application valuation . . . . 0 --------------
-------------- ------------------- ---- ---- ---- ----- ---- -
Application desc
pavers ---------- -------------------------------- ------
----------------------------
Owner Contractor
----- ---- ------- - -- -----
-------------- ------ ----
RICHARDS, JOHN OWNER
18 17TH ST
ATLANTIC BEACH FL 32233
-- -------------- ----------- ---------------------- ------ --------------------
Permit . . . . . . DRIVEWAY PERMIT
Additional desc . - 35 . 00 Plan Check Fee . 00
Permit Fee . . . . Valuation . . . . 0
Issue Date . . . .
Expiration Date - - 6/18/08 --------- ----------------------
---------- ---------------------------------
Special Notes and Comments
PARKING PAD ON BEACH AVE NOT ALLOWED -----------------------
--- ------- -----------------------------------------
Fee summary Charged Paid Credited ----Due---
----- ----------- ---------- ---- ------ ------- --- ---
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total . 00 ' 00 . 00 . 00
Grand Total 35 . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Bui1dinP--deDt(&coab.us
Application Number . . . . . 07-00001671 Date 12/21/07
Property Address . . . . . . 20 17TH ST
Application type description RIGHT-OF-WAY PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0 --------------
---------------------------------------------------- ----------
Application desc
pavers ---------------------------------------
--------------------- ------- --------
Owner Contractor
------------------------
------------------------
SCHIFANELLA, THOMAS OWNER
20 17TH STREET
ATLANTIC BEACH FL 32233
-- ------------ ------ ---------------- - ---- ----- ---- -------------------------
Permit DRIVEWAY PERMIT
Additional desc 35 . 00 Plan Check Fee . 00
Permit Fee . . . . Valuation . . . . 0
Issue Date . . . .
Expiration Date . . 6/18/08 -----------------------
-- ----------------------------------------- ----- ----
Special Notes and Comments
PARKING PAD ON BEACH AVE NOT ALLOWED --- - --------------------
-------------------- ------------------------------ --
Fee summary Charged Paid Credited Due---
----------------- ---------- ---------- ---- ------ ---
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 35 . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
PERMIT
BUILDING /ZONIING DEPARTMMNT
000 Sen2inole Road APPLICATION #
Mantic 13cach,Florida 32233 7e
-00
(904)247-�o
(904)247-5845 Fax RIFIC-EIVEED
www.coab.us
DEC 1 2 Zoo/
BY:
APPLICATION TRACKING FORM
REQUIRED DEPT:
Property Address: rN Y N PLANNING
z Y N BUILDING
P PUBLIC WORKS
AppHcant: Z)
0 Y N PUBLIC UTILITIES
Y N FIRE DEPT.
Project: 5
Y N PUBLIC SAFE w
LU -APPROVAL
0 0 REQUIRED AGENCY: RECEIVED BY:
Z J IN wm-" QVATE:
LU Y N D.E.P HUFSTETLER
< Y S.J.R.W.M.
3� --:::k— CARPER
Y ARMY CORPS of ENG�:T
7_—__ CARPER I/
LS 8,P
0 Y N R, TS
HOTELS&RESAURANWS HUFSTETLER
APPLICATION STATUS
CIRCLE ONE: SITE
BUILDING DA AP REVIEWED BY: INITMi !I PAT[E:
I ST REV I M 11 Ln
F-1 I
XAyA_r#
W/4 &VVC)AZ
PLANNING
BUILDING El 2ND REV
4L��S
PUBLIC UTILITIES
FIRE DEPT.
P UBLIC SAFETY
3RD REV
Return this form to the 1131d1dinE Department once you have entered your comments into the AS400.
CITY OF AT-LAP-JTjC BEACHE
PERMIT
HUMDING ZONING DEPAR-t-M-ENT
'00 Stminole Road
APPLICATION
Atlantic Beach,Florida 32233
(904)247-5-000 C)
(904)247-5845 F�x 1-F
R-8
W%wx.coab.as -0 -EIVED
DEC 1 2 Z007
APPUCATION TRACKING FORM FBXY:
REQUIRED DEPT:
PYOPerty Address- c2p /71w Y N PLANNING
z y BUILDING
AppHeant.- N PUBLIC WORKS
0 y N UBLIC UTILITIES
Projeetz- y M FIRE DlEPT.
y N P1'PI 1C SAFE TY
U)
L'i APPROVAL
REQUIRED AGENCY: RECEIVE BY: IN[
LJJ TIAL7 DATE:
LU Y N
0 D.E.P HUFSTETLER
<
x Cy Y N S.J.R.W.M.
LU W CARPER
Y N ARMY CORPS of ENG
CARPER
0 Y N HOTELS&RESAURANTS HUFSTETLER
APPLICATION STATUS
CIRCLE ONE: SITE BUILDING DA AP REVIEWED BY: INITIAL: 77DTATE�:A
E3�11 ST RE�
Driveways are okay. Parking pad at north end of lot too
close to stop sign and will block stormwater runoff.
PLANNING
BUILDING 2ND REV E]
C'U=BL�I Q—W�O S
PUBLIC UTILITIES
FIRE DEPT.
PUBLIC SAFETY
3RD REV
Return this fOl-m to the Rufldin2 Department
ce you have enteyed YOur cOmments fiato the A8400.
Public Works Plan Review Comments
Laitials:
Date: 2,
OnIT crmit _7W
project Name/AddTess:
---------------------
LN"
Provide impervious surface calculations- With inst a-dation details andmaintenance
Provide erosion and sediment control Plans
Schedule.
ide drainage-plans showing site topography (flow arrows' etc.)
P-rovi includin.g Ri�,ht-of_Way Permit if-using
Provide construction site inanageirient-plan,
righ�_of_way for construction Parking' d by a Flon*da Licensed
Provide a-pre-construction topograpbic, surveYPrePale
Professional Land Surveyor, showing V contours- storage for
ations requires on-site
Section 24-66(b) of the Land Development Re2�ul eretentjon-required per
increased runoff. Provide Delta volume calcuiations and on-sit
Section 24-66(b). (See attached info. Sheet)
If on-site storage is required, a post onstruction top o graphic survey do cumenting Prop er
construction will be required.
ARight-of-Way Permit must be obtained. obtained for -------
A Re-vocabieEncroachment P ennit must be
pool—Wellpoint(if used) must dischalare into vegetated area 10, minimum from street
or drainage feature (Swale or structure) from the
5 inches thick, 4000 PSI,with f1bermesh
All driveway aPrOas must be concrete' einforcina-rods or mesh are not allowed in
edge of the-pavement to the proPertY line- F-
hick)-
the ROW (Cornmercial diivewaYs—6" t i Standard Detail case X and must
tih cuts in the road must be-repaired-using CO Rep * must be shown on
Any u tY in each direction frorn�the center of the cut. air
be overlaid 10 feet ' �G CAr6 PA C-L.SA
the plans. 1 2�10 LA�A I( ( 1'�J
gag
CITY OF ATLANTIC BEACH PERMIT
NT APPLICATION #
BUILDING / ZONING DEPARTMM
'00 Seminole Road
Atlantic Beach,Florida 32233
(904)247-5-000
(904)247-5845 Fax
ww-x.coab.us
APPLICATION TRACKING FORM
REQU1RED_- DEPT:
y N PLANNING
y
7 Jj- Z y N' BUILDING
Property Address, z
17— N PUBLIC WORKS
AppUcaut- J�tA)_ni 0 Y N PUBLIC UTILITIES
y N FIRE DEPT.
Project: ?Aej,'a.5 y N PUBLIC SAFEIFY
-APPROVAL
DATE:
REQUIRED AGENCY: RECEIVED BY: INITIAL:
Z UJ
uJ y N D.E.P HUFSTETLER
< S.J.R.W.M. CARPER
Y CO
uj
Y N ARMY CORPS of ENG CARPER
7YU'RN OT S& U TS UFSTIETLER I I
Y N HOTELS&RESAURANTS
APPLICATION STATUS
CIRCLE ONE: SITE BUILDING DA AP REVIEWED BY: INITIAL: DATE:
El
Driveways are okay. Parking pad at north end of lot too
close to stop sign and will block stormwater runoff.
i
vewa�
0 s e tc
PLANNING 0-
0 1 2ND REV Ale—
E
BUILDING
0
rA
PUBLIC UTILITIES
FIRE DEPT.
PUBLIC SAFETY
3RD REV
INgivp r-nfr-rM vn,r enmments into the A8400.
CITY OF ATLANTIC BEACH
CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
904-247-5800
800 Seminole Road
Atlantic Beach,Florida 32233-5445 Fax 904-247-5845
PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION.
