Permit 352 Buoy LaneCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
Application Number 10-00000708 Date 6/15/10
Property Address 352 BUOY LN
Application type description RESIDENTIAL ADDITION
Property Zoning TO BE UPDATED
Application valuation 6000
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Application desc
SCREEN PORCH
Owner
Contractor
------------------------ ------------------------
SISARIO, FRANK OWNER
352 BUOY LANE
ATLANTIC BEACH FL 32233
--------------------- Structure Information 000 000 ----------------------
Construction Type TYPE 5-A
Occupancy Type RESIDENTIAL
Flood Zone ZONE X
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Permit BUILDING PERMIT
Additional desc .
Permit Fee 80.00 Plan Check Fee 40.00
Issue Date Valuation 6000
Expiration Date 12/12/10
----------------------------------------------------------------------------
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.
Roll off container company must be on City approved list
and container cannot be placed on City right-of-way.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 80.00 80.00 .00 .00
Plan Check Total 40.00 40.00 .00 .00
Grand Total 120.00 120.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
~. -s:=~'~:~~J; City of Atlantic Beach
ea• S, Building Department
800 Seminole Road
. '~? r)
. ~ Atlantic Beach, Florida 32233-5445
~ - Phone (904) 247-5826 Fax (904) 247-5845
''^"L~j; ~r E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
io ~ Ida
Date routed: ~
APPLICATION REVIEW AND TRACKING FORM
Property Address: ~~~~ kQ
Applicant: ~l~~l~-~
Project: ~`T7 ~C,~ ~~ -7-j pQLj ~{
De artment review re uired Ye o
Buildi
annin & Zonin
Tree istrator
ublic W
ublic Utilities
u is afety
Fire Services
~. _
Review fee $ Dept,Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified B Date
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:
APPLICATION STATUS
Reviewing Department First Review: [Approved. ^Denied.
(Circle one.) Comments:
BUILDIN
PLANNING & ZONING Reviewed by: Date: 6"'- 3 lC]
TREE ADMIN. Second Review: ^Approved as revised. ^Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ^Approved as revised. ^Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (9Q4) 247-5826 Fax (904) 247-5845
Job Address: ~ ~Z-- ~Ld Permit Number: _ 1 C~ "' ~Ca~`
Legal Description Parcel #
Valuation of Work $ ~ i ~ J~> Proposed Work heatedlcooled ~~~~~: non-heatedJcooled t ~___~ :~___
h~YRn4.
Class of Work (circle one): New Addition Alteration Repair Move Demolition pooUspa window/door
Use of earisting/pro osed structure(s) ((circle one): Commercial Residential
If an eausting struc~ure, is a fire sprinkler system installed? (Circle one): Yes No N /A
Florida Product Approval #
For multiple products use pro uct approva orm
Describe in detail the type of work to be performed:
~~ U
Property Owner Information: ~!~ - I Y ~ ~~2 2
Name: Address: r /~l D~ ~/~/~
City State ,Zip Phone `~
E-Mail or Fax # (Optional)
Contractor Information:
Company
Office Phone
State Certification/Registration #
Architect Name & Phone #
Engineer's Name & Phone # _
Fee Simple Title Holder Name
Bonding Company Name and a
Mortgage Lender Name and dd
a~~z.
Qualifying Agent:
City State Zip
Site/ Contact Number Fax #
Address.
Application is hereby made to obtain a permit to do the work and installations as indicated. I ceriz; fy that no work or installation has commenced prior to the
issuance of a permit and that atd 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 fora erzod of six (6) months at arty time after
work is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, ells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Conditioners, etG
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT 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 YOUR NOTICE OF
COMMENCEMENT.
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 o work wild be complied with whether speci ed herein or not. The granting of a permit does not presume to gzve authority to violate or cancel the
proviszons ofany other federal, state, or local law regulating construction or the performance of construction.
`~
Signature of Owner ~ Signature of Contractor ~-~7/~zz~ .,~'-o, gvL•~`"
Print Name .... F~~.'tl.~'..... s~.~~../`'t../..G ....................................... Print Name ... j~lf~ A/~ S! 5~~/~/..v..............................
