600 JASMINE ST RFNC21-0114 • 0s='''1 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
`s gr IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: (pOO Sashn c_4 REtCZ. Permit Number: ( — 01 ('1
Legal Description S34,, . )e c Alt list-0�-461:._No Y�-'k1Oh 14 AtiaM4 I::31/t t, RE#
Valuation of Work(Replacement Cost)$ Ji 2.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: XINew DAddition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial I4 Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit se arate Tree Removal Permit) XNo
Describe in detail the type of work to be performed: 61 ert v4ui Le yam' >< v` ki eta}, ,I PGS- i ,�'�ny'j
j Cel tc4 S 3Y 3(0'' I4 4(G rt; 3 for ?-s I.1` r t/,:�.-t r:()Jet: Gck )
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name SC((AINL6Ve..tarok 'PCcf LC%.1P�6in4 Address 6o0 11G5/0 /4L4 S-1,
City /r1C+f+'- ]3'Puell State Zip 3 3.-1-3 3 Phone 4y/ -7/3- i2.() *
E-Mail _FA ntC M co,'c(e d a (Jeri 2-ON• /It"
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 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
RECOR LAG YQUR NOTI COMMENCEMENT.
(Si ure of Owner or (Signature of Contractor)
Signed an sworn to(or affirmed)before me this& y of Signed and sworn to(or affirmed) before me this day of
aros Lou eA cA in d , ,by
:0.f.'••. MARISSALORDA
:•: i• . MY COMMISSION#GG 228145 (Signature of Notary) (Signature of Notary)
-.%12 EXPIRES:June 12,2022
�'EOF F°e` Bonded Thru Notary Public Underwriters
[ ] rsonally Known OR [ ]Personally Known OR
[ Produced Identificati n , [ ]Produced Identification
Type of Identification: De(I1/{15 (I L e►A,f L Type of Identification:
Fence Addendump
U dated 1/14/2021
Cit of Atlantic Beach Building Department
.// 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT#
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
6cc' s r 4\ S:+cee+
Property Type: Lot Type/ Features:
%Residential ❑ One Street frontage (interior lot)
❑ Commercial ►• ore than one street frontage(corner lot,through lot,
etc.)
❑ Swimming Pool
Fence Material: Fence Height (select all that apply):
Wood ❑ Four Foot(4ft)
❑ Chain Link 'Six Foot(6ft)
❑ Vinyl ❑ Other -
❑ Block/Stone(Plan details required for footings and/or
retaining walls)
❑ Other
Fence Location:
Please submit an accurate and current boundary survey showing all existing improvements(including building footprint,
driveway,swimming pool,etc.) and location of fence/wall and any gates. Plan details required for block wall footings and/or
retaining walls and any portion or fencing above 6ft in height.
Will the fence be built in an easement?
❑ Yes(must submit separate Revocable Encroachment Agreement)
►: No
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
12 No
onditions of Approval:
• Roll off container company must be on City approved list. Roll off container cannot be placed on City right-of-way.
• All old fencing and debris must be removed from job site by contractor or homeowner.
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
RECORDING YOUR NOTICE OF COMMENCEMENT.
4,1 N ,c-I Sl+M 1-f -II" 1-1
(...T
` �„ Owner Builder Affidavit A ��( I� mi 1 ,I*ALL INFORMATION
�r C� xi- HIGHLIGHTED IN
3'!j, City of Atlantic Beach Building Department -I = GRAY IS REQUIRED.
v 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$5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE
OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA"CONTRACTORS
CERTIFICATE"TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPT@COAB.US ) IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: 6be l4Sln1,iLt (S1 11f-14-$.4,e, e441, Ft-
/
Owner Name:S4r4A, LOYS4.>*J F,- I L t
ke/441d Phone Number: q ')-7/3-1-7-194,
Mailing Address: 'h* City: 5444 C State: Zip: 3.7--7-3 .
Notarized Signature of Owner ti _
The oregoing instrument was acknowledged before me this ,X U day ofAU (/S4- ,202 I, in the State of Florida, County
of ] 0 v&
liAL*C\-------------
Signature of Notary Public
e*. MARISSA LORDA
°I MY COMMISSION#GG 228145 [ ] Personally Known OR [ Produced Identification
;•,,. EXPIRES:June 12,2022
""F9F f.1/4 Bonded Thru Notary Public Underwriters ,
_ Type of Identification: br ,v e YS \I c e v., Q
e_...,
Updated 10/24/18
PEER TITLE, INC. ..,„,' }
ATitle Insurance and Closin'; -'.��.,
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PROPERTY ADDRESS:600 JASMINE STREET, ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER: FL2106.9668
*duce 1nclI cecrej i;►', ' i H CiRe,l
21069668 I/2" PIP
PARCEL ID: NO ID
BOUNDARY SURVEY 1709190510 1 @ LOT COR.
DUVAL COUNTY PARCEL ID:
1709190530
r D.P.TO Res. = 12'±
a
O ct
W W
R jo REMAINDER OF N89°0577'E 101.87'(M) o$
LOT 5 102.00' (P) E---20.0'
Q BLK 136 z ^25.0' ?
LOT 5 ''' o (NOT INCLUDED) c /fl��
BLK 137 1/2' FIP ; m a 1/2" FIPC t UP
NO ID o o# L8#6696
baW H ` ' ' 7A 6'wF ONS
I -Y
i/�K i,,�y�-_ 1_. S 20'OF CONC.D/W o o
7 Y Y�7 LOT 5 --
BLK 136 " 37.a eM 0 I "'W&
D = 1 STY. -
`'� -----1 RES#600 N �-
-
oO ---V-
,`:::ii I Oa CONC.D/W O .. vp
O1 29.8'i U> 37.0' - WOOD[ 3s.2' —8.—..^• 6i
o p APPROX. �I A/C DECK p W
,� DP± �1 O a
LOT 6 0 mi aLa j
BLK 137 2 T
I • Cc
L 23.8'± ; LOT 6
/ /84 -4 BLK 136 I
F.5 Q
0.211 Ac.
i IN
36'5 ' ;I qI ratz. I
V UP
—,e4/1.7I/2" FIPC •
t/2" FIPC ILL.
LB#6696
B.C.
102.00'(P)
m S 89°19'53'W 102.25'(M)
ti
W 6TH TREET(60'R/W)
€ i
A
* I4,,, 'C, ®A . t-1 4,4444115 66, ett>s \\/('c,./ N
- 'In all 1nStance5 - -enCe Shall _ J 'I
SURVEYOR'S NOTES: )
FENCE OWNERSHIP NOT DETERMINED. be. c_m-6—ru okPd n0 cI o S ef' -4/ion GRAPHIC SCALE(In Feet)
U
M 'pr r--y b OtAil4ctr V 1 inch=30'ft.
SURVEYORS CERTIFICATION: POINTS OF INTEREST:
NONE VISIBLE
(1141) i. Sem,-,„ I hereby certify that this Survey of the lands
PROPERTY ADDRESS:600 JASMINE STREET, ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER: FL2106.9668
JOB SPECIFIC SURVEYOR NOTES:
THE ASSUMED BEARING REFERENCE OF SOUTH 1 DEGREES 06 MINUTES 13 SECONDS EAST IS BASED ON THE WESTERLY RIGHT-OF-WAY LINE OF
JASMINE STREET, LOCATED WITHIN SECTION H,ATLANTIC BEACH ACCORDING TO THE PLAT THEREOF,AS RECORDED IN PLAT BOOK 18,PAGE 34
OF THE PUBLIC RECORDS OF DUVAL COUNTY,FLORIDA.
LEGAL DESCRIPTION:
SOUTH 20 FEET OF LOT 5,ALL OF LOT 6,BLOCK 136,SECTION H,ATLANTIC BEACH,ACCORDING TO THE PLAT THEREOF,RECORDED IN PLAT
BOOK 18, PAGE 34,OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
GENERAL SURVEYOR NOTES:
1 The Legal Description used to perform this survey was 5. Alterations to this survey map and report by other than the the field location and may not represent the actual shape
supplied by others.This survey does not determine signing surveyor are prohibited. or size of the feature.
nor imply ownership of the lands or any fences shown
hereon.Unless otherwise noted,an examination of 6. Dimensions are in feet and decimals thereof. 11.Points of Interest(POl s)are select above-ground
bythe signing improvements,which may appear in conflict with boundary.
the abstract of title was NOT
performed 9 g 7. Any FEMA flood zone data contained on this survey is for building setback or easement lines,as defined by the
surveyor to determine which instruments,if any,are informational purposes only.Research to obtain said data parameters of this survey.These POI's may not represent
affecting this property. was performed at www.fema.gov and may not reflect the
all items of interest to the viewer.There may be additional
2. The purpose of this survey is to establish the boundary of most recent information. POI's which are not shown or called-out as POI's,or which
the lands described by the legal description provided and 8. Unless otherwise noted"SIRC"indicates a Set Iron Rebar are otherwise unknown to the surveyor.
to depict the visible improvements thereon for a pending with a Cap stamped LB#8291,a minimum half inch in
financial transaction.Underground footings,utilities,or diameter and eighteen inches long. 12.Utilities tshe existencen on the subject recorded property may or may not
other service lines,including roof eave overhangs were not indicate the of or unrecorded
located as part of this survey Unless specifically stated 9. If you are reading this survey in an electronic format,the utility easements.
otherwise the purpose and intent of this survey is not for information contained on this document is only valid if this 13.The information contained on this survey has been performed
any construction activities or future planning. document is electronically signed as specified in Chapter exclusively by and is the sole responsibility of Exacta Land
5J17.062(3)of the Florida Administrative Code and Florida Surveyors,LLC.Additional logos or references to third party
3. If there is a septic tank or drain field shown on this survey, Statute 472.025.The Electronic Signature File related to this firms are for informational purposes only.
the location depicted hereon was either shown to the document is prominently displayed on the invoice for this
surveyor by a third party or it was estimated by visual survey which is sent under separate cover.Manually signed 14.Pursuant to F.S.558.0035,an individual employee or
above ground inspection.No excavation was performed to and sealed logs of all survey signature files are kept in the agent may not be held individually liable for negligence.
determine its location. office of the performing surveyor.
15.Due to varying construction standards,house dimensions
4. This survey is exclusively fora pending financial transaction and 10.The symbols reflected in the legend and on this survey are approximate and are not intended to be used for new
only to be used by the parties to whom it is certified. may have been enlarged or reduced for clarity.The construction or planning.
symbols have been plotted at the approximate center of
SURVEYOR'S LEGEND
IJIIETYPES_-- Bevatton I cis-Concrete Slab FIR-Found Iron Rod ORB-Official Records Book 51W-Sidewalk
—I CATV-Cable TV Riser FIRC-Found Iron Rod&Cap ORV-Official Record Volume SBL-Setback Line
__ BoundaryUne Are Hydrant
• CB-Concrete Block FN-Found Nail O/A-Overall SCL-Survey Closure Line
Center Line Rnd or Set
CH-Chord Bearing FN&D-Found Nail&Disc 0/5-Offset SCR-Screen
ChainLlnkorWlre IMonumeM
Fence IGuywireorAnchor (HIM-Chimney FRRSPK-Found Rail Road OFF-OutsideSubjectProperty SEC-Section
-- — i -----
CLF-Chain Link Fence Spike OH-Overhang SEP-Septic Tank
L. Easement Q Manhole GAR-Ga e
1--tt%% - ------ - CME-Canal Maintenance rag OHL-Overhead Utility Lines SEW-Sewer
Edge of Water �;y Tree Easement GM-Gas Meter ON-Inside Subject Property SIRC-Set Iron Rod&Cap
-4-0—Iron Fence 8X Utilityht Pole CO-Clean Out ID-Identification or Light on P/E-Pool Equipment SMWE-Storm Water
— HL—Overhead Lines Q 'Well CONC-Concrete IE/EE-Ingress/Egress Easement pB-Plat Book Management Easement
- COR-Corner ILL-Ille Illegible SN&D-Set Nail and Disc
Structure PC-Point of Curvature
i 9
ABBREVIATIONS
CS/W-Concrete Sidewalk INST-Instrument SOFT-Square Feet
Survey TieUne 1C1-Calculated PCC-Point of Compound
CUE-Control Utility Easement INT-Intersection Curvature STL-Survey Tie Line
• Vinyl Fence (D)-Deed
CVG-Concrete Valley Gutter IRRE-Irrigation Easement PCP-Permanent Control Point STY-Story
Wall orPartyWall IFI-Field D/W-Driveway L-Length PI-Point of Intersection SV-Sewer Valve
- .■._Wood Fence (MI-Measured
DE-Drainage Easement LAE-Limited Access Easement PLS-Professional Land S WE-Sidewalk Easement
SURFACE TYPES (P)-f tat DF-Drain Field LBS-License No.(Business) Surveyor TBM-Temporary Bench Mark
Asphalt (S)-Survey OH-Drill Hole LBE-Limited Buffer Easement PET-Planter TEL-Telephone Facilities
A/C-Air Conditioning POB-Point of Beginning
Brick or Tile DUE-Drainage&Utility LE-Landscape Easement TOB-Top of Bank' _-. AE-Access Easement Easement POC-Point of Commencement
Concrete LME-Lake/Landscape TUE-Technological UtilityANE-Anchor Easement ELEV-Elevation Maintenance Easement PRC-Point of Reverse Easement
_
I Covered Area ASBL-Accessory Setback Line EM-Electric Meter LSO-License No.(Surveyor) Curvature TWP-Township
�. Water BIW-Bay/Box Window ENCL-Enclosure' MB-Map Book PRM-Permanent Reference TX-Transformer
BC-Block CornerMonument
/Z Wood �� ENT-Envance ME-Maintenance Easement
TYP-Typical
BFP-Backflow PreventerPSM-Professional Surveyor
SYMBOLS EOP-Edge of Pavement MES-Mitered End Section UE-Utility Easement
&Mapper
BLDG-Building EdgeEOW- of Water MF-Metal Fence UG-Under round
Benchmark PT-Point of Tangency g
BLK-BlockPUE-Public Utility Easement
ESMT-Easement MH-Manhole UP-Utility Pole
Center Line
--y BM-Benchmark EUB-Electric Utility Box NR-Non-Radial UR-Utility Riser
Central Angle or IBR-Bearing Reference F/DH-Found Drill Hole NTS-Not to Scale R-Radius or Radial VF-Vin l Fence
DeltaR/W-Right of Way Y
--- BRL-Building Restriction Line FCM-Found Concrete NAVD88-North American W/C-Witness Corner
Common RES-Residential
BSMT-Basement Monument Vertical Datum 1988
Ownership W/F-Water Filter
_ RGE-Range
A C-Curve FF-Finished Floor NGVD29-National Geodetic
Control PdM W F-Wood Fence
_® -- C/L-Center Line F1P-Found Iron Pipe Vertical Datum 1929 ROE-Roof Overhang Easement
Catch Basin RP-Radius Point WM-Water Meter/Valve Box
— C/P-Covered Porch FIPC-Found Iron Pipe&Cap OG-On Ground
W V-Water valve
v ,1s.`Zt
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