2446 Seminole Rd FNCE19-0052 4' & 6' Fence FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH FNCE19-0052
800 SEMINOLE ROAD ISSUED: 5/2/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 10/29/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH 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.
INOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this P roperty
that may be found in the public records of this county,and there may be additional permits required 1. ht
governmental entities such as water management districts,state agencies,orfecleral agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
2446 SEMINOLE RD FENCE WALL OR BARRIER FENCE 4' & 6' FENCE $2500.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION: I
CONSTRUCTION: NUMBER: GROUP:
1683540100 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
PAULAANN COUGHLIN 2446 SEMINOLE RE) ATLANTIC BEACH FL 32233-5736
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 ORAN
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 MATIONAL
Notes:
Roll off container company must be on city approved list(Advanced Disposal,Realco,Recycling,Shapells,Inc.,Republic Services,Donovan Dumpsters,
Phillips Containers,JDag/Dennis Junk Removal,All American Roll Off,WCA Waste Corporation). Container cannot be placed on city right-of.,vay.
3 PUBLICWORKS RIGHT OF WAY RESTORATION INFORMATIONAL
�otes:
Fui right-of-.ay restoration,including sod,is required.
Issued Datei 5/2/2019 1 of 2
FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH FNCE19-0052
ISSUED: 5/2/2019
800 SEMINOLE ROAD EXPIRES: 10/29/2019
ATLANTIC BEACH.FIL 32233
4 PUBUCWORKS FENCING REMOVED INFORMATIONAL
Notes:
All old fencing must be removed from job site by contractor.
D -1 ION ACCOUNT QUANTITY PAID AMOUNT
ESCRIPT
BUILDING PLAN CHECK III D)(4 322 1001 0
FENCE 455,00DO,322 ICKG 0 $35GG
12
RR
455-0000-208-0700 0
0 52.00
7� 7
PW RWIEW BUILDING MOD OR ROW DOI 0,329-1004 D GE
�1;
$5 GE
$2 13
S ATE"PR sUCHAAG
TATE DBPR SURCH 5211
, T DEA'L C..G
STATEDCASURCHARGE 455
$81 So
7 TOTAL:$81.50
ISsUed Date:5/2/2019 2 of 2
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be amigned by the Building Department.)
800 Seminole Road P-M I
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 Fax(904)247-5845 Daterouted:
,P't E-mail: building-dept@oixib.us
City web-site http/Awww coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z446� (,:Zi C—X-r\(&3C)L.G Department review required Yes -No
Applicant: 0 _Plat,!g8,—ZI1,19-1)
Tree AdmiffisfFaTor
Project: 4E
Nlcc_�Wolru
Public Safety
Fire Services
RNEWRIK-_ Dept Signature
Other Agency Review or Permit Required Revirew
f Pe it=P Date
0 By
Flonda Dept.of Environmental Protection
Flonda Dept of Transportabon
St.Johns River Water Management District
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other
APPLICATION STATUS
Reviewing Department First Review: BaApproved. ElDenied. E]Not applicable
(Cincle one.) Comments:
(EED
PLANNING&ZONING Reviewed by: Date:.%b—0at—V
TREE ADMIN. Seccind Review: EIAPProved as revised. ElDenied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRE SERVICES Third Review: ElApproved as revised. ODemed. E]Not applicable
Comments;
Reviewed by: Date:
R.visiod 05/1912017
Building Permit Application Updoted 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(a)coab.us 15 REQUIRED.
Job Address:-9'1tq(P �F(M�DISA-e R�p —Permit Number: F&Cs 19 - C)C�s
Legal Description RE#
Valuation of Work(Replacement Cost)$ Heated/CooledSF Not Heated/Cooled_
_�F� - —
• ClassofWork: 4New ClAddition ElAlter.tion ORepair OMove ODemo OPool E]Window/Door
• Use oftaxisting/propcesed structure(s): ClCommercial OResidential
• [fan existing structure,is a Fire sprinkler system installed?: Dyes ONO
• Will tree(s)be removed h association with Proposed proiect?E]Yes(must submit separate T,ee Remov
he in dqwil the type of work to 4bDiperfortned: llirwinji 61
A CLL kk I"Al C 0 Y)C_e
0 yvx i,I 5+;Dod�
41 ycr
Florida Product Approval# for n-r1upre products use product approval for.
Property Owner If I"N
N ame rAwl AUI) v%h I 1' 0 Address 1)IS�e
City & F:) State 1-11- Zip 317- 3?,, Phone CTO 4 16
E-Mail fec ^4 1. W
or
Owner of Attorney ot-Akpocy Letter Required)
Contractor Information 0
LU In
Name of Company-se I Qualifying Agent n M I at
City_State Zip It I
Address
Office Phone Job Site Contact Number Lu i=
State Ceftification/Registration# E-Mail— 6 Z EE Z
Architect Name&Phone# 17-% -11 W .;:
Engineer's Name&Phone# PW
Workers Compensation Insurer OR Exempt 0 Expiration "EM
Application is hereby made to obtain a permit to do the work and tallatio,,a,indicated.I certify that no work or insgiAl aill S.:
t t -w., par It
commenced prior to the issuance of a permit and that all wor III be performed to meet the standards of all the laws
on'
Par mut must
construction in this jurisdiction.I understand that�aseipar permit must be secured for ELECTRICAL WORK,PLUMBINKi4l
WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE:In addition to the requireMint
permit,there may be additional restrictions applicable to this property that may be found in the public records of this c9my,and W
there may be additional permits required from other governmental entities such as water management districts,state Concles,or
federal agencies.
OWNER'S AFFIDAVIT:I cerUy 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
T AIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
C R NOTI F COMMENCEMENT.
(Signature a Per or Agent) (Signature of Co or)
n d anq wor o(o irm dill be hiis 245qof Signed and sworn to(or affi ed)before me this_day of
CL CD y
(Signature of Notary)
MyWMySS[0N#F`t2Q5l 5 It o
EXPIRES:atober 6,
1w Pensonally Known OR
I Produced Identification I Produced Identification
Type of liderfificirtion: CZA-S —C P
eofidertification:
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-6445 F-M
Phone(9G4)247-5826- Fax(904)247-5845
E-mail: building-dept@caab.us Date routed:
City web-site: hftp://�.mab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Z446y 1:'� C—.MIf00LjC_ De rtmerrtr iewrequired Yes No
04y�g
Applicant: 0 C/o r'3 C—g— (_Planning&Zoning
-To—
TreeAdministim r
Project:
Public Safety
Fire Semces
P
qview 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
Amy Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: VApproved. ElDenied. E]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed 4-_/� Date:6z
TREEADMIN. Second Review; EJApproved as revised. []Denied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date
FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable
Comments:
Reviewed by: Date:
�lsed 0511912017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Serriinole Road
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 Fm(904)247-5845
E-mail: building-dept@wab.us Date routed
City"In site: hilp:A�.coalb.us
APPLICATION REVIEW AND TRACKING FORM
Property Addre": Delartment review required Yes No
Applicant: 0 LA3 P,-)Is,te— Tanning &Zoning
Tree Adm inistia-Tv
Project: 4L
M.111C—W�Olrlis
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review t Date
Of Pernnit=y
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: ElApproved. ElDenied. PICapplicable
(Circle one.) Comments:
BUILDING
PLANNING&ZONING Reviewed by: Gl— L/� Date:
TREEADMIN. Second Review: E]Approved as naviself. E]Denied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRE SERVICES Third Review: ElApproveclasrevised. ElDenied. [-]Not applicable
Comments:
Reviewed by: Date
Revised 05119/2017
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach,Florida 3223M445
Phone(904)247-5826 Fax(904)247-5845
E-mail: building-dept@coalb.us Data ro.ted.
City welb-site: http:/t�coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Addresti: Z44(o (E�M(N-)o DeLartment review required Yes No
(31W
Applicant: L-D N3 C--rz-- (flinning&Zoning:)
Tree Administralpf
Project: 9E
13 ICE��Wcll S
Public Safety
Fire Services
Rev' w I
Other Agency Review or Permit Required ofPer`mft=PBy Date
Florida Dept of EmAronmental Protection
Florida Dept of Transportation
St.Johns RiverWater Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tabs=
Other.
APPLICATION STATUS
Reviewing Department First Review: ved. E]Denied. E]Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONING Reviewed by: Date: q—
TREEADMIN. Second Review: E]Approved as revised. []Denied. E]Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:—
FIRE SERVICES Third Review: E]Approved as revised. DDenied. E]Not applicable
Comments:
Reviewed by: Date
�17
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JOBCOPY .-ALLINFORMATION
Owner Builder Affidavit HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FIL 32233
Phone: (904) 247-5826 Email: Bu lid ing-Dept0coalb.us PERMIT#: EA&l�COZX
1. FLORIDA STATUTES;CHAPTER 489,FLORIDA STATUTES,PART I"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 CONTRACIFORS. YOU HAVE APPUED
FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER
OF YOUR PROPERTY,TO ACIFAS 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 ORA FARM OUTBUILDING. YOU MAY
ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS.
THE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY, IT MAY NOTBE BUILT FORIALE OR LEASE
IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WIT14IN ONE YEAR AFTER THE
CONSTRUCTION 15 COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH
IS IN VIOLATION OF THIS EXEMPTION.
YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACrOR.YOUR CONSTRUCTION MUST
BE DONE ACCORDING TO THE BUILDING CODES AND ZONINb REGULATIONS.
IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES
RE2UIRED BY STATE LAWAND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES.
H. INJURY LIABILITY;SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE,THE BUILDING DEPARTMENT
SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. .
111. IRS WITHHOLDING;OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING
TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES.
IV. PENALTY;UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES.OWNERS BEING SUBJECT
TO$S,GDO 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 15 A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904-
247-5826 OR BUILDING-DEPT(@COAB.US)IF IN DOUBT.
V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE D15CLOSURE STATEMENT AND THAT I
COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: :a4�& C,�r-%Z4- W
Owner Name: Paula ("p-M tlUti -Phone Numher:qb q (y (;� -7�5'14
-6 City: State: zip: 2._!�-3
MallingAddress: 7_H_qk sf-ytl'�_A
're 0,0
NotarizedSignat I o"Owne in the State of Florida, County
rume., :
. w.:
The cut w s A o�Icdgec1bcf.,.nretHV95diyof
of
In the State of Hor:11aCount,
Signature of Notary Public day of
REVIEWED FOR CODE COMPL lliIi Known OR I I ZProduced Identification
CITY OF ATLANTIC BEACljype of Identification:
SEE PERMITS FOR ADDITIONAL
REQUIREMENTS AND CONDITIONS TONI GAIRESPERGER UpdaW10124118
MY VmOS10'.N#FPq24M1
REVIEWEDBY: DATE:
RES 1)��b�,6.2019