40 17th St (vault) Q k ° CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
r�Jifl��
Application Number . . . . . 05-00030504 Date 6/07/05
Property Address . . . . . . 40 17TH ST
Tenant nbr, name . . . . . . REPLACE CONDENSOR
Application description . . . MECHANICAL ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
------------------------ ------------------------
REILLY, NANCY NORTHEAST FLORIDA HEAT & AIR
40 17TH STREET P.O. BOX 60533
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32236
(904) 389-7458
----------------------------------------------------------------------------
Permit . . . . . . MECHANICAL PERMIT
Additional desc . .
Permit Fee . . . . 51 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 51 . 00 51 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 51 . 00 51 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING
C
. C - 1?-^-k
BUILDING OFFICIAL
r CITY OF ATLANTIC BEACH
r' MECHANICAL PERMIT APPLICATION
Date:
Property Address: yo ,-7 wulm �-L 30D33
Owner: Qe VA Telephone #: c7y 1 - 1oa1 c9
Contractor: C44 '. f(I Telephone #: 7fj3 - 7003
Contractor Address: 541 poc-"e ', -6, FL 39990 Fax#: 793 ' 700 t-(
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
good practice listed therein.
Type of Heating Fuel: If other construction is being done on this building
/ or site,list the building permit number:
l� Electric
❑ Gas: _LP Natural _Central Utility
❑ Oil
❑ Other—Specify
MECHANICAL EQUIPMENT TO BE INSTALLED NATURE.OF WORK
❑ Heat _Space _Recessed /Central _Floor Sr*'Residential
O""Air Conditioning: _Room ZCentral
❑ Duct System: Material Thickness ❑ Commercial
Maximum capacity cfin
❑ Refrigeration ❑ New Building
❑ Cooling Tower: Capacity gpm ❑ Existing Building
❑ Fire Sprinklers:Number of Heads
❑ Elevator: __ Manlift Escalator (Number) C3 Replacement of Existing System
C3 Gasoline Pumps (Number)
❑ Tanks (Number) ❑ New Installation
❑ LPG Containers (Number) (No system previously installed)
❑ Unfired Pressure Vessel . ❑ Extension or Add-on to Existing System
❑ Boilers
❑ Gas Piping ❑ Other-Specify
❑ Other—Specify
LIST ALL EQUIPMENT
AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving
Number Units Description Model# Manufacturer Ton's Agency
1 �vnd o?7"wiZ I 0? U �--
HEATING—FURNACES,BOILERS,FIREPLACES&AIR HANDLER'S Approving
Number Units Description Model# Manufacturer BTU's Agency
TANKS Nominal Capacity Type Liquid Serial Approving
How Many &Dimensions Contained Manufacturer No. Agency
800 Seminole Road • Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 • Fax: (904)247-5845 • bttp://www.ei.atiantic-beach.fl.us
�j'`LrJrJr�
ass, CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
r� ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00026475 Date 7/11/03
Property Address . . . . . . 40 17TH ST
Tenant nbr, name . . . . . . RE-ROOF
Application description . . . ROOF
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
Owner Contractor
------------------------ ------------------------
REILLY, NANCY ROMANO ROOFING SERVICES
40 17TH STREET P.O. BOX 33037
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 246-5649
----------------------------------------------------------------------------
Permit ROOF PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 6000
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 90 . 00 90 . 00 . 00 . 00
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.
BUILDING OFFICIAL
CITY OF ATLANTIC BEACH PERMIT - CALCULATION' SHEET
Address_
Date l a'• O'�
Heated Square Footage @ $ per sq ft ..= $ '
Garage/Shed @ Sf ' Per .sq ft = $
Carport/Porch @ _per sq ft .= $
Deck _@ $ per sq ft = $
.Patio @ $ per sq ft = $
TOTAL VALUATION: 5
(90
.Total Valuation Is $ 2�
.Remaining Value . $6:Ob per thousand
or :portion thereof
TOTAL BUILDING FEE $ C�
+ 1/2 Filing Fee $ 3D
(. ). Fireplaces . @. $15 . 00. $ .
.BUILDING PERMIT FEE $ L1�.
