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336 8th St FNCE20-0089 Permit PacketOWNER:ADDRESS:CITY:STATE:ZIP: LONG JOHN R 1677 WELLS RD STE D ORANGE PARK FL 32073 COMPANY:ADDRESS:CITY:STATE:ZIP: T S B FENCING INC 10142 103rd STREET, SUITE 205 JACKSONVILLE FL 32210 TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 169927 0000 ATLANTIC BEACH JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 336 8TH ST FENCE WALL OR BARRIER FENCE FENCE $6750.00 LIST OF CONDITIONS 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. Approved list can be obtained at the Building Department at City Hall. Roll off container cannot be placed on City right-of-way. 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. 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. 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. 1 of 2Issued Date: 10/27/2020 PERMIT NUMBER FNCE20-0089 ISSUED: 10/27/2020 EXPIRES: 4/25/2021 FENCE WALL OR BARRIER PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00 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 $2.29 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $131.79 3 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL Notes: Full right-of-way restoration, including sod, is required. 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. 2 of 2Issued Date: 10/27/2020 PERMIT NUMBER FNCE20-0089 ISSUED: 10/27/2020 EXPIRES: 4/25/2021 FENCE WALL OR BARRIER PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $181.79 FNCE20-0089 Address: 336 8TH ST APN: 169927 0000 $181.79 BLDG SUBSEQUENT PLAN REVIEW FEES $100.00 BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00 BLDG 2ND PLAN REVIEW FEE 455-0000-322-1006 0 $50.00 BUILDING $35.00 FENCE 455-0000-322-1000 0 $35.00 BUILDING PLAN REVIEW $17.50 BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50 PUBLIC WORKS PLAN REVIEW $25.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 STATE SURCHARGES $4.29 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.29 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL FEES PAID BY RECEIPT: R13963 $181.79 Printed: Tuesday, October 27, 2020 4:00 PM Date Paid: Tuesday, October 27, 2020 Paid By: T S B FENCING INC Pay Method: CREDIT CARD 390108878 1 of 1 Cashier: CG Cash Register Receipt City of Atlantic Beach Receipt Number R13963 ~+; CENTRALSQUARE F N C E 2 0 - 0 0 8 9 E i J i l d i n g P e n n i t A p p l i c a t i o n 4 X / 8 t e d 1 0 / 9 1 1 8 r , C t y o f A t l a n t i c E m c h E l J i l d i n g D e p a r t m e n t 7 f t Q ~ . . . . - : . ~ B O O ~ m i n o l e F b a d , A t l a n t i c P J e a d i , F L 3 2 2 3 3 ( I ' R l o n e : ( 9 0 4 ) 2 4 7 - 5 8 2 6 B n a i l : B u i l d i n g - D e p t @ c o a b . u s • • A U - l ~ R : H f t A T I O N H G I U G f l l D I N ~ y I S R Q U J R : D . . b b A d d r e s s : 3 3 6 S U . 