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1965 W Sevila Blvd Fence Submittal (p---. 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.us IS REQUIRED. Job Address: i 9 G 5 .SQ.,,,kkc.„ B ku ck . `, Permit Number: Legal Description L f v�._ S.J i���6-EP`tott.j s lni'i- 2� r Ic�I� lex^'"K y5 RE# i c/y�2 - 0 3 605— . ); )4 Valuation of Work(Replacement Cost)$c4p(-61- Lis CC Heated/Cooled SF Non-H • Class of Work: ❑New DAddition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Win /Do r S • Use of existing/proposed structure(s): ❑Commercial tesidential EP 2 2 2021 • If an existing structure, is a fire sprinkler system installed?: ❑Yes ❑No BY: • Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No Describe in detail the type of work to be performed: AM �e .k- -t-o h 4kyurd Fevce_ ii eK t)4•\ ii-thc-11 Florida Product Approval# for multiple products use product approval form Property Owner Information Name ��ltY1' - (Ael +�y Address (0165 'S@J, 't' t /ck IC City At1cliitk1 IS State N--1.— Zip z72.3,� Phone_,ac 7 'JAGS. 2O 7 E-Mail J f.-'1{y I l eyck1s (m ItykA1l " Cco-k Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company Qualifying Agent Address City State Zip Office Phone Job Site Contact Numbe 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 wor .nd installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that a ork will be performed to meet the standards of all the laws regulating construction in this jurisdiction. I understand that a ' •arate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS,T. IKS,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 YO R NOTICE OF C /TENT. 7..(," Signature ner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed)before me th)si 22 day of Signed and sworn to(or affirmed) before me this day of SEPT , 2U21 ,byS e_ (�C4,I(e\ - fj�/t. , , by c.,/ (Signature of Notary) ✓`/ (Signature of Notary) I17-74:7:;: CHRISTIAN GILES [ ]Personally Known OR r 4�` ..; MY COMMISSICrE HI$i r t) n n OR *j`•.;:...,; EXPIRGS:[A�rRkki202fd Ide fication [�roduced Identification , I/ ! { •-,f.?%fl°?' COnded Thry fiNea ti lt3a n: Type of Identification: f- L � = ,) ••�^•' ���, � Owner Builder Affidavit **ALL INFORMATION =rs'.�.�ri�,\ HIGHLIGHTED IN �"' City of Atlantic Beach Building Department GRAY IS REQUIRED. } - 800 Seminole Rd, Atlantic Beach, FL 32233 ``'AS'` 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: 1765 ,S?ijl aq "('k. Ui 41-- cydic, I . Owner Name:-MyyvQS Kt ire e Y Phone Number: .d 7 6 P-)126 7 Mailing Address: /765 k.SWA L( ( NUC/t C/ ) City: l(Vf�'►`C.- 15 ci•-\ State: FL Zip: 3 2,1.63 Notarized Signature of Owner . _ / -d_..0.-- -��� ,/ � The foregoing instrument was acknowledged before me this 2Z- day of S Fp't � in the State of Florida, County of OUVRl, r,.., Signature of Notary Public C,/l / (.��/'� ..2/"--1-iiii-, 't�"""''• CHRISTIAN GILES �� . MYCOMMISSION#HH 117153 [ 1 Personally Known OR [ roduced Identification =` .�-ea= EXPIRES:April 13,2025 FL / %•' Bonded TNuNotary Public Underwksts Type of Identification: l_ Updated 10/24/18 0411`S'-1"ri- Fence Addendum Updated 1/14/2021 City of Atlantic Beach Building Department J ;,,. 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT # Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: Date: 19& .S4e&11\a " \v c,t u) 0 c1'/ 1 % c: I Property Type: Lot Type/ Features: (*Residential A One Street frontage (interior lot) LI Commercial El More than one street frontage (corner lot,through lot, etc.) ❑ Swimming Pool Fence Material: Fence Height (select all that apply): ❑ Wood %Four Foot(4ft) ❑ Chain Link El Six Foot(6ft) ❑ Vinyl ❑ Other ❑ Block/Stone (Plan details required for footings and/or retaining walls) %'Other 6iO4, c.t,cW. Aria)14WK- 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 eases iit? ❑ Yes(must submit separate Revocable Encroachment Agreement) I N o Will tree(s) be removed in association with proposed project? ❑ Yes(must submit separate Tree Removal Permit) XN o Conditions of Approval: • Roll off container company must be on City approved list. Roll off container cannot be placed on City right-of-way. • 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. MAP SHOWING SURVEY OBOOKF PAG"LUI 22. 5/VILLA GARDENS UNIT TWo A.;CUIN CDS o f DVS�EY AnpplpA 7 AND 7A,Of 1HE CURRENT PUKk RI CDRD f 1 Proposed location of 4' high l3 rail .a 0 ,. black aluminum fence 1 Tiv�F, 1 -M I , 1 1 / 't / o,' k* Coat- Gate / y •‘4' 50• LOT Te E` \ O .'^1q / LN6�56 E '� - ..,..-411" N • e, ,...,:, 4 g T',,,s_%-",,a65� C .. 41:9 .-.•i�j ' - 73 NUVO '° ' Gate SEVILLA BLVD. .8 S' ;o WEST YuSCD� A gym '$ *A RiC10 OF WAY VARIES PAVED PRIVATE GL 8 J a ROAD i W�~ '• A f k!, o me hI ` , g wnn f" /4 N74.OS 4$-W 3,• :u, � •A)44.- •• ,\ CsqS. 1 •50j --,--.241.4,..,..< c2I�".P \' 0 ) ` \ • ss \vs /' \ /' \ / ' NOTES 1.THIS ISA BOUNDARY SURVEY. 2.BEARINGS BASED ON TIE NORTHERLY PROPERTY UNE BONG N61Y3'S6Y AS PER PUT. 3.NO BUILDING RESTRICTION UNES AS PER PLAT. THE PROPERTY SHOWN HEREON UES IN FLOOD ZONE •x•(AREA OUTSIDE THE 0.2S ANNUAL CHANCE THIS SURVEY WAS MADE FOR THE BENEFIT OF FLOODPLAIN)AND FLOOD ZONE "AC (EL 6) AS WELL JAMES E. KELLY and CAROL L. KELLEY; PON TE VEDRA AS CAN BE DETERMINED FROM THE FLOOD INSURANCE TITLE, LLC/HATHAWAY and REYNOLDS. PA; AND OLD RATE MAP NUMBER 12031C0406H, REVISED JUNE 3. REPUBLIC NATIONAL TITLE INSURANCE COMPANY. 2013 FOR DUVAL COUNTY. FLORIDA. m v410 1671-10u77}11 SIGNATURE AND DO6.;L___,: OATWRIGHT, P.S.M. ST OGWAL RASESEAL OF A FLORIDA CEASED AIRVEYOAND MAPPER.' FLORIDA UC. SURVEYOR and MAPPER No. IS 3295 FLORIDA UC. SURVEYING&MAPPING BUSINESS No. LB 3672 ESD e7:._ niE 2216-0261 ,ORA*BO _ BOATWRIGHT LAND SURVEYORS, Inc. 1500 ROBERTS _.. • • DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 DATE: MARCH 7 2016 SHEET • OF , Eyc.„Nple c;i - , 4' high 3 rail black aluminum fence •.... .., - z 4 ' , . .,:,•• „, , , • .©" e• 1 1' st 4,10...- , tvif e ...". 4--'1%. 0116 - : *'' •" ' .4. - -- , ' 110111114. 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