Permit 1510 Selva Marina Drive CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00027562 Date 1/21/04
Property Address . . . . . . 1510 SELVA MARINA DR
Tenant nbr, name . . . . . . SPRINKLER SYSTEM
Application description . . . PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
----------- ---- ------ --- - ----- -- --- ---- - ---- - - - -
FOSTER, ALLEN HULIHAN TERRITORY
1510 SELVA MARINA DR P .O . BOX 331268
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 285-8505
-------------- --- ---- ------- - --- --- ------ - - - -- - -- - - -- -- -- -- ------- ----------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 50 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
---------------- ----------- ---- ---- ------- ----- -- - --- - - ---- -- - ---- -- - -- -----
Special Notes and Comments
OWNER MUST HIRE PLUMBER TO INSTALL
BACKFLOW PREVENTER AND MAKE THE
CONNECTION FROM THE PRIVATE PROPERTY
Fee summary Charged Paid Credited Due
----------------- ---------- -------- -- ----- ---- - - - ------ --
Permit Fee Total 50 . 00 50 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 50 . 00 50 . 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.
BUILD OFFICIAL
CITY OF-ATLANTIC BEACH
PLUMBING-PERMIT APPI-ICATION
IC ite: 0\+
Job Address: lv��
Cuner-of Property--GasLa T. lephone: QLq k-
Plumbing Contractor:
Contractor's Address:—
Tefephano.-_c4t U �s - 11:-So 75 Fa;
State License Nwnber:
flowmapy of the-following fvMves(re, piped or new):
S inks Showem Water
Lavatory WateT-fleatem Hose Bib
-aath� Dishyatshers Sewer
Urinars- Other
clowm- Machhw —Shower Pans
Floor-Drafiw Rc--Pipe(Ljst fixturt being re-piped)
Total Fixtures: x $7.0-0 + -V5.00 (Minimum Permit Fee: $35,00)
Signature of Contractor:
-Installation ofplumbing and fixtures must be in accordance- fith the most recent edition of the
Southern S�andard Plumbing Code.
Call a-day-aheadto schedule-inspqctions: (904) 247-5826
800 Seminole Road-AtlanticjBeach,Flor in 32233-5445
Phone: (904)247-5800 9 Fax: (904)247-5845- http:i www.cLatlantic-beachAus
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 04-00027561 Date 1/21/04
Property Address . . . . . . 1510 SELVA MARINA DR
Application description . . . WELL PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Owner Contractor
------------ - - -- - - -- --- - - - - - - -- -- - -- - ---- - --- - --
FOSTER, ALLEN R. J. WELLS
1510 SELVA MARINA DR 1078 NESTING SWALLOW
ATLANTIC BEACH JACKSONVILLE FL 32235
ATLANTIC BEACH FL 32233 (904) 221-7988
------------------- --------------- ----- - ------ - --------- --- - ---------- - -----
Permit . . . . . . WELL PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Fee summary Charged Paid Credited Due
------------- ---- ---- - ----- ---------- --- -- - ---- ---- -- - ---
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 35 . 00 35 . 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.
BUILDING OFFICIAL
A
CITY OF ATLANTIC BEACH
WELL PERMIT APPLICATION
Date:
Job Address:
Owner of Property: fiLLk-,t) '40 STE"F--
Owner's Telephone:
Contractor: /7F
contractor's Address: A0 441-57-1,V2,-- Z)e
Telephone: f�/*` .2.7/-217 Fax:
Is well to be used for drinking purposes?
Any person, individual, corporation or other entity receiving a permit as provided in
Section 22-40 of the Atlantic Beach Code, and who plans to use water from the permitted
well for drinking purposes, must first obtain a bacteriological test report from the State of
Florida Health Department-, flirnishing a certified copy thereof to the building department
of the City of Atlantic Beach. A certificate of occupancy will not be issued until said
report is on file with the building department.
Department Notes:
I agree to comply with regulations stated herein:
Signature
Date
800 Seminole Road e Atlantic Beach,Florida 32233-5445
Phone: (904)247-5800 e Fax: (904)247-5845 9 htti)://www.ei.atiantic-beach.fl.us
Revised 1/17/03
PLANS REVIEW CHECK LIST
Address
�--Owner
Le"l Description2-1Y.,.A ------------------
----------Contractor
----------------
- --------License Number
..........
License on File
999tion 24ZIgI No
Zoning District '3
------ Proposed Use
Required Lot Size
--- Actual Lot Size
Setbacks Required Provided S-e-c-tion
-IZ17
front
----- CORNER LOT ,"i'NTERIOR LOT
rear
side-1 Flood Zone__
Lf--- --------
side-2 /7 1 Required Elevation__
-- -------- AbL-
Max. Height Allowed
---- Proposed Height___-GLJ-
Section 24-82 * Minimum Lot Coveragg
Required Heated Area __ "e,--- Proposed Area
Section 24-161 * Offstreet Parking
Number Spaces Required__ t)/?,- Spaces Provided
Section 24-82 * Duplicate Buildingg
Is there a similar building within 5001 of proposed building?YES � NO
Utilities
Water and sewer service is to be provided by:
----- Buccaneer Utilities
4-q- City of Atlantic Beach Utilities
----- Private Source SEPTIC TANK WELL
YZPlans Reviewed by:2.,k - ----------- ---
Building Permit
--- r9SU DENIED
Address- VA-, m 4 g N
Mated Square Footoge $___��er,sq ft.
Garege/Sl L (a sq
Carpor C/P 0'r sq ft
Deck @ .---Yer sq -ft
er. sq f t
Patio (n
TOIAL VAUMON I
is t $ 0 e)0.
I b t a 1
iousan or
nabider Ve I 11,1 Lim er
portion thereof
------------------------------------------- Total Building Fee
AUDITIOWiL PE101ITS wid/or FUS mgmw�'_ +.k Filing Fee.,
i - OFireplace's @
Mechanical
BUILPING.I.PEIMT M. ,
- -------------:---------------------------
Electric/Nm4 -------
Electric/Tail) .
BUILDWG-PERM _12,_O(D
Septic Taik WIER W IE R CI ME
Well
SEWIR IWACT FE
01��iillidllg Pool
WATER IWACr FEE
Sign MISCELLANEOUS
Water Camectim
Sewer CminecLion
Water lip-ter
Elevatioti Certificate*
GMD TUML DUE
-------------
---------------------------------------------------------------- --------------7,
CALCULMONS and/or NUIES
CITY OF ATLANTIC BEACH
APPLICATION TO MKE ADDITIONS OR ALTERATIONS
Owne z4-4- _C__4 vv/-eAddress - phone
Architect Address Phone
Contractor.,,2�
c7- - C-ol Address
1�772_ )x_j7ec_
Contractors License/Certification NLubers
Expiration Date
Property Address
Lot iL_��Blcok or Unit # A�A Subdivisi
Valuation of Construction :Pfpe of Cons.truction
Describe Work to be Performed
Materials to be Use
Present Use of Buil
Proposed Use of Building
Flood Zone
Dimensions of New Area:
HEATED
CARAGE OR STORAGE
CARPORT OR PORCH
DECK
PATIO 'YES NO NU14BER
Will there be an increase in number .of units?,
Will there be a decrease in nunber of units?
Any additional plumbing fixtures?
Any new fireplaces?
SUB�aT TW CO�T= SETS OF PLANS INCLUDING SITE PLAN
Signature OWNER Date—
Signature CONTRACTOR
Date_,,��
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO. 9 3 7 9
PERMIT TO BUILD
THIS PERMIT MUST BE POSTED ON JOB W
Date December 30 _19 87 19 11 1/15/ 8
5379 'OfICA i
Valuation$ 6,000.00 $ 33.00 3019 1A I I r)/
This permit not valid until above fee has been paid to City Treasurer,and is inn I
subject to revocation for violation of applicable provisions of law.
This is to certify that Allen Congtru tion cBr n7_11,16
447-4 Atlantic Blvd. A.B. 32233
has permission to buitd wood screen pgreh on existing deck
Classification Residexhial —Zone RS"i
Owned by Wm. Ruc
Lot 6 Block 8 S)�elva Marina T4_
House No. 1510 Selva Marina Dri
According to approved plans which are part of this permit
NOTICE—ALL CONCRETE FORMS
AND FOOTINGS MUST BE IN-
SPECTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
4 -0 0 Building material, rubbish and debris
zi from this work must not be placed
in public space, and must be cleared
up and hauled away by either con-
tractor,,6r owner
/,�uilding Offic-ial.
