1812 Sea Oats Dr RES20-0050 Modify Bathroom _ I
rs' �'%•, RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH RES20-0050
800 SEMINOLE ROAD ISSUED: 3/18/2020
*P``''' '- ATLANTIC BEACH. FL 32233 EXPIRES: 9/14/2020
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:
1812 SEA OATS DR RESIDENTIAL ALTERATION MODIFY BATHROOM FOR $4900.00
RESIDENTIAL HANDICAPPED ACCESS
TYPE OF IREAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0562 SELVA MARINA UNIT 09
COMPANY: ADDRESS: CITY: STATE: ZIP:
OWNER: ADDRESS: CITY: STATE: , ZIP:
WARNOCK HARVEY K LIFE 301 1ST ST ATLANTIC BEACH FL 32233
ESTATE
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $75.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $37.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.46
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.98
WORK WITHOUT PERMIT 455-0000-322-1000 0 $185.00
TOTAL: $304.94
Issued Date:3/18/2020 1 of 2
4t'i:iX RESIDENTIAL PERMIT PERMIT NUMBER
2. `.4 RES20-0050
CITY OF ATLANTIC BEACH
ili
t)ts �~ 800 SEMINOLE ROAD ISSUED: 3/18/2020
`s3 ATLANTIC BEACH. FL 32233 EXPIRES: 9/14/2020
Issued Date:3/18/2020 2 of 2
a44t
?\ INSPECTIONS REQUIRED FOR BUILDING PERMITS
2 To verify compliance with building codes,inspections of the work authorized are required at various points of the construction.
'iThe following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
Power Pole Final Plumbing
Silt Fence Final Electrical
Piers/Stem Walls Final HVAC
Underground Plumbing CC Final
Underground Electric Final Building*
Foundation/Footing 'For new living space:When all construction work including electrical,plumbing,
- _ mechanical,exterior finish,grading,required paving and landscaping is complete
Slab** and the building is ready for occupancy,but before being occupied
**FORM BOARD ELEVATION CERTIFICATE MUST BEON-SITE FOR SLAB INSPECTION Swimming Pool Steel
Retaining Wall Footing Swimming Pool Safety
Driveway Electrical Grounding&Bonding
Sewer(Building Dept) Swimming Pool Final (Bldg)
Sewer Tap(Utilities Dept) Swimming Pool Final(PW)
* Additional inspections may apply to your project if your project
Rough Electric
contains these elements:
Rough Plumbing/Top Out* Formed Columns/Beams*
Rough Mechanical* Masonry Cell Fill
*When all rough electric,plumbing,mechanical are complete but before any work is 'When forms and reinforcing steel,anchor bolts,sleeves and inserts,and all
covered up. electrical,plumbing and mechanical work is in place,but before concrete is poured.
House Wrap
Structural Steel*
Wall Sheathing *When all structural steel members are in place and all connections ore complete,
but before such work is covered or concealed.
Roof Sheathing
OTHER:
Tie-down Framing Connections
OTHER:
Rough Framing
OTHER:
Roofing In Progress
OTHER:
Window/Door In-Progress
OTHER:
Insulation Ceiling aInsulation Wall {1�`NJ\ OcI
,F RI R F-,00\\
Exterior Lath
Permit Type
Stucco Scratch Coat � �
_ C,)
s c)
Exterior Siding In-Progress r'�
Brick Flashing&Ties Permit No.
