664 Beach Ave fence permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
-r ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
FENCE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
706 INFORMATION:
Job ID: 16-FNCE-2680
Job Type: FENCE PERMIT
Description: FENCE -
Estimated Value: $750.00
Issue Date: 12/15/2016
Expiration Date: 6/13/2017
PROPERTY ADDRESS:
Address: 664 BEACH AVE
RE Number: 170128-0000
PROPERTY OWNER:
Name: MELANCON, DEJEAN JR & LAURIE,
Address: 664 BEACH AVE
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.
M A P O F S U R V E Y
THE EAST 75 FEET OF LOT 5, DANIEL AND HACKETT REPLAT OF BLOCK 16, ATLANTIC
BEACH, AS RECORDED IN PLAT BOOK 9, PAGE 35 OF THE CURRENT PUBLIC RECORDS OF
DUVAL COUNTY, FLORIDA.
SEVENTH PA,TREEpAD
IV __ ryJWt l/F WAY E'—W
OFFICE COPY
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z m IK LOT 5 EXCEPT THE T f P
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or I $84'23�00'W 68.00 xo W px a1 SSg4 3'00" 7a.83' FIELD a E,xw as II
m< II LOT 4 u
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a
.70
INOTES:
THIS IS A BWNDARY SURVEY.
' BEING S8 BASED23'00'ON THE SOUTH UNE OF LOT 5 AS
BEING ANTIC BEAC T PROJECTED FROM THE PIAT
OF ATLANTIC BEACH TERRACE, PLAT BDCI( 15, PACE
34.
NO BUILDING RESTRICTION LINES AS PER PLAT.
THE PROPERTY SHOWN HEREON APPEARS TO LINE IN
FLOOD ZONE."X" (AREA OUTSIDE 500 YEAR FLOOD THIS SURVEY WAS MADE FOR THE BENEFIT OF
PLAIN) AS DETERMINED FROM THE 'FLOOC INSURANCE DEJEAN MELANCON, JR.
RATE MAP' COMMUNITY—PANEL NUMBER F ATL TIC D
REVISED AP IL 17,COUNTY,
FOR THE CITY OF ATLANTIC
BEACH, DU L COUNTY, FLORIDA. \
"NOT VALID WITHOUT THE 6HGNATURE AND THE
ORIGNAL RAISED SEAL pF A FLORIDA LICENSED FLORIDA UC. SURVEYOR and MAPPER No. LS 3295
SURVEYOR AND MAPPER."
FLORIDA LIC. SURVEYING h MAPPING BUSINESS No. LB 3672
CHECKED BY: DALE:
DRAWN BY: MCC BOATWRIGHT LAND SURVEYORS, INC. FEBRUARY 23, 2011
FILE: 2011-Olt 1500 ROBERTS DRIVE, DACKSONVILLE BEACH, FLORIDA 247-8550 SHEET 1 OF 1
lif
y City of Atlantic Beach APPLICATION NUMBER
m Building Department DEC 01 2016 o be assigned bythe Building Department.)
800 Seminole Road 7
Atlantic Beach,Florida 322335445 '(,o- FfV�'�, CCO o
Phone(904)2475826 - Fax(904)247-5845 BY O
E-mail: building-dept mab.usDate routed: ( (
Cityweb-stle: http:1Av .coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address:. 6 &4 �EQC�� a rE WU
nt review re uired Yes No
Applicant: 0 (��-�,�,p Zonin
C istratorProject: Ii t`-e.'�C�t= — estys
Review fee$ Dept Signature
Other Agency Review or Permit Required Review or Receipt Dat
Florida Dep[.of Environmental Protection of Permit Verified B e -
Florida Dept.of Transportation
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
owing Department First Review: [Approved. QDenied.
ircle one.) Comments: + /p��,y/�/�, /p- y-y/
UILDING JL� ' " / " qwo
ING&ZONING
Reviewed by: Date:
TREE ADMIN.
Approved aawxmwd. ❑ enied
C WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date: ✓2"S`1
FIRE SERVICES Third Review: QApproved as revised. ❑De ed.
Comments:
Reviewed by: Date:
Revised 05/14/09
City of Atlantic Beach APPLICATION NUMBER
Department
800 Semen (To be assignetl by the Building Department.)
n 666 Seminole Road
n r. Atlantic Beach,Florida 32233546
Phone(964)247-5826 Fax(964)247-5845 O
E-mail: building-dept@coab.us
City web-she: http:/6vww.coab.us Date routed: l ( 1
APPLICATION REVIEW AND TRACKING FORM
Property Address: &4 E µ If ) ✓E De artmentreviewre uired Yes No
din
Applicant: _� W t._"K=�� arming &tonin
ree Admims rater
Project: �(= .,_`1c�C Co icWe
lie Utilities
Pu Ic Safety
Fire Services
Review fee $ Dept Signature
N
gency Review or Permit Required Review or Receipt Dateof Permit Verified Bept.of Environmenhal Protecgenept.of Transportations River Water Management Districtrps of Engineersof Hotels and Restaurantsof Alcoholic Beverages and Tobacco
APPLICATION STATUS
FSecondReview:
ent First Review: Wp'proved. ❑Denied.
Comments:
G
Reviewed by: Date: Z-Z•/6
Second Review: []Approved as revised. ❑Denie .
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
AALof Atlantic Beach APPLICATION NUMBER
n Building Department (io be assigned by the Building Deparhnent.)
