1485 LINKSIDE DR 2015 DECK Jv�
,C"� CITY OF ATLANTIC BEACH
1 j 800 SEMINOLE ROAD
±� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�Dills)"
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Sob ID: 15-DECK-38
Job Type: DECK/PATIO
Description: PAVER WALKWY
Estimated Value: $6,700.00
Issue Date: 2/3/2015
Expiration Date: 8/2/2015
PROPERTY ADDRESS:
Address: 1485 LINKSIDE DR
RE Number: 172374-6020
PROPERTY OWNER:
Name: TASKER, SHEILA & RICHARD,
Address: 1485 LINKSIDE DR
PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS:
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.
A sewer cleanout must be installed at the property line. Cleanout must be covered with
an RT1 concrete box with metal lid. Cleanout to be set to grade and visible.
All runoff must remain on-site during construction.
Full right-of-way restoration, including sod, is required.
Roll off container company must be on City approved list and container cannot be placed on
City Right-of-Way. (Approved: Advanced Disposal, Realco Recycling, Republic Services and
Shapell's.)
Full erosion control measures must be installed and approved prior to beginning any earth
disturbing activities. Contact Public Works (247-5834) for Erosion and Sediment Control
Inspection prior to start of construction.
FEES:
M j�)PCODL T I Et IN ACCORDANCF$)tTj4LL CITE' OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
s)
J ti ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $41.75
STATE DBPR SURCHARGE $2.00
Total Payments: $129.25
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBER
Building Department Ci�lVED (To be assigned by the Building De artment.)
r f 800 Seminole Road
Atlantic Beach, Florida 32233-54 5 �^I Lc. jj
Phone(904)247-5826 - Fax(9 4)247 48 5 13 2015
E-mail: building-dept@coab.us Date routed: /9//
`
City web-site: http://www.coab. y:
APPLICATION REVIEW AND TRACKING FORM
Property Address: IV 6," ZM.E67'46 6 7' De artment review required Yes No
Applicant: rlt�r (,0AS7" J >
Vic a
ree dministrator
Project: A44 a)JA ublic Works
aey
Fire Services
Review fee $ ZS 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: 1 Date:
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 07/27/10
BUILDING P r
PERMIT APPLICATION � G
CITY OF ATLANTIC BEACH JAN 09
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845
B
Job Address: 1485 Linkside Drive
Legal Description— 6700.00 Parcel#
Floor Area o 4 t. Sq.Ft
Valuation of Work S Proposed Work heated/cooled non-heated/cooled
915
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial esidenti
If an existing structure,is a fire sprinkler system installed? (Circle one): No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: create 11 foot walkway on south side of lot, connecting to a patio
in rear(east)of home. -Will be removing 395 sq. ft of existing paver stones& adding&replacing with new paver
stones. Total coverage will be 915 sq. f.upon completion
Property Owner Information: r' 1
Name: Sheila C&Richard S.Tasker G v1 s Z — 4z L�
City Atlantic Beach
E-Mail or Fax#(Optional) rstasker48@yahoo.com
Contractor Information:
Company Name: First Coast Pavers
Address: PO Box 8090 City Fleming Island State FL Zip 32006
Office Phone 904-410-0278 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 cert 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
end void:f work isnot commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Wor/y Plumbing,Signs, Wells,Pools, urnaces,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
AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
21F�Pye�., JENNIFER WALK
p o.
MY COMMISSION#FF 011480 COMMENCEMENT.
ar EXPIRES:April 24,2017
-he „�k1Y tkNff@� YPdrolF �?P �h`i this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
Ype speci led herein or not. The granting of a permit does not presume to give authority to violate or cancel the
)rovistons of any other federal,state, or local law regulating construction or the performance of construction.
signature of OwnerAce�6jSignature of Contractor
'rint Name j i CA a� Sc4YPrint Name. ........... ...........
1wcj�qn d subscribed before me Sworn to and subscribed before me
Zis _ ay of 20this Day of ,20
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BENCHMARK (HIGH POINT USED TO DETERMINE A.B.M.)
