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1487 Begonia Street WELL-SEPTIC 05.07.2011 P4 • (-- iii,,. . _, 0 ''-4.01319� City of Atlantic Beach • 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax (904)247-5805 • http://www.coab.us APPLICATION FOR ASSISTANCE WITH CONVERSION FROM WELL AND SEPTIC TANK TO CITY WATER AND SEWER FY 2011-20-12 COMMUNITY DEVELOPMENT BLOCK GRANT PROGRAM The information requested on this form is required in order to determine your eligibility to participate in this program. (These funds may be available to homeowners whose incomes are within low and moderate levels based upon family size and as established by HUD Section 8 Income Limits.) Please answer all questions, and provide copies of all required documents. (Your information is considered confidential.) Funds for this program are available only to owner-occupied homes. In the case of a duplex or two-family dwelling, the property owner must live full-time in one of the two units as documented by a valid homestead exemption.) Grant funds are limited, and applicants are selected based upon most urgent and serious need and availability of funds. DATE: `S. - O 7 l I _ r 1. Homeowner Name(s): , t� h� AA) l ti 2. Address of Home: /-1 g7 A e6-6^)l. <' f1�'ce- - Wk`k t H 3. Telephone Number: / O . ) (/ /- S )-' (day) 9m y" )-yl-7,C? / (night) 4. Is the person completing this application the Head of 4 Household? Xyes ❑ no ❑ female ❑ male 5. How many family members live in this house? I 6. Are there people living in this house with disabilities or special needs? ❑ yesno If yes, please explain 7. Number and age of persons living in the household in addition to Head of Household. Ages 0—5 years old Male Female Ages 6—17 years old Male Female Ages 18—39 years old Male Female Ages 40—64 years old Male .2,.. Female Ages 65 and older Male Female 8. Water supply is provided by: ❑City Water X Private Well Other 9. Does septic system work properly? Yes ❑ No If no,please explain. Page 1 of 3 4 . 10. Does your plumbing work properly?% Yes ❑No If no,please explain. /` 11. Is there hot and cold running water in your house? XYes ❑ No 12. Do you have a complete kitchen with running water,a refrigerator and cooking facilities? 't S 13. How many persons are in your family and living at this address? 14. Federal regulations require that we keep track of certain demographic information and the type of households being served. Please check the appropriate box below. 7I White,Not Hispanic ❑ African-American,Not Hispanic ❑ American Indian or Native Alaskan ❑ Hispanic ❑ Asian or Pacific Islander ❑ Female Head of Household ❑ Other 15. What is the total annual income(before taxes)of your household? r 3 C'S). U� 16. Are you on a fixed income such as Social Security, SSI or retirement? 111Yes No 17. What are your sources of income? (A) Or — 11-t- }'OI1,tE i) c v.7-- 18. Do you own this home? Yes ❑ No C /Cf &' fIsk or 'CA— If If you own your home, p ase provide a copy of your deed and a recent water or electric bill which shows that you live at t is address. If yo nt your home,please provide a copy of the lease. '. ' ,frj- ik -- Signature of Owner Date If you have any questions about this application or need any assistance preparing the application, please contact the City of Atlantic Beach at (904) 247-5817. The following Income Verification Form must also be completed and mailed or delivered to: Community Development Department City of Atlantic Beach 800 Seminole Road Atlantic Beach, Florida 32233 Please provide the time of day and day of the week (Monday through Friday) when it would be most convenient to make arrangements for a City Inspector to meet with you, and the phone number where you wish to be called. Page 2 of 3 1 INCOME VERIFICATION FORM PART I. (To be filled out by the person (employee) completing this application.) Applicant/Employee name: J/174&-T AN. PoiJc PP P Address: 1 L Z 7 g oil,4!i - 6 • 7 , A Cf.) L 3a D-33 Social Security Number: g 4o y (Is'o 61 I hereby authorize release of my income information to the City of Atlantic Beach for the purpose of applying for participation in the septic to sewer conversion funding assistance rogram, which is nded by a Community Development Block Grant. )1H,, .5--- o ?