66 S FORRESTAL CIRCLE FNCE19-0029 FENCE PERM FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
s, FNCE19-0029
.. CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 3/11/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 9/7/2019
MUST CALL INSPECTION PHONE . BY 4 PM FOR NEXT DAY INSPECTION.
CODE,ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
OF i BEACH CODEOF • '
ALL CONDITIONS OF . . 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
66 S FORRESTAL CIR FENCE WALL OR BARRIER FENCE 4' & 6' FENCE $3300.00
TYPE OF
ZONING: :D •
• • GROUP:
171757 0000 ATLANTIC BEACH VILLA
#Ol
• ADDRESS:
• '.
ADDRESS:
Autumn Brook Design 5569 Autumnbrook Ct Jacksonville FL 32258
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 • .
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
I
1 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,All American Roll Off,WCA Waste Corporation). Container cannot be placed on City right-of-way.
Issued Date:3/11/2019 1 of 2
FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
FNCE19-0029
CITY OF ATLANTIC BEACH ISSUED: 3/11/2019
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233 EXPIRES: 9/7/2019
3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
4 PUBLIC WORKS FENCING REMOVED INFORMATIONAL
Notes:
All old fencing must be removed from job site by Contractor.
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 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$81.50
Issued Date:3/11/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road C
J
' Atlantic Beach, Florida 32233-5445 N�E_ 19 Qo2
\ Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (`o CD (Z2 EC7�()C_(?jj- Department review required Yes o
uildin
Applicant: � � (AD ;Manning &Zonin 9 ,
Tree Adminis ra or
Project: C�C u lic Works__
ublic Utilities---,
Pubic a e y
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: �pproved. ❑Denied. [—]Not applicable
(Circle one.) Comments:
ELDIN
PLANNING &ZONING 3 �l 2 a�
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
rs�L��;y� City of Atlantic Beach APPLICATION NUMBER
)� Building Department (To be assigned by the Building Department.)
800 Seminole Road N
Atlantic Beach, Florida 32233-5445 s l
Phone(904)247-5826- Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: (D (Z �_ �`��(� t► `� Department review required Yes No
uildin
Applicant: C,2arming &Zoning
re Admirns Fra-16—r
Project: f�C u lic Works -
ublic Utilities
Pubic a e y
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, a;�— 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 0511912017
rS� Ly;y, City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 i L�CE 9
Phone(904)247-5826 Fax(904)247-5845.
�1, /'
^!f;t 9' E-mail: building-dept@coab.us ' MAR U 4 20
1,( Date routed:
City web-site: http://www.coab.us i I
By—.._.
APPLICATION REVIEW AND TRACKING FORM
Property Address: L Cll
D R2 Department review required Yes No
uildin
Applicant: arming &Zoning
r e e Adminis ra or
Project: r f�C ulic works
ublic Utilities
ubic aey
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 b r 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
r5I—Vir� City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
i 800 Seminole Road ^�
r' Atlantic Beach, Florida 32233-5445 s k v
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed:
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
ll
Property Address: CD (�(2 �`��L, t! `� Department review required Yes No
uildin
Applicant: anning &Zoning—i
'Tree Admirns ra or
Project: r 6:�NDCJF, u lic Works
ublic Utilities
Pubic a e y
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. of applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING 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
Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department "ALL INFORMATION
-. 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (90n4) 247-58/26 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: C I Permit Numb
Legal Description Lo a RE#
Valuation of Work(Replacement Cost)$ 3.3an.o U Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial '*esidential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes '%No
• Will trees be removed in association with proposed ro'ect?❑Yes must submit separate Tree Removal Permit ❑No
Describe in detail the type of work to be performed:
4` ukQvJ ft bQ& U n✓ 4
Florida Product Approval# for multiw products use product approval form
Property Owner Information
Name !f I' Address ��� I�
City &1 State Zip �3 Phone
E-Mail Cl �'% L
Owner or Agent(if Agent, Power of Attorney or Age cy Letter Required)
Contractor Information
Name of Company Qualifying Agent
Address City State Zip
Office Phone Job Site Contact ffer
State Certification/Registration# E-Mail
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt❑ 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
ECORDING R N ICE F COMMENCEMENT.
_7(Siglatum of Own Agent) (Signature of Contract
Si ned nd sworn
��to�(or aff rmed)before is day of Signed and sworn to(or affirmed) fore me this day of
l S if , by
g atur of ota (Signature of Notary)
[ TOM GNOLESPERGER sonally Known OR rn''a vg�,; �„ [ ] Personally Known OR
x; .- MY CORQMISSION#FF 524951
[ ]Produced Identification [ ] Produced Identification
: � EXPIRES:October 5,2019 Type of Identification:
Type of Identification: ':�'••. oP:` _ �,� a i1naerxrters Yp
HEAP SHOWING BOUNDARY SURVEY OF
LOT 7, BLOCK 2 AS SHOWN ON MAP OF
ATLANTIC BEACH VILLA UNIT NO. 1
AS RECORDED IN PLAT BOOK 30 PACES 56 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLA.
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THIS SLRAtY W"AS PFRFORNED-HUN T THE 8EK111 OF A TITLE CCMMITWNT. UNLESS oTHeHWMSL NOIED
THERE MAY BE ADpTIDNAt EA11MlNTS AND/OR RESTRICTIONS THAT ARE NOT SHOWN
ON THIS$1NYEY THAT W.Y BE FLUID IN f E PUBLIC RECORDS OF THIS COUNIY.
UNOERCROUA9 ENCROACHMENTS NOT IOCATED
THE LAND SHOWN HEREON IS IN THE SPCCML ROOD 1 D ZONE•%'11'AE'(El 7.0)AS SHOWN
ON FLOOD INSURANCE RATE MAP 0408 H FOR DUV4 COUNTY.FLDRWA•IT RL INM DATE W-03-13
ALL AMERICAN SURVEYORS OF FLORIDA, INC.
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M -ooRrr-wa• SUPERVMIDN AND DRECOON.THAT THERE ARE NO ENCROACHMENTS f%LEAF AS SHOWN 1
p�q • Taln AND THAT THE SURVEY SHOWN HEREON MEETS THE MINIMUM iT:C
"•" AM ra•n m SET HNiCAI.STANDARDS
FORTH BY THE FLORIUA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS
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