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380 Seminole Rd DEMO20-0038 Carport, Int, Roof ���7 f %%'S Js» DEMO PERMIT PERMIT NUMBER :wr,rj DEMO20-0038 ��,� CITY OF ATLANTIC BEACH IssuED: 12/10/2020 800 SEMINOLE ROAD\'` ATLANTIC BEACH. FL 32233 EXPIRES: 6/8/2021 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. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property hat may be found in the public records of this county, and there may be additional permits required from other :overnmental entities such as water management districts, state agencies, or federal agencies. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 380 SEMINOLE RD DEMO PARTIAL DEMO CARPORT, INTERIOR $14000.00 AND PART OF ROOF TYPE OF ." REAL ESTATE ZONING: 3 BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170425 0000 SALTAIR SEC 02 COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: HINSON ERIC V 1106 W APACHE ST NORMAN OK 73069 (VAR NING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If' 'OUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT JIUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU NTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE tECORDING YOUR NOTICE OF COMMENCEMENT. toll off container company must be on City approved list . Container cannot be placed on City right-of-way. DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT DEMOLITION 455-0000-322-1000 0 $100.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$129.00 Issued Date: 12/10/2020 1 of 1 V''':-.'', Building Permit Application Updated 10/9/18 ' ) City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Email: Building-Dept@coab.us1-De IS REQUIRED. i7C. iA00-c�- 0 C) cc33 Job Address: O Semi 1'lO L't. ez-I • A�YlaYL. C c I'C pp 3l?Perm 3 it Number: f�E51k 70-GU2-0 Legal Description t0- ) 5 (,(Q 2s -21 E t $EC 2 5EAL-T4-11Z L-6—nao RE# tr10 425—OUO Valuation of Work(Replacement Cost)$ 1 49tPO-) Heated/Cooled SF ICO-4 Non- Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration DRepair ❑Move RCemo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial J2'Residential • If an existing structure, is a fire sprinkler system installed?: EYes IA-No • Will tree(s) be removed in association with proposed project? EYes(must submit separate Tree Removal Permit) 14f'No Describe in detail the type of work to be performed: CL . ,/ pC7 (� t t n*e_f't c7r- 0,r-'1- n� rce) \ t 14-€14) -P(5hvj C f key tolcX OvrOL Vlotnss . Florida Product Approval# for multiple products use product approval form Property Owner Information- Name rG` 'C-I Y\wibt.V ti(rl,c0 VI Address 36'6 .ce-trl(Y10 Le_ City I "Ckan.t I(_- f&k.Gh State 1L Zip 3 l3 Phone os--- q/2-'4'2 3 7 E-Mail cthlhSOYI?l eAkop -Ur')• Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information ,n' Name of Company I2 . / Y (Th Qualifying Agent Address City State Zip Office Phone Job Site Contact Number State Certification/Registration# E-Mail Architect Name& Phone# Engineer's Name& Phone# 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 af)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 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 TOUR NOTICE OF COMMENCEMENT. I Cft 0- (Signature of Owner or Agent) (Signature of Contractor) ned and sworn to(ot.a ed)before this/ day of Signed and sworn to (or affirme�f) before me this day of 1 L ', / V 1/ Ia.() , , by . Vii. rtiltg .T (Signature of Notary) 4.,:!VP";••. TONI GINDL'PERGER j ) Personally Known OR ' =_: :,; MY COMMISSION#GG 353178 1 Personally Known OR . a: EXPIRES:October 6,2023 "'%R.r:fnc• Bonded Thru Notary Public Underwriters Owner Builder Affidavit **ALL INFORMATION rs'%L'�r�, HIGHLIGHTED IN ` ,�'1 City of Atlantic Beach Building Department GRAY IS REQUIRED. -7W." 800 Seminole Rd, Atlantic Beach, FL 32233 j� ., �� /1�c ..ox Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: [)Ey,©Zo 003 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: 3S0 ,5e.Y' note, ed • y1-i6t.'t c.. gezc1't, FL Owner Name: ' I,r t►/K-s' 0)13(.)Y) //��'' Phone Number: Mailing Address: �86 ,S2lvilno -Ck ' City: k1LLiltL gettal. State: Ft Zip: 3u33 Notarized Signature of Owner( {,kAS ik4w)1.• f/ � The fpr�ego ns rument was acknowledged before me this l L/ day G_ 2020n the State of Florida, County of Signature of Notary Public -f C� 1,----- [ [ ] Personally Known OR [ ] Produced Identificatio6 Type of Identification: Updated 10/24/18 `26t""•°', TO!:I G1h:s LESPERGER : MY LOtriMiSSION#GG 353178 .'r` EXPIRES:October 6,2023 ""GP Bonded Thru N7twy Public Underwriters