2139 Seminole Rd POOL19-0009 pool permit .I I-Vi
SWIMMING POOL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH POOL19-0009
800 SEMINOLE ROAD ISSUED: 2/25/2019
Vii ATLANTIC BEACH. FIL 32233 EXPIRES: 8/24/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
2139 SEMINOLE RD SWIMMING POOL SWIMMING inground pool - transferred $45000.00
POOL RESIDENTIAL from POOL18-0037
BUILDING USE
TYPE OF REALESTATE ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1695150500 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
POOLS BY JOHN 600 ST JOHNS BLUFF RD JACKSONVILLE FL 32225
CLARKSON, INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
Camille Adams 2139 SEMINOLE RD ATLANTIC BEACH FL 32233-5921
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
:Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
W I
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 4S5-0000-322-1000 0 $55.00!
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2,00,
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00!
TOTAL:$59.00
Issued Date:2/25/2019 1 of 2
SWIMMING POOL PERMIT PERMIT NUMBER
POOL19-0009
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 2/25/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 8/24/2019
Issued Date:2/25/2019 2 of 2
SWIMMING POOL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH POOL18-0037
800 SEMINOLE ROAD ISSUED:
EXPIRES:
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
--- -_------__
21"'JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
2139 SEMINOLE RD SWIMMING POOL SWIMMING transferred to POOL19-0009 $31000.00
POOL RESIDENTIAL with new contractor
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1695150500 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
Florida Luxury Pools, Inc. 74 Levy Road Atlantic Beach FL 32233
OWNER: ADDRESS: CITY: STATE: ZIP:
Camille Adams 2139 SEMINOLE RD ATLANTIC BEACH FL 32233-5921
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 1 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(904-247-
5814)to request an Erosion and Sediment Control Inspection prior to start of construction.
2 PUBLIC WORKS ON SITE RUNOFF INFORMATICNAL
Notes:
All runoff must remain on-site during construction.
Issued Date: 1 of 2
SWIMMING POOL PERMIT PERMIT NUMBER
POOL18-0037
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED:
ATLANTIC BEACH, FL 32233 EXPIRES:
3 PUBLIC WORKS POOL WELLPOINT INFORMATIONAL
Notes:
Pool Wellpoint(if used)must discharge into vegetated area 10 minimum from street or drainage feature(swale,structure or lagoon). A separate Pool
Permit is required.
4 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapells,Inc.,Republic Services,Donovan Dumpsters,
Phillips Containers). Container cannot be placed on City right-of-way.
5 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
6 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking must be removed from job site by Contractor.
i��- ',
, - 'g 61iid11"","''V" e, ;' k�� '� '.'��--FEES
31-
4"1"
�,Nq:-�k&
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $210.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $105.00
BUILDING PLAN REVIEW RESUBMITTAL SECOND 455-0000-322-1006 0 $50.00
PW REVIEW RESIDENTIAL BLDG 001-0000-329-1004 0 $100.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $5.48
STATE DCA SURCHARGE 45S-0000-208-0600 0 $3.65
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $50.00
TOTAL:$524.13
Issued Date: 2 of 2
Building Permit Application Updated 12/8/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845
Job Address: Td. 322�5 Permit Number: L I Cl _W09
Legal Description9 -?-3- Z9C-. )42 P-rQQV7- Lot ) �FCN Ole /8fV6- I(XdO _RE# 1&9515- 0500
1
Valuation of Work(Replacement Cost)$ qfl 6W 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 the type of work to be performed:
10��OtA t) POD
Florida Product Approval# for multiple products use product approval form
ProDertv Owner Information
Name: OrAii-I �& no)5 Address: 2-i Seiniinpliq Rd .
city AA I rAt\,Vt r *,,Pa,-�% State F( —Zip *_�.ZZ 3:2, —Phone 52.0- ju)ZU 36
E-Mail' Z:I MIEZZ vah(A). CIC)A
- I -
Owner or Agent(if Agent, Power of Atto�ney or Agency Letter Required)
Contractor Information
Name of Comp y: K_-on4 QualifyIng Agent: kn CIQI-�_Soel
)b 6�4
Address
Office Phone City V/I State Zip5eZ.?.9
— - Job Site/C�oqtact Number
State Certification/Registration# E-Mail ()UM I C a^
Architect Name&Phone#
Engineer's Name& Phone#
Workers Compensation ['y3(.k C-h(2)< :Sbpe Po19
4 �J 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 OBT FINANCING, CONSULT WITH YOUR LE E 3 ANA NEY BEFORE
RECO IN U R NOT1,CE OF COMM ENCEMEN .
IV (40ature of Owner or Agent) (Signature of Contractor)
(including contractor)
Si d nd sworn to(or affirmed)before me this��clav of ed and sworn to(or affirmed)before me this2,5tay of
2D 16) 1 1 2OR by
ER 7
4A,
ed aL
rkrm cj-\ Q 0291 kl�
DEBORAH WERLII\Q,
(Signature of Notary) (Signature of Notary)
Commission # FF 936882
M Commission Expires DEBORAH WERLING
Ws�
&Wr6pAV�npw2 pItg Commission # FF 936882
kferonally Known OR
...........
Produced Identificatio
My Commission Expires
Type of Identification: Type of Identification: NciyA_nnhPr 17 917119
Joel Hartman
From: Camille Adams <Iilim222@yahoo.com>
Sent: Friday, February 22, 2019 3:26 PM
To: Joel Hartman
Subject: Re: permits
To whom it may concern at COAB
I approve transferring my, Camille Adams of 2139 Seminole Rd, pool permits from Florida Luxury Pools to Pools By John
Clarkson.
Thank you for your time,
Camille Adams
Sent from my iPhone
On Feb 1, 2019, at 6:28 PM,Joel Hartman <Joel@pbic.com>wrote:
Hi Camille
Hope you have had a nice week. Attached is our concept and budget as we discussed.
Once you have a chance to review, please let me know a good time we can talk through this in detail.
Thanks and have a great weekend!
Joel P. Hartman
VP of Residential Pools
Pools by John Clarkson
0: 904.223.4050
M: 904.252.7391
<SC364e I 9020118190.pdf>
<Pool3.JPG>
<Pool I.JPG>
<Pool2.JPG>
Cash Register Receipt Receipt Number
City of Atlantic Beach R9532
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $55.00
POOL19-0009 Address: 2139 SEMINOLE RD AlPN: 169515 0500 $55.00
POOL SAFETY 07/10/2019 RBE $55.00
POOL SAFETY 07/10/2019 RBE 45-j-0000-322 1002 0
TOTAL FEES PAID BY RECEIPT: R9532 $55.00
Date Paid: Thursday, July 11, 2019
Paid By: POOLS BY JOHN CLARKSON, INC.
Cashier: CB
Pay Method: CREDIT CARD 7
00,
I
Printed:Thursday,July 11, 2019 1:07 PM I of 1 1