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880 SAILFISH DR - FENCE (2) , ,.. " ;, :„f CITY OF ATLANTIC BEACH s) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 '--011 !) INSPECTION PHONE LINE 247-5814 FENCE WALL OR BARRIER - FENCE MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: FNCE17-0010 Description: 6 foot wooden fence Estimated Value: 3000 Issue Date: 5/24/2017 Expiration Date: 11/20/2017 PROPERTY ADDRESS: Address: 880 SAILFISH DR RE Number: 171162 0000 PROPERTY OWNER: Name: MCKENNA ANGELA E Address: 880 SAILFISH DR ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Address: Phone: PERMIT INFORMATION: Please see attached conditions of approval. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. 01.A1J;.4, City of Atlantic Beach APPLICATION NUMBER Js 40` 1 � Building Department (To be assigned by the Building Department.) A-.;� 800 Seminole Road ,, I ++ _ 7� `r) Atlantic Beach, Florida 32233-5445 rt �� 1 �L' V Phone(904)247-5826 • Fax(904)247-5845 x si 9? E-mail: building-dept@coab.us Date routed: OS l cl City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: � SaA�S' 'Of Department review required Yes o Applicant: CAA Manning &Zoning pp,,,, Tre A� dministrator Project: ( Q P��L� �0' � WDvU -n- --n(0 °: '- s� • ilities 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: fVoc.. PLANNING &ZONING Reviewed by: `� 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 07/27/10 rsy�y;,JCity of Atlantic Beach APPLICATION NUMBER lJ. Building Department (To be assigned by the Building Department.) f 1.- 800 Seminole Road Atlantic Beach, Florida 32233-5445 F706-6 + F — QC; (0 Phone(904)247-5826 • Fax(904)247-5845 '�c ) E-mail: building-dept@coab.us Date routed: GAS 1L j I City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �� SC- A- SA`Q{, Department review required Yes No Applicant: bW CRlanning &Zoning Tree Administrator Project: 10' p,,- 0O J \AYbc- ' -r't(Q • ' ilities 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: KlApproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed byJ - v /cam Date: 5 72-3/ I ? 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 07/27/10 s=Lpr City of Atlantic Beach APPLICATION NUMBER r + • ��. BuildingDepartment• \5,, p (To be assigned by the Building Department.) r 800 Seminole Road '-e Atlantic Beach, Florida 32233-5445 C E r" r tU CE I I- — o C, (t',� Phone(904)247-5826 • Fax(904) 247-5845 `"!0;119%' E-mail: building-dept@coab.us MAY 15 Date routed: ds L 111�- City web-site: http://www.coab.us Z�i 3 APPLICATION REVIEW ANo TRACKING FORM Property Address: 0 SCL ,S( °3{, Department review required Yes No Applicant: DA (1,1W -PJanni, p &?oning j_ rr 0,, Tree Administrator Project: I. _c�L L (0----DO V OAO-A--n(Q -- WQrk. • • ilities 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: 4e iff��• 4,042iiii BUILDING i PLANNING &ZONING Reviewed by,:---/ j�J,�laia___Date: % f TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. 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 r11:L`Jj-.4., City of Atlantic Beach APPLICATION NUMBER j' '',. s, Building Department (To be assigned by the Building Department.) 800 Seminole Road (VI i (C' �r Atlantic Beach, Florida 32233-5445 1 Phone(904) 247-5826 Fax(904)247-58 pi MAY 1 `��;���%= E-mail: building-dept@coab.us � 2�1� Date routed: C'�S70— I 1�- City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: WO SCL SIA,Lj{, Department review required Yes No Al: - 41:n. Applicant: CNA n C—Planninng &_Z_oning r p,, Administrator Project: ( .6) -CC(--/L1---- DO -k— Wtb0/10A 4—I1(Q ublic Utilities Public Safety Fire Services Review fee $ Dept Signature w' (., 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: APPLI ATION STATUS Reviewing Department First Review: I Approved. ❑Denied. (Circle one.) Comments: di BUILDING PLANNING &ZONING �c//( Reviewed by: Date: TREE ADMIN. Second Review: !Approved as revised. ❑Denied. P WORKS Comments: PUBLIC UTILITIES .5-is-ry PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: (Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 07/27/10 a,a y;. - FILE COPS( 1-• :t, BUILDING PERMIT APPLICATION 15 if - - 2 ��, CITY OF ATLANTIC BEACH DATE �~ 800 Seminole Road,Atlantic Beach FL 32233 ortisr? Office: (904)247-5826 • Fax: (904)247-5845 S-. e--1 Job Address: 8t 3 S a,Ri S n ri ,r-C- Permit Number: Do(6I.1—O0 (0 Legal Description RE# Valuation of Work(Replacement Cost)$3 000 Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): el Addition Alteration Repair o Pool Window/Door • Use of existing/proposed struc ire s) (Circle one): Commercial Residential • 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: mon IAJtdaR". lv‘CA- ivN toac,L S to fe ea-ce, CA k -i- Florida Product Approval#_ for multiple products use product approval form Property Owner Information Name: AnofA'a N\ -vin a Address: 3g b S 4\ V\S.V. DN('\‘1`f.. City A41ar 6La-c ti. State-FL Zip 3)-.)-- 1 Phone 9o4-1-Sr- 1$4a E-Mail aQMnC ...enha 3 l(,l- 1--c+0-Laws 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 Ag ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. ECEIVE Contractor Information: D Name of Company: Qualifying.Agent: Address: City StagiTiri 8 2017 Office Phone Job Site/Contact Number State Certification/Registration# E- 4 ail Building Architect Name&Phone# `�_ • City OtA Department Engineer's Name&Phone# �.� Chi FL Worker's Compensation --„,-,. Exempt / Insurer / Lease Empl. ees / Expiration Date Application is hereby made to obtain a permit to do the work and installations as indicated. 1 ce i 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 I • s regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6) months, or if construct •n or work is suspended or abandoned for a period of six(6)months at any time ajler work is commenced. I understandthat separate permits nuts se secured for Electrical Work,Plumbing, Signs, bells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. Signature of Property • •. er: � Signature of Contractor: Befor me . this b Da of V' , 'el "•::7 efore THl'a ti t.ESPERGER t. Day - /1� 1. � ,r •_'' MYCOMMISSION+tFr524 5' of `� ,,�_ - EXPIRES:October 6,2019 NotaryPublic: •gllgill( ''f 'ot:r P)flilb it aublicUrderxrtes • • I hereby cert j'that I have read and examined this application and know the same to be true and correct. All pi-ovine s o laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of ape •,t does not presume to give authority to violate or cancel the provisions of any other federal, state, or local lcnv regulating construction or the performance of construction. Rev.5/2/16 t FILE COPY ,., CITY OF ATLANTIC BEACH AiIt CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS NNE - 1 800 Seminole Road 904-247-5800 o1s Vr Atlantic Beach,Florida 32233-5445 Fax 904-247-5845 PERMIT# PLEASE SUBMIT(2)COMPLETE SETS OF PLANS WITH APPLICATION. Date `j-$- nISSUES BY THE CITY Job Address SRO Say t'&5t+ ( v E-mail 2etnnck-evnh331(oem covn Permitee: )1/4/B'-V-0/ina Telephone# 909-1155- 1$M1 Permitee Address: %g-D Requesting Permission to Construct: Ls oad �Cv��Q I (Q - k Location: (Reference to Cross-Street) 1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Utilities/Municipalities: Jacksonville Electric Authority Yes ( ) No ( ) Date: Bell South Telephone Company Yes ( ) No ( ) Date: Ferrell Gas Yes( ) No( ) Date: Comcast Yes( ) No ( ) Date: 2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permitee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision of (Contractor's Project Superintendent) located at Telephone#: 4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee. 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. 