1491 LINKSIDE DR - SUNROOM (---
,- !,"\IJ-j-->,,,,
,..ik \s CITY OF ATLANTIC BEACH
— . """ J 800 SEMINOLE ROAD
JJr,' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ADDITION
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
------------------
JOB INFORMATION:
Job ID: 16-RADD-1277
Job Type: RESIDENTIAL ADDITION
Description: Install Sunroom w/ concrete pour over existing.
Estimated Value: $34.000.00
Issue Date: 6/22/2016
Expiration Date: 12/19/2016
PROPERTY ADDRESS:
Address: 1491 LINKSIDE DR
RE Number: 172374-6025
PROPERTY OWNER:
Name: MARCHANT, GERALD E.& REGINA, *
Address: 1491 LINKSIDE DR
GENERAL CONTRACTOR INFORMATION:
Name: WCI GROUP, INC.
Address: 1100 SHETTER AVE STE 203 QA JOSEPH D WILSON
Phone: - -
PERMIT INFORMATION: PUBLIC WORKS:
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.
Full right-of-way restoration, including sod, is required.
FEES:
ENG REV RESIDENTIAL BLD $100.00
PLAN CHECK FEES $110.00
BUILDING PERMIT FEE $220.00
STATE DCA SURCHARGE $3.30
STATE DBPR SURCHARGE $3.30
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH :U,L CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
Ill II.DING CODES.
j y]J\J N
O" ' `' \S CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
-6101 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
j:401119
Total Payments: $436.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
;:s1APPI , City of Atlantic Beach C APPLICATION NUMBER
tj� ;.,, Building Department .,r (To be assigned by the Building Department.)
i:-::. 800 Seminole Road ddN
�'� Atlantic Beach, Florida 32233-54- P4'4�d Ile-Ph p-1277
Phone(904)247-5826 • Fax(904)2 r'- 45
`-4011/9'r- E-mail: building-dept@coab.us \ Date routed: _ 6/03/0101(6,
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
•
Property Address: 19 9 I Li n iCSict2 Pr. -pa ment review required Yes No
Buildirlq
Applicant: i) CI- Crdtr Planning &Zoning
anis rator
Project: -Install; S-tn ubiic Nor
u i i itie
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:
APPLICATION STATUS
Reviewing Department First Review: VrApproved. ['Denied.
(Circle one.) Comments: dee ,/t /id 60.44
BUILDING ��
PLANNING &ZONING Reviewed by: Date: 64/ 0
TREE ADMIN. Second Review: ['Approved as revised. enied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
1 .
Revised 05/14/09
/ - 27
L4�-
/0,r;JZ X f2 x -1'z rb
f-0 X h; zz - 11.r ,.z iJ
L/ X 3/ e 1? 63, 79
/Awe 4,41' X 02 /A- e AVMs
1112, A' Ar ? bIb,If
• k w it
qcP y /6
31? 711v
" 1”. 17117`/
Poq, pa
01094 gity4),t,
et ,PV
3q.
04L b 7�
SUNROOM, SCREEN ENCLOSURE, AND/OR SCREEN ROOM AFFIDAVIT
•
CITY OF ATLANTIC BEACH
JOB ADDRESS: /'4 q 1 Lin K s t a e Or PERMIT#
INSPECTION REQUEST PHONE LINE(904)247-5826
The purpose of this document is to make you aware of any limitations in the enclosure that is being permitted at your residence.
The table below, Sunroom and Screen Enclosure Requirements provides a brief description of the various sunroom category
requirements. There may be restrictions on the use of your present home depending on the category of sunroom you are installing.
The property owner is hereby notified that should any form of temperature control system be added to a Category I, II, or III
Sunroom or the removal of the doors separating any Category I thru IV Sunroom from the host structure occur, the room shall
become non-compliant and must comply fully with all of the requirements for habitable/conditioned spaces as mandated by the
Florida Building Code,The Florida Model Energy Code and State Statutes.
Screen Room,Sunroom and Screen ED& sure Requirements
Category I II II IV V
Habitable Space No No o Yes Yes
Foundation Walls<200plf can Walls<200plf can Walls<200plf can Walls<200plf can have Walls<200plf can have
have 8"Wx12"D ftg have 8"Wx12"D ftg have 8"Wx12"D ftg 8"Wx12"D ftg 8"Wx12"D fig
or 3-1/2"slab if no or 3-1/2"slab if no or 3-1/2"slab if no
concentrated load concentrated load concentrated load
>750lb >750Ib >7501b
Exit Lighting Not Required Required Required Required Required
Interior Electric Not Required Not Required Not Required Required Required
Outlets
Emergency EscapeEgress from exist. Egress and Exit must Egress and Exit must Egress and Exit must Egress and Exit must
Openings structure allowed if meet code meet code. Other meet code. Other meet code. Other
open to atmosphere or resistance -esistance requirements resistance requirements
considered screen requirements for For forced entry,air for forced entry,air
enclosure and has forced entry, air eakage and water leakage and water
screen door leading leakage and water penetration also apply. penetration also apply.
away from residence. penetration also apply.
Misc.Window and Host structure Removable windows Removable windows Host structure windows Host structure windows
Door Requirements windows/doors shall allowed in sunroom. allowed in sunroom. &doors shall not be &doors may be
not be removed. Host structure Host structure -emoved. removed.
windows/doors shall windows/doors shall
not be removed. not be removed.
Wind Borne Debris Not Required Not Required Not Required Required Required
Opening Protection
Energy Sheets Not Required Not Required Not Required Required Required
j
I hereby acknowled e that I have read and understand all the above on this qtt. Day of keit// £0,16 .
��-KffLI C / /fi2c 7I/(1#C, 1~
Home er's Signature Print Name
STATE OF FLORIDA, COUNTY OF DUVAL:
The foregoing instrument was acknowledged before me this q day of m al , 20 / b , by
C,eralsat AYlar4 o.r 1- herein by himself/herself and affirms all
statements and declarations herein are true and accurate. &b."-
:;/:,
,"'. BENJAMIN C REBMAN_, G
i: '_ MY COMMISSION#FF241271 ' NOTAR PUBLIC, STATE OF FLORIDA
% �-r.'o EXPIRES Juno 17,2019
n
.T; Print Name: ee 04.In C R w%O..
1IQ71JYe-0t59 �ROrldeNotsjrSarviee.00m - /
GYPersonally Known/Li Identification:
li 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 PHONE(904)247-5826 FAX(904)247-5845 REVISED 1-20-10
AFFIDAVIT FOR ATTACHING A NEW STRUCTURE TO AN EXISTING STRUCTURE
TO: Building Inspection Department, City of Atlantic Beach, 800 Seminole Road
Home Owner: err,,I of I/V1 arc h4,v1,
Name 11 I I tin r 5(Pe Or 32233
Street Address
lav f c 134, , it
City. State and Zip Code
Contractor: IAA/J Geo V
Permit Number -
As the Contractor for the proposed new structure located at the above address,I have personally viewed
with the above named home owner those portions of the existing structure on which portions of the
proposed new structure are to be attached for structural support. I am confident that the drawings and
details included with this permit application depict the existing conditions of the host structure, and the
members of the existing structure upon which the new structure are to be attached are sound with no rot
or deterioration. The home owner has been advised by me that, in my best judgment based on experience
and knowledge of structural adequacy,the members of the existing structure upon which the new
structure are to be attached are sound with no rot or deterioration and will support all structural loads and
forces imposed on them. By signing below,I hereby declare that I will hold the City of Atlantic Beach
harmless and release it from any responsibility and liability for any adverse consequences or failures
resulting from this work,and further that I will not initiate,execute or enjoin any legal action against the
City of Atlantic Beach for such consequences or failures.
A copy of this document will be recorded as an official record with the Building Inspection
Department permit history so that any and all future buyers/owners of this property may be made
aware of the status of work performed on this structure.
Signed x Date Y/
Before me this -! day of APrl1 ZC(6
In the County of Duval, State of Florida, has personally appeared
Ger 0, mq>/Y ave c herein by himselfi.- elf and
Affirms all statements and declarations herein are true and accurate.
BENJAMIN C REBMAN
i . MISSION.,41271
'
EsJune 17.2019
Notary Public at Large,State of ,County of 0001F °""°�'S°""Ce=«r
Personally Known V or Produced Identification
ID Type
F:building/affidavit for attaching a new structure to an existing structure.docx 7/21/09
` Q�,. o, w� b' • r/..B` 4•- .. IEA16 MB.vT •
4
• . - . . tui,s• 1)V RAO-1r.01
'` sO '4 •
' •
• • • , • • Z•° . , • •. .. . • • t4, • Ja1p , -1-e .
'Ceb
r1-. . hayIct
• ' .•,Nd•°,.45.-i�D-N: /'¢. ` •
: • •• • • , s) ' % Q Wct.y .C13/1.1.), . HOMne &WII1 ey
fsr cf�° -•• 1I.0 - ' •. . ' , •" • li4
_ -^7. • • •..• �, /.,Rf IA i 11 ../ 4". C)ofr •c r5 Se.reS•fv°
• .4€e•/4/.IJJ f,c.t) . ;'0•• •
- '. ', o.s• 'N6°45'DOh• /• • .- • . . .
•
. ' . 0Avee.1�.vc�'.C/-• '49 •N • • • •
.. • 1$'.EtgVEs '••lei ', •
•
•
• . .
• .
•
• . •erg • • - - • • .
•
U• Q1 N • , 0.9 •
3. 1 23G' •
• ' P /35' ''d . ••.._. - . 4 •
•
• W ceNc.a`fT' 0
0 A� Aon I ` ,' . .
• • • 3 1 x �i .. .
- GA+n e g • c, ,"41.A
? "_i"^--`-,— .• .. APPROX. TOP • •14 fijl�4TR,,d I/�
__ OF SANK o
z� •------ ' Zp in n
• e;- �-�.� ii E
• .
. . ... .
•
E. L 'ASEM EA.'r .A.O/' OE FEN7•/ON g A•CCE55 !=17.1, :MQ/NTEN.4NCE•-, •
�9 ••'A, •- • , • • 1 .
• 4 • AIPRD Ea6E •q.' r
A--- X OF 1✓ATER — _ %
Fz.tire21 il\'3. r : „ !I'M.
•L0• HASEMENr, fOR DRA/NAGE r
•
---•—•-•••— . 7.:95 RiPR oX OF' ANK I ••� R^-, I '
i .' 0 • I ay, 'I
o� .0'CNA/A' L/A'k v6NCE• •
I 1 .
�'� 4 IC...........-,-.r . " •- MAY ; •k 1995 •
• • 50 0' V
N6�4 -00 'J1/ wilding a"r)d ZonIng
PART DF 6OV-1 Ln7' J, 5E•CT/ON /7, 7-0NAL5A//P 2 S., RANGE ?9 E. . .
