14 SARATOGA CIR FENCE 2017 CITY OF ATLANTIC BEACH
si 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
;t INSPECTION PHONE LINE 247-5814
FENCE WALL OR BARRIER - FENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: FNCE17-0022
Description: replace fence with 6-foot fence
Estimated value: 2200
Issue Date: 6/9/2017
Expiration Date: 12/6/2017
PROPERTY ADDRESS:
Address: 14 N SARATOGA CIR
RE Number: 171815 0000
PROPERTY OWNER:
Name: ELLINGTON CYNTHIA ET AL
Address: 6420 E TROPICANA AVE#322
LAS VEGAS, NV 89122
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.
Permit Conditions
City of Atlantic Beach
Permit Number: FNCE17-0022 Description:replace fence with 6-foot fence
Applied:5/31/2017 Approved:6/6/2017 Site Address: 14 N SARATOGA CIR
Issued:6/9/2017 Floated: City,State Zip Code:Atlantic Beach,FI 32233
Status:ISSUED Applicant:<NONE>
Parent Permit: Owner:ELLINGTON CYNTHIA ET AL
Parent Project: Contractor:<NONE>
Details:
LIST OF CONDITIONS
SEQNO1 ADDED DATE REQUIREDDATE1 SATISFY DATE TYPE STATUS
DEPARTMENT CONTACT REMARKS
1 6/6/201] ON SITE RUNOFF INFORMATIONAL
PUBLIC WORKS Scott Williams
Notes:
All runoff must remain on-site during construction.
2 6/6/2017 ROLL OFF CONTAINER INFORMATIONAL
PUBLIC WORKS Scott Wllllams
Notes:
Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapell's,Inc.,Republic Services). Container cannot be
placed on City right-of-way.
3 1 6/6/2017 RIGHT OF WAY RESTORATION INFORMATIONAL
PUBLIC WORKS Scott Wllllams
Notes:
Full right-of-way restoration,including sod,is required.
4 6/6/2017 FENCING REMOVED INFORMATIONAL
PUBLIC WORKS Scott Wllllams
Nates:
All old fencing must be removed from job site by Contractor.
'a
Printed:Friday,09 June,2017 1 of 1 r
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road f=tvC61-4 -ooaa
j Agamic Beach, Florida 32233-5445 (
Phone(904)247-5826 Fax(904)2475845 Date routed: Q._ II�
"� pv E-mail: building-dept@coab.us
Cityweb-site'. hgpmviinv.coab.us
APPLICATION IREVIEW AND TRACKING FORM
Property Address: l SQ(C•I� ,/� yGl Ct r *Sewi�s
nt review re uired Yes,,No
Applicant: f) W hrL1� onmgis ra orProject: t- Ptn(.L W� — } ksiesty s
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
Almy Corps of Engineers
Division of Hotels and Restaurants
Division of Alwholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: proved. ❑Denied. . ❑Not applicable
(Circle one.) Comments:
UILDING
PLANNING&ZONING Reviewed by: Date: 66'17
TREE ADMIN. second Review: ❑Approved as revised. ❑Deni d. . [—]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: approved as revised. ❑Denied. . []Not applicable
Comments:
Reviewed by: Date:
Revised OW1912017
0 City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road !
Atlantic Beach,Florida 32233-5445 FN CG 1-4 —ODS.
Phone(904)247-5828 Fax(904)247-5845
E-mail: building-deptiiwab.us Date routed: asl3/II}
Cityweb-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 14 SQratp 5IGI Cir , *Sewices
nt review required Yes No
T
Applicant: n W ne l� onmg
f�� f�" Administrator
Project: d(,L fCfH:Q_ t,1� Q-TpD} ks
les
ty
es
Beyiew.feeI.. DeptS,igjLature
Other Agency Review or Permit Required Review
of Permit Verified B or Receipt Dale
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St.Johns River Water Management District
Any Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tabasco
Other:
APPLICATION STATUS
Reviewing Department First Review: vlapproved. ❑Denied. . ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by. Date:
TREE ADMIN. Second Review; A roved as revised.
❑ pp ❑Denied. . [-]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ❑Denied. . ❑Not applicable
Comments:
Reviewed by: Date:
R"l ed 05/19/2017
City of Atlantic Beach ..,.r. APPLICATION NUMBER
Building Department ' .� nay (To be assigned by the Building Depatlmenc)
800 Seminole Road N j
n Atlantic Beach, Florida 32233- �P58 n
s 69522017
Phone(9 uil ing-de 26 w Fax 2 4 I
r v Email: building-dept@wab.us Date routed: Or�3/l��
Cityvreb-site: http://www.coab.1J9Y'_____
APPLICATION REVIEW AND TRACKING FORM
Property Address: l SQ((.I,tpfil C.t ( - De artmentreviewre uired Yes No
m ng
Applicant: a Ing oning
Tree cminis ra or
Project: QL.L Fef,LL v — } ublic Works
C f1L� Public i i ies;
Public Safety
Fire Services
DeptSignat
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 Distinct
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other.
APPLICATION STATUS
Reviewing Department First Review: RApproved. ❑Denied. . ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed b : Date: 110
TREE ADMIN. Second Review: A roved as revised.
❑ PP ❑Denied. . ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . ❑Not applicable
Comments:
Reviewed by: Date:
Revised 106119/201
I
City of Atlantic Beach .,. s-ag�- APPLICATION NUMBER
Building Department ''as C I gy E j (To be assigned by the Building Department.)
600 Seminole Road { Fj�C�I Da?
rr Phone Beach, Florida 32233-5445Fax(94) 8 !N 9 2 2017 —O
Phone(904)247-5626 � Fax(904)24/-5845
r E-mail: building-dept@coab.us Date routed:
City wets-site: http:/Nrvnvcoab us
APPLICATION REVIEW AND TRACKING FORM
Property Address: N SQfU.'f7) FGI Ct t . Department review required Yes No
Applicant: h W nw( a ing onmg
r�- Tree minis a or
Project: QLL. fcnLL v — } < ublic Warks
L
ALt— Public rhes
Public Safety
Fire Services
Review fee $ �
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. . Not applicable
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed by: � Date:
TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. . ❑Not applicable
P WORKSComments:
UBI�IC JILI�ES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . ❑Not applicable
Comments:
Reviewed by: Date:
Revined 0511913017
Building Permit Application Updated 5/5/17
City of Atlantic Beach
800 Seminole Road,Atlantic Beach, FL 32233 OFFICE COPY
Phone:(904)247-5826 Fax: (904) 247-5845
Job Address:141 'T A'ISA a In Al Aft BcG FL Permit Number: FNGb/'7 - 0022
Legal Description RE#
Valuation of Work(Replacement Cost)$. Heated/Cooled SF Non-Heated/Cooled
• Class of work(Circle one): New /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 Jty�pe of work to be performed:
/`� /Axs✓ /Jr//err�5f F�'✓ _7, Z3ac�f rP 7lA
FFlori a Product Approval If V61 for multiple products use product approval form
Property Owner Information � /
Name: c✓eJ 1 It o/Z Address:�� h sl A �I.— N -
city fi • emo' - el^ State E�zip s2ys Phone goy - G6a - S'/7�
E-Mail Jr- If
Owner or Agent(if Agent,Power of Attorney or Agency etter Required)
Contractor Information
Name of Company: Qualifying Ag e V
Address City State Zi
Office Phone Job Site/Contact Numb
State Certification/Registraa, _a E-Mall
Architect Name&Phone#
Engineer's Name&Phone
Workers Compensation -
exempt/Insurer/Lease employees/expireNon�te
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 prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg
construction in this jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc.
OWNER'S AFFIDAVIT:I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
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 YOU`/RNOTICE OF COMMENCEMENT.
(Signatur nt) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this?_1 day of Signed and sworn to(or affirmed)before me this_day of
by
' JENNIFERJONNSTON
l: ry My COMMISSION RGOaL^ e
EXPIRES:Q 27.2413 ' (Sign ure lotary) (Signature of Notary)
NOV ax as Trvu NOMry Publk Uramnun
[ ]Personally Known OR I ]Personally Known OR
LXProduced Identificationnsa x 1. C,�ISJL I )Produced Identification
Type of Identification: O-ltJN S x Type of Identification:
CITY OF ATLANTIC BEACH
®WNFR/ BUILDER AFFIDAVIT
at
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
SUPERVfSE THH ONCTR tC YOURS LC YOU MAY BUII,D OR WROVE A ONE-OR
TWO FAMILY RESIDENCE OR A FARM OUTBUILDBSG. YOU MAY ALSO BUILD OR
IMPROVE A COMMERCIAL HURDING AT A COST OF$25,000.00 OR LESS. THE BUIL DING
MUST BE FOR YOIm i fcF AND OCCUPANCY. IT MAY NOT DE BUILTFOR SALE OR LEASE.
IP YOU SELL OR LEASE A HURDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR
AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BURT
IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT
HIR6 AN UNI ICENci'D PE25ON A YOUR ONTRA OR YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BURDMG CODES AND ZONING REGULATIONS. IT IS
YOUR RESPONSIBILITY TO MAICE SURE THAT PEOPLE EMPLOYED BY YOU HAVE }
RDINANCES IiNRD BY cT4TH LAW AND BY CO 1TY OR ML COAL i cra a
O
11. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, V
THE BUILDING DEPARTMENT SUGGESTS WORKERS COMPENSATION INSURANCE BE W
PURCHASED. V
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY O
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))FIN DOUBT.
W rl
V.ACKNOWLEDGEMENT;THEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE U
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN C Z
OWNER-BUILDER PERMIT.
IL z `o
AfBO Ess AJa. i°fA P 'r /-9Ay-��o—.5'/ 7L^2WF �
PHONE NUMBER O m p = L—
c�6fUs.✓ /�!� .✓ W f R G
PRINTNAME _'/ Q
Z w
2
r BA a O LL z
Mit a W
eisOUf 1,me dF7]o aeya 20�selffhemuritya
lbmehaEloaae,h t samtlmoanderea bean by M1lmaelUM1eraelf ana eiNms Nat 0 0 d ¢ m
Il atelemeae ena aedaRtiwia ere waena axurete. Q W
Notary Public at Large,Stale a FL coacrya '4 U N W 3
DP°"°n°INK^P^'n
�Pmeuaalaenuncamn- (..lee (1 J.1-ItS , [ Q {�S�
411
` JENNIPISIUONBTgq>p ¢ WMCOMNiSO� W
a` OPlIn; kbbar 2l,ZOPP'
P°^EealNU Notary PUNe UMemntert
NosrySignatum:
PRLD6'Ownv-Ouildv Nfey ;pgy1S®;Mb1Ma