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457 Sailfish Dr 2014 Fence :ll � ' % CITY OF ATLANTIC BEACH s) 800 SEMINOLE ROAD J ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000923 Date 7/07/14 Property Address . . . . . . 457 SAILFISH DR Application type description FENCE PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 6ft fence ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BROWN, BENJAMIN JR OWNER 457 SAILFISH DR E ATLANTIC BEACH FL 32233 ---------------------------------------------------------------------------- Permit . . . . . . FENCE PERMIT Additional desc . . Permit Fee . . . . 35 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/03/15 ---------------------------------------------------------------------------- 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: ��Per�mitumber: Legal Description Parcel# Floor ea o q.Ft. t Valuation of Work$ oZ.S?I, Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addrtio 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: 117!57�-c.- , Property Owner Information: Name: A-^w uIn Address: �S �.Z-t l ,�, �j City Stat _Zip Phone 3 E-Mail or Fax#(Optional) Contractor Information: CONTRACTOR EMAIL ADDRESS: Company Name: ATAN-- k 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 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 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 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 o1 work will be complied with whether speci 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,state, or local law regulating construction or the performance of construction. Signature of Owne x � r/ Signature of Contractor Print Name dW�1 �!Z , a............................... .. Print Name Be f e .,•y- , EBORAHAMM IMAV�iITE Before me tl Day of z �� this Day of 20 EY$RES:May PON Notary Public Notary Public Revised 01.26.10 CITY OF ATLANTIC BEACH (OWNER d BUILDER AFFIDAVIT I. 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 R\4PROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR EVIPROVE A COMVIERCIAL 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 TBE 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 REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. 191. 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 $5,000 PENALTY UNDER FLORIDA STAT UTE NO. 455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY' OR THE FLORIDA "CONTRACTORS CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826) IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. AESS PHONE NUMBER��� PRINT N SIGTURE DATE Before me this day Ae .2a 20!'in the county of Duval,State of Florida,has pppeared herin by himself/herself and affirms that all statements and declarationd accurate. �Y y Notary Public at Large,State of ,County of ar BEBOFIq� p Personally Known ,yj e f' Map RMISSIO E"ME /❑Produced Identification- r—'_ L h G /�/ \ �fi••` QHS M� 2015 0573a9 Bonded Y21, 7 Public Under,#e,, Notary Sionatur . F:BLDG/Owner-Builder Afhdavi�REVISED: 4/16/2009 i..'.......... ./r��wj//n�•.A [j"/'T�y�,.h.••Wr/�w`�.j(yM�"Trn"�'r•; jwMn! O(lr/)}/(.���, w�'/e/.y/•�+.y,�(n•.-qrw.+..h..H•w.r•rr•e..u..Vvw.w P WO O :r LOT_ 27 ' P ,4$ 81-10VI jQN MAP Or, wova� -A u it IT AS RCGUh'DE'O IN. 'CAT OtVr PAGF.'f _/� OF .17 E PVOWC ��5TVq•OF DUVAL COUN Pr. FLORIDA CER VIE V 1 Oh':w,�'F-._Ir e l � � f►,y, — 'l _; �''C� `_�_��___ y A N ~ �;rolc y + I r 1 � Att rs Aff � f N �..�•r, I Mp ZIP AZ I .x ) . NOT VALID UNLUS EMBOSS0 W7N SEAL dF 7HE' UNpE7?S/GNF0 9,EAR114GS BASED ON_...&f4L__ L 1 NEREUY CERr/FY 771,jr THE, ,SgQWN NF' E'oN 13 1N MN S P4ZIAL fLOPO ,NAZAPO ZONE_.._ .-,� -.- -- ON FLOOD IN$U-17 i14C;,f7A,74 i�fiff; qdL P'0 �eri-A u:'/�' �dds�.' +.� ' � FWRIMA, PA tE'D _.4.17.-6? City of Atlantic Beach APPLICATION NUMBER rj Building Department � CEIVED (To be assigned b the Building Department.) 800 Seminole Road � � 9�3 �r Atlantic Beach, Florida 32233- 45 �f(,� d Phone(904)247-5826 • Fax(004)23840 0 ?014 Lojo9' E-mail: building-dept@coab.us Date routed: (0 City web-site: http://www.coab his?r��___ APPLICATION REVIEW AND TRACKING FORM Property Address: ff7.Jtf7/ 5A � Department review required Yes No Build' Applicant: Q /A) Tree Administrator Project: ub ublic ili 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: k�proved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: []Approved as revised. ❑Denied. LI OR Comments: C UTILITIE PUBLIC SAFE Y 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 s s' o be assi the Building Department.) Rg w Building Department 800 Seminole Road 9,z—? Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Pro ert Address: ( / d/ Department review required Yes No p y Buildin Applicant: Q�,J &ZpHing Tree Administra or Project: u ' ubli ilA Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Dateof 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 PLANNING &ZONING Reviewed by: Date: r �� 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 05114109 SyV];lJ City of Atlantic Beacham APPLICATION NUMBER S r � Building Department `-��; t (To be assigW- Phone the Building Department.) i. .�f uN �/ 9'800 Seminole RoadAtlantic Beach, Florida 32233-5445 , �9(904)247-5826 • Fax(904)247-5845 ��f�( E-mail: building-dept@coab.us Date routed: (0 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ( ��� c�/� Department review required Yes No Buildin Applicant: Q 10annin &Zoning Tree Adminis ra or Project: Lub w ublic Ill i I i 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: ❑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 w•.w,,..r+.s.�rLUMur•w'R•r�.7�'1*.'°`w'r'w•�r+�'"�'w+ww•M�T'M"'' '^�.w. ��M '.^+`'�• ■(/per■.■�■�•jyr • - 1 1OWINGL,./ � MIS Iq• • .l. . DO + vp LOT . T �r--I i-V L to OF • E PVOUC RE T0�. COLIIy!7.:FLO:.RIDA AS RL G UKDE'4 !N. PLAT BOO 3!P�1 GF.� 1 CI CN .t . y . -.•ter W ��4'�c '' `4 l I ? r•k• ,�Ip' 4.17 s Alk y ri I \ 1 NOT VNi L SS EMBOSSk D wl7N SEAQ uaUGAM Cf TNS UND [n7" �1IG�wN N FaN 1S /N fN� PCcJ,AL FLOQ0 AZA(?D ZONE- i HEREBY CERTIFY T14 1NE �d FCt; � r..4 7"t 4' �s�,. , r � �nh'(DA. hA�D .. -�,-�.- Olii r10vi} lNSiY��il1C �fPA,t tifAf r- �L-~ e' TAT/'I .�...,....-----•'-'"'"'."`" .....•w.w. •.+rr iiw X77 Y'1 'N 1 "l 7Tl !'"Y