Permit Fence 890 Orchid 2011 CITY OF ATLANTIC BEACH
I s\
800 SEMINOLE ROAD
J ti 4 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002577 Date 9/08/11
Property Address 890 ORCHID ST
Application type description FENCE PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
REPLACE FENCE
Owner Contractor
FOURAKER HERBERT C OWNER
POST OFFICE BOX 50528
JAX BEACH FL 32240
Permit FENCE PERMIT
Additional desc .
Permit Fee . . . 35.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 3/06/12
Special Notes and Comments
SECTION 24- 157(c): For corner lots located on
right -of -ways that are 50 -feet or less in width, no fence,
wall or landscaping exceeding four (4) feet in height,
shall be allowed within ten (10) feet of any lot line which
abuts a street.
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.
0.m City of Atlantic Beach-- APPLICATION NUMBER
\ s� Building Department _� (To be assigned by the Building Department.)
800 Seminole Road /
a , 1 Atlantic Beach, Florida 32233 -5445 ' 7 an 1 i •' S/,
Phone (904) 247 -5826 • Fax (904) 247 -5845 ,+�
r j t sN E -mail: building- dept @coab.us =..— ____ Date routed: v�
City web -site: http: / /www.coab.us -" ~-°•--
APPLICATION REVIEW AND TRACKING FORM
Property Address:
O %2 &( de cP. De • artment review re • uired Yes No
Buildin•
Applicant: - Y - S - z , ti, t — C7 Mill
Tree Administrator _-
.r. ublic ' tm� I/--
ublic Safety _-
Fire Services _-
7 4' , i pr r'""�, nz o t a' ' k7I s ' '@ F. �:ry
is r u, �
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: ://ft/L___
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 07/27/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: s q 0 0/1-c14-,b Permit Number: f' ( '' Z 91 1
Legal Description Parcel #
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ (j 00 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 /pro osed structure(s) ( one): Commercial Residenti.
If an existing structure, is a fire sprinkler system installed? (Circle one • - No N /A
Florida Product Approval #
For multiple products use product approval form
■
Describe in detail the type of work to be performed: Ef t.AC_ 4— C.
P - 3 3or
Property Owner Information:
Name: P Q.=RT C. f" �c�ltP�+�(�� !'- Address: �ct0 D/L C. ' D S �
Cit State Zip Phone
E -Mail or Fax # (Optional)
Contractor Information:
Company Name: 6 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 a period of six (6) months at any time after
work is commenced. I understand that separate permits must be secured for Electrical iFork, Plumbing, Signs, Wells, Pools, 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.
I hereby certify that I have read and exa ined this a plicat' nd know the sa a to be true and correct. All provisions of laws and ordinances governing this
type of work will be compile, with w ether s'e erein or not. The grinting of a permit does not presume to give authority to violate or cancel the
provisions of any other fed • or lo .l w regulating construction o the performance of construction.
Signature of Owner I ' �/ a . / /1/ Signature of Contractor
Print Name} T C . i u.f' 07 Print Name
Sworv�tc n• subscribed b-f ►e m:' Sworn to and subscribed before me
this t- a of w Af 20 /7 this Day of , 20
Notary Public , .
M ' 'c ISSION # 057' May Notary Public
EXPIRES: Y 21,2015
er O��dThnoNdary pubticUnde Revised 01.26.10
r'
CITY OF ATLANTIC BEACH
IJ: WRYER / 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
HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. 1T IS
YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STAI LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
9. 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.
tq ei ,
,�.f 3— 33vk
ADDRESS PHONE NUMBER
/) /�
PRINT N • `� � / � l/
/ � ATE
A SIGNA U' E
Before me this day of 11./.1 20 / / in the county of
Duval, State of lorida, has personally -ared rin by himself / herself and affirms that
all statements and declarations are tr i =nd acc ate.
Notary Public at Large, State of of County of �y-
❑ Personally Known p f 2� 3 .� ✓ 339,
. It• DArts
produced Identification - C .• / w rte' � '?c� �y CQMM SSI N EE 657349
~'' � '' EXPIRES: May ION 21,20
ers
4141 � ' ` Oonded Ttuu NafalY publk UndetwlR
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Notary Signatu
F:/BLDG /Owner - Builder Affidavit; REVISED: 4/16/2009
Jul 1311 07:56a p.1
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BP250U01 CITY OF ATLANTIC BEACH 9/08/11
Application Tracking Step Selection by Revision 14:52:27
Application number . . . : 11 00002577
Address : 890 ORCHID ST
RE number : - - -
Application type : FENCE PERMIT
NCR OLD ACCOUNT NUMBERS . : AB12211
Tenant name, number . . . :
Type options, press Enter.
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Path - - -- Key Dates - -- - Action Summary -
Opt Agency description Rev A 0 1 Req 09/06/11 09/1 09/06/11 A P Type By
_ PUBLIC UTILITIES A 01 Y 09/08/11 09/13/11 09/08/11 AP LS
PUBLIC WORKS A 01 Y 09/08/11 09/13/11 09/08/11 AP LS
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