2329 BAREFOOT TRACE - PERMIT RESA17-0005 OFFICE COPY
BuILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH DATE
'617 800,Seminole Road,Atlantic Beach FL 32233
ce: (904)247-5826 Fax: (904)247-5845
Job Address:,IW Permit Number: S'S M-7-OCCE
Legal Description RE#
Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled
Class of Work(Circle one): New. �fio Alteration Repair Move Demo Pool Window/Door
Use of existing/proposed structare(s) (Circle one): Commercial -fl��_sid�enti
If an existing structure, is a fire sprinkler system installed?(Circle one): Yes 1S) N/A
Submit a Tree Removal Pen-nit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be fo ed:
Z er 0
5C
�,U r7_
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name:171&4ezee. �lf -/-6 Address: oUjRP z�,_,_e04oq,1
City: Statej�Lp Phone
E-Maff
Owner or Agent �jf Agent,Power of Attorney or Agency Letter Requiredl z Ils 121a 5�,'A 3
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 NOTffE OF COMMENCEMENT.
Contractor Information:
Name of Company: 'Qualifying Agent:
Address:_��O /�)AI-'.4"7., a- /vcity Wtate Zip
Office Phone'
Job.Site/Contact Number 1:241 Y
State Certification/Registration# ca L;?=_5-,?_-3!7� 'Z E-Mail 171 -S 612_.zg 0 41' C 0
Architect Name &Phone#
V 6
Engineer's N4me #
Worlcer�s Conipensation
Ex.empt InsureC_L-�aseEm�ployee Expiration Date
Applicati on is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced
e issuance o a pei�n i an uit a worcwi e per orm to ineet the standards of all laws regulating cohstruction in this jurisdiction.
lit becomes null L771 void i work is not coni ence wi six(6) m.onths, or if construction or work is s d d or abandonedf
qr-a
P six(�)months at rk is coin ence 1 erstand that separate permits must be securedjbrTe1nC't,�ic I Work,Plumbing,,
rio4.q any thne a ter wo
11 d1s,Pools,Furnaces,Boi ers,Heater' iks a it io
ire of Property Ownef�_ Signature of Con act
I me
Day of_)M- I Before me this D o
o (7
Public: W,Fz�� a Notary Public:
7�-z" LESPERGER
TONI GINj
Y OM I -e#,FF9�4q
certify that I have read and examined this application and know the same to aws and
es governing this type o w irk will be complied with whether specified her'N"on,
apeh does not
to gi authority to Worm e or'cancel the provisions of any otherfeederal, st 'r., w hon or-the
01, nee o7construction. Rev.5/2/16
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ADDITION - SINGLE OR TWO FAMILY RESIDENTIAL ADDITION
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RESAI 7-0005
Description: SECOND FLOOR ADDITION
Estimated Value: 90000
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 2329 BAREFOOT TRACE
RE Number: 1694630618
PROPERTY OWNER:
Name: HOSTO MICHAEL D
Address: 2329 BAREFOOT TRCE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
elk"
Phone:
Name: REMODELING PROS
Address: 2763 N MANDARIN MEADOWS DR
Phone: JACKSONVILLE, FL 32223
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
City of Atlantic Beach
APPLICATION NUMBER
Building Department (To.be a.s h
800 Seminole Road �!qneq y t e Building Department.)
Atlantic Beach,-Florida 32233-5445 ES P\ 1-7
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date touted
City Web-site: http://www.coab.us
APPLICATION REVIEW
AND TRACKING FORM'
2 �7 9 C-)r
Property Address: IJ partMent review required� Yes No
uildi
r,V1
Applicant: E� 0
-reeAUrninii ralor
Project: r— Lc) 0A_ P
Public Utilities
Public Safety
? Fire Services
t�evi .,w tee 4i
De t: -i' tu to
Aer Agency Review or Permit Required Review or Receipt
9 ,
; , date
of Permit Verified By
Florida Dept. of Env ironmental Protection
Florida Dept. of Transportiflon
St.Johns River Water Management District
Army Corps of Engineers
Pivision of Hotels-and Restaurants
bDivision of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: DApproved.
