434 Sailfish Dr 2014 bath remodel CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001334 Date 8/19/14
Property Address . . . . . . 434 SAILFISH DR
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2400
----------------------------------------------------------------------------
Application desc
bath remodel
---------------------------------------------
Owner Contractor
------------------------
------------------------
GAVIN, WALTER L. OWNER
434 SAILFISH DRIVE E.
ATLANTIC BEACH FL 32233
--- Structure Information 000 000 BATHROOM REMODEL
occupancy Type . . . . . . RESIDENTIAL
-- -------------------------------------------------------------------------
Permit RESIDENTIAL ALT/OTHER
Additional desc 65 . 00 Plan Check Fee . 00
Permit Fee . . . . Valuation . . . . 2400
Issue Date . . . .
Expiration Date - - 2/15/15 -----------------------
-----------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR 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 . 00 . 00 . 00 . 00
Other Fee Total 8 . 00 8 . 00 . 00 . 00
Grand Total 73 . 00 73 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
A% % .
)U -
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5814
INSPECTION PHONE LINE 247
C !tit
Application Number . . . . . 14-00001334 Date 8/19/14
Property Address . . . . . . 434 SAILFISH DR
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2400
----------------------------------------------------------------------------
Application desc
bath remodel
---------------------------------------------
Owner Contractor
------------------------
------------------------
GAVIN, WALTER L. OWNER
434 SAILFISH DRIVE E.
ATLANTIC BEACH FL 32233
--- Structure Information 000 000 BATHROOM REMODEL
occupancy Type . . . . . . RESIDENTIAL
-- ------------------------------------------------------------------- -----
Permit . . . . . . ELECTRICAL PERMIT
Additional desc - - Plan Check Fee . 00
Permit Fee . . . . . 60
Issue Date . . . . 8/19/14 Valuation . . . . 0
Expiration Date 2/15/15 -------------------------------
------------------------------------STATE DCA SURCHARGE 2 . 00
Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
Due
Fee summary Charged Paid Credited ----------
----------------- ---------- ---------- ---------- . 00
Permit Fee Total . 60 . 60 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 8 . 00 8 . 00 . 00 . 00
Grand Total 8 . 60 8 . 60 . 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
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
JobAddress: q3q ScLITA*4s,Al Ort_14r, Permit Number:
Legal Description Parcel
Floor 2k�ea of Sq.Ft.
Valuation of Work'S q00D.Cso Proposed Work heated/cooled non-heated/cooled
C�4 pit.)
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed.structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product apV—r_—ov—aTTo_rm
Describe in detail the type of work to be performed:—&"63 "10
Property Owner Information:
Name- Address: 5 a q sa; Dc
1h
city State: zi&,MPI onq !?t3q. Ay
E-Mail or Fax#(optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Qualifying Agent:
Address: city ate P
Office Phone Job Site/Contact Number X
State Certification/Registration#
Architect Name&Phone# A IiL.
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication is hereby made to obtain a permit to o the w nd installations as indicated. I certify that no work or installation has commencedprior to the
issuance of a permit and that all work will be e ormedt eet the standards of all laws regulating constructi'on in this jurisdiction. This permit becomes null
ix month if construction or work is suspended or abandonedfor aWeriod qf SiXP6)months at any time after
and void zywork is not commenced within t be securedfor Electricat Work,Plumbing,Signs, ells,Pools, urnaces,Boilers,Heaters,
work is commenced. I understand that s arate er is mus
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 FINANCIN439 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I here�certify that I have read and examined thisa lication and know the same to be true and correct. All provisions of laws and ordinances governing this
y to violate or cancel the
ty
P, ? work will be complied with whether speci ie§d herein or not. The granting of a permit does not piesume to give authorit
provisions of any otherfe&deral,state, or local 1 regulating conStruCtion or the peTformance of construction.
Signature of Contractor
Signature of Owner
Print Name j yj A Ui 0 ............. Print Name ......................................................................................................................................
............................ ..................................
Before me Before me - 20
this ay o 20 this Day of
orida otary ublic,
blic Shirley L Graham
My Commission FF 086990 Revised 01.26.10
Of Expires 02/14/2018
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,Fl, 32233
Ph(904,241-1821 Fax(904)247-5845
PERMIT#
JOB ADDRESS: ----
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$�
NEW SERVICEE] Overhead F-1 Underground D Underground up Pole
oResidential(Main) Service L]151-200amps 0 am s # of Meters
E10-100 amps 0 101-150amps p
[]Commercial(Main)Service [I 151-200amps am s E CT Service amps
00-100 amps D101-150amps p
Conductor Type, Size
oMulti-Family(Main)Service Ll 151-200amps Ll amps #of Unit Meters
[10-100 amps [110 1-15 Oamps
OTemporary Pole 11 amps
SERVICE UPGRADE El-amps E CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) EICT Service amps
[1100amps D150amps E1200amps El-amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: _]�__0-30amps -31-100amps _101-200amps
Appliances: -0-30amps _31-100amps _101-200amps
A/C Circuits: -0-60amps -6 1-1 00amps
Heat Circuits: - # circuits @-kw
Number of Lighting Outlets;�Including Fixtures: _ qj��
OTHER ELECTRICAL PROJECTS oTransformers; KVA o Motors hp
oSwimmingPool [] Sign []Smoke Detectors-Qty
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK
Qty_volts/amps
REpAIRS/MISCELLANEOUS 0 Panel Change [I OH to UG
[]Replace Burnt/Damaged Meter Can El Safety Inspection
.ElOther:
ork is suspended or abandoned for six months. I hereby certify that I have
Permit becomes void if work does not commence within a six month period or w
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 Phone Number
Fax
�Wiceftone
Electrical Company J01A
city State_Zip
Co.Address:
State Certification/Registration#
License Holder(Print):
Notarized Signature of License Holder
20-
Before me this day of
Signature of Notary Public
J
CITY OF ATLANTIC BEACH
OWNER / BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE 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 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. 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
IURE 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.
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
ill. 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 LIN
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
-OCCUPATIONAL LICENSE" IS NO THE OWNER SHOULD PHYSICALLY
455-228(l). AN 3 T ADEQUATE.
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 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. _05 30
3 q PHONE NUMBER
4DATrj
A ESS rd f7
P R;1111A M E
Sl TURE
Before me this_day of 2Q___ in the county of
Duval,State of Florida,has personally appeared herin by himself I herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Lar state of_,county of
0 Personally wn
0 Produ entificabon- ;4,t-_ IN10tafy Public State of Florida
ey ra am
My Commission FF 086990
S-Pifiss OV14/2018
Notary AAA
FJBLDG/0"er-Builder Affadavit; D:4/16/2009
,'L
V
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001330 Date 8/18/14
Property Address . . . . . . 434 SAILFISH DR
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0 --------------
--------------------------------------------------------------
Application desc
3 FIXTURES
---------------------------------------------
Owner Contractor
------------------------
SKINNER PLUMBING
GAVIN, WALTER L. 1416 ARLINGTON AVE
434 SAILFISH DRIVE E. FL 32211
ATLANTIC BEACH FL 32233 JACKSONVILLE
(904) 727-7000
-- -------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . - Plan Check Fee . 00
Permit Fee . . . . 76 . 00 Valuation . . . . 0
Issue Date . . . .
Expiration Date . . 2/14/15 -----------------------
-------------------------------------------- --------
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 76 . 00 76 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 80 . 00 80 . 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
JOBADDRESS: 14 Le , 4T, PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
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:
o Sewer Replacement F-1 Back Flow Preventer 0 .Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Ei Lawn Sprinkler System-Number of Heads Ei Well
** SJRWD Well Completion Form. Complete&f—orrn to be submitted to the Building Department for final inspection.'
0 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 1 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 W&77PJ� 6AV,*-fV .Phone Number-904*"??3 P"
Plumbing Company P1 06, K, —Office Phone -7 OW Fax
State-F—L–Zip 7t�J/
Co. Address: 1480 FrILLZINCt"00b AV69 city 0."4
License Holder(Print): r*A#VL- <k a e�rtification/Registration# d PCO Va 0 6
Notarized Signature of License Holder
Before me this_day of 20
Signature of Notary Public a*:��