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CE 38 17th ST 2014 I CODE ENFORCEMENT COVER SHEET 101, LOCATION: ' d5+ RESICOMM CASE NUMBER: NAME: COMPLAINT TYPE: DATE: VIOLATION: V40 1 n ajewy \.xd • r10 Llo aw") ACTION: INITIAL INSPECTION DOOR HANGER COURTESY NOTICE MEETING WITH TENANT ON SITE INSPECTION NOTICE OF VIOLATION REINSPECTION CHECK STATUS OF CMRRR NOT E POSTING NOV AND AFFIDAVIT MEETING WITH OWNER ON SITE NOTICE OF HEARING CODE BOARD MEETINGS OFFICER STATEMENT FORM POSTING NOH AND AFFIDAVIT TELEPHONE CALL TELEPHONE MESSAGE NOTICE OF REHEARING ORDER IMPOSING FINE W/COVERLTR AFF NON-COMP W/CONTEST LTR AFFIDAVIT OF COMPLIANCE FILE LIEN RECORD LIEN FILE TO CITY CLERK RELEASE OF LIEN -v- CE FINE MEMO TO FINANCE �� LIEN LETTER MEETING WITH RESPONDENT BUILDING PERMIT APPLIED FOR CLOSED CASE INTERNAL MEETING REFER TO CITY ATTY/LIEN COMPLIANCE MET ILA OWNER OCCUPIED TENANT OCCUPIED VACANT 5T- STOP - WORK CITY OF ATLANTIC BEACH Z BUILDING AND ZONING DEPARTMENT NOTICE This building has been inspected and: General Construction ❑ Mechanical ❑ Concrete and Masonry ❑ Electrical ❑ Plumbing ❑ Gas Piping IS NOT ACCEPTED CORRECT AS NOTED BELOW, BEFORE ANY FURTHER WORK DO NOT REMOVE TIIIS NOTICE Inspector: Date: Z� Failure to respond to this Notice within 10 days will result in this violation being forwarded to the CODE ENFORCEMENT BOARD. The posting of this Placard by its contents shall serve as due notice. Property Appraiser- Property Details Page 1 of 2 MAINERICH RITA Primary Site Address Official Record Book/Page Tile# 38 17TH ST 38 17TH ST 15732-00659 9409 ATLANTIC BEACH, FL 32233 Atlantic Beach FL 32233 38 17TH ST Property Detail Value Summary RE# 169589-0010 2013 Certified 2Q.14 In Progress Tax District USD3 Value Method CAMA CAMA Property Use 0100 SINGLE FAMILY Totel Building Value $132,332.00 $141,554.00 #of Buildings 1 Extra Feature Value $1,290.00 $1,273.00 09-2S-29E Land Value(Market) $129,375.00 $129,375.00 Legal Desc. OCEAN GROVE UNIT NO 1 S/D PT LOT 7 Land Value(Agric.) $0.00 $0.00 Subdivision 03096 OCEAN GROVE UNIT 01 Just(Market)Value $262,997.00 $272,202.00 Total Area 2690 Assessed Value $262,997.00 $266,941.00 The sale of this property may result in higher property taxes.For more information go Cap Diff/Portability Amt $0.00/$0.00 $5,261.00/$0.00 to Save Our Homes and our Property Tax Estimator.Property values,exemptions and Exemptions $50,000.00 See below other information listed as'In Progress'are subject to change.These numbers are part of the 2014 working tax roll and will not be certified until October.Learn how the Taxable Value $212,997.00 See below Property Appraiser's Office values property. Taxable Values and Exemptions—In Progress If there are no exemptions applicable to a taxing authority,the Taxable Value is the same as the Assessed Value listed above in the Value Summary box. County/Municipal Taxable Value SJRWMD/FIND Taxable Value School Taxable Value Assessed Value $266,941.00 Assessed Value $266,941.00 Assessed Value $266,941.00 ................................................................................. ........................................................................................................ ..................................................................................................... Homestead(HX) -$25,000.00 Homestead(HX) -$25, 00.00 Homestead(HX) $25,000.00 ................................................................................ ..................... .......,,........,...........,.........................................,... ....................,......,..,......................... ...,.,...,. Homestead Banding 196.031(1)(b)(HB) Homestead Banding 196.031(1)(b)(HB) Taxable Value $241,941.00 $25,000.00 g25, 00.00 Taxable Value $216,941.00 Taxable Value $216,941.00 Sales History Book/Page Sale Date Sale Price Deed Instrument Type Code Oualified/Unqualified Vacant/Improved 15732-00659 9/27/2011 $274,500.00 WD-Warranty Deed Qualified Improved 13456-02255 7/26/2006 $100.00 QC-Quit Claim Unqualified Improved 12772-01772 9/16/2005 $480,000.00 WD-Warranty Deed I Qualified Improved 09118-00478 10/24/1998 $100.00 QC-Quit Claim Unqualified Improved 09109-01879 10/22/1998 $100.00 MS-Miscellaneous Unqualified (Improved 05730-01072 11/28/1983 $128,000.00 WD-Warranty Deed Unqualified Improved Extra Features LN Feature Codg Feature Description Bldg. Length Width Total Units Value 1 DKWR2 Deck Wooden 1 12 13 156.00 $569.00 2 CVPR2 Covered Patio 1 17 8 136.00 $704.00 Land&Legal Land Legal LN Code Use Description Zoninq Front Depth Category Land Land Type Land LN,Legal Description Units Value 1 09-2S-29E 1 1 0100 I ARC LD 3-7 UNITS PER ARG-1 25.00 1 110.00 Common 25.00 Footage $129,375.00 2 OCEAN GROVE UNIT NO 1 S/D PT LOT 7 3 E1/2 LOT 8 BLK 8 Buildings Building 1 Building 1 Site Address Element Code Detail 38 17TH ST Atlantic Beach FL 32233 Exterior Wall 16 16 Tile/Frame Stucco Exterior Wall ! 17 17 C.B.Stucco Building Type 0105-TOWNHOUSE Roofing Structure !3 3 Gable or Hip Year Built 1983 i Roofing Cover 3 3 Asph/Comp Shingle Building Value $141,554.00 Interior Wall 5 5 Drywall I I http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?P E=1695890010 4/24/2014 Property Appraiser- Property Details Page 2 of 2 --, Int Flooring 12 112 Hardwood Gross Heated Effective Type Area Area Area Ful Int Flooring 11 11Ceramic Clay Tile F Finished upper Heating Fuel 4 4 Electric e M story 2 120 120 114 Heating Type 4 4 Forced-Ducted LA Finished 60 0 30 Air Conditioning 3 3 Central Garage Finished Open Porch , 0 8 I Element Code I (III Stories 3.000 Finished Open 0 8 ocrrc Porch Bedrooms 3.000 Finished upper 1190 1190 1130 Baths 2.500 story 2 Rooms/Units 1.000 Base Area 595 595 1 595 Balcony 72 0 11 i Finished Open 1 72 0 22 Porch Finished i 72 0 36 Garage Deck 1156 0 23 Finished 1156 0 78 Garage II Total 2543 1905 2055 2013 Notice of Proposed Property Taxes(Truth in Millage Notice) Taxinq District Assessed Value Exemptions Taxable Value Last Year Proposed Rolled-back Gen Govt Beaches $262,997.00 $50,000.00 $212,997.00 $1,455.54 $1,756.08 $1,436.90 Public Schools:By State Law $262,997.00 $25,000.00 $237,997.00 1$1,288.80 $1,223.30 $1,290.35 By Local Board $262,997.00 ($25,000.00 $237,997.00 $541.34 $535.02 $541.99 FL Inland Navigation Dist. $262,997.00 $50,000.00 $212,997.00 1$7.45 $7.35 $7.07 Atlantic Beach I$262,997.00 I$50,000.00 $212,997.00 1$718.32 $708.96 $706.21 Water Mgmt Dist.SJRWMD I$262,997.00 I$50,000.00 f$212,997.00 I$71.50 $69.93 $69.93 Gen Gov Voted $262,997.00 I$50,000.00 I$212,997.00 $0.00 $0.00 $0.00 School Board Voted I$262,997.00 f$25,000.00 I$237,997.00 $0.00 j $0.00 $0.00 Urban Service Dist3 $262,997.00 $50,000.00 $212,997.00 $0.00 $0.00 $0.00 1 Totals $4,082.95 $4,300.64 $4,052.45 Iust Value Assessed Value Exemptions Taxable Value Last Year $265,808.00 $265,808.00 $50,000.00 $215,808.00 Current Year $262,997.00 $262,997.00 $50,000.00 $212,997.00 III' Property Record Card(PRC) The Property Appraiser's Office(PAO)provides historical property record cards(PRCs)online for 1995-2005.The PAO no longer maintains a certified PRC file due to changes in appraisal software;therefore,there are no PRCs available online from 2006 forward.You may print this page which provides the current property record.(Sections not needed can be minimized.)To rint the past-year cards below,set your browser's Page Set Up for printing to Landscape. 2005 12004 1 2903 12002 1 2901 1 2000 1 9}999 r1998 11997 1 1996 1 More Information ontact Us I Parcel Tax Record I GIS Mai) I Mao this property on G000le Maps I City Fees Record http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1695890010 4/24/2014 Im 0A T LANTIC BEACH T CITY OF AT ` BUILDING AND z�N srfo-p IN 0111 610 ING DEPARTME No CE This building in has been inspected and: E] Mechanical General Construction ❑ Concrete and Masonry ❑ Electrical ❑ Plumbing E]Plumbing Piping IS NOT ACCEPTED CORRECT As NOTED BELOW, BEFORE ANY FURTHER WORK v r rnj - Inspector: , DO NO], lifts �S Failure to res p o nd to t�j o �s No he 10 da ys CoD re s� ''h�Postno Of ��V� �°s he ��i Posting fh�sA, ��C n"��, jt � tff, S J ��1 r r J S Compliance Investigation Form Investigation# Date of Request: 28 Time of Request: Location (Address) of Violation: t� Property Owner/Manager: VIOLATIONS: Action Taken: l o s�-0 .1 S (Gy D 6V S/'Y%P C c;,,- Compliance: al i Od r ✓y, IC-) C Ci Name of Perso Making Request/Complaint: 1(�O Address. `� Phone# Investigation Type xt, HCode Enforcement\Compliance Investigation Form.doc April 25 2013 ?s-=L` �, City of Atlantic Beach, APPLICATION NUMBER Ns s� Building Department `jr� i (To be assigned by th Building Department.) 800 Seminole Road U Atlantic Beach, Florida 32233-5445 APR 2 8 2D14 Phone(904)247-5826 • Fax(904)247 E-mail: building-dept @coab.us -w Date routed: City web-site: http://www.coab.us -- APPLICATION REVIEW AND TRACKING FORM Property y Addres s. l j, Department review required Yes No B " Applicant: �� Planning &Zonin ree A ministrator Project: Pu lic Works U tilitie l�J y Fire Services ew fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date ' of Permit Verified B 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: EffApproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: / /r 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 05/14/09 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Bea h, FL 32233 Office (904)247-5826 Fax (9(4)247-5845 Job Address: Permit Number: Legal Description oor ea o t. Parcel# Valuation of Work$ aSoc t 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/pro osed structures (circle If an existing structure,is a fire sprinkler system installed? (Circle one): esi es No N/A Florida Product Approval# For multiple products use product approva orm Describe in detail the type of work to be performed: ,E- Property Owner Information• Name: e'Tn I'n+.7 fFkiCt, Address: 7A( City State Zip 3g 3 Phone p S" E-Mail or Fax# (Optional) Contractor Information::14.4 CONTRACTOR EMAIL ADDRESS: Company Name:__ tj (20,y S T ,-fC 7-",)A) 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 c Yti 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 regulate g construction in this jurisdiction. This permit becomes null and void f work is not commenced within six(6)months, or tf construction or work is suspended or abandoned for aW�pereod of six 6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical'Work, luanbing,Signs, 1Vells,Pools,Fur aces,Boilers,Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYIN TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAI FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RE ORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type work will be complied with whether spect aed herein or not. The granting of a permit does not presume to gave 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� o Contractor Print Na 7dt• Print Name.... �........ B o ........................................................................................................................................e - Before me 1 y°f 20 this Day of 20 o Notary public State of F1 N aly Pu c M ley L Graham Notary Public ar�. E Pireo 02/14/2018 086990 Revised 01.26.10 CITE'OF ATLANTIC LEACH (OWNER 1, 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. LOU 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 BUILDIN G 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 YOUR WITiIQV pNE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BURT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF TINS 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 CO OR MUMCIPAL 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 $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR TELEPHONE THE BUILDING DEPARTMENT(247-5826) IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. °lo Sl 511 7/3. ADDRESS PHONE NUMBER �t774 tJ E�.tet� PRINT NAME SIGNATUR DATE Before me 1 ay o ( 20. i county of Duval,State o lod , as pers ally eared herin by /herself and affi s that all statements and clarations are true accurate. Notary public Large,State of County of erso Iy ❑Pro c denflica n- Y Note u No Public State of Florida � ip �Pr My Commission FF 080990 F:BLDG/Owner-Builder kffadavil;RHyISED: 4/ /2 9 �M1V' Expiras 02/14/2018 Ordered By: The Law Offices of Rod Schloth t = 9 2187 S Third St 4 � � Jacksonville Bch, FL 32250 r-• . �'' �' ' �� 904-372-9351 wa 38 beach@rod-law.com PROPERTY ADDRESS: 38 17TH STREET ATLANTIC BEACH, Florida 32233 SURVEY NUMBER: FL1109.0230 FIELD WORK DATE:9/9/2011 REVISION DATE(S):(rev.0 9/9/2011) i FL 1109.0230 BOUNDARYSURVEY DUVAL COUNTY �g o L 1 y K I C/L CJL — Q L K LU w N WM N I REMAIN ERf.' SHED w I LO 3.0' NOT IN 4l)1�E1 TABLE: I 0.4'ON L I N90 000'00"E 420.00' (P) ~12.7' N 89 53 35 E 419.33 (C) I LOT 7 L2 500°12'00"E 20.00'(P) N _ 5 0°12'00"E 20.00'(C) BLK 8 �� . L3 N90°00'00"E 25.00'(D) N 89°4345" E 24.79-(M) m o — OVEREE °O m L4 590°00'00"W 25.00'(D) I O O ° 5.4 06 LOT 9 —— BLK5 5 89°39'28"W 25.19'(M) — 3N ww �0 0'00 3 m* "t ON �NOL m NN bb O ZZ 17.8' EAST 1/2 OF C LOT 8 VIA BLK 8 0.T ON NOTE5: I 1/2"FIP B LOT APPEARS TO BE SERVICED BY CITY WATER AND 5EWER I NO ID 0.P ON FENCE OWNERSHIP NOT DETERMINED 1__-25.00" (P G'CHAIN LINK FENCE L4 U7 112"FIP O — NO ID Q LOT 14 LOT 13 LOT 12 BLK 8 BILK$ a� A. 10 BLK 8 l herebycertify SO the hereon described propedy has a ung"Tly dirk nd to the best ofmy knowledge a lief,it Is a bue and a t representation Of survey imp is aMs setforth bylhe Fonda Boa Professional La a bed in Chapter 30 0 15 30 5J-17of the F Adm— AQ, III ��jO1tLS p4� GRAPHIC SCALE (In Feet) N 1 inch = 30' ft. Merit A.Johnson State of FWlde Professional Surveyor end Mapper Lkense No.6572 Use of This Survey for Purposes other than intended,Without Written Verification,will be at the Use's Sole Risk and Without Liability to the Surveyor. Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Pther than those Certified. V"1:7 ,s-�`1r;,, City of Atlantic Beach 'PR,�8 X14 APPLICATION NUMBER Build De artment g p (To be assigned by th Building Department.) 800 Seminole Road j � Atlantic Beach, Florida 32233-5445 / .. Phone (904)247-5826 • Fax(904)247-5845 J, >� E-mail: building-dept @coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property y Addres s. � l �� Department review required Yes No CC B " Applicant: �� C� Planning &Zonin Tree Acrministrator Project: Public Works u tilitie Fire Services tewfee $ -- Dept Signature Other Agency Review or Permit Required Review or Receipt Date ' of Permit Verified B g 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 CyJ Reviewing Department First Review: YApproved. []Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: — Date: TREE ADMIN. Second Review: A roved as revised. *PL ❑ pp ❑Denied. ORK Comments: LITIE F T Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05114/09 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH j 800 Seminole Road, Atlantic Bea h, FL 32233 Office (904) 247-5826 Fax (9 4) 247-5845 Job Address: Lett Permit Number: Legal Description Parcel # Floor Area o q.Ft. q t Valuation of Work$ aS'oo Proposed Work heated/cool d 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 eside If an existing structure,is a fire sprinkler system