No preview available
 /
     
Permit Fence 780 Aquatic 2011 L'j r iteit ' rJy ,` CITY OF ATLANTIC BEACH � r , 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002391 Date 8/04/11 Property Address 780 AQUATIC DR Application type description FENCE PERMIT Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc 6ft fence in rear Owner Contractor TRIBOU, SUSAN OWNER 780 AQUATIC DRIVE ATLANTIC BEACH FL 32233 Permit FENCE PERMIT Additional desc . Permit Fee . . . 35.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 1/31/12 Special Notes and Comments Avoid damage to underground water /sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 35.00 35.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 39.00 39.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: - "Pc/ ) - 1 dA. fr L/liV Permit Number: Legal Description 1-43 3 Pl t d"► C Cmkro Parcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ 'G Proposed Work heated/cooled non heated /cooled Class of Work (circle one): New Addition Alteration Repai Move Demolition pool /spa window /door Use of existing/proposed structures) (circle one): Commercial Rsidents e If an existing structure, is a fire sprinkler system installed? (Circle one): 'Y No N /A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: i ep exi &? 7L ,} ('e GJ; i-� kl:° g - f , ' W O - ■ -s t' tci a kJ IZ A pa heir Property Owner Information: / Name: -� US's h CIY' l bad Address: 7J Uc,. 4 . '-.,b 1 7‘ 1° L.J City f ` C4K StateZip .321..? Phone yp5[ — %2 - 5" 6 i t 9 E -Mail or Fax # (Optional) Contractor Information: Company Name: Qualifying Agent: Address: City State Zip Office Phone Job Site/ Contact Number Fax # State Certification/Registration # Architect Name & Phone # Engineer's Name & Phone # Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks and Air Conditioners, etc. 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. 1 hereby certify that 1 have read and examined thisplication and know th to tru All provisions of laws and ordinances governing this type of work will be complied with w her specified in or not. The n g�f a , s of presume to give authority to violate or cancel the provisions of any other federal, state, local law re lati g construction th �er ` a . , tr tion. f , Signature of Owner i 7 Signature of Contractor Print Name o► 0 ` � Print Name _ S ,1 .d subsc , r eO of »Eti�` Sworn to and subscribed before me this ' Day of � � t .�,.'- M1 • ay 21 , �y ens this Day of , 20 ._,4 /' f �„ � '� otary Public -r Notary Public -- 7 - 6 7 a --) (Jrz- 7-Wo • Revised 01.26.10 " ' ' ' CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT 1. 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 LIAVE 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 jMPLOYED BY YOU HAVE LICENSES REOUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. 1I. INJURY UABILITY; 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. 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. 7,k « - : ic J)h / Ii4 -912-501-5 AD �) 3 5 1 PHONE NUMBER cleat,., 60 PRINT NAME /_ .. L..1 7/G / L TU'E DATE �/� Zvu Before me this „7 day o - ,4 the county of Duval of Florida, has . - ally a d herin by himself / herself and affirms that all statements and declarations are Dr-17.0, EE 057349 true and accurate. � — ' A " °t' C%s V CON t 1,2015 Notary Pubic at Large, Slate Of ' County Of . *. t• f M ptFtE W Unde11 NOON Srgnature'i / WAS FORM RI.D007; REVISED: $/14t2007 Kat 10 CIS .. tai .lI�03619 11111111111111111116111011111111 SMINIIIIMN MAP SHOWING BOUNDARY SURVEY OF LOT o -c BLOCK `" ' AS SHOWN ON MAP OF • AS RECORDED IN PLAT BOOK . 92? PAGES 7 1 f 7 /A OF THE CURRENT PUBLIC RECORDS OF DUVAL CO., FLA. FOR , ,9G /C 6'.9,P.D6 ,/o/x/7 / /,f 7/ NOTE : BEARING DATUM SHOWN HEREON ARE BASED ON THE ABOVE MENTIONED PLAT, - Li 7©/ / 'es " , y - 75.4 / c'o (...