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Permit 1708 W Park Ter Fence 2011 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD j ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002234 Date 6/28/11 Property Address . . . . . . 1708 W PARK TER Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Oft fence around shower ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MITRICK, JOE OWNER ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/25/11 ---------------------------------------------------------------------------- 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. CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT 1. 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. ADDRESS PHONE NUMBE RINT N SI NAT E DATE efo me this v`' y of - 2Q//!/ in the county of al,State of Florida,has per n Ily appeared herin by himself/herself and affirms that all statements and declaration true and accurate. FILE COPY Notary Public at Large,State of County of El Personally Known �, �}Produced Identifi ion- y. ota� Ac ISSION EEp 057349 'I 4/16/2009 f; F:,�1lIdEYdC7G89rC �SE Ic ndehvflfBrs BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 7 �GI/�� /� � (� Wooj 1 Permit Number: Legal Description Parcel# Floor Area of Sq.Ft. Sq. t Valuation of Work S 7U 3 Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s) (circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval# For multiple products use product approva orm Describe in detail the type of work to be performed: X y � I en'1 br xi id, rf? t Property Owner Information: Name: i'yl t''�'1r r C�C-- Address: I�7 City v� I CR' State 'C-Zip, "hone E-Mail or Fax# (Optional) ZEMi j1A J-EX A. ;,vl ZIA=& 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 arhd in 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 aperhod 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 hereby certify that I have read and examined this a lication an ow the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether speci ted erein not. The granting a permit does not presume to give authority to violate or cancel the provisions of any other fe tate, or local law re tin onstruc 'on or the per mance of construction. Signature of Owner Signature of Contractor Print Namef Y� L<< Print Name Swo subscri ed fore meSworn to and subscribed before me this ay of --'`'� 20 this Day of 120 Notary Public ,ti:r" DEBORAH AMANDA*M Notary Public 100 COMMISSION 4 El 057349 EXPIRES:May 21,2015 Revised 01.26.10 Bonded Thru Notary Public Underwv te- � w oo(C) I e1i�1�!InJ d m 1°..W-mtl"]do �- f .. "—ia7 V' r 1 giaq-s �� Mai City of Atlantic Beach APPLICATION NUMBER J r r'• 1 Building Department (To be assigned by the Building Dep rtynent.) a 800 Seminole Road it SFr Atlantic Beach, Florida 32233-5445 f 1 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: 0 Ll City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: !`!/ 0 �,'41Z Department review required Yes No Buildin Applicant: - Z tanning &Zoni Trwe"Maministrator Project: j 46 ,0jt--)7d ublic Wor '/ Public Utilities IL — Public Safety Fire Services Review fee$ `Lt `� Depiga#are Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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 ll / /Q PLAN NING &ZONIN Reviewed by:: 4�� Date: OhI�o�I TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10 VF City of Atlantic BeachC' r APPLICATION NUMBER Building DepartmentX011 9LJUN (To be assigned by the Building Department.) r � 800 Seminole Road �� Atlantic Beach, Florida 32233-544 �, 7,13 Phone(904)247-5826 • Fax(904 Olt S)" E-mail: building-dept@coab.us Date routed: C City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ;` �� a �' 7,1-11,1146- Department review required Yes No Buildin Applicant: -dPtanning &Zon ree Administrator Project: r Q,t77,d ublic Wo <--Public Utilities Public Safety Fire Services Review fed$rfill ep >Ig�tuer µ f Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: Approved. []Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b . Date: d TREE ADMIN. Second Review• A roved as revised. . ❑ pp ❑Denied. OPUBLO KS omments: T IT SAFETY/ Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/10 City of Atlantic Beach ��cF1VEI i r J� BuildingDepartment i APPLICATION NUMBER P (To be assigned b the Building Department.) 800 Seminole Road JUN 2 0 2011 Atlantic Beach, Florida 32233-5445 / Phone(904)247-5826 • Fax(904)24V$ 145 tt �o;;ipE-mail: building-dept@coab.us = =f Date routed: C 41/ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ,` � (� �� ,� Department review required Yes No Buildin Applicant: tanning&Zon ree ministrator Project: r (4 ',4A77I,d ublic Wor ublic Utilities Public Safety Fire Services ( eviev�r fed$ rPmu, e { Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B 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: 241 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 07/27110