575 Selva Lakes Cir Fence Submittal 7.,,,,4-f-:9: --_:.„, Building Permit Application Updated 10/9/18
(� *`" City of Atlantic Beach Building Department **ALL INFORMATION
rr}"// 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 575 S-ya Lotite..5 Cif Permit Number:
Legal Description 0I00 S;„j1.. 4 6, RE# 1722.c a-7-5530
Valuation of Work(Replacement Cost)$ 41 uv Heated/Cooled SF Non-He cited
• Class of Work: ❑New ❑Addition ❑Alteration )(Repair ❑Move ❑Demo ❑Pool ❑Win /Door
• Use of existing/proposed structure(s): ❑Commercial .Residential SEP 1 7 2021 I)
• If an existing structure, is a fire sprinkler system installed?: ❑Yes i'No BY:
• Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit —
Describe in detail the type of work to be performed:
Eltilic-;/4) e i s+'i Pt, L Citif� /r Te41ct.- :N S^-f 14"c- 10C-014-; .+•1 a S°►h'' - NS.4*esrY'u I/ S
Florida Product Approval# _J _ _for multiple products use product approval form
Property Owner Information
Name ,.ktw 3c.a.ri Ch14444i,in Address 57 5 Sf.itA4 Ie krs L;r _
City AfIav ;c Be...i, State FI Zip 322-33 Phone `'C)`1 7!U 9231-4
E-Mail ct 4o.,04t.1Hvlofnonr ,9pri«1i ,ccvVI
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company S up ov,I c✓' Fc,r1r.` aro'
R.4 I Qualifying Agent Z''c-I1 Pe+fr.^
Address 9170 /4 11 „� City Ja�J+soxv,'lli State r✓1 Zip 32 w
Office Phone 70y 615'3 3''l7 Job Site Contxt Number
State Certification/Registration# (65$5"1 E-Mail_ /Jvvd , po re..1GiM�juc.Ls.„u;J/, . cc4n1
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer Fe..{rw,.r-, /UuJu.,/ OR Exempt o Expiration Date ' '/f S/z z .
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 BEF• 'E
RECORDING Y UROTI OF O1VI1VIENCEMENT.
�// ..fitieddi........110
( t re of Owher or Agent) (Si; .ture of Contractor)
Signed and sworn to(or affirmed)before me this_I d. Signed and sworn to(or affirmed before me this /7 day of
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1 0- by Dom' S gyp+ UPL1 q_... v
:: .... 1t/ ( I' ,71 rr'' yr 1[" r r
_1 '•I¢. Nota PETE L„ (Si;
f (Signature of Notary)
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of�o�o, Comm Sblic•Stare of �� NotaryPublic State of Flonda
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• s� Flo
B.••��,y`cay,•oaitol i 55507 da ,- "Personally Known OR . Bnlani M Norman
N c_ • My Commission HH 011346
sI Pro.• - B;i'`Cmi 20�1 [ ]Produced Identification %a�s� Expires 06/16/2024
cJ ` Type of Identification:
Type of Identificatio':
MAP SHOWING BOUNDARY SURVEY OF
LOT 67, ACCORDING TO THE PIAT OF "SELVA LAKES UNIT TWO" AS RECORDED IN PLAT ROOK 43,
PAGES 1 l, 11A AND 11 B OF TIKE CURRENT PUBLIC RECORDS OF DUVAL. COUNTY, FLORIDA.
CERTIFIED TO;
ELDA .TFAN OUTMAN CROWE,
STEWART TITLE OF JACKSONVILLE, INC.
CN 1IORT(:AGE CORPORATION
AND WATSON & OSBORNE, P.A.
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SELVA L,Q55 CAeCLE (P 47--ao- D)
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ollilRAL NOTtt. p14f ///5.
2.STRUCTURE ASSOCIATED SURVEYORS INC. 1 BEARINGS ARE BASED P�aT ��URE N0.,5755 940HEREON DES INTIM FLOOD ZONE X AS ST
�. //l///i LAND & ENGINEERING SURVEYS DETERMINEDfRcB F.E.M.A F1000 MAPS PANEL_Na / pATED 7-A .
3.THIS IS A SURFACE SURVEY ONLY. THE EXTENT OF UNDERGROUND FOOTINGS,
3846 BLANDING BOULEVARD PIPES AND UTILITIES, IF ANY, NOT DETERMINED.
s SJACKSONVILLE. FLORIDA 32210 4.JURISDICTIONAL AND/OR ENVIRcNMENTALLY SENSITIVE AREAS IF ANY, NOT
? 504-771-5468 LOCATED BY IMS STRAY.
'0 - O 5.THIS SURVEY WAS BASED ON LEGAL
D THE
O S S V CERTIFICATE OF AUTHORIZATION NO. LB 0005485 PUBLIC RECORDS WERE NOT SEARCHED BYO THIS SURVEYOR FOR SHED EIAASETENTS, RILE,
COVENANTS OR RESTRICTIONS THAT MAY AFFECT THIS PARCEL
1 HEREBY CERTIFY THIS SURVEY WAS DONE UNDER MY &UNLESS OTHERINSE STATED ALL IRON PIPES FOUND HAVE NO IDENDOcARCN.
DIRECT SUPERVISION AND MEETS THE MINIMUM TECHNICAL
STANDARDS FOR LAND SURVEYING PURSUANT TO CHAPTER Y—x- FENCE LP !ND/ARIR!VIATION5 (R)- RECORD
61617-5 F RICA ADMINISTRATION CODHAP R 477• F.S. O e SET RON PI E OR RFRAR MARKEY P.C.- POINT or cuRVE (u)_MTAsuREo
ASSOC. SPI'.
VE "OR LI. '/RR P.T.-POINT OF TAIICENCY A - CENTRAL
BY: • - FOUND IRON PW OR PIPE C//L - CENTERLINE AMCLE
t�/�/�J• (// &
■ - FOUND CONCRETE MONUMENT I.11,- IRON PIPE OR PIN L-ARC LENOTH
CH LEHER FLORIE�g�j IFICATE NO.3771 X - CROSS CUT OR DRILL ROLE R/w - RIGHT Or WAY p ,. RHr
AOs
CHARLES L. STARLING FLORIDA C j.FIFICATE NO. 4579 P.R.C.- Po1NT OF REVERSE CURVE ELECT.- ELECTRIC
RAYMOND J. SCHAEFER FLORIDA CiiiIIERTIFICATE NO. 6132 P.c.c.-PONT OF COMPOUND cuRVE CONC.- CONCRETE (�)= cNoap
B.R.L.-BUILDING RESTRICTION UNE REF. COR.-REFERENCE Nk0-NAIL ANO
JOB NO. 2922'9 nnrE /2,<-�ol!��.v/ ORV - OFFICIAL RECORDS VtOLUM£ CORNER DISK
SCALE: 1' --- ORB - OFFICIAL RECORDS BOOK 1(CkR) PEsou NIS AND PB. - FLAT
_eo DRAFTER A.J•F JQ. J.EA -JACKSOTMLLE ELECTRIC AUTHORITY R-OUK---cgUilIEAD 011U0°IES
NOT VALID YATHOUI THE SIGNATURE AND IIIE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER
:tA;''r"; 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:
575 S'e)va ,Lok k 4z s / /'7r .2n 1
Property Type: Lot Type/ Features:
MResidential X 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):
xt Wood Four Foot (4ft)
❑ Chain Link .B] 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)
0,„N o
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.