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I D R C A L ~ F U J M B N G , S G N ~ ~ F O C X . $ R J ~ B O I ~ H E A . ~ T A N K $ ~ d A J R C D ' l l l l l l O N ~ e t c . N O l l C E I n a d d i t i o n t o t h e r e q u i r e m e n t s o f t h i s p e r m i t , t h e r e m a y b e a d d i t i o n a l r e s t r i d l o n s a p p l i c a b l e t o t h i s p r o p e r t y t h a t m a y - b e f o u n d l n t h e p u b l i c r e c o r d s o f t h i s c o u n t y , a n d t h e r e m a , , , b e a d d i t i o n a l p e r m i t s r e q u i r e d f r o m o t h e r g o v e r n m e n t a l e n t i t i e s s i c h a s w a t e r m a n a g e m e n t d i s t r i c t s , s t a t e a g e n c i e s , o r f e d e r a l a g e n c i e s . O W N E R ' S A F F I D A V I T : I c e r t i f y t h a t a l l t h e f o r e g o i n g I n f o r m a t i o n I s a c x : : u r a t e a n d t h a t a l l w o r k w i 1 1 b e d o n e i n c o m p l i a n c e w i t h a l l a p p l i c a b l e l a w s r e g u l a t i n g o o n s t r u c t i o n a n d 2 0 n i n g . 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" 1 : I X R J I N G Y f J U R N O O F < D V I M 9 4 C B \ n e l f . ~ r A . r t ( o 7 ? 1 4 s ) ( S i g n a t u r e o f C o n t r a d o r ) / 4 - - S ! 1 1 e d a n d s . v o r n t o ( o r a f f i · _ · / _ d a y o f / l u 1 I L > I - , , g o , 7 . 0 S g , e d a n d S N o r n t o { o r a f f i r m e d ) b e f o r e m e t h i s _ d a y o f - - - - - - ~ b y _ _ _ _ _ _ _ _ _ _ ( S g , a t u r e o f N o t a r y ) I ] F a ' s o n a l l y l < n o w n O R ( ] A - o d u c e d I d e n t i f i c a t i o n l y p e o f I d e n t i f i c a t i o n : _ _ _ _ _ _ _ _ _ _ _ _ • 1 I F N C E 2 0 - 0 0 8 9 R e v i s i o n R e q u e s t / C o r r e c t i o n t o C o m m e n t s C i t y o f A t l a n t i c B e a c h B u i l d i n g D e p a r t m e n t 8 0 0 S e m i n o l e R d , A t l a n t i c B e a c h , F L 3 2 2 3 3 . . A L L I N F O R M A T I O N H I G H L I G H T E D I N G R A Y I S R E Q U I R E D . 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( p r i n t e d n a m e • W i u i " r o p o s e d r e v i s i o n / c o r r e c t i o n s a d d a d d i t i o n a l s q u a r e f o o t a g e t o o r i g i n a l s u b m i t t a l ? 0 N ; D Y e s ( a d d i t i o n a l s . f . t o b e a d d e d : _ _ _ _ _ _ _ _ _ _ _ _ ) • W i l l / 4 p o s e d r e v i s i o n ~ ~ o r r e c ~ i o n s a d ~ a d d ' . t i ~ n a l i n c r e a s e i n b u i l d i n g v a l u e t o o r i g i n a l s u b m i t t a l ? ~ ; - - 1 D " ' Y e s ( a d d 1 t 1 o n a l i n c r e a s e I n b u 1 l d m g v · $ _ _ _ _ _ _ _ _ - , , - - - - _ _ ) ( C o n t r a c t o r m u s t s i g n i f i n c r e a s e i n v a l u a t i o n ) ( O f f i c e U s e O n l y ) c i p p r o v e d D D e n i e d D N o t A p p l i c a b l e t o D e p a r t m e n t P e r m i t F e e D u e $ - - - - - - R e v i s i o n / P l a n R e v i e w C o m m e n t s _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D e p a r t m e n t R e v i e w R e q u i r e d : B u i l d i n g P l a n n i n g & Z o n i n g T r e e A d m i n i s t r a t o r P u b l i c W o r k s P u b l i c U t i l i t i e s P u b l i c S a f e t y F i r e S e r v i