300 5th St RFNC21-0011 Pool Barrier FenceOWNER:ADDRESS:CITY:STATE:ZIP:
WINGATE OWEN W 300 5TH ST ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
PHILLIPS BUILDERS LLC 1250 SELVA MARINA CIR ATLANTIC BEACH FL 32233
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169827 0500 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
300 5TH ST RESIDENTIAL FENCE POOL
BARRIER 6' FENCE $1000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50
FENCE 455-0000-322-1000 0 $35.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00
TOTAL: $91.50
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 2Issued Date: 2/1/2021
PERMIT NUMBER
RFNC21-0011
ISSUED: 2/1/2021
EXPIRES: 7/31/2021
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 2/1/2021
PERMIT NUMBER
RFNC21-0011
ISSUED: 2/1/2021
EXPIRES: 7/31/2021
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $91.50
RFNC21-0011 Address: 300 5TH ST APN: 169827 0500 $91.50
BUILDING $35.00
FENCE 455-0000-322-1000 0 $35.00
BUILDING PLAN REVIEW $17.50
BUILDING PLAN CHECK 455-0000-322-1001 0 $17.50
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
ZONING PLAN REVIEW $35.00
ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00
TOTAL FEES PAID BY RECEIPT: R14758 $91.50
Printed: Monday, February 1, 2021 11:34 AM
Date Paid: Monday, February 01, 2021
Paid By: WINGATE OWEN W
Pay Method: CREDIT CARD 419160875
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R14758
~+; CENTRALSQUARE
RFNC21-0011
,) •;}!-'~'lr1~•.p Building Permit Application
€ ~ ...... Ji City of Atlantic Beach Building Department __ --2 800 Seminole Road, Atlantic Beach, FL 32233
"~!..o.al!J~
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Updated 10/9/18
**ALL INFORMATION
HIGHLIGHTED IN GRAY
IS REQUIRED.
Job Address: 300 51J;:L ST '3 '22.3 3 Permit Number: __________ _
LegalDescriptionL ~ •.~ ]3\\~l,IS-i,9 Hr2$:Z9E /A"'l'\A,-rt~LMA::_f:LRE# l1p°18Z,-osoo •
Valuation of Work (Replacement Cost)$ I o -<> 0 Heated/Cooled SF ____ Non-Heated/Cooled ____ _
• Class of Work: ~ew □Addition □Alteration □Repair □Move □Demo □Pool □Window/Door
• Use of existing/proposed structure(s): □Commercial )9.Residential
• If an existing structure, is a fire sprinkler system installed?: □Yes )!1/llo
• Will trees be removed in as ociation with ro osed ro ·ect? □Yes must submit se arate Tree Removal Permit 0
Describe in detail the type of work to be performed:
T\-\
Florida Product Approval# __________________ for multiple products use product approval form
Property Owner Information
Name D \f,J e.rv vJ C-.fXCr; Address __,·&>=o=-_..,,'5"-''!:--:CC"'-..... sr:.._.___-:-_---==-----=----
City A .1'5 . State ~l Zip '52.2.33> Phone C'fO«./ -553 -20 2..
E-Mail C, @ &'Bct-lTf:bS. U:,""'-
Owner or Agent (If Agent, Power of Attorney or Agency Letter Required) __________________ _
Contractor Information
Name of Company pµ, l \ i p s w,\ D -=>
Address 99 Z. 6L£'t\)-.) 1$\\ID
Office Phone 'JO':/ -31.fGt ~ ~ q &\
State Certification/Registration # L:e,l \ Z.5 '13 I &..I
Qualifying Agent '?)p.g_"BA(2..A y\-\ \ \ \, ?5
City A . ~ . State ~ l Zip '.3 '2..Z33
Job Site Contact Number-,-_______________ _
E-Mail :B-\',OiPS:BuilO{; ~€?C...C""GA.S:C ~\
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 in stallation 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
RECORD UR OTI E u.t;,:Wwm~K-EMENT.
~ed and sworn to (or affirmed) before me this/&~of
. ltl /U 'f, .:U7)../ •.
t~nally Known OR
I ] Produced Identification
.•·,,/t·~~//,;,··•, DONNA S. MOSS /f·~·t·-, Commission# HH 009364
l~-~-~~j Expires August 23, 2024
···tfo,;\.0~---Bonded nvu Troy Fain Insurance 800-36&-7019
Type of Identification: ____________ _
(Signature of Contractor)
Signed and sworn to (or affirmed) before me this __ day of
_______ by __________ _
(S ignature of Notary)
] Personally Known OR
] Produced Identification
Type of Identification: ____________ _
RFNC21-0011
NOTICE OF COMMENCEMENT
State of ~(='~[D_i2~i D~~~-----
County of Du v' A\
To Whom ft May Concern:
Tax Folio No. ____________ _
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 OF COMMENCEMENT .
