87 Forrestal Cir RFNC23-0088 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
RODRIGUEZ BENTON 1224 FOREST OAKS DR NEPTUNE BEACH FL 32266
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171729 0000 ATLANTIC BEACH VILLA
# 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
87 FORRESTAL CIR RESIDENTIAL FENCE ONE
STREET FRONTAGE Replace rotten fence $2600.00
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.
1 ZONING ZONING NOTES INFORMATIONAL
Notes:
Fence must be installed within the property.
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 2Issued Date: 9/8/2023
PERMIT NUMBER
RFNC23-0088
ISSUED: 9/8/2023
EXPIRES: 3/6/2024
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 9/8/2023
PERMIT NUMBER
RFNC23-0088
ISSUED: 9/8/2023
EXPIRES: 3/6/2024
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
sf1/2„, BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
A t• City of Atlantic Beach Building Department PERMIT# 12--FN 2 —Ca
800 Seminole Road, Atlantic Beach, FL 32233 ALL information required to process
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address Y'?/ 4iet%s--4._ (Y for,7,(i RE# 1-1 ) 721_wwoo
Legal Description GD r / A p'r / 47---/ OF,¢-C 1.!, 4 (it.Arz! r • /
Valuation of Work(Replacement Cost) AZ 00 Heated/Cooled SF Non-Heated/Cooled SF
Class of Work: New Addition Alteration %Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): DCommercial , Residential
If an existing structure,is a fire sprinkler system installed?: Yes PKNo
Will tree(s)be removed in association with proposed project? EYes(Must submit separate Tree Removal Permit) XNo
Describe in detail the type of work to be performed:
fi,---p t- P171 N FeWce-
Florida Product Approval# For multiple products use Product Approval Information Sheet)
Property Owner Inform /tion Name VEA/7/ , ,Q e G6 t 2 Phone `101- 74 - ,d4,c
Address 1AZ 4 osr d f City 49,77 6,e.-A4 State /L Zip 52 24 '
Email 04/475Te4)104 fJ,yfOwner or Agent(If Agent,Power of Attorney r Agency Letter Required)
Contractor Information Name of Company .544 j-2-j,L / i/CL- 6 Phone p'04..
i)'43 9 / 'l J
L.3Address2. '7 /r/-?C f-j--( ,--/ City ,„51.4 )-j g State /—L Zip 3 , 2 ii
Qualifying Agent State Certification/Registration#
Email Job Site Contact Number
Worker's Compensation Insurer OR Exempt__Er Expiration Date
Architect's Name /J4_ Email Phone
Engineer's Name N Emai Phone
Application is hereby made to obtain a permit to do the work an. ' stallations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work • ill 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 YOU PAYING TWICE
FOR IMPROVEMENTS TO Y R ROPERTY. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN
ATTO: . :Y BEF RE REC DI YO
iiR
NOTICE OF COMMENCEMENT.
Al meM ‘/e1 Q
l-
G - 1-6,---"'h
Sig - are of Owner or Aged) Signature of Contractor)
ed ands v to(•r affirmed)befor- me s- ay of Signed and sworn to(or affirmed)before met.' day of
M VIM
lea: OL •y J .r n • r-lobe by
Signature o 'otary _ Signature of Notary
Personally Kno •• OR [ ] Produced Iden ifica ion Personally Known r • [ ] Produced Identification
Type of Idefntificatiori .i Type of Identification:
p'TONI GINDLESPERGERr 4
2' i*.ig MY COMMISSION#GG 353178
s• EXPIRES:October 6,2023
4-•°,f;°,”' Bonded Thru Notary Public Underwriters
Owner Builder Affidavit ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
j; 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: PFN C 23-Ca8
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 IS A 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: 9? 41e=.5-7- L (,/ $,f•r,
Owner Name: L=A)[D k %
flcrJ"t n/ 4 L( f 2
Phone Number: q/4- 12Z)4-d it,f`f
Mailing Address: 1,Z-2.41;2i-s-7- (/tal_ City: 4./
1--. f L'4--Cif State: /------2— Zip: 5,22Z(
Notarized Signature of Owner v"L 64 7i1
The f egoing ins( rument was acknowledged before me this -.---/ day I/ , 20 f, in the State of Florida, County
of U,/CA ,- 4
Signature of Notary Public 4111111111 • ji'
Personally Known OR [ ] Produced Identification .
s""``c••, TON'^ I G pLESPERGER4'• ,;"• Type of Identification:
N? :,: MY COMMISSION#GG 3331781-------4..: EXPIRES:October 6,2023
Bonded i ru Ndiary •Public Underwriters Updated 10/24/18
Fence Addendum Updated 1/14/2021
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT# SNC23 coeie
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date: ,,
e__-/-1-3
Property Type:Lot Type/ Features:
Residential X One 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)
O Chain Link X Six Foot (6ft)
Vinyl 0 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)
53cNo
Will tree(s) be removed in association with proposed project?
O Yes (must submit separate Tree Removal Permit)
XNo
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 BOUNDARY SURVEY OF
LOT
l
1'
1I l
LBLOCK
1 ACCORDING
UNIT
TO TH1 AATHEPLTT OF
ATLANTIC ;;))EACH LA NI 91INO. 1
AS RECORDED IN PLAT BOOK 30 , PAGE(S) 56 OF THE CURRENT
U9
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO! GILBERT PBIT L1PS, COLLEEN PHILLIPS,
FIRST AMERICAN TITLE INSURANCE COMPANY,8t v/Tori oDkiG ! '2 WATSON & OSBORNE TITLE SERVICES, INC.
oNANDHOMESOUTHMORTGAGECORPORATION.
2,?4 ` o tJ•T 4 K.!' H
Al r, 7-11AI E A 14-f
FORRESTAL CIRCLE SOUTH
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S 59'31'25" E 90.00' (R)
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C & R = COVENANTS AND RESTRICTIONS N 69'31'25" W 43.16' (R)
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s1.BEARINGS ARE BASED ON GENERALPLAT BeOTON 0, PAGE 58y
2.STRUCTURE NO. 87 SHOWN HEREON UES 1M THIN FLOOD ZONE X AS BEST
0 A SSOCIATED SURVEYORS INCL NO 1 DATED04-17-1959
3.
DETERMINEDETRISA SURFACE SURVEY ONLY.
F.EM.A. F1000 APS
THEPEXTENT OF UNDERGROUND FOOTINGS
r 2
LAND & ENGINEERING SURVEYS PIPES ANO UTILITIES IF ANY, NOT DETERMINED.
3846 BLANDiNC BOULEVARD 4.JURISDICTIONAL AND/OR ENVIRONMENTALLY SENSITIVE AREAS IF ANY, NOT
JACKSONVILLE, FLORIDA 32210 THILOCS
BY
Y
SUR Y.
904-771-6468 5.THIS SURVEY BASED ON LEGAL DESCRIPTIONS FURNISHED. THE PUBLIC
J j RECORDS WERE NOT SEARCHED BY THIS SURVEYOR FOR EASEMENTS,
TITLE, COVENANTS, RESTRICTIONS, CLOSURES, TAKING 0 pO
S s v
CERTIFICATE OF AUTHORIZATION N0. LB 0005488'
5. Y01.tLYIBfsDTSIBf EVAIREHSCOFRIMFF9 q f.II
I HEREBY CERTIFY THIS SURVEY WAS DONE UNDER MY LEGEND/ABBREVIATIONSDIRECTSUPERVISIONANDMEETSTHEMINIMUMTECHNICAL0SETIRONPIPEORREBARP.C.= POINT OF CURVE COV'D = COVEREDSTANDARDSFORLANDSURVEYINGPURSUANTTOCHAPTER "ASSOC.SURVEY' OR L.B.5455 PT. -POINT OF TANGENCY CII - CHORD
61G17-6, i 0/IDA ADMirIISTRA'lON CODE• C AFT? 4 2, F.S. • FOUND IRON PIN OR PIPE (IP) P.R.C. =POINT OF REVERSE CURVE
I FOUND CONCRETE MONUMENT (C.M.) P.C.C. =POINT OF COMPOUND CURVE
X CROSS CUT OR DRILL HOLE C/L = CENTER UNE R/W=RICHT OF WAY
BY: / Le •
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CHARL B. HATCHER FLORIDA E FI .ATE NO. 37 R —RADIUS L a ARC LENGTH AC -ala CONDITIONER (LILT.) - SAVE TIE
CHARLES L. STARLING FLORIDA CERT1 CATE NO. 4579 O.R.B.=OFFICIAL RECORD BOOK ® =WATER METER a- UTN JTY POLE
RAYMOND J. SCHAEFER FLORIDA CERT1 ICATE NO. 6132 F R.M=OeP
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JOB NO. 31453;40994 I DATE 05-10-2004__ B.R.L =8_, INC IC110N llN X—x CHAIN LINK FENCE ,."„_,,,,, __„I,