WATER IMPACT FEE $
SEWER IMPACT FEE $
. WATER METER/TAP $
CAPITAL .IMPROVEMENT, $
SEWER TAP, $
) -RADON (HRS) . 0050: $
SECTION H PAVING ( } $
HYDRAUL.IC ,SHARES $
CROSS CONNECTION $
( ) SURCHARGE .0050 $
OTHER $
GRAND .TOTAL DUE
ADDITIONAL PERMITS OR FEES : Mec.hani,cal ..Plumbing
Electric/New Electric/Temp ;Swimmingpool
Septic Tank Well ; Sign Finish Floor Elevation
Survey Other
CALCULATIONS and/or NOTES :
Y OF
CI ATLANTIC
OL.800 S MIEICH
ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
til TELEPHONE: (904)247-5800
J FAX:(904)247-5805
r SUNCOM:852-5800
http://ci.atlantic-beach.fl.us
PLAN REVIEW COMMENTS
Permit Application # 0-s -7-6,4`l-S __
Applicant: o (2'Vt-_l.0
Address:
Project:
o Y r application is approved
Your permit application has been reviewed and the following items need
attention:
Please re-submit your application when these items have been completed.
Reviewed byk ' (( J 0
Signed Date
Contractor Notified Date
RECEIVED
CIT`( OF ATLANTIC BEACH
I BUILDING & ZONING
i
y . JUL 10 2003
CITY OF ATLANTIC BEACH
'r
ROOFING PERMIT APPLICATION
Alf
Date:
Job Address: -' " I V r
Owner of Property: i' e/0 /
� -7 ( C�, Telephone:
Address:
d State License Number:
Contractor: � �"'-�'..--rte o �
Contractor's Address: �
-7- �� Fax:
Telephone: /
Scope of Work: Cz--� db�`� D yr/—
Deck Slope: / L Greater than 2:12 Less than 2:12
Valuation of work: a
Product Name(Example:Timberline): t v',
Manufacturer(Example: GAF):
ASTM Designation(s): /
Required Inspections. g and Fin4Y
—7
Date: (l D [
Signature of O /
Date:
Signature of Contractor:
AS TO OWNER:
Sworn to and subscribed before m this
day of 20 .
State of Florida,County of Duval 7 / '
Notary's Signature:
t <' GLOMIXASTERLINE WLAI i,'r:;
� MY COMMISSION#CC 976739 ❑ personally known
Produced identification - 71b S/I�/_0
t�oo-3NOTARY rL,vuce v Se,v,a °:,'-�^_""9:1"x. Type of identification produced Y
AS TO CONTRACTOR
da
Sworn to and subscribed before me this Y of
/O
State of Florida,County of Duval _ .
Notary's Signature:
GLORIAP.
CASiE[tLltvL-Nic��+u�;t?�-•�
❑ Personally known
MY COMMISSION#CC 976739
' ❑ Produced identification
o FXP►Kes:pecembet 8.2004 Type of identification produced
t. t-80&3-NOTARY FL Notary Service&Bonding.Inc.
Book 11207 Page 1199
j/AA11N. RETURN
' NOTICE OF COMMENCEMENT
State of Tax Folio No.
County of
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance
with Section 713 of the Florida Statutes, the followi i Ormation is stated in this NOTICE Off OMMENCE,MENT.
Legal description of property being improved: C/ 0
Address of property being improved: c--
General description of improvements: i/ v;� //g fi,1 :-1
Owner: /
Address: 7 ,,-b Z- 13 e L
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Address:
pr�p�CfContractor: o 14==K L
)) Address: (T 4-
Phone No: — t Fax No: -71 -7
Surety(if any):
Address: Amount of Bond S
Phone No: Fax No:
Name and address of any person making a loan for the construction of the improvements.
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other
documents may be served:
Name:
Address:
Phone No: Fax No:
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2)(6), Florida Statues. (Fill in at Owner's option). _
Name:
Address:
Phone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
' SPACE FOR RECORDER'S USE ONLY OE
Signe _ ate:
Be re m thisday of in the County
o'Duval, State of orida,ha onally ed
eld,
otary PuVic at Large, Stite of Florida, ounty of Duval.
My commission expires:_6 : & ;?,W-3Personally Known: _ ' _
or
Produced identification: lj o - 7�o -�I-/ 1—
GWRIA I.CAS7ERLINE•hicLAUGHL;1
MY COMMISSION#CC976739 � ��'
��'OF F�OV� EXPIRES 1>ecember A,2004
1�00.4NOTARY FL Notazy Sernce&BorWing,.Inc.