Date I I - Z)l PERMIT#
Job Address 1 -7411 J1. ISSUED BY THE CITY
Permitee: C 00 Telephone# 12
Permittee Address: .2-0 1-7 A
Requesting Permission to Construct: PAve, re/.1140AO cmcyAe
Location: (Reference to Cross-Street)
1 Applicant declares that prior to filing this application he has ascertained the location of all existing utilities,
both aerial and underground and the accurate locations are shown on the sketches.
A Letter of Notification was mailed to the following Utilities/Municipalities..
Jacksonville Electric Authority -1) Yes ( ) No ( ) Date:
Bell South Telephone Company g (�vf Yes ( ) No ( ) Date:
Ferrell Gas Yes ( ) No ( ) Date.
Comcast goo 4�;k '4 7 70 Yes ( ) No ( ) Date:
2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation,
alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public
Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized
hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as
required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is
authorized. Standards and be
3. All work shall meet City of Atlantic Beach or Florida Department of Transportation
performed under the supervision of LV (Contractor's Project
Telephone#: qqfy,
Superintendent) located at I-x,
4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee.
5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications
and the manner satisfactory to the city. s, a copy of a recent survey shall be made a
6. A sketch of plans covering details of this installation, as well a
part of this permit. Calculations showing any increase in impervious area on owner's lot or in thL.9�
Right of WaV are to be included with this application. days. If the beginning date is
7. This permittee shall commence actual construction in good faith with
more than 60 days from date of permit approval, then permittee must review the permit with the Director of
Public Works to make sure no changes have occurred in the area that would affect the permitted construction.
8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the
City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all
times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and
against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted
exercises by the holder of the aforesaid rights and privileges. g work and again
9. The Director of Public Works shall be notified twenty-four (24) hours prior to startin
immedi tely P on completion
OWNE
lNI
Date: K. CUNN NGHAM
Sign ublic-State of F"a
Befo -day of�.Wv_rinlae in the County of Duval, Notary P
Feb 28,2010
State Of Florida, has personally appeared Ont--r4sil !f2Chi fn n-e I Wy commission Expires
Notary Public at Large,State of Florida C y of buval. Commission#DO 523638
my commission expires: SOILS Personalli Bonded By National Notary Assn.
i;:71 Produced Identif:1
R.O.W.Permit Attachment of for
R.O.W. Permit# is�ued 2005 Atlantic Beach,FL 32233
Owner's Name: _�c A�&e(1b
Property Address: 17 ps- Al-
Subdivision: Oced., 6y&,.e
Lot 4/Block#: (0 lect
R.E. #:
REVOCABLE ENCROACHMENT PERMIT
TMS REVOCABLE ENCROACHMENT PERMIT, issued on this day of
2001, by Atlantic Beach, Florida, a municipal corporation organized and existing
under the laws of the State of Florida, hereinafter referred to as "CITY" and
of Atlantic Beach,Florida, hereinafter referred to as"USER".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the
right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach Right-of-Way/Easement permit numbers noted above(copies attached).
This work is generally described as: te d nve
p&q&rr wkere cohcnt
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted
remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to
USER shall be given by certified mail, return receipt requested, to the following address:
9-10 1-74-h dy, j;eacA
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER's proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in
the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe
condition.
In the event it is necessary for the CITY or the City's approved representative or other franchised
utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's
sole expense, any and all material necessarily displaced during the action of maintaining, repairing,
operating, replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building
Codes,Land Development Code, and all other land use and code requirements of the CITY.
The USER, prior to making any changes from the approved plans and/or method, must obtain
written approval from the City of Atlantic Beach, Public Works Department, for said change. The
Page I of 2
USER shall, at the discretion of the CITY, be requested to submit as-built drawings showing the change
within thirty (30)days after the day of completion.
This permit shall inure to the benefit of, and be binding upon, the USER and their respective
successors and assigns.
USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY
laws and/or specifications, to include utilities locate requirements and use limitations/requirements of
public rights-of-way and other public land. USER further agrees that the CITY and its officers and
employees shall be saved harmless by the USER from any of the work herein under the terms of this
permit and that all of said liabilities ereby assumed by the USER.
DATED and SIGNED this
day of 20QrJ
V/
CITY OF ATLANTIC BEACH,FLORIDA, By
a municipal corporation: P Aope 5wner
K. CUNNI HAM
(W%
�4i Notary public-state of F Wide
City'
i son, City Manager ..z=My CommM&Expires Feb 28,20110
in
commission#DD 523638
Attest: I�_L�j L" t'tW Bonded By National Notary Assn.
Rick Car&r, Public Works Director
STATE OF FLORIDA
COUNTY OF DUVAL
On this "" day of Kove-M rx-r- 2007, personally appeared before me, a Notary
the property owner of
Public in and for said County and State, T�71 0( i" J 9
�2 D I-144A Atlantic Beach, Florida, known to me to be the person(s)
described in and who executed the foregoing instrument; who acknowledged to me that he or she
executed the same freely and voluntarily and for the uses and purposes therein mentioned.
By: JA). A,-
are 40;v�
No u n aid County and State p rty Owner
(to be signed in presence of the Notary)
K. CUNNINGHA
late olFlorida
Notary Public-S
Ny commission EXpires Feb 28,2010
# Commission#DO 52
Bonded By Nationa� t,,
Page 2 of 2
PubliC -VNTorlrs Plan Review CoMmelats
Initials:
Date: 12-Z/2� #:
ess: 7�17?#, ApplicationlP ermit
pro],ect N ame/Addr
.............�' ............-7-Mi'li...........0:'Z:.................... M
ME
o ------
I A
9PP
%
Provide impervious surface calculations'
provide erosion and sediment control planswith installation details and maintenance
schedule. aphy (flow arrows, etc-)
Provide drainage-plans showing site-topogr Right-of--way J)ermit if using
Provide construction site management plan, including
ng�at-of-way for oonstructiOnParking' surveyprepared by a Flon*da Licensed
provide a pre-construction topographic contours.
professional Land Surveyor, showing V rage for
Section 24-66(b) of the Land DeveloPrIlent Regulations requires On-site sto . er
increased runoff. Provide Delta volume calculations and on-site-retention required p
Section 24-66(b). (See attached info. Sheet) o graphic sunrey do cullaenting proper
If on-site storage s required, a post construction top
construction will be required.
A Right-of-WaY p crmit must be obtamied.
A Revocable Encroachment Permit In -stbe obtained for
ated area 10' minimum from street
P 00,
_ Wellpoi-at(if used)must discharcre into veget
OTdrainage feature (swale or structure) psi,-with f1berniesh from the
All driveway aprons must be concrete, 5 inches thick, 4000 r mesh are not allowed in
e. cinr
edge of the pavement to the property lin einfor grods o
the ROW (Com-mer-cial driveways-6" thick) Coj Standard Detail Case X and must
' the road must be repaired using the cut. Repair must be shown On
Any utility cuts in in each direction from�the center Of
be overlaid 10 feet '
the plans.
CITY OF ATLANTIC BEACH PERIMIT
LIC8
A
BUILDING / ZONING DEPARTMENT [FPPLICATION;#
-7
100 Seminole Road
0 7e
Atlantic each,Florida 32233
(904)247-5-000
(904)247-5845 Fax
vrww.coab.us
APPLICATION TRACKING FORM
REQUIRED DEPT:
y N PLANNING
y N BUILDING
RUIRNED DEPT*
Property Address, z BUILDING
I C 0
17— N PUBLIC WORKS
U I I I
Applicant: A24"kle Z 0 y N PUBLIC UTILITIES
y N ZFIREDEPT.
y N PUE63LIC SAFET Y
Project-
U) APPROVAL
w DATE:
C) 0 REQUIRED AGENCY: RECEIVED BY: INITIAL:
Z Ui HUFSTETLER
uJ Y N D.E.P
CD
< y S.j.R.W.M. CARPER
Ir
ui ui
y ARMY CORPS of ENG CAPPER
0 y N HOTELS&RESAURANTS, HUFSTETLER
APPLICATION STATUS
CIRCLE ONE- S1 BUILDING DA AP REVIEWED BY: INITIAL: 5D A T;E:
I IT REV
Y5. 44-,c-
C Z" T
I/X-
zvt-�- —S 5r-C)'LA-f
PLANNING 2ND REV
BUILDING
CL 4w
UBLIC WOR�S
rt�tf-4)A,
PUBLIC UTILITIES
FIRE DEPT.
PUBLIC SAFETY 3RD REV
Mal
CITY OF ATLANTIC BEACH
,At .0 CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
904-247-5800
800 Seminole Road Fax 904-247-5845
Atlantic Beach.Florida 32233-5445
Date PERMIT#
ISSUED BY T HE CITY
-7
Job Address t
Permitee� L_�j onA 12_,,JW Telephone#
Permittee Aciclress� P,4t 1-7� A4 1" 6 e-,� L—
Requesting Permission to ConstrucL Aq V 6,a S all,(C ._�2z e
Location� (Reference to Cross-Street)
Applicant declares that prior to 'filing this application he has ascertained the location of all existing utilities,
both aerial and underground and the accurate locations are shown on the sketches.
