Permit Fence 68 17th St 2011 y f CITY OF ATLANTIC BEACH
a 800 SEMINOLE ROAD
. " ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002021 Date 5/06/11
Property Address 68 17TH ST A
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
Application desc
REPLACE FENCE
Owner Contractor
PARISH, WAYNE A. OWNER
68 -A 17TH STREET
ATLANTIC BEACH FL 32233
Permit FENCE PERMIT
Additional desc .
Permit Fee . . . 35.00 Plan Check Fee .00
Issue Date Valuation . . 0
Expiration Date . . 11/02/11
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.
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.
.BUILDING PERMIT APPLICATION
I' CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
fob Address: (P8 ' 7"' -5r
Permit Number:
.4 egal Description
Floor Area of Sq,Et, Parcel # S rt
Taluation of Work $ Proposed Work heated cooled
n - heated cooled
:lass of Work (circle one): New Addition Alteration. Repair Move Demolition pool/spa window /door
Tse of existing /proposed structure(s) (circle one): Commercial Residential
f an existing structure, is a fire sprinkler system installed? (Circle one): Yes No N /A
lorida Product Approval #
or multiple products use product approval orf m
)escribe in detail the type of work to be performed: 1 / . r GuC 6li . f-77
w//
roperty Owner Information:
fame: o A�cn k S.. Address: 6 D 1 7 �'tV e,'-
i t y +\c s * c— c-� S t a t e F ( Zip 32Z3 3 Phone go if— 2 y - 314' Z_
- Mail or Fax # (Optional)
'o 1 . c or its ormation:
ompany Name: Qua' ■ _ Agent:
ddress:. City State Zip
ffice Phone Job S " Contact Number Fax #
tate Certification/Registra #
rchitect Name & Phone #
agineer's Name & Phone #
3e Simple Title Holder Name an. ' ddress
onding Company Name and : dres
[ortgage Lender Name and ddress
hi
plication 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
nuance 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
d void (work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a eriod of six _(6) months at any time after
)rk is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, ells, Pools, Furnaces, Boilers, Heaters,
inks 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 IN'T'END TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
:ereb certify that I have read and examined this placation and know the same to be true and correct. All provisions of laws and ordinances governing this
7e of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
gvisions of any other federal, state, or local law regulating construction or the performance of construction.
. ,
gnature of Owner , ,_ ■ - ,
Signature of Contractor
ant Name Print Name
vom rr ..' d : . .cri: .- o s . .. 20 e rbi
� , , Sworn to and subscribe b eEe C �p !
Y
s 4,..„ this Day of
,b
)tary Publio
r'''um: ta, 2ota Notary Public
m! Thru Notary public Underwriters
" �' "" Revised 01.26.10
CITY OF ATLANTIC BEACH
} � ® WNER / BUILDER AFFIDAVIT
,t ''
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 REOUIRED 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.
ADDRESS Leg l 7 7 s r
PHONE NUMBER
•
OUP S
P INT NAME
c/2/
SIGNATURE DATE /
Before me this 6 day of / n a 201j in the county of
Duval, State of Florida, has personally appeare h erin by himself / herself and affirms that
all statements and declarations are trueeaaa d accurate.
Notary Public at Large, State of r t" , County of ---- AAv Q.
❑ Personally Known )
uced Identification - (i �a
Notary Signature:
F: /BLDG /Owner - Builder Affadavit; REVISED: 4/16/2009
MAP OF BOUNDARY SURVEY
DESCRIPTION:
LOT 3 IN BLOCK 8 OF " OCEAN GROVE UNIT NO. 1 " ACCORDING TO THE PLAT THEREOF
AS RECORDED IN PLAT BOOK 15 PAGE 82 OF THE CURRENT PUBLIC
RECORDS OF DUVAL COUNTY, FLORIDA.
17TH MEET 40' RV?
17' ASPHALT — —
EDGE OF PAVEMENT
WM
95.38' (M) „157.7...F 3 WE
FNO. 4' X .4' 95.00' (P) S. I. R. C. 5/8'
CONCRETE F.I.P. 1/2'J `° LB47261
MONUMENT NO ID -o N CONCR ti
BLOCK
NO I CO ER ORIV '�
/ .. 28.3' ii. lip
/ 2 STORY/ " "d %
^ $ / STORY CC
LOT 2 a C - H ,r t n / /68 /in co "' " � =II a -q, BLOCK 8
F.
O LOT 4
BLOCK 8
I a
O / A/C
• /28.3
0.
