579 AQUATIC DR RFNC23-0018 '''''? Building Permit Application Updated 10/9/18
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City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
B9°-
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Deptccoab.us
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7
Job Address: S / A ?ue147- Dt'•C /414,0+71, Nee,,.(,, Permit Number: RrN Q.Z3 - 00 ( ES
Legal Description 3 V"" I 1-7-,2 5 f a 5 e A'q.c. 7 - &af d e+�S O4 at-ERE# 17 I ( is - 531
Valuation of Work(Replacement Cost)$ $I at) 0.Q C /Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ONew ❑Addition ❑Alteration QRepair l�JMove ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial mResidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes IAo
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) Z1No
Describe in detail the type of work to be performed:
(2-0 G/'r C)— G / p (t VA / -P-e f.rc e. i n) (« 1l G<Li
Florida Product Approval# for multiple products use product approval form
Property OwnerlIInformation f[
Name M , /c, ill ctte ! Address S 71) A iv�i'C b 'Ije'
City A F 1 A.i 4-r C- ( Gc+c n State re- Zip 3:-.233 Phone (.C't% `? to '7 ( .S'
E-Mail Nu')f; 0.A C he e jSc„ Lail
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 Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone# Z
Workers Compensation Insurer OR Exempt❑ Expiration Date
Application is hereby made to obtain a permit to do the work and in allations 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
REC y JNG O it j9111f..EDF COMMENCEMENT.
ly r
(Signature of Owner or Agent) (Signature of Contractor)
Sird nd sworn tor(o 'rmed of re •- clay. f_ Signed and sworn to(or affirmed)before me this day of
204 by \ l Y , 4 l ,by
ignature of Nota (Signa . e of Notary)
•,.:"!,i,:'.p it jo••,s TONI GINDLESPERGEP,
MY COM I1'P 6rcarfl Yla+
[ ]Personally Known OR ,iuo' ': n R
:,-,,,,,,'... .-F EXPIR ��°� E
c• �, ntifi ion
[ ]Produced Identification i"--
\ `n,--6,?: Bonded Thru arx�y� wrl,rs
Type of Identification: ) = �
Owner Builder Affidavit **ALL INFORMATION
HIGHLIGHTED IN
(:::
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
JPhone: (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 ISSUANCEpOF AN OWNER-BUILDER PERMIT.
Job Address: !n�5 2 c( / c�c.'/7 IV (' u( ti 1/ r'' IRC 13 CAC 1� f-- D/ �
Owner Name: fvt r (0 Me„ Pi-C- Phone Number: 01016 7(0 ?��,,
Mailing Address: 5 7 �7 A 'C ,,c, L. X i'Uf lerJhi;.
C City: � (7 ee174 r
State: t Zip: 3.)'D . 3
I ��'
Notarized Signature of Owner ((��
The foregoing instrum �nt was acknowledged before me this ' day : e_iJ , 20L _in the State of Florida, County
of _J L1 C1,
Signature of Notary Public ____S)---- .524---->\k"---- -;:—\---
[ ] Personally Known OR [ ] Produced Identification
Type of Identification: `l__
:-i- '''.'.,', TONI GINDLESPERGER Updated 10/24/18
•'2` '.. MY COMMISSION#GG 353178
'•!':;.. Pik., :*:
; Q�: EXPIRES:October 6,2023
.'-Fp'F ° Bonded Thru Notary Public Underwriters
Fence Addendum Updated 1/14/2021
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT# RFC-Z-
Phone: (904) 247-5826 Email: Building-Dept@coab.us 001
Job Address: 313 3 Date:
S ? ci l) ual'c 0((suc MlaAris (3cacG,f(`G a// / o3
Property Type: Lot Type/ Features:
1;1—Reesidential ❑ One Street frontage (interior lot)
❑ Commercial ❑ More than one street frontage (corner lot,through lot,
etc.)
❑ Swimming Pool
Fence Material: Fence Height (select all that apply):
L Wood ❑`Four Foot(4ft)
❑ Chain Link fJ Six Foot (6ft)
❑ Vinyl ❑ Other
❑ 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)
�o
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
D''N o
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 28—E ACCORDING TO THE PLAT OF
AQUATEC GA rilDENS
AS RECORDED IN PLAT BOOK 38 , PAGE(S) 71 AND 71A OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
MILO J. METTE,
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY,
KEITH WATSON TITLE SERVICES, INC. ,
AND WATSON MORTGAGE CORP.
