599 Vikings Ln ACC23-0029 App ---.1:--'7:,,-,,, BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
C. ; City of Atlantic Beach Building Department PERMIT# C213 - ou2ct
C' / I': 800 Seminole Road,Atlantic Beach, FL 32233 *ALL information required to process
%' Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address 599 Vikings In RE# 170703-0238
Legal Description 35-64 17-2S-29E SEASPRAY LOT 19 BLK
Valuation of Work(Replacement Cost) 2000 Heated/Cooled SF 0 Non-Heated/Cooled SF
- Class of Work: Z New n Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool [i]Window/Door
- Use of existing/proposed structure(s): ❑Commercial El 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) E]No
Describe in detail the type of work to be performed:
IPergula in backyard; 150sgft,5'from property lines,9'tall
Florida Product Approval# (For multiple products use Product Approval Information Sheet)
Property Owner Information Name Max Biggar Phone 407-625-3158
Address 599 Vikings In City Atlantic Beach State FL 24) 32233
Email rmbiggar@gmail.com Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Owner
Contractor Information Name of Company Owner Phone
Address City State Zip
Qualifying Agent State Certification/Registration#
Email Job Site Contact Number
Worker's Compensation Insurer OR Exempt ❑ Expiration Date
Architect's Name Email Phone
Engineer's Name Email Phone
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 YOU PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN
ATTORNEY B ORE RE •RDING YOUR NOTICE OF COMMENCEMENT.
,;.:"". ure of Owner or Agent) Ci (Signature of Contractor)
Signed and sworn to(or affirmed)before me this
g gv day of Signed and sworn to(or affirmed)before me this day of
&Al) /Y , 202 by 1Civl I'Vl . BIGJc.)U( by
Signature of Notary Signature of Notary
[ I Personally Known OR ,.}Produced Identification [ j Personally Known OR ( I Produced Identification
Type of Identification: 7 L 0 Type of Identification:
TR CTA T I
e.` '• VANESSA ANGERS
''' _ MY COMMISSION#HH 244118
' ."�"a'- EXPIRES:March 23,2026
Owner Builder Affidavit "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 n
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT IS: AIc2 -0029
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 RESPONSIBIUTY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE UCENSES
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.
tV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES.OWNERS BEING SUBJECT
TO$5,000 PENALTY UNDER FLORIDA STATUTE NO.455-228(1). AN "OCCUPATIONAL LICENSE"IS NOT ADEQUATE. THE
OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA"CONTRACTORS
CERTIFICATE"TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPT@COAB.US ) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: 599 Vikings Ln Atlantic Beach FL 32233
Owner Name:Max Biggar Phone Number: (407)625-3158
Mailing Address: 599 Vikings In City: Atlantic Beach State: FL Zip: 32233
Notarized Signature of Owner /74 �f
The foregoing instrument was acknowledged before me this ( day of ,bi-r ,2022), in the State of Florida, County
of 1.)(,,v .LI
Signature of Notary Public
[ ) Personally Known OR I a Produced Identification
: •' `' ••. VANESSA ANGERS
5.6E MY COMMISSION#HH 244118
.'�1�.:0_ Type of Identification: L k)L_ 4 ((Ci f� 1'0/ �r (I�(t i'
`o�: EXPIRES:March 23,2026 J
Updated 10/24/18
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•EXACTA
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www.execteiend.com I office:666.73519161 few 866.744.2882 -
PROPERTY ADDRESS:599 VIKINGS LANE,ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER:F12012 485)
F120124852
BOUNDARY SURVEY
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SURVEYORS CERTIFICATION: POINTS OF INTEREST:
1.6'WOOD FENCE OVER 10'D.U.E.AND SEWER ESMT.
1�' p F$g I hereby certify that this Survey of the lands
Et1 BA described hereon was made under my direct
o74. A,P supervision,and to the best of my knowledge
6132 and belief i$a true and accurate representation
' of said lands and meets the Standards of
Practice set forth in Chapter 5J-15.050 through
i /-2'. ' 5J-15.053,FIorldaAdministrative,Code, -.', Florida Landof pursuant to.section 472.027,Florida Statutes. 't' AFFILIATE
Pw� 44tq This survey is not valid without the signature and t. Title Association MEMBERS
original raised seal of a Florida licensed surveyor FLLA y
1P�TAT6 OF ..... ..Ic,ytl;..
'Pyr nottnA g, and mapper,except when the electronic
4V,ti t14- signature and seal of a Florida licensed surveyor
--8---- and mapper is affixed hereto.
RAYMOND J.SCHAEFER ♦EXACTA
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DATE OF SURVEY:01/05/21
FIELD WORK DATE:1/4/2021 SEE PAGE 2 OF 2 FOR LEGAL DESCRIPTION
PAGE 1 OF 2-NOT VALID WITHOUT ALL PAGES
REVISION DATE(S):(REV.() 1/5/2'221)