`Tl OF yl_ORt9A
cUalli> k Circ+tit Court.Duval s°e true
.;t3t=�tlEn Cfer� ni` ".t7 and foie..,°ing
DU ;icsi i. K i unty, Florida.
let COPY ut the s,ngr.al a•;it ap,eafs enJrountyecord and h e
Tice of the UWA of UjIfCua a Duof' ircuit Cowt at
my hand and seg -11 .0
Florida,this ttfe JI F LER Courts
CirC it an unty
Clerk Ci al Co lorida.
EY
eput Clerk
1
CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
JOB LOCATION: Xbo /-7' �T
OWNER OF PROPERTY:Tn1 �. -TELEPHONE
PLUMBING CONTRACTOR LAW TUGUE PLUMBING
CONTRACTOR' S ADDRESS : 30'3 >_ 7b-1 ;: fQ
STATE LICENSE NUMBER: �CFC056 7 TELEPHONE:
HOW MANY OF THE FOLLOWING FIXTURES INSTALLED
SINKS SHOWERS
LAVATORY WATER HEATERS
BATH TUBS DISHWASHERS
URINALS DISPOSALS
CLOSETS WASHING MACHINE
FLOOR DRAINS SHOWER PANS
SEWER WATER
L----REPIPE OTHER
TOTAL FIXTURES: x $3 . 50 + $15 . 00
MINIMUM PERMIT FEE9OR.SIGNATURE OF OWNER
SIGNATURE OF CONTR
-----------------------------------------------------------------
INSTALLATION OF PLUMBING AND FIXTURES MUST BE IN ACCORDANCE WITH
THE MOST RECENT EDITION OF THE SOUTHERN STANDARD PLUMBING COIJE.
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826
SEWER CONNECTIONS MUST BE CALLED INTO PUBLIC WORKS FOR INSPECTION
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 Seminole Road -Atlantic Beach, FL 32233 -Tel: 247-5826 - Fax: 247-5877
PLUMBING PERMIT
PERMIT INFORMATIONLOCATION INFORMATION
Permit—Number 19899 Address: 40 SEVENTEENTH STREET
Permit Type: PLUMBING ATLANTIC BEACH, FLORIDA 32233
Class of Work: ALTERATION Township: 0 Range: 0 Book:
Proposed Use: Lot(s): Block: Section:0
Square Feet: Subdivision:
Est. Value: Parcel Number:
—
Improv. Cost: OWNER INFORMATION �
Date Issued: 4/18/2000 Name: REILLY
Total Fees: 25.00 Address: 40 SEVENTEENTH STREET
Amount Paid: 25.00 ATLANTIC BEACH, FLORIDA 32233
_Date0
Paid: 4/18/200_ _Phone: (000)000-0000
_ _
Work_Desc: REP(PE
CONTRACTORS) APPLICATION FEES
LARRY TEAGUE AND SONS PERMIT 25.00
----------
Inspections Rqquired
FINAL – --.�
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.
LCB
t�C995014
� Date: 4/19/88 81 Receipt: 8850353
CHECKS 8277100394
A LANTIEA ABI LDING DEPT. 88188883221888
r
0003209
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
---- rEx:siT iNf�'t7RflATSaH —__.
LOCATION .THF•L:PMATION ------
ermit Humbert A(1dress: 140 17TH IMTREET
permi-t- Type= UTILITifr3
ATLANTIC bEAC1, rLORIDA --12'2 n
lass ox Norxi NEN - -------- LICOAL nE!9Cfi.iFTx0" -
Constr. Type: WOOD FRAME L t: $1ocK: ""erctlon:
Proposed Use: "XIMI-C PA"ILY Township: ft NO C�
xe111ngs: 1 Code: O r3 bdlvlsloii
stlmeted value % 50• OO
improv. cost: lot).00
Total Fees: X213.01
Amount Paid% 321 . 01
-- --- -- OWNER 1"froRfiATIO" __ _._-_ - _ -- ---- APPLXCATION f*E— -----
lfam PREveftxt:K ReYHOLD19 PEftPT1T So.010
ddress 40 1'77'1 15THEET WATER IMPACT Pre `00. 0 ��� tIL'
ATLANTIC SEAC", P'LURXDA zn2231:13 SEWER r"rACT rEE SoC1. 00
rnone 2 V9*4)241 -04n2 MATER HzTfrft OC)
RADON OA21-N. R. tf. ou
------ C0H'TfSAC.TOft INiF"OHnATION - RADO" 10A15 `."a.C)C
Name% rUBLiC Nt�tftn*211 DEPAfiTntINT NATER TAf fa�11115t't. 01
ddress: 1SENEft 'TAf 50.too
ft)rDftAULIC HARE 1�0. bO
Type: ti fit:-IN-IPLCT rEIS :$0.00
'°BEC. H IMPACT PEE c5t). tt"",
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."
