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345 1st St (vault) \Js )) �S, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 ri r 19 INSPECTION EMAIL REQUEST: Building-dept(a,coab.us Application Number . . . . . 07-00001353 Date 9/28/07 Property Address . . . . . . 345 1ST ST Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ----------------------------- ------------------------------ ----------------- Application desc rewire house 200 amps ------------ ---------------------------------------------------------------- Owner Contractor ------------------------ ---------------- -- ------ ARENS, MARK BROOKS & LIMBAUGH ELECTRIC CO 345 1ST ST Q/A BROOKS, CHRISTY ATLANTIC BEACH FL 32233 42 WEST 8TH ST. (904) 246-5570 ATLANTIC BEACH FL 32233 (904) 241-9051 ---------------- ----- ------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/26/08 -- -------------- ----- ------------------------------------------------- ------ Fee summary Charged Paid Credited Due ----------------- ---------- ---- ------ ---------- --------- - Permit Fee Total 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 70 . 00 70 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH n ELECTRICAL, PERMIT APPLICATION Date- Property Address: � IS� St r� , Owner: Mari( Telephone Contractor: !/ � � - Telephone tow!qo s t Contractor Address: L 12 \ ��h �t Fax A: Contractor Si attu•e• In consideration of Permit given or doing the work In the above accordance with the p attached Inns and specificxtio �vh tro a statement, we hereby agree to perform said work in ordinance and standards of ood ractice listed therein. pan heroof and in accordance with the City of Atlantic Beach Building: Building O New rn'O' ❑ hailer Service: ❑ Residence other �+cziW is C�OId ❑ Commercial p S�' ❑ New being done on�p�� O Re-wire O Addition � ❑ Increase Or site,ust the building Sq.Ft ❑ Repair Permit number. Conductor Size: �•;��7_ 3 AMPS: COPPER ALUMINUM Switch or Breaker AMPS Existing Service PH W VOLT W,,Y Size PH Meter j �y , RACE VOLT�J WAY S L� Number Feeders: N0. SIZE NO SIZE Lighting Outlets NO SIZE CONCEALED OPEN Receptacles CONCEALED OPEN Switches incandescent Fluorescent & M.V. Fixed 0.100 AMn OVERAhances BE Air H.P.RATINGTRANSFER. Conditionin COMP. MOTOR H.P.RATING CEILING OTHER MOTORS AMpS KW-HEAT HEAT Motors VOLTAGE PH NO. OVER 1 H.P. PHS Transformers NO. KVA No-Neon_Traasf NO. KVA Ea S' Miscellaneous / 800 Seminole Road.Atlantic Beach,Florida 32233-5445 Phone: (944)247-5800. Fax: (9o4)247-5845. 6ttp //www ci atlantic beach tl us Revised 1/04 CITY OF ATLANTIC BEACH ~V SI 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 jty}r INSPECTION EMAIL REQUEST: Building-dept(a�coab.us Application Number . . . . . 07-00000320 Date 9/18/07 Property Address . . . . . . 345 1ST ST Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 50000 ---------------------------------------------------------------------------- Application desc interior remodel/add patio and covered porch ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ARENS, MARK OWNER 345 1ST ST ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 246-5570 --------------------- Structure Information 000 000 ---------------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE X ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Sub Contractor . . STEEG PLUMBING CO. , INC. Permit Fee . . . . 126 . 00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/16/08 -------------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS. 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE. *EMAIL INSPECTION REQUESTS TO: BUILDING-DEPT@COAB.US *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 126 . 00 126 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 126 . 00 126 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES: • CITY OF ATLANTIC BEACH [t� PLUMBING PERMIT APPLICATION Date: d Property Address: J�i' / Owner: ,1'I/dcy�S Telephone#: Contractor: _t�'ftc4' M4 (',0 t Telephone r Contractor Address: f�Q/ �.