788 VECUNA RD - FENCE ,0 '* S� CITY OF ATLANTIC BEACH
.,.r' ) 800 SEMINOLE ROAD
J ip, - ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5826
\0;31:-,
FENCE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-FNCE-2415
Job Type: FENCE PERMIT
Description: 4 ft fence
Estimated Value: $1,000.00
Issue Date: 10/21/2015
Expiration Date: 4/18/2016
PROPERTY ADDRESS:
Address: 788 VECUNA RD
RE Number: 171352-0000
PROPERTY OWNER:
Name: STRANDHAGEN, JENO
Address: 788 VECUN RD
PERMIT INFORMATION:
FEES:
Fence/ROW $35.00
1
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
, rStAn,Jii City of Atlantic Beach
•' d\ Building Department APPLICATION NUMBER
J t;,,. 800 Seminole Road
(To be assigned by the Building Depart ent.)
w' .. .�r Atlantic Beach, Florida 32233-5445 /3 ����� + � /�
Phone(904)247-5826 • Fax(904)247-5845
7
�;;)�% E-mail: building-dept @coab.us Date routed: lQ //
City web-site: http://www.coab.us /
APPLICATION REVIEW AND TRACKING FORM
Property Address: 7(/ Vdk nQ, Department review required Yes
No
Build ..
W
Applicant: fi � anning : Zonis
-- A 'mini stra tor
Project: ��1 C1,� Public Works
Public Utilities
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By 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: Approved. ['Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING y �� i
Reviewed b : !✓— Date: l#)/I /Lr
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 07/27/10
■
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office (904)247-5826 Fax (904)247-5845
Job Address: Zgi V v Ka ,,,�
Legal Description Permit Number:
Parcel#
Valuation of Work$ oor • ea o q. t
Proposed Work heated/cooled t
non-heated/cooled
Class of Work(circle one): ,. Addition Alteration Repair Move Demolition pool/s a wind
Use of existing/pro osed structure(s)(circle one): Commercial p ow/door
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes
Florida Product Approval# 3j N/A
For multiple products use pro uct approva orm
Describe in detail the type of work to be performed:
Property Owner Information
City Address: ? . (pet v-
CiMail o-�r #(ppno `�4, State Wip 1 Phone
•
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name:
Address: alifying Agent:
Office Phone City State
State Certification/Registration# Job Site/Conta umber _Zip
Fax#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Addre
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 I cert fy 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 a period of six(6)months at any time aver
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.
t '
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVE
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULTIVIENH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF H
COMMENCEMENT.
I hereby certiol that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing, his
h'pe of work will be complied with whether specified or not. The granting of a permit does not presume to give authority o
provisions of any other federal,state,or local law ating construction or the performance of construction.
ty violate or cancel the
Signature of Owner
Signature of Contractor
'rint Name
=off Notary Public State of Florida ame
1ef• '� a ' /�tl Shire L Graham l3ef.
amv .to �2 0 I'm 'shop FF osses�his me
, ore Day of 20
10 ary Public
li Notary Public
7 g 7 Revised 01.26.10
'J. id
At );, CITY OF ATLANTIC BEACH
OWNER / 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 LICENSEI)
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 WITIIIN 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 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.
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(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.
738 VGCU...Ia .-ct i0c( ? fL( cr,CS
ADDRESS PHONE NUMBER
-3- 3kr .q
PRINT NAME Q a
SIGNATURE DATECr I 371
Before me this 13 day of OCT .41 the county of
Duval,State of Florida,has personally app ared herin by imseff/herself and affirms that
all statements and declarations are true and accurate.
tr
Notary Public at Large,State of j L ,County of
erson: •own 4�Y PV ry
•• ced(dent ?ot Nota Public State of Florida
. Shirley L Graham
` My Commission FF 086990
'1/4, .01 ExplreaO2/14/2018
Notary Sign- 4,-.a_ A
F:BL. •wner•Builder AB'adavil,R[VISE, 009
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MAP SHOWING BOUNDARY SURVEY OF
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ROYAL PA«s t'A 7r 7A/0 A
AS RECORDED IN PC.A 7 BOOK......_.....L___PAGES / Z6r41 /D OF THE PtJBL IC RECORDS OF DU'VAL' CO., FL A .
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