996 Stocks St RES20-0313 Permit PacketOWNER:ADDRESS:CITY:STATE:ZIP:
BILLINGSLEY DAVID L 996 STOCKS ST ATLANTIC BEACH FL 32233-2560
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170953 1000 ATLANTIC BEACH SEC H
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
996 STOCKS ST RESIDENTIAL ALTERATION
RESIDENTIAL
INTERIOR REMODEL - 2
BATHROOMS $20000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $155.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $77.50
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.49
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.33
TOTAL: $238.32
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 1Issued Date: 11/10/2020
PERMIT NUMBER
RES20-0313
ISSUED: 11/10/2020
EXPIRES: 5/9/2021
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $238.32
RES20-0313 Address: 996 STOCKS ST APN: 170953 1000 $238.32
BUILDING $155.00
BUILDING PERMIT 455-0000-322-1000 0 $155.00
BUILDING PLAN REVIEW $77.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $77.50
STATE SURCHARGES $5.82
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.49
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.33
TOTAL FEES PAID BY RECEIPT: R14073 $238.32
Printed: Tuesday, November 10, 2020 10:50 AM
Date Paid: Tuesday, November 10, 2020
Paid By: BILLINGSLEY DAVID L
Pay Method: CREDIT CARD 393877910
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R14073
~+; CENTRALSQUARE
RES20-0313
Building Permit Application
r City of Atlantic Beach Building Department
,nr~' 800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Updated 10/9/18
**ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
Job Address: re;, ,5f{)~,(_s '5f.r1,~+ Permit Number: ________ _
Legal Description J,.,/J f: 1,4 Z/4~ l(d. /11:I.U-,'e. 8"1,.~ .. dff p,tt J!/tJ. RE# /?!J 7 S's' 0 "a I{ , ,,, a,... -"t-.:J.., 'lM.F
Valuation of Work (Replacement Cost)$ flJ). dt::>O Heated/Cooled SF J;J.1'f NZI~-'Heated/Cooled "(M y •
• Class of Work: □New □Addition ~ration □Repair □Move □Demo □Pool □Window/Door
• Use of existing/proposed structure(s): □Commercial ~ential
• If an existing structure, is a fire sprinkler system installed?: □Yes llilN6'
• w· I tre
Describe in detai
Ffo~r T,•/,t. i.u (JoMMIJA} 14/'U(JS
Florida Product Approval# __________________ for multiple products use product approval form
Pr
Owner or Agent (If Agent, Power of Attorney or Agency letter Required) __________________ _
Contractor Information
Name of Company .S Al-Ml A:s ~µJu~ Qualifying Agent &J:~5 ,9~ O@.J C!..OW!J,Ua'"
Address. ___________________ City _______ ~tate ___ Zip. _____ _
Office Phone ______________ Job Site Contact Number ______________ _
State Certification/Registration# E-Mail. ____________________ ___
Architect Name & Phone# ________________________________ _
Engineer's Name & Phone# ________________________________ _
Workers Compensation Insurer ______________ 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 wil l 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 OUR PROPERTY. IF YOU INTEND
TO OBT ..... ~.,.,u.. CING, CONSULT WITH YOUR LEND TIO NE BEFORE
-3;~~~~~~~f--M_M_EN_C_E_MEN~T-~~~~t::Z:J:====~=--
Signed and sworn to (or affirmed) before me this 21._ day of
O<d::: . 1Jrz.o ~ 'L>~~slty hZ=
• (Signature of Notary)
I J ~sonally Known OR
['-rl'roduced Identification "f"[i)L
Type of Identification: I
_..fr.:/.~~---DACO~A_H PARRISH t/'~'\.~ Comm1ss10n # HH 024083
<~;,~:$"/ Expires July 27, 2024 ···.~~°f:i.~~~··· Bonded Tlw Troy Fain II\Sllfanc4 800-385-7019
,
RES20-0313
Owner Builder Affidavit
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-De pt @coab.u s
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT#: ______ _
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES
OWNER/ BU ILDER 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 BU ILD 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
RE UIRED 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 ..
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 $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: _9_96_S_t_oci<_s_S_t _______________________________ _
owner Name: David and Kim Billingsley
Mailing Address: 1015 Atlantic Blvd Box 493
Phone Number: 904-509-3213 ----------
Notarized Signature of Owner _.....Jo,c:::;::;~~~~~:;,.,:::;c:::'.'.::::::::=~~----------------
The foregoing instrument was acknowledged before me this 28_._day of O cl-, 20Ti) • in the State of Florida, County
of j:?uy,,J
,·s;'.!""... {JACODAHPAAA!SH Sigrn,t"" of Nota,y P"blk~ f~-~~h commission# HH 024083 ~ ·•· ·•· 7 2024 ( l Personally Known OR [ fProd uced Identification i..;. i~f Expires July 2 ,
--~'t1 ... ·ot··· n ................ Troy Fain Insurance 800-385-7019 -1-L]) L L.·:••P.;.~·!)i:·· -~· _:""';;"""',;.;"";;...".;;...-----Type of Identification:----~---------------
Updated 10/24/18
RES20-0313
MA'P ~HOWING BOUNDARY SURVEY OF
LOT BLOCK 160 ACCORDING TO THE PLAT OF
SECliEON ""IHJSYi A VllANTEC BEA CH
AS RECORDED IN PLAT BOOK 18 , PAGE(S) 34 OF THE
CERTIFIED TO:
LOT 6
.OT ·
LC! 3
BLOCtC \61
RLCC,< 161
LOT 5
CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
DAVID L . BILLINGSLEY, KDlBERLY A. BILLC~GSLEY, D,\~ESE TITLE & ABSTRACT CO~IPA:;
FIRST A.NERICAN TITLE l};SUR,\NCE C0~1PA..\"Y ,\};0 wxrso~ ~!ORTGAGE CORPORAT10};.
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TED SURVEYORS INC.
LAND A: ENGINEERING SURVEYS
P.O. BOX 382017
5915 CEDAR HILLS BOULEVARD
JACKSONVILLE, FLORIDA 3221 0
904-771 -6468
CERTI FICATE OF AUTliOR1ZATlON NO . LB 0005488
I r-iEREBY CERTIFY Tt-':S SU~Vc:.-Y WAS DONE UNDER MY
DIRECT SUPERVISION l~'.N D . V.C:CTS TH!:: tv111\::MUM TECH:-..lCAL
STAN'.JARDS FO LAND S~RV.t;:YING P:JRSliAN7 :fO CHAPTER
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SCALE : = 30'
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UNERAL NOTE$•
1. ANGLES ARE SHOWN FOR ll-1IS SURVEY.
2. STRUCTURE NO. ~ SHOWN HEREON LIES WITH
DE1ERMINED FROM F.E.M.A. FLOOO MAPS PANE!. ~
3. THIS IS A SURFACE SURVEY ONLY. THE EXTEN1
"IPES AND UTILITIES, iF ANY. NOT DETERMINED
4. ,JJRISOICTIONAL ANO/OR ENViRONMENTAl..l. Y SENSlii
BY THIS SUR\1:Y.
5. THIS SURVEY WAS BASED ON LEGAL DESCRII
PUBLIC RECORDS Yrt.RE NO'" SEARCHED BY "THIS S:J I
CONVENANTS OR RESTRICTIONS 1HAT MAY AFf"
6. JNLESS O"'HERWIS£ STATED ALL IRON PIPES FO
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UC'ENSEO SURVEYOR AND MAPPER.
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" .ASSOC. SURVEY " OR LB. ~ P.T. -POOlT I
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)( CROSS CUT OR DRILL HOU: C/L = CEIi
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RES20-0313
Doc# 2020242539, OR BK 19433 Page 2126 1 Number Pages: 1,
Recorded 10/30/2020 01:38 PM, RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10.00
NOTICE OF COMMENCEMENT
State of _F~lo~rl"""da"------------TaxFol!o No . 1354992.0000
County of _Ou_va_l _________ _
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713
of the Florida Statutes, "the following Information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of pr!)perty being improved: LOT 1 BLK 160 SEC H ATLANTIC BEACH 18-34 17-2S-29E .117
From the Duval"County Property Appraiser Web site
Address of property being Improved: 996 Stocks St Atlantic Beach FL 32233
General description of improvements: Bathroom remodels, new tile throughout common areas.
owner: David and Kimberly Billingsley Address: 996 Stocks SI Atlantic Beach FL32233
Owner's interest In site of the improvement: _R_es_ld_en_ce ________________________ _
Fee Simple Titleholder (if other than owner): ___________________________ _
. Na~
ContractorW/}1,1,iJ, -2, /JhJ ~..,U<e)I
Address: _________ / ______________________________ _
Telephone No.: _________ _ Fax No: ___________ _
Surety(ifany) _____________________________________ _
Address:· ______________________ Amount of Bond$ ________ _
Telephone No: _________ _ Fax No: ___________ _
Name and address of any person making a loan for the construction of the improvements
Name: _____________________________________ _
Address: ____________________________________ _
Phone No: ___________ _ Fax No: ___________ _
Name of person within.the State of Florida, other t han himself, designated by owner upon whom notices or other documents may
beserved; Name: ____________________________________ _
Address:-------------------------------------
Telephone No: _________ _ Fax No: ___________ _
In ·addition to himself, owner designates the following person to receive -a copy of the -\.ienor'·s ·Notice as ·provided ·in ·S-ectlo n
713.06{2) (b), Florida Statues. (FIii in at Owner's option)
Name: ____________________________________ _
Address: ____________________________________ _
Telephone No: _________ _
Expiration date of Notice of Commencement (the expiration date is
specffied):~=======-=~---~=~~~~~]~~t~~l~/.j._-~~~~~~~~~;;::i====-=-----
THIS SPACE FOR RECORDER'S USE ONLY
-~-_day of
Of Rorida, has personally appeared,,1l~~IQJ~..S...:._,J.~~~¥!!o!!i:l:L\---
Notary Public at large, State of Florl~_9)unty of Duvat.
My commission e~pires:.J.\...,\_.,,,G"--Y,:L...C. • .=?V.=.:2D="-------------PersonaUy Known: ___________________ or
Produced ldent\flcatJon:_..,FJc...=<-C-''D=-L.-"-_____________ _
--------------------------~ -------------------. --------