900 Plaza Dr Fence Submittal ' Building Permit Application Updated 10/9/18
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rfCity of Atlantic Beach Building Departmentjz **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904)( 247-5826 Email: Building-Dept@coab.us
Job Address: CI 00 �l�%1 •q [,1 c, 3 a 33 Permit Number:
Legal Description3 -c- D. 38 g,5 - '\C -IALPIV019 cc S -P1-T9--RGT1 RE# 1 1 c(5 -0 50 D
Valuation of Work(Replacement Cost)$ 1� Heated/Cooled
of?. G a�Z a e
( , /Heated Cooled SF on ea ed/Cooled
• Class of Work: ❑New ❑Addition ❑Alte?ommercial
tion /Repair ❑Move ❑Demo ❑Pool ❑Window/Do ECEIVE
I)
• Use of existing/proposed structure(s): ❑Residential NOV 17 2021
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
i
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removaikrmit) E iNe
Describe in detail the type of work to be performed:
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Florida Product Approval# for multiple products use product approval form
Property Owner InformaW n 1 r I_
Name 00 is ( cc ul5i' I ( L C Address 6�5 or)ciyQp({ �c, le(4 II
City -i U Lk-. State _Zip aa,33 Phone 90"1 a`A"1 5 -:-3 `j
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information `
O
Name of Company i � 6 rt ( c,+-(0,,&Co1 QualifyingAgent ' J
GtJ (� 3
Address (j-1s coy Pt( - Q\ c) S City p-tS
o.l . Picd.. State FL Zip '. ,./Ds33
Office Phone l 1 etb :`(1 s33L-1 Job Site Contact Number cm ' 4 3-7
State Certification/Registration# D.55OLi 3 E-Mail W AC-\---1i11- A C - Or'i5 2 c4(o---,-,5(-61. ( D M
Architect Name&Phone#
Engineer's Name&Phone#
`\,_
Workers Compensation Insurer J U]kl OR Exempt 0 Expiration Date ob/V;7,
Application is hereby made to obtain a hermit 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 •MMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR P*)�PE'TY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER O' AN ATTo•NE BEFORE
RECORDING Y- f R,NOTICE OF COMMENCEMENT.4, i,
—��- aa
g - • - . Owner or Agent) (Signature of Co• ractor)
Signed . c sworn to(or affirmed)before me this/6 day of Signed and sworn to or affir -. bef.re me this I •day •1
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,(2afe,-, tc —L 4'. 'ems
(Signature of Notary) (Signature of Nota
;,� .rid LISA A BINDER
'...49��'• NotaryPublic-State of Florida ,,,$:047",,, ATHENA FORTENBERRY
Personally Known OR L g'Personally Known OR
`•�o< Commission#GG 271994 : :Notary Public Sotate of Florida
[ I Produced Identificati "4W-f.' My Cofhm.Expires Jan 11,1013 [ [Produced Identification _.`ice ._ Commission GG 358994
Type of Identification: :.,... .. •h N.tional Nota Assn. I Type of Identification: I ' My Commission Expires
iii " July 25, 2023
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rt'=�' Fence Addendum Updated 1/14/2021
41E.
City of Atlantic Beach Building Department
' j
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
1
Job Address: Date:
1
( CD \\ \ ki\
Property Type: Lot Type/ Features:
Cesidential C"One Street frontage (interior lot)
ommercial ❑ More than one street frontage(corner lot,through lot,
etc.)
❑ Swimming Pool
Fence Material: Fence Height (select all that apply):
❑ Wood ❑ Four Foot(4ft)
ElChain Link L ”ix Foot (6ft)
❑ Vinyl ❑ Other
❑ Block/Stone (Plan details required for footings and/or
ret ining walls)
Other r�I J r`A.1 N`-Y^
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)
Ei/No
Will tree(s) be removed in association with proposed project?
I=1 Yes (must submit separate Tree Removal Permit)
GY No
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.
An ALTA/NSPS Land Title Survey
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i - _ BOUNDARY SURVEY OF
Point Of •
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,...i• SEA OATS APARTMENTS
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900 PLAZA DRIVE. ATLANTIC BEACH. FL 32233
"��"° \'...'\ ���'I1 T! FHA#063-11159
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2016-S0 REENDM pOTAL fpD NOTES CURRENT AEU)DALE:05/20/2021
JAR No.99-225 ORAFPNG SP5/MM5 PARTY MET:T.000IPRELL..LDd1RY F.B.152-L.PB.23-RI CAD ALE 2016-50.0.9 CNE0RE0 BY: ORIGINAL PELD DATE:06/06/1888 TOLlu[L 1 COMA:MD lit crr o.me FA[wM-E.