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Untitled �1 ' CITY OF ATLANTIC BEACH Ss1`,-.. 0 800 SEMINOLE ROAD gidit:� ATLANTIC BEACH, FL 32233 0;119INSPECTION PHONE LINE 247-5814 FENCE WALL OR BARRIER - FENCE MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: FNCE17-0095 Description: 6' FENCE Estimated Value: 1000 Issue Date: 1/5/2018 Expiration Date: 7/4/2018 PROPERTY ADDRESS: Address: 380 11TH ST RE Number: 170090 0000 PROPERTY OWNER: Name: WOOD THOMAS C Address: 380 11TH ST ATLANTIC BEACH, FL 32233-5532 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. 0.mri , City of Atlantic Beach APPLICATION NUMBER J4 - {1 Building Department (To be assigned by the Building Department.) s 8tla Seminolec Road FN C l 7 1 �� Atlantic Beach, Florida 32233-5445 ++ qc:Yi_S Phone(904)247-5826 • Fax(904)247-5845 I Z�Z—?--(1,7 -.i 0;3 9r E-mail: building-dept@coab.us Date routed: 6 1 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3E0 1 t—ti. S ( Department review required Yes No (building Applicant: Caw it . -(� - anning &Zoni . Tree Administrator Project: Ca ( FSC£ u is ublic Uti i i , 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. I 'Not applicable (Circle one.) Comments: BUILDING � PLANNING &ZONING Reviewed by:`%s.. G-•, -- /Date:f —�— I 6j 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 1..,,u flr� City of Atlantic Beach APPLICATION NUMBER (-- I:'At Building Department (To be assigned by the Building Department.) ru < 800 Seminole Road ` y ,, Atlantic Beach, Florida 32233-5445 ((S�EC 2 ? 2017 Phone(904)247 5826 Fax(904)247 5845r z Z� ,..,fil �r E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: �so i C11 . ( Department review required Yes No gUilding Applicant: OW i\_. ---(2-- planning &ZoniTnj., Tree Administrator Project: (_, ' ( FEr c E _ u lc 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: VrApproved. FIDenied. fNot applicable (Circle one.) Comments: BUILDING r / PLANNING &ZONING Reviewed b mate: 42;2 17 TREE ADMIN. Second Review: nApproved as revised. nDenied. 1Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. I IDenied. nNot applicable Comments: Reviewed by: Date: Revised 05/19/2017 rig v�r�r) City of Atlantic Beach APPLICATION NUMBER Js s� Building Department (To be assigned by the Building Department.) 800 Seminole Road FN .` y Y Atlantic Beach, Florida 32233-54459.4 iiiG Phone(904)247-5826 • Fax(904) 247-5845 I z Z---?--0j31q? E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM De artment review required Yes o Property Address: 5S0iC.-ri-= � ( q ffuilding Applicant: EC..ice--�2- ,Tanning &Zonih- Tree Administrator Project: ( Fe_m 'c ublic Uti i i , 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: r Approved. nDenied. nNot applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: /- 31:90/f TREE ADMIN. Second Review: Approved as revised. nDenie . I INot applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: I (Approved as revised. nDenied. nNot applicable Comments: Reviewed by: Date: Revised 05/19/2017 sya,yfJy, City of Atlantic Beach APPLICATION NUMBER 4s �* ' S, Building Department (To be assigned by the Building Department.) r. 800 Seminole Road �� ` 7_ ,, Atlantic Beach, Florida 32233-5445 CE Phone(904)247-5826 Fax(904) 247-5845 DEC Z 7 2O� Z Z� , l 4695 2-0;319%' E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: ago ,I Cut S ( Department review required Yes No (� Building / Applicant: C.L3 1QC—(2--- /Planning &Zo ii Tree Administrator Project: Ca F u is Warks- , -u•Iic Uti i i- Public Safety Fire Services Review fee $ #7 Dept Signature +^--N 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 ReviewingDepartment First Review: A roved. nDenied. Not applicable p I � pp (Circle one.) Comments: BUILDING PLANNING &ZONING �L Reviewed by: Date: /A-/f TREE ADMIN. Second Review: Approved as revised. nDenied. nNot applicable PUB ORK Comments: P BLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: nApproved as revised. nDenied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 114 Building Permit Application Updated 12/8/17 ' 2 City of Atlantic Beach VillW 800 Seminole Road,Atlantic Beach,FL 32233 f Phone: 904)247-5826 Fax:(904)247-5845 7 Job Address: 3'0 l ,, O. c- `• rcft, CI3 33 Permit Number: Ft c 17 O 9 S Legal Description 5-et 1e•25 -ZI� 414.44-..... &,. 44'37. F i/Z 37 Rt#'k ) Valuation of Work(Replacement Cost)$ t I C»O Heated/Cooled SF CC Non-Heated/Cooled 0 • Class of Work(Circle one): New n..itio Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial CR7sidential, • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes e) 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 tve of work to be performed: S"'rvct c.L av �v�t +l C e-z.t1 ' b b ecp Cr-Act C-trA (-4-444Leet ri4- or -1-L eaeoIt av. lx(-4- i‘olz o,P ptcp141.. q C-1- 901. L ' t1 tl.AU a.ro 9a/af►F Florida Product Approval# for multiple products use product approval form Property Owner Information t Name: oWMat 7�c Address: 320 i rat ST City /4 v\#t c ( C State FL. Zip 'IL Z 33 Phone 7b/ 7/• 79413 E-Mail 4-a,.>e�no/r l: yak6o. C.O✓vl Owner or Agent(If Agent, Power o4+Attorney or Agency Letter Required) `"`t.owtslS l cn+ocr Contractor Information Name of Company: S< <VE/m4✓\ i L /�ia 1). Qual yang Agent: L.J4 S:1'�1/M, � Address y49,� l c lt. eel' City uvlv:1, State IPL.. Zip 32207 Office Phone ctbl• 750-6882- Job Site/Contact Number State Certification/Registration# E-Mail %;I ocr 11,AaAct•eNc.L Z. sC v. i . God Architect Name&Phone# <I 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. NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property that may be found in the public records of this county,and there may be additional permits required from other governmental entities such as water management districts,state agencies,or federal agencies. 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. J 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 Contr. tor) (including o'tractor) '] ed and swo to or affirm,. .efore - this `-m • n ay of Signed and sworn to(or affirmed) •efore me this day of �7 by O MI'I NW"' by ,- ,‘I i Pa Illa G �"- •-- (Signature of Notary) s [ ]Personally Known OR _': ( * ! ; 'b"t'L'�„`el„,1CN#' 01 ]Personally Known OR r EXPII?f c:Oct.bor 6,2015 ]produced Identificati+n [ ]Produced Identification -."',4.&•'. Sanded Thr;Nat^r,,P;e;::Inriminter Type of Identification: ype of Identification: -- . 's CITY OF ATLANTIC BEACH xr ;._ii 13%WNER / BUILDER AFFIDAVIT 4 iil1r 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. -WO (I`t 4 A L✓1T,c 8ECi ' . c6‘7/` S 71. 7q Z. ADDRESS � � PHONE NUMBER - I S o a PRINT iaak --------- -1Q------ Z/2Z/i7 _f- y',, i DATE Before me this dayof Off• 20 171n the countyof Duval,State of Florida,haspersonallyappeared herin by himself/herself and affirms that all statements and declarations are true and accurate. , Notary Public at Large,State r ( ,County of 0 V"a.- ( o Personally Known ❑Produced Identification- 0 -` ,5 4a. 1 ,4*;;;.?, TCFll f iNGLESPER+�F:R l :1 Cr. I: 'ON 0 FF 924951 - - I E.Oi u. ;:.i ' r 6,2019 j %`'- b:r�r. ,,..'t ,''c Jroenrmter ' Notary Signature: .e ..-._ . - - .................. F:BLDG/Owner-Builder Affidavit;REVISED:4/16/2009 MAP SHOWING BOUNDARY SURVEY OF LOT 37 AND THE EAST 1/2 OF LOT 39, BLOCK 13 ACCORDING TO THE PLAT OF ATLANTC ; : :ACH AS RECORDED IN PLAT BOOK 5- , PAGE(S) 69 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA. CERTIFIED TO: THOMAS C. WOOD, FAYE M. WOOD, STEWART TITLE OF JACKSONVILLE, INC. , WELLS FARGO HOME MORTGAGE, INC. AND WATSON & OSBORNE, P.A. "^ p.-' ....,. .,. -- 17) 1 _ 4 ELEVENTH STREET .. . ,. 74.76' (M) E!`i Ja�, ,i i . 1/2- IP , u tai t�t't1t OMEN 75.00 (R) 1/2- IP LB 1048 NO CAP 25 � 2500' (R) 1000' (R) 11111 •"O.% 900.00' 90Q 00' (R�1A) bh 4bbl '0. n v. : DDMMUNITI'DEVELO Pi PMAT SCOW, WALK.: •.2' 0 o PPR O V i. STEPS o h as 23.6• q 23.1' a •• i d`'`) ( ro, CcONC. 11.9' 7.•i �s^GL / 0 N CONC. co a-:�. //l.Y Q STEPSBRICK 1 STORY FRAME CONC : / 2 r RESIDENCE No. 36o c°Nc 13 1 1.6. �/ A/C PAD �0-0loll – O: Q4' n 23.5' 12.3' 7.• me- ppw ( v v 4 BLOCK LOT 4/3 1 ! S p J ( 55; ' ... .. ^ LOT 35 I d j EAST 1/2 ( ne' o o BLOCK 13 w � K BLOCK 13 • -.., cbvEREO\ L_ ..•:;°$'1 ;... ;. CONc. x WEST 1/2 K ,. S ON UNE LOT 39 ••' . .. CONC. I BLOCK 13 I •' K LOT 37 r.s •"" �, I ,:.1• . BLOCK 13 fa), r• E, K •M 1 2 1 ..,. . :/ 1 3FP 5 401 A ry. 9O.'3Z4. Cit1 frUziantic Beach 25.00' (R)x �O.25.00' (R) 3000- R) a�'! x if a{�51 and Zoning o' 1/2 F4 '.2- e CAP NOT °' +75.00 ' (R) FENS NO Pr CAP READAOLE 74.08' (1i) ON LINE LOT 42 LOT 40 LOT 38 LOT 3$ BLOCK 13 BLOCK 13 BLOCK 13 BLOCK 13 E Y pt AL NOTA i��r/7Alo.R ., '1.ANGLES ARE SiON 1111S SURVEY.