1712 SEA OATS DR - FENCE � rA
(r.-)' ,..`Sd CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J it e ATLANTIC BEACH, FL 32233
'''.--r;; > INSPECTION PHONE LINE 247-5814
FENCE WALL OR BARRIER - FENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: FNCE17-0089
Description: 6' FENCE
Estimated Value: 1000
Issue Date: 12/18/2017
Expiration Date: 6/16/2018
PROPERTY ADDRESS:
Address: 1712 SEA OATS DR
RE Number: 172020 0438
PROPERTY OWNER:
Name: ALTER! WALLACE ANTHONY
Address: 1712 SEA OATS DR
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.
ri,.a,��f��, City of Atlantic Beach APPLICATION NUMBER
s ,t, Building Department (To be assigned by the Building Department.)
800 Seminole RoadN I _ OO�n
;, Atlantic Beach, Florida 32233-5445 l 7
Phone (904)247-5826 • Fax(904)247-5845 /7/t''� 0-sj;t E-mail: building-dept@coab.us Date routed: 17
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 171 � S -P'c CDC-ViS Department review required Yes No
(TBuildin
Applicant: CDCL)k7 G-1e . anning &Z no in
Tree Administrator
Project: CO ( FCK)C,,E, ublic Works
ub4icUhhties )
ic-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: rif pproved. ❑Denied. ❑Not applicable
(Circle one.) Comments:
B ILDI
PLANNING &ZONING
Reviewed by: ril y-- Date: /.3 ./67 '0
TREE ADMIN. Second Review: I jApproved as revised. ❑Denied. i INot applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I lApproved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
01-ty rir, City of Atlantic Beach APPLICATION NUMBER
as f � Building Department (To be assigned by the Building Department.)
- 800 Seminole Road t N ( _ oo8r)
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
art Er E-mail: building-dept@coab.us Date routed: I 7 /71( 7
City web-site: http://www.coab.us - - -
APPLICATION REVIEW AND TRACKING FORM
Property Address: 17 ( �� C:)c Department review required Yes No
(Idm
Applicant: CD(..0 Pt ning &Zonin
Tree Administrator
Project: CO Iublic Works
ublic Utilities
Pu .c-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. I 'Not applicable
(Circle one.) Comments:
BUILDING
PLANNING & ZONING Reviewed by: Date: Z—� - ( )
TREE ADMIN. Second Review: A roved as revised.
pp ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: nApproved as revised. F 'Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
ri1:Lv;yJCity of Atlantic Beach APPLICATION NUMBER
-•_1 Department DEC 0 $ 2017 (To be assigned by the Building Department.)
800 Seminole Road 1 N ( _ D08()
Atlantic Beach, Florida 32233-5445 l
Phone (904)247-5826 • Fax(904)247-5845 /71(ri%' E-mail: building-dept@coab.us Date routed: � 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: ( 7 ( . Sic\ CIDATS Department review required Yes No
(Buildin
Applicant: CDL/L.)k.) anning &Zonii
Tree Administrator
Project: CO t 'EK)C, ublic Works
ublic Utilities
Pu .c-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: I4Approved. Denied. I INot applicable
(Circle one.) Comments:
BUILDING
•
PLANNING &ZONING Reviewed by: Date: �������,
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
5,:�,tCity of Atlantic Beach APPLICATION NUMBER
�s � Building Department 8 (To be assigned by the Building Department.)
I _ 800 Seminole Road FEC C. 2017 --N ( oO Cz
-� �� Atlantic Beach, Florida 32233-5445 t 7 — 8
Phone (904)247-5826 • Fax(904)247-5845
011 y? E-mail: building-dept@coab.us Date routed: I Z /7 It 7
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 17 ( 7 SU\ EATS Department review required Yes No
(luild�g
Applicant: c LA3/v ie 91'anning &Zonin .
Tree Administrator
Project: CD ( I0CGublic Works
_�ublic Utilities
P ibtie-Safety
Fire Services
Review fee $ Dept Signature �Cw-..,
Review or Receipt
Other Agency Review or Permit Required 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 /G� � I Z1 (7
Reviewed by: Date: 111
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. LI Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
Building Permit Application U dated 5/5/17
.46 City of Atlantic Beach OFFICE COPY
Jv 800 Seminole Road, Atlantic Beach, FL 32233
I
j � OV-L"
(904)247-5826 Fax: (904) 247-5845 cam^
Job Address: D �� � Permit Number: F 1 aE (7- oC)5
Legal Description RE#
Valuation of Work(Replacement Cost)$ /000' 00 Heated/Cooled SF >) A Non-Heated/Cooled uA
• Class of Work(Circle one): New Addition Alteration Repair Move Demo Pool Window/Door
• Use of existing/proposed structure(s)(Circle one): CommerciaResidentia
• If an existing structure, is a fire sprinkler system installed?(Circle one): Yes (NZ' 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: s
Florida Product Approval# for multiple products use product approval form
Property Owner Information L
Name: 1Ne1I A Ce. Alf€lel Address: I 412 Jc
a!A 0A-is Dirt v e
City tictiztvt. k i G. la in LState fr t._ Zip -1, z 33 Phone qOy . $51 . 1113
E-Mail �/�+�(�Ace . ��"►Q v1s i4A"i1. C o►�.�
Owner or Agent(If Agent, Power of Attorney or Agency Lett Required)
Contractor Information
Name of Company: GV-QeL �A./4�. L Q JSc l - &GQualifyin Agent: I�rah-d s►^ C 5I t^ (
Address Ix 1y2I2 c;),„ r. 1. pg.. 'Jo. City J c fr .v;i(e State FL. Zip 322 ?
Office Phone qO9 -LI(et -1 %S Le Job Site/Contact Number
State Certification/Registration# E-Mail 8 ra(i &" o+ 6 r€ej. ec.., j Gk_ceTset...
Architect Name& Phone# AM-
Engineer's Name&Phone# A/A
Workers Compensation G 7-011- - ( 00 1- 1T)
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 Co ractor)
(including contractor)
Signed and sworn to (or affir -d) before me this . day of Signed and sworn to(or affir fined)before me this day of
1)-e LIvb. ' , 201- ,by , ,c '� t , 1�
- 1111k
S111gatu o__Nolan')'-- "' (Signature of Notary)
'Y` MY COMMISSION i FF 9124951
EXPIRES:October 6,2019
Bo
Notary PublicUndewrierc
[ ]Personally Known OR ] Personally Known OR
[ ]Produced Identification /+ 3 j Q ( 2
� v [ ]Produced Identification
Type of Identification: (.4. lg (� 0 -33 7'Type of Identification:
rS y.1i1 ,_
•J •
,
CITY OF ATLANTIC BEACH
)�L I0%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$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.
FMt2- Se, oars -l>ci .,, .e_ i0,-( ttlI f( 9
ADDRESSPHONE NUMBER
1 lac 6.(. M ' evi
NT NAME
ii rr.,.. --. .1____ - - 1 2-/1--/ I 1-
SI ATURE DATE
Before me this - day of ,11?C Zi44,6",Y/,20c1 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 T` ( ,County of )V 0—
❑Personally Known A r,. m�—„ :
❑Produced Identification- 3 6-l �r I- g 2 -33 7- ' - '=�i0.,..a"� '
' __ TONI GINDLESPERGER
,
rMMMlSSION#FF 924951
c� = U EY P RE`' October 6,2019
NotarySi nature:
F:BLDG/Owner-Budder Affadavit;REVISED:4/16/2009 L F • u; cd. In,atary P�..�ub cU�trrt
e
1111
rs
y,+
ORDERED BY: _
The Law Offices of Rod Schioth °�' .
