717 Triton Rd (vault) CITY OF ATLANTIC BEACH
ILDING
DEPARTMENT OF BUI - Tel. (904) 247-5826
800 Seminole Road -Atlantic Beach, A 32233
ROOFING PERMIT
LOCATION lNF
R ON IKIIU
PERMIT I dress: 1-11 11""1 u L 32233
P rmit Number: 20641 ATLANTIC BEACH, F Book:
e Permit Type: RE-ROOF Township: Range:
Class of Work: NEW Lot(s): Block: Section:
Proposed Use: SINGLE FAMILY Subdivision: ROYALPALMS
Square Feet: Parcel r:
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Est.Value' P r I F 1:�R_ M AT 1-0—W
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3,000-00 —Na n je- —DILLARD, HO ER
improv. Cost:
9/18/2000 ress
Date issued; Address: 717 TRITON ROAD
Total Fees: 30-00 ATLANTIC BEACH, FL 32233
30-00 P 0
Amount Paid: Phone: (9041221-3001
Date Paid: 9/18/2000-----
OF— ______S0_-00
�w �i�6_e��c APPL
ICATION FEES
PERMIT
A_(S)
PROPEK I Y UMMMM
ln��tio�nsft�quired
NOTICE - INSPECTIONS MUST,BE REQUESTED AT LEAST 24 HOURS PRIOR TO INSPECTION
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 LIEN LAW CAN RESULT IN THE PROPERTY
OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJECT TO REVOCATION
FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW.
$30.00 14
Receipt: 00900.-6
Date: 9/19/00 01
Clz�y OF IALANTTICC B qN
08100003221000
CITY OF ATLANTIC BEACH
ROOFING PERMIT APPLICATION
AI-L A L
JOB LOCATION: 717 t7�2
OWNER OF PROPERTY: 11,:� a TELEPHONE::J-"1/_300
CONTRACTOR: OUJA)'e "'
CONTRACTOR'S ADDRESS:
—ZIP:
STATE LICENSE NUMBER: TELEPHONE:
DESCRIBE WORK TO BE PERFORMED:
VALUATION OF PROPOSED CONSTRUCTION
1�
MATERIALS TO BE USED: kl.,—VA
SIGNATURE OF OWNER:
SIGNATURE OF CONTRACTOR:
DAY
SWORN TO AND S UBSCRIBED BEFORE ME THIS
"o .",
Patricia Amonette
S
MYCOMMISSION# CC947012 EXPf S
AS TO 0" A., - August 27,2004 —
BONDED THRU TROY FAIN INSURANCE,w- NOTARY PUBLIC
SWORN TO AND SUBSCRIBED BEFORE ME THIS_DAY OF 119
AS TO CONTRACTOR NOTARY PUBLIC
Liability Insurance Supplied
Workers Compensation Insurance Supplied
Contractor License Information Supplied
Occupational License Information Supplied
CITY OF
ge4d - 5&ud4 800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233-5445
-------- TELEPHONE(904)247-5800
FAX(904)247-5805
SLINCOM 852-5800
CHAPTER 489, FLORIDA STATUTES, PART I 'CONSTRUCTION CONTRACTING" REQUIRES OWNER/BUILDER TO
ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT FOR SECTION 489. 1 03(7), FLORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTION TO ISE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT
UNDER AN EXEMF-rlON 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 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 IS COMPLETE, THE LAW WILL PRE:SUME THAT YOU BUILT IT FOR SALE OR
LEASE, WHICH 15 IN IAOLAT10N 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. �r is YOUR
RESPONSIBILITY 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 IMF'ROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY
USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER $2,0(:)(:)) BE UNDER A BUILDING PERMIT AND PASS
ALL NORMAL INSPECTICNS� THE ORDINANCE STATES OWNERS MAY PHYSICALLY 00 WORK THEMSELVES; OR MAY HIRE
UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER "DIRECT SUPERVISION Or THE OWNER, WHO MUST 13E ON
THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THis DO— NOT ALLOW USE Or
UNLICENSED CONTRACTORS.
SINCE OWNERS MAY BE LIABLE: FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPAR-rmE:NT SUGGESTS
WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE: POLICY CLEARLY PROTECTS
THE OWNER. OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE: IRS WITHHOLDING TAX ANO/OR
FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY. CIRCUMSTANCES- OWNERS BEING SUBJECT
TO $5,000 PENALTY UNDER FLORIDA STATUTE No. 455-2260). AN "OcCUPATIONAL LICENSE" IS NOT ADEQUATE.
THE OWNER SHOULD PHYSICALLY SEE: THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFir-ATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247-
5826) IF IN DOUBT.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH
THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDFR PERMIT.
,4 R'0')*EOWNER/BUILDER
ADDRESS TELEPHONE
SWORN TO AND SUBSCRIBED BEFORE ME THIS D F
RY PUBLIC
Patricia Amonette
ISSION# CC947012 EXPIRES
mycomm
NOTE: PHRASES UNDERLINED ABOVE: MY COMMISSION EXPIRES:
Augult 27,2004
ARE EMPHASIZED BY THE BUILDING BONDED THRU TROY FAIN INSVRANC�INC,
DEPARTMENT.
'k-3 0
CITY OF
716 OCEAN BOULEVARD
P.0.BOX 25
ATLANTIC BEACH,FLORIDA 32233
TELEPHONE(W4)249-2395
March 15, 1991
CERTIFIED MAIL
RETURH RECEIPT REQUESTED
Mr. Homer L. Dillard
717 Triton Road
Atlantic Beach, FL 32233
Dear Sir:
At the request of the tenant at 53 Lewis Street, I have
inspected the property and found the following:
1. Septic tank is caved in and allowing fumes to escape and
rain water in.
Section E105. 4 of the Standard Plumbing Code requires septic
tanks to have a cover supporting not less then 300 pounds per
square foot.
2. The hot water heater was not working.
Section 301. 3 of the Standard Plumbing Code requires an
adequate source of hot water for each living unit.
Please contact me at 249-2395 between the hours of 9:00 a. m.
and 5:00 p. m. to schedule an appointment to address these
problems. If I have not received any communication from you
within 10 days from today's date, the City will proceed with
condemnation of 53 Levis Street.
Sincerely,
Don C. Ford
Code Enforcement Officer
CDF/pah
cc: City Manager
City Attorney