RESS: 1485 LINKSIDE DRIVE GRADE TYPE: A
iMUNITYS E LVA LINKSIDE SOD: 2507 Sq.Ft. �
84 UNIT 2 6 PALLETS ( n t P,x
H0i
Fri r (n,r First Coast Pavers
P.O. Box 8090 Estimate
pQ� "RS Fleming Island, FL 32006
www.firstcoastpaver.com Date Estimate No.
(904)410-0278 1/7/2015 2079
Ship To:
Shelia Tasker
1485 Linkside Dr
Atlantic Beach FL 32233
Sales Rep
Aaron
Description Qty Rate Total
Prepare area and installation of concrete pavers and related materials for walk 1 6,700.00 6,700.00
and patio areas in backyard
> Including 11 foot walk to side gate, cover full side of house less 1.5' planter
bed on outter side and patio area as drawing, in back, all for a total 915sf.
>Water side section of back patio will include small retaining wall for
elevation adjustment
> One remote downspout is included
> Notice: 395sf of homeowners existing paver stones will be used and
patterned into side section of patio
Sealing of pavers is available for additional cost of$1,100
Thank you for your business. Total $6,700.00
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 459.103(7),FLORIDA STATUTES:
SPATE 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 HAVOA LICENSE. YOU MUST
SUPERVISE'I'HE 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 ATA COST OF$25,000.00 O1 LESS. THE BUILDINC
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 1N 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
ORDINANCES. OR-AlUNICIPAL LICENSING
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S
PURCHASED. COMPENSATION INSURANCE BE
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.
R S- L iNkc�
s� 10
ADDRESS ADDDDRESSS
R PHONE NUMBER
_ I ( t• !l�'YG� S• � ���lr
PRINT NAME n
SIGNATURE 7
DATE
Before me this day of �" s 1 Zp� in the county of
Duval,State of Florida,has personally appeared herin by himself/herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of ,County of
Personally Known
oduced Identification- ,iso}^"•Y,'l:�i' JENNIFER WALKER
*; * MY COMMISSION#FF 011480
( , "'• o= EXPIRES:April 24,2017
W ', F'°'' Bonded Thru
Notary Signature: 4��,fy`' Notary Public Underwriters
F:/BLDG/O,<ner-Builder Affndaril;REVISED:4/16/2009
Atlantic Beach
Site impervious Calculation
Richard Sheila Tasker
1485 Linkside Dr
% Impervious Existing
Length Width Sq. Ft.Area
LOT SIZE (Per COJ.net) 148 50 7400
Main body of house(Per COJ.net) 2493
Additional House 0
Driveway(50%paver credit)* 418
Sidewalk 0
Concrete Sidewalk&Patio** 395
Outbuilding 0
A/C Pad 3 3 9
TOTAL 3315
• Impervious Existing 3420/7400 44.80%
• Impervious New
Length Width Sq. Ft.Area
LOT SIZE (Per COJ.net) 148 50 7400
Main body of house(Per COJ.net) 2493
Additional House 0
Driveway(50%paver credit) 418
Sidewalk 0
Patio&Sidewalk(50%paver credit) 500
Outbuilding 0
A/C Pad 3 3 9
TOTAL 3420
% Impervious New 3525/7400 46.22%
NOTES:
*Due to curve,driveway was measured as two rectangles. One with 20x25 dimensions,
the second with 21x16 dimensions.
**Current 395 sq.feet of concrete patio to be removed and replaced with
1000 sq. feet of same pavers as used on driveway.
