72 W 14th St 2013 Shed CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003554 Date 10/24/13
Property Address . . . . . . 72 W 14TH ST
Application type description SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2000
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Application desc
8 x 12 shed
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Owner Contractor
------------------------ ------------------------
INMAN, DEVON OWNER
72 W 14TH ST
ATLANTIC BEACH FL 32233
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Permit . . . . . . ACCESSORY STRUCTURE NEW RES
Additional desc . .
Permit Fee . . . . 60 . 00 Plan Check Fee 30 . 00
Issue Date . . . . Valuation . . . . 2000
Expiration Date . . 4/22/14
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*CALL FOR FINAL INSPECTION WHEN SHED COMPLETE AND ANCHORED
TO MEET 120MPH WIND LOAD.
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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
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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 54 . 00 54 . 00 . 00 . 00
Grand Total 144 . 00 144 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION D �(
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 OCT 21 2013
Office (904) 247-5826 Fax(904) 247-5845
Job Address: -2,23-3 Permit Number:
Legal Description Parcel#
Floor Area of q. t. 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/pro osed structure(s)(circle one):. Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: 8 X 12, AAETA G Wo QD P2PAiAT QS*Eb.
Property Owner Information:
Name., 1/2\/911 -TeX(YkCul- Address: _7 cC �fV e3�
city f?? State-Uip 2Z-3'�Phone S %
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS: ;
Company Name: Qualifying Agent:
ent:
Address: city
Office Phone Job Si / er
State Certification/Registration#
Architect Name&Phone# CITY OF ATLADMr- REACH
Engineer's Name&Phone# SEE PERMITS F NAI
Fee Simple Title Holder Name and Address REQUIREMENTS AND COND
Bonding Company Name and Address
Mortgage Lender Name and Address DATE—44)
RIQ
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod of six 6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,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 FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that I have read and examined this application and know the same to be trite and correct. All provisions of laws and ordinances governing this
type o 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 other federal,state, or local law regulating construction or the performance of construction.
�ti� �k U `�1"('"C�Signature of Contractor
Signature of O _ gn
Print Name V-w-,\ l cf-V_SLn-._..
Print Name
.................................................................
Befor
e Before me
thisa of 20 13 this Day of - 20
r r"J lc
Nota lic
*. ._ AY COMMISSION N DD 957760
—7 � x ., ,a EXPIRES:February 14,emRevised 01.26.10
�, V ��;p���4;,•' Bonded 7hru Nntary public Underwriitters
CITY OF ATLANTIC BEACH !
� FILE COPYE
OWNER / BUILDER AFFIDAVI' `
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 THE CONSTRUCTION YOURSELF YOU MAY BUILD OR IMPROVE A ONE-OR
TWO FAN 1LY 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 FORYOUR 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 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. 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(1). 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.
-79:\n; 141' �1,��-l' S �t t-006 0
ADDRESS PHONE NUMBER
PRINT (
NA RE �+ DATE
Before me this 1 day of �/ 20 the county of
Duval,State of Florida,has personally appeared herin by himself/herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of PL County of
❑Personally Known �A 71 -714 1 A q/
�cluced Identification- �(/ /(1
a "Py,, SHIRLEY L.GRAHAM
* *_ 1Y COMMISSION#DD 95776r
Notary Signature: a-` EXPIRES:February 14,2014
BondedThruNotary Public Underwriter
F:BLDG/Owner-Builde Affadavif REVISED: 4/1612109
MAP OF SURVEY 'S _- - - -
" BOUNDARY " `
FILE COPY ' f.'
7 �
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DESCRIPTION:
THE EAST 25' OF LOT 3 AND THE WEST 6. 25 ' OF LOT 2 IN BLOCK 56
OF " SECTION "H" ATLANTIC BEACH" ACCORDING
TO THE PLAT THEREOF AS RECORDED IN PLAT
BOOK 18 PAGE 34 OF THE PUBLIC RECORDS OF
DUVAL COUNTY, FLORIDA.