•
•
•
• Fecl44 ,24e S/ 6-4-/$ • ,copra': See 4 a..04 .. /.,ua '1-: vu•v.o.. orNze._ zeo.✓s
• I HERESY CERTIFY•THAT THIS SURVEY.PERFORMED UNDER MY RESPONSIBLE DIRECTION. MEETS THE MINIMUM LEGEND:
TECHNICAL STANDARDS FOR LAND SURVEYORS IN ACCORDANCE WITH CHAPTER 21HH-6,FLA.ADMINISTRATIVE CODE
• 'PURSUANT TO StcTION 472.027.FLORIDA STATUTES).AND FURTHER CERTIFY THAT THERE ARE NO VISIBLE ENCROACH- 4 cONCRi TE YONUM219
MENTS UPON THE SUBJECT.PROPERTY EXCEPT AS SHOWN ON THIS SURVEY.;. • o `.
Portio INON•.e sss
• o �`srT IRON-LS. ,ros
FLOQD CERTIFICATE; THE LOT SHOWN HEREON IS IN FLOOD ' , O.R.L. BUILDING RESTRICTION UNE
• ZONE . '•X AS SHOWN ON THE FLOOD INSUI#ANCE RATE CLARSON AND ASSOCIATES, INC. J Maillii AROLE
IUS
MAP, COMMUNITY PANEL• NO, 120075: 000/P • •, DATED 4.17.89. 1843 NALDO AVE.JACKSONVILLE, FLA 32207 R A •RC,uRC,c DIaTANCE
' •° CR. CHbnD DISTANCE
• • A I P.C. POINT OP CURVATURE
•
_
' SURVEYED /f 4 y/• 5 9.3 19.• •• /!I•',i � • I P.T. POINT OF TANOENCT
ySCALE: /"= 2d, • ISTERED.SURYEYIJA NO 234/• PI•A P.R.C.• POINT OP REVERSE CURVE
• JOSE A. N/LG • P.C.C. PonrT o►to,PPouNo.ctaItvE
• f.49., 5,0/IAS- .0 . FIELQ BOOK 47Z PG. d4,
ili
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
•,v 800 Seminole Road
Atlantic Beach, Florida 32233-5445 14' t?-177
\ Phone(904)24,7-5826 • Fax(904) 247-5845
• onio• E-mail: building-dept@coab.us Date routed: 6/03/°a(p
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 19 I L;n k5itil2 Dr• pa tment review required Yes No
Build'
Applicant: 4) G-1. Cnimuto `Planning &Zoning
l�rs' t4 in sratf or
Project: _ gtallSup(=A. Work3')
u c _tie
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:
APPLICATION STATUS
Reviewing Department First Review: Approved. nDenied.
(Circle one.) Comments: tv /�
BUILDING v
PLANNING &ZONING Reviewed by: 111 Date: Z• "17V4
TREE ADMIN. Second Review: ❑Approved as revised. ❑Den d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
rS> 11-,,- City of Atlantic Beach APPLICATION NUMBER
r BuildingDepartment �\ be assigned bythe BuildingDepartment.)
�� (To9 p )
'i 800 Seminole Road ?� I tr_�w�A +���
Atlantic Beach, Florida 32233-5445 /,
Phone(904)247_5826 Fax(904 247-58 /v 0 '� / /
'2-oR!>',- E-mail: building-dept@coab.us tly. B zoo Date routed: 6/U3/0b1(p
City web-site: http://www.coab.us
APPLICATION REVIEW A o�,r ACKING FORM
Property Address: - 19 61 ( L.;n ksia2 pr. garment review required Yes No
Build'
Applicant: L) CI- ercur Planning &Zoning
re zarninistrator
Project: _74%51101 Sur=IAA. -ub is Wor
1n:7rr3rrji .
Public Safety
Fire Services
Review fee $ / Dept Signature SG`
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:
APP ATION STATUS
Reviewing Department First Review: c Approved. nDenied.
(Circle one.) Comments:
BUILDING /
PLANNING &ZONING Reviewed by: ��� ''gi' Date: G q (G
TREE ADMIN. Second Review: Approved as revised. nDenied.
lkj C WORS-
Comments:
Alk
BICOLITS
'�IE(o
PUBLIC SAFETY-- Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
S�a,vr• City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
uv Atlantic Beach, Florida 32233-5445 I ij-• Q X77
/ Phone(904)247-5826 • Fax(904)247-5845
,`-;0;319%/ E-mail: building-dept@coab.us Date routed: A3/abi(p
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 19 9 I n 16Sidi2 r ' - • ment review required Yes No
Build.ii
Applicant: L} Gs. Crcur Planning &Zoning-)
- -• mis rator
Project: jell n fcciA.A ubfic Worcs
u i i itie
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By_
FloridaDept. 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. )4Denied.
(Circle one.) Comments: //�/
t�C'( h
BUILDING
PLANNING &ZONING — —— —Reviewed by: ...044,/ Date: 6/3/it
TREE ADMIN. Second Review: JA roved as revised.
pp ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: „//.�,t:, Date: OS/it
FIRE SERVICES Third Review: ❑Approved as revised. nDenied
Comments:
Reviewed by: Date:
Revised 05/14/09
z
`'IL' 1r�L, BUILDING PERMIT APPLICATION
9f1'
CITY OF ATLANTIC BEACH
\ 800 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 • Fax: (904)247-5845
Job Address: lI) l I L, ) SICfQ br Permit Number: 1 14+K(k-0 a77
ter
Legal Description 4748. 17 '2s 2Q(5v/vg)intt'sifp //pia LoRE#
Valuation of Work lacement Re Cost)$ 3Ili
Work(Replacement C Heated/Cooled SF Non-Heated/Cooled /
• Class of Work(Circle one): New : Addition.) Alteration Repair Move •emo Pool Window/Door
• Use of existing/proposed structure(s)`'(Circle one): Commercial 'eside 1 '-
■ If an existing structure, is a fire sprinkler system installed?(Circle one): Yes tv N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: 1"l1 -10..f/ 5v, roM / I/A Z3/, n 51 moil )0P, L'/,
Gonore-ie. f ovr over ex is n5 If pro 3 'd F(:a+ciwi
Florida Product Approval#_ for multiple products use product approval form
Property Owner Information n
Name:Gt1�Id p1at-di c/I --/- Address: / f/ 7/ 2-1`i /(S o eIJ r
City /Wan -}1C I3 each State/ Zip 3 Z)3 j Phone a7/ --• i.7 /C
E-Mail GYrR 1 d A1ure-I col /- tr''' cm c, 1 . Cc-nt"
Owner or Agent (If Agent,Power of Attorney or Agency Letter Required)
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.
