1241 OCEAN BLVD - POOL CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
SWIMMING POOL
MUST CALL BY 4PM FOR NE)CT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-POOL-940
Job Type: SWIMMING POOL/SPA
Description: NEW POOL
Estimated Value: $14,000.00
Issue Date: 6/10/2015
Expiration Date: 1217/2015
PROPERTY ADDRESS:
Address: 1241 OCEAN BLVD
RE Number: 171829-0000
PROPERTY OWNER:
Name: EZELIUS, PER OLOF
Address: 356 10TH ST
GENERAL CONTRACTOR INFORMATION:
Name: PHILLIPS BUILDERS LLC
Address: 1250 SELVA MARINA CIR OA BARBARA CAROLINE
PHILLIPS
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS:
All silt must remain on-site during construction.
POOL - Wellpoint (if used) must discharge into vegetated area 10' minimum from
street or drainage feature (swale, structure or lagoon).
Any roll off container 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.
FEES:
PLAN CHECK FEES $60.00
BUILDING PERMIT FEE $120.00
STATE DCA SURCHARGE $2.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
.s 800 SEMINOLE ROAD
- ...... . ;" ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
STATE DBPR SURCHARGE $2.00
Total Payments: $184.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
t `r CITY OF ATLANTIC BEACH
3 m Building Department
800 Seminole Road
j Atlanti(Be.6,(904)247-5800
-580a32237 FILE COPY
_ (900.)247-5800
Jn �'
PLAN REVIEW COMMENTS
Permit Application # /S' Ao/— 9 y0
Property Address: lr,? y/ drtOn WOO/
Applicant: A216!!S /3&;/&/t/P /-4 c
Project: &f 4/ ))n D rwno/�0poo(
This permit application has been:
Approved C, 10'1
Reviewed and the following items need attention:
S' / :e�✓
S
M ard 4L -f o/ 1-c ) /t a o/r i `ati7�
le rre loot
f
t o inl�r R
ano/ en / / ! uW// ba®M
w ole
S
dr w /
OV r i
Please re-submit your application when these items have been completed.
Reviewed By: Date: y'r7 y 15-
BUILDING PERMIT APPLICATION
FILE COPY CITY OF ATLANTIC BEACH
FA
Q �rJ800 Seminole Road,Atlantic BeachFL32233
Office (904)247-5826 Fax (904)247-5845PR AAV
Job Address: t Z.4-l a C)Fx ro ,(jar Permit N ber:—.
Legal Description Parcel# - Oa
Valuation of Work$ _ oop ea o q, t, q t
Pro osed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Repan Move Demolition poo pa window/door
Uscofexisting/proposed structure(s)(circle one): Commercial esi ntial
If an existing structure,is a fire spnn er system installed?(Circle one)�o N/A
Florida ProductApproval#
For multiple products use pro uct approve arm
Describe in detail the type of work to be performed: I IX I -] Pool
Property Owner Information•
_
city A _
/ Qk &V_ Address: Z_3g- l
Stateazip_ ,jhone�, AgtN�
E-Mail or Fax#(Optional) NCI,
Contractor Information: CONTRACTOR EMAII,ADDRESS:
Company Name: QI-FI(,(1GS i��.�IIS L_LC. Qualifying Agent:
Address: 17 \ 0 SelvLF MQ/1J'Art CA 2 City-A /3 , State 1_Zip z
Office Phone qa4 241-$,I,L9 Job Site/Contact Number 34n -TAQq Fax
State Certification/Registration#S,p,G I Z(-•7 31 �9
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 installation.,as indicated. I certify that no work or installation has commenced prior to the
issuance oja permit and that a!l work will be a armed to meet the standards ofal!laws regulating construction in this jur sdictlart This permit becomes nu!(
and void a work is not commenced thatne a rOormhs, or ifcanstruclion or work is suspended or abandoned jar a yyeriod ofsix//6)months at any time after
work is commenced. o understand that separate permits must be secured for Electrical Work,Plumbing,Signsedfor Wella,Pools,g)months
at any,Healers,
Tonka and Air Conditioners,ere
G TO
WNER:
COMMENCE
MENT ENT MAOY RESULT OUR INTN 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.
Thereby aerfijy that lhavereadand examined thiaa plication and know thesame to be true andconect. A/!provisions oflawsandordinaneesgoverningthis
type q work wit!be en lied with whether sPeci ted herein or not. The granting of permit does not presume to gave authority to violate or tante!the
proviriom ofasry other federal s ale,or loco( w regulating tom n.lion or a performance ofcorrstructioa
Signature ofOwn�� Signature of Contractor
Print Name . ..........L`��....................._.................. Print Name
3.....��......c`.0........ ..................._......._....._.........
_
Be5�i e ��yy rqq�
thi. Day of 20 this CtDay of ^ ' - 20 5
No u
` s JEranFtxwalaR N to r w.. "IReawwan
_ MYCOWdSSI0Nf FF011480 �A ': MYCeM1w11SSI0N0 11180.
EXPIRES:Anil 24,2011 EXPIRES'.hpn124=s 01.26.10
'2;p,;;n?a mm.a mrvsawnwdcdmewd.rs �^aewea mu wury vwv u�a�.nen
/z yi acs a-n FILE COPY
ANSI/ASP-7 2006 Specifies three methods for determining the maximum system'ficw rata.The follovdng
simplified TDH calculeeon is one of the methcd..pecified.
Simokified Total Hvnamic Head(TORI Calculation Worksheet
Determine Maximum System Flow Rate: Minimum Flow Rate Required:35 gpm per skimmer
1. Calculate Pool volume: L15a x 5 x 7.48(gaUcubic fool)= g 3fJ
(rwamxms) (Awnae 1 N bprsws)
2. Determ rie preferred Tumover Time in hours: one/�p,,nx x 60(minutes/hour)= 34 0
T
3. Determine Max Flow Rate:/!g.830 ( 3 b o = +��I = y'7
Naxmernpxompin whit= (Fad Ho.sea.) rate. fm.roel (aM+nnwwel
4. Spa Jets: ---------x --gpn perjet= flow rete.
Murosrarme (ret higher
R4Inthexwm)
(Fix single pump pooyrPa combo,use the highm d No.3 or No,b in Ma flowing ralaAatbrls for th pod d spa)
Determine Pipe Sizes:
iBranch Piping to be A.4' Inch to keep velocity @j 6 fps max.at 1)? gpm Maximum System Flow Rete.
Trunk Piping to be�_inch to keep velocity @ 8 fps max.at /D 3 gpm Maximum System Flow Rate. n �I+'IlI7
Return Piping to be Z inch to keep velocity @10 fps max.at $Z'gpm Maximum System Flow Rete.
Determine Slmdelod TDH' "nl�Llll MAY O6
1. Distance from pod to pump in feet: 3O LJ
2. Friction loss on suction pire)In O inch pipe par 1 ft.®&Zgpm= johorm pipe flowRdceon lose cosi BY
3. Fdctlon loss (in return pipe) in 2 Inch pipe per 1 It @ /O 3gpn= gram pipe floar Mdron lore dreg)
4. Length of suction pipe 0 x ft.of hoad/1 ft of pipe 09=TDH suction pipe
5. Length of return pipe xft.of he"I it of pipe . l b =TDH return pipe `1/. 8
TDH In Piping:
Filter loss in TDH(from fitter date sheet):_>.j
Heater loss in TDH(from heater data sheet):
Total all other loss:
Tobi Simplified TDH: i>S . -.
Selected Purnot and Main Dram Cover.