Sk
0
28.2' X 1:'S City of Atlan`:c 13
.2' EAST COVERED STAIRS ,'•;'::.. Planning and Zoniig Department
2' NORTH • PATIO 'r
F ENK:E TIES 2 STORMS • ..,;',•:,: :.rte . • .2' WEST
CONCRETE : �y "
PATIO '; 7 � r�� pro Nf�e compliance with apply- ; 'F
r • EMitliPon and other for ::n
l 5" EASEMENT FOR DRAINAG evelhpmer,' reguTtions- 51.7.716s i Ton utute
5' EASEMENT FOR DRAI r" • • 4 f'Jr the isel�3Rc.e pCw?i F `.;�: 2,pkancr
' t■ - icatiL3uagiipg C_de and all 1the ic7ti
F.LP. 1/2' -A N89.1258.w 5ar „yca', lair and Federal permittin re,gl�,rement,
NO ID I u5t 'e ' €rifier.l �i(2signature of t H. ".it‘ ,f .Atiant ` ,
49.83' Meat Buildi fficial prior to the is ::a nce ci f
LOT 19 1 LOT 18 Building Permit. LOT 17
BLOCK 8 I BLOCK 8 BLOCK 8.
APPrawed By , , a
CL mrnunity Gev. lopment Director
Date: 3 —/J
SLMTVEY NOTES:
i1 BEARINGS ARE BASED ON THE PLATS WEST LINE OF LOT 3 IN BLOCK 8
BEING N 00' 00' 00"E (ASSUMED) CERTIFIED TO AND FOR THE
/2 UNDERGROUND UTILITIES FOUNDATIONS OR OTHER N EXCLUSIVE BENEFIT OF:
c.
a
tri
IMPROVEMENTS WERE NOT LOCATED BY THIS SURVEY. OWNERS ASSURANCE TITLE AGENCY. LLC
03 ACCORDING TO THE FEDERAL EMERGENCY MANAGEMENT AGENCY FIRST AMERICAN TITLE INSURANCE COMPANY
1 D FIRM MAP PANEL NO. 120075 0001 D, EFFECTIVE 04-17-89, VYSTAR CREDIT UNION
c THE PROPERTY DESCRIBED HEREON APPEARS TO LIE IN ZONE 'X'. WAYNE A. PARISH 6 KAREN E. PARISH
c 14 THIS SURVEY PERFORMED WITHOUT BENEFIT OF AN ABSTRACT. ADDRESS: 68 17TH STREET
,., TITLE SEARCH! TITLE OPINION OR TITLE INSURANCE. ATLANTIC BEACH, FLORIDA
'" 05 DIMENSIONS ARE SHOWN IN FEET AND DECIMALS THEREOF SCALE: 1" = 30'
D o o r AND ARE PLAT AND MEASURED UNLESS SHOWN OTHERWISE.
v 06 ALL EASEMENTS ARE PER PLAT UNLESS SHOWN OTHERWISE. i ���
NOTICE OF LIABILITY: THIS SURVEY IS CERTIFIED TO THOSE INDIVIDUALS SHOWN ON
THE FACE THEREOF. ANY OTHER USE, BENEFIT OR RELIANCE BY ANY OTHER PARTY IS FLORIDA REGISTERED SURVEYOR AND ER NO. 2546 F`
. STRICTLY PROHIBITED AND RESTRICTED. SURVEYOR IS RESPONSIBLE ONLY TO THOSE ANTHONY P. O'NEIL
CERTIFIED AND HEREBY DISCLAIMS ANY OTHER LIABILITY AND HEREBY RESTRICTS THE FLORIDA REGISTERED SURVEYOR AND MAPPER N0.5684
RIGHTS OF ANY OTHER INDIVIDUAL OR FIRM TO USE THIS SURVEY, WITHOUT EXPRESS NOT VALID WITHOUT THE SIGNATURE 6 THE ORIGINAL RAISED
m WRITTEN CONSENT OF THE SURVEYOR.
0 SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER.
0
X
L F.C.M. - FOUND CONCRETE MONUMENT C.M. - CONCRETE MONUMENT SEC- SECTION FEN - FENCE ONE -OVERHEAD ELECTRIC
F .I. R. C. - FOLMD IRON ROD AND CAP P.T. - POINT OF TANGENCY TMP- TOWNSHIP CLR - CLEAR C.L.F. -CHAIN LINK FENCE
1:.: F.I.R. - FOUND IRON ADD P.C. - POINT OF CURVATURE RGE- RANGE FND - FOUND W.F. -WOOD FENCE
i F.I.P. - FOUND IRON PIPE U.E. - UTITLITY EASEMENT P.I. - POINT OF INTERSECTION ON - PLAT C.B. -CHORO BEARING
L S.I.R.C. - SET IRON ROD AND CAP D.E. - DRAINAGE EASEMENT A/C - AIR CONDITIONING UNIT EL - ELEVATION M.M.- WATER METER
F.N&D - FOUND NAIL AND DISK C & G - CURB & GUTTER NTS - NOT TO SCALE CONC. - CONCRETE M.P. N000 POLE
a 00 - FIELD MEASUREMENT R/M - RIGHT OF NAY (PR) - PROPOSED ESMT - EASEMENT P 6 M - PLAT 6 MEASURED
m (C) - CALCULATED MEASUREMENT C/L - CENTERLINE (E) - EXISTING COR - CORNER M/H MANHOLE
u
1 FIELD SURVEY DATE FIRST COAST LAND \ ( PROJECT INFORMA r'ION 9
PLOT PLAN
iu ORDER NO: 9615
z
BOUNDARY 06 -15 -06 SURVEYING, INC. DRAWN BY: APO
w FORMBOARD 1660 -8 LANE AVENUE SOUTH, JACKSONVILLE, FL. 32210 REVIEWED BY: TNP
L'" FOUNDATION PHONE (904) 779 -2062 FAX (904) 779 -7784
\INAL \_ CERTIFICATE NO. LB 7261
v..4 S .1;f• City of Atlantic Beach
t _
r
Buildin De artment APL4GATION NUMB
f'' 9 p (To be assignedb the Buildin De
J �' > -�
, - -~ � s � 800 Seminole Road ,, n -� F �.-^- ,_ � � 9. pa►tment j
1.-.7' Atlantic Beach, Florida 32233 -544 a` - T 1 -
t .. - - 1� 4 -{F T . - r
Phone (904) 247 -5826 • Fax (904) ,
�,a E -mail: building- dept @coab.us ) 247 -5845 {� 4::7 x"'t' i , . t�.�
City web -site: http: //www.coab.us
APPLICATION REVIEW AND TRACKING FORM
r
Property Address: 110 / 7Th J-7 Department review required Yes No
B "
Applicant: O 47)7 (arming & Zoning
free Administrator
Project: "9//a � 7c 6 , blic Works)
ublic Utili ie
r'u blicafety
Fire Services
^,- yLcSw .tm e. - 3}n .
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: Q ❑Denied.
(Circle one.) Comments:
BUILDING Ott
CANNING & ZONIN ,s - 3- /'/
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: flApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
RECEIVED
sLA City of Atlantic Beach r
/ r � " , Building Department MAY 0 3 2011 , �C TION NUM� ,
(To be assigned ent y the Building Departm V �;
800 Seminole Road {; TfK. `� tom. •f _SiEr} T js
r?, y
° � ::?;'44-17474=:* 7 ' ` ▪ € �
Atlantic Beach, Florida 32233 -5445 BY: i
f � Phone (904) 247 -5826 • Fax (904) 247-5845 h',,t :7
J 9r E -mail: building- dept @coab.us Date`s ▪ r - f
City web -site: http: //www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 00 / 7 r e ¢ L Department review required Yes No
B ..
applicant: L) ")/ tanning & Zonings
_p re inistrator
Projec £; S. -7e . ublic works
ublic Utili ie
r ilb cu Safety
Fire Services
"£" <iC3 .sr
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. Li Denied.
(Circle one.) Comments: /�
BUILDING / / `o /
PLANNING & ZONING y /� ��(� /�/
Reviewed b : Date: //
TREE ADMIN. Second Review: []Approved as revised. ❑D Hied.
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
RECEIVED
r s + 1 4rA City of Atlantic Beach q hC TION NU1<A,BER
Building Department MAY 0 3 2011 (To be assigned 6y the Burldmg Department }
r � .1p 800 Seminole Road t ;�
u• r Atlantic Beach, Florida 32233 -544' BY: 4^ `.'eL° r 7." = a
Phone (904) 247 -5826 • Fax (904 - _ .' 4,, ` ,
. • r ;� )•r E-mail : building- dept @coab.us Date routed yy`i�Sr ' r
City web -site: http: / /www.coab.us _.m_. ._.._, _ __.
APPLICATION REVIEW AND TRACKING FORM
Property Address: La 0 / Aeg i Department review required Yes No
B
applicant: Lr` l l..� I nnin & Zoningj
re inistrator
Project: ( 1)//) vs , . ublic Works
e 'ublic Utili i
vublic afety
Fire Services
17.1 v : eei$' A .i rs r�7i4`�� .; w '^4
t
rl —y • : ' _ ,f.. Sx J • M1n • , . i s rA . ! :Y . .�_.,. r�+y:...
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: ;c y--ii
TREE ADMIN. Second Review: approved as revised. Denied.
P 'OA - omments:
• - ETY Reviewed by: Date:
FIRE SERVICES Third Review: (Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09