1851 BEACH AVE - KITCHEN REMODEL 0.
, , l
_. CITY OF ATLANTIC BEACH
a 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
-I ol; r.)V INSPECTION PHONE LINE 247-5814
RESIDENTIAL - ALTERATION RESIDENTIAL
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: RES18-0029
Description: kitchen remodel
Estimated Value: 80000
Issue Date: 2/1/2018
Expiration Date: 7/31/2018
PROPERTY ADDRESS:
Address: 1851 BEACH AVE
RE Number: 169723 1105
PROPERTY OWNER:
Name: Jeff Yonge
Address: 1851 BEACH AV
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.
51,Appr�� City of Atlantic Beach APPLICATION NUMBER
Js - � Building Department (To be assigned by the Building Department.)
800 Seminole Road l2 E.s _ ooa ci
3 eAtlantic Beach, Florida 32233-5445 K
Phone(904)247-5826 • Fax(904)247-5845 ( (
A:(01t �r E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ¶.S ( e1L-&(J4 ,J.Q . Department review required Yes No
Building
Applicant: 01,.)c LA' Planning &Zoning
Tree Administrator
Project: 1Ll6U1(Y`U CQ, Public Works
Public 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: ipproved. ['Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: Date: b t 3 l
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
:a -
r.
S J U \\Y re.ni
'rpr„ Building Permit Application ' date3
PO A 2 City of Atlantic Beach JAN 2 22n18 (
1„,
800 Seminole Road,Atlantic Beach, FL 32233
I
�'� . _ Phone: (904) 247-5826 Fax: (904)247-5845 �— (-d 6
Job Address: /6'57 UJec a A-ve el4 ' � _¼rTNumber:
t-�"
1i _ b ,4.412233
Legal Description ,,iV A45./13$/ /V4w 7 ,r�H s cop,cD. RE#
Valuation of Work(Replacement Cost)$ EDCom. Heated/Cooled SF /07 O CL Non-Heated/Cooled
7
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Poolindow/Door
• Use of existing/proposed structure(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: Re_ oo/e/ h ir7th co/ C }�/_/ _c. /sw�/c 1 es,
�ty1J' T . �I f b �� \`,N(_��•D/A/"Z- 7 .�C-cam '7
6or✓1 L(J%h�ews, o�.rs, ct r�[ 1-LJ is r Ex T•^
Florida Product Appro6al# for multiple products use product approval form
Property Owner Information ��/ e /
('l L, C
Name: je, t 7 /0l/C 7' Address:/ /J dC UCity / �i„6 c.... .).3,)_,c7 c/ State -'l Zip;3 233 Phone .3 3�'/C/�
E-Mail J f)/ S'I/O R oo/- cost-t
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: v4
Qualifying Agent:
Address City State Zip
Office Phone Job Site/Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation
Exempt/Insurer/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 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
. O: ' LIN 'INA , G, CONSULT WITH YOUR LEr1oER ,R £ N ATTORNEY BEFORE
RECORD N'. •• 1. TI E OF COMMENCEMENT( �'e
i
(Signa of Ow or Agent) 111Fre of Contr.' or)
(inc .. g contractor) }}��
Signed and sworn to(or affirmed)before me this 1q/�day of Signed and sworn to(or affirmed) bef re me this (�'21ay of
'-chic;.-'/ , Z-e)(d , by .�' t.y 7t,o•.rc+S oy. -an , 61e , by -2 _.' U
/ J/ • 4, A 414....L... ra
r'Nq�l:�..,,• GRACE MACKEY n
,rft (SigrYrture of Notary) r►' GRACE MACKE (Sig a e of Notary)
•. *s MY COMMISSION#GG 2989 " Sti%
MY COMMISSION#GG 042989
-4.,...:„4.i EXPIRES:October 27,2020 ;,,,, ,t+t �.
,pN.h;�+' Bonded Thru Notary Public Underwriters
.'_i EXPIRES:October 27,2020
A e %.0::.` Bonded Thru Notary Public Undenelters ,
[ [Personally Known OR
Tyroduced Identification [ Produced Identification
pe of Identification: rLD11\MC S c—I CJnce ype of Identification: fL Of` 's cox
x y CITY OF ATLANTIC BEACH
I3.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.
f ac/ /3 eACI 4l✓L Ade 7°V V38-i‘93
ADDRESSPHONE NUMBER
e o �.
SIGNAT 77141111411V2/07(41111p /At.4 _ t // /zold
DATE
Before me thi day of -3 4ni.._,>r ,20 I c7 in 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.
Notary Public at Large,State of F Iris dti,County of `�t��tl� GRACE MACKEY
: `t" MY COMMISSION#GG 042989
❑Personally Known /(�� �t�,,, w �,�r :r EXPIRES:October 2T,2Q20
C}sProduced Identification- �"L Df1 V f LI�ri.� •dr? Bonded ThnJ Notary Public Undelvrriters
Notary Signature:
F./BLDG/Owner-Builder Affadavi REVISED: 4/16/2009
v.
l
PRODUCT APPR
OVAL INFORMATION SHEET FOR THE CITY OF ATLANTIC BEACH,FLORIDA
je Project Name: re pe Permit #
Project Address: /g 7 (3ei c L Ave /7/44-1--(c 6 c , /—
As required by Florida Statute 553.842 and Florida Administrative Code Rule 9B-72,please provide the information and product approval number(s)
for the building components listed below as applicable to the building construction project for the permit number listed above. You should contact
your product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide
roduct approval may be obtained at:www.floridabuilding.orr.
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
A.EXTERIOR DOORS
1. Swinging
2. Sliding Y FS !,✓d'acYt 2C,4v SG-43 F/4742-67
3. Sectional
4.Roll up
5.Automatic
6.Other
B.WINDOWS
1.Single hung
2.Horizontal slider
3. Casement
4.Double hung
_ ' 1
5.Fixed l CS lad-Q 6 ) 7- i e c. /=/f75',7
6.Awning
,:1
7.Pass-through
___________ jam
8.Projected
r 9.Mullion
10.Wind breaker
11.Dual action
12. Other
Category/Subcategory Manufacturer Product Description Limitation of Use State# Local#
C.PANEL WALL
1. Siding
2. Soffits
3.EIFS
4. Storefronts
5. Curtain walls
6. Wall louvers
..�.., .... - .—� ._....off .-.. w. _
7. Glass block
8.Membrane
9. Greenhouse
10. Synthetic stucco
11. Other
D. ROOFING PRODUCTS
1.Asphalt shingles
2.Underlayments
3.Roofing fasteners
4.Nonstructural metal roof
5.Built-up roofing
6.Modified bitumen
7. Single ply roofing
8.Roofing tiles
9.Roofing_insulation
10. Waterproofing
11. Wood shingles/shakes
12.Roofing slate
13.Liquid applied roofing
14. Cement-adhesive coats
15.Roof tile adhesive
16. Spray applied polyurethane
roof
1
17. Other
Category/Subcategory Manufacturer Product Description jLimitation of Use State# . Local#
E.SHUTTERS — J
1. Accordion
2.Bahama
3. Storm panels
4. Colonial
5.Roll-up
6.Equipment
7. Other
F. STRUCTURAL
COMPONENTS
1. Wood connector/anchor
2.Truss plates
3.Engineered lumber
4.Railing
5.Coolers-freezers
6. Concrete admixtures
7.Material
8.Insulation forms
9.Plastics
10. Deck-roof
11. Wall
12. Sheds
L.
13. Other
G.SKYLIGHTS
1. Skylight
2. Other
Category/Subcategory Manufacturer Product Description imitation of Use I State# Local#
H. NEW EXTERIOR
ENVELOPE PRODUCTS
1.
2.
In addition to completing the above list of manufacturers, product description and State approval number for the products used on this project, the
Contractor shall maintain on the job site and available to the Inspector, a legible copy of each manufacturer's printed specifications and installation
instructions along with this Product Approval Sheet.
I certify that this product approval list is true and correct to the best of my knowledge. I further certify that use of different components other than the ones
listed in this document must be approved by the Building Official.
4104
(Contractor Name) (Print N.— \ (Si: .tu,-
CompanyName: .��
=2 / - e Ot���r-
Mailing Address/9-r/ to PoC4 ,4ve" / //pr,rc (3eG. ,
111W
City: /ffi State: cZip Code: 2,02-3
Telephone Number: (9d') Fax Number: ( )
Cell Phone Number: (?(') 3,..3 9--/ )4,7 E-mail Address: J i5t g//OQc ol,coy��
NOTICE OF COMMENCEMENT '
State of FkW al Tax Folio No.
County of Oivn
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes,the following information is slated inthis NOTICE OF COMMENCEMENT.
Legal Description of property being improved: Oil/ NO_ / 9 5/ 71e_ 4.42/4/7/1,3- C.,ruit,,, .kt r"urn
t ope4¢,/ 1 2 O /C?72.?-/fo .5"i
Address of property being improved: (937 isesoc /l✓e- /$>fabiLiG. ac_I-, ICf 31;33
General description of improvements: ge I /4/ L. , c.cJ t l i�‘f,�' 4-- reAviAL a s/ Ans..
Qi Plop r;s1 Soo-!^ % b444 f,k/'u res
$ct Owner: e f/re it y 1, Address: SCV)41 e_
1"1 Owner's interest in site of the improvement: (� ' 1 *.1 C r
111 Fee Simple Titleholder(if other than owner): Doc#2018014353,OR BK 18256 Page 233,
Name: NX Number Pages:1
°r�,r� .I Recorded 01/19/2018 10:31 AM,
Contractor: /r4 Jvt't' �7Or8 f ' RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL
I COUNTY
Address: RECORDING $10.00
Telephone No.: Fax No:_
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name: /Y/f
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one (1)year from the date of recording unless a different date is
specified): '
THIS SPACE FOR RECORDER'S USE ONLY OWN' ' /
Signed: I
Date: iPCtP
Before me this j q say of "5.9 r ufr• in the County of Duval,State
Of Florida,has personally appeared .5e.ie rt IllprvtaS)Q r,2
GRACE MACKEY Notary Public at Large,State of Florida,County f Duval. ✓
'.Y ',? MY COMMISSION#GG 042989 My commission expires: f7Ctu ea-- o�7�'lc:3v
'' 2020
'' ". ; : EXPIRES:October 27, Personally Known: or
�'���'`= Public Underwriters 1�
:,Fo `''' BondedProduced Identification: L. 0,14Y( t3 L. Ca4A'
/(1// ANO
et