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Permit Fence 147 Belvedere 2011 � � ' `I CITY OF ATLANTIC BEACH ,.„. ,. ,,..:).. y 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 ________ INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002113 Date 5/24/11 Property Address 147 BELVEDERE ST Application type description FENCE PERMIT Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc replace 6ft fencing Owner Contractor RING JESSICA U OWNER 413 SCRUB JAY DR WET ST AUGUSTINE FL 32092 Permit FENCE PERMIT Additional desc . 6' VINYL FENCING Permit Fee . . . 35.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 11/20/11 Special Notes and Comments Avoid damage to underground water /sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 35.00 35.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 39.00 39.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. APPLICATION NUMBER City of Atlantic Beach �s ?..1.1.:‘,9)-.41, B uilding Department , (To be assigned by the Building Department.) v 800 Seminole Road u )v Atlantic Beach, Florida 32233 -5445 `— 2/43 Phone (904) 247 -5826 - Fax (904) 247 -5845 �a CM !Ye E -mail: building- dept @coab.us Date routed: 6 1- 2 t9 // City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 4 / De • artment review re • uired Yes No Bu; Applicant: g ` Manning & Zoning �� --� / t a r a or Project: ( (,/ d" - _,:���y'�'c•��:�w or °' Public Safety Fire Services _ - Review fee $ , Dept Signature ;, 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: APPLICATION STATUS Reviewing Department First Review: pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: ■ Date: $ 2-3"-// 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 07/27/10 Doc # 2010236432, OR BK 15393 Page 551, Number Pages: 2, Recorded 10/11/2010 at 09:18 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $18.50 DEED DOC ST $979.30 he Instrument Prepared By: Keith Watson Title Services, Inc. 208 Ponte Vedra Park Drive, Suite 101 Ponte Vedra Beach, Florida 32082 Record & Return To: Jessica U. Ring 413 Scrub Jay Drive West St. Augustine, Florida 32092 RE PARCEL ID #: /0 to 03s-6 TRUSTEE DEED THIS TRUSTEE DEED is made this 09/24/2010 by W111Iam J. Love, as Trustee and Mary W. Love, as Trustee of the Love Trust Agreement U /A/D May 16, 2006, hereinafter called Grantor, and Whose address is 320 3rd Street, Atlantic Beach, Florida 32233, to Jessica U. Ring, a married woman, hereinafter called Grantee and whose address is 413 Scrub Jay Drive West., St. Augustine, Florida 32092. (Wherever used herein the term " grantor" and grantee" include all the parties to this instrument and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporations.) WITNESSETH: THAT the Grantor, pursuant to the powers and authority granted by the teens and provisions of the aforesaid Trust Agreement, and in consideration of the sum of One Hundred Thirty Nine Thousand - Nine Hundred and NO /100 Dollars($139,900.00) and other good and valuable condsideration to Grantor in hand paid by Grantee, the receipt wereof is hereby acknowledged, has granted, bargained, and sold to the Grantee the following described land situate, lying and being in Duval, Florida, to wit: Lot 599, PLAT OF SECTION NO. 1, SALTAIR, a subdivision according to the plat thereof as recorded at Plat Book 10 page 8 in the Public records of Duval County, Florida. Said property is not the homestead of the Grantor under the laws and constitution of the State of Florida in that neither Grantor nor any members of the household of Grantor reside thereon. • SUBJECT TO taxes accruing subsequent to December 31, 2009. SUBJECT TO covenants, restrictions and easements of record, if any; however, this reference thereto shall not operate to reimpose same. TOGETHER with all the tenements, hereditaments and appurtenances thereunto belonging or in anywise appertaining. TO HAVE AND TO HOLD the same in fee simple forever. AND Grantor hereby covenants to and with said Grantee that Grantor is the duly appointed, qualified and acting Trustee under the aforesaid Trust Agreement, and in all things preliminary to and in and about the sale and conveyance of the proeprty described herein, the terms, conditions and provisions of the aforesaid Trust Agreement, and the laws of the State of Florida have been followed and complied with in all respects, and that the undersigned Grantor has the full power and authority to execute this deed for the uses and purposes herein expressed; and that said land is free of all encumbrances. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH F 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: It) 7 6, I e Permit Number: 4 / I t 4 Legal Description Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ Proposed Work heated /cooled non - heated /cooled 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 If an existing structure, is a fire sprinkler system installed? (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: Property Owner Information: Q Name: "'i. 14r- , Je «ci- C ti lc' ` / Address: / `l e �/e P r2 Sfi City . A-tt 1 A n- t c u? ac h State ft Zip 3 Z.Z. 3 3 Phone q 6q- 3. 3-3 4 107 E -Mail or Fax # (Optional) WI el - 6 6 g 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. I 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 f work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six 6) months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, Bo 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. I hereby certify that I have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this type o 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 provisions of any other federal, state, or local law regulating construction or the performance of construction. � � Signature of Owner / .��. f . ( g � w / . - � Sig ature of f l�is �� ■ -► Print Name ��� P r i n t N ame .1 cn --�` 4 ANDq � Swo ; b d . .r: a --- non p"Thry . aY2t, 6 349 4• y > AA� a 20 �) Swo j and subsc�� d be - _� a U ndo this � Da � f . this Day of ;,,a., '' l // r / -.20 . ' �� R I Y f SHIRLEY L. GRAHAM 60 / / � j e /�� J Ar Notary Public .7 - 1 3 EXPIRES: Februery 14, 2014 otary Public ',/t4f, Bonded into Notary Public Underwriters c-49 re..-4,9.0 y p m,d // . 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. 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. ► 7 Re \ erg CA q0 - 6 z ADDRESS PHONE NUMBER e—SS C • RINT NAME ; ,�� n 2 H RE DATE - ore me this day of a 201f in the county of Duval, State of Florida, has personally app ared herin by himself / herself and affirms that all statements and declarations are rue and accurate. � Notary Public at Large, State of Oh QCounty of mac• _ �►;AHAAIgIyp ❑Personally Known / ( � r/ y 6 �+Z r A MZSION# E roduced Identification - L R ` 3 d �0 ,t 9en R ��E „� Meu Q Q573gg L ____ w � Und bn1 btic � 20 e15 l tens Notary Signature: a F:/BLDG /Owner - Builder Affadavit; REVISED: 4/16/2009 � ;, ` City of Atlantic Beach + �j� APPLICATION NUMBER Building Department M4� (T o be assigned by the Building Department.) 800 Seminole Road O11 41 a: it Atlantic Beach, Florida 32233 -5445 ; / 2 /Y3 Phone (904) 247 -5826 Fax (904) 247 -': > E -mail: building- dept @coab.us Date routed: 6 // City web -site: http: / /www.coab.us '■11111111/ _ APPLICATION REVIEW AND TRACKING FORM Property Address: /4/-7 De • artment review re • uired Yes No E ..:,11111111111111.111111111. Applicant: , Manning & Zoning / or Project: c r'? U _ '` � � %�•�c•�� .. Public Safety Fire Services _- Review fee ; Q p 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: APPLICATION STATUS Reviewing Department First Review: Approved. ['Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by. ' Date: 0 TREE ADMIN. Second Review: Approved as revised. ['Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. ❑Denied. Comments: • Reviewed by: Date: Revised 07/27/10 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 1 I 1 i [, t' v't s: (' 1° Permit Number: Legal Description Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ Proposed Work heated /cooled non- heated /cooled 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 If an existing structure, is a fire sprinkler system installed? (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: Property Owner Information: 5 pp 6 ✓r �t�'(e , . -'" . , t' C, t (< ' ' Name ', Ad dre ss : ^ i 1 C' (' r f p $�_. ' , j - 3' ' , . , + ; c ' � ;� � a b City t � 1 ' State I Zip � � Phone ( I l if -� � e - 3 zi D ? E -Mail or Fax # (Optional) Contractor Information: Li ' -6 6 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. I 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. 1 understand that separate permits must be secured for Electrical Plumbing, Signs, Wells, Pools, Furnaces, Bo 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 application and know the same to be true and correct. All provisions 0/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 provisions of any other federal, state, or local law regulating construction or the performance of construction. Signature of Owner - f i, °,, F , � 7 7 1 ) Signature of Contractor i d Print Name - t 4 r ' '\-) Print Name Swo �hsubac ' d re me Sworn to and subscribed before me this Day f , 201 ! this Day of 20 , Vic- . L . . /AV?. . SHIRLEY L. GRAHAM 60 Notary Public..,, EXPIRES: February 14, 2014 Notary Public 7 , 4 Bonded ?hru Notary Public Underwriters Revised 01.26.10 r 'r'` 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 REOUIRED 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. 11I. 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 1 COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER- BUILDER PERMIT. ADDRESS PHONE NUMBER i !f i- / ( � 1 \ ` c PRINT N ]E.- -� 41 1 G' G0 / 1 SIGNATURE f DATE / 1 me tix:2_, day of Duval, State Fl as pers n o al� pp are erin by himself / herself and affirms that all statements and declarations are true and accurate. Notary Public at Large. State of e , County of A (/a/ L- ❑ Personally Known _I-11S g„Produced Identification -- -• f A .� t � : ":. ... & , L GRAHAM Notary Sign. ure: i • : i .,.� ■,.,...., . t :B '1 ; y '-.a: • "�,... E XPIRFS: February 14, 2014 , .. F LDG /Owner - Builder Affadavit; REVISED: • . , � ,,;• Thru Notary Public Underwriters MR.. II. I.. R- TPrl, �rr. r.. m..,- rrrr.r...M"YI.YM......... M.... ■rar® runs.. l�..a.■rr.av■_.aw..r...Irtr.eiYrI fl r. MIArP SHOWING I3< #UNI iAR'if SURVEY Ole." LOT 599 ACCORD /N1.4 10 THE PLAT OF SIECTION 10.1 *ALTIAIR AS RECORDED IN PLAT BOOK 11)' , 'I'1c;( 5)' El OF THE CURRENT PUBLIC RECORDS OF DU`IM L COUNTY, FL.ORIDA. CEMI'1F':'_ i) T0: City of Atlantic Beach J:LSSICA R , Planning and Zoning Department OLD REPUBLIC NAT:ICNAL TITLE INSU .NCE COM?ANY, KETTF1 WATSON TITLE tiiLTit'IZCRS 11,11E @toriroval verifies compliance with applicable AND cu,;ui.11J'i"Y "'Kos]: co .' Wing, subdivision and other lo l land oe`,/elcnrn nt regulations, but does not constitute approval tor the issuance of permits. Compliance r . •; Building Code. and all other applicable iota. - late -Ind Federal permitting requirements muss be yenned by •ig'nature of the City of Atlantic DES � �„� �,�� ��� TINE � c n n r fi i prior to the issuance of a f A° , k/ i l � 0 rl Zs a,(A,1/4. . . . . i. EDGE Ci PAVEMf7JT A `' ' � 'r�m• rnitl ' op nevi Director 4 rte - _ -- • • a i u't:t 17r9 . I � 1 150.0@9' ('R) f /2 � A - °10.06' ;M} 1��a 3 17() . LiO' 149. sn' (} . - - - -__ -- .-- .- ..�. - -�., I�.�...+..� R�im/I /3tntllrt,Y�M1�imNARN ..r...r.r..r....,..�...J jw�+....w - ... l I . 7Y • �. .' COPu:. I.n I Ism , , ,r . ; � �s 0,111 \._C1ov: 1.5 1-.1 1S,ta• CLAM:, �q, - ,� o iZ4 0,15/ es • ' • '', ,. ,0)140, 4 i : SWOOP 1 STORY �P �i sr-o.6' I., S g ° ,: • � UI d I T % • a • ,a 1 s 4-' , "' I ............C....,.......111 . . ° 1Z.9' LOT 600 I ° i_pT 599 LOT 598 r -' :.: ' MN . .. . . S3."'t (.all _ _.. _ )1 K X 75 0 .4' 0.2L-/ . 1 ` '..a4' q.7' -" j/ V2* N(JNA(L 50.12' AO LOT 616 tie,. Q0' (IV /; LOT 614 LOT f;1;:, s.�.......� ....�M�.Y.• ..........w.aw.wrw...r...... ■.■■.■. 1. P..... �MIM. Lwi ■I....ne.�oa�.■.■...n.M71aa..a FLOOD ZONg ° M " . AREAS DE1EM1WD1 TO SE OUTRIDE The 0.2 AIOR,IAL CNAM E Fl.00O PIIIIV ,FLOW TONE '11 sH.Irolal" - /,pt.A: Cr 0.24 AMNW . I:FCIWQE P1.000; ■\REAR Or 1% PiINUA_ CHARGE Wog Sterna AVCRAOC S Or 1. =3 - 119N1 1 ROOT OR RIM DRAWN AREAS t1.IS 'MIMI ■ SWIM! OR 1, MM AREAS PI101 CYE FROM 'X UAL MMUS . .+MS+.a. �__ ._ Y.r Y.I...n..: .a...Ml•.■...a..■.l.. YIIt1T�IJN E Y O� 1. k'lI t D ARE SHOIM I ON SUF VEY eseel �� p 2 S EUIRE' N©. SFIORTI HEiiI Xl UES WITHIN MOO ZONE , _AS A SSOCIII SURV INC sl:Sr DE'IER FROM EII F._t. FLOOD win PIMA NO....1 ..OA1EDo ?O.- �. SURFACE M INS IS A SURFACE URVIti ONLY. THE EX EMT 43F UNDERGROUND FOOT:NOS, 3 ''ezeme LAND & ENGINEERING SURVEYS PIM; ANA) UTILITIES,, IF Al) FECT 1141S THIS SURVEYOR 1 0f Eit5EIIIE AN'r NOT 0F„11EFMINED. 