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710 PLAZA RFNC21-0148 Building Permit Application Updated 10/9/18 r City of Atlantic Beach Building Department **ALL INFORMATION 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY "' IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us y[.�- /� Job Address: 11 �} -CLA �4 Permit Number: KV.Kg-2 —0(4 Q Legal Description (3 --t;1 17 -as '"��6/�-4)4OtM d.: ciiW l 1 a.(.CT'/9 6" RE# i 71 z'I'Z - (�00 G' Valuation of Work(Replacement Cost)$ 2 Ili D Heated/Cooled SF Non-Heated tC E IVE • Class of Work: ❑New ❑Addition OrAlteration DRepair ❑Move ❑Demo ❑Pool ❑Window or DEC 1 4 2021 • Use of existing/proposed structure(s): ❑Commercial , esidential • If an existing structure,is a fire sprinkler system installed?: ❑Yes I 'No B • Will tree(s) be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) l No Describe in detail the type of work to be performed: /P..e,'1 iai1r -/Ns TT,Q F-2,1r�/ .5' , A y„R-) Uf T�L� l.1ire V/ti"/L Florida Product Approval# for multiple products use product approval form Property Owner Information Name Lt,N N t-; t y Address ( )(G (-4?.4 1)Z- City ZCity 'i t.d1n1'r f( ,,L, State Zip &ZZ Z Phone 7 70 3!y 7% 9r- E-Mail E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information t Name of Company 1 t11 /4 F� 3f �rbYlG(L�4 Qualifying Agent Jd.t•-•/ PG°Z62i_ I 57- -Address $°t/il/11AJE .t IC. C y P ;, P R ^� City Pa , g C.E•.( State Fc_ Zip g22-3 3 Office Phone Z-( 7e-3 7 7 5") Job Site Contact Number State Certification/Registration# E-Mail t E4cH-6'5 F D P 6 67-1 4-14 G- . Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer Reeteek /ji41'ff-Rs, OR Exempt o Expiration Date 7 „ Zdrz_ 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. ,e4/14-6 (Signature of Owner or Agent) ` nature of Contractor) B r v ih 'b (o �l✓ 9.'eV elm(Si�c:�G✓ ,�nS Signed and sworn to(or affirmed before me this L3 day of Signed and sworn to(or affirmed)before me this l3 day of becemititr, 4?-41a4 • i Ci 4�1 d '. jltxi/ta lour ,b _ i t 4 3.1 1. i•n.t - o •' r S . r- • • . f Noc Notary Public State of Floridapor Neel, Notary PAublic Stets of Florida Jessica A Dolquist Jessica Dolquist [ ]Personally Known OR My Commission HH 142217 ]Personally Known OR • 4 My Commission NH 142217 of F_xpYr808114/2025 Produced Identification brtti Expkest)t311412025 ( ]Produced Identification tirti ] Type of Identification: pe of Identification: • . . nr t A • • . . F 1 k, PLAZA ROAD(F) PLAZA(P) • 80' R W(IMPROVED) FOUND 1/2" o IRON PIPE CS NO I.D. a •• G PROPERTY CORNER OF LOTS 17/16 N • n 161.30•(P) • ` cmcocIT �N85'37'27"W 80.65'(P)' • • SET I/2" ''' • • . IRON IRON ROD LB/ 7893 1- iI �• 'e '• FOUND 1/2" 1 co IRON PIPE BLOCK-) Ivi c h' • ,,0 I.D. CORNER LOT 19 BLOCK 8 a ) Q I o LOT 18 2., I I zgE BLOCK 8 10.7• 3 : - 30.0' :40.:21:,:i2.°' v► 2.0' ; --- N I 6.0' N O LOT 20 6 N I c IN BLOCK 8 a r BUILDING 2 ' I #710 I 10.8' SURVEY NOTES 49.1• I CONCRETE DRIVE CROSSING ��STORAGE 20'8 OVER PROPERTY UNE ON I NORTHERLY SIDE OF LOT. THERE ARE FENCES NEAR 'THE BOUNDARY OF THE PROPERTY ,.L,,,,,,1" AND CROSS INTO THE 6' DRAINAGE _ I &UTILITY EAS.IENT ON WESTERLY -- �a 0 AND SOUTERLY SIDES OT PROPERTY L — 5.0;DRNNACE R UTIUIY EAS€YENT�_ __ .o SET 1RO" IRON ROD N85'37'27"W 80.65'(P) b n LB/ 7893 a N v SET 1/2" LOT 4 IRON ROD BLOCK 8 LB/7893 PAGE 2 OF 2 PAGES BOUNDARY SURVEY LB;7893 TARGET 1fj 1 SURVEYORS CERI7FIU IF T 7 INFRFBY CER11FY MAT RRS BO1RDARY SI.F+VfY SURVEYING, LLC / ISA 7RLIEANOCORREC7 REPRESEWTAIKW DFA SURVEY PREPARED USER Ory DIREC7/ON r.,na Norvurowm+ourA.VAUn+ENrrU1EDEiEcrRavrc SERVING ALL FLORIDA COUNTIES 4„I' SIGNATURE ANOAUIMFNSE AND fIEG 4TURE SfAI. , , Y ORARAISEOfAlBOSSED SEAT AND 5(GNAIURE 6250 N.MILITARY TRAIL.SUITE 102 WEST PALM BEACH.FL 33407 PHONE(5611640-4800 FACSIMILE(561)670.576 (SIGNED) __ STATEWIDE PHONE 1800)2264607 WE.LL.PROFESSIONAL SlAWEYDR ANO ANPPER A7W STATEWIDE FACSIMILE(6001 741.0576 . , . ' magemi CLYDE O Y frFence Addendum Updated 1/14/2021 Al ' in City of Atlantic Beach Building Department 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT# Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: Date: /►V PLAZA f2I ► y 'Z Property Type: Lot Type/ Features: LKResidential 0 One Street frontage(interior lot) O Commercial ❑ More than one street frontage (corner lot,through lot, etc.) 0 Swimming Pool Fence Material: Fence Height (select all that apply): O Wood Z-Four Foot(4ft) O Chain Link 0 Six Foot (6ft) Vinyl 0 Other O Block/Stone(Plan details required for footings and/or retaining walls) O Other Fence Location: Please submit an accurate and current boundary survey showing all existing improvements (including building footprint, driveway, swimming pool, etc.)and location of fence/wall and any gates. Plan details required for block wall footings and/or retaining walls and any portion or fencing above 6ft in height. Will the fence be built in an easement? ❑ Yes (must submit separate Revocable Encroachment Agreement) 1,21\10 Will tree(s) be removed in association with proposed project? ❑ Yes (must submit separate Tree Removal Permit) ?No Conditions of Approval: • Roll off container company must be on City approved list. Roll off container cannot be placed on City right-of-way. • All old fencing and debris must be removed from job site by contractor or homeowner. 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. L X(o rv() CRS. w 1st-A 1Q-Ak, 13(E,)(, G c?.RAc. A--rs )-r4- T►c PL4 4r$ 1A'7— �� 0 r.► E NTS W . C-C) ' C ---T� 41 I ! ` 1,IZ 03' -ro s PA n, ri X 13 Q N• C Q e2A CI AJG l4--r " © ,J C C t,1a1;Q-- A t•/ 411-,1 G 1.1E9 w ,,- ++ e Wte 6-S ANS J v► s; 14 pi - -5 Aci2C' Af'L,c,48 LC. 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