1655 Atlantic Beach Dr FNCE20-0143 4,- Building Permit Application Updated 10/9/18
'= i City of Atlantic Beach Building Department **ALL INFORMATION
��; 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 1 . 5 S )641,014-1(.., (3u,c.,G p," Permit Number: E"1C,EZQ. 0143
Legal Description 01 UU '3 ;n,�c �aM;(l RE# 16?JAG S — 1 3 C{ 5
Valuation of Work(Replacement Cost)$ 2.6 3 L( UU Heated/Cooled SF Non-Heated/Cooled
• Class of Work: Aw ❑Addition DAlteration ❑Repair ElMove ❑Demo DPool ❑Window/Door
• Use of existing/proposed structure(s): ❑Commercial )esidential
• If an existing structure, is a fire sprinkler system installed?: DYes ,2INo
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed:
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Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Pell,i a Sumnr,✓ Address 16SS A+lent rc, f e. L Q
City A}).„1÷; - Pc,,c.i, State F:::1 Zip 32233 Phone 770 ifi7 g7Q5
E-Mail r��41 . SHmYlvr (99ync.,:) _ cow
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company S op'c.- v- R,,,,„... 4„,,,/ Re,.' I Qualifying Agent
Address S`170 I-)Ig1,wc4Av...+ City �^�alscmv,'))2. State F! Zip 3ZZ,sy
Office Phone 9 VL( 0c
453 4:31-1`1 Job Site Contact(� Number�
State Certification/Registration# l6 `3
5 9% E-Mail Rra.c) (
. ! iD -4,6C1 ry,:pC kSonvl)IY , Goyet
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer fe.JeAe4rJ AA wis l OR Exempt O Expiration Date '/j S `ZC2 1
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
RECOR,D/ING YOUR NOTICE OF COMMENCEMENT. ��
' i n urrofwne or nt
�� g ) (Sig,% lir of Contractor)
Signed and sworn to r affirmed before me this bb day of/ Signed and sworn to(or affirmed before me this 9' day of
bey__ , wL ,by �, 01 F 50 vie Y� kb-, ZC(LU, by 0rt-d a,.Irc/
Trry Hendry . i__" 1/ __ it 40
timi
Public (Signa i e of Notary) IF ignature of Notary
t,� 'i State of Florida
Commission Expires 11130/2021
� '� Myp �� � Notary Public State of Flonda
[ 1 P *Oct/0172 [�rsonally Known OR . Britani M Norman
Produced Identification '�; 1 My Commission HH 011346
Produced Identificatio�'`� v1/45.66 [ 1 7a Or Expires 06/182024
Type of Identification: r V( < Type of Identification: . _
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1655 ATLANTIOEACH DRIVE,
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_ ATLANTIM3EACH, FL. 32233
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-ALL ANGLES AND DISTANCES SHOWN HEREON ARE BOTH RECORD AND MEASURED UNLESS OTHERWISE NOTED
SHEET 1 OF 2(SKETCH OF SURVEY)-SEE SHEET 2 OF 2 FOR LEGAL DESCRIPTION,AND OTHER SURVEY RELATED DATA.SURVEY IS NOT COMPLETE WITHOUT ALL SHEETS
The survey map 64 report or the copies thereof are not valid without the digital signature
and seal of a Florida licensed surveyor and mapper
Date of Field Work : 10-23-2020 1,
'�0„„00.0 ,,.,,,
Drawn By: Glenn '••,,
Order#: 108475 fa�_. fo 4 ;� -
Last Revision Date: None 4° 'k` ''....4,-a%ci J'::s SEAL.PEA.NG ON rrus cocumtG'+
Boundary Survey prepared by: LB8111 1,.:f!"�, io-. ` a:o
NexGen Surveying, LLC
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- ON SD:J-]GTO F.
