197 Pine St DWAY21-0028 Concrete Driveway r '"`''' \`�,. DRIVEWAY PERMIT PERMIT NUMBER
J i
CITY OF ATLANTIC BEACH DWAY21-0028
800 SEMINOLE ROAD ISSUED: 11/1/2021
��=3»� ATLANTIC BEACH, FL 32233 EXPIRES: 4/30/2022
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.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
DRIVEWAYSINGLE OR TWO
197 PINE ST FAMILY DRIVEWAY CONCRETE DRIVEWAY $4000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170635 0010 SALTAIR SEC 03
COMPANY: ADDRESS: CITY: STATE: ZIP:
Solid Foundation Solutions, 2704 SW Main Blvd Lake City FL 32025
LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
SEYLER RICHARD MASON 197 PINE ST ATLANTIC BEACH FL 32233-4011
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II`
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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
7 PUBLIC WORKS DRIVEWAY APRON INFORMATIONAL
Notes:
All concrete driveway aprons must be 5 inches thick,4000 psi,with fibermesh from edge of pavement to the property line.Reinforcing rods or mesh are
not allowed in the City right-of-way.
Issued Date: 11/1/2021 1 of 2
A157,6*
DRIVEWAY PERMIT PERMIT NUMBER
A I CITY OF ATLANTIC BEACH DWAY21-0028
ISSUED: 11/1/2021
800 SEMINOLE ROAD
j3j ATLANTIC BEACH. FL 32233
EXPIRES:4/30/2022
2 PUBLIC WORKS EROSION CONTROL INSTALLATION INFORMATIONAL
Notes:
Full erosion control measures must be installed and approved prior to beginning any earth disturbing activities. Contact the Inspection Line(904-247-
5814)to request an Erosion and Sediment Control Inspection prior to start of construction.
3 PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
4 PUBLIC WORKS ROLL OFF CONTAINER INFORMATIONAL
Notes:
Roll off container company must be on City approved list. Approved list can be obtained at the Building Department at City Hall. Roll off container
cannot be placed on City right-of-way.
5 PUBLIC WORKS RIGHT OF WAY RESTORATION INFORMATIONAL
Notes:
Full right-of-way restoration,including sod,is required.
6 PUBLIC WORKS RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site. Cannot raise lot elevation.
7 PUBLIC WORKS MAXIMUM DRIVEWAY INFORMATIONAL
Notes:
Maximum driveway width within the City right-of-way is 20 feet. Replace driveway"as is"only.
8 PUBLIC WORKS REVISION INFORMATIONAL
Notes:
Any plan change must be submitted as a Revision to the Building Department.
9 PUBLIC WORKS DECKING REMOVED INFORMATIONAL
Notes:
All old decking and debris must be removed from job site by Contractor.
10 PUBLIC WORKS INFRASTRUCTURE INFORMATIONAL
Notes:
Any damage done to infrastructure must be repaired by Contractor.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PW REVIEW BUILDING MOD OR ROW 001-0000-329-1004 0 $25.00
ZONING REVIEW SINGLE AND TWO FAMILY USES 001-0000-329-1003 0 $100.00
TOTAL:$125.00
Issued Date:11/1/2021 2 of 2
RECEIVED
, r;•_.,..-i, Building Permit Application By Toni Gindlesperger at 2:55 pm, Oct 20, 2021
•
City of Atlantic Beach Building Department NEW CONTRACTOR **ALL INFORMATION
Jij800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: j c( .1 C I'WG Sf - Permit Number: DWAY21-0028
Legal Description 16-1(e I(Q Z5 ZE E 5 Ft 1{71-t1/4 a_ `-(_-_7L 3 Lot 6'7.5— REP 110 4'35'00 (0
Valuation of Work(Replacement Cost)$ 4 rX17.cic, Heated/Cooled SF Non-Heat E
• Class of Work: IilNew ❑Addition DAlteration ❑Repair DMove ❑Demo H Pool ❑Windo oor
• Use of existing/proposed structure(s): DCommercial IDResidential OCT 1 9 2021
• If an existing structure,is a fire sprinkler system installed?: DYes mooO
• Will tree(s)be removed in association with proposed project?❑Yes(must submit separate Tree Removal Permit) Litd>S
Desccribe in detail the type of work to be performed: f
l�/-h'lODE OW aIL+V .4,, - 0 '1.) .,.(-. W r`l'/l A}tP C` G�iVLrL ' Et i)rrw4c.1
Florida Product Approval# _for multiple products use product ap�'�roval form
Property Owner Information l
Name 1 (A'i 4tZc4 Vi - < t--'vll c4 Address I.6) )7 it'll/ ,1 •
City I4A4-1'c )lt h, s/ State 11 Zip 3LJ3 Phone `1 del-�j'/# f moi`?
E-Mail Vic.,11S'L i .Y2 initoL b SNA-iii COr(
Owner or Agent(If Aent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 5,trd c (-,�^n (v,1('r4c-cars'`4-Califying Agent b(s to „n bua-4-S
Address C 3'2,q (A- 4- ja,., U I Cj'.j City --5-0.-4. State L. Zip 322 (V
Office Phone e"i O4—SOS.} •--(; 4 7 8 Job Site Contact Number
State Certification/Registration# C( S ca' y i 2e,2-E-Mail be Uc,r• - _2 R 13 e e/GG1.,, ,,,,^--,
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt K Expiration Date CY7-.Z Z
Application is hereby made to obtain a permit to do the work and installations as indicated.)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 BEFORE
REC• •DING YOUR NOTICE OF COMMENCEMENT.
{ gyp^ /(Signature of Owne Agent) gnature of Contractor)
E��^CX/tsc.sC
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Signed and sworn to(or affir )before me this /9 day of Sined and sworn to(or affirmed)before me this// dayof
OCT , 202! ,by «-i'1 h• /1 , s _ OCT , 2021 ,by q 1G,r-, �? .A
car- -� -0- - tis --
(Signature of Notary) (Signature of Notary)
•�' CHRISTIAN G �"'
[ ]Personally Known OR ? '; [L ersonal Known OR :;a••••`. ;•-, CHRISTIAN GILES
MY COMMISSION M tIF�al MY COMMISSION u HH 117153
(► roduced Identification �. ealldentification ,;,, . •
;;�` �': EXPIRES:April 1 �'•c
Type of Identification:FL- r�•L- `�fldei ification: EXPIR63:AOri113.2075
P' 8onded�irvitofary Public Merwriters "..'f
.,...,...,,.,....�„ �` 8o^de0 Thru N..___Public Ut1dCtM�{t ry
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RECEIVED
By Toni Gindlesperger at 2:57 pm,Oct 20,2021
RIGHT-OF-WAY/EASEMENT PERMIT APPLICATION **ALL INFORMATION
City of Atlantic Beach HIGHLIGHTED IN GRAY IS
- "` 800 Seminole Road,Atlantic Beach,FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address ( 9 7 I Sj}f p,Q�— Permit Number Q W 4 ki 2.t -OO 2 '
Contractor Information
Company S a II' a. 6uN.cL' cavi' (-0.1 (4C(-urS L Qualifying Agent 6r1 41 (-)-S
Address a 3 IA Qc„1, � a City State (L Zip 3-2Z(6
Phone a 4+4 ^ S 6 8'�6 1 ?U Email ft)C164n `;a2 JIS e 4 a .-•"--
State Certification/Registration# L l 5 OvUU ' / 28 2–
Architect
Architect Phone Email
Engineer Phone Email
Workers Compensation Insurer OR Exempt yk Expiration Date (P 2 2_
• Permittee declares that prior to filing this application they have ascertained the location of all existing utilities,both aerial
and underground and the accurate locations are shown on the sketches.
• Whenever necessary for the construction,repair,improvement,maintenance,safe and efficient operation,alteration or
relocation of all,or any portion of said street or easement as determined by the Public Works Director,any or all said poles,
wires,pipes,cables or other facilities and appurtenances authorized hereunder,shall be immediately removed from said
street or easement or reset or relocated hereon as required by the Public Works Director and at the expense of the
Permittee unless reimbursement is authorized.
• All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed under the
supervision of 1.-�c1 k 'Ai (Project Superintendent)
with(Company Name) 5oltt4 %e✓" t tettLy r LL,(ehone4thy_c 03—G'!7 v
• All materials and equipment shall be subject to inspection by the Public Works Director.
• All city property shall be restored to its original condition as far as practical,in keeping with City specifications and the
manner satisfactory to the City.
• A sketch of plans covering details of this installation,as well as a copy of a recent survey shall be made a part of this permit.
Calculations showing any increase in impervious area on owner's lot or in the City right-of-way are to be included with
this application.
• The permittee shall commence actual construction in good faith within days. If the beginning date is more than 60
days from date of permit approval then permittee must review the permit with the Public Works Director to make sure no
changes have occurred in the area that would affect the permitted construction.
• It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's right,
title and interest in the land to be entered upon and used by the holder,and the holder will,at all times,assume all risk of
and indemnify,defend and save harmless the City of Atlantic Beach from and against any and all loss,damage and cost of
expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges.
•q e
The Public Works Director shall be notified 24 hours prior to starting work and again immediately upon completion.
`G�l r t., li14/1 - Date /O II /Z1
Permittee(signed in presence of tary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this 1(1/ th day of_D CIO F;C2 .20 -by gise 44*nt..,ci N St/tic ,who p
(prin d name of Permittee) :.�.'• CHRISTIAN GILES
p t ;; MY COMMISSIONS HH 117153
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. �� . EXPIRES:April 13,2025
•EeF f 0:*. Bonded Thru Notary Pubic Undenv tws
��� ./dAAI I P sonally Known
Produced Identification Noe)Signature of Notary Public,State of Florida ( ( YP ) FL-_ 1)' �^�
H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
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1. AGREEMENT TO ACCEPT TRANSFER
1*0
41OF UNCOMPLETED BUILDING PERMIT
This agreement and a new Permit Application are required
to transfer an uncompleted building permit.
I Bcl�,� N\ �u{ , Phone qa 4 ''SO9 —6`-f7 d .
Address b 33 P-ukk
Email QS vo �- q a(/O v Cv -N
State Certification/Registration # L. ( S 00 UO y ► 2. ' ' , understand that Building
Permit DtA3 was started by another contractor and is currently
uncompleted.
I agree to, after reviewing the approved plans and the unfinished as-built construction, to
submitting a Revision Form and revised construction drawings to the Building Department to
correct any deviation between the approved plans and as-built construction, where found.
I understand that, based on the current inspection record, I am responsible for the Code
compliance of the finished project.
Details (Optional)
State of Florida
County of Duval
The foregoing instrument was acknowledged before me this day of
by ,who personally appeared before me
and acknowledged that he/she/they signed the instrument voluntarily for the purpose expressed in it.
Signature of Notary Public
[ ) Personally Known OR
[ J Produced Identification
Type of Identification:
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DWAY21-0028
NOTICE OF COMMENCEMENT
State of Tax Folio No. I 'i OG 3S--00 10County of t,/IJVA-(
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713
of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: l''`1 a d KA"ecwi.,
10C:.16eir — A)1-2--,k) C')2_4'1)00441
t 11)S+41(6c4 Ce-O)deli!_cf E ) -� fdt,oe...kr- le,-- i /i - Zci E
Address of property being improved: ml f( k.'L �l,( — Jo;if1 t 5 E L-3 j-'6t61?
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Gen al description of improvements: L L.t 4 but, a td lii2-i Op*A) — 1 NS A-/[i4 Nt=�
efF)
Owner: e\c2,17,. ,,....d H ,-C= i, Address: K. .-/ t'ellu (
Owner's interest in site of the improvement: ` Y IOMe ok.).o6en_ _
Fee Simple Titleholder(if other than owner):
Name: Ll'<cr‘ (-). .,,r).-1-
` — —
Contractor: ca �I1 ,Ak���4I L.� CO3r•. c�.tt,i.11 (.-.t-•L-
Address: 6 33(1 N-Lk-k-lc,v` �i '-&
Telephone No.: CIdt(•-sof (, -I '70 Fax No:
Surety(if any)
Address: -Amount of Bond$
Telephone No: 610'4— Cud^(-w70 Fax No: -
Name and address of any person making a loan for the construction of the improvements
Name:
Address:
Phone No: Fax No:
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other documents may
be served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b), Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified):
THIS SPACE FOR RECORDER'S USE ONLY OWNER i_e_..L_.,,,t,-,..
Doc#2021274497,OR BK 19965 Page 1219, Signed: tet/ r"'l' Date: rI 01(ci )z- i
Before me this i q day of �) in the County of Duval,State
Number Pages'1 � ��
Recorded 10/19/2021 11.16 AM, Of Florida,has personally appeared L-p•L-
JODY PHILLIPS CLERK CIRCUIT COURT DUVAL Notary Public at Large,State of Florida,County of Duval. ,/% ,�
COUNTY My commission expires: O
RECORDING $10.00 Per or
Pro c " tfication:CHRIsfANr�11Esf, it MY COMMISSION#HH 117153
. .��'.r8 EXPIR5S:April 13,2025
:r,' !�O,' Bonded TTN Notary Public Underwriters
- MAP SHOWING BOUNDARY SURVEY OF
LOT Co—,-s=BLOCK -----`--- AS SHOWN ON MAP OF
S.. i.._T r� ..5C.-...c.....-r-,0,_J M
AS RECORDED IN PLAT BOOK t0 PAGES 1C-e' OF THE PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA
CER 77F/ED FOR: (Z-K—- L-o N" . S G Y c-_-C.I_%6^^..- rr`a�,.�- ��,�-'ST 'a...,a . CI's.. , --1--;-,-,.._€
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• EP o' C OF ATLANTIC BEACH3
G `.;,• p� a BUILDING OFFICE
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• •eg P�\� �,� pna, ':.11
JAN 1 3 2000
-k v ni... pitik c.,,,,,
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RECEIVED
By Toni Gindlesperger at 2:59 pm,Oct 20,2021
J
NOT VALID UNLESS EMBOSSED WITH SEAL OF THE UNDERSIGNED.
THE PROPERTY SHOWN HEREO.V APPEARS TO LIE WITHIN FLOOD HAZARD ZONE • X' AS SCALED FROM FLOOD
INSURANCE RATE MAP CYe)i FOP. -+z_-...0-r,c_. L3G�G..`4i FLORIDA, DATED