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1770 E PARK TER - FENCE f CITY OF ATLANTIC BEACH s) 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: FNCE17-0046 Description: 4'ALUM. FENCE Estimated Value: 0 Issue Date: Expiration Date: PROPERTY ADDRESS: Address: 1770 E PARK TER RE Number: 172020 0386 PROPERTY OWNER: Name: ANDERSON TERROLL J Address: 1770 PARK TER E ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: SUPERIOR FENCE AND RAIL OF NFL Address: 5470 HIGHWAY AVE JACKSONVILLE, FL 32217 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. rS,,tL"fi�3 FENCE WALL OR BARRIER r - PERMIT NUMBER u , ___ /),' PERMIT FNCE17-0046 City of Atlantic Beach PERMIT TYPE: FENCE WALL OR BARRIER SUBDIVISION/COMM SITE: SELVA MARINA TAX MAP NO: 172020 0386 PERMIT SUB TYPE : FENCE UNIT 08 BLDG USE GROUP: JOB ADDRESS: 1770 E PARK TER DESCRIPTION:4'ALUM. FENCE ZONED AS: TOTAL SQFT:0 SPRINKLERS: TOTAL WORK VALUE:$0.00 TYPE OF CONSTRUCTION: BUILDING USE: APPLICANT: PHONE: MAILING ADDRESS: , FAX: CONTRACTOR: PHONE: MAILING ADDRESS: , FAX: OWNER:ANDERSON TERROLLJ PHONE: MAILING ADDRESS: 1770 PARK TER E ATLANTIC BEACH, FL 32233 FAX: ARCHITECT: PHONE: MAILING ADDRESS: , FAX: COMMENTS FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50 FENCE 455-0000-322-1000 0 $35.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00 STATE DCA SURCHARGE 45500002080700 0 $2.00 TOTAL:$81.50 ALL WORK TO CONFORM TO THE CURRENT EDITION OF THE INTERNATIONAL BUILDING CODE(IBC). A 24 HOUR NOTICE IS REQUIRED FOR ALL INSPECTIONS. Building Official: Issued By: Date. Printed: Wednesday,August 23,2017 1 of 1 Or 01.,A,9,74, City of Atlantic Beach PLICATION NUMBER 6$ -\ Building Department �^w (To be assigned bythe Building ng De aartment. N �..i , p� �i `�, 9 P ) - 1 ..• 800 Seminole Road / /se Atlantic Beach, Florida 32233- 5 A /� M7 �IsQ_ 17 - Oc�Jw Phone(904)247-5826 • Fax(9f 247'6149 f 2u1! r L P��; >/ E-mail: building dept@coab.us3 r Date routed: City web-site: http://www.coab.diY° APPLICATION REVIEW AND TRACKING FORM Property Address: 177Q f: Qtc Tee_ Department review required Yes No =-Building) Applicant: ,S i)PG-21,O(L. �C� tinning &Z(3nin ` ree Administrator Project: C c Work_s2) Prlb1ic Utilities Ptibi, Sdfety._ Fire Services Review fee $ Agv Dept Signature ferir. 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. of applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: 47(.._ i/< J . Date: 04 7 TREE ADMIN. Second Review: A roved as revised. ❑ pp ❑Denied. ['Not applicable IC WORKS Comments: G- �-✓-" PU:�.IC UTILITIES '-/D —17 PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. ['Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 01 v: City of Atlantic Beach APPLICATION NUMBER Js `'• .� Building Department (To be assigned by the Building Department.) A800 Seminole Road ��j �u �r Atlantic Beach, Florida 32233-5445 (=l�e_t l 7 70 Phone(904)247-5826 • Fax(904)247-5845 ( *or �? E-mail: building-dept@coab.us Date routed: c''::,..) 