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2277 Seminole ROW18-0021 Overlay in Parking Lot 1.st CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 RIGHT OF WAY - COMMERCIAL RIGHT OF WAY MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: ROW1 8-0021 Description: 1" OVERLAY OF PARKING LOT Estimated Value: 27000 Issue Date: 7/27/2018 Expiration Date: 10/25/2018 PROPERTY ADDRESS: Address: 2277 SEMINOLE RD RE Number: 1683450000 PROPERTY OWNER: Name: CITY OF ATLANTIC BEACH Address: 800 SEMINOLE RD ATLANTIC BEACH, FL 32233-5444 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: D.T. Servies Inc. Address: 1932 Dahlia Road Jacksonville, FL 32254 Phone: PERMIT INFORMATION: Please see aftached conditions of approval. 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 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. 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. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. Ak' Cash Register Receipt Receipt Number City of Atlantic Beach R5868 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $25.00 ROW18-0021 Address: 2277 SEMINOLE RD APN: 168345 0000 $25.00 PUBLIC WORKS PLAN REVIEW $25.00 PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00 TOTAL FEES PAID BY RECEIPT: R5868 $25.00 Date Paid: Friday, July 27, 2018 Paid By: D T Services Cashier:A Pay Method: CHECK 3569 Sc i it, e-S k' Printed: Friday,July 27,2018 10:21 AM I of 1 TPMT City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road (Do Z_ Atlantic Beach,Florida 32233-5"5 Phone(904)247-5826- Fax(904)247-5845 E-mail: building-dept@wab.us Date muted: :21 s City web-site: htfp:/&vww.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: '2!7-77 (,:�� EfnwoLe Department review required Yes No L), —1 . S C,65S Applicant: L Tree Administrator Project: PAR-Kjor" Fulbli.2 Wo PM u utilftieu�i Lo Public-galef7— Fire Services Review fee $ Dept Signature_ ,i� Other Agency Review or Permit Required Review o It of Permit Verillied By Date Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management D.Stnct hm—y Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tabs= Other: — I 1 –1 APPLICATION STATUS Reviewing Department First Review: [:]Approved. E]Denied. applicable (Clicle one.) Comments: /Plot BUILDING PLANNING&ZONING Reviewed by: dl&� 0— Date: TREE ADMIN. Second Review: E]Appmved as revised. DDenied. E]Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date:— FIRE SERVICES Third Review: ElApproved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date:— Revised 05/1912017 City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road Atlantic Beach, Florida 32233-5445 JUL 06 2018 Row t(s - 00 7- Phone(904)247-5826 Fax(904)247-5945 -7/S E-mail: building-dept@coebms Date muted: City%velb-slte: thtp1h�.coalb.us APPLICATION REVIEW AND TRACKING FORM Property Address: ZZ77 '��' Ejywoc)Lc Department review required Yes No Building Applicant: Ep'y(Cf—'s c�LE!aamag _&Zonm----� Tree Administrator Project: OVERAA�z I I kDr, ITu—blic ao P-Mc UtIlitit3_____1 u Ut'll't", Lo-T Public�a�e Fire Services Review fee $ DeptSignature-- Review Other Agency Review or Permit Required of Pe.lt=PB'y Date Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: VrApproved. E]Denled. E]Not applicable (Circle one.) Comments: BUILDING PLANNING&ZONING Reviewed by� Date:AA& TREE ADMIN. Second Review: E]Approved as revised. DDenied. E]Not applicable PUBLICWORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date:— FIRE SERVICES Third Review: E]Approved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date:— R�vm�d 0511912017 11, A�NMC MEM N Al . aff MN L A CMF OI� Nil PVa AMIN, PM RIGHT-OF-WAY/EASEMENT PERMrr Row) 8— oo z I Pemit#leaned by the City ofAuffiartic Beach JobAdd.