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379 6th St (vault) CITY OF 4&4#ttic /3e4cA-0;&U-4& Office of Building Official REQUEST FOR INSPECTION �h Date 8 /Q 9' ! Permit No. �y Time Received r � District No. Job Address Locality Owner's Contractor BUI G CONCRETE ELECTRICAL PLUMBING MECHANICAL Footing ❑ Rough Wiring ❑ Rough ❑ Air.Cond.& ❑ Re Roofing ❑ Slab ❑ Temp Pole ❑ Top Out ❑ Heating Lintel ❑ Fire Place ❑ Pre Fab READY FOR INSPECTION A.M. Tues. Wed. Thurs. Friday-P.M. A:M Inspection Made Inspector Final Inspection❑ Certificate of Occupancy Date CITY OF Office of Building Official g REQUEST FOR INSPECTION Date Permit No. Time A.M. Received P.M. District No. Job Address Locality Owner's Contractor Name BUILDING CONCRETE ELECTRICAL PLUMBING MECHANICAL Framing ❑ Footing ❑ Rough Wiring ❑ Rough ❑ Air.Cond.& 0 As Roofing Q Slab ❑ T}mp Pole _ ❑ �op Out ❑ Heatingla Lintel ❑ 7�i�- // �' Fire Place ❑ Pre-Fab READY FOR INSPECTION Mon. Tuesf Wed. Thurs. Friday A.M. Inspection Made P.M. Inspector Final Inspection❑ Ito Certificate of Occupancy Data F CITY OF ATLANTIC BEACH -' 800 SEMINOLE ROAD .J . ATLANTIC BEACH, FLORIDA 32233 INSPECTION PHONE LINE 247-5826 Application Number . . . . . 04-00027986 Date 3/26/04 Property Address . . . . . . 379 6TH ST Tenant nbr, name . . . . . . 3 FIXTURES Application description . . . PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor ----- ---------------- --- ------------------------ COTTI , CHRIS PLUMB-PAL, INC . 379 6TH STREET 1728 SABEL PALM ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 (904) 246-8856 ---- --- --------------------- ----------- -------------------------- ----------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 56 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Fee summary Charged Paid Credited Due ----------------- ---------- ---------- - --------- ---------- Permit Fee Total 56 . 00 56 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 56 . 00 56 . 00 . 00 . 00 BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER. "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN RESULT IN THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS"ISSUED ACCORDING TO APPROVED PLANS WHIZPART OF THIS PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION OF APPLICABLE PROVISIONS OF LAW. * ,., ( . BUILDING OFFICIAL CITY OF ATLANTIC BEACH PLUMBING PERMIT APPLICATION Date: 3 Property Address: 3 7 11 S 4-- Owner: C h s a Telephone#• Contractor: /��U/1'l L� �i�� -�`'� Telephone#: Z?'r £s' ' .�«4x 'a�4e4 Contractor Address: 7Zv S'¢6Ccs f'�C� L^'' f-C_32 o e.�- Fax#• 2 Y - v �'� In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinance and standards of good practice listed therein. Installation of plumbing and fixtures must be in accordance with the most recent edition of the Southern Standard Plumbing Code. Plumbing Type: If other construction is being done on this building or site, ❑ New list the building permit number: 01" Re-Pipe Number of Fixtures: Bath Tubs d Showers Closets C) Shower Pans 0 Dishwashers �' Sinks Disposals 0 Urinals Floor Drains © Washing Machine Lavatory C) Water 6 Sewer Water Heaters d Other Fees Permit Issuing Fee: $35.00 Total Fixtures: 3 X $7.00 + $35.00= 800 Seminole Road . Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5800. Fax: (904) 247-5845. http://www.ci.atiantic-beach.fl.us 40-99, t3E00rTMEMT.01P 8tltLOINt�' tTYt ATLANTIC BEAD.H . r pe RKIT, It "tI I4A'`IDR . �. __w . . :. Lo A�`IDt�; �GfiC `> l�A`�"TI�N Ut A'TI.A tT'IC Alk*6 [rt FLO'IDA 32213 L OAL D RIPTfox . . _:...� .�. . Cq�Cit�ri' TYP+�s ' F'1A 't l.ct 32t � Itr, Pr s*d.,UJ D L?a 11 x i s 1 C Subclivi i n t AT LARTIC stivo lotfil 00JO $22.SO 'TO 'STOR*GE SHE ATTACHED TO R4.ID9wdklIm" REAR, ION ATIOW FEES:, R R1 ]RENDIRY Add T t 'P . WATER , 0104CT � �� $0.00 it,. )�LokibA � � �� 4 .; 00.OW a� " .;., w .., !'1r_ 17 7 '�H' :r 'i: Mme► ►�:;..;.>, 00 RADON m 13P R ATR TTA R "A X40 od w S14AAE *0 00 �1140.00 TyP SEC. A �INOA T FE Al R,y ta7xro, :`' MITE$ . t Y tooTlCE-�A1�1`C TTB, �i B AND f6dtING#$MUST 8E 14$0 J: i 'BI FEAR 'F�?u ll!ttS. PR#vtlT VQID S#X MQNTHS AFTER OAT D ;ISSUE �9U#;LD IC t #T 1 ,-f klRR#$H A# t D $ R�Jh�# #S WORK MUST NOT SE* LACED IN RC1B�tC�F�AC�,,AND AAUST I3E Cl'EARD tk ANt 'HAI.tIfl R�NAY$ ElTHEI .0©NTR�CTf3R'©Fi©INNI:Fk. Ts fi I uE ACCORDING TOQ.,APPROVED PLANS WHICH ARE PART 4F THIS PERMIT AND U f3 REi�CA I"E�A 1 C Qfit' 00 A#�E 00'-�. i E$141 iS QE LAW. ATk ANTI REACH BUFLDIN�x DEPARTMENT ' 27 77 ' k, `" ''`"e t,a` k., Address 3 7 S t'f ED 11.7>05�,7`1 o Heated Square Footage @ $ — per sq ft = $ Garage/Shed@ $ / 3 per sq ft = $_�.3� Carport/Porch @ $ — per sq ft = $ Deck @ $ -- per sq ft = $ Patio @ $ r""__. per sq ft = $ TOTAL VALUATION: $ ;?3_2- 00 Total Valuation 1st $ / c o,e)4 f Remainder Valuation per thousand or portion thereof --------------------------------------------, Total Building Fee $ ADDITIONAL PERMITS and/or FEES REQUIRED + Filing Fee $ Fireplaces @ 15.00 $ Mechanical BUILDINGPERMIT FEE $ 0 Plumbing Electric/New Electric/Temp Septic Tank BUILDING PERMIT $ .2 Well WATER METER CHARGE $ Swanning Pool SEWER IMPACT FEE $ Sign WATER IMPACT FEE $ Water Cormection MISCELLANEOUS $ Sewer Connection $ Water Meter $ Elevation Certificate GRAND TOTAL DUE $ ---------------------------------------------------------------------------------------------- CALCUTLATIONS and/or NOTES CITY OF ATLANTIC BEACH PERMIT APPLICATION REMODEL, ADDITIONS OR ALTERATIONS Owner(s) : f_G _ AI.�l_3.QD'i� - 114k-_ .Address: 3,7! -� /��� '� --------- -- -G7.�/?+ � J Phone s Lot #__ �'64 EUv ) Lot 3� ock or Unit #____ Subdivision: t _ _ ,__-- Contractor: 5------------------------------------------ Describe work to be done: r X , ,? - 7 46 Sa ------------------- ----------------------------------------------------------------- Present use of--buildings__A�z Valuations— '. 00_-(00 J-- = `-------------------------- Proposed use:_ L ��-u�_,_ m_rn. t 2 4- - Is this an addition?--Nb --- If yes, what are the dimensions of the added spaces---------ft- X _________f t. Will the added area be heated and cooled?__Z�Q __ New electrical (or increase) ? A/0 New plumbing fixtures?�/ New fireplace? /Ys,,'�New Heat/AC?__,[V":2__ SUBMIT TWO COMPLETE SETS OF PLANS, INCLUDING SITE PLAN, SURVEY, ENERGY CODE FORMS, NOTICE OF COMMENCEMENT, AND OWNER/CONTRACTOR AFFIDAVIT, IF OWNER IS CONTRACTOR.,/ Signature OWNER:--- - �G:. :G��,y '_� '� =-- Date: Signature CONTRACTORS/ Date: 1� 9 a JUL 17" 1993 Budding and Zoning PLA. I*y LAWS ►f 713.13 nIAawo room w of dramnunrenwnt 0016PAR4 W DUFUGA141 �Io fnhom it uta === The undersigned hereby informs all concerned that improvements will be made to certain real property, and in accordance with section 713.13 of the Florida Statutes, the following information is.stated in this NOTICE OF COMMENCEMENT. 0•scripfion pf prop•r1y...�✓..:91 7...».... f ' .... cr •• it! •• y � r «..,-....... ..... .,...y..,�... �. ......................... ... General description of kWovwmvs... •GZ;LTA•c�!4::.�..�....,C..E'..c�.�:.....�?�.....f;iv•ct�sE';...�....,�"�:...L: 1...��.. � � / ....»....»...«.. ... : ..f .... ::aL :...... »f .: ryz j�t,; ...........................................«......«.»..«......«...... ......«. . Owner....%• ✓.....1`Tl!!N.......f k1 .l�G.l. 's....... svc ........ �?SFr .. �' ...... .r.....,� f? ........«.....«.. ..... Address... , .�«� .... .. .......«.........«» ........... Owners intered in sit• of the anprovm•M...... ..,,, I" Simpl• Tide hoidw (d odar don owrW) ......... !, 44:.............................................,..... ..................................................... .............:....»....................................................»..............................................................»........ ».«........»............................_......_ .. .... Contrador......................«».....».......«.»«.».................. ......«.......................<.................................................«.....«..».......».......»»........»..»...».....,,, A"em............».........».................................................... .».......»... :...:.......................................«.......»....».....»......... Surety (d any)......«.......»».»..............................................«..«...........................................»......................».«.«......».._.»._....»...�..«....._...»....»..» Address............«...........»».««.........«.......»..............«.........»....«..............»»............ ............. «.«... ».........Arnow of bond �.«»«.»..« ...�».... Nam• of person within the State of AMWO &4naW by owner upon whoa*notion or d1 w doa+meirs s�•y be served: Name....... ..«.................»«.........»...........».»».......«»..........»......«............................»...«»...».»...«.«•. Address.................«......................................"... .................."............»..............:.........................»........................«........._.............«................ ..»......... In addition to himself,owner designates the following person to receive a copy of the Lienoes Notice as provided in Section 713.13 (1) (F), Florida Statutes. (Fill In at Owner's option). Name.....................................................................».................»................ ................ ......... «»... «...«.................... ......... ....»_.......»..»»....._.............»». Address.......................................... r ? MAP SHOWING SURVEY OF Lot 32 except the East 40 feet, and all of Lot 34► Block 8, Atlantic Beach, as reoorded in Plat Book ,5o, Page b9 of the current public records of Duval Countys ' glvrida, • / . N� rocs �'- ! Fis�.✓o V E V �X r R ASIC BEACH Awmp rt";Ito•✓ ..L o• t ;o• �5 -4 -UDk JINIGA OpF1ZE J ju�, 1 ; v � i� r � I ti Y, O D N FAhAti!F l Y j h .V°37a is rr �w�+t r 11 � vw t/d• 74 / w c7. rpOf/NO ifs"/AtON -�'`� ,I�'Fnuvv a-1 I '<'d.v AP P R NSIC 60 CH CIZY OFA n��N� �FF�GE .E:w ,vaTE• � BY R��.•�Cc.c CC7 is l siZc,�v /!l, /97!! 7b �rlti.r/! Sr�i1✓CY.tJP 7V De 7",c �® 0 70/ 49MAV r �f&FwnW ✓,6tKgo�✓✓iu lie i AA A M OVE CITY Off ATLANTIC BEACH BUILDING OFFICE JUL 181 91 OILl l� t b a F g � 2 7 tt� � E 5 } 9 3 I a OWNER BUILDER PERMIT AFFIDAVIT State of Florida ) City of Atlantic Beach > BEFORE ME, the undersigned authority, personally appeared --------------------------------• who upon firat being duly sworn, deposes and says: I' ------------------------------------- and the legal owner of the following property: Subdivision Afldn41 cc� (�-------- ------- Black $------------ Lots 1{0 _ AKA ----------------------------------- I am applying for a building permit pursuant to the Owner Builder exemption not forth in Florida Statute, Section 485. 103. Florida law requires that I have been provided with the following DISCLOSURE STATEMENT: DISCLOSURE STATEMENT 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 more than one 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 a violation of this exemption. Your construction must be done according to 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. 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. Further, affiant sayeth not. Pop �ri; n e r Swo o and subscribed be orae this ____ day 19_ r r [BUILDING, PLANNING AND ZONING INSPCCTIUNf DEPAHI'll ENT CITY OF ATLANTIC BEACH, FLORIDA !­' CERTIFICATE OF OCCUPANCY !.+ WORK SHEET ,•. ; '•'r r'+ Date Requested! ` •i �ii r f• �i'" i• � g Contractors Buildin Con / ;.S i. :•t i Building -.1, U, f Permit Numbers .�,,,%' !+ i Address tr1.lJ1 r, i:, , }tip• Legal Descriptions� t�,f � Improvements to the above described property have been completed in accordance with the term® of the permitiand in. eerti#ied to be r ready ,for occupancy as It �/' ;.; s�i� •�; Lowest Floor Elevations required an built��''; ' -r�n/a---- Sales Tax Certificates date submitted BEFORE ISSUING CERTIFICATE OF OCCUPANCY,•TEiE- FOLLOWING MUST BE COMPLETE '; , DEPARTMENT ' DATE NOTIFIEDs DATE APPROV'Ebs '" BYs Fire Chief ---------------- Public ___--_ •Public Works __________ }r. :�:',!: , kl' /✓ ---- --------------- Planning Director _______________ __- . •r .,� !`'►;;�;'-rr_ +-- -� --------- Building Inspector ,r 'fl''�y,� ,' ' :5, •:. .... ... I :. ,.r�1� ,5 tori�� t' ac; RNI CITY OF ATLANTIC BEACH, FLORIDA �►ovW by APPLICATION FOR ELECTRICAL. PIRMIT ��� TO THE CHIEF ELECTRICAL INSPECTOR: DATE: IMPORTANT NOTICE: IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS, WHICH ARE A PART HEREOF,AND IN'ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF ATLANTIC BEACH ORDINANCES. IVAs LEC?TRICAL FIRM- Advanced MWER E E T IC NAME Richard Medlock ADDRESS: 379 6th st RFD --WX BLDG.SIZE BETWEEN: RES. APT.( i COMM.( ,1 PUBLIC-( ! INDUS.( ! NEW( ! OLD( ! REW.i ! ADDITION( ! TRAILER ( ! TEMP.t ! SIGNS t ! SQA.FT. ;SERVICE: NEW( I INCREASE 1)0 REPAIR d ! FEE CONOR SIZE 4/0 AMPS 200 COPPER 4 ALUM, X H DR BREA R 200 1 :PH 3 W 240V LT RAgEWAX EXIST.SERV.SIZE 60 AMPS 1 PH 3 W 240 VOLT RACEWAY FEEDERS NO. SIZE NO. SIZE NO. SIZE LIGHTING OUTLETS CONCEALED" OPEN: TOTAL RECEPTACLES CONCEALED OPEN TOTAL 's1 050'AMP8. 