2_/__4tt__7___ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: I / 70 PA 1211 T Department review required Yes No �6uildin� Applicant: LAPe---y _,c ,(Z CrC-- fanning &Zonin ree Administrator Project: ,t`�: -•• is Works `•• is Utilities Fire Services Review fee $ Dept Signature Review or Receipt Other Agency Review or Permit Required of Permit Verified By Date 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: App [V-roved. ['Denied. ❑Not applicable (Circle one.) Comments: itiV ___ BUILDIN PLANNING &ZONING Reviewed by: Date: d IO j 7 TREE ADMIN. Second Review: ❑Approved as revised. ['Den d. ❑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==L`/r�, City of Atlantic Beach �:3s � � Building DepartmentnECEIVEL) APPLICATION NUMBER /�, k s,� (To be assigned by the Building Department.) iiii s 800 Seminole Road r �� Atlantic Beach, Florida 32233-544 . 2017 �i\)e-L. 17 - UcAL Phone(904)247 5826 Fax(904)247- 49 0 r 01; !) E-mail: building-dept@coab.us Date routed: 674/1. City web-site: http://www.coab.us , , APPLICATION REVIEW AND TRACKING FORM Property Address: 1.770 1 (t Qtc. TSI._ Department review required Yes No p-- - `-Buildi`�R n-)Applicant: `tj UPG(2-I.C�C , E;3 C_ - lanning &Zonin _- fee Administrator Project: F. c -•• is Works` 1117r:-ic Utilities 41 Pttrlic-SafetyM 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: .-----V ❑Denied. I 'Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by:,/0444e1/4"....„, !1 Date: ,- -, 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 ir�J�irr1 City of Atlantic Beach APPLICATION NUMBER d Building Department t,� (To be assigned by the Building Department.) r 800 Seminole Road �� Atlantic Beach, Florida 32233 5445 [3C..( 1 7 - (JO4 ����� Phone(904)247-5826 • Fax(904)247-5845 "`0;31�'� E-mail: building-dept@coab.us Date routed: ie214.41._. _ City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 1770 PA k1 . 'Y _ Department review required Yes No ( (a'Build ni q Applicant: T 0PC%2.(,01.,, �- ,,;j( lanniinng &Zonin y Fee Administrator Project: PC „k)C-rte, -•• is Works' •• is Utilities�y 'obit—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 e� , -, 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 10LAny. Building Permit Application Updated 5/5/17 ,V )r> City of Atlantic Beach OFFICE COPY 800 Seminole Road, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Fax: (904) 247-5845 �/ Job Address: I 1 ?O P4V(C 7E6`C� t A. e ., Permit Number: FN� 17 -O`erk,, Legal Description RE# Valuation of Work(Replacement Cost)$ 3 Heated/Cooled SF Non-Heated/Cooled • Class of Work(Circle one): New di • Alteration Repair Move D o Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial esidentia • If an existing structure, is a fire sprinkler 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 perfor ed: ,{� 'FA t.-C- ( ^ (.,.‘,A4 i )1,./--1,-, f—IVCD d,�.i S / D Ef Florida Product Approval# for multiple products use product approval form Property Owner Information Name:%&vti - '/ . A/W .' ' Address: (`1 )o ft)Atc tz\ t-7•.. CityA Z State Ft Zip 3 '2_2-3 3 Phone ,2 -ici -01 J-Li E-Mail i AN0Ci -' VIS' G /SIL • ( Q Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information Name of Company: .,jo*'r'p/roz K-eAcei-/g4 L7!' `� Qualifying Agent: Address S-41 7 C.' !->'//f'6c)IV AVS City GkSZ//VU/6. State (L Zip 22 ' Office Phone CM y 38'2.- '22Z- 0 Job Site/Contact Number gO L/ 3c-2._ Z 2 2/ State Certification/Registration# ///A E-Mail Architect Name& Phone# 4 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. 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. a1 ignp. , 5..�/ i , (Sign ure of Owner or Agent) + ( ,.ature of Contractor) (including contractor) l/ Si ned and sworn to(or affirmed)before me this day of Signed and sworn to(or affirmed)before me this 7 day of �S 7.0►1 , by TOl l-50,'o . 41,...; (%906ce: 21- , by 71/2k1/0\ G:—Ce,-KSCNirT at .,'',.'"if. KAREN C. 1dff° .t' +,. GRACE MACKEY ,:e.►r' .c�,: I •VIt.._ . . .. r.•.• =.� p. Commission#FF 124673 `�°•., s- MY COMMISSION#GG 04209 MY COMMISSION#F 157186 =',.%7-•a: Expires June 25,2018 `� ' ; EXPIRES:October 27, Y�, -"i,°' EXPIRES September 4.2018 ?', �`''` pivo,'�'d Bonded Tlru Troy Fan In•u•ae8p9486.7ot9 %':'e dl1,o?. Bonded Thru Notary Public Uni ei-e7. 1 •-•J •153 FloridallotaryService.com Personally Known OR •ersonally Kn •- [ roduced Identification f tinter' L .car-g__ [ 1 Produced Identification pe o Identification: Type of Identification: r ,5 I, �';= CITY OF ATLANTIC BEACH OFFICE y Ow'WNER / BUILDER AFFIDAVIT COPY • 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 TIIE 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 REOUIRED 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. /2 1st ZiraLce__-A-a ��9-0-;5,' . ADDREg S PHONE NUMBER kercc)/1,...— ,. hidei6O1 PRINT NAME _n/ . c. l +.yam G 01 �/ SIGN TURE DATE Before me this 2 day of I'114 f- 2011 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. --�r-'L-"-'�-�- Notary Public at Large,State of IL ,County of I� Personally Known r„rr=e El Produced Identification- =aiR1' S KAREN C.HOFFMAN in Commission#FF 124673 - '{-: Expires June 25,2018 Notary Signature: La�e.Y ��TzG _ • h% OonMdnroAq•Fah M�uno,e00..8.5ana F:/BLDG/0wner-BuilderAffadavit;REVISED:4/16/2009 rJ _ ' MAP SHOWING BOUNDARY SURVEY OF LOT 24, BLOCK 12, SELVA MARINA UNIT NO. 8, AS RECORDED IN PLAT BOOK 34, PAGE 85 OF THE CURRENT PUBLIC RECORDS OF DUVAL. COUNTY, FLORIDA. CERTIFIED TO: TERRELL J. & CINDY •.L. ANDERSON t • • Z- O Z3 • a 4 vt • ¢. . �� . /ZS 6 3• \ y, Z54-s• �.,. t • 3e.5 to. M •%..-..'".. ... .* , . fr41 ZZ' V O Ad • 0 O w 0-) -...... _. v \,4 k 40 M ^ NI ,S 0 q IL] N o Q .Z. �e . M , cam.. '''' . ° �6 \ \I VI Ill \ 1 ... dit? D-.. W N K 0 io ill�. • 0 i,-- PU - LICW y '` S os• 34 'frALi /Z • ' 4-;APPROVED Ni• o.i. x { } DENIED Q { OT APPLIC• =4,E TO ,`,- c ., A . .t IliStrii., '`'4 - CITY OF ATLANTIC BEACH JOB COPY j,; `,.;.,. r may,;. IJ%WNER / BUILDER AFFIDAVIT W N I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTIC CONTRACTING" REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: Z y Z d = .1 1e DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: e 0 O ,, p O STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED 0 CO E Z r`' CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT 0 0 8 8 Cill {V 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 0 z Qz SUPERVISE THE CONSTRUCTION YOURSELF. YOU MAY BUILD OR IMPROVE A ONE—OR 0 2 TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR V ni CO IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING' it a MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. 0u. W IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR 0 W I AImR THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT ma 4' 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 t 0 N 0 BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS 'a 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. 1?26 t�.