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699 Selva Lakes Circle RESO21-0010 Renewed PermitOWNER:ADDRESS:CITY:STATE:ZIP: DAHLIN HANS M ET AL C/O HANS M DAHLIN ATLANTIC BEACH FL 32233-7326 COMPANY:ADDRESS:CITY:STATE:ZIP: TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 172027 5874 SELVA LAKES UNIT 03 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 699 SELVA LAKES CIR RESIDENTIAL OTHER SINGLE OR TWO FAMILY RESIDENTIAL OTHER RAISE CONCRETE PORCH AND ADD CONCRETE PAD $2400.00 LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 2 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off 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 2Issued Date: 4/2/2024 PERMIT NUMBER RESO21-0010 ISSUED: 4/2/2024 EXPIRES: 9/29/2024 RESIDENTIAL OTHER PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00 BUILDING PERMIT 455-0000-322-1000 0 $65.00 BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $15.17 BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.21 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $166.88 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration, including sod, is required. 4 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 5 PUBLIC WORKS DECKING REMOVED INFORMATIONAL Notes: All old decking and debris must be removed from job site by Owner. 6 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL Notes: No additional impervious area can be added to this property. 2 of 2Issued Date: 4/2/2024 PERMIT NUMBER RESO21-0010 ISSUED: 4/2/2024 EXPIRES: 9/29/2024 RESIDENTIAL OTHER PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 Building Permit Application Updated 10/9/18 J K City of Atlantic Beach Building Department ALL INFORMATION 1/800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Email: Building-Dept@coab.us REQUIRED. Job Address: K.,' i1,r.o 4 A /t r i%w Permit Number:e SO[ I -V©I Q Legal Description 5-'614./4 t'21 f /5v'''' R E# ';72 E'-.1 7.)-xi l Valuation of Work(Replacement Cost)$ 7 (S b Heated/Cooled SF Non-Heated/Cooled Class of Work: New Addition AIAlteration DRepair Move Demo Pool Window/Door Use of existing/proposed structure(s): Commercial , 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) ,-$(No Describe in detail the t e of,vyork to be performed• 9o: yf i.••••'1"', , ,l lG" Yf2 Ci g/+15 /0a/00/1.64 flu" .f/,Vx,. y , Florida Product Approval# for multiple products use product approval form Property Owner Information Namev 727 /.=,J Address City / /9— Z7Chc, (/ St to /7:. Zip ..: '2Z 5_3 Phone 77 `j"c (/' /7 / rE-Mail j, :'c`4 / / /3' /1,,Ctim 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# Workers Compensation Insurer OR Exempt Expiration Date 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 OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECO ING YOUR NOT OF COMMENCEMENT.4 nl / Signature of Owner or Agent)Signature of Contractor) and sworn to(or afirmed) before me tgis9 day of Signed and sworn to(or affirmed)before me this day of ZOZ( , Y . _ .,'-I1!\ by Sign, . cry) Signature of Notary) V flYo •,,i TONI GINDLESPERGER Personally Known OR 1Nrld'AM ISSIPH# , t178 Produced Identification r. .o [ ER ESgMbeit44 n Type of Identification: C FOF;Ft°'° 6c1)Q0TbNIN@ ?IPAORd 4 ALLOwnerBuilderAffidavitHIGHLI HIED I ON HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233F`" j 'Phone: (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 ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address: . . 17 Sr— L,0 4 frr-X,es 4-4-,_4-4-,_ , Owner Name: .441..vS" /''l -4d/—J Phone Number: 72 %-6. °l.-/1/y Mailing Address: Gff Se./v.0 z..,4 ,,. City: AV% s-„ tate: /7. Zip: 32 2,33 Notarized Signature of Owner /1......4 /11 al , J.JTeUnsinstillmentwasacknowledgedbeforemethisdayof1 .e 20Z(in the State of Florida, County I Signature of Notary Publi cL , Personally Known OR [ ] Produced Identification 4Th A Type of Identification: '. L Updated 10/ 24/18 114"YI. TONIMYcoMMISSION#GGGIVDLESPERGER353178 ifli 1,::,7 EXPIRES:October 6,2023 f.pvBonded TM Notary Public Underwriters vio Ajipt11P0 hOillisiati 1 i'' 1 1 t efra A 0-`:• 18 t tei te7Ci C ;P p .-. 14/....._......z,i 1 I ,.... tl- " fa Q4 % 4,N t.t:04*tt‘ A*,Itt.1* 'M S tl 11I 4 Na kt t,•*It ,r-4-'- N.* II N of, I."e*- 7:,e,,eis ..., ' ,,..,_ Iv f--/ /–s- ' 74 49'7 catotistAN 1401rAioweYsimfp syYD,f 41rgovio*er 4a4 7.94>eii-l4 ii,A177 6.,,,t/e7 te,73:P AO dViAl NO NMOHS SV - ------ '800'18 ---/-*-;;;" - 101 O A3Atins Ativomnos ONIMOHS tiVVI Revision Request/Correction to Comments ALL INFORMATION HIGHLIGHTED INfitACityofAtlanticBeachBuildingDepartmentGRAYISREQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: k:5 OZ/- JO/G Revision to Issued Permit OR Corrections to Comments Dater t‘•3 Z f Project Address: 6 9 via L, / / $ ri Contractor/Contact Name: 9 +k/ 5 /3.7 / ii L / u i Contact Phone: 17 Z Y -G 2/fre Email: `,,Y7 47) (Z?j 9 6017,s9 < r l c1/47 Description of Proposed Revision/Corrections: j D l-" 0 X75 I / °J / 97t* q /S/%vrr C>? s2.Qe 1C Ila Gait vete J I .a 43/ / affirm the revision/correction to comments is inclusive of the proposed changes. printed name) Will proposed revision/corrections add additional square footage to original submittal? XNo Yes (additional s.f.to be added: Will proposed revision/corrections add additional increase in building value to original submittal? QNo *Yes (additional increase in building value: $ l)/( Contractor must sign if increase in valuation) Signature of Contractor/Agent: /a,E,,,,o /4 ,,Cjtr,vf s Office Use Only) Approved Denied Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Department Review Required: Building Planning&Zoning Reviewed By Tree Administrator Public Works Public Utilities Public Safety Date Fire Services Updated 10/17/18