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395 12 TH ST - FENCE (t' jCITY OF ATLANTIC BEACH s1l 800 SEMINOLE ROAD Jf: ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 FENCE PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 16-FNCE-2809 Job Type: FENCE PERMIT Description: install new 6-foot fence Estimated Value: $2,500.00 Issue Date: 12/28/2016 Expiration Date: 6/26/2017 PROPERTY ADDRESS: Address: 395 12TH ST RE Number: 171922-0000 PROPERTY OWNER: Name: AF AB VENTURE LLC Address: PERMIT INFORMATION: PUBLIC WORKS: Full right-of-way restoration, including sod, is required. All runoff must remain on-site. Cannot raise lot elevation. All old fencing must be removed from job site by Contractor. FEES: Fence/ROW $35.00 Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WI"1'II ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. s \,`p;r;;, City of Atlantic Beach ,:—.. _ ,�., APPLICATION Building Department . ti .4E4 (To be assigned by the Building Department.) 800 Seminole Road ), Atlantic Beach, Florida 32233-54k UES; j 6 2016 1 to F.-N C& `a V.1 Phone(904)247-5826 • Fax(904.)247-5845 0109% E-mail: building-dept@coab.us r Date routed: I a I I S (3-0 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 S 1 SA- Department review required Yes No Applicant: OL-3 Panning &Zoning—) " Tree Administrator Project: l n Sit C} � D LQ : . 'us is Utiliti-- _^- �� I Pu. is Safety Fire Services 3S- '06 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: (v'pproved. ❑Denied. (Circle one.) Comments: 6444 ��e BUILDING PLANNING & ZONING /2 Reviewed by: Date: /•_- (6, TREE ADMIN. Second Review: ['Approved as revised. ❑De led. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. [Denied. Comments: Reviewed by: Date: Revised 05/14/09 51..m„ City of Atlantic Beach irl �s ;� �t, Building Department APPLICATION NUMBER 800 Seminole Road EC � •`, (To be assigned by the Building Department.) 15'f, �r Atlantic Beach, Florida 32233-5445 ; HO— r/v G e — `a C OC, Phone(904)247-5826 • Fax(904)247- 5 DEC s 2016 ( �,1 l ".,o;; >� E-mail: building-dept@coab.us F•. Date routed: I a l I S I U U I (`j City web-site: http://www.coab.us BY: APPLICATION REVIEW AND TRACKING FORM Property Address: C1 g I S-k- , Department review required Yes No Applicant: pl..J,n.Q__(' 4 P annin• 8., •11111.11111.• f" Tree Administrator 11C� Project: \ &Vt.k 1 -1)(D.'c ((2 drocti_sairmiMimml 4iiiMagrAMMENI �r . - PAID 3 S- ‘" Fire Services _- . 7 Review fee $ Dept Signature �/v• • 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: proved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:— ;--44 Date: t g I l J ((- TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. G WORKS J Comme ts: PUBLIC UTILITIES ,42 ‘._ /Z ?.16 /6 PUBLIC AFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 rte ?�•` J City of Atlantic Beach APPLICATION NUMBER �S �� BuildingDepartment p (To be assigned by the Building Department.) r �--- sf 800 Seminole Road .