A Letter of Notification was mailed to the following Utilities/Municipalities�
Jacksonville Electric Authority Yes( ) No ( ) Datei
Bell South Telephone Company Yes( ) No ( ) Date:
Yes No Date:
Ferrell Gas Yes No Date:
Comcast
2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation,
alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public
Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized
hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as
required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is
authorized.
3. All work shall meet City of Atlantic Beach or Floriya De ment of Transportation Standards and be
�4 t W
performed under the supervision of Z M4 7" -(Contractor's Project
Superintendent) located at % /?,C) ..(-7'tk �4�A— Telephone#� 2_9 6 — 17 7-7
4. All materials and equipment shair be subject to inspection by the DireCtOT of Public Works or his designee,
5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications
and the manner satisfactory to the city. a copy of a recent survey shall be made a
6. A sketch of plans covering details of this installation. as well as, on owner's lot or in the SLty
part of this permit. Calculations showing anV increase in impervious area
Right of WaV are to be included with thisa�ficat�ion- (C-0 days. If the beginning date is
7. This permittee shall commence actual construction in good faith with
more than 60 days from date of permit approval, then permittee must review the permit vAth the Director of
Public Works to make sure no changes have occurred in the area that would affect the permitted construction.
8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the
City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all
times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and
against any and all loss, damage, and cost of expenses ansing in any manner of the exercise or attempted
exercises by the holder of the aforesaid rights and privileges. prior to starting work and again
9. The Director of Public Works shall be notified twenty-fOUT (24) hours
immediately upon completion.
OWNER
CZ ....................................
Signed� Datel
;d MICHAEL FRANCO
Before me this day of y in the County of Duval,
CGmm#DD0286574
State Of Florida,has personally appeared
ff(AtA
Notary Public at Large,State of Florida,County of Duval. Expires 2JIMM
Bonded thru(800)4324254:
my commission expires: b /2 o 4,
I or Florida Notary Assn.,inc
Personally Known: ...........................
Produced Ideriff
R-O.W. Permit Attachment of for
R.O.W. Permit#-issued .2005 Atlantic Beach,FL 32233
Owner's Name: 001
Property Address: 17
T
AIVZ Is"--
Subdivision: 0
Lot 4 Block#:
R.E.
REVOCABLE ENCROACHWNT PERMIT
THIS REVOCABLE ENCROACHMENT PERMT, issued on this day of
2005, by Atlantic Beach, Florida, a municipal corporation organized and existing
�i�dthe laws of the State of Florida,hereinafter referred to as "CITY' and
of Atlantic Beach,Florida,hereinafter referred to as"USER7.
WITNESSETH:
Cn
That the CITY does hereby grant the USER permission on a revocable basis as des 'bed herein the
right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of
Atlantic Beach Right-of-Way/Easement permit numbers noted above(copies attached).
This work is generally described as: ReL V //1.
Any facility maintained� repaired, erected, and/or installed in the exercise of the privilege granted
remains subject to relocation or removal on thirty (30) days notice by ClW to the USER, said notice to
USER shall be given by certified mail, return receipt requested, to the following address:
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER's proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in
the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe
condition.
In the event it is necessary for the CM or the City's approved representative or other franchised
utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's
sole expense, any and all material necessarily displaced during the action of maintaining, repairing,
operating,replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building
Codes,Land Development Code,and all other land use and code requirements of the CITY.
The USER, prior to making any changes from the approved plans and/or method, must obtain
written approval from the City of Atlantic Beach, Public Works Department, for said change. The
Page I of 2
USER shall, at the discretion of the CITY,be requested to submit as-built drawings showing the change
within thirty (30)days after the day of completion.
This pen-nit shall miure to the benefit of, and be binding upon, the USER and their respective
successors and assigns.
USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY
laws and/or specifications, to include utilities locate requirements and use limitations/requirements of
public rights-of-way and other public land. USER ftirther agrees that the CITY and its officers and
employees shall be saved harmless by the USER from any of the work herein under the terms of this
permit and that all of said liabilities are hereby assumed by the USER-
S/"—
DATED and SIGNED this eZ day of �)P—c 20
By:
CITY OF ATLANTIC BEACH,FLORIDA,
a municipal corporation: Property Owner
By:
qJimoz) i Manager
ity M,
Attest:
Pick Carper,Public Works Director
STATE OF FLORIDA
COUNTY OF DUVAL
On this day of [�arxbep- 2001,�Fersonally appeared before me, a Notary
Public in and for said County and State, LXVr, oP i DA ___, the property owner of
/ ? /7 11" 3 7- - Atlantic Beach, Florida, known to me to be the person(s)
described in and who executed the foregoing instrument; who acknowledged to me that he or she
executed the same freely and voluntarily and for the uses and purposes therein mentioned.
C��'A-t- A�
By:
Notary Public'in for said County and State Property Owner
(to be signed in presence of the Notary)
....................0..........
MICHAEL FRANCO
C n*DD02OW4
orn
E*m via=
9WXW fn(000)4=-4254:
FWW Notary Assn..I
...............................o........
Page 2 of 2
_A/v
17TH STREET
(40 FOOT RIGHT OF WAY)
9c'l 5'8*'
(MEAS.)
54.30 (MEAS.).e 90'17'
54.30 (REC) (REC.)
FOUND 1/2
(RON PIPE
NO io.
8 48'
(R
3RICK
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1� 1 23.9
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8 L"LIRON PIPE. &01 CP L-3 708R
9 CANNAO� CON
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FOUND 1* ET 1/2;
tN PIP
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NO 10. N–U—N 9—F'N W CANNADY
LB 7080*
0 FOUND I'
90'12' 54.40 MEAS 89*43 IRON PIPE
— NO 10.
(REQ.) -54.46 (REC)- (REC.)
LOT LOT
13 LOT
12 11
FEBRUARY 14 M04
FWW CMWICAWN FIIELD DA FOMARY 8,2M
BY GR~PLOnM CKY. 7W PRCPEI?7y SMw pZMay ane
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MAP SHOWING BOUNDARY SURVEY OF
THE SOUTH 48 FOOT OF THE NORTH 100 FOOT OF LOT 10, BLOCK
8, OCEAN GROVE, UNIT NO. 1, THE SOUTH 48 FOOT OF THE
NORTH 100 FOOT, AS RECORDED IN PLAT BOOK 15, PAGE 82, OF
THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO: JOHN & L YNN RICHARDS
COMMONWEALTH LAND TITLE INSURANCE COMPANY
RICHARD G. HATHAWAY, PA
PONTE VEDRA TITLE, LLC
)fW7FS OONCRE7r MONUAAENT
)ENO7ES BOUNDARY PON AS NOTED
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FENCE LAVE ON SUBJECT PROPERTY UNE'
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VINT OF CURW
7 PONT Of'REWNSE CURW
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(CALD)-DENOTES CALCULATED DIMENSION PER PLAT
PK-DENOTES PARKER KALON(NAME BRAND)
POP-DENOTES PERMANENT CONTROV PUNT
GENERAL N07ES
1. 7HIS 6 A MAP SNOWNG BOUNDARY SURWY
I NO aEARfNGS SqOW HEREON, ANGLES SHOW HEREON REPRESENT FIELD MEASURED DA7A.
NORTH ARROW SIVON HEREON PR07RACMD FROM PLAT
I V&W MAY BE AM770HAL RESMiCTIONS OR EASEMENTS THAT ARE NOT 900IN ON 7HS ZION
MAP THAT MAY BE FOUND W TNE PUBUC RECORDS OF YHS COUNTY OR EMENCED By T`TLE EXAM'NA
,c ws suRvry WAS PvwvRA9P WTWT 7W BENERT Or A 77TLE COMM77MEN7
THE PROPERTY_WjW HEREON EMBRACED By HEAVY UNES 15 BASED ON A LEGAL DMMP77ON
PROWDED BY CUENT.
TKS SVRWY DOES NOT REFLECT OR DETERMWE OW4DMWP-
Z TWS SURKY SHOMS ONLY THE'ADOW GROUND/NDICK NO UNDERGROUND U7XIT=
FOOMTS; SMUCTLhRE& OR WPRDWWEN7S ARE RVWN ON 7HIS MAP
a Lft�OPERNSE NOTM,ANY POR77ON Or THE PARCEL THAT MAY BE DEVAED AS
NETLANDS BY STATE OR GOVEWAgNT AGDV= HAS NOT BEEN DE7ERANNED AND ANY
UANUTr RESUI 7M THEREFROM IS ACT THE RESPONSIOUTY OF THE UNVERSA2YED
UNLESS IT BEARS THE SYGNA TURE AND THE ORIMNAL RAJSED SEAL OF A FLORIDA UCENSED SURW-MR AND MAPPER, THIS DRA WNa
SKETCk� PLAT OR MAP IS FOR INF-ORMATIONAL PURPOSES ONLY. AND IS MI VAUD.
