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1336 Beach Ave 2013 Garage door 2013 IS, CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD +) _ ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ��JF Application Number . . . . . 13-00003097 Date 7/25/13 Property Address . . . . . . 1336 BEACH AVE Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 900 ---------------------------------------------------------------------------- Application desc garage door ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- BEARDALL GEOFFREY & EVE BAKER OWNER 1336 BEACH AVE ATLANTIC BEACH FL 322335732 ---------------------------------------------------------------------------- Permit . . . . . . W/W/O BUILDING PERMIT Additional desc . . Permit Fee . . . 110 . 00 Plan Check Fee 55 . 00 Issue Date . . . . Valuation . . . . 900 Expiration Date . . 1/21/14 ------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ---------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 110 . 00 110 . 00 . 00 . 00 Plan Check Total 55 . 00 55 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 169 . 00 169 . 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 JUL 18 2013 3 L �7 Job Address: &C C V% A�x Permit Nug��3- Sk-,,NJI*0/N Parcel 00 Lcgal Description C-v(c�c�e DL--,(- 1�� 'i 1-;Ioor Area ot Sq.Ft. Valuation of Work S 00 Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spC�indow./ oor circle one): Commercial QCps—idential Use of existing/proposed structure(s) If an existing structure,is a fire sprin=system installed9 (Circle.one): 0 Florida Product A 14 gprova For multiple pro ucts use approvaFFFor—m Describe in detail the type of work to be perfortned: Property Owner InformRtion: 's. Name: Addres City Ile StatelELZip Pho E-Mail or Fax (Optional) L. WWI a Contractor Information: Company Name: Qualifying Agent: Address: Ci!X State Zip Office Phone Job rite/Contact NUMMr L CLA State Certification/Registration RE,VIEWE D Fdff Architcct Name&Phone# 0 PPA OF AT4AN:F!c-fffi*ef f Engineer's Name & Phone# -;i-4 P-E-P 04FFS FOR A+M�)fff&47tt Fee Simple Title Holder Name and Address (00-NORRON-1. Bonding Company Name and Address By. DATF- Mortgage Lender Name and Address III REVIEWED 11171!E bliation h as commencedprior to the Application i's hereby made to obtain a permit to do the work and installations as Indicated,I cuet6 that no work 6r-757s i3p M -null issuance of a permit and that all work will be per , formed to meet the standards of all laws regulating construction in thisjurisdiction. Th � er It become� ommunced within six(6)months, or if construction or work is sus-omded or abandonedfor I Period of six )months at any time ofice and void#work is not c W, Aul work is commenced. I understand that separate permits must be securedfor Elecifical Work, Plumbing,Sikns, eus, Pooh, urnaces, Bollem,fleaters, TanksandAie Condlitlonen,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. Ithere certify that I have read and cxamined this opplication and know the same to be true and correct, All provisions of laws and ordinances governing this type 111�work-will be complied with whether specified herein or not, The granting of apermit does not presume to give authority to violate or cancel the provisions of any otherfederal,state, or local law regulating construction or the pe�formonce of construction, Signature of Owner. Signature of Contractor PrintName GQZ ?.(-a Print Name . ..... ........................................................................ .. ...... ...... ........... ................... Before me Before me t _Lf Day of 20(3-- this _Day of 20 his Gj- 'me . ................. ..... ... ........... nc Day oZf u 1 Notary Pub Notary Pub i ZANARY HANSFORD otl Revis V tly CotvIMISSION#DD968967 Revised 10.24.12 Xpj� EXPIRES:MAR 09,2014 idaa BIJ LPI !nq EA d 6960 L�2 �O 15"',e*V!V-2Yt—,nsurance 9E:60 LL-ZO-EL02 2013-07-17 12:50 Bui �ding Dept. 247 5845 >> 1 904 241 0989 P 1/1 FILE COPY CITY OF ATLANTIC BEACH k OWNER / BUILDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 469, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW., .T)JSCLO$URP-STATENiENT FOR SECTION 489.103(7).FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONM BY LICENSED CONTRACTORS, YOU HAVE APPILMD FOR A PERMIT UNDER AN IMNOTTON TO THAT LAW, T11E E�CEMFTIOTI�AL�OWS YOU.AS ITM:OWNER OF YOUR PROPERTY.TO ACT AS YOUR OVvrNCONTRACTOR CVENTI-TOU01-1 YOU DO NOT IIAVE A LICENSE. YOUMLIS SUPERVISE IME QQNSMUCDON YOURSELF, YOU MAY BUILD OR RVIPROVE A ONE—OR TWO 17ANTILY RESIDENCE OR A FARIM OUTBUILDING, YOU MAY ALSO BUI�D OR 1M.PkOVE A COM]VfERCLAL BUILDING AT A COST OF$25.000.00 OR LESS, nl&�� M-UST BE FOR XQL2 QS - OCCUPANCY, IT MAY NOT BE BUILT FOP,SALE OR LEASE, IF YOU SELL OR LEASE A 301LOING YOU RAVE BUILT YOURSELF WITTLIN ONE YEAR AFT7R ITT, CONSTRUCTION IS CONIPLETE,-n-JE LAW WILL PRESUNE THAT YOU BUILT IT FOR SAI-C Oit LEASE, WIECH IS IN VIOLATION OF TTUS E)CENIPTION, YQQ blay NQJ =AN UNLIMSED PERSON AS YQUR CONMUM YOUR CONSTRUC-nON MUST SC DONE ACCORDING TO TTIE BUILDING CODES AND ZONING RCGULATIONS, IT IS YOUR RESPONSIBUITY TO MAKE SURE niAT PEOPLE EMPLOYE12 5X XQU HAVE LICENSES REQ.0 Q BX SIAIE—LA3M 4ND BY COUNTY OR MLNICIPAL LICENSING ORDINANCES. 11. INJURY LIABILITY; SINCE Q_VVj1gR5_M BE LIABLE FOR INJURIES TO WORKERSTHEY HIRF_ THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOYO THE�R IMPROVEMENT TRADES, IV, PZTY; W&CENSED, CONTRACTORS CANNOT BE EMPLOY�Q_V.NDER ANY CIRCVMSTANQE$, OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO, 455-228(1)� AN-0,C � . CUPATIOAL LICENSE' 1�NOT ADEQQATE, 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 � COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. js�(o ADDRESS PHONE NUMOER PRIIIIN NAM C 5A T F -72 J SIGNATURE 13010MMOthIS dayQr inthecountyor Duval,Stato of riodda,�o%porionally o0ponrod heirin by hlrmsoir/hamlolf and a0ma that all statements and declarallona tire Iriza and accurate. Notary Publlcot�orgo,Stoic of FL Couny of Z'-XV 0- 1 ZACHARY HANSFORD ',;�y P(, T I (3 Ilmdutud Idenlintallom- MY ()MMISSION#DD968967 E IRES:MAR 09,2014 XP I surance state�j NotarySIgnaluro'. Bonded through IS* r City of Atlantic Beach APPLICATION NUMBER �S � Building Department (To be assigned by the Building Department.) r 'V800 Seminole Road 2 C� S-) /3 J 1 Q / air Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-58 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us �oy APPLICATION REVIEW AND TRACKING FORM Property Address: J 3� �j a V� ment review required Ye No :ingApplicant: Q f(' //f ning &Zoning Tree Administrator Project: Q ye Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other gency 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: QApproved. ❑Denied. (Circle one.) Comments: BUILDING PLAN NTNG Reviewed by: /`%� Date: 7-/y-/ .� TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09