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671 AMBERJACK MASTER BED/BATH 2015 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ri J131�f' RESIDENTIAL ADDITION MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-RADD-764 Job Type: RESIDENTIAL ADDITION Description: BATH.BED.CLOSET Estimated Value: $12,400.00 Issue Date: 4/14/2015 Expiration Date: 10/11/2015 PROPERTY ADDRESS: Address: 671 AMBERJACK LN RE Number: 171190-0000 PROPERTY OWNER: Name: KING, ADAM J Address: 671 AMBERJACK LN PERMIT INFORMATION: PUBLIC WORKS: All siltation must remain on-site during construction. Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappel's and Waste Pro.) Full right-of-way restoration, including sod, is required. No construction parking in right-of-way or street. FEES: PLAN CHECK FEES $56.00 UTIL REV RESIDENTIAL BLDG $25.00 BUILDING PERMIT FEE $112.00 PERMIT IS A PROVE 0NI,Y �'eCCORDANCE$�I'66 ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA CITY OF ATLANTIC BEACH r 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 STATE DBPR SURCHARGE $2.00 Total Payments: $197.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. City of lkfljuleue; 1--i-oolch Uildh APPLICATION NUMBER 800 Seminole i�oaci (To bp Iss',igned by the BUilding Deparlrnen Atlantic Beach, Florida 32233-5445 I by Phone(904)247,5826 - FAx(90/1) 247 '384S -7& E-mad: building-dept@coab.us City web-siteIP//w coab.t Date routed: _41 11 ==J APPLOCAST9001M REV0 A/V ANO TRAKONG FOURIM/1 Depa ' e IL Neeievir required yes 1�j in o 7) Ian iing & 27§1 Tree, clm-fl-11strat or C Lill ublic Wor lalc 7' u lic Sa ety - _� Fire Services Review fee Dept Signature Chher Agency Review or Permit Required Review or Receipt Florida Dept. Protection _f Permit Verifi Y Date Fl-odda Dept. of Transportation _-. St. Johns River Water Management District _;;rMy—Corps Of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: - ---------- APPLICAMN STATUS Reviewing Deparkment First Review: XApproved (Circle one.) nDenied. 4-ornments: BUILDING PLANNING &ZONING Reviewed by_ TREE ADMINDate.- Second Review: nApproved as i-evis.ed []Denied. PUBLIC WORKS Comments: 4. PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. []Denied. G'omrnents: Reviewed by: Date: ----- vises 67/27/10 67/ AA,�I�IL�i (L— L � /, S d J kid 3 � ° 3ffa f1.vs� 2 x 39 - 770 s/w 2! x 2• s 73 6�L a -7 Y v 2Zo / u BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 671 Ambejack Lane Permit Number: Legal Description Home Addition Parcel# Floor Area o q. t. q, t Valuation of Work$ 12,400 Proposed Work heated/cooled 300 non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/pro osed 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 approval form Describe in detail the type of work to be performed: New Addition to include master bedroom bathroom and closet Property Owner Information: Name: Adam King Address:671 Amberiack Lane City Atlantic Beach State F1 Zip 32233 Phone 904-333-8701 E-Mail or Fax#(Optional)aikinp47@yahoo.com Contractor Information: Company Name: Qualifying Agent: Address: Ci State Zip Office Phone Job Site/Contact m Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify at no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating co ction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or aban ed for a_period of six(6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, Pools, Furnaces, 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that 1 have read and examined thisplication and know the sante to be true and correct. All provisions of laws and ordinances governing this type o1 work will be complied with whether s ecw wed herein or not. The granting of a permit does not presume to gyve authority to violate or cancel the provisions of any other federal,state, or local law regulating construction or the performance of construction. Signature of Owner 4�' Signature of Contractor Print Name J�„-, / .�� lel. ( .:...... .............................................. ..... Print Name Swo and subscr' ed before meSworn to and subscribed before me this Day of 1r1 2015 this Day of 20 Not ubli ,�`• Y .:; dE NIFERwnucER Notary Pu lic ._ MY COMMISSION N FF 011480 EXPIRES:April 24 2017 Revised 01.26.10 Bonded Thru Notary Public Underwriters TREE & VEGETATION AFFIL TWIT <S, City of Atlantic Beach ' Department of community Development Planning&Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 (P) 904 247-5800 (F) 904 247-5845 PERMIT# SECTION I-APPLICANT INFORMATION r Owner(s r Legal Authorized Agent* NAME OF APPLICANTCM NAME OF COMPANY ADDRESS OF COMPANY 7/ 4^ C/< (�,�� 1 140 )3c 1, 2- Z PHONE �'jGY-3�3 b7c . CELL I,CU�! }� .