Early Power
Gas Rough
t C6 I Z SEA CTS
g Job Address
Gas Final* cif)
*When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance.All outlets must be capped and pipe pressurized at a
minimum of 15 lbs. Contractor
POST THIS CARD WITH PERMITS AND PERMIT
Building Department Public Works/Utilities Fire Department DOCUMENTATION IN FRONT OF BUILDING
Phone:904-247-5826 Phone:904-247-5834 Phone:904-630-4789
Fax:904-247-5845 Fax:904-247-5843 Fax:904-630-4203 INSPECTION LINE: 904-247-5814
MUST CALL BY IPM PREVIOUS DAY FOR NEXT DAY INSPECTION
Construction Hours per City Code:7a m-7pm Weekdays;9am-7pm Weekends
r
Building Permit Application Updated 10/9/18
-.- ' 1 City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
on>' IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us //��
` Job Address: j" /,,ZCd.5 �- AT S 002. Permit Number E 5ZL—QO.S0
Legal Description ^��' I V C, f VlQ`i f1 c& O r\CI -'t L c-I4- .3 1::`) I tS 'E... RE# 172.02-0-e)----,..c„,-1_,
Valuation of Work(Replacement Cost) $ it 9 pe,), t').:.> Heated/Cooled SF 14-09 Non-Heated/Cooled 4 t'i'
• Class of Work: ONew ❑Addition N'Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial ISCesidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes IXNo
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit_❑No
Describe in detail the type ofwork to be performed: h6 OLDit=y aik. 15:r tib ( E51I C=CA" T-4' A< 't:.' tlJAr' %MAW' -
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Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Hes,Q\icy Kr t.)rV c--1-t U (Z1SG C‹.._ _ Address Ji j2 Sz:r4 t. :451.5 i` 3v1 ill ST:
City ��,�r ie, +.( State f-G Zip g 2_4,3 Phone 5''0 T.1/ -3Z,,'3
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information )
Name of Company d� < k 'jQS /Z5 INC. Qualifying Agent 1-(i4.�.L�€/ K. .4•41(, i����'K
Address/5/S- 4j`04/Cri1c: JAW, -44-iC lam' City rice A)k)jUE State re_ Zip 32'2 r; 7
Office Phone 3S `73-YL' _ Job Site Contact Nu er .1 t "-T Y&6
State Certification/Registration# t(iL /;2033 3 E-Mail tin CL 74R KW' _M fact aP-C(/4R.3. (lc.sf
Architect Name&Phone# /� A
Engineer's Name&Phone# /14' EL
Workers Compensation Insurer ,'N Sii.piar-CC_ toF144:4,4.0r4KA, (4.OR Exempt o Expiration Date //iJ. a, 0
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 regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, MM
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 0
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies. F EB ' 0 2020
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all Q
applicable laws regulating construction and zoning. w N
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WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF C' MMENCEMENT M
N
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INZ61so o
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE g w _ a
RECORDING YOUR NOTIC OF CO MENCEMENT. 0moo [Li-
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Vignature of Owner or Agent) (Signature of Con :ctor) Z CC Z
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Signed and sworn to(or .+ med)before me this Z Qay of Signed and sworn to(or affirme, before me this WY° � F
(^ (• ,, i r\00-1C— ,by • Q ~ w
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[ ]Personally Known OR 'Egg(now IR ; V CO tU W
�a:i.1 TONT CC
[ ] Produced Identification \ = ',�� My COMMISiif�5R6���� ifi tion W
Type of Identification: n i' _ PIRE�1fd8(g�d3atior CC lx
"'.. o °P`. Bonded Thru Notary Pubic Underwrtters
JOB COP .,
Owner Builder Affidavit **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 //-
aPhone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:g6sao -cosO
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. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPT t(il. COAB.US ) 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.
Job Address: a S tT3 J V L
Owner Name: 1-1RQV' ' //1'R (cr Opel.1 t, Phone Number: --.3283
Mailing Address: 3D 1 STQ. T City: �Xicz ►1' }C+l State: Ft.. Zip: 3 zz 33
Notarized Signature of Owner /71(240y 71. /4/24,1
The foregoing instrument was acknowledged before me this ce day of Ac1-ARy ,201t, in the State of Florida, County
of Du i/A Lr
Signature of Notary Public
(--Personally Known OR roduced Identification
Type of Identification: L,
ER Updated 10/24/18
MY 70NI COMMISSIONGINOLESP#GR6G353178
=a;. L� EXPIRES:October 6,2023
''odn.°r;: Bonded Thru Notary Public Undervrtiters
JOB COPY
March 5, 2020
Mr. Mike Jones,
Building Inspector/Plans Examiner
City of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233
RE: Permit #RES20-0050
Dear Mr. Jones:
Enclosed are the submittals requested in your BUILDING
REVIEW COMMENTS dated 3/03/20.
I have tried to follow your Correction Comments and comply
with your directive. Please find "as built," plan modifications,
Memorandum of items, and some general comments not
pertaining to this permit.
I may be reached @ (Office) 398-7350, (Home) 246-3683, (Cell)
631-3802. Mailing: 301 1st Street, Atlantic Beach, FL 32233.
Sincer ly yours,
Qit,G�j
Harvey/K. Warnock
1812 Sea Oars Drive, Atlantic Beach, FL 32233 March 5, 2020
FLOOR PLAN PRIOR TO ANY AL'1'hRATIONS - "As Built"
JOB COPY
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JOB COPY
MEMORANDUM
REFERENCE: 1812 Sea Oats Drive
Atlantic Beach, FL 32233
Handicapped Accessibility
Enclosed is a floor plan of the premises "As Built."
