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358 8th 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 JOB INFORMATION: Job ID: 17-FNCE-3023 Job Type: FENCE PERMIT Description: REPLACE 6' FENCE Estimated value: $2,000.00 Issue Date: 1/26/2017 Expiration Date: 7/25/2017 PROPERTY ADDRESS: Address: 358 8TH ST RE Number: 169936-0000 PROPERTY OWNER: Name: PURNELL RUSSELL E & JILL M, ' Address: 334 6TH ST PERMIT INFORMATION: PUBLIC WORKS: All runoff must remain on-site during construction. Roll off container company must be on City approved list(Advanced Disposal, Realco Recycling, Shapell's Inc.(. Container cannot be placed on City right-of-way. Full right-of-way restoration, including sod, is required. All old fencing must be removed from job site by Contractor. New fence must be on private property, not in right-of-way. 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. City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) n 800 Seminole Road 2 Atlantic Beach,Florida 32233-5445 I '7— P I,) o.E.—3023 Phone(904)247-5826 " Fax(904)247-5845 ` d E-mail: building-dept@coab.us Date routed: I O City web-site: hftp:1twww.coab.us APPLICATION8-11n Department AND TRACKING FORM Property Address: Ms — � ( De artment review required Ye No Applicant: L J LD N DTZ. LeLanning&Zoning Tree Administrator Project: 0_1 ublic Works ublic Utilities Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Reviewor 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: APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. (Circle one.) Comments: UILDIN PLANNING &ZONINGI a ?-,e7Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. E]Derkd. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05114/09 tsan> City of Atlantic Beach APPLICATION NUMBER u Building Department (To be assigned by the Building Department.) 600 Seminole Road 30-23 =� s Atlantic Beach, Florida 32233-5445 —� Phone(904)247-5826 - Fax(904)247-5845 ` o 1 U E-mail: building-dept@wab.us Date routed: 15 City web-site: http:l/www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: m� V — De artment review required Yes No /� uil Applicant: C ) LD N3eiz_ annin &Zoning r7-+r rr Tree Administrator Project: ublic Works ublic Ut la es Public Safety Fire Services Dept Signature a Other Agency Review or Permit Required Review or Receipt Date of Permit Veritled B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Anny 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��y�� Date11!J7 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 ?s y City of Atlantic Beach APPLICATION NUMBER o'r Building Department jTo be assigned by the Building Department) 800 Seminole Road yi — `-7 'n PhoneBeach,Florida 3223%445 ys@ I ( — j` I�1 t� Phone(904)247-5826 Fax(904)247-5qi0 JAN 19 n ' t9Q E-mail building-dept@wab.us IU"Date routed: ) City web-site: http://w .mab.us BY APPLICATION REVIEW AND TRACKING FORM Property Address: _1_)� V — Department review required Yes No uil Applicant: LA3 N ejZ_ tannin &Zoning Tree Administrator Project: ublic Works ublicUtilities _ Public Safety Fire Services Review fee $ Dept Signature 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. APPLICATION STATUS Reviewing Department First Review: ZApproved. ❑Denied. 61-1f_17 (Circle one.) Comments: it,^Wki ` 14 BUILDING "��su PLANNING &ZONING Reviewed by: Date: � f' TREE ADMIN. Second Review: ❑Approved as revised. ❑D ied. 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 ittsrr City of Atlantic Beach EGE-.2Vr= APPLICATION NUMBER o� r Building Department To be assigned by the Building Department.) i 800 Seminole Road - ':� JAN 18 2011 Atlantic Beach,Florida 32233-5445 8 1 '7- 1` t\) O.E- 3023 ' Phone(904)247-5826 - Fax(904) 247-5845 " o ..o;r g.. E-mail: building-dept@mab.us -- -- Date routed: 1 ICJ City web-site: http://www.wab.us APPLICATION REVIEW` AND TRACKING FORM MProperty Address: � O J ( Department review required Yes No uil Applicant: LAD �3 ETL annin &Zoning Tree Administrator Project: EN CC_ ublic Works ublic Utilities Public Safety Fire Services Review fee $ _ Dept Signature Kw-\ 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 Amy 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 r V/ 'A Xe PLANNING&ZONING Reviewed by: / Date: jr ' 9/jam TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. ACommP WORKS J ents: UBLIC TI ITIES i 1-1'7 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/99 rctss Pu�vt2 ll @ o.4. v-,4 BUILDING PERMIT APPLICATION �� CITY OF ATLANTIC BEACH �OUSemmo e oa3Tfrantr0 eac , FL 32233 -- Office(904)247-5826 Fax(904)247-5845 1-7 ress: — Permit Number: t Legal Description Parcel# I A`) 93 - 0000 oor ea o q, t. q. t Valuation of Works Z.p:@i�Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): GD Addition Alteration Repair Move Demolition pool/spa window/door Useofemisting/proposed structure(s)(circle one): Commercial esidentia If an existing structure,is a fire spri ler system installed?(Circle one): No N/A OFFICE COPY Florida ProductApproval# For multiple products use pro uct approva orm Describe in detail the type of work to be performed: r&PLtt I 1 �('7 f.P b QG((Wnd Property Owner Information• Name: RUSSell E RAYN-1.eu Address: 'j3+4 (pdyt s&yyg City lQv� QC StateFLZip 223 hone 3tZ— Acte^'7q ct� E-Mail or Fax#(Optional) Contractor Information: CONTRACTOR EMAH,ADDRESS: Company Name: Address: Qualifying Agent: City State Office Phone Job Site/Coutact Number zip State Certification/Registration# Fax# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address .%Pance ed ojapemrmibyand tl�iatt allbwork w,ll bei�lo domed toomee tstandardss o awslootregulat lti ohaluoonththisjwisldtionh Thimmen itbecrom¢snhe vnd void t work is not commenced within six(b months, a if nshvcfion ar work is susyended or abandondfar ayeriod afsix/6J months at any becomes anter vork is commenced !understand that separate permits t be s¢cured jor&[ecfrica[ Work,Phmtbing,Signs, Wells Pools,Fwnaces,Botfers Healers, frtnks aMAlr Conditioners rete 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 NOTICE OF COMMENCEMENT. hereby certify that I have read and examined this p(ication andknow the same to be nue aml correct All provision ojlaws and ordinances governing this as o work will be complied with whether sppeed ed herein or mt. The granting of a permit does not presume to give aulhori to 'ovision of any otherfe�de�rat state, or local[mv regulating construction or the performance ofconstruchon 0' or tante(the gnatme of Own at tL - Signature of Contractor int Name ..R.teksSe.I.L._...gH.............► t.'we1.1.._- Print Name ...._.....................__ ......_........._.........--- ore me Before me s�Day of J1 this _Day of Nntery Public 20 any IIbhc - ate of Floiids IaV CbmmL1aw Expires 1113012017 Notary b c faecmhmm No.FF 6M Revised 01.26.10 j . F1L111 / CITY OF ATLANTIC BEACH rF 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 McROVE 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 MUSTER 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 ME 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. -4C( . -1�sC—SI 2,I-7—AG,ra--7G87 ADDRESS PHONE NUMBER R(1SS811 E jqA--W11 PRINT NAME //�� .�7 c[MMe!!£ (�tA. �t� 111711 -7 SIGNATURE TE `/�� ^L DA Befinema Mie 1- 1 eayd J� ,2011 Fthe wuntyd Duval,State of Flodda,has personally appel hem by himself I herself and some that all statements and declarations are hue and accurate. Notary Public at Lame,Stated R ,county of V&L, Try ey 13PaemelN I4awn """'R Pubk IK dldenllfirelion- R. D'rMuS L:L Stare Of Poida My Commisslon Expires 117300017 rvoran sisnaare: A/lAl ,, Commission No.FF 66026 -\ IYl� F iBIANO Rail.A .ir:REIWED:Nsmsv F AP SHOWING B04)"DARY 3URVIEy OF 4� ACCORDING TO THE PIANOF "PLATNO. 1 SUBDIVISION A ATLANTICBEACH" AS AT BODE 5, PAGE 64, OF THE CURRENTPUBLICRECORDS OF DUVAL COUNTY, FLORIDA PAMELA J. RABB, FIDELITY NATIONAL TITLE INSURANCE COMPANY AND WATSON & OSBORNE TITLE SERVICES INC. 6`P7ZEE7- leo eiw� y` `} "Pszns�tJ 4E'R/ Lo—r 2 .p.e 432.ia'MJ. fw<ar� I ue Gaerw ��{F� I e A tl P•Trs BG CKS � � I N • Iii Z"'s's`sv K K � � p.i /a2• .a' .r' G7 e.a • d ry W I \ LSTOJ2Y Q •/ V S C � ) N- w/it"etwGs ti N In <.s,» m, • Pssrr \l l3.2zSGv� A/G 4�, 9; 6:B I�'3rnry� ti 9 ».p A m S3 sp r. } n V 1?1 p y� �iv �I� �1h •�a � V `: � r. 4•• •b ��3a 0.4 y C}V � � wie iay'f xsG?.su 'r me .v ate. Gnx/<i<rc � N` • �>6 0 ..` QCT Z B G�7 2 fi E Y O L K 9 A s AL Norex. a SINICn - xa3 —F 9 o = W uIs wnu• boon zovE x 9SAC1ATFt) SIIRYFYAR! 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