-�7ai EMAIL CONTRACTOR CERTIFICATION NUMBER ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION If-SITE INFORMATION STREET ADDRESS OF PROPERTY If an address has not been assigned to this property,contact the AB Bui, i Department at(904)247-5826 to request an address. LEGAL DESCRIPTION LOT Sr BLOCK 3DIVISION j I REAL ESTATE NUMBER LOT OR PARCEL SIZE: 7 5 SQ FT AC RESIDENTIAL COMMERCIAL OTHER(SPECIFY) 1 affirm that 1 have reviewed the provisions of Chapter 23, 'Protection of Trees and Nc; 2 Vegetation" of the Municipal Code of Ordinances for the City of Atlantic Beach, FL and/or/have participated in a pre-applicati_, meeting with the Administrator of those regulations. Subsequently,l affirm that no regulated trees and no regulated vegetation w be damaged,destroyed and/or removed from the above-described or adjacent properties in conjunction with this project. SIGNATURE OF OWNER �t SIGNATURE OF O ER Signed and sworn before me on this I day of nw, ?Vt5,b� State of County of Identification verified: Oath sworn: I— Yes r—%, d0 IAA JENNIFER WALKER Not6yinature kt' MY COMMISSION#FF 011490 EXPIRES:April 24,2017 • 7 Bonded Thru Notary Public Underwriters My Commission expires: $FSt ,. CITY OF ATLANTIC BEACH OWNE L FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 'I "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW I DI:SCLOSUP.E STATEMENT FOP,SECTION 439.103(7),FLORIDA STATUTES: STATE LAW ?tEQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU I iAVE APPLIED FOR A PEP, T UNDER AN E};BM;o'IxOi I TO THAT LAW. THE EYEIVLPTIOrd AL LOWS YOU,AS THE OWNER OF YOUR PROPERTY.TO ACT AS YOUR OWN CONTRACTOR EVEN THOUCTH YOU DO NOT HAVE A LICENSE. 1'Olt_ ,�11i5 I I� til!t'EIL VISI: 111h,L'0N',t I<UC'7lON YUl_— _ IRSEi p YOU M4Y BUILD OR Il�II'P�OVE A ONE—OR I W*0 FAIV11LY I2ESID.E;NCE OR A FARM OUTBUILDING. YOU 11 jl Y ALSO BUILD OR A/PROVE A COMMERCIAL BUILDING AT A COST OF$25-000.00 OR ILF?S,T E B G u 1�'fUST BE POPS YOUR USE AND OCCUPANCY. IT NIAl'NO1 BE CiIIIL 1 FO[2 S.ALF.OR _ IF YOU SELL OR LEASE A BUILDING YOU HAVE BU llT YOUItSEIF WITrNL ONE EA AFTER TT7M CONSTRUCTTON IS COAYEAR IPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEAS•_'- uTIIICH IS IN VIOLATION OF THIS E)CE1\/g>TiON. Yt7lJ 1:11: NI I j Hllz�_,gN t1Nl [CuL:NSLI i'L-'RSUN ;1SPOUR_tU)NIRACTOIL_ YOUR CONSTRUCTION UST 13E DONE ACCORD ORDINt TO TI3E BUILDING CODES AND ZONING REGUI REGULATIONS rhll lIL ItI.SP(1NSl1311 [I 1 t t MAKE. SURF ll IAT PEOPLE EhiP1.O _ S I('I NSFti_Rit)UI1ZfD .-1 51 ATE L_1NYAND BY COUNTY ()Iz \.I I�11fAL ltltfflSif C II IiLL)I NANCES. R. IItJURY LIABILITY; SINCE OWNERS MAY LIABLE FOR INJURIES TO WORKERS THEY H1RI j i NE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION I(sISU4RANc'( i�F_ PURCHASED III. IRS WITHHOLDING; OWINERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO Ii OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EPJIPLOY ON THEIR IMPROVEMENT TRADES. t iV. PMSTLTY; UNUCEN9t_u CONTRACTORS CANNOT BE EMPLOYED IINDEP. I C_IP,C(IR9STANCFS. OWNERS BEING SUBJECT TO $5,000 PENALTI- UNDER ANY I 455-22228(1).—AN "OCCUPA T IGR'�1L LICENSE"IS NOT ADEQUATE. THE OWNERFLORIDA LD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA O 'CONTRACTORS l 1 CER T IFICA I E" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR.. TLONE BUILDING DEPARTMENT(247-5826) IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ ABOE, STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FORT I E ISSUN E OF AN OWNER-BUILDER PERMIT. 7 -- ADDRESS glp'7-33 3 4-77, / PHONE NUMBER PRINT NAME SIGNATURE ` S+ DATE Before me this I da of _ Duval,State of Florida,hast' sonall ' the county of Pe y al e+rv'd herin by himself/herself and affirms that all statements and declarations aretrueend-lccurate- notary Public at Large,State of County of Ue' vA,4 ersonally Knotnvn El Produced Ideniific3iion- — I . r JENNIFER WALKER " F Notary Sic-mature: y; #s MY COMM13SfON if FF 011480 j • ' EXPIRES:April 24,2017 Bonded Thtu Notary mic underwriters 1+:/13I_U<i/Owner-1.il&AP,adav,r,l:n VIsEU: d/log -)'u MAPSHOARY 1. OF -- LOT 5 BLOCK 's AS SHOWN ON MAP OF Z0 YO L. P,o1.m L/A/17- 0A/E AS RECORDED IN PLAT BUVK 10 PAGES 40-('OBJ OF 7HE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA CER77FIED FOR. LInQM //./n/ 11411024 1✓of-7- ,4 E COZP TErn/a/LT %/TCS vdxgdry I CI-14 A J�vr�l cr Z$ Zg So7r1 0z'E 75.00' °L T011.5 r,l n 14c-r) r x 1 21_5' O 2'0,-7 O O � „°° rry cc o r � � 4 x 110.(o71 � 21.5' x - 1&3' ZS --s 132` 0.10 x x N07'16'02OW 75.00' P.C. 1.1 j QNJREt-J4G4I✓ THE PROPERTY SHOWN HEREON APPEARS TO LIE W17HIN FLOOD HAZARD ZONE AS SCAFROM FLOOD INSURANCE RATE MAP 0001 FOR 7HE CITY OFAnA,177C &g,FLORIDA, DATED Q l7-�� AND IS SHOWN AS A COURTESY ONLY AND DOES NOT CONSTITUTE A CER71FC4710N Or SAME. TRI—STATE LAND SURVEYORS, INC. 8411 BAYMEADOWS WAY SUITE 12, JACKSONVILLE, FLORIDA 32256 (904) 731-7235 LEGM BEARINGS BASED ON 24.J LINE AS SHOWN. Nor at Rm eve THIS SURVEY DOES NOT REFLECT LIR DE7ERMINE OWNERSHIP. . wvr W wm CAP/u 4m) NOT VALID WITHOUT 711E SIGNATURE AND THE ORIGINAL RAISED SEAL ll�q rnv� OF A FLORIDA LICENSED SURVEYI7R AND MAPPER. war O°e ov-mv1 THIS SURVEY BASED UPON DESCMPflON AS FURNISHED. AND WITHOUT ®ama Q/7 BENEFIT OF A 117LE BINDER ABSTRACT OF TITLE AND OR DEED RESEARCH swl. MUMM AE"MCI w ur torr rwsrmr LARRY G. EDDY. P.L.S. Na 4144 xiw nwr-4w-wrCOLE 1" = 70, GLENN M. BROADSTREE•T, P.SAI NO 5814 f a AWC CEVWAWA£ T _ Cyt ,uv voncMw vwo PV RAmu°srAN¢ FIELD V#VRK DATE,-S"g"CS STEREO SURVEYOR AND MAPPER, O cavo r SIGNATURE DA 7E., �' I Z"OS STATE OF FLORIDA (LB 14921) F , /005 yr 7 fwrkrw Ain Oce-t71-1 City of Atlantic C NUMBER Building Departmera, b APPLICATION NUM I\A y tj Bu To T (To be assigned by the Building Department.) 19;; 800 Seminole Road "J' Atlantic Beach, Florida 32233-5445 FF '2 Phone(904)247,5826 - Fax(904)2417-SRj.r� A. -7& E-mail: building-dept@coab.us t City web-site httpHww\Acoab.L1S LDate routed: APPLOCATON PREVEMNS AND TRACKNG FORPH/i Depa -e-Int review required Yes No ing la' ninq R_Zoni Tree Ad_minis 7r_ator__ _ l 111 ublicWor Ola U LI eS--, l,97 U lic Sa ety Fire Services Review gee — Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept.of Environmental Protection f Permit Verified By Date 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 Depariment First Review: ,u,,c,e .) i (Circle []Approved. MDenied. ('Omments:Review, cor" w%&^+r i BUILDING P 1\11,j 8, LANN &ZONING TREE ADMReviewed Date: Second Review:__J�Cpp'rovecl as revi '5 Denied- PUBLIC WORKS Comments,: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: ---— Date: 3_ ——------------------- FIRE SERVICES Third Review: OffAppir-oved as revised. �EF]Deni Comments: Reviewed by: Date: Wised 07/27/10 CITY OF ATLANTIC BEACH s Building Department 800 Seminole Road Atlantic Beach,Florida 32233 Dill, % (904)247-5800 FILE ~� � Copy PLAN REVIEW COMMENTS Permit Application # /5- 76 91 Property Address: 6 7/ a c-k z-/-t Applicant: l 0/77P p cVI�-ed- 1Ci✓� Project: I/P�/ /�`o�a�v�ia�'1 J JIU /yic/vo�� aST oY �('a�oo.� /Ja>l�i 8`c to Se. 7 This permit application has been: E:J Approved xr Reviewed and the following items need attention: X10 3v 4,aS /?0-7 i n he SA m /0 C P c� iv �, v,^ S'� p r 7� 7h rP� r� a /a ivn i))rt irvc ' ri -V4 -i 4 -�'a ni n i-n karma T? /la 3IZAVa h cr �b czh m d 0FIT C— o -e— . e v r va/ yrs aki ol mow, /n H rt 07AMPF 0 Y PJ'J&V-qv C a IC i re c.'/ r� hLJ/ d . Sen /'rvitw cot,-"-PA1t `/— k-ao/ S" 8`Arr► lv^�- Please re-submit your application when these items have been completed. Reviewed By:/ Date: BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 FILE COPY Office (904) 247-5826 Fax(904) 247-5845 Job Address: 671 Amberjack Lane Permit Number: /.57 -R, tq op- 76y Legal Description Home Addition Parcel# Floor Area of Sq.Ft. Sq.Ft Valuation of Work$ 12,400 Proposed Work heated/cooled 300 non-heated/cooled 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 approval form Describe in detail the type of work to be performed: New Addition to include master bedroom bathroom and closet Property Owner Information: Name: Adam King Address:671 Amberjack Lane City Atlantic Beach State Fl Zip 32233 Phone 904-333-8701 E-Mail or Fax#(Optional �47@y—ahoo.com Contractor Information: Company Name: Quali ing Agent: Address: Ci State Zip Office Phone Job Site/Contact m Fax-# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. 1 cer�igtwork or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulatinon in thisjurisdiction. This permit becomes null od for a ereod of six6)months at any time after work is commenced. 1 understand that separate permits must be secured for Elec7rical Work,Plumbing,Signs, Wells,Pools, Fkirnaces,Boilers,Heaters, Tanks and Air Conditioners,etG 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereb certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether speci led herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state, or local law regulating construction or the performance of construction. Signature of Owner Signature of Contractor Print Name /oma C�r�...................................................... Print Name S i1hrid subsc ' d befo me5 Sworn to and subscribed before me this Day of Irl 20 this Day of - 20 No uI JE NIFERWALKER Notary Public MY COMMISSION#FF 011480 EXPIRES:April 24,2017 Revised 01.26.10 Bonded Thru Notary Public Underwriters DO NOT WRITE BELOW- OFFICE USE ONLY App Ica e Co es: 2010 FLORIDA BUILDING ODE Review Result (circle one): Approved Disapproved Approved w/ Conditions Review Initials/Date: 7-/ S" Development SizeFILE COPY Habitable Space .foo S E Non-Habitable Impervious area Miscellaneous Information Occupancy Group g-_3 } Type of Construction