- l/ Signature of Owner Date PART II. (To be filled out by employer, Social Security Administration or HRS.) Please provide the following information and return to: Community Development Department City of Atlantic Beach 800 Seminole Road Atlantic Beach, 2 Flor'da 32233 Applicant/ Employees Name: ° N AA - 1 dice Gross Monthly Income: $ 3D/Y Is employment: [permanent part-time n temporary Employer NameHke 4(79wei D . Address: I 7N 1 A-1---k,„, C. 8)1Y1 Telephone: 7Q76-MRex-1- I - L_/_e ; /r' . ,/li ` /21' 0,. _moi 07? -=-� y • . i' of personirroviding this informa 'o s. Date 5/9 // Page 3 of 3 nue rorerm,eron 1 ter` of the Treeeyry-Internal Revenue Service satuiWages,lips.otter compensation 2 Federal income tax withheld l Rerenye ..f reu 2748.20 acorea ty ine 4 • r.:;e;:;�„e, Social security tax withheld varnmer oro 17,F mo�.r" ° 5 2084.30 a j�>� Medicare wages and tips r,n:ereovrt.r. 6 Medicare tax withheld 33617.72 c Employer's name,address,and ZIP code 487.46 HOME DEPOT U.S.A. INC. STORE SUPPORT CENTER 2455 PACES FERRY RD • ATLANTA GA 30339 7 Social Security Tips 9 Advance EIC payment 10 Dependent care benefits J2a ee Instructions .r box 12 12b D 1086.50 b Employer identification number a Employee's social security number58-1853319 13 Stataatoor R 264-45-061 1 em to Retirement Third-party 14 ployplan sick payer X • Employee's name.address,and ZIP code JANET M PONCE 1487 BEGONIA STREET ATLANTIC BEACH FL 32233 Forrn 13 State Employer's state ID number 16 State wages.tips.etc. W-2 - -- - -- - - - -- - - _ _ _ _ _ _ _ Wage and Tax 17 State income tax Statement 16 Local wages,bps,etc. _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ __ _ _ _ 2010 . 20 Locality name Copy C For EMPLOYEE'S RECORDS. _ _ _ _ _ _ _ jEgi 21 West Church Street,Jacksonville,FL 32202-3139 Phone:904.665.6000•Fax:904.665.7990 •Internet:jea.com Page 1 of 1 Customer Name: PONCE JANET M Account#: 5374624200 Cycle: 19 Bill Date: 04/22/11 Please pay$87.23 by 05/16/11 to avoid 1.5%late payment fee. Billing Rate: Residential Electric Service Service Address: 1487 BEGONIA ST Service Period: 03/23/11-04/21/11 Reading Date: 04/21/11 Duval County residents who are transportation dependent or Meter Days Current Reading Meter require a Special Medical Needs Shelter during emergency evacuation Number Billed Reading Type Constant Consume. need to register annually. Forms can be downloaded online at 26887219 29 55173 Regular 1 626 kwh http://www.coj.net or by calling the City's Emergency Preparedness Electric Charges $ 77.25 Division at(904)630-2489. Conservation Charge 0.00 Gross Receipts Tax 2.11 Franchise Fee 5,07 Public Service Tax 2.80 TOTAL CURRENT ELECTRIC CHARGES $ 87.23 NON-TAXABLE FUEL AMOUNT$28.51 CONSUMPTION HISTORY TOTAL NEW CHARGES $ 87.23 Electric kwh Apr2011 626 Mar2011 565 Apr2010 657 Mar 2010 784 A LATE PAYMENT FEE WILL BE ASSESSED TO ALL UNPAID BALANCES Previous Balance Payment(s)Received Balance Before New Charges New Charges Please Pay WE APPRECIATE $79.34 -$79.34 $0.00 $87.23 $87.23 YOUR BUSINESS PLEASE DETACH AND RETURN PAYMENT STUB BELOW WITH TOTAL DUE IN ENVELOPE PROVIDED. Additional information on reverse side.--10- .4.1111501_ ide.—*' Add$ to my monthly bill:$ for Neighbor to Check here for telephone/mail addre Neighbor and/or$ for the Prosperity Scholarship correction and fill in on reverse side. Fund. I will notify JEA when I no longer wish to contribute. Acct#: 5374624200 Bill Date: 04/22/11 Please pay by 05/16/11 to avoid 1.5%late payment fee. Previous Balance Payment(s)Received Balance Before New Charges New Charges Please Pay TOTAL AMOUNT PAID $79.34 -$79.34 $0.00 $87.23 $87.23 I,IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIuIIII, I, **JEA** PONCE JANET M 1487 BEGONIA ST PO BOX 45047 JACKSONVILLE FL 32233-1846 JACKSONVILLE FL 32232-5047 A 2717 02085374624200000000000004000008723010100000001900011 at' `' e or 1',Ititsl8b i c15,38.7:ii 3' i.• .. � 1'i it .. ifs '� :iii . . 1.. ... w? frl ai Y zu, 1 ',.1,ra • • " J.1L. . 1 -.,� }-.!:I s�. ,'� /,• t�1:r..w:L i'? i C I ni,nen $te'3E,: °• ' ,t,'1 „ ..t,��Ah qtly} 9;1: ,a:r i8„s- #: t3:=. 1 ._.. ' �.)� „ `•(��. ,.�ti1+ i.,"1L ., ,atibi°,'•9$"it '. i l;t ' 83 68 Cit'y' of Atlantic Beach 800 Account Number: 4051-40.. 800 Seminolec Beach,Road 32233 Customer Name: PONCE,JANET Service Address: 1487 BEGONIA Telephone: (904) 247-5816 Bill Date: 05/01/1 Fax: (904)247-5877 Current Charges Due Date: 05/16/1 Service Period Meter Number Current Reading Previous Reading Usage in 1000 Gallons Service Total Service Total GARBAGE GARBAGE SERVICE 17.7T STORM WATER UTILITY STORMWATER 5.0( CURRENT BILL 22.7 PREY.BALANCE 0.0 -3-AL DUE 22.7 AFTER DUE DATE PAY 25.06 PERIOD GAL X 1000 DAILY AVG. CURRENT LAST PERIOD I YEAR AGO PLEASE BRING ENTIRE BILL IF PAYING IN PERSON. PLEASE DETACH AND RETURN BOTTOM PORTION IF PAYING BY MAIL. FL22574 -_ ACCOUNT# BILLING DATE 05/01/1 `" CityotAtlanticBeach 4051-4050 CURRENT BILL 22.7 800 Seminole Road ` Atlantic Beach,FL 32233-5444 DUE DATE PREY. BALANCE 0.0 Address Service Requested 05/16/11 TOTAL DUE 22.7 AFTER DUE DATE PAY 25.06 Check Box For Change of Address or Bank Draft Sign Up PLEASE ENTER AMOUNT PAID I $ *AUTO ***AUTO**5-DIGIT 32233 IIIIIIIIII.IIIIIIII'III'11'!III'IIIA.IIIIIIuI11'III11'II,,IIII1' City of Atlantic Beach 04-99 PONCE,JANET M. 800 Seminole Road 1487 BEGONIA STREET Atlantic Beach, FL 32233-5444 ATLANTIC BEACH FL 32233-1846 83 1 III"IIIIIIIII"I"'IIIII'II'I'I"II"IIII"III'IIIIII,IIIIIIuIII . . ••rt •_1'01 ' 7 • . • , -•• , ; , • ; • • . . . • t:(= -,. . . . . . _ . • — .,•1,•9'r• $ • • • • „— '•;s i , •7 1.. • (1'11-7-1'•••••. r _ . . , . 2 • .‘' - , . . „ . . . ....._— , . , , TZi”) !• „,. -'1"" 41 �: jv�� CITY OF ATLANTIC BEACH sA 800 SEMINOLE ROAD j ATLANTIC BEACH, FLORIDA 32233-5445 C TELEPHONE: (904) 247-5800 FAX: (904) 247-5805 — J1319 www.coab.us June 27,2011 Janet M. Ponce 1487 Begonia Street Atlantic Beach,FL 32233 Dear Ms.Ponce; The purpose of this letter is to confirm that the City of Atlantic Beach has received your APPLICATION FOR ASSISTANCE WITH CONVERSION FROM WELL AND SEPTIC TANK TO CITY WATER AND SEWER. At the present time,the City is compiling the applications and information so that we can schedule these projects in the coming year. The funding should be available starting in October 2011. City staff will contact you to review your application to assure that you qualify for the financial assistance. Additionally, staff will provide you with direction and guidance so that you can obtain qualified help to perform the services. This will be explained to you in more detail within the next few months. In the meantime, if you any have questions,then you are welcome to contact me for further discussion. Thank you for expressing your interest in this program. Sincerely yours, / AP David E. Thompson Asst. City Manager Property Appraiser - Property Details Page 1 of 2 PONCE JANET M Primary Site Address Official Record Book/Page Tile# 1487 BEGONIA ST 1487 BEGONIA ST 08061-00334 9418 ATLANTIC BEACH, FL 32233-1846 Atlantic Beach FL 32233 1487 BEGONIA ST Property Detail Value Summary RE# 171081-0100 _2010 Certified 12011 In Progress Tax District USD3 Value Method CAMA CAMA property Use 0100 SINGLE FAMILY Total Building Value $94,588.00 $77,635.00 #of Buildings 1 Extra Feature Value $1,394.00 $2,315.00 Legal Desc. 18-34 38-2S-29E Land Value(Market) $63,412.00 $63,412.00 SEC H ATLANTIC BEACH Land Value(Aaric.l $0.00 $0.00 Subdivision 03119 ATLANTIC BEACH SEC H Just(Market)Value $159,394.00 $143,362.00 The sale of this property may result in higher property taxes.For more information go Assessed Value $91,468.00 $92,840.00 to Save Our Home;and our Property Tax Estimator.Property values,exemptions and Cap Diff/Portability Amt $67,926.00/$0.00 $50,522.00/$0.00 other information listed as'In Progress'are subject to change.These numbers are part of the 2011 working tax roll and will not be certified until October.Learn how the exemptions $50,000.00 See below Property Appraiser's Office values Property. Taxable Value $41,468.00 See below Taxable Values and Exemptions—In Progress If there are no exemptions applicable to a taxing authority,the Taxable Value is the same as the Assessed Value listed above in the Value Summary box. County/Municipal Taxable Value SJRWMD/FIND Taxable Value School Taxable Value Assessed Value $92,840.00 Assessed Value $92,840.00 Assessed Value $92,840.00 Homestead Exemption(HX) -$25,000.00 Homestead Exemption(HX) -$25,000.00 Homestead Exemption(HX) -$25,000.00 Amend 1 Homestead(HB) -$25,000.00 Amend 1 Homestead(HB) -$25,000.00 Taxable Value $67,840.00 Taxable Value $42,840.00 Taxable Value $42,840.00 Sales History Book/Page Sale Date Sale Price