1810 Selva Grande Dr RFNC21-0096 FenceOWNER:ADDRESS:CITY:STATE:ZIP:
CARPER RICKY L 1810 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526
COMPANY:ADDRESS:CITY:STATE:ZIP:
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169542 5004 SELVA TIERRA
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1810 SELVA GRANDE DR RESIDENTIAL FENCE POOL
BARRIER 6' FENCE $9200.00
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: 7/20/2021
PERMIT NUMBER
RFNC21-0096
ISSUED: 7/20/2021
EXPIRES: 1/16/2022
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 7/20/2021
PERMIT NUMBER
RFNC21-0096
ISSUED: 7/20/2021
EXPIRES: 1/16/2022
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $91.50
RFNC21-0096 Address: 1810 SELVA GRANDE DR APN: 169542 5004 $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: R16379 $91.50
Printed: Tuesday, July 20, 2021 1:35 PM
Date Paid: Tuesday, July 20, 2021
Paid By: CARPER RICKY L
Pay Method: CREDIT CARD 484414071
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R16379
ze.",! Building Permit Application Updated 10/9/18
F.:City of Atlantic Beach Building Department ALL INFORMATIONr
HIGHLIGHTED IN GRAY800SeminoleRoad, Atlantic B ach FL 32233
Phone: (904) 247-5826 ETIl: Building-Dept@coab.us
IS REQUIRED.
Job Address: /F/O .5' VA 644icz9'1 1 L, 12P-8 Permit Number: t ( ' 00 1(
Legal Description 5 .( I'4 DL)'LA- Z,® 7-- 9-- RE# /69 191 , SGG
Valuation of Work(Replacement Cost)$ -g 9 2co Heated/Cooled SF Non-Heate t E gI ' 2.
Class of Work: New Addition ,Alteration Repair DMove DDemo DPool DWindo oor
JULUseofexisting/proposed structure(s): DCommercial (Residential 4 2021UIfanexistingstructure,is a fire sprinkler system installed?: DYes I'JtNo BY
Will tree(s) be removed in association with proposed proiect? DYes(must submit separate Tree Removal Permit) No
Describe in detail t e ype of work to be performed:
4.)coo ieZi V 4v AC •L 36-o r'_F"
Florida Product Approval#for multiple products use product approval form
Propertywner Information
Name k/(l9/ L- C--4-12 - Address /J/U ` 1 I/1 Cli2-4A-47 2A
city /)-1- TYL 5 State A1 Zip 3)..,,2 3Phone ja / -3-- S — J 1-r—
E-Mail b c:&4-. Sc7,1,0=)? 7o 6 laboa) i_r i}.
Owner or Agent(If Agent, Power of Attorn y or Agency Letter Required) ,c J2-Q
Contractor Information
t,.,,
Name of Company SCO 1-1 V I/1(r-
9i / c
Qualifying Agent--401 " ,T'i k-,“
Address 2 ,2 S .51- -737))1.2) (.//' __ I- City 7/ Gwll i )te• State /•'C Zip 7)..)2 Y(p
Office Phone 76Y— 307- b7 2 )-- Job Site Cont.• Number
State Certification/Registration# E-Mail
Architect Name& Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt o Expiration Date
Application is hereby made to obtain a permit to d• he work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit a . that all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction.I understand at 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
RECORDI U:
001.
bTICE OF COMMENCEMENT.
Sig"of wner or Agent Si! .ture of Contractor)
ned n. swo'to(o yi d before me his/ day of Signed and swor• o(or affirmed) before me this day of
O" ,ZUz/,by'&k i O by
na .
11 : Signature of Notary)
Al-Personally Known • 2:0:4-*;,,, TONT GINDLESPERGER
Personally Known ORMYCOMMISSION#GG 353178
I Produced Identifica : `' +: Produced Identification
Type of Identification: ';+,:.. ,e,= ars Typen`id- EXPIRES:October 6,2023
T e of Identification:
01A, „, Owner Builder Affidavit ALL INFORMATION
n City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
HIGHLIGHTED IN
r
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: IS-lo U' &#+2/ 6liv .. P/t. 46-
Owner Name: e/c27 C. Yx-! c q
Phone Number: / -sys-- I' s
Mailing Address: cct_`()'e, City:State: Zip:
eNotarizedSignatureofOwnerv
The`f regpin ins tru ent was acknowledge) .efore me this(`-' day . 11!AZ , in the State of Florida, County
of J J V i
i
Signature of Notary Public —_ • a
Personally Known OR [ ] Produced Identification
Type of Identification:
trK•v•Poq''.. TONI GINDLESPERGER
r. .. Updated 10/24/18n. :,: MY COMMISSION#GO 353178
vim' ,°EXPIRES:October 6,2023
1l p
4', ;f;;,•••oBonded Thru Notary Public Underwriters
j:Fence Addendum Updated 1/14/2021
x, ' 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:
I /e 5C-L (14 6 &)-)opfi 3 yz...
41 "—
r-s 3
it7)b(i.22_)
Property Type:Lot Type/ Features:
Residential 4 One Street frontage (interior lot)
Commercial El More than one street frontage(corner lot,through lot,
et
i'' Swimming Pool
Fence Material:
c
Ince Height (select all that apply):
si(Wood Four Foot(4ft)
Chain Link i Six Foot (6ft)
Vinyl Other
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.
Will the fence be built in an easement?
Yes (must submit separate Revocable Encroachment Agreement)
t3,4Vo
Will tree(s) be removed in association with proposed project?
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
RECORDING YOUR NOTICE OF COMMENCEMENT.
MAP SHG WING BOUNDARY Su RVEY OF
LOT Z BLOCK — AS SHOWN ON MAP OF
1 cE-L_.A,r,=-- ---ri 247--
AS RECORDED IN PLAT BOOK 38 PAGES - aOF THE PUBLIC RECORDS Of DUVAL COUNTY. FLORIDA
CERT1FIED FOR: tLic..+ - Ly • Joa" 1L Cr R-C'e n- Po V a JaTlo...0 4
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SHOWN THE PROPERTY SHOWN HEREON APPEARS TO LIE WITHIN FLOOD HAZARD ZONE AS SCALED FROM
FL000 INSURANCE RATE MAP 0001FOIR THE CITY OFA-ri_.. 12j , FLORIDA. DATED 4- r'7-SG .
AND IS SHOWN AS A COUR/L.NY ONLY AND DOES NOT CONSTITUTE A CERTIFCATTON OF
SAME TRI-STATE LAND SURVEYORS,
INC.8411 BAYMEADOWS WAY SUITE 112, JACKSONVILLE, FLORIDA 32256 (904) 731-
7235
LEGEND I HEREBY CERTIFY THAT THE ABOVE'LANDS WERE SURVEYED UNDER
MY 01"
61"'" RESPONSIBILE SUPERVISION AND DIRECTION, THAT THERE ARE
NO RCN°
0t ENCROACHMENTS EXCEPT AS SHOWN AND THAT THE SURVEY
SHOWN M""'w I s""I HEREON MEETS THE MINIMUM TECHNICAL STANDARDS SET FORTH BY THEun".
1 ,
1A
oPINCE (
7 ) FLORIDA STATE BOARD OF PROFESSIONAL SURVEYORS ANDMAPPERSmoN
cotTZ PURSUANT TO SECTION 472.027, FLORIDA
STATUTES.moss
an LILL 111/1119 ICSTIOCTION
II(carrWO/NT LARRY G EDDY. P.LS No.
4744 VII wvn-w-ter
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SCALE:
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MAPPER,67AMOF DATE 10 - II--G j STATE OR/
DA 8. d..-?PC (o l ORDER
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