&
ORDERED BY:
The Law Offices of Rod Schloth
2187 S Third St t,
Jacksonville Bch, FL 32250
904-372-9351
beachCa)rod-law com 4 "r
PROPERTY ADDRESS:1485 LJNKSIDE DRIVE ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER:FL1301.1739
FIELDWORK DATE:1292013 REVISION DATE(S):(REV.0 1/302013)
C-1 C-3 TABLE:
FL1301.1739 R= 1503.70'(P4M) R=1478.70(1`40) L-I N 06°45'W I I I.0'(P)
L= 150.25'(P) 150.05'(M) L=50.OT(P)49.95'(M) N 06°4647'W 1 1 1.04-(M)
BOUNDARY SURVEY A=5'43'30"(P)5'43'02"(M) A= 1"5G'24'(P) 1'56'08"(M) L-2 N 88°563(Y"E 25.00(P)
DUVAL COUNTY N 3-45-15-E, 150.191P) 5 3°50'32'E,50.06'(P) N 89°02'26'E 25.05'(C)
N 3"56'36"E, 149.96(M) 5 3"46'36'E,49.95'(M) L-3 N 83'15'00"E 37.00'(P)
N 83-15`00-E 37.01'(M)
C-2 L-4 5 06"45'00"E 11.00'(P)
R= 1478.70'(P4C) 5 06°32'16"E 10.98'(M)
L=47.67'(?)47.67'(C) L-5 N 06°45'0(Y'W 1 1.00(P)
L-2-- 0= 1-50-507) 1-5057'(C) N 09°05'41'W 10.74'(M)
rPN*D 5 I"56'55'E,47.67(1`)
6219 L-6 5 83°15'00"W 37.00'(P)
(/
g P.C. 5 1-53-03-E,47-72'(C) LOT 85 5 83'1723"W 37.05W)
I
N
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E 109.1' (C)
N
83-15-00"f 109.35'(P)
4.01'(M) 46.0'TO M.E.
B.R.(PER?LAn �o i 83°16'12 E 7 to z L>i�7
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LOT (5 N ;��� o m w �
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1
56311,609 W I I I.45-(G)
5 83`
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1 LOT 83
d COS e
FN4D NOTES: I hereby cert' t'diis S of f the hereon
16219 LOT APPEAR5 TO BE SERVICED BY CITY WATER AND 5EWER.
0 P.C. desc bed p rty has ade Linde direction,
PENCE OWNER5HIP NOT DETERMINED. and IO the 5 Of knowledgeand bpi f,t is a true
JEA-E.-JACK50NVILLE ELECTRIC AUTHORITY EA5EMENT.
and accu p)esentaGon gf,#;survey t t meets the
minimum t I standards set forth b Florida
Board Of Pro nal LarlaTW6yors `escdbed in
1 30' 201 1 C, 0 15' 30 Chapter 5J-17 lorida Admi Code.
1 f62 9 �A SURVLY ct
P.T.
GWesley B.Haas
GRAPHIC SCALE
State of Florida Professional SLrveytraN llegw
I Inch =30 feet License No 3708
Use of This Survey for Purposes other than Intended,Without written Verification,will be at the Users Sole Risk and Wlthout liability to the Surveyor.
Nothing hereon shall be Const-d to Give ANY Rights or Benefits to Anyone Other than those Certified
FLOOD INFORMATION: POINTS OF INTEREST
BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING (1)CONCRETE DRIVEWAY OVER 7.5'JACKSONVILLE ELECTRIC AUTHORITY EASEMENT.(2)
MUNICIPALITY OR W W W.FEMA.GOV,THE PROPERTY APPEARS TO BE 6'WOOD FENCE OVER MAINTENANCE EASEMENT.(3)CONCRETE PATIO OVER
LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE CITY OF MAINTENANCE EASEMENT.(4)WOOD BULKHEAD OVER 20'DRAINAGE EASEMENT.
ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 04/17/89.
