159 11TH ST - PAVER SIDWA;K 0,e ;toy)f CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
J Vie. =" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
1J;319�
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-RAAR-1755
Job Type: RESIDENTIAL ALTERATION
Description: PAVERS SIDE YARD
Estimated Value: $1,000.00
Issue Date: 8/17/2015
Expiration Date: 2/13/2016
PROPERTY ADDRESS:
Address: 159 11TH ST
RE Number: 170274-0000
PROPERTY OWNER:
Name: HENDERSON, ROBERT W & LYNN C, *
Address: 159 11TH ST
_ ---- -- ----- - ---- -----------------
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.
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.
All silt must remain on-site during construction.
Roll off Container Company must be on City approved list and container cannot be placed on
City Right-of-Way. (Approved: Advanced Disposal, Realco, Republic Services, Shappel's and
Waste Pro.)
Full right-of-way restoration, including sod, is required.
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CftY OF ATLANTIC BEACH ORDINANCES AND TILE FLORIDA
BUILDING CODES.
c ,=\ f,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
FEES:
BUILDING PERMIT FEE $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
!BIDDING CODES.
r`Jf BUILDING PERMIT APPLICATION
A CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 JUL 21
Office (904) 247-5826 Fax (904) 247-5845 -
Job Address: ISC, //l gj �7", �Y
Permit Number:
Legal Description
7 Floor Area of Sq.Ft. Parcel #
Valuation of Work$ Proposed Work heated/cooled t
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 approvallorm-
scribe in detail the type of work to be performed:
gi V.e ' 0A Srol yetrd ';-- X GI
Property Owner Information:
Name: 12-,csbc7r-t- Hedry \ddress:
City �� `rate Zip Phone • —
E-Mail or Fax#(Optional) �cX `\.� P
Contractor Information: CONTRACTOR EMAIL ADDRESS: `.
Company Name: Qualifying Agen •
Address: City
Office Phone Job Site/Contact Number State Zip
State Certification/Registration# Fax#
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 .o 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 -',formed 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 period of six(6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical fVork, 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 hereby certify that I have read and examined this...plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied w ,het spec ed erein or not. The granting of a permit does not presume to give authority to violate or cancel the
Provisions of any other federal, .tate or ...1 law e: ating construction or the performance of construction.
Or I
i Cab
Signature of Owner I Signature of Contractor
r
'Tint Name A I v, Ijed-iderso Print Name
3ef e v` 20 l S Before me
hi ay of this Day of
,20
ASALL4ti A la . , LA lotaly ,p' .
;�+'>y'• JENNIFER WALKER Notary Public
MY COMMISSION IIFF011480
- t EXPIRES:April 24 2017
pr F.°' Bonded Nu Notary Public Underwriters Revised 01.26.]0
�S�� Alt, CITY OF ATLANTIC BEACH
Iiii
OWNER / BUILDER AFFIDAVIT
rjt��
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. TILE 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 IIAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER"I-IIE 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 -TIE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REOUIRED 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.
siq /811 5 7/ -7 1 D --AI PH NE NUMBER
dii / - /jc�/��s'mil
PRINT N M ��
1 � s
SIGN �' DATE
Before me this t day of \O".0(V ,2i=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 *.A\"
Y'%j'% JENNIFER WALKER
rsonauy Known ri, MY COMMISSION i FF 011480 •
❑Produced Identification- -i: 7,
EXPIRES:April 24,2017
1::74'.,...",a,; p C�"•'� Bonded Duo Notary Public Underwriter
. , J
Notary Signature: �''I L/ I A A (Al ill
F:/Bt.DG/Owner-Builder Affidavit;REVISED:4/16/2009
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Property Appraiser - Property Details Page 1 of 2
HENDERSON ROBERT W• , Primary Site Address Official Record Book/Page Tile#
159 11TH ST 159 11Th ST 09705-01702 9416
ATLANTIC BEACH, FL 32233-5751 Atlantic Beach FL 32233
HENDERSON LYNN C
159 11TH ST
Property Detail Value Summary
RE# `170274-0000 ,2014 Certified 15 In P _ore
Value Method CAMA CAMA
Di�tri�t USD3 ___
.prpin iarSEW ;0100 Single Family Total Building Value $377,497.00 $379,755.00
#of Buildings ;1 Extra Feature Value $9,367.00 I$11,008.00
Legal Desc 1 6-1 16-2S-29E Land Value(Market) $350,000.00 1$555,360.00
ATLANTIC BEACH Land Value(AuriC.) $0.00 I$0.00
Subdivision ;03108 ATLANTIC BEACH Just(Market)Value $736,864.00 i $946,123.00
—--- ---
Total Area 7942 Assessed Value $713,428.00 _$753,030.00
The sale of this property may result in higher property taxes.For more information go Cap Diff/Portability Amt $23,436.00/$0.00. /$0.00
to Save Our Homes and our Property Tax Estimator.'In Progress'property values, E e! P i of $50,000.00 See below
exemptions and other supporting information on this page are part of the working tax -.
roll and are subject to change.Certified values listed in the Value Summary are those Taxable Value $663,428.00 See below
certified in October,but may include any official changes made after certification
Learn how the Property Appraiser's Office values property.
Taxable Values and Exemptions—In Progress t-,
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 S]RWMD/FIND Taxable Value School Taxable Value
Assessed Value $753,030.00 Assessed Value $753,030.00 Assessed Value $753,030.00
Homestead(HX) -$25,000.00 Homestead(HX) -$25,000.00 Homestead(HX) -$25,000.00
Homestead Banding 196.031(1)(b)(HB) Homestead Banding 196.031(1)(b)(HB) Taxable Value $728,030.00
-$25,000.00 -$25,000.00
Taxable Value $703,030.00 Taxable Value $703,030.00
+
Sales History
Book/Page I Sale Date Sale Price J Deed Instrument Type Code Oualified/Unaualified Vacant/Improved
09705-01702 1 7/31/2000 $562,500.00 I WD-Warranty Deed Qualified Improved
07680-00270 1 9/27/1993 $185,000.00 I WD-Warranty Deed Qualified Improved
07680-00269 1 11/26/1991 $100.00 I MS-Miscellaneous Unqualified Improved
07228-00691 1 11/26/1991 $100.00 MS-Miscellaneous Unqualified Improved
04464-01153 1 9/9/1977 $65,000.00 I WD-Warranty Deed Unqualified Improved
4
Extra Features - _
LN Feature Code Feature Description Bldg. Length _ Total Units Value
1 SPARS Spa 1 0 0 4.00 $1,216.00
2 POLR3 Pool 1 0 0 1.00 $9,792.00
•
Land&Legal J
Land Legal
LN code Use Description Zonng i Front Depth Category Units Land Type Value (LN' Legal Description
1 16-1 16-2S-29E
1 0100 ACS LD 3-7 UNITS PER ARS-2 78.00 100.00 Common 78.00 Footage $555,360.00 2 I ATLANTIC BEACH
3 E 2SFT LOTS 1,2&W 53FT LOTS
8,7
4 BLK 43
•
Buildings
Building 1
Building 1 Site Address Element Code Detail
159 11TH ST
Atlantic Beach FL 32233 Exterior Wall 17 17 C.B.Stucco
Roof Struct 3 3 Gable or Hip
Building Type 0108-SFR CLASS 2 1 Roofing Cover 8 8 Clay/Berm Tile I
http://apps.coj.net/PAO PropertySearch/Basic/Detail.aspx?RE=1702740000 7/24/2015
Property Appraiser - Property Details Page 2 of 2
Year Built 1 1962 Interior Wall 13 13 Plastered
Building Value $379,755.00 Int Flooring 14 14 Carpet
Int Flooring 11 11 Cer day Tile I _
Gross I Heated Effective Heating Fuel 4 4 Electric _1 Wit--1
1
Tvoe J L
Area Area Area Heating Type 4 4 Forced-Ducted I I.F ens Fri "A
Base Area 452 452 452 s L"'
1 Air Cond 3 3 Central I 'WI'1._� �J
Base Area 1310 1310 1310 `—,_
Finished upper 458 458 435 Element Code
story 1
Finished Open Stories 2.000
Porch 126 0 138 I Bedrooms 4.000 I
Finished upper 1188 1188 1129 Baths 3.000
story 1 Rooms/Units 1.000
Finished Open 78 0 23
Porch
Unfin Screened 143 0 36
Porch
Finished 207 0 104
Garage
Base Area 16 16 16
Addition 100 100 90
Finished Open 30 0 9
Porch
Base Area 1 126 1 126 126
Finished 1
445 0 222
Garage
Total 4679 13650 3990
2014 Notice of Proposed Property Taxes Notice(TRIM Notice
Taxing District ,Assessed Value Exemptions Taxable Value Last Year Proposed I Rolled-back 1
Gen Govt Beaches $713,428.00 $50,000.00 $663,428.00 $5,179.83 $5,407.73 $5,158.68
Public Schools:By State Law $713,428.00 $25,000.00 1$688,428.00 $3,394.81 $3,481.38 i$3,418.18
By Local Board $713,428.00 $25,000.00 1$688,428.00 $1,484.73 $1,547.59 $1,494.92
FL Inland Navigation Dist. $713,428.00 $50,000.00 1$663,428.00 $21.92 $22.89 1$21.43
Atlantic Beach $713,428.00 $50,000.00 1$663,428.00 $2,115.16 $2,208.22 $2,104.06
