332 6th St ACC21-0031 Front Porch, Wood DeckFinal Plumbing
Final Electrical
Final HVAC
CC Final
Final Building*
Swimming Pool Steel
Swimming Pool Safety
Electrical Grounding & Bonding
Swimming Pool Final (Bldg)
Swimming Pool Final (PW)
Formed Columns/ Beams*
Masonry Cell Fill
Structural Steel*
OTHER:
OTHER:
OTHER:
OTHER:
OTHER:
Power Pole
Silt Fence
Piers/ Stem Walls
Underground Plumbing
Underground Electric
Foundation/ Footing
Slab**
Retaining Wall Footing
Driveway
Sewer (Building Dept)
Sewer Tap (Utilities Dept)
Rough Electric*
Rough Plumbing/ Top Out*
Rough Mechanical*
House Wrap
Wall Sheathing
Roof Sheathing
Tie-down Framing Connections
Rough Framing
Roofing In Progress
Window/Door In-Progress
Insulation Ceiling
Insulation Wall
Exterior Lath
Stucco Scratch Coat
Exterior Siding In-Progress
Brick Flashing & Ties
Early Power
Gas Rough
Gas Final*
* When all rough electric, plumbing, mechanical are complete but before any work is
covered up.
* When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance. All outlets must be capped and pipe pressurized at a
minimum of 15 lbs.
* For new living space: When all construction work including electrical, plumbing,
mechanical, exterior finish, grading, required paving and landscaping is complete
and the building is ready for occupancy, but before being occupied
Additional inspections may apply to your project if your project
contains these elements:
INSPECTIONS REQUIRED FOR BUILDING PERMITS
To verify compliance with building codes, inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
_____________________________________________________
Permit Type
____________________________________________________
Permit No.
__________________________________________________________
Job Address
____________________________________________________
Contractor
POST THIS CARD WITH PERMITS AND PERMIT
DOCUMENTATION IN FRONT OF BUILDING
Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends
Building Department Public Works/Utilities Fire Department
Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789
Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203
* When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all
electrical, plumbing and mechanical work is in place, but before concrete is poured.
* When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION
OWNER:ADDRESS:CITY:STATE:ZIP:
DEITCHMAN GEORGE C 332 6TH ST ATLANTIC BEACH FL 32233-5348
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169861 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
332 6TH ST ACCESSORY SINGLE OR TWO
FAMILY ACCESSORY
FRONT PORCH AND WOOD
DECK $5000.00
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: 5/11/2021
PERMIT NUMBER
ACC21-0031
ISSUED: 5/11/2021
EXPIRES: 11/7/2021
ACCESSORY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PERMIT 455-0000-322-1000 0 $80.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $40.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.45
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.30
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL: $360.75
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 Owner.
2 of 2Issued Date: 5/11/2021
PERMIT NUMBER
ACC21-0031
ISSUED: 5/11/2021
EXPIRES: 11/7/2021
ACCESSORY PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $360.75
ACC21-0031 Address: 332 6TH ST APN: 169861 0000 $360.75
BUILDING $80.00
BUILDING PERMIT 455-0000-322-1000 0 $80.00
BUILDING PLAN REVIEW $40.00
BUILDING PLAN CHECK 455-0000-322-1001 0 $40.00
PUBLIC WORKS PLAN REVIEW $25.00
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE SURCHARGES $5.75
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.45
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.30
WORK WITHOUT PERMIT $110.00
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
ZONING PLAN REVIEW $100.00
ZONING REVIEW SINGLE AND TWO FAMILY
USES 001-0000-329-1003 0 $100.00
TOTAL FEES PAID BY RECEIPT: R15770 $360.75
Printed: Tuesday, May 11, 2021 3:40 PM
Date Paid: Tuesday, May 11, 2021
Paid By: DEITCHMAN GEORGE C
Pay Method: CREDIT CARD 454489169
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R15770
Building Permit Application Updated l0/9/1811. City of Atlantic Beach Building Department ALL INFORMATION
r, 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
ilj IS REQUIRED.Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 3 2 (0 12 Si—. Permit Number:
Legal Description 1t,- 2S— oZ1E Alia nhL-
1`rReacLLf, 3 Blk7- etg-8 RE#
IV
LA01 )((li- 000c
Valuation of Work(Replacement Cost)$ 5-00 0 t VI) Heated/Cooled SF 0 Non-Heated/Cooled
Class of Work: New Addition Alteration 2/Repair Move Demo Pool EWindow/Door
Use of existing/proposed structure(s): Commercial Residential
If an existing structure, is a fire sprinkler system installed?: Yes L'f o
Will tree(s)be removed in association with pro osed project? Yes(must submit separate Tree Removal Permit) LJo
Describe in detail the type of work to be performed: (0-yA- p L a ,pa Ut..j 1,A.)&o d
4 i iCtu- C t,L Vl,I?{ 4
V
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name lc—Will Pe f(•Luryietv Address -32)2- (o -1 St
City a'State EL.- Zip V2._2_33 Phone t)( 4- c1 Cl .4--,.2 16v
E-Mail -1-- e. t tr k ma UL ' civmCt r I . C 0 6n. E C E I V E
l)Owner or Agent (If Agent, Power of Attdrney or Agency Letter Required)
Contractor Information 1 APR 2 8 2021
Name of Company /- e-yy ' 0 Qualifying Agent I. 4
Address City State BY: lip_
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
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
REC• ' 1ING YOU ' OTIC OF COMMENCEMENT.
L./i. ._ _ I . r. . A ef (------
Signature of Owner or Agent)
p
Signature of Contractor)
S.:ned and sworn to(or affirmed)before me •'s 20 day of Si nec and sworn to(or affirmed) before me this a day of
4111111"--
0"iir 44. 0 i;1'. 1,L ' I kk , 70 ( , by 'k tie VG A •-•i •
o Notary Public,St.
UUU
wiel Commission#GG 328057,1ature of Notary)w'
My comm.expires Apr.25, . '1 r ,
G
ENRIQUE A.FLORES
4 c - t Notary Public.State of Florida
Personally Known OR Personally Known OR
it e' Commission#GG 328087
4 Produced Identificatior
1
Produced Identification `
rte'' My comm.expires Apr. 25.2023
Type of Identification:tC4'b_ Type of Identification: Fk,ovv4, t WY &k S4
ACC21-0031
NOTICE OF COMMENCEMENT
State of V I---t o 4 Tax Folio No. 16 '156 1,-- 61e) 0
County of D u JA
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 OFF COMMENCEMENT.
Legal Description of property being improved: )(p--„2 -, ' L" )4f1U1,d, u L ( Lo I-- 1 S _
f 1o le6 r-33
4.
Address of property being improved: 33 2_6., l" i 1 (
General description of improvements: V pe LA F Cut-p P-LC Il./ )va C . 6,.c_e 114 t4 -
Ay. ItlitAlr ' At c. 6-
Owner: I ( Address: -53 2. 4
nn
t" / / --,z 2
Owner's interest in site of the improvement: _ 1/ 1/4--(1'.___
Fee Simple Titlehold 'f other than owner): & roe
y(
d I u VII ( b t .litm a U--
Name:Name: I atil 1e ( C/i(04C?/I_
Contractor: . , i /// A ' r . Al .'
l 2-73Address: 3J 3 Z 6 5 r -La Li h(' G-vr_ lit- FL 3 3
Telephone No.: q(i`//T --67--671q4 - i O--)2 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: :
1n` A-
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 rPcopi , urie gog. ocary Public,State of Florida
specified):Z A IICoii ni siou#CC 3 0007
IAP My cornrn.expires Apr.26,2023
THIS SPACE FOR RECORDER'S USE
ONLY06(
2)
VIM
igned: ga444A:Li-di/kAag) Date: 4-2-8- 2 rDoc# 2021107791,OR BK 19698 Page 1476,Number Pages: 1 fore me this 2' day of i$g ! .410 LI in the County of Duval,St e
Recorded 04/28/2021 11:28 AM, f Florida,has personally appeared b.Mnt " L SI\WVOA/`
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL otary Public at Large,State of Flor'yda,County of Duval.COUNTY
RECORDING $10.00 1y commission expires:2---)1it\ 2---)17_,Vl/3
ersonally Known: or
roduced Identification: .R5‘.".4. '/\,V('d \r-t.CI"-k--e-
ACC21-0031
s-vr Owner Builder Affidavit ALL INFORMATION
sHIGHLIGHTED IN
AfrNjCity of Atlantic Beach Building Department GRAY IS REQUIRED.
J 800 Seminole Rd, Atlantic Beach, FL 32233
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. .
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. 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: 5 Z Li t c h ts_e ar L 3 2
Owner Name: la (,i /(1/"V) ( 1)P( (`/ (/1/1111 Phone Number: rO4 +I/ q- Z/)
Mailing Address: -2,32_ ( P > - City: 4+lo of i ( 6-C'State: (— [_ Zip: 32-233
Notarized Signature of Owner grA'fliJ f
The foregoing instrument was acknowledged before me this F day of AF1 , 02( , in the tate of Florida, County
of %0 vt,fi•
Signature of Notary Public
Qv AoENRIQUE A.FLORES Personally Known OR [ ] Produced Identification
Votary Public,State of Florida
Niac:Commission#GG 328087
A)0,4
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tdv comm.expires Apr.25,202 Type of Identification: T) Y 1)2 V c_
Updated 10/24/18
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