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630 Aquatic Dr ACC21-0001 Permit, App Notarized ri' ''�� PERMIT NUMBER J , � ACCESSORY PERMIT l'' ACC21-0001 CITY OF ATLANTIC BEACH :), ~, 800 SEMINOLE ROAD ISSUED: 3/9/2021 '"��si�` ATLANTIC BEACH. FL 32233 EXPIRES: 9/5/2021 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. 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. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 630 AQUATIC DR ACCESSORY SINGLE OR TWO STORAGE SHEAD AND KAYAK $650.00 FAMILY ACCESSORY RACK TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171818 5210 AQUATIC GARDENS COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: ; STATE: ZIP: TOPPING BRIAN 630 AQUATIC DR ATLANTIC BEACH FL 32233-3841 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT I(` 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. LIST OF CONDITIONS I Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL 'Notes: All runoff must remain on-site during construction. 2 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. Issued Date:3/9/2021 1 of 2 ACCESSORY PERMIT PERMIT NUMBER /-_, ACC21-0001 yr CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 3/9/2021 ��;,),..),:c- EXPIRES: 9/5/2021 ATLANTIC BEACH, FL 32233 3 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 4 PUBLIC WORKS DECKING REMOVED INFORMATIONAL Notes: All old decking and debris must be removed from job site by Contractor. iilik FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00 BUILDING PERMIT 455-0000-322-1000 0 $55.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $27.50 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00 TOTAL:$261.50 Issued Date:3/9/2021 2 of 2 City of Atlantic Beach Building Department NCVICWClJ 800 Seminole Road, Atlantic Beach, FL 32233 By Mike Jones at 3:03 pm, Mar 04, 2021 rJ ritljUiKCU. /Phone: (904)n247-5826 Email: Building-Dept )coao.us e Job Address: 43C A ✓.1+lG i —i/e. f 4r/4K�IC. 13e4.Cti Permit Number: ACC21 0001 Legal Description FI3C S fiL+. IO7) ( RE# 171 gi3 5-2-10 Valuation of Work(Replacement Cost) $ 6 ..O 01) Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition OAlteration ❑Repair ❑Move ❑Demo [Wool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ❑Residential • If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No • Will tree(s)be removed in association with proposed project?❑Yes(must submit separate Tree Removal Permit) ❑No Describe in detail the type of work to be performed: .j,-y S 1-6.11 et,4'r c•r C t- 5 f ,'-et y>k S'� k.c.yct, -. rete' Or c/Je yard Florida Product Approval# for multiple products use product approval form Property Owner Information Name b'^i cin %��/�.„y Address t Jr) /- 1,:-1c: Df I've_ City /1 �,,„ H ,t :32. rc.. c3.' 3 ' State FL Zip 233 hone ('7c 1) $g 7 `7S-5-2 E-Mail [l t`ic3"r+"c.tfin ' tl1,14)-- Owner or Agent(If Agent, Pdwer orAttofney or Agency Letter Required) Contractor Information Name of Company 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 RECQJ3DING YOUR NOTICE OF COMMENCEMENT. r or Agent)�g�, trne4 ti� (Sign turof Contractor) Signed and sworn to(or affirmed)before me this cl day of Signed and sworn to(or affirmed)before me this day of � ' r~.ri�1 , 40:61 ,by itft c141 (QQGt,11o) , by ature of Notary) (Signature of Notary) f 1 Personally Known OR z'elqi"1.4Pla=04111 ' ;•V CO AS a iii •ic Po: EXPIRES:October 27,2024 Bonded Thru Wary Kt*U derwiters :•c r,r, Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN n YCity of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 `°` 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 IS A 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 AN OWNER-BUILDER PERMIT. Job Address: �J 0 0 N-/A-1,4, I to- ' Owner Name: g(�i�iC-�.. (ta i/�� Phone Number:^ qo y 8 7 ��- Mailing Address: 3C) --eerie- wrtj City: �twi-re. pcacLkState: ,rL-- Zip: 3223> Notarized Signature of Owner X.----2"--* ' ;71.--"--y The foregoing instrument was acknowledged before e this 9 day of I .Wt V] , 20 d,jn the State of Florida, County of r3A tiGt (?)Signature of Notary Public --"1"-S._------ [ ] Personally Known OR [ roduced Identification `l few,, JENNIFER JOHNSTON , 1"C°144168"8141/1357"9 J aI'* '•` 4 Type of Identification: FL- V , 1/,�, S ,< < e n f� , ;,.- EXPIRES:October 27,2024 "•!, f4• °' Bonded mu Noary Rd*UndenrRus Updated 10/24/18