AlPROVEMEMM
I HERMY CERTFY THAT rHS SJRWY WAS MADE 70 7HE WSI OF MY
KNONLEDGE AND OBJEF AND MEM M MAWOUM TECHNICAL STANDARDS AS
SET FOR7H By THE FLoRVA_fJKR0 OF PROFESSKINAL LAND SURWYORS IN 5793 Mining T�, Sufte 5
CHAP71M 6 0( CHAPTER 21HH-&0A FLORADA ADANN)STRATIlf Jockwonvllv6 FlwWc 32257
To "7ZG27, FLORfDA ST;A7 Phmw (904)260-662a
F= (004)250-02ee
;T Uwod Buvin�No.: 7DW 4-4W Carnady
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CODE PURSUANT
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FILE NO. B-113
SS-q;70&;37: M"'I 17TH STREET
(40 FOOT RIGHT OF WAY)
<a— 90'15'8"
(MEAS.)
5 EAS.),e 9017
5 30 7C) (REC.)
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FOUND 1/2-
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R
II NO 10.
89*48'
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0 FOUND I"
90'12' 54.40 (ME;KS 89*43' IRON PIPE
NO ID.
(REC.) 54.46 (REC� (RE—CT.
LOT LOT LOT
13 12 11
REWSM FEBIRVARY 14 2W4 T
FIELD DAM FEBRUARY a, 2003
FLOOD CIERIMAWN "Na.104--=B 13CALE'I"-
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CADD FILE
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CITY OF ATLA IC BEACH, FLORIDA
LA IC B
UTILITY PA NT PLAN AGREEMENT jib
E
A
A
NCH
AG9
R
PR PERTY DESCRIPTION:
OWNER: ".M
5 1 Str t
6 17'h Street
ftie lorida 32233
RE# 1695870000
LEGAL DESCRIPTION 15-82 09-2S-29E Ocean Grove Unit No 1 Lot 5 Blk 8
TOTAL AMOUNT OF AGREEMENT: $9,884.16
This document shall serve as an extended payment agreement between you and the City of
Atlantic Beach, Florida for the above listed total amount and for which said amount will be filed
as a lien with the Court of the Circuit Court for Duval County, Florida until the entire balance is
paid. CHARGES: Sewer Impact Fees $2,500.00>
Tap fee 2,900.00
Contractor Amount 2,700.00
Filing Fee 35.50
TOTAL CHARGES: $8,135.50
TOTAL AMOUNT FINANCED $8,135.50
TOTAL AMOUNT OF LIEN $9,884.16
TERMS: Number of Monthly Payments 120
Due Date: Due monthly with your utility bill
Billing Included on utility bill
Late Charges 10%
Failure to pay all charges will result in the water services being cut-off.
Payment Amount $82.37 per month
Total Interest over term of loan $1,748.66
LIEN: A lien in the amount of the TOTAL AGREEMENT above shall be executed and
recorded against the above referenced propprty. The owner hereby agrees to pay
all recording fees and costs involved with the execution of the lien. Upon
payment being made in full, the lien shall be released of record.
Please indicate your acceptance of the provisions of this agreement by signing in the place
indicated. Your signature signifies your agreement to indemnify and hold harmless the City of
Atlantic Beach, Fl., from any and all damages resulting from your failure to timely make the
above payments, including reasonable attorneys fees and court costs.
The City of Atlantic Beach looks forward to cooperating with you under this agreement.
PROP TY qWNER
By: K I "� Date:
j &vv v'
ZR o Pj-e r sW
City of Atlantic Beach
Date: ghtla.
Jim r on, City Manager
Prepared by and return to:
Debra A. Ramsay, Accountant
City of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233
REAL PROPERTY LIEN
The parties have agreed that this LIEN be filed against the real property owned by Kim
Rogers, and shall be recorded in the official public records of Duval County, Florida.
This LIEN is for finariced costs associated with the conversion of a private septic system
to public sewer system and including sewer impact fees on the following real property located in
Duval County, Florida,more particularly described as follows:
RE#: 1695870000
LEGAL DESCRIPTION: 15-82 09-2S-29E Ocean Grove Unit No I Lot 5 Blk 8
OWNER NAME &
PROPERTY ADDRESS: Kim Rogers
56 17'h Street
ATLANTIC BEACH, FLORIDA, 32233
This LIEN is to secure payment from Kim Rogers to Ci of Atlantic Beach in the
amount of$9,884.16.
Witness (Sign Name) OWNER: Kim Rogers
C-J-0 r ry\ C�
t',e ty
Ldtl—z --
Witness (Print Name) CITY OF TLANTI ACH
Y XL
'::��iZ�ess (Sign���� B
f a-J1 e P. S-\'a'o Donna Bussey
Witness (Print Name) City Clerk
Page 1 of 2 Rogers Lien
STATE OF FLORIDA
COUNTY OF DUVAL
Sworn to and subscribed before me ffiis �1 dayofApi-, 2tO5,by
Kimtr-irt!j P1,PpQP-,(5 who is personally known to me or pLoduced
iv G" C
as identification, and who didA Lid not take an oath.
JEANNE M.SHAW PIA
MY COMMISSION 4 DO
435986
EXPIRES:May 31,20W ' Nq�4y Public, State of Florida
Banded Thru Wary Public underwriters
My Commission expires:
Page 2 of 2 Rogers Lien
V V
PAGE TWO Names of
MINUTES Comrftrs. M S Y N
MARCH 28, 1983
je.co ,n tjon of Visitors - continued
_L�
either maintain the roads and islands and correct the drainage probleis
or give that area a tax relief. Mrs. Davison stated that the group
would probably be willing to have extra taxes levied on their proper-
ties to get the problems straightened out as they did not want it in
the bands of Mr. Bull - they wanted it in the hands of the City. The
Commission emphasized the fact that the streets are owned by Mr. Bull
and the Commission has no control over the maintenance of the streets
the islands or the drainage problems. Mr. Peter Johnson, 1549 Beach
Avenue, a representative of several developers, agreed that the group
from that area of Selva Marina had problems, but stated on the plus
side that Selva Marina is one of the most beautiful areas in the City
and it would be ruined if the City came in with wide streets, curbs,
and gutters. He suggested the group set up an association as other
developments had done. The City Attorney stated that he could not
give legal advice to the group as be represented the City. He comment-
ed that he felt their recourse would be with Mr. Bull, and added that
he thought there was a maintenance contract between Mr. Bull and B.B.
McCormick to maintain those roads that may still be in effect, and
could be a means by which the group could get enforcement. Commission( r
Morris then made the following motion: Cook x
Motion:Move for the Mayor to appoint a Committee to help the Gulliford x x
citizens seek relief and also give them advice. Morris x x
Persons x
The motion carried unanimously. The Mayor appointed Commissioner
Gulliford to ser-ve as Chairman and all other Commissioners vo-lun-
teered to serve on the Committee. The Mayor set the meeting as a
Committee of the Whole to meet with the group on Monday, April 4,
1983 at 7:00 p.m.
Correspondence
Mr. Moss listed the correspondence as:A. To JEA re installation of
street lights - 725 West Plaza and the intersection of East Coast
Drive and Seminole Road. This was mentioned at the last Commission
meeting; B. From Chief Carl Stucki re noise nuisance at Breakaway
Lounge - he has assured the Chief that the problem will not occur aga -n;
C. From Larry Stokely re resignation of employment as city's Communit
Development Administrator- be has taken a position as Production
Manager for Container Corporation. He will be missed by all.
D. From Donna Ross Real Estate re Request for City Water Hookup by
Mr. L. Peter Johnson to property located corner 17th St. and Beach.
The City Manager recommended approval. /7 01A _�kf 0
Motion:Approve hookup for water services requested by Mr. L. Peter Cook x
Johnson to property located at the corner of 17th Street Gulliford x x
and Beach Avenue provided that all costs be borne by the Morris x x
owner of the property, Mr. Johnson, with no reimbursement Persons x
expected.
The motion carried unanimously.
'oel
PLUMBING WORKSHEET
SINKS SHOWERS DISHWASHERS
CLOSETS BATH TUBS FLOOR DRAINS
WASHING MACHINE WATER HEATERS DISPOSALS
LAVATORY URINALS OTHER
TOTAL FIXTURE COUNT
FIXTURE UNIT BREAKDOWN
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 $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM.
