530 Sherry Dr 2013 fence CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
oil
Application Number . . . . . 13-00003772 Date 12/10/13
Property Address . . . . . . 530 SHERRY DR
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 6000
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Application desc
6 f t FENCE
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Owner Contractor
-
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COX JEREMY N OWNER
530 SHERRY DRIVE
ATLANTIC BEACH FL 322335354
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Permit . . . . . . FENCE PERMIT
Additional desc . .
Permit Fee . . . . 35 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/08/14
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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 .
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 . )
Existing fence shown to be in drainage easement . Move
back to property line.
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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 ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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City of Atlantic Beach APPLICATION NUMBER
�s Building Department (To be assigned by the Building Department.)
800 Seminole Road
.� Atlantic Beach, Florida 32233-5445 13— 37-1
Phone(904)247-5826 • Fax(904)247-5845 Date routed: 1 '2— L/
E-mail: building-dept@coab.us
City web-site: http://wviw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: SS�" \��''1� t,V_ Pegartment review required Yes No
Applicant: 0 ley-nY) Ccx Plannin &Zo
Tree Administrator
t
Project: ce is Works
Public i ities
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or ReceiptDate
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: 19 pproved. ❑Denied.
(Circle one.) Comments:
PLANNING &ZONINGReviewed by: r Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [—]Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
,j Building Department (To be assigned by the Building Department.)
800 Seminole Road
s� Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 550 �SV�-C" Dv,- De artment review required Yes No
��^^
Building
Applicant: ��Kf7�a W)�_ annin &Zonin
Tree Administrator
Project: lDl �
ublic Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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: XApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
P RK Comments:
U L C TILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
BUILDING PERMIT APPLICATION �e
CITY OF ATLANTIC BEACH £l 0 f �3 D
800 Seminole Road;Atlantic Beach, FL 32233
Office (904)247-5826 Fax(904)247-5845
Job Address: .531) 5�er r•d .0 r Permit Number: 2
Legal Description Parcel#
Floor Area of Sq[.Ft. q. t
Valuation of Work S C r pop Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition )
Repair Move Demolition pool/spa window/door
Use of existing/proposed structures)(circle one): ommercial 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 approval form
Describe in detail the type of work to be performed: ( 0++ L_->C� CArd OY-Ik0001 CD
Property Owner Information:
Name: :Y6un- I'ox Address: Skr ' <i"{
City Nt1aj},% e c-k State nZip :??It; Phone a4*1 ,-14'10
E-Mail or Fax#(Optional)
i
Contractor Information:
Company Name: s v QPM tot Vfeetp Qua h mg Agent:
Address: 1 City 5oickson,yiIW 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
Application is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
and void if wot k is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of six(6)months at any tame after
work is conznzenced. I understand that separate permits must b's scufor Electrics!Work,Plumbing,Signs, Wells, Pools, Furnaces, Boilers, Heaters,
Tanks and Air Conditioners,eta
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 hereby certify that I have read and examined this a plication and know the sante to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether spect 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 Signature of Contractor
� F t./►c2oa- 4 --72-L4 5-3—D
Print Name �lP 1►.y ` Print Name
_S...x........................................................................
Swott�o-�and subscribed before me Sworn to and subscribed before me
this A�Kay of (J 20� this Day of . 20
Not ublic Nota P 1
,IMFERwnuER Revised 01.26.10
ricers :,: MY cOMMISSION t FF 011480
U d�7�wENSdaryPril 24,2017
Bon
Public U-W"fft-
CITY OF ATLANTIC BEACH
(OWNER / BUILDER 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. 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
ORDMANCES.
IL 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
"54re rt-/
PRINT NAME
12141 i;
GNAT DATE
Before me thisL4 day of ,20 In the county of
Duval,State of Florida,has personally appeared herin by himself/herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of ,County of Jam` v
.❑.�Personally Known
yl,vroaucedIdentification-
JENNIFER WALKER
MY COMMISSION#FF 011480
I\ /nV1 (/I, _• a EXPIRES:April 24,2017
Notary Signa 1 " fT Bonded Thru Notary Public Underx he s
F:BLDG/Owner-Builder Affadavit;REVISED. 4/16/2009
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
• 800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 71
�• E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -Department review required Yes No
Applicant: ,Y�,rY� `1 anning &Zonin
minis rator
Project: �1 �� Public orks
tilities
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or ReceiptDate
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. []Denied.
(Circle one.) Comments:
BUILDING '
PLANNING &ZONING Reviewed by: Date: f
TREE ADMIN. Second Review: [-]Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09