774 Aquatic Dr SHED PERMIT ACA-H
CITY OF ATLANTIC BE . '
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
-5814
INSPECTION PHONE LINE 247
Application Number . . . . . 13-00002416 Date 4/12/13
Property Address . . . . . . 774 AQUATIC DR
Application type description SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2000 ------
---------------------------------------------------------------------
Application desc
8 X 16 SHED
--------------------------------------------
Owner Contractor
------------------------
------------------------
LEBOUTON, MARDEN OWNER
774 AQUATIC DRIVE
ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . ACCESSORY STRUCTURE NEW RES
Additional desc - - 30 . 00
Permit Fee . . . . 60 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 2000
Expiration Date . . 10/09/13 ---------------
------------------------------------------------------------
Special Notes and Comments
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
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 30 . 00 30 . 00 . 00 . 00
Other Fee Total 29 . 00 29 . 00 . 00 . 00
Grand Total 119 . 00 119 . 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 FILE COPY
800 Seminole Road, Atlantic Beach,FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 11,L14 ku4nc," DR - Permit Number: o29416
Legal Description 117 , I '': ii , t Parcel# _Sq.P I
ed/cooled non-heated/cooled.
Valuation of Work$g400- 00_ProposedWork heat
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/pro osed 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_�roduct approval form
Describe in detail the type of work to be performed: (6 Y_
CL
Property owner Information:
Address-
cl f
P
M ho
Name: M. Address:
city A State ip Phone 14 tv,�
E-Mail or Fax 4 (Optional)
Contractor Information:
Company Name: QualifyingRgent: State Zip
city
Address: Fax
office Phone Job Site/Contac umber
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
Application!is hereby made to obtain apermit to o the work and installations as indicated. I certify that no work or installation has commenced prior to the
bepe ormed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
issuance o or work is suspended or abandonedfor aWeriod of six P6)months at any time after
a permit and that all work will
and void ff work is not commenced within six(6) months, or if construction
work is commenced I understand that separate permits must be securedfor Electrical-Work, Plumbing,Signs, ells,Pools, j urnaees,Boilers,Heaters,
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.
Ihereb 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 o7work 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 otherfederal, state, or local law regulating construction or the peFformance of construction.
f
Signature of Owner �71 . 1-e Signature of Con r tor
Print Name .............. ........................................................................... ...........
Print Name *gnature of Coritr tor
me
rmt Na)<
Before me
B14eforme this Day of 120
"i'or this Day of
this ay 20 /3
HIRLEY L.GRAHAM
ot ry lub
Notary bi
Nota blic
PIRES,February 14,2014
Notary PublIGUnderwritefs
Revised 10.24.12
ndedThw
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City of Atlartir r.1"—',
Planning and
verifies compliance with applicable low",
wit
ling subdivision and other local land
oevelop r"-.,,ritt regulations, but doe s not constitute
approval for he issuance of permits. Compliance
with Florida Building Code and all other applicable FILE COPY
local, State and Federal permitting requirements
must be verified by signature of the City of Atlantic
Beach Building Official prior to the issuance of a
Building Permit.
Approved By:
Date:
CzfjeD
-.-7-71
7DV
CITY OF ATLANTIC BEACH FILE COP
®R
OWNER WELDER AFFIDAV pi
1. FLOR IDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW.
D_ISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES:
REQUIRES CONSTRUCTION TO BE DONE BY LICENSED
STATE LAW EXEMPTION TO THAT
YOU HAVE APPLIED FOR A PERMIT UNDER AN
CONTRACTORS. TBE OWNER OF YOUR pROPERTY�TO ACT AS
WS YOU,AS
LAW. TBE EXEMPTION ALLO ST
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU
SUPERVISE THECONSTRUCTION YOURSFLF. YOU MAY BUILD OR IMPROVE A ONE—OR
INC
TWO FAMILY RESIDENCE UK A FARM OU113UELD 1-. 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 FOR SALEORLEASF-
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER TBE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT
LEASE, WfUcH IS RT VIOLATION OF TMS E)M-MPT1ON- YOU MAY NOT
IT FOR SALE OR AS YOUR CONTRACTO YOUR CONSTRUCTION MUST
HIRE AN UNLICENSED PERSON BUILDINU CODES AND LONING REGULATIONS' IT IS
BE DONE ACCORDING TO THE E EMPLOYED BY YOU HAVE
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPL
LICENSES REQUIRED BY STATE -LAW AND BY—COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
It. INJURY LIABILITY; SINCE OWNE S MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKERS COMPENSATION 1NSURANCE 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 EMPLO ED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,00U PENALTY UNDER FLORIDA STATUTE NO.
