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Permit Fence 500 Plaza 2012 lit CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 I r INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000688 Date 6/05/12 Property Address . . . . . . 500 PLAZA Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1000 ---------------------------------------------------------------------------- Application desc Gft fence ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SANDS REX OWNER 500 PLAZA ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . NEW 61 FENCE REAR YARD Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/02/12 ---------------------------------------------------------------------------- Special Notes and Comments Avoid damage to underground water/sewer utilities . Verif 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. (Approved: Advanced Disposal, Realco, Shapelle ' s and Waste management) ---------------------------------------------------------------------------- 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 ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. akk�tgt;oo) I�klvol .%CJK NP?v BJ'Ali bl" CRY Of Atlantic Beach BUIlding DOPartfnent APPLICATION NUMBER SW Seminole Road (ro be als'siigned by Atlantic Beach, Florida 32233-5445 the Building D"rtmerfl Phone(904)247-5826 - Fax(904)247-5U5 E-mail; building-dept@coab.us C"Y"b-800: WIDIA1,11.1,16.u. EDate routed: APPLICATION REVIEW AN.D TRACKING FORM Property Address: '5�lz ' - �164� De artrngnt rai. Mired Yes No Applicant: Building Project: T AurninfStrator u U lic Safetv F-ire services Other Agency Review or Peffnit Required Review 0 eipt Florida Dept. of Permit Date Florida Dept St.Johns River Water Management District Army Corps Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Mer APPLICATION STATUS ROViewing Department First Review: EIAPProved. (Circle one.) Comments: ElDenied. BUILDING PLANNING&ZONING TREE ADMIN. Second Review: [E]JAp Reviewed by: Date: PUBLIC WORKS Comments: E04 enied. PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: DAPProved as revised. E]Denied. Comments: Rev fewed by: RwIW 07WIlo BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office (904)247-5826 Fax (904)247-5845 Job Address: Legal Description Number: $ oor ea o Pa�rcel q t q. roposed Work hea*t�d/cooled Valuation Of Work �p P roopr o s�ed '�o Erk Class of work(circle f1011-heated/cooled-------- One): New Addition Alteration Repair Move Demolition Pool/spa window/door Use Of�X'�ting/proposed structure(s)(circle one): If an existing structure C Florida Product A I is a fire sprinkler system insta,l ommercial jRes;identia ed?(Circle one): s pproval# es 0 N/A For multiple proaucts use P_To_du`ct_ap­P_rov—aMor—m Describe in detail the type Of work to be Performed: k�o/ V211ST11Y-0--an 'r Infor e ma tion- Name: city Address: ora� State Zi—p E-Mail or Fax (Optional) P. Phone Contractor Informat' ------------ Company Name: Address: Qualifying Agent: Office Phone city Job Site/Contact Number State State Cert'f-lcat'On/Registration# # /-IP Architect Name& Phone# ----------- Engineer's Name& Phone# Fee Simple Title Holder Name and Address Bonding Company Narne and Address Mortgage Lender Name and Address 4PPlication is hereby mad,to qbtain a permit to do I issuance o a Permit an at all ork work and installations as indicated I c�rtify that no wo and void i work is not c01nmen willbeperforme to meet the standards of all laws * work is within six(6) rk or installation has commencedprior to thE commenced I un ers months or ifconstructio regulating constryclion in ndA!r on n or work is sus �dqd or abandonedfor eriodofsix Tanks a iff,11 ers, that separate permi;s must be securedfor fie'ct'r'tc'74 thisJurisdiction. ThisPernzilbecomeS171111 ork,Plumbing,S,,jn. 0 w1dis, Pools, j,)months at aj7V time aftel, urnaces, Boileis, Heaters, WARNING TO OWNER: COMMENCEMENT MAY RE YOUR FAILURE TO RECORD A NOTICE OF SULT 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 NT. y that I ha,,read and examined th a plication and know the same to be true and correct. 