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226 1st St 05-00030792 Siding/Deck ,S Ni- CITY OF ATLANTIC BEACH �� ifs 800 SEMINOLE ROAD J V ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 JFil9 Application Number . . . . . 05-00030792 Date 7/22/05 Property Address . . . . . . 226 1ST ST Tenant nbr, name . . . . . . SIDING & DECK BOARDS Application description . . . SIDING Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 7000 Owner Contractor - --- -- - - ---- -- ------ ----- ---- - - -- - ---- - - -- - - - --- MCCRARY, PAMELA WILHITE BROTHERS 226 1ST ST 2610 STATE RD 'AlA 308 JAX BEACH FL 32240 ATLANTIC BEACH FL 32233 (904) 241-1155 (904) 955-5737 -- - -- - ---- -- ---------- --- ----- --- --- - ----- -- -- ------ ----------- - ---- --- Permit . . . . . . BUILDING PERMIT Additional desc . . Permit Fee . . . . 98 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 7000 Fee summary Charged Paid Credited Due ----- - - ------ - - -- -- --- ----- - - -------- ------ ---- ----- --- Permit Fee Total 98 . 00 98 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 98 . 00 98 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDIN CODES. BUILDING OFFICIAL CITY OF ATLANTIC BEACH PERMIT CALCULATION SHEET �N Date: 7 2 2 Address S r S7-. — cs Di,� Heated Square Footage @ $ per sq ft= $ Garage/ Shed @$ per sq ft= $ J Carport/Porch @ $ per sq ft = $ Deck s $ per sq ft= $ Patio @ $ per sq ft = $ TOTAL VALUATION: $ ���'©0 -7 G (0 0 3 J� $ Total Valuation IS, $ X00.0 o 36 $ 30 Remaining Value $,, der thousand or portion thereof CONSTRUCTION TYPE: TOTAL BUILDING FEE $ ZONING: + '/2 Filing Fee $ 3 3 FLOOD ZONE: ( ) Fireplaces @$35.00 $ IMPERVIOUS SURFACE: BUILDING PERMIT FEE $ 1 WATER IMPACT FEE $ SEWER IMPACT FEE $ WATER METER/TAP $ CAPITAL IMPROVEMENT$ SEWER TAP $ C ( ) RADON HRS .0050 $ SECTION H PAVING ( ) $ CROSS CONNECTION $ ST( ) SURCHARGE $ OTHER $ GRAND TOTAL DUE: $ 9 l' 1/13/03 t � _CIAL SERVICES CUSTOMER INVOICE Page 1 of 6 NO. b3bb-"I Lbs VALIDATION AREA -1, If ire 6365 JACKSONVILLE BEACH N Phone: (904 ) 220-0822 2721 ATLANTIC BLVD Contact Center: (800 ) 908-9105 6365 00-123 97818 07/1. JACKSONVILLE, FL 32225 Salesperson: RSL1 58 ALE 72 RSL158 11:x Reviewer: a�QUOTE for the merchandise and services printed below. This becomes an Agreemen po CUSTOMER AGREEMENT ' 125274 n 0rsement b a Home Depot register validation. ADDL MDSECALL. SUBTOTAL Y P 9 ASDL MD�E �UE,TOTAL •�: ie Home Phone , SUBTOTAL 1061 ICCRARY PAM (904) 241.1155 SALES TAX A Work Phone I OTAL $113E Address 226 1ST STREET () - XXXXXXX{:9498 GIFT CARD 1131 Company Name CARD BALANCE :'f,0 c City ATLANTIC BEACH Job Description DECK State FL Zip 32233 county DUVAL t QUOTE is valid for this date: 0711612 MERCHANDISE AND SERVICE SUMMARY merc�ianr seso�c�gt0 to limit quantities of HOME DEPOT DELIVERY #1 EF#v08 STOCK MERCHANDISE TO BE DELIVERED: ;:::.: RER S;KU QTY UtVI l� a:i: ?FiIC1..... R01 553-777 18.00 EA 4X8 81N OC STELEAIWPVARDIE PNL / L'� Y $19.95 $35' R02 315-412 30.00 EA 1 X2-8 EE PT / Y $1.29 53., R03 533-829 14.00 EA 80LB SAKRETE CONCRETE MIX / Y $3.45 $4� R04 221-631 2.00 EAj GREEN 25LB 3 IN DECKMATE DECK SCREW Y $76.00 $15 R05 734-965 5.00 EA GREEN 5LB 1 5/81N DECKMATE DECK SCRW " Y $23.93 $11 R06 501-583 14.00 EA ZMAX HIGH UPLIFT 4X4POSTBASE \ Y $12.39 $17 R07 510-955 5.00 EA 6D 2" HOT GALV SS SIDING, Y $11.46 $5 MERCHANDISE TOTAL: $94 V08 1 515-663 1.001 EAJ CURBSI11< SERVICE N $59.00 $5 DELIVERY SERVICE SUBTOTAL: $5 APPROVED \ _eft. UILDING OFFICE "CONTINUED ON NEXT PAGE JUL 2 .,' 2004 Page 1 of 6 NO. 6365-125274 Customer Coov (9801) 0100148; SPECIAL SERVICES CHANGE ORDER Pagel of 1 No. 6365-125274 2005-07-18 10:16 Store 6365 JACKSONVILLE BEACH N Phone: (904 ) 220-0822 12721 ATLANTIC BLVD Contact Center: (800 ) 908-9105 JACKSONVILLE, FL 32225 Salesperson: RSL158 Reviewer: CHANGE ORDER Name Home Phone MCCRARY PAM (904) 241.1155 Address 226 1 ST STREET Work Phone () - Company Name city ATLANTIC BEACH Job Description DECK State FL Zip 32233 County DUVAL REVISION: 1, 0711812005 SUMMARY OF CHANGES merc�ianr ise solrc�gt0 to limit quantities of )ESCRIPTION OF CHANGES \ \\ DD S/0 TO ORDER HOME DEPOT DELIVERY REF#V08 0-MDSE TO BE DELIVERED: SIO GREAT SOUTHERN REF#S09 ESTIMATED ARRI ;0 005 P.O.