Permit Bldg Enclose Porch 1929 Seminole 2010 ° CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
- " 4 01i1 9
Application Number 10- 00001343 Date 11/09/10
Property Address 1929 SEMINOLE RD
Application type description RESIDENTIAL OTHER
Property Zoning TO BE UPDATED
Application valuation . . . 3000
Application desc
ENCL SCREEN PRCH
Owner Contractor
LAMBERT OWNER
1929 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
Permit BUILDING PERMIT
Additional desc .
Permit Fee . . . 65.00 Plan Check Fee . . 32.50
Issue Date . . . Valuation . . . . 3000
Expiration Date . 5/08/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 65.00 65.00 .00 .00
Plan Check Total 32.50 32.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 101.50 101.50 .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
Job Address: ( �� &�, MI (2 1('__. �� ' Permit Number: to — /3g 3
Vc.
Legal Description
1 ' #
Valuation of Work $ /,, ° L S' O /�
Class of Work (circle one): New Addition Alteration Repair Move Demoliti• , `•ow/4 wind/fl�•-
Use of existing /proposed structure(s) (circle one): i Commercial Residential 0 ��f
ow
If an existing structure, is a fire sprinkler system installed? (Circle one): Yes No ' , , lA ° /0
Florida Product Approval # 1(J / 0 / '7 42
For multiple products use product approva orm
Describe in detail the typ work to be performed:
C _ ��C &O S l /t/ Cr 7 (--
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J t�
Property Owner Information: �s /
Name: 1 �C Address: 1c21 2-- P ! ?C/1U `
City -( C'(� Stag- - .Zip 32232 Phone h i V 3,jY� �V
E -Mail or Fax # ( p tional)
Contractor Information:
Company Name: 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
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical ;York, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Conditioners, etc.
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 RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereby certify that I have read and examined this a placation and know the same to be true and correct. All provisions of 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
loco
provisions of any other federal, state, or law regulating construction or the performance of construction.
Signature of Owner cam/ Signature of Contractor
Print Name AC L Print Name 1 if
Sworaelgand subs • ed before m 20 �� Sworn and subscribed before me : ,; f
ll t fe
this Day of
REVIEWED FOR CODE COMPLIANCE 1 :i v
Notary Public ..." x C
071k, SE PERMITS FOR ADDITIONAL �° V " ,
01 �i .t 0
>•� A DEBORAH A. WHITE MY COMMISSION # DD 6, :lo 1 REQUIREMENTS AND CONDITIONS. Revise i ,_ !,i ,
} : EXPIRES: May 21 20 11 1, 1 �—! r� 1 o ' •
HP; t�' r , Sowed rhni *wry Public U , .a a avo ) n:, , REVIEWED BY: DATE:, j „� . ; .
„�.' -•-- >, '
MAP SHOWING BOUNDARY SURVEY OF
LOT 7A, BLOCK 1, BEACHSIDE, AS RECORDED IN PLAT BOOK 42, PAGES 14 AND 14A THROUGH 14C,
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
MARK LAMBERT
E -LOAN, INC.
COMMONWEALTH LAND TITLE INSURANCE COMPANY
SUN STATE TITLE & ABSTRACT, INC.
S 00'31'00" E
LOT 2 40.00' (PLAT) LOT 3
BLOCK 1 S 00'52'34" E BLOCK 1
39.93' (MEASURED)
FOUND 1/2" IRON PIPE FOUND CAP 1 / IRON PIPE
CAP DESTROYED ' ~ X
X X J1�
— >< 0 . 0 ' 0.1 15' PRIVATE DRAINAGE. / 0.1 0.0'
/ UTILITY AND SEWER —
// EASEMENT }
j/ LOT 7A
BLOCK 1 x
N wood
/DECK
COVERED /
0 / DECK 3.4' 0
NN\ - W
W K 20.6' N N. 4.0' W
O STEPS —
1- Q
J W TWO STORY W
0_ M FRAME a
`• �/ - m
X POSTED # 1929 J p o
N
O O AIR a n C%I O
LOT 6B O X CONDITIONER O o LOT 76
BLOCK 1 O O� �: — / PAD ,� O
i.i Z o r BLOCK 1
0.3'- I a o 4,
X 7.2' &� , N m o
W 9.8' \ v, s a
W O
x
p O w, O
O ow vt 0
m O)
(V (V /' \ CD CNN
CD • �, N rn
°p co p W o0
z 00 0
Z N
19 20.1 I
••
S 0•31'00" E '- cMASONRY
' COLUMNS.
