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Permit 335 E Sailfish Dr ��!r.•L�l,r1�a . CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD `# ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 10-00000192 Date 2/22/10 Property Address . . . . . . 335 E SAILFISH DR Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2000 ---------------------------------------------------------------------------- Application desc REROOF FL1956 . 3 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CHAILLE OWNER 335 SAILFISH DRIVE ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . . Permit Fee . . . . 60 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 2000 Expiration Date . . 8/21/10 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 60 . 00 60 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 60 . 00 60 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r y11.s1P . 3 y C) xa�ti: FS � 10- CITY OF ATLANTIC BEACH •� ROOFING PERMIT APPLICATION Date: �" �„�� (/ Job Address �� ` L S�'1 ,q_ '�� TL '}-cam -� L►j;� Owner of Property: in E, i Address: _ Telephone: qt—!fi' iS Roof Contractor: 6 � State License Number: Contractor's Address:_. Telephone: qpwag Fax: ,!� Email: o�y�_�Qf- Scope of Work: Roofing Material ( j•f— � Q S FL Product Approval# ;!��Q Valuation of Work: $ gQTAAA_ j o Required Inspections: Sheathing/In Progress-Dry In /Final If re-roof: Assessed Value of Structure: Z t$300,000/_>$300,000;Roof-to-wall improvements required? (Applies to single family structures only) "WARNING TO OWNER: YOUR FAILURE TO RECORD NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT" SIGNATURE OF OWNER: A Date: A,l /n AS TO OWNER: DEBORAH a WHr1E ? , t MY COMMISSION N DD 634128 Sworn to and subscribed before me this 2� — day of 20/y EXPIAES:May 21,2011 BOWWState of Florida,County of Duval /' "' "ryUnd°" 8f Notary's Signature: L!. 0 Personally known Produced identification Type of identification produced eS"&o 7t 3G V7$Q-0 SIGNATURE OF CONTRACTOR: Date: AS TO CONTRACTOR: Sworn to and subscribed before me this day of 20 State of Florida,County of Duval Notary's Signature: Personally known F1 Produced identification Type of identification produced 800 Seminole Road•Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800•Fax:(904)247-5845 F:\roof permit applicaton 2010 J !J �M g THE CITY OF ATLANTIC BEACH BUILDING INSPECTION DEPARTMENT ROOFING INSPECTION AFFIDAVIT Re: Permit# I, , licensed as a Contractor*/Engineer/Architect,or Building Inspector* (print name) (print type) License#: On or about did personally inspect the roof-to-wall connections as required by Rule 96-3.0475 at , (Job Site Address) Based upon that examination I have determined: (circle one) The roof-to wall connections were installed according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S. ) I made the necessary corrections to comply with the Hurricane Mitigation Retrofit Manual. Signature STATE OF FLORIDA COUNTY OF Sworn to and subscribed before me this day of ,20 By Notary Public,Stat of Florida (Print,type or stamp name) Commission No.: Personally Known or Produced identification Type of identification produced *General, Building,or Residential Contractor or any individual certified under 468 F.S.to make such an inspection. This form must be on file at the Building Department prior to calling for a Hurricane Clip Inspection, F:\roof permit applicaton 2010 800 Seminole Road J`s Atlantic Beach,Florida 32233 i Telephone(904)247-5800 FAX(904)247-5845 Construction Site Management Plan Compliance A construction site management plan conforming to Atlantic Beach City Code Sec 6-18 has been approved as a part of this building permit. The Construction site management plan was approved based upon the following information. 1. Parking plan-parking plan showing how site will be accessed and all onsite and abutting street parking areas. 2. Location of construction trailers, loading/unloading area and material storage area. 3. Location of chemical toilet area-chemical toilets must be kept out of City right-of-way and not further than 15 feet from structure under construction. 4. Location of dumpster- dumpster must be from approved waste company(in accordance with Chapter 16 City Code). As of 2009, approved dumpster companies for Atl.Beach are Advanced Disposal,Realco Recycling,and Shappells. Dumpsters are to have tarp covers or rigid covers on windy days. Dumpsters must be removed prior to issuance of Certificate of Occupancy or Completion. 5. Traffic control plan, showing access with dimensions, area to be stabilized, narrative on phasing of construction with adequate parking and delivery of materials. 6. Site cleanliness. Contractor must have the entire construction site cleaned by Friday of each week. This means removal of scrap lumber, concrete remnants and other such construction debris including cans,metal,plastic and paper. 7. Erosion and Sediment Control. Contractor must maintain all elements of the approved Erosion& Sediment Control Plan(silt fence,catch basin filters,etc.) until sod or other stabilization has been placed and approved by Public Works. 8. Other activities,where special conditions are identified by the Building Official. Failure to comply with the Construction Site Management Ordinance may result in a Stop Work Order being issued in accordance with City Code Sec. 6-17 (3) Revised 6/2009 Joys c2y-7- ssaA � �lid } CITY OF ATLANTIC BEACH V� OWNER / BUILDER AFFIDAVIT 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 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. 111. 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 CANNOTBE 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. TELEPHONE THE BUILDING DEPARTMENT(247-5826)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. ADDRESS PHONE N B R PRINT N E TU E / DATE Before me this �-�Mdray of 2.,a in the county of Duval,State of Florida,has ersonall ::v:•1 �a '"�i°a p ppeared herin by himself/herself and affirms that ._--:--------�•'—'. all statements and declarations are true and accurate. DEBORAH A.IA Notary Public at Large,State of�,County ofr PYA ' MY COMMISSION Oil 634126 EXPIRES:May 21,20,11 Personally Known n�Z) "•'1;�,••••• �" Bonded ThmNotary Pub!icUnde;rnriters y P'iL C.._ 7� `�7�� duced Identscation Notary Signature: F:BLDG/Owner-Builder Affadavit,REVISED:4/76/2009 i