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Permit Windows/ door 433 Sailfish 2011 - 0 11 4k4 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 4 N ATLANTIC BEACH, FL 32233 *WV INSPECTION PHONE LINE 247 -5814 ,l s Application Number 11- 00002345 Date 8/12/11 Property Address 433 SAILFISH DR Application type description WINDOW AND /OR DOOR Property Zoning TO BE UPDATED Application valuation . . . 2500 Application desc replace door windows Owner Contractor SPRUANCE OWNER 433 SAILFISH DRIVE ATLANTIC BEACH FL 32233 Permit W /W /O BUILDING PERMIT Additional desc . Permit Fee . . . 130.00 Plan Check Fee . . 65.00 Issue Date . . . Valuation . . . . 2500 Expiration Date . 2/08/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC 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 130.00 130.00 .00 .00 Plan Check Total 65.00 65.00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 199.00 199.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ' BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH D 0 T t) p I 800 Seminole Road, Atlantic Beach, FL 32233 t5 Office (904) 247 -5826 Fax (904) 247 -5845 11 JUL 5 1 _r Job Address: ` f — £ / 4 - F ( S 1 . ��G� I � i_. Permit Numb f .- S Legal Description 4/ 1 , / I Y— / 2 ' / 4( it &.41 , - ' Parcel # ✓ F Area of Sq.Ft. Sq.Ft Valuation of Work $ L G >U Proposed Work heated /cooled non - heated /cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door Use of existing /pro osed structures) (circle one): Commercial (Residential, If an existing structure, is a fire sprinkler system installed? (Circle one): Yes -- �) N /A Florida Product Approval # ��� C For multiple products use product approval o rf / I / Describe detail the type of work to be performed: /�)t p l`< / ' / It /r � * � ,5 c � : /7 - 1 ' - in � / 7 '' G'rG 'l�!lfc�,' S ri,�',: -�, tom' �% L-c., 'i C4';(6-1../S. Property Owner Information: , ;� •�� Name: V ' Ja i et �;1� i eA Address: 1 �� ,� . / ► r City State _Zip Phone / , -- 21 7' E -Mail or Fax # (Optional) Contractor Information: i t ���{� 'L _ d j i / / ,_. Company Name: &- /f4 ' (14(11 - Qualifying Agent: Address: City State Zip Office Phone 4/4 - / .& ./. b Site/ Contact Number Fax # State Certification/Registration # G''/ f. 7/cv, ".cR. 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 if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six f6) months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, 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 ertify that I have read and examined this a plication and know the same to be true and correct. All prc 5"lf iY3"o �12t' tln tee rig this type of work will be complied with whether specified herein or not. The granting of a permit does not pres ' l l..« el the provisions of any other federal, state, or local law regulating construction or the performance of construction. # .iii FILE copy ii, ( ►s/i, /, Signature of Contract Signature of Owner , _ 4 , ■ Print Name ) C.�r IC?l , p..r. uc' r\ . 4 „,,„.11...., A" . Sworn, � . al, subscribe. be ore me gPL^15C1�1R��-t7r 1h�'114OMPLIANCE 1 th's 0 . of I/. 20 / this _ CIWOF ATL ANTIC BEACH , 20 J Jo iII*► ; SEE PERMITS FOR ADDITIONAL ire, / !?r L"a'.. 1 s� " ; ' 1 . „ .11111. _ _.11 _ a .1I YY 1 .. Notary P rev co — SS ■N Notary Pu r is /�� / // EXPIFIE5: Fe,rusty 14, 2014 4 ' a*` Bonded Thru Notary Public UnClerw j REVIEWED BY: 4 `' torn scd 01.20.10 t ".J fi, CITY OF ATLANTIC BEACH. ' . OWNER / BUILDER AFFIDAVIT I. FLORIDA 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, BE THE DEPARTMENT SUGGESTS WORKERS PURCHASED N UNDER THE HOMEOWNERS INSURANCE ' POLICY TO CLEARLY THE OWNER. 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. )/8 7, /7-kc, ADDRESS PHONE NUMBER \IN(` tc G S,r(A u1 C e PRI NAME d S e' LIRE , r DATE F ��� Before me this J i day of CJG/ / , 2007 In the county of Duval, State of Florida, has Personally app red herin by himself 1 herself and affkms that all statements and wagons are, true nd accurate. L at F L , County of (/ Notary Public at Large, State of O P Known /tilt, 4 / „ ' SHIRLEY L GRAHAM Notary Signal `� , s MY COMMISSION A DD 967760 +noo1 :* ' " , EXPIRES: February 14, 2014 coca 91.0007„ REVISED ur ‘F"'• t Of o s o ndetl th ru Notary Public Untlerwritors 2011 -07 -15 16:26 Building Dept. '247 5845 » 9048581173 P 1/1 ...or - City of Atlantic Beach Building Department • 800 Seminole Road tit { T..y A Atlantic Beach, Florida 32233 �� Telephone (904) 247 -5800 Fax (904) 247 -5845 www.coab.us WIND -BORNE DEBRIS PROTECTION AFFIDAVIT Date:, 7 h9A . / Permit #: /1 'a 7 S :Ifie �, �f -f( / ?L F _ Property Address: �3 3 ' 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. l I agree to have the required window protection installed on or before: / / // (Date) I will be using the folio ' g material to provide the window protection: (check one) A, Plywood per the Florida Building Code B. Other approved method (Provide Florida Prod ct Number) ` r Nam •Homeowner's Ranee Compa � � 4 ^ ? �n ;. 46aVI1... - 7p.5 ) V) 11 ( gnature of Pro er) 1 (Date) Vi a Drii Sp,rt1& (Print Name STATE OF FLORIDA COUNTY OF DUVAL 3 The foregoing instrument was acknowledged before me this al day of 3 ` j. , 20 ji. by (name of person acknowledging). a . ca,i...es_s4T-r•-e....- Signature of Not Public —State of Florida Personally known OR Produced Identification Type ofIdentitcation - M 1 Nifty PtMlle • $IaN a MAO 4 - ; MI GsMm. MOM ,NW 2. 10 111 MMtwwn II 11 1*N f 7 L ( " c„ ( k je C X 5?e, i'Z H /0 77 - Aii ( -c' ic 7 0 /-1f - - - 1 ‘-('- (-( /1-- 1 715/7-1 ' 71:ta- ' /76-4,.%() p .. /2_ - .1)1 o/ d , ,, s f ic.) C 3 ) i--/c F / onwasmostiw / /V/1 co 17 v )--, F /2 T V (2 i 7 i / i fli-e-4 i C. C-u , ,, ,i i 7 //*& (4{14 15 c eice):A_ 7-/ /4// A-7 7x26,7_ v r s + _ -- --' J, City of Atlantic Beach Fax (904) 247 -5845 i APPLICATION NUMBER c)' , °,.,N Building Department (1) too (To be assigned by the Building Department.) 800 Seminole 2 47 -5 Road / n - � . ,, Atlantic Beach, Fl 32233 -5445 1 7 Phone (904) 826 • Nil/ 0109 %• E -mail: building- dept ©coab.us Date routed: City web -site: http: //www.coab.us APPLICATION REVIEW AND TRACKING FORM /3 ,�'/ :pale Property Address: � � S� _ d ent review required Yes No Building Applicant: 7) /) .? nning & Zoning Tree Administrator Project: C0 / 72D e to / /b 6D £ Public Works /-W Public Utilities /C of /fit F /( ( Public Safety Fire Services ' R ' 0 fee . W ;' 1,, e? ft fef .- j, fig' . 7 Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By 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: BcDproved. El Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING 9 � �~!/ � yy� d� Reviewed by: `- / ` Date: TREE ADMIN. Second Review: DApproved as revised. DDen . PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ( Denied. Comments: Reviewed by: Date: Revised 07/27/10