455-228(1). AN'OCCUPATiONALLI ENSE" IS NOT ADEQUATE THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE Ul- COMPETENGY" 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 NUMBER
ADDRESS
K,
PRINT NAME (2
" J 4 JOL3
DATE[
SIGNATURE
Before me this :;I day of 20 3n the county of
_L If herself and affirms that
Duval,State of Florida,has persbriallfappeared henn oy himse
all statements and declarations are true,and accurate'
Notary Public at Large,State of #41�'E ,County of
0 Personally Known
[9p-roduced Identrmcation-
Notzr�signa, ......
�q-14,2014
0 EYRPES:F ,
F IBLDG/0—er-Builder Afm�dRvi RE�FISFD:: 4/16/2 elm.
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LOAD OF 4725 Fp*, W-T -2
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lb.,ANC,AN ULTIMATE LOAD Of 5200 lb�- to I" a j- 3 3 -.L
4, ANCHORS k4UST L%E INSTALLED To MANUFACTURERS,RECOMMENDATIONS.ANY BENDING OR 17�0* Iw-w -Tw� 4 2 2 2 2
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w-r to 0 4 6 1 of
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4�VIAND IMFOFTANCe rACTOR; 1.0 13r is
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f,�DESIGN MEETS INTERNATIONAL WILDING CODE 9009 6 FLORIDA IT-7 -V 14 o a 0 a
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511.115.CLAYS AND COAKL.A jV5TFPCClf TOROUE VALUE OF 550+V�m —
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lVV 44-V v4r 0
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MIGNEO FOR;
Al=*.
F.O.50A 830 f4utttiz-
,,1,H, Hane Associates, Inc.
5wainsbN�a,GA 304,01 VH+t±M Fnginietering&Coustructlan Plantudbf!
PPOJECT NUMBER, W-W-70dAtlik
12EN224
DATE:Mamh 27nd.2012
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 D I ate routed: .....
E-mail: building-dept@coab.us
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -7 -7 I)r Deaartm_ent review required Yes -No
Lu I�g �
r
Applicant: LQ _27 A a-n—ning &Zon�i
g y ublic Work
Project:
,�PV�icfil�,fies
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
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
0'
Reviewing Department First Review: 2A/pproved. E]Denied.
(Circle one.) Comments:
BUILDINP
PLANNING &ZONING Reviewed by: Date:
4
TREE ADMIN. Second Review: F]Approved as revised. F�Deniec(/
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F]Approved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
IgoCity of Atlantic Beach ,�,,APPLICATION,-NUMBE�R�,,,:.�,.
Building Department eia,s,sigh�46�.theBuildin6::b6p'6�rtment,)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coab.us
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -7 -7� 1)r Department review required Yes No
Applicant: /Ma--nning &ZonLin
Efiii9kcTministrator
gy ublic Work
Project: Z�ti�i�ies
Public Safety
Fire Services
HEM
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: EJA/pproved. F�Denied.
(Circle one.) Comments:
�B U I�L ��
PLANNING&ZONING Reviewed by: SA�-6-1�fbate: NIOL11060
TREE ADMIN. Second Review: E]Approved as revised. Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [:]Approved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised OV27110
City of Atlantic Beach APPLICATION INUMBER
Building Department be assigned 6y'ih6,I§ulIqIin4b6p6rtmqnt)
800 Seminole Road 0
Atlantic Beach, Florida 32233-5445
?013
Phone(904)247-5826 - Fax(904)2 5
E-mail: building-dept@coab.us
Cityweb-site: hftp://www.coab.us A
APPLICATION REVIEW AND TRACKING FORM
-7 -7 140dy"--f c I)r -De ired Yes No
Property Address: partm_ent review requ
Applicant: ee /Ma—nning&Zon=in
:���ministrator
ublic Work
Project: y
���ic U�tilities
-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
Army Corps of Engineers
Division of Hotels and Restaurants
Division of All holic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: �Approved. F]Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN.
Second Review: []Approved as revised. ODenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: MApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 07/27110
APOLICATION NV
City of Atlantic Beach
E,1VR7D '.'��'(To b6i�Ssighed'i�yih i i�'Bu I
Building Department ent.
800 Seminole Road
APR 0 32013
Atlantic Beach, Florida 32233-5445
M
-5826 Fax(904)247-5845
Phone(904)247
E-mail: building-dept@coab.us
Cityweb-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -7 -7 I)r Depaftent review required Yes No
Applicant: /Man-ning &Zoni
Z:'��ministrator
Project: ublic Work
,�I�ic U�fififies
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
Army Corps of Engineers
ivis on t Hotels and Restaurants
Division of Alcoholi c Beverages and Tobacco
Other:
APPLICATION STATUS
(Circle one.) Comments: '?"pproved. F�Denied.
Reviewing Department First Review:
BUILDING
PLANNING&ZONING Date: 7` /
Reviewed by:C2
TREE ADMIN. Second Review: DApproved as revised. F�Denied.
P 4P WORKeS Comments:
TIL I
USOF E Reviewed by: Date:
FIRE SERVICES Third Review: FlApproved as revised. (-]Denied.
Comments:
Reviewed by: Date:
Revised 07127110