�Ir 'S f Fax#: Contractor Signature: In consideration of permit given for doing work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: If other construction is being done on this building or site, ❑ New list the building permit number: ❑ Re-Pipe Number of Fixtures: Bath Tubs Showers Closets Shower Pans Dishwashers Sinks Disposals Urinals Floor Drains �_ Washing Machine --j Lavatory Water Sewer T Water Heaters Sprinkler System Other *See attached sheet see For Backflow and Irrigation procedures Fees Permit Issuing Fee: $35.00 Total Fixtures: X$7.00 + $35.00= 800 Seminole Road a Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800 . Fax: (904) 247-5845• http://Www.cl.atiantic-beach.fl.us Revised 9/06 CITY OF ATLANTIC BEACH :r g1 } 800 SEMINOLE ROAD j ,k ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 i ,JJ3I>c ? INSPECTION EMAIL REQUEST: � Buildingdept@coab.us Application Number . . . . . 07-00001315 Date 9/24/07 Property Address . . . . . . 345 1ST ST Application type description MECHANICAL ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------------ ------------------------- ------ ------- -------------- - ----------- Application desc 1 hp 1 ahu ------------------------------------------------------ ------- ------- -- ------ Owner Contractor ------------------------ ------------------------ ARENS, MARK DONOVAN HEATING & AIR 345 1ST ST 315 SIXTH AVENUE SOUTH ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 246-5570 (904) 241-3785 ----------------- ----------------- ------ ------ ------ ---------- - ------------- Permit . . . . . . MECHANICAL PERMIT Additional desc . . Permit Fee . . . . 87 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/22/08 --- ------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ------- --- Permit Fee Total 87 . 00 87 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 87 . 00 87 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. F7Lf�i. CITY OF ATLANTIC BEACH 7_ to ` O■ "' 2�a'��''•� 800 SEMINOLE ROAD,ATLANTIC BEACH,FL 32233 it OFFICE:(9G4)247-5826 0 FAX NO.:(904)247-5845 BUILDING-DEPT@COAB.US �P MECHANICAL PERMIT APPLICATION DUVAL COUNTY 1.JOB ADDRESS: 12.IS THIS A SUB PERMIT: 13.DATE 3 YT / S 1 -r ❑NO Atlantic Beach, FL 32233 ❑YES PERMIT#: PROPERTY OWNER: s NAME �! q 5.ADDRESS IF DIFFERENT FROM JOB ADDRESS 6 PHONE. MECHANICAL CONTRACTOR: 7.NAME OF COMPANY: 8.ADDRESS.: 15- co �e � � s- 9.STATE OF FLORIDA LICENSE NO: 2/ 10.CELL PHONE: 11.FAX NO.: C a(_o5c( 2 DqS - -1 ) s q 1;)-f I -37 VS 12.EMAIL ADDRESS: 13.OFFICE PHONE: 14. Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6) months,or if construction or work is suspended or abandoned for a period of six(6)months at any time after work is commenced. CONTRACTORS SIGNATURE:: 15.CLASS OF WORK: 16.BUILDING: 17.SER 18.CURRENT CODE: ❑ NEW INSTALLATION ❑ NEW ARESIDENTIAL -['06 FLORIDA BUILDING CODE- ,,,VREPLACEMENT OF EXISTING SYSTEM EXISTING ❑COMMERCIAL MECHANICAL ❑ALTERATION/ADDITION TO EXIST SYSTEM ❑REPAIR ❑OTHER MECHANICAL EQUIPMENT TO BE INSTALLED: 19. HEAT: ❑ SPACE ❑ RECESSED kCENTRAL ❑ FLOOR BURNERS: 20.AIR CONDITIONING: ❑ ROOM CENTRAL 21. DUCT SYSTEM: MATERIAL: T-ie-f, Lkc 1 THICKNESS:_JL(, MAX CAPACITY: fJG cfm 22. REFRIGERATION: MAX CAPACITY: Cfm 23.COOLING TOWER: CAPACITY: Spm 24. FIRE SPRINKLER: NUMBER OF HEADS: 25. LIFT SYSTEM: ELEVATOR: MANLIFT: ESCALATOR: AUTOLIFT: 26.COMMERCIAL HOOD NUMBER: 27. FIREPLACE: PREFABRICATED: MASONRY: 28. IRRIGATION: ❑ PUMP ❑WELL ❑ PIPING 29. GAS PIPING: #OF OUTLETS: ❑GAS AHU: ❑GAS WATER HEATER: 30.OTHER-SPECIFY: SOLAR HEATING, BOILERS,UNFIRED PRESSURE VESSEL,HEAT EXCHANGER OR COIL IN DUCTS ETC. IVALUE FOR OTHER ITEMS: 31.COOLING EQUIPMENT: AIR CONDITIONING REFRIGERATION EQUIPMENT CONDENSORS ETC. NUMBER APPROVING OF UNITS DESCRIPTION MODEL#_ MANUFACTURER TONS AGENCY 2c,f LMP Z-3t4e- u C 32.HEATING EQUIPMENT: FURNACES BOILERS FIREPLACES AIR HANDLERS ETC. NUMBER APPROVING OF UNITS DESCRIPTION MODEL# MANUFACTURER BTU AGENCY 33.TANKS: TYPE LI UI AFYROVING NUMBER GALLONS CONTAINED MANUFACTURER SERIAL# AGENCY COAB FORM BLDG03:REVISED:8/13/2007 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ±) ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 4Jiil� INSPECTION EMAIL REQUEST: Building-dept2coab.us Application Number . . . . . 