345 1ST ST - FENCE ,6'i CITY OF ATLANTIC BEACH
�� 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
1-0;319INSPECTION PHONE LINE 247-5814
FENCE WALL OR BARRIER - FENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: FNCE17-0029
Description: install 6-foot fence
Estimated Value: 9300
Issue Date: 6/28/2017
Expiration Date: 12/25/2017
PROPERTY ADDRESS:
Address: 345 1ST ST
RE Number: 169766 0000
PROPERTY OWNER:
Name: AVENS MARK
Address: 345 1ST ST
ATLANTIC BEACH, FL 32233-5227
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.
City of Atlantic Beach APPLICATION NUMBER
� Building Department (To be assigned by the Building Department.)
` 800 Seminole Road
Oci —`- - Atlantic Beach, Florida 32233-5445 f r ni CE (1-OOa
Phone(904)247-5826 • Fax(904) 247-5845
E-mail: building-dept@coab.us Date routed: 0 (Q Ca ( 1 0.-
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 34-C t 5-1-. Department review required Yes No
Applicant: d -nnin2 &Zoning
Tree Administrator
Project: 1 n S--GU( (0-.o r4- � �PubIic o
blic Utilitie
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. ❑Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING & ZONING
Reviewed by: Date: 2l t1
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
0!..J `ori„ City of Atlantic Beach
ill
�� Building Department APPLICATION NUMBER
c)
800 Seminole Road (To be assigned by the Building Department.)
(,"
.5, Atlantic Beach, Florida 32233-5445 -00ci
Phone(904)247-5826 • Fax(904)247-5845
�0;3 E-mail: building-dept@coab.us Date routed: 0(g t 1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 Lig t S'�'. Department review required Yes No
gaguziakw
Applicant: d (Pinnin &Zonin.
Tree Administrator
Project: c S-k-Cat �C CD 0-F UL Public oW �
blic Utih ie
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. ONot applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING
Reviewed by Date(jZ ( 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
-51-11,`PrCity of Atlantic Beach
1 Building Department
i'•""" APPLICATION NUMBER
800 Seminole Road JUN 1 (To be assigned by the Building Department.)
2111/
Atlantic Beach, Florida 32233-5445 Fnf CE O(
a
Phone(904)247-5826 • Fax(904)247-5845
V
'401130. E-mail: building-dept@coab.us - ---- Date routed: 0(g Ccs( 1
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 Lig � S�'. Department review required Yes No
Applicant: d W r L renins &Zonin.
Tree Administrator
Project: 1 (l SA-C.tt 6-.60+ pv nom. 4 Public or
.4 blic Utili ie
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: 14proved. ❑Denied. ❑Not applicable
(Circle one.) Comments: 4 4( j4 / , tai
BUILDING L
PLANNING & ZONING /�
Reviewed bye` Date:4,✓22 V
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
c1-=1,`ir. City of Atlantic BeachAPPLICATION NUMBER
�� Building Department (To be assigned by the Building Department.)
=-"- \•� 800 Seminole Road. -- r� Atlantic Beach, Florida 32233-5445 F/J CE (.-OOa c,
Phone(904)247-5826 • Fax(904)247-5845
\\01.051 E-mail: building-dept@coab.us !;` Date routed: O(e 13 t ( (-4_
City web-site: http://www.coab.us
APPLICATION REVIEAND TRACKING FORM
Property Address: 3 L-CS- ( 54. Department review required Yes No
Applicant: d W n-Q..( annin & Zonin•
Tree Administrator
Project: sk n SA--Ga t 6-4 o 0 •¢..{tom Cubli
Pc or
' blic Utili ie
Public Safety
Fire Services
Review fee $ l Dept Signature X
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 CATION STATUS
Reviewing Department First Review: Approved. ❑Denied. Not applicable
(Circle one.) Comments:
BUILDING
PLANNING & ZONING / (4,(2-3
Reviewed by: 4? Date: f 7
TREE ADMIN.
Second Review: ❑Approved as revised. ❑Denied. ❑Not applicable
511WORKS Corn, ents:
UBLIC UTILITIES
60-20-0 7
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
f%� Building Permit Application• Updated5/5/17
v ' :;;. o City of Atlantic Beach •
800 Seminole Road,Atlantic Beach, FL 32233
Phone: (904) 247-5826 Fax: (904) 247-5845
Job Address: I`SGGA? Permit Number: f /) C-6(1- — 00 aci
Legal Description RE#
G� ��/ G 0
Valuation of Work(Replacement Cost)$ /,c_ 'c2/ - Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition 'I erotic:), Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Commercial ardent'.
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No
• 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:
cer-)2/-2 74 0',1. C 6GL'Cl /
Florida Product Approval# for multiple products use product approval form
Property Owner Information
{v/
Name: 1 T/ .44ie s-S Address:
City /97/Cri-77`7C State ,L Zip 0),$$ Phone ?G/ ft
E-Mail "7--2.%/ -/f_ i7' %fes <
Owner or Agent(If Agent, •iit' r X br tiAgni.Fy Letter Required)
Contractor Information`s 1" ♦ 7
73/
1
Name of Company: ' >{ Qualifying Agent:
Address 14 IANN t City State Zip
Office Phone / 2°1. Job Site/Contact Number
State Certification/Registration# E-Mail
Architect Name& Phone ft
Engineer's Name&Phone# •
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.
(Signature of Owner or Agent) (Signature of Contractor)
(including contractor)
Si ned and sworn to(or affirmed)before me this&t day of Signed and sworn to(or affirmed) before me this day of
JL4 - , ZD ,by Mw '. A\IkAS , by
Signature Not ) (Signature of Notary)
JENNIFER JOHNSTON
*: MY COMMISSION A GG 042984
EXPIRES:October 27.2920
[ ]Personally Known OR "'•%!;g i'•P• Bonded ThruNotary PubGcUnderwriters ]Personally Known OR
[Produced Identification i ►, ] Produced Identification
Type of Identification: Cir tv� S \t t_P.Y,Sk Type of Identification:
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� - \''\� CITY OF ATLANTIC BEACH
r/1 il WNER / BUILDER AFFIDAVIT
--0_1_,.„19."-
•1°%
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 TI-IE 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 $5,000 PENALTY UNDER FLORIDA STATUTE NO.
455-228(1). AN"OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS
CERTIFICATE" TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826) IF IN DOUBT.
V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE
STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN
OWNER-BUILDER PERMIT.
Y\S`" /(-5-74 s77g€ 74 9 •L/-e6'6 - /Oo
ADDRESS PHONE NUMBER
r2�oi CM /9,/€c? S
PRINT NAME
DATE 1/ 7
SIGNATUREA
Before me this v day of J a n t. ,2O1 In the county of
Duval,State of Florida,has personally appeared herin by himself/herself and affirms that
all statements and declarations are true and accurate. (� f
Notary Public at Large,State of rt .County of iJ�V C-1 r
❑Personally Known �p ` ` r �E;; JENNIFER JOHNSTON
,B�Produced Identification- a (A J y S V t L IQ A J Q *, wi M1 COMMISSION#GG 042984
��,, EXPIRES:October 27,2020
'•:4,,,I,,;:.' Bonded Thru Notary P;,bl,c Underwnlers
Notary Signature: �^(L, 6..,.... __. y
F:BLDG/0,,�ndiuitderAffadavi •VISED:4/16/2009
NOTICE OF COMMENCEMENT
State of //Or/nia County of /D c////'/ Tax Folio No.
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of
the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: S-4"j I -c2$-a�E i/gh/,C za417C1,
14/ q'/ITLOT 1y .6-,w,gf1 L 27 /b R XS
Address of property being improved: -3 y.S--- 1/-5-'4 ,_S-71-,g¢--1- ,, .4,zJc;,n yc,,C faorftti ,Z2.
eneral description of improvements: '4-i/e'rC✓,-.7 .0.e4S, `i i-, s lyaad --,CP /i-, 'L,2
ba y yClcJVsveyo vndj-y /•74'!/CC ,
1( e Owner: //1t�,y{,` .4v12reS Address: 5/1/45-- /-sem- S7` - '714//771i' ,BPA-'h,�L
( - Owner's interest in site of the improvement:
Fee Simple Titleholder(if other than owner):
Name:
Contractor: ,5-tJfi P.i s i,c �.2 h Cf il ye,all 04- .44.; A orGev,;1 j/ 2-4C.
Address: S 70 /74s e , cA5e0i1 .iie �Az _fa a45-9
Telephone No.: 9 oN (a& eve- 63 V Fax No:
Surety(if any)
Address: Amount of Bond$
Telephone No: Fax No:
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida, other than himself,designated by owner upon whom notices or other documents may be
served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
• Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one t i t from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER •
Signed: i`dZd ._(7 Date: 6Alf/i 7
MIRIAM GRIFFIN Before me this 1< of '7U A �- in,the county of Du6a1 State
o" R"G Notary Public,State of Florida Of Florida,has per a!I_. . ared CM—K— v
�� Commission#FF 163906 Personally Known: __ / or
'��'' My comm.expires Oct.14,2018 Produced Identification: �r r
Notary Public: , • i`d-►.yt C.Pl 1 ''-7 •
Doc 2017151593, OR BK 18034 Page 1802, My commission expires: , 11- / T— 2 el
Number Pages: 1
Recorded 06/28/2017 at 01:43 PM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00