Permit 939 Amberjack Lane CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
............
-5826
INSPECTION PHONE LINE 247
Application Number . . . . . 09-00001957 Date 12/16/09
Property Address . . . . . . 939 AMBERJACK LN
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
6ft fence
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Owner Contractor
------------------------
------------------------
GILES, LEIGH ANNE OWNER
939 AMBERJACK LN
ATLANTIC BEACH FL 32233
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Permit FENCE PERMIT
Additional desc . -
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/14/10
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 35 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 35 . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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This approval verifies compliance with applicable
zoning, subdivision and other local land
development regulations, but does not constitute
approval for the issuance of permits. Compliance
with Florida Building Code and all other applicable
local, State and Federal permitting requirements
must be verified by signature of the City of Atlantic
Beach Building 0"al p I t the issuance of a
L Building Peornit. 13
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WA City of Atlantic Beach APPL.ICATIO.N NUMBER,
ld"
the But ing De�artrnant.)
(To be assigned b
Building Department
Boo Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-58263 - Fax(904)247-5845
a roUt6e8_-'-' tZ Z�V
E-mail: building-deptQcoab.us [:Dat
City web-site: http://Www.coab.us
APPLICATION REVIEW AND TRACKING FORM
)party Address, t rev aw required Yes No
pficant:
inistrator
L
a e
rvices
SERIES
Other Agency Review or Permit
-Florida Dept.of Environmental Prote
-Florida Dept of Transportation
St.Johns River Water Manage
Army Corps of Engineers
Division of Hotels and R
Division cyf Alcohdic 6—h-
-Other:
APP
viewing Department First Review: pprove
(Circle one.) Comments:
BUILDING
.4E�ING�Z.NING Reviewed b D ate:
TREE ADMIN. Second Review: E]Approved as revised. 7Denied.
PUBLIC WORKS Comments:
3UBLIC UTILITIES
PUBLIC SAFET Y Reviewed by: Date:
FIRE SERVICES Third Review: 7Approved as revised. F�Denied.
Comments:
R,a v�7 e vv a d b y Date:
sed 05i141,09
CITY OF ATLANTIC SFACH 09-
soo SEMINOLE ROAD,ATLANTIC BEACH,FL 32233
OFMR F,(9N)247-5826 0 FAX NO.1(904)247'5845
BUILDiNC-oEPTQC0AB-US ICATION DUVAL COUNTY
PERMIT APPL
BUILDING
0
'acy-
3q Cl RESIDENTIAL
G C3 DEMOLITION E3 COMMIERQAL
13 ADDITION 0 CONVERTING USE
LOT ZOL BLOC. 114 SUB D(VISION Ins UAI ........ ION E3 ACCESSORY BLDG. "I YES El NIA
El REPAIR E3 POOL I SPA (71 No
Wh%K Vill E3 H E-
COMPAW VAME:
YXC
S.NAME'
civic EE N ME:
25.STATE OF FL NO.:
17,STATE OF FLORIDA LICENSE NO'
ESS: 26.ADDRESS:
q3q L&YLQ-- is.ADDRESS' fWey)k"-
�-L, 5AA-10 i"
-Solryl/i G 13�Q
iZ FAX 0.: 19.0 mc= .449 20.FAXNO.: 27.OFFICE PHON 28.FAX NO.:
i i.OFFICE PHONE: %OM "tP83040? 29.CELL PHONE:
21 CELL PH
1 1 LL 22,E AJL ADDRESS:ol,3 sufevt or Mr I
14.EMAJ L ADDRESS: Wig. olid n7i I-coyv%
NAME:
3-NAMEi
1,NAME
32.ADDRESS: 34.ADDRESS:
do the work and installations as indi led. I certify that no work or installation has
Application is hereby made to obtain a permit to the standards of all laws regulating oonstruclion in this
commenced prior to the issuance of a permit and that all work will be performed to meet
work is not commenced within six(6)months, or if construction or work is Suspended Or
jurisdiction. This permit becomes null and void if me after work is commenced. I understand that separate permits must be secured for
abandoned for a period of sbc(6)months at any 9
Electrical Work,Plumbing,Sigiris,Wells,Poole,Furnaces,Sollers,Heaters,Tanks, Air Conditioners,Oft.