� , lir � 62Y91-U/SY AD 12.11..c69,9 // JT ��� PHONE NUMBER /eri PRINT NAME A i SIGN• URE DATE Before me this 2,ie day i7 4 f"' ,20/7 in the county of vv Duval,State of Florida,has personally appeared herin by himself/herself and affirms that all statements and declarations are trueand accurate. Notary Public at Large,State of FL ,County of Personally Known 5+"'rv�y'','% KAREN C.HOFFMAN El Produced Identification- r. tie :F _•: .: Commission#FF 124673 • , _- �P Expires June 25,2018 .Pf,(�Co Bonded Nu Troy fain Inurence 800-385-7019 Notary Signature: ��-i-r C I7 y F:BLDG/Ovmer-Builder Affadavit;REVISED:4/16/2009 4 t • • MAP SHOWING BOUNDARY SURVEY OF LOT 24, BLOCK 12, SELVA MARINA UNIT NO. 8, AS RECORDED IN PLAT BOOK 34, PAGE 85 OF THE CURRENT PUBLIC RECORDS OF DUVAL• COUNTY, FLORIDA. CERTIFIED TO: TERRELL J. & CINDY •.L. ANDERSON JOB COPY G o Z 3 . . . t(17 i z• 41 . x P ..Y . 4. • • /2s 63. °ld( V Z ,s' 1,1 i` Ill.... IO: /te' '.... . 4:9.: .,. ala It . Z••Z' Q V k 0 (.1 Z 17 1%. . ' . ki %•11 N 4 ,o A w I.i'' --___ 10 \;} k 'en q 1? V 1 1 ' t (\ 4 18 t.t. , r �' 1-r.. . 0 /. 3.,.g.. tio \ t.c• ; u) ifi 1. i 0 ,z .1 <) -, - z. .. ., , .. 370, � \ . d (�c,- z „. ,. W o 4' ti. N 6. . A • 0 n F X L_ o -`/ T (R.1- a ATTN:THD SERVICE PROVIDER-PLEASE UPLOAD THIS DOCUMENT IN INSTALLCONNECT(ICON) ,��• `'�- DO NOT FAX OR EMAIL THIS DOCUMENT ,. \> Home Improvement Agreement: Proposal for Fencing Installation First Name Last Name Store# Lead# Service Address Date /' I i; e ,— i 'i !,_/y.-�i Y, 3 PRICE IS VALID FOR 30 DAYS FROM /�''L.-7V J— 2DATE OF PROPOSAL City State Zip Ti/9/ Home Phone# Work Phone# Cell Phone# Customer E-mail Address JOB COPY Nearest Cross Street PERMIT/INSPECTION INFORMATION -` `, Homeowner to obtain permit =' Permit Required? 0 Yes ❑ No (Install Professional-regalres a copy of permit before installation) Install professional to obtain permit Selection$ : ='`� ! APPROXIMATE LAYOUT ADDITIONAL COST OPTIONS FENCE FOOTAGE CONTAINED IN THIS PROPOSAL IS APPROXIMATE BASED ON FIELD ADD THE PRICES IN THIS MEASUREMENT,PRICE WILL BE ADJUSTED BASED ON ACTUAL FENCE FOOTAGE USED,AS COLUMN TO THE SELECTION SET FORTH IN TERMS AND CONDITIONS,L) TAKE DOWN AND HAUL AWAY OLD FENCE$ , ENCE DI A GR AM i PERMIT COST$ `C , _ - i; / /r I- r rr SUB TOTAL$ ) .,' t',' J r• --.�v` I _ 4' '-1'4 1 SALES TAX$ + //C.J/-j C. 1 / `f, n / {.:,..,,.. a y.._.-.may. Y' Partial Payment f 121 l+ l,. FINAL AMOUNT DUE J _ , l I P-f Nem -/Al ' ffe-/s' `:6 CG. `,‹R F-AJ C'' .fK.7 (Due in full upon contract execution) //'' , -"G� ( , 77/,j) ,jj -"• 1;-- ?�'. ' :-/--.7.,7,.?:- '.-. +,G • Stock Product, dpecial Qrd�ur Product Design Approved by Customer 0_. FENCE INSTALLATION RELATED TO GRADE:PLEASE INITIAL ONE� PLEASING TO THE EYE FOLLOWING FLOW 1- I STEPPED MSTALLATPON I1 -- --- _ 1_------ ---.-_—_I FENCE TO BE LEVEL W(TH HIGHEST GRADE , SLIGHTLY UNEVEN GRADE WITH FENCE STEEP SLOPE WHERE FENCE CANNOT'RACK' (CUSTOMER TO FILL IN GAPS) FENCE MIG F E E V GROUND ENOUGH RE LT 4 I LARGGPLADE E GAPS UPE H S - ENCWILL BE UNEVEN AT TOP FES-(CUSTOMER TO PILL IN GAPS) Product/96(J,'/ Af4E'i. /` Product Product Style:4trZIR -,- Height: 14 ' Style: Height: Style: Height: Footage ../ "... If Gates: Footage If Gates: Footage If Gates: Post Cap: ?f/ Color: / Post Cap: Color: Post Cap: Color: Rail Type: f/' Post Type: .i, " Rail Type: Post Type: Rail Type: Post Type: Picket Type: ' `, $ 're--7' .' Picket Type: $ Picket Type: $ Customer Care: 1-877-467-2581 Home Depot U.S.A.Inc.,2455 Paces Ferry Road,N.W.Bldg.B-3,Atlanta,Georgia 30339 HS-299(06/15)MAIN 1