342 6th St shed 2014 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001035 Date 7/09/14
Property Address . . . . . . 342 6TH ST
Application type description SHED PERMIT
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 22000
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Application desc
DEMO REBUILD SHED
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Owner Contractor
------------------------
------------------------
KIRK, ROBERT & CHRISTINE E OWNER
342 6TH STREET
ATLANTIC BEACH FL 32233
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Permit ACCESSORY STRUCTURE NEW RES
Additional desc . -
Permit Fee . . . . 160 . 00 Plan Check Fee 80 . 00
Issue Date . . . . Valuation . . . . 22000
Expiration Date . . 1/05/15
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Special Notes and Comments
Parking on right-of-way only in front of project site .
Full right-of-way restoration, including sod, is required.
Roll off container company must be on City approved list
and container cannot be placed on City Right-of-Way.
(Approved: Advanced Disposal, Realco, Shappelle ' s and Waste
Management. )
2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE
*CALL FOR FINAL INSPECTION WHEN SHED COMPLETE AND ANCHORED
TO MEET 120MPH WIND LOAD.
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 .40
ENG REV BLDG MOD OR ROW 25 . 00
STATE DBPR SURCHARGE 2 .40
UTIL REV MODIF OR ROW 25 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 160 . 00 160 . 00 . 00 . 00
Plan Check Total 80 . 00 80 . 00 . 00 . 00
Other Fee Total 54 . 80 54 . 80 . 00 . 00
Grand Total 294 . 80 294 . 80 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
i BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
FILE COPY 800 Seminole Road, Atlantic Beach, FL 32233 JUN 26 2�14
Office (904)247-5826 Fax (904) 247-5845
By :!t7!!!t -
Job Address: Permit Numt er: /0-3 2—
Legal Description Floor Area of SS q.F t. Parcel# Sq Ft
Valuation of Work$ 000, Proposed Work heated/cooled 116LIS&r— non-heated/cooled
Class of Work(circle one): Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial <��E�gsidenti�,
s a
If an existing structure,is a fire spriWer system installed? (Circle one)" s 2g> N/A
Florida Product Approval# 549 021-4 hi.5
For multiple products use product dpproval form r r-
Describe in detail the type of work to be performed: 0FA1Pt9F_14PL1X_ EY1377AIZ, Sl�fO , 1311IL-4
Property Owner Information:
Name: 0 Rq- )ea4 Address: 2t�� K7t�41 -:0-
-/7-1 C— /3 C-Af State 61
city 411-4, 23 3 Phone 90
E-Mail or Fax# (Optional)— ;el
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Qualifying Agent:
Address: city State Zip
Office Phone Job Site/Contact Number Fax
State Certification/Registration#
Archite6t Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication 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 qf a permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void ff work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a Period ofsix months at any time after
fo t r 9��
work is commenced I understand that separate permits must be secured r Elec rica Work, Plumbing,Signs, Wells,Pools,I urnaces,Boileis,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 herelb certify that I have read and examined thisfap f laws and ordinances governicneg this
glication and know the same to be true and correct. All provisions o can I
Work will be co�nplied with whether speci ied herein or not. The granting of a permit does not presume to give authority to violate or the
provisi.ons of any otherfederal,state, or local law regulating construction or the pe�formance of construction.
Signature of Owner Signature of Contractor
PrintName Print Name ........................................................................................................................................
.........................................................................................................................................
Be Before me
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Nota ublic Notary Public
JENNIFER WALKER
Revised 01.26.10
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1EXPIRES:Aphl 24,2017
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CITY OF ATLANTIC BEACH
FILE COPY
OWNER / BUILDER AFFIDAVIT i '!
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING"REQUIRES OWNER I 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 YOUR-SELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUM[E 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 MAYE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANC S.
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 PENAL TY UNDER FLORIDA STAT LITE 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.
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ADDRESS PHONE NUMBER
PRINT NAME
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Before me thi4 2114 in the county of
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Duval,State of Florida,has personally appeared herin by himself/herself and affin"ns that
all statements and declarations are true and accura'te.
Notary Public at Large,State of County of LXAVA.A
0 Personally Known
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Notary Signature:
FJBLDG/Own�-'Buildff 4111i,�:R-E-\IrISED: 4t/16/200
City of Atlantic Beach
APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
I %_ 1-1 CEIVE'D
800 Seminole Road I-L-IL /z/
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845J U N 2 7 2014
19 E-mail: building-dept@coab.us I L_Iate rOUtE d:
City web-sit e: http://www.coab.us LF�-Y':
APPLICATION REVIEW AND TRACKING FORM
Property Address: .c;N2_ b" J7_ review required Yes No
Applicant: aw/m Ctanning & Zoni
Tree Administrator
Project: d'��ublic Work
�'Nbric tiiit7,e-s-:>
Tr _P-uBTi-c-Sa_fety
Fire Services
Review fee $ C�' Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Prot-ection
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: KApproved. FIDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:_*P v
TREE ADMIN.
Second Review: []Approved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. F]Denied.
Comments:
Reviewed by: Date:
Revised 05114/09
City of Atlantic Beach APPLICATION NUMBER
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
I E-mail: building-dept@coab.us L Date routed: 12
Cityweb-site: hftp://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: cN2_ J Jr J*"!"Rt review required Yes No
C-155-nning &Zo�n�i ?
Applicant: OW12t4 ft— —
Tree Administrator
Project: ublic Wor
< '[5—ublic Utiliti—es->
170-57ic-Tra-fety
Fire Services
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
Reviewing Department First Review: NApproved. El I Denied.
(Circle one.) Comments: /Aek �el�k4 ix 001e J4
BUILDING i5t sl Y� erqlf
PLANNING &ZONING oe
Reviewed b : 10eA,',_1_ - Date: y
TREE ADMIN. Second Review: []Approved as revised. [-]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: RApproved as revised. F]Denied.
Comments:
Reviewed by: Date:
Revised 05/14109
City of Atlantic Beach APPLICATION NUMBER
� "CEIVEl '
Iding Department.)
Building Department (To be assigned by the Bui
800 Seminole Road 141 - /
Atlantic Beach, Florida 32233-5445
JUN 2 7 2014
Phone(904)247-5826 - Fax(904)24 5145
LDate routed:
E-mail: building-dept@coab.us
Cityweb-site: http://vmm.coab.u,, �B Y:
APPLICATION REVIEW AND TRACKING FORM
Property Address: t;N2- 'P""Rt review required Yes No
Applicant: <-Vlanning &
Tree Administrator
Project: ublic Wor
< b P u b Ric U t i I i t 7ie_s__->
.';i,f Tr P u b I i c_7—a re t—y
Fire Services
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
Reviewing Department First Review: pproved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:-1-
TREE ADMIN. Second Review: [—]Approved as revised. F]Denied.
Lfc Comments:
UBLIC UTIL
Reviewed by: Date:
4*TY
PUBLIC SAF
FIRE SERVICES Third Review: FlApproved as revised. [:]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
6. City of Atlantic Beach APPLICATION NUMBER
1.st Building Department (To be assigned by the Building Department
800 Seminole Road -5445
Atlantic Beach, Florida 32233
Phone (904)247-5826 - Fax(904)247-5845 )2 ,o Z140
E-mail: building-dept@coab.us Date ro uted:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: C3�2_ le" J7- review required Yes No
e'-�Iannin
g &Zonii
Applicant: 0A)l7t4 Tree Administrator
Project: ublic Wor
PulAcUtilities_,>
< Notz-Sho )0
P u b I ic�55�ety
Fire Services
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
Reviewing Department First Review: [YApproved. ODenied.
(Circle one.) Comments:
PLANNING &ZONING Reviewed by: Date:
4=
TREE ADMIN. Second Review: [-]Approved as revised. [ ]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05114109
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