386 2nd St fence permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
FENCE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
305 INFORMATION:
Job ID: 17-FNCE-3133
Job Type: FENCE PERMIT
Description: 6' FENCE
Estimated Value: $6,729.00
Issue Date: 2/13/2017
Expiration Date: 8/12/2017
PROPERTY ADDRESS:
Address: 386 2ND ST
RE Number: 169793-0000
PROPERTY OWNER:
Name: Sklenicka, Laura
Address: 386 2Nd ST
GENERAL CONTRACTOR INFORMATION:
Name: SUPERIOR FENCE AND RAIL OF NFL
, N/A
Address: 5470 HIGHWAY AVE
Phone: 904-382-2221
PERMIT INFORMATION: PUBLIC WORKS:
All runoff must remain on-site during construction.
Roll off container company must be on City approved list(Advanced Disposal, Realco Recycling,
Shapell's Inc.). Container cannot be placed on City right-of-way.
Full right-of-way restoration, including sod,is required.
All old fencing must be removed from job site by Contractor.
FEES:
Fence/ROW $35.00
Total Payments: $35.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CTTV OF ATIAATIC BEAM ORDINANCES AND THE FLORIDA
BUILDING CODES.
* City of Atlantic Beach
Building Department
800 Seminole Road
Atlantic Beach, Florida 32233-5445
Phone(904)247-5826 - Fox(904)247-5845
� o E-mail: building-dept@coatims
City web-site: hftp:/Awww.coa1b.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Sa(e I Depa ent review re uIred Yes No
Applicant: R nIng &Zonm
Project: me tor
FE�-3ce ublic Wo
lic Utilities
Public Safety
es
Fire Servic FT
ReViewfee $--Dept Si nature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
-Florida Dept-of Environmental Protectiow—
Florida Dept.of Transportation
St.Johns River Water Management District
Army Corps of Engineems
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tabs=
Other:
APPLICATION STATUS
rReviewing Department First Review: N?fApproved. [-]Denied.
(Circle one.) Comments: -fa
BUILDING
I UiL
PLANNING&ZONING Reviewed by:: Date:
TREEADMIN. Second Review: EIAPProved as revised. E]De d,
PUBLICWORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date,
FIRE SERVICES Third Review: ElApproved as revised. oDenied.
Comments:
Reviewed by: Date:_
Revised 05114tO9
City of Atlantic Beach
Building Department
800 Seminole Road
Aflanfic Beach, Florida 32233-5445
Phone(904)247-5826 - Fa�(904)247-5845
E-mail: building-dept@wab.us
City web-site: httP.*www.coab.us JAN 3 u
APPLICATION REVI KING FORM
Property Address: Ss& 'z Department review re uIred Yes No
��Ufldmq_,)
Applicant: QL&)k3,ic_-P _. - ning &Zonin
Project: ZL /I — ree na or
-4 � 651 1--ENOCE ublic We
lie Utilities
Public Safety
Fire Services
WM
:Rev'ew fee $ Dept
Ir - _ - _� -.
Other Agency Review or Permit Required Review or Receipt ate
of Permit Verified B
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: Eg/Approved. DDenied.
(Circle one.) Comments:
C
BUILDING
3
men, F
Co
rs
m-
Re
a
vw
n
A re e
d
led
rPLANNING &ZONING
vie ad by Date:
TREEADMIN. Second Review: DApproved as revised. ElDemed.
W Comments:
B BLI
C I
UETUTI3TES
PUBLIC SAFE9 Reviewed by: Date:—
FIRE SERVICES Third Review: ElApproved as revised. ElDenled.
Comments:
Reviewed by: Date:—
Revised 05114109
City of Atlantic Beach
Building Department
800 Seminole Road
Atlantic Beach,Florida 32233-5445
Phone(904)247-5826 - Fax 1904)247,5a45
E-mail: building-dept@mab.us
Citywelb-site: hftp-1hvmmcoa1b.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: Sa 61 De artment review reoulred Yes No
P ino
WildlnR2
Applicant: L&2 ming&Zonm
Project: 4 ree tor
FE-toe� ublic Wor
lic,Utilities
Public Safety
Fire WSewices
Review fee D pf S!gnature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified IS
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: kApproved. E]Denied.
ev' W' g "partons
((Circle one.) Comments:
C'cl-0
B U
UILDING
B IL
ZO
PLANNING a ZONING
Reviewed by:'&----' Data-V?k�rf
pp
TREEADMIN. Second Review: EDApproved as revised. DiDenied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by Date:-
FIRE SERVICES Third Review: EIAPProved as revised. ElDenled.
Comments:
Reviewed by: Date:-
Revised OW14109
City of Atlantic Beach APPLICATION NUMBER
Building Department (To be assigned by the Building Department.)
800 Seminole Road
Atlantic Beach, Florida 32233-5445 i_7- EMQ&- �3133
Phone(904)247-5826 - Fax(904)247-5845
E-mail: building-dept@coab.us Date routed: J
Cityweb-site: http:#�.coalous
APPLICATION REVIEW AND TRACKING FORM
Property Address: Sa(' -z s" Department review reguired Yes No
;Auildinc-),
Applicant: OL&Dt'Dc-l? V�ning &Zoniq
f Tre-e7MMTM9 nmor
Project: FENDcF- L�ubhc WorRb
'2011c Ufihtku;�
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: D?rPP-1ved. E]Denied.
(Circle one.) Comments:
LDINW
PLANNING&ZONING Reviewed by:— Date:i::_�/7
TREEADMIN.
Second Review: E]Approved as revised. E]Denied.
PUBLICWORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: —Date:
FIRE SERVICES Third Review: ElApproved as revised. DDenied.
Comments:
Reviewed by: —Date:
Revised 06/14109
BUILDING PERmrr APPLICATION
OFFICE COPY CITY oF ATLANTIc BEAcH
SW Seminole Road,Atlantic Beach,FL 32233
I1111111111111111111111==1247 592=6 I/F (904)247-5945
Jill;
YAUQ4WAWAWAUA9Q jig
JobAddress: 32/0 2wb Sr Permit Number:
Legal Descriptim QAIedAwillz kles)"Or'17ce p�i#
r loor Area of Sq.Ft �nq�,MF th
Valuation of Work$ 7�, Proposed Work beated/coolled eated/coolled
Class of Work(circle om,)�,.�mjiaidition Alteration Repair Move Demolition pool/spa �mdowldoirr
Use of existing/prorosed structure(s)�ircic one): Commercial Residential
Han existing struc lure,is a fire sprot er system installed?(Circle one): Yes No (�N:/:A:)
Florida Product Approval 4-_
For multiple products use pr�swt approval form
Describe m detail the type of wo&ta be pefformed, 6 ' 7,411' e'VC0�h lsfd-Ke-
r enoe? 7ro eePI-Rent CiUrrenZ Chl?/Al I W
IN &JK-e- rAir cX J?6(v
Property 0onser Informistlew
Name z6--/V/C,<Jq e-AVIZI, Ad&=. 8,6 2 A10 --f
E-Mail crrFax�#(Optional) 4e��t Com
Contractor ftformation:
Company Nama:S-i�-QOR J"t"r"All,/&r_dt A//Z QmhfZft Agent: _Z1" 1"C1704-
Address: City,3A,-
,<S�Wvda&- State t-4- Zipf�44�jO
!lJobSit�e1ConWNumbcr —Fax#
state Certificanomirgegistration 0
Amhitect Name&Phone fi
Engineer's Name&Phone#
Fee Simple Title RoklerNameand Address ?4V 1
Bonding Company Name and Address
Mortgage Leader Name and Address
Application is heri�by made to obtain apemil to do dise work and instigations as indicated fewrt6th�ww�*��IdLWmbwe�edp�wtothr
issu�e%ape,rmitandthwallw�kwdl&p,4� 4rmdfo nima the standwals ofall Laws regalahmil conshocrim in dusjuisdartion,
.f
andvoid workwnoic==,r Is &
"161 d
,;�LboVag -a oirsup,sa,,kk%W;.e
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work is cstmnced I Lf,be
T,a*ksandA1rCona1d;,anng,�
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR DIPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITII
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y6M NOTICE OF
CONIWNCEMIENT.