91.100 AMPS... SNIMTCH ES INCANDESCENT FL!tORESCENT&M.V. FIXED 0.100 AMPS. gVER APPLIANCES BELL TRANSF. AIR, H.P.RATING H.P.RATING CONDITIONING` COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: K"EAT q 31 0.1 OVER MOTORS H.P. VOLTAGE PHS ' NO. I N.P. VOLTAGE PHS ( �ELLANEOUS. TRANSFORMERS: UNDER 600 V. OVER 600 V. f DEPARTMENT OF BUILDING 8189 CITY OF ATLANTIC BEACH,FLORIDA PERMIT NO. PERMIT TO BUILD 42,00M u THIS PERMIT MUST BE POSTED ON JOB 7712 1 A 12/11 /9 12/18 g6 rit�9 *00CA Date 19 7712 1 A 11"/rs/8 Valuation$ F�$ 42.00 r nit? This permit not valid until above fee has been paid to City Treasurer,and is subject to revocation for violation of applicable provisions of law. This is to certify that Ocean State Heat & AirMMR-786 has permission to`btffitl install heat & air Classification residential Zone Owned by Peggy Phillips Lot Block S/D House No. 379 – 6th sty wet- According to approved plans which are part of this permit NOTICE—ALL CONCRETE FORMS AND FOOTINGS MUST BE IN- SPECTED BEFORE POURING. PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE --� —i O Building material, rubbish and debris 31 from this work must not be placed in public space, and must be cleared up and hauled away by either con- tra for or owner., Building Official. FOR OFFICE PERMIT DATE CONTRACTOR USE ONLY NUMBER PLUMBING ELECTRICAL SEWER WATER BUILDING AND ZONING INSPECTION DIVISION CITY OF ATLANTIC BEACH .ATLANTIC BEACH, FLORIDA 32233 APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER IMPORTANT — Applicant to complete all items in sections 1,'11, 111, and IV. 31 LO_�j'_7 ' LOCATION Street Address: 3 OF Intersecting Streets: Between And BUILDING Sub-division 11. IDENTIFICATION - To be completed by all applicants In consideration of permit given for doing the work as described in the abcve statement we herebyagree to perform said work in accordance with the attached plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards of good-practice listed therein. Name of Mechanical Contractors M — Contractor (Print) Master '11 Name of Property Owner r6r y Signature of Owner Signature of w Author'Isod Agent Architect or Engineer IIL GENERAL IN R A, Typo of heating fuel: B. IS OTHER CONSTRUCTION BEING GONE ON Electric THIS BUILDING OR SITE (3 Gas--O LP ❑ Natural ❑ Central Utility IF YES, GIVE NUMBER OF CONSTRUCTION 0 on PERMIT O OfMr-- Specify IV. MICK404 CAL IpUIPMMIT TO RI INSTALLED NATURE OF WORK (Provide complete list of components on beck of this farm) Y Residential or ❑ Commercial most O Space O Recessed Xcentro) O Floor ❑ New Building Air Condlfloninq: ❑ Room X central I, X Existing Building Duct System Materiel lxwy&Aej�� Thickness ❑ Replacement of existing system t X New Installation(No system previously installed) Maximum capacity e.f.m. ❑ Extension or add-on to existing system Refri"retion ❑ Other— Specify [� Cooling tower: Capacity g•p•rn• Q Fire sprinklers: Number of head Q Ebwter Q Monlift ❑ Escalator (number) G THIS SPACE pOR OFFICE USE ONLY C3 ,Gasoline pumps (number) (Rewiwd) Q Tank (number) Remarks 13 LPG containers. -(number) Q Unfired pressure vessel Permit Approved by D04 6— C3 Boilers (3 Other —Specify