Permit Shed 1847 Forsyth St 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
---------------- .............. ATLANTIC BEACH, FL 32233
..........
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000659 Date 6/07/12
Property Address . . . . . . 1847 FORSYTH CT
Application type description SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
NEW SHED
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Owner Contractor
------------------------ ------------------------
REYES JAMES R & LORNA COTTO OWNER
1847 FORSYTH CT
ATLANTIC BEACH FL 32233
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Permit . . . . . . ACCESSORY STRUCTURE NEW RES
Additional desc . .
Permit Fee . . . . 5S . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 800
Expiration Date . . 12/04/12
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE
*CALL FOR FINAL INSPECTION WHEN SHED COMPLETE AND ANCHORED
TO MEET 120MPH WIND LOAD.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 55 . 00 55 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 59 . 00 59 . 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: -7 --Fb(,n+6 c-+ Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work S &6 -00_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/proposed structure(s)(circle one): Commercial CResidenti
If an existing structure,is a fire sprinkler system installed? (Circle on, Yes o N/A
Florida Product Approval #
For multiple products use product approval form
Describe in detail the type of work to be performed: 0 Se i f) 0— WOZX46-n a(-eA vjt-tH 0,
-�Cr) -�o a - 1--IlAel S hm :5 1 '3,$ C-�* 6 y 6 �F,� , W 14'r-1 CL, W q 0 oo I-
Provertv Owner Information: t
Name- Address: 18ql-
City
-WEIC Stat4T- Zip Phone
E-Mai I or Fax#(Optional —Wow""
Contractor Information:
Company Name: Qualifying Agent: FILE COPY
Address: city
Office Phone Job Si-fry' 11191111!!! X
State Certification/Registration REVIMM FOR CODE COMPtM
Architect Name&Phone# CITY OF*TLjtNTTC BEACH
Engineer's Name& Phone# SEE PERMfTSPOKADDITIONAL
Fee Simple Title Holder Name and Address RP0jjjRE;MEArFS
Bonding Company Name and Address
Mortgage Lender Name and Address REVIEWED By. DATE. 4—4—(7
4pplication is hereby made to obtain a permit to do the work and installations as in, e- on has commencedprior to the
issuance oica permit and that all work will be performed to meet the standards ofall F laws re latin construction inthisjurisdiction. This permit becomes nidl
and void if work is not commenced within six(6)months, or if construction or work is sus nded or aba�donedjbr a period of sixP6)months at any time after
work is commenced I understand that separate permits must be securedfor Electric Work,Plumbing,Signs, Wells, POWs, urnaces, Boileis, Heiziers,
Tanks and Air Conifidoners,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.
I hereby certify that I have read and examined this qpplication and know the same to be true and correct. All provisions oflaws and ordinances governing this
ope p�work ivill be compli d whether specified herein or not. The granting of a permit does not presume to give authority to violate or canc�l the
ral
provisions ofa?iy olherjede��e, or local aw regulating construction or the peFformance of construction.
Signature of Own�eer Signature of Contractor
Print Name Print Name
.......................................................................................................................................
Swo a d sub efore me Sworn to and subscribed before me
thai 4"R A . 20 is Day of 20
a
G HAM
957760
��tRLFY L.GRAHAM
s—ncirw v nn Q�7760
lic R 1 0
N Ublic 4
�IVIRES�Feb,Liary 14,2014
U t....
T ' ttypuntary Public
r der_ rs
q,,nfialThru Notaty Pubk undervda
Revised 0 1.26.10
19z12 rc)rs/Aj fiJ3
S TOP WORK
CITY OF ATLANTIC BEACH
BUILDING AND ZONING DEPARTMENT
NOTICE FILE COPY
This building has been inspected and:
0- General Construction F-1 Mechanical
F-1 Concrete and Masonry F-1 Electrical
F� Plumbing Fj Gas Piping
IS NOT ACCEPTED
CORRECT AS NOTED BELOW, BEFORE ANY FURTHER WORK
3h4,S 242 y rf\ "I'
AVI-1 kr C� Qo r-,-in o r- rn 0 11-0- T4,,V el
DO NOT REMOVE TMS NOTICE
Inspector: th a� Date:
Failure to respond toVhis Notice within 10 days will result in this violation being forwarded
to the
CODE ENFORCEMENT BOARD.
The posting of this Placard by its contents shall servc as dUe notice.
I
CITY OF ATLANTIC BEACH
OWNER / BMDER AFFID
AVIT
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 ENEMPTION 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 ORHAPROVE 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 WITI-EN ONE YEAR
AFTER TBE 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 C TRACTOR. 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 HAV
LICENSES REQUIRED BY STATE LAW AND By C0jjNTy OR MUNICIPAL LICENSIN
ORDINANCES.
1j. 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 AN
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY-UNDER FLORIDA S IATUTE 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.
r-,% I. 4--l. 9 ca_-3,54-
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ADD SS PHONE NUMBER
71,
P T ME
GNATURE DATE
Before m9th6?S__L_day 01 2,��n the county of
Duval,State of Florida,1..Personally ap. himself herself and affirms that
all statements and declarations are true and accurate
,Z;�
n' FILE COPY
Notary Public at Large,State of Cou ty of
P ME
GNATUR
.for�
0 P rally Known
�4doced Identffinraflan-
n SHIRLEY L.GRAHAM
MY COMMISSION�DO 957760
*7 EXPIRES:February 14,2014
Notary Si- ature: Bondod Thru Notary Public Underwriters
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M A P 0 F
LOT 8, FRANCIS COVE THREE, AS RECORDED IN PLAT BOOK 56,
PAGES 26 AND 26A OF THE CURRENT PUBLIC RECORDS OF
DUVAL COUNTY, FLORIDA.
