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467 Inland Way 2013 fence CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002543 Date 5/01/13 Property Address . . . . . . 467 INLAND WAY Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 6 FT FENCE REPLACEMENT ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PERELLO MARCOS V & IRENE A OWNER 467 INLAND WAY ATLANTIC BEACH FL 322334682 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/28/13 ---------------------------------------------------------------------------- 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 water/sewer easements . Water and sewer lines exist in easments . ---------------------------------------------------------------------------- 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. MAP SHO nVG BO LOT-Z�f ARY SURVEY OF BLOCK UND CDC AS SHOWN ON MAP OF AS RECORDED A, PLA r BOOK 9-44 (- ifc�� I ........... 4Z CER 77FIED of PAGES lb OF THE PUBL VWA-IlDii, 11.� 'C RECORDS OF DUVAL COUNT-�: t1OR/DA ol 7L,-7. A 1-14.4-JA-JA 1b AJ- 04 City of Atlantic Beach Planning and Zoning Departme (1-74- This approval verifies compliance Wth licable zoning, subdivision and other lo I land development regulations, but does not nstitute approval for the issuance of permits. pliance with Florida Building Code and all other plicable local, State and Federal permitting re rements must be verified by signature of the Cit Atlantic %�a,h Building Official prior to the Is of a Building Permit. App ved 13y:- t )N ri 4� IWAO c.�C> to 0 to' 41) &0 ,LID 13� VY, 012 9 e I �41 C7 4Z V, �-,/L�k/ A LEM F7(Y)n BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 ffjAP7R�24 20131 Job Address: 62 J 04 q Permit NumbI4� r hio nce, reP1QCCP#4'a+rcel Legal Description_S 1'r,Q r4mh i t 1049'r Ar S q.Ft. Sq*PT Valuation of Work$ Propos( heated/cooled non-heated/cooled azl-g Class of Work(circle one): New Addition Alteration(:�R6�pair) Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial <jR�es�identi. e i If an existing structure,is a fire sprinkler system installed? (Circle.one): e Mp N/A Florida Product Approval 4 For multiple products use product ap r I form Describe in detail the type of work to be performed: O'ld tioder, Loord on kwrd -�(zncja �o le, -fon) djum (A)A ilevi -Oepce� CTC sgmc 0(<ntqh /Co4frnc�ldr Property Owner Information: Name: 12 f-C-6 S LeefIJ/0 1=renif, PCA/Oddress: ubu / ��State iD -�ZZ33Phone .5 City Aflointl"C, Re-aC�k _ �LZ E-Mail or Fax#(optional) rnm Contractor Information: Company Name: Qualifying Agent: 1-11 Address: city State Zip Office Phone Job Site/Contact Number Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address_Z" Mortgage Lender Name and Address. "z Application is hereby made to obtain a permit to d 4e-'work and installations as indicated I certify that no work or installation has commenced hle u issuance of a permit and that all work will be pe�fo�med to meet the standards of all laws regulating construction in thisjurisdiction. This permit bepero'0mretsont and void ff work is not commenced within six(6)months, or if construction or work is suspended or abandonedfor eriod of six P�)months at any time after Signs, P work is commenced I understand that separate permits must be securedfor Electricar Work,Plumbing, Wells,Pools, J urnaces,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 this application and know the same to be true and correct. All provisions of laws and ordinances governing this type.P��work will be coTplied with whether srecified 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 pe�formance of construction. Signature of Owner Signature of Contractor PrintName .............PC.F.(J(0/ Print Name .......................................................... ............................................................................ .......... .............V, .......................................... Befor Before me 20 e this of 120 this Day of for Notary Public Notary ublic Revised 10.24.12 73 CITY OF ATLANTIC BEACH ER BUMDER 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. TBE 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. YOUMAYBLTILDORR%4PROVEAONE—OR TWO FAMILY RESIDENCE OR A FARM OUIBUILDING. YOU MAY ALSO BUILD OR RvIPROVE 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 WITHN ONE YEAR AFTER TBE CONSTRUCTION IS COMPLETE, TBE LAW WILL PRESUME TfIAT YOU BUILT IT FOR SALE OR LEASE. WHICH IS IN VIOLATION OF THIS E)T_MpTTON. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO TIM BUILDING CODES AND ZONDJG REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW... D BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. 11. INJURY LIABILITY; SINCE OWNERS h?, BE LLABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. Ill. 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 BEI G 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. C 0,T) KI ADDRESS PHONE NUMBER r ea_ 0 PRINT NAME, SIGNATURE DATE Before me this day o� 20,L1 the county of Duval,State of Flonda,has pe onimVIappeared henn by nimself I herself and affirms that al!statements and declarations are true and accurate- Notary Public at Large,State of county of 0 Personally Known El Produced Ideritfficagon- SHIRLEY L GRAHAM 957760 XPIRES:February 14,2014 NotarySign Ic rwriters F/BIDG/Own—Build�Affaclavit; SED: 411612009 CF,IVE '':APPLICATION NUMBER C -'VFD City of Atlantic Beach APR 2 5 2013 (To be C-assigned by the Building Departme-�'L.', Building Department 800 Seminole Road Y: Atlantic Beach, Florida 322 Phone(904)247-5826 - Fax(904)247--5845 E-mail: building-dept@coab.us Date routed: City web-sitv. http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: A AtIM v Department review require Yes No Boldip� O�JanWing&Zo— Applicant: Tree Administrator ublic Project: Public Wety Fire Services 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 Toba= Father APPLICATION STATUS Reviewing Department First Review: proved. nDenied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: TREE ADMIN. Second Review: RApproved as revised. MDenied. 4P Comments: PU L TILITIES — TY Reviewed by: Date: PU kLICSAFETY FIRE SERVICES Third Review: DApproved as revised. MIDenied. Comments: Reviewed by: Date: Revised 07127110 RECFTV� City of Atlantic Beach -APPLICATION NUMBER Building Department APR 2 5 2013 (To be assigned by the_B-uilding Department) 800 Seminole Road Atlantic Beach, Florida 3"!3-, Y: y FS .......... Phone(904)247-58265 51104)247' -dept@coab.us Date ro.iea. E-mail: building _J Cityweb-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM ,A V :qe:—pa Property Address: 2, _/_e2 IaA Wit v— �rtment review re4uired Yes No �qilding_ (eign igg&Zo–ning Applicant: Tree Administrator ork Project: k ALblic Utilities, Public-Safety Fire Services Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By_ Florida Dept.of Environmental Protection Florida Dept.of TransWation St.Johns River Water Management District Army Corps oY Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages an�Tobacco Other: APPLICATION STATUS Reviewing Department First Review: KApproved.' FlDenied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by:Aet;2_='_Date: VA6)e TREE ADMIN. Second Review: DApproved as revised. FlDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: RApproved as revised. []Denied. Comments: Reviewed by: Date: Revised 07127110 City of Atlantic Beach I APPLICATION NUMBER Building Department (To be assioned by the Building Department.) 800 Seminole Road 5 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://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 2 /_,a 1#421 /L) v Department review required Yes No BuHding Applicant: Ejanriing &Zoning Tree Administrator Project: ublic -rks�. Public afety Fire Services A 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. APPLI.CATION STATUS Reviewing Department First Review: 13A' pproved. F_JlDenied. (Circle one.) Comments: B U'L" C��NING 8,ZONI�Nr- ') Reviewed by: ate: TREEADMIN. Second Review: ElApproved as revised. F�Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: F-JApproved as revised. ElDenied. Comments: Reviewed by: Date: Revised 07127/10