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533 Seaspray Ave 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 JOB INFORMATION: Job ID: 17-FNCE-2957 Job Type: FENCE PERMIT Description: 6' FENCE Estimated Value: $5,112.00 Issue Date: 1/23/2017 Expiration Date: 7/22/2017 PROPERTY ADDRESS: Address: 533 SFASPRAY AVE RE Number: 170703-0312 GENERAL CONTRACTOR INFORMATION: Name: SUNSET FENCE, INC. , N/A Address: 12341 CLEAR LAGOON TIR Phone: - - PERMIT INFORMATION: FEES: Fence/ROW $35.00 Total Payments: $35.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WILD ALL CUrY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 1 -7-Fk)C& - 'z9S7 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date muted: 119 /) 7 City web-site: http://Wm.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: SSS S)F_ASP(ZPL1' �)UC_ Department review required Y No j�ll'd�,n -7 Applicant: C') a mg 8,Z"ini7�— Project: Tree Administi-ator 1subtic Work-sD ��rubllc Utlliti2� Public Safety Fire Services Reviiew fee $ Dept SignatuEgA RovLw Other Agency Review or permit Required OfPe t=PB'y Data Florida Dept.of Environmental Pmtection Ronda Dept of Tnmsp.rtfion St.Johns River Water Management District Amy Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other APPLICATION STATUS Reviewing Department First Review: EqrApproved. E]Denied. (Circle one. 6�) Comments:/VO PLANNING&ZONING Reviewed by: —Date:1-t�_t ? TREEADMIN. Second Review: E]Approved as revised. E]Denlek/ PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date FIRE SERVICES Third Review: E]Approved as revised. DDented. Comments: Reviewed by: Date: Revised 05114109 City of Atlantic Beach APPLICATION NUMBER Ra, rl;: 7 Building Department (To be assigned by the Building�Djepalme�I 800 Seminole Road nt.) Atlantic Beach, Florida 32233-1445 12-EN)C Z Phone(904)247-5826 - Fax(904)247-6M E-mail: building-dept@wab.us [[Date muted: City web-she: mIp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: SSS SEASPlZAY PjUC_ I Department review Applicant: 0 uo Project: Fe\occ- ke-view fee-- -------___1_$_PE�pj Signature., Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept.oaf Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Amy Corps of Engineers Division of Hotels and Restaurants 9M Division of Alcoholic Beverages and Tobacco Other. APPLICATION STATUS r Reviewing Department First Review: JXIApproved. ElDenied. (Circle one.) Comments: BUILDING PLANNING &ZONING S R�vi.rl hv- Darte..-LAIAt TREEADMIN. Second Review: ED]APproved as revised. E]Denled. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ElAppraved as revised. ElDenled. Comments: Reviewed by: Date: Revised 05/14109 City of Atlantic Beach APPLICATION NUMBER �N"N ii�IERrt7 Building Department To a assigned by the Building Department) 800 Seminole Road Atlantic Beach, Florida 32233-54 45 Phone(904)247-5826 - Fax(904)2 584 E-mail: budding-dept@walams I A N 09 2017 Date roure&=1 Cityweb-site: httip:/A�.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: S 3 S P1 J 6:, 1 Department review required Yes No Applicant: 0 uo <Puildino-.) Project: Fc--(�pcc- 6� T Review fee De ature Other Agency Review or permit Required Review or Receipt of Permit Verified B Date Florida Dept.of Environment 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: VApproved. ODenied. el, (Circle one.) Comments: Yele M&I 6oA(4 BUILDING FPLANNING &ZONING R.vi..d h,, Date:/ TREEADMIN. S Second Review: ElApproved as revised. E]DeZedl, PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ElApproved as revised. E]Denied. C mments: o Reviewed by: Date:- Revised 06/14/09 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach,Florida 32233-5445 JAN 0 9 201 11-C-13 OIL - S7 Phone(904)247-5826 Fax(904)247-5845 11 E-mail: building-dept@coab.us 'Dato routed: 1 -7 Citywelb-site: thttia./A�.coath.us 8 1': _L=] APPLICATION REVIEW AND TRACKING FORM Property Address: SS�S SEASPRAY �)Ur_ Denpirtment review required Yes No Applicant: CO�,DG anning &Zoniri_V Tree Administrator Project: FGf�p(-Ez- ublic Works ublic Utilities Public Safety Fire Sewices;WN Dept Signature iz� MOther Agency Review or Permit Required Review or Receipt of Per 12 Of ermit Verified B Date Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Amy Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverage-and I---- Other. APDl 11�'ATIAKI 07A� S Reviewing Department First Review: [?fApproved. []Denied. (Circle one.) Comments: BUILDING �W PLANNING &ZONING 1 -7 1.4 WX 