848 AMBERJACK LN - SHED `t)' l "` CITY OF ATLANTIC BEACH
s> 800 SEMINOLE ROAD
\ �« ATLANTIC BEACH, FL 32233
\r;3 c-) INSPECTION PHONE LINE 247-5814
ACCESSORY - SINGLE OR TWO FAMILY ACCESSORY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ACC17-0057
Description: construct a 10' x 12' storage shed
Estimated Value: 1200
Issue Date: 11/3/2017
Expiration Date: 5/2/2018
PROPERTY ADDRESS:
Address: 848 AMBERJACK LN
RE Number: 171144 0000
PROPERTY OWNER:
Name: David and Morgan Sanders
Address: 848 Amberjack Lane
Atlantic Beach, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name:
Address:
Phone:
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.
riyv.i, City of Atlantic Beach APPLICATION NUMBER
�S - ►' � Building Department (To be assigned by the Building Department.)
J s 800 Seminole Road ,Q._�I .�r�05 4-
w .") Atlantic Beach, Florida 32233 5445 �1 / ,
Phone (904)247-5826 c Fax(904)247-5845 OC j'(j Jj7 Date routed: 10 I 3a I I
j;;�yr E-mail: building dept@coab.us 1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ILI % A rel by(J QL� ( . De•artment review required Yes No
:uildin•
Applicant: DX,3(‘..L( ' .nnin• &Zonin•
I Tree Administrator
Project: -oc S 1 L L* lQ X l, -1 S Il i4 Public Workp
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
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 bkliezeatza(7/a4e40Date: /, 7//7
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
r/1..tvin City of Atlantic Beach APPLICATION NUMBER
4S Building Department (To be assigned by the Building Department.)
r J `� 800 Seminole Road /��
s� A—CL I I- -0 0S
f •/ Atlantic Beach, Florida 32233-5445 OCT 3
Phone (904)247 5826 Fax(904)247 5845 2017 I O 13o I 14-
orti9r E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1`-[ % A rq WiJ VAC LA . Department review required Yes No
(Duildinq)
Applicant: Dt,VVP--( nnin &Zoning
nTree Administrator
A){\Project: 1 WLA-Lk tOk )(I.'1 &(\ Public Works
ill "IlOrDIMMIllo.
Public Safety
Fire Services
Review fee $ 7 Dept Signature `✓"1
Review or Receipt r
.1
Other Agency Review or Permit Required of Permit Verified By Date
Florida Dept. of Environmental Protection
Florida Dept. of Transportation ''_____e
St.Johns River Water Management District d
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: I 'Approved. I 'Denied. VCapplicable
(Circle one.) Comments:
BUILDING /l7
PLANNING &ZONING t i� l 3(/
Reviewed by: `� —
- Date: D tt
TREETREirli MIN. Second Re iew: I 'Approved as revised. ❑Denied. Not applicable
P.:111 ORKS Com ts:
PUBLIC UTILITIES
/0 - 3/ — l7
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. Denied. Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
< <;i.t.iv. J City of Atlantic Beach APPLICATION NUMBER
JS ` ' 1\ Building Department (To be assigned by the Building Department.)
800 Seminole Road �� -�OS
'L r� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845 p I o( 1'1
'm o;i c..)', E-mail: building-dept@coab.us Date routed: T
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: A r10041 G(_,(,_ C\ . Department review required Ye No
u___
Applicant: Oi.A t\-Q--1nnin & Zonin
;;�� Tree Administrator
nn
Project: W'� t'{-Lk 1D' X I. -I S h-eA Public Works
Public Utili
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
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: F pproved. ❑Denied. I 'Not applicable
(Circle one.) Comments:
BUILDINJG
PLANNING & ZONING17
Reviewed by: Date: f" 3"
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. fNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
i
OFFICE C
A
Fitilfling Permit Application Updated 5/5/17
City of Atlantic Beach
�• � OCT
800 Seminole Road,Atlantic Beach, FL 32233 2 2017
'''1":):, .---•
. Phone: (904)247-5826 Fax: (904) 247-5845
Job Address: I 0 'lkOjerJ-6%ci•-- L., Permit Number: A-cc( —00
VW (TS rte_ CN ( ° ' E9I
� JI � — 0000
Legal DescriptionRtS L.) 3-1-Valuation of Wdrk(Replacement Cost)$ 12.Od Heated/Cooled SF Non-Heated/Cooled ?Y`'
• Class o Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of xisting/proposed structure(s)(Circle one): Commercial Residentia
• If an ex sting structure,is a fire sprinkler system installed?(Circle one): Yes No N/
• Submit Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in deta I the type of work to be performed:
61.A,Id;n 1 a s -c. , c,,.. /0' x ( 2_ ,
Florida Product Approval# for multiple products use product approval form
Property.Owner Information
Name: ,V GI ECA Add v3 Address: 84 S L e uc-L
City A-1-(a ` ` ,La State PC Zipp 3 Z x-33 Phone_`�(3;!�}) �,o�{- 4463!A• d�v�..S'a .t(J, a..........1 , c.o.....
