Permit Fence 1949 Seminole 2011 I. CITY OF ATLANTIC BEACH
= '` 800 SEMINOLE ROAD
J ` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001936 Date 4/20/11
Property Address 1949 SEMINOLE RD
Application type description FENCE PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
replace 6ft fence
Owner Contractor
MARIG /KENNETZ OWNER
1949 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
Permit FENCE PERMIT
Additional desc .
Permit Fee . . . 35.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/17/11
Special Notes and Comments
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Other Fees STATE DCA SURCHARGE 2.00
STATE DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 35.00 35.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 39.00 39.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MAP SHOWING SURVEY OF
LOT 4B, BLOCK 1, BEACHSIDE, AS RECORDED IN PLAT BOOK 42, PACFS 14, 14A, 14B, AND 14C OF
THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
N
L 0 T 26 ! L 0 T 26 ' \j,..... 0 T 27
0 POUND 1/2" IRON PIPE (5.00 ° 31' ;6 "E. FIELD), FOUND V2" IRON PIPE
,: L.S.I9111 _S. 00 31 00 E. 40.00 0.4 NO CAP
4, 1 5' PRIVATE 0.6' 0.1' . ' . J 0.2'
,: EASEMENT 6 WOOD PRIVAC �
FENCE
J WOOD DECK
W0 00 STEPS 6 o tt4 V
Q���
$11. 2' i PRIyVAC '.
D
4
=
4 FEN
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` 1. 7 p
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a O 2 STORY 1 '�
v v FRAME RESIDENCE t yl
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in_W No. 1949 ` _ �� Cr"
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L O T 4A o 0 b a 6 ' 6 0 0 T 5A
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" CONCRETE Ci! NOTES:
(21 2 t° CONCRETE o THIS IS A BOUNDARY SURVEY. I Z
0) STOOP NO BUILDING RESTRICTION LINE AS PER PLAT. <
N e , CONCRETE W
o
_ • WALK N BEARINGS BASED ON THE SOUTH LINE OF LOT m
— 48, BLOCK AS PER PLAT.
• f.
200' ALL EASEMENTS SHOWN HEREON ARE FOR STORM
; ' . UNLLESS OTHERWISE STATED S ,WATER. AND UTILITIES
1.4'*1.4' 1
,'COQUINA COLUMNS
W /WOOD FENCE.�(,p CONCRETE DRIVE 1
(TYPICAL) OJ / ••
6' EASEMENT O 6' 9.00 I1 E. 119.99' F14.1)) / /
r S.O0 Q E. 120.0 _�
FOUND 1/1" RON PIPE,' N.00 31 00 I W. 40.00 FOUND 1 /2" IRON PIPE 77�� 6FFOUND V2" IRON PIPE
NO CAP (N.00°34 31 W. 40.14 FIELD) RLS. 4144 CAP NOT READABLE
SEMINOLE ROAD
100' RIGHT -OF -WAY (PAVED)
THIS SURVEY WAS MADE FOR THE BENEFIT OF
TERESA MAZUR KAUNATH;
HOMESIDE LENDING. INC.;
RICHARD T. MOREHEAD. P.A. AND
STEWART TITLE GUARANTY COMPANY
THE PROPERTY SHOWN HEREON APPEARS TO LIE IN FLOOD AND IS IN COMPLIANCE WITH THE MINIMUM TECHNICAL
STANDARDS SET FORTH IN CHAPTER 61 G17 -6
ZONE "X" (AREA OUTSIDE 500 —YEAR FLOOD PLAIN) AS WELL OF THE FLORIDA ADMINISTRATIVE CODE.
AS CAN BE DETERMINED FROM THE "FLOOD INSURANCE RATE
MAP" COMMUNITY -PANEL NUMBER 120075 0001 D. REVISED
APRIL 17. 1989 FOR ATLANTIC BEACH. FLORIDA.
UNLESS IT BEARS THE SIGNATURE AND
THE ORIGINAL RAISED SEAL OF A FLORIDA
LICENSED SURVEYOR AND MAPPER, THIS I. _ �(
MAP IS FOR INFORMATIONAL PURPOSES
ONLY AND IS NOT VALID. DONN W. BOATWRIGHT, L.S.
RECHECK: OCTOBER 24, 2000 FLORIDA REG. LAND SURVEYOR No. 3295
SCALE: I "; 20' BOATWRIGHT LAND SURVEYORS, INC. DATE: DECEMBER 28,1992
DRAWN BY p. FREEMAN IT I I 5th STREET SOUTH
FILE: 2000 -769 JACKSONVILLE BEACH, FLORIDA 241 -8550 SHEET 1 OF I
s -- L`�•rie City of Atlantic Beach y = Q�pLIC NUMBER
C !
, Buddin De artment L 1r� o be as st ned f t Bui De artment
�� ,► 9 p ' r ED Cr +# 9 YF z , 9 ,7 a
.� 800 Seminole Road
fi , z Atlantic Beach, Florida 32233 -5445 APR 1 � e� �
X01
'` F''`.- Phone (904) 247 -5826 • Fax (904) 24r� 5845 �� r. ? ".
., r1 9f' E -mail: building- dept @coab.us ; ',7 - I Dat , ° n„ , r ` �' s {
City web -site: http: //www.coab.us '--- ______
APPLICATION REVIEW AND TRACKING FORM
Property Address: 9V' Jim /AI / , Department review required Yes No
B •. -.
Applicant: a /() )/ C e. Plannin • & • •' • =
Tree Administrator
Project: : ?
. V6 ' 7 ___ ("public Utilities Utilities
1 Public Safety
-(at Fire Services
/ ,
Re ,� � y� 77�,h' 9t .� .P' 's2 � gip �` .r � �+"� *;��
viewifeeISP fisa ,. ;"r�` .,..p CSi 9 w,, , ,,41 r . 7.�s: �,- {.; , ;+_
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 C�
Reviewed by: Date: ''" -j— //
TREE ADMIN. Second Review: QApproved as revised. ❑Denied.
p ,,ii grAA ORK Comments:
•UBLIC UTILITIE
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: (Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
r:
,S L�r - City of Atlantic Beach APPLICATION NUMBER
` js ;1 Building Department / �I V (To be assigned by t Building D _
z. w 800 Seminole Road / ^ /� ]""'�
Atlantic Beach, Florida 32233 -544 6 , -
-vAi u n� Phone (904) 247 -5826 • Fax (904 X4.7 - 5845 ? ' 1 � x i , * 5 ,. - q-i1:_;-,•.1.,:, ' ; r
..1 9r E -mail: building- dept @coab.us - Date routed r r
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / / J iii4 /t 23d Department review required Yes No
B
Applicant: dial) Planning & Z
Tree Administrator
Project: / � g. e cE ✓� 6 r ub • s
ublic Utilities
1) Public Safety
Fire Services
"11' _
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: Denied.
(Circle one.) Comments: gApproved.
BUILDING p_ 4 ,/,
PLANNING & ZONING Reviewed by: Date: �
TREE ADMIN. Second Review: QApproved 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 05114(09
S+ �'1,,. City of Atlantic Beach APPLICigION� NUMBER
g' ? ', Building Department 7 ' 1(Tb be a ssigi f y the B uilding De a )
y am 800 Seminole Road 1 k i t r r ' • ; `; i �
.� # f1 r .4 k F t
u r n Atlantic Beach, Florida 32233 -5445 .' « f R -
.„ �` ; Phone (904) 247 -5826 Fax (904) 247 -5845 �. -F , 4 {.e -T ,� 4 - `(...,a 9 % E-mail: building- dept @coab.us n Dte a ro Ute d ,k iv
1 r
City web -site: http: //www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: i Y Li
"/ ,f4 'wok a Department review required Yes No
B .
Applicant: L4.f 1 L Planning &
Tree Administrator
Project: T ti, ca,/��l— I1 ei 6 c•Public Utilities 1
Public Safety
-(at : Fire Services
Fte rVieW d- 'nom P W4",sP' Ma-a .iir v v> .•e =r
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: OrApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONIN -- Reviewed by: 1 46—
Date: }t `Pe lf
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
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233 % � j � t N l'. n ,
Office (904) 247 -5826 Fax (904) 247 -5845 /1)) I I 1 r
, 1 1I / ( .-
)b Address: / sf •t , /'`.1,)� 4 .--_, f
1
gp
Permit N ber:
egal Description Sieil..t_C Parcel # y ``°-�- ::.. ._
Floor Area of Sq.F't, b r't • =--
aluation of Work $ , 0� Proposed Work heated cooled rton- heated/coole
[ass of Work (circle one): New Addition Alteration Repair Move Demolition pool/spa window /door
;e of existing /proposed structures) (circle one): ommercial Resider:...
an existing structure, is a fire sprinkler system installed? (Circle one): o /A
orida Product Approval #
)r multiple products use product approval form
.scribe in detail the type of work to be per 4i FP e. (� c- �
n
. operty Owner Information:: trE7 6 ,s I X CCU' 0 AI Si jD- 5 77 0
me: (—Er 4 /1--t ' le.-4. `°J Address: 1 V/' e-E_- i
ty Ag i1 :3 ? ' &VW Stat GZip,, " Pho 1 e "1�.�
Vlail or Fax # (Optional) ii, r _ , t .'_ "i.., r, a • _
■retractor Information:
I mpany Nam. �
Air,/ ' C �� .A A 0' ,h, _ :ent: A Al r gm
fice Phone Jo L Sit- !act NMber p .,
ate Certification/Registration. #
hitect Name & Phone #
gineer's Name & Phone #
Simple Title Holder Name and Address
ndii g Company Name and Address
rrtgage Lender Name and Address
dication Ls 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
once 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
void (work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a_ period of six j6) months at any time after
k is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Bo Heaters,
tics 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.
, eb certify that I have read and examined this a placation and know the same to be true and correct. All provisions f laws and ordinances governing this
of work will be complied wi whether specd herein or not. The granti of of a permit does not presume to gave authority to violate or cancel the
'isions of any other federal, s te, or local law re: ating construction or the performance of construction.
nature of Owner - r' '_ �+ Si ature of Contractor
it Name
_� ��2 1 Print Name
am to.an. bscribe•.efor- _• e Sworn to and subscribed before me
/9 /i lay .f ' 6.'! -„i%. 20 this Day of , 20
_.....ba ary Pub ' ��' ``` •
H -74 EXPIRES: Februa ' • Notary Public
ry 14, 2014
Rf -- B onded 7hru No Pubik Underwriters
- Revised 01.26.10
c
• , , CITY OF ATLANTIC BEACH
, w ° � � ® WNER / BUILDER AFFIDAVIT
r�! ,tis ,
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.
i /I/ 1 - 5 L = nr /.e��:=; 4 `rt f —i --s j ci
ADDRESS PHONE NUMBER
�=s.4 V/1' 4 z A
PRINT AME
SI ATURE . Aid_,.......„..... D /#12,9 0
Before me this • o r, L 20.14 in the county of
Duval, State of Flo da, has personal) ppeared herin by himself / herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large, State of f L , County of A(,1 L_
❑ Pers ally Known ' ,40' .:
ilipAllt . .s a 76o
� r 2c IND
Notary Sig '4 �.:; � 7 !il': . 1 . :.t oa r i' a
F:BLDG /Owner - Builder Affadavit; REVISED: 4/16/2009