272 3rd St RFNC22-0094 R FN3Lzz-CO94
Building Permit Application URdoted10918
_ City of Atlantic Beach Building Department **ALL INFORMATION
800 Seminole Road, Atlantic Beach, FL 32233 • HIGHLIGHTED IN GRAY
Phone: (904))247-5826 Email: Building-Dept@coab.us IS REQUIRED.
Job Address: 0a ...-Y6 SI- I\ ,), Permit Number: e \ 1 \ - 1c.
Legal Description \ (- - ?\ \L-: S - r)c REq L1' SLiR C1-b3
Valuation of Work(Replacement Cost)$ . C\,` SC) Heated/Cooled SF Non-Heated/Cooled
• Class of Work: ❑New 16Addition ❑Alteration ❑Repair OMove ODemo OPool Window/Door
• Use of existing/proposed structure(s): DCommercial iStResidential
• If an existing structure, is a fire sprinkler system installed?: DYes `I<JNo
• Will tree(s)be removed in association with proposed project?DYes(must submit separate Tree Removal Permit) RINo
Describe in detail the type of work to be performed:
Florida Product Approval k for multiple products use product approval form
Property Owner Information
Name V-_aS\ C`n4 c-k t`c\'M Ll C Address \'1 c1 1 S S"\ r R A
City +e,'‘1ct.L-,c. ec.c-\^ State F L Zip '-\'a'YN-', Phone C2,6n3` r ST-P-A,
E-Mail MMGirCllCA�fraYgv\C1t1cv rnro ,e0,'--
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company i(T\C \eU. E)t,,t 1(Vetrc IN' Qualifying Agent $k-on 3,-,
Address - 2 U 01 d-'^ S‘ - City IrA C State F L.- Zip '`rX-'Z,-: --z
Office Phone q()Li- 80 3Co 6 1 Job Site Contact Number
State Certification/Registration t4 C ?-,C 1 aSb SKI E-Mail altsk 4\e; (`nCt Y'Y (.u,1 t.-td's- c 0 ✓----
Architect Name&Phone U
Engineer's Name&Phone U
Workers Compensation Insurer OR Exempt, i<Expiration Date a`2/&(-)a�
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no wor 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
RE _DIN Y�NOTICE F COMMENCEMENT. Act/L.--/g
(Signature of Owner or Agent) (Signature of Contractor)
;igmit d- •rn to(or affirmed)before me this6 ' day of Signed and sworn to(or affirmed)before me this b 4-taN,t�f111111t/1jr
,- .. r:aJ/` L' . ,by I'n\J-.At.A Mc�we s , gt02.1- by �t�. i 4 f'. I&ak 'b Y 0,,
j025 (Signature of Notary) (Signature of Nota 06i1 A"'es
Ooh � Personally Known OR �--1 MyConl %sac.,
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- Fence Addendum Updated1/14/2021
City of Atlantic Beach Building Department
AMP
+ � 800 Seminole Road, Atlantic Beach, FL 32233 PERMIT#? ' RT1-CC
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
ata 3rd / az-Yara
Property Type: Lot Type/ Features:
Residential ❑ One Street frontage (interior lot)
O Commercial ,) More than one street frontage (corner lot,through lot,
etc.)
❑ Swimming Pool
Fence Material: Fence Height (select all that apply):
O Wood pl Four Foot(4ft)
O Chain Link 0 Six Foot (6ft)
l Vinyl 0 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)
No
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.
NOTICE OF COMMENCEMENT
State of Tax Folio No. In N S'1 gj C
County of ( .l,(V'CX
To Whom It May Concern:
The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713
of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT.
Legal Description of property being improved: i S-'3`1 1 id- Ds - jat I \'lc be . _
Address of property being improved: W) 3c-6- Jk- A _
General description of improvements: V V(l l�\ �F c\t` e \-\ �\,(\ / �. Sic e
Owner: V-QS� C fo ss rn\ LLC Address: \1'
Owner's interest in site of the improvement: c�o\ (`>\Y' -P Cl P•£' is f rr; -
Fee Simple Titleholder(if other than owner): �t J _
Name: L —
Contractor: XN1 \eu. lL..Q v;
Address: A% U t S , e XJ0 c- XJz O
m O O m c
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Telephone No.: t - O\3 3 66 t Fax No: N
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Surety(if any)
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Address: Amount of Bond$ o o o cn
mr,J 0
Telephone No: Fax No: x oCri
Name and address of any person making a loan for the construction of the improvements D
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Name:
o
Address:
OD
Phone No: Fax No: o
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other docume
be served: Name:
Address:
Telephone No: Fax No:
In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713.06(2)(b),Florida Statues. (Fill in at Owner's option)
Name:
Address:
Telephone No: Fax No:
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is
specified): _
�mnw�(
THIS SPACE FOR i ,ONLY OWNER _
t‘at
a O i Ep / Signed: 4
ate 1 l0 / -
06115/2025 (7 Before me this ( day of S -} , in the County of Duval,State
Of Florida,has personally appeared ` ( }.I\cv-cc,
Fr, Heather Messer - Notary Public at Large,State of Florida,County of Duval.
e
My commission# Q My commission expires: 6 1 S/( c)-4
% HH 142824
� �Q`? Personally Known: 1/ or
',��i�; , .OF iN�O````` Produced Identification:
MAP SHOWING BOUNDARY & TOPOGRAPHIC SURVEY OF:
THE NORTH 1/2 OF LOTS 22 AND 23, ATLANTIC BEACH TERRACE, AS RECORDED
N IN PLAT BOOK 15, PAGE 34 OF THE CURRENT PUBLIC RECORDS OF DUVAL
COUNTY, FLORIDA
FOUND 5/8" 8139
REBAR L. . $
REFERENCE
3RDRIcTREwaY (3.5' OFFSET) BENCHMARK 12:
(,oz+k oat, SET PK NAIL&DISK
//'� (+o.ob1 DURDEN BM(WEST FACE
IF�\.� 49.80) OF WOOD POWER POLE)
' 49s3) 10.02 t.+0 EL(12.94)NAVD"88
49z°) FOUND 1/2
`6' IRON PIPE
•?z •PNM NO IDENTIFl A710N
p' M)REBAR TO REBAR a
,..t6 96�00(M) 00' PLAT) '°•�" ,,.T) ,,.6) N.T.S.
REBARtAJ, ,a2) n., _ 'coRNc"^7 M
FOUND 5/8" N84•141OO;A1o.8)
LB #8139 5 1`1 50.0
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14'P;411 PNM (10.5) G ,0'CREOY' ". CD ve
fT1 p'o.4 (10.8) % NORTH t/2 0 W
(n Z o z OF LOT 22 Fri 0
O N...I D O S (10.49 I r a+e•PALM C (J p 0
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G7 n O (.>J OF LOT 23 •,'vMM x 4756) �( '0 FTl
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I O C (1 I) I P m RON PIPE
(fo`�) ^SET 1/2"
T-- 12 o"D'R' DURDEN L.B. ;p6696
rn ;, 5 .R.1... : ,.o. - .). P ((A sl .EFERENCE
20.1'
0 PATER METER •+2•P.A. ..PNM , /0.con (2. OFFSET)
BENCHMARK DILA B rn :e 6WaER uETEO + 1 00.00 e
SET PK NAIL&DISK 2'V0 2 584.15'00 IRON PIPE',1. O1z)
DUROEN BM(IN s 11 FOUND 1/2' 98` 00'(M)IRON PIPE T IcO) (I,.+)
CONCRETE SIDEWALK) -.
EL(9-48)NAVO r)e IRON PIPE (3b) (Tu.0) I ATLANTIC BEACH
NO- IDENTIFICATION
` o PLAT BOOK 5,
Lo PAGE 69
SOUTH 1/2 OF LOTS 5&6,
Iu,
OF V" LOT 22 BLOCK 29
Ib. SOU 1/2LOT3 I NOT INCLUDED
NOT INCLUDED I
\ I
50."
ATLANTIC BEACH
I PLAT BOOK 5,
u.
PAGE 69
LOT 4,
0.
LOT 2� BLOCK 29
I0,N
NOTES
THIS PROPERTY LIES IN FLOOD ZONE•1('PER FLOOD INSURANCE
RATE MAP(FIRM),CITY OF ATLANTIC BEACH DUVAL COUNTY, _
COMMUNITY No. 120075,MAP/PANEL No. I2031C-0409-J,
REVISED NOVEMBER 2,2018
BEARINGS BASED ON THE SOUTH RIGHT-OF-WAY UNE OF 3RD I 100.0'
STREET AS BEING N 84'15'00'E
ELEVATIONS SHOWN AS THUS(10.49)AND ARE(USED ON THE
NORTH AMERICAN VERTICAL DATUM(NAV.D.)OF 1988 LOT 20
TREES NAVE BEEN LOCATED AS ACCURATELY AS POSSIBLE UNDER
CURRENT CONDITIONS.TREE SIZE AND LOCATION ARE MEASURED BY 0811
(DIAMETER BREAST HEIGHT)APPROXIMATELY 48 INCHES ABOVE GROUND
NO BUILDING RESTRICTION LINE BY PLAT
N.T.S.DENOTES NOT TO SCALE
OHE DENOTES OVERHEAD ELECTRIC
(M)DENOTES MEASURED
F.F.E. DENOTES FINISH FLOOR ELEVATION
,/---A-DENOTES EXISTING DRAINAGE FLOW
-X— DENOTES 3'CHAIN LINK FENCE EXCEPT AS NOTED
THERE MAY BE ADDITIONAL RESTRICTIONS THAT ARE NOT SHOWN CERTIFIED TO:
ON THIS SURVEY THAT MAY BE FOUND IN THE PUBLIC RECORDS MATHIEU BUILDERS INC
OF DUVAL COUNTY,FLORIDA.
' I hereby certify that this survey meets the
C ^N I I minimum technical standards as set forth by
A D U R D E I the Florida Board of Land Surveyors, pursuant to
I
I' Section 472.027 Florida Statutes and Chapter
SURVEYING AND MAPPING, INC. I 5J17 Florida Administrative Co e
' I
985 TH AVENUE H
JACKSONVILLE BEACH, FLORRIDAA32250
' (904) 853-6822 FAX 853-6825
LIENS D BU SINESSXNO. 6696 I
FLORIDA REGISTERED SURVEYOR No.470
H.BRUCE DURDEN,Jr.
SURVEYOR'S ICTE)
THE SURVEY HEREON WAS MADE WITHOUT THE BENEFIT OF ABSTRACT OR SEARCH OF TITLE AND SIGNED FEBRUARY B. 2021
THEREFORE THE UNDERSIGNED AND DURDEN SURVEYING AND MAPPING,INC.,MAKE NO CERTIFICATIONS
REGARDING INFORMATION SHOWN OR NOT SHOWN HEREON PERTAINING TO EASEMENTS,CLAIMS OF SCALE: 1" = 20'
EASEMENTS.RIGHTS-OF-WAY,SETBACK LINES.OVERLAPS.BOUNDARY LINE DISPUTES,AGREEMENTS.
RESERVATIONS OR OTHER SIMILAR MATTERS WHICH MAY APPEAR IN THE ABSTRACT OR SEARCH OF TOLE. WORK ORDER NUMBER: 21037 B—9 8 3 2
THIS SURVEY NOT VALID UNLESS THIS PRINT IS EMBOSSED WITH THE SEAL OF THE ABOVE SIGNED.