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1849 Seminole Rd 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: Job ID: 17-FNCE-3207 Job Type: FENCE PERMIT Description: replace 6 foot wood fence Estimated Value: Issue Date: 2/15/2017 Expiration Date: 8/14/2017 PROPERTY ADDRESS: Address: 1849 SEMINOLE RD RE Number: 169629-0000 PROPERTY OWNER: Name: MORIN, EDWARD H Address: 1849 SEMINOLE RD PERMIT INFORMATION: UTILITY DEPT.: PUBLIC WORKS: Note easement at west side of property. 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. 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 J/ �n Building Department (To he assigned by the Builtling Department.) 'r 800 Seminole Road Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 Fax(904)247-5845 E-mail: building-dept@mab.us Date routed: c�lo� Il� City web-site: hap://W ,CDab.US APPLICATION REVIEW AND TRACKING FORM Property Address: � �6y-� SQMLRt)kQ_ D treviewre uired Yes No Applicant: �1.JV��( tanning&Zoni ree istrator Project: �jD�0.l1L �Q— �i 6,N4'0L4 �- u ublic Utilitie u is Safety Fire Services Review fee $ Dept Signgttre;,.,. ft gency Review or Permit Required Review or ReceiptDate of Permit Verified Bept.of Environmental Protectionept.of Transportations River Water Management District rps of Engineersof Hotels and Restaurantsof Alcoholic Beverages and Tobamo APPLICATION STATUS rPLANNING Department First Review: proved. ❑Denied. one.) Comments: DING &ZONING "� ' Reviewed by:�yl/lj�— Date: DMIN. 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 sunir. City of Atlantic Beach APPLICATION NUMBER �. Building Department (To be assigned by the Building Department.) 800 Seminole Road .1 Atlantic Beach, Florida 322335445 I� —r/v Phone(904)247-5828 Fax(904)247-5845 1 E-mail: buildingdept@wab.us Date routed: oalogl(9 -- City web-site: http:11www.wab.us APPLICATION REVIEW AND TRACKING FORM Property Address: f �`-l�1 SPariLR0�1Z '�.QI . llantnin & , re vi ewrequired YNo Applicant: DLIA Zo i Project: LkaL2 Treeator ublic Utilitie u is Safety Fire Services Other Agency Review or Permit Required Review or RriRed eceipt of Pernik VeB Date Florida Dept.of Environmemal 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: HApproved. ❑Denied. (Circle one.) Comments: BU LDING PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: roved as revised. ❑App ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 06114/09 BUILDING PERMIT APPLICATION OFFICE COPY CITY OF ATLANTIC BEACH DATE 800 Seminole Road,Atlantic Beach Fl,32233 a p A `i 1) Office:(904)247-5826pp• Fax: (904)247-5845 Job Address: Permit Number: Legal Description RE# Valuation of Work(Replacement Cost)$ Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New Addition Alterationspa' Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial <1 esidenti • 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: Florida Product Approval# for multiple products use product approval form Property Owner Inform/ati�on Name: 76 �l.�rr^ Address: IR'V'c7 ea epC�- City State Mipt 7 Phone T-416 Brio E-Mail F Owneror Agent (IfAgent,PowerofAaomeym Agency Lever 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 NOTIC7E OF COMMENCEMENT. Contractor Information: Name of Company: Qualifying Agent: Address: City State Zip Office Phone Job Site/Contact Number State Certification/Registration# E-Mail Architect Name &Phone# Engineer's Name&Phone# Workers Compensation Exempt usurer ease Einployems xpuatton to - 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 Wtar to the issuance ofa permit and that all work will be performed to meet the standards ofa/l laws regulating construction in this jurisdiction. is permit becomes null and void if work is not commenced within sag months, or if construction or work is suspended or abandoned(or a period o six(6)months at anytime oiler work is commenced. I medersta that separate permits mast be securedfor EredricalWork,Plumb7ng, Signs, Wells,Pools,Furnaces,Boils Hea Tanks a Alr Conditioners,do Signature of Property Owne NY Signature of Contractor: Before me this 3ffDay of t\�\ N4! �-Jl't Before me this Day of Notary Public V' Notary Public: I hereby certify that I have read an a thisa 1pN9t=V! same to be true and correct. All provisions of laws and ordinances governing this type of a ckryryrpfl4�'a/8�1.e ci ted herein or not. The granting of a permit does not presume to give authority to vro(a! µµµ((( e-rhe g;tM, jgr?"joli, era{ state, or local law,regulating construction or the performance ofeonslrnclron. j q•pgilua uoan vuuvcumernnr. MAP SMOVYING SURVEY OF LOT 33, OCEAN (ROVE LNIT ID. Z AS REAMED IN PLAT BOIX 20, PAGE 2U 0= TrE OJ*tENT PUBLIC REMPIDS OF DWAL OOJ-j Y, FLORIDA. BROAD NogrH 100' RIW CAVGP ROADWAY GRASS -BoRDiP COPY THIS PLAN MUET BE GNP YI PIN 0 R �u AGI-ON PEC' "10N p = j zwW n y « t .Q 1-ST0[Y a 014 LAII LxJ � A C' r • CONL lY. ^vg M a(Nl. N 19 VII 41 1N N! I-6TOtY . .� v FRAMQ ~ rt)k lie Rif. ►yn* x�tnr.a yy�p FWPL '.. Tp um Ile CNP IkRy1N4T "-"' M[t F rice .v.,, PY l `0 CITY OF ATLANTIC BEI OWNER/ BUILDER AF I LAN MUST BE t B9P B SITE FOR 1. DCONTRACTING'REQUIRES OWNER/BUISTATUTES; CHAPTER LDER TO ACKNOWLEt)9. FLORIDA STATI. rEACH INtSREGi'dION 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 YOUR ELF 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 525,000.00 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. TI IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY SLATE LAW AND BY COIMTY OR CIP L LICENSING ORDINANCES II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKERS 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. w IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BEEMPLOYED UNDER N L CIRCUMSTANCES OWNERS BEING SUBJECT TO$5,000 PENALTY UNDER FLORIDA STATUTE O L 455226(1). AN-OCCUPATIONAL LICENSE'IS NOT ADEQUATE _THE OWNER SHOULD PHVSICALL SEE THE COUNTY 'CERTIFICATE OF COMPETENCW OR THE FLORIDA -CONTRACTORIL V CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE 7iHIS Ua S p BUILDING DEPARTMENT(247-5826)IF IN DOUBT. - m f 2 00 V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSR U Q V STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE O 1"' c OWNER-BUILDER PERMIT. O Z O 2 U. 2r15 XJ /O 0 U. AOORESS PHONE NUMBER � 0 IX /7 /'�10��/V W a PRINT NAME W 3 ` diuRAORE GATE cc Beroie me mi. daYd Ft. (LL6(' 20111.ma muM, ¢ 1 Duval.smm ar Flonaa,nas peaanallyappuleaWin bynimearc/narsNtanaarctrms that - ----" a0 amtamenm and nadma0ons area and a urete. Notary Publicat Lama.SmmW FC_ ,Gwntya �I'I'Mu' I aMY S JENMFER JOHNSiON MY OOMM$$I QV M GG 042981 rPnNov"°""" dl.('Id WLS IiCe/!S� `I EXPIREs:ottoba,zi,zozB Pmaumd ieemmmuam Bwidadmy Nnlay PabIk UlManNilq Notary Si9namre: FRIDG'Ou„u-Bi1tic ARVJ,n, EO:V16RLC9 CITY OF ATLANTIC BEACH ; OFFICE COPY ®WNER/ 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 BAPROVE 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 BUB.DING MOST BE FOR YOUR USE AND OCCUPANCY. IT MAYNOT 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 MUNICIP 1 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. ADDRES�,4 9 � •�H 4 -�I IO PHONE NUMBER NAME ll� f/ /I�forlylr PRINT NAME SIGNATURE p C DATE Berore me this l daym 1 (LC(1(. 30jj N uo county of Duval.Slam dram. ,baa Porsmon,,,aeared erin by himself I herself and alNms that all ammmenm and deaareWna are Wa and eaurem. Nomry Public N Large,scha& OuLm I Eml F� ryERJOHNSTgySION NGG Wg994❑Pertonarymown�Praducedlmmr non- V-(t —/ lL �l �er2T,IBM lary Puble OMatwnmrs Nogry Signelure: PIBID(VOwnvBwNV ARadav�, Sm NAddIa i City of Atlantic Beach APPLICATION NUMBER } Building Sr,Department 80 ,,,,,_ t,� o (To be assigned by the Building Department) 800 Seminole Road U Atlantic Beach, Florida 32233-5445 Phone(904)2475826 Fax(904) 2475345 ��/ E-mail: building-dept@wab.us Date routetl: ba�og l(� Cityweb-site: httpJiwm.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I Lt C1 SO'M'L 0�2 � . D nt review re uired Yes No Applicant: 0l.Mtanning&Zoni Tree inistrator Project: f�- tLuL 0--[jotWtz� �tnu ublic Utilitie u is Safety Fire Services (teviewfee_ 6. /. ...: Dept_Sonaturey � MAgencygency Review or Permit Required Review or ReceiptDate of Permit Verified Bept.of Environmental Protectionept.of Transportations River Water Management Districtrps of Engineersof Hotels and Restaurantsof Alcoholic Beverages and Tobacco APPLICATION STATUS FReviewingDepartmentent First Review: Qgpproved. ❑Denied. Comments: rING Reviewedby: N' "H" Date: 2toSecond Review: ❑Approved as revised. []Denied. P C WORKS Comments: LI UTILITIES - g -i7 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 City of Atlantic Beach 9 f �.L�� Y gppLICATION NUMBER Building Department Rr (Ta be assigned by the Building Department.) ' 800 Seminole Road FEB Q 9 2017 Y� Atlantic Beach, Florida 322335445 Phone(904)247-5826 - Fax(904)247-5845 ',z' .-r \'nlg? E-mail building-p:/Amvoab.us Date routed: O� I / City web-site: http://wvrvr.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: � SP�nln.p�.2 WSewi�s view uired Yes No Applicant: Dt,.�n.n,{ ((�� tor Project: f Q A1Q( � �Q--bcu"� ;13-� . -nu Mew 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: Approved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by: Date TREE ADMIN. Second Review: ❑Approved as revised. ❑Deni PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05114109 R.O.W.Permit Attachment of for R.O.W.Permit# issued 20 Atlantic Beach,FL 32233 Owner's Name: cJCc(� Property Address: 1Bt-I/A Stm�no\� Q-i , ltt lanb� Q2a(Jn , FL3aa3-3 Subdivision: OC 20.(1 11 rD t1 Q R.E.#: I �0 9(01-0000 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 desc b�: I �NAmw Sir ,. 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, return receipt requested, to the following address: I A' �-a S'Eivu.yet.6 ". The depositing of said notice of cancellation in the United States 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 any 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 1 of 2 The USER, prior to making any changes from 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 limitations/requirements of public rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said liabilities are hereby assumed by the USER- DATED SERDATED and SIGNED this day of ,20 01 BY re Afssri Property Owner (to be signed in presence of the Notary) STATE OF FLORIDA COUNTY OF DUVAL On this 1 Stn day of Ff-bfkwl i 20 l� personally appeared before me, a Notary Public in and for said County and State, �I.IJQ�aA�L( FIIXId.q , the property owner of �$yG1 bQ_1M',n0\Q_ �ct(�l , Atlantic Beach, Florida, known to me to be the person(s) described in and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely and voluntarily and for the uses and purposes therein mentioned. Notly Publi&An for aid County and State R; JENNIFER „�:�l••o•�'yt��•`.•e•M1`�x' 9mMhYEdKCTOwMMNISouSIryOJPONUHpMNeGSGUTMO01N,e m%RESOn21.20 CITY OF ATLANTIC BEACH,FLORIDA, a municipal corporation: Approved: D aldD co oy ,P.E. Public V ork, Director File: 12/12/16 i Page 2 of 2