2233 Seminole Rd Unit 25 RFNC21-0085 4'OWNER:ADDRESS:CITY:STATE:ZIP:
COOPER WILLIAM G &
MALLORY D ET AL 13860 LONGS LANDING RD E JACKSONVILLE FL 32225-5422
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169519 0148 OCEAN VILLAGE ONE
CONDO
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2233 SEMINOLE RD UNIT 25 RESIDENTIAL FENCE ONE
STREET FRONTAGE 4' FENCE $900.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00
TOTAL: $35.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 1Issued Date: 6/21/2021
PERMIT NUMBER
RFNC21-0085
ISSUED: 6/21/2021
EXPIRES: 12/18/2021
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Building Permit Application Updated 10/9/18
ew .,.._. City of Atlantic Beach Building Department ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
wolf—
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: __3 3t2t- 1/416/i1 Lt R..046 "1 u iterr'mit Number: R "- C Z I - C)C SS
Legal Description 0 C- 1tl V LLC 4Ck 6D F-ll V ti 1141c RE#
Valuation of Work(Replacement Cost)$ 'leo a v 1' Heated/Cooled SF Non-Heated/Cooled
Class of Work: INew Addition Alteration Repair Move Demo Pool Window/Door
Use of existing/proposed structure(s): Commercial jkesidential
If an existing structure,is a fire sprinkler system installed?: Yes fiklo
Will tree(s) be removed in association with proposed project? Yes(must submit separate Tree Removal Permit) kNo
Describe in detail the type of work to be performed:
1 1
IK eP O t k I<z` 1 C -- i it 4_01.Ar- (t--
Florida Product Approval# for multiple products use product approval form
Property Owner Information
t-I-e/Name L Address t
City It AM 0.-'C State Zip moo' Phone qt 7 6 t—.5 '
E-Mail 6^. KI 0 x'C p e --ra yf X . e. ovil
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company Qualifying Agent
Address City State Zip
Office Phone Job Site Contact Number
State Certification/Registration# E-Mail
Architect Name&Phone#
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
RECORDING Y R NOTI QF COMMENCEMENT.
Air
Signature of Owner or Agen Signature of Contractor)
I.igned and sworn to(or aff )before me this daav of Signed and sworn to(or affirmed)before me this day of
O(''Q ,202 ( ,b 'c`.% ice` , by
i
ature 7'. . ' Signature of Notary)
YPg4,, TONI GINDLESPERGER
Personally Known OR MYCOMMISSIOti t)91 31* own OR
Produced Identification i.: ,
rr * ed Id: tification
L 1..s.,.....",..,..-........„5:. EXPIRES:Oct bi ,°1g29
Type of Identification: ary dtd lull i s:ton:
Owner Builder Affidavit ALL INFORMATION
HIGHLIGHTED IN
vricCity of Atlantic Beach Building Department GRAY IS REQUIRED.
t800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
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 BUILDING-DEPT@COAB.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: 'ZZ-Ro Ir-a (A 1011
Owner Name:
p
COC-
b- RI C
f 1
Phone Number: g 613 `- 7
Mailing Address: 14 b l 4' K10E11.-- 1.51 iN City: tate: Zip: 3 lv---13
JP x-rvi c22;4_,€,Notarized Signature of Owner 2L4__ -
Theoing instr ment was acknowledged before me this I jay • 202 tin the State of Florida, County
of + ) fc -
Signature of Notary Pub •c
Personally Known OR [ ] Produced Identification
Type of Identification:
ItPav,vy., TONI GINDLESPERGER
Updated 10/24/182P ' c
MYCOMMiS0N ' 317lss ':,:
8
au6 EXPIRES:October 6,2023
o Bonded"Wu Notary Public Underwriters
Fence Addendum Updated 1/14/2021
014...n.0 City of Atlantic Beach Building Department
l/'
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT#
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
42.:1:33 10,;o 0 upu LI a--) t pe, k),22.,/
Property Type: Lot Type/ Features:
P N1 c.,- v'
l(Residential a eO. frontage(interior lot)
Commercial 0 More than one street frontage (corner lot,through lot,
etc.)
Swimming Pool
Fence Material: Fence Height (select all that apply):
O Wood llk Four Foot(4ft)
Chain Link 0 Six Foot (6ft)
VkVinyl Other
LI 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
retaining walls and any portion or fencing above 6ft in height.ttti 0
Will the fence be built in an easement?
Yes (must submit separate Revocable Encroachment Agreement)
ikN o
Will tree(s) be removed in association with proposed project?
Yes (must submit separate Tree Removal Permit)
FAQ
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.
3710 fc 673wt.
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