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750 CAVALLA RD - FENCE 4' 1#: CITY OF ATLANTIC BEACH ` r 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 NO: FNCE17-0078 Description: 4' FENCE Estimated Value: 1000 Issue Date: 11/30/2017 Expiration Date: 5/29/2018 PROPERTY ADDRESS: Address: 750 CAVALLA RD RE Number: 171365 0320 PROPERTY OWNER: Name: BARBAGALLO ANTHONY M Address: 750 CAVALLA RD ATLANTIC BEACH, FL 32233 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 s4,95/ City of Atlantic Beach APPLICATION NUMBER t �s� Building Department (To be assigned by the Building Department.) .?•;1*‘;Lt. 800 Seminole Road - r� .:;,, :-�r Atlantic Beach, Florida 32233-5445 � N(�.[—� l J 1, 7 - _/.�j . one •i, - : . • ax •I - - / r�,;17p- E-mail: building-dept@coab.us Date routed: I ( if (0 / 1 7 City web-site: http://www.coab.us ((( APPLICATION REVIEW AND TRACKING FORM Property Address: 'X) CfvI2L,LM �� tc artment review required Yes No uilding2 Applicant: O annm &tonin p p �� i� �-6z. Tree Administrator Project: - r i\--) ublic Works _ ublic Utilities Public Safety Fire Services Review fee $ Dept Signature ~T{ 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: rl<A—pproved. ❑Denied. ['Not applicable (Circle one.) Comments: BUILDING Reviewed by: ,�— Date: fr--2'1-1 -1 TREE ADMIN. Second Review: Approved as revised. nDenied. 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 City of Atlantic Beach APPLICATION NUMBER (1411,- Building Department E ; T ,,,(To be assigned by the Building Department) a... , 800 Seminole Road r Atlantic Beach, Florida 32233-5445 [i,1 NOV 1 ' V / f __ Phone(904)241-5826 • Fax(904)247-5845 401 f - ter11 `' Date routed: ( /1 / 7 t13i '' Email: building-dept@coab.us 1, (o / City web-site: http://www.coab.us �`— ! APPLICATION REVIEW AND TRACKING FORM Property Address: "7SO 1-<,D De artment review required Yes No uildinq� Applicant: (O / arming &Zonin� _ Tree Administrator Project: ( f �`3(1 ublic Wor CPublice-(i i ted Public Safety Fire Services ;Review fee $ eK 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. �ot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: l./ Date: I( TREE ADMIN. Second Review: Approved as revised. ['Denied. ['Not applicable P ..410' WOR Comments: L.C�U�T TtE�S PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. ❑Denied. ['Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 vyCity of Atlantic Beach APPLICATION NUMBER S r --,::.,r Y3, Building Department -. (To be assigned by the Building Department.) f r{s,-, 800 Seminole Road /`'� 'Atlantic Beach, Florida 32233-5445 �� ('. 7 l t 7 Phone(904)247-5826 • Fax(904)247-5845 ri,,;.I j E-mail: building-dept@coab.us Date routed: 1 1 f City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 7 so 0_,v,„GER R3 De artment review required Yes No _' iaildin . Applicant: OW /0 c = arming &Zoniri Tree istrator Project: t r" ��aG, .Y Public 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 First Review: 2-proved. ❑Denied. ❑Not applicable (Circle one.) Comments: 3 IRA-a-- PLANNING &ZONINGc , Reviewed by: Date: p96 f 7 TREE ADMIN. Second Review: Approved as revised. ❑Deni . nNot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. nNot applicable Comments: Reviewed by: Date: Revised 05/19/2017 , z++°lfz . City of Atlantic Beach APPLICATION NUMBER A'c1 Building Department ••(To be assigned by the Building Department.) ' 2 800 Seminole Road ;I --�� r Atlantic Beach, Florida 32233-5445 �; NOV^ — Phone(904)24/-b826 • Fax(904)24/-b845 �l �a 6'� 6 L 2 ii +� ?qul;;3R�r7 E-mail: building-dept@coab.us Date routed: ! I (� i I 7 City web-site: http://www.coab.usLY:____________________ e'er ; ' APPLICATION REVIEW AND TRACKING FORM Property Address: 7Lc aR-vi3iLLA i.<3 De•artment review required Yes No . uilding Applicant: OW /0 CZ. ,-PrEnning &Zoning _ Tr-- _•• •istrator Project: / 1-- i -)0 v t-i?ublic.Wor ���� 'u•lic Utilities Public Safety Fire Services !Review fee $ ------ Dept t Si nature !Y 7 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: r Date: #:-/7--/7 TREE ADMIN. Second Review: ['Approved 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 05/19/2017 � Building Permit Application , OFFICE C O PYr _Pr City of Atlantic Beach 800 Seminole Road,Atlantic Beach, FL 32233 'i% Phone: (904)247-5826 Fax: (904)247-5845 Job Address: 7Co Cad r-;11IQc-si Permit Number: F/V (_El [ -00 7 8' Legal Description law r kar.14 RE# Valuation of Work(Replacement Cost)$ Heated/Cooled SF )11D O Non-Heated/Cooled • Class of Work(Circle one):CD 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 0 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 type of work to be performed: i. F 1-,"11, 0,1„, by .15ph is f p../t"..3 -vror ,,,,•II' w`y s kIk (—oI N ��� i,«, P0„1- CoQ,.. Florida Product Approval# for multiple products use product approval form Property Owner Information Name: k,i'1•,r1 8s16 .5aa Address: ?SG (QUr,ilc ,Q.,..,6i City /rjc.