68 W 10th St - Fence Permit e . CITY OF ATLANTIC BEACH
A s) 800 SEMINOLE ROAD
J t?',.' t---- - =" 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: 16-FNCE-367
Job Type: FENCE PERMIT
Description: FENCE
Estimated Value: $1,500.00
Issue Date: 2/16/2016
Expiration Date: 8/21/2016
PROPERTY ADDRESS:
Address: 68 W 10TH ST
RE Number: LOC ID-0000
PERMIT INFORMATION:
FEES:
Fence/ROW $35.00
Total Payments: $35.00
1 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
. •City of Atlantic Beach
::51-41.1/2,,,;A Building Department APPLICATION NUMBER
� :i 800 Seminole Road (To be assigned by the Building Department)
i .- „r Atlantic Beach, Florida 32233-5445 rte,
Phone(904)247-5826 • Fax(904)247-5845 1 V �`+�
01311- E-mail: building-dept @coab.us Date routed: Z. Z
City web-site: http://www.coab.us i
APPLICATION REVIEW AND TRACKING FORM
Property Address: & 6 % 6 01/4f2--C S?-- : -par -nt review required Yes No
1 IN) L-( �• Buildin.1!
Applicant: (;�t K - U w N F - - &Zoning
Tree Administrator
Project: CGAt 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: 0 2 A pproved. ODenied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING /
Reviewed by: v��Date: ,77/154/
•
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
I
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M A R O F S U R E Y ,,R
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THE WEST 27.40 FEET OF LOT 2 AND LOT 3, EXCEPT THE WEST 32.60 FEET,
BLOCK 66, SECTION "H", ATLANTIC BEACH, AS RECORDED IN PLAT BOOK 18,
PAGE 34 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
10th STREET WEST
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50' RIGHT OF WAY PAVED PUBLIC ROAD i
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IRON PIPE. (S69'48'00"E 44.82' FIELD) IRON PIPE.
CAP No. � � ►� � CAP No.
LB3672 SS9 48 00 E 44.80' LB3672
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CAP No. (N69'45'24"W 44.79' FIELD) CAP No.
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BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
QQ�� Office (904) 247-5826 Fax (904) 247-5845 1 6- �N C E_- /' "7
Job Address: iQ O c $ 'O�5# Permit Number:
Legal Description Parcel #
, Floor Area of Valuation of Work$ Proposed Work he ted/cooled S 1 t
�5�0� 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 T----
I
Describe in detail the type of work to be performed: f e n C
Property Owner Information:
Name Add•essijg 14451— !0A Si-
City Ci State /Zip hone loci- ‘113- ffe
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Qualifying Agent:
Address: City State
Office Phone Job Site/Contact Number Zip
State Certification/Registration# Fax#
Archim #
Engineertect's Na Name e&&Phone 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 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 after
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.
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 I have r• d and examined this a..lication and know the same to be true and correct. All provisions of laws and ordinances governing this
type oYwork will be core- ,� a whether sped r:' herein or not. The granting of a permit does not presume to give authority to violate or cancel the
provisions of any oth: edei • .r I,c.l law rep rla ' construction or the performance of construction.
I,
signature of 0 ler _ I11,. ,►.4. Signature of Contractor
Tint Name
►.J. ,, ... 1....4 Print Name
3efore ti Before me
his ,f , A ----_
�.r� — Day of ,20
•
®� r: NI GINDLE8PERGER
. N MY COMMISSION FF 924951
rotary Publ." •• •• ...mbar s,
Boded ThrU NM'Pubic uneolif'ttblic
Revised 01.26.10
l' ' '� 800 Seminole Road
1
J1 ss1
J Atlantic Beach,Florida 32233
` c Telephone(904)247-5800
`J FAX (904) 247-5805
�
J;31:�
Construction Site Management Plan Compliance
A construction site management plan conforming to Atlantic Beach City Code Sec 6-18
has been approved as a part of this building permit. The Construction site management
plan was approved based upon the following information.
1. Parking plan—parking plan showing how site will be accessed and all onsite
and abutting street parking areas.
2. Location of construction trailers, loading/unloading area and material storage
area.
3. Location of chemical toilet area.(chemical toilets must be kept out of City
right-of-way and not further than 15 feet from structure under construction)
4. Location of dumpster. Dumpster must be from an approved waste company
(in accordance with Chapter 16 City Code) as of 2009 the permitted
dumpsters are Advanced Disposal, Realco Recycling, Republic
Services, and Shappells. Dumpsters will have tarp covers or rigid covers
on windy days. Dumpsters must be removed prior to issuance of Certificate of
Occupancy.
5. Traffic control plan, showing access with dimensions, area to be stabilized,
narrative on phasing of construction with adequate parking and delivery of
materials.
6. Site cleanliness. Contractor must have the entire construction site cleaned by
Friday of each week. This means removal of scrap lumber, concrete remnants
and other such construction debris including cans, metal, plastic and paper.
7. Erosion and Sediment Control. Contractor must maintain all elements of the
approved Erosion & Sediment Control Plan (silt fence, catch basin filters, etc.)
until sod or other stabilization has been placed and approved by Public Works.
8. Other activities,where special conditions are identified by the Building
Official.
Failure to comply with the Construction Site Management
Ordinance may result in a Stop Work Order being issued in
accordance with City Code Sec. 6-17 (3)
Revised 1/2016
`s CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
\ ATLANTIC BEACH, FL 32233
(904) 247-5800
NOTICE
THE 5TH EDITION OF
THE FLORIDA BUILDING CODE
TAKES EFFECT
JUNE 30, 2015
ALL BUILDING PERMITS, APPLIED FOR, ON OR
AFTER JUNE 30, WILL BE REVIEWED AND
INSPECTED UNDER THE FBC, 5TH EDITION.
BUILDING PERMITS APPLIED FOR BEFORE JUNE
30, WILL BE REVIEWED AND INSPECTED UNDER
THE CURRENT 2010 FBC.
•
DO NOT WRITE BELOW- OFFICE USE ONLY
Applicable Codes: 2010 FLORIDA BUILDING CODE
Review Result (circle one):
Approved Disapproved Approved w/ Conditions
Review Initials/Date:
Development Size
Habitable Space Non-Habitable
Impervious area
Miscellaneous Information
Occupancy Group
Type of Construction
Number of Stories
Zoning District
Max. Occupancy Load
Fire Sprinklers Required
Flood Zone
Conditions/Comments:
4 rs�S,y
�.:
• —,,b; ,s CITY OF ATLANTIC BEACH
J yr 'J.WNER / BUILDER AFFIDAVIT
A-01,191-
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 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 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 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.
' II /- I ;ors -/ - " eirffe
•DBR
;■ 1 PHONE NUMBER
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SIGNA RE �/�
DATE
=
Before •this day of r-P_h 201 (ale county of
I. ate of Florida,has personally appear herin by himself/herself and affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of I` CO...County of O v��
D Personally Known _r —S
SYRroduced Identification- I a /L 2
WIIMPRAmb 70N1 GINDlE3�E�/ My COMMISSION 82019
�_ eoPI µ� is Unfit
411011141 Notary Signature:
•
F:/BLDG/Owner-Builder AffadavitpREV1SED:4/162009
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THE WEST 27.40 FEET OF LOT 2 AND LOT 3, EXCEPT THE WEST 32.60 FEET,
P BLOCK 66, SECTION "H", ATLANTIC BEACH, AS RECORDED IN PLAT BOOK 18,
PAGE 34 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. fi
• I
10th STREET WEST 1
50' RIGHT OF WAY PAVED PUBLIC ROAD
SET 1/2"
e
I U O PIIPE. (S69'48'00"E 44.82' 1FIpELD) RONIPIPE,
L83672 S69'48'00"E 44.80' LB3672
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RON PIPE,
CAP No. (N69'45'28"W 44.79' FIELD) CAP No.
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