#65535616 ;:::< ::::.. .....:.:.:::..:.:::.::.;>::::.:.::.:;::.:;:;;::.;.;: :::::::::::.:::::.:::... f3f...T ... .... ... . SAX.. fF€;<>:.; .:. w.:£3st.._ +.:..#... .:......Sk ..........:.:.:::::: ::::::::..... :: .:::.:.::::::::.:. ................:::.::.::.::::::.::::::.::::::...... :: .:::.:::::::::::::.::._:::::::::::.:::::...... ................................... . ADDED S0901 125-415 14.00 4X4X16 PT /4X4X16 PT � A \ Y $20.97 $293.58 /4X4X16 PT \ 0 $293.58 END OF HOME OEPO PRIV I Y REF V SUMMARY OF ORDS PREVIOUS ORDER TOTAL(pre-tax) $1,007.51 NET CHANGE AIVIT $293.58 By signing below,the Customer jacce epr �s, cifications and all other terms and conditions of this Change Order and the Customer agrees that REVISED ORDER TOTAL(pre taxi $1,301.09 all of the terms and conditiq r t Agreement(order#125274)remain in effect unless superceded by this Change Order. REVISED SALES TAX $86.94 �J REVISED TOTAL $1,388.03 1 AMOUNT PAID $1,073.91 ISTOMER StbNATURE: DATE: OA ANGEDUI; $314.12 END OF OROERAo.6365-125274 of 1 No. 6365-125274 Page I of 1 James Hardie building products& siding products Home >> About Us James hardiB Siding Products About James Hardie Building Products ►About Us James Hardie Building Products come from a world leader in fiber-cement techm •Corporate History •Industry Links •Investor Relations •Career Opportunities Our operations encompass the United States, Australia, New Zealand and Chile. James H� ►Siding Products ►Backerboard Building Products are also now available in Asia, with a manufacturing plant in the Philipp ►�� Europe, our operations are headquartered in Amsterdam. In every country in which we of our goal is to remain at the forefront of the fiber-cement industry, capitalizing on our glot leadership in products, manufacturing and technology for both new home construction an remodeling. Innovation is vital to maintaining our pre-eminent position in the fiber-cement industry. Consequently, we invest heavily in research and development, with a special emphasis or product quality and production efficiency to develop durable and low maintenance siding products, backerboard and pipe. About James Hardie I Contact Us I site Map I Search I Disclaimer I Privacy Policy ` 7/20/2005 http://www.jameshardie.com/about/ House siding -- James Hardie siding Page 1 of 2 Home»Siding Products>> Homeowner/Realtor u� ►lpmmwner/Realtor' " Janws Yi► Siding Prock&d* T And we'll still lave the feeling of coming back hone ►Products&Home Styles James Hardie ® Siding Products ►Product Comparisons i,Remodeling & Whether you're building a new home or remodeling, James Replacement ►Installation Hardie siding provides low maintenance, but unlike vinyl, ►Technical information 1 ti ►Advantages R Accolades ►James Hardie Neat You doesn't sacrifice the beauty and character of wood. James ►RemodeLer Locator ►dealer Locator Hardie fiber-cement siding resists rotting or cracking and it ►Literature"uest ►FAQ resists damage from rain, hail and flying debris. Our house tNl Mk1YM lU�M000 IMY1�(1 r THE HOMES BEG YOU TC siding is also available pre-finished with a 15-year paint warranty. Best of all, James Hardie siding is non-combustible, with a limited, transferable warranty for up to 50 years. No To learn more about time neighborhoods and Jame: wonder it's protecting over 3.5 million homes in North America Hardie click here. alone. Faux Vs. Real As seen in Builder James Hardie is Featured in lifestyl Building Products magazine's article proud to be publications' idea as seen on: "You're Hired" featured on: and dream homes eW+y08hC7W L—Alma.j