85 W 3rd St (vault) CITY OF ALTANTIC BEACH
COMPLAINT MANAGEMENT 3YSTEM
TAKEN (date/time) :
COMPLAINANT: Z�zf
Lagit Name First game MI
ADDRESS:
CITY/STATE/ZIP:
TELEPHONE:
COMPLAINT:
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LOCATION: /e�
PROPERTY 0 ERS PHONE:
PROPERTY OWNERS NAME:
DEPARTMENT FORWARDED TO:
COMPLAINT TAKEN BY: DATE/TIME:
OFFICE USE ONLY
INVESTIGATED; (date/time)
ASSIGNED DEP , ./DIVISION: PRIORITY:
INVESTIGATOR�
CONDITIONS F UND:
ACTION TAKEN:
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COMPLIANCE:
NOTES:
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 Seminole Road - Atlantic Beach, FL 32233 - Tel: 247-5826 - Fax 247-5877
PLUMBING PERMIT
PERMIT INFORMATION LOCATION INFORMATION
Permit Number: 21486 Address: 85 THAD STREET WEST
Permit Type: PLUMBING ATLANTIC BEACH, FLORIDA 32233
Class of Work: NEW Township: 0 Range: 0 Book:
Proposed Use: Lot(s): Block: Section: 0
Square Feet: Subdivision: SECTION H
Est. Value: Parcel Number:
OWNER INFORMATION
Improv. Cost: 25.00
Date Issued: 2/21/2001 Name: LARRY W. IDDINGS
Total Fees: 25.00 Address: 85 THIRD STREET WEST
Amount Paid: 25.00 ATLANTIC BEACH, FLORIDA 32233
Date Paid: 2/16/2001 Phone: (904)247-7446
Work Desc: SEWER
CONTRACTOR(S) APPLICATION FEES
AMELIA PLUMBING PERMIT 25.00
Inspections Required
SEWERiWATER
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.
$25.0014
Date: 2/22/01 81 Receipt: 6036542
T. CHECKS 1052
ATLANTIC BEACH BUILDING
CITY OF A�rjANTIC BEACH
APPLICATION FOR PLl7llB:r2qC;' PERWT
TION: NO
JOB LOCA TELEPHONE
OWNER OF PROPERTY*
PLUMBING CONTRACTOR
CONTRACTOR' S ADDRESS:
TZLEPHON
STATE LICENSE NUMBER' FOLLOW114G FIXTURES
110W MA= o-F THE
pZ-p3:PF,D OP, NEW SHOWERS
SINKS WATER HEATERS
LAVATORY DISHWASHERS
13ATH TUBS DISPOSALS
URINALS WASHING MACHINE
CLOSETS SHOWER PANS
FLOOR DRAINS WATER
SEWER S BE-114G PgPIPED)
RE-PIPE (LIST FTXTUPZ
OTHER
$3 . 50 + $15 -00
TOTAL FIXTURES: ------
MINIMUM PERMIT FEE - $25 - 00
SIGNATURE OF OWNER: -
SIGNATURE OF CONTRACTOR:
--------------------------------------------------------------
---- PLUMBING AND FIXTURES MUST BE IN ACCORDANCE Al"'d
INSTALLATION OF HERN STANDARD PLUMBING CODE-
THE MOST RECENT EDITION OF THE SOUT (904 ) 247-5826
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS -
CITY OF
4&4ft1&-C Be44CA-1&U*44
Office of Building Official
REQUEST FOR INSPECTION
Date 2 Permit No. 2,
Time M.
Received
g55- 3rd 6�-f-
Job Address Locality
owner,s
Name L.4 6—Contractor 4M e/,;n .40L V
BUILDING ZONCRETE ELECTRICAL 6� MECHAh11AI
Framing Ll Footing El Rough Wiring El Rough 0 Air Cond.& El
Re Roofing 0 Slab El Temp Pole El T 0 t 0 Heating
ju'
Insulation 0 Lintel E Final C1 Fire Place E�
Pre Fab
READY FOR INSPECTION
Mon. Wed. Thurs. Friday
—0 A.M.
Inspection Made P.M.
Final Inspection 11
Inspector—
Certificate of Occupancy E
Date
CITY OF
Be4cA-A;&w'4&
Office ot Building Officill
REOUEST FOR INSPECTION
-7 o?3 permit No.
Date
Time 3 P.M. /7
Received
L al'y
Job Address
owner's Contractor
MECHANICAL
CON RETE ELECTRICAL PLUMBING 11 Air Cond.&
UILD Footing 11 Rough Wiring Ei Rough Ei Heating
Framing M Temp Pole D To p 0 ut [i Fire Place
Re Rooting Slab Final Ei Sewer Pre Fab
insulation Lintel READY FOR INSPECTION
Tues. Wed. 0 Friday
Mon. A.M.
�-3 —P.M.
inspection,Made Final inspection D
inspector Certificate of occupancy El
Date
PSR-3844
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
FERMIT INFORMATION LOCATION INFORMATION
ermit Number ! -753f; :,I.ddress - 85 THIRD STREET WEST
Peri I nit Type : BUILDING ATLANTIC BEACH , FLORIDA
ODEL ---------- LEGAL DESCRIPTION
.lass .it Work! REM Lot : Block: Section :
, rmstr Type: WOOD FRA14E
Township : RNG* 0
Proposed Use: GARAGE/CARPORT subdivision: SECTION H
I I ings Code : 0
—7ti-mated Value' S5600 �00
Improv , Cost. : $0 ,00
Total Fees * 4M&gr.�- 60.00
A iiA;kX-5& 6 0.0 0
APPLICATION FEES -----
------ -— .�WNER iNFORMATION
W . TDrINGS PERMIT 8��Xki:r 60.00
Tql"- STREET WEST WATER !MPACT'IFEE SO . 00
EWER I KV ACT �-, �$0 0
FLORIDA 3 2 FEE
A
WATER METER TAP
F,h 641 4 4 6 $0 . 00
RADON GAS-H- -R - S-
ONTRACTCR INFORMATION RADION GAS - 5-% SO .00
- ------ I- - CAPITAL IMPROVE , $0 .00
Name - PR".,PERTY �--,WNER SEWER TAP 80 . 00
e S, `10 .00
HYDRAULIC SHARE -
-ONNECTION
rROSS C
SEC -H IMPACT FEE $n .
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.99
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO R&rWrION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW.
ATLANTIC BEACH BUILDING DE A TMENT Uf Atlantic Bc4j
By:
MAP SHOWING SURVEY OF-:,
I-e-,I
64cc,< 79, fTfC7-1C,^1
according to plot recorded In Plot Book Page 34 of the current puNIC
records of County,Florida. Examination of Flood Hazard Boundary Map, cornmnity
No. ponel doled -'7' n Icatet
" " 0 -"' .r�e -5,,0
that the property shown and described hereon liss within a Zone L7 area.
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Building and zoning
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DAVID CLARK & ASSOCIATES
LAND SURVEY0113
f)-?41-0) QT jr)"mciniiir;: Pr) -.IArKOONVILLE. FLORIDA-(904) 641--6700
FLA 1047 LAWS MANCO FoRld A"
FS 713.13
ire of
WWGFA49 IN
to hlh= it =q =W=
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.
Description of property...... 44�� A.!�.r......2..........A
....... 12---- !2-Z....1-2.4 . ......
..........I.........................I....................................... .................................................................................. ...............................................
...... ............................... ..........................................................................................I.......................... ............................................
Cmnor&l description of kWovwmrd&........ ...... ......
.........
...........
........ ......Q-j.........!L.........-1�r.. ..... I..............................................................................................................................
Owner...........
W.......... �'7........
.......... ......................
Owner's inlerea in ae of the WWovegnent..................................................................................................
Fee Simple Tide holder (if other than owner)
Name ...........-.�. Y?2
.........................................................................................................................................................................................
Addro.......................................................................................................................................................................................................
Contractor—
A"ea-. � ..................................................................... .........
Surety .......................
.........................................................Arnours ol bond S...............................
Nww Of PW"n w*hin 16 State Of Ploride desi"od 6y owner upon w6m wim or Other doom-,O.Vs r"Y
6e sorved,
Nww ...... .......
...................... ........... .................
Addres&....................................... ...................................................................................................................................................
In addition to himself. owner designates the following person to receive a copy of the Lienor's Notice
as provided in Section 713.13 (1) (F), Florida Statutes. (Fill In at Owner's option).
.................................................................................................... ......................
Address...................................................................................................................
This *PAC*Fool MAGORDswe Use DNLV
Ownse
Sworn to and "scr"d boloro me 16s....I/........................
..........................dayof -_41 ......................................19..........
.................... .......... ............. .... ................ ..........
