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1933 SEMINOLE RD FNCE18-0133 FENCE PERMIT FENCE WALL OR BARRIER PERMIT PERMIT NUMBER FNCE18-0133 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 1/11/2019 Uji 9 EXPIRES: 7/10/2019 ATLANTIC BEACH. FIL 32233 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL WORK MUST CONFORM TO THE CURRENT ISTH EDITION (2017) OF THE FLORIDA BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES . ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY. 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. JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK: 1933 SEMINOLE RD FENCE WALL OR BARRIER FENCE 6FENCE $678.00 TYPE OF REALESTATE BUILDING USE CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION: 1695420524 BEACHSIDE Co ADDRESS: CITY: STATE: ZIP: MPANY: OWNER: ADDRESS: CITY: STATE: ZIP: HOLLEY CECIL M 13711 SHIPWATCH DR JACKSONVILLE FIL 32225-5404 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR 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. LIST OF CONDITIONS ,Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL Notes: All runoff must remain on-site during construction. 2 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL Notes: Roll off container company must be on City approved list(Advanced Disposal,Realco Recycling,Shapells,Inc.,Republic Services,Donovan Dumpsters, Phillips Containers,JDog/Dennis Junk Removal). Container cannot be placed on City right-of-way. 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. Issued Date: 1/11/2019 1 of 2 FENCE WALL OR BARRIER PERMIT PERMIT NUMBER FNCE18-0133 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 1/11/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 7/10/2019 4 PUBLICWORKS FENCING REMOVED INFORMATIONAL Notes: All old fencing must be removed from job site by Contractor. 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 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 4SS-0000-208-0600 0 $2.00 TOTAL:$81.50 Issued Date: 1/11/2019 2 of 2 T City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road At antic Beach, Florida 32233-5445 1\,) C_C-_ Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: Z_ 2-CL2 City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3�5 xnn L--C— Popartrqent review required Yes No Planning &Zon—in Applicant: C) --73m _cj,--> Tree :__�inisrator Project: EL-'1\3 C- <_P_ubIicWork-) t i I i t i e s`:> Public Safety Fire Services Review fee $ Dept Signature Other Agency Review or Permit Required Review or Receipt Date -of Perm-it 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: [eApproved. E]Denied. E]Not applicable (Circle one.) Comments: (B U=ILD I N DG PLANNING &ZONING Reviewed by: Date: TREE ADMIN. Second Review: [:]Approved as revised. DIDenied. E]Not appiicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: []Approved as revised. [:]Denied. [-]Not appiicable Comments: Reviewed by: Date: Revised 05119/2017 T City of Atlantic Beach APPLICATION NUMBER u ing Department (To be assigned by the Building Department.) 800 Seminole Road t ntic Beach, Florida 32233-5445 I\)C_C-_ 0 ( ':S3 a Phone(904)247-5826 - Fax(904)247-5845 nj nail: building-dept@coab.us Date routed: I Z_ CS City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 19 3 3 rg,, ent review required Yes No ___1 Applicant: C)C'D L\_,i� Planning & Zonin7ij-> Tree A—dm—inistrator �<_Public WorL-�> Project: (�O ,�U t i I 7it_ie—s: 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. [:]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: 12-3t- i Fr TREE ADMIN. Second Review: FlApproved as revised. E]Denied. F]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: E]Approved as revised. ElDenied. E]Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road ECEIA/ i - I— - S- 0 i 'S Atlantic Beach, Florida 32233-5445 1\'J C_ciz-_ Phone(904)247-5826 - Fax(904)247-5 DEC 2 7 2018 E-mail: building-dept@coab.us 11 1 Date routed: Z- C12 4C City web-site: http://www.coab.us Sy_ APPLICATION REVIEW AND TRACKING FORM Property Address: 193�5 S�IF-(V\IN-)(-)(_-C b, pepaitment review required Yes No .f.Buddino� — Applicant: lanning &Zon—incr-> Tree AEF—inistrator Project: 61 C-(F �<_Public Wor.KO ,Y_uWir,U t i I itke_s::�) Public Safety Fire Services Review fee Dept Signature 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: E]Approved. E]Denied. M/Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: 1Z TREE ADMIN. Second Review: ElApproved as revisd F�Denied. E]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: F]Approved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date� Revised 05/19/2017 City of Atlantic Beach ECEIVE. APPLICATION NUMBER Building Department (To be assigned by the Building Department.) V 800 Seminole Road Atlantic Beach, Florida 32233-5445 DEC 2 7 2018 1 Phone(904)247-5826 - Fax(904) 247- 5 E-mail: building-dept@coab.us BYL- Date routed: _:Ju CS City web-site: http-://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 5 S�f-7- PRpa4trqent review required Yes No Applicant: Planning &Zon—inil:-,> --A Tree Wm_i—n—isfrator Project: <_P_ublicWor� I:gu hkUtilitie_�s Public Safety Fire Services keview 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 Reviewed by�,__/_Z� Date'. TREE ADMIN. Second Review: ElApproved as revised. F]Denied. F]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: FlApproved as revised. OlDenied. E]Not applicable Comments: Reviewed by: Date: Revised 05/1912017 Building Permit Application Updated 1019118 City of Atlantic Beach Building Department "ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED. Job Address: 113-3 Permit Number: FN cc-- a 0 33 C> Legal Description k1k C6 —RE# Valuation of Work(Replacement Cost)$ to Heated/Cooled SF Non-Heated/Cooled • ClassofWork: ONew DAddition KAlteration &epair DMove E]Demo []Pool DWindow/Door • Use of existing/pro posed structure(s): OCommercial AlResidential • If an existing structure,is a fire sprinkler system installed?: OYes No • Will tree(s) be removed in association with proposed proiect? DYes(must submit separate Tree Removal Permit) CYN. E;ibe in detail the type of work to be performed- It% uxiall 8 q.�_ qA wiK 1-0,y\ 0_6)0-r4 vir\j( �0,�, Florida Product Approval# for multiple products use product approval form PropertV Owner Information Name _e, Address Mil city—Z_Tf�g�S 0 St�aate, p My--ff ly Zi Phone - -Mail VV\ r\4 E C�0-46% Owner or Agent(if Agent, Power of Att8rney or Agency Letter Required) Contractor Information Name of Company -n-,st r-Qy\C_,b Qualifying Agent Address !13�;6 eh'lllieg H116xi 5+e. 1031a city ae-0vT6TyA\e_ State r L zip 3-2-2.5-,6 Office Phone .9 q--�L62 - 163V (I Job Site Contact Number State Certification/Registration# WA E-Mail T7s,k 0 Architect Name& Phone# AVeL Engineer's Name&Phone# 'NIA Workers Compensation Insurer . 140,Ats OR Exempt 0 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 regulating 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. 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 NOTISE OF COMMENCEMENT. (Signature of OwnV or Agent) (Signatur f Contractor) fol day of �ecl and sworn to(ofaffi d)befo methis7pdayof Signed and sworn to(or affirmi\ed) fore me this by 4—)Q-0— ZDL,r- bmWm I-'in P-4 '�rry) i nat r f ta (Signature o IF J Personally Known OR UPersonally KnowirI..95-tobc,- Produced Identification Produced lclentifitaitioMk Under4,6ters Type of Identification: CITY OF ATLANTIC BEACH OWNER / BUILDER AFFIDAVIT 1. 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, WFUCH 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, 11. 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(l). 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. ffl3 5imi-yNvik 0, ADDRESS PHONE NUMBER k .I V, c-b .1, PRINT NAME /2—/2— SIGNATURE DATE Before me this (She county of Duval,State of Florida,ha pe onally app herin himself erself and affirms at all statements and declara"ons re true and accurate.. Notary Public at Large,Stat ou 0-- Personally Known Produced Identification- OIL, Notary Signature: F/BLDG/0�e�Builder Affadavit;REVISED: 4/16/2009 MAP SHOWING BOUNDARY SURVEY OF LOT 6B, BLOCK 1, BEACHSIDE, AS RECORDED IN PLAT BOOK 42, PAGES 14, 14A, 14B & 14C, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA CERTIFIED TO- KAREN S BROW BANK OF AMERICA FIRST AMERICAN 77TLE INSURANCE COMPANY CHRISTOPHER J HURST P.A. LOT 2 LOT 3 - - - - - - - -- - - - - - - - - - CL 15' PRI VA TE EASEMENT S00031'00"E Off 40.00' X�4A-A IF 0.1' FND. REBAR 4'x4' HOLE (No C 0.3' (NO CAP) TYP. kn -FOR PALM 10.2*1' KFOOD & TILE SINK UPPERX Wb6D11 18.5' ch '3"6MKI lz�J42 11.4 14) 1.6 03 00 1// 11933 TWO STORY FRAME 0 z TWO STORY FRAME 1. 8.4' RESIDENCE x RESIDENCE zi 'x4' LO T 8A AIC LO T 7A 1.6 4 B.6' PAD APPROXIMATE 4.0. 10.1' —X—X—X— CEN TERLJNE OF PARTY WALL C) PO Ci 0i 20.0' 20.1' A 1.3'xi.3' 1 04..' BLOCK & d & 4OCK A SHELL DASH COLUMN (TYP.) S' EASEMENT 19.5' 0.6L4 -i � . R_ _ FND. 112" I.P. (PL� -N(J Q40;3F f W 40.00' 0.4' (PLS 44470) SEMINOLE BEACH ROAD (100' RIGHT OF WAY) UNLrIS IT BEARS THE SIGNATURE 1111. THE RIGI.AL RAISE. SEAL OF A FLORIDA LJCENS0 SURVEYOR A11D MAPPER, THIS BRA.ING,SKETrH, PLAT OR MAP LY, AND IS NOT VAlin. NOTES DA IT 0,9-02-03 1 Bdor�h9s-9)01M ory Boscd on Cc"fcHbv P-CP-s as hakg(Noo:71100"W) LEGEND 2. 7his ,s a MAP TO sHow acumom r SURWr DDWW CZKiWC7F AAWAMNr SCALE 1'1=20' J. Clawilons sho� thus(15.0)reler to IlS Coastal and i7aaoWle&wrwy Datum, Notlonal /03 No. 200-f-1774 Geodetic Vertical Datum of 1929, (N.G VD. of 1929). Lowas"Nar 4. 8Y arrPhIc plottkig onN theproparty showi hffuon Avs with*)Zaws: -x' f.8. 744 Pro , National 17DOd Iftsurunce 0 DZAVWS A?OV APE FaAW P0919 76 as-1h'*" on the F-dWol FM&-9tWcy Monoyam—t Agency(f.E.Ao'.A.) 0 XWAWIW WW APE MT pram l`7aod lksuranc_-Rate mqa (KIR.M,)Communl4e-Ponel Number: 1-90975-6WID (R-ANJ") Cornp Fllc 03-1774 dwq Atop Raw�*d date - 41171;Yg AV Lowas omz a1r Drawn By B.R.B. 5 th7vess otherv*e noted OnY Padhw of the pa-val that may be o1carned as MC-11ands by Slote or Gomvnmantal Agencies has not been d&t&Fm4?&d a7d any 11obfity re"Ith7g ffi�ltfivm Ar nOl the m-Waasibillty of the unalamipned RICHARD A. MILLER & ASSOCIATES 7h,v,c may be Rcstnctlons or losements of Riccord ewat-nced by title emm"Inabon that AR0fZ_S_96WAZ LAND SURkEYORS how not bean shoon berven. 5701 BEACH&W, SU17E 1200 Fax(904) 721-5758 AR9REK.4 PaVS 7HA)r MAY BE-VSF jq IN MIS SLIRWr -1ACffS6WWLLZ, RORIDA J2215 7cle (904) 721-1226 ASSREWA 77CW DbRN1flcW ASRREWAnav DERvlp6w P.C.A pffmaneni cont01 pokt Z.S. P.R.Al. Pivmweat Reference Uonument R.L S. LR' f Curm7lum JEA d P.0 C p0h)t a R.0.8. po'W of8 �h' y P.r f CfKAnn 7g p 0__,L Cd Paht a tu V A A ij A r p0i7t of ra" 7A-,cr' V C25/. jrywi. P.R.0 pop?t of R.XQcXQ,..N,, OHL 0�hccd Lkas P.L Pain t of Intersectlon (F /�t of Way '�tj Field Measured RadWs 7 0. . Vol. 07"0"71 Volume I- Arc Lent u4lsal, 19.8. D,,,d Chord 8eating&DIstang 117071S RICHARD A. UILLFR, STA TE OF f Z ORIDA, RE-G1S7Z-RFD PgL page Delta cr C&7hW Angle e LAND SURWY6�g CER77FICA 7F 11a. jg48 B.R.L. hiction Lho Iron PO& r5mt 8u,01,19 r 2.1.01 I'S con-