ZDenied.
i (Circle one.) Comments:
B�UILDING
Reviewed by:_ Date: )A6,
TREE ADMIN.
Second Review: 7JApproved as revised. FIDenied.
PUBLIC WORKS Comments: //T
PUBLI6 UTILITIES
Reviewe
PUBLIC SAFETY d by-/A�_,�,— Date:
FIRE SERVICES Third Review: [—]Approved as revised. ]Denied.
Comments:
Reviewed by: Date:
Revised 07/27/,10
RECEIVEE)c �
ITY OF ATLANTIC BfACH
800 Seminole Road
Atlantic Beach,Florida 32233
MAY 3 0 2W i
Telephone(904)247-5800
J
FAX(904)247-5845
13ullft
REQW*bAWVA*AAET OR
CORRECTIONS TO REVIEW COMMENT
1-7
Date Received by. Resubmitted:
Permit Number:
Original Plans Examiner: 11ile ProjectNarl�ie:
e9,1
Project Address: A 0.7L—
Contractor: le e
5 Contact Name:
Contact Phone Cogutaetr--ff twj:'y /1�5 /gv L
ZI-0 4, C 0
Revisio lan Check: rmit Pee(s) Due:
' Description of Proposed Aevision to ExisfinLy Permit:
&I A
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised:
Public W U Approval:—
By signing below.I(print name)— /Le,
-5 4& affirm that the above revision
is inclusive of the proposed chang"es.
S Im
ign re, Contractor Ag-C"'nt(Contractor must sign if increase in valuation) Date
off
ice'use only
Date: :5 0 -1 Approyed-
Rejected: Notified by:
Plan Review Comments:-
nt review required Yes 0
U
Pan I Zoning
Tree Administrator Plans Examiner
Public Works
Public Utilities
Public Safety
Fire Services Date C'eated 4113116 Rev.3
CITY OF ATLANTIC BEACH.
800 SEMINOLE ROAD
ATLANT& BEACH'FL 32233
OFFICE COPY -5800
(904)247
j
BUILDING DEPARTMENT REVIEW COMMENTS
Date: 5.25.2017
Permit RESA17-0005
Siie Address: 2763 Mandarin Meadows Dr.
Site Address: 2329 Barefoot Trace,AB N., Jax
Review: I Phone: 904.545.4638
RE#: Email: bks*aol.com
Homeowner: Michael Hosto
Applicanih Remodeling Pros
CORRECTION COMMENTS: These.comments are from 1 of 4 departments that-are
reviewing this a )c
. From the current existing building code, choose a metho&of co structio
-5^ 30,t
compliance method/alteration level. This information shall be place on the
r sheet. 2 PS-
gap
02-20149 111!1i:!�i;�
. Please.submit 2 copies of the,,,Form R4 dentia�uildfii�' 11��iermal,
Envelope Approach, Florida Building Code, Energy Conservation. This
Ithod 11
sha
entla
ons
orm can e oun in e,. t
xis ing ui ing co e un er he resi en ia
ovisions APPENDIX C.
Mike Jones
Build'frig Inspector/Plan Reviewer
�7pity Of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233-5445
Ofc (904) 247-5844
Pax (904) 247-5845
d-el R�pv,- le LA-1) C-0 r�yx VY\ n 4:;r svz.7//
OFFICE COPY FORMS
FLORIDA BUIL CODE,ENERGY CO VAA TION
FORM R402-2014 Residential Building Thermal Envelope Approach
Climate Zone E:a2--
Scope:Co with Section R402 the Florida Building
mpliance .1.1 of Code,Energy Conservation,shall be demonstrated by the use of Form R402
for single'and multiple-family residences of three stories or less In height,additions to existing residential buildings,alterations,renovations,
and building systems In existing buildings,as applicable.To comply.a building must meet or exceed all of the energy efficiency requirements
on Table R402A and all applicable mandatory requirements summarized In Table R402B of this form.If a building does not comply with this
method,or by the UA Alternative method,It may still comply under Section R405 of the Florida Building Code,Energy Conservation.
PROJECT NAME: o?
AND ADORES
BUILDER:
OWNER: V4 e-
PERMITTING OFFICE:
JURISDICTION NUMBER:
I General Instructions: PERMIT NUMBER:
1.Fill In 811 the applicable spaces Of the"To Be Installed"column on Table R402A with the Information requested.All"To Be Installed"values must be
equal to or more efficient than the required levels.
2.Complete page I based an the"To Be Installed"column information.
3.Read the requirements of Table R402B and check each box to indicate your intent to Comply with all applicable items.
4.Read,sign and date the"Prepared By"certification statement at the bottom Of Page I-The owner or owner's agent must also sign and date the form.
1. Now ownstruction,addition,or exis-t ng building
2- Single-family detached or muftiple-family attached
2.
3. If multlPle-family,number of units Covered by this submission 3.
4. Is this a worst case?(yes/no)
S. Conditioned floor area(sq.ft.) 4.
6. Windows,type and area 5.
a) U-Mrtor:
b) Solar Heat Gain Coefficient(SHGC) ea.
6b.
c) Area e-1
7. Skylights so.
a) U-factor.-
b) Solar Heat Gain coefficient(SHGC) 7a.
8. Floor type,area or perimeter,and Insulation: 7b- ------------
a) Slab-on-grade(R-value)
b) Wood,raised(R-value) Be.
c) Wood,common(R-value) 8b.
d) Concrete,raised(R-Value) Be.
a) Concrete.common(R-value) ad.
9. Wall type and Insulation.- Be- ----------
a) Exterior 1. Wood frame(insulation R-value) Bel.
b) Adis 2. Masonry(insulation R-value) 9a2.
cent: 1. Wood frame(Insulation R-value)
2. Masonry(Insulation R-value) 9bi.
10. Coiling type and Insulation 9b2.
a) Attic(Insulation R-value) 108.
b) Single assembly(insulation R-value)
11. Air distribution system: 10b.
8) Duct location,Insulation
b) AHU location 11a.
c) Total duct leakage.Test report attached. 11b.
12. Cooling system: 0)type 11c. --�cfmtjoti S.f. Yes 13-No 15-
b)efficiency 12a.
13. Heating system: a)type 12b.
b)efficiency: Ise.
14. HVAC sizing calculation:attached 13b.
IS. Water heating system: a)type 14. . ..........................
,Be.
sE3 No[3
I hereby certify b)efficiency 15b.
In compliance with t
that the plans and specifications covered by this farm are Review of plans and specifications covered by this form Indicate
PREPARED BY: ,nh,F�IoVa Bullffl 9 Code,Energy Conservation.
-ge 101 compliance with the Flodda Building Code,Energy Conservation.Before
I hereby certify that this�bplfdlng is I - construction Is Complete,this building will be inspected for compliance In
Code,Energy Cons n compliance with the FlOdda Building accordance with Se tj 53. 8 F.S.
OWNERIAGENT. CODE OFFI IAL:
Date:
FLORIDA BUILDING CODE-ENERGY CONSERVATION,Sth EDITION(2014)
Copyright to,or licensed by ICC(ALL RIGHTS RESERVED);accessed by St ve R-C.3
Agreement.No fiuiherrc��ducdonq authorized. e n SchOeff On May 19.20151:16:43 Plulpux-suant to License
.FORMS OFFICE COPY
TABLE R402A
BUILDING COMPONENT PRESCRIPTIVE REQUIREMENTS1 INSTALLED VALUES
Climate Zone 1 DERR-44APAR
Windows: U-Factor 0.652 U-Factor=0.402 U-Factor= P
SHGC=0.25 SHGC=0.26 SHGC=
Skylights U-factor=0.75 U-factor=0.65 U-factor
SHGC=0.30 SHGC=0.30
SHGC
FOO;.Exterior door U-factor 0.653 U-factor 0.f403 U-factor—
Floors: -3 5?
