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�S CITY OF ATLANTIC BEACH
- �� 800 SEMINOLE ROAD
J 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-1003
Job Type: FENCE PERMIT
Description: 6ft fence
Estimated Value:
Issue Date: 6/2/2016
Expiration Date: 11/29/2016
PROPERTY ADDRESS:
Address: 1113 E SANDPIPER LN
RE Number: 172374-5265
PROPERTY OWNER:
Name: HANSON, JACK A
Address: 1113 E SANDPIPER LN
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.
Vis.-viper, City of Atlantic Beach APPLICATION NUMBER
A Building Department (To be assigned by the Building Department.)
800 SeminoleRoad _����
-.,-._
AtlanticticBeach, Florida 32233-5445 � 63
� Atlantic
Phone(904)247-5826 • Fax(904)247-5845
J;3 s? E-mail: building-dept@coab.us Date routed: Z '
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: /1�3 Ate'► �p .�� �`�'j Department review required Yes No
r
Applicant: t0 ) Planning &Zoning
I ree Administrator
Project: ti r / C/ 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 by: 'bate:4/9//e
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
• BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office(904)247-5826 Fax(904) 247-5845
Job Address: 1II; 904;1Fe"Q i-f' ERsr g1(AN-fl( Ie to 32y3} Permit Number:
Legal Description Parcel# L.bT 5 Z
Valuation of Work$ 1200' , Floor Area of Sq.Ft. t
Proposed Work heated/cooled 0Ik non-heated/cooled N/A
Class of Work(circle one): ew Addition Alteration Repair M. e Demolition pool/spa window/door
Use of existing/proposed structures)(circle one): Commercial . - 'a•- , ••
I.If an existing structure,is a fire sprinkler system installed?(Circle one): 'es Or. N/A
Florida Product Approval#
For multiple products use product approve orm 13-5
Describe in detail the type of work to be performed: Rre.pl.a.G.e. C..QV r'iL. ` o ke. —
oA fe vtct. a� �°'^ cr b C- tt -c� •
Pronerty Owner Information: U
Name: JAWA i S•ek. yea 6N Address: w3 Sou„0, P i p W Lovsk, e
City !r4 % . 4 L StateA—Zip 3U-3 3 Phone a4 c 24,-544* (D401e1A.0
E-Mail or Fax#(Optional) rt. '],5 l . S11Z. C(.34n )
Contractor Information: CONTRACTOR EMAIL ADDRESS:
Company Name: •�
6 G. A f i. 1 Quali ing • gent:
Address: $ 1 r$ a �� Y
1 Ci State _Zip_ �z
Office Phone 70i/ .C�I�--S 3 Job Site/Contact Number �/ -5—$'0 Fax#
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone# M E ( r1 FI I V/ LS
Fee Simple Title Holder Name and Address
I
1
Bonding Company Name and Address
Mortgage Lender Name and Address
A.PR 2 2016
Application is hereby made to obtain a permit to do the work and installations as indicated. I cert. .ti•,no work or 'n . . 'ern hav ommenced prior to the
issuance of a permit and that all work will be performed to meet the standards ofall laws re ulatin const .
g iodurirc ix This ata becomes null
after and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a�eriod of sixL(6)months any time after
work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing Sipes Wolk R..lc ..eb,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 certt&that I have read and examined this qpplicatipn 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 Owner19Signature of Contractor `.
Print Name AM ES 4 J 0 ttNSON Print Name Of /e- f V,/,(
Bef a me Lb 1R1` • ) Before me L
this Dayrof _`,-4- - :t.FRESH this ,Day of ,20 /-d
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5042 I
otary Public ; T. S August 13,2018 s a 'ubli
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007)398.0153 faneallowys.►no..con 1 J "` 0 L— Qri • �`:�`l' FIRES:July12.2019
'` 1 R ';X; , Notary Pblic Undervrtiters
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MAP SHOWING BOUNDARY SURVEY OF
LOT 52 ACCORDING TO THE PLAT OF
SELVA LIIIIKSWE UNIT 'I
AS RECORDED IN PLAT BOOK 44 . PAGE(S) 23 AND 23A OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY. FLORIDA.
CERTIFIED TO:
.JACK HANSON, JACKIE HANSON, KEITH WATSON TITLE SERVICE, INC. ,
DIM REPUBLIC NATIONAL TITLE INSURANCE. COMPANY AND USAA FFUERAL SAVINGS BANK.
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