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404 OCEANWALK DR S - FENCE , '` F„'s f CITY OF ATLANTIC BEACH rr. A s-) 800 SEMINOLE ROAD .5 tr ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �J,11�� FENCE PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-FNCE-1694 Job Type: FENCE PERMIT Description: RETAINING WALL / CURB Estimated Value: $4,000.00 Issue Date: 8/18/2016 Expiration Date: 2/14/2017 PROPERTY ADDRESS: Address: 404 S OCEANWALK DR RE Number: 169463-0524 PROPERTY OWNER: Name: FLANAGAN JR, WILLIAM J Address: 404 S S OCEANWALK DR PERMIT INFORMATION: PUBLIC WORKS: Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact Public Works(247-5834)for Erosion and Sediment Control Inspection prior to start of construction. All silt must remain on-site during construction. Full right-of-way restoration, including sod, is required. FEES: Fence/ROW $35.00 Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AM) THE FLORIDA BUILDING CODES. • Ir\ City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road �� , Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 • Fax(904)247-5845 I G ` Piv CE.` I X94 ' on sy,- E-mail: building-dept@coab.us Date routed: 7/ a-7/1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 404 OCePtiVLOPtCK art gent review required Yes o ildin :> Applicant: 0(ADLC---2___, Plan ing &Zoning Tr-- _•••' istrator Project: 0 L? 12._emr._P�blic Works Public Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date 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: APPLIC TION STATUS Reviewing Department Firs r w: pproved. ❑Denied. (Circle one.) .`.` iv •I% fes./% /� BUILDING `� PLANNING &ZONING ���� Reviewed by: 1 , Date: TREE ADMIN. Second Review: QApproved 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 .\ 1 ,t=A.o.r.jr, City of Atlantic Beach ' Building Department (; IV APPLICATION NUMBER E0 ,1, ... yi 1 ItA 800 Seminole Road (To be assigned by the Building Department.) rj* • I Atlantic Beach, Florida 32233-5445 JUL 2 9 2016 167 `PK)CE- ( G3.(4 Phone(904)247-5826 • Fax(904) -5845 o„i Email: building-dept@coab.us y . City web-site: http://www.coab.us BY: Date routed: ! i APPLICATION REVIEW AND TRACKING FORM Property Address: 404 CD e , , _ Depot� .1 1 ent review required Yes No �_uildin.Applicant: OwK7E-_{� Plan ing &Zoning Tre- :.„'nistrator = Project: 0 L, `ublic Works_AMIIIIIIII Public Utilities Public Safety Fire Services _- Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date 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. nDen//ied. (Circle one.) Comments: feiicy-t C4 £ 4i 1- BUILDING PLANNING &ZONING �/ Reviewed by: Date: V2- TREE ADMIN. Second Review: QApproved 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: 1 ised 05/14/09 . i !•S, L�r4r �otr BUILDING PERMIT APPLICATION t OFFICE COPY �� CITY OF ATLANTIC BEACH � .; 800 Seminole Road,Atlantic Beach FL 32233 �`J"'9r Office:(904)247-5826 • Fax:(904)247-5845 r` Job Address: 4',y O(t 4AJ t J/4 L k b - . Permit Number: Legal Description RE# 1 (p� !i.' G:3 - d J Z4 Valuation of Work(Replacement Cost)$ 5/000 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): 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 th type of work to be perfsorme : t_ 1 o 51r� i A. r r 14A ..�F 4~ Z J Q. !� i.:, G S4c +tel+•` `e,J c.-- r O p �`1 w r..) L._.e E -_re. 4,�- 4 t be i .4 �v�o 4).1/4,-. Florida Product Approval # for multiple proadcts use product approval form Property Owner Information Name: t i - F\a..,_ a'% - Address: le' (5t'0..—c.)c..( 7< L)r City A+(a-74i ►�35 cI�UStateFLZi 3'2 r E-Mail W / ,a . j p 3 3 Phone <$ 7- f �1�' l q z wa.�� eee.�4 . e r 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: ifying Agent: Address: City State Zip Office Phone Job • e/Contact Number State Certification/Registration# E-Mail 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 certify that no work or installation has commenced nto the issuance of a permit and that all work will be performed not commenced within six(6)months, or if construction or work is suspended or abandoned{{or a period o six(6 months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing, Signs, ells,Pools,Furnaces,Boilers,Heaters, anks and it Conditioners,etc. Signature of Prope Owner: i -(-----/ -- Signature of Contractor: Bef thisDay of AO 2Tipirits _11110 I Before �tr`''ry T• INDLESPERGER Notary Public: _� 1 I'*', al,II'.•- M • MISSION*FF 924951 Notary :a.,.� PIRES:October 6,2019 T . I hereby certifi,that I have read and examined this appli OPandknow 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 .:r; CITY OF ATLANTIC BEACH OFFICE COPY '�' ®WNER/ BUILDER AFFIDAVIT F r;t �r 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 TIIAT 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 I-IAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS 1N 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. ii, bf .,c.ICc. rd— A/2 • 5.i !>ih,-14ff gr7-yea -079 -L- ADDRESS �Zz 33 PHONE NUMBER av ix-7 , *e..,4-.., �2 PRINT N' E/ SIGNAT DATE Before me this 27 day of'J j 1::j 20.the county of Duval,State of Florida,has personally appeared h rin by himself/herself and affirms that all statements and declarations are true and a r e. \ Notary Public at Large,State of l ,County of V 1Jvc-( ❑Personally Known /i c.--_, __ft D — / .._.1 Induced Identification Oh C Ir`J /�L�/,/tJl ilk 411 Notary Signature: " _ ` ,,•_ 0 TONT GINDLE3PERGER ' +? MY COMMISSION#FF 924951 •i'z5 EXPIRES:October 6,2019 FJBLDG/Owner-Builder Affadavit;REVISED:0/162009fl,,.;°P'. Bonded Thru Notary Public Undenvr'ters w+wrw..