381 3RD ST - FENCE i!,„,.,:ri.,
i4ip, �' , CITY OF ATLANTIC BEACH
-,`' 0 800 SEMINOLE ROAD
,� v ATLANTIC BEACH, FL 32233
-.o;3 sf INSPECTION PHONE LINE 247-5814
FENCE WALL OR BARRIER - FENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: FNCE17-0079
Description: 6' FENCE
Estimated Value: 2051
Issue Date: 11/29/2017
Expiration Date: 5/28/2018
PROPERTY ADDRESS:
Address: 381 3RD ST
RE Number: 169824 0020
PROPERTY OWNER:
Name: BEW DAVID FITZSIMONS JR
Address: 381 3RD ST
ATLANTIC BEACH, FL 32233-5231
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.
CrLvf City of Atlantic Beach APPLICATION NUMBER
iiiia� Building Department (To be assigned by the Building Department.)
i. 800 Seminole Road 1 ^ ,C e 17
+ OQ7C�
-0 Atlantic Beach, Florida 32233-5445 `�! r- Phone(904)247-5826 • Fax(904)247-5845
il �? E-mail: building-dept@coab.us Date routed: ' t
11Colt7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
8 ( Department review required Yes No
I,
Property Address: 3c7 3 — sp q
ld in
Applicant: CD W - ere__. anning &Zoning
Tree Administrator
// ( " •lic Work
Project: LO (— E1�CE
'.. is Utilities')
..lic 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: di; proved. ❑Denied. ['Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONINGReviewed by: Date: ' Z d
J
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
?S�ali: City of Atlantic Beach APPLICATION NUMBER
(cBuilding Department (To be assigned by the Building Department.)
800 Seminole Road 1 n ,cEV r 0079
` 0 Atlantic Beach, Florida 32233-5445 t�J 7
,\ Phone(904)247-5826 • Fax(904)247-5845 AR` `
JR �? E-mail: building-dept@coab.us Z017 Date routed: I. l Co /1. 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 38 [ 3r y Department required Yes No review( p
uilding�
Applicant: CD W Iv C2 ning &Zonin
Tree Administrator
// � t , u lic Work
Project: Lo (— �7(' E
is Utilities
tilic 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 b J44k__ Date: /fraij
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
i!,i-Lyjie, City of Atlantic Beach APPLICATION NUMBER
Js. A Building Department (To be assigned by the Building Department.)
r • 800 Seminole Road ^ 1 n C - OQ��
c� Atlantic Beach, Florida 32233-5445 NOV F`�J C.
yr
� -� Phone(904)247 5826 Fax(904)247=5M4-5- 6 �Q��
01119? E-mail: building-dept@coab.us Date routed: IL 1Lcit7
o it 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 38 I, 3r 8 ( p required( Department review re uired Yes No
uildingTh
Applicant: CD W N Cie—. Manning &Zonin)
Tree Administrator
// t ,
Project: �O F E1'C E 40.1i or
'.. is Utilities
'..lic Safety
Fire Services
Review fee $ f 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: if I LI (( T
TREE ADMIN. Second Review: [1]Approved as revised. ❑Denied. ['Not applicable
P 1.1 ORK Comments:
'UBLIC UTILITIES
//—17 -17
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ['Denied. ['Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
i!.:�,`1r City of Atlantic Beach APPLICATION NUMBER
j r Building Department (To be assigned by the Building Department.)
r 800 Seminole Road n 1 n�- OD-79
Beach, Florida 32233-5445 `�J G
V. Phone (904)247-5826 • Fax(904)247-5845
�0;3 9',' E-mail: building-dept@coab.us
Date routed: i L / I Co /I, 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 38 1 3 — &...._ Department review required Y7.,NoNo
uildinq
Applicant: CD W N Et?-__. _ arming &ZoningD
Tree Administrator
// �
( , •lic Work
Project: Lo (— �Ip .
•• is Utilities
•.lic 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: fri Date: /l'a 'i 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
s..}-',� Building Permit Application Updated 5/5/17
FFICE COPY City of Atlantic Beach Pi-4 l'h `� �� ��-
_� 800 Seminole Road, Atlantic Beach, FL 32233 Sp dfi'' I� -` �L �<<,,�a
�/ Phone: (904) 247-5826 Fax: (904). 247-5845 6-f 13K �� �
Job Address: 3O j 3 rG( ( �IJj Ill. J a'2 r Plermit Number: qo t �4�-2 9 7 T
Legal Descriptior 6,-P If- z - -1-76 I, /. R, 2_.c0{-4-_c+- hof 301 5 RE# r NQt 7- O(in
Valuation of Work(Replacement Cost)$ a-,/n3-1 Heated/Cooled SF Non-Heated/Cooled
• Class of Work(Circle one): New Addition Alteratio Repair ove emo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): Co la Resident'
• If an existing structure, is a fire sprinkler system installed?(Circle one): YesNo 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: bo
O �f v-,�� ��,v`e 6N P S+- S`ole o e l/'l er-i-- �'
Florida Product Approval# for multiple products use product approval form
Property Owner Information
--7--
Name:
( Q� rr
Name: (-Xc V i 1 1 . ¢c'_ J v- Address: 3�l 3 5 (,,, A4-14.)--c'
4 c III 1-4 D..2.3__.)
City 4 ■' II State {� L_ Zip 3 '-3 3 Phone Yb ^ ,Z1-(r6 - -,r/'y f-
E Mail LACe V4/ l�!~ �)2 T
Owner or Agent(It A gent, PobTer of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Qualifying Ag-• :
Address City State Zip
Office Phone Job Site/Conta umber
State Certification/Registration# E-Mail
Architect Name& Phone#
Engineer's Name& Phone#
Workers Compensation
E pt/Insurer/Lease Employees/Expiration Date
Application is hereby made to obtain a permit to .• 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
RECOR NG YOUR NOTICE OF COM CEMENT.
.f, */
(Signature of Owner,r Agent) (Signature of Contract•
(including contractor)
Signed and sworn to(or affirmed) before me this 14 'day of Signed and sworn to(or affirmed) b• ore me this day of
WQY4r , 1.__, by t - A'Z : k&A.eJ. i. , , by
;11:PV Pit: I
;.�..,..,A GRACE MACKEY 1 natur �f Notary) (Signature of Notary)
:,'Icii MY COMMISSION#GG 04' :9
_r'.. •', EXPIRES:October 27,2020
X: Y ! Du^-ad nr,:Notary Public Underwriters
[ ] Personally Known OR [ I Personally Known OR
[.produced Identification ,e,( [ ] Produced Identification
type of Identification: Y(.• IN
t -'S L Ce.f, Type of Identification:
•
•.1,I <. ..'�J
CITY OF ATLANTIC BEACH
,r
s 'j%WNER / BUILDER AFFIDAVIT
4:6-\ J;f1��
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.
ADD-)ckv ii . , e ,A.,, 0 r-
RESS PHO ENUMBER
PRINT NAMEf./
0 (i II?. ' . ) I ) \ li ) 34-DH 7
SIS' ATURE ►y, �1v.� r DA E
Before me this l 1 'day of 0 oJe1 2041 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.
�p!�
Notary Public at Large,State of flORUW ,County of D1-4104A
p"......"1".."7,L:e1::::,:.4,1GRACEMAC❑ ersonally Known YCOMMISSION# 2989rs
C educed Identification- D1�I t c•� �I�ICY�i� EXPIRES:October20ed Thru Notary Publrwriters
Notary Signature:
t
F:/BLDG'Owner-BuilderAffadavit;REVIS :4/16/1009 i
MAP SHOWING SURVEY OF
THE WEST 25.00 FEET OF LOT 28, TOGETHER WITH 'NE EAST 2.50 FEET OF LOT 30, BLOCK 5, '
PLAT .NO. 1 SUBDIVISION "A" ATLArTI'IC BEACH, AS RECORDED IN PLAT BOOK 5, PAGE 6910F THE
CURRENT PUBLIC RECORDS. OF DUVAL COUNTY, FLORIDA.
LOT 31 I LOT 29 (N.1r33°39'55"E. 27.71'FIELD)
N.83°42'00'1E. LOT 27
LOT 25
SET V2"IRON PIPEI FOUND I/2"IRON PIPE 'I
L.B.3672 1 27.50 1 NO CAP
• --- a K " °
r g\ $-
20.00' 27.50' 0.6 4to•s. 25.00' i
0.5'
m
NOTES N
(--
THIS IS A BOUNDARY SURVEY. o O
NO BUILDING RESTRICTION LINE o o
PER PLAT_ o
BEARINGS BASED ON THE NORTH o w O
RIGHT-OF-WAY LINE OF THIRD I I • W O
Li_STREET AS PER MILBERT I I O L W ml N 0
HOMES AS RECORDED IN PLAT '
BOOK 21, PAGE 38. '' w 10N F-to —
F
ALL FENCES SHOWN ARE 6'WOOD. 0 U.
w
In 3 x
N w
\ z
V N F I- =
w �--0.4' o O
_ W
ro N �� - <L
6:0 3rd LEVELS O 00, 2
LOT 32 1- 0. I -- BALCONY N
w I --�6_7� 1 - F- LOT 26
w X 1 9.3' O
0-
to w >QI o
I-
W F-
w c JAI W
LL
tli
O O U ' ° ° IL
LL. U 5.�' — O to •'
W I-
I-- O N
t1 of __ ; li. h7 c 8o I LL1 w
w
I ro
O
I ► _ O JZ I 8 „.
3.5.3'
a N co ' »c ,,
w — I W ltJ C�
w o O JJ z 1.3 = _ O
(Tl w I H ,0 (D t CL 06 = - CD
I z O � 0 o O
1 Z E-- 0
1 L_ N
o �. ' N
....
3, 20.4 7.a'
0,1' •,8ALC0 Y •
-.
Ill •— —
•':;'CONCRETE.? x
DRIVE .:
AND
WALK Oi
. 0.7'
122.75' 20.00' 27.50' 25.00'
-t- ,
SET V2"IRON PIPE-' 27.50' `-FOUND I/2"IRON PIPE
L.B. 3672 NO CAP
S. 83°42'00"W.
(27.47'FIELD)
THIRD P°yio STREET
THE PROPERTY SIICMJN HEREON APPEARS TO LIE IN FLOOD ZONE "X" (AREA OUTSIDE 500 YEAR FLOOD
PLAIN) AS WELL AS CAN BE DETERMINED FROM THE "FLOOD INSURANCE RATE MAP" FOR ATLANTIC
BEACH, FLORIDA.
I HEREBY CERTIFY TO DAVID F. AND ANGELA W. 13EW, ST. JOI-INS MORTGAGE AND INVESTMENT; CORP-
ORATION, TITLE INSURANCE OF MINNESOTA THAT I HAVE SURVEYED THE LANDS AS SHOWN IN THE
ABOVE CAPTION AND THAT THIS MAP IS A TRUE AND CORRECT REPRESENTATION OF THAT SUY AND
THAT THE SURVEY REPRESENTED HEREON MEETS THE MINIMUM TECHNICAL STANDARDS OF THEFLORIDA
ADMINISTRATIVE CODE CHAPTER 21-HH-6 AND THE FLORIDA LAND ' TLE ASSOCIATION. ‘
THIS SURVEY NOT VALID UNLESS DONN W. BOATWRIGHT, L.S. `-
SEALED WITH AN EMBOSSED SEAL FLORIDA REG. LAND SURVEYOR No. .3295
OF SURVEYOR SIGNED HEREON
SCALE: A���'
I" 20' BOATWRIGHT LAND SURVEYORS, INC. DATE: NOVEMBER 15, 1991
DRAWN BY swc 1711 5th STREET SOUTH
FILE: 91 -678 JACKSONVILLE BEACH, FLORIDA 241-8550 SHEET 1 OF I
MI esimummise im® onimminsimI misimmis =MO! 1152111111•10111 . Ii;