Permit Fence 43 Stanley Rd 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001378 Date 10/09/12
Revision number . . . . . . . 1
Property Address . . . . . . 43 STANLEY RD
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . Soo
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Application desc
INSTALL 6-FT WOOD FENCE IN FRONT YARD
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Owner Contractor
------------------------ ------------------------
SATANI YOUSEF OWNER
2086 FOREST GATE DRIVE W
JACKSONVILLE FL 322161115
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Permit FENCE PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/07/13
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Special Notes and Comments
201 setback from Stanley Road property line.
Roll off container company must be on City approved list
and container cannot be placed on City Right-of-Way.
(Approved: Advanced Disposal, Realco, Shappelle ' s and Waste
Management. )
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 .
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- - ---------
Permit Fee Total 35 . 00 35 . 00 .00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 3S . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MAP SHOWING BOUNDARY SURVEY OF
LOTS 3 AND 4, BLOCK 19 , AS SHOWN ON MAP OF
DONNER'S REPLAT
AS RECORDED IN PLAT BOOK 19, PAGE 16, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLA.
CERTIFIED TO: YOUSUF SULTANI
SCALE: I"=30' - —City of Atlantic Beach DATE: 03-11-09
Planning and Zoning Department
This approval verifies compliance with applicable
zoning, subdivision and other local landl
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
Beach Building official prior to the Issuance of a
Building PermiL
Approved B .-
y- 1,7�7 'FOstor
Date,
OFFICIALI RECORDS' 13514, PAGE 957 FW(?E-12-a7F
I
LOT 6 1 00'(P)
FILE COPY N89*49'02"E 99.97'(ACT)
FND. 3'X3" COQUINA
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-SET 1/2-I.P. 50.00' 49.97'(ACT)
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FND. 3"X3-COQUINA
MON., NOT LA13ELED LS6076
S90*00'00"W 99.97'�ACT)
(BEARING BASE) 1 Do' P)
ffb STANLEY ROAD
(FORMERLY STANDLEY ROAD, 30'. R/W)
461-h-Lk lyz�!rLl
L,A�
BUILDING ]PERMIT APPLICATION
CITY OF ATLANTIC BEACH
900 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: 4Y�
Permit Number:
Legal Description Parcel#
C,j Floor Area of Sq.Ft. Sq.k't
Valuation of Work S 's-Z)0. —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 4
For multiple products use product approval Uo—rm
Describe iq detail the type of wo$to be performed: wood
C V a-
Property Owner Information:
Name: Vo(-,5 tj p ... Address:- 41 Q 4c-
city State(�I�i P Phone
t,* ftj
E-Mail or Fax#(Optional) AA
Contractor Information:
Company Name: Qualifying Agent:
Address: city —State Zip
Office Phone Job Site/Contact Number Fax 4
State Certification/Registration#
Architect Name& Phone 4
Engineer's Narne&Phone 4
Fee Simple Title Holder Narne and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
.�pplicatioq is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commencedprior to the
issuance o
,fa0permit and that all work will bepedbrmed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void w rk is not commenced within six(6)months, or if construction or workis suspended or abandonedfor a period ofsixfio)months at 017V lime qfter
work is commenced. I understand that separate permits must be securedfor Electrical'Work, Plumbing,Signs, Wells, Pools, urnaces, Boileis, 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.
I herehy certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governimT this
ope P�work�vill be complied with whether specified herein or1not. The granting of a permit does not presume to give authority to violate Or MX�l the
provisions of any otherfederal,state, or local law reg I struction or the peFformance ofconstruction.
A
Signature of Owner A U71 Signature of Contractor
L/
Print Name Print Name
............. ........... ..................................................... .......................................................................
SWOVI'And subscribed I re i e Sworn to and subscribed be'lore nle
20 this Day of ' 20
Notary Public lot_.,4rF;05,34Fj
r Notary Public
PUNO Oder0ters
!�undad Triru NotarY Revised 0 1.26.10
j
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 TEE 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, WIUCH IS IN VIOLATION OF TIES 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.
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.
