88 W 4th ST (vault) PREPARED 7/03, 12 : 57 : 03 �f PAYMENTS DUE RECEIPT
CITY OF ATLANT ACH PROGRAM BP820L
--------------------- ------------ ---------------- - --------------------
APILICATION NUMBER: 03-0 7148 88 W 4TH ST
FEE DESCRIPTION AMOUNT DUE
FENCE PERMIT 3 . 00 �J
TOTAL DUE 35 . 0
Please present this receipt to the cashier th full ment .
SS
1
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Cc:
CITY OF ATLANTIC BEACH D. Ford
BUILDING / ZONING DEPARTMENT L. HI Ins
r
Ll 800 Seminole Road oerr
sl
` Atlantic Beach,Florida 32233
y v (904)247-5800
(904)247-5845 Fax
2 7 2003
PLAN REVIEW COMMENTS
c�,
Permit Application # a5 - 21-7 147 J 0-A-0—
Property Address: L 4-Th 7�+
Applicant:
P ro j ect: F.
This pe it application has been:
Approved
Reviewed and the following items need attention:
,.(/)-YI
Please re-subyour applicati hen these items have been completed.
Reviewed y: Date: /� a"
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J CITY OF ATLANTIC BEACH ; E00? L Z 100
Y" FENCE PERMIT APPLICATION
Date: �2-3,103
Job Address:
Owner's Name: 1&w F_� p
Address:_ 'S0. t Phone: 1�6q) ZLI
Legal Description: Block Number: Lot Number: 'i� IQ—Zoning District:
Fence Contractor:
Address: P e.
City: State: Zip: 00
4
Type of fence and materials to be used:
L aa s , k��� �o �eVndd0
Valuation of fence: '
Is approval of Homeowner's Association or other private entity required? If yes,please submit with kapplication.
❑ Interior Lot Corner Lot Dumpster or storage tank enc sure
Tree Protection:
NO. Applicant certifies that no trees will be removed for the installatio this tfeYES. Removal of Protected Trees will be required for this fence. TREE REMOPERMIT IS REQUIRED.
Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. eences
AND THE FOLLOWING REQUIRED INFORMATION:
PLEASE PROVIDE TWO(2)COPIES OF APPLICATION A property lines of the proposed fence.
1. Attach copy of property survey showing location,height and all distances from prop y P P
shall not be placed within any utility or drainage easements without written permission from the Utility and/or Public Works
Departments. Fences shall not restrict any private easement.)
2. Provide completed Owner's Authorization Form if applicant is other than property owner.
I hereby certify that all information provided with this application is correct.
Signature of Owner: Date:
Date:
Signature of Contractor:
Address and contact information of person to receive all correspondence regarding this application (please print):
Name:
Mailing Address: �� ��QS+ -L ►i` ht L �? ��
Phone: CgU� �y� Fax: wh1 _ E-Mail: 3LV)V-tqs(A � 1-�O4i'y�-�)-_C!Lt."
800 Seminole Road • Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atiantic-beach-fl-us Revised 1/14/03
Page 1
MAP SHOM N'O BOUNDARY SURVNY OF
LOTfi_�� Co BLOCK 70 AS SHOWN (IN MAP OF
A-r(-,A �J 7-1 �
AS RECORDED-IN PLAT BOOKPAGES OF TIIE PUBLIC RECORDS 0-- DUVAL COUNTY, FLORIDA
CERTIFIED FOR: .�en/ �F�-2 �-• /L S Saves y�
41ME2I nl P/ O"I�Ci -7-1 7- f �iiZSi C..O Sr Ili L
S�2vic �S � /A/c
2, c� /-( ( lam
�l�N`r� �� �Pr►,mac
890 e lk�
c
o � �
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L07-
r L 0 7- & m
_ U
City of `lantic Beach
anning ant ning Department
• b
This ap val v compliance with applica
oning, ubdi on and other local la
z
detta4op t ations, but does not constit EPJ1N �o
approJ'a f is�nce of permits. Complian e o
with Flo If
Bull in gode and all other applica le -Zr;i 0•� d
local, S t ed e i
Beach ilding O 1 prior to the Issuance of a
Building Permit.
om um evelopm it (� 1
Date:
THE PROPERTY SHOW HEREON APPEARS TO UE RfTHIN FLOOD HAZARD ZONE X AS SCALED FROM FLOOO
INSURANCE RATE,MAPoo0/ FOR jHE CITY OF,4r(^•13C14,U-ORIDA, DATED 4 7 bO AND
IS SHOWN AS A COURTESY ONLY AND DOES NOT CONSTITUTE A CERTIFCATION OF SAAfE.
TRI—,STATE LAND SURVEYORS, INC.
8411 BAYMEADOWS WAY SUITE #2, JACKSONVILLE, FLORIDA •322:;6 (904) 731-7235
� O BEARINGS BASED ON — UNE AS SHOWN.
• C6Y^. 'ION
THIS SURVEY DOES NOT REFLECT OR DE7rRAUNE 01WERSHIP.
(Xr wrN CAP/LS 044) NOT VAUD WITHOUT INE SIGNATURE ANO THC ORIGINAL RAISED SEAL
err OF A FLORIDA LICENSED SURVEYOR AND MAPPER,
o rW CM(rw+o)
a arass cur LARRY G. F73DY, P.L.S- No. -4141•
RRL e"mo RestAlcnw UNE
cs�T cAswwrGLENN P. BROADSIREET, P.S.M. No 58
/
ZD'
' .
A�lr AXW—CF—KAY / L D' ; /')
cev cnHV?EO ARP SCALE.
f Qriaa W �(�•� s �t
Alt AN Ca'a'POWNa PAO RE6'iFDS1 RSc1RVFYOR AND !AAV'PER,
�A
00 L MrAWE DATE- _Q g - �S STA OF FLORIDA (L13 14921)
0 mvOMW
B. PG ORDER NO. -
DEPARTMENT OF PUBLIC WORKS
}i�.:1►�� 1u� 1200 SANDPIPER LANE
ATLANTIC BEACH,FLORIDA 32233-4318
TELEPHONE:(904)247-5834
FAX:(904)247-5843
1 ) a SUNCOM: 852-5834
J _... http://ci.atiantic-beach.fl.us
�r
PLAN REVIEW COMMENTS FROM THE
PUBLIC WORKS DEPARTMENT
Permit Application # O3—
Applicant: SI
Address: 8 8 U .-- 'f+)
Project: NCe -
Your application is approved as noted by the Public Works Department. Final
application approval must come from the Building Department.
❑ Your permit application has been reviewed by the Public Works Department and the
following items need attention:
as sOV-11700 /_4_ /no real closer
Please submit these requirements to the Public Works Department, 1200 Sandpiper Lane,
Atlantic Beach, FL 32233 in order that we can approve your application. If you have any
questions please call (904) 247-5834.
Reviewed by Robert S. Kosoy, P.E., Director of Public Works
Date
Signature
Contractor Notified Date
r s� CITY OF ATLANTIC BEACH
r�.
FENCE PERMIT APPLICATION
Date: A(1L 03
q 1 `
Job Address:
Owner's Named
Address: `,0. Phone: (Ii 2�
Legal Description: Block Number: Lot Number: Zoning District:
Fence Contractor:
Address:
Phone:
City: State: Zip: Fa
Type of fence and materials to be used: b�
ad 2 1 A1C U� �5t t v c t apt -\-C, IQ-rvt0✓
Valuation of fence: V,,je_L e VVI W
Is approval of Homeowner's Association or other private entity required? If yes,please submit with this application.
❑ Interior Lot ( Corner Lot Dumpster or storage tank enclosure
Tree Protection:
NO. Applicant certifies that no trees will be removed for the installation of this fence.
YES. Removal of Protected Trees will be required
the Tee Cls fence. TREE onservation Boarw REMOVAL h meets t�wolT IS times�eacQh month•
Tree Removal Permits to be reviewed by
PLEASE PROVIDE TWO(2)COPIES OF APPLICATION AND THE FOLLOWING REQUIRED INFORMATION:
1. Attach copy of property survey showing location,height and all distances from property lines of the proposed fence. (Fences
shall not be placed within any utility or drainage easements without written permission from the Utility and/or Public Works
Departments. Fences shall not restrict any private easement.)
2. Provide completed Owner's Authorization Form if applicant is other than property owner.
I hereby certify that all information provided with this application is correct.
Date:
Signature of Owner:
Date:
Signature of Contractor:
Address and contact information of person to receive all correspondence regarding this application (please print):
Name:
T'ti
Mailing Address: C�� ��l'.S+ �� �
Phone: Q50�) _DLAIIi Fax: E-Mail:
800 Seminole Road Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atiantic-beach.fl.us Revised 1/14/03
Page 1
MAP SHOWING BOUNDARY SURVNY OF
LOTfiBLOCK 7 8 AS SHOWN (IN MAP OF
A rL A ,J'7-1 c- �-� c /-r 'S c 7-1 0 J
AS RECORDED•IN PLA r BOOK--Z-6-_PAGES OF THE PUBLIC RECORDS 0-- DUVAL COUNTY, FLORIDA
CER TIFIED FOR.4mYvc--
SFE- L IlL S X70 U-7 y� vs M 6X-T
_ _ 1 o p S �- Ti T L
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37.3
INE PROPERTY SHORN HEREON APPEARS TO LIE µ1 THIN FLOOD HAZARD .ZONE 4S SCALED FROM FL000
INSURANCE RATE:MAP 00/FOR ,THE CITY OF A-rL.8c j4,FLORIDA, DATED--!5L-1 7• AND
IS SHOWN AS A COURTESY ONLY AND DOES NOT CONS771UTF A CERTIFCATION OF SAVE.
