1963 COLINA CT - SUMMER KITCHEN J 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
JOB INFORMATION:
Job ID: 16-RAAR-1435
Job Type: RESIDENTIAL ALTERATION
Description: FINISH SUMMER KITCHEN - PERMIT 15-RAAR-664
Estimated Value: $100.00
Issue Date: 6/22/2016
Expiration Date: 12/19/2016
PROPERTY ADDRESS:
Address: 1963 COLINA CT
RE Number: 169506-1060
PROPERTY OWNER:
Name: MURPHY, STEPHEN & PATRICIA, *
Address: 1963 COLINA CT
I
I
PERMIT INFORMATION:
FEES:
BUILDING PERMIT FEE $55.00
STATE DCA SURCHARGE $2.00
STATE DBPR SURCHARGE $2.00
Total Payments: $59.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
131 IIDING CODES.
BUILDING PE_RMITAPP_LLCATIQN___
- - if; -(I �iJ
1-_-) lEav
�- CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
`0'31>r Office: (904)247-5826 • Fax:(904)247-5845 '
Job Address: /9 4 3 '2o L l N d_.4- Permit Number:
Legal Description RE#
4— GS
Valuation of Work(Replacement Cost) $ t 0 v Heated/Cooled SF Non-Heated/Cooled OC
• Class of Work(Circle one): Ne Addition iteration Repair �. : •----- : . Pool Window/Door
• Use of existing/proposed structure(s • ale u e): Commercial Residential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes liai N/A
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describef in detail the type of work to be performed: e, a✓c old \dee k. - Ipu..le( .Cr,eeA room. (Idd;i;ew
61b is 4_ remewaL pc ffroa4-.3 /SSJeI/ +;. J.1V aoI . )
`Florida Product Approval #_ /
for multiple products use product approval form
Property Owner Information
Name: .1e:a 4- Sie rata Mvrppl. Address: l if b3 C a ( Slit t Q •
City >�f 62,144.(G t ae 1. State.Zip i3 a 2 33 Phone 9 0 y 4 0 E ti(q a/ (FM •41)4 Ste v0
E-Mai, f Ibt rAvcp A,1 e a•
cner Agent (If Agent,Power of Attorney or Agency Letter Required)
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: R e p lar&. S -RAA 2-- G7 G4
Name of Company: Nl IA- Qualif ' g Agent:
Address: City State Zip
Office Phone Job Site/Contac umber
State Certification/Registration # -Mail
Architect Name & Phone #
Engineer's Name & Phone#
Worker's Compensation
Exem. / Insurer / Lease Employees / Expiration Date
Application is hereby made to obtain a permit to do the work an installations as indicated. I cert fy that no work or installation has commenced
Tprior to the issuance of a permit and that all work will be pert, med to meet the standards of all laws regulating construction in this jurisdiction.
his permit becomes null and void if work is not commence, within six(6)months, or if construction or work is suspended or abandoned or a
period of 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,Bod27
ee.. Heaters, Tanks an• Air Conditioners,etc.
Signature of Property Owne /►,A J RGER
Befe� e p Y� l.�1. _,?:;4 e nf>��F
this (,��Day of C7 n p A'•%t-.A.jESOcob6, 19
i "e,=',, mNraunPu le {
__,
Notary Public: _� �_ ' -s..
Notary Public:
I hereby cert that 1 have read and examined this applicati,!and know the same to bet e and correct. All provisions of laws and
ordinances governing this type of work 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 provisions of any other federal, state, or local law regulating construction or the
performance of construction.
Rev.3/14/16
6/Zc/( (o
INSPECTIONS REQUIRED
(T)---.-')
l
U ) Q-r\ 1
To verify compliance with building codes,inspection of the work authorized at v. V\ J L owing
inspections are typically,for residential projects. (/ O
6
‘..
Date: Initial: _ c n aU e_ Ck_ t, e r-- - Initial:
• Power Pole S m � ^ `
*When power pole is ready to be released to JEA for connection. ° *When 0___o n-41"4_gCor-ed.
