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354 5TH ST - FENCE OIL S, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD 3 ;r 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-1263 Job Type: FENCE PERMIT Description: FENCE Estimated Value: $1,371.00 Issue Date: 6/2/2016 Expiration Date: 11/29/2016 PROPERTY ADDRESS: Address: 354 5TH ST RE Number: 169842-0000 PROPERTY OWNER: Name: HUNT, MITCHELL W AND TONYA W, * Address: 14402 MARINA SAN PABLO PL PERMIT INFORMATION: FEES: Fence/ROW $35.00 II Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA Bill DING CODES. l ,•11.b`ly City of Atlantic Beach f '\ BuildingDepartment APPLICATION NUMBER` s (To be assigned by the Building Department.) , ,. y- , 800 Seminole Road \J . - '"--- -: , Atlantic Beach, Florida 32233-5445 �' ���) `� Z�� \ Phone(904)247-5826 • Fax(904)247-5845 0509',- E-mail: building-dept@coab.us Date routed: 77.-ii City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 354 5i S7 Department review required Yes No Building Applicant: w(U ealannin &Zoni� ng> Tree Administrator Project: r C.n r t° 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: %�f.' ' (� i� G� y — Date: VI/ /4 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 05/14/09 )-m- _* s 00.. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH iii800 Seminole Road,Atlantic Beach FL 32233 ��Ji31Or Office: (904)247-5826 • Fax:(904)247-5845 I,Co -Fiv CE-I zC_. 3 Job Address: 35 L} 5th 5free t A V Permit Number: Legal Description Lot 23, 5l ock6,/ P Iat No. I t SUbd 'A" A RE# Valuation of Work(Replacement Cost) $ I31 i — Heated/Cooled SF N/ft Non-Heated/Cooled N/A • Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial Residents ) • If an existing structure,is a fire sprinkler system installed?(Circle one): 112P No N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal N/4 Describe in detail the type of work to be performed: Replacing robing 4'-eince with Same -fence, 3tf-[. Ioh9 3f1 irk AID`' high Florida Product Approval# for multiple products use product approval form Property Owner Information Name: TO a. }-kit Address: 54- 5% s et City Ali an-ti c RF QeAf\ State FL Zip 322 3 Phone (' Ll) F. I-127 4 E-Mail ton t Vlwelt GI 2. ( C3 on a i l . Co m 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: Qualifying Agent: Address: City State Zip Office Phone Job Site/Contact Number State Certification/Registration E-Mail Architect Name&Phone# Engineer's Name&Phon Worker's Compensate Exempt / Insurer / Lease Employees / Expiration Date Application is hereby made to obtain a permit to do the work and installations as indicated. I certifil that no work or installation has commenced rtor to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating ru constction 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 fig a period ofsix(6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbin- Signs, Wells,Pools,Furnaces,Boilers Heaters,Tanks and Air Conditioners,etc. Owne Prope of Signature ' � g P ,.. lbw. Signature of Contractor: Befot me this Day of ft a i=;` r t r-T ,, , 'panESPERGEDay o f .. ,., MY COMMISSION II FF 924951 Notary Public: • •_( --,.,,,,•,..c...�a= PIRES:October 6,2019 -WOP�,mNountlecrUnd n I hereby certijj,that I have read and examined this application 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. Rev. 3/14/16 CITY OF ATLANTIC BEACH rr (OWNER / BUILDER AFFIDAVIT 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 THAT 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 FAMILY 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 TI-IE CONSTRUCTION IS COMPLETE, THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICFI IS IN VIOLATION OF THIS 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 THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW 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. :35 Street niic- 13eachFL Ca'oy�61)-1774 ADDRESS 322 33 PHONE NUMB R • [�hY0. \ PRIN NAME ll 2 m 60— � Sf NA URE DATE Before me this l day of 0 f\0 ,201(ae county of Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of ( ,County of (_,VcL ❑Personally Known ❑Produced Identification- t _tA0 7 r - - Z-71 . .i TONT GINDLESPERGER 7.1 MY COMMISSION COMMISSIONIFF 924951-, EXPIRES:October 6,2019 Notary Signature: WEk `R t4Bonded Thru Notary Pablo U, n F:BLDG/Owner-Builder Atradavit;REVISED:4/162009