BATHROOM GROUP CONSISTING OF LAVATORY (I UNIT)
WATER CLOSET, LAVATORY, AND
SERVICE SINK TRAP STAND
BATH TUB OR SHOWER STALL (3 UNITS)
(6 UNITS)
DRINKING FOUNTAIN (11 UNITI URINAL, WALL LIP
(4 UNITS)
FLOOR DRAIN (1 UNIT) WASHING MACHINE RES.
URINAL, PEDESTAL, SYPHON (3 UNITS)
JET BLOWOUT (8 UNITS) WATER CLOSETS, VALVE OPERATED
WATER CLOSETS, TANTK-OPERATED (8 UNITS)
OUNITS) SHOWER STALL, DOMESTIC
BATHTUB (W/OR W/O OVERHEAD (2 UNITS)
SHOWER) (2UNITS) LAUNDRY TRAY
BIDGET (3 UNITS) (2 UNITS)
DISHWASHER C2 UNITS) KITCHEN SINK (2 UNITS)
KITCHEN SINK/WASTE GRINDER
(3 UNITS) /
TOTAL FIXTURE UNITS @ $10.00 EACH
CIO
420 .
17
PLUMBING WORKSHEET
SINKS SHOWERS DISH14ASHERS
CLOSETS BATH TUBS FLOOR DRAINS
WASHING MACHINE WATER HEATERS DISPOSALS
LAVATORY URINALS OTHER
TOTAL FIXTURE COUNT
FIXTURE UNIT BREAKDOWN
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 $10.00 PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM.
BATHROOM GROUP CONSISTING OF LAVATORY (I UNIT)
WATER CLOSET, LAVATORY, AND
SERVICE SINK TRAP STAND
BATH TUB OR SHOWER STALL (3 UNITS)
(6 UNITS)
DRINKING FOUNTAIN (11 UNIT) URINAL, WALL LIP
(4 UNITS)
FLOOR DRAIN Cl UNIT) WASHING MACHINE RES.
URINAL, PEDESTAL, SYPHON (3 UNITS)
JET BLOWOUT (8 UNITS) WATER CLOSETS, VALVE OPERATED
WATER CLOSETS, TAN'K-OPERATED (8 UNITS)
OUNITS) SHOWER STALL, DOMESTIC
BATHTUB (W/OR W/O OVERHEAD (2 UNITS)
SHOWER) (2UNITS) LAUNDRY TRAY
BIDGET (3 UNITS) (2 UNITS)
DISHWASHER C2 UNITS) KITCHEN SINK (2 UNITS)
KITCHEN SIN-K/WASTE GRINDER
(3 UNITS)
TOTAL FIXTURE UNITS $10.00 EACH
e�z,�ez,
Map Output /� Fro,� )C:tcoz;�7 F-- ( r- L/ Page I of I
C o C)
JAXGIS Property Information
ZZIG =9
4M
407 353
2M
418 -------- 2211 313
410
390 342 334 326 318
310 302
2069
2M 204S
W
A
2075
2OW 20
21M
r 2020
2M
2087 2060
487 2082 2014
Copyrig ht JC)2W2 C Ky of JWI00flv1Ik FI
Total Acres Plat Wap ega Flo Od LandUse
RE# Name Address Value Book Panel L i Descriptions zone Zoning ENT
2045 39-94 08,09-2S-29E
FE GEL VELA NORTE CR 317690 0.36 0000 5532 SELVA NORTE UNIT ONE NO
IC
1695061098 LEONARD V JR LOT 49
132233
0
(ST
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http�//maps.coj.net/websiteiDuvalMaps/toolbar.asp 5/20/2003
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00028400 Date 6/01/04
Property Address . . . . . . 18 17TH ST
Tenant nbr, name . . . . . . HVAC
Application description . . . MECHANICAL ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
------------------------
------ -- ----------------
RICHARDS, JOHN OCEAN STATE HEAT & AIR
18 17TH STREET 1476 ATLANTIC BLVD.
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 249-8251
---------------- ---------------------------- --------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . - Plan Check Fee . 00
Permit Fee . . . . 87 . 00 Valuation . . . . 0
Issue Date . . . .
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 87 . 00 87 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 87 . 00 87 . 00 . 00 . 00
C.t of tjantic Beach
RECEIPT ***
Type. OC Wrawe,
no.
overt 0(000-- Receipt
tite.
%I Amount
DescTi Ition Quantity
am*
1%6 s87.6%
BP WILD
TeTAeT detail 17620 $1&7.00
CW tKCKS
,ptal teude-red 07 %1 LL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING
,,t.l paysent 9-.42-.25
date: 6/11
TIC BEACH
CITY OF ATLAN
MECHANICAL PERMIT APPLICATION
Date: Rhzru Z. 04
Property Address: Lfhu�
Telephone 9:
Owner: LChQA
Contractor: Oce= P-)TO -76- [�-In 9' Telephoneg:c> cl-?),�51
Contractor Address: 14-1 to Ca G 1NIfA r F) Fax 4:
In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance
with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of
Pood practice listed therein. If other construction is being done on t1iis building
Type of Heating Fuel: or site,list the building permit number:
Electric 1W
D Gas: _LP —Natural —Central Utility
D oil
ZJ Other—Specify
MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK
)h Heat _Space —Recessed -NCentral —Floor Residential
1�k Air Conditioning: _Room Ncentral
D Duct System: Material- Thickness 0 Commercial
ZI Refrigeration Maximum capacity cfin 0 New Building
2 Cooling Tower:Capacity gpm Existing Building
El Fire Sprinklers:Number of Heads
0 Elevator: Manlift Escalator (Number) Replacement of Existing System
Z3 Gasoline Pumps (Number) New Installation
ZI Tanks (Number) (No system previously installed)
Z) LPG Containers (Number)
0 Unfired Pressure Vessel Zl Extension or Add-on to Existing System
ZI Boilers
• Gas Piping 0 Other-Specify—
• Other—Specify
LIST ALL EQUIPMENT
AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving
Number Units Description Model 4 Manufacturer Too's Agency
HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving
"F
�r A C E S Model 4 Manufacturer BTU's Agency
Number Units Description
6) 1 f in L4 L,
TANKS No mal Capacity Type Liquid Serial Approving
nv sl, Manufacturer No. Agency
How,Manv 8,Dimensions Contained
800 Seminole Road - Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 - Fax: (904)247-5845 - http:/Iwww.ei.atlantic-beach.fl.us
CITY OF ,kTLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Building-degtagoab.us
Application Number . . . . . 07-00000519 Date 4/18/07
Property Address . . . . . . 18 17TH ST
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
RE-PIPE/NEW FIXTURES - 12
----------------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
RICHARDS, JOHN PLUMBERS INC.
18 17TH ST 8437 ALTON AVE.
ATLANTIC BEACH FL 32233 Q/A:RICHARD MANSEAU
JACKSONVILLE FL 32211
(904) 724-1945
----------------------------------------------------------------------------
Permit * * * * * ' PLUM13ING PERMIT
Additional desc . -
Permit Fee . . . . 119 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/15/07
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 119. 00 119. 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 119. 00 119. 00 . 00 . 00
PERmrr Is APPROVED ONLY IN ACCORDANCE wrrH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
FROM :Plumber's Inc. FAX NO. :9047241950 Apr. 18 2007 07:20AM P1
CITY OF ATLANTIC BEACH
PLUMBING PERMIT APPLICATION
Date: 67
44,
Property Address: Pi �—T
Owner:jzl�a,. &jtA4nCd—S Telephone#:
Contractor: AC e A Tcicphone#:
Contractor Address: 4V37 Fax 0: '7 Z!j I-q
Con-tractor Signature: jowl IZ.7-,(
In consideration of perrift given for doing the work as described in the above mtemm. L we hcroby agree to per(brin said work in
accordance with the artached plans and spociftoutims whivh aro a part hereof and in accordance with the City of Atlankv Bon.ch
ordinance anddandardq of good practice JjW:d therein.
Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Stamlard Plumbing
Code. ...........
if othor canstruction is being dono an this building or sfte,
Plumbing Type:
list the bruilding permit number:
Nuw
Re-Pipe
Number of F ixtures:
. ....... Bath Tubs Showers
Closets Shower Pans
Dishwashers Sinks
Disposals Urinals
'ng Machine
Floor Drains Wasbi
j.avatwy Water
Sewer Water Heaters
Sprinkler Systein Other *See attached sheet see
For Backi'low and Jmgati.on Vrct���ures
Fees
Permit Issuing Fee: S35.0
Total Fixtures: 19, X$7.00 + $35.00
800 Seminole Road.Atlantic Beach,Florida 32233-5"5
Phone: (904)247-6800- Fax: (904)247-584S. http:l/www.ci.atiantic-beach.fl.us
Revised 9106
TLANTIC BEACH
'MS CITY OF A I
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
INSPECTION EMAIL REQUEST:
Building-dept&gab.ps
Application Number . . . . . 07-00000461 Date 4/06/07
Property Address . . . . . . 18 17TH ST
Application type description ELECTRIC ONLY
Property zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0 -----
-----------------------------------------------------------------------
Application desc
ADDITION
----------------------------------------------------------------------------
Owner Contractor
------------------------
------------------------
RICHARDS, JOHN BEACHES ELECTRIC SERVICES INC.
