126 15th ST DWAY22-0016 ',:e"•/7., Building Permit Application Updated 10/9/18
' c ` ) City of Atlantic Beach Building Department **ALL INFORMATION
,y' r
800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
Phone: (904) 247-5826 Email: Building-Dept@coab.us IS REQUIRED.�/��,.�
Job Address: I Z i S T N 51 REQ r Permit Number: XD
'\1 Z
Legal Description 10-II I (2 Z.S Zyf MANDALAY Lars 10/ It IL aLkVRE# / >Z /8 by —0oo0
Valuation of Work(Replacement Cost)$ 1,0--00.00 Heated/Cooled SF N' '4
❑ //
4 Non-Heated/Cooled 4
• Class of Work:
New ❑Addition Alteration ❑Repair,,❑Move ❑Demo ❑Pool OWindow/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 proiect? ❑Yes(must submit separate Tree Removal Permit) No
Describe in detail the type of work to be performed: Fp2 4• �ui,Q tw►• ,r
' • 7 ' c.onic;Rkr 1,4D ON CirV
FA, iiit ✓i ADJA.fvr is i5"" 5Ta 'r, pvir4LsL Go C�rf p�0 6.'44. Qgpa4,,1 -URQirr
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Florida Product Approval# /-'14 for multiple products use product approval form
Property Owner Information
Name M A J O r✓F S Address 12 t I S' " 57it
City /TL,4 'rrt, i3E4Lri State L. Zip 32233 Phone boy . ZLlY . Z 4uj
E-Mail Nth
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) v wNE2
Contractor Information
Name of Company 5 v N')HJNE 6)45r Lo ,Lvtrio.ti i'' . Qualifying Agent *I o5i PH /Yt /Zvm 4/VL/k
Address 5-1S City ATL4A riL ;)FAcp State FL. Zip 3 223.d
Office Phone ic)Li. 2 V , /CO' Job Site Contact Number yt?'/. ZOt;, i 0E y
State Certification/Registration# C/3C. /LS-41W E-Mail .1 oe C (-151,id(o9 sr;Ac •C
Architect Name&Phone# /V/4
Engineer's Name&Phone#
Workers Compensation Insurer 61 (,A SOL yr►QN$/ 11V(;. OR Exempt❑ Expiration Date A,/ /2 012
Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING,SIGNS,
WELLS,POOLS, FURNACES, BOILERS, HEATERS,TANKS,and AIR CONDITIONERS,etc. NOTICE: In addition to the requirements of this
permit,there may be additional restrictions applicable to this property that may be found in the public records of this county, and
there may be additional permits required from other governmental entities such as water management districts,state agencies,or
federal agencies.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN TTORNEY BEFORE
RECORD! G YOUR NOTIOF COMMENCEMENT.
• ,..moi. .G 1.�.�_�
(Si_,:ture of r or Agent) (Signature of Contractor)
need and sworn to(or a7 e.)before m- � day of ned an sworn to(or affi •efore me his
_ day of
1$::::
t1 410
sY?d4,•. TONI GINDLESPERGEf�' Sig drill" • - t, atur
fah `;t MY COMMISSION#GG 353178 v
nu'
r.�.(�.��; EXPIRES:October 6,2023 _
-•FOF FL ')tehlafTR{JO ppt+'Rlndeiwriters ]Personally Know t
°''' TONI GINDLESPERGER
I ]Produced Identifi f*E ' • MY COMMISSION#GG 353178 I
Type of Identification: Type of Identificatio *: ^`o EXPIRES:October 6,2023
'le.° `°� Bonded Thru Notary Public Underwriters
N NI J r
�(�.J j �' Sunshine Coast Construction, Inc.
— 0,4016
J � 513 Vikings Lane
r r" 'f Atlantic Beach, Florida 32233
`� '� vJ IJ- 904.208.1084
t-. CONSTRUCTION
3/8/22
Scott Williams/Public Works Department,
Mae Jones, my customer, has owned her beach home since 1930. Her property/landscape
is preserved as it was when her grandparents originally purchased the home and property.
