Permit Fence 1762 Sea Oats 2011 f -11-A `l,pl . At CITY OF ATLANTIC BEACH
. x ' r ;r 800 SEMINOLE ROAD
.rte} ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
,.
r WO"
Application Number . . . . • 11- 00002231 Date 6/30/11
Property Address 1762 SEA OATS DR
Application type description FENCE PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 2950
Application desc
INSTALL 4' ALUMINUM FENCE
Owner Contractor
FOGARTY MICHAEL & MARLEEN OWNER
1762 SEA OATS DRIVE
ATLANTIC BEACH FL 32233
Permit FENCE PERMIT
Additional desc . .00
Permit Fee . . . 35.00 Plan Check Fee .
Issue Date . . . • Valuation . . . . 0
Expiration Date . . 12/27/11
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.
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 u2 S e (2/ Vje , // 2 Z3
Permit Number:
Legal Description Parcel #
ry . Floor Area of Sq.Ft. Sq.Ft of Work $ v ( ISO 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 approval form
Describe in detail the type of work to be performed: i ,Q, f.un ,u'tv /r.
Property Owner Information:
Nae: , ( '/" / C " (7-1 Address: / 7 6 5 jif
m ,L), 1J49-
City �F /�i `_ ' i ,7-, tate i „p,-.
.
E -Mail or Fax # (Optional) / p Phone 96 V J 5 / Y
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 aperiod of six f6) months at any time after
work is commenced. 1 understand that separate permits must be secured for ElectricalWork, Plumbing, Signs, W ells, Pools, Furnaces, Bo 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.
1 hereb certify that I 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 specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any other federal, state, or local law regulating construction or the performance of construction.
Signature of Owner / � � �I,LC/'LD Signature of Contractor
Print Name /i/C T f4 E4 J • F a rr ',
r Print Name
Sworird subs i d before me Sworn to and subscribed b.for- it
this ( 1 Day of , 20'` �4 this Day of L '° — 20
_
- ,
. C -- z,& - -62 . Public
Y" '” DEBORAH AMANDA WHITE Notary Public
=k_ t r_ MY COMMISSION # EE 057349 Revised 01.26.10
i-� if EXPIRES: May 21, 2015
4,4t, Bonded Thru Notary Public Underwriters
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
HERE 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.
/76 6 a 5 E A e- �, vim. ( r & 1 37, - /
ADDRES5 PHONE NUMBER
Melt/M.4- ftfRh A NC h :/,R -RTY
PRII NAME
r l tJU p 2, D 11
SI NATURE DATE
t
Before me this / day of . , 20 / in the county of
Duval, State of Florida, has persop II appeared herin by himself / herself and affirms that
all statements and declarations af ue and accurate.
Notary Public at Large, State of 7 -6'74-- , County of
Personally Known ✓;, ' • i7 � C� ; / O
Produced Identification, � �- � '� _ �'' DEBORAH AMANDAWHITE
) C . , • # 057349
EXPIRES: May 21, 2015
Notary Signature: ' °— `` 'a ' " Oon MY dedThtuNotCOMMISSION a %Public EE Underwriters
F: BLDG /Owner- Builder Affidavit, REVISED: 4/16/2009
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NOTICE OF COMMENCEMENT
Permit No. Tax Folio No.
State of Florida, County of Duval
THE UNDERSIGNED hereby give notice that the improvement will be made to certain real property in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of property (legal description of� pperry Jnd a�Idres&„if available):
/ 2. General Description of improvements: /� � +
/4_77 �_ 4 ' L /i 2 // ?' 'ice,
Owner Information: a� /, ,�.
GZaL.-�
T \ a) Name and Address: l`. V`- / e-7-Q. -ft r .4_,
�Y ` b) Interest in property: OC-k) le r
c) Name and address of simple titleholder (if other than owner):
4. Contractor Information:
a) Name and Address:
b) Phone Number:
5. Surety Information:
a) Name and Address:
b) Phone Number:
c) Amount of Bond: $
6. Lender Information:
a) Name and Address:
b) Phone Number:
7. Person within the State of Florida designated by owner upon whom notices or other documents may be served as
provided by 713.13 (1)(a) 7, Florida Statutes:
a) Name and Address:
b) Phone Numbers of Designated Person:
8. In addition to himself /herself, Owner designates of to receive
a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes.
a) Name and Address:
b) Phone Number of person or entity designated by owner:
9 Expiration date of Notice of Commencement (The expiration date is one (1) year from the date of Recording unless a
different date is specified:
WARNING T() OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART
I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING
YOUR NOTICE OF COMMENCEMENT.
The foregoing instrument was acknowledged before me this � ' day of , 20
..., ; . a we �� 9 5 • TARP PUBLIC, STATE OF LORIDA
���' su � a"" ' Print Name: �t a (ti( GL GL .
❑ Personally Known
❑ Identification/Type: f =3SS 3 0 /-6 /0
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the
foregoing and that the facts stated in it are true to the best of my knowledge and belief.
