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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;