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Permit Fence 2010 4; , CITY OF ATLANTIC BEACH ' � ;.� 800 SEMINOLE ROAD 75 ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Application Number 10- 00000943 Date 8/06/10 Property Address 880 ORCHID ST Application type description FENCE PERMIT Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc 6ft fence Owner Contractor REAGAN MICHAEL WILLIAM ET AL OWNER 880 ORCHID STREET ATLANTIC BEACH FL 32233 Permit FENCE PERMIT Additional desc . Permit Fee . . . 35.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/02/11 Special Notes and Comments Avoid damage to underground water /sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834. 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. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: g S © Or yid S+ Permit Number: Legal Description ( g--- 31 11 - 2. S - 21F A /a r c &. c / Cc-1 arcel # Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ 2 at) 2 Proposed Work heated /cooled 717 non heated/cooled 9 Class of Work (circle one): New Addition Alteration Repair Mo molition pool/spa window /door Use of existing /proposed structure(s) (circle one): Commercial esidential If an existing structure, is a fire sprinkler system installed? (Circle one): Yes o N /A Florida Product Approval # For multiple products use product approval orf m Describe in detail the type of work to be performed: R._,,,, ,,,,r e )a, sfii „ i „ re em i '1 O_r, c „ /.., es, l ire bb,x yb'u.41 U srkj G A b oard On h >A-J 1 aod ( i ./& Property Owner Information: Name: M it t,. fi / ,� e ! n Address: ‘O e rc j e/ S City /1. Iee StateS_Zip 322 3 ) ) Phone Plavi S /ef - 6 ze2g 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 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 is not commenced within six (6) months, or if construction or work is suspended or abandoned for a period of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical 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 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 of work will be complied with whether speci zed herein or not. The granting of a permit does not presume to gave authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the performance of construction. Si afore of Owner w Signature of Contractor JOBSITE COPY Print Name Alt lC 4,..41 k'. k 4 9 Print Name Swon3 s and subscri'•et bef• - - Sworn to and subscribed before me thi o r '2 L 3i1�L►” ■.. !i this Day of , 20 MI Wytirtil MISSION # DD 95776 t i s : Febroa 01 Notary 1 -2.f. - 1 4 5w ' � .1 -- acss il 's'% ” , Notary Public Revised 01.26.10 4'r' �� { ' T CITY OF ATLANTIC BEACH ®WNER / BUILDER AFFIDAVIT 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 $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455- 228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT (247 -5826) IF IN DOUBT. V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER- BUILDER PERMIT. drCLtid 004/) go-/-6 ADDRE S 1 /c PHONE NUMBER '—` ° GLAcl (AL e 0,4 PRINT NAM SIGNATURE DATE -, Before me thia! day of , 20 in the county of Duval, State of Florida, has personally a eared herin by himself / herself and affirms that all statements and declarations are true nd accurate. / \� Notary Public at Large, State of L , County of ��'(,( ❑ Personally Known ❑ Produced Idenfrfic,Fidn SHIR LEY L. GRAHAM � r 0,\ MY COMMISSI # Dp 957760 L,; � EXPIRES: February 14, 2014 Notary ' • e ( r ' 3onded Thru Notary Public Underwriters F:BLDG/ Owner - Builder Affadavit; REVISED: 4/16/2009 o.:ay fJr, City of Atlantic Beach APPLICATION NUMBER (To be assigned by the Building Department.) S� Building Department ( 9 y 9 P ) Y r 800 Seminole Road //t a y' 73 „r Atlantic Beach, Florida 32233 -5445 / U Phone (904) 247 -5826 • Fax (904) 247 -5845 ) - E -mail: building- dept @coab.us Date routed: 7 MID City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 0 � '2/ cST Department review required Yes No Buil Applicant: Lt) t Zo re- 1. inistrator Project: it P • Utilities Public Safety Fire Services tit a � *$en, a, 4 , � 4'�”: �! �'`g��r�'�"s�i �.. fl r oog� ��� ''� '� ,t Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By 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 First Review: XApproved. ❑Denied. (Circle one.) Comments: BUILDI PLANNING & ZONING 7 730/201 0 Reviewed by: � Date: 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. Comments: Reviewed by: Date: Revised 05/14/09 1.A.,� City of Atlantic Beach APPLICATION NUMBER 0 !'� Building Department (To be assigned by the Building Department.) s 800 Seminole Road / t/ _ of i/3 Atlantic Beach, Florida 32233 -5445 �� ter Phone (904) 247 -5826 • Fax (904) 247- 5845 E -mail: building- dept @coab.us Date routed: l � City web -site: http: / /www.coab.us rjj APPLICATION REVIEW AND TRACKING FORM Property Address: trO Ch cL c Department review required Yes No Buil.'•: Applicant: _ Q 6'3 Tannin• & Zo • /_ re- Administrator Project: �T! e �_ CL' Fr • Utilities Public Sa ety Fire Services Mtge /4_, $ , ;4. w ' ,giltigiaaliaiLtgili , O _ IV > . Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By 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 First Review: [Approved. (Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: � �-- Date: G IW 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. Comments: Reviewed by: Date: Revised 05/14/09 , ; CITY OF ATLANTIC BEACH -�� ®WNER / BUILDER AFFIDAVIT 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. 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. T (O 2-c 11M C1-. COY) 5 1 ADDRESS PHONE NUMBER / 4 1.6 1/411 ci w- ' PRINT NAM ✓ n O -- 7 /Z ? / /b SIGNATURE DATE Before me this!' day of 4,/ 20 / ' the county of Duval, State of Florida, has personally appeared herin by himself / herself and affirms that all statements and declarations are true accurate. ,� Notary Public at Large, State of 1 L J , County of , ❑ Personally Known �► ❑ Produced Identific- '•n - ANL AI, I��r� — / / SHIR I.EV L G RAHAM' My COMMISSION fe DD 957760 ' EXPIRES: Februa 14, 2014 Notary - / I . J LIw�iC� r Bonded Thru N Public Underwriters F:BLDG/ Owner - Builder Affadavit, REVISED: 4/16/2009 01.A11- City of Atlantic Beach APPLICATION NUMBER tS Building Department F � _ (To be ass by the Bu Department.) r 800 Seminole Road ��� 9 1) 61 y + r � Atlantic Beach, Florida 32233 -5445 Phone (904) 247 -5826 • • Fax (904)247. -5845 �� ! 7 z id s. " Jar E -mail: building- dept @coab.us / Date routed: City web -site: http: / /www.coab.us / t APPLICATION REVIEW AND TRACKING FORM Property Address: (/J 0 �!/)i ST Department review required Yes No Buil Applicant: e, 4) - 2) /e._ Ian in & Zo ' 'Ire Ad inistrator Project: t-?7 e E 6 /" / r P - - - _ - . Utilities Public Sa ty Fire Services �, a ^'�"FN+ r fi r^ "3' "P � a .� '4S� K� �'��'`7 � Rea rWI i ` ©e Sl ure4 k� � �, Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By 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 First Review: Approved. ❑Denied. I (Circle one.) Comments: g BUILDING PLANNING & ZONING Reviewed by: Date: 8'..3-A TREE ADMIN. Second Review: DApproved as revised. ❑Denied. P,4 W6RK, omments: PUB IC AFETY Reviewed by: Date: FIRE SERVICES Third Review: DApproved as revised. ❑Denied. Comments: Reviewed by: Date: 7 Revised 05114/09 MAP SHOWING SURVEY OF THE SOUTH 22.50' OF LOT 1, AND THE NORTH 15.00' OF LOT 2, BLOCK 155, SECTION "H", ATLANTIC BEACH, ACCORDING TO PLAT THEREOF RECORDED IN PLAT BOOK 18, PAGE 34, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED TO: MICHAEL W REAGAN; NAVAL FEDERAL CREDIT UNION, NFRES, LLC; FIRST AMERICAN TITLE INSURANCE COMPANY 3. O 4 ) \ R D (s0• S S ; S tir os T 2p. :. wg y"F. F F j FOUND %2.. I. P. 2 1 , O , < 2 1 UNREADABLE r te. FOUND %2. LP. I CONCRET 1 61' ,/' 1946 en DRIVE AN I r4 WALK ■ O �6 \ 1` I\ CONCRETE ■ PORCH J • _ � 14.3' o r x 10 lLI r v 12.8- x x I tsri I 1 -STORY I I ^ FRAME .� 3 AND S TUCCOI � p I 26.9' I ^ # 880 I y" ki 0 - -- N U m.S' o N 2 J A/C o I h PAD V ILE COPY (,) , 1 . 1' 6 6.5' 24.2' 6.8' 1-ST k FRAMEDBLDG.`� LOT 3 ;6' 24 6 . x O " `N ( ^ FENCE ^ 1 O) I ' 0.1' p N (M J O "V ' 00 N � ILE COPY b EEI I Eg B 0 1 °' AManHc eaa L O C "� 1 5 5 1 snd Zon�r� � v1S*4 47.5 O AA zoning, iu , it 00m Si , 15.0 22. \ 00 114 r � •� ' ,n FOUN yi" I P / N V 7 1 ',Q JJ + y # 194 v V „ ! o 1 ! �- "�77`��� fill] P'r'r 37, :,