Permit Roof 760 Triton 2000 CITY OF ATLANTIC BEACH
DEPARTMENT OF BUILDING
800 Seminole Road - Atlantic Beach, Fl 32233 - Tel. (904) 247 -5826
ROOFING PERMIT
Syr_ ' ERMrr INFORMA`CIO T, . , ., . Z>q'' , t ¢,.4 .., ' .; M.,,) OCAr1O 1 . _ FORMATION1 :. ,
Permit Number: 21218 Address: 760 TRITON ROAD
Permit Type: RE -ROOF ATLANTIC BEACH, FLORIDA 32233
Class of Work: NEW Township: 0 Range: 0 Book:
Proposed Use: SINGLE FAMILY Lot(s): Block: Section: 0
Square Feet: Subdivision:
Est. Value: Parcel Number:
Improv. Cost: 1,200.00 - 'l : .*•:i..;." 17, .' , 0 l ER, 59 R ION; ,.. .x
Date Issued: 12/28/2000 Name: CAMILE REVES
Total Fees: 30.00 Address: 760 TRITON ROAD
Amount Paid: 30.00 ATLANTIC BEACH, FLORIDA 32233
_ Date Paid: 12/28/2000 Phone: (904)765-1622
Work Desc: REROOF
PROPERTY OWNER PERMIT 30.00
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NOTICE - INSPECTIONS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE, AND
MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY
OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
�' $38.80 14
Date: 12/28/88 91 Receipt: 8822521
Cr.- CHECKS 3646
CI OF ATLANTIC BEACH 88 1 88893221888
•
• CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
JOB LOCATION: VlI, Tr ITV Ar/ A9AJT 2 RF_f'-0- •J
OWNER OF PROPERTY: # 1/7.i LEI/ / 5 TELEPHONE:: 7/8/'i /
CONTRACTOR: A'v/ V/ 5 (OWAJE/ .)
CONTRACTOR'S ADDRESS: / - 5/9 /4 /1t AV.
W 17 ,EiTnivg JJ y/ ZIP: / J. h"'7
STATE LICENSE NUMBER: TELEPHONE:
DESCRIBE WORK TO BE PERFORMED: f) EPL �C'� 2or
VALUATION OF PROPOSED CONSTRUCTION $ //?
MATERIALS TO BE USED: /'c..00Fi.Cld FELT 5 t0 Let �ES /r 31yAt.a,
SIGNATURE OF OWNER: vD ;/-
. SIGNATURE OF CONTRACTOR:
SWORN TO AND SUBSCRIBED BEFORE ME THIS OZ- D: • 4 -�. �jvL ° `D
VQTARY Pt uute, sr WI (P,7 VW, rr
AS TO OWNER: A NO.41470)24
• NOT , T' " BLIC ;, „. , �,
-
SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF
AS TO CONTRACTOR
NOT
Liability Insurance Supplied
•• Workers Compensation Insurance Supplied
Contractor license Information Supplied '• °- •
Occupational License Information Supplied
•
,; ,; CITY OF
fietivctie &ad - ilwrida
800 SEMINOLE ROAD
4 ATLANTIC BEACH, FLORIDA 32233 -5445
%, TELEPHONE (904) 247 -5800
FAX (904) 247 -5805
SUNCOM 852 -5800
CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REQUIRES OWNER /BUILDER TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489. 1 03(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY UCENSED 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 I5 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
ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL. OR FAMILY
USE, AND LIKEWISE REQUIRE ALL WORK (EXC.cPT MAINTENANCE UNDER $2,000) SE UNDER A BUILDING PERMIT AND PASS
ALL NORMAL INSPECTIONS, THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES; OR MAY HIRE;
UNUCENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION OF THE OWNER, WHO MUST BE ON
THE JOB AT ALL TIMES WHILE WORK I5 IN PROGRESS BY UNLICENSED TRADES PEOPLE. " T)i1S DOES NOT ALLOW USE OF
UNLICENSED CONTRACTORS.
SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS
WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY CLEARLY PROTECTS
THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND /OR
FORM 1 099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT
TO $5,000 PENALTY UNDER FLORIDA STATUTE No. 455 AN "OCCUPATIONAL LICENSE" 15 NOT ADEQUATE.
THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A UCENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247 -
5828) IF IN DOUBT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT 1 COMPLY WITH ALL
THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER PERMIT.
PROP O
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ADDRESS EPHONE
SWORN TO AND SUBSCRIBED BEFORE ME THIS o - D tir @ 2 .
I/ i-
reel PUBLIC , ` a u :s ��
Wan Pt LTIC, ST r:
NOTE: PHRASES UNDERLINED ABOVE COMMISSION EXPIRES: E(ila1 ( ;
ARE EMPHASIZED BY THE BUILDING CIALIRED INOLI 15, °7
DEPARTMENT.