installed? (Circle one): es No N/A Florida Product Approval# For multiple products use product approval forin Describe in detail the type of work to be performed: c Q,.irQ of J Property Owner Information: Name: )e t m n'I+7ArFR_i o* Address: &F 7k City ar.,C� State_Zip 32 3 Phone O S'3 i A. E-Mail or Fax#(Optional) (� Contractor Information: `� CONTRACTOR EMAIL ADDRESS: Company Name: 1'411 A14D Cot 5TP tJC 7-14A) Qualifying gent: 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 regu ting construction in this jurisdiction. This permit becomes null and void of work is not commenced within six(6)months, or if construction or work is suspend d 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 Wor,Plumbing,Signs, Wells,Pools, furnaces, Boilers,Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE T RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTA N FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE CORDING YOUR NOTICE OF COMMENCEMEN . I hereby certify that I have read and examined this application and know the same to be true a 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 per it 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 f construction. Signature of Owner \ Signature of Contractor $aryPu 6-.M. ....... .........!!/..et k e V— �................ .......... Print Name - Before e f 20 this Day of 20 Nota ry public State of F Shirley L Graham Notary P iblic My Commission FF 086990 as Expirss02/14/2018 Revised 01.26.10 I w CITY OF ATLANTIC BEACH (OWNER / 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 . 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. 191. 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. 38 i 7� S ,b 53V 7/3. ADDRESS PHONE NUM ER PRINT NAME SIGNATUR DATE Before me I ay o 2 i county of Duval,State o lord , as pers ally eared herin by /herself and affil s that all statements and clarations are true accurate. Notary Public Large,State of County of erso ly ED]Pr uc dentificat' n- Nof- r N Public State of Florida w � My Commission FF 088990 F:BLDG/own -Duilde Affadavit REVISED: 41 /2 9 Expires 02/14/2018 FTheL�aw s o Offices of Rod Schloth � �� 2187 S Third St i4 til'I '� Jacksonville Bch, FL 32250 .f ,� 38 904-372-9351 . �' 4 V 1 Y beach @rod-law"com , k PROPERTY ADDRESS: 38 17TH STREET ATLANTIC BEACH,Florida 32233 SURVEY NUMBER: FL1109.0230 i FIELD WORK DATE:9/9/2011 REVISION DATE(S):(rev 0 9/9/2011) i i �I FL 1109.0230 BOUNDARYSURVEY DWAL COUNTY owl L E]W M FIP ----- LU m — — -r Ls_ NO ID— 1 1.5'x 5' w REMAIN �K'Or. LL,• SHED n I LO S.'. ' > r` ro 3.0' I NOT IN IsU1�Ep 0.4'ON w to 1 TABLE: 12.-P L I N90 100100"E 420.00' (P) I N 89°53'35"E 41 9.33'(C) LOT 7 L2 500°1 2'00"E 20.00' (P) BLK 8 N o N 5 0012'00'E 20.00'(C) v�KE L3 N90 100100"E 25.00'(D) 0 O a ENT ENTRY o m av N 89°43'45"E 24.79'(M) 1 m o o 5 4 O p LOT 9 L4 590°00100"W 25.00'(D) 33 —— 5 89°39'28"W 25.19-(M) l o — Ln Z "� w w tt� 3 _ N 1 0002 a M m/ ON I o° 0O I Z OO to I _ IEA5T 1/2 OF c I LOT 8 'I I BLK 8 1 0.7'ON NOTES: I I/2"FIP NO ID 0.I'ON LOT APPEARS TO BE 5EKVIGED BY CITY WATER AND SEWER 1 5.00'(P FENCE OWNER5HIP NOT DETERMINED 6'CHAIN LINK FENCE L I a _ NO ID O Q ' z O LOT 14 LOT 13 LOT 12 BLK 8 5I.K 8 BLK 8 �,� ti roNNSo 1 herebycertlfy .4 h the hereon described ` property has ur fymv dlrr3� nd to the best of my I knowledge a lief,it Is a hue and aoou t representation of survey im+� !s n ands set forth by the I Florida Boa Professional Lan y w a in Chapter 30 ° s 1 5J-17ofthe �A 1P Admit1� j GRAPHIC SCALE (In Feet) N �IONlL-SURVEY04� 1 inch = 30 ft. ` Slate of FlorWe Professional Surveyor and Mapper License No.6572 Use of This Survey for Purposes other than Intended,Without Written Verification,will beat the User's Sole Risk and Without Liability to the Surveyor. Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified.