318 Aquatic 2011 - Siding f (
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
e INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002144 Date 5/27/11
Property Address 318 AQUATIC DR
Application type description SIDING PERMIT
Property Zoning TO BE UPDATED
Application valuation . 2700
Application desc
REPLACE SIDING WITH HARDI BOARD
Owner Contractor
WIGMORE CHIRISTINA M OWNER
318 AQUATIC DR
ATLANTIC BEACH FL 32233
Permit SIDING PERMIT
Additional desc . REPLACE SIDING
Permit Fee . . . 65.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 2700
Expiration Date 11/23/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONALELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 65.00 65.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 69.00 69.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
"."" TIC BEAM " ir, CITY OF ATLANTIC
� ER AFFID AVI -T
r3 a 4 a ki �'1 lY
� � V.9 i' PART 1 "CONSTRUCTION
STATUTES, LPW
CHAPTER 489, FLORIDA L ACKNOWLEDGE
STATUTE
QU R ES OWNER I BUILDER
FLORIDA A STATUTES,
E DIT NV ACN111 233
���,UI G v � us,Nro $ F � 3 5 845
1 11 B Sel l R oad, n .c, Beach, '2,41 t� °nbe��
g �� 5em19o�� Z�� - 5826 p erms'
0 1 °e < Par Si q t eate dlcoolea'
Pa on b or
4 f BUILDING PERMIT APPLICATION
1
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: 3.z l Z, Permit Number: ' q!te
Legal Description Parcel #
//// t o Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ �7` (q l, Proposed Work heated /cooled non - heated /cooled
Class of Work (circle one): New Addition Alteration ' epair Move Demolition pool/spa window /door
Use of existing/proposed structure(s) (circle one): Commerci: Residential
If an existing structure, is a fire s • i i kler 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: fh (14A ri & 41i
Property Owner In ormation•
1---- Name: `) Address: / -
City Stat %,Zip 3Z2 r� v
E -Mail or Fax # (Optional) 2 ; , ' ( 1 CI
Contractor Information:
Company Name: 52".------ Qualifying Agent:
Address: ___ ;r_, ___ State Zi
Office Phone Job ` � b i - ,_ _ - ;u."" p`"'< "-
State Certification/Registration # / ' _ _. _ . ,i t; , 1
Architect Name & Phone # ( ' 1 AT I ► t L i 11 a ,
Engineer's Name & Phone # 1 AULLiql 1 111 A I i ;idiv-
Fee Simple Title Holder Name and Address '1 MENTS AND C• 11 • . r r. .
Bonding Company Name and Address I ! I! __ ,_ ,, .�� � A -.• - «.,,r
Mortgage Lender Name and Address - ; DATE. •-lfirMi
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or insta lotion 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 apertod of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical 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.
1 hereby certify that I have read and examined this a plication and know the same to be true and correct. Al! provisions of laws and ordinances governing this
type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, st or 1 cal law regulating const or the performance of construction.
Signature of Owner -. Signature of Contractor
Print Name ( /"/ 5t 4 Gz.._ 141-- (--t:' i t,71OT`C -., Print Name
Swelt an ubscribe. " ,' ., • re me Sworn to and subscribed before me
thi: ay of _ - ,t this Day of , 20
- • / ANDA ' ,
■ , ` nr i ,1. D ,' EE , r
i�L � �i Inbi • , e
Notary Public 4= ExpmES: May 21 d •° 2C Bonded Thru Notary Pubiic Uod erNriters fit;
Revised 01.26.10
MAY-27-2011 12:51 FROM: CLERK OF COURTS 904 270 1512 TO: 92475845
Doc 4 ;i0 83'13, OR oK . i6613 Page1403,
Number Pages:1
Recorded 05127/2011 at 01:01 PM,
NOTICE OF COMMEND
JIM PuLLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.11D
State or jte
KIDA
County of t
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of
the Florida Statutes, the •fi informal= is stated in this NOTICE OF CO CEMENT.
Legal Description of property being improved:
A
Address of property being improved: MAW • Nt
Garai description of improvements: uJ rt cto (.c. 5 SL4_..1)
tt:4-)z
,
g owner: m.4A- . it 1• Address: ?-A,R ASAIIC
Owner's interest in site of the im.. anent:
Fcc Simple Titleholder (if other than owner):
Name:
Contractor:
•
Address:
Telephone No.: _ Fax. No:
Surety (if any)
Address: .Am ount of Bond S
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Address:
Phone No: Fax No:
• Name of person within the Stato of Florida, other than himself, designated by owner upon whom notices or other documents may be
served: Namc:
- Address:
Telephone Nn! Fax No:
In addition to himself, owner designates the following person to recoi.vo a copy of the Lienor's Notice as provided in Section
713.06(2)(b), ibrida Statues. (Fill in at Owner's option)
Name: •
•.
•
Address;
Telephone No: Fax No:
lixpiration date of Notico of Commencement (the expiration date is one (1) year from the date of recording unless a different date is
specified):
THIS spAct FOR RECORDER'S USE ONLY OWNER •
•
• Signedis' Date;
Before mo /- day of 20 ; in the County of Duval, State
. ol:BOR otoSE
s ieft cotAlASsI, z oms Of Florida, has personally appeared euie 417 Ar/3 zkir 6 e"
EVTTiartPaISGUndOrWritISS , Notary Public at Urge, Stato of Florida, County of Duval.
* V I Pi3n68d My commission expires: .1
Porsonntly Known: or
(W,.. /en ) Produced Identification: r-' (A)
co 7 73 er Ezo
10-
`;' CITY OF ATLANTIC BEACH
''� _ eWNER / 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.
r TiC
• bCZ. 'i..-4, ∎(\
kiM �-e,
NO rcze e — 2
5
Y
Before me
this 1 day of , 20' ! in the county of
Duval, State of Florida, has personally appeared erin by himself / herself and affirms that
all statements and declarations are and ac rate.
Notary Public at Large, State of County of i� '' �,, DEBORAH AMANDA WHITE
` v _,,. ,4t .: MY COMMISSION # E 057349
❑ P ovally Known �� L lJ „��� 'Ga �`t� - i ' x.,. b` EXPIRES: May 21, 2015
Produced Identification - ' ,`
. z d... ,7/4 �� � ,� . of F Bonded Thru Notary Public Underwriters
Notary Signature: 1
F:BLDG /Owner - Builder Affadavit; REVISED: 4/16/2009
v
r." , : City of Atlantic Beach Building Department
-�° 800 Seminole Road
. ' Atlantic Beach, Florida 32233
Jji Telephone (904) 247 -5800
Fax (904) 247 -5845
www.coab.us
WIND -BORNE DEBRIS PROTECTION AFFIDAVIT
Date: i J Z1 ( f
Permit #:
Property Address: M ACQQ1k-Tie t\ _ LJ
I understand the Florida Building Code requires replacement windows in a Wind -borne Debris
Zone be impact glass or have openings provided with wind-borne debris protection. I recognize
the structure involved is located in a Wind -borne Debris Zone. I am in the process of having
windows replaced which require this protection but have elected not to have the required
protection installed by my window contractor. I understand that before a final inspection may be
approved, the required window protection must be provided. If the required window protection is
not provided it will be a violation of State law and the City of Atlantic Beach may take appropriate
code enforcement action which may result in fines beings made against this property. I also
understand that my insurance company may not reimburse me for damages suffered due to the lack
of required window protection.
I agree to have the required window protection installed on or before:
(Date)
I will be using the following material to provide the window protection: (check one)
A. /) Plywood per the Florida Building Code
B. Other approved method
(P:ovide Product Number)
Name o om o er's Insurance Company `�► r
X 27 0
(Sign o Pr Owner) (Date)
)
C i i7 ' s/;), 1 , `
d
(Print Name) .,, , DEBORAH AMANDA WHITE ,,
_.. ... ; = _ MY COMMISSION # EE 057349 1
STATE OF FLORIDA ',
EXPIRES: May 21, 2015 1 '
COUNTY OF DUVAL
�. 3.h• • ` Bonded Thru Notary Public Undr , f
The foregoing instrument was acknowledged before me this 7-:i day of 20 by
L /
(name ofperson acknowledging).
.sue 1
. ature Y No f blic — State of Florida
Personally known OR Produced Identification X Type of Identification Pr__---P L— .
(� — 2370 // )
: 0-4 Jr », City of Atlantic Beach APPLICATION NUMBER
s r - ' i Building Department
''� (To be assigned by the Building De artment.)
800 Seminole Road /� r 2/ 2
1
'e' j :
Atlantic Beach, Florida 32233 -5445 / J
Phone (904) 247 -5826 - Fax (904) 247 - 5845
. . . �% E -mail: building - dept @coab.us Date routed: ��
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 318 6fuL44:12-<_(__
De . ent review required Yes No
� { uilding t.--7 Applicant: - - ng & Zoning
/ 9 Tree Administrator
Project: V L�- � )-t, S I (ii Public Works
1
Public Utilities
Public Safety
Fire Services
Revievi► fee $; k*d .1 i : r, ' h .,
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection / WI Florida Dept. of Transportation —:7
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other: `\
O ( I
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
UILDIN�
PLANNING & ZONING Reviewed by: 14/ Date: 5=9-7
TREE ADMIN. Second Review: Approved as revised. ❑De led.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ['Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10