07-00000320 Date 7/03/07 Property Address . . . . . . 345 1ST ST Application type description RESIDENTIAL ADDITION/ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 50000 ----------------------------------------------------------------- Application desc interior remodel/add patio and covered porch ----------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ARENS, MARK OWNER 345 1ST ST ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 246-5570 -------------------------- Structure Information 000 000 ----------------- Construction Type . . . . . TYPE 5-A Occupancy Type . . . . . . RESIDENTIAL 2 Flood Zone . . . . . . . . ZONE X ------------------------------------------------------------ Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 280 . 00 Plan Check Fee 140 . 00 Issue Date . . . . Valuation . . . . 50000 Expiration Date . . 12/30/07 ----------------------------------------------------------- Special Notes and Comments *2004 FLROIDA BUILDING CODE W/ 105- 106 SUPPLEMENTS . 2004 FLORIDA BUILDING CODE - RESIDENTIAL. 2005 NATIONAL ELECTRICAL CODE . *EMAIL INSPECTION REQUESTS TO: BUILDING-DEPT@COAB.US *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. --------------------------------------------------------- Fee summary Charged Paid Credited Due ---------- ---------- ---------- ---------- ---------- Permit Fee Total 280 . 00 280 . 00 . 00 . 00 Plan Check Total 140 . 00 140 . 00 . 00 . 00 Grand Total 420 . 00 420 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BP250U01 CITY OF ATLANTIC BEACH 7/03/07 Application Tracking Step Selection by Revision 10: 08 : 40 Application number . . . . : 07 00000320 Address . . . . . . . . . . . 345 1ST ST RE number . . . . . . . . . . 169766-0000- - Application type . . . . . : RESIDENTIAL ADDITION/ALTERATION NCR OLD ACCOUNT NUMBERS . . : AB09046 Tenant name, number . . . . . Type options, press Enter. 2=Change 4=Delete 5=View 6=Fast log 8=Action log maintenance 9=In/out maint Path ---- Rey Dates --- - Action Summary - Opt Agency description Rev Step Req In Est Cmpl Last Type By _ BUILDING DEPT. A 01 Y 07/03/07 03/23/07 07/03/07 AP DH _ PLANNING & ZONING A 01 Y 03/22/07 03/23/07 03/22/07 AP SD PUBLIC WORKS A 01 N 03/21/07 03/23/07 06/29/07 AP LS Bottom F3=Exit F5=Land inquiry F6=Add F7=Revisions F8=Misc info inquiry F10=View 3 F11=Sort by agency F12=Cancel F14 Action log inq F24 More keys f!.'blp CITY OF ATLANTIC BEACH PLAN REVIEW SHEET Route Building Department Public Works&Public Utilities Departments 800 Seminole Road 1200 Sandpiper Lane Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 D. Kaluzniak (904)247-5800 (904)247-5834 Public Safety (904)247-5845 Fax (904)247-5843 Fax Jax Fire dept. PLAN REVIEW COMMENTS Permit Application# Q 1• e o3 2 0 Property Address J�� 1.51- S- w T Applicant: 4 Vi-n Project: gZ_ CP09V-*rrS f�nD evz2ED Peck This permit application has been: ❑ Approved as noted by the Department. Final application approval must come from the Building Department. Reviewed and the following items need attention: 45i1S7ie-cry M/v DJr70ics' Co 4WCir IN 4.1C,,ry G 7-a S/ o S� i�7idG C4zCS W 40�9 r fe 7o f 4Aft-6 I.v / Please re-submit 2-copies of all revisions. Please re-submit your revisions to the Department requesting them. Building Dept, Public Works and Utility information at top of page, failure to notify the correct department may delay your permit from bein issued. Reviewed By: Date: Z D Date Contractor Notified: 2, 2-3. ,o -7 BUILDING PERMIT APPLICATION ISI CITY OF ATLANTIC BEACH �pD J;ior 800 Seminole Road,Atlantic Beach FL 32233 Office: (904)247-5826 • Fax: (904)247-5845 Address: 3VCY- /IS,/- SfiQ p f Permit Number: Legal Description Valuation of Work(Replacement Cost) $ no ■ Class of Work(Circle one): New Addition Alteration Repair -Move ■ Use of existing/proposed structures) (Circle one): Commercial en is esi ■ If an existing structure, is a fire sprinkler system installed? (Circle one): es o ■ Is approval of homeowner's association or other private entity required? (Circle one): Ye—s o Describe in detail the type of work to be performed: 1--nTex1*e4 eEma alB vt�ejQ ;Doee H Property Owner Information Address: 1-i?e- S'` City State/2 Zip ?z3 Phone Contractor Information: Name of Company: t Qualifying Agent: Address: City State Zip Office Phone Job Site/Contact Number State Certification/Registration# Office Fax# Architect Name & Phone# Engineer's Name& Phone# 4pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the ssuance of a permit and that all work will be performed to meet the standards o/'all laws regulating construction in this1�urisdiction. This permit becomes null one void if work �s not commenced within six(6)months,or if construction or work is suspended or abandoned for a period of six(6)months at any time after work is ommeneed. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks andAh Conditioners,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. there certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type �f work tivill be complied with whether specified herein or not. The granting of a ermit does not presume to give authority to violate or cancel the provisions o any ether federal,state, or local law regulating construction or the performance ojconstruction. Signature of Property Owner: Z?Yi52� /--21. Signature of Contractor: Swoy�yQ aid sub eSworn to and subscribed before me his Day of '00 -7 this Day of Votary Public: Notary Public: Nowy Pubk-Sto of F1016 • Ay Commission Expires Feb 14,2010 Commission N DO 518533 OF fl Bonded By National Notary Assn. 14 2 ffvce 72 3�3 - b DO NOT WRITE BELOW THIS LINE: OFFICE USE ONLY Special Information for Owner/Builders 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 THE LAW. The exemption allows you as the owner of your property,to act as your own contractor even through you do not have a license. You must s>ervise the construction yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial building at a cost of$25,000 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. Ifyou sell or lease more than one building you have built yourself within one(1)year after the construction is complete,the law will presume that you built it for sale or lease,which is a violation of this exemption. You may not hire an un-licensed person as your contractor. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that the people employed by you have licenses required by state law and b county ounty or municipal licensing ordinances. In addition, the owner must supervise construction and becomes liable and responsible for the employees he/she hires. This responsibility includes,but may not be limited to: 1. Workers Compensation, for workers injured on the job. 2. Social Security Tax must be deducted from employee's wages and matched with owner's funds. 3. Federal Withholding. Since owners must be liable for injuries to workers they hire,the Building Division suggests Workers Compensation Insurance be purchased unless the homeowners insurance policy clearly protects the owner. Owners hiring workers become employers and should also observe IRS withholding tax Form 1099 requirements on the workers they employ on their improvement work. Un-licensed contractors cannot be employed under any circumstances. Owners are subject to a$5,000 penalty under Florida Statute#455.288(1)instigated via Building Division citations. An Occupational License is not adequate. The owner should physically see the county Certificate of Competency or the Florida Contractors Certificate to ascertain a person is a licensed contractor. Telephone the building Division (:247-5826 yf in doubt. I hereby acknowledge that I have read and understand all the above on this c:7�O Day of,i-�'� -Ch Owner Builder Signature Address Print Name Telephone Number STATE OF FLORIDA: COUNTY OF DUVAL Before me personally appeared to me well known to be the individual and owner builder described in and who executed this instrument and severally acknowledged the execution thereof to be his own free act and deed as such owner builder hereunto authorized. WITNESS my hand and official seal thi�day of�, tl n B ach. o an State aforesaid. NOT P S TE RM SW1Ftl.EY L.GRAHAM Print Name: Notary Pubk,-state of Florida €Mr Commission Expires Feb 14,2010 MY COMMISSION EXPIRES: Commission#DD 518533 ❑personally Known Bonded By Natrona Nota y Assn ❑Identification: NOTICE OF COMMENCEMENT State of /---/o r,`ad a Tax Folio No. County of / To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: Address of property being improved: �'/S /S¢ Sf- ��/grf�C ��Q eh -3:20,52 - General description of improvements: ��r�r✓d�'C iia., /� �� r'�� lam/ Owner: ./�nq/� ` ,Q� Z,21e .4,ivr — Address: Owner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): Name: Contractor: Address: TelephoneNo.: Fax No: Surety(if any) Address: Amount of Bond S Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: 0CL Phone No:- �,/., —S 5 70 Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: Expiration date of Notice of Commencement (the expiration date is one (1)year from g�d � unless a different date is specified): MISSIO. BY EXPIRES: N t DD 314806 HIl TS SPACE FOR RECORDER'S USE ONLY OWNER B� � drnNNota Publc 2�8 ry Public(/q� Signed: Arwtf 5 Doc#2007092717,OR BK 13876 Page 145, Before me this day of p the Cou o arm l,S e Number Pages: 1 Of Florida,has personally Filed&Recorded 03;20/2007 st 01:49 PM, No Public at Large tate of Flori County of Duval JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY o commission Public a expir s: RECORDING$10.00 r Personally Known: Produced Identification: Special Information for Owner/Builders DISCLOSURE STATER "' 1030,Florida Statutes.- STATE tatutes:STATE LAW RF `'BE DONE BY LICENSED CONTRACTORS. You HAv, i(// '? AN EXEMPTION TO THE LAW. The exemption alio 1� -i contractor even through you do not have a license. You m• A or improve a one-family or two-family residence or a far C -tercial building at a cost of$25,000 or less. . The building miG I lilt for sale or lease. Ifyou sell or lease more than one build/ D l ;onstruction is complete,the law will presume that you built - in. You may not hire an un-licensed person as your contras Ming codes and zoning regulations. It is your responsibil licenses required by state Iaw and by county or municipal In addition, the owner _ ible and responsible for the employees he/she hires. This responsibility includes,but L 1. Workers Compensau- l 3� i on the job. 2. Social Security Tax must J 1 employee's wages and matched with owner's funds. 3. Federal Withholding. Since owners must be liable for injuries to workers they hire,the Building Division suggests Workers Compensation Insurance be purchased unless the homeowners insurance policy clearly protects the owner. Owners hiring workers become employers and should also observe IRS withholding tax Form 1099 requirements on the workers they employ on their improvement work. Un-licensed contractors cannot be employed under any circumstances. Owners are subject to a$5,000 penalty under Florida Statute#455.288(1)instigated via Building Division citations. An Occupational License is not adequate. The owner should physically see the county Certificate of Competency or the Florida Contractors Certificate to ascertain a person is a licensed contractor. Telephone the building Division (247-5826}f in doubt. I hereby acknowledge that I have read and understand all the above on this c7;�Q Day of, SCh IX Owner Builder Signature Address Print Name Telephone Number STATE OF FLORIDA: COUNTY OF DIIVAL Before me personally appeared to me well known to be the individual and owner builder described in and who executed this instrument and severally acknowledged the execution thereof to be his own free act and deed as such owner builder hereunto authorized. WI'T'NESS my hand and official seal thi�day of� aX�dt tl n c B ach- Co an State aforesaid. NOT P S TE10 IR+Y+GRAHAM Print Name: lnpY P�je i� =o �� Notary Public,-State of Florida ,! _My Commission