SUSAN DUNHAM
CLIENT NUMBER:RS12-1103 DATE:1/30/2013 R E A LTO R
"Al --
BUYER:RICHARDSTASKERANDSHEILACTASKERMOBILE:904-742-3442 �
OFFICE:904-Z47-0059 WO.idAMS-
I E A L
SELLER:JACQUELYN MUTH BARRETT
CERTIFIED TO:RICHARD 5 TASKERAND SHEILA C TASKER;THE LAW ==ACT A
OFFICES OF ROD SCHLOTH,PA;OLD REPUBLIC NATIONAL
TITLE INSURANCE COMPANY,BANK OF AMERICANA
www.surveystars.com
Land Surveyors,Inc. P 866-735-1916•F866-744-2882
This is page 1 of 2 and is not valid without all pages. LB*7337 1222o Towne Lake Drive,Suite 55•Ft.Myers,FL 33913
City of Atlantic Beach I APPLICATION NUMBER
Building Department REQ CE' I�r�i (To be assigned by the Building De artment.)
f 800 Seminole Road G�.�i Q
Atlantic Beach, Florida 32233-5445 JAN 13 2015 �C.�-,(, O
Phone(904)247
-5826 Fax(904)24 -5845
E-mail: building-dept@coab.usDate routed: ` 9
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /VP,5-
,5- De artment review required Yes No
Applicant: rfi- r_ (. AST
ree istrator
Project: ?, ( W p-/4 to AV ublic W
ublic gWifies
ublic Safety
Fire Services
Review fee $ —� Dept Signat
bda
gency Review or Permit Required Review or Receipt
of Permit Verified By Date
ept. of Environmental Protection
ept.of Transportation
s River Water Management District
rps of Engineers
of Hotels and Restaurants
of Alcoholic Beverages and Tobacco
APPLICATION STATUS
Reviewing Department First Review: pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING / �
Reviewed by: Date: o
TREE ADMIN.
Second Review: DApproved as revised. ❑Denied.
BLIC WO KS Comments:
BLIC UTILITI
UB IC SAF TY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ODenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION ly
CITY OF ATLANTIC BEACH800 Seminole Road,Atlantic Beach, FL 32233JAN 0 9
Office (904)247-5826 Fax (904)247-5845
Job Address: 1485 Linkside Drive
Legal Description 6700.0 ) Parcel#
Valuation of Work$ oor ea o t.e
915 Proposed Work heated/cooled non-hea SqTt
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)(circle one): Commercial sidenti
If an existing structure,is a fire sprinkler system installed?(Circle one): No N/A
Florida Product Approval#
For multiple products use product approva orm
Describe in detail the type of work to be performed: create 11 foot walkway on south side of lot, connecting to a patio
in rear(east) of home. Will be removing 395 sq. ft of existing paver stones& adding&replacing with new paver
stones. Total coverage will be 915 sq. ft. upon completion
Property
_ Owner Information:
Name: Sheila C&Richard S.Tasker G O"I — 452-- - 4 z l
City Atlantic Beach
E-Mail or Fax#(Optional) rstasker48@yahoo.com
contractor Information:
:ompany Name: First Coast Pavers
address: PO Box 8090 City Fleming Island State FL Zip 32006
)ffice Phone 904-410-0278 Job Site/Contact Number Fax#
tate Certification/Registration#
,rchitect Name&Phone#
ngineer's Name&Phone#
ee Simple Title Holder Name and Address
onding Company Name and Address
lortgage Lender Name and Address
P1
is hereby made to obtaincommenced w a permit to do the work and installations as indicated I cert that no work or installation has commenced prior to the
�kuance of a permit and that all work will be performed to meet the standards of all lawspregulating construction in t_hpis jurisdiction( This permit becomes null
thin
�s�mmenced.not
tI understand that separat per>n s must be secured for Electrical W dPlumb g,Signsor aWells�Pools,XPur months at aces,Boilers,time Heaters(
nks and Air Conditioners,dc.
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
JENN=MMTN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
W COMMI COMMENCEMENT.
EXPIREt1$ �tllfhll�@1this a plication and know the same to be true and correct. Allprovisions of laws and ordinances governing this
ppeci:ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
V, of any other federal,state, or local 1Rw regulating construction or the performance of construction.
�—
nature of Owner Signature of Contractor
It Name e i C.�Q►'.....................5...._ rr__
l..r��.�c............................ Print Name
tp and subscribed before me Sworn to and subscribed before me
^Day of 20 PS this Day of 20
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® BENCHMARK (HIGH POINT USED TO DETERMINE A.B.M.)