TRI-STATE LAND ,SURVEYORS, .INC.
8411 BAYMEADOW5 WAY SUITE #2, JACKSON MLLE, FLORIDA 322:6 (904) 731-7235
� D BEARINGS BASED ON — UNE AS SHOWN.
■ ar+c uan
7N/S SURVEY DOES NOT REFLECT OR 0E7£RA41NE UIYTIERSHIP.
(srr YM p1P f L5 1144) NOT VAUD WITHOUT ME SIGNATURE A.1\10 THC ORIGINAL RAISED SEAL
nvct OF A FLORIDA LICENSED SURVEYOR AND MAPPER.
— :l
0 wom oat(fnLM) �_—
a a�cur LARRY G. FrDY, P.L.S- No. 4141• N44
arcs aaam°nf3MitnW MhC GLENN M. BROAOSTMEET, P.S.M. W./,58
a/lr mHr-cr war ARP SCALE: / Z�COV. COYEAED EA — -A
f mrroaNf
yc uv oOfnPaV a PAoREG'iSTERED SURVEYOR AND !.MA PER,
+vz
IR) wAt mrA ' DAA. _q STA 7c OF FLORIDA (LB P921)
Q muu�E
- 0140ER N0. -
B. PC,
DEPARTMENT OF PUBLIC WORKS
f i„ �fJc� -7 1200 SANDPIPER LANE
OCT 2 I ATLANTIC BEACH,FLORIDA 32233-4318
i TELEPHONE:(904)247-5834
FAX: (904)247-5843
SUNCOM: 852-5834
http://ci.atiantic-beach.fl.us
iJ
PLAN REVIEW COMMENTS FROM THE
PUBLIC UTILITIES DEPARTMENT
B�
r
Permit Application # Off- Z`7 l io�
Applicant: ��-ter- ��tJtFEf2-
Address: `
Project:
Your application is approved as noted by the Public Utilities Department. Final
application approval must come from the Building Department.
❑ Your permit application has been reviewed by the Public Utilities Department and the
following items need attention:
Please submit these requirements to the Public Utilities Department, 1200 Sandpiper Lane,
Atlantic Beach, FL 32233 in order that we can approve your application. If you have any
questions please call (904) 247-5834.
Reviewed by Donna Kaluz ak,Public Utilities Director
Date
Signature
Contractor Notified Date
S _40
t
CITY OF ATLANTIC BEACH i
FENCE PERMIT APPLICATION
Date:
Job Address:
y � 'Q�IG+•� L u� �—L 3 z z 3 3
Owner's Name:
one:
Address:
Ph
Lot Number: Zoning District:
Legal Description: Block Number:
Fence Contractor:
Phone:
Address:
State: Zip: F
City:
to
Type of fence and materials to be used: l 1,'1rYl� eS oy, �i
'C`1n�►2 1r1�� � C " � O A,J,,....� �2aM0d�-
Valuation of fence:
Is approval of Homeowner's As or other private entity required? If yes,please submit with this application.
[]Dumpster or storage tank enclosure
❑ Interior Lot Corner Lot
Tree Protection:
NO. Applicant certifies that no trees,will be removed for the installation of this fence. D.
YES. Removal of Protected Treeswill be reviewed by required
the Tree Cts fence. TREE onservation Boarw REMOVAL hmeets t�wolT IS times�ea�ch month.
Tree Removal Permits to b
PLEASE PROVIDE TWO(2)COPIES OF APPLICATION
ight and all THE
stFOL fromFOLLOWING
pr. p REQUIRED
1 nes D tproposed INFORMATION: (Fences
1. Attach copy of property survey showing
shall not be placed within any utility or drainage easements
easement)without written permssion from the Utility and/or Public Works
Departments. Fences shall not restrict any private
2. Provide completed Owner's Authorization Form if applicant is other than property owner.
I hereby certify that all information provided with this application is correct.
