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Permit Fence 431 Selva lakes 2011 � �, CITY OF ATLANTIC BEACH ` 1 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002480 Date 8/16/11 Property Address 431 SELVA LAKES CIR Application type description FENCE PERMIT Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc replace 6ft fence Owner Contractor RAINES KENDRA D OWNER 431 SELVA LAKES CIRCLE ATLANTIC BEACH FL 32233 Permit FENCE PERMIT Additional desc . Permit Fee . . . 35.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/12/12 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. 5� City of Atlantic Beach 1 APPLICATION NUMBER a, r 4 Building Department C (To be assigned by the Building Department.) & , :: 800 Seminole Road 1 // — e '''''.;11r.":.:.1;?, Atlantic Beach, Florida 3223 5445 �f /� • / Phone (904) 247 -5826 F= . • ) 24T-5 � I ,, I ` o;t l> '• E -mail: building- dept(coa• P i .• /, Date routed: • // / City web -site: http: //www.coab.us��- APPLICATION REVIEW AN 0 TRACKING FORM Property Address: 43/ � ) /1/A- Z, J L 4 / 4 De . artment review re • uired Yes No Applicant: e 0--a) I°' 4 g / T - - : � 1 inistrator Project: f (1 _- Public Safety • Fire Service i a: ' u .. 4, ;*" ... AO ,i4 Other Agency Review or Permit Required Review or Receipt Date of Permit Verffied 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: X /v /' TREE ADMIN. Second Review: ['Approved as revised. ['Denied. PUB A : - - Comments: PUBLIC UTILITIES AFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ['Denied. Comments: FILE COPY Reviewed by: Date: Revised 07/27110 • S r141 City of Atlantic Beach APPLICATION NUMBER , r ;, - \ Building Department `„ , (To be assigned by the Bwlcfing Department.) 800 Seminole Road 7, '' " Atlantic Beach, Florida 32233 -544 - 4 � } C . > Phone (904) 247 -5826 Fax (904) 2' ; 44/ j1 ' `-- :.�,tfs) % ' i E -mail: building- deptgcoab.us Date routed: , / i / City web -site: http: //www.coab.us -\ APPLICATION REVIEW AND TACKING FORM I, <, (✓ t ' Department review required Yes No Property Address: 4 /-3 ( : / - � ��° A, . ;�: ; �' . ��. , 3uilding °` C: Planning & Zoning Applicant: L� `" k Tree Administrator Project: .! ,i A (' (I j .Public Works t. Public Safety Fire Services r : -baKb, �c - • i 'r"t'r�,, s .sw. � .. . i •; kw u 'yyr .-i 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: proved. ❑Denied. (Circle one.) Comments: BUILDING p / ca 1 PLANNING & ZONING Reviewed by: Date: / .49 TREE ADMIN. Second Review: DApproved as revised. ❑Den' . 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 C J • rS�‘rTr r City of Atlantic Beach APPLICATION NUMBER .-•.\ Building Department (To be assigned by the Building Department.) v 800 Seminole Road '' -f , Atlantic Beach, Florida 32233 -5445 ' '� '' '' Phone (904) 247 -5826 Fax (904) 247 -5845 Date routed: , / 7 ,`-� o,tf >'' E -mail: building- deptQcoab.us City web -site: http: / /www.coab.us APPLICATION REVIEW AND TRACKING FORM a / V 7r Department review required Yes No Property Address: / . ) � °,fit , , , . ti I /" P q Building / Applicant: 1 L )) /=- c Planning & Zoning ✓ Tree Administrator P roject: 1 2 )( (! f 0 r ( bitc Wodcs ,.„ - 0ubfc Utilities 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: 4pproved. ['Denied. (Circle one.) Comments: \\ BUILDING NNING & ZONING / 0� ' hiJ // Reviewed by: ��'�`� Date: REE 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 07127/10 CITY OF ATLANTIC BEACH WNER / BUILDER AFFIDAVIT L 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 Al 1 ER 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. I1. 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; UNUCENSED 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; 1 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. n \ 5&\ c J � . \e Ctts \e ADDRESS PHONE NUMBER PR i � ID )►I SIGNATU E // DATE Before me this / day of � / - ) 2011_ in the county of Duval, State of Florida, has personally ared herin by himself / herse4 and affirms that all statements and declarations are true and accurate. --- Notary Public at Large. State of / L County of r/ , i . C ❑ Personally Known ❑'eroduced Identification - i I � , r / )ice ` " SHIRLEY L. GRAHAM Notary Signature: i — _ „.„..:.15,4`: - Q . MY COMMISSION 4 DD 957760 . 4€ EXPIRES: February 14, 2014 F./BLDG/Owner Affidavit; REVISED: 4/16/2" • ............. . 14""'"""447"'"---;"."--" of ..;,, bonded Thni Notary Public Underwriters . SE1,VA LA!ES UQM1 OWNERS ASSOCIATION REQUEST FOR ARCHITECTURAL APPROVAL This t .. ucst form is to be corer *lewd by the Homeowner and submitted to the (ARC) onor to the commencement of work, DATE RECEIVED BY ARC: THIS SIX T+ION TO 13E COMPLETED ED BY HOMEOWNER Malt si 1 i/ t I ....... _�_ _...____._..____ 'Lot __...__.- t.__ ____..__ __..... ____ . ____ .______.. tvrtrne: __....___.,Kendra I2aitres__,,,..._.._ ..._._._......_ r retail: ___..._..._r'aineskd l l ?t°c tiltoo.ecmr _._. __ Address: __ 431 Selva Lakes Circle_.__.__...._...... _.._._..._....._..._.. Home Phonic' _$60-9393 •_._--__ ____ . _.___..____ Other Phone: _.__. _____ _.._._____....__.__ ...... ___ Contractor — __.___ D once approved _ __- .___._____._. ___._.__ _.—___ �__ _ .... ______ -_. Describe the work to be done. ti,e. screen room. addition, fence. gage door. siding. outdoor tights. exterior painting roof repairs/replacement, gutters. etc r t w Plan 1. Tree, Driveway and Front Sidewalk „oX t F ' 8 o v`' 1,1 Remove tree by driveway as it is cracking the stab - replace with A palm tree , 3, 1.2 Expand drive way 3 feet to the tight 'r- AO Q t '� X ,,�� ��' l3' 1.3 Reshape and pour new 36 inch wide sidewalk to front door -- a` K 1 /r't Plan 2 -- Remove Trees and replace 2 1 Remove two Oak trees in front side yard and replace with Drake Elm Trees because � 1 ak trees da not lose all their leaves in the winter and will eventually] kill the grass. /-I i Plan 3 Backyard Patio c4-ti AP' d, 3 1 Replace existing patio with new concrete and extend patio to a total of 18 feet from back wa��'�oclP 3 2 Add 36 inch wide sidewalk from front door around the side of the house to the h ck patio e y 6 Plan 4 - Fence eifrn.tiek 4 1 Replace existing 3' fence with lattice topper on street side with a 5' fence with lattice topper ri. �- -�vvf 4.2 Remove shrubs on the outside fence along street and replace with fruit trees and berry bushes Location Attach a copy of your sure) indicating the location of the work to be done.. 1 / 1 C 0 t Describe Location _._ Driveway. sidewalk and patio_ _.__ . ___ _ _ __—___..- __ Specifications: Attach a copy of the plans. drawing.. picture. specifications t indict color. etc) All extcnor paint Must meet SLA specifications. Purchase at Duval Paint and Hardware. ? Si. South, Jacksonville Beach. Reference Selva Lakes standard. Estimated date of completion: 7/31/ I f._.._ _......._....__._._.._ _....... ..- .__ -_. NOTE: Owners are responsible for the conduct of the contractor. You are requited to supervise the work being done. Yon are personally responsible and liable for any damage done to common properly or adjacent propert) When required by the City of Atlantic Bead!. you are required..to pro%ide the ARC with a copy of the building permit. �+ Dare. Homeowners Signature: --- ---- _-- ._.___....._ Date Approved , .. • i � :_L(_____... 0a1e Denied ___. • _._..__-._...v ........_._.._ �� �'' ' ? AR(' Signatur'�si' - - ---�- � Y� � � � '” : �, ....------ ,._..__._.__._. r Comments or conditions: Mail form to Selva Lakes Homeowners Association. Inc. , P.O. Box 331365, Atlantic Beach. FL 32233 Email .. for questions or comments BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: yip/ fe / ✓a 4 A, G;tc e . Permit Number: Legal Description Parcel # _` Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ 6' 0 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 structures) (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 app roval I orm a Describe in detail the type of work to be pe formed: t✓e.) , I4c. ( feid /&c i •J & • e• Property Owner Information: / Name: /r ✓.f // 1. Awe./ Address: / fe / ✓G hies C; PGle City ie.. CA Statef/Zip XXAX3 Phone E -Mai or Fax # (Optional) 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. 1 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 6) months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, F urnaces, 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. 1 hereby certify that 1 have read and examined thisplication and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether speci ied 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 1. -` lating construction or the performance of construction. Signature of Owner Signature of Contractor Print Name Print Name Sworn to and subscr Ibgd before me Sworn to and subscribed before me this , : ay of c ? t °. 1 , 20 / 1 this Day of , 20 Notary 'u. IC 4.,K.W.. ` ' Notary Public ,.=*:. .. + MY COMMISSION k DD 957760 r i.- EXPIRES. Febn.lary 14, 2014 ,5.:% '� R • ��`''' " 6ondea Tofu Notary �: Diic ilnderwriters Revised 01.26.10 PM w i§ n m N 1 m 1 >XI 7, 11 D 0 D m m m V N Fri r o rr O O N • m m A frl • to O OD Z y m zm 0 �R� • d i -r 1 • Q v 4, m ; .°. � Z•p . ':� CU ° v dab • e (p Z Z p Li ■4 c) i, ►� X1.0 A D C v .. xi ° _ 8 r m (7 2.0' 2.0' C e- s • 4 s . z - O c • i O (TI C ° D m •• ° , trl (4 4 511 8 Uir m • � � .. Z .---. X \ e 1.0' 20.2' I ci �, g v XI ti. O v -' a *NC . 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