Z S7atD
Pump selection A)IP using pump save for Simplified TDH&System Flow Rata
mMd ud elm MHweepmb) 99OeiYp
Main Drain Cover c tea. S F e+' byslem Flaw Rete most not exceed approved cover flow rate)
pxwle ens.well
Notes:Minimum system flow based on minimum flow per skimmer l35 gpm.
Determine the Number d Tvoe of Remared In-FIcor Suction Outl is
Check all that apply.
P 3'-0" ® 2 Z suction outlets@ /03 gpm maxfiow(see note 2)
Q •---•• 3_suction outlets @_gpm max.flow(a.note 3)
Q Aquamar Channel Drell®316 gpm max.flow rate
O A&A Channel Drain @217 gpm w/2 pori &278 gpm w/3 ports(see note 4)
L; 191, Verfol mance Pump
Quiet. Efficient. Durable.
The VASP f pun,dolrvs mmazean Ir Al n
dGcmcyazthe eayg mrtaN Mxgneble- Peziormance Curves
k-ed op
fix 6k with rvvmmalriienlmyiic pnkyendary n .z _ „,
�%d"e iedes�n haz ben My dav�3earz for ....0' -L»MS
PeorPFbniwicn hb wardvmore Man 2 million 6r0
Mrtar Purtps haze beai stlN'WdPwf�onak ggppy + -`�—
lo
•:lzxga firaadl'k^dFinrandh�eRamry Rfn � w�
npekrmaanve wak Ikw andeeFidmry
whikm'vemiEny Wrbukiice and nsie.
•�^ePkimt nwtw dvs, m, e+cialgade frann,
i aa�xwfsdiN¢a Seel dwR,and Pe"+nanently
IUlximrW sexed bavings Mrbng Vfe. ' ` ti w i.
•MzUble in sngk.speed and iwo spe�modds a to _..n.,.•.r.. 'o a
pva
•Idealfcrpoolandspacnml,a andf Available from: m
o0'ng n-0oor deaning systvaas,
•aneF r,f"ukd w"r'neE Sesv -My Porde k
NAMPM�
Rw/PmdUct,.
Bvcavro radedliry mal&rs nns(®
"K"ttiPe^ra4Pedmnt
Rmna9pie31-]I33
pin+p= fllws heaters:haf pwnps/azlNmatlon'li r
aww<swzzz 8 !�8 dmners�smlmec;warcr f®turxrnwimnwicepird
(nl.(p.QRommam:wa.rowwwaa.rmm.,...._;
T0H CaWaflaa 0 tins Total Had In Feat Ctlnvanlon Chart
Fa each pump
Nlchs asulan
I- Cnedl erne0 R 4 8 12 14 16 10
♦n 0 0.0 2.9 4b 8.8 Al9. 11.3 13.0 1&8 1&1 209
pip &mpMFed Total OvnanC Head fSTDH1 1 2.3 4.8 &8 8.1 11.4 13.6 16.9 1&1 M.4 227
Complete MH Wakaheet-FJI N aO 2 4.8 6A 8.1 11.4 13.7 15.9 18.2 20A 22.7 26.0
bknks 3 6.9 92 /1S 13.7 16.0 182 20.5 228 2&0 27.9
Td&DwwmN Head 1TOH1 4 9.2 11.5 1&0 1&0 18.3 20b 22.8 25.1 27.3 29A
O Cma*te Program a other mks.F61 5 11.6 13A 18.1 18.3 20.8 2T.8 25.1 2].d 29.8 31.p
N required blanks waksheat8 8 13A 18.1 i8A 20A 2Z.9 26.2 2],4 29.7 31A 31.2
.Inched cakdetlon¢. 7 162 18A 20.7 MAD 262 27.5 29.7 32.0 34.3 3&5
8 18.6 20.7 2&0 259 27.6 R9.8 Wo 34A 3&8 9&8
9 20.8 29.1 269 T1.6 2&6 321 94.3 3&8 3&9 41.1
10 23.1 25.4 T7A 29.8 32.1 94.1 90.7 38.8 41.2 434
11 25A 27.7 28.9 32.2 34.5 3&7 39.0 412 43.5 4&8
12 27.7 90.0 322 34.5 36.8 39.0 41.3 43.6 46.8 48.1
13 30.0 92.3 34.5 38.8 99.1 d1.9 438 45A /&1 SOA
Notes. 13
92.9 30.8 38.9 39.1 41A d3A 4&9 482 1 M41 527