Date:
Signature of Owner:—Si
Date:
Signature of Contractor:
Address and contact information of person to receive all correspondence regarding this application (please print):
Name: 1"n't �"(,
Mailing Address:
� ��� E-Mail: �e►�ti e Cod OD k 1-4,' -tea''+,
Phone: Fax:C°tU�l) .��, ��-�-
800 Seminole Road Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.us Revised 1/14/03
Page 1
MAP HOjYLN'G .]3O UNDARY SURVEY OFOF$ �7� AS SHOWN C N MAPCo BLOCK J
LOTS (-/
—--_---
A-rLA-.l-7`1 c
OF THE PUBUG RECORDS 0' DUVAL COUNTY, FLORIDA
AS RECORDED-IN PLAY BOOK PAGES M �—
/ S
CERTIFIED FOR: J�
E
=0
P
0
z_° �z•° o �
oCU
� r
r'\
0 l• �'
�-- L 0 T
f Lal
Y
7(0.3
� O t
�• �\1 a �•p � Z� 0-L �_
37.3
¢ ¢
1S SCALED FROM SOOD
AND
THE PROPERTY SHOWN HEREON APPEARS TO UE µ17111N FLOOD FLORIDA,ADATED RD ZONE 4 . 1-7-00
' �7 �d
INSURANCE RATE;MAP boo/ FOR THE CITY OF A-rL- fjC-N,
IS SHOWN AS A COURTESY ONLY AND DOES NOr CONSn1U SURVEYORS,rE.INC.
TRI-STATE l kVD
FLORIDA 322,;6 (904) 731-7235
8411 BAYMEADOWS WAY SUITE �2, JACKSONVILLE,
I. awf) BEARINGS BASED ON
— UNE AS SHOWN. '
■ ava UON7}i15 SURVEI' DOES NOT REFLECT OR DE7ERAIINE OIYNERSHIP-
. r C"cap.
(�T yM CAP/LS SIN) NOT VALID {NINOUT THE SIGNATURE ANO THE ORIGINAL RAISED SE
ravcf OF A FLORIDA LICENSED SURVE'roR AND MAPPER. '
cot LARRY G. F-1%OY P.LS- No. 4144
anis"'rGLrNN Al. BROADSTREET, P.S.M. yo3/58
RRL svKneo rtEsMcnCH UNE /
LWT E soduir : Z o 1
a^r MeHr-or WA SCALE:
LOY. (AYEDED AAEAJ�l
f Q]fD3allE TEGiSTERED riURVFYOR AND bIA�PER,
A,t �a,n pohnTxM PAO _TSTA lc OF FI ORIDA (LB X921)
(AJ RADAL WSrAr� DATE _1 _
muoww _ --- URDER N0.
B. pal
YHVL+
INSPECTION TICKET DATE 7/31/03
PREPARED 7/31/03, 14:58:07INSPECTOR: LARRY J HIGGIN ----------------
CITY OF ATLANTIC BEACH ---------------------------------
- - _ _
SUBDIV:
.ADDRESS : 88 W 4TH ST
TENANT, NBR: SEWER IMPACT FEES PHONE
CONTRACTOR : PHONE (904) 241-3108
OWNER : KEYS, JENNIFER
PARCEL 170827-0000- - -----------------------------
-
APPL NUMBER: 03-00026584 PLUMBING ONLY
--- -----------
-----------
--------------------
PERMIT: PLBG 00 PLUMBINGPERMIT
DESCRIPTION
REQUESTED ---------
RESULTS/COMMENTS -----�
TYP/SQ COMPLETED RESULT -----_-___
------------
------------------------------ -- INAL TIME: 13:00
7/31/03 LJH
45 01 � RO ROOTER - GORDON - 591-7573
- - -
COMMENTS AND NOTES ---
PAGE 1"
PREPARED 8/04/03, 7 :35:29
INSPECTION TICKET DATE 8/04/03
--- INSPECTOR: LARRY J HIGGINS -------- --------
CITY OF ATLANTIC BEACH
--------------------------
- -
--------------------------------
SUBDIV:
ADDRESS : 88 W 4TH ST
TENANT, NBR: SEWER, 8 FIXTURES PHONE (904) 695-1911
CONTRACTOR CERTIFIED ENVIRONMENTAL SVC. PHONE
OWNER KEYS, JENNIFER
PARCEL 170827-0000-
APPL NUMBER:NUMBER: 03-00026587 PLUMBING ONL-------------------
pF.RMIT: PLBG 00 PLUMBING DES IPTION
REQUESTED
RE LTS/COMMENTS --------
TYp/SQ COMPLETED RESULT --------
------------------
____ -----------------
8 04 03 LJH L FINAL TIME: 08:00
45 01 � METRO ROOTER - GORDON - 591-7573
695-1911
COMMENTS AND NOTES --------------
CITY OF ATLANTIC BEACH
y 800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233
INSPECTION PHONE LINE 247-5826
03-00026584
Date 7/29/03
Application Number 88 W 4TH ST
Property Address - SEWER IMPACT FEES
Tenant nbr, name • . • . • . PLUMBING ONLY
Application description TO BE UPDATED
Property Zoning - 0
Application valuation -
Contractor
Owner ------------------------
wner --------- --
-----------------------
OWNER
KEYS, JENNIFER
88 WEST 4TH STREET FL 32233
ATLANTIC BEACH
(904) 241-3108 --
