1228 LINKSIDE DR RFNC22-0020 Building Permit Application Updated l0/9/18
- _- City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: /2 22 L/N KS I DL- DO w.- A r CA,vT)C Permit Number: RF N CZZ " DO2O
(.3 L--.
Legal Description L01— q 5ELV v 6/Kt 1(St ol- (:r-c 3,70743 RE#
Li Valuation of Work (Replacement Cost)$ 4 ( Heated/Cooled SF Non-Heated/Cooled
BUD
• Class of Work: ,'New Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial i{tesidential
• If an pyistinp stnirtiirp is a firp snrinklpr systpm installprl?• fYps yrNn
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit)YNo
Describe in detail the type of work to be performed:
IZ L PcA-Cc; C4 i L
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name , CL(ll 2)4.- 6141 AIN/ Address /ad8 LiNkS(j&= De/V� -
City 'TL✓.N?1C Pit 7' (H State EL Zip 3da3 3 Phone gcyc, (i 6 3. V C q/
E-Mail rjc4_-er.9i ri Lle 1 a-be vsy,lain i-rla 1 • 0nill
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Qualifying Agent
Address City State Zip
Office Phone Job Site Contact Nu ,%-r
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 •- work and installations as indicated.I certify that no work or installation has
commenced prior to the issuance of a permit an• at all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction. I understand at a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEA •S,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this
permit,there may be additional restri ons 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 YOUILNOTICE OF COMMENCEMENT.
(Signature of Owner or Agent) (Signature of Cont -ctor)
Signe and sworn to(or:ffirm-d)before me thi . iiay •f Signed and sworn to(or affirm-• before me this day of
C�h Zo?7 by M3 ' -' ..f'Yy c c\ ,b
•<': ;W47•• TONI GINOLESPE' atu �
; -41 ......_ c)._______
'."' �l (Signature of Notary)
s,. ,•_ : MY COMMISSION 8 C,f3 353178_1
'",•.e.�`.: EXPIRES:October 6,2023 i
;oF•F,o•: •. •ed Thru Nit PIS 4 i
AMMO, .-.-.. - [ ]Personally Kn.wn OR
[ ]Produced Identification [ ]Produced Identification
Type of Identification: . Type of Identification:
Owner Builder Affidavit **ALL INFORMATION
,S' U,r�' HIGHLIGHTED IN
�,s ,v,,iii„,,
of Atlantic Beach Building Department GRAY IS REQUIRED.
srl
800 Seminole Rd, Atlantic Beach, FL 32233 _
fix, . „�
J''�' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: S Th iC 2-2-
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING” REQUIRES Z_O
OWNER/ BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUTES: --1
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.
I 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 $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE
OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA"CONTRACTORS
CERTIFICATE"TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPT@COAB.US ) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: /d L/N IC51 D L -.00 V L:
Owner Name: C (L,L v AL..—Y76i>1"4-i' Phone Number: d 5• V '3 , V 61-j/
Mailing Address: ii4-,1l Lf City: 411-4 NC1C State: FL-- Zip: .3023 3
U'9 k,1` C H
Notarized Signature of Owner /"e1 LO,..4t- ç'- 'ria , --
~
The:-for oing instru4nent was acknowledged before me this 2 Ejay of p 2024in the State of Florida, County
of � l v G,-
Signature of Notary Public , �� L
[ I Personally Known OR [ ] Produced Identification
Type of Identification: \-J- �---
•C'"`:;''44
's TONI GINDLESPERGER Updated 10/24/18
'kMY COMMISSION#GG 353178
;•V�3. :' EXPIRES:October 6,2023
''FO,r;°.'4 Bonded Thru Notary Pubrrc Underellus
'A" Fence Addendum Updated1/14/2021
City of Atlantic Beach Building Department
Wj 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT#
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
las C ',i kS,.D D✓Zl vc=
11t,4.Jil C. 8 c:A-c i1, 1_'L. 3,2.233 Q/a$/do da--
Property Type: Lot Type/ Features:
Residential [ One Street frontage (interior lot)
❑ Commercial 0 More than one street frontage(corner lot,through lot,
etc.)
0 Swimming Pool
Fence Material: Fence Height (select all that apply):
❑ Wood ❑ Four Foot (4ft)
❑ Chain Link ti( Six Foot(6ft)
J Vinyl ❑ Other
O Block/Stone(Plan details required for footings and/or
retaining walls)
❑ Other
Fence Location:
Please submit an accurate and current boundary survey showing all existing improvements(including building footprint,
driveway, swimming pool, etc.) and location of fence/wall and any gates. Plan details required for block wall footings and/or
retaining walls and any portion or fencing above 6ft in height.
Will the fence be built in an easement?
❑ Yes (must submit separate Revocable Encroachment Agreement)
%No
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
X' No
Conditions of Approval:
• Roll off container company must be on City approved list. Roll off container cannot be placed on City right-of-way.
• All old fencing and debris must be removed from job site by contractor or homeowner.
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 YOUR NOTICE OF COMMENCEMENT.
MAP SHOWING BOUNDARY SURVEY OF
LOT 9, ACCORDING TO THE PLAT OF
5 : :LVA LINKSIDE UNT 1
AS RECORDED IN PLAT BOOK 44 , PAGE(S) 23 & 23A OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO: WILLIAM K. BERGMAN, GWEN GIALLELA BERGMAN,
FIRST AMERICAN TITLE INSURANCE COMPANY,
PHH MORTGAGE SERVICES CORPORATION
AND WATSON & OSBORNE, P.A.
LINKSIDE DRIVE
(50' R/W)
BEARING REFERENCE LINE i .
N 83'42'00" E, 49.84'(M)
N 83'42'00" E, 50.00'(R)
10'x10' J.E.A.
4"x4"
1/2' IP it TRANSFORMER
5. LB 1704 EASEMENT
64' 4 V54 i� 1
. i
• 7.5' J.E.A. EASEMENT • . 4. 1 -1.21 R
• r'ot -4 r' f _1 Z 0
•
1 -•-• 3.6'x4.7' CONC . J
. 4 . 6.3' 0 8.7' 0 6.3' 8.8'� E.T. PAD ` . E'4• E
• . CONC . 4s.
DRIVE, 4/
• o \ Ht
4 \
1.5' . 4
N.
i 4
Ce •• DIRT IY
u ,•-• wap .. N h
' -❑-❑
0 •
•
tg.2
D.4' 00 \\A.
>
N 1e' 8.7' COVERED CONC ❑ aD \
O0
1-STORY Q' DO
VINYL SIDED ❑ L i w I-
o 3 3 & BRICK U
J wp RESIDENCE I o 't J
m tg o NO. 1228 0 o P
`10 00 '- O
u1 -- .-
o cD ❑ t0 In
Z o 0
-❑-❑-❑ Ifl 03
Z [ • 3.8' 23.1' ❑ K.
0.1' • o /�
❑ •GONG o u 0.3'14.4' ❑-❑-❑-❑ 0
PATIO ,o El .4'
f0.4'
i,, •112.0 . CON[
1" ❑ A/C PAD ❑
• N
6.
LOT 9
❑ ❑
4-x4"0.1' ,�^5-v6 D l V/5,o�l -0.6'
1/2" P
S 83'42'00" W, 50.00'(R) LB 1704
id S 83'20'45Is, " W. 50.01'(M) Iti
° u! ❑ -.- 20 10 0 20
NOW OR FORMERLY, PART OF SECTION 17 -e..1-- I
❑ ❑ ❑-1❑ ❑ ❑ 48.0' ❑ ❑ \D• SCALE IN FEET
1' = 20'
TOWNSHIP 2 SOUTH, RANGE 29 EAST opo
E Y O R 1. BEARINGS ARE BASED ON GENERAL PIOOOK
�y � PLAT BOOK 44, PAGE 23A.
J s 2.STRUCTURE N0. 1228 SHOWN HEREON LIES WITHIN FLOOD ZONE X AS BEST
A SSOCIATED SURVEYORS INC. DETERMINED FROM F.E.M.A. FLOOD MAPS PANELTE NO. DATED04/17/1980
O ,
3.THI5 IS A SURFACE SURVEY ONLY. THE EXTENT OF UNDERGROUND FOOTINGS,
)RflCATE
LAND & ENGINEERING SURVEYS PIPES AND UTILITIES, IF ANY, NOT DETERMINED.
4.JURISDICTIONAL AND/OR ENVIRONMENTALLY SENSITIVE AREAS IF ANY, NOT
j5915 CEDAR HILLS BOULEVARD LOCAIID BY THIS SUR Y.
,-
/ JACKSONVILLE, FLORIDA 32210 5.THIS SURVEY WAS BASED ON LEGAL DESCRIPTIONS FURNISHED AND THE
/ 904-771-6468 PUBLIC RECORDS WERE NOT SEARCHED BY THIS SURVEYOR FOR EASEMENTS, TITLE.
COVENANTS OR RESTRICTIONS THAT MAY AFFECT THIS PARCEL
J j OF AUTHORIZATION NO. LB 0005488 6.UNLESS OTHERWISE STATED ALL IRON PIPES FOUND HAVE NO IDENTIFICATION.
S •
S V 7.NOT VAUD WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A
FLORIDA UCENSED SURVEYOR AND MAPPER.
I HEREBY CERTIFY THIS SURVEY WAS DONE UNDER MY -3 -GUY ANCHOR LEGEND/ABBREVIATIONS (R) - RECORC
DIRECT SUPERVISION AND MEETS THE MINIMUM TECHNICAL 0 =SET IRON PIPE (SIP) MARKED P.C. = POINT OF CURVE (M -MEASURE[
STANDARDS FOR LAND SURVEYING PURSUANT TO CHAPTER -ASSOC. suRVEY' OR L.B. 5488 P.T.-POINT OF TANGENCY A =CENTRAL AMM
61917 .'1 ARIDA Al INISTRATII COD HA' E' 472, F.S. -FONDDcIRONONCRINE MONUMENT(OR PIPE(F1P FCM C/LR/B ..- REBARRUNE L eA ILUTSG}
AO' ` . , A..4110• eei/ / '"� _ X = CROSS CUT OR DRILL HOLE R/W - RIGHT OF WAY C - CHORD
C 'LES B. P.R.C. .• POINT OF REVERSE CURVE W-W = WIRE FENCE OM = WATER 11ETEF
BY: 7P.C.C.••• POINT OF COMPOUND CURVE 0-0 = WOOD FENCE ® ••• WELL
FLORIDA C CERTIFICATEB. HATCHER NO. 3771
B.R.L. = BUILDING RESTRICTION UNE CONC.= CONCRETE SI12 J UGHI
JOB NO. 24877 _ DATE 08/24/2000 (oRe) = OFFICIAL RECORDS BOOK X-X = CHNNUNK FENCE = ELECTRIC
SCALE: 1- = 20' DRAFTER T.V. ZEFF (ORV) - OFFICIAL RECORDS VOLUME cll., - UTILITY POLE TRANSFORMEF
J.E.A. = JAGKSONMU.E ELECTRIC AIITHOR>TIY-ou- =WERHFAD UT1UTES PE=F'OCL EAUP1ETT