1883 Atlantic Beach Dr ACC20-0084 Permit PacketOWNER:ADDRESS:CITY:STATE:ZIP:
David Lamolinara 1883 Atlantic Beach Atlantic Beach FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169505 1570 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1883 ATLANTIC BEACH DR ACCESSORY SINGLE OR TWO
FAMILY ACCESSORY PAVER PATIO AND FIREPIT $17000.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line (904-247-
5814) to request an Erosion and Sediment Control Inspection prior to start of construction.
2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
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 2Issued Date: 12/29/2020
PERMIT NUMBER
ACC20-0084
ISSUED: 12/29/2020
EXPIRES: 6/27/2021
ACCESSORY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00
BUILDING PERMIT 455-0000-322-1000 0 $140.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $70.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.65
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.10
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL: $392.75
3 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off container
cannot be placed on City right-of-way.
4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
5 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking and debris must be removed from job site by Contractor.
6 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 2Issued Date: 12/29/2020
PERMIT NUMBER
ACC20-0084
ISSUED: 12/29/2020
EXPIRES: 6/27/2021
ACCESSORY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $442.75
ACC20-0084 Address: 1883 ATLANTIC BEACH DR APN: 169505 1570 $442.75
BLDG SUBSEQUENT PLAN REVIEW FEES $100.00
BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00
BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00
BUILDING $140.00
BUILDING PERMIT 455-0000-322-1000 0 $140.00
BUILDING PLAN REVIEW $70.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $70.00
PUBLIC WORKS PLAN REVIEW $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE SURCHARGES $7.75
STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.65
STATE DCA SURCHARGE 455-0000-208-0600 0 $3.10
ZONING PLAN REVIEW $100.00
ZONING REVIEW SINGLE AND TWO FAMILY
USES 001-0000-329-1003 0 $100.00
TOTAL FEES PAID BY RECEIPT: R14462 $442.75
Printed: Tuesday, December 29, 2020 2:07 PM
Date Paid: Tuesday, December 29, 2020
Paid By: David Lamolinara
Pay Method: CREDIT CARD 408593912
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R14462
~+; CENTRALSQUARE
ACC20-0084
Building Permit Application
:: City of Atlantic Beach Building Department
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.
JobAddress: 1e;133 A+la"tft? 13:j,, ]),]_ Permit Number: _________ _
Legal Description LDt: >°'2 et> S~ 01'1 f2'5-f: O Af{AA+£c..Bc,/, C..C. RE# u,.., i--f-;}-tif_ s rt',:---~-'t:1/41.-----,.-ed--,-------
Valuation of Work (Replacement Cost) $ 12 Q{JO-OD Heated/Cooled SF _____ Non-Heated/Cooled ____ _
• Class of Work: □New OOdition □Alteration □Repair □Move □Demo □Pool □Window/Door
• Use of existing/proposed structure(s}: □Commercial ~sidential
• If an existing structure, is a fire sprinkler system installed?: □Yes □No tJ/ A
• Will tree be re ved in a ociation with ro osed ro·ect? □Yes must submit se a ate Tree Removal Permit ~
Describe in detail the type of work to be performed: ~\..P lab~ -p~+i 6 e t--le.l'\,,~O ......_ fp~v-)Jl/'<-.o 1
w/,Pi "~ 1A..c. e_
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) ___________________ _
Contractor Information
Name of Company ________________ Qualifying Agent _______________ _
Address City ________ State ___ 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 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
NCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
UR NOTICE OF COMMENCEMENT.
""
(Signature of owner or Agent}
-~ Signed and sworn to (or affirmed} before me this /r, ~day of
N,v~.19'P~~
(SignatBfi~rvl
W NotaryPubliO
State of Florida
[ ) Personally Known O UV Commission Expir8I 01IDSl2024
l'-fl>roduced Identification 7::. Commlallan No.. 0G 943811G
Type of Identification: __ ,_◄L-...,D--t..-~--------
(Signature of Contractor)
Signed and sworn to (or affirmed) before me this __ day of
----~---~by __________ _
(Signature of Notary)
[ ) Personally Known OR
[ ) Produced Identification
Type of Identification : _____________ _
ACC20-0084
NOTICE OF COMMENCEMENT
State of _F_lo_ri_da ___________ _ Tax Folio No. _____________ _
County of _D_u_v_al __________ _
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 property being improved: Lot 55 as shown on plat of atlantic beach country club unit 2 as recorded
on plat book 67, pages 132 -137 of the current public records of duval county, FL
Address of property being improved: 1883 Atlantic Beach Dr., Atlantic Beach, FL 32233
General description of improvements: Additional 14' x 15' paver pation extention with Qas fireplace
Owner: David E. Lamolinara Address: 1883 Atlantic Bch Dr.. Atlantic Bch, FL 32233
Owner's interest in site of the improvement:--------------------------------
Fee Simple Titleholder (if other than owner):--------------------------------
Name: _________________________________________ _
Contractor: __________________________________________ _
Address: ______________________________________ _
Telephone No.: __________ _ Fax No: ____________ _
Surety (if any)_nl_a _______________________________________ _
Address: ________________________ Amount of Bond$ _________ _
Telephone No: __________ _ Fax No: -------------
Name and address of any person making a loan for the construction of the improvements
Name: _n_la ________________________________________ _
Address: ________________________________________ _
Phone No: ____________ _ Fax No: ____________ _
Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may
be served: Name:-----------------------------------------
Address: ________________________________________ _
Telephone No : ___________ _ Fax No: ____________ _
In addition to himself, owner designates the following person to receive a copy of the lienor's Notice as provided in Section
713.06(2) (b), Florida Statues. (Fill in at Owner's option)
Name: _________________________________________ _
Address:-----------------------------------------
Telephone No: ___________ _ Fax No: -------------
Expiration date of Notice of Commencement (the expiration date is one (1) year from the date of recording unless a different date is
specified): ____________________ -=------------------------
::•• ,o vb Da<e ,,/,i/k THIS SPACE FOR RECORDER'S USE ONLY
%ahra Emil
W Nota,y PubliO
State of Florldl
My Commission Expi111$ 01/05/2024
Commilaion No. GG 943990
Before me [7":{t, ~ day of .....,_=.-r=.--f-l'~--1 in the County of Duval, State
Of Florida, has personally appeared ~..., Ii n ,-...__
Notary Public at large, State of Florida, County of Duval.
