Loading...
525 Beach Avenue RERF24-0065 Re-Roof Shingle REROOF SHINGLE PERMIT PERMIT NUMBER - •04 '� RERF24-0065 CITY OF ATLANTIC BEACH \�r "� ISSUED:800 SEMINOLE ROAD 4/23/2024 °i;1` ATLANTIC BEACH. FL 32233 EXPIRES: 10/20/2024 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. 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. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 525 BEACH AVE REROOF SHINGLE SHINGLE ROOF $5900.00 TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170154 0000 ATLANTIC BEACH COMPANY: ADDRESS: CITY: r STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: MOORE RONALD E 525 BEACH AVE ATLANTIC BEACH FL 32233-5323 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. LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. FEES JiiE DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $80.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $4.05 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.70 WORK WITHOUT PERMIT 455-0000-322-1000 0 $190.00 TOTAL: $276.75 Issued Date:4/23/2024 1 of 1 T:'i , BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY �'3 '� City of Atlantic Beach Building Department iltri s, PERMIT# ���'e�5 800 Seminole Road, Atlantic Beach, FL 32233 v **ALL informationRrequired to process • ,'"--v!l�' Phone: (904) 247-5826 Email: Building-Dept@coab.us PbJob Address ,l /_ I°Wi'/ -G/c/ RE# b(A '"0000 Legal Description PN .ex,-c,V\ Lai z., 2i 1 ZC) if D Valuation of Work(Replacement Cost) s7e), Heated/Cooled 5E.-- 1?____ Non-Heated/Cooled SF •Class of Work: ZNew ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door •Use of existing/proposed structure(s): ❑Commercial Residential • If existing structure, is a fire sprinkler system installed?:❑Yes❑No •Will tree(s) be removed in association with proposed project? ❑ Yes (Must submit separate Tree Removal Permit) No Describe in detail the type of work to be performed: c\Lf13le © vel l,l , ( -€ Florida Product Approval# / /d y. 1 (For multiple products use Product Approval Information Sheet) Property Owner Information Name 211/4 kr f- /20 o,G Phone J' V 7/., gy5'7 Address 31;9__V- Ae ,,, 4. C, t. City 0474!0,(/•, /le z State r( Zip ;24- J 3 Email Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Phone Address C' State Zip Qualifying Agent State Certification/Registration# Email Job Site Contact Number Worker's Compensation Insurer OR Exempt ❑ Expiration Date Architect's Name Email Phone Engineer's Name Email Phone 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 city/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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN —) ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. (A" 1/4,(e/te--- -77" &TL-c (Signature of Owner or Agent) (Signatur f Contractor) Si ned and sworn to(0, . med)bef• e me this �� day of Signed and sworn to(or of' med) before me this day of t A 14y r„4. 4 C .YV(oore_ by Signature of Notary • �1� Signature of Notary [ ] Personally Known OR [ ] Produced .-tification [ ] Personally Known OR [ ] Produced Identification Type of Identification: Type of Identification: :• •'��'1,• . TONI GINDLESPERGER • i ����r :*i MY COMMISSION#HH 407122 -:jz.o?;• EXPIRES:October 6,2027 ' ,:51-vi .,,, OWNER BUILDER AFFIDAVIT 1 i\. N. City of Atlantic Beach Building Department JOB ADDRESS: " 800 Seminole Road, Atlantic Beach, FL 32233 Sys ,,�'Gl4-4. 4- v'`= Phone: (904) 247-5826 Email: Building-Dept@coab.us **OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DEPARTMENT TO SIGN THIS DOCUMENT** I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER / BUILDER TO ACKNOWLEDGE THE LAW: To qualify for exemption under this subsection, an owner must personally appear and sign the building permit application and must satisfy local permitting agency requirements, if any, proving that the owner has a complete understanding of the owner's obligations under the law as specified in the disclosure statement in this section. However, for purposes of implementing a "United States Department of Energy SunShot Initiative: Rooftop Solar Challenge" grant and the participation of county and municipal governments, including local permitting agencies under the jurisdiction of such county and municipal governments, an owner's notarized signature or personal appearance to sign the permit application is not required for a solar project, as described in subparagraph (a)3., if the building permit application is submitted electronically to the permitting agency and the owner certifies the application and disclosure statement using the permitting agency's electronic confirmation system. If any person violates the requirements of this subsection, the local permitting agency shall withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity against the owner and any person performing work that requires licensure under the permit issued.The local permitting agency shall provide the person with a disclosure statement in substantially the following form: DISCLOSURE STATEMENT- Please initial Items 1 - 13 1. , I understand that state law requires construction to be done by a licensed contractor and have applied for an owner- builder permit under an exemption from the law.The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. 2. 4funderstand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. 3. A• u rstand that, as an owner-builder, I am the responsible party of record on a permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. I also understand that a contractor is required by law to be licensed in Florida and to list his or her license numbers on permits and contracts. 