297 Pine St 2014 fence CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000962 Date 7/01/14
Property Address . . . . . . 297 PINE ST
Application type description FENCE PERMIT
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
4 ft fence
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Owner Contractor
------------------------ ------------------------
LATIMER ET AL, BRUCE T OWNER
C/O JEANNIE LATIMER
297 PINE ST
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 . . 12/28/14
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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 .
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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 ONLt' IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
13UILDING PERMIT APPLICATION
CITY OF ATLANTIC 13EACH
N 1
800 Seminole Road, Atlantic Beach, FL 32233 FJ�UX2 201(]
Office (904) 247-5826 Fax (904) 247-5845 On
Py W*11 W-V I
Job Address: (M Permit Number:
Legal Description Parcel 4
Floor Area of Sq'.Ft. Tq—.F7
Valuation of Work Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): 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 approval form
Describe in detail the type of work to be performed: ft(o 00 �Mc/ vyA ) ,ojDM
�TRSQfA'� P�4&- I
lorma I tion:
Proper Owner In
Name.\Y6Ny\*M& Addres4ffl qaAe/ ��Weo
city WIMAb(i wo'k
Stat4��Zip�7�) hone
E-Mail c�Fax 9(Opti-onal)
Contractor Information:
Company Name: Qualifying Agent:
Address: city State Zip
Office Phone Job Site/Contact Number Jax#
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 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 eriod ofsix(6)months at any time after
work is commenced. I understand that separate permits must be securedfor Electricar Work, Plumbing,Signs,awMs, Pools, Flirnaces,Boilers, Heaters,
Tanks and Air Conditioners,ele.
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. Allprovisions of laws and ordinances governing this
t 17, be complied wi 4fi`ed h6rein or not. The granting of a permit does not presume to give authority to violate or cancel the
ype 'o work will th wh�ther specytea ,
Provisions ofany otherfe 0 ating constructio, e performance of construction.
Signature of Ow r Signature of Contractor
Print Name Print Name
3ef Before me
hisl Day of i—vy-'vc 20 this —Day of 20
A^. L
�ot biie JENNIFER WALKER Notary Public
Vu
kly commissioN#FF 011480 Revised 10.24.12
1124,2017
--k at U--Zcq; A X9 AX.hfit UndGrWOefS
J
CITY OF ATLANTIC BEACH
OWNER / BUMDER AFFMAVIT
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 ENEMPTION. 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 ENTLOYED 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.
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(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.
0 lyre
ADDRESS PHONE NUMBER
PRINT NAME
7N TURE v _X DATE
B
B remethis[�!_deryof OUe L_A in the county of
D u i s
val,State of Florida,has personally appeared herin by hims If/herself and affirms that
all statements and declarations are true and accurate.
FLI 0 'xAV
Notary Public at Large,state of County f
0 P nally Known
Zd.c,ecl Identification--
JENNIFER WALKER
Notary Signatu ommissION#FF 011480
MYC
EXPIRES:Apfil 24,2017
FIBLDG/0�er-Bu4ilderlAfflad it�;:-1-1 tW Bonded Thru Notary Public Underwriters
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City of Atlantic Beach
APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
-141/v
800 Seminole Road 41#
�?�' 1 �2�wb'
Atlantic Beach, Florida 32233-5445 ?014 /� e 9� 2—
Phone(904)247-5826 - Fax(904)247-5845 Date routed: ae /Y
tojilq' E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: c X7 Department review required Yes No
Applicant: ye (fla�nning &�Zonin���
Tre—e Administrator
Project: A-72M 6Tu_F7c V_Vor�k�s>
e—ty
Public aT
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: I
(Circle one.) Comments: �rApproved. []Denied.
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: F]Approved as revised. ODenied.
1CW R S Comments:
'VO 'S
0
-Z 1 1-1
U �l UTIL T71E
;7
Reviewed by: Date:
PUBIL C SAFE
FIRE SERVICES Third Review: EjApproved as revised. ElDenied.
Comments:
Reviewed by: Date:
Revised 05114/09
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road 2-
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fax(904)247-5845 Date routed: ae
Oil E-mail: building-dept@coab.us
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
. cR lal'wt XT Department review required Yes No
Property Address.
Planning & Zonin
Applicant: Tree Administrator
65ublic Work
Project: b--woz �s:> -
�7 .4
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified By
Florida Dept. of Environmental Prot�ction
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: _�ZApproved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by z Date:
TREE ADMIN. Second Review: FlApproved as revised. ODenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: RApproved as revised. DDenied.
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
E-mail: building-dept@coab.us Date routed: Ilk
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address C AV 6 XT Department review required Yes —N—O]
fP!1a n n inn g f8,Z o7rfl:n
Applicant: T—ree Administrator
_eu_b_ficWo_r_k
Project: C'6
Public a ety
Fire Services
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: V(Approved. E]Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: FlApproved as revised. ]Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: [–]Approved as revised. F]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
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