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1949 Seminole Rd - Permit RESO18-0016 SS CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 RESIDENTIAL OTHER - SINGLE OR TWO FAMILY RESIDENTIAL OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RES018-0016 Description: refurbish &extend existing deck Estimated Value: 900 Issue Date: 4/26/2018 Expiration Date: 10/23/2018 PROPERTY ADDRESS: Address: 1949 SEMINOLE RD RE Number: 1695420516 PROPERTYOWNER: Name: KAUNATH TERESA MAZUR Address: 1949 SEMINOLE RD ATLANTIC BEACH, FL 32233-5917 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. 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. City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road oo 1 (6 Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us L late routed: 4W I (K City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM .s. �17 Property Addres, Department review required Yes No ing Applicant: ,—I�a_n n—i n�4g_�o n i��n , Tree Administrator P Project: Public Utilities -P-5EFFS-a—fety 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: 4Approved. [:]Denied. [:]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b Date: TREE ADM IN. Second Review: DApproved as revised. [-]Denied. F]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: F]Approved as revised. ElDenied. [:]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247- E-mail: building-dept@coab.us 'AM 16 Date routed: City web-site: http://vvww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I 'M1 -L A Depa-rtment review required Yes No ing Applicant: C)" —L_l—an—ni i� ,g�o n i�n Tree Administrator Project: Public Utilities —PUFF-8—afety Fire Services Dept Signatuit; 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: FlApproved. ElDenied. RJI�0't applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by- ;L1 Date: TREE ADMIN. Second Review: ElApproved as revised. F]Denied. ONot applicable P�Ue WORK Comments: BLI UTILITIE UK L_'1 PUZI(C SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. DIDenied. ONot applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) i 800 Seminole Road Atlantic Beach, Florida 32233-5445 00 Phone(904)247-5826 - Fax(904)247-5845 ":-" . Date routed: lilt E-mail: building-dept@coab.us City web-site: http://vmw.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: (a-tab[ v- - Department review required Yes No IA I:i ng�, Applicant: in a�nn_iMg_��o n�� Tree Administrator Project: L-,k I Public Utilities -7uT Fic-79—afety 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: J?�Approved. FIDenied. []Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: []Approved as revised. ODenied. []Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: E]Approved as revised. E]Denied. ONot applicable Comments: Reviewed by: Date: Revised 05119/2017 'Vf� City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us LDate routed- City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: i c' It rn L Ab v-d Department review required Y No ,S ing Applicant: VO N4 g--a�_nn_Mg_��o n i��n , Tree Administrator Project: ('P Public Utilities -ru-5 FIC-79—afety 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: rApproved. []Denied. L]Not applicable (Circle one.) Comments: BUILDIN PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: []Approved as revised. F]Denied. F]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: E]Approved as revised. F]Denied. E]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Building Permit Application Updated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FL 32233 APR Phone:(904)247-5826 Fax:(904)247-5845 Job Address: 1\)OLE7 )?,b Permit Number: ?: 60 (to Legal Description /-\) 0 4 E� RE# q ot) Valuation of Work(Replacement Cost)$ rrK .COHeated/Cooled SF--<!�nn-�Heated/Coo14 A e air o • Class of Work(Circle one): New Addition'Iteratio ve Demo Pool WWin ow or • Use of existi ng/p ro posed structure(s)(Circle-oEne�.. Commercial /Residential • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit_oT_No Tree Removal Describ in detail the type of work to be pqrformed: _Rk_61A-r IvLfs-k cul,-� ( Ja oy� ie.�4e_�:s t 3,0 Lv�_C� Florida Product Approval# for multiple products use product approval form Propertv Owner Information Name: Address: q I (_i �*Atn ?� Phone I:q Z- ,ty_ State Ex, zip 1 21-Z _!�j o 4 E-Mail (C�, 1 1 I-)A <, ,19-1 Owner or Agent(if Agent, Power of�brney or Agency Letter Required) Contractor Information Name of Company: 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. 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 RE7 YOUR NOTICE OF COMMENCEMENT. ,#Y(Signature of OwneU Agent) (signature of Contracto) (including contractor) Signed and sworn to(or affirmed)before me this day o: SigLndand sworn to(or affirmed)before me this day of �0_(Usc% by MYCOMMISSION*GG00422�OP64 �g� re-oVNotary) EXPIRES:Ocftw ZT.200 Urkled Tlvu NoWy Pubic tkdmw Va. (jSA t r e N ota ry) (Signature of Notary) ]Personally Known OR Personally Known OR N.Produced Identification Produced Identification Type of Identification: F L_ 41", J s-� Type of Identification: -�% ,v Vj CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: W z Ca CA DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: -i Z U < 0 STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED (L z 0 CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LU — 0 W LAW. THE EXEMPTION ALLOWS YOU,AS T14E OWNER OF YOUR PROPERTY,TO ACT AS 0 in t: z I-- ,ACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST 0 (.) no YOUR OWN CONTP 00 SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE-OR Uj 40 TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR Q Z x Z IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING 0 < 0 < 0 _3 U- (j) MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. 0 1.- IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITI-HN ONE YEAR �- Z AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT 0 LL E W LL 0 cc 2 IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT j3 Uj W >- HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST W >. CL M M BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT Is �: != Uj M a W C.) W 0 W YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE W LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING CC W ORDINANCES. W > 11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. 111. 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(l). 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. C� if I e-)Lt -1�4 ADDRESS PHONE NUMBER P NAME IGNATURE DATE Before me this d AD 20_LSn the county Of Duval,State of Florida,has personally appeared h y himself/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of County of -L El Personally Known El-producedidentification- ENI41FER JOViNSTO" 84 My COMMISSjot4*GG 0420 8(eWES..Odldw 2T,2020 Notary Signature: '4 ire -Aw..'eiv. F/BLDG/O�er-Builder Affad(JEV(N�4/16/2009 9M LOT 4B, BLOCK 1, MAP SHOWING SURVEY OF REACHSIOE, AS RE)CORDE0 IN PLAT BOOK 42, PAGES THE CURRENT PUBLIC RECORDS OF DUVAL COUNTy, FLORILIA. 14, 14A, 14B, ANn 14C OF- T -2 5 L 0 T 26 1 27 0 T FOUND 1/2' [RON PIPE , (S.00031 KE�-jj40-02' FIELD) 19 it FOUND 1/2"IRON PIPE — S-0003 1 00' E. 40. 0' 0.4" No CAP I 5'Wl�ATE EASEMENT 0.5, 0.1'6 1 WOOD PRIVACY 0.2, FENCE Cj WOOD DECK 0.4!0 . I STE 8 ()-��'P—yo-117 is. AA ,, t "k CL W 0 04 F- 0 u- i C; c\1 Z) 0) L)0 2 STORY ai FRAME RESIDENCE 0) w No.1949 > L 0 T 4A -0 0 0 L 0 T 5A Li CONCRETE I LLJ a) NOTES: A/C PAD CONCRETE THIS IS A BOUNDARY SURVEY. STOOP co a) CONCRETE Go NO BUILDING RESTRICTION LINE AS PER PLAT. 0 Z WALK BEARINGS 13ASED ON THE SOUTH LINE OF LOT uj 4B,BLOCK AS PER PLAT. im 20.0, ALL EASEMENTS SHOWN HEREON ARE FOR STORM DRAINAGE SANITARY SEWERS,WATER AND UTILITIES 14's 1.4' UNLESS OYHERWISE STATED, a'COQUINA COLUMNS W/W OOD FENCE CONCRETE DRIVE (TYPICAL) 5'EASEMENT 0 is' TSTO!,41'51"E. 1!9.99-FIEP) S-00031 O'E. 12C�00 FOUND I/S-W;PIPE N.000 3 1' 11 --- NO CAP N 000 3 4'3 1"W. 40.00 OUND 1/2"IRON PIPE . 4'FIELD) RLS. 4144 ---7ZND 1/2'IRON PVT CAPNOTREADABLE E M N 0 L E R 0 A D 100. RIGHT-OF-WAY (PAVED) THIS SURVEY WAS MADE FOR THE BENEFIT OF TERESA MAZUR KAUNATH; HOMESIDE LENDING, INQ: RICHARD T. MOREHEAD. P.A. AND STEWART TITLE GUARANTY COMPANY THE PROPERTY SHOWN HEREON APPEARS TO LIE IN FLOOD AND IS IN COMPLIANCE WITH THE MINIMUM TECHNICAL ZONE -X- (AREA OUTSJDE 500—YEAR FLOOD PLAIN) AS WELL STANDARDS SET FORTH IN CHAPTER 61 C17-6 AS CAN BE DETERMINED FROM TMF -Fir'unn OF THE FLORIDA Ar)khMlCT0ATll- c Vl� Nk �04 4T'r