344 10th St awning permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
1 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-1817
Job Type: RESI DENTIAL ALTERATION
Description: 18' RETRACTABLE AWNING
Estimated Value: $2,475.00
Issue Date: 8/26/2016
Expiration Date: 2/22/2017
PROPERTY ADDRESS:
Address: 344 10TH ST
RE Number: 170039-0000
PROPERTY OWNER:
Name: KRAWIEC, ROBERT
Address: 344 10TH ST
PERMIT INFORMATION: PUBLIC WORKS:
Full right-of-way restoration, including sod,is required.
FEES:
PLAN CHECK FEES $31.19
BUILDING PERMIT FEE $62.38
Total Payments: $93.57
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
I
f. City of Atlantic Beach APPLICATION NUMBER
A Building Department (To be assignedby the Building Department.)
r 800 Seminole Road I�� 17
Atlantic Beach,Florida 32233-5445
IJ
Phone(904)247-5826 - I'm(904)247-5845 q
E-mail: building-dept@coab.us Date routed: 8 I f
City web-site: http://www.00ab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:,._J44 i Q� ZS7 ent review re uired Yes No
Builth
Applicant: 0( I,D (L BZonin
j Tree Ad trator
Project: I�E`l 2 PC TA �6 I—i WNt ub ks
blit Utilities
Public Safety
Fire Services
fRe�leYf fee„$. . Dept Signature.;
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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
PLANN ON Reviewed by: Date:
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
Building Department (To be assigned by the Building Depaan�ment.)
800 Seminole Road tip—
° Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845
?jjrty>' E-mail: building-dept@wab.us Date routed: t i� I jb
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3ti�{ l00� St . De artment review required Yes No
ui in
Applicant: <alannng&tonin
Tree Admmis ra or
Project: C0wila- LIOUL a JtnifNl 'Public Works
y Public Utilities
ptUVIIXy JU', WtA 6k
Public Safety
Fire Services
Dept Sig"
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: 4o /
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
t;t,.tiy City of Atlantic Beach APPLICATION NUMBER
Building Department D1-Ery 1:_ To be assigned by the Building Department.)
n 800 Seminole Road �n,1{/84 E II�V C7..
:r Atlantic Beach, Florida 32233-5445 eUG ' 6 t't0— (LhA�— I%1"'1
Phone(904)247-5626 Fax(904)2
_p; q E-mail: building-dept@wab.us f Date routed: D r 110 1 -h
Cityweb-site: http://w .mab.us BY:__
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3ti�{ l�# St • Department review required Yes No
ui din
Applicant: O1rJ f\u Plann ng &Zonirigj
Tree Admlms ra or
Project: Publi orks
P(Q J �kS�y (Qtj�Q t y b �puit 1 A t j Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature .;
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: fie /JJ• .j _A 6
BUILDING
PLANNING &ZONING Reviewed by: Date: ZS
TREE ADMIN. Second Review:
❑Approved as revised. ❑De
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 09/14/09
i > > , _ City of Atlantic Beach fz+ APPLICATION NUMBER
�" ap Building Department EC ��IJ' �
E ; (To be assigned by the Building Department.)
800 Seminole Road �D
Atlantic Beach,Florida 32233-54'Wl �� i b 1015 ilko— RAAR— i
Phone(904)247-5826 Fax(9 47-
E-mail: building-dept@wab.us Date routed: DI rut 1 -19
CdywetMsite: http://www.mab.ua BY:—_
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3r-1 y l� St kSewlms
ent review required Yes No
Applicant: Dw(\U( Zonin
lms ra or
Project: f"O.LULIOL aWV1.ONA Public Work-s-1
Qf r�vA�V I W 0—wo 6 by ht;r ob A. ities W- D� etyeces"
Review fee $ Dept Signature h
Other Agency Review or Permit Required Review orReceipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPL1,GATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: r Date: f$ f�'
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
P 1C WORxS Comments:
PUB UTILITIES
PIAT�SAFETT Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 95/14/09
FILE COPY
BUILDING PERMIT APPLICATION
�n
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach Fl,32233
OiS1o� Office:(904)247-5826 a Fax:(904)247-5845
Job Address:3Ly LOTIA Sr AnANric 3Cnru FL. 3ZZM Permit Number:
Legal Description 29E RE# I ')0O39O0OAR
Valuation of Work(Replacement Cost)$ 2�4a5 0o Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition CStemtion Repair Move Demo Pool Wmdow/Door
• Use of existmg/proposed structure(s)(Circle one): Commercial Gesidential
• If an existing structure,is a the sprinkler system installed?(Circle one): Yes No N/
• 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:
SrE A- TAPn ED 1)Ro.TEct ZbC5CrIP.TI0tj) Zilc ?Nolo 1RoDuc-r IAiFoRMA71014
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name:Qo9ERT KFAW IEC_ Address: 0TH 51.