411provisionso aws and ordinances governinq this I hereby cert�f COMMENCEME type pf workivill be complied with whether s I'S Provisions ofany otherfedepat state, ?ci Xd' herein or not. The granting of a permit does not presume to give authority 10 violate or to at 4 fl raew regulating struction or the peCfOrmance ofconsruction. or concO the signature of Owne Print Name W Signature Of Contractor ........................................7( .............................................. Print Narne Swor d subscribed Ir re me ..............I........................................... ........................................... this I�Inay of 20 Sworn to and subscribed before Me this — Day of --------120 pub t, 7j��p I Nota BMW nru NoWy PW*UnderWm Revised 0 1.26.10 CITY OF ATLANTIC 11EACH E)WNER / BtUDER AFFIDAWT L FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES PART 'CONSTRUCTION CONTRACTING'REQUIRES OWNER/BUILDER TO ACKNOWLEDGE�HE LAW: DISCLOSURE STATEMENT SECTION 489.103(7),FLORIDA STATUTES- STATE LAW REQ CONTRACTORS UIRES CONSTRUCTION TO LAW. TnEE * YOU HAVE APPLIED FOR A PERNITT UNDE BE DONE By LICENSED Y NEAPTIONALLOWs YOU,AS T R AN E-XEA4PRON TO THAT S OUR OWNr CONTRACTOR EVEN THOUc HE OWNER OF YOUR PROPERTY.TO ACT AS UPERVISE THE CONSTRU _,H YOU DO NO CRON YOURULE YOU MA T HAVE A LICENSE YOU MUST TWO FAMLY 15E_-j� , 11 IE OR A FARM Y BUILD OR IAIPROVE RAPROVE A C OUTBUILDING. OACNAERCIAL BUILDING AT A C YOU MAY ALSO BUILD OR ST BE FOR Yo USE AND OCCUPANCY OST OF$251000.00 OR LESS !g BUILDING IF YOU SELL 0 . IT MAY NOT BE BUILT . T R LEASE A 13UILDING FOR SALE OR LEASE. AFTER THE CONSTRUCTION IS COA4PL YOU HAVE BUILT YOURSELF MTHIN ONE IT FOR SALE OR LEASE, WHICH IS IN ETE, THE LAW WILL PRES YEAR UME THAT YOU BUILT HIRE AN UNL VIOLA-RON OF THIS EXEAvRON. YRYL�MAYNOT _11:1���" UNLICENSED PERSO AS iE DONE ACCORDING To OURCONIRACTOR YOURCONS TRUCT70N MUST YOUR RESPONSIBILITY To U)VES AND ZONING REGULATIONS. IT IS Ep Fj S, ICIENSES REOUIRFT. r A KE SURE THAT PEOPLE _F_11P�LOYED�B Y YOU HAVE V Q �O TE I AW 4ND B Y CQUNTY R Cl NSI AL Ll�ENG 11- INJURY LIABILITY; SINCE OWNERS MAY BE LLIA THE BUILDING DEPARTME_N_T��G��W�T�S'_-�_ FO�R IN��JUR�IE W%B LEU� 0 �V I _Q TO WORKERS THEY HIRE PURCHASED. ORKER'S COMPENSATION INSURANCE B� Ill. IRS WITHHOLDING,-OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHH�LDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKER THEY EMPLOY ON THEIR IMPROVEMENT TRADES. S IV- PENALTY; UNLICENSED CONTRACTORS CANNOT B �� ! :� 1;11 1 9@��PSTAN6ES, OWNERS BEI ll� zi III:l�,� )YED UNDER ANY 1 $5,000 PENALTY UNDER �l 455-228(l). AN'OCCUPATIONAL LICENSE"IS NOT ADE SEE THE Co�.1111`1� 1Y QUA THE OWNER SH' OULD PHYSICALLY l�,ER�'IFICATE OF t_(JT E. CERTIFICAT OMPETENCY" OR THE FLORIDA "CONTRACTORS E" 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 OftER-BUILDER PERMIT. Q-0 2-4 ADDRESS THONE NUMBER DATE A ww A'i6— i V �C'- t A."Y 0.— A 'y A Cc, r'('V'5' r'-e 4? J 7' tr.) 4 A,�.7' CRY Of Atlantic Beach r, Me"and Zoning 7' Thle'approve o A;` 18 M Verifies Gor"Phn",VA zoning, subdivision-a evelo r nd Oth4i 16041 land, development regulations, but does.4W co OPProval for the issuance of permits., notilute with I Flofia Su#dlnq Code and an Compliance ce at, offw applies* Fi local, $tat*and Federal P's"Oftnill Mquirementi must be varilled b&:f i a 0 gn furs Of the CkY Of Aftrft Beach eul�lnq. J*r so BP25OU01 CITY OF ATLANTIC BEACH 6/04/12 Application Tracking Step Selection by Revision 16:46: 14 Application number . . . . : 12 00000688 Address . . . . . . . . . . : 500 PLAZA RE number . . . . . . . . . : 170703-0202- - Application type . . . . . : FENCE PERMIT NCR OLD ACCOUNT NUMBERS . . : AB06133 Tenant name , number . . . . : Type options, press Enter . 2=Change 4--Delete 5=View 6=Fast log 8=Action log maintenance 9=In/out maint Path ---- Key Dates Review Summary - opt Agency description Rev Step Req In Est Cmpl Resulted Stat By PLANNING & ZONING A 01 Y 06/04/12 06/13/12 06/04/12 AP EH PUBLIC UTILITIES A 01 Y 06/04/12 06/13/12 06/04/12 AP DK PUBLIC WORKS A 01 Y 06/04/12 06/13/12 06/04/12 AP LS Bottom F3=Exit F5=Land inquiry F6=Add F7=Revisions F8=Misc info inquiry F9=Corrections report F10=View 2 F11=Sort by agency F24--More keys CITY OF ATLANTIC BEACH V OWNER BUILDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER I 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 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 RAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. I __ - I 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. 0 ADDRESS PHONE NUMBER PR I 4NT M 8 N TURE DATE Before me this day of 2/,I—in the county of Duval,State of Florida,has pe Ily appeared�herin by t Tim—self I herself and affirms that curate. all statements and declaration true and accurate. �e Notary Public at Large,State of County of DEWWAMA"Vff I i: ­pf;�sonally Known MY COMM&"ll EE057349 EXPIRES:May 21,2016 El Produced Identification- Borided Thru Notary Pubk UnIlerwnlers Notary Signet R/BLDG/0�er-Build�Affada�i�REVISED:4/16/2009