540 Sailfish Dr fence 2012 CIT OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
1................
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-1)0000914 Date 7/26/12
Property Address . . . . . . 540 SAILFISH DR
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO ]BE UPDATED
Application valuation . . . . 0 --------------
--------------------------------------- ----------------------
Application desc
6ft fence
------------------------------------
Owner Contractor
------------------------
------------------------
BAC HOMES LOANS SERVICING LP OWNER
% COUNTRYWIDE HOMES LOANS INC
7105 CORPORATE DR
PLANO TX 75024
--------------------------------------- -------------------------------------
Permit . . . . . . FENCE PERMIT
Additional desc - - . 00
Permit Fee . . . . 35 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/22/13 ---------------
--------------------------------------------------------------
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 .
Remain clear of easement .
An 811 sewer main is located in the easement along the south
property line . Avoid damage to 5ewer main.
Roll off container company, if u3ed, must be on City
approved list and container compiny cannot be placed on
City right-of-way. (Approved: Alvanced Disposal, Realco,
Shappelle ' 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 0, ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach
Planning and Zoning Department
This appreval vedfts compffence with applicable
zoning, subdivision and other local land
development regulations, but does not constitute
approval for the Issuance of permits. Compliance
with Florida Building Code and all other applicable
local, State and Federal permitting requirements
must be verified by signature of the City of Atlantic
1: Beach Building Official prior to the issuance of a
Building Permit.
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Approved By:
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City of Atlantic Beach APPLICATION NUMBER
Building Department (ro be assOied by the Building Departmert.)
800 Seminole Road
Atlantic Beach,Flonda 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
2-
E-mail: building-dept@wab.us DaterouW: 2 ZI?
CHyweb-sNa: hft!/A~.coab.us
APPLICATION REVIEW ANP TRACKING FORM
Property Address: c�) 40 SA41tiSh 10r— Department review required Yes No
A4"rxJ---- -
Applicant: Lo Planning&Zonin-gb
79"aml ffv�- r
TWS to
Project: 1"Public Woik&--%
�;;Polic Utiliff
c�f—e ty
Fire Services
R view or Receipt
arm=
it Ver:
Other Agency Review or Permit Required 0 Date
of ormit 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
Revisiwing Department First Review: OkIp"Proved. []Denied.
(Circle one.) Comments:
BUILDING
��NNING&ZONING Reviewed y: Date: 671,,112.-'
0,
TREE ADMIN. Second Review: DApproved as revis . DDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as revised. []Denied.
Comments:
Reviewed by:_ Date:
Revised 07127110
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: .5ko Permit Number:
Legal Description Parcel#
Floor Area of Sq. t. Sq.Ft
Valuation of Work S Proposed Work heatedicooled 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 sprin=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:
Property Owner Information:
Name: h1i /�N-, Address-
city JIV, St�iq)!��(ZiP3
ki��&hone
E-Mail Sr!Fax# (6p-tio n-al
Contractor Information:
Company Name: Quali��*A`Agent:
Address: Ci Zip
Office Phone Job Sit x#
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
Z
A
isp ca e e ade b a n a erm* to do the work and installation s indi te I certify that ork or installation has commencedprior to the
a
-in 1 1.1 N,
11 a 'on tru t'
11 Vrf r. to sZ
0 0 P elf ed 11 la s regulating construch n thisjurisdiction. This permit becomes null
k pe�ormed to meet the standa o all la
all 0_ - 't�rk is - 'ba doned
7 d thin six(6)months, or if construction or work is uspended or abandoned a period of sixP6)months at any time after
s P' c'io s h r r by md h
ua" eo a e mit a at
and d Pk s ot coin e
i or in
k s . r t t rl I S
Z e ed nde ta d ha eparate permits in�st be securedfor Elect ar Work, Plummbing, igns, Wells, Pools, urnaces, Boileis, Heaters,
Tanks andAir Conditioners,etc.
WARNING TO OWNER: YOUR FAILU TO RECORD A NOTICE OF
YO
COMMENCEMENT MAY RESULT IN �UR P YING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO 0 TAIN FINANCING, CONSULT WITH
I
YOUR LENDER OR AN ATTORNEY BEFO)tE RECORDING YOUR NOTICE OF
COMMENCE ENT.
I hereby certify that I have read and examined this application and know the some to N!true and correct. Allprovisions of laws and ordinances governing this
-1�work will be complied with whether specified herein or not. The granting q(a permit does not presume to give authority to violate or cancel the
provisions ofany otherfederal,state, or local law regulating construction or the pe�foi mance of construction.
ignature of Owner Signature of Contractor
S I
Print Name At-Ai. Ptint Name
.. ............. ............................................................................... .........................................................................................................................................
SwvAliltb-an -subscr
,��rere Sworn to and subscribed before me
20 this —Day of 20
I ".GRAHAM —]
Tq�obli Notary Public
EXPIRES:February 14,2014
AF
Bonded Thru Notary Public Underwriters
Revised 01.26.10
CITY OF ATLANTIC BEACH
OWNER / BUILDERAFF11DAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA 33TATUTES, PART 1 "CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNC NLEDGE THE LAW'
DISCLOSURE STATEMENT FOR SECTION 489.103(7),F ORIDA STATUTES:
STATE LAW REQUIRES CONSTRUCTIO�- TO BE DONE BY LICENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERM�T UNDER AN EXEMPTION TO THAT
LAW. THE EXEMPTION ALLOWS YOU,AS THE OW ER OF YOUR PROPERTY.TO ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
SUPERVISE THE CONSTRUCTI YOURSELF. YOU N LAY 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 01 $25,000-00 OR LESS. THE BUILDING
MUST BE FOR YOUR USE AND OCCUPANCY. IT MAi NOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE B JILT YOURSELF WITHIN ONE YEA-R
AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WELL pRESUME THAT YOU BUILT
IT FOR SALE OR LEASE. WHICH IS IN VIOLATION THIS EXEMPTION. YOU MAY NOT
HIRE AN UNLICENSED PERS AS YOUR CONTRA JOI YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS- IT IS
YOUR RESPONSIBILITY TO MAKE SURE THAT FEOPLE EMPLOYED BY YOU HAVE
LICENSES REQUIRED BY STATE LAW AND BY OUNTY OR MUNICIP L LICENSING
ORDINANCES.
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE �:OR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
ill. IRS WITHHOLDING; OWNERS HIRING WORKERS B COME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 �EQUIREMENTS ON THE WORKERS THEY
EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY; UNLICENSED CONTRACTORS C qNOT BE EMPLOYED. UNDER ANY
CIRCUMSTANCES. OWNERS BEING SUBJECT TO$5,00( PENALTY UNDER FLORIDA STATUTE NO.
455-228(l). AN-OCCUPATIONAL LICENSE" IS NOT ADE UATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA 'CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826)IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE TF AT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
q6 0, 24q,5--32-5.
ADDRE$S1 �HONE NUMBER
H33i�>, ,q I D r,aw
PRINT NAME
DATE
79WTUFRE
Before me this day of 20 );?ffthe county pf
Duval,State of Florida,has personally app, red herin by f�imself herself and affirms that
all statements and declarations are t7nd accurate. —�;�
county of
va�
Notary Public at Large,State Of
' ally Known
d d I on-
SHIRLEY L.G AM
MY
COMMISSIo 760
Notary S 'tur - - -- -4- d /&,�3,3 6, 75/ 5--6
nded Thru Notary Public Uridervirit�rs
F:/BLDG/0�ff-liuild�Affad&avi� S 411 009 1 1 1
City of Atlantic Beach
Building Deparbnent APPLICATION NUMBER
800 Seminole Road (TO be assigned by the BL"M Deparbmrt.)
Adank 11, FlorWa 32233-5445
Phone(90-4)247-5826 - Fax(904)247-SM
E-rnalf. buMng-dept@coab.us Date routed: lqh2-
City WS&Sile: htfPJA~eoab.ur.
APPLICATION REVIEW AND TRACKING FORM
I--,
Prop"Address: c�)-40 eDepartment review required -Ye—s No
e
Applicant: P,fanning Zonin-t>
Project: aublic Inisbatol
TUTIC'Miety,
Fire Services
CMer Agency Review or Permit Required Review or Receipt
of I lermit Verifted By
Florida Dept.of Environmental Protection
Flonda Dept.of Tiransportabon
St.Johns Riveir Water Management District
Affny Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
AP LICATION STATUS
RevWwIng Deparbnent First Review: E*pproved. E]Denied.
(Cirde one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by:io�ilet, Date:
TREE ADMIN.
Second Review: []Approved as revised. E]Denie(d.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revisei. []Denied.
Comments:
Reviewed by: Da*:-
Rwind 0?WM8
City of Atlantic Beach
Building Departrnent APPLICATION NUMBER
(ro be angried by the Buildirig D"artinett)
800 Seminole Road
Affarific Beach,Flonda 32233-5445
Phorve(904)247-5826 - Fax(904)247-5845
E-nmfl: buildrig-dep[Ccoab.us Daft routed: P? /2—
Cky web-sife- hffpJAAPww.eoab.u9 —
APPLICATION REVIEW AND TRACKING FORM
Property Address: Sk;4Lish _,P�r_ Department review required--Yes No]
LO 0J 6� 'n
Applicant- aPlanning&Zoni
I �
r
Project: _�J r JF--,?7 -'Public
Fire Seryic"
lime
Other Agency Review or Permit Required Ri view or Receipt Daft
Fbnds Dept.of Envimrimenlal Protection of F ermit Vedfled By
Florida Dept.of Transportation
St.Johns River Water Management District
Affny Corps of ErVir"m
Divisim of HoWls arid Resfturarft
DWWw of Alcohac Beverages and Tobacco
00W.
APPLICATION STATUS
Reviewing Department First Review: Mppixived. FIDenied.
(Circle one.) Comments: F
BUILDING
PLANNING&ZONING Kz�_'
Reviewed bir Date.jfl-
TREE ADMIN.
Second Review: E]Approved as revisel. [-]Denied.
^P I RKS Comments:
UB L
PUBLIC SAFEiTYt Reviewed by: Date:
FIRE SERVICES Third Review: E]Approved as reviseq. E]Denied.
Comments:
Reviewed by Date:
Rwind NW110