1628 BEACH AVE RESO22-0001 application_1RESO22-0001
;,: ,;.i !.:\i'Jr/~·? Building Permit Application
111 Updated 10/9/18
**ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
2 City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email : Building-Dept@coab.us
Job Address: ___._l.slr....;:~=$,__ __ :&K,__,.""""'""Y::i___,A""-"'\IC3'E'---"""'3L!U.=..DL.aii!~-----Permit Number: __________ _
Legal Description 15-Si OC\-2$-21( OctAH e,e.ov1e wit: t.111,1. S/D Ptu;,n t.,r7&'"1 RE# \\0°\5 '{ff-0000
Valuation of Work (Replacement Cost) $ ,t~ (>J) .0 Heated/Cooled SF ____ Non-Heated/Cooled ____ _
• Class of Work: □New □Addition ~Iteration □Repair □Move □Demo □Pool □Window/Door
• Use of existing/proposed structure(s): □Commercial ~esidential
• If an existing structure, is a fire sprinkler system installed?: □Yes 15(No
• Will trees be removed in association with ro osed ro·ect? □Yes must submit se arate Tree Remova l Permit o
Florida Product Approval # __________________ for multiple products use product approval form
Property Owner Information
Name \l.~M~£.\'/ S\t\""Al:>
City AI\AN.,..tC. "e>EAl,,Y State ~ \
E-Mail \LJ.¼.S\:\yJt(g@C~,\ . (Of'v\
Address \(o2S, ~H Av€
Zip 32:%..3~ Phone Cf(J-t,CJ(i:-0737
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) ___________________ _
Contractor Information
Name of Co mpany ,'Y\\',l\'it?S ~~ lbE'2--S.
Address c,qz_ C,LtAN JS\\ID
Office Phone Cf 04-2L/f, -/50 o
State Certification/Registration# CBC 1'2-57 :3 / '{
Qualifying Agent ~Y:AAA ~,\\,1?,S
City A ;:B State ~ \ Zip 32233
Job Site Con~a~t Number 'io</-,S'S-<=i~
E-Mail Pl-\,\\ 1 P$'Bu1\])6'2.S et Co ,:. WJ:
Architect Name & Phone# _________________________________ _
Engineer's Name & Phone# ___ ---;::;---,;;::------------,s;;;:::--------------=.---..--,:-----c:---
Workers Compensation Insurer , _ "" ,..,__ OR Exempt'(( Expiration Date -. Tl,z.,-s, .:J"'
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 OBTA).N FINANCING, CONSULT WITH YOUR LENDER OR RNEY BEFORE
RECOR NG YOU~TIC ~ENCEMENT ..
~--:::;A~:....=.__~=---,r----:-:---:-------
Signed and sworn to (or affirmed) before me this /..S__ day of
Alovt?£?1..c, ion , by k rl .J t:-h v .. b
Signed and sworn to (or affir ~fJ.wlf •~ by -t...l#J.~~~~'L........,,l-
\,,•:!":•,,, 1;,.: ..... i.\\ RIN MARIE STEHl
[ ) Personally Known OR \iA.l:J MY COMMISSION# GG 266182
[ ] Produced ldentificatio~ '•~:.;s:;:'t~,• CXPIRES: October 14, 2022
Type of Identification:_,_{{-.•~ ~Z~~l!~~~~~~~~3i§E!ii~;;J
By Mike Jones at 8:48 am, Jan 26, 2022
REVIEWED FOR CODE COMPLIANCE.
RESO22-0001
NOTICE OF COMMENCEMENT
State of t:= L -------------Tax Folio No. ____________ _
County of pv Vt>.\
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713
of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: e.E • \IF\5 48 -00(>0 15-82. 0Cf-2.S-'Z.q€ 45:J:'113\\c'-1.
0c.EA,tJ (!,@NE VM(t NO 1. SID J':!Lo, 1
Address of property being improved: \ (o 'Z.'l, JS6o,.c. \-I b,,lJ6 3:ZZ33
General description of improvements: (}.,~'5 ~P:n)J> 1)£<. l'
Address: )t,:zg 13,e~ ~" €'
Owner's interest in site of the improvement: __,M'--"~""'t)....._\£"--'(1------'0..,?t>J.....,a:RAC~ ... ::). .... Es..... _________________ _
Fee Simple Titleholder (if other than owner): _____________________________ _
Name: _______________________________________ _
.-., . • r.2 .• Contractor: s \.X,\\,ys J:Ji,\~
Address: _O,O,......,_.rz.=---....,.~= .... DN"'-"'-_1$_,__,~~ .... ..._ ...... 322; __ ~""'-:3,.__ ___________________ _
Telephone No.: 'lOlt -2-<-l<o-lSt>o Fax No: ___________ _
Surety (if any) _____________________________________ _
Address: _______________________ Amount of Bond$ _________ _
Telephone No: _________ _ Fax No: ___________ _
Name and address of any person making a loan for the construction of the improvements
Name: _______ ~--------------------------------
Address: ---------------------------------------
Phone No: ___________ _ Fax No: ___________ _
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may
be served: Name:---------------------------------------
Address: ------------------,,--~~~~l0994S~Re;;;;;~~=-:;--=======-
Telephone No: __________ _ N;Duocm#ber20P2200994s' OR BK"""""' c....... 99 ages: 1 '"""-1 • ~ , ----
Recorded 01/13/2022 09"28 AM Fax No:
In addition to himself, owner designates the following person to n
713.06(2) (b), Florida Statues. (Fill in at Owner's option)
JODY PHILLIPS CL . • COUNTY ERK CIRCUIT COURT DUVAL
RECORDING $10.00
Name: _________________ _
Address:--------------------------------
Telephone No: __________ _ Fax No: ___________ _
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a different date is
specified):----------------------------------------
THIS SPACE FOR RECORDER'S USE ONLY
-i'if--~~~ifc;~. JANMAURICIO WALKER ROBERTSON {/'/:a\) MY COMMISSION# HH 009325
'-~·~:$'.-' EXPIRES:June 11, 2024 ·<r.~·r:f~f··· Bonded Thru Notary Pubfic Underwrtters
OWNER
Signed: --'-="-'-'-c:;::............::_,c:::_-,-_ __,___ Date: II I I 'i , ~,
Before me this /q day of ve-. in the County of Duval, State
Of Florida, has personally appeared k..., k ~ ,Cc),v, {,,
Notary Public at Large, State of Florida~ounty of ~val.
My commission expires: Ob/' I lf'J--0 ]...'{,
Personally Known : ____________________ or
Produced Identification: Q r ,yc/ L.<.ec.,,. 02
RESO22-0001
TREE & VEGETATION AFFIDAVIT
City of Atlantic Beach
Community Development Department
800 Sem inole Road Atlantic Beach, FL 32233
(Pl 904-247-5800
SITE INFORMATION
ADDRESS \(o"l.S ~µ ~'-'' 3-Z.'Z .. 33
FOR INTERNAL OFFICE USE ONLY
PERMIT # --------
SUBDIVISION NONb BLOCK 1.. LOT 7 --"--__,;;___________________ -----
RE# lftf:\SL/8-0000 ~ RESIDENTIAL 0 COMMERCIAL 0 OTHER
APPLICANT INFORMATION
NAME tfjf 6 i' \l..\~~\'4
ADDRESS \\o2.S :1::iEP<U ~~
CITY ~.3's
PHONE# C,17-/p'14,-0l.37
CELL#
STATE i=°\ ZIP CODE :g'2Z. 33
EMAIL '4.'LS\:\~ @ ~ \ , ~N"\ ~OWNER 0 LEGAL AUTHORIZED AGENT
I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation", of
the Municipal Code of Ordinances for the City of Atlantic Beach Florida and/or I have participated in a pre-
application meeting with the Administrator of those regulations. Subsequently, I affirm that no regulated
trees and no regulated veget ation will be damaged, destroyed and/or removed from the above-described
property and/or adjacent properties including right-of-way.
