1639 SEA OATS DR 2015 DOC REMODEL ADDITION I
Keith and Jennifer Collier
1639 Sea Oats Drive
Atlantic Beach,FL 32233
904-535-3698
hastie@keithdcollier.com
3/2/2016
Dear City of Atlantic Beach,
Mathieu Builders is no longer the contractor for our home at 1639 Sea Oats
Drive, Atlantic Beach. Please transfer the permit to us as discussed.
Thank you,
_ L'0,41- ai, •
___,----
ith and Jennifer Collier
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 / '/ i i S I/ - , , !- 9 •'' 4 /`Permit Number:
Legal Description Parcel#
Floor Area of Sq.r't. Sq.1-t
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 structures)(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: / /J. �
Nam (,(/ii Address: /lo3?Sea cgd-S a ,Held %C. &r4C4
City S to_Zip Phone gp 35 3695 32Z 3 r'
E-Mail or Fax#(Optional) S i ireAdC'p/ eon
Contractor Information: CONTRACTOR EMAIL ADDRESS:
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 cert5 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. I understand that separate permits must be secured for ElectricalWork,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 herebycertify 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 ofworkwill be complied with whether spect 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 Print Name
Before me Before me
this Day of .20 this Day of 20
Notary Public Notary Public
Revised 01.26.10
1
r'-jiJ`J,j
it J J�
(rCITY OF ATLANTIC BEACH
. ;, 800 SEMINOLE ROAD
J7ATLANTIC BEACH, FL 32233
(904) 247-5800
NOTICE
THE 5TH EDITION OF
THE FLORIDA BUILDING CODE
TAKES EFFECT
JUNE 30, 2015
ALL BUILDING PERMITS, APPLIED FOR, ON OR
AFTER JUNE 30, WILL BE REVIEWED AND
INSPECTED UNDER THE FBC, 5TH EDITION.
BUILDING PERMITS APPLIED FOR BEFORE JUNE
30, WILL BE REVIEWED AND INSPECTED UNDER
THE CURRENT 2010 FBC.
•
DO NOT WRITE BELOW- OFFICE USE ONLY
Applicable Codes: 2010 FLORIDA BUILDING CODE
Review Result (circle one):
Approved Disapproved Approved w/ Conditions
Review Initials/Date:
Development Size
Habitable Space Non-Habitable
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone
Conditions/Comments:
JJ 3F \(Ss, 800 Seminole Road
`� Atlantic Beach,Florida 32233
Telephone(904)247-5800
FAX(904)247-5805
Construction Site Management Plan Compliance
A construction site management plan conforming to Atlantic Beach City Code Sec 6-18
has been approved as a part of this building permit. The Construction site management
plan was approved based upon the following information.
1. Parking plan—parking plan showing how site will be accessed and all onsite
and abutting street parking areas.
2.
3. Location of construction trailers, loading/unloading area and material storage
area.
4. Location of chemical toilet area.(chemical toilets must be kept out of City
right-of-way and not further than 15 feet from structure under construction)
5. Location of dumpster. Dumpster must be from an approved waste company
(in accordance with Chapter 16 City Code) as of 2009 the permitted
dumpsters are Advanced Disposal,Realco Recycling, and
Shappells. Dumpsters will have tarp covers or rigid covers on windy days.
Dumpsters must be removed prior to issuance of Certificate of Occupancy.
6. Traffic control plan, showing access with dimensions, area to be stabilized,
narrative on phasing of construction with adequate parking and delivery of
materials.
7. Site cleanliness. Contractor must have the entire construction site cleaned by
Friday of each week. This means removal of scrap lumber, concrete remnants
and other such construction debris including cans, metal,plastic and paper.
8. Erosion and Sediment Control. Contractor must maintain all elements of the
approved Erosion& Sediment Control Plan(silt fence, catch basin filters, etc.)
until sod or other stabilization has been placed and approved by Public Works.
9. Other activities, where special conditions are identified by the Building
Official.
Failure to comply with the Construction Site Management
Ordinance may result in a Stop Work Order being issued in
accordance with City Code Sec. 6-17 (3)
Revised 5/2009
I - CITY OF ATLANTIC BEACH
- 11: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 $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
d / /0, uck_ 901535--.5 9S
/ADDRESS PHONE NUMBER
NUL+ e r <c ��i t/i
PRINT NAM
"// 1-e--;Z., Gl/f/i&
•
IGNATURE � � DATE
�
Before me this ? day of '1,47 Ch ,2cin the county of L-- .. ,:------- �.
Duval,State of Florida,has personally appeared herin by 'mself/herself and affirms that 1 :--_,:.-1 V ..
all statements and declarations are tr nd accurate. _— •_-' u Lr--
Notary Public at Lar.- _tate off ,County of _____1 n
"J
I
N. pally KnownAle MAR 9 2,216
•Pro.. ed Identificatio.
Notary Sign '
Shirley L raharn
FmLociown,.Hodder Atf,lav,t;REVI D a H.2u% ..�C` My Commission FF 086990
')'o�0.01' Expnes 02/14/2018
. 1jgbEllVg NOTICE OF COMMENCEMENT
U IPREPARE IN DUPLICATE)
P m ' Tax Folio No. /72o O-o/.3
te6� s' i' /, County of �iLvp(• �
To whom it m., • cern:
The undersigned lereby informs you that improvements will be made to certain real property,and in
rnrrlanra with Aort,on 713 of the Florida Statutes,the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property being improve...... ' /moi 7 /• `, jd
I�///, E/ t Mi /�! ice./�� "Yr
Addre s of p pe being� proved: `��'�`-� /
��A':��' ' � �if1i. -Lys.,'
% � /.I . � . iii ii _/��Il`� aJ
General description of improvement-: ' 4_
Owner I. 0/ e2.--frt
r" I Addrss /3 i //I . .1 i. .�/ t
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
Name
Address
Contractor
Address
Phone No. Fax No.
Surety(if any)
Address Amount of bond$
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida.other than himself,designated by owner upon whom notices or other
documents may be served:
Name
•
Address
Phone No. Fax No.
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 Statutes.(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): a o
0 m
m
THIS SPACE FOR RECORDER'S USE ONLY OWNE- o 0
Sig //�/ . . 'TE (�
Before this 4_d. j�, A_ ! r ro c ry
Co r, val,State• Fior' a s personally in the .o
Doc#2016052743,OR BK 17485 Page 1601, d " ' � � appeared z J o
herein by a
Number Pages: 1 himself.•'herself and affirms that all statements and declarations herein
Recorded 03/08/2016 at 02:53 PM, are true and accurate .,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL "
COUNTY
RECORDING$10.0041111r , '''°
No- - - . ..- -at,.. County of
y commission expires: • '4',sx
Personally Known_ or
Produced Identification