1505 JORDAN ST - FENCE -r->3
'` s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
;r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�J13�9r"
FENCE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-FNCE-526
Job Type: FENCE PERMIT
Description: 3 - 3/5 FENCE
Estimated Value:
Issue Date: 3/8/2016
Expiration Date: 9/4/2016
PROPERTY ADDRESS:
Address: 1505 JORDAN ST
RE Number: 172296-0010
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.
.is s!JP`fr.4„ . • City of Atlantic Beach APPLICATION NUMBER
. Building Department
(To be assigned by the Building Department.)
ov Atlantic Road /(O filet
r� Atlantic Beacac h, Florida 32233-5445
t -- 6 Z 6,
Phone(904)247-5826 • Fax(904)247-5845
'4'40;09i' E-mail: building-dept @coab.us Date routed: c?' .2//6,
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /.50/ S ,Seder-,, ST' Department review required Yes No
Build_.
Applicant: _ 40 Planning &Zoning
Project: _ - . 7) C 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: XApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING / /
Reviewed by: !/ �� Date: i`
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:
Zevised 07/27/10
i
ly
BUILDING PERMIT APPLICATION
• CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904)247-5845
Job Address: 16b3 Sc A C ,--- - Permit Number:
Legal Description Parcel#
Floor Area of Sq.Ft. q, t
Valuation of Work$ '$ 5(1)b Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): dip Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s) (circle one): Commercial 'esidenti. 43"
If an existing structure,is a fire sprinkler system installed? (Circle one): • -s No
Florida Product Approval #
For multiple products use product approval orm
Describe in detail the type of work to be performed: 3'17_ "�'"�' –=\�, c b1C� R-A
t 3' c � c� � c ` z-A
Property Owner Information:
Name: a %tw St --.A Address: W a Ill,
City diV ,�
; 4jIRA. ` State f ip 3?J2 Phone • Via cYZ, — Z`:::\ ..L
E-Mail or Fax#(Optional)
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: Qualifying Agent:
Address: City State Zip
Office Phone Job Site/Contact Number Fax#
State Certification/Registration#
Architect Name&Phone# In1l
J 11111
Engineer's Name&Phone#
IWI
Fee Simple Title Holder Name and Address �
Bonding Company Name and Address
Mortgage Lender Name and Address �hI�� IIiij
Application is hereby made to obtain a permit to do the work and installations as indi ated. I certi t at no wor' • .11atio has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all la s regulating construction in this jurisdict •n. This permit becomes null
and void i f work i s not commenced within s i x(6)months, or i f construction or work i s - •-••• . •. .• •., o s (6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrica Work,Plumbing, igns, "e , •• ,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 o1 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 o 'ruction or the performance of construction.
Signature of Owne>„eik � a- Signature of Contractor
Print Name `'' (' V N\\' Print Name
Bef• gi' - ,/ /�--- Before me
this I. • av ,20 1 this Day of ,20
—NAIL
otary Pub is ,
N4• -y L Graham Notary Public
My 1y Commission FF 086990
Expires o2r14t2o16 Revised 01.26.10
1
t l.4
CITY OF ATLANTIC BEACH
tl'fifOr'
ort
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 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.
cib4--qz3-39bLI
ADDRESS PHONE NUMBER
\ c-
PT '1'NAME
,A4i - a� \ \‹)
''• URE DATE
Before me this 2- day of Ala R r 20 n the county of
Duval,State of Florida,has personally appeared herin by ITrhself/herself an affirms that
all statements and declarations are true and accurate.
Notary Public at Large,State of / L ,County of to•XY Nle,ef, Notary Public State of Florida
• !,rinam
El Personally Known ✓ - Shirley L
M F 086990
induced Identification- 40,to F'.„ .•s
!?2714/2018
Notary Signatur-• ito _
F:/BLDG/Owner-Builde,Affadavit REVISED: •/16/2009
MAP SHOWING SURVEY OF
A PART OF LOT 1, BLOCK 2, ED SMITH SUBDIVISION AS RECORDED IN PLAT BOOK 26, PAGE 50 OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA, BEING MORE PARTICULARLY DESCRIBED AS FOLLOWS:
FOR A POINT OF REFERENCE, COMMENCE AT THE SOUTHEAST CORNER OF LOT 1, BLOCK 2, ED SMITH
SUBDIVISION; THENCE NORTH 0'15'00" WEST ALONG THE WEST LINE OF LOT 1, A DISTANCE OF 53.33 FEET TO A
POINT ON THE NORTH LINE OF PARCEL No. 172296-0000, AND THE POINT OF BEGINNING; THENCE CONTINUE
NORTH 0'15'00" WEST ALONG THE WEST LINE OF LOT 1, A DISTANCE OF 20.66 FEET TO A POINT ON THE SOUTH
LINE OF PARCEL No. 172296-0030; THENCE NORTH 89'36'00" EAST ALONG THE SOUTH LINE OF SAID PARCEL
No. 172296-0030, A DISTANCE OF 100.00 FEET TO A POINT ON THE EAST LINE OF LOT 1; THENCE SOUTH
0'15'00" WEST ALONG THE EAST LINE OF LOT 1, A DISTANCE OF 20.66 FEET TO A POINT ON THE NORTH LINE OF
SAID PARCEL No. 172296-0000; THENCE SOUTH 89'36'00" WEST ALONG THE NORTH LINE OF SAID PARCEL No.
172296-0000, A DISTANCE OF 100.00 FEET TO THE POINT OF BEGINNING.
------- ---------------
e
o I-
C
LOT 2 L
I 1
s
PART OF LOT 2 26'7
PARCEL 172296-0040 l
�/ LOT 13
N
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t:. S
4 ii
I I
O I __—__ __—_ 'S'0 O `
x
a) (� PART OF LOTS 1 AND 2 LOT 2
PARCEL 172296-0030 t.s
, > FOUND 1/2-IRON -LOT __ L
NO CAP N89 28 06 E 98.09 FIELD
, 1.93'EASTERLY N89 36'00"E 100 00' LoT ' FOUND c
PIPE,NO CAP co
p O ( / 8o O 9 PART OF LOT 1 51.3' 1 / 8 l� tE pro^
z at -; \
D —I o,O CONCRETE DRIVE ° BRICK STORY N (-O__t g--—_-—--—
5,„O7 p 4 TOWNHOUSE s d7 m m
m Z° Os 51.3' I ICONrCRETE WALK V \ No. 1505 , c p -
- 1 N S89'36'00"W 100.00 8' FOUND ,/r IRON rrj
PIPE,NO CAP
I S89'36'00'W 99.91' FIELD)
POINT OF 7NO I FF 2-t ON PART OF LOT 1
BEGINNING PARCEL 172296-0000 \
0 I
0 ----- ' _----
LOT 14
_I I
O 1
N N •1:
I !tl
chi PART OF LOT 1 r
,1
i., PARCEL 172296-0020
u_
POINT OF 26.7 I
REFERENCE
NOTES: __ -
1. THIS IS A BOUNDARY -- __
SURVEY. DONNER'S
2. BEARINGS ARE BASED ON ROAD � --
THE 22968 00NBENGPNORTH 40' RIGHT OF WAY
89'36'00' EAST, AS PER PAVED
OFF1CAL RECORDS BOOK
15731, PAGE 933.
3. NO BUILDING RESTRICTION
UNES PER PLAT.
Q 1p 2,0 40
SCALE: 1- = 20'
THE PROPERTY SHOWN HEREON APPEARS TO
LIE IN FLOOD ZONE "X" (AREA OUTSIDE OF
THE 0.2% ANNUAL CHANCE FLOODPLAIN) AS THIS SURVEY WAS MADE FOR THE BENEFIT
WELL AS CAN BE DETERMINED FROM THE OF SHARON P. MILLER; ALLISON W.
FLOOD INSURANCE RATE MAP No. FORSYTH; 'THAWAY & REYNOLDS, P.A.;
12031C0408H, REVISED JUNE 3, 2013 FOR CHICA3O TI SURANCE COMPANY.
DUVAL COUNTY, FLORIDA. .
NOT VALID WITHOUT THE SIGNATURE AND DONN W. BOATWRIGHT, P.S.M.
THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA UC. SURVEYOR and MAPPER No. LS 3295
UCENSED SURVEYOR AND MAPPER." FLORIDA UC. SURVEYING & MAPPING BUSINESS No. LB 3672 DATE:
CHECKED BY: BOATWRIGHT LAND SURVEYORS, INC. OCTOBER 29, 2014
DRAWN BY: CL
FILE: 2014-1197 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF1