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705 AMBERJACK - VOIDED PERMIT NOTES RGP /Res17-o1 ZO , City of Atlantic Beach APPLICATION NUMBER isis Building Department (To be assigned by the Building Department.) "( ,� )•?, 800 Seminole Road R �S 1 � , • j.• Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax.(904)247-5845 �c jc E-mail: building-dept@coab.us Date routed: - I (O City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address:705 �NtC�F� C' K Department review required Yes No uildin Applicant: ft ERI('.Axs C L.PISS7 Q., • anning &Zoning) Tree Administrator Project: r G--r() Si Pt "M i L`� I-4efrr—ublicWorks blic 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: ❑Approved. Wenied. . ❑Not applicable (Circle one.) Comments: BUILDING �MM�.MT5 PLANNING &ZONING 1 Reviewed by: R �. si!1k • Date: 1 (o el 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 05/19/2017 1.1v j7, City of Atlantic Beach APPLICATION NUMBER 0 II' ". Building Department , �;,t (To be assigned by the Building Department.) - 4 1800 Seminole Road .y , Atlantic Beach, Florida 32233-5445 ES 1 7 — • Phone(904)247-5826 • Fax.(904)247-5845 ;71117. E-mail: building-dept@coab.us Date routed: - I (p City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address:`7OS �wlgp�RSAC (-c i Department review required Yes No uildi a :3 Applicant: rn(=j�j(`�/�� e. L.►�SS c . /, 1a,nnrung &Zoninis Tree Administrator Project: Mc--.-5E,0 Si vCxL% PA}yyl, t L1/4--( Me ublic Works ublic Utilities j 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: QApproved. Denied. . ❑Not applicable (Circle one.) Comments: BUILDING 1��% (. 4Ca.V. /`'[v% ��e,`yA+ lU (cide PLANNING &ZONING Date:b /2 )-�(7 Reviewed by: TREE ADMIN. Second Review: ['Approved as revised. ['Denied. . ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: QApproved as revised. ❑Denied. . ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 yl--,x City of Atlantic Beach s�t's'v E�"', E , _,,, APPLICATION NUMBER r k',, ' .,gin Building Department I (To be assigned by the Building Department.) 4 )s� 800 Seminole Road JUN 1ii ,y._ •r Atlantic Beach, Florida 32233-5445 ate 6 2017 1� �� 7 _ • 7117, Phone(904)247-5826 • Fax 247-5845 �r ji,� E-mail: building-dept@coab.us Date routed: (O City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 705 F�fkeR LJV Department review required Yes No uildina Applicant: Pk rnC:2i(,jam, C L6ss-te, Ham " anning &Zonings Tree Administrator Project: M€--,1,0 S i x. (--),t PA-nit ; LL ko in& ublic Work—s:) ublic Utilities Public Safety Fire Services Review fee $ cb Dept Signature )C1 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. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING W 14-0// lam ' 7 Reviewed by: Date: `/ TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. [Not applicable P WORKS Co encs: PUBLIC UTILITIES 6 / 9 —/ 7 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach x• SUN2017 APPLICATION NUMBER Building Department y (To be assigned by the Building Department.) 1:s 800 Seminole Road 't Atlantic Beach, Florida 32233-5445• Y' P Es i 7 -"_ . 3 Phone(904)247-5826 • Fax(904)247-5845 e r!3 9 E-mail: building-dept@coab.us Date routed: - I Co City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address:-/05 f1 n/lg F R,SACK l_/ D Department review required Yes No uildiny Applicant: Pk nikE2t 0 F - C LF5S(C', /6 anning &Zoning, Tree Administrator Project: Me-t0 Si tJa �t4 M t 4D,Ine ublic Work 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: [Approved. ['Denied. . ❑Not applicable (Circle one.) Comments: See 11/1-4dbi LO,nOeldi BUILDING PLANNING &ZONING Reviewed by Date: ‘if—/7 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 05/19/2017 City of Atlantic Beach PUBLIC UTILITIES DEPARTMENT 11 -. -; ') 1200 Sandpiper Lane Atlantic Beach, FL 32233 ::;- J �9. (904) 247-5834 NEW WATER / SEWER TAP REQUEST Date (P' / 9 - / 7 Project Address 70 5 ,4,11 E1 J .fL (i%J Number of Units I Commercial Residential ✓ Multi-Family 3 New Water Tap(s) & Meter(s) Meter Size(s) /LI New Irrigation Meter Upgrade Existing Meter from to (size) New Reclaim Water Meter Size New Connection to City Sewer Applicant Name Applicant Address City State Zip Phone Cell Email Applicant Signature CITY STAFF USE ONLY Application # gL5 1 -7 - O 0 Lo 3 Water System Development Charge $ `� ��C I r Sewer System Development Charge $ /(/ OV J Water Meter Only $ •.8' Reclaim Meter Only $ ,49--- Water Meter Tap $ 'ems Sewer Tap $ ,-19 - Cross Connection $ y?), 00 Other $ TOTAL $ .5C r DO (Notes) APPROVED Kayle Moore, P.E. Date 1/40(17 Public Utilities Director or Authorized Signature ALL TAP REQUESTS MUST BE APPROVED BY THE PUBLIC UTILITIES DEPARTMENT BEFORE FEES CAN BE ASSESSED 0: L ;i `` � >> Permit Reviews �°' City of Atlantic Beach Permit Number: RES17-0063 Description: NEW SINGLE FAMILY Applied 6/16/2017 Approved: Site Address:705 AMBERJACK LN Issued. Finaled: City,State Zip Code:Atlantic Beach,Fl 32233 4 Status:AWAITING REVISION Applicant:<NONE> li Parent Permit: Owner:SALT AIR HOMES INC Parent Project: Contractor:<NONE> Details: LIST OF REVIEWS SENT DATE RETURNED DUE DATE TYPE CONTACT STATUS REMARKS DATE i Review Group:AUTO 6/16/2017 6/16/2017 SUBMITTAL Permit Tech APPROVED COMPLETENESS Notes: PERMIT RUNNER DROPPED THIS OFF. MISSING PIECES. 6/16/2017 7/6/2017 6/26/2017 BUILDING Building DENIED See comments Notes: 1.A contractor and an owner/builder form were submitted with the application. Contractor/builder must comply with F.S.489,including the one-year stipulation for sale/rent/lease of the property. Please clarify licenses,worker's comp,liability insurance,and builder's responsibilities. 2.Please indicate all proposed setbacks and FFE on survey. See attached FFE guidelines. ._�� S>,r.jT C./VlL1(L T o C'G 3.Please verify if optional lanai is part of project. 4 ,-_,- ‹:.--.a rr is K}(=C u T F/--C' CIV r71o210, 4.Valuation of work will be calculated per ICC Valuation Guidelines. „.- 5. r5.Window flashing detail does not FBC-R 703.8. Please update. An acceptable details can be found at http://www.firstcoastchapter.org/?page_id=7 I. 6.Truss engineering must signed off by Engineer of Record(EOR),as meeting his design. 7.The revised plans and documents may generate new comments. 1.A contractor and an owner/builder form were submitted with the application. Contractor/builder must comply with F.S.489,including the one-year stipulation for sale/rent/lease of the property. Please clarify licenses,worker's comp,liability insurance,and builder's responsibilities. 2.Please indicate all proposed setbacks and FFE on survey. See attached FFE guidelines. 3.Please verify if optional lanai is part of project. 4.Valuation of work will be calculated per ICC Valuation Guidelines. 5.Window flashing detail does not FBC-R 703.8. Please update. An acceptable details can be found at http://www.firstcoastchapter.org/?page_id=7 6.Truss engineering must signed off by Engineer of Record(EOR),as meeting his design. 7.The revised plans and documents may generate new comments. 6/16/2017 6/23/2017 6/26/2017 ZONING Brian Broedell DENIED Notes: 1.Tree Removal:Section 23-21 requires a Tree Removal Permit for any trees removed within 2 year!of this project.Please submit a Tree Removal Permit Application if any trees are to be removed or were removed in the last 2 years.If no trees are to be removed or were 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. 2.Setbacks:Section 24-67(c)requires a site plan showing setbacks.Please provide the rear setbacks for the house and porch. 3.Section 24-17 requires height to be measured from average calculated grade to the highest point of a building's roof structure or parapet and any attachments thereto,exclusive of chimneys.Please show the height measured from grade. ' Printed: Monday, 17 July,2017 1 of 2 $ i i >r 4,',* �11 � Permit Reviews M City of Atlantic Beach 6/16/2017 6/19/2017 6/26/2017 PUBLIC WORKS Public Works APPROVED W/CONDITIONS Notes: -.,::-t-5, Y 6/16/2017 6/20/2017 6/26/2017 PUBLIC UTILITIES Public Utilities APPROVED W/CONDITIONS Notes: See attached Water/Sewer Tap Request form. Printed:Monday,17 July,2017 2 of 2 r nMo, f t.AJJ j- • ,, CITY OF ATLANTIC BEACH a .s, 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 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. ADD S b ock Lane / cola PHONE NUMBER PRINT AME i i SIGNATURE i ' I"' o DATE Before me this day ofJa f L (q ,20 an the county of Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are true and accurate. NotaryPublicat Large,State of T�[,1r/C10 ,County of (/R L! / 7 'Rrso enaiiy Known :::t F:BLDG/Owner-Buildar Affadavit;REVISED:4/16/2009