95 Robert St 2013 SHED CITY OF ATLANTIC BEAQO -.
1 s) 800 SEMINOLERb.
J ATLANTIC BEACH, FL 32 3
INSPECTION PHONE LINE 247-5 14
Application Number . . . . . 13-00003347 Date 10/01/13
Property Address . . . . . . 95 ROBERT ST
Application type description SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 900
----------------------------------------------------------------------------
Application desc
10 ' X 14 ' SHED
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
REYNOLDS, JEREMY A & ANGELA OWNER
95 ROBERT ST
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . ACCESSORY STRUCTURE NEW RES
Additional desc . .
Permit Fee . . . . 55 . 00 Plan Check Fee 27 . 50
Issue Date . . . . Valuation . . . . 900
Expiration Date . . 3/30/14
----------------------------------------------------------------------------
Special Notes and Comments
Roll off container company must be on City approved list
and container cannot be placed on City Right-of-Way.
(Approved: Advanced Disposal, Realco, Shappelle ' s and Waste
Management . )
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*CALL FOR FINAL INSPECTION WHEN SHED COMPLETE AND ANCHORED
TO MEET 120MPH WIND LOAD.
----------------------------------------------------------------------------
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 D [ Q
f CITY OF ATLANTIC BEACH SET 0 3 21
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: &r Permit Number: 3 3�
Legal Description Parcel #
00 oor Area o q.Ft. q. t
Valuation of Work$ �l�• Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): Ne Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial es nnti
If an existing strucure,is a fire sprinkler system installed? (Circle one): Yes No /A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: A /01x / I 454exl wt� Weoc(
Property Owner Inf rmation
Name: eXZT, ,•, /��o_a)�%� Address:
City_ ^ getiel, State j�_Zip 3?Z33 Phone 9dy-•Z3T-7F7s
E-Mail or Fax# (Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Qualifying Agent:
Address: City State Zip
Office Phone Fax#
State Certification/Registration# RMEWED FOR CODE COM
Architect Name&Phone#
A-4 PLMU
w4AkW05
Engineer's Name&Phone# CITY OF ATIANTICIMA—CI-1SEE PERml 11
Fee Simple Title Holder Name and dress DITIONAL
Bonding Company Name and Addre ONS.
Mortgage Lender Name and Addres REVIEWS — - ..--
Application is hereby made to obtain a permit to do the work and installations ds or installation has commenced p;tTla` '•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 eriod of six 6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,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.
I here b certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type oVwork 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 Signature of Contractor
Print Name . ,�� Print Name
BefyrWj� Before me
this—1'Day of 20 this Day of .20
dAry\"_ tX L'ZI ��
N&Public Notary Public
„ ay•., =A2
KER Revised 01.26.10
FF 011480
r'oKv- 4,2017
p6 Fy4rc Und..rilen
-
CITY OF ATLANTIC BEACH FILE COPY
(OWNERBUILDER 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.
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
111. 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.
ADDRESS PHONE NUMBER
vve) R59-3 42A R
PRINT NAME
q
DATE
in the county of
Before me this —1 dayof__ 1
- �
Duval,State of Florida,has personally affeared herin by himself herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of County of
11 Personally Known
JENNIFER WALKER
MY COMMISSION 0 FF 011480
Notary SignatuQ ..z EXPIRES:April 24,2017
Bonded Thru Notary Public Underwriters
F:/BLDG/Oµm�-Builde,Affad.vitREVISED: 4/16/2009
MAP SHOWING BOUNDARY SURVEY OF
DESCRIPTION AS FURNISHED:
FILE COPS'
LOT 18 AND THE SOUTH Y2 OF LOT 16, BLOCK 3 OF DONNER S R ;
ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 19, PAGE(S)
16, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA,
EER--fIFtED 'Ccs'• DUVvz-1j t'1zoGECCTlES l.._LC,)
p5 oict3 5 Sl1EFKlt_t D -CIZL:. 5c_n_el1(_E5 y LLC. �1LZ5'dZIZLE
ttSuReaF tC.� CoC-d{�Ati�
FO•'lz••l.P. ... ...
X4238 fio.�la••t.v.
° 4 4238
IL
c0 0 �s
'n ® O
Ki coo O
� LO Ki0
Lo-r
OC L. -[ llv N
N90'00'00 'E" Fpµ« 120.00'Feuc�
3ET dlz-t PI.o 1-3 50.00° (M) F��'14Z3e
u�Tds .�
@(x$00 t•Z4 3.3 i '� lc..o / v °�n�--`�'o.o Q4.U2-'L.P.
(. WOoP S
o.y"q' Feucg ', 15 8 y4Z38
x
0 S
® I 10 `n 15:1 0
0 a —" y0
Lu Lri I A 1 C -� 7 { 0
1J. 3o.q r
24�o �0 a---
o
vi 1 y �.s.M o w
SCJ I °7
Q u ,Ito 0 L,.o' 3,
43 ll •JLL
� 7
ul 1• S (o2r S
IZ.z
LlJ S[ooP: b 95
S76PS LU O
�p r
6+ ® m u QNo m
® ® 30.I tout ni j Q d
WLPIi`� ® 30.q 1 rti.3� B.d ;.t.;W 0
„0 ® 41.Z y:
0 ' Coot N .o O. 0 1 '
In 0 0
0
0.5 U)
SES tlz.. S•4 4 cwwdu So•oo P1
o.Z LdNK Fr,uCE
A 54.54° M
`'„5 N90'00'00 'W 120.00' FD•dI2 l �D IIi'd.V•
d 4 23 B dL l°L°4 S
V,4c>5Srz-T .5-T IZE E—T
e 3,o CZ bw�
pj 7RRZ 77 1 1 D ASSOC1,4TZS. lyV4l 0
5627 ATLAN77C BOULEVARD SUITE JACKSONVILLE FLORIDA 32207 904 805-0030 — FAX904 805-9888
GENERAL NOT LEGEND
P.C. POINT OF CURVATURE
(1) BEARINGS SHOWN HEREON ARE BASED ON P.T. POINT OF TANGENCY o- D DELTA RADIUS(CENTRAL ANGLE)
THE EAST BOUNDARY LINE OF LOT 16 AS P.R.C. POINT OF REVERSE CURVE A or L ARC LENGTH
S00'00 00"E, ASSUMED. P.C.C. POINT OF COMPOUND CURVE C or CH CHORD
P.O.C. POINT ON CURVE CB CHORD BEARING
(2) THIS PROPERTY HAS NOT BEEN ABSTRACTED P'C'P' PERMANENT CONTROL POINT (R) UNE RADIAL TO CURVE
B.R.L BUILDING RESTRICTION UNE AO/NC AIR CONDITIONER
FOR EASEMENTS, COVENANTS, RESTRICTIONS c/L CENTER LINE C C. CONCRETE
R/W RICHT-OF-WAY ID.
FOUND
(3) UNDERGROUND UTILITIES SERVING THIS O.R.V. OFFICIAL RECORDS VOLUME I.P. IRON PIPE
PROPERTY HAVE NOT BEEN LOCATED OR 0A ON UNE (M) MEASURED
SHOWN �— BREAK LINE (D) DEED
(4) IT IS THE LENDER'S RESPONSIBILITY TO SCALE 1 :=30' �T��) �
DETERMINE FEMA F.I.R.MAP STATUS FOR THE
LIFE OF THE LOAN ON THE PROPERTY SHOW 7-7-11
ABOVE. SURVEYOR HEREON WILL CONFIRM
FOR ADDITIONAL FEE. DATE OF FIELD SURREY GLENN M. BROADSTREET, FLA. CERT NO. 5814 LB — 6715
F.B. . 34 PG. 1.2 NOT VALID W17HOUT THE SIGNAWE& ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR & MAPPERORDER N0. 2011-865
Xe Y�
".'I; City of Atlantic Beach
% APPLICATION NUMBER
Building Department a (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
J;lit E-mail: building-dept@coab.us \ Date routed:
Cityweb-site: hftp://www.coab_us \�
APPLICATION REVIEWAND TRACKING FORM
Property Address: �- S� D rtment review required Yes No
Buildin
Applicant: �� S mg &Zonin
Tree Administrator
Project: 10 XZ s
ublic Utilitie
a ety
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
I Reviewing Department First Review: Rpproved. ❑Denied.
(Circle one.) Comments:
BUILDING
I PLANNING &ZONING / - q
Reviewed by: Date:
TREE AD MIN. Second Review:
QApproved 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 05/14/09
"s-=�`1r City of Atlantic Beach APPLICATION NUMBER
Building Department
(To be assigned by the Buildieq Department.)
800 Seminole Road
.. �� Atlantic Beach, Florida 32233-5445 I 33y7
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
®City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 4angnin
ent review required Yes No
Applicant: K�1 S dnin
xsherd Tree Administrator trator
Project: Q ublic rks
ublic Uti
u is afey
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: EjApproved. ❑Denied.
(Circle one.) Comments: 5�2�
BUILDING
PLANNING &ZONING 01011
TREE
Reviewed by: �t Date:
TREE ADMIN. Second Review:
QApproved 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 05/14/09
sy �1 ,J, City of Atlantic Beach
s� Building Department APPLICATION NUMBER
r 800 Seminole Road (To be assigned by the Building Department.)
Atlantic Beach, Florida 32233-5445 3- 3 jU
Phone(904)247-5826 Fax(904)247-5845 ^ l
E-mail: building-dept@coab.us Date router,. "I _
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: '") /�� cS�. ment review required Yes No
Buildin
Applicant: ���� S ning &Zornn
Tree Admirns
Project: �X �� tic or
Public
Public
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: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Deni d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05N4/09
City of Atlantic Beach
Building De ; - APPLICATION NUMBER
9 artment p .� (To be assigned by the Building Department.)
800 Seminole Road "+ � ►4 ']�
Atlantic Beach, Florida 32233-5445 2413
Phone(904)247-5826 Fax(904)247-5845
��JiJ°fir E-mail: building-dept@coab.us '�,_ Date routed:
Cityweb-site: http://www.coab.us '\
APPLICATION REVIEW AND TRACKING FORM
Property Address: S S� ment review required Yes No
Buil
Applicant: ►��r� � 1d S Planning
Tree Administrator
Project: X S� ublic Wor
'c Utilities
Public Safety
Fire Services
Review fee $ Dept Signature Q
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:
TREF, MIN. Second Review:
*PU13LCIC
QApproved as revised. ❑Denied.
KS omments:IES
TY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09