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND, SUBJECT TO REVOCATION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW. C+ #.88
ATLANTIC BEACH BUILDING DEPARTMENT
By:
It" WATER SERVICE 28 17TH STREET
AND
40 17TH STREET
)OB COST RECORD
'F Z DESCRIPTION .`•`_` `. QTY, MATERIALS : LABOR TOTAL
2" 90 :1, PVC 1 $0.80
2" SCH 40 PVC PIPE 1 ' 0 38
2" X 3/4" REDUCER PVI 1 $0.60
3/4" SCH 40 PVC PIPE 1 ' $0. 14
3/4" MALE ADAPTER PVC 1 $0. 16
3/4" CURB STOP 1 $11 . 60
3/4" METER ENDS. 2 $660
3/4" RUBBER WASHERS 2 $0150
3/4" X 5/8" METER 1 $85 00
CONCRETE METER BOX/LID 1 $21 .00
SUB TOTAL $126. 78
10% O.H $12 67
TOTAL $139 45
2 MEN ($27 .45/HR) FO 1 HR $27.45
30% O.H. $8.23
TOTAL $35.68
MATERIALS LABOR TOTAL
TOTAL $139145t $35.68 $1751. 13
MISC.JOB EXPENSES _ �(QR
MOUNT OTHER JOB EXPENSES $101,00
1 TRUCK 10.00 HR 1 R. TOTAL COST $185 .13
10 O TOTAL SELLING PRICE
LESS TOTAL COST
GROSS PROFIT
' LESS OVERHEAD COST
%OF SELLING PRICE
TOTAL jjO.poINET PROFIT $185 . 131
ADD ON ' O-THIS ESTIMATE $89.88 FOR WATER(TAP $275 .01 TOT OWED
A P P RO E b
�I • H 0 1 1990
CITY OF ATLANTIC BEQ.CN
PUBLIC wopKc "p,"r"
!*COST OF TAP TO BE SHARED BY THE FOUR ADDRESSES INVOLVED.* 2" WATER TAP LOCATED AT
0-38 17TH STREET
JOB COST RECORD
DESCRIPTION=
r- QTY�=s MATERIALS I ' LABOR ;`. j�'L.TOTAL
6" X 2" T.S PVC 1 $17190
2" CORP STOP 1 $35 70
2" MALE ADAPTER PVC 1 $0 67
2" 90 L PVC 1 $0 80
2" SCH 40 PVC PIPE 20' $7 60
2" SCH 40 PVC T 1 $2F6
SUB TOTAL $6663
10% O.H. $6k6
TOTAL =$73 ,29
2 MEN ($27 .45/HR) FOR 5 .5 . HRS $150. 97
30% O.H. $45 29
TOTAL $196, 26
MATERIALSLABOR TOTAL
TOTAL S7391.2 $196[26 $26+9555
"' .MISC.)OB EXPENSES MOUNT OTHER SOB EXPENSES $C90
HRS. TOTAL COST $359155
�551010
TOTAL SELLING PRICE
1 BACKHOE ($35 .00/HR) FOR 1 HR. LESS TOTAL COST
35 00
GROSS PROFIT
' LESS OVERHEAD COST
16 OF SELLING PRICE
TOTAL SgoOCNET PROFIT 359 55
I4
IZ 3
PRICE QkAolne
APPLICATION FOR MATER AND/OR SEWER TAP APPLICANT NAME
MAILING ADDRESS
PHONE NUMBERo _L_. _}. z=-------- DATE_-- - -Q-------
• 1
�YL4-e
SERVICE REQUESTEDNs 4� ��-C
- ------------
------------------------g-�------------ ----------
SERVICE LOCATION � `
------
DATE SENT TO DATE RETURNED
PUBLIC MORKS_,I�L�31TO BUILD* DPT.-Jo�J� �-
-_--
DATE OWNER
NOTIFIED
City of Atlantic Beach
Fixture Unit Worksheet for Water Impact Fee
FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND
FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY
WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TEN
DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM.