I. #a vadaWe speed pump b used,use the 15 91.8 36.8 382 41A 0.9.] 45.8 4&2 50.6 S2.] 6&0
18 37A 392 41.5 43.7 46.0 48.3 SDS 528 55.0 57.3
mammum pump ffow mlmWtions. 17 38.3 41.5 43.8 46.1 4&3 50.6 528 56.1 I 51A 1 $9.6
2. Fa side a6 draln%use appmpdme aide 18 41A 43A 4&1 16.1 50.6 52.9 65.1 5]A 1 59.] 8
wap dmN Oow as puHlalled by tin 10 49.8 18.2 46.4 60.7 62B 552 57A S&7 02.0 84.81.2
20 46.2 18.6 50.7 53.0 65.2 157.6 69.8 82.0 642 88.5
menmedumr. 21 48.5 6&6 59.0 56.9 87.6 59.8 82.1 64.9 86.6 6&8
& Intl Va,mmahulaafa name and 22 SOA 59.1 659 57.0 59.9 62.1 60.4 MA 68.9 71.2
approved maximum flow. 23153.1 SSA 67.76B.B 822 64.d 66.7 BBA 712 '73.6
4. See Inme9ation Nstiactions for number a( 24 55.4 61.7 80.0 B2.6 61.5 BB.] No 71.3 73.6 76A
25 67.8 60.0 623 64.5 68.6 69.1 71.3 79.8 7&8 78.0
pats to be used. ZB 60,1 829 BIb BBA 89.1 71A 13.6 7&9 78.1 WAS
S. laB auction oust mva/Orate mam 27 WA 8/A 8&B W2 71A 73.7 ]69 782 90.6 82.]
can/am to mom recent edxanm 20 81.7 B&B 692 71b 73.7 78.0 782 60.6 628 85.0
29 dA 69.3 ]1.5 7&8 7&0 78.9 BOb 823 B&1 8].9
ASMF MSI A112.12.8 and be embossed 30 6B.3 71.8 73.8 76.1 7&3 80.8 82.9 66.1 WA 89.6
WN mm adman epprevm. 91 71.6 78.9 ]e.t 7&1 80.7 829 86.2 WA W.7 920
6. Pump 8 Hoer make,model and Ncadon can 32 73.9 782 78.4 80.7 83.1 8&2 87.5 M.7 02.0 90.3
33 76.2 7&5 80.7 83.0 85.3 87.6 89.8 020 94.3 9&6
not change w out subm86ng revised plans 34 78.5 60.8 83.1 86.3 87.8 88.8 92.1 94A 96.6 MA
mH TDH wolkstreet 35 80.9 83.1 85A 87.6 89.9 822 84.4 98.7 08.9 101.2
Flow and Milan tea Par Foot Swimming Pool Spedfir23tion for:
Shcedub 40 PVC X
VMtty-FM Per9xnq
pt. 64 Bbs 10aa
1' 18 pm UT Ytpm 0.5Y E6 aqn 0&'
19 vwan 0.16' mpm 0.25' ¢f gpm OG9'
r ezwa 0,1T 62apm B.zs1a9 n..,, Job Address:/
2T a50Fm am 1179xn 0.15' Ibam
T 1M9pn am 181gm 0.11' wg7 023'
4' IN Ban Ow 3110 010 302wm 0.15 permit#
r 591 O0rn Ba• r1z9Fm O.Iw Bmapm o.f9
4> PENTAIR
STARGUARDr MAIN DRAINS
_ StarGuard dreins comply nilh provisions Pentalre StarGuard drains haw an
•"• of the ANSI/A SP 16-WI1 standaM as industry leading 15.35 square inches of
- requlredbythe Wlginia OPmnrs8aker open area for water Rare,If you are in an
• Pool&SO.Safety Act. areawhemeodervatockythmugh the
High quality StarGuard drains ere grate is limited to 1.5 feet/sewnd,the
available in white,black gray. dark Star-Gu2fd Carers allow how rates up to
- a4gappp0gray as well as a variety of configurations haw op naeasun a competitors
to fit arty residential ingmund pool or haw open areas under9 square inches
spa installation.Rawas the specifications thatwouN limit flaw to under 62 GPM.
to find the right StarGuard drain model
for your application
WE I'mI
SyolOp 8 5 rGueM[ IM1l 9Po 9'BUCF 7N �SOa1N a 5 ti i 1 L gfl g-Oar:Gor500is A 5 AuaNC 1hL gRlnq�Gray BralyaMlmW'so 8 A GuerEL hL gPing�WM1 a
50161 8"Ssm,aNCovar.d Lang Ping-Blad QaacFl
501110 A'SlarOuaN C—on Long R.ag-naM1 Gray 12 F.,al
51 8-StarGuard Caeer wuh Lang 11 @PssFI
5',gIW 0 s'.Gard[ h5�. Pby-glad ISingle!
5ra105 8'Sa aN th Shri Ring-Dark Gray ISnglel
SM106 BSI OarJC Sh Rnq-Gray IS nylel hauppp�rvr
9b1at a-"alai r-1 wnM1 S^on Rm9AO1m 12 a
500165 8"sbrGuard Cwv with Shotl Rlry-Bork 12 Pock
500166 8"SurOuaN Cover xrN Short Rory-Dark Grry 12 Pacxl
Wo A"sari Cov w1l SM1on or,Gray 12 Pace
pentairpoobeom
I
STARGUARU MAIN DRAINS
SAFETY TIPS Continued
Selecting Proper Drain Covers • Backup system Requirements—Suction piping ler each pump
Each pump will operate ar a different Ram rate depending on the must be inspected and wit be considered in compliance with the
system and assigned jobs,i.e.filtering,heating.cleaning,size lets. federal law if: no submerged drains connect to the pump.or 21
waterfatls,etc.Once this is understood.the proper suction system multiple drains or svdion outlets are at least three 131 Fee,
anbetlesignetl and installed Here arc some vl the design issues apart.or3)them is a single-unMockable"drain.An mlitackable
cant must be considered. drain includes a sump under the corer that is larger than 18
inches by 23 inches,ora channel type drain with a diagonal
• Maximum system Rom open area of at least 39 inches.
• Drain corers must be rated to handle the maximum system flow, Single-antl two-tlrain systems that fait to meet the listed
• Dual-drain and multiple-drain system branch piping must be requirements must be..cities by adding:11 Se"Vamum
sized to keep walereeinuty below 6 feet per second when Release System l$vBSI.JI Suction-Limiting Vent System,31 Gravity
operating at maximum system Row.Branch piping is the suction Dreir.ge System,A)Automatic Pump ShwOX System.51 Drain
pipe between drains.not the pipe leading back to the pump. Disablement,or 61 Other Systems determined by Consumer
Product Safety Commission to be equally ellectue.Another option
•The form and sump under the drain corer or a field built sump is to split the single drain into a dual-drain system with at least
mut be included or noted in Ne cover manufzdurers instructions. feel of separation using pmpedy sized branch piping.
• Oram wars must be attached using the original manufacturers Codes and Standards
hardware,including mounting frames,sumps,and Ratings.
