Loading...
1530 LINKSIDE DR DWAY22-0063 Building Permit Application Updated l0/9/18 J � �.�_.' , City of Atlantic Beach Building Department **ALL INFORMATION •,. • __/ :'/ 800 Seminole Road, Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY t- IS REQUIRED. Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address: l S 3,0 LI 0145 i elk Permit ,Nlumber: �,� Legal Description '/7-g5/7-- 75 - zZ,7F .5#'}Ll/A Lt of A/ RE# / 7z-37 V.3S Valuation of Work(Replacement Cost)$ /VC'00 Heated/Cooled SF / q `4 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 prosect? ❑Yes(must submit separate Tree Removal Permit) ❑No Describe in detail the type of work to be performed: L ur r✓.a7 bki _ L 1 (Lk..."tJ (--,- 14) 1 ) 1- -1,4 IMRv'' 5 Florida Product Approval# for multiple products use product approval form Property Owner Information Name 5'7A `-1. LA,/(2,4,,t A Cil. Address I 6-3c) Lt.() v.'s 10 E 54-Luc City A-tt.i4/L,V LC- X41 State FL_ Zip " 2..2._:' S Phone Ci.: 4 2,14S' ci Z z8 E-Mail 5-7.4e/Z,A. lCl( 6.,C{1 / e A-i"T-. Nk.T Owner or Agent(If Agent, Power of Attorney or Agency Letter Required) Contractor information Name of Company gam) 0.1.4A,t IV Qualifying Agent Address 3o 3a, FA Rai•.& C £!j 57-- city JA---,A State FL_ Zip 3 22'24-/ Office Phone 24,-Z 4.14-1-- eakli Job Site Contact Number State Certification/Registration#8631/2q080/ E-Mail Ft-F'ikr ic%\j e5). t Ar©it...• c.-,o Architect Name&Phone# 6,e- Engineer's Name&Phone# Workers Compensation Insurer O tORl5S P44.:A C4_5(44-C-OR Exempt❑ Expiration Date_ 6-"-3 -Z"z...-5 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 A O EY BEFORE REC•RDING YOUR NOTICE OF COMMENCEMENT. - (w°'yn ' / (Signature of Owner or Agent) Signature of Contractor) ed and swor to(or aff . • � l4 302Z., '(47 before )is ( ay of Signe• and sworn to(or affi - •efore • - thisay of 2O`[ ,b ctn(1 i%/ ., 1 oma c l� - ..-1..w '1.0 4. �:d% • TONIGINDLESP - A 1,� • . ',la' . n- r: \` (Si ature of N�-Mg � .. ,.•, .,.• MY COMMISSION#GG EXPIRES:October 6,2023 • 'faF i�°•tr Corded7� NotP lc Underwriters "t"i Gertnntfv'�nn h [ ]Personally Known OR ,441.':!&••-, TONI GINDLESP GER `� *''t MY COMMISSION# 178 [ ]Produced Identification \ I [ ]Produced Identification ,• Type of Identification: �J.L Type of Identification: ';'-,t11.,A`/ EXPIRES:October 6,2023 •„OFF'_ •ed '• •11.. I •ervmters 0L'i" `,, REVOCABLE ENCROACHMENT AGREEMENT City of Atlantic Beach **ALL INFORMATION /� 800 Seminole Road,Atlantic Beach, FL 32233 HIGHLIGHTED IN GRAY REQUIRED. .r`;J% 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 SN ciz U Wu A44 d< 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 D/UVIE.W�tit G.Ud.JC-/l ig /tJ�'t ti L/ P�V&/c— I I J.S771-(1 , . 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 /j,-tj /14.//4S"O' ,!U VE • 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 filliOdr‘jil liabilitiTs are hereby assumed by the USER. `- (001,244' 1 Date z /( 4 ZZProp y Ownent(signed in presence of Notary Public) Ifix, t - k-- STATE OF FLO IDA, COUNTY OF DUVAL The foregoing instrument was acknowledged this 1 4- day of e Q . , 20 Z ._ 4 by S t'l✓4'-I l y/Al PI- (i06Yljc(_k ,who personally appeared before me and (prin d name/of Signer) ackno I ged that he/she signed the instrument voluntarily for the purpose expressed in it. il --- Department Approval: Signature of Nota Publi ,State of Florida "•qtr''- TONIGINDLESPERGER IF'e*- ` MY COM I ]Personally Known 1� `o.;' I��� t�8 EXPIRES:October B,2023 Produced Identification(Type) g ''.f.f; Bonded Scott Williams Public Works Director ] ( YP ) Notary PubAc UndetYrriters H:\Applications&Forms\Word&Excel Document Originals\20180831 Revocable Encroachment Agreement.docx Revision Date:8/31/18 ,ti ) A • G °45'400" - 50.01 �x !N.b cel• . i r G'C.✓Nw ‘.A.r tivcf of ci•L0 \� /.7' f il `' 44/4440FIAKf �1 b �~ LI A { ` 4 - i '• �1 V.4., ' •CONC4.i- v)�4;•• - • '/4T.o 1 w N �v, ` (S' V h h ~ ; •\ !i ?kii 1:. 4,16 , �h 004 i.41 ?,* ti ij 1 tN �` ' b i le :4 X/. G°45'4197(/. N C .SGS f/Vc. Z _ _ � . v /1. . 8 ° - N 4 Q 70 /4./' 3 �1 75' J.E. O. IA ERSEA.fl vT ^ os r, �'.�, • t q — __.? - �i '1 °p i 1^ : f- - I. V V. ori k /00.0' Pr ` f _ R<c c : • /JJ'' '. .f �' • ! c0,7o• s.D'~`a'mI ,SD.Di'(cw.) S 74)43 '00" E. G=/°-56'-/6", .F=/,478.7o'1 A. 50.0/' L i.ci e S/0 E ay/ VE 666, A!.6N7-pF, W4✓) ,1-4/4Z s1.14141Ey 3-7-94 A/O7 : Fa AVI .411 /Qavf AauvoATAA41 Salsa*V i-/i)-P4 A/p7 . FAu4/D.444 /s* .40- I HEREBY CERTIFY THAT THIS SURVEY.PERFORMED UNDER MY RESPONSIBLE DIRECTION,MEETS THE MINIMUM LEGEND TECHNICAL STANDARDS FOR LAND SURVEYORS IN ACCORDANCE WITH CHAPTER 21HH-6.FLA.ADMINISTRATIVE CODE (PURSUANT TO SECTION 472.027,FLORIDA STATUTES),AND FURTHER CERTIFY THAT THERE ARE NO VISIBLE ENCROACH- s cowcRET[ MON11Y[NT MENTS UPON THE SUBJECT PROPERTY EXCEPT AS SHOWN ON THIS SURVEY R 1/2 FOUND 01011 O 1/2 SET PION Ll.1701 FLOOD CERTIFICATE: THE LOT SHOWN HEREON IS IN FLOOD SAL. DOR..1160 R[STRICTN)N LINE ZONE _ 'Y AS SHOWN ON THE FLOOD INSURANCE RATE CLARSON AND ASSOCIATES, INC. C[NTRA& ANGLE R RADMOS MAP COMMUNITY PANEL No 120075 4"/0 DATED 0-l7-I3, 1543 NALDO AVE JACKSONVILLE. FLA 32207 L.Ty AF Afi4N 777 .l4K.✓,FCA`/aq A ARC CHSTANCE •a / PN CHORPOIKT DISTANCE SURVEYED 2 C4 i�Eie 2IC _ 19 73 ./��///// P C POINT O! CURVATURE f P i PQ,NT Of iANOENCY i SCALE' !~' FO' O\STfNEr, SI IRVFVOR NC, Z / Fl A `P R c PONT Of REVERS*CURVE e,se A. �il P C PoIwi Of GO.1/OIRN1 CURVE J FIELD BOOK 5l01 PO. /