Nolary Public
Q OTA R - PATRICIA A 1�k'N-F 717L
PUqLj(_ STATE OF- F'LC,R,,-,A
PUBLIQ, &1y Co
mm Exr
COMNI NBR
CC220017
OWNER BUILDER PERMIT AFFIDAVIT
Stbte of Florida
City of Atlantic B*ncts
9EFORE HE, tho undersigned authority, Personally hppvarvd
---------- Who Upon fir"t being duly
sworn, deposes and sayss
--------------- and the legal
owner of the follow1no propertys
Subdivision
Block -------
Lots—
9� '0,c
ANA
I am applying for 4 building permit purmuent .o th* Owner
Builder exemption met forth in Florida Statute, Section 489. 103.
Florida law requires that I r have been provldwd witto thw following
DISCLOSURE STATEMENTs
DISCLOSURE STATEMENT
-State Inv requires construction to be done by licensed
Fontrectorn. You have applied for a permit under an
exemption to that law. The exemption allows you, as
the owner of your property# to act an 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 rouid*ncw cir a
farm outbuilding. You may also build or imprcovo &
commercial building at a coot of 025,000. 00 or lease
The building must be for your use and occupancy. it
may not be built for Palo or lemma. If you mail or
ieshe more then on& building you have built yourself
within one your after the construction in complete# the
law will presume that you built it for sale or lease,
which in a violation of this exemption. Your
construction must be done according to building codes
and zoning regulations. it in your roxponxibility to
make sure that people employed by you have licenses
required by state low and by county or municipal
licensing ordinances.
I hereby acknowledge that I have road the above DISCLOSURE
STATEMENT and that I comply with all the requirements for the
issuance of an Owner-buildor permit.
Further, afliant wayeth not.
Prop Owner
Sworn. to and subscribod
botare me, this -2------- day
0 1
NOTARY PUBLH
my Commission Expirest
PATRICIA AMO-NETTEF
STATE OF F'b_*,�;DA
FUSL My Cown E,1+6/97/96
'COMM NER CC220017
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CITY OF ATLANTIC BEACH PnKIT CALCULATI011 SHEET
Ef I z,0
Adciress— 3
Date //- Y - c7-
Heated Square Footage $ per sq ft = $
Garage/Shed @ $ per sq ft = $
Carport/Porch ver sq ft = $
Deck $ per sq ft = $
Patio @ $ per sq ft = $
TOTAL VALUA'rION: $
/-57oo $
TotaA. Valuation 1st 0
�2 6 C (�,, yfgtoo—�C:,
Remaining Value per thousand
or portion thereof
TOTAL BUILDING FEE $
<�j IT- + 1/2 Filing Fee
( ) Fireplaces @ $15 .00 $
FF-r:-- /9 4-)0u ,8L-e-- BUILDING PERMIT FEE $
,D L)C:; -
L)( L 0 eAJ Ic WATER IMPACT FEE
SEWER IMPACT FEE $
WATER METER/TAP
Cb fj_S T-p- 0 c 7(F- $—
CAPITAL IMPROVEMENT $
SEWER TAP $
RADON (HRS) .0045 $
RADON (CAB) .0005 $
SECTION H PAVI1TG $
HYDRAULIC SHARES $
CROSS CONNECTION $
) SURCHARGE .0050 $
OTHER $
$z
GRAND TOTAL DUE 4:z�(9 0
ADDITIONAL PERMITS OR FEES : Mechanical_; Pluinbing
Electric/New Electric/Temp_;SwimmingPool
Septic Tank Well Sign Finish Floor Elevation
Survey Other
CALCULATIONS and/or 1-110TES :
Val FIT,
0 '2 1993
CITY OF ATLANTIC BEACH Building and Zoning
PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS
DEMOLITIONS
A
owner(s ) : L 0 R 1Z-1 f A (S-5
Address :!- Phone : JL4 Ll Lf 6
Lot # Block or Unit # Subdivision:
Contractor :
Address : Phone No :
Describe work to be done : px' 1�- r)g c) r) )_t2_- j o j-':1 K T n
Opt a C�c
Present use of building: r'_
Valuation of Proposed Construction: 0 o
Proposed use: L In" r,t-�- e�
is this an addition? If yes , what are the dimensions of
the added space : ft . X -ft . Will the added area
be heated and cooled? (1, (_, New electrical (or increase)? 00
New plumbing fixtures?__L.��_ New fireplace?_�L�New Heat/AC?__1L1LJ_
SUBMIT THREE COMPLETE SETS OF PLANS , INCLUDING SITE PLAN , SURVEY ,
ENERGY CODE FORMS , NOTICE OF COMMENCEMENT , AND OWNER/CONTRACTOR
AFFIDAVIT, IF OWNER IS CONTRACTOR.
Signature OWNER: aa6::�, Date: I
Signature CONTRACTOR: Date :
0-j
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