_____BATHROOM GROUP CONSISTING OF _ _SERVICE SINK TRAP STAND
WATER CLOSET, LAVATORY & BATH j � (8)
TUB OR SHOWER STALL (6)
1 __ __WATER CLOSET VALVE
WATER CLOSET, TANK OPERATED (4) VALVE OPERATED (8)
--O--BATHTUB/SHOWER (2) _ __-URINAL WALL LIP (4)
___SHOWER GROUP PER HEAD (3) _ -_FLOOR DRAIN (1 )
_L_SHOWER STALL DOMESTIC (2) -_LAUNDRY TRAY (2)
_�LAVATORY ( 1 ) 2 _ ___COMBINATION SINK AND TRAY (3)
__1 _WASHING MACHINE (3) _ _--POT, SCULLERY SINK (4)
__1 _DISHWASHER (2) 2, _ ___WASH SINK EACH SET OF
FAUCETS (2)
C��_KITCHEN SINK (2)
_ ___DENTAL LAVATORY ( 1)
____KITCHEN SINK WITH WASTE
GRINDER (3) _ ___DENTAL UNIT OR CUSPIDOR (1)
DBIDGET (3) _ __URINAL STALL, WASHOUT (4)
FLUSHING RIM SINK (8) _ ___COMBINATION SINK AND TRAY WITH
-- -- FOOD DISPOS. (4)
__URINAL, PEDESTAL, SYPHON JET
BLOWOUT (8) _____DRINKING FOUNTAIN (1/2)
LAVATORY, BARBER/BEAUTY --
SHOP (2) _ _LAVATORY, SURGEONS (2)
_L_SURGEONS SINK (3) --C-URINAL STALL, WASgOUT(4)
TOTAL FIXTURE UNITS_`)9-1 -
_-- @ %2
EACHp_lv_O`__-_-
JOB INFORMATION____ �—
-------- - ------Szl-----------------
CITY OF
ATLANTIC BEACH 12 `
FLORIDA
12/6/90 19
NAME Frederick Reynoldo
ADDRESS. 4u 17t1i Street
CITY Atlantic Beach, FI, 32233
Water Impact Fee for 40 170, Street, Permit 2T0. 3209 650.00
issued 12/4/90
a
VALIUPT1ON DATE: 121Qk,/9p
},U d/y
TIME: 11C:X27 Am
ML
Yrp:�n�r<
When Signed, Dated and Numbered, This Becomes an Official Receipt
'EKE CHECKS PAYABLE TO Received Payment
TY OF ATLANTIC BEACH, FLORIDA TREASURER
PSR-3844 7115
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
T""T !NFE)RMh1F!E)N hoeftT16N iNFeRmftTfeN
Permit .Number : 711,5 Address : 40 SEVENTEENTH STREET
Permit Type: ELECTRICAL ATLANTIC BEACH, FLORIDA 32233
Class of Work : ADDITION
Constr. Type : WOOD FRAME ---------- LEGAL DESCRIPTION ----------
Lot : Block - Section:
Proposed Use : SINGLE FAMILY Township : RN,3: 0
410 -
Dwellingn : 1 de : 0 S
Estimated Value : $0 .00 ubdivision:
Improv. Cost : SO .00
' : Total Fees : ',25 , 00
Amount Paid : S25 . 0r,
[late aid : 7/28/93
Tj
Sik
PERMIT
6ZV,1E14TEENTH STREET WATER IMPACT FEE
,-'iTLANTIC BEACH, FLORIDA 32,2 353.3 SEWER
IMPACT FEE $0 .0(1
WATER METER - Sn
RADON Gjk$-oH,R_S .
CONTRACT INFORMATION ---- RADON GAS 5% x0 00
Name: SARKOSKIE ELECTRIC' SERVI,-*F,' WATER TAP $0 .00
Address * , 520 FOURTHAVENUENORTH SEWER TAP $0 .001
TAI-Tft!73'�NVTLLE BEACH. `FT
Tvp,- HYDRAULIC SHARE $0 , 00
CAPITAL IMPROVE. 50 , 00
SEQ .H IMPACT FEE $0 . 001
OTHER 0 (?!-.1
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."