3
Piers
ell O/->
Underground Plumbing (2.-0/1`8-/ ' \
UnderglRu_ nd ectric I • ` ✓! -`t I [ElectriWhenC} (l `� v� e c..�
Foundation/Sla I' ootin;)yij ,J$' in I i a� i1 to Q c o r`e(- P v t ( E
Retaining Wall Foo`�'-1.r ?•j$4jc q''oLC--`/ /hI. 'S wimr. p e -iin‘ `- o c- e,y-A-e n 5 t oi• .
*When all underground plumbing,electric and reinforc ent are complete but mar e ? =( o N t
before any backfill is placed. Additic -.`, -.„,, —yUui Ni ujeut,IT your project
contains these elements.
Rough Electric
Rough Plumbing/Top Out I Reinforced Concrete
Rough Mechanical ! *When forms and reinforcing steel, anchor bolts, sleeves, and inserts, and a
*When all rough electric,plumbing,mechanical are complete but before any work electrical,plumbing,and mechanical work is in place,but before concrete is placec
is covered up. •
Structural Steel
I I I *When all structural steel members are in place and all connections are complete,
House Wrap 1 but before such work is covered or concealed.
Tie-down Framing Connections Ito'
i
Wall Sheathing
i i
Rough Framing 4g11J•1 RoofSheathing10 .tyb `d.F'/S" ' ki+ehulrmit Ty
Window Installatidn—Door
e h C �oSuri
*When all framing,windows,sheathing,shear-walls and metal connectors are in /t y, ,,
place but before insulation is placed. /, r r��
(..,...._,-11P%
1\ 0Insulation Ceiling + r a ;rI �r {r_ ..
Insulation Wall I
, ;
*When insulation is in place but before insulation is covered. J;31��'
Exterior Lath /II6hlIP When ail backing and lathing,interior and exterior,is in place,but before any 66°.•• °RA 4 le di ‘4, 4
plaster is applied or insulation is installed.
/963
erm No.
Drywall 1 i�L 1 IMAP er
*When all wallboard is in place but before joints are taped and finished. .lob {gess
I Early Power I i ntractor
*When building electrical can be safely energized and all work is substantially
complete.
POST THIS CARD WITH PERMITS
Gas Test j j IN FRONT OF BUILDING
*When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance.All outlets must be capped and pipe pressurized at a Building Department Fire Department
minimum of 15 lbs. Phone:904-247-5814 Phone:904-630-4789
Fax:904-247-5845
Fax:904-630-4203
Final Plumbing
Final Electrical
Final HVAC
Email:building.dept�coab.us
{ Public Works/Public Utilities
Phone:904-247-5834
Fax:904-247-5843
Final Building ;
*When all construction work including electrical,plumbing,and mechanical, Construction Hours per City Code
exterior finish grading,required paving,and landscaping are complete and the 7 am-7 pm Weekdays 9 am-7 pm Weekends
building is ready for occupancy but before being occupied.
} . ., CITY OF ATLANTIC BEACH
'v •
'J%WNER / BUILDER AFFIDAVIT
':tE;t Wr
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 OUTBUII,DING. 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,
1 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.
1g63 CoL, u et gay Goe- yqal RI- curl
ADDRESS PHONE NUMBER
-,triGta 5�.et,At ( 1v,,l►) Y `f Kttrc ccG
" 4
NAME
SIG ATURE / DATE/
Before me this(it day of`.... Q fn 201_61the county of
Duval,State of Florida,has personally appeared erin by himself/herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of C ,County of 0 Lic..i(
❑Produced(Known ` ` C0 (— '...5
( `; 33
L�Producedldent�cat.�k / • CD � �p � `
(( •
Notary Signature: • fr- ;i:: TONI GINDLESPERGER
,i, MY COMMISSION 9 FF 924951
11 4. ��, EXPIRES:October 6,2019
F:BLDG/Owner-Builder AfTadavit,REVISED:4/16/2009 1.!..;'.z..;,,,.,-....,'071
.d;•` Banded Thr Notary Pubic Underwriters