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314 12th Street 2014 garage door kj N 'La" "' ' IS CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000490 Date 5/06/14 Property Address . . . . . . 314 12TH ST Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1150 ---------------------------------------------------------------------------- Application desc garage door ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ GOLDKNOPF, JOSHUA & LESLIE OWNER 314 12TH ST ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . WINDOW AND/OR DOOR PERMIT Additional desc . . GARAGE DOOR Permit Fee . . . . 60 . 00 Plan Check Fee 30 . 00 Issue Date . . . . Valuation . . . . 1150 Expiration Date . . 11/02/14 ---------------------------------------------------------------------------- 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 ONLk' IN ACCORDANCE WITH ALI, CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH Vj FILE COM Z800 Seminole Road, Atlantic Beach, Fl, 32233 ' Office (904) 247-5826 Fax(904) 247-5845 ADD il I MA Job Address: 314 Wh d4tet A11dntiC &aa Fi 3,m, 3Pcrmit Numb r: Legal Description Parcel 4 By Floor Area of q Ft. Sq.Ft Valuation of Work$ 1150.00 Proposed Work bea- ted/cooled non-heated/cooled Class of Work(circle one): New _-Addition—A _jterati n air Move Demolition pool/spa window/door 01 's Use of existing/propos structure(s) (circle one): Commerci4l Residential is If an existing structu ,is a fir;ysprinklerlptein installed? Circle o Yes No N/A V 36 2- je Florida Product Appr al For multiple productsbwxr�obd uct approval form Describe in detail the type of work to be per ormed: ara e door, 'n 14u-d 40' 6\ htw 600Y. PropeM Owner information: Name: ie Ad r ss: S1. AfkK& 6ew�, F) 3 E2.33 city —We- Statet Phone 50E-Tm I-Zip E-Mail or Fax#(Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: Qualifying Agent: Address: city State Zip Office Phone Job SiteLContact Number Fax# State Certification/Registration 4 == ,LTXA A.A1ZU'j%.,M, Architect Name&Phone E0R_C 01DE COA fPf I ILPICE Engineer's Name&Phone Q M OF ATU"e]JEACH Fee Simple Title Holder Name and Address RRP PERMPFS MR"DMONAI, Bonding Company Name and Address P%W1ffR-RhaNTS A (2 Mortgage Lender Name and Address if 4pplication is hereby made to obtain a permit to do the cert"igi 1;'tion has commencedprior to the issuance of a permit and that all work will be erormed et the stan r s of all la egulcitingeonstr=ft*omin-4hisjurisdiction. This permit becomes null and void if work is not commenced within six(16))mon r i construct or work is su d d or ahandonedfor a period of six16'),months at any time after I I sp work is commenced. I understand that separate permi ust be secure or Electrical lVorpk.Plumbing,Signs, Wells,Pools, urnaces,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. I hereb 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 'th eci*rz,d h * o )t. The granting of a permit does not presu t) work will be U d me to give authority to violate or cancel the 0 co Ner'e'l, eula=l rsntuction or the performance of construction. provisionsofany the,;e a reeg t; 1 on tr 1 -13 (Att 2 Signature of Owner % - V Signature of Contractor PrintName �811 e Go to Print Name ........................................................................................................................................ ..................................... .................................... ........................................................... B�fo - �,N Before me thV//n Way I Wvr,;C� �20 / — 20 this Day of sejid)(3 40 066990:1:1 W"t!WWOO,An d5b I i c weLlejo'l AspLIS eppou jo 4nvis omnd AJ14ON Revised 01.26.10 Mill X CITY OF ATLANTIC REACH FILE COPi OWNER / BUILDER AFFH)AVIT 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 EXEMPTTON TO THAT LAW. THE EXEMTTION 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 IM[PROVE 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 YOjM_USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU 14AVE 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 EM[PLOYED 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. 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 PENALTY 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 OMER-BUILDER PERMIT. !ADDRESS PHONE NUMBER NAM ATURE DATr:� Before me this day of docil 20din the county of Duval,State of Florida,has persdinally appeared herin by himself/herself and affirms that all statements and declarations are true and accurate. — Notary Public at Large,State of. County Of G Personally Known V'--d-.ced Identification- Notary PutAic state of Florida jp Shidey L Graham Notary Signature: My Commission FF 086990 OF Expires 02/11V201 8 F/BLDG/0�a-Buildu Affadavit;REVVIS D: 4/16/2009 City of Atlantic Beach APPLICATION LNUMB�ER Building Department iTo be assigned by the 13;uildin�g Departm]ent.) 0 eminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 L.ate r r-, r E-mail: building-dept@coab.us outed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: . . J1 V _L27W J7_ Department review requir—ed Yes No uilding Applicant: anning &Zoning Tree Administrator Project: 60/&1 Public Works Public Utilities Public Safety Fire Services Peview 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 0 F Ft 0 0 h r NeA en r g da Dept. Jda Dept. S 0 s jv( t. Johns River Water Management District A r Corps 0 rmy Corps of Engineers my io of Mo Division of Hotels and Restaurants i-vis io of Ic --- Division of Alcoholic Beverages and Tobacco vis ot r. Other: APPLICATION STATUS FFi Reviewing Department First Review: ffApproved. []Denied. (Circle one.) C o m nn e n ts;: (:E�p PLANNING &ZONING Reviewed-b y: Date:-. C)V TREE ADMIN. Second Review: []Approved as revised. EJDe ied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by.- Date: FIRE SERVICES Third Review: ElApproved as revised. FIDenied. Comments: Reviewed by: Date: ivised 05/14/09