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490 Main St 2012 siding CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00001543 Date 10/23/12 Property Address . . . . . . 490 MAIN ST Application type description SIDING PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2000 ---------------------------------------------------------------------------- Application desc REMOVE/REPLACE SIDING ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BRANDER ERIN M OWNER 490 MAIN ST ATLANTIC BEACH FL 322332562 --- Structure Information 000 000 SIDING ---------------------------------------------------------------------------- Permit . . . . . . SIDING PERMIT Additional desc . . SIDING REPLACEMENT Permit Fee . . . . 60 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 2000 Expiration Date . . 4/21/13 ---------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------------------------------------------------------- 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 . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 64 . 00 64 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. r CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT W CD °c 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CO T;F CTIOt- CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: FLAW. STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: loom �... TE LAW REQUIRES CONSTRUCTION TO BE DONE BY LIC RS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO XEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO A TAS CD YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU O SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A O - TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUIL "7 IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE B /y MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR L A ..� . IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE a*. AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU T IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MA NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR YOUR CONSTRUCTION ST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. 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. 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. I N ADDREPHONE NUMBER PRIN E O 0 [� DATE j S TURE 7— rr��'' W E A Before me this day of ! 20[�n the county of ~ a+ Duval,State of Florida,has personally appeared herin by,rnseff herself and affirms that � all statements and declarations are true and accurate. E Notary Public at Large,State of_ ,County of W ❑Personally Known w �uced Identificatii A SHIPLEY L.GRAFUUuI W {5 Nota nature: MY romIAiSSION;DD 95776]]4 U P4 Notary EXPiIiF.S:February 14,20 nFy Gpnded Thru Notary Public F:BLDG/Owner-Builder Affadavit;RE :4/16 9 '