Number of Stories Zoning District S— / Max. Occupancy Load Fire Sprinklers Required Flood Zone X Conditions/Comments: TREE & VEGETATION AFFIL WIT City of Atlantic Beach FILE COPY Department of Community Development Planning&Zoning Division vJ,f1�'r' 800 Seminole Road Atlantic Beach,FL 32233 n // (P)904 247-5800 (F) 904 247-5845 PERMIT# �5" '�/9,Op -7(e SECTION I-APPLICANT INFORMATION �%Owner(s Legal Authorized Agent* NAME OF APPLICANTa NAME OF COMPANY r ADDRESS OF COMPANY 4 -71 A^ oe�1 ick �� -(. j3ct, i PHONE r'jOY-3 33 CELL GGY } -lr7a( EMAIL G��'— V 7 Q) o,koo Cc CONTRACTOR CERTIFICATION NUMBER ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION II-SITE INFORMATION STREET ADDRESS OF PROPERTY If an address has not been assigned to this property,contact the AB Bui;, j Department at(904)247-5826 to request an address. LEGAL DESCRIPTION LOT BLOCK .31DIVISION REAL ESTATE NUMBER LOT OR PARCEL SIZE: 7 5-UU SQ FT AC RESIDENTIAL IDENTIAL COMMERCIAL OTHER(SPECIFY) I affirm that I have reviewed the provisions of Chapter 23, 'Protection of Trees and Nc. : Vegetation" of the Municipal Code of Ordinances for the City of Atlantic Beach, FL and/or I have participated in a pre-applicati•.; meeting with the Administrator of those regulations. Subsequently,1 affirm that no regulated trees and no regulated vegetation w.:'be damaged,destroyed and/or removed from the above-described or adjacent properties in conjunction with this project. SIGNATURE OF OWNER SIGNATURE OF C' ER Signed and sworn before me on this I day of by State of PL- County ofV Identification verified: Oath sworn: r Yes r`.Pdo JENNIFER WALKER Not y i nature MY COMMISSION ii FF 011480 ZvI a. o_ EXPIRES:Apri124,201 My Commission expires: Bonded Thru Notary Public Underwriters MAP SH BOVI DAIRY SV-- fir`Y OF LOT S BLOCK 5JAS SHOWN ON MAP OF ""r7 20 yQ L. Po L M L/A/17- OA/C- AS AIC- AS RECORDED IN PLAT BOOP( -30 PAGES `0-40Q OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA CERTIFIED FOR: 40,l Y1 /Cly/ QMP2o /17104-- A E caZP ""i re AIL7- %/TL6 vax&1 C1-14 A 40 ZS zg - -B.F.- - - - - - - - — S07'1 02T 7 0 5.00' � Mvt.fSEp-JLY T4-an IV � I ' 21_5' p o con/o. (071 ;n h Z4 t 21.5' x - 18.3' ZS Ob X - X 16.07' N07'19'02"W 75.00' P.C. Qiv►F�Er�JAG/� L4A/ THE PROPERTY SHOWN HEREON APPEARS TO UE WITHIN FLOOD HAZARD ZONE AS SCAFROM FLOOD INSURANCE RATE MAP 0001 FOR THE CITY OFAnA✓TIC Pyq,FLORIDA. DATED 4- /7-Or - AND IS SHOWN AS A COURTESY ONLY AND DOES NOT CONSTITUTE A LERTiFC47TON OF SAME TRI—STATE LAND SURVEYORS, INC. 8411 BAYMEADOWS WAY SUITE #2, JACKSONVILLE, FLORIDA 32256 (904) 731-7235 LEGpv BEARINGS BASED ON UNE AS SHOWN. * ran • Pw Dole THIS SURVEY DOES NOT REFLECT OR DETERMINE OWNERSHIP. wav W wrrr WP ee wn) NOT VALID W 774OUT 774E SIGMA7URE AND 774E ORICJNAL RAISED SEAL Fula OF A FLORIDA LICENSED SURVEYOR AND MAPPER. o wov me(rama) -THIS SURVEY BASEDDCSCNPRDN AS FURNISHED. AND W RMT *O1m°n BENEFIT OF A 717LE BINDER ABSTRACT'OF TITLE AND OR DEED RESEARCH mr7 uSEkerr LARRY G. EDDY, P.LS Na 4144 Aim Gorr-w wArGL CALF t" = 20' ENN M. BROADSTREETR, P.SM. N 5814 COV. COWM AWA £ aanaalE ,ut Arr cnnnawc rAA 00 AMAL 01STA^'a ELD *VRK DATE- S"q.Ori $]EKED SURVEYOR AND MAPPER, M caraar GNA 7URE DATE: S J Z-OS STATE OF FLORfDA (LB 14921) FR J0o5 P!: 7(J /1Rgi"R Ain -1-7J ' CITY OF ATLANTIC BEACH 1. FLORIDA STATUTES; CHAPTER. 489, FLORIDA STATUTES, PART -1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: iDISCLOSURE STATEMENT FOR SECTION 459.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU IIAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE ENEMPTIOkl ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY.TO ACT AS li YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONS I-RUCTION YOURSELF YOU MAY BUILD OR IMPROVE A ONE-O II rW0 FAMILY RESIDENCE OR A FARM OUTBUILDING. RYOU MAY ALSO BUILD OR (i IMPROVE A COM[vMR.CIAL BUILDING AT A COST OF$25.000.00 OR LESS. THE BUILDING N 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 TIS CONSTRUr"TON IS COMPLETE, THE LAW WILL PRESUME THAT YOU SUIT T IT FOR SALE OR LEAS Lr- '� MCH IS IN VIOLATION OF THIS EXEMPTION.� I- HIRI:i AN UNI ICENSCf, i'FRS� _ UN AS YOUR CONTRACTOR YOUR CONSTRUCTION MUST DONE ACCORDINC 'IO THE BUILDING CODES AND ZONING REGULATIONS. I I I,-. YOUR RESPONSIBILII', TO MAKE SURE THAT PEOPLE EMPI..UYED 13YYOLI HAVE I� 1II_SENSF.S REO --D -Y STATE LAW AND BY COUNTY OR N-11 ICIPAL LICENSINIf �I ORDINANCES. It. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, I"HE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. 111. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO I OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. W. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY Ii CIRCUMSTANCES OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. I 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS CERTIFICATE"E" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR.. TELEPHONE THE BUILDING DEPARTMENT(247-5826) IF IN DOUBT. I� V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. I 6 -7) IADDRESSPHONE NUMBER PRINT NAME - SIGNATURE L 1 DATE Before me this I day of� 2)�n the county of Duval,State of Florida,has personally,I ea,ed herin by himself/herself and affirms that all statements and declarations are true ant:accurate. Notary Public at Large,State of _ County of V K`v Ue`ersonally Known ❑Produced Identification- i JENNIFER WALKER MY COP.IMISSiON#FF 01 1480 j Notary Signature: ��(( � EXPIRES:April 24,2017 ..........$:S Bonded Thru Notm Public Underwrltere YABLU(Yormer-Buildei Affadavir;REVIS6U;4/)o:V..09 Job: FILE COPY Date: Mar 19,2015 r�+ wrightsoft Project Summary By: Enure House Donovan Heat&Air 315 6th Ave S.Jackson'lle Beach,FL 32250 Phone:904-241-3785 Fax 904-241-3745 Email:aaron@donovanac.combleb:vnvrtDonovanAC.com For: Adam King 671 Ambe9ack Ln, Atlantic Beach, FL 32233 Notes Weather: Jacksonville Mayport Naval, FL, US Summer Design Conditions Winter Design Conditions 95 °F 39 of Outside db 75 °F Outside db 70 °F Inside db 20 °F Inside db 31 °F Design TD L Design TD Daily range 50 Relative humidity 53 gr/lb Moisture difference Heating Summary Sensible Cooling Equipment Load Sizing 3119 Btuh 4863 Btuh Structure 523 Btuh Structure 460 Btuh Ducts f 0 Btuh Ducts 0 Btuh Central vent (0 cm} 0 Btuh Central vent (0 cfm) 0 Btuh Blower Humidification 0 Btuh n Piping 5323 Btuh Use manufacturer's data 1.00 Equipment load Rate/swing multiplier 3642 Btuh Equipment sensible load Infiltration Simplified Latent Cooling Equipment Load Sizing Method Average 626 Btuh Construction quality 0 Structure 103 Btuh iFireplaces Ducts 0 Btuh i Heat279 Coolin Central vent t cfm)ent load 729 Btuh 66 272 Equipment latent Area(ft') 2208 22084370 Btuh Volume(ft') 0.61 0.32 Equipment total load 0.4 ton Air changes/hour 12 Req. total capacity at 0.70 SNR I Equiv.AVF (cfm) 22 Cooling Equipment Summary Heating Equipment Summary �I �. 1 S 5 �- Make -1'"�"s Y"A-R Trade Trade tar 5F Cond a S �= r . Model I-A*#4517"Gig= '* Coil '` "� AHRI ref W. k� '541S3f oz AHRI ref no. 1�.� . SEER Btuh Efficiency \q-�t , Efficiency S .S �5C� Ag Sensible cooling 5 Btuh Heating input t1:. Latent cooking Btuh Heating output -F Total cooling Z� � cfm Temperature nse -Z--1 F Actual air flow , , 4 cfm/Btuh Actual air flow C�it 0 cfm Air flow factor o }� in H2O Air flow factor `;,c�nS cfm/Btuh in H2O Static pressure �' 0$3 Static pressure t Load sensible heat ratio Space thermostat Calculations approved byACCA to meet all requirements of Manual J 8th Ed. 2015-Mar-1 9 20:36 log Pagel 1 + wrightsoft Right-Suite®Universal 8.0.24 RSU05995 ProjecCrup Calc=MJ8 Front Door faces N ^ U O CL O .., o � W A o r � U I� 4 b > o as w d m Z C 00 N O0 0 0 A moo COO O n CZ Aen to to to 0 � � •� -� � �' W 3 � � o Fo � A � o � cn rs: d 0 Z v� x r,: ,) w d a a 3 Q OG sm. w -- N M V� �p r N M k/•) 06 C� O -- a, 0. d wo u 0 a� 0 a 0 s. u A v 'C 0 s. a u w 0 UD bb as cn -S O ►-� .� ,y = O cn O! o N a N m vi l� a1 a M oo a; k U U A E v 0 a 0 c 0 0 s, v A 0 a s. v w c 0 UN y s.. o o UG o o 0 Cc uwo � o3 � wcn 04 U [� N M l� V ^" N M 4 r-� 00 C� O U W w a� 0 0 ° a) V V O O O w U oA 'd C� U � 4, 1 z •d � ,•o --r. a� w w o o O 41.1 C O •� +' Q. y f M M A cl cn ci as o o a� � O ° = — b � U Job: wri htsofr Project Summary Date: Mar 19,2015 9 Entire House FILECOPY By: Donovan Heat&Air 315 6th Ave S,Jacksonville Beach,FL 32250 Phone:904-241-3785 Fax:904241-3745 Email:aaron@donovanac.com Web:wwKDonovanAC.com For: Adam King 671 Amber)ack Ln, Atlantic Beach, FL 32233 Notes: Design Information Weather: Jacksonville Mayport Naval, FL, US Winter Design Conditions Summer Design Conditions Outside db 39 °F Outside db 95 °F Inside db 70 °F Inside db 75 °F Design TD 31 °F Design TD 20 °F Daily range Relative humidity 50 % Moisture difference 53 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 4863 Btuh Structure 3119 Btuh Ducts 460 Btuh Ducts 523 Btuh Central vent (0 cfm) 0 Btuh Central vent (0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh piping 0 Btuh Equipment load 5323 Btuh Use manufacturers data n Rate/swing multiplier 1.00 Infiltration Equipment sensible load 3642 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average 626 Btuh Fireplaces 0 Structure Ducts 103 Btuh Heating Cooling Central vent (0 cfm) 0 Btuh Area (ftZ) 276 276 Equipment latent load 729 Btuh Volume(ft3) 2208 2208 tuh Air changes/hour 0.61 0.32 Equipment total load 43. on Equiv.AVF (cfm) 22 12 Req. total capacity at 0.70 SHR 0.4 4 ton ton Heating Equipment Summary Cooling Equipment Summary Make TV-:4AV T-P A Make �F�t'S'l7R It Trade ) 5G Trade seatf-s� 4{�`AT 12'KP Model Cond �; ,C E}S L;l� . N N S"3L .rrr� Coil t—V ti+ct1c-2-z4'F V* L_ AHRI ref no. 