725 Amberjack Ln RESO22-0026 remove concrete, replace pavers permit submittalrf'--Lvi%: Building Permit Application Updated 10/9/18
v r City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
c)nf r
IS REQUIRED.Phone: (904) 247-5826 Email: Building-Dept@coab.us
Line_I 3aa33JobAddress: -7a 5 pupp//I uc-k Linc, AI-LA, 4uw(.. IL- Permit Number:
Legal Description 1-.04- 4) D( J 5 A if'`a,( j (4S 1Vn.'
I
Rt
30 r-G Cosr V
j f_chJd
Valuation of Work(Replacement Cost)$ b f( Heated/CooledHeSF Nf- Non-Heated/Cooled
Class of Work: New Addition Alteration a Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial L3kesidential
If an existing structure,is a fire sprinkler system installed?: Yes l7No
Will tree(s)be removed in association with proposed oroiect? Yes(must submit eparate Tree Removal Permit) 8'No
Describe in detail the type of work to be performed: V4 . 114,,+ T- a,,n, ne,nv 4ny
I.1 (,, e0441,n9 511'(-C f( 6.)ore.L. wif[,. puvc.^j `S4'1Cdis}".'7 DAn.i if cc.,Ac_ t---
Florida Product Approval#for multiple products use product approval form
Property Owner Information
Name , ` phn nin Address 775 7'^l/U.:`t
City vi\-134.- (,L, State FL Zip 3>33 Phone 1"t 3c3- -7-749
E-Mail br' JW' tku i g to v I •Co',"
Owner or Agent(If Agent,Po,er ofAttorney or Agency Letter Required)
Contractor Information
Name of Company Nfr Qualifying Agent
Address City State Zip
Office Phone Job Site Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date
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 the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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 Y' i ' , ',TICE OF COMMENCEMENT.
i
gnature of Owner or Agent)Signature of Contractor)
Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this day of
Mitil' ,aDaa' ,by fah F A • by
4579 1 Signature of Notary)
t EXPIRES:October 27.2024Ojr, writers
is; BondedTtruNolaryPubfic _--
I J Per onally Kno .,,T•; I Personally Known OR
tPfoduced Identification J Produced Identification
Type of Identification: f L OL- Type of Identification:
4
RESO22-0026
OWNER:ADDRESS:CITY:STATE:ZIP:
FANNING JOHN BRANDON 725 AMBERJACK LN ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171195 0000 ROYAL PALMS UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
725 AMBERJACK LN
RESIDENTIAL OTHER SINGLE OR
TWO FAMILY RESIDENTIAL
OTHER
remove concrete, replace
existing pavers $6000.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (904-247-
5814) to request an Erosion and Sediment Control Inspection prior to start of construction.
2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR 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.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 6/7/2022
PERMIT NUMBER
RESO22-0026
ISSUED: 6/7/2022
EXPIRES: 12/4/2022
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL: $125.00
3 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off container
cannot be placed on City right-of-way.
4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
5 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
6 PUBLIC WORKS DOCUMENT IMPERVIOUS AREA INFORMATIONAL
Notes:
Strongly suggest thorough documentation of impervious areas be recorded.
7 PUBLIC WORKS GRASS INFORMATIONAL
Notes:
Full site to be grassed.
8 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
9 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Owner.
10 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL
Notes:
All construction debris must be removed from job site by Owner.
2 of 2Issued Date: 6/7/2022
PERMIT NUMBER
RESO22-0026
ISSUED: 6/7/2022
EXPIRES: 12/4/2022
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
it.L ., RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION ALL INFORMATION
41..." \\
City of Atlantic Beach HIGHLIGHTED IN GRAY ISA
MP 800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
3)->33
Job Address '7 S ^ j'w( Lam, A I' 4ti -, 8.e t1' Permit Number
Contractor Information
Company Jain I`uA,...);/ Qualifying Agent
Address 7?-5 Aen Le-
I'"Z. City ,44Lf1/4. B.G.k State FL Zip 32->33
Phone 9li`f- 3.'3• -774 / Email j
RESO22-0026
1i1,,;; Owner Builder Affidavit ALL INFORMATION
j ,, t
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
L
V
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
I. FLORIDA STATUTES;CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES
OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED
FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER
OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A
LICENSE.
YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF.
YOU MAY BUILD OR IMPROVE A ONE OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY
ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF $25,000.00 OR LESS.
THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE
CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH
IS IN VIOLATION OF THIS EXEMPTION.
YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR.YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS.
IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES
REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES.
II. INJURY LIABILITY;SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT
SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. .
III. IRS WITHHOLDING;OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING
TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES.OWNERS BEING SUBJECT
TO$5,000 PENALTY UNDER FLORIDA STATUTE NO.455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE
OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA"CONTRACTORS
CERTIFICATE"TO ASCERTAIN IF A PERSON ISA LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPT(COAB.US ) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE+ OF ANOWNER-BUILDERPERMIT.
Job Address: '`75 Awlbcr 6 A L_ A flc-n-1<<, ye..c(., f/ Sas 33
Owner Name: )ditet ann%AI Phone Number: Id i- 303- 77 6 7
Mailing Address: "< City: LI State: (' '` Zip: « 9
Notarized Signature of Owner 1—
The foregoing instrument was acknowledged before me this 1-day of tAktk.k ,20_ke-in the State of Florida, County
of DAY ti. 1
Signature of Notary Public
Personally Known OR [ oduce. dentification
MY
COMIIFER
SION#HH 067579 1
OHNSTON i
pIpIRek°mbx27.9 ype of Identification: j L-
a., •Bonded Thu,Nary Pl*lCWoven
Updated 10/24/18
RESO22-0026
MAP SHOWING BOUNDARY SURVEY OF
LOT 10 BLOCK 5 ACCORDING TO THE PLAT OF
OYAL PALMS UNIT ONE
AS RECORDED IN PLAT BOOK 30 , PAGE(S) 60 AND 60A OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO: JOHN BRANDON FANNING AND KELLY CASSIDY FANNING,
FIRST AMERICAN TITLE INSURANCE COMPANY, i
FIRST INTERNATIONAL TITLE, INC. AND
UNITED WHOLESALE MORTGAGE.
12.
0
C•1 cNI y LOT
0 1/2" II BLOCK 15 LOT 22
II J IRON PIPE 3x BLOCK 5JCOASSOC. S 85°20'02" F 80 65' (R) IRO1N PIPESURV.
0.6' `0.2' S 85'40'00" E 80.90' (M)
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1227.9' 35.8' 17.0'' n cn 0 n
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1/2" -x-x- 1/2" BE4RING REFERENCE LINE 1/2"REBAR P.T.
N 85'20'02" W 80.65' (M) ASSOC.SURV.
N 85°20'02" W 80.65' (R)L.8.5488
1.5' CURBGUTTER 1.74 '
X-REF: 45506 AMBERJACK LANE (60' RAW/
FLOOD ZONE"X" - AREAS DETERMINED TO BE OUTSIDE THE 0.2%ANNUAL CHANCE FLOOD PLAIN /FLOOD ZONE "X(SHADED).* .• AREAS OF 0.2%ANNUAL CHANCE FLOOD, AREAS CF 1X ANNUALCHANCEWTHAVERAGEDEPTHSOFLESSTHAN1FOOTORWTHDRAINAGEAREASLESSTHAN1SQUAREMILE; AND AREAS PROTECTED BY LEWES FROM 1X ANNUAL CHANCE FLOOD.
rf E Y GENERAL NOTES:
Ei %
S 1. BEARINGS ARE BASED aN PLAT BOOK 30, PACE 60
J 2. STRUCTURE NO 725 SHOWN HEREON UES WTHIN FL000 ZONE/LAS BEST DETERMINED
FROM F.E.M.A. FLOOD MAPS PANEL NO.. .DATED 06/03/2013D
0
ASSOCIATED SURVEYORS INC. 4. U11 n«"NAND/ORa' «IME „
EXTENT
yENAREASaIFmANY,NOTOCAED AND
U.! /
LAND be ENGINEERING SURVEYS THIS SURVEY.
