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131 S OCEANWALK DR - FNCE20-0102 Revision Request/Correction to Comments **ALL INFORMATION �s% HIGHLIGHTED IN P ° City of Atlantic Beach Building Department GRAY IS REQUIRED. l ' 800 Seminole Rd, Atlantic Beach, FL 32233 '' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 2.0 ""o/o2- / Zeraza ElRevision to Issued Permit OR Corrections to Comments Date: 414 Project Address: �3/ t g4/4A - A4--/t--7/, 'L mac. � 1t/ 3 2 Contractor/Contact Name: . �;J{ZE'e.,4d t"A"'‘..." Or.Pvaf/-....:74/7,-a _-- Contact Phone: !d/ 294- _o''33 Email: je. He e'5, ..5dr.r'/ e- & y-4. a•c-c)'11 Description of Proposed Revision/Corrections: .6R/se/l '' "f 3E- 7-A.se. Za a / 7....,_ �' . kms- cP (- 4-5,,z I affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) W. proposed revision/corrections add additional/&? e footage to original submittal? o 0 Yes(additional s.f.to be added: " ) Si.Sll proposed revision/corrections add additional increase in buildalue to original submittal? No Q*Yes(additional increase in building value: $ )(Contractor must sign if increase in valuation) *Signature of Contractor/Agent: d(b,..._"__A__ 3-1...) (Office Use Only) ❑ Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Department Review Required: Building Planning&Zoning Reviewed By Tree Administrator Public Works Public Utilities Public Safety Date Fire Services Updated 10/17/18 Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department **ALL INFORMATION Vir 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY n t*' IS REQUIRED. Phone: (904) 247-5826 Email: ,Building-Dept@coab.us ^� /° Job Address: />l ( . ) i144-a� O S £ 14,121. art)J9IZ(Permit Number:F N Q�.0 /- lel� Ci -(1)- Legal Description i-2 — oto I O - ZS 2.,9 E REti /L9 L.j62.3 • V©pY" Valuation of Work (Replacement Cost) $ Loi €137 ‘ Heated/Cooled SF Non- Heated/Cooled • Class of Work: ❑New L(Addition ❑Alteration Xepair DMove LIDemo l iPool LiWindow/Door /' • Use of existing/proposed structure(s): ❑Commercial UResidential a dp.Nf€cw,J fiA (,itlo.t! -Fro- • If an existing structure,is a fire sprinkler system installed?: DYes "o • Will tree(s)be removed in association with proposed project? DYes(must submit separate Tree Removal Permit) XNo Describe in detail the type of wor t be,perfor ed: i -A 3r 0/ Ae e tie- �v alit t� . °411 """..fj'� {eA...�e_. Florida Product Approval# - for multiple products use product approval form Property Owner Information �f j „ � Name pe-p......44....,'‘..1 /1D gig"' d t"'t 4J `(jet!- Address/j0/.A• III—"44— / _ City�.e $o:,-✓,,/ e ,ae�.e State ��- Zip 3 Z ZS C� Phone 90 �Z 4/ Z,/2 7/C E-Mail /Il i Q. Iii. Jct. /4, Lr k e v 4/„." -/.,t_ , J_e1,“-ke -1... y4 C.'f- - '�/''s ii1•t(.,,' ✓�..-- f....i-� Owner or Agent(If Agent, Power of Attorn y or Agency Letter Required) f / Contractor Information // //�1;z..4- .--''.7---J Name of CompanyS ..4� C 't•f k.s� Ism oi r.�•Ss- /�'�'�S r!� /�C'f Qualif ing Agent / Address //_./C,1��..S"i rr 'hc� Ave- C aS City d---C{&t, .1(e' State FL Zip 22•Z 3�C Office Phone 90'! _ Oq2- py_13 Job Site Contact Number State Certification/Registration# SC - 3oSi{ ze4 E-Mail )w"`''e S . C5 1 C o /4 f/c.ci , f�M Architect Name&Phone# J Engineer's Name&Phone# Workers Compensation Insurer LAW, 'Ins 444Gkci„,c(—)Tc t5 N/A OR Exempt❑ 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 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. 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 RECORDINGOUR-IQJOTICE OF COMMENCEMENT. //44..41.: d t7it_L.i..,t., (Signature of Owner or Agent) n nature of Contractor) lit Signed and sworn to(or affirmed before me this ILL say of Signed and sworn to(or affirmed)before me this & day of 5-i _,:›r1-3i1—,by I-' _. .1 7G Z� by CIA,le ),, G--Co.-h1 _ v I-etcRic.tigy Qrr,..:L_ -_ :�'Cj1 (Signature of Notary) (Signature of Notary) Ml HELE L.RI HEY-MARTIN • ¢(iirt CISIV(IR 13 a GG19126s . 4, - 'fd�ICHtLI"L!'{�IL�IEY-MARTIN '+� :•' coti4itBSf cW 1c01,2022 .. pf('�i9M f1Ss*tlt*ti GGI91265 •ell XPtliBST-Mit HID%.?Q2i- C., - '/ Building Permit Application Updated 10/9/18 r> ' City of Atlantic Beach Building Department **ALL INFORMATION LI,, - 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY .1 'it p' IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: / .,j/ ale- utd4"-=•k Od- 454, e4)/9104(-Permit Number: !'1\)C.-E.".- ZO ' (31 L L Legal Description 'f 2 - OO[ 0% - 2S 2_9 E RE# fL 9(46,3 • 6)6)41 Valuation of Work(Replacement Cost)$ t/ €8� 'c, Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration J�Repair ❑Move ❑Demo ❑Pool OWindow/Door • Use of existing/proposed structure(s): Commercial ❑Residential ' E4 4f/jJevi itge4 ( iJ /—i(' • If an existing structure,is a fire sprinkler system installed?: ❑Yes /KNo %% • Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) to D cribe in detail the type of wor t be erfor ed: 6, l Ai; iic y / i l c_ /_� 1Le•t- 3r p c-/d Cizi e^n,e.r_ Ali / l 7 E e � y Florida Product Approval# for multiple products use product approval form Property Owner Information �J /� /� 1 Name O �K.t.c3e. AD ex't..... State 165.4 -- Address 1301-/- "I .-A.c.as� /CG( / City.-(c-G $C��✓/i� /Se ' y'-- State ICI- Zip J Z L. <J Phone 1d�—Z i// iZ L- 7/C E-Mail /21, d ham_/:. ft/ C h C y 1%10-1 1,k *1 ec L`4'-Ve----1- (7 'aL f ter_' j ' Owner or Agent(If Agent, Power of Attorndy or Agency Letter Required) Contractor Information 1rs..4 Name of Company 5 c -'1 e4 ()rha'"'" Qual�ng Agent / Address //..g07 ., fr, c0— A '1 C o-sZ City-1 {tsb•4-U•/(�' State rL Zip 22'73r �� Office Phone 9C 4- — 2 qZ- -- Oy_f3 Job Site Contact Number State Certification/Registration# S'el - 3054 2Si4 E-Mail I a''" 5. > S 6 0 i C- L) VA/-f�� C' CJ/1 f Architect Name&Phone# J Engineer's Name&Phone# Workers Compensation Insurer L'c-t-il 7,..s ,Q,}-(.a..G(.d L')/C. I5 ,N/A OR Exempt 0 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 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. 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 Al ATTORNEY BEFORE RECOR 1 G YOUR= OTICE OF COMMENCEMENT. .�_r ?( 4412 --c.. (Signature of Owner or Agent) Ill :nature of Contractor) Signed and sworn to(or affirmed)before me this Dt.0 14.a'tt.y of Signed and sworn to(or affirmed)before me this a6/ day of U 54 ,30 3D ,by Get'¢ '7 . . I/% i,-..