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1927 SELVA MARINA DR DWAY22-0004 ,_,,,,-''-''''-i,,, ,, Building Permit Application Updated 10/9/18 tk.„, City of Atlantic Beach Building Department **ALL INFORMATION ' 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY \ku;:.? IS REQUIRED. Phone: (904) 247-5826• 6 Email: Building-Dept@coab.us_ t \ (� �J SQL-- C4 ' I ^N Ae.ermitNumber: `✓� t30-1 Z2-- C 0 O4 Job Address: ► r ". Legal Description -�\We 'ti ,,'ik U A X aU -- L Lar 28 RE# , 6.. T)ix 0 - b$�}? Valuation of Work(Replacement Cost)$ -3‘;') 2 WV Heated/Cooled SF Non-Heated/Cooled • Class of Work: ❑New ❑Addition ❑Alteration ❑Repair ❑Move ❑Demo ❑Pool ❑Window/Door • Use of existing/proposed structure(s): ❑Commercial ❑Residential • If an existing structure,is a fire sprinkler system installed?: ❑Yes ❑No • 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: 2?I,.► c.1—_ , & -*- - c..1 j�',L . - Florida Product Approval# for multiple products use product approval form PropertytyOwner Information , Name i 1 1•\.,�j }' ( �1� Address ((6 CA} �1-s'k' At- S City ))[1,_>G1na'� (J V State c-a _%� -- Zip 3 3.7 Phone C902-1:1)- i E '1- 3 6 E-Mail Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor Information nn''���nn � / Name of mpa Y LVArf i NoV r C Qualifying ent Address � -�,' l r C� City State _!1,11 a Zip <1. 4 Office Phone G� C' / Job Site Contact Number C - ' L//- State Certification/Registration# E-Mail TiNtAc 9sAt) fril C{vA.C. \1•Cs Architect Name&Phone# _) Engineer's Name&Phone# Workers Compensation Insurer " S'f( E c Pt,,'i'OR Exempt❑ Expiration Date Of/r2Q/c 3 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 04.TAW FINANCING, CONSULT WITH YOUR LENDERS ►N ATTORNEY BEFORE RE RDIN O 70T,ICE OF COMMENCEMENT.(Signao Own or Agent) _ . . - ,..ctor) Je z day of Signed and sworn to(or:ffir ed)before 1 e thi �l day of igned and sworn to(or of f-m d before m this • �,- 1, C_c LI-Aic� . b d �. := . 0 r "r aign IT re o1\433ta (Si -1 Ne . Vic,;.......... s..., .:. .. . OdYP01' TONI IND ' PERGER �•. c• MY COMMISSION#GG 353178 ]personally Known ORTONI G!NDLESPERGER [ ]Personally Known OR ; _a, r�sr - EXPIRES:October 6,2023 ,,,,;:!:);:(4 ,_,, [ ]Produced Identification ---;7 �P Produced Identificatio ,. MY COMMISSION#GG 353178 :F F F;? Bonded Thru Notary Public Underwriters ] Type of Identification: pe of Identification: y ii--EXPIRES:October 6,2023 ',. , d Thru Notary Public Underwriters RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION **ALL INFORMATION • ° City of Atlantic Beach HIGHLIGHTED IN GRAY IS "VP800 Seminole Road,Atlantic Beach,FL 32233 REQUIRED. nn PERMITTEE RESPONSIBLE� FOR(( NOTIFYING 811 AND OBTAINING UTILITY LOCATES Job Address f 1 - t � � , N1k Permit Number Contractor Information ,,, Company 1T.aRQ 4U} ' 4'E S Qualifying Agent k Address , 14( ( ��n l.WP_ Cc City yC n, �� C� State'` . Zip (4 7— Phone C \ ' 6�iX� R, lq Email k C -d�W L �\.. COP"' State Certification/Registration# Architect Phone Email Engineer Phone Email Workers Compensation Insurer _ Vrt Exempt n Expiration Date O,^ 44.3 • 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 Atl.ntic Beach or Florida Department of Transportation Standards and be performed under the supervision of r.,•( • ' (Project Superintendent) with(Company Name) ��' • ` NCCD\ 'E Phone `, yf� —�_ • 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 - senses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges. \• The •..lic Wor 'recto shall be notified 24 hours prior to starting work and again immediately upon complet' n. / Date 7 2 4 Z Z. Permitt e signed in Bence of otary ublic') 111 111 STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this z'+ day of Q(\ ,20 xby The__ C Lit}„,l ,who personally appeared before me and (printed nanfe of Permittee) ackn dged t • e/s . .igned t e instrument voluntarily for the purpose expresses '- .: TONI GINDLESPERGER ..s ;,, MY COMMISSION#GG 333178 ,'�; c; EXPIRES:October 6,2023 O Bonded Thru Notary Public Underwriters [ )PecsnnaltyKnsvw = Signature of Notary Public,State of lord. [ )Produced Identification(Type) L— H:\Applications — H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18 (-1 t.