Permit Window/Door 2337 Seminole 2011 /CI
> CITY OF ATLANTIC BEACH
Arit 800 SEMINOLE ROAD
-�` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001670 Date 2/14/11
Property Address 2337 SEMINOLE RD UNIT #A
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . . . 2000
Application desc
REPLACE SLIDER
Owner Contractor
BOHR SARAH OWNER
ATLANTIC BEACH FL 32233
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 60.00 Plan Check Fee . . 30.00
Issue Date . . . Valuation . . . . 2000
Expiration Date . 8/13/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC 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
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 60.00 60.00 .00 .00
Plan Check Total 30.00 30.00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 94.00 94.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 2 /2a! S 14 Permit Number: 1/ /67
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 2000 Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration Repair Move Demolition • : - •a indowldoajt
Use of existing /pro osed structure(s) (circle one): Commercial es 1 entl 1 / IE'
If an existing structure, is a fire sprinkler system installed? (Circle one): Y es g • Q
Florida Product Approval # / /?i5� 2 i
For multiple products use product approval form FE B 1 0 2011
Describe in detail the type of work to be performed: a•& 6 d4i'✓ : - es
Property Owner Information:
Name: ✓.6afuh ,l34hi, Address: . 5C4IiA
City 4/uns /- StatetlZip 32223 Phone t 4 f) 2-4
E -Mail or Fax # (Optional) ga ruh h ha Il r FJ ad /. co y-
Contractor Information:
Company Name: Qualifying Agent:
Address: City State Zip
Office Phone Job Site/ Contact Number Fax #
State Certification/Registration #
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 rf 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 'York, Plumbing, Signs, Wells, Pools, F urnaces, Bo Heaters,
Tanks and Air Conditioners, etc.
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 RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that /have read and examined thisplication and know the same to be true and correct. All provisions f .;� • . • : 1:7.`tdut•'
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to c au ` ority is 'to' • - • '
provisions of any other federal, state, or local law regulating construction or the performance of construction.
� F IL E' COPy
Signature of Ownelifi" — Signature of Contractor
Print Name clGyti A 6a Print Name • �
Swor l to and subscri' • • :fore me — ; ; --
this , . 1: • ko 20 1 REi VIE .Fi LODE COMPLIANCE , 20
_.► ` I •, :. .....�..,,� CITY OF ATLANTIC BEACH
Notary • i 1C � 4 • XPI RES: February 14, 2014 NIFIEEEINESMETS FOR ADDITIONAL
Bondee Thru Notary Public underwriters REQUIREMENTS AND CONDITIONS.
_. evised 01.2 .10
REVIEWED BY: _ DATE: 2 /
4
CITY OF ATLANTIC BEACH
®WNER / 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 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.
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. 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.
00 2 -'/ sus
ADDRESS P NUMBER
� rah hd//
PRINT NAME
SIGNATURE // / DATE
Before me this day of / 20 /in the county of
Duval, State of Florida, has personally appeared herin by himself / herself a d affirms that
all statements and declarations are true and accurate.
0 j
Notary Public at Large, = ate of 4 , County of ✓a
El Persone Known
Produced I'entiacati. • _S _
Air
Notary Signature: - iWa_>Y, , l , r
1 ` ► F EXPIRES:IF O N N DD1 9&776°
F: / BLDG /Owner - Builder Affadavit, REVISED: 4/16/ t t p ' B onde d Thru N � �a jc 4,Q° Underwriters
Print Quote
Page 1 of 2
,r<s s';, More doing
Home Depot Store # 6365
12721 ATLANTIC BLVD
JACKSONVILLE, FL 32225
. • 9042200822
CUSTOMER:
BOHR, SARAH DATE: 01/18/2011
2337 SEMINOLE REACH CT
ATLANTIC BEACH, FL 32233
9044726252
Thank you for shopping in The Home Depot! We value your business! SOCI LARRY
ITEM FRAME SIZE LOCATION PRODUCT CODE DESCRIPTION TOTAL
UNIT
PRICE QTY PRICE
0001 MANUFACTURER:JELD -WEN Windows &
Patio Doors - Venice 1
Frame Size = 90" W x 84" H Manufacturer: JELD -WEN Windows &
Patio Doors- Venice
Product Design: Patio Doors
Configuration: 2 Panel
Frame Size Width: 90"
Frame Size Height: 84"
Exterior Finish: Premium Atlantic
Aluminum
Product Type: Sliding Patio Door
Kij= I Quick Ship Option: Standard
Counter Top Unit: No
Door Type: Bypass
Impact Unit: No
Frame Type: Box Frame
Frame Color: White
Handing: OX
Dade NOA: Yes
NOA Number: 08- 1 1
on. - As • oval N n . -r: 11258.2
'lass Rating: DP50
Glazing: Insulated
Inner Glass Thickness: 3/16"
Outer Glass Thickness: 3/16"
Glass Tint: Clear
Obscure Glass: No
LowE Glass: LowE 366
Tempered Glass: Yes
Insulated Glass Option: None
Grille Pattern: None
Screen: With Extruded Frame Screen
Screen Color: Charcoal 18/16
Coastal Hardware Package: Coastal
Hardware
Hardware: D- Handle
Keyed Hardware: No
Track Depth: 6"
* *M2O Version Date: 10/27/10 **
* *M2O Catalog Version: 1.10.2 **
Base Price for 2 Panel: 6SD9696 $ 1,099.52
90" x 84" Door - Custom Size Charge: $ 164.93
LowE 366 - Glass: $ 252.81
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1/18/2011
s!y City of Atlantic Beach
f f Building Department APPLICATION NUMBER
800 Seminole Road (To be assigned by the Building Department.)
r Atlantic Beach, Florida 32233 -5445
Phone (904) 247-5826 • Fax (904) 247 -5845
l ' - -. on �%' E -mail: building- dept @coab.us Date routed: ,/ /D/ 1
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 23 3 7 cEi» . r D /i /fCX De artm review required Yes No
Buildin
Applicant: 0/,i1 ? Planning & Zoning
Project: / // , / 6z_ Public Administrator
� / � ublic Works
Public Utilities
Public Safety
Fire Services
Revlewfee ,
w
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By 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: roved. ❑Denied.
( one.) Comments:
(BUILDING
PLANNING & ZONING
Reviewed by: to Date: a — /I - 71
TREE ADMIN.
Second Review: []Approved as revised. OD vied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by:
Date:
FIRE SERVICES Third Review: OApproved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09