1705 MARITIME OAK DR RFNC22-0080 Building Permit Application Updated
l0/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
`` 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
`r: IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us CZ
Job Address: 1705 Maritime Oak Dr Permit Number: RF N C ZZ' OO 0
Legal Description (,67 — /E5ck CAS 76 a9 E. 62/9 (JJ)) 0 RE# i ( so S -(--7(,,
Valuation of Work(Replacement Cost)$ 5186.00 Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition DAlteration DRepair ❑Move ❑Demo %Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) I No
Describe in detail the type of work to be performed: '\
Install 2-rail pool code fence with 3 gates pool code
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name John Tracey Haley Address 1705 Maritime Oak Dr
City Atlantic Beach State FL Zip 32233 Phone 904-322-0193
E-Mail traceyabcctennis@gmail.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Bullard Fence Inc Qualifying Agent lila Bullard
Address 1241 Haines St City Jacksonville State FL Zip 32206
Office Phone 904-781-2397 Job Site Contact Number 904-813-0149
State Certification/Registration# E-Mail IisaPbullardfence.com
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer Bridgefield Employer Insurance OR Exempt 0 Expiration Date 10/04/22
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
REC ING YOUR NOTI OF COMMENCEMENT " gitSaAd
(Signature of Owner or Agent (Signature of Contractor)
Signed and sworn to(or affirmed)before me this `1'S day of igned and sworn to(or affir -a befo e me this da of
A�yu..1t-, ao� ;by 1Y\.� (1sit L tik_y W4 c9-0d.2, (t ) 12
VINIMIMIENIMO
.1: JENNIFER JOHNSTON ::"i2SC:- f Naat ry) (Signature of otary I
• MY COMMISSION#HH 057579
v
'"• ••',.! EXPIRES:October 27,2024
' f j �.rr"' Notary PuristineW,cJoyce State of Florida r,da
• `of• i0d�1f Underwriters Personally Known OR ei s
Ch
[ ]Produced Identification i y ir My Commission GG 916805
Type of Identification: i (J L Type of Identification: > % s- Expires 08/22/2023
k-'-'.:'',,p Addendum Updated 1/14/2021
�, ,.i ; City of Atlantic Beach Building Department
//y 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
1705i7)ac;6r k" fir: 9 //o f aoaa_
Property Type: Lot Type/ Features:
Residential ❑ One Street frontage (interior lot)
❑ Commercial ❑ 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 ❑ Six Foot(6ft)
❑ Vinyl ❑ Other
❑ Block/Stone (Plan details required for footings and/or
retaining walls)
4 Other iq)(Afro')01 try),
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?
XYes(must submit separate Revocable Encroachment Agreement)
❑ No
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
ANo
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.
REVOCABLE ENCROACHMENT AGREEMENT
so! City of Atlantic Beach **ALL INFORMATION
800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
i
0117%
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
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.
This work is generally described as
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 ►105 rrl&,t__&_4-tr7.R. OtAX—Df`. (�- k...
[AC-k..
• 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
liabirties are hereby assumed by the USER. �y )
410
Date c-u-la p�d
Property Owner/Agent(signed in presence of o ary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this D day of . 5 L& S ,20
by —AAV((2 S U_l( ,who personally appeared before me and
(printed name of Signer)
acknowledged •at he/she signed the instrument voluntarily for the purpose expressed in it.
`
� v.►' JENNIFER JOHNSTON Department Approval:
••• MY MY COMMISSION#HH 057579
Signaturtf otary Public,State of Florida W: ` o E)(PIRES:October 27,2024
[ I Personally Known `'•'Fp�b,,,,, Bonded'Nu Notary Pubic Underwriters
educed Identification(Type) PZ _ Scott Williams, Public Works Director
H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
}-I cil�.y Lot93.
- , X1.s1 '1 e_onci[1-x,1 any + p hofo5 incl L CIe /
MAP SHOWING BOUNDARY SURVEY OF
93 AS SHOWN ON MAP OF
447'LANTIC BEACH COUNTRY CLUB UNIT 2
oT y , 7 iN PLAT ROOK 67, FAG£'S 1J2-137 or pi( CURRENT PJ8 UC RFLOPDS OF Oi/VAL COUNTY, FLORCA
cEPrrnro To. JOHN it HALEY.& TRACY C HALEY
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,.' I PAPERY!OUS CALCULATIONS CURVE DATA CI CURVE DATA C2
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House:
w.syawalke: 3532 SF
Porch: 361 SF R 1: MAXI R s 320,00'
Deck: sSF
NC: 45 SF A 01 90.41' A 0145.05'
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Doc # 2022207989, OR BK 20392 Page 1363, Number Pages: 1 ,
Recorded 08/10/2022 11 :48 AM, JODY PHILLIPS CLERK CIRCUIT COURT DUVAL COUNTY
RECORDING $10 . 00
NOTICE OF COMMENCEMENT Q,C
State of Florida Tax Folio No. I ( [J Q f 5 / 7/_ LJ
County of Duval
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713
of the Florida Statutes,the following information issttated in this NOTICE OFCCCOMM CEM1E T.
Legal Description of property being improved;. '/ — /r�jc Q cS of o ,2( 7
2 - &Ur) y Nub
Address of property being improved: 1705 Maritime Oak DR Atlantic Beach Fl 32233 _
General description of improvements:
owner: John Tracey Haley Address: 1705 Maritime Oak Dr Atlantic Beach Fl 32233
Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner): _.
Name:
Contractor: Bullard Fence Inc
Address: 1241 Haines St Jacksonville FL 32206
Telephone No.: (904)781-2397 Fax No:
Surety(if any) —
Address: Amount of Bond$ —
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified): —
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Signe r Date: LI. 7,
2-v
Before me this tS day of , ra _ n the County o Duval,State
Of Florida,has personally appeared I. 1(4_S 61.
Notary Public at Large,Stae"f F rida,Count of Duval.
My commission expires:
Personally Known: _ v JENNIFER JOHNSTON
Produced Identification: 0L "' MY COMMISSION#HH 057579
1
`":f-" o: EXPIRES:October 27,2024
, nP' Banded Thu Notary Public Underwttere
Bullard Fence Inc Invoice
1241 Haines St
Jacksonville FL 32206 Date Invoice#
8/3/2022 3355
Bill To
John Haley
1705 Maritime Oak Dr
Altantic Beach Fl 32233 ge t.„
0.-9A/JA
C.y '
o\ o
P.O. No. Terms Due Date Account# Project
8/3/2022
Description Qty U/M Rate Amount
Install approx. 127 ' of 4' 2-rail black aluminum 0.5 ea 5,186.00 2,593.00
fencing
Install (3) 5'walk gates
Material and labor
Excludes : Permits and Fee
Deposit of 50% is required before job materials
can be ordered or scheduled. NO EXCEPTIONS.
0.00 0.00
Total $2,593.00
Payments/Credits $0.00
Balance Due $2.593.00
:{Y iAi
"`"`�`�� 2021 -2022 LOCAL BUSINESS TAX RECEIPT
'r * JIM OVERTON,DUVAL COUNTY TAX COLLECTOR
231 E.Forsyth Street,Suite 130,Jacksonville,FL 32202-3370
r r Phone:(904)255-5700,option 3 Fax:(904)255-8403
https://taxcollector.coj.net/
Note-A penalty is imposed for failure to keep this receipt exhibited conspicuously at your place of business. This
business tax receipt is furnished pursuant to Municipal Ordinance Code,Chapters 770-772,for the period
October 01,2021 through September 30, 2022 .
BULLARD ENTERPRISES
1241 HAINES ST
JACKSONVILLE, FL 32206
ACCOUNT NUMBER: 33555
BUSINESS NAME: BULLARD ENTERPRISES
PHYSICAL ADDRESS: 1241 HAINES ST
JACKSONVILLE, FL 32206
CLASSIFICATION CODE: 323079 PUBLIC SERVICE OR REPAIR, NOT SPEC
COUNTY TAX: 13.75
MUNICIPAL TAX: 51.25
COUNTY LATE PENALTY: 0.00
STATE LICENSE NO:
MUNICIPAL LATE PENALTY: 0.00
TOTAL TAX: 65.00
RENEWAL
VALID UNTIL September 30, 2022
***ATTENTION***
THIS RECEIPT IS FOR BUSINESS TAX RECEIPT ONLY.
CERTAIN BUSINESSES MAY REQUIRE ADDITIONAL STATE LICENSING.
This is a business tax receipt only. It does not permit the receipt holder to violate any existing regulatory or zoning laws of
the County or City. It does not exempt the receipt holder from any other license or permit required by law. This is not a
certification of the receipt holder's qualifications.
JIM OVERTON, TAX COLLECTOR
THIS BECOMES A RECEIPT AFTER VALIDATION.
Paid INT-22-00076033 09/14/2021 $ 65.00