2359 SEMINOLE RD - FENCE 1 y\l\r
•
•,- '��f CITY OF ATLANTIC BEACH
_ 800 SEMINOLE ROAD
T.' 0
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Jl),l9r"
FENCE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-FNCE-1863
Job Type: FENCE PERMIT
Description: NEW FENCE
Estimated Value: $2,388.00
Issue Date: 8/30/2016
Expiration Date: 2/26/2017
PROPERTY ADDRESS:
Address: 2359 SEMINOLE RD
RE Number: 168349-0000
PROPERTY OWNER:
Name: JACOBSON, SAMUEL S
Address: 2359 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: SUPERIOR FENCE AND RAIL OF NFL
N/A
Address: 5470 HIGHWAY AVE
Phone: 904-382-2221
PERMIT INFORMATION:
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
01.J.v r City of Atlantic Beach APPLICATION NUMBER
cs l Building Department (To be assigned by the Building Department.)
800 Seminole Road I _ File/
� �_ � �
� � Atlantic Beach, Florida 32233-5445
Phone(904)247 5826 • Fax(904)247-5845
j/ _ //
%575- • E-mail: building-dept@coab.us Date routed: v L�O 1 �j
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 369 Sc (rL& o(.& Qf) Department review required Yes No
" Building
Applicant: V Pe---9-4 O E/�-DC . anning & o
Tree Adm in1sira --
Project: F—E--iv C€ 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:rjr,,..' E...-----r-- Date: rjr57`
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
BUILDING PERMIT APPLICATION
• CITY OF ATLANTIC BEACH
800 Seminole Road.Atlantic Beach.FL 32233
Office(904)247--5826 Fax(904)247-584' i 6 - rN cc-1g 63
Job Address: 2 359 rn h no ie s: a Permit Number:
Legal Description Parcel#
Floor Area of Si4.Ft. Sq.'.t
Valuation of Work S 23$1^5 Proposed Work heated/cooled non-heated/cooled
( ass of Vs ork(circle one): Addition Alteration Repair Move Demolition pool/spa window/door
l'se of existing/pro rased structures)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A
Florida Product Approval,
For multiple products use product approval form I '
51)cscribc in detailthetype of•work to be pertixmed: �5\ A-C2,\ (s?4 L.��c:".4'0 CN-
�Qtp \t": ME?,(VP
Property Owner Information:
Address:Name: 3 LAA 7i o n •I i3J� i
City f}{�rx-t� eLt c IN.— Statue ip'Sa3Phonc ej
a+CC)-'aa.
E-Mailor Fax 14(Optional)
Contractor Information:
Company Name:_ •.aflcor-- - - J- kai i Qualif ing Agent:_
Address:'34 (0 N t-ht....)•� 012 City rt.!:l(c State F-- Zip
Office Phone O - •Joh Site/Contact Number Fax n
nte Certification/Registration me& » C�3 2 - 6 349
Architect Name&Phone# J
Fngineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
.4pply croon Is hereby mask to uhtant a penal to Jr,the work and installations as indicated I cern/i'than In.work or titsklllamn las commenced prs,r n,ih,
,ssuenk'e of a permit and than all work will he perlewnted to meet the standards of all I<rw.s regulating cenislrue.l al in ibis Iun.sd n-ii n. I hes fk'rfn l becomes null
and foal/f work is IBM eon,nk'aet'd within six/I/months.or el avmVnn'll<nt Of work 1s sto s'lsled ar a1dmalel1101 far a period of ssr III minlhr at airy time alley
w oak is commenced s'S I unskrsr:na!11101.separate fa'rmats must he secured/or Electrical Hark,Plumbing.Signs.Wells.Ptak,Furnaces.Rollers.Beakers.
Tanks and Air Conditioners.eft..
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 YOu R NOTICE OF
COMMENCEMENT.
!here/n."710.that Ila.,.MAIO&cramak'd this application and kilos.Ila'PPPPPP e to he Ink'tllkl a orae a 1. All pnWIMlnx of lints and ordinances goeenrotg this
npe of stork,will be ec,mpl/ed with whether verified herein or Ian. Ila grading Ma permit<ka's mot presume too goo'antaortn's,enolate or cancel e!the'
pnn'lsums of any other federal.stale.or local law regulating commun.,'or lie'pe rtormalnca'of construction
I
Signature of Ow er, t --- 4. ' • __../..4 'ignature of Contract 0 " r
Ili
Print Name q4A 1 li •. Print Name Zt9Cif Ferro(‘,
Sworn to and subscribed JJuqre . Swom_ip and subscribedU�re n ��
this Li Day o v U - - 1045 this/ Day of fT -1
Notary_ Pu tc " `otary • tc
Re,,:y,J J I.21.I 0
�t` � DAVID EARL FLEISCHMANN .-' ;. DAVID EARL FLEISCHMANN
• /•I -•i MY COMMISSION #F'F157186 '� • MY COMMISSION#FF157186
ki„,4,, EXPIRES September 4,2018 ,,5 is EXPIRES September 4,2018
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(aoT 3064153 FlondallotaryService.com (407)396-0153 FloridallotaryService.Com
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