�4QAT;gN PATin 07428�qg
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJmTO REVOCTIWATI: 11:52 4
nM(lFjOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW. TENDERED $25.00
lur%kh_�
RECEIPT NLIMBER: 098762
ATLANTIC BEACH BUILDING DEPARTMENT
By:
CITY OF ATLANTIC. BEACH, FLORIDA !,�
Approved by APPLICATION FOR ELECTRICAL. PlIRMIT
1
.
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: A 191--J
IMPORTANT NOTICE: r
I �
• I
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN T111i FOLLOWING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF. AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES. t
i
94R. ate- �G
ELECTRICA FIRM:
NAME ADDRESS: �"y 1�4 S` RF X
BLDG.SIZE BETWEEN:
RES.LY' APT.( ) COMM.( 1 PUBLIC( 1 INDUS.( 1 NEW 1 11 OLD( ) REMIT.( )
AOOITION 1 1 TRAILER 1 ) TEMP.( I SIGNS ( Sm FT.
SERVICE: NEW( ) INCREASE( 1 REPAIR( 1 I FEt
CONDUCTOR SIZE AMPS COPPER I I ALUK
PVITCH OR 699AKER AM PH IN VOL-r RACEWAY
• I
EXl .SERV.SIZE O AMPS PH W L CEW
. I
FEEDERS NO. SIZE NO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES
3 CONCEALED OPEN TOTAL
O.XO AMM. 01.100 AMIE. }
SW' ITCHca I I r
INCANDESCENT
FLUORESCENT SI M.V.
!►lx[O 0.100 AMM. I ovum
APPLIANCE! BELL TRANSF.
AIR H.P.RATING H.P-RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT-
0.1 OVFi
MOTORS H.P. VOLTAGE PHS NO. I N.P. VOLTAGE PHS
MISCELLANEOUS
TRANSFORMERS: UNDER 6W'V. OVER 800 V.
NO. KVA NO. lKVA
NO.NEON TRANSF. NO. VA. MA. MOTOR SIZE SWITCH FLASHE I 1
EACH SIGN
I FORWARDED
TOTAL FEES
I
I �
PREPARED 8/12/03, 8:05:25 INSPECTION TICKET PAGE 1
CITY OF ATLANTIC BEACH INSPECTOR: LARRY J HIGGINS DATE 8/12/03
------------------------------------------------------------------------------------------------
ADDRESS . : 40 17TH ST SUBDIV:
TENANT, NBR: RE-ROOF
CONTRACTOR ROMANO ROOFING SERVICES PHONE (904) 246-5649
OWNER REILLY, NANCY PHONE
PARCEL 169589-0000- -
APPL NUMBER: 03-00026475 ROOF
------------------------------------------------------------------------------------------------
PERMIT: ROOF 00 ROOF PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
17 01 7/17/03 LJH /BDINAL
HING TIME: 17:00
7/18/03 AP , THIS IS A 3 STORY HOUSE. 571-6142
16 01 8/ 2/ 3 L TIME: 17:00
b �� JOE ROMANO 571-6142
--------- -------- --------- COMMENTS AND NOTES
PREPARED 7/16/03, 17:00:16 INSPECTION TICKET PAGE 8
CITY OF ATLANTIC BEACH INSPECTOR: LARRY J HIGGINS DATE 7/17/03
------------------------------------------------------------------------------------------------
ADDRESS . : 40 17TH ST SUBDIV:
TENANT, NBR: RE-ROOF
CONTRACTOR ROMANO ROOFING SERVICES PHONE (904) 246-5649
OWNER REILLY, NANCY PHONE
PARCEL 169589-0000- -
APPL NUMBER: 03-00026475 ROOF
------------------------------------------------------------------------------------------------
PBRNIT: ROOF 00 ROOF PERMIT
REQUESTED INSP DESCRIPTION
TYP/SQ COMPLETED RESULT RESULTS/COMMENTS
------------------------------------------------------------------------------------------------
17 01 7/17103 LJH -,,-\ Bp SHEATHING TIME: 17:00
k OR PM, THIS IS A 3 STORY HOUSE. 571-6142
-------------------------------------- COMMENTS AND NOTES --------------------------------------