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335 4th St 2014 library to garage CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000189 Date 2/14/14 Property Address . . . . . . 335 4TH ST Tenant nbr, name . . . . . . FL 158S3 Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 1699 ---------------------------------------------------------------------------- Application desc CONVERTING LIBRARY BACK INTO GARAGE (GARAGE DOOR) ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GRANT, PEGGY OWNER 335 4TH ST ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 501-3962 --- Structure Information 000 000 COVERT LIBRARY TO GARAGE Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Plan Check Fee 30 . 00 Permit Fee . . . . 60 . 00 Valuation . . . . 1699 Issue Date . . . . Expiration Date . - 8/13/14 ---------------------------------------------------------------------------- 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 60 . 00 60 . 00 . 00 . 00 Plan Check Total 30 . 00 30 . 00 . 00 . 00 other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 94 . 00 94 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. a-LA BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH FEB 0'1,H14 FILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 3 5 Office (904) 247-5826 Fax (904) 247-584 __]B yS4-1 y" Job Address: Permit Number: t-7 Legal Description Floor a of -S Parcel# hq.Ft. �'q Valuation of Work Proposed Work eated/cooled n�n-heated/cooled Class of Work(circle one): New Addition CA(terat_i"on_,� Repair Move Demolition pool/spa window/door Use of existing/pro osed structure(s) (circle one): Commercial �it i a lNi' N/A If an existing structure installed? (Circle one): (Yes No Florida Product p Val 1i For multiple prosuc use Oroduct appro I form le tv e C�C, Describe in detail the type of wor to be performed: r(,Nro )c Property Owner Information: 06 Q 1__�+ Address- 3S f_ LA*Fl� Name: tt_QQ�\l (�(_ 13 �> Phone clt!!L� ce-e Lc (2 M. City t4m,)-yd. 6tQ_C�-� State Zip E-Mail or Fax# (optional) M\1 C 0 Contractor Information: Company Name: Qualifying Agent: Address: city State Zip Office Phone Job Site/Contact Number Fax 9 State Certification/Registration 4 Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Ap ca here made airn a e r d he work and n a a n ndicgd 'certify that no work or installation has commenced prior to the ' t ' 0 Isa law e a ng construction in this jurisdiction. This permit becomes null I s ti s s ' �de dt or abandonedfor a period ofsix months at any time after l mit to 0 0 t tom tt standard 11 s y to 10't k p be ed he io f r'h" or Z, nstr cton or ork is s' Arnaces,Boilers, Heaters, 'r, t f (6 n P'i it and that a 1 0 P) 0 i t 0 crd or0E ect'Ica ork Plumbing, Signs, Wells, Pools, ".'c'0 a Per_ d thin', d' d f work is not co.'e ce ' t " is'o me c, I , "s , t, p , p r, s m. w" k m n d d ta d tha e a ate e b e 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. I here 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 Vlwo,rk will be complie ith whether specifie erein or not. The granting of a permit does not presume to give authority to violate or cancelthe provi.si ons of any otherfede 1, tate, or local law r 1 ing construction or the performance of construction. Signature of 0 r I Signature of Contractor �AA KR Print Name ......................................................................................................................................... Print Name I.,............6 r.-.9 ** ?.5,Ro ri d bef e me z %worn to and subscribed before me Sworn to and subs )e 20 or Day of this Day of P.0 1his #FF 005815 ota Public Notary Public &ncW '0 Revised 0 1.26.10 ""I,�866 SIN!- 1011111,11410 z 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 I-LAVE APPLIED FOR A PER1v1IT UNDER AN EXEMPTION TO THAT LAW. TBE ENEMPTION ALLOWS YOU,AS TEE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT RAVE A LICENSE. YOU MUST C-z SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR EVIPROVE 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. TBE 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 13UILT YOURSELF WITIIIN ONE YEAR AFTER TILE CONSTRUCTION IS COMPLETE, THE LAW WELL PRESUME TRAT YOU BUILT W. IT FOR SALE OR LEASE,WIUCH IS IN VIOLATION OF MS E)KEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR- YOUR CONSTRUCTION MUST BE DONE ACCORDING TO TBE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU RAVE 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, ei 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 PENAL TY 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. S J41-A af I-u--+ 19(.P DSS f" PHONE NUMBER C ( C In P INT E r r OW SIGNA(Wj D)t�_IE a jaA day of3-&a(aoj ,oAn the county of Before m this A K R ��4rjr** Duval,State of Florida,has personally appeared'herinly himself/herself and affirms that ,e� all s'tatements and declarations are true and accurate. 0 Vz �V o*45SIONe Notary Public at Large,State of-/4 Countyof,5i—- h nr ?.5 ,20 KPersonally Known P "Produced Identilicatilon- #FF oo5815 % to& Notary Signatulz�� t arj�0_106 lz� 0 F:/BLDG/0�er-BuilderAffadavi�REVISED:4/16/2009 /C S1 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: - http://www.coab.us City web-site. APPLICATION REVIEW AND TRACKING FORM Property Address: -DepWment review required Yes 'No '---) Building") 17 Applicant: _FIanning &Zoning Tree Administrator Project: Public Works Public Utilities Q9 rcl� IX c Public Safety 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: APPLI,CATION STATUS Reviewing Department First Review: [g/Approved. E]Denied. (Circle one.) PLANNING &ZONING Reviewed by: Date:,2- /2- -/15—/ TREE ADMIN. Second Review: F—]Approved as revised. nDfnied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: E]Approved as revised. [:]Denied. Comments: Reviewed by., Date: Revised 05114/09