801 Begonia St Fence Permit Submittal 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
Ott -' IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: go/ iQ' c !1� C J� Permit Nu I��,ee : /� nn /
Legal Description 18 -Sy 31. -oc� �Dr 4 4 �1 4- f7, �!4ef, RE# `'/U4
Valuation of Work(Replacement Cost)$ 45 0. 0 d Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New DAddition DAlteration •Repair ❑Move ❑Demo ❑Pool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial •Residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes No
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) allo
Describe in detail the type work to be performed: r_Qf t Q Q Q ,1/4 � 3(1-4".'r o4 `'1-0e 3' 6,,.J 001)
1-1421-2 a 14i,ovi-
Florida Product Approval# J for multiple products use product approval form
Property Owner Information
Name `4 r' be , iJ2^, C"" Address S C)( e.eg AI Si
-
City I, . S.; . Sate Zip 3 a PhorSe (co y-�pl /C{' r25G
E-Mail 14 C Ck r`i+ Qcrpvta!ie /Vk7
Owner or Agent(If Agent, Per of Attorney or Agency Letter Required)
Contractor Information
Name of Company Qualifying Agent
Address City State Zip
Office Phone Job Site Contact Number
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
RECORDING YOUR NOTICE OFC MMENCEMENT.
(Signature of Owner or Agent) I (Signature of Contractor)
Signed and sworn to(or affirmed)before me this t, day of Signed and sworn to(or affirmed)before me this day of
AjcUe•«b-A- , 2020 , by "L{Ar t i') ,6 47-V ,by
' TAMMY NISHIYAM i a u of N tary) (Signature of Notary)
.� ,a� ` �_ Notary Public-State of Florida
• «or Commission # GG 064732
y
[ ]Personally Known OR[.• allyl)(- . . . tires Jan 22,2021 I [ ]Produced Identification
Type of Identification: Type of Identification:
:-ILA,-„, Owner Builder Affidavit **ALL INFORMATION
's iv , HIGHLIGHTED IN
' jd City of Atlantic Beach Building Department GRAY IS REQUIRED.
f
VOW 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
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 1
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. 1
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 ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT.
Job Address: et t .1 acon /9 A.M... iiei _ / 3x.33
Owner Name: /'. Pt'//N frf 43e " il Phone Number: /6`I- a 7 " 8 a 6-6
Mailing Address: 9 of E. e�jc)Y1 /c, 5 4- City: Yt.- 4. 'R C A State: 4i. Zip: 3a9 3 3
Notarized Signature of Owner r f✓; ►...�j WA-
The foregoing instrument was acknowledged before me this 62day of A] , 20 2y, in the State of Florida, County
of bow f}C—
Signature of Notary Public a/hriA c/i_e,<9..-4, ezviye...„.,
IZOZ'ZZ ue('sa�idx3 wwo0�W .�p�i io"'�
[ ] Personally Known OR [ roduced Identification
o,i '
�C miiii - It
ZELb90 99 # uolsslwwoo =� , l ob.'s:
ep!Jold Jo atetS-aiignd AMON
s "' iCL�L
VWVAIHSIN AVJWdl =,I: or.; 0 Type of Identification.
o��aY a�a`s, TAMMY NISHIYAMA '_
2 y •0; Updated 10/24/18
_, : ,y : : Notary Public-State of Florida
9`,,, 'U'1 «,: Commission # GG 064732
',,;;;;;.;,,,;10,
My Comm. Expires Jan 22. 7'2' •
-- 102.00' i
> i
o ' ' REMAINDER OF LOT 3 6' WOOD FENCE o 7 y
(BEARING BASE) BLOCK 145-7.2
(75.8') 01W o�FND NAIL et DISK
I— q$55
5 N89'02'00"E r°x(1'020 ESQ. FT) , 102.00'
,� y .,-.00,/,-7.9
No Lo
W 29.64' (I P TO FENCE) .8 7,3 7. 17.9
j- 1' n
�'.EiH �. � r J 4 (O
p0.5 X3.5T�� Et x- d
• A C PADS rn l M'' w
V)/ LO 26.5' , 47 7' Io '� v I-Y z
14
I- tp OI 0 n 1 , OL••
wi I kQA e-:�ri-i ,-'•it� ts ou1 mm prv `k _
Z ,, QRIyWAY n d I I r0 I
1.G ,'Y�, ,1,jT�`T-r -t.6 LIJ I— 18 F- I
(�' OY I m ID
Or^ 5.9 6 6.69. . J ZGO--i mo UIZ I K
V v I S. )` 3 O �p O N .�^��'O U-OJ w �N (In —�
w d—� r�No O�Z aj �o (nOmo M 7.6
J v1 I w "i Ln W(n I I cog @7 I to I I 7.6 1
W' o I J v pwCC w LJ 3.3 17.3 Cj
I-C11111,- 1 a I o '.r.� • M 0 cr ,.- I`O '4 6.
