The URL can be used to link to this page

Permit Block Wall Fence 333 4th St 2011 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 11-00002844 Date 11/03/11 Property Address . . . . . . 333 4TH ST Application type description RESIDENTIAL OTHER Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 3000 ---------------------------------------------------------------------------- Application desc CONCRETE BLOCK FENCE/WALL IN REAR YARD ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ FOGELTON DANIEL S . OWNER 333 4TH STREET ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . . . 65 . 00 Plan Check Fee 32 . 50 Issue Date . . . . Valuation . . . . 3000 Expiration Date . . 5/01/12 ---------------------------------------------------------------------------- Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONAl ELECTRIC CODE * 1 . Footer inspection required. 2 . vertical steel/down cell inspection required. 3 . Tie-beam inspection required if applicable . * Full right-of-way restoration, including sod, is required. 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 6S . 00 65 . 00 . 00 . 00 Plan Check Total 32 . SO 32 . SO . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 101 . 50 101 . S0 . 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: 3 S-T— /_\1!S , I=L— PermitNumber: Legal Description do 1�loor Area of Sq.Ft. Parcel# Sq*Ft Valuation of Work$ !3", 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/proposed structure(s) (circle one): Commercial Residential If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A Florida Product Approval # For multiple products use product approval form -7 Z- C L\,\Lk Describe in detail the type of work to be performed: Property Owner Information: Name: PA'-�tOL- S F0GL_:-10Aj Address: city A-rL.&-v-j-Mc_ k-�C—Ac_tj StateFI-ZipA-2-7-0 Phone ':-'710-4-—GO2 -S(0 CXZ, E-Mail or Fax# (Optional) Contractor Information: Company Name: Qualifying Agent: Address: —city State Zip Office Phone Fax State Certification/Registration RMEM. —ul FOR eoDE compLumc—E— Architect Name&Phone# I ffW OF ATEAN Engineer's Name &Phone# I TIC BRA SEE PEA-All 1,N FOR AD s :WDInONAL Fee Simple Title Holder Name and Ad]dre n r rk"'I 0"� AND CONDITIONS. 11 Bonding Company Name and Address I L L Mortgage Lender Name and Address REVTFwFnn-v- Application is hereby made 10 obtain a permit to do the work and installationy `0ii-Fte-i. tallation has commence b pribelo t e issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in is 'urisdiction. This permit ecomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a period of sixp�)months at any time after work is commenced I understand that separate permits must be securedfor Electricar Work, mbing, Si ns, Wells, Pools, �urnaces, Boilers, ffeaters, Tanks and Air Conditioners,eta 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 FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. lhere certify that Ihave read and examined this,a plication andknow the same to be true andcorrect. Allprovisions oflaws andordinances governingthis ecj_pd herein type 7Mrk will be complied with whether ie or not. The granting of a permit does not presume to give authority to violate'or cancel the provist.ons of any otherfederal,state, or localsf1w regulating construction or the peiformance of construction. Signature of Owner Signature of Contractor Print Name j>-NVj I aL_ V::E3<:;rL:_IC3Kj Print Name ..............,..................................................................................................................... ......................................................................................................................I.................. Sworr/tgn—d subs'criN. b r Sworn to and subscribed before me lf&A 1% 20 this I Day of this Day of - 20 Notary Public DEIBOW AmANDA wHnE Notary Public MY COMMISSION 0 EF;57349 IL: -I EXPIRES:May 21,2015 Revised 01.26.10 4 Bon h=Pubk underwftrs 7�1-31-7- CITY OF ATLANTIC BEACH (OWNER / 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 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 H11;LE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONS113ILITY 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. 333 4-r'-, ST A P� , FL_ c/4- -6c)-7-S c4) ADDRESS PHONE NUMBER 0�to I-E G L::T-0jl,_) PRINT NAME 1)75 1 SIGNATURE DATE Before me this day of 20Z/in the county of Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations areLtrue W accurate. Notary Public at Large,State of County of 13 Personally Known roduced Identffication- 7_�L r—,2- K3 7 7 5fl 2- �rp DMOPM MMNDA ITE `0 COMMISSION#EE 057349 _F EXPIRES:May 21,2015 e,1 Thru Notary Public Underwriters Notary Signature:,//// :;Ona F/BLDG/0—er-Builder Affadmt;REVISED: 4/16/2009 ---TT ---F R& 4Y L op ;WS R 02 Rl 1 IATe, AL, 5;PL.Ir VA�-S, -------------- IF-11-T I rl FF IJ I I T MAP SHOWING SURVEY OF THE EAST 10 . 0 FEET OF LOT 14 TOGETHER WITH THE WEST 15 . 0 FEET OF LOT 12, BLOCK 6, ATLANTIC BEACH, AS RECORDED IN PLAT BOOK 5 , PAGE 69 OF THE CURREN'.!' PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. 67 0 L Z 13-7' hi 10 /9.3' ,=-0eZ,Q 7,-ot/ ��115- /-5 4 A-Tol-11-12D,4RX' "'/0 1!3k11Zf:>1lv4 7�2V/-'57 '-,'��,-Z54?7-7- i City of Atlantic Beach APPLICATION NUMBER "ss Building Department (To be assigned by the Building Department.) 800 Seminole Road // — Atlantic Beach, Florida 32233-5445 7- 7-- Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: C2 City web-site: http://www.coab.us J1 APPLICATION REVIEW AND TRACKING FORM Property Address: 333 Z//-/-4 DpjZarVient review required Yes,-No (-§6 i lq�,Dd Applicant: X�N� rpra�nning &zon�iag� istrator f ublic Project: eenaz�L A/ C16 Ic— c:-I�u_blic U Public Safety Fire Services Review fee $ Dept Signature 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. E]Denied. (Circle one.) Comments: PLANNING &ZONING Reviewed by: 'zW 51 Date: TREE ADMIN. Second Review: FlApproved as revised. F114/enied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: [:]Approved as revised. nDenied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER Building Department D (To be assigned by the Building Department.) 800 Seminole Road z/--// Nov 0 2 2011 Atlantic Beach, Florida 32233 544 1 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: _�2 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 333 Z//-?, D-ppallpent review required Yes No Applicant: zv_y� r45�_anning & oq:ir*� 'Tr-ee Ad--- istrator Project �f�UbLi 'C�.c Ut ......... Public Safety Fire Services Review fee $ Dept Signature 'A< 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: [�Approvecl. FlDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: D a t e: TREE ADMIN. Second Review: FlApproved as revised. nDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by.- Date: FIRE SERVICES Third Review: DApproved as revised. nDenied. Comments: Reviewed by: Date-. Revised 05/14/09 ��J,J:r City of Atlantic Beach APPLICATION NUMBER Y�C�El V�E U (To be assigned by the Building Department.) Building Department 800 Seminole Road I J �zl/ NOV 0 2 2011 Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)2 t7-5845 Date routed: E-mail: building-dept@coab.us Y: City web-site: http://vvww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Deppg[Mment review required Yes No C-guildiad Applicant: 611111V_Y� r 4 a ran—ni n--g'- -1�z��ol T-re-e Ad'M" Istrator :u b:F Project: /5/"o C/,--- _:ig_� P�ublic UtAaies)' Public Safety Fire Services Review fee $ Dept Signature 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: pproved. FlDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by(,_� D ate: TREE ADMIN. Second Review: E]Approved as revised. OlDenied. WORK omments: P P /C LIC UTILITIES "��PUBL�ICSAF�EY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. RDenied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER FF(Tobe�assigned by the Building Department.) Building Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904)247-5826 - Fax(904)247-5845 Date routed: -Icum)" E-mail: building-dept@coab.us City web-site: http-.//vvww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: D ent review required Yes No Buildi Applicant: 6(16_y� hning &Zoni re-e-Ad-i-J istrator Project: ISZ ubli Tfru—blic Ujuues)' Public Safety Fire Services Review fee $ Dept Signature �2y_ 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 D i v i s i o n,of A,1,c o hn o 11i c Be,-v er a g e S,an,du T o baCC o Other: APPLICATION STATUS Reviewing Department First Review: ;<Approved. FlDenied. (Circle one.) Comments: BU ILDING ,'��LANNING 8&,ZONINC te: 5f Reviewed by: TREE ADMIN. second Review: FlApproved as revised. ElDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: RApproved as revised. DIDenied. Comments: Reviewed by: Date: Revised 05/14/09