Permit Fence 76 17th St 2011 "we, , CITY OF ATLANTIC BEACH
A 800 SEMINOLE ROAD
= ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
l' iJ1319 t?
Application Number 11- 00002003 Date 5/09/11
Property Address 76 17TH ST
Application type description FENCE PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
INSTALL 6' WOOD FENCE
Owner Contractor
DAI XIAO -QIONG JLS BUILDERS LLC
P 0 BOX 2899 144 AZALEA POINT DR S
DURHAM NC 27715 PONTE VEDRA BCH FL 32082
(904) 881 -8952
Permit FENCE PERMIT
Additional desc . 6' WOOD FENCE
Permit Fee . . . 35.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 11/05/11
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.
;EMINOLE BEACH ROAD
100' RIGHT OF WAY (PAVED)
INE OF PAVEMENT
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� i,.Ly;,, , City of Atlantic Beach a / P LING TION; NUMB
44s , t B u ilding Department Q ' (To be assig by the Building Departmen ]
# i tea} -7. r f i a .
v 800 Seminole Road �� r -,-,.,i_;.
. .�> t �, EIVEI� k 4� „�
= C I:74 "j",''� ' ,
• ; Atlantic Beach Florida 32233 - 5445 4 � _ ,., ;
�� Phone (904) 247 -5826 • Fax (904) 247-5 845 t 4 K - t fir” . s '' 1 Ka , ;
APR 2 $ 20 11 T '` Date routed . n �" `r
- "-- a,3 yr E -mail: building- dept @coab.us 1' i.._ m .4a: -�-,:. =4: ., . , �r a "` T_ . {
City web -site: http: / /www.coab.us
BY:
APPLICATION REVIEW AND TRACKING FORM
Property Address: / t' /7 P ST Department review required Yes No
B
Applicant:
JL S i / d S _ansling &
/ Tre- s • inistrator
Project: A0/ 6., e - h e l.0 r rub!' • • .
Utili
Public Safety
Fire Services
'" .,' -+.,v — - ,-#1. , : • §T'�'�` .aP'' �� , R TM D`e • F'S N , f „ mow, tl f+a ,. , z �' , „ A
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: rii!Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
Al
PLANNING & ZONING Reviewed by: „ /�� Date: f 3 //
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 :" �; }, M10, .1.. , -� TION NIJIIABER ,
� r b � '
js Building Department (To beassignedb the Building Departm
a fS1 r } i VE k , T r � '�£ - Y
r�
800 Seminole Road '
Atlantic Beach, Florida 32233 - 5445 04 ? F h
• Phone (904) 247 -5826 • Fax (904) 247 -5E45 APR 2
8 20�� __ � s
E -mail: building- dept@coab.us Data rbtited w - , '"'"g . .` 4 r ' F
City web -site: http: //www.coab.us BY; . ` _�
APPLICATION REVIEW AND TRACKING FORM
Property Address: 71:o /7 Sr Department review required Yes No
J Buil •
Applicant: c� s ili/ de e s annin &
Tre- : • inistrator
Project: ,V /ft� z frhe ( j O r r' ubf • • 1.
Utili
Public Safety
Fire Services
" ::xn } k - 4 4 1 ;i g4, F t t'M-� <r t 1 '. r t r ' °x.
evtew el$ : t D t 4 SI 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: pproved. ['Denied.
(Circle one.) Comments:
BUILDING /,
PLANNING & ZONING Reviewed by: Date: y�2/4/
TREE ADMIN. Second Review:
nApproved as revised. ['Denied.
PUry WOR S Comments:
P1 /
" BL ILITI S
--2
PUB IC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. (Denied.
Comments:
Reviewed by: Date:
Zevised 05114(09
syvi,- City of Atlantic Beach Z• T ',APP(- CATION
Building Department NUMBER �,
� "; ZO1 ��. be # a ned�6 Buildin'�De ailment 4
L
Y �.> 800 Seminole Road ' + k .41 M -P : } 4
j� Atlantic Beach, Florida 32233 - 5445 4 x`ir* ' F • a
Phone (904) 247 - 5826 Fax (904) 247 - 5845 ° T i- s
1)r . E -mail: building- dept@coab.us Date, routed ..
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 7& /7 Department review required Yes No
i Buig
Applicant: c� mac' i d i e S an
Tree Administrator
Project: -1 Ze Cal r e ubli ..
Utilit
Public Safety
Fire Services
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: DApproved. EDenied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by: Date:
TREE ADMIN. Second Review: DApproved 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:
2evised 05114(09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
lob Address: "2 2- 1 ? G i71 1, -(4 A.9- Permit Number:
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.k t
Valuation of Work $ ISr Proposed Work heated /cooled non- heated/cooled
y
:lass of Work (circle one): N ew Addition Alteration. Repair Move Demolition pool/spa window /door
Jse of existing /proposed structure(s) (circle one): Commercial si ddentii
fan existing structure, is a fire sprinkler system installed? (Circle one): eY s o, N /A
lorida Product Approval #
C or multiple products use product approva form _
)escribe in detail the type of work to be performed: -r="--)A- -� 714 t Al t A./c c: . /'4i( , . Lc
'roperty Owner Information:
Tame: .b v,.A A ; Address: 2 s 2; ;.`,, v_
'ity A ,k C , v n, ; if, State , CtZip > .2.2-1 Phone f ? '1? -' ?1 zs'"
,Mail or Fax # (Optional) :%,, z i 2- A r i r
'ontractor Information:
an Name: T C d -i 4.. b r _ L __ .__ in Agent: J64,6-1..,,i c. /-( r'? cz e`A?.._
P y c Qualifying g g
'om
.ddress: i7Y z:a ti -:.,7 612 • City A , 7 ic. ViThet el State 1 Zip 3 Z.,- fz--
fffice Phone Job Site/ Contact Number 5,8i- 8V S' ?.._ Fax #
tate Certification/Registration # C. (� C is i t.6' L 3
rchitect Name & Phone #
ngineer's Name & Phone #
m Simple Title Holder Name and Address
onding Company Name and Address
[ortgage Lender Name and Address
)placation 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
uance 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 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
irk is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, 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 INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR. NOTICE OF
COMMENCEMENT.
ereby certify that I have read and examined this a placatio and know the same to be true and correct. All provisions of laws and ordinances governing this
re of work will be complied with whether specij e n d herein or not. The granting of a permit does not presume to give a . hori to violate or cancel the
)visions of any other federal, state, or local law regulating construction or the performance of construction.
----/ ,,, )I
g ature of Owner ./1..._.. ,..i%, . Signature of Contractor
int Name .,a rs; D A :Z Print Name j E 'Z_ r -4 v , . ,.-t .Z° e i
/o,. lt ' and subs ribed k efore me Swo rs'`;,nd�SYtbscric f
a
p d be�+�. ma r '
s,..,k(' �4a ay . ); t, t , 20 thi � ! o f ..�,,,,e.i 20
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)ta Public / 01 P °ai. JODY HART ;��� . s : t° t 6 — \ # R7 957760
,_ " c * MY COMMISSION # DD 965977 %. .�. S PIRES: f eb u;,,l i 4 ?014
Y _ • 4 Bonded Thru Notary Pubic Underwriters ' evised 01.26.10
s °> EXPIRES: June 26, 2014 *
• j 4 v o , Bonded Thru Budget Notary Services