'Is,�3t o-z AHRI ref no. Efficiency -3.,57 i4SCCi� �E" Efficiency ►�. . SEER Heating input Btuh Sensible cooling x°11 Btuh Heating output Z—'9 C• Btuh 41", Latent cooling Btuh Temperature rise 2'7 °F Total cooling -Z-'s o B ci cfm tu Actual air flow ►�o cfm Actual air flow "I Air flow factor 0,0(,5- cfm/Btuh Air flow factor �'� Cfm/Btuh n H2O Static pressure in H2O Static Load se ressure Space thermostat ns ble heat ratio 0.83 Calculations approved byACCA to meet all requirements of Manual J 8th Ed. 2015-Mar-19 20:36:09 wri htsoft Right-Suite®Universal 8.024 RSU05995 Pagel ACACK Project2.rup Calc=MJ8 FrontDoorraces. N APPENDIX 13-D Climate Zones 1,2.3 TABLE 6C-1:PRESCR"IJE REQUIREMENTS FOR SMALL ADORIONS(6ti0 Sq.Ft.and Less),RENOVATIONS TO EXISTING BUILDINGS AND SITE-INSTALLED COMPONENTS OF MANUFACTURED HOMES COMPONENT MINIMUM INSULATION EQUIPMENT MINIMUM INSTALLED INSULATION INSTALLED EFFICIENCY -. EFFICIENCY concrete Block R-7 I f O Frame,Y x 4' R-11 j� 2 Central AJC -Spit SEER-13.D' SEER- a Fraena,2'x 6' R-190 -Single Pkg. SEER=13.0' SEER= 3 Common,Frame R-11 V 1 Room ung or PTAC EER =8.5' EER - Common,Masonry R-3 Under Attic R-3i) ?)Q Elec'ric Resistance ANY J t O Heat prune-Split HSPF=7.7' HSPF= f- I� z Single FiciAssembly:Enclosed R-19 - r Single Pkg. HSPF=7.7' HSPF= J Metal Pans i. R-13 -_- --- Room unit or PTHP COP=2.7• HSPFlCOP 2 U !Single Assembly:Open l R-10 - -_ w ;Gas.natural or propane AFUE=.78 AFUE Common,Frame R-11 -- a Fuel Oil AFUE=.78 AFUE =_.._.- m Slab-on-grade No Minimum U O Raised Wood R-19 G ;Raised Concrete R-7 _ _ _ ¢ S T LL i Common.Forme R-11 r-w uric Resistarxp EF s.92 EF= Gas;natural or LP EF=.59 EF F- i In unconditioned space R-6 _ ,_ 3 Fuel Oil EF=.54 EF=_-__ In conditioned space No minimum a _ See Table 13-607.1.ABC.3.2 and 13-606.1-ABC.32 TABLE 6C-2:PRESCRIPTIVE REQUIREMENTS FOR GLASS AREAS IN ADDITIONS ONLY Mazanor percentage glass to floor area allowed is selected by type.Overhang length,and solar heat gain coefficient.Maximum% GLASS TYPE,OVERHANG.AND SOLAR HEAT GAIN COEFFICIENT REQUIRED FOR GLASS PERCENTAGE ALL - UP TO 20% UP TO 30% UP TO 40% UP TO 50% Single Double Single Double Single Double Single Double 0H-SHGC OH-SHGC OH-SHGC OH-SHGC OH-SHGC OH-SHGC OH-SHGC OH-SHGC V-.87 or-.78 T-.87 1'-.78 NOT 2'-.78 NOTALLOWED 3-.78 17-.75 V-75 0'-.61 ALLOWED T-61 a 7-.61 0'-.57 0-.44 I--.44 a-.35 Get certified SHGC from the manufacturer or Use defaults:Single dear SHGC=.75,double clear SHGC=.66.and single tint SHGC=-64 TABLE 603 MINIMUM REQUIREMENTS FOR ALL PACKAGES COMPONENTS SECTION REQLAREMENTS r CMECK Exterior Joints&Cracks 606.1 To be caulked,gasketed,weather-stripped or otherwise sealed. Exterlw Windows&Doors 606.1 Max.0.3 cWsq.N.window area;.5 dm/sq.ft.door area. Sole&Top Plates 606.1 Sole plates and penetrations through top plates Of exterior walls must be sealed. Recessed Lighting 606.1 Type IC rated with no penetrations(two alternatives allowed). - Multistory Houses 606.1 Air barrier on perimeter of Door cavity between floors. Exhaust Fans 606.1 Exhaust tans vented to unconditioned space shah have damprer%except for combustion devices with integral ✓ exhaust ductwork. Combustion Heating 606.1 Combustion space and water heating systems must be provided with outside combustion air,except tor direct vent N p appliances. �[ Water Heaters 612.1 Comply with efficiency requirements in Table 612.1.ABC.32.Switch or clearly marked circuit breaker electric or ✓ cutoff(gas)must be provided.External or built in heat trap required for vertical pipe risers. Swimming Poria&Spas 612.1 Spas 8 heated Pools must have covers(except solar heated).Noncommercial pools must have a pump timer.Gas spa 8 pod heaters must have minimum thermal efficiency of 78%. Fat Water Pipes 612.1 Insulation is required for hot water circulating systems(including heat recovery units). Shower Heads 612-1 Water flow must be restricted to no more than 2.5 gallons per minute at 80 psig. HVAC Duct Construction, 610.1 All ducts,fittings,mechanical equipment and plenum chambers shall be mechanically attached,sealed,insulated Insulation&Installation and installed in accordance with the criteria of Section 610.1.Ducts in attics must be insulated to a miiml+n of R-6. HVAC Controls 807.1 Separate readily accessible manual or automatic thermostat for each system. f GENERAL DIRECTIONS: 1. On Table 6C-1 indicate the R-value of the insulation being added to each component and the efficiency levels of the equipment being installed.All R-values and efficiencies installed must meet or exceed the mdrmum values listed.Components and equipment neither being added nor renovated may be left biank. 