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1965 BRISTA DE MAR CI DWAY22-0039 r" ''''r,, Building Permit Application Updated l0/9/18 �r � „ City of Atlantic Beach Building Department **ALL INFORMATION v C800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY °i; IS REQUIRED. Phone: (9 0 4) 247-5826 Email: Building-Dept@coab.us � 1n Job Address: ICG Bd\SrA N11^PY kr(La., Pemitmber: ►_JWCTC1 2 L' OO 39 Legal Description Loi M IUA Nrr-. Ur lRw c., QAE pook_r"0 - ..Ls:A# i 506 ,- ( (,ob Valuation of Work(Replacement Cost)$117" H ted/Cooled SF Non-Heated/Cooled • Class of Work: ❑New DAddition Iteration ❑Repair DMove ❑Demo DPool DWindow/Door • Use of existing/proposed structure(s): ❑Commercial E e idential • If an existing structure,is a fire sprinkler system installed?: DYes p,}No • Will tree(s)be removed in association with proposed proiect? ❑Yes(must submit separate Tree Removal Permit) �lo "� 1-6 Describe in detail the type of work to be performed: j�S,�gt) 1„td 1244 (1_0""r t t- - l7 J`tt"e:,+.'A-- I S I t/A WA. 1,4 ( X` `I‘f\41) V' S Florida Product Approval# for multiple products use product approval form Property Owner Inf rmation Name LP�'� - S-�°t e Address 1 n!VS- 13 Y+S'I'D (v1Av C Vt.(e City -C\AN c_ t.., State -L- Zip 52233 Phone g 18 SI' -1S-0 E-Mail \..4k S-i-%c_Cj(1) io mck l(. . to " Owner or Agent(If Agent, Powerf Attorney or Agency Letter Required) Contractor Information Name of Company rZ-V/e fees e Qualifying Agent 4, l Address •il, 24 4 ,_ QUI /1tM�k City _l x State ( ( Zip .j?-ll 1 Office Phone ) C"'((- .ye ' 6- Job Site Contact NGmber , State Certification/Registration# E-Mail 12 DEI S'd.L t'VV4 J , 01 C 1.01.)e- COAA- Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Insurer :-CCS„ OR Exempt Li Expiration Expiration Date /Z7_30 / e ?— Application 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 FINANCIN CONSULT WITH YOUR LENDER OR AN A ORNEY BEFORE RECOR YLJR N I COMMENCEMENT. ,1 • (Signature of Owner or Agent) (Signature of Contractor) Signed and sworn to(or affirmed)before me this 1 day of Si ned and sworn to(or a ' ed)before me thisZ qday of T r , D--0aa,by \cat ` Slp_e_c• 20 2_7, . .. a.. - • . L. a ,::..�?Ipg g,t: HH 057579 *a ":nat ff-ill• .- .. EXPIRES:October 27,2024 -f orY:., Bq d Thru Notary Public Underwriters [ ]Personally Known ORAN.... [ ]Personally Known OR .=o`.'n' 0 ,�;; TONI GjNDLESPERGER [Produced Identification [ ]Produced Identification lib " ;n MY COMMISSION#GG 353178 Type of Identification: F(- OL_ Type of Identification: l :� '°••' EXPIRES:October 6,2023 r.on.e• ru`otary Public Underwriters AL'1 ;;. REVOCABLE ENCROACHMENT AGREEMENT + City of Atlantic Beach **ALL INFORMATION HIGHLIGHTED IN GRAY si ) `�i800 Seminole Road,Atlantic Beach,FL 32233 IS REQUIRED. v tire:;1 / REVOCABLE ENCROACHMENT AGREEMENT by the City of Atlantic Beach, Florida, a municipal corporation organized and existing ynd�err the law o he State f Florida, hereinafter referred to as "CITY" and '-'��- � - 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. / This work is generally described as Vr -r \")f`v•-L"AgAl / Slut L1/444 kiL/ . 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 t k(o ' v ' 1 ' '1'2 11/44Yr,r c((C(- . • 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 a reby assum- i 4 the USER. Date 4 / z1 /2L Property Owner/Agent(signed in presence of Notary Public) STATE OF FLORIDA,COUNTY OF DUVAL The foregoing instrument was acknowledged this a 1 day of 7k.A_(\-L , 20 2 a-, by ( ( kl T k L L(- ( ,who personally appeared before me and (printed name of Signer) acknowledged that he/she signed the instrument voluntarily for the purpose expressed in it. ' •-r♦ • viic - - "".l: , JENNIFER JOHNSTON E.: 1,„1MYOOMMISSION8HH057579 Department Approval: Signat e • Notary Public,State of Florida ;-'� * EXPIRES:October 27,2024 [ ]Personally Known rA Bonded +Mabry CU [yroduced Identification(Type) F� p(-- Scott Williams, Public Works Director H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 f D.o 10 02 1O:O7a SURVEYING 904-399-f P- I MAP SHOWING BOUNDARY SURVEY OF LOT 89. SELVA NORTE UNIT TWO. AS RECORDED IN PLAT BOOK 40. PAGES 37 AND 37A. OF 111E CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORID. CERTIFIED TO: GERALD R. McGUFFIN. SR. AND RUTH N. UcGUFFIN ' COUNTRYWIDE HOME LOANS. INC. FIRST AMERICAN TITLE INSURANCE COMPANY S. - WATSON AND OSBORNE. P.A. BRISTA DE MAR CIRCLE (50.0'PJOR Cr WAY) N 89118'46' E 105.00" (PLAT) rTAPo lir wa..+s MIN)t/2"aor 1 N 89106'00" E 104.86' (MEASURED) - r6T...cur a la(tart w•0 ad 7say�n CURVATURE 71160&01Im) v • ;4 • - b 77".....-..:.:.:!....r i \ 0_ • to ri/ WiN a, -$ �a o W • 217 114 ,9 T1.a 91 S1 , N C LOT 90 2 I ONE STORY 4© LOT 88 W ( MASONRY "°` i I POSTED j 1965 �girl. ta 8 B�ORLEd 3 2 I .r I ; .r I D tli t7)o 00 Ixta?4,„. irzZI ><Lfr 1a.•t LOT 89 f fRW lrt wort RIK S 89'04'38' W 105.23' (MEASURED) 4frise LIS ROI Wt TWOS,'WNW 1wr S 89.08'46' W 105.00' (PLAT) 207A WAu LW as 1.2-A RAT 8001 Ja r,Q k 7 LOT 9 AD..IR, LEGEND' —.— - FD1 NOtES 1.sumacs ARE BAsm aN THE PLAT S _BEANC OF H 0051.14-M tala Ac DIE REVISIONS YESRRLY BOUNDARY LINE OF SUBJECT PARaL DATE OFSCRP71174 2 By CRAP/GC PLOTTNO ONLY THE CAP=NED LAMS 110 TNRY4 FLOCO 2014E x AS SNO'Wt ON INE RATIONAL 11.000 0SIIKA4CE YAP OATT NIDI IT. 11181+.COMRAa rr IA/M8131 120073.PANEL DMI 0 J.THIS SURVEY REFLECTS ALL EASEMENTS&FOGHTS OF WAY AS PER RECORDED FLAT AJOR 1111E CO16RTYENT IF SUPPLIED.UNLESS OT14Y 8WS5 STATED.HO 011101 TITLE VOW-ICA-BCH HAS BEER PERFORVED BY THE U1OER90IED 4.1105 SURVEY NOT VAUD WTNWT INE OBOSSED SCR.OF THE CERTW W0 SURVEYOR JOB 0 4797 J DATE OF FIELD SURVEY: 06-12-96 DISK A DP 10 I SCALE 1" = 20" CERTIFICATE �s�=1� 923 Pet*.auto.Placa. Solt.I 1 NW/$Y COMFY DAT DR3 CURVET WAS YAM ROM MY RtQOURW5 OIU1Q i4�i.A Joakssl.Na..Rar14a 32204 YO VSD THE WOW TEDNC.AL M CURVET 7:STIVO.VIDS IS YE 11378.GT TK Timm. .1';.� (Phone)904-354-1I41 0�� T2 J Ss10111R-i M1080A (194) 900-754--Ixss F"VV s u}IV EnI n n Inc QIAR1ES 1L UdNITOSI4 UCCUSCa Ba9NESS 1 6102 REGQSTERED SURVEYOR AND YAPPER 9 3302 STATE OF FLORIDA - LAND SURVEYS 0 CONSTRUCTION SURVEYS 0 SUBDIVISIONS