1085 HIBISCUS ST FENCE PERMIT City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
: 800 Seminole Road j
Atlantic Beach, Florida 32233-5445 L V< Ets)
Phone(904)247-5826 • Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ' C) B E> I Q ISCuS 7 Department review required Yes No
}— Building
Applicant: f—c-oy(J E)C) RTHWILK
arming &Zoning
Tree A min or
Project: F`ElUc. 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 , '� �f�'�� Date: v�
Reviewed by: i
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date.-
FIRE
ate:FIRE SERVICES Third Review: ❑Approved as revised. [—]Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
-- U LDW ERMIT PPLICATION —
s
�r CITY OF ATLANTIC BEACH
A 800 Seminole Road,Atlantic Beach FL 32233
Office: (904)247-5826 • Fax: (904)247-5845
Job Address: 8 ��'/ /S Gt' S S7- ,q- �G>�f 322-33 permit Number:
Legal Description re�i G Gr ga(I tAC C M ckj T RE#
Valuation of Work(Replacement Cost) $ /2- C O . *-4 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): es o 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:
RrInod cy 6)�C(S 7-,N l-a��s G C,� JZ c:��r� c� /Jc-L) r--Z;0 0L:--
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name:J5'Go y/J ,8o 21 A W 1 ov-- Address: 3/,S C-"S S
City On State FA-Zip 3 VJ Phone Z o V 7-V
E-Mail rnq60 /L7 1U4 6&nc&s r N ITT -
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: R .C 14A-pA p P6—, J e i a Qualifying Agent:
Address:-31 b 13 Ltto-jID,N !� S 1,V p City0aft,36G Pl-.tL State Zip PA_ 37Z-+3
Office Phone 0 04 3 P;F0 Job Site/Contact Number
State Certification/Reglstration# E-Mail
Architect Name &Phone#
Engineer's Name &Phone#
Worker's Compensation
Exempt Insurer Lease Emp oyees Expzratton 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
pnor 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 nttll and void if work is not commenced within six(6 months, or if construction or work is suspended or abandoned for a
period ofsix(6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,
Sig", Wells, "Is,
Furnaces,Boi He ers Tanks nd Air Conditioners,etc.
Signature of Prope20�
er: Si n t
thisBefe
this Day of 0 ( t TONT GINpLESPERGER
In�41t1Ur,MMISSION$FF 929 o
EXPIRES.Oeto er 19�
tl Bonded Thru Notary Pubk Underwriters
Notary Public:
I hereby certify that I have read and examined this application and know the same to be trite 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 fe eral, state, or local law regulating construction or the
performance of construction.
Rev. 3/14/16
R. ChampFencing 6584
316 Blanding Blvd.
Orange Park, FL 32073 Serving
Phone: (904)375-8729 (904)375-9153 Clay, Duval &
Email: randy_champO1@yahoo.com
Fax: (904) 375-9153 Surrounding Counties
www.rchampfencing.com
Date:
Buyer(s): —�V VP's
Address:— SUS S W�"-j'tSC Home Phone:
City: A St: —zip; Cell Phone: _1
]obsite: Fax:
Special Instructions: ��
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.NOT RESPONSIBLE FOR ANY UNDERGROUND WIRES OR WATER LINES AND SPRINKLER LINES
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(D "I
3uyer(s) By: Dated: Salesperson: Dated: sfasy
MAP SHOWING BOUNDARY SURVEY OF
LOT 3 A, ACCORDING TO THE PLAT OF "BEACH HARBOR" AS RECORDED IN PLAT BOOK 42,
PAGES 39 AND 39A, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
DIXIE J. BERTHWICK,
STEWART TITLE OF JACKSONVILLE, INC. ,
WATSON MORTGAGE COMPANY
AND WATSON & OSBORNE, P.A.
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E ' p 1. BEARINGS ARE BASED ON DE ff-M&N,,0,77*42, P.aGe: 39.4
�J 2.STRUCTURE NO. /0-6 SHOWN HEREON UES WITHIN FLOOD ZONE AS BEST
A SsocIATED SURVEYORS INC. DETERMINED FROM F.EM.A. FLOOD MAPS PANEL No. / DATE[)
3.THIS IS A SURFACE SURVEY ONLY. THE EXTENT OF UNDERGROUND FOOTINGS,
LAND do ENGINEERING SURVEYS PIPES AND UTILITIES, IF ANY, NOT DETERMINED.
4.JURISDICTIONAL AND/OR ENVIRONMENTALLY SENSITIVE AREAS IF ANY, NOT
5915 CEDAR HILLS BOULEVARD LOCATED BY THIS SURVEY,
SJACKSONVILLE, FLORIDA 32210 5. THIS SURVEY WAS BASED ON LEGAL DESCRIPTIONS FURNISHED AND THE
�' 904-771-6468 PUBUC RECORDS WERE NOT SEARCHED BY THIS SURVEYOR FOR EASEMENT'S, TITLE,
7 COVENANTS OR RESTRICTIONS THAT MAY AFFECT THIS PARCEL.
p � CERTIFICATE OF AUTHORIZATION NO. LB 0005488 6.UNLESS OTHERWISE STATED ALL IRON PIPES FOUND HAVE NO IDEN11FICAIION.
S S d T NOT VAUD WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A
FLORIDA LICENSED SURVEYOR AND MAPPER.
I HEREBY CERTIFY THIS SURVEY WAS DONE UNDER MY -O - GUY ANCHOR LEGItND/ANRIVIATIONS (R) — RECORD
DIRECT SUPERVISION AND MEETS THE MINIMUM TECHNICAL O —SET IRON PIPE OR REBAR MARXED P.C.- POINT OF CURVE (M) -MEASURED
STANDARDS FOR LAND SURVEYING PURSUANT TO CHAPTER ASSOC, SURVEY " OR L.B. 5488 P.T.-POINT OF TANGENCY A CENTRAL.
61G17 ORID ADMINiST ION C E i T R 472, F.S. - FOUND IRON PIN OR PIPE C/L - CENTERLINE ANGLE
■ — FOUND CONCRETE MONUMENT I.PP. — IRON PIPE OR PIN L —ARC LENGTH
X - CROSS CUT OR DRILL HOLE R/W - RIGHT OF WAY R - RADIUS
BY: CHARLES B. HATCHER P.R.C. — POINT OF REVERSE CURVE CONC.— CONCRETE WM — WATER
FLORIDA CERTIFICATE NO. 3771 P.C.C. - POINT OF COMPOUND CURVE X—X—FENCE METER
B.R.L. — BUILDING RESTRICTION LINE C&R) - COVENANT'S AN (GWA)-GUY *lR
JOB NO. 25658 DATE 20 Ot/. 2000 (ORB) — OFFICIAL RECORDS BOOK RESTRICTIONS N&D - ANCHOR
ANO
SCALE: / Zo' DRAFT ER ,Q.J. F �Q. (oRv) - OFFICIAL RECORDS VOLUME EF. COR.- R CE ) DISK
J.E.A. - JACKSONVILLE ELECTRIC AUTHORITY