472 Sailfish DR 2013 Fence CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003054 Date 7/19/13
Property Address . . . . . . 472 SAILFISH DR
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
4 ft fence
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Owner Contractor
------------------------ ------------------------
MOSES, ANA M B/M OWNER
472 SAILFISH DR E
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 . . 1/15/14
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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 .
Fence must be on Owner' s property, not 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 ONLV IN ACCORDANCE WITH ALL CITV OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
qW
MAP SHOWING URVEY 0
Loi 11, Block 10, as shown on the Replat of a Part )r 1',Ioyal Palms Unit 2-A, as recorded
in Plat Book 319 Pages 16, 16A, 163, 16C and 16D :)f tho.Current Public .Zocords of Duva
County, Florida.
City of Atlantic Beach oseph N. -^Ilcurios - JINs christiv
-ile
Your F -!o. 529 1-
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 appliaAle
local, State and Federal permitting requi�rerri
must be verified by signature of the City a�,�ticplyltl�
Beach Building Official prior to the issua gArf a
Building Permit. AUG 19 1996
Approved By: All
Zoning
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07 Building and
Date: 0
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5 City of Atlantic Beach
APPLICATION NUMBER
Building Department
(To be assigned by the Building Department.)
"i xv 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us led:
al
1 .1 Date rou
City web-site: http://Www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: . '5�t7-IAS'A Department review req-uired Yes No
Bu.1
Applicant: Planning��
iree Administrator
Project: Z/ ublic Wor—k:0
I Ic U t�
c Utilities
till
u u lic S i
blic Safety
Fire Services
Review fee Dept Signature
5�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:
APPLICATION STATUS
Reviewing Department First Review: 0-Approved. MDenied.
(Circle one.) Comments:
BUILDING
,--P_�LANNING &ZONIN
Reviewed by: Date: L�Tzl��1_12
TREE ADMIN. Second Review: []Approved as revised. nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 05114/09
R.,ECEIVED
I io City of Atlantic Beach APPLICATION NUMBER
JUL 15 2013
Building Department P
(To be a�ssigned by the Building DepartmeInt.)
P i.1%" J 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845
Date route
f02119 E-mail: building-dept@coab.us F d:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -2)Y-_ Department review required Yes No
Building
Planning
Applicant: �0
Fee Administrator
Project: 4// 7- /e,-nA ublic Wo=rks
I ic U
c Utilities-:�)
u U lic S
blic 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 Departm nt First Review: IpApproved. MDenied.
(Circle one.) Comments: 1,12 41�C� IIA-Y\ Ir— C-YJ
BUILDING 64,./
PLANNING &ZONING Reviewed by:_ Date2�.r)-/C3
TREE ADMIN. Second Review: []Approved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: OApproved as revised. ODenied.
Comments:
Reviewed by: Date:
Revised 05114/09
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH FFJUL 15 20131
800 Seminole Road, Atlantic Beach, Fl, 32233
Office (904) 247-5826 Fax (904) 247-5845
Lc
Job Address: lj472- Permit Number:
Legal Description 3 /)a e D Floor Area of Sq.Ft. Parcel 4 Sq.Ft
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—app—r-o-wal form
Describe in detail the type of work to be per ed:
ss
7m
Property 01Wher Infqrmatio
4
Name: Address:
Cityt State UZip,��A�Phone
E-Mail or Fax#(Optional
Contractor Information:
Company Name: V411, Qualifying Agent:
Address: a4� 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_
Mortgage Lender Name and Address
e e de ana e d he work and n 'at ns as i ndi cat or installation h as commenced prior to the
a a i ' to, tt i StO5 riods I�aw this jurisdiction. Thispermit becomes mill
0 1 rmi'to 0 0 d he t I s f sixPU5)months at any time after
m th to I't , p i b r a
d k e me an a k s aWeriod o
v s, or t s Odor 11 Pools, urnaces,Boilers,Heaters,
r
is h r by f
"c io
a r
(6)mont n n
P it a at 'a p
Ap
issuance 0 a P' s t om t six f
and id ok i no me ced'i hin i 0 e s
work is c ""ed I understand that separate Perm ts t be secured 0,Elec"ca
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 apolication and know the same to be true and correct. All provisions of laws and ordinances governing this
111work will be coTplied with whether ecifz'ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provist.ons of any otherfederal,sta or localsflalw re ting construction or the pe�jbrmance of construction.
Signature of Owner Signature of Contractor
PrintName Print Name ........................................................................................................................................
B -C-
efo Before me
this-A ay f 20 this Day of . 20
u
Not ry u ic - - MY MIS; blic
2. ION#DID 957760
"PIPES:Febnj:14,2014
1 c
Bonded Thru Notary Pubj c Un(jewrffem Revised 10.24.12
CITY OF ATLANTIC BEACH
OWNER / BUILDER AFFIDAVIT
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "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 THOUGII YOU DO NOT tIAVE 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 WITMN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME TITAT YOU BUILT
IT FOR SALE OR LEASE, WI-HCH IS IN VIOLATION OF TIES EXEMPTION. YOU MAY NOT
HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO TITE 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. IMJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
111. 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(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.
911-11/
ADDRESS PHONE NUMBER
A'
PRINT INAM -7
6-1
�rt�ATURE jp'ATE
B fore me this 2��day of .20 the county of
a
Duval,State of Florida,has pers4ona Iyappear herin byl,,�
all statements and declarations are true an rate. r "Iherself and ffl th at
Notary Public at Large,State of_,County of
�E]�Persl<nown
"y`
p ', ed dentifiration-
J-
Notary Sign HAW L
MytMISSION#613957760
14,201
F:,r BLDG lie J�
_Orpary 14,201
&ACTA"o ary Public Undo
C'EIVED ,
City of Atlantic Beach JUL 15 2013 APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
/9 -
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
, __;V
5-/) vJ Department review required Yes No
Property Address: �7Z_ Slat? V —
Applicant: ��_Planning &_4911E6��
=T=re;;--e'Administrator
Project: ZI 7- 1V a2,4 6 --P-ub Fic—Wor-k-s-7)
:r=icUtilities7::)
"7u-bricSafety
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: YApproved. FjDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:=�'v Date:
TREE ADMIN. Second Review: []Approved as revised. E]Denied.
C� comments:
W6
PUBLIC UTILITIES
PUBLICS F�E Reviewed by: Date:
FIRE SERVICES Third Review: F]Approved as revised. F-]Denied.
Comments:
Reviewed by: Date:
Revised 05114/09