4 J11121f )I )t4AL AIAG /OR EP .LY SEIJSJTIUL" AREAS Jr ANY, Nor /% r 3848 BIJ LADING F3ODULVARU LOCATED 811 INS SURVEY. - j / / /// J ACKSaNV14 LE. FLORIDA 32210 e . Vim : u vEY f1AL D ON LEGAL DEM tiPT F(;'RNISHI:O. 11-HE PLf3UC 904-771-04(16 IIE CRC'S lCRC NOT S+EAII2CHED BY F IJTS, ITLr, � / r 1 C�IVENANVS, B,R.L,'S RESTRICTIONS, CLOSURES, TAKING OR ORWNANC .. ETC. 0 S S y CERTIFICATE Or AUTHORIZATION NO. LI1 o lio. f8 8 TIER: COULD RE OTHER MKFIER5 OF R =CORD THAN PA.FCEL. E. UNLESS OTHERVNSE STATED ALL IRON NI ES FOUND N AVaE NO IDENTIFICATION. I HEREBY CF�RTIPY T1-1;5 SURVEY WAS DONE UNDER luI'* ' .... " "' ~r �� _ "'"'"'�� ~ s� '�'M......w DIRECT SUI'ERVISION AND MEETS THE MINIMUM TECHNICAL. 0 Sir IRON PIPE OR NEBAR P.C. . P T F Cl uI '• [rlcalu STANDARDS FOR LAND URV YING PUR TO CHA.PTI R: ' '°�Is:sflc.sEUrV1=N^ on 1_8,54E4 4 P.T. POSIT 61017 ' R F a ° Tilil s is Fi r va�o f L.ORICat D Y1 i51 ' t1 : COQ ✓; CHAP1 tR 0'p2. ,. 't+ Fr,�.AF o Iw:c>n1 PIN OR PIE (1P) • > < ) (/ F'a SI EI }�NII.CyLIRE MUNfsM.M,) R-p' n *E 11�Rp.M rq) 1 DATA r, .: CF1 l3 CI'T 4( CN t GIRIU_ UM HGU: I,^ e. CONCH"I?gi R, .. RA13 1i w•- _ ,� -.•' �r.f 9..�• d�l1Cl/IA. FtECrdRD k3Q•r O1: IC A\e .. i �6� CONDI71!)IfI I_ •. srR tJ�vGT BY: �' 44. .4 4. G I2\1 no 'IN CO 146:11f1 CHA l,E El. HA;ICI ER FLORIDA C '. A EF NCI.71115 It -F' V.•• e �FI t 11.K. RECORD 11CILUNE: lo a, FIGOL L0t14""EM ° P +1' lo tdli W' P F,M. A 711UJ1ENT RBFEIi11�KE MCNLMFYIT C JIJ PIK FENCE R/* ,° R ILF I $ 01' RAT CH LtS L. STAIRUNq FLORIDA C ' IFICATE NO. 4,iI9 : G,F I,,•• IILH.DING RESTRianoN UNE -A,. DIRE I ICE E•T. O',,N Or AT mu RA MOND J. SCHAEFER FLORIDA CERTIFICATE NO. 6132 f: .1. r. EBC1FIM) TftANEP'CRNIER M PAO .ca. . 1IRE MUM S.T. UTILITY VI _ ' J.E.A..• 4 CC NIAU.E t1.CC:114ic AwnialaTY -►.•■r t�.IY ANC W0 JOB NO. 5796..1 _ DATE 09/ /all'10 >C' i. 1I .I. D IAN'F at I RLOIIONS -1-- I'I TILE .. CC u ( i { n � ,r§ ,. 1aun coVo - COVERED q F'.C�. v. r ruin; OF ooMl�oU D CAME 6TM. E #:1' ti SCALE: 1" m . 20' - aI DRAFTER 1k....._. P.f,, c.. FONT OF REVERSE CURVE l'E.? . EAVIE 11E E.8 I LECIRC BOX M'AW/■N��I■Iw .■...I1u. MWn....w1. M...■....1. .■ p..■■.... ■q..1.■111/MYYIw■m4..I NOT. VALU WITHOUT TH'i: SIGNATURE AND THE ORIGINAL RASED SEAL OF A FLORIDA L,II:FNSED SURVEYOR AND MAPPER d Wd£T : £E 67.0? £Z 'd 'ON },U..:1 NOJ..:i / , -=>>, „ City of Atlantic Beach 'A. 61 11 APPLICATION NUMBER < Building Department `,,, (To be assigned by the Building Department) 800 Seminole Road r ' 41 r Atlantic Beach, Florida 32233 -5445 / 27 /S Phone (904) 247 -5826 • Fax (904) 247 -5845 ,rL ut. »:• E -mail: building- dept @coab.us Date routed: 61-20 / / City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: / /4-€-ZO-C--1-44.A.--' Department review required Yes No Bui • ' - : ----- Applicant: --L -T anning & Zoning r • - -• •' trator Project: (r" U Pc *•�- -� `_. _ - Public Safety Fire Services Review fee $ . { : - , ; D e P t Si k '' ature � , 9l 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: APPLICATION STATUS Reviewing Department First Review: Approved. ['Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: Date: L 'c'70-'/l TREE ADMIN. Second Review: ❑Approved as revised. ['Denied. " ,..,... Comments: .,...,,, , - :.;:L , S ,/i •: IC SA ETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 07/27/10 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: / i °) 7 c v e Permit Number: Legal Description Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ Proposed Work heated /cooled non - heated /cooled 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 If an existing structure, is a fire sprinkler system installed? (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: Property Owner Information: Name: 1 p a(° r _ 1 r �, t 4 ^ Address: C vP N i p Cit 4 fi ! ,'G, .