Hom� Edition, =1111 ! Sundays, 8�7c on APC. About James Hardie I Contact Us I Site Map I Search I Disclaimer I Privacy Policy http://www.j ameshardie.com/homeowner.htm 7/20/2005 J James Hardie North America - 1-888 jhardie Page 2 of 6 - NEVER use a power saw indoors - NEVER use a circular saw blade that does not carry the Hardiblade logo - NEVER dry sweep Additional exposure information is available at www.jameshardie.com to help you determ most appropriate cutting method for your job requirements. If concern still exists about exposure levels or protection levels, you should always consult a qualified industrial hygie FRAMING REQUIREMENTS: Hardipanel vertical siding can be installed to studs spaced a maximum of 24" o.c. Irregulz in framing can mirror through the finished application. The use of a Weather-resistive barrier is required in frame construction with siding. Jame: Hardie recommends the use of asphalt saturated felt or equivalent non-woven, non-perfo vapor permeable building paper or housewrap. Note: James Hardie does not recommend of water repellant wood based panel sheathing as the primary weather resistive barrier. T weather resistive barrier must be appropriately incorporated with penetration and junctioi flashings. Materials must be lapped such that water will drain down and to the outside. Ja Hardie will assume no responsibilty for water infiltration within the wall. Applying Hardipanel Siding: • Start Hardipanel vertical siding at middle of stud. • Keep nails 2" away from corners. • Start at edge and work across. figure 1 stud weather-resistive bafrier Ha+dipanel keep rails 00 siding 318'min. from panel edges plate _ o 318" o moderate contact' keep fasteners 2" away from corners *Space panel according to joint treatment either in "moderate contact" (joints not caulker accordance with the caulking manufacturer's written application instructions (joints caulk( figure 2. JOINT DETAIL • Keep fasteners 3/8" back from panel edges. • Place fasteners 2" in from all corners; don't nail into corners. • Joints may also be covered with lumber batten, PVC "H" or "T" type joint treatmer • Install Hardipanel vertical siding with joints butted in moderate contact. * • Horizontal Joints - use "Z-Bar" or similar type flashing for all horizontal joints. http://www.j ameshardie.com/homeowner/installati on/hardi panel installation.php 7/20/2005 Vinyl siding vs. James Hardie - choosing house siding Page 1 of2 Home >> siding Products >> Homeowner/Realtor >> Product Comparisons >> vs.Vinyl siding Fbmeowner/fledtor -. James Hardie' jow Vi Siding Products " Product Comparisons - James Hardie® Siding vs. Vinyl Siding Choosing house siding from James Hardie makes sense - it provides low maintenance, but unlike vinyl siding, doesn't sacrifice the beauty of wood. No wonder it's protecting over 3.5 million homes in North America alone. James Hardie Vinyl Siding Flame Resistance T R # Vinyl siding will melt Non-com bustible. rte-- or burn when exposed 11,Products ft Home Styles Approved for fire-rated to a significant source ►Product Comparisons construction. of heat or flame. k vs Vinyl vs Wood based siding Case Studies ►Remodeling & Replacement ►Installation Color Flexibility ►Technical information ►Advantages ft Accolades Color cannot be ►James Hardie Near You changed and is ►Remodeler Locator Can be painted susceptible to fading. any color you can imagine And it's difficult to ►Dealer Locator and lasts longer get a perfect match ►Literature Request than with wood. o when repairs are ►FAQ _ t necessary. Weather Resistance So durable it's "�r� Becomes brittle in guaranteed for up to cold weather. Can 50 years,even in the � ���,....�+�� be damaged by hail, most severe climates limbs, and other Ir flying debris. on earth. Thickness James Hardie siding's strength and thickness iL Premium vinyl siding provide impact resistance is only 5/100"thick. caused by hail or wind. 7/20/2005 http://wwwameshardl e.com/homeowner/prodcomp/default.php .j 1 James Hardie North America - 1-888-jhardie Page 1 of 6 Home » Siding Products >> Homeowner/ Realtor >> Installation >> Hardipanel0 Vertical Siding I'I0WA*'MRIlrlliesltor • r a a James Hardie' V;I Siding Product@ K Hardipanelm Vertical Siding Installation " Feu LM February 2005 Download Installation Instructions [ PDF ] Download Installation Instructions for Canada [ PDF ] SMOOTH - CEDARMILL© - SELECT SIERRA 8" - STUCCO IMPORTANT: FAILURE TO INSTALL AND FINISH THIS PRODUCT IN ACCORDANCE WITH ►Products li Home Styles APPLICABLE BUILDING CODES AND JAMES HARDIE'S WRITTEN APPLICATION INSTRUCTI ►Product Comparisons ►Remodeling & MAY AFFECT SYSTEM PERFORMANCE, VIOLATE LOCAL BUILDING CODES, AND VOID THE Replacement PRODUCT ONLY WARRANTY. ►Installation -Working Safely HANDLING & STORAGE: •Hardiplank •Hardipanel •Hardishingle •Harditrim �` ~ •Hardisoffit - ►Technical Information s ►Advantages li Accolades ►James Hardie Near You ►Remodeler Locator ►Dealer Locator Store flat and keep dry prior to installation. Installing siding wet or saturated may result i ►Literature Request ►FAQ shrinkage at butt joints. Carry panels on edge. RECOMMENDED CUTTING INSTRUCTIONS: OUTDOORS 1. Position cutting station so that wind will blow dust away from user or others in woi 2. Use one of the following methods based on the required cutting rate: a. a. Best: i. Score and snap ii. Shears (Pneumatic or Handheld) b. b. Better: i. Dust reducing circular saw equipped with Hardiblade and HEPA vacu extraction c. c. Good: i. i. Dust reducing circular saw with Hardiblade INDOORS 1. Position cutting station in well-ventilated area; otherwise, additional mechanical ventilation (e.g. box fan, HEPA vacuum, etc.) is required 2. Cut only using score and snap, or shears (manual, electric or pneumatic). http://www.j ameshardie.com/homeowner/install ation/hardipanel_installation.php 7/20/2005 J James Hardie North America - 1-888-jhardie Page 3 of 6 figure 2 Caulk Joint "H"Joint 2 x 4 stud 2 x4 stud i weather-resistive barrier weather-resistive barrier Batten Joint weather-resistive 2 x 4 stud barrier figure 3 ---"---- Suggedm:Using a double stud at panel pints A Mow for fastener Nacwnwd to be out of panel grooves(Serra 8)for improved eppeararce. Suggestion: Using a double stud at panel joints will allow for fastener placement to be ou panel grooves (Sierra 8) for improved appearance. WARNING AVOID BREATHING SILICA DUST James Hardie products contain respirable crystalline silica, which is known to the State c California to cause cancer and is considered by IARC and NIOSH to be a cause of cancer some occupational sources. Breathing excessive amounts of respirable silica dust can alE cause a disabling and potentially fatal lung disease called silicosis, and has been linked v other diseases. During installation or handling: (1) work in outdoor areas with ample ventilation; (2) use fiber cement shears for cutting or, where not feasible, use a Hardibli and dust-reducing circular saw attached to a HEPA vacuum; (3) warn others in the imm( area; (4) wear a properly-fitted, NIOSH-approved dust mask or respirator (e.g. N-95) in accordance with applicable government regulations and manufacturer instructions to fur limit respirable silica exposures. During clean-up, use HEPA vacuums or wet cleanup me - never dry sweep. For further information, refer to our installation instructions and _Mat( Safety Data Sheet available at www.jameshardie.com or by calling 1-800-9HARDIE (1-8 942-7343). FAILURE TO ADHERE TO OUR WARNINGS, MSDS, AND INSTALLATIOI INSTRUCTIONS MAY LEAD TO SERIOUS PERSONAL INJURY OR DEATH. James Hardie® Building Products 26300 La Alameda, Suite 250 Mission Viejo, CA 92691 RECOGNITION: In accordance with ICC-ES Legacy Report NER-405, Hardipanel vertical siding is http://www.j ameshardie.com/homeowner/installation/hardipanel_installation.php 