Permit Wind/Door 289 Pine 2011 LAN
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001955 Date 4/25/11
Property Address 289 PINE ST
Application type description WINDOW AND /OR DOOR
Property Zoning TO BE UPDATED
Application valuation . 890
Application desc
REPLACE SG DOOR. 2 NEW WINDOWS MODIFIED OPENINGS
Owner Contractor
ARCHER PAMELA A OWNER
289 PINE STREET
ATLANTIC BEACH FL 32233
Permit WINDOW AND /OR DOOR PERMIT
Additional desc .
Permit Fee . . . 55.00 Plan Check Fee 27.50
Issue Date . . . Valuation . . . . 890
Expiration Date . 10/22/11
Special Notes and Comments
PERMIT TO REPLACE 1 SLIDING GLASS DOOR
AND MODIFY 2 OPENING FOR WINDOWS AND
INSTALL NEW WINDOWS.
*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 55.00 55.00 .00 .00
Plan Check Total 27.50 27.50 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 86.50 86.50 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
6' f Se- " p\
,'''. '%.: g CITY OF ATLANTIC BEACH
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®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.
7 7 el F,, , J7- .4.11,,, s e. B°r: -t.J., r2 q 6 6 - 9 o >ir te �,
ADDRESS 1 PHONE NUMBER ay O wow i ■
P RI N T
INT.-NAMED
SIGNA URE DATE . v
�._�, H
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Before me this 4-" day of 2q�/ in the county of
Duval, State of Florida, has personal) ppeared herin by himself / herself and affirms that
all statements and declarations are t and accurate. /' - n o T
Notary Public at Large, State of , County of �f/Z.t( ._ - CL -5 i
❑ Personally Known � � L A_(;:, 2 / 6 ' ( � 7 � / � 0 l ♦ z 0
Produced Identification - (4J ( ( ( (1 M/ O il
rryy
Notary Sign: C t i E ►! , r, t . 4 CE ` . I ry DEBO H A WHITE�
'4 � '' dY COMMIS' ION II DD 634120
CITY OF ATLANTIC BEACH ^. ' * _ "
"" E
F:BLDG /Own • Builder Affadavit; e 5;74''I'' te�' y
R § '; ITS FOR ADDITIONAL y orl ' Lot ded Thiu Notary PlibIld UndOwdters
REVIEWED BY DATE: 1` a /- //
,.
..,
WARNING
Pulling an owner /Builder Permit is Risky Busioessl
_ If you do not intend to do the work yourself and have been asked by
,. "" someone without a contractor's license to pull the permit, you are at risk of
financial harm.
7
Section 489.103 (7), Florida Statutes requires that when property owners
act as their own contractor, they must supervise the work being performed.
, ,, # Any person working on your building who is not licensed must be employed
by you, which means that you must deduct F.LC.A. and withholding tax and
provide workers' compensation for that employee.
v Without workers' compensation insurance, you could'
t# be held liable for injuries incurred on your property.
; � yp y, your homeowners' insurance policy will �
T icall ,
4 not honor your claim if the work being performed
required a licensed contractor. You could end up $ '
I ii responsible for thousands of dollars of medical bills.
Not only is it dangerous, but it's against the law.
Section 455.227(1)(j), Florida Statutes prohibits any person from aiding,
assisting, procuring, employing or advising any unlicensed person or entity.
Individuals who aid unlicensed persons may face fines of up to $5,000.
Is it worth H.
For more information, speak with your local building FIondaDepartmentef
department before you apply for a permit or contact the Business(K)
Department of Business and Professional Regulation at
Professional
�` g Regulation
850.487.1395 or online at www.MyFloridaLicense.com
C' LicenseE cienHy.Regulate Fairly.
,e �1�+�1r�, 800 Seminole Road
Atlantic Beach, Florida 32233
', Telephone (904) 247 -5800
FAX (904) 247 -5845
J_`"
44.4 C1,111
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
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LOWE'S HOME CENTERS, INC. #1699 SPECIAL
L � 12945 ATLANTIC BLVD. ORDER
J ACKSONVILLE, FL 32225
` USA
Pectido a pi
Date: 04/21/2011 (904) 486 -4701
Project #: 323786294 1 Description: sliding window (lfl )
Customer Name: ERNIE VOISINo/%3,� hi yiii..