Sw xe. me.,,..___. Sworn to and subscribed before me
thi this ~ Day of T~ N ~ , 20 S o
,,,,,~ SUSAN ~ .,.,:~.~,«. :.,, , :.~~:.~»:..,~~,.?, .,..
No Public SEE p ITS FOR ADDITIONAL ~' M~cars; Fe~,.~,e„yzs z~a~~
REQUIREMENTS AND CONDITIONS. , .k F~. xo~,y ~;mzAwt ~so~. ca. I~vis
REVIEWED B .... ~' 3~ v ., E ~ L. L ~ ~~ ~ ~t~
NOTICE OF COD~IlI~NCEMENT
Permit No. ~ (~ '~ ~~
Tax Folio No.
THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Section
713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
1.Description of property (legal description):
a) Street (job) Address:
2.General description of improvements: ~.~%uJ ~C ~'.,PWJ>r,C~ s~: J~ ,~ ~.. ,;:?u t~",i„ ,
3.Owner Information
a) Name and address:
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4.Contractor Information
a) Name and address:
b) Telephone No.: _
S.Surety Information
`~
a} Name and address:
b) Amount of Bond: _
c) Telephone No.: _
6.Lender
a) Name and address:
Fax No. (Opt.)
Fax No. (Opt.)
Phone No.
7. Identity of person within the State of Florida designated by owner upon whom notices or other documents may be served:
a) Name and address:
b} Telephone No.: Fax No. (Opt.)
B.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713,13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.:
9.Expiration date of Notice of Commencement (the expiration date is
is specified):
Fax No. (Opt.)
one year from the date of recording unless a different date
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF
COMMENCEMENT ARE CONSIDERED IlIIPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13,
FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IlVIPROVEMENTS TO YOUR PROPERTY.
A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB STTE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR AN ATTORNEY BEFORE
COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
STATE OF FLORID ~~`"` "~, SUSAN SPEAKS GORMAN /~ ~~ '
~/ MY COMMI6510N # DD643668 10. L7~1~/h~ ~~
~+ d' EXPIRES: February 25, 2011 ~
~~~~ Si afore of Owner or Owner's Au orized OfFicer/Director/Parh~er/Manager
FI. Notary' giaanunt Assoc. Co. ~ ~/ / ,,,~_
i-g,)0.3•NOTARY ~"'~ /7 J~~iG. ~l.S ~J /~/ O
P `riot Name
The foregoing instrument was aclmowledged before me this ~_ day of J ~-l JJ ~ , 201 f~ , by f/~/} Al,~
~ - 551 Qt O as (type of authority, e.g, officer, trustee,
attorney in fact) for / (name of party on behalf of whom instr rument was ezecuted).
Personally Known `~ OR Produced Identification Notary Signature ~ tom, ,g~~o~ n~ ~9-tf1'l~lr~,,
Type of Identification Produced Name (print) ~ u-.S ~ ~ S~F' ~} /1S ~ M A ti
Q~
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read th going ati~~ } „AKS GORMAN
the facts stated in it are true to the best of my lalo~rledge and belief. ~'r~x#Dn643668
'ap ~ _ ~qry 25, 2011
FOR1~2S/NOC,rvsd2010 ~:+%p~~%~~ ~J I.8(ID-3-NOTAR"; "~-~d1 ASSOC. CO.
Sin afore of Natural P son Signing (in lute # 10.) AUove ~ ' ~~ `
~t ~~,.
~, ~:
CITY OF ATLANTIC BEACH
• =~
~~ - WNER 1 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 AONE - 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.
11. 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. 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.
ADDRESS ~ PHONE NUMBER
/=fY~~y K <S~s ~'/' ~v
PRINT NAME ~ ~7
Be re me thi•~/~"5 '~~dajy of 3UliJ ~ , 201. in the county of
Duval, State of Florida, has personally appeared herin by himself /herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large, State of -L, r A ,County of
personally Known
^ Produced Identification -
Notary Signature: Y 'S t!/~G.4..-. ~1~~_~~ ~.~
~/~ ~ ~
DATE
MY COMMISSION # OD643668
EXPIRES: February 25, 20 t l
r FI. Notary Discount Assoc. Co.
F.BLDCo'Owner-Builder Affidavit; RE.'ISHD- a/162U09
SUNROOM, SCREEN ENCLOSURE, AND/OR SCREEN ROOM AFFIDAVIT
CITY OF ATLANTIC BEACH
JOB ADDRESS:
PERMIT #~~
INSPECTION .REQUEST PHONE LINE (904247-5826
The purpose of this document is to make you aware of any limitations in the enclosure that is being permitted at your residence.
The table below, Sunroom and Screen Enclosure Requirements provides a brief description of the various Sunroom category
requirements. There may be restrictions on the use of your present home depending on the category of Sunroom you are installing.
The property owner is hereby notified that should any form of temperature control system be added to a Category I, II, or III
Sunroom or the removal of the doors separating any Category I thru IV Sunroom from the host structure occur, the room shall
become non-compliant and must comply fully with all of the requirements for habitablelconditioned spaces as mandated by the
Florida Building Code, The Florida Model Energy Code and State Statutes.
Screen Room Sunroom and Screen Enclosure Re uirements
Cate o I II III lV V
Habitable S ace No No No Yes Yes
Foundation alls <200p1f can ails <200p1f can ells <2,OOplf can alls <200p1f can have alls <200p1f can have
ave 8"Wx12"D ftg ave 8"Wx12"D ftg ave 8"Wx12"D ftg "Wx12"D ftg 8"Wx12"D ftg
r 3-1/2" slab if no r 3-1/2" slab if no r 3-1/2" slab if no
oncentrated load oncentrated load oncentrated load
7501b 7501b 7501b
Exit Lighting Not Required Required Required Required Required
Interior Electric Not Required Not Requixed Not Required Required Required
Outlets
Emergency Escap gress from exist. gress and Exit must gress and Exit must gress and Exit must gress and Exit must
Openings fracture allowed if eet code eet code. Other eet code. Other eet code. Other
pen to atmosphere or esistance esistance requirements esistance requirements
onsidered screen equirements for or forced entry, air or forced entry, air
nclosure and has orced entry, air eakage and water eakage and water
Green door leading eakage and water netration also apply. enetration also apply.
way from residence. enetration also apply.
Misc. Window and ost structure emovable windows emovable windows ost structure windows ost structure windows
oor Requirements doves/doors shall llowed in Sunroom. llowed in sunroom. doors shall not be doors may be
of be removed. ost structure ost structure emoved. emoved.
indows/doors shall indows/doors shall
of be removed. of be removed.
ind Borne Debris Not Required Not Required Not Required Required Required
enin Protection
Energy Sheets Not Required Not Required Not Required Required Required
I hereby acknowledge that I have read and understand all the above on this Day of ,
`_ ~
Home Owner's ignature Print Name
STATE OF FLORIDA, COUNTY OF DUVAL:
The foregoing instrument vas acknowledged before me this _~ day of TL.t ~l ~_ , 20 ~.O , by
~=/P.9~'/.~-. .Si.S~l.1' ~ ~' herein by himself/herself and affirms all
statements and declarations herein are true and accurate.
,a: ~.
,~~"""~: '''~~N SPEAKS GORMAN
"~iSSiON # AD643b68
1
OIM1 ._ •. .. ,
~~,
.. ,
1-8tq-'J•NOURY
s"i,:~,~~
..
'.^hruary25, 2011
~. •"+unt Assoc. Co.
