1847 Ocean Grove Dr Revision ' ..-4k1,
Building Permit Application Updated 10/9/18
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: M/ 7 0(2_eoEr C-1,---i,L) o , Permit Number:
Legal Description })iA�� 41ti:,14t:, RE# •
Valuation of Work (Replacement Cost)$ a .? i. ' Heated/Cooled SF Non-Heated Cooled
ECEIVE
• Class of Work: ONew DAddition ❑Alteration DRepair ❑Move LiDemo ❑Pool OWindo oor
• Use of existing/proposed structure(s): OCommercial ❑Residential APR 2 9 2021
• If an existing structure, is a fire sprinkler system installed?: ❑Yes SNo
BY:
• Will tree(s)be removed in association with proposed project? Des(must submit separate Tree Removal Permit) ii 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 ecL j‘..))/ivn rs Address 15(q 7 &,32.41:, (r--e4'e (-
City /.1±-t-t`t ck;\'fit(: ti-' e ,c 1,\ State FL Zip 2,".1 , � 3 Phone (it, '-/—e, / , _ _ _
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Owner or Agent(If Agent, Power of Attorneybr Agency Letter Required)
Contractor Information 1 t U�.r1
Name of Company J5/465 FLS.s M L� M
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Qualifying Agent t/2 . , 1, —
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Address Ii osD -vi i.‘`Je ,- cm„-- 11/41 City -502.6..0,,,,..‘i (lam State it..- Zip 3 J-aa-S--
Office Phone 'o'.f-350V-- 3o g (, Job Site Contact Number Ni rta- Vc N (3!44¢_v
tate Certification/Registration# E-Mail bs6b5 c(_ - 1 . Q WV
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Architect Name& Phone# J
Engineer's Name& Phone#
Workers Compensation Insurer OR Exempt 0 Expiration Date
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
RECO DING YOU NTICE OF COMMENCEMENT. � ,e4w2C_____
(Signature of Owner or Agent) (Signature of Contractor)
ed and worn to(or a' y•d)before met . .__. day of Signed and sworn to(or affirmed)beforermeetis 291 day of
l � ,70z(, •' •• 4 � t a APR-) t— ZU2I , by�iCAaI VGtnd, 12efr-
��r�7r rritnr•cary) (Si nature of Notary)
•s•O'' c; TONI GINDLESPERGER / 'i_iiF;i -,, CHRISTIAN GILES
... = MY OMISSION#GG 353178 . '•, •.,: MY COMMISSION#HH 117153
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MAP SHOWING BOUNDARY SURVEY OF
THE SOUTHERLY 30 FEET OF LOT 1, ACCORDING TO THE PLAT BOOK OF "OCEAN GROVE UNIT NO. 2",
AS RECORDED IN PLAT BOOK 20, PAGE 20 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
STEPHEN J. SULLIVAN, JEAN F. SULLIVAN,
OLD REPUBLIC NATIONAL TITLE INSURANCE COMPANY,
GIBRALTAR TITLE SERVICES AND
BANK OF AMERICA, N.A.
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GENERAL MOTES'
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Fence Addendum Updated 1/14/2021
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233
I PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: [ Date:
j
Property Type: Lot Type/ Features:
%Residential . One Street frontage (interior lot)
❑ Commercial ❑ More than one street frontage (corner lot,through lot,
etc.)
❑ Swimming Pool
Fence Material: Fence Height (select all that apply):
.1. Wood [A Four Foot(4ft)
❑ Chain Link Six Foot (6ft)
❑ Vinyl ❑ Other
❑ Block/Stone (Plan details required for footings and/or
retaining w3!1,„l
❑ Other
:nce 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
retaining walls and any portion or fencing above 6ft in height.
Will the fence be built in an easement?
i ❑ Yes (must submit separate Revocable Encroachment Agreement)
No
Will tree(s) be removed in association with proposed project?
Ei Yes (must submit separate Tree Removal Permit)
No
Conditions of Approval:
• 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 PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
IECORDING YOUR NOTICE OF COMMENCEMENT.