Slab-on-Grade NR N!R _Value=
over unconditioned spacee R-13 !R-13 fr
WaII94:Ext.and Adj. R-Value P
Frame R-1 3
mass R-13 R-Value= 13
Insulation on wall Interior. R-4 R-6
Insulation an wall exterior R-3 R-4 R-Value=
calling R=30 R-Value=
R-Value=
AIr Infil Eon: Blower door test is required on the building envelope to ve=1eakage 5 5 ACH; Total leaka e=ACH
test report provided to code official. 9
Test re rt Atta h d?
Air distribution systems: Yes 8 No Er
Air handling unit Not allowed in attic
Location:
DuctR-value R-value�:R-8(supply In attles)or�:R-6(all other duct locations)- R-Value
Air leakager,
Duct test Postconstruction test: Total leakage:5 4 cfmll 00 s.r.
Rough-in test Total leakage:5 3 cfm/100 s.f. Total leakage Cfmfl 00s.f.
Ducts In conditioned space Test not required If all ducts and AHU are In conditioned space Test report Atta(3he_d? yes E3 NOD
m: federal standard required by Location:
65,000 Btuth SEER 13.0
Central system Minimum
Room unit or PTAc EER[frorn Table C403.2.3(3)] SEER-
Other See Tables C403.2.3(l)-(l 1) EER
Heating system:
Heat pump:g 65.000 Btu/h Minimum federal standard requireu Dy 1Nt%t:UA-
HSPF 7.7(before 1/1/16);HSPF 8.2(as of 1/1115)
Gas furnace,non-weatherized AFUE80% HSPF=
Oil fumace,non-weatherized AFUE83% AFUE=
Other AFUE=
Water system(storage type): Minimum federal stan la-
Electric7eafing 40 get:EF=0.92 required by NAEC
Gas firedii 50 get:EF=0.90 Gallons=
40 gal:EF=0.59 EF=
Other(describe): 50 gal:EF=0.58 Gallons=
EF=
NR-No requirement
(1)Each component present in the As Proposed home must meet or exceed each of the applicable performance criteria in order to comply with this code using
this method.
(2)For impact rated fenestration complying with Section R301.2.1.2 ofthefilori�a Building Code,Residential or Section 1609.1.2 ofthe R
Building the maximum U-factor shall be 0.75 in Climate Zone I and 0.65 in Climate Zone 2.An area-weighted average Of U-factor and SHGC shall be
rom
accepted to meet the requjrements�or up to 15 square feet of glazed fenestration area are exempted f orida Building Code,
Sections R402.3.1,R402.3.2 and R402.3.3. the U-factor and SHGC requirement based on
(3)One side-hinged opaque door assembly up to 24 square feet is exempted fro th t.
(4)R-values are for insulation material only as applied in accordance with In is U-factor requiremen
manufacturers' installation instructions For mass walls the"interior of walp,
requirement must be met except ifat least 50 percent ofthe insulation required for the"exterior ofwall"is installed*exterior of or in to,the wall.
4�_
(5)Ducts&AHU installed"substantially leak free"per Section R403.2&Test reWifidliyl _t-e_rg_y-jhw
Y an energy, r certified in accordance with Section 553.99 Florida
Statutes,or as authorized by Florida Statutes.The total leakag
envelope. e tes -not�reqi air handlers located entirely within the buildini thermal
(6)Minimum efficiencies are those set by the National Appliance Energy ConservationAct of 1987 for typical residential equipment and are subject to NAECA
rules and regulations. For other types of equipment; see Tables C403.2.3(1-1 1)of the Commercial Provisions of the Florida Building Code, Energy
Conservado�.
(7)For other electric storage volumes,min.EF=0.97-(0.00132*volume).
(8)For other natural gas storage volumes,min.EF=0.67-(0,0019*volume).
R-CA
FLORIDA BUILDING CODE—ENERGY CONSERVATION,5th EDITION(2014)
111111131V111111J CopYright to,or licensed by,ICC(ALL RlaHTS RESERVED);accessed by Steven Schooff on may 19,2015 1:16.43 PM pursuant to License
JI �M Agreement.No further reproductions authorized.
OFFICE Copy FORMS
fTABLE R4021BI MANDA Y REQUIREMENTS
Com�
rna I I
Component action Summary of Requirement(s)
Air 1. 1
k ge having:5 2.0 cfm tesied to ASTM E 283. -rated as
Air leakage 402.4 To be caulked,gasketed,weatherstripped or otherwise sealed per Table R402.4.1.1.Recessed lighting:IC Check
Windows and doors:0.3 cfnVsq.ft(swinging doors:0.5 dm/sO when tested to NFRC 400 or AAMAIWDMAICSA 101/
I.S.21A440.
Fireplaces:Tight-fitting flue damp
MR=&outdoorcombustion air.
Tr;irammablla�� 403.1.2 Where forced-air furnace Is primary system,a Programmable the
thermostat rmostat Is requireEd.
Air distribution system R403.2.2 Ducts shall be tested to Section 803 of the RESN' r c
standards by an energy rater certified in accordance with
'r cco -wi
R403.2.4 Section 553.99.Florida Statutes,or as authorized by Flodda Statutes.Air handling units are not allowed In attics.
Water heaters R403.4 Comply with efficiencies In Table 0404.2.Hot water pipes insulated to�!R o kitchen outlets,other cases.
Circulating systems to have an automate or accessible manual OFF 9%vitch.Heat trap required for vertical pipe
Swimming pools&spas R403.9 risers.
Spas and heated Pools must have vapor-retardant covers or a liquid cover or other means proven to reduce heat
108sexceptif7O of heat from sIte-recovered energy.Off/timer switch required.Gas heaters minimum thermal
efficiency Is 82%.Heat pump pool heaters minimum COP Is 4.0.
Cooling/heafing R403. Sizing calcww n performed&attached.Special occasion cooll To,—he—al—ng—ca—pac—ly—req—ul--.--pa
equipment variable capacity system. rate system or
Lighting equipment R404. At I...#7ro"- Installed Ighting fbdures shall be hIgh-efficacy lamps.
FLORIDA BUILDING CODE—ENERGY CONSERVATION,5th EDITION(2014) R-C.5
Copyright to,or licensed by,ICC(ALL RIGHTS RESERVED);accessed by Steven Schoeff on May 19,2015 1:16:43 PM pursuant
Agreement.No further repmductions authorized. to License
CITY OF ATLANTIC BEACH
800 Seminole Road
Atlantic Beach,Florida 32233
Telephone(904)247-5 800
FAX(904)247-5845
REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COM[ME1%
Date: Lt o q,-Z- JD/-7Received b
Resubi.:titted:
. Permit Number: S
Original Plans Examiner: :
Project Name:- f-)
441,r
Project Addrps: )q fZ
N A`
Contracton. k Vk jo-5 Contact Name: cat C
L A
Contact Phone : S;41�1-16 3 'Contact e-rnail: A ('e_ 144 A
Revision/Plan Check Permit Fee (s)Due: $
Description of Proposed Revision to Existing Permit
/7
6-a
wllv� T-
Additional Increase mB $
Site Plan Revised: rL A- �ub Additional S.F.
li'c W U Approval:.
By signing below.I(print name)
k4al affirm that the above revision
prop f
is inclusive of the osed changes.
Signature of Contractor Agent(Contractor must sign if increase in valuation) Date
Office Use Only
Date: Approved: Rejected:
Notified by:
Plan Review Comments:
Department review req4ulred —Ve—s No
B u
uilding
-anning &Zoning .
Tree minis a or Plans Examiner
Public Works
Public Utilities
Public Safety
Fire Services Date Created 4/13/16 Rev.3
TREE VEGETATION AFFIDAVIT
City of Atlantic Beach
DePartment.of Corrimu-nitY DevOop'rnent
Pla'pning&Zoning Piosion.
800 Seminole Road Atlantic 8each,FL 32233
-7 KRIMITIr
(P)904 24 �5800. (F)9_04 2-1.7-58,15
WTION 1. APPLICANT INFORWATION 0�wn e r(s) F7 I,eqal A thorized-Agent"r
U
14T:
NAME OF APPLICA
.NAME OF COMPANY
YV\M-Adla/I a r4o 2 S
ADDRESS OF COMPANY
PHONE
L EMAIL
CONTRACTORCERTIFICATI[ON NY JIVIBER P3 "0
AtLBCH BUSINESS TAX RECEIPT NUMBER
tECTION 11 $ITE INFORMATION
STREET ADDRIESS'OF PROPERTY.
Itan add-ress ha's rqt been imigoedw thispropurlcontoct rheAB 60dir�gDepartmillrat
LEGAL DESCRIPTION A-Z 3�7 .75 -zg
LOT. BLOCK SUBDIVISION
REAL ESTATE NUMBER jl��R PARCEL SIZE:
JGC�463-0(v AC
RESIbENTIAL' COMMERCIAL OTHER(SpgCIFY
laffirn? that I�ave'revietved the
,P�visi6ns of Chapter 23, "Pr6tecdoh of Trees 4fid Native Veg,etaitbn"of the'Muhicipal Code df
r h1c]"d r r e it d1or I have pa �7ted it)0 Pre-qwlicafi6n,meeti0g.t;Mh th Adr�inistr a*tor of those
0 d c ach,R an rticip
r U citions. Subsequ'en I ot no reg
ted vejetotion will ed, froy6 and/or removed
®ruilalh _qhit�d trees and ogulb be daniag' di?j d
Iti.pin the-above- do cen to 'r;.diphy 0-n-cavio n v
with this project.,
SEGN _Q R VNER SIGNATURE OF OWNER
Signed and.morn befok�me on'this day of
by. State 6f
County.of
Identification verified:
Oath.sw6rn: F-----Yes N o
MIRIAM GRIFFIN
0
A,A�%
Notary Public,State of Florida
Commissio n#FF 163906
My comm.expires Oct.14,2018 My Cbmmission expires:
City of Jacksonville-Planning and Development OFFICE COPY
Building Inspection Division Permit Nu
mber: Rc—!'�r-\)-7 ocas
PRODUCT APPROVAL INFORMATION SHEET (PAIS)
(revised July 30,2015)
Project Name: 6 12 4
Project Address: Lo
Contractor: z Z-2�:
As required by Florida Statute 553.842 and Florida Administrative Code 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:www.floridabuilding.org.
01 -Version F
'P ici' r I' ',- ::.. i `
f` Urer, �db �c loii 'd - LA(4W6&Suffiik), .,Expiration;
ry Maitu ad oil':. C e
iV — . FQ . - - 1, . . 1, . . —
EXAMPLE ACME 36"Exterior Widget 2014 12345.01 12/31/2017
A.Exterior Doors
1.Swinging
2.Sliding
3.Sectional
4.Roll-up
5.Automatic
6.Other
B.Windows
1.Single Hung 0
2.Horizontal Slider
3.Casement
4.Double Hung
5.Fixed
6.Awning
7.Pass-through
8.Projected
9.Mullion
10.Wind Breaker
11.Dual Action
12.Other
C.PaW.Wall,,
1.Siding
2.Soffits
3.EIFS
4.Storefront
S.Curtain Walls
6.Wall Louvers
7.Glass Block
8. Membrane
9.Greenhouse
10.Synthetic Stucco
11.Other
D.Roofing Products
1.Asphalt Shingles (2
2. Underlayments I/ .00o,
3.Roofing Fasteners
4.Non-structural Roof
Metal
5.Built-up Roofing
6.Modified Bitumen
7.Single-ply Roofing
8.Roofing Tiles
9.Roofing Insulation
10.Water-proofing
!I.Wood
Shingles/Shakes
12.Roofing Slate
13.Liquid-applied
Roofing
14.Cement-adhesive
coats
15.Roof Tile Adhesive
16.Spray-applied
Polyurethane Roofing
17.Other
r
q
p.