• Con.[mnand motto.avers,frames,and sumps.Only instill All public pods,spas and wading pouts must comply win the
.amoA frames.sumps.or fiddbuilt sump designs that how Yryinia Gneme Baker Act.in addition,manystsle3.cades
been codified nationally 'ed testing laboratory resentmentsmay
applemoreennal and p.rcments,spas and by yrecogmz . rY+s standards ,These me residential MSVAicpods tion and
being compatible with that specific drain tracer' wading pools These me facts lheANSUAPSPJsucbon
ymc
The Virginia Graeme Baker Pool&Spa Safety Act Entrapment Avoidance Standard,the International Cade Council's
building codes(which adopt the International Building Code and
o[2007—Summary International Residential Code]and other codes and standards.Be
This federal law was enacted to help preant suction entrapment sum to consult your slate and local building and health modes and
injuries and became effective December 19,3008.The requirements standards for more information.
for public worming pads spas,and wading pools are summarized
below and must be met before these facilities can be operated. FOR MORE INFORMATION ABOUT;
• Drain Cover Rewiremenle—New dram covers.Leaders , • Pentab safety and compllanu products,
frames and sumps unified to ASME/Abi At 1E.19.8-3007 visit wmw.pencairp.ol.com.
must be installed •Yryinia Gramme Baker Pool and Spa Safety An.
muCamwcpeegov.
• ICC codes.wain wcw.ic<sal,it,
•ANSI/APSP-7 Suction Entrapment Avoidance Standard,
visit:mamapsp.oM.
PENTAIR
1$n.11 .aswvc,sswrpao.ncnsc scala. wwwrm^uanoot.cou.
tl,P:.r 'e nr Tr.LcS G ,InO.rr -a n..aa n:e nl5p•. •nLmm
F U a unW a esus un.weu./rap, p P<ts ay.rery G reaves vgeska In.ma
4ll qn anb]si OJnlSvn:c<::n¢ar:.v.•: .�...en mf
SECTIONIV. TECWdCAL DATA
A. Fuer Pre3mve Loos ChW 8. FIo RMa Tabk
mrlwerawYrew —'
�m�Cwfibpr
Commyy
nmu• .aa arY Y1f rr rr w aax rr ,r
I, nose m m asor ropro slam ' 1r i,im e,ew alm
�, 10116 x x I9y mpm YpA s I,W I4(m IaW
x018 Im Iw qm] Rpb
IOII fw a� x4110 Y }y I;m 1yx
Iw 6\OY )0114 Y atm RIm .y®
Y1ox mo 1w rom slam lrsm x rem mrm Rme
(Il 0.e OPYav Y 6 yanM,swAd bm.s b mbm'J i f 0Y w w M1
O7 emmm412m�4rmlmq Y3]3 QmWmam1Y..,,, �
iMt A,Y,Immw 6wwlb44'rmpinphatlmml Mvmm��
C. Repleremefl6Pa 2
7
' Mesl PMNmbY DespyNas
2 IE7�w�manudtlr tFMvrlve 3,4
3 1759 Uq 50.100x0 Blrr
4 178MI 116,75,152200p.ft0.1x
6 MUM amu'�'.
7 59018200 71'61re63akq
6 50 CYb1Cps,50ey0.W.
B 599[63600MD0 CYW CYa 754a0.2`r 8
10 526 CMr CYa 760 p.Alb _�
12 8173213 Cmew Care,750,200p.2MY
12 2179213 Cwbip6 E6mft 50 p.2 Mw
14 2179274 C bi*Eb .A to s ft M 8,9,10,it
74 RIMRIMIS CYhk2e El6xm1,1008xft M.
15 27]9216 Cadmpr Flan km,,,ft12w
16 17M Cere, Ebmm0.200 p.ft8ter 12,19,14,15,78
17 1765@ 6p=,M%kff.
18 17Be8wn,75 Bryft81er B17,18,19,20
a 17778589 Bd Kp.ft
20 6580 db1n,150,200 p,.ft ft fiper 21.22
61002000 DY Cap Apy.
V
22 51005000 UN
299707500 nWVR,
244 A6TtYN0 Uri* W CYp
m NX 2
zs m1426 ul:mamp �I O
zfi 793o66m aox7,9�,d
2
2ev.0 o-zeC9 7
PM 1>B566
i
City of Atlantic Beach APPLIC=Department)
Building Department (To be asst ned b800 Seminole Road ��Atlantic beach, Florida 322335445� Phone(804)247-5826 Fax(904)247-5645.,, 1�: E-mail: building-dept@coab.us Date routed:
-- Cilyweb-site: httr/lvv vcoab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:
1l 2.�1 I a.Cu✓��61 Vd . De rtmeat review required Yes No
1 `11 D5 'ld er'� u� WSewices
qjl
Applicant: oni
t, �C 1 I�I strator
Project: N�/�^' �
s
Review fee $ Dept Signature
Other Agency Reviewor Permit Required Review or Receipt Date
of Permit Verified B
Flodda Dept of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Anny Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
APPLICATION STATUS
Reviewing Department First Review: ]Approved. ❑Denied.
(Circle one.) Comments:
BUILDING /
PLANNING&ZONING Reviewed by: . z &I /l— Date: Y
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07127110
City of Atlantic Beach }�� APPLICALbe
MBER
Building Department — `�CEI�i`D (To be asci nod byg Department)
800 Seminole Road Al I
Atlantic Beach,Florida 3223&544 41-1
Phone(904)247-5826 Fax(904 247-5845 R 2 3 2�I5
� E-mail: building-dept@wab.us BYC I Date routed: ' 5
Cityweb-site: http//w .coab.us �l
APPLICATION REVIEW AND TRACKING FORM
Property Address: I2."I I C'L,CUY� �I \/d De rtment review required Yes No
Applicant: I L L I n� Ut.U'Ld e�S LLL Planni &Zoni
Tree inistrator
Project: _ NJ X501 - orks
Public Utilities
Public Safety
Fire Services
Review fee $ Z<— Dept Signature `ic+" l
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept of Environmental Protection
Flonda Dept.of Transportation
SL Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division W Alcoholic Beverages and Tobacco
Other.
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: �- �" Date: Y ZY
TR ADMIN. second Review:
❑Approved as revised. []Denied.
ICOR Comments:
U C IWTIIEESS
P BLC APEYY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
aevlsoe onnno '.
City of Atlantic BeachRECEIVED APPLICATION NUMBER
Building Department (Tobe assigned b the Building Department.)
800 Seminole Road APR Q ,� 2015 )
Atlantic Beach, Florida 322335445 (�� `yQ
Phone(904)247-5826 Fax(904) �2
E-mail: building-dept@cosb.us _ - Date routed:
-- City web-site: http://wvw.coab us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 12."1 I Ctf(An 131 Vol . De rtment review re wired Yes No
�'1 l l i ns uua'ld els U.C� °" "
Applicant: Planhin &Zoni
N'(��� I�I Tree i mks Project: N C arks
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature -
Other Agency RandResaurn
Permit Required Review
of Pe' V\\
Florida Dept.of Enl Protection - r'
Florida Dept.of Tra \�
SL Johns River Wament District
Anny Corps of EngT/) t`►�Y,�.
Divsion of Hotels aantsDivision of Alcoholis and Tobacco
Other:
APPLI ATION STATUS
Reviewing Department First Review: HApprmed. ❑Denied.
