RESO24-0100 BUILDING PERMIT APPLICATION FOR INTERNAL OFFICE USE ONLY
°
• ` City of Atlantic Beach Building Department
_ ; PERMIT#2ESC24`0(00
800 Seminole Road, Atlantic Beach, FL 32233
i **ALL information required to process
Phone: (904) 247-5826/ j/ Email:�aBuilding-D�eptPco)a�b.us > 2 c�
Job Address /8 L> 9 At/A/th ` 4(17 ) . /`t . I?l.1/3Z2J RE#169s—or-
Legal Description A,f' !/ 0��14///" lUg th(,l/f i ZI 1 j1j
Valuation of Work(Replacement Cost) 2/ O i Heated/Cooled SF .b- Non-Heated/Cooled SF ..64—
•Class of Work: E New ❑Addition giAlteration ❑Repair ❑Move ['Demo ❑Pool ❑Window/Door
•Use of existing/proposed structure(s): ❑Commercial`ZResidential •If existing structure, is a fire sprinkler system installed?:❑Yest2 No
•Will tree(s) be removed in association with proposed project? ❑Yes (Must submit separate Tree Removal Permit No
Describe in detail the type of work to be performed:
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Florida Product Approval# Alb/ (For multiple products use Product Approval Information She t)
Property Owner Information Name SC-Orr Aea/,'Lar/ Phone 9 %-,9 y'/
Address /50 / /c f/�{/t/ , (', ,rte'/V( City Arth t 14e1�// State Zip 3z 3 3
Email Se crit.694,7i.‘4,14.e.`91, • wner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information Name of Company Sr },4 /J 752( Phone 7v/.,< -5/7y2
Address 10 Pia- We t City !►ipPh °f,69. State f Zip _77246
Qualifying Agent State Certification/Registration# /v 4 /
Email 4ad(JP ,0e/ /4/ ()r �,'`J� Job Site Contact Number (//)6/1-584.-775/7—
Worker's Compensation Insurer Q4%js / OR Exempt ❑ Expiration Date _Za 2
Architect's Name /f J Email Phone
Engineer's Name /ti I Email Phone
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 prioPto 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 city/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 YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT
MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT W TH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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(Signature of Owner or Agent) (Signature of Contractor) 7
Signed an sworn to(or . med)before me this day f Si ned aril sworn to(o affirmed)beim- me his v� day of
z.V by _ ILv eLl�k��eN _
Signature of Notary I1" Signature of Notary--...,,____:s-
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[ ] Personally Known `ORif'] Produced I • cation [ ] Personally Known OR [ ) Produced Identification
Type of Identification: , - Type of Identific
5f TONI GINDLESPERGER \
•' r.'.�.! TONI GINDLESPERGER I,•\.`^` MY COMMISSION#HH 407122
i fi MY COMMISSION#HH 407122 % EXPIRES:October 6,2027
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���,•``. EXPIRES:October 6,2027 —
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MAP SHOWING BOUNDARY & TOPOGRAPHIC SURVEY OF
LOT 56 AS SHOWN ON MAP OF
ATLANTIC BEACH COUNTRY CLUB UNIT 2
AS RECORDED IN PLAT BOOK 67 PAGES 132-137 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLA.
CERTIFIED TO: 1889 AB DRIVE LLC, A FLORIDA LIMITED LIABILITY COMPANY
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I 9.J �r �� •5 �% A = 131.43'
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A = 38.37'
A = 43'58'10'
0-DENOTES END 1/2'I.P.
