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1835 Hickory Ln Shed CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 7 ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00001001 Date 7/07/14 Property Address . . . . . . 1835 HICKORY LN Application type description SHED PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2000 ---------------------------------------------------------------------------- Application desc 10 x 6 shed ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ STORY, GRAHAM N OWNER 1835 HICKORY LA ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit ACCESSORY STRUCTURE NEW RES Additional desc . . Permit Fee . . . . 60 . 00 Plan Check Fee 30 . 00 Issue Date . . . . 7/03/14 Valuation . . . . 2000 Expiration Date . . 12/30/14 ---------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE *CALL FOR FINAL INSPECTION WHEN SHED COMPLETE AND ANCHORED TO MEET 120MPH WIND LOAD. ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 UTIL REV MODIF OR ROW 25 . 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 29 . 00 29 . 00 . 00 . 00 Grand Total 119 . 00 119 . 00 . 00 . 00 PERMIT IS APPROVED ONLt' IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. "' PERMITS To verify compliance with buildin points of the construction are required.The following inspections are typically for resid Date: Initial: Power Pol Pool Steel I I *When power pole is ready to be relea, :Vmming pool steel Ts in place—but before any gunite is placed. ht &I I I C Dean Pool Safety Piers cusm__ ** I PER RECEIF, Underground Plumbing GPEF. ATIMML9 Dj L-e. GO, REC-t-w na. 86013 ;rounding&Bonding Underground Electric ool and deck steel is in place but before it is covered. Foundation/Slab/Footing R,cm, L"; 1 Pool Final Retaining Wall Footing I h I LnIfff I C E-r-ACK, FL 3-2433 *When all underground plumbing,ele, R r' -011— P-r--T,- Du I - inspections may apply to your project,if your project before any backfill is placed. TEadler dEta-,�, i:).UV hese elements. LK C—c" Rough Electric HE K $ Tota, tetTl- 4uln.uv d Concrete Rough Plumbing/Top Out T,,,,,, ,,,,u,_,tf16t,!u and all �Vl IS ns and reinforcing steel, anchor bolts, sleeves, and inserts, Rough Mechanical datE. -'m lumbing,and mechanical work is in place,but before concrete is placed. *When allrough electric,plum�i:n_g, Tune. 115.-15.-12 is covered up. Structural Steel *When all structural steel members are in place and all connections are complete, House Wrap but before such work is covered or concealed. Tie-down Framing Connections Wall Sheathing Rough Framing Roof Sheathing(Dry In) PermitType Window Installation-Door *When all framing,windows,sheathing,shear-walls and metal connectors are in place but before insulation is placed. Insulation Ceiling 9 Insulation Wall *When insulation is in place but before insulation is covered. I ---F---:= ath i *When all backing and lathing,interior and exterior,is in place,but before any plaster is applied or insulation is installed. oPer Job Ad ss Drywall "4:ii:: *Wt7en all wallboard is in place but before joints are taped and finished. 0 ler Contrartor *When building electrical can be safely energized and all work is substantially complete. POST THIS CARD WITH PERMITS [Gas Test IN FRONT OF BUILDING *When all gas piping is complete and wallboard is installed but before gas is attached to any appliance.All outlets must be capped and pipe pressurized at a Building Department Fire Department minimum of 15 ibs. Phone:904-247-5814 Phone:904-630-4789 Fax:904-247-5845 Fax:904-630-4203 Final Plumbing Email:building.dept0coab.us Final Electrical Public Works/Public Utilities Phone:904-247-5834 Final HVAC Fax:904-247-5843 Final Building Construction Hours per City Code *When all construction work including electrical,plumbing,and mechanical, 7 am-7 pm Weekdays 9 am-7 pm Weekends exterior finish grading,required paving,and landscaping are complete and the building is ready for occupancy but before being occupied. [.F I L E COPY v-z - 1� ;,. a Ll Sj-1) 1,4o z t Lp )> t tj Ci ri 3 D F'- o c�- C�3 z vilosaNKII-I ao )�!,!VdWOD a:)Nvaf)siqi ITI—TI.T. a m v �l v J W,o a L)V t)j��j o v I f.-I 0'10 0 19 2 p T-10 l'i I TI r,0 U A n(I jo spio.);Da DT Eqnd -aua-ianD aq- U-L papioDel , Jo 6Z ;DBBd LC 'iooq 1 d j o a.i q p r d a Ll '0' Z)e 'lvldRa D-zl M li.Rfi VMT.HVI4 VAIgs er I 9, 11 T 10 10 V 14 k S A U f,. S 5 N G CITY OF ATLANTIC REACH (OWNER / ,BUMIDER 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 LICZ CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EX MPTIONTO E I LAW THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT;i� 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 ,,I,; 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. TEE BUILDING tp A&- MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. 44 IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER TEE CONSTRUCTION IS COMPLETE, THE LAW WELL PRESUME THAT YOU BU1g)jj[.j IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU.MAY N LURE AN UNLICENSED PERSON AS YOUR CONTRACTOR- YOUR CONSTRUCTION MU BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT'14 YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YQ11 LICENSES REOUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING' OR-DfNANCES. 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 $5,000 PENALT Y UNDER FLORIDA STA TUTE NO. 455-228(1). AN-OCCUPATIONAL LICENSE" IS NOT ADEQUAT E. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE I BUILDING DEPARTMENT(247-5826) IF IN DOUBT. 0 V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. U ADDRESS PHONE NUMBER PRINVAO P64 SIG,,NATL�E iL) Be�ore r56.this 24�d2yo rllnn 20 the county of P� herin b h' �,self and affirms that DuvarState of Florida, -'sonally appefired all s'tatements and declarations are t urate. Notary Public at Large,State of rrCountyof valL, 91,0vouzo foil 3A AD .11 Vgrsonally Known dx3 066990:1guolssi.."DAW duced ldentlmi L weqejo-1 Agp!t4S FN �10 em000dAiBION 'ur Notary Signatur F--/BLDG/O�er-]3uilderAffadavi�RF-VISED: 411C BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH JUN 2 0 20141 -. FiFILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 By JobAddress: I i:�' - PermitNumber: lq— lbol Legal Description --2,6 f)A :F-b — Parcel 9 Floor Area of &0 Sq,Ft. Sq It Valuation of Work$ 351!�C Proposed Work heated/cooled 4p, non-heated/cooled Pi Class of Work(circle one): (�ew.,) Addition Alteration (�epai) Move Demolition pool/spa window/400r Use of existing/proposed structure(s)(circle one): Commercial s i de i-it i a , If an existing structure,is a fire sprinkler system installed? (Circle.one):QRNo N/A Florida ProductApproval For multiple products use product approvaTTo—rm Describe in detail the type of work to be performed: I A( �111111-� A")�> ?(�V�-rATz,�- 10-X/, Property Owner Information: Name: C1-1 Address: City State&Zip hone !k2+- 24�1' E-Mail or Fax 4(Optional� Contractor Information: Company Name: Qualifying Agent: Address: city —State zip Fax Office Phone Job Site/Contact Number 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 certijy that no work or installation has commenced prior to the issuance of a permit and that all work will be pe�jbrmed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandonedfoi aWeriod of six�6)months at any time after work is commenced I understand that separate permits must be securedfor Electrical Work,Plumbing,Signs, ells,Pools, urnaces,Boilers,Reaters, 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. 'here fy that I have read and examined this application and know the same to be true and correct. Allprovisions of laws and ordinances governing this �y certi be in li whether -ifted herein or not. The granting of a permit does not presume to give authority to violate or cancel the ype 9�work will c sfaewc regulating construction or the peiformance of construction. )rovisions of any other ede or local 'ignature of Owne Signature of Contractor Print Name )rint Name .............................................................................................. ................... ... .... ... .................. ......................... ftoeloozo sail 3 eho 0 =1 u0molulwo A 'r� �efore . . 0 Vy Before me e148JE);)A9 -iis f e this _Day of 20 Totary Public Notary Public Revised 10.24.12 rILE b CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION FCONTRACTING"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 EIMMPTION TO THAT LAW. THE EXEN2TION ALLOWS YOU,AS TBE 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 OUTBUILDIN`G. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BuaDiNG MUST BE FOR YOUR USE AND OCCUPANCY. IT MAYNOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE-BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COIVPLETE, THE LAW WILL PRESU&M THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT MRE AN UNLICENSED PERSON AS YOUR CONTRACTOR- YOUR CONSTRUCTION M`UST 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 ORDI`NANCES. 