Permit 2305 Barefoot TraceCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number
Property Address
Application type description
Property Zoning .
Application valuation .
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Application desc
4 replacement windows
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10-00000812 Date 6/23/10
2305 BAREFOOT TRAC
WINDOW AND/OR DOOR
RES SF DISTRICT
1800
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Owner Contractor
------------------------ ------------------------
WRAY BRIAN AND BRENDA OWNER
2305 BAREFOOT TRACE
ATLANTIC BEACH FL 32233
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Permit WINDOW AND/OR DOOR PERMIT
Additional desc .
Permit Fee 60.00 Plan Check Fee 30.00
Issue Date Valuation 1800
Expiration Date 12/20/10
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Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/'05-'06 SUPPLEMENTS.
2007 FLORIDA BUILDING CODE - RESIDENTIAL. --
2005 NATIONAL ELECTRICAL CODE.
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
*Window installation instruction shall be on site for final
window inspection*MJ.
Fee summary Charged Paid Credited Due
-----------------
Permit Fee Total
Plan Check Total
Grand Total
----- -
60.00 ---------
60.00
30.00 30.00
90.00 90.00
.00 .00
.00 .00
.00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BITII.,DING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: ~ 3 b ~ ~~ ,-c -(w~ ~~~ y~1c~ Permit Number: `G~ - (7 ~'/ ~..
Legal Description Parcel #
oor ea o q. t. q. t
Valuation of Work $ ~~~ Proposed Work heated/cooled non-heated/cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition pooUs a window/do
Use of ezisting/pro osed structure(s) ((circle one): Commercial sidenti
If an ezisting struc~ure, is a fire spri filer sys em installed? (Circle one): o N JA
Florida Product Approval # ~- ! 7 . -
For multiple products use pro uct approva orm
Describe in detail the type of work to be performed: ~ ~-' ~~-~-~'~~- ~.~,,~--u-~
Property Owner Information:
Name: ~~~~. a- ~w~,r. ~~"~ Address: Z 3 c7 J~ ~~,.{a.-~~r- -"T~_
City /-} -~S State ~- Zip T z ~- ~ ? Phone ~- ~` '~ `I Lc' ~'
E-Mail or Fax # (Optional)
Contractor Inform tion:
Company Name: -z ,..~,4- ~ -!vim. C.r Qua.l' g Agent: ~L a.~ ~ b ~. I(~.
Address: ~ ""= ~ City.. ~-~~.~. __ to Zip 3 Z J "~
Office Phone ~ 3 lob 'te/ Con ct N ber '~ " 5 F #
State Certificati a istrati n # U ~ O ~ t7
Architect Name Ph ne #
Engineer's N & P one
Fee Simple Titl Hold r ame and d ess
Bonding Company N and Address
Mortgage Lender Nam and Address
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 laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six 6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, ~urnaces, Boilers, Heaters,
Tanks and Air Conditioners, etG
WARNIlVG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
CONIlVIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IlVIPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YO~[JR NOTICE OF
COn~IlVlENCEMENT.
I hereby certify that I have read and examined this~plication and know the same to be true and correct. All provisions o, f laws and ordinances governing this
type of work will be complied with whether sppeci ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local Imv regulating construction or the performance of construction. _ _
Signature of Owner 1 ~`~ ~- ~ w
Print Name I S v--Lh .$a 1 _ ! l v-~ ..
Print
of
f
~a
REVIEWED BY::~~?'I 2. DATE: ~3 l!~ ..,..-,a.. _..,._
Revised 01.26.10
S i~.~.'lr,~~,
~~`~ 'y
r ~~~, ~ CITY OF ATLANTIC BEACH
~_
~, ~ ~" ®WNER /BUILDER AFFIDAVIT
''!. ~~ss
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 IIv1PROVE A ONE - OR
TWO FAMII.,Y 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 BUII,T 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
HIIZE 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 {NSURANCE 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. TELEPHONE THE
BUILDING DEPARTMENT (247-5826) IF IN DOUBT.
V. ACKNOWLEDGEMENT; (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.
X30 ~ -- ~ ~ ~
ADDRESS
PRINT AME
SIGNATURE ~ /
Before me this ~ day of , 20t D in the county of
Duval, State of Florida, has pens a appeared herin by himself /herself and affirms that
all statements and declarations a and accurate.
~Notpary Public at Large, State o L ,County o
C~Personally Known
Produced Identification -
Notary Signature ~ ~
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PHONE NUMBER
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DATE
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F:BLDG/Owner-Builder AfTadavit; REVISED: MI6/2009
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City of Q-tlantic Beach
i3uiieGing ®epartrrtent
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone (904) 247-5826 Fax (904) 247-5845
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
`~ ~~
Date routed: ~G Z 2 ~ Q
d' ~ ~
°Ir®per~ Address: a ~ ~ ~ ~~'
~pplocant: ~ ~/~ ~
Pr®ject: `7 ~ 015 ~/~' ~
~~
nt review required Yes No
Buildin
Wing & Zoning
Tree Administrator
Public Works
Public Utilities
Public Safety
Fire Services
Review fieess~'~~£ . ;`s'~~..~~_ '_~. F..,, ,~DeptsSignature=~:4k'A.~;~, .,: ~~~ ~: °~
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By ®ate
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLI~ATIOW STATUS
Reviewing Department
(Circle one.)
UILDIN
PLANNING & ZONING
TREE ADMIN.
PUBLIC WORKS
PUBLIC UTILITIES
PUBLIC SAFETY
FIRE SERVICES
First Review:
Comments:
Reviewed by:
Second Review: QApproved as revised
Comments:
Reviewed by:
Yhird Review:
Comments:
DApproved as revised
Reviewed by:
^Denied.
^Denied.
UCH ~~ ~~,~1~y~,
p ~'
Date: 6 `off 3"~
Date:
Date:
Revised 05114!09