0 Tulip St 6' Fence Submittal 0 Building Permit Application Updated 10/9/18
47 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: 0 Tulip Street-Platt 170985/170986-0000, 170989-0014 Permit Number:
Legal Description /705 —0MO L6T 3, f3' tX K. 1?7 7/70'b6-Obos RE#
Valuation of Work(Replacement Cost)$ /b1 066 Heated/Cooled SF Non-Heated heti
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• Class of Work: gliNew ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/ r
• Use of existing/proposed structure(s): ❑Commercial DResidential MAY 19 2021
• If an existing structure, is a fire sprinkler system installed?: [Nes ❑No
BY:
• Will tree(s)be removed in association with proposed project? ❑Yes (must submit separate Tree Removal Permit) V1No
Describe in detail the type of work to be performed:
6 Foot Privacy Fence around property
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name Adam McQuiston Address 768 Vecuna Road,Atlantic Beach,FL 32233
City State Zip Phone 904-874-5536
E-Mail mcquistona@gmail.com
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Owner
Contractor Information 7- T
Name of Company ///// //d, L4 7(ke/1 Qualifying Agent 0.. ,7;;; :
Address 'dIc //97/71-k_ L„ City /1991r,ML ilidg State ///Q- Zip 4zza
Office Phone /..)‘/-- 351-/ /cf/,3Job Site Contac Number ^,
State Certification/Registration# L1700c7/'h Z! 7 E-Mail `fiq Ai tic/6'le 4G G5'�9irtAi//'G�
Architect Name& Phone# / /
Engineer's Name&Phone#
Workers Compensation Insurer !7// OR Exempty`i Expiration Date izfryfroz.2
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 TTORNEY B_FORE
RECORDING YOUR N TI E O ''i.►4 ► , CEMENT. ,
(Signature o er.r Agent) (Signature of Contractor)
Signed and sworn to(or affirmed)before me this I61day of Signed and sworn to(or affirmed before me this 1u) day of
MAI , 2021 , by i•�p:M Mi-lith Sre- M 1 , -024 , by T�lrf
Cif ., (' 6
(Signature of Notary) (Signature of Notary)
:..;? CHRISTIAN GILES 4-: ..6'••.
[ I P rsonally Known OR r°' : ': [ Personally Known OR ;.•.• .t,•.: CHRISTIAN GILES l
[ ��� MY COMMISSION#HH 117153 [ roduced Identification I u MY COMMISSION#HH 117153 I
Produced Identification . a EXPIRES:April 13,2025
Type of Identification: 'r •,P ." Te of Identification: %':...................................:'n� d E :. U9
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Fence Addendum Updated 1/14/2021
- _ City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT#
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
0 Tulip Street-Platt 170985/ 170986-0000, 170989-0014 4/9/2021
Property Type: tat Type/ Features:
0 Residential 0 One Street frontage (interior lot)
❑ Commercial 0 More than one street frontage(corner lot,through lot,
etc.)
0 Swimming Pool
Fence Material: Fence Height (select all that apply):
O Wood 0 Four Foot(4ft)
❑ Chain Link f 1 Six Foot(6ft)
❑ Vinyl 0 Other
❑ Block/Stone (Plan details required for footings and/or
retaining walls)
O 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
retaining walls and any portion or fencing above 6ft in height.
Will the fence be built in an easement?
O Yes (must submit separate Revocable Encroachment Agreement)
fid No
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
O 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
RECORDING YOUR NOTICE OF COMMENCEMENT.