1892 Hickory Ln 2014 Fence CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
jrt ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000649 Date 5/02/14
Property Address . . . . . . 1892 HICKORY LN
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
6ft fence
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Owner Contractor
------------------------ ------------------------
COVINGTON, LARRY B. OWNER
1892 HICKORY LANE
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 . . 10/29/14
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Special Notes and Comments
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 . )
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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.
CASTRO MTG _ _ 904241.5554 09/28 19d 10:06 NO.425 U1/U•1
Di 1R@� LAANDD SURVEYOR t PAGE D3
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904) 247-5845
Job Address: _I E2- ACAW Permit Number:
Legal Description Parcel#
Fx F oor ea o q. t. t
Valuation of Work$ J �? r 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 approva orm
n �
Describe in detail the type of work to be performed:/
Property Owner Information: �Q j� �`
Name: L -eey 4W,,A 6- 0 A/ Address: �(1�J Z A�fWYt�j L/A)
City L /? StateF`LZip 2L Phone
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: JV842�t Qualifying A ent:
Address: 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
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 this jurisdiction. This permit becomes null
and void If work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod of six 6)months at any time after
work is commenced. I understand that separate permits must be secured for EfectricalpWork,Plumbing,Signs, Wells,Pools,�urnaces,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 hereby 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
type o work will be complied with whether speci 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 Owne Signature of Contractor
74
Print Name l—g Cr0V/.,L", J x,J Print Name
........................................................................... ......................................................................................................................_................
Be Before me
s Day f t ' Day of 20
roar �i� Notary Public State of Florida
Graham
C `a a v My Commission FF 08494ary iblic
of FLOP Expires 02/14/2018
Revised 01.26.10
CITY OF ATLANTIC BEACH
OWNER d 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 REOUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANCES.
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.
LADDRESS C`s � P� �d
NUMBER
PRINTC
SIGNATURE DATE
Before me this day of �� 20 in the county of
Duval,State of Flo'da,has personally appeared/hedby him elf/herself and affirms that
all statements and declarations are true and accurate.
No�wn
t Large,State of ,County of
❑Produced Identi ion-
�ui� Notary Public State of Florida
^. Shirley L Graham
` My Commission FF 086990
Notary Si 018
F:BLDG/Owner-BuilderAffadavit;RE :4/16/20
CASTRO MTG 9042415554 09/28 '9S 10:06 NO.425 01/01
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------- DtJRD LANA SURVEYOR t PAGE 03
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Larry B.Covington
1892 Hickory Ln.
\® Atlantic Beach,FL 32233
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5—U r� City of Atlantic Beach R APPLICATION NUMBER
Js � Building Department LBY: �`EIV .� (To be assigned by the Building Department.)
800 Seminole Road /�Atlantic Beach, Florida 32233-5445PR `2 bPhone(904)247-5826 • Fax(904)247 204E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: lf92- A'CrIgyZ-7) Department review required Yes No
ll
Bui
Applicant: D��n(� tannin &Zonin
Tree Administrator
Project: wor
tilitte
u is a ety
Fire Services
Review fee $ Dept Signature0
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: 4Approved. []Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: � �� 7
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
ICeWOS Comments:
P L ES
PU � Y Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date.-
Revised
ate:Revised 05/14/09
�� City of Atlantic Beach DECEIVED APPLICATION NUMBER
Js � Building Department (To be assigned by the Building Department.)
r 800 Seminole Road APR 2 5 2014 /�—•
Atlantic Beach, Florida 32233-5445
Phone (904)247-5826 • Fax(904) 45
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ffl2- Department review required Yes No
Bui
Applicant: Q f 17�� tannin & Zonin
Tree Administrator
Project: L XLEC Wo-ria)
LU tiIities
Public 7aTety
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: Approved. ❑Denied.
(Circle one.) Comments:_
BUILDING
01,
PLANNING &ZONING Reviewed b In Date:
4.2_c ��
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
i
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
Js � Building Department (To be assigned by the Building Department.)
800 Seminole Road (aj 41
�r Atlantic Beach, Florida 32233-5445 (/
Phone(904)247-5826 • Fax(904)247-5845
\ J �a E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: lf9Z. M'e6Py Department review required Yes No
l Q Bui
Applicant: D��nl� tannin &tonin
Tree Administrator
Project: Wor
tiIities
Public a ety
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. ❑Denied.
(Circle one.) Comments:
BUILDING
CANNING &ZONIN Reviewed by: 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