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1622 E Park Ter 2014 Fence CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000616 Date 4/2S/14 Property Address . . . . . . 1622 E PARK TER Application type description FENCE PERMIT Property zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------- ----------------------------------------------------- Application desc 4ft 6ft fence ------ -- ------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ALLEN, JOSHUA D OWNER 1622 PARK TERRACE EAST ATLANTIC BEACH FL 32233 -- ------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . - Plan Check Fee . 00 Permit Fee . . . . 35 . 00 Valuation . . . . 0 Issue Date . . . . Expiration Date . . 10/22/14 ----------------------- -------------------------------------------- ------- Special Notes and Comments Ensure fence does not encroach into Johnasen Park. --------------- ---------------------------------------------------- -------- Fee summary Charged Paid Credited Due ----- ----------- ---------- ---------- ---------- ---------- Permit Fee Total 3S . 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 FILE COPY Office (904) 247-5826 Fax (904) 247-5845 JobAddress: P+14L Permit Number: Legal Description 3q-t;-1 09-;S-2-'1F -574A 4PIA& U&J f& -7 Parcel# 1 '77-D7-0-030L/ q7oc) Floor Area of ---9q.Ft. "'IJ4 Sq Ft — Nl,� 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 �e�side�tia (� If an existing structure,is a fire sprinkler system installed? (Circle one)C11 o N/A Florida Product Approval # For multiple products use product approval Describe in detail the type of work to be performed:-!C,� �rmp- a,(mJ loa&,,,a�rA See- 9,(,,cj A�1%41 �� "IV5 V Property Owner Information: Name:--S-D-,�k ASLLC-A Address: )VZ� �4,r�L Te-�- P-- city A,0,w-rA-C- G&.+CH State . _g_7_ip 13 Phone fo-3��- �W-) E-Mail or Fax# (Optional) "105L,-6�T� e ��CO.C&V%- Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: Qualifying Agent: Address: city —State Zip Office Phone Job Site/Contact Number Fax State Certification/Registration Architect Name&Phone# Engineer's Name&Phone 4 Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address 4pplication 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�aopermit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null and void f rk is not commenced within six(6)months, or if construction or work is suspended or abandonedfor aWeriod of six(6)months at any time after work is commenced. I understand that separate permits must be securedfor Electrical Work, Pluinbing,Signs, ells,Pools, Furnaces,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. I herelb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any otherfederal,state, or local law regulating construction or the performance of construction. Signature of Owner U Signature of Contractor Print Name 1-305A I�Atv-, Print Name ......................................................................................................................................... ..................................................................................................................................... N Bekfore_RVe . e % = bi . 2M '.Sr Do A* ? t ' thi ry PubliC St .s of ra 'hirley L 7 FF 086 y Gra — 20 my C mi"On FF 086990 6Xpirgs 02/14/2018 A A Nota!T-Tru-671Z7 ��?�-PTib7ic Revised 01.26.10 7�00 --7 CITY OF ATLANTIC BEACH OWNER / BUMDER AFFMAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW. FDISCLOSURE 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 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 THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR FESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU RAVE LICENSES REQUIRED BY STATE LAW AND Y COUNTY OR MUNICIPAL LICENSING ORDINANCES, 11. INJURY LIABILITY; SINCE OWNERS M Y 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 STATU I E 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 OV\INER-BUILDER PERMIT. loy PHONE NUMBER ADDRESS IPRINT NA DATE SIGNATU Before me this day of 20 in the county of Duval,State of Florida,has per nally appeared herin by himself herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of county of 0 P nally Known ow 7.d..d Identifi 45- Notary Public State of Florida Shirley L Graham my Commission FF 086990 Expires 02/14/2018 Notary Sign __ , ffadavl -S 4/M/2.119 F/BLDG/0�—Build�Affadavit;REVIS 4/16/2009 MAP SHOWING BOUNDARY SURVEY OF LOT 1 , BLOCK 12, ACCORDING 70 THE PLAT OF SELVA MARNA UNET NO. 7' AS RECORDED IN PLAT BOOK 34, PAGE 52, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED TO: JOSHUA DANIEL ALLEN, COMMONWEALTH LAND TITLE INSURANCE COMPANY, REGIONS MORTGAGE AND OBERDORFER & BARRY, P.A. PARK S 06024'50'-' E 50.00' (R) S 06*24'50' E 50.00' (A4) BEARING REFERENCE LINE X4. 4 1/2- P.C. C.M. 100-6 lop— '7TELEPHONE. RISER ..CON6. C6: DRIVE cli. ----------- CONC. WALK CONC. WALK A/C NAIL & DISK UNIT LB 5488 IN MAG. TREE 0 P.R.C. C14 COVD CONC. kn I--- Lp 0 CS- '�d S- Vk� f2 v LOT 1 1/2' N 06*29'54- W I J2.68' (M) 1/2- N 06-24'50- #r .132.56' (R) P A R K 30, City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by th Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 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 th LDate routed-. Property Address: 20 2- Department review re uired Yes No B i i Applicant: Planning &Zonin -r-re-e-Administrator ublic Works Project: c blitie u ic afety Fire Services Review fee $ Dept Signature Review or Receipt Date of P rm� _ �dpt Other Agency Review or Permit Required I rif of Permit Verified By Florida Dept. of Environmental Protection 10 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 [94pproved. F]Denied. Reviewing Department First Review (Circle one.) Comments: BUILDING Date: PLANNING &ZONING Reviewed by: TREE ADMIN. evised. enied. Second Review: nApproved as revised. 11D PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14109 u Lj:-r,,, City of Atlantic Beach APPLICATION NUMBER RECEIVEID (To be assigned by tthn Building Department.) Building Department FD / 800 Seminole Road Atlantic Beach, Florida 32233-5445 APR 2 2 2014 7-5845F 2 Phone(904)247-5826 - Fax(904) 2 7-5845 �d- Y, LDate route E-mail: building-dept@coab.us City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Department review req6�ired Yes No Property Address: 2- �6�i"�/- '� 7! !n�ing &Z�oNin P!Ia!n Applicant: -17re��erninistrator ubl* Project: c filitie u ic afety Fire Services Review fee Dept Signature red Review or Receipt Date Other Agency Review or Permit Requi 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 epartment First Review: [XApproved. ElDenied. (Circle one.) Comments: Y) )4,Wct BUILDING -Tz ( ),07 PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: nApproved as revised. E]Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ElApproved as revised. FIDenied. Comments: Reviewed by: Datei Revised 05/14/09 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by thn Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 APR 2 2 2014 Phone(904)247-5826 - Fax(904)247 5845 Date route d: E-mail: building-dept@coab.us 1BY City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Lk 2- Department review require Yes No B Air"— Planning &Zoning Applicant: r�ee ministrator eT5-ubliQ Work-S Project: itie) — — 'PuTricMa-f-ety Fire Services Review fee $ Dept Signaturd�_�� 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: 'Ploproved. []Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:_("a Date:41 TREE ADMIN. Second Review: FlApproved as revised. FIDenied. WO KS C mments: UBLI UTI Reviewed by: Date: PU LIC AWT� FIRE SERVICES Third Review: [-]Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09