Loading...
2021 Selva Madera 2014 bath remodel CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000711 Date 5/09/14 Property Address . . . . . . 2021 SELVA MADERA CT Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 2500 ---------------------------------------------------------------------------- Application desc bath remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BURBRIDGE, H CLINTON OWNER 2021 SELVA MADERA CT. ATLANTIC BEACH FL 32233 --- Structure Information 000 000 BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50 Issue Date . . . . Valuation . . . . 2500 Expiration Date . . 11/05/14 ---------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. FINAL INSPECTION REQUIRED CALL WHEN JOB COMPLETED ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 65 . 00 65 . 00 . 00 . 00 Plan Check Total 32 . 50 32 . 50 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 101 . 50 101 . 50 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH FILE C 4 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 -- -- �' Job Address: ed✓c1 41 eh (y e, if-- Permit Number: lL/ 7 Legal Description Yo -31 ©?2 S-,7-q k7 5ejt1< nl ore i l ei:>r- 02 Parcel # —Floor Area of q.Ft. � S.Ft Valuation of Work$_ , 500,- Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition lteratio Repair Move Demolition pool/spa window/door Use of existing/pro osed structure(s) (circle one):, Commercial esidentia If an existing struc ure,is a fire sprinkler system installed? (Circle one): es o N/A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: .f?e m o tjZt-:,_1 _ RO.MVC)p tti. Property Owner Information: Name: , Ch i4o A w✓b v-;C( 9 c- Address: .20 A e//c,- C�- City23eor1n, StateFLZip �2�Phone `�o�/ - 02 2 - X1352 E-Mail or Fax#(Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: ualifying Agent: Address: City State Zip Office Phone Job Site/Cont umber Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and AddressAL rniwflgi� q" Mortgage Lender Name and Address BY: Application is hereby made to obtain a per t to 11 do the work an at no-worn ommenced prior to the issuance of a permit and that all work will e performed to meet the standards o a aws reg ' 'his permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspende or abandoned for a period o sixFu)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, rnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDEIR W AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereb certify that I have re d an xamined thi Ajli,,ti_q,`annow76?Le to be true and correct. All provisions of laws and ordinances governing this typeoivork wall be complied ith whether speci erein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, tate, or to al law regulating construction or the performance of construction. Signature of Owner Signature of Contractor Print Name , (rt f �j vrf t/` Print Name ..... Befor e Befo e this ay of ay of ,20 Notary Public State or Fl00" Mo Shirley L Graham NO Llb t fission FF Expires 02/14/2nOi lotary PU 1C Revised 01.26.10 (J CITY OF ATLANTIC BEACH FIL OWNER 0 BUDDER AFFIDAVIT E COPV, I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW- DISCLOSURE AWDISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR R\4PROVE 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 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. II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; 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. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA 'CONTRACTORS CER T IFICA T E" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. V.ACKNOWLEDGEMENT;I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. ?3 ADDRESS ADDRES/S� ( PHONE NUMBER PRIN NAME IG A RE ��((��// DATE Before me this day of A 20�in the county of Duval,State of Flon a,has personally appea d herin by mself/herself and affirms that all statements and declarations are true d ccurate. Notary Public at Large,State of 1, County ofJ� ersonally Known / Produced Identficatio - (� Notary Public State of Florida Notary Signa Shirley L Graham My Commission FF 086990 er n Expires 02/14!2018 F:BLDG/Owner-BuilderAffadavi> RfiVISBD: 4/16/2009 City of Atlantic Beach APPLICATION NUMBER Js Building Department (To be assigned by the Building Department.) 800 Seminole Road / 1 r� Atlantic Beach, Florida 32233-5445 / !� Phone(904)247-5826 • Fax(904)247-5845 / E-mail: building-dept@coab.us Date routed: e3 / City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM � Departmenteview required Yes No Property Address: �OcJ��/I�Q� l�d�,eQ, r uildin Applicant: Q o—;r) �� Planning &Zoning Tree Administrator Project: aRTN �1 ��L Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept. of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: l Approved. ❑Denied. Circle one. � ( ) Comments: (FUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. F]Deni(Ldd. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09 CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD r� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000711 Date 6/03/14 Property Address . . . . . . 2021 SELVA MADERA CT Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 2500 ----------------------------------------------- Application desc bath remodel --------------------------------------------- Owner Contractor - ------------------------ ----------------------- BURBRIDGE, H CLINTON OWNER 2021 SELVA MADERA CT. ATLANTIC BEACH FL 32233 --- Structure Information 000 000 BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL -----Permit . . ELECTRICAL PERMIT Additional desc . . Sub Contractor . . PAUL A. O'QUINN INC. . 00 Permit Fee . . . . 62 . 20 Plan Check Fee Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/30/14 -------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. FINAL INSPECTION REQUIRED CALL WHEN JOB COMPLETED __ ------------------------------- Other Fees . STATE ELEC DCA SURCHARGE 2 . 00 STATE ELEC DBPR SURCHARGE 2 . 00 Fee summary Charged Paid Credited Due ---------- Permit Fee Total 62 . 20 62 . 20 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 66 . 20 66 . 20 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach,FL 32233 Ph(904) 247-5826 Fax (9004) 247-5845 /J JOE ADDRESS: l ��1 V V" 1��O� M ( PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole ❑Residential(Main)Service 00-100 amps ❑101-150amps ❑151-200amps G amps #of Meters ❑Commercial(Main)Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps Conductor Type Size ❑Multi-Family(Main)Service ❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters []Temporary Pole ❑ amps SERVICE UPGRADE El—amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps ADDITIONS,REMODEL,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-3 Damps 31-l 00amps 101-200amps Appliances: 0-30amps 31-100amps 101-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: _ OTHER ELECTRICAL PROJECTS ❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty El Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can [I Safety Inspection ❑Panel Change OOH to UG ❑Other: Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. �{ Property Owners Name ,`�V� �,� �^2�Y j Q Phone Number —2,L Z — S Electrical Company�"AL � �C Office Phone�b _�1 OZFax?K3 Z �<Z Co.Address: ko V-a el city hState Zip3 2 Z 2 ) License Holder(Print): A State Certification/Registration# 1EC h0Q 1 4 Notariz , 4e Notary Public State of Florida Shirley L Graham Be f e me this of My Commission FF 086990 �'•d Expires 92114/2919 tore of Notary Pu is UZI ::5� /a/ - 6 CITY OF ATLANTIC BEACH \ ss1 -• J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 �.w " INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000711 Date 6/18/14 Property Address . . . . . . 2021 SELVA MADERA CT Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 2500 -------------------------------------------------- Application desc bath remodel ------------------------------------------------- Owner Contractor - ------------------------ ----------------------- BURBRIDGE, H CLINTON OWNER 2021 SELVA MADERA CT. ATLANTIC BEACH FL 32233 --- Structure Information 000 000 BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL --------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . . 00 Permit Fee . . . . 90 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/15/14 --------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. FINAL INSPECTION REQUIRED CALL WHEN JOB COMPLETED --------------------- ------------------------------ Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ________ _ ----- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- -- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 94 . 00 94 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax(904)247-5845 j JOB ADDRESS: 7i0Z1 5 �� M - C-7 PERMIT# �� 71/ NEW OR REPLACEMENT INSTALLATION: Project Value$ 31 W U TYPE of FIXTURE QTY TYPE of FIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower �— Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet �— Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: TYPE of FIXTURE QTY TYPE of FIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well **SJR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** ❑ Other Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name G Lt,,,Ta.i✓ Y. 19L4 Phone Number Plumbing Company. Vat 'S pCur--Zt-� Goy 11ALib+`' 14 C• Office Phoneg0'f'3�2`274J5_ Fax Co. Address: 3aU le V4L�x & 26;�' City '>CA45 "'ILL-67 State a Zip 32205_ License Holder(Print): KjVd n ' State Certification/Registration#`12F116491:56 Notarized Signature of License Holder i �� Diary Public State o/F r Shirley L Grah loridnn Before me this daL ,+",11-mon FF GV 4,60 Exp,'es 02/14/201,066990 Signature of Notary Public