346 5th St (vault) JOB ADDRESS TYPE WoRk.4
PROPERTYOWNFER TF-L :PHOAFE
CONMCTOR
M. EPHONE
PMUIZTNUWER' Z DATE
EVSPEMONS. FOonNG
SLAB
TH I W"
LEfm
N,4ff.jWG1S)MTAWG
FR,4AMVGICOVF-R UP �2-11 _-o
FEVAL BULLDEVG q-3-00
CER=C4TE OF OCCUPANCY 4-3-0
ELEC7WC4L PER&M
INSPEC77ONS ROUGH
FEVAL -3-0 0
MECHAATIC4L PERAmw
EVSPEC77ONS ROUGH
FEVAL
PLUAIBLVGPERAIM
Z —
J12VSPEC77ONS ROUGHATADER SLAB 445�-
TOPOUT 0L-l/-oo
WATERISE97ER
FEVAL
,3- O�LLl 4L, 12,1971,11-0 d,:ZSIZ1
NOTES.
w'
MAP SHOWING SURVEY uF
LOT 19 , BLOCK 6 , ATLANTIC BEACH AS RECORDED IN PLAT BOOK 51 PAGE 69 OF
CURRENT PLJBLTC RECORDS OF DUVAL COUNTY, FLORIDA .
AWkV
,cA1,:;' Ile Al A A-lov
v
Nil
/7
r
A 0
N
jr
I/jz I
7
HF-RFRY I-P7PTT9-V TWA-r Tuc- nnnn�,-,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FLORIDA 32233
INSPECTION PHONE LINE 247-5826
C
Application Number . . . . . 05-00029485 Date 1/06/05
Property Address . . . . . . 346 5TH ST
Tenant nbr, name . . . . . . REPL 5 EXTERIOR DOORS
Application description . . . RESIDENTIAL ADD/RENOVATE/ALTER
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 4000
Owner Contractor
------------------------ ------------------------
ARIAS' DONNA OWNER
346 5TH STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . BUILDING PERMIT
Additional desc . .
Permit Fee . . . . 50 . 00 Plan Check Fee 25 . 00
Issue Date . . . . Valuation . . . . 4000
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 50 . 00 50 . 00 . 00 . 00
Plan Check Total 25 . 00 25 . 00 . 00
Grand Total 75 . 00 75 . 00 . 00 . 00
. 00
BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED
UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LAW CAN
RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING LIEN
IMPROVEMENTS"ISSUED ACCORDING To APPROVED PLANS
WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
CLA1
BUILDING OFFI�
Cc:
CITY OF ATLANTIC BEACH D.Encd
BUILDING / ZONING DEPARTMENT
800 Seminole Road S. Doerr
U T-1 Atlantic Beach,Florida 32233
(904)247-5800
(904)247-5845 Fax
PLAN REVIEW COMMENTS
Permit Application # ep6- 7--14
Property Address.- 14
Applicant: —1 A,
AP
Project: T;�>EE-P>( )
This permit application has been:
Approved
Reviewed and the following items need attention:
Please re-submit your application when these items have been completed.
Reviewed By: WL Date: o
CITY OF ATLANTIC BEACH
BUILDING PERMIT APPLICATION
(Alterations &Additions)
jilt Date:
Job Address:
Owner of Property: 0 &1 oA
Address: Telephone: 50ef—Z'�F,*67
Legal Description: Block Number: Lot Number: Zoning District:
Contractor: State License Number:
Contractor Address: L"a-=> A
Telephone: Fax: '�POq—tl,-3�0 —S-3 �_t/_
Describe proposed use and work to be done: 9A��_ C _J )
1/ (57
Present use of land or building(s): Aez"�4-�a
Valuation of proposed construction: 000P
What are the dimensions of the added space: A2 0)1-A',_ feet x feet
Will the added area be heated and cooled? —Ad) A— New electrical or increase in service? 10-0
Add plumbing fixtures? A-)0 Add fireplace? *J — Add heating/air conditioning?_ yo b
Is approval of Homeowner's Association or other private entity required? If yes, please submit with this
application.