Contractor Information:
Name of Company: ` C:-/ C co tip Qualifying Agent:nt:
Address:MOO S` N /11+eCity �a c et
c). State Zip 3Z 2c
Office Phone Z- =Pi 4 'd Job Site/Contact Number 5:09- C 33V
State Certification/Registration# C GC ISO 41 16 2. E-Mail Cl an C/ e oJC t GC I Cap,`,
Architect Name &Phone#
Engineer's Name&Phone# R5,,;,, Cch ri
Worker's Compensation Sov-rk b h "h s i/—/ ?-' f 6
Exempt / Insurer / Lease Employees / Expiration Date
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.
his permit becomes null and void if work is not commenced within six(6 months, or if construction or work is suspended or abandoned{or a
period ofsix(6)months at any time after work is corn„- ed. I understand that separate permits must be securedfor Electrical Work,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers,Heaters . n .•and Air Conditioners,etc.
Signature of Property Owner:
g p �Y Signature of Contractor: �j��/���/..),.„1 Before we
this flX Day of 1,A- L �. .'' ; REB lis Z� 7-Day of f)pr i � 2oI(j
MAN7
4t(____c_
MY COMMISSION#FF241Notary Public: k..44;x1'6,
•: ExPigES 1u„e i � u ic: �1 '
,�c� I REBA4.
,pie-c,s3 , -.-
• ';d • AMIN C
iaioenoa+yso, .ro,,, •n My COMMISSION#FF2q 1
-�•..
I hereby certif,that I have read and examined this application and know the same to'be true and correct. A I- ' ' .ns o,6�AtRES
,�,� 4une Ru
otclinunces governing this type of work will be complied with whether specified herein or not. The grant :„.i,ta .:rmit. , <u �2019
presume to give authority to violate or cancel the provisions of an)'other.federal, state, or local law regulating cons ri 'aysa"+ee con.
performance of construction.
Rev.3/14/16
, ?iL"''try„ ZONING REVIEW COMMENTS
A City of Atlantic Beach
.....t....„--=,-:. :r Building and Zoning Department
800 Seminole Road Atlantic Beach, Florida 32233-5445
Fi 1:P"' Phone: (904) 247-5826 Fax: (904) 247-5845 Email: dreeves@coab.us
Date: 6/13/16
Permit: 16-RADD-1277 Applicant: WCI Group
Review: 1st Address: 1100 Shetter Ave, Jacksonville Beach, FL 32250
Site Address: 1491 Linkside Dr Phone: (904) 242-4444
RE#: 172374-6025 Email: Clancy@wcigc.com
Correction Comments
1. Side Setback: Side yard setbacks are 9 feet on one side and 1 foot on the other side. Please show that
this is being met.
2. Tree Removal: Please submit a Tree Removal Permit Application if any trees are to be removed. If no
trees are to be removed, then please fill out an Affidavit of No Tree Removal. Both forms are available
on the city website under"Planning and Zoning" and at City Hall.
Derek W. Reeves
Planner
dreeves@coab.us
-s► , �ir,r, TREE & VEGETATION AFFIDAVI'C EC E Q V(E' '
�3�, , City of Atlantic Beach D
t
Department of Community Development JUN 1 3 2016
DV\:...,.._ -, Planning&Zoning Division
800 Seminole Road Atlantic Beach,FL 32233
'"4013 r.)�
(P)904 247-5800 (F)904 247-5845 PE RMIT# /2,
SECTION I-APPLICANT INFORMATION r Owner(s) 7Legai Authorized Agent*
NAME OF APPLICANT Mar. G ha hi
NAME OF COMPANY (,SGT Croup OFFICE COPY
ADDRESS OF COMPANY
Mgr C EX(.v4-,vc Parg c-r
PHONE Z f 2-A) 9 (pi CELL S ,-6 .?3,,g EMAIL ckotere h2C1-66,Co/,
CONTRACTOR CERTIFICATION NUMBER G G c is-b?/6 2
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION Il-SITE INFORMATION
STREET ADDRESS OF PROPERTY / q?/ Z-t h K Si bc 0r
If an address has not been assigned to this property,contact the AB Building Department at(904)247-5826 to request an address.
LEGAL DESCRIPTION
LOT BLOCK SUBDIVISION
REAL ESTATE NUMBER LOT OR PARCEL SIZE: SQ FT AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
1 affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation" of the Municipal Code of
Ordinances for the City of Atlantic Beach,FL and/or I have participated in a pre-application meeting with the Administrator of those
regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the,.ove-described ora 'acent properties in conjunction with this project.
SIGNATURE fiF 0 NER SIGNATURE OF OWNER
Signed and sworn before me on this/ ay off,S V Gl e_ ,zo i l0 by State of
111 JJ County of •
Identification verified: R I 5s -0 -I ii'3
Oath sworn: r Yes r No 'i
;:itY" TOM GINDLESPERGER -`
MY C,OMMISSIONtFF924951 1otary Signature 11
_•,:�t-:
•
•
•
•
• .• "1 N •s/•. ,Z/.z' • • . •' ;•-?'.''� 4 5nsaM.s.r
r . �V.Ire • ., • 6.v Irk D V fV l S*r,on
�� �/+. . a .�; m s ja•,b 6 +e . •l7e ,ri-s. havlar.
