1731 PARK TER E INTERIOR BATH RENO CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
RESIDENTIAL ALT/OTHER
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOBINFORMATION:
Job ID: 15-RAAR-943
Job Type: RESIDENTIAL ALTERATION
Description: INTERIOR DOOR OPENING BATH REMODEL
Estimated Value: $6,000.00
Issue Date: 6/2/2015
Expiration Date: 11/29/2015
PROPERTY ADDRESS:
Address: 1731 E PARK TER
RE Number: 172020-0404
PROPERTYOWNER:
Name: HARRIS, IVY C
Address: 1731 PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: OWNER
Address:
Phone: - -
PERMIT INFORMATION:
FEES:
PLAN CHECK FEES $40.00
BUILDING PERMIT FEE $80.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $124-00
PERMIT IS "PROVED ONLY IN ACCORDANCE WITO ALL CITY OF ATI,ANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
C* p y
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Semincle Road
Atlantic Bwch, Florda 32233-5445 IS-RAAe-'143
Phone(904)247-5826 Fax(904)247�5845
E-mail: building-dept@wab.us Date routed:
Citywelb-site: http://�.�b�us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1-13 1 PrAY'Y---rC rr-. E D—ella rent review requir d Yes440
4 uulldi if
Applicant: 'P10MnI5g&Zoning
Tree Administrator
Project: yi cor ckoof QP:nj1N1I PublicWorks
Y-cry-\odci Public Utilities
Public Safety
Fire Services
Review fee $_ Dept Signature
Other Agency Review or Permit Required Review or Rece P, Date
of Permit Verified 13Y
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johni;River Water Management District
Any Carps of Engineers
Division of Hotels and Restaurants
Dimsion of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: MApproved. ElDenied.
(Circle one.) Comments:
fi) 0
PLANNING&ZONING Reviewed by:
TREEADMIN. Second Revim: LIAPProved as revised.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRE SERMCES Third Review: ElApproved as revised. E]Denied.
Comments:
Reviewed by: Date:—
UW.d 07127110
BUILDING PERMIT APPLICATION �� M g M � T T
CITY OF ATLANTIC BEACH APR -22-
FILE COPY 800 Seminole Road,Atlantic Beach,FL 32233 1
Office(904)247-5826 Fax(904)247-5845 By
Job Address: 17N���4n3&4,,1 Permit Nmmb,,: 16- )e)0,Aj2:Tf-;
Legal Description Parcel 9
'�Ebq Sq.rt
100rZ �',;tk he no
Valuation of Work$44��Prop alited/cooled M n-heated/cooled
Class of Work(circle one): New Addition Repair Move Demolition pool/spa window/door
Use of existing/pro osed structure(s) imle one): Commercial
If an existing structure,is a rim sprm=system installed?(Circle on.C)1�4iePto N/A
Florida Product Approval#
For multiple products use-prmfac-tappro-vSI`r5-rm—
Describe in detail thetype ofworkto beperfo=ed:j>;,2e "w,, tm Z",�
iWid900-M Al�� I/Am.V Atm J�kj"-r.� A�t 4,e,+�
1114 t C;
Pro=Ow formation:
Name: ellfteee�16COA&I Address17-f1&1-r—.e.
City-dvao.,na TLO"61 —
E-Mail or Fax#(Optional) -5-y.?I
Contractor Information: CONTRACTOR EMAEL ADDRESS- Ct�-;�ellccem,
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 Address /71/MeA ww.&E, eg A?- faalft
Bonding Company Name and Address
Mortgage Lender Name and Address A(*"
Applicationishereby made to obtain a permit to do the work and installations as indicated 1,e,tilv that no work or oucallation has commencedprio,to the
issuance o
,fa permit and that all work will be%
-formed to meet the standards ofall laws regulating construction in thisjurisdiction. Thispermit becomes null
and void ffwork is not commenced within six il� months,or ifconetraction or work is so
I undc,stund that separate permits most be socarcaffor E e r capoinded or baodooedfor a
work is commenced. b,
1 a I a Work Plumbing, Wperiod ofsag)months at an,y time after
Ton ks and Air Condillomm,da Signs; elle pools, rsaces,Bone.,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 FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hcre�cerrify that I have read and examined this lication analknow the same to be trus andcorrect. Allprovisionsofl agyord
type 0, 'work will be cot er,s , ed ana nice
malted ith wh ( X0 inornot. The granting of a permit does not presume to gweTth cothn,,go�er his
ny otherfederal. re, I w re J comotruc, . or thoperformaoce ofconstruction, a, an 5t the
FC517,Z048-
Signature of Owne Signature of Contractor
Print Name Print Name
................
................................. ............ ................. ............
Be Before me
thi of 2 this —Day of
Not -Tic
WHER WhM Notary Pub
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EXPIRES APA24.2017 Revised0l.26.10
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CITY OF ATLANUC BEACH F11 7 COPY
OWNER / BUILDER AFFIDAVIT
VW
1. FLORIDA STATUTE$; CHAPTER 489, FLORIDA STATUTES, PART 1 -CONSTRUCTION
T TUT
BACTI
' COPY
LT �TRUCTION
ON RACTIO REQUIER'ES CO=ER I BUILDER TO ACKNOWLEDGE THE LAW.
Fc,
DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES
STATE LAW REQUIRES CONSTRUCTION TO BE DONE By LICENSED
CONTRACTORS. YOU ILAVR APPLIED FOR A PERMIT UNDER AN EXEMPTION TO UIAT
LAW TIM E=MPUO,,ACL0WS YOU,AS THE OWNER OF yoUp,PROPER
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICE S TY,TO ACT AS
N E. YOU MUST
SGPERVISUTHECO SIRUCTION YOURSELF. YOU MAY BUILD ORB"ROvE k_p_�jF—OR
VWO FAMILY RESLIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COM�IERCLAL BUIr DING AT A COST OF$25-000.00 OR UESS, UM BUILDIN
MUST BE FOR XiQURMEAND OCcupANCy. IT MAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU
FSELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITUIN ONE YEAR
I AFTER TIM CONSTRUCTION IS COWLETS, THE LAW WILL PRESUME THAT YOU BUILT
I FOR SALE OR LRASL WHICH IS IN VIOLATION OF ITITS E)MlIPTION. YOU MAY NOT
HI&E AN UNLICENSED PEP_'SQN AS YOUR CON CTOg IR
BE DONE ACCORDING To THE BUILDING CO IFLA _ yOL CONSTRUCTION MUST
DES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILHN ro MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
AND By C
LICENSES REQULR_ED JY STATE LAW SQGNTY 0 RMUNICIPAL UICENSNG
LMDINANCES
It. INJURY LIABILITY; SINCE OWNERS MAY BE LIA13LE FOR INJURIES TO WORKERS THEY HIRE
THE BUILDING DEPARTMENT SUGGESTT XOM�_��S COMPENSATION INSURANCE B�_'
PURCHASED
Ill. 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.
ENA TY; UINLICEN ED CONTRACTORS CANNOT BE EMPLOYED
ST LT
CIRCUM ANCES. OWNERS 6EIN13 1:;NU UNDER ANY
z � E�TTO B�6'
PAT E 0 $X �'ENALf UO�NZ�MHMIIUIA STATUTE NO
455-228(l) AN�-OCCU IO�UAL LICENSE'IS NOT ADEQ(IATE. THE OWNER SHOULD PHYSICALLY
SEE THE lv.N'T ULKIINUAIL 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.ACKNOV&EDGEMENT;I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND T14AT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
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Scope of Work COPY
Building Permit Application
173 1 Park Terrace East,Atlantic Beach, FL 32233
aste a Fame n ne d openang in bedroom-a"
sure
<::om r oor add glass door
rB 'hro Relocate to flet and add glass enclo
N'w tile"'hower'nlo"re and
'10"te vanity and add new smk.
Master Bedroom Frame m new, 'set door'p'nmg m'heetrock wall
Hall Bathroom: Remove existing door frame and door. Relocate both 4 feet into
hallway to expand size of bathroom.
Remove existing closet door and sheetrock opening.
Carpentry work to add bench,shelving, etc.
Front Bedrooms: Frame in new opening between two bedrooms in sheetrock wall.
�1301