Owner or Agent If Agent, Power of Attorney or Agency Letter Required)
Contractor Inf rmation
Name of Compa y: 14�;— Qualifying Agent:
Address City State Zi
Office Phon� P
is. • • —,•a ,ct Number
State Certificatio Il/Registration# E-Mail
Architect Name ge Phone#
Engineer's Name : • •ne#
or - - •mpensation
Exempt/Insurer/Lease Employees/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 regulationg
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.
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 rgulating construction and zoning.
WARNING T� 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 •INANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTI a OE E ,bE iL.
9, G0 I M%>.
(Signa Ile of Owner or Agen ) \ (Signature of Contractor)
(including contractor)
Signed and swo n to(or affirmed)before me this a-l-clay of Signed and sworn to(or affirmed)before me this day of
DC'tU_l , of , by A0.Yid Aka n SanbJ{- , by
..
/('•Erure of Notary
(Signature of Notary)
, .,,.::.,,,f;';;;.„ JENNIFER JOHNSTON
'$.1:' ,*; MY COMMISSION#GG 042984
[ ]Personally Known OR f'j'...,, ,:,•!L\GEXPIRES:October 27.2020
'. `" �; Bonded Thru Notary Public Underwriters ' ]Personally Known OR
14 Produced Identification •: a "- ..
r V n6to skAk L. S � ]Produced Identification
Type of Identification: W qWAR_Type of Identification:
( � � OFFICE .
y —' CITY OF ATLANTIC BEACH CE COPY
OWNER / BUILDER AFFIDAVIT
iii
Jill-
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
PU RCHASED.
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
O SERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
E PLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CI CUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
45 -228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CE TIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE
S4TEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THEBIISSUANCE OFUAN
OVYNER-BUILDER PERMIT.
ADDRESS _ PHONE NUMBER
6
-'111 Gill S r � •
PRI I NAME A se
• (.,,ck• i .„46. It ci - cot ..)- Lti i-?-
SIG • REIA4 1 , ' DATE
Befo e me this of"F day of DC :N.0 i 20ja-in the county of
Duv I,State of Florida,has personally appeared herin by himself/herself and affirms that
all st tements and declarations are true and accurate.
Nota Public at Large,State of FL— ,County of DLO]'t I
❑P rsonally Known
IgPr9duced Identification- \J3( A:t Ab f) 5'Z'c L ci(v - � `('e.n t
IVB , n.P JENNIFER JOHNSTON
z.4'
;r
*• t :#: MY COMMISSION#GG 042984
Notary Signature: . lk EXPIRES:October 27,2020
%.!';4' Bonded Thru Notary Public Undenvritets
F:/BLDG/Owner-Builder Affect It;REVI ED: 4/1612009
OFFICE COPY
ysr—c-\"_-:- ‘f-------- ,.._
BOUNDARY SURVEY
•
_,. AMBERIACK LANE
'.% -,.-_.,600,1, (IMPROVED)
_
.,,,. ..,.-3..,....._.z........,..„..‘,,...,.,:....,„,t;,,,.;..:::::,.:,.....„........,,:,,.+.,:,„:..,;.,.;:.,;,.,..,.....7,.;:...,,,,-,...;:•'-',..•:•!=:•."..........1:.2;.,-.•:.•:•:',-':!-.."..-1.-,,..:..::•-,,-.,- •-•.,..::,..;..7.-2::,..:7::::s.::...:.7-
4 :
c
80.65{P){m)
FOUND 1t2" N85°20'02",®80.65'
IRON PIPE
SET 1/2" 4,p
IRON ROD 0.3'1 -••.,
LB#7893 0.1'
FOUND 1/2"
•1_9.
; v-5 IRON PIPE
I N 25 B.R.L
�, oma.
0 24.5 ——
rD f II 24.7' ..Z c..i
to 1
rn -.wz
CN f r ' UOf .
LOT 3
IIMIP
LOT 5 M W m BLOCK 3 10.7 2o.r BLOCK 3
BLOCK 3 z ei NC m BUILDING10
co
' CI #848 _GONG v-
zoCD
IZ
SURVEY NOTES
24.T CONCRE I E DRIVE CROSSING THE
4.6' PROPERTY LINE ON NORTHERLY
•Si f� SIDE OF LOT.
I.j�I 8 IL THERE ARE FENCES NEAR THE
11:2\ 1 L BOUNDARYO THE PROPERTY AND
CROSS INTO THE 5'U.E./DE AND THE
`Q —`— PROPERTYLINEATREARANDSIDES
LINES OF PROPERTY.
