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982 OCEAN BLVD 16-RAAR-1158 INTERIOR REMODEL 1---- - 'r '.X.S, CITY OF ATLANTIC BEACH '� .. _ .c) 800 SEMINOLE ROAD V ,...,, . ATLANTIC BEACH, FL 32233 \ se INSPECTION PHONE LINE 247-5814 RESIDENTIAL ALT/OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-RAAR-1158 Job Type: RESIDENTIAL ALTERATION Description: INTERIOR REMODEL Estimated Value: $25,000.00 Issue Date: 5/25/2016 Expiration Date: 11/21/2016 PROPERTY ADDRESS: Address: 982 OCEAN BLVD RE Number: 170342-0000 PROPERTY OWNER: Name: Woessner, Brian J Address: 982 Ocean BLVD PERMIT INFORMATION: FEES: PLAN CHECK FEES $87.50 BUILDING PERMIT FEE $175.00 STATE DCA SURCHARGE $2.63 STATE DBPR SURCHARGE $2.63 Total Payments: $267.76 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. o..Ank City of Atlantic Beach APPLICATION NUMBER / ' Building Department (To be assigned by the Building Department.) 800 Seminole Road I 1 6 -R 1^R R I (5 8 Atlantic Beach, Florida 32233-5445 �1 Phone(904)247-5826 • Fax(904)247-5845 it'-<01119%- E-mail: building-dept@coab.us Date routed: 1 ft City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 9z. cCEIkN L vt _Department review required Yes o BuildiriLD Applicant: Bçat w c ss ez-— ' an • oning Tree Administrator Project: ( J T ULL°R Rc - L Public Works Public Utilities Public Safety 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: 1iApproved. ❑Denied. (Circle one.) Comments: /� , lam' (/ _ :UILDING / V i PLANNING & ZONING Reviewed by: PI ri Date: 5---d al t, 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 S `'Ir14tr'`' BUILDING PERMIT APPLICATION FILE COPY CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 -1 °';ter Office:(904)247-5826 • Fax: (904)247-5845 1 6-R�A�.-c ( sg Job Address: 782, Oce! / 8 L V L Permit Number: Legal Description RE# Valuation of Work(Replacement Cost)$ 2C, 000 Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool 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 10 N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: ,k/41,.(, .t./&V�., GKF,v i2.Ec /?9 1 fj/,I/ A}U'p i,u I FyU amt. F/tU/S//F,S Florida Product Approval# for multiple products use product approval form Property Owner Information Name: 8/2-bin./ y/Oe&5A/rfFL. Address: 9(92_ 0 L�itev B L.(/,h. City �ATZ.h J/T/ C 13Fide# StateFF!,Zip 3 22 3;�Phone 40 y- S7/-380 ' E-Mail bev'a.4 w/)+eSSdr1tP� q#n#'V cao4-1 Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) 84.MAI G.JD E.3SA/$C�, 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. Contractor Information: Name of Company: °LAME] */�.ti — Qualifying Agent: Address: City State Zip Office Phone Job Site/Contact Number State Certification/Registration# C GG LrZ)f 1/9 2 E-Mail by/ay o ess j,e - d-q 141,41/, e nen Architect Name & Phone# ✓ Engineer's Name & Phone# Worker's Compensation Exempt / Insurer / Lease Employees / Expiration Date 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 if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period o_fJ'six(6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing, Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. Signature of Property Owner: Signature of Contractor: Befo e this Day of al Z O ( co Before me this %ay of Notary Public: Q j�4�/ -�- ! ,L2'., RGER- � V d ;�'�1;�� �' pFF9 •'' MY COMMISSION 4i-'�i I hereby certify that 1 have read and examined this applicationY;..:;-.'/F7:-;' t EXPIRES:October s tau a rrect. All provisions of laws and t#b�. • ordinances governing this type ofwork will be complied with,, s', • •_;.�..._._.•- . ie granting of a permit does not presume to give authority to violte or cancel the provisions a • mer Cc'era!, stale, or local law regulating construction or the petfortnance of construction. Rev.3/14/16 DO NOT WRITE BELOW- OFFICE USE ONLY Applicable Codes: 2010 FLORIDA BUILDING CODE Review Result (circle one): Approved Disapproved Approved w/ Conditions onditions Review Initials/Date: Development Size Habitable Space Non-Habitable Impervious area Miscellaneous Information Occupancy Group Type of Construction Number of Stories Zoning District Max. Occupancy Load Fire Sprinklers Required Flood Zone Conditions/Comments: r : G'. `S 800 Seminole Road _ l Atlantic Beach,Florida 32233 s) Telephone(904)247-5800 \ Vr FAX(904)247-5805 Construction Site Management Plan Compliance A construction site management plan conforming to Atlantic Beach City Code Sec 6-18 has been approved as a part of this building permit. The Construction site management plan was approved based upon the following information. 1. Parking plan—parking plan showing how site will be accessed and all onsite and abutting street parking areas. 2. Location of construction trailers, loading/unloading area and material storage area. 3. Location of chemical toilet area.(chemical toilets must be kept out of City right-of-way and not further than 15 feet from structure under construction) 4. Location of dumpster. Dumpster must be from an approved waste company (in accordance with Chapter 16 City Code)as of 2009 the permitted dumpsters are Advanced Disposal,Realco Recycling, Republic Services, Sunshine Recycling and Shappells. Dumpsters will have tarp covers or rigid covers on windy days. Dumpsters must be removed prior to issuance of Certificate of Occupancy. 5. Traffic control plan, showing access with dimensions, area to be stabilized, narrative on phasing of construction with adequate parking and delivery of materials. 6. Site cleanliness. Contractor must have the entire construction site cleaned by Friday of each week. This means removal of scrap lumber, concrete remnants and other such construction debris including cans,metal,plastic and paper. 7. Erosion and Sediment Control. Contractor must maintain all elements of the approved Erosion& Sediment Control Plan(silt fence,catch basin filters,etc.) until sod or other stabilization has been placed and approved by Public Works. 8. Other activities,where special conditions are identified by the Building Official. Failure to comply with the Construction Site Management Ordinance may result in a Stop Work Order being issued in accordance with City Code Sec. 6-17 (3) Revised 3/2016 .,:s1- ,,,,, • ,J-,Y .•�� CITY OF ATLANTIC BEACH 11:?... - OFFICE COPY '�►WNER / 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 TIIAT I,AW. 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 BUII.I' 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. qg2 c),c &/YD log-52/-390g ADDRESS PHONE NUMBER a fLo,L, zio-65,5,0 e-,,_.. PRINT NAME>� y/ RE � DAT Sl Before me thisICI day of t `//V 201/ e county of Duval,State of Flon a,has personally appeared herin by himself/herself and affirms that all statements and declarations are true and acc ate. Notary Public at Large,State of 1` ( ,County of C.)(JQ D Personally Known ©� r _ !� 0 --. Co-4 / 0 Produced Identification i. (O l/ ( 7" wawa �r' , TONI GINDLESPERGER 1�c4:) ExpiREs:october6.2019� MY COMMISSION#FF 924951Notary Signature: __ — / — mPublicUnderwn:ers/ ioBanded ThN Notacy F:BLDG/Owner-Builder Affadavit;REVISED:4/162009