LOT 23-B N 07'22'10" W 29.83' (M) LOT 23-C
N 07'16'02" W 30.00' (R)
1/2" 1/2"
1/2" N 07'14'11" W 45.01' (M) LB 6715 CORP
N 07'06'02" W 45.00' (R) 1/2" 19.94' (M) 1704
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U U n'� n n vi vin n
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1.3'--C
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C b LOT 28-E in
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Ct CONC CK
27' AC PAT10
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� 1.5' PAD
�/Y jp�,�� ti 00 1.9. 0 17.9' 0 0.1' 0
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co! O 12.0' O
N o O O fD
m p
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0 3 3 ,,, FRAME ", LTJ J N
CO RESIDENCE c I-
10 co o NO. 579 o o
a z z in N
f° � M
z
'^ COVERED
N CONCRETE Zy
v, •5'.n CO
J L cc 14.9' 15,0 01 N 10.6
N o -.i o . r Z
0.5' 075' ", 3.5'
0 0 < 3.8' b— 6.1'
1— •, a
J J
'a CONCRETE' ' '
DRIVE S
5/8 44.96' (M) N 07'16'02" W
I 15.00' (R) REBAR ec NI + 45.00' (R) < 29.98' (M)
;4 .d O •
a 1/2" N 0716'02" W 360.00' (R) d NAIL & DISK
1/2IN
LS 1576 N 07'16'02" W 359.83' (Al) CORP , a < O BASE SOFBTREE 1/2"
1704 < , CORP
1704
I . a- • a . . 1
BEARING REFERENCE LINE 1.5' CURB & GUTTER
S 07'16'02" E 30.00' (R)
S 0716'02" E 29.98' (M)
AQUATIC DRIVE
50' R/W
FLOW ZONE "X" - AREAS DLitt UINED TO BE OUTSIDE THE 0.2%ANNUAL CHANCE FLOOD PLAIN /FLOOD ZONE "X (SHADED)" - AREAS OF 0.2% ANNUAL CHANCE FLOOD; AREAS OF 1%ANNUAL
CHANCE M11H AVERAGE DEPTHS OF LESS THAN I FOOT OR PATH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 15 ANNUAL CHANCE FLOW.
R \J E Y O GENERAL NOTES:
J S 1. BEARINGS ARE BASED ON PLAT BOOK 38, PAGE 71A
2.STRUCTURE NO. 579 SHOWN HEREON UES WITHIN FLOOD ZONE X AS
BEST
-17-1989
0
ASSOCIATED SURVEYORS INC. 3.THIS IS ARSURFACE SURVEYMINED FROM AONLOY. THEOD PEXTENTS LOOUNDERGRDATED
ND04F0011NGS,
A LAND & ENGINEERING SURVEYS PIPES AND UTILITIES, IF ANY, NOT DETERMINED.
L., j 4.JURISDICTIONAL AND/OR ENVIRONMENTALLY SENSITIVE AREAS IF ANY, NOT
F / 3846 BLANDING BOULEVARD LOCATED BY THIS SUR Y.
A.
/ JACKSONVILLE, FLORIDA 32210 5,THIS SURVEY BASED ON LEGAL DESCRIPTIONS FURNISHED. THE PUBLIC
�' 904-771-6468
RECORDS WERENOT
v SEARCHED BY THIS SURVEYOR FOR EASEMENTS, TITLE,
CERTIFICATE OF AUTHORIZATION NO. LB 0005488
COVENANTS, B.R.L.'S RESTRICTIONS, CLOSURES, TAKINGS OR ORDINANCES, ETC.
S S V THERE COULD BE OTHER MATTERS OF RECORD THAT AFFECT THIS PARCEL.
6.UNLESS OTHERWISE STATED ALL IRON PIPES FOUND HAVE NO IDENTIFICATION.
I HEREBY CERTIFY THIS SURVEY WAS DONE UNDER MY LEGEND/ABBREVIATIONS
DIRECT SUPERVISION AND MEETS THE MINIMUM TECHNICAL 0 SET IRON PIPE OR REBAR P.C. = POINT OF CURVE CH = CHORD
STANDARDS FOR LAND SURVEYING PURSUANT TO CHAPTER "ASSOC.SURVEY" OR L.B.5488 P.T. = POINT OF TANGENCY (R) = RECORD
61G17-,FLORIDA AD1.� ISTN TIVE COD CHAPl R 472, F.S. O.U.-= OVER HEAD UIITLMES (M) MEASURED
■ FOUND
FOUND CONCRETEIRONPIN MONORUMENTPIPE(C.(IP)M.) -,,r,.O = FIRE HYDRANT (C) = COMPUTED DATA
X= CROSS CUT OR DRILL HOLE CONC. = CONCRETE R. = RADIUS
BY: /, , . .a,- , - O.R.B.=OFFICIAL RECORD BOOK A\C = AIR CONDITIONER L = ARC LENGTH
CH• •L B. HATC ER FLORIDA CE' FICATE NO. 3771
/ O.R.V.=OFFICIAL RECORD VOLUME ® = WATER METER PHONE RISER
P.R.M.=PERMANENT REFERENCE MONUMENT P.EQ. = POOL EQUIPMENT T _
CH•RLES L. S TARLIN, FLORIDA C"TIFICATE NO, 4579 B.R.L= BUILDING RESTRICTION LINE X—X CHAIN LINK FENCE R/W = RIGHT OF WAY
RA MOND J. SCHAE" R FLORIDA CERTIFICATE NO. 6132 E.T. = ELECTRIC TRANSFORMER & PAD W—W WIRE FENCE B.T.= BUILDING TIE
J.E.A.= JACKSONVILLE ELECTRIC AUTHORITY U U WOOD FENCE 43.= UTILITY POLE
JOB NO. 57620 1 DATE 05-18-2010 C & R = COVENANTS & RESTRICTIONS -I-1-IRON FENCE --= GUY ANCHOR
SCALE: 1" = 20' DRAFTER CLS P.C.C. = POINT OF COMPOUND CURVE BTN. = BETWEEN COVE) = COVERED
P.R.C. = POINT OF REVERSE CURVE (E.T.) = CAVE TIE E.B=ELECTRIC BOX
NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER