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404 OCEANWALK DR S - FIREPLACE ' J` , CITY OF ATLANTIC BEACH tr. 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 '-!!-J1119%' INSPECTION PHONE LINE 247-5814 RESIDENTIAL - ALTERATION RESIDENTIAL MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RES18-0313 Description: GAS FIRE PLACE Estimated Value: 4000 Issue Date: 9/18/2018 Expiration Date: 3/17/2019 PROPERTY ADDRESS: Address: 404 S OCEANWALK DR RE Number: 169463 0524 PROPERTY OWNER: Name: FLANAGAN WILLIAM J JR Address: 404 OCEANWALK DR S ATLANTIC BEACH, FL 32233-4573 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$7,500. , ' ;.,0 Building Permit Application Updated 12/8/17 1. T 4 k' City of Atlantic Beach Vy - 800 Seminole Road,Atlantic Beach,FL 32233 Phone: 4) 7-5826 Fax:(904)247-5845 eQJob Address: 44/ e��WA- J- Permit Number: � V --03 1 3 Legal Description RE# Valuation of Work(Replacement Cost)$ •0e3�1 v Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/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 jthe type of work to be pert med: KL_' t --(4e—e_ 4.-e Florida Product Approval# for multiple products use product approval form Property Owner Information Name: b_2i7��"^ _ •.r• G–`-— Address: 74 64-'z-4--"— i.....) b r City ,r/ :. ♦a-4-e_ 4State �L Zip 3_7-2,.q e 5-7--7374–Z � Phope 0 79 "— E-Mail t,)LY i6-e4.--- //• f o.."c, a-c--ED Co-�_c-S , it- '.e._-- • Owner or Agent(If Agent, Ftd.wer of AttorPrty or Agency Letter Required) Contractor Information Name of Company: -e- Qualif ing g nt: Address 68 9r X.:�#%s`7vi.../„1Z 1.1P—City a e State f--- Zip 372J -,. Office Phone 9 –3t - --3 (,7 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 -/-' RECORQ'RNG YOUR T -E OF C MMENCEMENT. NA/ -- (Signat e of Owner or ent) (Signature of Copt actor) (includin: ontractor) Signed and sworn to(or affir )before me�his- day of �igned and sworn to(or affir d)before me this day of /6 , ,Id/g , by -, I a. ` i-'- , �d,- F — ,b 14�(/ Signature o Nota AO (Signature of Notary) ]Personally Known OR _.:_. --7----- --f:-.-_ ]Personally Known OR [ ]Produced Identification .,,, TONI GINULESPERGER 1 ]Produced Identification i MY COMMISSION it FF 9239..1 Type of Identification: type of Identification: :as. ,;T' Bonded Thru Potay Public Underwriters rf idut,Jrr `irf� )f CITY OF ATLANTIC BEACH 41401 ' II%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. //" 'fa/ D�0..u..-Lit).----/k �r- 8 5-Z-qg-o79z ADDRESS PHONE NUMBER PRINT 1 /e eir)—/-2e2/eF S E U Ski"�I.I DATE Before me this/8 day oft / ,2diin the county of Duval,State of Florida,has personally a peared herin by himself/herself and affirms that all statements and declarations are true and accurate.P ,County of 1-----)0V0—^\ I Notary Public at Large,Sta- - ( If Personally Known 0 Produced Identification- Allilk vmsommin ' .'777-'�Pi;.c, TONT GINDLESPER ER MY COMMISSION#Fr 924951 Notary Signature: � � � � _ ;�ro[ EXPlRESOcb629 -%t„,,''''' Banded Tho Notary Public Underwriters F./BLDG/Owner-Builder Atfadavit;REVISED:4/16/2009 NOTICE OF COMMENCEMENT State of 1----C--0/2-/P"1.-- - Lc5/2-/P"1' Tax Folio No. I (o9 4(.05 -v5 Z.4 County of L)Uf t--- 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 state inthe i NOTICE OF CO CE NT. Legal Description of property being improved: co �" e 42 9 D AZ5- Oec (,)a-lK 0 4. Z- 1,e9- lt/ ©GRdtLdco i8S Address of propertybein improved: A e r— General description of improvements: Ce___ r'—e...7.01:-e_ _ Owner: 4..d t w� r2-4'-liik_4Address: q "' ( _ by-- s Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): mss(,. S t `...c) Q_ _ / / // , Name: E .: " G6,- (o ! ] '�, '/�5 � r ! C✓�� U�t-l�l/� `L' Contractor: L FtPri e.e,/2..e!_—_, / /� / Address: PA-,-/;� �i � `"CR"� 0-5 74/-t-,./ ''Z1 11b Telephone No.: 45 K---3 b 5- 7/7 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: 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 OWNER a q �p Signed: Date: /a /`c'/� Doc#2018221313,OR BK 18531 Page 2220, :Before me thi J day of S• Sizjt8in. the CoJ o uval,Stat Number Pages:1 ,Of Florida,h personally appeared P_ 0,p i� J ie.„:.^-,, Recorded 09/18/2018 09:22 AM, Notary Public at Large,State of Flo 'ounty coo Duval. RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL My commission expires: COUNTY Personally Known: �e S or RECORDING $10.00 Produced Identificatio �------ r TONT GINOLESPERt..ER MY COMMISSION#FF524951EXPIRES:October 6,2019 f F?"'� Bonded Thio Notary Pudic Underwr tern