1258 Beach Ave 2013(2012) fence v
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J =r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Ding"
Application Number . . . . . 12-00001019 Date 3/28/13
Property Address . . . . . . 1258 BEACH AVE
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
Oft front fence
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Owner Contractor
------------------------ ------------------------
DUSH ROGER R & RITA BAUER OWNER
1258 BEACH AVE
ATLANTIC BEACH FL 32233
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Permit . . . . . . FENCE PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/24/13
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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 .
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)
Fence must not intrude onto City right-of-way.
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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 35 . 00 35 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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CITY OF ATLANTIC BEACH
-ILDER AFFIDAVIT
OWNER R / BU
I. 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 TEE CONSTRUCTION IS COMPLETE, THE LAW WELL 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,
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.
W. 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.ACKNOV&EDGEMENT; 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.
330-3 17-05017
ADD PHONE NUMBER
PRIN
SIGNATURE DATE
Before me this (C day of 2oLZin the county of
Duval,State of Florida,has personally ap eared herin by himself/herself and affirms that
all statements and declarations are true nd accurate.
Notary Public at Large,States of County of
❑Personally Known , �L1v�? 3`0
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ED: : 9
8r5
E
City of Atlantic Beach APPLICATION NUMBER
Building Department (TO be assigned by the Swung Deparmwd.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 411 .
Phone(904)247-5626 - Fax(904)247-5845
s- E-mail: building-dept@coab.us_ �f'� Date routed: Z..
City web-silex ftJh%"W.coab.ug\-
APPLICATION REVIEW TRACKING FORM
Property Address: 2 �o �,q C y /�-I/�, Department review required Yes No
B '
Applicant: Planning &Zoniqd
ministrator
Project: - 7- ub
Utilitie
Puis Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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. ❑Denied.
(Circle one.) Comments:
BUILDING \�•�t
PLANNING&ZONING Reviewed by: Date:
TREE ADMIN. Second Review: QApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27110
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be ass+gned by the Building oepa�nt)
800 Seminole Road AUG c,
Atlantic Beach. Florida 32233-5445 ® ��o�� - /C
Phone(904)247-5826 - Fax(904)'*7--5845
E-mail: building-dept@coab.us ! Date routed: L
City web sife� MfpJlwuiw.eoab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: / 2 S_ WVL Department review recluired Yes No
B '
Applicant: a (4)��,�. Planning &Zoni
minisbator
Project: - T ub
Utiliti
Pu is Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept.of Environmental Protection
Florida Dept_of Transportation
St.Johns River Water Management District
Arty 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
PLANNING&ZONING Reviewed by: Date:-
TREE ADMIN. Second Review: QApproved as revised. ❑Denied.
P KS omments:
PLITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [][Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07127/10
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road /, 1
Atlantic Beach, Florida 32233-5445 /C
Phone(904)247-5626 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: Z.
City web-siie: ft:/lwww.eoab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 2- J,4-d,# WVL Department review required Yes No
B '
Applicant: ( Planning&Zonind
dministrator
Project: - T
Utilitie
Pu is Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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--_____
Pi�NNING&ZONING Reviewed by: �'" �'�"� Date:_46/0
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: QApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07=10