365 10th St FNCE19-0121 6' FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
FNCE19-0121
� .. _ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 12/17/2019
�U::»r ATLANTIC BEACH. FL 32233 EXPIRES: 6/14/2020
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.
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:
365 10TH ST FENCE WALL OR BARRIER FENCE 6' FENCE $6000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170085 0000 ATLANTIC BEACH
COMPANY: j ADDRESS: CITY: STATE: ZIP:
The FaverGray Company 415 Pablo Avenue Jacksonville FL 32250
OWNER: I ADDRESS: CITY: STATE: ZIP:
FAVERGRAY HOMES LLC 415 PABLO AVE JACKSONVILLE FL 32250
BEACH
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.
Issued Date: 12/17/2019 1 of 2
, „ i. 'f FENCE WALL OR BARRIER PERMIT PERMIT NUMBER
'' CITY OF ATLANTIC BEACH FNCE19-0121
r, v% ISSUED: 12/17/2019
800 SEMINOLE ROAD
`'40'219” ATLANTIC BEACH. FL 32233 EXPIRES: 6/14/2020ry i
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 and debris 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
i PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
1 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $81.50
Issued Date: 12/17/2019 2 of 2
� City of Atlantic Beach APPLICATION NUMBER
) r �� Building Department (To be assigned by the Building Department.)
800 Seminole Road FA\ r _/�( Z
F� Atlantic Beach, Florida 32233-5445
1111. Phone(904)247-5826 • Fax(904)247-5845
y:' E-mail: building-dept@coab.us Date routed: 1 0 / X ll CI
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: -S&•N5 I O41'— Department review required Yes No
y- e_oinf tanning &Applicant: I t-1G I` P,V E(� G-Py Tree Administrator
Project: (`€ f' C_E u is or
ublic Uti i ie
Public 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: Date:/0—/e�/9
TREE ADMIN.
Second Review: ['Approved as revi ed. ❑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
rilAnyy� City of Atlantic Beach APPLICATION NUMBER
0 iIiil, Building Department (To be assigned by the Building Department.)
;:�.ti 800 Seminole Road `'` OCT 14 2019 j=N l 9 -0( Z 1
r " Atlantic Beach, Florida 32233-5445
�� Phone(904)247-5826 Fax(904)247 5845
L,1119'' E-mail: building-dept@coab.us Date routed: i 0 / t 1 `k.CI
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 'S&NS I a .7 Department review required Yes No
. ,-• fanning &Zoning
Applicant: � E — V � � •2�-, y�u
� Tree Administrator
Project: ( v C_Eu is or<
ublic Uti
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: [07.Approved. ['Denied. ❑Not applicable
(Circle one.) Comments:
BUILDING
PLANNING &ZONINGReviewed b . 4 i. 4 : Date: / /6 _/
.�. � — /
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. I (Denied. ['Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
riy1,`JT., City of Atlantic Beach APPLICATION NUMBER
f.s
WBuilding Department (To be assigned by the Building Department.)
si800 Seminole Road IrAtlantic Beach, Florida 32233-5445 NC `� v'
KPhone(904)247-5826• Fax(904)247-5845 1
.^i.Ent 0- E-mail: building-dept@coab.us Date routed: t 0 / 1 k l l
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 43&5 I 0/ ( Department review required Yes No
Applicant: ( E•-f G 1-- A,1/ e-re- CP—Actm /T'lanning &Zonin)
Tree Administrator
f is or
Project: (ar�v��
•ublic Uti i ie
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: proved. ❑Denied. fNot applicable
(Circle one.) Comments:
BUILDING I
PLANNING &ZONING Reviewed by: � L� Date: 0-1 I - (c(
TREE ADMIN. Second Review: I lApproved as revised. ❑Denied. ❑Not applicable
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: I !Approved as revised. ❑Denied. ❑Not applicable
Comments:
Reviewed by: Date:
Revised 05/19/2017
iLLyr f, City of Atlantic Beach APPLICATION NUMBER
cis 3, Building Department (To be assigned by the Building Department.)
s 800 Seminole Road F�, `�,� 19 _O I zvailimpeI
z Atlantic Beach, Florida 32233-5445 'v ` ` 1
Phone(904)247-5826• Fax(904)247-5845
-1,1111r.,., �T E-mail: building-dept@coab.us Date routed: 0 / 1 l ;l
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 75 L a ( Department review required Ye`„No
Applicant: It ` ' V .' C I �, ,y la it27--"Planning &Zonin j
Tree Administrator
Project:
(0 c rCMC-E
u is orc
C ubli'c Utili iTesm
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: F4proved. I (Denied. ❑Not applicable
(Circle one.) Comments:
BUILDIN
PLANNING &ZONING /0-15 I
Reviewed by: Date:
TREE ADMIN. Second Review: ['Approved as revised. ❑Deni . ❑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
~Sf'''' ^ Building Permit Application OFFICE COPY Updated 10/9/18
;-• City of Atlantic Beach Building Department **ALL INFORMATION
~ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
'' Ort or IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address. 36S tv . i Ca
,-)?..f c ;F-,41.L ,1. �.{Z� 8 tc,1�• Permit Number: FI'D Q'.�G L 1 Or1
Legal Description 5'0J /6: 'c -A 7 E 1141 / �L
t , i 01 36 f3k.., 13 (4
- RE# 0o�3S—C sC
Valuation of Work(Replacement Cost)$ ‘i CVO Heated/Cooled SF / Non-Heated/Cooled 0"
W
• Class of Work: KNew ❑Addition ❑Alteration ❑Repair ❑Move DDemo ❑Pool ❑Window/Door v
z
N
• Use of existing/proposed structure(s): ❑Commercial Residential Q = J Z In
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ,<,No 111 < O F-
• Will tree(s) be removed in association with proposed project? DYes(must submit separate Tree Removal Permit c--t11.•T.— a H
Uacibe i ail type o k t`te performed: 503 IL o F-iticz c---,/01 earcrki r446.,) 0
p0psum prhvz
� � < 0
n� CC'� w N
Florida Product Approval# � U f A. for multiple products use product appl�v0w7r}..
ICC B N Z
Property Owner Information
' w
Name Fo.✓,� G�r-c•,,/ j1,u-►,rc LIC. Address y/S-- Aelo �y�,•.1-r_ 2� ® 0 >.
City .-1,o1GSwa✓rUL•___ ►e Gt� State FL Zip 3226-6 Phone C 1OL-f— 70°5—ADP/J >' °- —ir 0°
CI
E-Mail • • r _A I— tiia w
Owner or A'ent If Agent, Power of Attorney or Agency Letter Required) uJ_cc° n w w
Contractor Information > >
w
Name of Company ., Kt. t. _.1,4,t u4 Qualifying Agent - /i i Mt.L.il—
Address q/ R4,bl,-0 ' ,4L ' .t., City ix 4 -et t State Zip 3,' s
Office Phone /otj— czot, -,10.1) Job Site Contact Numberr 'Tetij�,S� —_q,,3G1
State Certification/Registration# GGC !Si 2,q3; E-Mail Aro
fav
vtVerefrotni (lvte
Architect Name&Phone# SII v
Engineer's Name&Phone# )
Workers Compensation Insurer 1}iyde/1 $r, . 6.0 1 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 addit' t u' �ts of this
permit,there may be additional restrictions applicable to this property that may be found in the pubic sf�co rID
there may be additional permits required from other governmental entities such as water management is riots,sta n ie ,
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in co iancc wit ,§
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMF MA Ant
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PRO e..
��6fi��i r- i . -5 , FL
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING- .,o U' NOTICE OF COMMENCEMENT. aje• , `
/� / signature of Owner or Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me�this` q day of Signed and sworn to(or affirmed) before me this qday of
OGfobk , Do 1N , by X13 A'► µwon Oc i-tb r, 9.Dt k , byv hGj' h raver-
,
0 a�,• Sign �wycAtu lryAENT ....a Tu re of`1I9tl210i9c AH CLEMENT
la
'�. Notary Public-State of Florida 'z° Notary Public State et Florida
", p`,•' Commission k GG 198331 m� a Commission#GG 198331 ,
'••'2 odP. '' My Comm,Expires Mar 20,2022 '�orExpires Mar 20,202_ t
[Personally Known OR Personally Known OR ...................National It Assr..
I Bonded through National Notary Assn. �.
[ ] Produced Identificati [ ] Produced Identification
Type of Identification: Type of Identification:
IAP SHOWING BOUNDARY SURVEY OF
NO.PLAT
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AS RECORDED IN PLAT BOOK 5 , PAGE(S) 69 OF THE CURRENT
PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFTED To:
GARY W. DANCIGER,
GIBRALTAR TITLE SERVICES,
AND OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY.
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