370 Plaza RES22-0151 COAB Permit Form with Conditions - RenewedOWNER:ADDRESS:CITY:STATE:ZIP:
TROY KIMBERLY 370 PLAZA ATLANTIC BEACH FL 32233-5442
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169976 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
370 PLAZA RESIDENTIAL ALTERATION
RESIDENTIAL
remodel 2 bathrooms -
Renewed $55000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PERMIT TECHNICIAN NOTICE OF COMMENCEMENT INFORMATIONAL
Notes:
No inspections may be scheduled until a copy a recorded Notice of Commencement has been submitted to the Building Department
2 BUILDING ROUGH TRADES INSPECTION INFORMATIONAL
Notes:
THE ROOF MUST BE COMPLETE AND THE BUILDING DRIED IN BEFORE SCHEDULING ROUGH TRADES INSPECTIONS.
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: 6/3/2022
PERMIT NUMBER
RES22-0151
ISSUED: 6/3/2022
EXPIRES: 2/7/2024
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
BUILDING PERMIT 455-0000-322-1000 0 $300.00
BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $46.12
BUILDING PLAN CHECK 455-0000-322-1001 0 $150.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $6.75
STATE DCA SURCHARGE 455-0000-208-0600 0 $4.50
TOTAL: $507.37
2 of 2Issued Date: 6/3/2022
PERMIT NUMBER
RES22-0151
ISSUED: 6/3/2022
EXPIRES: 2/7/2024
RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Final 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
remodel 2 bathrooms
370 PLAZA
N/A
RES22-0151
s ''''r;,, Building Permit Application Updated 10/ 9/18
J j,,
City of Atlantic Beach Building Department ALL INFORMATION
v
Ir
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us/
IS REQUIRED.
Job Address: 37 0
CC
l ! d 2 it 111 1 a 11 G 13 i CII Permit Number:
Legal Description RE4 LD 3 ~7 UN iiS PE4 It( 1 LoT 33 61.410 RE# I b'1 Ti4 - 0000
Valuation of Work(Replacement Cost)$ 55,060 Heated/Cooled SF 70 Non-Heated/Cooled
Class of Work: New Addition NU(eration Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial 101residential
If an existing structure,is a fire sprinkler system installed?: Yes KeHQo
Will tree(s)be removed in association with proposed project? Yes(must submit separate Tree Removal Permit)
Describe in detail the type of work to be performed:
R'emodi,' 2, 64,4room 3, hloviny vari,Yiesf showers, {-*/ lt
Florida Product Approval#for multiple products use product approval form
Property Owner Information
p
Name K: bhly A et-Alley Tcoy Address 310 f 1 424
City 71Qnf'Ty 1kq.ch State f L- Zip 12233 Phone 16-
E-Mail briny (,) V€V1 zon. Del
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Com any upi ri t n t EIe cry,I, Quali ing Agent •
Address 3401 0U ' 1V4 City JaCkSdhViIttState FL Zip 3221 ,
nOfficePhoneYI IO4 1,41 • ti.000 Job Site Contact Number
State Certification/Registration# I•it
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt o 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
RECORDIN YO R NOTICE OF COMMENCEMENT.
gn ture • Owner or Agent)Signature of Contractor)
Signed and sworn to(or affirmed)before me this 1 D day of Signed and sworn to(or affirmed)before me this day of
l --- JDA D,by t)y by
IrfYC OtrWISSION#HH 057579 B re of Notary) Signature of Notary)
o' EXPIRES:October 27,2024
j f Bolded Thu Notary Pubroc Underallers
a,t M'-.—„•,p,N.—NC i•VW.,, .I Personally Known OR
Produced Identification ,
A
I Produced Identification
Type of Identification: 1'r £ p -- Type of Identification:
Owner Builder Affidavit ALL INFORMATION
HIGHLIGHTED IN
J
City of Atlantic Beach Building Department GRAY IS REQUIRED.
r n
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 I
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: 37v P` A2A -
Owner Name: k orbe-(1/ . [F 44t l 1 troy Phone Number: `7 14)- 7S 7 9(
Mailing Address: 209 Ahv i) vial
1
City: Pit /171/30 State: /vleC Zip: 2/ .2_ 1 ,--
Notarized
ZI ,--
Notarized Signature of Owner 1--The foregoing instrument was acknowledgere me this rF, day of.'`tk 20 a in the State of Florida, County
of b iA\, CA ( L,
Signature of Notary Public
Personally Known OR [ oduced Identification
z•;
JENNIFER JOHNSTON
MY COMMISSION#HH 057579 Type of Identification: J'1 0 10 Lg..,.... -.-;:t EXPIRES:October 27,2024
e-0-;:.0,.: Bonded Thu Notary Public underwriters Updated 10/24/18
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