330 Sargo Rd RFNC23-0100 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
David R. Lawrence 330 Sargo Rd ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171684 0000 ROYAL PALMS UNIT
02A3.00
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
330 SARGO RD RESIDENTIAL FENCE ONE
STREET FRONTAGE
Extend existing 6' fence and
add gate to each side $1000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00
TOTAL: $35.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN 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.
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.
1 of 1Issued Date: 10/13/2023
PERMIT NUMBER
RFNC23-0100
ISSUED: 10/13/2023
EXPIRES: 4/10/2024
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
BUILDING PERMIT APPLICATION
FOR INTERNAL OFFICE USE ONLY
J City of Atlantic Beach Building Department PERMIT# C,2g -01 DO
800 Seminole Road, Atlantic Beach, FL 32233
ALL information required to process
Phone: (904) 247-5826 Email: Building-Dept(a coab.us
Job Address 330 Sarqo Road Atlantic Beach,FL 32233 RE# 171684-0000
Legal Description 31 -;(
o_11 -2-S— Z9'E e/poo Q1 per,ie 1P0Ary\ Ung k- 2_4 Lo-k- 1 to QLk, 1L
Valuation of Work(Replacement Cost) 31,Q ITU Heated/Cooled SF A•%Non-Heated/Cooled SF iU IA
Class of Work: 'New Addition Alteration Repair Move ['Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial ZResidential •If existing structure, is a fire sprinkler system installed?:Yes No
Will tree(s) be removed in association with proposed project? LI Yes (Must submit separate Tree Removal Permit) El No
Describe in detail the type of work to be performed:
Extending existing 6'fence to front corner of the house and adding a gate to each side.
Florida Product Approval# For multiple products use Product Approval Information Sheet)
Property Owner Information Name David Lawrence Phone 904-852-2333
Address 330 Sargo Rd City Atlantic Beach State FL Zip 32233
Email davelawrence06@gmail.con Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Owner
Contractor Information Name of Company 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.
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 city/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. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
v/A
Signature of Owner or Agent) Signature of Contractor)
Signed` and sworn to(or affirmed) before me this day of Signed and sworn to(or affirmed) before me this day of
VI:1Djt , c. by ala 12-
by
Signature of Notary Signature of Notary
Personally Kno OR [ .-Produced Identification Personally Known OR [ ] Produced Identification
Type of Identific.,:..• „+ I)`' Type of Identification:
g2•• • ••;. VANESSA ANGERS
MY COMMISSION#HH 244118
f EXPIRES:Mardi23,2026toiZ •:e
Fence Addendum Updated 1/14/2021
Imo.
I
City of Atlantic Beach Building Department
J
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT # C r13 0 IG4
Phone: (904) 247-5826 Email: t3uilding-Dept@coab.us
Job Address: Date:
0' S Tv/ 0/) 2/2)
Property Type:Lot Type/ Features:
Cid Residential One Street frontage (interior lot)
El Commercial More than one street frontage (corner lot,through lot,
etc.)
Swimming Pool
Fence Material: Fence Height (select all that apply):
@'Wood Four Foot(4ft)
Chain Link x 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)
C+3No
Will tree(s) be removed in association with proposed project?
El Yes (must submit separate Tree Removal Permit)
LAO
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.
Owner Builder Affidavit ALL INFORMATION
HIGHLIGHTED IN
City 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-1VC2;-C co
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: 3() Sp r 0 2 ry jQ -13eCCk L 32233
Owner Namer.-DOLv I[ cx_Luoar'lQ ?_
4
Phone Number: QUL SZ Z333
Mailing Address: r9Q 2c City: }t t 1C PQCLI State: 74--L Zip: 22:33
Notarized Signature of Owner
The foregoing instrument was acknowledged before me this 1 ' ay of 00Wr ,2023, in the State of Florida, County
of 6UV` A
Signature of Notary Public
r°` `
P`'
VANESSA ANGERS Personally Known OR [ }'Produced Identification
MY COMMISSION#HH 244118
EXPIRES:March 23,2026 I p
FOF,te: Type of Identification: -- Dl, A,td 1` • LQ.wre LC.e.
Updated 10/24/18
OUT fl LAW IZ ENc.c
MAP SHOWING SURVEY OF
33o
ys.
t a
LOT 16, BLOCK 24, REPLAT OF PART OF ROYAL PALMS UNIT 2A, ACCORDING TO THE PLAT S ugv I
THEREOF AS RECORDED IN PLAT BOOK 31, PAGES 16-160, OF THE CURRENT PUBLIC
RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO: MATHIEU BUILDERS
SARGO ROAD (60' R/W)
TBAI.(6.01)
cove
N0776'02'W 80.65'
z
Ea) __T__ j 4• GRAVEL
Iribr--70 —(
747I
aCIVE• . /
K
I TION II ay viN
1 p YARD au", YARD Aim I
I `}Tr'..(7.24) Rr-(7.J2) k
O GRAin SAY /
s
0
N D 0OPORCH01I
R
1.5'
o30.5' I h
Of .1L, I
I- 0 9.2'
1 0
0 !n o I .W
I InCla 0
0 r 1-STORY FRAME 3 z"to
N s RESIDENCE /'330 Ig ' P
m
F.F.EL.=(8.6O)E I
1 I ma
272'
0, o COVERED I I
4,5* 12.4'
QS PORCH I mO
24.2' ' 9.6' r
1I „
4,.7.,,--'(7:3)
LOT 16 1 i RETENTION p iAREAAn04„4.......jLeiZAVIL_173br.--
i---r-- -
h t •6_IYtJ00 FENCE t r n8)r •
In
Iliii
N0776'021W 80.65'
LOT 9 I LOT 10 Ir. Pro paSei C4Q
IIIIII Fence, Aid +ter
AUGUST 24, 202.5 RE-CHECK; WA/ 3 /444.46-I1
AUGUST 2,202.7 FINAL SURVEY WL PRINT
MARCH 29, 2023; FOUNDATION SURVEY(2023-36-3) W.L 1476-5
MARCH 15 202;RE-STAKE MOUSE(2023-56-2)NW
UNLESS IT BEARS THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA UCENSED SURVETDR AND MAPPER THIS DRAMNG, SKETCH,
PLAT CAR MAP IS FOR INFORMATIONAL PURPOSES ONLY,AND IS NOT VALID.
NO7ESDATE 3-7-23
I.Berings are based n Me RECORD PUT.
LEGEND
2. r r o BOUNDARY SURVEY. p °O°ms Ca W."."W."." SCALE 202 -Th3
S Erwtkne shoe,thus(150)rem to North American Vodka/Datum ll-s DElans f 472JABNo. 1472 6 2of1985(NATO M0 0 qap l/5'RON PIPE SET F.B. 1472
4.By GVphic plotting oo!p the property.hoe hereon Ire nth.,Zona ?f'(SHADED)&'AE'(EL 7) MIR CAI.LB M..Opage 67
0 Mawr on M.Federal Emergency Management Agency FEMA),Notknd Flood Insurance • nCrwlCS pay RFCfW.M
Program,Flood Insurance Rote Map(FJ.R.M.)Community-Panel number 12031C 0408 J KO/TnU Comp. Flie 23-36.OMC
Map Revised dote: 11-2-18 r r m m Drawn by MNB
S Unless others*.noted any portion of tel parcel that may be deemed os Wetlands r'tin
by State or Governmental Amok"hoe not been d.termhed and any I/abilty ree4thg INC.URI YI e'N13,MAPPING, INC.therefrom Is not the rspnsbIKy of the undersigned
6. There may be Restriction.or Easements of Record evidenced by Hite eoornhotlon Mot PROrE57pVA[ VE 7tA(S ''
have not been Muer hereon. 114,77 CEN Yr$fd14••107'9Q L6 No. 8295
ABBENATIOVS THAT MAY BE USED bN TMS SURVEY JACKSONgRlE, t', .1904)721-1226
ABBREWATK8 DIEFANITOV ABBREMA1108 DEFINITION y
b
P.CP. Permanent Control Pont LB Licensed Burnes. So,6 ha1g1ry MAr IHS SURVEY 0 A reK IISPRI ealAAaI Yr AM AMU
P.R.M. Permanent Reference Monument R.LS Registered tend SurveyorTee 7MOC IUm.SYSSevel,yav ANa M AammwCL rge iK
PILE .aoht of BenrhG TEA. .bdrear.NTe Ltcnh A66writy ,h'a,a•- 7:.e y., falx ':G.: :
P.C. Pont of Curvature Q',o Equpmnt eaaoAa`vcnu "' 10:•• y w l wvmr san>,
P, Pont of Tangency A Al-C:ndMlner Ano a.w.R.10, I. , 1. •' Ory[o ivea er 10
P.R.0 Pont of Revers.Curvature CATV. COW.T.*v*Mr Rte"
Pi Pont of Intersection Overhead Lees i
RA IN,wby
FW.