c e s R e v i e w e d B y D a t e U p d a t e d 1 0 / 1 7 / 1 8 FNCE20-0089 FNO 1/2 .. IRON PIPE HO 1.0. MAP SHOWING BOUNDARY SURVEY OF LOT 17 BLOCK 9 AS SHOWN ON MAP OF PLAT NO. 1 SUBDIVISION 'A" ATLANTIC BEACH AS RECORDED IN Pf.AT BOOK 5 PAGE 69 OF THE CURRENT PUBLIC RECORDS OF DCNAL COUNTY. flA. CERTIFIED ro: JOHN R. LONG &< ERIN M. LONG BENCHMt,RJ<· FND MAG NAIL ON PROLONGATION OF WEST PROPERTY LINE 1' NORTH OF SOUTHERN EDGE OF PAVEMENT ELEVATION:(9.00) ---------- ELEVATIONS SHOWN H~~ON "' REl'ER TO NAVG OF 1988 ~ 702.16'{A) 702.0S'(P) CD -0> f ND 1/r IRON PlPE NO 1.0. EXISTING FENCE >< >-o 0 0..J m ..J 0.6" nm 112· IRON PIPE NO 1,0, L O T 2 0 BLOCK 9 EIGHTH STREET ( 40' RIGHT OF WAY) ASSUMED BEARING BASE 50.00'(P) N90'00'00WE 49.98' A ,.s 16.0 ... "' .;. .., 20' B.R.L. ---7 TWO STORY HARDIE SOARD ,.. RESIDENCE ~ ~ A~~~:~rs~6 I L O T 1 8 BLOCK 9 0.4 5.7 nm 112· tRON PIPE NO 1.0. J ., -"' "' .... 0 0 0..J a, ..J L O T 1 6 BLOCK 9 tll2lL FINAL; W.0.# 148816; OJ-24-16 (FIEI.D) FOUNDATION, F.f.E.: W.O.f146J74; 09/19/15 (FIElD) 1. FENCES LOCA'TED BY EXAClA LAND SURVEYCRS. INC. 4/2/12. LOT & HOUSE S-O(GOOO):W.0.f145889; 08/19/15(RELO) 2. FRONT/SIDE TIES AR( TO 11-!E FOUNOATldN. THIS SURVEY WAS PERFORMED WITHOUT THE BfNEffT OF A T1Tl.E COMMITMENI'. 11-iERE MAY BE AOOmOWI. EASEMENTS ANO/OR RESTRICTIONS THAT ARE NOT SHOWN ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. THE LANO SHOWN HEREON IS IN '!HE SPECIAL FLOOD HAZARD ZONE "X" AS SHOWN OH FLOOO INSVRANCE RATE M4P 0409 H FOR THE atY OF JACKS0NV1ll£.. f'lOFUQ(. DAlED 06-03-1:5 ALL AMERICAN SURVEYORS OF FLORIDA, INC . lNIO SUIMl'!1RS -:ms, SAN JOSE PIACE. SUlTE: 15 -JACK5CNVIUE. Fl.ORIO,\ "2257 -9<U/279-Q088 -UCCNSED UNO ll(ISINESS Nt1. J857 ocw~ fMJ. -f"COl+O £SM'T -DSQ!f:NI' COHC •COHCREft --"'""""" ~P. .. ROH PPE LR. .. IION ROO 6. ... on:u. NtGLl: CH ... CHORO A 9 MelD'GTH R -.....,. ~.)-~ ~! : iifil ~s •N,OW..Li£ ft -com,t UM[ lf./W .. MQHT-of'-'IMY ,er •><N'L M _...,... FSL. -fJ,191 fl00R [U.'W0'l0N .,< .... _ Lb,. •IO£lffln::AllON P.R,\L •PC:RltWEMt'RrFERDICE NONMENT P,l. • POfll'OP'TANGl:NC'f r.u.-~COlrffltOLPQNT P.C, • POlNf 0/F ~ P.R.C. • ~ OF' REVERSE CllNE P.C.C. • POINT U COUPOI.M) CUM BJll. • S'Jt.mfO RESTRICTIOM F.PM.."" fl.OAICo\ P"O'«JI: &: UCKT (NP.) -1'l'PICl,L H<M> -MAllOIW. Gt'OOCTIC ~ ...... M,,WD -J40RIH Al,£M;llN w;Rrr.AI.. """' PJ. •l'C»CT0FINT(R$[C1DI 00W • EO«OYw.lflf roa -10P c,-8tlNC F'.B. 2001. PG . 3; DC 79091-146374 OR. gy ~ THIS IS TO comFY THAT THE ABOVE I.ANOS WERE SURVEYED UNDER MY RESPONSIBI.£ SUPER\'ISION ANO OIREC'TION, THAT THERE AR£ NO ENCROACHMENl'S EXCEPT AS SHOWN ANO THAT THE SURVEY SHOWN HEREON MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS ANO MAPPERS PURSUANT TO CHAPTER 472.027 / CHAPTER 6 1 G17-6, FLORIDA STATUTES. SCALE~ DATE 06-03-1 S SURVEY NOT VAi.JO UNLESS EMOOSSEO 0Y SEAi.. JAMES 0. HARRISON, JR.. No, 2647 808 L. PITIMA>I, No. -4827 c/2. L .#:Z#✓f' FLORIDA R G ED SURVEYOR ANO - 0/R. Pc\2015\78516\79091-148816-FNL ORDER NO.