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313 N Oceanwalk Dr 2014 bath remodel n CITY OF ATLANTIC BEACH ;r 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00001418 Date 8/28/14 Property Address . . . . . . 313 N OCEANWALK DR Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 2300 ---------------------------------------------------------------------------- Application desc bath remodel ---------------------------------------------------------------------------- Owner Contractor ` ------------------------ ------------------------ ANDERSON, DONALD D OWNER 313 OCEANWALK DR N ATLANTIC BEACH FL 32233 --- Structure Information 000 000 BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . . . 65 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 2300 Expiration Date . . 2/24/15 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 65 . 00 65 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 69 . 00 69 . 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 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: Permit Number: Legal Description Parcel # Floor Area o q.t . Sq.Ft Valuation of Work$ ! Proposed Work heated/cooled non-heated/cooled C Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/pro osed 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: a4k lre_,6 u C-�A Property Owner Inforrrmmation: n Name: C%t D D Address: 315 City State H Zip'hone 9 - f—9207 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 Ad,dfess Bonding Company Name and Addr s Mortgage Lender Name and Add ss 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 a�period of six 6)months at any time ager work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Healers, 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 this application and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with wh her specified erein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of arty other ,fedWtate, ,local l re ting construction or the performance of construction. Signature of Own Signature of Contractor Print Name F '' Print Name .. ......................................................................... Before me Before me this Day of 20 this Day of .20 Nota r ry Public— State of Fla Not c PubliMy Com am Notary Public SOF n Ex it mission FF 086990 P bs Oz�t4�2018 Revised 01.26.10 rjtyl�)r� j CITY OF ATLANTIC BEACH OWNER / 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. II. 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. �� ,�� (w z-b 7 3 ADDRE PHONE NUMBER P �r IGNATURE DATE ore me this day of 20 In the county of Duval,State of Florida,has persolially a ared herin by him If/herself and affirms that all statements and declarations are true// accurate. Notary Public at Large,State of �y County of /�).�yQ./L ❑Personally Known P` ❑Produced Identification- Notary Public State o/Florida hirtey L Graham ` My Commission FF 0,ndP Expires 02/.4/2018 086990 Notary Signature: F:/BLDG/Owner-Builder AtFadavit;REVO 16 2--000