KESS: 1485 LINKSIDE DRIVE GRADE TYPE: A
iMUNITY:S E LVA LI N K S l D E SOD: 2507 Sq.Ft.
84 UNIT 2 6 PALLETS n,g,� p pr��
- — .� .--• min(". T\1 I A t 9"'6
First Coast Pavers
PAVEeS P.O. Box 8090 Estimate
Fleming Island, FL 32006
www.firstcoastpaver.com Date Estimate No.
(904)410-0278 F:1/7/2015 2079
Ship To:
Shelia Tasker
1485 Linkside Dr
Atlantic Beach FL 32233
Sales Rep
--�_ - ------ Aaron
Description
Qty Rate Total
Prepare area and installation of concrete pavers and related materials for walk
and patio areas in backyard 1 6,700.00 6,700.00
> Including 11 foot walk to side gate, cover full side of house less 1.5'planter
bed on outter side and patio area as drawing, in back, all for a total 915sf.
>Water side section of back patio will include small retaining wall for
elevation adjustment
>One remote downspout is included
> Notice: 395sf of homeowners existing paver stones will be used and
patterned into side section of patio
I
Sealing of pavers is available for additional cost of$1,100
Thank you for your business.
Total $6,700.00
CITY OF ATLANTIC BE
OWNER / BUILDER AFFIDAVIT
L 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 TI-TOUGH YOU DO NOT HAVE---A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTION
A YOURSELF.
SELF. YOU MAY BUILD OR IMPROVE AONE—OR
TWO FAMILY RESIDENCE ORFAROUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 Ot�`Is
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
ESS. THE BUILDING
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF'WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PP�ESU F' THAT YOU BUILT
IT FOR SALE OR LEASE, WHICH IICH TS 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 SUPE THAT PEOPLE EMPLOYED OU
LICENSES REQUIRED BY STATE LAW AIVLt BY YIIA VEBY COUNTY OR-MUNICIPAL LICENSING
ORDINANCES
F
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE
HIRE,
CE BE
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES. ALSO
IV. PENALTY; UNLICENSED ' CONTRACTORS CANNOT BE CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
EMPLOYED UNDER ANY
455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT AbEQUATE. 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.
1`{ b5- L tNkgbc_ n>-
ADDRESSCC
�+ �� PHONE NUMBER
PRINT NAME
n
SIGNATURE
�� er
DATE
Before me this day of ��Y Y l S
Duval,State of Florida,has personally appeared herin by himself/the self he and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State ofr>AV V v)
—_�,County of JJJJ
Personally Known&Pf ^U 1�
oduced Identification- !4=
JENNIFER WALKER
MY COMMISSION#FF 011460
EXPIRES:Apl1124,2017
Notary Signature: v`J p y4P' BondedThruh'otaryFublcUridewrters
F:/BLDG/O\eller-Builder Affndavil;REVISED:4/16/2009
– A
LICATION
BER
City of Atlantic Beach To be assigned b t Building nMDe artment.
Building Department ( 9 Y 9 )
800 Seminole Road / —� - . 7 7
r Atlantic Beach, Florida 32233-5445
' Phone(904)247-5826 - Fax(904)247-5845 p
Iw uE-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: sQ '5- ��n x� Del2artment review required Yes No
Applicant: / /F- C��a ST �i0 ✓£ I nnin &tonin
ree dministrator
Project: r Public Works
Public Utilities
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:
APPLI TION STATUS
Reviewing Department First Review: 3/pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
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 07127/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH JAN 0 9
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
B _
Job Address: 1485 Linkside Drive
Legal Description Parcel#
6700.00 Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
915
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s)(circle one): Commercial �Residenti
If an existing structure ,is a fire sprinkler system installed? (Circle one): Y No N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: create 11 foot walkway on south side of lot, connecting to a patio
in rear(east) of home. Will be removing 395 sq. ft of existing paver stones& adding&replacing with new paver
stones. Total coverage will be 915 sq. ft. upon completion
Property Owner Information:
Name: Sheila C &Richard S. Tasker _' "I S Z 4
City Atlantic Beach
E-Mail or Fax#(Optional) rstasker48@yahoo.com
Contractor Information:
Company Name: First Coast Pavers
Address: PO Box 8090 City Fleming Island State FL Zip 32006
Office Phone 904-410-0278 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. /certify that no work or installation has commenced prior to the
issuance of a permit and that all work wtl/be performed to meet the standards of a[I 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 Electrics/ Work, Plumbing,Signs, Wells,Pools, 1(urnaces,Boilers,Heaters,
Tanks and Air Conditioners,eta
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
AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
JENNIFER W I COMMENCEMENT.