aR LB 3848
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CR-DENOTES CABLE RISER BOX
QENCHMARK: ®-DENOTES TELECOM RISER
TOPOGRAPHIC-;W.O.#218322; 05-15-2024 (FIELD) EAST FLANGE BOLT ON FIRE
FINAL:W.O.#153270; 12-21-16 (FIELD) HYDRANT IN FRONT OF LOT 1 ®-DENOTES WATER METER
FOUNDATION;W.O. #150620: 07-2.2-16 (FIELD) ELEVATION: (12.16) 0-DENOTES CONCRETE
LOT&HOUSE STA(E OUT(GOOD-SET F.F.E.);W.O. #150430; 07-08-16 (FIELD) [-DENOTES BRICK PAVERS
THIS SURVEY WAS PERFORMED WITHOUT THE BENEFIT OF A TITLE COMMITMENT. ELEVATIONS SHOWN HEREON
THERE MAY BE ADDITIONAL EASEMENTS AND/OR RESTRICTIONS THAT ARE NOT SHOWN REFER TO NAVD OF 1988
ON THIS SURVEY THAT MAY BE FOUND IN THE PUBUC RECORDS OF THIS COUNTY.
BEARINGS AND DIRECTIONAL NORTH ARE BASED ON FLORIDA STATE PLANE
COORDINATE GRID SYSTEM- FLORIDA EAST ZONE, NORTH AMERICAN DATUM 1983 UNDERGROUND ENCROACHMENTS NOT LOCATED
THE LOT SHOWN HEREON IS IN THE SPECIAL FLOOD HAZARD ZONE"X", -X-SHADED& 'WE'EL(7.0)AS SHOWN
ON FLOOD INSURANCE RATE MAP 0406 J FOR THE CITY OF JACKSONVILLE, FLORIDA, DATED 11-02-18
ALL AMERICAN SURVEYORS OF FLORIDA, INC.
LAND SURVEYORS -3751 SAN JOSE PLACE. SURE 15 -J4CSCSONNLLL FLORIDA, 32257- 904/279-0088-LICENSED LAND BUSINESS NO. 3857
ENO. FOUND Le v A/C a cDNwnoNER S
ESN'T EASEMENT oen D iDErmaunON THIS IS TO CERTIFY THAT THE ABOVE LANDS WERE SURVEYED UNDER MY RESPONSIBLE
CONE CONCRETE (TYP.) ',PCAL SUPERVISION AND DIRECTION, THAT THERE ARE NO ENCROACHMENTS EXCEPT AS SHOWN _-4
MON. MONUMENT P.R.M. PERMANENT ENTREFERENCE AND THAT THE SURVEY SHOWN HEREON MEETS THE STANDARDS OF PRACTICE AS SET
I.P. RCN RIPE P.T. ONT OT TANGENCY
R RCN ROD FORTH BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS
C COELTAHORD
ANGLE P.C.P. PERM50775 0 CONTROL PONT ALL
A ARC
P.R.C. POINT
OF RAE CURrt PURSUANT TO CHAPTER 472.027 /CHAPTER 5J77, FLORIDA ADMINISTRATIVE CODE AMERICAN
A CSECSONL'M P.C.C. Poi.OF COMPOUND NRK SURVEY NOT VALID UNLESS EMBOSSED BY SEAL SURVEYORS
(C) CALNUTED B.R.L au..RES-TROT5 UNE OF FLORIDA,
(D) DUO JEA JACNSDNOLLE ELECTRIC AUTHORITY JAMES D. HARRISON,JR., No. 2647 INC.
P PUT _
UDE .UNOBSTRUCTED DRAtNALE MICHAEL A. GARRETT, No. 6643
� EASEMNT
A CENTER� LINE NCW NATIONAL GEOOERC 055101.DATUM SCALE 1'420'
RM RG.-OF-WAY NAVO .NORTH AMERICAN VERTICAL DATUM
Z2/1 _(A) _ P.L =POI.OF INTERSECTION ^ 9
`W) _A TNE55 LOW .TDDE OF WATER U..E..P.NLSH ROOF ELEVATION , .uw+Osro...NESS DATE03-28-16FLORID RED SU VEYOR AN I-BI
F.B. MAP TB, 80119-218322 DR. BY SJM DIR. P:\2016\80119-153270-ENL ORDER NO. 218322-TOPD RLE 80119