• .. •
sFr.�J�t°•,.•A►5-OL N /¢.11: �•��• '� ' ,, 8, £ •
Q4y �a� Iy • OknCI�WNveq'.
p•*_ • /1.0 ; •
/O.d.A3) mo..•+__., r lO.o" 3'
.--s114...-- 41 /�:�:. • Ail l I .!ef' W O?Kt r5 v 5 e-re5{trr
• .4..v.„4....; L
(,4. `-) • • ii.o • • .
• v, •
, 'o• �t16 4S=0D w •• - •
• ��,� ,�,��,. ;9 N OFFICE -COPY
• ISOROVIE 'IN
.•
. D
• I • o ••z• : eke
row- �. JUN 1 2016 1
. • (�1 ;..f -..]
CeN�T- ��I iIOQQ , J
• 4• • 9� A'A[� , C W -;;--:-..•; ,-..."-----0-1. • •
• • 3 t .''gt X 23 I .
•
I Pli?ie �aor q • q�AR a.
• `• . '�-- r—���_ -• ofeO IX • . . '��1in/(&TZ?,",•1 4-
te
• • . •• • 8y' d o
FASEM EAT, FO,� OF FENT/On!.f A CCES.SF rR MA/NTEN.IINCE . • •.• / . - • • .....--"`"---,....„-..................,..,..,...... -
•
• .P - AAPRDX. 47765 OF *NATE'?•, __ '
TT
�'- •
• c�Q 5A SEM.NT, fDR DRA/A/AGE.)
•
• WilVgigliVii7Ler •
, ..4
• AiPROX- ro BANX I • (t fV' 1.111
O' 4.CHAIN•1/Ade F NCE-- I.O I •COQ Nx y
•
. 6 �.
N " '-OO yv -Building and Luning
PART DF GOVT•• 4.r77' /, SE.CTIQA/ /7, TOk&N.Sf1/P 2 S., RANGE 29 E. . .
4 f' :s, '- �3-' - ' . ,r-_ $'' .
Fnc/ .• . a'cal : ourll•,,p•.Ate,.4 pi-!e- /.Go'
• I HEREBY, CERTIFY.THAT THIS SURVEY.PERFO�tMED UNDER MY RESPONSIBLE DIRECTION. MEETS THE MINIMUM LEGEND:
TECHNICAL STANDARDS FOR LAND SURVEYORS IN ACCORDANCE WITH CHAPTER 2114H-6,FLA.ADMINISTRATIVE CODE
. I PURSUANT TO SECTION 472.027.FLORIDA STATUTES).AND FURTHER CERTIFY THAT THERE ARE NO VISIBLE ENCROACH- •
CONCRETE MONUMENT
• MENTS UPON ME SUBJECT.PROPERTY EXCEPT AS SHOWN ON THIS SURVEY.;'. • of ror IR IRON•s.4 6J19
• O rz`'yr IRIRON
-LB. 1)04
FLOOD CERTIFICATE: THE LOT SHOWN HEREON IS IN FL000 . • ,- �- ! INC. DAL BUILDING RESTRICTION UNE
• ZONE • 'X AS SHOWN ON THE FLOOD INSUI:TANCE PATE CLARSON .AND ASSOCIATES, CCENTRAL ANGLE
US
MAP. COMMUNITY PANEL NO, I2OO75- 000/P , DATED 4.17$9. 164$NALDO AVE.JACK90NVU I F, FLA 37207 R ARCRADDI •
• - A • ARC DISTANCE
•� '� CH. CHORD DISTANCE
• �� p7 ' P.C. POINT OP CURVATURE
• SURVEYED 2 5. 1 9 .9 •• I' P.T. POINT OF TANGENCY
/•�C 6746• • I$TERED•SURVEIT .NO 28G/. PLA •
P.R.C.• POINT OF REVERSE CURVE
Zi 'SCALE' -
- . • JOSE A. Ai/L4 • . P,c.c. POND'OP CowPoUND.E%1VE
•
• • Al. $/4),,,,s. 3o . FIELD BbOK 472 PG. ,$
f
Imo. 0
c 0u
o +'
0
= bn -
... 0 .. g
O5 : 4, —
c
Ua) 4
a .� v)
CL
o .= gib
0 ° a)
t .d A
W w ° � °
°
C.) b ill v
LL ,-i'
moo-,w° :o
c�
O U Mt 0 •� •
F{
z.
N .C2.
"
EiM �oo
k 4,-s
A .4
L. U2 �
(
Z v
O __ o, -
•
> o ra
i V .h) o •
,
A
\)V o0 .x
0
o o
O ci) ." N t, a
A4 • ' E.2 cl a1i 0 .
ZIS V) _o o �. A en 7 W bn i.
-" oCI' a°n v. cn a; O v) x U Q w Q a a 3
•O p + �i1 i(� N M 4Vl .--i N M 4 kri [: 00 Q. d
V
0
a
a,
O
t
r
O
0
w
w
..1
0
..,
....Q
G i JJ
A
ci
0
10
cl`..,
a 0Li
w
v
3
%
g
U 5 o a>
0 0 A „ E on ami 5 ii
o > o
0
° O fl 0 + bq L Q b.0 bA �" b4 t.�
a N ° o o ° ° ° - no
oD ' o � W oo , ai a va U 7 Ci O O In4
cNI �°'
+- Q, '- N M d- In � s op p; O .--, ,
i i f i t� oo c,i cr; 4 ,r;-
4
r
q
Ti
cd
O
a
w
4
I •
h
4-t
0
»
O
w
Cst
O
•F+
•i.
U
A
tY
-a • l
0 tvl
1
Z
u
ca
s.0
0 cn
U
C/1 a Z 2 0 '0 N W
O . v .z .E - d
) 5 bA a5yUO , bA :v. O o 2U 7:3(i) GH .U i2O O � ,H � � xwo03r� wc cr$ S Q o'111• b0 ' •--.4 N M di t"---: N m ct--; oo Q\ O ~ C/1-
—
I
o
.= o 0
L.
cn zs a,
0 o
cn
o = cn
Irk •s 0
'"z0e� a)
o 0 O.
�-1 '� 0
a 0
o ami a)
0,.S ami
°r a "o
at
s.. cn 4-10
L°o
0
a 0E
0 O..ct U
�.,
G aa., a) y iii
0 0
0. — L]
a ° 6 N
g � b
a�
o = 'bn
a v,
•U •Q cG ^z 'C3
V1 0 y 0 '�
A (44 Gz
0 .
�
U U Q z++ x
li
s &�
o 0 o
'� OA
0 0
0 0.fl
ice., cct p �_?
O > U 0
ct ct cd cd a> 0 W
, "0 c4 a]
+O+
0 > s ›,
¢, 0 up
O Q
O
cd 0
F, U ? N
.Z .8
E E
� � z
O A, cn 5 --...
O
a ss o
W E E 3 a, 0 ;.: ;~
-,- 0 ,, cn cd z b0 0
z z
W
CCS
03
o
MM -0
U W p 0 40
vV O o " 4142 a
i
i Vincent Seibold PE 48288 ►
T' ICO Y '
��
101 Levy Rd.
t ----'- Atlantic Beach, FL. 322331------ ----
I i. _ Phone: 904-568-4112 ►
IIMIIIMORM iir iiiiii,iii 411iiii _ ____
rIlIIIIIIIIgrAmp
niinnwitimi ••.._
Immamimm__ LI II II II
-1-- 1111111mMIMIMEIIII
1111111111111111 a
Malin' • 111
T t—
ill -_ /kb. OM P f �--
.ti,
----1-. • .. , . ...ili — 1- - ' ac,' a 1i _ i
_4._. 11-‘: . - 24.‘c, ib _______. ._____,_____;
ply
l
I i
IIIckmIlh. II III
+
6t4 i-fo ■ i
•o - 2 ��!
' r .
III ■ i -�-- / NM
MN
I ,
ENE _
IWO - GE
19111111111111" .4 7 ANWRItt. ,.1:. '. •,g_MERM IA _4______ ,
i RIIIMMIIIM111111111111111011 1
._,
ir 11 iiim,--7,skri _,_ swomi wip,,:H_ ,..... 1 in
, „_____,
i ii ,„1,1,1,.. all __. , 1 , ,
, .
I
■■■iil
.►
- • .,n J + il
–1.—..
litinillnillidli I ! . .
NENir�� , W
, ..00
//"Iilll!l..1
I r I I , ( 1 t , _
1
b I
• Vincent Seibold PE 48288 1 - -ii J._.__.'—.. • I
I '
• • x }
( ( 101 Levy Rd. -7._.. ._+__J......_.• ! r (
IS " Atlantic Beach, FL. 32233 ..� Y _ I ! j.
: __ 1 Phone: 904-568-4112 .:..it I 1' . ._I N
. iri,
• i
,
T
' . f I ! , -> ( i(_ tami '_� 4( r--j _
•
p Y t _
.
•
_. .._.. _.. r-- _• ,._ .rte
- - i—t-.•-•----r. 1-----T T -
v 1 -;
_1_4_4_.4_ . _ . ___i___TI_ ... ._.I . i .. .t_ .. . . i -.; ... .1-1 .-1....-.--
r_T �.__ 1 _ 1 v
i I 1 I Ill _kJ_ ' ' I I .- ! ; i : .- i
I
I.I. ( I.
- t r ---( -
i I . i 1 : I ; I . ,1 --I-- -. - I I f
•
-I- 1
•
1 . ii i 1, I 1 j 1 ,
_i '
I C t
- I- St• - - 1 i-41-: - i ----i- i • - ! v., •
r ... -f. 1 I I (
V;
Il ,L-11 - - .
- : 1
i\ I
f 4-JflI ( j ! i..
; 1 j - E
_.
. . tjf
I • I I 1 1
•L I I.. '. . L_.^_.. -' ..1 _ f..'.........14. .o...� '} `\\�tt 11act
1I1 Ill �,�,�
.... . __ .._.._ •' NSI - . . f. _ ...... ___.1_.. I---Jr--.i.....="'•. _ if I.+ • ./
.....__--- .. .1 . ...I. .....441.1.:• ,e, A,. . 1 ',,i,_.4c._.7,1%,. i
P9...i 4Yn
1
J1if =
46, 1
//i��FSSiONP������
Im\r" '''.4 . aonc-f e,Fe an I Y
:
--I--. I . I --_•1
_ f
i
M .
-I---i-----t----. - a _-�- ._- ....
Every sleeping room shall : : ; • • _
maintain at least one operable O o� M
. emergency escape and rescue - �- - +N, -- oo M
N N •
opening. CON
_-
Pe 9 __ 1.- -I-- M N
. . . Q. b._.____..4___ : - o = P
U-- -L - N — m0
QL
4'– S" • G{''- S' 4'- S" ,`!, ; i- c as :. ti
a� I
54$ 540 S4 s S4 N 54 X 5 14.1-1- ; ' ; ;
a____ d _..l ;- r i 1
-----
•
.N •N
- o = JZ v
`Dfoo — op. 2-us
. 1 .. i,31 8 .
_ . . 1 2, , ___[._ (cil ED. 6 -,113 , , o 0 a-0 4,-
•- IC aocaog
I I-----j- .a c am a 10 -; 0-2 ¢O,4
Q.,4 x 03 w- ; o
_ _ vLL -- ? 0 '�
oiT. u.
1:4:4-111-
1--;---- ' . ' al -xr> 1 .', j f...11 "a. it — m
i40. _.,_.,
Ev0.1 1
o
Y V. s' .
. Iii. , 4 .
YI ,
1 ; -
i- - ' 4 l �\ ' Ill!!,
N ,-' -- tt - . •\�� �. �//,
v. 1 ' i I ' - • ' °
U. QI
p : 4i\'' • I ILI=
1 = ; of : Z=
. ! ,x� I i'�if"r"/ SS14NP���
150 . V
, c . v y
'_
. 1 Y TI
. i 1 I
Yrti�)< 54-E-4 - `32x54H 1 .------- __I __.� , ._ -
1 i ;
I ' i I i
BUILDING PERMIT APPLICATION
,,,)
CITY OF ATLANTIC BEACH c
(filIN't
800 Seminole Road,Atlantic Beach FL 32233 OFFICE COPY
,:::.:,-,_-,„*--/ Office:(904)247-5826 • Fax:(904)247-5845
Job Address: 1 7 ` 1 L, -;� 5/Ct€ hr Permit Number: ( b--"K(-0 -{a'/7
trr
Legal Description 1/74513 '2 S-29 .Sq�va)inA'sro�e UN�2-`°RE#
Valuation of Work(Replacement — i
o
Cost)$ Heated/Cooled SF Non-Heated/Cooled I
• Class of Work(Circle one): New ; Addition) Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Ce-skl9.—
•
If an existing structure, is a fire sprinkler system installed?(Circle one): Yes No N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in detail the type of work to be performed: 1.n5-J0-f/ Sin r M l q A z3/, /, 5;motor ico, it:),
Acii
Gon oi"e-tt. Po v r over ex/ccn5 ! PD 3 'd F Coi‘c,mti
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name:Qern.1 a ar 'C/t c&n -t Address: 1 q 1/ L-!rt "NO<' 0 !.
City Ai)art -}-1 C 8 Back State/ Zip 3 27-3 Phone 271 I .2
/O
E-Mail_G-e r Ct (d /)1 d-c-I (z)i I- (5' rort iA, I , cvrt"
Owner or Agent (If Agent,Power of Attorney or Agend),Letter Required)
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.
Contractor Information:
Name of Company: 7 C y Cord V pQualifying Agent:
Address:/(DU .S e- I Nt,- 11 V e City far- /3�ct,C/-\ State Zip 31,z coOffice Phone9,Y2 - 4/q -I q Job Site/Contact Number cog L 33V
State Certification/Registration# C G C 150116 2 E-Mail CI an C1 l6 (AJG r GC ,Cc
Architect Name&Phone#
Engineer's Name &Phone # Sot 5,-1,L, Cott rt
Worker's Compensation 5ov fk et p, ' n.,s //-0- 16
Exempt / Insurer / Lease Employees / Expiration Date
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 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 f{or a
period esix(6)months at any time after work is corned. I understand that separate permits must be secured for Electrical Work,Plumbing,
Signs, Wells,Pools,Furnaces, oilers,Heaters -and Air Conditioners,etc.
io
Signature of Property Owner: __....../0"--- i(/
Signature of Contractor: //l���jI
Before we ' ( I
this)% Day of /PAu L ,. ,.' .• _ - is Z- /''Day of f)Fr( C 201 b
"�+ �'= MY COMMISSION
/
Notary Public:RG .i'r• EXPIRES_i„ne$ ?t21- 'ut ic: I/. — �'. ='a
C REBM
fmof° 0' °'0011 - i = � M1'COMMISSION tt FFY41
I hereby cert/;that I have read and examined this application and know the same to"be true and correct. A 1.1 '..--rrrc o, iRE$j
ordinances governing this type of work will be complied with whether specified herein or not. The gran :r • ..emir. . . <lune v,2019
presume to give authority to violate or cancel the provisions of any other,federal, state, or local law regulating cons 1.1 . `a 5(3"nle:on.
performance of construction.
Rev. 3/14/16
(-04
R, of S,, CITY OF ATLANTIC BEACH
it j 800 SEMINOLE ROAD
,,,,,•.,.,.\\\ .
0.1119 ATLANTIC BEACH, FL 32233
�N
OFFICE COPY (904) 247-5800
BUILDING DEPARTMENT REVIEW COMMENTS
Date: 6.1016
Permit#: 16-add-1277 Applicant: WCI Group
Site Address: 1491 Linkside Dr. Site Address: 1100 Shetter Ave.,Jax Beach
Review: 1 / cj rov4 01 /Yky Phone: 242-4444, 509-6338
RE#: '6.11-1( Email: Clancy@wcigc.com
Homeowner: Gerald Marchant
Email: geraldmarchant@gmail.com
C•ice tion Comments:
%' ubmit roof construction details of the sunroom to include all framing
P�1 embers dimensions and lengths, over framing onto existing roof and all
5Y-, t •-down connections. Rafter to wall tie-down connection. These should be
gned and sealed from engineer\architect, 2 copies.
(At l 2. levations submitte s s on't show any details of the rafter tails. This could
be critical with the close lot line setbacks.
0 ubmit product approval for all roofing materials onto the previously R f(
submitted Product Approval Forms. Come to office and add to exist' g 6 -e
^ �� 7.irfr
forms. P1'
1
Ulf
Mike Jones
Building Inspector/Plan Reviewer
City Of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233-5445
Ofc (904) 247-5844
/ 1
knaiLecoornvr-P4 �s 6 ./ `I1b w
0
SUNROOM, SCREEN ENCLOSURE, AND/OR SCREEN ROOM AFFIDAVIT
CITY OF ATLANTIC BEACH OFFICE COPY
JOB ADDRESS: 114 ct 1 L,r% kstae Dr PERMIT #/61240-/27-7
INSPECTION REQUEST PHONE LINE(904)247-5826
The purpose of this document is to make you aware of any limitations in the enclosure that is being permitted at your residence
The table below, Sunroom and Screen Enclosure Requirements provides a brief description of the various sunroom categor)
requirements. There may be restrictions on the use of your present home depending on the category of sunroom you are installing
The property owner is hereby notified that should any form of temperature control system be added to a Category I, II, or II]
Sunroom or the removal of the doors separating any Category I thru IV Sunroom from the host structure occur, the room shal;
become non-compliant and must comply fully with all of the requirements for habitable/conditioned spaces as mandated by the
Florida Building Code,The Florida Model Energy Code and State Statutes.
Screen Room,Sunroom and Screen Enc sure Requirements
Category I II IV V
Habitable Space No No o Yes Yes
Foundation Walls<200plf can Walls<200plf can Walls<200plf can Walls<200plf can have Walls<200plf can have
have 8"Wx12"D ftg have 8"Wx12"D ftg have 8"Wx12"D fig B Wx12 D ftg 8"Wx12"D fig
or 3-1/2"slab if no or 3-1/2"slab if no or 3-1/2"slab if no
concentrated load concentrated load concentrated load
>7501b >7501b >7501b
Exit Lighting Not Required Required Required Required Required
Interior
Out ets Electric Not Required Not Required Not Required Required Required
Emergency EscapeEgress from exist. Egress and Exit must Egress and Exit must Egress and Exit must Egress and Exit must
Openings structure allowed if meet code meet code. Other meet code. Other meet code. Other
open to atmosphere or resistance resistance requirements resistance requirements
considered screen requirements for for forced entry,air for forced entry,air
enclosure and has forced entry,air eakage and water leakage and water
screen door leading leakage and water Denetration also apply. penetration also apply.
away from residence. penetration also apply.
Misc.Window and Host structure Removable windows Removable windows Host structure windows Host structure windows
Door Requirements windows/doors shall allowed in sunroom. allowed in sunroom. &doors shall not be &doors may be
not be removed. Host structure Host structure removed. removed.
windows/doors shall windows/doors shall
not be removed. not be removed.
Wind Borne Debris Not Required Not Required Not Required Required Required
Opening Protection
Energy Sheets Not Required Not Required Not Required Required Required
Lu
I hereby acknowled a that I have read and understand all the above on this � L Day of k,t3V £0,1G •
Home er's Signature Print Name
STATE OF FLORIDA, COUNTY OF DUVAL:
the foregoing instrument was acknowledged before me this 4 day of In //al , 20 1 b ,by
a e r1.I d NI ar e4tan 4- herein by himself/herself and affirms all
;tatements and declarations herein are true and accurate.
4►" ,. BENJAMIN C REBMAN . c44b*-
MY COMMISSION#FF241271 NOTAR PUBLIC
STATE OF FLORIDA
''!•4;,` EXPIRES June 17,2019
(.7) eo,sa F+ona�ry ys o. «,. Print Name: M6%41C Remo"
E Personally Known/0 Identification:
00 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 PHONE(904)247-5826 FAX(9(141947-cR4c ARvrMCI-% 17n t A
AFFIDAVIT FOR ATTACHING A NEW STRUCTURE TO AN EXISTING STRUCTURE
TO: Building Inspection Department, City of Atlantic Beach, 800 Seminole Road OFFICE COPY
Home Owner: era,I d fm Gttl`cj ,Ct,yL
Name I`l l tIv K 5(j)e Or 32233
Street Address
City. State and Zip Code
Contractor: LAJC'.L G>rd u pD
O
Permit Number !6 -jefijip-0.77
As the Contractor for the proposed new structure located at the above address, I have personally viewed
with the above named home owner those portions of the existing structure on which portions of the
proposed new structure are to be attached for structural support. I am confident that the drawings and
details included with this permit application depict the existing conditions of the host structure, and the
members of the existing structure upon which the new structure are to be attached are sound with no rot
or deterioration. The home owner has been advised by me that, in my best judgment based on experience
and knowledge of structural adequacy,the members of the existing structure upon which the new
structure are to be attached are sound with no rot or deterioration and will support all structural loads and
forces imposed on them. By signing below, I hereby declare that I will hold the City of Atlantic Beach
harmless and release it from any responsibility and liability for any adverse consequences or failures
resulting from this work,and further that I will not initiate,execute or enjoin any legal action against the
City of Atlantic Beach for such consequences or failures.
A copy of this document will be recorded as an official record with the Building Inspection
Department permit history so that any and all future buyers/owners of this property may be made
aware of the status of work performed on this structure.
Signed g i Date Y/
Before me this -1 day of April 20(6
In the County of Duval, State of Florida,has personally appeared
GO q,c ma, . o.r c herein by himself . elf and
Affirms all statements and declarations herein are true and accurate.
" ' ,.� : BENJAMIN
m'cOMlyISS1 N C REBMAN
C ' . FF
��o1406,90.01406,90.0/s3 E7(PIRES Jun 241271
f e 17,2019
Notary Public at Large State of , County of (vii,1 `oncia'�"'S°'"Ge °^
Personally Known V or Produced Identification
ID Type
F:building/affidavit for attaching a new structure to an existing structure.docx 7/21/09