---2Y�7 Ph.. I?V�/ Emmi 7- Reqt=dng Permission to Constractl Qy�aA4 e-3f-PAd�L1 Lr fi,h gek+ OVA-)Aj L,ocation(Reference to Cmn-Suect) &,Clho 1�3.1411(- • Penance declares that Prior to filing thispplication they have asseammol the location fall existing undhic., both cartel and madmignound and th,accursto locations sam shown on the sketches. • Whenever...a.,far the carestraiti-it,Mail,urproverreat,assimarmsee,safe and efficient operation, \rCA-(0 e__� al�imuml�ionofall,ormypo�mof�ds�wtorem�tw&wminM byth.Direscarrol'Public Works,my or all said poles,wires,pipes,cables or other fiscilifies and appasacneseas authoriced lumander,shall 7,77 0 0 0 be immediately removed from said street or americans or scaut or mlocated hemon as required by the Director of Public Work.and at the expense ofthe Peamide,unless reimbursement is matharriced. • All work shall meet City.&A�mdlic Beach!��da Dynartrucaut.17muspoodestim,Standards and be performed under the supervision of JDA&J i&1160t� (Project Superintended) wiffiCompanyNarms, 2tC— �?-r • All comenals and ca,uportand shall be subject to inspection by&a Director afPublic Worlm • All city property Shall Is,matound in its original coardition as far a Practical,as keeping with City and the commer sudisfackay,to the City. • A ckcrcl�afplanx ornumang details ofthis instalation,as well as a copy of a moval survey shall he made a Pan ofthisparraft. -T S eR-vl ces • The Pennine,shall c.actual oarstractuat an Bond faith won._dyS. Ifffin,beginning date is than 60 days from date of permit approval into pearnitme mant review the permit with the Dissector ofPblic Works m make sum no changes have occurred in flic open dust would affava the Permitted construction. • It is understand and agreed that the rights and privileges hamin sat out arm granted only to the extent of the City's right,title and intereart in the land to be entered upon and used by the hilder,and the holder wfl],9 all faces, CLL So L)-r H maturne all risk of and indersunify,defend and save harradeas the City ofAllamic Beach from and against my and all loss,damage and cost ofespames,ansing in my mancer offfic exenow or attempted exemism by the holder of 11 /"s. 4 the aforesaid rights and privileges. • Tbe Direamor of Public Works shall be notified taxanty-fism(24)bows prior to morning work and again �—�dad com lution cet( P. sauaxl� mmxamxax.'Fkshsi�� y STATE OF Fl.ORDA,COlYNTY OF DJ& 9 0 4 -7--Z 7 Tba,to na was axiamohadnd flan,47—Ada, by , e If befism and (Purred na. be'exass"y spason, 91!Patterns) scursov'i he'sto 'ohistanly Bar thn ausee ex,aasser!m it tho smarmand I C--(3(�4 MC40r- +D 5�f� Personally Kno. il� am W`Nj�rfflb,Sum,W klonda Prolursd Identification Cryle)— K,'s ZV Asphalt Paving,Manholes Adjusted-Patchwork J. ,S ......... . as Concrete Repair 4 17, D. T. SERVICES, INC. P�O Box 6475 IM72 Jackwatilk.FL 3223�75 . ....... Telephonic:781-0055 6#1 DAN TAYLOR Fax:781-7007 dlxv,iccsmv(,,hellsouth.stut Mobile-237-2748 c, Lee— La,y4-on PE 678 -&-2E -7-3,S,3 City of Atlantic Beach APPLICATION NUMBER Building Department (Fo be assigned by the Building Department.) 800 Seminole Road R ow �(9 - 00 Z_ Atlantic Beach, Florida 32233-5445 Phone(904)247-5826 Fax(904)247ZM JUL 0 6 2018 Date routed: E-mail: building-dept@mab.us _c� A City"Iti-site: http:/hvvnv.coab.uS APPLICATION REVIEW AND TRACKING FORM Property Address: 'Z7-77 ',::� E�ryvQoLc Department review required Yes No Applicant: T, S epy I ncs �:_��,,_ngi-, Tme Administrator Project: I f)Pf2KJK)(C-" Lo Public-8057— Fire Services I Review or Rece 9 Other Agency Review or Permit Required o(PormliVerifietilty Date Florida Dept.of Environmental Protection Fborida Dept.of Transportation St.Johns River Water Management District Amy Corps of Engineers Division of Hotels and Restaurants Division of Aloolholic Beverages and Toba= Other: APPYCATION STATUS Reviewing Department First Review: [E(Appri E]Denied. E]Not applicable (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Date: TREEADMIN. Second Review: E]Approved as revised. []Denied. ONot applicable P FWORKS Comments: V4B PL;K_1(!W Reviewed by: Date: FIRE SERVICES Third Review: [-]Approved as revised. E]Denied. E]Not applicable Comments: Reviewed by: Date:— Revised 051IW2017 monop�-- A�= �AN If$ If L A, At 10,1 e)ve(d A ov� RIGHT-OF-WAY I EASEMENT PERMIT ob Z- Permit N listed by the City of Atlantic Beach Job Address c2_9 7 7 Rev Phone Perinnittee Z--C Email r RespecutingPistraissiontoConstuactl"Ov �l;—LA!4 6F--?Ad1L:) L �7 1111h '1414 Or—t-)Al Location(Reference,to Crom-Strect) 6-cow ul.'40C • Penalties,declares that print to filing this application dic,how smarmiest the location ofell existag utilities, both assoul and undercound=it the accurate hmatimas me,abown,on die sketches V-6-6-� • Whenever n cessary for the construction,repair,improvement maintenance,sale and efficient operstroar, attention m=cation of a,or my portion of mid acted or emement m determined by the Director of Public —700 0 Works,any or ail said pales,wors,pipes,cables mother fieflatics,said pipurr.,autherized hersunder,shall be immediately removed from said street or easement or react or retreated barman as required by the Diter of Public Works and at The expanse of the Perraince mileas reimbursement is authorized. • AflworkslamlimmCkyot'll Cli Besselb�pl a. �.t.fT,.V.�i.Swd.d..db�p.,f�..d maer fire supervision of 4 Ulr'A, (Project Supermandem) withCompmerName --y d :4;-C Ph...P -6W-r • Ali nationals and equipment shill be subject to inspection by the Charter of Public Works. • All city property shall be restored to its original conditioun m far m practical,in keeping with City specifications .it the..,sati.fixetery to the City, • A sketch of plans covering detals of this installation,use wall as a copy of a recent survey shall be made a pan of this permit C)—T S R—V I C E-1 • The pramince shall commerce actual constructions in good fisafth withindays. Ifthebeginciagdamiscoure date 60 days from date offientraft approval than pentriffee mact review flum permit with me Director of Public Works to make am no charges have oetatured in the area that would affiset the permitted commusenota • It is anderatmad mid agreed that the rights and privileges herein set out an, ramed caly to the extend of the City's right life and barman to the land to be emand man.and used by the holder,ard the hot&,will,9 91 tones, Q—L SO U T H assume all risk of and indemnify,defend and save himmem the City of Atlantic Beach from and against my and all I.,damage and at of expernes ansirg in any..at fthe mancise or astarrepted exercisms by the holder of 4 dam aforesaid rights and privileges. • The Docent of Public Works maill ba rarefied twearty-fiser(N)homs prior in starting wait and again PtMUft ameslLn,wasereateof1lotaryp STATE OF FIORI 904—ZS-7--Z'74� wasse Tm fi, at d,.f L� '7� who pmmmHy appeared Extum ne sed by atimmed that fla,immarmse volantanly findia puramearposesed mit PencrallyKnown provLC(se— Asphalt Paving,Manholes Adjusted,Patchwork c.\\N�S 1.Fk4 ........ zw. Concrete Repair D. T. SERVICES,INC. P.O.Box 6475 1 72 Jaclearriville,F1,3=36�75 led ..... ..... Telephone:781-0055 is lot DAN TAYLOR Fax:781-7007 dracivicesmetiPbellacauth.ma Mobile:237-2748 Qc)r,4c:ko-,4 Ar C)Q-P-o-,-\ Lcs-y4on PE 6778 -&-2 E --2-3,S 3