386 10th St RERF22-0108 lj+,'r, Building Permit Application
r, n Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
;� •� 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
'3 IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us / rl
Job Address: • 2 �' -1 4. •} Permit Number: RI NC. Z Z _(D� ,
Legal Description /...b (,O RE# 1) 0054 -ooOa
Valuation of Work(Replacement Cost)$ (5`7.1'f) Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move EDemo ❑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) ❑No
Describe in detail the type of work to be performed:
ReQIGc, Gx�5, 'I eii,c-.ivi-
Florida Product Approval# - for multiple products use product approval form
Property Owner Information
Name (Yla.. 1,i215r)Q-v Address 386 /Cs4Ls-f-
City AA -1(L. eae.CCs AZ& State Ft Zip 3 033 3 Phone 3‘17 - o? 6 D - H 195—
E-Mail Mc,-44t.,t�_.,...,e:IS Nt •-e 1jv.),.,,,e,. CDuK
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Rj 6\6 5 re v.,n9 LLL Qualifying Agent m i Ile- 1ls.,, 3i i 6@ C'
Address L113 s herr,vise v L:r IJ City Ja,f2 d to i I(e.._ State FL Zip 34.14.S.-
Office Phone 9 04-3( ;b 9 (p Job Site Contact Number 9 o 4- 3t a`-3c)g to
State Certification/Registration# ,,/27400 E-Mail b:1,64 Fere-i.•\ ons Ing 1 •CcI w
Architect Name&Phone# J
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt 0 Expiration Date /OAS/eiO,a3
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 " '• AIN FINANCI G, CQNSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
R'C'� ItyUR OTICE OF COMMENCEMENT.
. s�i�- - `
(Signature of Owner or Agent) 22 (Signature of Contractor)
;fined a sworn to or . irm before+e this day of S. ned d sworn to(ora rm-s befor- me thi C.t7of
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y. Y!v TONI GiNDLESPERGER
-j ]Produce Identification [ ]Produced Identification (�.?? #_ MY COMMISSION#GG 353178
Type of Identification: Type of Identification: ,• •
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yp ,-.1:;., .� o,.' EXPIRES.OLtvlmi 6,2023 I'
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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: Date:
Property Type: Lot Type/ Features:
residential 8-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):
9'<Vood ❑ Four Foot (4ft)
❑ Chain Link i' x Foot (6ft)
❑ Vinyl ❑ Other_
❑ Block/Stone (Plan details required for footings and/or
retaining walls)
❑ 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?
❑ Yes (must submit separate Revocable Encroachment Agreement)
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
11416
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.
MAP SHOWING SURVEY OF
LOT33_,-21..±.1.9____.BLOCK f-2 14nnx•i_1SiQ.t.._'.Q.'_A'iLAWL IL i&EAc. ,k__ :____
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4
AS RECORDED IN PLAT BOOK._5__ , PACE t.9 _. OF THE CURRENT PUBLIC RECORDS OF Dug nL
COUNTY.FLORIDA
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NOTES
1
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1. This is a boundary survey.
2. Flood zone x as best ascertained from Flood Insurance
Rate Map,community panel rtO.rceote-aml dated 4.t- ei NorE:
3. This survey is not a determination of ownership THERE MAY BE ADDITIONAL RESTRICTIONS 'RAT APPLY
HAT ARE NOT SHOWN ON TRIS SUPVP.Y BUT MAY 8E fo4RRG
A. Business license#6470
IN THE rURLIC RECORDS OR FACTLITTES OF THIS COUNTY:
I HEREBY CERTIFY TO: 27e1J.tts c. • t.outse (... c.a evASS ,
U SbJ A HERt(A FtU441Ct AL 1uG-,01814 1J31. AMe R IC t►
LT0 a t.AiEtY PATTee SOu , D.A.
THAT THIS SURVEY MEETS THE MINIMUM TECHNICAL STANDARDS AS
SET FORTH BY THE FLORIDA BOARD OF LAND SURVEYORS,PURSUANT
Marvin . Banks TO SECTION 472.027 FLORIDA STATUTES AND CHAPTER 61G)7-6
Surveyors, LTG FLORIDA ADMINISTRATION CODE.
2866 MANGROVE AVE. rtORIDA QEG45'ERED SURVEYOR NO 4470 'i
JACKSONVILLE.FLORIDA 32246 Marvin R.Banks
(904)641-2520 DATE 0410t'Se e 2 to _19 la
Ac.58,8 SCALE: t` , zb '
THIS SURVEY NOT VAUD UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE ABOVE SIGNED
0 (:if 4. U2Z Co c
Date: J�Ji �j '.I �
Buyer(s): ''lQt1 we6lit✓
16184.1.0 97 Levy Road, Unit 107-B Address:'] 3'4 101/%5"1-
()hi
D? 5"1-
Jacksonville, FL 32233 City: 14T► ilL��tGh St.: F1- Zip: ��Z3
I
Jake Van Bibber, SalesJobsite:
-- 904.472.6940Email: 3y?-fid- 'Mike Van Bibber, Owner Phone:�� 904.352.3096 Phone:
fietiBibbsFencing@gmail.com Fax:
INSTALLATION & REPAIR • FREE ESTIMATES
VINYL • ALUMINUM • WOOD • CHAIN LINK
WOOD SPECIFICATIONS
HEIGHT TYPE STYLE B ARD SIZE RAIL SIZE PERMIT CROSS STREET
U 3 ❑fL�ypress ❑ ockade /2 x 4 ❑�x 3 NEEDED
0 PTP ❑ Don BD 5-1/2 x 6-5/8 2 x 4
O Chain Link Shadowbox ❑1x4 ❑4 x 4 ❑Yes CORNE LOT
6 0 Aluminum U Picket ❑1x5 01 x 4 0 No LI es
U 8 ❑PVC ❑Full No
DESIGN INSTALL G$TE SWING SPECIAL INSTRUCTIONS TAKE DOWN&HAUL
U Dog-Eared 0 Good Side In Uln AWAY FOQTAGE
U Pointed LIGood Side Out U Up Hill 12
0 Gothic ❑Out
❑ U Down Hill Wes U No
i U Follow the ground line
1 7 ) S k a d a W bo% 4$ !3o O Top of fence straight
I H,ovi-L --- rrLL
1 $ do4k. 94 , -- $460
0
WI
2
4) S► .1 "5°
Lump Sum Total:
Deposit, if required:
Balance due upon completion:
20%restocking fee for cancellation of any job or order.Lifetime Warranty on vinyl and aluminum fence material supplied by manufacturer.
Buyer(s) By: Dated: Salesperson: