750 REDFIN DR - FENCE :', ' CITY OF ATLANTIC BEACH
Vr.
t 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
:`�J3i�% INSPECTION PHONE LINE 247-5814
FENCE WALL OR BARRIER - FENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: FNCE17-0024
Description: install 6-foot fence
Estimated Value: 2000
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 750 REDFIN DR
RE Number: 171311 0000
PROPERTY OWNER:
Name: ROSE BRIAN JOSEPH
Address: 750 REDFIN DR
ATLANTIC BEACH, FL 32233-3902
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.
1Artl4 City of Atlantic Beach APPLICATION NUMBER
jlfr Building Department (To be assigned by the Building Department.)
800 Seminole Road � 1 C i I 1 _ w3 v
Atlantic Beach, Florida 32233-5445 l� I
\J
Phone(904)247-5826 • Fax(904)247-5845I
''/-0;;!!) E-mail: building-dept@coab.us Date routed: 119
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
a
Property Address: n 40( D s t review required Yieyflo
Applicant: 0 (ve.�/ P-fanning&Zonirng--
Tree Administrator
Project: 1 ( .S k Ol le .(Wk Public Works
_uhlic Ut�ities� _
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. . ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING / 6617
Reviewed by: / / ` Date:
TREE ADMIN. Second Review: approved as revised. Denie� Notapplicable
❑ pP ❑ ❑
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 05/19/2017
rCity of Atlantic Beach APPLICATION NUMBER
- • , Building Department (To be assigned by the Building Department.)
r r 800 Seminole Road
is - 0 Atlantic Beach, Florida 32233-5445 ��� ,� --06. 5 _/`
Phone(904)247-5826 - Fax(904)247-5845 D J„ kis
.'%'�;i�, E-mail: building-dept@coab.us Date routed: tU0
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Li F De artment review required Yes No
n �;, q
Buil
Applicant: D---)(\r,--((\r,--( arming &Zoning'
l _ r (r�,^, - Tree minis rator
1.
Project: \ (\St . ( Turk -t�--e1 LQ
Public Utilitjs
Pu 16-Safety
Fire Services
Review fee $ Dept Signature _
Review or Receipt
Other Agency Review or Permit Required of 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: 4Approved. ['Denied. . ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Dater/Jr/`-7
Reviewed by.
TREE ADMIN. Second Review: Approved as revised. ❑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 05/19/2017
C...
1 v-i ... City of Atlantic Beach p APPLICATION NUMBER
�� Building Departmentfl' Cf .- (To be assigned by the Building Department.)
�' 800 Seminole Road -.(,)(1- �!
'' Atlantic Beach, Florida 32233-5445 JUN 0 . 11 -06--) -(
'-~ 2�1) h r
Phone(904)247-5826 • Fax(904)247-5845 l.'����--l
�i' i.i�>- E-mail: building-dept@coab.us i Date routed: c l
City web-site: http://www.coab.us
REVIEW AND TRACKING FORM
Property Address: `JS t) (tr,i_ ` it 01 De .rtment review required Yes No
B '
Applicant: 0—) 1Plna�
anning &Zoni
Tree Administrator
Project: \ir\ S k i b"-. -1.)-c)-k----- --n( c s'
�blies)
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: 'pproved. F (Denied. . ❑Not applicable
(Circle one.) Comments: ( e *Ad (a d,�,[�.
BUILDING
PLANNING &ZONING / ‘..r4., / 4/`
Reviewed by; _1•ti p^i �;� iet, 4 Date: 1.3.7,7---/7
TREE ADMIN. Second Review: ❑Approved as revised. ❑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 05/19/2017
t�;. •�, City of Atlantic Beach APPLICATION NUMBER
s, Building Department (To be assigned by the Building Department.)
800 Seminole Road / (.,,
7F.,„. : Atlantic Beach, Florida 32233-5445 ��`—� u� ��
Phone(904)247-5826 • Fax(904)247-5845. 2w/ I
-..f'7,6-.;,Icy, building-dept@coab.us Date routed: b( 1 1-
City web-site: http://www.coab.us
--
APPLICATION REVIEW AND TRACKING FORM
1
Property Address: 1S7 VL ii- n 01 - pgstadLnent review required Yes ' No
Build'
Applicant: CL-JV ----t tanning &Zoning .
L (` Tree A minis ra or
t
Project: nS ( ` \ ��"1 L�--t -4e___1<Q ' I• r--ss
Public UtilitiO
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. . Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING /
Reviewed by: Date: y (7
TREE ADMIN. Second Review: ['Approved as revised. ['Denied. . ['Not applicable
P WOR_ KS )�Comme V
PUBLIC UTILITIES'
(o—S— 17
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ['Denied. . ['Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
:-. .:''` Building Permit Application Updated 5/5/17
J
j. . ' r) City of Atlantic Beach
800 Seminole Road, Atlantic Beach, FL 32233 OFFICE COPY
o::1'r Phone: (904) 247-5826 Fax: (904) 247-5845 C
Job Address: ASO (t df lt'R (Ur I VC Permit Number: F4 Lb'c0a/
Legal Description LAIL6lockPI Lys)t 1 c Unl l4LQO (QUO id ir5ID 41--.Pt 2 Or RE# l 1 3)1 - 0 00 0
rlct{-li /e c c. Cr re,..
.wax rP ✓d.2 ,, j U i-Om k_.Valuation of Work(Replacement Cost)$ aOOb(Y1G�.x. Heated/Cooled SF n' ‘ Non-Heated/Cooled n� ' 30,elle(5)
• Class of Work(Circle one):4:10 Addition Alteration Repair Mo •• -�- ••. Pool Window/Door q Lf tind g 9A b
• Use of existing/proposed struc ure(s)(Circle one): Commercial •esidentia +Publcc. I Lu✓iJ
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No N/A v‘--OvJa-1.Ca)-41)
• Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit o No Tree Removal noi`d,
Describe in detail the type of work to be erformed: .
6 ' Lopod/Pi rLc, sh;clCad—Q- CA—. Insl-uILLci- Gco,n-)d p-01,--e41,-, o ycd ( ipid- 9nks)
p /- a li a (AL-(d C1 rh u,n s an 5 u 1 . Left nu yh liov's i c.�.s 1`r,,.j f 112 A(46 kr) _S til c,
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: G�,rld Cp7r lu.n I�Se._ Address: /50 1 C(att 0Y1(/C
City A4'l&tnll 6eci_cl State P Zip 32233 Phone (goLi)4CI-2Sg3
E-Mail °tin-telist P kia1,Do..torn
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information2
Name of Company: n`C Qualifying Agent: , ' it
Address_ City r State Zip I
Office Phone Job Site/Contact Number I
State Certification/Registration# E-Mail i JUN - 2 2117 I
Architect Name&Phone# I
Engineer's Name& Phone# L-2
Workers Compensation —____._._
Exempt/Insurer/Lease Employees/Expiration Date
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 YOUR NOTICE OF COMMENCEMENT.
iti/h--, --eC-1102c_ n 1 c,
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed) before me this2'U dayyof Signed and sworn to(or affirmed) before me this day of
211.14 - 20 ,by - (i GL s► , by
I
t JEREMY KNEESSI -`�
°' Notary Public -State of Florida (Sign to hof trot ) (Signature of Notary)
so, e Commission # GG 062536
--;',',e,........... MyComm. Expires Jan 12,2021
nr ;.�� P
[ ]Personally Known OR [ 1 Personally Known OR
roduced Identification [ ]Produced Identification
Type of Identification: I 'L ' Type of Identification:
s
J ; - `r
'� '�" CITY OF ATLANTIC BEACH
4J%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 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
AA1hR 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. a
II. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, 0
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE U
PURCHASED. W
U
III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO (L
OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY (L
EMPLOY ON THEIR IMPROVEMENT TRADES.
0
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 Lii
IN
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN Z
OWNER-BUILDER PERMIT. Q•
= J Z
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ADDRESS75C) I(�- -CIai� Orly- . (g0,-1 )y -
S� 2553 •
•
W o o
PHONE NUMBER 0 m Q O W
PRINT AME
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SIGNATURE DATE Q H co
CC Z
2).4Before me this � day of li ka 20 11 in thOe ty of U.
w
Duval,State of Florida,has personally appeared herin by himself/ ers and affirms that w
all statements and declarations are true and accurate. 0 0 W W
a cc m
Notary Public at Large,State of 'FL .County of 'DU VQ \ � W 5 CI
w.04
❑Personally Known I .oti c�!'i,, JEREMY KNEESSI VSA W
Sic-Produced Identification-�' �'D� k r �� °�= Notary Public-State of Florid ¢ �
7 �, P� Commission#GG 062536
,' "%',, ,p My Comm.Expires Jan 12.201 CC
Notary Signature: 6 11
F:BLDG/Owner-BuilderAtfndnvit;• 'SED:4/16/2009
3 "
►UN232017
R.O.W.Permit Attachment of for
R.O.W.Permit# l=N Ch I 1 y issued ,20 Atlantic Beach,FL
Owner's Name: ftrY1
Property Address: —7 Sb r.'1 n mut,
m ut, 1 J�
Subdivision: 1 JUN 2 2 2017 [�
R.E.#: � �
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT, issued on this ;49/'''1 day of
Il,h-ft- , 2017 , by Atlantic Beach, Florida, a municipal corporation organized and existing
under the laws of the State of Florida,hereinafter referred to as "CITY" and Am
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).
IS
This work is generally described as: Pence_ I, sh416 hot-,
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:
-1 5 0 (Ltd. Ov 1 Uc, A t LA" h-L. et 4.L.1,t c-L 32:2-3
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 and SIGNED this 22iid day of 11_1"A. , 20 (1 .
By:
Prope Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this aas day of cruor,./_ , 20 11-, personally appeared before me, a Notary
Public in and for said County and State, FL tu-Ta (Ai/ct , the property owner of
SSU P.P fiin O iJL. , 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.
. I 1r
No : Publi 4 n ft 1.aid County and State
d _,
p NI
JENNIFER JOHNS ON
•, i MY COMMISSION N cc 042984
, EXPIRES:October 27,2020
1NuM Bonded Thru Notary Public Underwriters
iur
CITY OF ATLANTIC BEACH,FLORIDA,
a municipal corporation:
Approved:
46,
co "i Tams irrr
Interim Public Works Director
File: 12/12/16
Page 2 of 2