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367 Belvedere St fence permit CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 FENCE PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOBINFORMATION: 3ob ID: 16-FNCE-2699 Job Type: FENCE PERMIT Description: install 6-foot wood panel privacy fence in backyard Estimated Value: $2,000.00 Issue Date: 12/14/2016 Expiration Date: 6/12/2017 PROPERTY ADDRESS: Address: 367 BELVEDERE ST RE Number: 170703-0266 PROPERTYOWNER: Name: Mcpherson, John Address: PERMIT INFORMATION: PUBLIC WORKS: All runoff must remain on-site during construction. Full right-of-way restoration,including sod,is required. All old fencing must be removed fromjob site by Contractor. FEES: Fence/ROW $35.00 Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL MY OF ATLANTIC BEACH OBJHNANCES AND ME FLORIDA BUILDING CODES. City of Atlantic Beach Building Department 800 Seminole Road Atlantic BoaCh, Florida 32233-544� 2016 Phone(904)247-5826 Fax(904�247-5845 E-mail: building-dept@coab.,s CitYweb-site: hftip:/M�.coalous APPLICATION REVIEW AND TRACKING FORM Property Address: !�I, - De rtment review required Yes No Applicant: (,L" u nin &Zonin Project: Tree Administrator ic Work Public Utilities Public Safety Fire Services WT Review fee DeptsignatUre— hOther Agency Review or Permit Required Review or Receipt Florida Dept.of Environmental Protection of permit Verified 8 Date Florida Dept.Of Transportation St.Johns River Water Management District Army Corps at Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other. em APPLICATION STATUS Reviewing Department First Review: Approved. ElDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING Led 'V/ (-L�: TREEADMIN. Reviewed by: Date:_�2�71 4 Second Review: ElApProved as revised. ElDenied. ICWORA Conn ents: PUBLIC UTILITIE /Z--7 -/% PUBLIC SAFETY Reviewed by Date FIRE SERVICES FThlrd Review: ElApproved as revised. ElDenied. Comments: Reviewed by: Date: R.ised 05114109 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 0 C I--a b9c), Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@wab.us Date Fouted- 121, Is- I I to City web-site: hffp:/hiww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: St.0"'t 1�-LWCA"k_ !S1 - D!R intent review re uIred Yes No inr n Applicant: 0W p'� nning &Zonin-> _q Tree Administrator Project: Public Safety Fire Services Review fee $_ Dept Signature V7T Other Agency Review or Permit Required Review or Rec�I ofperlitVerif! 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 Severe Other, APPLICATION STATUS Reviewing Department First Review: Approved. E]Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date- /2.-7-/6 TREE ADMIN. Second Review: ElApproved as revised. ODeniedv PUBLICWORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date:. FIRE SERVICES Third Review: DApproved as revised. DDenied. Comments: Reviewed by: Date Revised 05114109 City of Atlantic Beach Building Department 800 Seminole Road Atlantic Beach, Florida 32,233-5445 Phone(904)247-5826 Fax(904)247-5845 E-mail: building-dept@mab us City web-site: httP/A,,,.,,ab.us APPLICATION REVIEW AND TRACKING FORM Property Address: _Sthl ?,4 It De rtment review re uired Yes No Applicant: u nin &Zonin I ree Administrator Project: %r)'Sk(A lit, QO-R)hv 'wkd pandi4u . Wor Public Utilities Public Safety Fire Services Review fee Dept Signature aOtbor Agency Review or Permit Required Review or Receipt Florida Dept.of Environmental Protection of Permit Verified B Date Florida Dept Of Transportation St.Johns River Water Management District Any Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other. APPI In A— FLMReviewing Department First Review: Approved. E]Denied. (Circle one.) Comments: JIM BUILDING PLANNING &ZONING F Co ,"s mm R e e V'Q "'Approved '74 a'A'U' n D an, First Rev, r' T Q�w A� pproved E'Domed v'ew' 9 epa 'Circle one Comments B U[LDING P ANNING &ZONING R R'v,ewed by 0 V' w y T M REE AD IN rl pin e iew EJA rov d a '.V,.ed is. R L:e ,e_,d by w eviewed by Date: I TREEADMiN. Second Review: ElApprovedasnavi.ed. E-IDented. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date— FIRE SERVICES Third Review: EDAPProved as revised. ElDented. Comments: Reviewed by: Date:— R.0..d 05/14109 BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach, FL 32233 Office(904)247-5826 Fax (904) 247-5845 Job Address: 367 Belvedere Street AB 322250 Legal Description lot 33 blk I Seamg Parcel# 170703-0266 our Area ol Sq.Ft. qrt Valuation of Work$ 2000. -jr0posed Work heated/cooled — non-beated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use orexisting/prorsed structure(s)�cimle one): Commercial Residential Man existing struc Ulm,is afire sprm er system installed?(Circle one): Yes No N/A Florida Product proval# c- PA I D For multiple pr�lsucts use-Pr-0Juct—app-r.—varro-r-m— '4k 3-7 cs 0— Describe in detail the type of work to be performed: Install 6' wood panel privacy fence in backyard. Property Owner Information: Name: John McPherson Address:1433 Ponte Vedra Blvd City Ponte Vedra Bch State FL ip 320 E-Mail or Fax#(Optional -FLZ rhone 404-5 9-9234 2,-(- `;P`0 It o(-) 7'--?I&r Contractor InformatioR: Company Name: Qualifying Agent: Address: one City - Pit zip Office P�on�e (14- Job Site/Contact Number—4 4_Fa,# Rate—Cerfifi�non/Registnation# if f frok Architect Name&Phone# Eng incer's Name&Phone# Fee Simple Title Holder Name and ress Bonding Company Name a dress Mortgage�Lender N and Address Applicatir ereby made to obtain a permit to do the work and installations as indicated ]certify that.0�Vm�k a,installation has emmsencedpriarto the nor ho , n, issua ofapermit and that allworkwill beperformedt,meet thestrandards ofallfaws regulari 'work is not commenced within six(6)months. or ifemarruction m work is surnated ingoonstructioninthisjurisdienron. Thirpernotbecome,null or abandomedjm,a W7riod aftirg Its I ),mom atany .orkitc.memenced l.nde d that separate permits most b sem dfor d c Work,Plantbing Sijar els IV, rassaces .naZIer T=ksa.dAirCon,fle1m,e—a,'dV�c e re Ek d a , I , as, , e H e 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 YOUli NOTICE OF COMMENCEMENT. I her�y certify that I Arroo,read and coarrimed this ication astaknow the same to be true and correct Allprconoons ofl"j and ordinances goterning this ope ®r work will be earn 70' plied with whether feci red herein or not. The granang of a permit does wt P"ame 10 g'w "dor"y to"oh"or"'he to armnsam,ofany otherfederart,state, or local aw regulating conrowcaam or the performance ofcconarerfice. Signature of,Owner Signature of Contractor Print Nan<:��,Ijld � Print Name ............ . . ....................... ........................................... 3wom to and subscribed bef, e Sworn to an scribed before me ,his a Day-of L�1. -LM? 20 Ha- this of .20 NOUL 4AMA 4:�al_ JeNFER WUblic V U M*N#GG ublic .......... EKPMO*bv .2= Revised 01.26.10 MAP SHOWING SURVKY OF LOT-41--BLOCK / AS SHOWN ON MAP OF AS Rrc—m�w IN MAT NOOK Jy PAGE 0—�F-44—or PuaLIC RECORDS OF OUVAL CO..FLA. FOR Mir X MZC7 Ate At ou.a qat wl NO n, aprnr�� ,df I, �Aff ...�Iopt bUt do. vpl.val -W the hhvsr��of permit& corroI,, �ith Ronde BumhIg Code sne 4U In,, Stele and! F.de'.1 perrnl"��, rv- -t III, �qsvenfied Ab 'o ,I� In 11di g 0, at%e to RECEIVED 0 " ' ' pno' no u n 13.ildnig Pernnit. Approved By: NXQ 2 7 m Date: S, IT City Of Atlantic Ej,ach Baliding and Zoning ,�er,, ��wew e�g -�0 ,r44tA1.0.#71,q,V r&pF&ej-V Prrni4 :iV' 16—FAJCE —Q 6q5 CITY OF ATLANTIC BEACH 19WNER / BUILDER AFFIDAVIT OFFICECOPY 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART I "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 LICENSE CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. TIM EXEMP71ON ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUS SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAYBUILD OR]MPROVE 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. TIM SUIT, 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 THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE, WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NO HIRE AN UNLICENSED PERSQN 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 IICENSM 11. 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. 455-228(l). 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. 4) :V' AA, ADDRESS PHONE NUMBER _�FOA,l PRINT NJUiIE SIG DATE do,Id WhQn�..Mof Ol N B_dd od MI*of M. do,hod �P— honnbyhlidsefflmmeoandaffil�Oot od..dIdoo. re NotaqPublicMLMqe,Sta%& FL_ County& A)LtQCA 0�ally JBINIFERJOHNSTON Ycwmmsim#Imw,, EXPIRES Oft,r an 'd�N-�l Plbk�lcl�dl� N.,si'n.. ,=�Ml v v City of Atlantic Beach Building Department 71, 800 Seminole Road Atlantic Beach, Florida 32233- 1 Phone(904)247-5826 Fa� 241ft5o 7 2016 E-mail: building-dept@coab'u k Cityweb-sfte: http:/A�,coab.uq3y. APPLICATION REVIEW AND TRACKING FORM Property Address: 'SUI I�A�o dAtQ SJ De Mentreviewre tilted Yes No Applicant: f\" u nnin &Zonin 1 ree Aommrs rator Project: fvsk(A (0-17A Vzod i4ij 4W.1201 Ut bhL Public Utilities Public Safety Fire Services CT Review fee Dept Signature Other Agency Review or Permit Required Review or Receipt Florida Dept.of Environmental Protection of Permit Verified B Date Florida Dept Of Transportation St.Johns River Water Management District Army corps of Engineers Division at Hotels and Restaurants Division of Alcoholic Beverages and Tobacco APPI InA�1�., Reviewing Department First Review: VApproved. O'Denied. 0 Com ne ments. Irc=e (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: L27�/z—//6 TREEADMIN. SecondReview: ElApproveclas revised. 0EIlemed, PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date:— FIRE SERVICES Third Review: DAPProved as revised. DDemed. Comments: Reviewed by: Date:— :-1 Revised OW14109 Ig AnAld z ud.Roe .11h 14t 444, XA6 a Z 7.61 Z 46 al, ?20 31