659 OCEAN BLVD - FENCE -'• f CITY OF ATLANTIC BEACH
W--
;? 800 SEMINOLE ROAD
__ ) ATLANTIC BEACH, FL 32233
4.4 WI c-) PHONE LINE 247-5814
FENCE WALL OR BARRIER - FENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: 16-FNCE-2837
Description: replace fence
Estimated Value: 4200
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 659 OCEAN BLVD
RE Number: 170127 0000
PROPERTY OWNER:
Name:
Address:
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Address:
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
I
•
•
,51..J.v1/2 City of Atlantic Beach
APPLICATION NUMBER
J lir4 .� Building Department o be assigned by the Building
y 800 Department.)
E•, s� Seminole Road DEC 2 0 211
�� Atlantic Beach, Florida 32233-5445
ILO—FN CL-
Phone(904)247-5826 Fax(904)247-5845 !ds
l•-..,0;09P. E-mail: building-dept@coab.us - --- Date routed: ' i 14l.
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (-05I O C e gnu d . Department review required Yes No
wars
Applicant: Oi,3r L( Planning &
Tree Admmistrafor
Project: '(L.irtiR(, L (0—Voo \,60Q,124\ (s2 ublic�olis�
Cplic Utilities)
Public Safety
Fire Services
Review fee $ , Dept Signature 2G'`v�
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:
APP ATION STATUS
Reviewing Department First Review: Approved. ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: 5— ham^ Date: 44.6/16
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied.
IC WORDS Comments:
/
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
41 ',, Cash Register Receipt Receipt Number
-4. City of Atlantic Beach R1675
'4-40;119>"
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $35.00
16-FNCE-2837 Address: 659 OCEAN BLVD APN: 170127 0000 $35.00
Fence/ROW $35.00
Fence/ROW *NONE* 1 $35.00
TOTAL FEES PAID BY RECEIPT: R1675 $35.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
06;01,2017 13:26:19
CREDIT CARD
VISA SALE
Card; XXXXXXXXXXXX3122
SEQ u: 4
Batch#: 376
INVOICE 4
Approval Code: 02:ND
Entry Method: Maruial
Mode: Online
Card Code: M
SALE AMOUNT $35.00
CUSTOMER COPY
Date Paid:Thursday,June 01, 2017
Paid By: JONATHAN T HEYMAN
Cashier: BA
Pay Method: CREDIT CARD 4
Printed:Thursday,June 01,2017 1:27 PM 1 of 1 j
111MiT
01qJ \
., City of Atlantic Beach APPLICATION NUMBER
fyBuilding Department
c (To be assigned by the Building Department.)
800
j Atlantic BeachSeminoleRoad, Florida 32233-5445 1 LD"—Ff\)C(- --a- !}.
Phone(904)247-5826 • Fax(904)247-5845
CJia �� E-mail: building-dept@coab.us Date routed: 13_11(4 14,67
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (.QSci Cc€ IN d - Department review required Yes No
i din
Applicant: Ot,01‘14 Planning &Zoning
Tree Adminis ra or
Project: NL-piac. (9' C wOcifits4\D_-ecou77c-1Nork
Cublic Utilities
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.
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by: 403(..444# I I . 1------'- Date: /Vile'
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
01.J. yj.r, City of Atlantic Beach APPLICATION NUMBER
til;CI ' Building Department
A sa 800 Seminole Road (To be assigned by the Building Department.)
�; s� Atlantic Beach, Florida 32233-5445 ! + ,* Ike"FN(E --a
Phone(904)247-5826 • Fax(904)247-5845 ' 'F^-' I
A-..01110- v E-mail: building-dept@coab.us , y , Date routed: �� 1 .Gl ` LL
City web-site: http://www.coab.us ;;�, 2 Q 2O tb
APPLICATION REVIEW AND TRACKING FORM
Property Address: US-cl- 0 c t.cun evi d • Department review required Yes No
walliM
Applicant: 0wr ..L-( Planning &Zonin ,
f�
Tree Administrarr
Project: vL OL L (Q oOk O1\ Works
C-Eutlic Utilities )
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 ,Q /
Reviewing Department First Review: V�Approved. ❑Denied. ��'o1/'/ i
(Circle one.) Comments: 14e `�,/ O ita
BUILDING �/�"
PLANNING &ZONING
/2/�Ac
Reviewed by: Date:
TREE ADMIN. Second Review: Approved as revised. OD Hied.
