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Untitled (4) I hereby certify that I have read and examined this application and attached documentation and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. 1-10Signature of Owner: , 3 Date: AS TO OWNER: Sworn to and subscribed before me this � (l�- day of State of Florida,County of Duval K. CUNNINGHAM Notary's Signature: ,�'''" ` '•. Notary Pubk-State d Fb _ dds "Cpmrrrissioo Expires Feb 28,2010 ❑ Per ovally known Commission►N DD 523638 roduced identification T—L'DL flooded 8 Nations► Ate• Type of identification produced P( . >✓!�P• o i -ate-off Signature of Contractor: Date: AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 Fag: (904)247-5845 • http://www.ei.atlantic-beach.fl.us Page 2 Revised 3/04/04 r� �arfV� CITY OF ATLANTIC BEACH cc: Mt BUILDING ZONING DEPARTMENT D. Ford i Higgns 800 Seminole Road L. L PU Atlantic Beach,Florida 32233 ° (904)247-5800 JjO�rl✓Ty (904)247-5845 Fax www.coab.us PLAN REVIEW COMMENTS Permit Application # ()L0 Property Address: 1 �� D .i W- �-+l f-F- Applicant: Edf-Cr6 41– r Project: -5�Q.i ( -4 ' This permit application has been: &--Approved F-1 Reviewed and the following items need attention: Please re-submit y r a lication when these items have been completed. Reviewed BY: Date: D 3— Z Z�� Date Contractor Notified: f' L�lr CITY OF ATLANTIC BEACH 71 FENCE PERMIT APPLICATION ��JF31> Date: �. y PLEASE SUBMIT(3)COMPLETE SETS OF PLANS WITH APPLICATION. Job Address:_ /5 9 0 , Owner's Name: G L Address: s — �,4 I–IV Phone: Legal Description: Block Number: c Lot Number: Zoning District: Fence Contractor: S T/ A PA AQO MAIL ��. Address: WAIC-61 ,Phone: City: VLA N State: Zip: Fax: Type of fence and materials to be used: / Valuation Of Fence: 4 5P-o N ❑Interior Lot �yJ Corner Lot ❑Dumpster or storage tank enclosure Is approval of Homeowner's Association or other private entity required/? If yes,please submit with this application. Tree Protection: MNO. Applicant certifies that no trees will be removed for the installation of this fence. S. Removal of Protected Trees will be required for this fence. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. Procedure: In order to expedite issuance of permits, please follow all steps and provide all information as appropriate. Incomplete applications may result in delay in issuance of permit. 1. Attach copy of property survey showing location, height and all distances from property lines of the proposed fence. (Fences shall not be placed within any utility or drainage easements without written permission from the Utility and/or Public Works Departments. Fences shall not restrict any private easement.) Address and contact information of person to ' eatt espondence regarding this application(please print). Name: 0 � PARR� 1 V, Mailing Address: Phone: Fax: E-Mail: 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl.us Page I Revised 3/04/04 I hereby certify that I have read and examined this application and attached documentation and know the same to be true and correct. All provisions of the laws and ordinances governing this type of work will be complied with, whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any federal,state or local rules,regulations,ordinances,or laws in any manner,including the governing of construction or the performance of construction of the property. I understand that the issuance of this permit is contingent upon the above information being true and correct and that the plans and supporting data have been or shall be provided as required. Signature of Owner: , 3 Date: AS TO OWNER: Sworn to and subscribed before me this � rl day of � 1 (i� ,20 State of Florida,County of Duval MGWA Notary's Signature: 