Permits 726 Aquatic Drive 1.06-69
DEPARTMENT OF WILD ING
C OP ATLANTIC 0EACH',
ITY
'ON,
LOCATtow Im XON
'Per
Address* 72,6 :AQVATlq DRIVIlt ,
UACH; VLORIVA 32�33:
LZUL DESCRIPTION
Vast, f 0o �k_ �ODlttON
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out r.
Township: NO,
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I Clod 0 Subdivisiono,,AQUATIC 0ARDWIS
not,, : , 1 , , I
�kiiima t oA, V4lu $116,20 60
lm�rov Cott
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11plits
4
ION
aL $30.00
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WATOt 10TO TO
—RADON '40-li R.S. $0000
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+ 6,01PA T V $O,�,.00
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�CROS'S 40 .00 ,
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NOTES.,
6A
A MUST SO* OEFORil:"
NOT",— . LL,0ONq*ETEF,RM,SAND $PE0T#0i POURING
PERMIT VOID SIX MONTHS AFTER DATE QPiSsUE!
6U MATERIAL,I R(168igk:A
tL6JNG ND DEBRIS FROM THIS WORK MUST NOTBtPLACEO IN PUBLIC SPACE,'AND MUSTSE
P TNER CON OwgEA%ll
CLEARED U ANP�HAULED' AWAY BY,�El TRACTOR OR
WITH
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AYING EFORTHE" DINGJMP� ME'NTS15
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ISSUEDACCORDING TO AP�Flovi6 PLANS ARE PART OF THISPEAMlT AND SUBJECT
V16Z,�fION OFAP,,UCA6L SIONS OF LAW.
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'ATLIAN
CITY OF ATLANTIC 9EACH PERMIT CALCULATION SHEET
Address—.-I 2 (9 Q A-7-t C- "!�/Z11
Date-N- �-C( - 9
Heated Square Footage _@ $—per sq f t = $
Garage/Shed @ $—per sq f t = $
Carport/Porch @ $__2 n_Qp e r s q f t = v
Deck @ $—per sq ft = $
Patio @ $ per sq ft = $
TOTAL VALUATION: $
16 -
,;�o , 0 $
Total Valuation 1st $ /000
/Do , a 4_,, 6-
Remaining Value $_57. per thousand
or portion thereof
TOTAL BUILDING FEE $
+ 1/2 Filing Fee $
(o ) Fireplaces @ $15 . 00
BUILDING PERMIT FEE
WATER IMPACT FEE $
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT $_
SEWER TAP $
) RADON (HRS) . 0050 $
SECTION H PAVING ( $
HYDRAULIC SHARES $
CROSS CONNECTION $
) SURCHARGE . 0050 $
OTHER $iE
GRAND TOTAL DUE $ 3 C) 0
ADDITIONAL PERMITS OR FEES: Mechanical Plumbing
Electric/New Electric/Temp_; SwimmingPool
Septic Tank Well Sign_Finish Floor Ele_�_ation
Survey Other--
CALCULATIONS and/or NOTES:
PITY OF ATLANTIC BEACH
PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS
DEMOLITIONS
Own e r(s l'ot r1s
Address :-7,-2L/- Alglg-l-,,o Phone:
Lot # Block or Unit #726 Subdivision:
Contractor:- Kj7jk
State License #
Address : 01 --Phone No:
Describe work to be done:_,5creen iQ +,'o 4 e;r�et., q, adol
Present use of building: 0 rr
Valuation of Proposed Construction:
Proposed use: DO
Is this an addition? If yes , what are the dimensions of
the added space: X ft . Will the added area
be heated and cooled?_L�_ New electrical (or increase)? 06
New Plumbing fixtures?A)O New fireplace? New Heat/AC?_LL__
SUBMIT THREE COMPLETE SETS OF PLANS, INCLUDING SITE PLAN,
NeTteg OL. L; SURVEY,
uruTzwutWffl*T, AND OWNER/CONTRACTOR
AFFIDAVIT, IF OWNER IS CONTRACTOR.
Signature OWNER: Date:
Signature CONTRACTOR:
Date:
6*4
License Supplied:
Liability Insurance: q\!�
Worker's Compensation Insurance:
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CIlY OF AILANTIC BEACH
BUILDING OFFICE
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OWHER BUILDER PERMIT AFFIDAVIT---�'
Stut& of Florida
City of Atlantic Beach
I- BEFORE ME, thp undersigned authority, personally bppvarvd
-/____tL42f_LLI-1,11.9-- Z�.c--------- who upon 919"t bolnv duly
&Worn. deposes anct asyns
------------------- and the lvg&l
owner of the iol!;wIn0 property#
Subdivision j
Block Lots
AKA
am applying for a building permit pursuant .a ' %low Owner
Builder exemption met forth In Florida Statute@ Section 489. 103.
Florida low requires thei Xrhave been provided with th& following
DISCLOSURE STArtNEUTs
DISCLOSURE STATEMENT
�State low requires construction to be done by licensed
contractors. You have applied for a permit under
an
exemption to that law* The exemption allow& 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 cor a
form outbuilding* You way also build or Improve a
commorciaL building at a cost of $25,000#00 or lose.
The building must be Car your use and occupancy* it
way not be built for sale or lease. If you sell or
looke, more then one building you have built yourself
within one your after the construction In complete# the
low will presume that you built It for sale or lease,
which to a violation of this exemptiono your
construction must be done according to building codes
and zoning regulations& Xt to your r&oponalbility to
asks, sure that people employed by you have licensee;
required by state low and by county or municipal
licensing ordinances.
I hereby acknowledge that I have read the above DISCLOSURE
STATEMENT and that X comply with all the requirements for the
issuance of an Owner-Builder permit.
Further, 4fflant wayeth not.
10,
Property Own
Svorn, to aZd,:utjjtcrib&d
bv�or W h
FLA. t*61 LAWS
FS 713.13 PCM16 A"
rtre Vif
WaitrAns Im wupLwwrno
it =q ===
The undersigned hereby Informs all concerned that improvements will be made to certain real
property, and in accordance with section 713-13 of the Florida Statutes, the following information
is stated in this NOTICE OF COMMENCEMENT.
Description of prop.....
7-1
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Owner....Te.le.r., q.....
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Ow"I"s inleresl in ae of
F" &m* rl& W&r tij cow 0.
64--ft.. . �--/.................................................................................................................. ............................
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Am up" *+
be sem" om #$Ofim or 4" jocumoft Noy
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In addition to himself,0wrW designates the following person'to a copy of
as provided in Section 713.13 (1) rw*WS the Lienor's Notice
M, Florida Statute& (Fill In at Ownees option).
Nanto.......- ' I ....................... ......................
Ad&eu.........................................................................
'Moo",I"P"Ir'ligg"01we U"WILY ..........................