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383 10th St FNCE19-0096 FENCE WALL OR BARRIER PERMIT PERMIT NUMBER J FNCE19-0096 CITY OF ATLANTIC BEACH o ISSUED: 8/16/2019 800 SEMINOLE ROAD 0;319 ATLANTIC BEACH. FL 32233 EXPIRES: 2/12/2020 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + 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: 383 10TH ST FENCE WALL OR BARRIER FENCE FENCE $539.00 TYPE OF • • GROUP: 1700910000 ATLANTIC BEACH COMPANY: ADDRESS: • ADD' ' SABIA BARRY W 383 10TH ST ATLANTIC BEACH FL 32233-5529 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. Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. 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. 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration,including sod,is required. Issued Date: 8/16/2019 1 of 2 FENCE WALL OR BARRIER PERMIT PERMIT NUMBER FNCE19-0096 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 8/16/2019 ATLANTIC BEACH. FL 32233 EXPIRES: 2/12/2020 4 PUBLIC WORKS RUNOFF INFORMATIONAL Notes: All runoff must remain on-site. Cannot raise lot elevation. 5 PUBLIC WORKS FENCING REMOVED INFORMATIONAL Notes: All old fencing and debris must be removed from job site by Contractor. 6 PUBLIC WORKS ADDITIONAL COMMENTS PUBLIC WORKS INFORMATIONAL Notes: Any damage done to infrastructure must be repaired 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:8/16/2019 2 of 2 City of Atlantic Beach APPLICATION NUMBER �s Building Department (To be assigned by the Building Department.) 800 Seminole Road , _(�(� r� Atlantic Beach, Florida 32233-5445 F ,� C `-'9 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: City web-site: hftp://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 3 j�j (T� S4 Department review required Yes o uilding Applicant: 0(��{� nning &Zoning Tree A minis ra or Project: PE_z:-A ( ja u is Wor s isiities -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: roved. ❑Denied. []Not applicable (Circle one.) Comments: (ED PLANNING &ZONINGy' Reviewed by: i_rl Date: 1 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 OFFICE COPY .J' 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 IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us �-f�CE ( � _ D. Job Address: �I 3 S e '6 i� Permit Number: I-7 O O S 5 -000Z-_) Legal Description RE# Valuation of Work(Replacement Cost)$ 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 ❑Residential • If an existing structure,is a fire sprinkler system installed?: Dyes ❑No • Will trees be removed in association with proposed ro'ect? ❑Yes must submit separate Tree Removal Permit 8VO D/ scribe in detail the type of work to be performed: Florida Product Approval# for multiple products use product approval form Property Owner Information Name I 0_�-c SAddress 64M4ek _ City 4 1 o 1 ( G State Ft- Zip 3d.-)-3 3 Phone cl E-Mail OJT 0U e 363 (P •*)h Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information _ Name of Company , bh `5 rem- Qualifying Agent Address , )- C', a, lrct�; 1(a_ ��. , City j�le°kS�x'l�� I1C State Zip jrj}1,r Office Phone yo9 30A;, Job Site Cntact Number State Certification/Registration# E-Mail r i bb g Pei,di k s (V C,^,Z; Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer OR Exempt❑ Expiration Date Application is hereby made to obtain a permit to do th/work d installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and thatill be performed to meet the standards of all the laws regulating construction in this jurisdiction. I understand that a cemit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS,TANKS,anCONDITIONERS,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 wit eyll applicable laws regulating construction and zoning. Z ,\ 4 = JZ WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY U z 0 RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEN - o TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE U V °n 0 a RECORDING YOUR NOTICE OFCCOMMENC NT. (/� l p o C (Signature of wner or Agent) (Signature of Contractor) 0 E— h H Z Signed and sworn to(or affi m )before m this 5 r� day of Signed and sworn to(or affirmed)before me this �f R ( � b �F� ` o��' by W-IL LC m LJ a o �g�eturGER (Signature of Notary) Lit Q W YgNI GINGI ESPEFi 924951 Lll (n W COMMISSION#FF ; W 19 tober 6,20 W *: EXPIRES pub�wunde tens [ ]Personally Known OR A: e BondedThruNotanl onally Known OR Ix[ Produced Identification f,o:' Produced Identification] l Type of Identification: S O - &b-O ype of Identification: urrlut uur Y Owner Builder Affidavit **ALL INFORMATION HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 ,�I Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: FfPe, �'DUg6 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 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, 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 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 $5,000 PENALTY UNDER FLORIDA STATUTE NO.455-228(1). AN "OCCUPATIONAL LICENSE" IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY"CERTIFICATE OF COMPETENCY"OR THE FLORIDA"CONTRACTORS CERTIFICATE"TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. CONTACT THE BUILDING DEPARTMENT(904- 247-5826 OR BUILDING-DEPT@COAB.US) IF IN DOUBT. V. ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALLTHE REQUIREMENTS FOR THE ISS/NUANCE OF AN OWNER-BUILDER PERMIT. Job Address: �j 3 10� 5•,l-f,4 0u,tlic- f, E - 3433 Owner Name: 5ct�ia. Phone Number: q'2`( 9v 79 sj Mailing Address: 10�" 51Yr City: V10t-A t 64C,4', State: W<— Zip: 301 -33 Notarized Signature of Owner The fo oing ins rument was acknowledged before me this day of ,20in the State of Florida, County of Signature of Notary Public t0h [ ] Personally Known OR [ Produced Identification Type of Identification: - Updated 10124118 9 yr¢�& T JMi7Ji_ES?F9GFR .; MY COh4ftISSION FF 924951 EXPIRES:October 6,2019 bwoed Th.,u Noiary?aBfc Urderarit^.ra Pe r nq I f 0, r_-we_E19 - OFFICE COPY NOTICE OF COMMENCEMENT State of � Tax Folio No. 00,,'-5 J��J County of z) To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENrNT. Legal Description of property being improved: 11�'t= Address of property being improved: General description of improvements: Owner: 0 FA 'Gl Address: 36i /O Owner's interest in site of the improvement: ot.+-' ✓ Fee Simple Titleholder(if other than owner): Name: rr — Contractor: ��`r 4` �/� C'tj _ Address: c� Telephone No.: l oc( 35-2 3(_-)9C Fax No: Surety(if any) Address: Amount of Bond$ — Telephone No: Fax No: Name and address of any person making a loan for the construction of the improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b), Florida Statues. (Fill in at Owner's option) Name: Address: Telephone No: Fax No: _ ESPERGER Expiration date of Notice of Commencement(the expiration date is one (1)year from the date o re�cV??t(tg un "F,` ~;p is specified): " V1; pl •October 6,2019 •iF°f�F�•° Bnnded Thru Ncdary Public underanieTs THIS SPACE FOR RECORDER'S USE ONLY OWNER \;) _J Doc#2019181210,OR BK 18887 Page 1804, �`� �"�" r �C 42 Number Pages:1 Signed: Date: D Recorded 08/05/2019 12:30 PM, Before me this do J LL4 in the County of Duval,State RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL Of Florida,has personally app ad Z O 1 r r 11 C_ COUNTY Notary Public at Large,State lorida,C nt o uval. RECORDING $10.00 My commission expir Personally Known: —or Produced Identification: O — ? Nd �a/� `i5•,�uno] /vet�p ,fid .5,r�.�ooa� �i/qr�d U1 ��a�a�, ay,� .�� 6 7 aLst�s '�' �'ooh �%� Ui�o��a✓o..7�,..i sy , ',F/ �Y,/5/ 'Off' 107 -,. -7O 76�9Y7 O/ os q .sn nr oz z/ oz p la'Od�'dJ O Li rl :A ,E•L ,O ' a a 77N�O/I.Bd' p „ oI � �z v fr�J•od N 7/ W � i 1 _ I City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road /„ Atlantic Beach, Florida 32233-5445 1 �� _0a� (0 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: '; � -- _S4 Department review required Yes No uilding Applicant: 0 w 10 nning &Zoning Tree A d minis ra or Project: u lic Wor s , FIC tilltties 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 � 1G PLANNING &ZONING Reviewed by: ?Y— TREE Gig Date: v Y ` 1 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 5.'Ulf ;.r+ City of Atlantic Beach APPLICATION NUMBER Building Department $ (To be assigned by the Building Department.) v 800 Seminole Road AUG 0 6 � (�' _ C-) _LD001 r� Atlantic Beach, Florida 32233-5445 i i lG� Phone(904)247-5826 • Fax(904)24 45 E-mail: building-dept@coab.us —�___ Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: J � S Department review required Yes No ,Bluilding Applicant: nning &Zoning Tree A minis ra or Project: C�yC� �—, u lic Wor s (IPMis i ities 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 bDate: 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 City of Atlantic Beach APPLICATION NUMBER JS id Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 ^ 011 SA E-mail: building-dept@coab.us Date routed: City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: Sp,--:s cy� S4 Department review required Yes No uilding Applicant: O w L-:�(=,CC-- nning &Zoning Tree A minis ra or Project: �Cc� — u lic Wor s 3 hies 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: 9-7—/ 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