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1207 SEMINOLE FENCE 2017 CITY OF ATLANTIC BEACH fl 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 FENCE WALL OR BARRIER - FENCE MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NM FNCE17-0012 Description: OWNER BUILDER Estimated value: 0 Issue Date: 5/25/2017 Expiration Date: 11/21/2017 PROPERTY ADDRESS: Address: 1207 SEMINOLE RD RE Number: 171892 0000 PROPERTY OWNER: Name: SPEED DOUGLAS W JR Address: 1207 SEMINOLE RD ATLANTIC BEACH, FL 32233-5506 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$7,500. S,arr City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road '—(� �,�I - 00 ' Z Atlantic Beach, Florida 32233-5445 Phone(904)247-5826Fax alb.us 4)247-5845 Date routed: 1 O { E-mail: building-dept(aJcoab.us City web-site: http:/&w .coab.us APPLICATION REVIEW AND TRACKING FORM / Property Address' I Z07 UVOL,E 2D De ent review r uired Yes No uildin Applicant: tannin &Zon jW �( Tree Administrator Project: 4 ( {" NSE u is Utilitie ublic Safety Fire Services ®1'awfiaa$;.�. - Plant 9rnnatrir�.,.,g 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 Amy Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS M Reviewing Department First Review: Approved. []Denied. (Circle one.) Comments: UILDING PLANNING &ZONING Reviewed by: Dale: S7"1/'/ :2 TREE ADMIN. Second Review: ❑Approved as revised. ❑D ied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07127110 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road ,---N �,�I - 0O' Z Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 Fax(904)247-5845 F j E-mail: building-dept@wab.us Dale routed: % C Cityweb-site: http:/Awm.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 Z07 l nY ,iN 0L e ii�) Detint review re wired Yes No uildin Applicant: -Planning &ZgUW Tree Administrator Project: 4 U Ic Utilitl -Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receiptof Permit Verified By Date 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:ZeL_ "C Date:5i"L3(17 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 07/27110 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800S mole Roorida 32233-5445 ") Ff\) Q,E I - 001L AtlantV Phone(904)247-5826 Fax(904) 247-584NAY j j 2011 E-mail: building-dept@coab.usa Date routed: Cityweb-site: http://www.wab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1 Za / SI ,yil/VOLr= J De Hent review required Yes No uildin Applicant: (D CQ P-.) 'Planning &Zo g _ Tree Administrator Project: ( �` �P—� 'L� u Ic Utilihe Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Dale 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: VApproved. ❑Denied. (Circle one.) Comments: Aw � 4M;4 BUILDING PLANNING &ZONING Reviewed by: / /rYL 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 07/27/10 ?tsa,y„ City of Atlantic Beach APPLICATION NUMBER Dr Building Department �+. T�. f (To be assigned by the Building Department.) 800 Seminole Road ECEa�!'� ^Nr1 C17- _ O IZ Atlantic Beach, Florida 32233-5445 Q'E 1 Phone(�)247-5826 Fex(goo)247- MAY 1 1 2017 'L o;fiv E-mail: building-dept@coab.us Date routed: City web-site: http://v .mab.us BY: APPLICATION REVIEW AND ^TRACKING FORM Property Address: i Z© / De2ariment review required Yes No uildin Applicant: tannin boxop Tree Administrator Project: `//((C ( ��C�. Pu-5F_Utilitle -Public Safety Fire Services Review fee $ - Dept S na0'f$ � Other Agency Review or Permit Required Revirmew of Peit VeriFled or ReceiptB Data 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: 1111A BUILDING PLANNING &ZONING 9 A19 Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. P WORKS Comments: BLIC UTILITIES S 7 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. Comments: Reviewed by: Date: Revised 07/27/70 BUILDING PERMIT APPLICATION OFFICE COPY CITY OF ATLANTIC BEACH 800 S-e—nunole Road,Atlantic Beach,FL 32233 Office(904))2147-5826 Fax(904)247-5845 Job Address: 1aU7sell 'a /rP/e • Permit Number: FNKRI-7-00iZ— Legal Description L 11 o T s &11 S¢ tviA Afgrin.w U,Ill I Parcel# o0 oo eao q. t. q. Valuation of Work 21")10, Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of exis6ug/propposed structure(s)((circle one): Commercial esidential If an existing structure,is a fire spnnkler system installed?(Circle one): s N/A Florida ProductApproval# For multiple products use product approve orm /` /Describe in detail the type of work to be performe)d: r7e,U!C r �"t e✓ U� �`2(L�t V ,7z</C 2 1a erl r'o fVT it v 4,c� v T r ✓P Property Owner Information: vVe y /l Gt•s Aetf v do-I.y Name: ur 1A 0- ' se Jr• Address: CiTy State Zip 3r7�33 Phone 9r7Y .145-S6SS E-Mail or Fax#(Optional) e As Contractor Information: C NTRACTOR EMAIL ADDRESS: Company Name: �.v r e w. a K— Qualifying Agent: Address: CiTy State Zip Office Phone Job Site/Contact Number Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work a hstallationr as indicated. I cert f,that no work or installation has commenced prior to the issuance oJa permit and that all work will be pe�ormed to mee standards ofall laws regulating construction in this jurisdiction. TPo'spermit becomes null and void t work is not commencedwithin six 6 months, ori onsa uction or work is swpended or abandoned for a period ofsiz/6J months at any time alter work is commenced. I understand that separate permits t be secured for Electrico[Work,P(umb/ng,Signs, Wells,Pools,F}trnaces,Boilers,Healers, Tanks and Air Conditfoners,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 YOUi NOTICE OF COMMENCEMENT. I hereby certify that I have read and examined this plication and know the same to be true and correct. All provisions of laws and ordinances erning this type of work wd/be complied with whether sppeeci ted herein or not. The granting of a permit does not presume to gave authority to viol or cancel the provisions ofany other federal,state, or local law regulating construction or the performance ofcomstruction. Signature of owner Signature of Contractor Print Name _. DfAt��kS...W...a..��2.S� . ..J.-................................ Print Name .................._....... .........._..._....._..._..__._............ _.. . .... ..... Before me Before me this U)--Day of l��ay .20 M this —Dayof .20 s - i Notary 'f9 p n6d M Public hF 2219 ) E.pu,noruzic Revised 01.26.10 r lil' CITY OF ATLANTIC BEACH OFFICE COPY (OWNER / BUILDER AFFIDAVIT on 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 13UI.D 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 FIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR' YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING FZWLATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES UOUIRED BY STATE LAW AND BY COUNTY OR MUMCBAL LICENSING ORDINANCES. 11. 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 STAIUI t 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(2475B28)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. lao't Se,-iP.,Jule J�dl -6- ADDRESS PONE NUMBER P�NAME I SIGMTURE v mm Debrema 'oaayIX 28 In Me wunbof Duval ,SlabdFloada,M1ea personally eppa M1ean by M1im If/M1ersalf and efirma Mal ell sMbmenb ana tleaarellana ere Lueanas reb. ` Ynr � i / MMTtlOD1NMMIUGMNIIryEUCbPFND9KKQr+ nl1 RESSgPcomo _ NobryPUNlcaLage, bbob EOohor4ID9 BO JPmmllyn e n O RW—d IaemmunM- NolarySignelure: �- F:IBL➢O'Ovmer-BuilEu Me&J,I;AEV6®:NIdU-09 5 �',Y �eSr�!'R��Pr v JSrr• F ;: .��t li /?07C }A11C I• 1110 An 4.0 O �