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Permit Shed 211 Seminole Rd. 2011 CITY OF ATLANTIC BEACH A SS 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 . ..... -5814 INSPECTION PHONE LINE 247 Application Number . . . . . 11-00002718 Date 10/27/11 Property Address . . . . . . 211 SEMINOLE RD Application type description SHED PERMIT Property zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0------------------------------ -------------------------------------------- - Application desc new shed ------------------------------------ Owner Contractor ----------------------- ------------------------ FAIRBAIRN, CRAIG S . OWNER 211 SEMINOLE ROAD ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . ACCESSORY STRUCTURE NEW RES Additional desc . - 75 . 00 Plan Check Fee 35 . 00 Permit Fee . . . . Valuation . . . . 5000 Issue Date . . . . 10/21/11 Expiration Date . - 4/18/12 ------ --------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONAl ELECTRIC CODE *CALL FOR FINAL INSPECTION WHEN SHED COMPLETE AND ANCHORED TO MEET 120MPH WIND LOAD. Full right-of-way restoration, including sod, is required. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 ENG REV BLDG MOD OR ROW 25 . 00 STATE DBPR SURCHARGE 2 . 00 UTIL REV MODIF OR ROW 25 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 7S . 00 7S . 00 . 00 . 00 Plan Check Total 35 . 00 35 . 00 . 00 . 00 Other Fee Total 54 . 00 54 . 00 . 00 . 00 Grand Total 164 . 00 164 . 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 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: kno � ,e Permit Number: 2�7 Ik Parcel# Legal Description ...... F_ CIC"Ir IXTI'1�_11 13 q, t. Sqxt Valuation of Work$ Soo "0-,) 711�r o p ose'd 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 structure(s) (circle one): Commercial ( Residentia If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No Florida Product Approval For multiple products use�roduct approval torm Describe in detail the type of work to be performed: S; 1� yl �Q (0 C 0 Property Owner Information: r Name:��rc,k S 2--2-31 0 city Pr-Vk"_V_\- E-Mail or Fax# Contractor Information: Company Name: Qualifying Agent: Address: city State Zip Office Phone Job Si 'ontaCt NUM13— State Certification/Registration EVEMD FOR CODE COAKA A��'% Architect Name&Phone 1kTrmI Engineer's Name &Phone# RUM PE MM MR ADD!I IONAL Fee Simple Title Holder Name and Address REOMBE NTS A ONS. Bonding Company Name and Address BY: Mortgage Lender Name and Address DAM- Application is hereby made to obtain a permit to do the work and installations as indicated I cerhiy Inat no wur uf &,,- tion has commenced prior to the issuance of a permit and that all work w ill be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null ter and void if work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a period of sixP6)months at any time af work is commenced I understand that separate permits must be securedfor Electrical-Work,Plumbing,Sikns, Wells,Pools, urnaces, Boilers, Heaters, Tanks and Air Conditioners,eta 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 FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Ihereb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type o7work will be complied with whether ecified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any otherfederal,state, or localsf,w regulating construction or the pe�formance of construction. re of 0 ner Signature of Contractor Signatu ne Print ..........I.................................................................. .......... Print Nai ................... ... ........ ....................................... ...... ..........I........................ Sworn t subscribed be me Sworn to and subscribed before me this a o f 5�' 20 this Day of 20 J Notary Public MY CO Nota Public ;F Expi I IN#DID 95776o EXPIR b,,, 14,2014 Revised 0 1.26.10 80ndOod Thru t Pub Ic un�erwrifers CITY OF ATLANTIC BEACH (OWNER BUILDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING"REQUIRES OWNER I 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 14AVE 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 CONTRACTOK 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 REOVIRED-BY STATE LAW AND BY COUNTY_-OR MUNICIPAL LICENSING ORDINANCES. 11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. Ill. 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(l). 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. 0 !'12 C__ ---RES PHONE NUMBER ADD S '�:�v r"' L PRINT NAME DATE SIGNATURE Before me this day of 21) in the county of Duval,State of Florida,has personally T3ppeared herin by himself/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of County-7fJA_1j [3 Personally Known Produced Identificati 4p SHIR na EXPIR :February 14,201 Bonded Thrmu N v v vl I j WjighWill,01 9 1-cvr A,,3 p"L. 70 each APPLICATION NUMBER City of Atlantic B AP' (To be assigned by the Building Denartment) Building Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 rout Date rout E-mail: building-dept@coab.us EE ed City web-site: hftp:/twww.coab.us APPLICATION REVIEW AND TRACKING FORM S_ �m- /V6 D ment review required Ye No Property Address: B ' ' Applicant: �0 A�t Z- .lanning &Zonin Tree mini ator Project: Publ' r Public Utilities Public Safetv Fire Services ow W�_L_;_ Vow Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By _2! 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: BA/pproved. E]Denied. (Circle one.) Comments: BU�ILDIN PLANN ING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: OApproved as revised. ODenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. FIDenied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER �Idin D (T by the Bui e�artment-]) (To be assigned b the Building D! Building Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 Date routed: E-mail: building-dept@coab.us City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Yes No 1k A t. qepartment review re uired Property Address. B ,nt review re uired Y, (Planning &Zonirig h g A sir to Applicant: I r Tree Adifilhistrator Publir—Wor - - r P e-, ,.Ublic Utilities W 07 c Uti Project: 0 b ty Public Safety ub ic S vic s PireliSegre ir rFe vices 'TaJr NN, Other Agency Review or Permit Required Review or 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: XApproved. MIDenied. (Circle one.) Comments: (04) � rv\ake �AXK&3_07.) BUILDING CLAN�NING &�ZONING Reviewed by: Date: TREE ADMIN. Second Review: []Approved as revised. RDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [--JApproved as revised. []Denied. Comments: Reviewed by: Date: Revised 06114/09 APPLICATION NUMBER City of Atlantic Beach (To be assigned by the Building Department) Building Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 U �45 Phone(904)247-5826 - Fax(904)247�51 Date routed: 011 E-mail: building-dept@coab.us City web-site: hftp://www.coab.us APPLICATION REVIEW AND RACKING FORM k No Yes li, /A t' Department review re Property Address. �'B 6 Applicant: JPlanning &Zoning Tre—e-Ad-rhWtistrator �eu bli Works Project: b I blic Safetv u lic U� blic Utili.ties Publi f c S;i F S ire Services go*j 6wf Other Agency Review or Permit Required Review or 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 I Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: [;(Approved. [:]Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date:./ TREE ADMIN. Second Review: f-JApproved as revised. DDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. f-jDenied. Comments: Reviewed by: Date: Revised 05/14109 city of Atlantic Beach APPLICATION NUMBER P i ed by the Building Department.) FFbe (To be assign Building Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-58A 1: 1 Date routed: E-mail: building-dept@coab.us : . , ---7- -J I City web-site: httP:/twww.coab.us -------1:7-- 1 -1 _!J APPLICATION REVIEW AND TRACKING FORM D artment review re uired Yes No Property Address B view re Muired No 9 lanning &Zonigg Z' /V or Applicant: Tre -___ffiWistrator ubl' rks Project: ublic Utilities Public Safety Fire Services R evi, el�i Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B 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: 'KApproved. []Denied. (Circle one.) Comments: BUILDING Date: PLANNING &ZONING Reviewed by: TREE ADMIN. Second Review: F�Approved as revised. [–]Denied. omments: K& 4PI;OR 0 C ES Reviewed by: —Date: PUBLIC SAFETY FIRE SERVICES Third Review: DApproved as revised. ElDenied. Comments: Reviewed by: —Date: Revised 05114/09