363 4TH ST - FENCE f r\l\f\
\s f CITY OF ATLANTIC BEACH
ti
800 SEMINOLE ROAD
J , ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
• �J F119'r
FENCE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-FNCE-1276
Job Type: FENCE PERMIT
Description: NEW 4' AND 6' FENCE
Estimated Value: $2,500.00
Issue Date: 6/9/2016
Expiration Date: 12/6/2016
PROPERTY ADDRESS:
Address: 363 4TH ST
RE Number: 169843-0100
PROPERTY OWNER:
Name: PHILLIPS, LONNIE
Address: 4648 COLLINSWOOD DR
PERMIT INFORMATION:
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND TIIE FLORIDA
BUILDING CODES.
0=11,,pr,,„ City of Atlantic Beach APPLICATION NUMBER
- l Building Department (To be assigned by the Building Department.)
A800 Seminole Road ( �` r(v �7�7
yjI
Atlantic Beach, Florida 32233-5445 1 Cp -t / �Q
Phone(904)247-5826 • Fax(904)247-5845 //
w%- E-mail: building-dept@coab.us Date routed: CO/3/1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Jl 73 4 ( Department review required Yes No
Building
Applicant: CD 1ON annin &Zoning
ree Administrator
Project: 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: jejApproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by � � ��� / j C
Date: �/ ,3 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. ElDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
V
JS UILDING PERMIT APPLICATION----
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
``t';l 9r Office:(904)247-5826 • Fax:(904)247-5845
I Co EN -I Z7(_,
Job Address: (c 3 (1- 37yeA4- Permit Number:
Legal Description RE#
Valuation of Work(Replacement Cost)$ 2.5 o Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): CID 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 detail the type of work to be performed: L F,L € �d 74/..
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: Lv r K t-t- PL t i y S Address: 3( 3S}.
City 6eco-C• State PLZip 30233 Phone (3542Z9(0. -133 y
E-Mail L_pl. r I lyt f e 1p
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 NOTIdE OF COMMENCEMENT.
Contractor Information:
Name of Co • :.• • Qualifying Agent:
Address: City State Zip
Office Phone o• '' _ t Number
State Certification/Registration# E- aI
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 certi that no work or installation has commenced
Tnor 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.
his permit becomes null and void if work is not commenced within six(6)months, or if construction or work rs suspended or abandoned for a
period o fsix(6 • the at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,
Signs, Wells, 'ools, r ces,Boilers,Heaters,T, + and Air Conditioners,etc.
Signature of Prope a weer: ///!- Signature of Contractor:
Bef me
this Day of ► 411321// Q 41J / Be ore Day of
�i''r✓'.
Notary Public: QJ �.� • I�hBt TONTGINDLESPERGER FF 924951
Rf„n•' EXPIRES:October 6,2019
. . Bonded Thru Notary Public Undenenters
I hereby certify that I have read and examined this applications AR�,P /,rau„+e. tee-t,ue a„r1,r3rrect. 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 viollate or cancel the provisions of any other federal, state, or local law regulating construction or the
performance of construction.
Rev. 3/14/16
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0 THIS DRAWINGREPRESENTS A I ATLANTIC BEACH, FL 32233
Q PROPOSED CHANGE.IN THE
r CiOMTRACT DOCUMENTS AND IF
ACCEPTED WILL BECOME A PART
t0 OF THE CONTRACT DOCUMENTS ■ISSUE DAII
1 17JUNE15 4.0127