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Permit Fence 347 7th St 2011 CITY OF ATLANTIC BEACH S-) 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002803 Date 10/26/11 Property Address . . . . . . 347 7TH ST Application type description FENCE PERMIT Property zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc REPLACE 4FT FENCE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ANDERSON, DAVID OWNER 347 7TH STREET ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit W/W/O FENCE PERMIT Additional desc . . Permit Fee . . . . 70 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . - 4/23/12 ---------------------------------------------------------------------------- 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 70 . 00 70 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 74 . 00 74 . 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: Permit Nu Legal Description 3y -7 Parcel 4 Floor Area of Sq.Ft. Sq*Ft Valuation of Work �oo —Proposed Work heated/cooled non-heated7c*o o� Class of Work(circle one): New Addition Alteration Move Demolition pool/spa window/door Use of existing/proposed structure(s) circle one): Commercial Q ti If an existing structure,is a fire spriler system installed? (Circle one): No N/A Florida Product Approval 4 For multiple products use product approval ro—rm Describe in detail the type of work to be performed: L9 eo (a 6 �e Property Owner Information: Name: d7)4_1.11A L. k,,) �',Izsov Address: 7 7 city 4��11 z f-1 6- /i:Ll -(-A StatefZ=Zip 3,U33-Phone t/,37 " P 7 4 (Optional) ("Lla (It (2&2116--SZ- Avg: E-Mail or ax Contractor Information: Company Narne: Qu��ing AgenFILE COPY Address: —State Zip Office Phone Job Site/Contact r Fax State Certification/Registration 4 Architect Name&Phone# Z Engineer's Name&Phone# I-,,- Fee Simple Title Holder Name and Addres§z Bonding Company Name and Address Mortgage Lender Name and Address En E- Pnov I IL. L UU1 I a n a ermit to do the work and installations as indicated I c tatfation has commencedprior to the 11 be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null a i h 'e ade 0 0" p no rk w' i* wit k pp'c c io' s e by ml h 'ssuan e o a permit an at all wo and voi%_Ok ,not commenced hin six(6)months, or if construction or wor is suspended or abandonedfor aWeriod of six(6)months at any time after is c """ . I u 's t t s k ced nd, tand ha eparate permits must be securedfor Electricar Work,Plumbing,Signs, ells, 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 here certify that I have read and examined this ap§lication and know the same to be true and correct. All provisions of laws and ordinances governing this f 71work will be coTplied with whether s eci ie herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any otherfederal,state, or local aw regulating nstruction or the pe�fbrmance of construction. Signature of Owner I Signature of Contractor Print Name 4, Print Name ......................... ...... ...... ......... Swon an u sc ibed before me Sworn to and subscribei e,Zfe me 4-- this 0 1 this Day of 20 11"L My MIS i DD 957760 Kd'T'�ru Notary Public Underwriters Notary c B Notary Public _11 Revised 0 1.26.10 i T-.- _tA, CITY OF ATLANTIC REACH lift ;VWNER / 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 CONSTRUCT10N TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. TEE 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, WIRCH 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(l). 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. 3 Y-7 7'�t �L 4��4=,ae2,c_ &gig ADDRESS PHONE NUMBER M 4=u L PRINT l'"E 16 SIGNATURE— DATE Before me this day of 20/ I in the county of Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are true and accurate. ­ , C-1 Notary Public at Large,State of county f4Q�—VeLl 0 PerVnally Known dl�Froj.ced Identific.to.- SHIP Notary Signature'. —LELL-GRAHAM MISSIOO DD 957760 FALDG/0�er-Bujlder Affadavit;REVISED: 4116/2009 EXPIRES:February 14 2014 Bonded Thru Notary Public Un�erwritara Will MMWAMW� NG BOUNDARY SRVEY OF MA P SHO'� - i OT 16, BLOCK 9. SUBMVISM" A— LOT 20JOGETHER WITH THE WEST 1/2 OF L 'ATLANTIC BEACH ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 5, PAGE 69, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY1 FLORIDA. LOT 15 LOT 17 LOT 21 LOT 19 CHA INK FENCE 0,4"' RE FENCE 90,18,301, 20.3' 3* LIRE CF who LOT 22 LOT 20 LOT 18 LOT 18 LOT 16 WOOD F14r 3 0.8' 4.3' )L y ty of Atlantic each I TORY Plan ing and n partm 0 This approval verMes corn . 08 wilh Aceb d .347 WIRE FENCE zoning, subdivision enr ther 1 81 I*n development regulations, but oes not f, MIX approval for the issuance of rMits. Co once with Florida Building Code a all other a licable local, State and ede I tong requi Wants must be verified Big Btu the City Atlantic Beach Building icial pri Building Permit Approved By: 0 n1i Date! 93, 06 :01 J 89*4 1'30" 90'18'30" v FND 75.05, 468'*TO a OF EAST COAST DRIVE SEVENTH ( 40 ' R / W ) STREET NOTES. ESTMLISMn IN THE FIELD. WAL J . M."NEY . -ON OONS (FAX ND-j r, FLORIDA. 3a205 VO4w 3197� 6307 1367 CASSAT AVENLAK t .MCKSONVILLL FEDERAL CME017 UW901 MICAAEL DAVEorofty # HERESY 47ERTIFY TO ';"v"-- - -- %4 AND CORRECT MIP"AsILUTATION 9FLAM91 1"U ASMC CAP10"; THAT Mis ku"WaT Is 4 1" 01 V*Q"5m&T AM ACCuIlIATM IM"CaTW9 ?Hff 160"FICM Of ALL 04PROVaMaMll 04 111440 TPAIr 'US SWVEV 049 PRg" a -1110411110 sw&,tile&PW r U,Uj ft bt#Pb1fVIb jUn. AND Vt-At 1,11S SuRvil I offs T j Trif to 9cliduld 111COMICAL ITAMPOWS AN Off IMIMM NY 14111 ft"019 ru"VANI Ito M&CIIA)" 411.UJF IVINVIVA ITATI6119111. CIATIfV 11441 THE ASIOVE LUT SHOWN M9ft94W Kq Told MCIAI. FLUOD 14ARAM110 A141A 1101109 —fL— Ad 810111111111 ON FLU99 INGWRAIICE 44fl 12,)073 . * CtAwry ASA P. LcGt:No AmK Pt Ts AQPHALT r1*C1F a ossc Mt TZ it". Ca"s .'S Firc. CUT. JATZ SICAND. C) jLV tt-i r - a.L.s. -15 APPLICATION NUMBER City of Atlantic Beach PECEIVED Building Department (To be assigned by the Building Department.) 800 Seminole Road OCT 2 0 2011 owi�3 Atlantic Beach, Florida 32233-54*5 Phone(904)247-5826 - Fax(901)..�4775845 t routed: FEDa e E-mail: building-dept@coab.us City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Department review require Yes No Buil":=:!: R anninga 8&,Znnii Applicant: �straG�r Tr strator Project: t4 e A J /1 : gic Util'itie ic Utiliti Public Safety Fire Services 9" IV- 31 0, 0 Other Agency Review or Permit Required Review or Receipf— Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation ns 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: Opproved. []Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by- Date: /-0!::2-0 TREE ADMIN. $9cond Review: FlApproved as revised. F�Denied. 4P*IRKVSomm nts: U I I , / _/ t Reviewed by: Date: PUBLIC SAFETY FIRE SERVICES Third Review: ElApproved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER (To be assigned by the Building Department.) Building Department -)-/ 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 91 E-mail: building-dept@coab.us EMI City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Department review re uired Yes No _26�z�� ST e IQ Al Zanning &Zon' Applicant: Tr strator Project: lic Utilities Public Safety Fire Services 79 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: �KApproved. E:]Denied. (Circle one.) Comments: BUILDING -_�PLANNING &ZONIN Reviewed by::== Date: -]Denied. ___�__T�EE ADMIN. Second Review: F-lApproved as revised. F PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [_�Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 05114/09 City of Atlantic Beach APPLICATION NUMBER (To be assigned by the Building Department.) Building Department 2rd 3 800 Seminole Road tl Atlantic Beach, Florida 32233-5445 - Fax(904)2 1-584EMMCJ 2011 -5826 Phone(904)247 Date routed: E-mail: building-dept@coab.us it City web-site: http://www.coab.us B3 13YW:_ APPLICATION REVIEW AND TRACKING FORM Department review required Yes No Property Address: Buil anning &Zon' Applicant: Tr strator Project: i Utilities Public Safety Fire Services v7 7 N,_'10_'WvkPl�'�. .. ......... R&O X GICIAM Maiwl 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 Othe- APPLICATION STATUS Approved. MIDenied. Reviewing Department First Review Approved. DIDenied. (Circle one.) Comments: BUILDING Date:/0 PLANNING &ZONING Reviewed by: _4�421 A�t� ---------- TREE ADMIN. Second Review: DApproved as revised. []Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [_�Approved as revised. F_�Denied. Comments: Reviewed by: Date: Revised 05114/09