Water Mgmt Dist.SJRWMD $713,428.00 $50,000.00 1$663,428.00 $208.62 $209.91 '$209.91
Gen Gov Voted $713,428.00 $50,000.00 $663,428.00 $0.00 $0.00 $0.00
School Board Voted $713,428.00 $25,000.00 $688,428.00 $0.00 $0.00 $0.00
Urban Service Dist3 $713,428.00 $50,000.00 1$663,428.00 $0.00 $0.00 $0.00
1 Totals $12,405.07 $12,877.72 ,$12,407.18
Just Value Assessed Value Exemptions +Taxable Value
Last Year $691,142.00 $685,469.00 $50,000.00 $635,469.00
Current Year $736,864.00 $713,428.00 $50,000.00 $663,428.00
2014 TRIM Property Record Card (PRC)
This PRC reflects property details and values at the time of the original mailing of the Notices of Proposed
Property Taxes (TRIM Notices) in August.
Property Record Card(PRC)
The PRC accessed below reflects property details and values at the time of Tax Roll Certification in October of the
year listed.
2014
•To obtain a historic Property Record Card (PRC)from the Property Appraiser's Office, submit your request here:
t
More Information
ontact Us 1 Parcel Tax Record 1 GIS Map 1 Map this property on Goode Maps 1 City Fees Record
http://apps.coj.net/PAO_PropertySearch/Basic/Detail.aspx?RE=1702740000 7/24/2015
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RECEIVED
JUN 1 5 1998
City of Atlantic Beach
Building and Zoning
Joz
ss.u'►,;� City of Atlantic Beach
15 APPLICATION NUMBER
Building Department `' _
800 Seminole Road (To be assi ned by the Building Department.)
11-44g- 17.fc
- _ w :' Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
E-mail: buildmg-dept@coab.us �Z/A
•�-' Date routed: f
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /6-7q // nt %L7- Department review required Yes No
Building
Applicant: � O /() Planning &Zoning
Tree le NI`strator
Project:
-- PljaMMI,
Public afety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
-
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 � ' I /4-E Cea.k.rvi
PLANNING &ZONING
/ Reviewed by: 4 � � bate: 7 ?j 1
TREE ADMIN.
Second Review: nApproved as revised. a'0. ied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY f
Reviewed by: _ ,` Date: r/
FIRE SERVICES Third Review: ❑Approved as revised. 4.F Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
•
•:;1: : City of Atlantic Beach
; `" Building Department C APPLICATION NUMBER
`' �d (To be assi•ned by the Building Department.)
;� 800 Seminole Road (J` 24,/, ''
-` 7,; Atlantic Beach, Florida 32233 �,�'
i Phone(904)247-5826 - Fax ' .247.5845 �S - �� s
' E-mail: building-dept @coab.us
City web-site: http://www.coab.us Date routed: .2,2--
ammir
APPLICATION REVIEW AND RACKING FOI-IVI
Property Address: /53 // 7714 T
I Department review requi__red
Building �=
Applicant: —_O w - Planning &Zoning
Tree�.. strator ��
Project: f _
Pub is afety _-
Fire Services _ - ==
Review fee $ / Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St.Johns River Water Management District momm......____1111111111111111111.1M1
Army Corps of Engineers
IMMINIIMMEMEI
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLIC TION STATUS
----------
Reviewing Department First Review: imilpproved.
(Circle one.) Comments:
❑Denied.
BUILDING
PLANNING &ZONING ��( (?./(
Reviewed by: VLF
TREE ADMIN. —_--,Date:
Second Review: QApproved as revised. Denied
' A:LPC wy KS Comments:
I TILITIES_
PUBLIC � S
ET
— _ Reviewed by:
Date:
FIRE SERVICES Third Review: (Approved as revised. -- - -
nDenied.
Comments:
Reviewed by:
Date:-- ---- -- --
Revised 07/27/10