- 1
Doc # 20 i 1134470, OR BK 15632 Page 2375, Signature of irerty • • • r -
Number Pages 1 -
Recorded 0617-2011 at 03:36 PM
JIM FULLER CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING $10.00
Revised 10/1/2009
r( T o -.51.-y1) - -).., 1 „ City of Atlantic Beach RE CEIV APPLICATION NUMBER
�' ° ;� Building Department
be assigned by the Building Department.)
NO J 800 Seminole Road JUN 2 0 2011 / -7 2 /
6 T l''' =� Atlantic Beach, Flor 32233 -5445
\
Phone (904) 247 -5826 • Fax (904) 247 - _ /�_ ��
� o , E -mail: building- dept @coab.us Date routed:
✓/ City web -site: http: //www.coab.us A•
APPLICATION REVIEW AND TRACKING FORM
Property Address: / 7 a A . Department review required Yes No
Applicant: ' ' -
rator
1 11141-TnM- "
Project: die // — c'e---- 4 - ub __, • -
u•lic Utilities 1 /
Pubic Safety
Fire Services
f eyia,fe0 $ is ," , iif i ^ 0 D er b -r ? t 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: [Approved. ❑Denied.
(Circle one.) Comments: , n A ,
BUILDING :1"--- p_ (C! //
PLANNING & ZONING Reviewed by: Date: Z /i
y Vto) /
TREE ADMIN. Second Review: Q Approved as revised. El 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
APPLICATION NUMBER
Beach (To be assigned b the Building Department) o tlantic _. 2 2 /
1,; j City of Atlantic
D epartment
,,t-', .. ��,• Building Department
ms `s � mole Road / /
800 Seminole Florida 32233 -55 2 5845 Date routed:
Atlantic e (9 4) 247 -5826 Fax (904)
�.,_/ hnn E -mail: bwlomg-dcptecOab.us
City web -site: http://www.coab.us
TRACKING K
M
APPLICATION REVIEW AND
De • art
ment review re • aired �=
Property Address. �= fanning Zoning --
����� _ _ . , , . rator
Applicant: � � • ►_ � - �,-
Project: _-
eyiew..f $ < .
Review or Receipt Date
Other Agency Review or Permit Required of permit Verified B
Florida Dept. of Environmental Protection MIIIIII IIIIIIIIIIMIIIIIIIMII
Florida Dept. of Transportation IIIIIIIIIIIIIIIIIIINIIIIIII
St. Johns River Water Management District MIIIIIII IIIIIIIIIUIIIIIIIIIIII
Army Corps of Engineers -_
Division of Hotels and Restaurants and Tobacco ■
Division of Alcoholic Beverages
Other:
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑
Denied.
(Circle one.) Comments:
BUILDING
A NNING & ZONING S )
7 -
I
f
, -A. City of Atlantic Beach
'i Building Department APPLICATION NUMBER
R ,,, s ..? ) 800 Seminole Road
�� ? - . `r Atlantic Beach, Florida 32233 -5445 (To be assigned by the Building Department.)
\ . Phone (904) 247 -5826 • Fax (904) 247-5845 Z Z 3 1
'••� v;ti> E -mail: building- dept @coab.us /
City web -site: http: / /www,coab.us Date routed: �o "17 — //
APPLICATION REVIEW AND TRACKING FORM
Property Address: / ) a-4 A . De i artment review required
Applicant: f3uildin• ==
�� anning : Zoning ��
Project: y ���•��3 rator
/Lu. -� r- •c--e_ _-
�_ ' ublic A • 116.7-11 E 11011P —AINIMMEMIPAIII r_
Revie f ''
ee$
Other Agency Review or Permit Required Review or Receipt
Florida Dept. of Environmental Protection of Permit Verified B Date
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:
(Circle one.) Approved. ['Denied.
Comments:
BUILDING
-'\
NNING & ZONING) • (e Reviewed by: _ L / �� Date: Zd�2e(
—213EE ADMIN.
Second Review: DApproved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by:
FIRE SERVICES Third Review: Date:
(Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revise t1\191
City of Atlantic Beach RECEIVED
fr
�= r r Building Department JUN 1 7 2011 APPLICATION NUMBER
800 Seminole Road i (To be assigned by the Building Department)
Atlantic Beach, Florida 32233 -5445 iny: 2 5 /
Phone (904) 247 -5826 • Fax (904) 247 584 =
.! o %• V E -mail: building-dept@coab.us /
City web -site: http: //www.coab.us
Date routed: 6 - /7- - //
APPLICATION REVIEW AND TRACKING FORM
Property Address: / a-4 , Department review p evoew required Yes No
Buildin•
Applicant:
lanning : Zoning
r- - • 'minis rator
Project: AZ1117/1x-i--1—
'ublic • -
u lic Utilities
Public Safety
Fire Services
R VIetn , ee`$fi ;F k ,il t 9 . 4 .
_ � ' u n ° OePs., � tore, � x
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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:
APSPLICATION STATUS
Reviewing Department First Review: pproved.
DDenied.
(Circle one.) Comments:
BUILDING
PLANNING & ZONING a/0
Reviewed by: Date: ea' /l
TREE ADMIN. Second Review: []Approved as revised. ❑Denied.
P .: / • :. o ments:
PUBL S • FETY Reviewed by: Date:
FIRE SERVICES Third Review: [Approved as revised. (Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10