Permit Bldg Shed 2010 s
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
f, ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00001132 Date 9/22/10
Property Address . . . . . . 452 SARGO RD
Application type description SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
new shed
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Owner Contractor
------------------------ ------------------------
WALLACE-GASKELL OWNER
452 SARGO ROAD
ATLANTIC BEACH FL 32233
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Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 1000
Expiration Date . . 3/21/11
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*CALL FOR FINAL INSPECTION WHEN SHED COMPLETE AND ANCHORED
TO MEET 120MPH WIND LOAD.
Shed cannot be in drainage easement . Must be at least 5
feet from property line.
Roll off container company must be on City approved list
and container cannot be placed on City right-of-way.
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 55 . 00 55 . 00 . 00 . 00
Plan Check Total 27 . 50 27 . 50 . 00 . 00
Grand Total 82 . 50 82 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax(904)247-5845
ilo-
Job Address: 452 Sarg_o Rd Permit Number: f/ 3�-
Legal Description 31-16 38-2S-29E R/P PT OF ROYAL PALMS UNIT 2 Parcel# 171539-0000
P'loor Area of Sq.Ft. Sq.Ft
Valuation of Work$ 1000.00 Proposed Work heated/cooled non-heated/cooled 128
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
i
If an existing structure,is a fire sprinkler system nstalled? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Addition of 16'x8' Shed
Property Owner Information: 4 �e
Name: Tammi Gaskell Address: 452 Sargo Rd
City Atlantic Beach State FL Zip 32233 Phone 42
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: Owner to build Qualifying Agent
Address: City State Zip
Office Phone Job Site/Contact Number Fax#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address %ff vow MW qw
Application is hereby made to obtain a permit to do the work and installations as indicated. I certi th ' rja rir f;
773tttrrrrrruuuuuu
issuance of a permit and that all work will be performed to meet the standards of all laws regulatinglons #tion rn ihrs�urrsdiction. This permit becomes null i
and void if work is not commenced within six(6)months, or if construction or work is suspended or bando a t a er
work is commenced. I understand that separate permits must he secured for EledricalWork,Plu ing S� $ �ers,
Tanks and Air Conditioners,etc
WARNING TO OWNER: YOUR FAILURE TO c � ECT1ON
COMMENCEMENT MAY RESULT IN YOUR PAYING
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type a1 work will be complied with whether speci ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal,state,or local law regulating construction or the performance of construction.
Signature of Owner- ��LX�C Signature of Contractor
Print Name Print. ._{:...................................... Print Name
this rn a suo scrib befokno
REVIE* b �L NCE
/ 20
' AM CITY OF-AEIC 1
1 60 S E PERMITS FOR ADDITIONAL
Not u R 4,2014 g AND CON FIONS.Underwriters �/ l b
REVIEWED BY: DATE: 1S�eviced (1 26.10
ra CITY OF ATLANTIC BEACH
�~ OWNER / BUILDER AFFIDAVIT
}
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 $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
`11J ` _ 5C,,1 C _ ((HG,rl�;e.-
ADDRESS PHONE NUMBER
PRINT NAME
SIGNATURE DATE
Before me this day of ,./b in the county of
Duval,State of Florida,has personallylbppeared herin by himself/herself an affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of Co of
❑Per ally Kno
icat I-
;;�ti'""1fy'��r MY COMMI Feb rP b 1�nderrmte�s
'.: EXPIRES:
''tu ondedThru
F:BLDG/Owner-Builder Affadavit;REVISED: 4/16/2009
MAP SHOWING BOUNDARY SURVEY OF
LO.1 20. BLOCK 18, RE,ILA( OF PAR 101' ROM PAI.M'; UNI I TWO A. A$ RLCOROCD IN III AT BOOK 31,
PAGES 16. 1bA 1F•iF.'OUGH Kill• OF •I'lli CURRENT 1�U(ai.l(:: I21_CORDS Or DUVAL COUNTY, FIORIDA,
CERTIFIED TO:
MICHAEL A. MCRRILUS
RESUURCf, {SANK
ATTORNI YS' TITLE. INSURANCE FUNO. INC.
MIl_IAM C. NOE, JR.
SARGO RAOD
(60.0' RIGHT Ot WAY)
S 07'16'02" E 80.65' (PLAT)
CORNER FFO" 1/2-IRON
R N PIPE FOUND 1/2-IRON PIPE S 07'13'11" E 80.72' '(MEASURED)
NO IDENIVICATION NO R)ENTIFR;AnON FOUND NII IRON PIPE
D�' NO 10ENTKICATSON .
5 OTZO'OI'E 1.7' x --
330.93'(MEASURED) X .. ' „ �. -
0.�
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331.40' (PLAT) ff •�
j p •• 23' eulLa"c p
a13.>a RE5TRI MN LINE �
G = "'12.5' 3.8'n 12 T o COVEIIED cc
p _ :s: ?' 1.5' .� �.. 10.4• (n
�O F^ < x # 23.4 x f^.
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a FRAME �; o -�
GARAGE �c 2 q
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pto
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0 cy) 12.5• POSTED ✓/ 452 Goo 0
04vi LOT a1 0 X � Q1 BLOCK18
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LOT 21 LOT 20 CONDITIONER
BLOCK 18 BLOCK 18
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FOUND I/Z'IRON PIP[ D.9• 0.T .+
NO 1DCNTIFICATKIN T— _— /ID'DRAINAGE AND UTILITY CASEMENT Y."a w— Fa7AN PIPE
NOO IOE97IENTIfILICAIKIN
IRS LOT 5 N 07'18'01" W 80.70' (MEASURED) LOT 6
BLOCK 18 N 07'16'02" W 80.65' (PLAT) I BLOCK 18
1
No S: -' AcCCvrEu r:
LEGEND: ;
R = RADIUS —x— FENCE w
L = LENGTH a CONCRETE
• NOTES:
1. BEARINGS ARE BASED ON THE PLAT BEARING Qr N,8�e3 58_EALONG THE • REVISIONS
NORTHERLY BOUNDARY UNE OF SUGJL•'CT PARCEL.
GATE DESCRIPTION
2. NA GRAPHIC PLOTTING ONLY THE CAPTIONED (ANDS LIE WI TION F1,n00 ZONE x AN 514OWN ON THE
NATIONAL FLOOD INSURANCE MAP PLATED APRIL 17, 198'9. COMMUNITY NUMSL i 20U 6 I'ANF.L
3. THIS SURVEY REFLECTS ALL EASEMENTS & RIGHTS 0T WAY AS PER REeORDED PLAT &/OR TITLE COMMITMENT
IF SUPPLIED. UNLESS OTHERWISE SfATYO. NO OTHER TITLE VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED
'*7HCILIT :ME•ORIGNAL S:--NATURE AND CMBOScfn ee s nr
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MAP SHOWING BOUNDARY SURVEY OF
LO) 20, BLOCK 18, REPLA r OF PAX 1 01" ROYA1 PALM'; 1.1(411 TWO A, AS RLC01?riCD IN I'l AT BOOK 31,
PALLS 16, 115A 1hIROUGH ilii), OF 1'lli CuRRENI NUI31.11.` RI-CORDS 01' DUVAL COUNTY, FIORIDA;
CERTIFIED TO:
MICHAEL A. MI.RRILCES
RESOURC[" CiANK
ATTORNI YS' TITU: INSURANCL rLIND, INC.
Wil LIAM C. NOE, JR.
SARGO RAOD
(80.0' RIGHT W WAY)
S 07'16'02" E $0.65' (PLAT)
CORNER OF -Ik;ONECiIp►I r " � ' FOUND IIV IRON PMC
tIz-I�oN Ps'E couNo t/z•xeoN rhPE $ 07'1311 E 80.72 (MEASURED)
NO IDENTIFICATION NOIDENTIFICATIDN 0.3-, NO a+• 10ENTIfICAtION .
S Gr2o•ol'It 1.7' o.4•
330.23"(WASUREO)
5 07.18'02• C x �• ti
331.40'(PLAT) •�
< sY x
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•• RESmCTION LIK W
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COVERED
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..
