800 SHERRY DR - SHED PERMIT f CITY OF ATLANTIC BEACH
A s) 800 SEMINOLE ROAD
J w�.... „.... ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
0E19�
SHED PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SHED-1838
Job Type: SHED PERMIT
Description: SHED 10 X 12
Estimated Value:
Issue Date: 8/19/2015
Expiration Date: 2/15/2016
PROPERTY ADDRESS:
Address: 800 SHERRY DR
RE Number: 170393-0000
PROPERTY OWNER:
Name: Brown, Terry And DEBRA
Address: 800 Sherry DR
PERMIT INFORMATION: PUBLIC WORKS:
If pending circular driveway permit/variance is approved, storm water storage must be
enlarged to cover this impervious.
FEES:
BUILDING PERMIT FEE $55.00
STATE DCA SURCHARGE $2.00
PLAN CHECK FEES $27.50
STATE DBPR SURCHARGE $2.00
Total Payments: $86.50
PERMIT IS APPROVED ONLY IN ACCORDANCE W'ITII ALI, (:ITY OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
BI111,DINC CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233 C ,Office 904 247- F!LE
( )247-5826 Fax (904) ��
Job Address: fob 4kj Veg
Permit Number: 5—S' t -13S.
Legal Description
oor ea o t Parcel#
Valuation of Work S �O Proposed Work heated/cooled O t
non-heated/cooled I 2c:'
Class of Work circle one):) ft Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)(circle one):
If an existing structure,is a fire sprinkler system installed?Commercial(Circle one): Y snti No
Florida Product Approval# N/A
For multiple products use pro uct approva orm
Describe in detail the type of work to be performed: CO 1 TCVCY A I w"
Waop c,` Ta- - s g iox 12
PropOwner Information•
Name: -r' - v-p Address: 8o0 4ur�� r
City IT .,174111E," _ - H State Zi. 32233 rove
E-Mail or Fax#(Optional) Phone �t— 20—
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:
Address: Qualifying Agent:
Office Phone City State
Job Site/Contact Number Zip
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 j5i 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 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 null
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 f
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
hereby certify that I have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing this
'pe of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate of any other federal,stat or local l.. regulating construction or the performance of construction.
n' a or cancel the
ignature of Owner
/`` I
� ��� , ��o�/ Signature of Contractor
•int Name
Print Name
:fore ie
is Z"/ Day of 0-14cf , 20/5 Before me
/_d_ Notary Public State of Florida
20
1
1•-ry Public ,g. Karen
yrP(�Enge
�.►A I ir�B9o�.r79l2017 095442 -
Revised 01.26.10
t 1.1%..
,
11- i I.
- y 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 T-IAVE 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. TI-IE 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.
gbd . likkY Pe/ r& "/- 52o -71/7
ADDRESS PHONE NUMBER
7� 1 Ae0 WA/
PRINT NA r'-
li /dr — 727/2-0/
SIGNA DATE
Before me this 21 day of JilLy ,20g-in the county of
Duval,State of Florida,has personally appeared herin by himself I herself and affirms that
all statements and declarations are true and accurate. •
Notary Public at Large,State of A—OR/44,County of '1)(.4 1/1i'}L
)(Personally Known p' ' Notary Public State of Florida
❑Produced Identification- . Karen P Enge
"per My Commission FF 095442
?or t+� Expina 04/19/2017
Notary SignaturPge.4) F
F:BLDG/Owncr-Builder Afradavit;REVISED:4/16/2009
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LAND SURVEYORS `" ,: R' • 1
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PROPERTY ADDRESS:800 SHERRY DRIVE ATLANTIC BEACH,FLORIDA 322::; SURVEY NUMBER: :' :','•-.'.
FIELD WORK DATE:22^UyS REVISION DATE(S):(REV.1 3/232Ol5)
1410.0133
BOUNDARY SURVEY I
DUVAL COUNTY S -9 LESIGEBB 0 B.C. e.
TABLE: 'O
L-15 8°19'22'E 141.34'(M) r;
L-2 5 8°3256'E 26.02'(M) — 24.0
NOTES:
LOT APP5AR5 TO BE BERVICED BY CITY WATER ANO 50YER. 30. ' .1
re#ice OWNERSHIP NOT DETERMINED.
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yp-, and to the. sf•of ) nd bel f,'t is a true
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GRAPHIC 5CALE Wesley B.Maas
Slat o`Florida Professional Sterepr and Ne7Pa•
I inch =30 feet Wyse No.3709
Use of This Survey for Purposes other than Intended.Without Written Valhalla%MI beet the User's Sole Risk and Without Liability to the Surveyor.
No Ixreen shall beContrwd to Give ANY Maloof Benefits to Anyone Otter than those Cent+ed.
FLOOD INFORMATION: POINTS OF INTEREST
BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING NONE APPARENT.
MUNICIPALITY OR W W W.FEMA.GOV,THE PROPERTY APPEARS TO BE
LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE CITY OF
ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 06103/13.
_„ Mike Brown 4
CLIENT NUMBER: Q DATE:3/23/2015 ft:ikeBrown32034Qgmail.corn
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904.206.1161•
BUYER:Terry Brown and Debra Brown ,�,` ;I'uma.lii,i
SELLER:
=MP '
CERTIFIED TO:TERRY BROWN AND DEBRA BROWN E4A C T A
Land Surveyors, Inc. wwweractaia-.dto,
I Pioe.S 35.1916•Ram-7442m F133 13
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PREPARED BY:
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PROPERTY ADDRESS:ECO SHERRY DRIVE ATLANTIC BEACH,FLORIDA 32233 . a_�
SURVEY NUMBER:1410.0133-01
FIELD WORK DATE: -.c-: REVISION DATE(S):(Rrvt 3/2372015)
1410.0133
BOUNDARY SURVEY
DUVAL COUNTY �� lffi�B
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TABLE: V O
L-15 8°1 9'22'E 14 I.34'(M) r
L-2 5 8°3256'E 26.02'(M) -
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NOTES:
LOT APPEAR-5 TO BE SERVICED BY CITY WATER AND SEWER 30.0
PENCE OWNERSHIP NOT DETERMINED.
