1965 W Sevilla Blvd RFNC21-0122 FenceOWNER:ADDRESS:CITY:STATE:ZIP:
KELLEY JAMES E 1965 W SEVILLA BLVD ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169462 0365 SEVILLA GARDENS UNIT
02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1965 W SEVILLA BLVD RESIDENTIAL FENCE ONE
STREET FRONTAGE 4' FENCE $4500.00
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: 9/24/2021
PERMIT NUMBER
RFNC21-0122
ISSUED: 9/24/2021
EXPIRES: 3/23/2022
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $35.00
RFNC21-0122 Address: 1965 W SEVILLA BLVD APN: 169462 0365 $35.00
ZONING PLAN REVIEW $35.00
ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00
TOTAL FEES PAID BY RECEIPT: R17322 $35.00
Printed: Friday, September 24, 2021 1:49 PM
Date Paid: Friday, September 24, 2021
Paid By: KELLEY JAMES E
Pay Method: CREDIT CARD 516244968
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R17322
Final Plumbing
Final Electrical
Final HVAC
CC Final
Final Building*
Swimming Pool Steel
Swimming Pool Safety
Electrical Grounding & Bonding
Swimming Pool Final (Bldg)
Swimming Pool Final (PW)
Formed Columns/ Beams*
Masonry Cell Fill
Structural Steel*
OTHER:
OTHER:
OTHER:
OTHER:
OTHER:
Power Pole
Silt Fence
Piers/ Stem Walls
Underground Plumbing
Underground Electric
Foundation/ Footing
Slab**
Retaining Wall Footing
Driveway
Sewer (Building Dept)
Sewer Tap (Utilities Dept)
Rough Electric*
Rough Plumbing/ Top Out*
Rough Mechanical*
House Wrap
Wall Sheathing
Roof Sheathing
Tie-down Framing Connections
Rough Framing
Roofing In Progress
Window/Door In-Progress
Insulation Ceiling
Insulation Wall
Exterior Lath
Stucco Scratch Coat
Exterior Siding In-Progress
Brick Flashing & Ties
Early Power
Gas Rough
Gas Final*
* When all rough electric, plumbing, mechanical are complete but before any work is
covered up.
* When all gas piping is complete and wallboard is installed but before gas is
attached to any appliance. All outlets must be capped and pipe pressurized at a
minimum of 15 lbs.
* For new living space: When all construction work including electrical, plumbing,
mechanical, exterior finish, grading, required paving and landscaping is complete
and the building is ready for occupancy, but before being occupied
Additional inspections may apply to your project if your project
contains these elements:
INSPECTIONS REQUIRED FOR BUILDING PERMITS
To verify compliance with building codes, inspections of the work authorized are required at various points of the construction.
The following inspections are typically required for residential projects:
Date: Initial: Date: Initial:
_____________________________________________________
Permit Type
____________________________________________________
Permit No.
__________________________________________________________
Job Address
____________________________________________________
Contractor
POST THIS CARD WITH PERMITS AND PERMIT
DOCUMENTATION IN FRONT OF BUILDING
Construction Hours per City Code: 7am—7pm Weekdays; 9am—7pm Weekends
Building Department Public Works/Utilities Fire Department
Phone: 904-247-5826 Phone: 904-247-5834 Phone: 904-630-4789
Fax: 904-247-5845 Fax: 904-247-5843 Fax: 904-630-4203
* When forms and reinforcing steel, anchor bolts, sleeves and inserts, and all
electrical, plumbing and mechanical work is in place, but before concrete is poured.
* When all structural steel members are in place and all connections are complete,
but before such work is covered or concealed.
** FORM BOARD ELEVATION CERTIFICATE MUST BE ON-SITE FOR SLAB INSPECTION
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.js 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 ficationroducedIdentification
I/ !f.?%fl°?' COnded Thry fiNea ti lt3a n:Type of Identification: f- L = ,) ••^•'
RFNC21-0122
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 iree 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
FLBondedTNuNotaryPublicUnderwkstsTypeofIdentification: l_
Updated 10/24/ 18
RFNC21-0122
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.
RFNC21-0122
MAP SHOWING SURVEY OBOOKF
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LUI 22. 5/VILLA GARDENS UNIT TWo A.;
CUIN
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7 AND 7A,Of 1HE CURRENT PUKk RI CDRD
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Proposed location of 4' high l3 rail a
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black aluminum fence 1 TivF, 1 -M
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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 OLDRATEMAPNUMBER12031C0406H, 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 ,
RFNC21-0122
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