'w' c .~:.:., ...: i1
~I.a ,~c5'~~-----
NOTARY PUBLIC,'STATE OF FLORIDA
Print Name: s ~c.SA ^~ S ~'F~l /~ S ~/~ /Y1 ~~
~d'Yersonally Known/^ Identification:
800 SEMINOLE ROAD, ATLANTIC BEACH, FL 32233 PxONE (904) 247-5826 FAX (904) 247-5845 REVISED 1-20-10
s!-~'~r City of Atlantic Beach
^•a ~ _ l''fl Building Department ,.iUl~. ~ 3 Z~iO
' ~ 800 Seminole Road
~` r~ Atlantic Beach, Florida 32233-5445 iT-, w
~ _ Phone (904) 247-5826 Fax (904) 2475` ~°~~-~ -~ ~- =----=_
'' ~~tt yr E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
~o _ 7~a
Date routed: (/ /~
d'1~P~~'L+~~~®~ ~~ V ~~Yl1l f'ilY~ 1 ~f1C~~1~IV ~~f ~~
Property Address: ~~~~ k.e
Applicant: ~ly~l~.~
De artment review required Yes No
Buildi
annin & Zonin
Tre istrator
ublic W
ublic Utilities
u is afety
Fire Services
Review fee_.$ Dept•,Slgnature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified B Date
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:
APPLICATION STATUS
Reviewing Department First Review: Approved. ^Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING ~
°~y
~
Reviewed by: Date:
~
TREE ADMIN. Second Review: ^Approved as revised. ^Denied.
P ORKS Comments:
U IT S
PUBLI S ETY Reviewed by: Date:
FIRE SERVICES Third Review: ^Approved as revised. ^Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
~. ~:s•=~'~r~,; City of Atlantic Beach
,~ _ al Building Departr'nent
"° - v 800 Seminole Road
j , ; ~-z ~'`~~ Atlantic Beach, Florida 32233-5445
~ ~ ' Phone (904) 247-5826 Fax (904) 247-5845
~~st ~%' E-mail: building-dept@coab.us
City web-site: http:/lwww.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
~d ~ 76
Date routed: ~
Pr®perty Address:
Applicant:
~.~~~ k~
~k~~t~~
De artment review required Yes No
Buildi
annin & Zonin
Tree ~ istrator
ublic
ublic Utilities
u is afety
Fire Services
Pr®ject: ~~ l~ ., ~~~ c~E ~ pQLj
Review fee,$.' ~ .Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By pate
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:
APPLICATION STATUS
Reviewing Department First Review: Approved. ^Denied.
(Circle one.) Comments:
BUILD.IN~---
,-,
P AN ING & ZONI
3''/D
'0
~
!
~~~
Reviewed by: .
Date:
r
o
TR ADMIN. Second Review: ^Approved as revised. ^Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ^Denied.
Comments:
Reviewed by: Date: ~
Revised 05!14!09
-z.:~.>>:,yJ~ City of Atlantic Beach ~.~ ~:a"r, ~~++~'<.aY t.+:a
-~ ~1 Building Department
=•~ `~ 800 Seminole Road ~l.-N_ ~ ~ z~;~
j - ; _ "'`?` ~~ Atlantic Beach, Florida 32233-5445
_ Phone (904) 247-5826 Fax (904) 2 J 8.45 ______
9- P @ .s
',r"~~;t,Y E-mail: buildin de t coab.us ~----~_~___ ~"""-`"~'
City web-site: http://www.coab.us
APPLICATION NUMBER
(To be assigned by the Building Department.)
/D ~' 7~ ~
Date routed: ~•
Property Address: ~~~~ k,Q
Applicant: ~~~1~'~
De artment review required Yes No
Buildi
annin & Zonin
Tree istrator
ublic W
ublic Utilities
u is Safety
Fire Services
_. - .. r
Review fee $ ~ Dept_,S,ignafure
Other Agency Review or Permit Required Review or Receipt
of Permit Verified B Date
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:
APPLICATION STATUS
Reviewing Department First Review: ^Approved. Denied.
(Circle one.) Comments: ~ ~~~
~
BUILDING
PLANNING & ZONING Reviewed b
: Date: ~ 7/1(I
y
TREE ADMIN. Second Review: Approved as revised. ^Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
/
I
PUBLIC SAFETY Reviewed ~-'
~D
~
/O
Date:
FIRE SERVICES Third Review: ^Approved as revised. ^Denied.
Comments:
Reviewed by: Date:
Revised 05!14!09
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