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1785 BEACH AVE RESO21-0073 S ur' 11e y , 0,="'''--- Building Permit Application / Updated 10/9/18 City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY t p` IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: A8) eea.ci, 4,1( Permit Number: R gso Z ( —0073 Legal Descrption'4rr0 04-2S-2-gt NJittIQc,.l?(,gecLL\1,1...k- M t E# IL9b 1" —0000 Valuation of Work(Replacement Cost)$ (C271700 Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition DAlteration ,@epair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial / Residential • If an existing structure,is a fire sprinkler system installed?: :Wes ❑No • Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) :EJo Describe in detail the type of work to be performed: /l.t:..� i----4/) ( cl'5 C-I.i�t-rL,t 4— W'cV def)- wc4kwei Florida Product Approval# for multiple products use product approval form Property Owner Information Name P4et4— 1.t0/'i& cc Address /711_ /CRI ,4 f-c... City State Ft.... Zip .722.4.3, Phone 9 124/—‘-r2 3°1 E-Mail y e5 c yaJi .0 D W Owner or Agent( Agent, ower Attorney or Agency Letter Required) Contractor Information Name of Company Qualifying Agent Address City State Zip Office Phone Job Site Contact N • ser 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 t• io the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a per • and that all work will be performed to meet the standards of all the laws regulating construction in this jurisdiction. I under .nd that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS, WELLS, POOLS, FURNACES, BOILERS, EATERS,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, CONSUL TH YOUR LENDER OR AN ATTORNEY BEFORE citrCO DING YOU NO OF COMMS CEMENT. (Si ture o Owner or Agent) (Signa . e of Contractor) ned and sworn to(or affir m before me to is / 7day of Sig d and sworn t. or affirmed)before me this day of 20Z/,by ��• N.. i ,by 1 Si'.n•ture of,of 4,r7,w (Signature of Notary) .,ti.--.., _ [ ] Personally Known OR ;...VP:k.,•-,, t]Pe,lel i A7-: .. 1 I R [ I Produced Identification $liV: [ ]P�roe • 4 tifih':tion ATh Type of IdentificationED A)n elr Ta' lio '`' Nary Public Underwriters •st,v,r Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 ``j 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: /IN/�j/L� /IN/ Owner Name: 174n& L{ O1'la KL Phone Number: /o41/-4c2.-?oQ Mailing Address: /AS--- 'S btach ' City: +6 State: re- Zip: 3 2 Notarized Signature of Owner of g�ng innssttrs�ment was acknowledged before me this day of ti U , 202 fir the State of Florida, County Signature of Notary Public et. [ ] Personally Known OR [ ] Produced Identification Type of Identification: TONI GINDLESPERGER Updated 10/24/18 .I =.• y;: ,r. '; : MY COMMISSION#GG 353178 . 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'4 I ! . . .. . i 1 / 1 1 1 FLORIDA DEPARTMENT OF ENVIRONMENTAL PROTECTION Division of Water Resource Management '4'SeiCoastal Construction Control Line Program a% 2600 Blair Stone Road,MS.3522 i' FLORIDA .� • 1 Tallahassee,FL 32399-2400 Phone:(850)245-7669 Permit Number 8°4°662 - DU " IIIIIIVNo.of Pages Attached: 6 FIELD PERMIT PURSUANT TO SECTION 161.053 OR 161.052,FLORIDA STATUTES FINDINGS OF FACT AND CONCLUSION OF LAW: The request for a field permit was considered by the staff designee of the Department of Environmental Protection and found to be in compliance with the requirements of Chapter 62B-33,Florida Administrative Code(F.A.C.). Approval is specifically limited to the activity in the stated location and by the project description,approved plans(if any),attached standard conditions,and any special conditions stated below pursuant to Paragraph 161.053(5),Florida Statutes(F.S.). This permit may be suspended or revoked in accordance with Section 62-4 100.F.A.C. PROJECT LOCATION: 1785 Beach Ave., Atlantic Beach; Duval County. 425' to 475' south of R-44 PROJECT DESCRIPl ION: 1. Construction of a +1- 36" tall post supported landscape wall located east edge of developed lot. 2. Installation of 4' tall open style vinyl fence located top of or landward of new wall. 3. Above grade refurbishment of existing dune walkover and conversion of stair section to a ramped walkway using existing support post foundations. SPECIAL PERMIT CONDITIONS:The permit is valid only after all applicable federal,state,and local permits are obtained and does not authorize contravention of local setback requirements or zoning or building codes. This permit and public notice shall be posted on the site immediately upon issuance and shall remain posted along with local approval until the completion of any activity authonzed by this permit.Other special conditions of this permit include: 1.Landscape wall shall be frangible in both design and construction. 2.Horizontal wall members shall not extend more than one(1)foot below grade. 3.All debris shall be disposed of landward of the CCCL. 4.Concrete is not authorized. STANDARD PERMIT CONDITIONS: The permittee shall comply with the attached standard field permit conditions. APPLICANT INFORMATION:I hereby certify that I am either:(I a)the owner of the subject property or(lb)I have the owner's consent to secure this permit on the owner's behalf;and that(2)I shall obtain any applicable lie s or permits which may be required by federal,state,county,or municipal law prior to commencement of the authorized1 , I acknowle gc that the authorizedtw k is what I requested,and(4)I accept responsibility `for /compliance with all permit conditions. Applicant's Signature Date 71'i 'Q� I Telephone No.( Irl )`4S r 0 l Applicant's Printed Name_Glhrt_ (O/?a/1 Address I 710 &CUA ( r 1vc I4 Vl•kl.c 6aI % re- it it applicant is an agent: I /( ) Printed name of property owner Property owner's address Property owner's telephone no. DEPARTMENT FINAL ACTION AND FILING AND ACKNOWLEDGMENT:This field permit is approved on behalf of the Department of Environmental Protection by the undersigned staff designee,and filed on this date,pursuant to section 120.52,F.S.,with the undersigned designated Deputy Clerk,receipt of which is hereby acknowledged. Trey J. Hatch pz°°o°n1.:_: ,Trey J. Hatch ,07/22/2021 Staff Designee:'Deputy Clerk Printed Name of Designee'Deputy Clerk Date EXPIRATION DATE: 07/22/2022 (Emergency permits issued pursuant to Section 62B-33.014,F.A.C.,are valid for no more than ninety days and other field permits arc valid for no more than 12 months. The staff designee may specify a shorter time limit.) EMERGENCY PERMIT: EYES EiNO Approved plans arc attached EYES fl NO NOTICE OF COMMENCEMENT State of Tax Folio No, 1T —c o Q O County of UNet- ToWhom 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 CONJJ1QENCEMENT. Legal Description of property being improved: > 16-►O Oq_ 25 � N ,�-��h�j'll 15ca. c f)\.7) F Address of property being improved: 1'705 5 ge ct, 34Z3 3 General description of improvements: 'yy p f��L W�.�� c.�,� A Owner: Address: ag> t3e,c L { 3 Z-Z�,3 — Owner's interest in site of the improvement: b Fee Simple Titleholder(if other than owner): Name: Contractor: U1-9 cork/IL-6_5 Address: Telephone No.: 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 be served:Name: Address: t, I �'/e - Telephone No: 9 0`i - L5-2 7-10 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),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 t M,recorgegibt,Egpent cute is specified): br=a i :R= MY COMMISSION#GG 353178 _ =.,•, A4.v, EXPIRES:October 6,2023 THIS SPACE FOR RECORDER'S USE ONLY OWNER Thru Notary Public Underwriters yn Doc#2021213722,OR BK 19867 Page 2039, ned: fvv215.+ Date: Number Pages: 1 ore me this 1 -7 a . C) Z ( in the County of Duval,State Florida,has personally app Recorded 08/18/2021 08:50 AM, =��. �1_ (,o v�o.�1 JODY PHILLIPS CLERK CIRCUIT COURT DUVAL :ary Public at Large,S ate of •rida,Cou MT val. COUNTY commission expires: LokRECORDING $10.00 sonally Known: ‘16116,4 or i duced Identification: