1091 HIBISCUS ST - FENCE T3„„ CITY OF ATLANTIC BEACH
o 800 SEMINOLE ROAD
r , ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
1119V
FENCE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-FNCE-1260
Job Type: FENCE PERMIT
Description: 6' FENCE
Estimated Value: $2,100.00
Issue Date: 6/7/2016
Expiration Date: 12/4/2016
PROPERTY ADDRESS:
Address: 1091 HIBISCUS ST
RE Number: 171088-0116
PROPERTY OWNER:
Name: BISHOP, CATHLEEN M
Address: 530 GOLDENROD LA
PERMIT INFORMATION:
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE: WITH ALI. CITY OF ATLANTIC IIEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
sy�,y;.,J, City of Atlantic Beach APPLICATION NUMBER
r BuildingDepartment�� '� • •� p (To be assigned by the Building Department.)
R 8Atlantic
SeminoleRoad ) l0-FNQP.-- 1 Z G d
jr4 �� AtlanticticBeach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
`-`Lr)1119r E-mail: building-dept@coab.us Date routed: CO l ( 1 I 40
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 1 09 I 14,13,scps &-z- Department review required Yes No
Building
Applicant: 0 liJ i .Def ' - ng &Zonin.
/ ree Adminis ra or
\
Project: l7 P.n C P 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: pproved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: ��� L- ate: (/L//(
TREE ADMIN. Second Review: A roved as revised.
n 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
•
ilrt���i�� BUILDING PERMIT APPLICATION
l SA
�- CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233
<--:!.f..)1119',-- Office: (904)247-5826 • Fax: (904)247-5845
L to --Po Com- 1 zea
Job Address: t cCi jr�l K11`�x, S Permit Number:
Legal Description RE#_ f i c s - CI ) 14
Valuation of Work(Replacement Cost) $ 2-1W Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one)41011111,Addition Alteration Repair Move Demo Pool Window/Door
■ Use of existing/proposed structure(s) (Circle one): CommercialResidential
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes NoA
• 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:
ke- Plat e meld rf ni.k3 i IN e-, -a'hcC,
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: 0i1�'o Y' P) 11 p Address: �:-3O ' • . - viA_ h
City 1.4e 1 tw . itc1c1 Staten-Zip 32 vPho - e-tt, 1 _ 309 ,Ston
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: . C i _ .. F" I . Qualifying Agen •
Address:3 itA -blay�t' 13 ,e-\ City t State Zip L -ta�
Office Phone CIO 1 115. "1'2 Job Site/Contact Number
State Certification/Registration# E-Mail fan YA.MN
CAct) 1 ou \JCtt1 DD,()OWE
Architect Name & Phone# l I
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. 1 understand that separate permits must be secured for Electrical Work,Plumbing,
Signs, Wells,Pools,Furnaces,Boilers Heaters, inks and Air Conditioners,etc.
1
Signature of Prope I wner: f =, Signature of Contractor:
Befog me 7'�
this I Day of O C' A .� . I i Before me this D. .f
Notarywill .,. -
Public: � .•::�^ . .
— � .':s•• tory PQ1641tlExES:
ICY COMMISs1• 4 FF 924951
;;;. : = EXPIRES:r tober6,2019
I hereby cert that I have read and examined t is ap'lication an - •':•1, • 'ul;,i I'.kaithi eWAd arr: t. All provisions of laws and
ordinances governing this type of work will be . • .lied with w ietne7' . "--".:ranting of a permit does not
presume to give authority to violate or cancel the provisions of any other feseral, state, or local law regulating construction or the
, performance of construction.
Rev. 3/14/16
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