Permit Few LIST ALL EQUIPMENT AIR CONDITIONING AND REFRIGERATION EQUIPMENT CqWty d�4 NmmtMr Valb DoreMpfian I[odol Number Kanutaatuser ( ) c " �s S, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD r� ATLANTIC BEACH,FLORIDA 32233 v INSPECTION PHONE LINE 247-5826 03-00025983 Date 5/02/03 Application Number 379 6TH ST Property Address . . . • - Tenant nbr, name . . . . . . WOOD PICKET 30" , RED TRIM Application description . . . FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 1000 Owner Contractor -------------- ------------------------ ---------- KLEIN, GINNI OWNER 379 6TH STREET ATLANTIC BEACH FL 32233 (904) 372-4388 ------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . 00 Permit Fee 35 . 00 Plan Check Fee 0 Issue Date . . . Valuation Fee summary Charged Paid Credited Due ---------- ----- -- 00 . 00 Permit Fee Total 35 . 00 35 . 00 . Plan Check Total . 00 . 00 . 00 . 00 Grand Total 35 . 00 35 . 00 . 00 . 00 BUILDING MATERIAL,RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PACED IN PUBLIC SPACE,AND MUST BE CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER "FAILURE TO COMPLY WITH THE CONSTRUCTION LIEN LAW CAN E APPLICABLE ACCORDING TO"PROVED PLANS RESULT MOWNER PAYING IMPROVEMENT PART PERMIT AND SUBJECT TO REVOCATION FOR VIOLATION PROVIS PROVISIONS LAW.WH BUILDING OFFICIAL L�4_rrc� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FLORIDA 32233-5445 \J 1 TELEPHONE:(904)247-5800 _ y FAX:(904)247-5805 r� SUNCOM: 852-5800 http://ci.atlantic-beach.fl.us PLAN REVIEW COMMENTS Permit Application Applicant: Address: c t" Project: - tv Y our application is approved o Your permit application has been reviewed and the following items need attention: Please re-submit your application when these items have been completed. Reviewed by L S/� Signed Date Contractor Notified Date D �N NG r s CITY OF ATLANTIC BEACH 3 p 2003 FENCE PERMIT APPLICATION AQR Date: Job Address: ��-� Owner's Name: , r1 nVe ✓", Address: 3 C, a�r��a�k �` )fZ tj Phone: -3 7 dL V3 U Legal Description: Block Number:_ Lot Number:32_ Zoning District: Fence Contractor: —0 1,DNn ,P Address: Phone: City: `�— State: Zip: Fax: Type of fence and m+erlst' o be used: �OC-A t 1'� Redd �- Valuation of fence: 1` Is ap oval of Homeowner's Association or other private entity required? ( ,/f yes,please submit with this application. nterior Lot ❑ Corner Lot ElDumpster or storage tank enclosure ,T�r 'P rotection: NO. Applicant certifies that no trees will be removed for the installation of this fence. ❑ YES. Removal of Protected Trees will be required for this fence. TREE REMOVAL PERMIT IS REQUIRED. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. PLEASE PROVIDE TWO(2)COPIES OF APPLICATION AND THE FOLLOWING REQUIRED INFORMATION: 1. Attach copy of property survey showing location,height and all distances from property lines of the proposed fence. (Fences shall not be placed within any utility or drainage easements without written permission from the Utility and/or Public Works Departments. Fences shall not restrict any private easement.) 2. Provide completed Owner's Authorization Form if applicant is other than property owner. I hereby certify that all information provided with this application is correct. Date: Signature of Owner: ----- Signature of Contractor: w� Date: Address and contact information of person to receive all correspondence regarding this application (please print): 1 Name: n t � (1 ✓ � �..1(� i.(. � �� J/® / Mailing Address: l4)7 �t/� C klk �- 32 v3 Phone: Fax: � E-Mail: t� `�/1 � � '�� RO C AA 800 Seminole Road •Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atiantic-beach.fl.us Revised 1/14/03 Page 1 JS s CITY OF ATLANTIC BEACH ` FENCE PERMIT APPX.ICATION Date: Job Address: �� T 4 Owner's Name: r2+'1�1. ✓ —_------------------ ..------- ----- �, --- Address: '..�J^-� r--%(?c +�'c:�Q...l� << (z-. Phone: Legal Description: Block Number: { Lot Number: Zoning District: --Fence Contractor: Contractor: ---_-�- Address: -- —___--}- Phone: -- City: `" State:--Zip: Fax: Type of fence and nater•ais to be used: � � OA �'• l.i� Real .►y... Valuation of fence- Is approval of Homeowner's Association or other private entity required? N If yes,please submit with this application. nterior Lot ❑ Corner Lot Dumpster or storage tank enclosure TrProtection: NO. Applicant certifies that no trees will be removed for the installation of this fence. ❑YES. Removal of Protected Trees will be required for this fence. TREE,REMOVAL PERMIT'IS Rf?QUIRI,D. Tree Removal Permits to be reviewed by the Tree Conservation Board,which meets two times each month. PLEASE PROVIDE TWO(2)COPIES OF APPLICATION AND THE FOLLOWING REQUIRED INFORMATION: 1. Attach copy of property survey showing location,height and all distances from property lines of the proposed fence. (I'encn� shall not be placed within any utility or drainage easements without'written permission from the Utility and/or Public Works Departments. Fences shall not restrict any private easement.,) 2. Provide completed Owner's Authorization Form if applicant is other than property owner. I hereby certify that all information provided with this application is correct. `") : .� bate:_ �.. l ". - -- ------- Signature of Owner: .� •t - �_---- _—_— -__—_ �j Signature of Contractor: Address and contact information of person to receive all correspondence regarding this application(please print): Name: Mailing Address:—_ luti' _-_ -------— - — ----_ --- ---= ___—____._._- - � �._ � 4--LE-Mail: .�'�f1 t k �C'�_.�� ea � Phone: 7 ? Fax: J _ --- —_ _ -----— 800 Seminole Road -Atlantic Beach,Florida 32233-5445 Phone: (904)247-5800 • Fax: (904)247-5845 • http://www.ci.atlantic-beach.fl-us Revised 1/14/03 Page l 1 !� > o LA m r r _ � o� oo � Z N �o LA ca m r r- X 7' (M) 4Y ., m r o rri r�1 nO O O D —I O H Q C N cn 8.1 mr � I I cn mr x Z P ai O � O O cr "' no W r \� i O w P n C Tl m A o O ao �' O n �' D n -� ITi N � v C r (� rrl Ln -- t--, D y Hm x `d �r.� 7� Z 00 o- - - - - - - - - - - - - -J�Se x n Z Q� O0-i :< � � o � 0 60 O � w > O nco rn 7, •< > --� 00 .. tA _ A rrl m O r n C) C x � m �,7 m z E 0 O �7 G m m Z O D J O n:A L y ati3Ns CrC S O >r I X-1 m rn OtlOC3a �9 3RD {4 N m N 0 -< a lid l�Q f' II � ���m �� N D= m0<� zo� Z Z A `►' z(AZ(n m ro mac° nm ;0 (n z D<mc m LnLP �cr O W �' a ZZ( < Dzm iy 0 0 0 > �F� � rn Ij p mC 150.0 cm -,z �m 150. nc20 (0.D0 DZ�� z O -0 Tym O �� �m Z Z B.D. o z s o S O O N n S4, m • 'c7 C.1 OAC Z IC-0 /� ' •. 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