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1805 Mayport Rd SIGN18-0012 sign permit SIGN PERMIT PERMIT NUMBER r J CITY OF ATLANTIC BEACH SIGN18-0012 ISSUED: 2/7/2019 800 SEMINOLE ROAD ATLANTIC BEACH. FL 32233 EXPIRES: 8/6/2019 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. DESCRIPTION: -7�7A� JOB ADDRESS: PERMIT TYPE: F WORK: 1805 MAYPORT RD SIGN WALL SIGNS $100.00 TYPE OF i • • ' 172185 0000 DONNERS R/P COMPANY: ADDRESS: • ADDRESS: DETWILER ROBERT K 14012 ALDRIDGE RD N JACKSONVILLE FL 32250-1506 BEACH WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. LIST OF CONDITIONS Roll off container company must be on City approved list. Container cannot be placed on City right-of-way. DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PLAN CHECK 455-0000-322-1001 0 $0.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $127.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 ZONING REVIEW COMMERCIAL AND INDUSTRIAL USES 001-0000-329-1003 0 $300.00 TOTAL: $431.50 Issued Date: 2/7/2019 1 of 2 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road G N t 6 - v ' Z �r Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 -Z�7 I Z I S JE-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 �?,°� �' r } (�lj �Q(� j'�� Department review required Yes No n uilding Applicant: I E� L anning &Zoning Tree Administrator Project: 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: %Approved. []Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: 7� �t� Date: <5 U t 1 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. [—]Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 Building Permit Application Updated 12/8/17 City of Atlantic Beach 800 Seminole Road,Atlantic Beach,FL 32233 C7 r Phone:(904)247-5826 Fax:(904)247-5845 ( E 00) Job Address: r L��-) mew p C> � Permit Number: -"� Legal Description RE# Valuation of Work(Replacement Cost)$ j Qom: Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): Ne ddition Alteration Re air Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): ommerciat Residential • If an existing structure,is a fire sprinkler system installed?(Circle one): YesNo 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: Florida Product Approval# for multiple products use product approval form Property\Owner Information Name: C'_✓leikPSA L-ec)aoj-d Address: ice)' F-IPMICi S AVE City / L PLO State Zip 3 ZZ33 Phone 0104^ Co 1235--9 4 3 St E-Mail Mcoy'L C Kal SrnoL Q . 1"\C1 4= Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: Qualifying Agent: Address City State Zip Office Phone Job Site/Contact Numb State Certification/Registration# E-Mail Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Exempt/ins er/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 the laws regulationg construction in this jurisdiction.4 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS, WELLS,POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and there may be additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING +YOUR NOTICE OF COMMENCEMENT. (Signature of Owner or Agent) (Signature of Conygctor) (inclu n ontractnme Siped and sworn to(or affi m d)befoday of ( Signed and sworn to(or affirmpdefore me this_day of ec (Signature o Notary) (Signature of Notary) ,personally Known OR TON!GINDL03f�GER Personally Known 611 [ ]Produced Identification _ MYcoMMISSICN FF 924951 ] Produced Identification Type of Identification: -t` r= October 6 2019 pe of Identification: Bonded Thou Notary Pubhc Undervmiers CITY OF ATLANTIC BEACH OWNER / 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 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 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 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, 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. k PHONE SJ0 J �lAy POST ES E /k1-, 3 9 AD Oka5esll, Leona�rc� PR T AM SI ATURE Ulori /( DATE Before me thisday o 20'i in the county of Duval,State ofhas personally appeare herin by hi If/herself and affirms that all statements and declarations are true an/d ac urate. (1/ Notary Public at Large,St o County of C1.c_') 1 _P,P—ersonally Known 0 Produced Identification- as.s 1.0Nl GINDLESPERGER if;,CF.,;'1,. Notary Signature: -_+• of k;C in�S.Oo,dter 6,2019 P �F�2 st°F Bcnduc Thr::?'oY-:;PaNic Undenvrters F:/BLDG/Owner-Builder Affadavit;REVISED: 4/16/2009 ALL S�,,y. Revision Request/Correction to Comments **HIGHLI HIGHLIGHTED IN' HIGHLIGHTED IN n City of Atlantic Beach Building Department GRAY 15 REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: SiyN Is '—wa— L..Fd'Revision to Issued Permit OR ❑ Corrections to Comments Date: Project Address: I QQ� YY\a kA JD0 f R Contractor/Contact Name: MQ We o, y-Q Contact Phone: 5M —90`3 R Email: roQ©rtE!. , C�opdcz;eCiO� Ck-�—; fto-� Description of Proposed Revision/Corrections: NO LM)CIE - 7P6i-)�yzi tiG, 712ELLISES IS1G N 5 W\ LL PL I —)u)SecyU-Sona affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • Will proposed revision/corrections add additional square footage to original submittal? o ❑ Yes (additional s.f.to be added: ) • �W,ill proposed revision/corrections add additional increase in building value to original submittal? I�-'No El*Yes (additional increase in building value:$ ) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: (Office Use Only) Asl Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments_4 004lae 7 71d pi CR Ile -Toh c4,)2!;t R-eVF%it7✓1- D ,rpaamQpt Review Required: Bu�' �! Planning&Zoning Reviewed By Me A mils rator Public Works Public Utilities S " O/ Public Safety Date Fire Services Updoted 10/17/18 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road // //^^�� Atlantic Beach, Florida 32233-5445 V IV �� � E5 - do i Phone(904)247-5826 • Fax(904) 247-5845 F!�;s1vr E-mail: building-dept@coab.us Date routed: l City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �J KD Department review required Yes No uilding Applicant: cl {C�-SE>E� �U(�R+�� P nning &Zoning Tree Administrator Project:( Public Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Review or Receipt Other Agency Review or Permit Required of Permit Verified By Date 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 STATUSgDenied. Reviewing Department First Review: ❑Approved. [-]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: �i%G Date: TREE ADMIN. Second Review: pproved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed byp '/4!5_ Date: -S I Revised 05/19/2017 'fRevision Request/Correction to Comments **ALL INFORMATION HIGHLIGHTED IN s, City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 oil,r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: �1ra 1�1 --C,OIZ IL evision to Issued Permit OR ❑ Corrections to Comments Date: Project Address:_I QQc,:� Contractor/Contact Name:MR ��P 9� LP e)naAE Contact Phone: 50:-90'3 g Email: mrn re . Description of Proposed Revision/Corrections: NO L-nWGiE9, 7PIElLI SES --,IC-Ns W 1 LL PSE AUJM. -Cd N ex� Tv -&LoCk— '90kQU (N C—f I t!'.�l n,�Papna r� affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • Will posed revision/corrections add additional square footage to original submittal? o ❑ Yes (additional s.f.to be added: ) • Will proposed revision/corrections add additional increase in building value to original submittal? �lo []*Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: (Office Use Only) Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due$ Revision/Plan Review Comments D pac#m_nt Review Required: B u�_ Planning&Zoning Reviewed By ree A minis rator Public Works Public Utilities Public Safety Date Fire Services Updoted 10/17/18 .s s .7 •,,r ..7=4"�,' �t-•�/? q�., 'fie `! ��,���`�6�- � •��Jf'�', •� ,..� . • �I s, .�; >-: �:�-� J`� - - � - - BMJ NBT .- j ti tl 4y 1 Approved By •. 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