1180 LINKSIDE DR - FENCE (---
�
1, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
;r 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-720
Job Type: FENCE PERMIT
Description: 6FT FENCE
Estimated Value:
Issue Date: 3/24/2016
Expiration Date: 9/20/2016
PROPERTY ADDRESS:
Address: 1180 LINKSIDE DR
RE Number: 172374-5035
PROPERTY OWNER:
Name: MITCHELL, MARY ANN
Address: 1180 LINKSIDE DR
PERMIT INFORMATION:
FEES:
Fence/ROW $35.00
Total Payments: $35.00
1
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF A'T'LANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
j1.A JA n
BUILDING PERMIT APPLICATION
r
) CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
PiJ:l% Office: (904)247-5826 • Fax: (904)247-5845
Job Address: UPC 44Ii� 1 l't/b'ej Permit Number:
Legal Description RE#
Valuation of Work(Replacement Cost) $ Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool 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
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal
Describe in deta*4 the typ of work to be performed:
6 7
Florida Product Appr al# for multiple products use product approval form
Property Owner Information
.--r
Name: / jl � .4 ef Address: lid " �• to piy,6 City Sri%i', _ . r/ _ . Stati ip J' Phone 9��/^��, 7
E-Mail kill /'eV 1c4c 1
Owner or Agent If Age tt,, ower of Attorney or Agency Letter Required)
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.
Contractor Information:
Name of Company: Qualifying Agent:
Address: City State Zip
Office Phone Job Site/Contact Number
State Certification/Registration# E-Mail
Architect Name & Phone#
Engineer's Name &Phone#
Worker's Compensation
Exempt / Insurer / Lease Employees / Expiration Date
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 o//''six(6)months at any time after work is commenced. 1 understand that separate permits must be secured for Electrical Work,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Con:' oners etc.
/
Signature of Property Owner:. 4/ �Ad_ Al/y / Signature of Contractor:
Before me
this Day of ..■ 1 Before me this Day of(Or' 0
Notary Public: • / Notary Public:
I hereby •e t i f .at 4 , • . .n e%r''• his application and know the same
�1 � pp• a to be true and correct. All provisoes permit does and
ordinan, .s,•*: .,; r irk • y _ • °�Ffi���aill r,� complied with whether specified herein or not. The granting of a pet•mit does not
presum o?,••:.art �8 0i or cance the provisions of any other federal, state, or local law regulating construction or the
perform• c •f ulonS �{;r 11141 078 086990
Rev.3/14/16
r`a
t CITY OF ATLANTIC BEACH
u' s
WNER / BUILDER AFFIDAVIT
�o;ss
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 LICENSE])
CONTRACTORS. YOU IIAVE 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
AF'T'ER 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.
40 i ADDRE S '% /��wI. ie PHONE NUMBER
�I /I// .1'`/1 'I
PRI T L/
s/ /.1
S N' '.-E. C'' •� DATE
Before me is day of Ak,g/1 o i.--E9? in the county of
Duval,State of Florida, as personally appeared herin by himself/herself and affirms that
all statements and declarations are true and accurate.
41 Public at Large,State of ,County of
ersonaiiy Known
P
Illff
roduced Iden ation- I tPAY P4� Notary Public State of Florida
' �� :4 `: Shirley L Graham.11� �� �.`ate My Commission FF 086990
Not ry Igna r L •r 104 €.xpir 02/14/2018
I'/13LLXVOwner-Ruildcr ARadavii,REVISE . 4/1612009 `
MAP SHOWING BOUNDARY SURVEY OF
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. AS RECORDED IN PLA T BOOK L4- PACES Z3-Z34OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA
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NOT VAUD UNLESS EMBOSSED WITH SEAL OF THE UNDERSIGNED. BEARINGS BASED ON R,'^l UNE AS SHOT
THE PROPERTY SHOWN HEREON APPEARS TO LIE WITHIN FLOOD HAZARD ZONE A AS SCALED FROM FLOOD
INSURANCE RA 7E MAP o(Do/ FOR ATLI,J 77 C G,a c_L FLORIDA, DATED ¢ -/7 -/39
TRI-STATE LAND SURVEYORS, INC.
8411 BA YMEADOWS WAY SUITE #2, JACKSONVILLE, FLORIDA 32256 (904) 731-7235
LEGEND
I HEREBY CERTIFY THAT THE ABOVE LANDS WERE SURVEYED UNDER MY
■ CCWC MAV RESPONSIBILE SUPERVISION AND DIRECTION, THAT THERE ARE NO
• '"'"OIL ENCROACHMENTS EXCEPT AS SHOWN AND THAT THE SURVEY SHOWN
(SET WIN CAP j LS 4144) _ HEREON MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY
x EDVIX THE FLORIDA BOARD OF LAND SURVEYORS PURSUANT TO SECTION
NON COR.(AND)
472.027, FLORIDA STATUTES
® CROSS WT
B.RL BUILDING RESTRICTION UNE
•
ESV7 EASEMENT LARRY C. EDDY, P.L.S. No. 4144
R/W RTGNT-Q'•-WAY /" a o'CO / Alp
c°V. ED AREA SCALE:
€ GOVTFRLYVE 4,i'
A/C AIR CO"°InavlNC PAD REGIS -R.7, URVEYOR, - 7E OF FLORIDA
(R) RADIAL DISTANCE
DATE. 3-/ 3 -96- .
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