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309 Belvedere St 2014 siding 51 V 0 1 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 -5814 INSPECTION PHONE LINE 247 Application Number . . . . . 14-o0001068 Date 7/08/14 Property Address . . . . . . 309 BELVEDERE ST Application type description SIDING PERMIT Property zoning . . . . . . . TO BE UPDATED Application valuation . . . . 6000 ---------------------- ----------------------------------------------------- Application desc siding ------------------------------- -------------------------------------------- Owner Contractor-------------- ---------- ------------------------ STERN, ELIZABETH OWNER 309 BELVEDERE ST ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . SIDING PERMIT Additional desc - - 80 . 00 Plan Check Fee 40 . 00 Permit Fee . . . . Valuation . . . . 6000 Issue Date . . . . Expiration Date . . 1/04/15 -------------------------------- ---------- --------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE To THE BUILDING DEPARTMENT IMMEDIATELY. --------------- ------- ---------- ---------------------------------A SURCHARGE 2 . 00 other Fees . . . . . . . . . STATE DC STATE DBPR SURCHARGE 2 . 00 ---------- ------- ---------------------------------------------Due Fee summary Charged Paid Credited- ---------- ----------------- ---------- ------- -------- . 00 Permit Fee Total 80 . 00 80 - 00 . 00 Plan Check Total 40 . 00 40 . 00 . 00 . 00 4 . 00 4 . 00 . 00 . 00 Other Fee Total 124 . 00 124 . 00 . 00 . 00 Grand Total PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION � � 9 T 0 T � i CITY OF ATLANTIC BEACH 1 2 2014 800 Seminole Road, Atlantic Beach, Fl, 32233 Office (904)247-5826 Fax (904) 247-5845 R Frg &S4 &Zh, FLIIIPermit Number: J�'— IC6 Job Address: 303 &J04-ce '0 A!fjQj& 4y Legal Description oor ea of Sq.Ft. Parcel# - Sq.Ft Valuation of Work$ &0jQtQ 010 Troposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Additi :�AlEteration) Repair Move Demolition pool/spa window/door o:n�e : Commercial <�_Residential Use of ep�ting/pro osed structure(s) (circle If an existing structure,is a fire sprinkler system installed9 (Circle one): N /A Florida Product Approval# For multiple products use product approvaTTo—rm Describe in detail the type of work to belerformed: &&OL)al OVA to �-j Property Owner Information: Name: TL4nj, , Address: 7)r, W/4 go-(L W eellfv city 9 State--Zip Phone E-Mail or Fax#(Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: Qualifying Agent: Address: city -State Zip Office Phone Fax# State Certification/Registration# :Ilrw�e0jWPtM Architect Name&Phone# CH r III low Engineer's Name&Phone# SEEPE 1TSF01,,,II.DDM0NAL Fee Simple Title Holder Name and Addres; REOUMEMENT!�1AINU 1_,UNL)rT70NS. Bonding Company Name and Address 1 -k r .s, Mortgage Lender Name and Addre s REMERM 4 cFqe. :7— ic qmmence is permit becomes null o,ths at a time after ces,Boile ,Heaters, 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 FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 7is ap t*on and know the same to be true and correct. All provisions of laws and ordinances governing this ec, ty to violate or cancel the f I herelb certify that I have read and examined th glica i The g work will be complied with whether herein or not. granting of a permit does not presume to give authori sf, i f construction. provisions of any otherfederal,s , or local aw regulating construction or the pe formance q Signature of Owner 1A&AL..AI Signature of Contractor Print Name (f 111144K777 Print Name ........................................................................................................................................ ............................ ............ .................... ......... ........... Befo Before me thi D of 20 this —Day of 20 0 u I Notary Public Notary Public S May Graham Ission FF 086990 Revised 01.26.10 Of Expires 02/14/2018 CITY OF ATLANTIC BEACH OWNER / BUILDER 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 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 HAPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING 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 WITHN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WELL 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 RESPONSIBLUTY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU RAVE 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 Tly 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. C7 / 3,0? Pei 4de PHONE NUMBER ADDRESS Pint PRINT N T R DATE—71V re me this day of 20141n the county of Duval,State of Florida,has personally appeAred hedn by himself herself and affirms that all statements and declarations are true and accurate. 1�4�L_ Notary Public at Large,State of— 6n,County of--, (Conally Known P—r.duce ntfflica tary Public State of Florida Shirley L Graham My Commission F;!F 0869970 kxpores 02/14/2018 Not- re: R/BLDG/Ownar-Builder Affadavi�REVISED: 4/16/200 city of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned b th Building Department.) "A y? 800 eminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 Date routed: E-mail: building-dept@coab.us City web-site: hftp://www.coab.us EM APPLICATION REVIEW AND TRACKING FORM artn;ent review required Yes 0 Property Address �n ��IV6�af�rt uildinv, 7an ing &Zoning Applicant: 6 a -;n S - r tor Tree Ad4ministrator ist Public Works Project: 5-1 /79 Pu lic Utilit Public Utilities [-Fire Servi es 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 [:O�t h:e r�- Date t-Johns�iver Water Management District rmy Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco APPLICATION STATUS eview: Pcpproved. ElDenied. Reviewing Department First R (Circle one.) Comments: MCC—. (:��LDING PLANNING &ZONING Reviewed by: Date: 7- F-/ TREE ADMIN. Second Review: nApproved as revised.. []DeniE PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by:—, Date: FIRE SERVICES Third Review: FlApproved as revised. nDenied. Comments: Reviewed by: Date: Revised 05/14/09