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566 Clippership Ln 2013 shed CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 Application Number . . . . . 13-00002350 Date 3/29/13 Property Address . . . . . . 566 CLIPPERSHIP LN Application type description SHED PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 8 x 12 shed ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SHAW, MICHAEL OWNER 566 CLIPPERSHIP LANE ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit ACCESSORY STRUCTURE NEW RES Additional desc . . Permit Fee . . . . 60 . 00 Plan Check Fee . 00: Issue Date . . . . Valuation . . . . 1500� Expiration Date . . 9/25/13 ---------------------------------------------------------------------- Special Notes and Comments Remain clear of easement. Roll off container company must be on City approved list and container cannot be placed on City Right-of-Way. (Approved: Advanced Disposal, Realco, Shappelle' s and Waste Management . ) 2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE *CALL FOR FINAL INSPECTION WHEN SHED COMPLETE AND ANCHORED TO MEET 120MPH WIND LOAD. --------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 ENG REV BLDG MOD OR ROW 25 . 00 STATE DBPR SURCHARGE 2 . 00 UTIL REV MODIF OR ROW 25 . 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 54 . 00 54 . 00 . 00 . 00 Grand Total 114 . 00 114 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. AF 41343B MAP SHOWING SURVEY OF La-r %. eLcw--v- i A-z smOwm Vom mApoF SEASPLAY A4 ItEdOX0910 lU PLA-r soew- " PACrc U4 i u4 A op. 4UMEWT PUSLIe. ItG40X" OP DUVAL e_*UU-0( , FL0LiDA- FOX* DOWAL.D M. W.OGWICP e-LIPPER SHIP LANE SET I/.,. . ( t-sawri., t-p. V 0/4"1.r. 0-1. 0 or oxwe - J; IZA' UA' 0 161 City of Atlantic Beact 0 Planning and Zoning Depa Unerd L4.C. T approval verifies compliance 1 ofth app .2 z ining, subdivision. and- othe , -local Ian d velopment regulations, but does not constftitu lite LOT 1-1 1--ST4 ST U e.--0. CE-5- 9 a, proyolTfoFthe issuance of permit . Compliance + d5l't- w th Florida Building Code and all o her applicable OA. Ic al, State and Federal permittinl; requirements WELL. IT j4t be verified by signature of the 1;ity of Atlantic 0 B� h Building Official prior to the issuance of a B Ifiding Permit * 241- 0 A.1roved By, M��2_M C aTe- Mal- 2 go* LLSM,-r FOX DMAIMA T I To, -jz 01;0 MAIL Law IL: Lol LOT zi (M."'AALES BASSETT & ASSOCIATES, INC. SURVEYORS, ENGINEERS AND LAND PLANNERS (904).724-9433 \-JFF 215 CENTURY 21 DRIVE JACKSONVILLE. FLORIDA 32216 THE SOURCE OF INFORMATION USED+IN MAKING THIS SURVEY WAS P.R. 7-05 Pe,-r.4;04 A SEARING DATU14 BASED ON P A. FLOOD ZONE 6 AS BEST ASCERTAINED FROM THE FLOOD INSURANCE RATE MAP, COMMUNITY PANEL No. t?0070 001 DATED I HEREBY CERTIFY THAT THE ASOVE t-OT WAS GUAVEYED BY MR ANO THAT 'rul Ar-W Loc.%Teg)UPON%AMCA$SHOWN AN13 THAT THERE ARE NO KHMACHMENTO UPON SAVO tmis inounAr_yl SURVEY MEETS T14E MWIMUM TL5PTAL STANDA SET FORTH BY /'9 r T 0,17 Tlig FLOMDA BOARO Or LANO SUJV�Ey-nS PURSUANT TO SECTION A72. Al ScrNeD jjl�m 5-7 CKARL95 R,SA59FTT SCkLE. 20* REGMTERZO SURVEYOR NO. 157S.FLA. 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A City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 L ate routed:' E-mail: building-dept@coab.us Cityweb-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: An DgpArtment review required Yes No Applicant: di,,e- A I ree Adnniniwamr-- Public Works Project: t4k��: A A 912- Public Utilities Public Safety Fire Services PVl W ep- 0 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 Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: [jaApproved. E]Denied. (Circle one.) Comments: fibee1w d4&1--1 BUILDING Reviewed by: Date: e�3�ZZV*�' TREE ADMIN. Second Review: FlApproved as revised. F�Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: OApproved as revised. [—]Denied. Comments: Revievved by:_ Date:- Revised 07127/10 1:"`;'CF_,T-VT- JL xJP F C -T"\7T City of Atlantic Beach APPLICATION NUMBER Building DepartmentLM A R 2 .5 2 0 L13 (To be assigned by the Building Department.) 800 Seminole Road oy.� 1.3 Atlantic Beach, Florida 32233- By- (9 Phone(904)247-5826 - Fax(9 I Date routed: Ir E-mail: building-dept@coab.us City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ��nt review required Yes No (Planning &Zon�i Applicant: ao I Treg-Mministrator Project: 1P q��IiUtilities'S pftft samel—y Fire Services keme"W ee ,��,,, "'Signa. fe, pt Review or Receipt Other Agency Review or Permit Required of Permit Verified By Date 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: pproved. F�Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: [–]Approved as revised. FlDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: F]Approved as revised. F�Denied. Comments: Reviewed by: Date: Revised 07/27/10 �11.T E City of Atlantic Beach NA A-P 2013 APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: 21 R City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: .Bop7artm�nt review required Yes No Applicant: Planning &2 Tre ministrator - 0 e 1-2, - 4 P blic Wor Project: e )Fire Services ep .�: Jgpa U e eW, !Re�k Review or Receipt Other Agency Review or Permit Required of Permit Verified By Da e 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: VApproved. ElDenied. (Circle one.) Comments: BUILDING PLANNING &ZON(WG-7�4 Reviewed by: Date: �3LW_3 T t P7 6L wed as revised. E]Denied. OCCL� PU I C, dV6Ay7a3e PUE rR JA Pleas' Date: PU Reviewed by: FIF wed as revised. F�Denied. Se rvtekD. —7DA01q Reviewed by: Date: Revised BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: ell)oa)Oe�L 5111,oa 1,AJ- FL- Permit Number: Legal Description Parcel# -S-q—.Ft Floor ''sre, non-heated/cooled Valuation of Work$ 0 3 —Proposed Work 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 Residential If an existing structure,is a fire sprin=system installed? (Circle.one): Yes No N/A Florida Product Approval 4 ----- For multiple products use product approvaTform ,,�// A Describe in detail the type of work to be performed: Property Owner Information: Name: 4VR_)r-, , Address: 7/)0 )--/V City h47-4. 96/-/7 State_,QZip 3 Phone 0-&14 E-Mail or Fax#(optional) 2512�0�v /C f Aq e_aaj Contractor Information: Company Name: Qualit�in gent: Address: city State Zip Office Phone Job Site/C�n__tactNumbe Fax State Certification/Registration Architect Name&Phone# Engineer's Name&Phone Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address s ind�icated. I certify that no work or installation has commencedprior to the ca here ad an a e do h rk and nst la ns a i m 0 e w i a' tiods a ction in thisjurisdiction. Thispermit becomes null f 9��months at any time after 0 t t ta ork i s nedfor aWeriod ofsLx od a I er rmed to m he s n ar s i, )m t c 's ct 0 (6 on tr n or is m il r be it e'o o't p P'i io by d th 11 work w p an t f Ap mit hin or Ob,s ..red or E ecirc ens,Pools, I urnaces,Boilers,Heaters, issuance 0 a per. d _t a d 0'd work"not commence w t,p t it t Sikns, f de nd tha e ara Per s m. work is c "encd- " rst' T , s .r Co 1 o"rs, a k dA, nd tj etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT E*4 YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Ihere 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 .1111work will be coTplied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisi.ons of any otherfederal,state, or local law regulating construction or the peFformance of construction. Signature of Contractor Signature of Owner on actor PrintName ............................................................................................................. Print Name ........... .......................................... .. .... Before me Befor y this Day of &/L— 20/s_ this Day 20 11. ......... S I p,L E%, rAA H AIM, Notaiy Public ES-Feb-L!a�y 14,20*14 Not U Y Revised 10.24.12 Bonded Thr,.-NOW Public Uridenyri c�rs CITY OF ATLANTIC BEACH OWNER BUILDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW*. FDISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED C CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT L , "M I AW. 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 MAYNOT BE BUILT FORSALEOR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHN ONE YEAR AFTF ME THAT YOU BUILT ,R THE CONSTRUCTION IS COMPLETE, THE LAW WELL PRESU IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF TT-US EXEMPTION. Y01 J MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CON CTOR_ 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 RAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. IL INJURY LIABILITY; SINCE OWNERS M Y 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 ANY CIRCUMSTANCES. OWNERS BEING SUBJEC I TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(l). AN-OCCU ATIONAL LICENSE- IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE TF UNTY "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. PHONE qUMBER ADDRESS PRINT N41 DATE SIGNATURE Beforemethis C�/ dayof 20 Ithe county of Duval,State of Florida,has personally appeared herin oy nimself I herself and affirms that all statements and declarations are accurate. V Notary Public at Large,state ol County 0 P nally Known Zl.ced Idenbfication- D Notary Sig re: F/BLDG/0—u-BuilduAfffidavit;REVIS : 4/16/2 9 . City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 T)F" V Phone(904)247-5826 - Fax(904)247-5845 I E-mail: building-dept@coab.us Daterouted: �21 1.5 City web-site: hftp://www.mab.us APPLICATION REVIEW AND TRACKING FORM D ont review required 'N 0 Property Address: /1', An- M : i nnin Zoni Applicant: is tor Iretemienis rator Public Works Project: 12- Public Utilities Epublic Safety Fire Services NN'f 40 Review or Receipt Other Agency Review or Permit Required of Permit V Date 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: E�rApproved. ElDenied. (Circle one.) Comments: PLANNING &ZONING Reviewed by:_ Date:.3 2 41 TREE ADMIN. Second Review: ElApproved as revised. F�Den(4d. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: f--�Approved as revised. F]Denied. Comments: Reviewed by: Date: Revised 07127110 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 -0 Job Address: pg4 5111 ya 4AJ, FL--Permit Number: Legal Description Floor Area of -S–q.Ft. Parcel 4 __&q.Ft Valuation of Work$ 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 Residential If an existing structure,is a fire sprin=system installed? (Circle.one): Yes No N/A Florida Product Approval# For multiple products use prod ict approvaITo-rm A Zy 12, Describe in detail the type of work to be performed:— Property Owner Information: Name: Address: —/_�60 city A7- /_ 1361V_- State azip 3 Y7 hone E-Mail or Fax# (Optional) _�JD /Cg:I L /7,57ppl Contractor Information: FILE COPY Qualifyin gent: Company Name: ritv State Address: Office Phone Job Site/Contact State Certification/Registration# F, Architect Name&Phone# CM Oyr ATI A wne B Am >inXK'g"ent-. J Site/Contact ob ion RFF Engineer's Name&Phone# Ppl?KAIX---- Fee Simple Title Holder Name and Address REQUIREMIEM AND MNDfRqM. Bonding Company Name a nd Address I r ss DATE Mortgage Lender Name and Address W____ encedprior to the Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that n 11 issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in thisjuris iction. s permit becomes nu in six(6)months, or if construction or work is suspended or abandonedfor aWeriod of sixP6)months at any time after and void ff work is not commenced with be securedfor Electricar Work,Plumbing, Signs, ens,Pools, urnaees Bo rs,Heaters work is commenced I understand that separate permits must Tanks and Air 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 FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Ihere 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.1�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 ormance of construction. provisions of any otherfederal,state, or local law regulating construction or the peFf .4 1 1 Signature of Contractor Signature of Owner PrintName A/ .......... .......................................... Print Name ....................... ............................................................................................................... Befor Before me 20 this Day of &A- .20/s— this —Day SnAR0 L.GRAHAM -14 20 Not u EXPiRES-February 14, Notary Pubiic Und 60 Revised 10.24.12 nded Th,