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395 12TH ST - PERMIT r ''- "�S, CITY OF ATLANTIC BEACH -• J 800 SEMINOLE ROAD J \ r ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 \JS.{lc SINGLE FAMILY DWELLING NEW MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-SFR-1250 Job Type: SINGLE FAMILY RESIDENCE Description: NEW SINGLE FAMILY HOME Estimated Value: $479,500.00 Issue Date: 6/23/2016 Expiration Date: 12/20/2016 PROPERTY ADDRESS: Address: 395 12TH ST RE Number: 171922-0000 GENERAL CONTRACTOR INFORMATION: Name: MATHIEU BUILDERS Address: 1778 OCEAN GROVE DR QA DUSTIN MATHIEU BROWN Phone: - - PERMIT INFORMATION: FEES: UTIL REV RESIDENTIAL BLDG $50.00 WATER CROSS CONNECTION $50.00 BUILDING PERMIT FEE $1,618.50 ENG REV RESIDENTIAL BLD $100.00 PLAN CHECK FEES $809.25 STATE DBPR SURCHARGE $24.28 Total Payments: $2,652.03 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 1-tvy;.1J, City of Atlantic Beach APPLICATION NUMBER i ,-*Alt, Building Department (To be assigned by the Building Department.) �'= 800 Seminole Road 1 ,,. — ,— I ZSO �.- �r Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 --"!orou'r E-mail: building-dept@coab.us Date routed: Co 1 t ( 1G City web-site: http:l/www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: . $315 'z --c- Department review required Yes No �..a,d,din� Applicant: 1\AFk"T j41 E 0 eult... bea2.......S (ianning &Zoning] Tree Administrator � Project: N _ i. • 'ublic o 'ublic Utilities '•• aety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date . of Permit Verified By 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: i APPLICATION STATUS Reviewing Department First Review: ,Approved. ❑Denied. I (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by....." --, L ' - Date: il.//i` 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 05/14/09 s�a�y; City of Atlantic Beach APPLICATION NUMBER c?rte. ��, Building Department • ,,� (To be assigned by the Building Department.) J,f,- -,.pg ,J4 800 Seminole Road ICY—SF-R.'. `Z S O Atlantic Beach, Florida 32233-5445 r . Phone(904)247-5826 • Fax(904)247-5845 L\0;tl9E-mail: building-dept@coab.us Date routed: ( 1G City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ' (715 FZ ' T Department review required Yes No Applicant: MAI'>t1E U V I L DE(�S ` lanning &Zonings-) Tree Administrator Project: 'V _ N _ �4. -ublico 'ublic Uti i ies —Pubttt ety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By 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: roved. ❑Denied. (Circle one. Comments: BUILDING PLANNING &ZONING ���/G Reviewed by: Date: TREE ADMIN. Second Review: ['Approved as revised. ❑ ied. 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 RECEIVED i! �`/- City of Atlantic Beach APPLICATION NUMBER :l' . 1-1, Building Department JIU�� 0 1 2616 (To be assigned by the Building Department.) t rrf 1 v 800 Seminole Road ,rv,_.� .•4. `V...s, ICO--S� Z 72)W • �•• Atlantic Beach, Florida 32233-5445 BY. — cj \ Phone(904)247-5826 • Fax(904)24 - ;• ----_.�. _� wou',- E-mail: building-dept@coab.us Date routed: G it j I Cp City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 L S 12- 'T Department review required Yes No di Applicant: Mp - F+ec u e Wt..t•,(JE aS Manning &Zonin� Tree Administrator Project: J V _ K..1 _ -u• lc no ' - �'ublic Utilitie> 'i• aety . Fire Services Review fee $ 9-0 Dept Signature X- Other Agency Review or Permit Required Review or Receipt Date • of Permit Verified By 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: I Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING /Reviewed by: - i, t✓ri� � Date: 71.//.L TREE ADMIN. Second Review: OApproved as revised. ❑Denied. PFJ ' WORKS Com encs: 'UB C UTILITIES P LIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. EDenied. Comments: 111 Reviewed by: Date: Revised 05/14/09 >n,/„ City of Atlantic Beach REC VE - - APPLICATION NUMBER r i%• , Building Department (To be assigned by the Building Department.) .,so Jr,•i 800 Seminole Road JUN 01 2016 �j� C p Mfr:,ti;^:,_ 1 .s, I V F z 15, - -_ • ;, Atlantic Beach, Florida 32233-5445 I\.' S o \, : • Phone(904)247-5826 • Fax(904)24 X1139%- E-mail: building-dept@coab.us Date routed: G. I t ( 1G City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: . 