(Circle one.) Comments:
SGE rQ +�R�
BUILDING
PLANNING&ZONING Reviewed by: £ Date: 'tom +4 /
TREE ADMIN. Second Review:
❑Approved as revised. HDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Dale:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by Date:
Revised 07=10
I
BUILDING PERMIT APPLICATION
CITY OF ATLANTICBEACH Q d [ D
800 Seminole Road,Atlantic Beach, FL 32
Office (904)247-5826 Fax(904)247-5 APR 21
Job Address: L Z.41 O C-Fri/ 131 Pe
rl
Legal Description Parcel#
Valuation of Work$ 14�Oi)D — Proposed Work heated/cooled t
non-heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition(poo pa window/door
Use of esisting/propused structur (s)(circle one): Commercial est ennal
If an existing structure,is a fire sprinkler system installed?(Circle oue): Ve o N/A
Florida ProductApproval#
For multiple products use pro uM approve orm
Describe in detail the type of work to be performed: X 1 -7 Pool
I'mverty Owner Information,
Name: �C� 1�b41,�Id.Qs Address:_ l 2—` 1 O
city (,(�'AI✓
StateFf Zip 27.1 Phone_?Q-q - ZQgOI
E-Mail or Fax#(Optional) Du,It-apl
Contractor Information: - CONTRACTOR EMAIL ADDRESS:
Company Name: >Pf41(,(IAS Vi b1irC `1,G QualifyAgent:
Address: 'p v4 &W4WA 0(Z., City.AX
, State Zip Z
Office Phone�j n4 24 L 1.L9 Job%teJ ContAcr tq�,nber
State Certification/Registration#--Cl, 1 Z.1�") 31 q
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company.Name and Address
Mortgage Lender Name and Address
4pplissuance
on is hereby made to obtain a permit a do the work and instal(aliom as indicated. I certify that no work or installation has commenced prior to the
issuanceof worlds not commence withrk illbeperjormed fa mee[the standards ofall laws regulating construction in thfsjurudiction. This permit becomes null
aMvoi
commenced work is not cammencedwithin six(6)months, or#'am strucdon or work is suspended or abandoned jar a__pperiod ofsis/6)months at any time agger
work is commenced. 7 understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Watt,Pauls,Furnaces,Bailers,Heaters,
Tanks and.Alr Candahmen,etc
CEMETAPTINCCEFPVCOMMENNTMY RESULTINOUR FAILURE
TWOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT,
T hereby certify thatlhwe readaMexamfned tlus''appplicati�n and know the same to be true andcorrec[ Allprovuians oflaws and ordinawas governing this
type work will be compiled with whether sPec)red herein or not. The granting of a permit does no!presume to give authority la violate or col the
provisions ojarry otherj¢dera(s ete, or luta! w regulating cons ion or a performance afcanrtrucfion.
Signature of Ow��Jn//e '^ ''L'� Signatare of Contractor
Beffypg���e Befpprr����� .....
]ris/%y Day of I 20 5 thisll`-�ay of , (
201S
Vo u 'Nil t
d ERWmnA ,,.. PENWNIIEn
.p WCOMMSSIONf FF0f 1987 +:' "., MY CpAMI5510NYff Qp�t148],
'r EXPIRES:ARM 24.201] ` '� E%PIR ES:AptlI 24,at8Vis 01,26.10
ea,x4mnwunrlei2uoeer«me�e '*2,a:h�' eomeimv uaunwaeumer.,rn
_ _
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 tic Seminole Road c Lq 0
Atlantic Beach, Florida - Fax(445 IT P00 L
Phone(904)247-5826 � Fax(904)247-58451 I- �f
•...1";;01/ E-mail: building-dept@coeb.us Date routed L G� 5
- Cityweb-site: hfp://w ..mab.us
APPLICATION REVIEW AND TRACKING FORM
"1
Property Address: I2I Cr—C(AY) 61 Vd . De rtmant review required Yes o
Ph 1 111,05 adld evs U� nil
Applicant: Planhin &Zoni
r4 Te imstrator
Project: N {��� l recrks
—T Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept.of Environmental Protection
Flonda Dept.of Transportation
St.Johns River Water Management District
Any Caps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: L'�Proved. ❑Denied.
(Circle one.) Comments: r
BUILDIN NL e-A ry (W e" //
PLANNING R ZONING 6 b
Reviewed by: Date: C
TREEADMIN. Second Review:
❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
R e407/37110