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Permit 234 Ocean Boulevard CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD +} _ ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5826 �w ��J331a� Application Number . . . . . 10-00000454 Date 5/24/10 Property Address . . . . . . 234 OCEAN BLVD Application type description FENCE PERMIT Property Zoning . . . . . . . RESIDENTIAL SINGLE FAMILY Application valuation . . . . 1800 -------------------------------------------- Application desc REPLACE 6 ' WOOD FENCING ------------------------------------------------ Owner Contractor ------------------------ ------------------------ GAUSLOW, NORMAN OWNER 234 OCEAN BLVD. ATLANTIC BEACH FL 32233 ------------------------------------------ Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date Valuation . . 0 Expiration Date . . 11/20/10 -------------------- ------------------------ 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. CRY€3f Atlantic Beach ,APPL11CATf0M NUMBER i3E€i Edi DepartmentS ,tv'' �fl be assigned by TherFc€iri deg ,erg.) 6Dfl Seminole goad Manic Beach,Florida 329-33-5�a �pR t � ~� Qom`��'. P€�or[e('3Q4)9-47-5826 - Fax(mQ44) B ,Q SR E-mail. building-dep•€gcoab.us ��� � D Ae roduf4d- ' GPLY web-site: b :flv n r cc b.us APPLICATION REVIEW AND KING FOR PmPer ty A ddrass- Z-3 � Department raw raqujigd-1 Yes No Building r/ �ppffcant: Planning&Zoning Tres Ad€ninis€rator i ubiic works } Pubr-10 utififfes Public SafL`yr Fif'tk Sen�ices ROAdi •=t r-a`s=' -_-cis-v i�M"-= •::�:� , y''� ems'' Other Agency Review or permit Required Review or Feceep. Date of Pete veri€eed By FlarfEb DepL at Envizanmenfa€Profecgort Flci ida Dept_of TransEmriafroc St dolms River Water Management Distdet Army Carps of Engineers DRnsian of€iceals and Railburan€s E3e M o€Aicaftorla Beverages an€f TaF�atxo Comer_ PLICATION STATUS MeWing Deparftnent Hest Rev;sew: Approved. ElDenied. (Circle one.) Comments: BUILDING LA.[wKING&ZGNFiNG Reviewed by Date: TREE ADMIM SOCOnd Review QApproved as revised. FIDenied_ PUBLIC GRI{S Comments: ts: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by:Y FIRE SERVICES Th rd Review: [(Approved as revised. QDenied. Gann a€ents: Re, 1 ec b F. Date- OF BLOCK 29, PLAT N 1�, JB§PlSI( TV,•I�„�ql,�Tyr V�AS RECOWED IN PLAIT BOOK 5 PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. OCEAN BO�LEVARD 60' R/W A4VE0 FW,� /.. FND%/.P. f VO"�2' /.P. /.P.-LP COAG•. 5'COAC. .V 26'• /d 9' WALN I P/.o 6WL700 PRIVACY 1 " fEACf LOT 3 s'. o LOT / �jjZj QSt. la.z DECK o A W/AG "3 WALL CIS 2 — STORY " as 8.-7 ~ N FRA ME STONE 0.4' Res. No. 234 ci) B O 74' IWit r RINI '3IF Iwo z8-o' 85' w'oo OECN I k �— (49.65'1.P-L P.) a 6' XVW PRN. PEWS ArLANrIC BEAQY rER AGE PR /5 F9 34 NOTES' /TANGLE AS PER PLAT 2INO BRI. AS PER PLAT. I HERT F3Y CERTIFY THAT TlrIE PROPERTY SHOWN IiERhEON LITS IN FLOOD ZONE "C"' AS SIJOWN ON T'jJE FLOOD HAZARD R"TNhARV MAP T;nP rTI14r' l'TrPV nL Arrn- Anwtrrn onanrr T..r �r Gfty of A€lan€ic reach APPLICATION*140MBER c nL SUffding Depai•€rrr n � � r n be asdgned by lite 6u idiri Dep eat-) 800 Seminole Road �a Aganuc Beach,Florida 32233-54.455 �J Phone(904j 24Z-5826 - Fax(90 )247- '' / 1 E-mail: buMing-deme eaab us Date rciui4d_ MY web-siEa: ice:( coab.us APPLICATION F Warty Address: Z OVeparbuent rey"mr reqWred Yes No SurTdang giant: Planning&ming Tree Achnirilshabr- Public works Pubf'c UMes Pubfic Pits Services rulmlis g— _ Geer Agency Res€faw or ftr&a Refired Review P �r B ReceDate arida Dep_of F�naz�Prion HOdda Dept affransparlaffan SE JOhns E&er Waf r Maxiag=ent Ekskict Armor Corps of Engineers G-nnsbn of Hods and Restatuanic MuWonof Aic.:afmffc Bejerages and Tobacco . aifiet: A-P PLICA710N STATUS Sie g.DepartmeTd Flmt Review. pproved. QF3erried_ (Circle one.) D� et�: ' BULMUG ANNNG&ZONING Reviewed by: Date: TEPEE ADMDL SeCORd ReVievr: ElApprorred as revised Ql3enied_ E'U E3REf5 C ems: . �y s PUB E'TY Reviewed by. _D&Y FIRE SERVICES Tfdrd Review: ElAppnaved as revised. QDenied. Comments: Revie�uad by. paw_ sed O N4154 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904)247-5826 Fax (904) 247-5845 Job Address: Z3� ate, Permit Number: /0 + �� Legal Description Parcel# Floor Area o q. t. Sq.Ft Valuation of Work S (� _Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration CR5pd Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# For multiple products use product approval form Describe in detail the type of work to be performed: G% Property Owner Information: Name: Address: City State_Zi Z Phone r19 6 7r?—7/-7 E-Mail or Fax#(Optional) Contractor Information: Company Name: Qualifying Agent: Address: City State Zip Office Phone Job Site/Contact Number Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address "-W ullev 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 laws regulating construction in this jurisdiction. This permit becomes null and void if work zs not commenced within six(6)months, or if construction or work is suspended or abandoned for a_period of svc(6)months at any time after work is commenced. I understand that separate permits must be secured for ElectricaC Work,Plumbing,Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. 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. I hereb certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type ofYwork will be complied with whether sppecif ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state, or local lmv regulating construction or the performance ofconstruction. Signature of Owner Signature of Contractor Print Name �D .Q Print Name Sworn t subsc ed befor ne Sworn to and subscribed before me this of 20 this Day of . 20 N tary Pu ppAHf�#pp61126 Notary Public COMSJA 21 2011 EXPSEs ���re Revised 01.26.10 y� Notary _7�, gpaded� CITY OF ATLANTIC BEACH )% ® NE / BUILDER AFFIDAVIT I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW:- DISCLOSURE AW: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 EARAFTER 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. 11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. 911. 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. 1'V. 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. TELEPHONE THE BUILDING DEPARTMENT(247-5826) 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. 23 L{ ADDRESS PHONE NUMBER PRINT NAM SIGNATURE DATE F/L Before me this day of 20/0 in the county of Duval,State of lodda,has persona ppeared herin by himself!herself and affirms that co� all statements and declarations ar a and accurate. Notary Public at large,State of ,County of ❑Personally Known (/��7TV /�j_ rIm roduced Identifica'on- `� V✓V�}�—{Qtam D 634126 2011�Cenv*ers Notary Signat F:BLDG/Ovm Builder AffadaviY REVISL^.D: 4/16!2009 Ltt' BLOCK 29, PLAT N r1�, IVZSi " ''v AZ'! 'TC H1»�1Qi AS Q ED IN PLAT BOOK 5 PAGE — 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. OCEAN BMLEI/ARD /94VE0 . FAV, /.. FVD /,P. PND lk2 1.P. -- 45197: LP-1p co COAL. a'Cam. WALN : 6'MR�IDO ' Pp/VACY PEACE Lor 3 , LOT 1P.2 DECK � o ►. vo w/AG �[/v _� IYAL L 2 — STORY N FRAME STONE Res. No. 234 B 3 cn _.. 74' 3?' Qo 'Fe.o' 85" FILE COPS �— (49.65'I.P-/.P.) FAV 12 L�P-''� .� a PND P I.P 6' Mt w PNV. pn9wer ArLANM AFACN r09RAGE_�_, I -�- PR 15 Pg 34 I N07E.54 I)ANG-E AS PER PLAr VA10 RR.L. AS PER PLAT. I HERFBy CERTIFY THAT THE PROPERTY %XM fWJZE'ON LITS IN FLOOD ZONE "C" AS SHOWN ON THE FLOOD W 7ADi1 ll"Tkf lADV MA0 VV-%0 rM-XV I�TUTV nim Arnr awtn-ri+ m—^r■ ——11— Cfty of,Atfa It c Beach APFUICA.TION'MU€BER Suffidi ng Department CE c ba assigned by the Buildiri Dep 800 Seminole Ro2cl max. Atzantic Beach,Mmida 3223a-5445 Phone(9Q4)—747--5526 - Fax(9Q4)247-5845 E-mail: buUding-degtgcoa€ws Date rot Gi€y web-site: h�:f/Mv it ca6.is APPLICATION REVIEW AND TRACKING FOR 'roperty Address: Z Oce De a rtnent review reqWred J Y o ► € fl :. Planning&Zoning Tree Ad€riinisirafor Public Utilities Public SafiB y F Servicas .''tiJs.�e:�'jst_'= .:�:�__.�: ^5•+-.i+R .N��� i� ��E39Vr;:^-�v?N=% .v 3iaR�_r�'`-:."haw;=�LYL=?`n..i= Other Agan €review or Permit Re€ ired Review or P�eii� .of�Percaaia Vere€red Bir FEadda`a Dept of Environmental Protection Florida Dept cif Transport-sHa► St Johns Fier Wafer Marragement District Autry Carps of Engineers Divislort of€ atefs and Restouranfs Division of Akzbaiic Saverages and Tobacco Mer-- APPLICATION STATUS avie i€ag Department First Review'. ❑ApprGved. ElDenied. (Circle one.) Comments., BUILDING LAIkNING&ZONING Reviewed Icy Date: TREE AD-MDL Second Review: QA.pproved as revised. DDenied. PUBLiG W CRICS Comments: ts: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES T€frd Review: E]A.pproved as revised. FIDenied. Comments: s: Reviewed h-,,. iszd a Ea __ CftY€ - tia€r-tfc Beach ,�=`'t'_-_�- $flfl Serrrinr�fa mad FDavta N NUt�r$EPA antic BeacFa,Fiarida 3� gned bar fila Br iicfin ephone 9Q4 5 Pent E- }47-5826 - Fe,,(904)247-5a', �rrtaing-daPigcoabG!' u�eb-sr"- r :tfc crv�rcx 6 d_ ' APPLICATION REVIEW AN13 CRACKING FORM 'rWarfy Addr,,— Ipplicaret erB ee J Pfannfng&Zoon Tree Actmiffboator Pubfic works Pubfllc E� Cr�iea } Pu€x€ic S `y Firms Semis `'-�'' des AgeLley Revfiew or PSrEnit Requi ed or eat F(ariQa i�Pt Of Euvirtunmenfai Profectbn a Persia vermeil By Date Fiarida Dem of TranspOriaFfan Sf daiarrs Piver wafer hlfa€ragerr�eer�DfSt t Y Comas of Engineers l�iwisittr�cat[€cats� aurara€s man��r3tic Severag�grad i�fxa�o mer APPLIC STATUS 51faew4D9 DeParhment FirstRav�m : (Circle one.) [PAAPratred. ElDerried. BUILDIRG �_azokrlm jsERvjCEs Reviewed b . �� . � Dade: D�/•/ Second d€review. ❑APProved as revised ��3enred_ S 0€x� .€s: ES Reviewed by: FIRE 'a h! ev6ee : �a : []Approved ed as revised ElDenied. RevieE,vad htF_ s DCI E BLOCK 29, PLAT mM SC78£3IIsq Y 69 OF T� �Tf�11T�` pB ©F iE CURRENT PUBLIC RECORDS OF D��1L RDCf 7U D IN PLAT BOOK 5 PAGGF; .oLJI`PI'Y, FLORIDA. OCEAN Ba-t EVARD 601 AWED FAV, /p PND"/.p CO COAL. 3 COAL. WALK P/.O z/,Z 6 M4'b0 P17 /VAC LOT s LOT / DECK 0 o WAA41. m �, I • 2 — STORY " sP BaT FRAME STONE °'' Res. No. 234 .O ,4 J715r� dt02B.0 � O � WtxJ10 v OECA' City of Atlantic ach Planning and Zoning parlmeq This approval verifies compos tx with apptfcabte zoning, subdivision and ther local land (49-65'1.P-/P) o q development regulations, but oes not constitute r. IMPtOv rmits. compliance with Florida Building Code and all other applicable S' !� PAW. PVxLr 2 local, State and Federal pe tting requirements must be verified by signature a the City ofAtiantk ATLANT/C &,gpy T , BeachEF4Buildingi prior do me of's Building m P8 /5I 34 Approved Or. NOTES Date: /)ANGLE AS PER FLAT 2)NO 8R.L. AS PER PLAT. I HEI213}Y CERTIFY THAT THE Pi20PEr?,N :3HC)WN } xy LIFTS IN FLOOD ZONF: "C" AS Sjj0WN ON THE FLOW BOUNDARY MAI" FCR THE; CITY OF ATf.Aw-rr• P rnLr "r—,—