~ F1lE ~ Revision Request/Correction to Comments City of Atlantic Beach Building Department 800 Seminole Rd, Atlantic Beach, FL 32233 **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED. Phone: {904) 247-5826 Email: Building-Dept@coab.us PERMIT#: FNCE20-0089 0 Revision to Issued Permit OR [ZJ Corrections to Comments Date: 09/28/2020 Project Address: 336 8TH STREET, ATLANTIC BEACH , FLORIDA 32233 Contractor/Contact Name: TONY THOMAS --------------------------------- Contact Phone: (904)294-1966 Email: TTHOMAS@TSBFENCING.COM ------------- Description of Proposed Revision/ Corrections: REMOVAL OF EXISTING FENCE. l!'JSTALLATION OF WHITE VINYL PRIVACY FENCE. I_T_o_N_Y_TH_o_M_A_s _________ affirm the revision/correction to comments is inclusive of the proposed changes. (printed name) • Will proposed revision/corrections add additional square footage to original submittal? EJNo D Yes (additional s.f. to be added : · •~ill proposed revision/corrections add additional increase in building value to original submittal? LJNo El*Yes (additional increase in building value:$$ 3 000 00 ) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: -+P--'-·-'~--'--.eF--~bvw'--"--=-'-.:....;..-=:"'--------------- (Office Use Only) D Denied D Not Applicable to Department Permit Fee Due $ ------- Revision/Plan Review Comments -------------------------------- Department Review Required: Building Planning & Zoning Tree Administrator Public Works Public Utilities Public Safety Fire Services Reviewed By Date Updated 10/17/18 FNCE20-0089 THIS WAS RECIEVED 9-2-20 MISSINGLEGAL BUT IS NOTARIZED ~2· · · B.Jilding Pennit Application . I aty of Atlantic Beadl &Jilding Department 7n, 0 cp:lated10/9/18 '----=..--:• 800 ~minol e R:>ad, Atlantic Beach, R...32233 cl ** AU-IN.f.QfNATION I-IGHIJGfJB) IN <lRAY ISRQUJFe). Alone: (904) 247-5826 Bnail : 8uildin9:Dept@coab.us .bb .Address: 336 8th STREET, AT!,.ANTIC BEACH . FLORIDA 32233 ~rmit Number. ----------legal Das,ription FENCE INSTALLATION Fe~-________ _ Valuation ofWorfc ~lacement Cb&) $ __ 3_7s_o._oo ______ HeatedlO>oled S? ____ Non-Heated/Ox>led'-------- • Oassof\M:>rk: □New □.Addition OAlteration Ofepair □Move □Demo □Fbol □Window/D:>or • Use of exil:ting'propoS:XI strudure{s): DO:lmmerdal Ofe:idential • If an existingstrudure, is afire 5Prinkler system ins:alled?: □Yes □No • Will trees be removed in ro"ed?OYes must submit eTree oval Permit tJNo Desaibe in detai l the type of work to be performed: REMOVAL OF EXISTING FENCE, INSTALL VINYL FWNCE Florida A'oduct Ppproval #'--________________ for multiple products use product approval form Property ONner Jnfonnation Name RANDY LONG aty ATLANTIC BEACH SMail rlong@jalong.com sate FL. Address 336 8th STREET Zip 32233 Rlone 904 -264 -3073 ONner or ~t (If Agent, Fbwer of Attorney or Agaocy LetterR9quired) _________________ _ 0:mt ractor Informati on · . Name of O:lmpany T~B FENCING, INC. Address 101~2103~0 STREl;T, UNIT#20S aticeAlone 904-~03-1488 _ , S:ate Qrtification/ ~stration # P1soooo1s954 QualifyingPGent_T...,.o_NY_TH_O_MA_S-=---...,,,,,,,=---- Ot}qACKS0NVILl.E, FLORID~ate_FL ___ 2ip 32210 .bbSteO:mtad: Number _____________ _ 5Mail Til-lOMAS@TSBFENCING.COM Architect Name& Alone#. ______________________________ _ Engineer's Name& Phone# ________________________ ,..,..,..-,--____ _ WorkersCbmpensation tnsurer NIA . ~6cempt i1f 6cpitation Date_51_-2/2.022..;.·_-____ _ Application is hereby ma:!eto obtain a permit to do the work and installations as indicated. I oortifythat no work or installation has oommenced prior t o the issuance of a permit and that all work will be performed to meet thestcM1da'dsof all the laws regulating construd:ion in thisjuri::rlidion. I unders:and that a separate permit must be serured for B.ECIRCAL ~ R1JMBING, SGN~ V\18:1.& ~ RJR-lA.<$ 00~ HEA~ TANKS and AIROONIJllQNERS etc. NOTICE In addition to the requirements of t his permit, there may be additional restridionsapplicable to this property that may be found in the public records of this county, and there may be addition~ permits required from other governmental entitiesruch as water management d istricts. state agencies, or federal agencies. OWNER'S AFFIDAVIT: I certify that all the foregoing information is acx:urate and that all workwill be done in compliance w ith all applicable laws regulating construction and zoning. //f!.?4%:.,.,_ STELI:A ~INYARD f•: '"Ji,,'' :*E Comm1ss1on # GG 979421 ~~;~:t"i Expires August 17, 2024 ·•f l?fJ~?-·• Bondedlbru Troy Fain Insura nce 800-385-7019 FNCE20-0089 THIS WAS RECIEVED 9-2-20 MISSINGLEGAL BUT IS NOTARIZED ~2· · · B.Jilding Pennit Application . I aty of Atlantic Beadl &lilding Department 800 ~minole R:>ad, Atlantic Beach, R...32233 Alone: (904) 247-5826 Bnail: 8uildin9:Dept@coab.us cp:Iated10/9/18 ** AU-IN.f.QfNATION HGHIJGfJB) IN <PAY ISR:DUIFH>. .bb Address:: 336 8th STREET, AT!,ANTIC BEACH , FLORIDA 32233 ~rmit Number. ---------- legal ~iption FENCE INSTALLATION Fe~---------- Valuation ofWorfc ~racement Cl:>&) $ __ 3_75_o._oo ______ HeatedlO>oled s= ____ Non-He.rted/Ox>led-=-------- • OassofV\,brk: □New □.Addition □Alteration Ofepair □Move □Demo □Fbol □Window/D:>or • Use of exi&ing'propOS:!d strudure{s): DO:lmmerdal Ofe:idential • If an exi&ingstrudure, is afire 5Prinkler sy&em ins:alled?: □Yes □No • Will trees be removed in ro·ect?OYes must submit eTree oval Permit tJNo Desaibe in detail the type of work to be performed: REMOVAL OF EXISTING FENCE, INSTALL VINYL FWNCE Florida A'oduct Ppproval #;,__ ________________ for multiple products use product approval form Property OJvner Jnfonnation Name RANDY LONG aty ATLANTIC BEACH SMail rlong@jalong.com Sate FL. Address 336 8th STREET Zip 32233 Rlone 904 -264 -3073 ONner or ~t (If Agent, Fbwer of Attorney or Agancy LetterR3quired) _________________ _ 0:mtractor Information · . Name of O:lmpany T~B FENCING, INC. Address 101~2103~0 STRE.l;T, UNIT#20S aticeAlone 904-~03-1488 _ · 8:ate Qrtification/ Rajstration # P1soooo1ss64 Qualifying~t_T....,.O_NY_TH_O_MA_S-=---...,,,,,,=---- Ot½/ACKS0NVILLE, Fl.ORIDP8ate_FL ___ 2ip 32210 .bbSteO:mtad: Number _____________ _ 5Mail TIH.OMAS@TSBFENCING.COM Architect Name& Alone#. ______________________________ _ Engineer's Name& Phone# ___________ -------------,,..,..,------- WorkersCbmpensation tnsurer NIA _ ~6cempt i1f 6cpitation Date_51_-212.022..;;.