800 Seminole Road
n ° Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 - Fax(904)247.6845
O
7st E-mail: building-dept@wab.us Date routed: ( ( I
Cityweb-site: hitplhwnv.wab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 62 &4 EE O ty (—) ✓E Department review required Yes No
din
Applicant: nning&Zonin
��.n')oC ( ree Admimstra or
Project
_ Cr7 Ic We
lie Utilities
Pu Ic Safety
Fire Services
Review fee$ Dept Signature
Other Agency Review or Permit Required Review or Receipt
of Permit Verified B 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 Tobacxo
Other:
APPLICATION STATUS
Reviewing Department First Review: kApproved.
(Circle one.) Comments:
❑Denied.
BUILDING
PLANNING &ZONING
Reviewed by: Ovl� f� Date:
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
City of Atlantic Beach ECEIVE
A7bythe
UMBER
Building Department DEC 01 2016 (To he asing Department.)
800 Seminole Road ppAtlantic Beach,Flonda 3223 5 ' • �COpd
Phone(904)247-5820 - Fax 04J24�584&.
E-mail: buildingdept@mab.us Date rouI
Cityweb-site: http:1Aw .coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (o`-f- 1� �!✓(a(�H (� ✓E Department review required Yes No
I din
Applicant: nnin &Zoning
tee Administrator
Project: EalisDQG — ( Ic Wo
Ile Utilities
Pu Ic Safety
Fire Services
Review fee $ _ Dept Signature `T—
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
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:
APPL ATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING y�/�/.�/ 12-4/141
Reviewed b : "^ � Date:
TRE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
i
C WO S Comments:
PUBLIC UTILITIES
Z-i
P BLIC SA 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 S�77��
//
Office
�(904)247-5826 Fax(904)247-5845 � � '1'l,' '� _2618 ./
Job Address: b Yt fAv&j� Permit Number: _ _
Legal Description `JXoParcel#
Valuation of Work$ rj0 , oor ea o q. t. q.
Proposed Work heated/cooled non-heated/cooled
Class of Work(circle one): New Addition Alteration Reps' olition pool/spa window/door
Use of existing/pro structure(s)(circle one): Commercial idea
If an existing structure,is a fire sprinkler system installed?(Circle one): es No N/A
Florida Product Approval#
For multiple products use product approv orm
Describe in detail the type of work to be performed: ! 4 a C VL-W q Q __f•�. 1.C,
T
Pro er Owner Information: TtP_/7gQp/_��",1- /1
Naine: iTE 'i[.�4A�IL �G�'A{Cty j Address: (1,1 )r pc.{t ryl/F H 1�
F-Mail or Fax#(Optional)city c. a Stat _Zip Phone 1 ,...� nl
Contractor Information: r1 '7�•
Company Name:: aC /.1CLO_ QualiTyin Agent:
Address: - p•t/
Office Phone - ob Site/Contact Number! �r, �-u� ,ax State - 7' 77
Ciy
State Certification/Registration#
Architect Name&Phone#
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
dppitmtion is hereby made to obtain a permit to do the work and installations as todimted. 7certify that no work or installation hction.as commenced prior to the
issuance ofapermit and that all work will bepe ormedto meet the standards ofaillmvs regulating ronrlt no wa ikor installation h coonnrmitbecomtothe
Tandroid fworktsnot commestandt at separa�peon, or iif ob r tionor.rkis sus &dederab=donedfora rlodofsk/6f months atorry dmea er
nks andAUC rto Q ner ��nd that separate permnonthits must be secured for Elecnica�work,phunbing,signs, I dil pools,Phu nundh at any,i ers
COMMENCE�MENTTM AY RESULT
IN YOURPAYING 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.
ofheme cerwill be*lhatlhawrmdandxaminedh whether pthecb�plicadonandknherein or nalowthesametobetrue and correct. Allprovbtans oflaws and ordinances governing this
rovtsioK Janyotherfederl al,smed ite,orlocal[awmguladagmar"cltonorrthepe8forfmaoperowe ont noion�me to give authority to violate or conte! the
Signature ofOwner Signature of Contractor
Print Name OWI
.4r- . ....._ O_ UO �(_.._.._. Print Name
Swom to and subscribed before me Sworn to and subscribed before me
Itis D Da of /vtluehlber . 20 lb this _Day of 20
otaryPublic _,-�...:yfiDnCooAHPMRisx Notary Pu
! c
hi ComNu1m GG009947
l6viret,lu*70,t0E0 Revised 01.26.10
asp snmean10. mmrun�mwo-testore
CITY OF ATLANTIC BEACH
(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 ADM—OR
TWO TAMMY 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 MAYNOT BE BUILT FOR SALE OR LEASE.
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME T14AT YOU BUILT
IT FOR SALE OR LEASE,WHICH 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
LENSES REQUIRED BY STATE LAW AND BY CO 1NTY OR MUNICIPAL LICENSING
ORDINANCES
I. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE
PURCHASED.
Ill. 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.
455228(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.
A 0 ES PHONE NUMBER
✓c�2t! }�L 4�ur-ft
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S.-DE DATE
�ued1of
l,Sbbor Flodtle,h Pa Na�PPftreE herbbymlmaelf M1erselfcana affirm m.f
all ablemenb eM tledareuoaa are Wa eM accurate.
Nblary Public at Lar9a,Eteabl, FL C artyofNJ
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