Permit Fence 1334 Main St 2011 � CITY OF ATLANTIC BEACH
1 A $1 800 SEMINOLE ROAD
/ .Z. ATLANTIC BEACH, FL 32233
-;'
INSPECTION PHONE LINE 247 -5814
Application Number . . . . . 11- 00002701 Date 9/30/11
Property Address 1334 MAIN ST
Application type description FENCE PERMIT
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
6FT FENCE REPLACEMENT
Owner Contractor
RADA' OWNER
ATLANTIC BEACH FL 32233
Permit FENCE PERMIT
Additional desc .
Permit Fee . . . . 35.00 Plan Check Fee . . .00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/28/12
Special Notes and Comments
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.
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.
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CITY OF ATLANTIC BEACH
OWNER / 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. 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.
11. 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.
/5554: f - G� —L� - P� NUMBER 67�
ADDRESS
f/9 /
PRINT NAME / 7�
SIGNATURE DATE
Before me this T ay of 20 ( in the county of
Duval, State of F!odda, has personally a ;e - red herin by himself / herself and affirms that
all statements and declarations are true : d accurate.
Notary Public at Large, State of County of •t;''v DEBORAH AMANDA *FE
� ,. !. , MY COMMISSION # EE 057349
El Personally Known • ��� :a: , = EXPIRES: May 21, 2015
.O.Protiuced Identification - 'Jd of Bonded Piro Notary Public Underwriters
Notary Signatu =
F: BLDG / Owner - Builder Affadavit; REVISED: 4/16/2009
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Compliance Investigation Form
Investigation # Date of Request: " 24// Time of Request: M /U ,3'i-
Name of Person Making Re uest: Lc.e
Address: /..31
Phone #
Investigation Type:
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---,,,., Location (Address) of Violation: / 2 /0--A-Z—_,
Phone Number: Property Owner/Manager:
Request Taken by: Investigator: in 9- 16-.//
Action Taken: 44e4 /. 14 /334 ,,,, 5=, SPok -c w , i, p ia( Jo, w !o i 3
ae/1T/ 1S , /'%O/v/ 2c /li, Aovfi "i o r„ . i7ovt pv/liy Q 7PssC [ p !,r / El
�2aU,rr j t t larro9 1 orO/ S5e, 4'C,V , -I; /
Compliance: Qv if 4-4t r p ' —i / -, ' 4; 19 // .1 P 7 Y .
Legal Description: RE #:
F: \Code Enforcement \Compliance Investigation Form.doc Oct 9 2009