�v ;. REVOCABLE ENCROACHMENT AGREEMENT 4City of Atlantic Beach **ALLINFORMATIONHIGHLIGHTEDINGRAY\ 800 Seminole Road,Atlantic Beach,FL 32233 IS REQUIRED. REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and existing under the laws of the State of Florida, hereinafter referred to as"CITY" and C�D S� " \., 1 6 67 of Atlantic Beach, Florida, hereinafter referred 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. t This work is generally described as cip�1.. Gi,.. S ( W`�- � 1'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 notice to USER shall be given by certified mail,return receipt requested,to the following address • 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 r . bilities arhereby assumed by the USER. /' A Date Z / Z 4/ZZ___. Prop Own r/Agent (signe i presence of Notary Public) STATE OF FLORIDA, COUNTY OF DUVAL TM The foregoing instrument was acknowledged this day of—,—Y-1-n ,20 Kby .1.1.,,t-tc ( I ,.r,si� ,who personally appeared before me and pr. ted name of 'gner) ack ., edged till h: s e sign the instrument voluntarily for the purpose expressed in it. /� /- --2 Ff,x,*,,, TCNI GINDLESF%,,__., �{- Na Department Approval: . .; MY COMMISSION#GG 353178 If _v. Talc Signature of Notary Public,State o rida -.1,7 PJ:` EXPIRES:October 6,2023 .. .,,S Bonded Thru Notary Public Uederwni=r [ ] Personally Known F ,,,,,g,._r, [ ] Produced Identification (Type) — . L Scott Williams, Public Works Director H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 II IL L-Ul\I\LIV I r LL)LI�. flLl. J\UJ Ur UU VAAL I.UUIN I I, rLUf\Iu - I / 14 u i LOT / 4 r 12 3 o $ NO-7'43'13"W / FOUND 1/2.3 !NO CAPE ... N07'30'08"W 8686 (FIELD) 0.4' LOT � 13 ;t - ' 6 WO.. ENCE VI •. .. SHED Oi i i�,•j :LOCK WALL .• - - - s 1. 1I,frj/j1i1 ('TYPICAL) RONrouN PIPE2- - ��- 01411�IIl f• .r; 0.1 _NO CAPS 0) �'+ -X1.1..+� +V O CONCRETE . j1 .! 1T .+.. p .,� .. ; II 11, z J 2 • •. ._ .. . ..vE •�f1l�. jd •I'''.L. — co ' e Ira 113 Oi;n 0.0' 20.9' i, tt d''ORGHd co 56.0 N .• ONE STORY 0. aFRAME/BRICK �� LOT � `.•Ao N RESIDENCE W 1 26 "1927" a, P-1I CO , • PAD in M I Z rorn O PATIO . to O �/7 %. t.5' i0 i0 i0 10 Z 1= CO • '. i0 cn n. 0 0 0 0 ( . i •?? 15.6' ;0 35.3. 0.09'0.9' Z 0Lu I 4. ? 13.0' zi ._ . No —4 Iv/ wa,k,.►_�s 1 3 l . , co w I + 115Li • lr J,e itif% a .+,wit • 0I FOUND 1/2- FOUND 1/2-• IRON PIPE "' WATER METERS NO CAP"REBAR -6455' - QID - — ��"`lER CHORD BEARING— CHORD BEARING=515'11'59"E ie c°Ra —512 40 45 E CHORD LENGTH119.17' CHORD LENGTH=128.47' ARCDLIENGTH81419918' CHORD BEARING=S12'52'26"E DELTA=2'25'34" CHORD LENGTH=128.65' (FIELD) RADIUS=2814.79' ARC LENGTH=128.48' DELTA=2'36'55" SELVA MARINA DRIVE (100' RIGHT-OF-WAY) NOTES: (PAVED) 1)THIS IS A BOUNDARY SURVEY. 2)BEARINGS BASED ON THE NORTHERLY LINE OF LOT 28, BEING SOUTH 89.08'46" WEST, AS PER PLAT. THIS SURVEY WAS MADE FOR THE BENEFIT OF 3)NO BUILDING RESTRICTION LINE PER PLAT KATHRYN M. LANG & DENNIS C. LANG THE PROPERTY SHOWN HEREON APPEARS CHICAGO TITLE INSURANCE COMPANY TO LIE IN FLOOD ZONE "X" AS WELL AS THE LAW OFFICES OF ANNE MARIE GENNUSA CAN BE DETERMINED FROM THE FLOOD FIRST MANGUS FINANCIA'_ CORPORATION.