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2078 Beach Ave RFNC21-0124 6 FtOWNER:ADDRESS:CITY:STATE:ZIP: SHEPHERD ROBIN W 2077 BEACH AVE ATLANTIC BEACH FL 32233-5934 COMPANY:ADDRESS:CITY:STATE:ZIP: TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 169716 0030 NORTH ATLANTIC BCH UNIT 3 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 2078 BEACH AVE RESIDENTIAL FENCE ONE STREET FRONTAGE 6' FENCE $2500.00 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00 TOTAL: $35.00 LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. 1 of 1Issued Date: 10/4/2021 PERMIT NUMBER RFNC21-0124 ISSUED: 10/4/2021 EXPIRES: 4/2/2022 RESIDENTIAL FENCE PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 t*., Building Permit Application Updated 10/9/18 City of Atlantic Beach Building Department ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY 49,4IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: % 6' g etvA b4!/4"iht' ,5CAC4/ 37-23., Permit Number: `NC,Z I ' •2 •4 Legal Description -` i -2 - ZI E ,.,.-3* Mrall 71‘gena( 1114 IT 3 pr RE# /b`li7/6, - 0 0 3 0 5 74.7`f4 7L!M Valuation of Work(Replacement Co.t)$ Z-• 37.".5Z eated/Cooled SF Non- Heated/Cooled Class of Work: ONew Addition Alteration Repair Move ODemo Pool Window/Door Use of existing/proposed structure(s): Commercial Residential If an existing structure, is a fire sprinkler system installed?: [Nes No Will tree(s) be removed in association with proposed project? DYes (must submit separate Tree Removal Permit) ONo Describe in detail the type of work to be performed: / 1 Pep/ace- A. 'JiI l waxer, acX4c eX44 / " # PJX" /^/ 1/e15W/ 4n// "16b"fr- Florida Product Approval# for multiple products use product approval form Property Owner Information) C4-/Name 0 ll^ S` Gp/t Address T 7 e 11 Alit- City /4/14.$1//e, State P- Zip 37--2-35 Phone ?GI/4-.5-W- 43r f" E-Mail r51xep5AepAerrA 6tiz14' .ecwi / flew Copy . .,job')4fcmKcrtu5 3 410 is+aC-, Carb^ Owner or Agent (If Agent, Power of Attorney or Ag ncy Letter Required) 0741„ 44 cl'4y. 9 —9/o —//d$ Contractor Information Name of Company 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 o 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 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 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 RECORDIIy,G YO R *TICE SF COMMENCEMENT. Signature of Owner or Agent) Signature of Contractor) Signed and sworn to(or affirm before me this 1 day of Signed and sworn to (or affirmed) before me this day of 0C. T , 2 ; 11 ,by at Si-4 EP R.,1 by Signature of Notary) Signature of Notary) i[:•, ':` fi::: CHRISTIAN GILES j P rsonally Known OR i• ; t: MY COMMISSION#HH 1171`.3) rsonally Known OR Yw' oduced Identification 4;,.'P EXPIRES:April 13,2025 I 1 duced Identification r?Type of Identification:r-i._n , L7_ _•..., e«weamn,NataryP„eawunae f Identification: REVOCABLE ENCROACHMENT AGREEMENT w' City of Atlantic Beach ALL INFORMATION T ,sl HIGHLIGHTED IN GRAY 1 800 Seminole Road,Atlantic Beach, FL 32233 IS REQUIRED x / 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 as"CITY" and 11+4 5V.4,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. 1 This work is generally described as A b 't a/ 5 C d 0 2. 2 v1Yni"5 ; fyve0-- ceti71.-, 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 2...777 ci 4-t'` 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 assumed by the USER. 12t/i- Date /0/ 1 / 2 l Property Owner/Agent (signed in presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this 1— day of 0 CIO 6L fa 20 2 t , by ROI /N -S7E P Hf n who personally appeared before me and printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. i 1 '4 c-` Z1 '- f Department Approval: ASignatureofNotaryPublic, State of Florida CHRISTIAN GILES Personally Known a: :+ MY COMMISSION#HH 117153—.4 Type)L--, EXPIRES:Apri113,2025roducedIdentificationTeLFo«,o.: sae Williams, Public Works DirectorBondedTMuNotaryPublicUnderwriters 4 11.404. H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 ATION Owner Builder Affidavit ALL HIGHLIGHTED HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. y 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.usPERMIT#:I NC 2. t Ol z 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 ISA 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: 267g $ e Ave' 1 At/a. n 4 Bk"-- c_ll, f Ft- 3 213 3 Owner Name: Rd b ih 5-hey/ -V Phone Number: 9e,-571- Mailing 71- Mailing Address: 2-077 Bezi,c4 /'tib City: yefrkiltx AqvA State: /1--Zip: 3 z 2-33 Notarized Signature of Owner The foregoin instrument was acknowledged before me this day of 0 C7 ,20).-1, in the State of Florida, County of DLI V1 Signature of Notary Public /. // CHRISTIAN GILES Personally Known OR [ 46roduced Identification t 1.1 MY COMMISSION#H`;11'i153 I'ro7; EXPIRES:April 13,202$ L hOCFtO`• n Ty-."J- T e of Identification: 6_hni Notary YP t.- ry Pub1iC UrC;rNr{crs I: Updated 10/24/18 N 0 1 0 fif NI it ig al0 1.... Pe) toi.) C.)846 4 CS4 In Lu: Z tk,2 4e, Ir. fat 4, 4" ...A.41. 14. Of r 0 0.... rir!,CI) 4 vki Cs/ r Z tn. 0 0 im11 a N N89*50'00"E(DEED)0 '100..DO (DEED) coilN89•53.20"E(ACT)99 72 (AC 1,.. CL N. 1, i - , 4•Net V.IIP VW* 0.111,.... ' - r?,... S*V4ITAITY '• *- I'd MANIRXIE 404„," 4111 iv 1%* ' . g FN0. 414.14N NI * Co4 IP. ill. .... ix; 8.4* 0 26 er t,... 0, 4: —,,, . ... . . 2:/X 10. 40.....cc tm In 40.0 A.* ir Q iti ce 67%...... ' CON% • 4... 4(- - 0--- gipr1/4„,„.4.14i DitivE*..-' . 447., 7......,...s a.. tr. 11-- a 1.5E -4,, . 1—STORY CONC. ir 4 • 0< co i.f) iv y ii-x ID BLOCK RESIDENCE v.". " •, - 0 K 44 wcr I b 4 p co (0. . f t?.. 8 3.0'ty rs..- 4,, $ 1 FINISH FLOOR (14.36) Li 4, Nt` Nt• I z 4 3.4 „— ,,4 4:0 in 1c r ,3.1 01 Itt gri 1 Z lar ID 4. p Ar, fipikw,4411, cc 3.0 M .....\. 73 41--- N- 4 i C') 1 CAI44 4' 6 *REFENCE N112 NOCW Cif AMMO T.....HE S8950100W 10000° ON mmm* o.,,S 47-114 Tt 1 4 ,z.s.v r.,,. i L-a^J-,,)z Fence Addendum Updated 1/14/2021 r') City of Atlantic Beach Building Department c;, 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT# PrNCZ 16(Zz{- Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: Date: 20 7' b4 Ave- ii -Ac 3zz3 Property Type: Lot Type/ Features: E Residential pne Street frontage (interior lot) Commercial 0 More than one street frontage (corner lot, through lot, etc.) 0 Swimming Pool Fence Material:Fence Height (select all that apply): Wood 0 Four Foot(4ft) Chain Link Six Foot(6ft) CI Vinyl Other Block/Stone (Plan details required for footings and/or retaining walls) Cl 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? 72<Yes (must submit separate Revocable Encroachment Agreement) No 4 Will tree(s) be removed in association with proposed project? Yes (must submit separate Tree Removal Permit) N o 4. 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.