� " 4 Zz. - -- ,. C+ CQ. � .1 o w 410' � w • I .CI 7 ; D2 " cif/ ti z ,G.d ^ 1061:1 a' ll., M w A \ A, 30.0' -.... ti a p 34 �y �� t 41 4' \--1 .:.t , n \I • '‘'.,k , , M, c' • 44.0' %' 1' L v Au rs: t`',..:it :: io /as % ,, , o .. ti z; N u, % w A 1 • II o N NI - . k ..... ,, h Q o k a s .0 ;. � o ic ; 3.4,0' - HO' •'), a : k si a NI T ( o o . ' i t N a 1 5 7° /G 'D2' 1 6 -- /‘0.40/ n 4 o 7 iO- 0 1 FLOOD - RT1FICATE : 1 HEREBY CERTIFY THAT THE LOT SHOWN HEREON IS, AS BEST ASCERTAINED, IN FLOOD ZONE "C" A§ SHOWN ON THE FLOOD INSURANCE MAP, COMMUNITY PANEL N I200T5 - oaofa. FOR A7 / 9 QCW FLORIDA DATED A• /L iB, 198 CERTIFICATE: THIS SURVEY COMPLIES WITH THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THE FLORIDA BOARD OF LAND SURVEYORS, PURSUANT TO SECTION 472.077, FLORIDA STATUTES. • I HEREBY / CERTIFY THAT THE ABOVE LOT WAS SURVEYED By LEGEND. ME AND T H _( AT , c Z L�,' L 4-4. _ - CONC n[7[ MONUM[Ni _ • IRON CORNIER IS LOCATED UPON SAME AS SHOWN AND THAT THERE ARE NO ENCROACHMENTS UPON SAID - - - ZoT ... -. . CLARSON AND ASSOCIATES INC. n WOODEN STAKE 1643 NALDO AVE. JACKSONVILLE. F. SIGNED ✓ / 7 1 9 _ &- E O CORNIER �— X CROSS CUT SCALE ...__P ...__P . RE ( NED SURVEYOR NO ?3L /FLA. X -X- F ENCE • F 8 NO 9. O PG. -z 9 7 rt 1.a.q,. J , City of Atlantic Beach 1 �, APPLICATION NUMBER � �;� Building Department .. (To be assigned by the Building Department.) -- ` �� 800 Seminole Road r`J C� „� ' ", vj Atlantic B each, Florida 32233 -5445 /1 Phone (904) 247 -5826 • Fax (904) 24 -5845 U ._ 2 0, 20 , P., 0 „, 9 , -,- E -mail: building - dept @coab.us r),‘,„). 1 Date routed: c4' City web -site: http: //www.coab.us ' ' . APPLICATION REVIEW AN ' *• CKING FORM ii. �" - Department review required Yes No Property Address: /,,i j 71.c p q O .__ -.� Applicant: 1 f R./ 7,129 — Plan ' g& Zoni�a Tr Administrator Project: / t 4 U = I " ' Pu 1ic1 (_Worts„ ('_Public Utilities = :.i.a c Safety Fire Services �' . + b # px� 1 . . / ... gym ,, �T "`„+v t.4,„.7 e W ' �? 4 ' , `,,,v,, a �t f ° ' ,, . 3 ,, , 4 ,,,, ot reVi -W Y. .. , imaTS. a .'' �e . w > .'w "5 i , ,, ,a . E ,I : f ij a+ ..., _1 , ..,:. ._ ', I 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: nApproved. ['Denied. (Circle one.) Comments: BUILDING / PLANNING & ZONING ( Date: 71?" i Ii Reviewed by. TREE ADMIN. Second Review: ['Approved as revised. ['Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 „i`- sir , City of Atlantic Beach APPLICATION NUMBER is `� w - Building Department (To be assigned by the Building Department.) - to � 800 Seminole Road // _ j � - ! Atlantic Beach, Florida 32233 -5445 / Phone (904) 247 -5826 • Fax (904) 247 -5845 i7 ex �i l � J ! 'r E -mail: building- dept @coab.us Date routed: 7 City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Department review required Yes No Property Address: �� e;� /4 G? 4(4 6 A- p q _,Building -- Applicant: (a, j �'./1- Plan • g___&__ Zoning' ,l Tr Adr miss ator Project 1 / ( / - 2) ,e ii,(- . Pu Public Utilities - 1 3 7,5116 – Safety Fire Services _ r '* „ ..e :” }1, 4' 5 ' ,1 'f'..:::' , :' kawr, ' '' :' rW ''';'1,•., -.;6 v '4'",'''f4"°:. Other Agency Review or Permit Required Review or Receipt Date of Pe 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. (Circle one.) Comments: B :• PANNING & ZONING Reviewed by: _ L —! : / Date: -rr 72 - . DMIN. Second Review: ['Approved as revised. ['Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ['Denied. Comments: Reviewed by: Date: Revised 05/14/09 ri City of Atlantic Beach APPLICATION NUMBER ite.frti Building Department ? (To be assigned by the Building Department.) ` 800 Seminole Road i�� 4 7-40 / 9/ - Atlantic Beach, Florida 32233 -5445 JJ ;; L Phone (904) 247 -5826 • Fax (9O4) 1 5845 �ff �J +� E -mail: building- dept @coab.us — Date routed: / CX City web -site: http: / /www.coab.us APPLICATION REVIEW AND T - ACKING FORM Property Address: 716 Q`� C Department review required Yes No f� Applicant: oX L4. Plan • • & Zon' I • Tr Aft ' • trator Project: (7 r f;-1 C6g., //-7) ,�fY,' Pull is Wor CPuklc Utilities Public Safety Fire Services 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. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: Date: 1/9 `l TREE ADMIN. Second Review: Approved as revised. ❑Denied. ��� • - Comments: P 1: LIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09