18 17TH ST 214 COKESBURY CT. FL 32043
ATLANTIC BEACH FL 32233 GREEN COVE SPRINGS
(904) 629-3182
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc - - Plan Check Fee . 00
Permit Fee . . . . 70 . 00 Valuation . . . . 0
Issue Date . . . .
Expiration Date . . 10/03/07 ------
----------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 70 . 00 70 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Tic"
CITY OF ATLANTIC BEACH
ELECTRICAL PERMIT APPLICATION
Date: 1/o'-7
Property Address:
--j
Owner: Telephone#:
Contractor: Telephone#: � zci -3( F
Contractor Address: 2- Fax#:
Contractor Signature: el in�,—eabove iitate�m��enwe��hereby agree to perform said wor in
--in—cnsideration of permit given for doing the work'as descffr
accordance with the attached plans and specificatio.ns which are a part hereof and in accordance with the City of Atlantic Beach
ordinance and standards of good practice listed therem.
L] Trailer Service: If oth�, construction is
Building: Building Type: U New being done on this building
Li New Residence Lj Temp. Or site,list the building
Old _C ermal U Signs U Increase Permit number-
X7
U Repair 0:7 —06 ( (0,2—
e-Y Add, Sq.Ft.
Re-wire
Conductor Size: ANTS: 3 COP?_ER_
Switch or vOLT RACE
PH W VOLT WAY
Breaker AMPS RACE
I
EExisting EServjice vEoLT
iz WS PH W VOLT WAY
Size AMPS E
Meter
Number
Feeders: NO. SIZE NO SIZE No SIZE
Lighting Outlets CONCEALED OPEN
Rece tacles CONCEALED OPEN
31 100 AhE.,
Switches
0 S
OPEN
OPEN
Incandescent-
5Fluorescent &
M.V. BELL
F ix 0.100 AMPS OVER
ixed TRANSFER.
A j
liances
Ir H.P.RATING Mr. CEILING KW-HEAT
Conditioning COW.MOTOR OTHER MOTORS AWS BEAT
VOLTAGE PH NO. OVER I H.P. PHS
Motors 0-1 H.P.
OVER600V
I JNDER600V
Transformers NO. KVA NO. KVA
No.Neon—Transf
Ea. Si -
Miscellaneous
t_— I
800 Seminole Road-Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800- Fax: (904)247-5845- LI! -/�/,v"vw.c�i.atiant�ic-beac�h.fl.u�s Revised 1/04
Baker Klein Engineering, P
B ker
ei n STRUCTURAL ENGINEERING SERVICES
ENGINEERING,RL
May 8, 2007
Building Inspector
c/o John Storkman
Coastal Customs Construction
RE: Richard's Addition— 18 17 1h Street, Atlantic Beach
Dear Building Inspector:
Please accept this letter as the engineer's certification that the following revisions are acceptable
for the above-referenced project:
Where the floor joists have been cut to allow for plumbing, sister 2x6 SYP#2 joists with a
minimum distance of 4'-0" on each side of cut (or to end of joist, whichever is less.)
Connect joists with(4) .13 1 xY nails at 6" o.c. for entire distance.
Should you have any questions or need additional information, please call me directly at 904-
398-9837.
Sincerely,
Debra P. Klein, PE
Structural Enuineer
FL Lic.No. 59386
1628 San Marco Boulevard, Suite 13
Jacksonville, Florida 32207
(904) 398-9837 Phone (904) 398-9838 Fax
CA#26227
CITY OF
41 41
4244t
ji�a Be404
office of Building official
REQUEST FOR INSPECTION
Date A.M. permit No.
Time
P.M.
R eceiv
ed Job Address Locality
owner's Contractor P MECHANICAL
Name L PLUMBING
CONCRETE ELECTRICA 0 Air Cond. &
BUILDING Rough Wiring 0 Rough 0 Heating
0 Footing El Temp Pole 11 Top Out E5 Fire Place
Framing. 11 Slab E F_� Sewer Pre Fab
Fie Rooting Lintel 0 Final
insulation 0 READY FOR INSPECTION A.M.
Wed. Thurs. Friday P.M.
Mon. Tues. A.M.
P.M.
inspec4:n 0
Inspection Made Final
Inspector Certificate of occupancy
Date
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 SEMINOLE ROAD-ATLANTIC BEACH, FL 32233-TEL: 247-5826-FAX: 247-5877
PERMIT INFORMATION LOCATION INFORMATION
Permit Nui�ber: 18615 —Address: 18 SEVENTEENTH STREET
Permit Type: STAIRCASE ATLANTIC BEACH, FL 32233
Class of Work: ADDITION Township: Range: Book: 15
Proposed Use: SINGLE FAMILY Lot(s):10 Block: 8 Section:
Square Feet: Subdivision: NORTH ATLANTIC BEACH
Est. Value: Parcel Number:
Improv. Cost: 2,500.00 OWNER INFORMATION
Date Issued: 8/06/1999 Maim—e- HICKSON, HARRY L.
Total Fees: 3X�,50 $75.00 Address: 18 17TH STREET
Amount Paid: 3L,00 $75.00 ATLANTIC BEACH, FL 32233
Date Paid: 8/06/1999 Phone: (000)000-0000
&- 100 SQ.FT. LANDING &-S-TAIRWELL INCRESS/EGRESS FROM MAIN LIVING A—REA
VV0--rkDejc.
CONTRACTOR(S) APPLICATION FEES
PROPERTY OWNER PERMIT $75.00
PERMIT FEE DOUBLED: WORK COMMENCED PRIOR TO
PERMITTING.
Inspections Requlred�--
FINAE BUILDING
NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND
MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY
OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBjECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
$75.0014
Date; 8/96/99 01 Rc-ceipt: 0077-304
LH CASH
LANTIC BEACH UILDI
ATI A
00100003221000
D
RE C IV
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODELf ADDXTIONSf OR ALTERA�X&s
Cj�y Of Atiarl-,Lic Beach
MOVING,DE74OLITIONS k
BLIliding and Zoning
/�O% --il-r 4/5
Owner(s) 01,14r 41S I
Job Address: 17A �.5471-e Y Phone:
Lot # /10 Awl� 0 It )k UP '(44ve �Vjj'
Block < -itj# Subdivision: delmt
tt- ,L a —.t.-
Contractor: -R. _6,�K cr4 ft�j. - state License #
Address: sv ec 0 C)t-s 6%ja' Phone No:
City st State Fto,�,da Zip Code-
7�-�e �A J%
Describe work to be done: r I -5AL41LA)dl
4;15
A k�
(40, -
Present use of building:_Re3,1-#.,%5
Valuation of Proposed Construction:
JJO /,,'l4t3'5 n-M 4+
Proposed use: A,"I'll At S6411LWdl ft y I () t-k-
added
Is this an addition? 14D If yes, what are the dimensions of the
rj�*_ftx jv+- Ln,�di--j
space:_ft. X ft. Wi-14 the added area be heated and
cooled? 9b New electrical (or increase) ?-
New plumbing fixtures? 1\/0 New fireplace? A10 New Heat/AC?-do
tA;� .
TE
SUBMIT Th1REE (COMERCIAL) TWO (RESIDENTIAL) COLMPLE SETi
SITE PLAN, SURVEY, ENERGY CODE FORKS, NOTICE OF
SID
OWNERICONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR-
Av
d�& Date:
Signature OWNER: -9
S�op
Signature CONTRACTOR: Date:
AS TO O�W
DONNA 6.SAIS
ON-
MY COMMISSON#CC 681169
Sworn subaMd.-�WAbWfW:Le ri thjAtA day of 19—.
k"Al".0 Bwx%d Thru Nobq Kkk Un�ft
NOTARY PUBLIC
AS TO CONTRACTOR:
Sworn to and subscribed before me this—day of
NOTAkY PUBLIC
t";'ITY OF
800 SEMINOLE ROAD
ATLANTIC B.EACH,FLORIDA 32233-5445
TELEPHONE(904)247-Fi8ll(r- -
FAX(904)247-5805 -
SUNCOM 852-5800
CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489. 1 03(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSEE) CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT
UNDER AN EXEMPTION TO THAT LAW. THE EXEMPT10N 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 70NING 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.
ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY
USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER $2,000) BE UNDER A BUILDING PERMIT AND PASS
ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES; OR MAY HIRE
UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION OF THE OWNER, WHO MUST BE ON
THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOTALLOW USE OF
UNLICENSED CONTRACTORS.
SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS
WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY CLEARLY PROTECTS
THE OWNER. 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.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO $5,000 PENALTY UNDER FLORIDA STATUTE No. 455-226( 1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE.
THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247-
5826) IF IN DOUST.
I HERESY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL
THE REQUIREMENTS FOR THE ISSUANCE OF A14 OWNER-BUILDER PERMIT.
PR E /B R
ADDRESS A?,-4 ,34,3J3 TELEPHONE
SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF
NOTARY PUBLIC
NOTE: PHRASES UNDERLINED ABOVE MY COMMISSION EXPIRES:
ARE EMPHASIZED BY THE BUILDING
WNNA G.SAIS
DEPARTMENT.
MY COMMISSION III CC 581169
E)(PIRES:August 29,2000
,,;�F,VN, Bonded Thru Notary PublIc Under*TtWrs
SENT BY:60 0594
go/
MAP SHOWING SURVEY OF
a occh" eirtovil UprT L. CouxTY.
5j,,C f1geonU or toLIVA
oxcepT Twn f4 p
YLA,? xoo$ IA. PAC. 43? V& 0"'t"T
vm C3093
OFFICIAILRECAl"'
17 TH STREET '
q9?VfLP 54.
APPROVED
H
c )f OF ATLANTIC BEAC
VV14 FA I- BIJILDING 0551CFE
loto
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au, 17.4
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ANGLE AS PER PLAT-
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THAT PROPERTV smows
SMDW?( 011 TttK VLOOD J(h%ARU "UNDARY MAP ILOp '111& C -7
X914gay oculf1py TO I.. PMER 40ANSO9 "Alp I � o
XN TKj; ^SoVi.' CAPTION AND TMAT 'MtS MAP
SHOW14 1,glil SURVEY kND THAT TO 1"ft"'
RHoulphl,low op AMPTCD 01
4714lo4UN ST4NDA11D AtQVTllXr4SNTd
?"t # 440 Tito TI
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....... FLORIDA RK(L LAND IUAV YOR NO.320
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7a
iL
CITY OF
SUNCOM 852-5800
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE(904) 247-5800
FAX(904)247-5805
MEMORANDUM
July 29, 1999
TO: Finance Department
FROW Don C. Ford
RE: 56 Seventeenth Street
An inspection of the above property reveals that this is a duplex and should be
billed accordingly.
DCF/ph
M. File
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5290
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
-- PERMIT INFORMATION LOGATION INFORMATION --------
mit Number-: 5290 18 17TH. ST. 33
ermit Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 322
,as of Work : REMODEL --------- LEGAL DESCRIPTION ---------
,nstr. Type: WOOD FRAME Block: Section:
oposed Use: DUPLEX Township: NAB RNG: 0
-11ings: 2 Code: 0 t�,division: north atl. bch.
..imated Value:
Improv. Cost: $0. 00
Total FeeS31, $25. 00
$25. 00
mird
INFORMATION APPLICATION FEES
Name: JOH!,F70N PERMIT $25. 00
ST. WATER TMPACT FEE e-0. 00
,dress. 18 17TH. n '�iEWER IMPACTIFEE $0. 00
ATL.ANT! C �jEtjCl`!, FLORIDA WATER METER $0. 00
Phonet ( RADON GAS-H. R. S. $0. 00
- ------ CONTRACTaR INFORMATION, RADON GAS - 5% $0. 00
WATER TAP $0. 00
Name: STUART ELECTRICAL CONTRACTOR"
$0. 00
4751 SAM" ,JUAN AVE. SUITE 8 SEWER TAP $0. 00
jp,,-V-1nN7TT_T.E, FLORIDA 3221.0 HYDRAULIC SHARE
Cenmp! Type: 0 RE-INSPECT FEE $0. 00
SEC. H IMPACT FEE *O. or
T T-1 T,-f?,
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 MECHANICS' LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS.19
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW. LiriAUL
I or 1ki!
ATLANTIC BEACH BUILDING DEPARTMENT
By:
CITY OF ATL ANTIC BEACH, FLORIDA
Approved by APPLICATION FOR ELECTRICAL PERMIT
.1 1
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 19 �7 L
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 ANb CITY OF
ATLANTit BEACH ORDINANCES.
u –ci 1-4 JOUBNEYMAN
ELECTRICAL FIRM: S7 MASTER ELECTRICIAN SIGNAlR)BE
NAME ADDRESS: 7- RFD----"X
BLDG.SIZE BETWEEN:
REW.(4
RES.C-r- APT.I I comm.( PUBLIC INDUS. I NEW( OLD (
ADDITION (,4 TRAILER TEMP.I ) SIGNS ( ) --- SO.FT.
SERVICE: NEW( INCREASE( ) REPAIR ( FEE
CONDUCTOR SIZE AMPS COPP ALUMJ ) /s. 00
SWITCH OR BREAKER AMPS W -ZO—LI RACEWAY
VOLT RACEWAY
EXIST.SERV.SIZE AMPS PH W
FEEDERS NO. SIZE _I-NO. –SIZE:;OPNO. SIZE
LIGHTING OUTLETS 0 CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.30 AMPS. F- 1 31-1 AMPS.
SWITCHES A
INCANDESCENT
FLUORESCENT&M.V.
0.100 AM Vs. OVER
FIXED .......T- BELL TRANSF.
APPLIANCES
AIR H.P. RATING H.P.,RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS; CEIL HEAT: KW-HEAT
A
OVER
MOTORS H.P. VOLTAGE EPHES NO. I H.P. VOLTAGE PHS
MISCELLANEOUS c
TRANSFORMERS- UNDER-600 V. OVER 600 V.
NO. KVA NO. lKVA
NO.NEON TRANSF. NO. MOTOR SIZE SWITCH FLASHER
EACH SIGN
FORWARDED
TOTAL FEES
5155
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
PERMIT INFORMAZON ---- LOCATION INFORMATION
Address; 18 SEVENTEENTH STREET
4
Oermit Number: 5155
C ATLANTIC BEACH, FLORIDA 3223,:�
Permit Type: BUILDINC3 ---- -- LEGAL DESCRIPTION
ADDITION Block: 8
,7,lass of work : I-ot : 10 Section:
Constr. Type: WOOD FRAME Township: RNG: 0
proposed Use: SINGLE FAMILY Subdivision: OCEAN GROVE UNIT I
Dwellings: I Code: 0
Estimated Value : $5500- 00
Improv. Cost: $0. 00
Total Fees: $60. 00
Amount 061C $60. 00
-,,r, T�rTi PI-AN�, -
---- APPLICATION FEES -----
OWNI�k .(Nj�'URMATION $60. 00
-I ti PERMIT
Namfe: DOROThY F. JOHNSON WATER IMPACT FEE $0. 00
r
rAddress: 18 SEVENTEENTH STREET SEWER IMPAQT FEE
A�TLOL
NT 1 C hiEACH, FLORIDA A,, WATER METER
t,or �Oij )' -il-40�)O $0. 00
�,c
-H. R. S.