2. ADDITIONS ONLY.Determine the percentage of new glass to conditioned floor area in the addition as follows-Total the areas of all glass widows,sliding glass doors and glass door panels.Double the area of all noovedical roof glass and add it to the previous total.When glass in existing exterior walls is berg removed or enclosed by the addition,an amour equal to the total area of this glass may be subtracted from the total glass area Uivide the adjusted glass area total by the conditioned floor area of the addition.Multiply by 100 to gel the peeent.Find the largest glass percentage under which your catculated percentage faits on Table 6C 2.Prescriptives are given W the type of glass(single or double pane)and the overhang(OH)paired with a solar heat gain coefficient§HGC).For a given glass type and overhang,the minimum Soler heat gain coefficient allowed is specified.Actual glass wndows and doors previously in the exterior walls of the house and being reinstalled in the addition do not have to comply with the overhang and solar heat gain coethcient requirements on Table 6C-2.All new glass in the addition must meet the requirement for one of the options in the glass percentage category you indicated.The overhang(OH)distance is measured perpendicularly from the face of the glass to a point directly under the outermost edge of the overhang. 3. RENOVATIONS ONLY Replacement glass needs to meet the following requirements.Any glass type and solar heat gain coefficient may be used for glass areas which are under at least a 2-foot overhang and whose lowest edge does not extend further than 8 feet from the overhang.Glass areas being renovated that do riot meet this criteria must be either single-pane timed,double-pane clear or double-pane tinted. 4. BUILDING SYSTEMS.Comply when new system is installed for system installed. 5. Complete the information requested on the top half of page 1. 6 Read'Mnimmn Requirements for Small Addnbons and Renovations'Table 6C-3.and check all applicable items. 7. Read,sign and date Ure'Owneri"t'certification statement on page 1. 13-D.34R FLORIDA BUILDING CODE-BUILDING ' APPENDIX 13-D FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 60OC-04R Residential Limited Applications Prescriptive Method C NORTH 12 3 Small Additions.Renovations&Building Systems «Compliance with Method C of Sub-Chapter 6 of the Florida Energy Efficiency Code may be demonstrated by the use of Form 5WC-04 for addihons of 600 square feet or less,sne-installed components of manufactured nomes.and renovations to single-and multiple-family residences.Alternative methods are provided for additions by use of Farm 6008-04 or 60OA-04 PROJECT NAME: i W�: :.BUILDER: AND ADDRESS: U + (y ERMITTING CUMATE L-N LZ 3 OFFICE: ZONE: 12 J 3 OWNER: /r7-^ /L (N C- PERMIT NO.: JURISDICTION NO.: 1 SMALL ADDITIONS TO EXISTING RESIDENCES(600 square feet or less of conditioned areal-Prescriptive requirements in Tables 6C-1.6C-2.and 6C-3 apply only to the components of the addition.nm to the existing building.Space heating,cooling,and vrater heating equipment efficiency levels must be met only when equipment is installed specifically to serve the addition or is being installed m conjunction with the addition construction.Components separating unconditioned spaces from conditioned spaces must meet the presented minimum insulation levels-RENOAFIONS(Residential buildings undergoing renovations costing more than 30%of the assessed value of the building).Prescriptive requirements in Tables 6G-1 and 6C-2 apply only to the components and equipment being renovated a replaced.MANUFACTURED ROMCS AND BUILDINGS.Only sde-insialled components and features are covered by this form.BUILDING SYSTEMS.Cornph when complete new system is installed. Please Print CK 1. Renovation,Addition,New System or Manufactured Home I. c,-- 2. -2. Single-family detached or Multipie-family attached 2. F r l 3. If Multiple-family-No.of units covered by this submission 3. 4. Z - 4. Conditioned floor area(sq.ft.) 5 - 5. Predominant eave overhang(ft.) 6. Glass type and area: Single Pane Double Pane a.Clear glass 6a. sq.ft. � sq.ft. v b.Tint,film or solar screen 6b. D sq.ft. sq.ft. 7. Percentage of glass to floor area 7• % - 8. Floor type and insulation: r a.Slab-on-grade(R-value) 8a R= lin.ft- b.Wood,raised(R-value) 8b. R= - sq.ft. c.Wood,common(R-value) 8c. R= _ sq.ft. d.Concrete,raised(R-value) 8d- R= _sq.ft. e-Concrete,common(R-value) Be. R= _ sq.ft. 9. Wall type and insulation: a. Exterior t Masonry(Insulation R-value) ga-1 R=__ sq.ft. - 2. Wood frame(Insulation R-value) 9a-2 R=��_ .sq.ft. - b- Adjacent: 1. Masonry(Insulation R-value) 9b-1 R= sq.ft. 2. Wood frame(Insulation R-value) gb-2 R= __sq-ft. - c. Marriage Wails of Multiple Units'(Yes/No) gc _ 10. Ceiling type and insulation: a.Under attic(Insulation R-value) 10a. R= L��'_sq.ft. - b-Single assembly(Insulation R-value) 10b. R= sq.ft. - 11. Cooling system' 11. Type: �r 15-ft t> (Types_central,room unit,package terminal A.C.,gas,existing,none) SEER/EER- 12. Heating system' 12. Type: __ C x k,C (Types:heat pump,elec.strip,natural gas,LP-gas,gas h.p-,room or PTAC, HSPF/COP/AFUE:.