100 Seminole Rd 2014 shed t ��,,.rl,►`I�j�3
CITY OF ATLANTIC BEACH
s f 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
14-00001039 Date 7/11/14
Application Number 100 SEMINOLE RD
Property Address . . . . .
Application type description SHED PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1000
---------------
----------- ---------------------------------------------
----------------------------
Application desc
12 x 8 shed
----------------------------
Contractor
Owner
---------------
SOWARDS, KERRY E OWNER
1613 LINKSIDE DR
ATLANTIC BEACH FL 32233
__ _ _ ---
-----Permit----
ACCESSORY STRUCTURE NEW RES
Additional desc Plan Check Fee 27 . 50
Permit Fee . . . . 55 . 00 1000
Issue Date Valuation
Expiration Date . . 1/07/15
-------------------------------
---------- ---------------
Special Notes and Comments
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. ------------
_____ -----------------------------------
--- 2 . 00
Other Fees
• • . . STATE DCA SURCHARGE 25 , 00
• ENG REV BLDG MOD OR ROW 2 . 00
STATE DBPR SURCHARGE 25 . 00
UTIL REV MODIF OR ROW
--- --------
-----------------------------
----- -
Fee summary Charged Paid Credited
_ _ ---------- ------- . 00
. 00
Permit Fee Total 55 . 00 55 . 00 00 . 00
Plan Check Total 27 . 50 27 ' 50 . 00
54 . 00 54 . 00 . 00
Other Fee Total 00 . 00
Grand Total 136 . 50 136 . 50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
BUILDING PERMIT APPLICATION AdO3
p a
CITY OF ATLANTIC BEACH 1 ,
Atlantic Beach FL 32233
FILE C 800 Seminole Road, '
s Office (904) 247-5826 Fax (904) 247-5845
Job Address: /OD —r /lg woL.'e /0&z Permit Number:
Legal Description ST0tZ Parcel#
oor Ax—ea-o q. t. --Sq.Ft
Valuation of Work$ lOop Proposed Work heated/cooled non-heated/cooled /2 YI
Class of Work(circle one): 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#
For multiple products use product approva orm
Describe in detail the type of work to be performed: By j t-D 12 x of .97cmMA6E Si g
Property Owner Information:
Name: sowA-SAS' Address: /bo S MINA 4 -
City .R State Pt Zip2� ?.1? Phone !7&!( &1_&57Z r
E-Mail or Fax# (Optional)
Contractor Information:
Company Name: Qualifying A t:
City State Zip
Address:
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 a d installations as indicated. 1 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 rconstruction or work is pegulating construction in thpis jztrisdiction. This permit becomes null
or and work er
void
sc o wmenced.not 1commenced within six understand that separate permits muor st be secured for Electrical Work, Plumbing, Sigended or ns,aWells,Period o is plisix rnaces,Boilers,months tlHeatme ers,
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 BEOR ENTCORDING YOUR NOTICE OF
COMMEI herebycertify 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 of ork 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
orovisuons of any other federal,state, or local law regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
Print Name ....C..... Print Name .........................................................................................................................................
.... .....5c�,,. .r4�.�t.........................................
Bef Before me 20
:his9ti
of 20 this Day of
rotNotary Public
Revised 10.24.12
_. I
FILECOPYCITY OF ATLANTIC BEACH � E
(OWNER / BUILDER AFFIDAVIT 77-7_7-7
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 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 RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED 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 T AX 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.
/00 ,51FTn!N oLe
ADDRESS PHONE NUMBER
k6Y
PRINT NAME
7Beforeme
DATE
day of 20�n the county of
uva, f Florida,has personally appeared herin by himself/hers elf an affirms that
all statements and declarations are try�and accurate.
Notary Public at Large,State Of .� .county of
L / Z - 7-
❑Pe Wally Known 10 7
roducedlde
Notary
F:BLDG/Own -Budde Affadavil;RE SED: 4/16 09
CITY OF ATLANTIC BEACH
1 _ - 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
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 BUMP -
IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT
HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR- YOUR CONSTRUCTION MT1Stt BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. 1T I
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAV
LICENSES RE UIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSIN
ORDINANCES.
F. s2
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY'HIRE, _
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE '� AIL_
PURCHASED. I Az,_* o
III. IRS WITHHOLDING;'OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKER
EMPLOY ON THEIR IMPROVEMENT TRADES. ' '
IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER
CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATU
455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PH`FSIC
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. 1
90 C1 610
BOO Sin/NPHONE NUMBER i N
ADDRESS I
IC Y sw�-rt al '` , a- o
PRINT NAME j U U A 0 1
W i
SIGNATURE DATE
Before me this day of 20�n the county of t
Duval,State of Florida,has personally appeared herrn by himself/herself an affirms that V
all statements and declarations are trWD and accurate.
Notary Public at Large,State of /r{/ ,County of
low
❑P4Known
L z
6Notary
FBLDGit ,
RE SED: 4/16 09
a
S! awf City of Atlantic Beach ;_ APPLICATION NUMBER
J3 r Building Department (To be assigned bye Building Department.)
` 800 Seminole Road i / i X039
Atlantic Beach, Florida 32233-5445 11
Phone (904)247-5826 • Fax(904)111 ,6845
E-mail: building-dept@coab.us _ Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: led A0 0 I/V 6`£ �C4 Department review required Yes No
Build
Applicant: ing &zo
Tree Administrator
Project: al �AL "Public Works
ubli Utilitie
Public afety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Dateof 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: WApproved. ❑Deni&
(Circle one.) Comments: n
BUILDING `'
PLANNING &ZONING Reviewed by: Date: 7 hf
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
City of Atlantic Beach APPLICATION NUMBER
a
(To be assigned by he Building Department.)
�3
Building Department IP14 /
800 Seminole Road J
Atlantic Beach, Florida 32233-5445-
Phone(904)247-5826 • Fax(904) 247-58� Date routed:
E-mail: building-dept@coab.us '\-
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACv%,ING FORM
Property Address: IN J&A 1AW9 �" De artment review required Yes No
Buildi
Applicant:
pp Tree A: i,nistrator
Project: �� x �/T�!� ublic`) orks
ubli Utilitie
Public ;a`f y
Fire Services
Review fee $ ��S Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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 4Approved. ❑Dened
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: -
TREE ADMIN. Second Review: ❑Approved as revised. []Denied.
I WO K Comments:
UBLI UTIL I
PUBLIC SAF TY
Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Deniec
Comments:
Reviewed by: Date:
Revised 05/14/09
?frLJ' APPLICATION NUMBER
r City of Atlantic Beach (To be assigned by he Building Department.)
Building Department 3
800 Seminole Road
/
r� Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904)247-5845 7
Date routed:
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
/,"7 �AldDe artment review required Yes No
Property Address: U d Buildi
n /�, �
Applicant: ing &Zo
_ /' Tree Administrator
ublic Works
Project: / x ublic Utilitie
Public afety
Fire Services
Review fee $ Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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: Approved.
Denied.
(Circle one.) Comments:
BUILDIN
PLANN ZONING — Reviewed by:
Date:
TREE ADMIN. Second Review: [-]Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
Reviewed by: Date:
PUBLIC SAFETY
Third Review: ❑Approved as revised. ❑Denied.
FIRE SERVICES
Comments:
Reviewed by:
Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned b he BuildingDepartment.)
)
800 Seminole Road /V♦
1039
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904)247-5845
? E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /Q� c�9711 NdI£ De artment review required Yes No
Buildi
Applicant: .[) �4 ing Zo
Tree Administrator
x � �`�Lc b ublic Works
Project: d ubli Utilitie
Public afety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Dateof 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: ,Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by / Date: Z 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 MUM