City ATLANTIC %EACH State fLZip azz33 Phone 904) Z'19- 0153
E-Mail bk - 5LC (y C`ismtasf ew-*
OWneror Agent uAgent,PowerofAttose or Agencyletter RequirM)
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 NOTIC7E OF COMMENCEMENT.
Contractor Information:
pb" /p yuv SuPacnE
Name of Company: h�uPlto SEA.uicai iNL Qualifying Agent:
Address: 7 �•i CSS .F be n`V City 'S'm k-4OJJilier State Zip FL T2Z5L
Office Phone S- 1 t Job &te/Contact Number
State Certification/Registration# E-Mail Ki a q MN04zro 1 N.rnA414 r n
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation
xemp[ Insurer ase mp oyees I ExpirsturesDat,
Application is hereby made to obtain operant to do the work and installations as indicated. I certify that no work or instatlodon has commenced
War to the issuance of a permit and that all work will be peyarmed to meet the standards ofall Imes regulating construction in this prirdictioa
!'his permit becomes wtl and void if work is not commences within six(6)months, or if construction or work is susppeended or abandoned//o'r a
period ofsix(61 months at any time after work u commenced, f understand thatsepamte permits must be searedjar ElecMca!We k,P(umDing,
tgns, 111''e!!s,PP"Is,Furnaces,Bo AF H%afters;Tanks andAir Condvioners,eta
Signature of Property Owner: //i-OWA:f /�?i.//.O C' Signature of Contractor:
Bef me
this Day of Z c
TONI SPERGER
MY ISSIO PFFS24S51
Notary Public: ` - u
' ;iy,;' awdemmraarP�mc umxam
I hereby certify that I have read and examined this than and know the same to be true and correct. All provisions aflaws and
ordinances governing this type o(work will be complied with whether spa lied herein or not. The granting of a permit does not
presume to give authority to vso(ate or cancel the provisions of any other federal,state, or lata/law regulating construction or the
performance ofconstruction.
Rev.3/14/16
TREE & VEGETATION AFFIDAVIT
o„ City of Atlantic Beach FILE COPY
Department of Community Development
Planning&Zoning Division
B00 Seminole Road Atlantic Beach,FL 32233
(P)904247-5800 (F)904247-5845 PERMIT#
SECTION I-APPLICANT INFORMATION r✓Owner(s) r Legal Authorized Agent"
NAME OF APPLICANT �`O qRr ekW IfL - C)L-3 F\ pt-
NAME OF COMPANY
ADDRESS OF COMPANY
PHONE 'Z4q_0JS3CELL 349321 EMAIL
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATION
STREET ADDRESS OF PROPERTY y4 fDY}I ST-
LEGAL
rLEGAL DESCRIPTION
LOT BLOCK SUBDIVISION
REAL ESTATE NUMBER LOT OR PARCEL SIZE SOFT AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
I affirm that I have reviewed the provisions of Chapter 23, "Protection of Trees and Native Vegetation"of the Municipal Code of
Ordinances for the City of Atlantic Beach,FL and/or I have participated in a pre-application meeting with the Administrator of those
regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the above- ibedoradja at ropertles in conjunction with thisproject.
SIGNATURE OF OWNER /� SIGNATURE OF OWNER
Signed and sworn before me on this 1 day of ,� by State of
1/ / J- County of (7
Identification verified: KCozo (p f7- rjQ-Q]
Oath sworn: r7 Yes r No
NotarySignature 7oxlcNocbbftRCEq
fP. oOME.NBBpRIFF924951
REV-TVA-00.12 My Commission expires: EXPIflES:OetaCx AER
CITY OF ATLANTIC BEACH FILE
®WNER/BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 'CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW
DISCLOSURE STATEMENT FOR SECTION 459.103(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 ACP AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRIy`TTON YOIIRSELF YOU MAY BUILD OR IMPROVE TOME6iTWO 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 YOLm nc AND OCCUPANCY. IT MAY NOT BE BUILTFOR SALE OR LEASE.
1F 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
HIRH AN IINLICENcnn pER50N Ac vOUR CONTRACTOR YOUR CONSTRUCTION MUST
HE DONE ACCORDING TO 1TTE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MA703 SURE THAT PEOPLE EMPLOYED By YOU HAVE
-LICENSES REOLRRFD By STATE LAW AND BY COUNTY OR n
ORDINANCES EPl M
11. 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 TOPENALTY UNDER FLORIDA STATE 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 IFA PERSON 15 A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(2475826)IF IN DOUBT.