Legal Description of property being improved: te, .;I-/{ll8Z.1--0'5oo / S· 49 l{q-Z.S • 21 E /
A-1 IM):J::1c 13eAQ.\ / L.oTs I. 3 131 I~ u
Address of property being improved: _6""--'D .... D....._
1
__ 6'_!!:l __ 5.._iT<-...._ ____ 3._.zzca.. .... 3'---"3~--------------
General description of improvements: _ __,"f.....:::;Ec.:.N__;:G....;G:c;."" _________________________ _
Address: 300 sT!1 6[ 3ZZ33
Owner's interest in site of the improvement: ___..N-6~"-"-~r'~E~NG~~E~---------------------
Fee Simple Titleholder (if other than owner): ____________________________ _
Name: ______________________________________ _
Contractor: PJ.l,'/1 .·ps Bui I D5JZ-S
Address : __._'1_._j-=Z_...,,.Oc..:C=-=E'-'-A_,_N-'--_,R,__.__I V-'--D=-----'3=2,Z-.,3=-3---_____________ _
Telephone No.: CfCJ./-3 '/'f -z,e;qt::t Fax No: ___________ _
Surety (if any) ______________________________________ _
Address: ______________________ Amount of Bond$ _________ _
Telephone No: _________ _ Fax No ; ___________ _
Name and address of any person making a loan for the construction of the improvements
Name: _______________________ ~---------------
Address:------------------------------------
Phone No: ___________ _ Fax No: ___________ _
Name of person within the State of Florida, other than himself, designated by owner upon whom notices 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 Owner'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): -------------------------------,.;C---------
THIS SPACE FOR RECORDER'S USE ONLY OWNER
Doc# 2021018305 , OR BK 19549 Page 1922,
Number Pages : 1
Recorded 01 /22/2021 10 :33 AM , COURT DUVAL
Signed: --'<:::,-,,C---,-=::77----z2(:;:;r-----
Before
Of Florida, has p )
JODY PHILLIPS CLERK CIRCUIT
COUN TY
RECORDING $10.00
----------
Notary Public at Large,
My commission expires: --~"--,A:-'.i!>-<:--,,==..,.....,nmrrr..-rr..----+----'-"'-''---"-
Personally Known: ---+.~lll!t\~;....,-.;==-==.......-..,.,..,.,....:..---¼-----
Produced Identification: -t: ... "":;.~;,.lf.i..;.'oi;;:~ .. Bl.: .. 'iil.!} .. m:_i ... 'r6:!.r~iTl::.-i."fi: .. w.:~.rr:: .. r,m,; .. m_~,f----
-------------
RFNC21-0011
MAP SHOWING SURVEY OF
LOTS 1 ANO J, BLOCK 6, A TLAN IIC O[ACI 1 A$ RCCOROCO IN Pl A 1 11 00K 0,
PACE 69 OF THE CURREN 1 PUBLIC RLCORD S or DUVAi COUN rv, rLORIDA
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NOTES
1 TH IS IS A BOUNOARY SURVEY.
2. ANGLES •S P(R nrLO SURll!:Y
J NO BUii.DiNG R(STRICTION LINES PER PLAT,
•· NOR 1H PROTRACTED rROM PLAT.
210·
0 S100I'
C
500· l
NC(
LOT 4
y 1p 30
SCALE . 1· • 20'
THE PROPERTY SHOWN fl£R(ON APPEARS TO LIE IN FLOOD ZONE •x•
(ARCA OUTSIOC 500 lt•R rt.OCO Pl.JJN) AS OETCRl.ttNED FROl.t THE
"rLOOO INSURANCE RATE l.tAP" COMMUNIIY-PANEL NUMBER 120075
0001 0 R[\.1SEO APRI L 17, 1989 rOR TH[ OTY Of ATLANTIC 8(ACH,
DUVAL COUNT't, Fl.ORIOA.
•NOT VAUO WITHOOT THE SICNAllJRE ANO
ll<( ORICINAL RAIS[!) SEAL or A FLORIDA
UCENS£0 SURVfYOR ANO UAPPrn " RECHEa<IJ) MARCH 11, 2011
01'
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THIS SURVE Y WAS MADE FOR THE BENfflT OF
LOUIS R. JERNAGAN, 111 ANO HOPE V. WELLES;
LINDLEY TOLBERT DESIGN. INC.; 6t.p REPUBLIC
NATIONAL TITLE INSURANC CO~A)IY• ond
ANSBACHER & SCHNEIO . ,.~'..tl'j~N(!
100303C . .,-,. .·:i,. \\IC.(,.· •• +,._\,
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• a ¥• •. __. 'l, \) 'j;'.: I;: i::
CHECKED BY; __
DRAWN BY:~ BOATWRIGHT LAND SURVEYORS, INC. DATE:
S£PT(U 8(R 20 2010
FllE: 2011-0110 1500 ROBERTS DRIVE, JACKSONVI LLE BEACH, FLORIDA 241-8550 SHEET _,_ OF _,_
x -REF 2010-0577