1175 SEMINOLE RD - FENCE r\J`l r
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: 16-FNCE-428
Job Type: FENCE PERMIT
Description: 4FT FENCE
Estimated Value:
Issue Date: 3/3/2016
Expiration Date: 8/30/2016
PROPERTY ADDRESS:
Address: 1175 SEMINOLE RD
RE Number: 171890-0000
PROPERTY OWNER:
Name: NAUMANN LIFE ESTATE, ANNELIESE, *
Address: 908 PRINCE PHILLIP DR 908 PRINCE PHILLIP DR
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 TIIE FLORIDA
BUILDING CODES.
,s--vpr f City of Atlantic Beach
•s � APPLICATION NUMBER
:, y ,,1 Building Department
(To be assigned by the Building De artment.)
1 i`=_'' 800 Seminole Road
/‘_,7, . .g�
9 zr Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845 Vib
....____ ' Email: building dept @coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: //?5 . 4 /7W/ Id Department review
required Yes No
Buildi
Applicant: Q�'n E y ig
&z •
y Tree Administrator
Project: '2j et. 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
Reviewed by: /Z../ Date: 7/2_(-1//‘
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
i
I
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: I I -75$eiyYil rl jd . Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. Sq.Ft
Valuation of Work$ �vQ Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New AcktiT)D Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial Residentia
If an existing structure,is a fire sprinkler system installed? (Circle one): es N/A
Florida Product Approval#
For multiple products use product approva orm
1 Describe in detail the type of work to be performed: plAelli hujA VP 4-f-, (A
a1oima flAb 46144- 0-c mc, pro ' .
Property Owner Information: lT\ L k l M M
Name:' e &/ 43v M nil vv. Address: 1116 S(A 1 V `e 120( -
City i)4In✓L-tlt, Stateft Zi
� p 32-2-13 Phone COL(•ZIO. 15y ay X110
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADD'. SS:
Company Name: Qualifying Agent:
Address: City State Zip
Office Phone Job Site/Cont. Numb- 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 t.do the work and installations as indicated. I cert that no work or installation has commenced prior to the
issuance of a permit and that all work will be p:formed 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()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 read and examined this a plication 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 tint it M(1VJV\A- Signature of Contractor
?rint Name V(,1I vi c tA MIAA Print Name
3efore e 20 16 Before me
his ay o this Day of ,20
Jota ub '
Notary Public
Revised 01.26.10
�`
CITY OF ATLANTIC BEACH
0 WNER / BUILDER AFFIDAVIT
\--- -f.);,19%-*
r; r r
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 REOUIRED 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.
I x"15 SevvItoa1b 610-f . 4-1-1 • 1110
ADDRESS PHONE NUMBER
Valet/1'e, MC't'iw►vi"
PRINT NAME PO A ,� 1111/169
SIGNATURE
DATE
/
Before me this ` 6 day of 20 the county of___66_____,Duval,State of Florida,has personally appeared herin by i elf/herself and affirms that
all statements and declarations are true and/ L,County of accurate. __ //
Notary Public at Large,State of VGi
5eP r onally Known / / - ' /
uced Identification- L
' O o�
Notary Si. ature: _!. •
F:IBLDG/Owner-Bull_ de�davit;REVISE.:4/16/2009 `
i •
Lot# 40
Lot# 39
6' Wood Fence 6' Wood Fence
1.0' East —\41/4 805'29'44fW 84.22'(o) 1.0' East
n S05'49'06"IW 84.10 (m) r, •
c ■
a)
E 6' Wood Fence 6' Wood Fence
U 0.4' North 0.4' South
O
° Lot# 4 •
-o
a)
v 6' Woad Fence -• • '
0.4 North ®
a� 6' Wood Fence
_3 60.3' 1.1' SOUth
7
O
• N
✓ 1 Story Dwelling ._..�� ■ w
A' # 1175 al so, Lot# 2
:E g \t""qi
S E
' ° m-. s ' ' + _. m iN 111 I S P
IMMO
e v' b'. ..: :'.
c co
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D ---20.4' 26.�' •_. _a.—d -------
U --30' BSL
-a 4 .
a)
(n 32.1'
a) d ..
O 10' • E )(m)so
•
v c-
v1
Seminole Road
100' R/W 24' Asphalt Street
(Centered +\—)
1 ' = Open Concrete
CURVE TABLE
CURVE LENGTH RADIUS DELTA = Grassed Yard
C-1 00 109.91 542.15 11'36'56'
C-1 (p) 110.19 542.15 11'38'42' - = Brick Pavers
a�
E
o *O SEE SHEET 1 OF 2 FOR LEGAL DESCRIPTI❑N, LEGEND & ABBREVIATI❑NS
SHEET 2 OF 2 ALONE IS NOT A COMPLETE FLORIDA BOUNDARY SURVEY
a)
-v
GRAPHIC SCALE
7
o 20 a W 20 ,o eo
0
v ■.18/ 4404°----4WIE
rn ( IN FEET )
N 1 inch = 20 ft.
t
i-
Sheet 2 of 2
Boundary Survey # 032414.2 for McKimm