227 BELVEDERE 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 NE)(T DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-FNCE-641
Job Type: FENCE PERMIT ection of 8ft
Description: 6 ft fence and possibly a 12ft wide s
Estimated Value:
Issue Date: 4/2/2015
Expiration Date: 9/29/2015
PROPERTY ADDRESS:
Address: 227 BELVEDERE ST
RE Number: 170507-0000
PROPERTY OWN--R:
Name: YARBROUGH, INES
Address: 227 BELVEDERE ST
GENERAL CONTRACTOR INFORMATION:
Name: OWNER
Address:
Phone: - -
PER lIT INFORMATION: PLANNING AND ZONING:
8' x 12' PARTITION WALL MUST BE 5 FEET FROM SIDE AND REAR PROPERTY
LINES.
FEES:
Fence/ROW $35.00
Total Payments: $35-00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI, CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
j City of Atlantic Beach
APPLICATION NUMBER
Building Department
(To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 L4- I
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us
Cityweb-site: http://www.coab.us Date routed:
APPLICATION REVIEW AND TRACKING FORM
-z_?'--1 13CtVr_4f'rtS+ De a red Yes No
Property Address: Department review requi
B u if d i(ni
Applicant: S Va r k�) YOLA Planniii g &Zoning
T T or
j ree Administra or
Project: Public Works—
Public Utilities
jzf--f— C�+i f+ f-W Public SaEfety
U_ ic
Fire EService]s�����
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Date
— of Permit Verified By
Florida Dept. of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management 6-1s-trict
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: MApproved. FIDenied.
(Circle one.) Comments: 1ed
[��o X 12 -%ef
BUILDING s etr 41
PLANNING &ZONING 000
TREE ADMIN. Reviewed by:__A.� Date:_V,As-
Second Review: [-]Approved as revised. ODenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. F]Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
BUILDING PERMIT APPLICATION � T P) �[ � T M
CITY OF ATLANTIC BEACH MAR 18
800 Seminole Road, Atlantic Beach, FL 32233 It
Office (904) 247-5826 Fax (904)247;,5845 Igg
A-01
/.ob Address: Permit Number:
Legal Description Floor Area of Sq.Ft. Parcel Sq.Ft
Valuation of Work$ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration (EepDair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) circle one): Commercial tesidenti
es 0
If an existing structure,is a fire sprin=system installed? (Circle one): E4% N/A
Florida Product Approval#
For multiple products use product approvaFFo_rm
Describe in detail the type of work to be performed: c kt:L
416,11 &A!1<,5 b/y i yx �-e q r
Property Owner Information:
Name: Address:
city_,4 -State7gZip hone !t
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
,,o he e ade ana er d he work and n a la ns as nd ca d e t ths"no work or installation has commencedprior to the
y i
f
c r i
at,ng c n tructfo nthisjurisdiction. This permit becomes null
or , 0 or
mit to 0 0 t tom tt i S' ' ti i 1 s d a�b d ned� eriod of sixj6u)months at any time after
0 0' pi be e med he tan r al . sus e ul
ix k nd,
'p a io s r by"d th t rk � f
P s 0
ance a a e, an a r
s, or st Ut 0
r f h
)m t
issu t al w (6
mi t 1 0 w p
and void f P k s not com en ed thin s r f I P, S.
s s cure or c rica or U I g, ig's,
'or is co 0 i m c w 0 Obe e d Ele t �1� k n idis,Pools, urnaces,Boilers,Heate
k enced. I under ta'd t at separate permits mu t rs,
Tanks and Air Conditioners,eta
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 FINANCING9 CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
Ihere 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
111work will be conriplied with whethers or cancel the
recifiFed herein or not. The granting of a permit does not presume to give authority to violate
provisions of any otherfederal,state, or loca aw regulating construction or the peFfo�mance of construction.
Signature of Owner ly�Z4 -1 (2Nt1,ff.(A Signature of Contractor
4,R 6 Print Name ........................................................................................................................................
Print Name - 1;� I/
............................ ..0
. ...............................
Bef Before me
Miy
this 1�iOayy of _yy)0\y_ . 2015 this Day of 20
Notary " Notary Public
JENNIFERWALKER Revised 01.26.10
mycommissim#f-Foli'm
EXPIRES;ApOl 24,2�17
.'W Bomid-i?"Notary F0110 undemitell-i
CITY OF ATLANTIC BEACH
W\\,IER / BUILIDER _AFIF 11DAVIT
1
1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "CONSTRUCTION
CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW:
DfSCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES:
STATE LAW �,EQUIRES CONSTRUCTION TO BE DONE BY LICENSED
CONTRACTORS. YOU f LAVE APPLIE-D FOR A PERNffT UNDER AN EXEMPTION TO THAT
LAW. TFIE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERT11.TO ACT AS
YOUR OWN CONTRACTOR EVFN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST
S(-.Ii'E.RVI.S.I-,' IIIF',CON",'Il��ICTION 'Y'OLIRSEI-F. YOU IVLAYDUILD OREVIPROVE A 01\1E-OR
IW'0 FAiVILLY RESIDENCE OR A FARM OUTBUILDING. YOU NLAY ALSO BUILD OR
I1\4PROVE A COMAERCIAL BUILDING AT A COST OF$25-000.00 OR LESS. Tum BUFLDING
NEUST BE FOR YOUR USE AND OCCUPANCY. ITMAYNOTBE BUILT FOR SALF OR LEASF.
IF YOU SELL OR LEASE A BUILDING YOU I1AVE BUILT YOURSELF WITTEN ONE YEAR
AFTER TT1E CONSTRUCTION IS CO1\dTLETE, THE LAW WILL PRESUME T14-AT YOU BUILT
IT FOR SALE OR LEAS-'-'_ WFUCH IS IN VIOLATION OF TTT[S E)[E-1VfPT-1ON. 101-11\1A)� N01-
AN UNI ICENSE-1-1 f'ERSON AS-YOUR CONTRACTOI�_ YOUR CONSTRUCTION MUST
BE DONE ACCOBDINOTO TEE BUILDING CODES AND ZONING REGULATIONS. IT IS
YOUR Rl".SPONSI-1311-11�' -1-0 MAKE SURE THAT PEOPLE EMPLOYED BY 'w'0L) HAVE
LICENSES REOUIRED 3Y STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING
ORDINANC S.
It. 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 A LSO
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 PENALT Y UNDER FLORIDA STATUTE NO.
455-228(l). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUAT E_ THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICAT1E OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
E
CERTIFICAT F To A CER TAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
I's
BUILDING DEPARTMENT(2-17-5826) IF IN DOUBT.
V.ACKHCiWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STAT EMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
(j Gt_V&
p T
A inLI-A go tf G�q y-
FTHONE NL"BER
�MDDRESS
r
PRINT NAME
4ca INS
SIGNATURE DATE
11 Q—*\
Before me this-day of 215 in the county of
Duval,State of Florida,has pers(;nally ar'pe�ied herin by himself/hersell and affirms that
all statements and declarations are true_an,.��jccurate.
County o, L
Notary Public at Large,State ofE Old
El Personally K ok,.,n
fj,F-Koduced Identincation-
NotaFy Sign@L' M:�
L.ild..Affi,.d-it;RF VISED: 4/1 ':;i9