1464 JASMINE ST - 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-2398
Job Type: FENCE PERMIT
Description: 6FT FENCE REPLACEMENT
Estimated Value:
Issue Date: 10/20/2015
Expiration Date: 4/17/2016
PROPERTY ADDRESS:
Address: 1464 JASMINE ST
RE Number: 171081-0030
PROPERTY OWNER:
Name: RAMIREZ, JAMIE W & TERESA J. *
Address: 1464 JASMINE ST
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.
...CA 11r1C.0 I J.
.;AmiE w. AND TERESA RAMIREZ
FIRST UNION
STEWART 111LE OF JACKSONVILLE, INC
wATSON AND OSBORNE, P.A
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suPPUED oN.ES:.OTHERIMSF_ ;TATED.NB ofirER TITLE vewicArtcw HAS BEEN PERFORMED Br rs< zirrCERSUIrED .•
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- 6 CITY OF ATLANTIC BEACH
®WNER / 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 CONS FRUCTION 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 SEI,L 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. WIIICI-I 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.
ADDRESS PHONE NUMBER
1�C r\l L ; 1��:Ytt '
PRINT AME
SI NATURE DATE
I'I Before me this I-fit day of OCio , r. •2015 in the county of ?+ '. \ DAYNAH•WIIIJAMS
Duval,State of Florida,has personally appeared herin by himself/herself and affirms that I. A:, 14 MY COMMON iFF217841
all statements and declarations are true and accurate. EXPIRES: 7,
' :*J2,,:'' •Atgttst 2019
Notary Public at Large,State of FW 1�r1 ,County of IAL -- Notary
❑Personally Known 1 Q�7 C
,Produced Idenaficahon-_R��� ✓' 6-6) (J' _ w.wuy - "•
"arj!!Y S4 DAYNAH.WILUIeg.)
=. es MY COMMISSION it I F 217
(� ) EXPIRES:August 7,::?• •
Notary Signature 6� w �1, Bonded Thor Notary PUN:c::,,;.•.;:,
I'.A3LDGtOwner-Builder Afadavii.REVISED:4/162009
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904)247-5845
Job Address: 1464 Jasmine St Permit Number:
Legal Description 18-34 38-2S-29E SEC H ATLANTIC BEAC Parcel# Lot 4 Block 250
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work $ 800 Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New 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: Removing old then installing new 6'stockade fence.
Property Owner Information:
Name: Jamie Ramirez Address: 1464 Jasmine St
City Atlantic Beach State FL Zip 32233 Phone 904-241-1285
E-Mail or Fax#(Optional)
Contractor Information:
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
Application 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 a permit and that all work will be pe ormed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void f 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 after
work is commenced. /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/have read and examined this a placation and know the same to be true and correct. All provisions of laws and ordinances governing this
type of work will be complied with whether specified 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 Owner' �+ .-r Signature of Contractor
Print Name ;.afnie Ramirez Print Name
Sworn to and subscribed before me Sworn to and subscribed before me
this (Cm ,Day of Dc,1oBe R .201 this Day of .20
No ary public �; Notary Public
*''�Y fi MY DAYNA H. ##FF�217841
:r Revised 01.26.10
• ��,a EXPIRES:August 7,2019 li
„j " raided Tin Notary Pubic Undrwitera
1t\J9>,, City of Atlantic Beach APPLICATION NUMBER
. Building Department (To be assigned by the Building Department
• is .•r•' 800 Seminole Road `Atlantic Beach, Florida 32233-5445 is--6/ £ "W43?
Phone(904)247-5826 • Fax(904)247-5845
-an � Q r E-mail: building-dept @coab.us Date routed: 0 / /.5 .
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: id6 iv re ' I _ Department review required Yes No
Buildi
Applicant: +0 tW )- I £ Panning &Zoning
Project: G /a. G it x., I ree Ra ihistrator
Public Works
r 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: ®Approved. ❑Denied.
(Circle one.) Comments: /
BUILDING
PLANNING &ZONING /
Reviewed by: I/ /�� Date:id
TREE ADMIN. /���—'_
Second Review: QApproved 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