761 Paradise Ln ACC19-0052 Wood Deck ACCESSORY PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ACC19-0052
800 SEMINOLE ROAD ISSUED: 6/18/2019
...... EXPIRES: 12/15/2019
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
761 PARADISE LN ACCESSORY SINGLE OR TWO WOOD DECK $2300.00
FAMILY ACCESSORY
TYPE OF REALIESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1723760185 PARADISE PRESERVE
COMPANY: ADDRESS: CITY: STATE: ZIP:
OWNER: ADDRESS: CITY: STATE: ZIP:
TODISCO ANTONIO 761 PARADISE LN ATLANTIC BEACH FL 32233
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
AT-FORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
2 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,JDog/Dennis Junk Removal,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City right-of-way.
Issued Date: 6/18/2019 1 of 2
ACCESSORY PERMIT PERMIT NUMBER
ACC19-0052
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 6/18/2019
ATLANTIC BEACH. FIL 32233 EXPIRES: 12/15/2019
3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
4 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking must be removed from job site by Contractor.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 4S5-0000-322-1000 0 $65.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $32.SO
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $50.00
TOTAL: $176.50
Issued Date:6/18/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be a ned by the Building Department.)
800 Seminole Road
9 U0
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date routed:
E-mail: building-dept@coab.us
City web-site: hftp://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 76� P Depqdmjit review required Ye N
Applicant: C CkD ND
Tree A ministrator
Project: C)(D c) e C� e15u-blic Worl�
'TURF—Ut-ilities
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: 2/Approved. [:]Denied. [:]Not applicable
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date: 6 -1
TREE ADMIN.
Second Review: FApproved as revised. OlDenied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. []Denied. E]Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
City of Atlantic Beach EGE VEOPLICATION NUMBER
Building Department ("To be s igned by the Building Department.)
800 Seminole Road JUN 1 : 2019 (aC A QC) 5 Z
tlantic Beach, Florida 32233-5445 11 _I
Phone(904)247-5826 - Fax(904)247-5845 bi CL
BY.-- Date routed-
E-mail: building-dept@coab.us
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
0
Property Address: DepajbTwpt review required Yes No_
Applicant: ND
ee-A—
Tr dministrator
Project: 0(D e,:K
P�-Utilities
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: [V(Approved. E]Denied. []Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:-
TREE ADMIN. Second Review: [—]Approved as revised. ElDenied. DNot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ElDenied. ONot applicable
Comments:
Reviewed by: Date:
Revised 05/1912017
'Vir-, City of Atlantic Beach APPLICATION NUMBER
Building Department (To be agned by the Building Department.)
800 Seminole Road
- I q — (A)
Atlantic Beach, Florida 32233-5445 U,
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us L Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: P _Aoisc Lo Dep�jr
=�nt review required Yes No
Applicant:
TreeAdministrator
rrublic—Wor
Project: oc c_'-CIK �V
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: oApproved. []Denied. E]Not appiicabie
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed b Date.-
04"
TREE ADMIN. Second Review: DApproved as revised. ElDenied. F]Not applicabie
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. []Not applicabie
Comments:
Reviewed by: Date:
Revised 0511912017
,.t I ion OFFICE COPY Updated 1019118
Building Permit Applicat
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
fill Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
"�L 341�0-77 '7
Job Address: 71W :?Ko�.Alsc_ LK1 %611411c. Permit Number: R Q_0 Jq - 0 (DS(_
Legal Description VJt-_D S_->f_c-)C, RE#
'k?(20.1)U Heated/CooledSF Non-Heated/Cooled
Valuation of Work(Replacement Cost)$ �A,.
