1865 Hickory Ln ACC21-0062 Wood Deck 10 %1 ACCESSORY PERMIT PERMIT NUMBER
A 2CITY OF ATLANTIC BEACH ACC21-0062
800 SEMINOLE ROAD ISSUED: 1/6/2022
ATLANTIC BEACH, FL 32233
EXPIRES: 7/5/2022
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:
1865 HICKORY LN ACCESSORY SINGLE OR TWO WOOD DECK $2400.00
FAMILY ACCESSORY
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 1432 SELVA MARINA UNIT
12C R/P
COMPANY: ADDRESS: CITY: STATE: ZIP:
BEACHES FENCE DECK & 1122 9th ST JACKSONVILLE FL 32250
PERGOLA LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
CAMPBELL WALTER 1865 HICKORY LN ATLANTIC BEACH FL 32233-4548
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
1 f PUBLIC WORKS ON SITE RUNOFF INFORMATIONAL
Notes:
All runoff must remain on-site during construction.
Issued Date: 1/6/2022 1 of 2
- "''�' ACCESSORY PERMIT PERMIT NUMBER
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Building Permit Application
City of Atlantic Beach Building Department **ALL INFORMATION
6•v
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
�.T n IS REQUIRED.
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: I g�PS k.C,CK G. E•( �-iJ Permit Number: ACC„ C--7 �
_ I — Imo,
Legal Description 3�-C' oc '-a5"211, SC(,VA f� l's 4 us IT(?•c .r PLA r Wt- t RE# t 72O2A — / 13
Valuation of Work(Replacement Cost)$ Z.,041) Heated/Cooled SF Non-Hea
• Class of Work: ❑New ❑Addition Alteration ❑Repair ❑Move ❑Demo OPool ❑Wind /DoorUse of existing/proposed structure(s): ❑Commercial ❑Residential DECE1 4 2021
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ONo
BY:
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) ❑No
Describe in detail the type of work to be performed: (2Eh C j/ 1.)c c_I r i r-15:7A LL S 11.1:ALL`'k
Florida Product Approval ft for multiple products use product approval form
Property Owner Information/ _
Name L✓44Ti~ L�J4,41 j�e�t Address / ' �I C /Z/L�
City iZAN'T (L l,�[�� �+`I State F_- Zip ZZ3 �j Phone
E-Mail e YCCEC A /'&c Gr7 4i . NC 7--
Owner
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information j
Name of Company WOE-5 i�e�✓ PCCKf!feA4?4Qualifying Agent SJO 4-1
Address tt/j1J'1Q} c ).,(2 . City _6(2,1-1 State f �- Zip 3 2 23 :y
Office Phone 4,e /Ct 7 7 Job Site Contact Number J �
State Certification/Registration# E-Mail 13E4 C }l"c'� y� U P t ' 6 ,2-7.4 ii [��•��
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer A ilf T-1V_S T OR Exempt❑ Expiration Date 7I1 f /Z :Z--/
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
RECORDIN YOU ,NOTICE OF COMMENCEMENT. -
(Si nature of Owner ev Agent) (Sign ture of Contractor)
Sftveri �chQrn�f.1►�
Signed and sworn to(or affirmed)before me this 13 day of Signed and sworn to(or affirmed)before me this /3 day of
tecenti9,✓, t a `"/_ � boulotlam 0744't , b. ej I �1`
-. -
Si:nature of No ar (Signature of Notary)
PAut Steau ts of Fbrida bus+ ' Notary Public State of Florida
st
64 PersonallyKnown OR Commission NH 142217 PersonallyKnown OR Jessica A ission
My � My Commission NH 142217
[
]Produced Identificatio e ye r, Expires 06/14x2026 [ j Produced Identification ' or n/ Expires 06/14/2025
Type of Identification: Type of Identification:__ _ - _ _
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•
MAP SHOWING BOUNDARY SURVEY OF
LOT 15, SELVA MARINA UNIT NO. 12-C REPLAT, AS RECORDED IN 1
PLAT BOOK 37, PACE 29, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
CERTIFIED TO:
WALTER W. CAMPBELL AND LEA ANNE CAMPBELL BUILDING DEPARTMENT
T1COR TITLE INSURANCE COMPANY
JAX NAVY FEDERAL CREDIT UNION
BUSCHMAN. AHERN, PERSONS AND BANKSTON APPROVED
I LOT 10
S 00'24'53" E 86.00' (PLAT)
rOUNO 7/2- IRON PIPE S 00'08'03" E 86.34' (MEASURED) FQ1No 1/2-IRON PIPE
STAMPED "LB 6645 Ips
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sTAraPEo 'NLP .144,-
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HICKORY LANE
(60.0' H!cHT or WAY)
NOTES: _
RTIFIED TO HFA TRUE AND
LEGLNO: CORRECiy 01 THE ORtf,1NtCL.
N •- RADIUS --Y--Y FENCE /
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L LENGTH CD CONCRETE �
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NOTES' • REVISIONS
I. B✓.I:..CS ARE BASED ON THE PLAT BEARING OF N 6S"35•O7• E ALONG THE
NOW:,':RLY yOUNDARY LWE SLID-,ECTOF. SOJECT PARCEL ' DATE' DESCRIPTION
2. DY L.APHIC PLOTTING ONLY THE CAPTIONED LANDS LII. wI THIN FLOOD ZONE x AS SHOWN ON THE -
NATI..:IAL. FLOOD INSURANCE MAP DATED APRIL 17. I95S. COMMUNITY NU1.GER 120075. PANEL nnnl.IL
S. THIS :,UR VEY REFLECTS AIL EASEMENTS & RIGHTS OF WAY AS PER RECORDED PLAT &/OR TITLE COMMITMENT
IF St. •PLIED. UNLESS OTHER11ISE STATED. NO OTHER TITLE VERIFICATION HAS BEEN PERFORMED BY THE UNDERSIGNED_
a. THIS :.URvEY NOT VALID V.ITHOUT THE EMBOSSED SEAL OF THE CERTIFYING SURVEYOR.
JO}': /I 10655 [GATE OF FIELD SURVEY: 02-28-00 1 DISK /1 ' CD-3 I SCALE: 1" = 20'
ji;‘,... "A•i : )ie CERTIFICATE
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L = A J. �,` 2522 Oak SL,cl I NEREDY CLAVI'THAT T16.•.O:I1ESY wAS uw.0 UNDER WY RESPONSLILE CNARC.0
.Y! t•=; C• �i I , •oCYSon,71c• FlwiOo 3220. AN0 MEETS THC Nw1MU1 1CCRAICAL STOIDARDS .,-S ....:ET MAIN Ov THE FLORIDA
`! _�i..4 L�= r .. ' (Phone) 004-389-5989 90ARD OF PROF -• AL SUE ETCA> AVO uA.."PERS IN CHAPTER al CI7-6. FLONIDA
•L - ••..,: I, •fr' IE ( 1 AOUML:IRAT44.!' ,RSUANT 70 ',ECT 472_072. • •A STATUTES.
x % fo. 90a-30'J-6775
L' IT;•• 1',• EL J. NE 0
LICENSED BU4NESS K 6702 RCC15TERED SURVEYON AND •LAPP: ala STA I[ OI FLOAIOn
LAND SURVEYS 0 CONS I-RUCTION SURVEYS 0 SUBDIVISIONS
APPROVED
By Dan Arlington at 5:12 pm, Jan 03, 2022
REVIEWED FOR CODE COMPLIANCE
BUILDING DEPARTMENT
4 OR MORE STAIR RISERS REQUIRES A HAND RAIL
APPROVED
BEARING POINTS MUST HAVE FULL BEARING OR THRU BOLTS
STAIRS MUST COMPLY WITH FBC-R 311
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16'-0"±
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GRAPHIC SCALE 1/4 = 1'-0