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
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