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1921 SEMINOLE RD - DECK / PATIO CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 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: 17-DECK-3260 Job Type: DECK/PATIO Description: repair & replace deck Estimated Value: $2,000.00 Issue Date: 3/3/2017 Expiration Date: 8/30/2017 PROPERTY ADDRESS: Address: 1921 SEMINOLE RD RE Number: 169542-0530 PROPERTY OWNER: Name: JONES, RAYMOND E Address: 1921 SEMINOLE RD PERMIT INFORMATION: PUBLIC WORKS: All runoff must remain on-site during construction. Full right-of-way restoration, including sod, is required. All old decking must be removed from job site by Contractor. FEES: PLAN CHECK FEES $30.00 BUILDING PERMIT FEE $60.00 STATE DBPR SURCHARGE $2.00 STATE DCA SURCHARGE $2.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. - . s - Q P_O2 MAP SHOWING BOUNDARY SURVEY OF LOT 8A, BLOCk 1, BEACHSIDE, AS RECORDED IN PLAT BOOK 42, PAGES 14 AND 14A THROUGH 14C. OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED TO: RAYMOND AND JUNE JONES OFFICE COPY NVR MORTGAGE TRANSCON rINENTAL TITLE COMPANY OLD REPUBLIC NATIONAL TITLE INSURANCE COMPNAY LOT BLOCK 1 S 0031'00` E 40.00'(PLAT) S 08152' E FoIIND i/r IRCro FIFE 4.0.10( 1EASURE.C} NO:f>ET1T'IFICA11at FOUND 1/2'xx N pipe • --•- No wEu3+F CAnat ;"' 7 //,,y, .t.4.6 '-' ---4-1.4 r-4.11-1.- c P- DC zaZ Co 9'9, , 15 J t Kra itg ,LA0 RC: 11 UIT Si O • 1,1 ft 4 AE TWO STORY I TWO STORY FRAME FRAME POSTED # 1921 c,I j ' P 9.8' •,.r `•+ !!III cJ o 6 • 4 I o t--- LOT 78 S 1C !a LOT 88 LI a _..BLOCK-_1 . II -@t v `'J �� - I1 u) 'i o ice • • z7.s — 00 • _ X \A.. • 1•, 27.,.c<'(PL1TI Ip x Ei X_ 210.03'(NEASt%tED) __466 w LY ti %WND 1/2'ROAR FCJND 1/2"IR PPE FOUND 1/2'IRON 1'$P N NT1FtCAT1CM N 1:10'52'03" YY No cNTRtAnta� NO �DENTf1CATION 40.0S'(UEASUREO) N 00'31'00' w 40.00'(PPLAT) SEM1NLOE BEACH ROAD (100.0' RIGHT Of WAY) _N >'S-•.•.--- ACCEPTED BY: __... . -- LEGEND: R = RADIUS —•-x—X= FENCE L - LENGTH D = CONCRETE NOTES; REVISIONS 1. BEARINGS ARE BASED ON THE PLAT BEARING OF N 8979.00- E AL ONG THE NORTHERLY BOUNDARY UNE OF SUBJECT PARCEL. DATE 1 DESCRIPTION 2. BY GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS UT. W111•IIN FLOOD ZONE X AS SHOWN ON THE NATiONA.FL000 INSURANCE IAP DA,EO APRIL 17, 1980. CO44UN;TY NUNBEF 120075, PANEL {1QR1 TI 3. THIS SURVEY REFLECTS ALL EASEMENTS &RIGHTS OF WAY AS PER RECORDED PLAT ac/OR 111LE COmMI114ENT IF SUPPLIED. UNLESS OTHERWISE STATED, NO OTHER TITLE VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED 4, THIS SURVEY NOT VALID WITHOUT THE EMBOSSED SEAL OF THE CERTIFYING SURVEYOR, JOB # 7422 I DATE OF FIELD SURVEY: 03.• 19-99 DISK # ZIP 21 1 SCALE: 1" = 20' CERTIFICATE f4,.!ss.' 2522 Oak Street 1 HEREBY CERTIFY-MAT 1NAT THIS SURVEY WAS WADE LWDER IIT -.47-• 51011 CNARGE �� 0JackaOfl , FiarI&i 32204 AND RIMS'THE ►6teGllY TE .LAICAL STANDARDS AS SST F•j BY THE FLORIDA 1l1 a%i BOARD CF PROFEssioNAL - •" ORS • YAPPETRS IN • 61017-6. FLORIDA ,!..‘7.,5,.2,---i.,- (Pntxla) 904-388-5889 fDMARNSTRAT1vE CODE.PU-.: T TO= • a 72, A STA1U z (Fax) 904-389-8175 r SURVEfltfti Int. - • 4# VIN LICENSED BUSINESS 6702 REGISTERED SUR •• AN PER >i A984 STATE OF FLORIDA t I A..Ir. nI .,..1--....,-- "^k in'r1naI col irvi,ir-vc+ r. ri Inn II JIC'I IC' \s f CITY OF ATLANTIC BEACH - ;� 800 SEMINOLE ROAD +i ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Total Payments: $94.00 PERMIT IS APPROVED ONLY IN ACCORDANCE. WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA BUILDING CODES. rir\,\f .. City of Atlantic Beach APPLICATION NUMBER �S s� Building Department (To be assigned by the Building Department.) r 800 Seminole Road ' _ nL ! I 3 -, Atlantic Beach, Florida 32233-5445 UCL (C t) Phone (904)247-5826 • Fax(904)247-5845 0,tl> " E-mail: building-dept@coab.us Date routed: 3 I I LI I ( City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: \tc) , Se rrn,,,Nt0 ( t, -t;1 . D ent review required Yes o uilding Applicant: 00n ,i<. { Planning &Zonin Tree dministrator Project: fLPit( I f IQ lott_ atet •'.. rcWor Public tiliti ) 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: Q pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Al Date: 3)2 f 7 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 C=�`�r, City of Atlantic Beach+J, � APPLICATION NUMBER s Building Departmenti1 p� (To be assigned by the Building Department.) s 800 Seminole Road �r Atlantic Beach, Florida 32233 5445 1�C�( 1 .-3Phone(904)247-5826 • Fax(904)247-5845 i;ti9%' E-mail: building-dept@coab.us Date routed: a )I -II11 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: \SIc) 1 Strn r O (L 0 . D ent review required Yes No inildin i Applicant: Ofin.)n,P4 Panning &Zonin Tree7Adminis rt ator Project: ft p(t t( (ft ict(,.L._ Gk ,,L is Wor Ctublic 'Me 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: ii:Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:= ,s.......,v/ Date: ?///, 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 s>.a���;,, City of Atlantic Beach ;S APPLICATION NUMBER A , Building Department /� 800 Seminole Road (To be assigned by theBuildingDepartment.)/" 5 Y. �, Atlantic Beach, Florida 32233-5445 FEB �� K`3�� (/ Phone(904)247-5826 • Fax(904)247-5845 s 2��� A..o1119? E-mail: building-dept@coab.us Date routed: 3 114111 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 qc) 1 SP-MAO (;t, 0 . D ent review required Yes No wilding Applicant: 00n Panning &Zonin Tree dminisrt ator Project: r L pAt r (f04 ClLt..- de t .. is Wor Public tilitie, 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: VApproved. ❑Den`ijcd. 4:? -121-17(Circle one.) Comments: .-lee f� mi CD/K,�{er�7� ed BUILDING PLANNING &ZONING A Reviewed by: Dater z�3//,>• 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: Revised 05/14/09 il..A.ir. City of Atlantic Beach ,.4.,,,-sis Jr.,� Building Department APPLICATION NUMBER Ir _. .,a (To be assigned by the Building Department.) A 800 Seminole Road �.� _, j Atlantic Beach, Florida 32233-5445 I� p��C K (p :‘;'. Phone(904)247-5826 •• Fax(904)247-58 ' 2017 ,7'... o;ri0 E-mail: building-dept@coab.us Date routed: a 1141 City web-site: http://www.coab.us __ APPLICATION REVIEW AND TRACKING FORM Property Address: \ti) I StrYI.,A (L V---A . D ent review required Yes No uilding Applicant: 01,3 n ,a Panning &Zonin Tree dministrator Project: r t Ptk t( I tti) cat_ ttet,L ic Wor Public Utilitie 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. ❑Denied. (Circle one.) Comments: ,, /(ii- PLANNINGBUILDING A&ZONING )� Reviewed by: Date: kr---// 7 TREE ADMIN. Second Review: A roved as revised. ❑ pp ['Denied. C W RK Com encs: PUBLIC UTILITIES 2 -14, -/ 7 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 05/14/09 `!..Arl`'=`` J- illjfr. BUILDING PERMIT APPLICATION i�\ I. LI.. :-.e' CITY OF ATLANTIC BEACH OFFICE COPY 800 Seminole Road,Atlantic Beach FL 32233 �.sno J'' Office:(904)247-5826 • Fax:(904)247-5845 Job Address: 19 Q l e�y int p)e Gga Permit Number: I 0 ti-K- 3a ,,O Legal Description 6 t-ad-1451DG- Lei'g Ab SW; I RE# I 1.0 41 5+2, Q 5..3 i) Valuation of Work(Replacement Cost)$ 27000.00 Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial (ResidentiaD • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes •No (N.-7,-* • 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: REpAt2 A4) 0 IZCpLACE !,)ECIC Florida Product Approval# for multiple products use product approval form Property Owner Information • �/O Name: 1J9 1 . a1 N Q5 Address: 2 �1 5 1,Ia Ikt— pica City 4'�` rN l't t.. Pi GAG i. State FZip 3 Aki 3 Phone I p 4- 14-9- 1 0+8 E-Mail ret(0 gAl i D IrliAtuAri, CQ M Owner or Agent ( 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 WITI-I YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Contractor Information: _ Name of Company: Qualifying 1 © [1V Le Address: City 1 State Zip 6. Office Phone Job Site/Contact Number-, State Certification/Registration# E-mail FEB 1 4 2011 J Architect Name& Phone# — , ~ Engineer's Name& Phone# Worker's Compensation . -Exempt I Insurer / Lease Emp oyces I 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 for a period orsix(6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing, Signs, Wells,Pools,Furnaces,Boilers,Heaters,Tanks and Air Conditioners,etc. Signature of Property Owner:/iee: Signature of Contractor: Befor me this L Day of 014ra cpn Before me this Day of Notary Public:_____A....),_ti_,—..1 4(J- tary Public: `o .\-e-c. , •.•z-� k • I hereby certify th. .aq +ma�cc,,„},, ,e s app. ca!`n attlti�-now the same to be true and correct. All provisions of laws and ordinances govern ',4:0,i ; l' Wr it,, :, npli d with whether specified herein or not. The granting of a permit does not presume to give a rf rJti _tfeW iv4§P24!tj-t i rnr ions of any other.federal, .state,or local late regulating construction or the pe►formance 01 co o,,,,tExpires Demmer , btu' - •:,�Pt:,1$•••• B,ro,d Thi,Troy fin Insurance 1300.3654819 Rev.3/14/16 JONES RAYMOND E +J Primary Site Address Official Record Book/Page Tile# 1921 SEMINOLE RD 1921 SEMINOLE RD 06251-00070 9409 ATLANTIC BEACH,FL 32233-5903 Atlantic Beach FL 32233 JONESJUNEP OFFICE COPY 1921 SEMINOLE RD OFFICE Property Detail Value Summary RE# 169542-0530 2016 Certified 2017 In Progress Tax District USD3 Value Method CAMA CAMA Property Use 0100 Single Family Total Building Value $133,359.00 $132,039.00 #of Buildings 1 Extra Feature Value $2,131.00 $2,044.00 For full legal description sec Land Value(Market) $213,600.00 $213,600.00 Legal Deac Land&Legal section below 8 Land Value(Age,) 50.00 S0.00 Subdivision 04162 BEACHSIDE Jost(Market)Value $349,090.00 $347,683.00 Total Area 4000 Assessed Value $191,453.00 $195,473.00 The sale of this property may result in higher property taxes.For more information go to a$Ayg Cap Diff/Porabllity Amt $157,637.00/S0.00 $152,210.00/$0.00 Our Homes and our property Tax Estimator.'In Progress'property values,exemptions and E:emptiona $50,000.00 See below 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 arc those certified in October,but may Taxable Value $141,453.00 See below include any official changes made after certification Learn how the Property Appraiser's Office values property. Taxable Values and Exemptions—In Progress 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 SJRWMD/FIND Taxable Value School Taxable Value Assessed Value $195,473.00 Assessed Value $195,473.00 Assessed Value $195,473.00 Homestead(HX) -$25,000.00 Homestead(HX) -S25,000.00 Homestead(HX) -S25,000.00 Homestead Banding 196.031(l)(b)(HB) -$25,000.00 Homestead Banding 196.031(1Xb)(HB) -$25,000.00 Taxable Value $170,473.00 Taxable Value $145,473.00 Taxable Value $145,473.00 Sales History IBook/Page Sale Date I Sale Price I Deed Instrument Type Code I Qualified/Unqualified I Vacant/Improved 06251-00070 12/2/1986 1 550,000.00 WD-Warranty Deed Unqualified Vacant 06406-00868 9/25/1987 $143,300.00 I WD-Warranty Deed Unqualified Improved Extra Features LN I Feature Code I Feature Description 1 Bldg. ' Length I Width I Total Units I Value 11 FPPR7 Fireplace Prefab 1 , 0 0 1.00 15607.00 2 DKWR2 Deck Wooden 1 26 ( 13 338.00 1$1,437.00 Land&Legal Land Legal ILN I Cede I Use Description Ini g I Front 1 Depth I Category I Land Units 1, Land Type I Land Value I I LN Legal Description I 1 10102 I RES HD 20-60 UNITS PER ACI ARG-MI 40.00 1 100.00 I Common 140.00 Front Footage'; 5213,600.00 I I 42-14 09-2S-29E 2 BEACHSIDE 3 LOT 8A BLK I I +;3 Buildings —I Building 1 Building 1 Site Address I Element I Code Detail 1921 SEMINOLE RD r-- Atlantic Beach FL 32233 Exterior Wall 14 14 Wood Shingle (-+ ' F`1 I4-4-1 _ Exterior Wall 18 8 Horizontal Lap Building Type _0105-TOWNHOUSE Roof Struct 3 3 Gable or Hip il ss Year Built ^1987 Roofing Cover 3 3 Asph/Comp Shag F� Building Value 5132,039.00 Interior Wall 5 5 Drywall Li_ 1 Int flooring 12 12 Hardwood 1' L L r I FGR Ty� Gross Heated I Effective I Int Flooring 14 14 Carpet L Area Area Area Heating Fuel4 4 Electric ( 1 I i http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1695420530 2/12/17,10:23 PM Page 1 of 2 Finished upper 937 937 1890 Heating Type 4 4 Forced-Ducted story 1 Air Cond 3 3 Central Finished Open 102 0 31 Base Area ' 1013 1013 1013 I Element Code Finished Garage 420 0 210 Stories 2.000 Finished Open Bedrooms 3.000 I Porch 59 0 18 I Baths 2.500 O CIC I C E COPY Total 2531 1950 2162 Rooms/Units 1.000 r I�` V V 2016 Notice of Proposed Property Taxes Notice(TRIM Notice) ITaxing District I Assessed Value Exemptions I Taxable Value I Last Year Proposed I Rolled-back Gen Gov Beaches $191,453.00 $50,000.00 $141,453.00 $1,142.17 $1,153.01 $1,081.93 Public Schools:By State Law $191,453.00 $25,000.00 $166,453.00 $803.98 $758.03 $782.00 By Local Board $191,453.00 $25,000.00 $166,453.00 $371.20 $374.19 $361.04 FL Inland Navigation Dist. $191,453.00 $50,000.00 $141,453.00 $4.48 $4.53 $4.23 Atlantic Beach $191,453.00 $50,000.00 $141,453.00 $466.40 $470.83 $449.17 Water Mgmt Dist.SJRWMD $191,453.00 $50,000.00 $141,453.00 $42.36 $40.81 $40.81 Gen Gov Voted $191,453.00 $50,000.00 $141,453.00 $0.00 $0.00 $0.00 School Board Voted $191,453.00 $25,000.00 $166,453.00 $0.00 $0.00 $0.00 Urban Service Dist3 $191,453.00 $50,000.00 $141,453.00 $0.00 $0.00 $0.00 Totals S2,830.59 $2,801.40 $2,719.18 Just Value Assessed Value Exemptions Taxable Value Last Year $352,114.00 $190,123.00 $50,000.00 $140,123.00 —T Current Year $349,090.00 $191,453.00 $50,000.00 $141,453.00 2016 TRIM Progeny 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. 2016 2015 2014 4 , •To obtain a historic Property Record Card(PRC)from the Property Appraiser's Office,submit your request here: More Information 'outact Us (Parcel Tax Record I GIS Map I Map this property on Google Maps I Lay Fees Record http://apps.coj.net/pao_propertySearch/Basic/Detail.aspx?RE=1695420530 2/12/17, 10:23 PM Page 2 of 2 CITY OF ATLANTIC BEACH OFFICE COPY W NER / 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 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 $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. tgzi SF.M'NoLs a1 ri-LAArr,c ai-acrd ft 3zz3J qoL - 2 - L/ ' ADDRESS PHONE NUMBER RAymoma E 50ti£J' PRINT AME 116. 2 - 3 - 17 SIGNAT E / DATE Before me this \" day of MAW 20`l in the county of Duval,State of Florida,has personally appeared herinly himself/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of L .County of W- 03.--C1 • Personally Known •;rice , COLLEEN A.KEELING 0 Produced Identification- .a ., Commission#FF 074450 '-4= Ex res D• :mber 7,2017 \ Pr•- v :. TUa,t• in 800405.7819 ,��►__ Notary Signature: •w MM. F:BLDGOwner-Builder Affadavit;REVISED:4/16/2009 , REVIEWED FOR CODE COMPLIANCE CITY OF ATLANTIC BEACH OFFICE COPY SEE PERMITS FOR ADDITIONAL ��-REQUIREMENTS AND CONDITIONS REJVIEWED BY: /iI DATE: 3/2-M ;7---- R EXIST 2.><(-0 11 -c & ? A RDS 2xIa (A)/ O sg:l�lq LAG // ro sTS `��� �"f" Vous 032"e* o ...1\9 (T'eP (GAL) 1 \,_ jig_ e ,.... -, Q _, -4 2X.0 @l-a'°i 2x$ @j_41\ OIC 0- 9 L-0/zr 15-I --AtJGERa-P \ 0 n c C \ z o• Cal---SaG7' Ta ?DST u 12- 2' DIA. 130 1._75000.ppiitioni uttttp rt `Z`••,. GENS. ��%, G . f 3'-0 3`-0 �o`—a 6`-o =�.= ^���1E�. ':pcP' '� / = �� ,�'No.33996 -4-- _ * 441 I� ; STATE OF PECK. FKPrM t t NG PLAN N ‘10'44,,:<6••.ORIO._%c, �.�', scAL : 14'.‘ -_ ('-a" ��mNAL„E SH ,ET” 1 or 2- t t TALL BE HOT DIP GALVANIZED OR F'EORU {Z`{ (4-, 2017 AL SHALL BE PRESSURE TREATED I.HERwISENOTED. - n' :AS • Mal 38 JONES RESIDENCE S i ' • • a v 1N NM- n 13. 1921 SEMINOLE ROAD 0 I( IV 0 Sill 83 3 NEPTUNE BEACH, FLORIDA V i II ltd •• Alt 33NVI -1/11.0 •3 aQ a3r�- nay DECK REPLACEMENT .EX1STIN/ p15 gX)STWG Fc Rc XI�T (2. g - GENERAL NOTES: 1 . ALL HARDWARE SI STAINLESS STEEL. 2. ALL WOOD MATERI #2 Y.P., UNLESS 01 ZX2 13(c.1<57.5 ' v. rxtst . 2KG . •ti iii ilLI 2xlo tom; _ 2x& r Kg 4x4 PosT / JatT WANG5R 15E`(vN 1? (-rYP. EA, gist)) OFFICE COPY . sEerl oto 11-J3 11111111,:1))/ iiii E. ,;N�`.N.:*GEN • i `� •. o.33996 1.147-1 fir 2<<�� t• * = N. ope„rn Lim -cla i ,A s STATE • OF �•� R, 312, 1, 3, eet•epHon 0 2 - 6 it 5pAvre +��.�p,.,.��O ,� ros •,,................. ................ � hadd no�- posS � 1, "`,),,,,,,51101NIA1-1�,,,��,`,� ell ti.f _r 2. oF l ty 5,-1, ealf L, R•3/1. 7- s, U-) 'FEZRUAK`( 1412-01 JONES RESIDENCE 4)41-0-A4)� r R 311,7-g, 3 1921 SEMINOLE ROAD . NEPTUNE BEACH, FLORIDA DECK REPLACEMENT ii 1 • 1 -,<2. ?IGK -T6 TYp 1 . ' I&• NI(Kr. k � r T� i�S i - N W 5x 1sr co•v- • . z .. ' 2.5tLIP ---,.. dlii - , .....:. 1.....1�,— .. . MEM MIMI 11.1M...�� `' all til Trr 0C\ • ►,1►� . u 4w rw 2x - 6. p --- xAs-I- 2x& 5) (4'r , n • ,.. .., . -0 \1/4. •- ,--r-4 ' ,- • ' 4 , ; „. i .. c ! 2 P.1 A. 'g 12 % N 74 V.7 r—, :•. , . jii_ 6„iir,t . 4 R.0T. _ CrYP, ro5TI/QG) 5E. C.sr t 01.1 A-A r7 34 mots 1 no mane . -I'Aan 34" ' In h ei5hl- a 11ow pe Y. Pli3A4- oft B /ct%rs . P(3L- 2eSF644114/ a.� 14arid rai' I 5rj ) S % Ze- Frk - R.Pa. -h f 00f(4 s-4-A el 7y pe . ' De. type Dilly. i1' )- 2-4-17