Permit Fence 795 Triton 2012 " * CITY OF ATLANTIC BEACH
ihm
:� t� f 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
12- 00000109 Date 2/02/12
Application Number 795 TRITON RD
Property Address
Application type description FENCE PERMIT
Property Zoning TO BE UPDATED
Application valuation . . • 300
Application desc
replace 6ft fence
Owner Contractor
ALARAS, GODOFREDO A. OWNER
795 TRITON ROAD
ATLANTIC BEACH FL 32233
Permit FENCE PERMIT
Additional desc . .00
Permit Fee . . . • 35.00 Plan Check Fee .
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/31/12
Special Notes and Comments
PER SECTION 24- 157(C)(2): FOR CORNER LOTS LOCATED ON
RIGHTS -OF -WAY THAT ARE WIDER THAN FIFTY (50) FEET, FENCES
MAY BE CONSTRUCTED WITHIN THE SIDE YARD TO A MAXIMUM HEIGHT
OF SIX (6) FEET, PROVIDED THE FENCE IS LOCATED ON PRIVATE
PROPERTY AND NO CLOSER THAN FIFTEEN (15) FEET TO THE STREET
EDGE OF PAVEMENT, OR NO CLOSER THAN FIVE (5) FEET TO
SIDEWALK OR BIKEPATH.
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.
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Fee summary Charged Paid Credited Due
Permit Fee Total 35.00 35.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 35.00 35.00 .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: ( 96 1 To( Permit Number:
Legal Description Parcel #
r a Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ - s 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 /
Describe in detail the type of work to be performed: � !a d £� h ?" - n P
Property Owner Information: •
Name: 2G /J,4 t !�f} 79 £ ft S Address: ri 7G
City 7he StateRZip 3 2-r7-313ibne 094 O 2 c -/
E -Mail or Fax # (Optional) jo
Contractor Information:
Company Name: Qualifying Agent:
Address: City State Zip
Office Phone Job Site/ Contact Number Fax #
State Certification/Registration #
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated 1 certify that no work or installation has commenced prior to the
issuance ofa permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for a_ period of six (6) months at any time after
work is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, 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.
1 hereby certify that I have read and examined this opplication and know the same to be true and correct. All provisions of 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 other federal. state, or local law regulating construction or the performance of construction.
Si ature of Owner • �. • 0� �� 11.. EnVOc CNntractor
t
Print Name . . `., R Print Name
Swo : and subscrib= R befor- e Z Sworn to and subscribed before me
thi !�� Day • i<'s� 20 this Day of , 20
7
Notary ''' c � 1 +t, s. r ►� ��� Notary Public
..■ I MY 0171 # DD 957760
m � galled hmNotaryPub 14, Underwriters
Revised 01.26.10
_ . • i
CITY OF ATLANTIC BEACH
®WNER / BUILDER AFFID
I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION
CONTRACTING" REQUIRES OWNER / BUILDER TO ACKNOWLEDGE THE LAW: i
DISCLOSURE STATEMENT FOR SECTION 489.103(7), FLORIDA STATUT
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.
II. 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.
7 6-- 77-/1-7,-v- /
ADDRESS PHONE NUMBER
DDRESS
PRINT NAME A- Cz4�S
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SIGN RE
DATE
Before me this 4) day of 20 L 2 Th - 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.
Notary Public at Large, State of rt.-- , County of Ir L
I
l�
1'T" Personally Known .•/
L;]; Produced Identification -
<.* P y SHIRLEY L. GRAHAM '
I / � .a� �' MY COMMISSION r; OC 957760
`� » ,,- -- -EXPIRES: February 14, 2014
Notary Signature: �s.`�� A ,q" Bonded Thru Notary Public Underwriters
F:BLDG /Owner - Builder X REVISED: 4/16/2009 '
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Lot 26, Block 13, as shown on the Replat of part of Royal Palms Unit 2A, as recorded in
Plat Book 31, Payes 16. 16A, 1.6F , 16C and 16D of the Current Public Records of Duval
County, Florida.
For: Godof •edo A. Al aras - S W D - Fran .
You' File No. 8612 -A
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City of Atlantic Beach / 0 A l _ L1 G 19A2 / 1/E Ptar n and zoning Department
�vi - rj, City of Atlantic Beach APPLICATION NUMBER
s ` -_ S� Building Department (To be assigned by the Building Department.)
� ,y 800 Seminole Road
2 -- / o S
1 - Atlantic Beach, Florida 32233 -5445
�� • Phone (904) 247 -5826 . Fax (904) 247 -5845 Date routed:
r Dli ls, ? E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 7?$ 7-/-7-747-1 Department review required Yes No
Building - -__
Applicant: .660/7r ( Planning & Zonin ) /
i res"Adrii iistrator
Project: d pJ. -e 617-- f /i eL oyblic_WQrks
C Pubtic _Utilities_
Public Safety
Fire Services
RA p M . , lAgi ' K , : Dept Sigiiatur 4 � . l x * "0 � '3
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. ['Denied.
(Circle one.) Comments:
BUILDING / P NNING & ZONIN Reviewed by: gi Date: �` �7! VI L
MIN. Second Review: Approved as revised. (Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: (Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
s City of Atlantic Beach APPLICATION NUMBER
�i%= 1, �Jri �� (To be assigned by the Building Department.)
sa . ,;. z Building Department 800 Seminole Road -101
2
yr Atlantic Beach, Florida 32233 -5445
�° Phone (904) 247 -5826 • Fax (904) 247 -5845 Date routed:
��
ol35�� E-mail: building-dePt@coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
�
/�
7;:;:Frr-) Department review required Yes No
Property Address: /
Planning &Zoning
Applicant: n -- -= - . or
- 7 - Project: f� , hlir rks
r��l��� 6 l les
Public Safety
Fire Services
Review fee $ l�k Dept Signature
Review or Receipt Date
Other Agency Review or Permit Required 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. n
Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: I-29-12-
TREE :IIIMIN. Second Review: nApproved as revised. nDenied.
p . : , • - Co ments:
■U;: IL -
02
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: 1 'Approved as revised. nDenied.
Comments:
Reviewed by: Date:
Revised 07/27/10
C APPLICATION NUMBER
fS1; City of Atlantic Beach (To be assigned by the Building Department.)
4' �� Building Department JAN 2 7 2012 �
�„.. v 800 Semino Road
a te . , Atlantic Beach, Florida 32233 -5445 1
Phone (904) 247 -5826 • Fax (904) 2 _ 1 Date routed: C �1 ����
"7405110 E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
g ," :71 Department review required Yes No
Property Address: / 7?,( � / /��
(� Planning &Zoning
)
Applicant: l� r t or
i /) 64 yblic_WQrks
Project: / -. II i i ies
Public Safety
Fire Services
Revie4fee $ Dept Signatur" ` ' `v - = s 1 ' `,"
Review or Receipt Date
Other Agency Review or Permit Required 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:
141 Approved. ❑Denied.
(Circle one.) Comments: /43/61 /% BUILDING //
PLANNING & ZONING Reviewed b : / / A % - Dater �) 1 �-
PL Y
TREE ADMIN. Second Review: Approved as revised. ['Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY
Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
i i,