FOR OFFICE 'ERMIT
USE N DATE
__!�S ONLY IUMBER CONTRACTOR
PLUMBING
ELECTRICAL
SEWER
WATER
L
,40W
DATE :
PkE--'-'EkVICE DIVISION
JACKSONVILLE ELECTRIC AUTHORITY
,'JJ WEST DUVAL STREET
JACKSONVILLE, FLORIDA 32202
THE FOLLOWING FINAL INSPECTION(S) HAVE BEEN MADE AND ARE
6ATI'S'FACTORY:
Y"�
-------------------------------------------------
-------------------------------------------------
-------------------------------------------------
-------------------------------------------------
Enclosed are the blue copies of the permits.
-';INCERELY,
BUILDING INSPECTION DIVISI.ON
cc : FILE
r'T q 7
T r3E"C'
-U� O-F
NO .
zi Date :-- -7 -z-
_,�T T C,
L t r S t t
LOT BLOCK No ..
0;1_C�E R
.7
1"..ASTER PLT-HIBER
WA L_ 7 Pk Y0 w 6_ F: Bidg .
Coll ZD
BUILDER OR �TRACTOR S C— I
TY2E OF BUILDIN� < I PV
SI1.!`_S 4- LAVATORY 2- BATH TUBS
-,S '"TOSETS
ZL
FLOOR DFLITNS SHOTIIERS ;,i_'AT E-0t. HE.a"2_2P,S_j DT AS_H-EPS
------ _S'H�J
DISPOS.LT,S —OTHEP,/—,/ R //A-C
__z
TO?--'-,-L FIXTURES
3— 00
NO' ORl' 1',_TUST BE DONE UNTII A PEMMIT HAS BEEN -TROICURED
P -LED S"E'_-'1IFIC-`,'TIO1_'S rust show a plan a d desc-ription o_f' the
size �'.a.,Llid location of a�l tile soil and- vent pipts, and the numb-3-r -,-r.d
location ofL all fixtures , (in accordan(�e T""itlh_ Ord-�rancc -n3. 188 of
the Cit-V of Atiantic B-each, Flurida ) -must, be shiT,1T__n_ on back of appli-
cation and be approved by the Plumbing irspeot.,Ar,
0, B C"
DP J PLA" '-iTD S'_-E"'Tq1jC.i",.TIO' OF ABOVE PLU?,
by
Plunnbin- Insp� ecto,�
Date
(F01-It OFFTC�P USE ONLY )
��L_T'J T-i"SPECPED
F i A L !i'll S 1,E CT 1011,", T--,'T C!,
DEPARTMENT OF SUILDING
CITY OF ATLANTIC BEACH,FLOR,oA PERMfT No. 9 35 2
PERMIT TO BUILD
THIS PEWT MUST 13E POSTED Ot4 JOB
Date 7*�In T
Dec 15
19 87 7,5nCRT
Valuation$ 6 243 7S
_50 121 5/m
This Permit not V21id 12
"'�'b",6 ha b--pid to Ci,y T,,,'.ur�,, d i, 51/1 ar
SUbjeCt to reVoCat"'n for Vi012ti0n of appfiCabje P'oVS,onS of 6 rion
This is to Crtify that New JerUsalem
10fin
has permis 1139 Ist Ave 322so RC0034687
sion to Umm re roof
Classification Residimat"i
Owned by Zone
Lot Buclianan
House No. Block
is
According to approved plans which a
re part of this permit
NOTICE—ALL CONCRETE FORMS
A FOOTINGS MUST BE IN-
S CTED BEFORE POURING.
PERMIT VOID SIX MONTHS
AFTER DATE OF ISSUE
;U
ZO Building materialp rubbish and debris
i from this work
in public sp,c must lot be Placed
es and must be le ed
up '"d hauled away by either
r or owner.
FOR OFFI E Uilding offici,j.
USE ON y PERMIT
NUMBER DATE
CONTRACTOR
PLUMBING
ELECTRICAL
SEWER
WATER
CITY Or. 'ATLANTIC B.EACll
APPLICATION 1--olt 1100FING PE-11MIT
R
BUILDING OWN1311 / , PHONE IZ?O
JOB ADDRESS yV,04j � . . . I I
LOTH
BLOCK Olt UNIT #
SUBDIVISION
PlIONE
Al)DU-SS
LICENSE NUMBl-:l?--9C003q(-y-? rxpiRA:1,1()N
J013 VALU/Vl'ION $ 'T �5-
MATERIALS:
SIGNATURE OjVNElZ
SIGN/Vl'URE' DATH
12
MAP SHOWING SURVEY OF
LOT 6, BLOCK 8, SELVA MARINA UNIT NO. 4, AS RECORDED IN PLAT BOOK 30, PAGE
28 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
00A/
lor 5 CA4
-f" v
to
r%
,41AI6 IV49 /5
49
r
IVO 8.,f 4. qS PrR P1077
.00.VAo' 4 dV.**
.CAOhP 9*'A 10' AAAAM VX-Alp
b*4%_,Or
P.C.
AI-P -'5jS/
I HEREBY CERTIFY THAT THE PROPERTY SHOWN HEREON IS IN FLOOD ZONE "C" AS
FOR OFFICE USE ONLY
W7
Date........1112-.,l.......1 .....
Permit ...Fee s...7 947.1".............
CITY OF ATLANTIC BEACH ,. Valuation o�'0'4
.. ...........................
FLORIDA House . ...................*04(�
............................................................................
APPLICATION FOR BUILDING PERMIT ............................................................................
...........................................................................
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the
building or other structure described. This application is made in compliance and conformity with the Building Ordinance of
the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic
Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether
herein specified or not.
The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub-
contractors engaged by him are duly licensed in the City of Atlanfic Beach,Florida. To prevent delay or embarrasment regard-
ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can
be verified. Date............. .........&I;�110............................ 19_7�
Owner...../4 r—L.X/- .............................................AddressIp fod -v-212 7
W/ 1 6 -I--------------------
........................... ..................14 41phone No241
/el"n.0 ......Telephone No.............................
Architect...;&Q-6,6 .................Address,/PA.......
. ..............................;-------------------------
Contractor Builder.......;5 q—L. r— ...........Address.................-------------- Telephone No-------_--_--------------
....................................----------------- 9-------------*..........**
------- .................Sub Division.....5.--M.........1J..11- �'�----------------------- ----------
Lot No---------------_----- ------------------------Block No. ..... ..... - ---- - --- --- ............Zone.......
DP V Sts
f tw
.kRI L'-Street------- .. .........Side Be een...... ...................-----_--------....and-----------------------------------------------
- ---------------io..........
Valuation $171-P.0-1)...�9_Yor what purpose will building be of confftruct1on.'YP.1.Cki.F**tt-
---- ....... 16 V'V
OIJ 14 5 Y A-Y0---------........Size of Footings...............A
Dimensions of Building.-.P---Vkj.�-------------------Dimensions Of Lot....................................... ...9�......
Size of Piers--------_--------_---------------Size of Sills.----------------------......Greatest Sill Span in ft..........................Type Roof--------------------------------------
How will Building be Heated?-.... ......--P-...Will Building be on Solid or Filled Ground?----------------------------------------
Size of Ceiling Joists---------------- .................... Distance on Centers............................................I Greatest Span-------------------------------------------- to
Size of Floor Joists------------------------......................Distance on Centers.......... ................................I Greatest Span--------_................................ I.
Size of Rafters...------------------_--------....................Distance on Centers....... .............................I Greatest Span.................-------------------------- It
This rectangle is to represent the lot.
Locate the building or buildings in the
right position. Give distance In feet from
all lot-lines and existing buildings.
REAR LOT LINE
Two copies of plans and specifications shall
be submitted with application.
Inspections required.
1. When steel is in place and ready to pour footing. N
2. When steel is in place and ready to pour columns and/or lintel. Z Z
S. When steel is in place and ready to pour beam.
4. When framing is completed.
5. When rough plumbing is completed,and ready to cover up.
6. When septic tank drain field or sewer is laid but before it is covered.
7. Electrical inspection by City of Jacksonville.
8. Final inspection.
Note: In case of any rejection,re-mspecdon MUST be called for slur
corrections are made.
FRONT OF LOT
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 building
tlalic Beacly,,' -�_H- /�-v c
regulations of the City t4
................................
Signature of Builder......V7N............................................................... Address- ..........
.............................................
Signatureof Owner---------------------------------------------------------------------------------- Address-------------------_--------- ------............................................................
CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 SEMINOLE ROAD-ATLANTIC BEACH,FL 32233-TEL: 247-5826-FAX: 247-5877
Aw MIOR,LW—ORMATION
Number: 21699 Address: 1510 Selva Marina Drive
Permit Type: BUILDING Atlantic Beach, FI 32233
Class of Work: ADDITION Township: Range: Book:
Proposed Use: SINGLE FAMILY Lot(s): Block: Section:
Square Feet: Subdivision:
Est. Value: Parcel Number:
Improv. Cost: 6,000.00 Ift
1 . 09"":
Date Issued: 4/02/2001 Name-: Kaye Lawson
Total Fees: 60.00 Address: 1510 Selva Marina Drive
Amount Paid: 60.00 Atlantic Beach, FI 32233
Date Paid: 4/02/2001 -.-------Phone: (904)241-3609
Work Desc: Shed & Porch Addition
co 'I
h T R�ATQ�
PROPERTY OWNER PERMIT
77
COVER UP 'FRAMING FINAL
NOTICE- INSPECTIONS611UST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
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 Oil OWNER
"FAILURE TO COMPLY WITH THE CONSTRUCTION' LIEN LAW CAN RESULT IN THE
PROPERTY OWNER PAYING TWICEFOR BUILDING IMPROVErAENirsi,
ISSUED ACCORDING TO APPROVED PLANS VVHiCH�ARE�PARTTOF THIS PERMIT AND SUBJECT To REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
W.88 14
..............
ATLANTIC�1 I BEACH BUILDING DEPT. Date: 4/62/91 81 Receipt: W63%
CHECKS 2525
10i""322tw
CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET
Address— Si� e- VA ItIA 1Z(X A- 2)rz,Isf*-:-0 P640� 4D,01 7rtoAJ
Date '3 - 2- 9-Qj
Heated Square Footage @ $_per sq f t $
Garage/Shed
@ $_per sq ft $
Carport/Porch
@ $—per sq f t = $
Deck
$—per sq ft = $
Patio $—per sq ft = $
TOTAL VALUATION:
Total Valuation 1st $
5-0 n 0 — 9-- �-
Remaining Value $ - per thousand
Wportion thereof
TOTAL BUILDING FEE
+ 1/2 Filing Fee $
( ) Fireplaces @ $15 . 00 $
BUILDING PERMIT FEE $
WATER IMPACT FEE $- cF
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT $
SEWER TAP $
RADON (HRS) . 0050 $
SECTION H PAVING $
HYDRAULIC SHARES $-
CROSS CONNECTION $
) SURCHARGE . 0050 $
OTHER
GRAND TOTAL DUE
ADDITIONAL PERMITS OR FEES: Mechanical Plumbing_
Electric/New Electric/Temp_; SwimmingPool--
Septic Tank Well Sign_Finish Floor Elevation
Survey Other
CALCULATIONS and/or NOTES:
FFIYES?
CITY OF ATLANTXC BEACINAR 2 6 2001
PERMIT APPLIC.ATXON REMODEL, ADDXT1 w"A Aftf'-v-TONS
MOVXNG,DEM0LXT1QNffj�j*hNftdtiZAfth
g pullding and Zoning
Owner(s)
Job Address: I 5tO SP-1 VA )One�-/2, /J^ &Phone: 2 Yl- 3409,
Lot # Block or unit # Subdivision: -
,5'e I V A- An,4-AL-I AJ.4
Contractor: 0&,2AJe1L State License
Address: —Phone No:
City State Zip Code—
Describe work to be done:
9=6[n e tj
%13
Present use of building:
Valuation of Proposed Construction:
Proposed use:._
Is this an addition? If yes, what are the dimensions of the added
space: ft. X C, ft. Will the added area be heated and
cooled? 0 New electrical (or increase) ? Alb
New plumbing fixtures* New f-ireplace?d#New Heat/AC?