• ZO 2 0 ,J y ,cL 1' r./ C-1.44.1 MP r-i-i4 M;au lam- RI& lua ;✓I Cz3� i'1[0�ani ,141/ C@,1. (Signature of Notary) (Signature of Notary) / 1/ MI HELE L.RICHEY-MARTIN f. ' • �Cbf 1613#GG191265 �'=OICI�`ELc'ti`.'1 4IEY-MARTIN `y;;.' 4£7$Ik1tBPftc.Uiter01,2022 A ' 'g j 1414Oss UNrl1 GGI91265 . . 4�...y;,,expt) ES 1aRS►9W 2 C,_„„ Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN q� City of Atlantic Beach Building Department GRAY IS REQUIRED. larir 800 Seminole Rd, Atlantic Beach, FL 32233 `on Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 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@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: /3/ .6e°e -.- Lc.� j1 b1' �. �rS �r o4._ r . - Owner Name: OOeo-0-wn/G rune- �Ai 44-€5 �5 � . Phone Number: `'. a-tf. 5.701 56/ID Mailing Address:/3I"R" -Pt," �►+-«�v /C-s�.r, city:1T it . //etate:322 Zip: A Notarized Signature of Owner XX- G''Ake/ 054.51-1.o �G i �G�-- tt��At-41- -14 The f-pregoing instrument was acknowledged before me this )G' `day of.4uBv54 , 202' in the State of Florida, County of 1L)JVA-L- � C Signature of Notary Publi/ �� :;, liCtt- f? �"'""' MICHELEL. MYCOMMISSION#RICHEY00191265-MARTIN rsonally Known OR [ ] Produced Identification C(&)_ EXPIRES:March 01,2022 Type of Identification: Updated 10/24/18 MAP O F SURVEY A PART OF PARCEL A.RECREATION AREA.OCEANWALK UNIT ONE,AS RECORDED IN PLAT BOOK 42.PACES 1,IA, 19, IC,ID,1E AND IF OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY.FLORIDA. L A K E P A R C E L " B" RECREATION AREA rhes s NETa 7-1*,.N1.,,t 4 4 '2=,==i° .° mac_ .\ SCALE: 1•-217 Is PAKR 4 T ;<>» MT as „OW 11111 3.0 Poo,. IS \\ 0” l.N T .`/�a w NF �rLy ATF` 91 2 T7 Tw ^ (FrQPY EED Tn P4 K9 P24.CCR TM m 4b kf 'VC) IF) T.a kJ I- T'��_' 1A ��a a BEINQMA9c // / f1y� sirma. 1 I w O I\ EuOATKINSET BAG'44 HMO\azo PALMMO MSC IN / i 1V "' Av 6/1 ir / ' / / . II et ..l11 1 CM"..." �� S89'S719'W / /' T ''''4"'c'•\1 _ / �/ ii\ / '� °`°" OCEANWALK DRIVE SOUTH y\ j s j289�` ° _ 589-57'15-w V ..N Jay �Y. p.WE MAG MAK MD DM Al I,�_— __- ,� ,,», J 4-\ / /r1B 36n N ELEVATE. EVAA� / 91. �� / NRC A6`5° N► .„...,"-s 01."-01,07s EE0 \ �K /' LOT 90 \ �" • / .+, i �'9,qs N°TEs. / 'O":am.: MSBEAISA vin APCAI IC SL Mato a /�' IVO III AU OCEA(WALK DIME SUM As 90IC SE7y'24'W AS PFA RAT. ' DI RESER TO 1.40,1)1.40,1)tREFERENCE // BENCHMARK IS A CALL 110E N THE NONNI ROF A / UAW,"Y MI9E N YAE AT THE CEN&ERU TFRSECTKN OF OCEANSIDE MBE WTH OCEANSDE CANT. / ELEVATION 14.50 11050 1929. /' THIS SURVEY WAS MADE FOR THE BENEFIT OF OCEANWALKASSOCIATION,INC. THE PROPERTY SHOWN HEREON APPEARS TO UE IN FLOOD ZONE n FR'(AREA OUTSIDE YEAR RED PLAIN)AS DETERMINED FROM 'FLOOD INSURANCE RATE MLP'COMMUNITY-PANEL NUMBER 1 BE 1 D RDASED APRIL .1989 FOR THE CITY CF ATLANTIC BEACH,DUVAL COUNTY.FLORIDA.RIDA. \ .; DONN W. BOATWRIGHT, P.S.M. NOT VAD WHEW THE SKNATIME AND ME FLORIDA UC.SURVEYOR and MAPPER Na LS 3295 ORIGINAL HSEAL°F A il1EmA UM., FLORIDA ICG 510,411A.A YAPPING 919NE5S No.EB 3672 SlN`.ETOP IND ND YAPPER.. !CHEMED Rr._]FaE:201}°269'DRAaN Or. _!BOATWRIGHT LAND SURVEYORS, Inc. 1500 RODEOS DRIVE JACKSONVILLE BEACH, FLORIDA 241-8550 'DATE:APRIL 22.2013 ��°F_1_