Also enclosed is a floor plan with modifications for handicapped
use.
Modifications will include:
Removal of nonbearing wall for HC access to BA. A portion
of wall remains as a "knee wall."
Shower drop ceiling removed.
3 Lavatory relocated to other side of knee wall.
Water Closet relocated about 3'. (Completed under
Plumber's permit).
Shower & walls prepped for Sluder system with minimum
rise for HC accessibility. Purple or Green Rock added as
necessary around shower.
Ceramic tile on shower wall and tile or vinyl on BA floor.
Electrical Work Included:
Ceiling fixture for Shower Light.
Ceiling fixture for Vent Fan.
/6 ceiling fixture for light over lavatory.
GFI duplex outlet by lavatory.
Safe off any necessary electric by Allstate Electric.
t ' ,
1814 Sea Oats DriVe, Atlantic Beach, FL 32233 March 5, 2020
Floor Plan with Alteration for Handicapped Accessibility
Level 2 Alteration ,
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JOB COPY
COMMENTS: Not at this time but future work at
1812 Sea Oats Drive, Atlantic Beach, FL 32233 will
include:
Roof & rotten wood replacement.
Concrete driveway removed and replaced with
same.
Yard replaced with sprinkler system. Landscape.
Electrical upgrade with replacement of duplex
outlets, add GFI in kitchen, replace Georgia Pacific
CB panel with new.
Inside floor covering.
Painting interior. Possibly texture LR & Hallway
walls.
Install HC grab bars as necessary.
By: Harvey Warnock, 03/05/2020
Homeowner & CGC1520338
ri
. **I Cash Register Receipt Receipt Number
vtirsipCity of Atlantic Beach R12015
DESCRIPTION ACCOUNT I QTY I PAID
PermitTRAK $304.94
RES20-0050 Address: 1812 SEA OATS DR APN: 172020 0562 $304.94
BUILDING $75.00
BUILDING PERMIT 455-0000-322-1000 0 $75.00
BUILDING PLAN REVIEW $37.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $37.50
STATE SURCHARGES $7.44
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.46
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.98
WORK WITHOUT PERMIT $185.00
WORK WITHOUT PERMIT 455-0000-322-1000 0 $185.00
TOTAL FEES PAID BY RECEIPT: R12015 $304.94
Date Paid: Wednesday, March 18, 2020
Paid By: WARNOCK HARVEY K
Cashier: FJ
Pay Method: CREDIT CARD 7
Printed:Wednesday, March 18,2020 2:21 PM 1 of 1
City of Atlantic Beach APPLICATION NUMBER
�, , Building Department (To be assigned by the Building Department.)
�- ''' 800 Seminole Road (^�
O
. "`1,�. Atlantic Beach, Florida 32233-5445 I �szc� `J��
\ Phone(904)247-5826 • Fax(904)247-5845
br;l�: E-mail: building-dept@coab.us
Date routed: 2- /2—C) /Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 el Z.. �eR Cr{V D nt review required Yes, No
Buildin V
Applicant: (3 UD kD C---g--, .Pl &Zoning
�(� Tree Administrator
Project: I V\�j Di �(1 �9`tH a:011,1 Public Works
Public 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 I First Review: Approved. Denied. I 'Not applicable
(Circle one.) Comments: 5 ( .,
BUILDI
PLANNING &ZONING ^
Reviewed by: � Date: 3/SJR
TREE ADMIN. Second Review: I,XlApproved as revised. (Denied. I INot applicable
PUBLIC WORKS Comments: 1 to /
PUBLIC UTILITIES / �/ (/
PUBLIC SAFETY Reviewed by: r/ ' Date: 3//7/26
FIRE SERVICES Third Review: Approved as revised. Denie . Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
, OFFICE COP-
.
,,t Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
n "`ji'=, City of Atlantic Beach Building Department GRAY IS REQUIRED.
i 800 Seminole Rd, Atlantic Beach, FL 32233 �y V`,/
` v? Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: R ESZV— ( ):cs 0
❑ Revision to Issued Permit OR Corrections to Comments Date: 3/(G,/6.-(.1
Project Address: rE 1 7 „SP q. 0 Qi,-S
Contractor/Contact Name: CD GO kD l+cx.r"Uefi L a r-n DC`
Contact Phone: 3 G 53 Email:
Description of Proposed Revision/Corrections:
S l.�U t t lr D G'S
• To: Mice ones , ans
Examiner #RES20-0050
I _affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
❑No ❑ Yes (additional s.f.to be added: )
• Will proposed revision/corrections add additional increase in building value to original submittal?