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR
V.ACKNOWLEDGEMENT;I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
OWNER-BUILDER PERMIT. THE ISSUANCE OF AN
A DREssY /n-ru ST1A11.An1 µ 3 (gpyl 249. 0/C4
I NE NUMBER
rIC'AB a> �kAw)Fc
PRINT NAM � /--
SIGNA URE 1(� .� GATE o/94
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ouwl,State aFlodde.neanalry v anLy nlmaercl nerselrena efimis Mat
all detemama and aeclamt&mn ere
Notary Publlcat Larye,Staba ��_ coumya i� ] (J✓Q�
❑Paowiay Kn.
❑PmEuua `p� ` 60so-o
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Notary Signature: FXPIflES:(ktobaz6,p1B
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P:/BIDGgw,y.Bwltiv AHarvi[RGNRp:Nyp]9
y; Howare SunSetters inthe wind?Can l leave my
^^V./ awning open all the time?
AAnindependent lab tested our awnings for wind
resistance.All of our models withstood between 55 and 75 mph
wkhout damage in controlled tests.However,we do
recommend that you retract them tludng strong,gusty wintls.
Because they retract,they're great for breery locales where a
permanent awning woultl be somewhat impractical and prone
to damage. Our optional Wireless Wind Sensor for the
Motorized awning gives you additional peace of mind by closing
your awning automatically on very wintly tlays.
If youtl like to keep your Motle1900M or Mode11000XT open
most of the time,even in breezy locales,we recommentl that
you order our optional ftainaway Arches'. They make the
awning more rigid and keep the awning fabric at maximum
tautness.
• 1-800-876-2340
Feature.. Matod:ed PRO Motodzed 8
6 PRO%L M 3torbed IL
Integrated roll-down Front NO NO
Weatherbreaker Panel
comfy motor with ✓ NO
plug-in cord
Multi-Channel Remote Control Q
Manual override in case of
power failure C � '
Heavy duty from bar -^
Baked enamel high quality �/ •? �[ '.
aluminum supports
Double stainless steel cable system
Rich designer color choices ✓
All Sunsetter fabrics block 99%of
UVA and UVB rays
Up to 20°cooler on your deck or patio
5-Year Limited Warranty
Good Housekeeping Seal
UL Listed Motor (File No.E60495) N/A
Skin Cancer Foundation ✓ ✓
Seal of Recommendation
Adjustable pitch (during install)
Installs over any kind of siding �/ p
Installs on the wall or to the _/ ✓
underside of eaves and overhangs �P
Optional roof mounting brackets ✓
available
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t .,r - - - FILE COPY
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach Fl,32233
,une% Office:(904)247-5826 • Fax:(904)247-5845 O
Job Address:344 IpTIa Sr. AT ANTIC. f>EWW ft- 3ZZJ3 Permit Number:
Legal Descripfion 16-25. 79 £ RE#� '70039000nR
Valuation of Work(Replacement Cost)S 2415oa
Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition C2temtion Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial esidential
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/
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:
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name:409EQT KRAW IEC Address: 0TN 5 .
City_AILAan C. 8 A u State Zip=Phone 904) 249. 0153
E-Mail mak - 5LC (J C'eimteef. ew
Owner or Agent (rAgmt,Pa—idAttamry or Agency Letter Raptirc+3)
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:
pbP C/}WN ftAr'RG'iAd
Name of Company: ry�,h�V PRrin3 SE/tVi ceS lNt, Qualifying Agent:
Address: 7 �,.i� S Rk- ryLvO IV City n'pLk'SaiJll'i State Zip 1'G 422sL
Office Phone S- 3 Job Site/Contact Number
State Certification/Registration# E-Mail �i c W�r}W4 z'a I w N r • + ; c
Architect Name&Phone#
Engineer's Name&Phone#
Worker's Compensation
erupt nearer a tap oyees prranon ate
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
Wor to the issuance ot'a permit and that all warkwill be per(�omed to meet the standards ofall laws regulating mnstruclion in this jurisdiction.
fhis permit berom or null and void if work u mt commenced avidin siz(6)months, or ifconsou no or x+ork es suspended or abandoned Pro
period Qx(V)months at anytime after work is commenced. Iundurlca that se ouopermm main,osemredfor Geclrical Wo Plumbing,
Signs, Wells,Pools,Furnaces,Boilers,N tors,Tankss and Air Conditioners,em
Signature of Property Owner: �/( /O lie C' Signature of Contractor:
Befme
this�Day of Zc:) L
'N;jkY MTTOM Ia910N�ai
Notary Public:
.q'k;(>• aeMNThq Na'r/PUEkager•6xe
I hereby cert that I have read and examined this kation and know the same to be[rue and rorrect. All provisions of laws and
ordinances governing this type yf work will be complied with whether specifted herein ar not. The granting of i permit does not
presume 10 give authority to violate or cancel the provisions ojany other federal,state, or local law regulating construction or the
performance ofconstruction.
Rev. 3/14/16
TREE & VEGETATION-AFFIDAVIT
City of Atlantic Beach FI7COPY
i Department of Community Development
D - Planning&Zoning Division
ry �" 800 Seminole Road Atlantic Beach,FL 32233
yr�t9 (P)904247-5800 (F)904247-5845 PERMIT#
SECTION I-APPLICANT INFORMATION )YOwner(s) n Legal Authorized Agent*
NAMEOFAPPUCANT L<QF Rkf 'IKkAu if1 _ — d(�
NAME OF COMPANY
ADDRESS OF COMPANY (A�
PHONE 7,4q_01,5 CELL 34-1 EMAIL
CONTRACTOR CERTIFICATION NUMBER
ATLBCH BUSINESS TAX RECEIPT NUMBER
SECTION II-SITE INFORMATION
STREETADDRESS OF PROPERTY Iyy /VTH ST-
Ilan addresslwsnotbem assignedro Mlspropert};mntatttheAB BulldlnaDepamm¢ntat(904)20-5816 to requert an address.
LEGAL DESCRIPTION r(0 - 25
LOT BLOCK SUBDIVISION
REAL ESTATE NUMBER LOTOR PARCEL SIZE: SOFT AC
RESIDENTIAL COMMERCIAL OTHER(SPECIFY)
I affirm that I have reviewed the provisions of Chapter 23, "protection of Trees and Native Vegetation"of the Municipal Code of
Ordinances for the City of Atlantic Beach,FL and(or 1 have participated in a preapplication meeting with the Administrator of those
regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed
from the above- bedoradj/a/rknt roperties in conjunction with thisproject.
NUNATUREOFOWNER SIGNATURE OFOWNER
Signed and mom before me on this 1 dayof 10 ZQ` by State of
I�
County of
Identification verified: K CoZ o (pb— s o
Oath sworn: n yes n No
Notary Signature n TOM GINCIEBPERGER
V OOEMSSION#FFM951
REV-NA-v1 0.12 My Commission expires: }� •t EXPIRES:OMW6,MIS
CITY OF ATLANTIC BEACH FILE C��Y
OWNER/ BUILDER AFFIDAVIT V
NB
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING°REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DISCLOSURE STATEMENT.—SECTION 489.103(72 FLORIDA STATUTES:
STATE LAW REQUIRES
CONSTRUCTION TO BE DONE BY LICENSED
LAWN THE EXEMPTION ALLOWSP OU AS THP OFOR A WNER OF YOUR PRUMER AN EXEMPTION
MPTY,TO ACT AT
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUSAS
SUPERVISE UM CONSTR tCUM YOURSELF, YOU MAY BUD,D OR IMPROVE A ONE–OR
TWO FAMB.y RESIDENCE OR A FARM OUTBUILDING. YO
IMPROVE A COMMERCIAL U MAY ALSO BUILD OR AT A COST OF 525,000.00 OR LESS. THE B 0I DSV
MUSTBRFORYO g/ SPAND OCCUPANCY. ITMAY NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WTIHEV ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WE,L PRESUME THAT YOU BUILT
LI FOR SALE IC LEASH,WHICH IS IN VIOLATION OF THIS EXEMPITON. YOU MAY NOi
LIME AN UNLICENSED PPRc c ' ONTrs C'7 Q& YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO ITiE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE E
LI PLACES EOLERED STATE I �vr�OYH AY YOU HA
ORDINANCES AW ANm BY COill� E,R"gp li
1]CERSING
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 THEWORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNUCENS D CONTRACTORS CANNOT BE EMPLOYED UNDER ANY
CIRCUMSTANCES OWNERS BEING SUBJECT TO$5,000 PENALTY UNDER FLORE
455-228(1). AN'OCCUPATIONAL LICENS 'IS NOT ADEQUATE IDA TA UTE NO.
SEE THE UN
THE OWNER SHOULD PHYSICALLY
CERTIFICE" TCOTY CERTIFICATE OF COMPETENCY° OR THE FLORIDA "CONTRACTORS
ATO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(24 6)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.
A EE s4 ; 7x C'.LA'H.A r� gOYI 1/4. 0/C4
P NE NUMBER
l'Z.c9 All, +2.QWICc
rnlM NAM
S GNANR
I/ GATE
Be(eremefbia tleY o1 • 1V ]Y SG. Nacounh of
euvel,Btete of Floritla,haa pelacnelty p Iln by bimseX/ber»I(entl egillna Nel
u atatemenb ane aedaraeona alabc.an rea.
Notary,public of Large,Sdte W_�Jcepery0 n V eZ C
O pemnaly Wwwn
opca,m ,m abuec_ Ca7-0 - (�O-So-p
�,".""`- EINIGINMESPEEGER
;.� �� MYO7MM1851PNRFF 920.A61
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AWNW(r �1i �� �E MOUNTF7 IPO ' SACK Fco�n
FTZO"-r EAVES r IS I to L&i c,TF1 . 05E* ING Awrl!NE
WI>7IN WILL- 'FJF_ IN COMPLIANCE Wr71
LIME SE-r 'gact-, K AwwJa CovR
No T? iE 'F rTMWAL I�FCC SAS y Foe i on c
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• SUI.ISF i T'EfC. \kI A erio Anf WOW"r 'NTo2mh"Po
r CI TYOFATLANTICBEA BTHIS PLAN MUST BE
®WNER/BUILDER AFF JOB SITE FOR
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STAIR EACH INSPECTION
CONTRACTING"REQUIRES OWNER I BUILDER TO ACKNOWLEDGE THE LAW;
DISCLOSURE STATEMENT FOR SECTION 489.103(7) REBA STgTUTBE
STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION IC THAT
LAW. .THE EXEMP77ON 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 7H8fn c NYO cF yOU MAY BUILD OR IMPROVE A ONE—OR
TWO FAMB,Y RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
LMPT�OB E AORCOMMER cR BUILDING AT A COST OF$25,000.00 OR LESS. -THE B 11r DH4
AND OCCUPANCY. IT MAY NOT BH HUB,TFOR SALE OR LEASE.
IF YOU SELL OA LEASE A BUILDING YOU HAVE HUILT YOURSELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT
TT FOR SALE OA LEASE,WHICH IS IN VIOLATION OF THIS EXEPdP'RON. YOU Y NOT
BLRfl AN IINLICENCFn nn O*1 pq yO] YOUR CONSTRUCTION MUST
HE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED HY YOU H
AV
LICENSES RPnIIrRED BY STATE LAW AA^ *'Y OR NRJMfIFAI EN
SING
ANCES rL
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY ENHIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
111. 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.
456-228(E AN"OCCUPATIONAL LICENSE'IS NOT ADEO ATE 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.
A...IYY 107W Ci/-TLp l (�-g gpNl 2y9 OIC
r/ NE NUM9ER
2cRcet K"LJ1Fc
PRINTNAMM
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SIGNATURE
// DATE
Betore me Nis h.a P. 2L5C��ma aaan m
Duval,Stab of Flo4da,M1es parsonallY ePP u erin by blmaeift M1a.w.nd afiinna fba,
an amremanb:and awa,auona areAw�a an 2b.
Notary Publlcat Lage,Sinmace _1 I_ Count,I
op.v
❑Pnr d a'p l,lAir uw- Lll
yA''' i. TONI GINOIEJPEPGEA
AIV COMMISSION l FF 92.951
Notary Signature: ' �§ EXPIRES,Odober6.20/9
' 9anEaElaa W: Nbk UMVMna
FiBLpCAxya-BwItic AOLrit aEVLSEp;UIbIW3
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Hand Operated...
SunSetter VISTA® Awning
Economical and Easy to Use
(Non-Motorized) j
Don't need the ease and convenience of our Motorized
model, but still like the look and sophisticated lateral arm
technology of an awning without vertical support arms?
Then our manually operated SunSetter VISTA is the perfect lu ,
awning choice for your home. A non-motorized version of
our motorized model, it opens and closes with a simple - +
hand crank tool (provided) that anyone can use. The VISTA
requires no electricity. It includes the same high quality alu- The VISTA hand crank only operates
minum components and dual stainless steel cable lateral from the right side—facing the house.
arm system as our Motorized SunSetter.
VISTA.Up to 10 ft.2 in. projection.Widths _
from 8 to 18 ft.Woven acrylic and lami-
nated fabric available on all widths. p y
Over 650,000 Satisfied SunSetter Owners! T.
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