262 NAUTICAL BLVD S - RES18-0251 (.21 ,* \h, CITY OF ATLANTIC BEACH
�-` 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
/ (904) 247-5800
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BUILDING REVIEW COMMENTS
Date: 8/2/2018
Permit#: RES18-0251 Site Address: 262 S NAUTICAL BLVD
Review Status: denied RE#: 170703 0404
Applicant: Sarshan Group, LLC Property Owner: BISBING WILLIAM BRUCE
Sarshangroupllc@gmail.com Email: irvingscrodnik@netscape.net
Phone: 904.252.8066 Phone: 9042495334
THIS REVIEW IS ONE OF MULTIPLE DEPARTMENT REVIEWS.
Revisions may not be submitted until ALL departments have completed their respective reviews.
Revisions submitted MUST respond to EACH department review. Submittals that respond to only one or a
few correction items will not be accepted.
Correction Comments:
1. Submit the Florida Product Approval Number for the siding to be installed.
2. Submit the manufacturer's installation instructions for the siding product.
3. The Owner/Builder Affidavit submitted by William B. Bisbing, states under item IV. UNLICENSED
CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCE. If the Sarshn Group,
LLC, has a state licensed contractor's license they should submit the license number as well as the name
of the license qualifier. If that is the case the Sarshan Group, LLC should also sumbit their worker's
comp insurance as well as liability insurance.
Building ll-'
Mike Jones O
Building Inspector/Plans Examiner
City of Atlantic Beach .. �a �J
800 Seminole Road (P
Atlantic Beach, FL 32233
904.247.5 844
Email:mjones@coab.us
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Resubmittal Notes:
All revisions and changes shall clearly stand out from the rest of the drawing on the sheet as a revision by way of
completely encircling the change with "clouding".The revision shall also be identified as to the sequence of revision by
indicating a triangle with the revision sequence number within it and located adjacent to the cloud.The revision date
II
�:14:, City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
td00)
w 800 Seminole Road E5(g---oZs I
,� ,l Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904) 247-5845 "t ftc? / ¢
A'Omsk/ E-mail: building-dept@coab.us Date routed: o
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 21t2-• S • 1..QGd, cDe ment review required Yes No
Buildin
Applicant: f Cale,0 W fl&/ Planning &Zoning
Tree Administrator
•Project: st-ctinj Wood ,` 4 i r Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineers
i 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 Reviewed by: Date:
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
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CITY OF ATLANTIC BEACH
®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 $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
2 'L Nao 4o. S\JAS 9'06/ -2c/g --03Y
ADDRESS I PHONE NUMBER
P /
SIG ATURE \ 1 DATE ///
Before me this 'CI day dTV V 20. the county of
Duval,State of Florida,has personally appeared herin by hims herself and affirms that
all statements and declarations are true and ace ate. ^
Notary Public at Large,St r- C ,County of t J ,.1✓
SCI Personally Known
0 Produced Identification-
TONI GINDLESPERGER
MYC061MISSION p FF 94951
Notary Signature: - f�`--
I =*� •+=
Bended Thru Notary Public Urderw�ters
EXPIRES:October 6,2019
FJBLDG/Owner-Builder ARadarit:REVISED:4/16d2009 ••'•�'h•'
Building Permit Application Updated 12/8/17
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City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
`
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: 2. 2 N CCA('-t1 Low\ � j c1 S �l ‘.3e-‘.3e- Permit Number: REs/g- O25/
Legal Description RE#
Valuation of Work(Replacement Cost)$ - I'5 .qv Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteratio 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 the type of work to be pe ormed: I
lci ( n" a/` G000 J r
Florida Product Approval# for multiple products use product approval form
Property Owner Information ^ L
Name: .\ l \� ) 5`J i�1 Address: ?- N A(Al \ � ( V ,3 5
City Pc-1(104\ h'C'PK.h State Et. Zip 3 2 33 Phone QOcf ^A (4 —S313`-f
E-Mail t('v i r\�SCfocl f‘I he--k5upe •Ott
Owner or Agent(I Agent, Power of Attorney or Agency Letter Required) (A)t ((t'eLr"1 +7 b
Contractor Information
Name of Company: 'SA.f('Sho0'1 6-('e J() )---LC-- Quali Ing Agent:
Address �j5 17 Mme'\o S'I', City &c-ICsv-n'(I it State Zip 32_2-33
Office Phone Q'0'4 2.5 ' _-�5 0 6 Job Site/Contact Number
State Certification/Registration# E-Mail 5 d+Sk Aft $ re)./? U. - 3 ok Al I • co m
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation SA rw•t S
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
RECORDING YOUR OTICEOF COMMENCEMENT.
(Signature of Owner or Agent) (Signature of .ntractor)
(incl .ing contractor)
igned and sworn to%: e.)befo - e this I •a�of Signed and sworn to(or affi ed)before me this day of
itt sh • 6r. nc, •y
• �� Arr J
(Signature o 'otary) ' (Signature of Notary)
ersonally Known OR _ [ i Personally Known OR
[ )Produced Identification "'y.-. TONI GINDLESPERGER [ )Produced Identification
,.. Type of Identification:
Type of Identification: y: .� MYCOMiUISSIpN@FF92C051
=`-•-..i:g EXPIRES:October 6,2019
........ Bonded Thru No:ary Public Underwriters