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800 Stocks St - Fence
rli`l ( %'' \s CITY OF ATLANTIC BEACH ,~ , """' 800 SEMINOLE ROAD .) yy—ry 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-1184 Job Type: FENCE PERMIT Description: NEW FENCE Estimated Value: $500.00 Issue Date: 6/2/2016 Expiration Date: 11/29/2016 PROPERTY ADDRESS: Address: 800 STOCKS ST RE Number: 170945-0010 PROPERTY OWNER: Name: Hernandez, Rufino Address: 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 771E FLORIDA BUILDING CODES. 31:4%; City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 —'-- NCE .. t (81- J Phone(904)247-5826 • Fax(904)247-5845 ��, •• E-mail: building-dept@coab.us Date routed: 5/23 1 t (Q City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Addresst j0O Sro C«CD T Department review required Yes No Building Applicant: ' --�Z� 1E2^j�N�� ming &Zoning min ra or Project: Npsem(. Pie 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: ,Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed b / Y: ies ��v Date: 731 !6 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 IP 1 ,o ,:,. ,, `',.r BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 �JH)t)., Office:(904)247-5826 • Fax: (904)247-5845 Job Address: 80 O Sc.�- 5 Permit Number: wC3 Legal Description 1<ix1 C, RE# Valuation of Work(Replacement Cost) $ ..©O,�4Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): Ne Addition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s) (Circle one): Commercial Residen • If an existing structure, is a fire sprinkler system installed?(Circle one): Yes N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: 1 w©0 . Qr1 C-02. 61 Tq\ 1 42 t Lel r1 . j Florida Product Approval # for multiple products use product approval form Property Owner Information Name: RL ?-tri 4\Qr► alf\c ,C. Address: r r v awr �. t• City T"t�}l kv\-1-a C., Bea ch State Zip 3j233 hone ciO4 3 oo 6 q6 E-Mail Owner or Agent (If Agent,Power 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: Qualif ••: - gent: Address: • • State Zip Office Phone Job S• : -ontact 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 of six(6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,P umbing, Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. Signature of Property 0 '- . / • i� t On� �re of Contractor: Bethis�ay of lir, _� _ I„� ��,� Before me this ay of Notary Public: iMkt 1,411 Notary Publi • I hereby certi tlt ,�,-tjave rc �Q • d tin applicati. •• nd know th• .ame to be true and correct. All provisions of laws and ordinances g cwt isniiijis Mye9 sglmNlitTit hire c nplied with whether s.'ci red herein or not. The grantin, of a permit does not presume to gi : r �ola@y tempt gtootbbsi'gt2M6 the rovisions of any other federal, state, or local law regulating construction or the performance o. 't 8&ed Thru Notafy PubrcUnderwriters Rev. 3/14/16 r I /., tr; `' CITY OF ATLANTIC BEACH ®WNER / BUILDER AFFIDAVIT � ...„) �;t 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 TI IAT 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 FAMII,Y 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 WII,I, PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WI IICH IS IN VIOLATION OF TIllS 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 TI-IAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE I,AW 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. 500 5-Ec3c :5t g i 0.• :9 6 A ADD ESS ��I �/� �/3 �(j •.SNE NU R PR'SyINTLf \O c( �\�` tr- 12,z;:im.j"), olZ 0/ Cp SIGNA Ew*{ DATE Before me this Z0 day of `('LL/ .2d(a the county of Duval,State of Florida,has personally appeared h rin by himself/herself and affirms that all statements and declarations are true and ac ra / Notary Public at Large,State of ( ,County of C�4a- 1 ❑Produced Known C S—Aha?0-7 -06 v— ( '�i i ..:N.;iy" TONI GINDLESPERGEn ❑Produced Identification- ilt J `;''Z' AA < My COMMISSION t FF 924,).')I EXPIRES:October 6,2019 / q: Bonded Dm Notary Public Undeiw4tars Notary Signature: __ _��- E.mr.nc'Owner-litoldcr Affidavit.REVISED 4,!6x2009 1 I • Iv. 1 • • :: t.:, .:', : 1; 7'4 : ,.. ......... . . .., , 1 I-i ® + i , 1 = I� -� '. -- ®�;-_ t. . ma• y - I .- �-- _ --- I L _ 0< • .O S is g' � — — / p ^ ...., . -;*. .Iii.'..' 7•-7--.-, -.......--.1._.7 7.±..-71.-. 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