A Z �. L,aQV D' <f 7 6f
_ �
BENCHMARK: :,v,, Z i g°DI o-..� ,i/5. o • �io. :to.o'� —6.2'
NAIL & DISK [ND LB 3857 HSI W I .Of O Y •o a.:mew
IN E.A. ACROSS FROM LOT o , . o "' >z co,a. f
3+4 ON BEGONIA STRFFT �` A 15 :I o ow O J t0.6� ' s��� >
1 1 26.4' " 37.2' zOm - - T %�•�i4 •
ELEVATION:(5.28) t. n J rn
8 ° V. 6 69'� '?' ET.--i?t.. SCREENED & ci
-V )w • 0.4'N N COVERED' 7.• - 7.• X
ELEVATIONS SHOWN 1-IEREON " 47.07'(FENCE
5. O.t'N 6. 0.3'5 (n (nCD. j 4_0.2' �o
REFER TO NAVD OF 1988 5 4' wooD 6 58902 00 W TO FENCE) 102.00' , .0-3c-).
FENCE (32.4') .51 �'9 6' WOOD z
t- FENCE (32.4') '+'T H- Y
O
REMAINDER OF z O
FINAL; W.O. �! --
181593; 0423-2020 (FIELD) LOT 4 BLOCK 145 m
FOUNDATION, F,F.E.; W.O.# 178370, 12-05-19 (FIELD) 3,060 SQ. FT.
LOT & HOUSE- S-O(GOOD SET F.F.E.) W.O.#178008: 11-25-19 (FIELD)
MOVE HOUSE; 10-17-19; (OFFICE)
BOUNDARY. TOPOGRAPHIC AND TREE: W.O. #176314: 09-20-19; (FIELD)
REVISE DRIVEWAY; 09-10-19 (OFFICE)
THIS SURVEY WAS PERFORMED WITHOUT THE BENEFIT OF A TITLE COMMITMENT.
THERE MAY BE ADDITIONAL EASEMENTS AND/OR RESTRICTIONS THAT ARE NOT SHOWN `4 II
.N THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY. ':IDE./PRONI BUILUINI,, 1TE.'J ARE 11 II !'OUNDATIUN
UNDERGROUND ENCROACHMENTS NOT LOCATED
THE LAND SHOWN HEREON IS IN THE SPECIAL FLOOD HAZARD ZONE "X-SHADED" AS SHOWN
ON FLOOD INSURANCE RATE MAP 0408 J FOR DUVAL COUNTY, FLORIDA. F-I.R.M INDEX DATE 11-02-18
ALL AMERICAN SURVEYORS OF FLORIDA , INC.
LAND SURVEYORS - 3751 SAN JOSE PLACE, SUITE 15 - .JACKSONVILLE, FLORIDA, 32257 - 904/279-0088 - UCENSED LAND BUSINESS NO. 3857
Legend
—5
COV. COVERED F.E.E. - FINISH FLOOR ELEVATION THIS IS TO CERTIFY THAT THE ABOVE LANDS WERE SURVEYED UNDER MY RESPONSIBLE
A/C - CONDITIONERAIR
ENO. FOUND SUPERVISION AND DIRECTION, THAT THERE ARE NO ENCROACHMENTS EXCEPT AS SHOWN —4
ESM•T EASEMENT I.D. - IDENTIFICATION
CONC CONCRETE P.R.M.. PERMANENT REFERENCE AND THAT THE SURVEY SHOWN HEREON MEETS TH,E MINIMUM TECHNICAL STANDARDS -
MON. MONUMENT MONUMENT SET FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS
I.P. IRON PIPE P.T. POINT OF TANGENCY
LR. IRON ROD P.C.P. - PERMANENT CONTROL POINT PURSUANT TO CHAPTER 472.027 / CHAPTER .6101 7:-6, FLORIDA STATUTES. ALL
A .DELTA ; W. D.R.C. POINT OF REVERSE CURVE
A ARC LENGTH P.C.C. - POINT OF COMPOUND CURVE
B.R.L. BUILDING RESTRICTION NOT VALID UNLESS EMBOSSED BY SEAL SURVEYORS
(C) CALCULATED F.P.&L. FLORIDA POWER & LIGHT OF FLORIDA,
D) DEED (rip.)- TYPICAL JAMES D. HARRISON, JR., No. 2647
P PLAT NGVO - NATIONAL GEODETIC VERTICAL DATUM MICHAEL A. GARRETT, No. 6643 INC.
R - RADIAL LINE NAVD . NORTH AMERICAN VERTICAL DATUM
F[ CENTER LINE N.T.S. . NOT TO SCALE SCALE 1“-=20' /7/...,)9- ..),D..),D
R/W - RIGHT-OF-WAY LB LICENSED BUSINESS
(A) - ACTUAL P.I. . POINT OF INTERSECTION
EOW - EDGE OF WATER a ` „y —91
(w) - WITNESS TOR - TOP OF BANK DATE 08-29-19 __-_-•
FLORID REGISTERED SU RAN MAPPER L.8
F
F.B. NOTES n r RARAn_,W,'.a._wo ..-