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808 Amberjack Ln RFNC24-0139 PermitOWNER:ADDRESS:CITY:STATE:ZIP: Tana Mankus 14571 Marsh View Drive Jacksonville Beach FL 32250 COMPANY:ADDRESS:CITY:STATE:ZIP: TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 171141 0000 ROYAL PALMS UNIT 01 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 808 AMBERJACK LN RESIDENTIAL FENCE ONE STREET FRONTAGE 6ft and 4ft Fence $10000.00 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00 TOTAL: $35.00 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 1Issued Date: 11/14/2024 PERMIT NUMBER RFNC24-0139 ISSUED: 11/14/2024 EXPIRES: 5/13/2025 RESIDENTIAL FENCE PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $35.00 RFNC24-0139 Address: 808 AMBERJACK LN APN: 171141 0000 $35.00 ZONING PLAN REVIEW $35.00 ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00 TOTAL FEES PAID BY RECEIPT: R29029 $35.00 Printed: Thursday, November 14, 2024 11:21 AM Date Paid: Thursday, November 14, 2024 Paid By: Tana Mankus Pay Method: CREDIT CARD 10359640026 1 of 1 Cashier: KW Cash Register Receipt City of Atlantic Beach Receipt Number R29029 a f ii,) REVOCABLE ENCROACHMENT AGREEMENT ALL INFORMATION City of Atlantic Beach IS REQUIRED. IN GRAY 4 HIGHLIGHTED 800 Seminole Road,Atlantic Beach,FL 32233 REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to asCITYII and S of Atlantic Beach, Florida, hereinafter referred to as "USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property for the purpose as described in the City of Atlantic Beach. This work is generally described as Y1Q'A) rC C R d 1/40` {l` c,Lc e' Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty(30)days'notice by CITY to USER,said notice to USER shall be given by certified mail,return receipt requested,to the following address I ti S71 f`r\c--rViN. V 1aal1t) D( Jac,k,C•vi\ B& , fl- 321_56 . In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above described easement or property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining,repairing,operating, replacing or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code and all other land use and code requirements of the CITY, including City Code Section 19-7(h) which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." The USER, prior to making any changes from the approved plans and/or method, must obtain written approval from the City of Atlantic Beach Public Works Department, for said change within 30 days after the day of completion. This permit shall inure to the benefit of,and be binding upon,the USER and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications,to include utilities locate requirements and use limitations/requirements of easements, public right- of-ways and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby as pd by the USER. Date nOV \ i ? O&i Prev nt(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this / 3 day of \ 20 2-4/M by ( cr\CI, LLin n iilAar.k 0 S printed name of Signer),who personally appeared before me and acknowledged that he/she signed the instrument voluntarily for the •u •• - -xpressed in it. 44 . ..f---) 9<<• TONI GINDLESPERGER E„MY COMMISSION#HH 407122 c ';. EXPIRES:October 6,2027 i.l--:-- Department Approval: Signature of Notary Public, State of Florid 1 Personally Known j Produced Identification(Type) Public Works Department Date Revision Date:05/09/2023 i` ,BUILDING PERMIT APPLICATION FOR INTERNAL OFFICEIUSE ONLY I . City of Atlantic Beach Building Department PERMIT# VN (. Ly —013 1 800 Seminole Road, Atlantic Beach, FL 32233 ALL information required to process Phone: (904) 247-5826 Email: Building-Dept E coab.us Job Address 808 Amber Lane Atlantic Beach FL 32223 RE#4,7441-44-4044 VA\\A\ -Q( Legal Description 30-60 17-2S-29E ROYAL Palms Unit 1 Lot 1 BLK 3 Valuation of Work (Replacement Cost) $10,000.00 Heated/Cooled SF Non-Heated/Cooled SF Class of Work: E] New Addition F Alteration Repair Move Demo Pool E Window/Door Use of existing/proposed structure(s): Commercial Residential • If existing structure, is a fire sprinkler system installed?:Yes No Will tree(s) be removed in association with proposed project? [ Yes (Must submit separate Tree Removal Permit) E No Describe in detail the type of work to be performed: New fence Florida Product Approval#For multiple products use Product Approval Information Sheet) Property Owner Information Name Tana Mankus Phone 904-514-8890 Address 14571 Marsh View Drive City Jacksonville Beach State FL Zip 32250 Email tmankus21@gmail.com Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Phone A,la city State 7in ---------- Qualifying Agent State Certification/Registration# Email Coitact`N lu :m_ Worker's Compensation Insurer OR Exempt Expirati. 9. e Architect's NameEmail Phon• Engineer's Name Email Phone 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 city/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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO ICE OF COMMENCEMENT. Age Signature of Owner or Agent) / 4-. Signature of Con . tor) Signed and sworn to(or affirmed) before me this /0Z/ 4-. of Signed and sw.rn to (or affirme. sefore me this day of 1' evL,.hc'r , 20 -i by Tina Ly inn MwvrKI,5 by r,eSienatureof NotaryINPV)1/Y1 d ,'K C,, Signature of Not . , Personally Known OR vi Produced Identification Pe ..nally Kno • OR [ ] Produced Identification Ty - air, , i Ica i.bi,; gr:'!!.47:1f r t V r'- I C-C.- ' Type . Identification: A, • MY COMMISSION#HH 085656 EXPIRES:May 14,2025 oi;0. Bonded Thru Notary Public Underwriters 9. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern owner-builders as well as employers. I also understand that the construction must comply with all applicable laws,ordinances, building codes,and zoning regulations. 10.'-' I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue service, the United States Small Business Administration, the Florida Department of Financial Services, and the Florida Department of Revenue. I also understand that I may contact the Florida Construction Industry Licensing Board at (850) 487-1395 or the DBPR for more information about licensed contractors. 11. I am aware of, and consent to, an owner-builder building permit applied for in my name and understand that I am the arty legally and financially responsible for the proposed construction activity at job address listed on this document. 12 I agree to notify the Atlantic Beach Building Department immediately of any additions, deletions,or changes to any of the information that I have provided on this disclosure. LAO 13. Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not Cave a license, the Construction Industry Licensing Board and Department of Business and Professional Regulation may be unable to assist you with any financial loss that you sustain as a result of a complaint. Your only remedy against an unlicensed contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property,you may be held liable for damages. If you obtain an owner-builder permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed and the status of the contractor's workers'compensation coverage. Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when the permit is issued. 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- DEPTPCOAB.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: gop, O rber;ac,k Lx,„ RE# 1 71 1 Li 1 _D000 Owner Name: --V----AA_AA_ \ Phone Number: 1d `51 y-BR io Mailing Address: N57) 1' 'C,r 5}‘ U ie1,,)D', -sem- City: 130c k State: 1%1_ Zip: , 22..5O Adritit- Signature of Owner or Agent) egii•' DONNAL BARTLE Signed and sworn to (or affirmed) before me this /a / n day of 6._. ;•' MY COMwNSSION#HH 085656 NO veh, her , 2;0j_11 by iCts Yh ll I"li i gks- EXIRES:May 14,2025 nT ryB 1,141.11.Bonded uoayPublic Undermeeia Signature of[ ] Personally Known OR KI Produced Identification Type of Identification: rt- Dri ver LtGGh ce. stAak OWNER BUILDER AFFIDAVIT r City of Atlantic Beach Building Department JOB ADDRESS: 800 Seminole Road, Atlantic Beach, FL 32233 jt'r Phone: (904) 247-5826 Email: Building-Dept@coab.us a(lvb.e . G c lc Le, OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DEPARTMENT TO SIGN THIS DOCUMENT** I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER/ BUILDER TO ACKNOWLEDGE THE LAW: To qualify for exemption under this subsection, an owner must personally appear and sign the building permit application and must satisfy local permitting agency requirements, if any, proving that the owner has a complete understanding of the owner's obligations under the law as specified in the disclosure statement in this section. However, for purposes of implementing a "United States Department of Energy SunShot Initiative: Rooftop Solar Challenge"grant and the participation of county and municipal governments, including local permitting agencies under the jurisdiction of such county and municipal governments,an owner's notarized signature or personal appearance to sign the permit application is not required for a solar project, as described in subparagraph (a)3., if the building permit application is submitted electronically to the permitting agency and the owner certifies the application and disclosure statement using the permitting agency's electronic confirmation system. If any person violates the requirements of this subsection, the local permitting agency shall withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity against the owner and any person performing work that requires licensure under the permit issued.The local permitting agency shall provide the person with a disclosure statement in substantially the following form: DISCLOSURE STATEMENT- Please initial Items 1 - 13 1. stiO I understand that state law requires construction to be done by a licensed contractor and have applied for an owner- builder permit under an exemption from the law.The exemption specifies that I, as the owner of the property listed, may act as my own contractor with certain restrictions even though I do not have a license. 2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the construction and is not hiring a licensed contractor to assume responsibility. 3. ,., I understand that, as an owner-builder, I am the responsible party of record on a permit. I understand that I may protectf myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own name. i also understand that a contractor is required by law to be licensed in Florida and to list his or her license numbers onpermitsand contracts. 4. ,I" I understand that I may build or improve a one-family or two-family residence or a farm outbuilding. I may also build or improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my own use or occupancy. It may not be built or substantially improved for sale or lease, unless I am completing the requirements of a building permit where the contractor listed on the permit substantially completed the project. If a building or residence that I have built or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I built or substantially improved it for sale or lease, which violates the exemption. 5. 1` I understand that,as the owner-builder, I must provide direct, onsite supervision of the construction. 6. ` I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my wilding or residence. It is my responsibility to ensure that the persons whom I employ have the licenses required by law and by county or municipal ordinance. 7. I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an owner-builder ermit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner-builder, may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am lifully acting as an owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 8. I understand that I may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform the work being done. Any person working on my building who is not licensed must work under my direct supervision and must be employed by me, which means that i must comply with laws requiring the withholding of federal income tax and social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers' compensation for the employee. I understand that my failure to follow these laws may subject me to serious financial risk. 6 b Oi 1 1 i 1 14/ 1 r I 1 g G.g m0 G r 1 I 2 7 2 n~ 14 I LX O 7 2H u Iy` I BLOCK 2 374 N0419'58`E 93.00'a X I 1ilas 28.0' CI I g rl xs I n. r oig ii.O 4ig c.,..., m0 L ,I I _. ._. 0 1 27%*w I I x Dmz u ' Ii I Iicor, //nn I3»3£ V I II IRx 2q1._ rNr o 7 fTl 1g I I r 3 PI D; I I Iq sZ 11IiI AD D c r xii fig cPe"oaw —Yr— ——— -j rir z SO4'39'58'W 31 93.00' BACK OFMaCVAWRY./ i 1E11 111 ILII 1 ii rig!'" 1 1 1 I t:1/11:lig!P! i m ' 11.4 Fence Addendum Updated 03/07/2024 41 )f_t 1 City of Atlantic Beach Building Department J;tl; 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT # Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: Date: EO ClrnbeSIA6k L.c,Ac 3L22.- N6 1 ? , Z OZ(-4 Property Type: Lot Type/ Features: residential El One Street frontage (interior lot) Commercial PMore than one street frontage (corner lot,through lot, etc.) Swimming Pool FenceA a.......1 r......... Height 1....1...,a all that ....,.... .1. ren ce Ivla erial: Fence Height (select all that apply. L'Wood flour Foot(4ft) Chain Link B'Six Foot (6ft) Vinyl Other El Block/Stone (Plan details required for footings and/or retaining walls) Other Fence Location: Please submit an accurate and current boundary survey showing all existing improvements (including building footprint, driveway, swimming pool, etc.) and location of fence/wall and any gates. Plan details required for block wall footings and/or retaining walls and any portion or fencing above 6ft in height. Will the fence be built in an easement? Yes (must submit separate Revocable Encroachment Agreement) il'No Will tree(s) be removed in association with proposed project? l Yes (must submit separate Tree Removal Permit) Lam'No Conditions of Approval: All old fencing and debris must be removed from job site by contractor or homeowner. 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.