4"� lee' Date Reviewed bv Date: TREE ADMIN. Second Review: ElApproved as revised. ElDenled. (�*�'4 KS Comme ts: PI _W UBLIC U�T 10 TIES / JA: PUBLIZ _-�,7 F TY Reviewed by: Date: FIRE SERVICES Third Review: ElApproved as revised. OlDenied. Comments: Reviewed by: Date:- Revised 05114109 OFFICE COPY BUILDING PERMIT APPLICATION �firlj-\ J7�5 CITY OF ATLANTIC BEACH 800 Seminole Road,Atlantic Beech Fl,32233 Office:(904)247-5826 . Fax:(904)247-5945 -7 Job Address: 5�eA, Permit Number: Legal Description RE# Valuation of Work(Replacement Cost)$5�11-ated/Coolled SF Non-Ileated/Cooled • Class of Work(Circle one) N; Addition Alteration Repair Mf��e�emm Pool Window/Door • Use of existing/proposed stm-tll (Circle one): Cc meacial sidmua6 • If an existing structure,is a fire sprinkler system installed?(Circle one):(::= (�;� • Submit a Tree Removal Permit Application if any treesare to be removed or Affidavit of No Twe Removal Describe in detail the We of work to be yeriliormed: XRP&,aej AAAh4 / // "k)"A lfd,-5 Florida Product Approval W forroultipleproducteX productpp...I f.. Primertv Owner Information Name: �7_00A Address: 1'3 3 <eA- I EV"I It '1�1 city d, kSteMZi Phone 7Q V- :1 t211 E-M 92 Owner or Agent (WAgent,Power ofAtimm,or Aeircy L�st�parxi) 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 NOTIUE OF COMMENCEMENT. Contractor Information: et Q"i Name of Company: 04.5 e 10'rrii e �ngAgcnt:: Address: 0 r I'll I city State Zio OfficePhone Job Site/Contact Number � ,'l - t, -6- 1 State Certification/Regi E-mail m,lo 0?&6 Q &ob 90*11 Architect Name &Phone# Engineer's Name&Phone 9 Worker's Compensation Exempt / lnjareFTaF�iomp1oyccx / txpimtion Uate Notary Public: No Public; lhereb certi that have an exa ine I ' a ication and know the same to trueandcorrect. Allprovisions;oflaws,and o- aces ove in this ,o or will a led with whether spe dhereinornot. The granting of a permit does not vi ateorcancelth roWsionsofanyotherfeefe p so elogiveautori e eral, state, or local law regulating construction or the p imance a const ction. Rev.3/14/16 CrrY OF ATIANHC BEACH OFFICE COPY OWNER/ BUELDER AFFIDAVIT 1. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER I BUILDER TO ACKNOWLEDGE THE LAW. DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE 13Y LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN E)MMPTIUN TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS TIM OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MU SUPERM—E THE CONS YOURSELF. YOUMAYBUff ORIlffR0VRAONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING YOU MAY ALSO BUILD OR IMPROVE A CON94ERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUSTBE R.YOURUSE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF V7117HIN ONE YEAR AFTER TIM CONSTRUCTION IS COMPLETE,TIM LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HERE AN UNLICEN�M 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 I ICMES REQUIRED BY STATE LAW AND BY QQUNTY OR MUNICIPAL LICEN ORDINANCES. Ih 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 AN CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 45r�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. ADD t'S PRPONENUM If 1171�lr'kir - INT s E DA� ,�day,ol� '.a a Duval,Stateal .'h.. . y apaeauad hadn 62y! llflglla.T..that allstabame �uta. ou N.taq Put: .- a- ntyof_ T.�.JG�N ESPEIkG.ER ,�L D Mcl dentr47n- Nola�Slhgnalum: CIIZ O�F ATLANTIC BEACH 00 STF RUCTION PER -RiGHTS MIT WITHIN CITY OF WAY AND EASEMENTS 800 Seminole Road 90�247-5800 V. Atlantic Beach,Florida 32233-64,15 Fax 904-247-5845 Date Job Address Permitee: -C/ �1A V`IE C LAO Telephone# Permittee Address: 3 XJ) Requesting Permission to Construct: Location: (Reference to Cross-Street) Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both aerial and underground and the accurate locations are shown on the sketches. A Letter of Notification was mailed to the following Uttities/Municipalities: Jacksonville Electric Authority Yes No Date: Bell South Telephone Company Yes No Date: Ferrell Gas Yes No Date: Comcast Yes No Date: 2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation, alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder, shall be immediately removed from said street or easement or reset or relocated hereon as required by the Director of Public Works, and at the expense of the Permittee unless reimbursement is authorized. 3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the supervision 'pf L&211 If r- (Contractor's Pro' t Superintendent) located at jgg �c -A inspettlon by the Director of Public Works or his designee. 