· _____ _ Application is hereby ma:!eto obtain a permit to do the work and installations as indicated. I oortifythat no work or installation has oommenced prior to the issuance of a permit and that all work will be performed to meet the sc11da'ds of all the laws regulating construd:ion in thisjuril:didion. I unders:and that a separate permit must be serured for B.ECIRCAL. ~ R1JMBING, SGN~ V\18:1.& ~ RJR-JA.a:s 00~ HEA~ TANKS and AIROONIJTIQNffiS etc. Nanre In addition to the requirements of this permit, there may be additional restrictionsapplicable to this property that may be found in the public records of this county, and there may be addition~ permits required from other governmental entitiesruch as water management districts. state agencies, or federal agencies. OWNER'S AFFIDAVIT: I certify that all the foregoing information is acx:urate and that all workwill be done in compliance with all applicable laws regulating cons ruction and zoning. //f!.?4%:--.,_ STELI:A ~INYARD ;•: ,.-A.., :*E Comm1ss1on # GG 979421 ~~~~W Expires August 17, 2024 ·•f l?fJ~?-·• Bondedlbru Troy Fain Insurance 800-385-7019 ~ · B u i l d i n g P e r m i t A p p l i c a t i o n ' " ~ · , . ~ C i t y o f A t l a n t i c B e a c h B u i l d i n g D e p a r t m e n t , . , ~ ( J H l ! J ; . 8 0 0 S e m i n o l e R o a d , A t l a n t i c B e a c h , F L 3 2 2 3 3 P h o n e : ( 9 0 4 ) 2 4 7 - 5 8 2 6 E m a i l : B u i l d i n g - D e p t @ c o a b . u s U p d a t e d 1 0 / 9 / 1 8 • • A L L I N F O R M A T I O N H I G H L I G H T E D I N G R A V I S R E Q U I R E D . J o b A d d r e s s : 3 3 6 8 t h S T , R E E , T , A I L . A N T I C B E A C H I F L O R I D A 3 2 2 3 3 P e r m i t N u m b e r : - : F : : : : N - : - " C = : : E 2 : : : : : : : 0 - 0 : : : 0 ~ B = = = 9 = = = - - - - - - L e g a l D e s c r i p t i o n ~ ! _ I b - 2 $ _ - 2 . I f G " : = A - - - ; : ~ f l . ; ; , : : . \ S ~ : C . t . _ L o T I i B l k . ' l R ~ 1 - - - - V a l u a t i o n o f W o r k ( R e p l a c e m e n t C o s t ) 3 7 5 0 . 0 0 H e a t e d / C o o l e d S F _ _ _ _ N o n - H e a t e d / C o o l e d _ _ _ _ _ • C l a s s o f W o r k : ' 2 1 N e w □ A d d i t i o n □ A l t e r a t i o n □ R e p a i r □ M o v e □ D e m o □ P o o l □ W i n d o w / D o o r • U s e o f e x i s t i n g / p r o p o s e d s t r u c t u r e ( s ) : □ C o m m e r c i a l ~ ~ d e n t i a l • I f a n e x i s t i n g s t r u c t u r e , i s a f i r e s p r i n k l e r s y s t e m i n s t a l l e d ? : □ Y e s - - E i N o • I l l t r e s r m o v e d l n a s s o c i t i n w · h r o s e d r o · e c t ? □ Y e s m u s t s u b m i t s e a r a t e T r e e R e m o v a l P e r m i t ~ N o D e s c r i b e I n d e t a i l t h