1845 Taylor Way 2014 Fence CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000759 Date 5/16/14
Property Address . . . . . . 1845 TAYLOR WAY
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
------------------------
------------------------
OWNER
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Permit . . . . . . FENCE PERMIT
Additional desc . .
Permit Fee . . . . 3S . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 11/12/14
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Special Notes and Comments
Fence must not encroach into pond maintenance bank (51 from
top of bank) .
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 35 . 00 3S . 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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CM OF ATLANTIC BEACH
(OWNER / BUMDER 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 ENEMPTION 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 HAPROVE A ONE—OR
TWO FANELY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR
H\4PROVE A COMIVIERCIAL 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 EXENIPTION. 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
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.
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 $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(l). AN-OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
/9 46 —rq V V
ADDRESS PHONE NUMBER
PRI. N ME
SIGAkTURE- 2 4/the county of DATE
Before me this day of �/_ in
Duval,State of F�1. d..,the.p.rsn.11y'A%r.ed herin by himself I herself and affirTns that
all statements and declarations are true an accurate.
Notary Public at Large,State of—FL— County of 7DU VCLI
kersonally Known
10
roducedld .6sy ft;i� Notary Public State of Florida
0- 1�
'o
Shirley L Graharmn
My Commission FF 086990
Expires 02/14/2018
N t
otaFy Signature:
'U"
F:113LDG/Ownu-Build�Affadavit SED: 4/1U
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.tt
Valuation of Work$ c;� 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/pro osed structure(s) circle one): Commercial Residential
If an existing strucrure,is a fire sprinMr system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approvaTform
Describe in detail the type of work to be performed: 117—
Proyery,,�ftner Information:
Name: Address: /kVl,!�_
city UAW&iL19 State—Tzip_-J2,z,��Pfione
E-Mail or Fax#(O'ptional)
Conti-actor Information: CONTRACTOR EMAEL ADDRESS:
Company Name (�fz
Qualifying Agent: L�
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
4pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commencedprior 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 ly-work is not commenced within six(6)months, or ifconstruction or work is suspAded or abandonedfor a period ofsi%)months at any time after
work is commenced. I understand that separate permits must be securedfor Electrical-Work,Plumbing,Signs, Wells,Pools, urnaces,Boilers,Heaters,
Tanks andAir 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 thi's application and know the same to be true and correct. A 11 provisions of laws and ordinances governing this
work will be complied with whethersfecified herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any otherfederal,s te, or loca aw regulating construction or the pe�fo�mance of construction.
Signature of OW)(r Signature of Contractor
Print Name Print Name
eflor e AV Before me
I D o this Day of 20
riozary Publi State of
No'Tffi�Public- Shirley L Graham Notary Public
my commission FF 086990
Expires 02/1412018 Revised 01.26.10
City of Atlantic Beach APPLICATION NUMBER
by the
Building Department F� k TT 4' Building Department.)
(To be assigned
800 Seminole Road
Atlantic Beach, Florida 32233-5445 MAY 12 2014
Phone(904)247-5826 - Fax(904)24 7-5845
E-mail: building-dept@coab.us I Date routed: J go
City web-site: http://vmw.coab.us BY:
APPLICATION REVIEW AND TRACKING FORM
Property Address: /�y
J0 1! A, Department review required Yes No
I Build�.
Applicant: Planninq &Zqpj
bg�
Tree -d—ministrator
Project: .�f�u__bric W�®rk
:Iilu�
Public Safety
Fire Services
Review fee $ 61� Dept Signature
F
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: OApproved. E]Denied.
(Circle one.) Co ents� E)�J(� X�-C 17' 1
//A
BUILDING A)3� /V)/�/PTtv
7o
PLANNING &ZONING Reviewed by: 1)a t e:
TREE ADMIN. Second Review: RApproved as revised. nDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: F]Approved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
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 Date routed:
E-mail: building-dept@coab.us
City web-site: hftp://vvww.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Department review required Yes No
B i
Applicant: Planninq
-A
Tree 7Tm—inistrator
Project: J7_ '46-2) 0 ublic Work
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 All oholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: XApproved. OlDenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed bv: Date:,V9A
Y
TREE ADMIN. Second Review: FlApproved as revised. FIDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date'.
FIRE SERVICES Third Review: FlApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach TNIED APPLICATION NUMBER
Building Department REC (To be assigned by the Building Department.)
V 800 Seminole Road MAY 12 2014
At antic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904) 47-5845
Date routed:
E-mail: building-dept@coab.us 11
City web-site: http://www.coab.us FF
APPLICATION REVIEW AND TRACKING FORM
Property Address: Depa ment review required Yes No
B i
-Y� Planning &Zon
Applicant: , _[l�
Tree dr_i�inistrator
Project: /7- '4-7) ublic Work
LI;b-��_Q m4i�� -
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: Approved. [-]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:_ Date:
TREE ADMIN. Second Review: FlApproved as revised. ElDenied.
S*C W06ORKS Comments:
;nd
kf_�
PUBLIC TILI
Date:
PUBLIC SAFETY Reviewed by:
FIRE SERVICES Third Review: nApproved as revised. E]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09