321 1st St RFNC24-0035 PermitOWNER:ADDRESS:CITY:STATE:ZIP:
MADDEN PATRICIA A 321 1ST ST ATLANTIC BEACH FL 32233-5227
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169761 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
321 1ST ST RESIDENTIAL FENCE ONE
STREET FRONTAGE 6' FENCE $2000.00
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.
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 1Issued Date: 3/20/2024
PERMIT NUMBER
RFNC24-0035
ISSUED: 3/20/2024
EXPIRES: 9/16/2024
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
s 'jr,, BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
City of Atlantic Beach Building Department PERMIT# Rrt Cz4-c055
1 800 Seminole Road, Atlantic Beach, FL 32233 ALL information required to process
rj 0 Phone: (904) 247-5826 Email: Building-Dept@coab.us
7
Job Address 3,, t , s-t- 2)-2- t I s- -4 I G, RE#6,1 _0006-
Legal Description
Valuation of Work(Replacement Cost) 2 Q ®`2 Heated/Cooled SF Non-Heated/Cooled SF
Class of Work: New Addition Alteration RRepair Move EDemo Pool Window/Door
Use of existing/proposed structure(s): El Commercial Residential • If 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:
DJ Z-M- •F-G y1C re per, *..Fxd rte.(ck_ity\c d d e(1 , inacl d e
a M`. (, con-
a,,-...., t~-Na).14.... Mor,J,1-It gMee.,/ . Gaon g
Florida Product Approval#For multiple products use Product Approval Information Sheet)
31
Property Owner Information Name` ,A't"n-Ica - /`t-//44Dp Zit Phone 90 y-! 4711—04.14
Address 3)1 t pc-- t-- City A--b State f2. Zip .s1 3
Email Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information Name of Company Phone
Address City State Zip
Qualifying Agent State Certification/ ' ration#
Email Job Site Co ct Number
Worker's Compensation Insurer R Exempt Expiration Date
Architect's Name Email Phone
Engineer's Name Email Phone
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 city/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 YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
041-6.' ain(J---1-12
Signature of Owner or Agent) 3 Signature of Co ractor)
igned and sworn to(or ed) b ire a his a of d 6igned and sworn to(or affirmed) •efore me t day of
iikj sy
Signature of Notary I - ` Signature of Notary
Personally Known OR [ ] Produced Identif..n Personally Know• OR [ ] Produced Identification
Type of' ifiiwti t.. Type of Identification:
r`: TONI GINDLESPERGER
w; ,t MY COMMISSION#HH 407122
fOF F•'e EXPIRES:October 6,2027
1
i.,, Fence Addendum Updated 1/14/2021
r a .,., i City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job ddre s: Date: , i .4/ e Y
Property Type:Lot Type/ Features:
Residential 6ne 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):
Ly Wood Four Foot (4ft)
Chain Link IP-Six Foot (6ft)
Vinyl Other
Block/Stone (Plan details required for footings and/or
retaining walls)
Other
Fence Location: tu e--,-t— hike( 4j J
Please submit an accurate and current bo ndary 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)
CIAO
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.
frAP. OWNER BUILDER AFFIDAVIT
City of Atlantic Beach Building Department JOB ADDRESS:
800 Seminole Road, Atlantic Beach, FL 32233 311 1 gc. Sr
nv.Phone: (904) 247-5826 Email: Building-Dept@coab.us
OWNERS MUST PERSONALLY APPEAR AT THE BUILDING DEPARTMENT TO SIGN THIS DOCUMENT**
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING" REQUIRES OWNER/ BUILDER
TO ACKNOWLEDGE THE LAW:
To qualify for exemption under this subsection, an owner must personally appear and sign the building permit application and must
satisfy local permitting agency requirements, if any, proving that the owner has a complete understanding of the owner's obligations
under the law as specified in the disclosure statement in this section. However, for purposes of implementing a "United States
Department of Energy SunShot Initiative: Rooftop Solar Challenge"grant and the participation of county and municipal governments,
including local permitting agencies under the jurisdiction of such county and municipal governments, an owner's notarized signature
or personal appearance to sign the permit application is not required for a solar project, as described in subparagraph (a)3., if the
building permit application is submitted electronically to the permitting agency and the owner certifies the application and disclosure
statement using the permitting agency's electronic confirmation system. If any person violates the requirements of this subsection,
the local permitting agency shall withhold final approval, revoke the permit, or pursue any action or remedy for unlicensed activity
against the owner and any person performing work that requires licensure under the permit issued.The local permitting agency shall
provide the person with a disclosure statement in substantially the following form:
DISCLOSURE STATEMENT- Please initial Items 1 - 13
1. Pete-I understand that state law requires construction to be done by a licensed contractor and have applied for an owner-
builder permit under an exemption from the law.The exemption specifies that I,as the owner of the property listed, may act as
my own contractor with certain restrictions even though I do not have a license.
2. p4&'I understand that building permits are not required to be signed by a property owner unless he or she is responsible for
the construction and is not hiring a licensed contractor to assume responsibility.
3. pal understand that, as an owner-builder, I am the responsible party of record on a permit. I understand that I may protect
myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my
own name. I also understand that a contractor is required by law to be licensed in Florida and to list his or her license numbers
on permits and contracts.
4. pijirs. I understand that I may build or improve a one-family or two-family residence or a farm outbuilding. I may also build or
improve a commercial building if the costs do not exceed $75,000. The building or residence must be for my own use or
occupancy. It may not be built or substantially improved for sale or lease, unless I am completing the requirements of a building
permit where the contractor listed on the permit substantially completed the project. If a building or residence that I have built
or substantially improved myself is sold or leased within 1 year after the construction is complete, the law will presume that I
built or substantially improved it for sale or lease,which violates the exemption.
5. fr`I understand that, as the owner-builder, I must provide direct,onsite supervision of the construction.
6. I understand that I may not hire an unlicensed person to act as my contractor or to supervise persons working on my
uilding or residence. It is my responsibility to ensure that the persons whom I employ have the licenses required by law and by
county or municipal ordinance.
7. ice' I understand that it is a frequent practice of unlicensed persons to have the property owner obtain an owner-builder
permit that erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner-builder,
may be held liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or her
employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am
willfully acting as an owner-builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
8.l•understand that I may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to
perform the work being done. Any person working on my building who is not licensed must work under my direct supervision
and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and
social security contributions under the Federal Insurance Contributions Act(FICA) and must provide workers' compensation for
the employee. I understand that my failure to follow these laws may subject me to serious financial risk.
9. J ts. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all
applicable laws and requirements that govern owner-builders as well as employers. I also understand that the construction
must comply with all applicable laws, ordinances, building codes, and zoning regulations.
10. understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue
ervlce, the United States Small Business Administration, the Florida Department of Financial Services, and the Florida
Department of Revenue. I also understand that I may contact the Florida Construction Industry Licensing Board at (850)
487-1395 or the DBPR for more information about licensed contractors.
11,41 .--P am aware of, and consent to, an owner-builder building permit applied for in my name and understand that I am the
party legally and financially responsible for the proposed construction activity at job address listed on this document.
12.1eCl/rragree to notify the Atlantic Beach Building Department immediately of any additions, deletions, or changes to any of the
information that I have provided on this disclosure.
13.4944--Cicensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not
have a license, the Construction Industry Licensing Board and Department of Business and Professional Regulation may be
unable to assist you with any financial loss that you sustain as a result of a complaint. Your only remedy against an unlicensed
contractor may be in civil court. It is also important for you to understand that, if an unlicensed contractor or employee of an
individual or firm is injured while working on your property, you may be held liable for damages. If you obtain an owner-builder
permit and wish to hire a licensed contractor, you will be responsible for verifying whether the contractor is properly licensed
and the status of the contractor's workers' compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and
returned to the local permitting agency responsible for issuing the permit. A copy of the property owner's driver license, the
notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required
when the permit is issued.
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.
I /
Job Address: 01 ( ki Sr k 1").. .b3 RE# I la c 7 Co 1
J
lJ on c)
i 4041-'44'1—"Owner Name: Ge/t. I' Y Dj Phone Number: 41-4
Mailing Address: 3011 lgt ST City: State: Zip: 3.d43
TONI GINDLESPERGER Signature of Owner or Agent)
MY COMMISSION#HH 407122 Si ed and swor to (or of med) before e thi l day of
P: EXPIRES:October 6,2027 Aa 0C- 7 by \.. kt C(
fOf '
YYY YY a%
Signature of Notary
r
Personally Known OR [ ] Produce. dentification
Type of Identification: t L.
MAP O F S U R V E Y
LOT 6, BLOCK 3, PLAT No.1, SUBDIVISION "A" ATLANTIC BEACH, AS RECORDED IN PLAT BOOK 5,
PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
LOT 7
I LOT 5
I
LOT 3 I
FOUND
REC _.I V E I (49.91' - FIELD)I __,/iiiLUUI , )1L 1
L. B. No.3672 50.00'
FOUND-Th.PON — -- — City of AtI3i1;(c Beachs•
WOODI
5ry PIP[,No CAP
S) FENCE / ,,
le'
E`illl )!i'.nIO,I L.')f11f14?
G0.7' 6' WOOD
o /I 4.
FENCE
W
ID'S
35,1' 74 I _, THIS IS A BOUNDARY SURVEY.
LLJ INTERIOR LOT ANGLES ARE BASED ON
PLAT AND FOUND FIELD MONUMENTATION.
In NORTH ARROW IS PROTRACTED FROM THE PLAT.
4t. N N I THERE ARE NO BUILDING RESTRICTION LINES BY
TWO STORY PLAT.
o STUCCO D
hi'b RESIDENCE b N in.,11Wl=i
LOT 8 No.S 319 :Lit Ll1, . '{11JI t-h_slIII27and32117. LOT 4
FINISHED noon I 1."--
iOELEVATION-IL!! O 1 G r..Z.•.i —GARAGE HOCK 0 i i l
O
p
ELEVATION.H.l5 I y"
ID 0 0
caNcncrt A/C PACs t _CL"- l L!',!..1,1
I
ZONA( .O : \II ,1LLst. '6" Q
f)
75 35.1' 7.. 1 O
CLEAN-OUT c1EAN-GUT .
U
I F-4.!Q I (nnCONCRETEDRIVEA
and WALKS ,PFOUND1/2" FOUND 1/2" (100.00' - PLAT)
IRON PIPE h IRON PIPE W
L. B. No.3672 WI L. B. No.3672 4‘4,0
1 1 1 L!
49.99' - FIELD) ftQN\ %0* Oji
1st STREET civ .
40' RIGHT OF WAY — PAVED I#77
CfA
THE PROPERTY SHOWN HEREON APPEARS TO THIS SURVEY WAS MADE FOR THE BENEFIT OF
UE IN FLOOD ZONE "X' (AREA OUTSIDE THE CHARLES E. BLUMESTEIN, TRUSTEE. BLUMESTEIN
500-YEAR FLOOD PLAIN) AS WELL AS CAN BE FAMILY TRUST; FIRST FEDERAL SAVINGS AND LOAN
DETERMINED FROM FLOOD INSURANCE RATE ASSOCIATION (ST. AUGUSTINE); AND IS IN COMPLIANCE
MAP COMMUNITY PANEL NUMBER 120075 WITH THE MINIMUM TECHNICAL STANDARDS SET FORTH
0001 D, REVISED APRIL 17. 1989 FOR THE IN CHAPTER 61 G17-6 OF THE FLORIDA ADMINISTRA-
CITY f1F ATLANTIC BEACH, DUVAL COUNTY, TIVE CODE.
FLORIDA.
UNLESS IT BEARS THE SIGNATURE AND A ,V
Es
THE ORIGINAL RAISED SEAL OF A FLORIDA
UCENSED SURVEYOR AND MAPPER, THIS DONN W. BOATWRIGHT, .M.
MAP IS FOR INFORMATIONAL PURPOSES FLA. UC. SURVEYOR AND MAPPER No, 3295
ONLY AND IS NOT VALID. FINAL SURVEY JUNE 11, 1999 FLA. LIC. SURVEYING AND MAPPING BUSINESS No. 3672
SCALE: 1'-2D BOATWRIGHT LAND SURVEYORS, INC. I DATE:DRAWN BY: MP/CC AUGUST 28, 1996
FILE: 99-412 _ 1711 SOUTH 5th STREET, JACKSONVILLE BEACH, FLORIDA 241-8550 1(SHEET__l_. OF=—I
DISK 98MP-10