Deed Instrument Type Code Oualified/Unqualified Vacant/Improved 08061-00334 3/24/1995 $64,000.00 SW-Special Warranty Qualified Improved I 107896-00484 7/15/1994 $58,500.00 CT-Certificate of Title Unqualified Improved I 106647-01739 1/25/1989 $74,000.00 WD-Warranty Deed Unqualified Improved I Land&Legal Land Legal LN I Code Use Description zoning I Front I Depth Category Land Units Land Value I LN Legal Description 11 10100 1 RES LD 3-7 UNITS PER AC ARS-2 195.00 1102.00 i Common 195.00 $63,412.00 1 118-34 38-2S-29E I 2 SEC H ATLANTIC BEACH I 13 LOTS 1,2 BLK 251 Buildings Building 1 Building 1 Site Address Element I Code I Detail 1487 BEGONIA ST Atlantic Beach FL 32233 Exterior Wall 8 8 Horizontal Lap Roofing Structure 3 3 Gable or Hip Building Type 0102-SFR 2 STORY SOH Roofing Cover (3 3 Asph/Comp Shingle 1e I, i Fua Year Built 1989 Interior Wall 5 5 Drywall I:1--1 J - Int Flooring 11 11Ceramic Clay Tile FGa Type Gross Area I Heated Area Int Flooring ( 14 14 Carpet �'``� Base Area 776 1776 Heating Fuel 4 4 Electric Finished upper story 1 504 1504 Heating Type 4 4 Forced-Ducted Finished Garage 460 0 Air Conditioning ( 3 3 Central Finished Open Porch 48 0 Total 1788 11280 I Element Code Stories 2.000 Bedrooms 3.000 I Baths 2.000 I Rooms/Units 1.000 I http://apps.coj.net/pao propertySearch/Basic/Detail.aspx?RE=171 ... 9/9/2011 (/J'`,XJ3. i :.-" `S, CITY OF ATLANTIC BEACH PUBLIC UTILITIES � 1200 Sandpiper Lane ATLANTIC BEACH,FL 32233 0169`- (904)270-2535 or(904) 247-5874 NEW WATER/SEWER TAP REQUEST Date: 11/15/2011 Project Address: 1487 Begonia Street No. of Units: 1 Commercial Residential XXX Multi-Family New Water Tap(s) & Meter(s) I Meter Size(s) ‘7/41‘ New Irrigation Meter Upgrade Existing Meter from to (size) New Connection to City Sewer: XXX 0 Name: Janet M. Ponce Applicant Address: 1487 Begonia Street City: Atlantic Beach State: FL Zip: 32233 Phone Number: 904 249-7527 Cell Number: Email Address Fax: Signature: David Thompson: (Applicant) CITY STAFF USE ONLY Application# Water System Development Charge $ 0 O6 (,26. � �� Sewer System Development Charge $ Oso,O 0 Pees Water Meter Only $ ; , Do Water Meter Tap $ ��G /P� � Con✓emso.) Sewer Tap $ w14' C 21 t'eC4D,1 `° __ J Cross Connection $ .O a c' --P.'. . Other Cw ?At PLuwttsc,i6.- V.-V-71.2-2-700 TOTALv (notes) • APPROVED: IL (Utility Director or Autho A Signature) ALL TAP REQUEST MUST BE APPROVED BY UTLITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED Prepared by and return to: • _ Aid David Thompson,Asst. City Manager City of Atlantic Beach 800 Seminole Road Atlantic Beach, FL 32233 WELL AND SEPTIC TO WATER/SEWER CONNECTION AGREEMENT CITY OF ATLANTIC BEACH, COUNTY OF DUVAL, STATE OF FLORIDA For the value of services received, which may include, abandonment and removal of existing septic tank, construction of the connection, the sewer tap fee and any impact fees related to connection of this property to centralized sewer and/or water services, the undersigned promises to pay, in accordance with the following terms of this Agreement, to the City of Atlantic Beach, hereinafter known as the Holder of this Agreement, which is a municipality of the State of Florida, located at 800 Seminole Road,Atlantic Beach, Florida 32233,the principal sum of: $ 8,847.00 being payable in lawful currency of the United States of America to the Holder at 800 Seminole Road, Atlantic Beach, Florida 32233, or at other such address as the Holder may specify by written notice to the Maker. Said sum shall bear no interest and shall be reduced in amount at the rate of one/fifth (1/5th) per year, on each year anniversary of this Connection Agreement, until reduced to a balance of zero (0) dollars at the end of five years. Any unforgiven balance shall become immediately due and payable in the event that the Maker transfers title of ownership or moves from the premises, which secures this Connection Agreement within the five (5) year period of time. In the event of the death of the Maker of this Agreement, said Agreement shall remain in effect and the principal sum that is due shall be reduced as described above only in the case that an immediate family member, with qualifying income eligibility, takes residence upon the premises, which secures this Agreement. In all other cases, and under any other circumstance, any