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N ONE STORY. w J
FRAME
GARAGE ONE STORY ~•
U 0 toMASONRY b
0 ,2Ili .5• POSTED N 452 00 M LOT 19
01 " CA p1 BLOCK 18
W
30.3'
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Z
u I:DV1:Hk:D �, c0
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lot
oN0CK
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Z 14.4' (n
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"� • LOT 21 ( LOT 20
',1• BLOCK 18 BLOCK 18
x
x
_x xx x x x x x x--
TUUND IIZ�IRDN ARSE ��• ID'DRAINAGE AND UTILITY EASEMENT D`T FOUND t/2•IRON PIPE
IDENTIFICATION NO IDENTIFICATION
LOT 5 N 07'18'01" IN 80.70' (MEASURED) LOT 6
BLOCK 18 N 07'16.02" W 80.65 (PLAT) BLOCK 18
Mons- ACCEPTEU ar.
LEGEND: ;
R = RADIUS --x— = FENCE
L - LENGTH O - CONCRETE
NOTES; PLAT N 874395• E REVISIONS
1. BEARINGS ARE BASED ON THE ______....__ BEAR!Nr, of ALONG THE
NORTHERN BOUNDARY UNE OF rAJ04CT PARCEL.
DATE DESCRIPTION
2. BY GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS LIE YATIaN Ft 000 ZOIC x _ n5 ;TOWN v THE
NATIONAL FLOOD INSURANCE MAP PLATED APRIL 17, 1960. COMMUNIIY NOM!1ER 1200/:1, PAN(L •.__ U__
3. THIS SURVEY REFLECTS ALL EASEMENT!-, & RIGHTS Or WAY AS PER RECORDED PLAT &/OR TITLE COMMITMENT
If SUPPLIED. UNLESS OTHERWISE STATED. NO OTHER TITLE VERIFICATION HAS BEEN PERFORM[D BY THE UNDERSIGNED
4y: r 1R1 YTt1bT;YAUO AWIHDU,T IK•ORIGWAL S.CNATURE .ANO CMBOSRfn ccs+
pf!�.yrlrCity of Atlantic Beach APPLICATION NUMBER
:? Building Department (To be assigned b the BuildingDepartment.)
r 800 Seminole Road g y p )
f� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: 9z/y/ �d
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: A Department review required Ye No
B '
Applicant: e4d LEnning &Zoni
Tree Administrator
Project: ublic o
ublic Uti i
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN. Second Review: []Approved as revised. RDerWed.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Ftt"�'1rf�� City of Atlantic Beach APPLICATION NUMBER
Building Department
(To be assigned by the Building Department.)
r 800 Seminole Road
Atlantic Beach, Florida 32233-5445 �� —
Phone(904)247-5826 • Fax(904)247-5845
-D11 E-mail: building-dept@coab.us Date routed: 9 � /D
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 4/6-'Z 9 DUFS4Lartment review required Yes No
T—
Applicant: la 7I I'lLnning & o—n-ift
Tree Administrator
Project: ublic o
ublic Utili i
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION TUS
Reviewing Department First Review: �oyed. ❑Denied.
(Circle one.) Comments:
ILDING
�iZON Reviewed by: Date:
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14109
City of Atlantic Beach APPLICATION NUMBER
jr x � Building Department S r r o 1Q (Tobe assigned by the Building Department.)
s 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)1 -5845
^�tilt %' E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: `��2 e Department review required Yes No
Applicant: �`G�1 '?� Z- nning &Zoni
Tree Administrator
Project: ublic o
ublic Uti i i
Public Safety
Fire Servi
Reulevi fee y4431,11, ;', Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: /XApproved. ODenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: 9'2 "1U
TREE ADMIN. Second Review: OApproved as revised. ❑Denied.
PU ><tl0 4mments:
C U ILI
PUBL S ETY Reviewed by: Date:
FIRE SERVICES Third Review: OApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05114/09
City of Atlantic Beach
APPLICATION NUMBER
JS P Building Department a SEP 1 5 2010 (To be assigned by the Building Department.)
r , 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)24 t=58715 .
V;t E-mail: building-dept@coab.us Date routed: 911y /d
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: _ Z/�z I h 7,0/ VDqpgrtment review required Yes No
Applicant: ' `a nning &Zorn
Tree Administrator
Project: ublic o
ublic Utili i
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments-
BUILDING
omments /� r"_�PC
��
BUILDING �
PLANNING &ZONING Reviewed by: 1040e� Date:—!)/(,h0
TREE ADMIN. Second Review:
❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09