Will this project involve changes in elevation, site grade or any use of fill material, or the addition of 5% or more to
the original impervious area or the removal of any trees?
[�[NO. Applicant certifies that no change in site grade, impervious area or fill material will be used on this
project.
YES. See Step 2 below. Approval of the Public Works Department is required prior to issuance of a Building
Permit.
JaNO. Applicant certifies that no trees will be removed for this project.
YES. Removal of Trees will be required for this project TREE REMOVAL PERMIT IS REQUIRED. Tree
Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month.
Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate
Incomplete applications may result in delay in issuance of permit.
STEP 1. Verify zoning designation and proper setbacks for the proposed construction. If you are unsure of this information, please
contact the Planning and Zoning Department at 904-247-5826. In order to correctly verify zoning designation, please have
Property Appraiser's Real Estate Number available.
STEP 2. Contact the City of Atlantic Beach Department of Public Works to determine if a pre-construction or post-construction
topographical survey or grading plan is required. (If not required, written verification must be provided with this application.)
'Me Department of Public Works is located at: 1200 Sandpiper Lane,Atlantic Beach,FL 32233 Telephone:(904)247-5834
STEP 3. Submit Tree Removal Application if trees are to be removed or relocated.
STEP 4. Please submit Building Permit Application, Energy Code Forms, Notice of Commencement, Owner/Contractor Affidavit if
owner is contractor,and four(4)complete sets of construction plans to the Building Department,which is located at the Atlantic
Beach City Hall,800 Seminole Road,Atlantic Beach,FL 32233 Telephone:(904)247-5826
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atlantic-beach.fl.us
Page 2 Revised 8/04
In addition to construction and engineering detail,plans must contain the following information as appropriate for the type of work being
performed. Scale of drawings should be sufficient to depict all required information in a clear and legible manner.
I. Current survey showing the property boundary with bearings and distances and the legal description.
2. Location of all structures,temporary and permanent,including setbacks,building height,number of stories and square footage. Identify
any existing structures and uses.
3. If required by the Department of Public Works,a pre-construction topographical survey.
4. Any significant environmental features,including any jurisdictional wetlands,CCCL,natural water bodies.
5. Impervious Surface area calculations: include driveways, sidewalks, patios and other Impervious Surfaces. Swimming pools
may be excluded from total Impervious Surface.
6. Other information as may be appropriate for indiv* plicatio
ic
I hereby certify that all information pr i ed wi ap I ation* correc
Signature of owner: A Date:
I V
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the laws and
ordinances governing this type of work will be complied with,whether specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the
governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the
above information being true and corTect and that the plans and supporting data have been or shall be provided as required.
Signature of Contractor: Date:
Address and contact information of person to receive all correspondence regarding this application(please print).
Name:
Mailing Address:
Telephone: Fax: E-Mail:
AS TO OWNER:
Swom to and subscribed before me this day of 20G5.
State of Florida,County of Duval
Notary's Signature:
W.,FPA,�,6 JENNIFER SCHLUETER
W,
My C
MY COMMISSION#DD 121301
V
EXPIRES:May 27,2006 0 Personally known
B."de
Bonded Thru Notary Pubk Underwr4ers
NO K�l Produced identification
14 E*,
Type of identification producedFL,
AS TO CONTRACTOR: 0
Sworn to and subscribed before me this day of 20_.