• Class of Work: 74New ElAddition ElAlteration DRepair ElMove E]Demo OPool E]Window/Door
• use of existing/proposed structure(s): ElCommercial 'AResidential
• If an existing structure, is a fire sprinkler system installed?: Dyes 'ANo
• Will tree(s)be removed in association with proposed proiect?E]Yes(must submit separate Tree Removal Permit) ANo
cribe in detail the type of work to be performed: C 0-60V
c)o cl 9
Florida Product Approval# for multiple products use product approval form
PropertV Owner Information QP1
Name r,\. r,44bII,4 'P 776�OLO —Address -7Lri -PNizNA_5.- L,,1
City P�l%.,A 4 C_ -06, State zip —Phone it,y vll yo
E-Mail —T-7.0-b".5-6 C-) k I U%-%DD . C b r-%. 6 5 1 -4d)UES
Owner or Agent(If Agent, Powe'rof At?orney or Agency Letter Required) Z
X: _J Z
Contractor Information L) Cr 0 1
Z
Name of Company Qualifying Agent 04 Lu 0
Address city State Zip d Z
Office Phone Job Site Contact Number 0
State Certification/Registration# E-Mail
Architect Name&Phone# Z
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt 0 Expiration Date
10
Z
Application is hereby made to obtain a permit to d 0 the work a installations as indicated. I certify that no work or instal IaQ 111a E_ UJ
t a,,w
commenced prior to the issuance of a permit and tha will be performed to meet the standards of all the laws regu4ti M
19 0 UJ La
construction in this jurisdiction. I understand that a separa�k ermit must be secured for ELECTRICAL WORK, PLUMBING,S11I S>. CL CC W
Co I(
WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR Co IONERS,etc. NOTICE: In addition to the requiremen otlhyjj
C3 W
permit,there may be additional restrictions applicable to this property that may be found in the public records of this coun!4�Q U) W _;;t
there may be additional permits required from other governmental entities such as water management districts,state ager>es,or CC W
LL1 5;
federal agencies. W
cc
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 OBY.,�IN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC?��= OF CO MMENICEMENT.
U, (Signature of Owner or Agent) (Signature of Contractor)
SiAned and sworip to(Aa, irm:e )before m his day of Signed and sworn to(or affirmed)before me this day of
'Zoo, t%O— C5 by
I So"
(Virptur o ta TONI GINDLESPERGE9S reo ota ry)
MY COMMISSION#FF 924951
EXPIRES:October 6,2019
iw Bond3d Thru,%m Public Undewters
Personally Known OR 11 .11,W]LID
Produced Identification J.1ProdtrcJd Identification
Type of Identificat-c. Z0 too -73-4 Wpe—of WpaFtification:
OFFICECOPY "ALL INFORMATION
Owner Builder Affidavit
HIGHLIGHTED IN
City of Atlantic Beach Buildin Department GRAY IS REQUIRED.
9
800 Seminole Rd, Atlantic Beach, FL 32233
-0a Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: J�6� 3-
1. 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$25,000.00 OR LESS.
THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE
CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH
IS IN VIOLATION OF THIS EXEMPTION.
YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR.YOUR CONSTRUCTION MUST
CORDING TO THE BUILDING CODES AND ZONING REGULATIONS.
IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES
REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES.
IL INJURY LIABILITY;SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT
SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. .
Ill. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING
TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO$S,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. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPT@COAB.US) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALLTHE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: (ji B�,RN&.�3t L t-J NA) mm A 32);)-33
Owner Name: q+bw Phone Number: qoy- 6SI., Y�5)IT
MailingAddress: -SNP1%4_ A City: State: Zi P:
Notarized Signature of Owner
The r g .n nt was acknowIledged before me thisAday of,&, I)e 20Q, in the State of Florida, County
of kn_-LO)
Signature of Notary Public
Personally Known OR Produced Identification
'T:57 6)-000-73 1,�F6
TONI GINDLESPERGER
pe of Identification:
issioN#FF 924951 Ty
MY Gomm
EXPIRES:oclober 6.2019
Bonded Thru Notary Pubric Underweters
Updated 10124118
tot-AP OF. BOUNDARY SURVEY OFFICE COP�y ,,
DESCRIPTION:
LOT 28, PARAOISE LANE ACCOPOING TO TH—F PLAT THEREOF AS RECORGED IN PLAT BOW
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MAP OF BOUNDARY SURVEY
DESCRIPTION.
'57. LOT 28 -0 r
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761 PARADZW LANE
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