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 PENALT Y UNDER FLORIDA STA TUTE 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. q� 2AJI; DRESS PHONE NUMBER L PRIN)��_ SIG ATL,�E 41 BeLwe )this -20 dpyo .20 the county of ta -��Iorida,has pe�A d herin by hl' rself and affirms that Du tate of onaliy appefire all s'atements and declarations are trupanq accurate. Notary Public at Large,State of countyal Va qwzjtp�/zo 9ojldx3 M go 0669q0:j_quoiS9!wwo0AW ce en 1�i n- 'd t ujeqej!D-1 Aepq& /X epu -NIMS o!lqnd/JBiON Notary Slglnatura,-- F..LDGIO��-Buill�,All�d.vi�R.VISED:III III City of Atlantic Beach APPLICATION NUMBER �S C Buil (To be assigned by the Building Department.) ding Department 800 Seminole Road /610/ 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 Property Address: Z-4 D ..ent review req-uired Yes 0 1 Bu' " Applicant: Planninq &Zoni Tree Administrator Project. Id x CU lic W 7 Public Safety u"ic Fire Sei 1�ces 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 17= Other: APPLICATION STATUS Reviewing Department First Review: R�IApproved. []Den-IL (Circle one.) Comments: PLANNING &ZONING Reviewed by: A171 Date: 2-7 TREE ADMIN. ed. Second Review: FlApproved as revised. FFJ1 PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. DDenieili Comments: Reviewed by:_ Date: Revised 05/14/09 city APPLICATION NUMBER of Atlantic Beach (To be assigned by the Building Department.) Building Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 Date routed: E-mail- building-dept@coab.us Cityweb-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: J�S7 A-064— Z-w_ ..ent review required——Yes -14-0— Z -- oPlanning &Zon' Applicant: Tree Administrator Id x Cublic W Project. —r-frObTic TPublic Safeety 'Ic --I! Fiur e S e Ti "�c e s 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: APPLICATION STATUS 1.--^ -]Deni, Reviewing Department First Review: XApproved. (Circle one.) Comments: BUILDING Date: PLANNING &ZONING Reviewed by: TREE ADMIN. Second Review: nApproved as revised. RDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. DDenie;-J- Comments: Reviewed by:_ Date: Revised 05114/09 city of Atlantic Beach APPLICATION NUMBER RIECEIVEE (To be assigned by the Building Department.) Building Department 800 Seminole Road JUN 2 3 2014 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-q845 Date routed: il- building-dept@coab.us E-ma City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM q --entreviewre uired '�7es 0 u* Property Address: vs- A-may B= 100 4PIanning &Zoni Applicant: nistrator Tree Admi s Project. /0 X �0 ublic W 1C ty Public Safety "e Fire Ser,'.ces Review fee $ Dept Signature Review or Receipt Other Agency Review or Permit Required of Permit Verified By Date 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 1\1 RDenit Reviewing Department First Review: RApproved. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by-.,� Date,:_6 TREE ADMIN. Second Review: nApproved as revised. []Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES Reviewed by: Date: PUBLIC SAFETY FIRE SERVICES Third Review: FlApproved as revised. RDenied. Comments: Reviewed by:_ Date: Revised 05/14109 city of Atlantic Beach APPLICATION NUMBER be assigned by the Building Department-) PPLI Building Department be ssig ed --FIVED 800 Seminole Road ECEIVED )233-5445 Atlantic Beach, Florida 32 �r-5845JUN 2 3 201 Phone(904)247-5826 - Fax(904)244 2014 Date route E-mail: building-dept@coab.us City web-site: httP://www.coab.us LBY: APPLICATION REVIEW AND TRACKING FORM nt review required Yes No If i 4r Property Address: ffieklay—Z-4 Bu* Plannin(. Zoning Applicant: Tree n .iistrator u lic V: Id X SA b w Project. ic U"'. ublic S - --ty Fi e Sei -.,s Review fee $ Dept Signat re Review or Receipt Date Other Agency Review or Permit Required of Permit Verified B Florida Dept.of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing epartment First Review: �fApproved. DDeni, (Circle one.) Comments: BUILDING Date: PLANNING &ZONING Reviewed by:_ TREE ADMIN. Second Review: FlApproved as revised. []Denied. I C'V V'O RY,S Comments: v ur' D:at6 �2 Y�UBLIC UTJLIT�� T Revi Date: PUBLIC SAFTY Reviewed by:_ VIC S F- proved 2 Third Review: F]Approved as revised. nDenie FIRE SE7:RVICES Comments: Reviewed by: Datei Revised 05114109