S. THIS SURVEY BASED ON LEGAL DESCRIPTIONS FURNISHED. THE PUBLIC RECORDS MERE
F-j 3846 BLANDING BOULEVARD NOT SEARCHED BY THIS SURVEYOR FOR EASEMENTS. TITLE COVENANTS B.R.L'S
JACKSONVILLE, FLORIDA 32210RESTRICTIONS, CLOSURES, TAKINGS OR ORDINANCES. ETC.6. UNLESS OTHERWSE STATED ALL IRON PIPES FOUND HAVE NO IDENTIFICATION.
904-771-6468
LEGEND/ABBREVIATIONS
AC " AIR CONDITIONER P5M .. PROFESSIONAL SURVEYOR &MAPPERJ
0 S S V CERTIFICATE OF AUTHORIZATION NO. LB 0005488 11RI UILDINGBUILDINGBRESTRICTIONTIE LINE R<
R) RADIUSRECORDBBIN . BETWEEN RLS • REGISTERED LAND SURVEYOR
I HEREBY CERTIFY THIS SURVEY WAS DONE UNDER MY cH .. NcHoRDANTS L RESTRICTIONS aiv RIGHT OF WAY
DIRECT SUPERVISION AND MEETS THE MINIMUM TECHNICAL (OMA) - CAN NOT READ 0 SET IRON PIPE OR REBAR
STANDARDS FOR LAND SURVEYING PURSUANT TO CHAPTER 5J-17.050 co]VD •
COVEREDE
SURV' CR LB. 5488
EB - ELECTRIC BOX
FOUND IRON "ASSOCPIPE(IP), PIN(IP) OR REBAR(RB)
THROUGH 17.052, FLORIDA ADMI STRATTVE CODE, C '' R 472, F.S. ET = ELECTRIC TRANSFORMER L PAD FOUND CONCRETE MONUMENT(cM
JEA • JACKSONVILLE ELECTRIC AUTHORITY X - ' CROSS COT ClfoRtu.HOLE (X-CU
L = ARC LENGTH 0' NAIL& DISC(Na)
LB = LICENSED BUSINESS X-X-X-X-X-X-x-CHAIN UNK FENCE
LS " LICENSED SURVEYOR LI M M N HA M M METAL FENCE
BY: I ///.-.4 i HO - MEASURED W-W-"1A'-V v W W WIRE FENCE
T ORB OFFICIAL RECORDS BOOK
n n n n n n n WOOD FENCE
CH•'LE B. HATC ER FLORIDA CE' KATE NO. 3771 ORV • OFFICIAL RECORDS VOLUME
WNx- FENCE
CH:RLES L. STARLING FLORIDA "TIFICATE NO. 4579 PC - POINT OF CURVE OVERHEAD VDU TY
PCC POINT OF COMPOUND CURVE FIRE HPDR/JIT
RAYMOND J. SCH.AEF FLORIDA ERTIFICATE NO. 6132 PEa " P00L EQUIPMENT PAD PHONE RISER
PI " POINT OF INTERSECTION WATER METER
PRC " POINT OF REVERSE CURVE n• •UTILITY POLE
ENJOBNO. 66408 DATE 03/15/2016 PAN " PERMANENT REFERENCE NOMJMT 0 DIAMF.DER
PT • POINT OF TANGENCY GUY ANcIIOR
SCALE: 1" = 20' DRAFTER W.PADGET/ECA PLs - PROFESSIONAL LAND SURVEYOR
NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER
RESO22-0026
By Jennifer Johnston at 4:33 pm, Jun 01, 2022