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46 15TH ST - SIDING t I. CITY OF ATLANTIC BEACH J 1�Y } � 800 SEMINOLE ROAD j 'n`" _ , ATLANTIC BEACH, FL 32233 N� INSPECTION PHONE LINE 247-5814 JJ,1�`" SIDING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 17-SIDE-3599 Job Type: SIDING PERMIT Description: replace soffit with tongue & groove pine & install cedar shakes on porch Estimated Value: $5,000.00 Issue Date: 4/5/2017 Expiration Date: 10/2/2017_ PROPERTY ADDRESS: Address: 46 15TH ST RE Number: 170307-0000 PROPERTY OWNER: Name: Geddes, Timothy Address: 46 15Th ST PERMIT INFORMATION: FEES: IPLAN CHECK FEES $37.50 4 BUILDING PERMIT FEE $75.00 STATE DBPR SURCHARGE $2.00 STATE DCA SURCHARGE $2.00 Total Payments: $116.50 PERMIT IS APPROVED ONLY IN ACCORDANCE N1'177I ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. LA4j:41 City of Atlantic Beach APPLICATION NUMBER �s Building Department - ••:`� 800 Seminole Road (To be assigned byCthe Building Department.) u • r) Atlantic Beach, Florida 32233-5445 V5T- U�, 3S''el � a Phone(904)247-5826 • Fax(904)247-5845 1 \on t). E-mail: building-dept@coab.us Date routed: 193 131-- 1 19 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM �l St Property Address: �-� `G ' ent review required Yes No Building Applicant: () Oft PA 1-planning &Zoning 1 Tree Administrator Project: V�`CR-t- SDA-k- Sl� n� D Public Works Public Utilities nn t' 04 LV) 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: [pproved. ['Denied. (Circle one.) Comments: :UILDIN it)° PLANNING &ZONING Reviewed by: Date: / 917 TREE ADMIN. Second Review: A roved as revised. ❑ pp ['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 -fo- , Building Permit Application RLE COPY it ';0 City of Atlantic Beach `' 800 Seminole Road,Atlantic Beach, FL 32233 on Ve- Phone: (904) 247-5826 Fax: (904) 247-5845 Job Address: !' �J Til J`{T e e "t Permit Number: ‘9.-- 5=-0 E.---- 5 ` Legal Description Art" I/ AJ—J /2f Jr ht, i/ ri) pLf 4,/ RE# /'76/'? 3O'?- COCl Valuation of Work(Replacement Cost)$ CW .00 Heated/Cooled SF 1 gek9 Non-Heated/Cooled ---- • .• Class of Work(Circle one): New Addition Alteration epair jviove Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial esidenti • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes SA:57 N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal ` scribe in detail the type of work to be performed: p.ew'cve 3 Qeelwc Q 5o Ott w ii.l4 i ou 3 G�Ve 04. I"' `Wrk" Ne‘A' v°'4-i-,, S T'N5`iAiU CQdA\L. 5 11K2 S mit oxi o yea_b� l�'eAteti P©o2 AN() o veil-Mil 0> Pa.oNt pets4+ -u,K4 Myc Peat 1 &-flc_kc 2 FIA51-11 Florida Product Approval# for multiple products use product approval form 1 Property Owner Information ,L1 Name: �/'nt GfcL f-s' Address: 76 /...51i-4 ( L 11 City tz . .. _ _. • . State..�I Zip 322 33 Phone d(/ -50'2- d D OS' E-Mail k�P..i e gg . .,rkek, , c o h Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: Qualifying . Address City State Zip Office Phone Job Site/Co ct Number State Certification/Registration# E-Mail Architect Name&Phone# Engineer's Name&Phone# Workers Compensation xempt/Insurer/Lease Employees/Expiration Date Application is hereby made to obtain a permit do the work and installations as indicated.I certify that no work or installation has commenced prior to the issuance of a per ' and that all work will be performed to meet the standards of all the laws regulationg construction in this jurisdiction.I unders nd that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, WELLS, POOLS,FURNACES, BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. 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 FIN , CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECO DI OUR ' 0TICE OF COMMENCEMENT. nature of Owner or Age including Contractor) (Signature of Contr. or) Signe .nd s orn to(or affirmedore m- th -7:7 d,y of Signed and sworn to(or affirmed)b- ore me this day of 0 �A i • by _ A ,by ~'wY:ei TONI GINDLESPERGER , � 1- ' '' yji _': i `' "MY COMMISSION# ' V s 4aa EXPIRES:October 6,2019 ` t%t.."trig,n ' Bonded Thru Notary Public Underwrters( nature of rotary) 411 (Signature of Notary) [ ]Personally Known OR [ ]Personally Known OR [ ] produced Identification C_--) CO Q O_ / —Z`7 j�]Produced Identification Type of Identification: 10 ! lJfype of Identification: i .• FILE COPY • . . > . rtt_.v,,,, 0- ,:cs-fr,..,, _p'� CITY OF ATLANTIC BEACH '4' oWNFR / BUILDER AFFIDAVIT `-�f�;tlJr 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 O\VNEIt OF YOUR PROPERTY.TO ACT AS YOUR OWN CONTRACTOR EVEN 'I'IIOIIGI I YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONS MUM ION YOURSELF. YOU MAY BI.FILI)OR IMPROVE A ONE-OR TWO FAMILY RESIDENCE OR A i'ARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF S25,000.00 OR LESS. THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. 1'I'MAY NOT BE BUILT FOR SAI.E OR LEASE, 1F YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITIIIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WILL('RESUME TTIAT YOU BUILT • IT FOR SALE OR LEASE,\VHICII 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, II IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE. LICENSES REQUIRED BY STATE LAW AND BY COTJay 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 FIAVE READ THE ABOVE DISCLOSURE - STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. .. 4, /7K 9e3 --.5,e —0000 ADDRESS !` PHONE NUMBER _ 64,s` G � PRINT to dr . IGNATU E DATz7 4 7E Z7day of .Mat-n.k.Before me this 2 In the county of Duval.Stain of Florida,has personally appeared herin by ltl self!herself and affirms that all statements and declarations are true and(( accurate. Notary Public at Large.Stale of .r1 .County of t+� L) V r \ , , 0 Personally Init; LaPtolucodtceW:cauoa- 3z0„.„,..,./ •- z0_..,I ._ � /D._7 0 �j.�s;:�`'•P"�6- TONT GINOLESPERGER NotarySignature: ` r MY COMMISSION#FF 924951 -sr""~ 1 i':3 EXPIRES:October 6,2019 .1 ............. Bonded Thru Notary Public Underwriters FJIIUXi.'Uwnei-UuitJ,YAb'adu-A.11E11SM 4,IN?00IIP .'•'*��a FILE COPY U.S. LUMBER Shake and Shingle Stock List for our Florida branches US Lumber Miami Item Export Dade Florida Code Only Approved Approved #1 18"Perfection Shingles raw CE118 Yes #1 18"Perfection Shingles raw CE118D Yes Yes #1 18"Perfection Shingles CCA CE/18T Yes Yes #1 18" Perfection Shingles Class B firetreated national CE118FRB Yes Yes #1 18"Grooved sidewall shingles CEG118RR Yes Yes #1 18"R&R sidewall shingles CEN118RR Yes Yes #1 18"R&R sidewall shingles CCA CEN118RRT Yes Yes #1 18"Fancy Cut fishscal shingles for sidewall CE118FS Yes Yes #2 18"Perfection shingles raw CE218 #2 18"Perfection shingles CCA CE218T Medium 24"shakes raw CEM1224 Yes Medium 24"shakes CCA CEM1224T Yes Medium 24"shakes CCA CEM1224T8 Yes Yes Medium 24"shakes Class B firetreated national CEM1224FRB Yes Yes Heavy 24"shakes raw CEH3424 Yes Heavy 24"shakes CCA CEH3424T Yes Heavy 24"shakes CCA CEH3424TB Yes Yes 5/8 24"Tapersawn H&R raw CEHRSHM 5/8 24"Tapersawn H&R CCA CEHRSHMT 5/8 24"Tapersawn H&R Class B firetreated national CEHRSHFTB Notes: 1.#2 shingles are never FL approved for exposed applications, OK for starters. 2.Hip&Ridge does not require FL approval. 3.Miami Dade ACOA#12-1120,06 4.Florida Approval#1377.4 r ( r( ON.Q L 3 0..e p FPCf j & V (o (941-0e'ue ‘N 2, =7A)Si' (i u eW v e Lv 4 t Q e 'ect-cd ) S H kM5(C5 LUiiEF me-<-0 P QAC 3 5 -ic_<< c N f) - oU eLhAS AAJ C uel- x-4,P1/4:vn 0)0 Paz e, ) Yry�3 ii F t:3 F ., F ' COPY a ;1 i M kir': U y x •�.„' •�iY' .y. Ifµ i y �.. a:..n ------------ C i-et a t 1 r` • f & _.. t 1 A <<, ,( . . Ilk .. * ° 111111161/4 illph.... ...... . . . - - -', , 1�` Niik. ,k O, _ �;` 1 . ^ ..f 110` Doc # 2017072769, OR BK 17927 Page 1707, Number Pages: 1, Recorded 03/30/2017 at 10:02 AM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 / NOTICE OF COMMENCEMENT State of .— County of 0 t,.c./a( Tax Folio No. /70 /7, C)7 -66,00 To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is s , e in this NOTICE OF OMMENCE� t' T.e--1 2-5 r 2�� Legal Descri tion of property being improved: k.;,.-sr- uw,x,A�n.i. R -e ,/.cw _ /1 Z e wee, �f- :lit- 6 • Address of property being improved: General description of improvements: (r,„ 71---S r ./ et,C26k p,4 Owner: ^X.0 c'" -• e,/p Address: L 4 L� r-k i o .. . L 'AI r• ;4/ Owner's interest in site of the improvement: ._.ez_. >. Fee Simple Titleholder(if otheran owner): Name: 11 (- 6re fr Contractor: 4:a.../.42.- of �u.A.- � Address: . . Telephone No.: Fax No: Surety(if any) Address: Amount of Bond$ Telephone No: _ Fax No: Name and address of any person making a Ioan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself, designated by owner upon whom notices or other documents may be served: Name: • Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: . Address: • Tele• phone No: Fax No: • Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date specified): • THIS SPACE FOR RECORDER'S USE ONLY OWNER 0 Signed: / Date: 3 /Z71i 7 Before me this day of)'\f ..-0.4\ }i,the unty o u a 40t to Of Florida,has personally appeared t„t 8.-.& j;,ML;) 1 iii:. TONI GINDLESPERGER Personally Known: or ' .1'- MY COMMISSION!FF 924951 Produced Identification: os • + i4nGg�l� s.r ,u . r IL :, EXPIRES:October 6,2019 Notary Public: a ��! 4' '4� Bonded Thru Wary Under/Am My commission expires: H ���-1.11111•