CERTIFY THAT ALL INFORMATION PROVIDED IS CORRECT: Signature of Property Owner(s) or Authorized Agent
< ,/0 (,'rVJ Oe-l-1<.vc.~ ttJ,'l/'1...1
PRINT OR TYPE NAME DAT
SIGNATURE OF APPLICANT (2) PRINT OR TYPE NAME DATE
Signed and sworn before me on this / 't day of Nove..-.. k . 2£}1,( by State of I-;:/ Or,•c/(:
/<;,,.,. /,e;r/., Jt:_~v,1;: b I
County of tJo v.: (
Identification verified: _ __,.iJcr.Li~ver=---'L=•:.::~=n.fC2.-:::::~!!:::::=::;:__ _________ _
Oath Sworn: D Yes ifN'o r,!!!!!!!!_!!!: ... :!!! ... ~~!!!!!"!!!!!!!!!!!!!:!!!!!!!!!!:!!!!!!!!!!!!!!!!!!!!!!!~ ~ _.-~;,~v.~~~.;-. JANMAURICIO WALKER ROBERTSo~-....,..<,;=:=---<-=:...=:~:c..-_;;_ ______ _ tr~·):J MYCOMMIS~ION#HH009325
,-,,.~<': EXPIRES. June 11, 2024
·--{~'r}.~f··· Bonded Thru Notary Pubfic Underwrtters Commission expires 06/ttJ!}..()J-'t
04 TREE AND VEGETATION AFFIDAVIT 03.01.2018
LJG Engineering, Inc.
Principal Engineer: Louis Gabriel PE
419 Sophia Terrace
Saint Augustine, Fl. 32095
Ph# (904) 982 1935
12/18/2021
Mr. Mike Jones
Building Inspector/ Plan Reviewer
City of Atlantic Beach, Fl.
Subject: compliance method for addition to 1628
Beach Avenue, Atlantic Beach, and Fl.
Dear Mr. Jones;
This letter is to certify all repairs and alterations
of the subject remodeling will comply with "method
301.1.1 Prescriptive Compliance Method Existing
Structures of chapter 3 of FBC-2020 Existing
Structures".
Also, the level of alterations to the subject
structure are deemed to fall onto level 3 per chapter
6 of FBC-2020 "Existing Structures"
""'""'lit ,,,,,,,.
By Mike Jones at 8:51 am, Jan 26, 2022
LJG Engineering, Inc.
Principal Engineer: Louis Gabriel PE
419 Sophia Terrace
Saint Augustine, Fl. 32095
Ph# (904) 982 1935
12/16/2021
Mr. Mike Jones
Building Inspector/ Plan Reviewer
City of Atlantic Beach, Fl.
Subject: Structural adequacy of the altered
structure at 1728 Beach Avenue, Atlantic Beach, Fl.
Dear Mr. Jones;
I evaluated the structural loading impact on the
remaining existing walls and footings due to the
future alterations per section 907.4.1 of FBC2020-
Existing Structures by adopting rational structural
analysis that compared the existing roof and wall
areas verses the future roof and wall areas after
future alterations and concluded the following;
1-Down ward gravity load impact due to the
alterations will not cause any increase to the
existing garage footings since the new deck
joist framing will be running in the direction
of the new footings at the garage door opening
2-Main wind force horizontal wind pressure will
not be altered from the current wall pressures
in either direction since there is no change to
the projected wall surface area or configuration
before and after alterations.
By Mike Jones at 8:53 am, Jan 26, 2022
3-Roof uplift will not be altered since the
projected roof surface area is still the same.
Keep in mind that almost all proposed alterations
onto the subject structure are self-supporting and
have their own walls, foundations, roof, strapping
for structural support with the one exception where
the existing left wall that will end being common
wall with the Proposed alterations.
Therefore, it is my professional opinion that the
proposed alterations to the subject structure will
not adversely impact the structural integrity or
cause additional objectionable stresses to the
remaining walls and footings.
Attached to this letter is brief rational structural
analysis where
wall/footings,
investigated.
the alterations impact on the existing
that will remain in place, are
PRODUCT APPROVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH, FLORIDA (*REQUIRED) *Project Address: \lo"'Z.'o ·~AC..\-\ A\J6 :31.2-33 Permit#: __________ _ *Owner/Project Name:-i.\l_,~M__,__,~_.,.,"""''2.=-'-) ~..ait------==:S=-:+\c...:.w.c.......;;;;~_,_·~----------------------------As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72, please provide the information and product approval number(s) for the building components listed below as applicable to the building construction project for the permit number listed above. You should contact your product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide product approval may be obtained at: www.floridabuilding.org. Category/Subcategory Manufacturer Product Description Limitation of Use State# Local# A. EXTERIOR DOORS !.Swinging f'IIA(L_\tiN Fl -\0\9-<o., 2. Sliding MA~VI~ ~\-(ro29 .·2 3. Sectional 4. Garage Roll-Up f. i-1, I \:" l -\'Sb-1'-I (2].tlj 5. Automatic 6. Other B.WINDOWS 1. Single hung 2. Horizontal slider 3. Casement 4. Double hung 5. Fixed Mf)..a..v, N c, -\D\17 , \ 6.Awning 7. Pass-through 8. Projected 9. Mullion 10. Wind breaker 11. Dual action 12. Other Page 1 of4 Updated 10/17/18 By Mike Jones at 8:54 am, Jan 26, 2022
category/Subcategory Manufacturer Product Description Limitation of Use State# Local# C. PANEL WALL 1. Siding S,ucco 2. Soffits 3. EIFS 4. Storefronts 5. Curtain walls 6.Walllouvers 7. Glass block 8. Membrane 9.Greenhouse 10. Synthetic stucco 11. Other D. ROOFING PRODUCTS 1. Asphalt shingles 2. Underlayments 3. Roofing fasteners 4. Nonstructural metal roof 5. Built-up roofing 6. Modified bitumen 7. Single ply roofing 8. Roofing tiles 9. Roofing insulation 10. Waterproofing 11. Wood shingles/shakes 12. Roofing slate 13. Liquid applied roofing \/U\ \'-EN\ ~\-'l,ln1 Z."'\ 14. Cement-adhesive coats 15. Roof tile adhesive 16. Spray applied polyurethane roof 17.0ther Page 2 of 4 Updated 10/17/18
Category/subcategory Manufacturer Product Description limitation of Use State# Local# E. SHUTTERS 1. Accordion 2. Bahama 3. Storm panels 4.Colonial 5. Roll-up 6. Equipment 7. Other F. STRUCTURAL COMPONENTS 1. Wood connector/anchor 2. Truss plates 3. Engineered lumber ( 4) V\--1 /~; biL t~: i-h= 1'2...-4. Railing 5. Coolers-freezers 6. Concrete admixtures 7. Material 8. Insulation forms 9. Plastics 10. Deck-roof VUll~f:fV"--J: L -11,.1 Z 4 11. Wall 12.Sheds 13.0ther G.SKYUGHTS 1. Skylight 2. Other H. NEW EXTERIOR ENVELOPE PRODUCTS 1. 2. Page i of 4 Updated 10/17/18
In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project, the Contractor shall maintain on the job site and available to the Inspector, a legible copy of each manufacturer's printed specifications and installation instructions along with this Product Approval Sheet. I certify that this product approval list is true and correct to the best of my knowledge. I further certify that use of different components other than the ones listed in this document must be approved by the Building Official. *Contractor Name (Print Name):~g:Bp..gA )fu\.\(0.5 *Company Name: }::\\,H~Tu\\tE"-.s@~~T-Net *Mailing Address: C\C\.--Z... OU"~ n\lD *City: ~~ *State: ~L. *Telephone Number: °\~Y --Z..4(o -1500 *Zip Code: 32-"Z.. 3 S Cell Phone Number: _______________ Fax Number: ______________________ _ Page 4 of 4 Updated 10/17 /18