547 SELVA LAKES CIR ACC21-0056 1-7,:,''''',/,=•..,,,, Building Permit Application Updated 10/9/18
.
L. City of Atlantic Beach Building Department **ALL INFORMATION
. j,), 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
°f� IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us �� ��
Job Address: 547 SELVA LAKES CIRCLE i\-Permit Number: LQ. 2i - v C 5 7
Legal Description PAVER WALKWAY RE# 17 Z dz.7-55 1 Cr.-
Valuation of Work(Replacement Cost)$ 3,500.00 Heated/Cooled SF Non-Heate Cooled
ECEIVE
• Class of Work: ❑New ❑Addition DAlteration ❑Repair ❑Move ❑Demo ❑Pool ❑Windo / oor
• Use of existing/proposed structure(s): ❑Commercial ❑Residential NOV 1 6 2021
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No
• Will tree(s)be removed in association with proposed proiect?❑Yes(must submit separate Tree Ri'F't
Describe in detail the type of work to be performed:
PAVER WALKWAY ON SIDE HOUSE AND FRONT DOOR
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name ELENI CRUISE Address 547 SELVA LAKES CIRCLE
City ATLANTIC BEACH State FL Zip 32233 Phone 904-309-4978
E-Mail gatorcruises@comcast.net
Owner or Agent(If Agent,Power of Attorney or Agency Letter Required)
Contractor Information
Name of Comp ny r 7y .4 , /w 6L. Qualifying Agent 6i.-/ /4•(3•-/C, Te-
Address I Z 11 LA-t--4- w�=^c4 'f City 5 -57, 2- State i----t.- Zip Z.)y
Office Phone tip Y - LiyE — 6 z z, Job Site Contact Number ?c`f - 51y4, - 4-,z -z....
State Certification/Registration# C gt. /2(. /5 / E-Mail -c--A-(1.1., 6' i N/' R✓r \,ice/ coo.
Architect Name&Phone# u 1 t> t, /3 t/Zz-
Engineers Name&Phone# .-I A
Workers Compensation Insurer Jv' ib OR Exempt Expiration Date
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 BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT.
(Signature of Owner or Agent) (Signature o ntractor)
a
Signed and sworn to(or affirmed)before me this I day of Si ned and sworn to(or affirme.)before e this 6day of
WieM\10 , 2-� ll , y Cl6fli C,ry:se Signed
Gr)•1 ,b " 'c s`c::6
C ' .
(Signature of Notary) (Sign•ture of Notary)
[ ) personally Known OR [ ) rsonally Known OR
[ Produced Identscation
,'.;;'''!* *°"4.-, •. • t gRtification:. L i L/ o en i ca ion:' (b(`.Ic\C,.S ,
f ;: Commission#HH 034840 1 .0.';k4"PGe�. ZACHARY MCCUTCHEON
=`: spar,
=
:Y8
•
•
1I%r p
++.�;-._i�.llOr.�t7w.,�t4`lk.�A.+iW.r6s..�.r•. ... _. .. .. ... _ - u+•p]}
4
^ r
.f, r �L'
.....,
, ' S\ CITY OF ATLANTIC BEACH
, , ,,i
800 SEMINOLE ROAD
�J �r ATLANTIC BEACH,FL 32233
(904)247-5800
1
SURVEY AGREEMENT
NOTICE
All new projects creating more than 250 Square Feet of impervious surface or requiring on-site storm water
retention,including swimming pools,will require pre-construction and post-construction topographic surveys,
as required by COAB,Section 24-66 and described in Bulletin 2-18,Surveys. The surveys must be new
original documents,from a licensed surveyor,signed,sealed,and dated.
Other small projects, such as fences and construction less than 250 SF,will not require a new topographical
survey,but a current original-size survey with all relevant details is still needed. These surveys,when included
as part of a building permit application,must be complete,up-to-date,and original size and scale,as produced
by the surveyor.
Copies of old surveys lacking details or copies not of original size cannot be accepted. Building permit
applications with unacceptable surveys cannot be reviewed and the application will be returned to the
applicant.
Thank you for your cooperation in this matter.
AGREEMENT
I have read and understand the Notice above and affirm that the outdated survey I am
submitting is still accurate and complete, and all structures and impervious surfaces on the
property are shown on the survey.
I further understand that, if the survey is found to be inaccurate or incomplete, a$50.00 Plan
Resubmittal Fee will be charged; or if the permit has been issued, a Stop Work Order will be
posted with the associated$110.00 Fee.
JOB ADDRESS S7 fit,U,4 -4 ie-ES CA/1C -&
OWNER or CONTRACTOR(Print) g-I 2✓l co S'¢'
Signature Jk Q2 tn - Date SIO\ a dzD-
1
~ ' MA. SHOWING SURVEY JF
LOT 60, SELVA LAKES UNIT TWO, AS RECORDED IN PLAT BOOK 43, PAGES 11, 11A
AND 11B OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
Z5.,4.1/D /P6e e kek/
r�A✓EO / ASSTE'o)
/: '3 5•0 0 '` —111.-17 r '
.WtSi..K/ If
"...0 ca...e
Cac.w./ Q ....r..l.,7
d...7-57
tfl
k1
rtl
0 1-
sd-
N. •. 1x7,1►: 04•O'c,Q t
`.' `o4' P`pE`„a/,i. tj
elet
AriAfi
N Ale7-T�177 V
• 4 r 8
N.
N.
In g
E T� VI 1/7- ,s.
- i`
er
SAY H !',/I�rM� •
'Tr!lc.r \\ h
(2-6mvAvol.) S
_ �.,, a -+� Fal ......./..-44-3.-`Z..� r4�v„ EG "e-Ss, .a�:tµ446m
Nye •:• ( vT/c,ribs 6
`�• +:.t.,„ 4,T.c,s.11<3 w.s.0.� /AslNi..tT C7:1
_ npT roc lTtb SY T.,' n.,..,..„..,,.
SEL t/ L.4/�'ES T4- . I 10--- sr 4/1.0
C/ GE A k ' c.d.'45'oo-6-
/4.0Z '
se-,-- •/.l.✓
is
6. f {tS /..,„1„,),44 ,
4 63 ..+/n/ T�us /f
A /$ [,� ,t.'/ /Zsxaa zon/E�1C��
y�/ 1C /S 771 e A Ng/Ads e /'mss
61 Rio ..A�
Qw.iIi.W/7y /KAZZ7_ .4.6. /1.e77 .e.aarC
I,1111R7Ar CERSST FY.OAi
SS72,14 -21`
WO,7SA 7-AS6,. .V A4. EJE �irE /
THAT THIS SURVEY MELTS THE MINIMUM TECHNICAL
STANDARDS Al SET FORTH BY THE FLORIDA BOARD
OF LAND SURVEYORS, PURSUANT TO SECTION 471.017
H. A. DURDEN FLORIDA
TRATION cepa.STATUTES AND CHAPTER II HH-S FLORIDA
ADMI& ASSOCIATES - f
INC. 1 J II. I '../i I.
LAND \ >�.fA-''� NC .ZEiL(c.CE
JSUIIV[YOM SIGNET) _�A/G e¢ . IS_R
Pool Owo,goo 601170
I Ito Sou".7111.0 Sumo SCALE' l .2P
leas../„Mach.Flvq.144/0
THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE ABOVE SIGNED.
-2 -z)02 JL GCS / 001-7 -Avl
)0A -1, Is- 0 J - (v,
r.,