675 Sailfish Dr 2014 Shed ?it ' '1r
CITY OF ATLANTIC BEACH
y 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000179 Date 2/18/14
Property Address . . . . . . 675 SAILFISH DR
Application type description SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2375
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Application desc
10 X 14 SHED
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Owner Contractor
------------------------ ------------------------
RIPPLE, MINA O OWNER
675 SAILFISH DRIVE
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
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Permit . . . . . . ACCESSORY STRUCTURE NEW RES
Additional desc . .
Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50
Issue Date . . . . Valuation . . . . 2375
Expiration Date . . 8/17/14
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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
STATE DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 65 . 00 65 . 00 . 00 . 00
Plan Check Total 32 . 50 32 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 101 . 50 101 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
f
^ CITY OF ATLANTIC BEACH
a �
.: ;
OWNER A 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 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 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.
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
111. 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.
6
0� � 7 .. oZ�l�
ADDRESS PHONE NUMBER
' /06
PRINT NAME
94AWe<__— a/ 6 � -
SIGNATURE V1 DATE
Before me this 16 day of FT01k> ,20�gin 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 �/ County of p .k'V W
Q Personally Known P4-" f L4 O "S SLI S) 45 O 1
roduced Identification- 1 , H`•�:"!%: JENNIFER WALKER
MY COMMISSION t FF 011480
EXPIRES:W Apri4 2017Bonded Thru Notary PublNiC UnWnvrkers
Notary Signature:
F:BLDG/Ownu-Builder Affada REVISED: 4/16/2009
< WARNING
2EE ED
Pulling an Owner/Builder Permit iS RiSkV Business.
If you do not intend to do the work yourself and have been asked by
someone without a contractor's license to pull the permit,you are at risk of
financial harm.
Section 489.103 (7),Florida Statutes requires that when property owners
act as their own contractor,they must supervise the work being performed.
Any person working on your building who is not licensed must be employed
by you,which means that you must deduct F.I.C.A.and withholding tax and
provide workers'compensation for that employee.
Without workers'compensation insurance,you could
be held liable for injuries incurred on your property.
Typically,your homeowners'insurance policy will
not honor your claim if the work being performed
required a licensed contractor.You could end up •
responsible for thousands of dollars of medical bills.
t
Not only is it dangerous,but it's against the law.
Section 455.227(1)(j),Florida Statutes prohibits any person from aiding,
assisting,procuring,employing or advising any unlicensed person or entity.
Individuals who aid unlicensed persons may face fines of up to $5,000.
rg
Is it worth UP
f" For more information,speak with your local building Florida Departrnent4
department before you apply for a permit or contact the Busines����
Department of Business and Professional Regulation at PfOfeSSlrk
850.487.1395 or online at www.MyFloridaLicense.com Regulation
,,.. License Efficiently.Reyulele Fairly.
d
BUILDING PERMIT APPLi%.,.
CITY OF ATLANTIC BEACH t FILE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 675 S ,Sly►;i e Ski n;- ��Permit Number: L� r q
Legal Description�O -(PO 3 S 'v25 ' E% K/)4W ,��r 4S til,'f/Parcel# 6
_ 00 Floor ea o q. t. Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled C
Class of Work(circle one): 1e Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/propposed structure(s)(circle one): Commercial es;ide l
If an existing struc}ure,is a fire sprinkler system installed?(Circle one): s No N/A
Florida Product Approval# Ind(A
For multiple products use product approval form /
Describe in detail the type of work to be performed: /U X/y JCA �ed f e Ifr)an a f ac fol?cl
Property Owner Information:
Name: M;N A lZ; PP/z- Address: 67 S Skd ri S,4 ))A-
City
City Af Am x- Z-_1, State ELZip,3223 3 Phone 69cO -21/?-1$l r
E-Mail or Fax#(Optional)
Contractor Information:
Company Name:_ _ _ Qualifying Agent:
Address: City State Zip
Office Phone Job Site/Contact Number Fax#
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 a permit to do the work and installations as indicated. I cert that no work or inhas commenced prior to the
issuance o�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 f work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a perrod of sur6)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,eta
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
r
COMMENCEMENT.
yam _.. d
I hereb certify that I have read and examined this plication and know the same to be true and corn t. All provisions of laws and ordinances governt this
type ojYwork will be complied with whether spec;ied herein or not. The granting of a permit d snot presAe to a auth i to o ate r cance he
provisions of any other federal,state, or local law regulating construction or the performance of co !ruction. ��/ � �
L------
Signature of Owner Signature of C6nitueteF4_-. -
Print Name 1i�� ._ _�. , .1.. ......._ Print Name
Sworn to and subsc ' d fore me,, 01 Sworn to and subscribed before me
thisj Day of this Day of .20
CHRISTINA M.CNAIM 111 M
IV,W,
Notary Public•SpN M FWW
N blic MyComm. a 2017 otary Public
Commission I FF 065971
Revised 01.26.10
City of Atlantic Beach APPLICATION NUMBER
Building Department ,To be assigned by the Building Department.)
800 Seminole Road C�
r� Atlantic Beach, Florida 32233-5445 I L4— [ 1 q
Phone(904)247-5826 • Fax(904)`247-5AE6
9? E-mail: building-dept@coab.us Date routed: -2-1(o
City web-site: http://wvvw.coab.us $Y, LL
APPLICATION REVIEW AND TRACKING FORM
Property Address: �� t�ri De ment review re uired Yes No
Building
Applicant: 'yr annin &Zoning
Tree Administrator
Project: Works
Publ
icUtl
Public 77ety
Fire Ser\foes
Review fee $ Dept Signature
9
Other Agency Review or Permit Required Review or Recc pt Date
of Permit Verified_PL_
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
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:—�� Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie
1
P B WORKS Comments:
U LIC UTILITIES
Z—/ ► �
PUBLIC SAFET Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
�s Building Department (To be assigned by the Building Department.)
r 800 Seminole Road
j � Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 i7
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (Q—I15 3 ]L 1 L>-, De241
tment review required Yes No
Buildin
Applicant: '�1 annin &Zoning
Tree Administrator
Project: Works
Public Utilitie
u is Safety-
Fire Services
Review fee $ Dept Signature
Other Review or Permit Required Review or Receipt Date
of Permit Verified B
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: proved. ❑Denied.
(Circle one.) Comments:
�
Ok.r�-�'v- �3�, Idyr l� ;(f �duu,f Nvf A4-hi�- nuc �
=DI
PLANNING &ZONING
Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denie .
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
rsas*.awrCity of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
r� Atlantic Beach, Florida 32233-5445 L4
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: �J
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (0-1,5 '��/ 1 �► De ment review re uired Yes No
Building
Applicant: annin &Zoning
Tree Administrator
Project: Pu Utilitie
PubTic Safety-
Fire Services
Review fee`$ Dept Signature
Other Agency Review or Permit Required Review or Receiptof Permit Verified_B 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: 04a,5/roved. ❑Denied.
(Circle one.) Comments: 1• �" r am A�1 ;C
BUILDING J I I
PLANNING &ZONIN Reviewed by: Date:
,2/11 ho
TREE ADMIN. Second Review: []Approved as revised. ❑Denis
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
City of Atlantic Beach APPLICATION NUMBER
Building Department RECEIVED (To be assigned by the Building Department.)
800 Seminole Road Q
Atlantic Beach, Florida 32233-5445 `'4 J ` -1
Phone(904)247-5826 • Fax(904)2 7-5845FEB 0 7 2014
E-mail: building-dept@coab.us Date routed: `
City web-site: http://www.coab.us BY: —
APPLICATION REVIEW AND TRACKING FORM
Property Address: (0—IJ5 �,� t�+� De ment review required Yes No
(- Building _
Applicant: nning & Zoning
Tree Administrator
Project: Works
Public Utilitie
Fu- is Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Recei :_ Date
of Permit Verified B
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:
APPI,ICATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: []Approved as revised. ❑Denie.
PUBLIC WO KS Comments:
PUBLIC UTIL S
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [-]Approved as revised. ❑Deniz
Comments:
Reviewed by: Date.-
Revised
ate:Revised 05/14/09
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t 1-1
5wau:5boro.GA 30=01 Fngineerlog&Construction Planning
Mzor--,T 71UM119M
17- 12EN7.7.4
DATF:WL-h 271%1.2012
i
STATE Of FLORIDA
DEPARTMENT OF COMMUNITY AFFAIRS
-N61Caf9d to Making Florida a better pt$ae to tali homo`
CHARLIE CRIST
Governor THOMAS 0.PELHAM
Smuatary
November 08, 'Celt!
Donald Flanders
Handl-tiouse Manufacturing Company
P.O. Drawer B30
Swainsboro,GA 30501
RE_ Manufacturer Certiflcatlon, ID MFT-178; Expiration Date: November 16. 2413
DCar Donald Flanders
It IS my pleasure to lnfgrm you that Handl-Hnuse Manufacturing Company, Located at 74%IlWY 1
SOUTH,P O BOX 830, SWAINSBORO,GA 30401, has teen approved under the Maiwfactur
Buildings Program, as provided for Under Chapter 553, Part f, Florida Statutes,to manurar:ure
Storage Sheds, Manufactured Buildings for Installation in Florida.
Construction or modification on 5 manufactured building cannot begin until the Third Party
Agency has approved the plans In accordance with the current Florida Building Code. Your Third
Party Agency Is a Contractor for the Detiartment and has statutory authority and mspon::ibJl ties
that must be met to maintain approved status. You may expect and dernand quant{plans
review and inspections.
FaCh Code change will make your pians obsolete until they have been reviewed, approved a�Ed
indicated(on the cover page of the plans]for compliance with the Code by your Third Fortylll
Agency for plans review.Please ensure that your plans are In compliance and are properly
pasted On our website.All site-related 4151,3llation issues are subject tD the focal authority
having jutIsulction,
-The Department's contractor will make unannounced monitoring visits at least once each year-
You must grant complete access to your manufacturing facility and records to remain In
complinrtcr with the rules and regulations of this program,
Your certincation is approved for three years from thin date-You will recerve a renewal notice by
Email generated by the 50S(1Nw.W.flgr(r4rbuf!q!ng.Orct) for online renewal. if you have questlUnS
you may Contact me or t,eola Baldw€,t of 650-921-0956 or our FAX at 850-414-8436.
Please visit our web9lte at wwwJ)qrldnb1siJ 1i1g.cjrg to see valuable informatton on the FlOr ld
Manufactured eunoings Program A copy of the letter must accompany applications for€oca
building permits.
i
Sincerely,
Robert€..oren2o
Manufactured Buildings Pmgr-dM
cc:National Design and inspection, Inc.
2564 SHUMARO OAK BOULEVARD I TALLAHASSEE, FL 33399. 2100
050-488 8486 (g) a 850,921-0781 (f) s We b s i I ri wwrr,dter s 0_us
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