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185 Pine St 2014 windows siding t CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J =" ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 moil s) Application Number . . . . . 14-00000827 Date 5/21/14 Property Address . . . . . . 185 PINE ST Application type description WINDOW AND/OR DOOR Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 4000 ---------------------------------------------------------------------------- Application desc WINDOW REPLACEMENT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SANDERSON,JOSEPH OWNER 1101 SANDPIPER LN E ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . WINDOW AND/OR DOOR PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee 35 . 00 Issue Date . . . . Valuation . . . . 4000 Expiration Date . . 11/17/14 ---------------------------------------------------------------------------- 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 70 . 00 70 . 00 . 00 . 00 Plan Check Total 35 . 00 35 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 109 . 00 109 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION "° "� "" i CITY OF ATLANTIC BEACH FILE C 11 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax(904)247-5845 Job Address: /D5- jp�..t, S k_me � Permit Number: JG��R 7 Legal Description Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work WO Proposed Work heated/cooled non-heated/cooled 11 1 Class of Work(circle one): New Additi Iteration Repair Move Demolition pool/spa window/door Use of existing/propose ructure(s) (circle one . mercial Residential If an existing structu ,is a fire sprinklers stem installe ? (Circle one): Yes No N/A Florida Product Appp val # I2 Sn0% P 1 114111 For multiple produc use product approva form Describe in detail the typ work to b rmed: Qe (ke-s H. 4�51 W j•,Attm% ae—A1 ?j -6 y-wJ., Property Owner Information: Name: JHe. r'Sc,,, Address: /10 t S•tj APtkAy- &%. , JssL City tti State FI Zip 3ZZ 33 Phone! -314 —76,6, > E-Mail or Fax# (Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: 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 certify that no work or installation has commenced prior to the issuance of 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 tf work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod of six((6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools,1 urnaces,Boilers,Heaters, 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined thisapplication and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of arty other federal,state local law regulating construction or the performance of construction. Signature of Owner Signature of Contractor Print Name ...................................7�v�.�....... .................................................. Print Name Be fo Before me this D o 2014- this Day of ,20 o lic A / �." I otary Public Notary Public State of Florida Shirley l Graham Revised 01.26.10 +� My commit ow OF 086990 'D or EApiMa 02/14/2019 '/ .'t; N _ � `�A�•'a99Wc�.ifPlNfisaeas:rw,r.. CITY OF ATLANTIC BEACH A. - 1 , . � FILE COPOWNER / BUILDER AFFIDAVI , I. 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. 11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, 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 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. ADDRESS \\ 1 PHONE NUMBER J&C_ e lSO' PRINT NAME /J SIGNAT -1201 /—` DATE Before me thi day of-M p ? ' in the county of Duval,State of Florida,has personally apptared herin by himself/herself and affirms that all statements and declarations are true and accurate.�-- Notary Public at Large,State of �L .County of V rl_ SI.AeFonally Known ❑Produced Identification- tail, I'll I'll Ill I'll I I Ill IN Ill 1,, 111,11 L I Notary Signa ure: Notary Public State of Florida • Shirley L Graharrl F:BLDG/Owner-Builder Affada i�Rr—VISED: 4/1 2009 0' e pCi1s 07/14/2018 066990 psi ' vCity of Atlantic Beach APPLICATION NUMBER \Js sa Building Department (To be assigned by the Building Department.) 800 Seminole Road / D Q►� Atlantic Beach, Florida 32233-5445 Q - Phone(904)247-5826 • Fax(904)247-5845 LL,,2-,4 ` E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �(� / 141 J7_ -Department review required Ye No Buildin Applicant: 4 W77 Planning &Zoning yy�� Tree Administrator J Project: �j(///II4b i A)S Public Works Public Utilities Public Safety Fire Services 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: ( Approved. ❑Denied. (Circle one.) Comments: ri C) =BUILDING PLANNING &ZONING Reviewed by: Date: S'00-,901 TREE 0O- TREE ADMIN. Second Review: ❑Approved as revised. RDA/ed. 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 1%" - ,�� CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Jit �;• Application Number . . . . . 14-00000828 Date 5/21/14 Property Address . . . . . . 185 PINE ST Application type description SIDING PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 6000 Owner Contractor ------------------------ ------------------------ SANDERSON, JOSEPH OWNER 1101 SANDPIPER LN E ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . SIDING PERMIT Additional desc . . Permit Fee . . . . 80 . 00 Plan Check Fee 40 . 00 Issue Date . . . . Valuation . . . . 6000 Expiration Date . . 11/17/14 ---------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 80 . 00 80 . 00 . 00 . 00 Plan Check Total 40 . 00 40 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 124 . 00 124 . 00 . 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 FILE C 800 Seminole Road, Atlantic Beach, FL 32233 Office (904)247-5826 Fax (904) 247-5845 ac�4• Job Address: ! �3 5 P 14' mac. �c 7 1-ye e Permit Number: Legal Description Parcel # Floor Area of SoV Ft. Sq.Ft Valuation of Work S. aqvu Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# r L 1 3 4 Z For multiple products use product approval form Describe in detail the type of work to be performed: A-)JeA�l{� 1. ,�. S(n ..��C w. Z rd'► d 1a r•4 Property Owner Information: Name: -�*It Address: (p( City At to.,%V C. 644A= _ State C tZip ST Z 313 Phone h-4 t G-7GG 7 E-Mail or Fax# (Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: 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 certify that no work or installation has commenced prior to the issuance of 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 aperiod of six 6)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,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 type ofYwork will be compliedwith whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,sta , r local law regulating construction or the performance of construction. Signature of Owner \ Signature of Contractor Print Name e �jpr Print Name ......................................................................................................................................... ........................................................................................................................................ Befo aBefore me ay f this Day of .20 N14 NotaryPublic Stag off rida m My Counnissim F,0059 is o, Expires 02/14/2018 Notary Public Revised 01.26.10 CITE'OF ATLANTIC BEACH FILE COPY OWNER 0 BUILDER AFFIDAVIT . I. 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. 11. 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. lS"s 1�,�� Sok �oK-3iG - 766-7 ADDRESS PHONE NUMBER PRINT NAME zoM SIGNA E DATE Before me thisC,';;�day of 21�n the county of Duval,State of Florida,has personal appe red herin by himself/herself and affirms that all statements and declarations are true an accurate. Notary Public at Large,State of �County cf ve/� l/ Xrsonally Known �`�❑ induced Idenfi5 n Notary Public Stats of Fror Baa Snlliey L tWaif' My commission FF 088@90 i 3f F� Expires 0211412018 Notary Signature: F:BLDG/Owner-Buildu Affadavi�REVISED:411 City of Atlantic Beach APPLICATION NUMBER js � 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 �d / o,3 �? E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us 11 APPLICATION REVIEW AND TRACKING FORM Property Address: / De artment review required Yes No �� p Building )) Applicant: Q W Allo Planning &Zoning Tree Administrator Project: Public Works Public Utilities Public Safety Fire Services 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: proved. []Denied. (Circle one.) Comments: - BUILDING PLANNIN ONING Reviewed by: Ir Date: S O/y TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. 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