Permit Deck 1949 Seminole 2011 1 J
P`~ Jr \
; CITY OF ATLANTIC BEACH
''' , 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
- 0131
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001937 Date 4/15/11
Property Address 1949 SEMINOLE RD
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 900
Application desc
replace deck
Owner Contractor
MAZUR OWNER
1949 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
Permit RESIDENTIAL ALT /OTHER
Additional desc .
Permit Fee . . . 55.00 Plan Check Fee 27.50
Issue Date . . . Valuation . . . . 900
Expiration Date . 10/12/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 55.00 55.00 .00 .00
Plan Check Total 27.50 27.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 86.50 86.50 .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 2 T ,U TA'
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845 I 4 PR 4 2011
rob Address:
1 0 L.C. , A4C.) Permit Num
legal Description S aiq_- - Parcel #
Floor Area of Sq.Ft. S , '
Taluation of Work $ 1Q®, Q& Proposed Work heated /cooled on- heated/coole
lass of Work (circle one): New Addition ' teration h epair Move Demolition pool/spa window /door
Ise of existing /proposed structure(s) (circle one): Commercial Resident.
f an existing structure, is a fire sprinkler system installed? (Circle one): o OA
lorida Product Approval #
or multiple products use product approval orf m
)escribe in detail the type of work to be performed: 1I ?Like - A ) 1, - -- c.Ricz)s,.1 5
6 a 'tom, it MI 0 i. r ■ /■' data 1 )V A 41
roperty Owner Information: 1 2 --U -
dame :: 7 6S fls / n , /� 2_4_,....P--- Address: f q L il SE7 1 "3° e..-6:: /e.)
ity TZ_f" K►"T l G _ (l'. State Ft 33P one 9 01-1 _ 2-i.. ' 1 ` ?j) li" t
-Mail or Fax # (Optional) wt.._ .. . - A -' ( , t ....ur... ■ .. .. • • ,
'ontractor Information:
ompany Name•,t & La& C
ddress: L� � WL'11�'!I ' !��ls @��la'��i���± • Qua ��� . g A: - nt: • . . I
n. LTIP VI M! • �Ci i,._ r�L =
� 1tat ; �VECli'
face Phone ,`iv .�. _►r!7!!!!� .� # ♦ •
tate Certificati .. ' egistration # w 1 v —
rchite Name & Phone # I �� ti 1 1 1 E 1 ►/ .' . 'A .,x;.� r.,.. - , . 7.,,�,�►' k
agineer's Name & Phone # I 1 e ► Y Y - ti
.,e Simple Title Holder Name and Address SEE PERMITS F• R ADDtTin Tr :` 1 1 -
onding Company Name and Address I 4 • UIREMENTS AND CONDITIONS. 1
[ortgage Lender Name and Address I ,� i. I i
'I.N'iIN%J:YL� ,,, ,-
�plication is hereby made to obtain a permit to do the 'o • J . . • , o
, z r Ims't r lation has commenced rior to the TT
'uance of a permit and that all work will be performed to meet the standards of all laws regu ating cons — 7 : --- r''sdictzon. This permit becomes null
:d void (work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a eriod of six 6) months at any time after
i rk is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, ells, Pools, F urnaces, Bo Heaters,
mks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMIVENCEMENT 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.
ereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of T aws and ordinances governing this
,e of work will be complied nth whether spec d herein or not. The granting of a permit does not presume to give authority to violate or cancel the
9visions of any other federal tate, or local law regulating construction or the performance of .. nstruction.
gnature of Own- _
. -viii
e „.--- 7 ,--_____
int Name .0 — . / /h( /1A - ... , - j
ao ■ . • subscr before m- , :. -- —. ;and sjgisr�r bed before me
is di D. • o ...4„ . Gr ..�. / . SHIRLEY L G Day of , 20
`�� ' I � SHIRLEY C X # 35 bT1 O1 ; y 7 i �- I ,,� MY °ea 2 i _XPIRES: COMMISSION F9biBery 14 2014
)taTy — •' : . Thru Notary Public Und
4,.. Bonded Thru Notary w'i 1 r e : blic
Revised 01.26.10
"," ` CITY OF ATLANTIC BEACH
�%r ,, •.
®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 REOUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
11. 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.
/ 1r A
- ' V'. ' .% •, �O4 — ( I y-
ADDRESS t p 1 / 0 / . 127 PHONE NUMBER
PRI TN• E /
i
c TURE / DATE
I�y
Before me this / [ day of i L- , 20 in the county of
Duval, State of Florida, has personal) appeared herin b himself / herself and affirms that
all statements and declarations are due and accurate. (
Notary Public at Large, State of , County o Al
�
❑ P er ally Known ?;ti'�P SHIRLEY L. GRAHAM
❑ duced Identification - ---i
PIR F. 1q l 4,4 B oni : i Thru Not • Olio Underwriters
ers
Notary Signature: ._�) ( Ail � _ '
F./BLDG/Owner-Builder Affadavit; REVISED: 4/16/2109
MAP SHOWING SURVEY OF
LOT 4B, BLOCK 1, BEACHSIDE, AS RECORDED IN PLAT BOOK 42, PAGES 14, 14A, 14B, AND 14C OF
THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
L 0 T 23
L 0 T 26 i L 0.
' \� T 2 7
0.2' - FOUND 1/2" IRON PIPE , - (S.00 ° 31'', 6 "E. 40.02' FIELD)
t.:. L.E. 1919 S, 00 3 I 00 E • 40. 0 ' �O CAP X °
IRON PIPE UND
- — ` 0.4' N
M' EAEEMENT 0.6' p I' �` -- —.
g 6 WOOD PRIVACY) J ,
FENCE I
r
I
WOOD DECK
0 W�STEE
0.4''O
�■ 4' WOOD
• 0 L 18 � + PRIVACY „____Erair
11.7' ' ^ N--------=
_ 1.7 0
Q K J
F WC) 4 0.9 0
Q 0
O O a7
2 STORY 1 7 O Oi
0 FRAME RESIDENCE o' W
� W No.1949 - 3 v _ >
L 0 p ,, b 9.E' O
0 T 4 A
O
o d� L O T 5A
• 4 ~ a A/C PAD TE NOTES: p
. O
N �
a Q
S THIS IS A BOUNDARY SURVEY. _
• CONCRETE CO NO BUILDING RESTRICTION LINE AS PER P LAT. U
o 2 w .
o °° WALK co B E AR INGS BASED ON THE SOUTH LINE OF LOT W
g8, BLOCK AS PER PLAT, m
20.0' ALL EASEMENTS SHOWN HEREON ARE FOR STORM •
• DRAINAGE SANITARY SEWERS, WATER AND UTILITIES
UNLESS OTHERWISE STATED.
1.4'!! 1.4' • • 0 .
6'c000INA COLUMNS N I
W /WOOD FENCE 11 „ CONCRETE DRIVE
(TYPICAL) `
5' EASEMENT , , /
" /
----- r----- '.:. :.: 11 S.00 E. 1 19.99'FIEI.D)
I1 •• ■ oa ,11 ^_� - °
_ S. 00 3 Q0 .
E. 12000
FOUND I /2" RON PIPE N.00° 31 oo" W. 4 0.00 ' - -�' ' ' - —
NO CAP (N.00 "W 40.14' FIELD) RL g
FOUND I/2" IRON PIPE
CAP NOT READABLE
SEMINOLE
ROAD
100' RIGHT -OF -WAY (PAVED)
THIS SURVEY WAS MADE FOR THE BENEFIT OF
TERESA MAZUR KAUNATH;
HOMESIDE LENDING, INC.;
RICHARD T. MOREHEAD, P.A. AND
THE PROPERTY SHOWN HEREON APPEARS TO LIE IN FLOOD STEWART TITLE GUARANTY COMPANY
AND IS IN COMPLIANCE WITH THE MINIMUM TECHNICAL
PTER
ZONE "X" (AREA OUTSIDE 500 -YEAR FLOOD PLAIN) AS WELL STANDARDS OF THE FLORIDA O SET A ADMDM IN CHV INISTRATIVE CO CO 61 G17 -
AS CAN BE DETERMINED FROM THE "FLOOD INSURANCE RATE DE.
MAP" COMMUNITY -PANEL NUMBER 120075 0001 0, REVISED
APRIL 17, 1989 FOR ATLANTIC BEACH, FLORIDA.
UNLESS IT BEARS THE SIGNATURE AND
‘ 1)
i . .
THE ORIGINAL RAISED SEAL OF A FLORIDA
LICENSED SURVEYOR AND MAPPER, THIS
MAP IS FOR INFORMATIONAL PURPOSES - •
ONLY AND IS NOT VALID. ~ :
DONN W. BOATWRIGHT, L.S.
RECHECK.. CCAOBER 24, 2000 FLORIDA REG. LAND SURVEYOR No. 3295
SCALE= I". 201 BOATWRIGHT LAND SURVEYORS, INC.
DRAWN BY D. FREEMAN 1711 5th STREET SOUTH DATE: DECEMBER 28, Iss2
FILE: 2000 -769 JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET! OF 1
s � L�l, ; City of Atlantic Beach APPLICATION NUMBER
eir l '...; Building Department o be a E ned b the Buildrn De art rnent
Y ,,k : 800 Seminole Road ° ` ' Y g p )
3 Atlantic Beach, Floda 32233 -5445
" Phon ( 904 ) 247 - 582 6 Fax (904) 247 -5845 : * w -, .�.
P ttit
�r E-mail: building - dept @coab.us Date routed }
City web -site: http: / /www.coab.us
*. * u ,
APPLICATION REVIEW AND TRACKING FORM
Property Address: m4,9 s kd DP rtment review required Ye No
p < Building r
Applicant: Q Of) E•4 anni`ng & Zoning
Tree Administrator
Project: Py /fi ,�� e e.- Public Works
Public Utilities
Public Safety
Fire Services
K.S3 , a i
ti cy J 3 '� �'d 4 �H "'� a �ii a fi3�i , � .Fr h- ""�'�^� i a^ r
Review feed$ : g . u � gn,.Dep, .S lg?atUre;.:. �
Other Agency Review or Permit Required Review or Receipt Date
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:
APPL CATION STATUS
Reviewing Department First Review: IgApproved. ❑Denied.
(Circle one.) Comments:
BUILDIN'
PLANNING & ZONING
Reviewed by: Date: Date: y� /�
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