She does not want to change the feel of her property and is not considering any additional
concrete on her property and would rather not change her current dirt driveway for a
hardscape type. She is however having issues of being parked (trapped) in her property
during high beach traffic days seeing that her house sits back on a triple lot. This being
said beach visitors can simply not see her house and are not aware that the dirt driveway
leads to a residential property. She has expressed the danger of her being lock in by cars
parking perpendicular on her property entrance as she is not able to get out in a medical
emergency. Mae Jones would like to hire Sunshine Coast Construction, with your
approval, to add a concrete section between the existing city sidewalk and the existing
paved 15th Street. This will then allow beach visitors to be aware that this area is an
entrance to a residential home and will help avoid a potential dangerous situation in an
emergency.
Please see the attached drawings and please call if anything is unclear. Thank you.
Sincerely,
Joe Rumancik
•
ori i,, RIGHT-OF-WAY/ EASEMENT PERMIT APPLICATION **ALL INFORMATION
City of Atlantic Beach HIGHLIGHTED IN GRAY IS
00 w
,� 800 Seminole Road,Atlantic Beach, FL 32233 REQUIRED.
PERMITTEE RESPONSIBLE FOR NOTIFYING 811 AND OBTAINING UTILITY LOCATES
Job Address I26 1(1h 5TRf-4T A8/ft, 31233 Permit Number
Contractor Information
Company SUksrr/if Co 457 COry>TZvcT NA' , /mac• Qualifying Agent J eS: )// M f?vm4 A'`/A,
Address S/3 LIKINGS L'1'" City /47Le-r,C }3Ffk H State FL Zip 3 L Z 33
Phone `PI 2-Of. /0gq. Email .10 e€ Sv4s/ti'cCo9 5r/'1 C. L o m
State Certification/Registration# «L "i $—b 3 yr
Architect Ait3 Phone Neff Email N//61
Engineer AI///f Phone /t,//f Email i✓/A
Workers Compensation Insurer GI 6A OL v j Io"i / SNC , OR Exempt o Expiration Date /0%'OZZ
• 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 Atlantic Beach or Florida Department of Transportation Standards and be performed under the
supervision of .1OS /PH M Rvin/1 '/r (Project Superintendent)
with(Company Name) 4',vy Hifi6 COAST CvNST R vt71(W/0VAione fo y• Zo7. /0 Y'/
• 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 3 O 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
expenses arising in any manner of the exercise or attempted exercises by the holder of the aforesaid rights and privileges.
• �The Public Works Director shall be notified 24 hours prior to starting work and again immediately up n com letion.
h�1*iL � Date j
)42
ermittee(signed in presence of Nota Public)
STATE OF FLORIDA,COUNTY OF DUVAL i �7
The foregoing instrument was acknowledged this ! day of PROtte—k `
,20 a_,
by ff\ p . kU(NIL 430SOc\ V arty ,who personally appeared before me and
(printed name of Permittee) F
4`• Y°4 , TONI GINDLESPERGER
ackno edge, that h e si ned the i trument voluntarily for the purpose expressed in it : . ., . • MYCOMMISSION#GG 353178
+: iiu :R:
- . EXPIRES:October 6,2023
r�o?: .0 Bonded Thru Notary Public Undetwrfters
- Cu._ [ J Personally Known
Signature of Notary Public,State of Florida [ ]Produced Identification(Type)
H:\Applications&Forms\Word&Excel Document Originals\201801001 Right-of-Way Easement Permit Application.docx Revision Date:10/1/18
I • MAP SHOWING SURVEY OF
LOTS 10, 11 AND 12, BLOCK 60, MANDALAY, AS RECORDED IN PLAT BOOK 10, PAGE
11 OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA.
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AA:'6V-1/4o,,W* RE.sjR/CT.o../ z./�E er ,:r..-4T THIS PRINT IS FOR INFORMATION
;.;/""::-,.`,:::`...4-4:e7-41.,L/E9 h�iL a ', 21a "C•'i✓ "
by � H/+�//��� Fcaaa� PURPOSES ONLY. THIS PRINT HAS
NOT BEEN EMBOSSED WITH THE
i SURVEYORS SEAL AND IS NOT VALID.
I hereby certify that this survey meets the
minimum technical standards as set forth by
the Florida Board of Land Surveyors,pursuant
pi N. A. DURDEN to Section 472.07 Florida Statutes.
& ASSOCIATES INC r��7 �V4
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SURVEYORS _J Oi�Y/� lt.,/ ,:i� �•�
SIGNEt .1
Post Office Bo.50670 fYUI BEEN Er'6C�;. D WJ[ f1E
Jac Beach Boulevard scAt_ &RVEYORS Still. ANIS NO %
Jacksonville Beach,Florida 32250
THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THEA ONED.
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