SUBMIT TAUZEE (COMdERCIAL) TWO (RESIDENTIAL) COMPLETE SETS OF PLANS, INCLUDING
SITE PLAN, SURVEY, ENERGY CODE FORKS, NOTICE OF COMMEMCM-ONT, AND
OWNERICONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR.
Signature OWNER: Date:
Signature CONTRACTOR: Date:
AS TO OWNER:
Sworn to and ribed before me this4Z E_ 4�_day of 19
4, Me- ii
MLLIAMS
C
#C
# C98
74905
A
AMY MELISSA WILLIAMS
M MYC
C
PIF b3or 310 2oo4 Ti
-W']"s
A Y COMMISSION 984 5 L
-.w EXPIRES:Novem
TT�y PUBLIC
j d
AS TO CONTRA Bonded Thru Notery Public Und�rwrjters
Sworn to and subscribed before me this— day I of 19—.
NOTARY PUBLIC
C101M)P67217
Book 9925 Page 1268 Pa e: 1268
Filed 8 Recorded
03/26/2001 09:44:58 M
5 MIK RETURN JIM FULLER
CLERK CIRCUIT CUT
NOTICE OF COMMENCEMENT WA cowTy
PHONE TRUST FUND $ 1.00
RECMDING $ 5.00
TO WHOM IT MAY CONCERN:
The undersigned hereby informs all concerned that improvements will be made to certain
real property, and in accordance with Section 713.13 of the Florida Statutes, the following
information is stated in this NOTICE OF COMMENCEMENT.
A/-A &t�
Description of Property_'�� S9 -
1+
General Description of Impr-ovements__Z4_)L
\j
-9 Owner 4Lp-� ro ig�p- -it 4:24,,e L
Address: j a lo -5e IyA .,� ' b
A-mmi�mc zgzinr�r Lc E2Z23
Owner's interest in site of improvements:
Fee Simple Title Holder(if other than owner)
Name
Address
Co ntra cto r '�j Fo Z-4-r-i g 0 zj
Address— Sr/a Sle ly-4- M /L /�--77 470J7'-2C A-e-1-4
Surety (if any)
Address— Amount of Bond $
Name of person within the State of Florida designated by owner upon whom notices or other
documents may be served:
Name
Address
In addition to himself, owner designates the following person to receive a copy of the Leinoljs
Notice as provided in Section 713.13(l)(F), Florida Statutes. (Fill in at Owners option).
Name
Address:
Owner
-?ir 6Q 00/
Sworn to and subscribed before me this day of---- aa 't 4a-
SHARON STARLING
Notary Public,State of Florida
my comm.expires Mar.21,2003 ---/:���Notary�Public
,;-x 5V-
CITY OF
Fe4d - ';?&ud4
MINOLE ROAD
SOO SE.
ATLANTIC BEACH. FLORIDA :322:i3-5445
TFLEPHONE 1904)2.17-5800
FAX(904) 247-580.5
Sl-NCOM 852-5800
CHAPTER 489. FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REQUIRE NE
ACKNOWLEDGE THE LAW: S OW R/BUILDER TO
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 M JST SUPERVISE THE CONST tUCTIO 4 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 $2 5,000.00 OR LESS. _M`AAURUSE 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 EXEMPMON. SED PERSO 4 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 EMPL YF BY YOU HAVE
COUNTY OR MUNICIPAL LICEN--
ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS POR PERSONAL OR frAMILY
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 00 WORK THEMSELVES; 2R 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 TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS
WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY CLEARLY PROTECTS
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 C NTRACTORS CANNnT RP WUp . OWNERS BEING SUBJECT
To $5,000 PENALTY UNDER FLORIDA STATUTE No. 455-228(l). AN "OCCUPATIONAL
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.
P RO/E4WN EaR/B U I L'D ER
&lxaj Is� W-3o-d
ADDRESS TELEPHONE
SWORN TO AND SUBSCRIBED BEFORE ME: THIS23�&DAY OF A� -2&)2, 19—.
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NOTE: PHRASES UNDERLINED ABOVE NOTA_* PUBLIC
ARE EMPHASIZED BY THE BUILDING My COMMISSION EXPIRES:
DEPARTMENT.
MELIrA MLLIAMS
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My COMMISSION III
984905
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EXPIRES:November 30,2o04
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