295 Belvedere St IRR19-0029 App (j!...evt,-, City of Atlantic Beach APPLICATION NUMBER
dBuilding Department (To be assigned by the Building Department.)
800 Seminole Road 1 R R I Q ei. ?Q
j.=:: . Atlantic Beach, Florida 32233-5445 I I\ _
,\ Phone(904)247-5826 • Fax(904)247-5845 5 /�� /( (�
v � E-mail: building-dept@coab.us Date routed: !/ ` `9
City web-site: http://www.coab.us /
APPLICATION REVIEW AND TRACKING FORM
Property Address: • Z-
95 Re_ v9xiQt-e. „S.A.. _Dear Hent review required Yes No
t......„....... ,Building
Applicant: k p`tkc n ( €;C I--- arming &Zonings
r ree Administrator
Project: I N`-Lo c �1,
, " t IS-i cQ Public Works
Public Utilities
Public Safety
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 el
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. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by` .� Date: is-30s( Cl
TREE ADMIN.
Second Review: ❑Approved as revised. Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/1912017
ot..ai , City of Atlantic Beach APPLICATION NUMBER
/` tfrot. Building Department (To be assigned by the Building Department.)
800 Seminole Road 1 9
�,
j
Atlantic Beach, Florida 32233-5445 I \ �r �(
\' Phone(904)247-5826 • Fax(904)247-5845
` o;tE-mail: building-dept@coab.us Date routed: 0 1
City web-site: http://www.coab.us
%/
APPLICATION REVIEW AND TRACKING FORM
Property Address: ZCI S gelve_cterass, . De ment review required .7 No
(-building
I._4 / h
Applicant: t C• • [- t--' ° arming &Zoning
`Tree Administrator
Project: I r lam' c, - n 1__j pjc-IS Public Works
Public Utilities
Public Safety
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 e >
Florida Dept. of Transportation \V
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: Fr4proved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
:UILDING
PLANNING &ZONING (j-y-d-
Reviewed by: � Date: (X/L�
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Plumbin Permit Application **ALL INFORMATION
, �1rir\ gpp HIGHLIGHTED IN
• City of Atlantic Beach Building Department GRAY IS REQUIRED.
� 800 Seminole Rd, Atlantic Beach, FL 32233 (� `Q
Phone: 247-5826 Email: Buildin -Det coab.us PERMIT#: 1„g`- f - 002-9
Pho e ( ) � p @
JOB ADDRESS: ZI S Bet\toel P eeA- PROJECT VALUE $
['NEW OR REPLACEMENT INSTALLATION and/or ❑RE-PIPE
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS
['Sewer Replacement
['Back Flow Preventer
Cf7Lawn Sprinkler System (number of sprinkler heads) 11
❑Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
0 Well **SJRWD Well Completion Form.Completed form to be submitted to the Building Department for final inspection. **
❑Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.
I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws and ordinances
governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions
of any other state or local law regulation construction or the performance of construction.
Owner Name: Alen,/ Pra.lite- Phone Number:
Plumbing Company: ftiih t 4.4„ s eet.te.-y Office Phone: 7 SSS cScc: c Fax
Co. Address: lo'l'ltic '(vc( City: Ai? State: Zip: 32 Z 3 3
License Holder: SLvH- ``'M�Iia—. State Certification/Registration# 7. 3 7
Notarized Signature of License Holder cj
The fore strumen was acknowledged before me thiCI day o , 201 1, in the State of Florida,
County of J_1 Uri
—— _ &'bSig ature of Notary Public
4 ;.ti Y'P..e., CHERYL LYNN OVERBY
NotaryPublic-Sate of Florida
Comrrussior#GG 085997 ersonally Known OR [ ] Produced Identification
My Comm.Expires Jul 17.202t
••' O+;V' Bonoedtough National Notary Assn 0 ype of Identification:
amormirglimirNowwwwwrillworm Updated 10/17/18
-----
;T r Florida Friendly Landscapes
r: • ? IRRIGATION COMPLIANCE CHECKLIST
,J13 91-_,"/
DATE: 5125(
A. PROVIDE PROJECT INFORMATION:
` C� 11 RESIDENTIAL,
ADDRESS: -2.- S 1VeC1 eJ P ,�1 f��--T NEW INSTALLATION
1 ❑ RESIDENTIAL,
CONTRACTOR: ‘-' 01 1YG . -- l✓1A-0.--y UPGRADE/REPLACE
1-K-11 2
CI NON-RESIDENTIAL,
2-8'S-- Q
OFFICE:
'S-- sCELL: -B8 351 FAX: NEW INSTALLATION
p` �' �L�` \\ ❑NON-RESIDENTIAL,
EMAIL: 4c /TiAQ ►1�,11rL4.�.-Verr:4cr. Q' "l UPGRADE/REPLACE
B. CALCULATE MAXIMUM HIGH VOLUME IRRIGATION HYDROZONE shall mean an irrigation watering zone in
which plant materials with similar water needs are
TOTAL LOT AREA 16D O SQ FT grouped together.
..--„,,....0....--2.75r)2.75r) HIGH VOLUME IRRIGATION shall mean an irrigation
TOTAL IMPERVIOUS SURFACE AREA - SQ FT system that does'not limit the delivery of water
directly to the root zone and which has a minimum
TOTAL PERVIOUS AREA/LANDSCAPE 4150 SQ FT flow rate,per emitter,of thirty(30)gallons per hour
(gph)or one-half(.5)gallons per minute(gpm)or
greater.
(Per COAG Code Section 24-181(b)(4)ii) X 0.60
IRRIGATION ZONE shall mean the grouping together
MAX HIGH VOLUME IRRIGATION SQ FT of any type of water emitter and irrigation equipment
operated simultaneously by the control of a timer and
a single valve.
C. PREPARE AND ATTACH A HYDROZONE PLAN:
ON A COPY OF THE SITE PLAN OR SURVEY(RESIDENTIAL APPLICANTS) OR A LANDSCAPE PLAN (NON-RESIDENTIAL
APPLICANTS), INDICATE THE LOCATION OF THE FOLLOWING AND FILL IN APPROXIMATE COVERAGES BELOW:
X HIGH WATER USE HYDROZONE(S) [ALL APPLICANTS] /74C' SQ FT Z/ %TLA
High Water Use Hydrozones contain plants that require supplemental watering on a regular basis throughout the year.These areas include
turf and lawn grasses and are typically characterized by high visibility focal points of landscaping design where High Volume Irrigation is
used.High Water Use Zones shall be placed on a separate irrigation zone.
❑ MODERATE WATER USE HYDROZONE(S) [NON-RESIDENTIAL ONLY] SQ FT %TLA
Moderate Water Use Hydrozones contain plants that,once established,require irrigation every two to three weeks in absence of rainfall or
when they show visible stress such as wilted foliage or pale color. These are typically perennials,seasonal plants and flower beds.
LI LOW WATER USE HYDROZONE(S) [NON-RESIDENTIAL ONLY] SQ FT %TLA
Low Water Use Hydrozones contain plants that rarely require supplemental watering and that are drought tolerant during extreme dry
periods,such as native shrubs and vegetation,established trees and ground covers,and wooded areas.
YMOISTURE SENSOR(S) [ALL APPLICANTS] At least one(1)moisture sensor shall be located in each Irrigation Zone.
❑ EMITTERS [ALL APPLICANTS] Emitters shall be sized and spaced to avoid excessive overspray on to impervious surfaces.
City of Atlantic Beach •800 Seminole Road•Atlantic Beach,FL 32233 •(P)904.247.5800•(F)904.247.5845•www.coab.us
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