e t y p e o f w o r k t o b e p e r f o r m e d : R e m o v e a n d H a u l A w a y E x i s t i n g F e n c e . I N S T A L L A T I O N O F W H I T E V I N Y L P R I V A C Y F E N C E . F l o r i d a P r o d u c t A p p r o v a l # _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f o r m u l t i p l e p r o d u c t s u s e p r o d u c t a p p r o v a l f o r m P r o p e r t y O w n e r I n f o r m a t i o n N a m e - \ , 9 b : J ~ . L : : i n < : : : ) A d d r e s s 3 3 6 8 t h S T R E E T C i t y A T L A N T I C B E A C H S t a t e _ F _ L _ . _ Z i p 3 2 2 3 3 P h o n e _ 9 : . . : 0 4 - ' - - · . . ; ; . 2 6 4 , ; . . _ ~ . . . . ; . 3 _ 0 7 ; . . . . ; 3 ' - - - - - - - - - E - M a i l r l o n g @ j a l o n g . c o m O w n e r o r A g e n t ( I f A g e n t , P o w e r o f A t t o r n e y o r A g e n c y L e t t e r R e q u i r e d ) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ C o n t r a c t o r I n f o r m a t i o n N a m e o f C o m p a n y T S B F E N C I N G , I N C . A d d r e s s 1 0 1 4 2 1 0 3 R D S T R E E T , U N I T # 2 0 5 O f f i c e P h o n e 9 0 4 - 5 0 3 - 1 4 8 8 S t a t e C e r t i f i c a t i o n / R e g i s t r a t i o n # P 1 5 0 0 0 0 7 8 9 6 4 Q u a l i f y i n g A g e n t T O M M Y A T H O M A S C i t y J A C K S O N V I L L E S t a t e F L Z i p , . . . . . . : : . 3 2 2 . ; ; ; ; ; ; . ; . 1 . c . . 0 _ _ _ _ J o b S i t e C o n t a c t N u m b e r _ - - ' - ' - - = - 9 0 4 ~ · . ; ; ; 2 ; ; ; . 9 4 . c . . - _ 1 ; . ; : 9 - = - 6 6 ; ; . . _ _ _ _ _ _ _ _ E - M a i l T T H O M A S @ T S B F E N C I N G . C O M A r c h i t e c t N a m e & P h o n e # _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ E n g i n e e r ' s N a m e & P h o n e # _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ W o r k e r s C o m p e n s a t i o n I n s u r e r N I A O ~ E x e m p t 1 2 1 E x p i r a t i o n D a t e 6 1 2 / 2 0 2 2 A p p l i c a t i o n i s h e r e b y m a d e t o o b t a i n a p e r m i t t o d o t h e w o r k a n d i n s t a l l a t i o n s a s i n d i c a t e d . J c e r t i f y t h a t n o w o r k o r i n s t a l l a t i o n h a s c o m m e n c e d p r i o r t o t h e i s s u a n c e o f a p e r m . i t a n d t h a t a I I w o r k w i l l b e p e r f o r m e d t o m e e t t h e s t a n d a r d s o f a l l t h e l a w s r e g u l a t i n g c o n s t r u c , t i o n i n t h i s j u r i s d i c t i o n . I u n d e r s t a n d t h a t a s e p a r a t e p e r m i t m u s t b e s e c u r e d f o r E L E C T R I C A L W O R K , P L U M B I N G , S I G N S , W E L l S , P O O L S , F U R N A C E S , B O 1 L E R S , H E A T E R S , T A N K S , a n d A I R C O N D I T I O N E R S , e t c . N O T I C E : I n a d d i t i o n t o t h e r e q u i r e m e n t s o f t h i s p e r m i t , t h e r e m a y b e a d d i t i o n a l r e s t r i c t i o n s a p p l i c a b l e t o t h i s p r o p e r t y t h a t m a y b e f o u n d i n t h e p u b l i c r e c o r d s o f t h i s c o u n t y , a n d t h e r e m a y b e a