L) TTMd Measured
erW
Rodu.pods j: :Q 0m-
Ass d
re.Cyth
edg d D*tncs Wads Br--- eN
E.nLt Eaw„'V„R..trfoUon Lhe
I . he Phe
Ceho'Mg/s.Buds
µf/,(K'\ a mit f14 est RfGSTERED
Cone Concrete 1V VE -.VW, ''NAA 5843
L
t
Ponte Vedra Title,LLC
ALTA Combined Settlement Statement
50 AlA North,Suite 108
Ponte Vedra Beach,FL 32082
904)280-5540
File#: 23-1704 Property 330 Sargo Road Settlement Date 10/13/2023
Prepared: 10/11/2023 Atlantic Beach,FL 32233 Disbursement Date 10/13/2023
Escrow Officer: Julie Johnson Buyer Kronos Management&
Consulting,LLC
Seller V.Allison W.Forsyth
Lender V.Allison W.Forsyth
Seller
Buyer
Debit Credit Debit Credit
Primary Charges&Credits
825,000.00 Sales Price of Property 825,000.00
Deposit 15,000.00
Loan Amount 742,500.00
742,500.00 Seller Financing
Prorations/Adjustments
876.00 County Taxes 10/13/2023 to 01/01/2024 876.00
Loan Charges
500.00 Document Prep Fee to Hathaway&Reynolds
Government Recording and Transfer Charges
130.50 Recording Fees
Deed:$18.50
Mortgage:$112.00
5,775.00 Documentary Stamp Tax(Deed)to Clerk of Court
1,299.37 Documentary Stamp Tax(Mortgage)to Clerk of Court 2,000.00
1,485.00 Intangible Tax(Mortgage)to Clerk of Court
61.00 Recording Fee:LLC Affidavit to Clerk of Court
27.00 Recording Fee:NOTNOC to Clerk of Court
Commissions
10,312.50 Listing Agent Commission to Cowford Realty and Design LLC
10,312.50 Selling Agent Commission to Cowford Realty and Design LLC
Title Charges
150.00 Title-Lender's Title Policy to First American Title Insurance Company
3,677.00 Title-Owner's Title Policy to First American Title Insurance Company
395.00 Title-Settlement Fee to Ponte Vedra Title,LLC
85.00 Title-Title Search Fee to First American Title Insurance Company
Miscellaneous Charges
3,997.99 2023 Taxes to Tax Collector
10.00 Municipal Lien Report to City of Atlantic Beach-Pd in Adv by PVT
Seller Buyer
Debit Credit Debit Credit
780,717.86 $825,876.00 Subtotals 827,876.00 $757,500.00
Due from Buyer 70,376.00
45,158.14 Due to Seller
825,876.00 $825,876.00 Totals 827,876.00 $827,876.00
Produced by Ponte Vedra Title.LLC
Using Qualia Page 1 of 2 23-1704
Printed on 10/11/2023
Signature Addendum
Acknowledgement
We/I have carefully reviewed the Settlement Statement and find it to be a true and accurate statement of all receipts and disbursements made on my
account or by me in this transaction and further certify that I have received a copy of the Settlement Statement.
We/I authorize Ponte Vedra Title,LLC to cause the funds to be disbursed in accordance with this statement.
Kronos Management&Consulting,LLC,a Florida Limited Liability Company
By:
V.Allison W.Forsyth Date
O /313
David R.Lawrence,Manager Date
All ii' •. . _ reinc o . °
P193
Holli Lawrence,Manager Date
Settlement Agent Date
Produced by Ponte Vedra Title.LLC 23-1704
Using Qualia Printed on 10/11/2023