298 PINE ST - FENCE ,\.,,,,) ,
. f CITY OF ATLANTIC BEACH
rf____,,,
_ 5-) 800 SEMINOLE ROAD
J ",' 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-3276
Job Type: FENCE PERMIT
Description: replace 6-foot wood fence
Estimated Value: $992.00
Issue Date: 3/3/2017
Expiration Date: 8/30/2017
PROPERTY ADDRESS:
Address: 298 PINE ST
RE Number: 170549-0000
PROPERTY OWNER:
Name: BERNSTEIN, FRANK AND KAREN, *
Address: 298 PINE ST
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 from job site by Contractor.
Any damaged sidewalk must be replaced by Contractor.
Fence is allowed on Private Property ONLY—cannot install fence on City right-of-way.
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
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. CITY OF ATLANTIC BEACH
/ BUILDER AFFIDAVIT OFFICE COPY
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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 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.
leis Pine s+ -is&-32sey4,3
ADDRESS •
Vo
��LL PHONE NUMBER
PRINT NA
11(,1/1
SIGNATURE DATE
1, C `,�
Before me this '•J day of T 03(tA 6'>4 ,20\I 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 r L- ,County of AA-0 60 _
❑Personally Known ��V ^ 1.C
I roduced Identification- Y'l - \l( -coif )--n-- '.g.: ,.,, JENNIFER JOHNSTON
''R t MY COMMISSION#GG 042984
it "'' �` EXPIRES:October 27,2020
Notary Signature: A/\-iVL. ':So7.c�' '. Bonded Thru Notary Pubk Underwriters
F'BLDG/Owner-Builder A vit;REVISED:4/16/2009
rrS"',, ,, City of Atlantic Beach APPLICATION NUMBER
� \ Building Department (To be assigned by the Building Department.)
_ 2 800 Seminole Road wII // /-
I' ,.' 'j Atlantic Beach, Florida 32233-5445 1 1—FIvC t — (c
,�\` Phone(904)247-5826 . Fax(904)247-5845 I
\b5;19:. E-mail: building-dept@coab.us Date routed: Oa l 1 (Q i I-1-
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: a c1 r I(\._S1 • D t review required YeA No
oPlilli
Applicant: uvJR.0--( Iiir•rw� �. ._ _• __
``__ Tree Administrator
Project: ( - LL Q `
U - V - -) t -1�-()L_ ° ::,,.,:.
. Public Utilitie&
Public Safety
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. I 'Denied.
(Circle one.) Comments:
BUILDI G
PLANNING &ZONING y 1 -� ._(7Reviewed b : 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
rjr�s+ +ir City of Atlantic Beach APPLICATION NUMBER
+- Building Department
s+� (To be assigned by the Building Department.)
it 1 800 Seminole Road c^
13.'« .Atlantic Beach, Florida 32233-5445 1 1 J(L— 11(Q
AV Phone(904)247-5826 • Fax(904)247-5845
.J;; gP E-mail: building-dept@coab.us Date routed: ea I 'co I r
(i-
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: a cil' P t(\Si • I_• _ t review required Yes No
•��` — ,
Applicant: uW�-1) � r��u �. :. orn�•
Tree Administrator
Project: c 9 \.L1L 1-- l( --- ck - ... n>�r
4 Public UtilitA.111.11111111
Public Safety
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: JZTApproved. ['Denied.
(Circle one.) Comments: fet-4i fejt t r " L,.11 0,,i),
BUILDING
PLANNING &ZONING �`
Reviewed by:�� Date: 7/2/47
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑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
0}-Any City of Atlantic Beach
;� Building Department APPLICATION NUMBER
ip 800 Seminole Road (To be assigned by the Building Department.)
' Atlantic Beach, Florida 32233-5445 1.—EN(t -if,?
Phone(904)247-5826 • Fax(904)247-5845
..on 1) E-mail: building-dept@coab.us �,�� Date routed: I l(Q
City web-site: http://www.coab.us FEB 7 L 1,"
APPLICATION REVIEW AND TRACKING FORM
Property Address: a Cj 0 r t n _Si • ;;� t review required Yes No
Applicant: DW -( ���r � oni,•
Tree Administrator
Project: C sLy\ L C ,-,iii11111.11111.11111
i+R••+�rfi
. Public UtiltiA11.1.111
Public Safety
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. ❑Denied. �.Z����
(Circle one.) Comments: ss'ie iffeftdd t(Ologir f
BUILDING
PLANNING &ZONING
Reviewed by: Date: 234.>
TREE ADMIN. Second Review: ❑Approved as revised. OD ied.
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
?i�:ay;y City of Atlantic Beach
?�� Buildin Department APPLICATION NUMBER
g ��'
r �)s 800 Seminole Road( To be assigned by the Building Department.)
��, # r Atlantic Beach, Florida 32233-5445 1 1—FA L— --11
Phone(904)247-5826 • Fax(904)247-5845
-"�0109P. E-mail: building-dept@coab.us FEB 1 7 / Date routed: I (Q �
�
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: a 61 1 'P 1RLS� • I t review required Yes No
111111.111111111
Applicant: uW(V)-,( �.�►'''"�';:
Tree Administrator
Project: C Q-�‘/QL 1 l( -- .Pu
. Public UtilitiAMIIIIIIII.Public Safety
Fire ervices =_=-
,review fee $ ` Dept Signature K^A •
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: 1VApproved. ❑Denied.
(Circle one.) Comments:
BUILDING ti(A-
PLANNING
&ZONING Wf )7//1`/
� 2/132-((7
Reviewed by: Date:
TREE ADMIN. Second Review: Approved as revised. ❑ enied.
r` W RKSments:
PUBLIC UTILITIES
...12.fk
2- 21 -17
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
3S-A. I` _
BUILDING PERMIT APPLICATION
_.41
CITY OF ATLANTIC BEACH
800 Seminole Road,Atlantic Beach FL 32233 OFFICE COPY
Office:(904)247-5826 • Fax:(904)247-5845
Job Address: pg 2, a re, N- Permit Number: n F—N C L — &),-9-k,
Legal Description Lot SO teakitint► 3 S.c14'ette 41ik *kiaol l RE#
Valuation of Work(Replacement Cost)$ qq 2. CO Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): 4110 Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial Residential>
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No 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:
OPNA1 �O1U! - ►n. .U4 A annl '-Qisiln3 fgrte.e. fe-rno\L,-(. (y F4' Wood -genet__
Florida Product Approval# for multiple products use product approval form
Property' Owner- Information
l
Name: �I�XPirN ,r(I te4v l Address: MB P
City F1k-letil.h'e, 1Pleacin State q_Zip v2.33 Phone -15;t,- 3 215-841.03
E-Mail tl-jppY(t 1 tt3 a a zi.e.orn
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 BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
Contractor Information:
Name of Company: Qualifying Agent:
Address: - City State Zip
Office Phone lab-Site/Contact Number
State Certification/Registration# - E=Mail_
Architect Name&Phone#
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
nor to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction.
his unit becomes null and►bld i work is not commenced within six 6)months,ori construction or work is suspended or abandoned/or a
period of six(6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work,Plumbing,
Signs,Wells,Pools,Furnaces,Boilers, eaters, Ta ks and Air Conditioners,etc.
Signature of Property Owner: Signature of Contractor:
Before me
this 10 Day of F#.b(LA-0-f L a O I 'A— Before me this Day of
Notary Public: \, i .AA .11 lig \ Notary Public:
- - -- --I examined this application and know the same to be true and correct. All provisions of laws and
2:444aiices 016611jtie of, onk will he complied with whether specified herein or not. The granting ol'a permit does not
Ane IRY {;optatJa or cancel the provisions of any other federal, state,or local law regulating construction or the
... = ,nan .bj,{yOjp
•k„„Y 4. Bonded Thor Notary Publa U davrrltos Rev.3/14/16
I
OFFICE CO Y
MAP SHOWING BOUNDARY SURVEY OF
LOT 514. SECTION 3 SALTAIR, AS RECORDED IN PLAT BOOK 10.
PAGE 16, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY,FLORIDA.
CERTIFIED TO:
FRANK BERNSTEIN &KAREN BERNSTEIN
BANK OF ENGLAND d b/o ENG LENDING
PONTE VEDRA TITLE,LLC/FIA HAWAY&REYNOLDS, PA
OLD REPUBLIC NATIONAL TILE INSURANCE COMPANY
li-IsA
�..
LOT 503 LOT SO2 / ....-".7..0!..4. $'49\12523'2'(PLAT) , 3(010°.:..41A
•
•
N 23'2710" E i
•.3. 50.00' (MEASU(jED) 9
• 1,'1`�ti.'l FI'
�i1'Utv4rlq!�tl,!•
-61 1� w.� I
b'pN 4
1 �P
.111 v w
^i.- a w • ? e Q%
ry of Atlantic Be pa is �,. :
and Zoning Dep g n "a }e
Planning o Ic a
applicable '
royal rerifiea aomPnance with ePP o tt
Thta ePP _ -
zoning, aubc ivislon and other local land •"" jw
development r;gulations,but does not oconstitute y An
approval for the Issuance ofd all'other
r applicable 1f`•_t ,..
with Florida BI ilding Code and all other uD ements ,
local,State a Id Federal permitting y of Atlantic• ` ';:i
f
must be verlfil d by signature of the Clawanoe Df a: bD a
Beach Building Officialr to the ., t'
�7f�H aztt _ . r
Building Permit. ,
Approved By: �
---rte ', . �,
�iZyliy�
Date: •9 ,P
S 23'08'45' W Aa t�
50.17 (MEASURED)
50.00'(PLAT) i-
t
PINE STREET
(00 NOn 01 lu»
LEGEND:
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O i� MOO OR'..,w[
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p- irenet 110120na-a�wwp AMOR
pus
a•r1M•own*wren roe• row 0,COOMOD
Ale- M rq Q.oa,.tcC![L
—K— � REVISIONS
Ray Thompson • DATE DSswPnDK
SURVEYING, Inc.
1Going the DISTANCE for Yot{
4617Ph14s 1-Noway.atJr210 PONTE VED TITLE,L.L.C.
1 JACkSO,1110.Fb116 32207
(p 90444163178
(
JOB/ 21849 1 DATE OF FIELD SURVEY: 12-3-2012 I SCALE: 1"= 20'
NOTES
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LAND SURVEYS O CONSTRUCTION SURVEYS O SUBDIVISIONS