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331 4th st 2015 fence CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 FENCE PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-FNCE-126 Job Type: FENCE PERMIT Description: REPLACE A SECTION OF 6 FOOT FENCE Estimated Value: Issue Date: 1/22/2015 Expiration Date: 7/21/2015 PROPERTY ADDRESS: Address: 331 4TH ST RE Number: 169834-0100 PROPERTY OWNER: Name: HEWITT, DIANE M Address: 150 EXECUTIVE CIR PERMIT INFORMATION: FEES: Fence/ROW $35.00 Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 ' JAN 16 Office (904) 247-5826 Fax (904) 247-5845 Job Address: 33j- 14 54r"7t Permit Number: ------ Legal Description Parcel# Floor Area o -Fq-Ft NqTT Valuation of Work$ —Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration <5D Move Demolition pool/spa window/door Use of existing/proposed structure(�) circle one): Commercial Residential If an existing structure,is a fire sprUer system installed? (Circle one): Yes No N/A Florida Product Approval# For multiple products use product app­r5vaor�m � Describe in detail the type of work to be performed: rtlokce— Property Owner Information: Nam��.) if-wl# Address:. a ztle-le� city t- i3eA.tA, —StateFL Zip qja33 -Phone 16q 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 4 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 ofa 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 ffwork is not commenced within six(6)months, or if construction or work is suspended or abandonedfor a period ofsUP6)months at any time after work is commenced. I understand that separate permits must be securedfor Electrica-Work,Plu ingSiins, MsPools, urnacesBoileis, Tanks andAir Conditioners,etc. Mb Heiziers, 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 YOVIi NOTICE OF COMMENCEMENT. I herelb certify that I have read and examined this a lication and know the same to be true and correct. All provisions of laws and ordinances governing this _pp work will be co�nplied with whether sfecifi-ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the Provisions ofany otherfederal,state, or local a w regulating construction or the peifio�mance ofconstruction. Signature of Owner JL�- Signature of Contractor Print Name D i L . .......................................... ............................................................ Print Name ........................................................................................................................................ Bef I 0-\ Before me thisw Dayof 01 this Day of )n No ry ublic Notary Public Revised 01.26.10 CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDA VIT 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 I (,T ." LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PZPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE-A LICENSE. YOU MUS SUPERVISE'I'HECONSTRIJCTIONYOtJRSE[IF. 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 14AVE 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 REQUIRED BY STATE LAW AND BY COUNTY QR-MUNICIPAL LICENSING ORDINANCES. IL 11. INJURY LIABILITY; SINCE OWNERS MAY BE I IABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTM SU(j(3L61S WORKER'S CdMPENSATION INSURANCE BE PURCHASED. Ill. 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 EMPI OYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIUA 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. 3 31 AUUHESS 0 C�L_ i Gh it- f-k/Iff PHONE NUMBEH PRII T NAME AIGAT RE 14 1 Cb Before me this UA FE y of__ 206in the county of Duval,State or Honcla,nas personally appeared herin by himself/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of Countyof D\JvtA 0 Personally Known -3 —7 ItIo,wr —713 11 -0 oduced Identification- Notary Signature: F:/BLDG/0­e,-l3,nld1er VAI—vo,REVISE11D. 4/160-009 City of Atlantic Beach APPLICATION NUMBER '-5' AJIJ*r� Building Department (To be assigned by the Building Department.) -2 800 Seminole Road Atlantic Beach, Florida 32233-5445 I=Nc E— I Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us ate routed: L5 City web-site: http://www.coab.us L_�_ — APPLICATION REVIEW AND TRACKING FORM Property Address: 3a)t 4+ --' Sk Department review required Yes No _Qj�Wing Applicant: Dian +_'W tt Planning &zoning A d rn i n ZTF-50—r �eDl ( Tree Project: Public Works Public Utilities 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: fidApproved. [-]Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by:Aez- 4���Date: TREEADMIN. Second Review: []Approved as revised. nDenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. F]Denied. Comments: Reviewed by: Date: Revised 07/27/10