1677 N Linkside Ct 2013 bath remodel CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
/oil
Application Number . . . . . 13-00002999 Date 7/05/13
Property Address . . . . . . 1677 N LINKSIDE CT
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1000
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Application desc
bathroom remodel
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Owner Contractor
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ECHOLS, HAROLD B AND C DIANE OWNER
1677 LINKSIDE CT N
ATLANTIC BEACH FL 322337316
--- Structure Information 000 000 BATHROOM REMODEL
Occupancy Type . . . . . . RESIDENTIAL
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Permit RESIDENTIAL ALT/OTHER
Additional desc . -
Permit Fee . . . . 55 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 1000
Expiration Date . . 1/01/14
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 55 . 00 55 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 59 . 00 59 . 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
800 Seminole Road, Atlantic Beach, Fl, 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 7 7 Al -1-17 45 1 A.,A, e r —Permit Number:
Legal Description Floor Area of Sq.Ft. Parcel 9 Sq.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 structureQ)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle.one): Yes No N/A
Florida Product Approval 4
For multiple products use product approval form
Describe in detail the type of work to be perform
ed: 4Xek, 5d 4 lde, 047
Property Owner Information:
Name: - JA- A'o /e, -Address: 16 -77 A/ ZI'o
city A—A, - - State ip ::5 2) 315ne
E-Mail or f a'x V�(Optional)
Contractor Information:
Company Name: ifying Agent:
f iq
Address: ity State Zip
Office Phone Job Site/Contac umber Jax#
State Certification/Registration
Architect Name&Phone#
Engineer's Name&Phone 4
Fee Simple Title Holder Name and Addre
s
Bonding Company Name and Address
Mortgage Lender Name and Address
1
A a e e de obana e d he work and n a a as ndca d e n k or installation has commencedprior to the
tfy' i
n 'c r i "it 0 wor
i 1 11 rmit to 0 0 t to m t t i s' tio s .511 s u tng constructio n this jurisdiction. Thispermit becomes null
ic 'io s ma t 0 11 t , p be e ed h tan ards o
'y d h k
d or aba do-ed or a period ofsixp6)months at any time after
1� , Plum g,Sj S, W is, I
r d �i lak b n gn el Pools, urnaces,Boilers, Heaters,
f r'hs or c trct on" ork s s nde
a W' r
n )in t
(6 n
P t 'o P
p
issuance o a permit an a
d"id f o'k is not co,-e ..d within six 0 0 s f Dec r ca or
work is co nie"ed. I understand that separate Perini m, t be s ..red 0,
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
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
provisions of any otherfederal,state, or local law regulating construction or the pe�formance of construction.
Signature of Own&&�� Signature of Contractor
PrintName Print Name ........................................................................................................................................
zB HIRLEY L GRAHA
for Before me - 20
t I of OMMISSM0 this Day of
E 1RES:Febftwq14,20f4
N Fdft Undewrde-
Notary u ic Notary Public
0 � I e�� Revised 10.24.12
CITY OF ATLANTIC BEACH
OWNER / BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "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 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 T14E 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 IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT
IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF TIT[S 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 RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(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.
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.
/&7 -7 Al
ADDRESS PHONE NUMBER
PRINT NAME
r 7N
SI N-KT—URRE DATE
Before me this,5-- day of e--� 2j in the county of
D uval,State of Florida,has pers6nally appilared herin bLaimself herself and affirms that
all statements and declarations are true and accurate.
11:::�L_ _,/L
Notary Public at Large,State of County of
Iversonally Known
roduced Identifi on- L
My cOWISSION#DD 96M
e(PIRES'FebMW 14,2014
Notary Signaturz�
RI\ISE 41 1 10"