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185 Pine St 2014 Fence CITY OF ATLANTIC BEACH \ I11 J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000825 Date 5/28/14 Property Address . . . . . . 185 PINE ST Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------------------------------------------ Application desc 6ft and 4ft ----------------------------------------- Owner Contractor - ------------------------ ----------------------- SANDERSON, JOSEPH OWNER 1101 SANDPIPER LN E ATLANTIC BEACH FL 32233 --------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . . 00 Permit Fee . . . . 35 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/24/14 -------------------------------------- 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 . 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 Office (904)247-5826 Fax (904) 247/-5845 Job Address: 195 P,wL SA"-Qk Permit Number: Legal Description Parcel# Floor Area o q. t. Sq.Ft 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 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 Describe in detail the type of work to be performed: 6-Or Fen« �v y4" Fend Property Owner Information: Name:— ,)%e S"-y� Address: IfO1 'Go^ Q•per LAr.4- , thlw..h. P,�,�l, ,F( City A*6,.4ke Qlr*. , State FiLZip23 'i33 Phone 104-314-760-7 E-Mail or Fax#(Optional) 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# 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. 1 certify that no work or installation has commenced prior to the issuance of a he 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:f work is not commenced within six(6)months, or if construction or work is suspended or aba-idoned for apenod of six(6)months at arty time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,Signs, Wells, 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 hereb 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 of work will be complied wit ether sppeci ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, te, r local la regulating construction or the performance of construction. Signature of Owner / Signature of Contractor PrintName -3,A G `fin.-C��tr5ow Print Name ........................................-.............................................................................................. Befor Before me th' ay f 20/ this Day of 20 No ub is Notary Public State of Florida otary Public Shirley L Graham My commission,FF 086990 Revised 01.26.10 OF n Expires 03/14/2018 CITE' OF ATLANTIC BEACH OWNER / BUILDER AFFIDA`71T I. 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 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 MRE AN UNLICENSED PERSON AS YOUR CONTRACTOR YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAICE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUMCIPAL 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. 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 STA TU I E NO. 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICAT E" 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. 1135- P-,-t S�-ree(r lqd 21-316- ?(,G7 ADDRESS PHONE NUMFE:; doe S �eI PRINT NAME SIGNA DATE Before me this 2v day of � 20 in the county of Duval,State of Florida,has personally appe red herin by himself I herself and affirms that all statements and declarations are true da ccurate. La, �-- Notary Public at Large,State of County of y' ersonally Known 0 Produced Identificz' - r Notary Public State of Florida Shirley L Graham Notary Signatu ommission FF 086990 L6or Expires 02114/2018 F:BLDG/Ownu-Buildu ANadavit;REVISED: 4/16/2009 jylyy�� City of Atlantic Beach APPLICATION NUMBER 7.-o be assigned y the Building Department.) Building Department r ECEIVED r i 800 Seminole Road /V _ Ae2 Atlantic Beach, Florida 32233-5445 MAY 2 12014 Phone(904)247-5826 • Fax(904)2845 2,01W r jj yr E-mail: build ing-dept@coab'us Nate routed: 2,0 W City web-site: http://www.coab.us BY' APPLICATION REVIEW AND TRACKING FORM Property Address: d'7— Department review required Yes No Bu 4W 'Y` Applicant: Planning Plannin ^. Zoni /- Tree Adr istrator Project: 41r cL tilities Public S, `ety Fire Sera es Review fee $ Depf Signature Other Agency Review or Permit Required Review or Receiof Permit Verifie,, ;_ Date 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: ❑Denie,, (Circle one.) Comments: �Approved. BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑Denic- Comments: LI PUBLIC SAFE Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. Comments: Reviewed by: Date: Revised 05/14/09 S,ay;�� City of Atlantic Beach RECEIVED NUMBER Building Department (To be assigned y the Building Department.) 19 n r s 800 Seminole Road + 00 6" Atlantic Beach, Florida 32233-5445 MAY 2 12014 Phone(904)247-5826 • Fax(904):!47-5845 Date routed: Z� r` ja E-mail: building-dept@coab.us BY: City web-site: hftp://www.coab.us -- APPLICATION REVIEW AND TRACKING FORM (J � srProperty Address: 0 /n� Department review required Yes No B ' Applicant: Plannir ,f�& Zoni ree Admir:istrator Project: <. 41r �mcL CajW�tilities Public Safety Fire Services Review fee $_ Dept Signature R Other Agency Review or Permit Required Review or eceipt Dateof 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 t- PLANNING &ZONING / / Reviewed by:�� Date: l TREE ADMIN. Second Review: ❑Approved as revised. ❑Deniea. PUBLIC WORKS Comments: t PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: _ Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denier Comments: Reviewed by: Date: Revised 05/14/09 AP ]L] j Lyf City of Atlantic Beach (To be assiBuilding Department 800 Seminole RoadAtlantic Beach, Florida 32233-5445Phone (904)247-5826 • Fax(904)247-5845 Date rout E-mail: building-dept@coab.us City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM I (f ! Department review required Yes No Property Address: / U �nL B Plannin &Zoni Applicant: V" ree Administrator < 4 T- u Project: tilities Public Safety Fire Services Review fee $ Dept Signature Review or Receipt Date Other Agency Review or Permit Required 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: XApproved. Denied. 4 G h (Circle one.) Comments: in ,1(! 6-E 7h� `(�nf r-o j7G''T y BUILDING MCX r_&C G �G is y'. See •v4a Plgh o•, s �c ' Date: PLANNING &ZONING Reviewed by: TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES Date: PUBLIC SAFETY Reviewed by: FIRE SERVICES Third Review: ❑App roved as revised. ❑Denied. 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