+ , c' ( ■( , L State f ( Zip 32-1 ) Phone C' - .3 -> `i 0 7 E -Mail or Fax # (Optional) Contractor Information: Lig -fi 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 aperiod of six (6) months at any time after work is commenced. 1 understand that separate permits must be secured for ElectricalWork, Plumbing, Signs, Wells, Pools, F urnaces, Bo 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. I hereby certify that I have read and examined this 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 provisions of any other federal, state, or local law regulating construction or the performance of construction. Signature of Owner 2 , , . // C ,f Signature of Contractor Print Name,' -„ ei Print Name Swor , ' d bScx' • -d . - ere me Sworn to and subscribed before me this Day e f 20 /1 this Day of , 20 ' I 41? SHIRLEY L. GRAHAM — Notary Public `;,��;Nr EXPIRES: February 14, 2014 Notary Public 110 ' Jq i(:` Bonded 7hru Notary Public Underwriters Revised 01.26.10 `tf, 3Llrj, -, r �{. ` CITY OF ATLANTIC BEACH a ' 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. II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKERS 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 1 COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER - BUILDER PERMIT. I f ! , II� Sn G i ' t Cj <' U(:�j_ ) 5 U . . ) el s- / ADDRESS PHONE NUMBER ' \ PRINT N SIGNATURE �/� DATE Before me this�T + day of 1 " Cr Z 20 � ( in the county of Duval, State of Florida, has personally appeareci/herin by himself / herself and affirms that all statements and declarations are true and accurate. (/ Notary Public at Large, State of 1 L- , County of uG `.-- ❑ Personally Known L � I�,Pl-oduced Identification -- , __ �. Ilk F °,!,�'�� L GRAHAM Notary Signe: �, .�' i _ s� : ► : • : 4y,.,.Ae 144..: . , j • I " EXPIRES: February 14, 2014 F: BLDG /Owner•Builder Affadavin REVISED: I ■ 1 ded Thu Notary Public Underwriters ... ®.,.....1....._.■•••••■ ......,....�..— ,�___. ..e................ ........�....,......,.......... MAP SHOWING 13OU C ►ARY SURVEY Olin" LOT 599 ACCORDING 70 THE PLAT OF SECTION 1140:1 *ALTAIR 145 RE:CORDED 114 PLAT BOOK 10 , PA.Gi'E:(5) El OF THE CURRENT PUBLIC RECORD OF 'DU'IAL COUNTY FLORIDA. cEwriF': :3iD ZO: J :ISSICA R.I :tG, OLD REPUBLIC NATICNAL TITLE INSURANCE CUM ?ANY, KEITH WATSON` TITLE SE /ICES, ;tNC. , AND CU. LUJTY T KOS1 COMPANY. BELVEDERE $1"rmer ,:5,9. ,,,'iav EDGE OF PAYEAIF:NT • 1, • • • ,1 O.0,9' 67) 1 sa aa' (R) 1/2 . 5046' (M) 1/2' 149. S' 04 s 00.00' / fp.— . �( fI . d<L, i Y 1.2' . • 1 1 2 ..3 ■ 7, coi c. gd� 1 ., g Lim I 16 c .r $ .a. 3. �O y• 6.ta• -{ :QV :: 4 4 a 0.6: n • • S1 )14C. ~ d .. 1 STORY � el e: F ud�IE t� � % 11 '} • --- �do NQ. 147 X •0.3 ° • .• .. .• , 11,11 ,I• x a ♦ . I . f 4•• x •�Y_ _ I�ll�d�lOO1_•_ • ' d 12.1 9.«I'