1315 1_ — ' ' T Department review required Yes No r ildi Applicant: M A1-I41 E U U 1 L b E laS .fanning &Zonings-) t� \ Tree Administrator Project: 'V _ N _ �• -u.lic o • 'ublic Utilities •• aety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By 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: ['Approved. Denied. (Circle one.) Comments: SLlGG 1 / W*VA BUILDING PLANNING &ZONING Reviewed by:,1,64/W , �,4, Date: 6 -/-46 TREE ADMIN. Second Review: A roved as revised. I+rylpp ['Denied. PUBLIC WORKS Comments: -46t *,,,J,„/ 6,,,,a PUBLIC UTILITIES // PUBLIC SAFETY Reviewed by: Date: 6�i6A FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 05/14/09 MAP SHOWING SURVEY OF THE SOUTHERLY 30.00 FEET OF LOT 40 AND ALL OF LOT 41, BLOCK 1, SELVA MARINA UNIT No 1 AS RECORDED IN PLAT BOOK 23, PAGE 4, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. w LOT 39 "' o I pN- ----______ S88'34'34"E__ 118_90__ I OWN - _-�-- Z 91 O OD 0 'I w 1 0 1p20 410 1 I 1 N 1 SCALE: 1" = 20' I m I I LOT 40 t1 1 EXCEPT THE o1 SOUTHERLY 30.00 w l to AE I 11 r o 1 m A'! 1.... 11t , O % 1J 11111R�,}sFSr 0,4.83. (1...,190:E.: 20.16' N63'x g „ 120.16' FIELD) f •�- c6- LUGUS ti2•bi.:..:::'. 19"E �20.00 L.. 11 N83 42' •E Y5. 8-12• -r::....,. TIN m .1...a.10:::;• :'::•i: ••: O! FENCE ___ 0.3 HOLLY CLUSTER :^ a§;..: `,;•i:•:: 6- � x161 I CJ ; ::::,..::::.::::::::::::::::::::.::.::q, ::::::::O i...., O ' • 4.2 c� I :. 05 O Z E •5 .. 00) it •::-C ii:•:ii •14"HAGNOUA LOT _ p Ot .,...D I _�---- LOT 41 p ni `� __ - w •• •'..::;.: 04.-.....:::.: :;:i•:. Z \ Ili 24•SYCAMORE ':•:•15.•::,,,,,CD �:: p '::•:•'i:•:C7 10 Z� 145 o 1 r }}}. ?l c f 6 0 p �` O s x19 0 0 p WATER ::r ':i.`?, 0 te� - - p ,I57P ?::ce:ia.r.:::::::.c:: L 16.3 ;:16 4 m O •::•::':.:;C'Lti T•: :: •i::•i:•::.> c WATER FLOi� Z FAUCET p •::;:::'••'':tt•:.:�:::::::::•: tom• p 6'WOOD.. - •1 3'MAGNOLIA ,mj, 4T ��X 5gg 0.2' O m Qi o� (pir=" :o •'55 .i2`j7l; i::;i ;:ii?iii}::}:•. •12-PALM 0 'T3. FIRE Ox16 4 x15. 9 HYDRANT - 186 A RESTRICTION U` 24'18'3a•LIVE OAK CLUSTER n'-VV • ::.::::.:::..::. - 25'BUIl01NG RESY• �, J1 •: ST:,: :i:•:i:: .) 0.104 � pyo` ::::::::::::::::::::://:f.':::,::•:.:.:::::::::::::::. 3"PAUL 18•UVE OAK i53 !� n �•11-.0e'401;\ •::i:::C.:•i:SY:::::.:�::::.�:::: 12'&14'PALM 14'PALM 4. OC-Y Gf��1+j'!�� :::•:.::::i�i::4••:•i• •i:•::•:i• 16 CAMPHOR 0�•14•LIVE 0 • G` ' _p c.f ,v .i2,9. :�j ':ilk.::;f:: • 022'CAMPHOR )05.0 15. 14•PALM ft- O' FOUND i/2"P •12•PALM FOUND i/2•IRON 6. Ary. PIPE.NO Y T f ` .:•:::::::•:•::•i::;:i•i:•i::i::•ii:•i:•::•i:•::•i;;i;;2:i: „ 90.00 PIPE.NO CAP OF PAVEMENT...,....::::.....::•:: 19 4.4' NOUT11WE5 O ‘5.5 x 14. t EDGE :•i:::•::•:::•:::•i•i': :��::•:::•:::•il •:•i:�•••:•::••:•!i'::::•:::•:•ii:•: -- �4�L n0 W • FIELD ..........................::::::::::::::::::::::::::•;::::;•::::::.,.......:.::.:•:•:::•:::..-..:• ::::::;•::•:; :••• •:•::• :2.60::•:•:,E: 51'22 W 90.18 ...• .............................. ................. _� FOUND 1/2•IRON $83 .........:::::::..:::: :ii::::::' 55':•:i•::i:ii:i:::i:•i:::::• ;:•: ....... :•:•i:i:•:i :::::::............. •:i}.!"_•"vrc: ::I15: ::•:•i:::? PIPE.NO CAP ........................:............. . T %siri:::: :•i:•i:•:::::•i:•is i:•:isi:••::::::•i::•::•i::•::•t::•i: .................................................... .......................................................... :;::.;;A:::::::::::..:::.::•.....:::::::::::::•::•::.:::::::::::::::•:.:.::'::.:::;: 11 BUC ROA....:•i:•:::::::::.::::.:'::::::•:::::::.::.:::::: ::.:.:•:::::::•::::: PAVED P�::::::• •::• ::•::::.::::. ::• ::.:::.::.: ::. ::.�:::::.- •• :::•::•::......�::::::.�:::::•::•:.:.::::::::.�::.�::::•::::::.�.............. .........::.:::::: F WAY.......:.......:::::::::::::::::::::::::::.�.�:::._::.:::::::::i:i:::ii::ii::�:i::�:•:iiiitt:�ii::ii:i:i'..:**.'..:.- '•':::::::::- ::::. 11.x:::::::::::............................. ....:.�. .::..::::::•::::.�:::.�:.:�::::.�. T 0 ....................................................................................................... ... ...40 RIGH......�:::.�::•;:•::•::•::•::::•::•::•::•::•:::•::::•::::::::::::::::::::::::•::•:::::.:�:.:�:.�........................................... .. •:•�::::::::: :•::.........::•�.-�""•r"•.'.: :�•::::•iii:•: :• ii::•::�:::.......:::::::::::.�.�::::•:::•:::::::...............:::::::•::::::::::::::::•::: ....... •i:i:•ii:•iii::::::•:::•i::•:is :•i::•ii:•:::•::::•i:•:::•i:i•:i:•:•i•ii:•ii:::i::•i:•iso •::•::•is•::•i :::::::::•ii:: • i:•::•iii?: .....1' ................................. .............................. ............... NOTES: .............. 1. THIS IS A BOUNDARY, TOPOGRAPHIC AND TREE SURVEY. 2. BEARINGS BASED ON THE WESTERLY PROPERTY LINE BEING N0618.00"W AS PER PLAT. 3. BUILDING RESTRICTION UNES AS PER PLAT. THIS SURVEY WAS MADE FOR THE BENEFIT OF 4. BENCHMARK USED: FOUND NAIL AND DISK IN 12" PALM NORTHWEST INTERSECTION OF AFAB VENTURE LLC; THE LAW OFFICES OF ROD 12TH STREET AND EAST COAST DRIVE (ELEVATION 12.70' - NAVD 88). SCHLOTH, P.A.; AND OLD REPUBLIC NATIONAL 5. SITE BENCH MARK: AS SHOWN ON SURVEY. TITLE INSURANCE COMPANY. 5. CH = CHORD. THE PROPERTY SHOWN HEREON APPEARS TO UE IN FLOOD ZONE "X" (AREA OUTSIDE THE 0.2% ANNUAL CHANCE FLOODPLAIN) AS WELL AS 1 CAN BE DETERMINED FROM THE FLOOD INSURANCE RATE MAP - NUMBER 12031C0409H, REVISED JUNE 3, 2013 FOR DUVAL COUNTY, FLORIDA. "NOT VAUD WITHOUT THE SIGNATURE AND DONATWRICHT, P.S.M. THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA UC. SURVEYOR and MAPPER No. LS 3295 LICENSED SURVEYOR AND MAPPER." ADDED TOPOGRAPHIC AND TREE-JANUARY 27,2018 FLORIDA LIC. SURVEYING dt MAPPING BUSINESS No. LB 3672 REVISED TO SHOW FENCE-DECEMBER 1. 2015 CHECKED BY: BOATWRIGHT LAND SURVEYORS, INC. DA OBER 26, 2015 DRAWN BY: JAH FILE: 2016-0084 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF 1 2015-1329 P P �S ,;1rL`I J s , CITY OF ATLANTIC BEACH ' - r PUBLIC UTILITIES 1200 Sandpiper Lane ATLANTIC BEACH,FL 32233 r4 0111>r (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: 7-/-/e, Project Address: 39, - /Z ? 577ETT No. of Units: I Commercial Residential ✓ Multi-Family ,1 New Water Tap(s)& Meter(s) Meter Size(s) 3/q New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaim Water Meter Size New Connection to City Sewer Name: Applicant Address: City: State: Zip Phone Number: Cell Number: Email Address Fax: Signature: (Applicant) CITY STAFF USE ONLY Application# /b- 5F# - I ZSa Water System Development Charge $ a✓/fid f.l-aol'ilkF�-r- - Sewer System Development Charge $ .er- No SSC 1 Water Meter Only $ Reclaim Meter Only $ Water Meter Tap $ (notes) Sewer Tap $ Cross Connection $ sr, DO Other $ TOTAL $ .Sb. OD APPROVED: Kayle Moore, PE (Deputy PW Director or Author' ed Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED 0 L.1-\1-P.r., CITY OF ATLANTIC BEACH LI DEPARTMENT OF PUBLIC WORKS eil1 r 1200 Sandpiper Lane n �. 7sAtlantic Beach,FL 32233-4318 0 TELEPHONE:(904)247-5834 15 77 FAX:(904)247-5843 www.coab.us P4 01119 CONTRACTOR: DATE: 6-2-16 Mathieu Builders PERMIT# 16-SFR-1250 38 W.9'h Street r ADDRESS: 1738 Selva Marina Drive Atlantic Beach,FL 32233 l t�'r0 Atlantic Beach,FL 32233 /-e,AA/a4:. Email: dustin@;mathieubuilders.com PERMIT APPLICATION FOR NEW INGLE FAMILY HOME Your permit application has been by the Public Works Department for the reasons listed below. Please submit this information at your earliest convenience in order that we may approve your application. If you have any questions,please contact Scott Williams, Deputy Public Works Director at 904-247-5834 or email swilliams@coab.us. PUBLIC WORKS CORRECTION ITEMS: (Submit the following information to the Public Works Department) **Provide drainage plans showing site topography(flow arrows,etc.) **Need detailed plans showing proposed water retention (approximately 1,350 I/f) **Section 24-66(b) of the Land Development Regulations requires on-site storage for increased run-off if adding 400 SF or more impervious surface. Provide Delta volume calculations and on-site retention required per Section 24-66(b). **Show detailed plans of how water runoff gets to retention area and then to street. **All runoff must remain on-site. Cannot raise lot elevation without measures to retain runoff. **Provide a pre-construction topographic survey prepared by a Florida Licensed Professional Land Surveyor, showing 1' contours. PUBLIC WORKS CONDITIONS OF APPROVAL: (The following comments will be printed on your permit as Conditions of Approval) **All concrete driveway aprons must be 5" thick,4000 psi, with fibermesh from the edge of pavement to the property line. Reinforcing rods or mesh area not allowed in the right-of-way. **Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact Public Works(247-5834)for Erosion and Sediment Control Inspection prior to start of construction. **All silt must remain on-site during construction. **If on-site storage is required, a post construction topographic survey documenting proper construction will be required. **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,Shapell's,Sunshine Recycling and Waste Pro). **Full right-of-wayri/ l"4r`,� restoration, including Qsod, is required. / st Ale0Ot Mt, t/WrW tlifso %✓ 02 0 0 7hJ pitgl �, ►n fot ;'d aCC�'�^ 4;4,7 cc: Toni Gindlesper er,But to part Perrone, Jennifer C. From: Perrone, Jennifer C. Sent: Thursday, June 02, 2016 9:05 AM To: 'dustinmathieu@yahoo.com' Cc: Williams, Scott; Gindlesperger,Toni Subject: FW: Plan Review Comments for 1738 Selva Marina Drive Attachments: Plan Review Comments 16-SFR-1250.pdf From: Perrone, Jennifer C. Sent: Thursday, June 02, 2016 9:02 AM To: 'dustin@mathieubuilders.com' Cc: Williams, Scott; Gindlesperger,Toni Subject: Plan Review Comments for 1738 Selva Marina Drive Permit application#16-SFR-1250 for 1738 Selva Marina Drive is currently denied by Public Works. Attached are the plan review comments. Please submit required information at your earliest convenience in order that we can process approval for our Department. Thank you, Jennifer Perrone Administrative Clerk City of Atlantic Beach Public Works Department 1200 Sandpiper Lane Atlantic Beach, FL 32233 Phone (904) 247-5834 Fax (904) 247-5843 email: jperrone@coab.us 1 39S' /2 ' 'j64 /b ~ M - /2,r0 Lot e; / 'J( /2 0 6 k o r7. /9Z /tep z kifa4 4 0.1 17 At /2 >Li vs3 y t� z 4414.4/ -21 k / 336 spr /11 -r 5'y if aim icrx "TO Gov 41601176.V I i y ,72, 0 `4 52 Do e1 hoi Me414 Poker b-/'-f6 I J�'` — CITY OF ATLANTIC BEACH �� 800 Seminole Road -- '_ Atlantic Beach,Florida 32233 ?) T �r Telephone(904)247-5800 FAX(904)247-5845 pjil�I. I (f) 5 ��_ l25� / REVISION REQUEST SHEET Date: i�7 l — Received by: Resubmitted: Permit Num er: Original Plans Examiner: Project Name: ' Project Address: 39 3 I a-4'S- S"T Contractor: M AT H l G v &t it S Contact Name: Contact Phone : Contact e-mail: Revision/Plan Check/Permit Fee(s)Due: $ Description of Proposed Revision to Existing Permit: 46Ar ,14.....4 A G.,_ eve, - 4,....,..at /� sit Ste�ve.p �.%I'f'�C d �sf> �tic..��E7-6/o Additional Increase in Building Value: $ 0 Additional S.F. ot/a Site Plan Revised: /VT) Public W/U Approval: a By signing below. I(print name) &SA/it 4'0 14/".-- affirm that the is in . , of the proposed changes. above revision ,4101,0 1‘20-8.- - 4 7/!..i ignature of Contractor/Agent(Contractor must sign if increase in valuation) Office Use Only E © V E Date: l (4 Approved:/` vW Rejected: _ p tificd Plan Review Comments: Department review required Yes No Building 411 i .. .- Planning &Zoning „„„ Tree Administrator lc Wor<s PI . s Ex er Public Safety / 4,C Fire Services Date Created 8!20115 Rev.2 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office(904)247-5826 Fax (904) 247-5845 I ( ,-S FR- I z50 Job Address: '3 q5.- f 9-1A 54 rrt ie(ik.4,` _. &C ' Permit Number: Legal Description 1\o r // dui cf � 50o� 3O-A- trf IS '4 Parcel# 61/4 / (-4/^Z!' I Oat- 8k3 Floor Area of Sq.Ft. Sq.FtS Valuation of Work$ r100l 00 0 Proposed Work heated/cooled .i5 0 non-heated/cooled L`' �� 4.7ctS Class of Work(circle one): f ew Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial esi nti" If an existing structure, is a fire sprinkler system installed? (Circle one): es No N/A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: Can /.- sc.c .4,oof "1 ..S] / Itt i,7r -wcsIs ic(enc-e_ Property Owner Information:: ,,n Name: /I' f-, /:'(471A/LaLC— Address: I' ` ' 342_)el&A- i'/ 1 uJK1Vl0<._ . City 196 State F(Zip �::)r2 3Phone q'C'- `4/6 3'7-9 -7-- E-Mail or Fax#(Optional) Contractor Information: 6461i0 vfti-hieka yaw, oi,US+in AJ 1'V\0!4t, eubkl tdQ)rS. (pyy, (0 ben Company Name: Mit fh %eu- c' JIe.'S •uali fyinb b Agent: �t 4-i 4 ,gt'a t,✓vl 'J Address: 3( W 7 fh Sf City Allan h r gearJA„ State Ft- Zip 3Z Office Phone Job Site/Contact Number 'WY /•3. ' / Fax# State Certification/Registration# C 3c� /z_575f . Architect Name& Phone# ,{are/son Par Aes "?74 '70V.1 Z• X 364 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. I certifil that no work or installation has commenced prior to the issuance of a permit and that all work will he performed to meet the standards of all laws regulating construction 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 abandoned for a period of six(6)months at any time after work is commenced. I understand that separate permits must be secured for ElectricalWork,Plumbing,Signs, Wells, Pools, Furnaces, Rollers,Healers, 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 I have read and examined this application 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 specified 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 7' .. i nit' w a �J�'��.t/vt r Signature of Contra Print Name (/� I 1 ( ,, ....../. r t a.....'4/./1.. fikA. -1-0r.. l�.... ........ ... Print Name , to v! .1L Sworn to and subscgbed before me ` Swo -7r. and sub, k.-. •efore t e his 3i 'Day of` /14114 ,2014 this `' Day of, �'%.. 20 4' fi , . �,:..,.,.,..:... ��.rrte�� � �1�-1111� 'Totar Public :;i•`." !n'!NA H.WILLIAMS No .' . C MY COMMI ION 1 `' • ,.1` _ r.' ()MISSION u FF 217841 EXPIRES:October 6,2019 EXPIRES:August 7,2019 >��d•' Bonded Thru Notary Public Unde b•f5—� a '�1.26.10 •,:n i_J Toru Notary Pubic Underwriter. % , ' NOTICE OF COMMENCEMENT State of F LA,,V 0` County of bVexi 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: tot t t f f et v at `f _ s e, c4. 