010Y pub%, ❑ Per onally known �#pp�1 roduced identification �L Type of identification produced ESP• a � -a-�-d-� Signature of Contractor: Date: AS TO CONTRACTOR: Sworn to and subscribed before me this day of ,20 State of Florida,County of Duval Notary's Signature: ❑ Personally known ❑ Produced identification Type of identification produced 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 Fax: (904)247-5845 - http://www.ei.atlantic-beach.fl.us Page 2 Revised 3/04/04 J .s1 .J . : CITY OF ATLANTIC BEACH OWNER/BUILDER AFFIDAVIT Date: Job Address: CHAPTER 489,FLORIDA STATUTES,PART 1 "CONSTRUCTION CONTRACTING"REQU S 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 IWROVE 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. ORDINANCES ALSO ALLOW AN OWNER TO "ROVE THEIR OWN PROPERTY WHEN IT IS FOR PERSONAL OR FAMILY USE, AND LIKEWISE REQUIRE ALL WORK (EXCEPT MAINTENANCE UNDER$2,000)BE UNDER A BUILDING PERMIT AND PASS ALL NORMAL INSPECTIONS. THE ORDINANCE STATES OWNERS MAY PHYSICALLY DO WORK THEMSELVES;OR MAY HIRE UNLICENSED WORKERS PROVIDED SUCH WORKERS BE UNDER"DIRECT SUPERVISION OF THE OWNER, WHO MUST BE ON THE JOB AT ALL TIMES WHILE WORK IS IN PROGRESS BY UNLICENSED TRADES PEOPLE." THIS DOES NOT ALLOW USE OF UNLICENSED CONTRACTORS. SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED UNDER THE HOMEOWNERS INSURANCE POLICY TO CLEARLY PROTECT THE OWNER. 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. UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMI . ~r K CUMN_ www:x� S 0� P TY WNER/BUILD OLP to-519-45_,\9,¢ nOL. ted' SWORN TO AND SUBSCRIBED BEFORE ME THIS��DAY OF rA 6t. Ck 20(XI9 NOTARY P I MY CO N NOTE: PHRASES UNDERLINED ABOVE. AX Part of G_ SURVEY Lot 1 Section�l a SUR . E , O ore particularly described as fora : Township 2 South Ranke 2 east corner of said Section 18 and run youth 0 degrees t Hhe rth- paint of reference, commence at the North- feet along thy, , + , w , ' North- center line of �� .�� ,, "e, as u �3ection f l0 East 1r�1 89 de�Srees t Levy Road, County Road # 222 { being; also along the 49 10 West x to a point ; and thence run North said Levy Ra$d 3� feet to a point in the '�lest right of way line of South line of the lands of`tTis oi;j�qth�4 degrees � �. greea� 23 10 East feet from the. iii - . .... ..:__ ��,,,.R:�,.a-;, � _. 77 pageC7b, of the current public- reeord�l �f�I3uvilaCauntrdecn Dead Por a point of bag nninSf thence run earth degrees C County,, Florida,l a p�+i1Zt thence run `youth 4 degrees ? 'Zpri s 4� lC Joest leC #'set to South 89 degrees ,. East 4 frost to a paint;, thence run r 4W... 4_ 49 to East 120 feet to a Doint � � .. 1ry ii3+ �z*. thenc a run v"orth 0 ds „ T the �t�st right of way line of said T�evy Road to the 20 fest �0 feet along nine, and being a part of the same lands described. inoin or place of �e jn_ Book 10- _ .. d__.re+3arc�e . �-__ , , t+iuis iid Du-" i County, Floridar,LL - "OR— c%RIF l3E8MENTE'R cit �raa a 1`+G"i?LINT)" ROR N'222) a Manning mid Zoning �� --- _ —_ _ This `' provei verifies compoenee Ift zonln subdivision and sthet lecai lsrtd development regu� 8PProval for the issuance of pentiii. -- with Florida Building Code vd ad oft " Wcai, State and Wortsl must be ve"01 �i 61we s#the �Bisach� .. 7 j z } A`Mf - t it ° a a +.+.,• .-++-+;:Lie`..',v�r,rr,wui'..,;,,�,.w�+, .,...,,e. ,,....y.++*.ww'��+w+.r* K' NP NEST &CR ,RaAPD t'i-nEtnery O r3 go Nt r n rn .ae a-snS ra 4d�j ` E 10 �_- !f * r � 1 i �: { I HEREBY CERTIFY THAT I HAVE SURVEYED THE LANDS AS SHOWN IN TAA-BOVECAPTIO'N .y�s!'! ?I�l ! I• ss.. raa.s+Ts sw /^sl} �x.r a A S' E N i,..Tyax�.:,..M&ITr: ''fir �Y��/y 4Jf�}y� j�y�/� 1 07CCC r i7 a�lr Fro,°d nrf SIGNEDSCALERIEGISTEREO sSuRvzro� N SOVTHS109 B/P SERVICE INC. t MtiiEFj.'l h ;d