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Permit 1984 & 1986 Mary StCITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5826 Application Number Property Address Application type description Property Zoning . Application valuation . ---------------------------- Application desc 6FT FENCE REPLACMENT ---------------------------- Owner ------------------------ RODGERS BUILDERS 794 FOXRTDGE COURT DR. #109 ORANGE PARK FL 32065 10-00000733 Date 6/14/10 1986 MARY ST FENCE PERMIT TO BE UPDATED 0 -------------------------------------- -------------------------------------- Contractor ------------------------ OWNER ---------------------------------------------------------------------------- Permit FENCE PERMIT Additional desc . Permit Fee 35.00 Plan Check Fee .00 Issue Date Valuation 0 Expiration Date I2/11/IO ---------------------------------------------------------------------------- Special Notes and Comments Roll off container company must be on City approved list and container cannot be placed on City right-of-way. 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. BUII,DING PERNIIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: ~ r ~ tv I~i ~ ~~1" ~ Legal Description ~~~ Permit Num N 0 7 2010 Valuation of Work $ Proposed Work heated/cooled non-heated/c oled~~ Class of Work (circle one): New Addition Alteration Repair Move Demolition pooUspa window/door _~-~.-.. Use of existing/proposed structure(s) (circle one):. Commercial esidenti If an existing structure, is a fire sprinkler system installed? (Circle one): es No Florida Product Approval # For multiple products use pro uct approva orm Describe in detail the type of work to be Property Owner Information: 1 ~ ~ M a~ S~ee.~ City ~~ ! (l~y-~ 1(_ l5{ ~t C.{~ State~L Zip 5 d d 55 Phone t-I' ld % ~S ~ ~( E-1VIai1 or Fax # (Optional) Contractor Information: Company Name: Qualifying Agent: Address: City State Zip Office Phone Job Site/ Contact Number Fax # State CertificationlRegistration # Architect Name & Phone # Engineer's Name & Phone # ~- Fee Simple Title Holder Name and Address ~, Bonding Company Name and Address ' Mortgage Lender Name and Address _ 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 o, f 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 f work zr not commenced within six (6) months, or if construction or work is suspended or abandoned for a_per:od of six 6) months at any time after work is commenced I understand that separate permits must be secured for Electrical Worly Plumbing, .Signs, Wells, Pools, ~urnaces, Boilers, Heaters, Tanks and Air Conditioners, etc WARNING TO OWNER; YOUR FAILURE TO RECORD A NOTICE OF COMII~NCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IlVIPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMIVIENCEMENT. I hereb certify that I have read and examined this a placation and know the same to be true and correct. All provis~rns Qf laws and ordinances governing this type ofYwork will be complied with whether sppeed herein or not. The granting of a permit does not presume~lo gf,~e~a rity to violate or cancel the provisions of any other federal, state, or local lmv r ulating construction or the performance of construction. ~ ,,: ~ r ~~,- „~. fd~ ~ ~'~ ~ Signature of Owner Signature of Contractor Print Name ~ ~ ~ ~~ Print Name Swo to and subscri ed before me worn to and subscribed before me this a of ,•••::~ °y''••,, 1 L GRAHAM is Day of - *. :"- N # Da 957760 ~/ ;; EXPIRES: Februaryry 14, 2014 // // (, ~.