30 4" , $.f L c..+1io 1210,k_ t se a Nl a J n i& No i e f c>;,- 'oov k a 3 p • y Address of property being improved: 3'1 S / q ,sT tetA I General description of improvements: �(� ; S-�r tJC�r v'lt� } Aa f Owner: �- p rn I�n;( L L.G Address: % `� wner's interest in site of the improvement: j / J 1-le...". ,t� r , �, `j� e Simple Titleholder(if other than owner): Name: ;� -: / ,/ Contractor: D t r) -t',, 1�? c 0 )J., f Amex-14A,'(24.A.__ �. &J I�J 3$ LJ. 7 '"elf Address: .�swA ._�AP t.a.�.�■,�1 . . t & • I • - 3 Telephone No.: 1 f - `2)6 Ca l 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: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER / Vei Signed: 6A1.01 UV 1 / '9 ate: S- Ct'ICP :efore me this day of /A _ •46 C the Copniy-of Duv.1, .tate ;1.•y MY COMMISSION I R 4� i f Florida,has personall appeared _ ` ` _ -� .NL ik - •ersonally Known: or -roduced Identification: Z.3 Z•• J - - -7(A4ted, a BonXdedPREStOyctPoubbelicr U6nd,20ew1ri9ers otary Public: ��11 / b_____ Doc#2016110315,OR BK 17563 Page 1949, commission expir •__ r Number Pages: 1 Recorded 05/17/2016 at 08:59 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING$10.00 I Comp. By: SRW Date: 6/1/2016 Public Works Department City of Atlantic Beach Permit No: 16-SFR-1250 Address: 395 12th Street Provided Storage: Elevation Area Storage (ft) (ft2) (ft3) ? 0 BOTTOM ? 0 TOB Elevation Area Storage (ft) (ft2) (ft3) 0 BOTTOM 0 TOB Elevation Area Storage (ft) (ft) (ft3) D BOTTOM 0 TOB Inground storage=A*d*pf A=Area= 0.0 d=depth to ESHWT= 6.0 pf= pore factor= 0.3 Inground Storage= 0.0 ft3 Required Treatment Volume= 1,344 ft3 Supplied Treatment Volume = 0 ft3 Retention MASTER WATER RETENTION 6/1/2016 !Ad. Comp. By: SRW Date: 6/1/2016 VW. Public Works Department City of Atlantic Beach Permit No: 16-SFR-1250 Address: 395 12th Street Required Storage Volume Criteria: Section 24-66 of the City of Atlantic Beach's Zoning, Subdivsion, and Land Development Regulations requires that the difference between the pre-and postdevelopment volume of stormwawter runoff be stored on site. Volume of Runoff is defined as follows: V= CAR/12 Where: V=Volume of Runoff C=Coefficient of Runoff A=Area of lot in square feet R=25-yr/24-hr rainfall depth (9.3-inches for Atlantic Beach) Predevelopment Runoff Volume: Lot Area (A) = 15,360 ft2 Runoff Coefficient AreaLot Area Description (ft2) (ft2) "C" Wtd"C" Impervious 2,867 15,360 1.00 0.19 Pervious 12,493 15,360 0.20 0.16 Runoff Coefficient(C)= 0.35 Runoff Volume V= 0.35 x 15,360 x 9.3 / 12 V= 4,158 ft3 Postdevelopment Runoff Volume: Lot Area (A) = 15,360 ft2 Runoff Coefficient Area Lot Area Description (ft) (ft) "C" Wtd "C" Impervious 5,035 15,360 1.00 0.33 %ISA = 32.8% Pervious 10,325 15,360 0.20 0.13 Runoff Coefficient(C)= 0.46 Runoff Volume V= 0.46 x 15,360 x 9.3 / 12 V= 5,503 ft3 Required Storage Volume DV= Postdevelopment Runoff Volume- Predevelopment Runoff Volume DV= 5,503 - 4,158 DV= 1,344 ft3 Retention MASTER WATER RETENTION 6/1/2016 rgivte t , /s ILA- t Comp. By: SRW ;.. �► ) Date: 6/9/2016 Public Works Department City of Atlantic Beach Permit No: 16-SFR-1250 Address: 395 12th Street Required Storage Volume Criteria: Section 24-66 of the City of Atlantic Beach's Zoning, Subdivsion, and Land Development Regulations requires that the difference between the pre-and postdevelopment volume of stormwawter runoff be stored on site. Volume of Runoff is defined as follows: V= CAR/12 Where: V=Volume of Runoff C =Coefficient of Runoff A=Area of lot in square feet R= 25-yr 124-hr rainfall depth(9.3-inches for Atlantic Beach) Predevelopment Runoff Volume: Lot Area (A) = 15,360 ft2 Runoff Coefficient Area Lot Area Description (ft2) (ft2) "C" Wtd "C" Impervious 2,867 15,360 1.00 0.19 Pervious 12,493 15,360 0.20 0.16 Runoff Coefficient(C)= 0.35 Runoff Volume V= 0.35 x 15,360 x 9.3 / 12 V= 4,158 ft3 Postdevelopment Runoff Volume: Lot Area(A) = 15,360 ft2 Runoff Coefficient Area Lot Area Description (ft) (ft2) "C" Wtd "C" Impervious 5,035 15,360 1.00 0.33 %ISA = 32.8% Pervious 10,325 15,360 0.20 0.13 Runoff Coefficient(C)= 0.46 Runoff Volume V= 0.46 x 15,360 x 9.3 / 12 V= 5,503 ft3 Required Storage Volume DV= Postdevelopment Runoff Volume- Predevelopment Runoff Volume DV= 5,503 - 4,158 DV= 1,344 ft3 Retention 12th Street 395 6/9/2016 I ,. X1,,1 i./ s Comp. By: SRW :) Date: 6/9/2016 i31v----:,t Public Works Department City of Atlantic Beach Permit No: 16-SFR-1250 Address: 395 12th Street Provided Storage: Elevation Area Storage (ft) (ft) (ft) 