298 13th St RESO21-0011 Bath Remodel, Deck RepairOWNER:ADDRESS:CITY:STATE:ZIP:
GALLI DONALD N 298 13TH ST ATLANTIC BEACH FL 32233-5714
COMPANY:ADDRESS:CITY:STATE:ZIP:
SANDIFER DESIGN BUILD
REMODEL 4788 HODGES BLVD. B-102 JACKSONVILLE FL 32224
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170370 0000 ATLANTIC BEACH PRKWY
#02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
298 13TH ST
RESIDENTIAL OTHER SINGLE OR
TWO FAMILY RESIDENTIAL
OTHER
HALL BATH REMODEL AND
DECK REPAIR $61500.00
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 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: 3/2/2021
PERMIT NUMBER
RESO21-0011
ISSUED: 3/2/2021
EXPIRES: 8/29/2021
RESIDENTIAL OTHER 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 $328.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $164.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $8.13
STATE DCA SURCHARGE 455-0000-208-0600 0 $5.42
TOTAL: $555.55
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.
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 Contractor.
6 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 2Issued Date: 3/2/2021
PERMIT NUMBER
RESO21-0011
ISSUED: 3/2/2021
EXPIRES: 8/29/2021
RESIDENTIAL OTHER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $555.55
RESO21-0011 Address: 298 13TH ST APN: 170370 0000 $555.55
BLDG SUBSEQUENT PLAN REVIEW FEES $50.00
BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00
BUILDING $328.00
BUILDING PERMIT 455-0000-322-1000 0 $328.00
BUILDING PLAN REVIEW $164.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $164.00
STATE SURCHARGES $13.55
STATE DBPR SURCHARGE 455-0000-208-0700 0 $8.13
STATE DCA SURCHARGE 455-0000-208-0600 0 $5.42
TOTAL FEES PAID BY RECEIPT: R15055 $555.55
Printed: Tuesday, March 2, 2021 10:21 AM
Date Paid: Tuesday, March 02, 2021
Paid By: SANDIFER DESIGN BUILD REMODEL
Pay Method: CREDIT CARD 428856208
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R15055
~+; CENTRALSQUARE
RESO21-0011
Building Permit Application
-~J½ City of Atlantic Beach Building Department
, , _;;i 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: -=;;s..........,g'""'g.,_ _ ___.]_3_,,_+-"' __ 3-6.._.. c,....i...0 ....::ee+;;;.._.,___ _____ P it umber:-~-------
Leg~cription \ I -S -d f A-TL c__i3 -Rt{,'i / J O 3-70
V~u~ion tt1&ork Re J-r£Irn¥nt t1~\) $ (0 / 1 0 OfJ • Q.9--Heated/Cooled SF ____ Non-Heated/Cooled ____ _
• Class of Work: □New □Addition □Alteration ~.Repair □Move □Demo □Pool □Window/Door
• Use of existing/proposed structure(s): □Commercial (g'f(esidential
• If an existing structure, is a fire sprinkler system installed?: □Yes □No
must submit se arate Tree Removal Permit □No
Describe in detail the type of work to be performed:
-Pcw('J :;.·n'\•1(1,A \-t-A4-v-~ '-'\ ~r~L...
'.:> \Ne..,~«;. fi., 't'O fJ.-::>r"f' fl-\,'-.)
Florida Product Approval # ___________________ for multiple products use product approval form
Pro ·
Address J'.?k I:#: s±r ee -f-'
Zip 3 ~.?--33 Phone ___________ _
Owner or Agent (If Agent, Powe· of Attorney or Agency Letter Required) ___________________ _
Y'\ 13u~ \cl ~M<-J,(C!l~&
--',.--1.J.L.l.L..-=:-'--'-:'--'"""\'--:-L~.::<l.-'~.t-'--:--=--------City__,,_.,;.::::;s.=->-,;,.::..:...,>-><,;.,.:.:,..:=
_.:::.µ,"-'1'--.::..:::-1+<~-,.;..~~t,.-.,,.-.--,,,,....-""1.,..Job Site ~nt
State Certification/Registration # .....,,..,_,f-=-__,_=--=-=---......_.'-""-E-Ma il....;:;;~=~I ~.:.:..i..:wu:::i_-=..~:::1..!..~..:....:..~..i...i:=-,;i..:..=µ..i.J..1.:~=--''...::CSM=--'-'
Architect Name & Phone# __________________________________ _
Engineer's Name & Phone# ----:::::;-....--r--r:-=,,~--r----:::::---------------------:--:--------:c---=----:::--r--
Workers Compensation Insurer -+-~.l..ll.=.:....::::-=~z..:..._--=i;_..:_-=+------OR Exempt o Expiration Date 11 -30 -~.
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 iss uance 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 t o the require ments of this
permit, there may be additional r estrictions applicabl e to t his property that m ay be found in the public r ecord s of this county, and
there may b e additio nal permits requ ir ed from other governmental enti tie s su ch as wate r m anage ment districts, state agencies, or
f ederal ag encies .
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 constr Jction 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 LE~DER OR TTORNEY BEFORE
C/) ;tg tt ·G-c Qfh ~ RECORPING. YOUR NOT!CE OF COMMENCEMENT. ~
[ Personally Known OR
[ ] Produced Identification
Type of Identification : _____________ _
ersonally Known OR
[ ] Produced Identification
.-·~••• •~. SAMANTHA ROBERTS WEBB
.1f~r,\ Notary Public • State of Florida
\~w~; Commission# GG 255850
\1orf\.~,.. My Comm . Expires Sep 6, 2022
.......... Bo nded thro11gh National Notary Assn.
Type of Identification: _____________ _
RESO21-0011
Owner Builder Affidavit
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
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 S COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH
IS IN VIOLATION :)F 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 UN'.)ER 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: ~q g , \ ~ S±ree-:r I A--+ \axJ~ c:-WC\ Ch I kl--< 3 J;).::,3
Owner Name: t.D<"'-~ L: ~Q Sq l l , Phone Number:
Mailing Address:2A'.6' ~#,-,S+re.J City: J+-H QJ; <., "Be,d ck State: F-L---z-ip-: -~--~--
Notarized Signature of Owner &~V\..<f} ~ oJ I ~
~re fwo;rgnc'.'._ument was acknowledged before me thisqhav of ~o;;i/, in the State of Florida,
/'"t;;~•••,, SAMANTHA ROBERTS WE3B //m~-"jN.~\ Notary P~b\!c . State of Florida
1 • • •1 Commissi on# GG 255850 '-J1 . of/ My Comm, Expires Sep f>, 202 2
·••,,!!.~.~Bonded throu~h National Notar~ Assn. Personally Known OR [ ] Produced Identification
Type of Identification: ____________________ _
Updated 10/24/18
RESO21-0011NOT FILED
NOTICE OF COMMENCEMENT
State of I\=\ 12 , : d ""-. Tax Folio No. _____________ _
County of \) U \J A l.--
To Whom It May Concern:
0 .
Address of property being improved: P.
General description of improvements: _,O::..°"=.;=,J'--'s"'·:-(Y.\..>.e..-...!..!.' :..,!l..::.:S-:::..__;"rlA>=.e.:LL:=B=~=c-r.,__,t\_,__==-===::i..==--+-"P::.,'--ec.· Lf .c,t:'.ec·=--
Owner: ---'\.,,LJ:1.L.1,_.,__::::~=~---''-lc:0.:;..,(__1_.c,-__ ~ Address: .....sde::,_.u.1__.L.,.i__.bL.LLJ:.J;;..L.j...1[:LJ..M.Ll:'iLl..de'.=>Ll..j..'......:
Owner's interest in site of the improvement:-+/ '-Q-'-"'0"-~--1-'(~)'-------------------------
Fee Simple Titleholder (if other than owner): ______________________________ _
Contractor: ---"--l-'--'-..2L.~~.1,_4---,,-,._,!&iLlf:-l.,-!....l-f"--=-,----==--.,----,---,----,--------,,'-
Address: -L....!-'+1-L-,-1..J""-"'"""'"--'---'"-'-'""'-.J-l..L..1.:::.:::...\----""'-=.=::c,.>.:::.O_,_(\-'--"-<J-'-\ _,_\.:.::,.fa..+---"--'l.-=---_'=3-=<e,;i;c:::...;;;iee:::..s;;)..::..__L_
Telephone No.: -'-"-'----""<.1.....L._..LI,.'-l. Fax No: ____________ _
Surety (if any) ______________________________________ _
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 than himself, designated by owner upon whom notices or other documents may
l '
be served: Name: ---1:+'-'½;;l-';,,,..~p...-t--'-2::'.-'::!~~='=-=-------,,------,--,,-----,=,----~----t---
Address:_:::1..~~-_]~~~~,P',;!..f.l..,-......,l./.!::~-->...l.J:l~b~~..lli--llt;..J'.::::.<:::=-..2~:z'.!:':'.:..]~--
Telephone No: -'--0--'-¥JH-......,.L..J.'--"="---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), Flori
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): __________________________________________ _
THIS SPACE FOR RECORDER'S USE ONLY OWNER
, -~~·;:i,;t P~~-. SAMANTHA ROBERTS WEBB
;>: :• ~~: ~ Notary Public· State of Florida
~,i tffe' Comm1ssron II GG 255850
·· .... ~r.f~°?,• My Comm. Expires Sep 6, 2022
Bonded through Nationa
Signed,=.LC-+M'r'l.""'--1.c=":'-~~flr-,-:-:----Date: ~;}.._-_CJ-'---";;,._/ __
Before
Of Florida, has appeared _ _;:=!L!...L._-1:µ-11..'---------
Notary Public · nt of val.
s -c;::=:~a~lly~Kn~gs.:,_--1::.n.,"'r2l.'.l-"'.ll.±t---~u::::,i::;..1-.,.L._ _______ or
ro uced Ide
Revision Request/Correction to Comments
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#: (),ES Q,JI -oo I I
0 Revision to Issued Permit OR D Corrections to Comments
Project Address: _,2c,...g...,i.,____,_,j ?}_,_tb-_ _,.u:f:"--'--+-1 __,_,_4:__,+~l?Jc.un._.++..w~ c"""""-'tG,.We""'-?l.>..CC~h_,_· +-\ f1-'"--. _· --=3~.;i=d:-<--3~-S~-
Contractor/Contact Name: -~o~· ~~C~,,-h~• ~o~\q....,..$ __ ~S-ct~'=0~41--'·~-+<~e~._r _____________ _
Contact Phone: Of OL/ (p { '.13 il( '½
Description of Proposed Revision/ Corrections:
Email:. SQffi\a d-t?Z. <@ Sltvi d: te ( c\e s :s ~\ kv,'\d v C9M
G<J'.-\-L -1>.JLC..µ,.....1.CC~c--l->J:..!C.C,...!-.""'-C......::::..!.>=-.Ll.¥-':1.l."--"::::..,,..-¥-'-""-"'-""::....,_:'="--'-.!..l::.!"'-'.-'=-''--'""'--'-'-=-t.-"-"'"'-'-"""='--=..:.
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\ > '" ~ -s1on correc p .
(printed name)
• Will proposed revision/corrections add additional square footage to original submittal?
i;;JNo lJ Yes (additional s.f. to be added:-----------~
(Office Use Only)
~Approved 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
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SANDIFER DESIGN BUILD
GALLI RESIDENCE
WITHOUT PERMISSION.
CANNOT BE USED OR REUSED
PROPERTY OF THIS FIRM AND
DESIGN PLANS REMAIN THE
LISTED WITHIN THIS CONTRACT.
COMPLETING THE PROJECT AS
CLIENT OR HIS/HER AGENT IN
FOR THE FAIR USE BY THE
DESIGN PLANS ARE PROVIDED
PHONE: (904) 343-8288
LISA CARROTHERS
DESIGNED BY:
2020c
ALL DIMENSIONS AND SIZE
DESIGNATIONS GIVEN ARE
SUBJECT TO VERIFICATION
JOB SITE AND ADJUSTMENT
TO FIT JOB CONDITIONS.
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REV DATE
REV3
DATE
DATE
DATE
DATEREV1
LDA
2/25/2021
Permit
A1
Scale: 1 - 1/2" = 1'
Demo Plan1
Remove window and finish exterior to existing stucco
Finish interior with drywall to match existing finish
Remove tub & turn into standup shower
Replace existing vanity with new cabient
& plumbing fixutres
New flooring
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DATE
DATE
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2/9/2021
Permit
Site Plan
Scale: 1/4" = 1'
VIEW NAME1
Location of Front Deck to be repaired
NO CHANGE TO THE EXISTING FOOTPRINT
General Notes:
1. Front decking materials to be
replaced.
2. Front Deck stair stringers (3) to
be replaced & new stainless
steel hangers.
3. NO CHANGE TO THE
FOOTPRINT OF EXISTING
FRONT DECK
4. Downstairs bathroom
renovation to include new tile,
plumbing fixtures, cabinets,
paint.
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