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1955 Beachside Ct 2013 fence N . CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002414 Date 4/23/13 Property Address . . . . . . 1955 BEACHSIDE CT Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 4FT FENCE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ JURASIC MATEO AND MARGAUX OWNER 1955 BEACHSIDE CT ATLANTIC BEACH FL 322335955 ---------------------------------------------------------------------------- Permit FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/20/13 ---------------------------------------------------------------------------- Special Notes and Comments Roll off container company, if used, 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 . ) ---------------------------------------------------------------------------- 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. —J.c A�"OhG Ald3ciQYd Yll CI) CD cl- �n P, —�L o Ily Ll lov .V-2- cs-. CP 0 :AS POAoiddV I!wlgcl Buippq e jo aouenssi ato JOP 101140 Buippe qoeag b47 ainleu6i . q pa!j.jJ9A aq Isnw 3!luellv JO 40 aqj jo sluawaiinbai 6ulIl!wjad jeja G-A pue alels 'le0ol alqeoildde jaLljo lie pue apoo Buipling ep!jolJ Lillm eoueildwoo *sItwjad jo gouenss! aqj Jol JeAoidde z alniq.suoo IOU saop inq suoilelnbaj juawdol9A@P pUel le3o, jqqjO pue UO!S!A!pqns 'BuluOz ajqeojjdd8 411m eouelidwcra S9Ljjj9A 1BAOidde sli4i juawliedeci BuluoZ PuB Bu!uueld qoeaq O!iueiiv jo Ain IV] —)tql--5 a -3t--i-LV-D P -7\4 -C,--:� L/V IV (7 7/JjL Y-7-1 Y'A na -io sawagy onsnd .3fa -40 5-37 s"vW -z-,o Aws -1 v7d N' 03ab4c,:Uv 5 v -C, r NO mmoArs sy X007or -7107 -A--VA-M 19 Am vam o- g- DAuoHs aw BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, Fl, 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: z�6_5" .5-7 Permit Numbe - I��A/ Legal Description Parcel 4 .2n, Floor Area of Sq.Ft. 'Sq /j Valuation of Work 2-7— -Proposed Work heated/cooled noWh c Class of Work(circle one): New Addition Alteration Repair Move Demolition pooll/spa window/ 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# For multiple products use product approvaMorm Describe in detail the type of work to be performed: Property Owner Information: Name: AcJec,- _,TVV-Co,C- Address: trISS eW�kcLI&:44 City All uAk,� Stat r-' 113 Phone SOY 19 e k , — —te-0–,4rcaic- %1 11LI60. (0�v\ E-Mail or Fax# (Optional) Mci Contractor Information: Company Name: Qualifying Agent: State Zip Address: city Fax 4 Office Phone Job Site ontact Number State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone 4 Fee Simple Title Holder Name and Ad ess Bonding Company Name and Addre Mortgage Lender Name and Addr s rtify that no work or installation has commenced prior to the ing construction in thisjurisdiction. Thispermit becomes null or abandonedfor aWeriod of six(6)months at any time after Plumbing,Signs, ells,Pools, Purnaces,Boilers,Heaters, Tanks andAir 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 FINANCING9 CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Ihere certify that I have read and examined thi's application and know the same to be true and correct. All provisions of laws and ordinances governing this 'Vwork will be complied with whether sf eciti-ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any otherfederal,state, or local aw regulating construction or the peTformance of construction. Signature of Owne�_, Signature of Contractor Print Name Ak ................. Print Name .................................................................................................................... cl; e Before me Before me 20 this a f this Da of S'rfR[Eli L.,3,RA14.AM 1WAPQ10N�DD 957760 m 41- -r rq L:ary i-MV NotayPublic 5 N No-ary ublic ry Public Underwritems _kde.dThri!N W10__M-4 STAMM Revised 10.24.12 CITY OF ATLANTIC BEACH (OWNER / BULDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 'CONSTRUCTION CONTRACTING"REQUIRES OWNER I BUILDER TO ACKNOWLEDGE THE LAW: MEW- 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 Y012—USE AND OCCUPANCY- IT MAYNOT BE BUILT FOR SALE ORLEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE, THE LAW WELL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE. WHICH IS IN VIOLATION OF THIS E--U-NTTION. YO1 J 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 AN 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. '64 Ct ADDRESS PHONE NUMBER PRIN AME Aw , �5ATE SIGNATURE Beforemethis dayof 20L&the county of Duval,State of Florida,has personally appeared henn by nimself/herself and affirms that all statements and declarations are true and accurate' L Notary Publioat Large,State of County Of 4 D P nally Known rrodoured Identinratio .11,,, . 111, -' L LIX S:F 1 -0 FJB� 7u V�rll_ City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road 13 P Atlantic Beach, Florida 32233-5445 Phone(904) 247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: http://vmw.coeb.us I APPLICATION REVIEW AND TRACKING FORM Property Address: Department review required Yes No Bu,ilding, Applicant: 'Planning &Zonin'-g ;'-�e zhintgfr—ator Project: Z/ Ar) --15-ublFc W6 �1�lic Utiliti 49 Public Saf'ety Fire Services Review fee P0. 1901 Other Agency Review or Permit Required Review or Receipt Date of Permit 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: DXP/Proved. ElDenied. (Circle one.) Comments: BUILDING CPLANINING&ZONIN Date:0L�/O 2 Reviewed by: TREE ADMIN. Second Review: []Approved as revised. E]Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. ElDenied. Comments: Reviewed by: Date: Revised 07/27/10 City of Atlantic Beach APR APPLICATION NUMBER Building Department 0 82013 (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904) 247-5826 - Fax(904)24ET-53834115 E-mail: building-dept@coab.us Date routed: Cityweb-site: http-//www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: eh.5ialf, C7- Department review required Yes No B�Jidmg___ Applicant: "-Planning &Zon_[�vq 3'�' �Fator Project: 'z/ -15-ub Lic W_o]�) -) z_Pttblic Utilities- Public Safety Fire Services Review fee Dept Signature( Other Agency Review or Permit Required Review or Receipt Date of Permit 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: �Approved. ElDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by-.-- Date: TREE ADMIN. Second Review: DApproved as revised, FIDenied. P Comments: LIC I TIE PUB12 C ftSFE Reviewed by: Date: FIRE SERVICES Third Review: ElApproved as revised. OlDenied. Comments: Reviewed by� Date: Revised 07/27/10 City of Atlantic Beach APPLICATION NUMBER Building Department �To be assigned by the Building Department.) 800 Seminole Road 0 3 /:V�1 py Atlantic Beach, Florida 32233-5445 ted'. E-mail: building-dept@coab.us Date rou Phone(904)247-5826 - Fax(904)247-5845 Cityweb-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: /�3� Department review required Yes No Boqoq—_ — Applicant: /V le "Planning &Zon�hq Project: 4 17- yrx�0, 4Q -'P-ubl =—P-vb ic Utilitis�2 r Public Safety Fire Services A Review fee Other Agency Review or Permit Requir7ed Review or Receipt Date of Permit 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: pproved. ODenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: 31z TREE ADMIN. Second Review: ElApproved as revised. E]Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. [:]Denied. Comments: Reviewed by: Date: Revised 07127/10