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787 VECUNA RD - DECK CITY OF ATLANTIC BEACH Al 'J 800 SEMINOLE ROAD -0V . ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 RESIDENTIAL ALT/OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-DECK-2644 Job Type: DECK/PATIO Description: PAVER SIDEWALK Estimated Value: $4,000.00 Issue Date: 1/11/2017 Expiration Date: 7/10/2017 PROPERTY ADDRESS: Address: 787 VECUNA RD RE Number: 171328-0000 PROPERTY OWNER: Name: HOEDEL, JUDY L Address: 787 VECUNA RD 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 runoff 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 Recycling, Republic Services,Shapell's, Sunshine Recycling and Waste Pro). Full right-of-way restoration, including sod, is required. All runoff must remain on-site. Cannot raise lot elevation. MAWP , Il}yl staM 4Qr AOQEAt ('KVi+A11.RP.0 lY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. (--- , ;� , CITY OF ATLANTIC BEACH ,�� 800 SEMINOLE ROAD .J wu- — 1 ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Any plan change must be submitted as a Revision to the Building Department. FEES: ENG REV BLDG MOD OR ROW $25.00 UTIL REV MODIF OR ROW $25.00 Total Payments: $50.00 PERMIT IS APPROVED ONLY IN ACCORDANCE W ITII ALL CITY OF Al LANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. rf>.:wr,J, City of Atlantic Beach li"i,::.` , --., .. `'I 1..�s-� APPLICATION NUMBER �� Building Department a `To be assigned by the Building Department.) :' 800 Seminole Road 1 NOV 2 8 2016 i ,�:_ Atlantic Beach, Florida 32233-5445 i' 1 `ID �{ -Z.24 4 y Phone(904)247-5826 • Fax(904)247-584 1_0;10' E-mail: building-dept@coab.us BY:---------- -. Date routed: t I f Z 3// (p City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 787 V ECUNA R lTh Department review required Yes No Building Applicant: a ,) _ Planning &Zoning Tree Administrator Project: 1 AVE—P—. \I'j /k-U(kk)A- ublic Works ublic 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: APPLICATION STATUS Reviewing Department First Review: iv(proved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING J�,liv�� Reviewed by: ' Date: t ( 3..:./& TREE ADMIN. Second Review: ❑Approved as revised. ['Denied. .lC WORK Comments: PUB IC UTILITIES i -2q%�PUBLIC SAFET Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 I F N 6.7 V�{ • W ,(y O Ic . , \ 1 1.' 1 \ __ __ —4 1r. ea !: . 11), _i_.... r~ 8 I\ ` I ! i J i, / G � :;I tii% --,t--__ ____3.2:g . -$ \il I . 1 I I t i (r1 i 1 rLC_____„ ft t i /:) bi( I ' J , -4 PI G T.,:::, s `Jr City of Atlantic Beach E C E� E '� I APPLICATION NUMBER BuildingDepartment N0V 2 8 2016 R assignedbyBuilding Department.) VI p � o be the De artment. " ,V,.; 800 Seminole Road vierix Atlantic Beach,Florida 32233-5445 zr 1 G `I EC.K Z X04 4- Phone(904)247-5826 • Fax(904)247-5 '--- &Din '. E-mail: building-dept@coab.us Date routed: t /*Z 311 Co City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: '787 \/6 & A R Department review required Yes No Building Applicant: IvE�� Planning &Zoning Tree Administrator Project: iV12 \k) icvL/ (radio Works ubhc 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: APPLICATION STATUS Reviewing Department First Review: Iyf'Approved. ❑Denied. % 4-otm (Circle one.) Comments: %Ca Y1idd /Ottitt p(t f BUILDING PLANNING &ZONING / l2/Z Reviewed by: �L , Date: -A 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 05/14/09 1 3x ,e0 G 7 -�Y 2 = 4'3 ld�k /n,/ f //z7 lqX /o 19 k II 3/ I X 1 t 9/ Zoof tip/ 2 X/e'esr Z h f /00 ;7,/ k3 /00Q ,j'ij 27 t so H ,ideata 2,se/ Ate© l/ klv /00 do2. 371 0 I . s cZ �r1 n vim' C>%.1);:t.1 N.:,t 7 ob15 c :1i 4 a m AIIIIIIIMMWL O O Z I n N 4 -i Ii. O a ___ \ ,00'£6 'M„££,ZZ.bO'S —4 33N3 r- x x ----rA� 1- - M 33N3.1 )IMI" MIVND,p.. 1 H •+ 0 a �s ics I � am ~ C. E-I , LL. .da FIIIII1H ?- ,8 8 Z cw Z Milt ; I 1 ti 1..1 V 06c 0 * . ti .i•:: u >.. CO ;!: C W Wa W I 1`' Ir CL 0 p N N O U i '' W U I y W 14 c _N COor)a. — mom CO in i .06f �. 1.0Z v in V < O N 9(z: Jo it. , O LO , .s ,9 0 - ..ti r U cti N CON 1-f E'' ..7 O. i 0 = Z m O 331134 NNIS NIV)43,� d CO a z — - j o w ,00'£6 '3„t'4,ZZAPO'N 4 W 2 < t?11_1 ►- o m l o� \ � �� o E- a i ; -J � I Lt '.75- w 4 V) LO .-1 0 o O as N 0 Q \U-' Cc `-CICI z 4 4 CYN,--4721�i0 SW11” '1d A08E~ M/a ,oe3/C 0C ...I.-4 rTit '`'' BUILDING PERMIT APPLICATION : CITY OF ATLANTIC BEACH Ji 9.r800 Seminole Road,Atlantic Beach FL 32233 Office:(904)247-5826 • Fax:(904)247-5845 j Co- ` �C K✓Z/ /1/) Job Address: 7 7 1EC..qe-eihNIR i2 CiC Permit Number: Legal Description •.. t.i✓I i2P6-tc t- c-e RE# Valuation of Work(Replacement Cost)$ 'fh lsC'3 , IIeated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): . lew AdditionIteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial Residemttial • 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: lay yt.ea) f4,,ea- tlalkobi t t� �d�-(�iiavuR�t2e.�(4c-t. ulcQ ki�al ,..-1) 10,14e s Florida Product Approval# for multiple products use product approval form Property Owner Information , 1 Name: _ t;�j i-kx c W Oe k l itt& Address: 7''7 J c CJ to i2 City 4-Lt. lc Flea State i 3c 3 3 Phone •- "� �p `��`� ��3 (c777 E-Mail S h al e k.-1(►u a,•t 0 t. aiwo t C- Owner or Agent (If Agent,Power of Attoincy 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: 4 ft QiCkle-[ 5:�,$''t>v+S Qualifying Agent: { 't t / )./u& '& Address: / g--7 9 io a.l N-Q,r t. t aAt-t City y �1-�,� .I-5(a�tate Zip '3�t��j Office Phone 90 N (6/0 ._ (Q 7(, Job Site/Contact Number State Certification/Registration# E-Mail (-((-(PVl dGt1 S CO ate(. Cowl Architect Name&Phone# Engineer's Name&Phone# Worker's Compensation Exempt / Insurer i 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 prror•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 constn:Won or work is suspended or abandoned for a period of six(6)months at any time after work is commenced. I understandthat separate permits must be secured for Electrical Work,Plumbing, Signs, Wells,Pools,Furnaces,Boilers, F cute Ta ks an it Conditioners,etc. Signature of Property tier: I . 0 ,'�`t`4f'l Signature of Contractor. 8 th Day of 14 , °le .e Q Before me this a ay of Notary Public: _ � (, Notary Public: I hereby certify that i have read and examined this appli•' . h and know the same to be true and correct. All provisions of laws and of ordinances governing this type work will be compile •-••;--- :._ __: ,•- • • .._, The granting of a permtl does not presume to give authority to violate or cancel the provisio. ,other'o ,codizogitemr oc law regulating construction or the performance of construction. .4.! +, „ MY COMMISSION#FF 924951 �" EXPIRES:October 6,2019 Rev.3I14/16 "P,t;::,` BondedoThru Hoary Public Un '�' denyr2ers '‘),0 CITY OF ATLANTIC BEACH v J 'J%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 TI-IOUGH 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 TI-IIS 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. 7 7c;;ti to 90(f 3--677 ADDRESS PHONE NUMBER Tu: t,1 i u3oe1C N NJ PRINT NAME (� SIGNATURE DATE / Before me this Z Zy of 1\s")0V ,20/_662 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,Stat Countyof .w • .A)LESPERGER t. * :+= M. `r�SSION fr FF 925951 Personally Known v �~P c E• S.October 6,2019 I.';P,;i-V Bon. •?baN PublicUrderwdters ❑Produced Identification- Notary Signature: 11P '_, F:BLDG/Owner-Builder AtTadavit,REVISED: 4/16/2009