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297 Pine St gate 2014 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000220 Date 2/24/14 Property Address . . . . . . 297 PINE ST Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 6FT GATE ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ LATIMER BRUCE T ET AL OWNER C/O JEANNIE LATIMER 297 PINE ST ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/23/14 ---------------------------------------------------------------------------- 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. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 FFEB 14 20141 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 9 -7 Permit Number: Legal Description _q.F—t Parcel 3q.r L Valuation of Work S 72-doo - 0 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 Fro—d—uc—t_ap`p__ro_—vaTTo--rm Describe in detail the type of work to be performed: feti I Kiol tj Property 0 vner Information: Vy Name:,jeavi city AdIdre : Am State IVZip , E-Mail or Fax# (Opti 941-79i?sPhone onal),A' FD,V)� 0 �t L,; - -1yl Y,11 t \DO 0- C, 00 \Ij I Contractor Information: CON tACT�)R F 4AIL ADD UESS: Company Name: Qualifying Agent: Address:- city �ZiD Office Phone JobSite/�Cont�actNu�mber -State—_ P State Certification/Registration 4 Fax 4 Architect Name&Phone 4 Engineer's Name&Phone Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address .rtify that no work or installation has commencedprior to the ng construction in thisjurisdiction. Thispermit becomes null or abandonedfor aeeriod ofsU16)months at any time after Phinibing,Skns, ells,Pools, urnaces,Boll6s,Heaters, 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 thi's lication and know the same to be true and correct. Allprovisions of laws and ordinances governing thi's type ol�work will be co�nplied with whether (17,� eci ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions ofany otherfederal,state, or localsfaw regulating construction or the performance of construction. Signature ofOwner Print Name Signature of Contractor ..................................................................... .............................. Print Name Befo ........................................................................................................................................ Before me his ay of 20 this —Day of ,�ota u lic a Shirley L Graham My Commission FF 086990 or f F_xpires 02/14/2018 Revised 01.26.10 CITY OF ATLANTIC BEACH (OWNER / BUOLDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER I 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 MUS 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, TEE LAW WELL 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 TEE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILJTY TO MAKE SURE THAT PEOPLE EMPLOYED By YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. [I. 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 AN CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STA TUTE 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 PRINT NAME 4/1 4 DATE IG ATURE Before me this Xdayof_ 20_�q the county of Duval,State of Florida,has personally appeared herin�y himself/herself and at all statements and declarations are tahea ,, and accurate. KN Public at Large,State of L ,Coun, 2;�v�C Zonally Known duced ldentiffiic�at' ublic S te of Florida S L Gra M 0 , si F 08A00A Notary Signa, Exp 3 0 FJBLDG/Own�-Builder Affadavi�REVISED: 4/16/2009 _11r- City of Atlantic Beach .jp Build APPLICATION NUMBER ing Department P4& (To be assigned by the Building Department.) 00 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904) 247-5845 5 E-mail: building-dept@coab.us t City web-site: http://www.coab.us [Date routed: APPLICATION REVIEW AND TRACKING FORM Property Address: Department review required Yes No Applicant: ing Planning &I Zonin Project: istrator Public Utilities Public 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 Department First Review: pproved. ElDenied. (Circle one.) Comments. DIDenied. A BUILDING PLANNING &ZONING Reviewed by: _00� Date: 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. nDenied. Comments: Reviewed by: Date: ?evised 05/14109 City of Atlantic Beach APPLICATION NUMBER Building Department 4 7?014 (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904) 247-58455: E-mail: building-dept@coab.us LDate routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Department review re uired Yes--No ing Applicant: Planning &Zonin ffistrator Project: 7- (Q—P u b I i c-U t Ri—ti e—s Public Safety Fire Services Review fee $ Dept Signat<re]p 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: PApproved. ODenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: []Approved as revised. E]Denied. WORR Comments: L C UTILITIE A* Date: PUBLIC SAFETY Reviewed by: FIRE SERVICES Third Review: E]Approved as revised. [—]Denied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach r P 7F� i r� Building Department APPLICATION NUMBER 800 Seminole Road (To be assigned by the Building Department,) Atlantic Beach, Florida 32233-5445 H 0 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: c:2,q' I Department review r-equired -Yes No ing D epar'ment review trequired Applicant: Planning istrator Project: - Public Utilities Pu blic Safety Fire*Services 'keview 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 FReviewing Department First Review: [7Approved. F�Denied. _�_ _pi �tment (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewecd by: TREE ADMIN. Second Review: E]Approved as revise MDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: EjApproved as revised. FjDenied. Comments: Reviewed by: Date: Zevised 05/14109 lRjk&Irlljw A arAmwWw MA S17,,—+IAIG BOUNDARY 5ti, -'VEY' Of- _,A LOT- - 59F6 ------hLOCff S SHOW 01V MAP OF 9.44 7-WIR Al2" CERIXED TO.-fAMMIZE -iWA?MEC&C-� ti_rcff_ tv, t e o 71- -4,,VO awe . (PO4) ft�6- ?6TA A IAN=—MW_,M5_Fyy Lr_ JA(:WMLML'w._Ft,?I?IDA 322V LEGEND FCIW w ow_�6m M fw"" �A "MM KII" PAM Hlklk�&T BM A55MAelM raft cksDd%is,t*vv—'M%#wcno43 wow Ty,t;"3 TO ve As se 0 FV g F Po,"F-f FLA CERZ NO �iM FLOM :�Wj scr,0". Ted4 NA