-----Permit------
PLUMBING PERMIT
Additional desc Plan Check Fee .00
. 00 0
Permit Fee 7/29/03 valuation
----_ - --------------------
Issue Date
_ ------------ ------ 1250 . 00
Other Fees SEWER IMPACT FEES
-- Paid Credited
Fee summaryCharged -__--ue---
_ ------- --.00
Permit Fee Total 00 00 . 00
Plan Check Total •00 00 . 00
1250 . 00 1250 . 00 . 00
Other Fee Total 1250 . 00 1250 . 00 .00
Grand Total
AND DEBRIS FROM THIS WORK UST NOT BE PLACED IN
t
BUILDING MATERIAL, BBEITHER CONTRACTOR OR OWNER FPUBLIC
ISH AILURE TO COMPLYY WITTHE CONSTRUCTION LIEN LAWACAN
Y
UP AND HAULED OWNER
RESULT IN THE TPROPERTY OF THIS PERMIT AND PAYING
UUBJECT TO REVOCATION FOR VIOLATION OFIAPPLICABLE PROVISIONS OF AW. PLAN
WHICH ARE PAR
BUILDING OFFICIAL
a Lx�7�-t&Y�
CITY OF ATLANITC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
TELEPHONE:(904)247-5800
FAX:(904)247-5805
SUNCOM:852-5800
http://ci.atiantic-beach.fl.us
Date:
LjAddress:
The cost to connect to the City sewer and/or water system are as follows:
Sewer Tap—Labor and Materials to tap into sewer main $ ��,�• l
(Estimate from Public Utilities) �✓1"
Water Tap —Labor and Materials to tap into water main
(From Ord. 22-28)
Water Meter—Cost of Meter(85.00) $
Cross Connection Inspection—Inspection by Public Works
to insure backflow prevention
(35.003/4"—Ord. 22-28(a)) $
Sewer Impact Fees—Funds future expansion of the sewer
plant
(1250.00 each living unit—Ord. 22-17-0) $ ' G
Water Impact Fee—Funds future expansion of the water
plant
(From Building Dept. —Ord. 22-29 FLA. Plumbing Code) $
Capital Improvement—Funds for improvements, expansion
or replacement to water system
(325.00—Ord. 22-28) $
TOTAL COSTS $ 112—c?, O-
DCF/js
PROPERTY OWNER NAME: I:k:f L
SERVICE LOCATION
ADDRESS:
PROPERTY OWNER PHONE NUMBER: l t`� 1� <� c)�
TENANT NAME:
L[:SE:RV:ICE:NOW: ON CITY WATER ON WELL El
CONVERT FROM ON-SITE SEPTIC SYSTEM TO CITY SEWER:
OPTION A: Customer hires own contractor and pays costs.
OPTION B: Customer pays costs and hires contractor with City's assistance.
OPTION C: Customer hires own contractor and finances costs through the
City of Atlantic Beach.
OPTION D: Turnkey Support. City assists with entire conversion.
CUSTOMER SELECT OPTION PREFERRED:
❑ Option A ❑ Option B ' Option C ❑ Option D
OWNER'S SIGNATURE: --- 0
Please return to:
TO BE COMPLETED BY CITY: DATE RECEIVED:
REAL ESTATE NUMBER:
LEGAL DESCRIPTION:
PRICE QUOTE:
7/24/00
CITY OF ATLANTIC BEACH
S 800 SEMINOLE ROAD
-r ATLANTIC BEACH, FLORIDA 32233
V INSPECTION PHONE LINE 247-5826
Application Number . . . . . 03-00026587 Date 7/30/03
Property Address . . . . . . 88 W 4TH ST
Tenant nbr, name . . . . . . SEWER, 8 FIXTURES
Application description . . . PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
-
------------------------
-----------------------
KEYS, JENNIFER CERTIFIED ENVIRONMENTAL SVC.
88 WEST 4TH STREET 8892 NORMANDY BLVD.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32221
(904) 695-1911
-------------------------------------------------------------------
Permit PLUMBING PERMIT
Additional desc . .
Permit Fee . . 98 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 98 . 00 98 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 98 . 00 98 . 00 . 00 . 00
1
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
-111 05 '96 0-9: 11 All ATL BCH CITY HALL F. 1
CITY OF ATLANTIC BEACH
QAPQPLICAT1ION, FOR PLLU^MBING PERMIT
JOB LOCATION: Q C�
OWNER OF PROPERTY:
PLUMBING CONTRACTOR: � ����2ND SGj�/1 CjP/� Y
CONTRACTORS ADDRESS: 9 lord.