My commission expires: -'-I/ ..... _~-=--· 1.4~'1M~---------------
Personally Known: -----,=------:--..--:---------------or
Produced Identification: _£"'-'l-=--,,""'/_.Doc...aL""'-_____________ _
ACC20-0084
Owner Builder Affidavit
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
**All INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
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 ..
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: 1883 Atlantic Beach Dr
Owner Name: Dayid E. Lamolinaca
Mailing Address: 1883 Atlantic Beach Dr City: Atlantic Bch
Phone Number: ..,_(9_04.....:)_44_5_-8_0_5_5 ____ _
State: _F_L ___ Zip: 32233
Notarized Signature of Owner ____ _.....~1-------------------------
The foregoing instrument was ackno edged before me this ~day of µ<1'1,v..4,v 1v:, 20-Z!!, in the State of Florida, County
of 1)(1:tlg (
Zahra~
W NotaryPubliO
State of Flonda ~ My Commission Explrea 011D512024
CommiUlon No. GG 943990
SignatureofNota,yP~~
[ ] Personally Known O~duced Identification
Type of Identification: ..... r-_l_--=D::...,_L _______________ _
Updated 10/24/18
--:51rn LR JOB ClJf'•
LOT 55 AS SHOWN ON PLAT OF
ATLANTIC BEACH COUNTRY CLUB UNIT 2
AS RECORDED IN PLAT BOOK 67, PAGES 132-137 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FL.
GRAPHIC SCALE
JO O '' ~----( IN FEET)
Inch -30 It.
MEASUREMENTS ARE FROM
POOL WATERLINE TO
PROPERTY LINE
SCALE: 1/30" = 1'
BARRIERS:
~
FENCE
ALARMS
'11·1i ----~[SI~) 2a.s1·\"",.,,-.,,.-:..,.i.-_-..i:-r:..:;
;.;;,.__ 48.00'
~ -~"<'" i-3 I/) "'0o-:!1 ii' C "° ''°) ....... ~ ~-\
!l~\
ts1~ l ft· t-)1
~ --/ ~ \,1 ~ !!ii!)jj DENOTES PROPOSED WOOO t;';l
LJ DENOTES PROPOSEO CONCRETE
~ DENOTES PROPOSED PAVERS
@I DENOTES CHEMJCAL TOILET f }-OENOlES FUTURE 4• TREE
e'Nf!N M?!f"',
N/A
11£1.0 ~""1< COI.IPi:iiiiO
\
jMPERVIOUS CALCULATIONS
OTAL LOT AREA: 10,672 SQ FT
HOUSE: 2,115 SQ FT
DRNEWAY/SW: 1,065 SQ FT
OVERED PATIO: 585 SQ FT
POOUCOPING/DECK:868 SQ FT
OTAL: 31765 SQ FT
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Revision Request/Correction to Comments
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
0 Revision to Issued Permit OR D Corrections to Comments
Project Address: 1883 Atlantic Beach Dr. Atlantic Beach FL
Contractor/Contact Name: Davidand Jennifer Lamolinara -Homeowner
Contact Phone: ..:.(9_0_4.:...) _23_7_-1_6_1_5 ________ Email: jlamolinara@gmail.com
Description of Proposed Revision / Corrections:
per the calculations on the survey provided we are adding 234 square feet
We are doing this work ourself
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT #: : ACC20-0084
Date: 1210212020
I Davidand Jennifer Lamolinara -Homeowner 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?
0No E] Yes (additional s.f. to be added: 234 )
•.,W.ill proposed revision~~orrec!ions ad~ add'.ti~nal increase in building value to original submittal?
UNo E]•ves (add1t1onal increase In building value: $.-ll'--->Lu=~C>L..----..--) (Contractor must sign if increase in valuation)
(Office Use Only)
[YApproved D Denied D Not Applicable to Department Permit Fee Due$. ______ _
Revision/Plan Review Comments _____________________________ _
Department Review Required:
Building
Planning & Zoning
Tree Administrator
Public Works
Public Utilities
Public Safety
Fire Services
Reviewed By
Date
Updated 10/17/18
Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED. City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: _____________________
Revision to Issued Permit OR Corrections to Comments Date: ________________
Project Address: ____________________________________________________________________________________
Contractor/Contact Name: ____________________________________________________________________________
Contact Phone: ______________________________ Email: _________________________________________________
Description of Proposed Revision / Corrections:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
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 $_______________
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
□ □
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