2187SThird St
Jacksonville Bch, FL 32250 A ' '4,;„ 1.
904-372-9351 __"___. —_ - .
beach®rod-law.com
PROPERTY ADDRESS:1712 SEA OATS DRIVE ATLANTIC BEACH,FLORIDA 32233 III SURVEY NUMBER:FL1410.2936
fir
FIELD WORK DATE:10/28/2014 REVISION DATE(S):(REM 0 10/29/2014)
TABLE: C-I C-2
FL1410.2936 L-15 5°52'23'E 31.33'(P) R=4704.38'(P4M) 8-a,-. R=4704.38'(P4M)
BOUNDARY SURVEY 5 6°1 6'14"E 31.33'(M) L=192.86'(P), 192.98'(M) 5i: L=65.10'(P),65.02'(M)
L-2 N 5°52'23"W 70.00(P) A=2°20'56"(P).2°2 I'0 I"(M) A=0°4734"(P),0°47'3 I".(M)
DUVAL COUNTY N 6°075 I"W 70.09'(M) CH=5 04°1 8'08"E 192.85'(P), O CH=S 05°5223"E 65.10'(P),
L-3 N 6°I G'1 0"W 5.00'(P) 5 04°09'58"E 192.96'(M) S 05°53'1 4"E 65.02'(M)
• N 6°23'38"W 5.08'(M) 'L ..
N 84°2184°20 1'02"8'E 137.E 7(M) 04
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I hereby cert' rVgoukiASry -y of the hereon r Ncc O/No.o ii° rO,t r-RA.1el.D
described r ro.-r19 hasproa madeu i- my direction,
and to th:.,st pf my knowledge and b-li:f,it is a true
and accu at•rejY,'eserltation of asame t .t meets the h ST�F ET
standard-..practice-set fbrtttby the a Board of / t n A f\
Professio •urveyo6sr;Tbappers In r:-.pier 5J-17 of �5o N v v J
the Florida r,'istraf tiRte. , '
s�oH $ 3a 20 IO O I5' 30
Wesley B.Haas "� �� ,�,N tl ,
Slate of Florida Professional Surveyor and Mapper GRAPHIC SCALE \ ` /
License No.3708 I inch=30 feet '\.10%
ll re of This Survey for Purposes other than Intended,Without Wratten Verikat inn,will beat the User's Sole Risk and Without Liability to the Surveyor.
Nothing hereon shall be Construed to Aloe ANY Rights or Benefits to Anyone Other than those Certified.
FLOOD INFORMATION: POINTS OP IN LERESF
BY PERFORMING A SEARCH WITH THE LOCAL GOVERNING NONE VISIBLE
MUNICIPALITY OR WWW.FEMA.GOV,THE PROPERTY APPEARS TO BE
LOCATED IN ZONE X.THIS PROPERTY WAS FOUND IN THE CITY OF
ATLANTIC BEACH,COMMUNITY NUMBER 120075,DATED 06/03/13. JAN SHIELDS ANGELA BRADLEY
REFI-OR" REPLlO;"
CLIENT NUMBER:RS14-2509 DATE: 10/29/2014
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LUYER:WALLACEANTHONYALTERIE —_— -1
904.853 2004 904.511/016
[FELLER:MOSHE SHIMSHONI - JA8SHIELOS®1IA1S0RREAL1YCORRCON ANGELABRAOLEYRfAUORIyGRAILCON
I CERTIFIED TO:WALLACE ANTHONY ALTERIE;THE LAW OFFICES OF ROD
L SCHLOTH,P.A.;OLD REPUBUC NATIONAL TITLE INSURANCE
COMPANY;HOMEBRIDGE FINANCIAL SERVICES,INC.
Land Surveyors, Inc, www.exactalund.com
P.866-735e1916•F.866-7442887
This is page 1 of 2 and is not valid without all pages. LBS 7337 11940 Fairway Lakes Drive,Suite 1•Ft.Myers.FL 33913