- existing.none) 13. Air distribution system" �A a.Backflow damper or single package systems'(Yes/No) 13a. b.Ducts on marriage walls adequately sealed'(Yes/No) 13b. 14. Hot water system: 14. Type: (Types:elec.,natural gas,other,existing,none) EF: Fes{F_ Pertains to manufactured homes with Site-installed components. I trendy ceMtytnal the plans and specifications covered by the calculation are in compliance with Review of plans and specifications covered by this calculation indicates compliance vath the Florida the Florida Energy Code. Energy Code.Before construction is completed.this budding will be inspecled for romphance in ,��1 �,f ' "M ! accordance with Section 553.908.F.SPREPARED BY:� �� '�ZDATE: BUILDING OFFICIAL:---- I FFICIAL:_ _I hereby certify that IITS building 6 in compliance with the Florida Energy Code: OWNER AGENT:_ DATE: DATE:_- FLORIDA BUILDING CODE-BUILDING 13-D.33R City of A-dall-dc rjleach Building Depar-ICroent APPLICAT10i\i NUMBER 300 sefninole Hoad CEIVED (To bpqs.qigned by the BUildirig Departrrieiit)�i o h" Atlantic Beach, Florida 32233-5445 Phone(904) 247,5826 - Fax(00/1)�)-1 APR 02 205 76 7 E-i)iail. building-dept@coab_us Date routed: ;i City web-site http//wvmcoab.tjs 1BY; A PPIUCAMON REV�EW A IND TRACK HMG F00-MiriM/i Pk'opc rky Addrpg_s- Z17 Departmi-e-ni-k review required Yes No in lannina P- Tree A minis razor ubli C /Q S L1 I I u lic Sa ety Fire Services Review fee $ Dept Signature (3ther Agency Review or P er mit_ R7- e q uired Re iew or Receipt e i t pate of Permit Verified py 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 i Reviewing Def.-tatiment First Review: pP ]Denied, (Circle one.) Comment--,: SFS A M7-A, BUILDII',JG PLANNING &ZONING Reviewed by. Cx�'tL__ Date-- TREE ADMIN Second Review: (Approved as reviled enied PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. OlDenied, Comments: Reviewed by: Date: vises 07/27/10 ("Ity oifl_A-flanNc Plezic 11 "milding Deparkr(nent APPLICAT101 6- \1 NUMBER TI Ll (To ba assigned by the Building Department.) 800 Seminole[Road Atlantic Beach, Florida 32233-5445RECEIVED -7& Phone(904)247:5826 Fax(90,11 J47 ;84 E-mad: building-dept@coalb.us APR 0 2 2015 Date routed Al City web-site http//wvmcoab.tp; BY: II APPUCATMOHRE'015 Ab/ W/V 1U) U MAlKNG 11FORM/i Property Addii-pss: A • D e a M review required Yes • 7) Tree A Minis rator--'--' -_4 Ublic Wor El I I /#/,c 7' u liC a ety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Peview or Receipt of Perfterifi By Date Florida Dept. of Environmental Protection - Florida Dept.of Transportation St. Johns River Water Management District — Army Corps of Engineers Division of Hotels andRestaurants Division of Alcoholic Beverages and Tobacco Other APPLICATION STATINSE; Reviewing Department First Review: -Approved V<p"pro nDenied. (Circle one.) 4" ommenis: BUILDING PLANNING &ZONING Reviewed lby:_ Date- TREE ADIVIII,,J. Second Pevievv: DApproved as reviled OlDenied. i 17/OR Comments: T C WOR 1311 UTILITIFS JBI I IDU Llc;�A/E rY Reviewed by.- �C S Date: FIRE SERVICES Third Review: []Approved as revised. OlDenied. ,ornments: Reviewed by: Date: visas W/27110 NvP fiTICE OF COMMENCEMENT State of County of — —Tax Folio No. _ 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 following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: r. Address of property being improved. 7 I General description of improvements: Owner: Address: n , Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: ; Contractor: Address: Telephone No.: Fax No: Surety(if any) Address: _ Amount of Bond$ Telephone 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: Telephone 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)(b),Florida Statues. (Fill in at Owner's option) Name: v_ p Address: o Telephone No: Fax No: E 0 m W WLLo Expiration date of Notice of Commencement(the expiration date is one (1) year from the date of recording unless a different t� m specified): --- --- - '-' E a ---- �T E THIS SPACE FOR RECORDER'S USE ONLY OWNER Q L r x zcn2UE Signed: Date: �1 -/ - ) S� �•°` rQ�g Before me this day of rI_ in the County of Duval i� a Doc#2015084327,OR BK 17131 Page 1780, Of Fl , tasp�ally ap eared 7op� Number Pages: 1 sonal arr [ y Recorded 04115%2015 at 12:32 PM, ro a Ad4iientificati Ronnie Fussell CLERK CIRCUIT COURT DUVAL otary Public: _ COUNTY RECORDING$10.00 My commission ex -