6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit. Calculations showing any increase in impervious area on owner's lot or in the city Right of Way are to be included with this application. 7. This permittee shall commence actual construction in good faith with days. If the beginning date is more than 60 days from date of permit approval, then permittee must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four(24) hours prior to starting work and again immediately upon completion. OWNER Signed: A VLA Date: 0 Before me this VV\ day 7oNI civ gra �`E":}- ' in the County of Duval, State Of Florida, has personally appeared 0 F/YcO 'lS c`, s2=a, Notary Public at Large, State of Florida, County of Duval. My ,. EXPIRES.CO fl1 itm ai pires: ry o;; .... B_.1drd?hr tzry , d' _ ,� _ Personally Known: • Produced Identification: Revised 7/29/15 i Permit Attachment of for Permit# issued ,20_Atlantic Beach,FL 32233 Owner's Name: Property Address: R.E.#: Subdivision: Lot#/Block#: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT,issued on this day of ,20_, by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as "CITY" and of Atlantic Beach, Florida, hereinafter referred to as"USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers ted above(copies attached). This work is generally described as: ,Q.G1ae Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty(30)days notice by CITY to the USER, said notice to USER shall be given by certified mail, return receipt requested, to the following address: The depositing of said notice of cancellation in the United States mail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating,replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code,and all other land use and code requirements of the CITY,including City Code Section 19-7(h)which states"Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." Page 1 of 2 The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach,Public Works Department, for said change. The USER shall,at the discretion of the CITY, be requested to submit as-built drawings showing the change within thirty(30) days after the day of completion. This permit shall insure to the benefit of, and be binding upon, the USER and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use limitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this day of V1 , 20 I — By: Pro erty O er (to be signed in presence of the Notary) re.a.,..arardwoBarramakoramarerserarmamparrer _ ,:,'411 r' TONI GINDLESPERGER STATE OF FLORIDA : MY COMMISSION#FF 924951 COUNTY OF DUVAL �? EXPIRES:October 6,2019 .,�(f 1 a Rcnded Thru No:ery Pcblic UnderHoters On this es day of L 20 , personally appeared before me, a Notary Public in and for s� county--( d State, Q the property owner of S Or` ,Atlantic Beach,Florida,known to me to be the person(s)described in and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the uses and purposes therein mentioned. Notary Public in for said County and State , CITY OF ATLANTIC BEACH, FLORIDA, a municipal corporation: Approved: Kayle Moore,Public Works Director For Permits where city sidewalk is impacted, City Manager approval required: Nelson Van Liere, City Manager Page 2 of 2 • J _ -.., RLE COPY . '" CITY OF ATLANTIC BEACH 'a- }v '0%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 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 $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN"OCCUPATIONAL LICENSE"IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THEW BUILDING DEPARTMENT(247-5826) IF IN DOUBT. .ZU CA N V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE• .... Z J Z ry STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF ANJ C) z O v1 OWNER-BUILDER PERMIT. 0. Q O 2W - o • Om ~ z 23YU S4N, 0rt _ 90K - -1- s- (Via- W 0 8 8 o ADDRESS PHONE NUMBER Q f" Q a Z Arr\el a MC{e.lv va o o d7 c.-1.