2233 Seminole Rd # 43 (vault) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 06-00033143 Date 6/09/06
Property Address . . . . . . 2233 SEMINOLE RD UNIT 043
Tenant nbr, name . . . . . . - REPLACE DECK
Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6500
Owner Contractor
------------------------ ------------------------
JOHNSON, WILLIAM M. OWNER
2233 SEMINOLE #043
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit BUILDING PERMIT
Additional desc . -
Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . . Valuation . . . . 6500
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 65 . 00 65 . 00 . 00 .00
Plan Check Total 32 . 50 32 . 50 . 00 .00
Grand Total 97 . 50 97 . 50 . 00 . 00
pERmff Is AppRovED ONLy*iN ACCORDANCE wrm ALL crry OF ATLANnC BEACH ORDINANCES AND TM FLORIDA
BtflaMING CODES.
CITY OF ATLANTIC'BEACH Cc:
N t) Q..WF
BUILDING / ZONING DEPARTMENT Piggins
x 800 Seminole Road oerr
Atlantic Beach,Florida 32233
(904)247-5800
(904)247-5845 Fax
www.coab.us
PLAN REVIEW COMMENTS
Permit Application # 60-, �-55/4
Property Address: 9)'55 '�5f win 61C &a,
Applicant: 1, 11 I'am �' )0 h r,-2q�
Project: kep (1r, Dfn�'
T7ermit application has been:
Approved
F-1 Reviewed and the following items need attention:
Please re-submit your application when these items have been completed.
Reviewed By: L-� -- Date:
Date Contractor Notified:
CITY OF ATLANTIC BEACH
CITY
BUILDING PERMIT APPLICATION
(Alterations&Additions)
JUN 0 1 200b
-;1 33 * q3 Date: / zz�
Job Address: Amd . 33
Z
Owner of Property: Alm Al r,40J.50A)
Address:2-Z 3 3 5eoI4-ale tfcl ;if V? Telephone: le-1
Legal Description: Block Number: Lot Number: Zoning District:
Contractor: 1-14 IR/S IC, /a/ 14a"C I,"
AfWKA)0ko1r State License Number:
If 32050
Contractor Address: )p OX :�44 zVJJ4 Seee, )"'Z
Telephone: 119Y–71f 42-S — Fax: /q,05� -Z 9 2 -
Describe proposed use and work to�e d�ne: C�pW3foT&C-110AO' ef
-be– vrod 1'erlJoiv 4� A Q4.0-05"e 5,
Present use of land or building(s): 1?4e r lVevY14-61 , S-,C
Valuation of proposed construction: .0- 6-5-400
Dimensions of the added space: feet x feet
Will this project involve:
Ll Heating&Air- Li Plumbing Ll Electrical Li Fireplace
Conditioning
Is approval of Homeowner's Association or other private entity required? IV40 If yes, please submit with this
application.
Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to
thp nricyinal imn�rvimjc pre� or the removal of any trees?
,�'NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this
project.
El YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building
Permit.
"Q NO. Applicant certifies that no trees will be removed for this project.
[J*YES. Removal of Trees will be required for this project TREE REMOVAIL PERMIT IS REQUHUD. Tree
Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate
Incomplete applications may result in delay in issuance of permit.
STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please
contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have
Property Appraiser's Real Estate Number available.
STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction
topographical survey or grading plan is required. (If not required, written verification must be provided with this application.)
The Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834
STEP 3. Submit Tree Removal Application if trees are to be removed or relocated.
STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if
owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic
Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -hftp://www.ci.atlantic-beach.fl.us
Page 2 Revised 8/04
In addition to construction dnd engineering detail,plans must contain the following information as appropriate for the type of work being
performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner.
1. Current survey showing the property boundary with bearings and distances and the legal description.
2. Location of all structures,temporary and permanent,including setbacks,building height number of stories and square footage. Identify
any existing structures and uses.
3. If required by the Department of Public Works,a pre-construction topographical survey.
4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies.
5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools
may be excluded from total Impervious Surface.
6. Other information as may be appropriate for individual applications.
Address and contact information of person to receive all correspondence regarding this application(please print).
'30 �0�
Name: 0 "i I I" M , 611
Mailing Address: 3 7),1( S 41t4,V716 15z_44� 3 2 2 S-3
Telephone: -7 05" Fax: '-�foq 2-7 0 -6 C'5 E-Mail:NAM�-,
Ab9W1_ Yn
I hereby certify that I have read and examined this application and attached documentation and know the same to be true and correct. All
provisions of the 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 federal,state or local rules,regulations,ordinances,or laws
in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this
permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as
required.
