262 2ND ST - CLOSE OUT PERMIT `�' CITY OF ATLANTIC BEACH
St1
_= 800 SEMINOLE ROAD
J ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
✓J��1r
SINGLE FAMILY DWELLING NEW
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-SFR-4
Job Type: SINGLE FAMILY RESIDENCE
Description: to close out permit
Estimated Value:
Issue Date: 1/4/2016
Expiration Date: 7/2/2016
PROPERTY ADDRESS:
Address: 262 2ND ST
RE Number: 172542-0000
PROPERTY OWNER:
Name: SMITH III,CARL HOLT & JULIA L, *
Address: 4670 BADEN LN
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
�' ' 3 CITY OF ATLANTIC BEACH
- ._. 800 SEMINOLE ROAD
.)
'� �r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
SINGLE FAMILY DWELLING NEW
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-SFR-4
Job Type: SINGLE FAMILY RESIDENCE
Description: to close out permit
Estimated Value:
Issue Date: 1/4/2016
Expiration Date: 7/2/2016
PROPERTY ADDRESS:
Address: 262 2ND ST
RE Number: 172542-0000
PROPERTY OWNER:
Name: SMITH III,CARL HOLT & JULIA L, *
Address: 4670 BADEN LN
PERMIT INFORMATION:
FEES:
Total Payments: $0.00
I'ERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
lik .
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32253 �(/
Office (904)247-5826 Fax(904)247-5845 JJ6
Job Address: ,, ,� •-.V'M
Legal Description = Permit Number:
oor A ea o q. t Parcel#
Valuation of Work$ Proposed Work heated/cooled t
no.n- heated/cooled
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial
If an existing strucure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approva orm
Describe in detail the type of work to be performed:
Pro er Owner Information:
Name:CAR co l.. S i' chNe '�.��
City A., NOM, ►.. Address: /V- off.]._
State V-Zip '_Phone
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:
Address: Qualifying Agent-
Office Phone Cif' State
Job Site/Contact Number Zip
Fax#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
•
Application is hereby made to obtain a permit to do the work and installations as indicated I certifi,that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six 6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters,
Tanks and Air Conditioners,etc.
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 WIH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF H
COMMENCEMENT.
hereby cert fy that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances governing this
pe ofYwork will be complied hether s.eci zed herein or not. The granting of a permit does not presume to give authority o vi
-ovisions of any other feder,,stag, - lo a .ire: lati`c.
traction or the performance of construction. tY violate or cancel the
gnature of Owne r,....,/ �'�' '-• I /
�'
Signature of Contractor
int Name i �1
... .. }.I'.��....1..........1..�10..(.,. .....__ ..a c.vr, Print Name
:fore e 0
I Wilk.��`' ", ota Public Ste-1 Ronde �' of 20
. Shi ey L Graham
taffy Pu• 1C
all • ., •mmission FF 086990
of ' Expires 02/14n taly Pu.1,.
Revised 01.26.10
1/4/2016 Gmail-262 Second Street Atlantic Beach,Florida 32233
II 1 jY Julie Smith <julieandholt @gmail.com>
262 Second Street Atlantic Beach, Florida 32233
1 message
Julie Smith <julieandholt @gmail.com> Mon, Jan 4, 2016 at 9:29 AM
Reply-To: julieandholt @gmail.com
To: julie smith <julieandholt @gmail.com>
Building Department
Attention: Dan Arlington
Dear Dan, In follow up to our telephone conference today this is to confirm
that we have terminated our building contractor, FLA.Design Build, Inc.
(Scott Cessna and John Rowan) effective today January 4, 2016. The
property address is 262 Second Street, Atlantic Beach and we will be
personally residing at this address as our permanent address as soon as we
obtain a Certificate of occupancy. The work is 90 percent complete. You
may contact us at the following telephone numbers-
Holt Smith cell- 904 465 1986
Julie Smith cell-904 465 3712
Thank you very much.
Sincerely,
(.)A?.L. L`t '' jja-'
f( ue LrniH
https://mail.google.com/mail/u/0/?ui=2&i k=f707e20beb&view=pt&search=i nbox&th=1520d0b171 c0d418&sim 1=1520d0b171 c0d418 1/1
S r(LA,T;
ti--.4:::., CITY OF ATLANTIC BEACH
0 WNER / BUILDER AFFIDAVIT
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, WI-IICH 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. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) 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.'ID sg'S?\
PHONE NUMBER 2
s b _we) ---1- _,M % L.
INT
I /At i /1/17//6.
i p I I I I/` DAT
'
Before me this day of Ji 2�,,in the county of
Duval,State of Flo da,has personally appeared herin by himself/herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of F L ,County of-
rsonally Known
Produced I. 4icatio -
v�
2p� Not.: Notary Public State of Florida
Not.,.....;.!.:. / Shirley L Graham
ills X,, 7 My Commission FF 086990
or n'' Expires 02/14/2010
F:/BLDG/Owner-Builder AB'adavit;• VISED:4/16/2009
I
i r •
SS\ CITY OF ATLANTIC BEACH
r ..� 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
r W
�JJ1S l
SINGLE FAMILY DWELLING NEW
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-SFR-639
Job Type: SINGLE FAMILY RESIDENCE
Description: NEW SINGLE FAMILY HOME TO REPLACE DEMO
Estimated Value: $320,000.00
Issue Date: 4/8/2015
Expiration Date: 6/11/2016
PROPERTY ADDRESS:
Address: 262 2ND ST
RE Number: 172542-0000
PROPERTY OWNER:
Name: SMITH III,CARL HOLT & JULIA L, *
Address: 4670 BADEN LN
GENERAL CONTRACTOR INFORMATION:
Name: FLA DESIGN BUILD INC
Address: 5 GUANO DR JOHN W ROWAN
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $570.00
UTIL REV RESIDENTIAL BLDG $50.00
BUILDING PERMIT FEE $1,140.00
STATE DCA SURCHARGE $17.10
STATE DBPR SURCHARGE $17.10
RE-INSPECTION FEE $55.00
RE-INSPECTION FEE $55.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J =" ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Total Payments: $1,904.20
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.