120..00' (PLAT)
S 00'31'12" E .--- - =-r
119.98' (MEASURED) '••,•. '• \ 5' DRAINAGE. UTILITY
AND SEWER EASEMENT
POINT OF CURVATURP FOUND 1/2" IRON PIPE 0.6' MASONRY t ' 0.4. 0!4' FOUND 1/2" IRON PIPE
. FOUND 1/4" REBAR STAMPED "PLS 4470" COLUMNS
NO IDENTIFICATION p STAMPED "PLS 4470"
N 00 W
40.00' (MEASURED) SEMINOLE BEACH ROAD
N 00'31'00' W (100.0' RIGHT OF WAY)
40.00' (PLAT)
NOTES: ACCEPTED BY:
LEGEND:
R = RADIUS — X — = FENCE
L = LENGTH O = CONCRETE
NOTES: - _ ..
RF \ /ICI(lf\IC
NOU -4 -2010 13:03 FROM:CLERK OF COURTS 904 270 1512 TO:92475845 P:1'1
NOTICE OF COMMENCEMENT
(PREPARE IN DUPUCATE)
Permit No. 10 —i3 C / 4 3 Tax FANO No
state of County of
To whom it may concern:
The undersigned hereby informs you Met Improvements wid be made to certain real property, and hs
accordance with Section 713 of the Florida Statute*, the following Information Is stated In this NOTICE OF
COMMENCEMENT. �f
Legs) description of property being improved: 1■.. 407 ! 4 4 k
sof properly being ' ro • !•
1
Gonarat description of improvements: 1.
�'`
Owner M t [
V' Address , t _ •� _... b.,. — maw 1
-
Owners interest in site of the Improvement _. _ _
Fee Simple Titleholder Qf other than owner) -
Name _
Address
Contractor r< VI'
Address - J
y
Phone No. Fes No. ,A n
Sum' (1f any) m' ir
Addrtlss }V cunt of bond $ 2
rn -
Phone No. Fax No. V
= o- H
Name and address of any person n p a loan for the eonstr udorr of the improvements. . 1 : 1 e3 Li
Name _ tYc oU 0.
Address ri ore ?
uh� c vw o
Phone No. FOX No. y 9
C7
Name of person within the State of Florida, other then hlmaolf, designated by owner upon whom notices or other 9 n . e — w
documents mayf — be saved: .Q F u J z r p o
Name >`YyI 0 - �2a[°'=iUa
Address
Phone No. Fes No.
In addition to himself, owner designates tho following person lo =eh" a copy of the Limon Notice as provided In
SKIM 713.06 (2) @), Florida Statutes. (Fill In at Owners option),
Noma
Address
Phone No. Fax No.
Iradon Bete of Notice of Comme oament (the expiration date la one (1) year from the date of recording unless a
different date Is spedfed): -
THiS SPACE FOR RECORDER'S USE ONLY ' OMn1ER
edam Signe& m �i a Ina DAT@ S ` • v
edam e lhie ay or ra � �s r � in OW
County of ,Staleetr tS
OMN, � ppwI 4en:Mh n�
S by
Mosel Wieland ammo Chat all etetamontr and dar4 m(Ion: Mein
DEBORAH A WHFI'E eat we and aauaIe
m MY COMMISSION 0 DD 634126
,, _, �; `! FXPtRES: May 21, 2011
• (, none__ ___ Notary v�erle une.iw, ecm
NOW KM al locg o unly t
My wmmrsdbn etply
PmvoyKnown /� ' Z- �!G'�-' 7C'G as--6
rdan en l° c- - ' �..•—
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CITY OF ATLANTIC BEACH
WNER / 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.