FOUND 1/7' 0.2'
IRON
�'—0 SHEOCROSSMGWT05 UE�D.EON
IRON PIPE • f ` N85°20'02"1// 80.65' SOUlHER1YSIDE0F10T.
LOT 10 o2 •
sEr Pr
IRONBLOCK 3 t LOT 11 9�D
0 BLOCK 3 LOT 12
BLOCK 3
I
1
l ` `' ''e'�\\, �_ CERTIFICATETARGET
IN 4� II YCERTFY'NAT THIS&%SIDAR'%AMY
SURVEYING,f\ ('�
le 'SSURVEY Pi+FPARED UNOHtMY OFECTK?NATpNOFA SUR i ING,L C
1
�~ NOT YA1D M114OUT AN AURIENTICATED ELECTRONIC
\,>+*+STO TE 31 AATUREMD AUTIFMiCAT®6EC7RCYfC SEN. 1B 1P7S93
°' ORARAL�E/�OssEvsFAlNos#1AT SERVING FLORIDA
6.,#
%//�J/ Kenneth °��"�;g�°�
(.Jr 1(F°°eth Osborne 6250 N.MILITARY TRAIL,SURE 102
Due:1Di 7A2A3 WEST PALM BEACH,FL 334Q1
Osborne/ ��2Q PHONE BBB 60-48°0
(SK»Veil_ STATEWIDE PHONE(800)2261807
pp�;F fTF p c STATEYADE FACSIMILE MO)741-0576
�w� AEiovatssxse/rs Her Cd fkiliN+[}1tUt tcfa D N'E'951TE Mv'J�geffirveritba yet
. /.
10' o" 12
t•- 3 ,x_ w S `� 2x PLYWOOORSH ATHING
di.-__ L - ROOFING-
PLYWOOD I Y`' �� r1xG FACIA
SHEATHING 1 4x 4 - 1 ' F- -- 2x6 7 I�1 r
i - i .ir=--t 2'�0"O.C. 2x4...._
. TRACK - - SCREENING
..- i t c /SFt1DS •i -_. .... L _ -
. P --S —.—; s
•
o
4
1 „ \ .
. ,
3/4112" 1 ,LIN ! 4"CONCRETE SLAG
ANCHOR -i I �r li i
ROLFS 1 ;r 1 2x4
t66.FratMIGMIRa —
{2t 2-35c6' :°-."::�:�^ Cflt4CtiE LAG 1 - a:.��
I.L—.................._..._.,..-,,..,..,..._..._.�.t ` 44 b"GRAVEL FILL - e / 6x6 co/.o
PLAN '$•' c WIRE MESH
FRONT ELEVATION SECTION A-A
— - TYPE 3 — — ----- ________ __ `_�
OFFICE COPY
i—+ _=r F��__ 'Jt'EXTERIOR
x 2. -- • �x4 { 1 _` P4YW6Op Sl1EAF}flltb
°/®'EKTERIOR 1
'#a11I111111M1111111RtMIFN1IMIHMRINt114 ,ie �•�`-2L•
PLYWOOD 1 �_ 1-----"--
SHEATHING-1—
P
`^ 2xb / --.11_
1R00PING
;t -.11 2=0"0.0. ~—'.�_ . . I e
1,-----
�2 x� SUDS I �;-- S x FACIA
- I 2x4•�-
1 I 1 j •
SCREENING
Vii{ y yi' '
..at-064'
) N :O
�fi i I t FLOOR 111
• 1,-
1
!`
4'CONCRETE SLAG' • 1 t LIRE •
1 4"CONCRETE SLAB
1 A to[ "4 .
i_ _ �I 1�� r _,,X f £ 2x4-- 'F
6/aax12' �. i LL �� i t( ;:. '''`* 'Vii' ,
ANCHOR I 6'GRAVEL PILL % 6xb tYie
80L7S X111;11 31Nw�lgl,s.-- [ WIRE/AESN
_�_ _ . . .... WE ELEVATION SECTION A•-A
CITY OF ATLAItttIC BEACH TYPE
C4f}E<RAFt1'F.EXTENSION
IN
•
SEE PERMITS FOR ADDITIONAL AGRICULTURE AND ECONOMICSHOME
REQUIREMENTS AND CONDITIONS 370.78 OF TENNESSEE
uNt veRstry 91" TENNEssEr
u•..nwr[arT.n,o-.•aov rneprp,nK:1lTVaLG40.xnAT/HO-
REVIEWEDBY; aid,. ,DATE: //17 STORAGE SHEDS .....www.wewM
5.C. 464 1 6086 SHEET'J Of 3