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1185 E SANDPIPER LN - PERMIT FNCE18-0046CITY OF ATLANTIC BEACH 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: Description: Estimated Value: Issue Date: Expiration Date: PROPERTY ADDRESS: Address: RE Number: FNCE18-0046 6' FENCE 1000 1185 E'SANDPIPER LN 172374 5235 PROPERTY OWNER: Name: PETERSON GWEN Address: 1185 SANDPIPER LN E ATLANTIC BEACH, FL 32233-4398 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. 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. * 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. Permit Number: FNCE18-0046 Applied: 4/25/2018 Approved:5/7/2018 Issued: Finaled: Status: APPROVED Parent Permit: Parent Project: Details: OWNER BUILDER Description: 6' FENCE Site Address: 1185 E SANDPIPER LN City, State Zip Code: Atlantic Beach, FI 32233 Applicant: <NONE> Owner: PETERSON GWEN Contractor: <NONE> Printed: Monday, 07 May, 2018 1of1 0rL IA O.FCONDITIONS. I ADDED DATE REQUJRED DATE SATISFY DATE TYPE STATUS SEQ NO DEPARTMENT CONTACT REMARKS 1 4/27/2018 ON SITE RUNOFF INFORMATIONAL PUBLIC WORKS Scott Williams Notes: All runoff must remain;on-site during construction. 2 4/27/2018 ROLL OFF CONTAINER INFORMATIONAL PUBLIC WORKS Scott Williams Notes: Roll off.container company must be on City approved list (Advanced Disposal, Realco Recycling, Shapell's, Inc., Republic Services; Donovan Dumpsters). Container cannot be placed on City right-of-way. 3 4/27/2018 RIGHT OFW AY RESTORATION INFORMATIONAL PUBLIC WORKS Scott Williams Notes: Full•right-of-way restoration, including sod, is required.: 4 4/27/2018 FENCING REMOVED INFORMATIONAL PUBLIC WORKS Scott Williams Notes: All oldfencing must'be'removed from job site by Contractor. Printed: Monday, 07 May, 2018 1of1 0rL IA City of.Atlantic Beach Building Department 800 Seminole Road s� Atlantic Beach F •�� ,- ;a.._- .< - :- :N lorida 32233-5445 ^? Phone (904) 247-5826 • Fax (904) 247-5845 APR ;'��c E-mail: bdilding-dept@coab.us i l; A R City web -site: http://www.coab.us .i APPLICATION NUMBER (To be assigned by the Building Department.) Fn CG --004 4v APPLICATION REVIEW AND TRACKING FORM G Property Address: 1185: m) n P (PePz_Lio e Applicant:',�lU(---� Project: a Department review required Yes. No i in anning & Zoni Tree Administrator u lic Works �,ublic Utilities: ' � 1 c�Safety Fire Services Review fee $ D.ept 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: APPL-ICATIC)N STATIIS M Reviewing Department First Review: ❑Approved. ❑Denied. Not applicable (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed �� ��� Z.S��Ff by: Date: TREE ADMIN. Second Review:A ❑ pp roved as revised. ❑Denied. ❑Not applicable PUBLIC WORKS Comments: PU.BLI CIfTI L`ITIES"`� PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 iAT-V1rr- City of Atlantic Beach 4 Building Department Florida Dept. of Transportation 800 Seminole Road St. Johns River Water Management District Atlantic Beach, Florida 32233-5445 - Phone (904) 247-5826 • Fax (904) 247-5845 Division of Hotels and Restaurants E-mail: building-dept@coab.us Division of Alcoholic Beverages and Tobacco City web -site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) FN CG 0 —004 Co Date routed: APPLICATION REVIEW AND TRACKING FORM J G Property Address: 1 1 OJC �h P1 P&Pz-W Applicant:ti Project: Department review required Yes No anning &Zoni Tree Administrator u lic Works ublic Utilities —Publit Safety Fire Services Review fee $ Dept .Signature Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept. of Environmental Protection [-]Denied. Florida Dept. of Transportation (Circle one.) St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: PLANNING & ZONING APPLICATION STATHS Reviewing Department First Review: M proved. [-]Denied. ❑Not applicable (Circle one.) Comments: BUILD;IiN'G PLANNING & ZONING Reviewed by: Date:4%25~2&do TREE ADMIN. Second Review:A ❑ pp roved 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 City of.Atlantic Beach Building Department S J 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 • Fax (904) 247-5845 E-mail: bdilding-dept@coab.us City web -site: http://www.coab.us APPLICATION NUMBER (To be assigned by the Building Department.) F� cc ( --004 (15� Date routed: APPLICATION REVIEW AND TRACKING FORM © J G Property Address: I I, ®'S P ( P& Z_L v) Applicant: Project: �- Department review required Yes No i in an_ning &fio, Tree Administrator u lic Works ublic Utilities —Public Safety Fire Services F0 154K816 fee $ De -_ - -- nature. evie Other Agency Review or Permit Required Review or Receipt of Permit Verified By Date Florida Dept. of Environmental Protection ❑Denied. Florida Dept. of Transportation (Circle one.) St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: PLANNINGVZO'N' I G APPI IrATIC)KI _RTATI IA Reviewing Department First Review: Approved. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNINGVZO'N' I G Reviewed by: Date: q 2-S fz 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: ❑Approved as revised. ❑Denied. ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach a. Building Department 1 ` 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone (904) 247-5826 • Fax (904) 247758i -WR 2 5 2018 r? i vi;iE-mail: building-dept@coab.us City web -site: http://www.coab.us 4 APPLICATION NUMBER (To be assigned by the Building Department.) Fm cc --y o4 Date routed: APPLICATION REVIEW AND TRACKING FORM J G Property Address: 1 I ® R -ND n P ( PeiZ_ I) Department review required Yes No anning & Zoni Tree Administrator u�licV,Vori<s, ublic Utilities ... blc'Safety Fire Services Applicant: �ti 41, Project: ��,/� NO Review fee $ Dep'.I..Sig nature.... 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. ❑Denied. ❑Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed b Date:= TREE ADMIN. Second Review:A roved as revised. ❑ pp ❑Denied. ❑Not applicable P,UBLIgz&'(DR � 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 CITY OF ATLANTIC BEACH DATE 800 Seminole Road, Atlantic Beach FL 32233 . 1Office: (904)247-5826 • Fax: (904) 247-5845 Job Address: Permit Number: FtU c -c—,- ( P- w41 Legal Description 607— JAd " t�/" /�,(i�t�� //4' RE# Valuation of Work (Replacement Cost) $ /r00 O.` il Heated/Cooled SF _ Non- Heated/Cooled Class of Work (Circle one): New. Addition Alteration Repair Move Demo Pool Window/Door Use of existing/proposed structure(s) (Circle one): Commercialesidential If an existing structure, is a fire sprin1der system installed? (Circle one): Yes No 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: l C�1 -k,( i YI-5 (�`+r� �c� ' �,Q lid ��[ GJUy 7 G Z) )S it?k Z Florida Pro(Yuct Approval # G for multiple products use ProperOwner Infoormation Name: City _1111-11W E -Mail Owner or A nt (zf O°J Address: State Zip Phone Power of Attorney or Ajency Letter 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. Contractor Information:) Name of Company: Address: Office Phone State Certification/F.egistration # Architect Name & Aone # Engineer's Name & Phone # _ Worker's Compensation Qualifying City Job Site/Contact NuxnbE flpplication is hereby made to obtaicz apermit to clo e work anti iczstallations as indicated. I certify that no prcor to the issuance of apermit and that all tivorl ill be perforzzzecl to meet the standards of all laws regz�lc This permit becomes null and void if work is t conznzenced within six (6 months, or if construction or w. ped iod of six (6) months at any tune after wor s omnzezzced.. I ztnd t nd that sepm ate permits nzzcst be sec Scgczs, Y�el/s, Pools, Fccrnaces, Boilers, Tayrhxl anrl, C z� 'Toners, etc. Signature of Property Owne . ig ature of Be fo�� _ this Day of �/� efcre me th Notary Public:r����J, (i( f/►� GfiZ�%`.� ��L ic. /` =gi>igFfsLc' .!`?,iNn', ,':SPGR! I hereby certify that have read and examined this a lication and kn a tt3Yln �Jrat� � ordinances governing this type o�work will be complied with whethe s • Pd beNeitr#anrb� presume to give authority to violate or cancel the provisions of any of , performance of construction. State Zip installation has commenced truction in this jurisdiction, provisions of laws and iof a permit does not ng construction or the Rev. 5/2/16 NV I t'.- t1,t7.A.H1NU3 bhUWM MWtUR A -Ht bjPitiED UN THF_ ABOVE MENTIONEU PLA I 407' -19.4 407— 4-4 64 X Cr` varricqy'ry, Of njlf�� I . 11 , r�'', 1 L. " 1 1,1,7 1F. t. , a — '11 .3 ale B E min fitin Piace. LQ,- 4TIO (1) 74 1. 14 V PLA14 Brio2-A-j qj -V vo N cm. .A& OMMUNITY DEVELOPMENT IDS .v 'ED /40 /z® /V 9; Ap 00 50.0, v L AMC E4ST i U N 2 1992 Ile Ria-molval B R n pr and Zoning M g Ct-n CITY OF ATLANTIC BEACH OWNER / 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. TIE 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 TAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER -BUILDER ERMIT. i 1p121J P,2 ADrk SPHONE NUMBER PRINT NAM SIGN,ATdRf�— V DATE Before me this 4--Dday of < 204 n the county of Duval, State of Florida, has personall appeared herin by himself / herself and affi s that all statements and declarations are and accurate. Notary Public at Large, State of , County of ❑Personally Known c3 z� "art E3 Produced Identifica6o ` (1/' I (� Notary F:BLDG/0w er-Builder Affadavit; REVISED: 4/16/2009