1815 Hickory Ln Fence Submittal Building Permit Application Updated10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
- tv IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: MS 1 :J crvy Li A4-1...44.:c f,cl FI 3Z2-33 Permit Number:
Legal Description 0100 c :„,L . (y RE# I-72 ca.0 - 1 Ll LI 2
Valuation of Work(Replacement Cost)$ 6200 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: XNew DAddition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/ CEIVE
• Use of existing/proposed structure(s): ❑Commercial Residential NOV 1 7 2021
• If an existing structure,is a fire sprinkler system installed?: ❑Yes A.No
• Will treels) be removed in association with proposed project? EYes (must submit/separate Tree Rem/if/al Permit . 1No
Describe in detail the type of work to be performed: Ths +a Hl'vly �''N w tau- :vi s c - c of
lit c4v_ p --.)'>, ( _
Florida Product Approval# for multiple products use product approval form
Property Owner information /
Name M;c,L J Lo,n6,vd. Address Iis1S 14ICI w),. L,n
City Atl,4:c ( I,. State Fl Zip 32233 Phone 1&t-( y2-,( 770 _
E-Mail th�J fowl loare/ (yednooa COM
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information p
Name of Company Su .IU, F�.+u- uri RG,I Qualifying Agent ZQcL re...),l-44
Address 5170 1.1;51.,‘.. Alp. City S.,caiw.s,. h, State Fl Zip 322.54
Office Phone 70c/ 312_ 3E25 Job Site ContaAt Number/
State Certification/Registration# GS f56f E-Mail 13tre.. s p. roc;„J N.(+sbry;itc, .c,cvn
Architect Name&Phone#
Engineer's Name&Phone# _
Workers Compensation Insurer_ t.a,.. ../ At,h-vf OR Exempt ❑ Expiration Date elS f zUyZ
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
RECORDING I R NO ICE OF CsMMENCEMENT.✓/
— �, .��
(Signature of Owner or Agent) C (Signature of Contractor)
.Signed and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed before me this 27 day of
ve•en berms a 11/I 1 c.Aa� .(orrv(o avtclOt Uc}0(�.- ZUl l y e1_ = ;_ _i / I /
�_Jtii`�>,rri��r��
(Signature of Notary)" (Signature of otary)
I ,,rf JANIS KAY LEWIS
[ ]P onall Known OR °4` r� f' tvaary Public Stall of Florida
Y 1 •; Notary Public•State•f Florid ll2=Q1 ally KnownL: N. Britani M Norman
Produced Identifica n q `. P' Commission I GG 344765 [ `Produced Identification
�:` � • My Commission HH 011346
Type of Identification: ori.:• �,�
1 My Comm.Expires DecO14,1023( a of Identification: M� Expires 08r16i2024
,J. Fence Addendum Updated 1/14/2021
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: 'g IS 4,ekof\_/ � Date: \` I j?/a
Prorty Type: Lot Type/ Features:
Residential ❑ One Street frontage (interior lot)
❑ Commercial ❑ More than one street frontage (corner lot,through lot,
etc.)
❑ Swimming Pool
Fencenc� Material: Fence Height (select all that apply):
LW od Gi Four Foot (4ft) arni'"" pr.5'
❑ Chain Link CVix Foot (6ft) W a64,J► or' P P^t-,
❑ Vinyl ❑ Other
❑ Block/Stone (Plan details required for footings and/or
retaining walls)
13-Other /4vMlrtJh
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. cs
Will the fence be built in an easement?
El Yes (must submit separate Revocable Encroachment Agreement)
NYC)
Will tree(s) be removed in association with proposed project?
❑ Yes(must submit separate Tree Removal Permit)
t 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.
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MAP SHL .✓ING BDLNDARY Sb,\ VE... Y OF:
LOT 20, SELVA MARINA.UNIT NO. I2-C REPLAT, AS RECORDED IN PLAT BOOK 37,
PAGE 29 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
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n1,E SAN d) NOTES:
4, OA°35'01eE' Pr'l° Rp0 BEARINGS ARE BASED ON THE WESTERLY LINE OF LOT 20
g g9t�r I,n f wAy AS BEING 5.00'24'53"E.BY PLAT.
�- GIC) D NO BUILDING RESTRICTION LINE BY PLAT, BUT THERE MAY BE
w� RESTRICTION LINES OR EASEMENTS THAT AFFECT THIS
rnZ PROPERTY BY ZONING OR RECORDED IN THE PUBLIC RECORDS
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OF THIS COUNTY THAT ARE NOT SHOWN ON THIS SURVEY.
3\w THIS PROPERTY LIES IN FLOOD ZONE "X"BY FLOOD MAPS
o e REVISED 4/17'/1989, COMMUNITY PANEL NO.120075 0001 D. ;11\
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Se/vo Mom/ina U59f N° '0 5 v jrence/ I HEREBY CERTIFY TO: GEORGE M. a GAYNELLE G.BAIN:
p B. 26,, %. CHASE MANHATTAN MORTGAGE : COMMONWEALTH LAND TITLE
INSURANCE CO.: BUSCHMAN, AHERN, PERSONS 8 BANKSTON
THAT THIS SURVEY MEETS THE MINIMUM TECHNICAL
STANDARDS AS SET FORTH BY THE FLORIDA BOARD OF
PROFESSIONAL SURVEYORS AND MAPPERS, PURSUANT TO
SECTION 472.027 FLORIDA STATUTES AND CHAPTER
/T\D U R D C N LAND 61G1 —6 FLORIDA ADMINISTRATIVE CODE.
SURVEYORS INC. ,
LB 6645 PROFESSIONAL LAND SURVEYOR NO.1674 FLORIDA
H. BRUCE DURDEN, SR.
1 103 SOUTH THIRD STREET DATE: t"U/y /4 /997
JACKSONVILLE BEACH, FLORIDA •32250 SCALE: /"= 30'
(904) 249-7261 FAX.(904) 241-1252
THIS MAP OF SURVEY IS NOT VALID AND MAY BE USED FOR INFORMATIONAL PURPOSES ONLY UNLESS IT IS SIGNED
AND HAS THE ORIGINAL RAISED SEAL OF THE FLORIDA LICENSED LAND SURVEYOR WHOSE N,;WE IS PRINTED HEREON.