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Permit Door 238 S Oceanwalk Dr 2012 s � `f` CITY OF ATLANTIC BEACH ^' :a 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 4' ''' ..r, ' INSPECTION PHONE LINE 247 -5814 01319 Application Number 12- 00000573 Date 5/11/12 Property Address 238 S OCEANWALK DR Application type description WINDOW AND /OR DOOR Property Zoning TO BE UPDATED Application valuation . . . 1200 Application desc front door Owner Contractor OLIVER WILLIAM S ET AL OWNER BRENNAN MARY K 238 OCEANWALK DR S ATLANTIC BEACH FL 32233 Permit WINDOW AND /OR DOOR PERMIT Additional desc . Permit Fee . . . 60.00 Plan Check Fee . . 30.00 Issue Date . . . Valuation . . . . 1200 Expiration Date . 11/07/12 Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 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 60.00 60.00 .00 .00 Plan Check Total 30.00 30.00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 94.00 94.00 .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: - ©cv w4. Di-- . S • Permit Number: /d - C7 3 Legal Description Parcel # LacJ -- rAm -.-, Floor Area of Sq.Ft. Sq•I't Valuation of Work $ ,,24© Proposed Work heated /cooled non - heated /cooled Class of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /doh Use of existing/proposed installed? (circle one): Commercial 11c - • • • i If an existing structure, is a fire sprinkler system nstalled? (Circle one): Yes d ip N /A Florida Product Approval # For multiple products use product approval oI' rm - / Describe in detail the type of work to be performed: 'gel) ;;" * " --7-7 (.-A' Q- y- -rte"' t� 'k Q `"'�'` G i- c r •9r--1 e- .a- Po IZJ . Property Owner Information: Y�� Name: W',' /4 C Ca, � I- i i/fr Ube.`1 , D-3 c5 pc- c./a 1 J i.)/? S • City 4-1-4..9 B t 9c H . State r e . Zip . L 21 3 Phone 9e, v 2 ;' "2 -- 6 r5 9 E -Mail or Fax # (Optional) -- » -;#sz y /<- k A'_ if & z-L- sG a4`'`e4 , Ait Contractor Information: SL -Z — W e A/ F4oRI 6 /4- Co be" # /.1-7 6 9, / i . Company Name: 5 - L r--'. Qualifying Agent: p Y Address: City State Office Phone Job Site/ Contact Number Fax # State Certification/Registration # Architect Name & Phone # t Dim* . rl . _• ; ; ` Q�►i r1►:�►[�J a! 1= 1 1•1111111• Engineer's Name & Phone # w -�� 1 M 1 1� 1` I Fee Simple Title Holder Name and Address . • • 1• • • Bonding Company Name and Address . _ . � 1 ii Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work a • • • • • • • • ix • • thai comma ' issuance of a permit and that all work will be performed to meet e s %•• % • : ""'° -" •- • --------- •: • • • •_; This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is sus ended or abandon . • or aperto• • . months at any time after work is commenced. I understand that separate permits must be secured for Electrical Plumbing, Signs, 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this a plication an• know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whet -r speci ted erein • ot. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, • / al law r • : ati , • • truction or the performance of construction. Signature of Owner // ' , /1L' ,, W i A Signature of Contractor Print Name \6/,' ,' t1 y,, , C) i t) e, r Print Name Sword subscri. - : - Sworn to and subscribed before me this Da of 11�+ ,:.: _ . .. rrP this Day of , 20 r i,, y '. � / • „. �. N N E.,„ 7,,,, t!• / I ' °' .. " ' ; Es ,:y ''nr No iy Public ^"" e� Notary Public • / ' ./o53'2 Revised 01.26.10 X337 ' 0 :1 voesoor riovo.mrewairm0P111IMIMS CITY OF ATLANTIC BEACH C / 4 ]; wNER / BUILDER AFF+ IDAVIT FILE o P ¥ . •. I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 � Z RSTRrICTI'C:7N""s 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. N. 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. (9C- Dr- 90 - 6 ADDRESS > PHONE NUMBER PRINT NAME C St■NATURE DATE Before me this / day of 21 the county of Duval, State of Florida, has personally appear herin by himself / herself and affirms that all statements and declarations re tru and accurate. Notary Public at Large, State of� County of ❑ �� DEBORAHAND ATE - y , :rulA4RMNEOSS:AMY COION E057349 Personally Known � 3 EXP Ma /.../ L Y 21, 2015 ducedldentification - '` ��yPab llcUndenvrilers • Notary Signature: / F: BLDG /Owner- Builder Affadavit; REVISED: 4/16/2009 , _