unforgiven balance shall become immediately due and payable to the Holder. This Connection Agreement is to be construed and enforced in accordance with the laws of the State of Florida, and is secured by the real property, located at: 1487 Begonia Street,Atlantic Beach,FL 32233 Legal Description: 18-34 3802S-29E, Section H,Atlantic Beach, Lots 1,2 BLK 251 RE# 171081-0100 In the event that default is made in the payment of any of the sums as described and required herein, or in the performance of any agreements contained herein, then at the option of the Holder of this Connection Agreement,the remaining principal balance shall immediately become due to the Holder and collectable without notice, time being of the essence of this Connection Agreement contract, and said remaining principal balance shall bear interest at the highest rate allowed by applicable law, from such time until paid in full. Each Maker and Endorser waives presentment, protest, notice of protest and notice of dishonor and agrees to pay all costs, including reasonable attorney's fees, whether suit be brought or not, Connection Agreement-Page 1 of 2 if counsel shall be required after maturity of this Agreement, and if counsel shall be employed to collect said Agreement or to protect the security thereof. MAKER(S): By: Date: � �_ a' id -// Janet Ponce CITY OF ATLANTIC BEACH By: C Date: it /,2/,,/ Jim H son, City Manager / STATE OF FLORIDA COUNTY OF DUVAL Swor and Subscribed before me this /a¢� day of 7ecenv Ale ,20 /7,by ZJ of f one who is personally known to me or produced -V33-d o-. s- as identification, and who did not t. e an oath. otary Public, S .;Y• ••0:commr��WLEY Dna100 EXPIRES:July 29,2012 STATE OF FLORIDA I', s+°.` Bonded Mau Notary Pubic r COUNTY OF DUVAL Sworn and Subscribed before me this day of , 20 , by who is personally known to me or produced as identification, and who did not take an oath. Notary Public, State of Florida at Large Connection Agreement-Page 2 of 2 Nov 22 11 01:11p Christy First Coast Plumb 9042494660 p.1 Inq CHRISTY FIRST COAST PLUMBING, INC. 1651 MAYPORT ROAD, ATLANTIC BEACH, FL 32233 247-4419(Office); 249-4660(Fax) FAX COVER SHEET Date: ± I ea- --1 I To: R-atte9t. icbrc(2_ From: Julie Young Christy Re: Cry L7 PP Ponc, brobn ca6(/ ct-± 161N-3- 1pof- dDC, ;ACia_d& uact, ,rsorr-c_e_ _ 3--- /PlckA (30bur Grctinti,L et read ti) DSK seen -' - .� I 'd L2SG-64 -406 aouod zaueC d9e :20 TT SO 0a0 We propose to furnish material and labor in accordance with the above prices and specifications for the sum of Three Thousand Four Hundred Twenty Two Dollars ($3,422.00). This price is for work performed during normal business hours; no overtime included. DRAWS: $3,422.00 to be paid upon job completion. Draws to be paid when Invoice is presented. If not paid, a service charge of 1.5% of the unpaid balance per month (18% annum) plus all cost of collection, including attorney's fees incurred in the event of legal action will be assessed. No plumbing will be performed unless or until prior billings for this job have been paid. The above prices, specifications and conditions are satisfactory and are hereby accepted. You have authorization to perform the work as specified above. Signature Date Our proposal is subject to any industrystandard price increases. E 'd L2SL-6b2-b06 aouod zauer d9E :20 TT SO oaa PROPOSAL CHRISTY FIRST COAST PLUMBING, INC. 1651 MAYPORT ROAD, ATLANTIC BEACH, FL 32233 247-4419 (Office); 249-4660 (Fax) CFC1428'141 PROPOSAL October 17, 2011 Janet Ponce 1487 Begonia Street Atlantic Beach, FL 32233 249-7527 We will provide labor, material and permit to run approximately 110' of 4" Schedule 40 sewer line and tap into 6" city lateral. We will provide labor, material and permit to run approximately 55' water service to city meter from house. Backhoe service will be used to facilitate the job. Ditches will be backfilled to grade. We will contact Central Locating to mark utilities. Please allow 3 to 5 days for locating once contract is signed. We will permit through the Duval County Health Department to abandon the septic tank; it will be pumped out and then inspected by Health Department officials and filled with clean fill after the inspection. DWV to be Schedule 40 PVC. Water piping to be CPVC. Water taps, sewer taps and any other city charges