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Use of This Survey for Purposes other than Intended,Without Written Verification,will be a the User's Sole Risk and Without Liability to the Surveyor.
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FLOOD INFORMATION: POINTS OF INTEREST
BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING NONE APPARENT.
MUNICIPALITY OR WWIN.FEMA.GOV,THE PROPERTY APPEARS TO BE
LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE CITY OF
ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 06/03/13.
'le Brown III
CUENT NUMBER: DATE:3/23/2015 ,MikeBrown32034Qgmail.corn
BUYER:Terry Brown and Debra Brown C C'• 904.205.1161
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SELLER:
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CERTIFIED TO:TERRY BROWN AND DEBRA BROWN
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,=___ Land Surveyors, Inc. vrww.eractelandcorn
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/% :;:,. ;. City of Atlantic Beach APPLICATION NUMBER
j
, . ' ,, Building Department
800 Seminole Road (To be assigned by the Building Department.)
i, " F` Atlantic Beach, Florida 32233-5445 / - 2/t�� `tur
Phone(904)247-5826 • Fax(904)247-5845
-;,; 7
E-mail:Email: building-dept@coab.us Date routed: �Q j
"� City web-site: http://www.coab.us
SINImI
APPLICATION REVIEW AND TRACKING FO M
Property Address: 0'°e) ..Sl7irr 2)te- De @ailment review required Yes No
Applicant: a & k W.-Planning&Zoning
�! Tree •.n'nis ra or
Project: /d X /2. J/9 (4 Public W. , . �-
Public Safety
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: in •pproved.
❑Denied-
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed b � -e: �Y I
TREE ADMIN.
at
Second Review: QApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
;• i.,i, City of Atlantic Beach Cs∎/
;'% r,- Building Department , rte APPLICATION NUMBER
j.-
*y"' 800 Seminole Road .�(/� ,e� i (To be assigned by the Building Department.)
Atlantic Beach, Florida 32233-5445,r> `� ZQ / C
t,/ / Phone(904)247-5826 • Fax(904)'247-5845 �S ��i r ���r�
,vim E-mail: building-dept @coab.us
City web-site: http://www.coab.us Date routed: / %�
py y�� ��
APPLICATION REVIEW AND TRACKING FORM
Property Address: I" ) .$/ Pr Z)e- Department review required Yes
No
Applicant: 0 a) 7) /`. 41—Plann ing&Zoning
�!
AA Tree `ra or ==
Project: /Q z 2/yCU _ ��ublic W. . _
Public Safety _=
Review fee $ Dept Signature_ 1-.
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
Florida Dept. of Environmental Protection _II _I _II _11111111111111.11111111
Florida Dept. of Transportation MMMMMMIMMIIMIIIIIIIIIIII
St.Johns River Water Management District
Army Corps of Engineers IIMMMIIMIIMIIII.. ---IIIIIIIIIIIIIIIIMII
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLIC .TIONJ STATUS
Reviewing Department First Review: 'Approved.
(Circle one.) Comments:
❑Denied.
BUILDING
PLANNING&ZONING /
Reviewed by: �� t"�— �'/3 l
TREE ADMIN. Date:
Second Review: QApproved as revised. ❑Denied.
' �j:LIC WO' omments:
1 PUBLIC UTILITIES
7--..w-
PBL SAFE
Reviewed by:
Date:
FIRE SERVICES Third Review:
DApproved as revised. nDenied.
Comments:
1
Reviewed by:
Date:
Revised 07/27/10
City of Atlantic Beach ! -��J
>,- Building Department JUL ED APPLICATION NUMBER
(To be assigned by the Building Department.)
800 Seminole Road r,, / 2015 /6 -— � %
;'°' ).' Atlantic Beach, Florida 32233-544'5'
2233 5445 -f// 4 r �3�
• Phone(904)247-5826 • Fax(904)247-58
/ E-mail: building-dept @coab.us � Date routed: 7 .3Q /15-'
City web-site: http://www.coab.us
APPLICATION ION REVIEW AND TRACKING FORM
Property Address: �'U ��7�r'� Department review view required Yes No
Applicant: _ 0 a) 7) k Planning&Zoning
Project: /d lV /2- 2//‘A Tublic Adminis ra or
4r
erge Utilities
Public Safety
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:
APP,LICATION STATUS
Reviewing Department First Review: (Approved. ❑Denied.
(Circle one.) Comments:
.�l=C .- t-tt ?) 0...,..--...-e...-....., 1,-:J-
,
BUILDING
PLANNING &ZONING
Reviewed by: 7--:\ -- Date: v�9/i
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 07/27/10
;;.: , City ®f Atlantic Beach E! ATNMB1 j ;- Building De partment d by the Building Department)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
. Phone(904)247-5826 • Fax(904)247-5845 r;.;• Email: building dept @coabus
7 c3o j�
City web-site: http://www.coab.us
AINIIMmI
APPLICATION REVIEW AND TRACKING FO . ;'L i
Property Address: a°U -Skir/ br
De•artrnenf review required ",o
Applicant: 0 a) /C 4 Planning&Zoning ==
Project: /d X /2 J (d Tree ••u'nis ra or _
�'ublic W. ,:
Public Safety ==
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: I Approved.
❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed by:__ Date: �� _ l S�
TREE ADMIN.
Second Review: DApproved as revised. DDenie
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