JSignature of Owner: Date V
AS TO OV9,TER:
Sworn to and subscribed before me this day of 2co-CO
JLAA
State of Florida,County of Duval
Notary's SignaW
K.CtONWHAM
NdWy puW-Sma of Fbft Personally known
cww*Wm E*m Fab 211,2M01-1 tt at�
CNWMW#W 5011111 91�roduced identific produced IX-45
Is Am. Type of identificati FL_
Signature of Contractor: Date:
AS TO CONTRACTOR:
Sworn to and subscribed before me this day of 20
State of Florida,County of Duval
Notary's Signature:
Personally known
Produced identification
Type of identification produced
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -hftp://www.ci.atlantic-beach.fl.us
Page 3 Revised 8/04
Doc#2006190894,OR BK 13300 Page 259,
Number Pages: I
Filed&Recorded 06/0112006 at 03:26 PM,
JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING$10.00
NOTICE OF CONMENCEMENT
State of I- L,�(j a Tax Folio No.
County of--4A!
To Whom ItMay Concern:
Ile undersigned hereby informs you that improvements will be made to certain real property, and in accordance
with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMWNICEMENT-
Legal description of property being improved: Z 3 3 ,
Address of property being improved: 2-2- ? 3 Sr, Are Al"I C e,4
32-2.33 -- — �e—1 _
0.4
General description o improvements: r fn 14 r 0 Z ,
V -jC T,,.v,- 40ene /2 "r/0
Owner: IV, 1& 0
C'm A -1
Address: 2-1 13 Z2-1 3
Owner's interest in site of the improvement: C&,poilletc Q�WACoesiz
Fee Simple Titleholder(if other than owner):
Name:
Address:
Contractor: .9 OF
(ju Address: P0 13 MdVle A004
Phone No: !J&�(- 75' Z92-5 Fax No: 705!!�! 2-,?2 Z-!rO
Surety(if any):_
Address: Amount of Bond S
Phone No: Fax No:
Name and address of any person making a loan for the construction of the improvements.
Name:
k�&ess:
1�111t3ne No: Fax No:
Nart I q:.of person within the State of Florida, other than himself, designated by owner upon)-,e�?O in notices or other
documents may be served:
Name: No,<, t,04 f,,�6
Address: S'7-0 ali-cd L,4,tl,-- c
Phone No:—'W-2-70-5-12 6,/ 5-2 Z- Fax No: !JOY--2 70- -5-0
In addition to himself� owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option).
Name:
Address:
Phone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
different date is specified):
TIUS SPACE FOR RECORDEW S USE ONLY Sign Date: 0
Before m this 'W-dayof IUV-.k-- in the County
of Duval, tate o onda-,has personally appeared
K. CUNNINGHAM C, 0�\ C-,n Lrrl 01
ry Public-State of Florda Notary Public at Large, State of Florida,County of Duval.
Notal My commission expires:
.44 commtssiGn Expires Feb 28,20101
Personally Known: or
Commission#DO 523638
',,OF
Bonded By National Notary Assn. Produced Identification: T>C-
R ECE I VE ED
C17y(OF AT LANTIC BEACH
Bt,W
JUN 0 12006
CITY OF ATLANTIC BEACH
jil.) OWNER/BUILDER AFFIDAVIT
Date:
Job Addressl 2 **A i4o 0 z13 L
lfwTle, j&.ef c, F 322.?3
CHAPTER 489,FLORIDA STATUTES,PART 1 "CONSTRUCnON 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 TIE CONSTRUC71ON 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 EXENUMON. 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 RESPONS1131LITY TO MAKE SURE THAT
PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL
LICENSING ORDINANCES.
ORDINANCES ALSO ALLOW AN.OWNER TO IMPROVE THEIR OWN PROPERTY WHEN rr IS FOR PERSONAL
OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A
BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY
PHYSICALLY DC4)'l,(ORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WOVIKERS BE
UNDER"DIRECI-NNERVISION OF THE OWNER, WHO MUST BE ON THE JOB AT ALL TRVIES WHILE ORK IS IN
PROGRESS BY UIPLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CON'fRACTORS.
SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT
SUGGESTS-WORKER'.S COMPENSA`nON INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE
POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND
SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS
THEY ENVLOY ON THEIR IMPROVEMEI-fr TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING
SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(l). AN "OCCUPATIONAL LICENSE- IS
NOT ADEQUATE. TfIE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR
TEE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR-
TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WrM ALL TS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
K. CUNNINGHAM
Notary Pubk-State of Florida
My CownwiDn Exom Feb 28,2010
Commmion#DO 523638
'I%.F 0, Bonded 8Z National Notary jAun. PRO] TY OWNERMAJILDER
SWORN TO AND SUBSCRIBED BEFORE MEMS DAY OFJLA.W,(- 20b(p
IRES: D
zccom
NOTE: PHRASES UNDERLINED ABOVE.
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