1964 Beachside Ct. CITY OF ATLANTIC BEACH,
J� BUILDING / ZONING DEPARTMENT i ins
s 800 Seminole Road
x , Atlantic Beach,Florida 32233
(904)247-5800
(904)247-5845 Fax
PLAN REVIEW COMMENTS
Permit Application # CN - ci�1/99 3
Property Address: P-4-ti rf,Sr rJc
Applicant: /� 1� bd S
Project: .,y) J' 110 n
This perfnit application has been:
Approved
❑ Reviewed and the following items need attention:
Please re-submit your aolication when t e e items have been completed.
Reviewed By: Date: 173
CITY OF ATLANTIC BEACH
J� BUILDING / ZONING DEPARTMENT L. ins
1 sei S. Doerr
r J 800 Seminole Road
J � Atlantic Beach,Florida 32233
(904)247-5800
3 � (904)247-5845 Fax
Ol
PLAN REVIEW COMMENTS
Permit Application # a-1-/ -Cdj7c1 cj 3
Property Address: /96-1 - d
Applicant: i3i -S hr,d r
Project: addl. yrcu
This permit application has been:
Approved
F1 Reviewed and the following items need attention:
Please re-submit your application when Oese items have been completed. L
Reviewed Ey: 1. - Date:
j MIN. RETURN Book 11715 Page 3
PH"ONE# a Y7- 71 % 6
NOTICE OF COMMENCEMENT
r
State of r L o -i b bt Tax Folio No.
County of �4�i4�•
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:_ R i_1- I ` L-07 23 &AC.tts 1.J
Address of property being improved; 19
I '►4c r►Si aE ' aT TL440,1
General description of improvements: `'-;
icHyt&h y2c-V ROCI 536-
Owner: ,S (~t+v ,
Address: IcL� r -
Owner's interest in site of the improvement: 'TC-7031-1- 03/26/2004 01:31:58 pM
Fee Simple Titleholder(if other than owner): 0 61r ULUX
Name:
Address: REC INS 5.00
Contractor: D # 1.00
Address: ---5Aj%e A< bcx-,7 CUP1,Fr 1.00
Phone No: Rom_ 2�-i - 7 Fax No: *4 _?.ca t �" ��i ��i 1.00
Surety(if any): 14o
Address: N It* Amount of Bond S
Phone No: Fax No: t 4 r cit
Name and address of any person making a loan for the construction of the impro ments.
Name:_ 00"C
Address:
Phone No: — Fax No:
Name of person within the State of Florida,other than himsel4designated by owner upon whom notices or other
documents may be served:
Name: 0 o k rr _
Address:
Phone No: Fax No:
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2xb),Florida Statues. (Fill in at Owner's option). --
Name:_ -1014e
Address:
Phone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recordine uniess a
different date is spec'
THIS SP
IIn t1.iL
VGibui� .� 31:e1
D.Apy ilvlo-'T OF
M 5HOWING BOUN Sut
A M,
L 0 T BL OCK S SHOWN ON
4Z /4' 14 OF THE PUBLIC RECORDS OF
r, I jrz-CORDED IN F-IL A T BOOK
--sedr-7
CERTIFIED .7'0. : ----
-Irze seev1ee--, , Mee.
e
IAI tl
LEGEND
tr. Rroa rot
goo
AC. ACMAI
//wRWM!-or- wAr
(S.-f Wfut"t
F.C. 10-r Or CL-VAIVAI
m A,Vut Imt
101Mr Or gnlgjt CURVAIVAC
twossmucito
C= 45�00
C = 44. 84
-lA .or'
PQI
Ne
lg ;�o
Z
IS
J-.
V,
c
6-Al 7
Ple 1/,q 7--C 5 4e 127
ro
woo& rswe
V0
-3.0. 0 0
L0 7- LOT 60 7-
113
/0-28-93 6clez,9) 711ERE MAY BE ADDITICNAL E&M'T AN-n,'-M RE=,,.--qrz&,:; T-,Wr. iu-,z ficir micwa
x4 0 F 3 76 7-'�--—11 F 8.
.3 Cfl THE SURVEY THAT MAY BE FOUM IN THE PUBLIC REODRW OF Mil S CaMTY
20, 4�f
FDUUP. W-0. 0313.lzo 'u- 'm BEARINGS BASED ON PLA 7' AS SHORN
:AIli)]
,r liERFLUK rFqTIFY THAT THE-.�!LSHOWN HEREON IS IN THE SPECIAL FLOOD HAZARD ZONE ")e" AS SHOWN
ON FL 000 pjsj,,;A IvCC RA TF MAP_aoo/ 0 roR THE c.-ri, OF X r,,VIlrle , FL OnIDA. DA M-D 47-/'/-.AS
CITY OF ATLANTIC BEACH
FLOOD PLAIN DEVELOPMENT INFORMATION
Location: Ow, ti 5 A iLt4m-n G lJC 1-4 . 'R-
Type
R-Type of Development: r G 1 � � �� i)C r y i t-
Flood Zone: Y
Required Lowest Floor Elevation:
If building is located within a flood hazard zone, a survey must be made AFTER THE SLAB
HAS BEEN POURED, certifying that the LOWEST FLOOR ELEVATION is equal to or above
the base flood elevation established for that zone.
No final inspection will be made and no Certificate of Occupancy will be issued until the survey
is on file with the Building Department.
COMMENTS: ,, ii
/\A 0-71-6 0 (7\t i S:`i
Applicant Acknowledgement: I understand that the issuance of this permit is contingent upon
the above information being correct and that the plans and supporting data have been or shall be
provided as required. I agree to comply with all applicable provisions of Ordinance No. 25-7-11
and all other laws or ordinances affecting the proposed development.
Applicant's Signature: Date: X ;2
Department Use:
Required lowest floor elevation:
As built lowest floor elevation:
Survey filed with Building Department:
Building Department Representative
Revised 1/17/03
s+
CITY OF ATLANTIC BEACH
" 1 OWNER/BUILDER AFFIDAVIT
„r
BRI"
Date: ,t"H
Job Address: ��I(�� 3EAC 66 i�- Lit A--iLA ttl 1-`C_ �( 4. t'C..
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.
ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL
OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A
BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY
PHYSICALLY DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE
UNDER"DIRECT SUPERVISION OF THE OWNER,WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN
PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS.
SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT
SUGGESTS-WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE
POLICY TO CLEARLY PROTECT THE OWNER 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.
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
TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
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.
1P 1,o oa, JENNIFER GUTHRIE
_~ % Notary Public,State of Florida
My comm.expires Oct.27, 2007 PROPERTY OWNER/BUILDER'
No.DD 262421
SWORN TO AND SUBSCRIBED BEFORE ME THISZ<"'DAY OF 42047
N T Y PUBLIC
MY—COMMISSION EXPIRES:
NOTE: PHRASES UNDERLINED ABOVE.
In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being
" performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner.
1. Current survey showing the property boundary with bearings and distances and the legal description.
2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify
any existing structures and uses.
3. If required by the Department of Public Works,a pre-construction topographical survey.
4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies.
5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools
may be excluded from total Impervious Surface.
6. Other information as may be appropriate for individual applications.
I hereby certify that all information provided with this appli tion is correct.
Signature of owner: Date:
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and
ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the
governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the
above information being true and correct and that the plans and supporting data have been or shall be provided as required.
Signature of Contractor: Date:
Address and contact information of person to receive all correspondence regarding this application (please print).
Name:
Mailing Address:
Telephone: Fax: E-Mail:
AS TO OWNER:
Sworn to and subscribed before me this S day of ,20 2
State of Florida,County of Duval t
EIPA g JENNIFER GUTHRIE Notary's Signature:
'� Notary Public,State of Florida
My comm.expires Oct.27,2007 F-1Personally known
No.DD 262421 Produced identification
Type of identification produced 'Z��'
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of ,20
State of Florida,County of Duval
Notary's Signature:
❑ Personally known
❑ Produced identification
Type of identification produced
800 Seminole Road •Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 •Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.us
Page 2 Revised 1/14/03
"N'
s
f�d CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION
(ALTERATIONS/ADDITIONS)
C - 51Y— q31 D
Date: Q(
Job Address: B A CH-5 i 17)c CCALAw T , A-7 LA i,-1►C 3 EA<_ lV fL, ,3223-3
Owner of Property: , !S . HCatht= A"I>
Address: 19(Q i-I _FAC f{516t~ LT. Pi:�A MT-ic &41 FL. Telephone: c11,A 2_i- 1 l q Zv
Legal Description: Block Number: Lot Number: Z Zoning District: &4,ti t�C
Contractor: f wt._)6 o' - OLS , O Hoi�c'S State License Number: C is C, (,)Lam,2-C,
Contractor's Address: tri b,LI ?)eAC?6J bC- UT 1 L-tAWri C,- 'BC iA , 1-f,., 37-233
Telephone: C�'p ZJ-J 7 --7rS`s' , Fax: �t,4 - 2.4 I 3&49
Describe proposed use and work to be done: 6AT - *' i o# ' 6204 ,. -"k-
AU ac -11 3 7 5 G ,� ' C a 'L-
Present use of land or building(s): QE-jt-QkE ti)C C - Akc r} t� C l-ti l y et"t wv ocy
Valuation of proposed construction.. Ci
What are the dimensions of the added space: (u -( feet x Z r SS � feet
Will the added area be heated and cooled? YE New electrical or increase in service? �1 j �L oCT-,
Add plumbing fixtures? Add fireplace? �v Add,,oheating/air conditioning?_ l�
Is approval of Homeowner's Association or other private entity required? Nq If yes,please submit with this application.
