336 12TH ST - FENCE ',:''-j- ',1:- .,,\
' \s� CITY OF ATLANTIC BEACH
"I '• C), 800 SEMINOLE ROAD
KIg_ ' rATLANTIC BEACH, FL 32233
'' 1:* INSPECTION PHONE LINE 247-5814
FENCE WALL OR BARRIER - FENCE
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: FNCE18-0097
Description: replace existing 4-ft. &6-ft. wood fence
Estimated Value: 7600
Issue Date: 9/7/2018
Expiration Date: 3/6/2019
PROPERTY ADDRESS:
Address: 336 12TH ST
RE Number: 171926 0000
PROPERTY OWNER:
Name: BODGE KEVIN R
Address: 336 12TH ST
ATLANTIC BEACH, FL 32233-5514
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.
r51.A4py, City of Atlantic Beach APPLICATION NUMBER
:s f A-4,01,7-,•;\ Building Department (To be assigned by the Building Department.)
.`� 800 Seminole Road
�►1_sl N 66 ( I -00i--
c'
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 • Fax(904)247-5845
0100' E-mail: building-dept@coab.us Date routed: S'/3 -i---I I Tc
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 3 Lp ',--S} - De•artment review required Yes No
'uildin•
Applicant: Off,,)11-L1 arming &Zoning
Tree Adminis ra or
Project: ( .0_F\ 4.--VA- . .4- to--k. L )0) OubliblZ76r s
r��Q CPublic Utilities
f Public Safety
Fire Services
Review fee $ Dept Signature l
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. El Denied. I INot applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by:�i Date: ?-30— 1g
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied. I Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ['Approved as revised. I (Denied. ['Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
(?,ii-tvp,..4., City of Atlantic Beach APPLICATION NUMBER
, .� Building Department —, -b---,..-,,; ---• (To be assigned by the Building Department.)
800 Seminole Road A' /6 ( I ^DOG
\,7110'
-r, Atlantic Beach, Florida 32233-5445 AUG1 I
Phone(904)247-5826 • Fax(904)247-5845 U
J;3J�r E-mail: building-dept@coab.us Date routed: Zc'c� T II
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 3Lp ' as-ks . Department review required Yes No
uildB i
Applicant: 0 W 11-Q-( annin &Zoning)
l Tree Administrator
Project: ( �1_P`1 (Q 4-v} . to- -k . t, 0 Publ ores
r„'nC_Q Public Utilities
�` Public Safety
Fire Services
Review fee $ Dept Signature I
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. I IDenied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed b • i or/ ' Date: 12-2/-17D
TREE ADMIN.
Second Review: Approved as revised. I 'Denied. ['Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: Approved as revised. I !Denied. nNot applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
rrt
City of Atlantic Beach APPLICATION NUMBER
Building Department .. - (To be assigned by the Building Department.)
800 Seminole Road
'''` �r Atlantic Beach, Florida 32233-5445 N L� ( � —UOCJ�-
`4 " `'' Phone(904)247-5826 • Fax(904)247-5845 AUG Z 8 2018
^!J;il�% E-mail: building-dept@coab.us Date routed: 6/ -3- 11 7S"
-
City web-site: http://www.coab.us ti(.
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 3Lc, ' ,- `--f-sk . _ Department review required Yes No
uild 1
Applicant: O W n--Q-( annin &Zoning,
Tree Administrator
Project: ( p_F\_q (� --4 } , 4- (O Srr\ . wt.) �u bl or s
1 r„ nC-Q (Public Utilitie�
f` Public Safety
Fire Services
Review fee $ Dept Signature dt)
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: W , o -/
BUILDING
PLANNING &ZONING Reviewed by: 11------91--"A" Date: v —Z9f.-41
TREE ADMIN. I Approved as revis d. I 1Denied. I '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
0Lv;yf, City of Atlantic Beach APPLICATION NUMBER
rl .� Building Department (To
.r `",.� be assigned by the Building Department.)
tla tic Seminole Road A, 66 ( 7 _00
-r. �� Atlantic Beach, Florida 32233-5445
1`� I
Phone(904)247-5826 • Fax(904)247-5845 Q
-Mt!,
E-mail: building-dept@coab.us Date routed: Fla d
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 3 3 4 I 3:-M- S} . _ Department review required Yes o
uildin
Applicant: Caw n-Q,( annin &Zoning,
Tree Administrator
Project: ( g_Qla ( L{- , q- (Q—ill , WJ (----Publicor s
r„ _,� Pubic Utilities
�` 1 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: ri{ . ❑Denied. ['Not applicable
(Circle one.) Comments:
BUILDI
PLANNING &ZONING / RYA/
YA/Reviewed by: Date:
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
Building Permit Application Updated 12/
^ I I
G
IV
�¢ City of Atlantic Beach 2 7 2018
800 Seminole Road,Atlantic Beach,FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 _
Job Address: 33L, 12 S41-, kitaik B ,,_(, Permit Number: r IV L&-( c — 0011_
Legal Description toff 4, Block 2, Sekve. Mar bekc ()Alt' [k)o. 1. RE#
Valuation of Work(Replacement Cost)$ 7 é 0 0 Heated/Cooled SF Yl'a Non-Heated/Cooled i\ (a
• Class of Work(Circle one): New Addition Alteration Repair)Move Demo Pool Window/Door
• Use of existing/proposed structure(s) (Circle one): Commercial cesidentia
• If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No (N/))
• 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:
REQCPc.A E$tST(cJ(i Wo,O i FC(...)c_45 AI.ocJ(R S0 ES 2, Y-E-A(2_ of FtoPorirry,
(9' NVI6R - , C KA DcA,A. 0I CAP 4- FM k A ; HT 4' Al FrvN i G-ATEs.
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name: \L-Ni lei dot)GE Address: 3% I2.'L, sricte--t
City LAr1(1L aL {-( State t.. Zip `32233 Phone 90\1--3a-7- cis 2 2
E-Mail k�p(kSPr\--ASSac;G4-PS. Cnc�
Owner or Agent(If Ag�e oent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company: Qualifying Agent:
Address City State Zip
Office Phone Job Site/Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
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 maybe 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.
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.
.m0 I • --
• (Signatur-of Owner or Agent) (Signature of Contractor)
(including contractor)
Signed and sworn to(or affirmed)before me this A -day of Signed and sworn to(or affirmed)before me this day of
,........?:.
-1$ y IL �-'f) 0 , by
.4`;:. %,' JOMMiS R JOHNSTON
,�. it i. %, My comp,iiSSION#GG 042984
- •�, :•., EXPit:GS:October 27,2020 ( SignaCI t a of Notary) (Signature of Notary)
;,gyp' ic?• Bon ird TI-•ru Notary Public Undermiters v
[ ]Personally Known OR
N,Broduced Identification ` c [ I Produced Identification
Type of Identification: pi__ l-1 iv .4-, S `LLP 1 A Type of Identification: