872 AMBERJACK LN - FENCE iCITY'" \��s
OF ATLANTIC BEACH
SSl
\y 800 SEMINOLE ROAD
'~ r " ATLANTIC BEACH, FL 32233
N INSPECTION PHONE LINE 247-5814
\J;31�`'
FENCE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-FNCE-236
Job Type: FENCE PERMIT
Description: NEW FENCE
Estimated Value: $1,000.00
Issue Date: 2/4/2016
Expiration Date: 8/2/2016
PROPERTY ADDRESS:
Address: 872 AMBERJACK LN
RE Number: 171146-0000
PERMIT INFORMATION:
FEES: - - -----
Fence/ROW $35.00
Fence/ROW $35.00
Total Payments: $70.00
II
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
s 't City of Atlantic Beach
APPLICATION NUMBER
JS `-' ' � Building Department (To be assigned by the Building Department.)
- V ) 800 Seminole Road
"W— Atlantic Beach, Florida 32233-5445 „F —23,6
Phone(904)247-5826 Fax(904)247-5845
�.unis " E-mail: building-dept @coab.us Date routed: Z
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 8 7 z 'Pa\ L De• - ' i ent review required Yes No
Applicant: @ (-1 C.,'' P\ (K Romes Panning &Zonin_g
Tree Administra of r
Project: [\3 E w trEADQ.E 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: VApproved. ['Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by:��,,,.� ��—pate:
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:
II 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 i 6 r
Job Address: 7-1 2- 'fig'
����2,'�"�� �� Permit Number: _
Legal Description Parcel#
Valuation of Work$ 1 "" - Proposed Work he ted/cooled t
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 CResidentia l
If an existing structure,is a fire sprinkler system installed? (Circle on "—Yes No N/A
Florida Product Approval #
For multiple products use product approva orm
Describe in detail the type of work to be performed: Rfi.f QQ UL .Q ' ���
"c4/
,ktk . 6 f- ..M kQ (
Property Owner Information: (QL Name: Sr h-t(Z 401/Vll=•S Address: .7 2(D TA LL_Nc 1240
City_)41. to Statef,Zip j2250 Phone °(O If— 3 3 3 -- 6(00 7
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: 5,..c„-1----- A-02_ ikvinF, Qualifying Agent:
Address:
Office Phone Job Site/Contact Number rx State Zip
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 installai: /.'( '
issuance of a permit and that all work will be performed to meet the star \/ commenced prior to the
and void if work is not commenced within six(6)months, or if consr �'" 'is permit becomes null
work is commenced. I understand that separate permits must be (� nths at any time after
Tanks and Air Conditioners,etc. j� v •s, Boilers,Heaters,
WARNING TO OWNER: YOUI. `-' C�
COMMENCEMENT MAY RESULT IN Y C ENTS
TO YOUR PROPERTY. IF YOU INTEND
YOUR LENDER OR AN ATTORNEY B C,C, YTH
I hereby certify that I have read and examined this a plication and know the same u. ti� _,mantes governing this
type of work will be complied with whether specified herein or not. The granting , 1 to violate or can
provisions of any other federal,state, or local law regulating consul Lion or the peefo,. `_ ��\Q/ 1 cancel the
Signature of Owner , • J _ • t O J
Signat, O
?rint Name (D L\ V22-- • L J Print Nan, 41..1 V f . 1,2k>
hiis6.- . f - 1 --` ",r ,►SPERGER - 'j-fore me
. si,, PP 924951 t s Day of 20
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dotaiy Public a ,:.i --•-.•-•-••-- 1 otar -ublic
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Revised 01.26.10
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