1840 LIVE OAK WIND INT REMODEL 2017 ?1�1
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL -ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES17-0067
Description: interior remodel R replace window
Estimated Value: 25000
Issue Date: 6/30/2017
Expiration Date: 12/27/2017
PROPERTY ADDRESS:
Address: 1840 LIVE OAK LN
RE Number: 1720201428
PROPERTY OWNER:
Name: CAVANAGH MICHAEL J
Address: 1840 LIVE OAK LN
ATLANTIC BEACH, FL 322334510
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$7,500.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
1. 800 Seminole Road (Q--)
Atlantic Beach, Florida 32233-5445 I�l�
Phone(904)247-5826 Fax(904)247-5845
Email: building-dept@wab.us Date routed: O�I<<1IIa-
Cityweb-sitehffp://w coabus
APPLICATION REVIEW AND TRACKING FORM
Property Address: I 0'l 0 U JL Du Y_ C'n - Department review re uired Yes No
,,�" / Building
Applicant: �l�r un Planning B Zoning
1 Tree Administrator
Project: IiOA l0( ttMOW � ( .�lQ(-�- Public Works
w. ,O Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: ]Approved. ❑Denied. . ❑Not applicable
(Circle one.) Comments: A
BUILDING `t I� S
PLANNING&ZONING Reviewed by: Date: r
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. . ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . []Not applicable
Comments:
Reviewed by: Date:
Revised 0911912017
Building Permit Application
0 City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904)247-5826 Fax:(904)247-5845
Job Address: 1840 Live Oak Lane,Atlantic Beach,FL 32233 Permit Number:
Legal Description Lot 13 SELVA MARINA UNIT NO.12-C REPIAT RE#1720261428
Valuation of Work(Replacement Cost)$__L5.000 Heated/Cooled SF 3272 Non-Heated/furled 400
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Qrcle 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: complete renovation of master bathroom:moving water closet to new location;
new shower;new tub;combine two closets to make one large doret new vanities;new sink;nen lighting;two naw ezrerior windows
Florida Product Approval# FL — I S 3'fI • I for multiple products use product approval form
Property Owner Information
Name: Vanessa K.Harper&Michael Cavanagh Address: 1840 Live Oak Lane
City Atlantic Beach State FL Zip 32233 Phone 352-2840500
E-Mail vkharpehOgmail.com or cavanagm®comcaecnet
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required) Ownere:Vanessa K.Hamer&Michael Cavanagh
Contractor Information
Name of Company: NSA Qualifying 11
Address City
Office Phone lob Site/Contact Nun
State Certification/Registration# E-Mail ''-`
Architect Name&Phone#
Engineer's Name&Phone# -
Workers Compensation
Exempt/lm mr/lease Empbyees/&O%ti2nDate-.... _
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 the laws regulationg
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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.
(SigYature or or Akent including ContraNr) (Signature of Contractor)
Signed and swornto(or affirmed)before me thi r day of Signed and sworn to(or affirmed)before me this_day of
G ce ,car by
wrcokMlssYia' Ill �'
�j EXPIRES:Decal 1r,2018 ig ur Iota (Signature of Notary)
x2gf j' eoGEOR MYrRS lxEvnbn
(r1 Personally Known OR [ I Personally Known OR
[ I Produced Identification [ I Produced Identification
Type of Identification: Type of Identification:
NOTICE OF CO1VMENCEMENT
State of Florida County of Duval
Tax Folia No. 172020-1428
To Whom ItMay Coocem:
The undeeaignedhersbyinfarma youthat improvements will be made to cerminrealproperty,and in accordance with Section 713 of
the Florida Standegthefollowinginfonnad.issitedhrthis NOTICEOFCOM,MH cm,MNT.
Legal Description of property being improved:
Lot 13 SELVA MARINA UNIT NO.12-C REPLAT
Addressofpropertybeingm,lem ad: 1840 Live Oak Lane,Atlantic Beach,FL 32233
General description oflmprovement, complete renovation ofthe master bathroom movmgwaterdoaet to nmlocatiom
newshow,—. 1ub;combim two dose[sto make one large doses new vamhea;new stake;new Lgbbn$newezteriot win w
Owner: VanesseK Harper&Michael Cavanagh Address: 1840 Live Oak Laua,Atlmtic Beadu FL32233
Ownsi's.interrstin site afthe improvement: renovetionofthemssterbathroom
Fee Simple Titlehohler(ifotbmihmovmm): N/A
Name:
l Contractor: Vanessa K Harper and Michael Cavanagh
p` Address: 1840 Live Oak Lane AOanuc&ads.FL 32233
C TelephoneNo.: (352)284.0500&(904)386-7254 Fax No:
N)/1
Sandy(if MY) N/A
Address:
Amount ofBond$
Telephone We: Fax NO:
Name and address of anyparean making a lom for the co
natruetion oftha improvements
Name: N/A
Address:
phone No: ` Fax No:
Name of person within gra State of Florida,O&ar than himself, designated .
by Owner upon whom noticss or other documents may
served: Name: N/A
Address:
Telephone No:
Fax No:
In addition)to as�wsaet desigsaree the following person to receive a copy of the.Lienm's Notice as provided in Seedrm
713.06 Mll in at Owner's option)
Name: N/A
Address:
Telephone No:
� FazNo:
Bxpimgon date of Notice of Commencement(the expiration date is one i
specified): ( )Year from the date ofrecordmg unless a diftmul date is
1HLS SPACE FORRECORDER'S USE ONLY OWNER
Signed: net: �l Ei�i qfi
Betoxe ;A
day of /� in the Comity ofDuvel,Stara
OfFlonds,has personally appeared
P.R
Prodmed ldentlE�g4on: °f
NsroryPublic: YL�...._��✓�j'��
MY wmmissi0n_exP'fr°s.7 / /'
Doc p 2017142856.OR BK 18022 Page 1757,
Number Pages:1
Recorded 06/19/2017 at 09:54 AM. r .die.=rE
19NO !
Ronnie Fussell CLERK CIRCUIT COURT DUVAL y? FF 942491
COUNTY . er 17.2019
RECORDING$1000 z0kuwmAY'e
CITY OF ATLANTIC BEACH
OWNER / BUILDER AFFIDAM
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 EMETION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERASE THE CONSTRUCIION YOURSELF YOU MAY BUILD ORIMPROVEA ONE—OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL BUILDING AT A COST OF 525,000.00 OR LESS. THE BIDING
MUST BE FOR YOUR USEAND OCCUPANCY. IT MAY NOT BEBUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHN 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 E7{ APIION. 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 RESPONSBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
Ill. 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.
N. 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 LI N '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.
1840 U.Oak Lane,Atlantic Beach,R 32233 352-284 0500
AOORESS PHONE NUMBER
Vanessa K.Harper
PRINT NAME
l
SIGWITUR I-/". OmwBelpre me tbis ,,� yef ,fPgA— .20/?In the county el
Nu I,SiMad Fbida,bas PereonaRyal ared M1min Ery bbwE/bwaelfaM algmm XM
all satemelda and dedenra ns are true and a=aale.
N/et.q Public at Large,Male of A,County or h✓ L
QPmw.anwm GEORGERAYWASHINGiON
O Puxl,E Nemm®tion- 4 '
Y MYCOMMISSION, Fg42437
... EXPIRES:December 17.2019
'aA4t> m„ew7nmxowwMagnteraan
Notary Sgnature: -
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