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
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Application desc
REPLACE 4FT FENCE
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Owner Contractor
------------------------ ------------------------
ANDERSON, DAVID OWNER
347 7TH STREET
ATLANTIC BEACH FL 32233
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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
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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 .
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Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
STATE DBPR SURCHARGE 2 . 00
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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.
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# HERESY 47ERTIFY TO ';"v"-- - --
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THAT Mis ku"WaT Is 4 1" 01
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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