6.0 450 0 BOTTOM Area 3 30 X 15 6.3 1,120 236 TOB 40 X 28 Elevation Area Storage (ft) (ft) (ft3) 6.0 100 0 BOTTOM Area 2 20 X 5 6.3 450 83 TOB 30 X 15 Elevation Area Storage (ft) (ft2) (ft3) Area 1 20 X 5 4 6.0 100 0 BOTTOM 30 X 15 6.3 450 83 TOB Inground storage=A*d*pf A=Area= 2020.0 d=depth to ESHWT= 3.0 pf=pore factor= 0.3 Inground Storage= 1818.0 ft3 4 Required Treatment Volume = 1,344 ft3 Supplied Treatment Volume= 2,054 ft3 I 0 I 0 Ell Retention 12th Street 395 6/9/2016 -s y,,,,lj TREE & VEGETATION AFFIDAVIT t' S, City of Atlantic Beach r ► Department of Community Development �v �" Planning&Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 A.4 WI ,,r (P)904 247-5800 (F)904 247-5845 PERMIT# SECTION I -APPLICANT INFORMATION E Owner(s) y Legal Authorized Agent* NAME OF APPLICANT 6(.S1i 4 lvd 0/h NAME OF COMPANY Ma,f t e, f /c S ADDRESS OF COMPANY _3/ 6) ?/4 51- PHONE CELL fo f8/3366/ EMAIL A571/4pilltd-h;e u Lk,/ife✓S. Ce 44,1 CONTRACTOR CERTIFICATION NUMBER 6 i 5 .- /L 5- 7 5f ATLBCH BUSINESS TAX RECEIPT NUMBER gi 3 SECTION II-SITE INFORMATION STREET ADDRESS OF PROPERTY 3 /5 ( i- S7-- If --if an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address. LEGAL DESCRIPTION LOT BLOCK SUBDIVISION REAL ESTATE NUMBER LOT OR PARCEL SIZE: SQ FT AC RESIDENTIAL COMMERCIAL OTHER(SPECIFY) I affirm that 1 have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation" of the Municipal Code of Ordinances for the City of Atlantic Beach, FL and/or I have participated in a pre-application meeting with the Administrator of those regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed from the above-described or adjacent properties in conjunction with this project. SIGNATURE OF OWNER SIGNATURE OF OWNER (` Signed and sworn before me on this day of J U ac ,ZO� (6rby State of t` ( Q 7 County of 0 o Ve_ c Identification verified: 6 (05 r 7 3 74 -016,--Z Oath sworn: r Yes r No ' Yilk .ma.' ` TONI GINDLEVERGER Notary Signature i4 r MY COMMISSION It FF 924951 r ..• .4• EXPIRES:October 6,2019 ,P o,,y Banded Thru Notary Public Ufdentnters REV-TVA-v10.11 My Commission expires: Comp. By: RLC Date: 6/3/2016 \ ,tir �rliil fir' Public Works Department City of Atlantic Beach Permit No: tbd Address: tbd Required Storage Volume Criteria: Section 24-66 of the City of Atlantic Beach's Zoning, Subdivsion, and Land Development Regulations requires that the difference between the pre-and postdevelopment volume of stormwawter runoff be stored on site. Volume of Runoff is defined as follows: V= CAR/12 Where: V=Volume of Runoff C = Coefficient of Runoff A=Area of lot in square feet R= 25-yr/ 24-hr rainfall depth (9.3-inches for Atlantic Beach) Predevelopment Runoff Volume: Lot Area (A) = ft2 Runoff Coefficient Area Lot Area Description (ft2) (ft2) "C" Wtd "C" Impervious 2,867 15,353 1.00 0.19 Pervious 12,486 15,353 0.20 0.16 Runoff Coefficient(C) = 0.35 Runoff Volume V = 0.35 x 15,353 x 9.3 I 12 V = 4,157 ft3 Postdevelopment Runoff Volume: Lot Area (A) = 15,353 ft2 Runoff Coefficient Area Lot Area Description (ft) (ft2) "C" Wtd "C" Impervious 4,967 15,353 1.00 0.32 %ISA= 32.4% Pervious 10,386 15,353 0.20 0.14 Runoff Coefficient(C)= 0.46 Runoff Volume V= 0.46 x 15,353 x 9.3 I 12 V= 5,459 ft3 Required Storage Volume DV = Postdevelopment Runoff Volume - Predevelopment Runoff Volume DV = 5,459 - 4,157 DV = 1,302 ft3 Retention Stormwater Calcs AB-onsite Retention w-grnd 6/4/2016 Comp. By: RLC Date: 6/3/2016 \ r f,"---4 Uit19r Public Works Department City of Atlantic Beach Permit No: tbd Address: tbd Provided Storage: Elevation Area Storage (ft) (ft2) (ft3) 100 0 BOTTOM 1.50 83 TOB Elevation Area Storage (ft) (ft2) (ft3) 0.0 0 BOTTOM 0.3 83 TOB Elevation Area Storage (ft) (ft) (ft3) 0.0 100 0 BOTTOM 0.3 450 83 TOB Inground storage=A*d*pf A=Area= 1350.0 d= depth to ESHWT= 3.0 pf= pore factor= 0.3 Inground Storage= 1215.0 ft3 Required Treatment Volume= 1,302 ft3 Supplied Treatment Volume= 1,463 ft3 Retention Stormwater Calcs_AB-onsite Retention w-grnd 6/4/2016 r, v.� CITY OF ATLANTIC BEACH ' A ` s f 800 SEMINOLE ROAD r: ATLANTIC BEACH, FL 32233 OFFICE COPY (904) 247-5800 ~2J;tl9� BUILDING DEPARTMENT REVIEW COMMENTS Date: '35 I Z -k-. Permit#: 16-SFR-1250 Applicant: Mathieu Builders Site Address: 325 5th C+ Site Address: 38 West 9th St., A.B. Review: Ai rove 6 ./616 111 Phone: 904-813-3661 RE#: : : : /7/ 722 1/Op.O Email: dustin@mathieubuilders.com Property Owner: AF AB Venture LLC Phone: 904-716-3797 Correction Comments: 1. he Manual . ompliance Report is incomp e e. 'age or each sys e shows 0% of load for the Sensible, Latent and Total Capacity at actual desig conditions. This should not be the case. An email was sent to the preparer o Hit calculations, Dorothy Deaae1— 0 ontractor shall come to the Building Department and record on the Job copy and File copy set of plans the proposed Finish Floor Elevation; initial and date both sets. 0 - – = — i - • ili - a S P nO 3. A/C units location needs to shown on the site plans. /n p' b•/6!b 4. Total height of building to ridge line shall be given from grade. 51A • . , -- • a • . • ealed. a . . • . • ions--sh e the attics-are_rented. Verify_wh.icli-w' t ' - . ' i ' • • • 6 46•16 th• . ' . _ • - 1 . 'I ', . ' • e e • 'esu i - i ed. 6. -Submit2 copies of an IC _ ' - • . : • • i : : : •• e ;e-used as insulation: . When the energy calcu ations get resubmitted will need you to sign t • . necessary pages. Mike Jones Building Inspector/Plan Reviewer 1 E rna I I S-e.e. 6.8-/6 /►l-- e.30 .►i i BUILDING PERMIT APPLICATIONPY OFFICE CO CITY OF ATLANTIC BEACH . 800 Seminole Road, Atlantic Beach,FL 32233 7� Office (904)247-5826 Fax (904) 247-5845 1 (p-s F-R- 1 Z50 Job Address: 3 q 5-- r c S+, Al-k<t L4-)1 c- &cid Permit Numb • Legal Description 1.41.6 i- ccj9cl Seo9'( 3tl-At of IS YO Par/ cel 4 / Ui^t'''Z I la IL 81e- 3 Floor Area of Sq.Ft. Sq.Ft (:) Valuation of Work$ 'I0410 0 0 Proposed Work heated/cooled 3..5-, --0 non-heated/cooled 1/9'6 470t5 Class of Work(circle one): ew Addition Alteration Repair Mov��iolition pool/spa window/door Use of existing/proposed structures)(circle one): Commercial 4'estd-nti. . If an existing structure,is a fire sprinkler system installed?(Circle one): •es 4 N /A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: Cffn'J•-u.c-1.e A o c 4e4) S47/ rami r �es,len c-e__ Property Owner Information:: ,,n Name: /9`)- /1-6 V (c&,A1LP 2.-LC Address: 1 `7-. 5 t2 �u& ►'� 1 u 4Ai0 ( 1 . City /9 L State FI Zip ,)(2 `3Phone q 044 - /6 z',7-9 -3-- E-Mail or Fax#(Optional) Contractor Information: Q Company Name: /17•t th )ice-pJcc; /IerS Qualifying Agent: DuS-/-r 4 L rCWI1 Address: 3 38' W qfh Si- City i1f/antic_ &etc& State Fi----- Zip .3zZ} Office Phone Job Site/Contact Number goy b'336t:/ Fax# State Certification/Registration# C/3c, 12 575.? Architect Name&Phone# / t-e./son Pi& Ae..s M `7o4' 1 Z• GJ67 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. I certify that 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 construction in this jurisdiction. This permit becomes null and void If work is not commenced within six(61 months, or if construction or work is suspended or abandoned for aperiod of six 16)months at any time after work is commenced. I 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 I have read and examined thisplication and know the same to he true and correct. All provisions of laws and ordinances governing this type of work'will be complied with whether specified 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 141 /N,rA4,4 a aVAia // \- 7/ ._ Signature of Contra ,,�� r:Iint Name V...'/.. Lr11.1.1 a ili Il.S.4,JA. Tc.�.f..�.l..( Print Name , in !i/c.^-1.�, Sworn to and subsc bed before me 1 Swoiro and sub; . Before i e his 3)w Day of /{/J� ,20 11{ this Day of ►�� 20� g► alliik \Total Public ., :;�c"`•r.',. OP(NAH.WILLIAMS Not.''! " i` `E my cow ION t: i OMISSION f FF 217841 n = EXPIRES:October 6,2018 EXPIRES:August 7,2019 � i1 Bonded Th u Notary Public Unde �'i 1.26.l0 :1TbyPubbcUndetiikn OFFICE COPY DO NOT WRITE BELOW- OFFICE USE ONLY Applicable Codes: 2010 FLORIDA BUILDING CODE Review Result (circle one): Approved Disapproved Approved w/ Conditions Review Initials/Date: i, '7!6 I'I'►n6r G Development Size Habitable Space351 9 S;F Non-Habitable Impervious area Miscellaneous Information Occupancy Group (L- 3 Type of Construction Number of Stories aZ Zoning District R S - 1- Max. Occupancy Load Fire Sprinklers Required Flood Zone X Conditions/Comments: & Ifni1- -# /6 - SrR — /9' 5'() OFFICE COPY NOTICE OF COMMENCEMENT State of f i May County of bi d a. Tax Folio No. To Whom It 'd 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 COMMEANICEMENT. Legal Description of property being improved: 404. q I Q vlck "1 -e_ 5 d, ,3 U -(- , 0-r 1,--F go Ria(L l Sia ►wikum ak J o i'E We 1 efcct Bonk a 3 p . I Address of property being improved: 37S- / 3' (1.6 tI eo� General description of improvements: N �� , Owner:___4y911-- A a VEAT{A.Q LLQLC- Address:f�crr,�1 j `7- 3 , / car /I1 wner's interest in site of the improvement: / j J ) I Al / e Simple Titleholder(if other than owner): Name: Contractor: x"P U_ 'I41:ae..A 3'8 g 1, y j_L Address: ..Agra_�e:sjiiA .t _ & I ' [xC—k ~ - 3 Telephone No.: ?' I `'ec,6 I. 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: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: LL/lri,lA t/\, �/ gate: efore me this dayof D _ NT GIpERGER f Florida,has personall appeared ,, 9 ". • the Coynt3i•of Duv• , .tate * 924951 i7JTiiiJmdubon3 b 2019 roduion3 4or bic Underwriters _ —7 otary Public: • � / Doc#2016110315,OR BK 17563 Page 1949, commission expir- Number Pages:1 I Recorded 05/17/2016 at 08:59 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL ' COUNTY i RECORDING$10.00 Map Output Page 1 of 1 JAXGIS Property Information f / -- 'oa,, Ira/ �' \ / UM °`- OFFICE COPY . ----\ i . „„.. (------ fon . um (1 ( i \ .----------\ as ..0 .wS sr \\ .r.air 0000 -�_--- ..aa \ --\ \\ -.e.r.7.917711191` 0.��g1111(y1ALa>M11�Y. {r W \ 1\...\ \--"-V". a.a i1a • Sea Y aa _—_ ®_.. asw.. va sn - s ". . <�,•.,esem,0........ \ Or ilifft .aSO ao 1 • Civ C/v Mf C.v WI RES Name Address TnruacMo Map Floo EDC Evacuatlo Hois Mf HN ghtln 7Acne600k-Page ogaf Descdptiuns o,,si.dl n._ /IPaHH Schoo�SCMof'r AHoticeNoth Price Panel' Zorro Zorn Zone Zone Zo °nB Reg Req Rog Zone Zon. 395 23-4 16-2S-29E Mayporl 12TH ST SENA MARINA UNIT 1 Vol in Not in NiA/ Horizonte 171922 999°A9 AB VENTURE LLCwTLANTIC BEACN475000 0 35 173870145:!9,18 S 30TT LOT 40,LOT 41,BLK 1,D BK 1700 NA4shSite EMerpnseQONE 8 plannin{�`'A NA NA Swine NA NAVA NA NA 32233 370 Zone Zone Dist: Ele" A 3001 http://gismaps.coj.net/WEBSITE/DuvalMapsSQL/toolbar.asp 6/16/2016 OFFICE COPY • PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA Project Name: "F i16 tie 4)14 A'c-r 5pc c— Permit # �6^Sr-R-1.)Sv Project Address: 3 9S /02/`, 574 As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72,please provide the information and product approval number(s) for the building components listed below as applicable to the building construction project for the permit number listed above. You should contact your product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide product approval may be obtained at:ww.floridabuilding.orr�. Category/Subcategory Manufacturer Product Description `Limitation of Use State# Local# A.EXTERIOR DOORS 1.Swinging " /ermq Trr{ J-5/4.4171-i-Tar 3-171. `f 2.Sliding rG - , r SY7 o 1.208, I 3.Sectional /C(f filch/'/2Q3 f5o7'i 123.13 4.Roll up 5.Automatic 6.Other B.WINDOWS 1.Single hung 77 T S 1..Slo a 1 .3.5". 2.Horizontal slider 7G r 1657 5A 3.Casement 4.Double hung 5.Fixed 6.Awning 7.Pass-through 8.Projected 9.Mullion 10.Wind breaker 11.Dual action 1 12.Other Category/Subcategory Manufacturer Product Description Limitation of Use State# Local# C.PANEL WALL 1.142-9- 1. ,1.Siding /t cltilta(SSA �,.L; 4.4.-d /d0`r,1 2.Soffits /1) ch:a Us4 Jic4:Oeze.l /0-oQQ, 3.EIFS 4.Storefronts 5.Curtain walls 6.Wall louvers 7.Glass block 8.Membrane 9.Greenhouse 10.Synthetic stucco l 1.Other D.ROOFING PRODUCTS 1.Asphalt shingles 4-/-(2S tini c lv /131s 2.Underlayments ias Sc4.ntort,-J (d (‘2Lpp 3.Roofing fasteners 4.Nonstructural metal roof 5.Built-up roofing 6.Modified bitumen 7.Single ply roofing 8.Roofing tiles 9.Roofing insulation 10.Waterproofing 11.Wood shingles/shakes • 12.Roofing slate 13.Liquid applied roofing 14.Cement-adhesive coats 15.Roof tile adhesive 16.Spray applied polyurethane roof . 17.Other Category/Subcategory Manufacturer Product Description Limitation of Use State# Local# E.SHUTTERS I.Accordion 2.Bahama 3.Storm panels 4.Colonial 5.Roll-up 6.Equipment 7.Other F.STRUCTURAL COMPONENTS 1.Wood connector/anchor S„„toso.tz,S /(1/78z3 2.Truss plates 3.Engineered lumber 4.Railing 5.Coolers-freezers 6.Concrete admixtures 7.Material 8.Insulation forms 9.Plastics 10.Deck-roof 11.Wall Y�- 12.Sheds 13.Other G.SKYLIGHTS 1.Skylight 2.Other • Category/Subcategory Manufacturer Product Description Limitation of Use State# Local# H.NEW EXTERIOR ENVELOPE PRODUCTS 1. 2. In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project, the Contractor shall maintain on the job site and available to the Inspector, a legible copy of each manufacturer's printed specifications and installation instructions along with this Product Approval Sheet. I certify that this product approval list is true and correct to the best of my knowledge.I further certify that use of different components other than the ones listed in this document must be approved by the Building Official. (Contractor Name) (Print Name) 44 roc�� (Signature) Company Name: /1?Q/4ticu. 34; Me/S Mailing Address: ..3S to q>th S/— vt1-% City: f/ilcc gekx/A+ State: PL Zip Code: 32,233 Telephone Number:(?0 r) S"/3.3 6 6/ Fax Number:( ) Cell Phone Number:( )_ E-mail Address: ,K S T!N @�1_�T H I E�(13(4:11-6 ERS. Co M