to be billed to and paid for by owner/builder. Patchwork and landscaping are not responsibility of plumber. Price does not include permit fee. A signed copy of this contract must be in our possession before the mentioned work commences. Freight charges on special order items to be paid for by owner/builder. Christy First Coast Plumbing, Inc. will warranty our craftsmanship (installation only of products and materials) for one year after completion of job. Products and material provided by Christy First Coast Plumbing, Inc. will carry the manufacturer's own warranty as applicable on defective products. The term "defective° shall not be construed as embracing damage that arises from misuse, negligence, Acts of God, normal wear and tear or failure to follow operating or cleaning instructions. Warranty work will be performed during regular working hours between 8:00 a.m. and 5:00 p.m., Monday through Friday. except on holidays. 2 'd L2SL-6b2-4.06 aouod 'aauer dgE :20 II SO oaQ fa K %`n • • • • • • • • • • • • S Z. • • .., •« ..+.;, :;i" ^ [::' ae ice,�° 2' .. • • • • PROPOSAL lutt CHRISTY FIRST COAST PLUMBING, INC. 1651 MAYPORT ROAD, ATLANTIC BEACH, FL 32233 247-4419 (Office); 249-4660 (Fax) CFC 1428444 PROPOSAL October 17, 2011 Janet Ponce 1487 Begonia Street Atlantic Beach, FL 32233 249-7527 We will provide labor, material and permit to run approximately 110' of 4" Schedule 40 sewer line and tap into 6" city lateral. We will provide labor, material and permit to run approximately 55' water service to city meter from house. Backhoe service will be used to facilitate the job. Ditches will be backfilled to grade. We will contact Central Locating to mark utilities. Please allow 3 to 5 days for locating once contract is signed. We will permit through the Duval County Health Department to abandon the septic tank; it will be pumped out and then inspected by Health Department officials and filled with clean fill after the inspection. DWV to be Schedule 40 PVC. Water piping to be CPVC. Water taps, sewer taps and any other city charges to be billed to and paid for by owner/builder. Patchwork and landscaping are not responsibility of plumber. Price does not include permit fee. A signed copy of this contract must be in our possession before the mentioned work commences. Freight charges on special order items to be paid for by owner/builder. Christy First Coast Plumbing, Inc. will warranty our craftsmanship (installation only of products and materials) for one year after completion of job. Products and material provided by Christy First Coast Plumbing, Inc. will carry the manufacturer's own warranty as applicable on defective products. The term "defective" shall not be construed as embracing damage that arises from misuse, negligence, Acts of God, normal wear and tear or failure to follow operating or cleaning instructions. Warranty work will be performed during regular working hours between 8:00 a.m. and 5:00 p.m., Monday through Friday, except on holidays. S • - • We propose to furnish material and labor in accordance with the above prices and specifications for the sum of Three Thousand Four Hundred Twenty Two Dollars ($3,422.00). This price is for work performed during normal business hours; no overtime included. DRAWS: $3,422.00 to be paid upon job completion. Draws to be paid when Invoice is presented. If not paid, a service charge of 1.5% of the unpaid balance per month (18% annum) plus all cost of collection, including attorney's fees incurred in the event of legal action will be assessed. No plumbing will be performed unless or until prior billings for this job have been paid. The above prices, specifications and conditions are satisfactory and are hereby accepted. You have authorization to perform the work as specified above. Signature Date Our proposal is subject to any industry standard price increases. P.O.Box 49225 Estimate Jacksonville Beach,FL 32240 Date 10/20/2011 10202011.1P Name/Address Job Address Janet Ponce 1487 Begonia Street Atlantic Beach,Fl 32233 Item Description Total Sewer/Water Install new sewer from house to new city tap in front yard with schedule 3,818.00 40 PVC pipe Pull lids on septic tank,pump out tank,break holes in bottom of tank and backfill with dirt and compact for abandonment Run new water service from meter to house and disconnect well from house supply Price does not include any sod or concrete repair Deck may have to be pulled for sewer and abandonment Is is in bad shape and may not be able to be repaired or put back together Will price new deck if needed Sewer and permit$2223.00 Abandonment$1075.00 Water service$520.00 Thank you for your interest in Advantage Plumbing.This estimate is good for 30 days. Total $3,818.00 1. • , rftr,; !, • • 0•• ;: ,-z ; „; '1•oft C,4% fic=1•. = , , ; Co') • •=' =i; ' ° • 3. f ;i "'•;! ; ' .1; M :4".: •*.• • i. .; . . „.. Amelia Plumbing Inc. Estimate P.O. Box 50155 Date Estimate# Jacksonville Beach, Fl 32240-0155 Office 904.821.8355 11/10/2011 Fax 904.223.5365 CFC057641 Name/Address Ponce,Janet 1487 Beogonia Estimates are good for Atlantic Beach,Fl 32233 only 30 days from the date on this estimate. P.O.No. Project Description Cost Total This is an estimate to install a new sewer line and delete the existing septic tank. 3,945.00 3,945.00 1.We will be installing a new 4"sch 40 type pvc sewer from the back of the house around the northside of house and then towards the driveway where existing tap location is. All work will be according to state and local codes. 2. We will be deleting the existing septic tank by disabling the bottom and the sides of the septic tank according to health department specs. Home owner will have tank pumped out and grease balls and solids removed. We will backfill the tank with fine fill dirt. We will have to pack the dirt good because part of the tank is under concrete patio. If patio falls in while work is being performed we are not responsible for replacement. If patio cracks due to setting or dirt settles because we cant pack the dirt in because of patio being over the septic tank we are not responsible for it or replacement. Yard will be put back to rough backfill,raked smooth and sod replacement is NOT included in this estimate this would be done by others. Permits are required and will be added to the total of the estimate. They are not included in the estimate. Estimate to replace water service 600.00 600.00 Total $4,545.00 Signature Phone# Fax# E-mail www.amelia-plumbing.com 904-821-8355 904-223-5365 ameliaplumbing@yahoo.com amelia-plumbing.com .*.--, t ...i 91'13 fr!im!'"olad ••P, ',.,..#4. t'.‘ 10(1..lik.).ccA 1 , '•• r- ::.,.....:7*.;.,:i: '-1 ,'-;•' : '!'' t Ili('1•''',-,•' '' r ) , . . F._•.... :...(..•.-. , . ; _'. ;.,.. ) . . . ,.. .. ) ! _ ,. .. . _ _.............. ... 1 ; . . . . . ,. . , ) i 1 : I - _ ..--. -- . -...- .- - --.-_ - -- - • - • - - ------_. ,.-_. .. ... ! : : 1 " , r $,:? ,'. •• , ; t . t i • . . . . ' t i 1 , I i i f i : : • ., ,,, ..,! , . t - . . i . . • t ' t t ' , 1 1 i r -' ' ' .itrt-t.ti'''' i-1 '`..l'it t, ' f; .. , -' $, ' itr '.-; t t . . t ' t t . t I .. :,'"": .7. ir..4''1 ;•.' ,..i''. . '. `..'•''..' ..•'.: -.1 ' ,- C,., -',, . ,j- ,i,. pf• ,• f, I i L . . ' t . i I . I 1 1 I . •'' •' •.. ' .,.,..:V ' • , ! i - ,i:!•.tf.:rmil.:., - ....... ,_ , Amelia Plumbing Inc. Estimate P.O. Box 50155 Jacksonville Beach, Fl 32240-0155 Date Estimate# Office 904.821.8355 11/10/2011 Fax 904.223.5365 • powikk dress 1487 Beogonia Atlantic Beach,Fl 31233 P,O. No. Project Description Cost Total 3,94500 3.94500 All work to be completed in a workmanlike manner according to standard practices and local codes. Any alterations or deviation from the above specifications involving extra cost will be executed only upon strikes, accidents or delays beyond our control Owner to carry fire, tornado and other necessary insurance Our employees are fully covered by Workers Compensation Insurance, Acceptance of proposal-- The above prices,specifications and conditions are satisfactory and are hereby accepted You are authorized to do the work as specified. Payment will be made as outlined above CONSTRUCTION INDUSTRIES RECOVERY FUND Payment may be available from the Construction Industries Recovery Fund if you lose money on a project performed under contract, where the loss results from specified violations of Florida law by o state-licensed contractor. For information about the Recovery Fund and filing a claim, contact the Florida Construction Industry Licensing Board at: 1940 North Monroe Street Tallahassee, Fl 32399-1039 (850)4871395 Total $3,945.00 Signature www.nme I is-plumbing.cam 70/70 7ClHlJ c ESEZZV06 VE:60 ttOZ/tt/it • Amelia Plumbing Inc. Estimate P.O. Box 50155 Jacksonville Beach, Fl 32240-0155 Date Estimate it Office 904.821.8355 11/10/2011 Fax 904.223.5365 CFC05764 I Name/Address Ponce,Janet 1487 Seogonia Atlantic Beach,Fl 32233 P.O. No. Project Description Cost Total This is an estimate to install a new sewer line and delete the existing septic tank. 3,945.00 3,945,00 1. We will be installing a new 4"sch 40 typc pvc sewer from the back of the house around the northside of house and then towards the driveway where existing tap location is All work will he according to state and local codes. 2. We will be deleting the existing septic tank by disabling the bottom and the sides of the septic tank according to health department specs. Home owner will have tank pumped out and grease balls and solids removed. We will backfill the tank with tine till dirt. We will have to pack the dirt good because part ache tank is under concrete patio. If patio falls in while work is being performed we arc not responsible tier replacement. If patio cracks due to setting or dirt settles because we cant pack the dirt in because of patio being over the septic tank we are not responsible for it or replacement. Yard will be put back to rough backfill.raked smooth and sod replacement is NOT included in this estimate this would be done by others. Permits are required and will be added to the total of'the estimate. They are not included in the estimate. Total $3,945,00 Signature Phone# Fax* E-mail www.amelia-plumbing.com 904-821-8355 904-223-5365 ameliaplumbing®yahoo.com amelia-plumbing.com 7aiTa ILIWA 99ESEZZb06 PE:60 iiOZ/ii/ii (Technician-Please check the correct box) CFC056659 CGC1504600 ❑ A.S.A.P. Plumbin ind Drain Cleaners ❑ A.S.A.P. Carpet Cleaning, Inc. 'WORK ORDER NO. U A.S.A.P. Drywall Installers ' 0 A.S.A.P. General Contracting 0 A.S.A.P.Tile Installers ❑ All Pro Contracting, Inc. 0%5,,/1 y Jacksonville (904) 346-1266 Orange Park (904) 264-6444 CONTROL NO. Flagler-Palm Coast (386) 439-5290 Palatka (386) 328-7255 102430 Fernandina (904)277-3040 Starke (904) 964-3995 Gainesville (352) 335-8555 St.Augustine (904) 824-7144 Lake City (386) 755-5727 Volusia-Daytona (386) 253-4911 DATE OF SERVICE Ocala/Marion County (352) 732-6060 P.O. Box 48070•Jacksonville, FL 32247 �/- _2 3-// SAVE THIS CONTRACT FOR YOUR GUARANTEE CUSTOMER CUSTOMERTENANT NAME T1t/1,,. 4 �G�� PHONE 2 1/y" 7r� 7 PHONE BILLING Jj�X�r �`///�� TENANT ! ADDRESS 7 If7.-4 ,_ , �/_ NAME CITY STATE ZIP CHARGE /S 7,e l'- ZJ' ,C Jj1 J] AUTHORIZATION# JOB ADDRESS(If different than Billing Address) STATE ZIP PURCHASE ORDER#: APARTMENT/SUITE#: / �- DESCRIPTION OF WORK: /�f, . // �, �,�j,, ��. f r,-�v. �- c l i i�V/� / /'ris.�/ /VC[Ai 2 't_ 7:-...- / 6 %.:,f,l�r- �l....s� �. ��J.ti/✓e-C.1 t......- i� ,� QV e._ ,`4 4 f.0 G/l/ //- 4' A'i./ Al iJ./.4/is-! (-0,,,,-i✓t./ L77442.r'lt t •- i c c:' .1,.s! 24---c" _4./t //4 ,, ti ?"i' /•-e- z. //v G/!/C-/t'! A--,,....,/,',1, /�`�t�/� c /� ilivwvc O/ / 7 �� 7L Ewa <iQ OGv�- Yr f� ��y �'/ J• �t rs- // /4 &&r rf�.i- 2---1a/s" y Unless otherwise stated drywall repairs, tile repairs, sod repairs, wallpaper repairs, painting repairs, isometric drawings, engineered drawings, roof repairs or painting repairs will not be included in this contract. WORK ORDER AUTHORIZATION OTHER CHARGES INVOICE AMOUNTS I hereby authorize you to perform the above described services GUARANTEE and I agree to pay the amounts indicated to the right. I hereby $ TOTAL $ certify that I am duly authorized to order and approve the work PARTS ADDITIONAL requested. TERMS ON $ LABOR SIGNATURE Title REVERSE $ Mlsc $4.95 VAN SUPPLIES Tax Exempt TERM OF PAYMENT: ❑CREDIT CARD ❑CASH ❑NET 10 CI NET 30 REE ESTIMATE # TAX ❑ CHECK# In the event this check is returned,the COMPANY will charge the DEDUCTABLE PAID < > CUSTOMER for the amount of the check plus a $30.00 processing fee,or 5%whichever is greater. DISCOUNTS < > I/we are the lawful owners of this property,or I/we are the agent(s)for the property owner,and I/we personally guarantee payment of this debt. I/we are completely satisfied with the above work. I/we have read and agree to the terms and conditions on the reverse side of this contract which are part of this contract. � / Total $ d7/4 DATF CUSTOMER SIGNATURE SERVICEMAN'S NAME