1700 E park ter fence 201 3 CITY OF ATLANTIC BEM.�.
800 SEMINOLE ROAM
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002491 Date 1/06/14
Property Address . . . . . . 1700 E PARK TER
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0 --------------
----------- ----
Application desc
4ft and 6ft fence
-----------------------------------------------------
Owner Contractor
------------------------
------------------------
POPPELL, RONEL J. OWNER
1700 PARK TERRACE EAST ATLANTIC BEACH FL 32233
ATLANTIC BEACH FL 32233
--------------------------- ------------------------------------------------
Permit . . . . . . FENCE PERMIT
Additional desc - - . 00
Permit Fee . . . . 35 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/05/14 -----------------------
-----------------------------------------------------
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 easement south end of property. Sewer main
is located in easement . t be on City approved list
Roll off container company mus
and container cannot be placed on City Right-of-Way.
(Approved: Advanced Disposal, Realco, Shappelle' s and Waste
Management . )
Sanitary sewer is in the easement where fence location is
proposed. Ensure it is located and not damaged by fence
installation. -----------------------
---------- -----------------------------------------
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 SHOWING BOUNDARY SURVEY OF
LOT- B-BLOCK AS SHOWN ON MAP OF
F SELVA MARNA- UN M 0. 7
AS REcoRDED w Pur sooK 32 PAGEs 5Z OF THE r-Ve;Z-5"7- P006iC Ree-alebv O..r brIvAL eo, FeA
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rompliance with applicable
This appro local land
on and other
zoning, U.t reg' tions, but does not constitute
development reg lits. Compliance
approval for the is!! ance of per I other applicable
with Florida Buildir Code and al
local, State.and F deral permitting requirements
ust be verified b' signature of the City of Atlantic
each Building 0 ciai prior to the issuance of a
Building Permit-
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CITY OF ATLANTIC BEACH
(OWNER / BMDER 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 L710ENSED
CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION T T I
0 HAT
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 MUS
SUPERVISE THE CONSTRUCTION YOURSELF. YOUMAYBUILDORIMPROVEAONE—OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
IMPROVE A COMIAERCIAL,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.
rF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER UM CONSTRUCTION IS COMPLETE,TBE LAW WILL PRESUNIE THAT YOU BUILT
IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION, YOU MAY NOT
HIRE AN UNLICENSED PERSON AS YOUR C TRACTOR- YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO TTIE 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.
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 BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(l). AN-OCCUPATIONAL LIC NSE- IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
fTH__0NEE NUMBER
ADDRESS
rIMNT NAME
DATE
SIGNATURE
Beforemethis 7 dayof 24:4tr L_20_Z2� in the counly of
Duval,State of Florida,has personally Alp,pearecl henn by himself I herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of county of --)4!1�1
0 Personmy Known
(5,procured Identification-
Sri'
a
EXPIRES:February 14,201
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: -7 C-`j Q� r . IEZ--m Permit Number:
Legal Description ''I Parcel# ...........
Floor Area 11 1 1
Valuation of Work$, 2 1 A-sc�l Proposed Work heated/cooled n6n-heated/cooled�
Class of Work(circle one): �Dew Addition Alteration Repair Move Demolition pool/spa window/door
Commercial 61tesidenti
Use of existing/proposed structure(s) (circle one): 4i�& N/A
If an existing structure,is a fire sprinkler system installed? (Circle.one): es
Florida Product Approval#
For multiple products use product approval torm
Describe in detail the type of work to be performed:
<5% Z1 I r &2-7 0'
Property Owner ln_formation: Address:
Name: Z:S3 licine
Qlatek I Z p
city por\ i
-9�Z —
E-Mail or Fax#(Opticil fl,�,
Contractor Information:
Company Name: Qualifyin Agent- State Zip
Address: Sity Fax
office Phone Job Site/Contact Number
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 -k and installations as indicated. I certify that no work or installation has commencedprior to the
4pplication is hereby made to obtain a permit to do the wot eet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null
issuance of a permit and that all work will be performed to in nedfor aWeriod of six �any time after
ix(6)months, or if construction or work is suspended or abando, P6,)months at
and void ff work is not commenced within s r Electrical Work,Plumbing,sians, ells,Pools, urnaces,Boilers,Heaters,
work is commenced I understand that separate permits must be securedfo
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 FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
ion and know the same to be true and correct. All provisions of laws and ordinances governing this
lhereb certify that I have read and examined this applicat thority to violate or cancel the
type o work will be complied with whether srecified herein or not. The granting of a permit does not presume to give au
-7 1 aw n or the pe�formance of construction.