d d i t i o n a l p e r m i t s r e q u i r e d f r o m o t h e r g o v e r n m e n t a l e n t i t i e s s u c h a s w a t e r m a n a g e m e n t d i s t r i c t s , s t a t e a g e n c i e s , o r f e d e r a l a g e n c i e s . O W N E R ' S A F F I D A V I T : I c e r t i f y t h a t a l l t h e f o r e g o i n g i n f o r m a t i o n i s a c c u r a t e a n d t h a t a l l w o r k w i l l b e d o n e I n c o m p l i a n c e w i t h a l l a p p l i c a b l e l a w s r e g u l a t i n g c o n s t r u c t i o n a n d z o n i n g . R e v i s i o n R e q u e s t / C o r r e c t i o n t o C o m m e n t s C i t y o f A t l a n t i c B e a c h B u i l d i n g D e p a r t m e n t 8 0 0 S e m i n o l e R d , A t l a n t i c B e a c h , F L 3 2 2 3 3 . . A L L I N F O R M A T I O N H I G H L I G H T E D I N G R A Y I S R E Q U I R E D . P h o n e : ( 9 0 4 ) 2 4 7 - 5 8 2 6 E m a i l : B u i l d i n g - D e p t @ c o a b . u s P E R M I T # : _ _ _ _ _ _ _ _ D R e v i s i o n t o I s s u e d P e r m i t O R ~ r r e c t i o n s t o C o m m e n t s C o n t r a c t o r / C o n t a c t N a m e : 7 ! : ) ~ - F c 1 1 1 < • ~ , . . l " ' c ; , C o n t a c t P h o n e : C , o l . ( . - S r . ! > 3 , - I C o f i h ' E m a i l : _ _ _ , j - . . . . . . . . ; . - 1 ' _ ~ _ o _ . . . , ' - . , , _ $ . _ ( ! _ 7 _ ~ _ & _ - f - ' - - e _ , , _ c _ i _ . , _ : , J - - • _ C _ o _ ~ _ _ _ _ _ D e s c r i p t i o n o f P r o p o s e d R e v i s i o n / C o r r e c t i o n s : h J c . \ C o ( ' . ' r ~ c + - l e t ) " I \ b e ~ , ~ p + , o " I ( l e i " . . . _ _ . . , . . , \ . . . , o . _ _ h a . . . a " ' - . . . . . . _ - - = L - " • - ~ - - - - - a f f i r m t h e r e v i s i o n / c o r r e c t i o n t o c o m m e n t s i s i n c l u s i v e o f t h e p r o p o s e d c h a n g e s . ( p r i n t e d n a m e T • W . i i ~ p r o p o s e d r e v i s i o n / c o r r e c t i o n s a d d a d d i t i o n a l s q u a r e f o o t a g e t o o r i g i n a l s u b m i t t a l ? f i t N ~ E J Y e s ( a d d i t i o n a l s . f . t o b e a d d e d : _ _ _ _ _ _ _ _ _ _ _ _ ) • W l l l ~ p o s e d r e v i s i o n / c o r r e c t i o n s a d d a d d i t i o n a l i n c r e a s e i n b u i l d i n g v a l u e t o o r i g i n a l s u b m i t t a l ? ~ ; · - , D * Y e s ( a d d i t i o n a l i n c r e a s e I n b u i l d i n g V • $ _ - - - : : : : - - - - - ~ - - · ) ( C o n t r a c t o r m u s t s i g n I f I n c r e a s e i n v a l u a t f o n ) ( O f f i c e U s e O n l y ) D A p p r o v e d D D e n i e d D N o t A p p l i c a b l e t o D e p a r t m e n t P e r m i t F e e D u e $ - - - - - - R e v i s i o n / P l a n R e v i e w C o m m e n t s _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ D e p a r t m e n t R e v i e w R e q u i r e d : B u i l d i n g P l a n n i n g & Z o n i n g T r e e A d m i n i s t r a t o r P u b l i c W o r k s P u b l i c U t i l i t i e s P u b l i c S a f e t y F i r e S e r v i c e s R e v i e w e d B y D a t e U p d a t e d 1 0 / 1 7 / 1 8