lhem�certify that I have mad and examined this ication and know the save,to be fte and correct. Allprovisions oflaws,and oixibiancesgoverning this
qpe p wark will be coin ird
plied with whether erect ed sector o, at. The grambill avra pecoo,does not pmn,,ne to saw,audiaray to sailase,o,cancel the
an
Smiature of Signature of
PrintNaruc Printloarne 2.44-11
Sworn,to and an beibreffle Swom to g nd subs�mbed before
dds13 Dayof 1%,Q," IMP P go n 4 " y .201
MOMFLUSC11110MI
OM=
Nol 7P(d!3[i, 1"wl�zl �AIESSepaitrtxeil,Mol V=�. ,a Revisc,101.26.10
NOTICE OF COMMENCEMENT OFFICE COPY
State of flaciJ,, Cousnyof —DOU�� Tax Folio No. I co 9 7 93—0 C)L)o
To Whom It May Coticem:
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
Legal Description of property being improved: fe,"P P, e c-
Address olproperty being improved: 39(g 7,-" SA LL 32z-<,�
General descriptionof improvements:
we
::a interest in site of the improvement:
Fee Siznplentleholda(ifotbuthmo�er):
Name:
Contractor: SUPWIC ��Wiq
Address:
Telephone No.: Fax:No:
Surety(if-Y)
Address; Amount of Bond
Telephone No: Fax No:
Name and address of my person making a loan for the construction of the improvements
Name:
Address:
Phone No: Poor No:
Name of person within the State of Florida,other than himself, designated by owner upon whom tintless 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 Omer's option)
Name:
Address:
Telephone No: Fax:No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
TBIS SPACE FOR RECORDER'S USE ONLY OWNER
Si Dato: / 3b /7
B Zor cly�cf �. o,;nty 61
eeeee� ()fPlorida,has personally appeared =c
TON,GloleSIEF10"a
'Ole'SIE10"a
isY Co 1 0 # 4951 Personally Known:
0
T 92
ION#
Mu 0,
Co ES.OcIrbu 6,X19 Produced Identifica
r,_
?fEX
Notary Public:_
Dw#2017022180.ORBK17859 Pa9e1274. Mycominissionexpires:
Hurnbet Pages:I
R�rcled 01)3W2017 at 11:29 AM,
Ronnie Fusse'll CLERK CIRCUIT COURT DUVAL
COUNTY
RECORDING$10.00
OFFICE COPY
CITY OF ATLANTIC BEACH
OWNER/BUILDER AFFIDAVIT
1. FLORIDA STATUTE& CHAPTER 489. FLORIDA STATUTES, PART I 'CONSTRUCTION
I
F CONTRACTING�REQUIR�S OWNER/BUILDER TO ACKNOWLEDGE THE LAW.
DISCLOSURE STATEMENT FOR SECTION 499,103(7),FLORIDA STATUTE$:
STATE LAW REQUIRES CONSTRUCTION TO BE 1011 BY LICENSED
CONIRACIORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO IHAT
LAW. THE EXEMPTION ALLOWS YOU.AS THE OWNER OF YOUR pRoppRTYTC,ACT AS
YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUS
)OR IMPROVE A ONE-OR
U MAY ALSO BUILD OR
OR LESS. THE BUILDIND
UILT FOR SALE OR LEASE
RSELF WITHIN ONE YEA Z
UME THAI YOU BUJLIJ� I
MPTION. YOU MAY NOT
CONSTRUCTION MUSI
Y G REGULATIONS. 11 IS
CLEAL LICENSING
11. INJURY LIABILITY; SINCE NERS MAY
QtNE-_ _2E LIABLE FOR INJURIES TO WORKERS THEY HIRE
THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE B�
PURCHASED.
Ill. IRS VRTHHOLDING; 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
CIBCUMSIANCES,�����R FLORIDA STATUTE NO.
455-228(1). AN'OCCUPATION L LICENSE'IS NOT ADEQUATE, THE OWNER SHOULD PHYSICALLY
SEE THE COUNTY "CERTIFICATE OF COMPUTENCY� OR THE FLORIDA 'CONTRACTORS
CERTIFICATE* TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE
BUILDING DEPARTMENT(247-5826)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.
A a 6
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