'�1 5'44" L i�44 1<_;i1_ 9-
ADDRESS PHONE NUMBER
XQ u4rl r U I-;(*A4 ['I
MINT NAME
nA
SIGNATUM k,,," DATE
1.1 j-Vr Yv
Before me this (--I day of __20L-2—in the county of
Duval,State of Florida,has perstonally�pev.red herin by himself herself and affirms that
all statements and declarations are tLru d :urate
,q an acc
Notary Public at Large,State of County of
d
0"OWAftDA'
%;1-2�e sonally Known MYOOMMISSION
0 Produced Identification- M
aY21 20,,
OWYNbfic
Notary Signature:
F/BLDG/0�er-RujlderAffadavit;REVISED: 4/16/2009
.S% City of Atlantic Beach
APPLICATION NUMBER
Building Department
(To be assigned by the Building oDepartlmnent)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-M26
- Fax(W4)247-5845
E-mail: buj[dJng-dept@?coab.us Date rotited:
City web-site: http://www.coab.us E_
APPLICATION REVIEW AND TRACKING FORM
Property Address: A 54?.
Department review re Yes nNo
-Buildin 00�
Applicant: r%Aot"P 071_anD1p&"_"W_
e Administrator
Project: b I i c
UAW*
J—Public Utilities
1 1 Publi Safety
LFire Services
Review fee Dept Signature
Other Agency Review or Permit Requim Rev ew or Receipt Date
of Pennit 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: D�Approved. nDenied.
(Circle one.) Comments,
BUILDING
PLANNING&ZONING 4)4"/0i.ewed1by:t Date:
TREE ADMIN. Second Review: nApproved as revised. DDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERMCES Third Review: DApproved as revised. [-]Denied.
Comments:
Reviewed by: Date:
I
Revised 07127110
City of Atlantic Beach
APPLICATION NUMBER
Building Department (To be assigned by the Building Department)
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail. building-dept@coab.us Dat routed: —fp
Cityweb-site: hftp://www.coab.us P
APPLICATION REVIEW AND TRACKING FORM
Property Address: 0.4 4W
Ara_ --Department review required Yes No
Buildin-Q
Applicant: lea7nning&Zoni"n%
Project: 0 *Alf I I ree Administrator
y
s
Review fee Dept Signature C3?�:�
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Protection
ubli
Public Safet
Fire Service
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
A^
'eview: V*QApproved. E]Denied.
Reviewing Department First R
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
*TRDMIN. f
r Second Review: ElApproved as revised. [:]Denied.
W
U W RK�+Comments:
P L UTILI
�S
- —/ z-
PUBLIC SA ETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised 07127110
City of Atlantic Beach
Building Department APPLICATION NUMBER
800 Seminole Road (To be assigned by the Building Deparbrnent)
Atlantic Beach. Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-deptQcoab.us I Date routed:
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: A 2j--- 5JA� - Department review required Yes No
B 'Idin
u'I'('____ - - 1111=11% —
Applicant: Jujanni zgaion� 0-1
ree Administrator
br
Ic VMM
Project: U444 _e ubli�c � POW
blic Utilities
Public Safety
Um to *- o i FFire S,
Review fee Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Perm it 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: [2A/pproved. E]Denied.
(Circle one.) Comments: As eiajLsw
B
LANNING&ZONING Reviewed by: Date:
TREE ADMIN.
Second Review: FlApproved as revised. nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. FIDenied.
Comments:
Reviewed by: Date:
Revised 07127110
BP250U01 CITY OF ATLANTIC BEACH 10/05/12
Application Tracking Step Selection by Revision 08:35:07
Application number . . . . 12 00001378
Address . . . . . . . . . . 43 STANLEY RD
RE number . . . . . . . . . 172186-0000- -
Application type . . . . . FENCE PERMIT
NCR OLD ACCOUNT NUMBERS . . AB10110
Tenant name, number . . . .
Type options, press Enter .
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9=In/out maint
Path ---- Key Dates Action Summary -
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PLANNING & ZONING A 01 Y 09/21/12 10/02/12 09/28/12 AP EH
PUBLIC UTILITIES A 01 Y 09/25/12 10/02/12 09/25/12 AP LS
PUBLIC WORKS 1 A 01 Y 09/27/12 10/08/12 10/03/12 AP LS
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