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CERTIFIED TO AND FOR THE
EXCLUSIVE BENEFIT OF:
DEVON IMMAN
SUNSHINE TITLE CORPORATION
FIRST AMERICAN TITLE INSURANCE COMPANY
ADDRESS: 72 WEST 14TH STREET
N
I HEREBY CERTIFY THAT THE MAP OF SURVEY SHOWN
SURVEY NOTES.' HEREON IS IN ACCORDANCE WITH THE TECHNICAL
STANDARDS AS SET FORTH BY THE BOARD OF
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1. City of Atlantic Beach APPLICATION NUMBER
Building Deparbnent Cfro be assigned by the Bu�9 )
800 Seminole Road �Ir�
Atlantic Beach,Florida 32233.640 Oct y
Phone(so4)247�82s = Fax(so4)24�- 4s 2 '?0)13 oar.
.....
E-mail: binding-dept@coab.us
City web-site: httpJ/www.coab.us \
APPLICATION REVIEW AND TRACKING FORM
Property Address: 72- nt review required Yes No
Applicant J�j 22 8 Zoning~-
Tree7khTnktiaWr
Project 9X 12=
r�c�Jtilit3
u
Fire Services
Review fee Dept Signature
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: 6Approved. []Denied.
i
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by,-z&==.-Da: O
TREE ADMIN. Second Review: [,Approved as revised. ODenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. [Denied.
Comments:
Reviewed by: Date:
Retidsed 05R4AM9
3' lF City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Bu&ft Depwknwi.)
800 Seminole Road
Atlantic Bim,Florida 32?.33- W
Phone(904)247.5826 : Fax(904)2475845
E mail• bur7dirng4epQcoab.us Orate nested:
City web-site: http:/A~coab.us
APPLICATION REVIEW AND `RACKING FORM
Property Address: /z DqAW*nent review required Yes No
Applicant da) y &Zonin
ree min
Project ,
Fins Services
Review fee Dept Signature
rDivision
Agency Review or Permit Required Review or Receipt Date
Of Permit Verifted
Dept.of Environmental Protection
Dept.of Transportation
s River Water Management District
orps of Engineers
of Hotels and Restaurants
of Alcoholic Beverages and Tobacco
Other.
APPLICATION STATUS
Reviewing Department First Review: �Appnoved. [Denled.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed Date: o
` 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 05H4W
rs1Fn City of Atlantic Beach APPLICATION NUMBER
Building Department (ro be assigned by the Building DeparUr nt)
800 Seminole Road 445
Atlantic Beach,Florida 32233-6
Phone(904)247-5826 Fax(904)2475845 /O 2 .1
E-mail: bui�ng-dept�Oab.us 0a /
City web-site: hV1ANww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address• 2—LN �`� �� DeRaronent review required Yes flo
Applicant &Zoning
r+ee n r
Project Z2_ SJ7'i A
lits
u ty
Fire Services
Review fee Dept Signature
Other Agency Review or Permit Required Review]
eor Receipt
of Peerrmmit 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: Approved. ❑Denied. j
(Circle one.) Comments:
B ILDING
PLANNING &ZONING Reviewed by: Date:-/0 'o?!-,2013
TREE ADMIN. Second Review: ❑Approved as revised. F]Ifinfed.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05M4M
City of Atlantic Beach APPLICATION NUMBER
`r Building Department (To be assigned by the Bu&ft DW*rie s
i 800 Seminole Road r
. Atlantic Beach,Florida 322332445 y
Phone(904)247-5= Fax(904)247-5845
E mail• buiIding4Wt@ooab.us Dade muted:
City web-site: http:/Mww.c:oab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 7Z1,A) `� '� nt review required Yes No
Applicant: &Zoning
�l nee minrstr�r
Project z 2- 1, tic W
u tic_�Itifiti
l�ub` 6fety
Fire Services
Review fee$ Dept Signature
Emy
gency Review or Permit Required Review or Receipt Date
of Permit Yeritied
ept.of Envimmental Protection
ept.of Transportation
s River Water Management District
rps of Engineers
f Hotels and Restaurants
f Alcoholic Beverages and Tobacco
APPLICATION STATUS
Reviewing Department First Review: proved. Denied.
(Circle one.) Comments:
1 ' _ i
BUILDING
PLANNING&ZONING Reviewed by*Z ) Date: d.
TREE ADMIN. Second Review: OApproved as revised. ®Denied.
RKS Comments:
PU IC L ES
PUBLIC AFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. []Denied.
Comments:
Reviewed by: Date: