1769 Seminole Rd 2014 Solar CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000543 Date 4/16/14
Property Address . . . . . . 1769 SEMINOLE RD
Application type description RESIDENTIAL OTHER
Property zoning . . . . . . . RES GEN 2F DISTRICT
Application valuation . . . . 13000 --------------
--------------------------------------------------------------
Application desc
solar pv system on roof ----------------------
-----------------------------------------------------
Owner Contractor
------------------------
------------------------
NARKIEWICZ, BRENT OWNER
1769 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
----------------------------------------------------------------------------
Permit . . . . . . RESIDENTIAL ALT/OTHER
Additional desc - - 57 . 50
Permit Fee . . . . 115 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 13000
Expiration Date . . 10/13/14 -----------------------
-----------------------------------------------------
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE
FINAL INSPECTION REQUIRED CALL WHEN JOB COMPLETED ------
----------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
-- -------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 115 . 00 11S . 00 . 00 . 00
Plan Check Total 57 . 50 57 . 50 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 176 . 50 176 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach,FL 32233
FILE COPY Office (904) 247-5826 Fax(904)247-5845
FR� A P R 0 9 2 014
4/_3
Ole Perm
Job Address: it Nu r: /"/— S-4/3
Legal Description Floor Area of Sq.Ft. Parcel# Sq t
Valuation of Work S 8, iq Pro work heated/cooled n�n�heated/cooled
Class of Work(circle one): New AQLtion---Alfe-rati on Repair Move Demolition pool/spa window/door
Use of exisfing/pro ed structure(s)(circle one): Commercial Reside�il
s s
If an existing strucCre,is a fire sprinkler system installed? (Circle one �es N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: fV Tie J
Property Owner Information:
Name: ?Ae Address:
City 2E��—Ae 6<4.rA StateF:4Zip 3229V Phone 5S;2-,;P3-
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 4
Engineer's Name&Phone
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
A a ee ade ajn a e he work andinstallations as indicated I certify that no work or installation has commencedprior to the
0 s'I�r
a ng construction in thisjurisdiction. Ais permit becomes null
I s fsix months at any time after
s
p ti m t to tom tt � ' "ds sjork or abandonedfor a period o
s'uan an e rmed he t r
s'or , s ct or
r f h f
t
(6 n iZ n
r p 0
ot rk P I be
0 S' m t to 1'w I
c r by d ha a
p m t t 0 w
1 s ce o a er
0 , p k s not com enced thin s
,d d f, t s x mo t 0 c;nc cins, Wells,Po6ls, I urnaces,Boilei�s,Heaters,
p r rnuts mu e cu
'o M or Zha e a ate pe b efre'd r0E e Plumbing,Si,
rk s commenced. I uderstan
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.
I hereb�ce?Vfy that I have read and examined this application and know the same to be true and correct. All provisions oflaws and ordinances governing this
�mit does not presume to give authority to violate or cancel the
0 work will be cotnplied with whether specified herein or not. The granting of a pei
prow.si.ons of any otherfederal,state,or loca llaw?egulating construction or the peFformance of construction.
Signature of Owner Signature of Contractor
jU4...... .... ................
...........
__..�1
Print Name Raxt Print Name .................................................... ............................................................................
................................... ........ .....................................
Sworn*�'an"ubscribed before me Sworn to and subscribed before me
of 20M ... this _Day of
N -EhaWa
Shirley L Graham Notary Public
my Commission FF 086990
or Expires 02/14/2018 Revised 0 1.26.10
oifti�,Ar
c
CITY 0
F ATLANTIC BEACH
FILE COPY
eWNER BUILDER AFFIDAVA .,
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "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 PERNRT UNDER AN ENEMPTION TO THAT
LAW. TBE EXENIPTION 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 MROVE A ONE—OR
TWO FANffLY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
RVIPROVE A CON24ERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. 'THE BUILDING
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAYNOT BE BUILTFOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COWLETE,THE LAW WILL PRESUTVM THAT YOU BUILT
IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXENIPTION. 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 ENPLOYED 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.
Ill. 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-1 Y 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.
LZO 5�0
ADDRESS PHONE NUMBER
PRINf NAME
SIGNA DATE
for the county of
Before me this day of 24-611
ay of
Duval,State of Florida, as e onally 9ppeared herin by himself/herself and affirms that
all statements and declarations are t d urate.
Notary Public at Large,State of run_.County of
0 personally Known
rodured IdentincaflorrV
Notary Public State of Florida
Shirley L Graharn
Not-arysig 'ure: MY Commission FF 086990
Expires o2tw2ole
FIBLDG/Owrier-Buildu Affadavi�REWSED:4/16/2009 U 4
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The Right Way!
S-5-N Clamp
S-5-N and S-5-N Mini clamps were Lf)
designed with patented S-5! zero
penetration technology for application
on the popular I" nail strip metal roof
profiles:Taylor Metals' Easy Lock"", ASC
Building Products' Skyline Roofing',
McElroy Metals' Meridian, and NewTech
4— Machinery's FFI 00, and roofing types
0 with si rn ilar profiles,The clamp boa sts a L
0
L_ wider throat that accommodates most
-84 nail strip profiles, minimizing the need to
field crimp. An angled wall with a nose
permits the S-5-N to engage the triangle
Etype profiles during the installation
0 process—there is no longer a need to hold
the clamp in place while setscrews are
tensioned.The combination of these two
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on the seam. Nail strip profiles just got a
whole lot simpler!
S-5-N Mini Clamp E
4-1 0
(All The S-5-N Mini is a bit shorter than the U
0
S-5-N and has one setscrew rather than
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all kinds of rooftop accessories: signs,
walkways, satellite dishes, antennas,
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4J systems, solar arrays,exhaust stack
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0 mechanical equipment—just about 04-
+-J anythjng!�
The S-5-N clamp is ce)
designed for use on the I
Ul)
most popular 1" nail strip (N
CO
metal roofs. I
CO
S-5!Mini clamps can be used with RamGard unitized snow 00
guards.They are not compatible with,and should not be used
ith S-T.SnoRail/SnoFenceor ColorGard'snow retention
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The S-5-N and S-5-N Mini clamps are each furnished .5-75-N -Clat,
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S-5-N is compatible with most common metal roofing FILE 11f of parts
materials excluding copper.All included hardware is
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more information including CAD details,metallurgical C=
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The S-5-N clamp has been tested for load-to-failure results
on most major brands of 1" nail strip profiles of standing 1.69"
seam roofing.The independent lab test data found at (43.00 mm) 49"
www.S-5.com can be used for load-critical designs and (1
applications.S-5!"holding strength is unmatched in the 1.091, .02"
industry. (2 .00 mm) (26100 mr I
0 -1
/.,7
'00 m
Example Profiles toty/�
0.56" 2 setscrews
(14.00 mm)
1.57" ---------aft-
(40.00 mm)
S-5-N Mini Clamp.
AL
M8 hole centered
on part
1.181,
(30.00 mm)
0 9"
(43.00 mm) 12.6to'n,n) 1'
1.091, 1 02�
(28.00 m 6.60"..1
0�M 1,
0'
18�00 M) Setscrew
0.56"
(14.00 mm)
1.57"
(40.00 mm)
Please note:All measurements
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S-510 Warning!Please use this product responsibly! Distributed by
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of steel.Consult the S-5!
an d between 130 and 150 inch pounds for all other metals and thinner gauges
website at www.S-S.com for published data regarding holding strength.
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S-9.aggressively prowcts its patents,trademarks and copyrights.
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
- Fax(904)247-5845 rou
Phone(904)247-5826 Lited:
E-mail: building-dept@coab.us LDateiroi
City web-site: hftp://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: De artmentreviewre uired Ye No
ildin
Planning Zonin
Applicant: ree ministrator 7T
ublic Works
I t
Project: Public Work
Public Utilities
ItT
u I. Safe y
Rao Public Safety
d/V
lFireServices
Review fee $ Dept Signature
Other Agency 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: [B�Approved. E]Denied.
(Circle one.) Comments:
PLANNING &ZONING Reviewed by:_ Date:
TREE ADMIN. ODenied.
Second Review: FlApprovedas revised.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F-JApproved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
(To be assigned by the Building Department.)
ding Department
Buil
...... 800 eminole Road �13
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date routed:
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
PPL'
be ssigne
(To
[Date rLouted
Yes No
d De artment review required
Property Address: uildin
Planning &Zonin
Applicant: min tO
Public Works
Project: V Public U I L�.Jes
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
Florida Dept. of Environmental Protection of Permit Verified B
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:
APPLICATI STATUS
Reviewing Department First Review: pproved. nDenied.
(Circle one.) Comments:
ZIPCATI _STATU
p roved
BUILDING ]Da t e:
PLANNING &ZONING Reviewed by.'
TREE ADMIN. Second Review: nApproved as revised. []Denii
PUBLIC WORKS Comments:
PUBLIC UTILITIES Reviewed by-.- Date-.
PUBLIC SAFETY s revised. [-]Denied.
FIRE SERVICES Third Review: FlApproved a
Comments:
Reviewed by-., Date:
Revised 05/14/09