- ;. - a Foci '-�y ` • � Atlantic Beach, Florida 32233-5445 110-- IJV C6 Phone(904)247-5826 • Fax(904)247-5845 ( J;; 9%' E-mail: building-dept@coab.us Date routed: I'' ' IIS 130 16 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: C1 s I 03 . Department review required Yes No Applicant: Ot—J,(\,P___(- 4 P annin. & .1•1,___ 111111.1111 Tree Administrator Project: \ "\Zt I b_ -/Do--'r LQ S_�":. . �PAI . - 3S- •off 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. nDenied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: `------1 Date: /2/21// TREE ADMIN. Second Review: jApproved as revised. ODenied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: OApproved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 r ryv��� City of Atlantic Beach APPLICATION NUMBER S� Building Department (To be assigned by the Building Department.) • s:-- 800 Seminole Road •''v .-. - - Atlantic Beach, Florida 32233-5445 I 0_ Ad _l(-� a OC) Phone(904)247-5826 • Fax(904)247-5845 II ,- .P'Di�y9.= E-mail: building-dept@coab.us Date routed: (a { I , - 130 16 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Ciat�1 S�Property Address: Department review required Ye /N o Applicant: DL-3 c' " P annin• &Z••••• Tree Administrator Project: k n 5 t.k 1 - 0-\ (k •- ,A . •u• is Utiliti- s P A I F • afety f. _ Fire Services i-413S aa 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: roved. I (Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING /"Reviewed by: Date: 4'22-'6' TREE ADMIN. Second Review: Approved as revised. I '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 v 0 ' BUILDING PERMIT APPLICATION , ,, PAI D s td �_ ;• CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beach FL 32233 <2,Ji;1r)r Office: (904)247-5826 • Fax: (904)247-5845 OFFICE COPY Job Address: 1 1 I `a- S"bt a-C± Permit Number: 1 C r C -3-V=9 Legal Description RE# Valuation of Work(Replacement Cost) $ j Sb 6-0 6 Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alteration Repair Mon Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Comme '• Residential • If an existing structure, is a fire sprinkler system installed?(Circle one): Yes o N/A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe in detail the type of work to be performed: L�0 0 J 6 / 3 had ad 0 ej rLl hn CJt PoojCIr) (ionn17 :0R� Florida Product Approval # for multiple products use product approval form Property(( Owner Information P & a kJQ n i-ccA LL-C-- % L _ ,r�/1 Name: V l i'01101 Ct ' 111 SOY\ 1—di S t-( '` Address: ( � J p 14c1/414.01\13"4 1�4� " 'w � Stat 1- Zi d 3S Phone b `� 1 3 �(�' City A :3 _ p 3 � � E-Mail 4� f cr 1 i O( c &( ,c t�Y1 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 BEFORF RECORDING YOUR NOTICE OF COMMENCEMENT. E © IEttU V E 1 Contractor Information: D Name of Company: Qualifying Agent: DEC 1 5 2016 Address: City State Zip --/ Office Phone Job Site/Contact Number State Certification/Registration# E-Mail Architect Name & Phone# r 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 prior to the issuance ofua permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six(6 months, or if construction or work is suspended or abandoned for a period of six(6)months at any time after work is commenced. 1 understand drat separate permits must be secured for Electrical Work,Plumbing, Signs, Wells,Pools,Furnaces,Boilers,Heaters, Tanks and Air Conditioners,etc. Signature of Property Owner: V • 1 nature of Contractor: Before me this Lc Day of 0 U.e vnt(30-,f 'O 1 LP Before me this Day of Notary Public: .�►u...) ••g.- — Notary Public: w I hereby certifi,thar R, :ct an j pr{ti phi pplic� ion and know the same to be true and correct. All provisions of laws and ordinances govern 'j'i"'.• x ec i,vith whether speci/ted herein or not. The granting of a permit does not presume to give ai.}t�g•i t i'o a ,avis,, ns of any other federal, state, or local law regulating construction or the performance of col ttaa.a Nota,y Pu�c I « _.._I Rev. 3/14/16 OFFICE COPY li l.Ai`fr/ . „ CITY OF NEOFF41VE U ��� ATLANTIC BEACH WNER / BUILDER AFFIDA DEC 1 5 2016 I I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, P'RT "CONS CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE 'W: 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 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 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 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. 31 1 A"" . Jam_ , 9Q Y, 7-fC ?- 9 `?- ADDRESS PHONE NUMBER �`r�; d. ► tJ,-5r \ F 5 Li` ` - AT= 1O3 V� n-N t.�.0 PRINT NAME VILA/VAAA-‘ " 0/td& ct•- /S—f Z40 SIGNATURF DATE Before me this I S day of o ec.t-111 ,20'b in the county of Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are true and accurate. Notary Public at Large,State of ` ,County of 0 k-k-J ❑Personaly Known ,,a4� XProduced Identification- c 4fi�' 8 JENNIFER JOHNSTON _{; ! ;*I MY COMMISSION#OG 042984 / - EXPIRES: October 27,2020 aP Bonded Thru Notary ----- Public llrNenvdters Notary Signature: lrLL��. .A.miL .all F:BLDG/Owner-Builder Affidavit REVISED:4/16/2009 -----k-5-1 gVED e a ca. DEC 1 5 2016 0_ o o` gicBYipPOIEPPe3irpt4VM p 4 i 0 0�- R I i 114 1 Ee t # qi I31 Pi $i 1 ! :41 Fl ill 4g 3o vii�itp ll grl 4 l II II I pi59 A` + 0 za ill R$$agecspxxstxxegxcsexxs 11110 1454 p Fa n Il@ ee l S 1101 5! 91R`XPIP#Rt$"gQe�pr.g3 1� $ f iri 8i81 ail 8 I $I opo ; — IliE1lBE,fe, p�exn4eaeEt$r rx c_ i 4yp4fEcci!EF!tgltEtcBE�4E� 4 q - 1 i elf gs i E °!P ax N 191 m 151 iiA ELEVENTH STREET R fi / ;1 i i cl H / / r iii 1 IN • ..ID C-' n G 1.111 :To trgW� 104---,3-r € lA 11 D 1441-(171.:: R m ` I O rii t!�` 6 .11■ I: 1 U 11J R m r Iic4 1 ° _,gas ¢ a x M � � � ^ cA P ri if ll, £6 �t i!L111. !il �----111oV.:Vett_ IIsiN til til R1�RRrxP ��-• tl X 9E• �°D ° PIII Cif, r$ a -i f ,1_,. ._..,..y -. SCJ — --1—. --,,yy� �_ v �� RA.L6----I.URFS.RA [At s RESIDENCE CF'wx" c)1-3,1�,;r t' i 9Q1;----- -----=--, f\R HIT 3 CT \/ , r 395 12th STREET N. 1 ATLANTIC BEACH. FLORIDA ( /C P MAP SHOWING SURVEY OF THE SOUTHERLY 30.00 FEET OF LOT 40 AND ALL OF LOT 41, BLOCK 1, SELVA MARINA UNIT No 1 AS RECORDED IN PLAT BOOK 23, PAGE 4, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. W LOT 39 p 1 11: 11 o~ S88'34'34'E_- 118_90_-- I O • N Z.'- i .0 9n In A)XGA v s; ...4.14:11-1. L. 1 0 10 2D 410 N 1 I I� L d o ell ri I SCALE: 1' = 20' I ; c''.IS '1' — lOT 40 1 i 9 % ' EXCEPT THE 0 1 o g gOUT,{ERIY 30.00' (Al 5 I$ } IriI < IS r Im �o O I X61 ^) II FIELD) 2 1267 �t �.(N8300"E2o.,6' 120.00' r CAMPHOR ...:;: ': : o 483''2 0.3' ,ALLY O1IS� ...:........... 51 zn. 6•WOOD FENCE __- --- 1 x 101 U _ C :•:::::::O �..:•::....•... - - g 4x >�'.. CI LOT 40 �--�--- —--—-- r � :rr::. Nd 'P •14'MAGNOLIA AI LOT 41 O4 ::::iii' / Z I rt 24'SYCAMOREEE:.::tO •:C (TI I O) ` 9!oCP S. o00 • 1A? °O � ' A (3 x15a \,...1SOCO -... :9 T WATER ..:::.:.::::.::.:::::4::::::.:::.:::.:,.::.:. ro FAUCET O u::::::::::�:::: ::::::::�:;::.'.:2 ,j.'m \f,s1 .. ..... ............... off_ 6'W000.P •13'MAGNOLIA 4 FEN�x a i Ll 0.2 y ',FS •04, 161 / f r ON ............'............... •9.q(� `rl / •12'PALM 1}' �FlRE i`C IITORANT O x159 x164 {J .186 P` :::: �::;::,:::::��:::�i:::;; %1 f 0;c:;::':::;:;;;;:;;:: �., 00 Vii:...::•;:•:;•:::::::::•:::::. 24'16'36'LIVE OAK CLUSTER P� PAA'i` , 25' n- G RG RESTR1600N UNE �. `, 3.PLA, 16'USE OAK x 15? /� +•K.09' 1 .::::::::::::::..:...... .....::. '{ J 12'k 14'PALL 14'PALM o J lf1/,y0 s es .;::::::::::::::::::::K::�::: 16'CAMPHOR �` OJ J.O4^ A.2.14.5.1:::::::::::::::::::::::. ?:;:•:•:• • 0�•14'LIVE 13 • Kj Y' •22-CAMPHOR x15. 14'PALM Q' ��O a,. FOIMD 7/2'WON •12'PALM ,p 1�'IRON L` ND CAP 1 F .iiii! :::::::::Rini:::::::::: ,,, NORTHWES1ERL.YO 155 x1 1 „ .00 NO CAP EDGE OF PAVEMENT...:....::::::::•::::'::t}�9.:::.i:::.:ii:::v::•::::: :::::::::':::::::::•�:•:: S83 42 00, 90.,6 FlELD . :;:..:;.:.:';•:':::::.::::::::: ':•:::.;y::::.:::::::::: ea...... --—;n'WON s,22'w .................................. FaLx+D 963 ::�:I.1:55'`:: ::: :: : :::::::: ....... ::€:� :: :•::i: PIPE.NO°� ........:::::::::::•::;r::; :•i:•i: •ii:-i:•i:•i:-:;•:;-is�i:•i::::::::Y........4..... .'"•'.:: :>:::>:>:>:>:>:a: ; ::::::t t;•>•>•i>i•i:t:::;;•....... :::::::.:----•••••=,,,,,,,,,,,,,,,,,,.......,.....y.• STR .::::.:;:.:. ::::: �.:.::.::.:.::.:.:..::.: :;:::•:::::;::::::;::: 11TH UC ROAD.::::::•::::::•:::::;:>:;;>:::::::::::::::::::.X.X.�:::::-E.X..E::::::•. ::::H.X.: r:::s>r: ;•:::•::rr::a::•:::•r::::t•:::::::tt:•::r::.....,::::::::::a...,-•::: _ PUB .......:: ::.-.::::::::::::::..:...............:::::::::::::::..::::::: >:�i:?.::::::::::.-:::::::::::::::::::::::::.-::::::::::::::::::::::::::::::::::.-:::::::::::::::::::�• PAVED kv,:':.........::':':''''........................................ ...... . OF WAY.......::::::::::•:x•;:•s•::: e: :>:::>:: •:•:•,:•:: ::::.:: .:.:: ;�::;:;;:•::.:.K '";::::::::: ::::::i: ::::::•::::::::c.=::nn::n::::::::• ?::c:•:•:inn:•:.X.:•:•:•:;?;i•::ii::::ii;:::::::::........ il•. :::::::::::::.:.:::: NOTES: 1. THIS IS A BOUNDARY, TOPOGRAPHIC AND TREE SURVEY. 2. BEARINGS BASED ON THE WESTERLY PROPERTY LINE BEING N0618'00"W AS PER PLAT. 3. BUILDING RESTRICTION LINES AS PER PLAT. THIS SURVEY WAS MADE FOR THE BENEFIT OF 4. BENCHMARK USED: FOUND NAIL AND DISK IN 12" PALM NORTHWEST INTERSECTION OF AFAB VENTURE LLC; THE LAW OFFICES OF ROD 12TH STREET AND EAST COAST DRIVE (ELEVATION 12.70' - NAVD 88). SCHLOTH, P.A.; AND OLD REPUBLIC NATIONAL 5. SITE BENCH MARK: AS SHOWN ON SURVEY. TITLE INSURANCE COMPANY. 5. CH .. CHORD. THE PROPERTY SHOWN HEREON APPEARS TO UE IN FLOOD ZONE "X" (AREA OUTSIDE THE 0.2%ANNUAL CHANCE FLOODPLAIN) AS WELL AS CAN BE DETERMINED FROM THE FLOOD INSURANCE RATE MAP NUMBER 12031C0409H, REVISED JUNE 3, 2013 FOR DUVAL COUNTY, FLORIDA. 'NOT VAUD WITHOUT THE SIGNATURE AND DONN ATWRIGHT, P.S.M. THE ORIGINAL RAISED SEAL OF A FLORIDA FLORIDA UC. SURVEYOR and MAPPER No. LS 3295 LICENSED SURVEYOR AND MAPPER.' ADDED TOPOGRAPHIC AND TREE-JANUARY 27,2016 FLORIDA UC. SURVEYING &MAPPING BUSINESS No. LB 3672 REVISED TO SHOW FENCE-DECEMBER 1,2015 _ CHECKED BY: BOATWRIGHT LAND SURVEYORS, INC. OCTOBER 26, 2015 DRAWN BY: JAH FILE: 2016-0084 1500 ROBERTS DRIVE, JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF 1 2015-1329 P P