STATE LICENSE NUMBER: C aS a-7 a �-- TELEPHONE: SCC S'
HOW M"Y OF THE FOLLOWING FIXTURES INSTALLED
SINKS SHOWERS
LAVATORIES .WATER HEATERS
_BATH TUBS DISHWASHERS
URINALS DISPOSALS
CLOSETS WASHING MACHINES
FLOOR DRAINS SHOWER PANS
OTHER Yt W eC
TOTAL FIXTURES: X 3.50 + $15.00
MINIMUM PERMIT FEE a $25.00
SIGNATURE OF OWNER:
SIGNATURE OF COOR:
INSTALLATION OF UMBING AND FIXTURES MUST BE IN ACCORDANCE WITH THE 1994
STAJN'DARD PLUMBING CODE.
CALL A DAY AHEAD TO SCHEDULE INSPECTIONS - (904) 247-5826
SEWER CONNECTIONS MUST BE CALLED IN TO PUBLIC WORKS FOR INSPECTION PRIOR
TO COVERING UP - (904) 247-5834.
CITY OF v���
'4&� �`"" 800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233-5445
TELEPHONE (904) 247-5800
FAX (904) 247-5805
SUNCOM 852-5800
DATE � r-26
JEA Construction & Maintenance
2325 Emerson Street
Jacksonville, FL 32207
Attention: Connie
Re: Final Electrical Inspections
Dear Connie:
Final
have been completed and approved:
Inspections on the following loca
PERMIT NO.
ADDRESS
(New Sir v�ce
2 1 -3 S�w►� � D l e
�gq Vel. �f f� �SerWe Tnc�etise
2 /I/� C TQ.� . Po%
� �,. a ero►� )
-�6 6/8' P�,d, - a! ar se
q 75-
Please
SPlease call me at 904-247-5826 if you have any questions.
Sincerely,
ATLANTIC BEACH BUILDING DEPARTMENT
h0a
CITY OF �-
ae=A-4
Office of Building Official
REQUEST FOR INSPECTION
Permit No.
Date
Time A.M.
Received P.M.
— ` CL ality '
Job Address I
Owner's Contractor 0
Name
iONCETE LECTRICAL PLUMBINGMECHANICAL
BUILDINGEl Air Cond. & ❑
Framin El 1:1
Rough
g 1:1 Temp Pole ❑ Top Out E] Heating
Re Roofing El Slab ❑ Final ❑ Sewer ❑ Fire Place ❑
Insulation 1:1 Lintel Pre Fab
READY FOR INSPECTION
Mon. Tues. ed.
FridayP.M.
A
j Inspection Made Final Inspection
Inspectorlop � nCY C'
Date
i
PSP 38,14 16778
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
PERMIT INFORMATION LOCATION INFORMATION -------
-rmit Number : 16778 88 FOURTH STREET WEST
Permit -Type :REMICDELING ATLANTIC BEACH . FLORIDA 32231
Lass of Work:REMODEL LEGAL DESCRIPTION --------
onstr . Type:WOOD FRAME B1ock : 78 Lot ! 5 & 6 Twp:
Proposed Use: SINGLE FAMILY Section : 0 Subd- Rna * 0
Dwellinas : n Subdivision: SECTION H
Est . Value* 0 .00
,mprov , Cost - 8 , 000 , 00
Total Fees : 75 .00
Amount Paid: 75 . 00
Date Paid: 7!14/199P
.rk Desc :.PAINTING . CARPET . NEW KITCHEN CABINETS AND REPLACE ROTTEN P002
C-WNER !NFORMATION APPLICATION FEES
ime*, MARK VIGO ?ERMIT
idr , 8e FOURTH STREET WEST
ATLANTTr-' BEACH , FLORIDA 322 " '
I"hr
--- CONTRACTICIR INFORMATION --- -
flame: PROPERTY OWNER
Addr :
Lic- E x T-)
NOTES:
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 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 REVOCATION FOR
VIOLATION OF APPLICABLE PROVISIONS OF LAW. $75.00 14
DAtp- 7/1(,/SA Aj Receipts gi71440
CHECKS 40'67
ATLANTIC BEACH BUILDING DARTMENT 00100003221000
By:
�g v
CITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS, OR ALTERATIONS
MOVING, DEMOLITIONS
Owner(s)
�� �- Phone:
Address:
Lot # 5410 Block or unit p Subdivision:
Contractor:
State License
Phone No:
Address:
City State
zin code
� JJ
Describe work to be done: Oc ��`� ►�` ��
)��?
Present use of building:
Valuation of Proposed Construction: 4000
e
Proposed use:
Is this an addition? 1V If yes, what are the dimensions of the added
space:___rt. X
ft. Will the added area be heated and
cooled? New elec�:rical (or increase) ?
New fireplace? New Heat/AC?
New plumbing fixtures?
(RESIDENTIAL) COMPLETE SETS OF PLANS, INCLUDIWG
SUBMIT TFTREE (COI�iERCIAL) TWO
SITE PLAN,
SURVEY, NOTICE OF COMMENC�NT, AND
OWNER/CONTRACTOR AFF7DA T, IF OWNER IS CONTRACTOR-
!S7-,,q-/-Lc
ONTRACTOR.
S-rA,-Lc OF FLO�c�l
Of- � q
COc/ntry oJV4
Date:
Signature OWNER:
Date:
Signature CONTRACTOR:
/lam
� , 9
Sworn to and subscribed before me this of '
NOTA Y PUBLIC STATE OF ORIDA AT LARGE
No"Pubk-We of MCAW
CWM*dw&0wMar 31,2=
Cam CCn=1
CITY OF
I )I)SE\[INOLE ROAD
y ^-- ----- - --- :\TLA T[('. VL'':\Cf{. FLORIDA
TELEI'[-o E ,')O-)I 247,
FAX 904 -5605
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:
STATELAW REQUIRES CONSTRUCTION TO BE CONE BY LICENSED CONTRACTORS. YCU HAVE APPLIED FOR A PERMIT
UNDER AN EXEMPTION TO THAT LAW. THE =XEMPTICN ALLOWS -CU. AS THE CWNER CF ".JUR P CPER-". TC ACT AS ELF.
OWN CONTRACTOR EVEN .`HOUGH YOU CO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF.
YOU MAY BUILD OR IMPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUIL:ING. YOU MAY ALSO BUIL) OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF $25.COO.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND
CCCUPANCY. 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 5AL-Z OR
LEASE, WHICH IS IN VIOLATION CF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR.
YOUR CONSTRUCTION MUST BE CONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR
RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY
COUNTY OR MUNICIPAL LICENSING ORDINANCES.
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,CO(3) BE UNDER A BUILDING PERMIT AND PASS
ALL NORMAL INSPECTICNS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY CO 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 COES NOT ALLOW USE OF-
UNLICENSED
FUNLICENSED 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 1 099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO $5.CCO PENALTY UNDER FLORIDA STATUTE No. 455-228( I ). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE.
THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA,"CONTRACTORS
CFF:MFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247-
5826) IF IN DOUBT.
I HEREBY ACKNOWLEDGE THAT HAVE READ THE ABOVE DI a
E STATENEPIr ANO THAT I COMPLY WITH ALL
THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILD£
S?A; DF r(_0 Ice Dl4
Cov,,_[-ry of by��
PRO OWNER/ UILDE
CIC-
F),,— # V;Do-S-%f-b 3-4,cq ADDRESS TELEPHONE
�j
P,-0 C-;�-J TPD 19 /
SWORN TO AND SUBSCRIBED BEFORE ME THIS"PUESLIC
—
NOTE: PHRASES UNDERLINED ABOVE -- UREENKING
ARE EMPHASIZED BY THE BUILDINGNotary Public-State of Florida
DEPARTMENT. My Commlssfon Eypires MQ 31,2=
Commission Y CC720761
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 Seminole Road-Atlantic Beach, FL 32233RTeel: 247-5826-Fax: 247-5877
ELECTRICAL PE
PERMIT INFORMATION LOCgT10N INFORMATION
Permit Number: 21422 Address: 88 FOURTH STREET WEST
ELECTRICAL ATLANTIC BEACH, FL 32 Book.
Permit Type: Township: Range:
Class of Work: INCREASE Lot(s): Block: Section:
Proposed Use: SINGLE FAMILY Subdivision: SECTION H
Square Feet: Parcel Number: --
Est. Value: OWNER INFORMATION
Improv. Cost: Name: KEYS, JENNIFER
Date Issued: 2/07/2001 Address: 88 W. 4THSTREET
Total Fees: 30.00 ATLANTIC BECH, FL 32233
Amount Paid: 30.00 phone: 000)000-0000
Date Paid: 2/07/2001
Work Des!- ESS100AMPS 00A2 MPS 1 PH 4W 240V SER
ALU P CRSE AND
SN FEES 30.00
CONTRACTOR S
PERMIT
BROOKS & LIMBAUGH
Ins ctions Re uired
FINAL ELECTRIC
NOTICE- INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION D
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS R CONTRACTOR O BE PLACED IN PUBLIC SPACE,AN
MUST BE CLEARED UP AND HAULED AWAY BY EI
ER
"FAILURE TO COMPLY WITH THE CONSTRUCTION IEN LA CAN N RESULT IN THE
PROPERTY OWNER PAYING TWICE FOR BUILDING
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
$38.6914
Date: 2/87/81 81 Receipt: M32257
WECK5
ATLANTIC BEACH BUILDING DEPT.
CACI-I FLORIDA � � `�Z �
CITY OF ATLANTIC BEACH,
Approved by APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE:Ji9 L
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
CECTRICAL FIRM: u MASTE 4ELECTR' JOURNEYMAN
CTy/ SIGNATURE
NAME - ADDRESS:�%"+� RFD BOX
BLDG.SIZE BETWEEN:
RES. APT. 1 1 COMM. ( 1 PUBLIC ( 1 INDUS. ( 1 NEW ( 1 OLD ( 1 REW. ( 1
ADDITION ( 1 TRAILER ( 1 TEMP. ( 1 SIGNS ( 1 SO. FT.
SERVICE: NEW 1 1 INCREASE ( R PAIR ( 1 FEE
CONDUCTOR SIZE ! AM S COPPER ( I ALUM
SWITCH OR BREAKER AMPS PFI 1 W VOLT ACEWAY
EXIST.SERV.SIZE o AMPS PFi W VOLT RACEWAY
FEEDERS NO. SIZE IND. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.70 AMPS. Vl�
I-100 AMPS.
SWITCHES
INCANDESCENT
FLUORESCENT & M. V.
FIXED o.too AMPs. ovEn
APPLIANCES _� BELL TRANSF.
AIR H.P. RATING H.P. RATING
CONDITIONING COMP. MOTOR OTHER MOTORS AMPS CEIL IIEAT: KW-HEAT
E�_
O.i OVER
MOTORS H.P. VOLTAGE PNS NO. i H.P. VOLTAGE PHS
MISCELLANEOUS
TRANSFORMERS: UNDER 600 V. OVER 600 V.
IND. KVA NO. IKVA
NO. NEON TRANSF. NO. VA. A. MOTOR SIZE SWITCH FLASHER
EACH SIGN
FORWARDED
TOTAL FEES _
FOR OFFICF� USE ONLY
L
Date------ F---1 L- ---•------19 �..3
Permit #7470--Fee$----12-----------
CITY OF ATLANTIC BEACH.,
Valuation $ ----------------------------------
FLORIDA House #_
..................................---
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can
be verified. �
Date----------- •-----� / ---------------- 19---6 �
` -----------------------Address------------------------------•- -----Telephone No.------------------•--------
Owner-------�----`�----------------•------------------------ -------
Architect `— --•-------- ...Address----------------------------------------------------------Telephone No----------------------------
Contractor Builder. l0! - ---------•---p---•-�--------Address Telephone No. -
------- -----------------�
Lot No---------------} ("T' Block No. ..-6_------------Sub Division------ •• -------------.Zone-----------------
. �"+7. --------------- ----
------------- --------Side Between------ +--------------------and--- -------------------- -------Sts.
Valuation $_.3__�.�---_--.For what purpose will building be used--- ___._. Type of construction_____ ______________ _______________
K
Dimensions of Building---___._-_.-_---.--________-._-_----Dimensions
�of Lot-...___-.----t --DC7_�_.___ .�----.--Size of Footings............ .... ----------
Size of Piers--�-_xz..�_.---___Size of Sills-..-` _�-.!1_-----_.--..Greatest Sill Span in ft------/_0-------------Type Roof.-.. ..----_- __----------------
Will Buildin be on Solid or Filled Ground?.___S._______.. ___�!----�-----
How will Building be Heated?----�J� -------------------------------------- 16.1-e/ g
Size of Ceiling Joists.----- x-(B--_.----------, Distance on Centers__._..-._(_6.1—Q�_____________ Greatest Span....___.___.___.- "
Size of Floor Joists-.---a_x---!r-------------------- Distance on Centers......... ------------- Greatest Span-------------------------------------------- "
Size of Rafters-------------cam---X--�a---------.-----.--- Distance on Centers_..�fO.107--2.Y , Greatest Span-------------------------------.._--------- "
This rectangle is to represent the lot.
Locate the building or buildings in the
right position. Give distance in feet from
all lot-lines and existing buildings.
REAR LOT LINE
Two copies of plans and specifications shall . �
be submitted with application.
Inspections required.
1. When steel is in place and ready to pour footing. W W
2. When steel is in place and ready to pour columns and/or lintel. Z ( l y, a
dk
Z
3. When steel is in place and ready to pour beam.
Fo Fo'
4. When framing is completed.
5. When rough plumbing is completed,and ready to cover up. W
6. When septic tank drain field or sewer is laid but before it is covered. A N A
7. Electrical inspection by City of Jacksonville. U
8. Final inspection.
Note: In case of any rejection,re-inspection MUST be called for after
corrections are made.
FRONT OF LOT
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 building
regulations of the City of At is Be .
Signatureof Builder r W" ----•--•-- Address-------•--•------------------------------------------------ --------------------------------
Signature of Owner--------------------_----_ --- ------------------------- Address