~'• ~'~•' nded Thru Notary PuWlc Undanvrlters Notary Public - ~ " I ` - - - otary ~~~Q ~! Revised 01.26.10 .5.t-1 i' rS ~/f.+ ~~ ~ lsy CITY OF ATLANTIC BEACH ~~~ ' ~%'"Y Q~WNER /BUILDER AFFIDAVIT ~`` -C,sSS~` 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 Il~dPROVE A ONE - OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IIv1PROVE 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. il. INJURY LIABILITY; SINCE OWNERS MAY 8E 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. TELEPHONE THE BUILDING DEPARTMENT (247-5826) IF IN DOUBT. V. ACKNOWLEDGEMENT; (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. PHONE NUMBER lo' / ~~V DATE Before me this / day of U , 20 ~ ~ in the county of Duval, State of Florida, has personally appeared herin by himself /herself and affirms that all statements and declarations are true and accurate. / Notary Public at large, State of-#-`=-~ Couniy of __~l'_~ (_...~' Q Personally Known ^ Produced Identificatlon - Notary Signature: F:BLDG/Otwa-Builda~ Affedavil; REVISED: M] - MAP SHOWING I-30 U.NDARY S~IRVL'Y OF PA,PCEL °Ar" rN~ ~vo,~rf/ 3 2. S S ~ aF ~ o ~- 1 , a ~. o ~/<' ¢ . AS SHOWN ON MAP OF L ~w'i5 S~~~i yisio,y AS RECORDED IN PLAT 80OK 24 PAGES ~2 OF THE CURRENT PUBLIC RECORDS OF DUVAL CO., FLA. CERTIFIED T0: n/~t ~'~ ~ N. ~~SA I Cdc/~/TR y vv l o~ 1-l0/~~l ~: L~~ /Nc. %/1 r`,r.~i.J ~ OS/~Dh'r/C f? /1 /=ik'sr M~rC'I C ~/ 7/~r~ /NS~/F'/ n%~' :~ Co !' ~/, / "- 7v' ~/IA/~Y STREETIZE~FIVF.D ~\ 0 ~- ~ ~ t~-- ~ O Q `~~)GC~m~~1, ~~~ QXI S~1Vl~i ~~VGU~ ~<-P J to ~vo~ ~i~a S .~ Sb~ L~Fc c~.,P - v~~~~c~~ ~c~1-C ; v v~ S ~' Out ~ V ^1(~V ~ 1999 ~iR ~~~ /~°/P 5~,_ ~~ 5~~3~~'- City of Atlantic E3each ^'°~P) Suildin~ and ~©niri~ 9 32, 5 ' ~ o a ~~ "- 2.~'. i5' moo. ~../.n (NO GAP) • ~O • ~ . . Cotilc. Gouc. ~ DR ivy . • . ' ' DRi~~ "q~ , 8• h ' f ~. O ' ~ ~. e 5 ' ~ ity of Atlantic Beach ~ >. t s • ~rr~i g and Z~ng Department Thls appr val erifies compliance with applicable Z- Ste' zoning, ub vision and other focal tartd developm nt r gulations, but does not constitute FRAME RES/OENCE y ap rpvai f r th isaUance of permits. Compliance ~ `jFl '' ~ o Bu ding Code and ail other applicabk ~. #i~B~ ~ ~ Q local, S an Federat permitting requirements must be rifle by signa><ure of the City of Atlantic ~ Beach Bu ding Official rior ti 1M i p 0 sauanq o1 a O Building erm ~ ~~T~ ~ Appno~-~d /5.0' ~~.es' 3X 3' FtaE,Q Col ~~q~•g PA. A/c PAa ,. ~ .. L ~ ' 3'x3' Ce~./C. irefT PAv PAO 1 ..