487 Royal Palms Dr Fence Submittal Building Permit Application Updated 10/9/18
City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
`t3 IS REQUIRED.
/ Phone: (904) 247-5826 Email: Building-Dept@coab.us
Address: 1 ( /2{)
4' IkJ11-S DnVe Permit Number:
Lescripti. (Replacement
_' r �� _l!,`
RE# ��� T -04060�
Sl_ �' Uni CC ���
Va uation Work ost)$ Lf�d Q Heated/Cooled SF Non- - r•T.COE
• Class of Work: ❑New ❑Addition alteration ❑Repair ❑Move ❑Demo ❑Pool ❑ ..ow r n
� ,�AN 1 1 202
• Use of existing/proposed structure(s): ❑Commercial residential
• If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No BY:
• Will tree(s)be removed in association with proposed project? ❑Yes(must submit separate Tree Removal Permit) VII<
Describe in detail the type of work to be performed:
Florida Product Approval# for multiple products use product approval form
Propern O�w, ner Information f
Name N`bt,L�;t''!j �i/Y' ' Address �o-Th >7`-e
City M?1L (�; ItiState Zip ''7327 {(J
, Phone La
E-Mail i'Y1 ( z-T?-r l i C,fO►,114►C LTT
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information gName of 9m ny F { r2S �6-4 1 6 S atali i Agent
Address' -f5 Citya,/ (_ &date �' L Zip -;5
Z'?��3
Office Phone / l Job Site Contact umber f
State Certification/Registration#C t ( l��i?Si2 E-Mail (.�Cr e'- Q Larrach(/), -_(,
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer OR Exempt rY 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 •BTAIN FINANCING, CONSULT WITH YOUR LEN ER OR AN ATTOJNEY BEFORE
R • ' P ING YOUR ► i TICE OF COMMENCEMENT. N
MP' q1
(Signat re of Owner or Ag‘ t) (Signature of Contractor)
Si ned and sworn to(or affir ed)before me this I I day of Signed and sworn to(or affirm before me this 1 day of
022,by / J/1 ZQ21,by A1.wiza. �t 41 i
G ,lid
(Signature of Notary) (Signature of Notary)
[ ]Personally Known OR •., ersurvlly Known OR ii+"► CHRISTIAN GILES
vis... CHRISTIAN GIL ` ;
Produced Identification d Identification c••
["� •a• :,: MY COMMISSION#H � „� MY COMMISSION#HH 117153
Type of Identification: t- 1 - () L. "' = of Ichntification: F L - V. _• :4 .o: EXPIRGS:April 13,2025
,o�op`, EXPIRES:Apri)13, i ''E'or:OPS Bonded Thru Notary Public Underwriter
., Bonded Pro Notary Public Underwriters
.,LAN.-4,, REVOCABLE ENCROACHMENT AGREEMENT
,„A \ City of Atlantic Beach **ALL INFORMATION
HIGHLIGHTED IN GRAY
800 Seminole Road,Atlantic Beach, FL 32233
IS REQUIRED.
REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and
exi t. under the laws o the State of Florida, hereinafter referred to as "CITY"and
eX 1, of Atlantic Beach, Florida, hereinafter
re erred to as "USER".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to enter upon
the property for the purpose as described in the City of Atlantic Beach.
This work is generally described as —1046-e...--
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains subject to
relocation or removal on thirty(30)days'notice by CITY to USER,said n ice to USER be.given b certified mail,return
receipt requested,to the following address 4E7 � i[.`/i li j 2;7. -/ �
• In the event it is necessary for the CITY or the City's approved representative or other franchised utility to enter
upon the above described easement or property of the CITY, the USER shall replace at the USER's sole expense,
any and all material necessarily displaced during the action of maintaining, repairing, operating, replacing or
adding to of the utilities and facilities of the CITY or franchise utility provider.
• The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes, Land
Development Code and all other land use and code requirements of the CITY, including City Code Section 19-7(h)
which states "Driveways that cross sidewalks: City sidewalks may not be replaced with other materials, but must
be replaced with smooth concrete left natural in color so that it matches the existing and adjoining sidewalks."
• The USER, prior to making any changes from the approved plans and/or method, must obtain written approval
from the City of Atlantic Beach Public Works Department, for said change within 30 days after the day of
completion.
• This permit shall inure to the benefit of, and be binding upon, the USER and their respective successors and
assigns.
• USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws and/or
specifications, to include utilities locate requirements and use limitations/requirements of easements, public
right-of-ways and other public land. USER further agrees that the CITY and its officers and employees shall be
saved harmless by the USER from any of the work herein under the terms of this permit and that all of said
liabilities are hereby as med by the USER.
Ti1,i1JV�-� £ t ( ! 70 7-9'roperty Owner/Agent (si in presence Notary Public)
STATE OF FLORIDA,COUNTY OF DUVAL
The foregoing instrument was acknowledged this II f{i day of ,JA IV , 20 ZZ ,
by CIA rt J h 0 ii 6j I KJ ,who personally appeared before me and
(printed name of Signer)
acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it.
J1 Ag .,tiA �. - r Department Approval:
Signature of Notary Public,State of Florida CHRISTIAN GILES
MY COMMISSION#HH 117153
[ 1 Personally Known ;, w/ EXPIR6S:April 13,2025 —
[4roduced Identification(Type) FL - / ' I - '!O"`O' Bonded ThiuNotaryPubic un'aarr,ttetSoott Williams, Public Works Director
H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
SHEFFIELD &BOATRIGHT 9 M° ..-
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TITLE SERVICES, LLC •
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6101 Gazebo Park Place N.Suite 101 •
Jacksonville,Florida 32257
904-733-7900 { •
PROPERTY ADDRESS:4437 ROYAL PALMS DRIVE,ATLANTIC BEACH,FLORIDA 32233
SURVEY NUMBER: FL2101.0827
FL2101 0827
BOUNDARY SURVEY ,Ir pi? - 5A6A00 DBJVE
DUVAL COUNTY Nov
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i.AKPtA:‹10 Kt.Sdn'ICtD BY CITY WARR AND St:wtK , r GRAPHIC SCALE (In Feet) �
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SURVEYORS CERTIFICATIO POINTS OF INTEREST:
1.4'CHAIN LINK FENCE OVER 5 DRAINAGE AND UTILITY
A I hereby certify that this Survey of the lands EASEMENT
4+ , described hereon was made under my direct
�,�;$ '8a 6+ supervision,and to the best of my knowledge
- 6132 C and belief is a true and accurate representation
of said lands and meets the Standards of .
Practice set forth in Chapter SJ-15.050 through
,g 5J-15.053,Florida Administrative Code, .EXACTA
le pursuant to section 472.027,Florida Statutes. y uAuw..ra..LLC E�cSCE Land sur..Yor..L c
p /A This survey is not valid without the signature and LBM 39�
O4 original raised seal of a Florida licensed surveyor o:es6J36.Wt61 r aus.7aa.zsez
� STATE � ttta40 Fairway LaMrR Drew,Sulo 1 I Fort Myers,FL 33973
J� and mapper,except when the electronic
�� r% signature and seal of a Florida licensed surveyor
'' dU[VE• % and mapper is affixed hereto. : Florida Land
e AFFILIATE
RAYMOND J.SCHAEFER II����1�,��^.\ Title Association MEMBERS
Stine d FbNa ProkNblw Surveyor ono Mao, 1 .
License Number 8132 i
DATE OF SURVEY:01/15/21
SEE PAGE 2 OF 2 FOR LEGAL DESCRIPTION
FIELD WORK DATE:1/12/2021 PAGE 1 OF 2-NOT VALID WITHOUT ALL PAGES
REVISION DATE(SI:OtEV.1 1/15/2021)
Fence Addendum Updated 1/14/2021
f---_, � ' City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233 jPERMIT #
��J;i1 J'"
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
4'1 Po W v�e, D'o . 11 ,202'i
Property Type: Lot Type/ Features:
Residential Kone Street frontage (interior lot)
❑ Commercial D More than one street frontage (corner lot,through lot,
etc.)
❑ Swimming Pool
Fe ce Material: Fence Height (select all that apply):
FlAi Wood ❑ Four Foot(4ft)
❑ Chain Link L'g'Six Foot(6ft)
❑ Vinyl ❑ Other
❑ Block/Stone (Plan details required for footings and/or
retaining walls)
❑ 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)
❑ No
Will tree(s) be removed in association with proposed project?
❑ Yes (must submit separate Tree Removal Permit)
Q"N o
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.