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774 Aquatic Dr fence 2013 1 CITY OF ATLANTIC BEACH 111 s 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Jr31s) Application Number . . . . . 13-00002657 Date 6/11/13 Property Address . . . . . . 774 AQUATIC DR Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc addition to 6ft fence ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- LEBOUTON, MARDEN OWNER 774 AQUATIC DRIVE ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/08/13 ---------------------------------------------------------------------------- Special Notes and Comments 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 . ) ----------------------------------------------------------------------- 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. 1.1 ) � � I C m n Ln 4,S. 00 o e o o So r S' * a � sE� �tJr�� a � �� ►� o 1DO G z 3 Z, \ y tv A � rn ►ta t ° Z a �4. o c— p �1 C) q 0Ll o a M1 a•5-. - BOO TO '� n '—�=.=�azo•¢3 :s8°E • � � . _ � I m �/��j�- 4s•oo � � I � o City of Atlantic Beach Planning and Zoning Department This approval verifies compliance with applicable zoning, subdivision and other local land development regulations, but does not constitute approval for the issuance of permits. Compliance with Florida Building Code and all other applicable P 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 Permit. Approved By: y� Date: t� � �L ntitor i27- 2��'1 I City of Atlantic Beach' Building Department d C7s)n , 800 Seminole Road Afiandc Beach,Florida 322334M 4 ' Phone(9W)247-5W-6 • Fax(904)247- E-mail: buiidrn"ePt@Wab.us Cib/web-site: W:/Awjw.0O2b.ua APPLICATION REVI 2W AND TRACKING FORM Property Address: De rtment review uired Yes No Applicant: & 10 n/E Planning&Zoning • OP Project: ubiTh ic works rc Utilities U iG Fire Services , Other Agency Review or Permit Rkuieed R 'ew or Receipt of Permit Verified Date Florida Dept of Envirwmentai Protection Florida Dept:of Transpertabon _ St.Johns River Water Management Dish Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other. APPLICATION STATUS 1 Reviewing'Department First Review: Dppraved. QI)enied. (Circle one.) Comments: BUILDING �— 26k�I�LANNING&ZO G Reviewed by: Date: OSII'+/240. TREE ADMIN. Second Review. FlApproved as revised. []Denied. PUBLIC WORKS Comments: J_Y PUBLIC UTILITIES PUBLIC SAFETY Reviewed i7y. FIRE SERVICES 'i'hir+d Review: Appr:,ved as revised. L Denied. Comments: Reviewed by Date: Ferrised 07127190 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: IN u Gl.l l C, Permit Number: Legal Description Parcel# Floor Area of Sq.Ft. q• t Valuation of Work$ 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# For multiple products use product approva orm Describe in detail the type of work to be performed: fit-(,dffl0?1 +0 liyl sh(UI na Property Owner Information: Name: 1qalajLe Address: t1A d7 City State Zi 2 Phone - E-Mail or Fax# (Optional) �% C 0 C Contractor Information: Company Name: Quali ng Agent: Address: Ci State Zip Office Phone Job Site/Cont a t Numb Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do t work and installations as indicated. 1 c ti that no work or installation has commenced prior to the issuance of a permit and that all work will be perfor d to meet the standards of all laws regulatin construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six 16)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical-Work,Plumbing, Signs, Wells,Pools, urnaces,Boilers,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. 1 hereb certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whetherspeci ted herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state, or local law regulating construction or the performance of construction. Signature of Owner Y&/16,_2t�� Signature of Contractor Print Name 1"� ✓�.........._l ....J.) �.�?'..1.............................................. Print Name ........................................................................... Before Before me this a o this Day of 120 "fir L_oRNHN 60 N u is = i:WTIRES:February14,2014 Notary Public ''• oQ onaed hruNotary Public umwWriters Revised 10.24.12 CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT 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 THE CONSTRUCTION IS COMPLETE,THE LAW WILL 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. II. 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(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.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. ADDRESS PHONE NUMBER M Wtn b T/�Jcc�fn PRINT NAME 1--m Qj__)1_ f3 � d-0(3 SIGNATURE DATE Before me this day of2t)�in the county of Duval,State of Florida,has personal ap ared herin by himself/herself and affirms that all statements and declarations are trueA d accurate. Notary Public at Large,State of County ofv� _ Personally Known Produced Identification- :aAl1A� - "�, uRAHAM Notary Signature: t QN#DD 957760 I r oPE5 February 14,2014 F:BLDG/Owner-Builder Affadavit;REVISED:4A 009 }',�° 4oE ;onrierl T)ru Notary Public Underwriters BP250U01 CITY OF ATLANTIC BEACH 5/20/13 Application Tracking Step Selection by Revision 09:08:33 Application number . . . . : 13 00002657 Address . . . . . . . . . . : 774 AQUATIC DR RE number . . . . . . . . . : 171818-5258- - Application type . . : FENCE PERMIT NCR OLD ACCOUNT NUMBERS : AB25079 Tenant name, number . . . . : Type options, press Enter . 2=Change 4=Delete 5=View 6=Fast log 8=Action log maintenance 9=In/out maint Path ---- Key Dates --- - Review Summary - Opt Agency description Rev Step Req In Est Cmpl Resulted Stat By _ PLANNING & ZONING A 01 Y 05/14/13 05/22/13 05/14/13 AP EH _ PUBLIC UTILITIES A O1 Y 05/13/13 05/22/13 05/15/13 AP LS PUBLIC WORKS A O1 Y 05/13/13 05/22/13 05/15/13 AP LS Bottom F3=Exit FS=Land inquiry F6=Add F7=Revisions FB=Misc info inquiry F9=Corrections report F10=View 2 F11=Sort by agency F24=More keys 13 pw�' city of Atlantic Beach RE I Building Department800Seminole Road MAY 14 2qAtlantic Beach Florida 322 Phone(904)247-5826 - Fax(E-maff: buflc0ng-dept@coab.usCity web-site_ httpJAN~coab.us APPLICATION REVI;EW ANP' TRACKING FOS .4 Property Address: 4 124 0 � De rtment review roquired Yes No Applicant: /1/6 ie, i y Planning&Zoning i �� _ or FF1rei%erWces_..._.._.A Project: WU R6vew or Other Agency Review or Permit Rof Permit rmit VVerified apt Date Florida Dept of Environmental Protection Florida Dept of Transportation St Johns River Water Management District Army Corps of Engineers Division of Hotels and Reshwrarts Division of Alcoholic Beverages and Tobacco Other: J. APPLICATION STATUS Reviewing Department First Review: . Approver. [Denied. (Circle one.) Comments: i BUILDING I PLANNING&ZONING Reviewed by' Date: S 3 TREE ADMIN. Second Review: DAppraved as revised. ❑Deni . PUBLIC WORKS Comments: PUBLIC UTILITIES I PUBLIC SAFETY Reviewed by: Date:__ FIRE SERVICES Third Review: DApproved as revised. []Denied. Comments: Revi by: Date: e0a's ed U7f�'df`iQ RE T-, D jj ;y City of Atlantic BeachN AY 14 2013 9, Building Department a tib t T&� 800 Seminole Road " wsg ) . Atlantic Beach,Florida 32233-5445 # Phone(904)247-5826 • Fax(904) k E-mail: building-dept@coahus City web-site_ http:/ANww.coab.us I APPLICATION REVIEW AN TRACKING FQRIIII Property Address: �� lQ De rtrnent review required Yes No i Applicant: A) /V 1� le— Planning&Zoning or Project: — ublic Works j tc Utilities i Public ety Fire Services i Other Agency Review or Permit Required Review or Receiptof Permit Verified By Date 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 PLANNING&ZONING Reviewed by: Date: TREE ADMIN. Second Review. ®Approved as revised. ❑Denied. Comments: UTILITI P LI� SAFElY Reviewed by: Date: FIRE SERVICES Third Review: ElApproved as revised. ❑Denied. Comments: { Reviewed by- Date: Revised 07/27/10