~ r 1 6~~ 9a . ^° 23.5' FA/la'fi "l. P /~ ^ ~'31o7Z '~LD. ~~ 5~;(~~7' ~ v T /3 ~ v ~ ,~ \' O O ~, G~Q~ ~°~~G ~ pr,~~g ~`Q~ 4('. ~f ~~ /N'l ~/z'/. P. ~' 3Ce7Z /2 Tc: MP 1"Lv%~; LOZ-gyn., r~~r. ~~ r'ty ~ ~r1~; r` ~ it ~~ sV_ :. City of Atlantic Beach Building ®eparts~ent 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 Fax (904) 247-5845 E-mail: building-dept@coab.us City web-site: http://www.coab.us APPLICATION NUMBER (ro be assigned by the Building Department.) / D - ~ /~~ Date routed: 'r®perty Ad~9ress: / "/ n ~o ,,,~~A~(/ ~~ ~pplocant: D~~ ~~ ~ Pr®ject: ~ APPLICATtQN STATUS Reviewing Department First Review: proved. ^Denied. (Circle one.) Comments: BUILDING LA G & ZONI ~a,v{h_ Reviewed by: ADMIN. Second Review: ^Approved as revised. ^Denied. PUBLIC WORKS I Comments: PUBLIC UTILITIES PUBLIC SAFETY FIRE SERVICES Third Review Comments: ®epartrnent review required Yes lVo B g i Planning & Zo r dministrator ublic sties Public Safety Fire Services f~ev ew-fee,~~K, ~ Dept Signature ~. Other Agency Review or Permit Required Review or Receipt of Permit Verified ray ®ate Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: Reviewed by: ^Approved as revised. ^Denied. Reviewed by: Date: ~ ~ ~~ /D Date: Date: Revised 05/14!09 ,, 1~Y~~'~`d~i~, City of Atlantic i3each ~~ i3uii~ii~g ®epart~erat ~ r:,.-__ ~ 800 Seminole Road -' ., ~~r Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 Fax (904) '~!,J,t ar E-mail: building-dept@coab.us ~ City web-site: hftp://www.coab.us / '~ '~ {'. ///j ~~ -. ~ ~`"`w. 7-584~'~ t_ ,~r '~ ~~ f~ AP~~~C~TI®N R~\/~~V~O A 'r®perity A~~8lress: ~~~~~ ~~ ~pplaca~t: ~~~ ~1~-•- 'r®ject: ~ APPLICATION NUMBER (To be assigned by the Building Department.) /D- 073 Date routed: C~16VG F®R6~1 ®epartnnerat review requared Yes N® B~ 9 Planning & Zo re dministrator ublic W sties Public Safety Fire Services F~ev~ew-fee ~ f ~`-` ~ ~~, ~ ~ ' '~`' ti:~ Dep~~S g n'atu re ~ ~~ ~ w , i Other Agency Review or Permit Ree~uired Review or Receipt of Permit Verified i3y ®ete Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department f=irst Review: Approved. ^Denied. (Circle one.) Cor~nents• BUILDING 46•/ ~~/~~~ PLANNING & ZONING Reviewed by: Date: ~•~C/~ ~~ TREE ADMIN. Second Review: ^Approved as revised. ^Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ^Approved as revised. ^Denied. C®mments: Reviewed by: Date: Revised 05/14!09 t ~~~;`1r~~, . P xa ~ .r t;1 s+ E5 N ` ~ ~ ~: j. j ~. ~J33 ~!- City of Atlantic i3eaci~ i3uiidirog ®epartrraent 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 Fax (904} E-mail: building-dept@coab.us City web-site: http;//www.coab.us APPLICATION NUMBER ,,.... (To be assigned by the Building Department.) .~. ~ {~ ~ ~~~ 9~ Date routed: ~o~~~ ~r®perty Address: ~~ ~pT!~AZV ~~ sppl'aca~t: d~~l'!, ~~ ~ at.®~pec$: ~ Reviewed by: Reviewing Department I First Review: (Circle one.) Comments: BUILDING PLANNING & ZONING TREE ADMIN. P WaR B IC UTILITIES ~- ~-~v PUBLIC SAFETY FIRE SERVICES Second Review: ^Approved as revised ®e artr~ecat review required Yes No B 9 Planning & Zo re dministrator ublic sties Public Safety Fire Services ^Denied. Denied. Reviewed by: Third Review: Approved as revised. ^Denied. Comuv~ents: Reviewed by: ^~-~- ~~ ~ .r ~ a. -,,- ~.~. - •m ~ .rte-~k, -rrs^-. .- -, Review~fee~~~'~~~~~... _:: .:~= . ti. ~DepttSigna~ure~ 6 =~: Other Agency Review or Permit Required Review or Receipt 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 Division of Alcoholic Beverages and Tobacco Other; LIGATION STATUS Date: (0- ~~ ~~ Date: Date: Revised 05/14/09