Will this project involve changes in elevation,site grade or any use of fill material or the removal of any trees?
X NO. Applicant certifies that no change in site grade or fill material will be used on this project.
❑ YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building
Permit.
t(NO. Applicant certifies that no trees will be removed for this project.
❑ YES. Removal of Trees will be required for this project. TREE REMOVAL PERMIT IS REQUIRED. Tree
Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate.
Incomplete applications may result in delay in issuance of permit.
STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please
contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have
Property Appraiser's Real Estate Number available.
STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction
topographical survey or grading plan is required. (If not required, written verification must be provided with this application.)
The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834
STEP 3. Submit Tree Removal Application if trees are to be removed or relocated.
STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if
owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic
Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.us
Page 1 Revised 1/14/03
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00027993 Date 4/02/04
Property Address . . . . . . 1964 BEACHSIDE CT
Tenant nbr, name . . . . . . BATHROOM ADDITION
Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9500
Owner Contractor
--------- --------------- ------------------------
RHODES, R. S . OWNER
1964 BEACHSIDE COURT
ATLANTIC BEACH FL 32233
(904) 241-1420
----- --- ----------- ------------------ ---------------------------------------
Permit BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 80 . 00 Plan Check Fee 40 . 00
Issue Date . . . . Valuation . . . . 9500
Expiration Date . . 11/04/04
----------------------------------------------------------------------------
Other Fees . . . . . . . . . WATER IMPACT FEE 120 . 00
WATER CROSS CONNECTION 35 . 00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 80 . 00 80 . 00 . 00 . 00
141
- Plan Check Total 40 . 00 40 . 00 . 00 . 00
Other Fee Total 155 . 00 155 . 00 . 00 . 00
Grand Total 275 . 00 275 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
Q
d1.. C - 1,k
BUILDING OFFICIAL
f
CITY OF ATLANTIC BEACH
`� yt
r PLUMBING PERMIT APPLICATION
_Dill'
Date:
Property Address: 1 Tri �, �.�C� <-ibe c6QU
Owner: &' ,C,�4//'j Telephone
Contractor:
tom J`, ephone #•
, —
Contractor Address: -'Fax#:
x s
In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in
accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach
ordinance and standards of good practice listed therein.
Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing
Code.
Plumbing Type: Ioge'r construction is being done on this building or site,
&'' New list the building i`g pe�i�um��3
❑ Re-Pipe
Number of Fixtures:
Bath Tubs f Showers
J Closets Shower Pans
Dishwashers Sinks
Disposals Urinals
Floor Drains Washing Machine
Lavatory Water
Sewer Water Heaters
Other
Fees
Permit Issuing Fee: $35.00
Total Fixtures: 3 X $7.00 + $35.00= 6 6
800 Seminole Road- Atlantic Beach, Florida 32233-5445
Phone: (904) 247-5800 - Fax: (904) 247-5845• http://www.ci.atiantic-beach.fl.us
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
r
Application Number . . . . . 04-00027993 Date 4/20/04
Property Address . . . . . . 1964 BEACHSIDE CT
Tenant nbr, name . . . . . . BATHROOM ADDITION
Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 9500
Owner Contractor
- ------------ ---- ------- ------------------------
RHODES, R. S . OWNER
1964 BEACHSIDE COURT
ATLANTIC BEACH FL 32233
(904) 241-1420
------------------------------------------ ----------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc 3 FIXTURES
Sub Contractor ROLLAND REASH PLUMBING
Permit Fee . . . . 56 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 56 . 00 56 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 56 . 00 56 . 00 . 00 . 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS" ISSUED ACCORDING TO APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
r
BUILDING OFFICIAL