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City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Btjdkfing Depaftw.)
800 Seminole Road
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-deptQcoab.us Date routed:
Cky vmb-cge- htfp:/A~eoab.u*
APPLICATION REVIEW AND TRACKING FORM
Property Address: IfY7 lo_z_� vl-,;v Qepaiftent review required Yes lWo
Applicant: &)II11ble lannin &
ST?WmienLi-t�,r'
Mmino"or
Project: I-L I I hfin wfn%
es
tiliti!!�:�
4Pubfic Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
I of PerTnit 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: Ej;�P_pr_oved. MDenied.
(Circle one.) Comments:
C D
PLANNING&ZONING Reviewed by: Date:6-6-1-z--
4
TREE ADMIN. Second Review: 04proved as revised. [-]Deni
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. [-]Denied.
Comments:
Reviewed by: Date:
Revised 07127110
CITY OF ATLANTIC BEACH
(OWNER / BUMDER AFFMAVIT
1. 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 EYEMPTION 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 FAM[ILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A CONBffiRCIAL 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 CONIPLETE, THE LAW WELL PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMpnON. YOU MAY NOT
HIRE AN UNLICENSED PERSON AS YOUZ CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILJTY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAV
LICENSES REOUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSIN
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.
111. 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 9
c-r, 6LI-) f
ADD59SS 21
PHONE NUMBER
P T ME
Z
GNATURE UAlt
B efor. t 1.
efore me this day of 2p in the county of
Duval,State of Florida,has pers;nall�apl5eared herin by himself herself and affirms that
.11 statements and declarations are true and accurate.
Notary Public at Large,State of county of
0 Personally Known
[VPmduced Identincation
N,
SHIRLEY L.GRAHAM
DO 957760
My COMMISSION 4
EXPIRES:February 14,2014
Bonded Trru Notary Public Underwriters
Notary Slx,�vr-
F:/BLDG/0%�er-BuilderAffadavi�REI,9SED:4/16/2009
C4 of Atlantic Beach —D
Building Department JV�F APPLICATION NUMBER
/40k
800 Seminole Road (rO be assi9n8d by the Building Depafterg.)
Atlantic Beach MAY 3 0 201 1
Florida 32233-5445
Phone(904)247-W26 - Fax(904)247-359� 5
-mail: building-dept@coab.us
E
I ,--.*/Jk Date routed:
CKY mb-eka- hft-1A~a*ab-us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /f/7 rtment reviewrequired Yes No
V
,,Planr!ing&ZonirV
Applicant: �,vj 'A"i,
TrWAd--
�ministrator
ee
Project: 1 0*
-P ic
P icUtili
_ub 1c ties'
% e,
—Util
P Pu�ic Saf
ublic
Other Agency Review or Permit Required Review or Receipt
--- I of Permit Ve By
Florida DePt.Of Environmental Protecfion
Florida Dept of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Toba=
Other
APPLICATION STATUS
Reviewing Department First Review: �A'pproved. [:]Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN. Second Review: E]Approved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F]Approved as revised. [—]Denied.
Comments:
Reviewed by: Date:
Revised 07/27110
C4 of Atlantic Beach
[:APPLICATION NUMBER
Building Department be 7� :C
8W Seminole Road (To be assigned by the Building D"myiert.)
> - -z")
Atlantic Beach, Florida 32233-5445 /-'a
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date route]d: '
CitY Ymb-cita.- ft.-/AwAu.ao*b.ua
APPLICATION REVIEW AN D TRACKING FORM
Property Address: 4�/
v7 rtment review required Yes No]
Applicant: lannin
Project: rninis�"Wr
,u lic tilifiei-k
Public --fety
Fire Services
...... A�2
Review or Receipt
Other Agency Review or Permit Required of Permit Verified y Date
[Florida Dept.of Environmental Protection --
Florida Dept of Transportation L
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: 03 rpproved. F_]Denied.
(Circle one.) Comments: W� O&a2� 150-5q�+j 110OLK
BUILDING spmaks, -&5,1 r~ , 6
LANNING&ZONI Reviewed by: Date:
TREE ADMIN. Second Review: EJApproved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. []Denied.
Comments:
Reviewed,by: Date:
Revised 07127110
City of Atlantic Beach
Building Department E'IVF--,D APPLICATION NUMBER
201 T
8W Seminole Road F: MAY 30 2012 (rO be aSS018d by the Btdkgng DepartmM.)
Atlantic Beach, Florida 32233-5445
Rhone(904)247-5826 - Fax(904)24
E-mail: building-dept@coab.us Wcm
T-7--l— Date routed:
City mb-aita: hft.-/AwAv.eoab.u*
APPLICATION REVIEW AN D TRACKING FORM
Property Address: L":5- V7 nt review uIred No
Applicant: fanning&Zonit4
Tifft-Adminisbvior
Project: am,0*0-11
.publig,Utilities
Public Safety
Fire Services
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
r
ta
Pe
'Prff
0 n
tec
R
�'o 7ulmd
ion
t s
Army Corps of Engineers I en Di trict
Division of Hotels and Restaurants
s To acco
IM
Division of Alcoholic Beverages and Tobacco 77- 1 1
Other.
APPLICATION STATUS
Reviewing Department First Review: pproved. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN.
Second Review: E]Approved as revised. DDenied.
P RK Comments:
064
C UTILIT
L C UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SER%ACES Third Review: E]Approved as revised. E]Denied.
Comments:
Reviewed by: Date:
RevWd 07/27110