7/20/2005 James Hardie North America - 1-888-jhardie Page 4 of 6 recognized as a suitable alternate to that specified in: the BOCA National Building Code/1999, the Standard Building Code, the 1997 Uniform Building Code, the 1998 International One- and Two-Fa Dwelling Code, the 2003 International Building Code, and the 2003 International Residential Code One-and Two-Family Dwellings. Hardipanel vertical siding is also recognized for application in the following: City of Los Angeles Research Report No. 24862, State of Florida listing FL#889, Dade Cc Florida NOA No. 02-0729.02, U.S. Dept. of HUD Materials Release 1263c, Texas Department of Ins Product Evaluation EC-23, City of New York MEA 223-93-M, and California DSA PA-019.These doc should also be consulted for additional information concerning the suitability of this product for spe applications. GRADE CLEARANCE figure 4 Install Hardipanel® vertical siding in compliance with local building code requirements for clearance between the bottom edge of panel and the adjacent finished grade (see Import Note). Hardipanel sWd Siding n, r • Denier 1 • plate • concrins ROOF CLEARANCE tA` figure 5 At the juncture of the roof and vertical surfaces, flashing and counterflashing shall be pro per the roofing manufacturer's Instructions. Provide a minimum of a 2" clearance betweei roofing and bottom edge of siding. Wrdahirrng CONCRETE CONSTRUCTION figure 6 Hardipanel vertical siding can be installed directly to masonry block. Hardiplank siding car be installed to concrete construction when the wall is furred out with wood framing or mir No. 20 gauge steel framing anchored to the wall. Framing can be spaced up to 24" o.c. G applicable code compliance report for recognized application to masonry block. A weather resistive barrier is recommended between the framing and the siding. 7/20/2005 http://www.j ameshardie.com/homeowner/installation/hardi panel_i nstal l ation.php J James Hardie North America - 1-888-1hardie Page 5 of6 "Bathe r mses'.vo Darier 11 �! waW or metal Kor*mnel siding t-ra9 IMPORTANT NOTE • Install James Hardie@ products with a minimum 6" clearance to the earth on the e of the building or in accordance with local building codes if greater than 6" is requi • Maintain a minimum 2" clearance between James Hardie@ products and roofs, de( paths, steps and driveways. • Adjacent finished grade must slope away from the building in accordance with loco building codes - typically a minimum of 6" in the first 10'. • Do not install Hardipanel@ vertical siding, such that it may remain in contact with standing water. FASTENING REQUIREMENTS: Fasteners must be corrosion resistant, galvanized, or stainless steel. Electro-galvanized a acceptable may exhibit premature corrosion. James Hardie@ recommends the use of qua hot-dipped galvanized nails. James Hardie is not responsible for the corrosion resistance c fasteners. Stainless steel fasteners are recommended when installing James Hardie prod near the ocean, large bodies of water, or in very humid climates. Do not use aluminum fasteners, staples, or clipped head nails. PNEUMATIC FASTENING: Hardipanel@ vertical siding products can be hand nailed or fastened with a pneumatic tool. Pneumatic fastening is highly recommended. Set air pressure so that the fastener is driven snug with the surface of the siding. A flush mount attachment o on the pneumatic tool is recommended. This will help control the depth the nail is 5 driven. If setting the nail depth proves difficult, choose a setting that under drives the nail. Hit the under driven nails snug with a smooth faced hammer. Do not over drive 1 into Hardipanel@ vertical siding. • Consult applicable code compliance report for correct fasteners type and placemer achieve specified design wind loads and shear values. • NOTE: Published shear values and wind loads may not be applicable to all areas w Local Building Codes have specific jurisdiction. Consult James Hardie Technical Ser you are unsure of applicable Building Code jurisdiction. • Drive fasteners perpendicular to siding and framing. • Fastener heads should fit snug against siding (no air space). (Fig. A & B) • Do not over-drive nail heads or drive nails at an angle. • If nail is countersunk, caulk nail hole and add a nail. (Fig. C) • Under driven nails should be hit flush to the panel with a hammer. �,'J /�� Countersunk. j (may$nug FIuSh P]Cad nail �\1[�yy add nail do r"under figure A Agure B figure C drive nails PATCHING http://www.j ameshardi e.com/homeowner/install ati on/hardipanel_installation.php 7/20/2005 James Hardie North America - 1-888 jhardie Page 6 of 6 Dents, chips and cracks can be filled with a cementitious patching compound. CAULKING For best results use a latex sealant that complies with either ASTM C834 or ASTM C920 (c NS, Class 25). Caulking should be applied in accordance with the caulking manufacturer's written instructions. PAINTING It is recommended that James Hardie products be painted with 100% acrylic topcoats. Dc paint when wet. For application rates refer to paint manufacturers specifications. Back-rol recommended if the siding is sprayed. About James Hardie I Contact Us I Site Map I Search I Disclaimer I Privacy Policy http://www.j ameshardie.com/homeowner/installation/hardipanel_i nstal l ation.php 7/20/2005 James Hardie North America- 1-888-jhardie Page 1 of 2 Home >> Siding Products >> Homeowner/Realtor >> Technical Information >> Technical Reports Fkrtteowr�IResltor �• • James IF wdie' Siding Products ` � x ;r . Technical Reports Technical Reports Technical information is now available as a PDF. Links to the information are set out belo% the links to view and Adobe Acrobat will load. Material Safety Data Sheet (PDF) NER Report NER-405 (PDF) U.S. HUD Materials Release 1263c(PDF) City of New York Department of Buildings Report MEA 233-93-M (PDF) ►Products 6 Home Styles Texas Department of Insurance Product Evaluation EC-23 (PDF) ►Product Comparisons City of Los Angeles_Research Report RR 24862 (PDF) ►Remodeling & Division of the State Architect Acceptance Report PA-019 (PDF) Replacement JHBP Internal Memorandum dated 11/3/97 from John Mulder regarding FEMA Recognition ►Instaltation JHBP Internal Memorandum dated 11/26/97 from John Mulder regarding ARPE Recognitlo ►Technical Information Ontario Canada Ruling 95-17-36-(12678-R) •Caulking Tips U.S. HUD Materials Release 1268c(PDF) •Painting Tips National Research Council Canada CCMC 12678-R (PDF) .Technical Reports Miami Dade County BCCO Notice of Acceptance 02-0729.02 (PDF) •Warranty ►Advantages&.Accolades %You'll need Adobe Acrobat to download PDF files. If you don't already have it, please c ►James Hardie Near You Adobe icon to download the program for free ►Remodeler Locator ►Dealer Locator ►Literature Request Factory Built Construction Information ►FAQ General Telephone and E-mail 1-888-JHARDIE info@ Imh.com 7/20/2005 http://www. ameshardi e.com/homeowner/techni cal/gov_docs.php j RECEIVED C'TY OF ATLAN �C BUILDING&ZONING �H S�L`JrJ J� r j CITY OF ATLANTIC BEACH JUL 2 0 2005 SIDING PERMIT APPLICATIO D Job Address: Owner of Property: Pc& --\Jo, R . Address: �r, S� C ,�Y�� Telephone: 9 Legal Description: Block Number: Lot Number: Zoning District: Siding Contractor: ow n P y- Contractor's Address: Telephone: Fax: Describe proposed use and work to be done: 0 r jP S 1', 0 C(_Y j © � �-- rd © co_Ae_ C)V"1\/a_CU a YJ 0 sJs Present use of land or building(s): r r l V cl�-- Y 1© m'- Valuation of proposed construction: i Doc)• 6-6 Is approval of Homeowner's Association or other private entity required? l yy If yes,please submit with this application. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incommplete applications may result in delay in issuance of permit. C1_ pJ Provide detailed information of product being used and how it is to be attached,i.e.,fasteners,etc. 2. Provide completed Owner's Authorization Form if licant'is other than property owner. np S ) QU'1�57 S S i r eC3 k O rN r a►� �� Ct)rl CS �� Calt n qq OL J Address and contact information of person to receive all correspondence regarding this application(please print). Name: Mailing Address: t SA- S-+y'e 1f Telephone: 9 0 4—� SS Fax: N E-Mail: Ti TL l�( G71 (0a C) C D/�-� 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ci.atlantic-beach.fl.us Page 1 Revised 3/04/04 i I hereby certify that all information provided with this application is correct. Signature of Owner: /) C Date: 7Lc c_5 I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of the 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 federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Contractor: Date: AS TO OWNER: , Sworn to and subscribed before me this 0 day of 20 0'3 State of Florida,County of Duval }� Notary's Signature: •1�pr app-., JEANNE M.SHAW MY COMMISSION#DD 435986 ❑ Personally known EXPIRES:May 31,2009 j 'or 4• Bonded Thru Notary Public Underw ler II Produced Identification Type of Identification Produced ,M 011p('0 L., Q . 90 a AS TO CONTRACTOR: Sworn to and subscribed before me this day of .20 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced Identification Type of Identification Produced 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Telephone: (904)247-5800 -Fax: (904)247-5845 -http://www.ei.atlantic-beach.fl.us Page 2 Revised 3/04/04 Jam" Y .f CITY OF ATLANTIC BEACH OWNER/BUILDER AFFIDAVIT Date: 7 Job Address: ` 5+Y 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. ORDINANCES ALSO ALLOW AN OWNER TO IMPROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER"DIRECT SUPERVISION OF THE OWNER,WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS. SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. 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. UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. PROPERTY OWNER/BUILDER F SWORN e, ME THIS :9DAY OF 2005 JEANNE M.SHAW :. MY COMMISSION#DD 435986 EXPIRES:May 31,2009 r. bonded Thru Notary Pudic Underwriters TARY PUBLIC MY COMMISSION EXPIRES: NOTE: PHRASES UNDERLINED ABOVE. NOTICE OF COMMENCEMENT State of L Tax Folio No. County of �i a To Whom It May Concern: The undersigned hereby informs you that imp ro nts will be made to ceWa—inie-al-p.mperty,and accordance with Section 713 of the Florida Statutes,the following inform a ' s stated in this NOTICE OF COMMENCEMENT. Legal Description of property being im ed: Address of property being improved: C)-- General description of improvements: i Y Y Owner: �G. Address: r �n 15f e�e� +►Ce Vl�i+� K r hL Owner's interest in site of the improvement: \1 e Fee Simple Titleholder(if other than owner): Name: Contractor: O � Address: 5 i'r� -I- a�-�i c �$ c� FL����� Cj 1 Telephone No.: D - `/ /S�.S Fax No: 11 ��Tzo �lv Surety( any) m fD 3 o if r> 3 a Amount of Bond$ °� - Address: LD r-LD N o Fax No: 0 S Telephone No: a N J Name and address of any person making a loan for the construction of the improvements o m a cn opo 0 O Name: M Tl N W Address: c U Phone No: Fax No: o A o Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other docum C:o ID served: Name: o N < D Address: Telephone No: Fax No: c In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as providei 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Name: Address: Telephone 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 is specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER i Signed: Date: Before me this day of in the ounty of Duval,State Of Florida,has personally appeared a val. =o�'t`Y Pie, William G. :DD34673�2 , JrNotary Public at Large,State of Florida,C * : Commission My commission expires: or A` Expires Augus200$ Personally Known: OF A.�BontlM Troy Fain insur�noeProduced Identification: 03857019