q a
a
q
q
p.
q:
�2.Dther
q
q.
a a �a:tego tibicatezo
a ry Mantlfactftr6�' Pr-oduct Des flon Limftation:cif Use:: StateV Local 9
crip
H.'NEW EXTERIOR.
p
-:ENVELOIE.PRODU' C'TS
w 1: .
d
7
6.
In 'addition to to leti the:ab list of manufactd' fefs',,:'p' r' 'n
p mp ng ove oduct descripiion' 'a d State app�6Vad':number for th"produ6ts used on t a :i
ps e. his.pr9ject, the
Contractor. shall�maintain,on the'job-site and available.: '6 copy:of each manufacturer's-printed specifications and installation
to,the ln.sp�ctot, :a legibl
:ihstr6ctions along'Ariththi§:Product Approval Sheet.
.. .. .. ... .. ..
I certify thafihis�product apprdVal list'is,true and co'
rrect to-die best of my:kn6w, l d
e ge. I further:certify that use of dift6renf mppnents other than'the.ones
co
listed in this document ust 6 approved ky*'
M the Building Official. a
(C6nt�actor Name) '(P'r'* t'Name)
Company�
Name.
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MAP SHOWING BOUNDARY SURVEY OF
LOT 56
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E16ggp - HEREON IS,AS BEST ASCERTAINED, IN FLOOD
--ORTIFICATE I HEREBY CERTIFY TRAT THE �LOT SHOWN
ANSURANCr MAP, COMMUNITY PA14EL N' 12OOT7-0 FOR
-ZONE A9.4SHOWN ON'THE FLoOb
RIDA,DATED DEC-15, 1903.
DUVAL COUNTY, FLO
rr FLORIDA
WITH THE MINIMUM TECHNICAL STANDARDS SET FORTH BY TH
IES
CATE'-THIS SURVCY COMPL
BURW70-tko SURVEYORS.PURSUANT TO SECTION 472.027.FLORIDA STATUT98-
LEGEND:
I HEREBY CERTIFYTHAV T141C ABOVE SURVIEVED�BY
DRIEWN4! 12 CCHC^CTK MCHUM&HT
MC ANO THAT 4p em*N cottwen
Anr NOINCROAC14mgNTS UPON
Is LOCATCO UPON $AMC AS qHo,�!MANd YHAV THrRr 0
CLARSON Atip ASSOCIATES INC.
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SAI.O u42 NALDO AV -JACK 0 CD14HICR
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SIGNED cmas%cuy
n is(Ac"Co sunve von fio�. 11L.A.
SCALE:-/-"--_.9� X-X-fccf.
City of AtlanticBeach NUMBER--
"b;
(Tb� y_ Da,me
Building Department -_,b' th'""' 'diidin'd e` *t' _' hQz,
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us.
J
City web-site: hftp://vmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 0_PDSepart;_ent review required Yes -No
PP
_ [_� 1 8,Zo i
Applicant: Rl�-: rv�o 0IF—a-t NDC,- C) nnin Zoning
T r e e A d-m—i n—i smam—r
Project: R, cz) a Public Works
Public Utilities
Public Safety
Fire Services
Review foe $.
Review or Receipt
Other Agency Review or Permit Required of Permit Date
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:
APPLIC-ATION STATUS
Reviewing Department First Review: EgA/pproved. ElDenied.
(Circle one.) Comments: tv
CJ
PLANNING 8,ZONING
Reviewed by: Date:
4-
TREE ADMIN. Second Review: F
]Approved as revised. F-]Deniejj
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLI C SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. FlDenied.
Comments:
Reviewed by: Date:
Revised 07/27110