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183 Poinsettia RFNCE21-0006 Permit PacketOWNER:ADDRESS:CITY:STATE:ZIP: KERR PAUL G 12625 HIGH BLUFF DR SUITE 315 SAN DIEGO CA 92130 COMPANY:ADDRESS:CITY:STATE:ZIP: TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 170641 0020 SALTAIR SEC 03 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 183 POINSETTIA ST RESIDENTIAL FENCE ONE STREET FRONTAGE FENCE $260.00 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00 TOTAL: $35.00 LIST OF CONDITIONS Roll off container company must be on City approved list . 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 1Issued Date: 1/21/2021 PERMIT NUMBER RFNC21-0006 ISSUED: 1/21/2021 EXPIRES: 7/20/2021 RESIDENTIAL FENCE PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 183 Poinsettia, Atlantic Beach, FL 32233 Paul G. Kerr (858) 947-3425 12625 High Bluff Drive, Ste 315 San Diego CA 92130 Owner Builder Affidavit City of Atlantic Beach Building Department 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904} 247-5826 Email: Building-Dept@coab.us **ALL INFORMATION HIGHLIGHTED IN GRAV IS REQUIRED. PERMIT#: ______ _ I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CO NTRACTING" 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. YO U 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 OU TBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BU ILD ING AT A COST OF $2S,000.00 OR LESS. TH E BU I LDING 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 TH E BUI LDI NG CODES AND ZON I NG REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICE NSES 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 BUI LDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED .. Ill. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS TH EY EMPLOY ON THE IR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EM PLOY ED 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 DISCL OSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMEN TS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. Job Address: ------------------------------------- 0 w n er Name: ______________________ Phone Number: _________ _ Mailing Address: _______________ City: -,--------State: ____ Zip: ____ _ Notarized Signature of Owner ___ ,1-~-=----'"'"'t'--"-/~---------------------- The foregoing instrument was acknowledged before me this __ day of 20_, in the State of Florida, County of ____ _, Signatu re of Notary Public -------------------- [ ] Personally Known OR [ ] Produced Identifica t ion Type of Iden tification: ____________________ _ Upda ted 10/24/18 CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 ig@~~{MOO~~!J®l.l#:!98~®ll9iloil❖oo.E®ll~ A notary public or other officer completing this certificate verifies only the identity of the individua l who sign ed the document to wh ich this certificate is attached, and not the truthfu lness , accuracy, or validity of that document. State of California County of I rn Vl 12' l 1 0 } onl{J Vl vHIY\j I~, '2,-011 before me, tle.itfl--i tr-Ni UJ l:e Wvi1'1i., q No+z:t t:k1 Pv1 ¥1 i l. Here Insert Name and Title of the Offiter Date personally appeared _______ _,f'-'-'a---"vt-'-'--1 _,,(;?"---. _\SL.......:Wc....=...._...._V-__________ _ Name{s) of Signer{s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/ar e subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signatu re(s) on the instrument the person(s), or the ent ity upon behalf of which the person(s) acted, executed t he instrument. i············ HEATHER NICOL E WfllG HT I :;, Notary P.ublic -California z t Sa n Diego County ~ Commis sion# 2209 139 -· My Comm. Expirc1 Aug r,, 2021 Place Notary Seal and/or Stamp Above I certify under PENAL TY OF PERJURY under the laws of the State of California that the foregoing paragraph is t rue and correct. WITNESS my hand and offici al seal. s ;gnatc,e~<MA ~~ Signature of Notary Publi OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to on unintended document. Description of Attached Document . . . (A;\\1. bf .Af-\ '1Vl 1\ L-BQ.4. (,.t,,, Title or Type of Docu ment: DWVl tV \3 \,Al I~ Q.tl'.: Af-b ci ~ v1t,1 (yl O vt vi .A.) Document Date: ____________________ Number of Pages: ___ _ Signer(s) Other Than Named Above: _______________________ _ Capacity(i es) Clai med by Signer(s) Sig ner's Na me: ___________ _ Signer's Name: ___________ _ □ Corporate Officer -Title(s): ______ _ □ Corporate Officer -Titl e(s): ______ _ □ Partner -□ Limited □ General □ Partner -□ Limit ed □ Genera l □ Ind ividual □ Attorney in Fact □ Individual □ Attorney in Fact □ Trustee □ Guardian or Conservator □ T r ustee D Gua rdian or Co nservator □ Other: ______________ _ □ Other: Signer is Representing: ________ _ Signer is Representing: ________ _ ~~{!{00~~~9~~❖~8½8#l®!»~~~™Mli ©2018 National Notary Association RFNCE21-0006 f i " ~S/'IO tllfl ~9'11 \I(.,---) ~IP,(~ /!l~ lhi§ =@11Y d _.,,.._-=".£~w....,....,,..-====--== ' 1,,..,,-N,; """'lfffl 8fl I ) f•i>e~'4 !~"'ii~ l'Vll" vf ~, ....,_,,....,,.,......,_~,...-=--------=--==---..,,,""""- .. AU INfORMATION HIGICUGff'TW 1,i GAAW Ii IIIQ,Ulaf_D. ji~c,;! ill'\! tw.om \9 ltf Rffirflli,J) ~191'~ "'' tlli\ .....,., (lijy cl _________ ...;J~t>v==-...... --=,....,..~= I 1r,•~'!li,,1111oWnqa I J ~..-4 ldetl\ifiiqlli!fl fy,t ,f l~!\ffl~!...,..=====~=.,--.,_,.,,..._... CAUFC>RNIA ACKNOW'-IDOMJNT ~'ji"_ri.<3'~'ll!lii~~~11.:ii!r:::ill~:1t1!f11t:t1~tilllilr~'lliJl1ar>lfilf1(rn,1;1;1~ia'arc~•~*~ A Ml~ PublK 01 other officer co,,,pli,11ng tt,ie tl!fliflc11Je verll1es onlv lhe Id.entity of t!Je indiYlduol wtio ,1gned ~ ttetlll'l!e,,t to wllicll tll1s (fftifit:-ete is •ttarhetl, and nGt IIN! tn1t11fulnc~. 11ccuracy, or validity ol Ihm document. Slate of Califor-nit } Cc,urtty of Sa Y] 21 t@Jl . °" :laJ1 ij~Yvl n, M'l,1 pefor11 ffl~. t!Lftlmy t.ficQ(I, W11~h-t_ f14lljc t',qre Here /f,se(/ Name ,ll; TIiie fJ( /Jie om~r ~1'$Ql"olllly appe11re~ ----~--drb-,..:-_ IA:a., _!.JHut~G:..:.---ll'::~t'....JV~k~. =======- Nr;imE;l~ qi $ign~t('?) -' WM l,lr~yed ta iTlf. an the l;)cisis Qf satisf,;1c;:tc;>ty evj<;laf1~ tQ be! tMe P,~r1,i:itl{.s) wl'IQ~e n9m~($1 is/~re $1,lt;l~ri~etj to the with11'I im;;trum!iml and iteknowledged to me •nijt he/sheMey ~1tecJ,rti;!d t.h~ 5ome i!'l rils/herftfu:ir itlJtl\ofi:u,d !::apacity{ieli}, l;I~ thi\lt by lllsiti~r/t!'leir 5ignat1,1,e(s) ~ ltlE} iflstr1,1~m 11'1~ ~r~QfllS), ~r ~~ entity ~Of-I b~alt of wtii(;h tl-te perwn{~ .-,te.!il. e~p.,(~(f tne iA~tn,im~n~ · · · I !;~r\ify und~f l'!~NAtfY 01< ~RJURY 1.inder tile l~w§ 9f the $t.Jte of !'.:iMPrnia l;tli~t the f9Fegoirn,;, 1,;!i!lfi\lQt?Jpli ~ t11.1~ ii\lWJ ~Qff'1(;t, Wffl'·mi~ rny hind ~m!;l 9ffi~i~I ~g@I. COfnp/eting this inf0Frnqtiort CQfl dete.r alteration ef th~ (kxqment or fr<mdq/ent rcatt~hfll~m Qf tf'rl~ fqrm ~ ()rt unl~(~n(ft;c. QQr;1,1m~,,t. O.•crtption of AtM{:tieg Docucnent . '._k A,mF u (AM ()f ffll'W:\1(. 'f~ ~r Typ~ ~, OoctJment: . \3',A l la I n 1 r M".J1U± .. L~ f:L 1 I (th I D h,. . -Ji-i/4 Wt "' rL Dl>'urrrent Dtt~: ==========--==------N1,1ml:)tr~f P~g~,:===~ S~t1er(~ Other fh~n N•m.ed ,4.bove: =· ====----======""=======---- C•pec:lty(~5) e1~im~d by $i~n•r(tl Sl{Jner'lii Na.me: ---~=~-===~== O Corpo,ele Offic~, "" Title{~): ---=-=:-=-= g ?arm~ ~ g !-ilflil!;'~ c Generpl ~ 1ndivld4,i@I Q Attorney itl Fi:1ct u Tr1-1&1.U g ~IJ~f~illl\ .,r Cor,~ViJl(lf 0 0th~: $,q,,., iJ, Q~pr~i~IUjfl!iJ: -. -------- §igr,~r•s Ni!me; ~-=-------~ f:I C~rpar~lf Offie~r = Till~($):------= □ PattneF = ~ LJmi\~d ~ Gener~I Q lm;livich..tii!I ~ Auorn.ay in Fai:;t 1=1 Trus~ ~ Gual'(llan Qr Co11se,vatQf tJ Omer; __ Si~ner i~ R~pri1~!oflllt1~: __ ,,,,.....,....,,,.__,,~--=== --~~.'~-~.~.~~J!l'~~.!~illlflllt,~,W!\ilWl~~l!l!Ji,/lli-:i[f./Ji<.~J&\lllJil~ilt.~.ti4} tl1011J ftl~iqn~I N®jry M/iAO<ltlQtl cr--::ttt:">~:t< Fence Addendum ,?;. -~ \;~~ City of Atlantic Beach Building Department ~t.>-;; i?J 800 Seminole Road, Atlantic Beach, FL 32233 ~--Phone: (904) 247-5826 Email: frulldi11g -Dcut@co J b.us Job Address: Date: 1~3 Po·,\A5(~ 1(A.S'+ /U-bV\-l,(_ &~tyli__ , l,'11-z-, Property Type: Lot Type/ Features: Updatt!d 1/14/2021 I PERMIT# ___ _ ~ Residential El One Street frontage (interior lot) □ Commercial D More than one street frontage (corner lot, through lot, etc.) D Swimming Pool Fence Material: Fence Height (select all that apply): L')t..Wood ~ Four Foot (4ft) □ O\ain Link !_xi Six Foot (6ft) OVinyf ,El.Other ,L f<'-c f- □ Block/ Stone (Plan details required for footings and/or retaining walls) □ Other fence Location: Please submit an accurate and current boundary survey showing all existing improvements (including building footprint, driveway, swimming pool, etc.) and location of fence/wall and any gates. Plan details required for block wall footings and/or retainjT>B waJJs and any portion or fenciT>B above 6ft in height. Will the fence be built in an easement? 0 Yes (must submit separate Revocable Encroachment Agreement} jiil.No Will tree(s) be removed in association with proposed project? D Yes (must submit separate Tree Removal Permit) RI No Conditions of Approva f: • Roll off container company must be on City approved list. Roll off container cannot be placed on City right-of-way . • All old fencing and debris must be removed from job site by contractor or homeowner. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAVING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I I I I I I I I I . I . 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