Expires Feb 14,2010 MY COMMISSIONEXPIRES: .f f " Commission #DD 5.18533 . o Personally Known Bonded By. National Notary Assn' ❑Identification: BUILDING PERMIT APPLICATION is1 CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 Office: (904)247-5826 • Fax: (904)247-5845 Address: 1_:?z/S_ /S-/- ls�"C f Permit Number: Legal Description Valuation of Work(Replacement Cost) $ DDD . ■ Class of Work(Circle one): New Addition Alteration Repair0eito ve ■ Use of existing/proposed structures) Circle one): Commercial en to■ If an existing structure, is a fire sprml�er system installed? (Circle one): o ■ Is approval of homeowner's association or other private entity required?(Circle one): es o Describe in detail the type of work to be performed: ��T�� �,e ,��a d�L ,4 D d ?,V'TiO ��A✓�GS� Property Owner Information Dame: r Address: City A-; State tZ Zip 3 Phone Contractor Information: Name of Company: Qualifying Agent: Address: City State Zip Office Phone Job Site/Contact Number State-.Certification/Registration# Office Fax# =Architect Name &Phone# Engineer's Name &Phone# 4pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has conznzenced prior to the ssuance of a permit and that all work will be performed to meet the standards o/all laws regulating construction in tl2is1'urisdiction, This permit becomes null ana void if work zs not commenced within six(6)months, or if construction or wort ds suspended or abandoned for a�eriod ofsix(6)months at any time after work is ommenced. I understand that separate permits must be secured forElectncal Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks andAii Conditioners,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. There 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 'f workwill e complied with whether specified herein or not. The granting of a ernzit does not presume to give authority to violate or cancel the provisions o arty ,ther federal,state, or local law regulating construction or the performance of�onstruction. Signature of Property Owner: z2�Y�-ti�� Signature of Contractor: Swoy�yp amid sub je k! �oo Sworn to and subscribed before me his Day of K-(:�11� this Day of Votary Public: Notary Public: SHIKLEY t.OF 1 Notary Public-State CA Fbrida _my Commission Expires Feb 14,1010 Commission#DO 518533 OF FL�P�` Bonded By National Notary As ,,,,, sn. 72 343 - 6 DO NOT WRITE BELOW THIS LINE: OFFICE USE ONLY �S rL`1:rJ J� CITY OF ATLANTIC BEACH ,, yr PLAN REVIEW SHEET Routed o: Building Department Public Works&Public Utilities Departments 800 Seminole Road 1200 Sandpiper Lane Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 D. Kaluzniak (904)247-5800 (904)247-5834 Public Safety (904)247-5845 Fax (904)247-5843 Fax Jax Fire dept. =BY: PLAN REVIEW COMMENTS Permit Application # 47- e032-0 Property Address ��� �� S i o T Applicant: Jwn. - Q alm Project: f 1- 460 PWr20 (Al✓�r� /1VP eD ,e2C/L This permit application has been: ❑ Approved as noted by the b IG 2Qh!_S Department. Final application approval must come from the Building Department. 71 Reviewed and the following items need attention: Provide survey of lot with existing improvements. Provide erosion and sediment control plans with details and maintenance schedule. Provide impervious surface area calculations . If adding >5o impervious, on-site storage of excess runoff is required. Please re-submit 2-copies of all revisions. Please re-submit your revisions to the Department requesting them. Building Dept, Public Works and Utility information at top of page, failure to notify the correct department may delay your permit from being issued. Reviewed By: D Date: Date Contractor Notified: v! �J t CITY OF ATLANTIC BEACH SHEET Route _ PLAN REVIEW J s� .. <= Building Department Public Works&Public Utilities Departments 800 Seminole Road 1200 Sandpiper Lane Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 D. Kaluzniak (904)247-5800 (904)247-5834 Public Safety (904)247-5845 Fax (904)247-5843 Fax RECEIVED Jax Fire dept. PLAN REVIEW COMMENTS 1% A ' 2 1 2007 Permit Application # 41- 403 2 D By: Property Address r s ei� / Applicant: Vit-n Q W n � ,;, Protect: ��7�,e;D,� .�C� �� �6 D TAno� CSD Y_04EQeC h. This permit application has been: Approved as noted by the b IG _Department. from the Building Department. Final application approval must come 67 Reviewed and the following items need attention: - rT� �r- j JUNI - ; Provide survey of lot with existing improvements. Provide erosion and sediment control plans with details and maintenance schedule. Provide impervious surface area calculations. If adding e of excess runoff is >5% impervious, on-site storag required. A g R SE D Please re-submit 2-copies of all revisions. Please re-submit your revisions to the Department re uestin them. Building Dept, Public Works and Utility information at top of page, failure to notify the correct department may delay your permit from being issued. Date: Reviewed By: Date Contractor Notified: K BP250UO2 CITY OF ATLANTIC BEACH 4/09/07 Application Tracking Individual Step Review 13: 48 : 48 Application number . . . . : 07 00000320 Application type . . . . . : RESIDENTIAL ADD/RENOVATE/ALTER Revision number . . . . . . . Agency/path/step/seq . . . : PUBLIC WORKS A 01 00 Date submitted, resulted . . 32107 Approval code . . . . . . . . Reviewed by . . . . . . . . . Revised est cpl date . . . . 32307 Copies of plans . . . . . . . Seq Comments Prt Date 1 . 00 Provide survey of lot with existing improvements . 32207 2 . 00 Provide erosion and sediment control plans with details and 32207 maintenance schedule. 3 . 00 Provide impervious surface area calculations . If adding 32207 >5o impervious, on-site storage of excess runoff is required. More. . . F3=Exit F12=Cancel V(J CITY OF ATLANTIC BEACH PLAN REVIEW SHEET Route o: Building Department Public Works&Public Utilities Departments 800 Seminole Road 1200 Sandpiper Lane Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 D. Kaluzniak (904)247-5800 (904)247-5834 Public Safety (904)247-5845 Fax (904)247-5843 Fax Jax Fire dept. PLAN REVIEW COMMENTS Permit Application # Q 7 e 03 Z D Property Address J�4�' Applicant: 14 Vi 7'I - Q al7l Project: El- .�46 D PATIO (?,#✓6rs lfnD e0✓DEQ PP-C/. This permit ication has been: 0 Approved as noted by th Department. Final application approval must coV from the Building Department. `Reviewed and the following items need attention: 22 .0 -7 - Please re-submit 2-copies of all revisions. Please re-submit your revisions to the Department requesting them. Building Dept, Public Works and Utility information at top of page, failure to notify the correct department may delay your permit from being issute:ed. Reviewed By: /�`—` Da - Date Contractor Notified: L� YoftkA,# 3. 21' 0-7/r0/ M a 3/z Z BUILDING PERMIT APPLICATION S11 xN s CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 Office: (904)247-5826 • Fax: (904)247-5845 Address: 3_/XY_ 1574 Permit Number: Legal Description Valuation of Work(Replacement Cost) $ no . ■ Class of Work(Circle one): New Addition Alteration Repair �esiiocVeen_ e ■ Use of existing/proposed structures) (Circle one): Commercial is ■ If an existing structure, is a fire sprinkler system installed? (Circle one): o ■ Is approval of homeowner's association or other private entity required? (Circle one): o Describe in detail the type of work to be performed: I-n 7_f e t p,e ,e lno dE L ,a D d ��r�0 `�q✓FLS Property Owner Information Dame: -4Ze/-. r7Address: City e,24 -/,.;c e4 State f=L Zip X 223 Phone �a2 z/-c;-2 y(o Contractor Information: Name of Company: Qualifying Agent: Address: City State Zip .Office Phone Job Site/Contact Number State=Certification/Registration# Office Fax# Architect Name&Phone# Engineer's Name &Phone# 4pplicati0 n is he made to obtain a ermit to do the work and installa'o' asts indicated. I certify that no work or nstallation has commencedprior to the ssuance of a permit and thatallworkwilbeperformed to meetthe standads o/all laws regulating construction in this 'urisdiction. Thpermit becomes null ana void ifwok isnotomenced within six(6)nsonths, or if construction or ork is suspended or abandoned for a perioofsix(ti)months at any time after work is :ommenced. I understand tlsat separate permits must be secured forElectncal Work,Plumbing,Signs,Wells,Pools,Furnaces,Boilers,Heaters,Tanks mtdAh Conditioners,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. 