1I. 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.
C2 �^�. c oV _ 3 S --5 73
ADDRESS rl..� I22 3 PHONE NUMBER
L kirw)b .. t v� —
PRINT NAME
/ 0
SIGNA I RE �' DATE
Before me this day of "'�' [y � 2 20P in the county of
Duval, State of Florida, has personally appeared herin by himself / herself and affirms that
all statements and declarations ar and accurate.
w®rrrma,wr
Notary Public at Large, State of County of 7,4i t ' „ r'r"' •. DEBORAH A. WHITE
MY COMMISSION # DD 634126
ird
❑ Personally Known r ± ze EXPIRES: May 21, 2011 o
duced Identification - ( f / „% ceded Thru Notary Pubac Underwriters
Notary Signat
F: BLDG /Owner - Builder Affadavit; REVISED: 4/16/2009
AFFIDAVIT FOR ATTACHING A NEW STRUCTURE TO AN EXISTING STRUCTURE
TO: Building Inspection Department, City of Atlantic Beach, 800 Seminole Road
Home Owner: \ Lc_ Lt.
Name r�
9g c
Street Addr�
'tCril1 C. I c C Pc 32z32
City. State and Zip Code
Contractor:
Permit Number -
As the Contractor for the proposed new structure located at the above address, I have personally viewed
with the above named home owner those portions of the existing structure on which portions of the
proposed new structure are to be attached for structural support. I am confident that the drawings and
details included with this permit application depict the existing conditions of the host structure, and the
members of the existing structure upon which the new structure are to be attached are sound with no rot
or deterioration. The home owner has been advised by me that, in my best judgment based on experience
and knowledge of structural adequacy, the members of the existing structure upon which the new
structure are to be attached are sound with no rot or deterioration and will support all structural loads and
forces imposed on them. By signing below, I hereby declare that I will hold the City of Atlantic Beach
harmless and release it from any responsibility and liability for any adverse consequences or failures
resulting from this work, and further that I will not initiate, execute or enjoin any legal action against the
City of Atlantic Beach for such consequences or failures.
A copy of this document will be recorded as an official record with the Building Inspection
Department permit history so that any and all future buyers /owners of this property may be made
aware of the status of work performed on this structure.
Signed � _ Date k / / to
Before me this 0 of / U
In the County of Duval, State of Florida, has personally appeared
// l Sr herein by himself/herself and
Affirms all statements and declarations herein are true and accurate.
.Y . ^ py �plli. ..
;_�. DEBORpHA.YVHITE
d'. `: *= MY COMMISSION # DD 634126
�• '3a�" uond�XnruRrEi y 2, 20t 1
riters
AL (- 7/(1 k—
ry Pub1� 1 Underw
Notary Public gi Large, State of , County of //A-
Personally Known or Produced identification
ID Type • r TO INT or %
F: building/affidavit for attaching a new structure to an existing structure.docx 7/21/09
SUNROOM, SCREEN ENCLOSURE, AND /OR SCREEN ROOM AFFIDAVIT
CITY OF ATLANTIC BEACH
JOB ADDRESS: /9,/, 9 S Pi 7zofe ,-6 PERMIT # /0 — / 3 '$
INSPECTION REQUEST PHONE LINE (904)247 -5826
The purpose of this document is to make you aware of any limitations in the enclosure that is being permitted at your residence.
The table below, Sunroom and Screen Enclosure Requirements provides a brief description of the various sunroom category
requirements. There may be restrictions on the use of your present home depending on the category of sunroom you are installing.
The property owner is hereby notified that should any form of temperature control system be added to a Category I, II, or III
Sunroom or the removal of the doors separating any Category I thru W Sunroom from the host structure occur, the room shall
become non - compliant and must comply fully with all of the requirements for habitable /conditioned spaces as mandated by the
Florida Building Code, The Florida Model Energy Code and State Statutes.
Screen Room Sunroom and Screen - rw . ure Re 1 uirements
Category I II ( III IV V
Habitable Space No No , • Yes Yes
Foundation Walls <200plf can Walls <200plf can Walls <200plf can Walls <200plf can have Walls <200plf can have
have 8 "Wx12 "D ftg have 8 "Wx12 "D ftg have 8 "Wx12 "D ftg 3 "Wx12 "D ftg 8 "Wx12 "D ftg
or 3 -1/2" slab if no or 3 -1/2" slab if no or 3 -1/2" slab if no
concentrated load concentrated load concentrated load
>7501b >7501b >7501b
Exit Lighting Not Required Required Required Required Required
Interior Electric Not Required Not Required Not Required Required Required
Outlets
Emergency EscapeEgress from exist. Egress and Exit must Egress and Exit must Egress and Exit must Egress and Exit must
Openings structure allowed if meet code meet code. Other meet code. Other meet code. Other
open to atmosphere or resistance - esistance requirements resistance requirements
considered screen requirements for for forced entry, air for forced entry, air
enclosure and has forced entry, air eakage and water leakage and water
screen door leading leakage and water penetration also apply. penetration also apply.
away from residence. penetration also apply.
Misc. Window and Host structure Removable windows Removable windows Host structure windows Host structure windows
Door Requirements windows /doors shall allowed in sunroom. allowed in sunroom. & doors shall not be & doors may be
not be removed. Host structure Host structure - emoved. removed.
windows /doors shall windows /doors shall
not be removed. not be removed.
Wind Borne Debris Not Required Not Required Not Required Required Required
Opening Protection
Energy Sheets Not Required Not Required Not Required Required Required
I hereby acknowledge that I have read and understand all the above on this y Day of / v ((V , - 2 c,)/1.?
(12Fie it— ( f,f
Home I wner's Signature Print Name
STATE OF FLORIDA, COUNTY OF DUVAL:
The foregoing instrument was acknow edged efore me this �'' day of — .. , 20 (U , by
in /I, R -� �f Gd'C-rt herein by himself/herself and affirms all
stateme its and declarations herein are true and accurate.,'
" ;._ MY COMMISSION # DD 6341 26 NOTARY P , STATE OF FLORIDA �
c [ :::._ ;a` eon d No t May 21, 2011 : �p � Qi ��:/ L
ru Not Public Underwmers Print Name
❑ Personally Known/0 Identification: P 1)
800 SEMINOLE ROAD, ATLANTIC BEACH, n 32233 PHONE (904) 247 -5826 FAX (904) 247 -5845 REVISED 1 -20 -10
r ,;ay ;j ,, City of Atlantic Beach APPLICATION NUMBER
• }� Building Department (To be assigned by the Building Department.)
t ; 1 800 Seminole Road /i; - I 3
Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 • Fax (904) 247 -5845 // l0
''bit 1'" E -mail: building- dept @coab.us Date routed:
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /9.0 T epartm nt review required Ye No
Applicant: Planning & Zoning
Tree Administrator
Project: Public Works
Public Utilities
Public Safety
Fire + Services
� . ;re I � '� � �4� � 7 �� . � a a++a7 a �{ 11 �3iJ "'I''ub i r l{ � �i ;' h" °9�
Revie � . ,,i � ,fi , r Dept: Signature ,� �, xa� �, 4 0
sr �nm ��,. �
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
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 -‘1(- n ,
Reviewing Department First Review: Approved. ❑D, nied. �+.
(Circle one.) Comments:
BUILDIN
PLANNING & ZONING Reviewed by:
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. EDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09