5601 Corporate Way, Suite 41103 J. RILEY WI LLIAMS ' �y..�'• sutee:
West Palm Beach, FL 33407 n,1
0�, <r -<<�-°i r:oa.� ;`
561-508-6272 L . Q "'"mss„„�G'O
SUPERIOR
AFA MEMBER BBB
II,,m
FENCE&RAe. Proposal for Fencing Installation 111 , American Fence —�
Where Quality Matters! Association,Inc. MEMBER
Sumner, Debbie Date 11 / 30 / 2020
Customer's Last Name,First Name
--- ------------- -----------
PRICE ISVALID 30 DAYS FROM
1655 Atlantic Beach Dr DATE OF PROPOSAL.
Service Address
Atlantic Beach FL 32233
City,State,Zip
7708279705 debbi.sumner@gmail.com �
Preferred Phone No. Customer's E-mail Address Municipality
i]Yes Permit required? Homeowner to obtain permit Superior Fence&Rail to obtain permit ]Yes Plot plan or survey available?
(Superior Fence&Rail requires copy ]
®No of permit before installation) ®No
APPROXIMATE LAYOUT
FENCE FOOTAGE CONTAINED IN THIS PROPOSAL IS APPROXIMATE BASED ON THE FIELD MEASUREMENT,FINAL PRICE WILL BE ADJUSTED BASED ON ACTUAL FENCE FOOTAGE
USED,AS SET FORTH IN TERMS AND CONDITIONS,)
pool latches
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II 4'H Black 400 Heritage(R)
Superior Fence and Rail of North Florida
5470 Highway Avenue
Jacksonville, FL 32254 DS
(9041683-6349 FENCE TO FOLLOW GRADE OF PROPERTY:PLEASE INITIAL
AASUPERIOR V' �l/
AFA MEMBER BBB
, II II I I FENCE&RAIL,nrc. Proposal for Fencing Installation Co. American Fence —T—
w�lel'6 QualityMatters! Association,Inc. NORTHEASSTFFIARIDA
001
SIAIM>~.CAr , Dib
Customer's Last Name,First Name (� 7
ILJ 5 {Lv*:c. f3e..cL 0✓ Date I I / 30 / LV2-0
Service Address
I PRICE IS VALID 30 DAYS FROM
1c :c. awd, F 1 i 3 7-2-33 DATE OF PROPOSAL.
City State Zip
-7M 15-2-7 970S
Customer's Daytime Phone No. Customer's Evening Phone No. Customer's E-mail Address
Nearest Cross Street
PERMIT/INSPECTION INFORMATION
Permit required? Yes No Homeowner to obtain permit Superior Fence&Rail Plot plan or surveyavailable?
0 (Superior Fence&Rail requires copy of permit before installation) "a to obtain permit Q Yes IQI No
Selection APPROXIMATE LAYOUT
FENCE FOOTAGE CONTAINED IN THIS PROPOSAL IS APPROXIMATE BASED ON THE FIELD MEASUREMENT,FINAL PRICE
WILL BE ADJUSTED BASED ON ACTUAL FENCE FOOTAGE USED,AS SET FORTH IN TERMS AND CONDmONS,L)
ADDITIONAL COST OPTIONS
ADD THE PRICES ON THIS
COLUMN TO THE SELECTION
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TAKE DOWN AND HAUL 'S
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AWAY OLD FENCE $ /V A
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SUB TOTAL 2 G 3 if
DEPOSIT AMOUNT DUE $ 11111111 1=11111 111111
FINAL AMOUNT DUE! $ l
FENCE TO FOLLOW GRADE OF PROPERTY:PLEASE INITIAL
Product Ai,„:yty..., Product Product
Style: u :k,4f.t, Height: I Style: Height: Style: Height:
Footage: G I If Gates: 2 Footage: If Gates: Footage: If Gates:
Post Cap: P} ;J Color: D)�.� Post Cap: Color: Post Cap: Color:
Rail Type: I a Post Type: 2 J1 Rail Type: Post Type: Rail Type: Post Type:
I Picket Type:5�$ ii $ Picket Type: $ Picket Type: $
DISTRIBUTION:White-Superior Fence&Rail Copy Yellow-Customer Copy