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342 19th St (vault) CITY OF ATLANTIC BEACH PLAN REVIEW SHEET tie Building Department Public Works&Public Utilities Departments S. D r 800 Seminole Road 1200 Sandpiper Lane Car er Atlantic Beach,Florida 32233 aiuzni Atlantic Beach,Florida 32233 ip t a ety (904)247-5800 (904)247-5834 6 1 Jax Fire dept.. (904)247-5845 Fax (904)247-5843 Fax rol J ax PLAN REVIEW COMMENTS Permit Application# '0 '0 Property Address Applicant: A/ Project: Review Result (Circle o; :IA ;�2 Disapproved Approved w/Conditions c Review Initials/Da;e L—f Development Size: Habitable Space_ Non-Habitable Impervious area Total Area Miscellaneous Information : Occupancy Group _Type of Construction Number Of Stories Zoning District -# Parking Spaces Max. Occupancy Load_ Fire Sprinklers Required Flood Zone ILI V- n Conditions or Comments: 111 11��L"v Building Dept, Public Works and Utility information at top of page, failure to notify the correct department of your revisions may delay your permit from being issued. Bu, ILDINI�- PERMIT APPLICATION CITY OF ATLANTIC BEACH IN 6 411 -o' 800 Seminole Road,Atlantic Beach Fl,32233 L/ -5845 Office: (904)247-5826 9 Fax: (904)247 Job Address: . (4y ZRA Permit Number: Legal Description QC)AC, Valuation of Work(Replacement Cost) $ 09 Class of Wo�rk(Circle one): New Addition iteration Repair Circle one): (@�iEmeDrcial RZidential Use of existmg/proposed structure(s) N/A If an existing structure, is a fire sprink er system installed?(Circle one): Is approval of homeowner's association or other private entity required?(Circle one): Yes Describe in detail the type of work to be performe Property Owner Information Lo Name: city 01 Contractor Information: Name of Company: �1)04r Qualifying Agent: Address: city State zip Office Phone Job Site/Contact Number State Certification/Registration# Office Fax# Architect Name&Phone# Engineer's Name&Phone# Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commen,cedprior to the issuance ofapermit and that all work will be performed to meet ihe standards ofall laws regulating construction in thisjurisdiction, This permit becomes null and void ifwork is not commenced within six(6) months, or if construction or work is suspended or abandonedfor a period of six (6) months at any.time after work is its must be securedfor Elearkal Work,Plumbing, Signs, Wells,Pools, commenced I understand that separate perm Furnaces,Boilers,Heaters, Tanks andAir 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. true and correct Allprovisionspf i hereby cert�o that I have read and examined this application and know the same to be laws and ordinances governing this type ofwork wfll be complied with whether specified herein or no,,t. Thegrantin&ofa permit does not presume to give authoriP, to vi late or cancel the provisir, )f ry to"a state, or local law 'o regulating construction or the performance of construction. Signature of Property Owne Signature of contractor: - AM6NAbr6WiNAM Swo lid subscribeAbefore me S subscr Id a 1 this 1�rDay of C;Lo a-7 th, f Nowy Pubk-&o of F Cwaftan Expka Feb 14;,ZUIU S Commfton 0 DD 518533 'OF ota'y ssn , 11 Bonded By National 9NotaryAssn.. Notary Public: N REVISED 03.05.07Lo q-1-o - 76) �3 S-S' Special information for Owner/Builders DISCLOSURE STATENffiNT for Section 499.103(77),Florida Statutes: STATE LAW RE D CONTRACTORS. QUMES CONSTRUCTION TO BE-DONE BY LICENSE YOU HAVF,,A PPLIEED FOR A PER-ACIT UNDER AN EXEAVTION TO THE LAW. The exemption allows you as the owner of your property,to act as your own contractor even through you do not have� a license., You m" t sul3e_rvise the construction yourseff You may build or improve a one-family or two-family residence or a farm olTt-1�1— al building at a cost of$25,000 or lass. lilding_ you may also build or improve a commerei The building must be for your own use and occupancy. Itmay notbe built for sale or lease. Ifyou.sell or lease more ter the construction is complete,.thelawwillpres"m than one building you have built yourselfwithdn one(1)year aft ed r)erson as that you built it for sale or lease,which is a violation of this exemption- You may hire an un-licens your contractor. Your construction must be,done according to building codes and zoning regulations. it is your es Muired by state I and by co1m responsibility to make.sure that the people emPloved by you h licens or municipal licensing ordinances. In addition,the owner must supervise construction and becomes liable and responsible for the employees he/she hires. This responsibility includes,but may not be limited to: 1. Workers Compensation,for workers injured on the job. s and matched with owner's funds. 2. Social Security Tax must be deducted from employee's wage 3. Federal Withholding- Since ownprs must be liable flor injuries to workers they hire,the Building Division sugg: ,es,Ls Workers Compensation policy clearly protects the owner. Owners hiring workers insurance�be puxchased unless the homeowners in-SUrancc become employers and should also observe IRS withholding tax Form 1099 requirements on the workers they employ on their improvement work. anafty under Un-lic6nsed contractors cannot.be employgd under��ffiy circumstances. Owners are subject to a$5,000 p LL�I��se i� Florida Statute 4455.288(l)instigated via Building Division citations. AnocMational-L _ Lnota��et�e� The owner should physically see the county Cerdficate of Competency or the Florida Contractors Certificate To asct;rUuuL person is a licensed contiactor. Telephone the building Division(247-5826�f in doubt. stand all the above on this Day of, C-)q I hereby acknowledge that I have read and under C_ Address CAAmer Builder Signature it 6 Tefephone er Print Name STATE OF FLORIDA. COUNTY OF DUVAL &,ml and to j- ae weR known 'a th-0 ree Before ma personally appearecl owner builder described in and who executed this instniment and severaFy acknowledgedthe execution thereofto be his own f act and deed as such owner builder hereunto authorized. _1V t c Beach"Co L and S&q aforesaid. WITNESS my hand and official seal this c�--'5day of, cB-ach IC'S TE 0 OPJDA NO Co ty a, F _0 ....... SHIRLEY L.GRAHAM print Name: "I�,!_ky�'&" tary blic�b Sta s No Pu te of Florida Nff Co�vMSSION EXPWS: =my qornrn.*io,�'Expires-Feb 14,2010 Co �,�;iono-D051853a _ El Pe onally Known (2A -7q.3 6 S 4ationit Notary Assn. ication: Rondod cWenfif -OAME5 Lo ANO. R- 460, N 10.35 14. 7 ' C" 0 5TOR Co (:pcj/kjA If tll-,::5 14.6 C, 0 IV FILE C�-O P I L/ JL k 7�42 y Z - :04 1079 A.09 ,x., ve W07 R4 Y .9 SAI YVER 0 .46SOCIA r.F-6 qZW07T5 AfEML srvrE PROA-E.651OMW LAA10. SURVEYOR5 Al rl -7 rAf CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 INSPECTION EMAIL REQUEST: 19 Building-dept&gab.11S Application Number . . . . . 07-00000565 Date 5/01/07 Property Address . . . . . . 342 19TH ST Application type description FENCE PERMIT Property zoning . . . . . . . TO BE UPDATED Applicatign -valuation . . . . 0 ----------- ------------- ------------------------------------ -------------- -Application desc replace fence 6ft - ---------------------- --------------------------------------------------- Contractor ------------------------ ------------------------ LONGACRE, JAMES W. OWNER 342 19TH STREET ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/28/07 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 35 . 00 35 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH P PLAN REVIEW SHEET 61�� r Q446Wetlec) Public Works&Public Utilities Departments S. D r Building Department 800 Seminole Road 1200 Sandpiper Lane Car e Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 aluzni (904)247-5800 (904)247-5834 'Wa etv Jax 7ire dept (904)247-5845 Fax (904)247-5843 Fax PLAN REVIEW COMMENTS ` Permit Application 4 0 0 6 5� Property Address 21�4 19 Applicant: JJ AIF 4 Project: A Review Result (Circle one pproved Disapproved Approved w/Conditions Review Initials/Date Development Size: Habitable Space Non-Habitable Impervious area Total Area Miscellaneous Information : Occupancy Group Type of Construction Number Of Stories Zoning District Parking Spaces _Max. Occupancy Load_ Fire Sprinklers Required Flood Zone----- rConditions ! ments: or Com Building Dept, Public Works and Utility information at top of page, failure to notify the correct department of your revisions may delay your permit from being issued. BUIILD' ING, PERMIT APP,LICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 4)247-5826 Fax: (904)247-5845 Office: (90 Permit Number: Job Address. Legal Description Valuation of Work(Replacement Cost) $ 6(f • Class of Work(Circle one): New Additi Theration DiaRepair on ---U I Midential • Use of existingiproposed structure(�s)�Circle one): o—mmere loe��Po N/A ire spri er system installed? (Circle one): • If an existing structure, is a f • Is approval of homeowner's association or other private entity required?(Circle one): Yes Describe in detail the type of work to be performed: C& 00) r Property Owner Information �� p A�ddress�: Sta��Z� Name: k7&� G zip hone C9 city 01 42 Contractor Information: Name of Company: QualiPjing Agent: Address: city State zip Office Phone Job Site/Contact Number State Certification/Registration# —Office Fax Architect Name &Phone# Engineer's Name&Phone# Application is hereby made to obtain a permit to do the work and installations as indicated I c?rtify that no work or ' t Me standards ofall installation has commen!cedprior to the issuance ofapermit and that all work will be Performed to mee risdiction, This permit becomes null and void ifwork is not commenced within six(6) time after work is ns, Wells,Pools, CEMENTMAY WARNING TO 0 YOUR PROPERTY. IF YOU RESULT IN YOUR PAYING TWICE FOR IMPRO TS TO TTORNEY INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN A BEFORE RECORDING YOUR NOTICE OF CO CEMENT. be true and correct. Allprovisions 9f ihereby certify that I have read and examined this application and know the same to grantinj o plied with whether specified herein or not. The,, ra a laws and ordinances governing this type ofwork wfll be com. permit does not presume to give authority to vi late or cancel the provisions bf ai�y other federak state, or loca aw .0 f construction. regulating construction or the performance o Signature of Property ownen�� Signature of Contractor: before me S subscroaMilbr6ROAM S,�o Od subscribeA oa-7 tNbhi f this rXDay of 2!tw 11 Wy Coffaftsion ExpWes Feb V commission#DD 518533 Bonded By National Notary Assn Notary Public: No REVISED 03.05.07wq-2 o - 76) s Speelat Jnfarma--dan for owner/Ruffders DISCLOSURE STATEMM�T for Section 499.103(77),Florida Statutes: DONE BY LICENSED CONTRACTORS. E LAW REQUMES CONSTRUCTION TO BE N k,FPTTO�T To TEM LA�W. STAT N TO THE LA�W- YOU HAVE APPLIED FOR A PFAMU UNDER AN EXEMPTIO The exemption allows you as the owner ofyourprop5rty,to act as your own contractor eventhroughyou do not have� - the constn on vourse.1f. You may build or improve a one-family or-L�vo-familY a licznse.t You Must.S—UPe-1v1Sa me- residence or a farm outb1ii1ding. You may also build or improve a commercial building at a cost of$25,000 or less The building must be for your own use and occupancy. It may notbe built for sale or lease. Ifyou sell Or lease more than one building you have built yourselfwithin One(1)year after the construction is cOMPIeU--,the lav"V-�Jl Preslym that you built it for sale or lease,which isa violation of this examption- You may not hire an un-licensed.person as y Your construction must be done according to building codes and zoning regulations. it is your ��ur contractor. _countY-or responsibility to M&esure that the peaple gMploved by you have licenses Muired by state law and.ty municipal Hcansing ordinances- construction and becomes liable and responsibla for the employees he/she hires. This In addition,the owner must surpamsO responsibility includes,but may not be limited to: 1. Workers Compensation,for workers injured oa the job. s and matched with owner's 2. Social Security Tax must be deducted fi7om employee's wage Lunds. 3- Federal W-Ahholding. Since owners must be liable-Lor ini to workers they hire,rho Building Division sugg ,,ests Workers Compensation insurance policy clearly protects the owner. Owners hiring workers Insurance be purchased unless the homeowners become employers and should also observe M withholding tax Form 1099 reqmirements on the workers they employ on their improvement work. es wne s e su e Un-licensed contractors cannot be em-ployed der qpy cireumstmc . 0 r ar bj ct to a$5,000 penalty under Florida Sttte:9455.289(l)instigated via Building Division citations. An OccupationalLicense is not adeguate. The ate-of Competency or the Florida Contractors Certificale to ascerunn a owner should physically see the county Certific h building Division(2 47-5 8 2 6 y in doubt. person is a licensed contLactor. Telep one the Z- Day of, C�oq .on this I hereby acknowledge that I have read and understand all the abo I ve NAA a ri+I C lg�,- -Z Address 0;v�rner Builder Signature (/ 15uclon Tefophone,Number Print Name STATE OF FLORIDA: COUNTY OF DUVAL to T-a t1- he dual and to ina WOLL K-aumu U -Ind I ree l3efore me,personally appeared reofto b3 his own f owner builder described in and executed this instrument and sev-er�liy acknowledgedthe execution the act and deed as such owner builder hereunto authorized. --rw '� 1 tic Beach-Co L andS!takoresaid. ):)da -ITNE — y of, VV SS my hand and official seal this c; NO 1c,S 1 0 OFJDA "011y...... SHIRLEY L. GRAHAM PrintName: Wary Public,�,Slate of FloNda -XPIRES: My-pqmmimio��Expi�e�Feb 1.4,2010 Nff coNMSSION F ssioh A�b- 51853a - 4 T? 6 -Uy Kno Conlml ona ona, N uVElentification. p Bo.nded B�-Nati I otary Assn. Sw CITY OF ATLANTIC BEACH PLAN REVIEW SHEET Building Department Public Works&Public Utilities Departments S. Do r 800 Seminole Road 1200 Sandpiper Lane Car e Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 aluzni (904)247-5800 (904)247-5834 (904)247-5845 Fax (904)247-5843 Fax '�[ PLAN REVIEW COMMENTS APR 2 7 Zoo? Permit Application 4 '0 V- . 0 � 4 5� Property Address 21�4 19 7P Jr Applicant: �A)A44 Project: Review Result (Circle on4l�� Disapproved Approved w/Conditions Review Initials/Date 0-7 Non-Habitable Development Size: Habitable Space eve'op'r Impervious area Total Area Miscellaneous Information : Occupancy Group Type of Construction Number Of Stories Zoning District # Parking Spaces Max. Occupancy Load_ Fire Sprinklers Required Flood Zone Conditions or Comments: Building Dept, Public Works and Utility information at top of pageg failure to notify the correct department of your revisions may delay your permit from being issued. T -1 �jlj BuILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach Fl,32233 Office: (904)247-5826 9 Fax: (904)247-5845 Job Address. tk ar ZJQ�- Permit Number: Legal Description Valuation of Work(Replacement Cost) $ ---DiaRepair • Class of Work(Circle one): New Addition �Tlieration I • Use of existing/proposed structure(js)&ircle one): Co-mmerc RMdential N/A r. q0e�;�bp • If an existing structure,is a fire spr er system installed? (Circle one): Yes • Is approval of homeowner's association or other private entity required?(Circle one): Describe in detail the type of work to be performed: C& Property Owner Informatio Name: Zip �Addre�ss �S�ta hon city 0( Contractor Information: Name of Company: Qualifying Agent: Address: city State Zip Office Phone Job Site/Contact Number State Certification/Registration Office Fax Architect Name &Phone 9 Engineer's Name&Phone 4 Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commencedprior to the issuance ofapermit and that all workwill beper/ormed to meet ihe standards ofall laws regulating construction in thisjurisdiction. This permit becomes null and void ij-work is not commenced within six(6) d or abandonedfor a period of six (6) months at any time after work is months-, or if construction or work is suspende be securedfor Electrical Work, Plumbing, Signs, Wells,Pools, commenced I understand that separate permits must Furnaces,Boilers,Heaters, Tan"andAir Conditioners, etc.CORD A NOTICE OF COMMENCEMENT MAY WARNING TO OWNER: YOUR FAILURE TO RE 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. visions pf i hereby certify that I have read and examined this application and know the same to be true and correct. Allpro laws and ordinances governing this!ge ofwork wX be complied with whether specified herein or not. Thegrantingofa nf an�y other federal, state� or local raw cel the provisions permit dtoes not presume to give authority to violate or can .Y regulating construction or the performance of construction. Signature of Property owne Signature of Contractor: Swo 4d subscribeAbefore me S Day of -7 thi f Notart State of F a this r�V Public- jmy commission Expires Feb 1�94,,2010 commission#DO 518533 OF I s ,M . Bonded By National Notary Assn Notary Public: No REVISED 03.05.07LO q-2 0 70, Sp,-ejal information for Owner/BIdiders DISCLOSURE sTATFMENT for Section 499.103(7),F lorida Sta±71tes: STATF,LAW REQUMES CONSTRUCTION TO BF ,-DONB By LICENSED CONTRACTORS. yoU aA-V-EA A PPLrF-,D FOR A PFRA11T UN- DFR AN F-xEAJPT1ON TO THF-LkW. The exemption allows you as the owner ofyourproperty,to art as your own contractor even.through you do not have� a liwnse.7 you must su-Datvisa the co.nstruction yourself You may build or improve a one-family or-L�vo-fmily .. also bv2ding at a cost of$25,000 or less. residence or a farm outb-uilding. You build orn' nprove a commercial a uil 0 Lf o sell The building must be for your own us and occupancy.-It may notb b tf rs leorlease. y u or lease more than one building-you have built yourselfwithin ane(1)year after the const�tion is complete,the law will Presurn that you built it for sale or lease,which is a violation of this exemption- You may not Iii an un-licensed Derson as your contractor. Your construction must be done according to building codes zoning M-gulations. it is Your e people employed hy_you have nses required by-state law and.by counW-or responsibility to make sure that th municipal licensing ordinances- In addition, the owner must supemse construction and becomes liable and responsible for The employees heAha hires. This responsibility includes,but may not be linnted to: L Workers Compcmsation, for workers injured on the job. s and matched with owner's 2. Social Security Tax must be deducted fi7om amployea's wage funds. 3- Federal W-ithholding. Ion Since owners must ba liable fior injuriesto workers they hire,the BuildingDivis' sugg ,,,es�Ls Workers Compensation homeowner olicy clearly protects the awner. Owners hiring workers Insurance be purchased unless the s,in&uianca p rea=emmts on the workers they PMploy become employers and should also obsorve 1RS withholding tax Form 1099 on their improvement work. Un-lic6nsed contractors cannot be employed under qny circumstances. Owners are subject'LO a$5,000 penalty under Florida Statute 4455.289(l)instigated via Building Division citations. An Occ-a-p_adopil License not adgqqqte., The owner should physically see the county Cc�rtificate of Competency or the Florida Contractors CartAlcate 10 ascemm a person is a licensed contractor. Telephona the buflding Division(247-5826�f in doubt. Day of, I hereby acknowledge that I have read and understand A the abo ve on this Z- al a Aclaress Cf"mer Builder Signaure Tefcphona Ni er Print Name STATE OF FLORIDA: COUNTY OF DUVAL to MC,well'k—nown Lu ba tl,-c- dual and Before me parsonatly appeared the executionthereofto be his own free owner builder dese.ribed in and w exc caTte d thi s inst,=ent and s ever ally owledged act and deed as such owner buildcr hereunto authorized. '-I?r I I� I tic Beach-'Co L and S��aforesaid. W�f NESS my hand and official seal this,;.)5day of,t1l=J -c,4!1ea,�,1, Cfotyand S' 1c,9 1 0 M ORMA oolyl...... SHIRLEY L. GRAHAM printNarne: Notary Public w State of Florida =My q9Mrnission Expire.s,Feb 14,2010 1N/ff COIVMSSION EXPIRES: El pqj:sonally Known T? Rv onil N t Lion: ._9aq-.Pd , iNat nil oary.Assn. W_ rw - - - - - - - - LO oor4i�o S"o- - ..—TAIMC5 tPNOCOi- OT a too 27 f'V.&.Z 14. 7 ' cl 17 ' 5TORY 7, "V c q 97. 6 9'095077,V. ;4 Y,, 4-4— -0>1079 RA Ys SA f YDER .4 650 CIA 7A FS OAC-AIOTES- AfE7,4L 6r.4ArE 5&-r PROAESSIOMWL LAA149 SURVEYOR5 rip-.1^ jw Or rl :ZJ:t J=A-=7' 1'7 M CITY OF ATLANTIC BEACH 6� PLAN REVIEW SHEET r tler S. Do rr Building Department Public Works&Public Utilities Departments Car e d)JI 19 800 Seminole Road 1200 Sandpiper Lane Atlantic Beach,Florida 32233 Atlantic Beach,Florida 32233 aluzni (904)247-5800 (904)247-5834 U a e t�y (904)247-5845 Fax (904)247-5843 Fax Jax 4FFire dept. PLAN REVIEW COMMENTS '0 '0'6 /0 5' Permit Application 4 Property Address 7;V 1?100,> Applicant: JV�44 Project: Review Result (Circle one): prov Disapproved Approved w/Conditions Review Initials/Date Development Size: Habitable Space_ Non-Habitable Impervious area Total Area Miscellaneous Information : Occupancy Group _ Type of Construction Number Of Stories Zoning District # Parkini! Spaces Max. Occupancy Load_ Fire Sprinklers Required Flood Zone 6�� Conditions or Comments: Building Dept, Public Works and Utility information at top of page, failure to notify the correct department of your revisions may delay your permit from being issued. BuILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH goo Seminole Road,Atlantic Beach FL 32233 47-5845 Office: (904)247-5826 Fax: (904)2 AAA Permit Number: Job Address. Legal Descrip2tiontA U 0-) �-K A-e-, Valuation of Work(Replacement Cost) 0 Class of Work(Circle one): New Addition (TIteration epair 0 re(js)&ircle one): ---Mo—mmerci! RQdential Use of existing/proposed structu . I MeP N/A E ire spr er system installed? (Circle one): Yes If an.existing structure, is a f r (E5 K Is approval of homeowner's association or other private entity required?(Circle one): d- I Describe in detail the type of work to be performed. IS1 I K C& Property Owner Information N CZe Contractor Information: Name of Company: Qualifying Agent: Address: city State Zip Office Phone Job Site/Contact Number State Certification/Registration 4 Office Fax# Architect Name &Phone# Engineer's Name&Phone 4 Application is hereby made to obtain a permit to do the work and installations as indicated I certift that no work or installation has commencedprior to the issuance ofapermit and that all workwill beper/ormed to meet Me standards ofall laws regulating construction in thisjurisdiction, Thispermit becomes null and void ij-work is not commenced within six(6) months, or if construction or work is suspended or abandonedjor a period of six (6) months at any time after work is commenced I understand that separate permits must be securedfor Electrical Work, Plumbing, Signs, Wells,Pools, Furnaces,Boilers,Heaters, Tanks andAir Conditioners, etc.CORD A NOTICE OF COMMENCEMENT MAY WARNING TO OWNER:YOUR FAILURE TO RE 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 certo that I have read and examined this application and know the same to be true and correct. Allprovisions9f iedhereinornot negrantin-aofa laws and ordinances governing this type ofwork will be complied with whether specif a - authoriP, to vi late or cancel the provisions bf any other jedera� state, or local raw permit does not pre,ume to glve , 'o regulating construction or the performance of construction. Signature of Property owne signature of contractor: S subscr0:016[b G—WAM S,�ro Od subscribeAbefore me %r "M this r�rinlay of r1L C�-oo-7 thi f No"Pubk-State of FWWa 14,2 SAy Commission Expires Feb r UIU 0 51853� 0 ry s Commission#DO 518533 OF N Bonded_By National Notary Assn. Notary Public: REVISED 03.05.07Wq-2 o - 76) Informatiala for Owner/Ruflders DISCLOSURE STATEMEI�T for Section 499.103(7),Florida Statutes' STATE LA_ ,V RF ,QUiRES CoNsTRTJCTION TO BE DONE By LICENSED CONTRALCTORS LALW. YOU HAVE APPLIED FOR A PERAUT UNDER AN F—)CEADTION TO THE The exemption allows you as the owner of your property,to act as your own con-tractor even through you do not have a licznse.t You mu t sU1351--vise co qtn cdon vourself Yon may build or imprrove a one-family or t�vo-familY or improve a commarcial building at a cost of$25,000 or lass. residence or a farm outbi 1-ilding. You.may also build n Thebuildin,o,,inustbe,forygurownus and occupancy.-It may not be built for sale or lease. lfyousellor:lease more than one building you.have built yours elf within one(1)Y car after the constructi:on is complete,the law Will pres i un may not hire an un-licensed person as that you built it for sale or lease,which is a violation of this exemption. you Y2U_r contractor. Your construction must be done according to building codes and zoning regulations. It is You- responsibility to make sure that the people employed by you have licenses E�quired by law and bv county or municipal licensing ordinances. In addition,the owner must supervise construction and becomes liable and respGnsibl-for the employees helshe hires- This responsibility includes,but may not be limited to: 1. Workers Compensation,for workers injured on the job.w fu ds 2. Social Security Tax must be deducted fi7om.employee's ages and matched with owner's I n - 3. Federal Withholding- Since owners must be liable_'Lor injuries to workers they hire,the Building Division suggests Workers Compensation irance policy clearly protects the awner. owners hiring workers r lnsurance�be purchased unless the homeowners insu become employers and should also observe IRS withholding tax Form 1099 requirements on the workers they employ on their improvement work. Un-lic&nsed contractors cannot be employgd-under gpy circumstances. Owners are subject'LO a$5,000 penalty under Florida Statute 4455.288(l)ins=dgated via Building Division citations. An Occupational License is not adeqggte The owner should physically see the county Cartificate of Competency or the Florida Contractors Cardficaia to ascertain a I M �f in doubt. person is a licensed contractor. Telephone,the building,Division(247-5826 Dayo�L stand all the above on ffiis QI) I hereby acknowledge that I have read and under -V Zu- ri+I CFwner Builder Signature Address Telephone Number Print Name STATE OF FLORIDA: CoUNTY OF DUVAL and he-4 tO Ede WCLI &UU Vv'I Luuivl_�L Before me�personally appeared ecuted this instrument and s��v_erally-ackaowledged the execution thereofto be his own free owner buildcrdescribed in and who act and deed as such owner builder hereunto authorized. '_"Ir 1 1� I tic Beach-CO L and S&7 aforesaid. WITNESS my hand and official seal this c�:)day 4 , L__1 I 's 0 ORIDA SHIRLEYT. GRAHAM' printNama: C -of]n Notary Publi w State of FWda vMSSION My qqrqrnjs§ion'ExPires Feb 14,2010 ivff col EXPIRES: '0 51853 onaUy Known ss oa Bond,.,d R 14ational,Notary Assn. cWentification: .0�. -TIAM65 L40146ACKE LC) ' j AA10.I 'oe- e,-zr,-v '0W Ir 41 01 Ir Ir, /0.3.0' 14. 7 j7 ' 0 5TOR a. 14.6 e, 7 *4- Irz 139 95 07-k-V go , '465 4 Y�� xwe eFC1YE-CKEO _9e,07. 1079 ROL ea L L R4 Y SAI YVER 0 46SOCIA 7 ES OENOTC5- "Er4L 5r4,WE 5,6;r PROFESSIOMW 1-41V19 SURVEYOR5 =A-=V- 1,7rAf CITY OF ALTANTIC BEACH np COMPLAINT MANAGEMENT SYSTEM TAKEN (date/time) : 3 - 9-a COMPLAINANT: ]Vagt Name First Name MI ADDRESS: CITY/STATE/ZIP: TELEPHONE: -9-V6, COMPLAINT: ly-k 0 407- �5-, LOCATION: PROPERTY OWNERS PHONE: PROPERTY OWNERS NAME: -7- DEPARTMENT FORWARDED TO: COMPLAINT TAKEN BY: DATE/TIME: OFFICE USE ONLY INVESTIGATED: (date/time) jz r-srt PRIORITY: ASSIGNED DEPT. /DIVISION: op Ir INVESTIGATOR: 001(, CONDITIONS FOUND: A I A,*-A A* A-A A ACTION TAKEN: Ao, COMPLIANCE: NOTES: 4106-t.7', /ook-, 4-1 AIRAOTYC BEACH FOR )VAKER CUT-Pf CUT-Illpf, AT P L.0 Clk "PtICCONT XPE., _�7 fiv eL CITY OF ATLZViT_TC nEACH WATER CONNECTION C�VkR Z DIALTE.., &::_ZO owNER 4"// PLUMBING MASTER PLUMBER BUILDER OR CONTRACTOR_ TYPE OF BUILDING l^,2dw BAIRROOM GROUP. CONSISTING OF SHOWER STALT,, DOMMESTIC (2 T,,.,'ATER CLOSET, LAVAtOORY & BATHTU17�. OR SHOWER STALL (6 units) SHOWERS (GROtM.). PER RE-AD (3 units) ' BATHTUB (WITH OR WITHOUT OVER fiviD SHOWER) (2 units) STIRGEONS SINK Unite,) ---BIDET 0 units) FLUSHING RIM SINK (8 units) COMBINATION SINK & TRA'Y SE'AVICE SINN-TRA-P STAND (3 units) (3. units) AO COivOINATION SINK & TRAY W/FOOD SERVICE SnIK-P TF.4P (�2. UnitS� DISPOSAL UINIT (4 units) POT, SCULLERY .SINK (4 units) DENTAL UNIT OR CUSPIDOR (I unit-) URX-NAL, PEDESTAL, SYPHON JET -DENTAL LAVAIVORY ',(I units) BLOWOUT �8 units) DRINKING FOUNTAIN (1/2 unJit) URINAL, WALL LIP (4 units) DISHWASHER (2 units) URINAL STALL, TIASROUTT �4 anits) FLOOR DRAXNS (1' Unit) --URX14AL TROUGH (EACH 2--FT. SE1117T-.. XON, (2 units) KITCHEN SINK (2 units) -WASHING MACIRTNE .(Pr.S.� �3 units ITCHEN SINK W/FOOD WASTE GRI14DER (3 units) WASH SINKI EACH SET OF FAUt-'2TS (2 units) LAvATORY U unW WATER CLOSET, T-XiK OPERATED -L.,A.VATORY, BARBER, BEAUTY PARLOR (4 units) (2 units) rAVATORYr SURGEONS (2 units) WATER CLOSETe VALVE-OPERATED (8 units) LAUNDRY TRAY (2 units) DEPARTMENT OF BUILDING 3930 CITY OF ATLANTIC BEACH, FLORIDA PERMIT NO. PERMIT TO BUILD THIS PERMIT MUST BE POSTED ON JOB Date 12/_41/25._19 - Fee $ 110-00 Valuation$- 49,232 This perunit not valid until above fee has been paid to City Treasurer, and is bject to revocation for violation of applicable provisions of law. This is to certify tha has permission to build a residential Classification ne Owned b- Lot Z; Block__S/D -qb'#1 2A House No 342 - 19th -Street According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE X 0 Building material, rubbish and debris z from this work must not be placed I public space, and must be cleared up- and hatiled away by eitlwir c nt� or owner. –1 9�. 1 A 12/04/78 393U 900CAM B il 1"I tki.6 DaMAe I--1.i L.17 Building OfliciaL 10oul FOR OFFICE CONTRACTOR PERMIT DATE USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER FOR OFFICE USE ONLY Date-------- -----Fee Permit Xv /1% 1,31' ATLANTIC BEACH Valuation $.... ........... FLORIDA House NOW 1978 ................ ................. .0;�� - b751 C"y OF AT,' .,APPLICATION FOR BUILDING PERMIT .............................................................. -0- --- -- --- --------- .............g Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building or other structure described. This application is made in compliance and conformity with the Building Ordinance of the City of Atlantic Beach, Florida, and all provisions of the Laws of the State of Florida, all ordinances of the City of Atlantic Beach and all rules and regulations of the Building Department of the City of Atlantic Beach, shall be complied with, whether herein specified or not. The Contractor or Owner-Builder who has been issued a Building Permit is automatically responsible to ascertain that all sub- contractors engaged by him are duly licensed in the City of Atlantic Beach, Florida. To prevent delay or embarrasment regard- ing intermediate or final inspections it is suggested that a list of sub-contractors be submitted to this office so that licenses can be verified. Dat...... ......... ------------------------V 19............ ...............Address.....f........... .-/W- Telephone No., b�7-------I...... ........................ ...8 Architect.... ...................A1QM.E ...............Address,...........................................................Telephone No----------------------------- 66 ............Address... 43/_U(.�elephone No._.7�ZV ............ ............................. Contractor Builder./.`�"/_V1 9 ... ..............Zone................. T-t No ...............................Block No,�Zv.?.�---iQ Sub Division- Za.. ..../221? ...... ----------------------Street--------------- _-.-Side Between.(--'e."4e_ ....and------------------------------------------------------Sto. Val uation ---_-_--_-For what purpose will building be used-_'ftSe�1mk)_1,1A_kype of construction... --------- Dimensions of Building---------------- ------------ ------Dimensions of Lot- ----- ........................................Size of Footings..... ...... in ft--------------------------Type Roof------7_� ........... Size of Piers- ------ ----------------------_Size of Sills............----- ... ....Greatest Sill Span d?C:�r .1!�6------------ How will Building be Heated?------------........ ----------------_------Will Building be on Solid or Filled Groun Size of Ceiling Joists------------------------------------------- Distance on Centers------------ .............................. Greatest Span............................................ Size of Floor Joists----------------------------------------------- Distance on Centers- ------ -------------------------------- Greatest Span--------------------------------------.... Distance on Centers ................ Greatest Span------------------------------------------- Size of Rafters ......... ----------------------- This rectangle is to represent the lot. Locate the building or buildings in the AF,PROVE: D right position. Give distance in feet from CITY qj� ATLANTIC BEACH all lot-lines and existing buildings. B U DING OFFICE REAR LOT LINE U DING OFFICE L Two copies of plans and specifications shall C be submitted with application. t4c to Inspections required. 1. When steel is in place and ready to pour footing B, Z 2. When steel is in place and ready to pour columns andi/or lintel. 3. When steel is in place and ready to pour beam. E- 4. When framing is completed. 5. When rough plumbing is completed,and ready to cover up. 6. When septic tank drain field or sewer is laid but before it is covered. 7. Electrical inspection by City of Jacksonville. 8. Final inspection. Note: In case of any rejection,re-inspection MUST be called for after corrections are made. FRONT OF LOT In consideration of permit given for doing the work as described in the above statement, we hereby agree to perform said work in accordance with the attached plans and specifications, which are a part hereof, and in accordance with the building regulations of the City !�f�lantie Beac�., .................... Signature of Builder.-.-.-. ..... ................ Address__�'�/e_) ......... .............. 1 ........A_7.�� - /,-,M .............. I ............... Address-�/Z)----------- ................... Signature of Owner.... . .... . ........ .4,4. XA 0 V6 -P-rvk- xc.A3V 505 PS, OXA 0 0 S VO -30 \ANS Y,,s a to ok vs� "q�.WVA k�e V's eT .,,040. ot to% olt ve CeT to to e IWO V-0 'Ask'sl e to Ai S c 7, co s �tt YO -Ins 0 -p -Y 0 1c) OY &IC' 2,ve V s , -A N�lc v f� ve v 0' tdt -ql t OX cNe se vis e, 10VIV eta 6,vv�o, . .\ 11 *0,1 el e, to v 0 &C \\4 0 V, 01"Llev. A CIO A\'v OS r,lvk,,F�N s5t APIPLEU3,11TOR FOP Fi.,MWlZNG Pf.*Inlfir -QA rE, 3o - /7 .,.T,ry1VGUYr,, (IrCUPAMMAL LICENSE ,STA'll CEPTIFICATE No, BUff-DER OR 1WHYRAL-TIN't #'YPE OF lwA WEAFERS F-17TURE f-MIr- qusl- BE A; AMIROAKU W-aH ME IV I R W5 ?Er.C-,NT Ai"AR 7 5 6 OMM ELVD. AIMANTIC SSW, FMRVDA AMOM Maing f". But 141M LOCMHWL�' a cj W tj ag fte j 1)Ian for -'Ale *bwm bul I d;no I a 4W ObjWt to Pee , I jeawie tonotruetion reKwl romwft: a� adwi or Wo eol I iW1 moti mous OM01 t T-Ot MIW1��qd W?ift IVA-) 5/6" ftformd rel afm�c�nq� relft fcr-ARRIMM val,afaml tv.rots f4*F.'qv*-m*N raft she tl I be p t Sped I it "te to 1'rd Of it* WE I din� - Rot OWC', q f=ftinga' prqxruy pCe,-Wand fasi-ened *a O*ftl SOMISS �Slii% ut1*8- NO bv A x .4 nchou W1 der on esch St do "on "W map I abaft, 'SMI.1 �he Gist Mio eatim'Ot res+ m firs 'SVI I at least 4Wt-j6-'-l;c6GS WOW until Sturbid SW 1. b 1 11111. "1' ... awh. unit zftt L to rat Oars" �wlth aj I cm— p"red Ond t&ROd with aimpvto; k't least we ft. 5 t%j ;,44 Sm4h rul?OoWng Stz-1 I be PMPIT-Ilf tled Into the -Toating a" Spok", b0m. dtal I bo SWjr*jy fasiv"d to ft* exterior utnivvrs Or cl;lps� of nWA* WW-fmj IV *Ojjl�jqo, which we dWE40101 Or lwftnwf"f 0. t r �i I omf I-OWIM sjF,,j usr, !), 1 -0 . . � r r ba.,r be 6v4A4%PL Such cl-,4 Imf, S;Izs 11iid AISISR, Chu"OqW1 stics) *a Onowm. In WOM-4 wl�* "m Iftroplifts. 'CWjSftuClSA w1itiv. aloe podulty sial lar -w t4plJON10 hOMOS StOl I F* 66 - of mob Other, An&*At 1 66 at 144# 300 f"t Owt If OW 00 Pr "Vi MW fip* Cd 111�. I I ft. 0. Saw s6r-ACM amwttlam; *Wt be: Coewt-Out r*ft tn .9goor lee '1: 7 f 7#0 f 11. a I an bvtwmn ift 1 Corowti an Cat pnveriy t" bVI no COVW-46. hwalby cel-tt f j es f4jet hs #" ,rmd the abom and "of udden"- 8-my =nftwy *"I'Is t* Ift plam md Wao COORY With fte Ilytent of this SNOWN& ki E-T 5—= A T H C—.;T 1Q. o",.ro�u, t+- �60"C. r-^-T 10 4pPROVED )Ty F ATLANPC BEACH ll_DING OFFI Ty L 113 6G OF F 14 �Al-r -,517 E r '�4 C, :�;I�I L�t�:�5 A,,RZH 1-r r= 7 Tc=3 A H_U N 1:c:;^ E ^-r 111'0�4 11�4 UOLJ 15 15�?q CJE:-:H 651:;, VO4"r tva. Lo I Ve, , tlj4ce�, w 04.tiL. 'r-4 doo A D 'D BY SPECIAL r%[ AD S Y LA',,.'N1IN` BOARD DATE 81979 --Z OX 4+ �O A�r a W low. Ae, W Ca M I L V I 154A pv f5-r Z�n I�ri wr+1-t-1 ti -t—y OT 10�-4 v g�o E�e- i�� T w I-rH L L-^M t�,,rKJCIA,,' )A, PNO V t2e, LO e'A 147� M L W V%//&\'�. 'I'll 7 IE-:�U P,L '70 LA Wi-,-�4 �Vj-rt-i ALI, ?OIX -rL�K015 ju e�5 -74- WlFrH V^ LL -1 e' W �'rri VA :�LlaY -r?q-i L.AV-5 I - oa fl,Q eco v AAPPiD BY SPECIAL ADVI LAINNI:iOr DATE: 1,4v v