State of Florida,County of Duval
Notary's Signature:
Personally known
Produced identification
Type of identification produced
800 Seminole Road -Atlantic Beach,Florida 32233-5445
Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ei.atiantic-beach.fl.us
Page 3 Revised 8/04
CITY OF ATLANTIC BEACH
OWNER/BUILDER AFFIDAVIT
Date: /s—/v
V\ 4�st-
Job Address: �('�,q
CHAPTER 489,FLORIDA STATUTES,PART I "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 EXEMPTION TO THAT LAW. THE EXEMPTTON 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 JS COMPLETE, THE LAW WELL PRESUME
THAT YOU BUILT rr 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 RESPONS113ELITY TO MAKE SURE THAT
PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL
LICENSING ORDINANCES.
ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL
OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A
BUILDING PERMIT` AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY
PHYSICALLY'DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE
UNDER"DIRECT SUPERVISION OF THE OWNER,WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN
PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS.
SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT
SUGGESTS-WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE
POLICY TO CLEARLY PROTECT THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND
SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS
THEY EMI;LOY ON THEIR IMPROVEMENT TRADES.
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.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THE DISC SURE STATEMENT AND THAT I
COMPLY WrM ALL THE REQUIREMENTS FOR THE ISSU. OF AN 0 R-BUILDER PERMIT.
JENNIFER SCHWETER
MY COMMISSION#DD 121301
EXPIRES:May 27,2006
�f,,PF Bonded Thru Notary Public Underwriters PROPERTY OWNER/BUILDER
—t*"
SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF
N()JARY PUBLW
MTCOMMISSION EXPIRES:
NOTE: PHRASES UNDERLINED ABOVE.
JAN. 5: 2005 7:49AM NO, 4962 P. 2
Equal Opportunity Employer
DEPARTMENT OF PUBLIC WORKS
Btiilding Inspection Division Inv I "j �71 c
E AC
July 10, 2002
JAN 0 5 2004 ON a
Randy Darsey, Manager
Builders First Source
5930 Orlando Street BY
Jacksonville, Florida 32208
Attention: Randy Darsey
ENTERGY DOOR5 BY PREMDOR/MASONITE INTE7NATIONAL CORP,
Subject: APPROVAL OF DOOR DOCUMENTATION FOR WIND LOAD COMPLIANCE
7he product documentation submitted by PREMDOR for ENTERGY ENTRY SYSTEMS to be
installed within the jurisdiction of the City of Jacksonville, Building Inspection Division,has
been reviewed for compliaJace with the FLORIDA BUILDING CODE 2001. We are pleased to
inform yoti that the documentation has been approved.
In accordance with our Bulletin G01-02, REQUIRED WINDOW AND DOOR
DOCUMENTATION FOR MND LOAD COMPLIANCE, revised 3/19/02, the product
information submitted will be filed in our office as ""Master On File' documentation.
We are returning two (2) set to you, Both copies of the signed and sealedjrtstallatiort r)IJ
Drawings have been stamped, REVIT*�, D FOR CODE COMPLIA?rl it I-S your :, '4� 1
responsibility to furnish youi -,,, 0
tq ei with a legible copy of the ap�roved ffistailation
Drawings. The cullt r '112ponsible for having a legible copy of tMa document at the
job site for the City Inspector's use at the time of the "dry-in" inspection. An
AAMA or WDMA o other approved certification label shall be attached to each window
unit, clearly visible aiter the window is installed.
Should any changes be made to your product, including installation drawings,new
documentation shall be submitted to this office for review and approval in accordance with
Bulletin G01-02. If you have any questions, please refer them Wflliarn L. Lyle at 904-630-
2351.
REVIEWED BY: APPROVED BY:
�t �
William L. Lyle, R. A. Thomas H. Goldsbury, P. E., C56
Plans Exarrdner Supervisor Chief, Building Inspection Division
ARF—ACCIDE 904/630-11001200 E,BAY STREET/JACKSONVILLE,FLORIDA 32202-3401
J AN.- 5
5. 2005 7:49AM NO- 4962 P. 3
Imntertek Testing Services
ETL SEMKO'
BUILDING PLAN$ EXANIINF.R
14 June, 2002 REVIEWEI) FOR
CODE COMPLIANCE
County of Duval/Jacksonville KEEP THIS PLAN 01') JOB
Attention: Chief Building Official JUN 2 5 2002
220 E Bay Street, Room 100
Jacksonville, FL 32202-3401 Bull ing AO' 9 ln$400npl�-lax.,FL.
904/630-1088
Examiner SignattLre
SENT VIA OVERNIGHT MAIL License No,__a,0CKNj
RE: Masonite International Entry Door Test Results (includes Entergy, Castlegate, and a
revised Johnson product line submission)
Attention: Chief Building Official
[ritectek Testing Services—ETL Semko has been retained by Masonite International to
review test results and product design ratings for their entry door product lines, The test
reports submitted were produced by National Certified Testing Laboratory and Certified
Testing Laboratory. The test reports were reviewed by ITS staff to determine if the
design load information supplied by Masonite in their Product Performance Data
Manuals was fully supported by tests conducted in accordance with Miami,Dede County
protocols PA 20 1, PA 202 and PA 203. Based on our review and the data contained in
the reports, we have issued certificates for the product lines that indicate Conformance
with Florida Building Code requirements for the design structural loads indicated in the
Masonite procedure manuals.
ITS — ETL Semko did not witness the tests conducted and has assumed that the reports
are accurate reflections of the actual performance, All of the test reports were produced
by laboratories that are recognized by Miami-Dade County Product Control and are
r" s.igned by a Florida Registered Professional Engineer. Our certificates, therefore, attest to
the correctness of Masonite's claims of conformance to the Florida Building code with
regard ,, suuclu,al and impact resistance rating, assuming that tle test reports supplied
are reliable indicators of the product's performance. [Note: Products referenced within
these documents are not currently listed by Intertek Testing Services for windstorm
resistance.]
Where errors or discrepancies were found, Masonite has agreed to revise specific daug
sheets (or COF's) to reflect the correct information. Corrections that have not yet been
made to printed versions are indicated in by notes on the sheets contained in the
enclosures to this submission,
The attachments to the certificates include a table that correlates the Masoniti data sheets
to speciFic test reports by report number and laboratory. The ITS review was specific to
the following items,
Intertek Testing Services NA, Inc. WarrAxk Hersey
8431 Wirphy Drive,Middletam.W1 53562
n,, Telephone 606-836-4400 Fax 608-831,9279 Hom4!Page www.etlwmko.com
11T 6�Q
JAN. '5.'2005 7:49AM NO. 4962 P. 4
Test report describes the product and its izstaDahon details adequately to
verify that it matches the Masoaite sPeciefiCations and installation instruCtiom.
2. Test report Provides Physical load test results per the applicable protocols
iadicating no failure Occurred at the proper test lOad to'support the
design load rating. Claimed
3. Where COMPliance with PA 201 and PA 203 (Empact and Cyclic Wind
Pressure Loading) are indicated, test reports were reviewed to verify that large
Missile impacts where conducted and the assembly subsequently Passed the
cr-lic load test based nn the specified desiga pressurc,
(Note:Ifosonite's specrications only claim conformance of the opaque
portions Ofthe ossembties for ImpactpVctic load resistance, CrIazedareaT
require use Of approved shutter
Ay where impact resistance is required.)
4. Installation guidelines were reviewed to dote '
n1lime that frame design and
fastetLing requirements were equal to or more stingent that those indicated in
the applicable test reports,
All reports were reviewed for completeness and signatures of Florida
The purpose Of this Project was to Provide Florida Authorities Having Yurisdiction with a
comprehensive independent review of Masonite's test data base and provide an assurance
from a third party testing and certification body that the desiga information supplied by
Masonite shows ccmpliazce with the requirements of the Florida Building Code.
establish compUance due to concerns regarding the Florida requirement that th ri
Masonite does not intend to provide full Copies of their test reports to code au 0 tiesto
S contain sensitive
information be made pubUc. Masonite contends that the test report such
proprietary informati'
on which they do not wish to be made available to their competitors
or customers, They therefore have asked us to conduct this review on their behalf and
submit our findings to Your jurisdiction in the form described herein.
information and answer any questions you may have. S wou d PY to discuss any
A representative of Masonite Will be COntacting YOU soon to discuss the enclosed
IT I be hap
questions you have as well. Please feel free to contact the undersigned if we Can be f
assistance. 0
Sincerely,
"Ilk
J Turge�e_110_
�011
Project Manager
JAN. -5' 2005 7: 50AM NO, 4962 P. 5
haterWk Testing Services
Data Review Ce"MCN,
Certificate #.3026447C
This certifies that Intertek Tes&g Services- ETL.Semko has reviewed structural
load test data and documentation supplied by Masonite International on the product
lines indicated below to determine the appropriate desig' n load and impact ratings
as specified by Miami-Dade County, Florida Protocol PA 201� PA202 and PA203.
The data supplied was reviewed for applicabjEty in support of the data contained in
the Masonite International Product Performance Dat*a Manual for the product line
and product models indicated below. ITS-ETL-Semko certifies that the test,reports
provided are consistent with the NWoaite Certificate of Performance sheets
(COP's) contained in the product performance data manual specifed herein. The
attached Masonite International COP/Test Report Validation Matrices (uniquely
numbered by product model) provides correlation information' for each product
model reviewed indicating the test lab, report nlwksol-,�APROAAiZe and
installation information and ratings for design load and�gpp�ob4fjy(bf the large
missile impact test, All applicable COP's and Matr1WfnM- W�rl-6*ic'Warnock
%JM.W KECP THIS PLAM 0,11 010S
Hersey verification stamp and signature
JUN 2 5 2CO2
Product Line-, Eatergy Entr_y DQQrs su Idl g"On I R
spW,ion Oi ax,, FL
Product Models: Wood-Edge StQd Dogr -4Wa
MeW--Edze �tgeel Door UM eNQ.
Fiberalas&D—wr Wa . #30 447C-003)
ITS-EM Semko has no direct Imowledge,of the tests conducted and has made no att ptto
verify the accuracy or correctness of the data submitted ne review conducted was only to
determine #iw the manufacturer's claims as represented in the COP's are correct
represenWons of the data suppliedfrorn the laboratories. ITS ELT-Semko's review wasfor
stmcArralperformance results only and did not include review of air-in Itr on or r
ati wate
pene�rafion test re.mits.
ISSUED: e� - /"x- vim&
r-r.-,,wamock Homey
B Y. JUN 4 2002
Ur g e s 0 n" "---Oj e ct�Man a�gp, 3026447
VERIFIED S Y�
C
'ji
i--N i i 1 i- i'i
"LKIM a NO U10
MUM I swill; In Jim Inilb- kv A I.ILJIV
9 i A301 a
9p-.- ATi Ahi—I jr. RE A-(-H FL-ORID 3M3
Class of Work: NEW i Town5hip:- u�- u
vroposeu use;
-Squaro Feet: SUbdivIsIon:
tsi. VaRjel
Improv. Cost, 8_000M OWNWRINFORIVIATION
A rl A t-
Date issued: -1ii4i,4UU-i
Total Fee_- Address: 346 FIFTH STREET
r%r-A 1�1 1 r-1 P-%MIMA 1�1n')1312
Amnunt Paid: 75.UU 1A I u%14 I i%.' r L_N';rN;Ljr-.
Date Paid' Phone- (904)241-7969
1Tr
VNG-I- D 0 S c: HEN-1
I%
jqj
-AR
W
CONT"OTOR
i PROWIPERT ( ek)"Y'AYINIETZ i Or-PRAIT 75-00
J"s Ulfed
1 IFQQ1 1i ATi(-)N
R A ii i N G/C OVE R%
NOTICE- 1NqPE(-TI0NS MUST BE REQUESTED AT LEAST 24 HOURS PRIOR TO !NSPECTiON
ILI-
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED iN PUBLiC SPACE, m1mu
11 �r% AIAIA%l n%/r-rrLir7n f1^kI-rDAf1'rnD nD rN%AIkIr_p
MU%")l
I "FAII I JRF Tt) C0MPLY WITH THE GONSTRUCTiON LiErN LXW CAN RESULT 1"N THIrE rg%gr%%Wrr%v_m I I
i OWNER PAYINGi MICE rOR 13'.."ILDINC3 'IMPOROVEIVIE'll'TS"
I'LIS WHICH ADC OIAD-r nP TWIQ PI=QRAIT AND 5Z1 JRJFrT To RFVo
iSSUED AGCORDRIGG-1 GA'rr'r%wv w vi-A114a lot CATION
1 11 Al A71MI flr ADDI IPARI P PPOVIRIONR OF I AW
J�k PLO 14
'IM7
Itimeiftl IL
-I LAN I K; k3hAL;H t3UILUIVU UtV 1.
A CHECKS
RECEIVFD
JAN 18 2001
City of Atlantic Beach
Building and Zoning.
CITY OF ATLANTXC REACH
PERMIT APPL-TCATION R�EMO=, ADDITIONS, OR AL-TTMT-TONS
240VZMG, LZMCLITIONS
Owner(s) : Ro beA ly AS
Job Address: nl� ZTI�- ?hone:�
Lot # Block or Gnit 4 Subdivision:
Contractor:. State License
-SE
Address: Phone No-
City State Zip Code
Describe work to be done:
Present use of building: 1571/0c; i4F _P-AM i L44 4DM e
Valuation of Proposed Construction:
Proposed use:
Is this an addition? t'j xz� If yes, what are. the dimensions of the added
sp�ace: ft. X ft. Will the added area be heated and
cooled? New electrical (or increase),? �fs(0?/A"/0 —oue C-..k MOU4"
4 '&A
New plumbing fixtures? New fireplace? tjo New Heat/AC?—X)D
SUBI-11T TW= (Ccz-�ZAL) Two (PzS==.7-AL) CCAWLE= -TWTS or PL"S, INCIVDING
sx=r PLAv, LosaRvzy, mamG;,-\coms Imms, mcrzcz or AND
CWNERICONTRACTCR AF7XMA72T- 17 OWNER COMMACTOR.
Signature OWN4< Date':
. V- /(,�Z,Z? o
Signature CONTRACTOR: Date:
AS TO OWNER:
Sworn to and subscribed before me this JZ-K day of "Jill 2000.
NOTARY PUBLIC ----RpVk1a Amoneft
AS TO CONTRACTOR: WCOMMISS100 C047012 WM
August 27,2004
2 0 0 FAN WSUMWA IC
Sworn to and subscribed before me this- day of
NOTARY PUBLIC
CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET
Address- �� v (, �- �<-r- I (",h-I T-"eye A-;
Date—/- 21V- 0 /
Heated Square Footage per sq ft
Garage/Shed @ $_per sq ft $
Carport/Porch @ $—per sq ft
'Deck @ $_per sq ft $
Patio --@ $_per sq ft $
TOTAL VALUATION: s
moo
$ p;-0
Total Valuation 1st $ 106 L,
Remaining Value per thousand
or portion thereof
TOTAL BUILDING FEE $
+ 1/2 Filing Fee $ -:2)'-
(6 ) Fireplaces @ $15 . 00 $
BUILDING PERMIT FEE s
WATER IMPACT FEE $
SEWER IMPACT FEE $
WATER METER/TAP $
CAPITAL IMPROVEMENT $
SEWER TAP $—
) RADON (HRS) . 0050
SECTION H PAVING $
HYDRAULIC SHARES $
CROSS CONNECTION $
) SURCHARGE . 0050 $
OTHER $ 275
GRAND-TOTAL DUE s
ADDITIONAL PERMITS OR FEES : Mechanical Plumbing
Electric/New Electric/Temp_; SwimmingPool
Septic Tank Well Sign Finish Floor Elevation
Survey Other
CALCULATIONS and/or NOTES :
PLAN REVIEW CHECKUST
PROPERTY DESCRIPTION: V 4 15—r'& J r.. (/ ts
OWNER:— �AJD )om I W &A
Determine Occupancy Classification of the structure. Select Occupancy classification
which most accurately fits the use of the Building. (Chapter 133)
2. Determine actual physical properties of building.
a. Determine building area each floor. (Area definition Chapter 132)
b. Determine grade elevation for building. (Grade definition Chapter 132)
ler C. Determine building height in feet above grade. (Height definition Chapter 132)
d. Determine building height in stories. (Story definition Chapter 132)
e. Determine separation distance from exterior walls to assumed and common
property lines. (Property line definition Chapter 132)
f. Determine percent of exterior openings per floor.
3. Determine minimum Type of Construction necessary to accommodate proposed structure.
(Chapter 136)
a. Determine maximum allowable heights and floor areas for Types of Construction
and Occupancy classification. (Table B500)
b. Check allowable height and area increases permitted. (Chapter 135)
4. Check detailed Occupancy requirements. (Chapter 134)
5. Check detailed Construction requirements
a. Fire Protection of Structural Members(Chapter B6&Table B600)
b. Fire Protection Requirements(Chapter B7 and Table B700)
C. Means of Egress Requirements(Chapter B1 0)
d. Special restrictions if in Fire District. (Appendix BF The provisions of Appendix BF
are applicable only where specifically adopted by Ordinance)
6. Review design as related to standards. (Chapters B16-B26)
7. Check other requirements as necessary.
a. Construction projecting into public property(chapter 832)
b. Elevators and conveying systems(Chapter B30)
C. Sprinklers, standpipes and alarm systems(Chapter 139)
d. Use of combustible materials on the interior(Chapter 138)
e. Roofs and roof structures(Chapter B1 5)
f. Light,ventilation and sanitation (Chapter B12)
9. Other
Date CITY OF ATLANTIC BEACH BUILDING DEPARTMENT
By:
Don C. Ford, Building Official
don/sb.1
CITY OF
,-**ezc: Te4" — 57&Ud4
800 SEMINOLE ROAD
ATLANMC BEACH,FLORMA 32233-5445
TELEPHONE(904)247-5800
FAX(904)247-5805
SUNCOM 852-5800
CHAo-ma 4a9, FLORIDA STATUTES. PART I 'CON:�MUCT10N CONTRACTING' REOUIRMS OwmzR/BuILMER To
ACKNOWI orcoa THE LAW:
DISCLOSURE STATEMENT FOR Sacnom 489. 103(7). FLORID^ STATUTES:
STATE LAW REOUIRES comsTRuanom To 151E DONE BY UCXJt-5=CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT
UNDER AN exemi-noN To THAT LAW. THE ccEMpnoN ALLOWS YOU, AS THE OWNER OF YOUR PROPERTY, TO ACT AS YOUR
OWN CONTRACTOR EVEN THOUGH YOU DO P40T HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION yougsgi-r.
YOU MAY BUILD OR IMPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A C*MMERCIAL ISUIIJX14G AT A COST OF $25,000.00 OR 1—. THE mui62imp musT BE rop YOUR use AND
OccuPANcy. IT MAY NOT me BUILT FOR RAI Z OR L EASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE 13UILT YOURSELF
WITHIN ONE YEAP AP-rER THE CONSTRUCTION IS COMFqXM, THE LAW WILL pRESUME THAT YOU BUILT IT FOR SALE OR
LEASE, WHICH is IN VIOLATION Orr THIS EXEMPnON. YOU MAY NOT HIRE AN UNUCENSAD PERSON AS YOUR CONTRACTOR.