•PRINT AM U ..1 H Cc 2 GN TU 5 ^$- 1i o 2W Q� i�n DATE 0 4. Before me this v day of f y 20 1 in the county of W W 5 c3 Duval,State of Florida,has personally appear herin by himself/herself and affirms that W all statements and declarations are true and accurate. I`LI Uwla Notary Public at Large,State of IL ,County of 1.),-(\i \ t1J ¢ W ❑Personally Known Ai* _00 , ..S 5 G Lc — ❑Produced Identification1 ED Notary Signature: ��r / , r7,77-77 --177,777:E7"',,,,xN F 924951 Odl VGIF _• MY COMMISSION �i EXPIRES:October 6,2019 F:/BLDG/Owner-Builder Affidavit;REVISED:4/16/2009cr ° Bonded Thru Notary Publx underwriters /` c- 1 ,..1 ' CITY OF ATLANTIC BEACH �'M 0)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 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 MUS BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT I. LII cc YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAV 0] LICENSES REIUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSIN,. 0 ORDINANCES. a I. LL II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THE IR =� W THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURAN(E G PURCHASED. z Cl) III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULI, (I,RI OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKER . Cl„ EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDE*4 '= Z CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STAT • E NO. O ' 455-228(1). AN"OCCUPATIONAL LICENSE"IS NOT ADEQUATE. THE OWNER SHOULD PHY`'CALLY 1"' 1 SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRA 'I UKS 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 L STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF Al OWNER-BUILDER PERMIT. 0 S coZ Y0 Ck;\(t)l., tJ rk` %L( - --SS- 064-( - v a o �,.� ADDRESS PHONE NUMBER Z is o eta M elteta • o co c z PRINT AME V V a 3 0 W • S -S- f ozzi GN TU DATE Q at o �` VIA N y Before me this V day of ►I.A 20 I' in the county of CC Q F� ~ Duval,State of Florida,has personally appear herin by himself/herself and affirms that 0 M Ul all statements and declarations are true and accurate. IL LLQ 2 Notary Public at Large,State of S L ,County of f U V \ W O n Q ❑Personally Known 7 • c��y Co _ � illW Q W ❑Produced Identification Z �v —OO 1 7 W V N LIQ . / Q LL . 1.---:r." TGty{GIt1DLESPRGER W U. Notary Signature: 0 r� '� r& = MY COM1t�I{SS{Oti rF 495 U. >` 2019 VW v�'I EXPIRES:October 6, F:BLDG/owner-Builder Affidavit;REVISED;4/16/2009 •:;F c;�.°Q'� BondedThn+Nol�'PO�cUndervRiters F -0 (A0 BECEIVEU MAY 19 2017 R.O.W.Permit Attachment BYef for R.O.W.Permit# issued ,20 Atlantic Beach,FL .32233,---- r • Owner's Name: G�� �Il��e n a• ( -•` E C i `-=' ULE Property Address: $$0 Say vc-,c L, Or MAY 1 8 2017 ` LdSubdivision: R.E.#: J REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this day of , 201 by Atlantic Beach, Florida, a municipal corporation organized and existing under tellis of the State of Florida,hereinafter referred to as "CITY"and of Atlantic Beach,Florida,hereinafter referred to as"USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit n hers noted above(copies attached). This work is generally described as: c\e Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty(30)days notice by CITY to the USER, said notice to USER shall be given by certified mail, return receipt requested, to the following address: The depositing of said notice of cancellation in the United States mail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. • In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating,replacing,or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes,Land Development Code,and all other land use and code requirements of the CITY,including City Code Section 19-7 (h) which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." Page 1 of 2 4r The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach, Public Works Department, for said change. The USER shall, at the discretion of the CITY, be requested to submit as-built drawings showing the change within thirty(30)days after the day of completion. This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use limitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this 1 ?) day of (/y\2,�y , ‘----+.20 � . 