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328 5TH ST - FENCE ,_/ igpst, �Sf CITY OF ATLANTIC BEACH r_, As� 800 SEMINOLE ROAD -„,� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ''..- 0.219%f" FENCE PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 17-FNCE-3328 Job Type: FENCE PERMIT Description: NEW FENCE Estimated Value: $2,500.00 Issue Date: 4/12/2017 Expiration Date: 10/9/2017 PROPERTY ADDRESS: Address: 328 5TH ST RE Number: 169834-0000 PROPERTY OWNER: Name: Paulk, Joseph Address: 328 5Th 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. 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. City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) I /� 1 s) 800 Seminole Road `t 7- F��_33 z p Atlantic Beach, Florida 32233-544544C.d Phone(904)247-5826 • Fax(904)247-5845 22 J ',;3 ) E-mail: building-dept@coab.us Date routed:Z��J6 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3Z 5 - . - + s ent review required Yes No :uildin•�� Applicant: 0(.0/0E:te_ 'lanning &Zoning Tree Adminis atur Project: �' � '�— -u. is TY() ublic Utilitie Public a e y 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: [q pproved. ❑Denied. (Circle one.) Comments: BUILDING PLANNING &ZONING0/1 Reviewed by: Date: 3/07 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 r-t v City of Atlantic Beach ; .r., s APPLICATION NUMBER Building Department f' `y'. (To be assigned by the Building Department.) r .< `. 800 Seminole Road O !aF Ar Atlantic Beach, Florida 32233-5445 r_.Q� 3 ' 7 �NC'�C- Phone(904)247-5826 • Fax(904)247-5845 1 ;� 7 -"zonisp• E-mail: building-dept@coab.us 7�'r' Date routed: z/ v3 / 7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3Z B 51-1-. ..--( ent review required Yes No ,� uil n Applicant: d(•01‘DF)Z-- . Planning &Zoning Tree Admmi Project: i' E 3 public vvor F ` Public Utilitie Public a e y Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By i 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: pproved. ['Denied. (Circle one.) Comments: BUILDING Al/i4 PLANNING &ZONING Reviewed by: W 14"`"---' Date: ''1 2? t y � � 7 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. P d i _WORKS Comment : PUBIC UTITIp1 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I }Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 �Sir,JCity of Atlantic Beach , " �. APPLICATION NUMBER .J� ,\ Building Department /..•)""^ (To be assigned bythe BuildingDepartment.) ' .. 9 /(' 800 Seminole Roada' �r Atlantic Beach, Florida 32233-5445 Fee 17, j-jet;;C- 3 3 Phone, (904)247-5826 •• Fax(904)247-5845 y �;3J�•�• E-mail: building-dept@coab.us �'r 47011 1 Date routed:21 a3 1-7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3Z B S` ent review required Yes No uildin Applicant: d( v,1/4.DF►Z 'fanning &Zoning Tree Admmis _ . Project: I ei\)C: =u. is ►Yo • Public Utilitie Public a e y 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: W.Approved. ❑Denied. (Circle one.) Comments: '-J **d `i 1,1144 BUILDING PLANNING &ZONING / /�? Reviewed by: Date: TREE ADMIN. Second Review: ['Approved as revised. ❑•enied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. Comments: Reviewed by: Date: 1 Revised 05/14/09 0.wyyf, City of Atlantic Beach APPLICATION NUMBER A d '• Building Department (To be assigned by the Building Department.) 800 Seminole Road �7 t-- Atlantic Beach, Florida 32233-5445 I / ` 1- .�- 3 Z Phone(904)247-5826 • Fax(904)247-5845 2 E-mail: building-dept@coab.us Date routed:21 Z-3t 7 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: "S.Z.B S1k_ - . ent review required Yes No uildin.4 Applicant: d(.v�F:IZ Tanning &Zoning Tree Admini t"d'lur Project: `u. IC ►►o Public Utilitie --Public a e y 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: ❑Approve . Denied. (Circle one.) Comments: cf—ei te'2n- BUILDING PLANNING &ZONING Reviewed by: �� v�-Date: 1/Z4/i7 TREE ADMIN. Second Review: JA roved as revised. ` pp ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by, Date: (l�/`I7 FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 05/14/09 w, ZONING REVIEW COMMENTS City of Atlantic Beach Community Development Department 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone: (904) 247-5826 Fax: (904)247-5845 Email: dreeves@coab.us Date: 03/23/17 Permit: 17-FNCE-3328 Applicant: Joseph L. Paulk Review: 1st Address: 9839 Hecksher Dr.,Jacksonville, FL 32226 Site Address: 328 5th St. Phone: (904) 631-4921 RE#: 169834-0000 Email: Treefarmer44@att.net Correction Comments 1. Fence Height: Fence height maximum is 6 feet,please revise plans accordingly. Derek W. Reeves Planner dreeves@coab.us u BUILDING PERMIT APPLICATION r l�,. �, CITY OF ATLANTIC BEACH .. -- 800 Seminole Road,Atlantic Beach FL 32233 v W." Office:(904)247-5826 • Fax:(904)247-5845 17 -Flo -3 3Zg Job Address: S 2 S—'-IA- c I Permit Number: Legal Description RE# Valuation of Work(Replacement Cost)$ 2.6-00, (se) Heated/Cooled SF Non-Heated/Cooled ■ Class of Work(Circle one): ew Addition Alteration Repair Mo e De o Pool Window/Door I • Use of existing/proposed structure(s)(Circle one): Commercial Residential !; • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes 45 N/A I1 • 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: t iv I t-Y•q-11 il I Urvt :NtA,M eity t.1 J (r' i it, FKotut- f,e eaV1(l•ofi /t2i) trirtcnE 3'. I„ve tpI)4EeFhv t, (Q INST( -R UuoC CFiv�tt tl•e,t4.055 dote*. Lbr1-/ 'Ve1IV AF"- Florida Product Approval# for multiple products use product approval form Property Owner Information Name: .-J p s e f IN L , i'r t,e..l c_ Address: q 3 ? 1`k c Kt e k 6.a- OrAi City —176-i.14. c t,to or i t t_ State fZip 3 22 24 Phone 4 54 r/ -41 y 2-/ E-Mail "Art plc:F.a+tm4.0_ lief G e7G/-./(-.4,4.>F- Owner or Agent (If Agent,Power of Attorney or Agency Letter Required) WARNING TO OWNER: YOUR FAILURE TO RECORD A No ICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO OUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR L- 1DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Contractor Information: Name of Company: /"oglr% Qualifying Agent: Address: City State Zip Office Phone J.a 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 Inst lotions as indicated I certify that no work or installation has commen prior to the issuance of a permit and that all work will be petforrne meet the standards of all laws re ating construction in this furls . ion. i This permit becomes null and told tf work is not commenced w' it six(6)months . or if construction or!.is suspended or abando'•d for a period ofsix(6)months at any time after t Ik is commenced it custard that sep. to permits must a carred for Electrical Work •lumbing, Signs, Wells,Pools,Furnaces,Boilers, tern,Tanks an r onditioners,etc.. Signature of Property 0 t et •tgn. re o IPoc tract 1 Bef t this e )ay of ite a, 4111 4 ( Before me this Day of Notary Public: *A , �i A Notary Public: I hereby certify that I have read and examined this app and know the sante to be true and correct. All provisions allows and ordinutitces governing this type of nark will be complied with wit • • , ' _,:._.._..:., The granting of a permit dots not presume to gine authority to Prolate or cancel the provisi. : :_o, Icon g( ' S�ntlEtvr/out/lair regulating construction or the per/onnancc o/construction. ;=4` ` : COMMISSION!�lFF 924951 '' :3e EXPIRE'S%October 6,2019 IRev.3/14/16 -14 i/c:,:� Bonded Thru Wary Public Underwd'ers } CITY OF ATLANTIC BEACH o v ®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. TILE 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, WI-HCH 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. Q�39 Z/t5e-Asz41&t2 bft, JAL 322--2. ra 4W-q-?2.f ADDRESS PHONE NUMBER Jvsr_e k PRINT NAME A p •SIGE / 2 . 2 ler rr�r DATE Before me this : ay of 20• in the county of Duval,State of Florida, as personally appeared herin by himself/herself and affir s that all statements and declarations are trruee and accurate. 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