MY COMMISSION N FF 011480
,y .`,�= EXPIRES:April 24,2017
1 he „{l� fy t)Wfdfi?&V0Wddb"ft,0ffit this application and know the same to be true and correct. All provisions of laws and ordinances governing this
type speci ted 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 .i t.._;._C 4 a� 0 5. ' QS �Y................. Print Name
................ ......................................
Swop tp and subscribed before me ' Sworn to and subscribed before me
this 'T Day oft . 20 this Day of ,20
Nota Public V Notary Public
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II II II II II 11 II tl it II II If •II II II II II II II II II II II II II 11 II II II II II II II 11 II II II II II II II �i II JU14o 0 o O
(O tD(D(D C7 00 00 'J V V V V M 01 03 07 G (J1 V1 7 rn(P Ln 4 P,. -P L-(�+W WN N N( N N N——- -'
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L � N K S I D E ® R � V E
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7.5' J.E.A E51AT. 0 rn oa
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® BENCHMARK (HIGH POINT USED TO DETERMINE A.B.M.)
RESS: 1485 LINKSIDE DRIVE GRADE TYPE: A
iMUNITY:S E LVA LINKSIDE SOD: 2507 Sq.Ft.
84 UNIT 2 _ 6 PALLETS of
. rrunP'. A! /A
;., r> �t • First Coast Pavers Estimate
PAVERS P.O. Box 8090
Fleming Island, FL 32006
Date Estimate No.
www.firstcoastpaver.com
(904) 410-0278 1/7/2015 2079
Ship To:
Shelia Tasker
1485 Linkside Dr
Atlantic Beach FL 32233
Sales Rep
Aaron
Description Qty Rate Total
Prepare area and installation of concrete pavers and related materials for walk 1 6,700.00 6,700.00
j and patio areas in backyard
{ > Including 11 foot walk to side gate, cover full side of house less 1.5' planter
bed on outter side and patio area as drawing, in back, all for a total 915sf.
>Water side section of back patio will include small retaining wall for
Ielevation adjustment
> One remote downspout is included
> Notice: 395sf of homeowners existing paver stones will be used and
patterned into side section of patio
i
Sealing of pavers is available for additional cost of$1,100
Thank you for your business. Total $6,700.00
CITY OF ATLANTIC BEACH
OWNER / BUILDER AFFIDA V�IT
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 PRESUIi4E 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.
_1`{�S � �NksrC� 'pY q�k—bre—L(Lcy
ADDRESS PHONE NUMBER
I� l•G!/RyGf S• �(i��Clr
PRINT NAME
/ /'
I/
SIGNATURE DATE
Before me thisd f �" 1 2j�n the county of
ha
Duval,State of Florida, s personally appeared herin by himself/herself and affirms that
all statements and declarations aretrue and
Notary Public at Large,State of County ofy
VPersfnally Known
eGlu educed Identification- F •'f�c,; JENNIFER WALKER
MY COMMISSION Y FF 011480
l 4"-4w Q,;,
a EXPIRES:April 24,2017
W ' �:g' Bonded Thru Notary Public UnAarwriten
Notary Signature:
F:/BLDG/Owner-Builder Affadacii;REVISED: 4/16/2009