0 By: (f------- Prop rty Owner (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this 1 t day ofrIA , 20 (j-, personally appeared before me, a Notary Public in and for said C. ty and te, ' t q_ the property owner of Atlantic Beach, Florida, known to me to be the person(s) desc • in and who executed the foregoing instrument; who acknowledged to me that he or she exec , -d the same-ly. d voluntarily and for the uses and purposes therein mentioned. 1. Notary Public in for sat. ount,I: d State ii TONI GINDLESPERGER ,C MY COMMISSION#FF 924951 k` EXPIRES:October 6,2019 ,-:',./..."...,,, `. °t', Bonded Thru Notary Public Undenvrters CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: sj ii if / I. • I. aco.owv, ''. x4 J&Pubic Works Director -rca u ik„,„ File: 12/12/16 • Page 2 of 2 MAP SHOWING BOUNDARY SURVEY OF LOT $ BLOCK 4 AS SHOWN ON MAP OF ROYAL PALMS UNIT ONE AS RECORDED IN PLAT BOOK 30 PAGES 60-60A OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY,FLORIDA. CERTIFIED TO: ANGELA E.MCKENNA,EVERETT E.GARVIN,JR.,BEVERLY J.GARVIN,VYSTAR CREDIT UNION p� OSBORNE&SHEFFIELD TITLE SERVICES,LLC,FIRST AMERICAN TITLE INSURANCE COMPANY JY \ 1 / I/U —' ,�1`r C2 SAILFISH DRIVE(60' R/W) J FD.Y"I.P. NO ID. • S85°20'021, 80.66N) b E 80.65 P) FD.NAIL/DISK#7261 0.5' (IN TREE ROOT) 8.1' 18.4' • FD.#4 REBAR #7261 S85°20'02" E 80 .65'(p) • S °10'47"E 80.71'(M) 85 `*I CONC. c\J 'DRIVE 6? 0, N 1 oi 25'B.R.I�pLATj CONC.yWALK7 • I 18.0' _ Z a ' Z Ci 24.7' Li 17.5' 2 0 I- o l v0 00 /-0.6. o s— co Li,Cr o X 10.0' Cr o U N OOD 0 E. LOT 9 1 STORY I a �; MASONRY 10 4' 0.3' W oo #880 4'c F� " I 0 63 to ' Ac rn LOT 7 ;") M1 • V0 o d • - zO 27.7' °z 24.7' I LC 28.?' . o LL O 0) r 1 d1Ov - 3 COo u. . . o I p 0 si C� _ _ _ _ / •'" �-� �L_10'EASEMENT FOR 0 _ — a FD.Y2"I.P. 4'CLF RAINAGE ANO UTILITIES M 0.1'I 0.7' — — — 4 ` AA NO ID. 4'CLF o o — / '? 0 / o ' _ — — o o6 000 q F0.Yi'I.P. 7 ��F � N85 20 02"W 69.35' P - - - NOLO. // / `Q� SET NAIUDISK N84°54'47"W , — — — _ _ / &6 j 0. #6715 69.39'(M) / GJ •/ �-el, (IN TREE ROOT) '0.o\• 2�/ ,Q - e • 59/ c1 c°/y59" LOT 24 . LOT 25 • LINE TABLE LINE I LENGTH BEARING S59°08'20"W LENGTH(M) BEARING(M) L1 13.88' 13.70' S59°01'20"W FERRET ANIS ASSOCIATES; INC. 5627 ATLANTIC BOULEVARD SUITE#6 ,JACKSONVILLE,FLORIDA 32207-(904)805-0030-FAA(904)805-9888 GENERAL NOTES: LEGEND °/P' (11 BEARINGS SHOWN HEREON ARE BASED ON P.C. POINT OF CURVATURE R RADIUS °�� P.T. POINT OF TANGENCY Dor D DELTA(CENTRAL ANGLE) THE SOUTH R/W LINE OF SAILFISH DRIVE AS P.R.C. POINT OF REVERSE CURVE A orL ARC LENGTH _ S85°20'02"E,PER PLAT. P.C.C. POINT OF COMPOUND CURVE C or CH CHORD i"(. P.O.C. POINT ON CURVE CB CHORD BEARING (2) THIS PROPERTY HAS NOT BEEN ABSTRACTED P.R.M. PERMANENT REFERENCE MONUMENT (R) LINE RADIAL TO CJRVE P.C.P. PERMANENT CONTROL POINT AIC AIR CONDITIONER FOR EASEMENTS,COVENANTS.RESTRICTIONS B.R.L. BUILDING RESTRICTION LINE CONC. CONCRETE CLF CHAIN LINK FENCE FD. FOUND (3) UNDERGROUND UTILITIES SERVING THIS RAN RIGHT-OF-WAY I.P. IRON PIPE PROPERTY HAVE NOT BEEN LOCATED OR O.R.B. OFFICIAL RECORDS BOOK (M) ASURE SHOWN on. ONLINE I>FE CE -n.-- BREAK LINE (4) IT IS THE LENDER'S RESPONSIBILITY TO SCALE 1"=20' DETERMINE FEMA F.I.R.MAP STATUS FOR THE .............'"�/ r LIFE OF THE LOAN ON THE PROPERTY SHOWN 8-6-15 d C . ABOVE.SURVEYOR HEREON WILL CONFIRM �— FOR ADDITIONAL FEE. DATE OF FIELD SURVEY NATHAN P. PERRET, FLA.CERT.NO.6900 LB -6715 F.B. 569 PG. 30 NOT VALID WITHOUT THE SIGNATURE 8 ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR&MAPPER ORDER NO. 2015-1410