500 Clipper Ship Ln FNCE20-0144 Permit PacketOWNER:ADDRESS:CITY:STATE:ZIP:
HILLER CARLYN MARIE 500 CLIPPER SHIP LN ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170703 0226 SEASPRAY
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
500 CLIPPER SHIP LN FENCE WALL OR BARRIER FENCE FENCE - 6'$800.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 PUBLIC UTILITIES UNDERGROUND WATER SEWER UTILITIES INFORMATIONAL
Notes:
Avoid damage to underground water and sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is
needed, call 247-5878.
2 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
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: 1/4/2021
PERMIT NUMBER
FNCE20-0144
ISSUED: 1/4/2021
EXPIRES: 7/3/2021
FENCE WALL OR BARRIER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
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 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $81.50
3 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.
4 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration, including sod, is required.
5 PUBLIC WORKS FENCING REMOVED INFORMATIONAL
Notes:
All old fencing and debris must be removed from job site by Contractor.
6 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
2 of 2Issued Date: 1/4/2021
PERMIT NUMBER
FNCE20-0144
ISSUED: 1/4/2021
EXPIRES: 7/3/2021
FENCE WALL OR BARRIER PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
City of Atlantic Beach Building DepartmentCOALLINFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us
IS REQUIRED.
Job Address: 500 Clipper Ship Lane Permit Number: r kke.20 Cil 44
Extend PrivacyFence • c-P r
I 7LegalDescriptionIIRE# 1 _ C j — OZ,
Valuation of Work(Replacement Cost)$800 Heated/Cooled SF Non-Heated/Cooled
Class of Work: New Addition EAlteration Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial EIResidential
If an existing structure,is a fire sprinkler system installed?: Yes ONo
Will tree(s)be removed in association with proposed project? Yes(must submit separate Tree Removal Permit) ONo
Describe in detail the type of work to be performed:
Extend existing privacy fence on garage side
to match with front of the house
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Christopher M. Geraty Address 500 Clipper Ship Lane
City Atlantic Beach State FL Zip 32233 phone 904- 472-4563
E-Mail chrisgeraty@yahoo.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Ow
Contractor Information
Name of Company alifying Agent
Address City State Zip
Office Phone Jo ite Contact Number
State Certification/Registration# t-Mail
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt Expiration Date
Application is hereby made to obtain a per ' to do the work and installat ns as indicated. I certify that no work or installation has
commenced prior to the issuance of a per it and that all wo • e performe 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.
permit,there may be additional restrictions applicable to this property that may be found in—the public records o t is county,
there may be ' ioqaglgIIIIIIIIIW froth tal, h a .ter manageme te a
federa
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 IMPROV ENTS TO YOUR PROPERT IF YOU INTEND
TO OBTAIN NCING, a' SU TH YO ENDER OR AN ATTORN,f BEFORE
RECORD! G UR NOT/OFOF O ENC NT.
Signatur- . i ner or A n /
re
gnature of Contractor)
ned and sworn to(or of r • d)before me``this C day of Signed and swor to(or affirmed)before me this day of
ZOZQ, b TJ .A• _ . ,by
t _ err . e, Signature of Notary)
PH°'P,' TONI GlNDLE1Y: 1110MYCOMMISSION#GG 353178
fl,.%1,),,,ililly FEcKFOREQPDctober 6,2023 1 Personally Known OR
I ?" Bonded Thru Notary Public Underwriters
City of Atlantic Beach Building Department GRAY IS REQUIRED.
W 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT 1*:
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
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.
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 3UILDING-DEPTPCOAB.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: 500 Clipper Ship Lane
Owner Name:Christopher Geraty Phone Number: 904-472-4563
Mailing Address: 500 Clipper S , i -bane city: Atlantic Beach State: FL Zip: 32233
Notarized Signature of Owner X
The for ing instru ent was acknowledged before me this t 3day of C , 20?1 the State of Florida, County
of ,( )L tG _
Signature of Notary Public Or
Personally Known OR []Produced Identification
Type of Identification:
TONI GINDLESPERGEP,Updated 10/24/18
OMISSION#GG 353178
RES:October 6,2023
NotaryPublic Underwriters
1r, REVOCABLE ENCROACHMENT AGREEMENT
9 i ' City of Atlantic Beach
ALL INFORMATION
J 800 Seminole Road,Atlantic Beach,FL 32233
HIGHLIGHTED IN GRAYit%
IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and
existing under the laws of the State of Florida, hereinafter referred to as "CITY"and
CJ-f-41 ST 6i) 12._ G' rTL.1--1( of Atlantic Beach, Florida, hereinafter
referred to as"USER".
t
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon
the property for the purpose as described in the City of Atlantic Beach.
This work is generally described as FE'r ' CL
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to
relocation or removal on thirty(30)days'notice by CITY to USER,said notice to USER shall be given by certified mail,return
receipt requested,to the following address S-00 C-i J P 12— Sf+i P L13
f
47i-A-,i iL Q€ 1-C..N.
322-33
In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter
upon the above described easement or property of the CITY, the USER shall replace at the USER's sole expense,
any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing or
adding to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land
Development Code and all other land use and code requirements of the CITY, including City Code Section 19-7(h)
which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must
be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks."
The USER, prior to making any changes from the approved plans and/or method, must obtain written approval
from the City of Atlantic Beach Public Works Department, for said change within 30 days after the day of
completion.
This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and
assigns.
USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or
specifications, to include utilities locate requirements and use limitations/requirements of easements, public
right-of-ways and other public land. USER further agrees that the CITY and its officers and employees shall be
saved a . es. by the USER :m any of the work herein under the terms of this permit and that all of said
liab" itie are ereby assu •d b the USER.
vr" -Date /.2-//V2-c)
Property • . ner/Agent(signed n presence of Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this / e...)_day of _____c_-_____C_202 0,
by m k (>4'0VSig 1 O a-4)
who personally appeared before me and•
rinted name o -r)
ack,• ledged that h /sh• s :ned the instrument voluntarily for the purpose expressed in it.
J A Department Approval:
Sign of Notary Public,State of ' ± da ` 4.,:.;.:;:'6.;(4-, TONI GINDLESPERGER
r' ' MY COMMISSION#GG 353178PersonallyKnown
S'•!,,,,,...-W EXPIRES:October 6,2023
Scott WilliamsProducedIdentification(Type) F..••• •
Bonded7hruNotaryPublicunderHrtters
Public Works Director
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
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