583 ROYAL PALM RFNC22-0097 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
GALLAGHER GLENN T 583 ROYAL PALMS DR ATLANTIC BEACH FL 32233-3942
COMPANY:ADDRESS:CITY:STATE:ZIP:
BEACHES FENCE DECK &
PERGOLA LLC 844 MAJESTIC CYPRESS DR JACKSONVILLE FL 32233
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171285 0000 ROYAL PALMS UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
583 ROYAL PALMS DR RESIDENTIAL FENCE MULTIPLE
STREET FRONTAGE 4' AND 6' FENCE $6946.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ZONING FENCE PLAN REVIEW FEE 001-0000-329-1003 0 $35.00
TOTAL: $35.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 1Issued Date: 10/19/2022
PERMIT NUMBER
RFNC22-0097
ISSUED: 10/19/2022
EXPIRES: 4/17/2023
RESIDENTIAL FENCE PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
r REVOCABLE ENCROACHMENT AGREEMENT
16` ALL INFORMATIONCityofAtlanticBeach
800 Seminole Road,Atlantic Beach, FL 32233
HIGHLIGHTED IN GRAY
IS REQUIRED.
0109
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
SCLC ESFE'-I'C 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 1E^' .E1( P'8Lk' r
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 5 4/ (74 Afri 5
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 hereb ed the USER.
Date lCJ/U
Pro. - y Owner/Agent(signed in presence of Notary Public)
STATE OF FLORIDA, COUNTY OF DUVAL
The foregoing instrument was acknowledged this /0 day of 0 20__ZZ
by jdr/147-14" sem-- who personally appeared before me and
prl ed na •f Signer)
atkno ledged tha is - .igned the instrument voluntarily for the purpose expressed in it.
Department App roval:
Signature of Notary Pub!ic, tte oida
MYTcOMMGIlNs;
DsplLocENtS#GG1378
undemiters
esonally Known 1,1,ti
dd
Produced Identification(Type) i. ,—.y4" Scott Williams, Public Works Director
H:\Applications&Forms\Word Documents\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18
Building Permit Application Updated 10/9/18
15J
City of Atlantic Beach Building Department ALL INFORMATION
A, ,;,,' 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY
s_ IS REQUIRED.Phone: (904)
1247-
5826 Email: Building-Dept@coab.us
2
Job Address: -JgJ +`,,7'41- PA-, VP.- Permit Number: ` `ENC.. LZ.- 6C]ci7
Legal Description 30-/,-/ !7S' t IWAtP,vo L'# 12 Coy iz /3c.K f RE# 17/Zg - 0o.,)
Valuation of Work(Replacement Cost)$ (44 NJb Heated/Cooled SF Non-Heated/Cooled
Class of Work: rlew 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 ENO
Will tree(s) be removed in association with proposed project? Yes(must submit separate Tree Removal Permit) into
Describe in detail the type of work to be performed: Uf^B Ti OZ. L( 1.4/ PC" ` 2,,P'-AcC,V-z,, b ,,, t
TAC.`
Florida Product Approval# for multiple products use product approval form
Property Owner Information
Name 6' -44-4.-44tesi - Address r?(3 tJ ---- I,'Lt{''"' () g.
City 6,4A7-04-/r- (C- C;e4 r-1--- State _c_ Zip ?2 Z-3 3 Phone
E-Mail
Owner or Agent(If Agent, Power of Attorney or Agency Letter Required)
Contractor Information
Name of Company 5 AC:I4r-5 FI"c pc ie I-' 4O_4 Qualifying Agent J0^) ' z-a 'y-T—
Address gS`(N N'I.rbch IC, C`(PQt:. 1!y City 3.4/ State JL Zip 3z Z 3"z>
Office Phone 9G-el 7 --7 5-'5--- Job Site Contact Number
State Certification/Registration# E-Mail TEf4C(4"
Architect Name&Phone#
Engineer's Name&Phone#
Workers Compensation Insurer Aire..)5'7"-- OR Exempt o Expiration Date C31,(/Z
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 TW E FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN`FIN ' CI: , " SULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORD!t?0T E OF COMMENCEMENT.
Ilit
42 '‘
AVI ‘
S:natu - of Owner or Agent)Signature of Contractor)
Signed and sworn to(or affirmed)before me this Le day of Signed and sworn to(or affirmed)before me this io day of
t)ekbrr , at a a ,by l'— i 6. / ,u s t lk.-1-6 her , a0 ,b c4t57 -
Signature of Notak)
It Notary Public State of Florida
Jessica A
issionDolquist
1ar^ri Public State of Florida
Commission HH 142217 r 't Jessica A[ ]
Personally Known . ' s 09!14!2025 rid Personally Known OR • My CommissionHH142217
N Produced Identific ion n'^ 1 Produced Identification ‘ties Expfres09h4/2025
Type of Identification: Type of Identification: _ ,. . . . „ _ _ - _ _
Lii- Fence Addendum Updated 1/14/2021
em s City of Atlantic Beach Building DepartmentVi ,, `~
800 Seminole Road, Atlantic Beach, FL 32233 PERMIT #
Phone: (904) 247-5826 Email: Building-Dept@coab.us
Job Address: Date:
Property Type:Lot Type/ Features:
d"Residential One Street frontage (interior lot)
Commercial More than one street frontage (corner lot, through lot,
etc.)
Swimming Pool
Fence Material: Fence Height (select all that apply):
Wood 0.Four Foot (4ft)
Chain Link ix Foot (6ft)
Vinyl Other
E Block/Stone (Plan details required for footings and/or
retaining walls)
O 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?
O Yes (must submit separate Revocable Encroachment Agreement)
2"N o
Will tree(s) be removed in association with proposed project?
O Yes (must submit separate Tree Removal Permit)
1No
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.
r
MAP SHOWING SURVEY OF
LOT 12, BLOCK 8, OPAL PALM UNIT NO. 2, A8 RECORDED IA PLAT BOOK 30, PAOFB 94 4 94A, 0ICURRENTTHECENTPULLRECORDSOFDUVALCOUNTY, FLORIDA.
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C TY OF ATI ANTIC REACHOUIt_DI./ or- -1,.-:E
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I HEREBY CERTIFY THAT I HAVE SURVEYED THE LANDS AR SHOWN IN THE ABOVE CAPTION
AND THERE ARE MI EINCROACHMENT$. AS syow/'•H. A. DURDEN & ASSOCIATES,
j1121-7r.. AVE. SOUTH LNG
JACKSONVILLE BEACH FLA. 1
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