provisions of any otherfederal,state, or oca regula nstruch o
Signature of Owner Signature of Contractor
PrintName ......................................................................................................................................... Print Name .......................................................................................................................................
Befo 1 .� Before me 20
D o i20 - this _Day of
L G
7760
j 4
EXp c,:February 14,20
Notary P V otary Public Underwriters
Bonde Thr
hr Revised 10.24.12
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
13
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 routed:
Date
E-mail: building-dept@coab.us
City web-site: http://www.coab.us 7-
APPLICATION REVIEW AND TRACKING FORM
.s. F-be-p-aaftment review required Yes No
Property Addres
(Planning&Zoning:) V
Applicant: Administrator
Tree
Project:
–P,ubTi d-Lffi 111 tl e s_>
Public Safety
Fire Services
'Raw
Other Agency Review or Permit Required Review or eceipt 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: 24proved. ElDenied.
(Circle one.) Comments:
BUILDING
q�NNING�&ZO Reviewed by: Date:
TREE ADMIN. Second Review: DApproved as revised. [—IDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
Reviewed by: Date.
PUBLIC SAFETY
FIRE SERVICES Third Review: [_JApproved as revised. [:]Denied.
Comments:
Reviewed by: Date:—
Revised 07127/10
City of Atlantic Beach APR 18 2013 APPLICATION �UMBER
(To be assigned by the Building Department.)
Building Department
800 Seminole Road
Atlantic Beach, Florida 32233-5446_!_----=-----==
Fax(904)247-5845
Phone(904)247-5826
Date routed:
E-mail: building-dept@coab.us
City web-site: http://\wmw.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
BuHdin
.g
Applicant: �nnin &Zonipcp
T-ree Administrator
Project: �Wo[k�s
I -Utiflifies -
Publ-16-Safety
Fire Services
Review or Receipt
Other Agency Review or Permit Required Date
of Permit Verified By
Florida Dept. of Environmental Prot;�Fio—n
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: FlApproved as revised. []Denied.
P S Comments:
B C TILITIES
iy
P5 1-
U Reviewed by: Date:
PU IC SAFETY
FIRE SERVICES Third Review: F�Approved as revised. []Denied.
Comments:
Reviewed by: Date:
Revised 07127110
i<-ECEIVED
City of Atlantic Beach APPLICATION NUMBER
APR 18 2013
Building Department (To be assigned by the Building Department.)
800 Seminole Road ID 13 L
Atlantic Beach, Florida 32233-5445 1 LJ.1
�3
Phone(904)247-5826 - Fax(904)247-5845 Date routed:
E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 14 Depa-rtment review req Yes No
Building_
Applicant: (Planning &Zoning>
Tr—ee- Administrator
Project: dbfic_Workp,:�
Public Safety
Fire Services
it I eq=
Other Agency Review or Penn I ullred Review or Receipt Date
Florida Dept. of Environmental Protection of Permit Verified By
Florida Dept. of Transportation
St.Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
DivisLion of Alcoholic Beverages and T obacco
Other:
APPLICATION STATUS
F�Deniecl.
Reviewing Department First Review: o(Approved.
(Circle one.) Comments:
BUILDING D /t/5 14�
PLANNING&ZONING Reviewed by: ate:
TREE ADMIN. Second Review: []Approved as revised. []Denied.
Comments:
PUBLIC WORKS
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
-]Denied.
FIRE SERVICES Third Review: FlApproved as revised. E
Comments:
Date:
Reviewed by:
Revised 07127110