-,hc. Ae k State F-L. Zip 1J0., 33 Phone lei(, —?./Q7.— z-3 E-Mail f-Io),,hisgt 05e4.,t,1,ontn Owne or Agent(If Agent,Power of Attorney or Agency Letter Required) ik,I-1-0n\J U�c/h�jK((6 Contractor Information Name of Company: N/I\ Qualifying Agent: Address City State Zip__. — Office Phone Job Site/Contact Number c.- - State Certification/Registration# E-Mail .t 1 E 1_,— _.. Architect Name&Phone# i '. Engineer's Name&Phone# -- ,"` Workers Compensation �� + 1 4 2017 I 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 installatiori 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. A4p(Signatur of Owner or Agent including Contractgr� (Signature of Contractor) Signe sworn to('r a' m-d)before me this day of Signed and sworn to(or affirmed)before me this day of NbVeM13^2. aCt 4- \ . I'. "71.10 V/ g..e_•&,a.c 1—t-O ,by ._...i illiAL.A. 1,4-vloel.-/I"ri,'•'4 1=,14. Q SSignature of-fVotarfy) `'" I (Signature of Notary) SOS" k ALBERT MORENO f ''i P(,-0 i �, Notary Public-State of Florida `_" : !I� *°_ Commission#FF 239295 .. 9,7� �,� My Comm.Expires Jun 9,2019 [ ]Personally Known OR `�.,�ovF��..� [ij]Personally Known OR Produced Identification 1 Bonded throughNational Notary Assn[f{] •produced Identification Type of Identification: f i•-c-4 o4 "1:2> Type of Identification: _ __ - .. ORDERED BY: a _ I / I r 2 Cirf,R. dbW ,HILLEREsT IL b C,rvn:e5! 7ia!e &7 ,ge•cq V. i i F O a Oeeerrwn.s•w5 4.r r„trit.„u„`:O p TMnowns w0 O Tows 10245 Centurion ParkwayNorhISuite310 """"°° .Jacksonville:FL32256 ' 0 ne.n,® '' ®q? Or P:904-234-36461 F.904•239-3647 ..u.O / ® wwfua •" .urmra / www.HillrestTitle.com e© 22 ^ r / I . .. PROPERTY ADDRESS: 750 CAVALLA ROAD ATLANTIC BEACH,FLORIDA 32233 SURVEY NUMBER: 1703.3748 FIELD WORK DATE:3/27/2017 REVISION DATE(S):(REV.0 3/27/2017) • 17033748 BOUNDARY SURVEY DUVAL COUNTY ;� dp,, � 4 IN _____„.. .. . .........0 ars co ..___ B.R. (PER PLAT) FND. x.CUT '5 55o4I'15"E 45.3 S N 85°37'27"W 737.34' I 39.12' 3T,7�3• (� INO D N 85°37'27"W 737.5T(D) /2'FIP NO IR1=MAINDER OF , ; �• @ B.C.c I LOT I O �::r!...4,i 73.82' I (NOT INCLUDED) /I' •,•,.!..,.'::;.:.! I -o hi ilso 25'5,5.AO ` if.. _�.;.i E. 6.83 OF I r� b0 1"' IOr --' LOT 9 I N Z cci tri J ® / ij— BLK 16 1 a' 70 wW P or CZ) I •, rn I I I mN g M f r / pj� I tv N 2 STY. %NRES# El I• •' (NOLUDED) I16. I . 1 I ..rsL- ,1111. .S • V 1- I • / to to I • 1 I Ai I I CITY OF ATLANTIC BEACH '- -- . r 41%WNER / BUILDER AFFIDAVIT .`fi''''t 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. MILIL .0 Cc,vc,((. 1<oo4/ mg- 2/;L—C(7313 ADDRESS PHONE NUMBER A��r�0n, a�; �c.�,Ila . PRINT NAME ii 1) j--7 -yb 1--) SIGN T RE / DATE J 77t,i u✓"-{3D- P-- Before me this •T day of ,20P-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. Notary Public at Large,State of Ji°R 194-,County of D✓I ✓/3 r, , v '+,,, I r.-. '' :;C,�"�, "` F;LSE{I7M08EP<0,_,i_ '-i �',. P0tary?ublic-St.te ofF!crida it;'','(': C'nr, c 0 Personally Kno • � ; �"i�}`J J' Produced Idents, io ` a G1/Z i D a =1 r,', :,.,VI,', unission 1=F 239295 I( ,. -,-;,. ..--6_,, -*:,- i'iy Cornu.cxittuus Jun 9 ' ,2U"IIs ,J. n,;,,J ,..., i. 8nii��u through,rational;:'c2<�f>rlssr,. Notary Signature: C - r/t'/ fri .: . FIELD Owner-Builder Affadavit;REVISED:4/16/2009 fg Mt ,.,-14,4,. ..., 411,5i.,,.r.,,,,1".1•':4....,;',1.,-,,: VO.,' a ; I ' ''11... -,',..°N;if,-..--At",i'•i."-v:.!..,-.'..-.•,,i,;',!Izlif,i-,•...-,..-,:,. . ..; -••. • . ._ • .,.--?a,•*:,.,11-,,,,....-,:- . -. - ---.., „„-,. i As -. .. • _:.',,, .-?,-- :. -. . -01......t7 ,-,,....,, ,••- • --,••... -. ,,. ,-,,• •-• . •,.„. . /If •,,•• - • .., *, •'., '--14 -.,' . 2 .•,,, ''t 0 ipittik. , .„, . •Y•ott L•• --'4 • - . ., L.) ' ,;,..,1,' reti I, ' .i.i,--- • '1",', . ,.. . , .- . . % . 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