❑No ❑*yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
❑ Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$ SCS. 0c)
Revision/Plan Review Comments pj1/S S UI U cr.,S
D ent Review Required: ^
Buildin r'
nning&Zoning Reviewed By
Tree Administrator
Public Works -1
Public Utilities 31/7/265
Public Safety Date
Fire Services Updated10/17/18
'! r-(11 "--- , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j :«r ATLANTIC BEACH, FL 32233
OFFICE COPY (904) 247-5800
J.-4-61319
BUILDING REVIEW COMMENTS
Date: 3/3/2020
Permit#: RES20-0050 Site Address: 1812 SEA OATS DR
Review Status: Denied RE#: 172020 0562
Applicant: Property Owner: WARNOCK HARVEY K LIFE ESTATE
Email: Email:
HARVEYWARNOCK@DEMETREEBROTHERS.COM
Phone: Phone: 9042463683
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 Comment:
1. Submit existing and proposed floor plans to show the changes to take place.
2. Show new dimensions.
3. Note on documents that this will be a Level 2 Alteration.
Building
Mike Jones
Building Inspector/Plans Examiner
City of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233
(904) 247-5844
Email:mjones@coab.us
lR{ViC'v Was e /ridiloci I1't VT/ze
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
and revision sequence number shall also be indicated in a conspicuous location in the title block for each sheet on which
a revision for that sequence occurs. For projects still in the initial review stage and permit pending, all sheets with
0" • Building Permit Application Updated10/9/18
OFFICE COP'. g City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
n 9%' IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us /� j�
Job Address: /8/,Z 5F* b-47-5 O R, Permit NumberR E SZC)-00 v
Legal Description g e. Iva. Mal-i A a. L)nCV) Lar 3 @I K RE# 1 72_07-0-ci Z_,
Valuation of Work(Replacement Cost)$ /.t. 9e>o by Heated/Cooled SF /4,00 Non-Heated/Cooled OP
• Class of Work: ❑New ❑Addition E 'Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes D4No
• Will tree(s)be removed in association with proposed protect?❑Yes(must submit separate Tree Removal Permit)NTE
Describe in detail the type of orlto beerformed: t Oi I Y ,sf( 1571,-36 RE5rtzccwt To Ate .C'M Lig �' �Az,;p1
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Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name 42 Vc y .)0 -Pt (Alm z ge.
+�n2iUG C Address p312 364 t.47s opie. t•` 3-o/ f "
City / g.. )'rle emcA4 State -r . Zip 32z.3.3 Phone 104 Z4/4-3/SI3
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company DElAtaFLLa~"' fpr. g we._ Qualifying Agent f-64At.,i€7' K (,r, (ZNtSck
Address/615 47-<d1(Jrtc .B 4 , _1144 f'5 0 City 070q;JU L E State re_ Zip 3Z2 6 7
Office Phone Yz4 aQre-13-7bJob Site Contact Numper .,,6i✓^ 61ae•
State Certification/Registration# ( C/520.43 3 E-mail Nf,fwe .NOCt< mfr.-fa e-Eilearga2.-30 da nr
Architect Name&Phone# N A
Engineer's Name&Phone# //9'
Workers Compensation Insurer /,t/ 6C1/2,LCS iliorterEVAWA4A, 1+,L.OR Exempt❑ Expiration Date ihk d
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 regulating
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. N'OcB:•L61 addition to:the requicernents 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. F E B 2 0 2020
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance withal
applicable laws regulating construction and zoning. 0
i! !;; Z N
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE,05t9MMENCEMEiN;T MA`6 i -I z n
At G: / C J a o
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INT IR o t_
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE U co n z a
RECORDIN YOUR NOTIC OF COMMENCEMENT. 0 a 8 2
/� v 'i z z
ignature of Owner or Agent) (Signature of Con ctor) V LL a
igned and sworn to(or . med)before me this Z nay of Signed and sworn to(or affirme before me this dg oc. .5 w
�b -?,?0, (ol l' • , oc K ' by LL INOMME, ® aw m
�'_ ctign 1'e o� i .0 (Signature of Notary) ! I-- w -/ ❑
ill V (i) WI 5
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[ ]Personally Known OR TONI 1•EsfirRajgnow. IR. LU >
Jp'r•vy c' w
[ ]Produced Identification 136jt7$ifi tion Cr CC
Type of Identification: d L Ail •#, MY COMMS i�R 3atio
- PIRE . Berle
.�" p -J 'y Public Underwriters
Owner Builder Affidavit OFFICE COPY **ALL INFORMATION
f!LAT,. HIGHLIGHTED IN
•us City of Atlantic Beach Building Department GRAY IS REQUIRED.
.j';1111r. 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:g6SaO -OOs'O
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 ISA 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 ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: jg j,/, S ,= _13 , , V L
Owner Name: Fike V�'y/JA I C� Opp.ti1t ctc Phone Number: 9051 o14/4—3‘
Mailing Address: ,3/)1 1 s 5 i Q e�-T City: fl-aAnkric_ PE++I State: gt.. Zip:s ZZ 33
Notarized Signature of Owner 4/71y Z-14/2.41.44-
The
/2.41.4 -The foregoing instrument was acknowledged before me this o:t.0 day of <J',AR , 20 Zu, in the State of Florida, County
of YJUVAL
Signature of Notary Public ► c�
L]-P-ersonally Known OR roduced IdentificationJ
Type of Identification: I ,
TONI GINDLESPERGER Updated 10/24/18
.i. '. MY COMMISSION#GG 353178
EXPIRES:October 6,2023
-:f;Y t1-?: Bonded Thru Notary Public Underwriters
OFFICE COPY
March 5, 2020
Mr. Mike Jones,
Building Inspector/Plans Examiner
City of Atlantic Beach
800 Seminole Road
Atlantic Beach, FL 32233
RE: Permit #RES20-0050
Dear Mr. Jones:
Enclosed are the submittals requested in your BUILDING
REVIEW COMMENTS dated 3/03/20.
I have tried to follow your Correction Comments and comply
with your directive. Please find "as built," plan modifications,
Memorandum of items, and some general comments not
pertaining to this permit.
I may be reached @ (Office) 398-7350, (Home) 246-3683, (Cell)
631-3802. Mailing: 301 1st Street, Atlantic Beach, FL 32233.
Sincer ly yours,
744,0-74/Ly1D
Harvey K. Warnock
1812 Bea Oars. Dxiye, 1#lantic Beach,. FL .32233 March 5, 2020.
FLOOR PLAN PRIOR TO ANY ALTERATIONS _ "As Built"
OFFICE COPY
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MEMORANDUM
OFFICE COPY
REFERENCE: 1812 Sea Oats Drive
Atlantic Beach, FL 32233
Handicapped Accessibility
Enclosed is a floor plan of the premises "As Built."
Also enclosed is a floor plan with modifications for handicapped
use.
Modifications will include:
Removal of nonbearing wall for HC access to BA. A portion
of wall remains as a "knee wall."
Shower drop ceiling removed.
Lavatory relocated to other side of knee wall.
Water Closet relocated about 3'. (Completed under
Plumber's permit).
Shower & walls prepped for Sluder system with minimum
rise for HC accessibility. Purple or Green Rock added as
necessary around shower.
ACeramic tile on shower wall and tile or vinyl on BA floor.
Electrical Work Included:
Ceiling fixture for Shower Light.
Ceiling fixture for Vent Fan.
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ceiling fixture for light over lavatory.
GFI duplex outlet by lavatory.
Safe off any necessary electric by Allstate Electric.
•
181g Sea Oats Drive, Atlantic Beach, FL 32233 March 5, 2020
Floor Plan with Alteration for Handicapped Accessibility.
Level 2 Alteration OFFICE C0pY
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OFFICE COPY
COMMENTS: Not at this time but future work at
1812 Sea Oats Drive, Atlantic Beach, FL 32233 will
include:
Roof & rotten wood replacement.
Concrete driveway removed and replaced with
same.
Yard replaced with sprinkler system. Landscape.
Electrical upgrade with replacement of duplex
outlets, add GFI in kitchen, replace Georgia Pacific
CB panel with new.
Inside floor covering.
Painting interior. Possibly texture LR & Hallway
walls.
Install HC grab bars as necessary.
By: Harvey Warnock, 03/05/2020
Homeowner & CGC1520338