Customer Phone: (904) 403-802/ /-71/?. ` /`'E Z.
Customer Address: 289 PINE ST
ATL BCH, FL 32233
USA
Line Item Product Code
Frame Size Description Unit Price Quantity Total Price
0001 Manufacturer: JELD -WEN Windows & Patio Doors-
Frame Size = 71 1/2" W x 35 Venice
1/2" H Division: Millwork
Product: Windows
Type: Sliding
Manufacturer: JELD -WEN Windows & Patio Doors-
t \� Venice
t! Configuration: Roller
Frame Size Width: 71 1/2"
Frame Size Height: 35 1/2"
Exterior Finish: Premium Atlantic Vinyl
Product Type: Roller
Impact Unit: No
Frame Type: Nail Fin
Frame Color: White
Size Type: Standard and Custom Sizes
Handing: XO
Qualify for Stimulus Tax Credit Option: No
Dade NOA: No
Florida Approval Number: 10953.1
Glass 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: No
Insulated Glass Option: Argon
Grille Pattern: None
$251.63 1 $251.63
1 of 2
04/21/2011 04:56 PM
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Screen: With Fiberglass Screen
Screen Color: Charcoal 18/16
Screen Installation: Installed
Coastal Hardware Package: Coastal Hardware
Hardware: Double Cam -Lock
Jamb Thickness: 3"
Egress: Meets 5.7 Net Opening
Mull Prep: None
Extension Jamb: No
* *M2O Version Date: 02/09/11**
* *M2O Catalog Version: 1.24.6 **
* * *20% off of Special Order Window and Patio Door
Promotion from 04/13/11 to 04/27/11 - no further
deductions needed. * **
Project Total: $251.63
Salesperson: LARRY FRANKOSKI (S1699LF1)
Accepted by: Date: 04/21/2011
Print this Page
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *All Millwork images are viewed from exterior unless otherwise
noted.*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
This Millwork Quote is valid until 5/20/2011 on all regularly priced items. For promotional pricing please see the disclaimer
noted with each item above. This is an estimate only.This estimate does not include tax or delivery charges. Delivery of all
materials contained in this estimate are subject to availability from the manufacturer or supplier. All the above quantities,
dimensions, specifications and accessories have been verified and accepted.
2 of 2
04/21/2011 04:56 PM
a
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0 W El
L 12945 ATLANTIC BLVD.
LOWE'S HOME CENTERS, INC. #1699 SPECIAL
J ACKSONVILLE, FL 32225 ORDER
" USA d► 1
Date: 04/21/2011 (904) 486 -4701
Project #: 323786294 Description: sliding window (lf1)
Customer Name: ERNIE VOISIN /R1/4// . /u
Customer Phone: (904) 403 -80261
Customer Address: 289 PINE ST GCf�
ATLBCH,FL 32233
USA
Line Item Product Code
Frame Size Description Unit Price Quantity Total Price
1002 Manufacturer: Atri um-Rel i aB i It
RO Size = 71 1/2" W x 80" ** *promo 20% Off Door Products 4/13 - 4/27***
H Meets Energy Star Requirements for Northern /North-
FS Size = 70 3/4" W x 79 Central /South- Central /Southern Regions * **
1/2" H U- Value:0.30, SHGC:0.22
Division: Millwork
Product: Doors
Type: Patio
Manufacturer: Atrium- ReliaBilt
Product Line: New Construction
Series: 332 DP50 Best
Configuration: 2 Lite
Color: White
** *See in -store displays for exact color samples for both
interior and exterior color. * **
r Interior Wood Finish: Color Matched
t Opening Direction: XO
Glass Energy Efficiency: Ultra Low -E w/ Argon
I I (9 Glass Color: Clear
** *The graphics present an estimation of the color and are
not acompletely accurate representation. * **
Glass Strength /Safety: Tempered
Grid Type: No Grids
Hardware Color: Painted
Footbolt: Yes
Screen: Screen
** *Project Lead Time: 21 Days * ** $555.74 1 $555.74
1001 Manufacturer: JELD -WEN Windows & Patio Doors
Frame Size= 71 1/2" W x 35 Venice
1/2" H $251.63 1 $251.63
1 of 3 04/21/2011 05:02 PM
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