513 VIKING LN - PAVERS '
.�' '` A CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
.t-401119. PHONE LINE 247-5814
ACCESSORY - SINGLE OR TWO FAMILY ACCESSORY
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ACC18-0024
Description: REMOVING AND ADDING PAVERS
Estimated Value: 1000
Issue Date: 4/3/2018
Expiration Date: 9/30/2018
PROPERTY ADDRESS:
Address: 513 VIKINGS LN
RE Number: 170703 0256
PROPERTY OWNER:
Name: RUMANCIK AMBER L
Address: 513 VIKINGS LN
ATLANTIC BEACH, FL 32233-4150
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: SUNSHINE COAST CONSTRUCTION
Address: 513 VIKINGS LN QA JOSEPH MARTIN RUMANCIK
ATLANTIC BEACH, FL 32233
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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.
i.A,,J.,..,
t *, ; Permit Conditions
ii
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City of Atlantic Beach
r;3 T)'
Permit Number:ACC18-0024 Description: REMOVING AND ADDING PAVERS
Applied: 3/22/2018 Approved:3/26/2018 Site Address:513 VIKINGS LN
Issued:4/3/2018 Finaled: City,State Zip Code:Atlantic Beach, Fl 32233
Status: ISSUED Applicant: <NONE>
Parent Permit: Owner: RUMANCIK AMBER L
Parent Project: Contractor:<NONE>
Details:
OWNER BUILDER
LIST OF CONDITIONS
SEQ NO ADDED DATE REQUIRED DATE SATISFY DATE TYPE STATUS
DEPARTMENT CONTACT REMARKS
1 3/22/2018 ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site during construction.
2 3/22/2018 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapell's,Inc.,Republic Services,Donovan
Dumpsters). Container cannot be placed on City right-of-way.
3 3/22/2018 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
Full right-of-way restoration,including sod,is required.
Printed:Tuesday,03 April, 2018 1 of 1 •
1..ill..4, City of Atlantic Beach APPLICATION NUMBER
JS� � Building Department (To be assigned by the Building Department.)
r \--� 800 Seminole RoadQ
,jOZ el—
'sr Atlantic Beach, Florida 32233-5445 ���C.' V —lJ
Phone(904)247-5826 • Fax(904)247-5845
/ViDate routed: (t.
'_oit 9? E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: t Z VI KI c. Li...) Department review required Yes No
Building
Applicant: C) L/0 ID P--R-___ lanning &Zonin
1� Tree Administrator
Y
Project: P-V 2S 1 ublic Works
` ti6Tc Utiliti-
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: giApproved. ❑Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: ,/.. --- / Date: C—I!'
TREE ADMIN. Second Review: A roved as revised. Denied.
❑ pp ❑ ❑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
5�.:VI:jer City of Atlantic Beach APPLICATION NUMBER
Js s� Building Department (To be assigned by the Building Department.)
800 Seminole Road r1 CCI ,oy —
b�Z 4
Atlantic Beach, Florida 32233-5445 �`j
Phone (904)247-5826 • Fax(904)247-5MAR 2 2 2018l
1,013 �� E-mail: building-dept@coab.us Date routed: 3/z fv E3
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 51 3 Vi kkIVe,S Lk) Department review required Yes No
�c l Building
Applicant: v GO iV �2 Planning &Zoning
Tree Administrator
Project: =u• .c Works:
ublic Uti i ie
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: i pproved. ❑Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by. /
TREE ADMIN. Second Review: ❑Approved as revised. [1]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
f i;r., City of Atlantic Beach APPLICATION NUMBER
, 4 �, � Building Department (To be assigned by the Building Department.)
800 Seminole Road CC I @
r.. Atlantic Beach, Florida 32233-5445 ``} C7 — d` 4
r
Phone(904)247-5826 • Fax(904)247 584` AR 2 2 2018 / �j
>„ �? E-mail: building-dept@coab.us Date routed: 3 Z zel. O
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 51 V t 1-l!!3 5 Lk) Department review required Yes No
Building
Applicant: C)GO N.3 G-2— Planning &Zoning
Tree Administrator
Project: `�IPkVCI2--- `S u lic WorIS,S:
Cublil��TcUtil t s�
Public Safety
Fire Services
Review fee $ Dept Signature .cXev
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: nApproved. ❑Denied. FHCapplicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: )5 .--61. �i"-----J Date: 3 2,3 1$
TREE ADMIN.
Second Review: I 'Approved as revised. I 'Denied. I 'Not applicable
Rile" WORKS Comments:
•UBLIC UTILITIES
331
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
/74,6 Building Permit Application Updated 12/8/17
City of Atlantic Beach
l'-,; DP 800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 I
Job Address: /3 V 114), (,S LA^'If Permit Number: i- aes b` o z 4-
Legal Description 35- b y q - 2.5 —2 I t 5tAsP' ' Lu' 21 ba ! RE# /1707 F 63 —a 2 r
Valuation of Work(Replacement Cost)$$11/00" Heated/Cooled SF i-74 Non-Heated/Cooled hf/'1
• Class of Work(Circle one): New Addition Alteration Repa' Mov emo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial 'eside.
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No
• 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 beerformed:
QEN�uVI / l� C2.0 Sy. 4r of fw✓erS
A00 lAv t., 5'►0 9. ft. of Pci vPr5
Florida Product Approval# r'/A for multiple products use product approval form
Property Owner Information 2
Name: J0!` AvAAA,coK Address: 5 /3 VIK,v&S LAA/e
City Arc4NTic est AtN State FL. Zip 3213) Phone ycy ZGI —/o$ y
E-Mail i ue Q 5 vnsti:4r C olorin(• Co '1
Owner or Xgent(If Agent, Power of Attorney or Agency Letter Required) /1/1
Contractor Information
Name of Company: St"/t II►^'f (Air CukiV Av"ito/ ii`-'`.Qualifying Agent: —)of /,vfr''V'(lk
Address 573 V I I<"('$ t 4.vE City 4 6 State FL Zip 32 2.3 .1
Office Phone `/oi. Z 61"l D by Job Site/Contact Number 901. Zu1_ /01 y
State Certification/Registration# C Bc izf&31( E-Mail J ''= ( 5v451:ac Coc1 yin(•c.s
Architect Name&Phone# NtA
Engineer's Name&Phone# /'ith
Workers Compensation CoAll,tAbbvi.f E,.iI-" YE' L`ASim 6, 1,t' . Exp. 9,3u//1
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. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
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
RECORDIN;4 er OTICE OF COMMENCEMENT.
/ !
Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
/, ,/'
w. n to(or affirmed before me this __. day of Signed and sworn to(or affirmed)before me this day of
A_ _. , \ ZOfv, CASE? ;► CCAC,C K , , by
ignature of Notary) (Signature of Notary)
— r
[ ]Personally Known OR di:-^ TONPOINDUE8Piiilanwn OI
[ ]Produced Identification r =+: ' *2 My �fl9EIP lcat'.n
Type of Identification: l/ �'' ` °•' E � �ip )tn'
Ronde ru tary u enrm era
J " CITY OF ATLANTIC BEACH
sI
'`` - 1J%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.
5" 6 V/kiiv&s i44,e y zuy. oIv
ADDRESS PHONE NUMBER
JJf v ' AA1 lK
PRINT NAME
37303
SIGNATU ^ /
/ DATE
Befor me this (lay of M
,�(�1Jn1 }}-0 /y/_\ C
2f -fn the county of
Duval,State of Flo da,has personally appeared he by himself/herself and affirms that
all statements and declarations aand accurate. /
Notary Public at Large,State of , ( ,County of 0 VC
o Personally Known j <-- z---t [_ /�)
❑Produced Identification _cation- ' S iC J 1 z L/ ��J - v
Al
Notary Signature: �_ Imp,
;;;s,.•v.,+ _ TONI GINDI.ESPERGER
F./BLDG/Owner-Builder Affadavit;REVISED: 4/16/2009 , =*i , ►_ MY COMMISSION#FF 924951
.:; EXPIRES:October 6,2019
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I
MAP SHOWING BOUNDARY SURVEY OF
LOT 28, BLOCK 1, SEASPRAY AS RECORDED IN PLAT BOOK 35, PAGES 64 & 64A,
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
AMBER L. RUMANCIK Sc JOSEPH M. RUMANCIK
COLDWELL BANKER MORTGAGE
RICHARD T. MOREHEAD TITLE & ESCROW, INC.
STEWART TITLE GUARANTY COMPANY
PALM STREET
S 67'24'27" E 74.68' (MEASURED)
FOUND 1/2'IRON PIPE S 6728'00" E 75.00 (PLAT) FOUND 1/2"IRON PIPE
NO IDENTIFICATIONNCO IDENTIFICATION
-;.1
. x x \\z z z x x 0.3' r0.9'x
0.3 \
10' DRAINAGE. UTIUTY x
K AND SEWER EASEMENT
LOT 27 \\— — o��a 8 — — — ^x LOT 29
BLOCK 1 BLD''' L BLOCK 1
20.2��
66 ADDED A tRFm
Q ,l.. W 3'Z u 59 f r
.....".E. �'
AlirU
of PAuffzi �in o xo �r oo
Oo 39• x 0o S
N� PAvER
0.1
W W ONE STORY 3 3
MASONRY ,
O POSTED # 513 o Ln
O IN N M N
'CMV (NI i NCV
N ..Z 38.8' NN
Z 7.5' W
COVERED N
ENTRY LI I
21.2' 7.5'
20'BUILDING RESTRICTION UNE .,;:.!. l ¢
S6718'00" E a
-•�%%'•.�': 60.00' (PLAT)
0 • r.:.' ( OFOUND 1/2' IRON PIPE
FOUND IRON PIPE N 67.28'00" W 75.00' PLAT) NO IDENTIFICATION
NO IDENTIFICATION
N 67'44'35" W 75.10' MEASURED) 1
VIKINGS LANE
(60.0' RIGHT OF WAY)
a
REVISIONS
ROTES: , ACCEPTED BY. DATE DESCRIPTION
i
rJOB # 08-0065 ] DATE OF FIELD SURVEY: 03-08-08 DATE OF ISSUE: 03-09-08 SCALE: 1" = 20'
j NOTES: PLAT N 22'32'00" E ALONG SHE
TtI�4
G� 1. BEARINGS ARE BASED ON THE BEARING OF
NORTHWESTERLY BOUNDARY UNE OF SUBJECT PARCEL. X AS
2. BY GRAPHICIC PLOTTING ONLY, THE CAPTIONED LANDS UE WITHIN FLOOD ZONE
SHOWN ON THE NATIONAL FLOOD INSURANCE MAP DATED APRIL 17, 1989, COMMUNITY
NUMBER 120075, PANEL 0001.Q._.
3. THIS SURVEY REFLECTS ALL EASEMENTS & RIGHTS OF WAY AS PER RECORDED PLAT. UNLESS
�• OTHERWISE STATED, NO OTHER TITLE VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED.
11'IF , ),.. 4. THIS SURVEY IS NOT VAUD WITHOUT THE ORIGINAL SIGNATURE AND EMBOSSED SEAL OF THE
744 CERTIFYING SURVEYOR.
CERTIFICATE LEGEND:
I HEREBY CERTIFY THAT THIS SURVEY WAS MADE UNDER MY RESPONSIBLE CHARGE R .. RADIUS
AND MEETS THE MINIMUM TECHNICAL STANDARDS AS SET FORTH BY THE FLORIDA
BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS IN CHAPTER 61017-6. FLORIDA L s LENGTH
AOMINISTRATIVE CODE;fURSUANT TO SECTION 472.072. FLORIDA STATUTES.
ttiliySy1 Ctcr::2_._._.______ —x— = FENCE
1008 Ldring Avenue _ O .• CONCRETE
Suite 29 'If
Orange Pork, FL 32073 CHARLES K. MCINTOSH
(Phone) 904-215-0900 (Fox) 904-215-0910 REGISTERED SURVEYOR AND MAPPER # 5502 STATE OF FLORIDA
Licensed Business 9 7361