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
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Pemit#leaned by the City ofAuffiartic Beach
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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(
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STATE OF Fl.ORDA,COlYNTY OF DJ& 9 0 4 -7--Z 7
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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
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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
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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
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