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699 Selva Lakes Cir RESO21-0010 Raise Concrete Porch . RESIDENTIAL OTHER PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH RESO21-0010 ur ISSUED: 3/22/2021 800 SEMINOLE ROAD C`osivr ATLANTIC BEACH, FL 32233 EXPIRES: 9/18/2021 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: RESIDENTIAL OTHER SINGLE OR RAISE CONCRETE PORCH 699 SELVA LAKES CIR TWO FAMILY RESIDENTIAL $2400.00 AND ADD CONCRETE PAD OTHER TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 172027 5874 SELVA LAKES UNIT 03 COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: DAHLIN HANS M ET AL C/O HANS M DAHLIN ATLANTIC BEACH FL 32233-7326 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. 1 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 2 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. Issued Date:3/22/2021 1 of 2 `"4' RESIDENTIAL OTHER PERMIT PERMIT NUMBER r r, J , ,0 RES021-0010 . '. -. CITY OF ATLANTIC BEACH ov r 800 SEMINOLE ROAD ISSUED: 3/22/2021 °- ATLANTIC BEACH, FL 32233 EXPIRES: 9/18/2021 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. 4 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 5 PUBLIC WORKS DECKING REMOVED INFORMATIONAL Notes: All old decking and debris must be removed from job site by Owner. 6 PUBLIC WORKS OTHER PUBLIC WORKS CONDITION INFORMATIONAL Notes: No additional impervious area can be added to this property. 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 $65.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $32.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.21 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$151.71 Issued Date:3/22/2021 2 of 2 JOB (O P\ Reviewed for code compliance 2.20.2021 Building Permit Application C Updated 10/9/18 r� .. 4~ x . �.♦ City of Atlantic Beach Building Department ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us (� Job Address: K;l l ,,,,-/„.7 4 Aj /.,f , Permit Number: R e Soi- ( -001 0 Legal Description 5€,/j 4 f,¢f :. L,,,v..t- "' 9' G'7'IL /77 REN /22C,2 2 rj347 ? Valuation of Work(Replacement Cost)$ 40'150 _—Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New DAddition,Alteration ❑Repair ❑Move DDemo DPool []Window/Door • Use of existing/proposed structure(s): DCommercial XResidential • If an existing structure,is a fire sprinkler system installed?: DYes ,No • Will tree(s)be removed in association with proposed proiect? i.]Yes(must submit separate Tree Removal Permit) Mlo Describe in detail the type of,work to be performed: ,/ 1 /., ` �p p n `t�f %�/?i -r// ra j i,vS /l l Cw-1 J Florida Product Approval# for multiple products use product approval form Property Owner Information Name 7)/ __-211,,,'4,.t.--1 Address 4 5 /ir> /-e 4„. l ,..c City /� XI,/-7' e_ .�'1 t�H� 4,: �� Ste /.7, ,22,7Zi ,22,7 _13',..„T ',2i7j`i Phone /' /l � � E-Mail 1?/'t J. c- l'�!J /., �•7*,. 7 . e u 7,2 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 if Workers Compensation Insurer 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 AN ATTORNEY BEFORE RECOIWING YOUR NOTICE OF COMMENCEMENT. t_.� ,til 14 4- (Signature of Owner or Agent) (Signature of Contractor) � and sworn to(or a irmed)before me tJiis9 day of Signed and sworn to(or affirmed)before me this_ _day of '- z�z , y} Qr I to . by — Qign f fy) (s�,,,,�t.,re of Notary) � ,:;;F4*,_''',. TONI GINDLESPERGER ] ]Personally Known OR 'R fir. fNY'.V©ASJ:f1SD LESPER, t78 Produced Identification x • I F.KR 6si'JataDeRR' ' ' ] 1 ,-. ,.ems rt Type of Identification: . . jCi.., `f°`•`?..' {«i4!�AMNO ¢ifi!�C�I� ` JOB COPY Owner Builder Affidavit ""ALL INFORMATION ,.;, HIGHLIGHTED IN .r:.- City of Atlantic Beach Building Department GRAY IS REQUIRED, 2/ 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT a: RESO21-0010 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$5,000 PENALTY UNDER FLORIDA STATUTE NO.455-228(4 AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY" OR THE FLORIDA"CONTRACTORS CERTIFICATE"TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904- 247-5826 OR BUILDING-DEPT@COAB.US)IF IN DOUBT. V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address: :P 19 .S, 11, L,j-rr$; �, . , Owner Name: , ' / , /, V -40---//, -,-' Phone Number: 72 V-607-/1/.`, Mailing Address: -,71'. -S1/,•,,4; %..,/,', . L City: f1/4,, fr, 4 -,. tate: /":-.7 Zip: 32 Z?J Notarized Signature of Owner / 71/ ""' /, ( -i r--- The or om ins ument was acknowledged before me this 1 day of I. e/ I__ ) , 20Z(in the State of Florida, County of _-�V,rQ Signature of Notary Public ____ .(---------- 6.-) [ 1 Personally Known OR[ I Produced Identification Type of Identification: L L . 1t . '''''''''7:: •',,.,' �— Updated 10/24/18 TONI GINC:.ESPERGER I1' : ,•. '-. MY COMMISSION#GG 353178 ri1�:1 EXPIRES:October 6,2023 ,ecr`°`,' Bonded TNu Newry Public Underwitbrs .. . ,_. . .. ... . .., MAP SHOWING BOUNDARY SURVEY OF - .,. ... . ..., LOT /4ii BLOCK .. AS SHOWN ON MAP OF ..„ ...... ...... , '-.-- ..,_ • .576114 Z A;',4eS 5 id,Nir ',77:41,c'E5 ,.,............., 4"...,.: ' ' AS. LtECORD Ell IN PLAI. 134.)i.)0( ,_41,....... PA.c.ts cet 49-41 C't l'I'li. .:1ACAt N'' >JtS '„ ,it C ,)1,4C , ,0 .A.,v A, , , f,A p:Op ,S44 iffeAreeQ Af,Silt44•45 lidtd74474,?....V4r4l; r., --... NOTP KAA.NGS $kis„ANN ,,I At -D ON i'4 ABC-wt hieNnONED KAI ---- ---— -- - ' --------E---indi; BASE ..;- ' i 4 4'...'' ,,,.. 4,er Tf•'..717.•....raa•....- TTITialit- "7"--771":":. 4,..'4,...,-- 'e 4 7-"'"r.— -- - - - ;74r7 ..c. ,yrk-r..-":;:r-1474---'- •--- -- 5,11.-7i 4.;ii -S- ::: .- „. ii,.I/0 e .( ..i ,),..,i, ;....,f1, 5• 4. „.... :-:'.:1'.; ?, .4. • • JOB COPY .,..,,..,. 1 ' • .„-. „... ‘ .„.,..,,, . ...„ . .. . • , .. i . \ *.PA I a al • i I 44 1..• St tk kki T I I '''' 1 '• K. t) -N) * A ntl , ,N. !I, 4 A 1:1I) CA •. 'v t A ' 1 k•A/ .'4 _4$ 4) , 1 5".„ ; TA , , ,• A . ... 5,. ..' I ai •a : 1 .). .,•11,“.. 5 **...4..11.44,4 , 4 1 14 1 ,4 ••• . • 1 ' ' . 1 , .i,4,..Ak , ''''. 14 ••,it I'. ' ., V t I1 .. 7-,,,,I ..'4,.4 =5 i ....„,., ..,. , 5,„ ..,.•: b * 5-. .,- -- i -,...,.155-4„sitite,..4h...Alk.st.t.5,. I - 5 4 T 4T 44#tail at#000TitilK t T.WO t.'t**** ^ 4. ''' i • 4•IR ilt t.`4. 4 li I ii 44 ,mit litrinlit, t'l r., ''''---t•1 ,' v .. ..,...',„0.4,,',.„.„i ,,A iamwoodittla r,%1 ,,,,t IFFICF COPY '` Revision Request/Correction to Comments **ALL INFORMATION /'� *,,', HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. f.-- f) 800 Seminole Rd, Atlantic Beach, FL 32233 F'1J-'�f� Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:r L. i'2/-GID/Ci Revision to Issued Permit OR Corrections to Comments Date: 3 (0, Z.7 Project Address: C' y I t'/1,..1 L. /t .e'S C / is Contractor/Contact Name: //) -V 5 /7 0r7// fV Contact Phone: 7 L V - 64 ci/ 0 /r Email: 1/ i/') S e > e jr L%7"/Yf ,q, / e- 0/----7 Description of Proposed Revision/Corrections: r ��,[ JJ 4_.S / -ti' Li % "Lri.• /) e"? `.. t C-',L 4/:f,,r' V 1 ,,;3 lA ;1/4/.A _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 11*Yes(additional increase in building value: $__ )(Contractor must sign if increase in valuation) / *Signature of Contractor/Agent: / ✓►.j /1/ /74,..a./.11 (Office Use Only) 50.00 I I Approved r I Denied I I Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments Department Review Required: Building Planning& Zoning Tree Administrator REVIEWED Public Works By Mike Jones at 3:58 pm, Mar 12, 2021 Public Utilities Public Safety Date Fire Services Updated 10/17/18