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432 Irex Rd RES20-0352 Permit PacketOWNER:ADDRESS:CITY:STATE:ZIP: STITES STEPHEN 432 IREX ROAD OCALAATLANTIC BEACH FL 32233 COMPANY:ADDRESS:CITY:STATE:ZIP: TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 171422 0000 ROYAL PALMS UNIT 02A3.00 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 432 IREX RD RESIDENTIAL ALTERATION RESIDENTIAL RENOVATE 2 BATHROOMS $100.00 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PERMIT 455-0000-322-1000 0 $55.00 BUILDING PLAN CHECK 455-0000-322-1001 0 $27.50 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $86.50 LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 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. 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. MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. 1 of 2Issued Date: 1/6/2021 PERMIT NUMBER RES20-0352 ISSUED: 1/6/2021 EXPIRES: 7/5/2021 RESIDENTIAL PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 2 of 2Issued Date: 1/6/2021 PERMIT NUMBER RES20-0352 ISSUED: 1/6/2021 EXPIRES: 7/5/2021 RESIDENTIAL PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $86.50 RES20-0352 Address: 432 IREX RD APN: 171422 0000 $86.50 BUILDING $55.00 BUILDING PERMIT 455-0000-322-1000 0 $55.00 BUILDING PLAN REVIEW $27.50 BUILDING PLAN CHECK 455-0000-322-1001 0 $27.50 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL FEES PAID BY RECEIPT: R14518 $86.50 Printed: Wednesday, January 6, 2021 1:26 PM Date Paid: Wednesday, January 06, 2021 Paid By: STITES STEPHEN Pay Method: CREDIT CARD 411115367 1 of 1 Cashier: CG Cash Register Receipt City of Atlantic Beach Receipt Number R14518 1'..-ii: Building Permit Application Updated 10/9/18 j4.0.2 ) City of Atlantic Beach Building Department ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY oloW IS REQUIRED.Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: `7-3, . ../"t.0 Q c- Permit Number: `\ESZ.0 — 0 3 Z' t' u,-„t- Z iA i2 Legal Description R©1f.,... a.t tYtS.t}0 O k ( 1 to o r S iI k < ( RE# 1 7 i 4 2 Z —000c) I Valuation of Work(Replacement Cost)$Heated/Cooled SF Non-Heated/Cooled Class of Work: New Addition""-Alteration, Repair/'Move Demo Pool Window/Door Use of existing/proposed structure(s): Commercial l esidential If an existing structure,is a fire sprinkler system installed?: DYes 1J1Vo Will tree(s) be removed in association with proposed prosect? Yes(must submit separate Tree Removal Permit) J'I1 Describe in detail the type of work to be performed: a 12, r.,'INLrt;3 11 S I S ?A u-4 Ca{-t cA t `,/ 6 er,0 Wit. `4- ho„r-u- t w c,( td (ei() ) it( ,,, h 1e)-}.,S..) y k o .ti;{'* -h Xws , Sc{,t,ce-f v: (i. s f S i A S , 5-7.,s-iii 11 Ce , u.t -t—ti/ exI ,, 1, LnorrePI( Florida Product Approval# for multiple products use product approval form Property Owner Information Name ::)--1.1 cc` tAZ 5hS Address L(3 El-C>e 4a. City A- I(,1-A {-1• L (1'tc..k.)-•\ State -- — Zip '3 )-a- 3 3 Phone 1 c1L.a rt 3 I`1 E-Mail S'SS5/'‘SC (0M(4STNQe- Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Z I\ ' e I /S 1P- Di k ' 1 Qualifying Agent ZG h r -2.e_\\ i1 r Address S "1 L(./ F-i.r..I A '2. City Pt L1.3.4 Vtl State FL_ Zip 3,).a. III Office Phone Job Site Contact Number State Certification/Registration# E-Mail Architect Name&Phone# 6... Engineer's Name&Phone# (I 1 0%--- Workers Compensation Insurer OR Exempt 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 regulating construction in this jurisdiction. I 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 M Y RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTO•BEFORE RECORDING)OUR NOTICE OF CO MENCEMENT. G (SiViature of Owner or Agent)Signature of Contractor) ed and sworn to(or of . d)before me hi 3l/d•y •f signed and sworn to(or affirmed)before me this day of AL =1 ,_ 1eS by AIIIEL 0. ; .;. TONIGINDLESPE' : iii A , Signature of Notary) 1 MY COMMISSION#GG 353178 Q,- EXPIRES:October 6,2023 4•PeenIfitfhiiinf rogfolicUnderwriters Per onally Known OR PP ed Identification Type of Identification: n n eC' ype o Identification: Owner Builder Affidavit ALL INFORMATION r{'"'`% HIGHLIGHTED IN J `- 1Firri City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 on Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 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. CONTACT THE BUILDING DEPARTMENT(904- 247-5826 OR BUILDING-DEPT@COAB.US) 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. Job Address: 4/3 a =r--e,}C R-0 a (-IL r4" CL " K c aC.irt F"L-- 3 Owner Name: J ac yu-e la '1 5+1 -S Phone Number: .(Qv kOS—zq3 [ 1 Mailing Address: SAH e City:State: Zip: Notarized Signature of Owner Th oing instr ment was acknowledged before me thisay 20Zjthe State of Florida, County of Signature of Notary Public Q' CIA° Personally Known OR [ ] Produced Identification Type of Identification: TONI GiNDLESPERGER Updated 10/ 24/ 18 MY COMMISSION#GG 353178 t ;,„,•' EXPIRES:October 6,2023 F;F F°`' Bonded Thru Notary Public Underwriters