YOUR coNsrRucTioN MUST SEE 0014E ACCORDING To Tme aujumma; coor-s AND zoNimc3 Rr-GuLA-noms. IT is YOUR
RESPONSIBILITY TO MAKE SURE THAT MO
COUNTY OR MUNICIPAt- LIC&MING ORDINANC".
ORDINANCES ALSO A'1 W AN OWNER TO IMPROVE 774CIR QW rr is jr eRsomAL R P,
N PROPERTY WHEN OR P 0 AMILY
Use-AND LIKE101SE REQUIRIM ALL WORK (Z)(CZFwr MAINTENANCE UNDER $Z,000) BC UNDER A BUILDING PERMIT AND PASS
ALL NORMAL imspecrtoNs. THe oRcjmANcc srATzs OWNERS MAY FDO-ffMCIALLY 00 WORK THEMSELVES; OR MAY HIR
UNUCIENSED WORKERS PROVIDED SUCH WORKERS Be UNDER 'DIRECT SupigrRVISIoN op 77-fe owNeR. Wf4o mUST ae ON
T?46 JON AT ALL TIW-S WHILE WORK 15 IN PROGRESS 19Y UNLICENSED TR^DCS PEOPLE.' 7)qjz Does mcrr ALLow Use Oor
UNLICENSED CON77ZACTORS.
SINCE OWNERS MAY BIE LIABLE MR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMCNY SUGGESTS
WORKEWS COMPIDISATION INSUR^NCZ 131E PURCHASED UNDER THE HOMCOWNERS INSURMCM FbOUCY CLEARLY PROTECTS
THE OWNER. OWNERS HIRING V*)RKERS BEC40ME 104F-Laymns AND SHOULD A,q OBSERVE IRS wrreimoLoimo TAx Amo/op
FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
Umucemsen cowrpACTORs CANNOT Oft XMPLOYZQ UNDER A04Y QIRCUMSTANQEs. OWNERS BEING SU4WECT
To $5,C00 Pemm-Ty umcaR FwRicASTATuTc No, 455-228(1). Am 'Qccuppmogal, Ljrgmse' is NOT Aocau&=.
THE OWNER sHouLo Pmys4c.A"y set THE COUNTY "CaRTIricATz or Comrwrxiocy' OR THe FLORID^ 'CONTRACTORS
CompicATz" To AscriTrAiN IF A PERSON 15 A LICENSED CONTRACTOR. TELEPHONE-THE BUILDING OcPARTmeNT(247-
5a26) ior IN DOUBT.
i HEREBY AcKmovnjitooc THAT I HAVE READ THE ABOVE DISCLOSURE STA-rEMENT AND THAT I compLy WITH ALL
THE REQUIREMENTS FOR THE ISSUANCE Oir AN OWNER-BUILOUR
owwwamot;;t
>y
s'm
ADORES3 TELEPHONE
SWORN TO AND SUBSCRIBED BEFORE ME THIS D
NOTARY PUBLIC Pkaft"ricto 111no
NOTE: PHRASES uNcaRuNcc AnovE MY COMMMION EXPI My COMMION III CC947012 10"I
UUM 2004
ARE EMPHASIZED By THIM BUILMING 1111101)7m TROY FANNUVACk tkg'
DEPARTMENT.
5 MIN. RETURN Book 9857 Page 2003
MONE# �?L41, 7)0
fioure of
(009PARC IN DUPUCATZ)
To whom it mav concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in
accordance with section 713.13 of the Morida Statute.% the following information is stated in this NOTICz
OF COMMZNCENZ".
Description-of property 3-q ----
IF-0---------------------
-----------------------------------------------------------------------------------------------------------
General description of improvements ------�f i-AP-Cia ,
—-—--------------------------------------110- -------------------------------
Owner
Address ------
Owner's interest in site of the improvement ------ Fee ----------------—------