4. I understand that I may build or improve a one-family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my own use or occupancy. It may not be built or substantially improved for sale or lease, unless I am completing the requirements of a building permit where the contractor listed on the permit substantially completed the project. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease,which violates the exemption. 5. I understand that,as the owner-builder, I must provide direct, onsite supervision of the construction. 6. /17-1 understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or residence. It is my responsibility to ensure that the persons whom I employ have the licenses required by law and by county or municipal ordinance. 7. nderstand that it is a frequent practice of unlicensed persons to have the property owner obtain an owner-builder permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner-builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 8. 1 I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers'compensation for the employee. I understand that my failure to follow these laws may subject me to serious financial risk. 9. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern owner-builders as well as employers. I also understand that the construction must com with all applicable laws,ordinances, building codes, and zoning regulations. 10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue ervice, the United States Small Business Administration, the Florida Department of Financial Services, and the Florida Department of Revenue. I also understand that I may contact the Florida Construction Industry Licensing Board at (850) 487-1395 or the DBPR for more information about licensed contractors. 11. I am aware of, and consent to, an owner-builder building permit applied for in my name and understand that I am the party legall nd financially responsible for the proposed construction activity at job address listed on this document. 12. I agree to notify the Atlantic Beach Building Department immediately of any additions, deletions, or changes to any of the information,that I have provided on this disclosure. 13. Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not h ve a license, the Construction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property,you may be held liable for damages. If you obtain an owner-builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers'compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the pr e owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. �& � /eV- .JiL 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: 5.1. j /Ie /4'"�� RE# Owner Name: /,.,v¢7q 4.F. Phone Number: J V. 7/c V'/ 7 Mailing Address: �e't'-4:4 ,,_,/c City: tl�/C 3f,,ed,Otate:FY Zip: 1,7.433 t---- -,0/1ZC___ X___ /(-Cdt- o'..... . TONI GINDLESPERGER (Signature o Owner or Agent) !" MY COMMISSION#HH 407122 ' ed and sworn to(ora • ed) b; • e me this CiZ day of +,''!`'e EXPIRES:October 6,2027 ri • �Ili by a. jJ • L•�t0 :FOF f0,.` . Signature of Notary • lir [ ] Personally Known OR [ I Produced 40 ation Type of Identification: �. s fL'IJ%- Destructive Roofing In Progress Application Updated 02/13/2020 -4111k City of Atlantic Beach Building Department **ALL INFORMATION V 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: 6'2 Permit Number: R Eft Z`-1' ROOFING IN PROGRESS INSPECTIONS A roofing in progress inspection is a required inspection per the Florida Building Code-Existing Building (FBC- EB). The purpose of the inspection is to confirm any required deck nailing has been completed and proper installation of a secondary water barrier as required by Rule 9B-0475. This required inspection was not requested by the contractor prior to completing the shingle installation for the above referenced permit, and now a Destructive Roofing In Progress inspection must be performed by removing certain portions of shingles and/or underlayment to insure compliance with state law. Not complying with this requirement could affect your insurance coverage for storm damage. OWNER AFFIRMATION I understand that the contractor, for the reason listed below, was unable to acquire a PASSED roofing in progress inspection. I also understand the destructive roofing in progress inspection will require the contractor to remove and replace shingles and/or underlayment as required by the City of Atlantic Beach Building Department to verify work is in compliance with all state and local codes. igned aneil sworn to(or a . -d)before me t isZZ day of Age.t.ce_ k ,zoz 4, yr:4.r,ck. • (Signature of Owner or Agent) gnature o Notary) ::?• � TONI GINDLESPERGER [ ] Personally Known OR i�y • MY COMMISSION#HH 407122 [ ]Produced Identification l > "���• �` EXPIRES:October 6,2027 :FOF Fro; Type of Identification: CONTRACTOR AFFIRMATION COMPANY: ADDRESS OF PROJECT: REQUESTED BY: REASON FOR REQUEST: I, , understand City of Atlantic Beach Building Department procedures as outlined in Bulletin ???. I also understand the destructive roofing in progress inspection is not part of those procedures and is an exception to the procedure. In addition, I understand that any non-code compliant work identified during this inspection may result in the assessment of additional re-inspection fees. Signed: Date: AN APPROVED COPY OF THIS APPLICATION MUST BE ON SITE AT TIME OF DESTRUCTIVE ROOFING IN PROGRESS INSPECTION.