RADON GAS
RADON GAS - 5% $O. 00J
GONTR,4CTOR INFORMATIO" WATER TAP $0. Ou
Name: PROPERTY OWNER SEWER TAP $0. 00
Address: HYDRAULIC SHARE $0. 00
! "Ypt- ; RE-IHSPECT FEE $0. 00
L i -nen se: SEC. H IMPACT $0- 00
$01.1,00
N TES:
0
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
S' LIEN LAW CAN RESULT IN
"FAILURE TO COMPLY WITH THE MECHANIC ROVEMEON41T,§�"
NER PAYING TWICE FOR BUILDING IMP
THE PROPERTY OW VALIDATION DATE:
6FOR
D SU�A� RO REVOCAJ
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AN _kj $.00
D NG A ERIA fRB F LAW. CHANGE
UB ISI`
IL I M T L�
CL EARED up AND H LED AW
F'U'F ILURE 10 CO.M
VIOLATION OF APPLICABLE PROVISIONS 0
ATLANTIC=BEACH BUILDING DEPARTMENT
By:
T, 0
Address
Heated Square Footage @ $ er sq ft
er sq ft
Garage/Shed @ $
I I er sq ft
Carport/Porch @ $
4���,, __per sq ft =
Deck S� @ $
$ per sq ft = $
Patio 0 C)
TOTAL VALUATION:
Total �ailuation 1 S t $—1—e_-_Ie
C) C,
per usaan-nd or
F,anainder Va tion I -
portion thereof
Total Building Fee
----- -------:-------------------------------
ADDrrIO1,1AL PERM�TS and/or FEES REQUIRED' 11
+ k Filing Fee
Fireplaces @ 15-00 $
Mechanical BUILDING,1 TERMT FEE
PluTbing
ElectA-1 clNew L------------------------------------- -----------
Electric/TeT BunDING, PEMT
Septic Tank WATER METER CHARGE
Well SEWER IMPACT FEE
S�Amning Pool WATER IMPACr FEE
Sign . MISCELIANEOUS
Water Comectim /j
Sewer Comectim
.4ater Meter
Elevatian Certificate GRAND TOM DUE
---------------------------------------------------------------------------- -----------------
cAlDiLATIONS and/or NOTES
=Y OF
MAP SHOWING SURVE
�LOT. 10 EXCEPT THE SOUTH 1,0 FXET ALOCK 8 OCEAN GROVE UNIT NO. I AS RECORDED
2 7TU'1T.02" 82 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY,
_1N,.'4>LA,T BOOK 15, PAGE
FLORIDA. (SHE ATTACHED LEGAL DESCRIPTIONS)
17 TH STREET
40' R/W (PAVED) MAR 2 5 1992,
0 Building and Zoning
S E T 1/2!'1.P 5 4.3' FND.1/2" I.P
1.0,
0
PARCEL
jw
A
DRAIN FIELD
S REENF
.......;RD.A pro ease cL
_jAq. ORCII
extension
LIA 0A, 13.5 0*8'
CONC PA 10 17.4
lqt I civ r
to IST
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LLD A C' '*:' _-.91 0�
- I 3-STORY '416
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I ST. LEVEL
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:::..- .'..'.....* PT.8, , I
0 —717 0
....% 11. 27A' 4.
0
7DIVIoING WALL 0.9'WIOE
'I CONC.CARPORT DRINE.'
111t LEVEL
24.5'
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-STORY .1 W> I
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w 2 0. 10 41
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11.19' 1 .0 1 -11, Im
ow 14W
PARCEL 5
1�Uj
15
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CKAIN LINK FENCE
0'1' cli
Omt: FND.1/2"I.P
FND I"I.P d 54.3 NOTE -
j7 EEA 6:EE M�_E N T -ANGLE AS PER PLAT.
-NO B.R.L.ASPER PLAT
rz'
I HEREBY CERTIFY THAT THE PROPERTY SHOWN HEREON IS IN FLOOD ZONE 'C' AS
R THE crry OF JACKSONVILLE, FLORIDA.
SHOWN. ON THE FLOOD HAZARD BOUNDARY MAP FO SURVEYED THE .,LANDS AS
JOHNSON THAT I HAVE
I HEREBY CERTIFY TO L. PETER IS MAP IS A TRUE AND CORRECT. REP-
SHOWN IN THE ABOVE , CAPTION AND THAT TH SURVEY REPREUNTED HEREON XEETS
RESENTATION OF THAT SURVEY AND THAT THE i A SOCIETY OF PRO-
STANDARD REQUIREMENTS ADOPTED BY THE FLORID
THE, MINIMUM �8� LAND TITLE ASSOCIATION -
FESSIONAL LAND SURVEYORS AND THE FL
,,,w W Rf)ATWRIGHT. LS
DONN W. BOATWRIGHT. L.S.
FLORIDA REG. LAND: SURVEYOR NQ,,�1296',
SURVEYORS, INC- !LITE8.
BOA�T_WRIGHT
- ( 'OF *
S CAL E_�: 1301 PENMAft ROAD SUITE SH.EET
�DRAWWM BY: EACH. FLORIDA �4i_8560
I� P VILLE 8
JACKSON
J.
4.1
MA64CO FORM 400
FLA. 1*67 LAWS
FS 713.1 3 MAR-2 5 1992
afire of
AV49FARK tm ourLICATO
ZU W4= it
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 NOTICE OF COMMENCEMENT.
Tri-level townhouse , wood contempora y ...................
Descriptionof property......I.........I.....................I....................................I.....................I......................................
designcd by Pete Rumpel , with covered carport ............. ....................
........................................................................................................................I...................
...................................................I......I...............................................................................I...........................
................................................................................................I.................................................................... ......
Extend existia(
j
General description of improvements..................................................... ....
existing west corner of building plus misc interior ch ...............
............I.....................I......I....................................................................... ......................................................... n a_
permtt furniture placement (Owner anticipates making....thl s....h.e.r..................
................................................................................................................................................r............................
permane.nt residence) _ . Doroth F . Johnson.....(.�!U.......L........F..Q I P,X....j.Q.11UzQD
Owner..........................................................;.....................I......................y.......................................
118 17th Street
Address.............. . ........ .. . ..... . ..........................................................................................
Owner's interest in site of the improvement..........................................................................................................
fee Simple Title Wd*r (if other than owner)
Name............................................................................................................ .........................
.................................. .............
Address......................................................................................................... ..............
........................I.................. .......
Contractor...................................................................;........................... .....................
Address.........................................................................................;................................................................
Surety (if any)..................................................................................................................................................
Addrea......................................................................................................................................................Amourd of bond $..........................
Name of person vMhin the State of FloriAs
CITY OF ATLANTIC BEACH
OHS OR ALTERATIONS
L, ADDITI
PERMIT APPLICATION REMODE
L ------- n
Dorothy F - Johnson (of prese t home
Ovner(s) !---------;-------- Bch Phone:_241=4D3D_0,,_ocoan Blvd)
18 17th St , Atlantic------------- i n;
Address; ----- Subdivis 0 --
1-0------o-c-k-or Un
Bl - th 100 feet of Lot 10
Lot * of the nor
The 951it-F-48 feet I-----
Dorot]�y F . Johnson ---------------------- 2- i-feet to
Contractor:_ _ --Z F�
don ootprint of house)
Describe work 0 e (staying within existing f -pantry
ng West corner wall kitchen
existi t.Q ' in order to be able to
.,i_.Qizd.Q_r_- --t- misc interior changes
by 4 square feet. Also , -MY- F-e-644e
ously rented_to_tenantsi-
to T8 _17th street vacant (previ -Z-------- --
present Use of building:-------------------
---------f-r-cm residence of 2600 sq ft
$ (10 st)
__ic - ------------------
Valuation:_ (plan to relocate _1.7th.
on ocean
Proposed If-yes, what are the dilnensions Of
Is this an
_31 Will the added area
ce% Ist floor will increase 9,1,2 1 x31,2'
the added spa sting overhang 2nd floor ' -ease) ?-- rrets
(** due to exi New elertrical (or ind5dIng new ou
be heated and ce?D2__NeV Heat/AC'-a"-----
New plumbing fixtures%no_ New f i3rePla . S TTE PLAN, SURVEY,
SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING OWNER/CONTRAcTOR
ENERGY--CODE--F0RhS1 NOTICE OF COMIIENCEMENT, AND
-AFFIDAVIT, IF OWNER IS CONTRACTOR. Date%-�jq
OWNER:--
signature
Date:--
Signature CONTRACTOR:
MAR 2 5 1992
Building and Zoning
OWNER. DUILDER PERMIT AFFIDAVIT
state of Florida
City of Atluntic Beach
BE.FORE ME, the undersigned authority, Personally &Ppeared
y F -- ----------- who upors f ix iit Llzirsg duly
___J� "L
Gworn, deposes and- says%
I, Dorothy F . Johnson -- -------------- and the legal
owner of th4v lollowinO propertyi
Ocean Grove Unit
Subdivision
' The south 48 feet of the north
Block 8 Lots-- - - io
18 17th 100 .feet of Lot
ARA
I am applying for a building permit pursuant Lo -LjAe Owner
Builder exemption not Sorth in Florida Statute, Section 489- 10:3.
Florida law rvquirea that I have been providwd with the fullOving
DISCLOSURE STATEMEUT:
DISCLOSURE STATEMENT
.State law requires conatruction to be done by lic&nsed
applied for A permit under an
contractors. You have I YOUP as
�Xemption to that low. The exemption allow&
of your property, to 'act ajj; your own
the owner a license. You
contractor even though you do not have
ise the construction Yourself. You may
must supery twO family residence or a
build or improve a one - or
farm outbuilding. You may also build or improve a a
building at a cost of 025, 000. 00 or ler- -
commercial g must be Sor your use and occupancy. it
The buildin gale or leauvo it you sell or
may not be built for
1.0i3a more then one building You have built yourself
within one your alter the construction in complete, the
at you built it for sale .or lease,
law will preaume th ion of this exemption. Your
which is a violet cording to building codes
construction must be done ac
a�d zoning regulations# It is your responsibility to
Pjg employed by you have "censes
make Sure that peo municipal
required by "tate law and by county Or
licensing c.)rdinance0o r4 +him nTczri ncz"Pr
ankhowledn" that T hava "Pn