OWNEWS 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.I will not occupy or use the referenced building or any part therof,until all inspeclions are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
*** 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
COMME C MENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
EN -Nil
FIRST I S CTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR
NnER AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Date:
Date:_L41- /-- 0 C/ Signed'.
Before 7i.7day of—V&Lt
g 2 -
Signed: LOM12CJ2009 in the county Of
Before this day of -f_W"M(2009 in the County Of is day of--P—t CLO-1
D.vw 7State of Floricla,has personally appeared
Duval,State of Florida,has personally appeared vw,,� rid,
rag
herin by himself I herself and affirms that all staternerds and declarations we lerin by himself I herself and affirms#W all statements and deda ons are
me and accurate.
true and accurate. V-L Notary puWc ek Large,State of County of
""Public:at Large,State Of —Co�rrlyot *P...11,KlOwn
2111-4 �En� '7
13 P(odu 0 Produced Iftr'§Q�Mk- ........
mo=, I - —
Wary Signature\IJ Notary Signature-A�
BL n Ift R EV16"tawy 0111111131Y $00 of FW
WES Notary P*NC-stmate of Florida *Colm-". A"31,2013
My Comm.Expires Aug 311-]2(0113 Collitriftalm 0 W 921581
Commission 0 00 221511111
'NUMBER '
City of Atlaritic Beach APPLICATION
-P
artment (robe�asslgnedb the Building De�artm6nt'.
Building Dep To
5
800 Seminole Road
Atlantic Beach, Florida 32-233-5445
Fax(904)247-6845 46.
8 Ob
Date rdut48:
-5826 tz
Phone(904)247
E-mail: building-dept@coab.us E
City web-site: hftp:/Iwww.coab.us
APPLICATION REVIEW AND TRACKING FORM
roperty Address: 95 kAk�d,4 Z^li Devarhwt review required Yes No
pplicant.
7Mw:3�tnistrator
40 roject: :��Ic R141tiest)-
Fire Services
R-m-0 Elle
71 wal
Review or Receipt
Other Agency Review or Permit Required of Permit Verified By Date
Florida Dept of Environmental Protection
Florida Dept of Transportation
St Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
_6:Ws_ionof Alcoholic Beverages and Tobacco
Other:
APPUPATION STATUS
Bviewing Department First Review: E�A�Pproved. E]Denied.
(C' I e.) Comments:
BUILDIN
LANNING &ZONING Reviewed by: Date.
TREE ADMIN. Second Review: FlApproved as revised. F�Denied.
PUBLIC WORKS Comments-
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F�Approved as revised. ElDenied.
Comments:
Revievvted by: Data:
vised 05i1Q09
CITY OF ATLANTIC BEACH 09-
aW SEMINOLE ROAD,ATLANTr_BEACH,FL 32233
OFRCE�(904)24T-5825#FAX NO,j(W4)24?-5845
BUILDINC-MPTOCOAS-US
BUILDING PERMIT APPLICATION DUVAL COUNTY
41600 0
3q IDENT
IDENT
RE
R
S
q oly WYES E3 WA,
M,
1 (3 NEW BUILDING 0 DEMOLITION U RES
3i- SU Cl
UAj-r E3 ADDITION 0 CONVERnNG use OCC
Lcrr ii- LOO..jSU1D.1SION RONOL' ALTERATION 13 ACCESSORY SLOG.
E . .1 — [3 REPAIR [3 POOL I SPA C3 un E3 PvA
Fence./ Whign WhjK Ving tg ke 10 '%anm
115.COMPAW 14A 23.COMIPMJY pAME:
I-�) V Yxe PXL�Lp N(�,
9.NAM: 24.LICENSFE E:
avic h N
John 16-NAME' Ir J
ZQ(. L DA __ E NO-:
lmikdn� 25. OF FL DA Lo
77 STATE OF FLORIDA LICENSE NO-: :0
to.ADDRESS:
,6 SS
q3lq 18 ADDRESS' 25-IADDRtEA'
Nv t�tey)k"_
w.kagIc QOCK ju. f(I 3�c)5tj_
19 OfF1 20 FAX NO' 7(WICE P"O 0.:
PHONE: 12-F NO.: 60040MI149 IZ04 v40 29-CELL PHONE:
21.CE
'!M0013
0 Iaoo RXKC,130 EMAI E
MAILADORESS:
14.EMAIL ADDRESS. toy"
0 NEW
31 NAMP: 33 NA-ME: 35.NAM:
32.ADDRESS: 34.ADDRESS 36.ADDRESS:
Application is hereby made to obtain a permit to do Me work and Installations as IndicaM. I cer" 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 laws regulating construction in this
jurisdiction. This permit becomes null and void If work is not commenced within six(6)months. or it cOnStnJC11on or work is suspended Or
abandoned for a period of ab(6)months at any time after work is commenced. I understand lhat separate permits must be secured for
Ellechical Work,Plumbing,319M Welk.Pools,Furnaces,"Ion,HeateM Tanks, Air CondlillIortem 4ft.
OWNERS 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.I will not occupy or use the referenced building or any part therof.until all inspections are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building oWal.as required by law.
**A,-_ WARNING TO OWNER: *** RESULT IN YOUR
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF
COMMENC ME MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
,I
IN
FIRST IS CTION. IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR
I LENDER 52AN ATTO EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
ftrod' Data: 'A' /� 091 9ned.
S
day of CCMbCf2oO9 in On COUnty Of
Be" nJ9thi3__j_dayof 1)eCCMt&2"1inQhecourvtyof
Du%W.State of Fbdft has Personally HPPOared DiW 7SWft of Florida,hm persorvilly app
hedn by himillf i herself and affimis Itud all stopamerits and declarations am Iterin by himelf I tiersell arid affirm ow all statemerds and dederatiam NO
Um and accurate. true and accurate. cotx*of taorl_
[tPubk at Lar",State Of C Of Notary Publicat L-W,SWIS of
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My Co".Expim Aug 31._20113 CWMMM"4F W 921591
81
COWANW"0 OD 221151
T VV
CPA
APPLICATION NUMBER
city of Atlantic Beach DEC 0 3 2009 (To be assigne.d b the Building De*tme;ntl
Building Department
Boo Seminole Road
-Y
Atlantic Beach, Florida 32233-5445 r�
04)2,���-
Phone(904)247-5826 * Fax(9 t
-deptgooab.us
E-mail: building
City web-site: httP:/Iwww.coab.us
14D CKING FORM
APPLICATION REVIEW AN TRA
)Party Address: t ad Yes NO
plicant: on'
inistrator
:wject: U Ic tilities
Fire Services
ow ip,
...... 11"N
i -11
r als. IM
M 0-
Rwa 65-M—�M-eNNN
MINOR
Review or Receipt Date
Other Agency Review or Permit Required of Permit Verified B
a evt.
Florida Dept.of Environmental Protection
Florida Dept of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Divisi an of Hotels and Restaurants
Division of Alcohofic Beverages and Tobacco_
Other:
APPLICAPON STATUS
viewing Department First Review' pproved. FDenied.
(Circle one.) Comments: Io
BUILDING P�
ANNING &ZONING Reviewed by:-2 Date:
TREE ADMIN. Second Review" F�Approved as revised. F�Denied.
PUBLIC WORKS Comments:
:IUBLIC UTILITIES
PUBLIC SAFET Y Reviewed by: Date:
FIRE SERVICES ThlrdRiavlew: 7Approved as revised. 7Denied.
Comments:
D,a t
Rev�avvred by:_
sad 051UJI09
CITY OF ATLANTIC BEAC14 09—,
SW SEMINOLE ROAD,ATLANTIC BEACH,FL32Z33
.5845
OFFIr
'E I(904)247-5M 9 FAX NO.1(904)247
qUILDING-MPTQCOAI Us DUVAL COUNTY
ATION
BUILDING PERMIT�APPLIC
0
5,3q ombffj 41600 13 DEMOLITION 13 RESIDENTIAL
a3q n Ln 1�., [3 CONVERTING USE [3 cOMMERCIAl
E3,,D'ExTION
13 ACCESSOR BLDG.
LOT j:i BLOC SUB DIVISION P Y F13 I-I NIA
inrr2i BLOCK LI ALTERATION A YES
E3 POOL I S r
E3 REPAIR 'MOTHER 171 tan
0 M0V_r=
Fence" (Viii WW vit,
i �
15.COMFPVTTty)L1.e . M_
9.NAME' " 24.LICENSEE E:
joh6 i PaXN_� 16.NAME* cknc V1
2&STATE OF FL IDA LICENSE NO-:
17.ST E OF FLORIDA LICENSE NO.:
V
Ia.ADDRESS!
q3ct iS,ADDRESS' ey)VLL-
S-Lno pw
O_AAal OOCK=il\k 'FL, 3�Q5E4 27.Urr PHON
. . n-2, 19.0 FICEpWZS)N,�.C1 20.FAXNO.:
11.OFFICE PHONE: 1Z FAX NO.: %OY &0493040? 29-CELL PHONE:
1 LL 21.CELL PHON 1 10
%244 01 30.EMAIL ADORE
)0 22.EMAIL ADDRESS: lor
14.EMAIL ADDRESS: 'die j.�aM1r47j1.CVyy%
-NAME:
31.NAME: ADDRESS:
34�ADDRESS:
32,ADDRESS: I that no work or installation has
AppliCallon is hereby made to obtain a permit to 11 be performed to meet the standards of all laws regulating construction in this
commenced Prior to the issuance of a permit and that all work Wi nced within six(6)months, or if construction or work is suspended or
jurisdiction, This permit becomes null and void if work is not comme mmenced. I understand that separate Permits must be secured for
abandoned for a period of six(6)months at any time after work is co
Electrical Work..Plumbing.-Si ns,Wells,Pool$,Furnace$,Sollers.Heatem,Tanks, Air CondMigners,eft. with all applicable
ing information is accurate and that all work will be done In compliance
OWNERS AFFIDAVIT-I cerft that all the forego ii
laws regulabrig construction and zoning.I will not occupy or use the referenced building or any part therof,until all inspec ons are finaled and
prior to obtaining a certificate of occupancy or completion issued by the building official,as required by law.
WARNING TO OWNER:
'or to OD'am""'"" NT MAY RESULT IN YOUR
YOUR FAILURE TO RECORD A NOTICE OF COMMENCEME ICE OF
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOT RE THE
C MM UST BE RECORDED AND POSTED ON THE JOB SITE BEFO
OMMENC MENT M WITH YOUR
I G,CONSULT
14
1 ST S
Sj OU INTEND TO OBTAIN FINANCIN
FFIRST IN'. CTION. IF Y MMENCEMENT.
I I;m F AN ATTORNEY BE ORE RECORDING YOUR NOTICE OF CO
Date:
Date. 0 C1 Signed: -W9 in the countY Of
Signed: 2009 in the countY Of Before M� i�ed�ay odf�IC�0 2
Before mrithis day of__D0C_0dJ&, Duval,State Of Florida,has per$Ona]IY 8PP88red
Duval,State of Florida,has pemorW appeared
hedn by himself I herself and affirms that all statements and dedareions are hadn by himself I herself and affirms that all statements and dedarations NO
tnue and accurat8. true and accurate. 1— cotty of DkNot.1
County of Notary Public at Large.State Of r
Putilket LOW,State Of monally Known
43%monally own t3 Produced IdantifATO&-
13 Produced I
11 Notary Signatunic.
Notary*natL*e:
ON"Guam
n Bldg:R NOWY F .st"d ftwMa
Bt- My Comm-Exl*n A"31,2013
.QP.
Newry pok stivate of FkWaimdall #
my comm.Expires Aug 31.*201,
Commission#00 921591
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