4. All metal als and equipment Snail be subject A Of_Telephone#: 5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and the manner satisfactory to the city. 6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of this permit, Calculations showinut any increase In impervious area on owner's lot or In the city Riaht of Way are be included with this application. 7. 1 his permittee snail commence actual construction ingod faith with A 0 days. If the beginning date is more than 60 days from date of permit approval, then permittee, must review the permit with the Director of Public Works to make sure no changes have occurred in the area that would affect the permitted construction. 8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times, assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. 9. The Director of Public Works shall be notified twenty-four (24) hours prior to starting work and again immediately upon completion. OWNER Signed. Data:NO-If Set., me is Y intheCountyof Duval, 7(D 1 '7 State FI rida,has personally a p ared Notary Public at Large,State of a,C unty f MY commission expires; TONI GINDLESKRGER WCOMMISSIONIPFF9MI Pensonally Known EXPIRES:octoo.,62019 Produced Identification r 1,n&dTl�lx�ftb�UM.— R.O.W. Permit Attachment of for R.O.W. Permit# issued. 20 Atlantic Beach, Fl, 32233 Owner's Name: Property Address: Subdivision: R.E. #: REVOCABLE ENCROACHMENT PERMIT THIS REVOCABLE ENCROACHMENT PERMIT, issued on this _ day of , 20, by Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as"CITY" and of Atlantic Beach,Florida,hereinafter referred to as"USER". WITNESSETH: That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic Beach Right-of-Way/Easement permit numbers noted above(copies attached). This work is generally described as: C X, '�'r,.4 -_�&h stf� J Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to relocation or removal on thirty (30) days notice by CITY to the USER, said notice to USER shall be given by certified mail, re receipt requested, to the following address: . Ca 1�a'-(Mo I/ - The depositing of said notice of caai�cila,;_iri in ilieUrifted State, mail shall constitute the notice of cancellation and the burden is upon USER to keep the CITY informed of USER's proper address. The USER shall promptly make my and all necessary repairs to any facility erected or maintained in the exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition. In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense, any and all material necessarily displaced during the action of maintaining, repairing, operating,replacing, or adding to of the utilities and facilities of the CITY or franchise utility provider. The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land Development Code,and all other land use and code requirements of the CITY, including City Code Section 19-7 (h) which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks." Page I of 2 The USER, prior to making any changes ftom the approved plans and/or method, must obtain written approval from the City of Atlantic Beach, Public Works Department, for said change. The USER shall, at the discretion of the CITY,be requested to submit as-built drawings showing the change within thirty (30) days after the day of completion. This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and assigns. USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or specifications, to include utilities locate requirements and use linnitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harralless by the USER from my of the work herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER. DATED and SIGNED this 0 day of 4N 204 By: &Z Property 0wref (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this I (D day of �Qr- 20FJ personally appeared before me, a Notary Public m x)d for said Co and State, (:I,— the property owner of "S or, Q_)Sz�m n: , Atlantic Beach, Florida, known to me to be the person(s) de i d in and An exe&ed the foregoing instrument; who acknowledged to me that he or she exe the sarpe freely andivolumarily and for the uses and purposes therein mentioned. TONI GIMLESPERGER W GOMWION 0 FF 924951 Notary Public in for said Comnyak EXPIRES alob�l 6 2D19 ThN Wt�Pvb�UO��' CITY OF ATLANTIC BEACH, FLORIDA, TONI OMM G 7� EXI ThN a municipal corporation: Approved: Donaid'D.jv&ovit4 P.E. Public Worfs Director File: 12/12/16 Page 2 of 2