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
01..a4City of Atlantic Beach APPLICATION NUMBER
4$ �` Building Department (To be assigned by the Building Department.)
"' `i 800 Seminole Road c
j Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax (904) 247-5845 1 ii I
�Jf1 �� E-mail: building-dept@coab.us Date routed: la It et I l b
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Sc/ O C-CPA gV)d • Department review required Yeses No
Applicant: 01/‘'1\ Planning &Zoning
ff�� c Tree Administrator
Project: ,(L RLL (0-Voo-� 10 -n(._Q �,ublic Works<'
- ublic Utilities
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 I First Review: pproved. ❑Denied.
(Circle one.) Comments: /�
(..........,
BUILDIN V
PLANNING & ZONING Reviewed by: P Date: /22716
c
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
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH OFFICE COPY
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: 6 C9 0 Ce-ckv, IR Lv R , Permit Number: I b—1J L6-- a`6'31-
Le al Description i�loks4I .4‘,.%‘•�P rt 4 e_k&k-4- P mak- �c R ' Parcel#
g p . Floor Area oft Sq.Ft. t Sq.Ft
Valuation of Work $ y/a O C Proposed Work heated/cooled N/A non-heated/cooled 4) A
Class of Work(circle one): New Addition Alteration Repair Moveemolitio pool/spa window/door
Use of existing/proposed structure(s)(circle one):. Commercial esidentia Re_ ice rvc
If an existing strucure,is a fire sprinkler system installed? (Circle one): Yes LNg N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed: Sti (e ve-wo QA - ' & .
dW cR
VQ-FL1
D - oor-,N N -ic.v..c0
•
Property Owner Information:
Name: I °,el• 14.9-y .v Address: 6 -&---1 Ocems.r -Nl v et.,
City A•i-k v. ;c Reach. StateLLZip 32-233 Phone (90,) 923 —Oa-7-7
E-Mail or Fax#(Optional) '+& Q, ka-j w•,, u l 4-vo,+ea..1^ 6 va,.,Q s . `o w.
Contractor Information:
Company Name: v.'o.\ 'Fc.�e ' �� Qualifying.Agent: , ° s L L .
Address: 115 •- Ph:W et Ow./ City `SNack-s ehiNAI; klc State FL Zip 3.22c-4
Office Phone a too-x-/7`17 Job Site/Contact Number Fax#
State Certification/Registration#
Architect Name&Phone# N/A ECEOVED
Engineer's Name&Phone# /1// A
Fee Simple Title Holder Name and Address DECg 1��
Bonding Company Name and Address
JO
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as ndicated. I certify that no work or instalt`ition has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of ad hnvs regeekatingeensirr^t:^n in th«j,icirliction. This permit becomes null
and void if work is not commenced within six(6)months,or if construction or work is suspended or abandoned for 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, Healers,
Tanks and Air Conditioners,etc.
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.
,`,{ 1111,,,,,,
I herebycertify that 1 have read and examined this a plication a 4.go fBms to die true and correct. All provisions of laws and ordinances governing this
type ofworkwill be complied with whether speci ted herein:�,i grlup of s7 permit does not presume to give authority to violate or cancel the
provisions of any other federal,state,or local law regulating cOis c Wu�meyrce of construction.
y..►�
Signature of Owner U �o& b!:X ..
ture of Contractor ��f� c
Print Name -S - -1---,,,AHey...xrra+►'� ',,.. .e, u•RSO' t Name
Sworr),tp,and subscribed before me '''''„`�� Sworn to and subscribed before me
thi I} Da f �t(�mkr- ,20/(0. this Day of ,20
- I
Notary Pub is ,/ Notary Public
Revised 01.26.10
OFFICE COPY
C C E a M E
it •-*
CITY OF ATLANTIC BEACH DEC 1 9 2016
• r 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 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.
5-9 Ak.,R. A . , Ft_ 3 )-33 010 14 9a3-0X-77
ADDRESS PHONE NUMB
= titi R'Cy
PRINT NAME
kk/o/it
SIGNA DATE
Before me this / day of DeG•e.l-t6.et— 20/6'in the county of �03II,IIg
Duval,State of Florida,has personally appeared herin by himself/herself and affirms that �01
, fF ,
!
all statements and declarations are true and accurate. `�. c 1
%
Notary Public at Large,State of d fT ,County of 1—
q
Qr•
onally Known
uced Identification 411111
f+z. •
n
Notary Signature: ! .Op MAA �
• Vis!!. OF cm,v,.
IS11111tt
F:/BLDG/Owner-Builder Afradavit;REVISED:4/16/2009
T
MAP SHOWING BOUNDARY SURVEY OF
LOT 5 EXCEPT THE EAST 75 FEET, BLOCK 16, DANIEL AND HACKETT, AS RECORDED IN PLAT BOOK 9, PAGE 35,
OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO: I� C E O'�/J E
J. TAD HEYMAN L� v I
COUNTRYWIDE HOME LOANS, INC.
STEWART TITLE OF JACKSONVILLE, INC.
WATSON & OSBORNE, P.A. DEC 1 9 2016
BEACH AVENUE
(40.0' RIGHT OF WAY)
0
50.02' 0 50.0'
0
`\ LOT 3
f. LOT 5 h
r.
k x
S 10'00'00" E
FOUND 1/2• IRON PIPE 0.9' 50.02,
GO
FOUND 1/2" IRON PIPE
/�\ NO IDENTIFICATION X X Ogi NO IDENTIFICATION
1�//1
0.6' anon
,,/ p,, anon 0.3'
NIA,...) • ^ _ . 0000
• PA
•a•. • 0000 CI
Q1 v ' 1Y^ anaanu
o0oogp
LOT 2
1 � � ,• 0000aD 7.-- LOT 4
p �o�Le o i• POOL ,
v
j
. 4
/^ ^ ,1.•.6.1' 8.6'3 . ,, .. ,
/�,Ke_
�r 18.6'
v .
r
i
v
• ti -
J
W , TWO STORY 6'0 3
'.. - FRAME N a
t _a_ n
W O >I. =N= " POSTED # 659 p
W8.0' -
a b \ N o LOT 1
I— 3 0 �I
- 0
(f) p 1.4 d co
._ . �- -
I 6
z 1.4' U)
•
E a, iBRICKI-
" co
Z -0 x 27.1' ., N -
t- X6.2' -1166.7' -
LOT 5 r -
U _
' m ^
-
0_f 100.0' - - - 50.0'
X O 0
FOUND 1/2" FOUND 1/2"IRON PIPE IRON PIPE
NO IDENTIFICATION N 10'00'00" W NO IDENTIFICATION
50.00'
BEACH AVENUE
(50.0' RIGHT OF WAY)
NOTES: ACCEPTED BY:
LEGEND:
—X— = FENCE
O = CONCRETE
NOTES: REVISIONS
1. BEARINGS ARE BASED ON THE ASSUMED BEARING OF _ N 10'00'00" W ALONG THE
EAST RIGHT OF WAY UNE OCEAN BOULEVARD. DATE DESCRIPTION
2. BY GRAPHIC PLOTTING ONLY THE CAPTIONED LANDS LIE WITHIN FLOOD ZONE X AS SHOWN ON THE
NATIONAL FLOOD INSURANCE MAP DATED APRIL 17, 1989, COMMUNITY NUMBER 120075, PANEL 0001 0 .
3. THIS SURVEY REFLECTS ALL EASEMENTS & RIGHTS OF WAY AS PER RECORDED PLAT &/OR TITLE COMMITMENT
IF SUPPLIED. UNLESS OTHERWISE STATED, NO OTHER 1111E VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED.
4. THIS SURVEY NOT VALID WITHOUT THE EMBOSSED SEAL OF THE CERTIFYING SURVEYOR. 1
JOB # 2210 DATE OF FIELD SURVEY: 08-10-97 DISK # ZIP 3 1 SCALE: 1" = 20'
CERTIFICATE
(ij \
923 Peninsular Place, Suite 1 I HEREBY CERTIFY THRT THIS SURVEY WAS MADE UNDER MY RESPONSIBLE CHARGE
_._ Jacksonville, Florida 32204 AND MEETS THE 'IJsI TECHNICAL STANDARDS AS SET FO•.. 6Y THE FLORIDA
•-w (Phone) 904-354-1141 BOARD OF PR SS101 AL SU V£YORS A110 MAPPERS IN CH •, a'' . 017-6. FLORIDA
(Fax) 904-354-1255 gpMINISTRATI CODE, PUR T TOrSF'GAON 47 .0�2,/�L� ,' TES.
s u RV E n r o n Inc CHARLES K. McINTOSH
LICENSED BUSINESS # 6702 REGISTERED SURVEYOR AND MAPPER # 5502 STATE OF FLORIDA
LAND SURVEYS 0 CONSTRUCTION SURVEYS 0 SUBDIVISIONS