1 hereby 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 pe �f wor tivill e complied with whether specified herein or not. The granting of a ermit does not presume to gcve aa�thority to violate or cancel the provisions ony 9ther federal,state, or local law regulating construction or the performance of construction. Signature of Property Owner: -L � Signature of Contractor: Swo amid sub je kp _ r� Sworn to and subscribed before me hisp Day of KK((::��h o<d this Day of votary Public: Notary Public: OWLEY t.%vj7fm%Ann AM Notary Public•State of Florida :My Commission Expires Feb 14,2010 Commission#DO 518533 Bonded By National Notary Assn. 72 N-3--_6 DO NOT WRITE BELOW THIS LINE: OFFICE USE ONLY Special Information for Owner/BuRders DISCLOSURE STATEMENT for Section 489.1030=Florida Statutes: _ STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THE LAW. The exemption allows you as the owner of your property,to act as your own contractor even through you do not have a license. You must supervise the construction yourself. You may build or improve a one-family or two-family residence or a farm outbuilding. You may also build or improve a commercial building at a cost of$25,000 or less. The building must be for your own use and occupancy. It may not be built for sale or lease. Ifyou sell or lease more than one building you have built yourself within one(1)year after the construction is complete,the law will presume that you built it for sale or lease,which is a violation of this exemption. You may not hire an un-licensed person as your contractor. Your construction must be done according to building codes and zoning regulations. It is your responsibility to make sure that the people employed by-you have licenses required by state Iaw and by county or municipal licensing ordinances. In addition, the owner must supervise construction and becomes liable and responsible for the employees he./she hires. This responsibility includes,but may not be limited to: 1. Workers Compensation,for workers injured on the job. 2. Social Security Tax must be deducted from employee's wages and matched with owner's funds. 3. Federal Withholding. Since owners must be liable for injuries to workers they hire,the Building Division suggests Workers Compensation Insurance be purchased unless the homeowners insurance policy clearly protects the owner. Owners hiring workers become employers and should also observe IRS withholding tax Form 1099 requirements on the workers they employ on their improvement work. Un-licensed contractors cannot be employed under any circumstances. Owners are subject to a$5,000 penalty under Florida Statute#455.288(1)instigated via Building Division citations. An OcMational License is not adequate. The owner should physically see the county Certificate of Competency or the Florida Contractors Certificate to ascertain a person is a licensed contractor. Telephone the building Division (247_5826�f in doubt. I hereby acknowledge that I have read and understand all the above on this c;;�Q Day of, SCh Owner Builder Builder Signature Address -eff Pri tNam�e f� S Telephone Number STATE OF FLORIDA: COUNTY OF DUVAL Before me personally appeared to me well known to be the individual and owner builder described in and who executed this instrument and severally acknowledged the execution thereof to be his own free act and deed as such owner builder hereunto authorized. WITNESS my hand and official seal thi-az­day ojf X, tl n c B ach_ Co an State aforesaid- NOT P S TE SHIRLEY L.IRAHAM Print Name: 9 i jo ��;, Notary Public,-Stets of Florida My Commission Expires Feb 14,2010 MY COMMISSION EXPIRES: �T l F e Commission#DD 5.18533 ❑personally I{nOWn °`. Bonded By National Notar`v Assn ❑Identification: